scholarly journals Charcot arthropathy of the foot and ankle

2021 ◽  
Vol 15 (1) ◽  
pp. 83-91
Author(s):  
João Montechi ◽  
Weslen Barros ◽  
Alexandre Godoy-Santos ◽  
Rafael Sposeto ◽  
Rodrigo Macedo ◽  
...  

To critically evaluate the current literature on the etiopathogenesis of Charcot neuroarthropathy, its diagnostic methods and therapeutic management. Methods: We searched for studies that related Charcot arthropathy with a location in the foot and ankle in the PUBMED and MEDLINE databases. Results: A total of 52 studies were used for this analysis. Conclusion: Charcot neuroarthropathy is a serious disease with significant potential to impact patient quality of life. Although its pathogenesis still raises much controversy, neuropathy seems to have a central role, leading to a trauma, injury, and inflammation cycle. Level of Evidence V; Therapeutic Studies; Expert Opinion.

2008 ◽  
Vol 14 (1) ◽  
pp. 11-15 ◽  
Author(s):  
Michael P. Sochocki ◽  
Shawn Verity ◽  
Pamela J. Atherton ◽  
Jefrey L. Huntington ◽  
Jeff A. Sloan ◽  
...  

2021 ◽  
Vol 6 (1) ◽  
pp. 247301142199406
Author(s):  
Sameh A. Labib ◽  
Rahul Goel ◽  
Wesley Manz ◽  
Jason Bariteau

Background: The COVID-19 pandemic created a difficult environment to provide musculoskeletal care to patients with foot and ankle pathology given the limitations placed on in-office visits. Telemedicine offered a unique avenue to reach these patients; however, the efficacy of telemedicine visits in patients with foot and ankle pathology is not well studied. We propose a telemedicine protocol that has allowed us to effectively see and treat patients with foot and ankle pathology. Methods: A 12-step standardized telemedicine protocol was created within the Foot and Ankle division that was used for seeing patients through telemedicine. Also included in this is previsit preparation and follow-up recommendations. Press Ganey surveys were retrospectively reviewed to understand patient experience with telemedicine. Results: 85.2% of patients surveyed responded with scores indicating excellent care. When comparing patients who were seen in-office and through telemedicine, 89.2% and 83.4% responded with scores indicating excellent care, respectively ( P = .37). Conclusion: Telemedicine offers an effective and convenient way to provide excellent musculoskeletal care to patients affected with foot and ankle pathology. This is the first study that evaluated a comprehensive protocol for telemedicine encounters and can be used to implement telemedicine by others using this approach. Level of Evidence: Level V, expert opinion.


2008 ◽  
Vol 36 (2) ◽  
pp. 369-374 ◽  
Author(s):  
Panagiotis Baltopoulos ◽  
Charalampos Tsintzos ◽  
George Prionas ◽  
Maria Tsironi

Background Thoracic outlet syndrome is described as a group of distinct disorders producing signs and symptoms attributed to compression of nerves and blood vessels in the thoracic outlet region. Purpose To describe the exercise-induced scalenus anticus syndrome attributed to the anterior scalenus hypertrophy as a thoracic outlet syndrome underlying mechanism and to give recommendations for a safe and effective surgical treatment. Study Design Case series; Level of evidence, 4. Methods Twelve young professional athletes admitted for thoracic outlet syndrome (8 cases of neurologic thoracic outlet syndrome, 4 cases of mixed neurologic and vascular thoracic outlet syndrome) who reported numbness, tingling, early fatigue, muscle weakness, and pain were enrolled in the study. Scalenus hypertrophy was suspected to be the causative factor. Scalenectomy was performed in all cases. Results All patients had moderate to severe hypertrophy of the anterior scalenus muscle. Scalenectomy was performed, and there were no intraoperative or postoperative complications. Full activity was quickly achieved, and no recurrence of symptoms was documented. Conclusion Surgical intervention for scalenus anticus syndrome can allow an athlete to return to full activity and improve quality of life. Surgical intervention seems to be the treatment of choice in terms of restoring quality of life and physical activity.


The Eye ◽  
2021 ◽  
Vol 23 (2) ◽  
pp. 41-45
Author(s):  
O. E. Russkikh ◽  
N. Y. Nikolenko

Ocular tuberculosis is a serious disease with a long recurrent course, often leading to a significant decrease in the visual functions and quality of life of patients as well as disability. In recent years, the incidence rate of the ocular tuberculosis in the Russian Federation has been declining: in 2016, according to a number of authors, its incidence amounted to 5.2%.Purpose. To systematize literature data on the topic of ocular tuberculosis.Materials and methods. We reviewed literature available on elibrary.ru, cyberleninka.ru websites and in “Clinical Ophthalmology” journal. Results. We suggested classification of the ocular tuberculosis lesions, analyzed modern diagnostic methods and treatment regimens and evaluated their effectiveness.Conclusions. Literature review revealed that in order to improve the quality of detection, diagnosis and treatment of ocular tuberculosis, joint efforts of ophthalmologists and phthisiologists as well as use of modern methods of tuberculinodiagnosis are essential.


2021 ◽  
Vol 27 (8) ◽  
pp. 783-785
Author(s):  
Mian Wang ◽  
Fan Wu

ABSTRACT Introduction: Myocardial infarction caused by human obesity can cause a decline in mobility and a decline in the quality of a healthy life. Sports training is beneficial to maintain early physical functions after myocardial infarction. Objective: This article deals with the effect of applying walking aerobic exercise in the rehabilitation treatment of patients with myocardial infarction. Methods: We enrolled 91 patients with myocardial infarction in the early exercise group and 90 patients in the control group. The control group received the routine nursing intervention, and the early exercise group received early physical exercise rehabilitation therapy. Results: The actual quality of life of the early exercise group was higher than that of the control group. The incidence of cardiovascular adverse events was lower than that of the control group. Conclusion: Physical exercise therapy used in acute myocardial infarction can reduce adverse cardiovascular events and improve the quality of life of patients. Level of evidence II; Therapeutic studies - investigation of treatment results.


2015 ◽  
Vol 2;18 (2;3) ◽  
pp. E109-E130
Author(s):  
Amit Asopa

Background: Cervicogenic headache is a secondary headache that has a source in the upper cervical spine. There is a small but growing body of evidence to establish effectiveness of radiofrequency (RF) neurotomy, and the pulsed RF (PRF) procedure for management of cervicogenic headache. Objective: To investigate the clinical utility of RF neurotomy, and PRF ablation for the management of cervicogenic headache. Study Design: Systematic review. Methods: The review included relevant literature identified through searches of PubMed, Cochrane, Clinical trials, U.S. National Guideline Clearinghouse and EMBASE from 1960 to January 2014.The quality assessment and clinical relevance criteria utilized were the Cochrane Musculoskeletal Review Group criteria for randomized control trials and the Newcastle-Ottawa Scale criteria for observational studies. The level of evidence was classified as good, fair, and poor based on the quality of evidence. Outcomes Measured: The primary outcome measures were reduction in pain scores and improvement in quality of life. Results: The primary outcome measures were headache relief and improved quality of life. Twenty five studies were identified for full text review of these, 9 studies met inclusion criteria. There were 5 non-randomized, among them 4/5 were of moderate quality, 3/5 showed RF ablation and 1/5 showed PRF as an effective intervention for cervicogenic headache. There were 4 randomized trials among them 2/4 were of high quality, 3/4 investigated RF ablation as an intervention for CHA, 1/4 investigated PRF ablation as an intervention for CHA and none of the randomized studies showed strong evidence for RF and PRF ablation as an effective intervention for CHA. Limitations: In the selected studies there were inconsistencies between randomized trials, flaws in trial design, and gaps in the chain of evidence. Conclusion: There is limited evidence to support RF ablation for management of CHA as there are no high quality RCTs and/ or multiple consistent non-RCTs without methodological flaws. There is poor evidence to support PRF for CHA as there are no high quality RCTs or Non-RCTs. Key Words: Chronic pain, cervicogenic headache, radiofrequency (rf) neurotomy, pulsed radiofrequency (PRF) ablation, reduction in pain, improvement in quality of life, level of evidence


2021 ◽  
Vol 27 (3) ◽  
pp. 315-318
Author(s):  
Fanfan Li

ABSTRACT Introduction Human motor dysfunction can affect the quality of life, especially waist dysfunction. And an effective means to improve muscle strength during exercise. Object This article compares and analyzes the effectiveness of human muscle exercise on the decline in quality of life caused by motor dysfunction. Method The article divides patients with motor dysfunction into trunk isokinetic training group (experimental group) and waist and abdominal muscle functional training group (control group), and comparative analysis of related indicators before and after treatment. Results Before treatment, the specific indicators of the two were different (P>0.05). After treatment, the patients’ quality of life indicators and motor function indicators were significantly different (P<0.05). Conclusion Exercise has an obvious curative effect for patients with human motor dysfunction, and it is worthy of clinical promotion. Level of evidence II; Therapeutic studies - investigation of treatment results.


2018 ◽  
Vol 100-B (2) ◽  
pp. 190-196 ◽  
Author(s):  
M. Chraim ◽  
S. Krenn ◽  
H. M. Alrabai ◽  
H-J. Trnka ◽  
P. Bock

Aims Hindfoot arthrodesis with retrograde intramedullary nailing has been described as a surgical strategy to reconstruct deformities of the ankle and hindfoot in patients with Charcot arthropathy. This study presents case series of Charcot arthropathy patients treated with two different retrograde intramedullary straight compression nails in order to reconstruct the hindfoot and assess the results over a mid-term follow-up. Patients and Methods We performed a retrospective analysis of 18 consecutive patients and 19 operated feet with Charcot arthropathy who underwent a hindfoot arthrodesis using a retrograde intramedullary compression nail. Patients were ten men and eight women with a mean age of 63.43 years (38.5 to 79.8). We report the rate of limb salvage, complications requiring additional surgery, and fusion rate in both groups. The mean duration of follow-up was 46.36 months (37 to 70). Results The limb salvage rate was 16 of 19 limbs. Three patients had to undergo below-knee amputation due to persistent infection followed by osteomyelitis resistant to parenteral antibiotic therapy and repeated debridement. Complications including infection, hardware removal, nonunion, and persistent ulcers requiring further intervention were also observed. Postoperative functional scores revealed significant improvement compared with preoperative scores on American Orthopaedic Foot and Ankle Society (AOFAS) – Hindfoot scale, Foot Function Index (FFI), visual analogue scale (VAS), and Foot and Ankle Outcome Score (FAOS). Conclusion The use of retrograde intramedullary compression nail results in good rates of limb salvage when used for hindfoot reconstruction in patients with Charcot arthropathy. Cite this article: Bone Joint J 2018;100-B:190–6.


2020 ◽  
Vol 5 (4) ◽  
pp. 2473011420S0010
Author(s):  
Bradley Alexander ◽  
James Hicks ◽  
Abhinav Agarwal ◽  
Aaradhana J. Jha ◽  
Spaulding F. Solar ◽  
...  

Category: Other Introduction/Purpose: As the field of foot and ankle surgery grows and new innovations continue to be made it is important that the quality of research improves. This will help to lay a strong foundation for current and future surgeons in the field. Leading journals need to set the tone for all orthopedic journals by publishing quality literature. This current study will look at all foot and ankle articles published by JBJS[A] over a 15-year period and analyze authorship, article type, geographic origin of articles, and level of evidence trends. This study will give a representative view of where foot and ankle research is currently and where it can go as we enter the new decade. Methods: A foot and ankle research fellow reviewed all of the articles published in JBJS[A] from January 2004 to December of 2018. Articles that related to foot and ankle topics were then selected to analyzed. Editorials, letters to the editor, announcements, technical notes, retraction notes, events, errata, retracted manuscripts, historical papers and pediatric foot and ankle articles were excluded. After exclusions were applied 321 and information pertaining to each article was analyzed. Additionally, a Google Scholar search was conducted for each article to determine the number of times an article had been cited. For calculations relating to median number of citations for each article we excluded articles that were published less than three years ago (2017 and 2018). For level of evidence a kappa value (0.82) was calculated to measure interobserver reliability between two reviewers. Results: We found the following results to be significant. Clinical therapeutic studies were the predominant study design over 15 years. The amount of literature over ankle arthroplasty has increased more than any other article topic. The amount of level IV and V evidence has decreased and the amount of level II and III evidence has increased. The median number of authors has been increasing. This includes female authorship. There has been in an increase in MD, PhDs as last authors. There is more foot and ankle research being produced by Asian countries. A majority of high level of evidence articles (level I and II) comes from North America and Europe. Level of evidence doesn’t correlate with the amount of times an article is cited. Conclusion: As the field of foot and ankle surgery continues to grow it is important that there is a high quality of research being conducted and published to guide surgical and clinical decisions. Our study shows that research is being produced more globally and the number of individuals involved in the research process is increasing and diversifying. This has led to higher quality research being produced (more level II and III) and a decrease in lower quality research (IV and V). Overall, the standard of research has increased in JBJS[A] which benefits the foot and ankle surgery community. [Table: see text]


2020 ◽  
Vol 5 (4) ◽  
pp. 2473011420S0036
Author(s):  
Christopher G. Neville ◽  
Judith F. Baumhauer ◽  
Jeff Houck

Category: Other Introduction/Purpose: Patients with foot and ankle conditions have been shown to demonstrate improvement in their generic outcomes using the Patient Reported Outcome Measurement Information System (PROMIS). However, the responsiveness to change and the impact change may have on quality of life has not been explored following non-operative care with physical therapy. The effect size (ES) is an assessment of the magnitude of change while the impact of change in physical function can be assed with quality of life utility scores. Therefore, the purpose of this analysis was to investigate the responsiveness of the PROMIS physical function (PF) scale on changes in quality of life. Methods: The PROMIS PF scale was available at the start and end of physical therapy treatment for 352 patients with foot and ankle ICD10 codes. PF was chosen as a good outcome measure to assess overall outcome from physical therapy care. Changes from baseline to post-care were examine using Cohen’s d to remove dependence on sample size and was interpreted as d=0.20 as a small effect, d=0.05 as a medium effect, and d=0.80 as a large effect. Using available isotonic regression with linear interpolation functions, health state utility scores were calculated from the PROMIS PF scores. These scores represent a health state between 0, representing ‘being dead’, and 1 being the utility of ‘full health’. This methodology has been shown to be reliable and valid for assessing overall health quality of life from changes in physical function. Repeated measures ANOVA models were used to compare outcomes across time. Results: A significant improvement (p<0.01) in PF scores was seen across the sample following physical therapy (PF t-score; baseline 38.6+-8.8; follow-up 45+-9.1). This change was associated with a moderate to large ES of 0.75. The average ES for those subjects with a starting t-score less than 45 (n=294) was 0.86 (large effect) while for those with a starting t-score of greater than 45 (n=58) was 0.27 (small effect). There was also a significant (p<0.01) improvement in utility scores following physical therapy (utility score; baseline 0.58+-0.2; follow-up 0.72+-0.2). Conclusion: There is a general improvement in reported physical function following physical therapy but the magnitude of this effect depends on baseline function. Lower function is associated with greater changes. Improvement in physical function was associated with an overall improvement in quality of life. The non-linear nature of utility scores suggests some patients may have large increases in quality of life with small changes in physical function.


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