PO 18121 - Reconstruction of peroneus brevis tendon tears by semitendinosus tendon autograft

Introduction: Reconstruction for irreparable tears of the peroneal brevis tendon (PBT) using tendon allograft has provided satisfactory clinical results. The aim of this study is to present the surgical technique for reconstruction of PBT tears using semitendinosus tendon autograft (SA) as an alternative to allograft and its early results. Methods: We describe the surgical technique for the reconstruction of irreparable tears of the PBT using SA performed in 3 patients, from December 2016 to May 2017, and early results. Two patients were male and one female, with a mean age of 46.6 years and a mean follow-up of 21 months. The indication for reconstruction was the presence of degenerative tissue that involved more than 50% of the cross-sectional area of the PBT. Preoperative planning included a clinical and imaging evaluation to search for conditions such as ankle instability, cavovarus foot, low-lying muscle belly of the PBT and peroneus quartus tendon. In the pre and postoperative period, they were prospectively assessed using visual analog scale (VAS) scores for pain and the American Orthopaedic Foot and Ankle Society (AOFAS) ankle-hindfoot score. At 6 months, they were submitted to an isokinetic evaluation of the strength of both feet. Results: At the final follow-up, the mean VAS score was 8,7 preoperatively and 0 postoperatively. The mean AOFAS score was 43 preoperatively and 98,7 postoperatively. The 3 patients had different conditions associated with the lesions: a peroneus quartus tendon, a low-lying muscle belly and a cavovarus foot. They were addressed with resection of the peroneus quartus, resection of the low-lying muscle belly and with a lateral sliding calcaneal osteotomy. At 3 months, they were pain free and able to resume labor activities. At 6 months, they were able to return to sports. The isokinetic evaluation showed no eversion strength deficits compared with the contralateral side. At a mean follow-up of 21 months, they remain asymptomatic and fully active. Conclusion: Reconstruction of PBT tears with SA may be an effective alternative to allograft tissues. It can decrease pain and restore PBT function.

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Hybrid Endovascular Repair of Thoracoabdominal Aorta: Early Results

The Heart Surgery Forum ◽

10.1532/hsf98.2014315 ◽

2014 ◽

Vol 17 (3) ◽

pp. 146

Author(s):

Osman Tansel Darcin ◽

Mehmet Kalender ◽

Ayse Gul Kunt ◽

Okay Guven Karaca ◽

Ata Niyazi Ecevit ◽

...

Keyword(s):

Endovascular Repair ◽

Therapeutic Option ◽

Complete Recovery ◽

Aortic Aneurysms ◽

Thoracoabdominal Aorta ◽

Mortality And Morbidity ◽

Early Results ◽

The Mean ◽

Procedural Success

Background: Thoracoabdominal aortic aneurysms (TAAA) present a significant clinical challenge, as they are complex and require invasive surgery. In an attempt to prevent considerably high mortality and morbidity in open repair, hybrid endovascular repair has been developed by many authors. In this study, we evaluated the early-term results obtained from this procedure.Methods: From November 2010 to February 2013, we performed thoracoabdominal hybrid aortic repair in 18 patients. The mean age was 68 years (12 men, 6 women). All of the patients had significant comorbidities. Follow-up computed tomography (CT) scans were performed at 1 week, 3 months, 6 months, and annually thereafter.Results: All patients were operated on in a staged procedure and stent graft deployment was achieved. Procedural success was achieved in all cases. All patients were discharged with complete recovery. No endoleaks weres detected in further CT examination.Conclusion: Our results suggests that hybrid debranching and endovascular repair of extensive thoracoabdominal aneurysms represents a suitable therapeutic option to reduce the morbidity and mortality of TAAA repair, particularly in those typically considered at high risk for standard repair.

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An Isolated Medial Patellofemoral Ligament Reconstruction with Patellar Tendon Autograft

BioMed Research International ◽

10.1155/2013/637678 ◽

2013 ◽

Vol 2013 ◽

pp. 1-5 ◽

Cited By ~ 25

Author(s):

Dariusz Witoński ◽

Rafał Kęska ◽

Marek Synder ◽

Marcin Sibiński

Keyword(s):

Patellar Tendon ◽

Patellofemoral Joint ◽

Ligament Reconstruction ◽

Medial Patellofemoral Ligament ◽

Effective Procedure ◽

Medial Patellofemoral Ligament Reconstruction ◽

Role Functioning ◽

The Mean ◽

Tendon Autograft

The aim of the study was to evaluate the results of the medial patellofemoral ligament reconstruction with a medial strip of patellar tendon autograft after a minimum 2-year followup. Ten patients (10 knees) were operated on by one surgeon, according to the modified technique, described by Camanho, without any bone plug at free graft end. The mean age of the patients was 27.2 years (ranging from 18 to 42 years). The mean follow-up period was 3 years and 7 months. All patients were reviewed prospectively. At the last follow-up visit, all the patients demonstrated a significant improvement in terms of patellofemoral joint stability, all aspects of the KOOS questionnaire, and Kujala et al.’s score (59.7 points preoperatively and 84.4 points at the last followup). No patient revealed recurrent dislocation. The SF-36 score revealed a significant improvement in bodily pain, general health, physical role functioning, social role functioning, and physical functioning domains. The described MPFL reconstruction with the use of the medial 1/3rd of patella tendon is an effective procedure that gives satisfactorily patellofemoral joint functions, improves the quality of life, and provides much pain relief. It is relatively simple, surgically not extensive, and economically cost-effective procedure.

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Criteria for Return to Play After Hip Arthroscopy in the Treatment of Femoroacetabular Impingement: A Systematic Review

The American Journal of Sports Medicine ◽

10.1177/03635465211038959 ◽

2021 ◽

pp. 036354652110389

Author(s):

Martin S. Davey ◽

Eoghan T. Hurley ◽

Matthew G. Davey ◽

Jordan W. Fried ◽

Andrew J. Hughes ◽

...

Keyword(s):

Systematic Review ◽

Femoroacetabular Impingement ◽

Hip Arthroscopy ◽

Operative Management ◽

Return To Play ◽

Return To Sports ◽

Level Of Evidence ◽

The Mean

Background: Femoroacetabular impingement (FAI) is a common pathology in athletes that often requires operative management in the form of hip arthroscopy. Purpose: To systematically review the rates and level of return to play (RTP) and the criteria used for RTP after hip arthroscopy for FAI in athletes. Study Design: Systematic review; Level of evidence, 4. Methods: A systematic review of the literature, based on the PRISMA guidelines, was performed using PubMed, Embase, and Scopus databases. Studies reporting outcomes after the use of hip arthroscopy for FAI were included. Outcomes analyzed were RTP rate, RTP level, and criteria used for RTP. Statistical analysis was performed using SPSS software. Results: Our review found 130 studies, which included 14,069 patients (14,517 hips) and had a mean methodological quality of evidence (MQOE) of 40.4 (range, 5-67). The majority of patients were female (53.7%), the mean patient age was 30.4 years (range, 15-47 years), and the mean follow-up was 29.7 months (range, 6-75 months). A total of 81 studies reported RTP rates, with an overall RTP rate of 85.4% over a mean period of 6.6 months. Additionally, 49 studies reported the rate of RTP at preinjury level as 72.6%. Specific RTP criteria were reported in 97 studies (77.2%), with time being the most commonly reported item, which was reported in 80 studies (69.2%). A total of 45 studies (57.9%) advised RTP at 3 to 6 months after hip arthroscopy. Conclusion: The overall rate of reported RTP was high after hip arthroscopy for FAI. However, more than one-fourth of athletes who returned to sports did not return at their preinjury level. Development of validated rehabilitation criteria for safe return to sports after hip arthroscopy for FAI could potentially improve clinical outcomes while also increasing rates of RTP at preinjury levels.

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Early results and medico-economic evaluation of a short daily home hemodialysis program in a Private hemodialysis center

Bulletin de la Dialyse à Domicile ◽

10.25796/bdd.v4i2.61653 ◽

2021 ◽

Vol 4 (2) ◽

pp. 105-119

Author(s):

Hadia Hebibi ◽

Magali Ciroldi ◽

Laure Cornillac ◽

Samah Saibi ◽

Fatia El Boundri ◽

...

Keyword(s):

Professional Activity ◽

Average Volume ◽

Training Time ◽

Professional Integration ◽

Daily Hemodialysis ◽

Early Results ◽

Average Residual ◽

The Mean ◽

Medico Economic

Abstract: Between 2015 and 2017 there was a 40% increase in daily hemodialysis, according to the REIN database. This increase concerns 1% of patients and the private sector remains under-represented. Our retrospective study aims to describe the clinical features, the organizational and medico-economic specificities of this technique in a private hemodialysis center. Methods: We included 12 dialyzed patients trained on Nx Stage® machine from February 2020 to April 2021. Data were retrospectively obtained through review of our electronic medical records (EUCLID®). Results: Of the 12 patients trained, 11 dialyzed from home, with an average follow-up of 9 months (1-14). The average age was 45 with a sex ratio of 4/8 (M/W), and a median Charlson score of 3 (2-4). The average residual urinary output was 700 mL/24h, and 50% of patients were anuric. 100% of patients had an arteriovenous fistula and were cannulated using the buttonhole technique. 9 patients are on a transplant list. One patient needed anticoagulants. The mean training time was 35 days (28-35). 83% of patients were dialyzed 6 days a week with an average duration of 210 minutes (130-150) per session. The average volume of dialysate was 24.85 liters. One patient developed an allergy to the PUREMA® membrane. Pre-dialytic hemoglobin, serum creatinine, urea, phosphoremia and B2-microglobuline are stable at 9 months with improvement in metabolic acidosis. Conclusion: DHHD allowed a better socio-professional integration. One patient received a transplant and 3 patients resumed professional activity.

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Are the Classic and the Congruent Arc Latarjet Procedures Equally Effective for the Treatment of Recurrent Shoulder Instability in Athletes?

The American Journal of Sports Medicine ◽

10.1177/0363546520928343 ◽

2020 ◽

Vol 48 (9) ◽

pp. 2081-2089

Author(s):

Luciano A. Rossi ◽

Ignacio Tanoira ◽

Tomás Gorodischer ◽

Ignacio Pasqualini ◽

Domingo Luis Muscolo ◽

...

Keyword(s):

Functional Outcomes ◽

Bone Block ◽

Return To Sports ◽

Glenohumeral Instability ◽

Level Of Evidence ◽

Significant Difference ◽

Functional Scores ◽

The Mean ◽

Anterior Glenohumeral Instability

Background: There is a lack of evidence in the literature comparing outcomes between the classic and the congruent arc Latarjet procedures in athletes. Purpose: To compare return to sports, functional outcomes, and complications between the classic and the congruent arc Latarjet procedures in athletes with recurrent glenohumeral instability. Study Design: Cohort study; Level of evidence, 3. Methods: Between June 2009 and June 2017, 145 athletes with recurrent anterior glenohumeral instability underwent surgery with the Latarjet as a primary procedure in our institution. The classic procedure was used in 66 patients, and the congruent arc method was used in 79 patients. Return to sports, range of motion (ROM), the Rowe score, a visual analog scale (VAS) for pain in sports activity, and the Athletic Shoulder Outcome Scoring System (ASOSS) were used to assess functional outcomes. Recurrences were also evaluated. The postoperative bone block position and consolidation were assessed with computed tomography. Results: In the total population, the mean follow-up was 41.3 months (range, 24-90 months) and the mean age was 25.3 years (range, 18-45 years). In total, 90% of patients were able to return to sports; of these, 91% returned at their preinjury level of play. No significant difference in shoulder ROM was found between preoperative and postoperative results. The Rowe, VAS, and ASOSS scores showed statistical improvement after operation ( P < .001). The Rowe score increased from a preoperative mean of 42.8 points to a postoperative mean of 95.2 points ( P < .01). Subjective pain during sports improved from 3.2 points preoperatively to 0.7 points at last follow-up ( P < .01). The ASOSS score improved significantly from a preoperative mean of 46.4 points to a postoperative mean of 88.4 points ( P < .01). No significant differences in shoulder ROM and functional scores were found between patients who received the classic vs congruent arc procedures. There were 5 recurrences (3.5%): 3 dislocations (2%) and 2 subluxations (1%). No significant difference in the recurrence rate was noted between groups. The bone block healed in 134 cases (92%). Conclusion: In athletes with recurrent anterior glenohumeral instability, the Latarjet procedure produced excellent functional outcomes. Most athletes returned to sports at their preinjury level, and the rate of recurrence was very low, regardless of whether the patients received surgery with the classic or congruent arc technique.

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Midterm Results after Implant-Free Patellar Fixation Technique for Medial Patellofemoral Ligament Reconstruction

The Journal of Knee Surgery ◽

10.1055/s-0039-1692654 ◽

2019 ◽

Vol 33 (11) ◽

pp. 1140-1146

Author(s):

Philipp Mayer ◽

Philipp Schuster ◽

Michael Schlumberger ◽

Martin Eichinger ◽

Michael Pfaff ◽

...

Keyword(s):

Patient Satisfaction ◽

Surgical Technique ◽

Functional Outcome ◽

Revision Surgery ◽

Ligament Reconstruction ◽

Medial Patellofemoral Ligament ◽

Return To Sports ◽

Medial Patellofemoral Ligament Reconstruction ◽

Preoperative Level

AbstractProblems and complications concerning the patellar fixation in medial patellofemoral ligament reconstruction (MPFLR) have been reported. The purpose of this retrospective study was to systematically analyze the surgical technique for MPFLR with a V-shaped patellar bonetunnel for implant-free fixation of an autologous gracilis tendon, allowing early functional rehabilitation, regarding restoration of the patellofemoral stability, patient satisfaction, return to sports, and technique-specific complications. In 2010, 128 cases of consecutive isolated MPFLR were performed. All these cases were included. After a minimum follow-up of 3 years, 104 cases were retrospectively analyzed (follow-up: 81.3%) with regard to redislocation, subjective functional outcome (Tegner's score and sports level compared with preoperative level), patient satisfaction, revision surgery, and technique-specific complications. After a follow-up of 45.7 ± 3.2 months, 101 of 104 cases (97.1%) showed no redislocation. Mean Tegner's score was 5.1 ± 1.8 (range, 2–9). A total of 61.5% patients reported about a higher sports level compared with their preoperative level. The patient satisfaction was high with 94.2%. In two cases (1.9%), technique-specific problems occurred as the bone bridge of the V-shaped tunnel was insufficient due to a malpositioning of the aiming device. No further technique-specific problems occurred and no revision surgery was necessary during the observational period. The presented surgical technique is safe and it reliably restores the patellofemoral stability, with a low rate of redislocations, an excellent subjective functional outcome, and a high-patient-reported satisfaction. No major technique-specific complications occurred.

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Minimum 5-Year Clinical Outcomes, Survivorship, and Return to Sports after Hamstring Autograft Reconstruction for Sternoclavicular Joint Instability

Orthopaedic Journal of Sports Medicine ◽

10.1177/2325967120s00339 ◽

2020 ◽

Vol 8 (7_suppl6) ◽

pp. 2325967120S0033

Author(s):

Lucca Lacheta ◽

Brandon Goldenberg ◽

Marilee Horan ◽

Sam Rosenberg ◽

Jonas Pogorzelski ◽

...

Keyword(s):

Patient Satisfaction ◽

Clinical Outcomes ◽

Joint Instability ◽

Hamstring Tendon ◽

Rate Of Return ◽

Return To Sports ◽

Joint Reconstruction ◽

Hamstring Tendon Autograft ◽

Tendon Autograft

Objectives: Instability of the sternoclavicular (SC) joint is a rare but potentially devastating pathology, particularly when it occurs in young or active patients, where it can lead to persistent pain and impairment of shoulder function. SC reconstruction using a hamstring tendon autograft is a commonly used treatment option, but mid-term results are still lacking. To assess clinical outcomes, survivorship, and return to sports rate after SC joint reconstruction using hamstring tendon autograft in patients suffering from SC joint instability. We hypothesized that SC joint reconstruction would result in good clinical outcomes, a high survivorship, and a high rate of return to sports. Methods: All patients who underwent SC joint reconstruction with a hamstring tendon autograft for SC joint instability, with a minimum 5-year follow up, were included. Patient reported outcomes were assessed prospectively by the use of the American Shoulder and Elbow Surgeons (ASES) Score, Single Assessment Numerical Evaluation (SANE) Score, Quick Disabilities of the Arm, Shoulder and Hand (DASH) Score, General heath physical component of the SF-12 (PCS) and patient satisfaction. Survivorship of reconstruction was defined as no further SC joint dislocation events or revision surgery. Return to sports and pain were assessed using a customized questionnaire. Results: 22 SC joint reconstructions with a mean age of 31.3 (range 15.8 - 57.0 years) at the time of surgery were included. At final evaluation, 18 SC joint reconstructions with a mean follow up of 6.0 years (range 5.0 – 7.3 years) were eligible for minimum 5-year follow-up. All clinical outcome scores improved significantly pre- to postoperatively, ASES (50.0 to 91.0; p = .005), SANE (45.9 to 86.0; p = .007), QuickDASH (44.2 to 12.1; p = .003), and PCS (39.4 to 50.9; p = .001). Median postoperative satisfaction was 9 (range 7 - 10). The construct survivorship was 90% at 5-year follow-up. Two patients failed at 82 and 336 days postoperatively and were revised with revision SC joint reconstruction and capsulorrhaphy. Another patient had a superficial wound infection, which was debrided once, and resulted in a good clinical outcome. Of the patients who answered optional sports activity questionnaires, 17 (77%) shoulders participated in recreational or professional sports before injury. At final follow-up, 16/17 (94%) shoulders returned to their pre-injury level of sport or better. The VAS score for pain today (p = 0.004) and pain at its worst (p = 0.004) improved significantly pre- to postoperatively. Conclusions: SC joint reconstruction with hamstring tendon autograft for SC joint instability resulted in significantly improved clinical outcomes with high patient satisfaction and 90% survivorship at mid-term follow up. Furthermore, a reliable rate of return to previous level of sports was observed in this young and high-demanding patient population. Concerns in terms of advanced post-instability arthritis were not confirmed since a significant decrease in pain was found after minimum 5-year follow-up.

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Breast sensation following reduction mammaplasty

Canadian Journal of Plastic Surgery ◽

10.1177/229255039400200102 ◽

1994 ◽

Vol 2 (1) ◽

pp. 28-31

Author(s):

Joel S Fish ◽

James R Bain ◽

Ronald Levine

Keyword(s):

Surgical Technique ◽

Reduction Mammaplasty ◽

Threshold Values ◽

Early Results ◽

Long Term Follow Up ◽

Breast Sensation

This study has quantitatively measured breast sensation following reduction mammaplasty using a vertical bipedicle technique. Breast sensation was quantitatively assessed by determining pressure and vibratory threshold values preoperatively in 20 subjects, and postoperatively in 15 patients. The nipple, areola and breast body were all independently assessed. Early results, less than one month postoperatively, revealed significant reductions in vibratory and pressure thresholds in the nipple and areola. Long term follow-up revealed that breast sensation returned to normal using this surgical technique.

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Clinical Outcomes and Return to Sport After Minimally Invasive Reconstruction of the Lateral Ligament Complex with Semitendinosus Tendon Autograft in Chronic Lateral Ankle Instability

Journal of the American Podiatric Medical Association ◽

10.7547/19-012 ◽

2020 ◽

Author(s):

Federico Usuelli ◽

Cristian Indino ◽

Claudia Angela Di Silvestri ◽

Luigi Manzi ◽

Nicola Maffulli

Keyword(s):

Minimally Invasive ◽

Clinical Outcomes ◽

Ankle Instability ◽

Return To Sport ◽

Semitendinosus Tendon ◽

Lateral Ligament ◽

Ankle Sprains ◽

Lateral Ligaments ◽

The Mean ◽

Tendon Autograft

Background: Ankle sprains are common, affecting especially the lateral ligament complex of the ankle, often leading to chronic symptoms and instability. Many procedures have been described for chronic ankle instability. This study analyses clinical outcomes and returns to sport in patients who underwent minimally invasive reconstruction of the lateral ligaments complex of the ankle with a semitendinosus tendon autograft.Methods: Twenty-three patients (mean age: 33.9 years) with grade 3 lesion of both anterior-talofibular (ATFL) and calcaneofibular (CFL) ligaments, underwent minimally invasive reconstruction of the ATFL and CFL ligaments with an ipsilateral semitendinosus tendon autograft. They were retrospectively reviewed and return to sport was evaluated with the Halasi ankle activity scale.Results: The mean follow-up was 30 months (range 26-53 months). The mean AOFAS score increased from 68.6 to 95.3 point. The average VAS decreased from 3.6 to 1.3. The Halasi score changed from 5.0 to 5.1. Excepts for Halasi, the differences were statistically significant (p <0.001).19 patients judged the received treatment as excellent, 2 as good. No revision procedures were performed. No major complications were reported. Conclusions: This study confirms good clinical and sports outcomes following minimally invasive reconstruction of the lateral ligaments complex of the ankle with a semitendinosus autograft.

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Comparison of Clinical and Radiographic Outcomes Between Central and Lateral Lesions After Osteochondral Autograft Transplantation for Osteochondritis Dissecans of the Humeral Capitellum

The American Journal of Sports Medicine ◽

10.1177/0363546517730358 ◽

2017 ◽

Vol 45 (14) ◽

pp. 3331-3339 ◽

Cited By ~ 12

Author(s):

Takeshi Matsuura ◽

Yusuke Hashimoto ◽

Kazuya Nishino ◽

Yohei Nishida ◽

Shinji Takahashi ◽

...

Keyword(s):

Osteochondritis Dissecans ◽

Rate Of Return ◽

Return To Sports ◽

Central Group ◽

Osteochondral Autograft ◽

Radiographic Outcomes ◽

Lateral Group ◽

The Mean ◽

Central Lesions

Background: Clinical studies have reported satisfactory results after osteochondral autograft transplantation (OAT) for central lesions of unstable osteochondritis dissecans (OCD) of the elbow. However, the outcomes after OAT for lateral lesions remain unclear. Hypothesis: The clinical outcomes of OAT would be better for central lesions than for lateral lesions. Study Design: Cohort study; Level of evidence, 3. Methods: The authors retrospectively evaluated 103 juvenile athletes (mean age, 13.2 years; range, 11-16 years) who underwent OAT for symptomatic OCD of the humeral capitellum from 2003 to 2014. Sixteen patients were excluded because they did not fit the inclusion criteria. The final cohort of 87 patients was divided by lesion type into central lesion (n = 43) and lateral lesion (n = 44) groups. When possible, a single large plug was created for grafting and trimmed to reconstruct the rounded joint surface. The clinical, radiographic, and magnetic resonance imaging outcomes were evaluated for each group at a mean follow-up of 43 months (range, 24-100 months). Results: There were no significant differences in the age, sex, height, weight, duration of symptoms, follow-up time, preoperative range of motion, or Timmerman and Andrews score between the 2 groups. The preoperative osteoarthritic changes (0 of 43 for central vs 5 of 44 cases for lateral; P = .023), mean lesion size (12.2 ± 2.9 vs 18.2 ± 7.0 mm; P < .001), and graft number (1.6 vs 2.8; P < .001) were significantly greater in the lateral group versus the central group. The mean range of extension (2.3° ± 5.4° vs −3.2° ± 8.7°; P < .001) and Timmerman and Andrews score (194 vs 185; P = .006) at the final follow-up were significantly better for patients in the central group. More patients in the lateral group had postoperative radial head subluxation (0 of 43 vs 6 of 44; P = .012) and osteoarthritic changes (1 of 43 vs 9 of 44; P = .008). The mean MOCART score showed no significant differences between the groups (78.0 ± 15.7 vs 72.6 ± 20.9; P = .181). The rate of return to sports at the previous level was 100% in the central group and 86% in the lateral group ( P = .012). Conclusion: The clinical and radiographic outcomes after OAT associated with unstable OCD of the humeral capitellum were better for central lesions than for lateral lesions. However, satisfactory outcomes and a high rate of return to sports were obtained for unstable lateral lesions after OAT.

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