Current Issue : October - December Volume : 2017 Issue Number : 4 Articles : 7 Articles
Background: Although arthroscopic surgical treatment of the first metatarsophalangeal (MTP) joint involves painful\nsesamoid excision, synovectomy, debridement, and partial cheilectomy, no gold standard treatment technique has\nbeen defined in the literature for hallux rigidus and focal osteochondral lesions. This study aimed to assess the\narthroscopic treatment for early grade focal osteochondral lesions of the first MTP joint and to determine the\nimpact of arthroscopic microhole drill surgery on foot function and activities of daily living in a group of patients\nwho failed conservative treatment.\nMethods: This prospective study included 14 patients with hallux rigidus and focal osteochondral lesions of the\nfirst MTP joint who underwent surgery in 2014 and were followed on a regular basis thereafter.\nResults: The patients had mean preoperative VPS (visual pain score) and AOFAS (American Orthopedic Foot and\nankle Society)-Hallux scores of 8.14 �± 0.86 SD and 48.64 �± 4.27, respectively; the corresponding postoperative values\nof both scores were 1.86 �± 0.66 SD and 87.00 �± 3.70. Both VPS and AOFAS-Hallux scores changed significantly.\nDiscussion: In this prospective study, we explored the impact of arthroscopic microhole drill surgery on foot\nfunction and activities of daily living in patients with focal osteochondral lesions of the first MTP joint. Our results\nshowed significant improvements in VPS and AOFAS scores with this treatment.\nConclusions: An arthroscopic microhole drill technique can be used with impressive functional scores and without\nany complications in patients who failed conservative therapy for hallux rigidus with focal chondral injury....
Introduction: Pseudoarthrosis is one of the most dreadful complications of\nolecranon fractures. It seriously compromises the function of the elbow. Objectives:\nTo determine the epidemiological factors of this complication in order\nto prevent them and to assess the results of the therapeutic management.\nMaterial and method: This was a retrospective study that involved patients\nwith olecranon pseudoarthrosis who were treated in the department between\nJanuary 2006 and December 2016. The diagnosis of pseudoarthrosis was made\nat least 6 months after the management of the fracture. There were 16 men and\n5 women. We analyzed the epidemiological factors, the treatment of pseudoarthrosis,\nand the postoperative outcome. Results: The incriminated factors\nwere the complexity of the fracture line and the quality of treatment of the recent\nfracture. The osteosynthesis of pseudoarthrosis is similar to that of recent\nfractures. It requires in some cases a bone graft. The results of the treatment\nare satisfactory with 100% of consolidation, and a good functional result in\n75% of the cases. Conclusion: The treatment of olecranon pseudoarthrosis is\nbased above all on prevention by an optimal management of the recent fractures.\nThe curative treatment gives satisfactory functional results....
Background: Studies have reported on the arthroscopic technique for release of external snapping hip syndrome.\nHowever, no study with large sample size has been reported for arthroscopic surgery.\nMethods: Patients with 229 bilateral and 19 unilateral external snapping hips were treated from January 2012 to\nJune 2013. After locating the contracture position, arthroscopic surgery was performed accordingly. Preoperative\nand postoperative angles were compared.\nResults: Comparing range of motion, all patients obtained higher adduction and flexion angles. At postoperative\nfollow-up of 24 months, the adduction angle was improved from âË?â??14.4 Ã?± 5.14 to 35.7 Ã?± 4.21 for type I, from âË?â??31.2 Ã?± 5.\n22 to 31.7 Ã?± 2.84 for type II, from âË?â??49.0 Ã?± 3.47 to 21.6 Ã?± 3.43 for type III, and from âË?â??64.5 Ã?± 4.65 to 18.3 Ã?± 3.10 for type IV\n(P < 0.001). Similarly, the flexion angle was also significantly improved for all the four types (P < 0.001). Excellent ratio\nand satisfaction rate were good in types I and II. All the clinical features were cured after arthroscopic surgery.\nConclusions: Arthroscopic surgery could be an effective procedure for external snapping hip, due to less operating\ntime, small scar, fast postoperative recovery, and complete contracture release....
Background: This meta-analysis aimed to perform a meta-analysis to evaluate the efficiency and safety between\nlocal infiltration analgesia (LIA) and sciatic nerve block (SNB) when combined with femoral nerve block (FNB) after\ntotal knee arthroplasty (TKA).\nMethods: A systematic search was performed in MEDLINE (1966-2017.04), PubMed (1966-2017.04), Embase\n(1980-2017.04), ScienceDirect (1985-2017.04), and the Cochrane Library. Only high-quality studies were selected.\nMeta-analysis was performed using Stata 11.0 software.\nResults: Four randomized controlled trials (RCTs) and two non-randomized controlled trials (non-RCTs), including 273\npatients met the inclusion criteria. The present meta-analysis indicated that there were significant differences between\ngroups in terms of visual analogue scale (VAS) score at 12 h (SMD = âË?â??0.303, 95% CI âË?â??0.543 to âË?â??0.064, P = 0.013),\nVAS score at 24 h (SMD = âË?â??0.395, 95% CI âË?â??0.636 to âË?â??0.154, P = 0.001), morphine equivalent consumption at 24 h\n(SMD = âË?â??0.395, 95% CI âË?â??0.636 to âË?â??0.154, P = 0.001), and incidence of nausea (RD = 0.233, 95% CI 0.107 to 0.360,\nP = 0.000) and vomiting (RD = 0.131, 95% CI 0.025 to 0.237, P = 0.015).\nConclusion: FNB-combined SNB provides superior pain relief and less morphine consumption within the first\n24 h compared FNB-combined LIA in total knee arthroplasty. In addition, there were fewer side effects associated\nwith SNB. Because the sample size and the number of included studies were limited, a multicenter RCT is needed\nto identify the effects of the two kinds of methods and further work must include range of motion analyses and\nfunctional test....
Purpose.Medial meniscal extrusion (MME) has attracted attention as an index of knee pain in conjunction with clinical symptoms\nthat could bemore useful than the diagnosis of knee osteoarthritis on X-ray. However, the size ofMME that would cause knee pain\nhas not been clarified. The aim of the present study was to investigate the cut-off value of MME for knee pain. Methods. A total of\n318 knees were evaluated. The presence of current or past knee pain was confirmed by interview. Next, MME was measured using\nvertical sonographic images of themedial joint spaces during weightbearing. Results. Overall, 71 knees were painful (P-group), and\n247 knees were not (N-group). MME was 5.9 �± 1.8mm in the P-group and 2.9 �± 1.5mm in the N-group (...
Background: In a prospective cohort study, we wanted to detect thresholds distinguishing between patients with\na satisfactory and an unsatisfactory outcome after total knee replacement (TKR) based on Patient-Reported\nOutcome Measures (PROMs), namely the Oxford Knee Score (OKS), using patient satisfaction and patient-perceived\nfunction as global transition items.\nMethods: Seventy-three TKR patients completed the OKS questionnaire before surgery and were invited to complete\nthe same questionnaire again 6 (4 to 9) months after surgery. Correlations between outcome measures and anchors\nwere calculated using Pearson�s correlation coefficient. Thresholds were established by receiver operating\ncharacteristics (ROC) analysis, using multiple anchor-based approaches.\nResults: Patients showed a mean increase of 16.5 (SD 9.5) in OKS following TKR. Significant positive correlations were\nfound between outcome measures and anchors. Six different thresholds were determined for outcome measures\ncoupled with satisfaction, patient-perceived function and a combination thereof using a cut-off of 50 and 70.\nConclusions: This study has established a set of clinically meaningful thresholds for Oxford Knee scores that may\nhelp to detect TKR patients who might be in need of post-operative evaluation...
An avulsion of the posterior tibial insertion of the lateral meniscus occurs during rotational distortion of the knee and can\nbe associated with a tear of the anterior cruciate ligament (ACL). We performed a follow-up of 28 patients who, following\nanatomical ACL reconstruction using the ipsilateral semitendinosus graft, underwent either transosseous repair of the posterior\nlateral meniscus root (...
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