1,720,977 research outputs found
The Endo-Model(®) rotating hinge for rheumatoid knees : Functional results in primary and revision surgery
No full textLong-Term Results of Surgical Treatment of Valenti Procedures for Hallux Rigidus: A Minimum Ten-Year Follow-Up Retrospective Study
No full textFew studies reporting long-term results of surgical treatment of hallux rigidus have been published. The aim of this study is to assess the clinical outcome of Valenti procedures in a series of patients with hallux limitus/rigidus with a minimum 10-year follow-up time. We retrospectively evaluated 38 patients (40 feet) who underwent a Valenti procedure with a mean follow-up of 132 ± 19.6 (range 114 to 184) months. All patients were clinically reassessed on the basis of the evaluation of pain (visual analogue scale), function (American Orthopaedic Foot and Ankle Society Hallux Metatarsophalangeal-Interphalangeal Scale Assessment and Foot & Ankle Disability Index), and subjective satisfaction. The scores before and after treatment, obtained from clinical recordings and clinical evaluation during the last follow-up visits, were compared. We found significant improvement of the mean values of the visual analogue score (p <.0001), Foot & Ankle Disability Index (p <.0001), and American Orthopaedic Foot and Ankle Society Hallux Metatarsophalangeal-Interphalangeal Scale Assessment (p <.0001) during the latest follow-up visits. The results suggest that the Valenti technique represents a safe, reproducible surgical procedure that allows satisfying long-term results. The few reported complications were essentially the progressive worsening of the joint stiffness, but no sesamoiditis, metatarsal overload, secondary surgeries, or failures were documented
Lumbar Traction in the Management of Low Back Pain: A Survey of Latest Results
No full textIntroduction : Low back pain (LBP) is one of the most common complaints in the general population, affecting
about 70-80% of the population at some point in life. LBP management comprises a wide range of different
intervention strategies. One of the treatment options is traction therapy. The aim of our short review is to summarize
and analyze the latest result reporting the use of lumbar traction in LBP treatment in order to evaluate the real
effectiveness and indications of this specific physical therapy.
Materials and methods: A comprehensive search of PubMed, Medline, Cochrane, Embase, and Google Scholar
databases was performed, covering the period between 2006 and 2013. 54 citations were obtained. Relevant data
from each included study were extracted and recorded.
Results: A total of 14 studies were included in the review. Among these 14 studies, 11 were randomized clinical
trials, 1 was a retrospective cohort study and 2 were case series. The majority of included studies used traction on
patients that suffered nerve root compression symptoms. The mean number of traction sessions was 19. At most,
the duration of each session was 30 min (range 3-30 min). The mean period of traction treatment was 6 weeks
(range 3-12 weeks). 11 studies coupled with traction other therapies. Only 3 studies used traction as a single
treatment. The mean follow up period was 16,5 weeks from the end of treatment.
Conclusion: Several biases can be introduced by limited quality evidence from the included studies. Lumbar
traction seems to produce positive results in nerve root compression symptoms. Data in degenerative and
discogenic pain are debatable. To date, the use of lumbar traction therapy alone in LBP management is not
recommended by the best available evidence
Intradiscal ozone therapy for the treatment of low back pain: a review of the literature
No full textAuthor Reply to “Regarding ‘Clinical Outcome of Arthroscopic Lateral Retinacular Release for Symptomatic Bipartite Patella in Athletes’”
No full textInterposition arthroplasty with bovine collagenous membrane for hallux rigidus: A long-term results retrospective study
No full textHallux rigidus (HR) is a degenerative arthritis of the first metatarsophalangeal joint (MTP1) with progressive loss of range of movement (ROM). Interposition arthroplasty (IA) is a technique widely used for the treatment of HR;however, few studies reported long-term clinical results. This study aims to report the clinical results of IA using a bovine pericardium collagen matrix for HR with a minimum 10-years follow-up
Surgical treatment of critical size bone defects with Masquelet technique versus bone transport: a systematic review and meta-analysis of comparative studies
No full textIntroduction: To date, the management of critical-sized bone defects lacks a universally accepted approach among orthopedic surgeons. Currently, the main options to treat severe bone loss include autologous grafting, free vascularized bone transfer, bone transport and induced-membrane technique. The purpose of this study is to critically compare the outcomes of Masquelet technique and bone transport to provide a higher level of evidence regarding the indexed techniques. Material and methods: The authors conducted a systematic search on several databases according to the PRISMA guidelines. English-written reports comparing outcomes of the Masquelet technique versus the bone transport technique in patients with critical-sized defects in lower extremities were included. Results: Six observational studies involving 364 patients were included. The systematic review and meta-analysis of pooled data showed no significant difference in most outcomes, except for ASAMI bone outcomes and residual deformity, which showed better results in the bone transport group. The 64% of patients treated with Masquelet technique obtained excellent/good bone ASAMI results compared to 82.8% with bone transport (p = 0.01). Post-operative residual deformity was 1.9% with the bone transport method versus 9.7% with the Masquelet technique (p = 0.02). Conclusions: Both the Masquelet technique and bone transport showed comparable results for the management of critical-sized bone defects of the lower limb. However, these findings must be carefully interpreted due to the high risk of bias. Further prospective randomized controlled trials are necessary to better clarify the strengths and limitations of these two techniques and to identify the variables affecting the outcomes
Surgical management of complex proximal humeral fractures: pinning, locked plate and arthroplasty : Clinical results and functional outcome on retrospective series of patients.
No full textPURPOSE: The aim of the study was to compare the clinical results and related complications of four different surgical treatments of complex proximal humeral fractures according to their classification and features of patients. METHODS: Between 2007 and 2011, 92 consecutive patients with diagnosis of three-four-part displaced fractures, fractures with head dislocation and head-splitting fractures were evaluated postoperatively with Constant-Murley score, disability of arm, shoulder and hand score and simple shoulder test. RESULTS: All the treatment modalities showed from optimal to good mean functional results. The statistical analysis comparing each treatment group showed better outcomes scores (p < 0.05) for: locked plating versus HA, locked plating versus RSA and RSA versus HA. No differences between postoperative range of motion, complication rate and overall revision rate of the treatment groups were found at the end of follow-up (p > 0.05). Overall complication rate of surgical treatment of complex PHF was 31.5% (29 patients) with overall revision rate of 14.1%. Among patients with complications 77.8% of HA (7 of 9) required revision surgery (p < 0.05). CONCLUSIONS: The treatment of complex PHF is nowadays a challenge even for skilled shoulder surgeons. The several viable operative options give good results whenever used for the correct indication. The range of reported complications from 18.2 to 37.5% remains concerning, but most of them did not affect clinical outcome in this series. Accurate preoperative characterization of the fracture pattern is necessary, and high surgical skills of the different operative techniques, including arthroplasty, are recommended to meet the increased functional expectations of patients
Conservative treatment of meniscal tears in anterior cruciate ligament reconstruction
No full textBackground Management of small and stable meniscal tears within the vascular zone at the time of anterior cruciate ligament (ACL) reconstruction is controversial. The purpose of this study was to evaluate the outcome of meniscal tear left in situ at the time of ACL reconstruction. Methods Using the IKDC, KT-1000 and the Tegner Activity Score (TAS), we retrospectively analysed 175 cases of ACL reconstruction with meniscal tears performed from 2006 to 2012. Patients with residual laxity on clinical assessment were identified and considered as a subgroup. Clinical outcome and failure rate were evaluated. Results In 83 patients (47.4%), a meniscal tear was left in situ at the time of ACL reconstruction: 45 were medial and 38 were lateral. Patients were clinically reassessed with a minimum follow-up of 24 months. The overall failure rate of conservative meniscal treatment in patients with objective residual laxity was 87.5%, and 6.7% in patients with a stable knee (P < 0.001). Those with stable knees had higher postoperative IKDC subjective scores (P = 0.0022) and TAS (P < 0.0001). Patients without residual laxity had higher failure rate for the medial meniscus compared with lateral meniscus - 10.5% versus 2.7% (P=0.36)—and the red-red zone had lower revision rate compared with the red-white zone (P = 0.0322). Conclusions The conservative treatment of small and stable peripheral tears of the medial and lateral menisci had low failure rate and no described complications. In our series residual laxity significantly increased the failure rate. Level of evidence level IV, therapeutic case serie
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