1,720,992 research outputs found
Outcomes of Bi-unicompartmental Versus Total Knee Arthroplasty for the Treatment of Medial and Lateral Knee Osteoarthritis: A Systematic Review and Meta-analysis of Comparative Studies
No full textThe functional relevance of neurological recovery 20 years or more after lumbar discectomy.
No full textSpondylodiscitis After Endovascular Aortic Repair Due to Noninvasive Listeriosis
No full textAn 83-year-old man suffered progressive lower back pain 4 weeks after an endovascular aortic repair (EVAR) procedure. Computed tomography showed L4 vertebral body collapse and abnormal soft tissue-like density swelling with increased uptake on 18F-fluoro-D-glucose (FDG) positron emission tomography (PET)/CT. Listeria monocytogenes was identified from ultrasound-guided fine-needle aspiration. Ultrasound-guided drainage of the retroperitoneal abscess and intravenous antibiotic therapy with ampicillin and gentamicin resulted in the rapid relief of symptoms
Posterior versus lateral surgical approach: functionality and quality of life after total hip arthroplasty in a matched cohort study
No full textAbstract Background One of the most controversial aspects for maximizing outcomes after total hip arthroplasty (THA) remains the surgical approach to the hip joint. The posterior (PA) and lateral approaches (LA) are the two most commonly performed approaches used worldwide, but sparse data are available for their comparison in terms of health-related quality-of-life (HRQoL). The aim of this study was to assess the role of the PA and LA in the HRQoL and hip functionality of patients who underwent primary and elective THA for osteoarthritis, after a minimum 2-year follow-up. Methods One hundred twenty-eight patients (140 THAs: 68 with PA and 72 with LA) were evaluated in a matched cohort study. Data gathered included the body mass index, the American Society of Anesthesiologists score, surgery time, serum creatine phosphokinase (CpK) levels, estimated intraoperative blood loss and intra- or postoperative complications. Preoperatively and at the last follow-up, the activities of daily living, and the instrumental activities of daily living (IADL) scales, the Western Ontario and Mac Master University (WOMAC) Questionnaire, the Harris Hip Score (HHS) and the Visual Analogue Scale (VAS) were used to assess HRQoL and functionality. The Short Form-36 Health Survey (SF-36) Questionnaire was administered at the last follow-up. Results Postoperatively, CpK was higher in the LA group compared to the PA (695 ± 648 vs. 447 ± 326 UI/L, p < 0.001). At a mean follow-up of 47 ± 22 months for the LA group and 42 ± 29 months for the PA group, IADL, VAS, HHS and WOMAC scores significantly improved for both groups (all p < 0.001), but PA reported better VAS, residual pain and WOMAC scores (p = 0.002, p = 0.004 and p = 0.018, respectively). The PA group demonstrated a significant higher mental SF-36 subscale values than the LA group (49 ± 13 vs. 42 ± 19, p = 0.001). The LA group showed a higher number of Trendelenburg signs (p = 0.029). On the contrary, the PA group showed a higher number of leg lengthening (p = 0.020); however, most of these cases was less than the clinically significant value of 10 mm (p = 0.738). Conclusions Patients who underwent THA performed with the PA reported greater improvement in HRQoL with lower residual pain, postoperative muscle damage and Trendelenburg signs than those who underwent the LA
Better functional outcomes and a lower infection rate can be expected after superior capsular reconstruction in comparison with latissimus dorsi tendon transfer for massive, irreparable posterosuperior rotator cuff tears: a systematic review
No full textBackground: Massive, irreparable rotator cuff tears, if left untreated, may result in cuff tear arthropathy, which causes shoulder disability and pain. The primary outcome of this systematic review was to evaluate differences in functional outcomes between the arthroscopic superior capsular reconstruction (SCR) and latissimus dorsi tendon transfer (LDTT) for the treatment of massive, irrepa-rable posterosuperior rotator cuff tears without arthritis. The secondary outcome was to compare complication and reoperation rates between the 2 surgical procedures.Methods: The PubMed, MEDLINE, Scopus, and Cochrane Central databases were searched using keywords, and 20 studies were included in this review. Data extracted for quantitative analysis included the American Shoulder and Elbow Surgeons score, the Con-stant-Murley score, the subjective shoulder value, the range of motion, the visual analog scale for pain, numbers and types of compli-cations, and reoperation rate. The preoperative fatty degeneration of the muscles and the preoperative and follow-up acromiohumeral distance and glenohumeral osteoarthritis according to the Hamada grading system were also reported.Results: A total of 1112 patients were identified, among whom 407 and 399 underwent SCR and LDTT, respectively. The SCR group showed a higher mean age at the time of operation (64.5 +/- 7.8 vs. 62.1 +/- 8.9 years; P < .001). The SCR group showed a lower rate of previous surgical procedures on the shoulder (35 out of 407 vs. 111 out of 399; P < .001) and a shorter mean follow-up (30.4 +/- 7.5 vs. 36.3 +/- 10.3 months; P < .001). Patients who underwent SCR reported significantly better functionality and residual pain as measured by the Constant-Murley score (75.5 +/- 11.2 vs. 65.6 +/- 22.8, P < .001), the American Shoulder and Elbow Surgeons score (84.3 +/- 13 vs. 67.7 +/- 23, P <.001), the subjective shoulder value (79.4 +/- 13 vs. 64.4 +/- 23, P <.001), and the visual analog scale (1.4 +/- 2 vs. 2.8 +/- 3, P < .001) than patients who underwent LDTT. A greater acromiohumeral distance (5.8 +/- 2.5 vs. 7.6 +/- 2.7, P < .001) was found in the SCR group. The SCR group showed a significantly lower infection rate (0.2% vs. 2.8%., P =.003) and a higher graft failure rate (12.3% vs. 6.8%, P = .012). No differences in terms of reoperation for graft failure (1% vs. 2.3% for SCR and LDTT, respectively; P = .172) or for conversion to reverse total shoulder arthroplasty (1.7% vs. 2% for SCR and LDTT, respectively; P = .800) were found.Conclusion: Patients undergoing SCR report better functional outcomes and greater acromiohumeral distance than those undergoing LDTT. The LDTT group shows a significantly higher infection rate, while the SCR group shows a significantly higher graft failure rate, but there are no differences in terms of reoperation between the 2 surgical procedures.Level of evidence: Level IV; Systematic Review (c) 2022 Journal of Shoulder and Elbow Surgery Board of Trustees. All rights reserved
Componenti acetabolari in tantalio nella protesizzazione primaria dell'anca. Studio prospettico
No full textGli autori riportano eccellenti risultati clinici e radiografici con l'utilizzo di componenti acetabolari con rivestimento esterno in tantalio poroso nell'artroprotesi primaria dell'anc
Modified Weaver-Dunn Procedure for Type 3 Acromioclavicular Joint Dislocation: Functional and Radiological Outcomes
No full textArthroscopic rotator cuff repair in patients over 65 years of age: Successful functional outcomes and a high tendon integrity rate can be obtained after surgery
No full textRevision surgery for periprosthetic elbow infection: eradication rate, complications, and functional outcomes-a systematic review
No full textThe aim of this systematic review was to investigate the outcomes of revision surgery after periprosthetic elbow infection (PEI)
Cemented total knee arthroplasty shows less blood loss but a higher rate of aseptic loosening compared with cementless fixation. An updated meta-analysis of comparative studies
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