1,720,974 research outputs found
Hallux rigidus: How do I approach it?
No full textHallux rigidus is a degenerative disease of the first
metatarsalphalangeal (MTP) joint and affects 2.5% of
people over age 50. Dorsal osteophytes and narrowed
joint space leads to debilitating pain and limited range of
motion. Altered gait mechanics often ensued as 119%
of the body force transmit through the 1st MTP joint
during gait cycle. Precise etiology remains under debate
with trauma being often cited in the literature. Hallux
valgus interphalangeus, female gender, inflammatory
and metabolic conditions have all been identified as
associative factors. Clinical symptoms, physical exam
and radiographic evidence are important in assessing
and grading the disease. Non-operative managements
including nonsteroidal antiinflammatory drugs, intraarticular
injections, shoe modification, activity modification
and physical therapy, should always be attempted for all
hallux rigidus patients. The goal of surgery is to relieve
pain, maintain stability of the first MTP joint, and improve
function and quality of life. Operative treatments can
be divided into joint-sparing versus joint-sacrificing.
Cheilectomy and moberg osteotomy are examples of
joint-sparing techniques that have demonstrated great
success in early stages of hallux rigidus. Arthrodesis is a
joint-sacrificing procedure that has been the gold standard
for advanced hallux rigidus. Other newer procedures such
as implant arthroplasty, interpositional arthroplasty and
arthroscopy, have demonstrated promising early patient
outcomes. However, future studies are still needed to
validate its long-term efficacy and safety. The choice of
procedure should be based on the condition of the joint,
patient’s goal and expectations, and surgeon’s experience
with the technique
CONVENTIONAL VERSUS CROSS-LINKED POLYETHYLENE FOR TOTAL HIP ARTHROPLASTY: CLINICAL AND RADIOGRAPHIC OUTCOMES AT A MEAN OF NINE YEARS
No full textPolyethylene wear is the main factor leading to periprosthetic osteolysis, aseptic loosening and long-term failure of the implant in total hip arthroplasty (THA). The present study compares the clinical and radiographic outcomes of 88 patients who underwent primary THA with either conventional polyethylene or cross-linked polyethylene (XLPE) from the same manufacturer (Zimmer®, Warsaw, IN, USA). There were no significant differences between the two sub-populations in average age, gender, side affected and prosthetic stem and cup size. The average follow-up was 104 months, ranging from 55 to 131 months: to our knowledge this is the longest follow-up for this particular insert. Clinical and x-ray evaluation was obtained at 1, 3, 6 and 12 months and yearly thereafter. Our results showed that cross-linked polyethylene has a significantly greater wear reduction than that of standard polyethylene
Age-Related Outcome of Mobile-Bearing Total Ankle Replacement
No full textThe aim of this study was to investigate clinical and radiographic outcomes in patients 50 years and younger vs patients older than 50 years undergoing total ankle replacement. Seventy consecutive patients who underwent primary total ankle replacement were included in this retrospective study. Patients were assessed clinically and radiographically. There was a statistically significant difference between the 2 groups for the American Orthopaedic Foot & Ankle Society score at final follow-up. The younger group had significantly greater improvement compared with the older group. Total ankle arthroplasty is an effective treatment for young, active patients with symptomatic end-stage ankle arthritis. [Orthopedics. 2017; 40(3):e567-e573.]
Conventional versus cross-linked polyethylene for total hip arthroplasty
No full textThe clinical and radiographic outcomes of 88 patients who underwent primary total hip arthroplasty with either conventional polyethylene or cross-linked polyethylene (XLPE) from the same manufacturer were compared. There were no significant differences between the 2 subpopulations regarding average age, gender, side affected, or prosthetic stem and cup size. The average follow-up was 104 months (range, 55 to 131 months). To the authors' knowledge, this is the longest follow-up for this particular insert. Clinical and radiographic evaluations were performed at 1, 3, 6, and 12 months and then annually. Results showed that XLPE has a significantly greater wear reduction than that of standard polyethylene in primary total hip arthroplasty. At the longest available follow-up for these specific inserts, XLPE proved to be effective in reducing wear
Anterior longitudinal osteotomy of the greater trochanter in total hip arthroplasty
No full textThe extra-articular impingement of the greater trochanter against the ileum is an underrated cause of early dislocation in total hip arthroplasty. In this preliminary study, the authors assess the effectiveness of an anterior longitudinal osteotomy of the greater trochanter for preventing dislocation. A total of 115 patients underwent a total hip arthroplasty through a posterolateral approach. All patients underwent clinical and radiological follow-up at 1, 3, and 6 months. No dislocation was reported. All patients demonstrated fast recovery of range of motion and walking. No trochanter fractures were observed. The osteotomy of the greater trochanter is an effective surgical technique that decreases anterior impingement and consequently lowers the dislocation rate in primary total hip arthroplasty
Arthroscopic treatment of acute acromioclavicular joint dislocation with double flip button.
No full textThe ideal treatment for acute acromioclavicular joint dislocation is still controversial, both in terms of indications and surgical technique. The clinical and radiographic outcomes of 16 patients affected by acute AC joint dislocation (type III-V) and arthroscopically treated with a coracoclavicular double flip button are presented. Despite the excellent clinical results both in terms of Constant score (mean 97 points) and patient satisfaction, at a mean follow-up of 31 months the radiographs showed partial loss of reduction due to distal migration of the flip button within the upper third of the clavicle in one-fourth of the cases. The technique presented here proved to be safe and minimally invasive while delivering good aesthetic results and allowing for the treatment of associated lesions. Furthermore, the technique could benefit from more advanced retention devices, which ought to reduce or avoid migration of the flip buttons
Going Beyond Counting First Authors in Author Co-citation Analysis
Full text linkThe present study examines one of the fundamental aspects of author co-citation analysis (ACA) - the way co-citation
counts are defined. Co-citation counting provides the data on which all subsequent statistical analyses and mappings
are based, and we compare ACA results based on two different types of co-citation counting - the traditional type that
only counts the first one among a cited work's authors on the one hand and a non-traditional type that takes into
account the first 5 authors of a cited work on the other hand. Results indicate that the picture produced through this non-traditional author co-citation counting contains more coherent author groups and is therefore considerably clearer. However, this picture represents fewer specialties in the research field being studied than that produced through the traditional first-author co-citation counting when the same number of top-ranked authors is selected and analyzed. Reasons for these effects are discussed
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