scholarly journals Retrograde Intramedullary Nail Fixation for Derotational Femoral Osteotomy for Recurrent Femoropatellar Instability

2019 ◽  
Vol 2019 ◽  
pp. 1-7
Author(s):  
Maximiliano Barahona ◽  
Alvaro Zamorano ◽  
Cristian Barrientos ◽  
Mauricio Guzmán ◽  
Yoshiro Sato ◽  
...  
Keyword(s):  
Intramedullary Nail ◽  
Femoral Osteotomy ◽  
Fixation Method ◽  
Functional Score ◽  
Femoral Torsion ◽  
Stability Problems ◽  
Retrograde Intramedullary Nail ◽  
Femoral Nail ◽  
Derotational Osteotomy

Axial alignment of the femur and tibia is often misdiagnosed in patients with patellofemoral stability problems. Femoral torsion is critical for patellofemoral biomechanics, so it must be evaluated in every patient before the plan of surgery is decided. This case describes a femoral derotational osteotomy due to excessive internal torsion of the femur fixed with a retrograde femoral nail. This type of fixation provides a biomechanical advantage compared to plates. At the two-year follow-up, the patient achieved excellent results, reaching a functional score of 91 points on the Lysholm scale. Derotational femoral osteotomy should be considered in patellofemoral pathology, and a retrograde femoral nail is a valid fixation method for this surgery.

Tibiotalocalcaneal Arthrodesis Using a Novel Retrograde Intramedullary Nail

2019 ◽  
Vol 13 (6) ◽  
pp. 463-469
Author(s):  
John R. Steele ◽  
Alexander L. Lazarides ◽  
James K. DeOrio
Keyword(s):  
High Risk ◽  
Intramedullary Nail ◽  
Weight Bearing ◽  
Bone Defects ◽  
Inclusion Criteria ◽  
Union Rate ◽  
Level Of Evidence ◽  
Retrograde Intramedullary Nail ◽  
Favorable Safety

Background. Tibiotalocalcaneal (TTC) arthrodesis is a common treatment option for complex hindfoot pathology. Overall union rates range from 50% to 86% but can be even lower in certain populations. A novel retrograde intramedullary nail has recently been developed. The purpose of this study was to report fusion rates, time to weight-bearing, and complications with the use of the A3 Fusion Nail. Methods. All patients 18 years or older who underwent TTC arthrodesis with an A3 Fusion Nail at a single institution from 2010 to 2015 with a minimum 3-month follow-up were included in this study. Rates of successful fusion, time to union, time to weight-bearing, and complications were evaluated. A total of 20 patients with an average age of 58.1 years and an average follow-up of 12.5 months met inclusion criteria. Results. Successful TTC arthrodesis was achieved in 14 of 20 patients (70%) overall. Average time to union was 8.1 months, and average time to weight-bearing was 6.8 weeks. Of 20 patients, 17 (85%) required femoral head allograft for bulk bone defects, and the union rate in this subset of patients was 76.5%. The rates of revision surgery (10%) and complications were low. Conclusion. The A3 Fusion Nail demonstrated a favorable safety profile and achieved TTC arthrodesis at a rate consistent with historical data despite being used in a patient population at high risk for nonunion. In patients with bulk bone defects at high risk for nonunion, the A3 Fusion Nail demonstrated superior rates of fusion (76.5%) to those reported in the literature (50%). Level of Evidence: Level III: Retrospective cohort study

Tibiotalocalcaneal arthrodesis with a retrograde intramedullary nail: a prospective cohort study at a minimum five year follow-up

2021 ◽  
Author(s):  
Adolfo Perez-Aznar ◽  
Blanca Gonzalez-Navarro ◽  
Laiz L. Bello-Tejeda ◽  
Carolina Alonso-Montero ◽  
Alejandro Lizaur-Utrilla ◽  
...  
Keyword(s):  
Cohort Study ◽  
Prospective Cohort Study ◽  
Intramedullary Nail ◽  
Prospective Cohort ◽  
Retrograde Intramedullary Nail ◽  
Tibiotalocalcaneal Arthrodesis

scholarly journals Double femoral osteotomy fixed with a Puddu plate and a retrograde intramedullary nail to treat biapical deformity of the femur

2018 ◽  
Vol 53 (3) ◽  
pp. 378-383
Author(s):  
Patrícia Moreno Grangeiro ◽  
Márcia Uchoa de Rezende ◽  
Camilo Partezani Helito ◽  
Alessandro Monterroso Felix ◽  
Guilherme Pereira Ocampos ◽  
...  
Keyword(s):  
Intramedullary Nail ◽  
Femoral Osteotomy ◽  
Retrograde Intramedullary Nail ◽  
Puddu Plate

scholarly journals 3D Printed Cage in Patients with Tibiotalocalcaneal Arthrodesis Using a Retrograde Intramedullary Nail: Early Outcomes

2019 ◽  
Vol 4 (4) ◽  
pp. 2473011419S0010
Author(s):  
Lorena Bejarano-Pineda ◽  
Samuel B. Adams ◽  
Selene G. Parekh
Keyword(s):  
Intramedullary Nail ◽  
Titanium Implants ◽  
Salvage Procedure ◽  
Hindfoot Alignment ◽  
Titanium Cage ◽  
Retrograde Intramedullary Nail ◽  
Tibiotalocalcaneal Arthrodesis ◽  
3D Printed ◽  
Hindfoot Arthrodesis

Category: Diabetes, Hindfoot, Trauma, salvage procedure Introduction/Purpose: Segmental bone loss in the hindfoot hinders the chance of successful outcomes. Tibiotalocalcaneal arthrodesis is a reliable option; however, the risk of nonunion is high. Structural graft is needed to fill the gap, but the use of bone grafts are limited by the availability, risk of collapse, and disease transmission. Three-dimensional (3D) printed titanium implants offer a strong scaffold that can be customized and present similar healing rates. The purpose of the study was to describe the clinical outcomes and the radiologic union rate of a case series of patients with hindfoot arthrodesis, using a retrograde intramedullary nail associated to a 3D printed titanium cage. Methods: After obtaining approval from our institution review board, a retrospective chart review was performed on seven patients undergoing hindfoot arthrodesis, using a retrograde intramedullary nail associated to a custom 3D printed titanium cage from March 2015 to December 2017. Demographic and clinical data were collected. Functional outcomes were assessed using The American Orthopedic Foot and Ankle Score (AOFAS) and the Visual Analog Scale (VAS) for pain. Hindfoot alignment was evaluated using preoperative and postoperative weightbearing radiographs that included anteroposterior, lateral and Saltzman views. Radiographic union was assessed using computed tomography scan at 6 and 12 months postoperatively. Results: All patients had ankle arthritis and six of them (85%) had prior surgery in the compromised hindfoot. The average age at TTC fusion was 57 (range, 29 to 71) years. The mean follow-up time was 21 (range, 12 to 32) months. Six patients had a healed fusion and one patient underwent below knee amputation due to recurrence of chronic osteomyelitis in the ankle. Two additional patients had minor complications. The average AOFAS at pre-op was 35 (range, 20 to 42) points as compared to 68 (range, 53 to 78) points at final follow-up; P=0.004. Preoperative VAS pain was 80.4 (range, 70 to 85) points as compared to 26.8 (range, 6 to 60) points; P=0.002. Conclusion: Tibiotalocalcaneal arthrodesis using customized titanium cages for patients with large bone defects has shown a high rate of union in those at high risk of nonunion. Further research is needed to monitor the development of late complications.

Effect of Manipulation under Anesthesia of the First Knee in Staged Bilateral Total Knee Arthroplasty on Clinical Outcome and Satisfaction

2020 ◽  
Author(s):  
Jung-Won Lim ◽  
Yong-Beom Park ◽  
Dong-Hoon Lee ◽  
Han-Jun Lee
Keyword(s):  
Total Knee Arthroplasty ◽  
Patient Satisfaction ◽  
Clinical Outcome ◽  
Clinical Outcomes ◽  
Knee Arthroplasty ◽  
Knee Flexion ◽  
Functional Score ◽  
Manipulation Under Anesthesia ◽  
Total Knee

AbstractThis study aimed to evaluate whether manipulation under anesthesia (MUA) affect clinical outcome including range of motion (ROM) and patient satisfaction after total knee arthroplasty (TKA). It is hypothesized that MUA improves clinical outcomes and patient satisfaction after primary TKA. This retrospective study analyzed 97 patients who underwent staged bilateral primary TKA. MUA of knee flexion more than 120 degrees was performed a week after index surgery just before operation of the opposite site. The first knees with MUA were classified as the MUA group and the second knees without MUA as the control group. ROM, Knee Society Knee Score, Knee Society Functional Score, Western Ontario and McMaster Universities (WOMAC) score, and patient satisfaction were assessed. Postoperative flexion was significantly greater in the MUA group during 6 months follow-up (6 weeks: 111.6 vs. 99.8 degrees, p < 0.001; 3 months: 115.9 vs. 110.2 degrees, p = 0.001; 6 months: 120.2 vs. 117.0 degrees, p = 0.019). Clinical outcomes also showed similar results with knee flexion during 2 years follow-up. Patient satisfaction was significantly high in the MUA group during 12 months (3 months: 80.2 vs. 71.5, p < 0.001; 6 months: 85.8 vs. 79.8, p < 0.001; 12 months: 86.1 vs. 83.9, p < 0.001; 24 months: 86.6 vs. 85.5, p = 0.013). MUA yielded improvement of clinical outcomes including ROM, and patient satisfaction, especially in the early period after TKA. MUA in the first knee could be taken into account to obtain early recovery and to improve patient satisfaction in staged bilateral TKA.

scholarly journals Comparison Between With Kirschner-wires Only And Combined Screw Fixation in Proximal Reverse Chevron osteotomy(PCMO) For Hallux Valgus Deformity

2017 ◽  
Vol 2 (3) ◽  
pp. 2473011417S0002
Author(s):  
Hwa Jun Kang ◽  
Hong-Geun Jung ◽  
Jong-Soo Lee ◽  
Sungwook Kim ◽  
Mao Yuan Sun
Keyword(s):  
Hallux Valgus ◽  
Screw Fixation ◽  
Fixation Method ◽  
Kirschner Wires ◽  
Significant Difference ◽  
Group A ◽  
The Mean ◽  
Group B ◽  
Severe Hallux Valgus

Category: Bunion Introduction/Purpose: Kirschner-wires fixation, sometimes we have encountered pin irritation or pull-out. This is the reason why we consider additional fixation. Moreover, there are few reports according to comparison of fixation method, and Most of them focused on comparison K-wires or screw fixation only. Purpose of study is to compare clinical and radiographic outcome between Kirschner-wires only and combined screw fixation. Methods: The study included two different groups according to fixation methods. One with Kirschner-wires fixation (KW group) included 117 feet(of 98 patients), the other with combined screw fixation (KWS group) 56 feet (of 40 patients) with moderate to severe hallux valgus. Clinically, the preoperative and final follow-up visual analog scale (VAS) pain scores, the preoperative and final follow-up American Orthopaedic Foot & Ankle Society (AOFAS) hallux metatarsophalangeal (MTP)-interphalangeal (IP) scores, and patient satisfaction after the surgery were evaluated. Radiographically, the hallux valgus angle (HVA), intermetatarsal angle (IMA), medial sesamoid position (MSP), and first to fifth metatarsal width (1-5MTW) were analyzed before and after surgery. Results: The mean AOFAS score improved preoperative 65.5 to 95.3 at final follow up in group A, while preoperative 56.5 to 88.6 at final follow up. Pain VAS decreased from 5.7 to 0.5 in group A, whereas from 6.2 to 1.6 in group B. The mean HVA all improved from preoperative 38.5 to 9.3 at final follow up in group A and 34.7 to 9.1 in group B. The mean IMA and MSP also improved significantly at final follow up. In comparative analysis, the IMA did not show significant difference between postoperative and final state in group A, while showed significant increase in group B. Conclusion: We achieved favorable clinical and radiographic outcomes with minimal complications in patient with moderate to severe hallux valgus in both groups. However, this study shows no statistically significant difference in IMA during follow-up period and lower recurrence rate. Therefore we need to consider combined fixation method to provide better stability and can expect lower recurrence rate.

scholarly journals Radiological and clinical outcome of lateral ankle instability with medial compartment osteoarthritis

2017 ◽  
Vol 2 (3) ◽  
pp. 2473011417S0002
Author(s):  
Sungwook Kim ◽  
Hong-Geun Jung ◽  
Jong-Soo Lee ◽  
Hwa Jun Kang ◽  
Mao Yuan Sun
Keyword(s):  
Clinical Outcome ◽  
Pain Score ◽  
Ligament Reconstruction ◽  
Ankle Instability ◽  
Degenerative Change ◽  
Medial Compartment ◽  
Functional Score ◽  
Lateral Ankle ◽  
Lateral Ankle Instability

Category: Ankle, Ankle Arthritis, osteoarthritis, ankle instability Introduction/Purpose: When lateral ankle instability (LAI) is not treated for long period, unbalanced loading on medial ankle may proceed to osteoarthritis (OA). Outcome studies about osteoarthritis with lateral ankle instability after stabilization, however, have rarely been reported. The authors have investigated the radiological and clinical outcome of ligament stabilization for LAI with medial compartment OA. Methods: The study is based on 25 ankles of LAI with medial compartment ankle OA that underwent lateral ankle ligament reconstruction from 2007 to 2014 with at least 1 year follow-up. The medial ankle OA was diagnosed with degenerative change of medial ankle on plain X-ray or MRI or arthroscopic findings. The OA was classified using Takakura stage, and arthroscopic degenerative change was classified by modified Outerbridge grading. Ligament stabilization surgery was done using either modified Broström procedure or lateral ligament reconstruction using semitendinosus tendon allograft. Arthroscopic synovectomy, debridement, and microfracture for osteochondral lesion were performed when needed. Clinical outcomes were evaluated using visual analogue scale (VAS) pain score, American Orthopedic Foot and Ankle Society (AOFAS) ankle-hindfoot score, Karlsson- Peterson score, and subjective patient satisfaction. Statistical analysis were done using Wilcoxon signed rank test. Results: The average instability duration was 98 (range, 12-480) months and the average follow up period was 46 (range, 13-108) months. Preoperative Takakura stage was mostly I (n=19, 76%) and II (n=4, 17%), and was same postoperatively. MRI OA findings of 18 ankles were medial cartilage denudation (17%), cartilage thinning/erosion (44%), medial osteophyte (50%), and loose bodies (30%). Modified Outerbridge grade 2 and 4 were most common (both 41%). The VAS pain score decreased from 6.1 ± 1.6 preoperatively to 1.8 ± 1.6 postoperatively (P<0.05). The AOFAS score improved from 61.8 ± 14.7 preoperatively to 90.0 ± 6.3 postoperatively, and the Karlsson-Peterson score improved from 54.5 ±14.4 to 89.4 ± 8.4 (P<0.05). There were no significant complications. All patients were satisfied. Conclusion: Ligament stabilization accompanied with arthroscopic procedure could draw good outcome, even without structural bony deformity correction. Even with no improvement in plain radiograph, functional score could be improved.

scholarly journals Role of leukocyte free platelet rich plasma in planter fasciitis: a prospective study

2017 ◽  
Vol 5 (12) ◽  
pp. 5432
Author(s):  
Chandre Shekhar ◽  
Alamgir Jhan ◽  
Ganesh Singh ◽  
Pankaj Singh ◽  
Shailendre S. Bhandhari
Keyword(s):  
Placebo Group ◽  
Functional Outcome ◽  
Platelet Rich Plasma ◽  
Functional Results ◽  
Visual Analogue Scale Pain ◽  
Functional Score ◽  
Outcome Scores ◽  
The Mean ◽  
Post Graduate Institute

Background: Planter fasciitis, is by definition, inflammation of planter fascia. Most of the cases are well treated conservatively and a few responds to surgery only. Objectives of present study were evaluating the efficacy of a single injection of leukocyte free platelet rich plasma in plantar fasciitis and to derive a correlation between the clinical and radiological outcome.Methods: The present study consisted of 120 patients of bilateral (PF), (240 feet). These patients were divided into two groups PRP group of 60 patients and Placebo group of 60 patients. The study was conducted on patients attending Orthopaedics outpatient department Post Graduate Institute of Medial Education and Research (PGIMER) from July 2011 to June 2012. A primary efficacy criterion was changes from baseline in pain using (VAS). Functional results, level of satisfaction and outcome were measured by – AOFAS Foot Scale. Correlation of clinical with radiological outcome were performed.Results: There was a significant decrease in the visual analogue scale (pain score) in the PRP. Group while in placebo group it was increased significantly at the end of 6 month. Functional outcome scores were improved significantly from their baseline values in PRP group while in placebo group the mean functional score were deteriorated at 6 months follow up. There was no improvement seen in functional status with normal saline injection. In PRP group the mean heal pad thickness was reduced significantly at 6 months follow up while in placebo group was not changed significantly at 6 months follow up. Correlation between radiological parameters and VAS was found to be positive while it was found negative with other functional outcome scores like AOFAS.Conclusions: Platelet-rich plasma (PRP), which is a natural concentrate of autologous growth factors,plays a role in the regeneration process in treatment of (PF).

scholarly journals A Single Retrograde Intramedullary Nail Technique for Treatment of Displaced Proximal Humeral Fractures in Children

2021 ◽  
Vol 6 (1) ◽  
pp. e20.00119
Author(s):  
Eleftheria Samara ◽  
Benjamin Tschopp ◽  
Barbara Kwiatkowski ◽  
Elif Vardar ◽  
Nicolas Lutz ◽  
...  
Keyword(s):  
Intramedullary Nail ◽  
Proximal Humeral Fractures ◽  
Humeral Fractures ◽  
Retrograde Intramedullary Nail ◽  
Fractures In Children
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