scholarly journals Establishing the Role of Unlinked Total Elbow Arthroplasty in Low Demand Patients: A Long-Term Follow-up Study

2016 ◽  
Vol 29 (6) ◽  
pp. 367
Author(s):  
Sara Machado ◽  
Isabel Almeida Pinto ◽  
Rui Pinto ◽  
Paulo Ribeiro de Oliveira
Keyword(s):  
Range Of Motion ◽  
Total Elbow Arthroplasty ◽  
Great Loss ◽  
Elbow Arthroplasty ◽  
Mayo Score ◽  
Long Term Follow Up ◽  
Limiting Condition ◽  
Mayo Elbow Score

<p><strong>Introduction:</strong> Experience with total elbow arthroplasty is scarce in most centers. It seems to have a significant rate of associated complications. Most studies are based on non-validated outcome measures and short-term results. <br /><strong>Material and Methods:</strong> We selected patients undergoing unlinked total elbow arthroplasty, with a resultant sample of thirteen cases, with a mean postoperative follow-up of 72 months. We applied the Mayo Elbow Score and all patients underwent an X-ray study, prior to surgery and during the follow-up period. <br /><strong>Results:</strong> All patients have a systemic inflammatory condition. The mean Mayo score increased from 43 points preoperatively to 70 and 80 points at the intermediate follow-up period (with a mean of 15 months after the operation) and at the time of the latest follow-up evaluation (with a mean of 72 months after the operation). There was an increase in range of motion in all cases. There was one case of mechanical failure and two cases of transient ulnar neuropathy. <br /><strong>Discussion:</strong> Elbow dysfunction causes great loss in patient´s quality of life, incapacitating them for the simplest activities. Small improvements in range of motion and pain relief result in significant changes in the patient’s functional ability. There is a demand to clarify the performance of total elbow arthroplasty in selected patient groups in order to throw more light on the relative roles of the available implants. <br /><strong>Conclusions:</strong> The results obtained in this study seem to confirm the long-term benefit of the unlinked arthroplasty in severe joint dysfunction in patients with low physical demand, particularly in rheumatoid arthritis, a common and limiting condition in our population.</p>

scholarly journals Reduction and Association of the Scaphoid and Lunate: A Functional and Radiographical Outcome Study

2018 ◽  
Vol 08 (01) ◽  
pp. 037-042
Author(s):  
William Aibinder ◽  
Ali Izadpanah ◽  
Bassem Elhassan
Keyword(s):  
Range Of Motion ◽  
Grip Strength ◽  
High Rate ◽  
Salvage Procedure ◽  
Level Of Evidence ◽  
Long Term Follow Up ◽  
The Mean ◽  
Ligament Disruption

Background Management of scapholunate (SL) ligament disruption is a challenging problem. The reduction and association of the scaphoid and lunate (RASL) procedure has been described with varying results. This study assessed the outcomes of the RASL procedure. Purpose The objective of this study was to assess the outcomes of patients undergoing the RASL procedure at our institution in regard to pain relief, range of motion, radiographic and functional outcomes, complications, and reoperations. Materials and Methods Twelve patients with symptomatic chronic SL instability underwent the RASL procedure. The mean age was 35 years. The mean time from injury to surgery was 40 weeks. The mean follow-up was 89 months. Outcomes included visual analog score for pain, wrist range of motion, grip strength, and Mayo Wrist Scores. Preoperative and postoperative radiographs were reviewed. Results Pain scores improved in 10 wrists. Range of motion and grip strength worsened. The average Mayo Wrist Score was 63.3. The mean SL diastasis and angle improved, but seven wrists developed progressive degenerative changes, with two requiring a salvage procedure. Symptomatic progressive screw lucency occurred in eight wrists requiring screw removal. Conclusion The RASL procedure can improve SL widening but has a high rate of early failure and reoperation. Following reoperation, long-term follow-up demonstrates reasonable long-term durability in some cases. Level of Evidence This is a Level IV, therapeutic case study.

scholarly journals Role of Total Ankle Arthroplasty in Stiff Ankles – Long Term Follow-Up

2019 ◽  
Vol 4 (4) ◽  
pp. 2473011419S0001
Author(s):  
James W. Brodsky ◽  
Justin M. Kane ◽  
Andrew W. Pao ◽  
David D. Vier ◽  
Scott Coleman ◽  
...  
Keyword(s):  
Range Of Motion ◽  
Step Length ◽  
Total Ankle Arthroplasty ◽  
Ankle Arthritis ◽  
Ankle Arthroplasty ◽  
Post Surgery ◽  
Long Term Follow Up ◽  
Gait Function

Category: Ankle, Ankle Arthritis Introduction/Purpose: Operative treatment of end-stage ankle arthritis involves either ankle arthrodesis (AA) or total ankle arthroplasty (TAA). The theoretical benefit of TAA is the ability to preserve range of motion (ROM) at the tibiotalar joint. Previous studies have questioned whether it is justified to perform TAA over AA in stiff, arthritic ankles. However, a recent study showed that patients who underwent TAA with stiff ankles preoperatively experienced significant clinical improvement in range of motion and gait function compared to more flexible groups at 1-year follow-up. We retrospectively assessed these same gait and functional parameters to see if these improvements held up in long-term follow-up. Methods: A retrospective study of long-term, prospectively collected functional gait data in 33 TAA patients at a mean of 7.6 years postoperatively (range 4.8-13.3) used a multivariate regression model to determine the effect of ankle stiffness on the long- term, objective outcomes of TAA. Data was analyzed by quartiles (Q1, Q2+Q3, Q4) of preoperative sagittal ROM using one-way analysis of variance (ANOVA) to compare both preop and postop gait parameters. The two middle quartiles were combined to conform to distribution of the data. The multivariate analysis determined the independent effect of age, gender, BMI, years post- surgery, and preop ROM on every preop and postop parameter of gait. Results: Statistically significant differences were found in all three gait parameter categories, including temporal-spatial (step length and walking speed), kinematic (total sagittal ROM and maximum plantarflexion), and kinetic (peak ankle power). The stiffest ankles preoperatively (Q1) had the greatest absolute increase in total sagittal ROM postoperatively, +5.3o, compared to -1.3o (p<0.0174) in Q4 (most flexible). However, Q1 had the lowest absolute total postoperative sagittal ROM of 13.1 o, compared to 19.7 o (p<0.0108) in Q4. Q1 also had the lowest preoperative step length, walking speed, maximal plantarflexion, and peak ankle power when compared to the other subgroups. There was no difference in any of these same parameters postoperatively. BMI and years post-surgery had no effect on outcomes, while age and gender had a minimal effect. Conclusion: Preoperative range of motion was once again predictive of overall postoperative gait function in long-term follow-up at an average of 7.2 years. A greater degree of preoperative sagittal range of motion was predictive of greater postoperative sagittal range of motion in long-term follow-up. Patients with the stiffest ankles preoperatively once again had a statistically and clinically greater improvement in function as measured by multiple parameters of gait. This shows that the clinically meaningful improvement in gait function after total ankle arthroplasty holds up in long-term follow-up, even in the setting of limited preoperative sagittal range of motion.

scholarly journals Clinical outcomes and complications following primary total elbow arthroplasty using the Latitude prosthesis

2018 ◽  
Vol 11 (5) ◽  
pp. 359-371 ◽  
Author(s):  
David Cinats ◽  
Aaron J Bois ◽  
Kevin A Hildebrand
Keyword(s):  
Range Of Motion ◽  
Clinical Outcomes ◽  
Total Elbow Arthroplasty ◽  
Published Data ◽  
Mayo Elbow Performance Score ◽  
Elbow Arthroplasty ◽  
Radiographic Outcomes ◽  
Flexion Extension ◽  
Functional Outcome Measures

Background The Latitude total elbow arthroplasty (TEA) is an implant with limited published data on its performance and outcomes. The aim of this study was to report the short-term outcomes of the Latitude TEA as well as to describe the radiographic outcomes and complications. Methods The Latitude was implanted in 20 patients (23 elbows) in a linked configuration. Patients were recalled to clinic for the assessment of their range-of-motion and compared to preoperative values. Administration of functional outcome measures was also performed. Results Mean follow-up was 4.7 years (range, 1 to 7.5 years) with four elbows requiring revision. The flexion–extension arc improved from 86.6 to 101.3 (range, 76 to 126) postoperatively (p = 0.04). The average Disabilities of the Arm, Shoulder, and Hand score was 28.1 (range, 5.8 to 50.4) and the average Mayo Elbow Performance Score was 89.6 (range, 76 to 100), with 83% of elbows scoring in the good or excellent range. Radiolucencies were detected in 60% of patients and 31% of these lucencies progressed in size at the time of follow-up. Conclusions The Latitude prosthesis provides patients with favorable clinical outcomes with improvements in their range-of-motion and a complication rate comparable to other elbow arthroplasty implants.

LONG TERM FOLLOW-UP AFTER FINGER REPLANTATION

2008 ◽  
Vol 33 (1) ◽  
pp. 59-64 ◽  
Author(s):  
I. WALASZEK ◽  
A. ZYLUK
Keyword(s):  
Blood Flow ◽  
Range Of Motion ◽  
Grip Strength ◽  
Long Term Results ◽  
Functional Score ◽  
Pinch Grip ◽  
Active Range Of Motion ◽  
Long Term Follow Up

The aim of this retrospective study was to assess objective and subjective aspects of the long-term results of finger replantations and revascularisations. Forty patients with 59 successfully replanted or revascularised fingers, who had a mean age of 38 years, were followed-up over an average of 3.5 years. The assessment included: the profile of the blood flow in the digital arteries of replanted fingers with Doppler ultrasound, active range of motion, total grip strength, pinch grip, static two-point discrimination test and Semmes–Weinstein monofilament testing. The dexterity of the hand was evaluated subjectively with the Carlsson’s questionnaire and cold intolerance with a modified McCabe’s questionnaire. Statistical analysis was performed and a statistically significant correlation was found between the Carlsson’s functional score, active range of motion and total grip strength. In 28 fingers (74%), blood flow in the digital arteries showed an undisturbed profile, while ten fingers showed mild stenosis or impaired microcirculation.

Long-term outcomes after Instrumented Bone Preserving total elbow arthroplasty: a radiostereometric study with a minimum follow-up of 10 years

2020 ◽  
Vol 29 (1) ◽  
pp. 126-131
Author(s):  
Bart ten Brinke ◽  
Nienke M. Kosse ◽  
Petra E. Flikweert ◽  
Marco van der Pluijm ◽  
Denise Eygendaal
Keyword(s):  
Total Elbow Arthroplasty ◽  
Long Term Outcomes ◽  
Elbow Arthroplasty
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