The Cup-Cage Reconstruction for Pelvic Discontinuity has Encouraging Patient Satisfaction and Functional Outcome at Median 6-Year Follow-Up

2017 ◽  
Vol 27 (5) ◽  
pp. 509-513 ◽  
Author(s):  
Sujith Konan ◽  
Clive P. Duncan ◽  
Bassam A. Masri ◽  
Donald S. Garbuz
Keyword(s):  
Patient Satisfaction ◽  
Pain Relief ◽  
Functional Outcome ◽  
Womac Pain ◽  
Pelvic Discontinuity ◽  
Patient Reported ◽  
Excision Arthroplasty ◽  
Viable Method

Introduction The aim of this study was to review the clinical, radiological and patient-reported outcomes with the use of cup-cage construct for pelvic discontinuity at our institution. Methods 24 patients were identified at median 6-year (minimum 2 year, maximum 10 years) follow-up. 1 patient was converted to excision arthroplasty for infection. A further 3 patients required revision for instability but the cup-cage construct was not revised. Results We noted encouraging pain relief (mean WOMAC pain 85.6) and good functional outcome (mean WOMAC function 78.2, mean UCLA 5, mean OHS 78.6). Patient satisfaction with regards pain relief, function and return to recreational activities were noted to be good. Conclusions The cup-cage construct is a viable method of dealing with complex pelvic discontinuity. However, the failure rate due to loosening (4 cases) in this and other reports does prompt the need for further refinement of the technique and technology in this very challenging group of patients, as well as continued evaluation at the mid- and long-term so as to confirm the ongoing success of this method of reconstruction.

scholarly journals Ankle Arthroplasty

2018 ◽  
Vol 3 (3) ◽  
pp. 2473011418S0001
Author(s):  
Jack Allport ◽  
Adam Bennett ◽  
Jayasree Ramaskandhan ◽  
Malik Siddique
Keyword(s):  
Patient Satisfaction ◽  
Weight Bearing ◽  
Surgical Techniques ◽  
Womac Pain ◽  
Ankle Arthritis ◽  
Ankle Arthroplasty ◽  
Patient Reported ◽  
Equinus Deformity ◽  
Clinical Records

Category: Ankle Arthritis Introduction/Purpose: Total ankle arthroplasty (TAA) has been shown to be an effective treatment for end stage ankle arthritis. Achieving normal anatomical alignment has been shown to be important in long term outcomes and revision rates. Recent data from the British NJR has shown that revision rates are higher in patients with pre-operative fixed equinus. Although there is literature about surgical techniques to deal with pre-operative equinus we are not aware of any papers presenting patient outcomes. We present patient reported outcomes for our cohort of patients with pre-operative fixed equinus compared to those able to achieve a plantigrade ankle. Methods: This is a single surgeon, retrospective cohort study of consecutive cases. A mobile bearing prosthesis was used (Mobility TAA system, DePuy, Raynham, Massachusetts, USA). Cases were identified from a locally held joint registry which routinely records PROMS data pre-operatively and at annual intervals post-operatively. Patients undergoing primary TAA between March 2006 and June 2014 were included, revision procedures along with those with inadequate PROMS data were excluded. PROMS scores used were FAOS (WOMAC Pain, Function and Stiffness), SF-36 scores and patient satisfaction. All pre-operative lateral weight bearing xrays were reviewed to screen for potential fixed equinus deformity (tibia-sole angle >90 degrees). Clinical records were then reviewed to confirm clinical diagnosis of fixed equinus deformity. Results: 259 cases were identified, 95 cases were excluded based on our criteria leaving 164 cases for analysis (mean follow up 61.6 months). 144 were classified as neutral and 20 as fixed equinus. The fixed equinus group were significantly younger (neutral 64.2 vs equinus 53.9, p=0.0002), there was no difference in BMI or length of follow up. There was no difference in baseline scores except WOMAC stiffness, with the fixed equinus group significantly worse (36.9 vs 25.6, p=0.0014). Final PROMS score, change from baseline and patient satisfaction was the same in all domains for both groups. There was no difference in revision rates. Conclusion: A pre-operative fixed equinus deformity does not negatively impact on clinical outcomes in patients undergoing TAA. We are not aware of any previous studies to compare results. As expected the equinus group showed higher levels of stiffness pre-operatively. Contrary to the British NJR dataset we did not find a difference in revision rates.

scholarly journals Long-Term Sports Participation and Satisfaction After UCL Reconstruction in Amateur Baseball Players

2021 ◽  
Vol 9 (8) ◽  
pp. 232596712110275
Author(s):  
Robert A. Jack ◽  
Somnath Rao ◽  
Taylor D’Amore ◽  
Donald P. Willier ◽  
Robert Gallivan ◽  
...  
Keyword(s):  
Patient Satisfaction ◽  
Case Series ◽  
Sports Participation ◽  
High Rate ◽  
Return To Play ◽  
Baseball Players ◽  
Patient Reported ◽  
Rate Of Progression

Background: While the incidence of ulnar collateral ligament reconstruction (UCLR) has increased across all levels of play, few studies have investigated the long-term outcomes in nonprofessional athletes. Purpose: To determine the rate of progression to higher levels of play, long-term patient-reported outcomes (PROs), and long-term patient satisfaction in nonprofessional baseball players after UCLR. Study Design: Case series; Level of evidence, 4. Methods: We evaluated UCLR patients who were nonprofessional baseball athletes aged <25 years at a minimum of 5 years postoperatively. Patients were assessed with the Kerlan-Jobe Orthopaedic Clinic Shoulder and Elbow Score (KJOC), the Timmerman-Andrews (T-A) Elbow score, the Mayo Elbow Performance Score (MEPS), and a custom return-to-play questionnaire. Results: A total of 91 baseball players met the inclusion criteria, and 67 (74%) patients were available to complete the follow-up surveys at a mean follow-up of 8.9 years (range, 5.5-13.9 years). At the time of the surgery, the mean age was 18.9 ± 1.9 years (range, 15-24 years). Return to play at any level was achieved in 57 (85%) players at a mean time of 12.6 months. Twenty-two (32.8%) of the initial cohort returned to play at the professional level. Also, 43 (79.1%) patients who initially returned to play after surgery reported not playing baseball at the final follow-up; of those patients, 12 reported their elbow as the main reason for eventual retirement. The overall KJOC, MEPS, and T-A scores were 82.8 ± 18.5 (range, 36-100), 96.7 ± 6.7 (range, 75-100), and 91.9 ± 11.4 (range, 50-100), respectively . There was an overall satisfaction score of 90.6 ± 21.5 out of 100, and 64 (95.5%) patients reported that they would undergo UCLR again. Conclusion: In nonprofessional baseball players after UCLR, there was a high rate of progression to higher levels of play. Long-term PRO scores and patient satisfaction were high. The large majority of patients who underwent UCLR would undergo surgery again at long-term follow-up, regardless of career advancement.

scholarly journals Patient-Reported Outcomes and Satisfaction after Cervical Epidural Steroid Injection for Cervical Radiculopathy

2019 ◽  
Vol 8 ◽  
Author(s):  
Masoud Hashemi ◽  
Payman Dadkhah ◽  
Mehrdad Taheri ◽  
Mahshid Ghasemi ◽  
Ali Hosseinpoor ◽  
...  
Keyword(s):  
Patient Satisfaction ◽  
Pain Relief ◽  
Patient Reported Outcomes ◽  
Steroid Injection ◽  
Cervical Radiculopathy ◽  
Epidural Steroid Injection ◽  
Patient Reported ◽  
The Mean ◽  
Epidural Steroid

Background: Cervical radiculopathy caused by disc herniation is a frequent public health issue with economical and socio-professional impacts. The objective of the present study is to evaluate the patient-reported outcomes and satisfaction from cervical epidural steroid injection during a 2-year follow-up. Materials and Methods: Results based on patients’ reports from a previously performed intervention of cervical epidural steroid injection on patients with cervical radiculopathy due to cervical disc herniation are prospectively collected. Outcome measures are Neck Disability Index (NDI), numerical rating scale (NRS) for pain assessment, and 5-scale patient satisfaction questionnaire (PSQ) plus opioid medication for pain relief, additional injections, and progression to surgery. Results: Of total 37 cases, 34 were available for follow-up after 2-year postoperatively. The mean preoperative NDI was 21.17 and improved to 17.38, and the mean NRS was 7.7 and improved to 5.00; both were statistically significant. Mean patient satisfaction after 2 years was 3.17 out of 5. 11 cases needed additional injections, and 4 of patients proceeded to surgery. Conclusion: We showed that transforaminal cervical epidural steroid injection for cervical radiculopathy is an effective non-surgical treatment option, providing significant pain relief and functional improvement during 2-years follow-up along with higher-than-average patient satisfaction in most of our patients. [GMJ.2019;8:e1478]

Evaluation of Long-term Outcomes Following Plantar Fasciotomy

2018 ◽  
Vol 39 (11) ◽  
pp. 1312-1319 ◽  
Author(s):  
Rebekah Gibbons ◽  
Katherine E. Mackie ◽  
Todd Beveridge ◽  
Dana Hince ◽  
Peter Ammon
Keyword(s):  
Patient Satisfaction ◽  
Plantar Fasciitis ◽  
Satisfaction Score ◽  
Satisfaction Survey ◽  
Long Term Outcomes ◽  
Short Term ◽  
Patient Reported ◽  
Plantar Fasciotomy

Background: Plantar fasciitis is a common condition prevalent in both athletic and nonathletic populations. Approximately 10% of patients do not respond to conservative treatment and suffer chronic recalcitrant plantar fasciitis. Outcomes following plantar fasciotomy vary but short-term studies have reported excellent early pain relief and return to activity, and significant improvements in symptoms. Previous study limitations include small patient cohorts, short-term duration of follow-up or lack of validated outcome measures. We therefore aimed to investigate the long-term outcomes following complete plantar fasciotomy. Methods: Patients who underwent complete plantar fasciotomy surgery from a single surgeon within the past 10 years (minimum 7 months) were invited to participate in this retrospective survey study. To evaluate patient-reported function, participants were asked to complete the Foot and Ankle Outcome Score (FAOS). To assess subjective outcome, the participants were provided a satisfaction survey. The satisfaction survey was designed to include the 3 key factors for assessing postoperative patient satisfaction, which are preoperative expectations, symptom relief, and hospital experience. A total of 74 questionnaires were returned. Results: The median global satisfaction score was 85.4 (IQR=37.5) points out of 100. Significant correlations between the global patient satisfaction score and all FAOS subscale scores were identified. Only 3 participants (4%) reported a complication following surgery; however, 32 participants (44.4%) indicated that they still experienced swelling and/or tenderness in their foot at the time of the survey (mean follow-up time 4.8 ± 2.8 years) but for the majority of patients this was improved from before surgery. Conclusion: Long-term patient satisfaction was experienced by the majority of patients following plantar fasciotomy. Although 44% of patients continue to have postoperative complaints, 73% indicated that they were satisfied with their symptoms postoperatively, and 74% would undergo a similar procedure again. Level of Evidence: Level IV, case series.

scholarly journals Long-term patient satisfaction and durability of laparoscopic anti-reflux surgery in a large Danish cohort: study protocol for a retrospective cohort study with development of a novel scoring system for patient selection

BMJ Open ◽  
2020 ◽  
Vol 10 (3) ◽  
pp. e034257
Author(s):  
Jonas Sanberg Ljungdalh ◽  
Katrine Hass Rubin ◽  
Jesper Durup ◽  
Kim Christian Houlind
Keyword(s):  
Quality Of Life ◽  
Cohort Study ◽  
Patient Satisfaction ◽  
Retrospective Cohort Study ◽  
Reflux Disease ◽  
Retrospective Cohort ◽  
Patient Reported

IntroductionLaparoscopic anti-reflux surgery is standard of care in surgical treatment of gastro-oesophageal reflux disease and is not without risks of adverse effects, including disruption of the fundoplication and postfundoplication dysphagia, in some cases leading to reoperation. Non-surgical factors such as pre-existing anxiety or depression influence postoperative satisfaction and symptom relief. Previous studies have focused on a short-term follow-up or only certain aspects of disease, such as reoperation or postoperative quality of life. The aim of this study is to evaluate long-term patient-satisfaction and durability of laparoscopic anti-reflux surgery in a large Danish cohort using a comprehensive multimodal follow-up, and to develop a clinically applicable scoring system usable in selecting patients for anti-reflux surgery.Methods and analysisThe study is a retrospective cohort study utilising data from patient records and follow-up with patient-reported quality of life as well as registry-based data. The study population consists of all adult patients having undergone laparoscopic anti-reflux surgery at The Department of Surgery, Kolding Hospital, a part of Lillebaelt Hospital Denmark in an 11-year period. From electronic records; patient characteristics, preoperative endoscopic findings, reflux disease characteristics and details on type of surgery, will be identified. Disease-specific quality of life and dysphagia will be collected from a patient-reported follow-up. From Danish national registries, data on comorbidity, reoperative surgery, use of pharmacological anti-reflux treatment, mortality and socioeconomic factors will be included. Primary outcome of this study is treatment success at follow-up.Ethics and disseminationStudy approval has been obtained from The Danish Patient Safety Agency, The Danish Health Data Authority and Statistics Denmark, complying to Danish and EU legislation. Inclusion in the study will require informed consent from participating subjects. The results of the study will be published in peer-reviewed medical journals regardless of whether these are positive, negative or inconclusive.Trial registration numberClinicaltrials.gov (NCT03959020).

scholarly journals Long-Term Outcomes and Alignment following Isolated Fibular Sesamoidectomy

2019 ◽  
Vol 4 (4) ◽  
pp. 2473011419S0002
Author(s):  
Samuel E. Ford ◽  
Christopher R. Adair ◽  
Bruce E. Cohen ◽  
W. Hodges Davis ◽  
J. Kent Ellington ◽  
...  
Keyword(s):  
Pain Relief ◽  
Functional Outcome ◽  
Office Visit ◽  
Primary Outcome Measure ◽  
Phone Call ◽  
Administrative Database ◽  
Tertiary Referral Center ◽  
Flexion Strength

Category: Bunion, Midfoot/Forefoot, Sesamoid Introduction/Purpose: Potential etiologies of sesamoid related pain include repetitive stresses, fracture, cartilage lesions, arthrosis, and/or osteonecrosis. When patients fail to respond to conservative treatment, surgical intervention may be indicated in the form of sesamoid bone grafting, shaving/debridement, and/or sesamoid excision. Minimal published literature exists regarding the long-term safety and efficacy of fibular sesamoidectomy. The purpose of this study was to evaluate patients following isolated, complete fibular sesamoidectomy for long-term pain relief, functional outcome, and changes in hallux alignment. Methods: A query of a tertiary referral center administrative database was performed using the CPT code 28135 for sesamoidectomy between 10/1/2005 and 9/1/2016. Patients who underwent an isolated fibular sesamoidectomy were identified and contacted by their treating physicians with a recruitment letter, phone call, or e-mail to return for an office visit. The primary outcome measure was preoperative to final postoperative change in ten-point visual analog scale pain score. Secondary measures included satisfaction, hallux flexion strength, change in hallux alignment, and final post-operative functional outcome scores. Patients who met the 2-year clinical or radiographic follow-up minimum were included. Patients who underwent concomitant joint realignment procedures or had a medical history of either diabetes or peripheral neuropathy were excluded. Results: Ninety-three fibular sesamoidectomies were identified. Thirty-six sesamoidectomies (35 patients) met inclusion criteria (median follow-up 60 months). The average patient was 36-years-old with a BMI of 24.7 kg/m2 and underwent sesamoidectomy a mean 1.1 years after initial diagnosis. Median VAS scores improved 5 (6 to 1) points at final follow-up (p<0.0001). Final post- operative hallux valgus angle (HVA) did not differ from pre-operative values (10.5°/8.5°, p=0.12); similarly, intermetatarsal angle (IMA) did not differ (8.0°/7.9°, p=0.53). 88% of patients would have surgery again and 70% were “very satisfied” with their result. Hallux flexion strength (mean 14.7 pounds) did not differ following sesamoidectomy relative to the contralateral foot (mean 16.1 pounds) (p=0.23). Among the full 93 case cohort, 3 patients underwent 4 known reoperations. Conclusion: Fibular sesamoidectomy effectively provides long-term pain relief for patients with sesamoiditis, fracture, nonunion, osteonecrosis, and arthritis at long-term follow-up (median 5 years). Potential long-term sequelae, including hallux flexion weakness, change in hallux alignment, and deterioration of patient satisfaction/function were not encountered.

Ultrasonic Percutaneous Tenotomy for Recalcitrant Lateral Elbow Tendinopathy: Clinical and Sonographic Results at 90 Months

2021 ◽  
pp. 036354652110101
Author(s):  
Benjamin F.H. Ang ◽  
P. Chandra Mohan ◽  
Meng Ai Png ◽  
John Carson Allen ◽  
Tet Sen Howe ◽  
...  
Keyword(s):  
Pain Relief ◽  
Extensor Tendon ◽  
Tissue Healing ◽  
Lateral Elbow ◽  
Percutaneous Tenotomy ◽  
Vas Scores ◽  
The Common ◽  
Lateral Elbow Tendinopathy

Background: In a study from our institution, ultrasonic percutaneous tenotomy of the brevis and the common extensor tendon for recalcitrant lateral elbow tendinopathy showed excellent safety profiles, high tolerability, efficiency, sustained pain relief, functional improvement, and sonographic evidence of tissue healing in 20 patients at 3 years’ follow-up. Purpose: To explore the long-term clinical and sonographic results of ultrasonic percutaneous tenotomy of the brevis and the common extensor tendon. Study Design: Case series; Level of evidence, 4. Methods: The same cohort of 20 patients was recalled after 7 years, and visual analog scale (VAS) for pain and Disabilities of the Arm, Shoulder and Hand (DASH) scores, need for secondary intervention, and overall satisfaction were assessed. They were also reassessed using ultrasound imaging of the brevis and the common extensor tendon to evaluate tendon hypervascularity, tendon thickness, and the progress or the recurrence of the hypoechoic scar tissue. Results: We successfully scored 19 patients and performed ultrasound on 16 patients with a median follow-up of 90 months (range, 86-102 months). There were no adverse outcomes and satisfaction remained at 100% (6 patients, satisfied; 13 patients, very satisfied). No patient developed a recurrence of symptoms and signs of lateral elbow tendinopathy, and therefore no secondary intervention was required. The improvement from baseline and early term scores was sustained ( P < .001 for all). At 90 months, there was a significant improvement in VAS scores and DASH–Compulsory scores compared with preprocedure scores and all follow-up times until 3 months. There was no difference in VAS scores and DASH–Compulsory scores at 90 months compared with 6 and 36 months. For DASH–Work scores, there was a significant improvement at 90 months compared with preprocedure scores, but there was no difference between DASH–Work scores at 90 months and scores at all other points of follow-up. At 90 months, hypervascularity remained resolved in 79% of patients, while all patients had reduced tendon swelling and sustained resolution or reduction of the hypoechoic lesion. Conclusion: At the long-term follow-up of 90 months, ultrasonic percutaneous tenotomy of the brevis and the common extensor tendon, previously shown to enhance recovery of lateral elbow tendinopathy, demonstrated good durability of pain relief and functional recovery that was previously achieved. This was accompanied by sustained sonographic tissue healing with no significant deterioration.

scholarly journals Hybrid treatment of fibroadipose vascular anomaly: A case report

Open Medicine ◽  
2020 ◽  
Vol 15 (1) ◽  
pp. 890-897
Author(s):  
Francesco Stillo ◽  
Federica Ruggiero ◽  
Antonio De Fiores ◽  
Rita Compagna ◽  
Bruno Amato
Keyword(s):  
Patient Satisfaction ◽  
Vascular Anomaly ◽  
Rare Type ◽  
Complete Excision ◽  
Hybrid Treatment ◽  
Constant Pain ◽  
Additional Surgery ◽  
Ethanol Embolization

AbstractBackgroundFirst identified in 2014, fibroadipose vascular anomaly (FAVA) is a very rare type of venous and lymphatic malformation. Marked by tough fibrofatty tissue in the extremities overtaking portions of the muscles, it is associated with constant pain and contracture of the affected extremity. There is a paucity of literature, and no guidelines on treatment procedure are available. This case highlights the role of hybrid treatment with primary ethanol percutaneous ethanol embolization and additional surgery for radicality in excision of FAVA lesions.Case summaryA 9-year-old girl with FAVA underwent the hybrid treatment. The achievements of complete excision, clinical response, and patient satisfaction in long-term follow-up were assessed. Following the hybrid treatment, the patient experienced significant improvement in pain. Concurrent symptoms of physical limitation, leg swelling, and skin hyperesthesia also improved. The clinical benefit, supported by postoperative physiotherapy, was well stabilized at 6-month follow-up, resulting in complete patient satisfaction at 12- and 36-month follow-ups. No major complications were encountered.ConclusionEthanol embolization plus surgery is a safe, effective, and long-term hybrid treatment of symptomatic FAVA lesions.

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