Comparison of Clinical Efficacy Among Endoscopy-Assisted Radio-Frequency Ablation, Extracorporeal Shockwaves, and Eccentric Exercises in Treatment of Insertional Achilles Tendinosis

2017 ◽  
Vol 107 (1) ◽  
pp. 11-16 ◽  
Author(s):  
Min Wei ◽  
Yujie Liu ◽  
Zhongli Li ◽  
Zhigang Wang
Keyword(s):  
Retrospective Study ◽  
Radio Frequency ◽  
Clinical Efficacy ◽  
Radio Frequency Ablation ◽  
Foot And Ankle ◽  
Analog Scale ◽  
Achilles Tendinosis ◽  
Scale Scores ◽  
Before And After ◽  
American Orthopaedic

Background: We sought to compare clinical efficacy among endoscopy-assisted radio-frequency ablation under local anesthesia, extracorporeal shockwaves (ESWs), and eccentric exercises in treating insertional Achilles tendinosis. Methods: In this retrospective study, 78 patients diagnosed as having unilateral insertional Achilles tendinosis were enrolled. These participants underwent endoscopy-assisted radio-frequency ablation, ESWs, and eccentric calf muscle exercises between March 1, 2006, and February 28, 2011. Clinical efficacy was evaluated by the visual analog scale (VAS), the American Orthopaedic Foot and Ankle Society (AOFAS) ankle/hindfoot scale, and the Victorian Institute of Sport Assessment–Achilles (VISA-A) scale before and after treatment. Results: Before treatment, there were no statistically significant differences in VAS, AOFAS ankle/hindfoot scale, and VISA-A scale scores among the different groups (all P > .05). For the endoscopy and ESW groups, VAS, AOFAS ankle/hindfoot scale, and VISA-A scale scores were significantly improved after 18 months of treatment (all P < .05). The VAS, AOFAS ankle/hindfoot scale, and VISA-A scale scores in the endoscopy group were significantly higher than those in the ESW and eccentric exercise groups after 18 months of therapy (all P < .05). Conclusions: Combined with synovectomy and tendon debridement, endoscopy-assisted radio-frequency ablation yields better clinical efficacy compared with ESWs in treating insertional Achilles tendinosis.

scholarly journals Hállux Rígidus: estudo prospectivo da substituição articular com hemiartroplastia

2013 ◽  
Vol 21 (2) ◽  
pp. 71-75 ◽  
Author(s):  
Alexandre Leme Godoy dos Santos ◽  
Fernando Aires Duarte ◽  
Carlos Augusto Itiu Seito ◽  
Rafael Trevisan Ortiz ◽  
Marcos Hideyo Sakaki ◽  
...  
Keyword(s):  
Visual Analog Scale ◽  
Hallux Rigidus ◽  
Foot And Ankle ◽  
Analog Scale ◽  
American Orthopaedic

OBJETIVO: Relatar os resultados com médio prazo de seguimento após a implantação de Arthrosurface-HemiCap® em pacientes com diagnóstico de hállux rígidus (HR). MÉTODO: Onze pacientes foram submetidos à artroplastia parcial da primeira metatarso-falangeana. Seis mulheres e cinco homens com idade média de 51,9 anos (46 a 58 anos) e média de seguimento pós-operatório de 3,73 anos (3-4 anos); foram classificados através do sistema de Kravitz e avaliados pelas escalas da american orthopaedic foot and ankle society (AOFAS) para hállux, visual analog scale (VAS) - analógico funcional de dor - e pela amplitude de movimento da primeira articulação metatarsofalangeana no periodo pré-operatório, pós-operatório de seis meses e pós-operatório atual. RESULTADOS: Os resultados revelam melhora significativa dos três parâmetros analisados no estudo, tanto para análise global como para comparações pré e pós-operatórias individuais. A análise comparativa de cada variável nos períodos pós-operatórios de seis meses e atual não mostram diferença estatística o que indica manutenção dos parâmetros durante esse intervalo. CONCLUSÃO: A hemiartroplastia da primeira metatarsofalangeana é opção reprodutível e segura para o tratamento cirúrgico do hállux rígidus II e III, com significativa melhora dos parâmetros avaliados para a população estudada. Nível de Evidência IV, Série de casos.

scholarly journals Comparison of Midfoot and Metatarsal Dorsal Wedge Osteotomy to Treat Cavovarus Foot Deformity in Adolescents

2018 ◽  
Vol 3 (3) ◽  
pp. 2473011418S0024
Author(s):  
Jinsong Hong
Keyword(s):  
Retrospective Study ◽  
Analogue Scale ◽  
Early Stage ◽  
Wedge Osteotomy ◽  
Foot And Ankle ◽  
Foot Deformity ◽  
Significant Difference ◽  
Spss Software ◽  
American Orthopaedic

Category: Midfoot/Forefoot Introduction/Purpose: To compare the clinical result of midfoot and metatarsal dorsal wedge osteotomy for the treatment of cavovarus foot deformity in adolescents. Methods: A comparative retrospective study of 24 patients with cavovarus foot deformity in adolescents was conducted between March 2012 and March 2015 in the Guangzhou Orthopaedic Hospital. All patients were flexible deformity. 10 patients were treated with midfoot dorsal wedge osteotomy, while 14 patients received metatarsal dorsal wedge osteotomy. The clinical curative effects, complications and image differences were compared between the two groups. American Orthopaedic Foot and Ankle Society (AOFAS) hindfoot score and Visual Analogue Scale (VAS) score were evaluated for each patient during the follow-up. All statistics were analyzed using the SPSS software system. Results: No early stage soft tissue complications occurred in all patients. All the patients obtained an average 21.5 months (ranged,10-30 months) follow-up.X-ray demonstrated that bone healing was obtained, the midfoot dorsal wedge osteotomy group at an average of 11.2 weeks (ranged,10-13 weeks). the metatarsal dorsal wedge osteotomy group at an average of 13.4 weeks (ranged,12-15 weeks). By AOFAS foot score and VAS pain score: There is no significant difference between the two groups (P=0.138). No complications of nonunion, recurrence of de-fortuity or implant failure were seen during follow-up. Conclusion: The midfoot and metatarsal dorsal wedge osteotomy are the effective methods for the treatment of cavovarus foot deformity in adolescents. For severe deformity midfoot metatarsal dorsal wedge osteotomy can provide more powerful correction.

Cheilectomy as a First-Line Surgical Treatment Option Yields Good Functional Results in Grade III Hallux Rigidus

2016 ◽  
Vol 106 (1) ◽  
pp. 22-26 ◽  
Author(s):  
Engin Cetinkaya ◽  
Merter Yalcinkaya ◽  
Sami Sokucu ◽  
Abdulkadir Polat ◽  
Ufuk Ozkaya ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Visual Analog Scale ◽  
Functional Results ◽  
Hallux Rigidus ◽  
Wilcoxon Test ◽  
Foot And Ankle ◽  
First Line ◽  
Analog Scale ◽  
American Orthopaedic ◽  
Grade Iii

Background: This study aimed to analyze the functional results of cheilectomy in the surgical treatment of grade III hallux rigidus and to evaluate whether cheilectomy is a preferable first-line treatment over other surgical methods. Methods: Of 29 patients with moderate daily physical activity who underwent cheilectomy between 2009 and 2012 on being diagnosed as having grade III hallux rigidus according to the Coughlin-Shurnas grading system, 21 patients (14 women and 7 men; mean age, 59.2 years; age range, 52–67 years) (22 feet) with regular follow-up and complete medical records were included in the study. The patients were evaluated in the preoperative and postoperative periods using a visual analog scale for pain and the American Orthopaedic Foot and Ankle Society metatarsophalangeal assessment forms. Results: The preoperative mean American Orthopaedic Foot and Ankle Society score of 53 (range, 29–67) improved to 78 (range, 57–92) postoperatively (Wilcoxon test P = .001). The preoperative mean visual analog scale score of 89 (range, 60–100) improved to 29 (range, 0–70) in the postoperative period (Wilcoxon test P = .001). Conclusions: As a simple and repeatable procedure that allows for further joint-sacrificing surgical procedures when required, cheilectomy is a preferable method to be applied as a first-line option for the surgical treatment of grade III hallux rigidus.

Treatment of Bone Marrow Edema of the Talus with Pulsed Electromagnetic Fields

2015 ◽  
Vol 105 (1) ◽  
pp. 27-32 ◽  
Author(s):  
Nicolò Martinelli ◽  
Alberto Bianchi ◽  
Elena Sartorelli ◽  
Alessandra Dondi ◽  
Carlo Bonifacini ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Bone Marrow Edema ◽  
Foot And Ankle ◽  
Resonance Imaging ◽  
Analog Scale ◽  
Pulsed Electromagnetic ◽  
American Orthopaedic ◽  
Marrow Edema

Background Bone marrow edema (BME) of the talus is a rare, mostly self-limiting cause of foot and ankle pain. We sought to investigate in patients with idiopathic BME of the talus the effectiveness of pulsed electromagnetic fields and to determine the effect of this therapy on magnetic resonance imaging findings. Methods Six patients with BME of the talus confirmed by magnetic resonance imaging were enrolled. Pain was quantified with a visual analog scale from 0 (no pain) to 10 (the worst pain imaginable). The clinical outcome was assessed using the American Orthopaedic Foot and Ankle Society scoring system. Treatment consisted of pulsed electromagnetic field stimulation 8 h/d for 30 days. The device used generated pulses 1.3 milliseconds in duration, with a frequency of 75 Hz and a mean ± SD induced electric field of 3.5 ± 0.5 mV. Results The mean American Orthopaedic Foot and Ankle Society score improved from 59.4 (range, 40–66) before treatment to 94 (range, 80–100) at the last follow-up. The visual analog scale score decreased significantly from 5.6 (range, 4–7) before treatment to 1 (range, 0–2) at the last follow-up. Magnetic resonance imaging showed that BME improved after 1 month of treatment and resolved completely within 3 months in 5 patients, with normal signal intensity and no signs of progression to avascular necrosis. Conclusions A significant reduction in BME area was associated with a significant decrease in pain within 3 months of beginning treatment.

Arthroscopic Treatment of Osteochondral Lesions of the Talus in a Pediatric Population: A Minimum 2-Year Follow-up

2020 ◽  
Vol 48 (8) ◽  
pp. 1989-1998
Author(s):  
Michael J. Carlson ◽  
Tomasz T. Antkowiak ◽  
Nicholas J. Larsen ◽  
Gregory R. Applegate ◽  
Richard D. Ferkel
Keyword(s):  
Patient Satisfaction ◽  
Short Form ◽  
Arthroscopic Treatment ◽  
Osteochondral Lesions ◽  
Study Group ◽  
Foot And Ankle ◽  
Analog Scale ◽  
Foot Function ◽  
American Orthopaedic

Background: Treatment of osteochondral lesions of the talus (OLTs) in children presents a difficult clinical challenge, with few large series reported. Purpose: To evaluate functional and radiographic outcomes for children and adolescents undergoing arthroscopic treatment of symptomatic OLT with a minimum follow-up of 2 years. Study Design: Case series; Level of evidence, 4. Methods: Patients were identified who had symptomatic OLT treated arthroscopically with marrow stimulation techniques. Inclusion criteria were age ≤18 years, symptomatic chronic OLT as the surgical indication, failure of nonoperative treatment, and minimum follow-up of 24 months. Outcome measures included Foot Function Index, American Orthopaedic Foot and Ankle Society Hindfoot Score, Tegner Activity Scale, 36-Item Short Form Health Survey (Short Form-36, v 2), visual analog scale, ankle range of motion, and patient satisfaction survey. Weightbearing radiographs were compared with preoperative radiographs via an ankle arthritis classification system. Magnetic resonance imaging (MRI) was used to evaluate postoperative lesion characteristics per the MOCART scale (magnetic resonance observation of cartilage repair tissue). The size, location, lesion stability, traumatic etiology, skeletal maturity, and length of follow-up were recorded and analyzed through univariate logistic regression. Results: The study group consisted of 22 patients (11 male, 11 female) with a mean age of 14.4 years (range, 8-18 years) and a mean follow-up of 8.3 years (range, 2-27 years). Of 22 patients, 20 were satisfied with the results from surgery and would recommend it to others. Mean follow-up visual analog scale for pain was reported as 2.2 on a 10-point scale, and mean American Orthopaedic Foot and Ankle Society score at follow-up was 86.6. Mean postoperative Foot Function Index scores for the study group were as follows: pain, 17.1; disability, 16.5; activity, 4.7; and overall, 38.7. Mean Short Form-36 physical component score was 50.7. Postoperative radiographs indicated a van Dijk osteoarthritis grade of 0 in 56%, I in 38%, II in 6%, and III in 0%. Postoperative MRI MOCART scores showed complete filling of the cartilage in 27% of cases, complete graft integration in 22%, and intact repair surface in 22%, with a mean MOCART score of 48.0. No correlation was found between radiographic and MRI findings and clinical outcomes. None of the prognostic factors were significantly associated with patient satisfaction, progression of arthritis, or MOCART scores. Conclusion: Arthroscopic treatment of symptomatic OLT in adolescent patients (≤18 years) demonstrated high functional outcomes, high clinical satisfaction rates, and minimal radiographic osteoarthritic progression despite low MOCART scores.

Incidence of asymptomatic atrial arrhythmia following the modified Fontan procedure before and after radio-frequency ablation

Heart Rhythm ◽  
2005 ◽  
Vol 2 (5) ◽  
pp. S290
Author(s):  
Dominic J. Abrams ◽  
Mark J. Earley ◽  
Simon C. Sporton ◽  
Michael A. Gatzoulis ◽  
Michael J. Mullen ◽  
...  
Keyword(s):  
Radio Frequency ◽  
Fontan Procedure ◽  
Radio Frequency Ablation ◽  
Atrial Arrhythmia ◽  
Before And After

Platelet-Rich Plasma Versus Corticosteroids for the Treatment of Plantar Fasciitis: A Systematic Review and Meta-analysis

2020 ◽  
pp. 036354652093729
Author(s):  
Erik Hohmann ◽  
Kevin Tetsworth ◽  
Vaida Glatt
Keyword(s):  
Systematic Review ◽  
High Risk ◽  
Plantar Fasciitis ◽  
Platelet Rich Plasma ◽  
Meta Analysis ◽  
Risk Of Bias ◽  
Foot And Ankle ◽  
Analog Scale ◽  
American Orthopaedic ◽  
Corticosteroid Injections

Background: Plantar fasciitis is a common cause of heel pain. Corticosteroid injections are commonly used and proven to be effective, and lately platelet-rich plasma (PRP) has been used with mixed results. Purpose: To perform a systematic review and meta-analysis comparing intralesional injections of PRP and steroid infiltration. Study Design: Systematic review and meta-analysis. Methods: A systematic review of Medline, Embase, Scopus, and Google Scholar including all level 1 and 2 studies from 2010 to 2019 was perfomed. American Orthopaedic Foot and Ankle Society and visual analog scale for pain scores were used as outcome variables. Publication bias and risk of bias was assessed with the Cochrane Collaboration tools. The Grading of Recommendations, Assessment, Development and Evaluations system was used to assess the quality of the body of evidence. Heterogeneity was assessed with χ2 and I2 statistics. Results: Fifteen studies were included in the analysis. Nine studies had a high risk of bias. There was 1 study with high quality, 9 with moderate, 2 studies with low, and 3 with very low quality. The pooled estimate for the American Orthopaedic Foot and Ankle Society score demonstrated nonsignificant differences at 1 month ( P = .4) and 3 months ( P = .076). At 6 months ( P = .009) and 12 months ( P = .009), it indicated significant differences in favor of PRP. The pooled estimate for visual analog scale demonstrated nonsignificant differences at 1 month ( P = .653). At 3 months ( P = .0001), 6 months ( P = .002), and 12 months ( P = .019), it yielded significant differences in favor of PRP. Conclusion: The results of this systematic review and meta-analysis suggest that PRP is superior to corticosteroid injections for pain control at 3 months and lasts up to 1 year. In the short term, there is no advantage of corticosteroid infiltration. However, the low study quality, high risk of bias, and different protocols for PRP preparation reduce the internal and external validity of these findings, and these results must be viewed with caution.

Percutaneous CT-guided radio-frequency ablation of osteoid osteoma of the foot and ankle

2012 ◽  
Vol 132 (12) ◽  
pp. 1707-1710 ◽  
Author(s):  
Kiriakos Daniilidis ◽  
N. Martinelli ◽  
G. Gosheger ◽  
S. Hoell ◽  
M. Henrichs ◽  
...  
Keyword(s):  
Radio Frequency ◽  
Osteoid Osteoma ◽  
Radio Frequency Ablation ◽  
Foot And Ankle ◽  
Ct Guided

scholarly journals The Efficacy of Strokectomy in the Treatment of Malignant Cerebral Infarction Patients

2021 ◽  
Author(s):  
Ning Li ◽  
Chunmei He ◽  
Wei Li ◽  
Liu Zhang ◽  
Yehai Li ◽  
...  
Keyword(s):  
Retrospective Study ◽  
Cerebral Infarction ◽  
Functional Outcomes ◽  
Midline Shift ◽  
Decompressive Hemicraniectomy ◽  
Beneficial Effects ◽  
Post Surgery ◽  
Scale Scores ◽  
Before And After ◽  
Poor Outcomes

Abstract IntroductionStrokectomy refers to the resection of infarct brain tissue. Used alone, in combination with decompressive hemicraniectomy (DHC), or as a remedial surgery to DHC for malignant cerebral infarction (MCI) patients, strokectomy has reduced mortality rates and improved functional outcomes of patients with MCI. However, the role of strokectomy in the treatment of MCI patients is controversial. The aim of this retrospective study was to investigate the efficacy of strokectomy in MCI treatment in order to explore its beneficial effects on improving patient outcomes.MethodsThis retrospective study was carried out between January 2017 and September 2019 in the First Affiliated Hospital of Jinan University and Guangdong 999 Brain Hospital in Guangzhou, China. We reviewed patients with MCI who underwent DHC with or without strokectomy. We collected and analyzed the following data for all patients: demographics, Glasgow Coma Scale scores (GCS), National Institutes of Health Stroke Scale (NIHSS) scores, observational data in the intensive care unit (ICU), post-surgery intracranial pressure (ICP) monitoring, midline shift before and after surgery, and functional outcomes measured with the modified Rankin Scale (mRS) at 6 months.ResultsWe recruited 95 patients (53 men; mean age, 59.71 ± 10.65 years; age range, 38 - 78 years). After surgery, patients who received DHC and strokectomy were associated with a lower ICP curve; decreased midline shift; and less mannitol, hypothermia, and hypertonic saline therapies than those who received DHC alone. No patient in the DHC+strokectomy group had malignant high ICP or needed remedial surgery; in contrast, 16 patients in the DHC group had malignant high ICP after DHC, and remedial surgery was recommended. Five patients received remedial surgery and survived, while the 11 who refused remedial surgery died. The mortality rate during ICU stay was 19.4% in the DHC group and 7.1% in the DHC+strokectomy group. While the rate of poor outcomes and mortality was significantly different between the two groups at 6 months after surgery, good outcomes did not differ significantly.Conclusions Strokectomy performed in combination with DHC can effectively decrease post-surgery ICP, reduce midline shift, and reduce mortality during the six months following surgery. Moreover, strokectomy performed as a remedial surgery could decrease malignant high ICP after DHC and reduce mortality.

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