Pub Date : 2022-05-17DOI: 10.1177/22104917221085725
Calvin Tsoi, Y. Wong
A successful Total knee arthroplasty (TKA) procedure requires restoration of mechanical axis and soft tissue balancing. Deformity of tibia and femur occurs with history of trauma or osteotomy, infection, metabolic bone disease and excessive bowing. Tackling pre-existing extra-articular deformity of lower limbs during total knee arthroplasty can be challenging due to difficulty in restoring alignment axis and soft tissue balancing. We have recorded 6 patients underwent total knee arthroplasty with preexisting extra-articular femoral deformity by intra-articular correction from 1995 to 2017. All patients had extra-articular deformity of the femur due to fracture malunion which were treated either conservatively, plating or intra-medullary nail. Coronal deformity is corrected from an average of 15.5 degrees to 4.6 degrees from neutral axis. Sagittal deformity is corrected from average of 6.8 degrees to 3.6 degrees. One patient developed progressive genu recurvatum at 7 years follow-up with range of motion at 25 degrees extension and 110 degrees flexion. The average pre-operative Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) score was 68.5 (range 51−87) decreased to 50.7 (range 21–71) at 12 months post-operative and Knee score averaged 53.3 (range 51–55) increased to an average of 88.5 (range 82–94). There was only one revision for aseptic loosening 16 years after total knee replacement (TKR) and no other cases of radiological sign of aseptic loosening. In conclusion, Intra-articular correction of an extra articular femoral deformity for TKR is an attractive approach in mild to moderate deformity further from the knee joint.
{"title":"Knee osteoarthrosis with extra-articular femoral deformity treated with total knee arthroplasty: A case series","authors":"Calvin Tsoi, Y. Wong","doi":"10.1177/22104917221085725","DOIUrl":"https://doi.org/10.1177/22104917221085725","url":null,"abstract":"A successful Total knee arthroplasty (TKA) procedure requires restoration of mechanical axis and soft tissue balancing. Deformity of tibia and femur occurs with history of trauma or osteotomy, infection, metabolic bone disease and excessive bowing. Tackling pre-existing extra-articular deformity of lower limbs during total knee arthroplasty can be challenging due to difficulty in restoring alignment axis and soft tissue balancing. We have recorded 6 patients underwent total knee arthroplasty with preexisting extra-articular femoral deformity by intra-articular correction from 1995 to 2017. All patients had extra-articular deformity of the femur due to fracture malunion which were treated either conservatively, plating or intra-medullary nail. Coronal deformity is corrected from an average of 15.5 degrees to 4.6 degrees from neutral axis. Sagittal deformity is corrected from average of 6.8 degrees to 3.6 degrees. One patient developed progressive genu recurvatum at 7 years follow-up with range of motion at 25 degrees extension and 110 degrees flexion. The average pre-operative Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) score was 68.5 (range 51−87) decreased to 50.7 (range 21–71) at 12 months post-operative and Knee score averaged 53.3 (range 51–55) increased to an average of 88.5 (range 82–94). There was only one revision for aseptic loosening 16 years after total knee replacement (TKR) and no other cases of radiological sign of aseptic loosening. In conclusion, Intra-articular correction of an extra articular femoral deformity for TKR is an attractive approach in mild to moderate deformity further from the knee joint.","PeriodicalId":42408,"journal":{"name":"Journal of Orthopaedics Trauma and Rehabilitation","volume":"27 1","pages":""},"PeriodicalIF":0.3,"publicationDate":"2022-05-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"82793629","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-05-16DOI: 10.1177/22104917221101407
Vivek Kumar, Ashish Rustagi, Jatin Talwar, Rajat Yadav, L. Krishna
Background: Wide resection of the tumor is essential for the treatment of Campanacci grade III giant cell tumor of the distal ulna but radioulnar convergence and dorsal displacement of the ulnar stump are known complications. Various reconstructive options to reduce these complications have been described in the literature. Methods: Seven patients with Campanacci grade III giant cell tumor distal end of the ulna were treated at our institute by extra-periosteal wide local excision of the tumor followed by reconstruction of the distal radioulnar joint by fixation of tricortical iliac crest graft to the distal end radius using two cancellous screws and extensor carpi ulnaris (ECU) tenodesis for stabilizing the residual ulnar stump. All patients were followed up for an average period of 3.5 years (32–48 months) at regular intervals. Functional outcome and complications if any, were recorded at every follow-up. Results: At final follow-up, the mean range of motion of wrist with 42.1° ± 5.9° of flexion, 72.9° ± 6.4° of extension, 82.1° ± 8.1° of supination and 85.0° ± 5.8° of pronation was achieved. The mean visual analog scale score at the final follow-up was 0.9 ± 0.9. The mean modified Mayo wrist score was 71.4 ± 6.4 with a mean modified Musculoskeletal Tumor Society score of 25.9 ± 0.8 and a mean Disability of Arm, Shoulder, and Hand score of 17.9 ± 1.6 at the final follow-up. The average time for the radiological union of iliac crest graft with the distal end radius was 13.3 weeks. None of the patient reported any complication or recurrence. Conclusion: The reconstruction of distal radioulnar joint by fixation of tricortical iliac crest graft with distal end radius and stabilization of ulnar stump by extensor capi ulnaris tenodesis after the wide resection of distal ulna giant cell tumor is recommended for good to excellent functional outcomes.
{"title":"Clinical and functional outcomes of reconstruction following en bloc resection for the Campanacci grade III distal ulnar giant cell tumors","authors":"Vivek Kumar, Ashish Rustagi, Jatin Talwar, Rajat Yadav, L. Krishna","doi":"10.1177/22104917221101407","DOIUrl":"https://doi.org/10.1177/22104917221101407","url":null,"abstract":"Background: Wide resection of the tumor is essential for the treatment of Campanacci grade III giant cell tumor of the distal ulna but radioulnar convergence and dorsal displacement of the ulnar stump are known complications. Various reconstructive options to reduce these complications have been described in the literature. Methods: Seven patients with Campanacci grade III giant cell tumor distal end of the ulna were treated at our institute by extra-periosteal wide local excision of the tumor followed by reconstruction of the distal radioulnar joint by fixation of tricortical iliac crest graft to the distal end radius using two cancellous screws and extensor carpi ulnaris (ECU) tenodesis for stabilizing the residual ulnar stump. All patients were followed up for an average period of 3.5 years (32–48 months) at regular intervals. Functional outcome and complications if any, were recorded at every follow-up. Results: At final follow-up, the mean range of motion of wrist with 42.1° ± 5.9° of flexion, 72.9° ± 6.4° of extension, 82.1° ± 8.1° of supination and 85.0° ± 5.8° of pronation was achieved. The mean visual analog scale score at the final follow-up was 0.9 ± 0.9. The mean modified Mayo wrist score was 71.4 ± 6.4 with a mean modified Musculoskeletal Tumor Society score of 25.9 ± 0.8 and a mean Disability of Arm, Shoulder, and Hand score of 17.9 ± 1.6 at the final follow-up. The average time for the radiological union of iliac crest graft with the distal end radius was 13.3 weeks. None of the patient reported any complication or recurrence. Conclusion: The reconstruction of distal radioulnar joint by fixation of tricortical iliac crest graft with distal end radius and stabilization of ulnar stump by extensor capi ulnaris tenodesis after the wide resection of distal ulna giant cell tumor is recommended for good to excellent functional outcomes.","PeriodicalId":42408,"journal":{"name":"Journal of Orthopaedics Trauma and Rehabilitation","volume":"10 1","pages":""},"PeriodicalIF":0.3,"publicationDate":"2022-05-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"73196815","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-05-12DOI: 10.1177/22104917221095256
Raagavi Dwarakanathan, Dr. Rajesh Kumar Mohanty, Swapnasarit Sahoo, Sakti Prasad
Background Medial knee osteoarthritis can contribute to pain and stiffness, interfere with balance and limit functional activities of daily living. Unloader knee orthosis or lateral wedged insoles are current conservative approaches used to treat these conditions. The aim of this study was to identify and compare the effects of them on the balance parameters. Methods 66 subjects with mild to moderate medial knee osteoarthritis were randomly assigned to wear unloader knee brace or full-length 6° lateral wedge insole. Primary outcome balance parameters were stability %, path length and average velocity of center of pressure and mobility score which were investigated by HUMAC® Balance and Tilt system. Secondary outcome measures were knee function score using Knee Injury and Osteoarthritis Outcome Score scale. Assessment was performed at baseline and six months post orthotic intervention period. Findings Both orthoses improved all parameters compared to the baseline condition (p < 0.05). Unloader knee orthosis showed a significant improvement in all balance parameters compared to lateral wedged insoles (p < 0.001) except mobility scores (p = 0.527). Except activities of daily living (p = 0.752) and sports and recreational activities (p = 0.437), unloader knee orthosis had a greater effect on the pain (p = 0.002) and symptoms (p < 0.001) sub scales than lateral wedged insoles. However, quality of life sub-scale scores for insoles were more effective than the knee orthosis. Interpretation Unloader knee orthosis improved balance and knee function scores more than lateral wedged insole, though both orthoses produced significantly improved results compared to baseline assessment.
{"title":"Efficacy of unloader knee orthosis and lateral wedge insole on static balance in medial knee osteoarthritis","authors":"Raagavi Dwarakanathan, Dr. Rajesh Kumar Mohanty, Swapnasarit Sahoo, Sakti Prasad","doi":"10.1177/22104917221095256","DOIUrl":"https://doi.org/10.1177/22104917221095256","url":null,"abstract":"Background Medial knee osteoarthritis can contribute to pain and stiffness, interfere with balance and limit functional activities of daily living. Unloader knee orthosis or lateral wedged insoles are current conservative approaches used to treat these conditions. The aim of this study was to identify and compare the effects of them on the balance parameters. Methods 66 subjects with mild to moderate medial knee osteoarthritis were randomly assigned to wear unloader knee brace or full-length 6° lateral wedge insole. Primary outcome balance parameters were stability %, path length and average velocity of center of pressure and mobility score which were investigated by HUMAC® Balance and Tilt system. Secondary outcome measures were knee function score using Knee Injury and Osteoarthritis Outcome Score scale. Assessment was performed at baseline and six months post orthotic intervention period. Findings Both orthoses improved all parameters compared to the baseline condition (p < 0.05). Unloader knee orthosis showed a significant improvement in all balance parameters compared to lateral wedged insoles (p < 0.001) except mobility scores (p = 0.527). Except activities of daily living (p = 0.752) and sports and recreational activities (p = 0.437), unloader knee orthosis had a greater effect on the pain (p = 0.002) and symptoms (p < 0.001) sub scales than lateral wedged insoles. However, quality of life sub-scale scores for insoles were more effective than the knee orthosis. Interpretation Unloader knee orthosis improved balance and knee function scores more than lateral wedged insole, though both orthoses produced significantly improved results compared to baseline assessment.","PeriodicalId":42408,"journal":{"name":"Journal of Orthopaedics Trauma and Rehabilitation","volume":"18 1","pages":""},"PeriodicalIF":0.3,"publicationDate":"2022-05-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79299385","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-05-12DOI: 10.1177/22104917221085722
U. Gunadham, P. Woratanarat
Background: The anterior half of the peroneus longus tendon (AHPLT) has recently gained popularity to become the alternate graft choice for anterior cruciate ligament reconstruction due to its acceptable biomechanical properties, easy and safe to harvest. Methods: A retrospective study was conducted to compare the results of anterior cruciate ligament (ACL) reconstruction with AHPLT and hamstring graft at the minimum of 3 years follow-up. Knee stability, International Knee Documentation Committee (IKDC) subjective score and Tegner activity level were collected. Results: There was no clinical significance regarding physical examination. Postoperative IKDC score was higher in the hamstring group compared with AHPLT group. Multiple regression analysis was done. The parsimonious model revealed graft types and gender were the most optimal variables explained postoperative IKDC score. Conclusion: AHPLT graft can be an alternative choice to conventional graft for single anatomic ACL reconstruction with less donor site morbidity, however there must be concern for smaller graft in short and thin female patients.
{"title":"A retrospective cohort study of anterior half peroneus longus tendon vs hamstring tendon for anterior cruciate ligament reconstruction: A minimum 3-years follow-up","authors":"U. Gunadham, P. Woratanarat","doi":"10.1177/22104917221085722","DOIUrl":"https://doi.org/10.1177/22104917221085722","url":null,"abstract":"Background: The anterior half of the peroneus longus tendon (AHPLT) has recently gained popularity to become the alternate graft choice for anterior cruciate ligament reconstruction due to its acceptable biomechanical properties, easy and safe to harvest. Methods: A retrospective study was conducted to compare the results of anterior cruciate ligament (ACL) reconstruction with AHPLT and hamstring graft at the minimum of 3 years follow-up. Knee stability, International Knee Documentation Committee (IKDC) subjective score and Tegner activity level were collected. Results: There was no clinical significance regarding physical examination. Postoperative IKDC score was higher in the hamstring group compared with AHPLT group. Multiple regression analysis was done. The parsimonious model revealed graft types and gender were the most optimal variables explained postoperative IKDC score. Conclusion: AHPLT graft can be an alternative choice to conventional graft for single anatomic ACL reconstruction with less donor site morbidity, however there must be concern for smaller graft in short and thin female patients.","PeriodicalId":42408,"journal":{"name":"Journal of Orthopaedics Trauma and Rehabilitation","volume":"13 1","pages":""},"PeriodicalIF":0.3,"publicationDate":"2022-05-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81953003","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-05-11DOI: 10.1177/22104917221095255
I. Au, Nicole Yan Nok Lau, Shirley Ka Wai Lee, Kwok Leung Tiu, Kin Bong Lee, A. Chan
Background/Purpose Fragility hip fracture (FHF) is the most prevalent fragility fracture, causing deterioration in ambulatory ability and disability. Early detection of patients who are at risk of prolonged hospitalization and functional decline after FHF is crucial as this facilitates post-operative management and healthcare resources allocation. Handgrip strength (HGS) is an easily-administered and cost-effective tool to assess whole body strength. The objectives of this study were to examine the relationship between pre-operative HGS, length of stay (LOS) and functional outcomes at 1-year follow up in patients with FHF in Hong Kong. Methods Patients aged 65 years old or above who were admitted to a local acute hospital from April 2017 to March 2020 due to FHF that were treated operatively, and subsequently attended the multidisciplinary fragility fracture clinic at 1-year follow up were evaluated. HGS measured at pre-operative physiotherapy initial assessment, post-fracture total LOS, Modified Functional Ambulation Classification (MFAC) and Elderly Mobility Scale (EMS) at 1-year follow up were retrieved for analysis. Correlation between HGS and LOS was analyzed using Pearson's correlation coefficient. Correlations between HGS and MFAC, and HGS and EMS were analyzed using Spearman's rank correlation coefficient. Results One hundred and nineteen patients (mean age = 80.8 ± 7.3 years) (33 males, 86 females) were evaluated. Statistical significant negative correlation between HGS and LOS was found (r = -0.245, p = 0.007), implying that the lower the HGS, the longer the period of hospitalization. HGS also showed statistical significant positive correlation with MFAC (r = 0.358, p < 0.001) and EMS (r = 0.507, p < 0.001), suggesting that the greater the HGS, the better the functional outcomes after 1 year. In short, pre-operative HGS measured by physiotherapists was shown to be associated with LOS and functional outcomes at 1-year follow up. Conclusion HGS is significantly associated with patient's LOS, MFAC and EMS after FHF. HGS is an easily-administered and cost-effective tool to facilitate frontline practitioners to determine and stratify patients’ rehabilitation potential and subsequently establish customized rehabilitation and discharge plan, such as intensive training, caregiver education and potential prediction of discharge destination. Key Messages HGS is significantly associated with patient's LOS, MFAC and EMS after FHF. HGS is an easily-administered and cost-effective tool to facilitate frontline practitioners to determine and stratify patients’ rehabilitation potential and subsequently establish customized rehabilitation and discharge plan.
背景/目的脆性髋部骨折(FHF)是最常见的脆性骨折，可导致活动能力恶化和残疾。对于FHF术后有长期住院和功能下降风险的患者，早期发现至关重要，因为这有助于术后管理和医疗资源分配。握力(HGS)是一种易于管理和经济有效的评估全身力量的工具。本研究的目的是研究香港FHF患者术前HGS、住院时间(LOS)和1年随访功能结局之间的关系。方法对2017年4月至2020年3月在当地某急症医院收治的65岁及以上FHF患者进行手术治疗，并于1年随访期间到多学科脆性骨折门诊就诊。取术前物理治疗初始评估HGS、骨折后总LOS、改良功能行走分级(MFAC)和随访1年的老年人活动能力量表(EMS)进行分析。采用Pearson相关系数分析HGS与LOS的相关性。采用Spearman秩相关系数分析HGS与MFAC、HGS与EMS的相关性。结果191例患者(平均年龄80.8±7.3岁)，其中男性33例，女性86例。HGS与LOS呈显著负相关(r = -0.245, p = 0.007)，说明HGS越低，住院时间越长。HGS与MFAC (r = 0.358, p < 0.001)、EMS (r = 0.507, p < 0.001)也有统计学意义的正相关，说明HGS越大，1年后功能结局越好。简而言之，物理治疗师测量的术前HGS与1年随访时的LOS和功能结果相关。结论HGS与FHF患者的LOS、MFAC和EMS有显著相关性。HGS是一种易于管理和具有成本效益的工具，可帮助一线从业人员确定和分层患者的康复潜力，并随后制定定制的康复和出院计划，如强化培训，护理人员教育和出院目的地的潜在预测。HGS与FHF后患者LOS、MFAC和EMS显著相关。HGS是一种易于管理和具有成本效益的工具，可帮助一线医生确定和分层患者的康复潜力，并随后制定定制的康复和出院计划。
{"title":"Handgrip strength is associated with length of stay and functional outcomes at 1-year follow up in fragility hip fracture patients","authors":"I. Au, Nicole Yan Nok Lau, Shirley Ka Wai Lee, Kwok Leung Tiu, Kin Bong Lee, A. Chan","doi":"10.1177/22104917221095255","DOIUrl":"https://doi.org/10.1177/22104917221095255","url":null,"abstract":"Background/Purpose Fragility hip fracture (FHF) is the most prevalent fragility fracture, causing deterioration in ambulatory ability and disability. Early detection of patients who are at risk of prolonged hospitalization and functional decline after FHF is crucial as this facilitates post-operative management and healthcare resources allocation. Handgrip strength (HGS) is an easily-administered and cost-effective tool to assess whole body strength. The objectives of this study were to examine the relationship between pre-operative HGS, length of stay (LOS) and functional outcomes at 1-year follow up in patients with FHF in Hong Kong. Methods Patients aged 65 years old or above who were admitted to a local acute hospital from April 2017 to March 2020 due to FHF that were treated operatively, and subsequently attended the multidisciplinary fragility fracture clinic at 1-year follow up were evaluated. HGS measured at pre-operative physiotherapy initial assessment, post-fracture total LOS, Modified Functional Ambulation Classification (MFAC) and Elderly Mobility Scale (EMS) at 1-year follow up were retrieved for analysis. Correlation between HGS and LOS was analyzed using Pearson's correlation coefficient. Correlations between HGS and MFAC, and HGS and EMS were analyzed using Spearman's rank correlation coefficient. Results One hundred and nineteen patients (mean age = 80.8 ± 7.3 years) (33 males, 86 females) were evaluated. Statistical significant negative correlation between HGS and LOS was found (r = -0.245, p = 0.007), implying that the lower the HGS, the longer the period of hospitalization. HGS also showed statistical significant positive correlation with MFAC (r = 0.358, p < 0.001) and EMS (r = 0.507, p < 0.001), suggesting that the greater the HGS, the better the functional outcomes after 1 year. In short, pre-operative HGS measured by physiotherapists was shown to be associated with LOS and functional outcomes at 1-year follow up. Conclusion HGS is significantly associated with patient's LOS, MFAC and EMS after FHF. HGS is an easily-administered and cost-effective tool to facilitate frontline practitioners to determine and stratify patients’ rehabilitation potential and subsequently establish customized rehabilitation and discharge plan, such as intensive training, caregiver education and potential prediction of discharge destination. Key Messages HGS is significantly associated with patient's LOS, MFAC and EMS after FHF. HGS is an easily-administered and cost-effective tool to facilitate frontline practitioners to determine and stratify patients’ rehabilitation potential and subsequently establish customized rehabilitation and discharge plan.","PeriodicalId":42408,"journal":{"name":"Journal of Orthopaedics Trauma and Rehabilitation","volume":"377 1","pages":""},"PeriodicalIF":0.3,"publicationDate":"2022-05-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80587236","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-04-20DOI: 10.1177/22104917221082314
Adrienne Lei Yung Wong, G. C. Man, Yuen-Man Wu, H. Wong, M. Ong, P. Yung
Background Although participation in sports and exercise is promoted widely due to its health benefits, sports-related injuries can also be a detriment to an individual's health and a burden for the healthcare system. Herein, the aim of this study is to provide a comprehensive review on the epidemiological profile and the risk for surgery of athletes presented to a sports injuries clinic in Hong Kong. Methods A total of 566 patients attending the sports injuries clinic at a local hospital between October 2017 and September 2018 were reviewed. Only 271 patients sustaining injuries from sports activities were included. These patients attended a survey-based data collection session, which recorded their demographic, injury site, events leading to injury, exercise details (type, level-of-play, frequency, experience), and functional score according to the injury site. Results The highest proportion of injuries was observed in amateur athletes (45.4%) than in recreational (28.8%) and professional (25.8%). Those patients aged between 18–29 years old (50.2%) had the most injuries. Both soccer (25.1%) and basketball (25.1%) were the two most common sports to incurred injuries. Whereas, the lower extremities being the most common injured sites. Based on our logistic model, athletes with less experience were more prone to required surgeries with injuries in the lower extremities. Conclusion Preventive measures should be targeted at less experience athletes, focusing on strengthening the knee region, to reduce sports-related injuries and surgeries. Importantly, this study demonstrates the need to further identify factors to develop effective sports injury prevention programmes for tailoring athletes at different levels-of-play.
{"title":"Risk of surgery and epidemiological profile of athletes presenting to a single sports injury clinic in Hong Kong","authors":"Adrienne Lei Yung Wong, G. C. Man, Yuen-Man Wu, H. Wong, M. Ong, P. Yung","doi":"10.1177/22104917221082314","DOIUrl":"https://doi.org/10.1177/22104917221082314","url":null,"abstract":"Background Although participation in sports and exercise is promoted widely due to its health benefits, sports-related injuries can also be a detriment to an individual's health and a burden for the healthcare system. Herein, the aim of this study is to provide a comprehensive review on the epidemiological profile and the risk for surgery of athletes presented to a sports injuries clinic in Hong Kong. Methods A total of 566 patients attending the sports injuries clinic at a local hospital between October 2017 and September 2018 were reviewed. Only 271 patients sustaining injuries from sports activities were included. These patients attended a survey-based data collection session, which recorded their demographic, injury site, events leading to injury, exercise details (type, level-of-play, frequency, experience), and functional score according to the injury site. Results The highest proportion of injuries was observed in amateur athletes (45.4%) than in recreational (28.8%) and professional (25.8%). Those patients aged between 18–29 years old (50.2%) had the most injuries. Both soccer (25.1%) and basketball (25.1%) were the two most common sports to incurred injuries. Whereas, the lower extremities being the most common injured sites. Based on our logistic model, athletes with less experience were more prone to required surgeries with injuries in the lower extremities. Conclusion Preventive measures should be targeted at less experience athletes, focusing on strengthening the knee region, to reduce sports-related injuries and surgeries. Importantly, this study demonstrates the need to further identify factors to develop effective sports injury prevention programmes for tailoring athletes at different levels-of-play.","PeriodicalId":42408,"journal":{"name":"Journal of Orthopaedics Trauma and Rehabilitation","volume":"16 1","pages":""},"PeriodicalIF":0.3,"publicationDate":"2022-04-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"91013503","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-04-19DOI: 10.1177/22104917221085717
Ferdinand Nyankoué Mebouinz, Boris Tchakounte Youngui
Purpose: The aim of this study was to assess the impact of surgery on autonomy in the elderly after a fracture of the proximal femur; and the factors associated with its alteration. Materials and methods: A prospective longitudinal study was performed on 66 patients aged at least 90 years treated for a fracture of the proximal femur between 2008 and 2017. Physical autonomy was assessed using the Katz scale Results: After the surgical management, the previous level of autonomy was found progressively increasing in 9.1% at 1 month, 17.5% in the 3rd month, 23.5% in the 6th month and 22% at 1 year (P value <0.001). The factors associated with the deterioration in patient autonomy one month postoperatively were as follows: late admission (P = 0.02), a period of verticalization greater than 15 days (P = 0.02), at least one complication of decubitus (P = 0.004), anemia (P = 0.02) and an ASA score ≥ 2 (P = 0.05). The comparison of the autonomy between hip fixation and hip prosthetic replacement did not show a significant difference in the first postoperative month (P = 0.83). Conclusion: Even at over 90 years of age, surgery can significantly restore previous autonomy. The early admission and management of patients, the prevention of complications in the decubitus position, the early rise after surgery and the management of anemia are key points in restoring physical autonomy.
{"title":"Autonomy of the elderly after a hip fracture surgery in a subsaharan country","authors":"Ferdinand Nyankoué Mebouinz, Boris Tchakounte Youngui","doi":"10.1177/22104917221085717","DOIUrl":"https://doi.org/10.1177/22104917221085717","url":null,"abstract":"Purpose: The aim of this study was to assess the impact of surgery on autonomy in the elderly after a fracture of the proximal femur; and the factors associated with its alteration. Materials and methods: A prospective longitudinal study was performed on 66 patients aged at least 90 years treated for a fracture of the proximal femur between 2008 and 2017. Physical autonomy was assessed using the Katz scale Results: After the surgical management, the previous level of autonomy was found progressively increasing in 9.1% at 1 month, 17.5% in the 3rd month, 23.5% in the 6th month and 22% at 1 year (P value <0.001). The factors associated with the deterioration in patient autonomy one month postoperatively were as follows: late admission (P = 0.02), a period of verticalization greater than 15 days (P = 0.02), at least one complication of decubitus (P = 0.004), anemia (P = 0.02) and an ASA score ≥ 2 (P = 0.05). The comparison of the autonomy between hip fixation and hip prosthetic replacement did not show a significant difference in the first postoperative month (P = 0.83). Conclusion: Even at over 90 years of age, surgery can significantly restore previous autonomy. The early admission and management of patients, the prevention of complications in the decubitus position, the early rise after surgery and the management of anemia are key points in restoring physical autonomy.","PeriodicalId":42408,"journal":{"name":"Journal of Orthopaedics Trauma and Rehabilitation","volume":"41 1","pages":""},"PeriodicalIF":0.3,"publicationDate":"2022-04-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80836172","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-04-19DOI: 10.1177/22104917221087401
C. Laycock, D. Kieser, Connor Fitz-Gerald, S. Soltani, C. Frampton
Background: Traumatic spinal cord injury (TSCI) is a devastating condition and the search for a cure remains one of the most tenacious healthcare challenges to date. Current therapies are limited in their efficacy to restore full neurological function – resulting in lifelong disability and loss of autonomy. Whilst there remains a necessity to refine therapeutic protocols, stem cell (SC) studies have shown promise in the mending and re-establishment of the spinal cord neuroanatomy. Objectives: We conducted a systematic review of functional outcomes in stem cell therapeutics over the last three decades in large animals and humans. Methods: Medline, Embase, Cochrane and SCOPUS databases were searched for potentially pertinent articles from 1990 to 2020. Studies published in English were included if the stem cells were directly injected into the intraspinal, epidural or intrathecal compartments within two weeks of a traumatic mechanism of injury, including acute intervertebral disc prolapse. The participants were either large animals – defined as canine, porcine or non-human primate in-vivo models – or human patients. Results: Nine studies were included in this review. Statistically significant improvements in motor function and deep pain perception were seen at 8 weeks to 6 months post-SC injection compared to controls. Limitations: Functional outcomes are variably measured across studies. Almost all studies used experimentally induced trauma, which may not accurately represent the complexity of human spinal cord injury. Due to the exclusion criteria, there were no non-human primate studies included, yet these animal models are considered a closer anatomical match to humans than other large mammals. No human studies were included. Conclusions and Implications: Autologous and allogeneic stem cells have been trialled for the reconstitution of damaged and lost cells, remyelination of axons and remodelling of the pathophysiological microenvironment within the injured spinal cord, with some promising outcome data. This may translate to more successful future Phase I/II human clinical trials into the use of stem cells after TSCI in adults.
{"title":"A systematic review of large animal and human studies of stem cell therapeutics for acute adult traumatic spinal cord injury","authors":"C. Laycock, D. Kieser, Connor Fitz-Gerald, S. Soltani, C. Frampton","doi":"10.1177/22104917221087401","DOIUrl":"https://doi.org/10.1177/22104917221087401","url":null,"abstract":"Background: Traumatic spinal cord injury (TSCI) is a devastating condition and the search for a cure remains one of the most tenacious healthcare challenges to date. Current therapies are limited in their efficacy to restore full neurological function – resulting in lifelong disability and loss of autonomy. Whilst there remains a necessity to refine therapeutic protocols, stem cell (SC) studies have shown promise in the mending and re-establishment of the spinal cord neuroanatomy. Objectives: We conducted a systematic review of functional outcomes in stem cell therapeutics over the last three decades in large animals and humans. Methods: Medline, Embase, Cochrane and SCOPUS databases were searched for potentially pertinent articles from 1990 to 2020. Studies published in English were included if the stem cells were directly injected into the intraspinal, epidural or intrathecal compartments within two weeks of a traumatic mechanism of injury, including acute intervertebral disc prolapse. The participants were either large animals – defined as canine, porcine or non-human primate in-vivo models – or human patients. Results: Nine studies were included in this review. Statistically significant improvements in motor function and deep pain perception were seen at 8 weeks to 6 months post-SC injection compared to controls. Limitations: Functional outcomes are variably measured across studies. Almost all studies used experimentally induced trauma, which may not accurately represent the complexity of human spinal cord injury. Due to the exclusion criteria, there were no non-human primate studies included, yet these animal models are considered a closer anatomical match to humans than other large mammals. No human studies were included. Conclusions and Implications: Autologous and allogeneic stem cells have been trialled for the reconstitution of damaged and lost cells, remyelination of axons and remodelling of the pathophysiological microenvironment within the injured spinal cord, with some promising outcome data. This may translate to more successful future Phase I/II human clinical trials into the use of stem cells after TSCI in adults.","PeriodicalId":42408,"journal":{"name":"Journal of Orthopaedics Trauma and Rehabilitation","volume":"7 1","pages":""},"PeriodicalIF":0.3,"publicationDate":"2022-04-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89503217","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-04-13DOI: 10.1177/22104917221082312
Osman Çimen, A. Oner, Alper Koksal, Ferdi Dırvar, M. Mert, Mümine Nursu Şahin, D. Kargın
Background/purpose In the current study, our aim was to compare the efficacy and biocompatibility of teicoplanin-loaded and vancomycin-and-gentamicin-loaded articulating spacers used in two-stage revision arthroplasty for eradication of periprosthetic knee joint infection. Methods In the current retrospective cohort study, there were 24 patients who were given 2 g or less antibiotics per 40 g of cement in the low-dose teicoplanin group, and 20 patients who were given a total of 3.6 g or more antibiotics per 40 g of cement in the high-dose vancomycin and gentamicin group. Two groups were compared statistically. Results There was no statistically significant difference in the treatment failure between the two groups (p = 0.488). No statistically significant differences were found in spacer fracture rates between the two groups (p = 0.802). Conclusion The current study has demonstrated that low-dose teicoplanin protocol is as effective and safe as high-dose vancomycin and gentamycin protocol.
{"title":"A comparison of low-dose teicoplanin-loaded spacer application vs. high-dose vancomycin-and-gentamicin-loaded spacer application in the treatment of periprosthetic knee infection","authors":"Osman Çimen, A. Oner, Alper Koksal, Ferdi Dırvar, M. Mert, Mümine Nursu Şahin, D. Kargın","doi":"10.1177/22104917221082312","DOIUrl":"https://doi.org/10.1177/22104917221082312","url":null,"abstract":"Background/purpose In the current study, our aim was to compare the efficacy and biocompatibility of teicoplanin-loaded and vancomycin-and-gentamicin-loaded articulating spacers used in two-stage revision arthroplasty for eradication of periprosthetic knee joint infection. Methods In the current retrospective cohort study, there were 24 patients who were given 2 g or less antibiotics per 40 g of cement in the low-dose teicoplanin group, and 20 patients who were given a total of 3.6 g or more antibiotics per 40 g of cement in the high-dose vancomycin and gentamicin group. Two groups were compared statistically. Results There was no statistically significant difference in the treatment failure between the two groups (p = 0.488). No statistically significant differences were found in spacer fracture rates between the two groups (p = 0.802). Conclusion The current study has demonstrated that low-dose teicoplanin protocol is as effective and safe as high-dose vancomycin and gentamycin protocol.","PeriodicalId":42408,"journal":{"name":"Journal of Orthopaedics Trauma and Rehabilitation","volume":"23 1","pages":""},"PeriodicalIF":0.3,"publicationDate":"2022-04-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84710468","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-04-13DOI: 10.1177/22104917221092165
J. J. Morales De Cano, Ramon Clos Molina, Estela Trias Puertolas
Background Prosthetic surgery has shown good short-term results with the use of short stems, results comparable with the experience of conventional stems. The aim of this study was to investigate and describe the characteristics and clinical course of patients operated on with the short stem GTS in the medium term. Methods Between November 2010 and September 2014, 152 primary hip prostheses were operated on in 142 patients with a mean follow-up of 95.49 months (range 75–120). We analyzed the intraoperative and postoperative complications and the reviews performed during the follow-up. Results One intraoperative complications occurred; case in which a femoral calcar fracture occurred and a screw was required during the operation. The clinical evaluation at the end of the follow-up, according to the Merle D’Aubigne Scale, showed the mean value was 17.3684 (SD 0,79472), with a survival at the end of the follow-up of 99.3% of the placed GTS stems. Conclusions GTS short stems have shown good results after more than 6 years of follow-up, with comparable results to conventional uncemented stems. Short-stem hip arthroplasty is an advanced way to preserve bone stock while protecting soft tissue
使用短柄的假体手术已显示出良好的短期效果，其效果可与常规柄的经验相媲美。本研究的目的是调查和描述短茎GTS中期手术患者的特征和临床过程。方法2010年11月至2014年9月，对142例患者进行一期人工髋关节置换手术152例，平均随访95.49个月(75 ~ 120个月)。我们分析了术中和术后并发症，并在随访期间进行了回顾。结果术中并发症1例;股骨跟骨骨折，术中需要螺钉的病例。随访结束时临床评价，根据Merle D 'Aubigne量表，平均值为17.3684 (SD 0,79472)，随访结束时放置的GTS茎的生存率为99.3%。结论经过6年多的随访，GTS短柄具有良好的效果，与常规非骨水泥短柄效果相当。短柄髋关节置换术是一种在保护软组织的同时保留骨存量的先进方法
{"title":"Medium-term outcomes of short stems in total hip arthroplasty","authors":"J. J. Morales De Cano, Ramon Clos Molina, Estela Trias Puertolas","doi":"10.1177/22104917221092165","DOIUrl":"https://doi.org/10.1177/22104917221092165","url":null,"abstract":"Background Prosthetic surgery has shown good short-term results with the use of short stems, results comparable with the experience of conventional stems. The aim of this study was to investigate and describe the characteristics and clinical course of patients operated on with the short stem GTS in the medium term. Methods Between November 2010 and September 2014, 152 primary hip prostheses were operated on in 142 patients with a mean follow-up of 95.49 months (range 75–120). We analyzed the intraoperative and postoperative complications and the reviews performed during the follow-up. Results One intraoperative complications occurred; case in which a femoral calcar fracture occurred and a screw was required during the operation. The clinical evaluation at the end of the follow-up, according to the Merle D’Aubigne Scale, showed the mean value was 17.3684 (SD 0,79472), with a survival at the end of the follow-up of 99.3% of the placed GTS stems. Conclusions GTS short stems have shown good results after more than 6 years of follow-up, with comparable results to conventional uncemented stems. Short-stem hip arthroplasty is an advanced way to preserve bone stock while protecting soft tissue","PeriodicalId":42408,"journal":{"name":"Journal of Orthopaedics Trauma and Rehabilitation","volume":"59 1","pages":""},"PeriodicalIF":0.3,"publicationDate":"2022-04-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80156895","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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