Pub Date : 2018-01-01DOI: 10.4172/2167-7921.1000275
R. Gunaratne, R. Khan, D. Fick, J. Ilyas, S. Haebich, Anne J. Smith
Introduction: Prospective total knee replacement patients often enquire about the likelihood that surgery will resolve their knee pain, enable them to walk “normally”, and to resume activities important to them. However, considerable variability exists in patient outcomes, which makes it difficult for clinicians to accurately answer these questions, and for patients to make informed decisions. In this study five patient-centred outcomes were explored: pain resolution, walk without limping, perform usual work, ability to kneel, and satisfaction. Significance: The goal of this paper was not to create a fully predictive framework of outcomes after TKR, but to focus on patient-centred goals using only easily measured baseline factors to see if doing this might be achievable and potentially useful in terms of discussion of expectations in shared decision making for surgery. The added value of personalising each outcome, as opposed to providing all patients with a generic probability, was also assessed from the statistical models. Method: Data from 470 patients was used in multivariable logistic regression analyses to identify independent significant predictors for each goal. Predictors assessed were age, gender, body mass index, preoperative knee function, physical health status and mental health status. Results: The likelihood of achieving a desirable outcome varied across goals examined. Whilst 82% of patients were able to walk without a consistent limp, only 32% could kneel with ease. Furthermore, we identified a consistent pattern where patients with greater preoperative knee function and mental health, had improved odds for attaining each goal. Preoperative physical health and body mass also had some predictive utility. Conclusion: We found that when assessing the merits of undergoing total knee replacement, consideration of a patient’s pre-operative knee function and mental health allows a more accurate prediction of the benefit they may achieve.
{"title":"Probabilities of TKR patients achieving their goals","authors":"R. Gunaratne, R. Khan, D. Fick, J. Ilyas, S. Haebich, Anne J. Smith","doi":"10.4172/2167-7921.1000275","DOIUrl":"https://doi.org/10.4172/2167-7921.1000275","url":null,"abstract":"Introduction: Prospective total knee replacement patients often enquire about the likelihood that surgery will resolve their knee pain, enable them to walk “normally”, and to resume activities important to them. However, considerable variability exists in patient outcomes, which makes it difficult for clinicians to accurately answer these questions, and for patients to make informed decisions. In this study five patient-centred outcomes were explored: pain resolution, walk without limping, perform usual work, ability to kneel, and satisfaction. Significance: The goal of this paper was not to create a fully predictive framework of outcomes after TKR, but to focus on patient-centred goals using only easily measured baseline factors to see if doing this might be achievable and potentially useful in terms of discussion of expectations in shared decision making for surgery. The added value of personalising each outcome, as opposed to providing all patients with a generic probability, was also assessed from the statistical models. Method: Data from 470 patients was used in multivariable logistic regression analyses to identify independent significant predictors for each goal. Predictors assessed were age, gender, body mass index, preoperative knee function, physical health status and mental health status. Results: The likelihood of achieving a desirable outcome varied across goals examined. Whilst 82% of patients were able to walk without a consistent limp, only 32% could kneel with ease. Furthermore, we identified a consistent pattern where patients with greater preoperative knee function and mental health, had improved odds for attaining each goal. Preoperative physical health and body mass also had some predictive utility. Conclusion: We found that when assessing the merits of undergoing total knee replacement, consideration of a patient’s pre-operative knee function and mental health allows a more accurate prediction of the benefit they may achieve.","PeriodicalId":91304,"journal":{"name":"Journal of arthritis","volume":"07 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2018-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.4172/2167-7921.1000275","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70836793","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 : 2018-01-01DOI: 10.4172/2167-7921.1000277
de Souza-Galvao Ml, Fernandes Ac, Casarino Rl, Zanchin Al, H. Ciol, de Aquino Junior Ae, Bagnato Vs
Osteoarthritis is a degenerative joint disease that affects predominantly hands and knees of the elderly population, being characterized by chronic pain and limitation of joint movements. Therapeutic approaches to ease the pain, as low-intensity pulsed ultrasound and photobiomodulation (low-level laser therapy) have been broadly used as a complement to drug treatment of osteoarthritis. The aim of this study was to evaluate the synergic effect of LIPUS associated to LLLT on osteoarthritis of hands and knees. For this, 69 patients, being 48 affected by knee osteoarthritis and 21 affected by hand osteoarthritis were selected for the study. Patients were evaluated by the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) for knee osteoarthritis and by Australian Canadian Osteoarthritis Hand (AUSCAN), for hands osteoarthritis. All patients filled out the Visual Analogue Scale (VAS) pain questionnaire, which showed statistical improvement of hands (p<0.001) and knees (p<0.001) when comparing before and after treatment. Functional evaluation by AUSCAN showed improvement of hands functionality (p<0.002). Results showed that the synergic therapy of LIPUS and LLLT were efficient in the treatment of hands and knees osteoarthritis, providing a new approach of a non-pharmacological and non-invasive treatment that contributes to better quality of life for the patients with this chronic and degenerative pathology.
{"title":"Sinergic Effect of Therapeutic Ultrasound and Low-Level Laser Therapy in the Treatment of Hands and Knees Ostheoarthritis","authors":"de Souza-Galvao Ml, Fernandes Ac, Casarino Rl, Zanchin Al, H. Ciol, de Aquino Junior Ae, Bagnato Vs","doi":"10.4172/2167-7921.1000277","DOIUrl":"https://doi.org/10.4172/2167-7921.1000277","url":null,"abstract":"Osteoarthritis is a degenerative joint disease that affects predominantly hands and knees of the elderly population, being characterized by chronic pain and limitation of joint movements. Therapeutic approaches to ease the pain, as low-intensity pulsed ultrasound and photobiomodulation (low-level laser therapy) have been broadly used as a complement to drug treatment of osteoarthritis. The aim of this study was to evaluate the synergic effect of LIPUS associated to LLLT on osteoarthritis of hands and knees. For this, 69 patients, being 48 affected by knee osteoarthritis and 21 affected by hand osteoarthritis were selected for the study. Patients were evaluated by the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) for knee osteoarthritis and by Australian Canadian Osteoarthritis Hand (AUSCAN), for hands osteoarthritis. All patients filled out the Visual Analogue Scale (VAS) pain questionnaire, which showed statistical improvement of hands (p<0.001) and knees (p<0.001) when comparing before and after treatment. Functional evaluation by AUSCAN showed improvement of hands functionality (p<0.002). Results showed that the synergic therapy of LIPUS and LLLT were efficient in the treatment of hands and knees osteoarthritis, providing a new approach of a non-pharmacological and non-invasive treatment that contributes to better quality of life for the patients with this chronic and degenerative pathology.","PeriodicalId":91304,"journal":{"name":"Journal of arthritis","volume":"07 1","pages":"1-4"},"PeriodicalIF":0.0,"publicationDate":"2018-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.4172/2167-7921.1000277","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70837047","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 : 2018-01-01DOI: 10.4172/2167-7921.1000E118
E. Nabih
Pyroptosis induction requires two types of receptors that sense harmful signals which can be given off by invasive pathogens or by an injury to a tissue. These receptors are Nod-like receptors (NLRs) and Toll-like receptors [7]. The nucleotide binding domain and leucinerich repeat pyrin 3 domain (NLRP3 or cryopyrin) sensor protein, organizes the assembly of the best-characterized inflammasome, the NLRP3-inflammasome. NLRP3 is kept in an inactive state complexed with Heat Shock Protein 90 (HSP90) and suppressor of the G2 allele of skp1 (SGT1) in the cytoplasm. Upon detecting harmful signals, HSP90 and SGT1 are released from NLRP3 which then recruits apoptosisassociated speck-like protein containing a CARD (ASC) protein and caspase-1 to the inflammasome complex. ASC contains a caspase activation and recruitment domain (CARD) that binds and facilitates activation of pro-caspase-1 through CARD-CARD interactions. Activated caspase-1 cleaves the precursors of interleukin (IL)-1β and IL-18 converting them into the mature, secreted inflammatory cytokines [8]. Furthermore, the inflammatory caspases 1, 4 and 5 can induce pyroptosis directly by cleaving gasdermin D (GSDMD) into a pore-forming amino-terminal domain (GSDMDN) and an inhibitory carboxy-terminal (GSDMDC) domain. GSDMDN then oligomerizes and inserts in the plasma membrane inducing rapid cell lysis [9-12].
焦亡诱导需要两种类型的受体来感知有害信号，这些信号可以由侵入性病原体或组织损伤发出。这些受体是nod样受体(NLRs)和toll样受体[7]。核苷酸结合域和富含亮氨酸的重复pyrin 3结构域(NLRP3或crypyrin)传感器蛋白，组织最具特征的炎性小体NLRP3-炎性小体的组装。NLRP3在细胞质中与热休克蛋白90 (HSP90)和skp1的G2等位基因抑制子(SGT1)复合物保持失活状态。当检测到有害信号时，HSP90和SGT1从NLRP3释放，然后NLRP3招募含有CARD (ASC)蛋白和caspase-1的凋亡相关斑点样蛋白到炎症小体复合体。ASC包含一个caspase激活和募集结构域(CARD)，通过CARD-CARD相互作用结合并促进caspase-1前的激活。活化的caspase-1切割白介素(IL)-1β和IL-18的前体，将它们转化为成熟的分泌炎性细胞因子[8]。此外，炎性caspase 1、4和5可通过将gasdermin D (GSDMD)裂解为成孔氨基末端结构域(GSDMDN)和抑制性羧基末端结构域(GSDMDC)直接诱导焦亡。GSDMDN随后寡聚并插入质膜，诱导细胞快速裂解[9-12]。
{"title":"NLRP3 Inflammasome: A Novel Therapeutic Target in Arthritis","authors":"E. Nabih","doi":"10.4172/2167-7921.1000E118","DOIUrl":"https://doi.org/10.4172/2167-7921.1000E118","url":null,"abstract":"Pyroptosis induction requires two types of receptors that sense harmful signals which can be given off by invasive pathogens or by an injury to a tissue. These receptors are Nod-like receptors (NLRs) and Toll-like receptors [7]. The nucleotide binding domain and leucinerich repeat pyrin 3 domain (NLRP3 or cryopyrin) sensor protein, organizes the assembly of the best-characterized inflammasome, the NLRP3-inflammasome. NLRP3 is kept in an inactive state complexed with Heat Shock Protein 90 (HSP90) and suppressor of the G2 allele of skp1 (SGT1) in the cytoplasm. Upon detecting harmful signals, HSP90 and SGT1 are released from NLRP3 which then recruits apoptosisassociated speck-like protein containing a CARD (ASC) protein and caspase-1 to the inflammasome complex. ASC contains a caspase activation and recruitment domain (CARD) that binds and facilitates activation of pro-caspase-1 through CARD-CARD interactions. Activated caspase-1 cleaves the precursors of interleukin (IL)-1β and IL-18 converting them into the mature, secreted inflammatory cytokines [8]. Furthermore, the inflammatory caspases 1, 4 and 5 can induce pyroptosis directly by cleaving gasdermin D (GSDMD) into a pore-forming amino-terminal domain (GSDMDN) and an inhibitory carboxy-terminal (GSDMDC) domain. GSDMDN then oligomerizes and inserts in the plasma membrane inducing rapid cell lysis [9-12].","PeriodicalId":91304,"journal":{"name":"Journal of arthritis","volume":"7 1","pages":"1-2"},"PeriodicalIF":0.0,"publicationDate":"2018-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.4172/2167-7921.1000E118","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70837490","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 : 2018-01-01DOI: 10.4172/2167-7921.1000e119
José M. Serra López-Matencioa, Concepción Martínez Nietoa, S. Castañeda
José M. Serra López-Matencioa1, Concepción Martínez Nietoa1 and Santos Castañeda2* 1Hospital Pharmacy Service, Hospital de la Princesa, IIS-Princesa, c/Diego de León 62, Madrid 2Rheumatology Division, Hospital de la Princesa, IIS-Princesa, c/ Diego de León 62, Madrid *Corresponding author: Santos Castañeda, MD, PhD, Rheumatology Division, Hospital de la Princesa, IIS-Princesa, c/ Diego de León 62; 28006-Madrid, Tel: +34 91 52
Jos M.Serra López-MatencioA1，Concepci Martínez NietoA1和Santos Castaneda2*1公主医院药房，IIS-Princessa，C/Diego de Leon 62，马德里2风湿病科，公主医院，IIS-Princessa，C/Diego de Leon 62，马德里*对应作者：Santos Castaneda，MD，博士，风湿病科，公主医院，IIS-Princessa，C/Diego de Leon 62；28006-马德里，电话：+34 91 52
{"title":"Jakinibs in Inflammatory Rheumatic Diseases. Clinical Perspective","authors":"José M. Serra López-Matencioa, Concepción Martínez Nietoa, S. Castañeda","doi":"10.4172/2167-7921.1000e119","DOIUrl":"https://doi.org/10.4172/2167-7921.1000e119","url":null,"abstract":"José M. Serra López-Matencioa1, Concepción Martínez Nietoa1 and Santos Castañeda2* 1Hospital Pharmacy Service, Hospital de la Princesa, IIS-Princesa, c/Diego de León 62, Madrid 2Rheumatology Division, Hospital de la Princesa, IIS-Princesa, c/ Diego de León 62, Madrid *Corresponding author: Santos Castañeda, MD, PhD, Rheumatology Division, Hospital de la Princesa, IIS-Princesa, c/ Diego de León 62; 28006-Madrid, Tel: +34 91 52","PeriodicalId":91304,"journal":{"name":"Journal of arthritis","volume":"7 1","pages":"1-2"},"PeriodicalIF":0.0,"publicationDate":"2018-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.4172/2167-7921.1000e119","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70837370","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 : 2018-01-01DOI: 10.4172/2167-7921.1000I108
Varun Gupta, P. Gupta
{"title":"A Typical Presentation of Crystal Arthritis (Gout)","authors":"Varun Gupta, P. Gupta","doi":"10.4172/2167-7921.1000I108","DOIUrl":"https://doi.org/10.4172/2167-7921.1000I108","url":null,"abstract":"","PeriodicalId":91304,"journal":{"name":"Journal of arthritis","volume":"7 1","pages":"1-1"},"PeriodicalIF":0.0,"publicationDate":"2018-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.4172/2167-7921.1000I108","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70837672","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 : 2018-01-01DOI: 10.4172/2167-7921.1000263
A. ShanthiPriya, Jobin Christ Mc
Psoriatic arthritis is one of the rare types of autoimmune disease that cause body's own immune system to harm skin and joints which leads to painful areas of swelling and inflammation. Psoriatic arthritis (PsA) is not like the other forms of arthritis that are clearly distinguishable , where arthritis is accompanied by typical psoriasis symptoms, such as a red, scaly rash that will develop silvery white patches. It’s a chronic condition where hands, fingers, feet, large joints of the lower body, and the lower back are the most common areas to be affected by PsA. Effects will be worsening over time in case of no treatment provided on time. Permanent damage occurs to joints and tissues if not treated promptly. This paper has an analysis over the recent advancement in imaging techniques such as SPECT (Single Photon Emission Computed Tomography) and FDG-PET/CT (Fluorodeoxyglucose - Positron Emission Tomography /Comupted Tomography ) have showed more reliable and accurate diagnosis of early stage Psoriatic Arthritis.
{"title":"Early Stage Detection of Psoriatic Arthritis Using SPECT and FDG-PET/CT","authors":"A. ShanthiPriya, Jobin Christ Mc","doi":"10.4172/2167-7921.1000263","DOIUrl":"https://doi.org/10.4172/2167-7921.1000263","url":null,"abstract":"Psoriatic arthritis is one of the rare types of autoimmune disease that cause body's own immune system to harm skin and joints which leads to painful areas of swelling and inflammation. Psoriatic arthritis (PsA) is not like the other forms of arthritis that are clearly distinguishable , where arthritis is accompanied by typical psoriasis symptoms, such as a red, scaly rash that will develop silvery white patches. It’s a chronic condition where hands, fingers, feet, large joints of the lower body, and the lower back are the most common areas to be affected by PsA. Effects will be worsening over time in case of no treatment provided on time. Permanent damage occurs to joints and tissues if not treated promptly. This paper has an analysis over the recent advancement in imaging techniques such as SPECT (Single Photon Emission Computed Tomography) and FDG-PET/CT (Fluorodeoxyglucose - Positron Emission Tomography /Comupted Tomography ) have showed more reliable and accurate diagnosis of early stage Psoriatic Arthritis.","PeriodicalId":91304,"journal":{"name":"Journal of arthritis","volume":"7 1","pages":"1-3"},"PeriodicalIF":0.0,"publicationDate":"2018-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.4172/2167-7921.1000263","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70836832","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 : 2018-01-01DOI: 10.4172/2167-7921.1000264
A. Herman, A. Mor, G. Segal, N. Shazar, Y. Beer, N. Halperin, R. Debi, A. Elbaz
Objective: The purpose of the current study was to validate time dependent changes of a novel functional classification for patients with knee osteoarthritis (KOA), following a home-based biomechanical treatment (HBBT).Methods: A retrospective analysis of 518 patients with KOA was conducted. All patients were classified using a novel knee osteoarthritis functional grade (KOFG) classification for KOA, based on spatio-temporal gait analysis. Patients were re-classified after 3 months and 1 year of HBBT to examine and validate this classification using timedependant changes. The time dependent changes in the classification were compared to gold-standard selfassessment questionnaires, WOMAC and short form 36 (SF-36).Results: The changes in KOFG were demonstrated over time, with most changes occurring after 3 months of treatment with consolidation of the effect at 12 months. For example, of 427 patients that were classified in KOFG 2-4 grade at baseline, 44.9% and 51.5% had lower (better) KOFG grades at 3 and 12 months of treatment, respectively. The changes in KOFG were validated with WOMAC and SF-36 questionnaires showing a significant correlation between KOFG changes and changes in WOMAC and SF-36. SF-36 pain sub-scale showed an improvement of 33.0% and 38.0% following 3 months and 12 months of treatment, respectively (p values <0.0001).Conclusions: The results of the current study validate the knee osteoarthritis functional grade classification scheme as a tool to assess time dependant changes in KOA as well as its sensitivity to assess treatment effect. The KOFG can offer a more robust mode of reporting clinical results in describing the natural history and time-dependent treatment results of patients suffering from knee OA and should be considered as an additional outcome measure in future studies.
{"title":"Knee Osteoarthritis Functional Classification Scheme - Validation of Time Dependent Treatment Effect. One Year Follow - Up of 518 Patients","authors":"A. Herman, A. Mor, G. Segal, N. Shazar, Y. Beer, N. Halperin, R. Debi, A. Elbaz","doi":"10.4172/2167-7921.1000264","DOIUrl":"https://doi.org/10.4172/2167-7921.1000264","url":null,"abstract":"Objective: The purpose of the current study was to validate time dependent changes of a novel functional classification for patients with knee osteoarthritis (KOA), following a home-based biomechanical treatment (HBBT).Methods: A retrospective analysis of 518 patients with KOA was conducted. All patients were classified using a novel knee osteoarthritis functional grade (KOFG) classification for KOA, based on spatio-temporal gait analysis. Patients were re-classified after 3 months and 1 year of HBBT to examine and validate this classification using timedependant changes. The time dependent changes in the classification were compared to gold-standard selfassessment questionnaires, WOMAC and short form 36 (SF-36).Results: The changes in KOFG were demonstrated over time, with most changes occurring after 3 months of treatment with consolidation of the effect at 12 months. For example, of 427 patients that were classified in KOFG 2-4 grade at baseline, 44.9% and 51.5% had lower (better) KOFG grades at 3 and 12 months of treatment, respectively. The changes in KOFG were validated with WOMAC and SF-36 questionnaires showing a significant correlation between KOFG changes and changes in WOMAC and SF-36. SF-36 pain sub-scale showed an improvement of 33.0% and 38.0% following 3 months and 12 months of treatment, respectively (p values <0.0001).Conclusions: The results of the current study validate the knee osteoarthritis functional grade classification scheme as a tool to assess time dependant changes in KOA as well as its sensitivity to assess treatment effect. The KOFG can offer a more robust mode of reporting clinical results in describing the natural history and time-dependent treatment results of patients suffering from knee OA and should be considered as an additional outcome measure in future studies.","PeriodicalId":91304,"journal":{"name":"Journal of arthritis","volume":"7 1","pages":"1-6"},"PeriodicalIF":0.0,"publicationDate":"2018-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.4172/2167-7921.1000264","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70836892","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 : 2018-01-01DOI: 10.4172/2167-7921.1000276
R. Gunaratne, Y. Heng, C. Ironside, A. Taheri
Background: Preoperative templating is an integral part of planning a successful total hip arthroplasty (THA), and helps minimise complications that can arise both intraoperatively and postoperatively. The aim of our study is to determine the reliability of the robotic arm assisted (MAKO fully enhanced) total hip replacement surgical system as a surgical planning tool (not to validate the robot in its execution as it has previously been done) in comparison to conventional acetate and digital templating. Method: The planning stages of fifty consecutive uncemented THA performed by a single robotic orthopedic surgeon was analyzed against what was achieved during the surgery. The variables analyzed were cup inclination, cup anteversion, combined anteversion, hip length, hip combined offset, femur size, femur component neck angle and cup size. Results: There was a significant correlation between planned and actual results. The component sizes were planned to accuracy within one size in 100% of femurs, 100% of femur neck-shaft angles and 98% of cups. Cup inclination, anteversion and combined anteversion were planned to accuracy within three degrees in 84%, 96% and 94% of cases respectively. Hip length and combined offset were planned to accuracy within three millimeters in 88% and 78% of cases respectively. Conclusion: The robotic arm assisted total hip replacement surgical system is a predictable and accurate planning tool and is superior to conventional acetate and digital templating. Level of evidence: Level III
{"title":"Accuracy of Robotic Arm Assisted Total Hip Replacement Planning Tool","authors":"R. Gunaratne, Y. Heng, C. Ironside, A. Taheri","doi":"10.4172/2167-7921.1000276","DOIUrl":"https://doi.org/10.4172/2167-7921.1000276","url":null,"abstract":"Background: Preoperative templating is an integral part of planning a successful total hip arthroplasty (THA), and helps minimise complications that can arise both intraoperatively and postoperatively. The aim of our study is to determine the reliability of the robotic arm assisted (MAKO fully enhanced) total hip replacement surgical system as a surgical planning tool (not to validate the robot in its execution as it has previously been done) in comparison to conventional acetate and digital templating. Method: The planning stages of fifty consecutive uncemented THA performed by a single robotic orthopedic surgeon was analyzed against what was achieved during the surgery. The variables analyzed were cup inclination, cup anteversion, combined anteversion, hip length, hip combined offset, femur size, femur component neck angle and cup size. Results: There was a significant correlation between planned and actual results. The component sizes were planned to accuracy within one size in 100% of femurs, 100% of femur neck-shaft angles and 98% of cups. Cup inclination, anteversion and combined anteversion were planned to accuracy within three degrees in 84%, 96% and 94% of cases respectively. Hip length and combined offset were planned to accuracy within three millimeters in 88% and 78% of cases respectively. Conclusion: The robotic arm assisted total hip replacement surgical system is a predictable and accurate planning tool and is superior to conventional acetate and digital templating. Level of evidence: Level III","PeriodicalId":91304,"journal":{"name":"Journal of arthritis","volume":"35 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2018-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.4172/2167-7921.1000276","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70836991","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 : 2018-01-01DOI: 10.4172/2167-7921.1000266
M. Rihl, N. Baerlecken, B. Wiese, R. Schmidt, H. Zeidler
Objective: High dose intravenous glucocorticoid (IVGC) pulse therapy is known to effectively reduce inflammatory signs and symptoms in patients with active inflammatory conditions. However, the efficacy of IVGC in ankylosing spondylitis (AS) is not clearly established. Methods: We performed a retrospective analysis with repeated measurements including patients with active, NSAID refractory axial AS (n=15) who underwent high dose IVGC pulse therapy. Parameters of clinical and humoral disease activity were compared to active AS patients (n=14) under continuous anti-TNF treatment. Patients were seen every 3 months and followed up for a total period of 12 months. Results: Both IVGC pulse and anti-TNF therapy lead to a significant and sustained reduction of the mean bath ankylosing spondylitis disease activity index (BASDAI 7.4 ± 1.5 at baseline vs. 5.4 ± 2.1 at 12 months in the pulse group and 6.9 ± 1.2 at baseline vs. 5.0 ± 2.7 at 12 months in the anti-TNF group, p<0.001), CRP (p=0.018), ESR (p=0.028), morning stiffness (p<0.001), and finger-to-floor-distance (p=0.001; within group comparison). Conclusions: Patients with active axial AS treated with one IVGC pulse show a substantial decrease in disease activity over a period of 12 months in this retrospective analysis.
{"title":"Intravenous Glucocorticoid Pulse Therapy in Active, NSAID Refractory Axial An","authors":"M. Rihl, N. Baerlecken, B. Wiese, R. Schmidt, H. Zeidler","doi":"10.4172/2167-7921.1000266","DOIUrl":"https://doi.org/10.4172/2167-7921.1000266","url":null,"abstract":"Objective: High dose intravenous glucocorticoid (IVGC) pulse therapy is known to effectively reduce inflammatory signs and symptoms in patients with active inflammatory conditions. However, the efficacy of IVGC in ankylosing spondylitis (AS) is not clearly established. Methods: We performed a retrospective analysis with repeated measurements including patients with active, NSAID refractory axial AS (n=15) who underwent high dose IVGC pulse therapy. Parameters of clinical and humoral disease activity were compared to active AS patients (n=14) under continuous anti-TNF treatment. Patients were seen every 3 months and followed up for a total period of 12 months. Results: Both IVGC pulse and anti-TNF therapy lead to a significant and sustained reduction of the mean bath ankylosing spondylitis disease activity index (BASDAI 7.4 ± 1.5 at baseline vs. 5.4 ± 2.1 at 12 months in the pulse group and 6.9 ± 1.2 at baseline vs. 5.0 ± 2.7 at 12 months in the anti-TNF group, p<0.001), CRP (p=0.018), ESR (p=0.028), morning stiffness (p<0.001), and finger-to-floor-distance (p=0.001; within group comparison). Conclusions: Patients with active axial AS treated with one IVGC pulse show a substantial decrease in disease activity over a period of 12 months in this retrospective analysis.","PeriodicalId":91304,"journal":{"name":"Journal of arthritis","volume":"7 1","pages":"1-4"},"PeriodicalIF":0.0,"publicationDate":"2018-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.4172/2167-7921.1000266","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70836564","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 : 2018-01-01DOI: 10.4172/2167-7921.1000I107
K. Sigurjonsdottir, H. Jonsson
82 years old woman with a history of severe nodal hand osteoarthritis affecting both fingers and thumb base. She also had hypertension and chronic renal failure and in 1992 she started getting attacks of gout. Attempts to treat her with allopurinol had to be stopped due to side effects. Her hands became progressively affected by tophaceous gout with chronic pain particularly in the DIP joints. In 2012 she started febuxostat 80mg daily. Her symptoms improved within weeks and serum uric acid levels changed from 712 μmol/l in 2012 to 89 μmol/l in 2014. Tophy at other sites, including a large olecranon tophus regressed and have now disappeared (Figure 1).
{"title":"A New Form of Arthritis Mutilans Related to Successful Gout Treatment","authors":"K. Sigurjonsdottir, H. Jonsson","doi":"10.4172/2167-7921.1000I107","DOIUrl":"https://doi.org/10.4172/2167-7921.1000I107","url":null,"abstract":"82 years old woman with a history of severe nodal hand osteoarthritis affecting both fingers and thumb base. She also had hypertension and chronic renal failure and in 1992 she started getting attacks of gout. Attempts to treat her with allopurinol had to be stopped due to side effects. Her hands became progressively affected by tophaceous gout with chronic pain particularly in the DIP joints. In 2012 she started febuxostat 80mg daily. Her symptoms improved within weeks and serum uric acid levels changed from 712 μmol/l in 2012 to 89 μmol/l in 2014. Tophy at other sites, including a large olecranon tophus regressed and have now disappeared (Figure 1).","PeriodicalId":91304,"journal":{"name":"Journal of arthritis","volume":"69 1","pages":"1-1"},"PeriodicalIF":0.0,"publicationDate":"2018-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.4172/2167-7921.1000I107","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70837608","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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