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High Complication and Revision Rates in Anatomical Total Shoulder Arthroplasty with the Combination of Polyethylene and Cementless Convertible Metal-Backed Glenoid Components: A Retrospective Cohort Study. 使用聚乙烯和无水泥可转换金属支撑盂状关节组件的解剖型全肩关节置换术并发症和翻修率较高:一项回顾性队列研究。
IF 2
Orthopedic Research and Reviews Pub Date : 2024-02-27 eCollection Date: 2024-01-01 DOI: 10.2147/ORR.S442128
Klaus W J Hanisch
{"title":"High Complication and Revision Rates in Anatomical Total Shoulder Arthroplasty with the Combination of Polyethylene and Cementless Convertible Metal-Backed Glenoid Components: A Retrospective Cohort Study.","authors":"Klaus W J Hanisch","doi":"10.2147/ORR.S442128","DOIUrl":"10.2147/ORR.S442128","url":null,"abstract":"<p><strong>Background: </strong>Historically, Metal-Backed (MB) glenoid components in anatomical total Shoulder arthroplasty (aTSA) are prone to failure primarily due to loosening between the metal and bony surface. However, newer generations of MB glenoid components have performed well in reverse shoulder arthroplasty (RSA), with convertibility being considered to be the most significant benefit of MB components. Theoretically, MB components may be a viable option in \"Rotator cuff at risk\" cases. The aim of this study is to compare revisions versus revision-free survivorship and highlight problems associated with using convertible MB glenoid components in aTSA.</p><p><strong>Methods: </strong>Between December 2015 and September 2018, aTSA was performed on 30 patients utilizing 32 implants with convertible MB glenoid (two patients were operated bilaterally). The first investigation was performed at a mean of 55.9 months (43-76) by search in the national registry for revisions with twelve cases. The second FU on all remaining patients without revisions was conducted at a mean of 54.9 months (46-71) through physical examination with fourteen patients (sixteen implants), with four patients missing. Demographic data, indications, complications, revisions, and re-operations were recorded for each patient.</p><p><strong>Results: </strong>High rates of complications led to revisions or re-operation in aTSA in combination with MB (15/32). Seven problems were associated with polyethylene (PE), which included loosening, disengagement, or wear. Eight complications were not directly associated with the MB component. There was one with loosening on the metal-bone interface side. Conversion to RSA was possible in three cases, and secondary cuff failure was seen once. High infection rates (2/32) led to a different strategy for antibiotics and preoperative preparations.</p><p><strong>Conclusion: </strong>MB glenoid components caused unacceptably high complication and revision rates in aTSA. PE wear, disengagement, or loosening were the main reasons for revisions. Therefore, procedures with MB glenoid components were abandoned in aTSA.</p><p><strong>Level of evidence: </strong>Level IV case series, treatment study.</p>","PeriodicalId":19608,"journal":{"name":"Orthopedic Research and Reviews","volume":"16 ","pages":"93-101"},"PeriodicalIF":2.0,"publicationDate":"2024-02-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10908272/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140022351","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Efficacy and Safety of Generic Alendronate for Osteoporosis Treatment. 非专利阿仑膦酸钠治疗骨质疏松症的有效性和安全性。
IF 2
Orthopedic Research and Reviews Pub Date : 2024-02-22 eCollection Date: 2024-01-01 DOI: 10.2147/ORR.S445202
Atthakorn Jarusriwanna, Saran Malisorn, Sirikarn Tananoo, Kwanchanok Areewong, Supachok Rasamimongkol, Artit Laoruengthana
{"title":"Efficacy and Safety of Generic Alendronate for Osteoporosis Treatment.","authors":"Atthakorn Jarusriwanna, Saran Malisorn, Sirikarn Tananoo, Kwanchanok Areewong, Supachok Rasamimongkol, Artit Laoruengthana","doi":"10.2147/ORR.S445202","DOIUrl":"10.2147/ORR.S445202","url":null,"abstract":"<p><strong>Background: </strong>While osteoporosis increases the risk of fragility fractures, bisphosphonate has been proven to increase bone strength and reduce the risk of vertebral and non-vertebral fractures. In addition to its efficacy, substituting the brand with generic medication is a strategy to optimize healthcare expenditures. This study aimed to evaluate the efficacy of generic alendronate treatment and assess potential adverse events in patients with osteoporosis.</p><p><strong>Materials and methods: </strong>A retrospective review was conducted on 120 patients who met the indications for osteoporosis treatment, received weekly generic alendronate (70 mg) for >1 year, and underwent evaluation through standard axial dual-energy X-ray absorptiometry (DXA). The outcomes of this study were the percent change in bone mineral density (BMD) at the lumbar spine, femoral neck, and total hip after one year of treatment. The major adverse events occurring during medication that led to the discontinuation of drug administration were documented.</p><p><strong>Results: </strong>Most patients were female (96.7%) with an average age of 69.0 ± 9.3 years. The percent change in BMD increased at all sites after one year of generic alendronate treatment (lumbar spine: 5.6 ± 13.7, <i>p</i>-value <0.001; femoral neck: 2.3 ± 8.3, <i>p</i>-value = 0.023; total hip: 2.1 ± 6.2, <i>p</i>-value = 0.003), with over 85% of patients experiencing increased or stable BMD. Three patients discontinued the medication due to adverse effects: two had dyspepsia, and one had persistent myalgia.</p><p><strong>Conclusion: </strong>Generic alendronate may be considered an effective antiresorptive agent for osteoporosis treatment with a low incidence of adverse effects.</p>","PeriodicalId":19608,"journal":{"name":"Orthopedic Research and Reviews","volume":"16 ","pages":"85-91"},"PeriodicalIF":2.0,"publicationDate":"2024-02-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10895978/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139972927","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
External Fixation as a Primary and Definitive Treatment for Complex Tibial Diaphyseal Fractures: An Underutilized and Efficacious Approach. 外固定作为复杂胫骨骺端骨折的主要和最终治疗方法:一种未被充分利用的有效方法。
IF 2
Orthopedic Research and Reviews Pub Date : 2024-02-21 eCollection Date: 2024-01-01 DOI: 10.2147/ORR.S450774
Ahmed Albushtra, Abdulsalam Hadi Mohsen, Khaled Ali Alnozaili, Faisal Ahmed, Younes Mohsen Ali Abdu Aljobahi, Fawaz Mohammed, Mohamed Badheeb
{"title":"External Fixation as a Primary and Definitive Treatment for Complex Tibial Diaphyseal Fractures: An Underutilized and Efficacious Approach.","authors":"Ahmed Albushtra, Abdulsalam Hadi Mohsen, Khaled Ali Alnozaili, Faisal Ahmed, Younes Mohsen Ali Abdu Aljobahi, Fawaz Mohammed, Mohamed Badheeb","doi":"10.2147/ORR.S450774","DOIUrl":"https://doi.org/10.2147/ORR.S450774","url":null,"abstract":"<p><strong>Background: </strong>External fixation is one of the most often utilized treatment options for complicated tibial diaphyseal fractures (TDF). The purpose of this study was to assess the efficacy of unilateral external fixators as primary and definitive therapy for complex TDF in a resource-limited setting.</p><p><strong>Materials and methods: </strong>A retrospective study between June 2016 and March 2021 included 110 subjects with TDF who were treated with an external fixator as definitive fixation in hospitals affiliated with Ibb University. The patient's demographic characteristics, complications, and outcomes were gathered and analyzed. Factors associated with pin site infection were also investigated.</p><p><strong>Results: </strong>The mean age was 42.1 ± 10.1 years, with 92.7% being male. Rural residents accounted for 22.7%. Smoking and diabetes mellitus were present in 27.3% and 30.0%, respectively. General complications occurred in 12.0%, with pulmonary embolism being the most common at 4.5%. Orthopedic complications included pin-track infections in 27.3% (30) and osteomyelitis in 1.8% (2). Pin site infections required medical treatment in 21 cases and external fixator changes in five. Two cases each needed several debridements for osteomyelitis and soft tissue. Full union occurred in 79.1% (87) over 23.1 ± 3.2 weeks and final alignment in 97.3% (107) over 34.8 ± 4.8 weeks. Malunions occurred in 1.8% (2), and one case had hypertrophic nonunion. Factors like rural residency, smoking, diabetes, open fractures, worst fracture grade (Gustilo and Anderson type C), and general complications occurrence significantly correlated with pin site infection (all p-values < 0.05).</p><p><strong>Conclusion: </strong>A unilateral external fixator as a primary and definitive treatment is a viable, simple, and effective option for TDF with a high success rate even in a resource-limited setting. In this study, residents in rural areas, smoking, diabetes, open fracture, worst fracture grade, and general complication occurrence were associated with pin site infection occurrence.</p>","PeriodicalId":19608,"journal":{"name":"Orthopedic Research and Reviews","volume":"16 ","pages":"75-84"},"PeriodicalIF":2.0,"publicationDate":"2024-02-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10894515/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139972928","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Patient Reported Clinical Outcomes Following PCL Suture Augmentation in Patients with Multiligamentous Knee Injury: A Retrospective Observational Study. 多韧带膝关节损伤患者 PCL 缝合增强术后患者临床疗效报告:回顾性观察研究
IF 2
Orthopedic Research and Reviews Pub Date : 2024-02-16 eCollection Date: 2024-01-01 DOI: 10.2147/ORR.S425781
Amir Fathi, Ashley A Thompson, Ioanna K Bolia, Cory K Mayfield, Shane S Korber, Avinash Iyer, George F Hatch Iii
{"title":"Patient Reported Clinical Outcomes Following PCL Suture Augmentation in Patients with Multiligamentous Knee Injury: A Retrospective Observational Study.","authors":"Amir Fathi, Ashley A Thompson, Ioanna K Bolia, Cory K Mayfield, Shane S Korber, Avinash Iyer, George F Hatch Iii","doi":"10.2147/ORR.S425781","DOIUrl":"10.2147/ORR.S425781","url":null,"abstract":"<p><strong>Purpose: </strong>To compare the patient-reported outcomes between patients with posterior cruciate ligament (PCL) reconstruction or repair alone versus PCL reconstruction or repair with internal bracing (IB) in the context of multi-ligament knee injuries (MLKI).</p><p><strong>Methods: </strong>All patients who underwent surgical management of MLKI at two institutions between 2006 and 2020 were retrospectively identified and offered participation in the study. Patient reported outcomes were measured via three instruments: Lysholm Knee score, Multiligament Quality of Life (ML-QOL), and the Patient-Reported Outcomes Measurement Information System (PROMIS) computer adaptive testing (CAT). The postoperative outcomes and reoperation rates were compared between the internal bracing and non-internal bracing groups.</p><p><strong>Results: </strong>Fifty-two patients were analyzed; 34 were included in the IB group (17.6% female; age 33.1 ±1.60 years), and 18 were included in the non-IB group (11.1% female; age 34.1 ±3.72 years). Mean follow-up time of the entire cohort was 1.44 ± 0.22 years (IB: 1.21 ± 0.18; non-IB: 2.1 ±0.65). There were no significant differences between PROMIS CAT [PROMIS Pain (54.4 ±1.78 vs 51.7 ±1.70, p=0.319), Physical Function (44.3 ±2.27 vs 47.9 ±1.52, p=0.294), Mobility (44.0 ±1.71 vs 46.1 ±2.10, p=0.463)], ML-QOL [ML-QOL Physical Impairment (40.7 ±4.21 vs 41.7±5.10, p=0.884), Emotional Impairment (49.2 ±4.88 vs 44.7±5.87, p=0.579), Activity Limitation (43.5 ±4.56 vs 31.5±3.62, p=0.087), Societal Involvement (44.9 ±4.96 vs 37.5 ±5.30, p=0.345)] and Lysholm knee score (61.8 ±4.55 vs 61.0 ±4.95, p=0.916) postoperatively compared to the non-IB group.</p><p><strong>Conclusion: </strong>In this group of patients, function and patient-reported outcomes between patients treated with PCL reconstruction and repair without internal brace versus those with additional internal brace augmentation were not significantly different. Further research encompassing a larger patient sample is necessary to investigate the efficacy of the internal brace for PCL injury in the context of MLKI injuries.</p>","PeriodicalId":19608,"journal":{"name":"Orthopedic Research and Reviews","volume":"16 ","pages":"67-74"},"PeriodicalIF":2.0,"publicationDate":"2024-02-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10878190/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139913201","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Management of Garden-I and II Femoral Neck Fractures: Perspectives on Primary Arthroplasty Garden-I 和 II 型股骨颈骨折的处理:初级关节置换术的视角
IF 2
Orthopedic Research and Reviews Pub Date : 2024-01-01 DOI: 10.2147/ORR.S340535
Jon Olansen, Zainab Ibrahim, Roy K Aaron
{"title":"Management of Garden-I and II Femoral Neck Fractures: Perspectives on Primary Arthroplasty","authors":"Jon Olansen, Zainab Ibrahim, Roy K Aaron","doi":"10.2147/ORR.S340535","DOIUrl":"https://doi.org/10.2147/ORR.S340535","url":null,"abstract":"Abstract This review compares internal fixation versus arthroplasty in the treatment of nondisplaced femoral neck fractures (FNFs) calling attention to evolving areas of consensus that influence clinical decision-making. The Garden classification system, typically dichotomized into nondisplaced (types I and II) and displaced (types III and IV) fractures, has been used as a guide for surgical decision-making. Conventionally, treatment of nondisplaced FNF in the elderly has been with internal fixation, and treatment of a displaced FNF has been hemi-, or more recently total hip, arthroplasty. Studies over the last decade have raised concern over the appropriate treatment of nondisplaced FNFs due to high rates of reoperation of nondisplaced FNFs treated with internal fixation. Avascular necrosis (AVN), failure of internal fixation, secondary malunion, and pin/nail penetration through the femoral head have all been observed. Several studies have attributed fixation failure to a degree of femoral neck tilt ≥20°, either posteriorly or anteriorly as seen on the lateral X-ray. Because of these observations of fixation failures, the suggestion has been made that arthroplasty be used when the degree of posterior tilt exceeds a threshold of ≥20° tilt with the expectation of diminishing failure of fixation, decreasing the risk of reoperation and preserving function without increasing mortality rate. Frustrating additional analyses are uncertainties over the mechanisms of failure of internal fixation with ≥20° tilt and the persistently substantial 1-year mortality rate after FNF, which has not been influenced by fixation or replacement type. Due to the lack of consensus regarding the determination of the appropriate surgical intervention for nondisplaced FNFs, an improved algorithm for surgical decision-making for these fractures may prove useful.","PeriodicalId":19608,"journal":{"name":"Orthopedic Research and Reviews","volume":" 3","pages":"1 - 20"},"PeriodicalIF":2.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139393023","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}
引用次数: 0
Efficacy and Safety Study of Low-Molecular-Weight Heparin and Fondaparinux Sodium After Hip Arthroplasty: A Retrospective Cohort Study. 低分子肝素和Fondaparinux钠在髋关节置换术后的疗效和安全性研究:一项回顾性队列研究。
IF 2
Orthopedic Research and Reviews Pub Date : 2023-11-24 eCollection Date: 2023-01-01 DOI: 10.2147/ORR.S431372
Abuduwupuer Haibier, Alimujiang Yusufu, Hang Lin, Aiben Kayierhan, Yimuran Abudukelimu, Tuerhongjiang Abudurexiti
{"title":"Efficacy and Safety Study of Low-Molecular-Weight Heparin and Fondaparinux Sodium After Hip Arthroplasty: A Retrospective Cohort Study.","authors":"Abuduwupuer Haibier, Alimujiang Yusufu, Hang Lin, Aiben Kayierhan, Yimuran Abudukelimu, Tuerhongjiang Abudurexiti","doi":"10.2147/ORR.S431372","DOIUrl":"10.2147/ORR.S431372","url":null,"abstract":"<p><strong>Background: </strong>Low molecular heparin(LMWH) and sodium sulfadiazine heparin(FPX) are commonly used to prevent deep vein thrombosis(DVT) after total hip arthroplasty(THA). In this study, we compared the role of these drugs in preventing DVT after THA.</p><p><strong>Methods: </strong>Patients who underwent unilateral THA at the Sixth Affiliated Hospital of Xinjiang Medical University from April 2020 to December 2022 were retrospectively analyzed for inclusion in this study. According to the anticoagulant drugs used, the patients were divided into LMWH group (n=106) and FPX group (n=97). Changes in perioperative coagulation-related indices, hemoglobin, blood loss And the postoperative complications.</p><p><strong>Results: </strong>The preoperative indexes of the two groups of patients, the difference was not statistically significant (P>0.05); the indexes of Intraoperative blood loss, Visible blood loss, Hidden blood loss, and Total blood loss of the two groups of patients were compared, and the difference was not significant (P>0.05); PT activity and INR in the LMWH group were significantly lower than those in the FPX group on the 1st and 5th postoperative days, and the differences were significant (P<0.05); Platelets, Hemoglobin, Hematocrit, D-dimer, and Fibrinogen were compared between the two groups on the 1st and 5th postoperative days, and the differences were not significant (P<0.05). The differences were not significant (P>0.05). The differences in blood transfusion rate and blood volume between the two groups were not significant (P>0.05); the total hospitalization cost of the LMWH group was significantly lower than that of the FPX group, and the difference was significant (P<0.05); and the differences in the incidence of postoperative complications between the two groups were not significant (P>0.05).</p><p><strong>Conclusion: </strong>In this study, we found that the efficacy and safety of FPX and LMWH in preventing VTE after THA were basically the same, and the total cost of hospitalization in the LMWH group was significantly lower than that in the FPX group; however, due to the limited inclusion of the sample size, high-quality, large-sample, long-term follow-up clinical studies are necessary.</p>","PeriodicalId":19608,"journal":{"name":"Orthopedic Research and Reviews","volume":"15 ","pages":"253-261"},"PeriodicalIF":2.0,"publicationDate":"2023-11-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10684995/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138461375","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Arthroscopic Minced Cartilage Repair in the Glenohumeral Joint - Short Term Clinical Outcome in a 33-Year-Old Handyman: A Case Report. 关节镜下肱骨关节绞碎软骨修复术-一例33岁杂工的短期临床结果报告。
IF 2
Orthopedic Research and Reviews Pub Date : 2023-11-23 eCollection Date: 2023-01-01 DOI: 10.2147/ORR.S418032
Roman Frederik Karkosch, Tomas Smith, Gunnar Jensen, Lars Rene Tuecking, Hauke Horstmann
{"title":"Arthroscopic Minced Cartilage Repair in the Glenohumeral Joint - Short Term Clinical Outcome in a 33-Year-Old Handyman: A Case Report.","authors":"Roman Frederik Karkosch, Tomas Smith, Gunnar Jensen, Lars Rene Tuecking, Hauke Horstmann","doi":"10.2147/ORR.S418032","DOIUrl":"https://doi.org/10.2147/ORR.S418032","url":null,"abstract":"<p><strong>Objective: </strong>Clinical outcome data for the novel minced cartilage procedure are sparse. While good results have been shown for the knee joint, this is the first report in the current literature regarding this increasingly important procedure in the glenohumeral joint.</p><p><strong>Case description: </strong>A 33-year-old handyman with a cartilage defect in the humeral head underwent an all arthroscopic one-stage cartilage repair with the AutoCart<sup>TM</sup> procedure (Arthrex GmbH, Munich, Germany). A senior specialist examined the patient before surgery, five-, 12-and 24-weeks post-surgery. Outcome parameters (Constant-Murley Score, UCLA Shoulder Score and ASES Score) and radiographic imaging were recorded.</p><p><strong>Results: </strong>At six months, follow-up the outcome parameter showed excellent results, the joint pain decreased to numeric rating scale (NRS) 0. The postoperative magnetic resonance imaging (MRI) revealed a thin cartilage layer in the treated area with sufficient integration to the surrounding tissue. The cartilage in the former defect zone presented a homogeneous signal, which was comparable to the intact cartilage.</p><p><strong>Conclusion: </strong>This case report underlines the growing interest in single-stage arthroscopic minced cartilage procedures and shows promising results in the glenohumeral joint. Yet, larger investigations with long-term follow-up are necessary to provide reliable clinical data to determine if comparable results can be achieved over time.</p>","PeriodicalId":19608,"journal":{"name":"Orthopedic Research and Reviews","volume":"15 ","pages":"245-251"},"PeriodicalIF":2.0,"publicationDate":"2023-11-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10680470/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138461373","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Outcome of Surgical Management of Dermatofibrosarcoma Protuberance: A Single-Institution Multidisciplinary Approach. 皮肤纤维肉瘤隆突的外科治疗结果:单一机构多学科方法。
IF 2
Orthopedic Research and Reviews Pub Date : 2023-11-20 eCollection Date: 2023-01-01 DOI: 10.2147/ORR.S437175
Abdulrahman Yousef Alhabeeb, Ahmed O Idrees, Thamer S Alhowaish, Moustafa S Alhamadh, Emad Masudi, Abdullah Alanazi, Wazzan Aljuhani
{"title":"Outcome of Surgical Management of Dermatofibrosarcoma Protuberance: A Single-Institution Multidisciplinary Approach.","authors":"Abdulrahman Yousef Alhabeeb, Ahmed O Idrees, Thamer S Alhowaish, Moustafa S Alhamadh, Emad Masudi, Abdullah Alanazi, Wazzan Aljuhani","doi":"10.2147/ORR.S437175","DOIUrl":"https://doi.org/10.2147/ORR.S437175","url":null,"abstract":"<p><strong>Introduction: </strong>Dermatofibrosarcoma protuberans (DFSP) is a rare, slow-growing, and locally aggressive soft tissue tumor with a high recurrence rate and metastatic potential, even with the proper treatment.</p><p><strong>Methods: </strong>This was a retrospective (case series) study that took place at King Abdulaziz Medical City, Riyadh, Kingdom of Saudi Arabia, to determine the outcomes of and appropriate margin excision for DFSP. All patients who were diagnosed with DFSP from 2016 to 2021 were included. The following variables were assessed: demographics, tumor characteristics, management options, and most importantly, whether patients were managed with an oncology-oriented approach or a non-oncology-oriented approach.</p><p><strong>Results: </strong>There were a total of seventeen patients with DFSP, four of whom had fibrosarcomatous differentiation (FS-DFSP). The majority (N = 13, 76.5%) of the patients were females. The lower extremities and back were the most common locations for DFSP, accounting for 47.1% and 23.5%, respectively. Only two (11.76%) patients had metastatic disease, one of whom had FS-DFSP. The minimum resection margin was 3 cm, and the maximum was 5 cm. Thirteen (76.47%) patients were managed with an oncology-oriented approach (Group I), 23% of whom had post-excision positive margins. However, all patients who were managed with a non-oncology-oriented approach (Group II) had positive margins post-excision. More than three-quarters (76.9%) of group I underwent wide resection. Split-thickness skin grafting and primary closure were the most commonly used reconstruction methods in groups I and II, respectively. The mean planned margins in groups I and II were 3.9 cm and 1.7 cm, respectively.</p><p><strong>Conclusion: </strong>The findings of this study suggest that a planned wide-margin excision with a minimum safe margin of 3-5 cm should be implemented to reduce the recurrence, metastasis, and need for further surgeries in patients with DFSP.</p>","PeriodicalId":19608,"journal":{"name":"Orthopedic Research and Reviews","volume":"15 ","pages":"237-243"},"PeriodicalIF":2.0,"publicationDate":"2023-11-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10675642/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138461376","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Clinical Effects of the End-Love Technique in the Treatment of Recurrent Lumbar Disc Herniation 1 Year After Surgery. 终爱技术治疗术后1年复发性腰椎间盘突出症的临床效果。
IF 2
Orthopedic Research and Reviews Pub Date : 2023-11-16 eCollection Date: 2023-01-01 DOI: 10.2147/ORR.S433846
Peng Li, Xiang Li, Lin Ma, Hai Yi He
{"title":"Clinical Effects of the End-Love Technique in the Treatment of Recurrent Lumbar Disc Herniation 1 Year After Surgery.","authors":"Peng Li, Xiang Li, Lin Ma, Hai Yi He","doi":"10.2147/ORR.S433846","DOIUrl":"https://doi.org/10.2147/ORR.S433846","url":null,"abstract":"<p><strong>Background: </strong>The number of patients with lumbar disc herniation in China is increasing year by year. Percutaneous endoscopic lumbar discectomy (PELD) is currently the main surgical method for treating lumbar disc herniation (LDH). However, with the increase in the number of surgical cases, the number of patients with recurrent lumbar disc herniation (RLDH) is also increasing. Currently, the common method in China is lumbar fusion surgery, but this surgery would cause the loss of fusion segment mobility and considerable postoperative complications. In order to solve the problem above the following technique will be studied: the technique of posterior lumbar laminectomy and nucleus pulposus removal under fully visualized spinal endoscopy (ENDO-LOVE) to treat RLDH. Its clinical effects will be observed in this paper, too.</p><p><strong>Methods: </strong>This series includes RLDH patients treated with ENDO-LOVE technology between January 2017 and January 2021. All patients will undergo at least three follow-up visits one year after surgery. The modified MacNab standard, VAS, JOA, and ODI scores will be used to evaluate clinical efficacy, observe for cerebrospinal fluid leak, nerve root injury, and surgical site infection, and evaluate clinical safety.</p><p><strong>Results: </strong>All 29 patients completed the surgery successfully. Three patients had postoperative pain and numbness in the area of nerve root innervation, and all patients had no serious complications. The VAS, JOA scores and ODI indices of back pain and leg pain 1-day, 3-months, and 1-year postoperatively differed statistically significantly from the preoperative scores (<i>p</i> < 0.05). Efficacy evaluated at 1-year postoperatively using the modified MacNab criteria showed an excellent rate of 89.7%.</p><p><strong>Conclusion: </strong>ENDO-LOVE technology has demonstrated good clinical efficacy and safety in the treatment of patients with RLDH. It should be considered for all patients with this condition.</p>","PeriodicalId":19608,"journal":{"name":"Orthopedic Research and Reviews","volume":"15 ","pages":"225-236"},"PeriodicalIF":2.0,"publicationDate":"2023-11-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10659146/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138461374","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Tissue Augmentation Techniques in the Management of Ligamentous Knee Injuries. 组织增强技术在膝关节韧带损伤治疗中的应用。
IF 2
Orthopedic Research and Reviews Pub Date : 2023-11-15 eCollection Date: 2023-01-01 DOI: 10.2147/ORR.S385817
Ashley A Thompson, Ioanna K Bolia, Amir Fathi, Andrew Dobitsch, Christian A Cruz, Rajvarun Grewal, Alexander E Weber, Frank A Petrigliano, George F Hatch Iii
{"title":"Tissue Augmentation Techniques in the Management of Ligamentous Knee Injuries.","authors":"Ashley A Thompson, Ioanna K Bolia, Amir Fathi, Andrew Dobitsch, Christian A Cruz, Rajvarun Grewal, Alexander E Weber, Frank A Petrigliano, George F Hatch Iii","doi":"10.2147/ORR.S385817","DOIUrl":"https://doi.org/10.2147/ORR.S385817","url":null,"abstract":"<p><p>Despite early reports of high failure rates in knee ligament repair techniques resulting in favor of reconstruction, newer advances in surgical technology have shifted the attention back to repair with the addition of various tissue augmentation techniques. Ligament repair preserves proprioceptors in the native ligament and avoids autograft tendon harvest, minimizing the complications associated with donor site ruptures in reconstruction techniques. Tissue augmentation has been successfully used in knee ligamentous and tendon repair procedures, as well as in some upper extremity procedures. This study provides a clinical update on the surgical techniques, biomechanics, and outcomes with the application of various tissue augmentation techniques in the ligaments surrounding the knee joint.</p>","PeriodicalId":19608,"journal":{"name":"Orthopedic Research and Reviews","volume":"15 ","pages":"215-223"},"PeriodicalIF":2.0,"publicationDate":"2023-11-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10657762/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138461377","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
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