World Journal of Orthopedics最新文献

{"title":"Anterior cruciate ligament reconstruction: Effect of graft tunnel position on early to mid-term clinical outcomes.","authors":"Oliver Mann, Oday Al-Dadah","doi":"10.5312/wjo.v15.i8.744","DOIUrl":"10.5312/wjo.v15.i8.744","url":null,"abstract":"<p><strong>Background: </strong>Patient reported outcome measures (PROMs) can be used to assess knee function following anterior cruciate ligament (ACL) reconstruction. Intra-operatively, femoral and tibial tunnels are created to accommodate the new ACL graft. It is postulated that there is an optimum position and orientation of these tunnels and that outcomes from this procedure are affected by their position.</p><p><strong>Aim: </strong>To evaluate the influence of graft tunnel position on early to mid-term clinical outcomes following ACL reconstruction.</p><p><strong>Methods: </strong>Six PROMs were collected following ACL reconstruction which included the Knee Injury and Osteoarthritis Outcome Score (KOOS), International Knee Documentation Committee, Lysholm, Tegner, EuroQol-5 Dimension-5 level, and Short Form 12-item Health Survey. A total of 8 radiological parameters were measured from post-operative X-rays relating to graft tunnel positions. This data was analysed to assess for any correlations between graft tunnel position and post-operative PROMs.</p><p><strong>Results: </strong>A total of 87 patients were included in the study with a mean post-operative follow-up of 2.3 years (range 1 to 7 years). Posterior position of tibial tunnel was associated with improved KOOS quality of life (rho = 0.43, <i>P</i> = 0.002) and EQ-5D VAS (rho = 0.36, <i>P</i> = 0.010). Anterior position of EndoButton femoral tunnel was associated with an improved EQ-5D index (rho = -0.38, <i>P</i> = 0.028). There were no other significant correlations between any of the other radiological parameters and PROM scores.</p><p><strong>Conclusion: </strong>Overall, graft tunnel position had very little correlation with clinical outcomes following ACL reconstruction. A few (posterior) tibial tunnel and (anterior) EndoButton femoral tunnel measurements were associated with better PROMs.</p>","PeriodicalId":47843,"journal":{"name":"World Journal of Orthopedics","volume":"15 8","pages":"744-753"},"PeriodicalIF":2.0,"publicationDate":"2024-08-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11331329/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142010242","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}

{"title":"Hemophagocytic lymphohistiocytosis triggered by relapsing polychondritis: A case report.","authors":"Mi-Ran Han, Jeong-Hwan Hwang, Seungah Cha, So-Yeon Jeon, Kyu Yun Jang, Namsu Kim, Chang-Hoon Lee","doi":"10.5312/wjo.v15.i8.813","DOIUrl":"10.5312/wjo.v15.i8.813","url":null,"abstract":"<p><strong>Background: </strong>Hemophagocytic lymphohistiocytosis (HLH) is a rare, life-threatening disorder caused by abnormal histiocytes and T cell activation. In adults, it is predominantly associated with infections, cancers, and autoimmune diseases. Relapsing polychondritis (RP), another rare disease, is diagnosed based on symptoms without specific tests, featuring cartilage inflammation characterized by swelling, redness, and pain, rarely inducing HLH.</p><p><strong>Case summary: </strong>A 74-year-old woman visited the emergency room with a fever of 38.6 °C. Blood tests, cultures, and imaging were performed to evaluate fever. Results showed increased fluorescent antinuclear antibody levels and mild cytopenia, with no other specific findings. Imaging revealed lymph node enlargement was observed; however, biopsy results were inconclusive. Upon re-evaluation of the physical exam, inflammatory signs suggestive of RP were observed in the ears and nose, prompting a tissue biopsy for confirmation. Simultaneously, persistent fever accompanied by cytopenia prompted a bone marrow examination, revealing hemophagocytic cells. After finding no significant results in blood culture, viral markers, and tissue examination of enlarged lymph nodes, HLH was diagnosed by RP. Treatment involved methylprednisolone followed by azathioprine. After two months, bone marrow examination confirmed resolution of hemophagocytosis, with normalization of hyperferritinemia and pancytopenia.</p><p><strong>Conclusion: </strong>Thorough physical examination enabled diagnosis and treatment of HLH triggered by RP in patients presenting with fever of unknown origin.</p>","PeriodicalId":47843,"journal":{"name":"World Journal of Orthopedics","volume":"15 8","pages":"813-819"},"PeriodicalIF":2.0,"publicationDate":"2024-08-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11331317/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142009710","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}

{"title":"Clinical effect of operative <i>vs</i> nonoperative treatment on humeral shaft fractures: Systematic review and meta-analysis of clinical trials.","authors":"Yang Li, Yi Luo, Jing Peng, Jun Fan, Xiao-Tao Long","doi":"10.5312/wjo.v15.i8.783","DOIUrl":"10.5312/wjo.v15.i8.783","url":null,"abstract":"<p><strong>Background: </strong>Whether operation is superior to non-operation for humeral shaft fracture remains debatable. We hypothesized that operation could decrease the nonunion and reintervention rates and increase the functional outcomes.</p><p><strong>Aim: </strong>To compare the clinical efficacy between operative and nonoperative approaches for humeral shaft fractures.</p><p><strong>Methods: </strong>We searched the PubMed, Web of Science, ScienceDirect, and Cochrane databases from 1990 to December 2023 for clinical trials and cohort studies comparing the effects of operative and conservative methods on humeral shaft fractures. Two investigators independently extracted data from the eligible studies, and the other two assessed the methodological quality of each study. The quality of the included studies was assessed using the Cochrane risk bias or Newcastle-Ottawa Scale. The nonunion, reintervention and the overall complications and functional scores were pooled and analyzed using Review Manager software (version 5.3).</p><p><strong>Results: </strong>A total of four randomized control trials and 13 cohort studies were included, with 1285 and 1346 patients in the operative and nonoperative groups, respectively. Patients in the operative group were treated with a plate or nail, whereas those in the conservative group were managed with splint or functional bracing. Four studies were assessed as having a high risk of bias, and the other 13 were of a low risk of bias according to the Newcastle-Ottawa Scale or Cochrane risk bias tool. The operative group had a significantly decreased rate of nonunion [odds ratio (OR) 0.30; 95%CI: 0.23 to 0.40), reintervention (OR: 0.33; 95%CI: 0.24 to 0.47), and overall complications (OR: 0.62; 95%CI: 0.49 to 0.78)]. The pooled effect of the Disabilities of Arm, Shoulder, and Hand score showed a significant difference at 3 [mean difference (MD) -8.26; 95%CI: -13.60 to -2.92], 6 (MD: -6.72; 95%CI: -11.34 to -2.10), and 12 months (MD: -2.55; 95%CI: -4.36 to -0.74). The pooled effect of Visual Analog Scale scores and the Constant-Murley score did not significantly differ between the two groups.</p><p><strong>Conclusion: </strong>This systematic review and meta-analysis revealed a trend of rapid functional recovery and decreased rates of nonunion and reintervention after operation for humeral shaft fracture compared to conservative treatment.</p>","PeriodicalId":47843,"journal":{"name":"World Journal of Orthopedics","volume":"15 8","pages":"783-795"},"PeriodicalIF":2.0,"publicationDate":"2024-08-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11331324/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142009706","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}

{"title":"Factors that influence the results of indirect decompression employing oblique lumbar interbody fusion.","authors":"Andrey E Bokov, Svetlana Y Kalinina, Mingiyan I Khaltyrov, Alexandr P Saifullin, Anatoliy A Bulkin","doi":"10.5312/wjo.v15.i8.734","DOIUrl":"10.5312/wjo.v15.i8.734","url":null,"abstract":"<p><strong>Background: </strong>Indirect decompression is one of the potential benefits of anterior reconstruction in patients with spinal stenosis. On the other hand, the reported rate of revision surgery after indirect decompression highlights the necessity of working out prediction models for the radiographic results of indirect decompression with assessing their clinical relevance.</p><p><strong>Aim: </strong>To assess factors that influence radiographic and clinical results of the indirect decompression in patients with stenosis of the lumbar spine.</p><p><strong>Methods: </strong>This study is a single-center cross-sectional evaluation of 80 consecutive patients (17 males and 63 females) with lumbar spinal stenosis combined with the instability of the lumbar spinal segment. Patients underwent single level or bisegmental spinal instrumentation employing oblique lumbar interbody fusion (OLIF) with percutaneous pedicle screw fixation. Radiographic results of the indirect decompression were assessed using computerized tomography, while MacNab scale was used to assess clinical results.</p><p><strong>Results: </strong>After indirect decompression employing anterior reconstruction using OLIF, the statistically significant increase in the disc space height, vertebral canal square, right and left lateral canal depth were detected (<i>Р</i> < 0.0001). The median (<i>M</i>) relative vertebral canal square increase came to <i>М</i> = 24.5% with 25%-75% quartile border (16.3%; 33.3%) if indirect decompression was achieved by restoration of the segment height. In patients with the reduction of the upper vertebrae slip, the median of the relative increase in vertebral canal square accounted for 49.5% with 25%-75% quartile border (2.35; 99.75). Six out of 80 patients (7.5%) presented with unsatisfactory results because of residual nerve root compression. The critical values for lateral recess depth and vertebral canal square that were associated with indirect decompression failure were 3 mm and 80 mm² respectively.</p><p><strong>Conclusion: </strong>Indirect decompression employing anterior reconstruction is achieved by the increase in disc height along the posterior boarder and reduction of the slipped vertebrae in patients with degenerative spondylolisthesis. Vertebral canal square below 80 mm² and lateral recess depth less than 3 mm are associated with indirect decompression failures that require direct microsurgical decompression.</p>","PeriodicalId":47843,"journal":{"name":"World Journal of Orthopedics","volume":"15 8","pages":"734-743"},"PeriodicalIF":2.0,"publicationDate":"2024-08-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11331328/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142009709","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}

{"title":"Intra-articular interventions in osteoarthritis: Navigating the landscape of hyaluronic acid, mesenchymal stem cells, and platelet-rich plasma.","authors":"Somar Soufan, Joenne Al Khoury, Zahi Hamdan, Mohamad Ali Rida","doi":"10.5312/wjo.v15.i8.704","DOIUrl":"10.5312/wjo.v15.i8.704","url":null,"abstract":"<p><p>Osteoarthritis (OA) poses a substantial burden on patients, leading to pain, functional decline, and reduced quality of life. While conventional treatments focus on symptom management, disease-modifying interventions are yet to be established. This review explores the efficacy of intra-articular interventions, particularly hyaluronic acid (HA), mesenchymal stem cells (MSCs), and platelet-rich plasma (PRP), in the context of OA management. HA injections, with diverse formulations like Hylan G-F20, sodium hyaluronate, and hyaluronan, present varying outcomes, necessitating a nuanced understanding of their effectiveness and timing. MSC therapy, derived from adipose tissue, umbilical cord, or bone marrow, shows promising results in clinical improvement, with adipose-derived MSCs demonstrating efficacy in maintaining benefits over 6 mo. Conversely, bone-marrow-derived MSCs show limited effectiveness, highlighting the need for source-specific considerations. PRP has emerged as a superior option for long-term pain reduction and quality of life improvement, with leukocyte-poor formulations and a critical platelet count of 10 billion demonstrating optimal results. This comprehensive analysis underscores the potential of intra-articular interventions in OA management, emphasizing the need for personalized and evidence-based approaches to enhance treatment efficacy and patient outcomes.</p>","PeriodicalId":47843,"journal":{"name":"World Journal of Orthopedics","volume":"15 8","pages":"704-712"},"PeriodicalIF":2.0,"publicationDate":"2024-08-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11331319/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142009713","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}

{"title":"Readmission rate and early complications in patients undergoing total knee arthroplasty: A retrospective study.","authors":"Tushar Jethi, Deepak Jain, Rajnish Garg, Harpal Singh Selhi","doi":"10.5312/wjo.v15.i8.713","DOIUrl":"10.5312/wjo.v15.i8.713","url":null,"abstract":"<p><strong>Background: </strong>Total knee arthroplasty (TKA) can improve pain, quality of life, and functional outcomes. Although uncommon, postoperative complications are extremely consequential and thus must be carefully tracked and communicated to patients to assist their decision-making before surgery. Identification of the risk factors for complications and readmissions after TKA, taking into account common causes, temporal trends, and risk variables that can be changed or left unmodified, will benefit this process.</p><p><strong>Aim: </strong>To assess readmission rates, early complications and their causes after TKA at 30 days and 90 days post-surgery.</p><p><strong>Methods: </strong>This was a prospective and retrospective study of 633 patients who underwent TKA at our hospital between January 1, 2017, and February 28, 2022. Of the 633 patients, 28 were not contactable, leaving 609 who met the inclusion criteria. Both inpatient and outpatient hospital records were retrieved, and observations were noted in the data collection forms.</p><p><strong>Results: </strong>Following TKA, the 30-day and 90-day readmission rates were determined to be 1.1% (<i>n</i> = 7) and 1.8% (<i>n</i> = 11), respectively. The unplanned visit rate at 30 days following TKA was 2.6% (<i>n</i> = 16) and at 90 days was 4.6% (<i>n</i> = 28). At 90 days, the unplanned readmission rate was 1.4% (<i>n</i> = 9). Reasons for readmissions included medical (27.2%, <i>n</i> = 3) and surgical (72.7%, <i>n</i> = 8). Unplanned readmissions and visits within 90 days of follow-up did not substantially differ by age group (<i>P</i> = 0.922), body mass index (BMI) (<i>P</i> = 0.633), unilateral <i>vs</i> bilateral TKA (<i>P</i> = 0.696), or patient comorbidity status (30-day <i>P</i> = 0.171 and 90-day <i>P</i> = 0.813). Reoperation rates after TKA were 0.66% (<i>n</i> = 4) at 30 days and 1.15% (<i>n</i> = 8) at 90 days. The average length of stay was 6.53 days.</p><p><strong>Conclusion: </strong>In this study, there was a low readmission rate following TKA. There was no significant correlation between readmission rate and patient factors such as age, BMI, and co-morbidity status.</p>","PeriodicalId":47843,"journal":{"name":"World Journal of Orthopedics","volume":"15 8","pages":"713-721"},"PeriodicalIF":2.0,"publicationDate":"2024-08-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11331325/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142009717","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}

{"title":"Offset restoration in total hip arthroplasty: Important: A current review.","authors":"Anil Thomas Oommen","doi":"10.5312/wjo.v15.i8.696","DOIUrl":"10.5312/wjo.v15.i8.696","url":null,"abstract":"<p><p>Normal vertical and horizontal offset is essential for hip biomechanics, muscle functioning and gait pattern. Total hip arthroplasty (THA) should aim to restore normal offset with implantation of femoral and acetabular components. This would be possible with proper preoperative planning, templating and ensuring implant options are available for offset restoration. Templating is essential for understanding the vertical and horizontal offset change, especially in hip arthritis presenting late with significant limb length discrepancy at THA. Planning should include appropriate soft tissue releases and the use of ideal implants to achieve restoration of horizontal and vertical offset. Under correction of horizontal offset at THA for fracture neck of femur could result in abductor fatigue, limp and increased wear. Restoration of horizontal offset is imperative at THA for a fractured neck of the femur to achieve optimal abductor function. Horizontal offset is necessary for optimal abductor muscle tension and function. Revision THA for acetabular bone loss would require hip center restoration with the acetabular and femoral offset correction to achieve limb length correction and abductor length. The inability to achieve vertical and horizontal offset correction could lead to dislocation or signs of abductor fatigue. Careful vertical and horizontal femur offset restoration is required for normal hip biomechanics, decreased wear and increased longevity.</p>","PeriodicalId":47843,"journal":{"name":"World Journal of Orthopedics","volume":"15 8","pages":"696-703"},"PeriodicalIF":2.0,"publicationDate":"2024-08-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11331330/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142010243","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}

{"title":"Foot and ankle surgery: Tourniquet placement site to cause as little postoperative pain as possible.","authors":"Emerito Carlos Rodriguez-Merchan","doi":"10.5312/wjo.v15.i6.498","DOIUrl":"10.5312/wjo.v15.i6.498","url":null,"abstract":"<p><p>There is controversy in the literature on where to place the tourniquet (thigh, calf, ankle) for foot and ankle surgery. While some authors prefer the ankle tourniquet to the calf tourniquet, others state that the surgeon can decide between using the thigh tourniquet or the ankle tourniquet, since there was no difference in postoperative pain between them. Where to place the tourniquet during foot and ankle surgery to cause the least possible postoperative pain to the patient as a result of the tourniquet is a common question in clinical practice. The reality is that, unfortunately, there is no consensus on this issue. Perhaps the only possible way to answer this question would be to conduct a comparative study with sufficient statistical power to reach scientifically sound conclusions. It does not seem easy to carry out such a study, but it would be important to be able to answer the question posed in the title of this Editorial once and for all.</p>","PeriodicalId":47843,"journal":{"name":"World Journal of Orthopedics","volume":"15 6","pages":"498-500"},"PeriodicalIF":2.0,"publicationDate":"2024-06-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11212542/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141471603","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}

{"title":"Comparison of clinical outcomes between total hip replacement and total knee replacement","authors":"Alexander Green, Alex Walsh, O. Al-Dadah","doi":"10.5312/wjo.v14.i12.853","DOIUrl":"https://doi.org/10.5312/wjo.v14.i12.853","url":null,"abstract":"BACKGROUND\u0000 Total hip replacements (THR) and total knee replacements (TKR) are effective treatments for severe osteoarthritis (OA). Some studies suggest clinical outcomes following THR are superior to TKR, the reason for which remains unknown. This study compares clinical outcomes between THR and TKR.\u0000 AIM\u0000 To compare the clinic outcomes of THR anad TKR using a comprehensive range of patient reported outcome measures (PROMs).\u0000 METHODS\u0000 A prospective longitudinal observational study of patients with OA undergoing THR and TKR were evaluated using a comprehensive range of generic and joint specific PROMs pre- and post-operatively.\u0000 RESULTS\u0000 A total of 131 patients were included in the study which comprised the THR group (68 patients) and the TKR group (63 patients). Both groups demonstrated significant post-operative improvements in all PROM scores (P < 0.001). There were no significant differences in post-operative PROM scores between the two groups: Hip and Knee Osteoarthritis Outcome scores (P = 0.140), Western Ontario and McMaster Universities Osteoarthritis Index pain (P = 0.297) stiffness (P = 0.309) and function (P = 0.945), Oxford Hip and Knee Score (P = 0.076), EuroQol-5D index (P = 0.386) and Short-Form 12-item survey physical component score (P = 0.106). Subgroup analyses showed no significant difference (P > 0.05) between cruciate retaining and posterior stabilised prostheses in the TKR group and no significant difference (P > 0.05) between cemented and uncemented fixation in the THR group. Obese patients had poorer outcomes following TKR but did not significantly influence the outcome following THR.\u0000 CONCLUSION\u0000 Contrary to some literature, THR and TKR are equally efficacious in alleviating the pain and disability of OA when assessed using a comprehensive range of PROMs. The varying knee prosthesis types and hip fixation techniques did not significantly influence clinical outcome. Obesity had a greater influence on the outcome following TKR than that of THR.","PeriodicalId":47843,"journal":{"name":"World Journal of Orthopedics","volume":" 38","pages":""},"PeriodicalIF":1.9,"publicationDate":"2023-12-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138994824","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}

{"title":"Role of lateral soft tissues release in percutaneous hallux valgus correction: A medium term retrospective study.","authors":"Fabio Zanchini, Ottorino Catani, Fabrizio Sergio, Alessia Boemio, Angelo Sieczak, Davide Piscopo, Salvatore Risitano, Gabriele Colò, Federico Fusini","doi":"10.5312/wjo.v14.i12.843","DOIUrl":"10.5312/wjo.v14.i12.843","url":null,"abstract":"<p><strong>Background: </strong>In the field of minimally invasive surgery (MIS) for the treatment of hallux valgus (HV), different techniques have begun to emerge in the literature concerning the distal osteotomy of the first metatarsal bone, the synthesis or not of the metatarsal head, the possible association with lateral soft tissues release (LSTR) and osteotomy of the base of the first phalanx.</p><p><strong>Aim: </strong>To evaluate the role of LSTR on percutaneous HV correction, evaluating functional and radiographical results.</p><p><strong>Methods: </strong>From January 2012 to May 2016 a total of 396 patients with mild to moderate symptomatic HV treated with the MIS technique were included in this retrospective study. The technique provides no internal fixation (WOS). Patients were divided into the LSTR group and no LSTR group (LSTR N). This surgical procedure (LSTR) was reserved for insufficient HV angle (HVA) correction during fluoroscopic control. Patients were evaluated at each follow-up by two other authors after appropriate training by senior authors (first practitioners). Clinical evaluation was performed before surgery, 6 mo after surgery, and 48 mo follow-up. American Orthopaedic Foot and Ankle Society (AOFAS) and visual analog scale (VAS) score was used to evaluate pain and function, and complications were recorded. In addition, the incidence of relapses and the degree of joint range of motion (ROM) with the association with the LSTR (capsule, adductor tendon, phalanx-sesamoid ligament, and the deep transverse metatarsal ligament) were evaluated. Radiological parameters included HVA and intermetatarsal angle (IMA). Patient satisfaction was assessed. Student <i>t</i>-test and Fisher exact test were used to assess statistical analysis.</p><p><strong>Results: </strong>From our study it is clear that no differences in term of HVA, VAS, IMA correction, rate of complications, and AOFAS score were found between groups, while a significant improvement of the same variables was found in each group between pre and postoperative values. A significant improvement in ROM at 6 mo (<i>P =</i> 0.018) and 48 mo (<i>P</i> = 0.02) of follow-up was found in LSTR N group. Complications were rare in both groups.</p><p><strong>Conclusion: </strong>LSTR procedure on percutaneous HV correction seems to increase postoperative joint stiffness with a comparable incidence of relapse and a low incidence of complications.</p>","PeriodicalId":47843,"journal":{"name":"World Journal of Orthopedics","volume":"14 12","pages":"843-852"},"PeriodicalIF":1.9,"publicationDate":"2023-12-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10758593/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139088985","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}