Advances in Orthopedics最新文献

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Fixator-Assisted Nailing for Femur Neck Fracture Nonunion: A Case Series Study 固定器辅助内钉治疗股骨颈骨折不愈合:病例系列研究
IF 1.3
Advances in Orthopedics Pub Date : 2022-04-14 DOI: 10.1155/2022/5676144
Majdi Hashem, Mohammad S. Al-Tuwaijri
{"title":"Fixator-Assisted Nailing for Femur Neck Fracture Nonunion: A Case Series Study","authors":"Majdi Hashem, Mohammad S. Al-Tuwaijri","doi":"10.1155/2022/5676144","DOIUrl":"https://doi.org/10.1155/2022/5676144","url":null,"abstract":"Background Femoral neck fractures in young adults tend to be a result of high-energy trauma with a common pattern of Pauwels type III fracture, and they require timely and meticulous diagnosis and management. The objective of this study was to assess the clinical and radiological outcomes of the fixator-assisted nailing technique for managing femur neck fracture nonunion. Methods. This was a case series study of 16 patients with nonunion femoral neck fractures treated via a fixator-assisted nailing technique. Our inclusion criteria comprised the inclusion of any patient between the ages of 14 and 60 years old with a neglected neck of femur fracture or nonunion of the femur neck. In addition, we only included patients without further posttreatment trauma and without known metabolic diseases. The conditions that were excluded from this study included hip joints with preexisting osteoarthritis, radiographic evidence of avascular necrosis of the femoral head, and associated ipsilateral acetabulum fracture or fracture-dislocation. The fracture characteristics that were selected for the fixator-assisted nailing (FAN) technique were clear signs of pseudoarthrosis (such as sclerosis, clear fracture line defects, and failure of implants), in addition to evidence of varus malalignment. All fractures were Pauwels type III. Radiographs of the pelvis with both hips and a posteroanterior (PA) view of the injured hip were taken. Full weight bearing was allowed in all the patients from the first day postoperatively. Physical therapy was started for pain reduction modalities, stretching, and abductor strengthening. Results Union of the femur neck fracture and osteotomy site was achieved in all patients. An excellent functional status after four months of follow-up was found based on a modified Harris hip score questionnaire. At follow-up, no patient was suffering from pain or flexion contracture. Preoperative limb length discrepancy (LLD) (cm) was 1.8 ± 0.8 cm and postoperative was 0 ± 0.1 cm, p < 0.001. Preoperative neck-shaft angle (NSA) (o) was 85.6 ± 4.4 and postoperative was 126.9 ± 2.5, p < 0.001. Preoperative Pauwels angle (o) was an average of 50.4 ± 5.9 and postoperative was 31.3 ± 2.5, p < 0.001. Conclusion Our study indicates that FAN has a high success rate in young patients with nonunited femoral neck fractures.","PeriodicalId":7358,"journal":{"name":"Advances in Orthopedics","volume":null,"pages":null},"PeriodicalIF":1.3,"publicationDate":"2022-04-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48887315","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
Satisfactory Functional Outcome and Significant Correlation with the Length of Haglund's Deformity after Endoscopic Calcaneoplasty: A Minimum 4-Year Follow-Up Study 内窥镜下跟骨成形术后满意的功能结果及与Haglund畸形长度的显著相关性:一项至少4年的随访研究
IF 1.3
Advances in Orthopedics Pub Date : 2022-04-13 DOI: 10.1155/2022/7889684
Hossam Fathi Mahmoud, Walid Feisal, Fahmy Samir Fahmy
{"title":"Satisfactory Functional Outcome and Significant Correlation with the Length of Haglund's Deformity after Endoscopic Calcaneoplasty: A Minimum 4-Year Follow-Up Study","authors":"Hossam Fathi Mahmoud, Walid Feisal, Fahmy Samir Fahmy","doi":"10.1155/2022/7889684","DOIUrl":"https://doi.org/10.1155/2022/7889684","url":null,"abstract":"Background Haglund's syndrome is a posterosuperior calcaneal prominence with posterior heel pain causing functional disability to the patient. Operative treatment is indicated after failure of conservative measures and includes resection of the bony hump along with retrocalcaneal bursectomy. This study aimed to evaluate the functional outcome and degree of patient satisfaction after endoscopic resection of Haglund's deformity with assessment of correlation with the length of bony exostosis. Methods Seventeen patients (21 feet) with a mean age of 44.7 ± 5.1 years were included in this study. Six females and 11 males underwent endoscopic calcaneoplasty. Clinical outcome evaluation included the assessment of the visual analog scale (VAS) and the American Orthopedic Foot and Ankle Society score (AOFAS). The preoperative and postoperative lengths of bony exostosis were measured radiologically. The paired t test and the Wilcoxon signed-rank test compared the preoperative and final postoperative means. P < 0.05 was considered statistically significant. Results The mean follow-up period was 56.4 ± 5.1 months. Statistically significant improvements in the preoperative mean of AOFAS (from 55.7 ± 9.3 to 94.3 ± 7.1) and VAS (from 8.1 ± 1.4 to 0.7 ± 1.04) at the final follow-up were noted (P < 0.0001). There was a statistically significant correlation between clinical scores (AOFAS and VAS) and the final postoperative length of the bone above parallel pitch lines (PPLs). The patients were satisfied and returned to their previous activities without reporting major morbidities except one patient who had mild pain with exertion. Conclusion Endoscopic calcaneoplasty is a safe, less invasive surgical procedure for the management of Haglund's syndrome after failure of conservative treatment. It provided a satisfactory clinical result without serious complications at a minimum 4-year follow-up.","PeriodicalId":7358,"journal":{"name":"Advances in Orthopedics","volume":null,"pages":null},"PeriodicalIF":1.3,"publicationDate":"2022-04-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48464138","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
Humeral Capitellum Fractures in Adolescents: A Study of 6 Cases Treated by Open Reduction and Internal Fixation with Bioabsorbable Nails 青少年肱骨小头骨折切开复位内固定生物吸收钉6例分析
IF 1.3
Advances in Orthopedics Pub Date : 2022-04-11 DOI: 10.1155/2022/4012125
Łukasz Wiktor, R. Tomaszewski
{"title":"Humeral Capitellum Fractures in Adolescents: A Study of 6 Cases Treated by Open Reduction and Internal Fixation with Bioabsorbable Nails","authors":"Łukasz Wiktor, R. Tomaszewski","doi":"10.1155/2022/4012125","DOIUrl":"https://doi.org/10.1155/2022/4012125","url":null,"abstract":"Purpose The purpose of our study was to evaluate the clinical outcome following open reduction and internal fixation of humeral capitellum fractures in adolescents and to assess the usefulness of bioresorbable implants in that procedure. Due to the rarity of these fractures, there are not many studies dealing with the problem in the literature. Methods We retrospectively evaluated a group of 6 skeletally immature patients aged 10.6–15.3 treated at our department from January 2015 to December 2021. Four type I and two type IV were diagnosed based on the Bryan and Morrey classification. Our patients underwent an open reduction and internal fixation of coronal shear fractures with the use of SmartNail®. Results All patients were satisfied with the treatment outcome and had full pronation and flexion after surgery. Two patients presented minor deficits of extension and supination compared with the contralateral elbow. At the one-year follow-up, all patients scored 100 on the Mayo Elbow Performance Score. Conclusions Correct diagnosis and early surgical intervention in humeral capitellum fractures are crucial. That fractures should be anatomically reduced with no articular cartilage damage in order to prevent osteoarthritis. Based on our experience, SmartNail® implant is accurate for the osteochondral fragment fixation.","PeriodicalId":7358,"journal":{"name":"Advances in Orthopedics","volume":null,"pages":null},"PeriodicalIF":1.3,"publicationDate":"2022-04-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44514340","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
The Clinical History and Basic Science Origins of Transcutaneous Osseointegration for Amputees. 经皮骨整合治疗截肢的临床历史与基础科学渊源
IF 1.2
Advances in Orthopedics Pub Date : 2022-03-18 eCollection Date: 2022-01-01 DOI: 10.1155/2022/7960559
Jason Shih Hoellwarth, Kevin Tetsworth, Muhammad Adeel Akhtar, Munjed Al Muderis
{"title":"The Clinical History and Basic Science Origins of Transcutaneous Osseointegration for Amputees.","authors":"Jason Shih Hoellwarth, Kevin Tetsworth, Muhammad Adeel Akhtar, Munjed Al Muderis","doi":"10.1155/2022/7960559","DOIUrl":"10.1155/2022/7960559","url":null,"abstract":"<p><p>Transcutaneous osseointegration for amputees (TOFA) refers to an intramedullary metal endoprosthesis which passes transcutaneously to connect with a limb exoprosthesis. The first recognizably modern experiments and attempts occurred in the 1940s. Multiple researchers using a plethora of materials and techniques over the following 50 years identified principles and obstacles which informed the first long-term successful surgery in 1990. Unfortunately, the current mainstream TOFA literature presents almost exclusively subsequent developments, generally omitting prior research, leading to some historical mistakes being repeated. Given the increasing interest and surgical volume of TOFA, this literature review was performed to delineate TOFA's basic science and surgical origins and to integrate these early efforts within the contemporary understanding. Studying this research could protect and benefit future patients, surgeons, and implant developers as TOFA is entering a phase of increased attention and innovation. The aim of this article is to provide a focused reference of foundational research, much of which is difficult to identify and retrieve, for clinicians and researchers.</p>","PeriodicalId":7358,"journal":{"name":"Advances in Orthopedics","volume":null,"pages":null},"PeriodicalIF":1.2,"publicationDate":"2022-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8956382/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44966462","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
A Cost-Utility Analysis of Robotic Arm-Assisted Total Hip Arthroplasty: Using Robotic Data from the Private Sector and Manual Data from the National Health Service 机械臂辅助全髋关节置换术的成本-效用分析:使用来自私营部门的机器人数据和来自国家卫生服务的人工数据
IF 1.3
Advances in Orthopedics Pub Date : 2022-02-27 DOI: 10.1155/2022/5962260
N. Clement, P. Gaston, D. Hamilton, A. Bell, P. Simpson, G. Macpherson, J. Patton
{"title":"A Cost-Utility Analysis of Robotic Arm-Assisted Total Hip Arthroplasty: Using Robotic Data from the Private Sector and Manual Data from the National Health Service","authors":"N. Clement, P. Gaston, D. Hamilton, A. Bell, P. Simpson, G. Macpherson, J. Patton","doi":"10.1155/2022/5962260","DOIUrl":"https://doi.org/10.1155/2022/5962260","url":null,"abstract":"Purpose The aim was to assess the cost-effectiveness of robotic arm-assisted total hip arthroplasty (rTHA) compared with manual total hip arthroplasty (mTHA) and to assess the influence of annual volume on the relative cost-effectiveness of rTHA. Methods A database of both rTHA (n = 48 performed in a private centre) and mTHA (n = 512 performed in the National Health Service) was used. Patient demographics, preoperative Oxford hip score, forgotten joint score, EuroQol 5-dimensional 3-level (EQ-5D), and postoperative EQ-5D were recorded. Two models for incremental cost-effectiveness ratios using cost per quality-adjusted life year (QALY) for rTHA were calculated based on a unit performing 100 rTHAs per year: 10-year follow-up and a lifetime time horizon (remaining life expectancy of a 69-year-old patient). Results When adjusting for confounding factors, rTHA was independently associated with a 0.091 (p=0.029) greater improvement in the EQ-5D compared to mTHA. This resulted in a 10-year time horizon cost per QALY for rTHA of £1,910 relative to mTHA, which increased to £2,349 per QALY when discounted (5%/year). When using the 10-year time horizon cost per QALY was approximately £3,000 for a centre undertaking 50 rTHAs per year and decreased to £1,000 for centre undertaking 200 rTHAs per year. Using a lifetime horizon, the incremental unadjusted cost per QALY gained was £980 and £1432 when discounted (5%/year) for rTHA compared with mTHA. Conclusions Despite the increased cost associated with rTHA, it was a cost-effective intervention relative to mTHA due to the associated greater health-related quality of health gain, according to the EQ-5D outcome measure.","PeriodicalId":7358,"journal":{"name":"Advances in Orthopedics","volume":null,"pages":null},"PeriodicalIF":1.3,"publicationDate":"2022-02-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41572345","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: 3
Multiple Venous Thromboembolism Pharmacologic Agents Are Associated with an Increased Risk for Early Postoperative Complications following a Total Joint Arthroplasty. 多静脉血栓栓塞药物与全关节置换术后早期并发症的风险增加有关。
IF 1.3
Advances in Orthopedics Pub Date : 2022-02-07 eCollection Date: 2022-01-01 DOI: 10.1155/2022/8318595
Jonathan H Shaw, Luke D Wesemann, Omar M Kadri, Clifford M Les, Wayne T North, Michael A Charters
{"title":"Multiple Venous Thromboembolism Pharmacologic Agents Are Associated with an Increased Risk for Early Postoperative Complications following a Total Joint Arthroplasty.","authors":"Jonathan H Shaw,&nbsp;Luke D Wesemann,&nbsp;Omar M Kadri,&nbsp;Clifford M Les,&nbsp;Wayne T North,&nbsp;Michael A Charters","doi":"10.1155/2022/8318595","DOIUrl":"https://doi.org/10.1155/2022/8318595","url":null,"abstract":"<p><p>The purpose of this study was to determine the effect that concurrent venous thromboembolism (VTE) medications had on early outcomes following primary total joint arthroplasty (TJA). 2653 total knee and hip arthroplasties were reviewed at a tertiary medical center. The study performed a multivariable comparison of outcomes in patients on 2 or more VTE medications, as well as a logistic regression on outcomes following each addition of a VTE medication postoperatively (number of VTE medications was 1-4). Controlling for gender, age, body mass index, and preoperative American Society of Anesthesiologists score throughout the analysis, patients who received 2 or more VTE prophylaxis medications had increased LOS (<i>p</i> < 0.001), transfusions (<i>p</i> < 0.001), emergency department visits (<i>p</i>=0.001), readmissions (<i>p</i> < 0.001), 90dPOE (<i>p</i> < 0.001), and PE (<i>p</i> < 0.001). Every additional postoperative VTE medication incrementally increased the risk for longer LOS (<i>p</i> < 0.001), transfusions (<i>p</i> < 0.001), 90dPOE (<i>p</i> < 0.001), deep vein thrombosis (<i>p</i>=0.049), PE (<i>p</i> < 0.001), emergency department visits (<i>p</i>=0.005), and readmission (<i>p</i>=0.010). Patients on multiple VTE medications following TJA demonstrate significantly poorer outcomes. The current study's findings caution the use of multiple VTE medications whenever possible immediately following a TJA.</p>","PeriodicalId":7358,"journal":{"name":"Advances in Orthopedics","volume":null,"pages":null},"PeriodicalIF":1.3,"publicationDate":"2022-02-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8844431/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39809856","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
A Balanced Arthroscopic Debridement of the Inner Layer of the Knee Retinaculum Increases the Tibiofemoral Joint Space Width. 关节镜下平衡切除膝关节网膜内层可增加胫股关节间隙宽度。
IF 1.2
Advances in Orthopedics Pub Date : 2022-01-29 eCollection Date: 2022-01-01 DOI: 10.1155/2022/1766401
Roberto Yáñez-Diaz, Lars Strömbäck, Francisco Vergara, Gaston Caracciolo, Anthony Saravia, Carlos Sandoval, Héctor Zamorano, Sebastián Abusleme, Carlos De la Fuente
{"title":"A Balanced Arthroscopic Debridement of the Inner Layer of the Knee Retinaculum Increases the Tibiofemoral Joint Space Width.","authors":"Roberto Yáñez-Diaz, Lars Strömbäck, Francisco Vergara, Gaston Caracciolo, Anthony Saravia, Carlos Sandoval, Héctor Zamorano, Sebastián Abusleme, Carlos De la Fuente","doi":"10.1155/2022/1766401","DOIUrl":"10.1155/2022/1766401","url":null,"abstract":"<p><strong>Introduction: </strong>Traditional techniques can enlarge the medial tibiofemoral joint space width (JSW) for meniscal repairs, but a remnant ligament laxity may be developed. Alternatively, the debridement of the inner retinaculum layer may result in a balanced JSW without causing extra-ligament damage (retinaculum layers II and collateral ligament).</p><p><strong>Purpose: </strong>The purpose of this study was to determine whether a concentric arthroscopic debridement of the inner retinaculum layer increases the tibiofemoral JSW in patients with meniscal injuries. Secondarily, we determine whether the increase in JSW is symmetrical between compartments and describe the rate of complications and patient satisfaction.</p><p><strong>Method: </strong>Twenty middle-aged (15 male and five female) patients diagnosed with acute meniscal injury aged 36 ± 12 years were enrolled. The patients were submitted to an arthroscopic debridement of the inner layer of the knee retinaculum for both the medial and lateral compartments. The tibiofemoral JSW was measured intra-articularly using a custom instrument. A two-way ANOVA for repeated measures was used to compare the JSW. A Bland-Altman analysis and test-retest analysis were performed.</p><p><strong>Results: </strong>The JSW increased following the debridement of the inner retinaculum layer, for both the medial and lateral compartments (<i>p</i> < 0.001). No complications were identified, and the patients were satisfied with the intervention. The minimal detectable change and bias of the custom instrument were 0.06 mm and 0.02 mm, respectively.</p><p><strong>Conclusion: </strong>The debridement allows a clinically important (>1 mm) symmetric tibiofemoral JSW enlargement. The technique suggests favoring the diagnosis of meniscus injuries and manipulating arthroscopic instruments without secondary complications after one year.</p>","PeriodicalId":7358,"journal":{"name":"Advances in Orthopedics","volume":null,"pages":null},"PeriodicalIF":1.2,"publicationDate":"2022-01-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8817879/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39595505","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
Cruciate Substituting Implants in Primary Total Knee Arthroplasty. 初级全膝关节置换术中的关键替代植入物。
IF 1.3
Advances in Orthopedics Pub Date : 2022-01-24 eCollection Date: 2022-01-01 DOI: 10.1155/2022/2676715
Alexander J Volkmar, Robert Elrod, Justin W Vickery, Charlie C Yang, Gregory G Polkowski, J Ryan Martin
{"title":"Cruciate Substituting Implants in Primary Total Knee Arthroplasty.","authors":"Alexander J Volkmar,&nbsp;Robert Elrod,&nbsp;Justin W Vickery,&nbsp;Charlie C Yang,&nbsp;Gregory G Polkowski,&nbsp;J Ryan Martin","doi":"10.1155/2022/2676715","DOIUrl":"https://doi.org/10.1155/2022/2676715","url":null,"abstract":"<p><p>The use of cruciate substituting (CS) total knee replacement has been increasing in popularity. There are numerous factors that have likely contributed to this expansion. The CS philosophy incorporates the ease of use commonly cited by advocates of the posterior stabilized (PS) total knee design with the bone preservation associated with a cruciate retaining (CR) design. The ultra-congruent highly cross-linked polyethylene liner increases stability without an appreciable change in wear. Furthermore, balancing the flexion and extension gaps does not require \"titrating\" the posterior cruciate ligament, improving the user-friendliness. This paper reviews the nuances of this implant design compared to PS and CR designs as well as provides surgical technique recommendations/considerations.</p>","PeriodicalId":7358,"journal":{"name":"Advances in Orthopedics","volume":null,"pages":null},"PeriodicalIF":1.3,"publicationDate":"2022-01-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8803465/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39759479","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: 2
Sacroiliitis: A Review on Anatomy, Diagnosis, and Treatment. 骶髂炎:解剖学、诊断和治疗综述。
IF 1.3
Advances in Orthopedics Pub Date : 2022-01-01 DOI: 10.1155/2022/3283296
Anderson Lee, Monik Gupta, Kiran Boyinepally, Phillip J Stokey, Nabil A Ebraheim
{"title":"Sacroiliitis: A Review on Anatomy, Diagnosis, and Treatment.","authors":"Anderson Lee,&nbsp;Monik Gupta,&nbsp;Kiran Boyinepally,&nbsp;Phillip J Stokey,&nbsp;Nabil A Ebraheim","doi":"10.1155/2022/3283296","DOIUrl":"https://doi.org/10.1155/2022/3283296","url":null,"abstract":"<p><strong>Introduction: </strong>Sacroiliitis is an inflammation of one or both of the sacroiliac (SI) joints, most often resulting pain in the lower back that can extend down the legs. Pain arising from the SI joint can be difficult to diagnose and treat due to the intricate surrounding ligamentous structure, nerve innervation, and its role in transferring weight from the upper body to the lower limbs. SI joint dysfunction accounts for up to 25% of cases of lower back pain and has a debilitating effect on patient functionality. This review aims to provide comprehensive coverage of all aspects of SI joint pain, with a specific focus on differential diagnosis and treatment.</p><p><strong>Methods: </strong>Current literature on SI joint pain and inflammation, other etiologies of lower back pain, and new treatment options were compiled using the databases PubMed and Cochrane and used to write this comprehensive review. There were no restrictions when conducting the literature search with regard to publication date, study language, or study type.</p><p><strong>Results: </strong>The diagnosis protocol of SI joint pain arising from sacroiliitis usually begins with the presentation of lower back pain and confirmatory diagnostic testing through fluoroscopy joint block. Reduction in pain following the anesthetic is considered the golden standard for diagnosis. The treatment begins with the conservative approach of physical therapy and analgesics for symptom relief. However, refractory cases often require interventional methods such as corticosteroid injections, prolotherapy, radiofrequency ablation, and even SI joint fusion surgery.</p><p><strong>Conclusion: </strong>SI joint pain is a complex problem that can present with varying patterns of pain due to uncertainty regarding its innervation and its prominent surrounding structure. It is therefore especially important to obtain a thorough history and physical on top of diagnostic tests such as a diagnostic block to properly identify the source of pain. Conservative treatment options with physical therapy and analgesics should be attempted first before interventional strategies such as ablation, injections, and prolotherapy can be considered. SI joint fusion surgery is a solution to cases in which previous methods do not provide significant relief.</p>","PeriodicalId":7358,"journal":{"name":"Advances in Orthopedics","volume":null,"pages":null},"PeriodicalIF":1.3,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9812593/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10507396","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: 2
Comparison of the Hook Plate versus TightRope System in the Treatment of Acute Type III Acromioclavicular Dislocation. 钩钢板与钢丝系统治疗急性III型肩锁关节脱位的比较。
IF 1.3
Advances in Orthopedics Pub Date : 2022-01-01 DOI: 10.1155/2022/8706638
Abdulrahim Dündar, Deniz İpek
{"title":"Comparison of the Hook Plate versus TightRope System in the Treatment of Acute Type III Acromioclavicular Dislocation.","authors":"Abdulrahim Dündar,&nbsp;Deniz İpek","doi":"10.1155/2022/8706638","DOIUrl":"https://doi.org/10.1155/2022/8706638","url":null,"abstract":"<p><strong>Introduction: </strong>The objective of this study is to compare the effectiveness of the clavicular hook plate (HP) technique and the minimally invasive coracoclavicular (CC) fixation with a TightRope (MITR) procedure in treating acute unstable distal clavicle dislocation.</p><p><strong>Method: </strong>MITR (minimally invasive TightRope) group had 21 patients, and the open reduction and internal fixation (HP) group included 23 patients. Researchers compared MITR and HP (hook plate) outcomes for the treatment of acute type III AC joint dislocation in a retrospective analysis. The patients were followed up at 1 3, 6, and 12 months postoperatively. Complications were analyzed such as redislocation, fractures, implant-related complications, or subacromial erosion. For the clinical outcomes, the visual analog scale (VAS) (0: no pain, 10: worst possible pain), Constant-Murley score (CMS) (100: no pain, 0: maximum pain), the average satisfaction score with their current shoulder function (range: 0-10), and the University of California at Los Angeles Shoulder score (UCLA) (>27 good/excellent <27 fair/poor) were recorded at the last follow-up.</p><p><strong>Result: </strong>There were 21 sufferers in the MITR group, which comprises 19 males and 2 females and 23 individuals in the HP group (20 men and 3 women), with average ages of 43.9 and 39.2, respectively. Age, sex, laterality, and the interval between injury and surgery did not significantly differ between the two groups (0.357, 0.792, 0.432, and 0.55, respectively). No statistically significant difference was found between the groups in terms of the VAS score and CMS score at one year postoperatively. The mean CCD at the initial trauma and last follow-up was not significantly different between the MITR and HP groups (<i>p</i>=0.365, <i>p</i>=0.412 respectively).</p><p><strong>Conclusion: </strong>For treating acute type III AC dislocations, the minimally invasive TightRope (MITR) system and the hook plate technique were great options. However, the minimally invasive TightRope system showed further benefits such as reduced reoperation for implant removal and reduced risk of subacromial distal clavicle osteolysis.</p>","PeriodicalId":7358,"journal":{"name":"Advances in Orthopedics","volume":null,"pages":null},"PeriodicalIF":1.3,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9744602/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10363067","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}
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