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Thompson Didriksen posted an update 6 months ago
hinge orientation and distraction site. The intraoperative planning of manipulating hinge orientation is an effective method to adjust sagittal rotation. A large angle of wedge inclination is an indicator of horizontal rotation, and it should be carefully mitigated to reduce the risk of cracking in the lateral hinge.
We aimed to investigate the impact of long corrective fusion to the ilium on the physical function in elderly patients with adult spinal deformity and its correlation with spinopelvic parameters and health-related quality of life outcomes.
We included 60 female patients who underwent long corrective fusion from T9 or T10 to the pelvis for adult spinal deformities (mean age of 69.8 years, range 55-78 years). The radiographic parameters, health-related quality of life outcomes using the Scoliosis Research Society Outcome Instrument-22 and physical function assessments were reviewed preoperatively and at 1-year postoperatively.
All spinopelvic parameters, except for thoracolumbar kyphosis, and all domains of the Scoliosis Research Society Outcome Instrument-22 significantly improved at 1-year postoperatively (p<0.0001). Physical function results, including those for one-leg standing time, timed up-and-go test, and 6-min walk tests, significantly improved at 1-year postoperatively (p<0.005). Based on nce. Postoperative physical function depends on the preoperative physical performance status and skeletal muscle status; thus, preoperative interventions for improved physical function are recommended.
Kinematically aligned total knee arthroplasty (KA-TKA), in which femoral component is placed 3-5° of internal rotation relative to mechanically aligned (MA)-TKA, may have a potential risk of patellofemoral malalignment. This study aimed to assess patellofemoral alignment and compare the data between KA-TKA and MA-TKA, and the relationship with patellofemoral radiographic parameters and patient reported outcomes.
Among patients who underwent TKA in 2015 and 2016 in our institute, 28KA-TKAs with a metal-backed patellar component were retrospectively assessed for patellofemoral alignment, and 28MA-TKAs with a metal-backed patellar component served as controls. A year postoperatively, patellar tilt and shift at 30°, 60°, and 90° knee flexion were measured on Merchant views and compared between the two TKAs. Implant positioning in each patient was assessed based on preoperative CT images and correlations of femoral component positioning with patellar tilt/shift were assessed.
Patellar shift at 30° flexion was significantly greater in KA-TKA than in MA-TKA (p=0.04), whereas patellar tilt angle was comparable between the two TKAs. No statistical correlation was evident between femoral component positioning and patellar shift/tilt, regardless of knee flexion angle in the two TKAs. Knee Society Score 2011at 1 year follow-up was comparable in all subcategories between the two TKAs.
Radiographic analysis of KA-TKA revealed lateral shift of the patella at 30° knee flexion at 1 year postoperatively, however patients with patellar shift were asymptomatic. Further long-term observation is required to examine the impact of KA-TKA on the patellofemoral complication.
Radiographic analysis of KA-TKA revealed lateral shift of the patella at 30° knee flexion at 1 year postoperatively, however patients with patellar shift were asymptomatic. Further long-term observation is required to examine the impact of KA-TKA on the patellofemoral complication.
The outcome of carpal tunnel release (CTR) one year postoperatively was assessed by the Japanese version of Carpal tunnel syndrome questionnaire, CTSI-JSSH. Patients were further graded by the electrophysiological severity scale and the CTSI-JSSH scores were compared amongst the Stages before surgery and one-year postoperatively.
This study included 247 hands and the mean age of the patients was 68 years (range26-91). They completed the CTSI-JSSH consisting of the two subscales of the symptom scale (CTSI-JSSH-SS) and the functional scale (CTSI-JSSH-FS) both preoperatively and at the follow-up period of one year. https://www.selleckchem.com/products/deutenzalutamide.html The change of the scores of the CTSI-JSSH-SS, CTSI-JSSH-FS and total CTSI-JSSH were examined. Electrophysiological examination was performed before CTR and graded according to the electrophysiological severity scale as Stage 1-5. The scores of the CTSI-JSSH-SS, CTSI-JSSH-FS and total CTSI-JSSH were compared amongst Stage 1-5.
All CTSI-JSSH-SS, CTSI-JSSH-FS and total CTSI-JSSH scores improved significantly one-year postoperatively. Also, the standardized response mean (SRM) and effect size (ES) showed large responsiveness, i.e. 1.36/1.43, 1.12/1.08 and 1.43/1.45 respectively. There was no significant difference in the score of the CTSI-JSSH-SS, CTSI-JSSH-FS and total CTSI-JSSH amongst any of the Stages preoperatively, while the scores in Stage 5 were significantly inferior to the ones in Stages 3 and 4 one-year postoperatively.
The clinical outcomes of CTR were favorable by assessment of the CTSI-JSSH. We suggest the postoperative inferior scores in Stage 5 may be due to the potential axonal damage which could explain the disappearance of distal motor latency and sensory nerve conduction velocity in Stage 5.
The clinical outcomes of CTR were favorable by assessment of the CTSI-JSSH. We suggest the postoperative inferior scores in Stage 5 may be due to the potential axonal damage which could explain the disappearance of distal motor latency and sensory nerve conduction velocity in Stage 5.
Deterioration of quality of life in patients with chronic pain is difficult to treat. Chronic pain in patients with low quality of life may be “severe” and require multidisciplinary treatments. This study aimed to develop an objective severity discrimination scale based on quality of life measurements to identify patients with “severely disabling” chronic pain.
Subjects were 156 patients with chronic pain whose numerical rating pain score was ≥1 and who had pain for ≥3 months. Diseases associated with chronic pain included spinal diseases, joint diseases, concomitant diseases, complex regional pain syndromes, and other musculoskeletal diseases. Patients were divided into low, middle, and high groups based on physical quality of life summary scores on the Short Form-36. The mental component summary, painDETECT, Japanese version of the Pain Catastrophizing Scale, Brief Scale for Psychiatric Problems in Orthopaedic Patients, and factors related to degree/quality of pain during the past 4 weeks were analyzed to identify components in the low group.