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1.
Joyce White Lisa Coppola Andrea Skomurski Emma Mitchell-Rekrut 《Journal of hand therapy》2018,31(3):390-397
Study Design
Cross-sectional clinical measurement study.Introduction
The carpometacarpal (CMC) joint of the thumb is a complex joint making accurate measurement of range of motion (ROM) challenging. There are limited normative data available to base rehabilitative decisions, which is unfortunate as this joint is frequently affected by arthritis and is critical to hand function.Purpose of the Study
To provide passive ROM values for the first CMC joint and investigate the effects of age and gender.Methods
Ninety-six healthy subjects were divided into 4 age groups of equal gender: 20-34, 35-49, 50-64, and 65+ years. Six-inch plastic universal goniometers were used to take 3 measurements of flexion, extension, and abduction of the dominant hand.Results
Mean ROM values were 21.7 ± 6.8 degrees of flexion, 19.5 ± 5.7 degrees of extension, and 51.1 ± 5.5 degrees of abduction. There was a weak negative correlation (r = ?0.22; P = .03) between age and abduction and a difference between 2 age groups. No other relationship or difference due to age, gender, or interactions reached significance.Conclusions
These normative ROM values for adults can be used by clinicians assessing patients for impaired motion at the CMC joint. No differences in flexion, extension, and abduction due to age and gender were supported, except for a small decrease (4.5°) in abduction in adults 65+ years compared with those of 35-49 years.Level of Evidence
3. 相似文献2.
Raquel Cantero-Téllez Jorge Hugo Villafañe Kristin Valdes Pedro Berjano 《Journal of hand therapy》2018,31(1):68-73
Study Design
A quasi-experimental trial.Introduction
Orthoses are effective to decrease pain and improve function in patients with carpometacarpal osteoarthritis (CMC OA). However, current research does not support one design of an orthosis as more effective and/or more favorable than another.Purpose of the Study
The aim of this study was to compare the effectiveness of 2 different static orthosis on pain and functional abilities on CMC OA.Methods
Eighty-four patients, 91.7% females (mean ± standard deviation age, 60.1 ± 9.6 years), with thumb CMC OA were randomized into 1 of 2 groups. For group A, a Ballena orthotic was constructed, and for group B, a Colditz orthotic was constructed. Both static orthoses were worn for 3 months. The outcome measures included pain with activity measured with the visual analog scale and functional abilities assessed with the Disabilities of the Arm, Shoulder and Hand.Results
Both orthoses improved pain level and functional abilities (F[1.0] = 413.327 and F[1.0] = 211.742; both P < .001). There was no statistically significant difference between 2 groups regarding to pain recovery and functional improvement (F[1.0] = 0.075 and F[1.0] = 7.248; both P > .05).Discussion
The main purpose was to compare the effect of 2 different thermoplastic thumb orthoses. Previous studies support the use of CMC orthoses to decrease hand pain and improve hand function, but different orthoses have been described and in most cases, orthotic interventions were accompanied by other medical treatments.Conclusions
A clinically significant reduction in pain intensity and improvement in functional abilities was achieved with both orthoses in patients with thumb CMC OA.Level of Evidence
2.3.
Eva Barrett Carmela Conroy Marie Corcoran Kieran O&#x; Sullivan Helen Purtill Jeremy Lewis Karen McCreesh 《Journal of hand therapy》2018,31(3):301-307
Study Design
A case series was carried out.Introduction
There is a lack of evidence exploring the effectiveness of group exercise classes for people with nonspecific shoulder pain (NSSP). Also, there is a lack of research that measures potential reductions in thoracic kyphosis after exercise interventions in people with NSSP.Purpose of the Study
To observe changes in shoulder pain, disability, and thoracic kyphosis in 2 groups of people with NSSP, after 2 different types of group exercise classes.Methods
People with NSSP received a 6-week block of exercises classes containing either shoulder exercises alone (shoulder group, n = 20) or a mixture of shoulder and thoracic extension exercises (thoracic group, n = 19). The Disabilities of the Arm, Shoulder and Hand questionnaire for disability and the Numeric Rating Scale for pain were measured at baseline, 6 weeks, and 6 months. Thoracic kyphosis was measured at baseline and 6 weeks using the manual inclinometer.Results
Significant and clinically meaningful improvements in Numeric Rating Scale and Disabilities of the Arm, Shoulder and Hand were demonstrated in both groups at 6-week and 6-month follow-up (P < .001). Effect sizes ranged from 0.78–1.16 in the shoulder group and 0.85–1.88 in the thoracic group. Thoracic kyphosis did not change beyond measurement error in either group.Discussion/Conclusion
Group exercise classes can improve shoulder pain and disability in people with NSSP. Resting thoracic kyphosis did not change after either exercise intervention, which suggests that the treatment effect was not due to a change in static thoracic spine posture. 相似文献4.
Mike Szekeres Joy C. MacDermid Ruby Grewal Trevor Birmingham 《Journal of hand therapy》2018,31(3):276-281
Study Design
Blinded randomized controlled trial.Introduction
It is generally accepted that heat is beneficial for improving range of motion (ROM). However, the mechanism of action is not clearly understood, and the optimal method of heat application has not been established.Purpose of the Study
To investigate the immediate effects of using a moist hot pack (MHP) vs therapeutic whirlpool bath (WB) for improving wrist ROM during a therapy session for patients with distal radius fracture.Methods
About 60 adult patients, with a mean age of 54 years in the MHP group and 53 years in the WB group, with healed distal radius fracture were randomized into 2 groups of 30. Patients in group 1 were placed in an MHP for 15 minutes during therapy. Patients in group 2 had their arm placed in a WB and were asked to perform active wrist ROM exercises for the same period. This occurred for 3 consecutive therapy visits, with wrist and forearm ROM being measured before and after heat during each visit.Results
The multivariate analysis of variance demonstrated that the canonical variate for ROM was significantly different between groups (F[6,53] = 6.01; P < .05), indicating that patients in the WB group had a significantly larger increase in ROM than patients receiving MHP application.Discussion
Both WB and MHP improved wrist ROM during therapy sessions in this study, making both these acceptable options for clinical use when the goal is to precondition a patient for other treatments.Conclusions
Individuals who received WB showed a statistically greater increase in wrist ROM than those receiving MHP during a therapy session, although the difference between groups may or may not be clinically important considering the small changes in ROM observed in this study.Level of Evidence
Level II. 相似文献5.
Eva Vallés-Carrascosa Tomás Gallego-Izquierdo José Jesús Jiménez-Rejano Gustavo Plaza-Manzano Daniel Pecos-Martín Fidel Hita-Contreras Alexander Achalandabaso Ochoa 《Journal of hand therapy》2018,31(2):227-237
Study Design
Randomized clinical trial.Introduction
Eccentric exercise (EE) was shown to be an effective treatment in tendinopathies. However, the evidence of its effectiveness in subacromial syndrome (SS) is scarce. Moreover, consensus has not been reached on whether best results for SS are obtained by means of EE with or without pain.Purpose of the Study
The purpose of this is to compare the effect on pain, active range of motion (AROM), and shoulder function of an exercise protocol performed with pain <40 mm Visual Analog Scale (VAS) and without pain, in patients with SS.Methods
Twenty-two subjects (mean age: 59 years [Q1 = 48.50-Q3 = 70], 54.5% women) were randomized into a not-painful EE group (NPEE; G0: n = 11) and a painful EE group (PEE; G1: n = 11). The intervention lasted 4 weeks. Pain was recorded using VAS; AROM was measured using a goniometer; and shoulder function using the modified Constant-Murley Score (CMS) before and after intervention.Results
All dependent variables improved significantly in both groups (P < .05): NPEE VAS median: pretest = 55.0 posttest = 28.0; CMS median: pretest = 36.0 posttest = 65.0. PEE VAS median: pretest = 37.0 posttest = 12.0; CMS median: pretest = 35.0 posttest = 59.0. The comparison between groups showed no significant differences, with small effect size values (VAS = 0.09; CMS = 0.21; AROM = 0.12-0.43).Discussion
In contrast to the previous findings, our results suggest that PEE do not add benefit in SS patients compared to NPEE.Conclusion
Our results suggest that both interventions are effective in terms of pain, function, and shoulder AROM. Furthermore, PEE does not provide greater benefits. Further studies are needed with long-term follow-up to reinforce these results. 相似文献6.
Alice Bonnefoy-Mazure Pierre Martz Stéphane Armand Yoshimasa Sagawa Domizio Suva Katia Turcot Hermes H. Miozzari Anne Lübbeke 《The Journal of arthroplasty》2017,32(8):2404-2410
Background
The purpose of this prospective study was to investigate the influence of body mass index (BMI) on gait parameters preoperatively and 1 year after total knee arthroplasty (TKA).Methods
Seventy-nine patients were evaluated before and 1 year after TKA using clinical gait analysis. The gait velocity, the knee range of motion (ROM) during gait, their gains (difference between baseline and 1 year after TKA), the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), quality of life, and patient satisfaction were assessed. Nonobese (BMI <30 kg/m2) and obese patients (BMI ≥30 kg/m2) were compared. Healthy controls were also assessed. Univariate and multivariate linear regression analyses were used to assess the association between gait speed and ROM gains. Adjustment was performed for gender, age, and WOMAC pain improvement.Results
At baseline, gait velocity and knee ROM were significantly lower in obese compared with those in the nonobese patients (0.99 ± 0.27 m/s vs 1.11 ± 0.18 m/s; effect size, 0.53; P = .021; and ROM, 41.33° ± 9.6° vs 46.05° ± 8.39°; effect size, 0.52; P = .022). Univariate and multivariate linear regressions did not show any significant relation between gait speed gain or knee ROM gain and BMI. At baseline, obese patients were more symptomatic than nonobese (WOMAC pain: 36.1 ± 14.0 vs 50.4 ± 16.9; effect size, 0.9; P < .001), and their improvement was significantly higher (WOMAC pain gain, 44.5 vs 32.3; effect size, 0.59; P = .011).Conclusion
These findings show that all patients improved biomechanically and clinically, regardless of their BMI. 相似文献7.
Alex Gu Adam J. Michalak Jordan S. Cohen Neil D. Almeida Alexander S. McLawhorn Peter K. Sculco 《The Journal of arthroplasty》2018,33(5):1598-1605
Background
Knee stiffness following primary total knee arthroplasty can lead to unsatisfactory patient outcomes secondary to persistent pain and loss of function. Manipulation under anesthesia (MUA) remains a viable option for treatment of post-operative stiffness. However, the optimal timing and clinical efficacy of manipulation of anesthesia remains unknown.Methods
A systematic review of the literature was performed to identify studies that reported clinical outcomes for patients who underwent MUA for post-operative stiffness treatment. Repeat MUA procedures were included in the study but were analyzed separately.Results
Twenty-two studies (1488 patients) reported on range of motion (ROM) after MUA, and 4 studies (81 patients) reported ROM after repeat MUA. All studies reported pre-MUA motion of less than 90°, while mean ROM at last follow-up exceeded 90° in all studies except 2. For studies reporting ROM improvement following repeat MUA, the mean pre-manipulation ROM was 80° and the mean post-manipulation ROM was 100.6°.Conclusion
MUA remains an efficacious, minimally invasive treatment option for post-operative stiffness following TKA. MUA provides clinically significant improvement in ROM for most patients, with the best outcomes occurring in patients treated within 12 weeks post-operatively.Prospero Registration Number
CRD42016052215. 相似文献8.
9.
Hassan Shakeri Manijeh Soleimanifar A.M. Arab Shirin Hamneshin Behbahani 《Journal of hand therapy》2018,31(1):35-41
Study Design
Randomized clinical trial.Introduction
KinesioTape (KT) is a noninvasive method to treat pain and muscular dysfunction.Purpose
To investigate the effect of KT with and without tension on pain intensity, pain pressure threshold, grip strength and disability in individuals with lateral epicondylitis, and myofacial trigger points in forearm muscles.Methods
Thirty women with lateral epicondylitis and myofacial trigger point in forearm muscles were randomly assigned to KT with tension and placebo (KT without tension). The treatment was provided 3 times in one week, and outcome measures were assess pre-post treatment.Results
The mean score of visual analogue scale (VAS) during activity decreased significantly from 6.4 and 6 pretest to 2.53 and 4.66 posttest, respectively, for the KT with and without tension groups. The mean score of Disabilities of the Arm, Shoulder and Hand decreased significantly from 16.82 and 22.79 pretest to 8.65 and 8.29 posttest, respectively, for the KT with and without tension groups. A paired t-test revealed a significant reduction in VAS during activity and Disabilities of the Arm, Shoulder and Hand before and after treatment in both groups (P < .05). Pain pressure threshold, grip strength, and VAS using an algometer revealed no significant differences. The study showed no significant difference in variables immediately after intervention.Discussion
Improvements in functional disability were superior when KT was used with tension, than obtained with a placebo-no tension application.Conclusion
The application of KT produces an improvement in pain intensity and upper extremity disability in subjects with LE and MTP in forearm muscles, and KT with tension was more effective than placebo group.Level of Evidence
NA.Trial Registration Number
100-216. 相似文献10.
Bianca Callegari Marília Maniglia de Resende Manoel da Silva Filho 《Journal of hand therapy》2018,31(1):42-51
Study Design
Case series (longitudinal).Introduction
Only few reports concerning the efficacy of commonly used strategies for preventing upper limb occupational disorders associated with prolonged typing exist.Purpose of the Study
We aimed to investigate whether the duration of typing and the use of 2 strategies (hand rest and wrist support) changes muscle physiological response and therefore the electromyography records.Methods
We enrolled 25 volunteers, who were unfamiliar with the task and did not have musculoskeletal disorders. The subjects underwent 3 prolonged typing protocols to investigate the efficacy of the 2 adopted strategies in reducing the trapezius, biceps brachii, and extensor digitorum communis fatigue.Results
Typing for 1 hour induced muscular fatigue (60%-67% of the subjects). The extensor digitorum communis muscle exhibited the highest percentage of fatigue (72%-84%) after 1 and 4 hours of typing (1 hour, P = .04; 4 hours, P = .02). Fatigue levels in this muscle were significantly reduced (24%) with the use of pause typing (4 hours, P = .045), whereas biceps brachii muscle fatigue was reduced (32%) only with the use of wrist supports (P = .02, after 4 hours). Trapezius muscle fatigue was unaffected by the tested occupational strategies (1 hour, P = .62; 4 hours, P = .85).Discussion
Despite presenting an overall tendency for fatigue detected during the application of the protocols, the assessed muscles exhibited different behavior patterns, depending on both the preventive strategy applied and the muscle mechanical role during the task.Conclusion
Hand rest and wrist support can successfully reduce muscle fatigue in specific upper limb muscles during prolonged typing, leading to a muscle-selective reduction in the occurrence of fatigue and thus provide direct evidence that they may prevent work-related musculoskeletal disorders.Level of Evidence
N/A 相似文献11.
Design
Case study.Introduction
Hand therapists are often called upon to provide treatment for thumb carpometacarpal joint osteoarthritis.Purpose
These 2 case studies present a client-centered approach in the selection of orthoses and joint protection strategies for patients with thumb carpometacarpal joint osteoarthritis. At baseline, the participants presented with pain, decreased active range of motion, decreased pinch strength, and limitations in activity and participation.Methods
The outcome measures utilized at study entry and 6 weeks included the pain Visual Analog Scale, the Australian Canadian Osteoarthritis Hand Index, the Disabilities of the Arm, Shoulder and Hand questionnaire, the Canadian Occupational Performance Measure, active range of motion measured with goniometry, and pinch strength measured with a pinch gauge. The Canadian Occupational Performance Measure facilitated the client-centered approach by identifying occupational performance issues and rating the participant's performance and satisfaction for each. Each participant was prescribed a different orthotic design, received client-centered joint protection instruction, and evidence-based exercises.Results
After 6 weeks, both clients had decreased pain and improvement in their activities, participation, and satisfaction.Discussion
Using a client-centered approach can help therapists to carefully consider a patient's occupational needs when designing and fabricating orthoses and customizing their joint protection education for carpometacarpal joint osteoarthritis.Conclusion
Focusing rehabilitation strategies on that which is most important to the client should be considered to optimize their occupational performance. 相似文献12.
Bina Eftekharsadat Peyman Roomizadeh Shervin Torabi Fariba Heshmati-Afshar Fatemeh Jahanjoo Arash Babaei-Ghazani 《Journal of hand therapy》2018,31(4):437-442
Study Design
Randomized controlled trial.Introduction
Carpal tunnel syndrome (CTS) is the most common entrapment neuropathy of the upper extremity. To date, no previous study has evaluated the efficacy of topical Lavendula stoechas (Lavender) oil in CTS patients.Purpose of the Study
To investigate the effectiveness of topical Lavender essential oil in pain intensity, isometric pinch strength, electrophysiological features, and functional status of patients with mild to moderate CTS.Methods
Forty eight patients with mild to moderate CTS were enrolled in this randomized placebo-controlled trial. Group A was treated with night wrist orthotic and topical lavender oil ointment. Group B was treated with night wrist orthotic and a placebo ointment. Patients were evaluated at baseline, and after 40 days of intervention with Boston CTS questionnaire (BCTQ), visual analog scale (VAS) for pain, pinch grip strength, power grip, median compound motor action potential latency, and median sensory nerve action potential latency.Results
At the end of the study period, both groups improved significantly in terms of BCTQ, VAS, isometric pinch powers, and electrodiagnosis study parameters. However, group A showed significantly greater improvements in BCTQ (mean difference, 0.39 ± 0.31 vs 0.6 ± 0.35; P = .03), VAS (3.37 ± 1.86 vs 1.33 ± 2.07; P = .001), and pinch grip strength (0.73 ± 0.63 vs 0.27 ± 0.54; P = .01) than group B. No significant differences in power grip, median compound motor action potential latency, and median sensory nerve action potential latency were seen between the 2 groups.Conclusion
This study was the first trial of topical lavender oil used in patients with CTS. Wrist orthotic combined with topical lavender oil was more effective than orthotic and placebo in treatment of mild to moderate CTS.Level of Evidence
1b. 相似文献13.
David A. Samy Jesse I. Wolfstadt Iman Vaidee David J. Backstein 《The Journal of arthroplasty》2018,33(5):1379-1383
Background
Medial pivot (MP) type total knee arthroplasty (TKA) implants are designed with a highly congruent medial tibiofemoral articulation. Compared with the cam-and-post design of the posterior-stabilized (PS) TKA, the MP-TKA design has been hypothesized to better replicate the natural kinematics of the knee. We compared the MP-TKA and PS-TKA designs, with our primary outcome measures being range of motion (ROM) and patient-reported satisfaction.Methods
This study was a retrospective comparison between the 2 groups (76 MP-TKA vs 88 PS-TKA). ROM was collected preoperatively, 6 weeks, 6 months, and 1 year postoperatively. The Forgotten Joint Score-12 (FJS-12) scores were collected at a minimum of 1 year postoperatively.Results
There was no statistically significant difference in age, gender, or body mass index between the groups. We found a statistical difference in preoperative ROM (MP = 120.3°, PS = 112.8°, P = .002). There was no difference in ΔROM at 6 weeks (MP = ?12.36, PS = ?3.79, P = .066), 6 months (MP = ?4.23, PS = 2.73, P = .182), or 1 year (MP = .17, PS = 3.31, P = .499). Patients who underwent the MP-TKA scored significantly better than the PS-TKA on the FJS-12 score (MP = 59.72, PS = 44.77, P = .007).Conclusion
We found that patients who underwent the MP-TKA scored better on the FJS than those who underwent the PS-TKA; particularly with regard to deep knee flexion and stability of the prosthesis. The MP-TKA design may offer improved patient outcomes because of its highly congruent medial tibiofemoral articulation. 相似文献14.
Kazu Matsumoto Hiroyasu Ogawa Hiroki Yoshioka Haruhiko Akiyama 《The Journal of arthroplasty》2017,32(6):1845-1849
Background
We hypothesized that postoperative anteroposterior (AP) stability of the knee correlates with patient-reported clinical outcome and knee function after total knee arthroplasty (TKA).Methods
This study enrolled 110 knees in 81 patients after TKA. AP laxity was measured with a KS Measure Arthrometer at 30°, 60°, and 90° flexion, which was confirmed with a goniometer. We assessed knee pain and function by using the Knee Society Function Score (KSS) and Knee Injury and Osteoarthritis Outcome Score (KOOS). Correlations among AP translation values and KOOS subscale scores (pain symptom, activities of daily living, and knee-related quality of life), KSS, and range of motion (ROM) were analyzed.Results
The mean follow-up period for the assessment of the KOOS was 4.4 ± 2.2 years (range, 1.1-11.5 years). Twenty-five knees had posterior-stabilized fixed-bearing TKA, and 85 knees had posterior-stabilized mobile-bearing TKA. The mean KSS functional score and mean ROM were 96.3 ± 5.7 (range, 75-100) and 121.6° ± 14.4° (range, 90°-145°), respectively. The mean AP laxity was 4.5 ± 2.2 mm, 3.6 ± 1.9 mm, and 3.0 ± 1.9 mm at 30°, 60°, and 90° knee flexion, respectively. A significant inverse association was observed between AP laxity at 60° knee flexion and KOOS pain (P = .021, R2 = 0.05), but no significant association was found between AP laxity and other KOOS subscale score, KSS, and ROM.Conclusion
We found that the AP laxity at 60° knee flexion in this study significantly correlated with patient-reported pain. The observed AP laxity can be considered as a register of normal AP translations after arthroplasty. 相似文献15.
James E. Coverdill Adnan Alseidi David C. Borgstrom Daniel L. Dent Russell Dumire Jonathan Fryer Thomas H. Hartranft Steven B. Holsten M. Timothy Nelson Mohsen M. Shabahang Stanley R. Sherman Paula M. Termuhlen Randy J. Woods John D. Mellinger 《American journal of surgery》2018,215(2):326-330
Background
The study explores how residents and faculty assess the ACGME's 16-h limit on intern shifts.Methods
Questionnaire response rates were 76% for residents (N = 291) and 71% for faculty (N = 279) in 13 general surgery residency programs. Results include means, percentage in agreement, and statistical tests for 15 questionnaire items. Semi-structured interviews conducted with 39 residents and 43 faculty were analyzed for main themes.Results
Few view the intern shift limit as a positive change. Views differ (P < 0.01) for residents and faculty on 12 of 15 item means and across PGY levels on all 15 items. Interviews indicate concerns about losses with respect to education and professional development, difficulties when interns transition to their second year, and how intern shifts may be more fatiguing than expected.Conclusions
The 16-h limit on intern shifts has remained a source of concern and an educational challenge for residents and faculty. 相似文献16.
Nikolaus Johannes Wachter Martin Mentzel Gert D. Krischak Joachim Gülke 《Journal of hand therapy》2018,31(4):524-529
Introduction
In the assessment of hand and upper limb function, grip strength is of the major importance. The measurement by dynamometers has been established.Purpose of the Study
In this study, the effect of a simulated ulnar nerve lesion on different grip force measurements was evaluated.Methods
In 25 healthy volunteers, grip force measurement was done by the JAMAR dynamometer (Fabrication Enterprises Inc, Irvington, NY) for power grip and by a pinch strength dynamometer for tip pinch strength, tripod grip, and key pinch strength.Study Design
A within-subject research design was used in this prospective study. Each subject served as the control by preinjection measurements of grip and pinch strength. Subsequent measurements after ulnar nerve block were used to examine within-subject change.Results
In power grip, there was a significant reduction of maximum grip force of 26.9% with ulnar nerve block compared with grip force without block (P < .0001). Larger reductions in pinch strength were observed with block: 57.5% in tip pinch strength (P < .0001), 61.0% in tripod grip (P < .0001), and 58.3% in key pinch strength (P < .0001).Discussion
The effect of the distal ulnar nerve block on grip and pinch force could be confirmed. However, the assessment of other dimensions of hand strength as tip pinch, tripod pinch and key pinch had more relevance in demonstrating hand strength changes resulting from an distal ulnar nerve lesion.Conclusions
The measurement of tip pinch, tripod grip and key pinch can improve the follow-up in hand rehabilitation.Level of Evidence
II. 相似文献17.
Hiroaki Onuma Takashi Hirai Toshitaka Yoshii Hiroyuki Inose Masato Yuasa Shigenori Kawabata Atsushi Okawa 《Journal of orthopaedic science》2018,23(6):923-928
Purpose
To clarify whether there is any difference in mid-term clinical and radiologic outcomes between bone-grafted laminoplasty (BG LAMP) and non-bone-grafted laminoplasty (non-BG LAMP) when used to treat cervical spondylotic myelopathy.Background
Conventional BG LAMP includes bone grafting at the lamina hinge site to prevent closure of the lamina postoperatively, but it often results in segmental fusion and sometimes causes loss of cervical mobility and lordotic alignment. Non-BG LAMP can now be performed to address this problem and preserve mobility postoperatively. However, there have been no studies comparing BG LAMP and non-BG LAMP to date.Methods
Forty-one patients who underwent BG LAMP (n = 24) or non-BG LAMP (n = 17) and had 5 years of follow-up were enrolled in the study. Neurological status was assessed preoperatively and postoperatively using the Japanese Orthopedic Association (JOA) scoring system. The Numeric Rating Scale (NRS) was used to assess neck pain after surgery at the final visit. Radiographic parameters were evaluated at 1, 3, and 5 years after surgery. Postoperative segmental fusion was defined as the level at which the segmental flexion–extension range of motion was <1°.Results
There was no significant difference in JOA score or recovery rate between the groups. NRS score was significantly lower in the BG group, indicating less neck pain (P < .01). The lordotic angle and range of motion at C2-C7 were significantly decreased in the BG group (P < .05). The segmental fusion was evident from 1 year postoperatively in both groups, but the fusion rate was significantly higher in the BG group (P < .05).Conclusions
Neurologic outcomes were similar between the two groups, whereas axial symptom was lower in the BG group than in the non-BG group.Level of evidence
Ⅳ 相似文献18.
Tomoharu Mochizuki Takashi Sato Osamu Tanifuji Satoshi Watanabe Koichi Kobayashi Naoto Endo 《The Journal of arthroplasty》2018,33(7):2100-2110
Background
This study aimed to identify the factors affecting postoperative rotational limb alignment of the tibia relative to the femur. We hypothesized that not only component positions but also several intrinsic factors were associated with postoperative rotational limb alignment.Methods
This study included 99 knees (90 women and 9 men) with a mean age of 77 ± 6 years. A three-dimensional (3D) assessment system was applied under weight-bearing conditions to biplanar long-leg radiographs using 3D-to-2D image registration technique. The evaluation parameters were (1) component position; (2) preoperative and postoperative coronal, sagittal, and rotational limb alignment; (3) preoperative bony deformity, including femoral torsion, condylar twist angle, and tibial torsion; and (4) preoperative and postoperative range of motion (ROM).Results
In multiple linear regression analysis using a stepwise procedure, postoperative rotational limb alignment was associated with the following: (1) rotation of the component position (tibia: β = 0.371, P < .0001; femur: β = ?0.327, P < .0001), (2) preoperative rotational limb alignment (β = 0.253, P = .001), (3) postoperative flexion angle (β = 0.195, P = .007), and (4) tibial torsion (β = 0.193, P = .010).Conclusion
In addition to component positions, the intrinsic factors, such as preoperative rotational limb alignment, ROM, and tibial torsion, affected postoperative rotational limb alignment. On a premise of correct component positions, the intrinsic factors that can be controlled by surgeons should be taken care. In particular, ROM is necessary to be improved within the possible range to acquire better postoperative rotational limb alignment. 相似文献19.
Shu-Kun He Min Yi Gang Zhong Shi-Qiang Cen Jia-Lei Chen Fu-Guo Huang 《Acta orthopaedica et traumatologica turcica》2018,52(1):27-31
Objective
The aim of this study was to investigate the optimal timing for the resection of heterotopic ossification (HO) of the elbow.Methods
We retrospectively reviewed 42 patients who were treated operatively for heterotopic ossification of the elbow from March 2010 to December 2014 at our institution. The patients were divided into early (before 12 months) and late (after 12 months) excision groups. In the early excision group (17 patients), the average time from the initial injury to HO excision was 7.4 (3–11) months, and in the late excision group (25 patients), the average time was 33.5 (12–240) months. Every patient was evaluated by range of motion (ROM), the Mayo Elbow Performance Score (MEPS), postoperative complications and HO recurrence.Results
The preoperative mean ROM in the late excision group was greater than that of the early excision group, suggesting that the ROM is expected to increase even without surgery. Both early and late surgery increased ROM and MEPS, but early surgery improved ROM and MEPS more than late surgery did (p < .05).Conclusions
Early excision of HO can provide better elbow function, as indicated by ROM and MEPS. Considering that there were no notable differences in postoperative ROM and MEPS, HO recurrence, or postoperative complications, we concluded that early excision is safe and that the time from an elbow injury to surgery may be shortened.Level of Evidence
Level III, therapeutic study. 相似文献20.
Lu-kai Zhang Jian-xiong Ma Ming-jie Kuang Xin-long Ma 《The Journal of arthroplasty》2018,33(6):1972-1978.e4