共查询到20条相似文献,搜索用时 15 毫秒
1.
《Journal of orthopaedic research》2017,35(11):2345-2355
2.
《Foot and Ankle Surgery》2014,20(1):52-56
BackgroundPatients with hip and knee osteoarthritis (OA) have high bone mineral density (BMD) and high BMI. If the same accounts for patients with foot or ankle OA is unknown.MethodsWe measured BMD and femoral neck (FN) width by dual-energy X-ray absorptiometry in 42 women and 19 men with idiopathic OA in the foot or ankle, and in 99 women and 82 men as controls.ResultsWomen with OA had significant higher BMI than controls. Women with OA had higher BMI-adjusted BMD (p < 0.01) and smaller BMI-adjusted FN width (p < 0.01) than controls. Men with OA had higher BMI adjusted-BMD (p < 0.05) and smaller BMI-adjusted FN width (p < 0.01) than controls.ConclusionPatients with OA in the foot or ankle have higher BMD and smaller bone size than being expected by their BMI. This phenotype may provide unfavourable forces across the joint and is hypothetically important for development of OA. 相似文献
3.
4.
《Foot and Ankle Surgery》2014,20(3):195-200
BackgroundTotal ankle arthroplasty is being used more frequently as an alternative for arthrodesis in final stages of ankle osteoarthritis. However, there are few studies which describe the biomechanics of gait of these patients.MethodsBetween March 2006 and May 2011, 17 patients (n = 18 ankles) suffering end-stage osteoarthritis of the ankle who underwent an ankle replacement (HINTEGRA) were evaluated retrospectively. We evaluated clinical, radiological and biomechanical gait parameters using the NedAMH/IBV dynamometric platform.ResultsAt last follow-up (average: 37 months), the AOFAS score improved from 31 to 83 with a high rate of satisfaction (83.3%). Kinetic gait parameters were more similar to a healthy ankle. We detected a radiolucent line in 8 patients (44%) without any subsidence case.ConclusionsOur study showed a high rate of satisfaction and biomechanics of the gait similar to a healthy ankle. The complication rate was analogous to those previously published in the literature. 相似文献
5.
Ankle osteoarthritis (OA) is often associated with deformities. Valgus OA is less frequent than varus OA and causes of valgus OA include medial ligament instability, flat foot and posttraumatic situations, e.g. fractures of the fibula or lateral tibial plafond. The importance of the mechanical axis is generally accepted in orthopedic surgery. In cases of implantation of total ankle replacements the normal biomechanics need to be restored in order to have a correct and pain-free functioning total ankle replacement both in the short and long-term. The two most important criteria are (1) an anterior tibio-talar angle of about 90° and (2) a neutral hindfoot position. The hindfoot position is measured with the hindfoot alignment view according to Saltzman. In this view, healthy feet are in neutral or minimal varus position of 1-2° and not in a valgus position as generally assumed. The following operative steps are performed depending on the degree and localization of the valgus deformity: (1) total ankle replacement, (2) supramalleolar or (3) inframalleolar osteotomy/arthrodesis, (4) medial ligament repair, (5) fibula osteotomy and (6) syndesmotic reconstruction. 相似文献
6.
7.
Impact of comorbidities on post-prostatectomy incontinence 总被引:1,自引:0,他引:1
Wille S Heidenreich A von Knobloch R Hofmann R Engelmann U 《Urologia internationalis》2006,76(3):223-226
INTRODUCTION: The aim of this retrospective study was to evaluate various factors that may influence post-prostatectomy incontinence (PPI). PATIENTS AND METHODS: 1,088 men with prostate cancer underwent radical retropubic prostatectomy. 742 patients were evaluable for analysis. Continence was defined as usage of no or one pad daily. Mean follow-up was 45 months (12-143). RESULTS: Based on protective pad requirement 100% and 76% of men were continent at baseline and at the time of questionnaire evaluation (at least 12 months), respectively. Univariate analysis was performed to identify factors that may influence the return of continence. Age, body mass index (BMI), previous TUR-P, smoking, hypertension, diabetes and attempted nerve sparing did not predict postoperative continence status. CONCLUSIONS: In contrast to several reports, our analysis revealed that age, BMI, previous TUR-P, smoking, hypertension and diabetes do not have a statistically significant impact on continence after radical retropubic prostatectomy and are therefore not useful as predictors for PPI. 相似文献
8.
Published data show that bariatric surgery not only leads to significant and sustained weight loss but also resolves or improves multiple comorbidities associated with morbid obesity. Evidence suggests that the earlier the intervention the better the resolution of comorbidities. Patients with metabolic syndrome and comorbidities associated with morbid obesity should be promptly referred for consideration for bariatric surgery earlier in the disease process. 相似文献
9.
Sun SF Chou YJ Hsu CW Hwang CW Hsu PT Wang JL Hsu YW Chou MC 《Osteoarthritis and cartilage / OARS, Osteoarthritis Research Society》2006,14(9):867-874
OBJECTIVE: To investigate the efficacy, safety and the duration of treatment effectiveness of intra-articular hyaluronic acid (Artz, Japan) in patients with ankle osteoarthritis (OA). METHOD: As a prospective clinical trial, 93 patients with unilateral ankle pain for at least 6 months and radiographically classified as Kellgren-Lawrence grade I or II ankle OA were included. After five weekly intra-articular Artz injections, the Ankle Osteoarthritis Scale (AOS), the American Orthopaedic Foot and Ankle Society (AOFAS) ankle/hindfoot score, ankle sagittal range of motion (ROM), patients' global satisfaction, local adverse events and consumption of rescue analgesics were analyzed. RESULTS: Seventy-five patients completed the study. Significant improvement in AOS and AOFAS ankle/hindfoot scores was noted at 1 week, 1 month, 3 months and 6 months post the fifth injection (P < 0.001 compared with baseline). The mean reduction of AOS score was 1.9, 2.6, 2.5 and 2.6 at each following visit (P < 0.001). The mean AOFAS ankle/hindfoot score improved from 64 points at baseline to 75, 78, 78, and 78 points at 1 week, 1 month, 3 months and 6 months, respectively, post the fifth injection (P < 0.001). Ankle sagittal ROM did not improve significantly (P > 0.05). The majority of patients reported satisfaction at 1 week (100%), 1 month (100%), 3 months (90.7%) and 6 months (86.7%) follow-up. Local adverse events occurred in 6.7% of patients. Acetaminophen consumption dropped significantly following treatment (P < 0.001). CONCLUSION: Five weekly intra-articular injections of Artz provide pain relief and functional improvements in patients with Kellgren-Lawrence grades I and II ankle OA. The clinical effect was rapid at 1 week and may last for 6 months or more. 相似文献
10.
11.
《Journal of orthopaedic science》2021,26(5):878-884
BackgroundConsidering the invasiveness of standard multidisciplinary approaches used for the treatment of soft tissue sarcoma, including surgery with wide margins, intensive chemotherapy, and radiotherapy, evaluation of comorbidities in high-grade soft tissue sarcoma patients is essential. Several previous studies have reported the impact of comorbidities on the survival of soft tissue sarcoma patients. Patient health status differs between nationalities or ethnic groups and only limited data has been reported with respect to the impact of comorbidities on Japanese soft tissue sarcoma patients.MethodsThe incidence of each comorbidity, relationship between comorbidities and underlying clinicopathological factors, relationship between treatment status and comorbidities, and impact of comorbidities on disease-specific death in 136 patients with high-grade soft tissue sarcoma at the authors' institution were analyzed. For the evaluation of comorbidities, the updated Charlson comorbidity index was applied.ResultsOf the patients, 25% presented with more than one comorbidity. Elderly patients showed a significantly higher incidence of comorbidities (p < 0.0001). Patients with congestive heart failure (p = 0.004), dementia (p < 0.0001), hemiplegia/paraplegia (p < 0.0001), and renal disease (p < 0.0001) showed worse prognosis. Tumor grade (p = 0.01) and updated Charlson comorbidity index (p < 0.0001) were independent risk factors for disease-specific death.ConclusionsComorbidity status was a significant risk factor for disease-specific death in Japanese patients with high-grade soft tissue sarcoma. Innovations in comorbidity management may be a means for the improvement of oncological outcomes in soft tissue sarcoma. Given the difficulties in conducting standard randomized control studies in this field, data accumulation from real-world cases appears to be the most practical approach in establishing and applying strategies for the treatment of patients with comorbidities or elderly patients. 相似文献
12.
Biomechanical analysis for osteoarthritis of the ankle 总被引:1,自引:0,他引:1
K Noguchi 《Nippon Seikeigeka Gakkai zasshi》1985,59(2):215-222
The study of three-dimensional model of the human arthritic ankle joint by the stress freezing photoelastic technique showed regional increases of stress distribution in contact area of the medial side of the talocrural joint and medial shift of the stress distribution center in the subtalar joint. From the study of the ankle joint in a contact stress analysis under a variety of conditions, the possible cause of primary or secondary osteoarthritis is discussed, and the joint instability resulting from lateral collateral ligament injuries might be one of the major cause of the disease. For the treatment of the disease, low tibial osteotomy with ligament plasty is considered to be effective. 相似文献
13.
14.
Nicola Krähenbühl Lena Siegler Manja Deforth Lukas Zwicky Beat Hintermann Markus Knupp 《Foot and Ankle Surgery》2019,25(2):143-149
Background
Although it has been proposed that in mid-stage ankle osteoarthritis, the subtalar joint can compensate for deformities above the ankle joint, the evidence is weak. We thus investigated subtalar joint alignment in different stages of ankle osteoarthritis using weightbearing computed tomography (CT) scans.Methods
The subtalar joint of 88 patients with osteoarthritis of the ankle joint and a control group of 27 healthy volunteers were assessed. Subgroups were performed according to the ankle deformity (varus and valgus) and stage of ankle joint osteoarthritis. Subtalar joint alignment was assessed on weightbearing CT scans.Results
A more valgus subtalar joint alignment was found in patients with varus ankle osteoarthritis. No significant difference of the subtalar joint alignment was evident when comparing different stages of ankle osteoarthritis.Conclusions
Varus ankles compensate in the subtalar joint for deformities above the ankle joint. Compensation does not correlate with the stage of ankle osteoarthritis. 相似文献15.
《Foot and Ankle Surgery》2023,29(5):424-429
BackgroundVarus ankle osteoarthritis (OA) is typically associated with peritalar instability, which may result in altered subtalar joint position. This study aimed to determine the extent to which total ankle replacement (TAR) in varus ankle OA can restore the subtalar alignment.MethodsFourteen patients (15 ankles, mean age 61 ± 6 years) who underwent TAR for varus ankle OA were analyzed using semi-automated measurements based on weight-bearing computed tomography. Twenty healthy individuals served as a control group.ResultsAll angles improved between preoperative and a minimum of 1 year (mean 2.1 years) postoperative and were statistically significant in 6 out of 8 angles (P < 0.05).ConclusionsOur findings indicate that talus repositioning after TAR restores the subtalar joint alignment which may improve hindfoot biomechanics. Future studies are required to implement these findings for TAR in presence of hindfoot deformity.Level of evidenceIV. 相似文献
16.
Anne Tournadre Bruno Pereira Laure Gossec Martin Soubrier Maxime Dougados 《Joint, bone, spine : revue du rhumatisme》2019,86(1):55-60
Objectives
To analyze the factors associated with fatigue focusing on comorbidities in a large cohort of rheumatoid arthritis (RA).Methods
Cross-sectional analyses were performed on RA patients from the French COMEDRA cohort study, a nurse-led program for comorbidities management. Fatigue was assessed using Question 3 of the Rheumatoid Arthritis Impact of Disease (RAID) score on a 0–10 numerical rating scale (NRS). Fatigue was defined as acceptable if?≤?2, moderate if 3 or 4, or severe if?≥?5 out of 10. Using univariate and multivariate models, the relationship between fatigue and demographics, social, disease characteristics, comorbidities (cardiovascular, infections, cancer, pulmonary, osteoporosis, and psychiatric disorders), physical activity, quality of life, and treatments was investigated.Results
In total, 962 patients were analyzed. The mean fatigue score was 3.8?±?2.7, 40% of patients reported severe fatigue. Patients had an average of 1.8 additional morbid conditions, with anxiety/depression the most common (52%). In univariate analysis, severe fatigue was more frequent in women, in patients not working, and in those with less physical activity. It was associated with disease duration and activity, mHAQ, pain, sleeping and emotional difficulties. Severe fatigue correlated with Multimorbidity index assessing the number of morbid conditions and was associated with obesity, hypertension, COPD, and anxiety/depression. In multivariate models, the risk of severe fatigue was associated with female gender, disease activity, mHAQ, current treatment with NSAIDs and biologics, multimorbidity, obesity and anxiety/depression.Conclusions
Assessment of comorbidities, psychological health and physical activity should be taken into account in order to address frequent RA-related severe fatigue. 相似文献17.
Sherif Dabash Joshua R Buksbaum Austin Fragomen S Robert Rozbruch 《World journal of orthopedics》2020,11(3):145-157
Post-traumatic osteoarthritis(PTOA) is a complex and painful problem in the foot and ankle.Ninety percent of osteoarthritis cases in the foot and ankle can be classified as post-traumatic.PTOA can affect any of the 33 joints in the foot and the ankle.Distraction arthroplasty is a method for treatment of early arthritic joints without fusing or replacing them and its effectiveness has been well documented.The purpose of this case series is to present our successful experiences and positive results using distraction arthroplasty to treat PTOA in the ankle,subtalar,first metatarsophalangeal,and second tarsometatarsal joints,and to present distraction arthroplasty as a viable alternative to invasive joint sacrificing procedures such as arthrodesis or arthroplasty.Distraction Arthroplasty effectively and safely treats PTOA and improves the stability of joints in the Foot and Ankle.Additionally,the use of bone marrow aspirate concentrate as an adjuvant can improve the long-term functional and structural outcomes of the joint,and can prolong the need for further,more aggressive surgical interventions such as fusion or arthroplasty. 相似文献
18.
19.
While ankle arthrodesis has remained the gold standard treatment for symptomatic primary, secondary, and posttraumatic ankle
arthritis, more recently, total ankle replacement (TAR) has seen considerable improvement in terms of biomechanics, function,
and complication rates. However, while in the long-term degeneration of the adjacent joints is almost always found on radiographs
after ankle arthrodesis, the longevity of TAR is still insufficient and does not match that of total knee and hip joints.
The current review article focuses on the treatment of ankle arthritis by means of arthrodesis and TAR. 相似文献
20.
Joint distraction has demonstrated substantial promise in the treatment of tibiotalar arthritis. Its minimally invasive nature, combined with the fact that it does not seem to "burn any bridges," lends considerable clinical appeal. Even if joint distraction provides only temporary relief and clinical results slowly deteriorate over time, more definitive and committed procedures potentially can be forestalled for a considerable period of time. Nevertheless, the current literature and clinical experience with this technique is limited. Further research and analysis is ongoing and will be necessary to understand, validate, and refine this novel approach to ankle arthritis. 相似文献