BACKGROUND:: Patient-reported outcomes (PROs) are being used to compare health care providers with little knowledge of how the choice of measure affects such comparisons. OBJECTIVES:: To assess how much difference the choice of PRO makes to a provider's adjusted outcome and whether the choice affects a provider's rating. RESEARCH DESIGN:: ...

BACKGROUND: Clinical joint examination is less time-consuming than ultrasound in rheumatoid arthritis. Knowledge of clinical and ultrasound concordance of joints groups could help in selecting joints for a best ultrasonographic assessment. OBJECTIVE: To evaluate concordance between clinical examination and ultrasound of joints in a heterogeneous group of patients with rheumatoid ...

Deep dermal burns can be covered with different kind of materials and techniques; one of them is a polylactide-based temporary skin substitute. The aim of this study was to intraindividually compare its 1-year outcome with the results obtained by use of autologous skin grafts in patients suffering from deep dermal ...

INTRODUCTION: Previous studies on the impact of nonworking hours (NWH) have produced conflicting results. We aimed to compare the time to treatment with thrombolysis between NWH and working hours (WH) at an Australian comprehensive stroke center. MATERIALS AND METHODS: All acute ischemic stroke patients treated with intravenous alteplase (IV-alteplase) from ...

AIM: To demonstrate the possible use of a tumescent solution containing lidocaine and prilocaine for radiofrequency-assisted segmental thermal ablation and to reduce the need for postoperative analgesics. METHODS: Fifty patients (51 limbs) underwent radiofrequency-assisted segmental thermal ablation (VNUS Closure FAST(™) ) of insufficient great and small saphenous veins and phlebectomy. ...

PURPOSE: The purpose of this study was to perform a retrospective clinical and radiographic evaluation after opening-wedge high tibial osteotomy (HTO) using a short spacer plate (Aescula; B. Braun Korea, Seoul, South Korea) and rigid long plate (TomoFix plate; Mathys, Bettlach, Switzerland) at follow-up 2 years postoperatively. METHODS: We performed ...

OBJECTIVES: The presence of postoperative atrial fibrillation predicts a higher short- and long-term mortality rates; however, no scoring system has been used to discriminate patients at high risk for this complication. The aim of this study was to investigate whether the CHADS2 and CHA2DS2-VASc scores are useful risk assessment tools ...

OBJECTIVES/HYPOTHESIS: To determine whether snoring sound intensity measured after a first soft palate radiofrequency (RF) session for simple snoring helps predict the final result of the treatment. STUDY DESIGN: Observational retrospective study. METHODS: We conducted a retrospective review of 105 subjects presenting with simple snoring or mild sleep apnea. All ...

The objective of this paper is to evaluate and compare hearing outcomes, intraoperative and postoperative complications and tinnitus characteristics, with particular regard to the effects of stapes surgery on the course of tinnitus. Two groups were evaluated: one group of patients were treated with classical stapedotomy and the second group ...

BACKGROUND: Tibiotalocalcaneal arthrodesis is a salvage option for severe ankle and hindfoot deformities, arthritis of the ankle and subtalar joints, avascular necrosis of the talus, failed total ankle arthroplasty, and Charcot arthropathy. This multicenter study reports clinical experience with the hindfoot arthrodesis nail (HAN) in the treatment of patients with ...

The aims of this study were to evaluate the long term clinical outcomes and survival rate of total knee arthroplasty (TKA) in Chinese population and the risk factors for failure. Between 1985 to 2001, 297 patients underwent primary TKAs with cemented fixed bearing platform in our center. Survival rate was ...

BACKGROUND: Irreparable peroneal tendon tears are uncommon and require complex surgical decision making. Intercalary segment allograft reconstruction has been previously described as a treatment option; however, there are no reports of the outcomes of this technique in the literature. We describe our technique and present our results using this method. ...

BACKGROUND: Loosening of the glenoid component remains the most common problem in total shoulder arthroplasty. It has been described that the round-backed, all-polyethylene components with cemented peg fixation perform better biomechanically and clinically than flat-backed, metal-backed, or keeled components. However, side effects of cementing have been described. We hypothesized that ...

PURPOSE: This study aimed to develop and validate a scoring system to identify long-term survivors after conventional radiotherapy (RT) for metastatic spinal cord compression (MSCC). PATIENTS AND METHODS: Data from 1,125 patients who had received long-course RT for MSCC were included in this study. Of these patients, 344 survived for over 12 months ...

BACKGROUND: Total hip arthroplasty is a successful surgical procedure to treat hip osteoarthritis. Clinicians use different questionnaires to assess the patient's pain and functional capacity. Furthermore, they assess the quality of gait in a very global way.This clinical evaluation usually shows significant improvement after total hip arthroplasty, however, does not ...

BACKGROUND:As anterior cruciate ligament (ACL) reconstruction is performed increasingly in the United States, the rate of revision ACL reconstruction continues to rise. A paucity of literature exists with respect to repeat ACL revision surgery. PURPOSE:To evaluate the functional outcomes of patients who had undergone at least 2 revision ACL reconstructions. ...

OBJECTIVES/HYPOTHESIS: In-office percutaneous injection laryngoplasty is a common treatment for glottal insufficiency. Our objective was to prospectively study voice outcomes and patient tolerance of the procedure. STUDY DESIGN: Prospective case series. METHODS: Consecutive adult patients undergoing awake injection laryngoplasty were recruited. Voice Handicap Index (VHI)-30; Consensus Auditory-Perceptual Evaluation of Voice ...

BACKGROUND CONTEXT: The proximity (<5 mm) of the plate to the adjacent disc space is known to be a critical risk factor for adjacent-level ossification development (ALOD). As plates provide many advantages including higher fusion rates and improved alignment, their use will continue. Instead, it is necessary to modify the ...

The purpose of this study was to compare the dislocation rates, functional outcomes, and radiographic results between large- and small-diameter femoral head components. A total of 225 patients (248-hips) who received total hip arthroplasties with large-diameter components (36mm or greater) were compared to 501 patients (559-hips) who received smaller diameter ...

BACKGROUND AND AIMS: Body temperature, inflammation, and infections may modify response to thrombolytic therapy. We studied their associations with clinical improvement after intravenous thrombolysis and three-month outcome. METHODS: We included 985 consecutive acute ischemic stroke patients treated with intravenous thrombolysis at the Helsinki University Central Hospital during 1995-2008. Body temperature, ...

BACKGROUND: Missed or chronic subscapularis tendon ruptures may have muscle atrophy and tendon retraction resulting in a large defect with high risk of re-tear after a surgical repair. To improve the clinical results of this challenging surgery, the repaired tendon could be augmented with endogenous or exogenous materials. The purpose ...

BACKGROUND: /st>Distractions are cited as contributory to healthcare-associated errors in a large proportion of incidents including those involving anaesthetists. The anaesthetist is relatively understudied, despite the closer coupling between action and outcome than in surgery. METHODS: /st>After formal regulatory approval, we undertook an observational study using a validated rating scale ...

BACKGROUND:Trochlear dysplasia is one of the most consistent anatomic factors that can lead to recurrent patellar dislocations. Various trochleoplasty procedures have been described to treat patellar dislocations in high-grade dysplasia by creating a new congruent trochlea. PURPOSE:To present the midterm efficacy and outcome of the sulcus-deepening trochleoplasty procedure in patients ...

PURPOSE: To determine the reproducibility of MR elastography (MRE) and the reproducibility and repeatability of the stiffness measurement of MRE in the staging of liver fibrosis. MATERIALS AND METHODS: Ninety-four patients, who underwent liver MRE, were included in this study. The patients were classified into group 1 (n = 47) and group ...

BACKGROUND: The aim of the present study was to clarify the efficacy of peroral endoscopic myotomy (POEM) for esophageal achalasia. PATIENTS AND METHODS: Twenty-eight esophageal achalasia patients who underwent POEM in our institution between August 2010 and October 2012 were enrolled. Under general anesthesia with tracheal intubation, initial incision was ...

BACKGROUND: Augmentation and remodelling of the calf is becoming more and more frequent, representing a challenge for the surgeon who must consider this body zone as a functional and aesthetical whole. Historically, calf reshaping has been carried out with silicone implants, mainly in the subaponeurotic plane; nonetheless, as in other ...

BACKGROUND: Previous studies have indicated poor outcomes in patients having revision of hip resurfacing resulting from adverse local tissue reaction and pseudotumor. QUESTIONS/PURPOSES: We reviewed all patients at our institution who had revision of failed large-head metal-on-metal total hip arthroplasty to determine (1) complications including reoperations; (2) radiologic outcomes; and ...

The aim of this study was to determine whether recovery from a drop-foot at 6 months can be predicted within 72 h after stroke and to investigate the effect of timing on the accuracy of prediction. One hundred and five patients with a first-ever anterior circulation stroke without full voluntary ...

BACKGROUND:Partial tears of the hamstring muscle origin represent a challenging clinical problem to the patient and orthopaedic surgeon. Although nonoperative treatment is frequently met with limited success, there is a paucity of data on the efficacy of surgical management for partial proximal hamstring tears in the active and athletic population. ...

BACKGROUND: Postoperative nausea and vomiting are a common complication after surgery. The objective of the study was to identify risk factors, and to determine the incidence of postoperative nausea and vomiting in a cohort of patients in a tertiary university hospital. METHODS: Prospective cohort study was conducted in a Post ...

AIM: Passive post-defecatory incontinence is poorly understood and yet is an important clinical problem. The aim of this study was to characterize the pathophysiology of post-defecatory incontinence in patients affected by faecal soiling. METHOD: Seventy-two patients [30 women; age range, 49-79 years; 42 men; age range, 53-75 years] affected by ...

OBJECTIVE: To evaluate maternal analgesia after an episiotomy during delivery. METHODS: The present case-control study compared 2 protocols of post-episiotomy infiltration: period A, 20mL of lidocaine 10mg/mL; period B, 20mL of ropivacaine 7.5mg/mL. The primary study endpoint was the visual analog scale (VAS) score at 24hours after episiotomy; secondary endpoints ...

BACKGROUND: Scoring systems in critical care patients are essential for prediction of outcome and for evaluation of therapy. In this study we determined the value of the APACHE II, APACHE III, Elebute-Stoner, SOFA, and SAPS II scoring systems in the prediction of mortality in patients with cardiogenic shock (CS) complicating ...

STUDY OBJECTIVE: We compare metoclopramide 20 mg intravenously, combined with diphenhydramine 25 mg intravenously, with ketorolac 30 mg intravenously in adults with tension-type headache and all nonmigraine, noncluster recurrent headaches. METHODS: In this emergency department (ED)-based randomized, double-blind study, we enrolled adults with nonmigraine, noncluster recurrent headaches. Patients with tension-type ...

Object The purpose of this study was to evaluate the feasibility and safety of minimally invasive pedicle screw fixation combined with percutaneous vertebroplasty (PVP) for treating acute thoracolumbar osteoporotic vertebral compression fracture (VCF) and preventing secondary VCF after PVP. Methods Twenty patients with a mean age of 73.6 years (range ...

BACKGROUND: The purpose of this study is to report on cost, outcomes, reliability, and safety of reverse shoulder arthroplasty (RSA) in patients with symptomatic advanced rotator cuff deficiency. METHODS: Fifty-five primary RSA patients operated on at a single institution by a single surgeon were prospectively studied for a mean of ...

BACKGROUND:In our study, we evaluated the analgesic effect and plasma level time course of subanesthetic doses of intraoperative S(+)-ketamine administered by continuous epidural infusion for postthoracotomic pain.METHODS:A study population of 140 patients undergoing thoracic surgery was randomly assigned to either S(+)-ketamine or ropivacaine by continuous epidural infusion. The outcome measures ...

We describe a novel technique of combining the Hastings bipolar head, matched in size to the acetabular cup liner, with a fixed, cemented monoblock stem allowing for isolated uncemented acetabular revision arthroplasty.
Aim: To assess patient clinical and radiological outcomes after isolated uncemented acetabular revision arthroplasty using the Hastings bipolar head.
Methods: ...

PURPOSE: Osteochondral autologous transplantation (OAT) from the ipsilateral femoral lateral condyle in osteochondritis dissecans (OD) of the talus has shown good clinical results in the past. To further define, indications and limitations of OAT various factors have been discussed which might influence the clinical outcome. METHODS: In this study, the ...

The modified Dunn procedure has rapidly gained popularity as a treatment for unstable slipped capital femoral epiphysis (SCFE), but limited data exist regarding its safety and efficacy. The purpose of this study was to present results and complications following this procedure in a large multicenter series. We reviewed the outcomes ...

Abstract Augmentation rhinoplasty requires addition of materials of various natures to reshape the nasal pyramid. Onlay tip grafts are single or multilayered grafts placed horizontally over the alar domes. The aim of the present study was to assess the 18-month permanence of onlay septal cartilage grafts. Twenty-eight patients underwent rhinoplasty ...

The objective of this study was to compare the postoperative analgesic effects of dexketoprofen, tramadol, and buprenorphine in dogs undergoing ovariohysterectomy. Seventy-five adult female dogs were randomly assigned to receive an intravenous injection (IV) of 1mg/kg of dexketoprofen (D), 0.02mg/kg of buprenorphine (B) or 2mg/kg of tramadol (T). Pain assessment ...

Little information exists regarding the long-term outcome after structural failure of rotator cuff repair. We previously reported clinical improvement, despite a 94% rate of failure of healing, at two years of follow-up in a cohort of eighteen patients who had undergone arthroscopic repair of massive rotator cuff tears. The purpose ...

STUDY DESIGN:: Retrospective clinical case series. OBJECTIVE:: To investigate knee osteoarthritis (KOA) and total knee replacement (TKR) status as prognostic factors for surgical outcomes in female patients with lumbar spinal stenosis (LSS). SUMMARY OF BACKGROUND DATA:: There have been many reports on numerous prognostic factors for surgical outcomes in patients ...

PURPOSE: To assess the long-term clinical outcome of arthroscopic transtendon repair of partial articular-sided supraspinatus tendon avulsion (PASTA) lesions using University of California, Los Angeles (UCLA) and Short Form 36 (SF-36) scores. METHODS: We prospectively collected and retrospectively reviewed data on 15 patients who underwent arthroscopic transtendon PASTA repair between ...

BACKGROUND: Although laparoscopic intra-peritoneal mesh repair (LVHR) is a well-established treatment option to repair ventral and incisional hernias, no consensus in the literature can be found on the best method of fixation of the mesh to the abdominal wall. METHODS: Between December 2004 and July 2008, 76 patients undergoing a ...

BACKGROUND AND PURPOSE: Thrombolysis in ischemic stroke is contraindicated in patients who have had a stroke within 3 months. However, it is unclear whether thrombolytic therapy is associated with adverse outcomes in this population. We report the characteristics and outcomes of patients treated with systemic recombinant tissue-type plasminogen activator in ...

PURPOSE. To report the midterm outcome of the Endolog system for correction of moderate-to-severe hallux valgus. METHODS. 23 women and 2 men (33 feet) aged 35 to 80 (mean, 52) years underwent minimally invasive surgery for moderate (n=25) and severe (n=8) hallux valgus using the Endolog system. The hallux valgus ...

Disc perforation (DP) is one of the most important pathologic signs of intracapsular temporomandibular joint (TMJ) disease; however, few clinical studies have focused on the arthroscopic management of this feature. The purpose of the present study was to assess whether operative arthroscopy with abrasion of the perforation borders is effective ...

The BRAVISSIMO study is a prospective, non-randomized, multi-center, multi-national, monitored trial, conducted at 12 hospitals in Belgium and 11 hospitals in Italy. This manuscript reports the findings up to the 12-month follow-up time point for both the TASC A&B cohort and the TASC C&D cohort. The primary endpoint of the ...