27 research outputs found
Outcome-Affecting Parameters of Hip Arthroscopy for Femoroacetabular Impingement with Concomitant Cartilage Damage—Data Analysis from the German Cartilage Registry
This study aims to report on a prospectively collected, multicenter database of patients
undergoing hip arthroscopy for femoroacetabular impingement syndrome (FAI) and concomitant
cartilage damage (according to the International Cartilage Repair Society) and to assess the outcomeaffecting parameters. In the study, 353 hips with up to 24 months’ follow-up were assessed by
iHOT-33 scoring and achievement of the minimal clinically important difference (MCID) and patient
acceptable symptom state (PASS) levels. Multiple and binary regression analyses were performed to
identify factors related to (un-) favorable outcomes and to assess their clinical relevance with regard
to achieving the MCID and PASS. Multiple regression yielded the parameters of male sex (p = 0.022)
and lower body mass index (BMI) (p = 0.019) at 6 months, lower BMI (p = 0.022) and younger age
(p = 0.022) at 12 months, and younger age at 24 months (p = 0.039) to be significantly associated with
higher iHOT scoring. Male sex (p = 0.019) and lower BMI (p = 0.018) were significantly correlated
with achievement of the PASS in binary regression at 6 months, whereas at 12 (p = 0.010) and at 24
(p = 0.003) only younger age was shown to be significantly correlated. None of the parameters was
statistically associated with achievement of the MCID. As the parameters of younger age, male sex,
and lower BMI were identified as temporarily correlated with a preferable outcome in general and
with achievement of the PASS in particular, these findings help to preoperatively identify factors
associated with (un-) favorable therapy results
Patients with Small Acetabular Cartilage Defects Caused by Femoroacetabular Impingement Do Not Benefit from Microfracture
Objective: According to current recommendations, large cartilage defects of the hip over
2 cm2 are suggested to undergo autologous chondrocyte transplantation (ACT), while small defects
should be treated with microfracture. We investigated if patients with small chondral defects of the
hip joint (≤100 mm2
) actually benefit from microfracture. Design: In this retrospective multicenter
cohort study 40 patients with focal acetabular cartilage defects smaller than 100 mm2 and of ICRS
grade ≥2 caused by femoroacetabular impingement were included. Twenty-six unrandomized
patients underwent microfracture besides treatment of the underlying pathology; in 14 patients
cartilage lesions were left untreated during arthroscopy. Over a mean follow-up of 28.8 months
patient-reported outcome was determined using the iHOT33 (international hip outcome tool) and the
VAS (visual analog scale) for pain. Results: The untreated group showed a statistically significant
improvement of the iHOT33 after 12 (p = 0.005), 24 (p = 0.019), and 36 months (p = 0.002) compared
to the preoperative score, whereas iHOT33 in the microfracture group did not reveal statistically
significant changes over time. There was no significant difference between both groups on any time
point. Regarding pain both groups did not show a significant improvement over time in the VAS.
Conclusion: The subjective outcome of patients with small cartilage defects of the hip (≤100 mm2
)
improves 12 months after arthroscopic FAIS surgery without any cartilage treatment. However, no
improvement could be seen after microfracture. Therefore, a reserved surgical treatment for small
cartilage defects of the hip under preservation of the subchondral bone is recommended especially if
a simultaneous impingement correction is performed
Patients with Small Acetabular Cartilage Defects Caused by Femoroacetabular Impingement Do Not Benefit from Microfracture
Objective:
According to current recommendations, large cartilage defects of the hip over 2 cm2 are suggested to undergo autologous chondrocyte transplantation (ACT), while small defects should be treated with microfracture. We investigated if patients with small chondral defects of the hip joint (≤100 mm2) actually benefit from microfracture.
Design:
In this retrospective multicenter cohort study 40 patients with focal acetabular cartilage defects smaller than 100 mm2 and of ICRS grade ≥2 caused by femoroacetabular impingement were included. Twenty-six unrandomized patients underwent microfracture besides treatment of the underlying pathology; in 14 patients cartilage lesions were left untreated during arthroscopy. Over a mean follow-up of 28.8 months patient-reported outcome was determined using the iHOT33 (international hip outcome tool) and the VAS (visual analog scale) for pain.
Results:
The untreated group showed a statistically significant improvement of the iHOT33 after 12 (p = 0.005), 24 (p = 0.019), and 36 months (p = 0.002) compared to the preoperative score, whereas iHOT33 in the microfracture group did not reveal statistically significant changes over time. There was no significant difference between both groups on any time point. Regarding pain both groups did not show a significant improvement over time in the VAS.
Conclusion:
The subjective outcome of patients with small cartilage defects of the hip (≤100 mm2) improves 12 months after arthroscopic FAIS surgery without any cartilage treatment. However, no improvement could be seen after microfracture. Therefore, a reserved surgical treatment for small cartilage defects of the hip under preservation of the subchondral bone is recommended especially if a simultaneous impingement correction is performed
Clinically Relevant Effectiveness of Focused Extracorporeal Shock Wave Therapy in the Treatment of Chronic Plantar Fasciitis A Randomized, Controlled Multicenter Study
Background: The effectiveness of extracorporeal shock wave therapy in the treatment of plantar fasciitis is controver
Bilateral diaphyseal bone cysts of the tibia mimicking shin splints in a young professional athlete—a case report and depiction of a less-invasive surgical technique
Synthetic augmented suture anchor reconstruction for a complete traumatic distal triceps tendon rupture in a male professional bodybuilder with postoperative biomechanical assessment.
Bodybuilding is a high-risk sport for distal triceps tendon ruptures. Management, especially in high-demanding athletes, is operative with suture anchor refixation technique being frequently used. However, the rate of rerupture is high due to underlying poor tendon quality. Thus, additional augmentation could be useful. This case report presents a reconstruction technique for a complete traumatic distal triceps tendon rupture in a bodybuilder with postoperative biomechanical assessment. A 28-year-old male professional bodybuilder was treated with a synthetic augmented suture anchor reconstruction for a complete triceps tendon rupture of his right dominant elbow. Postoperative biomechanical assessment included isokinetic elbow strength and endurance testing by using multiple angular velocities to simulate the "off-season" and "precompetition" phases of training. Eighteen months postoperatively and after full return to training, the biomechanical assessment indicated that the strength and endurance of the operated elbow joint was fully restored with even higher ratings compared to the contralateral healthy arm. The described reconstruction technique can be considered as an advisable option in high-performance athletes with underlying poor tendon quality due to high tensile strength and lack of donor site morbidity, thus enabling them to restore preinjury status and achieve safe return to sports
Antibacterial efficacy of ultrahigh molecular weight polyethylene with silver containing diamond-like surface layers
Case Report Synthetic Augmented Suture Anchor Reconstruction for a Complete Traumatic Distal Triceps Tendon Rupture in a Male Professional Bodybuilder with Postoperative Biomechanical Assessment
Bodybuilding is a high-risk sport for distal triceps tendon ruptures. Management, especially in high-demanding athletes, is operative with suture anchor refixation technique being frequently used. However, the rate of rerupture is high due to underlying poor tendon quality. Thus, additional augmentation could be useful. This case report presents a reconstruction technique for a complete traumatic distal triceps tendon rupture in a bodybuilder with postoperative biomechanical assessment. A 28-year-old male professional bodybuilder was treated with a synthetic augmented suture anchor reconstruction for a complete triceps tendon rupture of his right dominant elbow. Postoperative biomechanical assessment included isokinetic elbow strength and endurance testing by using multiple angular velocities to simulate the "off-season" and "precompetition" phases of training. Eighteen months postoperatively and after full return to training, the biomechanical assessment indicated that the strength and endurance of the operated elbow joint was fully restored with even higher ratings compared to the contralateral healthy arm. The described reconstruction technique can be considered as an advisable option in high-performance athletes with underlying poor tendon quality due to high tensile strength and lack of donor site morbidity, thus enabling them to restore preinjury status and achieve safe return to sports
Synthetic Augmented Suture Anchor Reconstruction for a Complete Traumatic Distal Triceps Tendon Rupture in a Male Professional Bodybuilder with Postoperative Biomechanical Assessment
Bodybuilding is a high-risk sport for distal triceps tendon ruptures. Management, especially in high-demanding athletes, is operative with suture anchor refixation technique being frequently used. However, the rate of rerupture is high due to underlying poor tendon quality. Thus, additional augmentation could be useful. This case report presents a reconstruction technique for a complete traumatic distal triceps tendon rupture in a bodybuilder with postoperative biomechanical assessment. A 28-year-old male professional bodybuilder was treated with a synthetic augmented suture anchor reconstruction for a complete triceps tendon rupture of his right dominant elbow. Postoperative biomechanical assessment included isokinetic elbow strength and endurance testing by using multiple angular velocities to simulate the “off-season” and “precompetition” phases of training. Eighteen months postoperatively and after full return to training, the biomechanical assessment indicated that the strength and endurance of the operated elbow joint was fully restored with even higher ratings compared to the contralateral healthy arm. The described reconstruction technique can be considered as an advisable option in high-performance athletes with underlying poor tendon quality due to high tensile strength and lack of donor site morbidity, thus enabling them to restore preinjury status and achieve safe return to sports