A Systematic Review of Patient-reported Outcome Measures Used in Circular Frame Fixation (original) (raw)
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Interest of circular external fixator in orthopaedic in low-income country
International Journal of Orthopaedics Sciences, 2020
The purpose of this study was to describe the indications of Ilizarov's technique in orthopedic trauma and their results. Material and method: The study involved a retrospective multicenter cohort. It included patients treated with Ilizarov's technique between July 2014 and September 2019 and followed through to recovery. The analysis focused on types of lesions, intraoperative data, complications, cure and failure rates. Only the pins were the responsibility of the patient and cost between 60,000 to 120,000 CFA (91, 5-183 euros). Results: Forty-seven patients were treated. The average age was 37.4 years. Males represented 63.8%. The main diagnoses were: tibial fractures (n = 31; 65.9%), including 14 fractures of the tibial plateau; vicious ankle calluses (3; 6.4%); loss of bone substances (3; 6.4%). The main interventions carried out were: Osteosynthesis (n = 34; 72.3%); ankle arthrodesis (n = 5; 10.6%); equine varus foot correction (n = 4; 8.5%). The average duration of an intervention was 130.5 min. the average ablation time was 98.7 days. The cure rate was 95.6%. The main complications were: infection on a spindle (n = 11; 23.4%); pain (n = 6; 12.8%), stiff knee (n = 7; 15.9%). Conclusion: The rate of positive results is similar to that observed in the literature. Ilizarov's external fixator has achieved satisfactory results for complex leg and ankle injuries at a reduced cost.
Clinical Orthopaedics & Related Research, 2021
Background Patient-reported outcome measures (PROMs) are validated questionnaires that are completed by patients. Arthroplasty registries vary in PROM collection and use. Current information about registry collection and use of PROMs is important to help improve methods of PROM data analysis, reporting, comparison, and use toward improving clinical practice. Questions/purposes To characterize PROM collection and use by registries, we asked: (1) What is the current practice of PROM collection by arthroplasty registries that are current or former members of the International Society of Arthroplasty Registries, and are there sufficient similarities in PROM collection between registries to enable useful international comparisons that could inform the improvement of arthroplasty care? (2) How do registries differ in PROM administration and demographic, clinical, and comorbidity index variables collected for case-mix adjustment in data analysis and reporting? (3) What quality assurance me...
SpringerPlus, 2016
Background: Total knee replacement is an effective treatment for knee arthritis. While the majority of TKAs have demonstrated promising long-term results, up to 20 % of patients remain dissatisfied with the outcome of surgery at 1 year. Implant malalignment has been implicated as a contributing factor to less successful outcomes. Recent evidence has challenged the relationship between alignment and patient reported outcome measures. Given the number of procedures per year, clarity on this integral aspect of the procedure is necessary.
The Effect of Circular External Fixation on Limb Alignment
Journal of Pediatric Orthopaedics, 2008
Introduction: A full-length standing radiograph of the entire lower extremity is the standard imaging modality for assessing lower limb alignment. However, the effect of an overlying circular external fixator on the radiographic alignment of the lower extremity is not well documented. Methods: After correction of angular deformity using a circular external fixator, 29 patients (31 limbs) underwent 2 sets of full-length standing radiographs, one done before, and the other, after removal of the fixator. The difference in the measurement of frontal plane alignment, limb lengths, and rotation between the 2 radiographs was analyzed. Results: The mean absolute difference in the measurement of mechanical axis deviation (MAD) between the 2 radiographs was 11.5 mm (P G 0.0001) for the ipsilateral limb (with the external fixator) and 8.9 mm (P G 0.0001) for the contralateral limb. The mean difference in the radiographic measurement of limb lengths was 20 mm (P G 0.0001) for the ipsilateral and 20.2 mm (P G 0.0001) for the contralateral limb. As the magnitude of MAD and external rotation of the ipsilateral limb increased, a progressive increase in the magnitude of discrepancy in the measurement of MAD between the 2 sets of radiographs was noted. There was no significant effect (P 9 0.05) of the patient's age, sex, body mass index, primary diagnosis, duration between the 2 radiographs, and the direction of malalignment found on the discrepancy in the measurement of MAD for both limbs. Conclusions: The standing full-length radiograph with an overlying circular external fixator may not be a reliable indicator of limb alignment and length of the operated extremity. Moreover, the presence of the circular external fixator on the lower extremity can affect the alignment and length of the opposite limb. Clinicians using circular external fixators for lower extremity trauma and reconstruction should be aware of the pitfalls of using a full-length standing radiograph for assessing limb alignment and length during osseous healing. Level of Evidence: Diagnostic level II.
Circular External Fixation Frames with Divergent Half Pins: A Pilot Biomechanical Study
Clinical Orthopaedics and Related Research, 2008
The use of hexapod circular external fixators has simplified the ability to correct complex limb deformities without cumbersome frame reconfigurations. These frames are applied primarily using half pin mountings and may be difficult to utilize given the constraints of traditional half pin constructs. We compared the biomechanical performance of simplified divergent half pin frames to mountings currently being utilized for application of hexapod frames. Three 6-mm half pins per limb segment were placed into sawbones at 60°divergent angles in both the sagittal and coronal planes in a 2-cm diaphyseal fracture gap model. Pin mountings were attached to a standardized four-ring construct. This was compared to similar four-ring frames with two differing pin/wire configurations: (1) two tensioned wires per ring placed at 90°a ngles, a total eight wires; and (2) two 5-mm half pins per ring placed at 90°angles, a total eight half pins. The divergent 6-mm half pin frames demonstrated similar performance compared the standardized tensioned wire and 5-mm half pin frames in terms of axial micromotion and angular deflection. Based on the mechanical performance of these divergent half pin frames we believe they can be used clinically without detrimental consequences.
A more patient-friendly use of circular fixators in deformity correction
Journal of Children's Orthopaedics, 2010
Purpose The evaluation of a construction that allows the exchange of circular and unilateral external fixators on the same fixation pins to the bone in outpatient circumstances during bone lengthening and alignment procedures. Methods Nine children were treated with this concept. After bone lengthening and alignment, the circular fixators were exchanged for unilateral fixators in the outpatient clinic to hold the position of the bony parts during the consolidation phase. Results The decrease of time needed to use the circular fixator during the treatment was considered to be an improvement in comfort. Conclusions The concept of using both a circular and a unilateral external fixator in a construction that allows the exchange of the external fixators in outpatient circumstances combines the advantages of both systems, and creates more options in the different stages of bone deformity correction. Patient comfort is increased by the decrease of time needed to use the circular fixator.
Which Are the Most Frequently Used Outcome Instruments in Studies on Total Ankle Arthroplasty?
Clinical Orthopaedics & Related Research, 2009
The number of studies reporting on outcomes after total ankle arthroplasty is continuously increasing. As the use of valid outcome measures represents the cornerstone for successful clinical research, we aimed to identify the most frequently used outcome instruments in ankle arthroplasty studies and to analyze the evidence to support their use in terms of different quality criteria. A systematic review of the literature identified 15 outcome instruments reported in 79 original studies. The most commonly used measures were the American Orthopaedic Foot and Ankle Society hindfoot score (n = 41), the Kofoed ankle score (n = 21), a visual analog scale assessing pain (n = 15), and the generic SF-36 (n = 6). Eight additional instruments were used only once or twice. The American Orthopaedic Foot and Ankle Society and Kofoed instruments include a clinical examination and score up to 100 points. Evidence to support their use in terms of validity, reliability, responsiveness, and interpretability is limited, raising the question whether their use is justified. Selfreported questionnaires related to ankle osteoarthritis or arthroplasty are rather disregarded in the current literature, and only the Foot Function Index is associated with evidence in terms of the above-mentioned quality criteria. Future research is warranted to improve the outcome assessment after total ankle arthroplasty. Each author certifies that he or she has no commercial associations (eg, consultancies, stock ownership, equity interest, patent/licensing arrangements, etc) that might pose a conflict of interest in connection with the submitted article.
BMJ, 2009
Objective To compare the reporting of essential applicability data from randomised controlled trials and non-randomised studies evaluating four new orthopaedic surgical procedures. Data sources Medline and the Cochrane central register of controlled trials. Study selection All articles of comparative studies assessing total hip or knee arthroplasty carried out by a minimally invasive approach or computer assisted navigation system. Data extraction Items judged to be essential for interpreting the applicability of findings about such procedures were identified by a survey of a sample of orthopaedic surgeons (77 of 512 completed the survey). Reports were evaluated for data describing these "essential" items and the number of centres and surgeons involved in the trials. When data on the number of centres and surgeons were not reported, the corresponding author of the selected trials was contacted. Results 84 articles were identified (38 randomised controlled trials, 46 non-randomised studies). The median percentage (interquartile range) of essential items reported for non-randomised studies compared with randomised controlled trials was 38% (25-63%) versus 44% (38-45%) for items about patients, 71% (43-86%) versus 71% (57-86%) for items considered essential for all interventions, and 38% (25-50%) versus 50% (25-50%) for items about the context of care. More than 80% of both study types were single centre studies, with one or two participating surgeons. Conclusion The reporting of data related to the applicability of results was poor in published articles of both non-randomised studies and randomised controlled trials and did not differ by study design. The applicability of results from the trials and studies was similar in terms of number of centres and surgeons involved and the reproducibility of the intervention.
The Journal of bone and joint surgery. American volume, 2014
In the U.S. and abroad, the use of patient-reported outcome measures to evaluate the impact of total joint replacement surgery on patient quality of life is increasingly common. Analyses of patient-reported outcomes have documented substantial pain relief and functional gain among the vast majority of patients managed with total joint replacement. In addition, postoperative patient-reported outcomes are useful to identify persistent pain and suboptimal outcomes in the minority of patients who have them. The leaders of five U.S. total joint replacement registries report the rationale, current status, and vision for the use of patient-reported outcome measures in U.S. total joint replacement registries. Surgeon leaders of the Function and Outcomes Research for Comparative Effectiveness in Total Joint Replacement registry, American Joint Replacement Registry, California Joint Replacement Registry, Michigan Arthroplasty Registry Collaborative Quality Initiative, and Virginia Joint Regis...