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Vineeta T. Swaroop - One of the best experts on this subject based on the ideXlab platform.
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long term retrospective study of patients with idiopathic clubfoot treated with posterior medial Lateral Release
Journal of Bone and Joint Surgery American Volume, 2013Co-Authors: Luciano S. Dias, Vineeta T. SwaroopAbstract:Background: It has been demonstrated that an important component of clubfoot deformity is related to pathologic external rotation of the talus with respect to the remainder of the foot. The purpose of the present study was to review the long-term results for a cohort of patients with idiopathic clubfoot who were managed by a single surgeon with a uniform surgical protocol consisting of extensive posterior medial-Lateral Release in addition to the use of a temporary Kirschner wire to derotate the talus prior to fixation. Methods: Eighty patients (120 clubfeet) with idiopathic clubfoot without previous surgery were managed with posterior medial-Lateral Release. At an average of twenty-one years postoperatively, patients underwent a detailed physical examination and completed four quality-of-life surveys (the Short Form-36, the Laaveg and Ponseti scale, the Foot Function Index, and the modified Atar scale). Results: Thirty-two clubfeet (27%) had required additional procedures at the time of follow-up, with only one patient requiring complete revision posterior medial-Lateral Release and none requiring subtalar or triple arthrodesis. In patients with uniLateral clubfoot, clinical examination demonstrated a significant decrease in the range of motion (p < 0.001), foot length (p = 0.045), and calf circumference (p = 0.008) on the affected side as compared with the unaffected, contraLateral side. The results on all four quality-of-life scales remained durable, with no decline in relation to the time from the index procedure (p ≥ 0.48). Significantly worse scores were found for patients who required additional surgical procedures (p ≤ 0.03). Conclusions: Previous studies have demonstrated inconsistent long-term results following the treatment of clubfoot with extensive soft-tissue Releases. With our technique, thirty-two clubfeet (27%) required additional procedures and only one clubfoot required revision posterior medial-Lateral Release. We demonstrate that our technique, which involves aggressive posterior medial-Lateral soft-tissue Release in addition to manual derotation of the talus with a Kirschner wire to correct pathologic external rotation, produces acceptable results. Level of Evidence: Therapeutic Level IV. See Instructions for Authors for a complete description of levels of evidence.
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Long-term retrospective study of patients with idiopathic clubfoot treated with posterior medial-Lateral Release
Journal of Bone and Joint Surgery - Series A, 2013Co-Authors: Lawrence P. Hsu, Luciano S. Dias, Vineeta T. SwaroopAbstract:BACKGROUND: It has been demonstrated that an important component of clubfoot deformity is related to pathologic external rotation of the talus with respect to the remainder of the foot. The purpose of the present study was to review the long-term results for a cohort of patients with idiopathic clubfoot who were managed by a single surgeon with a uniform surgical protocol consisting of extensive posterior medial-Lateral Release in addition to the use of a temporary Kirschner wire to derotate the talus prior to fixation. METHODS: Eighty patients (120 clubfeet) with idiopathic clubfoot without previous surgery were managed with posterior medial-Lateral Release. At an average of twenty-one years postoperatively, patients underwent a detailed physical examination and completed four quality-of-life surveys (the Short Form-36, the Laaveg and Ponseti scale, the Foot Function Index, and the modified Atar scale). RESULTS: Thirty-two clubfeet (27%) had required additional procedures at the time of follow-up, with only one patient requiring complete revision posterior medial-Lateral Release and none requiring subtalar or triple arthrodesis. In patients with uniLateral clubfoot, clinical examination demonstrated a significant decrease in the range of motion (p < 0.001), foot length (p = 0.045), and calf circumference (p = 0.008) on the affected side as compared with the unaffected, contraLateral side. The results on all four quality-of-life scales remained durable, with no decline in relation to the time from the index procedure (p ≥ 0.48). Significantly worse scores were found for patients who required additional surgical procedures (p ≤ 0.03). CONCLUSIONS: Previous studies have demonstrated inconsistent long-term results following the treatment of clubfoot with extensive soft-tissue Releases. With our technique, thirty-two clubfeet (27%) required additional procedures and only one clubfoot required revision posterior medial-Lateral Release. We demonstrate that our technique, which involves aggressive posterior medial-Lateral soft-tissue Release in addition to manual derotation of the talus with a Kirschner wire to correct pathologic external rotation, produces acceptable results.
M. J. G. Blyth - One of the best experts on this subject based on the ideXlab platform.
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A comparison of Lateral Release rates in fixed- versus mobile-bearing total knee arthroplasty
Journal of Orthopaedics and Traumatology, 2015Co-Authors: K. B. Ferguson, O. Bailey, I. Anthony, P. J. James, I. G. Stother, M. J. G. BlythAbstract:Background With increasing functional demands of patients undergoing total knee arthroplasty, mobile-bearing (MB) implants were developed in an attempt to increase the functional outcome of such patients. In theory, with MB implants, the self-alignment should reduce the rate of Lateral Release of the patella, which is usually performed to optimise patellofemoral mechanics. This study reports on the Lateral Release rates for the P.F.C. Sigma® MB posterior-stabilised total knee replacement (TKR) implant compared with its fixed-bearing (FB) equivalent. Materials and methods A total of 352 patients undergoing TKR were randomly allocated to receive either MB (176 knees) or FB (176 knees) posterior-stabilised TKR. Further sub-randomisation into patellar resurfacing or retention was performed for both designs. The need for Lateral patellar Release was assessed during surgery using a ‘no thumb technique’, and after releasing the tourniquet if indicated. Results The Lateral Release rate was the same for FB (10 %) and MB implants (10 %) ( p = 0.9). However, patellar resurfacing resulted in lower Lateral Release rates when compared to patellar retention (6 vs 14 %; p = 0.0179) especially in MB implants (3 %). Conclusions It has been previously reported that alterations to the design of the P.F.C. system with a more anatomical trochlea in the femoral component improved patellar tracking. The addition of a rotating platform tibial component to the P.F.C. Sigma system has, on its own, had no impact on the Lateral Release rate in this study. Optimising patellar geometry by patellar resurfacing appears more important than tibial-bearing design. Although MB implants appear to reduce the need for Lateral Release in the P.F.C. Sigma Rotating Platform, this only occurs when the patellar geometry has been optimised with patellar resurfacing. Level of evidence Level 2.
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a comparison of Lateral Release rates in fixed versus mobile bearing total knee arthroplasty
Journal of Orthopaedics and Traumatology, 2015Co-Authors: K. B. Ferguson, O. Bailey, I. Anthony, P. J. James, I. G. Stother, M. J. G. BlythAbstract:Background With increasing functional demands of patients undergoing total knee arthroplasty, mobile-bearing (MB) implants were developed in an attempt to increase the functional outcome of such patients. In theory, with MB implants, the self-alignment should reduce the rate of Lateral Release of the patella, which is usually performed to optimise patellofemoral mechanics. This study reports on the Lateral Release rates for the P.F.C. Sigma® MB posterior-stabilised total knee replacement (TKR) implant compared with its fixed-bearing (FB) equivalent.
K. B. Ferguson - One of the best experts on this subject based on the ideXlab platform.
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A comparison of Lateral Release rates in fixed- versus mobile-bearing total knee arthroplasty
Journal of Orthopaedics and Traumatology, 2015Co-Authors: K. B. Ferguson, O. Bailey, I. Anthony, P. J. James, I. G. Stother, M. J. G. BlythAbstract:Background With increasing functional demands of patients undergoing total knee arthroplasty, mobile-bearing (MB) implants were developed in an attempt to increase the functional outcome of such patients. In theory, with MB implants, the self-alignment should reduce the rate of Lateral Release of the patella, which is usually performed to optimise patellofemoral mechanics. This study reports on the Lateral Release rates for the P.F.C. Sigma® MB posterior-stabilised total knee replacement (TKR) implant compared with its fixed-bearing (FB) equivalent. Materials and methods A total of 352 patients undergoing TKR were randomly allocated to receive either MB (176 knees) or FB (176 knees) posterior-stabilised TKR. Further sub-randomisation into patellar resurfacing or retention was performed for both designs. The need for Lateral patellar Release was assessed during surgery using a ‘no thumb technique’, and after releasing the tourniquet if indicated. Results The Lateral Release rate was the same for FB (10 %) and MB implants (10 %) ( p = 0.9). However, patellar resurfacing resulted in lower Lateral Release rates when compared to patellar retention (6 vs 14 %; p = 0.0179) especially in MB implants (3 %). Conclusions It has been previously reported that alterations to the design of the P.F.C. system with a more anatomical trochlea in the femoral component improved patellar tracking. The addition of a rotating platform tibial component to the P.F.C. Sigma system has, on its own, had no impact on the Lateral Release rate in this study. Optimising patellar geometry by patellar resurfacing appears more important than tibial-bearing design. Although MB implants appear to reduce the need for Lateral Release in the P.F.C. Sigma Rotating Platform, this only occurs when the patellar geometry has been optimised with patellar resurfacing. Level of evidence Level 2.
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a comparison of Lateral Release rates in fixed versus mobile bearing total knee arthroplasty
Journal of Orthopaedics and Traumatology, 2015Co-Authors: K. B. Ferguson, O. Bailey, I. Anthony, P. J. James, I. G. Stother, M. J. G. BlythAbstract:Background With increasing functional demands of patients undergoing total knee arthroplasty, mobile-bearing (MB) implants were developed in an attempt to increase the functional outcome of such patients. In theory, with MB implants, the self-alignment should reduce the rate of Lateral Release of the patella, which is usually performed to optimise patellofemoral mechanics. This study reports on the Lateral Release rates for the P.F.C. Sigma® MB posterior-stabilised total knee replacement (TKR) implant compared with its fixed-bearing (FB) equivalent.
Luciano S. Dias - One of the best experts on this subject based on the ideXlab platform.
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long term retrospective study of patients with idiopathic clubfoot treated with posterior medial Lateral Release
Journal of Bone and Joint Surgery American Volume, 2013Co-Authors: Luciano S. Dias, Vineeta T. SwaroopAbstract:Background: It has been demonstrated that an important component of clubfoot deformity is related to pathologic external rotation of the talus with respect to the remainder of the foot. The purpose of the present study was to review the long-term results for a cohort of patients with idiopathic clubfoot who were managed by a single surgeon with a uniform surgical protocol consisting of extensive posterior medial-Lateral Release in addition to the use of a temporary Kirschner wire to derotate the talus prior to fixation. Methods: Eighty patients (120 clubfeet) with idiopathic clubfoot without previous surgery were managed with posterior medial-Lateral Release. At an average of twenty-one years postoperatively, patients underwent a detailed physical examination and completed four quality-of-life surveys (the Short Form-36, the Laaveg and Ponseti scale, the Foot Function Index, and the modified Atar scale). Results: Thirty-two clubfeet (27%) had required additional procedures at the time of follow-up, with only one patient requiring complete revision posterior medial-Lateral Release and none requiring subtalar or triple arthrodesis. In patients with uniLateral clubfoot, clinical examination demonstrated a significant decrease in the range of motion (p < 0.001), foot length (p = 0.045), and calf circumference (p = 0.008) on the affected side as compared with the unaffected, contraLateral side. The results on all four quality-of-life scales remained durable, with no decline in relation to the time from the index procedure (p ≥ 0.48). Significantly worse scores were found for patients who required additional surgical procedures (p ≤ 0.03). Conclusions: Previous studies have demonstrated inconsistent long-term results following the treatment of clubfoot with extensive soft-tissue Releases. With our technique, thirty-two clubfeet (27%) required additional procedures and only one clubfoot required revision posterior medial-Lateral Release. We demonstrate that our technique, which involves aggressive posterior medial-Lateral soft-tissue Release in addition to manual derotation of the talus with a Kirschner wire to correct pathologic external rotation, produces acceptable results. Level of Evidence: Therapeutic Level IV. See Instructions for Authors for a complete description of levels of evidence.
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Long-term retrospective study of patients with idiopathic clubfoot treated with posterior medial-Lateral Release
Journal of Bone and Joint Surgery - Series A, 2013Co-Authors: Lawrence P. Hsu, Luciano S. Dias, Vineeta T. SwaroopAbstract:BACKGROUND: It has been demonstrated that an important component of clubfoot deformity is related to pathologic external rotation of the talus with respect to the remainder of the foot. The purpose of the present study was to review the long-term results for a cohort of patients with idiopathic clubfoot who were managed by a single surgeon with a uniform surgical protocol consisting of extensive posterior medial-Lateral Release in addition to the use of a temporary Kirschner wire to derotate the talus prior to fixation. METHODS: Eighty patients (120 clubfeet) with idiopathic clubfoot without previous surgery were managed with posterior medial-Lateral Release. At an average of twenty-one years postoperatively, patients underwent a detailed physical examination and completed four quality-of-life surveys (the Short Form-36, the Laaveg and Ponseti scale, the Foot Function Index, and the modified Atar scale). RESULTS: Thirty-two clubfeet (27%) had required additional procedures at the time of follow-up, with only one patient requiring complete revision posterior medial-Lateral Release and none requiring subtalar or triple arthrodesis. In patients with uniLateral clubfoot, clinical examination demonstrated a significant decrease in the range of motion (p < 0.001), foot length (p = 0.045), and calf circumference (p = 0.008) on the affected side as compared with the unaffected, contraLateral side. The results on all four quality-of-life scales remained durable, with no decline in relation to the time from the index procedure (p ≥ 0.48). Significantly worse scores were found for patients who required additional surgical procedures (p ≤ 0.03). CONCLUSIONS: Previous studies have demonstrated inconsistent long-term results following the treatment of clubfoot with extensive soft-tissue Releases. With our technique, thirty-two clubfeet (27%) required additional procedures and only one clubfoot required revision posterior medial-Lateral Release. We demonstrate that our technique, which involves aggressive posterior medial-Lateral soft-tissue Release in addition to manual derotation of the talus with a Kirschner wire to correct pathologic external rotation, produces acceptable results.
I. G. Stother - One of the best experts on this subject based on the ideXlab platform.
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A comparison of Lateral Release rates in fixed- versus mobile-bearing total knee arthroplasty
Journal of Orthopaedics and Traumatology, 2015Co-Authors: K. B. Ferguson, O. Bailey, I. Anthony, P. J. James, I. G. Stother, M. J. G. BlythAbstract:Background With increasing functional demands of patients undergoing total knee arthroplasty, mobile-bearing (MB) implants were developed in an attempt to increase the functional outcome of such patients. In theory, with MB implants, the self-alignment should reduce the rate of Lateral Release of the patella, which is usually performed to optimise patellofemoral mechanics. This study reports on the Lateral Release rates for the P.F.C. Sigma® MB posterior-stabilised total knee replacement (TKR) implant compared with its fixed-bearing (FB) equivalent. Materials and methods A total of 352 patients undergoing TKR were randomly allocated to receive either MB (176 knees) or FB (176 knees) posterior-stabilised TKR. Further sub-randomisation into patellar resurfacing or retention was performed for both designs. The need for Lateral patellar Release was assessed during surgery using a ‘no thumb technique’, and after releasing the tourniquet if indicated. Results The Lateral Release rate was the same for FB (10 %) and MB implants (10 %) ( p = 0.9). However, patellar resurfacing resulted in lower Lateral Release rates when compared to patellar retention (6 vs 14 %; p = 0.0179) especially in MB implants (3 %). Conclusions It has been previously reported that alterations to the design of the P.F.C. system with a more anatomical trochlea in the femoral component improved patellar tracking. The addition of a rotating platform tibial component to the P.F.C. Sigma system has, on its own, had no impact on the Lateral Release rate in this study. Optimising patellar geometry by patellar resurfacing appears more important than tibial-bearing design. Although MB implants appear to reduce the need for Lateral Release in the P.F.C. Sigma Rotating Platform, this only occurs when the patellar geometry has been optimised with patellar resurfacing. Level of evidence Level 2.
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a comparison of Lateral Release rates in fixed versus mobile bearing total knee arthroplasty
Journal of Orthopaedics and Traumatology, 2015Co-Authors: K. B. Ferguson, O. Bailey, I. Anthony, P. J. James, I. G. Stother, M. J. G. BlythAbstract:Background With increasing functional demands of patients undergoing total knee arthroplasty, mobile-bearing (MB) implants were developed in an attempt to increase the functional outcome of such patients. In theory, with MB implants, the self-alignment should reduce the rate of Lateral Release of the patella, which is usually performed to optimise patellofemoral mechanics. This study reports on the Lateral Release rates for the P.F.C. Sigma® MB posterior-stabilised total knee replacement (TKR) implant compared with its fixed-bearing (FB) equivalent.
