Retrograde Intramedullary Nailing for Ankle Arthrodesis

1995 ◽  
Vol 16 (7) ◽  
pp. 433-436 ◽  
Author(s):  
Thomas J. Moore ◽  
Robert Prince ◽  
David Pochatko ◽  
Judith W. Smith ◽  
Samuel Fleming
Keyword(s):  
Rheumatoid Arthritis ◽  
Ankle Arthrodesis ◽  
Deep Infection ◽  
Salvage Procedure ◽  
Neuropathic Arthropathy ◽  
Intramedullary Rodding ◽  
Post Traumatic ◽  
Cancellous Screws ◽  
Clinically Significant ◽  
Tibial Plafond Fractures

This is a retrospective study of retrograde intramedullary rodding for ankle arthrodesis in 19 ankles in 16 patients. The preoperative diagnosis of 16 patients was diabetic neuropathic arthropathy in seven patients, rheumatoid arthritis in three patients, post traumatic arthrosis in three patients, paraplegia with fixed equinovarus of the foot in two patients, and avascular necrosis of the talus in one patient. Retrograde intramedullary rodding for ankle arthrodesis was done as a salvage procedure in each patient. Fourteen of the 19 ankles had radiographic evidence of solid arthrodesis. In the four patients with five ankles with pseudarthrosis, no case was clinically significant. There was one deep infection and one broken rod. Thirteen of the 16 patients are ambulatory, and nine required either an ankle-foot orthosis or shoe modification. The standard method of ankle fusion using crossed cancellous screws is the procedure of choice because it preserves the subtalar joint. Retrograde intramedullary rodding for ankle arthrodesis should be considered for patients with significant posttraumatic arthrosis and bone loss following distal tibial plafond fractures, concomitant subtalar arthrosis, severe osteopenia, such as in patients with rheumatoid arthritis, or neuropathic arthropathy.

scholarly journals Outcomes following total elbow arthroplasty for rheumatoid arthritis versus post-traumatic conditions

2019 ◽  
Vol 101-B (12) ◽  
pp. 1489-1497 ◽  
Author(s):  
Jou-Hua Wang ◽  
Hsuan-Hsiao Ma ◽  
Te-Feng A. Chou ◽  
Shang-Wen Tsai ◽  
Cheng-Fong Chen ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Functional Outcome ◽  
Aseptic Loosening ◽  
Perioperative Complications ◽  
Meta Analysis ◽  
Deep Infection ◽  
Range Of Movement ◽  
Septic Loosening ◽  
Post Traumatic ◽  
Dash Questionnaire

Aims The aim of this meta-analysis was to compare the outcome of total elbow arthroplasty (TEA) undertaken for rheumatoid arthritis (RA) with TEA performed for post-traumatic conditions with regard to implant failure, functional outcome, and perioperative complications. Materials and Methods We completed a comprehensive literature search on PubMed, Web of Science, Embase, and the Cochrane Library and conducted a systematic review and meta-analysis. Nine cohort studies investigated the outcome of TEA between RA and post-traumatic conditions. The preferred reporting items for systematic reviews and meta-analysis (Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA)) guidelines and Newcastle-Ottawa scale were applied to assess the quality of the included studies. We assessed three major outcome domains: implant failures (including aseptic loosening, septic loosening, bushing wear, axle failure, component disassembly, or component fracture); functional outcomes (including arc of range of movement, Mayo Elbow Performance Score (MEPS), and the Disabilities of the Arm, Shoulder and Hand (DASH) questionnaire), and perioperative complications (including deep infection, intraoperative fracture, postoperative fracture, and ulnar neuropathy). Results This study included a total of 679 TEAs for RA (n = 482) or post-traumatic conditions (n = 197). After exclusion, all of the TEAs included in this meta-analysis were cemented with linked components. Our analysis demonstrated that the RA group was associated with a higher risk of septic loosening after TEA (odds ratio (OR) 3.96, 95% confidence interval (CI) 1.11 to 14.12), while there was an increased risk of bushing wear, axle failure, component disassembly, or component fracture in the post-traumatic group (OR 4.72, 95% CI 2.37 to 9.35). A higher MEPS (standardized mean difference 0.634, 95% CI 0.379 to 0.890) was found in the RA group. There were no significant differences in arc of range of movement, DASH questionnaire, and risk of aseptic loosening, deep infection, perioperative fracture, or ulnar neuropathy. Conclusion The aetiology of TEA surgery appears to have an impact on the outcome in terms of specific modes of implant failures. RA patients might have a better functional outcome after TEA surgery. Cite this article: Bone Joint J 2019;101-B:1489–1497

scholarly journals Trajectories of fatigue in actively treated patients with established rheumatoid arthritis starting biologic DMARD therapy

RMD Open ◽  
2020 ◽  
Vol 6 (3) ◽  
pp. e001372
Author(s):  
Sella Aarrestad Provan ◽  
Brigitte Michelsen ◽  
Joseph Sexton ◽  
Tillmann Uhlig ◽  
Hilde Berner Hammer
Keyword(s):  
Rheumatoid Arthritis ◽  
Rating Scale ◽  
Numeric Rating Scale ◽  
Tender Joint Count ◽  
Tender Joint ◽  
Logistic Regression Models ◽  
Patient Reported ◽  
Biologic Dmard ◽  
Clinically Significant

ObjectivesTo define fatigue trajectories in patients with rheumatoid arthritis (RA) who initiate biological DMARD (bDMARD) treatment, and explore baseline predictors for a trajectory of continued fatigue.MethodsOne-hundred and eighty-four patients with RA initiating bDMARDs were assessed at 0, 1, 2, 3, 6 and 12 months. Swollen and tender joint counts, patient reported outcomes (PROMs), blood samples and ultrasound examinations were collected at each time point. Fatigue was assessed by the fatigue Numeric Rating Scale (0–10) from the Rheumatoid Arthritis Impact of Disease (RAID) questionnaire. Clinically significant fatigue was predefined as fatigue ≥4. Three trajectories of interest were defined according to level of RAID fatigue: no fatigue (≤3 at 5/6 visits), improved fatigue (≥4 at start, but ≤3 at follow-up) and continued fatigue (≥4 at 5/6 visits). Baseline variables were compared between groups by bivariate analyses, and logistic regression models were used to explore baseline predictors of continued vs improved fatigue.ResultsThe majority of patients starting bDMARD therapy followed one of three fatigue trajectories, (no fatigue; n=61, improved; n=33 and continued fatigue; n=53). Patients with continued fatigue were more likely to be anti–citrullinated protein antibody and/or rheumatoid factor positive and had higher baseline PROMs compared to the other groups, while there were no differences between the groups for variables of inflammation including. Patient global, tender joint count and anxiety were predictors for the continued fatigue trajectory.DiscussionA trajectory of continued fatigue was determined by PROMs and not by inflammatory RA disease activity.

scholarly journals Etanercept therapy in rheumatoid arthritis: Efficacy and safety

2013 ◽  
Vol 141 (7-8) ◽  
pp. 495-502
Author(s):  
Tatjana Ilic ◽  
Biljana Milic ◽  
Dejan Celic ◽  
Biljana Vuckovic ◽  
Igor Mitic
Keyword(s):  
Rheumatoid Arthritis ◽  
Joint Destruction ◽  
Life Quality ◽  
Activity Level ◽  
Inadequate Response ◽  
Efficacy And Safety ◽  
Etanercept Therapy ◽  
Acr20 Response ◽  
Clinically Significant ◽  
High Level

Introduction. Etanercept, tumor necrosis factor (TNF?) antagonist, lowers the disease activity level in patients with rheumatoid arthritis (RA), reduces joint destruction saving physical functions and improving life quality. Objective. The aim of this study was to establish efficacy and safety of etanercept in combination with disease modifying antirheumatic drugs (DMARDs) in the treatment of RA. Methods. To patients with active RA, who were on therapy with DMARD, etanercept was introduced in weekly doses of 50 mg, with continuation of DMARD. Efficacy of this form of treatment was evaluated in the 12th week. Maintenance of the effect of treatment was also evaluated during 24, 48 and 96 weeks. Long term evaluation of etanercept safety was assessed by registering all unwanted events during a two year period. Results. After 12 weeks of treatment with etanercept, 80% of patients had ACR20 response, while 85% showed clinically significant decrease of DAS28 index. We achieved remission in five patients (12.5%) and low activity of RA in 17 patients (42.5%). During a 96week of followup period, achieved therapy effects were maintained. In four patients (10%) etanercept therapy was interrupted after 24 weeks because of inadequate response. In one of them (2.5%) we recorded a cardiovascular incident. Acute infections were registered in 47 cases. Four of those were severe infections. Neither cases of malignancy development were noted, nor were there any lethal disease outcomes. Conclusion. Etanercept in combination with DMARD shows a high level of efficacy in the treatment of RA. The safety profile of the drug is satisfactory.

Long-Term Results Following Ankle Arthrodesis for Post-Traumatic Arthritis

2001 ◽  
Vol 83 (2) ◽  
pp. 219-228 ◽  
Author(s):  
Lisa M. Coester ◽  
Charles L. Saltzman ◽  
John Leupold ◽  
William Pontarelli
Keyword(s):  
Ankle Arthrodesis ◽  
Long Term Results ◽  
Post Traumatic ◽  
Traumatic Arthritis

Anatomic total shoulder arthroplasty in rheumatoid arthritis: A systematic review

2020 ◽  
pp. 175857322095415
Author(s):  
Ahmed Haleem ◽  
Ajaykumar Shanmugaraj ◽  
Nolan S. Horner ◽  
Timothy Leroux ◽  
Moin Khan ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Range Of Motion ◽  
Shoulder Arthroplasty ◽  
Constant Score ◽  
Total Shoulder Arthroplasty ◽  
Significant Heterogeneity ◽  
Tissue Quality ◽  
Patient Reported ◽  
Clinically Significant ◽  
Reverse Total Shoulder

Purpose Given the poor soft-tissue quality in rheumatoid arthritis patients, many believe that rheumatoid arthritis should be treated with reverse total shoulder arthroplasty (rTSA). The purpose of this paper is to systematically assess outcomes of anatomic total shoulder arthroplasty (aTSA) in rheumatoid arthritis to determine if aTSA remains a viable option. Methods A comprehensive literature search was conducted identifying articles relevant to aTSA in the setting of rheumatoid arthritis with intact rotator cuff. Outcomes include clinical outcomes and rates of complication and revision. Results Ten studies were included with a total of 279 shoulders with mean follow-up of 116 ± 69 months. The mean age was 68 ± 10 years. Survivorship was 97%, 97% and 89% at 5, 10 and 20 years, respectively. The overall complication rate was 9%. Radiolucency was present in 69% of patients, of which 34% were at risk of loosening at 79 months. The overall rate of revision was 8.4%. Studies generally reported clinically significant improvements in range of motion, Constant score and ASES score. Conclusion aTSA in the rheumatoid patient results in improvements in range of motion and patient-reported outcomes. Rates of complications and survivorship are generally good in this population. However, it should be noted that there is significant heterogeneity in outcome reporting amongst the literature on this topic and that many studies fail to adequately report complication and revision rates. When compared to rTSA in patients with rheumatoid arthritis, evidence suggests that aTSA is still a viable treatment option despite the shift in utilization to rTSA.

Diclofenac Sodium (Voltaren): Results of a Multi-Centre Comparative Trial in Adult-Onset Rheumatoid Arthritis

1975 ◽  
Vol 3 (3) ◽  
pp. 139-144 ◽  
Author(s):  
T Dürrigl ◽  
M Vitaus ◽  
I Pucar ◽  
M Miko
Keyword(s):  
Rheumatoid Arthritis ◽  
Urine Analysis ◽  
Diclofenac Sodium ◽  
Comparative Trial ◽  
Blood Picture ◽  
Short Term ◽  
Double Blind ◽  
Short Term Trial ◽  
Term Trial ◽  
Clinically Significant

A short-term trial has been performed under double-blind conditions in 50 adult patients with rheumatoid arthritis to compare diclofenac sodium (Voltaren) with both indomethacin and placebo for efficacy and tolerability. The duration of the trial was two weeks and was a between-patient comparison of 25 mg t.i.d. diclofenac sodium, 25 mg t.i.d. indomethacin or placebo using a double-dummy technique. Forty-eight patients completed the trial. In the majority of parameters examined, diclofenac sodium was superior to placebo and indomethacin in therapeutic effect. One patient was withdrawn from the trial because of intolerance to indomethacin and one other because of severe joint pain under indomethacin therapy. Neither active compound caused clinically significant changes in blood picture or urine analysis.

scholarly journals Long-term Results of Ankle Arthrodesis Using an Intramedullary Nail with Fins in Patients with Rheumatoid Arthritis Hindfoot Deformity

2009 ◽  
Vol 76 (5) ◽  
pp. 240-246 ◽  
Author(s):  
Kenji Takenouchi ◽  
Minoru Morishita ◽  
Kimihisa Saitoh ◽  
Kouichi Wauke ◽  
Hiroshi Takahashi ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Intramedullary Nail ◽  
Ankle Arthrodesis ◽  
Long Term Results ◽  
Hindfoot Deformity

Follow-up study of ankle arthrodesis in severe hind foot deformity in patients with rheumatoid arthritis using an intramedullary nail with fins

2005 ◽  
Vol 15 (4) ◽  
pp. 269-274 ◽  
Author(s):  
Masakazu Nagashima ◽  
Akitoshi Tachihara ◽  
Tsuyoshi Matsuzaki ◽  
Kenji Takenouchi ◽  
Juhro Fujimori ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Intramedullary Nail ◽  
Ankle Arthrodesis ◽  
Foot Deformity ◽  
Follow Up Study ◽  
Hind Foot

Another Look at the Legal and Ethical Consequences of Pharmacological Memory Dampening: The Case of Sexual Assault

2013 ◽  
Vol 41 (4) ◽  
pp. 859-871 ◽  
Author(s):  
Jennifer A. Chandler ◽  
Alexandra Mogyoros ◽  
Tristana Martin Rubio ◽  
Eric Racine
Keyword(s):  
Sexual Assault ◽  
Traumatic Event ◽  
The United States ◽  
Traumatic Experience ◽  
Post Traumatic Stress ◽  
Persistent Symptoms ◽  
Intense Fear ◽  
Post Traumatic ◽  
Uncommon Condition ◽  
Clinically Significant

Post-traumatic stress disorder (PTSD) is a “young” disorder formally recognized in the early 1980s, although the symptoms have been noted for centuries particularly in relation to military conflicts. PTSD may develop after a serious traumatic experience that induces feelings of intense fear, helplessness or horror. It is currently characterized by three key classes of symptoms which must cause clinically significant distress or impairment of functioning: (1) persistent and distressing re-experiencing of the trauma; (2) persistent avoidance of stimuli associated with the trauma and numbing of general responsiveness; and (3) persistent symptoms of hyper-arousal. One of the possible symptoms within the second class is difficulty in remembering an important aspect of the traumatic event.PTSD is not an uncommon condition, with an estimated lifetime prevalence of about 7-9% based on studies conducted in the United States and Canada, with women at higher risk than men. While not everyone who experiences a significant trauma will go on to develop PTSD, about a third will do so. Sexual assault, along with other forms of assaultive violence, pose a comparatively high risk of PTSD.

Sign in / Sign up

Export Citation Format

Share Document