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Hoveidaei AH, Esmaeili S, Ghaseminejad-Raeini A, Pirahesh K, Fallahi MS, Sandiford NA, Citak M. Robotic assisted Total Knee Arthroplasty (TKA) is not associated with increased patient satisfaction: a systematic review and meta-analysis. INTERNATIONAL ORTHOPAEDICS 2024; 48:1771-1784. [PMID: 38705892 DOI: 10.1007/s00264-024-06206-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/04/2024] [Accepted: 04/25/2024] [Indexed: 05/07/2024]
Abstract
PURPOSE Total knee arthroplasty (TKA) is a common orthopedic surgery, yet postoperative dissatisfaction persists in around 20% of cases. Robotic total knee arthroplasty (rTKA) promises enhanced precision, but its impact on patient satisfaction compared to conventional TKA remains controversial (cTKA). This systematic review aims to evaluate patient satisfaction post-rTKA and compare outcomes with cTKA. METHODS Papers from the following databases were identified and reviewed: PubMed, Scopus, Web of Science, and the Cochrane Online Library, using keywords like "Knee replacement," "Total knee arthroplasty," "Robotic," and "Patient satisfaction." Extracted data included patient satisfaction measures, Knee Society Score, Oxford Knee Score, Forgotten Joint Score, SF-36, HSS, and KOOS. Statistical analysis, including odds ratio and 95% CI was performed using R software. Heterogeneity was assessed using Cochrane's Q test. RESULTS The systematic review included 17 articles, involving 1148 patients (571 in the rTKA group and 577 in the cTKA group) assessing patient satisfaction following rTKA. An analysis of proportions reveals rTKA satisfaction rate was 95%, while for cTKA, it was 91%. A meta-analysis comparing rTKA and cTKA found no statistically significant difference in patient satisfaction. Additionally, various patient-reported outcome measures (PROMs) were examined, showing mixed results across different studies and follow-up periods. CONCLUSIONS The results of this study found no difference in patient satisfaction outcomes in the short to mid-term for rTKA compared to conventional methods. This study does not assert superiority for the robotic approach, highlighting the need for careful consideration of various factors influencing outcomes in knee arthroplasty.
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Affiliation(s)
- Amir Human Hoveidaei
- International Center for Limb Lengthening, Rubin Institute for Advanced Orthopedics, Sinai Hospital of Baltimore, Baltimore, MD, USA
| | - Sina Esmaeili
- Sina University Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | | | - Kasra Pirahesh
- School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | | | - Nemandra A Sandiford
- Joint Reconstruction Unit, Southland Teaching Hospital, Invercargill, New Zealand
| | - Mustafa Citak
- Department of Orthopaedic Surgery, Helios ENDO-Klinik Hamburg Holstenstrasse 2, 22767, Hamburg, Germany.
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Webb AR, Manz WJ, Fuqua A, Coleman MM, Bariteau JT, Kadakia RJ. Effect of Obesity on Patient-Perceived Outcomes After First Metatarsophalangeal Joint Arthrodesis. Foot Ankle Spec 2024; 17:58-66. [PMID: 36124436 DOI: 10.1177/19386400221118894] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND While first metatarsophalangeal joint (MTPJ) arthrodesis is a common and effective procedure, there is a paucity of studies examining obesity's effect on outcomes of 1st MTPJ arthrodesis. This study's purpose was to evaluate patient-reported outcomes following 1st MTPJ arthrodesis in obese versus non-obese patients. METHODS A retrospective cohort study of 94 patients undergoing first MTPJ fusion over the age of 18 with a diagnosis of hallux valgus or hallux rigidus was performed. Surgical and postoperative outcomes were examined preoperatively and at 6 and 12 months follow-up via Visual Analog Pain scale (VAS), and Short Form 36 (SF-36) surveys, and data were stratified into 2 patient groups: BMI < 30 (n = 62, mean age 63.9 ± 9.1 and ≥ 30 (n = 32, mean age 61.9 ± 8.4). RESULTS Average overall VAS and SF-36 physical component scores improved significantly at 6 months (P < .001, .006) and 1 year postoperative visits (P < .001, .007) with no differences in survey scores, outcomes, or complications between weight groups. CONCLUSION Our study showed first MTPJ fusion improves short-term pain and physical quality-of-life in arthritic obese and non-obese patients without differences in nonunion, complications, or patient-reported measures. LEVEL OF EVIDENCE Level III, Prognostic, Case-Control Study.
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Affiliation(s)
- Alex R Webb
- Department of Orthopaedic Surgery, Emory University School of Medicine, Atlanta, Georgia
- Emory University School of Medicine, Atlanta, Georgia
| | - Wesley J Manz
- Department of Orthopaedic Surgery, Emory University School of Medicine, Atlanta, Georgia
- Emory University School of Medicine, Atlanta, Georgia
| | - Andrew Fuqua
- Emory University School of Medicine, Atlanta, Georgia
| | - Michelle M Coleman
- Department of Orthopaedic Surgery, Emory University School of Medicine, Atlanta, Georgia
- Emory University School of Medicine, Atlanta, Georgia
| | - Jason T Bariteau
- Department of Orthopaedic Surgery, Emory University School of Medicine, Atlanta, Georgia
- Emory University School of Medicine, Atlanta, Georgia
| | - Rishin J Kadakia
- Department of Orthopaedic Surgery, Emory University School of Medicine, Atlanta, Georgia
- Emory University School of Medicine, Atlanta, Georgia
- Department of Orthopaedics, Emory University, Atlanta, Georgia
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Hoveidaei AH, Hashemi SM, Pazoki S, Nakhostin-Ansari A, Maleki Ghorbani Z, Eghdami S, Bahari H, Sarzaeim M, Forogh B. Effects of whole-body vibration on chronic ankle instability: a systematic review. Ann Med Surg (Lond) 2024; 86:401-411. [PMID: 38222746 PMCID: PMC10783336 DOI: 10.1097/ms9.0000000000001510] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2023] [Accepted: 11/03/2023] [Indexed: 01/16/2024] Open
Abstract
Background and objective Chronic ankle instability (CAI) is one of the most common sports injuries, and whole-body vibration (WBV) training has been used lately as a potential rehabilitation modality for these patients. The authors conducted a systematic review and meta-analysis to assess whether WBV training positively affects patients with CAI. Materials and methods The authors systematically searched four databases, including MEDLINE (PubMed), Scopus, Web of Science, and Cochrane Central Register of Controlled Trials, for randomized and non-randomized trials evaluating the effects of WBV on individuals with CAI. The authors used Cochrane RoB2 to assess the risk of bias in randomized trials. A meta-analysis was conducted if three or more studies measured the same outcome. Effect estimates were pooled using a random-effects model. Results Results were retrieved from seven articles encompassing 288 participants who had CAI. The reach distance of the Star Excursion Balance Test (SEBT) was regarded as the study's main finding. The authors saw a significant training effect on certain planes of motion on dynamic balance. The findings showed that the post-intervention measurements in the WBV group compared to control groups showed improvements in the posterolateral, posteromedial, and medial directions, respectively. There were also promising results on improvements in muscle activity, strength, and proprioception sense measurements with a great diversity in the reported parameters. Conclusion The authors observed a significant WBV training effect on dynamic balance over posterolateral, posteromedial, and medial reach distances. These findings suggest future studies on the effects of WBV on muscle activity, strength, and proprioception in addition to dynamic and static balance.
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Affiliation(s)
- Amir Human Hoveidaei
- Neuromusculoskeletal Research Center, Department of Physical Medicine and Rehabilitation, School of Medicine, Iran University of Medical Sciences
- Sports Medicine Research Center, Neuroscience Institute
| | | | - Shayan Pazoki
- Students’ Scientific Research Center, Exceptional Talents Development Center, Tehran University of Medical Sciences
| | - Amin Nakhostin-Ansari
- Neuromusculoskeletal Research Center, Department of Physical Medicine and Rehabilitation, School of Medicine, Iran University of Medical Sciences
- Sports Medicine Research Center, Neuroscience Institute
| | - Zahra Maleki Ghorbani
- Students’ Scientific Research Center, Exceptional Talents Development Center, Tehran University of Medical Sciences
| | - Shayan Eghdami
- Research Committee, School of Medicine, Iran University of Medical Sciences, Tehran
| | - Hossein Bahari
- Neuromusculoskeletal Research Center, Department of Physical Medicine and Rehabilitation, School of Medicine, Iran University of Medical Sciences
- School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
| | | | - Bijan Forogh
- Neuromusculoskeletal Research Center, Department of Physical Medicine and Rehabilitation, School of Medicine, Iran University of Medical Sciences
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Chopra A, Fletcher AN, Madi NS, Parekh SG. Revision Surgery After Failed Index Synthetic Cartilage Implant Resurfacing for Hallux Rigidus: Single-Surgeon 5-Year Experience. Foot Ankle Spec 2023:19386400221147773. [PMID: 36727310 DOI: 10.1177/19386400221147773] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
BACKGROUND While metatarsophalangeal joint (MTPJ) arthrodesis is regarded as the gold standard treatment option for end-stage hallux rigidus (HR), synthetic cartilage implant (SCI) resurfacing has gained popularity. This study aimed to identify the SCI resurfacing failure rate for a single surgeon, while also comparing clinical outcomes of patients who underwent SCI replacement or MTPJ arthrodesis after failed index SCI resurfacing. METHODS Health records were queried from 2016 to 2021 for patients with HR who were treated with SCI resurfacing by a single surgeon. Preoperative and postoperative range of motion, visual analog scale (VAS) pain scores, and hallux valgus angles were compared. A subgroup analysis was performed on patients who underwent revision with SCI replacement or MTPJ arthrodesis. SCI replacement included the use of bone graft, bone putty, or a custom 3D printed baseplate to prevent implant subsidence. RESULTS A total of 219 SCI resurfacing procedures were performed by a single surgeon, including 23 revisions. When analyzing index procedures, an 8.2% revision rate was determined. The revision cohort (n = 23) consisted of 19 female patients and presented with a mean body mass index of 29.5 ± 5 kg/m2, mean age of 52.8 ± 11 years, mean follow-up duration of 22.3 (range, 3-54) months, and mean time to a revision surgery of 12.1 ± 12 (range, 1-50) months. Specifically, 12 procedures resulted in an SCI replacement, while 11 procedures resulted in arthrodesis. While all patients experienced significant improvement in their VAS pain scores (P < .001), the arthrodesis cohort experienced a greater improvement than the SCI revision cohort (P = .04). CONCLUSION When analyzing SCI revision procedures, MTPJ arthrodesis reduced pain more significantly than SCI replacement. LEVELS OF EVIDENCE Level IV: Retrospective case series.
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Affiliation(s)
- Aman Chopra
- Georgetown University School of Medicine, Washington, District of Columbia
| | - Amanda N Fletcher
- Department of Orthopaedic Surgery, Duke University, Durham, North Carolina
| | - Naji S Madi
- Department of Orthopaedic Surgery, Duke University, Durham, North Carolina
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Retrospective Comparison of Two Different Fixation Methods for First Metatarsophalangeal Joint Arthrodesis. JOURNAL OF BASIC AND CLINICAL HEALTH SCIENCES 2022. [DOI: 10.30621/jbachs.1091385] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
Background and Purpose: Arthrosis of the first MTP joint is a common condition. Among the available arthrodesis methods, plate/screw and screw methods are the current treatment methods of choice. In this study, we investigate whether there is a difference between these two methods.
Methods: Thirty-four toes of 32 patients with advanced arthrosis were included in the study. Eighteen toes were fixed with plates/screws and 16 with cross-screws. In the radiological evaluations, malunion and nonunion were examined. Clinical evaluation was made according to AOFAS-HMI scoring.
Results: The mean age of the patients was 57.74 years and the mean follow-up period was 22.21 months. There was no statistically significant difference in clinical scores or union times between the two groups. As complications, superficial skin problems developed in 2 (5.9%) cases, deep infection in 3 (8.8%) cases, and nonunion in 3 (8.8%) cases. There was no statistically significant difference between the two groups in this regard.
Conclusion: Plate/screw and cross-screw techniques give similar clinical and radiological results in cases of arthrodesis of the first MTP joint. The cross-screw technique, which can be performed more easily and has lower costs, should be the first choice.
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Rajan L, Kim J, An T, Mizher R, Srikumar S, Fuller R, Zhu J, Ellis SJ. Effect of Prior Cheilectomy on Outcomes of First Metatarsophalangeal Joint Fusion for Treatment of Hallux Rigidus. FOOT & ANKLE ORTHOPAEDICS 2022; 7:24730114221119740. [PMID: 36046554 PMCID: PMC9421027 DOI: 10.1177/24730114221119740] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Background Patients with hallux rigidus who do not experience significant pain relief after cheilectomy often require a conversion to metatarsophalangeal (MTP) fusion. However, it is unclear whether the previous cheilectomy affects outcomes of the subsequent fusion. The aim of this study was to compare patient-reported outcomes and complications in patients undergoing MTP fusion for hallux rigidus between patients with a history of cheilectomy and those undergoing a fusion as a primary procedure. Methods This retrospective cohort study included patients who underwent MTP fusion who had preoperative and minimum 1-year postoperative Patient Reported Outcomes Measurement Information System (PROMIS) scores. Patients were divided into a "primary MTP fusion" cohort and a "prior cheilectomy" cohort based on their history of a previous cheilectomy. Preoperative, postoperative, and improvement in PROMIS scores, along with rates of complications including nonunion, infection, interphalangeal (IP) joint pain, and removal of hardware were compared between groups. Results The prior cheilectomy group had significantly lower preoperative physical function scores than the primary MTP fusion group (P < .05). Postoperatively, the prior cheilectomy group had worse physical function (P < .017) and global physical health (P < .017) scores. However, there were no significant differences in pre- to postoperative change in PROMIS scores. There were no significant differences in rates of nonunion (P = .99), infection (P = .99), or hardware removal (P = .99). More patients in the prior cheilectomy group had IP joint pain (P = .034). Conclusion This study found that a prior cheilectomy may not affect serious complication rates of a subsequent fusion, but it may be associated with worse baseline function. Overall, our results suggest that a prior failed cheilectomy does not influence the amount of improvement in function and pain from MTP fusion. Level of Evidence Level III, retrospective cohort study.
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Affiliation(s)
- Lavan Rajan
- Hospital for Special Surgery, New York, NY, USA
| | | | - Tonya An
- Hospital for Special Surgery, New York, NY, USA
| | - Rami Mizher
- Hospital for Special Surgery, New York, NY, USA
| | | | | | - Jiaqi Zhu
- Hospital for Special Surgery, New York, NY, USA
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Roth KE, Klos K, Simons P, Ossendorff R, Drees P, Maier GS, Salzmann GM. [Cartilage chip transplantation for cartilage defects of the first metatarsophalangeal joint]. OPERATIVE ORTHOPADIE UND TRAUMATOLOGIE 2021; 33:480-486. [PMID: 34724079 DOI: 10.1007/s00064-021-00745-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/05/2021] [Revised: 05/16/2021] [Accepted: 06/06/2021] [Indexed: 11/24/2022]
Abstract
OBJECTIVE Treatment of circumscribed cartilage defects in the first metatarsophalangeal joint (MTP1) using autologous cartilage fragments. INDICATIONS Full thickness cartilage defects (ICRS IV) or focal osteoarthritis in combination with hallux rigidus. CONTRAINDICATIONS Pre-existing ankylosis of the metatarsophalangeal joint; global osteoarthritis of the joint; advanced osteoarthritis of the sesamoidal articulation; osteonecrotic cysts in the head of the first metatarsal bone. SURGICAL TECHNIQUE Preparation of the metatarsophalangeal joint. Mobilization of the first metatarsal head. Harvesting of the cartilage fragments from the dorsal rim portion as part of the cheilectomy. Mincing the cartilage fragments with a 3.0 mm shaver in sterile conditions. Augmenting the cartilage fragments with autologous conditioned plasma (ACP). Preparing the defect area and creation of a "contained" defect. Replantation of the resulting minced cartilage mass into the defect of the articular surface on the first metatarsal head. POSTOPERATIVE MANAGEMENT Immobilization of the MTP1 for 48 h. Intensive physiotherapy for 3 months. Full weight bearing after reduced swelling. RESULTS In 2020, 5 patients were treated with the method described and followed up for a period of 1 year. All patients were subjectively satisfied with the result of the operation. There were no relevant surgery-associated complications.
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Affiliation(s)
| | | | - Paul Simons
- Gelenkzentrum Rhein-Main, Hochheim, Deutschland
| | - Robert Ossendorff
- Klinik und Poliklinik für Orthopädie und Unfallchirurgie, Universitätsklinikum Bonn (AöR), Venusberg-Campus 1, 53127, Bonn, Deutschland.
| | - Philipp Drees
- Zentrum für Orthopädie und Unfallchirurgie, Universitätsmedizin Mainz, Mainz, Deutschland
| | | | - Gian M Salzmann
- Gelenkzentrum Rhein-Main, Hochheim, Deutschland.,Schulthess Klinik Zürich, Zürich, Schweiz
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Li CHC, Lui TH, Pan X. Arthroscopic Arthrodesis of the First Metatarsophalangeal Joint in Hallux Varus. Arthrosc Tech 2021; 10:e2443-e2447. [PMID: 34868846 PMCID: PMC8626559 DOI: 10.1016/j.eats.2021.07.009] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/16/2021] [Accepted: 07/15/2021] [Indexed: 02/03/2023] Open
Abstract
Hallux varus deformity most commonly occurs as a complication of bunion surgery. Surgical option depends on the underlying cause, flexibility of the deformity, and presence of osteoarthritis of the first metatarsophalangeal joint. Joint-preserving surgery including medial soft tissue release, metatarsal osteotomy, and tendon transfer can be considered in flexible deformity without degeneration of the first metatarsophalangeal joint. First metatarsophalangeal arthrodesis is indicated in cases of inflammatory arthritis, avascular necrosis, osteoarthritis, neuromuscular disorder, or failed previous hallux varus corrective surgery. The purpose of this technical note is to describe the technique of arthroscopic arthrodesis of the first metatarsophalangeal joint to correct hallux varus deformity. It has the potential advantages of less surgical trauma, preservation of blood supply, less postoperative pain, and better cosmetic results.
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Affiliation(s)
- Churk Hang Charles Li
- Department of Orthopaedics and Traumatology, North District Hospital, Hong Kong, China,Shenzhen University, Shenzhen, China
| | - Tun Hing Lui
- Department of Orthopaedics and Traumatology, North District Hospital, Hong Kong, China,Shenzhen University, Shenzhen, China,Address correspondence to Tun Hing Lui, M.B.B.S. (HK), F.R.C.S. (Edin), F.H.K.A.M., F.H.K.C.O.S., Department of Orthopaedics and Traumatology, North District Hospital, 9 Po Kin Road, Sheung Shui, NT, Hong Kong SAR, China, Shenzhen University, Shenzhen, China.
| | - Xiaohua Pan
- Department of Trauma and Orthopedics, Second Affiliated Hospital of Shenzhen University & Affiliated Baoan Hospital of Shenzhen, Southern Medical University, The 8th People's Hospital of Shenzhen, Shenzhen, China,Guangdong Provincial Engineering Research Center of Wound Repair and Regenerative Medicine, Guangdong Provincial Academician Workstation of Wound repair and Regenerative Medicine
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