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Endoscopic Plantar Fascia Release Combined With Calcaneal Spur Resection: A Case Series of 40 Patients

FOOT & ANKLE SPECIALIST 2025年第1期18卷 51-57页

作者： Nakajima, Kenichiro Yashio Cent Gen Hosp Dept Orthopaed Surg 845 Minamikawasaki Yashio Saitama 3400814 Japan

Purpose. To review the cases of patients treated using endoscopic plantar fascia release (PFR) with calcaneal spur resection (CSR) and examine why the combined procedures cause complications. Methods. The medical records of patients treated with endoscopic PFR with CSR from November 2017 to December 2019 with a follow-up of >2 years were reviewed. Results. A total of 40 feet in 40 patients (22 females, 18 males) were enrolled. The mean age and body mass index were 51.1 years and 24.7 kg/m2, respectively. The mean follow-up duration was 5.7 years. The visual analog scale for pain improved from 80.7 to 8.8 mm, and the Japanese Society for Surgery of the Foot score improved from 44.7 to 95.6 points (Wilcoxon signed rank test, P < .001 for both). Complications occurred in 8 patients (20%): 3 had flatfoot, 3 had an injury to the first branch of the lateral plantar nerve, 1 had scar pain, and 1 had a wound infection. Conclusion. The 40 patients treated with endoscopic PFR with CSR for plantar fasciitis had good outcomes with a high complication rate;the invasiveness of creating the working space for the combined procedures was thought to be responsible.

关键词： complication minimally invasive surgery plantar fasciitis visual analog scale score working space

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Effectiveness of platelet-rich plasma in partial-thickness rotator cuff tears: a systematic review

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JOURNAL OF ISAKOS JOINT DISORDERS & ORTHOPAEDIC SPORTS MEDICINE 2024年第4期9卷 699-708页

作者： Desouza, Clevio Shetty, Vijay SAANVI Orthopaed 2003 SorrentoHigh StHiranandani Gardens Mumbai 400076 India Kokilaben Dhirubhai Ambani Hosp & Med Res Inst Mumbai 400053 India Dr L H Hiranandani Hosp Hiranandani Gardens Mumbai 400076 India

Importance: Partial-thickness rotator cuff tears (PTRCTs) commonly affect overhead athletes, leading to a decline in sports performance. Platelet-rich plasma (PRP) is being explored as an alternative treatment modality for individuals with PTRCTs to reduce discomfort and enhance functional recovery. We conducted a systematic review study of randomized controlled clinical trials to determine the effectiveness of PRP in treating PTRCTs. Aim: To determine the effectiveness of PRP in treating PTRCTs. Evidence review: We conducted a comprehensive literature search for randomized controlled trials (RCTs) that compared the effectiveness of PRP with eccentric exercise and placebo injections as treatments for PTRCTs. We searched databases such as the Cochrane Library, Web of Science, PubMed, and EMBASE. The visual analog scale (VAS) score, American Shoulder and Elbow Surgeon (ASES) score, and Constant-Murley score (CMS) was utilized as an outcome measure. Statistical analysis was performed using RevMan 5.3 software. Findings: Our meta-analysis included 12 studies involving 762 patients. At six weeks post-treatment, the PRP group had significantly higher VAS scores compared to the control group, indicating improvement (standard mean difference (SMD): -2.04 [95% confidence interval (CI): -4.00 to -0.08], I2 = 97%, P-value = 0.04). Patients who received PRP showed statistically significant improvements in VAS scores at 3 months and 6 months follow-up (SMD, -1.78 [95% CI: -3.03 to -0.52], I2 = 96%, P-value = 0.005) (SMD: -2.26 [95% CI: -3.77 to -0.76], I2 = 97%, P-value = 0.003). A statistically significant difference was also observed in VAS scores at the long-term 1-year follow-up (SMD: -2.27 [95% CI: -4.07 to -0.47];I2 = 98%;P-value = 0.031). There were statistically significant differences in ASES scores and CMS scores in the short-term (SMD: 1.21 [95% CI: 0.19 to 2.24], I2 = 96%, P-value = 0.02) (SMD, 2.01 [95% CI: 0.14 to 3.88], I2 = 97%, P-value = 0.04). However, in the l

关键词： Platelet-rich plasma Partial thickness rotator cuff tears visual analog scale score American shoulder and elbow surgeon score Constant-Murley score

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Assessment of Pain During Nerve Conduction Studies in Patients With Carpal Tunnel Syndrome

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Journal of Hand Surgery Global Online 2022年第2期4卷 89-92页

作者： Sasaki, Toru Nimura, Akimoto Kuroiwa, Tomoyuki Koyama, Takafumi Okawa, Atsushi Fujita, Koji Department of Orthopaedic and Spinal Surgery Graduate School of Medical and Dental Sciences Tokyo Medical and Dental University Tokyo Japan Department of Functional Joint Anatomy Graduate School of Medical and Dental Sciences Tokyo Medical and Dental University Tokyo Japan

Purpose: Patients with suspected carpal tunnel syndrome (CTS) often undergo nerve conduction studies (NCSs). Although patients sometimes complain of NCS-related discomfort, including severe pain, pain evaluations during such NCSs are lacking. We aimed to measure the pain experienced by patients with CTS during NCSs. Methods: This prospective study included 30 patients with CTS who underwent NCSs between April 2018 and March 2019. Pain because of electrical stimulation during NCSs was evaluated using a visual analog scale, and we statistically analyzed pain-related factors such as age, sex, complications, severity grading scale, the intensity of maximum stimulation, and examination time. Results: The mean visual analog scale score for NCSs was 5.2, and the visual analog scale score increased as the intensity of maximum stimulation and examination time increased. Conclusions: We measured the pain because of electrical stimulation experienced by patients with CTS during NCSs. Our findings indicate that medical staff must be mindful of the potential pain experienced by patients during NCSs and educate patients regarding the necessity of the examination and its procedures. Type of study/level of evidence: Diagnostic Ⅳ. © 2021 The Authors

关键词： Carpal tunnel syndrome Nerve conduction study Pain visual analog scale score

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Fluoroscopic and Endoscopic Calcaneal Spur Resection Without Plantar Fascial Release for Recalcitrant Plantar Fasciitis

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Foot and Ankle Orthopaedics 2022年第2期7卷 24730114221108104页

作者： Nakajima, Kenichiro Department of Orthopedic Surgery Yashio Central General Hospital Saitama Japan

Background: Studies on endoscopic calcaneal spur resection (CSR) without plantar fascial release (PFR) are limited. This study aimed to review the data of patients who underwent fluoroscopic and endoscopic CSR without PFR for plantar fasciitis with a calcaneal spur to assess the effectiveness of CSR. Methods: Medical records of consecutive patients with plantar fasciitis with ≥2 mm calcaneal spur who underwent endoscopic CSR without PFR from November 2017 to December 2019 were reviewed. Patients with ≥2 years of follow-up were included, whereas those who underwent another surgery on the operated foot were excluded. Age, body mass index (BMI), follow-up duration, calcaneal spur length, duration to full weightbearing postoperatively, Japanese Society for Surgery of the Foot (JSSF) score, visual analog scale (VAS) score for pain, and complications were assessed. Results: The mean follow-up duration was 2.7 years. A total of 47 patients (31 female, 16 male;mean age, 56.4 years;mean BMI, 25.5) were included. The mean calcaneal spur length was 5.7 mm. The VAS score improved from 79.6 ± 12.9 mm preoperatively to 5.3 ± 7.3 mm postoperatively. The JSSF score improved from 54.0 ± 19.1 points preoperatively to 97.5 ± 5.7 points postoperatively (Wilcoxon signed-rank test, P <.001, respectively). The mean duration to full weightbearing postoperatively was 4.4 ± 4.2 days. Two patients presented with tenderness, and one presented with hypesthesia at the portal site. Conclusion: Endoscopic CSR without PFR resulted in good outcomes, early return to full weightbearing, and few complications in patients with plantar fasciitis with ≥2 mm calcaneal spur. The results suggested that CSR was sufficient to relieve symtoms and improve function. PFR may not be necessary for treating plantar fasciitis with calcaneal spur. Level of Evidence: Level IV, retrospective case series. © The Author(s) 2022.

关键词： heel pain Japanese Society for Surgery of the Foot score minimally invasive surgery pathology tensile loads vertical stress visual analog scale score

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Quality improvement project provides unexpected insights into hospitalized pain management

JCA Advances

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JCA Advances 2024年第3期1卷 100076-100076页

作者： Emily H. Garmon Jasmin Saucedo Brittney Morgan Malinda Sykora

Patient education and multidisciplinary treatment plans are key best practices for pain management in hospitalized patients. In a routine compliance review, stakeholders at Baylor Scott & White Medical Center – Temple identified pain management patient education as an area needing improvement. A dual-sided medication explanation card was developed, including functional expectations and a QR code linking a companion website with additional pain management educational materials. This short communication details the results from a small quality improvement pilot study using QR code technology to deliver pain management education materials to hospitalized patients. Patients were surveyed the morning after admission and survey results are reported using standard descriptive statistics. Of 46 patients who received the education card, 44 reported well-controlled or moderately-controlled pain and 36 asked for as-needed pain medications. Fourteen patients said that the card was straightforward or made the medication options easy to understand. Per analytics, the companion website had at least 37 unique visitors during the survey period, with at least 8 visitors clicking additional links from the homepage. Though 30 % of patients reported that the education card was helpful and/or straightforward regarding medication options (as intended), five patients with moderately controlled pain who asked for as-needed medications reported they were delayed or ineffective, which revealed that timely administration and adjustments to regimens per patient feedback is also essential. Website analytics suggested that patients utilize and engage with available resources at differing rates. Limitations of this pilot study include small patient population, no pre-intervention comparator group, and disruption in analytics data gathering capabilities during the pilot. Despite limited qualitative data, the quality improvement objectively demonstrated regulatory compliance with pain management edu

关键词： Pain management Postoperative pain Acute pain Patient education ABCDEF Method Audience, Blueprint, Collaborators, Dissemination, Education, Feedback Method BSWMC-T Baylor Scott & White Medical Center – Temple PMBP Pain Management Best Practices Team QR code Quick-response code VAS score visual analog scale score

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Biceps Tenodesis Is a Viable Option for Management of Proximal Biceps Injuries in Patients Less Than 25 Years of Age

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ARTHROSCOPY-THE JOURNAL OF ARTHROSCOPIC AND RELATED SURGERY 2019年第4期35卷 1036-1041页

作者： Griffin, Justin W. Cvetanovich, Gregory L. Kim, Jae Leroux, Timothy S. Riboh, Jonathan Bach, Bernard R. Cole, Brian J. Nicholson, Gregory P. Verma, Nikhil N. Romeo, Anthony A. Rush Univ Med Ctr Dept Orthopaed Surg Chicago IL 60612 USA Ohio State Univ Wexner Med Ctr Dept Orthopaed Columbus OH 43210 USA

Purpose: To evaluate outcomes after biceps tenodesis performed in patients younger than 25 years, to evaluate reoperations and complications in this population, and to critically appraise return to preinjury level of play for this population. Methods: Forty-five consecutive patients younger than 25 years underwent subpectoral biceps tenodesis for biceps tendinopathy or biceps-labral complex injuries including SLAP tears. Biceps tenodesis was performed using an interference screw technique. Patients with a minimum 2-year follow-up were analyzed. Functional outcomes were assessed with the visual analog scale score, American Shoulder and Elbow Surgeons (ASES) score, ASES functional score, Simple Shoulder Test score, and range of motion. Activity level and return to sport were followed postoperatively. Results: Of the 45 patients younger than 25 years who underwent biceps tenodesis, 36 (80%) were available for follow-up at a minimum of 2 years, with a mean age of 19.8 years and mean follow-up period of 38.6 months. Of these 36 patients, 34 (94%) were athletes, with 20 patients playing at collegiate level. All clinical outcome scores improved, with the ASES score improving from 54.7 to 81.7, the ASES functional score improving from 17.5 to 25.1, and the Simple Shoulder Test score improving from 7.4 to 10.1 (P < .001). At the time of follow-up, 4 patients (11%) had undergone revision surgery for other injuries. Of the 34 athletes, 25 (73%) returned to sports, with 19 returning at the same level and 6 returning at a lower level of play;77% of overhead athletes returned to sports. Conclusions: When indicated, biceps tenodesis offers an alternative to SLAP repair in young patients. Biceps tenodesis in patients younger than 25 years yields satisfactory outcomes, with two-thirds of patients returning to sport and a low revision rate.

关键词： Biceps Brachii Muscle Sports Surgical Revision Athletes Tenodesis visual analog scale score

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Arthroscopic Superior Capsular Reconstruction for Massive, Irreparable Rotator Cuff Tears: A Systematic Review of Modern Literature

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ARTHROSCOPY-THE JOURNAL OF ARTHROSCOPIC AND RELATED SURGERY 2019年第4期35卷 1243-1253页

作者： Catapano, Michael de Sa, Darren Ekhtiari, Seper Lin, Albert Bedi, Asheesh Lesniak, Bryson P. Univ Toronto Phys Med & Rehabil Toronto ON Canada Univ Pittsburgh Med Ctr Ctr Sports Med Pittsburgh PA 15260 USA McMaster Univ Dept Surg Div Orthopaed Surg Hamilton ON Canada Univ Michigan Dept Orthopaed Surg MedSport Ann Arbor MI 48109 USA

Purpose: To systematically review and evaluate the efficacy and complication profile of superior capsular reconstruction (SCR) as a technique to address massive, irreparable rotator cuff tears (MIRCTs). Methods: Searches of the Cochrane Database of Systematic Reviews, Embase, MEDLINE, PubMed, and conference abstracts of 4 major conferences identified clinical studies addressing SCR for MIRCTs. Two reviewers independently screened the titles, abstracts, and full texts, extracting data from eligible studies. Reported outcome measures and complications were descriptively analyzed. Results: A total of 10 studies, 7 full texts and 3 conference abstracts, satisfied the inclusion criteria. The included studies examined a total of 350 shoulders with a mean patient age of 60.6 years and mean follow-up period of 20.6 months postoperatively. Only 4 studies had a minimum of 24-month follow-up data. Statistically significant improvements in pain and function were noted in all studies reporting results, with mean improvement ranging from 29.4 to 68.5 and from 2.5 to 5.9 points across the American Shoulder and Elbow Surgeons score and visual analog scale score, respectively. Mean improvement in range of motion ranged from 21.7 degrees to 64.0 degrees in elevation and from 9.0 degrees to 15.0 degrees in external rotation. Statistically significant improvements in the postoperative acromiohumeral distance were noted in 4 of 5 reporting studies, with a mean increase ranging from 2.2 to 5.0 mm. The combined clinical and radiographic failure and/or retear rate ranged from 3.4% to 36.1%. Complications for all studies included deep infection (0%-2%), symptomatic suture anchor loosening (0%-4%), and severe shoulder contracture (0%-2%). Conclusions: Arthroscopic SCR represents an accepted surgical option for patients with MIRCTs, with short-term improvements shown in pain, range of motion, and function. Although early results are promising, further studies are necessary to determine the lo

关键词： Risk Factors Dens visual analog scale score Rotator Cuff Tears Review, Systematic irreparable Modern Literature Suture Anchors

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Autologous Interleukin 1 Receptor Antagonist Blood-Derived Products for Knee Osteoarthritis: A Systematic Review

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ARTHROSCOPY-THE JOURNAL OF ARTHROSCOPIC AND RELATED SURGERY 2019年第7期35卷 2211-2221页

作者： Ajrawat, Prabjit Dwyer, Tim Chahal, Jaskarndip Univ Toronto Womens Coll Hosp Orthopaed Sports Med Toronto ON Canada

Purpose: To systematically review the available clinical data regarding the use of autologous IL-1 receptor antagonist blood products (AILBPs) and their validity as an alternative intra-articular (IA) therapy for symptomatic knee osteoarthritis (OA). Methods: The PubMed, MEDLINE, Embase, and Cochrane Library databases were searched from inception to June 2018. All randomized controlled trials (RCTs) and noncomparative studies that evaluated the clinical efficacy of AILBPs (i.e., autologous protein solution and autologous conditioned serum) for knee OA were included. The primary outcome measure was the Western Ontario and McMaster Universities Osteoarthritis Index. The secondary outcomes measured were the Knee Injury and Osteoarthritis Outcome score, visual analog scale score, Short Form 36 (SF-36) score, radiographic scores, and adverse events, which were qualitatively analyzed. Results: We included 8 studies, comprising 3 RCTs (Level II) and 5 noncomparative studies (Level IV), with a total of 592 patients (mean age, 56.4 years;49.7% male patients). The RCTs represented high methodologic quality, whereas the noncomparative studies represented moderate to good quality. With AILBPs, 2 of 4 studies (50%) showed improvements in the Knee Injury and Osteoarthritis Outcome score symptom and sport subscales, 5 of 7 studies (71%) achieved improvements in the Western Ontario and McMaster Universities Osteoarthritis Index score, and 4 of 5 studies (80%) attained improvements in the visual analog scale pain score from baseline to final follow-up. Most adverse events associated with AILBPs were mild to moderate in severity and were primarily localized to the injection site. Conclusions: Limited evidence substantiates that AILBPs are a safe and tolerable IA injection therapy that may improve pain parameters and functionality for mild to moderate knee OA patients and may be an effective adjunct for those unresponsive to traditional IA therapies.

关键词： INFORMATION ASSURANCE Knee osteoarthritis Adverse Event autologous bone marrow transplants Outcome Measures visual analog scale score Dens Adverse Reaction pain parameters Knee Injuries visual analog scale pain score

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An assessment of injection site reaction and injection site pain of 1-month and 3-month long-acting injectable formulations of paliperidone palmitate

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PERSPECTIVES IN PSYCHIATRIC CARE 2018年第4期54卷 530-538页

作者： Sliwa, Jennifer Kern Savitz, Adam Nuamah, Isaac Mathews, Maju Gopal, Srihari Elefant, Erica Najarian, Dean Alphs, Larry Janssen Sci Affairs LLC Titusville NJ USA Janssen Res & Dev LLC Titusville NJ USA

Purpose To evaluate injection site reactions and pain following paliperidone palmitate 1-month (PP1M) and 3-month (PP3M) administration using safety data of double-blind (DB), noninferiority study. MethodsFindingsPatients (n=1,429) with schizophrenia, treated with PP1M (50-150mg-eq, 17-week open-label [OL] phase) were randomized to PP1M or PP3M in 48-week DB phase. PP1M and PP3M injections were well tolerated. Incidence of induration, redness, and swelling were low in both phases (OL: 9-12%;DB: 7-13%), and were mostly mild in both groups. Mean (SD) visual analog scale scores decreased from OL-baseline (22.0 [21.6]) to DB-baseline (19.5 [20.6] vs. 18.4 [20.4]) and DB-endpoint (15.6 [17.9] vs. 15.5 [18.3]). Practice ImplicationsInjection site reactions and pain were low and similar between both treatments, regardless of administration site and dose.

关键词： injection site pain injection site reaction injection site volume paliperidone palmitate 1-monthly paliperidone palmitate 3-monthly schizophrenia visual analog scale score

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Effect of Intercostal Nerve Block and Nephrostomy Tract Infiltration With Ropivacaine on Postoperative Pain Control After Tubeless Percutaneous Nephrolithotomy: A Prospective, Randomized, and Case-controlled Trial

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UROLOGY 2018年第1期114卷 49-55页

作者： Choi, Sae Woong Cho, Shin Jay Moon, Hyong Woo Lee, Kyu Won Lee, Sang Hoon Hong, Sang Hyun Choi, Yong Sun Bae, Woong Jin Ha, Syn Hong, Sung-Hoo Lee, Ji Youl Kim, Sae Woong Cho, Hyuk Jin Catholic Univ Korea Coll Med Dept Urol Seoul South Korea St Marys Will Hosp Dept Anesthesiol Seoul South Korea Catholic Univ Korea Coll Med Dept Anesthesiol Seoul South Korea

OBJECTIVE To determine the efficacy of intercostal nerve block and nephrostomy tract infiltration (NTI) with ropivacaine in patients undergoing tubeless percutaneous nephrolithotomy (TPCNL). MATERIALS AND METHODS From February 2015 to March 2017, a total of 226 patients undergoing TPCNL were enrolled. After excluding 130 patients who failed to meet the inclusion criteria, a total of 96 eligible patients were randomized into 3 groups: group I, control group (n = 32);group II, intercostal nerve block with 15 mL of 0.5% ropivacaine and epinephrine (n = 32);and group III, NTI with 20 mL of 0.25% ropivacaine and epinephrine (n = 32). Pain status was assessed at postoperative 2, 8, and 24 hours and at discharge by visual analog scale score at rest (RVAS) and on deep breathing and coughing. RESULTS Patient demographics and perioperative data between groups were comparable except for length of stay. Mean RVAS scores at postoperative 2 and 8 hours for group III were significantly less than those for group I (RVAS at 2 hours: 2.6 vs 4.9, P = .001;RVAS at 8 hours: 1.7 vs 3.3, P = .007). Mean RVAS scores at postoperative 24 hours had borderline significance (P = .050) among the 3 groups. Differences in mean deep breathing and coughing scores among groups were statistically significant (P = .002) only in the first 2 hours. All postoperative complications (5.4%, 5 per 92) were of grade 1 and not significantly different among groups. CONCLUSION NTI is safe and effective in alleviating early postoperative pain for patients who underwent TPCNL. (C) 2017 Elsevier Inc.

关键词： Nerve Block ropivacaine pain control Percutaneous Nephrolithotomy postoperative pain intercostal nerve block nephrostomy visual analog scale score

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