Comparative Study Of Outcomes Research Articles

Single-Stage Immediate Breast Reconstruction with Acellular Dermal Matrix after Breast Cancer: Comparative Study and Evaluation of Breast Reconstruction Outcomes.

We evaluate postoperative complications, aesthetic results and satisfaction outcomes in patients with breast cancer after intervening with a skin-sparing or nipple-sparing mastectomy with an immediate prosthetic reconstruction with or without a biological mesh. Patients with multifocal breast cancer, ductal carcinoma in situ with an indication for a mastectomy and cT2 tumors with no response to primary systemic treatment were included, whereas patients aged >75 years, with inflammatory carcinoma, and severe circulatory disorders were excluded. Patients in the control group were reconstructed using a prosthesis, whereas the study group included patients reconstructed using a prosthesis and biological acellular porcine dermal mesh (Strattice™). In both groups, the result was assessed using the BREAST-Q instrument. A total of 51 patients (62 intervened breasts) were included in the study group and 38 patients (41 intervened breasts) in the control group. Implant loss and removal occurred in three patients in the study group (5.9%) and nine patients in the control group (24.3%; p = 0.030). Infections appeared in three patients in the study group (4.8%) and three patients in the control group (7.3%; p = 1.00). Skin necrosis appeared in 5 patients in the study group (12.2%) and 11 patients in the control group (21.6%; p = 0.367). Seroma appeared in five patients in the study group (12.2%) and five patients in the control group (8.1%; p = 0.514). The BREAST-Q questionnaire is a comparison between both groups regarding "satisfaction with breasts after surgery" (p = 0.026), "sexual well-being after intervention" (p = 0.010) and "satisfaction with the information received" (p = 0.049). We have noted a statistically significant decrease in implant loss in women receiving an implant with a biological mesh. A higher satisfaction was observed in patients reconstructed using Strattice™, with statistically significant differences in three items.

Results of a clinical trial of humeral neck osteosynthesis with carbon – carbon composite material

The metals utilized in the production of various implants in traumatology possess all the required mechanical properties. However, these materials are susceptible to oxidation. Carbon-carbon composites, on the other hand, exhibit X-ray transparency and are easily machinable. Thanks to their intricate yet essential physical, mechanical, and chemical properties, they find effective application in osteosynthesis and endoprosthesis procedures for bone structures. The aim of this study is to comparative view of the treatment outcomes for patients with fractures of the proximal part of the humerus by carbon-carbon composite material plates and titanium plates. Materials and methods. In this study, a carbon-carbon composite material plate was conducted osteosynthesis of the proximal part of the shoulder. In the comparison group, a titanium plate was employed. The study group comprised 20 patients, while the comparison group included 15 patients. The analysis of the results was carried out utilizing the Constant–Murley scale and the Quick DASH questionnaire. Results. A comparative study of treatment outcomes between the main and comparison groups revealed a more significant positive treatment effect in the group that underwent osteosynthesis of the humeral neck by a carbon-carbon composite material plate. This effect was observed at the 3-month, 6-month, and 12-month evaluation points. It was characterized by reduced shoulder pain, alleviated dysfunction manifestations, enhanced daily activities, and improved overall quality of life among patients in this group. Conclusions. The analysis of long-term treatment outcomes for proximal humerus fractures, utilizing both carbon-carbon composite material plates and titanium plates, by the Constant–Murley scale and the Quick DASH questionnaire, demonstrated statistically confirmed improvements in shoulder joint function for both treatment methods.

Comparative study of functional and radiological outcomes of the usage of two devices, derotation type cephalomedullary nail and the helical blade type in unstable intertrochanteric fractures in the geriatric population at a tertiary-level center

Background: Intertrochanteric fracture is a common osteoporotic fracture among elderly populations in an aging society. Early surgical fixation on these aging patients has been proposed recently for early rehabilitation and has had a positive impact on reducing comorbidities. For unstable fractures, intramedullary implants generally present biomechanical advantages over their extramedullary counterparts. Methods: The study was a 2 years prospective comparative study from 1st December 2020 to 1st December 2022 conducted in the department of orthopaedics, Rajendra institute of medical sciences, Ranchi, Jharkhand, India. Total number of patients were 50, PFN done in 25 cases and PFN-A2 in another 25 cases. Results: Mean age is 64.4 years in PFN group as compared to 67.3 years in PFN-A2 group. PFN-A2 was done in 84% male while PFN in only 76 % male and in both groups right side was mostly affected. Average surgery time, amount of blood loss, average number of C-arm shoot was more in PFN group. Conclusions: In this study of 50 patients, 25 treated by PFN and 25 by PFN-A2, it was concluded that PFN-A2 was a better construct to treat patients of older age group having osteoporosis because here reaming was not done and helical blade was inserted by hammering which caused compaction of bones in head and neck region.

BIO-RSA vs metal augmented baseplate in shoulder osteoarthritis with multiplanar glenoid deformity: a comparative study of radiographic findings and patient outcomes.

Reverse shoulder arthroplasty (RSA) requiring extensive reaming to address severe glenoid bone loss increases the risk of glenoid medialization and baseplate failure. We hypothesized that i) metal augmented baseplate prevents the medialization of the joint line and preserves glenoid bone stock similarly to BIO-RSA; ii) bone graft viability and healing in BIO-RSA patients become compromised over time. Eighty-one patients (83 shoulders) underwent glenoid lateralization with bone (BIO-RSA group, 44) or metal augmented baseplate (MIO-RSA group, 39) and a minimum follow-up of 24 months were included. The orientation and direction of glenoid erosion was identified and recorded using computerized 3D planning. Active range of motion, and the Western Ontario Osteoarthritis of the Shoulder (WOOS) index were assessed before arthroplasty and at the last follow-up visits. Radiographic changes around the glenoid and humeral components were assessed. Healing and thickness of bone graft were evaluated by predefined criteria. Postoperative global glenoid inclination (β angle) and retroversion were also measured. Delta scores of active anterior elevation were higher in the MIO-RSA group (p= 0.027). The differences in the other planes of shoulder motion and in WOOS index scores between the groups were not significant. Preoperative glenoid retroversion was higher in BIO-RSA patients, glenoid inclination was similar in both groups. Type B2 and B3 glenoids had a posterior-central (91%) and posterior-superior (90%) erosion with a mean posterior humeral head subluxation of 76% and 78%, respectively. The direction of erosion in Type E2 and E3 glenoids was posterior-superior, with a mean posterior humeral head subluxation of 74%. The rate of high position of the glenosphere was higher in the BIO-RSA group (p = 0.022), while the values of β angle and postoperative retroversion were similar in the two groups. BIO-RSA group showed radiolucent lines < 2mm around the bone graft in 16 patients (36.4%) and decreased thickness in 15 (34.1%). Incomplete baseplate seating was found in 4 MIO-RSA patients (10%). We found higher rate of humerus condensation lines in MIO-RSA patients (p= 0.01) and higher rate of cortical thinning and tuberosity resorption in the BIO-RSA group (p= 0.027 and p = 0.004, respectively). Metal augmented glenoid is a suitable alternative to BIO-RSA to preserve bone and prevent the medialization of the joint line in arthritic glenoid with multiplanar glenoid deformity. Bone and metal augmentation provided satisfactory clinical outcomes. Bone graft resorption in BIO-RSA patient raise concern about the risk of baseplate loosening and requires further long term studies.

Minimally Invasive Surgical Versus Transcatheter Aortic Valve Replacement: A Retrospective Observational Single-Center Study in Japan.

This study aimed to compare the outcomes of minimally invasive aortic valve replacement (MICS-AVR) versus transfemoral transcatheter aortic valve replacement (TF-TAVR) in Asian patients. We conducted a retrospective, observational, single-center study in Japan, including cases of MICS-AVR (n = 202) and TF-TAVR (n = 248) between 2014 and 2021. In a total of 450 cases, propensity score matching was performed at a ratio of 1:1, resulting in 96 pairs. Furthermore, we performed competing-risk regression and mediation analyses to determine the treatment effect on outcomes of interests, considering death as a competing risk, and to evaluate the mediation effect of paravalvular leak (PVL) severity. There were similar incidences of all-cause death, cardiac death, stroke and cerebral hemorrhage, and aortic valve reintervention between the 2 groups. However, the TF-TAVR cohort had a longer hospital length of stay and higher rates of significant PVL compared with the MICS-AVR cohort. Multivariable-adjusted Cox regression analyses revealed that heart failure hospitalization (hazard ratio [HR] = 0.129, 95% confidence interval [CI]: 0.038 to 0.445, p = 0.001) and permanent pacemaker implantation (HR = 0.050, 95% CI: 0.006 to 0.409, p = 0.005) favored MICS-AVR. Competing-risk regression analyses confirmed similar findings. All outcomes were unrelated to PVL severity. To our knowledge, this is the first comparative study of clinical outcomes in Asian patients undergoing MICS-AVR versus TF-TAVR, revealing that MICS-AVR could be a feasible and efficient alternative to TF-TAVR. Future larger-scale randomized controlled trials are needed to validate the present results.

Poorer outcomes associated with more invasive lead management strategies for Abbott Riata® leads: a large, multicenter experience.

Over 100,000 Abbott Riata® were implanted in the United States before they were recalled in 2010. There are still a significant number of Abbott Riata® leads in use, and it is unclear how these leads should be managed at the time of generator change or lead malfunction. Although data comparing both Sprint Fidelis® and Abbott Riata® leads in this setting is available, there are no multicenter comparative studies of outcomes for various lead management strategies, including lead extraction (LE), lead abandonment/revision (LA), and generator change (GC)only at the time of device at elective replacement interval(ERI) for Abbott Riata® leads. A retrospective, multicenter study was undertaken to compare short-term outcomes (major complications-MC, death, extended or re-hospitalizations within 60days-RH, lead malfunction-LM) and total outcomes (short-term outcomes & lead malfunction during follow-up) of patients with Riata® leads undergoing LE, LA, or GC. 152 patients (65 ± 13years, 68% male) were followed for a mean 33 ± 30months following intervention. Out of 166 procedures,13 patients underwent LE, 16 patients underwent LA, and 137 patients underwent GC. There was 1 major complication in each group, yielding an event rate of 7.7% for LE, 6.3% for LA, and 0.7% for GC cohorts. There were significantly more short-term and total adverse outcomes in the group of patients getting LE and LA versus GC only (38.5% & 31.3% vs 7.3%, P < 0.001). Total Riata® lead dwell time follow-up was 17,067months. A total of 3 Riata® lead malfunctions were noted during long-term follow-up. Inappropriate shocks were similar between LE 7.7% (1/13), LA 6.3% (1/16). and GC 11.0% (4/136); P = 0.57. There were more short-term and total adverse outcomes in more invasive management strategies (LE and LA) versus GC alone. The failure rate of Riata® leads was substantially lower compared to previous reports. Therefore, we recommend only performing battery exchange when a device with an active Riata® lead is at ERI, unless there is malfunction of the Riata® lead noted on testing. There were significantly more short-term adverse outcomes in the lead extraction (5/13) and lead abandonment/revision (5/16) groups than the generator only (8/137) group (P < 0.001). GIB - Gastrointestinal bleed, CHF - congestive heart failure, NSTEMI - non-ST elevation MI.

Technique Variation in the Surgical Treatment of Lateral Ankle Instability.

Lateral ankle sprains are the most common type of injury to the ankle and can lead to ankle instability. There are many described techniques for the surgical treatment of lateral ankle instability. The purpose of this study is to quantify the variation in surgeon technique for lateral ankle instability treatment. Surveys were sent to 62 orthopaedic foot and ankle surgeons regarding surgical technique for the treatment of lateral ankle instability. Clinical agreement was defined as greater than 80% agreement to assess the cohesiveness of surgical methods as described by Marx et al. Results. Response rate was 49/62 (79%). There was clinical agreement for not using bone tunnels and not using metal anchors. All other factors lacked clinical agreement. A greater average number of throws and knots (4.2 for each, range 1-6 throws, range 2-12 knots) were used by surgeons that do not believe knots cause pain compared to an average of 3.9 (range, 1-6) throws and 4.0 (range, 2-15) knots by surgeons who do believe knots cause pain. The association that surgeon who believed knots do cause pain and thus used fewer knots and throws was not statistically significant (P > .05). The preferred material by surgeons in our study are as follows: nonabsorbable braided suture (26/49, 53%), suture tape (15/49, 31%), and fiber tape (4/49, 8%). Among surgeons who use absorbable suture (34/49, 69%), there was no significant difference (P > .05) between surgeons who believe knots cause pain (23/34, 68%) and those who do not (11/34, 32%). Among this small sample of orthopaedic foot and ankle surgeons, there is wide variation in surgical technique for lateral ankle instability treatment and little agreement on the clinical standard of care. This disagreement highlights the need for comparative outcome studies in the treatment of ankle instability. Level III: Retrospective cohort study.

Prospective observational comparative study of outcomes between single-layer versus double-layer gastrointestinal anastomosis

Prospective observational comparative study of outcomes between single-layer versus double-layer gastrointestinal anastomosis

Zancolli Lasso Technique Versus Brand Technique in Hand Clawing: A Comparative Study of Functional Outcomes

Zancolli Lasso Technique Versus Brand Technique in Hand Clawing: A Comparative Study of Functional Outcomes

626 Timing of Pseudomonas aeruginosa acquisition in children diagnosed with cystic fibrosis recruited in the Irish Comparative Outcome Study Part 2

626 Timing of Pseudomonas aeruginosa acquisition in children diagnosed with cystic fibrosis recruited in the Irish Comparative Outcome Study Part 2

In-Clinic versus Hybrid Cancer Rehabilitation Service Delivery during the COVID-19 Pandemic: An Outcome Comparison Study.

Diminished health-related quality of life (HRQOL) is common among cancer survivors but often amendable to rehabilitation. However, few access real-world rehabilitation services. Hybrid delivery modes (using a combination of in-clinic and synchronous telehealth visits) became popular during the COVID-19 pandemic and offer a promising solution to improve access beyond the pandemic. However, it is unclear if hybrid delivery has the same impact on patient-reported outcomes and experiences as standard, in-clinic-only delivery. To fill this gap, we performed a retrospective, observational, comparative outcomes study of real-world electronic medical record (EMR) data collected by a national outpatient rehabilitation provider in 2020-2021. Of the cases meeting the inclusion criteria (N = 2611), 60 were seen to via hybrid delivery. The outcomes evaluated pre and post-rehabilitation included PROMIS® global physical health (GPH), global mental health (GMH), physical function (PF), and the ability to participate in social roles and activities (SRA). The patient experience outcomes included the Net Promoter Survey (NPS®) and the Select Medical Patient-Reported Experience Measure (SM-PREM). A linear and logistic regression was used to examine the between-group differences in the PROMIS and SM-PREM scores while controlling for covariates. The hybrid and in-clinic-only cases improved similarly in all PROMIS outcomes (all p < 0.05). The association between the delivery mode and the likelihood of achieving the minimal important change in the PROMIS outcomes was non-significant (all p > 0.05). No between-group differences were observed in the NPS or SM-PREM scores (all p > 0.05). Although more research is needed, this real-world evidence suggests that hybrid rehabilitation care may be equally beneficial for and acceptable to cancer survivors and supports calls to expand access to and reimbursement for telerehabilitation.

A Comparative Study of Clinical Outcomes Between Cruciate-Retaining and Posterior-Stabilized Total Knee Arthroplasty: A Propensity Score-Matched Cohort Study.

We investigated a comparison of clinical outcomes between cruciate-retaining (CR) and posterior-stabilized (PS) total knee arthroplasty. However, it is still controversial which design leads to better clinical results. In clinical settings, choosing either CR or PS is likely based on the surgeon's preferences. In this study, short-term clinical outcomes between CR and PS in patients who received a single knee prosthesis were compared using propensity score matching. Two hundred and twelve CR and 43 PS of a single knee prosthesis were enrolled in this study. After propensity score matching, 34 knees each in the CR and PS groups were chosen and were without significant differences in age at operation, gender, BMI, preoperative range of motion (ROM), preoperative femorotibial angle (FTA), and presence or absence of patellar replacement. Clinical scores, including ROM, Knee Society score (KSS), knee injury and osteoarthritis outcome score (KOOS), except for the sports subscale, were compared between the CR and PS groups preoperatively and two years postoperatively. Postoperatively, there were no significant differences in FTA, ROM, or KSS. Preoperative scores for the KOOS except for the pain subscale were comparable between the groups. Postoperatively, however, the PS group had a significantly higher score in the ADL subscale compared to the CR group (PS: 89.5 vs. CR: 80.8,p= 0.017). The KOOS subscales other than activities of daily living (ADL) were comparable between the groups. In this propensity score-matched cohort study, PS showed a better outcome for the ADL than the CR design. These findings suggest that choosing either CR or PS should not depend on the surgeon's preferences. A PS design may be preferable to CR for elderly patients.

A comparative study of anatomical and functional outcomes after 20, 23 and 25 gauge pars plana vitrectomy in adult population at a tertiary care center in Rajasthan

Pars plana vitrectomy is the most common technique in vitreoretinal surgery that enables access to the posterior segment for treating conditions such as retinal detachment, vitreous hemorrhage, macular hole, endophthalmitis, dropped nucleus and dropped iol in a controlled closed system.Prospective, comparative study of patients, more than 18 years of age, who underwent pars plana vitrectomy for various vitreoretinal disease at J.L.N. Medical College, Ajmer, from October 2020 to March 2022,with no previous history of any vitreoretinal surgery.96 eyes of 96 patients that underwent 20-gauge (n=32), 23-gauge (n=32) and 25-gauge (n=32) Pars plana vitrectomy were included in this study. The mean duration of surgery was significantly higher in the conventional 20-Gauge as compared to the micro incisional vitrectomy system. Mean Best corrected visual acuity (BCVA) improved significantly in all three groups at postoperative 3 months, no significant difference between the 3 groups. Re retinal detachment occurs in 6 eyes(2 eyes in each group). Recurrent vitreous hemorrhage occurs in 1 eye in 25-gauge and postoperative endophthalmitis occurs in 2 eyes(1 eye each in 20-gauge and 23-gauge). There was a similar rate of ocular hypertension in all three groups. Postoperatively 20-gauge showed significantly higher mean conjunctival hyperemia and subconjunctival hemorrhage compared to Sutureless microincisional vitrectomy surgery.Functional and anatomical outcomes assessed by BCVA and retinal status postoperatively seem to be comparable between 20,23 and 25-gauge vitrectomy systems. Sutureless microincisional vitrectomy surgery showed significantly shorter duration of surgery.

A comparative study of epidemiological characteristics, treatment outcomes, and mortality among patients undergoing hemodialysis by health insurance types: data from the Korean Renal Data System.

The prevalence of end-stage renal disease (ESRD) requiring dialysis has progressively increased. Therefore, to achieve financial stability by managing the increasing numbers of patients undergoing hemodialysis (HD), a fixed-payment system was introduced in 2001 for medical aid (MA) beneficiaries receiving HD in Korea. We identified patients in the Korean Renal Data System that received HD between 2001 and 2017 and stratified them into the following two groups: the National Health Insurance (NHI) and MA groups. Then, we compared the two groups that differed in demographic characteristics, the treatment process and outcomes, and mortality based on health insurance type. Among 52,574 patients, the number of patients aged 65 years or older, hypertension was higher in the NHI group, but diabetes was higher in the MA group. Additionally, the MA group had more weekly dialysis sessions, and expensive drugs tended to be used less frequently. Regarding treatment outcomes, including laboratory test results, the MA group achieved significantly lower goals than the NHI group (p < 0.001). Furthermore, the mortality rate per 1,000 persons was 31 and 27 in the MA and NHI groups, respectively, and the mortality rate ratio was 1.2 (95% confidence interval [CI], 1.076-1.230). Moreover, the hazard ratio for mortality was 1.39 (95% CI, 1.30-1.49, p < 0.001) after adjusting for age, sex, causes of ESRD, and comorbidities. There were significant differences in the treatment and mortality indicators between the groups. Therefore, policy support should be strengthened to provide better medical services to MA beneficiaries undergoing HD.

Intramedullary Fibular Strut Allograft and a Small Fragment Nonlocking T-plate for Periprosthetic Lateral Femoral Condyle Fracture: A Case Report

Intramedullary Fibular Strut Allograft and a Small Fragment Nonlocking T-plate for Periprosthetic Lateral Femoral Condyle Fracture: A Case Report

Use of Tranexamic Acid in Aesthetic Surgery: A Retrospective Comparative Study of Outcomes and Complications.

Bleeding is a potential complication of aesthetic surgery. Surgeons have adhered to the principle of minimizing blood loss. Tranexamic acid (TXA) is an antifibrinolytic medication capable of reducing bleeding. This study aimed to investigate TXA and its effect on complications and overall outcomes in aesthetic surgery patients. This retrospective chart review of patients undergoing various aesthetic procedures between 2019 and 2022 was conducted in Riyadh, Saudi Arabia. Preoperative and postoperative hemoglobin levels, blood transfusions, and complications were the primary outcomes. Furthermore, the predictors of giving TXA were studied. In total, 435 patients were included in the study. TXA was administered to 181 patients (41.6%). Significantly higher proportions of patients who received TXA underwent trunk aesthetic surgery (P < 0.001), and those who received TXA underwent combined procedures more frequently than non-users (P < 0.001). The mean operative time and length of hospital stay were significantly longer among patients who did not receive TXA (P < 0.001, and P < 0.001, respectively). Most predictors for using TXA were significantly associated with performing liposuction (OR = 5.5), trunk aesthetic surgery (OR = 4.9), and undergoing combined procedures (OR = 2.7). No significant difference was noted in the rate of complications between the two cohorts. Although our data show improvement in patient outcomes in multiple aspects, the heterogeneity of our cohort makes us unable to draw definite conclusions to recommend the use of TXA in aesthetic surgery. Thus, a randomized controlled trial is necessary to support the findings of this study.

A comparative study of hearing outcome in cholesteatoma surgery canal wall up versus canal wall downmastoidectomy in 100 patients

Cholesteatoma is a well-demarcated sac of keratinizing squamous epithelium in the temporal bone, which is commonly characterized as “skin in the wrong place. The major goal of surgery for cholesteatoma is to make the ear safe and dry with increasing concern of the hearing outcome of patients. Two main surgical techniques employed are Canal Wall down (CWD) and Canal Wall up Mastoidectomy (CWU). In the current study, an attempt would be made to evaluate which technique would be better for achieving disease clearance with favorable hearing outcome and dry ear.1. To evaluate the hearing results following CWU and CWD surgery in patient with cholesteatoma.2. To decide surgical approach according to extension of disease.Materials and Methods:This is a prospective study involving 100 patients with cholesteatoma who had undergone CWD and CWU surgery over the period of 3 years.The choice of mastoidectomy, CWD or CWU, was the decision of the surgeon, after completely evaluating the patient, preoperatively and intraoperatively. All cases were followed up &amp; assessed by autoscopic examination &amp; PTA for minimum of 3 months. In the CWD group, mean hearing gain, in 3 months was 12±1.73dB. In the CWU group, hearing gain in 3 month postoperative period was 18±2.06 dB. Also the hearing gain between the two groups was compared and it was found to be statistically significant for the 3 months (p=0.0002) postoperatively; signifying that there was a comparable difference for CWU over CWD mastoidectomy in the matter of Hearing Gain. SNHL was also seen post operatively in both group. Total 3 (6%) patient in CWU had SNHL post operatively in comparison to 7(14%) patients in CWD. From our study results, we think that CWU is superior to the CWD surgery in cases of cholesteatoma because of good post-operative hearing outcome as well as less complication and law morbidity. CWD surgery should be used in cases of extensive cholesteatoma, mental retardation, not sure about follow up and inadequate middle ear space cases.

Validation of a Wearable System for Lower Extremity Assessment.

Remote assessment and diagnosis of functional impairment caused by osteoarthritis (OA) of the knee can achieve early intervention of patients' functional impairment, prevent the deterioration of OA of the knee, and provide functional remote screening for patients with knee OA. This study introduced an inertial measurement unit (IMU) sensor-based system to assess lower extremity function and perform gait analysis. Then, we compared its accuracy to gold-standard motion capture and gait measurement systems. Nine adults were selected to participate in a comparative study of gait assessment outcomes using an IMU sensor-based wearable system, a gold-standard motion capture system, and a pressure-based gait analysis system. The subject walked on a path that incorporated all three systems. Data analysis was performed on spatiotemporal gait parameters, including velocity, cycle time, cadence, and stride length. This was followed by gait phases, including stance, swing, double stance, and single limb support phases. Data were processed using the data processing software of each system. An independent sample t-test was conducted for inter-group comparison to analyze the data. The spatiotemporal gait parameters of the systems demonstrated excellent consistency, and the gait phases showed high consistency. Compared to the gold-standard pressure-based gait analysis system (the GATERite system), the mean gait cycle time results were 1.124 s vs. 1.127 s (p = 0.404); cadence was 93.333 steps/min vs. 94.189 steps/min (p = 0.482); stance phase was 60.89% vs. 63.26% (p < 0.001); swing phase was 39.11% vs. 36.74% (p < 0.001); stride length was 1.404 m vs. 1.420 m (p = 0.743); speed was 1.093 m/s vs. 1.110 m/s (p = 0.725). Compared to the gold-standard video-based motion capture system, the root mean square error was 2.7° for the hip angle and 2.6° for the knee angle. This IMU-based wearable system delivered precise measuring results to evaluate patients with knee OA. This technology can also be used to guide rehabilitation exercises for patients with knee OA.

Comparative study of outcomes between application of negative pressure wound therapy to split skin graft versus split skin graft immobilized by traditional bolster dressing

Background: SSG is a versatile technique used for the reconstruction of wounds. The conventional techniques like traditional bolster dressing (TBD) to secure graft have been in use since the long time for the management of these wounds. NPWT is an effective advanced therapy which increase graft take by providing negative pressure to seal the space and provide persistent and uniform pressure. Methods: 60 patients were enrolled in the study. In the TBD group (30 patients) a bolster was placed on the graft which was made using a nonadherent dressing. In the NPWT group (30 patients) the SSG was secured using circumferential staples, followed by placement of VAC dressing with continuous negative pressure. Percentage of graft take assessed on 5th, 7th and 9th postop day. Results: Graft take on day 5th with NPWT group was 83.16±4.1% and in TBD group was 78.12±3.76%. On day 7th with NPWT group was 89.83±4.12% and in TBD group was 84.33±4.66%. On Day 9th with NPWT group was 96.33±5.3% and in TBD group was 92.67±5.24%. In NPWT group, mean Post SSG days were 9.9±0.61days. In TBD group, mean Post SSG days were 13.03±1.4 days. Conclusions: Our study suggest that Application of NPWT on SSG is beneficial in terms of better graft take, lesser infection, shortened post graft hospital stays and less no who needs for redo SSG and it is particularly useful anatomically challenging sites.

Comparative Study of Surgical Outcomes of Occipitocervical and Atlantoaxial Fusion for Retro-Odontoid Pseudotumor

To compare the surgical and radiographic outcomes of occipitocervical fusion (OCF) with those of atlantoaxial fusion (AAF) in patients with cervical myelopathy caused by retroodontoid pseudotumors (ROPs). This retrospective, comparative study included 26 patients; 12 underwent occipitocervical fusion (OCF) (group O) and 14 retroodontoid pseudotumor (AAF) (group A) with a minimum 2-year follow-up. Neurologic outcomes were evaluated using the Japanese Orthopedic Association (JOA) score. Radiologic assessment included the maximum anteroposterior (AP) diameter of the anteroposterior-retroodontoid pseudotumor (AP-ROP), C2-7 angle, O-C2 angle, C1-2 angle, atlantodental interval (ADI), range of motion (ROM) of the ADI, C2-C7 sagittal vertical axis (C2-7 SVA), and T1 slope. Global spinal alignments (pelvic incidence [PI] minus lumbar lordosis [LL] [PI-LL], pelvic tilt, sacral slope, and C7 sagittal vertical axis) were also compared between the groups. Both groups had equally good clinical outcomes with equal complication rates. Three patients had a three-level fusion, 5 cases had a four-level fusion, and 4 cases had more than five-level fusion in group O. All cases had a single-level fusion in group A. Surgical time was significantly shorter in group A. AP-ROP was significantly downsized postoperatively in both groups and was more prominent in group O. C2-7 SVA was significantly increased and C2-7A ROM was significantly reduced in group O at the final follow-up. The PI-LL showed a significant increase in group O at the final follow-up. Although OCF and AAF were similarly effective for cervical myelopathy with ROP, AAF was less invasive, and spinal alignment was better maintained postoperatively in AAF than OCF.