Excellent Patient Satisfaction Research Articles

Comparative evaluation of ultrasound and fluoroscope guided intra-articular sacroiliac joint injection in patients with sacroiliac joint pain

Background: Tissues which transmit pain in the lower back include disc, nerve root, dura, muscles, ligaments, facet joints, and sacroiliac joint (SIJ). The SIJ contributes around 13–30% in patients with chronic low back pain. The SIJ is difficult to enter with a needle because of its complex configuration. Ultrasound and fluoroscopy are the two tools which guide in performing SIJ injections. Aims and Objectives: The SIJ is susceptible to arthritis, trauma, and degeneration which lead to pain and dysfunction. Intra-articular SIJ injections (IASIJIs) have diagnostic and therapeutic value and have been administered for the treatment of SIJ pain. Materials and Methods: Sixty patients (aged 20–60 years) with pain patterns consistent with SIJ pain who did not respond to conservative treatment were included in the study. The patients were randomly divided into two groups of 30 each: Group U (n=30): Ultrasound-guided IASIJI and Group F (n=30): Fluoroscope-guided IASIJI. A total of 3 mL drug solution comprising 1 mL of 0.25% bupivacaine plus 2 mL of methylprednisolone (80 mg) was injected in both groups. Results: There was a statistically significant improvement in pain scores after IASIJI in both groups. The change in pain score was significantly more in Group F as compared to Group U at 3 and 6 months after IASIJI. Two weeks after IASIJI, the mean pain score in both groups remained < 2 at all time intervals throughout the study period. The variation in the Oswestry Disability Index (ODI) at different time intervals when compared to ODI before injection in both the groups was clinically and statistically significant (P<0.001). The change in ODI was more in Group F as compared to Group U at all time intervals. Excellent patient satisfaction was reported by the majority of the patients at different time intervals in both groups. Conclusion: Both techniques were effective and provided good pain relief to the patients with SIJ pain. Fluoroscope-guided SIJ injection is better than ultrasound-guided SIJ injection in terms of improvement in pain score and functional disability.

EGS SO35 - Emergency laparotomies in the elderly: A patient perspective

Abstract Background Emergency laparotomy is known to convey worse morbidity and mortality for elderly patients. Despite a growing elderly population, there is a limited understanding of the patient experience in emergency laparotomy. This study aims to assess patient satisfaction following emergency laparotomy. Method Patients were identified from the National Emergency Laparotomy Audit (NELA) database, who were aged 80 and above, and underwent surgery between: January 2020 and August 2023 at Torbay Hospital. Of the patients who survived to discharge, a telephone-based interview was undertaken in January 2024. Exclusion criteria included: confusion, severe illness and relook laparotomy. Data was collected on functional status and satisfaction with the procedure. Patients were also asked what they wished they known prior to the operation. Post-operative outcomes were assessed in a separate study. Results 132 cases were undertaken in this period. 72 cases met inclusion criteria. We achieved a 54% response rate. 59% of respondents were living independently post operatively and had no functional decline. 92% of respondents were happy to have had the operation and if given the opportunity again would still have had the procedure. Patients were overall very happy with the information offered prior to the procedure, 8% felt they had no alternative option. One patient was not satisfied with the follow up received. Conclusion Although emergency laparotomy in the elderly is high risk, our data demonstrate excellent patient satisfaction. This study provides a better understanding of what is important to patients; this should be considered in the consent process and communication.

Single stage direct -to- implant breast reconstruction following mastectomy (The use of Ultrapro® Mesh)

BackgroundImmediate breast reconstruction (IBR) with direct to implant (DTI) is the preferred method of reconstruction by many surgeons and patients, however, acellular dermal matrix (ADM) and other synthetic meshes are expensive especially in low- and middle-income countries.Aim of the workTo evaluate the technique, indications, aesthetic outcomes, and short and long-term complications of DTI breast reconstruction performed with Ultrapro®, a low-cost alternative mesh to ADM and other synthetic meshes.MethodsOur study is a prospective cohort study that was conducted on 133 patients who experienced IBR following nipple-sparing mastectomy (NSM) or skin sparing mastectomy (SSM) using silicone implants and Ultrapro® mesh between December 2020 and December 2023. Techniques used were either sub-pectoral or pre-pectoral, evaluating aesthetic outcome, complication rate and patient satisfaction using breast Q questionnaire.ResultsWe included 133 patients (141 breasts) with a median age of 39 years. Mean duration of follow up: 20.364 ± 5.39 months. The sub-pectoral and the pre pectoral techniques were used for 80 breasts and 61 breasts respectively. We used the Ultrapro® mesh in all our patients. Smooth round silicone implants were used. The overall Major complications rate was 16.3%. 8 implants (5.7%) were lost within 6 months post-operatively while 2 implants were removed in the late post-operative period (after 6 months) one due to rupture and the other due to local recurrence.Capsular contracture Baker 3 and 4 was observed in 36 breasts (25%), 31 of them had post mastectomy radiotherapy treatment. 11 (7.8%) were managed by capsulotomies and re-insertion of the same implant.Radiotherapy was a significant risk factors for major complications and capsular contracture with p value of (0.01) and (0.0001) respectively.ConclusionDTI in properly selected patients offers excellent outcomes and patient satisfaction. The complication rate is low and improves with the experience of the surgeon. The Ultrapro® mesh is a safe, low-cost alternative to ADM or other synthetic meshes especially in low socioeconomic countries. Radiotherapy is a significant risk factor for major complications and capsular contractures.

Current status of autologous breast reconstruction in Argentina.

Although the most common procedure for breast reconstruction in Argentina is tissue expansion and implant devices, autologous tissue is frequently utilized. Deep inferior epigastric artery perforator flap (DIEP) is the gold standard for autologous breast reconstruction and, whenever possible, it is the first option. However, there are clinical or other circumstances, when a local or vicinity flaps for autologous reconstruction is preferred, even if exists a surgical and hospital facility for doing microsurgical procedures. The purpose of this manuscript is to describe our experience with the use of local and vicinity flaps for volume and surface replacement in different requirements-autologous breast reconstructions post oncologic resections, volume replacement in weight loss patients and implant-explantation cases. We have utilized the modification of latissimus dorsi musculocutaneous flap (LD) described by Hammond with excellent results and high patient satisfaction. Thoraco-dorsal artery perforator flap is indicated on skin sparing mastectomies (SSMs), immediate reconstruction of the nipple areolar complex and simultaneous coverage of an implant or tissue expander, in irradiated or to be irradiated patients. Lateral intercostal artery perforator (LICAP) flap has gained popularity because the unique position of the perforator at the lower lateral corner of the breast. It allows harvesting immediate vicinity tissue and easy rotation to the breast mound. We have used a modification towards the lateral thoracic wall of the anterior intercostal artery perforator flap for volume reconstruction after implant explantation.in patients who required volume preservation. Medial intercostal artery perforator flap is advantageous whenever the sub-mammary tissue can be used deepithelialized for volume reconstruction with a medial base. The same submammary area harvested as a medially based flap can be irrigated by the LICAP as a reverse LICAP flap that might be designed toward any direction from the piercing point of its perforator. The rest of the donor areas described for breast autologous reconstruction are rarely reported. When surgical facilities and adequate surgical teams are available, the lower abdominal wall is the main donor area, and DIEP, the most common technique utilized.

Auricular deformity correction with simultaneous reconstruction of the conchal bowl using autologous ear cartilage for “flat ear”: A novel surgical technique

Backgrounds"Flat ear" is a subtype of Grade II conchal-type microtia characterized by severely underdeveloped conchal bowl. Traditional surgical techniques often rely on autologous costal cartilage, which poses several risks and complications. This study aimed to introduce a novel surgical technique using autologous ear cartilage in auricular deformity correction surgery with simultaneous conchal bowl reconstruction for “flat ear”. MethodsA total of 19 patients were involved in this single-center, retrospective cohort study. All patients underwent the described surgical technique. The data before the surgery, immediately after the surgery, and at the last follow-up were collected, including length, width, perimeter of auricle and depth of conchal bowl. Patient satisfaction was assessed via the Visual Analog Scale (VAS). ResultsThe study included 12 males and 7 females, with an average age of 10.67 ± 3.86 years. Postoperative results showed significant improvements in auricular measurements, with the affected ear achieving near symmetry with the normal ear. The mean conchal bowl depth was restored from a preoperative 4.33±1.78mm to 17.32±1.28mm postoperatively. VAS scores for patient satisfaction increased significantly from 1.44±0.92 preoperatively to 7.72±1.49 postoperatively, with stability observed at the last follow-up. ConclusionThe novel technique offers a promising alternative to traditional costal cartilage-based auricular deformity correction surgery, providing excellent aesthetic outcomes and high patient satisfaction. This approach may expand treatment options for patients with "flat ear" and related auricular deformities, with reduced invasiveness and potential for future auditory rehabilitation.

WP5.9 - Emergency laparotomies in the elderly: a patient perspective

Abstract Aims Emergency laparotomy is known to convey worse morbidity and mortality for elderly patients. Despite a growing elderly population, there is a limited understanding of the patient experience in emergency laparotomy. This study aims to assess patient satisfaction following emergency laparotomy. Methods Patients were identified from the National Emergency Laparotomy Audit (NELA) database, who were aged 80 and above, and underwent surgery between: January 2020 and August 2023 at Torbay Hospital. Of the patients who survived to discharge, a telephone-based interview was undertaken in January 2024. Exclusion criteria included: confusion, severe illness and relook laparotomy. Data were collected on functional status and satisfaction with the procedure. Patients were also asked what they wished they known prior to the operation. Post-operative outcomes were assessed in a separate study. Results 132 cases were undertaken in this period. 72 cases met inclusion criteria. We achieved a 61% response rate. 59% of respondents were living independently post operatively and 61% had no functional decline. 93% of respondents were happy to have had the operation and if given the opportunity again would still have had the procedure. Patients were overall very happy with the information offered prior to the procedure, 7% felt they had no alternative option. One patient was not satisfied with the follow up received. Conclusions Although emergency laparotomy in the elderly is high risk, our data demonstrate excellent patient satisfaction. This study provides a better understanding of what is important to patients; this should be considered in the consent process and communication.

One-Year Results of Ear Reconstruction with 3D Printed Implants.

External ear reconstruction has been a challenging subject for plastic surgeons for decades. Popular methods using autologous costal cartilage or polyethylene still have their drawbacks. With the advance of three-dimensional (3D) printing technique, bioscaffold engineering using synthetic polymer draws attention as an alternative. This is a clinical trial of ear reconstruction using 3D printed scaffold, presented with clinical results after 1 year. From 2021 to 2022, five adult patients with unilateral microtia underwent two-staged total ear reconstruction using 3D printed implants. For each patient, a patient-specific 3D printed scaffold was designed and produced with polycaprolactone (PCL) based on computed tomography images, using fused deposition modeling. Computed tomography scan was obtained preoperatively, within 2 weeks following the surgery and after 1 year, to compare the volume of the normal side and the reconstructed ear. At 1-year visit, clinical photo was taken for scoring by two surgeons and patients themselves. All five patients had completely healed reconstructed ear at 1-year follow-up. On average, the volume of reconstructed ear was 161.54% of that of the normal side ear. In a range of 0 to 10, objective assessors gave scores 3 to 6, whereas patients gave scores 8 to 10. External ear reconstruction using 3D printed PCL implant showed durable, safe results reflected by excellent volume restoration and patient satisfaction at 1 year postoperatively. Further clinical follow-up with more cases and refinement of scaffold with advancing bioprinting technique is anticipated. The study's plan and results have been registered with the Clinical Research Information Service (CRIS No. 3-2019-0306) and the Ministry of Food and Drug Safety (MFDS No. 1182).

Hubungan Pelayanan Service Excellent dengan Tingkatkepuasan Pasien Ibu Bersalin di PMB Pera Kota Medan

The National Health System (SKN) states that the goal of health development is to achieve the ability to live healthily for every resident in order to realize an optimal level of health as one of the elements of general welfare, one of the efforts to achieve this goal is to carry out comprehensive, integrated and equitable health efforts that can be accepted and affordable by the entire community with the active role of the community, namely hospital referrals. Customer satisfaction can be increased by improving the quality of service, namely by using customer analysis including reliability, credibility, competence, tangible and responsiveness. This study aims to determine the Relationship between Service Excellent Midwifery Services and Patient Satisfaction of Maternity Mothers. The population in this study were all mothers giving birth at the Independent Practice of Midwives Pera. The number of samples in this study was taken by random sampling, totaling 63 people. The results obtained in this study from 63 respondents at the Independent Practice of Midwives Pera, Medan City in 2021 stated that service excellent Good towards Satisfaction of Maternity Mothers who were dissatisfied were 35 people (83%) and in service excellent Good towards satisfaction of satisfied mothers there were 7 people (17%). There is a Reability variable with good service with poor patient satisfaction of 34 people (83%) and good service with good patient satisfaction of 7 people (17%). There is a Credibility variable with good service with poor patient satisfaction of 18 people (53%) and good service with good patient satisfaction of 16 people (47%). There is a Competence variable with good service with poor patient satisfaction of 33 people (80%) and good service with good patient satisfaction of 8 people (19%). There is a Tangible variable with good service with poor patient satisfaction of 35 people (83%) and good service with good patient satisfaction of 7 people (17%). There is a Responsiveness variable with good service with poor patient satisfaction of 34 people (83%) and good service with good patient satisfaction of 7 people (17%).

Modern multiligament knee injury surgical reconstruction techniques can achieve excellent knee function and patient satisfaction, with low complication rates.

To report on the recovery of strength and functional capacity symmetry following multiligament knee surgical reconstruction (MLKR), as well as the capacity of athletes to return to sport. This prospective cohort study recruited 47 patients undergoing MLKR between February 2018 and July 2021. Forty patients had full outcome assessment postoperatively at 6, 12 and 24 months and were included in the analysis, 75% were knee dislocation one injuries and 60% were injured playing sport. Patient-reported outcome measures (PROMs) assessed included the International Knee Documentation Committee score, the Knee Outcome Survey, the Lysholm Knee Score and the Tegner Activity Scale (TAS). Patient satisfaction was also assessed. Objective assessment included assessment of active knee flexion and extension range of motion (ROM), the single (single horizontal hop for distance [SHD]) and triple (triple horizontal hop for distance [THD]) hop tests for distance and peak isokinetic knee flexor/extensor torque. All PROMs significantly improved (p < 0.001) from presurgery to 24 months postsurgery. At 24 months, 70% of patients were satisfied with their sports participation. Active knee flexion (p < 0.0001) and extension (p < 0.0001) ROM significantly improved over time, as did the limb symmetry indices (LSIs) for the SHD (p < 0.0001), THD (p < 0.0001), peak knee extensor (p < 0.0001) and flexor (p = 0.012) torque. While LSIs for the SHD, THD and knee flexor strength tended to plateau by 12 months, knee extensor strength continued to improve from 12 to 24 months. The majority of patients undergoing modern MLKR surgical techniques and rehabilitation can achieve excellent knee function, with low complication rates. Level IV.

A mixed-method review of the efficacy of a virtual fracture clinic: an 8-year follow up

Background: Virtual fracture clinics are well established methods of managing trauma patients safely and effectively. While they have been widely adopted, there is a lack of research on their longer-term implementation and success. Aims: This paper aimed to review factors that may influence the success of a virtual fracture clinic. Methods: Business analytics were used to calculate clinic discharge and return rates, as well as the reasons for them. Qualitative analysis was used to look at patient satisfaction with virtual consultations; data were extracted from two differing time points via telephone interviews. Results: The mean discharge rate across the 2014–2021 period was 28%. The largest discharge rate was seen in 2014 (43%) and the lowest was seen in 2021 (28%). Return rates to the emergency department at the two different time points were 2% and 0.9% respectively. Patient satisfaction was rated as ‘good’ or higher in all parameters at both time points. Discussion: This article describes the long-term success of a virtual fracture clinic. Results demonstrate excellent patient satisfaction coupled with the lowest return rates in the published literature. Discharge rates started extremely high and have declined with time. The factors for these results are discussed along with ideas for further prospective research.

WALANT office based endoscopic cubital tunnel release

Background: Cubital tunnel syndrome is a common condition caused by compression of the ulnar nerve around the medial elbow. Surgical treatment usually involves open in situ ulnar nerve decompression unless ulnar nerve instability is noted. Endoscopic techniques for cubital tunnel release have been developed and implemented with excellent patient and surgeon satisfaction. Endoscopic cubital tunnel release can be performed in an office based procedure room under wide awake local anesthesia no tourniquet principles. We present our setup and technique for performing an endoscopic cubital tunnel release procedure in an office based setting under local anesthesia. Methods: Local anesthesia is injected along the course of the ulnar nerve on the medial arm and forearm extending 10 cm proximal and distal to the medial epicondyle. After allowing approximately 30 min for appropriate vasoconstriction, the patient is placed in a supine position with the arm abducted and externally rotated position. The endoscopic cubital tunnel release is then performed. Discussion: Our described technique eliminates the need for placement of a prophylactic tourniquet and thereby the need for the procedure to be performed within an OR setting. It also utilizes a single-stage anesthetic administration, which facilitates ease of completion and performance in an office based setting. There is a significant cost savings when endoscopic cubital tunnel release is performed in an office-based procedure room compared to in the operating room. Conclusions: Office-based endoscopic cubital tunnel release can be safely performed utilizing WALANT techniques, leading to high patient satisfaction and decreased overall cost of care. Level of Evidence: Therapeutic IV

The Relationship of Culture-Based Primary Service with Patient Satisfaction in the Inpatition Room of Hospital X in Pontianak

The aim of this research is to analyze the relationship between culture-based excellent service and patient satisfaction in the inpatient room at Hospital X in Pontianak.The research uses quantitative descriptive methods with a cross-sectional study approach. The total sample is 86 respondents, the measuring instrument is a questionnaire of excellent service and customer satisfaction which was created by the author himself with validation results of calculated r values ranging from 0.40 to 0.887 and reliability of 0.944 and 0.956. The research results showed that almost all of the respondents said it was very good, 68 people or (79.07%), the level of patient satisfaction, the majority of respondents said it was very satisfied, 63 people or (73.26%), the results of the analysis of excellent service relationships based on Culture and patient satisfaction with the Spearman Rank obtained a SIG value = 0.000 (Sig &lt; 0.05), so it can be concluded that there is a very significant relationship between excellent service and patient satisfaction in the Inpatient Room at Hospital X in Pontianak. It is hoped that the results of this research can be used to improve excellent nursing service because of the importance of excellent nursing service in increasing the satisfaction of inpatients at Hospital X in Pontianak.

Effectiveness of traditional band and loop space maintainer vs 3D-printed space maintainer following the loss of primary teeth: a randomized clinical trial

This study evaluates the efficacy of 3D-printed band and loop space maintainers (3D-BLSMs) to mitigate concerns caused by early primary tooth loss in children when compared to their conventional equivalents. Over 9 months, 62 participants aged 6 to 12 years participated in a randomized clinical study. This study evaluated their failure rates (de-cementation, debonding, solder breakage, loop breakage, band breakage, and abutment tooth fracture), gingival health, and patient overall satisfaction. Random assignments were made to place the participants in two groups: traditional band and loop space maintainers or the 3D-BLSMs. The findings show that at 9 months, 3D-BLSMs provided significantly higher survival rates (77.4%) than conventional maintainers (51.6%, p < 0.01). Gum inflammation was mild in both groups, highlighting the need for good oral hygiene. In both groups, patient satisfaction exceeded 90%. Although there was some pain at first with 3D-BLSMs, this eventually subsided and aesthetic preferences disappeared. There were no negative consequences noted, and both groups needed ongoing dental treatment. In conclusion, with excellent patient satisfaction in both groups, 3D-printed space maintainers offer greater long-term durability in reducing dental concerns following early primary tooth loss.

The Health Arab Tourists’ Satisfaction Level of Services Provided: A Cross-sectional Study in Bangalore-Cross Sectional Study

Introduction: An indication of the quality of medical treatment is how satisfied patients are with the services received. Patient satisfaction is determined by how well they feel their care met their expectations. This survey was conducted in 2023 to assess how satisfied health tourists were with the services received from Bangalore Multispecialty hospitals. Method: It is a cross-sectional study was conducted from 21-3–2023 to 26-1-2023 at Multispecialty Hospital in Bangalore. : In this a cross-sectional study, 400 253 (63.2%) men and 147 (36.8%) women, the data collection instrument is a semi-structured questionnaire in this study. The respondents of this study are Arab tourists who received inpatient and outpatient services at least one day at hospitals. The hospitals were selected purposively but the potential respondents were chosen conveniently. These procedures ensure the researchers access a sufficient number of potential respondents from the hospitals for this study. Researchers of this study approached the respondents and requested they participate in this survey. The researchers informed participants that the information would be utilized only for research purposes and their support was anonymous and voluntary. The questionnaire has 56 general and specific items. Each of the specific items is scaled on five points; Very Good, Good, Moderate, Poor and very poor. In order to analyze the data both descriptive and inferential statistics were used Patient satisfaction and surgical outcomes were the main outcome measures. Results: 400 participants were included in the study (63.2% male and 36.85% Female). 79 of the surgeries were Neurosurgeries cases (19.8%) compared to 75 Oncology cases (18.8%). Regarding patient satisfaction, 96.8% of the patients regarding the quality of care. 66 % were satisfied with the hospital privacy and confidentiality measures. Conclusion: All of the Analyzed domains had excellent patient satisfaction rates, little problems, and successful surgical results in general. There is few things make patients unsatisfied like the waiting time for consultation so long, the method of payment in some hospital that there is limitation for cash payment ,and the language barrier the important factor play the major role.

Surgical and Biological Treatment with a Platelet-Rich Fibrin Matrix for Patellar Tendinopathy: Clinical Outcomes and Return to Sport at 2-Year Follow-Up.

Patellar tendinopathy (PT) involves anterior knee pain and functional. Platelet-rich fibrin matrix (PRFM) is a promising biological therapy for tendinopathies. We examined a cohort of PT patients treated with tendon debridement and autologous PRFM at the 24-month follow-up to assess whether the combined treatment facilitated return to sports and yielded satisfactory clinical and functional scores. Baseline and 24-month visual analogue scale (VAS), Victorian Institute of Sport Assessment Scale for Patellar Tendinopathy (VISA-P), Tegner Activity Scale (TAS), and Blazina scores were compared to evaluate treatment effectiveness. The Friedman test was used to compare repeated observations of VAS, VISA-P, TAS, and Blazina Score values. Return to sport rate, Tampa Scale of Kinesiophobia (TKS) score and patient satisfaction were collected at 24 months. The postoperative clinical scores demonstrated significant improvement compared with their preoperative values (all p < 0.001). Specifically, the VISA-P score was 80.32 (±20.58), 92.10% of patients had resumed sports activities and patient satisfaction was 9.21 (±1.21) at 24 months. Surgical debridement and autologous PRFM application in patients with chronic PT resulted in a higher rate of return to sports when compared to solely surgical treatment, significantly improved clinical outcomes and excellent patient satisfaction at 24 months.

Pengaruh Kualitas Pelayanan Terhadap Kepuasan Pasien Pada Instalasi Rawat Inap Rumah Sakit Umum Daerah Pandega Pangandaran

Overall patient satisfaction at the Pandega Hospital Inpatient Installation, Pangandaran Regency may be considered less than optimal in terms of suitability and consistency. Concerns regarding appropriateness arise from the lack of services provided by physicians and nurses in a timely and consistent manner. In particular, nurses were not adept at adequately explaining the necessary steps to patients. The level of patient satisfaction is influenced by the standard of service provided, and it is proven that Pandega Pangandaran Regional Hospital is still lagging behind in terms of reliability and responsiveness. The reliability of nurses is still lacking in providing comprehensive, thorough and fast services in accordance with the timeframe and responsiveness that has been determined, with nurses showing reluctance to handle patient complaints. This research was conducted using an explanatory survey method with quantitative methodology. The data analysis methodology used includes instrument testing to assess validity and reliability, research model testing using the coefficient of determination, and hypothesis testing using the t-test. The research results show that the level of service provided at the Pandega Pangandaran Hospital Inpatient Installation is of a high standard. Has the highest score on the empathy indicator and the lowest score on the responsiveness indicator. The level of patient satisfaction at the Pandega Pangandaran Hospital Inpatient Installation is quite high. Has the highest score on the aesthetic indicator and the lowest score on the suitability indicator. The research results found that service quality has a strong and beneficial influence on patient satisfaction at the Inpatient Installation of Pandega Pangandaran Regional Hospital. Thus, there is a direct relationship between the level of excellent service and patient satisfaction at the Pandega Pangandaran Hospital Inpatient Installation.

Distal biceps tendon repair using a double intracortical button anatomic footprint repair technique

Distal biceps tendon repair is usually performed via a double-incision or single-incision bicortical drilling technique. However, these techniques are associated with specific complications and usually do not allow for anatomic footprint restoration. It was the aim of this study to report the clinical results of a double intracortical button anatomic footprint repair technique for distal biceps tendon tears. We hypothesized that this technique would result in supination strength comparable to the uninjured side with a low rerupture rate and minimal bony or neurologic complications. This was a retrospective, single-surgeon cohort study of a consecutive series of 22 patients with a mean (standard deviation) age of 50.7 (9.4) years and at least 1-year follow-up after distal biceps tendon repair. At final follow-up, complications, range of motion (ROM), the Patient-rated Elbow Evaluation (PREE), Mayo Elbow Performance Score (MEPS), Disabilities of the Arm, Shoulder, and Hand (DASH) questionnaire, visual analog scale (VAS) for pain, patient satisfaction, and supination strength in neutral as well as 60° of supination were analyzed. Radiographic evaluation was performed on a computed tomography scan. One patient (4.5%) experienced slight paresthesia in the area of the lateral antebrachial cutaneous nerve. Heterotopic ossification was seen in 1 patient (4.5%). All patients recovered full ROM except for 1 who had 10° of loss of flexion and extension. Median PREE score was 4.6 (0-39.6), median MEP was 100 (70-100), and median DASH score was 1.4 (0-16.7). All but 1 patient were very satisfied with the outcome. The affected arm had a mean of 98% (±13%) of neutral supination strength (P=.633) and 94% (±12%) of supination strength in 60° (P=.054) compared with the contralateral, unaffected side. There were 4 cases (18.2%) of cortical thinning due to at least 1 button and 1 case of button pullout (4.5%). The double intracortical button anatomic footprint repair technique seems to provide reliable restoration of supination strength and excellent patient satisfaction while minimizing complications, particularly nerve damage and heterotopic ossification.

The "fascia taco" for nasal septum perforation closure-A retrospective Cohort study on success rates and patient reported outcomes.

Nasal septum perforation (NSP) is a common condition affecting ~1.2% of the general population and is still considered challenging to treat. Therapeutic strategies range from conservative local treatments and septal button closures to over 40 different surgical approaches. This study aimed to present a novel secure approach. We describe our novel and unique NSP closure approach using a "fascia taco," in which conchal cartilage is enveloped by temporalis fascia like a taco and splints are left in place for 6-8 weeks. A review of patient charts was conducted and questionnaires including the German-SNOT-22 and D-NOSE were sent by mail to all eligible patients who received a fascia taco between 2016 and 2021. Thirty-three patients were identified. The questionnaire response rate was 54.5%. The mean operative time (cut to sew) for all patients who only underwent NSP closure was 90.4 min. The overall success rate in terms of postoperative NSP closure was 81.8%. We found an apparent but nonsignificant association between closure failure and smoking (failure rate 66.6% in smokers vs. 15.4% in nonsmokers; X 2 = 3.4188, p = .064). Questionnaire analysis showed a significant postoperative reduction of mean values in D-NOSE from 60.8 to 33.1 (p = .009) and in German-SNOT-22 from 38.6 to 21.2 (p = .005). The fascia taco technique is an easy-to-apply, safe procedure for NSP closure that is short in duration and associated with a low morbidity, resulting in excellent patient satisfaction. 4.

Patient-Reported Outcome Measures in Cataract Surgery

Abstract Purpose: To assess the patient-reported outcome measures and health-related quality of life in cataract patients after their cataract surgery. Method: A prospective observational pilot study was conducted on 197 patients with cataract who underwent phacoemulsification cataract surgery in an urban-based eye care hospital. Result: Out of 197 patients, 110 patients fulfilled the inclusion criteria of the study. In our study, we chose Catquest-9SF as our parent questionnaire and made a few modifications in it based on the livelihood of our patients. The patient satisfaction percentage with reference to improvement in vision after cataract surgery with intraocular lens (IOL) implantation in our study was 87%. A total of 96% of the patients who had multifocal/trifocal IOL implantation were completely satisfied with the cataract surgery. Conclusion: Due to improvement in life expectancy of elderly patients and increased usage of gadgets by them, spectacle independence and functional improvement have become their requirements. With standardised techniques, expertise and experience with the right use of advanced equipment and appropriate IOLs, we were able to get excellent results and complete patient satisfaction by knowing their lifestyle and requirement. Patient-reported outcome measures helped us in improving the vision and health-related quality of life after cataract surgery.

Preoperative factors associated with patient satisfaction after modified kinematically aligned total knee arthroplasty in varus knees

PurposeKinematically aligned-total knee arthroplasty (KA-TKA) has recently attracted significant interest because it delivers better clinical outcomes than mechanically aligned (MA)-TKA. However, the optimal preoperative factors that maximize the effectiveness of KA-TKA remain controversial. Therefore, we aimed to determine the preoperative factors that are appropriate for and might benefit from modified KA-TKA, based on patient-reported outcome measures (PROMs). MethodsThe relationships between postoperative satisfaction and other variables in 84 patients with varus-type osteoarthritis of the knee who underwent primary modified KA-TKAs were investigated using stepwise multiple regression analysis. Patients were assigned to groups that were satisfied or dissatisfied with their outcomes after KA-TKA according to the 2011 Knee Society Scores. The cutoff for preoperative advanced activities scores (AASs) for excellent satisfaction were determined by analyzing receiver operating characteristic (ROC) curves. The variables correlated with excellent satisfaction were identified using logistic regression models. ResultsA preoperative variable relevant to patient satisfaction was AAS (β ​= ​0.465). The results of the ROC curve analysis revealed eight optimal cut-offs for preoperative AASs that predicted excellent satisfaction, with a sensitivity and specificity of 0.700 and 0.625, respectively. Logistic regression analysis revealed that AASs significantly contributed to excellent patient satisfaction (odds ratio, 1.181; p ​= ​0.001). ConclusionsIndividuals who were highly active preoperatively were good candidates for KA-TKA. This modified kinematically aligned surgical technique can satisfy the demands of highly active patients.