Patients In Terms Of Pain Research Articles

Effects of a new magnetostrictive ultrasonic scaler and a traditional piezoelectric ultrasonic scaler on root surfaces and patient complaints

Tooth wear and pain are the primary concerns of patients undergoing periodontal scaling. The aims of this study were to compare the effects of a new magnetostrictive ultrasonic scaler and a traditional piezoelectric ultrasonic scaler on tooth surface roughness and calculus removal and to determine their impacts on patient discomfort during supragingival cleaning. This article had two parts: an in vitro study and a clinical study. In the in vitro study, thirty teeth with subgingival calculus were randomly assigned to two scaling treatment groups: magnetostrictive scalers (n = 15) and piezoelectric scalers (n = 15). Surface roughness measurements were taken at baseline and after scaling, and the root samples were visualised by SEM after scaling. Additionally, a single-centre randomised split-mouth clinical trial was conducted. Eighty-five participants diagnosed with chronic gingivitis or periodontitis were randomly assigned to receive supragingival scaling. The magnetostrictive scaler was used in half of the mouths (n = 85), and the piezoelectric scaler was used in the other half of the mouths (n = 85). Data on pain, noise, and vibration were collected using a VAS questionnaire, and the operating time was recorded. In both in vitro and clinical studies, magnetostrictive scalers were reported to be more effective than piezoelectric scalers in removing dental deposits (P < 0.05). Additionally, the root surface after scaling with the magnetostrictive scaler was smoother than that after scaling with the piezoelectric scaler in the in vitro study (P = 0.02). SEM examination also revealed that fewer dental materials were lost after instrumentation with the magnetostrictive scaler than after instrumentation with the piezoelectric scaler. Piezoelectric scalers caused less discomfort to patients in terms of pain, noise, and vibration than magnetostrictive scalers (P < 0.05). According to this clinical study, the magnetostrictive scaler caused more discomfort during supragingival scaling than the piezoelectric scaler. Moreover, the magnetostrictive scaler was also more efficient and produced a smoother root surface with less material loss after scaling than the piezoelectric scaler, as demonstrated in the in vitro study.

Economic Implications of Endometriosis: A Review.

Endometriosis is a chronic inflammatory disease that can have serious physical and emotional consequences for patients in terms of pain, quality of life, and infertility. Despite affecting about 10% of women, the pathophysiology and economic impact of the disease are not fully understood. This study aimed to review and summarize research articles quantifying the direct and indirect costs of endometriosis in the context of current national and international treatment guidelines. A search including the terms 'endometriosis' AND 'costs' OR 'cost of illness' OR 'cost analysis' OR 'economic burden' was performed, focusing on studies published between January 2000 and May 2022. Total costs, costs of primary and secondary care, productivity losses, and indirect costs were reported. The medical costs of endometriosis were principally registered in secondary care settings, where surgery was the main cost driver. There was considerable variability of populations and study settings, with the overall direct medical cost range of endometriosis from US$1459 to US$20,239 (2022) per patient per year. An increasing trend has been reported in secondary care costs over time; however, not enough data were available at this time to evaluate inpatient and outpatient costs versus treatment strategies. Similarly, further research is required to evaluate the costs and potential savings associated with new therapies. Numerous studies have evaluated the indirect costs of endometriosis in recent years, finding costs between US$4572 and US$14,079 (2022). Currently, limited data are available on the economic burden of the disease at the patient level.

Sex and gender determinants following spinal fusion surgery: A systematic review of clinical data.

In the last decade, numerous studies analyzed and described the surgical outcomes in male and female patients submitted to orthopedic surgery. Although this, the impact of sex/gender on spinal fusion surgery clinical outcomes is still poorly defined. This review systematically maps and synthesizes the scientific literature on sex/gender differences in postoperative outcomes for patients undergoing spinal fusion surgery. The search was performed in PubMed, Scopus, and Web of Science in the last 22 years. Clinical studies evaluating potential sex/gender differences in postoperative outcomes and/or complications, as primary or secondary aim, were included and analyzed. Out of the 1,885 records screened, 47 studies were included. These studies comprised a total of 1,158,555 patients (51.31% female; 48.69% male). About 77% of the analyzed studies reported sex/gender-related differences in postoperative outcomes. Most studies treated patients for lumbar degenerative diseases and more than 55% of them reported a worse postoperative outcome in female patients in terms of pain, disability, health-related quality of life questionnaires, and complications. Differently, a significant heterogeneity across studies on patients treated for cervical and sacral degenerative diseases as well as for spinal deformity and traumatic spinal fracture prevented the understanding of specific sex/gender differences after spinal fusion surgery. Despite this, the present review highlighted those female patients treated for lumbar degenerative spine diseases could require more clinical awareness during postoperative care. The understanding of how sex/gender differences can really affect clinical outcomes after spinal fusion surgeries is mandatory for all spinal pathological conditions to drive clinical research toward oriented and personalized protocols.

Total Diz Protezi Olan Hastalarda Video-Temelli Eğitim Programının Ağrı, Fiziksel Fonksiyon ve Yaşam Kalitesi Üzerine Etkileri

This study aimed to examine the effects of a video-based education program on pain, physical function, and quality of life in patients with total knee replacement and to explore their perceptions of the intervention. In this study, mixed methods were used. The intervention group (n= 40) patients were given the Video Based Education Program, whereas control group patients were given usual care (n=43). Data were evaluated using the WOMAC Index and Short Form-36 Health Survey. Data were collected at the postoperative sixth week and third month. After the quasi-experimental study data were collected, eleven patients were interviewed by in-depth interview method. While statistically significant differences were determined among patients in terms of pain, physical functioning, physical role, social functioning, emotional role, and mental component summary (p&amp;lt;0.05), no significant differences were determined in terms of stiffness, general health, vitality, and physical component summary (p&amp;gt;0.05). Five themes were identified after qualitative analyses. The video education seems to positively affect the participants’ pain, physical function, and quality of life. Because patients have difficulty in remembering information and need support in applying the taught information, it may be recommended that the education is given to the patients be visual and interactive during the perioperative process.

A quality improvement programme to reduce hospital-acquired pressure injuries

BackgroundAt Heart Hospital in Doha, Qatar (HH), 127 pressure injuries (PI) were identified in 2014, corresponding to an incidence of 6.1/1000 patient-days in first 4 months of 2014. Hospital-acquired pressure...

Partial Capitate with/without Hamate Osteotomy in the Treatment of Kienböck's Disease: Influence of the Stage of the Disease on the Midterm Outcome.

Objective Moritomo et al introduced partial capitate osteotomy as a treatment modality for early stages of Kienböck's disease. This technique maintains articular contact between the capitate and the scaphoid. We added hamate-shortening osteotomy in addition to partial capitate shortening in cases of lunate type II. The purpose of this study was to evaluate intermediate-term results of partial capitate shortening, investigate the influence of the stage of the disease on the outcome, and assess the clinical and radiological outcomes of adding hamate osteotomy in cases of type II lunate. Patients and Methods A total of 17 consecutive patients (3 women, 14 men) with early stages of Kienböck's disease were prospectively reviewed using the aforementioned technique. Eight patients were in stage II and nine patients were in stage IIIA according to the Lichtman classification system. Clinical outcome measures included pain visual analog score, grip strength and range of motion as a percentage of the unaffected side, and assessment using the Patient-Rated Hand and Wrist Evaluation (PRHWE) and the modified Wrightington Hospital Wrist Score (MWHWS). Radiological outcome measures included healing of the osteotomy site, Stahl index, radioscaphoid angle, and progression of the disease. Results Follow-up period averaged 72 months. All cases of isolated capitate osteotomy and combined capitate and hamate osteotomies united fully. Clinical results revealed significant improvement in pain, grip strength and extension, and PRHWE and MWHWS values. Wrist flexion did not change postoperatively. Patients with stage II showed better overall results and significant MWHWS improvement. Conclusion At the intermediate term, partial capitate with/without hamate shortening is an effective modality for the treatment of patients with early stage Kienböck's disease. Stage II patients showed better results than stage IIIA patients in terms of pain, flexion, grip, PRHWE, and MWHWS. Adding hamate osteotomy may improve the functional results for type II lunate; however, a larger sample is needed to elicit statistical significance. Level of Evidence This is a Level IV, therapeutic study.

The IL-23/IL-17 pathway in human chronic inflammatory diseases – new insight from genetics and targeted therapies

Chronic inflammatory diseases such as rheumatoid arthritis, inflammatory bowel disease, spondyloarthritis and psoriasis cause significant morbidity and are a considerable burden for the patients in terms of pain, impaired function and diminished quality of life, as well as for society, because of the associated high health-care costs, and loss of productivity. Our limited understanding of the pathogenic mechanisms involved in these diseases currently hinders early diagnosis and the development of more specific and effective therapies.The past years have been marked by considerable progress in our insight of the genetic basis of many diseases. In particular, genome-wide association studies (GWAS) performed with thousands of patients have provided detailed information about the genetic variants associated with a large number of chronic inflammatory diseases. These studies have brought to the forefront many genes linked to signaling pathways that were not previously known to be involved in pathogenesis, pointing to new directions in the study of disease mechanisms. GWAS also provided fundamental evidence for a key role of the immune system in the pathogenesis of these diseases, because many of the identified loci map to genes involved in different immune processes. However, the mechanisms by which disease-associated genetic variants act on disease development and the targeted cell populations remain poorly understood. The challenge of the post-GWAS era is to understand how these variants affect pathogenesis, to allow translation of genetic data into better diagnostics and innovative treatment strategies.Here, we review recent results that document the importance of the IL-23/IL-17 pathway for the pathogenesis of several chronic inflammatory diseases and summarize data that demonstrate how therapeutic targeting of this pathway can benefit affected patients.

The IL-23/IL-17 pathway in human chronic inflammatory diseases-new insight from genetics and targeted therapies.

Chronic inflammatory diseases such as rheumatoid arthritis, inflammatory bowel disease, spondyloarthritis, and psoriasis cause significant morbidity and are a considerable burden for the patients in terms of pain, impaired function, and diminished quality of life, as well as for society, because of the associated high health-care costs and loss of productivity. Our limited understanding of the pathogenic mechanisms involved in these diseases currently hinders early diagnosis and the development of more specific and effective therapies. The past years have been marked by considerable progress in our insight of the genetic basis of many diseases. In particular, genome-wide association studies (GWAS) performed with thousands of patients have provided detailed information about the genetic variants associated with a large number of chronic inflammatory diseases. These studies have brought to the forefront many genes linked to signaling pathways that were not previously known to be involved in pathogenesis, pointing to new directions in the study of disease mechanisms. GWAS also provided fundamental evidence for a key role of the immune system in the pathogenesis of these diseases, because many of the identified loci map to genes involved in different immune processes. However, the mechanisms by which disease-associated genetic variants act on disease development and the targeted cell populations remain poorly understood. The challenge of the post-GWAS era is to understand how these variants affect pathogenesis, to allow translation of genetic data into better diagnostics and innovative treatment strategies. Here, we review recent results that document the importance of the IL-23/IL-17 pathway for the pathogenesis of several chronic inflammatory diseases and summarize data that demonstrate how therapeutic targeting of this pathway can benefit affected patients.

Physiotherapy treatment for atraumatic recurrent shoulder instability: Updated results of the Derby Shoulder Instability Rehabilitation Programme

BackgroundThere is limited evidence to guide therapists in the management of patients with atraumatic shoulder instability however physiotherapy remains the recommended course of treatment. In this paper we report the updated results of a rehabilitation programme designed for this patient group. MethodA service evaluation was conducted at a large university teaching hospital in the UK between August 2013 and September 2018 including patients with atraumatic Stanmore type 2 or 3 instability. Western Ontario Shoulder Index (WOSI) and Oxford Instability Shoulder Scores (OISS) were measured at baseline and final follow-up. OISS was also repeated at every clinic visit. Patients were treated using the Derby Shoulder Instability Rehabilitation Programme until a point of agreed discharge. Results66 patients were included but 15 were lost to follow-up. Patients attended for a mean of 6.9 sessions over 30 weeks. The mean OISS (n = 51) improved from 38.00 to 21.96 (p < 0.001). Including patients that did not complete follow-up in a sensitivity analysis, the mean OISS (n = 63) improved from 38.41 to 24.46 (p < 0.001). The mean WOSI (n = 51) improved from 45.10% to 85.81% (p < 0.001). In terms of the four WOSI sub-groups: the ‘Physical’ domain improved from mean 47.98%–81.19% (p < 0.001), the ‘Sport & Work’ domain improved from mean 40.17%–82.00% (p < 0.001), the ‘Lifestyle’ domain improved from 50.73% to 83.45% (p < 0.001) and the ‘Emotions’ domain improved from 32.84% to 79.78% (p < 0.001). ConclusionFor patients with atraumatic shoulder instability the Derby Shoulder Instability Rehabilitation Programme provides significant benefit to patients in terms of pain, stability and function. Further study is required to assess whether such improvements can be sustained in the medium and long terms.

Effects of eccentric control exercise for wrist extensor and shoulder stabilization exercise on the pain and functions of tennis elbow.

[Purpose] This study aimed to conduct experiments to examine the effects of wrist eccentric control exercise or shoulder stabilization exercises after a basic direct treatment of the elbow in the treatment of tennis elbow patients in terms of pain and grip strength. [Subjects and Methods] The subjects were divided into two groups: one group conducted wrist eccentric control exercise and was comprised of 5 male and 4 female subjects, and the other group received shoulder stabilization exercise and was comprised of 5 male and 4 female subjects. [Results] In the intragroup comparison, both groups showed a significant decrease in pain level and a significant increase in the measurement of the tenderness thresholds of the upper trapezius muscle, lateral epicondyle, and grip strength. In the intergroup comparison, the shoulder stabilization exercise group showed a significantly greater increase in the measurement of the tenderness thresholds of the upper trapezius muscle and grip strength, and the differences were not significant in the pain level and tenderness threshold of the lateral epicondyle. [Conclusion] Wrist eccentric control exercise and shoulder stabilization exercises can be useful as intervention methods for relief from pain due to lateral epicondylitis and for the improvement of functions impaired by tennis elbow.

Knee Flexion Contractures are Associated with Worse Pain, Stiffness and Function in Patients with Knee Osteoarthritis: Data from the Osteoarthritis Initiative

Background: Patients with, or at risk of developing knee osteoarthritis (OA) can acquire the complication of a knee flexion contracture (FC). The prevalence of knee FCs, their severity, and their impact on patients in terms of pain, stiffness and function is unknown. We examined if the presence and severity of knee FC affected these outcomes in patients with, or at risk of, developing knee OA. Methods: Cross-sectional study using the Osteoarthritis Initiative (OAI), a multicenter, prospective cohort of 4,796 participants aged 45 to 79 divided into 3 subcohorts: those with radiographically-established knee OA (n=1390), those at risk of developing knee OA (n=3284), and low-risk non-OA controls (n=122). At study enrollment, knee range of motion was used to categorize FCs as none, mild, moderate or severe. Pain was evaluated using the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) pain subscale and the numeric rating scale (NRS). Stiffness was evaluated using the WOMAC stiffness subscale. Function was evaluated using the WOMAC function subscale and 400-meter walk time. Findings: Participants with FC reported worse knee pain, stiffness and function (all p<0.001). Participants with knee OA had worse FC severity-dependent pain, stiffness and function versus those at risk of OA (all p<0.05 for statistical interaction with knee FC severity). Knee FC was associated in a severity-dependent manner with worse WOMAC pain (p<0.001), WOMAC stiffness (p<0.001), and 400-meter completion time (p<0.001) after correcting for subcohort, demographic factors and radiographic severity. Interpretation: Flexion contractures were associated with worse pain, stiffness, and function in people with, or at risk of, knee OA. Flexion contractures may constitute a marker of knee disease severity. Measuring extension should be a routine component of the clinical assessment of the knee joint. Addressing this gap in clinical care may lead to better patient outcomes throughout the spectrum of knee OA. Funding Statement: Funding was provided by the Bruyere Academic Medical Organization Innovation Fund. The funding source had no influence on data analysis, manuscript generation, submission, or any other portion of this report. Declaration of Interests: None declared by the authors. Ethics Approval Statement: The Osteoarthritis Initiative Project was approved by the Institutional Review Board at the OAI Coordinating Center, the University of California at San Francisco.

Prospective study on clinical outcomes of lichtensteins tension free inguinal hernioplasty under local anaesthesia

Background: Hernia may be generally defined as a protrusion of viscus or part of a viscus though an abnormal opening in the walls of its containing cavity. The Greek word ‘hernia’ means an offshoot, a budding or bulge. But the Latin word ‘hernia’ means a rupture or tear. The most important principle in reconstruction surgery is to avoid tension when restoring the muscular or elastic structures. The modern biologically based concept for repair of groin hernia, acquired during adult life, is application of a patch, avoidance of tension and use of local, spinal or epidermal anaesthesia.Methods: Present study is a Prospective study conducted in the Department of General Surgery in Sri Guru Ramdas Medical College and Hospital. Patients admitted in wards with inguinal hernia from General Surgery out-patient Department were selected for study. The study consisted of 60 patients between 15 to 74 years; The study period is from April 2015 to September 2016. The main aim and objective of any hernia repair is to avoid any recurrence and also acceptability to the patient in terms of pain, discomfort, other complications during follow up and obviously in terms of cost- effectiveness of repair.Results: The present study comprises 60 cases of inguinal hernia who were admitted in the wards of Department of General Surgery in the Sri Guru Ramdas Institute of Medical sciences and research. The study was carried out during span of 1½ years. All of these cases were studied prospectively and results were analysed from various angles. Among total 60 cases in this study, maximum cases belonged to age group 35-44 years ;15 (25%) and minimum to age group 65-74 years 5 (8.3%). Case distribution as per type of hernia, it was observed that among total 60 cases 34 (56.67%)had inguinal hernia and rest 26 (43.3%) had inguino scrotal hernia. Most 0f the cases had right sided hernia 35 (58.33%), left sided hernia was seen only in 23 cases (38.33%) whereas bilateral hernia was present in 2 (3.33%).Conclusions: From our results of observations in the study we can conclude that-The methods of Lichtenstein’s tension free inguinal hernioplasty under local anaesthesia is safe, simple, effective, economical, and without any side effects such as hypotension, nausea, vomiting, urinary retention, and spinal headache.

The spine instability neoplastic score (SINS) in the assessment of response to radiotherapy for bone metastases.

Vertebral metastases are often causing pain and spine instability. Radiotherapy is of significant benefit for painful spine metastases but the response can be very variable. The spine instability neoplastic score (SINS) is a recent classification system for diagnosis of spinal instability caused by vertebral metastases. We analysed the degree of pain relief, the need of drug therapy and the imaging features and the SINS before and after radiotherapy. In particular, we investigated the possible correlation of spine instability defined by pre-treatment SINS with pretreatment pain and with response to radiotherapy. This study included 121 patients with spine metastases treated with palliative 3D conformal radiotherapy. Pain "at rest" and "breakthrough pain", need for drug therapy in terms of "anti-inflammatory", "weak opioid", "strong opioid", imaging studies and SINS were assessed before and after radiotherapy. Statistical analysis was performed by the correlation coefficient of Spearman and Kruskal-Wallis test. Pain relief after radiotherapy was observed in 50.4 and 57.8% of patients in terms of pain at rest and breakthrough pain, respectively. The correlation between pain before radiotherapy and SINS was not statistically significant for both pain at rest (p=0.4) and breakthrough pain (p=0.49). The correlation between pain response after radiotherapy and SINS was statistically significant for both pain at rest (p=0.007) and breakthrough pain (p=0.047). The degree of instability, classified according to SINS, resulted to be predictive factor for pain response after radiotherapy. SINS might become a valid tool to identify those patients who can benefit the most from radiotherapy.

1793 - The spine instability neoplastic score (SINS) in the assessment of response to radiotherapy for bone metastases

Vertebral metastases are often causing pain and spine instability. Radiotherapy is of significant benefit for painful spine metastases but the response can be very variable. The spine instability neoplastic score (SINS) is a recent classification system for diagnosis of spinal instability caused by vertebral metastases. We analysed the degree of pain relief, the need of drug therapy and the imaging features and the SINS before and after radiotherapy. In particular, we investigated the possible correlation of spine instability defined by pre-treatment SINS with pretreatment pain and with response to radiotherapy. This study included 121 patients with spine metastases treated with palliative 3D conformal radiotherapy. Pain “at rest” and “breakthrough pain”, need for drug therapy in terms of “anti-inflammatory”, “weak opioid”, “strong opioid”, imaging studies and SINS were assessed before and after radiotherapy. Statistical analysis was performed by the correlation coefficient of Spearman and Kruskal–Wallis test. Pain relief after radiotherapy was observed in 50.4 and 57.8% of patients in terms of pain at rest and breakthrough pain, respectively. The correlation between pain before radiotherapy and SINS was not statistically significant for both pain at rest (p = 0.4) and breakthrough pain (p = 0.49). The correlation between pain response after radiotherapy and SINS was statistically significant for both pain at rest (p = 0.007) and breakthrough pain (p = 0.047). The degree of instability, classified according to SINS, resulted to be predictive factor for pain response after radiotherapy. SINS might become a valid tool to identify those patients who can benefit the most from radiotherapy.

Identifying fibromyalgia subgroups using cluster analysis: Relationships with clinical variables.

Patients with fibromyalgia (FM) exhibit significant clinical heterogeneity, in terms of physical, social and psychological functions, as well as therapeutic responses. Here, we examined FM patients in terms of pain, physical, social and psychological variables to identify clinical subgroups that may be predictive of treatment patterns. A total of 313 FM patients were interviewed using a structured questionnaire that included sociodemographic data, current or past FM symptoms and current use of relevant medications. A K-means cluster analysis was conducted using variables reflecting tender points, the Fibromyalgia Impact Questionnaire, Beck Depression Inventory, State-Trait Anxiety Inventor and Social Support Scale. Four distinct clusters were identified in these patients. Group 1 was characterized by high pain levels, severe physical and mental impairment and low social support. Group 2 had moderate pain and physical impairment, mild mental impairment and moderate social support. Group 3 had moderate pain, low physical and moderate mental impairment and low social support. Group 4 had low pain levels, nearly normal physical and mental function and high social support. Group 1 was more often a current or past smoker, more likely to have a variety of symptoms, including swelling, cognitive dysfunction, dizziness, syncope, oesophageal dysmotility, dyspepsia, irritable bladder, vulvodynia and restless leg syndrome. We identified four subgroups of FM patients based on pain, physical, social and psychological function. These subgroups had different clinical symptoms and medication profiles, suggesting that FM may be better managed using a more comprehensive assessment of an individual patient's symptoms. FM patients can be clustered into four distinct subgroups based on clinically measurable variables - pain, physical involvement, psychological function and social support. These subgroups had different clinical symptoms and medication profiles.

Reoperative surgery for persistent anal fistulae

Failure of treatment of a primary anal fistula is rarely life threatening, but the cost to the patient in terms of pain, discomfort, and interruption of daily life is substantial. Complex or recurrent fistulas must be methodically evaluated so a successful treatment strategy can be developed, and therapy completed, ideally without compromising fecal continence. Advanced imaging can be useful in identifying complex tracts and accumulated sepsis but is rarely indicated in the setting of a primary fistula. Multiple methods to repair complex, recurrent fistulas have been described with varying success rates. Diversion of the fecal stream is often employed after repeat repair of a fistula but is not universally beneficial. Treatment must be individualized according to pre-existing patient factors, number of internal openings, and condition of the tissues in and around the anus.

Treatment of non-healing leg ulcers with honeydew honey

BackgroundHoney is used as a traditional medicine for centuries by different cultures for the treatment of various disorders. However, not all honeys exhibit equal antimicrobial potency and only a few meet the criteria for clinical usage. AimThe aim of the study was to determine clinical efficacy of sterilised honeydew honey in the treatment of the lower leg ulcers in 25 patients. Furthermore, we evaluated honey acceptability of patients in terms of pain and overall satisfaction. MethodologyA total of 25 patients with chronic venous leg ulcers were recruited into this study. The 100% γ-irradiated sterile honeydew honey was applied onto the cleaned wounds and each wound was assessed at the least two times in for a period of 6 weeks. ResultsDuring the course of treatment, the average wound area of all patients decreased significantly from 51 (3–150) to 22 (0–91) cm2. Eighteen patients (72%) experienced a decrease in reported pain levels while five patients (20%) experienced the same level of pain throughout the study. The overall satisfaction with honey treatment was positive in 80% of patients. Only two patients experienced poor tolerance due to problems at ulcer site related to pain. ConclusionBased on these findings, honeydew honey has the potential to be one of the medical-grade honeys.

AB0881 Quality of life determines sick leave in ankylosing spondylitis

BackgroundAnkylosing Spondylitis (AS), adversely affect patients in terms of pain, function, and quality of life. AS have a significant influence on individual employment status and work-related productivity, in addition to...

SAT0375 Chronic low back pain in osteoporotic females with rheumatoid arthritis a randomized clinical trial

BackgroundChronic low back pain (LBP) is one of the most common symptom in osteoporosis rheumatoid arthritis patients leading to complex disability (1). Various therapeutic approaches (range-of-motion exercises and exercise programs)...

Metalwork removal in elective foot and ankle practice: Does it make any difference to the patient?

BackgroundIncreasing use of metalwork in foot and ankle surgery has led to an increasing number of subsequent surgeries for metalwork removal. The aim of the current study was to determine whether removing metalwork from foot and ankle makes any difference to the patients in terms of pain, function or shoe wear related outcomes. Methods27 consecutive patients were identified from a single surgeon database that had undergone metalwork removal over a four year period and sent out a validated Visual Analogue Scale-Foot and Ankle questionnaire. Additional demographic and radiographic data were collected. Results24 patients returned completed questionnaires. Mean interval between index procedure and metalwork removal was 18months. Overall for the whole group, only moderate satisfaction was noted after metalwork removal with mean VAS-FA scores of 60.39. The mean VAS-FA scores and the pain, function and other complaints sub-scores were significantly better in patients who had metalwork removal after 1st ray surgery (p=0.07 for total VAS-FA score and p=0.006, p=0.005, and p=0.032 for pain, function and other complaints sub-scores respectively). ConclusionWe can recommend removal of metalwork in symptomatic patients after 1st ray surgeries but other foot and ankle surgeries require further investigation.