bluuebunny/crossref_metadata_2025_split huggingface dataset:
Comparison of above-the-knee prosthetic femoro-popliteal bypass versus percutaneous transluminal angioplasty and stenting for treatment of occlusive superficial femoral artery disease
Authors: Linnakoski H. , Uurto I. , Suominen V. , Vakhitov D. , Salenius J. 
Published: September 2013

Background and Aims: Treatment of occlusive femoro-popliteal artery disease has changed during the last decade because of intensive development of endovascular technology. The aim of this study was to evaluate patient treated endovascularly or surgically for femoro-popliteal atherosclerotic lesions and to assess perioperative and mid-term outcome. Material and Methods: This is a retrospective analysis of consecutive patients who had undergone prosthetic above-the-knee femoro-popliteal bypass or percutaneous transluminal angioplasty and stenting of superficial femoral artery stenosis or occlusion at Tampere University Hospital, Finland, between January 2007 and December 2009. Patients who were alive were re-evaluated in 2010. Primary and secondary patency and outcomes were assessed. Results: A total of 131 patients were treated; surgically 63 patients (69 procedures) and endovascularly 68 patients (74 procedures). The mean follow-up time was 17 months (SD ± 13 months). In the late follow-up visit, 8 (18%) patients in the bypass group suffered from claudication and 9 (20%) from critical limb ischemia. The corresponding figures for the endovascular group were 20 (36%) and 8 (20%), respectively. The primary patency was 60% at 2 years in the bypass group and 73% in the endovascular group (p = 0.092); the primary assisted patency was 62% versus 76%, respectively (p = 0.068). The secondary patency was 74% in the bypass group versus 79% in the endovascular group (p = 0.487). Conclusions: According to current results following TASC II guideline, satisfied overall mid-term results can be achieved in the treatment of superficial femoral artery atherosclerotic disease.
Coinfection with Hepatitis C Virus among HIV-Positive People in the Kathmandu Valley, Nepal
Authors: Poudel Krishna C. , Palmer Paula H. , Jimba Masamine , Mizoue Tetsuya , Kobayashi Jun , Poudel-Tandukar Kalpana 
Published: September 2013

Background: Previous research has studied the rate of hepatitis C virus (HCV) coinfection among HIV-positive people regardless of their antiretroviral therapy (ART) status. Our objectives were to measure the seroprevalence of HCV both in HIV-positive people receiving ART and in those not receiving ART and to describe the characteristics of coinfected people in the Kathmandu Valley, Nepal. Methods: We conducted a cross-sectional survey of 319 HIV-positive people residing in the Kathmandu Valley, Nepal. We screened the participants’ serum samples for HCV antibodies using the Latex Photometric Immunoassay based on third-generation assay. Results: A total of 138 (43.3%) participants were HCV positive. The prevalence of HCV coinfection was 96.2% (125 of 130) among participants with lifetime injection drug use (IDU). Among participants not receiving ART, the coinfection rate was 58.1% (50 of 86) compared with 37.8% (88 of 233) among those receiving ART. In multivariable analysis, participants who reported lifetime IDU and were current smokers were more likely to have HCV coinfection. The adjusted odds ratio (AOR) of HCV coinfection for ART was decreased, although it was not statistically significant (AOR = 0.45; 95% confidence interval = 0.13-1.48). Conclusion: The high prevalence of HCV coinfection among both individuals receiving ART and those not receiving ART suggests that screening for HCV among HIV-positive people would be useful, in particular, for those with lifetime IDU and soon after their HIV diagnosis.
Mucocutaneous Disorders of Pediatric HIV in South West Nigeria
Authors: Katibi Oludolapo Sherifat , Ogunbiyi Adebola O. , Oladokun Regina E. , Ernest Samuel K. , Osinusi Kikelomo , Brown Biobele J. , Adedoyin Olanrewaju T. , Ojuawo Ayodele I. 
Published: September 2013

Objectives: Nigeria has the world’s highest burden of pediatric HIV. In the face of paucity of monitoring tests in Nigeria, we studied the spectrum of pediatric mucocutaneous manifestations and evaluated their clinical utility as surrogate markers for immunodeficiency and plasma viral load levels. Methods: Cross-sectional study comparing mucocutaneous manifestations in 155 HIV-positive children aged 12 weeks to 14 years with 155 HIV-negative children. Relationships between mucocutaneous manifestations in HIV-infected patients and their immunologic and virologic indices were analyzed. Results: Mucocutaneous lesions were seen in 53.5% of HIV-infected children compared with 18.1% of the controls. Prevalence of lesions increased with worsening levels of immunodeficiency and increasing viral loads ( P < .01). Oral candidiasis, angular stomatitis, and fluffy hair were associated with more severe degrees of immunodeficiency. Conclusion: Mucocutaneous disorders are common in HIV-infected children. Oral candidiasis and nutritional dermatoses can be used as surrogates for advanced or severe immunodeficiency.
Three-Dimensional Gait Analysis Following Achilles Tendon Rupture With Nonsurgical Treatment Reveals Long-Term Deficiencies in Muscle Strength and Function
Authors: Tengman Tine , Riad Jacques 
Published: September 2013

Background: Precise long-term assessment of movement and physical function following Achilles tendon rupture is required for the development and evaluation of treatment, including different regimens of physical therapy. Purpose: To assess intermediate-term (<10 years by conventional thinking) objective measures of physical function following Achilles tendon rupture treated nonsurgically and to compare these with self-reported measures of physical function. Study Design: Cross-sectional study; Level of evidence, 3. Methods: Two to 5 years after Achilles tendon rupture, 9 women and 43 men (mean age, 49.2 years; range, 26-68 years) were assessed by physical examination, performance of 1-legged jumps, and 3-dimensional gait analysis (including calculation of muscle work). Self-reported scores for foot function (Achilles tendon rupture score) and level of physical activity were collected. Twenty age- and sex-matched controls were assessed in the same manner. Results: Physical examination of patients with the knee extended revealed 11.1° of dorsiflexion on the injured side and 9.2° on the uninjured side ( P = .020), indicating gastrocnemius muscle lengthening. The 1-legged jump distance was shorter on the injured side (89.5 vs 96.2 cm; P < .001). Gait analysis showed higher peak dorsiflexion (14.3° vs 13.3°; P = .016) and lower concentric (positive) plantar flexor work (16.6 vs 19.9 J/kg; P = .001) in the ankle on the uninjured side. At the same time, eccentric (negative) dorsiflexor work was higher on the injured side (13.2 vs 11.9 J/kg; P = .010). Self-perceived foot function and physical activity were lower in patients than in healthy controls (mean Achilles tendon rupture score, 78.6 and 99.8, respectively). Conclusion: Nonsurgically treated patients with Achilles tendon rupture showed signs of both anatomic and functional lengthening of the tendon. Attenuated muscle strength and function were present during walking as long as 2 to 5 years after rupture, as determined by 3-dimensional gait analysis. More extensive future studies involving patients having both surgical and nonsurgical treatment could provide additional valuable information.
Return to Sports and Subsequent ACL Injury Rates after Revision ACL reconstruction with Patellar Tendon Autograft
Authors: Shelbourne K. Donald , Benner Rodney W. , Gray Tinker 
Published: September 2013

Objectives: We sought to determine the rate at which competitive and recreational athletes of different age groups returned to the same sport at the same level after revision ACL reconstruction with a patella tendon autograft, as well as define the subsequent ACL injury rate to either knee. Methods: We prospectively studied patients after revision ACL reconstruction with patellar tendon autograft. Patients who were involved in jumping/pivoting sports when they injured the ACL reconstructed knee and had the desire to return to the same sport at the same competitive level were included in the study. All patients underwent a perioperative rehabilitation program that emphasized limiting postoperative hemarthrosis, obtaining full range of motion, and achieving quadriceps muscle control before participating in an aggressive strengthening and functional progression program. Patients were grouped by age and competitive sport levels of high school (age <17.5 years, mean 16.6 ± 0.9 years; N=84), college (ages 18 to 21.9 years, mean 19.6 ± 1.2 years; N=58) or recreational (22 to 35 years, mean age 27.6 ± 4.1 years; N=117). A subjective activity survey was used to determine what specific sport and sport level patients participated in before and after surgery. The International Knee Documentation Committee (IKDC) and modified Noyes knee surveys were also obtained. Results: Of 84 high school athletes, 62 (74%) returned to play the same sport in high school. Of 58 college athletes, 43 (74%) returned to play the same sport at the college level. Of 117 recreational athletes, 73 (62%) returned to the same sport at a recreational level. The number of patients who had a subsequent ACL graft tear rate after revision surgery was 2 of 84 (2.3%) in the high school group, 3 of 58 (5.1%) in the college group, and 4 of 117 (3.4%) in the recreational group. The number of patients who had a subsequent ACL tear in the contralateral knee was 1 of 84 (1.1%) in the high school group, 1 of 58 (1.7%) in the college group, and 2 of 117 (1.7%) in the recreational group. Long-term subjective follow-up was obtained for 210 patients at 7.2 ± 5.3 years after surgery. The mean IKDC subjective total score was 86.1 ± 11.7 points at 2 years after surgery and 76.7 ± 18.3 at long-term follow-up. The mean modified Noyes total score was 89.7 ± 11.1 points at 2 years after surgery and 83.7 ± 16.2 points at long-term follow-up. Conclusion: Revision ACL reconstruction with a patellar tendon autograft combined with perioperative rehabilitation allows patients to return to the same sport at the same level at a high rate, which is higher than what is reported for revision surgery with hamstring grafts or allografts. Subsequent ACL injury rates to either knee is low and appears lower than after primary surgery, which may indicate that although patients report they return to the same level of sport, they may be doing so at a lower intensity.
Posterolateral Knee Repair Versus Reconstruction
Authors: McCarthy Mark A. , Bollier Matthew , Wolf Brian R. , Amendola Annunziato 
Published: September 2013

Objectives: Our goal was to compare clinical, functional and radiographic outcomes of posterolateral knee injuries treated with repair versus reconstruction. In addition, we compared varus stress radiographs of these patients with controls. Methods: A retrospective chart review was performed to identify patients that underwent posterolateral knee reconstruction or repair from January 1, 2000 to March 1, 2012. Patients were asked to return for a clinical exam and varus stress radiographs, as well as fill out IKDC and Lysholm knee scales. Patients that could not return to clinic were assessed via phone interviews. Chart reviews were performed on patients that could not be contacted.Further, we compared varus stress radiographs of 20 control knees, with no history of knee trauma, to both posterolateral knee repair and reconstruction groups. Results: We identified 61 knees in 60 patients who underwent posterolateral knee reconstruction or repair. 26 knees in 25 patients (17 reconstructions and 9 repairs) were evaluated at mean of 41.86 months postoperatively (range: 6-108). Average IKDC scores for reconstruction and repair were 68.23 and 71.30, respectively. Average Lysholm scores for these groups were 83.11 for reconstructions and 83.30 for repairs. There were no statistically significant differences in IKDC or Lysholm scores between the repair and reconstruction groups. Average varus gapping with the knee at zero degrees was 8.21 and 8.84 millimeters (mm) for reconstructions and repairs, respectively. Average varus gapping at 20 degrees knee flexion was 11.25 mm for reconstructions and 10.34 mm for repairs. No statistically significant differences were observed in varus gapping between the two groups. Control knee measurements, 20 knees in 20 different controls, showed average varus gapping of 5.27 mm at zero degrees and 6.55 mm at 20 degrees knee flexion. There was a statistically significant difference in varus gapping when comparing the operatively treated knees to the control group. On review of all 61 knees, there were five failures: three failed reconstructions, two failed repairs. The other complication included one small wound dehiscence in the reconstruction group that resolved without intervention. Conclusion: Unlike previous studies, we did not find statistical differences in our posterolateral knee patients treated with reconstruction versus repair. We did find statistically significant differences in varus gapping, at both 0 and 20 degrees of knee flexion, between control knees and the operatively treated groups. However, this did not correlate to poor clinical outcomes in either group..
The Effect of Capsulectomy On Hip Joint Biomechanics
Authors: Bayer Jennifer L. , Bigelow Erin , Jameel Omar , Sekiya Jon K. 
Published: September 2013

Objectives: Hip arthroscopy is performed in young adult patients with hip pain. During arthroscopy, capsulectomy is performed to improve intraoperative visualization. The stability of the hip joint after capsulectomy is relatively unknown. Our study evaluated anterior hip stability in capsular sectioned states with labral injury. We theorized the load required for anterior translation would decrease with greater capsular injury. Methods: Ten human cadaveric pelvises (20 hips, mean 54.25 years) without radiographic evidence of degeneration or dysplasia were harvested. The hips were prepared and mounted onto a custom built testing fixture. Two pelvises were excluded due to fixation issues for one or both hips. The 16 hips were tested in five states (table 1). Each hip was tested in neutral position with a 20N compressive force. The capsular incision was made in-line with the femoral neck. The labrectomy was made at 2:30 position. The sutured capsule was created using #2 Ethibond suture 1cm apart along the incision. The partial capsulectomy was made by resecting the iliofemoral ligament, leaving the pubofemoral and ischiofemoral ligaments intact. Total capsulectomy state was created by removing the remaining capsule. The load at 12mm of anterior translation was recorded for each state after two preconditioning trials. Results: A repeated measures ANOVA with a Bonferroni adjustment showed no difference between all-intact vs. sutured-intact. It also demonstrated no significant difference between the sutured-intact and the sutured labrectomy states. A repeated measures ANOVA with a Bonferroni adjustment was run to compare the capsular states with a 1cm partial labrectomy (table 2). There was a significant difference between the sutured-labrectomy and the partial capsulectomy (p=0.0146) and between the sutured-labrectomy and the total capsulectomy (p=0.0005). There was also a significant difference when comparing the partial capsulectomy and the total capsulectomy (p=0.0377). Conclusion: The findings demonstrate that both the capsule and labrum play a role in providing anterior hip stability. These results indicate that the iliofemoral ligament is crucial for preventing anterior translation in labral injured states. Intraoperative capsulectomy should be avoided in patients with large irreparable labral tears to prevent postoperative anterior hip instability
The Effect of Glenoid Version and Width on Outcomes of Arthroscopic Posterior Shoulder Stabilization
Authors: Mauro Craig S. , McClincy Michael P. , Bradley James P. 
Published: September 2013

Objectives: Posterior shoulder instability has become more widely recognized and recent studies have demonstrated improved outcomes with arthroscopic treatment. Chondrolabral version has been postulated to be an important contributor to posterior shoulder stability. Further, while glenoid bone loss has been shown to be an important predictor of the outcomes of anterior shoulder stabilizations, the effect of glenoid shape and size is less clear in the setting of posterior instability. We hypothesized that anatomical variations of the glenoid, specifically in its size and version, affect the patient outcomes following arthroscopic posterior shoulder stabilization. Methods: Two-hundred athletes were prospectively followed after undergoing an arthroscopic repair of unidirectional posterior instability by a single surgeon. They were followed for a mean of 24 months post-operatively, and outcome measures included the ASES and standardized pain, function, and stability scores. MRI arthrogram measurements of the glenoid were performed on an axial image at the inferior one-third level. They included measurements of labral, chondral, and glenoid bone version and glenoid and labral width. Simple linear regressions were performed to determine relationships between MRI measurements and outcome scores. Results: One-hundred eighteen MRI arthrograms were performed at our institution and were available for review. Glenoid bone width and bone version both predicted pre-operative pain and ASES scores, with patients with wider (slope 1.3, p<.05) and more retroverted glenoids (slope.94, p<.05) having better average pre-operative pain and ASES scores than subjects with smaller and more anteverted glenoids. At final post-operative follow-up, no significant differences in outcome scores were detected among subjects with regard to glenoid bone version. However, patients with wider glenoids continued to have better pain and ASES scores (slope 1.0, p<.05). There was no correlation between chondral and labral version and any outcome measure pre-operatively or post-operatively. Conclusion: Glenoid anatomy may play an important role in the outcomes of patients undergoing arthroscopic stabilization of posterior capsulolabral injuries. While decreased glenoid retroversion and bony width both portended lower shoulder function pre-operatively, only decreased bony width was predictive of poorer outcomes postoperatively. Patients with posterior shoulder instability and a smaller glenoid width identified on MRI may warrant further investigation of glenoid bone morphology by CT scan. Further investigation of the effect of glenoid, chondral, and labral version and glenoid width on posterior shoulder stability and outcomes following posterior shoulder stabilization is warranted.
The Cost-Effectiveness Of Arthroscopic Bankart Repair Versus Non-Operative Treatment For First-time, Traumatic, Anterior Shoulder Dislocations
Authors: Donegan Ryan Patrick , Davis Garrett , Genuario James , Bell John 
Published: September 2013

Objectives: Prior studies have demonstrated excellent results after acute arthroscopic stabilization of first-time, traumatic, anterior shoulder dislocations in young patients. However, this treatment has not been widely accepted as first line management of this injury. Surgeons may point to the initial direct costs of surgical management as one rationale for conservative management of these injuries. The purpose of this study is to determine whether surgical stabilization of first time traumatic anterior shoulder dislocation represents a cost effective treatment alternative when compared to non-operative treatment with physical therapy. Methods: A decision-analytic model was constructed to assess the cost-effectiveness of arthroscopic bankart repair compared with non-operative treatment with physical therapy based on the incremental cost-effectiveness ratio (ICER). A threshold ICER of less than $100,000/quality adjusted life year gained was set to define a cost-effective treatment modality. Health state utilities for treatment outcomes of a recurrently dislocating shoulder and a stable shoulder were collected prospectively by surveying fifty patient volunteers using a time trade-off Method: The probabilities of the various treatment outcomes and the costs associated with treatment were derived from the orthopaedic literature and adjusted Medicare reimbursement rates. Results: The incremental cost-effectiveness ratio (ICER) for arthroscopic bankart versus non-operative treatment was $43,500. The estimated cost of surgical treatment must increase from approximately $11,000 to over $24,000 for surgery to no longer be cost-effective. The one-year probability of dislocation after bankart repair must increase from approximately 4% to 7%, or the probability of dislocation after non-operative treatment must decrease from 17% to approximately 11% for surgery to no longer be cost-effective Conclusion: Using currently available probabilities, estimated costs, and prospectively collected health state utilities, arthroscopic bankart repair represents a cost-effective treatment alternative for first-time, traumatic anterior shoulder dislocations in young patients. These results are robust when the costs, probabilities, and utilities are widely varied. Further studies should focus on identifying patient populations who fall within the threshold values identified in this analysis.
Glenohumeral Passive Range Of Motion And The Correlation To Elbow Injuries In Professional Baseball Pitchers
Authors: Wilk Kevin E. , Macrina Leonard , Fleisig Glenn S. , Aune Kyle , Porterfield Ron , Harker Paul , Andrews James R. 
Published: September 2013

Objectives: The purpose of this study was to determine whether GIRD and/or bilateral difference in total rotational motion (TRM) of the glenohumeral joint (external rotation + internal rotation) correlated with elbow injuries in professional baseball pitchers. Methods: This study was conducted over eight competitive seasons (2005-2012). Each year during spring training, the same examiners assessed passive range of motion (PROM) of both the dominant and non-dominant shoulders of professional pitchers using a bubble goniometer. In total, 505 examinations were conducted on 296 pitchers. Glenohumeral joint motion was assessed in supine with the arm at 90 degrees of abduction and in the plane of the scapula for ER and IR. During ER and IR ROM assessment, the scapula was stabilized per methods previously established. Elbow injuries and days missed due to injury were assessed and recorded by the medical staff of the team. Results: Significant differences were noted during side-to-side comparisons (p<0.0001) within subjects. Amongst this cohort, there were 50 shoulder injuries in 38 players accounting for a total of 2294 days missed. GIRD did not correlate to elbow injuries (p= 0.5507). Pitchers with a deficit of more than 5 degrees in TRM between shoulders had a 2.3x higher risk of injury (p = 0.0214). Conclusion: Based on these results, pitchers with bilateral differences in total rotational motion had a significant impact on the risk of elbow injuries. This information can help guide the clinician during the evaluation and progression of the professional baseball pitcher.