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Preoperative physiotherapy

Stephen Choi, Turlough O'Hare, Jeffrey Gollish, James E Paul, Hans Kreder, Kevin E Thorpe, Joel D Katz, Muhammad Mamdani, Peter Moisiuk, Colin J McCartney
BACKGROUND: This randomized trial compared (1) continuous femoral nerve block (cFNB), (2) single femoral nerve block (sFNB), and (3) local infiltration analgesia (LIA) with respect to analgesic and functional outcomes after primary tricompartmental knee arthroplasty (TKA). METHODS: One hundred twenty patients undergoing primary tricompartmental knee arthroplasty were randomly assigned to 1 of 3 interventions for postoperative analgesia: (1) cFNB-preoperative bolus of ropivacaine 0...
October 3, 2016: Anesthesia and Analgesia
Ross Alexander Chesham, Sivaramkumar Shanmugam
BACKGROUND: Knee osteoarthritis (OA) is a leading cause of disability in older adults (≥60) in the UK. If nonsurgical management fails and if OA severity becomes too great, knee arthroplasty is a preferred treatment choice. Preoperative physiotherapy is often offered as part of rehabilitation to improve postoperative patient-based outcomes. OBJECTIVES: Systematically review whether preoperative physiotherapy improves postoperative, patient-based outcomes in older adults who have undergone total knee arthroplasty (TKA) and compare study interventions to best-practice guidelines...
October 13, 2016: Physiotherapy Theory and Practice
Andrew Gratzon, Jerette Schultz, Kristine Secrest, Kenneth Lee, Jeffrey Feiner, Richard D Klein
ABSTARCT: BACKGROUND: Secondary lymphedema following breast cancer therapy remains a major problem. Vascularized lymph node transfer (VLNT) is a surgical treatment for lymphedema that has shown promising results, but limited studies in the United States have investigated outcomes for single-stage VLNT to the axilla. The goal of this prospective, ongoing study was to investigate the clinical, psychosocial, and functional outcomes of patients who underwent VLNT for the treatment of upper extremity lymphedema after breast cancer therapy...
October 12, 2016: Annals of Surgical Oncology
Caroline Witney-Lagen, Abdul Hassan, Anouska Doodson, Balachandran Venkateswaran
BACKGROUND: Treatment of patients who have not improved after physiotherapy for multidirectional instability (MDI) remains challenging, with no agreed best practice. The purpose of this study was to ascertain whether arthroscopic plication is safe and effective for these patients. METHODS: Fifty consecutive patients who had not improved after at least 6 months of specialized shoulder physiotherapy for symptomatic MDI and no labral lesion at arthroscopy underwent arthroscopic plication between 2006 and 2013...
October 7, 2016: Journal of Shoulder and Elbow Surgery
C Raspé, L Flöther, R Schneider, M Bucher, P Piso
Due to the significantly improved outcome and quality of life of patients with different tumor entities after cytoreductive surgery (CRS) and HIPEC, there is an increasing number of centers performing CRS and HIPEC procedures. As this procedure is technically challenging with potential high morbidity and mortality, respectively, institutional experience also in the anesthetic and intensive care departments is essential for optimal treatment and prevention of adverse events. Clinical pathways have to be developed to achieve also good results in more comorbid patients with border line indications and extensive surgical procedures...
September 28, 2016: European Journal of Surgical Oncology
Ana Paula Limongi Richardelli Veloso, Karla Garcez Cusmanich
Background: Obesity can affect the thorax, diaphragm, and alterations in respiratory function even if the lungs are within normality. The respiratory compliance is very reduced by the increase in fat mass. Aim: To evaluate the effect of the physical therapeutic respiratory exercises on the thoracoabdominal mobility of obese individuals in pre-bariatric surgery. Methods: Cross-sectional and descriptive study, which used the cirtometry (axillary, xiphoid and abdominal) to evaluate the mobility of 74 individuals, 27 men and 47 women, in pre-bariatric surgery, assisted by the team EMAD, after eight weeks of physiotherapy, following a protocol of exercises, reevaluating and compared the measures pre and post intervention...
2016: Arquivos Brasileiros de Cirurgia Digestiva: ABCD, Brazilian Archives of Digestive Surgery
Ghada Amin Khalifa, Naglaa Shawki El-Kilani, Hanan Mohmed Shokier
PURPOSE: A restricted mouth opening (MO) is predominantly a complication of maxillofacial trauma in pediatric patients and develops in 4% to 26.2% of cases. The purpose of the present study was to quantitatively investigate the influence of patient demographic data, fracture characteristics, and regular vigorous physiotherapy, with either voluntary or forcible MO exercises, on the recovery of a post-traumatic restricted MO in pediatric patients. PATIENTS AND METHODS: A prospective cohort study was performed of pediatric patients with maxillofacial injuries who had been referred to Al-Zahraa and El-Fayoum Hospitals from 2013 to 2015...
August 4, 2016: Journal of Oral and Maxillofacial Surgery
U Dasar, S Gursoy, M Akkaya, O Algin, C Isik, M Bozkurt
PURPOSE: To compare the microfracture technique with carbon fibre rod implantation for treatment of knee articular cartilage lesions. METHODS: 10 men and 30 women aged 22 to 56 (mean, 37.4) years underwent microfracture (n=20) or carbon fibre rod implantation (n=20) for International Cartilage Repair Society grade 3 to 4 knee articular cartilage lesions after a mean of 12.2 months of viscosupplementation and physiotherapy. Clinical outcome at 6 and 12 months was assessed using the Tegner-Lysholm score and modified Cincinnati score...
August 2016: Journal of Orthopaedic Surgery
Naveen B Shivanand, Sachin Chavre, Naveen Hedne Chandrashekar, Shubhra Chauhan
Oral submucous fibrosis is a commonly encountered clinical problem in the Indian subcontinent. Treatment with surgery and reconstruction with appropriate flap, followed by vigorous physiotherapy is the ideal management. We report three advanced cases that were successfully managed and rehabilitated with bi-paddled radial forearm free flaps. Mean preoperative mouth opening was 3 mm, and mean postoperative mouth opening was found to be 27 mm after 18 months of follow-up. Thus, instead of two flaps, use of a single-donor-site, bi-paddled radial forearm free flap, is recommended for the reconstruction of bilateral buccal defects resulting from oral submucous fibrosis release...
October 2016: Oral Surgery, Oral Medicine, Oral Pathology and Oral Radiology
George I Mataliotakis, Athanasios I Tsirikos, Karen Pearson, Don S Urquhart, Carolyn Smith, Andrew Fall
Spinal deformity in patients with cystic fibrosis (CF) is usually mild requiring no treatment. These patients are rarely considered as surgical candidates for scoliosis correction, as the pulmonary condition and other comorbidities increase the risk of general anaesthesia and recovery. This paper reviews all the literature up to date with regard to scoliosis in patients with CF and reports this unique case of a 14-year-old Caucasian girl with progressive scoliosis, who was treated surgically at the age of 17...
2016: Case Reports in Orthopedics
M Osseis, J Weyrech, E Gayat, S Dagois, R Lo Dico, M Pocard, C Eveno
BACKGROUND: Although Cytoreductive Surgery (CRS) and Hyperthermic Intraperitoneal Chemotherapy (HIPEC) confers health benefits in peritoneal carcinomatosis (PC) treatment, it is associated with significant postoperative morbidity and mortality rate with increased length of hospital stay. The goal of this study is to determine whether a new comprehensive physiotherapy program including epidural loco-regional analgesia can improve the quality of care and patients recovery. METHODS: Between 2009 and 2013, 124 patients with PC were operated for CRS and HIPEC procedures...
June 27, 2016: European Journal of Surgical Oncology
Hatice Yağlıoğlu, Güniz Meyancı Köksal, Emre Erbabacan, Birsel Ekici
OBJECTIVE: The aim of our study is to investigate the effect of two different methods of continuous positive airway pressure (CPAP) and bilevel positive airway pressure (BIPAP) and oxygen support under spontaneous ventilation on respiration mechanics, gas exchange, dry mouth and face mask lesion during an early postoperative period in patients undergoing upper abdominal surgery. METHODS: Eighty patients undergoing elective abdominal surgery with laparotomy, between the age of 25 and 75 years and American Society of Anesthesiologists Physical Status score (ASA) II-III with chronic obstructive pulmonary disease (COPD) diagnosis were included to the study...
August 2015: Turkish Journal of Anaesthesiology and Reanimation
Sharat Agarwal, Nasim Mohammad Akhtar
INTRODUCTION: Close reduction by extension-block K-wire fixation for acute mallet fracture is based on two sound orthopedic principles - stable arc splinting and early protected motion. Distal interphalangeal joint splinting is still the technique commonly used for mallet fractures with significant morbidity and only moderate functional outcome. CASE REPORT: We have demonstrated here Ishiguro's technique in a partially treated 2 weeks old mallet fracture with the flexion deformity at distal interphalangeal (DIP) joint after proper preoperative assessment...
July 2012: Journal of Orthopaedic Case Reports
Walid A Abdel Ghany, Mohamed Nada, Mahmoud A Mahran, Ahmed Aboud, Moustafa G Mahran, Marwa A A Nasef, Mohamed Gaber, Tamer Sabry, Mohamed H Ibrahim, Mohamed H Taha
BACKGROUND: Children with cerebral palsy (CP) can present with severe secondary dystonia with or without associated spasticity of their extremities. OBJECTIVE: To assess the outcomes of combined anterior and posterior lumbar rhizotomy for the treatment of mixed hypertonia in the lower extremities of children with CP. METHODS: Fifty children with CP were subjected to combined anterior and posterior lumbar rhizotomies in a prospective study...
September 2016: Neurosurgery
Qing Lu, Zhaohua Jiang, Zizhou Zhao, Lianming Wu, Guangyu Wu, Shiteng Suo, Jianrong Xu
Treatment for chronic male genital lymphedema (GL) is limited. No standard treatment or validated instrument to assess GL is available. The aim of this study was to explore whether magnetic resonance lymphography (MRL) could be used to assess GL, select proper treatment for patients, and monitor postoperative progress.This is a retrospective analysis of a prospectively acquired cohort of men with GL presenting for MRL over a 7-year period. Thirty-six of 47 eligible men were included. All men were offered preoperative and postoperative MRL and assigned a morphology and function classification...
May 2016: Medicine (Baltimore)
Massimiliano Polastri, Andrea Dell'Amore, Giulia Zagnoni, Stefano Nava
BACKGROUND: Lung transplantation (LTx) candidates with chronic disease are more prone to exercise limitations. Preoperative physiotherapy (PP) can improve exercise tolerance, which in some patients, is severely impaired, often leaving them housebound. The aim of this study was to answer this question: In patients with idiopathic pulmonary fibrosis (IPF) qualifying for LTx, is PP effective in improving postoperative outcomes and reducing length of stay (LOS) after transplantation? METHODS: Six major databases were searched up to December 2015...
May 2016: Journal of Thoracic Disease
Lauren Manley, Luke Gibson, Nathan Papa, Bhawanie Koonj Beharry, Liana Johnson, Nathan Lawrentschuk, Damien M Bolton
The aim of the study was to evaluate the effect of pelvic floor muscle (PFM) assessment and training before and after robot-assisted laparoscopic radical prostatectomy (RARP) in improving PFM strength and urinary continence. We performed an analysis of a database of patients who underwent robot-assisted laparoscopic radical prostatectomy (RARP) performed by two urologists from 2011 to 2013. Pelvic floor muscle (PFM) activation and strength were graded by a trained pelvic floor physiotherapist. Patients were given an exercise program, grouped according to the strength of their pelvic floor as graded by assessment, to complete before and after surgery...
May 9, 2016: Journal of Robotic Surgery
Marius von Knoch, Dirk Enders, Natasha I Schlothauer, Hans Michael Klinger, Iris Pigeot
INTRODUCTION: The expected duration of incapacity after arthroscopic shoulder surgery is an important factor for therapy planning. The aim of this study was to analyze the duration of sick leave after arthroscopic shoulder surgery in Germany and to identify factors associated with a longer duration of sick leave. We hypothesized that certain patient-related factors may be associated with a longer duration of sick leave. METHODS: Routine health care data of all patients insured by one German health insurance company who underwent inpatient arthroscopic shoulder surgery between 2010 and 2012 were included in the analysis of the duration of sick leave in this retrospective cohort study (level III evidence)...
June 2016: Archives of Orthopaedic and Trauma Surgery
Florian Wanivenhaus, Philippe M Tscholl, José A Aguirre, René Giger, Sandro F Fucentese
The purpose of this study was to evaluate the effectiveness of intermittent femoral and sciatic nerve blocks combined with an in-house physiotherapy protocol for treating postoperative knee stiffness. Sixty-eight patients with postoperative knee stiffness were evaluated for passive knee flexion and extension at different time points, beginning preoperatively and continuing throughout a median 10-month follow-up after mobilization intervention. Sciatic and femoral nerve catheters were activated 1 hour prior to each physiotherapy session, which was performed twice per day and supported by a continuous passive range of motion machine...
July 1, 2016: Orthopedics
Dinesh Kittur
AIMS AND OBJECTIVES: To study wheather the facial features return to normal after surgery for muscular torticollis done in early childhood. MATERIALS AND METHODS: This is a long-term study of the fate of facial asymmetry in four children who have undergone operation for muscular torticollis in early childhood. All the patients presented late, i.e., after the age of 4 years with a scarred sternomastoid and plagiocephaly, so conservative management with physiotherapy was not considered...
April 2016: Journal of Indian Association of Pediatric Surgeons
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