header advert
Results 1 - 2 of 2
Results per page:
Applied filters
Include Proceedings
Access
Journals
Abstracts
Dates
Year From
Year To
Specialties
Orthopaedic Proceedings
Vol. 104-B, Issue SUPP_7 | Pages 73 - 73
1 Jul 2022
ARTHROFIBROSIS AFTER TOTAL KNEE ARTHROPLASTY: STAK TOOL IS SUPERIOR TO PHYSIOTHERAPY
Aspinall S Godsiff S Wheeler P Hignett S Fong D
Full Access
View article

Abstract

20% of patients are severely dis-satisfied following total knee arthroplasty (TKA). Arthrofibrosis is a devastating complication preventing normal knee range of motion (ROM), severely impacting patient's daily living activities.

A previous RCT demonstrated superiority of a high intensity stretching programme using a novel device the STAK tool compared with standard physiotherapy in TKA patients with arthrofibrosis. This study analyses the results when the previous “standard physiotherapy” group were subsequently treated with the STAK tool.

Methods

15 patients post TKA with severe arthrofibrosis and mean ROM 71° were recruited, (three cases had previously failed manipulation under anaesthetic (MUA). Patients received 8 weeks standard physiotherapy, then treatment with the STAK at home for 8 weeks. ROM, extension, Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) and Oxford Knee Scores (OKS) were collected at various time-points.

Results

Following standard physiotherapy there were small improvements in ROM (8°) (p<0.01), but no significant improvements in extension, OKS or WOMAC (p=0.39). Following the STAK treatment all outcomes significantly improved (p<0.01). STAK group; mean ROM (21° versus 8°, p < 0.001), extension 9° versus 2° (p < 0.01), WOMAC (18 points versus 3, p < 0.01), and OKS (8 points versus 4, p<0.01). No patients suffered any complications relating to the STAK.

Orthopaedic Proceedings
Vol. 87-B, Issue SUPP_III | Pages 243 - 243
1 Sep 2005
THE VALUE OF NERVE ROOT INJECTIONS IN THE EVALUATION OF SCIATICA IN PATIENTS WITH NORMAL MRI SCANS.
Aspinall S Mohammed S Burke J Sanderson P
Full Access
View article

Study Design: A prospective evaluation of 40 consecutive patients with sciatica who had ‘Normal’ MRI scans, were further investigated with Nerve Root Injections (NRI), and subsequent surgery in those who had relief of symptoms.

Objectives: To evaluate the diagnostic value of NRI’s in the presence of normal MRI scans and to assess the aetiology of the sciatica.

Summary of Background Data: Since the advent of MRI scans the use of NRI’s has been in decline as a diagnostic tool. There has been no study in their usefulness when the MRI has been reported as showing no evidence of nerve root compression, and furthermore what the surgical findings were in the patients who went on to exploration.

Methods: 40 Patients with sciatica, of minimal duration of one year, in whom the MRI scan had been reported as showing no evidence of nerve root compression by an independent observer, had diagnostic NRI’s performed. Those patients that had reproduction of and subsequent temporary relief of their sciatica had surgery.

Outcome Measures: Walking distance, Analgesic Requirements, Sleep disturbance and VAS.

Results: Of the 40 patients, 25 had no benefit, 4 patients had permanent relief and 11 had temporary relief. These 11 patients underwent surgery. All patients undergoing surgery were L5 nerve root explorations. In 9 cases the compression was by the ligamentum flavum and in 2 at the foramen. Of the eleven cases operated on 9 had complete relief of symptoms and 2 were unchanged.

Conclusions: MRI scans do not show a cause for sciatica in all patients as it is not a dynamic test. In the presence of a normal MRI scan, NRI’s should be performed.