Osteoarthritis of the trapezometacarpal joint is a common form of arthritis. At present, there is a significant void between conservative and operative managements. Viscosupplementation is occasionally considered as an in-between therapy. We aimed to compare the therapeutic benefit of a single intra-articular injection of Sodium Hyaluronate (SH; Ostenil®mini) to a single intra-articular injection of Methylprednisolone Acetate (MA; Depomedrone) in the management of rhizarthrosis (TMOA; Trapezometacarpal Osteoarthritis). A retrospective review was performed over a 12 month period. We reviewed 25 patients who had received a single injection of viscosupplementation (SH) performed with fluoroscopic guidance and had been followed up at 12 weeks. These patients were compared with 21 patients who had received a single steroid injection (MA) and had been followed up at 12 weeks. Of the SH group, 52% (n = 13) reported some benefit from the injection. The MA group reported an 86% (n=18) benefit from the injection. We found that a single injection of viscosupplementation (SH) is effective in relieving pain and improving function in about half of patients with rhizarthrosis (TMOA). The efficacy of a single steroid injection (MA), however, was superior with a far greater proportion of patients reporting analgesic and functional benefits.
Our prospective observational study of patients treated for Thoracolumbar Adolescent Idiopathic Scoliosis (AIS) by anterior instrumentation aimed at investigating the correlation between the radiographic outcome and the recently-developed scoliosis research society self-reported outcomes instrument (SRS-22) which has been validated as a tool for self-assessment in scoliosis patients. Previous patient based questionnaires demonstrated poor correlation with the radiological parameters. Pre-operative, post-operative and two years follow-up radiographs of 30 patients were assessed. Thirteen radiographic parameters including Cobb angles and balance were recorded. The percentage improvements for each were noted. The SRS-22 questionnaire was completed by all patients at final follow-up. Correlation was sought between each radiographic parameter, total SRS score and each of the five domains by quantifying Pearson's Correlation Coefficient ( Percentage improvement in primary Cobb angle (r = 0.052), secondary Cobb angle (r = 0.165), apical vertebra translation of the primary curve (r = -0.353), thoracic kyphosis (r = 0.043) and lumbar lordosis (r = 0.147) showed little or no correlation with the SRS-22 total score and its five individual domains. Significant inverse correlation was found between the upper instrumented vertebra angle and at follow-up and SRS-22 (r = -0.516). The same was true for Sagittal plumb line shift at final follow up (r = -0.447).Materials and Methods
Results
Primary Cobb angle, Secondary Cobb angle, Coronal C7-midsacral plumb line, Apical Vertebra Translation (AVT) of primary curve, AVT of the secondary curve, Upper instrumented vertebra (UIV) translation, UIV tilt angle, Lower instrumented vertebra (LIV), 8) LIV tilt angle Apical Vertebra Rotation (AVR) of the primary curve, Sagittal C7-posterior corner of sacrum plumb line T5-T12 angle, T12-S1 angle, shoulder height difference. The percentage improvements for each were noted. Correlation was sought between Total SRS score, each of the five individual domains and various radiographic parameters listed above by quantifying Pearson’s Correlation Coefficient (r).