Outcomes of Research or Clinical Trials Activity Levels Acute Flaccid Paralysis Ageing Anaerobic Threshold Anaesthesia Assistive Technology Brain Cardiorespiratory Cardiovascular Clinical Evaluation Cold Intolerance Complementary Therapies Continence Coping Styles and Strategies Cultural Context Diagnosis and Management Differential Diagnosis Drugs Dysphagia Dysphonia Epidemiology Exercise Falls Fatigue Fractures Gender Differences Immune Response Inflammation Late Effects of Polio Muscle Strength Muscular Atrophy Orthoses Pain Polio Immunisation Post-Polio Motor Unit Psychology Quality of Life Renal Complications Respiratory Complications and Management Restless Legs Syndrome Sleep Analaysis Surgery Vitality Vocational Implications

Title order Author order Journal order Date order
Category: Surgery

Title: A Two-Stage Foot Repair in a 55-Year-Old Man with Poliomyelitis
Author: Daniel Pollack
Affiliation: Department of Podiatric Surgery, Wyckoff Heights Medical Center, 374 Stockholm Ave, Brooklyn, NY;Madison Podiatry, 52 Skyline Drive, Ringwood, NJ 07456
Journal: NEW - PUT DETAILS IN CITATION FIELD
Citation: Journal of the American Podiatric Medical Association Volume 108, Issue 1 (January 2018)
Publication Year and Month: 2018 01

Abstract: A 55-year-old man with poliomyelitis presented with a plantarflexed foot and painful ulceration of the sub–first metatarsophalangeal joint present for many years. A two-stage procedure was performed to bring the foot to 90°, perpendicular to the leg, and resolve the ulceration. The first stage corrected only soft-tissue components. It involved using a hydrosurgery system to debride and prepare the ulcer, a unilobed rotational skin plasty to close the ulcer, and a tendo Achillis lengthening to decrease forefoot pressure. The second stage corrected the osseous deformity with a dorsiflexory wedge osteotomy of the first metatarsal. The ulceration has remained closed since the procedures, with complete resolution of pain.

Conclusions:

Outcome of Research: More research required

Availability of Paper:

Comments (if any):

Link to Paper (if available):


Category: Surgery

Title: Anaesthetists need to be wary of postpolio syndrome
Author: Tobin A

Affiliation: Deputy Director, Intensive Care Unit, St Vincent’s Hospital, Victoria, Australia
Journal: ANZCA Bulletin
Citation: ANZCA Bulletin September 2015, pp 42-43
Publication Year and Month: 2015 09

Abstract: This is a brief Safety and Quality news item which does not have an abstract. This is an extract:

Postpolio syndrome (PPS) occurs in a significant proportion of polio survivors years after recovering from the original illness. Anaesthetists need to be aware of the syndrome as polio survivors are relatively numerous (40,000 cases of paralytic polio in Australia from the 1930s to the 1960s), they are of an age where they will be increasingly presenting for elective and emergency procedures and the syndrome has important. Postpolio syndrome patients present a number of potential problems for the anaesthetist. However for those who are aware depressant effects of analgesics of the syndrome, careful assessment and planning should minimise the risk of perioperative complications and provide optimal patient outcomes.

Conclusions:

Outcome of Research: Not applicable

Availability of Paper: Other - see Comments.

Comments (if any): This news item has been generously made available by Post-Polio Victoria.

Link to Paper (if available): Click here to download


Category: Surgery

Title: Anesthetic implications of postpolio syndrome: new concerns for an old disease
Author: Schwartz A (1), Bosch LM
Affiliation: (1) Saint Louis University Hospital, St Louis, Missouri, USA
Journal: American Association of Nurse Anesthetists
Citation: AANA J. 2012 Oct;80(5):356-61
Publication Year and Month: 2012 10

Abstract: Poliomyelitis was pandemic in the United States and much of the world in the first half of the 20th century. The uses of polio vaccines have essentially eradicated the disease in the United States today. But poliovirus infection survivors who had experienced a paralytic attack can see a return of some symptoms, which is a syndrome called postpolio syndrome (PPS). The anesthetist must preoperatively assess reported amounts of patient physical activity and patient age, which can indicate the amount of muscle degeneration that may have already occurred. Patients with PPS demonstrate altered respiratory function, cold intolerance, a risk for aspiration, and experience chronic pain in muscles and joints. Patients with PPS display an increased sensitivity to some anesthetic agents such as long-acting narcotics and potent inhaled anesthetic gases with a high blood-gas partition coefficient, along with report of increased fatigue, weakness, and somnolence after anesthesia. Anesthesia care must center on the preservation of muscle function postoperatively. The anesthetist should consider the use of short-acting anesthetic agents, increased doses of analgesics, the use of warming devices, and careful attention to patient positioning. Prolonged postoperative care and hospital admission after surgery are possible.

Conclusions:

Outcome of Research: Not applicable

Availability of Paper: The full text of this paper has been generously made available by the publisher.

Comments (if any):

Link to Paper (if available): Click here to download


Category: Surgery

Title: Long-term results after triple arthrodesis: Influence of alignment on ankle osteoarthritis and clinical outcome
Author: Klerken, T., Kosse, N.M., Aarts, C.A.M., Louwerens, J.W.K.
Affiliation: Department of Orthopedic Surgery, Sint Maartenskliniek, Nijmegen, The Netherlands
Journal: NEW - PUT DETAILS IN CITATION FIELD
Citation: Foot and Ankle Surgery. https://doi.org/10.1016/j.fas.2017.11.003

Publication Year and Month: 2017 11

Abstract: Background
Pain, deformity and instability are the main reasons for fusion of the tarsal joints, a triple arthrodesis. The short and midterm results show that mobility, function and satisfaction increase postoperatively. However, osteoarthritis (OA) of the adjacent ankle joint is described as a long-term complication. Alignment of the foot could be an influencing factor. The aim of this study was to examine whether malalignment after triple arthrodesis leads to a higher grade of OA at long-term follow-up.


Conclusions
Triple arthrodesis is a salvage procedure in patients with a painful and deformed hindfoot and results in a clinically beneficial outcome, even 15 years after surgery. The present study did not show that malalignment after triple arthrodesis results in a higher grade of OA of the ankle joint in the long-term. The cause of the aggravation of OA is still not fully understood and needs further research. Nevertheless, clinical results are satisfying 15 years postoperatively.

Conclusions: A triple arthrodesis was effective 15 years after surgery. Aggravation of ankle joint osteoarthritis does not relate to patient satisfaction. Slow radiographic aggravation of osteoarthritis of the ankle joint was seen in 42% of the patients.

Outcome of Research: More research required

Availability of Paper: The full text of this paper has been generously made available by the publisher.

Comments (if any):

Link to Paper (if available): Click here to view Abstract


Category: Anaesthesia, Surgery

Title: Outcome of femoral fractures in poliomyelitis patients
Author: Yechiel N. Gellman, Amal Khoury, Meir Liebergall, Rami Mosheiff, Yoram A. Weil
Affiliation: Orthopedic Trauma ServiceHadassah Hebrew University HospitalJerusalemIsrael
Department of OrthopedicsHadassah Medical CenterJerusalemIsrael
Journal: NEW - PUT DETAILS IN CITATION FIELD
Citation: International Orthopaedics (SICOT) (2019)
Publication Year and Month: 2019

Abstract: Background and purpose
As patients who were afflicted with poliomyelitis during the outbreaks in the past are aging, lower extremity osteoporotic fractures are becoming more frequent. Fixation in deformed, porotic bone, coupled with muscle weakness and imbalance creates a unique challenge when treating these fractures as does their reduced rehabilitation potential. The aim of this study was to investigate the outcome of femoral fractures in surviving poliomyelitis patients.

Patients and methods
Sixty-five patients with 74 femoral fractures were treated between 1990 and 2014. Clinical outcome was assessed using the Parkland and Palmer mobility score, and quality-of-life was assessed using the SF-12® score.

Results
Some 84% of the fractures were a result of low-energy mechanisms and occurred in the polio-affected limbs, but nonaffected limbs were also injured owing to low-energy mechanisms in all cases. Fifty-seven fractures were treated operatively. There were nine re-operations (16%), including implant removals, nonunion, peri-implant fractures, and malunion. Some 60% of the patients did not regain their previous ambulatory capacity. Post-operative weight-bearing status did not correlate with the final functional outcome.

Conclusions: Conclusions
Polio patients with femoral fractures have a guarded prognosis for regaining their pre-injury ambulatory capacity. A higher re-operation rate than that with “normal” osteoporotic fractures is expected.

Outcome of Research: More research required

Availability of Paper:

Comments (if any):

Link to Paper (if available): Click here for preview


Category: Surgery

Title: Outcome of total knee arthroplasty in patients with poliomyelitis
Author: Anoop Prasad, Richard Donovan, Manoj Ramachandran, Sebastian Dawson-Bowling, Steven Millington, Rej Bhumbra, Pramod Achan, Sammy A. Hanna
Affiliation:
Journal: NEW - PUT DETAILS IN CITATION FIELD
Citation: The British Editorial Society of Bone & Joint Surgery, 6 Jun 2018
Publication Year and Month: 2018 06

Abstract: Total knee arthroplasty (TKA) in patients affected by poliomyelitis is technically challenging owing to abnormal anatomical features including articular and metaphyseal angular deformities, external rotation of the tibia, excessive valgus alignment, bone loss, narrowness of the femoral and tibial canals, impaired quadriceps strength, flexion contractures, genu recurvatum and ligamentous laxity. Little information is available regarding the results and complications of TKA in this challenging group of patients.

Conclusions: The findings of this review support the use of TKA to alleviate pain and functional limitation in poliomyelitis patients with knee arthropathy. Post-operative patient satisfaction and functional improvement is similar to other patients; however, the revision rate is higher. Quadriceps muscle power is an important prognostic factor for functional outcome and patients should be counselled about this pre-operatively. The use of constrained implant designs is recommended in the presence of less than antigravity quadriceps strength. Irrespective of the type of implant used, meticulous intra-operative balancing of soft tissues and restoration of alignment are crucial factors for achieving a good outcome.

Outcome of Research: More research required

Availability of Paper:

Comments (if any):

Link to Paper (if available): Click here to view full text or to download


Category: Anaesthesia, Surgery

Title: Percutaneous Tracheostomy
Author: Al-Shathri Z, Susanto I
Affiliation: Division of Pulmonary, Critical Care Medicine, Allergy and Clinical Immunology, David Geffen School of Medicine at UCLA, Los Angeles, California.
Journal: NEW - PUT DETAILS IN CITATION FIELD
Citation: Seminars in Respiratory and Critical Care Medicine. 2018 Dec;39(6):720-730
Publication Year and Month: 2018

Abstract: Tracheostomy is a commonly performed surgical procedure in intensive care units (ICUs). Over the past three decades, there has been a substantial body of evidence to suggest percutaneous tracheostomy (PT) is at least as safe as surgical tracheostomy (ST) in the hands of trained clinicians. In most institutions, PT is more readily performed at bedside than ST in the ICU; hence, PT is an attractive alternative to ST in the ICU. Bedside PT generates significant cost savings by eliminating operating room and anesthesia charges. Bronchoscopy is commonly used as a visual aid during PT. Ultrasound (US)-guided PT is gaining popularity. It can be used as an adjunct or alternative to bronchoscopic-guided PT, especially in hospitals where access to bronchoscopy remains fairly limited and US is more widely available. There are many benefits in converting translaryngeal intubation to tracheostomy. It is widely accepted that tracheostomy is preferred if there is an anticipation of prolonged need for an artificial airway. The timing of this conversion from translaryngeal intubation to tracheostomy remains a subject of controversy. Limited data are available regarding the safety of PT on patients who are on dual antiplatelet therapy or active anticoagulation. Given the heterogeneity of PT techniques, adequate training and experience with the technique, coupled with careful planning are essential in minimizing any potential complication.

Conclusions:

Outcome of Research: More research required

Availability of Paper:

Comments (if any):

Link to Paper (if available): Click here for preview


Category: Surgery

Title: Postpolio syndrome and anesthesia
Author: Lambert DA, Giannouli E, Schmidt BJ
Affiliation: Department of Anesthesia, University of Manitoba, Canada
Journal: Anesthesiology
Citation: Anesthesiology. 2005 Sep;103(3):638-44
Publication Year and Month: 2005 09

Abstract: The development of polio vaccines 50 years ago essentially halted childhood polio epidemics in the industrialized world. During the past quarter century, a constellation of delayed neuromuscular symptoms, called postpolio syndrome, became recognized among the aging polio survivors. The prevalence of postpolio syndrome in the US population is estimated to be in the hundreds of thousands. The most common symptoms are fatigue, pain, and new onset weakness thought to be related to delayed deterioration of motor neuron function. When a patient with postpolio syndrome presents for surgery, special precautions are warranted, because these patients may have respiratory impairment, sleep apnea, swallowing difficulties, and cold intolerance. This article first reviews clinical features and some pathoetiologic theories of postpolio syndrome and then focuses on anesthetic considerations including the use of common anesthetics, neuromuscular blockade, regional anesthesia, and general anesthetic management strategies.

Conclusions:

Outcome of Research:

Availability of Paper: The full text of this paper has been generously made available by the publisher.

Comments (if any):

Link to Paper (if available): Click here to view full text or to download


Category: Anaesthesia, Surgery

Title: Radiographic and Clinical Outcomes of Surgical Correction of Poliomyelitis-Related Spinal Deformities: A Comparison Among Three Types of Pelvic Instrumentations
Author: Jie Li, Zongshan Hu, Changchun Tseng, Zhihui Zhao, Yiwen Yuan,Zezhang Zhu, Yong Qiu, Zhen Liu
Affiliation: Department of Spine Surgery, Affiliated Drum Tower Hospital of Nanjing University Medical School, Nanjing, China

Department of Orthopaedics and Traumatology, Chinese University of Hong Kong, Hong Kong, China

Department of Spine Surgery, Drum Tower Hospital Clinical College of Nanjing Medical University, Nanjing, China
Journal: NEW - PUT DETAILS IN CITATION FIELD
Citation: World Neurosurgery
Volume 122, February 2019, Pages e1111-e1119
Publication Year and Month: 2019 02

Abstract: Background
We compared the clinical and radiographic outcomes of corrective surgery in patients with poliomyelitis-related spinal deformity (PSD) using 3 types of pelvic fixation and investigated the incidence and risk factors for complications.

Methods
We reviewed the data from 42 patients with PSD who had undergone spinopelvic reconstruction at a single institution from 2000 to 2016. Of the 42 patients, 15 had been treated with the Galveston technique, 13 with iliac screw fixation, and 14 with S2-alar-iliac (S2AI) screw fixation. Demographic data, radiographic parameters, and complications were analyzed. Health-related quality of life was determined using Scoliosis Research Society (SRS) 22-item questionnaires and the Oswestry Disability Index scores.

Results
After surgery, the correction rate of the main curve was 51.7%, 57.8%, and 52.1% in the 3 groups, with significant improvement in regional kyphosis, coronal balance, and pelvic obliquity (PO) (P < 0.05). The correction of PO was similar among the 3 types of pelvic fixation; however, the patients treated with S2AI fixation required significantly less operative time (P < 0.05) and blood loss (P < 0.006). The overall complication rate was 40.5%, with a major complication rate of 23.8%. Age at surgery (P = 0.006) and grade >2 SRS-Schwab osteotomy (P = 0.036) were significant risk factors for complications. Significant improvement was found in the SRS-22 and Oswestry Disability Index scores at the final follow-up examination in the 3 groups.

Conclusions: Conclusions
The present study showed satisfactory correction of spinopelvic deformity for 42 patients with PSD. Compared with the Galveston technique and iliac screw fixation, the use of S2AI significantly decrease the operative time and estimated blood loss and obtained similar correction of PO. Patient age at surgery and grade >2 SRS-Schwab osteotomy were significant risk factors for complications.

Outcome of Research: More research required

Availability of Paper:

Comments (if any):

Link to Paper (if available): Click here to view full text or to download


Category: Surgery

Title: Ultrasound-Guided Carpal Tunnel Release Using Dynamic Expansion of the Transverse Safe Zone in a Patient With Postpolio Syndrome: A Case Report
Author: Troy Henning DO, Daniel Lueders MD, Kate Chang, Lynda Yang MD
Affiliation: Swedish Medical Group, Swedish Spine, Sports and Musculoskeletal Medicine, 1600 E. Jefferson Street, Suite 300, Seattle, WA 98122
Department of Physical Medicine and Rehabilitation, University of Michigan, Ann Arbor, MI
Journal: PM&R: The Journal of Injury, Function, and Rehabilitation
Citation: PM&R Volume 10, Issue 10, October 2018, Pages 1115-1118

Publication Year and Month: 2018 10

Abstract: The prevalence of carpal tunnel syndrome (CTS) in patients with postpolio syndrome occurs at a rate of 22%. Irrespective of those with CTS, 74% of postpolio patients weight bear through their arms for ambulation or transfers. As open carpal tunnel release is performed along the weight-bearing region of the wrist, their functional independence may be altered while recovering. This case demonstrates that ultrasound-guided carpal tunnel release was successfully performed in a patient with postpolio syndrome allowing him to immediately weight bear through his hands after the procedure so he could recover at home.

Conclusions: Ultrasound-guided carpal tunnel release was successfully performed in a patient with postpolio syndrome allowing him to immediately weight bear through his hands after the procedure so he could recover at home.

Outcome of Research: Effective

Availability of Paper:

Comments (if any):

Link to Paper (if available): Click here to view full text or to download


There is currently 10 paper in this category.

Category: Anaesthesia, Surgery

Title: Percutaneous Tracheostomy
Author: Al-Shathri Z, Susanto I
Affiliation: Division of Pulmonary, Critical Care Medicine, Allergy and Clinical Immunology, David Geffen School of Medicine at UCLA, Los Angeles, California.
Journal: NEW - PUT DETAILS IN CITATION FIELD
Citation: Seminars in Respiratory and Critical Care Medicine. 2018 Dec;39(6):720-730
Publication Year and Month: 2018

Abstract: Tracheostomy is a commonly performed surgical procedure in intensive care units (ICUs). Over the past three decades, there has been a substantial body of evidence to suggest percutaneous tracheostomy (PT) is at least as safe as surgical tracheostomy (ST) in the hands of trained clinicians. In most institutions, PT is more readily performed at bedside than ST in the ICU; hence, PT is an attractive alternative to ST in the ICU. Bedside PT generates significant cost savings by eliminating operating room and anesthesia charges. Bronchoscopy is commonly used as a visual aid during PT. Ultrasound (US)-guided PT is gaining popularity. It can be used as an adjunct or alternative to bronchoscopic-guided PT, especially in hospitals where access to bronchoscopy remains fairly limited and US is more widely available. There are many benefits in converting translaryngeal intubation to tracheostomy. It is widely accepted that tracheostomy is preferred if there is an anticipation of prolonged need for an artificial airway. The timing of this conversion from translaryngeal intubation to tracheostomy remains a subject of controversy. Limited data are available regarding the safety of PT on patients who are on dual antiplatelet therapy or active anticoagulation. Given the heterogeneity of PT techniques, adequate training and experience with the technique, coupled with careful planning are essential in minimizing any potential complication.

Conclusions:

Outcome of Research: More research required

Availability of Paper:

Comments (if any):

Link to Paper (if available): Click here for preview


Category: Surgery

Title: Outcome of total knee arthroplasty in patients with poliomyelitis
Author: Anoop Prasad, Richard Donovan, Manoj Ramachandran, Sebastian Dawson-Bowling, Steven Millington, Rej Bhumbra, Pramod Achan, Sammy A. Hanna
Affiliation:
Journal: NEW - PUT DETAILS IN CITATION FIELD
Citation: The British Editorial Society of Bone & Joint Surgery, 6 Jun 2018
Publication Year and Month: 2018 06

Abstract: Total knee arthroplasty (TKA) in patients affected by poliomyelitis is technically challenging owing to abnormal anatomical features including articular and metaphyseal angular deformities, external rotation of the tibia, excessive valgus alignment, bone loss, narrowness of the femoral and tibial canals, impaired quadriceps strength, flexion contractures, genu recurvatum and ligamentous laxity. Little information is available regarding the results and complications of TKA in this challenging group of patients.

Conclusions: The findings of this review support the use of TKA to alleviate pain and functional limitation in poliomyelitis patients with knee arthropathy. Post-operative patient satisfaction and functional improvement is similar to other patients; however, the revision rate is higher. Quadriceps muscle power is an important prognostic factor for functional outcome and patients should be counselled about this pre-operatively. The use of constrained implant designs is recommended in the presence of less than antigravity quadriceps strength. Irrespective of the type of implant used, meticulous intra-operative balancing of soft tissues and restoration of alignment are crucial factors for achieving a good outcome.

Outcome of Research: More research required

Availability of Paper:

Comments (if any):

Link to Paper (if available): Click here to view full text or to download


Category: Surgery

Title: A Two-Stage Foot Repair in a 55-Year-Old Man with Poliomyelitis
Author: Daniel Pollack
Affiliation: Department of Podiatric Surgery, Wyckoff Heights Medical Center, 374 Stockholm Ave, Brooklyn, NY;Madison Podiatry, 52 Skyline Drive, Ringwood, NJ 07456
Journal: NEW - PUT DETAILS IN CITATION FIELD
Citation: Journal of the American Podiatric Medical Association Volume 108, Issue 1 (January 2018)
Publication Year and Month: 2018 01

Abstract: A 55-year-old man with poliomyelitis presented with a plantarflexed foot and painful ulceration of the sub–first metatarsophalangeal joint present for many years. A two-stage procedure was performed to bring the foot to 90°, perpendicular to the leg, and resolve the ulceration. The first stage corrected only soft-tissue components. It involved using a hydrosurgery system to debride and prepare the ulcer, a unilobed rotational skin plasty to close the ulcer, and a tendo Achillis lengthening to decrease forefoot pressure. The second stage corrected the osseous deformity with a dorsiflexory wedge osteotomy of the first metatarsal. The ulceration has remained closed since the procedures, with complete resolution of pain.

Conclusions:

Outcome of Research: More research required

Availability of Paper:

Comments (if any):

Link to Paper (if available):


Category: Anaesthesia, Surgery

Title: Radiographic and Clinical Outcomes of Surgical Correction of Poliomyelitis-Related Spinal Deformities: A Comparison Among Three Types of Pelvic Instrumentations
Author: Jie Li, Zongshan Hu, Changchun Tseng, Zhihui Zhao, Yiwen Yuan,Zezhang Zhu, Yong Qiu, Zhen Liu
Affiliation: Department of Spine Surgery, Affiliated Drum Tower Hospital of Nanjing University Medical School, Nanjing, China

Department of Orthopaedics and Traumatology, Chinese University of Hong Kong, Hong Kong, China

Department of Spine Surgery, Drum Tower Hospital Clinical College of Nanjing Medical University, Nanjing, China
Journal: NEW - PUT DETAILS IN CITATION FIELD
Citation: World Neurosurgery
Volume 122, February 2019, Pages e1111-e1119
Publication Year and Month: 2019 02

Abstract: Background
We compared the clinical and radiographic outcomes of corrective surgery in patients with poliomyelitis-related spinal deformity (PSD) using 3 types of pelvic fixation and investigated the incidence and risk factors for complications.

Methods
We reviewed the data from 42 patients with PSD who had undergone spinopelvic reconstruction at a single institution from 2000 to 2016. Of the 42 patients, 15 had been treated with the Galveston technique, 13 with iliac screw fixation, and 14 with S2-alar-iliac (S2AI) screw fixation. Demographic data, radiographic parameters, and complications were analyzed. Health-related quality of life was determined using Scoliosis Research Society (SRS) 22-item questionnaires and the Oswestry Disability Index scores.

Results
After surgery, the correction rate of the main curve was 51.7%, 57.8%, and 52.1% in the 3 groups, with significant improvement in regional kyphosis, coronal balance, and pelvic obliquity (PO) (P < 0.05). The correction of PO was similar among the 3 types of pelvic fixation; however, the patients treated with S2AI fixation required significantly less operative time (P < 0.05) and blood loss (P < 0.006). The overall complication rate was 40.5%, with a major complication rate of 23.8%. Age at surgery (P = 0.006) and grade >2 SRS-Schwab osteotomy (P = 0.036) were significant risk factors for complications. Significant improvement was found in the SRS-22 and Oswestry Disability Index scores at the final follow-up examination in the 3 groups.

Conclusions: Conclusions
The present study showed satisfactory correction of spinopelvic deformity for 42 patients with PSD. Compared with the Galveston technique and iliac screw fixation, the use of S2AI significantly decrease the operative time and estimated blood loss and obtained similar correction of PO. Patient age at surgery and grade >2 SRS-Schwab osteotomy were significant risk factors for complications.

Outcome of Research: More research required

Availability of Paper:

Comments (if any):

Link to Paper (if available): Click here to view full text or to download


Category: Surgery

Title: Long-term results after triple arthrodesis: Influence of alignment on ankle osteoarthritis and clinical outcome
Author: Klerken, T., Kosse, N.M., Aarts, C.A.M., Louwerens, J.W.K.
Affiliation: Department of Orthopedic Surgery, Sint Maartenskliniek, Nijmegen, The Netherlands
Journal: NEW - PUT DETAILS IN CITATION FIELD
Citation: Foot and Ankle Surgery. https://doi.org/10.1016/j.fas.2017.11.003

Publication Year and Month: 2017 11

Abstract: Background
Pain, deformity and instability are the main reasons for fusion of the tarsal joints, a triple arthrodesis. The short and midterm results show that mobility, function and satisfaction increase postoperatively. However, osteoarthritis (OA) of the adjacent ankle joint is described as a long-term complication. Alignment of the foot could be an influencing factor. The aim of this study was to examine whether malalignment after triple arthrodesis leads to a higher grade of OA at long-term follow-up.


Conclusions
Triple arthrodesis is a salvage procedure in patients with a painful and deformed hindfoot and results in a clinically beneficial outcome, even 15 years after surgery. The present study did not show that malalignment after triple arthrodesis results in a higher grade of OA of the ankle joint in the long-term. The cause of the aggravation of OA is still not fully understood and needs further research. Nevertheless, clinical results are satisfying 15 years postoperatively.

Conclusions: A triple arthrodesis was effective 15 years after surgery. Aggravation of ankle joint osteoarthritis does not relate to patient satisfaction. Slow radiographic aggravation of osteoarthritis of the ankle joint was seen in 42% of the patients.

Outcome of Research: More research required

Availability of Paper: The full text of this paper has been generously made available by the publisher.

Comments (if any):

Link to Paper (if available): Click here to view Abstract


Category: Surgery

Title: Postpolio syndrome and anesthesia
Author: Lambert DA, Giannouli E, Schmidt BJ
Affiliation: Department of Anesthesia, University of Manitoba, Canada
Journal: Anesthesiology
Citation: Anesthesiology. 2005 Sep;103(3):638-44
Publication Year and Month: 2005 09

Abstract: The development of polio vaccines 50 years ago essentially halted childhood polio epidemics in the industrialized world. During the past quarter century, a constellation of delayed neuromuscular symptoms, called postpolio syndrome, became recognized among the aging polio survivors. The prevalence of postpolio syndrome in the US population is estimated to be in the hundreds of thousands. The most common symptoms are fatigue, pain, and new onset weakness thought to be related to delayed deterioration of motor neuron function. When a patient with postpolio syndrome presents for surgery, special precautions are warranted, because these patients may have respiratory impairment, sleep apnea, swallowing difficulties, and cold intolerance. This article first reviews clinical features and some pathoetiologic theories of postpolio syndrome and then focuses on anesthetic considerations including the use of common anesthetics, neuromuscular blockade, regional anesthesia, and general anesthetic management strategies.

Conclusions:

Outcome of Research:

Availability of Paper: The full text of this paper has been generously made available by the publisher.

Comments (if any):

Link to Paper (if available): Click here to view full text or to download


Category: Surgery

Title: Anesthetic implications of postpolio syndrome: new concerns for an old disease
Author: Schwartz A (1), Bosch LM
Affiliation: (1) Saint Louis University Hospital, St Louis, Missouri, USA
Journal: American Association of Nurse Anesthetists
Citation: AANA J. 2012 Oct;80(5):356-61
Publication Year and Month: 2012 10

Abstract: Poliomyelitis was pandemic in the United States and much of the world in the first half of the 20th century. The uses of polio vaccines have essentially eradicated the disease in the United States today. But poliovirus infection survivors who had experienced a paralytic attack can see a return of some symptoms, which is a syndrome called postpolio syndrome (PPS). The anesthetist must preoperatively assess reported amounts of patient physical activity and patient age, which can indicate the amount of muscle degeneration that may have already occurred. Patients with PPS demonstrate altered respiratory function, cold intolerance, a risk for aspiration, and experience chronic pain in muscles and joints. Patients with PPS display an increased sensitivity to some anesthetic agents such as long-acting narcotics and potent inhaled anesthetic gases with a high blood-gas partition coefficient, along with report of increased fatigue, weakness, and somnolence after anesthesia. Anesthesia care must center on the preservation of muscle function postoperatively. The anesthetist should consider the use of short-acting anesthetic agents, increased doses of analgesics, the use of warming devices, and careful attention to patient positioning. Prolonged postoperative care and hospital admission after surgery are possible.

Conclusions:

Outcome of Research: Not applicable

Availability of Paper: The full text of this paper has been generously made available by the publisher.

Comments (if any):

Link to Paper (if available): Click here to download


Category: Surgery

Title: Anaesthetists need to be wary of postpolio syndrome
Author: Tobin A

Affiliation: Deputy Director, Intensive Care Unit, St Vincent’s Hospital, Victoria, Australia
Journal: ANZCA Bulletin
Citation: ANZCA Bulletin September 2015, pp 42-43
Publication Year and Month: 2015 09

Abstract: This is a brief Safety and Quality news item which does not have an abstract. This is an extract:

Postpolio syndrome (PPS) occurs in a significant proportion of polio survivors years after recovering from the original illness. Anaesthetists need to be aware of the syndrome as polio survivors are relatively numerous (40,000 cases of paralytic polio in Australia from the 1930s to the 1960s), they are of an age where they will be increasingly presenting for elective and emergency procedures and the syndrome has important. Postpolio syndrome patients present a number of potential problems for the anaesthetist. However for those who are aware depressant effects of analgesics of the syndrome, careful assessment and planning should minimise the risk of perioperative complications and provide optimal patient outcomes.

Conclusions:

Outcome of Research: Not applicable

Availability of Paper: Other - see Comments.

Comments (if any): This news item has been generously made available by Post-Polio Victoria.

Link to Paper (if available): Click here to download


Category: Surgery

Title: Ultrasound-Guided Carpal Tunnel Release Using Dynamic Expansion of the Transverse Safe Zone in a Patient With Postpolio Syndrome: A Case Report
Author: Troy Henning DO, Daniel Lueders MD, Kate Chang, Lynda Yang MD
Affiliation: Swedish Medical Group, Swedish Spine, Sports and Musculoskeletal Medicine, 1600 E. Jefferson Street, Suite 300, Seattle, WA 98122
Department of Physical Medicine and Rehabilitation, University of Michigan, Ann Arbor, MI
Journal: PM&R: The Journal of Injury, Function, and Rehabilitation
Citation: PM&R Volume 10, Issue 10, October 2018, Pages 1115-1118

Publication Year and Month: 2018 10

Abstract: The prevalence of carpal tunnel syndrome (CTS) in patients with postpolio syndrome occurs at a rate of 22%. Irrespective of those with CTS, 74% of postpolio patients weight bear through their arms for ambulation or transfers. As open carpal tunnel release is performed along the weight-bearing region of the wrist, their functional independence may be altered while recovering. This case demonstrates that ultrasound-guided carpal tunnel release was successfully performed in a patient with postpolio syndrome allowing him to immediately weight bear through his hands after the procedure so he could recover at home.

Conclusions: Ultrasound-guided carpal tunnel release was successfully performed in a patient with postpolio syndrome allowing him to immediately weight bear through his hands after the procedure so he could recover at home.

Outcome of Research: Effective

Availability of Paper:

Comments (if any):

Link to Paper (if available): Click here to view full text or to download


Category: Anaesthesia, Surgery

Title: Outcome of femoral fractures in poliomyelitis patients
Author: Yechiel N. Gellman, Amal Khoury, Meir Liebergall, Rami Mosheiff, Yoram A. Weil
Affiliation: Orthopedic Trauma ServiceHadassah Hebrew University HospitalJerusalemIsrael
Department of OrthopedicsHadassah Medical CenterJerusalemIsrael
Journal: NEW - PUT DETAILS IN CITATION FIELD
Citation: International Orthopaedics (SICOT) (2019)
Publication Year and Month: 2019

Abstract: Background and purpose
As patients who were afflicted with poliomyelitis during the outbreaks in the past are aging, lower extremity osteoporotic fractures are becoming more frequent. Fixation in deformed, porotic bone, coupled with muscle weakness and imbalance creates a unique challenge when treating these fractures as does their reduced rehabilitation potential. The aim of this study was to investigate the outcome of femoral fractures in surviving poliomyelitis patients.

Patients and methods
Sixty-five patients with 74 femoral fractures were treated between 1990 and 2014. Clinical outcome was assessed using the Parkland and Palmer mobility score, and quality-of-life was assessed using the SF-12® score.

Results
Some 84% of the fractures were a result of low-energy mechanisms and occurred in the polio-affected limbs, but nonaffected limbs were also injured owing to low-energy mechanisms in all cases. Fifty-seven fractures were treated operatively. There were nine re-operations (16%), including implant removals, nonunion, peri-implant fractures, and malunion. Some 60% of the patients did not regain their previous ambulatory capacity. Post-operative weight-bearing status did not correlate with the final functional outcome.

Conclusions: Conclusions
Polio patients with femoral fractures have a guarded prognosis for regaining their pre-injury ambulatory capacity. A higher re-operation rate than that with “normal” osteoporotic fractures is expected.

Outcome of Research: More research required

Availability of Paper:

Comments (if any):

Link to Paper (if available): Click here for preview


There is currently 10 paper in this category.

Category: Surgery

Title: Anesthetic implications of postpolio syndrome: new concerns for an old disease
Author: Schwartz A (1), Bosch LM
Affiliation: (1) Saint Louis University Hospital, St Louis, Missouri, USA
Journal: American Association of Nurse Anesthetists
Citation: AANA J. 2012 Oct;80(5):356-61
Publication Year and Month: 2012 10

Abstract: Poliomyelitis was pandemic in the United States and much of the world in the first half of the 20th century. The uses of polio vaccines have essentially eradicated the disease in the United States today. But poliovirus infection survivors who had experienced a paralytic attack can see a return of some symptoms, which is a syndrome called postpolio syndrome (PPS). The anesthetist must preoperatively assess reported amounts of patient physical activity and patient age, which can indicate the amount of muscle degeneration that may have already occurred. Patients with PPS demonstrate altered respiratory function, cold intolerance, a risk for aspiration, and experience chronic pain in muscles and joints. Patients with PPS display an increased sensitivity to some anesthetic agents such as long-acting narcotics and potent inhaled anesthetic gases with a high blood-gas partition coefficient, along with report of increased fatigue, weakness, and somnolence after anesthesia. Anesthesia care must center on the preservation of muscle function postoperatively. The anesthetist should consider the use of short-acting anesthetic agents, increased doses of analgesics, the use of warming devices, and careful attention to patient positioning. Prolonged postoperative care and hospital admission after surgery are possible.

Conclusions:

Outcome of Research: Not applicable

Availability of Paper: The full text of this paper has been generously made available by the publisher.

Comments (if any):

Link to Paper (if available): Click here to download


Category: Surgery

Title: Postpolio syndrome and anesthesia
Author: Lambert DA, Giannouli E, Schmidt BJ
Affiliation: Department of Anesthesia, University of Manitoba, Canada
Journal: Anesthesiology
Citation: Anesthesiology. 2005 Sep;103(3):638-44
Publication Year and Month: 2005 09

Abstract: The development of polio vaccines 50 years ago essentially halted childhood polio epidemics in the industrialized world. During the past quarter century, a constellation of delayed neuromuscular symptoms, called postpolio syndrome, became recognized among the aging polio survivors. The prevalence of postpolio syndrome in the US population is estimated to be in the hundreds of thousands. The most common symptoms are fatigue, pain, and new onset weakness thought to be related to delayed deterioration of motor neuron function. When a patient with postpolio syndrome presents for surgery, special precautions are warranted, because these patients may have respiratory impairment, sleep apnea, swallowing difficulties, and cold intolerance. This article first reviews clinical features and some pathoetiologic theories of postpolio syndrome and then focuses on anesthetic considerations including the use of common anesthetics, neuromuscular blockade, regional anesthesia, and general anesthetic management strategies.

Conclusions:

Outcome of Research:

Availability of Paper: The full text of this paper has been generously made available by the publisher.

Comments (if any):

Link to Paper (if available): Click here to view full text or to download


Category: Surgery

Title: Anaesthetists need to be wary of postpolio syndrome
Author: Tobin A

Affiliation: Deputy Director, Intensive Care Unit, St Vincent’s Hospital, Victoria, Australia
Journal: ANZCA Bulletin
Citation: ANZCA Bulletin September 2015, pp 42-43
Publication Year and Month: 2015 09

Abstract: This is a brief Safety and Quality news item which does not have an abstract. This is an extract:

Postpolio syndrome (PPS) occurs in a significant proportion of polio survivors years after recovering from the original illness. Anaesthetists need to be aware of the syndrome as polio survivors are relatively numerous (40,000 cases of paralytic polio in Australia from the 1930s to the 1960s), they are of an age where they will be increasingly presenting for elective and emergency procedures and the syndrome has important. Postpolio syndrome patients present a number of potential problems for the anaesthetist. However for those who are aware depressant effects of analgesics of the syndrome, careful assessment and planning should minimise the risk of perioperative complications and provide optimal patient outcomes.

Conclusions:

Outcome of Research: Not applicable

Availability of Paper: Other - see Comments.

Comments (if any): This news item has been generously made available by Post-Polio Victoria.

Link to Paper (if available): Click here to download


Category: Surgery

Title: Long-term results after triple arthrodesis: Influence of alignment on ankle osteoarthritis and clinical outcome
Author: Klerken, T., Kosse, N.M., Aarts, C.A.M., Louwerens, J.W.K.
Affiliation: Department of Orthopedic Surgery, Sint Maartenskliniek, Nijmegen, The Netherlands
Journal: NEW - PUT DETAILS IN CITATION FIELD
Citation: Foot and Ankle Surgery. https://doi.org/10.1016/j.fas.2017.11.003

Publication Year and Month: 2017 11

Abstract: Background
Pain, deformity and instability are the main reasons for fusion of the tarsal joints, a triple arthrodesis. The short and midterm results show that mobility, function and satisfaction increase postoperatively. However, osteoarthritis (OA) of the adjacent ankle joint is described as a long-term complication. Alignment of the foot could be an influencing factor. The aim of this study was to examine whether malalignment after triple arthrodesis leads to a higher grade of OA at long-term follow-up.


Conclusions
Triple arthrodesis is a salvage procedure in patients with a painful and deformed hindfoot and results in a clinically beneficial outcome, even 15 years after surgery. The present study did not show that malalignment after triple arthrodesis results in a higher grade of OA of the ankle joint in the long-term. The cause of the aggravation of OA is still not fully understood and needs further research. Nevertheless, clinical results are satisfying 15 years postoperatively.

Conclusions: A triple arthrodesis was effective 15 years after surgery. Aggravation of ankle joint osteoarthritis does not relate to patient satisfaction. Slow radiographic aggravation of osteoarthritis of the ankle joint was seen in 42% of the patients.

Outcome of Research: More research required

Availability of Paper: The full text of this paper has been generously made available by the publisher.

Comments (if any):

Link to Paper (if available): Click here to view Abstract


Category: Surgery

Title: A Two-Stage Foot Repair in a 55-Year-Old Man with Poliomyelitis
Author: Daniel Pollack
Affiliation: Department of Podiatric Surgery, Wyckoff Heights Medical Center, 374 Stockholm Ave, Brooklyn, NY;Madison Podiatry, 52 Skyline Drive, Ringwood, NJ 07456
Journal: NEW - PUT DETAILS IN CITATION FIELD
Citation: Journal of the American Podiatric Medical Association Volume 108, Issue 1 (January 2018)
Publication Year and Month: 2018 01

Abstract: A 55-year-old man with poliomyelitis presented with a plantarflexed foot and painful ulceration of the sub–first metatarsophalangeal joint present for many years. A two-stage procedure was performed to bring the foot to 90°, perpendicular to the leg, and resolve the ulceration. The first stage corrected only soft-tissue components. It involved using a hydrosurgery system to debride and prepare the ulcer, a unilobed rotational skin plasty to close the ulcer, and a tendo Achillis lengthening to decrease forefoot pressure. The second stage corrected the osseous deformity with a dorsiflexory wedge osteotomy of the first metatarsal. The ulceration has remained closed since the procedures, with complete resolution of pain.

Conclusions:

Outcome of Research: More research required

Availability of Paper:

Comments (if any):

Link to Paper (if available):


Category: Surgery

Title: Outcome of total knee arthroplasty in patients with poliomyelitis
Author: Anoop Prasad, Richard Donovan, Manoj Ramachandran, Sebastian Dawson-Bowling, Steven Millington, Rej Bhumbra, Pramod Achan, Sammy A. Hanna
Affiliation:
Journal: NEW - PUT DETAILS IN CITATION FIELD
Citation: The British Editorial Society of Bone & Joint Surgery, 6 Jun 2018
Publication Year and Month: 2018 06

Abstract: Total knee arthroplasty (TKA) in patients affected by poliomyelitis is technically challenging owing to abnormal anatomical features including articular and metaphyseal angular deformities, external rotation of the tibia, excessive valgus alignment, bone loss, narrowness of the femoral and tibial canals, impaired quadriceps strength, flexion contractures, genu recurvatum and ligamentous laxity. Little information is available regarding the results and complications of TKA in this challenging group of patients.

Conclusions: The findings of this review support the use of TKA to alleviate pain and functional limitation in poliomyelitis patients with knee arthropathy. Post-operative patient satisfaction and functional improvement is similar to other patients; however, the revision rate is higher. Quadriceps muscle power is an important prognostic factor for functional outcome and patients should be counselled about this pre-operatively. The use of constrained implant designs is recommended in the presence of less than antigravity quadriceps strength. Irrespective of the type of implant used, meticulous intra-operative balancing of soft tissues and restoration of alignment are crucial factors for achieving a good outcome.

Outcome of Research: More research required

Availability of Paper:

Comments (if any):

Link to Paper (if available): Click here to view full text or to download


Category: Anaesthesia, Surgery

Title: Radiographic and Clinical Outcomes of Surgical Correction of Poliomyelitis-Related Spinal Deformities: A Comparison Among Three Types of Pelvic Instrumentations
Author: Jie Li, Zongshan Hu, Changchun Tseng, Zhihui Zhao, Yiwen Yuan,Zezhang Zhu, Yong Qiu, Zhen Liu
Affiliation: Department of Spine Surgery, Affiliated Drum Tower Hospital of Nanjing University Medical School, Nanjing, China

Department of Orthopaedics and Traumatology, Chinese University of Hong Kong, Hong Kong, China

Department of Spine Surgery, Drum Tower Hospital Clinical College of Nanjing Medical University, Nanjing, China
Journal: NEW - PUT DETAILS IN CITATION FIELD
Citation: World Neurosurgery
Volume 122, February 2019, Pages e1111-e1119
Publication Year and Month: 2019 02

Abstract: Background
We compared the clinical and radiographic outcomes of corrective surgery in patients with poliomyelitis-related spinal deformity (PSD) using 3 types of pelvic fixation and investigated the incidence and risk factors for complications.

Methods
We reviewed the data from 42 patients with PSD who had undergone spinopelvic reconstruction at a single institution from 2000 to 2016. Of the 42 patients, 15 had been treated with the Galveston technique, 13 with iliac screw fixation, and 14 with S2-alar-iliac (S2AI) screw fixation. Demographic data, radiographic parameters, and complications were analyzed. Health-related quality of life was determined using Scoliosis Research Society (SRS) 22-item questionnaires and the Oswestry Disability Index scores.

Results
After surgery, the correction rate of the main curve was 51.7%, 57.8%, and 52.1% in the 3 groups, with significant improvement in regional kyphosis, coronal balance, and pelvic obliquity (PO) (P < 0.05). The correction of PO was similar among the 3 types of pelvic fixation; however, the patients treated with S2AI fixation required significantly less operative time (P < 0.05) and blood loss (P < 0.006). The overall complication rate was 40.5%, with a major complication rate of 23.8%. Age at surgery (P = 0.006) and grade >2 SRS-Schwab osteotomy (P = 0.036) were significant risk factors for complications. Significant improvement was found in the SRS-22 and Oswestry Disability Index scores at the final follow-up examination in the 3 groups.

Conclusions: Conclusions
The present study showed satisfactory correction of spinopelvic deformity for 42 patients with PSD. Compared with the Galveston technique and iliac screw fixation, the use of S2AI significantly decrease the operative time and estimated blood loss and obtained similar correction of PO. Patient age at surgery and grade >2 SRS-Schwab osteotomy were significant risk factors for complications.

Outcome of Research: More research required

Availability of Paper:

Comments (if any):

Link to Paper (if available): Click here to view full text or to download


Category: Anaesthesia, Surgery

Title: Outcome of femoral fractures in poliomyelitis patients
Author: Yechiel N. Gellman, Amal Khoury, Meir Liebergall, Rami Mosheiff, Yoram A. Weil
Affiliation: Orthopedic Trauma ServiceHadassah Hebrew University HospitalJerusalemIsrael
Department of OrthopedicsHadassah Medical CenterJerusalemIsrael
Journal: NEW - PUT DETAILS IN CITATION FIELD
Citation: International Orthopaedics (SICOT) (2019)
Publication Year and Month: 2019

Abstract: Background and purpose
As patients who were afflicted with poliomyelitis during the outbreaks in the past are aging, lower extremity osteoporotic fractures are becoming more frequent. Fixation in deformed, porotic bone, coupled with muscle weakness and imbalance creates a unique challenge when treating these fractures as does their reduced rehabilitation potential. The aim of this study was to investigate the outcome of femoral fractures in surviving poliomyelitis patients.

Patients and methods
Sixty-five patients with 74 femoral fractures were treated between 1990 and 2014. Clinical outcome was assessed using the Parkland and Palmer mobility score, and quality-of-life was assessed using the SF-12® score.

Results
Some 84% of the fractures were a result of low-energy mechanisms and occurred in the polio-affected limbs, but nonaffected limbs were also injured owing to low-energy mechanisms in all cases. Fifty-seven fractures were treated operatively. There were nine re-operations (16%), including implant removals, nonunion, peri-implant fractures, and malunion. Some 60% of the patients did not regain their previous ambulatory capacity. Post-operative weight-bearing status did not correlate with the final functional outcome.

Conclusions: Conclusions
Polio patients with femoral fractures have a guarded prognosis for regaining their pre-injury ambulatory capacity. A higher re-operation rate than that with “normal” osteoporotic fractures is expected.

Outcome of Research: More research required

Availability of Paper:

Comments (if any):

Link to Paper (if available): Click here for preview


Category: Anaesthesia, Surgery

Title: Percutaneous Tracheostomy
Author: Al-Shathri Z, Susanto I
Affiliation: Division of Pulmonary, Critical Care Medicine, Allergy and Clinical Immunology, David Geffen School of Medicine at UCLA, Los Angeles, California.
Journal: NEW - PUT DETAILS IN CITATION FIELD
Citation: Seminars in Respiratory and Critical Care Medicine. 2018 Dec;39(6):720-730
Publication Year and Month: 2018

Abstract: Tracheostomy is a commonly performed surgical procedure in intensive care units (ICUs). Over the past three decades, there has been a substantial body of evidence to suggest percutaneous tracheostomy (PT) is at least as safe as surgical tracheostomy (ST) in the hands of trained clinicians. In most institutions, PT is more readily performed at bedside than ST in the ICU; hence, PT is an attractive alternative to ST in the ICU. Bedside PT generates significant cost savings by eliminating operating room and anesthesia charges. Bronchoscopy is commonly used as a visual aid during PT. Ultrasound (US)-guided PT is gaining popularity. It can be used as an adjunct or alternative to bronchoscopic-guided PT, especially in hospitals where access to bronchoscopy remains fairly limited and US is more widely available. There are many benefits in converting translaryngeal intubation to tracheostomy. It is widely accepted that tracheostomy is preferred if there is an anticipation of prolonged need for an artificial airway. The timing of this conversion from translaryngeal intubation to tracheostomy remains a subject of controversy. Limited data are available regarding the safety of PT on patients who are on dual antiplatelet therapy or active anticoagulation. Given the heterogeneity of PT techniques, adequate training and experience with the technique, coupled with careful planning are essential in minimizing any potential complication.

Conclusions:

Outcome of Research: More research required

Availability of Paper:

Comments (if any):

Link to Paper (if available): Click here for preview


Category: Surgery

Title: Ultrasound-Guided Carpal Tunnel Release Using Dynamic Expansion of the Transverse Safe Zone in a Patient With Postpolio Syndrome: A Case Report
Author: Troy Henning DO, Daniel Lueders MD, Kate Chang, Lynda Yang MD
Affiliation: Swedish Medical Group, Swedish Spine, Sports and Musculoskeletal Medicine, 1600 E. Jefferson Street, Suite 300, Seattle, WA 98122
Department of Physical Medicine and Rehabilitation, University of Michigan, Ann Arbor, MI
Journal: PM&R: The Journal of Injury, Function, and Rehabilitation
Citation: PM&R Volume 10, Issue 10, October 2018, Pages 1115-1118

Publication Year and Month: 2018 10

Abstract: The prevalence of carpal tunnel syndrome (CTS) in patients with postpolio syndrome occurs at a rate of 22%. Irrespective of those with CTS, 74% of postpolio patients weight bear through their arms for ambulation or transfers. As open carpal tunnel release is performed along the weight-bearing region of the wrist, their functional independence may be altered while recovering. This case demonstrates that ultrasound-guided carpal tunnel release was successfully performed in a patient with postpolio syndrome allowing him to immediately weight bear through his hands after the procedure so he could recover at home.

Conclusions: Ultrasound-guided carpal tunnel release was successfully performed in a patient with postpolio syndrome allowing him to immediately weight bear through his hands after the procedure so he could recover at home.

Outcome of Research: Effective

Availability of Paper:

Comments (if any):

Link to Paper (if available): Click here to view full text or to download


There is currently 10 paper in this category.

Category: Anaesthesia, Surgery

Title: Radiographic and Clinical Outcomes of Surgical Correction of Poliomyelitis-Related Spinal Deformities: A Comparison Among Three Types of Pelvic Instrumentations
Author: Jie Li, Zongshan Hu, Changchun Tseng, Zhihui Zhao, Yiwen Yuan,Zezhang Zhu, Yong Qiu, Zhen Liu
Affiliation: Department of Spine Surgery, Affiliated Drum Tower Hospital of Nanjing University Medical School, Nanjing, China

Department of Orthopaedics and Traumatology, Chinese University of Hong Kong, Hong Kong, China

Department of Spine Surgery, Drum Tower Hospital Clinical College of Nanjing Medical University, Nanjing, China
Journal: NEW - PUT DETAILS IN CITATION FIELD
Citation: World Neurosurgery
Volume 122, February 2019, Pages e1111-e1119
Publication Year and Month: 2019 02

Abstract: Background
We compared the clinical and radiographic outcomes of corrective surgery in patients with poliomyelitis-related spinal deformity (PSD) using 3 types of pelvic fixation and investigated the incidence and risk factors for complications.

Methods
We reviewed the data from 42 patients with PSD who had undergone spinopelvic reconstruction at a single institution from 2000 to 2016. Of the 42 patients, 15 had been treated with the Galveston technique, 13 with iliac screw fixation, and 14 with S2-alar-iliac (S2AI) screw fixation. Demographic data, radiographic parameters, and complications were analyzed. Health-related quality of life was determined using Scoliosis Research Society (SRS) 22-item questionnaires and the Oswestry Disability Index scores.

Results
After surgery, the correction rate of the main curve was 51.7%, 57.8%, and 52.1% in the 3 groups, with significant improvement in regional kyphosis, coronal balance, and pelvic obliquity (PO) (P < 0.05). The correction of PO was similar among the 3 types of pelvic fixation; however, the patients treated with S2AI fixation required significantly less operative time (P < 0.05) and blood loss (P < 0.006). The overall complication rate was 40.5%, with a major complication rate of 23.8%. Age at surgery (P = 0.006) and grade >2 SRS-Schwab osteotomy (P = 0.036) were significant risk factors for complications. Significant improvement was found in the SRS-22 and Oswestry Disability Index scores at the final follow-up examination in the 3 groups.

Conclusions: Conclusions
The present study showed satisfactory correction of spinopelvic deformity for 42 patients with PSD. Compared with the Galveston technique and iliac screw fixation, the use of S2AI significantly decrease the operative time and estimated blood loss and obtained similar correction of PO. Patient age at surgery and grade >2 SRS-Schwab osteotomy were significant risk factors for complications.

Outcome of Research: More research required

Availability of Paper:

Comments (if any):

Link to Paper (if available): Click here to view full text or to download


Category: Anaesthesia, Surgery

Title: Outcome of femoral fractures in poliomyelitis patients
Author: Yechiel N. Gellman, Amal Khoury, Meir Liebergall, Rami Mosheiff, Yoram A. Weil
Affiliation: Orthopedic Trauma ServiceHadassah Hebrew University HospitalJerusalemIsrael
Department of OrthopedicsHadassah Medical CenterJerusalemIsrael
Journal: NEW - PUT DETAILS IN CITATION FIELD
Citation: International Orthopaedics (SICOT) (2019)
Publication Year and Month: 2019

Abstract: Background and purpose
As patients who were afflicted with poliomyelitis during the outbreaks in the past are aging, lower extremity osteoporotic fractures are becoming more frequent. Fixation in deformed, porotic bone, coupled with muscle weakness and imbalance creates a unique challenge when treating these fractures as does their reduced rehabilitation potential. The aim of this study was to investigate the outcome of femoral fractures in surviving poliomyelitis patients.

Patients and methods
Sixty-five patients with 74 femoral fractures were treated between 1990 and 2014. Clinical outcome was assessed using the Parkland and Palmer mobility score, and quality-of-life was assessed using the SF-12® score.

Results
Some 84% of the fractures were a result of low-energy mechanisms and occurred in the polio-affected limbs, but nonaffected limbs were also injured owing to low-energy mechanisms in all cases. Fifty-seven fractures were treated operatively. There were nine re-operations (16%), including implant removals, nonunion, peri-implant fractures, and malunion. Some 60% of the patients did not regain their previous ambulatory capacity. Post-operative weight-bearing status did not correlate with the final functional outcome.

Conclusions: Conclusions
Polio patients with femoral fractures have a guarded prognosis for regaining their pre-injury ambulatory capacity. A higher re-operation rate than that with “normal” osteoporotic fractures is expected.

Outcome of Research: More research required

Availability of Paper:

Comments (if any):

Link to Paper (if available): Click here for preview


Category: Surgery

Title: Ultrasound-Guided Carpal Tunnel Release Using Dynamic Expansion of the Transverse Safe Zone in a Patient With Postpolio Syndrome: A Case Report
Author: Troy Henning DO, Daniel Lueders MD, Kate Chang, Lynda Yang MD
Affiliation: Swedish Medical Group, Swedish Spine, Sports and Musculoskeletal Medicine, 1600 E. Jefferson Street, Suite 300, Seattle, WA 98122
Department of Physical Medicine and Rehabilitation, University of Michigan, Ann Arbor, MI
Journal: PM&R: The Journal of Injury, Function, and Rehabilitation
Citation: PM&R Volume 10, Issue 10, October 2018, Pages 1115-1118

Publication Year and Month: 2018 10

Abstract: The prevalence of carpal tunnel syndrome (CTS) in patients with postpolio syndrome occurs at a rate of 22%. Irrespective of those with CTS, 74% of postpolio patients weight bear through their arms for ambulation or transfers. As open carpal tunnel release is performed along the weight-bearing region of the wrist, their functional independence may be altered while recovering. This case demonstrates that ultrasound-guided carpal tunnel release was successfully performed in a patient with postpolio syndrome allowing him to immediately weight bear through his hands after the procedure so he could recover at home.

Conclusions: Ultrasound-guided carpal tunnel release was successfully performed in a patient with postpolio syndrome allowing him to immediately weight bear through his hands after the procedure so he could recover at home.

Outcome of Research: Effective

Availability of Paper:

Comments (if any):

Link to Paper (if available): Click here to view full text or to download


Category: Surgery

Title: Outcome of total knee arthroplasty in patients with poliomyelitis
Author: Anoop Prasad, Richard Donovan, Manoj Ramachandran, Sebastian Dawson-Bowling, Steven Millington, Rej Bhumbra, Pramod Achan, Sammy A. Hanna
Affiliation:
Journal: NEW - PUT DETAILS IN CITATION FIELD
Citation: The British Editorial Society of Bone & Joint Surgery, 6 Jun 2018
Publication Year and Month: 2018 06

Abstract: Total knee arthroplasty (TKA) in patients affected by poliomyelitis is technically challenging owing to abnormal anatomical features including articular and metaphyseal angular deformities, external rotation of the tibia, excessive valgus alignment, bone loss, narrowness of the femoral and tibial canals, impaired quadriceps strength, flexion contractures, genu recurvatum and ligamentous laxity. Little information is available regarding the results and complications of TKA in this challenging group of patients.

Conclusions: The findings of this review support the use of TKA to alleviate pain and functional limitation in poliomyelitis patients with knee arthropathy. Post-operative patient satisfaction and functional improvement is similar to other patients; however, the revision rate is higher. Quadriceps muscle power is an important prognostic factor for functional outcome and patients should be counselled about this pre-operatively. The use of constrained implant designs is recommended in the presence of less than antigravity quadriceps strength. Irrespective of the type of implant used, meticulous intra-operative balancing of soft tissues and restoration of alignment are crucial factors for achieving a good outcome.

Outcome of Research: More research required

Availability of Paper:

Comments (if any):

Link to Paper (if available): Click here to view full text or to download


Category: Surgery

Title: A Two-Stage Foot Repair in a 55-Year-Old Man with Poliomyelitis
Author: Daniel Pollack
Affiliation: Department of Podiatric Surgery, Wyckoff Heights Medical Center, 374 Stockholm Ave, Brooklyn, NY;Madison Podiatry, 52 Skyline Drive, Ringwood, NJ 07456
Journal: NEW - PUT DETAILS IN CITATION FIELD
Citation: Journal of the American Podiatric Medical Association Volume 108, Issue 1 (January 2018)
Publication Year and Month: 2018 01

Abstract: A 55-year-old man with poliomyelitis presented with a plantarflexed foot and painful ulceration of the sub–first metatarsophalangeal joint present for many years. A two-stage procedure was performed to bring the foot to 90°, perpendicular to the leg, and resolve the ulceration. The first stage corrected only soft-tissue components. It involved using a hydrosurgery system to debride and prepare the ulcer, a unilobed rotational skin plasty to close the ulcer, and a tendo Achillis lengthening to decrease forefoot pressure. The second stage corrected the osseous deformity with a dorsiflexory wedge osteotomy of the first metatarsal. The ulceration has remained closed since the procedures, with complete resolution of pain.

Conclusions:

Outcome of Research: More research required

Availability of Paper:

Comments (if any):

Link to Paper (if available):


Category: Anaesthesia, Surgery

Title: Percutaneous Tracheostomy
Author: Al-Shathri Z, Susanto I
Affiliation: Division of Pulmonary, Critical Care Medicine, Allergy and Clinical Immunology, David Geffen School of Medicine at UCLA, Los Angeles, California.
Journal: NEW - PUT DETAILS IN CITATION FIELD
Citation: Seminars in Respiratory and Critical Care Medicine. 2018 Dec;39(6):720-730
Publication Year and Month: 2018

Abstract: Tracheostomy is a commonly performed surgical procedure in intensive care units (ICUs). Over the past three decades, there has been a substantial body of evidence to suggest percutaneous tracheostomy (PT) is at least as safe as surgical tracheostomy (ST) in the hands of trained clinicians. In most institutions, PT is more readily performed at bedside than ST in the ICU; hence, PT is an attractive alternative to ST in the ICU. Bedside PT generates significant cost savings by eliminating operating room and anesthesia charges. Bronchoscopy is commonly used as a visual aid during PT. Ultrasound (US)-guided PT is gaining popularity. It can be used as an adjunct or alternative to bronchoscopic-guided PT, especially in hospitals where access to bronchoscopy remains fairly limited and US is more widely available. There are many benefits in converting translaryngeal intubation to tracheostomy. It is widely accepted that tracheostomy is preferred if there is an anticipation of prolonged need for an artificial airway. The timing of this conversion from translaryngeal intubation to tracheostomy remains a subject of controversy. Limited data are available regarding the safety of PT on patients who are on dual antiplatelet therapy or active anticoagulation. Given the heterogeneity of PT techniques, adequate training and experience with the technique, coupled with careful planning are essential in minimizing any potential complication.

Conclusions:

Outcome of Research: More research required

Availability of Paper:

Comments (if any):

Link to Paper (if available): Click here for preview


Category: Surgery

Title: Long-term results after triple arthrodesis: Influence of alignment on ankle osteoarthritis and clinical outcome
Author: Klerken, T., Kosse, N.M., Aarts, C.A.M., Louwerens, J.W.K.
Affiliation: Department of Orthopedic Surgery, Sint Maartenskliniek, Nijmegen, The Netherlands
Journal: NEW - PUT DETAILS IN CITATION FIELD
Citation: Foot and Ankle Surgery. https://doi.org/10.1016/j.fas.2017.11.003

Publication Year and Month: 2017 11

Abstract: Background
Pain, deformity and instability are the main reasons for fusion of the tarsal joints, a triple arthrodesis. The short and midterm results show that mobility, function and satisfaction increase postoperatively. However, osteoarthritis (OA) of the adjacent ankle joint is described as a long-term complication. Alignment of the foot could be an influencing factor. The aim of this study was to examine whether malalignment after triple arthrodesis leads to a higher grade of OA at long-term follow-up.


Conclusions
Triple arthrodesis is a salvage procedure in patients with a painful and deformed hindfoot and results in a clinically beneficial outcome, even 15 years after surgery. The present study did not show that malalignment after triple arthrodesis results in a higher grade of OA of the ankle joint in the long-term. The cause of the aggravation of OA is still not fully understood and needs further research. Nevertheless, clinical results are satisfying 15 years postoperatively.

Conclusions: A triple arthrodesis was effective 15 years after surgery. Aggravation of ankle joint osteoarthritis does not relate to patient satisfaction. Slow radiographic aggravation of osteoarthritis of the ankle joint was seen in 42% of the patients.

Outcome of Research: More research required

Availability of Paper: The full text of this paper has been generously made available by the publisher.

Comments (if any):

Link to Paper (if available): Click here to view Abstract


Category: Surgery

Title: Anaesthetists need to be wary of postpolio syndrome
Author: Tobin A

Affiliation: Deputy Director, Intensive Care Unit, St Vincent’s Hospital, Victoria, Australia
Journal: ANZCA Bulletin
Citation: ANZCA Bulletin September 2015, pp 42-43
Publication Year and Month: 2015 09

Abstract: This is a brief Safety and Quality news item which does not have an abstract. This is an extract:

Postpolio syndrome (PPS) occurs in a significant proportion of polio survivors years after recovering from the original illness. Anaesthetists need to be aware of the syndrome as polio survivors are relatively numerous (40,000 cases of paralytic polio in Australia from the 1930s to the 1960s), they are of an age where they will be increasingly presenting for elective and emergency procedures and the syndrome has important. Postpolio syndrome patients present a number of potential problems for the anaesthetist. However for those who are aware depressant effects of analgesics of the syndrome, careful assessment and planning should minimise the risk of perioperative complications and provide optimal patient outcomes.

Conclusions:

Outcome of Research: Not applicable

Availability of Paper: Other - see Comments.

Comments (if any): This news item has been generously made available by Post-Polio Victoria.

Link to Paper (if available): Click here to download


Category: Surgery

Title: Anesthetic implications of postpolio syndrome: new concerns for an old disease
Author: Schwartz A (1), Bosch LM
Affiliation: (1) Saint Louis University Hospital, St Louis, Missouri, USA
Journal: American Association of Nurse Anesthetists
Citation: AANA J. 2012 Oct;80(5):356-61
Publication Year and Month: 2012 10

Abstract: Poliomyelitis was pandemic in the United States and much of the world in the first half of the 20th century. The uses of polio vaccines have essentially eradicated the disease in the United States today. But poliovirus infection survivors who had experienced a paralytic attack can see a return of some symptoms, which is a syndrome called postpolio syndrome (PPS). The anesthetist must preoperatively assess reported amounts of patient physical activity and patient age, which can indicate the amount of muscle degeneration that may have already occurred. Patients with PPS demonstrate altered respiratory function, cold intolerance, a risk for aspiration, and experience chronic pain in muscles and joints. Patients with PPS display an increased sensitivity to some anesthetic agents such as long-acting narcotics and potent inhaled anesthetic gases with a high blood-gas partition coefficient, along with report of increased fatigue, weakness, and somnolence after anesthesia. Anesthesia care must center on the preservation of muscle function postoperatively. The anesthetist should consider the use of short-acting anesthetic agents, increased doses of analgesics, the use of warming devices, and careful attention to patient positioning. Prolonged postoperative care and hospital admission after surgery are possible.

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Outcome of Research: Not applicable

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Category: Surgery

Title: Postpolio syndrome and anesthesia
Author: Lambert DA, Giannouli E, Schmidt BJ
Affiliation: Department of Anesthesia, University of Manitoba, Canada
Journal: Anesthesiology
Citation: Anesthesiology. 2005 Sep;103(3):638-44
Publication Year and Month: 2005 09

Abstract: The development of polio vaccines 50 years ago essentially halted childhood polio epidemics in the industrialized world. During the past quarter century, a constellation of delayed neuromuscular symptoms, called postpolio syndrome, became recognized among the aging polio survivors. The prevalence of postpolio syndrome in the US population is estimated to be in the hundreds of thousands. The most common symptoms are fatigue, pain, and new onset weakness thought to be related to delayed deterioration of motor neuron function. When a patient with postpolio syndrome presents for surgery, special precautions are warranted, because these patients may have respiratory impairment, sleep apnea, swallowing difficulties, and cold intolerance. This article first reviews clinical features and some pathoetiologic theories of postpolio syndrome and then focuses on anesthetic considerations including the use of common anesthetics, neuromuscular blockade, regional anesthesia, and general anesthetic management strategies.

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There is currently 10 paper in this category.

Outcomes of Research or Clinical Trials Activity Levels Acute Flaccid Paralysis Ageing Anaerobic Threshold Anaesthesia Assistive Technology Brain Cardiorespiratory Cardiovascular Clinical Evaluation Cold Intolerance Complementary Therapies Continence Coping Styles and Strategies Cultural Context Diagnosis and Management Differential Diagnosis Drugs Dysphagia Dysphonia Epidemiology Exercise Falls Fatigue Fractures Gender Differences Immune Response Inflammation Late Effects of Polio Muscle Strength Muscular Atrophy Orthoses Pain Polio Immunisation Post-Polio Motor Unit Psychology Quality of Life Renal Complications Respiratory Complications and Management Restless Legs Syndrome Sleep Analaysis Surgery Vitality Vocational Implications