The results of this study support the idea that percutaneous distal metatarsal osteotomy yields good functional and radiological result and is associated with a high degree of postoperative patient satisfaction.

Purpose The purpose of this study was to assess the effectiveness of arthroscopic capsular release carried out for refractory cases of both primary and secondary adhesive shoulder capsulitis that were not responsive to at least 6 months of prior conservative therapy. Methods Arthroscopic 360-degree capsular release was performed on 167 patients (173 shoulders) with adhesive shoulder capsulitis. Ninety-one shoulders (52.6 %) had primary and 82 shoulders (47.4 %) secondary adhesive capsulitis. The median follow-up period was 36 months (range 14-67 months). Results All patients were evaluated according to the constant score. Both groups (primary and secondary adhesive capsulitis) experienced a significant improvement for all ranges of motion immediately postoperative, as well as at the time of follow-up. The median preoperative constant score was 41 (range 18-61) points and increased significantly to a median of 83 (range 27-100) at the time of follow-up. In the group of primary adhesive capsulitis, median preoperative score was 42 points (range 19-58) and increased to 85 points (range 36-100) at follow-up. In the group of secondary adhesive capsulitis, the preoperative mean increased from 41 points (range 18-61) to 74 points (range 27-100) at the time of the follow-up. The constant score component for pain and the visual analogue scale (VAS) score were also significantly increased. Conclusion Arthroscopic capsular release in patients with primary and secondary adhesive shoulder capsulitis represents a valuable therapeutic choice with minimal complications, to effectively reduce pain and improve movement in all planes of motion. Level of evidence Therapeutic retrospective case series study, Level IV.

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The purpose of this study was to determine the rate of documented counseling on lifestyle modifications in patients presenting to the primary care setting with a diagnosis of gastroesophageal reflux disease. Retrospective chart review was conducted for 502 active patients with a primary or secondary diagnosis of gastroesophageal reflux disease from two internal medicine clinics at the University of Kansas School of Medicine-Wichita. Charts were reviewed for documented counseling on four specific lifestyle modifications: (a) smoking and alcohol cessation, (b) dietary changes, (c) head of bed elevation, and (e) postprandial avoidance of recumbency. Only 12% of patients in this sample received documented counseling on lifestyle modifications. Of those patients receiving documented counseling, 71% were counseled on dietary changes, 41% smoking or alcohol cessation, 28% head of bed elevation, and 21% postprandial avoidance of recumbency. Documentation indicated that patients with gastroesophageal reflux disease are not adequately counseled regarding recommended lifestyle modifications.

Background Total hip arthroplasty (THA) with ceramic-on-ceramic (CoC) was created to minimise wear debris and aseptic loosening. A decade ago, a meta-analysis showed a 10-year survival rate of just 89%. Based on the excellent tribology of the current CoC, significant improvement of implant survivorship is expected. In patients younger than 60, we conducted a meta-analysis to assess 10-year survival and complications after using current primary CoC THA. Materials and methods PubMed, Scopus, EMBASE, Virtual Health Library, and Cochrane Library were used to scan for published trials that met the inclusion criteria until January 2019. The qualified studies were subjected to a systematic review and proportional analysis, and the randomised controlled trials (RCTs) were included in a comparison meta-analysis. Results Thirteen studies were included 156 findings. The total number of hips was 2278. Nine studies were cohort, and four were RCTs between ceramic and polyethylene cups. The analysis revealed an average age of 44 years (range 24–54). The 10-year survival 96% (95% CI; 95.4–96.8%), aseptic loosening rate 0.516. (95% CI; 0.265–0.903), ceramic fracture rate 0.620 (95% CI; 0.34–1.034) and squeaking rate 2.687 (95% CI; 1.279–4.593). A comparison meta-analysis revealed the risk ratio (RR) for revision was 0.27 (95% CI; 0.15–0.47), and for aseptic loosening 0.15 (0.03–0.70) favouring CoC, while RR for component fracture was 1.62 (95% CI; 0.27–9.66) favouring the polyethylene. Conclusion In patients under sixty, current CoC THAs are correlated with better 10-year outcomes than before and have high survivorship rates. Level of evidence: Level I.