Validation of a modified Scoliosis Research Society instrument for patients with limb deformity: The limb deformity-Scoliosis Research Society (LD-SRS) score

Fabricant, Peter D.; Borst, Eugene W.; Green, Stuart A.; Marx, Robert G.; Fragomen, Austin T.; Rozbruch, S. Robert

doi:10.4103/2455-3719.190710

Cited by 25 publications

(47 citation statements)

References 2 publications

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“…Starting and ending metacarpal lengths were measured from patients’ radiographs. Patients completed the Body Image Quality of Life Inventory (BIQLI) 4 and Limb Deformity Modified Scoliosis Research Society (LD-SRS) score 5 both preoperatively and at the latest follow-up.…”

Section: Methodsmentioning

confidence: 99%

Metacarpal Lengthening in Adults With Brachymetacarpia

Lam

Fragomen

Rozbruch

2017

Hand (New York, N,Y.)

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Section: Methodsmentioning

confidence: 99%

Metacarpal Lengthening in Adults With Brachymetacarpia

Lam

Fragomen

Rozbruch

2017

Hand (New York, N,Y.)

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“…We chose the improvement limit Δ (minimal clinically important difference, MCID) as 10% (0.5 point), as the possible finding of a smaller detectable difference would not be of clinical significance. In our pretest sample-size analysis, we used a standard deviation (SD) of LDR-SRS score of 0.6 points based on previous report in the literature (18). With a significance level of 5% (two-sided confidence interval of 95%), and a power of 90%, the sample size was calculated to include at least 30 in each group.…”

Section: Outcomes and Sample Sizementioning

confidence: 99%

STRYDE versus PRECICE magnetic internal lengthening nail for femur lengthening

Galal

Shin

Principe

et al. 2021

Arch Orthop Trauma Surg

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Introduction Magnetic internal lengthening nails (MILNs) have been used for femoral lengthening to avoid complications associated with external fixation. The titanium version of the MILN (PRECICE®) has been in use since 2011 but had limitations (50–75 lb) in post-operative weight bearing. A new stainless-steel version of the MILN (STRYDE®) allows 150–250 lb of post-operative weight bearing. The aim is to compare the outcomes of using these two different MILNs for both unilateral and bilateral femoral lengthening. Methods A single-center, retrospective cohort study was conducted in which patients’ records were reviewed from the period from January 2017 to March 2020. A total of 66 femoral lengthening procedures were included in the study and were divided into two groups: STRYDE® group (30 femora) and PRECICE® group (36 femora). Outcomes assessed were the 6-months post-operative Limb Deformity-Scoliosis Research Society (LD-SRS) Score, adjacent joint range of motion (ROM), average distraction rate, bone healing index (BHI), and complications. Results No statistically significant difference was found between the two groups in regard to the (LD-SRS) score, hip ROM, or knee ROM. Statistically significant differences were found between the two groups in regard to BHI (average of 0.84 months/cm and 0.67 months/cm for STRYDE® and PRECICE®, respectively) and distraction rate (average of 0.6 mm/day and 0.9 mm/day for STRYDE® and PRECICE®, respectively). No mechanical nail complications were reported in the STRYDE® group compared to three events of nail failure in the PRECICE® group. One femur in the PRECICE® group needed BMAC injection for delayed healing compared to four femurs in the STRYDE® group. Conclusion The STRYDE® MILN yields comparable functional results to those of PRECICE® MILN and shows fewer mechanical nail complications. However, STRYDE® MILN requires a slower distraction rate and yields slower healing (larger BHI). Level of evidence Level III, Therapeutic study.

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“…Although the sample size was small given the nature of this study, we observed improvements in almost all LD-SRS and PROMIS domain scores individually. Using previously validated minimal clinically important difference values of 0.3 for LD-SRS, 4.5 for PROMIS physical function, and 4.1 for PROMIS pain interference, 9,20 we observed mean improvements that translate to clinical improvement in the quality of life of patients treated with this staged approach. In addition, despite the staged approach to correction, patients in this series reported a high level of satisfaction following the procedures.…”

Section: Discussionmentioning

confidence: 78%

“…LD-SRS is a previously validated limb modified spinal score patient-reported outcomes measure that quantifies quality of life measures for patients with lower-limb deformity, with domains assessing function, pain, self-image, mental health, and satisfaction with management. 9 The PROMIS computerized adaptive tests (CAT) used in this study have been previously validated for foot and ankle surgery 1,18,19 and included physical function, pain interference, pain intensity, global physical health, and global mental health. Scores have a standardized mean of 50, the reference population average, with a standard deviation ( T score) of 10.…”

Section: Methodsmentioning

confidence: 99%

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A Staged Approach to Combined Extra-articular Limb Deformity Correction and Total Ankle Arthroplasty for End-Stage Ankle Arthritis

et al. 2020

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Background: Patients presenting with end-stage ankle osteoarthritis (OA) in the setting of a concomitant extra-articular limb deformity pose a challenging problem that has not yet been described in the literature. We describe a case series of patients treated with external and internal fixation techniques followed by total ankle arthroplasty (TAA) in a staged approach to treat this complex presentation. Methods: Eight patients with limb deformity and end-stage ankle OA who underwent staged deformity correction and TAA from 2016 to 2019 at our institution were retrospectively identified. Average age was 58.5 (range, 49-68) years, with an average follow-up of 2.6 (range, 0.8-4.2) years. All patients underwent limb reconstruction with either tibial osteotomy with a circular frame (n=6) or intramedullary nail (n=2). Limb deformities consisted of the following: posttraumatic tibial malunion (2), limb length discrepancy (1), acquired tibial deformity (1), genu varum (2), or genu valgum (2). Radiographic parameters were assessed pre- and postoperatively on 51-inch standing and ankle radiographs: limb length discrepancy (LLD), genu varum/valgum deformity, recurvatum deformity, mechanical axis deviation, medial proximal tibial angle, lateral distal tibial angle, anterior distal tibial angle, and tibiotalar alignment. Pre- and postoperative patient-reported outcomes were assessed using 2 metrics, the Limb Deformity–Scoliosis Research Society (LD-SRS) and Patient-Reported Outcomes Measurement Information System (PROMIS) scores (Physical Function, Pain Intensity, Pain Interference, Global Physical Function, and Global Mental Function). Results: Following staged limb deformity correction and TAA, all patients achieved correction of LLD and angular deformities of the lower limb, along with restoration of normal alignment of the ankle joint. There was significant mean improvement in all patient-reported LD-SRS and PROMIS domains, except for LD-SRS mental health. LD-SRS function improved from 2.6 (±0.7) to 4.6 (±0.2), P = .008; pain improved from 2.9 (±0.9) to 4.8 (±0.2), P = .012; self-image improved from 2.9 (±0.4) to 4.7 (±0.3), P < .001; and total LD-SRS improved from 3.3 (±0.4) to 4.8 (±0.2), P = .002. Average satisfaction was 4.9 (±0.3). PROMIS physical function improved from 32.3 (±6.8) to 51.3 (±5.3), P = .008; pain interference improved from 66.0 (±9.1) to 41.3 (±6.2), P = .004; pain intensity improved from 60.0 (±13.3) to 33.1 (±5.3), P = .007; global physical health improved from 39.3 (±6.8) to 60.7 (±5.1), P = .002; global mental health improved from 54.8 (±5.9) to 65.6 (±2.8), P = .007. There was one incidence of pin site infection and one reoperation. Conclusion: Deformity correction with either external frame or intramedullary nail fixation followed by TAA in a staged approach was a viable surgical option in the treatment of end-stage ankle OA with concurrent extra-articular limb deformity. This unique approach was capable of achieving deformity correction with improved patient-reported outcomes, minimal complications, and good patient satisfaction. Level of Evidence: Level IV, retrospective case series.

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Validation of a modified Scoliosis Research Society instrument for patients with limb deformity: The limb deformity-Scoliosis Research Society (LD-SRS) score

Cited by 25 publications

References 2 publications

Metacarpal Lengthening in Adults With Brachymetacarpia

Metacarpal Lengthening in Adults With Brachymetacarpia

STRYDE versus PRECICE magnetic internal lengthening nail for femur lengthening

A Staged Approach to Combined Extra-articular Limb Deformity Correction and Total Ankle Arthroplasty for End-Stage Ankle Arthritis

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