Immediately loaded full arch implant rehabilitation and oral health-related quality of life: A retrospective cohort study from primary dental care.

AIMS: This study evaluates patient-centered outcomes in patients undergoing full-arch rehabilitation, with immediate loading of implants. Using the Oral Health Impact Profile questionnaire pre-and post-treatment, it assesses the hypothesis that immediate full arch loading significantly improves quality of life. METHODOLOGY: A dataset was defined as: 20 consecutive patients from a research database who had undergone IFAL surgery (maxilla, mandible, or both) and definitive restoration by a single clinician, and completed the OHIP-14 questionnaire prior to treatment and after restoration. RESULTS: Pre (T0 ) and post (T1 ) treatment questionnaires were analyzed from 20 consecutive patients in whom a total of 160 implants were placed. The mean T0 score was 26.7, and mean T1 score 4.6. Differences were statistically significant (p = 0.00008). Greatest improvements were seen in psychological discomfort and disability, and pain. Worsening quality of life was shown by questions relating to speech in six patients and taste in three patients. CONCLUSION: This study demonstrates that overall IFAL significantly improves tooth-related quality of life. It suggests reasons for patients to seek treatment while providing evidence to manage expectations, such as possible implications on speech, thus supporting informed consent of future patients in a primary care setting.

High tibial osteotomy: A review of the readability and quality of patient information on the internet.

Background: High tibial osteotomy (HTO) is a common procedure performed for unicompartmental knee osteoarthritis (OA). Patients are increasingly using the internet to research surgical procedures to help aid decision making. Our aim was to assess the readability and quality of information available to patients online relating to HTO. Methods: A systematic review of three search engines Google®, Bing®, and Yahoo® using the search terms "high tibial osteotomy" and "tibial osteotomy" separately was performed. The first three pages of results for each search engine were analyzed. Readability was assessed using the Flesch Reading Ease Scale (FRES), Flesch-Kincaid Grade level (FKGL) and the Simple Measure of Gobbledygook formula (SMOG). Quality was assessed with the DISCERN questionnaire, JAMAbenchmarks and the presence of Health on the Net Foundation Code of Conduct (HONCode). Results: Twenty-four webpages were included after duplicates (n=42) and exclusions (n=24).The overall readability was low, with a mean FRES of 53.2 (SD: 9.1), FKGL 10.7 (SD: 1.8),SMOG 10.4 (SD: 1.5). Quality was also low with a mean DISCERN score of 42 (SD: 12.3).None of the webpages fulfilled all of the JAMA benchmarking criteria and only 2/24 (8.3%)webpages possessed HONCode certification. Conclusion: The overall online information available to patient's considering HTO is of lowreadability and quality. Improving the quality and readability of patient information online willbenefit informed patient decision making before HTO surgery.

Efficacy of the Adductor Canal Approach to Saphenous Nerve Block for Anterior Cruciate Ligament Reconstruction With Hamstring Autograft: A Randomized Controlled Trial.

BACKGROUND: For reconstruction of the anterior cruciate ligament (ACL) with hamstring autograft, perioperative analgesia can be achieved with multimodal analgesia and intra-articular local anesthesia infiltration with or without additional regional blocks. Saphenous nerve block (SNB) via the adductor canal is commonly used in our practice, but its benefit has not been well established in the literature. PURPOSE: To assess the efficacy of SNB in ACL reconstruction with hamstring autograft. STUDY DESIGN: Randomized controlled trial; Level of evidence, 1. METHODS: Consecutive patients undergoing arthroscopic ACL reconstruction with hamstring autograft were randomized into a control group (no SNB) and an intervention group (SNB). All patients received standardized anesthetic induction and maintenance agents with perioperative analgesia, per study protocol, with local anesthetic infiltration of the graft harvest site and intra-articular infiltration. RESULTS: Sixty patients were randomized into the 2 groups (n = 30 each). There was no statistically significant difference in total opiate consumption between the groups (control, 34 mg; SNB, 31 mg; P = .40). There was no statistically significant difference in visual analog scale scores for pain at 0, 8, and 24 hours postsurgery, and no difference in overall satisfaction score. The control group had a significantly higher visual analog scale score at 4 hours postsurgery (3.0 vs 1.9, P = .04). CONCLUSION: SNB has a minimal effect on postsurgical care for ACL reconstruction with hamstring autograft in the presence of multimodal analgesia and local anesthetic infiltration.

A comparison of nonoperative vs. Endobutton repair of distal biceps ruptures.

BACKGROUND: The aim of this study was to compare the outcome of patients who have undergone distal biceps tendon repair by a single-incision Endobutton fixation technique with the results of another cohort of patients who elected not to undergo surgery for distal biceps tendon rupture. METHODS: A retrospective cohort study was performed of patients diagnosed with distal biceps ruptures, repaired with an Endobutton (Smith & Nephew, Andover, MA, USA) technique or treated nonoperatively by the senior surgeon (S.A.S.). With a minimum follow-up of 6 months, a routine elbow examination, radiographs, and functional questionnaires were performed. Isometric supination, flexion, and grip strength was measured using a BTE machine (Baltimore Therapeutic Equipment, Hanover, MD, USA). There were 47 patients available for follow-up with 50 distal biceps ruptures; 40 ruptures have undergone repair, and 10 have been managed nonoperatively. Three patients had sustained bilateral ruptures. RESULTS: There was a significant difference in flexion and supination isometric strength between the operative and nonoperative cohorts compared with the uninjured contralateral side (92.94% vs. 70.65%, P = .01512; 87.91% vs 59.11%, P = .00414, respectively). The difference in grip strengths between the 2 cohorts compared with the uninjured side was not significant (100.00% vs. 79.16%; P = .16002). The operated cohort had significantly better QuickDASH score, Oxford Elbow Score, and Mayo Elbow Performance Score (6.29 vs. 14.10, P = .02123; 44.71 vs. 38.70, P = .00429; 93.13 vs. 84.50, P = .01423). CONCLUSION: Repair of distal biceps ruptures using an Endobutton fixation results in nearly normal return of strength and function, which is significantly better than in those managed nonoperatively. LEVEL OF EVIDENCE: Level III, Retrospective Cohort Design; Treatment Study.