Dupuytren's Contracture

Researchers are evaluating post-operative management approaches after a modified Lapidus arthrodesis surgery for hallux valgus, with or without additional surgeries such as Akin or WeilHohmann procedures. The study aims to compare the effectiveness and safety of immediate full weight-bearing versus partial weight-bearing 10-15 kg during rehabilitation. This randomized controlled trial explores a new rehabilitation method following foot surgery to improve recovery. Participants will be randomly assigned to one of two groups after surgery one group will follow partial weight-bearing with a specialized VACOPASO shoe and use crutches along with antithrombotic medication for 6 weeks, while the other group will have immediate complete weight-bearing with the same shoe and medication for the same period. The surgical operation follows standard clinical practices for hallux valgus correction. During the study, healing progress will be monitored through standard X-rays at 6, 12, and 24 weeks to check bone healing, hardware fixation, and fracture alignment. Pain will be measured using a Visual Analogue Scale at the day of surgery and at follow-up visits. Quality of life and functional recovery will be assessed through established foot and ankle scoring systems at multiple time points. The main outcome is the subjective functional recovery measured by the Olerud and Molander Ankle Score at 6 weeks post-surgery.

Researchers are evaluating the effect of a student-led multimodal prehabilitation service called BoneFit for people preparing for total hip or knee replacement surgery. The study aims to improve physical and mental health, quality of life, and reduce hospital stay length, complications, and readmission rates for patients undergoing orthopedic surgery in the Hull region. This pilot feasibility study will compare BoneFit to usual care, as no prehabilitation service is currently offered locally. Participants in the BoneFit intervention group will receive a personalized care plan that includes exercise, nutrition, and psychological support tailored to their needs during the 8 weeks before surgery. A control group will receive usual care without intervention. The groups will be compared to assess the impact of the prehabilitation service. During the study, participants will undergo baseline tests and will be invited to repeat these assessments 3 months after surgery. Researchers will monitor recruitment, attendance, and acceptability over several years. They will also measure physical fitness, hospital length of stay, readmission rates, overall quality of life, and specific pain and function related to the knee or hip. The study will last up to 3 years, with ongoing follow-up assessments to evaluate outcomes.

This observational study is focused on collecting data about the performance of CERAMENT BONE VOID FILLER, a synthetic biphasic bone graft substitute, when used in typical medical practice for orthopedic disorders. The study is sponsored by BONESUPPORT AB and aims to gather information on device performance and patient outcomes to understand its use in real-world settings. Participants will receive CERAMENT BVF as part of their treatment at approved healthcare centers following the products instructions for use. Data collection includes monitoring unexpected device performance, complaints, adverse events, and serious adverse events during surgery and continuing up to 18 months after treatment. Radiological assessments, pain scores, and quality of life evaluations will be conducted at intervals throughout the study. During the study, participants will undergo scheduled reviews at 6, 12, and 18 months to assess device-related outcomes and healing progress using imaging and questionnaires. Researchers will track safety events and gather patient-reported outcomes such as pain levels and quality of life. Participation involves following up with healthcare providers over this period to provide ongoing data for comprehensive evaluation of the devices performance.

This research evaluates the clinical and radiological outcomes in patients who have undergone total ankle replacement for advanced ankle osteoarthritis. The study aims to assess results achieved by surgeons who did not originally design the implant, addressing potential bias seen in prior studies where designers performed the surgeries. The goal is to compare these outcomes with those of ankle arthrodesis, considering improvements in surgical techniques and ankle biomechanics knowledge. Participants in the study have received total ankle arthroplasty using a third-generation ankle replacement device. Clinical assessments are performed before and after surgery, with a minimum follow-up of 12 months. These include the American Orthopedic Foot and Ankle AOFAS score, the Foot Function Index, and the visual analogue scale VAS for pain. Weightbearing ankle X-rays are taken before surgery and at the final follow-up, with independent review by an orthopedic surgeon. During the study, participants complete scheduled follow-up evaluations, questionnaires, and radiographic exams. Researchers measure implant survivorship over 10 years along with various ankle joint angles and functional scores. The study monitors clinical progress, radiological changes, and foot function to evaluate long-term outcomes of the ankle replacement procedure.

Proximal humerus fractures can seriously affect elderly patients by limiting shoulder movement and causing pain, which impacts daily activities. This trial evaluates the timing of rehabilitation after reverse total shoulder arthroplasty rTSA in patients with these fractures, focusing on whether starting physical therapy early or later affects recovery and post-surgery complications. The study aims to identify safer, more effective rehabilitation protocols for this specific trauma patient group. Participants will be randomly assigned to start physical therapy either 2 weeks or 6 weeks after their rTSA surgery. Both groups will follow their assigned rehabilitation schedule, and researchers will compare outcomes such as shoulder range of motion and patient-reported shoulder function. The study includes in-person clinic visits and X-rays at 6 weeks, 3 months, and 6 months post-surgery to track progress and complications. Throughout the study, participants will attend scheduled visits for assessments of shoulder movement using a goniometer and complete outcome questionnaires. Researchers will also review medical records to monitor postoperative complications. The total follow-up lasts 6 months, providing detailed data on how rehabilitation timing influences recovery, patient function, and safety after rTSA for proximal humerus fractures.

Researchers are evaluating the effect of a podcast about constipation on patients undergoing planned orthopedic surgeries such as knee, hip, shoulder, and back operations. This randomized controlled trial aims to see if the podcast can reduce the number of patients experiencing constipation before and after surgery. The study includes adults 18 years or older who can use digital devices and do not have certain gastrointestinal conditions or severe hearing or cognitive impairments. Participants will be randomly assigned to either a control group or an intervention group. Both groups receive standard preoperative information, but the intervention group also gets access to a 30-minute podcast featuring expert explanations and patient experiences related to constipation around surgery. The podcast is accessible throughout the study period. Data will be collected through online questionnaires at four points after the preoperative consultation, shortly before surgery, one week after surgery, and four weeks after surgery. During the study, participants will complete questionnaires assessing constipation using the ROME IV Diagnostic Criteria and quality of life related to constipation via the PAC-QOL tool. Additional information will be gathered about laxative use, educational and living situations, and healthcare contacts from patient records. The researchers will monitor hospitalizations, outpatient visits, and general practitioner contacts up to six months after surgery to evaluate the overall impact. Participation lasts from pre-surgery consultation through four weeks after surgery, with some data extending to six months post-surgery.

Dupuytrens contracture is a condition causing progressive finger stiffness due to fibrosis in the palm and fingers. This trial investigates whether using a night splint after a minimally invasive procedure called percutaneous needle fasciotomy PNF reduces the chance of the contracture coming back. The study compares two groups of patients receiving PNF treatment to see if night splinting adds benefit beyond physical therapy alone. Participants are randomly assigned to one of two groups one group will receive usual care including physical therapy and night splinting for three months after PNF, while the other group will have physical therapy without night splinting. Those in the no splint group will have an additional check three weeks after PNF to monitor finger extension. Follow-up visits occur at 2 weeks, then 3, 12, and 36 months after treatment. During the study, patients will undergo physical exams assessing finger motion, sensation, and grip strength. They will also complete questionnaires about hand function, pain, and quality of life at several timepoints including the day of procedure and months 3, 12, and 36. The main outcome measured is reduction in finger joint contracture at 1 year. Researchers will also evaluate changes in finger flexion, grip strength, pain levels, disability, sensation, and medical history over the follow-up period.

Researchers are evaluating whether percutaneous needle aponeurotomy is not less effective than open surgery with aponeurectomy for treating flexion contracture caused by Dupuytrens disease. This condition involves fibrosis of the palmar aponeurosis, leading to disabling joint contractures in the fingers. The study aims to determine if the minimally invasive needle procedure can reduce the need for open surgery while maintaining suitable safety and efficacy. Participants will be randomly assigned to receive either percutaneous needle aponeurotomy, which involves cutting the fibrotic cord with a needle under local anesthesia in one to three outpatient sessions, or open surgery with excision of the fibrotic tissue performed under regional anesthesia during a short hospital stay. Postoperative care including analgesics, splints, nursing, and physiotherapy is provided after surgery. Treatment completion is defined as the last needle session or stitch removal after surgery. Participants will be followed up at 1 week, 1, 3, 12, 24, and 36 months after treatment. Assessments include measuring joint contractures, range of motion, functional limitation questionnaires, patient satisfaction, complications, and recurrence. Efficacy assessments are conducted in a blinded manner, while complications are evaluated openly. The primary outcome is the degree of metacarpophalangeal joint contracture during passive extension at 3 months post-treatment.

Dupuytrens disease is a common hereditary condition in Northern Europe that causes progressive fibrosis in the hands palmar aponeurosis. This fibrosis leads to bending of the fingers, resulting in significant functional impairment. Various medical and surgical treatments exist, but none fully prevent recurrence of the disease. This trial investigates whether adding autologous adipose tissue grafting to open aponeurectomy can reduce the 2-year recurrence rate of Dupuytrens disease compared to aponeurectomy alone. The study compares two groups one receiving standard open aponeurectomy alone and the other receiving aponeurectomy combined with adipose tissue grafting. The grafting involves harvesting fat from the arm and injecting it into areas where fibrotic cords were removed, aiming to reconstruct tissue and potentially inhibit fibrosis. Both procedures are performed under anesthesia and follow standard surgical safety practices. Participants will be monitored over several years to assess recurrence rates at 2, 3, and 5 years after surgery. Other evaluations include scar appearance, complication rates shortly after surgery, occurrence of algodystrophy, and quality of life impacts at multiple time points. Researchers will conduct follow-up visits to collect data on these outcomes and overall safety, with participant involvement lasting up to five years post intervention.

Dupuytrens contracture is a condition that causes progressive thickening and tightening of the tissue in the palm, leading to hand deformity and difficulty moving the fingers. This research aims to study the use of a minimally invasive procedure called ultrasound-guided needle knife dissection to treat this condition. The study focuses on improving hand movement and patient satisfaction while reducing complications compared to traditional surgical methods. Participants will receive the ultrasound-guided needle knife dissection, where a small blade is guided by ultrasound imaging to carefully cut the fibrous cords causing the contracture. Local anesthesia with lidocaine and bupivacaine will be used for comfort during the procedure. The device used is a Sonosite M-Turbo ultrasound machine with a linear probe for real-time imaging to ensure precise and safe treatment. During the study, participants hand function and mobility will be assessed over six months to measure improvement. Researchers will also collect patient feedback on satisfaction and monitor for any complications related to the procedure. The study includes follow-up visits to evaluate results and safety, lasting a total of six months after treatment.