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Sun Z, Li N, Yang Z, Zhang W, Liu J. Anatomical cup implantation assisted with dynamic 3D planning improves functional outcomes in primary total hip arthroplasty: A retrospective study. J Back Musculoskelet Rehabil 2024; 37:295-304. [PMID: 37980641 DOI: 10.3233/bmr-230004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/21/2023]
Abstract
BACKGROUND Anatomical cup implantation is a promising approach in primary total hip arthroplasty (THA) and improves functional outcomes. OBJECTIVE We aimed to evaluate the cup position and functional outcomes in primary THA with preoperative dynamic 3D planning. METHODS We retrospectively reviewed 54 hips in 48 patients who underwent primary THA with anatomical cup implantation (mean follow-up time: 52 months). Cup positions were evaluated based on patient-specific morphology, the acetabular fossa and the combined anteversion test. Functional outcomes were assessed after THA. The paired-sample t-test was performed for surgical and contralateral native hips among 42 patients who underwent unilateral THA. RESULTS Two hips suffered intraoperative trochanteric fracture, but no hip dislocations occurred. No patients reported groin or thigh pain, and all patients were capable of deep squatting and one-leg standing. The mean Harris hip score, WOMAC score, and physical SF-36 score were 94.46 ± 6.16, 10.41 ± 3.62, and 95.19 ± 8.74, respectively. Except for acetabular offset, THA restored biomechanics to those of contralateral native hip, including cup anteversion, abduction, femoral offset and acetabular height (P> 0.05). CONCLUSION This study provided evidence for the application of anatomical cup implantation assisted with dynamic 3D planning in primary THA, which restored morphology and improved functional outcomes.
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Affiliation(s)
- Zhenhui Sun
- Department of Orthopaedics, Tianjin Hospital of Tianjin University, Tianjin, China
| | - Nan Li
- Department of Orthopaedics, Tianjin Hospital of Tianjin University, Tianjin, China
| | - Zhi Yang
- School of Biomedical Engineering, Capital Medical University, Beijing, China
| | - Wenhui Zhang
- Department of Orthopaedics, People's Hospital of Gansu Province, Lanzhou, Gansu, China
| | - Jie Liu
- Department of Orthopaedics, People's Hospital of Gansu Province, Lanzhou, Gansu, China
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Axelrod DE, Ekhtiari S, Winemaker MJ, de Beer J, Wood TJ. Management of Greater Trochanteric Pain Syndrome After Total Hip Arthroplasty: Practice Patterns and Surgeon Attitudes. J Am Acad Orthop Surg Glob Res Rev 2023; 7:01979360-202312000-00005. [PMID: 38048139 PMCID: PMC10697621 DOI: 10.5435/jaaosglobal-d-23-00085] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2023] [Revised: 09/11/2023] [Accepted: 09/23/2023] [Indexed: 12/05/2023]
Abstract
INTRODUCTION Greater trochanteric pain syndrome (GTPS) or trochanteric bursitis is described as pain on the lateral side of the hip that does not involve the hip joint and can be elicited clinically by palpation over the greater trochanter. To date, there remains no consensus on clinical guidelines for either diagnosis or management of GTPS. METHODS To understand the practice patterns, beliefs, and attitudes relating to the management of GTPS after total hip arthroplasty, a survey was developed and completed by Canadian arthroplasty surgeons. The final survey consisted of 23 questions divided into three sections: 1) screening questions; 2) demographic information; and 3) practice patterns, attitudes, and beliefs. RESULTS Most surgeons use physical examination alone for diagnosis. A detailed analysis indicates that surgeons primarily treat GTPS with oral anti-inflammatories (57.1%), structured physiotherapy (52.4%), and steroid injections (45.2%). Management options are typically nonsurgical and comprise a combination of either unstructured or targeted physiotherapy, corticosteroid injections, or platelet-rich plasma. DISCUSSION There remains an absence of clinical consensus for the diagnosis and management of GTPS after total hip arthroplasty. Physical examination is most often relied on, regardless of the availability of imaging aids. While common treatments of GTPS were identified, up to one-third of patients fail initial therapy.
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Affiliation(s)
- Daniel E. Axelrod
- From the Division of Orthopaedic Surgery, McMaster University, Hamilton, ON (Dr. Axelrod, Dr. Ekhtiari, Dr. Winemaker, and Dr. Wood), and the Hamilton Arthroplasty Group, Hamilton Health Sciences, Ontario, Canada (Dr. Winemaker and Dr. Wood)
| | - Seper Ekhtiari
- From the Division of Orthopaedic Surgery, McMaster University, Hamilton, ON (Dr. Axelrod, Dr. Ekhtiari, Dr. Winemaker, and Dr. Wood), and the Hamilton Arthroplasty Group, Hamilton Health Sciences, Ontario, Canada (Dr. Winemaker and Dr. Wood)
| | - Mitchell J. Winemaker
- From the Division of Orthopaedic Surgery, McMaster University, Hamilton, ON (Dr. Axelrod, Dr. Ekhtiari, Dr. Winemaker, and Dr. Wood), and the Hamilton Arthroplasty Group, Hamilton Health Sciences, Ontario, Canada (Dr. Winemaker and Dr. Wood)
| | - Justin de Beer
- From the Division of Orthopaedic Surgery, McMaster University, Hamilton, ON (Dr. Axelrod, Dr. Ekhtiari, Dr. Winemaker, and Dr. Wood), and the Hamilton Arthroplasty Group, Hamilton Health Sciences, Ontario, Canada (Dr. Winemaker and Dr. Wood)
| | - Thomas J. Wood
- From the Division of Orthopaedic Surgery, McMaster University, Hamilton, ON (Dr. Axelrod, Dr. Ekhtiari, Dr. Winemaker, and Dr. Wood), and the Hamilton Arthroplasty Group, Hamilton Health Sciences, Ontario, Canada (Dr. Winemaker and Dr. Wood)
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Fujita K, Makimoto K, Tabuchi Y, Matsunaga-Myoji Y, Mawatari M. Oxford Hip Scores, Floor-Sitting Score Trajectories, and Postoperative Satisfaction Rates at 10 Years After Primary Total Hip Arthroplasty. J Arthroplasty 2023; 38:2673-2679. [PMID: 37321523 DOI: 10.1016/j.arth.2023.06.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/04/2023] [Revised: 06/06/2023] [Accepted: 06/07/2023] [Indexed: 06/17/2023] Open
Abstract
BACKGROUND Available evidence on outcomes at 5 years and beyond for total hip arthroplasty (THA) is mainly limited to patient-reported outcome measures (PROMs). This study documented the trajectory of functional measurement using the Oxford hip score (OHS) and floor-sitting posture in Japan for up to 10 years post-THA and investigated predictors of dissatisfaction at 10 years with THA. METHODS Patients scheduled for primary THA at a university hospital in Japan between 2003 and 2006 were enrolled in this prospective study. Overall, 826 preoperative participants were eligible for follow-up, with response rates ranging from 93.6% to 69.4% at each postoperative survey point. The OHS and floor-sitting scores were calculated using a self-administered questionnaire 6 times up to 10 years postoperatively. Patient satisfaction, including general surgery, walking ability, and activities of daily living (ADL), was assessed in the 10-year survey. RESULTS The linear mixed-effects model demonstrated a postoperative improvement, peaking at 7 years for OHS and 5 years earlier for the floor-sitting score. The postoperative overall surgical dissatisfaction at 10 years with THA was very low (3.2%). No predictors of surgical dissatisfaction were identified in the logistic regression analyses. Predictors of walking ability dissatisfaction were older age, men, and worse OHS at 1 year postoperatively. Predictors of ADL dissatisfaction were poorer preoperative and 1-year postoperative floor-sitting scores and 1-year postoperative OHS. CONCLUSION The floor-sitting score is a simple PROM suitable for the Japanese population; other populations would require a scale suitable for their lifestyles.
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Affiliation(s)
- Kimie Fujita
- Department of Health Sciences, Kyushu University, Fukuoka, Japan
| | - Kiyoko Makimoto
- Department of Health Sciences, Osaka University, Osaka, Japan
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Barahona M, Bustos F, Navarro T, Chamorro P, Barahona MA, Carvajal S, Brañes J, Hinzpeter J, Barrientos C, Infante C. Similar Patient Satisfaction and Quality of Life Improvement Achieved with TKA and THA According to the Goodman Scale: A Comparative Study. J Clin Med 2023; 12:6096. [PMID: 37763035 PMCID: PMC10532345 DOI: 10.3390/jcm12186096] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2023] [Revised: 09/11/2023] [Accepted: 09/15/2023] [Indexed: 09/29/2023] Open
Abstract
Background: Total knee arthroplasty (TKA) and total hip arthroplasty (THA) are effective treatments for severe knee and hip osteoarthritis. Historically, TKA has been associated with lower satisfaction than THA, but recent advances in knee surgery have led to lower dissatisfaction rates. This study aimed to compare the satisfaction and self-reported improvement in the quality of life of two cohorts of patients who underwent TKA and THA, respectively. Methods: This observational study compared two previously published cohorts of patients who underwent THA and TKA in a single university center. The Goodman scale was used to assess satisfaction and self-perception of improved quality of life after TKA and THA at a minimum one-year follow-up. Propensity score matching was used to balance age, gender, and follow-up between groups. Significance was set at 0.05. Results: The study included a total of 105 THAs and 131 TKAs. Both groups had high levels of satisfaction with pain relief, ability to do house/yard work, and overall satisfaction, with above 90% satisfaction rates. Regarding improvement in quality of life, both groups had 86% of patients reporting improvement as "much better." After propensity score matching, no significant difference was found between THA and TKA for any of the comparisons made using the Goodman scale. Conclusions: The study showed that both TKA and THA resulted in high levels of satisfaction and improvement in quality of life. There was no significant difference in satisfaction rates between TKA and THA, contrary to the historical trend of lower satisfaction rates for TKA.
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Affiliation(s)
- Maximiliano Barahona
- Department of Orthopaedic Surgery, Hospital Clínico Universidad de Chile, Independencia, Santiago 8380420, Chile (C.I.)
| | - Felipe Bustos
- Department of Orthopaedic Surgery, Hospital Clínico Universidad de Chile, Independencia, Santiago 8380420, Chile (C.I.)
| | - Tomás Navarro
- Department of Orthopaedic Surgery, Hospital Clínico Universidad de Chile, Independencia, Santiago 8380420, Chile (C.I.)
| | - Pablo Chamorro
- Department of Orthopaedic Surgery, Hospital Clínico Universidad de Chile, Independencia, Santiago 8380420, Chile (C.I.)
| | - Macarena Alejandra Barahona
- Department of Orthopaedic Surgery, Hospital Clínico Universidad de Chile, Independencia, Santiago 8380420, Chile (C.I.)
| | - Sebastián Carvajal
- Department of Orthopaedic Surgery, Hospital del Salvador, Providencia, Santiago 7500922, Chile
| | - Julian Brañes
- Department of Orthopaedic Surgery, Hospital Clínico Universidad de Chile, Independencia, Santiago 8380420, Chile (C.I.)
| | - Jaime Hinzpeter
- Department of Orthopaedic Surgery, Hospital Clínico Universidad de Chile, Independencia, Santiago 8380420, Chile (C.I.)
| | - Cristian Barrientos
- Department of Orthopaedic Surgery, Hospital Clínico Universidad de Chile, Independencia, Santiago 8380420, Chile (C.I.)
- Department of Orthopaedic Surgery, Hospital del Salvador, Providencia, Santiago 7500922, Chile
| | - Carlos Infante
- Department of Orthopaedic Surgery, Hospital Clínico Universidad de Chile, Independencia, Santiago 8380420, Chile (C.I.)
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Shichman I, Kurapatti M, Roof M, Christensen TH, Rozell JC, Schwarzkopf R. Impact of Indication for Revision THA on Resource Utilization. J Arthroplasty 2022; 37:2333-2339. [PMID: 35738359 DOI: 10.1016/j.arth.2022.06.007] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/04/2022] [Revised: 06/08/2022] [Accepted: 06/08/2022] [Indexed: 02/02/2023] Open
Abstract
BACKGROUND Demographic variables play an important role in outcomes following revision total hip arthroplasty (rTHA). Surgical and in-patient variables as well as outcomes vary between indications for rTHA. The purpose of this study was to investigate the impact of the indication for the rTHA on costs and postoperative outcomes. METHODS This retrospective cohort analysis investigated all patients who underwent unilateral, aseptic rTHA at an academic orthopaedic specialty hospital who had at least 1-year postoperative follow-up. In total, 654 patients were evaluated and categorized based on their indication for aseptic rTHA. Demographics, direct and total procedure costs, surgical factors, postoperative outcomes, and re-revision rates were collected and compared between indications. RESULTS Younger patients had the greatest leg length discrepancy (LLD) and older patients had the highest incidence of periprosthetic fracture (PPF) (P = .001). The greatest proportion of full revisions were found for LLD (16.7%) and head/polyethylene liner-only revisions for metallosis/adverse tissue reaction (100%). Operative time was significantly longest for LLD revisions and shortest for metallosis/adverse tissue reaction revisions (P < .001). Length of stay was longest for periprosthetic fracture and shortest for LLD and stiffness/heterotopic ossification (P < .001). Re-revision rate was greatest for implant failure and lowest for LLD. Total cost was highest for PPF (148.9%) and lowest for polyethylene liner wear (87.7%). CONCLUSIONS Patients undergoing rTHA for indications such as PPF and aseptic loosening were associated with longer operative times, length of stay and higher total and direct costs. Therefore, they may need increased perioperative attention with respect to resource utilization, risk stratification, surgical planning, and cost-reducing measures. LEVEL III EVIDENCE Retrospective Cohort Study.
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Affiliation(s)
- Ittai Shichman
- Department of Orthopedic Surgery, NYU Langone Health, New York, New York
| | - Mark Kurapatti
- Department of Orthopedic Surgery, NYU Langone Health, New York, New York
| | - Mackenzie Roof
- Department of Orthopedic Surgery, NYU Langone Health, New York, New York
| | | | - Joshua C Rozell
- Department of Orthopedic Surgery, NYU Langone Health, New York, New York
| | - Ran Schwarzkopf
- Department of Orthopedic Surgery, NYU Langone Health, New York, New York
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Lan RH, Bell JW, Samuel LT, Kamath AF. Outcome measures in total hip arthroplasty: have our metrics changed over 15 years? Arch Orthop Trauma Surg 2022; 142:1753-1762. [PMID: 33570664 DOI: 10.1007/s00402-021-03809-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/27/2020] [Accepted: 01/25/2021] [Indexed: 12/18/2022]
Abstract
INTRODUCTION Consensus has not been reached regarding ideal outcome measures for total hip arthroplasty (THA) clinical evaluation and research. The goal of this review was to analyze the trends in outcome metrics within the THA literature and to discuss the potential impact of instrument heterogeneity on clinical practice. MATERIALS AND METHODS A PubMed search of all manuscripts related to THA from January 2005 to December 2019 was performed. Statistical and linear regression analyses were performed for individual outcome metrics as a proportion of total THA publications over time. RESULTS There was a statistically significant increase in studies utilizing outcomes metrics between 2005 and 2019 (15.1-29.5%; P < 0.001; R2 = 98.1%). Within the joint-specific subcategory, use of the Harris Hip Score (HHS) significantly decreased from 2005 to 2019 (82.8-57.3%; P < 0.001), use of the Hip Disability and Osteoarthritis Outcome Score (HOOS) significantly increased (0-6.7%; P < 0.001), and the modified HHS significantly increased (0-10.5%; P < 0.001). In the quality of life subcategory, EQ-5D demonstrated a significant increase in usage (0-34.8%; P < 0.001), while Short Form-36 significantly decreased (100% vs. 27.3%; P = 0.008). CONCLUSIONS The utilization of outcome-reporting metrics in THA has continued to increase, resulting in added complexity within the literature. The utilization rates of individual instruments have shifted over the past 15 years. Additional study is required to determine which specific instruments are recommended.
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Affiliation(s)
- Roy H Lan
- College of Medicine, University of Tennessee Health Science Center, 910 Madison Ave, Memphis, TN, 38163, USA
| | - Jack W Bell
- College of Medicine, University of Tennessee Health Science Center, 910 Madison Ave, Memphis, TN, 38163, USA
| | - Linsen T Samuel
- Department of Orthopaedic Surgery, Center for Hip Preservation, Orthopaedic and Rheumatologic Institute, Cleveland Clinic Foundation, 9500 Euclid Avenue Mail Code A40, Cleveland, OH, 44195, USA
| | - Atul F Kamath
- Department of Orthopaedic Surgery, Center for Hip Preservation, Orthopaedic and Rheumatologic Institute, Cleveland Clinic Foundation, 9500 Euclid Avenue Mail Code A40, Cleveland, OH, 44195, USA.
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Kuehling T, Schilling P, Bernstein A, Mayr HO, Serr A, Wittmer A, Bohner M, Seidenstuecker M. A human bone infection organ model for biomaterial research. Acta Biomater 2022; 144:230-241. [PMID: 35304323 DOI: 10.1016/j.actbio.2022.03.020] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2021] [Revised: 03/03/2022] [Accepted: 03/09/2022] [Indexed: 02/07/2023]
Abstract
The aim of this work was to establish an organ model for staphylococcal infection of human bone samples and to investigate the influence and efficacy of a microporous β-tricalcium phosphate ceramic (β-TCP, RMS Foundation) loaded with hydrogels (alginate, alginate-di-aldehyde (ADA)-gelatin) and clindamycin on infected human bone tissue over a period of 28 days. For this purpose, human tibia plateaus, collected during total knee replacement surgery, were used as a source of bone material. Samples were infected with S. aureus ATCC29213 and treated with differently loaded β-TCP composites (alginate +/- clindamycin, ADA-gelatin +/- clindamycin, unloaded). The loading of the composites was carried out by means of a flow chamber. The infection was observed for 28 days, quantifying bacteria in the medium and the osseus material on day 1, 7, 14, 21 and 28. All samples were histologically processed for bone vitality evaluation. Bone infection could be consistently performed within the organ model. In addition, a strong reduction in bacterial counts was recorded in the groups treated with ADA-gelatin + clindamycin and alginate + clindamycin, while the bacterial count in the control groups remained constant. No significant differences between groups could be observed in the number of lacunae filled with osteocytes suggesting no differences in bone vitality among groups. In an ex-vivo human bone infection model, over a period of 28 days bacterial growth could be reduced by treatment with ADA-Gel + CLI and ALG + CLI -releasing β-TCP composites. This could be relevant for its clinical use. Further work will be necessary to improve the loading of β-TCP and the bone infection organ model itself. STATEMENT OF SIGNIFICANCE: The common treatment of bone infections is debridement and systemic administration of antibiotics. In some cases, antibiotic-containing carriers are already used, but these must be removed again. Our work is intended to show another treatment option. The scaffold we have developed, made of a calcium phosphate ceramic and a hydrogel as the active substance carrier, can, in addition to releasing the active substance, also assume a load-bearing function of the bone and is biodegradable. In addition, the model we developed can also be used for the analysis and treatment of bone infections other than those of the musculoskeletal system. More importantly, it can also serve as a substitute for previously used animal experiments.
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Fujita M, Hayashi S, Kamenaga T, Fujishiro T, Matsumoto T, Kuroda R. LIGAMENT PRESERVING TOTAL HIP ARTHROPLASTY PREVENTS DIFFERENT LEG LENGTH AND FEMORAL OFFSET. ACTA ORTOPÉDICA BRASILEIRA 2022; 30:e242758. [PMID: 35864827 PMCID: PMC9270039 DOI: 10.1590/1413-785220223001e242758] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/31/2020] [Accepted: 01/21/2021] [Indexed: 11/21/2022]
Abstract
Objectives: The leg length (LL) and femoral offset (FO) discrepancy following total hip arthroplasty (THA) are important factors for postoperative outcomes and restoring native hip biomechanics is essential for THA. Hip capsular ligament contributes to joint stability; however, there are few studies about the influence of ligament preservation on LLD and FO following THA. Methods: We conducted a retrospective study involving 60 patients who underwent primary THA using a short stem through the anterolateral approach between June 2016 and August 2018. From August 2017, we preserved the vertical band of iliofemoral ligament and the pubofemoral ligament in THA, and the compared pre- and postoperative radiographic LLD and FO difference between the ligament preservation (n = 30) and ligament excision (n = 30) groups. Results: Postoperative LLD was significantly smaller in the ligament preservation than in the ligament excision group. The ratio of excessive LLD and FO difference was lower in the ligament preservation group than the ligament excision one. Conclusion: The preservation of the hip capsular ligament suppressed the increased LLD and FO difference. Level of Evidence II; Prognostic Study - Investigation of the Effect of a Patient Characteristic on the Outcome of a Disease .
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Affiliation(s)
- Masahiro Fujita
- Centre Takatsuki General Hospital, Japan; Kobe University Graduate School of Medicine, Japan
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Ueda Y, Matsushita T, Shibata Y, Takiguchi K, Ono K, Kida A, Ono R, Nagai K, Araki D, Hoshino Y, Matsumoto T, Niikura T, Sakai Y, Kuroda R. Satisfaction with playing pre-injury sports 1 year after anterior cruciate ligament reconstruction using a hamstring autograft. Knee 2021; 33:282-289. [PMID: 34739959 DOI: 10.1016/j.knee.2021.10.013] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/26/2021] [Revised: 09/24/2021] [Accepted: 10/11/2021] [Indexed: 02/02/2023]
Abstract
BACKGROUND Few studies have examined patient satisfaction with playing pre-injury sports after anterior cruciate ligament (ACL) reconstruction. The purpose of this study was to investigate patient satisfaction with playing pre-injury sport and identify factors associated with satisfaction. METHODS A total of 97 patients underwent unilateral ACL reconstruction using a hamstring autograft and returned to pre-injury sports 1 year after surgery. Patient satisfaction with playing pre-injury sport was assessed by a visual analog scale (VAS) and an ordinal four-grade scale. Problems related to the operated knee were also assessed. Knee muscle strength, single leg hop distance, knee laxity, subjective knee pain, and fear of movement/reinjury using Tampa Scale for Kinesiophobia-11 (TSK-11) were measured. Multivariate linear regression analysis was performed to determine the factors associated with patient satisfaction with playing pre-injury sport 1 year after surgery. RESULTS The average VAS score for patient satisfaction with playing pre-injury sports 1 year after surgery was 77.8 ± 20.2. Of the 97 patients, 87 patients (89.7%) answered "satisfied" or "mostly satisfied", whereas 51 patients (52.6%) had one or more problems. Multivariate linear regression analysis identified that the TSK-11 score was associated with patient satisfaction with playing a pre-injury sport 1 year after surgery. CONCLUSION Most of the patients who returned to pre-injury sports were satisfied with their outcomes. In contrast, approximately half of the patients had one or more problems after returning to play pre-injury sports. In particular, fear of movement/reinjury was significantly associated with patient satisfaction with playing pre-injury sport 1 year after surgery.
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Affiliation(s)
- Yuya Ueda
- Division of Rehabilitation Medicine, Kobe University Hospital, Kobe, Japan; Department of Community Health Sciences, Kobe University Graduate School of Health Sciences, Kobe, Japan
| | - Takehiko Matsushita
- Department of Orthopaedic Surgery, Kobe University Graduate School of Medicine, Kobe, Japan.
| | - Yohei Shibata
- Division of Rehabilitation Medicine, Kobe University Hospital, Kobe, Japan
| | - Kohei Takiguchi
- Division of Rehabilitation Medicine, Kobe University Hospital, Kobe, Japan
| | - Kumiko Ono
- Department of Community Health Sciences, Kobe University Graduate School of Health Sciences, Kobe, Japan
| | - Akihiro Kida
- Division of Rehabilitation Medicine, Kobe University Hospital, Kobe, Japan
| | - Rei Ono
- Department of Community Health Sciences, Kobe University Graduate School of Health Sciences, Kobe, Japan
| | - Kanto Nagai
- Department of Orthopaedic Surgery, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Daisuke Araki
- Department of Orthopaedic Surgery, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Yuichi Hoshino
- Department of Orthopaedic Surgery, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Tomoyuki Matsumoto
- Department of Orthopaedic Surgery, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Takahiro Niikura
- Department of Orthopaedic Surgery, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Yoshitada Sakai
- Division of Rehabilitation Medicine, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Ryosuke Kuroda
- Department of Orthopaedic Surgery, Kobe University Graduate School of Medicine, Kobe, Japan
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Feitz R, Khoshnaw S, van der Oest MJW, Souer JS, Slijper HP, Hovius SER, Selles RW. Long-term patient-reported outcomes for open surgery of the triangular fibrocartilage complex. Bone Jt Open 2021; 2:981-987. [PMID: 34818898 PMCID: PMC8636291 DOI: 10.1302/2633-1462.211.bjo-2021-0140.r1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
Abstract
Aims Studies on long-term patient-reported outcomes after open surgery for triangular fibrocartilage complex (TFCC) are scarce. Surgeons and patients would benefit from self-reported outcome data on pain, function, complications, and satisfaction after this surgery to enhance shared decision-making. The aim of this study is to determine the long-term outcome of adults who had open surgery for the TFCC. Methods A prospective cohort study that included patients with open surgery for the TFCC between December 2011 and September 2015. In September 2020, we sent these patients an additional follow-up questionnaire, including the Patient-Rated Wrist Evaluation (PRWE), to score satisfaction, complications, pain, and function. Results A total of 113 patients were included in the analysis. At ≥ 60 months after an open TFCC reinsertion, we found a mean PRWE total score of 19 (SD 21), a mean PRWE pain score of 11 (SD 11), and a PRWE function score of 9 (SD 10). The percentage of patients obtaining minimum clinically important difference rose from 77% at 12 months to 83% at more than 60 months (p < 0.001). Patients reported fewer complications than surgeons, and overall complication rate was low. Conclusion Outcomes of patient-reported pain, function scores, and satisfaction are improved five years after open surgery for the TFCC. Cite this article: Bone Jt Open 2021;2(11):981–987.
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Affiliation(s)
- Reinier Feitz
- Hand Surgery, Xpert Clinics, Amsterdam, Netherlands.,Department of Plastic, Reconstructive and Hand Surgery, Radboud University Medical Center, Radboud Institute for Health Sciences, Nijmegen, Netherlands
| | - Sara Khoshnaw
- Hand Surgery, Xpert Clinics, Amsterdam, Netherlands.,Department of Plastic, Reconstructive, and Hand Surgery, Erasmus Medical Center, Rotterdam, Netherlands
| | - Mark J W van der Oest
- Hand Surgery, Xpert Clinics, Amsterdam, Netherlands.,Department of Plastic, Reconstructive, and Hand Surgery, Erasmus Medical Center, Rotterdam, Netherlands.,Department of Rehabilitation Medicine, Erasmus Medical Center, Rotterdam, Netherlands
| | | | - Harm P Slijper
- Hand Surgery, Xpert Clinics, Amsterdam, Netherlands.,Department of Plastic, Reconstructive, and Hand Surgery, Erasmus Medical Center, Rotterdam, Netherlands
| | - Steven E R Hovius
- Hand Surgery, Xpert Clinics, Amsterdam, Netherlands.,Department of Plastic, Reconstructive and Hand Surgery, Radboud University Medical Center, Radboud Institute for Health Sciences, Nijmegen, Netherlands
| | - Ruud W Selles
- Department of Plastic, Reconstructive, and Hand Surgery, Erasmus Medical Center, Rotterdam, Netherlands.,Department of Rehabilitation Medicine, Erasmus Medical Center, Rotterdam, Netherlands
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11
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Galea VP, Rojanasopondist P, Connelly JW, Bragdon CR, Huddleston JI, Ingelsrud LH, Malchau H, Troelsen A. Changes in Patient Satisfaction Following Total Joint Arthroplasty. J Arthroplasty 2020; 35:32-38. [PMID: 31492454 DOI: 10.1016/j.arth.2019.08.018] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/06/2019] [Revised: 08/03/2019] [Accepted: 08/06/2019] [Indexed: 02/01/2023] Open
Abstract
BACKGROUND The primary aim is to identify the degree to which patient satisfaction with the outcome of total hip arthroplasty (THA) or total knee arthroplasty (TKA) changes between 1 and 3 years from the procedure. The secondary aim is to identify variables associated with satisfaction. METHODS Data were sourced from 2 prospective international, multicenter studies (919 THA and 450 TKA patients). Satisfaction was assessed by a 10-point numerical rating scale, at 1- and 3-year follow-up. Linear mixed-effects models were used to assess factors associated with satisfaction. RESULTS For the THA cohort, higher preoperative joint space width (odds ratio [OR] = 0.28; P = .004), pain from other joints (OR = 0.26; P = .033), and lower preoperative health state (OR = -0.02; P < .001) were associated with consistently lower levels of satisfaction. The model also showed that patients with preoperative anxiety/depression improved in satisfaction between 1 and 3 years (OR = -0.26; P = .031). For the TKA cohort, anterior (vs neutral or posterior) tibial component slope (OR = 0.90; P = .008), greater femoral component valgus angle (OR = 0.05; P = .012), less severe osteoarthritis (OR = -0.10; P < .001), and lower preoperative health state (OR = -0.02; P = .003) were associated with lower levels of satisfaction across the study period. In addition, patients with anterior tibial component slope improved in satisfaction level over time (OR = -0.33; P = .022). CONCLUSION Changes in satisfaction following THA and TKA are rare between 1- and 3-year follow-up. The findings of this study can be used to guide patient counseling preoperatively and to determine intervals of routine follow-up postoperatively.
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Affiliation(s)
- Vincent P Galea
- Harris Orthopaedic Laboratory, Department of Orthopedic Surgery, Massachusetts General Hospital, Boston, MA
| | - Pakdee Rojanasopondist
- Harris Orthopaedic Laboratory, Department of Orthopedic Surgery, Massachusetts General Hospital, Boston, MA
| | - James W Connelly
- Harris Orthopaedic Laboratory, Department of Orthopedic Surgery, Massachusetts General Hospital, Boston, MA
| | - Charles R Bragdon
- Harris Orthopaedic Laboratory, Department of Orthopedic Surgery, Massachusetts General Hospital, Boston, MA; Department of Orthopaedic Surgery, Harvard Medical School, Boston, MA
| | - James I Huddleston
- Department of Orthopaedic Surgery, Stanford University Medical Center, Redwood, CA
| | - Lina H Ingelsrud
- Department of Orthopedic Surgery, Copenhagen University Hospital Hvidovre, Hvidovre, Denmark
| | - Henrik Malchau
- Harris Orthopaedic Laboratory, Department of Orthopedic Surgery, Massachusetts General Hospital, Boston, MA; Department of Orthopaedic Surgery, Harvard Medical School, Boston, MA
| | - Anders Troelsen
- Department of Orthopedic Surgery, Copenhagen University Hospital Hvidovre, Hvidovre, Denmark
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Postoperative outcomes with neuraxial versus general anesthesia in bilateral total hip arthroplasty. J Clin Anesth 2019; 52:71-75. [DOI: 10.1016/j.jclinane.2018.09.016] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2018] [Revised: 08/23/2018] [Accepted: 09/08/2018] [Indexed: 12/11/2022]
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