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Kokic T, Pavic R, Vuksanic M, Jelica S, Sumanovac A, Banic T, Ostović H, Sklempe Kokic I. Effects of Electromyographic Biofeedback-Assisted Exercise on Functional Recovery and Quality of Life in Patients after Total Hip Arthroplasty: A Randomized Controlled Trial. J Pers Med 2023; 13:1716. [PMID: 38138943 PMCID: PMC10744500 DOI: 10.3390/jpm13121716] [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: 10/10/2023] [Revised: 12/07/2023] [Accepted: 12/13/2023] [Indexed: 12/24/2023] Open
Abstract
The goal of the trial was to examine the effects of adding electromyographic biofeedback (EMG-BF) to the conventional program of physiotherapy after total hip arthroplasty (THA) on functional recovery and quality of life. The trial was designed as a prospective, interventional, single-blinded randomized controlled study. Ninety patients were randomized into an experimental group (EG) (n = 45; mean age 63.9 ± 8.8) and control group (CG) (n = 45; mean age 63.9 ± 9). All patients received 21 days of physiotherapy which consisted of therapeutic exercise (land-based and aquatic), electrotherapy, and education. Electromyographic biofeedback was added to a portion of the land-based exercise in EG. The Hip Disability and Osteoarthritis Outcome Score (HOOS), Numeric Rating Scale (NRS), Short Form Health Survey-36 (SF-36), use of a walking aid, 30 s chair stand test (CST) as well as the Timed Up and Go (TUG) test were used for outcome measurement. A higher proportion of the participants in both groups did not need a walking aid after the intervention (p < 0.05). All participants improved their 30 s CST and TUG results (p < 0.001), as well as their NRS and HOOS scores (p < 0.05). No significant differences between the groups were found. There were no additional benefits from adding EMG-BF to the conventional physiotherapy protocol.
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Affiliation(s)
- Tomislav Kokic
- Faculty of Medicine, Josip Juraj Strossmayer University of Osijek, 31000 Osijek, Croatia
- Orthopaedics and Trauma Department, General County Hospital Vinkovci, 32100 Vinkovci, Croatia
- Faculty of Kinesiology Osijek, Josip Juraj Strossmayer University of Osijek, 31000 Osijek, Croatia
| | - Roman Pavic
- Faculty of Medicine, Josip Juraj Strossmayer University of Osijek, 31000 Osijek, Croatia
- Clinical Hospital of Traumatology, University Hospital Centre “Sestre Milosrdnice”, 10000 Zagreb, Croatia
| | - Matko Vuksanic
- Bizovacke Toplice Rehabilitation Hospital, 31222 Bizovac, Croatia
- Department of Health Studies, College of Applied Sciences “Lavoslav Ruzicka” in Vukovar, 32000 Vukovar, Croatia
| | - Stjepan Jelica
- Department of Health Studies, College of Applied Sciences “Lavoslav Ruzicka” in Vukovar, 32000 Vukovar, Croatia
| | - Antun Sumanovac
- Faculty of Medicine, Josip Juraj Strossmayer University of Osijek, 31000 Osijek, Croatia
- Orthopaedics and Trauma Department, General County Hospital Vinkovci, 32100 Vinkovci, Croatia
| | - Tihomir Banic
- Faculty of Medicine, University of Zagreb, 10000 Zagreb, Croatia
- Department of Surgery, University Hospital Centre Zagreb, 10000 Zagreb, Croatia
| | - Helena Ostović
- Faculty of Medicine, Josip Juraj Strossmayer University of Osijek, 31000 Osijek, Croatia
- Clinical Department of Anesthesiology, Reanimatology and Intensive Care Medicine, University Hospital Dubrava, 10000 Zagreb, Croatia
| | - Iva Sklempe Kokic
- Faculty of Kinesiology Osijek, Josip Juraj Strossmayer University of Osijek, 31000 Osijek, Croatia
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Mirghaderi P, Ghaseminejad-Raeini A, Azarboo A, Mirghaderi R, Ravanbod H, Mortazavi SJ. Cross-Cultural Adaptation and Validation of the Persian Version of the Harris Hip Score. Arthroplast Today 2023; 23:101180. [PMID: 37712073 PMCID: PMC10498405 DOI: 10.1016/j.artd.2023.101180] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/10/2023] [Revised: 06/10/2023] [Accepted: 07/01/2023] [Indexed: 09/16/2023] Open
Abstract
Background The Persian language, also known as Farsi, is a pluricentric language spoken in Iran, Afghanistan, and Tajikistan by about 140 million people. This study aims to translate the Harris hip score (HHS) into Persian with cross-cultural adaptation and to evaluate its validity and reliability. Methods One hundred fifty-six total hip arthroplasty patients completed the Persian version of the HHS, Western Ontario and McMaster Universities Osteoarthritis Index, Forgotten Joint Score, and visual analog scale (VAS) for pain and satisfaction postoperatively. Using Cronbach's alpha (α) coefficient, internal consistency was evaluated. Correlations (Spearman's Rho) were used to assess validity. A test-retest reliability assessment of the Persian HHS was conducted (n = 47) using the intraclass correlation coefficient. Content validity was evaluated using the floor and ceiling effects of the HHS. Results The final translation of the Persian HHS was approved to be used. The preoperative and postoperative Cronbach's alpha were 0.71 and 0.70, respectively, and showed acceptable internal consistency. The intraclass correlation coefficient was excellent (0.869, P < .001). Insignificant ceiling effects (13.5%) and no floor effects (0) were observed. The HHS score was significantly and strongly correlated with Western Ontario and McMaster Universities Osteoarthritis Index (r = 0.696, P < .001), VAS pain (r = 0.654, P < .001), VAS satisfaction (r = 0.634, P < .001), and Forgotten Joint Score (r = 0.648, P < .001). Conclusions The Persian HHS demonstrated excellent reliability and validity properties. Accordingly, Persian HHS may be a helpful tool for assessing patients undergoing total hip arthroplasty.
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Affiliation(s)
- Peyman Mirghaderi
- Surgical Research Society (SRS), Students' Scientific Research Center, Tehran University of Medical Sciences, Tehran, Iran
- Joint Reconstruction Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Amirhossein Ghaseminejad-Raeini
- Surgical Research Society (SRS), Students' Scientific Research Center, Tehran University of Medical Sciences, Tehran, Iran
- Joint Reconstruction Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Alireza Azarboo
- Surgical Research Society (SRS), Students' Scientific Research Center, Tehran University of Medical Sciences, Tehran, Iran
- Joint Reconstruction Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Reza Mirghaderi
- Surgical Research Society (SRS), Students' Scientific Research Center, Tehran University of Medical Sciences, Tehran, Iran
- Joint Reconstruction Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Hadi Ravanbod
- Department of Orthopedic Surgery, Al-Zahra Hospital, Isfahan University of Medical Sciences, Isfahan, Iran
| | - S.M. Javad Mortazavi
- Joint Reconstruction Research Center, Tehran University of Medical Sciences, Tehran, Iran
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Li G, Ji F, Guo W, Wei B. Decreased serum MMP-9 levels in patients with nontraumatic osteonecrosis of the femoral head. BMC Musculoskelet Disord 2023; 24:240. [PMID: 36991363 PMCID: PMC10053116 DOI: 10.1186/s12891-023-06342-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/12/2022] [Accepted: 03/20/2023] [Indexed: 03/31/2023] Open
Abstract
BACKGROUND Matrix metalloproteinase-9 (MMP-9) and tissue inhibitor of metalloproteinases-1 (TIMP-1) are involved in the pathological mechanism of osteonecrosis of the femoral head (ONFH). This study aimed to investigate the relationship of serum MMP-9, TIMP-1, and the MMP-9/TIMP-1 ratio with disease severity in patients with nontraumatic ONFH. METHODS Serum levels of MMP-9 and TIMP-1 among 102 nontraumatic ONFH patients and 96 healthy individuals were determined by enzyme-linked immunosorbent assay (ELISA). Imaging severity was determined using the FICAT classification system. The Harris hip score (HHS) and visual analogue scale (VAS) were used to evaluate clinical progress. The correlations of serum MMP-9 and TIMP-1 levels with imaging severity and clinical progress was evaluated statistically. The diagnostic value of MMP-9 for NONFH disease severity was evaluated by examining receiver operating characteristic (ROC) curves. RESULTS The serum MMP-9 levels and the MMP-9/TIMP-1 ratio were significantly increased in patients with ONFH compared to normal controls, and TIMP-1 levels did not differ between the two groups. Serum MMP-9 levels and the MMP-9/TIMP-1 ratio were positively correlated with FICAT stage and VAS and were negatively correlated with the HHS score. The ROC curve results indicated that MMP-9 could be used as a potential marker of nontraumatic ONFH imaging progression. CONCLUSIONS We hypothesize that increased MMP-9 expression and an imbalance in the MMP-9/TIMP-1 ratio play a role in the development of ONFH and are correlate with the severity of ONFH. The determination of MMP-9 can be a useful tool to assess the severity of the disease in patients with nontraumatic ONFH.
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Affiliation(s)
- Guopeng Li
- Weifang Medical University, Weifang, Shandong Province, China
- Department of Orthopedics, Linyi People's Hospital, Jie Fang Road East, No.27, Linyi, 276003, Shandong, China
| | - Fengxuan Ji
- Jinzhou Medical University, Jinzhou, Liaoning Province, China
| | - Wenchao Guo
- Weifang Medical University, Weifang, Shandong Province, China
| | - Biaofang Wei
- Department of Orthopedics, Linyi People's Hospital, Jie Fang Road East, No.27, Linyi, 276003, Shandong, China.
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Cross-Cultural Adaptation and Validation of the Arabic Version of the Harris Hip Score. Arthroplast Today 2022; 19:100990. [PMID: 36845291 PMCID: PMC9947979 DOI: 10.1016/j.artd.2022.07.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/22/2022] [Revised: 06/10/2022] [Accepted: 07/08/2022] [Indexed: 11/06/2022] Open
Abstract
Background The Harris Hip Score (HHS) questionnaire has been translated and validated into many languages including Italian, Portuguese, and Turkish but not Arabic. The goal of this study was to translate HHS into the Arabic language with cross-cultural adaptation to include and benefit Arabic speaking communities as it is the most widely used instrument for disease-specific hip joint evaluation and measurement of total hip arthroplasty outcome. Methods This questionnaire was translated following a clear and user-friendly guideline protocol. The Cronbach's alpha was used to assess the reliability and internal consistency of the items of HHS. Additionally, the constructive validity of HHS was evaluated against the 36-Item Short Form Survey (SF-36). Results A total of 100 participants were included in this study, of which 30 participants were re-evaluated for reliability testing. Cronbach's alpha of the total score of Arabic HHS is 0.528, and after the standardization, it changed to 0.742 which is within the recommended range (0.7-0.9). Lastly, the correlation between HHS and SF-36 was r = 0.71 (P < .001) which represents a strong correlation between the Arabic HHS and SF-36. Conclusions Based on the results, we believe that the Arabic HHS can be used by clinicians, researchers, and patients to evaluate and report hip pathologies and total hip arthroplasty treatment efficacy.
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Mathur HH, Shah HS, Vishwanathan K. Functional outcome of conversion total hip arthroplasty (CTHA) using uncemented distally loading femoral stem for failed fixation of proximal femoral nail - A case series. J Orthop 2022; 34:14-20. [PMID: 35992612 PMCID: PMC9382133 DOI: 10.1016/j.jor.2022.07.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/19/2022] [Revised: 07/21/2022] [Accepted: 07/22/2022] [Indexed: 11/19/2022] Open
Abstract
Introduction and aims There is paucity of prospective studies on conversion total hip arthroplasty (CTHA) for failed proximal femoral nailing. The objective of this study is to evaluate the functional outcome of CTHA using extensively porous coated distal loading stem for failed proximal femoral nailing. Patients and methods Fifteen consecutively operated patients for failed proximal femoral nail treated with single stage procedure of nail extraction and CTHA were included in this prospective observational study. All patients received metal-on-polyethylene bearing with uncemented press-fit acetabular cup (Pinnacle cup; DePuy, Warsaw [IN], USA) and extensively porous coated distally loading revision stem (Solution stem; DePuy, Warsaw [IN], USA). All patients were assessed preoperatively and postoperatively at one, three, six and more than twelve months using the Harris Hip Score (HHS). The responsiveness of HHS was assessed using Effect Size (ES) and Standardised Response Mean (SRM). ES and SRM >0.8 indicates adequate responsiveness. Results The mean duration of follow-up was 16.9 months for the overall cohort (SD: 7.9; range: 6-28 months). The mean preoperative HHS was 32 ± 6.1, the mean HHS at six months follow-up was 89.7 ± 4.0 and the mean HHS at final follow-up of atleast one year was 93.7 ± 3.0. There was a statistically and clinically significant improvement in the HHS from preoperatively to final follow-up postoperatively (p < 0.0001). At the final follow-up, twelve patients (80%) had an excellent outcome and three patients (20%) had a good outcome as per HHS grading. The ES was 9.87 and the SRM was 8.86 thereby suggesting adequate responsiveness. One patient developed surgical site infection and another patient developed dislocation. Both were successfully treated and subsequently the patients made uneventful recovery. None of the patients required revision surgery. Conclusion HHS has adequate responsiveness for assessing the functional outcome of CTHA. We recommend the use of an uncemented cup and uncemented extensively porous coated, distal loading stem for failed PFN fixation in intertrochanteric hip fractures.
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Affiliation(s)
- Hemant H. Mathur
- Department of Orthopaedics, Medical College and SSG Hospital, Baroda, Gujarat, India
| | - Harsh S. Shah
- Department of Orthopaedics, Medical College and SSG Hospital, Baroda, Gujarat, India
| | - Karthik Vishwanathan
- Department of Orthopaedics, Parul Institute of Medical Sciences and Research, Parul University, Limda, Waghodia, Vadodara, Gujarat, 391760, India
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Effect of nHA-Coated Femoral Stem Prosthesis Combined with Platelet-Rich Plasma in Hemi Hip Replacement of Femoral Neck Fracture in the Elderly. COMPUTATIONAL AND MATHEMATICAL METHODS IN MEDICINE 2022; 2022:9089084. [PMID: 35991151 PMCID: PMC9385353 DOI: 10.1155/2022/9089084] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/25/2022] [Revised: 07/04/2022] [Accepted: 07/11/2022] [Indexed: 11/30/2022]
Abstract
Purpose This study investigated the efficacy of nanohydroxyapatite- (nHA-) coated biological prosthesis combined with platelet-rich plasma (PRP) in hemi hip replacement of femoral neck fracture (FNF) in the elderly. Methods From September 2018 to September 2021, 102 elderly patients with FNF treated in our hospital were chosen and divided into two groups according to different intervention methods. Fifty-one patients in the bone cement group were treated with bone cement prosthesis, and the rest 51 patients in the observation group were treated with nHA biological prosthesis combined with PRP in hemi hip replacement. In order to explore the osteogenic effect of nHA and PRP, osteoblasts were cultured. Results It was found that nHA and PRP could both effectively promote the proliferation of osteoblasts and improve their mineralization ability, especially when used in combination. In the course of clinical therapy, we found that the use of biological prosthesis combined with PRP could effectively reduce the level of serum procollagen type I carboxy terminal peptide (PICP) and better improve the levels of bone alkaline phosphatase (BALP) and bone Gla protein (BGP), so as to reduce the bone conversion rate and promote the formation of new bone around the prosthesis. In addition, no significant difference was found in intraoperative bleeding, operation time, hospital stay, 48 h drainage volume, partial weight-bearing time, and complete weight-bearing time between two groups. Otherwise, the use of biological prosthesis could effectively avoid the occurrence of adverse reactions such as bone cement crisis and fracture around femoral prosthesis, so as to better restore the hip function and improve patients' life quality. Conclusions Therefore, in hemi hip replacement of FNF in the elderly, nHA biological prosthesis combined with PRP can effectively promote the formation of new bone around the prosthesis stem, so as to obtain good initial stability, enable patients to carry out early weight-bearing exercise, and effectively avoid adverse reactions caused by bone cement prosthesis, thus improving patients' hip function and life quality.
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Falez F, Mavrogenis A, Scarlat MM. Outcome scores after hip surgery in young adults: an editorial approach. INTERNATIONAL ORTHOPAEDICS 2022; 46:1675-1679. [PMID: 35829745 DOI: 10.1007/s00264-022-05491-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Affiliation(s)
- Francesco Falez
- San Filippo Neri et Santo Hospital, University Sapienza, Rome, Italy
| | - Andreas Mavrogenis
- First Department of Orthopaedics, National and Kapodistrian University of Athens, School of Medicine, 41 Ventouri Str, 15562, Athens, Greece
| | - Marius M Scarlat
- Clinique Chirurgicale St Michel, Avenue d'Orient, Groupe ELSAN, Toulon, France.
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Bilateral simultaneous total hip arthroplasty in ankylosed hips with and without computer navigation: a case report. CURRENT ORTHOPAEDIC PRACTICE 2021. [DOI: 10.1097/bco.0000000000000973] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Weick JW, Bullard J, Green JH, Gagnier JJ. Measures of Hip Function and Symptoms. Arthritis Care Res (Hoboken) 2020; 72 Suppl 10:200-218. [PMID: 33091262 DOI: 10.1002/acr.24231] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2020] [Accepted: 04/21/2020] [Indexed: 12/28/2022]
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Josipović P, Moharič M, Salamon D. Translation, cross-cultural adaptation and validation of the Slovenian version of Harris Hip Score. Health Qual Life Outcomes 2020; 18:335. [PMID: 33032625 PMCID: PMC7545539 DOI: 10.1186/s12955-020-01592-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2020] [Accepted: 10/01/2020] [Indexed: 12/22/2022] Open
Abstract
INTRODUCTION The Harris Hip Score is the most widely used outcome measure for the assessment of hip pathologies. An official Slovenian version has not been culturally adapted and validated. The aim of this study was to create a Slovenian valid and reliable version of the HHS. MATERIALS AND METHOD The HHS was translated and modified in Slovenian. The measurement properties of the Slovenian HHS were tested in 42 patients suffering from different hip pathologies. Reliability, responsiveness, construct validity, convergent/divergent validity and content validity of the Slovenian version of the HHS were tested. RESULTS Only minor adaptation was required in the translation process. The internal consistency of the HHS expressed by Cronbach's alpha was 0.94. The test-retest reliability expressed by the intraclass correlation coefficient was 0.983. The correlations of the HHS scale with the WOMAC scale (r = - 0.877) and the VAS scale (r = - 0.717) were statistically significant. The highest correlation between the HHS and SF-36 was with the General Health dimension (r = 0.61). while the lowest correlation was with the SF-36 Mental Health dimension (r = 0.43). MDC95% was 10.1. No floor or ceiling effects were found. CONCLUSION Slovenian version of HHS seems to has an acceptable level of reliability and validity. Slovenian HHS is short, comprehensible and easy to administer and interpret. TRIAL REGISTRATION Approved by the Slovenian National Medical Ethics Committee (0120-46/2019/19).
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Affiliation(s)
- Petra Josipović
- Univerza v Ljubljani Medicinska Fakulteta, Vrazov trg 2, Ljubljana, Slovenia
- Pula, Croatia
| | - Metka Moharič
- Univerzitetni rehabilitacijski institut SOČA, Linhartova 51, Ljubljana, Slovenia
| | - Dea Salamon
- Univerza na Primorskem Fakulteta za vede o zdravju, Polje 42, Izola, Slovenia
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Validation of Harris hip score in the indian population. JOURNAL OF ARTHROSCOPY AND JOINT SURGERY 2020. [DOI: 10.1016/j.jajs.2020.10.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
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Jin Y, Zhu HX, Wei BF. Reduced serum and local LncRNA MALAT1 expressions are linked with disease severity in patients with non-traumatic osteonecrosis of the femoral head. Technol Health Care 2020; 29:479-488. [PMID: 32716338 DOI: 10.3233/thc-202244] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
OBJECTIVE This study was performed to illustrate the potential relationship between reduced serum and local LncRNA MALAT1 expressions with disease severity in patients with non-traumatic osteonecrosis of the femoral head (ONFH). METHODS A total of 104 patients with non-traumatic ONFH and 100 healthy controls were consecutively recruited from our hospital. Serum and local LncRNA MALAT1 expressions were detected using real-time polymerase chain reaction (RT-PCR). Radiographic progression was defined by Ficat classification. Clinical severity was evaluated by Visual Analog Scale (VAS) and Harris Hip Score (HHS). Receiver operating characteristic (ROC) curve was carried out to determine the diagnostic value of MALAT1 in the radiographic progression. RESULTS Serum LncRNA MALAT1 expressions were significantly lower in non-traumatic ONFH patients than in healthy controls. In addition, local MALAT1 expressions in non-traumatic ONFH tissue were significantly lower in the affected area than in the non-affected area. Ficat grade 4 has significantly lower serum and local LncRNA MALAT1 expressions in comparison with grade 3, and Ficat grade 3 showed markedly decreased serum and local LncRNA MALAT1 expressions compared with grade 2. Serum and local LncRNA MALAT1 expressions were significantly and negatively associated with VAS and positively related to the HHS. Further ROC curve analysis indicated that serum MALAT1 may act as a decent indicator in the diagnosis of non-traumatic ONFH. CONCLUSIONS Decreased serum and local MALAT1 expressions may reflect disease severity in non-traumatic ONFH patients.
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Affiliation(s)
- Yan Jin
- Guangzhou University of Chinese Medicine, Guangzhou, Guangdong, China.,Department of Rehabilitation, Linyi People's Hospital, Linyi, Shandong, China
| | - Hong-Xun Zhu
- Guangzhou University of Chinese Medicine, Guangzhou, Guangdong, China.,Department of Orthopedics, Linyi People's Hospital, Linyi, Shandong, China
| | - Biao-Fang Wei
- Department of Orthopedics, Linyi People's Hospital, Linyi, Shandong, China
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Dikmen G, Ozden VE, Gulagaci F, Tozun IR. Long-term results of cementless total hip arthroplasty for the treatment of ankylosed hip. J Orthop Surg (Hong Kong) 2020; 27:2309499019858038. [PMID: 31262219 DOI: 10.1177/2309499019858038] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
PURPOSE The purpose of this study was to report the long-term results of total hip arthroplasty (THA) for the treatment of ankylosed hip. METHODS Twenty-nine consecutive THAs were performed in 26 patients. The mean age of the patients at the time of the operation was 43.3 years (range, 19-69 years). We used cementless fixation in all hips and the mean duration of follow-up was 10.1 years (range, 4.5-20 years). Radiological evaluation of components, osteolysis, radiolucent lines and loosening were assessed. The Harris Hip Score (HHS), range of motion (ROM), limb-length discrepancy and walking capacity with or without any support were used preoperatively and at final follow-up for clinical evaluation. Survivorship analysis was conducted using the Kaplan-Meier method using second revision for any reason as the endpoint. RESULTS The mean HHS was 85.6 (range, 55-98) points and mean ROM was 110.5° for flexion. The mean limb-length discrepancy improved from 4.1 cm to 1.1 cm. Positive Trendelenburg sign was recorded in 31% of the patients and 24% of patients needed any support for walking postoperatively. We observed surgical complications related to abductor arm in 25% of the patients. Radiolucency on the acetabular side was seen on one or more zones in 15 patients (16 hips). One aseptic acetabular component loosening was observed. On the femoral side, 11 patients demonstrated non-progressive radiolucent lines and osteolysis around the stem was seen in four hips but there was no aseptic stem loosening. The Kaplan-Meier survival rate considering revision for any reason as the endpoint was 81.5%, for aseptic loosening 91.3%, for a worst-case scenario of 66.4% at 10 years. CONCLUSION Cementless fixation showed good to excellent results at 10 years. Preoperative and postoperative abductor status of the patient is critical for patient satisfaction.
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Affiliation(s)
- Goksel Dikmen
- Department of Orthopaedic Surgery and Traumatology, Acibadem School of Medicine, Acibadem Maslak Hospital, Sarıyer/Istanbul, Turkey
| | - Vahit Emre Ozden
- Department of Orthopaedic Surgery and Traumatology, Acibadem School of Medicine, Acibadem Maslak Hospital, Sarıyer/Istanbul, Turkey
| | - Fırat Gulagaci
- Department of Orthopaedic Surgery and Traumatology, Acibadem School of Medicine, Acibadem Maslak Hospital, Sarıyer/Istanbul, Turkey
| | - I Remzi Tozun
- Department of Orthopaedic Surgery and Traumatology, Acibadem School of Medicine, Acibadem Maslak Hospital, Sarıyer/Istanbul, Turkey
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Feng B, Ren Y, Cao S, Lin J, Jin J, Qian W, Weng X. Comparison of ceramic-on-ceramic bearing vs ceramic-on-highly cross-linked polyethylene-bearing surfaces in total hip arthroplasty for avascular necrosis of femoral head: a prospective cohort study with a mid-term follow-up. J Orthop Surg Res 2019; 14:388. [PMID: 31775827 PMCID: PMC6882238 DOI: 10.1186/s13018-019-1410-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/06/2019] [Accepted: 10/10/2019] [Indexed: 11/18/2022] Open
Abstract
Background The ideal bearing surface for patients of avascular necrosis (AVN) undergoing total hip arthroplasty (THA) remains controversial. The purpose of this study is to evaluate the clinical outcomes, health-related quality of life (HRQL), and wear of the bearing surface between ceramic-on-ceramic (CoC) and ceramic-on-highly cross-linked polyethylene (CoXPE) THA for patients of AVN after midterm follow-up. Methods We performed a retrospective case-control analysis of 93 CoC and 77 CoXPE consecutive THAs for patients of AVN. The cases were followed at a minimum 5 years follow-up (average 7 years). Harris hip score (HHS) score and bearing-related complications were assessed. The health-related quality of life (HRQL) was assessed with the Short Form 36 (SF-36). Plain radiographs and computed tomography (CT) were used for radiographic evaluation. Results Both the CoC group and CoXPE group showed statistically significant improvements in HHS scores with no difference between the two bearing surfaces. There was no significant difference as for SF-36 at the latest follow-up between two groups, except for significant higher scores in the dimensions of general health in the CoC group (75.7 vs 64.7, P = 0.032). No radiographic evidence of osteolysis and loosening was present at the final follow-up. The mean wear rate of the CoC was 0.0096 mm/year and the CoXPE was 0.047 mm/year after evaluation with reconstructed CT. Conclusions CoC THAs acts as well as CoXPE THAs for patients with femoral head avascular necrosis after midterm follow-up. CoC bearing can significantly decrease the wearing rate than CoXPE bearing.
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Affiliation(s)
- Bin Feng
- Department of Orthopaedic Surgery, Peking Union Medical College Hospital, Peking Union Medical College, Beijing, 100730, China
| | - Yi Ren
- Peking Union Medical College, Beijing, 100730, China
| | - Shiliang Cao
- Peking Union Medical College, Beijing, 100730, China
| | - Jin Lin
- Department of Orthopaedic Surgery, Peking Union Medical College Hospital, Peking Union Medical College, Beijing, 100730, China
| | - Jin Jin
- Department of Orthopaedic Surgery, Peking Union Medical College Hospital, Peking Union Medical College, Beijing, 100730, China
| | - Wenwei Qian
- Department of Orthopaedic Surgery, Peking Union Medical College Hospital, Peking Union Medical College, Beijing, 100730, China
| | - Xisheng Weng
- Department of Orthopaedic Surgery, Peking Union Medical College Hospital, Peking Union Medical College, Beijing, 100730, China.
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15
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Ebert JR, Fearon AM, Smith A, Janes GC. Responsiveness of the Victorian Institute for Sport Assessment for Gluteal Tendinopathy (VISA-G), modified Harris hip and Oxford hip scores in patients undergoing hip abductor tendon repair. Musculoskelet Sci Pract 2019; 43:1-5. [PMID: 31129382 DOI: 10.1016/j.msksp.2019.05.005] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/09/2018] [Revised: 05/01/2019] [Accepted: 05/13/2019] [Indexed: 11/16/2022]
Abstract
BACKGROUND A lack of consensus exists on which patient-reported outcome measures (PROMs) best evaluate change following hip abductor tendon (HAT) repair. OBJECTIVES To compare the responsiveness of the Victorian Institute for Sport Assessment for Gluteal Tendinopathy (VISA-G), Oxford Hip (OHS) and modified Harris Hip (mHHS) scores in patients undergoing HAT repair. STUDY DESIGN Prospective case series. METHODS 56 patients underwent HAT repair and were evaluated pre-surgery and 3, 6 and 12 months post-operatively using the VISA-G, OHS, mHHS and a Global Rating of Change (GRC) scale. Internal and external responsiveness, the minimal clinically important change (MIC) and the presence of ceiling effects were evaluated. The extent to which VISA-G change was associated with mHHS and OHS change was investigated, as was the extent to which PROM changes were discriminatory for GRC improvement. RESULTS All PROMs demonstrated large standardized effect sizes (>1), with the VISA-G demonstrating responsiveness similar to the mHHS and OHS. At 12 months, the GRC correlated similarly with VISA-G (0.42, 95% CI: 0.17-0.61), mHHS (0.44, 95% CI: 0.17-0.61) and OHS (0.53, 95% CI: 0.31-0.70) changes. Using a GRC anchor of ≥4, an MIC of 29/100, 29/91 (32/100) and 16/48 (33/100) was observed for the VISA-G, mHHS and OHS, respectively. At 12 months ceiling effects existed for the mHHS (18/56, 32.1%) and OHS (13/56, 23.2%), but not VISA-G (1/56, 1.8%). CONCLUSION The VISA-G demonstrated acceptable responsiveness and was more resistant to ceiling effects, though demonstrated similar change scores and correlations with perceived improvement to the mHHS and OHS. CLINICAL TRIAL REGISTRATION This research trial is registered in the Australian New Zealand Clinical Trials Registry (ACTRN12616001655437).
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Affiliation(s)
- Jay R Ebert
- School of Human Sciences (Exercise and Sport Science), University of Western Australia, Crawley, Perth, Western Australia, 6009, Australia; HFRC Rehabilitation Clinic, 117 Stirling Highway, Nedlands, Western Australia, 6009, Australia.
| | - Angela M Fearon
- UCRISE, Faculty of Health, University of Canberra, ACT, 2617, Australia
| | - Anne Smith
- The School of Physiotherapy and Curtin Health Innovation Research Institute, Curtin University, Bentley, Perth, Western Australia, 6102, Australia
| | - Gregory C Janes
- Perth Orthopaedic and Sports Medicine Centre, 31 Outram Street, West Perth, Western Australia, 6005, Australia
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16
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Sim YE, Sim SED, Seng C, Howe TS, Koh SB, Abdullah HR. Preoperative Anemia, Functional Outcomes, and Quality of Life After Hip Fracture Surgery. J Am Geriatr Soc 2018; 66:1524-1531. [DOI: 10.1111/jgs.15428] [Citation(s) in RCA: 40] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2017] [Revised: 03/05/2018] [Accepted: 03/29/2018] [Indexed: 01/18/2023]
Affiliation(s)
- Yilin Eileen Sim
- Department of Anesthesiology; Singapore General Hospital; Singapore
| | - Shao-en David Sim
- Department of Orthopedic Surgery; Singapore General Hospital; Singapore
| | - Chusheng Seng
- Department of Orthopedic Surgery; Singapore General Hospital; Singapore
| | - Tet Sen Howe
- Department of Orthopedic Surgery; Singapore General Hospital; Singapore
| | - Suang Bee Koh
- Department of Orthopedic Surgery; Singapore General Hospital; Singapore
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17
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Fujita K, Kang HS, Mawatari M, Makimoto K, Lee M, Hwang J. Quality of life, effects on Asian Lifestyle, and perceived satisfaction after total hip arthroplasty in Japan and Korea. Int J Orthop Trauma Nurs 2018; 31:20-25. [PMID: 30049583 DOI: 10.1016/j.ijotn.2018.07.001] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2018] [Revised: 06/08/2018] [Accepted: 07/08/2018] [Indexed: 11/18/2022]
Abstract
BACKGROUND The Asian lifestyle requires deep hip flexion, which increases the risk of dislocation. Hence, Asian total hip arthroplasty (THA) patients may have problems postoperatively. This study aimed to 1) document quality of life (QoL), Asian lifestyle-related items (five postures that require deep hip flexion), and perceived satisfaction in patients who underwent THA in Japan versus Korea, 2) assess the differences in QoL and Asian lifestyle-related items by patient lifestyle, and 3) identify the factors predicting QoL. METHODS This cross-sectional study included 222 THA patients. Korean patients completed the questionnaires. Japanese patients were then matched with Korean patients by age, sex, and post-THA period. Assessed parameters included QoL measured by the EuroQoL, Oxford hip score (OHS), Asian lifestyle (measured by the Asian lifestyle-related items), and perceived satisfaction (measured by the five items of postoperative satisfaction). Multiple regression analysis was used to determine the predictors of QoL. RESULTS Compared with Korean patients, Japanese patients had better QoL, but more difficulty performing postures requiring deep hip flexion. Greater QoL was associated with greater satisfaction. The predictors of decreased QoL after THA were lower OHS in both countries, worse squatting ability in Japan, and worse leg-crossing ability in Korea. CONCLUSIONS In Japan and Korea, the OHS is an important predictor of QoL after THA.
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Affiliation(s)
- Kimie Fujita
- Division of Health Sciences, Graduate School of Medicine, Kyushu University, 3-1-1, Maidashi, Higashi-ku, Fukuoka, Japan.
| | - Hee Sun Kang
- Red Cross College of Nursing, Chung-Ang University, 84Heukseok-Rd, Dongjak-Gu, Seoul, 156-756, South Korea.
| | - Masaaki Mawatari
- Orthopaedic Surgery, Saga University, 5-1-1, Nabeshima Saga-city, Saga, Japan.
| | - Kiyoko Makimoto
- Konan Women's University, School of Nursing and Rehabilitation, 6-2-23, Morikita-machi, Higashinada-ku, Kobe, Hyogo, Japan.
| | - Mihee Lee
- Unit Manager, Department of Nursing, Hallym University Medical Center Kangnam Sacred Heart Hospital, 1 Singil Ro, Youngdeungpo Gu, Seoul, 07441, South Korea.
| | - Jihyo Hwang
- Orthopaedic Surgery, Hallym University Medical Center Kangnam Sacred Heart Hospital, 1 Singil Ro, Youngdeungpo Gu, Seoul, 07441, South Korea.
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18
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Parker SJM, Grammatopoulos G, Davies OLI, Lynch K, Pollard TCB, Andrade AJ. Outcomes of Hip Arthroplasty After Failed Hip Arthroscopy: A Case-Control Study. J Arthroplasty 2017; 32:3082-3087.e2. [PMID: 28602531 DOI: 10.1016/j.arth.2017.05.023] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/15/2016] [Revised: 04/21/2017] [Accepted: 05/10/2017] [Indexed: 02/01/2023] Open
Abstract
BACKGROUND Hip arthroscopy is increasingly being used in joint preservation surgery with clear benefits in the treatment of prearthritic conditions. A number of patients, however, will still go on to require subsequent hip arthroplasty, and at present, little evidence exists determining the impact that prior hip arthroscopy may have on the outcomes of a subsequent arthroplasty. METHODS Using prospectively collated data, we identified 35 patients who had a hip arthroplasty (22 total hip arthroplasties and 13 hip resurfacing arthroplasties) after prior ipsilateral hip arthroscopy (cases). Cases were matched for age, gender, and prosthesis type with 70 controls (patients who received a primary arthroplasty over the same period, without prior arthroscopy). Outcome measures included range of movement, implant survival, complications, and functional outcome (Oxford Hip Score and Harris Hip Score). RESULTS There was no demonstrable difference in improved range of motion after hip arthroplasty between the 2 groups, across any axis of movement (flexion, extension, internal/external rotation, abduction, and adduction; P = .07-.78). There was no significant difference in complication rate (P = .72). Overall 7-year implant survival was 85.9% (95% confidence interval [CI], 75-95.8). There was no difference in survival between cases (87.6%; 95% CI, 73.5-100) and controls (86.3%; 95% CI, 74.6%-98.0%; P = .2). Ten of the 11 revision arthroplasties performed were due to adverse reactions to metal debris in metal-on-metal hip resurfacing arthroplasty cases (P = .01). There was no difference in improvement of functional outcome postarthroplasty between groups (P = .48-.76). CONCLUSION This study demonstrates that hip arthroscopy does not adversely influence outcome of a subsequent hip arthroplasty.
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Affiliation(s)
- Simon J M Parker
- Trauma & Orthopaedic Surgery, John Radcliffe Hospital, Oxford, UK
| | | | - Owain L I Davies
- Trauma & Orthopaedic Surgery, Royal Berkshire Hospital, Reading, UK
| | - Karen Lynch
- Physiotherapy Department, Royal Berkshire Hospital, Reading, UK
| | - Tom C B Pollard
- Trauma & Orthopaedic Surgery, Royal Berkshire Hospital, Reading, UK
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Hammond CA, Hatfield GL, Gilbart MK, Garland SJ, Hunt MA. Trunk and lower limb biomechanics during stair climbing in people with and without symptomatic femoroacetabular impingement. Clin Biomech (Bristol, Avon) 2017; 42:108-114. [PMID: 28135662 DOI: 10.1016/j.clinbiomech.2017.01.015] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/10/2016] [Revised: 01/18/2017] [Accepted: 01/19/2017] [Indexed: 02/07/2023]
Abstract
BACKGROUND Femoroacetabular impingement is a pathomechanical hip condition leading to pain and impaired physical function. It has been shown that those with femoroacetabular impingement exhibit altered gait characteristics during level walking and stair climbing, and decreased muscle force production during isometric muscle contractions. However, no studies to-date have looked at trunk kinematics or muscle activation during dynamic movements such as stair climbing in this patient population. The purpose of this study was to compare biomechanical outcomes (trunk and lower limb kinematics as well as lower limb kinetics and muscle activation) during stair climbing in those with and without symptomatic femoroacetabular impingement. METHODS Trunk, hip, knee and ankle kinematics, as well as hip, knee and ankle kinetics and muscle activity of nine lower limb muscles were collected during stair climbing for 20 people with clinical and radiographic femoroacetabular impingement and compared to 20 age- and sex-matched pain-free individuals. FINDINGS Those with femoroacetabular impingement ascended the stairs slower (effect size=0.82), had significantly increased peak trunk forward flexion angles (effect size=0.99) and external hip flexion moments (effect size=0.94) and had decreased peak external knee flexion moments (effect size=0.90) compared to the control group. INTERPRETATION Findings from this study indicate that while those with and without femoroacetabular impingement exhibit many biomechanical similarities when ascending stairs, differences in trunk forward flexion and joint kinetics indicate some important differences. Further longitudinal research is required to elucidate the cause of these differences as well as the clinical relevance.
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Affiliation(s)
- Connor A Hammond
- Department of Physical Therapy, University of British Columbia, Vancouver, BC, Canada
| | - Gillian L Hatfield
- Department of Physical Therapy, University of British Columbia, Vancouver, BC, Canada
| | - Michael K Gilbart
- Department of Orthopaedics, University of British Columbia: Vancouver, BC, Canada
| | - S Jayne Garland
- Faculty of Health Sciences, Western University: London, Ontario, Canada
| | - Michael A Hunt
- Department of Physical Therapy, University of British Columbia, Vancouver, BC, Canada.
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20
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Abstract
Younger patients are affected more often by osteonecrosis than by osteoarthritis, and osteonecrosis has significantly greater long-term morbidity. Corticosteroids are the most common cause of nontraumatic osteonecrosis. The femoral head is the most common site of osteonecrosis. In rare instances, osteonecrosis of the jaw has been associated with bisphosphonate exposure. This phenomenon is more common with repeated intravenous infusions of bisphosphonates. Case reports of osteonecrosis of the jaw in association with other medications, such as denosumab, have been reported. The final common pathway in the pathogenesis of osteonecrosis is disruption of blood supply to a segment of bone. Abnormalities in lipid metabolism, bone homeostasis, regulation of apoptosis, coagulopathies, innate immunity, and oxidative stress may play a role in the pathogenesis of osteonecrosis. Epigenetics may alter the predisposition to develop osteonecrosis. MRI is currently the optimal test for early diagnosis and identification of the extent of osteonecrosis. Nonsurgical treatment of osteonecrosis does not change the natural history of the disease. Although surgical treatment of femoral head osteonecrosis has many variations, most symptomatic patients eventually require total hip arthroplasty. Knowledge of risk factors and early detection are crucial to the successful management of osteonecrosis. Because of the lack of successful treatment options, new modes of management focus on the prevention of osteonecrosis.
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21
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Henry BM, Wrażeń W, Hynnekleiv L, Kłosiński M, Pękała PA, Kucharska E, Golec EB, Tomaszewski KA, Pąchalska M. Health-Related Quality-of-Life and Functional Outcomes in Short-Stem Versus Standard-Stem Total Hip Arthroplasty: An 18-Month Follow-Up Cohort Study. Med Sci Monit 2016; 22:4406-4414. [PMID: 27853130 PMCID: PMC5123780 DOI: 10.12659/msm.900610] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
BACKGROUND Osteoarthritis (OA) progressively produces symptoms and disability that may significantly reduce health-related quality of life (HRQoL). Total hip arthroplasty (THA) is an important treatment for symptomatic OA. An alternative to standard-stem THA for younger patients is short-stem THA. The aim of this study was to investigate potential HRQoL and functional outcome differences between these patient groups to provide additional data that will be clinically useful in the decision making between the types of prosthesis. MATERIAL AND METHODS In an 18-month follow-up longitudinal cohort study, we conducted Harris Hip Score (HHS) evaluations and SF-36 questionnaires in a study group and a control group undergoing short-stem and standard-stem THA preoperatively and during follow-up at 1, 3, 6, 12, and 18 months. Effect size was calculated to estimate the size of changes in scores during follow-up between chosen time intervals. RESULTS A total of 168 patients were included in the study. The total HHS score was significantly increased postoperatively from 46.9 to 87.0 in the standard-stem group, and from 42.7 to 85.1 in the short-stem group. All SF-36 scores improved after THA in both groups. No HRQoL or functional differences were found in the use of either surgical option in the HHS or SF-36 score results (all p>0.05). CONCLUSIONS As there were no differences in HRQoL in the two groups, we strongly recommend considering short-stem THA, especially in younger patients, due to the benefit of future revision options and a minimally invasive approach.
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Affiliation(s)
| | - Waldemar Wrażeń
- Department of Orthopaedics and Trauma Surgery, 5th Military Clinical Hospital in Cracow, Cracow, Poland
| | - Leif Hynnekleiv
- Department of Anatomy, Jagiellonian University Medical College, Cracow, Poland
| | - Michał Kłosiński
- Department of Anatomy, Jagiellonian University Medical College, Cracow, Poland
| | - Przemysław A Pękała
- Department of Anatomy, Jagiellonian University Medical College, Cracow, Poland
| | - Ewa Kucharska
- Department of Gerontology, Geriatrics and Social Work, Ignatianum Academy, Cracow, Poland
| | - Edward B Golec
- Department of Orthopaedics and Trauma Surgery, 5th Military Clinical Hospital in Cracow, Cracow, Poland
| | | | - Maria Pąchalska
- Department of Neuropsychology, Andrzej Frycz-Modrzewski Cracow University, Cracow, Poland
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22
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Functional outcomes of total hip arthroplasty in patients aged 30 years or less: a systematic review and meta-analysis. Hip Int 2016; 26:424-431. [PMID: 27174066 DOI: 10.5301/hipint.5000376] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 02/18/2016] [Indexed: 02/04/2023]
Abstract
INTRODUCTION Young adult hip surgery is a growing subspecialty. Increasingly total hip arthroplasty (THA) is offered to patients aged 30 or less suffering from end-stage hip arthropathy from a variety of congenital, developmental and acquired conditions. There is a paucity of evidence to advise such patients and surgeons alike on the functional outcomes of THA in this age group, as individual studies tend to include small cohorts. METHODS A systematic review and meta-analysis was performed to assess whether THA in patients aged 30 years or less provides significant functional improvement. The primary outcome measure was change in Harris Hip Score. Secondary outcome measures were implant survivorship and the effect of fixation type and bearing surface. RESULTS The results of 743 primary THA procedures were included. Weighted mean patient age was 22.7 years. Harris Hip Score improved by a weighted mean difference of 42.17 points out of 100 (95% confidence interval, 36.48-47.86 points, p<0.001) after THA at a weighted mean follow-up of 8.4 years. Pooled revision rate was 5.0% for the same time period. CONCLUSIONS This is the largest review to date of THA in patients aged 30 or less. The results show significant functional improvement measured by Harris Hip Score. The revision rate of 5% at 8.4 years is comparable to the general THA population. This contrasts high revision rates reported in older reviews of the literature, suggesting adoption of improved techniques and implants in the more recent literature.
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23
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Mitrovic D, Davidovic M, Erceg P, Marinkovic J. The effectiveness of supplementary arm and upper body exercises following total hip arthroplasty for osteoarthritis in the elderly: a randomized controlled trial. Clin Rehabil 2016; 31:881-890. [PMID: 27353247 DOI: 10.1177/0269215516655591] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
OBJECTIVE To determine whether arm and upper body exercises in addition to the standard rehabilitation programme improve outcomes after hip arthroplasty. DESIGN Prospective, parallel, randomized, controlled trial. SETTING Orthopaedic and rehabilitation departments. SUBJECTS A total of 70 patients >60 years of age, who underwent hip replacement, out of 98 eligible candidates after exclusion criteria were implemented. INTERVENTIONS The study group took part in the supplementary arm and upper body exercise programme to be compared with the standard rehabilitation programme group. MAIN OUTCOME The primary outcome was a Harris Hip Score. Secondary outcomes were: Hand grip strength and Medical Outcomes Study 36-Item Short-Form Health Survey. Outcomes were assessed preoperatively, two weeks after surgery and at 12 weeks follow-up. RESULTS In the intervention group, significant improvements were found: in functional ability - Harris Hip Score after two (mean difference = 4.7 points) and 12 (mean difference = 5.85 points) weeks; in muscle strength - handgrip for both hands (mean difference for dominant hand = 4.16 and for the other hand = 2.8) after 12 weeks; and in role-physical dimension SF-36 Health Survey (mean difference = 6.42 points) after 12 weeks. CONCLUSION Results of this study indicate that arm and upper body exercises in addition to the standard rehabilitation programme improve outcomes 12 weeks after hip arthroplasty.
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Affiliation(s)
- Dragica Mitrovic
- 1 Department of Physical Medicine and Rehabilitation, "Zvezdara" University Hospital, Belgrade, Serbia
| | - Mladen Davidovic
- 2 Department of Geriatric Medicine, University of Belgrade, Belgrade, Serbia
| | - Predrag Erceg
- 2 Department of Geriatric Medicine, University of Belgrade, Belgrade, Serbia.,3 Clinical Department of Geriatrics, "Zvezdara" University Hospital, Belgrade, Serbia
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Shan L, Shan B, Suzuki A, Nouh F, Saxena A. Intermediate and long-term quality of life after total knee replacement: a systematic review and meta-analysis. J Bone Joint Surg Am 2015; 97:156-68. [PMID: 25609443 DOI: 10.2106/jbjs.m.00372] [Citation(s) in RCA: 163] [Impact Index Per Article: 18.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
BACKGROUND Total knee replacement is a highly successful and frequently performed operation. Technical outcomes of surgery are excellent, with favorable early postoperative health-related quality of life. This study reviews intermediate and long-term quality of life after surgery. METHODS A systematic review and meta-analysis of all studies published from January 2000 onward was performed to evaluate health-related quality of life after primary total knee replacement for osteoarthritis in patients with at least three years of follow-up. Key outcomes were postoperative quality of life, function, and satisfaction compared with the preoperative status. Strict inclusion and exclusion criteria were applied. Quality appraisal and data tabulation were performed with use of predefined criteria. Data were synthesized by narrative review and random-effects meta-analysis utilizing standardized mean differences. Heterogeneity was assessed with the tau(2) and I(2) statistics. RESULTS Nineteen studies were included in the review. Intermediate and long-term postoperative quality of life was superior to the preoperative level in qualitative and quantitative analyses. The pooled effect in combined WOMAC (Western Ontario and McMaster Universities Osteoarthritis Index) and KSS (Knee Society Score) outcomes was a marked improvement from baseline with respect to the total score (2.17; 95% CI [confidence interval], 1.13 to 3.22; p < 0.0001) and the pain (1.72; 95% CI, 0.97 to 2.46; p < 0.00001) and function (1.26; 95% CI, 0.87 to 1.64; p < 0.00001) domains. Most patients were satisfied with the surgery and derived substantial benefits for daily functional activities. Tau(2) (0.20 to 1.10) and I(2) (90% to 98%) values implied significant clinical and statistical heterogeneity. CONCLUSIONS Total knee replacement confers significant intermediate and long-term benefits with respect to both disease-specific and generic health-related quality of life, especially pain and function, leading to positive patient satisfaction. Recommendations for necessary future studies are provided. LEVEL OF EVIDENCE Therapeutic Level II. See Instructions for Authors for a complete description of levels of evidence.
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Affiliation(s)
- Leonard Shan
- Faculty of Medicine, Melbourne Medical School, Level 2 West, Medical Building (181), The University of Melbourne, Victoria 3010, Australia
| | - Bernard Shan
- Faculty of Medicine, Nursing, and Health Sciences, Monash University, Victoria 3800, Australia
| | - Arnold Suzuki
- Department of Orthopedic Surgery, Wollongong Hospital, 1 Crown Street, Wollongong, NSW 2500, Australia. Email address for A. Saxena:
| | - Fred Nouh
- Department of Orthopedic Surgery, Wollongong Hospital, 1 Crown Street, Wollongong, NSW 2500, Australia. Email address for A. Saxena:
| | - Akshat Saxena
- Department of Orthopedic Surgery, Wollongong Hospital, 1 Crown Street, Wollongong, NSW 2500, Australia. Email address for A. Saxena:
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Valera M, Bonifacio L, Basman S. Outcome of surgery for unstable intertrochanteric fractures in octogenarians. Malays Orthop J 2014; 8:26-31. [PMID: 25279081 PMCID: PMC4093549 DOI: 10.5704/moj.1403.014] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
This study aims to determine pre-morbid parameters as
possible predictors of outcome of hip fracture in
octogenarians with unstable intertrochanteric fracture treated
operatively. Presence of co-morbidities, pre-injury level of
ambulation, type of surgery, and period of delay in surgery
were considered, and their effect on the post-operative
outcome was evaluated using the Harris Hip Score. The
computed probability of survival of octogenarians who had
surgery was approximately 11 months. In patients with two
or more co-morbidities, there is a significant effect on Harris
Hip Score in terms of pain and deformity. Delay in surgery
of more than two weeks significantly decreased the distance
travelled at one year. The overall recovery is correlated to
preinjury level of ambulation and delay in surgery. Patients
with intertochanteric fracture in this age group, who have
less co-morbidities and with more independent ambulation,
are good candidates for timely operative treatment.
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Affiliation(s)
- Mv Valera
- Philippine Orthopedic Center, Maria Clara St. corner Banawe Ave., Quezon City, Philippines
| | - L Bonifacio
- Philippine Orthopedic Center, Maria Clara St. corner Banawe Ave., Quezon City, Philippines
| | - Sa Basman
- Philippine Orthopedic Center, Maria Clara St. corner Banawe Ave., Quezon City, Philippines
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26
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Total hip replacement: a systematic review and meta-analysis on mid-term quality of life. Osteoarthritis Cartilage 2014; 22:389-406. [PMID: 24389057 DOI: 10.1016/j.joca.2013.12.006] [Citation(s) in RCA: 130] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/16/2013] [Revised: 11/22/2013] [Accepted: 12/02/2013] [Indexed: 02/02/2023]
Abstract
OBJECTIVE Total hip replacement (THR) is one of the most successful and frequently performed operations worldwide. Health-related quality of life (HRQOL) is a key outcome measure of surgery. We investigated mid-term HRQOL after THR in patients with osteoarthritis (OA). DESIGN A systematic review of clinical studies published after January 2000 was performed using strict eligibility criteria. Quality appraisal and data tabulation were performed using pre-determined forms. Data were synthesised by narrative review and random-effects meta-analysis using standardised response means. Tau(2) and I(2) values and Funnel plots were analysed. RESULTS 20 studies were included. Mid-term post-operative HRQOL is superior compared to pre-operative status on qualitative and quantitative analysis. Pooled response means of total Harris Hip Score (HHS) (P < 0.00001) and combined pain (P = 0.00001) and physical function (P < 0.00001) domains of Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) and HHS improved markedly up to 7 years. Medical Outcomes Survey Short Form 36 shows physical functioning (PF) (P < 0.00001), bodily pain (BP) (P < 0.00001), role physical (P = 0.001), role emotional (P = 0.04), and social functioning (SF) (P = 0.03) were improved up to 7 years. General health (GH) (P = 0.29), mental health (MH) (P = 0.43), and vitality (P = 0.17) was similar. HRQOL is at least as good as reference populations in the first few years and subsequently plateaus or declines. Patient satisfaction and functional status was favourable. There was significant heterogeneity amongst all studies, but publication bias was low in pooled analysis. CONCLUSION THR confers significant mid-term HRQOL benefits across a broad range of health domains. Further studies based on consistent guidelines provided in this review are required.
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Abstract
Osteonecrosis affects younger patients more often than osteoarthritis and has significantly greater long-term morbidity. Corticosteroids constitute the most common cause of nontraumatic osteonecrosis. The femoral head is the most common site of osteonecrosis. Bisphosphonate use is associated with osteonecrosis of the jaw. The final common pathway in the pathogenesis of osteonecrosis is disruption of blood supply to a segment of bone. Abnormalities in lipid metabolism, bone homeostasis, regulation of apoptosis, coagulopathies, and oxidative stress may play a role in the pathogenesis of osteonecrosis. Magnetic resonance imaging is currently the optimal test for early diagnosis and identification of the extent of osteonecrosis. Nonsurgical treatment of osteonecrosis does not change the natural history of the disease. Although there are many variations on surgical treatment of femoral head osteonecrosis, most patients eventually require total hip arthroplasty. Knowledge of risk factors and early detection are crucial to the successful management of osteonecrosis. Due to the lack of successful treatment options, new modes focus on prevention of osteonecrosis.
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28
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Collins NJ, Roos EM. Patient-reported outcomes for total hip and knee arthroplasty: commonly used instruments and attributes of a "good" measure. Clin Geriatr Med 2012; 28:367-94. [PMID: 22840304 DOI: 10.1016/j.cger.2012.05.007] [Citation(s) in RCA: 114] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
Although the effectiveness of THA and TKA as interventions for end-stage degenerative joint disease has been well established, the use of instruments that measure outcome from the patient's perspective are relatively poorly investigated. Considering the increasing prevalence, associated risks, and high personal and financial cost associated with THA and TKA, patient-reported outcomes are required to ensure optimal selection of patients, and that postoperative outcomes outweigh the burden associated with surgical procedures. It is clear from the information presented that clinicians need to consider a number of factors when selecting a "good" patientreported outcome for use in their TJA patients. Not only does the instrument need to measure dimensions appropriate for THA and TKA patients, but it also needs to have minimal administrative burden, accessibility to a variety of clinicians and patients, reliability, validity, and responsiveness to change. Furthermore, knowledge regarding the minimal score that patients deem to be meaningful is useful in interpreting whether a patient has experienced real improvement in their condition after surgery. It is clear that further studies are required, particularly to fill some of the gaps regarding known psychometric properties of patient-reported outcomes for THA and TKA. Based on data acquired in THA and TKA patients for the instruments reviewed, it appears that OA-specific and TJA-specific measures for which patients have been involved in the developmental process (HOOS, KOOS, WOMAC, Oxford Hip and Knee Scores) can more consistently be considered "good" patient-reported outcomes for THA and TKA. Clinicians wishing to evaluate a broader range of dimensions may choose to complement these with one of the generic measures evaluated, bearing in mind the practical issues and psychometric limitations of these instruments when applied to THA and TKA patients.
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Affiliation(s)
- Natalie J Collins
- Department of Mechanical Engineering, The University of Melbourne, Victoria, Australia
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Nilsdotter A, Bremander A. Measures of hip function and symptoms: Harris Hip Score (HHS), Hip Disability and Osteoarthritis Outcome Score (HOOS), Oxford Hip Score (OHS), Lequesne Index of Severity for Osteoarthritis of the Hip (LISOH), and American Academy of Orthopedic Surgeons (A. Arthritis Care Res (Hoboken) 2011; 63 Suppl 11:S200-7. [DOI: 10.1002/acr.20549] [Citation(s) in RCA: 287] [Impact Index Per Article: 22.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
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Snowden JA, Ahmedzai SH, Ashcroft J, D’Sa S, Littlewood T, Low E, Lucraft H, Maclean R, Feyler S, Pratt G, Bird JM. Guidelines for supportive care in multiple myeloma 2011. Br J Haematol 2011; 154:76-103. [DOI: 10.1111/j.1365-2141.2011.08574.x] [Citation(s) in RCA: 151] [Impact Index Per Article: 11.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
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Wamper KE, Sierevelt IN, Poolman RW, Bhandari M, Haverkamp D. The Harris hip score: Do ceiling effects limit its usefulness in orthopedics? Acta Orthop 2010; 81:703-7. [PMID: 21110703 PMCID: PMC3216080 DOI: 10.3109/17453674.2010.537808] [Citation(s) in RCA: 177] [Impact Index Per Article: 12.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023] Open
Abstract
BACKGROUND AND PURPOSE The Harris hip score (HHS), a disease-specific health status scale that is frequently used to measure the outcome of total hip arthroplasty, has never been validated properly. A questionnaire is suitable only when all 5 psychometric properties are of sufficient quality. We questioned the usefulness of the HHS by investigating its content validity. METHODS We performed a systematic review based on a literature search in PubMed, Embase, and the Cochrane Library for descriptive studies published in 2007. 54 studies (59 patient groups) met our criteria and were included in the data analysis. To determine the content validity, we calculated the ceiling effect (percentage) for each separate study and we pooled data to measure the weighted mean. A subanalysis of indications for THA was performed to differentiate the populations for which the HHS would be suitable and for which it would not. A ceiling effect of 15% or less was considered to be acceptable. RESULTS Over half the studies (31/59) revealed unacceptable ceiling effects. Pooled data across the studies included (n = 6,667 patients) suggested ceiling effects of 20% (95%CI: 18-22). Ceiling effects were greater (32%, 95%CI:12-52) in those patients undergoing hip resurfacing arthroplasty. INTERPRETATION Although the Harris hip score is widely used in arthroplasty research on outcomes, ceiling effects are common and these severely limit its validity in this field of research.
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Affiliation(s)
- Kim E Wamper
- Department of Orthopaedic Surgery, Academic Medical Centre, Amsterdam
| | - Inger N Sierevelt
- Department of Orthopaedic Surgery, Academic Medical Centre, Amsterdam
| | - Rudolf W Poolman
- Department of Orthopaedic Surgery, OLVG, Amsterdam, the Netherlands
| | - Mohit Bhandari
- Division of Orthopaedic Surgery, Departments of Surgery and of Clinical Epidemiology and Biostatistics, McMaster University Medical Centre, Hamilton, ON, Canada
| | - Daniël Haverkamp
- Department of Orthopaedic Surgery, Academic Medical Centre, Amsterdam
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Traumatic arthritis of the hip after dislocation and acetabular fractures: treatment by mold arthroplasty. An end-result study using a new method of result evaluation. J Bone Joint Surg Am 1969. [PMID: 5783851 DOI: 10.1007/978-1-4471-5451-8_3] [Citation(s) in RCA: 24] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
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