Quality of life, effects on Asian Lifestyle, and perceived satisfaction after total hip arthroplasty in Japan and Korea

Satisfaction following correction of spinal deformity: Cultural and regional effects on outcome

Corrective spine surgery for spinal deformities, such as adolescent idiopathic scoliosis (AIS) and adult spinal deformity (ASD), aims to enhance the quality of life by addressing physical impairments. However, the extent of patient satisfaction after surgery, which includes pain management, functional recovery, and psychological contentment, exhibits considerable variation across different cultural and geographical landscapes. This review describes the influence of cultural and regional disparities on postoperative satisfaction in AIS and ASD surgery with a particular emphasis on the disparities between the US and Japan. This review underscores the intricate relationship between surgical outcomes and patient-reported satisfaction metrics. The investigation reveals significant contrasts in patient satisfaction and clinical results between these 2 countries, attributed to divergent cultural expectations, lifestyle adaptations, and perceptions of bodily image. These distinctions are crucial for healthcare professionals to recognize, as they necessitate a culturally nuanced approach to patient care. This comparative review not only enhances the understanding of patient experiences across cultures but also provides valuable guidance for physicians in customizing their strategies to align with the varied expectations of their patients, thereby improving postoperative satisfaction and overall quality of life. This review emphasizes the necessity of a tailored and culturally sensitive approach to managing spinal deformities, underscoring the need to factor in cultural and regional elements to enhance patient satisfaction and surgical outcomes.

The relationship between spino-pelvic-hip mobility and quality of life before and after total hip arthroplasty

INTRODUCTION

Total hip arthroplasty (THA) can significantly improve quality of life (QOL) in patients with hip osteoarthritis. A relationship exists between activity levels and postoperative QOL, but its determinants are not well known. The aim of this work was to investigate the relationship between hip, pelvis and lumbar spine mobility and alignment before and after THA with QOL.

MATERIAL AND METHODS

Consecutive patients with hip arthrosis and an indication for THA were included prospectively between July 2019 and December 2020, and they underwent lateral radiographs in free-standing, extension, relaxed- and flexed-seated position. Spinopelvic and hip parameters were measured, as well as their changes between positions to assess hip, pelvis and lumbar spine mobility. Patients were also administered QOL questionnaires. Data were collected preoperatively and 6 and 12 months postoperatively.

RESULTS

Seventy patients were included; QOL significantly increased 6 months after THA (from 18 [10; 27] to 61 [48; 72], p < 0.001). QOL further increased by 10 points or more after 6 months in 18% of patients, while it decreased in 16%. The latter showed higher pelvic range of motion (between flexion and extension) than the former.

CONCLUSIONS

This study confirmed that QOL is significantly improved by THA, and that spinopelvic alignment and function can play a role. Future work should elucidate how to better predict postoperative QOL from preoperative patient characteristics to improve patient treatment and establish early postoperative physical therapy for patients who could benefit from postoperative improvement of activity-related QOL.

Association between magnitude of femoral head collapse and quality of life in patients with osteonecrosis of the femoral head

OBJECTIVES

The magnitude of femoral head collapse (MFHC) is one of the criteria for staging osteonecrosis of the femoral head (ONFH). The present study aimed to clarify the relationship between MFHC and hip pain or functional quality of life (QOL) scores in patients with ONFH.

METHODS

Seventy patients with ONFH who had femoral head collapse without osteoarthritic changes were divided into four groups based on MFHC by 1 mm. Pain was assessed using the visual analogue scale (VAS). QOL was evaluated using patient-reported outcome measures such as the Japanese Orthopaedic Association Hip-Disease Evaluation Questionnaire (JHEQ), Oxford Hip Score (OHS), and Short Form-12 Health Survey, version 2 (SF-12v2). We also explored the relationship between MFHC and QOL.

RESULTS

Pain score and satisfaction score in the VAS, JHEQ pain subscale, JHEQ movement subscale, and JHEQ total score were significantly associated with MFHC, and no significant differences were found between groups in any subscale or total score for OHS and SF-12v2.

CONCLUSION

In patients with ONFH, differences in MFHC by 1 mm were associated with deterioration of some pain VAS and QOL outcomes.

Different expectations of patients and surgeons with regard to rotator cuff repair

BACKGROUND

Rotator cuff lesions are a common shoulder pathology mainly affecting patients aged >50 years. This condition is accompanied by not only pain and loss of function but also impaired quality of life and psychological stress. A frequently employed treatment option is arthroscopic repair. But expectations regarding the outcome after surgery might differ between patients and surgeons and therefore lead to dissatisfaction on both sides. The aim of this study was to document patient expectations of a planned arthroscopic rotator cuff repair and compare the results with the assessment of shoulder surgeons.

MATERIALS AND METHODS

A total of 303 patients and 25 surgeons were involved in this study. Patients with partial- or full-thickness tear of the rotator cuff scheduled for arthroscopic repair were included in this study. Preoperatively, they were asked to fill out questionnaires inquiring sociodemographic data, scores of the underlying pathology, as well as expectations regarding the operation with regard to pain relief, gain of range of motion and strength, as well as the effect on activities of daily life, work, and sports. Furthermore, 25 surgeons were surveyed on what they think their patients expected using the same standardized questions.

RESULTS

Among the patients, 43.9% considered gain of range of motion to be the most important goal after rotator cuff repair, followed by pain relief (30.6%) and gain of force (13.7%). Among the surgeons, 72% believed pain relief to be the most important for their patient followed by movement (20%) and strength (8%). When asked which parameter was the most important to achieve after operation, for patients, movement was on first place, pain second, and strength third. For shoulder specialists, the ranking was pain, movement, and strength. Surgeons significantly overrated pain relief when ranking against movement compared with their patients.

CONCLUSION

The expectations of patients regarding their operation differ from the surgeon's assessment. Whereas gaining range of motion was more important for patients, surgeons clearly voted for pain relief. Different expectations should therefore be discussed within the pretreatment interview and taken into account when planning the right therapy. This might lead to better satisfaction on both sides.

Marital Relationship and Quality of Life in Couples Following Hip Replacement Surgery

For the majority of patients with osteoarthritis, total hip (THA) arthroplasty results in a significant reduction in pain, emotional distress, and disability and a significant improvement in their quality of life. Little is known about how these recovery-related changes impact the spouse or the marital relationship. Methods: Twenty-nine couples whose spouse underwent a THA (29 THA) participated in a semi-structured retrospective interview designed for this study. They were each asked to recall the level of pain before and after surgery and to provide a numerical rating score for questions pertaining to the level of disability in seven different activities of daily living. Couples were also asked to list in order of importance the five ways in which the surgery affected their overall quality of life. Results: The spouses estimated their partner’s pain, both pre- and postoperatively, to be significantly higher level than the patient’s perception. The spouses perceived a greater improvement in family/home responsibilities, recreation and social activities, and in their occupation than that noted by the partner. After the arthroplasty, the spouses indicated that their lives had improved with respect to doing more activities/leisure (72%), because their partner had less suffering (59%), they had more independence/less caregiving (55%), it improved their marital relationship (52%), they had a better social/family life (28%), and they were able to travel (28%). Conclusions: This study indicates that THA result in a significant improvement in quality of life not only for the patients, but also for their spouses.

Factors associated with health-related quality of life in Japanese patients with hip osteoarthritis: A cross-sectional study

Background/Purpose:

Chronic symptoms related with hip osteoarthritis (OA) can negatively affect health-related quality of life (HRQoL). The purpose of this study was to examine factors related to a HRQoL measure that considers an Asian lifestyle in Japanese patients with hip OA.

Methods:

Forty-seven female subjects participated. The dependent variable was the Japanese Orthopaedic Association Hip Disease Evaluation Questionnaire (JHEQ), which assessed HRQoL. Potential factors were measured as independent variables. After screening, potential variables were entered into a multiple regression analysis to determine which variables were related to HRQoL.

Results:

In the regression model, knee extension muscle strength on the unaffected side and hip flexion range of motion (ROM) on the affected side were associated with HRQoL. Higher strength and higher ROM were related to greater HRQoL.

Conclusion:

Results can help health-care providers develop appropriate rehabilitation programs for improving HRQoL in patients with hip OA.

Total Hip Arthroplasty: Past, Present, and Future. What Has Been Achieved?

In the 1960s, Sir John Charnley introduced to clinical practice his concept of low-friction total hip arthroplasty (THA). Although early designs were plagued by poor performance and even failure, there have been steady advances in implant designs, biomaterials, surgical techniques and an understanding of the biomechanical restoration of the hip; these advances have contributed to improvements in implant survival and clinical outcomes of THA in the past three decades. With improved wear resistance and mechanical reliability, a potential to last for at least 25 to 30 years are now available for THA. In this review, we focus on the evolution of THA and review current controversies and future directions of this procedure based on a single surgeon's 29-year of experience at a single institution.