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Muir NB, Orlin M, Rubertone P, Williams G. Can We Enhance Shared Decision-making for Periacetabular Osteotomy Surgery? A Qualitative Study of Patient Experiences. Clin Orthop Relat Res 2024:00003086-990000000-01688. [PMID: 39051876 DOI: 10.1097/corr.0000000000003198] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/17/2024] [Accepted: 06/28/2024] [Indexed: 07/27/2024]
Abstract
BACKGROUND Periacetabular osteotomy (PAO) surgery presents an opportunity for shared decision-making (SDM) and may be facilitated by decision-making tools. Currently, no diagnosis or treatment-specific decision-making tools exist for this patient population. Understanding patient PAO surgery decision-making experiences and processes would enable development of a treatment-specific decision-making tool and would help hip preservation surgeons with SDM practices. QUESTIONS/PURPOSES Qualitative methodology was used to address the following questions: (1) What were the information support needs of adult patients with hip dysplasia who decided to have PAO? (2) What was important to adult patients with hip dysplasia who decided to have PAO? (3) How did adult patients with hip dysplasia who have undergone PAO experience the surgical decision-making process? (4) What elements of SDM did adult patients with hip dysplasia experience with their surgeons when deciding to have PAO? METHODS Fifteen volunteer, English-speaking patients in the United States who had been diagnosed with hip dysplasia and who had undergone PAO surgery 6 to 12 months prior to the study were recruited through five PAO surgery Facebook support groups. Individuals were excluded if they had an underlying neuromuscular condition or other diagnosis related to nondevelopmental dysplasia of the hip or if they had a previous PAO surgery > 12 months before data collection. We used purposive sampling strategies to promote sample heterogeneity based on age and preoperative activity level, as these are characteristics that may impact decision-making. Participants were categorized into three age groups: 20 to 29 years, 30 to 39 years, and ≥ 40 years. Participants were also categorized as having "low activity," "moderate activity," or "high activity" preoperatively based on self-reported University of California Los Angeles (UCLA) Activity Scale scores. Participants were enrolled consecutively if they met the inclusion criteria and fulfilled one of our sampling categories; we had plans to enroll more participants if thematic saturation was not achieved through the first 15 interviews. Participants included 14 women and one man ranging in age from 23 to 48 years, and all had undergone PAO surgery for hip dysplasia 6 to 12 months prior to the interview. One-on-one semistructured interviews were conducted with each participant by a single interviewer through Zoom video conferencing using video and audio recording. Participants answered semistructured interview questions and provided verbal responses to survey questions so researchers could gain demographic information and details about their symptoms, diagnosis, and PAO surgery between June 2021 and August 2021. Quantitative survey data were analyzed using descriptive statistics. Qualitative data were analyzed by three researchers using principles of reflexive thematic analysis. Candidate themes were iteratively defined and redefined until central themes were developed that were distinctly different, yet centrally relevant, and answered the research questions. All codes that informed category and theme development were generated within the first six transcripts that were analyzed. The team felt that thematic saturation was established with the 15 interviews. RESULTS The main information needs for adult patients with hip dysplasia included diagnosis and treatment-related information, as well as logistics related to surgery and recovery. Many patients described that their information needs were only partially met by their surgeon; most engaged in additional information-seeking from scientific research and online resources and relied on patient peers to meet information needs about the lived experience and logistics related to surgery and recovery. It was important to patients that PAO surgery could preserve their native hip or delay THA and that PAO surgery was likely to reduce their pain and improve function; decision-making was facilitated when patients were able to identify how the indications and goals of PAO surgery aligned with their own situation and goals for surgery. Patients' experiences with decision-making were more positive when information needs were met, when indications and goals for PAO surgery aligned with their personal values and goals, and when their preferred and actual decision-making roles aligned. Adult patients with hip dysplasia described high variability in the extent to which patients were invited to share personal preferences, values, and goals around PAO surgery and the extent to which preferred patient decision-making roles were assessed. CONCLUSION We found that elements of SDM are not consistently integrated into hip preservation practice. The knowledge gained through this work about patient PAO surgery information needs, what matters to patients when deciding to have surgery, and their experiences with PAO surgery decision-making can inform future PAO surgery decision-making tool development. Future studies are needed to validate the findings of this study and to determine whether they are generalizable to adult patients with hip dysplasia with different demographic characteristics or to patients who do not participate in social media support groups. CLINICAL RELEVANCE Surgeons should recognize that patients are likely to leave their office without their information needs being met. SDM strategies can promote more effective information exchanges in the clinic so surgeons can help patients identify their information needs, provide education and direction to accurate and reputable resources to meet those needs, and help patients appraise information they gather and apply it to their personal situation. Hip preservation surgeons can use the sample SDM script and checklist offered here to support adult patients with hip dysplasia who are making PAO surgery decisions until a future diagnosis and treatment-specific decision-making tool is available.
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Affiliation(s)
| | - Margo Orlin
- College of Nursing and Health Professions, Drexel University, Philadelphia, PA, USA
| | - Patricia Rubertone
- College of Nursing and Health Professions, Drexel University, Philadelphia, PA, USA
| | - Glenn Williams
- College of Nursing and Health Professions, Drexel University, Philadelphia, PA, USA
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Pacheco-Brousseau L, Poitras S, Ricard MA, Kashanian K, Carsen S, Wilkin G, Grammatopoulos G, Beaulé PE. The relationship of pain catastrophizing with postoperative patient-reported outcome measures in adults with pre-arthritic hip disease. J Hip Preserv Surg 2024; 11:118-124. [PMID: 39070213 PMCID: PMC11272638 DOI: 10.1093/jhps/hnad049] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/21/2023] [Revised: 09/07/2023] [Accepted: 01/16/2024] [Indexed: 07/30/2024] Open
Abstract
The association between preoperative pain catastrophizing and postoperative patient-reported outcome measures of patients with pre-arthritic hip disease was evaluated. All patients scheduled for joint-preserving surgeries of the hip (JPSH) at our institution were approached. Patient demographics (age, sex, body mass index (BMI)), pain intensity (Numeric Pain Scale (NPS)) and pain catastrophizing (Pain Catastrophizing Scale (PCS)) were collected preoperatively. Patient function (12-Item International Hip Outcome Tool (iHot-12)) and physical and mental health (Patient-Reported Outcomes Measurement Information System (PROMIS-10) mental/physical) were collected preoperatively, three-month and one-year postoperatively. The analysis consisted of multivariate linear regression models fitted for continuous scores of outcome measures at three-month and one-year. Correlation between preoperative PCS and iHot-12 was assessed using the Pearson correlation coefficient. A total of 274 patients completed the PCS and were included in the multivariate linear regression models. Most patients were females (66.8%), mean age was 33 (SD 9), mean BMI was 26.5 (SD 5.8) and most were diagnosed with femoro-acetabular impingement (46.0%) and underwent arthroscopy (77.0%). There were statistically significant correlations between PCS and iHot-12 (preoperatively -0.615, P < 0.001; three-month -0.242, P = 0.002). Statistically significant associations were found for function (three-month PCS P = 0.046, age P = 0.014, NPS P = 0.043; one-year BMI P = 0.005, NPS P = 0.014), physical health (three-month BMI, P = 0.002, NPS P = 0.008; one-year BMI P = 0.002, NPS P = 0.013) and mental health (three-month BMI P = 0.047; one-year BMI P = 0.030). There is an association between function and preoperative pain catastrophizing in patients with pre-arthritic hip disease undergoing JPSH. When considering confounding variables, preoperative pain catastrophizing is associated with short-term recovery.
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Affiliation(s)
- Lissa Pacheco-Brousseau
- Faculty of Health Sciences, School of Rehabilitation Sciences, University of Ottawa, 200 Lees Ave, Ottawa, Ontario K1S 5L5, Canada
- Division of Orthopaedic Surgery, The Ottawa Hospital, 501 Smyth Rd, Ottawa, Ontario K1H 8L6, Canada
| | - Stéphane Poitras
- Faculty of Health Sciences, School of Rehabilitation Sciences, University of Ottawa, 200 Lees Ave, Ottawa, Ontario K1S 5L5, Canada
| | - Marc-Antoine Ricard
- Division of Orthopaedic Surgery, The Ottawa Hospital, 501 Smyth Rd, Ottawa, Ontario K1H 8L6, Canada
| | - Koorosh Kashanian
- Division of Orthopaedic Surgery, The Ottawa Hospital, 501 Smyth Rd, Ottawa, Ontario K1H 8L6, Canada
| | - Sasha Carsen
- Division of Orthopaedic Surgery, Children’s Hospital of Eastern Ontario, 501 Symth Rd, Ottawa, Ontario K1H 8L1, Canada
| | - Geoffrey Wilkin
- Division of Orthopaedic Surgery, The Ottawa Hospital, 501 Smyth Rd, Ottawa, Ontario K1H 8L6, Canada
| | - George Grammatopoulos
- Division of Orthopaedic Surgery, The Ottawa Hospital, 501 Smyth Rd, Ottawa, Ontario K1H 8L6, Canada
| | - Paul E Beaulé
- Division of Orthopaedic Surgery, The Ottawa Hospital, 501 Smyth Rd, Ottawa, Ontario K1H 8L6, Canada
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Holm PM, Simonÿ C, Brydegaard NK, Høgsgaard D, Thorborg K, Møller M, Whittaker JL, Roos EM, Skou ST. An early care void: The injury experience and perceptions of treatment among knee-injured individuals and healthcare professionals - A qualitative interview study. Phys Ther Sport 2023; 64:32-40. [PMID: 37696196 DOI: 10.1016/j.ptsp.2023.08.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2023] [Revised: 08/27/2023] [Accepted: 08/29/2023] [Indexed: 09/13/2023]
Abstract
OBJECTIVES To better comprehend the initial injury experience and care requirements of knee-injured individuals, as well as healthcare professionals' interactions with early care. DESIGN Qualitative interviews. SETTING Public healthcare in Denmark. PARTICIPANTS Ten individuals (6 women) with major knee injuries (6 anterior cruciate ligament (ACL) and meniscal tears, 2 isolated ACL tears, 1 isolated meniscal tear, 1 patella dislocation), aged 16-33 years (median 19 years), 1-26 months post-injury (median 3 months). Thirteen HCPs (5 physiotherapists, 5 orthopedic surgeons, 3 general practitioners). MAIN OUTCOME MEASURE Semi-structured individual and focus group interviews, transcribed verbatim and with latent thematic analysis. RESULTS The three main themes were: 1) Emotional struggles in solitude - knee-injured individuals dealing with emotions alone due to limited HCP resources for emotional support. 2) Blurry beginning - knee-injured individuals finding initial care frustrating, a sentiment shared by HCPs. 3) A journey with no map - knee-injured individuals holding varied outcome expectations, while HCPs hesitate to discuss long-term knee health. CONCLUSION Early care for knee-injured individuals is filled with worries and unmet emotional and information support needs. HCPs need more support and training to deliver timely and appropriate care.
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Affiliation(s)
- Pætur M Holm
- The Research and Implementation Unit PROgrez, Department of Physiotherapy and Occupational Therapy, Næstved-Slagelse-Ringsted Hospitals, Region Zealand, Slagelse, Denmark; Research Unit for Musculoskeletal Function and Physiotherapy, Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark.
| | - Charlotte Simonÿ
- The Research and Implementation Unit PROgrez, Department of Physiotherapy and Occupational Therapy, Næstved-Slagelse-Ringsted Hospitals, Region Zealand, Slagelse, Denmark; Department of Regional Health Research, University of Southern Denmark, Odense, Denmark
| | - Nadia K Brydegaard
- The Research and Implementation Unit PROgrez, Department of Physiotherapy and Occupational Therapy, Næstved-Slagelse-Ringsted Hospitals, Region Zealand, Slagelse, Denmark
| | - Ditte Høgsgaard
- The Research and Implementation Unit PROgrez, Department of Physiotherapy and Occupational Therapy, Næstved-Slagelse-Ringsted Hospitals, Region Zealand, Slagelse, Denmark; Department of Regional Health Research, University of Southern Denmark, Odense, Denmark
| | - Kristian Thorborg
- Sports Orthopaedic Research Center-Copenhagen (SORC-C), Department of Orthopaedic Surgery, Copenhagen University Hospital, Amager-Hvidovre, Denmark; Physical Medicine and Rehabilitation Research-Copenhagen (PMR-C), Department of Physical and Occupational Therapy, Copenhagen University Hospital, Amager-Hvidovre, Denmark
| | - Merete Møller
- Research Unit for Musculoskeletal Function and Physiotherapy, Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark; Oslo Sports Trauma Research Centre, Norwegian School of Sport Sciences, Oslo, Norway
| | - Jackie L Whittaker
- Department of Physical Therapy, Faculty of Medicine, University of British Columbia, Vancouver, British Columbia, Canada; Arthritis Research Canada, Vancouver, British Columbia, Canada
| | - Ewa M Roos
- Research Unit for Musculoskeletal Function and Physiotherapy, Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark
| | - Søren T Skou
- The Research and Implementation Unit PROgrez, Department of Physiotherapy and Occupational Therapy, Næstved-Slagelse-Ringsted Hospitals, Region Zealand, Slagelse, Denmark; Research Unit for Musculoskeletal Function and Physiotherapy, Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark
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Coyle M, Jaggi A, Weatherburn L, DanielI H, Chester R. Post-operative rehabilitation following traumatic anterior shoulder dislocation: A systematic scoping review. Shoulder Elbow 2023; 15:554-565. [PMID: 37811389 PMCID: PMC10557935 DOI: 10.1177/17585732221089636] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/10/2021] [Accepted: 02/23/2022] [Indexed: 10/10/2023]
Abstract
Background This systematic scoping review aimed to describe the content of post-operative rehabilitation programmes, and outcome measures selection following stabilisation surgery for traumatic anterior shoulder dislocation (TASD). Methods An electronic search of Medline, EMBASE, CINAHL and AMED was conducted (2000-2021). Any cohort or clinical trial of patients receiving post-operative TASD rehabilitation were included. Study selection, data extraction and quality appraisal were undertaken by two independent reviewers. Results Twelve studies including fourteen treatment programmes were eligible. Period of post-operative immobilisation ranged from 1 day to 6 weeks, with exercise introduced between 1 and 7 weeks. Strengthening exercises were introduced between 1 and 12 weeks. Two studies described "accelerated" rehabilitation programmes, differing in immobilisation period and exercise milestones. No increased recurrence was reported in professional footballers. Two studies compared rehabilitation programmes, one not randomised, the other 18 years old. There was variability in selected outcomes measures, with only 4 studies using a common measure. Discussion There is minimal evidence to guide post-operative rehabilitation, variability in immobilisation periods and when exercise is introduced. There is no consensus on the definition of accelerated rehabilitation, or outcome measure selection. Clinical consensus of standardised terminology and stages of rehabilitation is required prior to efficacy studies.
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Affiliation(s)
- Martha Coyle
- School of Health Sciences, Faculty of Medicine and Health Sciences, University of East Anglia, Norwich, UK
| | - Anju Jaggi
- Physiotherapy Department, Royal National Orthopaedic Hospital NHS Trust, Stanmore, UK
| | - Lewis Weatherburn
- Physiotherapy Department, Norfolk and Norwich University Hospital NHS Trust, Norwich, UK
| | - Helena DanielI
- Physiotherapy Department, Norfolk and Norwich University Hospital NHS Trust, Norwich, UK
| | - Rachel Chester
- School of Health Sciences, Faculty of Medicine and Health Sciences, University of East Anglia, Norwich, UK
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Sajak PMJ, Kaveeshwar S, Aneizi A, Hahn A, Burt CI, Ventimiglia DJ, Stevens KN, Akabudike NM, Pensy RA, Henn III RF. Preoperative Expectations in Hand Surgery Patients. J Hand Microsurg 2023; 15:299-307. [PMID: 37701314 PMCID: PMC10495209 DOI: 10.1055/s-0042-1748782] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
Abstract
Introduction Studies have shown a link between patients' preoperative expectations and their postoperative satisfaction. However, limited studies exist concerning patient factors associated with higher preoperative expectations in the hand surgery population. This study analyzed preoperative expectation scores of patients undergoing hand surgery and aimed to determine associated patient characteristics. Materials and Methods A total of 418 elective hand surgery patients aged 15 years and older enrolled in a prospectively collected orthopaedic registry from June 2015 to December 2018 were analyzed. Patients were administered preoperative questionnaires including six Patient-Reported Outcome Measurement Information System domains and other activity and pain scales. Expectation scores were measured using the six domains of the Musculoskeletal Outcomes Data Evaluation and Management System expectations questionnaire. Bivariate and multivariable analyses were conducted to identify independent predictors of higher expectations. Results Overall, patients had high expectations (≥ 80.0) of their hand surgery. Higher mean expectation scores were seen with females, college graduates, better baseline health status, and fewer prior hand surgeries ( p < 0.05 for all). No significant associations were found among the Common Procedural Terminology codes and expectations. Multivariable analysis confirmed that college degree ( p = 0.023) and less pain ( p = 0.008) were predictive of higher baseline expectations. Conclusion In sum, more educated patients with less pain at baseline and better baseline health status have higher expectations of their hand surgery. Hand surgeons can use these results to help focus their preoperative counseling and expectation management.
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Affiliation(s)
- Patrick M. J. Sajak
- Department of Orthopaedics, University of Maryland School of Medicine, Baltimore, Maryland, United States
| | - Samir Kaveeshwar
- Department of Orthopaedics, University of Maryland School of Medicine, Baltimore, Maryland, United States
| | - Ali Aneizi
- Department of Orthopaedics, University of Maryland School of Medicine, Baltimore, Maryland, United States
| | - Alexander Hahn
- Department of Orthopaedics, University of Maryland School of Medicine, Baltimore, Maryland, United States
| | - Cameran I. Burt
- Department of Orthopaedics, University of Maryland School of Medicine, Baltimore, Maryland, United States
| | - Dominic J. Ventimiglia
- Department of Orthopaedics, University of Maryland School of Medicine, Baltimore, Maryland, United States
| | - Kali N. Stevens
- Department of Orthopaedics, University of Maryland School of Medicine, Baltimore, Maryland, United States
- Department of Orthopaedic Surgery, University Hospitals Case Medical Center, Cleveland, Ohio, United States
| | - Ngozi M. Akabudike
- Department of Orthopaedics, University of Maryland School of Medicine, Baltimore, Maryland, United States
| | - Raymond A. Pensy
- Department of Orthopaedics, University of Maryland School of Medicine, Baltimore, Maryland, United States
| | - R. Frank Henn III
- Department of Orthopaedics, University of Maryland School of Medicine, Baltimore, Maryland, United States
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Arsyi DH, Permana PBD, Karim RI, Abdurachman. The role of optimism in manifesting recovery outcomes after coronary artery bypass graft surgery: A systematic review. J Psychosom Res 2022; 162:111044. [PMID: 36170801 DOI: 10.1016/j.jpsychores.2022.111044] [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: 03/09/2022] [Revised: 09/12/2022] [Accepted: 09/13/2022] [Indexed: 11/25/2022]
Abstract
OBJECTIVE Coronary artery bypass graft (CABG) is a major surgery conducted in coronary heart disease management. Postoperative recovery is a crucial process for patients undergoing CABG. This systematic review evaluates current evidence regarding the association between trait optimism and recovery outcomes in patients following coronary artery bypass graft surgery. METHODS This review followed the Preferred Reporting Items of Systematic Review and Meta-Analysis (PRISMA) 2020 Guideline. The inclusion criteria focused on observational study that examined study participants aged ≥18 years old undergoing elective CABG and measurement of trait optimism with validated methods (i.e. LOT, LOT-R) and at least one recovery outcome. Studies in non-English languages and duplicates were excluded. A systematic literature search was carried out on PubMed, Scopus, and Web of Science electronic databases. Search results were screened based on the eligibility criteria. The Newcastle-Ottawa Scale was used to assess the quality of each included study. RESULTS The search yielded a total of 1853 articles, in which 7 articles fulfilled the eligibility criteria and were subsequently included in the analysis. Measurement of trait optimism was conducted on 1276 patients who underwent a non-emergency/elective CABG. Optimism was significantly associated with several categories of recovery, including reduced rehospitalization rate, complications, pain, and physical symptoms along with improved quality of life, rate of return to normal life, and psychological status. CONCLUSION Our review showed that trait optimism was associated with recovery outcomes following CABG surgery. However, the heterogeneity of recovery outcomes may hamper the clinical benefit of trait optimism in CABG. (PROSPERO CRD42022301882).
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Affiliation(s)
- Danial Habri Arsyi
- Faculty of Medicine, Universitas Airlangga, Mayjend. Prof. Dr. Moestopo Street no. 47, Surabaya, East Java 60132, Indonesia.
| | - Putu Bagus Dharma Permana
- Faculty of Medicine, Universitas Airlangga, Mayjend. Prof. Dr. Moestopo Street no. 47, Surabaya, East Java 60132, Indonesia.
| | - Raden Ikhsanuddin Karim
- Faculty of Medicine, Universitas Airlangga, Mayjend. Prof. Dr. Moestopo Street no. 47, Surabaya, East Java 60132, Indonesia.
| | - Abdurachman
- Department of Anatomy, Histology, and Pharmacology, Faculty of Medicine, Universitas Airlangga, Mayjend. Prof. Dr. Moestopo Street no. 47, Surabaya, East Java 60132, Indonesia.
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Alerskans S, Kostogiannis I, Neuman P. Patient's subjective knee function 3-5 years following partial meniscectomy or meniscus repair compared to a normal population: a retrospective cohort study. BMJ Open Sport Exerc Med 2022; 8:e001278. [PMID: 36111129 PMCID: PMC9438024 DOI: 10.1136/bmjsem-2021-001278] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/30/2022] [Indexed: 11/04/2022] Open
Abstract
Purpose Evaluate patient-reported knee function after arthroscopic partial meniscectomy (APM) and meniscus suture repair in two different age cohorts compared with a normal population. Method Arthroscopic meniscus surgery was performed on 421 patients at Skåne University Hospital from 2010 to 2014, with a mean (SD) follow-up of 4.2 (1.4) years. Patients and controls were divided into two age cohorts; 18-34 years (younger) and 35-54 years (middle-aged) as well as according to surgery performed; either solely meniscus surgery or with concurrent anterior cruciate ligament reconstruction (ACLR). The outcome is measured with the five subscales of the Knee and Osteoarthritis Outcome Score (KOOS). Results No significant difference in outcome after all studied types of meniscus surgeries between younger-aged and middle-aged patients.Younger patients with APM or meniscus suture repair, with or without, ACLR score lower than the normal population in all subscales of KOOS (p<0.001), except in Activities of Daily Living (ADL) for meniscus suture patients.Middle-aged patients with APM score lower in all subscales than the normal population (p≤0.009). Those with meniscus suture repair score lower than the normal population only for the subscales Sport/Rec and quality of life (p<0.001).Both younger-aged and middle-aged patients achieve better KOOS values after meniscus suture repair and ACLR than after all other combinations of surgery. Conclusion Patients with meniscus injuries do not reach the same KOOS score as the normal population, irrespective of age or type of meniscus surgery performed. However, combined with ACLR in younger-aged and middle-aged patients, meniscus suture gives a better subjective outcome than isolated meniscus surgery.
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Affiliation(s)
- Sofie Alerskans
- Department of Orthopaedics, Centralsjukhuset Kristianstad, Kristianstad, Sweden
| | | | - Paul Neuman
- Department of Orthopaedics, Clinical Sciences, Lund University, Malmö, Sweden
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Sports Participation and Performance 5 Years After Arthroscopic Partial Meniscectomy: A Retrospective Cohort Study of 288 Patients. J Orthop Sports Phys Ther 2022; 52:224-232. [PMID: 35442751 DOI: 10.2519/jospt.2022.10785] [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] [Indexed: 02/07/2023]
Abstract
OBJECTIVE To investigate return to sport (RTS) approximately 5 years after arthroscopic partial meniscectomy (APM). DESIGN Retrospective cohort study. METHODS Knee Arthroscopy Cohort Southern Denmark patients were asked about RTS and reasons for non-RTS approximately 5 years (range, 4-6 years) after APM using online questionnaires. Patients engaged in their sport at the pre-injury level at follow-up were classified as "RTS" (or "returned to sport") and as being engaged in their sport with (1) full participation and performance, (2) reduced performance, or (3) both reduced participation and performance. Self-reported knee function was assessed using the Knee injury and Osteoarthritis Outcome Score (KOOS). RESULTS We included 288 patients (mean ± SD age, 49 ± 12 years; 44% women). Of these, 172 patients (60%; 95% confidence interval, 54%-65%) were classified as returned to sport, but only 42% (72/172) reported full participation and performance. Persistent problems with the operated knee were reported by 60% of the patients as the main reason for reduced participation or performance and by 70% of the patients as the main reason for not returning to pre-injury levels of their sport. Patients who had returned to sport, on average, improved by 10.1 points (95% confidence interval, 5.7-14.4) more in KOOS4 scores from baseline to 5 years than non-RTS patients. CONCLUSION At approximately 5 years after APM, 6 in every 10 patients had returned to their sport at pre-injury levels, but only 1 in every 4 returned with full participation and performance, mainly due to persistent knee problems. Greater improvements in KOOS scores were observed in patients who were classified as returned to sport. J Orthop Sports Phys Ther 2022;52(4):224-232. doi:10.2519/jospt.2022.10785.
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Cutoff Values to Interpret Short-term Treatment Outcomes After Arthroscopic Meniscal Surgery, Measured With the Knee Injury and Osteoarthritis Outcome Score. J Orthop Sports Phys Ther 2021; 51:281-288. [PMID: 33522361 DOI: 10.2519/jospt.2021.10149] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
OBJECTIVE To determine the proportions of patients who (1) perceived their symptoms to be satisfactory, (2) perceived their treatment to have failed, or (3) perceived that they improved to an important degree at 3 months after arthroscopic meniscal surgery; and to determine Knee injury and Osteoarthritis Outcome Score (KOOS) subscale scores corresponding to the Patient Acceptable Symptom State (PASS), treatment failure, and the minimal important change (MIC) for improvement. DESIGN Prospective cohort study. METHODS Patients from the Knee Arthroscopy Cohort Southern Denmark who had arthroscopic meniscal surgery were included. The PASS, treatment failure, and MIC improvement values were calculated for the KOOS subscales with anchor-based approaches, using the adjusted predictive modeling method. Subgroup analyses were performed by stratifying by age (40 years or younger versus older than 40 years) and surgery type. RESULTS Six hundred fourteen patients (44% female; mean ± SD age, 50 ± 13 years) were included. At 3 months after arthroscopic meniscal surgery, 45% of patients perceived their symptoms to be satisfactory, 19% perceived the treatment to have failed, and 44% to 60% perceived that they had improved to an important degree across the 5 KOOS subscales (for PASS/treatment failure, respectively: pain, 74 and 60 points; symptoms, 72 and 61 points; function in activities of daily living, 81 and 68 points; sport and recreational function, 43 and 26 points; and knee-related quality of life, 52 and 40 points; for MIC improvement: pain, 12 points; symptoms, 8 points; function in activities of daily living, 12 points; sport and recreational function, 17 points; and knee-related quality of life, 9 points). The PASS values were 6 to 17 points higher for patients 40 years or younger compared to patients older than 40 years. CONCLUSION At 3 months after meniscal surgery, approximately half of the patients perceived their symptoms to have improved to an important degree, 4 in every 10 patients perceived their symptoms to be satisfactory, and 2 in every 10 patients perceived the treatment to have failed. J Orthop Sports Phys Ther 2021;51(6):281-288. Epub 30 Jan 2021. doi:10.2519/jospt.2021.10149.
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Stevens KN, Nadarajah V, Jauregui JJ, Song X, Medina SH, Smuda MP, Packer JD, Henn RF. Preoperative Expectations of Patients Undergoing Knee Surgery. J Knee Surg 2021; 34:612-620. [PMID: 31639850 DOI: 10.1055/s-0039-1698805] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
There is limited validated data regarding the relationship between preoperative expectations and patient-reported outcomes (PROs) in patients undergoing knee surgery. The purpose of this study was to (1) assess the preoperative expectations of patients undergoing knee surgery and (2) determine the relationship between preoperative patient demographics, PROs, and preoperative patient expectations. We hypothesized that younger patients with worse function and worse general health status would have greater expectations of knee surgery. We analyzed data from 399 patients undergoing knee surgery at an urban academic medical center. We utilized the Musculoskeletal Outcomes Data Evaluation and Management System to measure preoperative expectations. Multiple legacy PRO measures were recorded, as well as the new Patient-Reported Outcomes Measurement Information Systems (PROMIS) Computer Adaptive Testing. Nonparametric statistical analyses were performed to determine significance. Overall, patients undergoing knee surgery had high expectations, with a mean of 88.0 (95% confidence interval [CI], 86.7-89.3) and median of 91.7 (95% CI, 89.2-94.3). Greater preoperative expectations of knee surgery were associated with higher income, surgically naïve knee, lower Charlson Comorbidity Index, better PROMIS Depression and Anxiety scores, greater Marx knee activity scores, and lower total body pain (p < 0.05). Preoperative expectations of patients undergoing knee surgery are associated with a history of prior knee surgery, income, general and mental health, activity, and pain. Expectations were also found to be associated with PRO measures of function and psychological well-being. These findings may have implications for patient education and shared decision-making preoperatively. The level of evidence for the study is IV.
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Affiliation(s)
- Kali N Stevens
- Department of Orthopaedics, University of Maryland School of Medicine, Baltimore, Maryland
| | - Vidushan Nadarajah
- Department of Orthopaedic Surgery and Rehabilitation, SUNY Downstate College of Medicine, Brooklyn, New York
| | - Julio J Jauregui
- Department of Orthopaedics, University of Maryland School of Medicine, Baltimore, Maryland
| | - Xuyang Song
- Department of Orthopaedics, University of Maryland School of Medicine, Baltimore, Maryland
| | - Shaun H Medina
- Department of Orthopaedics, University of Maryland School of Medicine, Baltimore, Maryland
| | - Michael P Smuda
- Department of Orthopaedics, University of Maryland School of Medicine, Baltimore, Maryland
| | - Jonathan D Packer
- Department of Orthopaedics, University of Maryland School of Medicine, Baltimore, Maryland
| | - R Frank Henn
- Department of Orthopaedics, University of Maryland School of Medicine, Baltimore, Maryland
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11
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Cole BJ, Redondo ML, Cotter EJ. Articular Cartilage Injuries of the Knee: Patient Health Literacy, Expectations for Management, and Clinical Outcomes. Cartilage 2021; 12:139-145. [PMID: 30486654 PMCID: PMC7970381 DOI: 10.1177/1947603518816429] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
OBJECTIVE The purpose of this article is to review the orthopedic literature regarding patient understanding of articular cartilage disease, interpret literature reporting patient expectations for surgical management of articular cartilage injuries of the knee, and review patient-reported outcomes and patient satisfaction with management of these injuries. DESIGN A retrospective review of the current literature using the PubMed database (1980-current) was performed on July 15, 2017. The search terms used were "patient understanding knee cartilage," "patient satisfaction knee cartilage," "patient expectation knee cartilage," and "patient reported outcomes knee cartilage." All searches were filtered to human studies and English language only and were reviewed by 2 independent reviewers. Studies not relevant to articular cartilage injury and/or surgical management in the knee were excluded. Additional references were found by backtracing references from obtained articles. RESULTS The published study search results for the terms: "patient understanding knee cartilage," "patient satisfaction knee cartilage," "patient expectation knee cartilage," and "patient reported outcomes knee cartilage" displayed a total of 873 studies. Two independent reviewers screen all studies A total of 50 published studies were relevant and included. CONCLUSION The subjective and objective clinical outcomes reported are inconsistently obtained resulting in difficulty drawing comparisons between studies. While the relationship between preoperative patient expectations and patient-reported outcomes and patient satisfaction has yet to be well developed, authors have reported patient and injury specific variables associated with superior and inferior outcomes. In conclusion, more work is needed to correlate patient-reported outcomes and satisfaction for cartilage treatments with preoperative expectations and health literacy.
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Affiliation(s)
- Brian J. Cole
- Division of Sports Medicine,
Department of Orthopaedic Surgery, Rush University Medical Center, Chicago,
IL, USA,Brian J. Cole, Department of
Orthopaedic Surgery, Cartilage Restoration Center at Rush University,
Medical Center Midwest Orthopaedic at Rush, 1611 West Harrison Street,
Chicago, IL 60612, USA.
| | - Michael L. Redondo
- Division of Sports Medicine,
Department of Orthopaedic Surgery, Rush University Medical Center, Chicago,
IL, USA
| | - Eric J. Cotter
- Department of Orthopedics and
Rehabilitation, University of Wisconsin Madison School of Medicine and
Public Health, Madison, WI, USA
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12
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Lin BJ, Zhang T, Aneizi A, Henry LE, Mixa P, Wahl AJ, Shasti K, Meredith SJ, Henn RF. Predictors of met expectations two years after knee surgery. J Orthop 2021; 25:10-15. [PMID: 33897134 DOI: 10.1016/j.jor.2021.03.022] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/15/2021] [Accepted: 03/28/2021] [Indexed: 11/17/2022] Open
Abstract
Introduction The purpose of this study is to determine which patient factors predict two-year postoperative met expectations in a cohort of patients undergoing knee surgery. Additionally, this study aims to measure the association between met expectations and postoperative outcomes. Methods 319 patients undergoing knee surgery at one institution were studied. Patients completed patient-reported outcome questionnaires prior to surgery and again two years postoperatively. Preoperative Expectations and postoperative Met Expectations were measured using the Musculoskeletal Outcomes and Data Evaluation Management System (MODEMS) Expectations domain. Results The mean Met Expectations score was significantly lower than the preoperative Expectations Score. Worse two-year Met Expectations were associated with older age, higher BMI, greater comorbidities, more previous surgeries, black race, unemployment, lower income, government insurance, Worker's Compensation, smoking, and no injury prior to surgery. Greater Met Expectations were correlated with better scores on all two-year outcome measures as well as greater improvement on most outcome measures. Race, insurance status, function, mental health, and knee pain were found to be independent predictors of Met Expectations. Conclusion This study identified multiple patient factors and outcome measures that were associated with Met Expectations two years after knee surgery.
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Affiliation(s)
- Brian J Lin
- Department of Orthopaedics, University of Maryland School of Medicine, Baltimore, MD, USA
| | - Tina Zhang
- Department of Orthopaedics, University of Maryland School of Medicine, Baltimore, MD, USA
| | - Ali Aneizi
- Department of Orthopaedics, University of Maryland School of Medicine, Baltimore, MD, USA
| | - Leah E Henry
- Department of Orthopaedics, University of Maryland School of Medicine, Baltimore, MD, USA
| | - Patrick Mixa
- Department of Orthopaedics, University of Maryland School of Medicine, Baltimore, MD, USA
| | - Alexander J Wahl
- Department of Orthopaedics, University of Maryland School of Medicine, Baltimore, MD, USA
| | - Keyan Shasti
- Department of Orthopaedics, University of Maryland School of Medicine, Baltimore, MD, USA
| | - Sean J Meredith
- Department of Orthopaedics, University of Maryland School of Medicine, Baltimore, MD, USA
| | - R Frank Henn
- Department of Orthopaedics, University of Maryland School of Medicine, Baltimore, MD, USA
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13
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O'Leary H, Ryan LG, Robinson K, Conroy EJ, McCreesh K. "You'd be better off to do the keyhole and make a good job of it" a qualitative study of the beliefs and treatment expectations of patients attending secondary care with degenerative meniscal tears. Musculoskelet Sci Pract 2021; 51:102281. [PMID: 33161307 DOI: 10.1016/j.msksp.2020.102281] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/03/2020] [Revised: 10/18/2020] [Accepted: 10/23/2020] [Indexed: 12/31/2022]
Abstract
BACKGROUND Current clinical practice guidelines for degenerative meniscal tears recommend conservative management yet patients are frequently referred to the consultant orthopaedic surgeon despite a lack of evidence for the use of arthroscopy. OBJECTIVES To explore the beliefs about their condition and treatment expectations of patients referred to a secondary care orthopaedic clinic with a degenerative meniscal tear. DESIGN AND METHODS Design and MethodsThis qualitative study involved ten patients who participated in semi-structured telephone interviews. Data were subjected to thematic analysis and findings were reported in accordance with the Consolidated Criteria for Reporting Qualitative Studies. RESULTS Analysis identified five themes. Participants described beliefs, strongly influenced by magnetic resonance imaging (MRI) results, that damaged structures were causing their knee problems ("The meniscus is busted"), and expected their knee problems to inevitably worsen over time ("It's only going to get worse"). Participants were hopeful the orthopaedic consultation would clarify their problem and lead to a subsequent definitive intervention ("Hopefully they will give me answers"). Most participants viewed surgery as "the quick and straightforward solution" necessary to repair faulty cartilage. Exercise was not seen as compatible with the recovery process by most ("Would I make it worse?"). CONCLUSIONS How participants understand their knee problem contributes to surgical expectations and perceptions that it is not amenable to conservative management. Findings suggest a need to educate both patients and primary care clinicians about the safety and efficacy of exercise as first-line therapy for degenerative meniscal tears. The negative role of MRI in promoting surgical expectations needs further consideration.
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Affiliation(s)
- Helen O'Leary
- Physiotherapy Department, University Hospital Kerry, Tralee, Co. Kerry, Ireland.
| | - Liam G Ryan
- Physiotherapy Department, University Hospital Kerry, Tralee, Co. Kerry, Ireland
| | - Katie Robinson
- School of Allied Health, Health Research Institute, Ageing Research Centre, University of Limerick, Limerick, Ireland
| | - Eimear J Conroy
- Orthopaedic Department, University Hospital Kerry, Tralee, Co. Kerry, Ireland
| | - Karen McCreesh
- School of Allied Health, University of Limerick, Limerick, Ireland
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14
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Noorduyn JCA, Glastra van Loon T, van de Graaf VA, Willigenburg NW, Butter IK, Scholten-Peeters GGM, Coppieters MW, Poolman RW, Scholtes VAB, Mutsaerts ELAR, Krijnen MR, Moojen DJF, van Deurzen DFP, Bloembergen CH, Wolkenfelt J, de Gast A, Snijders T, Saris DBF, Wolterbeek N, Neeter C, Kerkhoffs GMMJ, Peters RW, van den Brand ICJB, de Vos-Jakobs S, Spoor AB, Gosens T, Rezaie W, Hofstee DJ, Burger BJ, Haverkamp D, Vervest AMJS, van Rheenen TA, Wijsbek AE, van Arkel ERA, Thomassen BJW, Sprague S, van Tulder MW, Schavemaker M, van Dijk R, van der Kraan J. Functional Outcomes of Arthroscopic Partial Meniscectomy Versus Physical Therapy for Degenerative Meniscal Tears Using a Patient-Specific Score: A Randomized Controlled Trial. Orthop J Sports Med 2020; 8:2325967120954392. [PMID: 33195707 PMCID: PMC7607803 DOI: 10.1177/2325967120954392] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/01/2020] [Accepted: 07/07/2020] [Indexed: 02/04/2023] Open
Abstract
Background It is unknown whether the treatment effects of partial meniscectomy and physical therapy differ when focusing on activities most valued by patients with degenerative meniscal tears. Purpose To compare partial meniscectomy with physical therapy in patients with a degenerative meniscal tear, focusing on patients' most important functional limitations as the outcome. Study Design Randomized controlled trial; Level of evidence, 1. Methods This study is part of the Cost-effectiveness of Early Surgery versus Conservative Treatment with Optional Delayed Meniscectomy for Patients over 45 years with non-obstructive meniscal tears (ESCAPE) trial, a multicenter noninferiority randomized controlled trial conducted in 9 orthopaedic hospital departments in the Netherlands. The ESCAPE trial included 321 patients aged between 45 and 70 years with a symptomatic, magnetic resonance imaging-confirmed meniscal tear. Exclusion criteria were severe osteoarthritis, body mass index >35 kg/m2, locking of the knee, and prior knee surgery or knee instability due to an anterior or posterior cruciate ligament rupture. This study compared partial meniscectomy with physical therapy consisting of a supervised incremental exercise protocol of 16 sessions over 8 weeks. The main outcome measure was the Dutch-language equivalent of the Patient-Specific Functional Scale (PSFS), a secondary outcome measure of the ESCAPE trial. We used crude and adjusted linear mixed-model analyses to reveal the between-group differences over 24 months. We calculated the minimal important change for the PSFS using an anchor-based method. Results After 24 months, 286 patients completed the follow-up. The partial meniscectomy group (n = 139) improved on the PSFS by a mean of 4.8 ± 2.6 points (from 6.8 ± 1.9 to 2.0 ± 2.2), and the physical therapy group (n = 147) improved by a mean of 4.0 ± 3.1 points (from 6.7 ± 2.0 to 2.7 ± 2.5). The crude overall between-group difference showed a -0.6-point difference (95% CI, -1.0 to -0.2; P = .004) in favor of the partial meniscectomy group. This improvement was statistically significant but not clinically meaningful, as the calculated minimal important change was 2.5 points on an 11-point scale. Conclusion Both interventions were associated with a clinically meaningful improvement regarding patients' most important functional limitations. Although partial meniscectomy was associated with a statistically larger improvement at some follow-up time points, the difference compared with physical therapy was small and clinically not meaningful at any follow-up time point. Registration NCT01850719 (ClinicalTrials.gov identifier) and NTR3908 (the Netherlands Trial Register).
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Affiliation(s)
| | | | | | | | - Ise K Butter
- Department of Orthopaedic Surgery, OLVG, Amsterdam, the Netherlands
| | - Gwendolyne G M Scholten-Peeters
- Amsterdam Movement Sciences, Faculty of Behavioural and Movement Sciences, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
| | - Michel W Coppieters
- Amsterdam Movement Sciences, Faculty of Behavioural and Movement Sciences, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands.,Menzies Health Institute Queensland, Griffith University, Gold Coast, Australia
| | - Rudolf W Poolman
- Department of Orthopaedic Surgery, OLVG, Amsterdam, the Netherlands.,Department of Orthopaedic Surgery, Leiden University Medical Center, Leiden, the Netherlands
| | | | - Vanessa A B Scholtes
- Department of Orthopaedic Surgery, OLVG, Amsterdam, the Netherlands.,Amsterdam Movement Sciences, Faculty of Behavioural and Movement Sciences, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands.,Menzies Health Institute Queensland, Griffith University, Gold Coast, Australia.,Department of Orthopaedic Surgery, Leiden University Medical Center, Leiden, the Netherlands.,Investigation performed at the Department of Orthopaedic Surgery, OLVG, Amsterdam, the Netherlands
| | - Eduard L A R Mutsaerts
- Department of Orthopaedic Surgery, OLVG, Amsterdam, the Netherlands.,Amsterdam Movement Sciences, Faculty of Behavioural and Movement Sciences, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands.,Menzies Health Institute Queensland, Griffith University, Gold Coast, Australia.,Department of Orthopaedic Surgery, Leiden University Medical Center, Leiden, the Netherlands.,Investigation performed at the Department of Orthopaedic Surgery, OLVG, Amsterdam, the Netherlands
| | - Matthijs R Krijnen
- Department of Orthopaedic Surgery, OLVG, Amsterdam, the Netherlands.,Amsterdam Movement Sciences, Faculty of Behavioural and Movement Sciences, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands.,Menzies Health Institute Queensland, Griffith University, Gold Coast, Australia.,Department of Orthopaedic Surgery, Leiden University Medical Center, Leiden, the Netherlands.,Investigation performed at the Department of Orthopaedic Surgery, OLVG, Amsterdam, the Netherlands
| | - Dirk Jan F Moojen
- Department of Orthopaedic Surgery, OLVG, Amsterdam, the Netherlands.,Amsterdam Movement Sciences, Faculty of Behavioural and Movement Sciences, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands.,Menzies Health Institute Queensland, Griffith University, Gold Coast, Australia.,Department of Orthopaedic Surgery, Leiden University Medical Center, Leiden, the Netherlands.,Investigation performed at the Department of Orthopaedic Surgery, OLVG, Amsterdam, the Netherlands
| | - Derek F P van Deurzen
- Department of Orthopaedic Surgery, OLVG, Amsterdam, the Netherlands.,Amsterdam Movement Sciences, Faculty of Behavioural and Movement Sciences, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands.,Menzies Health Institute Queensland, Griffith University, Gold Coast, Australia.,Department of Orthopaedic Surgery, Leiden University Medical Center, Leiden, the Netherlands.,Investigation performed at the Department of Orthopaedic Surgery, OLVG, Amsterdam, the Netherlands
| | - Coen H Bloembergen
- Department of Orthopaedic Surgery, OLVG, Amsterdam, the Netherlands.,Amsterdam Movement Sciences, Faculty of Behavioural and Movement Sciences, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands.,Menzies Health Institute Queensland, Griffith University, Gold Coast, Australia.,Department of Orthopaedic Surgery, Leiden University Medical Center, Leiden, the Netherlands.,Investigation performed at the Department of Orthopaedic Surgery, OLVG, Amsterdam, the Netherlands
| | - Julius Wolkenfelt
- Department of Orthopaedic Surgery, OLVG, Amsterdam, the Netherlands.,Amsterdam Movement Sciences, Faculty of Behavioural and Movement Sciences, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands.,Menzies Health Institute Queensland, Griffith University, Gold Coast, Australia.,Department of Orthopaedic Surgery, Leiden University Medical Center, Leiden, the Netherlands.,Investigation performed at the Department of Orthopaedic Surgery, OLVG, Amsterdam, the Netherlands
| | - Arthur de Gast
- Department of Orthopaedic Surgery, OLVG, Amsterdam, the Netherlands.,Amsterdam Movement Sciences, Faculty of Behavioural and Movement Sciences, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands.,Menzies Health Institute Queensland, Griffith University, Gold Coast, Australia.,Department of Orthopaedic Surgery, Leiden University Medical Center, Leiden, the Netherlands.,Investigation performed at the Department of Orthopaedic Surgery, OLVG, Amsterdam, the Netherlands
| | - Thom Snijders
- Department of Orthopaedic Surgery, OLVG, Amsterdam, the Netherlands.,Amsterdam Movement Sciences, Faculty of Behavioural and Movement Sciences, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands.,Menzies Health Institute Queensland, Griffith University, Gold Coast, Australia.,Department of Orthopaedic Surgery, Leiden University Medical Center, Leiden, the Netherlands.,Investigation performed at the Department of Orthopaedic Surgery, OLVG, Amsterdam, the Netherlands
| | - Daniel B F Saris
- Department of Orthopaedic Surgery, OLVG, Amsterdam, the Netherlands.,Amsterdam Movement Sciences, Faculty of Behavioural and Movement Sciences, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands.,Menzies Health Institute Queensland, Griffith University, Gold Coast, Australia.,Department of Orthopaedic Surgery, Leiden University Medical Center, Leiden, the Netherlands.,Investigation performed at the Department of Orthopaedic Surgery, OLVG, Amsterdam, the Netherlands
| | - Nienke Wolterbeek
- Department of Orthopaedic Surgery, OLVG, Amsterdam, the Netherlands.,Amsterdam Movement Sciences, Faculty of Behavioural and Movement Sciences, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands.,Menzies Health Institute Queensland, Griffith University, Gold Coast, Australia.,Department of Orthopaedic Surgery, Leiden University Medical Center, Leiden, the Netherlands.,Investigation performed at the Department of Orthopaedic Surgery, OLVG, Amsterdam, the Netherlands
| | - Camille Neeter
- Department of Orthopaedic Surgery, OLVG, Amsterdam, the Netherlands.,Amsterdam Movement Sciences, Faculty of Behavioural and Movement Sciences, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands.,Menzies Health Institute Queensland, Griffith University, Gold Coast, Australia.,Department of Orthopaedic Surgery, Leiden University Medical Center, Leiden, the Netherlands.,Investigation performed at the Department of Orthopaedic Surgery, OLVG, Amsterdam, the Netherlands
| | - Gino M M J Kerkhoffs
- Department of Orthopaedic Surgery, OLVG, Amsterdam, the Netherlands.,Amsterdam Movement Sciences, Faculty of Behavioural and Movement Sciences, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands.,Menzies Health Institute Queensland, Griffith University, Gold Coast, Australia.,Department of Orthopaedic Surgery, Leiden University Medical Center, Leiden, the Netherlands.,Investigation performed at the Department of Orthopaedic Surgery, OLVG, Amsterdam, the Netherlands
| | - Rolf W Peters
- Department of Orthopaedic Surgery, OLVG, Amsterdam, the Netherlands.,Amsterdam Movement Sciences, Faculty of Behavioural and Movement Sciences, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands.,Menzies Health Institute Queensland, Griffith University, Gold Coast, Australia.,Department of Orthopaedic Surgery, Leiden University Medical Center, Leiden, the Netherlands.,Investigation performed at the Department of Orthopaedic Surgery, OLVG, Amsterdam, the Netherlands
| | - Igor C J B van den Brand
- Department of Orthopaedic Surgery, OLVG, Amsterdam, the Netherlands.,Amsterdam Movement Sciences, Faculty of Behavioural and Movement Sciences, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands.,Menzies Health Institute Queensland, Griffith University, Gold Coast, Australia.,Department of Orthopaedic Surgery, Leiden University Medical Center, Leiden, the Netherlands.,Investigation performed at the Department of Orthopaedic Surgery, OLVG, Amsterdam, the Netherlands
| | - Suzanne de Vos-Jakobs
- Department of Orthopaedic Surgery, OLVG, Amsterdam, the Netherlands.,Amsterdam Movement Sciences, Faculty of Behavioural and Movement Sciences, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands.,Menzies Health Institute Queensland, Griffith University, Gold Coast, Australia.,Department of Orthopaedic Surgery, Leiden University Medical Center, Leiden, the Netherlands.,Investigation performed at the Department of Orthopaedic Surgery, OLVG, Amsterdam, the Netherlands
| | - Andy B Spoor
- Department of Orthopaedic Surgery, OLVG, Amsterdam, the Netherlands.,Amsterdam Movement Sciences, Faculty of Behavioural and Movement Sciences, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands.,Menzies Health Institute Queensland, Griffith University, Gold Coast, Australia.,Department of Orthopaedic Surgery, Leiden University Medical Center, Leiden, the Netherlands.,Investigation performed at the Department of Orthopaedic Surgery, OLVG, Amsterdam, the Netherlands
| | - Taco Gosens
- Department of Orthopaedic Surgery, OLVG, Amsterdam, the Netherlands.,Amsterdam Movement Sciences, Faculty of Behavioural and Movement Sciences, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands.,Menzies Health Institute Queensland, Griffith University, Gold Coast, Australia.,Department of Orthopaedic Surgery, Leiden University Medical Center, Leiden, the Netherlands.,Investigation performed at the Department of Orthopaedic Surgery, OLVG, Amsterdam, the Netherlands
| | - Wahid Rezaie
- Department of Orthopaedic Surgery, OLVG, Amsterdam, the Netherlands.,Amsterdam Movement Sciences, Faculty of Behavioural and Movement Sciences, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands.,Menzies Health Institute Queensland, Griffith University, Gold Coast, Australia.,Department of Orthopaedic Surgery, Leiden University Medical Center, Leiden, the Netherlands.,Investigation performed at the Department of Orthopaedic Surgery, OLVG, Amsterdam, the Netherlands
| | - Dirk Jan Hofstee
- Department of Orthopaedic Surgery, OLVG, Amsterdam, the Netherlands.,Amsterdam Movement Sciences, Faculty of Behavioural and Movement Sciences, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands.,Menzies Health Institute Queensland, Griffith University, Gold Coast, Australia.,Department of Orthopaedic Surgery, Leiden University Medical Center, Leiden, the Netherlands.,Investigation performed at the Department of Orthopaedic Surgery, OLVG, Amsterdam, the Netherlands
| | - Bart J Burger
- Department of Orthopaedic Surgery, OLVG, Amsterdam, the Netherlands.,Amsterdam Movement Sciences, Faculty of Behavioural and Movement Sciences, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands.,Menzies Health Institute Queensland, Griffith University, Gold Coast, Australia.,Department of Orthopaedic Surgery, Leiden University Medical Center, Leiden, the Netherlands.,Investigation performed at the Department of Orthopaedic Surgery, OLVG, Amsterdam, the Netherlands
| | - Daniel Haverkamp
- Department of Orthopaedic Surgery, OLVG, Amsterdam, the Netherlands.,Amsterdam Movement Sciences, Faculty of Behavioural and Movement Sciences, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands.,Menzies Health Institute Queensland, Griffith University, Gold Coast, Australia.,Department of Orthopaedic Surgery, Leiden University Medical Center, Leiden, the Netherlands.,Investigation performed at the Department of Orthopaedic Surgery, OLVG, Amsterdam, the Netherlands
| | - Anton M J S Vervest
- Department of Orthopaedic Surgery, OLVG, Amsterdam, the Netherlands.,Amsterdam Movement Sciences, Faculty of Behavioural and Movement Sciences, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands.,Menzies Health Institute Queensland, Griffith University, Gold Coast, Australia.,Department of Orthopaedic Surgery, Leiden University Medical Center, Leiden, the Netherlands.,Investigation performed at the Department of Orthopaedic Surgery, OLVG, Amsterdam, the Netherlands
| | - Thijs A van Rheenen
- Department of Orthopaedic Surgery, OLVG, Amsterdam, the Netherlands.,Amsterdam Movement Sciences, Faculty of Behavioural and Movement Sciences, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands.,Menzies Health Institute Queensland, Griffith University, Gold Coast, Australia.,Department of Orthopaedic Surgery, Leiden University Medical Center, Leiden, the Netherlands.,Investigation performed at the Department of Orthopaedic Surgery, OLVG, Amsterdam, the Netherlands
| | - Anne E Wijsbek
- Department of Orthopaedic Surgery, OLVG, Amsterdam, the Netherlands.,Amsterdam Movement Sciences, Faculty of Behavioural and Movement Sciences, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands.,Menzies Health Institute Queensland, Griffith University, Gold Coast, Australia.,Department of Orthopaedic Surgery, Leiden University Medical Center, Leiden, the Netherlands.,Investigation performed at the Department of Orthopaedic Surgery, OLVG, Amsterdam, the Netherlands
| | - Ewoud R A van Arkel
- Department of Orthopaedic Surgery, OLVG, Amsterdam, the Netherlands.,Amsterdam Movement Sciences, Faculty of Behavioural and Movement Sciences, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands.,Menzies Health Institute Queensland, Griffith University, Gold Coast, Australia.,Department of Orthopaedic Surgery, Leiden University Medical Center, Leiden, the Netherlands.,Investigation performed at the Department of Orthopaedic Surgery, OLVG, Amsterdam, the Netherlands
| | - Bregje J W Thomassen
- Department of Orthopaedic Surgery, OLVG, Amsterdam, the Netherlands.,Amsterdam Movement Sciences, Faculty of Behavioural and Movement Sciences, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands.,Menzies Health Institute Queensland, Griffith University, Gold Coast, Australia.,Department of Orthopaedic Surgery, Leiden University Medical Center, Leiden, the Netherlands.,Investigation performed at the Department of Orthopaedic Surgery, OLVG, Amsterdam, the Netherlands
| | - Sheila Sprague
- Department of Orthopaedic Surgery, OLVG, Amsterdam, the Netherlands.,Amsterdam Movement Sciences, Faculty of Behavioural and Movement Sciences, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands.,Menzies Health Institute Queensland, Griffith University, Gold Coast, Australia.,Department of Orthopaedic Surgery, Leiden University Medical Center, Leiden, the Netherlands.,Investigation performed at the Department of Orthopaedic Surgery, OLVG, Amsterdam, the Netherlands
| | - Maurits W van Tulder
- Department of Orthopaedic Surgery, OLVG, Amsterdam, the Netherlands.,Amsterdam Movement Sciences, Faculty of Behavioural and Movement Sciences, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands.,Menzies Health Institute Queensland, Griffith University, Gold Coast, Australia.,Department of Orthopaedic Surgery, Leiden University Medical Center, Leiden, the Netherlands.,Investigation performed at the Department of Orthopaedic Surgery, OLVG, Amsterdam, the Netherlands
| | - Mirjam Schavemaker
- Department of Orthopaedic Surgery, OLVG, Amsterdam, the Netherlands.,Amsterdam Movement Sciences, Faculty of Behavioural and Movement Sciences, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands.,Menzies Health Institute Queensland, Griffith University, Gold Coast, Australia.,Department of Orthopaedic Surgery, Leiden University Medical Center, Leiden, the Netherlands.,Investigation performed at the Department of Orthopaedic Surgery, OLVG, Amsterdam, the Netherlands
| | - Rogier van Dijk
- Department of Orthopaedic Surgery, OLVG, Amsterdam, the Netherlands.,Amsterdam Movement Sciences, Faculty of Behavioural and Movement Sciences, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands.,Menzies Health Institute Queensland, Griffith University, Gold Coast, Australia.,Department of Orthopaedic Surgery, Leiden University Medical Center, Leiden, the Netherlands.,Investigation performed at the Department of Orthopaedic Surgery, OLVG, Amsterdam, the Netherlands
| | - J van der Kraan
- Department of Orthopaedic Surgery, OLVG, Amsterdam, the Netherlands.,Amsterdam Movement Sciences, Faculty of Behavioural and Movement Sciences, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands.,Menzies Health Institute Queensland, Griffith University, Gold Coast, Australia.,Department of Orthopaedic Surgery, Leiden University Medical Center, Leiden, the Netherlands.,Investigation performed at the Department of Orthopaedic Surgery, OLVG, Amsterdam, the Netherlands
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15
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Abstract
STUDY DESIGN Retrospective database study. OBJECTIVE We sought to investigate trends and risk factors for new-onset anxiety and/or depression within 6 months after elective spine surgery. SUMMARY OF BACKGROUND DATA Surgery represents a stressful experience associated with a number of physiological and psychological consequences. A subset of patients develop clinically significant symptoms of new-onset anxiety or depression. However, the incidence of and risk factors for these adverse outcomes after spine surgery remain ill-defined. METHODS We performed a retrospective analysis including anterior cervical discectomy and fusion and posterior lumbar fusion cases from 2012 to 2015, utilizing the Truven MarketScan database. Primary outcomes were new-onset depression, new-onset anxiety, and new-onset depression and/or anxiety after surgery. Potential risk factors included patient demographics, comorbidities, hospital and procedural characteristics as well as perioperative opioid regimens. Multivariable logistic regression models measured associations between risk factors and outcomes. Odds ratios (OR) were reported and results with P < 0.0167 were considered statistically significant. RESULTS Among 39,495 unique patients, overall incidence of new-onset depression and anxiety was 6% and 11.2%, respectively. In adjusted analyses, significant risk factors across all three outcomes included chronic opioid use (ORs ranging from 1.31 to 2.93; P < 0.01), female sex (ORs ranging from 1.25 to 1.67; P < 0.01), longer length of stay (ORs ranging from 1.05 to 1.08; P < 0.01), and readmission within 6 months of surgery (OR ranging from 1.31 to 1.68; P < 0.01). CONCLUSION We identified several risk factors contributing to increased odds of new-onset depression and/or anxiety after spine fusion surgery. These data may aid the implementation of preventative measures among identified high-risk patients. LEVEL OF EVIDENCE 3.
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16
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Johns WL, Sowers CB, Walley KC, Ross D, Thordarson DB, Jackson JB, Gonzalez TA. Return to Sports and Activity After Total Ankle Arthroplasty and Arthrodesis: A Systematic Review. Foot Ankle Int 2020; 41:916-929. [PMID: 32501110 DOI: 10.1177/1071100720927706] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
BACKGROUND There is no consensus regarding participation in sports and recreational activities following total ankle replacement (TAR) and ankle arthrodesis (AA). This systematic review summarizes the evidence on return to sports and activity after operative management with either TAR or AA for ankle osteoarthritis (OA). METHODS A literature search of MEDLINE, EMBASE, CINAHL, and Cochrane Library databases was performed. Risk of bias of included studies was assessed using Methodological Index for Non-Randomized Studies (MINORS) criteria. Included studies reported sport and activity outcomes in patients undergoing TAR and AA, with primary outcomes being the percentage of sports participation and level of sports participation. RESULTS Twelve studies met inclusion criteria for analysis. There were 1270 ankle procedures, of which 923 TAR and 347 AA were performed. The mean reported patient age was 59.2 years and the mean BMI was 28 kg/m2. The mean follow-up was 43 months. Fifty-four percent of patients were active in sports preoperatively compared with 63.7% postoperatively. The mean preoperative activity participation rate was 41% in the TAR cohort, but it improved to 59% after TAR, whereas the preoperative activity participation rate of 73% was similar to the postoperative rate of 70% in the AA cohort. The most common sports in the TAR and AA groups were swimming, hiking, cycling, and skiing. CONCLUSION Participation in sports activity was nearly 10% improved after operative management of ankle OA with TAR and remains high after AA. The existing literature demonstrated a large improvement in pre- to postoperative activity levels after TAR, with minimal change in activity after AA; however, AA patients were more active at baseline. The most frequent postoperative sports activities after operative management of ankle OA were swimming, hiking, cycling, and skiing. Participation in high-impact sports such as tennis, soccer, and running was consistently limited after surgery. This review of the literature will allow patients and foot and ankle surgeons to set evidence-based goals and establish realistic expectations for postoperative physical activity after TAR and AA. LEVEL OF EVIDENCE Level III, systematic review.
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Affiliation(s)
- William L Johns
- School of Medicine, Virginia Commonwealth University, Richmond, VA, USA
| | | | - Kempland C Walley
- Department of Orthopaedic Surgery, Penn State Hershey Bone and Joint Institute, Penn State Milton S. Hershey Medical Center, Hershey, PA, USA
| | - Daniel Ross
- School of Medicine, University of South Carolina, Columbia, SC, USA
| | | | | | - Tyler A Gonzalez
- School of Medicine, University of South Carolina, Columbia, SC, USA
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Meniscal allograft transplantation in The Netherlands: long-term survival, patient-reported outcomes, and their association with preoperative complaints and interventions. Knee Surg Sports Traumatol Arthrosc 2020; 28:3551-3560. [PMID: 32979080 PMCID: PMC7591451 DOI: 10.1007/s00167-020-06276-y] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/02/2020] [Accepted: 09/10/2020] [Indexed: 11/17/2022]
Abstract
PURPOSE Evaluation of survival of meniscal allograft transplantation (MAT) and postoperative patient-reported outcome (PRO), and their association with prior interventions of the knee. METHODS A prospective consecutive study of 109 consecutive patients who had an arthroscopic meniscal allograft transplantation (MAT) between 1999 and 2017 by a single surgeon. Patients were assessed with KOOS scores, preoperative and after a minimal follow-up of 2 years. Furthermore, two anchor questions (whether expectations were met and overall satisfaction, on a five-point Likert scale) were asked. Additionally, prior interventions to MAT were evaluated. RESULTS Prior to MAT, patients had undergone an average of 2.8 (range 1-14) of surgical procedures of the knee. Overall, mean allograft survival was 16.1 years (95% CI 14.8-17.5 years). Higher age at surgery was associated with lower MAT survival: hazard ratio for MAT failure was 1.19 per year increase (95% CI 1.04 to 1.36, p = 0.009). At 4.5 years (IQR, 2-9) of follow-up, all KOOS score were still improved compared to baseline. Age below 35 years, simultaneous anterior cruciate ligament reconstruction and number of knee surgeries before MAT were associated with lower KOOS scores. Overall patient expectations and overall satisfaction after MAT were not associated with preoperative patient characteristics nor with the number or kind of preoperative interventions. CONCLUSION Meniscal allograft transplantation has a good overall survival with a clinically relevant improvement. Both meniscal allograft survival and PRO were associated with age. PRO was lower in patients younger than 35 years at time of MAT and meniscal allograft survival was worse in patients older than 50 years. PRO was associated with preoperative patient characteristics and number of surgical procedures prior to MAT. All patients reported improved postoperative satisfaction and met expectations after MAT, both independent of the preoperative history of knee interventions. LEVEL OF EVIDENCE Level III. Trial registration Medical ethical review board (METC) number: 17-104 (7 August 2017). Dutch Trial Register (NTR) number: NTR6630 (4 July 2017).
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18
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Second-Order Peer Reviews of Clinically Relevant Articles for the Physiatrist: Early Surgery or Physical Therapy for Nonobstructive Meniscal Tears. Am J Phys Med Rehabil 2019; 99:e50-e52. [PMID: 31335346 DOI: 10.1097/phm.0000000000001270] [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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O'Leary BD, Agnew GJ, Fitzpatrick M, Hanly AM. Patient satisfaction with a multidisciplinary colorectal and urogynaecology service. Ir J Med Sci 2019; 188:1275-1278. [PMID: 30945112 DOI: 10.1007/s11845-019-02010-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2018] [Accepted: 03/18/2019] [Indexed: 12/30/2022]
Abstract
INTRODUCTION Traditionally, the pelvic floor has been described as three separate compartments and problems in each compartment were managed separately. A more contemporary approach is to identify the entire pelvic floor as a single dynamic compartment. Multidisciplinary pelvic floor clinics such as ours with the support of physiotherapy, clinical nurse specialists, urodynamics, and endo-anal ultrasound are uncommon. The aim of this study was to assess patient satisfaction with a joint colorectal and urogynaecology clinic. METHOD All women who attended our service in 2015 were identified. Women who saw both a colorectal surgeon and urogynaecologist at the same clinic were included. The Satisfaction with Outpatient Services questionnaire, a multi-dimensional outpatient survey, was mailed to all women. RESULTS A total of 364 new women attended our service in 2015. One hundred thirty-six (35.2%) saw both a colorectal surgeon and urogynaecologist at the same visit. There was a 64% (87/136) response rate to the questionnaire. Overall, all questions regarding their attendance were responded to positively by 94% (82/87) of women. Confidence and trust in the doctor examining and treating them was reported by all women. Seeing multiple specialists was of benefit to 97% (84/87) of women and 94% (82/87) would recommend the Pelvic Floor Centre. CONCLUSION There is a high level of satisfaction amongst women attending our outpatient service. Being seen by multiple specialities at a single clinic was felt to be of benefit by the majority of women and all expressed physician confidence. Our multidisciplinary service may reduce waiting times, increase satisfaction, and is likely cost-effective.
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Affiliation(s)
- Bobby D O'Leary
- Pelvic Floor Centre, St. Michael's Hospital, Dún Laoghaire, Dublin, Ireland.
| | - Gerard J Agnew
- Pelvic Floor Centre, St. Michael's Hospital, Dún Laoghaire, Dublin, Ireland
| | - Myra Fitzpatrick
- Pelvic Floor Centre, St. Michael's Hospital, Dún Laoghaire, Dublin, Ireland
| | - Ann M Hanly
- Pelvic Floor Centre, St. Michael's Hospital, Dún Laoghaire, Dublin, Ireland
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Trojan JD, DeFroda SF, Mulcahey MK. Patient understanding, expectations, outcomes, and satisfaction regarding surgical management of shoulder instability. PHYSICIAN SPORTSMED 2018; 47:6-9. [PMID: 30424710 DOI: 10.1080/00913847.2019.1546535] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
Shoulder instability is a common condition encountered by sports medicine and shoulder surgeons. Management can be challenging, both with regards to the underlying pathology and the high expectations associated with the very active patient population that this condition typically affects. High-performance athletes who are used to performing at activity levels which typically challenge the normal physiologic limits of the glenohumeral joint may be particularly difficult to treat. As physicians increasingly evaluate patient reported outcomes (PROs), a growing body of literature has emerged related to patient expectations for a variety of orthopaedic conditions, including shoulder instability. Physicians may face difficulty when using the literature to counsel patients due to the difference between a successful PRO and true patient satisfaction. Having a better understanding of patient expectations may improve preoperative evaluation, patient counseling, postoperative PROs, and patient satisfaction with shoulder instability surgery. The purpose of this paper was to review the literature regarding patient understanding of shoulder instability injuries, expectations following surgical repair of shoulder instability pathology, and satisfaction with operative intervention. Additionally, we sought to determine the effect of patient expectations on outcomes.
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Affiliation(s)
| | - Steven F DeFroda
- b Orthopaedic Surgery , The Warren Alpert Medical School of Brown University , Providence , RI , USA
| | - Mary K Mulcahey
- c Orthopaedic Surgery , Tulane University School of Medicine , New Orleans , LA , USA
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21
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Rauck RC, Swarup I, Chang B, Dines DM, Warren RF, Gulotta LV, Henn RF. Effect of preoperative patient expectations on outcomes after reverse total shoulder arthroplasty. J Shoulder Elbow Surg 2018; 27:e323-e329. [PMID: 30343687 DOI: 10.1016/j.jse.2018.05.026] [Citation(s) in RCA: 37] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/22/2018] [Revised: 05/08/2018] [Accepted: 05/13/2018] [Indexed: 02/01/2023]
Abstract
BACKGROUND The purpose of this study was to determine the effect of preoperative expectations on outcomes after reverse shoulder arthroplasty (RSA). We hypothesized that patients with greater expectations would have better outcomes. METHODS Patients undergoing primary RSA completed the Hospital for Special Surgery's Shoulder Expectations Survey preoperatively. Preoperative and 2-year postoperative clinical outcomes were measured with the American Shoulder and Elbow Surgeons (ASES) Standardized Shoulder Assessment Form, Shoulder Activity Scale (SAS), 36-Item Short Form Health Survey (SF-36), and visual analog scales (VASs). Pearson correlations were used to assess the relationship between the number of expectations and outcomes. Differences in outcomes between those with higher and lower levels of expectations for each expectation question were assessed by independent samples t test. Multivariable linear regression analysis was used to control for potential confounding factors. RESULTS We evaluated 135 patients at 2 years postoperatively. Patients had higher expectations for relieving pain, improving self-care, improving ability to perform daily activities, and improving ability to drive or put on a seatbelt. Patients with a greater number of high expectations preoperatively did not have better ASES, SAS, or VAS pain scores postoperatively. However, higher expectations for relieving nighttime pain was associated with ASES (β = 7.0, P = .048) and VAS pain scores (β = -5.9, P = .047) as well as 2-year improvement of VAS pain (β = -6.1, P = .039). Higher expectations for improving the ability to participate in nonoverhead sports was associated with improvements in SAS (β = 2.8, P = .020). CONCLUSION A higher level of expectations for relief of nighttime pain and improving ability to participate in nonoverhead sports is associated with improved outcomes after RSA.
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Affiliation(s)
- Ryan C Rauck
- Department of Orthopaedics, Hospital for Special Surgery, New York, NY, USA.
| | - Ishaan Swarup
- Department of Orthopaedics, Hospital for Special Surgery, New York, NY, USA
| | - Brenda Chang
- Department of Orthopaedics, Hospital for Special Surgery, New York, NY, USA
| | - David M Dines
- Department of Orthopaedics, Hospital for Special Surgery, New York, NY, USA
| | - Russell F Warren
- Department of Orthopaedics, Hospital for Special Surgery, New York, NY, USA
| | - Lawrence V Gulotta
- Department of Orthopaedics, Hospital for Special Surgery, New York, NY, USA
| | - R Frank Henn
- Department of Orthopaedics, University of Maryland School of Medicine, Baltimore, MD, USA
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Chipperfield JG, Hamm JM, Perry RP, Parker PC, Ruthig JC, Lang FR. A healthy dose of realism: The role of optimistic and pessimistic expectations when facing a downward spiral in health. Soc Sci Med 2018; 232:444-452. [PMID: 30409727 DOI: 10.1016/j.socscimed.2018.08.030] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2017] [Revised: 08/14/2018] [Accepted: 08/24/2018] [Indexed: 12/14/2022]
Abstract
RATIONALE AND OBJECTIVES Whether expectations about future health are adaptive or maladaptive in late life likely depends on the extent to which they conform to or defy a future reality of declining health. Our premise was that, when adults face a downward spiral in health, it can be adaptive to realistically expect poorer future health and maladaptive to unrealistically expect good health. METHOD This 18-year-long study of community-dwelling older Canadians (n = 132, 72-98 years) involved a baseline interview to identify those who anticipated heath would decline (pessimistic expectation) or improve/remain stable (optimistic expectation). We determined initial (baseline) health status by assessing the severity of chronic conditions. An objective within-person measure of actual health change was derived by documenting hospital admissions (HAs) over time to capture a continuum that ranged from no declines (HAs remained stable) to greater declines in health (increasing numbers of HAs). Our a priori hypotheses examined the effects of health expectations (pessimistic, optimistic) and actual health change on the outcomes of depressive symptoms and mortality. RESULTS Support was found for our premise that it is adaptive to be realistic when forecasting future health, at least at low levels of initial chronic condition severity. Regression analyses showed that realistically pessimistic (vs. unrealistically optimistic) expectations predicted significantly fewer depressive symptoms and a lower risk of death. The results also supported our premise that it is maladaptive to be unrealistically optimistic when health subsequently declines in reality: The risk of death was 313% higher for those with optimistic expectations that were unrealistic (vs. realistic). CONCLUSION These findings provide insights for health care professionals regarding the messages they communicate to their patients. Together, they imply that, when good health is slipping away, it seems optimal to encourage a healthy dose of realism.
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Affiliation(s)
| | | | | | | | | | - Frieder R Lang
- Institute of Psychogerontology, Friedrich-Alexander-University of Erlangen-Nuremberg, Germany
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23
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Holtedahl R, Brox JI, Aune AK, Nguyen D, Risberg MA, Tjomsland O. Changes in the rate of publicly financed knee arthroscopies: an analysis of data from the Norwegian patient registry from 2012 to 2016. BMJ Open 2018; 8:e021199. [PMID: 29909370 PMCID: PMC6009626 DOI: 10.1136/bmjopen-2017-021199] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
OBJECTIVE To examine rates of publicly financed knee arthroscopic surgery in Norway between 2012 and 2016. DESIGN Analysis of anonymised data from the National Patient Registry. INTERVENTIONS Beginning in 2012, South-Eastern Norway Regional Health Authority implemented administrative measures to bring down rates of knee arthroscopy. Similar measures were not introduced in the other three Regional Health Authorities. MAIN OUTCOME MEASURES We analysed annual national rates of publicly financed knee arthroscopies in 2012 and 2016. We compared the rates in South-Eastern Norway Regional Health Authority with corresponding rates in the rest of the country. Variations by county, public hospital versus publicly reimbursed private hospital, gender and age were also assessed. RESULTS The overall annual rate of arthroscopic procedures declined by 33% from 2012 to 2016, from 310 to 207 per 100 000 inhabitants, respectively. Hospitals in South-Eastern Norway Regional Health Authority reported a 48% reduction, compared with mean 13% in the other three Regional Health Authorities. In public hospitals, rates decreased nationally by 42%, while rates in publicly reimbursed private hospitals increased by 12%. Rates in publicly reimbursed private hospitals decreased by 30% in South-Eastern Norway Regional Health Authority but increased by 63% in the other Regional Health Authorities. The proportion of patients ≥50 years (excluding meniscal repairs) in Norway was 54% in 2012 and fell to 46% in 2016. Average rates per county varied by a factor of 3:1. CONCLUSION We report a marked overall reduction of knee arthroscopic procedures from 2012 to 2016 in publicly funded hospitals. The largest decrease was reported in South-Eastern Norway Regional Health Authority, and this coincides in time with implemented administrative measures. The results suggest that the trend of increasing rates of knee arthroscopies can be reversed through purposeful professional and administrative interventions.
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Affiliation(s)
- Robin Holtedahl
- Department of Habilitation and Rehabilitation, Innlandet Hospital Trust-Division Ottestad, Ottestad, Norway
| | - Jens Ivar Brox
- Department of Physical Medicine and Rehabilitation, Oslo University Hospital, Oslo, Norway
- Medical Faculty, University of Oslo, Oslo, Norway
| | | | - Daniel Nguyen
- South-Eastern Norway Regional Health Authority, Hamar, Norway
| | - May Arna Risberg
- Department of Sports Medicine, Norwegian School of Sport Sciences, Oslo, Norway
| | - Ole Tjomsland
- South-Eastern Norway Regional Health Authority, Hamar, Norway
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24
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Liu CY, Li CD, Wang L, Ren S, Yu FB, Li JG, Ma JX, Ma XL. Function scores of different surgeries in the treatment of knee osteoarthritis: A PRISMA-compliant systematic review and network-meta analysis. Medicine (Baltimore) 2018; 97:e10828. [PMID: 29794771 PMCID: PMC6393067 DOI: 10.1097/md.0000000000010828] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/31/2017] [Accepted: 04/30/2018] [Indexed: 12/26/2022] Open
Abstract
BACKGROUND Osteoarthritis (OA) is the third most common diagnosis made by general practitioners in older patients. The aim of this study was to compare the function scores of different surgeries in the treatment of knee osteoarthritis (KOA). METHODS Cohort studies about different surgical treatments for KOA were included with a comprehensive search in PubMed, Cochrane Library, and Embase. The standard mean difference (SMD) value was evaluated and the surface under the cumulative ranking (SUCRA) curve was drawn with a combination of direct and indirect evidence. A total of 265 eligible patients were enrolled and served as the nonoperative treatment group, osteotomy group, unicompartmental knee arthroplasty (UKA) group, total knee arthroplasty (TKA) group, and arthroscopic surgery group. Before surgery, 6 months after surgery, 1 year after surgery and 5 years after surgery, the hospital for special surgery (HSS) knee score, Lysholm score, Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) score, and American knee society score (KSS) were recorded. RESULTS A total of 9 cohort studies including 954 patients with KOA were finally enrolled into the study. The network-meta analysis revealed that osteotomy and UKA treatments showed a better efficacy on improving the function score. Our cohort study further confirmed that, a higher HSS knee score after 1 year and higher Lysholm score after 6 months and 1 year were observed in the osteotomy and UKA groups, while better HSS knee score and KSS after 6 months and 1 year were showed in the osteotomy and TKA groups. In the TKA group, Lysholm score and KSS were higher and WOMAC score was lower after 5 years than other groups. WOMAC score was lowest in the UKA group after 6 months, 1 year and 5 years of surgery. CONCLUSION These results provide evidence that function scores of patients with KOA were improved by osteotomy, UKA, TKA, and arthroscopic surgery. And osteotomy and UKA showed better short-term efficacy, while TKA appeared better long-term efficacy.
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Affiliation(s)
| | | | - Liang Wang
- Department of Bone Trauma, The Sixth People's Hospital of Ji’nan City, Ji’nan, PR China
| | - Shan Ren
- Department of Bone and Joint Surgery
| | - Fu-Bin Yu
- Department of Bone and Joint Surgery
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Siemieniuk RAC, Harris IA, Agoritsas T, Poolman RW, Brignardello-Petersen R, Van de Velde S, Buchbinder R, Englund M, Lytvyn L, Quinlan C, Helsingen L, Knutsen G, Olsen NR, Macdonald H, Hailey L, Wilson HM, Lydiatt A, Kristiansen A. Arthroscopic surgery for degenerative knee arthritis and meniscal tears: a clinical practice guideline. Br J Sports Med 2018; 52:313. [PMID: 29449218 PMCID: PMC5867409 DOI: 10.1136/bjsports-2017-j1982rep] [Citation(s) in RCA: 33] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Affiliation(s)
- Reed A C Siemieniuk
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada
- Department of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Ian A Harris
- Whitlam Orthopaedic Research Centre, Ingham Institute for Applied Medical Research, Liverpool, Australia
- South Western Sydney Clinical School, UNSW, Australia
| | - Thomas Agoritsas
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada
- Division General Internal Medicine & Division of Clinical Epidemiology, University Hospitals of Geneva, Geneva, Switzerland
| | - Rudolf W Poolman
- Department of Orthopaedic Surgery, Joint Research, OLVG, Amsterdam, The Netherlands
| | - Romina Brignardello-Petersen
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada
- Faculty of Dentistry, Universidad de Chile, Independencia, Santiago, Chile
| | | | - Rachelle Buchbinder
- Department of Epidemiology and Preventive Medicine, School of Public Health & Preventive Medicine, Monash University, Melbourne, Victoria, Australia
- Monash Department of Clinical Epidemiology, Cabrini Institute, Malvern, Victoria, Australia
| | - Martin Englund
- Clinical Epidemiology Unit, Orthopaedics, Department of Clinical Sciences Lund Faculty of Medicine, Lund University, Lund, Sweden
| | | | | | - Lise Helsingen
- Clinical Effectiveness Research Group, Institute of Health and Society, University of Oslo, Oslo, Norway
| | | | - Nina Rydland Olsen
- Department of Occupational Therapy, Physiotherapy and Radiography, Faculty of Health and Social sciences, Bergen University College, Bergen, Norway
| | | | - Louise Hailey
- Nuffield Orthopaedic Centre, Oxford University Hospitals NHS Foundation Trust, Oxford, UK
| | | | | | - Annette Kristiansen
- Department of Health and Science, University of Oslo, Oslo, Norway
- Department of Medicine, Hospital Innlandet Trust, Gjøvik, Norway
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Impact of treatment strategy and physical performance on future knee-related self-efficacy in individuals with ACL injury. BMC Musculoskelet Disord 2018; 19:50. [PMID: 29433481 PMCID: PMC5809873 DOI: 10.1186/s12891-018-1973-2] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/09/2017] [Accepted: 02/08/2018] [Indexed: 01/14/2023] Open
Abstract
Background In people with anterior cruciate ligament (ACL) injury, high self-efficacy facilitates recovery, indicated by improved muscle function, reduced knee symptoms and increased physical activity. Impact of treatment on future self-efficacy is however not well investigated. The aims of the study were to 1) investigate knee-related self-efficacy 6 years after acute ACL injury in patients treated with exercise therapy alone or in combination with either early or the option of delayed ACL reconstruction (ACLR), and 2) to investigate associations between single-leg physical performance at various time points after ACL injury and knee self-efficacy at 6 years after injury. Methods Participants (n = 121) originated from the KANON-study (ISRCTN84752559), a treatment RCT including active adults with acute ACL injury treated with structured exercise therapy combined with early or the option of delayed ACLR. In this ancillary study, participants with knee self-efficacy data at 6 years (n = 89) were analyzed as treated; exercise therapy alone (n = 20), exercise therapy plus early ACLR (n = 46), and exercise therapy plus delayed ACLR (n = 23). The participants performed physical performance tests (hop, strength and balance) at the end the of exercise therapy (mean 10 (SD 6) months), and at 5 years, and rated their knee self-efficacy using Knee Self-Efficacy Scale (K-SES) questionnaire (0 to 10, worst to best) at 6 years. Results Median K-SES score for the total group (n = 89) was 7.8 (IQR 5.9–9.0). There were no differences between treatment groups in K-SES scores at 6 years nor in physical performance at any time point (p ≥ 0.097). Worse knee flexion strength LSI (rsp = 0.341, p = 0.042) at the end of the exercise therapy, and worse LSI for single-leg hop test (rsp = 0.310, p = 0.005) at the end of the exercise therapy and at 5 years, correlated moderately with worse knee-related self-efficacy at 6 years. Low associations were observed between the remaining physical performance tests and K-SES scores (rsp ≤ 0.265, p ≥ 0.045). Conclusion Knee-related self-efficacy at 6 years after ACL injury did not differ between those treated with ACLR, performed early or as a delayed procedure, or exercise therapy alone. Good physical performance at the end of the exercise therapy, and at 5 years, appears to have a positive, yet small, impact on future knee-related self-efficacy.
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Cole BJ, Cotter EJ, Wang KC, Davey A. Patient Understanding, Expectations, and Satisfaction Regarding Rotator Cuff Injuries and Surgical Management. Arthroscopy 2017; 33:1603-1606. [PMID: 28499920 DOI: 10.1016/j.arthro.2017.03.004] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/14/2016] [Revised: 02/04/2017] [Accepted: 03/02/2017] [Indexed: 02/02/2023]
Abstract
Rotator cuff injuries are among the most common in orthopaedics, with rotator cuff repair surgery consistently reported as one of the most commonly performed orthopaedic procedures. Patient satisfaction is becoming an increasingly important outcome metric as health care continues to evolve with regard to quality measures affecting physician reimbursement. Evidence supports that postoperative patient satisfaction, an important quality outcome metric, is highly influenced by preoperative patient expectations, which are in turn governed by patient knowledge and understanding. Many authors have delineated patient-, injury-, and surgery-specific variables associated with high preoperative expectations and satisfaction after rotator cuff surgery. Specifically, large rotator cuff tears, subscapularis tears, persistence of postoperative pain and dysfunction, worker's compensation cases, lower education level, and preoperative disability have been seen more frequently in patients reporting poor satisfaction. Others have reported variables associated with higher patient satisfaction such as being married, employed, and of older age at the time of surgery (>55 years old) predictive of higher satisfaction. Patient education preoperatively regarding details about the surgery and the postoperative plan both immediately after the procedure and for rehabilitation are critical in helping set patients' preoperative expectations that have a known effect on patients' subjective clinical outcomes.
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Affiliation(s)
- Brian J Cole
- Department of Orthopaedic Surgery, Rush University Medical Center, Chicago, Illinois, U.S.A..
| | - Eric J Cotter
- Department of Orthopaedic Surgery, Rush University Medical Center, Chicago, Illinois, U.S.A
| | - Kevin C Wang
- Department of Orthopaedic Surgery, Rush University Medical Center, Chicago, Illinois, U.S.A
| | - Annabelle Davey
- Department of Orthopaedic Surgery, Rush University Medical Center, Chicago, Illinois, U.S.A
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Brignardello-Petersen R, Guyatt GH, Buchbinder R, Poolman RW, Schandelmaier S, Chang Y, Sadeghirad B, Evaniew N, Vandvik PO. Knee arthroscopy versus conservative management in patients with degenerative knee disease: a systematic review. BMJ Open 2017; 7:e016114. [PMID: 28495819 PMCID: PMC5541494 DOI: 10.1136/bmjopen-2017-016114] [Citation(s) in RCA: 93] [Impact Index Per Article: 13.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/29/2022] Open
Abstract
OBJECTIVE To determine the effects and complications of arthroscopic surgery compared with conservative management strategies in patients with degenerative knee disease. DESIGN Systematic review. MAIN OUTCOME MEASURES Pain, function, adverse events. DATA SOURCES MEDLINE, EMBASE, the Cochrane Central Register of Controlled Trials (CENTRAL), Google Scholar and Open Grey up to August 2016. ELIGIBILITY CRITERIA For effects, randomised clinical trials (RCTs) comparing arthroscopic surgery with a conservative management strategy (including sham surgery) in patients with degenerative knee disease. For complications, RCTs and observational studies. REVIEW METHODS Two reviewers independently extracted data and assessed risk of bias for patient-important outcomes. A parallel guideline committee (BMJ Rapid Recommendations) provided input on the design and interpretation of the systematic review, including selection of patient-important outcomes. We used the GRADE approach to rate the certainty (quality) of the evidence. RESULTS We included 13 RCTs and 12 observational studies. With respect to pain, the review identified high-certainty evidence that knee arthroscopy results in a very small reduction in pain up to 3 months (mean difference =5.4 on a 100-point scale, 95% CI 2.0 to 8.8) and very small or no pain reduction up to 2 years (mean difference =3.1, 95% CI -0.2 to 6.4) when compared with conservative management. With respect to function, the review identified moderate-certainty evidence that knee arthroscopy results in a very small improvement in the short term (mean difference =4.9 on a 100-point scale, 95% CI 1.5 to 8.4) and very small or no improved function up to 2 years (mean difference =3.2, 95% CI -0.5 to 6.8). Alternative presentations of magnitude of effect, and associated sensitivity analyses, were consistent with the findings of the primary analysis. Low-quality evidence suggested a very low probability of serious complications after knee arthroscopy. CONCLUSIONS Over the long term, patients who undergo knee arthroscopy versus those who receive conservative management strategies do not have important benefits in pain or function. TRIAL REGISTRATION NUMBER PROSPERO CRD42016046242.
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Affiliation(s)
- Romina Brignardello-Petersen
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada
- Evidence-Based Dentistry Unit, Faculty of Dentistry, Universidad de Chile, Santiago, Chile
| | - Gordon H Guyatt
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada
| | - Rachelle Buchbinder
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
- Monash Department of Clinical Epidemiology, Cabrini Institute, Malvern, Victoria, Australia
| | - Rudolf W Poolman
- Department of Orthopedic Surgery and Traumatology, Joint Research, Onze Lieve Vrouwe Gasthuis (OLVG), Amsterdam, The Netherlands
| | - Stefan Schandelmaier
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada
- Department of Orthopedic Surgery and Traumatology, Joint Research, Onze Lieve Vrouwe Gasthuis (OLVG), Amsterdam, The Netherlands
- Institute for Clinical Epidemiology and Biostatistics, University Hospital Basel, Basel, Switzerland
| | - Yaping Chang
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada
| | - Behnam Sadeghirad
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada
- HIV/STI Surveillance Research Center, and WHO Collaborating Center for HIV Surveillance, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Medical University Campus, Haft-Bagh Highway, Kerman, Iran
| | - Nathan Evaniew
- Division of Orthopaedics, Department of Surgery, McMaster University, Hamilton, Ontario, Canada
| | - Per O Vandvik
- Department of Medicine, Innlandet Hospital Trust-Division Gjøvik, Gjøvik, Norway
- Faculty of Medicine, Institute of Health and Society, University of Oslo, Oslo, Norway
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Siemieniuk RAC, Harris IA, Agoritsas T, Poolman RW, Brignardello-Petersen R, Van de Velde S, Buchbinder R, Englund M, Lytvyn L, Quinlan C, Helsingen L, Knutsen G, Olsen NR, Macdonald H, Hailey L, Wilson HM, Lydiatt A, Kristiansen A. Arthroscopic surgery for degenerative knee arthritis and meniscal tears: a clinical practice guideline. BMJ 2017; 357:j1982. [PMID: 28490431 PMCID: PMC5426368 DOI: 10.1136/bmj.j1982] [Citation(s) in RCA: 131] [Impact Index Per Article: 18.7] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Affiliation(s)
- Reed A C Siemieniuk
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada L8S 4L8
- Department of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Ian A Harris
- South Western Sydney Clinical School, UNSW, Australia
- Whitlam Orthopaedic Research Centre, Ingham Institute for Applied Medical Research, Liverpool, NSW 2170, Australia
| | - Thomas Agoritsas
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada L8S 4L8
- Division General Internal Medicine & Division of Clinical Epidemiology, University Hospitals of Geneva, CH-1211, Geneva, Switzerland
| | - Rudolf W Poolman
- Department of Orthopaedic Surgery, Joint Research, OLVG, 1090 HM Amsterdam, The Netherlands
| | - Romina Brignardello-Petersen
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada L8S 4L8
- Faculty of Dentistry, Universidad de Chile, Independencia, Santiago, Chile
| | | | - Rachelle Buchbinder
- Department of Epidemiology and Preventive Medicine, School of Public Health & Preventive Medicine, Monash University, Melbourne, Vic 3004, Australia
- Monash Department of Clinical Epidemiology, Cabrini Institute; Suite 41 Cabrini Medical Centre, Malvern Vic, 3144, Australia
| | - Martin Englund
- Clinical Epidemiology Unit, Orthopaedics, Department of Clinical Sciences Lund Faculty of Medicine, Lund University, SE-221 85 Lund, Sweden
| | - Lyubov Lytvyn
- Oslo University Hospital, Blindern 0317 Oslo, Norway
| | | | - Lise Helsingen
- Clinical Effectiveness Research Group, Institute of Health and Society, University of Oslo, Blindern 0317 Oslo, Norway
| | | | - Nina Rydland Olsen
- Department of Occupational Therapy, Physiotherapy and Radiography, Faculty of Health and Social sciences, Bergen University College, 5020 Bergen, Norway
| | | | - Louise Hailey
- Nuffield Orthopaedic Centre, Oxford University Hospitals NHS Foundation Trust, Oxford OX3 7HE, UK
| | | | | | - Annette Kristiansen
- Department of Health and Science, University of Oslo, Oslo, Norway
- Department of Medicine, Hospital Innlandet Trust, Gjøvik, Norway
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