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Fonseca-Rodrigues D, Rodrigues A, Martins T, Pinto J, Amorim D, Almeida A, Pinto-Ribeiro F. Correlation between pain severity and levels of anxiety and depression in osteoarthritis patients: a systematic review and meta-analysis. Rheumatology (Oxford) 2021; 61:53-75. [PMID: 34152386 DOI: 10.1093/rheumatology/keab512] [Citation(s) in RCA: 49] [Impact Index Per Article: 16.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Abstract
OBJECTIVES Osteoarthritis (OA) is a chronic degenerative musculoskeletal disease that causes articular damage and chronic pain, with a prevalence of up to 50% in individuals >60 years of age. Patients suffering from chronic painful conditions, including OA, also frequently report anxiety or depression. A systematic review and meta-analysis were performed to assess the correlation between pain severity and depressive and anxious symptomatology in OA patients. METHODS A systematic search was conducted using four databases (PubMed, Medline, Scopus, and Web of Science) from inception up to 14th January of 2020. We included original articles evaluating pain severity and anxiety and/or depression severity in OA-diagnosed patients. Detailed data were extracted from each study, including patients' characteristics and pain, anxiety, and depression severity. When available, the Pearson correlation coefficient between pain and depression severity and pain and anxiety severity was collected and a meta-analysis of random effects was applied. RESULTS This systematic review included 121 studies, with a total of 38085 participants. The mean age was 64.3 years old and subjects were predominantly female (63%). The most used scale to evaluate pain severity was the Western Ontario and the McMaster Universities Osteoarthritis Index, while for anxiety and depression, the Hospital Anxiety and Depression Scale was the most used. The meta-analysis showed a moderate positive correlation between pain severity and both anxious (r = 0.31, p < 0.001) and depressive symptomatology (r = 0.36, p < 0.001). CONCLUSIONS Our results demonstrate a significant correlation between pain and depression/anxiety severity in OA patients, highlighting the need for its routine evaluation by clinicians.
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Affiliation(s)
- Diana Fonseca-Rodrigues
- Life and Health Sciences Research Institute (ICVS), School of Medicine, University of Minho, Braga, Portugal.,ICVS/3B's - PT Government Associate Laboratory, Braga/Guimarães, Portugal
| | - André Rodrigues
- School of Medicine, University of Minho, Braga, Portugal.,Anesthesiology Department, Coimbra Hospital and Universitary Centre (CHUC), Praceta Prof. Mota Pinto, Coimbra, Portugal
| | - Teresa Martins
- School of Medicine, University of Minho, Braga, Portugal
| | - Joana Pinto
- School of Medicine, University of Minho, Braga, Portugal
| | - Diana Amorim
- Life and Health Sciences Research Institute (ICVS), School of Medicine, University of Minho, Braga, Portugal.,ICVS/3B's - PT Government Associate Laboratory, Braga/Guimarães, Portugal
| | - Armando Almeida
- Life and Health Sciences Research Institute (ICVS), School of Medicine, University of Minho, Braga, Portugal.,ICVS/3B's - PT Government Associate Laboratory, Braga/Guimarães, Portugal.,School of Medicine, University of Minho, Braga, Portugal
| | - Filipa Pinto-Ribeiro
- Life and Health Sciences Research Institute (ICVS), School of Medicine, University of Minho, Braga, Portugal.,ICVS/3B's - PT Government Associate Laboratory, Braga/Guimarães, Portugal.,School of Medicine, University of Minho, Braga, Portugal
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Sturtivant A, Callanan A. The use of antifreeze proteins to modify pore structure in directionally frozen alginate sponges for cartilage tissue engineering. Biomed Phys Eng Express 2020; 6:055016. [PMID: 33444247 DOI: 10.1088/2057-1976/aba7aa] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
Abstract
It is thought that osteoarthritis is one of the world's leading causes of disability, with over 8.75 million people in the UK alone seeking medical treatment in 2013. Although a number of treatments are currently in use, a new wave of tissue engineered structures are being investigated as potential solutions for early intervention. One of the key challenges seen in cartilage tissue engineering is producing constructs that can support the formation of articular cartilage, rather than mechanically inferior fibrocartilage. Some research has suggested that mimicking structural properties of the natural cartilage can be used to enhance this response. Herein directional freezing was used to fabricate scaffolds with directionally aligned pores mimicking the mid-region of cartilage, anti-freeze proteins were used to modify the porous structure, which in turn effected the mechanical properties. Pore areas at the tops of the scaffolds were 180.46 ± 44.17 μm2 and 65.66 ± 36.20 μm2 for the AFP free and the AFP scaffolds respectively, and for the bases of the scaffolds were 91.22 ± 19.05 μm2 and 69.41 ± 21.94 μm2 respectively. Scaffolds were seeded with primary bovine chondrocytes, with viability maintained over the course of the study, and regulation of key genes was observed.
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Affiliation(s)
- Alexander Sturtivant
- Institute for Bioengineering, School of Engineering, University of Edinburgh, Faraday Building, King's Buildings, EH9 3JL, United Kingdom
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Psychological and psychiatric factors related to health-related quality of life after total hip replacement – preliminary report. Eur Psychiatry 2020; 24:119-24. [DOI: 10.1016/j.eurpsy.2008.06.009] [Citation(s) in RCA: 31] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/27/2007] [Revised: 06/19/2008] [Accepted: 06/21/2008] [Indexed: 11/20/2022] Open
Abstract
AbstractAbstractTotal hip replacement is one of the most successful orthopaedic interventions in improving considerably the patients' performance, nevertheless some patients demonstrate declined functional ability following an operation. Such condition is not a consequence of medical illness or the surgery itself but might rather be associated with mental status. The authors conduct an investigation concerning the relation between some psychological and psychiatric factors and their influence on health-related quality of life in patients after total hip replacement.MethodsInto the study group we included 102 subjects undergoing total hip replacement (59 female, 43 male). In all subjects we measured depression (Beck Depression Inventory – BDI), anxiety (State and Trait Anxiety Inventory – STAI), sense of coherence (SOC-29), personality traits (Eysenck Personality Inventory – EPI) and health related quality of life (SF-36).ResultsThe postoperative values of the PCS and the MCS for the whole group of patients correlated negatively with the SOC values (p = 0.04 and p = 0.03 respectively). Neuroticism (EPI) and anxiety as a trait (STAI) were also associated with postoperative performance, both in mental (p = 0.03 and p = 0.008 respectively) and physical (p = 0.005 and p = 0.04 respectively terms).ConclusionTotal hip replacement improves significantly the patient’s health-related quality of life at 6 months after surgery, what is influenced by sense of coherence, neuroticism and anxiety as a trait. Above mentioned factors should be taken into account when rehabilitation and social readaptation processes are planned.
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Tsapakis EM, Tsiridis E, Hunter A, Gamie Z, Georgakarakos N, Thomas P, Schizas C, West RM. Modelling the effect of minor orthopaedic day surgery on patient mood at the early post-operative period: A prospective population-based cohort study. Eur Psychiatry 2020; 24:112-8. [DOI: 10.1016/j.eurpsy.2008.09.002] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/14/2008] [Revised: 09/02/2008] [Accepted: 09/07/2008] [Indexed: 11/17/2022] Open
Abstract
AbstractObjectiveThe effect of minor orthopaedic day surgery (MiODS) on patient’s mood.MethodsA prospective population-based cohort study of 148 consecutive patients with age above 18 and less than 65, an American Society of Anaesthesiology (ASA) score of 1, and the requirement of general anaesthesia (GA) were included. The Medical Outcomes Study – Short Form 36 (SF-36), Beck Anxiety Inventory (BAI) and Beck Depression Inventory (BDI) were used pre- and post-operatively.ResultsThe mean physical component score of SF-36 before surgery was 45.3 (SD = ±10.1) and 8 weeks following surgery was 44.9 (SD = ±11.04) [n= 148,p= 0.51, 95% CI = (−1.03 to 1.52)]. For the measurement of the changes in mood using BDI, BAI and SF-36, latent construct modelling was employed to increase validity. The covariance between mood pre- and post-operatively (cov = 69.44) corresponded to a correlation coefficient,r= 0.88 indicating that patients suffering a greater number of mood symptoms before surgery continue to have a greater number of symptoms following surgery. When the latent mood constructs were permitted to have different means the model fitted well withχ2(df = 1) = 0.86 for whichp= 0.77, thus the null hypothesis that MiODS has no effect on patient mood was rejected.ConclusionsMiODS affects patient mood which deteriorates at 8 weeks post-operatively regardless of the pre-operative patient mood state. More importantly patients suffering a greater number of mood symptoms before MiODS continue to have a greater number of symptoms following surgery.
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Eymard F, Charles-Nelson A, Katsahian S, Chevalier X, Bercovy M. Predictive Factors of "Forgotten Knee" Acquisition After Total Knee Arthroplasty: Long-Term Follow-Up of a Large Prospective Cohort. J Arthroplasty 2017; 32:413-418.e1. [PMID: 27430181 DOI: 10.1016/j.arth.2016.06.020] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/10/2016] [Revised: 05/10/2016] [Accepted: 06/11/2016] [Indexed: 02/01/2023] Open
Abstract
BACKGROUND In a large prospective cohort, we recently showed that only 66.1% of total knee arthroplasty (TKA) with a perfect outcome according to Knee Society Knee Score was completely forgotten in all everyday activities. The main objective of this study was to identify clinical and orthopedic factors associated with the acquisition of "forgotten knee" (FK). METHODS Patients undergoing TKA were enrolled between January 2001 and January 2008. Preoperative medical history, anthropometric data, and clinical data were recorded, and composite scores (Knee Society Score, Lequesne) were assessed. Radiography was performed before and after surgery. At each follow-up, FK acquisition was assessed by a closed question "Does the operated knee feel always normal in all everyday activities?" RESULTS We included 510 TKAs performed in 423 patients followed up for a mean of 76.6 ± 28.5 months. On multivariate analysis, depression at baseline and presence of patellar subluxation after surgery were negatively associated with FK acquisition (odds ratio [OR] = 0.28 [95% confidence interval {CI}, 0.13-0.61], P = .001; and OR = 0.31 [0.12-0.79], P = .01, respectively), whereas increased active flexion at last follow-up was positively associated (OR = 1.07 [1.03-1.10], P < .0001). In patients with a perfect outcome (Knee Society Knee Score = 100), preoperative patellar pain, and postoperative patellar subluxation were negatively associated with FK acquisition (OR = 0.41 [0.18-0.93], P = .03 and OR = 0.21 [0.05-0.90], P = .04, respectively). Gender, age, body mass index, preoperative pain and functional limitation, and patellar resurfacing were not significantly related to FK. CONCLUSION Depression and patella maltracking may be associated with lack of FK acquisition after TKA, while postoperative increase in flexion may have a positive impact.
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Affiliation(s)
- Florent Eymard
- Department of Rheumatology, AP-HP Henri Mondor Hospital, Créteil Cedex, France
| | - Anais Charles-Nelson
- Department of Clinical Research, AP-HP Henri Mondor Hospital, Créteil Cedex, France
| | - Sandrine Katsahian
- Department of Clinical Research, AP-HP Henri Mondor Hospital, Créteil Cedex, France
| | - Xavier Chevalier
- Department of Rheumatology, AP-HP Henri Mondor Hospital, Créteil Cedex, France
| | - Michel Bercovy
- Department of Orthopaedic Surgery, Clinique Arago, Paris, France
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Scott JE, Mathias JL, Kneebone AC. Depression and anxiety after total joint replacement among older adults: a meta-analysis. Aging Ment Health 2016; 20:1243-1254. [PMID: 26252414 DOI: 10.1080/13607863.2015.1072801] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
OBJECTIVE Patients usually experience good physical recovery after total joint replacement (TJR); however, it is unclear whether mood also improves. The current meta-analysis examined changes in depression and anxiety following TJR in older (≥50 years) patients in order to address this gap in the literature. METHODS Data from 26 studies (4045 TJR, 55 controls) that assessed depression and/or anxiety pre- and post-surgery in TJR patients, with or without a control group, were analyzed. Prevalence rates and Cohen's d effect sizes were used to evaluate changes in the prevalence and severity of depression/anxiety, respectively. RESULTS Approximately 23% of TJR patients had clinically significant levels of depression prior to surgery, which decreased to 13% one year later. The prevalence of anxiety could not be evaluated due to the limited available data. TJR patients did not show any clinically meaningful reductions in symptoms of depression or anxiety, following surgery. Compared to controls, there was no difference in symptom progression over time; although only one study examined this. CONCLUSIONS TJR patients appear to have higher rates of clinically significant symptoms of depression before and after surgery, compared to the general population, however more research with adequate control groups is needed to confirm this. Only a modest improvement in the severity of depression and anxiety symptoms was noted post-surgery. However, existing research is limited; preventing definite conclusions regarding the impact of TJR on mood.
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Affiliation(s)
- J E Scott
- a School of Psychology , University of Adelaide , Adelaide , Australia
| | - J L Mathias
- a School of Psychology , University of Adelaide , Adelaide , Australia
| | - A C Kneebone
- a School of Psychology , University of Adelaide , Adelaide , Australia.,b Department of Clinical Psychology , Flinders Medical Centre , Bedford Park , Australia
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Abstract
In this article I aim to outline the ways in which psychological research, and in particular, a social–cognitive approach, can make a meaningful contribution to the development of public policy and health and community care practice.
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Affiliation(s)
- Sheina Orbell
- Department of Psychology, University of Sheffield, UK
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Cremeans-Smith JK, Contrera K, Speering L, Miller ET, Pfefferle K, Greene K, Delahanty DL. Using established predictors of post-traumatic stress to explain variations in recovery outcomes among orthopedic patients. J Health Psychol 2013; 20:1296-304. [DOI: 10.1177/1359105313511135] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
The present studies examine whether information contained in medical records can be used to predict outcomes following two orthopedic procedures: repair of hip fracture and total knee replacement. Study 1 reports the acute, in-hospital recovery data from the medical records of 119 hip fracture patients. Study 2 is a prospective, longitudinal investigation of 3-month postoperative recovery of 110 total knee replacement patients. Patients characterized by a greater number of post-traumatic stress risk factors experienced poorer outcomes following orthopedic surgery. Our results suggest that patients at risk for negative outcomes can be identified by information readily available to medical personnel.
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Affiliation(s)
| | | | | | | | | | | | - Douglas L Delahanty
- Summa Health System, USA
- Kent State University, USA
- Northeast Ohio Medical University (NEOMED), USA
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Sridhar MS, Jarrett CD, Xerogeanes JW, Labib SA. Obesity and symptomatic osteoarthritis of the knee. ACTA ACUST UNITED AC 2012; 94:433-40. [PMID: 22434455 DOI: 10.1302/0301-620x.94b4.27648] [Citation(s) in RCA: 48] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Given the growing prevalence of obesity around the world and its association with osteoarthritis of the knee, orthopaedic surgeons need to be familiar with the management of the obese patient with degenerative knee pain. The precise mechanism by which obesity leads to osteoarthritis remains unknown, but is likely to be due to a combination of mechanical, humoral and genetic factors. Weight loss has clear medical benefits for the obese patient and seems to be a logical way of relieving joint pain associated with degenerative arthritis. There are a variety of ways in which this may be done including diet and exercise, and treatment with drugs and bariatric surgery. Whether substantial weight loss can delay or even reverse the symptoms associated with osteoarthritis remains to be seen. Surgery for osteoarthritis in the obese patient can be technically more challenging and carries a risk of additional complications. Substantial weight loss before undertaking total knee replacement is advisable. More prospective studies that evaluate the effect of significant weight loss on the evolution of symptomatic osteoarthritis of the knee are needed so that orthopaedic surgeons can treat this patient group appropriately.
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Affiliation(s)
- M S Sridhar
- Emory University, Department of Orthopaedic Surgery, 59 Executive Park South, Atlanta, Georgia 30329, USA.
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Nyland J, Kanouse Z, Krupp R, Caborn D, Jakob R. Total knee arthroplasty in motivated patients with knee osteoarthritis and athletic activity approach type goals: a conceptual decision-making model. Disabil Rehabil 2010; 33:1683-92. [PMID: 21110726 DOI: 10.3109/09638288.2010.533816] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
Knee osteoarthritis is one of the most common disabling medical conditions. With longer life expectancy the number of total knee arthroplasty (TKA) procedures being performed worldwide is projected to increase dramatically. Patient education, physical activity, bodyweight levels, expectations and goals regarding the ability to continue athletic activity participation are also increasing. For the subset of motivated patients with knee osteoarthritis who have athletic activity approach type goals, early TKA may not be the best knee osteoarthritis treatment option to improve satisfaction, quality of life and outcomes. The purpose of this clinical commentary is to present a conceptual decision-making model designed to improve the knee osteoarthritis treatment intervention outcome for motivated patients with athletic activity approach type goals. The model focuses on improving knee surgeon, patient and rehabilitation clinician dialogue by rank ordering routine activities of daily living and quality of life evoking athletic activities based on knee symptom exacerbation or re-injury risk. This process should help establish realistic patient expectations and goals for a given knee osteoarthritis treatment intervention that will more likely improve self-efficacy, functional independence, satisfaction and outcomes while decreasing the failure risk associated with early TKA.
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Affiliation(s)
- John Nyland
- Department of Orthopaedic Surgery, University of Louisville, Louisville 40202, USA.
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Andersson AE, Bergh I, Karlsson J, Nilsson K. Patients' experiences of acquiring a deep surgical site infection: an interview study. Am J Infect Control 2010; 38:711-7. [PMID: 21034980 DOI: 10.1016/j.ajic.2010.03.017] [Citation(s) in RCA: 108] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2009] [Revised: 03/16/2010] [Accepted: 03/16/2010] [Indexed: 11/24/2022]
Abstract
BACKGROUND The negative impact of surgical site infection (SSI) in terms of morbidity, mortality, additional costs, and length of stay (LOS) in the hospital is well described in the literature, as are risk factors and preventive measures. Given the lack of knowledge regarding patients' experiences of SSI, the aim of the present study was to describe patients' experiences of acquiring a deep SSI. METHODS Content analysis was used to analyze data obtained from 14 open interviews with participants diagnosed with a deep SSI. RESULTS Patients acquiring a deep SSI suffer significantly from pain, isolation, and insecurity. The SSI changes physical, emotional, social, and economic aspects of life in extremely negative ways, and these changes are often persistent. CONCLUSION Health care professionals should focus on strategies to enable early diagnosis and treatment of SSIs. The unacceptable suffering related to the infection, medical treatment, and an insufficient patient-professional relationship should be addressed when planning individual care, because every effort is needed to support this group of patients and minimize their distress. All possible measures should be taken to avoid bacterial contamination of the surgical wound during and after surgery to prevent the development of SSI.
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Dowsey MM, Liew D, Stoney JD, Choong PF. The impact of pre-operative obesity on weight change and outcome in total knee replacement. ACTA ACUST UNITED AC 2010; 92:513-20. [DOI: 10.1302/0301-620x.92b4.23174] [Citation(s) in RCA: 116] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
We carried out a prospective, continuous study on 529 patients who underwent primary total knee replacement between January 2006 and December 2007 at a major teaching hospital. The aim was to investigate weight change and the functional and clinical outcome in non-obese and obese groups at 12 months post-operatively. The patients were grouped according to their pre-operative body mass index (BMI) as follows: non-obese (BMI < 30 kg/m2), obese (BMI 3 30 to 39 kg/m2) and morbidly obese (BMI > 40 kg/m2). The clinical outcome data were available for all patients and functional outcome data for 521 (98.5%). Overall, 318 (60.1%) of the patients were obese or morbidly obese. At 12 months, a clinically significant weight loss of ≥ 5% had occurred in 40 (12.6%) of the obese patients, but 107 (21%) gained weight. The change in the International Knee Society score was less in obese and morbidly obese compared with non-obese patients (p = 0.016). Adverse events occurred in 30 (14.2%) of the non-obese, 59 (22.6%) of the obese and 20 (35.1%) of the morbidly obese patients (p = 0.001).
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Affiliation(s)
| | - D. Liew
- Department of Medicine University of Melbourne, Level 4 Clinical Sciences Building, 29 Regents Street, Fitzroy 3065, Melbourne, Victoria, Australia
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Su HH, Tsai YF, Chen WJ, Chen MC. Health care needs of patients during early recovery after total knee-replacement surgery. J Clin Nurs 2010; 19:673-81. [DOI: 10.1111/j.1365-2702.2009.03107.x] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Abstract
BACKGROUND Knee joint arthritis causes pain, decreased range of motion, and mobility limitation. Knee replacement reduces pain effectively. However, people with knee replacement have decreases in muscle strength ("force-generating capacity") of the involved leg and difficulties with walking and other physical activities. OBJECTIVE AND DESIGN The aim of this cross-sectional study was to determine the extent of deficits in knee extensor and flexor muscle torque and power (ability to perform work over time) and in the extensor muscle cross-sectional area (CSA) after knee joint replacement. In addition, the association of lower-leg muscle deficits with mobility limitations was investigated. METHODS Participants were 29 women and 19 men who were 55 to 75 years old and had undergone unilateral knee replacement surgery an average of 10 months earlier. The maximal torque and power of the knee extensor and flexor muscles were measured with an isokinetic dynamometer. The knee extensor muscle CSA was measured with computed tomography. The symmetry deficit between the knee that underwent replacement surgery ("operated knee") and the knee that did not undergo replacement surgery ("nonoperated knee") was calculated. Maximal walking speed and stair-ascending and stair-descending times were assessed. RESULTS The mean deficits in knee extensor and flexor muscle torque and power were between 13% and 27%, and the mean deficit in the extensor muscle CSA was 14%. A larger deficit in knee extension power predicted slower stair-ascending and stair-descending times. This relationship remained unchanged when the power of the nonoperated side and the potential confounding factors were taken into account. LIMITATIONS The study sample consisted of people who were relatively healthy and mobile. Some participants had osteoarthritis in the nonoperated knee. CONCLUSIONS Deficits in muscle torque and power and in the extensor muscle CSA were present 10 months after knee replacement, potentially causing limitations in negotiating stairs. To prevent mobility limitations and disability, deficits in lower-limb power should be considered during rehabilitation after knee replacement.
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McHugh GA, Luker KA. Influences on individuals with osteoarthritis in deciding to undergo a hip or knee joint replacement: A qualitative study. Disabil Rehabil 2009; 31:1257-66. [DOI: 10.1080/09638280802535129] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
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Dixon D, Johnston M. Cognitive representations of disability behaviours in people with mobility limitations: Consistency with theoretical constructs. Disabil Rehabil 2009; 30:126-33. [PMID: 17852207 DOI: 10.1080/09638280701256983] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
PURPOSE Disability is conceptualized as behaviour by psychological theory and as a result of bodily impairment by medical models. However, how people with disabilities conceptualize those disabilities is unclear. The purpose of this study was to examine disability representations in people with mobility disabilities. METHOD Thirteen people with mobility disabilities completed personal repertory grids (using the method of triads) applied to activities used to measure disabilities. Ten judges with expertise in health psychology then examined the correspondence between the elicited disability constructs and psychological and medical models of disability. RESULTS Participants with mobility disabilities generated 73 personal constructs of disability. These constructs were judged consistent with the content of two psychological models, namely the theory of planned behaviour and social cognitive theory and with the main medical model of disability, the International Classification of Functioning Disability and Health. CONCLUSIONS Individuals with activity limitations conceptualize activities in a manner that is compatible with both psychological and medical models. This ensures adequate communication in contexts where the medical model is relevant, e.g., clinical contexts, as well as in everyday conversation about activities and behaviours. Finally, integrated models of disability may be of value for theory driven interdisciplinary approaches to disability and rehabilitation.
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Affiliation(s)
- Diane Dixon
- Department of Psychology, University of Aberdeen, Aberdeen, Scotland, UK.
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Patients' reasons for electing to undergo total knee arthroplasty impact post-operative pain severity and range of motion. J Behav Med 2009; 32:223-33. [PMID: 19137422 DOI: 10.1007/s10865-008-9191-2] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2008] [Accepted: 12/02/2008] [Indexed: 10/21/2022]
Abstract
The present study examines the reasons cited by 103 patients for their electing to undergo total knee arthroplastic surgery and the relationship between these reasons and their post-operative pain and range of motion. Results suggest that individuals who describe different reasons for undergoing surgery vary in their post-operative recovery. Specifically, patients who cite pain as the reason they are undergoing surgery report greater levels of pain during the early post-operative period. In contrast, patients who describe goals of regaining mobility or a specific activity as their reason for undergoing surgery achieve a greater range of motion during early post-operative physical therapy. Individuals who express avoidance goals for undergoing total knee arthroplasty report more severe post-operative pain at 1 and 3 months following surgery compared to patients who express approach goals. Interventions targeted towards patients reporting pre-operative pain or avoidance goals may decrease subsequent post-operative pain and increase mobility.
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O’Sullivan M, Savage E. Nursing contributions to mobilizing older adults following total hip replacement in Ireland. ACTA ACUST UNITED AC 2008. [DOI: 10.1016/j.joon.2008.07.004] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Genêt F, Schnitzler A, Lapeyre E, Roche N, Autret K, Fermanian C, Poiraudeau S. Change of impairment, disability and patient satisfaction after total knee arthroplasty in secondary care practice. ACTA ACUST UNITED AC 2008; 51:671-6, 676-82. [DOI: 10.1016/j.annrmp.2008.08.002] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2008] [Accepted: 08/01/2008] [Indexed: 01/22/2023]
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Shepherd DET, Azangwe G. Synthetic versus tissue-engineered implants for joint replacement. Appl Bionics Biomech 2008. [DOI: 10.1080/11762320701816966] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022] Open
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Badura-Brzoza K, Zajac P, Kasperska-Zajac A, Brzoza Z, Matysiakiewicz J, Piegza M, Hese RT, Rogala B, Semenowicz J, Koczy B. Anxiety and depression and their influence on the quality of life after total hip replacement: preliminary report. Int J Psychiatry Clin Pract 2008; 12:280-4. [PMID: 24937714 DOI: 10.1080/13651500802095012] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Objective. The study investigated health-related quality of life in relation to mental status (anxiety and depression) and demographic factors in patients before and after total hip replacement due to osteoarthrosis. Methods. The SF-36, HADS, socio-demographic data questionnaire was delivered to a group of 184 subjects (108 females, 76 males) at the mean age at the time of surgery of 59 years. Questionnaires were delivered to the subjects 2 weeks before the surgery and 6 months after the operation (by mail). Results. Patients after hip replacement showed significant improvement in health-related quality of life in most domains of SF-36 score and summary scale of PCS (Physical Component Summary Scale) and MCS (Mental Component Summary Scale). They also showed improvement in mental status. Elderly patients were more likely to show worse score in MCS and PCS before and after surgery. BMI (body mass index) was correlated only with preoperative PCS. Mental status was associated with postoperative PCS and MCS. Patients who were satisfied with the results of the surgery showed higher PCS and MCS score. Conclusion. Hip replacement surgery brings significant improvement to the quality of life. Age and mental status of those patients influence markedly their postoperative performance.
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Affiliation(s)
- Karina Badura-Brzoza
- Chair and Clinical Department of Psychiatry, Tarnowskie Góry, Medical University of Silesia, Katowice, Poland
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Dechartres A, Boutron I, Nizard R, Poiraudeau S, Roy C, Ravaud JF, Ravaud P. Evolution of disability in adults with hip arthroplasty: a national longitudinal study. ACTA ACUST UNITED AC 2007; 57:364-71. [PMID: 17394216 DOI: 10.1002/art.22607] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
OBJECTIVE To describe disability in individuals with hip arthroplasty and its evolution over 2 years compared with that in the general population, and to compare the degree of disability between subjects with recent and older hip arthroplasty. METHODS We selected a national representative sample of 16,945 subjects from the 1999 French population census. This sample, interviewed in 1999 and 2001 about their level of disability, included 527 subjects with hip arthroplasty (i.e., representing 424,000 individuals in the French noninstitutionalized population): 145 who underwent the procedure between 1999 and 2001 (recent hip arthroplasty) and 382 with an older hip arthroplasty. RESULTS Subjects with hip arthroplasty reported more difficulty in bending forward (odds ratio [OR] 4.5, 95% confidence interval [95% CI] 3.1-6.6), climbing stairs (OR 2.2, 95% CI 1.5-3.1), walking >300 meters (OR 1.6, 95% CI 1.03-2.6), dressing (OR 2.9, 95% CI 2.1-4.2), and getting in and out of a chair (OR 2.5, 95% CI 1.7-3.6) than the general population. However, the evolution in disability was similar to that of the general population. Compared with subjects with older hip arthroplasty, those with recent hip arthroplasty reported more difficulty walking >300 meters (OR 2.7, 95% CI 1.3-5.6), washing (OR 2.9, 95% CI 1.6-5.4), dressing (OR 2.2, 95% CI 1.2-4.2), and getting in and out of a chair (OR 2.1, 95% CI 1.1-3.9). CONCLUSION This study describes the potential future disability in the more elderly population, with implications for health-related planning.
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Affiliation(s)
- Agnes Dechartres
- INSERM, U738, Université Paris 7, UFR de Médecine, AP HP Hôpital Bichat, Département d'Epidémiologie, Biostatistique et Recherche Clinique, Paris, France
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Fujita K, Makimoto K, Hotokebuchi T. Qualitative study of osteoarthritis patients' experience before and after total hip arthroplasty in Japan. Nurs Health Sci 2006; 8:81-7. [PMID: 16764559 DOI: 10.1111/j.1442-2018.2006.00253.x] [Citation(s) in RCA: 39] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Quantitative studies on the quality of life of patients with osteoarthritis (OA) after total hip arthroplasty (THA) have focused on functional improvement and pain reduction, but patients' perspectives of THA have not been examined in detail. The aim of our study was to investigate, describe, and analyze patients' experience before and after THA by using a qualitative research method. Twenty patients with OA who had undergone primary THA were recruited for this study. The qualitative data obtained were analyzed using content analysis. Participants reported dramatic improvements in pain and disability. However, detailed interviews disclosed problems that the participants faced during the preoperative period, such as an inferiority complex related to abnormal posture. During the postoperative period, some participants suffered from distress over body image related to the artificial joint. This report also suggests possible nursing interventions to deal with these problems.
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Affiliation(s)
- Kimie Fujita
- Division of Nursing, Faculty of Medicine, Saga University, Saga, Japan.
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Dohnke B, Knäuper B, Müller-Fahrnow W. Perceived self-efficacy gained from, and health effects of, a rehabilitation program after hip joint replacement. ACTA ACUST UNITED AC 2005; 53:585-92. [PMID: 16082655 DOI: 10.1002/art.21324] [Citation(s) in RCA: 55] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
OBJECTIVE To examine whether a routine multidisciplinary inpatient rehabilitation program can increase patient self-efficacy, and to investigate the effects of high self-efficacy at admission, and increases in self-efficacy, on health changes in patients who undergo such rehabilitation after hip joint replacement. METHODS Participants in this longitudinal study were 1,065 patients who underwent inpatient rehabilitation after hip joint replacement. Questionnaires were administered at admission, discharge, and 6-month followup. The main outcome variables were disability, pain, depressive symptomatology, and self-efficacy to cope with disability and pain. RESULTS Significant improvements from admission to discharge from the inpatient rehabilitation program in disability, pain, depressive symptoms, and self-efficacy were found. In addition, higher levels of self-efficacy at admission and larger increases in self-efficacy over the course of the program predicted larger health changes (i.e., greater decreases in disability, pain, and depressive symptoms). Results were generally similar for health changes from discharge to 6-month followup. CONCLUSION A routine multidisciplinary inpatient rehabilitation program after hip joint replacement can result in enhanced self-efficacy.
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Affiliation(s)
- Birte Dohnke
- Charité-Universitätsmedizin Berlin, Berlin, Germany.
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Chang HJ, Mehta PS, Rosenberg A, Scrimshaw SC. Concerns of patients actively contemplating total knee replacement: differences by race and gender. ACTA ACUST UNITED AC 2004; 51:117-23. [PMID: 14872464 DOI: 10.1002/art.20073] [Citation(s) in RCA: 58] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
OBJECTIVE To examine differences by race/ethnicity and gender in patients' concerns regarding total knee replacement (TKR). METHODS Focus groups of patients actively considering TKR were conducted. Discussion included patients' questions and concerns regarding TKR. The software ATLAS.ti was used to tabulate themes by race/ethnicity and gender. Concerns raised by focus group participants were compared with thematic content from patient joint replacement information materials. This comparison used patient literature from 3 high-volume academic TKR centers, the Arthritis Foundation, and the American Academy of Orthopedic Surgeons. RESULTS All groups shared similar concerns. However, some issues were more prevalent among certain gender and racial groups. For instance, concerns regarding anesthesia were more important to white Americans and concerns regarding recovery were more important to women. Some of these concerns were not addressed in the available patient literature. CONCLUSIONS Different gender and racial subgroups focus on different concerns when considering TKR. These differences may contribute to gender and race/ethnicity disparity seen in TKR use.
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Affiliation(s)
- Huan J Chang
- University of Illinois at Chicago, Chicago, Illinois, USA
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Salmon P, Hall GM, Peerbhoy D, Shenkin A, Parker C. Recovery from hip and knee arthroplasty: Patients' perspective on pain, function, quality of life, and well-being up to 6 months postoperatively. Arch Phys Med Rehabil 2001; 82:360-6. [PMID: 11245759 DOI: 10.1053/apmr.2001.21522] [Citation(s) in RCA: 135] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
OBJECTIVE To provide a more detailed description from patients' perspectives than is yet available of recovery from hip and knee arthroplasty and to use this information to test 2 assumptions about recovery from these procedures: that recovery from knee arthroplasty, as assessed by patients, routinely reaches the level achieved by hip arthroplasty; and that fatigue is prolonged after major orthopedic surgery. DESIGN A cohort study. SETTING University teaching hospitals. PARTICIPANTS Consecutive patients undergoing hip (n = 107) or knee (n = 53) arthroplasty. INTERVENTIONS Unilateral hip or knee arthroplasty. MAIN OUTCOME MEASURES Standardized self-rated measurements of pain, function, quality of life, and well-being from preoperatively to 6 months follow-up. RESULTS Pain and function improved significantly less after knee arthroplasty than after hip arthroplasty, but the 2 procedures led to similar improvements in life evaluation, mood, and subjective health. Fatigue was only transiently increased. CONCLUSION The findings were inconsistent with both assumptions. Nevertheless, despite poorer recovery in pain and function, patients receiving knee arthroplasty felt that life had improved as much as did patients with hip arthroplasty. Detailed information about how major joint arthroplasty in routine practice affects patients' lives can be used to advise patients and clinicians and can invalidate influential, but inaccurate, assumptions.
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MESH Headings
- Activities of Daily Living
- Adaptation, Psychological
- Aged
- Analysis of Variance
- Arthroplasty, Replacement, Hip/psychology
- Arthroplasty, Replacement, Hip/rehabilitation
- Arthroplasty, Replacement, Knee/psychology
- Arthroplasty, Replacement, Knee/rehabilitation
- Cohort Studies
- Fatigue
- Female
- Humans
- Male
- Pain Measurement
- Pain, Postoperative
- Quality of Life
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Affiliation(s)
- P Salmon
- Department of Clinical Psychology, University of Liverpool, Liverpool, UK.
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Waldrop D, Lightsey ORJ, Ethington CA, Woemmel CA, Coke AL. Self-efficacy, optimism, health competence, and recovery from orthopedic surgery. J Couns Psychol 2001. [DOI: 10.1037/0022-0167.48.2.233] [Citation(s) in RCA: 62] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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