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Aalders MB, van der List JP, Keijser LCM, Benner JL. Anxiety and depression prior to total knee arthroplasty are associated with worse pain and subjective function: A prospective comparative study. Knee Surg Sports Traumatol Arthrosc 2024. [PMID: 38943459 DOI: 10.1002/ksa.12336] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/01/2024] [Revised: 06/13/2024] [Accepted: 06/16/2024] [Indexed: 07/01/2024]
Abstract
PURPOSE The aim of this study was to investigate the influence of preoperative anxiety and depression on subjective function, pain and revision rates following total knee arthroplasty (TKA). METHODS A prospective comparative study was conducted, including 349 patients undergoing TKA surgery between January 2019 and April 2021. Patients completed the Hospital Anxiety and Depression Scale (HADS) questionnaire preoperatively, and a set of Patient-Reported Outcome Measures (PROMs) preoperatively and at 6, 12 and 24 months postoperatively. Patients were categorized into anxiety and depression groups based on HADS scores. PROMs included the Knee injury and Osteoarthritis Outcome Score-Physical Function Shortform (KOOS-PS), Oxford Knee Score (OKS) and NRS-Pain. Differences in PROM scores between the anxiety/depression group and, respectively, nonanxiety/nondepression group were assessed, as well as differences in minimal clinical important difference (MCID) and attainment of Patient Acceptable Symptom State (PASS). Lastly, revision rates were compared. RESULTS Anxiety and depression groups exhibited inferior subjective function preoperatively and postoperatively compared to nonanxiety and nondepression groups (all p < 0.05), experienced more pain preoperatively (p < 0.001) and also postoperatively for depression patients (all p < 0.05). Significantly fewer patients with anxiety and depression reached the PASS for KOOS-PS, OKS and NRS-Pain (all p < 0.05). There were no differences in the proportion of patients reaching the MCID for all PROMs (all p > 0.060), and revision rates did not differ between groups (both p > 0.96). CONCLUSION Preoperative anxiety and depression negatively influence subjective function and pain preoperatively and up to 2-year follow-up in patients undergoing TKA. Revision rates did not differ between groups, and there were no relevant differences in clinical improvement of subjective function and pain. LEVEL OF EVIDENCE Level II, prospective comparative study.
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Affiliation(s)
- Margot B Aalders
- Department of Orthopaedic Surgery and Sports Medicine, Amsterdam UMC, Amsterdam, The Netherlands
- Department of Orthopaedic Surgery, NorthWest Clinics, Alkmaar, The Netherlands
- Department of Orthopaedic Surgery, Flinders University, Adelaide, South Australia, Australia
- Department of Human Movement Sciences, Faculty of Behavioral and Movement Sciences, Amsterdam Movement Sciences, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | | | - Lucien C M Keijser
- Department of Orthopaedic Surgery, NorthWest Clinics, Alkmaar, The Netherlands
- Department of Orthopaedic Surgery, Flinders University, Adelaide, South Australia, Australia
| | - Joyce L Benner
- Department of Orthopaedic Surgery, NorthWest Clinics, Alkmaar, The Netherlands
- Centre for Orthopaedic Research Alkmaar (CORAL), Alkmaar, The Netherlands
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Tian R, Duan X, Xing F, Zhao Y, Liu C, Li H, Kong N, Cao R, Guan H, Li Y, Li X, Zhang J, Wang K, Yang P, Wang C. Computed tomography radiomics in predicting patient satisfaction after robotic-assisted total knee arthroplasty. Int J Comput Assist Radiol Surg 2024:10.1007/s11548-024-03192-1. [PMID: 38836956 DOI: 10.1007/s11548-024-03192-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2024] [Accepted: 05/16/2024] [Indexed: 06/06/2024]
Abstract
PURPOSE After robotic-assisted total knee arthroplasty (RA-TKA) surgery, some patients still experience joint discomfort. We aimed to establish an effective machine learning model that integrates radiomic features extracted from computed tomography (CT) scans and relevant clinical information to predict patient satisfaction three months postoperatively following RA-TKA. MATERIALS AND METHODS After careful selection, data from 142 patients were randomly divided into a training set (n = 99) and a test set (n = 43), approximately in a 7:3 ratio. A total of 1329 radiomic features were extracted from the regions of interest delineated in CT scans. The features were standardized using normalization algorithms, and the least absolute shrinkage and selection operator regression model was employed to select radiomic features with ICC > 0.75 and P < 0.05, generating the Rad-score as feature markers. Univariate and multivariate logistic regression was then used to screen clinical information (age, body mass index, operation time, gender, surgical side, comorbidities, preoperative KSS score, preoperative range of motion (ROM), preoperative and postoperative HKA angle, preoperative and postoperative VAS score) as potential predictive factors. The satisfaction scale ≥ 20 indicates patient satisfaction. Finally, three prediction models were established, focusing on radiomic features, clinical features, and their fusion. Model performance was evaluated using Receiver Operating Characteristic curves and decision curve analysis. RESULTS In the training set, the area under the curve (AUC) of the clinical model was 0.793 (95% CI 0.681-0.906), the radiomic model was 0.854 (95% CI 0.743-0.964), and the combined radiomic-clinical model was 0.899 (95% CI 0.804-0.995). In the test set, the AUC of the clinical model was 0.908 (95% CI 0.814-1.000), the radiomic model was 0.709 (95% CI 0.541-0.878), and the combined radiomic-clinical model was 0.928 (95% CI 0.842-1.000). The AUC of the radiomic-clinical model was significantly higher than the other two models. The decision curve analysis indicated its clinical application value. CONCLUSION We developed a radiomic-based nomogram model using CT imaging to predict the satisfaction of RA-TKA patients at 3 months postoperatively. This model integrated clinical and radiomic features and demonstrated good predictive performance and excellent clinical application potential.
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Affiliation(s)
- Run Tian
- Department of Bone and Joint Surgery, The Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| | - Xudong Duan
- Department of Bone and Joint Surgery, The Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| | - Fangze Xing
- Department of Bone and Joint Surgery, The Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| | - Yiwei Zhao
- Department of Bone and Joint Surgery, The Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| | - ChengYan Liu
- Department of Bone and Joint Surgery, The Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| | - Heng Li
- Department of Bone and Joint Surgery, The Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| | - Ning Kong
- Department of Bone and Joint Surgery, The Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| | - Ruomu Cao
- Department of Bone and Joint Surgery, The Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| | - Huanshuai Guan
- Department of Bone and Joint Surgery, The Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| | - Yiyang Li
- Department of Bone and Joint Surgery, The Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| | - Xinghua Li
- Department of Radiology, The Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| | - Jiewen Zhang
- Department of Bone and Joint Surgery, The Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| | - Kunzheng Wang
- Department of Bone and Joint Surgery, The Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| | - Pei Yang
- Department of Bone and Joint Surgery, The Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China.
- Department of Radiology, The Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China.
| | - Chunsheng Wang
- Department of Bone and Joint Surgery, The Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China.
- Department of Radiology, The Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China.
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Migliorini F, Pilone M, Schäfer L, Simeone F, Bell A, Maffulli N. Functional alignment in robotic-assisted total knee arthroplasty: a systematic review. Arch Orthop Trauma Surg 2024; 144:1741-1749. [PMID: 38337093 DOI: 10.1007/s00402-023-05195-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/02/2023] [Accepted: 12/21/2023] [Indexed: 02/12/2024]
Abstract
PURPOSE The present study systematically reviewed current evidence on functional alignment (FA) in robotic total knee arthroplasty (TKA), discussing advantages and limitations, possible pitfalls, and prospects. METHODS This study was conducted according to the 2020 PRISMA statement. In August 2023, the following databases were accessed: PubMed, Web of Science, Google Scholar, and Embase with no additional filters or time constraints. All the clinical studies investigating functional alignment in robotic TKA were accessed. Only studies published in peer-reviewed journals were considered. The risk of bias was evaluated following the guidelines in the Cochrane Handbook for Systematic Reviews of Interventions. Non-randomized controlled trials (non-RCTs) were evaluated using the Risk of Bias in Nonrandomised Studies of Interventions (NRSI) (ROBINS-I) tool. RESULTS Data from 1198 patients (seven studies) were retrieved. The mean length of the follow-up was 17.1 ± 6.4 months. The mean age was 67.2 ± 5.4 years, and the mean BMI was 30.9 ± 2.7 kg/m2. CONCLUSION FA might improve resection accuracy, implant alignment, and gap balancing in TKA, and additional high-quality clinical trials are necessary to properly establish the superiority of FA to other alignment techniques in TKA. Long-term clinical trials are needed to investigate the impact of FA on implant survivorship. LEVEL OF EVIDENCE Level IV, systematic review and meta-analysis.
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Affiliation(s)
- Filippo Migliorini
- Department of Orthopaedic, Trauma, and Reconstructive Surgery, RWTH University Medical Centre, Pauwelsstraße 30, 52074, Aachen, Germany.
- Department of Orthopedics and Trauma Surgery, Academic Hospital of Bolzano (SABES-ASDAA), Teaching Hospital of the Paracelsus Medical University, 39100, Bolzano, Italy.
| | - Marco Pilone
- Residency Program in Orthopedics and Traumatology, University of Milan, Milan, Italy
| | - Luise Schäfer
- Department of Orthopaedic, Trauma, and Reconstructive Surgery, RWTH University Medical Centre, Pauwelsstraße 30, 52074, Aachen, Germany
| | - Francesco Simeone
- Department of Orthopedics and Trauma Surgery, Academic Hospital of Bolzano (SABES-ASDAA), Teaching Hospital of the Paracelsus Medical University, 39100, Bolzano, Italy
| | - Andreas Bell
- Department of Orthopedics, Eifelklinik St. Brigida, Simmerath, Germany
| | - Nicola Maffulli
- Department of Medicine and Psychology, University of Rome "La Sapienza", Rome, Italy
- School of Pharmacy and Bioengineering, Faculty of Medicine, Keele University, Stoke On Trent, ST4 7QB, UK
- Centre for Sports and Exercise Medicine, Barts and the London School of Medicine and Dentistry, Mile End Hospital, Queen Mary University of London, London, E1 4DG, UK
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Bossen JKJ, Wesselink JA, Heyligers IC, Jansen J. Implementation of a Decision Aid for Hip and Knee Osteoarthritis in Orthopedics: A Mixed-Methods Process Evaluation. Med Decis Making 2024; 44:112-122. [PMID: 37902570 PMCID: PMC10714711 DOI: 10.1177/0272989x231205858] [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: 09/20/2022] [Accepted: 09/19/2023] [Indexed: 10/31/2023]
Abstract
BACKGROUND In orthopedics, the use of patient decision aids (ptDAs) is limited. With a mixed-method process evaluation, we investigated patient factors associated with accepting versus declining the use of the ptDA, patients' reasons for declining the ptDA, and clinicians' perceived barriers and facilitators for its use. METHODS Patients with an indication for joint replacement surgery (N = 153) completed questionnaires measuring demographics, physical functioning, quality of life (EQ-5D-3L), and a visual analog scale (VAS) pain score at 1 time point. Subsequently, their clinician offered them the relevant ptDA. Using a retrospective design, we compared patients who used the ptDA (59%) with patients who declined (41%) on all these measures as well as the chosen treatment. If the use of the ptDA was declined, patients' reasons were recorded by their clinician and analysed (n = 46). To evaluate the experiences of clinicians (n = 5), semistructured interviews were conducted and thematically analyzed. Clinicians who did not use the ptDA substantially (<10 times) were also interviewed (n = 3). RESULTS Compared with patients who used the ptDA, patients who declined use had higher VAS pain scores (7.2 v. 6.2, P < .001), reported significantly worse quality of life (on 4 of 6 EQ-5D-3L subscales), and were less likely to receive nonsurgical treatment (4% v. 28%, P < .001). Of the patients who declined to use the ptDA, 46% said they had enough information and felt ready to make a decision without the ptDA. The interviews revealed that clinicians considered the ptDAs most useful for newly diagnosed patients who had not received previous treatment. CONCLUSION These results suggest that the uptake of a ptDA may be improved if it is introduced in the early disease stages of hip and knee osteoarthritis. HIGHLIGHTS Patients who declined the use of a patient decision aid (ptDA) for hip and knee osteoarthritis reported more pain and worse quality of life.Most patients who declined to use a ptDA felt sufficiently well informed to make a treatment decision.Patients who declined the ptDA were more likely to have received prior treatment in primary care.Clinicians found the ptDA to be a helpful addition to the consultation, particularly for newly diagnosed patients.
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Affiliation(s)
- Jeroen Klaas Jacobus Bossen
- School of Health Professions Education, Maastricht University, Maastricht, the Netherlands
- Department of Orthopedic Surgery and Traumatology, Zuyderland Medical Centre, Heerlen/Geleen, the Netherlands
- Orthopedic Department of University Hospitals Leuven, Leuven, Belgium
| | - Julia Aline Wesselink
- School for Public Health and Primary Care CAPHRI, Maastricht University, Maastricht, the Netherlands
| | - Ide Christiaan Heyligers
- School of Health Professions Education, Maastricht University, Maastricht, the Netherlands
- Department of Orthopedic Surgery and Traumatology, Zuyderland Medical Centre, Heerlen/Geleen, the Netherlands
| | - Jesse Jansen
- School for Public Health and Primary Care CAPHRI, Maastricht University, Maastricht, the Netherlands
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Vandenberk J, Mievis J, Deferm J, Janssen D, Bollars P, Vandenneucker H. NAVIO RATKA shows similar rates of hemoglobin-drop, adverse events, readmission and early revision vs conventional TKA: a single centre retrospective cohort study. Knee Surg Sports Traumatol Arthrosc 2023; 31:4798-4808. [PMID: 37555860 DOI: 10.1007/s00167-023-07524-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/13/2023] [Accepted: 07/23/2023] [Indexed: 08/10/2023]
Abstract
PURPOSE Despite widespread adoption of NAVIO robotic-assisted total knee arthroplasty (NAVIO RATKA) in clinical practice, clinical outcome in terms of adverse events and complications remains unclear. The purpose of this study was to compare adverse events, length of stay, surgical time, hemoglobin drop, early readmission rate and revision rate between conventional TKA (CTKA) and NAVIO RATKA. METHODS This single-centre retrospective cohort analysis compared 230 NAVIO RATKA patients to 489 CTKA patients with a minimal follow-up of 12 months. Baseline demographic and comorbidity parameters were collected, as well as length of stay, revision rate and reason for revision, early readmission rate (< 6w) and reason for readmission, post-operative hemoglobin levels, adverse events, surgical time and operating room time. Data were compared using Mann-Whitney U test for continuous data without normal distribution and ordinal data, categorical variables were compared using the Chi-square or Fisher exact test. RESULTS There were no clinically relevant baseline demographic or comorbidity differences between groups. CTKA had shorter length of stay than NAVIO RATKA (5.0 days vs 5.4 days, p = 0.010) but trended towards a higher reoperation rate (4.1% vs 1.7%, p = .144, n.s). No differences were found in hemoglobin drop, readmission rate or overall incidence of adverse events, but CTKA showed more hematoma formation (1.6% vs 0%, p = .044) and higher incidence of periprosthetic joint infection (PJI) (1% vs 0%, p = n.s.), whilst NAVIO RATKA showed more periprosthetic fractures and persistent wound drainage (0.4% vs 2.2%, p = .038 and 0.6% vs 4.3%, p = .001, respectively). Surgical time remained significantly longer in NAVIO RATKA during all 230 cases (87 min vs 67.6 min) and showed a continuous downward trend. CONCLUSIONS This study further validates the usage of NAVIO RATKA as a safe method to perform TKA, with comparable short term outcomes to CTKA in terms of early revisions and adverse events. Surgeons should be mindful of the differing adverse event profile in NAVIO RATKA and adjust their patient selection accordingly to ensure optimal outcomes. In addition, surgeons using NAVIO RATKA should expect a linear learning curve and a surgical time exceeding that of CTKA. LEVEL OF EVIDENCE Level III (therapeutic retrospective cohort study).
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Affiliation(s)
- Jim Vandenberk
- Department of Biomedical Sciences (Development and Regeneration), KU Leuven-University of Leuven, Herestraat 49, Box 700, 3000, Louvain, Belgium.
- Department of Orthopaedic Surgery, University Hospitals Leuven, Herestraat 49, 3000, Louvain, Belgium.
| | - Jan Mievis
- Orthoteam Limburg, Dienst Orthopedische Heelkunde St. Trudo, Sint-Truiden, Belgium
| | - Jorien Deferm
- St. Elisabeth Krankenhaus Geilenkirchen, Geilenkirchen, Duitsland
| | - Daniël Janssen
- Orthoteam Limburg, Dienst Orthopedische Heelkunde St. Trudo, Sint-Truiden, Belgium
| | | | - Hilde Vandenneucker
- Department of Biomedical Sciences (Development and Regeneration), KU Leuven-University of Leuven, Herestraat 49, Box 700, 3000, Louvain, Belgium
- Department of Orthopaedic Surgery, University Hospitals Leuven, Herestraat 49, 3000, Louvain, Belgium
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Gallo J, Kriegova E, Radvansky M, Sloviak M, Kudelka M. Odds-ratio network for postoperative factors revealing differences in the 2-year longitudinal pattern of satisfaction between women and men after total knee arthroplasty. Sci Rep 2022; 12:17470. [PMID: 36261570 PMCID: PMC9581980 DOI: 10.1038/s41598-022-21541-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2022] [Accepted: 09/28/2022] [Indexed: 01/12/2023] Open
Abstract
Timely and accurate assessments of the factors influencing satisfaction, a key indicator of success in primary total knee arthroplasty (TKA), may help improve TKA outcomes. Here we performed the longitudinal trend analysis of relation between satisfaction and 12 postoperative factors, which positively or negatively influence the patient satisfaction 2 years after TKA. In a real-world registry cohort (women/men: 1121/650), we showed similarities and differences between women and men in the contribution of postoperative factors to satisfaction 2 years after TKA as assessed by odds-ratio-similarity network. In men, the strongest negative factors were pain and complications, followed by mechanical problems. In women, the strongest negative factors were the pain and knee instability, followed by other mechanical problems, complications and low levels of sports activity. In both sexes, physical activity and the Knee Society Score (general and functional) influenced positively satisfaction; long-distance walking was associated with satisfaction only in women. A trend analysis revealed a reduction in the strength of satisfaction-related factors over 2 years of check-ups, particularly in women. Our study demonstrates that the key check-up for assessing the evolution of satisfaction in the 2 years after TKA was at 3 months in both sexes.
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Affiliation(s)
- J. Gallo
- grid.10979.360000 0001 1245 3953Department of Orthopedics, Faculty of Medicine and Dentistry, Palacky University Olomouc & University Hospital Olomouc, Hnevotinska 3, 775 15 Olomouc, Czech Republic
| | - E. Kriegova
- grid.10979.360000 0001 1245 3953Department of Immunology, Faculty of Medicine and Dentistry, Palacky University Olomouc & University Hospital Olomouc, Hnevotinska 3, 775 15 Olomouc, Czech Republic
| | - M. Radvansky
- grid.440850.d0000 0000 9643 2828Department of Computer Science, Faculty of Electrical Engineering and Computer Science, VSB-Technical University of Ostrava, 17. Listopadu 2175/15, 708 00 Ostrava-Poruba, Czech Republic
| | - M. Sloviak
- grid.10979.360000 0001 1245 3953Department of Orthopedics, Faculty of Medicine and Dentistry, Palacky University Olomouc & University Hospital Olomouc, Hnevotinska 3, 775 15 Olomouc, Czech Republic
| | - M. Kudelka
- grid.440850.d0000 0000 9643 2828Department of Computer Science, Faculty of Electrical Engineering and Computer Science, VSB-Technical University of Ostrava, 17. Listopadu 2175/15, 708 00 Ostrava-Poruba, Czech Republic
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Muertizha M, Cai X, Ji B, Aimaiti A, Cao L. Factors contributing to 1-year dissatisfaction after total knee arthroplasty: a nomogram prediction model. J Orthop Surg Res 2022; 17:367. [PMID: 35902950 PMCID: PMC9330701 DOI: 10.1186/s13018-022-03205-2] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/02/2022] [Accepted: 06/02/2022] [Indexed: 11/16/2022] Open
Abstract
Background Identifying risk factors and early intervention are critical for improving the satisfaction rate of total knee arthroplasty (TKA). Our study aimed to identify patient-specific variables and establish a nomogram model to predict dissatisfaction at 1 year after TKA. Methods This prospective cohort study involved 208 consecutive primary TKA patients with end-stage arthritis who completed self-reported measures preoperatively and at 1 year postoperatively. All participants were randomized into a training cohort (n = 154) and validation cohort (n = 54). Multiple regression models with preoperative and postoperative factors were used to establish the nomogram model for dissatisfaction at 1 year postoperatively. The least absolute shrinkage and selection operator method was used to screen the suitable and effective risk factors (demographic variables, preoperative variables, surgical variable, and postoperative variables) collected. These variables were compared between the satisfied and dissatisfied groups in the training cohort. The receiver operating characteristic (ROC) curve, calibration plot, and decision curve analysis were used to validate the discrimination, calibration, and clinical usefulness of the model. Results were evaluated by internal validation of the validation cohort. Results The overall satisfaction rate 1 year after TKA was 77.8%. The nomogram prediction model included the following risk factors: gender; primary diagnosis; postoperative residual pain; poor postoperative range of motion; wound healing; and the rate of change in the degree of coronal lower limb alignment (hip–knee–ankle angle, HKA).The ROC curves of the training and validation cohorts were 0.9206 (95% confidence interval [CI], 0.8785–0.9627) and 0.9662 (0.9231, 1.0000) (95% CI, 0.9231, 1.0000), respectively. The Hosmer–Lemeshow test showed good calibration of the nomogram (training cohort, p = 0.218; validation cohort, p = 0.103). Conclusion This study developed a prediction nomogram model based on partially modifiable risk factors for predicting dissatisfaction 1 year after TKA. This model demonstrated good discriminative capacity for identifying those at greatest risk for dissatisfaction and may help surgeons and patients identify and evaluate the risk factors for dissatisfaction and optimize TKA outcomes.
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Affiliation(s)
- Mieralimu Muertizha
- Department of Orthopedics, First Affiliated Hospital of Xinjiang Medical University, 137th South LiYuShan Road, Urumqi, 830054, Xinjiang, China
| | - XinTian Cai
- Xinjiang Medical University Urumqi, People's Republic of China, 137th South LiYuShan Road, Urumqi, Xinjiang, China
| | - Baochao Ji
- Department of Orthopedics, First Affiliated Hospital of Xinjiang Medical University, 137th South LiYuShan Road, Urumqi, 830054, Xinjiang, China
| | - Abudousaimi Aimaiti
- Department of Orthopedics, First Affiliated Hospital of Xinjiang Medical University, 137th South LiYuShan Road, Urumqi, 830054, Xinjiang, China
| | - Li Cao
- Department of Orthopedics, First Affiliated Hospital of Xinjiang Medical University, 137th South LiYuShan Road, Urumqi, 830054, Xinjiang, China.
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Fellows D, Hind J, Sidhu GAS, Amara VV, Ashwood N. How Do Orthopaedic Patients Prefer to Be Contacted During a Pandemic? Cureus 2022; 14:e25049. [PMID: 35719814 PMCID: PMC9200212 DOI: 10.7759/cureus.25049] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/16/2022] [Indexed: 11/12/2022] Open
Abstract
Introduction Communication with patients is a vital part of the surgical pathway, and when done effectively, it can greatly improve patient outcomes and patient satisfaction and reduce canceled appointments. Different forms of communication work well for different patient demographics, and it is important to optimize communication techniques. We designed a study to review the communication preferences of orthopedic patients during the COVID-19 pandemic. Methods A cross-sectional study was performed by asking patients who were due to undergo orthopedic procedures to answer a questionnaire on their communication preferences, the reminder notice period for appointments, and safety and satisfaction ratings during the COVID-19 pandemic. Results Communication method preferences are influenced by patient factors such as gender and age. Phone calls were the most popular communication method throughout all patient groups, with 61% selecting it as their preference. Younger patients preferred multiple communication methods of phone calls, texts, and emails, whereas the older group had a stronger preference for letters. Letters were more popular among females (28% compared to 10% of males), whereas males had a stronger preference for other communication methods. The majority of patients said they would not have liked a letter prior to their clinic appointment (65%). Of those who indicated a preferred notice period, 73% would have liked five days or less notice prior to their clinic appointment, while 65% would have liked 10-14 days notice prior to their surgery. The average safety rating was 55%. The overall satisfaction rating with the communication process was 71.7%. Conclusion The COVID-19 pandemic has changed patient feelings towards healthcare and, as a result, changed the way healthcare is delivered. Communication method preferences among trauma and orthopedic patients vary and depend on factors such as gender and age. If healthcare departments can optimize their communication processes, they will improve their patient outcomes and enhance their resources.
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Sun C, Zhao Z, Lee WG, Ma Q, Zhang X, Zhu J, Cai X. Sensor-guided gap balance versus manual gap balance in primary total knee arthroplasty: a meta-analysis. J Orthop Surg Res 2022; 17:243. [PMID: 35440065 PMCID: PMC9020069 DOI: 10.1186/s13018-022-03129-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/03/2022] [Accepted: 04/10/2022] [Indexed: 11/10/2022] Open
Abstract
Background Despite Vast improvements in technology and surgical technique in total knee arthroplasty (TKA), approximately 15–25% TKAs, have suboptimal subjective clinical outcomes. Our study sought to evaluate if sensor-guided balancing improves postoperative clinical outcomes compared to a conventional gap balancing technique. Methods We searched Web of Science, Embase, PubMed, Cochrane Controlled Trials Register, Cochrane Library, Highwire, CBM, CNKI, VIP, and Wanfang database in March 2022 to identify studies involving sensor-guided balancing versus conventional gap balancing technique in TKA. Finally, we identified 2147 knees assessed in nine studies. Results Compared with manual gap balancing, Sensor-guided gap balancing resulted in less rate of Manipulation under anesthesia (MUA) (P = 0.02), however more rate of intraoperative additional procedures (P = 0.0003). There were no significant differences in terms of KSS (P = 0.21), KSS Function score (P = 0.36), OKS (P = 0.61), KOOS (P = 0.78), operative time (P = 0.17), Mechanical axis (P = 0.69) and rate of reoperation between two groups. Conclusion Compared with conventional manual gap balancing techniques, sensors have more balancing procedures being performed. However, it did result in a reduction in the rate of MUA. More extensive, high-quality RCTs are required to verify our findings further.
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Affiliation(s)
- Changjiao Sun
- Department of Orthopedic, Beijing Tsinghua Changgung Hospital, School of Clinical Medicine, Tsinghua University, No. 168 Litang Road, Dongxiaokou Town, Changping District, Beijing, 102218, China.
| | - Zhe Zhao
- Department of Orthopedic, Beijing Tsinghua Changgung Hospital, School of Clinical Medicine, Tsinghua University, No. 168 Litang Road, Dongxiaokou Town, Changping District, Beijing, 102218, China
| | - Woo Guan Lee
- FRCS (Edinburgh), Kuching Specialist Hospital, Tabuan Stutong Commercial Centre, 93350, Kuching, Sarawak, Malaysia
| | - Qi Ma
- Department of Orthopedic, Beijing Tsinghua Changgung Hospital, School of Clinical Medicine, Tsinghua University, No. 168 Litang Road, Dongxiaokou Town, Changping District, Beijing, 102218, China
| | - Xiaofei Zhang
- Department of Orthopedic, Beijing Tsinghua Changgung Hospital, School of Clinical Medicine, Tsinghua University, No. 168 Litang Road, Dongxiaokou Town, Changping District, Beijing, 102218, China
| | - Jianjin Zhu
- Department of Orthopedic, Beijing Tsinghua Changgung Hospital, School of Clinical Medicine, Tsinghua University, No. 168 Litang Road, Dongxiaokou Town, Changping District, Beijing, 102218, China
| | - Xu Cai
- Department of Orthopedic, Beijing Tsinghua Changgung Hospital, School of Clinical Medicine, Tsinghua University, No. 168 Litang Road, Dongxiaokou Town, Changping District, Beijing, 102218, China.
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