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Silverberg ND, Iverson GL, Cogan A, Dams-O'Connor K, Delmonico R, Graf MJP, Iaccarino MA, Kajankova M, Kamins J, McCulloch KL, McKinney G, Nagele D, Panenka WJ, Rabinowitz AR, Reed N, Wethe JV, Whitehair V, Anderson V, Arciniegas DB, Bayley MT, Bazarian JJ, Bell KR, Broglio SP, Cifu D, Davis GA, Dvorak J, Echemendia RJ, Gioia GA, Giza CC, Hinds SR, Katz DI, Kurowski BG, Leddy JJ, Sage NL, Lumba-Brown A, Maas AIR, Manley GT, McCrea M, Menon DK, Ponsford J, Putukian M, Suskauer SJ, van der Naalt J, Walker WC, Yeates KO, Zafonte R, Zasler ND, Zemek R. The American Congress of Rehabilitation Medicine Diagnostic Criteria for Mild Traumatic Brain Injury. Arch Phys Med Rehabil 2023:S0003-9993(23)00297-6. [PMID: 37211140 DOI: 10.1016/j.apmr.2023.03.036] [Citation(s) in RCA: 29] [Impact Index Per Article: 29.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2022] [Revised: 03/13/2023] [Accepted: 03/16/2023] [Indexed: 05/23/2023]
Abstract
OBJECTIVE To develop new diagnostic criteria for mild traumatic brain injury (TBI) that are appropriate for use across the lifespan and in sports, civilian trauma, and military settings. DESIGN Rapid evidence reviews on 12 clinical questions and Delphi method for expert consensus. PARTICIPANTS The Mild Traumatic Brain Injury Task Force of the American Congress of Rehabilitation Medicine Brain Injury Special Interest Group convened a Working Group of 17 members and an external interdisciplinary expert panel of 32 clinician-scientists. Public stakeholder feedback was analyzed from 68 individuals and 23 organizations. RESULTS The first two Delphi votes asked the expert panel to rate their agreement with both the diagnostic criteria for mild TBI and the supporting evidence statements. In the first round, 10 of 12 evidence statements reached consensus agreement. Revised evidence statements underwent a second round of expert panel voting, where consensus was achieved for all. For the diagnostic criteria, the final agreement rate, after the third vote, was 90.7%. Public stakeholder feedback was incorporated into the diagnostic criteria revision prior to the third expert panel vote. A terminology question was added to the third round of Delphi voting, where 30 of 32 (93.8%) expert panel members agreed that 'the diagnostic label 'concussion' may be used interchangeably with 'mild TBI' when neuroimaging is normal or not clinically indicated.' CONCLUSIONS New diagnostic criteria for mild TBI were developed through an evidence review and expert consensus process. Having unified diagnostic criteria for mild TBI can improve the quality and consistency of mild TBI research and clinical care.
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Affiliation(s)
- Noah D Silverberg
- Department of Psychology, University of British Columbia; Vancouver Coastal Health Research Institute; Djavad Mowafaghian Centre for Brain Health, Vancouver, British Columbia, Canada; 2136 West Mall, Vancouver, British Columbia, Canada, V6T 1Z4.
| | - Grant L Iverson
- Department of Physical Medicine and Rehabilitation, Harvard Medical School; Spaulding Rehabilitation Hospital and the Schoen Adams Research Institute at Spaulding Rehabilitation; MassGeneral Hospital for Children Sports Concussion Program; & Home Base, A Red Sox Foundation and Massachusetts General Hospital Program, Boston, Massachusetts, USA; 79/96 Thirteenth Street, Charlestown Navy Yard, Charlestown, MA, 02129.
| | - Alison Cogan
- Center for the Study of Healthcare Innovation, Implementation & Policy; VA Greater Los Angeles Healthcare System; 11301 Wilshire Blvd, Los Angeles, CA 90073.
| | - Kristen Dams-O'Connor
- Department of Rehabilitation and Human Performance & Department of Neurology, Brain Injury Research Center of Mount Sinai, Box 1163, Icahn School of Medicine at Mount Sinai, New York, NY, USA 10029. kristen.dams-o'
| | - Richard Delmonico
- Kaiser Foundation Rehabilitation Center, The Permanente Medical Group, Kaiser Permanente, Northern California, 975 Sereno Drive, Vallejo, CA, USA 94589.
| | - Min Jeong P Graf
- Department of Physical Medicine and Rehabilitation, Hennepin Healthcare; Department of Rehabilitation Medicine, University of Minnesota, 701 Park Ave, Minneapolis, MN, USA 55415.
| | - Mary Alexis Iaccarino
- Department of Physical Medicine and Rehabilitation, Massachusetts General Hospital, Harvard Medical School, 300 1(st) Ave, Charlestown, MA, USA 02129; Department of Physical Medicine and Rehabilitation, Spaulding Rehabilitation Hospital, Harvard Medical School, 300 1(st) Ave, Charlestown, MA, USA 02129.
| | - Maria Kajankova
- Department of Rehabilitation and Human Performance, Brain Injury Research Center of Mount Sinai, Box 1163, Icahn School of Medicine at Mount Sinai, New York, NY, USA 10029.
| | - Joshua Kamins
- UCLA Steve Tisch BrainSPORT Program, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA, 300 Medical Plaza Ste B-200 Los Angeles, CA, USA 90095.
| | - Karen L McCulloch
- Division of Physical Therapy, Department of Health Sciences, School of Medicine, University of North Carolina at Chapel Hill, 3030 Bondurant Hall, CB# 7135, Chapel Hill, NC, USA 27599-7135.
| | - Gary McKinney
- Traumatic Brain Injury Center of Excellence, Defense Health Agency, 1335 East West Highway, Silver Spring, MD, USA 20910.
| | - Drew Nagele
- School of Professional and Applied Psychology, Philadelphia College of Osteopathic Medicine, 4170 City Ave, Philadelphia, PA, USA 19131.
| | - William J Panenka
- British Columbia Neuropsychiatry Program; Department of Psychiatry, University of British Columbia, 2255 Wesbrook Mall, UBC, Vancouver, BC, Canada, V6T2A1.
| | - Amanda R Rabinowitz
- Moss Rehabilitation Research Institute, 50 Township Line Rd., Elkins Park, PA, USA, 19027.
| | - Nick Reed
- Department of Occupational Science & Occupational Therapy, University of Toronto, 160-500 University Ave, Toronto, ON, Canada, M5G1V7.
| | - Jennifer V Wethe
- Mayo Clinic School of Medicine, 13400 E Shea Blvd, Scottsdale, AZ, USA 85259.
| | - Victoria Whitehair
- MetroHealth Rehabilitation Institute and Case Western Reserve University; 2500 MetroHealth Drive, Cleveland, OH, USA 44109.
| | - Vicki Anderson
- Murdoch Children's Research Institute; The Royal Children's Hospital, 50 Flemington Road, Parkville, Victoria 3052 Australia.
| | - David B Arciniegas
- University of New Mexico School of Medicine; University of Colorado School of Medicine; 1635 Aurora Ct, Aurora, CO, USA 80045.
| | - Mark T Bayley
- Toronto Rehabilitation Institute, University Health Network; University of Toronto; Room 3-102-12, 550 University Avenue, Toronto, Ontario, Canada, M5G2A2.
| | - Jeffrey J Bazarian
- University of Rochester School of Medicine and Dentistry; 265 Crittenden Blvd Box 655c, Rochester, NY, USA 14642.
| | - Kathleen R Bell
- University of Texas Southwestern Medical Center; 5323 Harry Hines Blvd, Dallas, TX, USA, 75390.
| | - Steven P Broglio
- University of Michigan, Michigan Concussion Center; 830 N University Ave., Ann Arbor, MI, USA 48109.
| | - David Cifu
- Department of Physical Medicine and Rehabilitation, Virginia Commonwealth University School of Medicine; U.S. Department of Veterans Affairs; 1223 East Marshall Street, Richmond, VA, USA 23298.
| | - Gavin A Davis
- Cabrini Health; Suite 53 - Neurosurgery, Cabrini Malvern, Victoria, 3144, Australia.
| | - Jiri Dvorak
- Schulthess Clinic, Department of Neurology, Swiss Concussion Center; Lengghalde 2, CH-8008, Switzerland.
| | - Ruben J Echemendia
- University Orthopedics Center, Concussion Care Clinic; University of Missouri-Kansas City, Kansas City, Missouri, USA. 107 Picadilly Rd., Port Matilda, PA, USA 16870.
| | - Gerard A Gioia
- Division of Neuropsychology/ SCORE Concussion Program, Children's National Hospital, George Washington University School of Medicine; 15245 Shady Grove Road #350, Rockville, MD, USA 20850.
| | - Christopher C Giza
- University of California at Los Angeles, Departments of Neurosurgery and Pediatrics, Steve Tisch BrainSPORT Program; Room 557 Wasserman, Department of Neurosurgery, 300 Stein Plaza, UCLA, Los Angeles, CA, USA 90095.
| | - Sidney R Hinds
- Uniformed Services University, Department of Neurology and Radiology, 4301 Jones Bridge Rd, Bethesda, MD 20814.
| | - Douglas I Katz
- Department of Neurology, Boston University School of Medicine; 72 E. Concord St. Robinson (B3), Boston University School of Medicine, Boston, MA, USA 02118.
| | - Brad G Kurowski
- Division of Pediatric Rehabilitation Medicine, Cincinnati Children's Hospital Medical Center, Departments of Pediatrics, Neurology, and Rehabilitation Medicine, University of Cincinnati College of Medicine; 3333 Burnet Avenue, MLC 4009, Cincinnati, OH, USA 45229.
| | - John J Leddy
- UBMD Department of Orthopaedics and Sports Medicine; SUNY Buffalo Jacobs School of Medicine and Biomedical Sciences; 160 Farber Hall, Buffalo, NY, USA 14214.
| | - Natalie Le Sage
- Population Health and Optimal Health Practices Axis, CHU de Québec-Université Laval Research Centre; VITAM-Centre de recherche en santé durable; 1401, 18e rue, Québec, Canada, G1J 1Z4.
| | - Angela Lumba-Brown
- Department of Emergency Medicine, Stanford University; 900 Welch Road, Stanford, CA, USA 94303.
| | - Andrew I R Maas
- Antwerp University Hospital, Edegem, and University of Antwerp; Drie Eikenstraat 655, 2650 Edegem, Belgium.
| | - Geoffrey T Manley
- Department of Neurosurgery, University of California, San Francisco; 1001 Potrero Ave, San Francisco, CA, USA 94110.
| | - Michael McCrea
- Medical College of Wisconsin; 8701 Watertown Plank Road, Milwaukee, WI, USA 53226.
| | - David K Menon
- University of Cambridge; Box 93, Addenbrooke's Hospital, Cambridge CB2 2QQ, UK.
| | - Jennie Ponsford
- Monash University; 18 Innovation Walk, Clayton campus, VIC 3800, Australia.
| | | | - Stacy J Suskauer
- Kennedy Krieger Institute and Department of Physical Medicine & Rehabilitation, Johns Hopkins University School of Medicine; 707 North Broadway, Baltimore, MD, USA 21205.
| | - Joukje van der Naalt
- Department of Neurology, University of Groningen, University Medical Center Groningen; Netherlands.
| | - William C Walker
- Virginia Commonwealth University; 1223 East Marshall Street, 4(th) Fl., Box 980677, Richmond, VA, USA 23298-0677.
| | - Keith Owen Yeates
- Department of Psychology, Alberta Children's Hospital Research Institute, and Hotchkiss Brain Institute, University of Calgary; 2500 University Dr NW, Calgary, AB T2N 1N4, Canada.
| | - Ross Zafonte
- Department of Physical Medicine and Rehabilitation Spaulding Rehabilitation Hospital/Massachusetts General Hospital/Brigham and Women's Hospital/Harvard Medical School; 300 First Avenue, Boston, MA, USA 02129.
| | - Nathan D Zasler
- Concussion Care Centre of Virginia, Ltd.; 3721 Westerre Parkway, Suite B, Henrico, VA, USA 23233.
| | - Roger Zemek
- Departments of Pediatrics and Emergency Medicine, University of Ottawa; Children's Hospital of Eastern Ontario; 401 Smyth Road, Ottawa, ON, Canada, K1H 8L1.
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Cogan A, Roberts P, Mallinson T. Using EHR Data to Examine Functional Recovery in Adults with Acquired Brain Injury. Arch Phys Med Rehabil 2023. [DOI: 10.1016/j.apmr.2022.12.178] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/05/2023]
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Weaver J, Cogan A, Bhandari P, Zainab BEA, Jacobs E, Pape A, Nguyen C, Guernon A, Harrod T, Bender Pape T, Mallinson T. Mapping outcomes for recovery of consciousness in studies from 1986 to 2020: a scoping review protocol. BMJ Open 2022; 12:e056538. [PMID: 35772816 PMCID: PMC9247663 DOI: 10.1136/bmjopen-2021-056538] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
Abstract
INTRODUCTION Historically, heterogeneous outcome assessments have been used to measure recovery of consciousness in patients with disorders of consciousness (DoC) following traumatic brain injury (TBI), making it difficult to compare across studies. To date, however, there is no comprehensive review of clinical outcome assessments that are used in intervention studies of adults with DoC. The objective of this scoping review is to develop a comprehensive inventory of clinical outcome assessments for recovery of consciousness that have been used in clinical studies of adults with DoC following TBI. METHODS AND ANALYSIS The methodological framework for this review is: (1) identify the research questions, (2) identify relevant studies, (3) select studies, (4) chart the data, (5) collate, summarise and report results and (6) consult stakeholders to drive knowledge translation. We will identify relevant studies by searching the following electronic bibliographic databases: PubMed, Scopus, EMBASE, PsycINFO and The Cochrane Library (including Cochrane Database of Systematic Reviews, Cochrane Central Register of Controlled Trials and Cochrane Methodology Register). Criteria for article inclusion are published in the English-language, peer-reviewed studies of interventions aimed at facilitating recovery of consciousness among adults (> 18 years) with DoC following a severe TBI, published from January 1986 to December 2020. Articles meeting inclusion criteria at this stage will undergo a full text review. We will chart the data by applying the WHO International Classification of Functioning, Disability and Health Framework to identify the content areas of clinical outcome assessments. To support knowledge translation efforts, we will involve clinicians and researchers experienced in TBI care throughout the project from conceptualisation of the study through dissemination of results. ETHICS AND DISSEMINATION No ethical approval is required for this study as it is not determined to be human subjects research. Results will be presented at national conferences and published in peer-reviewed journals. TRIAL REGISTRATION NUMBER CRD42017058383.
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Affiliation(s)
- Jennifer Weaver
- Department of Occupational Therapy, Colorado State University College of Health and Human Sciences, Fort Collins, Colorado, USA
- Department of Clinical Research and Leadership, The George Washington University School of Medicine and Health Sciences, Washington, District of Columbia, USA
| | - Alison Cogan
- Veterans Affairs Greater Los Angeles Healthcare System, Los Angeles, California, USA
| | - Parie Bhandari
- Department of Clinical Research and Leadership, The George Washington University School of Medicine and Health Sciences, Washington, District of Columbia, USA
| | - Bint-E Awan Zainab
- Department of Clinical Research and Leadership, The George Washington University School of Medicine and Health Sciences, Washington, District of Columbia, USA
| | - Erica Jacobs
- Department of Clinical Research and Leadership, The George Washington University School of Medicine and Health Sciences, Washington, District of Columbia, USA
| | - Ariana Pape
- Department of Clinical Research and Leadership, The George Washington University School of Medicine and Health Sciences, Washington, District of Columbia, USA
| | - Chantal Nguyen
- Department of Clinical Research and Leadership, The George Washington University School of Medicine and Health Sciences, Washington, District of Columbia, USA
| | - Ann Guernon
- Department of Speech Language Pathology, Lewis University - College of Nursing and Health Professions, Romeoville, Illinois, USA
- Center for Innovation in Complex Chronic Healthcare and Research Service, Hines Veterans Affairs Hospital, Hines, Illinois, USA
| | - Tom Harrod
- Department of Clinical Research and Leadership, The George Washington University School of Medicine and Health Sciences, Washington, District of Columbia, USA
| | - Theresa Bender Pape
- Center for Innovation in Complex Chronic Healthcare and Research Service, Hines Veterans Affairs Hospital, Hines, Illinois, USA
| | - Trudy Mallinson
- Department of Clinical Research and Leadership, The George Washington University School of Medicine and Health Sciences, Washington, District of Columbia, USA
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Weaver JA, Cogan A, O'Brien K, Hansen P, Giacino J, Whyte J, Bender Pape T, van der Wees P, Mallinson T. Determining the Hierarchy of Coma Recovery Scale-Revised Rating Scale Categories and Alignment with Aspen Consensus Criteria for Patients with Brain Injury: A Rasch Analysis. J Neurotrauma 2022; 39:1417-1428. [DOI: 10.1089/neu.2022.0095] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- Jennifer A Weaver
- Colorado State University, 3447, Occupational Therapy, 1573 Campus Delivery, Occupational Therapy Building, Fort Collins, Fort Collins, Colorado, United States, 80523-1019
| | - Alison Cogan
- VA Greater Los Angeles Healthcare System, 19975, Los Angeles, California, United States
| | - Katherine O'Brien
- Memorial Hermann Healthcare System, 23458, Houston, Texas, United States
| | - Piper Hansen
- University of Illinois Chicago College of Applied Health Sciences, 315410, Chicago, Illinois, United States
| | - Joseph Giacino
- Spaulding Rehabilitation Hospital, 24498, PM&R, 300 1st Ave, Charlestown, Massachusetts, United States, 02129-3109,
| | - John Whyte
- MossRehab/Einstein, Moss Rehabilitation Research Institute, 60 Township Line Rd., Elkins Park, Pennsylvania, United States, 19027
| | - Theresa Bender Pape
- Edward Hines Junior VA Hospital, 20013, Research and Development Services, Department of Veterans Affairs, 5000 S 5th Ave, Hines, Illinois, United States, 60141-1489
| | - Philip van der Wees
- Radboud University, 6029, Department of Rehabilitation and IQ healthcare, Nijmegen, Gelderland, Netherlands
| | - Trudy Mallinson
- The George Washington University School of Medicine and Health Sciences, 43989, Department of Clinical Research and Leadership, Washington, District of Columbia, United States
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Silverberg ND, Iverson GL, Arciniegas DB, Bayley MT, Bazarian JJ, Bell KR, Broglio SP, Cifu D, Davis GA, Dvorak J, Echemendia RJ, Gioia GA, Giza CC, Hinds SR, Katz DI, Kurowski BG, Leddy JJ, Le Sage N, Lumba-Brown A, Maas AI, Manley GT, McCrea M, McCrory P, Menon DK, Putukian M, Suskauer SJ, van der Naalt J, Walker WC, Yeates KO, Zafonte R, Zasler N, Zemek R, Brown J, Cogan A, Dams-O’Connor K, Delmonico R, Park Graf MJ, Iaccarino MA, Kajankova M, Kamins J, McCulloch KL, McKinney G, Nagele D, Panenka WJ, Rabinowitz AR, Reed N, Wethe JV, Whitehair V. Expert Panel Survey to Update the American Congress of Rehabilitation Medicine Definition of Mild Traumatic Brain Injury. Arch Phys Med Rehabil 2021; 102:76-86. [DOI: 10.1016/j.apmr.2020.08.022] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2020] [Revised: 08/08/2020] [Accepted: 08/15/2020] [Indexed: 12/20/2022]
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Cogan A. Using the Rehabilitation Treatment Specification System to Characterize Usual Care in a Military Concussion Care Clinic. Arch Phys Med Rehabil 2020. [DOI: 10.1016/j.apmr.2020.09.192] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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Weaver J, Maisano K, Cogan A, Mallinson T, Leeds S, Guernon A, Watters K, Nebel J, Pape TB. Rehabilitation Interventions to Facilitate Recovery of Consciousness Following a Traumatic Brain Injury: A Systematic Review. Am J Occup Ther 2020. [DOI: 10.5014/ajot.2020.74s1-po8733] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Abstract
Date Presented 03/28/20
We report rehabilitation interventions delivered to facilitate recovery of consciousness for patients with a traumatic brain injury. Interventions reported may prompt OT practitioners to seek advanced training in preparatory stimulation methods. The results of this review identify gaps in the literature, specifically the content of OT treatment.
Primary Author and Speaker: Jennifer Weaver
Additional Authors and Speakers: Kristen Maisano, Alison Cogan, Trudy Mallinson
Contributing Authors: Sophie Leeds, Ann Guernon, Kelsey Watters, Jennifer Nebel, Theresa Bender Pape
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Affiliation(s)
| | | | - Alison Cogan
- Washington DC VA Medical Center, Washington, DC, USA
| | | | - Sophie Leeds
- National Rehabilitation Hospital, Washington, DC, USA
| | - Ann Guernon
- Hines Veterans Administration Hospital, Hines, IL, USA
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Weaver J, Elgin E, Jones A, Guernon A, Cogan A, Mallinson T, Pape TB, Ehrlich-Jones L. Measurement Characteristics and Clinical Utility of the Disorders of Consciousness Scale Among Individuals With Brain Injury. Arch Phys Med Rehabil 2019. [DOI: 10.1016/j.apmr.2019.03.006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Carlson M, Vigen CL, Rubayi S, Blanche EI, Blanchard J, Atkins M, Bates-Jensen B, Garber SL, Pyatak EA, Diaz J, Florindez LI, Hay JW, Mallinson T, Unger JB, Azen SP, Scott M, Cogan A, Clark F. Lifestyle intervention for adults with spinal cord injury: Results of the USC-RLANRC Pressure Ulcer Prevention Study. J Spinal Cord Med 2019; 42:2-19. [PMID: 28414254 PMCID: PMC6340272 DOI: 10.1080/10790268.2017.1313931] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
Abstract
CONTEXT/OBJECTIVE Medically serious pressure injuries (MSPrIs), a common complication of spinal cord injury (SCI), have devastating consequences on health and well-being and are extremely expensive to treat. We aimed to test the efficacy of a lifestyle-based intervention designed to reduce incidence of MSPrIs in adults with SCI. DESIGN A randomized controlled trial (RCT), and a separate study wing involving a nonrandomized standard care control group. SETTING Rancho Los Amigos National Rehabilitation Center, a large facility serving ethnically diverse, low income residents of Los Angeles County. PARTICIPANTS Adults with SCI, with history of one or more MSPrIs over the past 5 years: N=166 for RCT component, N=66 in nonrandomized control group. INTERVENTIONS The Pressure Ulcer Prevention Program, a 12-month lifestyle-based treatment administered by healthcare professionals, largely via in-home visits and phone contacts. OUTCOME MEASURES Blinded assessments of annualized MSPrI incidence rates at 12 and 24 months, based on: skin checks, quarterly phone interviews with participants, and review of medical charts and billing records. Secondary outcomes included number of surgeries and various quality-of-life measures. RESULTS Annualized MSPrI rates did not differ significantly between study groups. At 12 months, rates were .56 for intervention recipients, .48 for randomized controls, and .65 for nonrandomized controls. At follow-up, rates were .44 and .39 respectively for randomized intervention and control participants. CONCLUSIONS Evidence for intervention efficacy was inconclusive. The intractable nature of MSPrI threat in high-risk SCI populations, and lack of statistical power, may have contributed to this inability to detect an effect. TRIAL REGISTRATION ClinicalTrials.gov NCT01999816.
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Affiliation(s)
- Mike Carlson
- Division of Occupational Science and Occupational Therapy, University of Southern California, Los Angeles, California, USA
| | - Cheryl L.P. Vigen
- Division of Occupational Science and Occupational Therapy, University of Southern California, Los Angeles, California, USA,Correspondence to: Cheryl L.P. Vigen, Division of Occupational Science and Occupational Therapy, University of Southern California, 1540 Alcazar St. CHP 133, Los Angeles, CA 90089–9003, USA.
| | - Salah Rubayi
- Rancho Los Amigos National Rehabilitation Center, Downey, California, USA
| | - Erna Imperatore Blanche
- Division of Occupational Science and Occupational Therapy, University of Southern California, Los Angeles, California, USA
| | - Jeanine Blanchard
- Division of Occupational Science and Occupational Therapy, University of Southern California, Los Angeles, California, USA
| | - Michal Atkins
- Rancho Los Amigos National Rehabilitation Center, Downey, California, USA
| | - Barbara Bates-Jensen
- School of Nursing, University of California Los Angeles, Los Angeles, California, USA
| | - Susan L Garber
- Department of Physical Medicine and Rehabilitation, Baylor College of Medicine, Houston, Texas, USA
| | - Elizabeth A Pyatak
- Division of Occupational Science and Occupational Therapy, University of Southern California, Los Angeles, California, USA
| | - Jesus Diaz
- Division of Occupational Science and Occupational Therapy, University of Southern California, Los Angeles, California, USA
| | - Lucia I Florindez
- Division of Occupational Science and Occupational Therapy, University of Southern California, Los Angeles, California, USA
| | - Joel W Hay
- Leonard Schaeffer Center for Health Policy and Economics, University of Southern California, Los Angeles, California, USA
| | - Trudy Mallinson
- Division of Occupational Science and Occupational Therapy, University of Southern California, Los Angeles, California, USA
| | - Jennifer B Unger
- Institute for Health Promotion & Disease Prevention Research, University of Southern California, Los Angeles, California, USA
| | - Stanley Paul Azen
- Division of Biostatistics, Department of Preventive Medicine, University of Southern California, Los Angeles, California, USA
| | - Michael Scott
- Rancho Los Amigos National Rehabilitation Center, Downey, California, USA
| | - Alison Cogan
- Division of Occupational Science and Occupational Therapy, University of Southern California, Los Angeles, California, USA
| | - Florence Clark
- Division of Occupational Science and Occupational Therapy, University of Southern California, Los Angeles, California, USA
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Cogan A. Treatment Model of Occupational Therapy Intervention for Service Members With Chronic Symptoms Following Mild Traumatic Brain Injury. Am J Occup Ther 2018. [DOI: 10.5014/ajot.2018.72s1-rp103a] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Abstract
Date Presented 4/19/2018
This study used intervention mapping methodology to describe current practice for military service members with mild traumatic brain injury and persistent symptoms. The results serve as a foundation for future research and intervention development for this underexplored area of practice.
Primary Author and Speaker: Alison Cogan
Contributing Authors: Paul Sargent, Maria D. Devore
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Cogan A, Cervelli L, Dillahunt-Aspillaga T, Rossiter AG. Treating Military Service Members and Veterans in the Private Sector: Information and Resources for Clinicians. Arch Phys Med Rehabil 2018; 99:2659-2661. [PMID: 30473021 DOI: 10.1016/j.apmr.2018.06.006] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2018] [Accepted: 06/15/2018] [Indexed: 11/28/2022]
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Cogan A. Treatment Model of Occupational Therapy Intervention for Service Members with Chronic Symptoms Following mTBI. Arch Phys Med Rehabil 2017. [DOI: 10.1016/j.apmr.2017.08.429] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Cogan A, Devore M, Haines C, Lepore K, Ryan M. “Ready to Be a Normal Person Again”: Occupational Needs of Service Members With Mild Traumatic Brain Injury. Am J Occup Ther 2017. [DOI: 10.5014/ajot.2017.71s1-rp303c] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Abstract
Date Presented 4/1/2017
The purpose of this study is to describe the occupational challenges in daily life faced by active duty military service members who experience persistent symptoms following mild traumatic brain injury. The findings establish needs that fall within each aspect of the occupational therapy domain of practice.
Primary Author and Speaker: Alison Cogan
Contributing Authors: Maria Devore, Christine Haines, Karla Lepore, Margaret Ryan
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Cogan A, Devore M, Haines C, Lepore K, Ryan M. Challenges of Military Service Members with Persistent Symptoms Following Mild Traumatic Brain Injury. Arch Phys Med Rehabil 2016. [DOI: 10.1016/j.apmr.2016.08.071] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Cogan A, Blanchard J, Garber SL. Systematic Review of Behavioral Interventions to Prevent Pressure Ulcers in Adults with Spinal Cord Injury. Arch Phys Med Rehabil 2016. [DOI: 10.1016/j.apmr.2016.08.438] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Sleight A, Hill V, Cogan A, Pyatak E, Diaz J, Diaz J, Clark F. Factors Protecting Against Medically Serious Pressure Ulcers in Adults with Spinal Cord Injury: A Qualitative Study. Arch Phys Med Rehabil 2016. [DOI: 10.1016/j.apmr.2016.08.111] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Florindez L, Clark F, Carlson M, Pyatak E, Sleight A, Diaz J, Hill V, Cogan A. Pressure Ulcer Development in the Context of A Lifestlye-Based Intervention. Arch Phys Med Rehabil 2016. [DOI: 10.1016/j.apmr.2016.08.132] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Abstract
A 17-year old boy with a history of a right femoral shaft
fracture, fixed with a reamed intramedullary nail four years
earlier, presented with a 15° genu recurvatum deformity,
presumably due to premature closure of the anterior
proximal tibial physeal plate following a Salter type V injury.
He was treated with a supra-tubercular anterior opening
wedge osteotomy, fixed with two Puddu plates and grafted
with bone matrix substitute. The patient went on to unite
without complication, but came back to clinic six years later
with anterior knee pain and patella infera. The paper
discusses genu recurvatum after growth plate arrest and the
various techniques to address the problem. Moving the tibial
tubercle by including it in the osteotomy should be
considered to avoid the complication of patella infera.
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Affiliation(s)
- A Cogan
- Department of Orthopaedics and Trauma, Norfolk and Norwich University Hospital, Norwich, United Kingdom
| | - St Donell
- Department of Orthopaedics and Trauma, Norfolk and Norwich University Hospital, Norwich, United Kingdom
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Bel JC, Court C, Cogan A, Chantelot C, Piétu G, Vandenbussche E. Unicondylar fractures of the distal femur. Orthop Traumatol Surg Res 2014; 100:873-7. [PMID: 25453913 DOI: 10.1016/j.otsr.2014.10.005] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/28/2014] [Accepted: 08/30/2014] [Indexed: 02/02/2023]
Abstract
BACKGROUND Unicondylar fractures of the distal femur are rare, complex, intra-articular fractures. The objective of this multicentre study was to assess the reduction and fixation of unicondylar fractures. HYPOTHESIS Anatomic reduction followed by strong fixation allows early rehabilitation therapy and provides good long-term outcomes. MATERIAL AND METHODS We studied 163 fractures included in two multicentre studies, of which one was retrospective (n=134) and the other prospective (n=29). Follow-up of at least 1 year was required for inclusion. The treatment was at the discretion of the surgeon. Outcome measures were the clinical results assessed using the International Knee Society (IKS) scores and presence after fracture healing of malunion with angulation, an articular surface step-off, and/or tibio-femoral malalignment. RESULTS Mean age of the study patients was 50.9 ± 24 years, and most patients were males with no previous history of knee disorders. The fracture was due to a high-energy trauma in 51% of cases; 17% of patients had compound fractures and 44% multiple fractures or injuries. The lateral and medial condyles were equally affected. The fracture line was sagittal in 82% of cases and coronal (Hoffa fracture) in 18% of cases. Non-operative treatment was used in 5% of cases and internal fixation in 95% of cases, with either direct screw or buttress-plate fixation for the sagittal fractures and either direct or indirect screw fixation for the coronal fractures. After treatment of the fracture, 15% of patients had articular malunion due to insufficient reduction, with either valgus-varus (10%) or flexion-recurvatum (5%) deformity; and 12% of patients had an articular step-off visible on the antero-posterior or lateral radiograph. Rehabilitation therapy was started immediately in 65% of patients. Time to full weight bearing was 90 days and time to fracture healing 120 days. Complications consisted of disassembly of the construct (2%), avascular necrosis of the condyle (2%), and arthrolysis (5%). The material was removed in 11% of patients. At last follow-up, the IKS knee score was 71 ± 20 and the IKS function score 64 ± 7; flexion range was 106 ± 28° (<90° in 27% of patients); and 12% of patients had knee osteoarthritis. CONCLUSION Anatomic reduction of unicondylar distal femoral fractures via an appropriate surgical approach, followed by stable internal fixation using either multiple large-diameter screws or a buttress-plate, allows immediate mobilisation, which in turn ensures good long-term outcomes. LEVEL OF EVIDENCE IV, cohort study.
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Affiliation(s)
- J-C Bel
- Service de chirurgie orthopédique et traumatologique, université Claude-Bernard, hôpital Édouard-Herriot - Pavillon T, 5, place D'Arsonval, 69003 Lyon, France.
| | - C Court
- Service de chirurgie orthopédique et traumatologique, hôpital CHU Bicêtre, 78, rue du Général-Leclerc, 94275 Le-Kremlin-Bicêtre, France
| | - A Cogan
- Service de chirurgie orthopédique et traumatologique, université Claude-Bernard, hôpital Édouard-Herriot - Pavillon T, 5, place D'Arsonval, 69003 Lyon, France
| | - C Chantelot
- Service de chirurgie orthopédique B, hôpital Roger-Salengro, CHU de Lille, 2, avenue Oscar-Lambret, 59037 Lille cedex, France
| | - G Piétu
- Service de chirurgie orthopédique et traumatologique, CHU de Nantes, 1, place Alexis-Ricordeau, 44000 Nantes, France
| | - E Vandenbussche
- Service de chirurgie orthopédique et traumatologique, université René-Descartes, hôpital européen Georges-Pompidou, 20, rue Leblanc, 75015 Paris, France
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- Société française de chirurgie orthopédique et traumatologique, 56, rue Boissonnade, 75014 Paris, France
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Mazel C, Owona P, Cogan A, Balabaud L, Grunenwald D. Long-term quality of life after en-bloc vertebrectomy: 25 patients followed up for 9 years. Orthop Traumatol Surg Res 2014; 100:119-26. [PMID: 24394919 DOI: 10.1016/j.otsr.2013.09.008] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/12/2012] [Revised: 09/10/2013] [Accepted: 09/27/2013] [Indexed: 02/02/2023]
Abstract
OBJECTIVE Assess quality-of-life results in patients who have undergone extensive curative surgery for spinal tumor and compare them to the general population in France. INTRODUCTION Life expectancy is not the only criterion to assess the outcomes after massive tumor resections. Residual quality of life is also crucial. An indication for major surgery for spinal tumor should take the patient's long-term functional status into account, but the literature is limited on this question. MATERIALS AND METHODS Twenty-five living patients from a group of 120 operated were assessed, all of whom were operated on by the same surgeon between 1984 and 2007. The mean follow-up was 9 years (range, 3-25 years). The mean age at surgery was 49 years. The patients completed different functional and quality-of-life questionnaires: the Oswestry Disability Index version 2 (ODI), the PROLO, the Karnofsky Index of performance status (KI), the Eastern Cooperative Oncology Group performance status (ECOG), the Short Form-36 Health Survey (SF-36), and the EuroQol-5 Dimensions (EQ5D). In addition, each patient was clinically and radiographically evaluated. Subgroups were identified considering the number of levels resected and histology. Their results on the SF-36 were compared with the results from the general population in France. RESULTS The mean PCS (physical component summary of the SF-36) was 52.4, the MCS (mental component summary, the psychological component of the SF-36) was 47.7, the ODI was 18.2, the PROLO was 7, the ECOG was 1, and the KI was 80%. The resections at three levels were associated with worse results in terms of quality of life, but overall, the results were similar to the French general population data for all categories of the SF-36. CONCLUSION Appropriate indications for massive spinal resection give good oncological and functional results. Although the expected life expectancy justifies this aggressive surgery, postoperative quality of life shows that it can also be successful on a functional level. LEVEL OF EVIDENCE Level IV; retrospective clinical study.
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Affiliation(s)
- C Mazel
- Service de chirurgie orthopédique et traumatologique, institut mutualiste Montsouris, 42, boulevard Jourdan, 75014 Paris, France; Paris XIII, Sorbonne-Paris-Cité, 99, avenue Jean-Baptiste-Clément, 93430 Villetaneuse, France.
| | - P Owona
- Service de chirurgie orthopédique et traumatologique, institut mutualiste Montsouris, 42, boulevard Jourdan, 75014 Paris, France
| | - A Cogan
- Service de chirurgie orthopédique et traumatologique, institut mutualiste Montsouris, 42, boulevard Jourdan, 75014 Paris, France
| | - L Balabaud
- Service de chirurgie orthopédique et traumatologique, institut mutualiste Montsouris, 42, boulevard Jourdan, 75014 Paris, France
| | - D Grunenwald
- Service de chirurgie thoracique, groupement hospitalier universitaire Est, AP-HP Tenon, 4, rue de la Chine, 75020 Paris, France
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Cogan A, Klouche S, Mamoudy P, Sariali E. Total hip arthroplasty dislocation rate following isolated cup revision using Hueter's direct anterior approach on a fracture table. Orthop Traumatol Surg Res 2011; 97:501-5. [PMID: 21782540 DOI: 10.1016/j.otsr.2011.04.005] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/25/2010] [Revised: 04/04/2011] [Accepted: 04/29/2011] [Indexed: 02/06/2023]
Abstract
INTRODUCTION Instability is a major complication after revision total hip arthroplasty. Studies in the literature have shown that the dislocation rate after primary arthroplasties by anterior approach on a fracture table is satisfactory, but the rate of instability following revision surgery is not known. HYPOTHESIS AND AIMS We hypothesized that the Hueter direct anterior approach would result in a lower rate of postoperative dislocation following revision surgery. This hypothesis was tested in a series of isolated acetabular component replacements. PATIENTS AND METHODS Seventy-three consecutive isolated acetabular component replacements were performed between January 2000 and December 2007. Twelve revisions using constrained liners or dual mobility cups were excluded, thus 61 revisions in 59 patients, mean age 65.8-year-old (range 27-86) were included. The indications for revision arthroplasty were: 51 (83.6%) cases of aseptic loosening, five (8.2%) non-integration of cementless cups, three (4.9%) cases of instability, one (1.6%) case of impingement with the psoas and one (1.6%) case of excessive (3cm) lengthening. Acetabular bone defects were moderate, with 12 stage I, 26 stage II, 19 stage III, and only four stage IV defects on the SOFCOT bone stock deficiency score. There was no acetabular reconstruction in 18 cases, while there were four isolated reconstruction cages and 39 cages with a graft. The replacement cup was cemented in 52 cases and cementless in nine. Inclination and anteversion were measured by the Pradhan method on standard X-rays. RESULTS Results were evaluated after a mean follow-up of 2.4 years±1.7 years (1-7 years). Four dislocations were observed (6.6%) all anterior and early in the postoperative period (less than 2 months): three patients had a single episode of dislocation and one patient again underwent revision cup replacement by Hueter anterior approach for recurrent anterior dislocation. The only factor associated with a risk of dislocation was a high body mass index: 29.7±0.8 in the group with dislocation compared to 25.6±3.2 in the group without (P=0.008). A high number of prior interventions was also a significant risk factor (P=0.045). On the other hand, there was no difference in cup inclination or femoral offset between the group with dislocation and that without. DISCUSSION Although the rate of dislocation is higher than after primary THA by anterior approach, it remains acceptable for revision THA and is similar to rates observed with other approaches. The literature does not clearly establish that one surgical approach is better than another in terms of instability. This study was limited by the absence of CT-scan measurements of component orientation both preoperatively to evaluate the femoral component which is preserved, as well as during follow-up to evaluate cup angle and compare the groups with and without dislocation. CONCLUSION The Hueter direct anterior approach is a viable option for isolated cup revision, as long as femoral loosening has been excluded, and the orientation of the preserved femoral component is known. LEVEL OF EVIDENCE Level IV; retrospective study.
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Affiliation(s)
- A Cogan
- Diaconesses and Croix Saint-Simon Hospitals Group, Department of bone surgery and Traumatology, 125, rue d'Avron, 75020 Paris, France.
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Cogan A, Boyer P, Soubeyrand M, Hamida FB, Vannier JL, Massin P. Cranial nerves neuropraxia after shoulder arthroscopy in beach chair position. Orthop Traumatol Surg Res 2011; 97:345-8. [PMID: 21459065 DOI: 10.1016/j.otsr.2010.09.020] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/22/2009] [Revised: 08/31/2010] [Accepted: 09/20/2010] [Indexed: 02/02/2023]
Abstract
We report a case of neuropraxia of the 9th, 10th and 12th cranial nerve pairs after arthroscopic rotator cuff repair in the beach chair position. The elements in the medical file seem to exclude an intracranial cause of the lesions and support a mechanical, extracranial cause due to intubation and/or the beach chair position. This clinical case report shows the neurological risks of the beach chair position during arthroscopic shoulder surgery and presents the essential safety measures to prevent these risks.
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Affiliation(s)
- A Cogan
- Department of Orthopaedic Surgery, Bichat Claude Bernard Teaching Hospital Center, Paris-7 University, 46, avenue Henri-Huchard, 75018 Paris, France.
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Cogan A, Nizard R, Sedel L. Occurrence of noise in alumina-on-alumina total hip arthroplasty. A survey on 284 consecutive hips. Orthop Traumatol Surg Res 2011; 97:206-10. [PMID: 21388904 DOI: 10.1016/j.otsr.2010.11.008] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/30/2010] [Revised: 11/14/2010] [Accepted: 11/30/2010] [Indexed: 02/02/2023]
Abstract
BACKGROUND Alumina-on-alumina bearings have been accepted as a valuable alternative for young and active patients. Alumina fractures, and socket loosening were the main complications reported. But, with the increasing number of prostheses implanted, noise occurrence appeared as a new concern. The primary aim of the present study was to quantify the prevalence of noticing noise in a population having received alumina-on-alumina total hip arthroplasty as well as its eventual impact on outcome. PATIENTS AND METHODS Two hundred and eighty-four ceramic-on-ceramic hips were performed in 238 patients from January 2003 to December 2004. The average age was 52.4 ± 13.4 years (range, 13 to 74 years). All the hips received the same prosthesis (Ceraver-Osteal™) with alumina bearing components (Ceraver-Osteal™): 32 mm liners were used for cups of 50mm or larger and 28 mm liners for cups smaller than 48 mm; the minimal alumina thickness was 6mm. The acetabular component (Cerafit™) was hemispherical, coated with a hydroxyapatite layer and press-fit fixed. The stem (Cerafit™) was a straight tapered cementless stem, fully coated with a hydroxyapatite layer. Clearance between femoral head and liner was between 20 and 50 microns. A retrospective survey was conducted by an independent surgeon who did not participate to surgery in 2007. He conducted phone interviews of patients using a standard questionnaire. No suggestion was offered on how they could describe the noise and they felt free to use the word that they considered to be the most adapted. Satisfaction was evaluated. When the noise was present, X-rays were taken to assess if sign of bearings fracture was present. RESULTS Four patients (six hips) died of unrelated causes during the follow-up period. Three patients (three hips) live outside France and could not be followed (1.3%). Nine patients (10 hips) could not be traced and were considered lost to follow-up (3.8%). Two hundred and twenty-two patients with 265 hips, therefore, were included (nine using bearing components in 28 mm diameter and 265 in 32 mm). Twenty-eight hips experienced noise generation (10.6%). It was defined as a snap for six patients, as a cracking sound by six, as rustling by six patients, as a squeaking by seven patients (2.6%), a tinkling by two patients, one patient was unable to define the sound she felt. No factor related to the patient influenced the occurrence of noise. Twelve patients were dissatisfied with the result of their hip prosthesis, five of them experienced noise (41.7%); 210 were satisfied or very satisfied, 23 of them experiencing noise (11%); this difference was significant (P=0.002). CONCLUSION The origins of noise occurrence are unknown. Squeaking may be related to generation of stripe wear and absence of sufficient lubrication. Other types of noise can be due to microseparation, occult dislocation, impingement between the femoral neck and the acetabular rim. LEVEL OF EVIDENCE Level IV. Retrospective study.
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Affiliation(s)
- A Cogan
- Department of Orthopaedics and Traumatology, Lariboisière Hospital, 2, rue Ambroise-Paré, 75010 Paris, France.
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Reignault PH, Cogan A, Muchembled J, Lounes-Hadj Sahraoui A, Durand R, Sancholle M. Trehalose induces resistance to powdery mildew in wheat. New Phytol 2001; 149:519-529. [PMID: 33873340 DOI: 10.1046/j.1469-8137.2001.00035.x] [Citation(s) in RCA: 55] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
• Reduction in the degree of powdery mildew infection of wheat leaves is observed after treatments with trehalose, a nonreducing disaccharide commonly found in a wide variety of organisms, including fungi. • Wheat (Triticum aestivum) cv. Sideral plants grown in phytotrons were inoculated with Blumeria graminis f.sp. tritici. In addition to degree of infection, the effect of trehalose solution was further investigated using light and fluorescence microscopy and enzyme assays. • Infection in wheat leaves was reduced by 50 and 95% with trehalose solution (15 g l-1 ) following a single spraying and three sprayings, respectively; in a detached leaf assay, trehalose was effective at concentrations as low as 0.01 g l-1 . Trehalose did not inhibit conidial germination and differentiation of appressoria (in vitro or on the leaf epidermis), but enhanced papilla deposition in epidermal cells. Trehalose also enhanced phenylalanine ammonia-lyase (PAL) and peroxidase (PO) activities; both markers of plant defence responses. However, the level of three cinnamyl alcohol dehydrogenase (CAD) activities (conyferyl, p-coumaryl and sinapyl alcohol dehydrogenase) was unchanged. • Trehalose treatment of wheat confers resistance to B. graminis infection by activating plant defence responses (e.g. papilla deposition, PAL and PO activities).
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Affiliation(s)
- P H Reignault
- Mycologie-Phytopathologie-Environnement, Université du Littoral Côte d'Opale, 17 avenue Louis Blériot, BP 699, F-62228 Calais cedex, France
| | - A Cogan
- Mycologie-Phytopathologie-Environnement, Université du Littoral Côte d'Opale, 17 avenue Louis Blériot, BP 699, F-62228 Calais cedex, France
| | - J Muchembled
- Mycologie-Phytopathologie-Environnement, Université du Littoral Côte d'Opale, 17 avenue Louis Blériot, BP 699, F-62228 Calais cedex, France
| | - A Lounes-Hadj Sahraoui
- Mycologie-Phytopathologie-Environnement, Université du Littoral Côte d'Opale, 17 avenue Louis Blériot, BP 699, F-62228 Calais cedex, France
| | - R Durand
- Mycologie-Phytopathologie-Environnement, Université du Littoral Côte d'Opale, 17 avenue Louis Blériot, BP 699, F-62228 Calais cedex, France
| | - M Sancholle
- Mycologie-Phytopathologie-Environnement, Université du Littoral Côte d'Opale, 17 avenue Louis Blériot, BP 699, F-62228 Calais cedex, France
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