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Di Gennaro D, Coletta G, Festa E, De Mauro D, Rizzo M, Diana L, Balato G, Mariconda M. The Effect of Spacer Treatment of Infected Hip and Knee Arthroplasties on Patients' Mental Health: A Narrative Review of the Literature. Healthcare (Basel) 2024; 12:790. [PMID: 38610212 PMCID: PMC11011799 DOI: 10.3390/healthcare12070790] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2024] [Revised: 04/01/2024] [Accepted: 04/03/2024] [Indexed: 04/14/2024] Open
Abstract
BACKGROUND The gold standard treatment for periprosthetic joint infections is the two-stage revision that includes the spacer placement before definitive reimplantation. The management of PJI affects patients' joint function and, subsequently, their mental health. Even though significant advances have been achieved, little to no attention has been paid to the psychological implications. So, based on standardized patient-reported outcome measures (PROMs), this study aimed to clarify the effect of spacer treatment of infected hip and knee arthroplasties on patients' mental health. METHODS We performed research on the literature on PJIs in the English language using the MEDLINE database with the search strings "spacer" OR "spacers" AND "hip" OR "knee" AND "SF-12" OR "SF-36" OR "EQ-5" OR "mental" OR "depression" OR "anxiety." The reference lists of selected articles were also hand-searched for any additional articles. RESULTS A total of 973 published papers were extracted, and 9 papers were finally included. A total of 384 patients who underwent spacer placement for PJI were identified. Of these 384 patients, 54% were female. The mean age ranged from 62 to 78.2 years. Of the11 papers identified for this review, 4 analyzed only hip spacers, including 119 patients; 4 only knee spacers, evaluating 153 patients; while a single study included 112 patients for both joints. CONCLUSIONS Patients with the spacer are living in a state of mental upset, albeit better than the preoperative state. Clinical improvement with the review is not assured. The alteration of mental state turns out not to be transient for all the patients.
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Affiliation(s)
- Donato Di Gennaro
- Orthopedic Unit, Department of Public Health, “Federico II” University, 80131 Naples, Italy; (D.D.G.); (G.C.); (E.F.); (M.R.); (L.D.); (M.M.)
| | - Giannantonio Coletta
- Orthopedic Unit, Department of Public Health, “Federico II” University, 80131 Naples, Italy; (D.D.G.); (G.C.); (E.F.); (M.R.); (L.D.); (M.M.)
| | - Enrico Festa
- Orthopedic Unit, Department of Public Health, “Federico II” University, 80131 Naples, Italy; (D.D.G.); (G.C.); (E.F.); (M.R.); (L.D.); (M.M.)
| | - Domenico De Mauro
- Department of Orthopedics and Geriatric Sciences, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy;
| | - Maria Rizzo
- Orthopedic Unit, Department of Public Health, “Federico II” University, 80131 Naples, Italy; (D.D.G.); (G.C.); (E.F.); (M.R.); (L.D.); (M.M.)
| | - Luca Diana
- Orthopedic Unit, Department of Public Health, “Federico II” University, 80131 Naples, Italy; (D.D.G.); (G.C.); (E.F.); (M.R.); (L.D.); (M.M.)
| | - Giovanni Balato
- Orthopedic Unit, Department of Public Health, “Federico II” University, 80131 Naples, Italy; (D.D.G.); (G.C.); (E.F.); (M.R.); (L.D.); (M.M.)
| | - Massimo Mariconda
- Orthopedic Unit, Department of Public Health, “Federico II” University, 80131 Naples, Italy; (D.D.G.); (G.C.); (E.F.); (M.R.); (L.D.); (M.M.)
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Conway JD, Annasamudram A, Abalkhail T, Tom JH, Farley RP, Gesheff M, Elhessy AH. Functional Outcomes of Knee Arthrodesis for Infected Total Knee Arthroplasty. Cureus 2023; 15:e46397. [PMID: 37927635 PMCID: PMC10620752 DOI: 10.7759/cureus.46397] [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] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/02/2023] [Indexed: 11/07/2023] Open
Abstract
INTRODUCTION As the occurrence of total knee arthroplasties (TKAs) is forecasted to continue rising, so too will the frequency of prosthetic joint infections (PJIs) and revision TKAs. Multiple revisions can result in an unreconstructible knee. In such instances, the knee may be salvaged through arthrodesis. We evaluated whether height, BMI, and age impacted patient-reported outcome measures (PROMs) in patients who underwent knee arthrodesis after revision TKA due to PJI. METHODS We conducted a retrospective review of patients undergoing arthrodesis for an infected TKA at a dedicated orthopedic infection service from 2014 to 2022. Patient demographics and PROMs from 36-Item Short Form Survey (SF-36) and Knee Injury and Osteoarthritis Outcome Score (KOOS) questionnaires were collected. Correlation analysis was performed to determine if any association between height, BMI, and age was present with the various PROMs and sub-scores. RESULTS Forty-four patients (19 males, 25 females) were included, with a mean follow-up of 48 months. Increases in height (>166 cm), BMI (>30), and age (>62 years) had a statistically significant negative impact on three SF-36 components: health changes (P = 0.016), physical functioning ability (P = 0.0096), and general health components (P = 0.0075). CONCLUSION Our results suggest that a knee arthrodesis is an acceptable option in patients with a persistent knee PJI with good functional PROMs and ambulatory status. Patients with shorter height, lower BMI, and younger age showed overall better outcomes. Knee arthrodesis can be an alternative option for amputation in patients with an infected TKA and provide good functional outcomes in selected patients.
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Affiliation(s)
- Janet D Conway
- Orthopedics, International Center for Limb Lengthening, Rubin Institute of Advanced Orthopedics, Baltimore, USA
| | - Abhijith Annasamudram
- Orthopedics, International Center for Limb Lengthening, Rubin Institute of Advanced Orthopedics, Baltimore, USA
| | - Talal Abalkhail
- Orthopaedics, King Faisal Specialist Hospital and Research Centre, Riyadh, SAU
| | - Jalen H Tom
- Orthopedic Surgery, University of Maryland, College Park, USA
| | | | - Martin Gesheff
- Orthopedics, International Center for Limb Lengthening, Rubin Institute of Advanced Orthopedics, Baltimore, USA
| | - Ahmed H Elhessy
- Medicine, University of Maryland School of Medicine, Baltimore, USA
- Orthopedics, International Center for Limb Lengthening, Rubin Institute of Advanced Orthopedics, Baltimore, USA
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Ahmed S, Barbera L, Bartlett SJ, Bebb DG, Brundage M, Bryan S, Cheung WY, Coburn N, Crump T, Cuthbertson L, Howell D, Klassen AF, Leduc S, Li M, Mayo NE, McKinnon G, Olson R, Pink J, Robinson JW, Santana MJ, Sawatzky R, Moxam RS, Sinclair S, Servidio-Italiano F, Temple W. A catalyst for transforming health systems and person-centred care: Canadian national position statement on patient-reported outcomes. Curr Oncol 2020; 27:90-99. [PMID: 32489251 PMCID: PMC7253746 DOI: 10.3747/co.27.6399] [Citation(s) in RCA: 6] [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] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
Background Patient-reported outcomes (pros) are essential to capture the patient's perspective and to influence care. Although pros and pro measures are known to have many important benefits, they are not consistently being used and there is there no Canadian pros oversight. The Position Statement presented here is the first step toward supporting the implementation of pros in the Canadian health care setting. Methods The Canadian pros National Steering Committee drafted position statements, which were submitted for stakeholder feedback before, during, and after the first National Canadian Patient Reported Outcomes (canpros) scientific conference, 14-15 November 2019 in Calgary, Alberta. In addition to the stakeholder feedback cycle, a patient advocate group submitted a section to capture the patient voice. Results The canpros Position Statement is an outcome of the 2019 canpros scientific conference, with an oncology focus. The Position Statement is categorized into 6 sections covering 4 theme areas: Patient and Families, Health Policy, Clinical Implementation, and Research. The patient voice perfectly mirrors the recommendations that the experts reached by consensus and provides an overriding impetus for the use of pros in health care. Conclusions Although our vision of pros transforming the health care system to be more patient-centred is still aspirational, the Position Statement presented here takes a first step toward providing recommendations in key areas to align Canadian efforts. The Position Statement is directed toward a health policy audience; future iterations will target other audiences, including researchers, clinicians, and patients. Our intent is that future versions will broaden the focus to include chronic diseases beyond cancer.
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Affiliation(s)
- S Ahmed
- Quebec: Department of Medicine School of Physical and Occupational Therapy, McGill University, Montreal (Ahmed, Mayo); Faculty of Medicine, McGill University, and McGill University Health Systems, Montreal (Bartlett)
| | - L Barbera
- Alberta: Department of Oncology, University of Calgary, Calgary (Barbera, Bebb, Cheung); University of Calgary, Calgary (Crump, Temple); Departments of Surgery and Oncology, University of Calgary, Calgary (McKinnon); Department of Oncology, Cumming School of Medicine, University of Calgary, Calgary (Pink, Santana); University of Calgary and Tom Baker Cancer Centre, Calgary (Robinson); Faculty of Nursing, University of Calgary, Calgary (Sinclair)
| | - S J Bartlett
- Quebec: Department of Medicine School of Physical and Occupational Therapy, McGill University, Montreal (Ahmed, Mayo); Faculty of Medicine, McGill University, and McGill University Health Systems, Montreal (Bartlett)
| | - D G Bebb
- Alberta: Department of Oncology, University of Calgary, Calgary (Barbera, Bebb, Cheung); University of Calgary, Calgary (Crump, Temple); Departments of Surgery and Oncology, University of Calgary, Calgary (McKinnon); Department of Oncology, Cumming School of Medicine, University of Calgary, Calgary (Pink, Santana); University of Calgary and Tom Baker Cancer Centre, Calgary (Robinson); Faculty of Nursing, University of Calgary, Calgary (Sinclair)
| | - M Brundage
- Ontario: Queen's Cancer Research Institute, Kingston (Brundage); Sunnybrook Health Sciences Centre, Toronto (Coburn); Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Toronto (Howell); McMaster University, Hamilton (Klassen); CancerInsight, Oakville (Leduc); Department of Supportive Care, Princess Margaret Cancer Centre, University of Toronto, Toronto (Li); Canadian Partnership Against Cancer, Toronto (Moxam); Colorectal Cancer Resource and Action Network, Oakville (Servidio-Italiano)
| | - S Bryan
- British Columbia: School of Population and Public Health, University of British Columbia, Vancouver (Bryan); Office of Patient-Centred Measurement, British Columbia Ministry of Health, Vancouver (Cuthbertson); Radiation Oncology and Developmental Radiotherapeutics, University of British Columbia, Prince George (Olson); School of Nursing, Trinity Western University, Langley (Sawatzky)
| | - W Y Cheung
- Alberta: Department of Oncology, University of Calgary, Calgary (Barbera, Bebb, Cheung); University of Calgary, Calgary (Crump, Temple); Departments of Surgery and Oncology, University of Calgary, Calgary (McKinnon); Department of Oncology, Cumming School of Medicine, University of Calgary, Calgary (Pink, Santana); University of Calgary and Tom Baker Cancer Centre, Calgary (Robinson); Faculty of Nursing, University of Calgary, Calgary (Sinclair)
| | - N Coburn
- Ontario: Queen's Cancer Research Institute, Kingston (Brundage); Sunnybrook Health Sciences Centre, Toronto (Coburn); Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Toronto (Howell); McMaster University, Hamilton (Klassen); CancerInsight, Oakville (Leduc); Department of Supportive Care, Princess Margaret Cancer Centre, University of Toronto, Toronto (Li); Canadian Partnership Against Cancer, Toronto (Moxam); Colorectal Cancer Resource and Action Network, Oakville (Servidio-Italiano)
| | - T Crump
- Alberta: Department of Oncology, University of Calgary, Calgary (Barbera, Bebb, Cheung); University of Calgary, Calgary (Crump, Temple); Departments of Surgery and Oncology, University of Calgary, Calgary (McKinnon); Department of Oncology, Cumming School of Medicine, University of Calgary, Calgary (Pink, Santana); University of Calgary and Tom Baker Cancer Centre, Calgary (Robinson); Faculty of Nursing, University of Calgary, Calgary (Sinclair)
| | - L Cuthbertson
- British Columbia: School of Population and Public Health, University of British Columbia, Vancouver (Bryan); Office of Patient-Centred Measurement, British Columbia Ministry of Health, Vancouver (Cuthbertson); Radiation Oncology and Developmental Radiotherapeutics, University of British Columbia, Prince George (Olson); School of Nursing, Trinity Western University, Langley (Sawatzky)
| | - D Howell
- Ontario: Queen's Cancer Research Institute, Kingston (Brundage); Sunnybrook Health Sciences Centre, Toronto (Coburn); Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Toronto (Howell); McMaster University, Hamilton (Klassen); CancerInsight, Oakville (Leduc); Department of Supportive Care, Princess Margaret Cancer Centre, University of Toronto, Toronto (Li); Canadian Partnership Against Cancer, Toronto (Moxam); Colorectal Cancer Resource and Action Network, Oakville (Servidio-Italiano)
| | - A F Klassen
- Ontario: Queen's Cancer Research Institute, Kingston (Brundage); Sunnybrook Health Sciences Centre, Toronto (Coburn); Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Toronto (Howell); McMaster University, Hamilton (Klassen); CancerInsight, Oakville (Leduc); Department of Supportive Care, Princess Margaret Cancer Centre, University of Toronto, Toronto (Li); Canadian Partnership Against Cancer, Toronto (Moxam); Colorectal Cancer Resource and Action Network, Oakville (Servidio-Italiano)
| | - S Leduc
- Ontario: Queen's Cancer Research Institute, Kingston (Brundage); Sunnybrook Health Sciences Centre, Toronto (Coburn); Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Toronto (Howell); McMaster University, Hamilton (Klassen); CancerInsight, Oakville (Leduc); Department of Supportive Care, Princess Margaret Cancer Centre, University of Toronto, Toronto (Li); Canadian Partnership Against Cancer, Toronto (Moxam); Colorectal Cancer Resource and Action Network, Oakville (Servidio-Italiano)
| | - M Li
- Ontario: Queen's Cancer Research Institute, Kingston (Brundage); Sunnybrook Health Sciences Centre, Toronto (Coburn); Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Toronto (Howell); McMaster University, Hamilton (Klassen); CancerInsight, Oakville (Leduc); Department of Supportive Care, Princess Margaret Cancer Centre, University of Toronto, Toronto (Li); Canadian Partnership Against Cancer, Toronto (Moxam); Colorectal Cancer Resource and Action Network, Oakville (Servidio-Italiano)
| | - N E Mayo
- Quebec: Department of Medicine School of Physical and Occupational Therapy, McGill University, Montreal (Ahmed, Mayo); Faculty of Medicine, McGill University, and McGill University Health Systems, Montreal (Bartlett)
| | - G McKinnon
- Alberta: Department of Oncology, University of Calgary, Calgary (Barbera, Bebb, Cheung); University of Calgary, Calgary (Crump, Temple); Departments of Surgery and Oncology, University of Calgary, Calgary (McKinnon); Department of Oncology, Cumming School of Medicine, University of Calgary, Calgary (Pink, Santana); University of Calgary and Tom Baker Cancer Centre, Calgary (Robinson); Faculty of Nursing, University of Calgary, Calgary (Sinclair)
| | - R Olson
- British Columbia: School of Population and Public Health, University of British Columbia, Vancouver (Bryan); Office of Patient-Centred Measurement, British Columbia Ministry of Health, Vancouver (Cuthbertson); Radiation Oncology and Developmental Radiotherapeutics, University of British Columbia, Prince George (Olson); School of Nursing, Trinity Western University, Langley (Sawatzky)
| | - J Pink
- Alberta: Department of Oncology, University of Calgary, Calgary (Barbera, Bebb, Cheung); University of Calgary, Calgary (Crump, Temple); Departments of Surgery and Oncology, University of Calgary, Calgary (McKinnon); Department of Oncology, Cumming School of Medicine, University of Calgary, Calgary (Pink, Santana); University of Calgary and Tom Baker Cancer Centre, Calgary (Robinson); Faculty of Nursing, University of Calgary, Calgary (Sinclair)
| | - J W Robinson
- Alberta: Department of Oncology, University of Calgary, Calgary (Barbera, Bebb, Cheung); University of Calgary, Calgary (Crump, Temple); Departments of Surgery and Oncology, University of Calgary, Calgary (McKinnon); Department of Oncology, Cumming School of Medicine, University of Calgary, Calgary (Pink, Santana); University of Calgary and Tom Baker Cancer Centre, Calgary (Robinson); Faculty of Nursing, University of Calgary, Calgary (Sinclair)
| | - M J Santana
- Alberta: Department of Oncology, University of Calgary, Calgary (Barbera, Bebb, Cheung); University of Calgary, Calgary (Crump, Temple); Departments of Surgery and Oncology, University of Calgary, Calgary (McKinnon); Department of Oncology, Cumming School of Medicine, University of Calgary, Calgary (Pink, Santana); University of Calgary and Tom Baker Cancer Centre, Calgary (Robinson); Faculty of Nursing, University of Calgary, Calgary (Sinclair)
| | - R Sawatzky
- British Columbia: School of Population and Public Health, University of British Columbia, Vancouver (Bryan); Office of Patient-Centred Measurement, British Columbia Ministry of Health, Vancouver (Cuthbertson); Radiation Oncology and Developmental Radiotherapeutics, University of British Columbia, Prince George (Olson); School of Nursing, Trinity Western University, Langley (Sawatzky)
| | - R S Moxam
- Ontario: Queen's Cancer Research Institute, Kingston (Brundage); Sunnybrook Health Sciences Centre, Toronto (Coburn); Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Toronto (Howell); McMaster University, Hamilton (Klassen); CancerInsight, Oakville (Leduc); Department of Supportive Care, Princess Margaret Cancer Centre, University of Toronto, Toronto (Li); Canadian Partnership Against Cancer, Toronto (Moxam); Colorectal Cancer Resource and Action Network, Oakville (Servidio-Italiano)
| | - S Sinclair
- Alberta: Department of Oncology, University of Calgary, Calgary (Barbera, Bebb, Cheung); University of Calgary, Calgary (Crump, Temple); Departments of Surgery and Oncology, University of Calgary, Calgary (McKinnon); Department of Oncology, Cumming School of Medicine, University of Calgary, Calgary (Pink, Santana); University of Calgary and Tom Baker Cancer Centre, Calgary (Robinson); Faculty of Nursing, University of Calgary, Calgary (Sinclair)
| | - F Servidio-Italiano
- Ontario: Queen's Cancer Research Institute, Kingston (Brundage); Sunnybrook Health Sciences Centre, Toronto (Coburn); Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Toronto (Howell); McMaster University, Hamilton (Klassen); CancerInsight, Oakville (Leduc); Department of Supportive Care, Princess Margaret Cancer Centre, University of Toronto, Toronto (Li); Canadian Partnership Against Cancer, Toronto (Moxam); Colorectal Cancer Resource and Action Network, Oakville (Servidio-Italiano)
| | - W Temple
- Alberta: Department of Oncology, University of Calgary, Calgary (Barbera, Bebb, Cheung); University of Calgary, Calgary (Crump, Temple); Departments of Surgery and Oncology, University of Calgary, Calgary (McKinnon); Department of Oncology, Cumming School of Medicine, University of Calgary, Calgary (Pink, Santana); University of Calgary and Tom Baker Cancer Centre, Calgary (Robinson); Faculty of Nursing, University of Calgary, Calgary (Sinclair)
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