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Tan SSH, Law GW, Kim SS, Sethi E, Lim AKS, Hui JHP. Trochleoplasty Provides Good Outcomes for Recurrent Patellofemoral Dislocations with No Clear Superiority across Different Techniques. J Clin Med 2024; 13:3009. [PMID: 38792556 DOI: 10.3390/jcm13103009] [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: 03/12/2024] [Revised: 04/17/2024] [Accepted: 04/22/2024] [Indexed: 05/26/2024] Open
Abstract
Background: Literature is sparse on outcome comparisons between different trochleoplasty techniques in the treatment of patella instability. To date, it is unclear whether there is a technique that offers superior outcomes. This systematic review and meta-analysis aims to compare and evaluate the outcomes of trochleoplasty techniques in the treatment of patellofemoral instability in trochlea dysplasia to establish whether there is an ideal choice of trochleoplasty technique for superior outcomes. Methods: 21 studies involving 880 knees were included. The mean age of the patients was 21.7 years (range 8-49 years). Mean follow-up timeframe of 43.5 months (range 8.8-100 months). Clinical outcomes assessed included rates of recurrence of patellofemoral dislocation, patient satisfaction, Kujala score, International Knee Documentation Committee (IKDC) score, Tegner score, and Lysholm score. Egger's test showed no publication bias across all outcomes assessed. Results: Favourable results were seen across all outcomes assessed and patient satisfaction. Improvements were seen with Kujala, IKDC, and Lysholm scores. Tegner scores showed good return to function. Post-operative dislocation and complication rates were low across the different techniques. Meta-regression for Kujala and IKDC scores showed good outcomes regardless of trochleoplasty technique used (Kujala, p = 0.549, relative risk 492.06; IKDC, p = 0.193, RR 0.001). The exact risk that trochleoplasty poses to the cartilage remains uncertain, as no study had a conservatively managed arm for comparison. Conclusions: Trochleoplasty yielded good outcomes irrespective of technique used with no clear superiority demonstrated in any technique in terms of outcome scores, satisfaction, post-operative dislocation rates or complications.
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Affiliation(s)
- Sharon Si Heng Tan
- Department of Orthopaedic Surgery, National University Health System, Singapore 119228, Singapore
| | - Gin Way Law
- Department of Orthopaedic Surgery, National University Health System, Singapore 119228, Singapore
| | - Sunny Sunwoo Kim
- Department of Orthopaedic Surgery, National University Health System, Singapore 119228, Singapore
| | - Ervin Sethi
- Department of Orthopaedic Surgery, National University Health System, Singapore 119228, Singapore
| | - Andrew Kean Seng Lim
- Department of Orthopaedic Surgery, National University Health System, Singapore 119228, Singapore
| | - James Hoi Po Hui
- Department of Orthopaedic Surgery, National University Health System, Singapore 119228, Singapore
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Guglielmi R, Di Chio T, Kaleeta Maalu JP, Aparisi Gómez MP, De Leucio A, Simoni P. Preoperative and Postoperative Imaging in Idiopathic Scoliosis: What the Surgeon Wants to Know. Semin Musculoskelet Radiol 2021; 25:155-166. [PMID: 34020475 DOI: 10.1055/s-0041-1724018] [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: 10/21/2022]
Abstract
The term idiopathic scoliosis covers a broad spectrum of spinal deformities in the pediatric population without an underlying congenital anomaly of the spine. Depending on the age of presentation, it has both characteristic clinical and imaging features and a different prognosis. The radiologist should provide the surgeon with critical information to assess the degree of deformity and eventually plan surgery. Thoracic deformities and lung volume must also be part of the preoperative assessment. Imaging has a critical role in postsurgical follow-up and in surgical complications. This review highlights the importance of common terminology and measurement methods to avoid incongruences. The different imaging modalities are discussed with their indications and limitations. We pay special attention to imaging modalities that can help the surgeon assess skeletal maturation reliably and thus predict the prognosis of scoliosis. Radiation protection and the risk of cumulative radiation exposure in these patients is emphasized.
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Affiliation(s)
- Riccardo Guglielmi
- Institute of Radiology, Spital Thurgau AG, Cantonal Hospital Münsterlingen, Münsterlingen, Switzerland
| | - Teresa Di Chio
- Pediatric Institute of Southern Switzerland, Ospedale Regionale di Bellinzona e Valli, Bellinzona, Switzerland
| | - Jean-Paul Kaleeta Maalu
- Orthopedic Surgery Department, "Reine Fabiola" Children's University Hospital, Université Libre de Bruxelles, Bruxelles, Belgium
| | - Maria Pilar Aparisi Gómez
- Department of Radiology, Auckland City Hospital, Auckland, New Zealand.,Department of Radiology, Hospital Vithas Nueve de Octubre, Valencia, Spain
| | - Alessandro De Leucio
- Diagnostic Imaging Department, "Reine Fabiola" Children's University Hospital, Université Libre de Bruxelles, Bruxelles, Belgium
| | - Paolo Simoni
- Diagnostic Imaging Department, "Reine Fabiola" Children's University Hospital, Université Libre de Bruxelles, Bruxelles, Belgium
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Ohlmeier M, Lausmann C, Wolff M, Abdelaziz H, Gehrke T, Citak M. Preliminary clinical results of coated porous tibia cones in septic and aseptic revision knee arthroplasty. Arch Orthop Trauma Surg 2021; 141:555-60. [PMID: 32274569 DOI: 10.1007/s00402-020-03434-2] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/03/2019] [Indexed: 10/24/2022]
Abstract
PURPOSE To analyze the first results of calcium-phosphate-coated porous tibia cones. METHODS Patients treated with TrabecuLink®-CaP Cones were retrospectively recruited from January 2016 to December 2017. These custom-made cones were produced using titanium alloy Ti-6Al-4 V (Tilastan®) and using additive manufacturing with a special calcium-phosphate coating (HX®-coating). Clinical outcome was evaluated using Oxford Knee Score. For radiological evaluation of the implants, patients sent us outpatient taken radiographs. A minimum follow-up of one year was required. Lastly, we analyzed postoperative complications and revision rates. RESULTS 52 patients with revision knee arthroplasty (RKA) were recruited for final analysis, of whom, we had 17 septic RKAs (33%) and 35 aseptic cases of RKA (67%). The bone defects were grouped into 17 AORI Type 2A (32.7%), 14 Type 2B (26.9%) and 21 Type 3 (40.4%). After a mean follow-up of 22 months (13.2-34.8; SD = ± 10), we had 4 surgical revisions (7.7%), 2 septic and 2 aseptic cases. The mean Oxford Knee Score was 28.6 points (8-47; SD = ± 10). 22 of 28 radiographs (78.6%) showed regular positioning of the cones and TKAs at a mean follow-up of 16.8 months (13.2-34.8; SD = ± 6). Three patients (10.7%) showed slight radiolucencies in the bone-cement interfaces and 3 patients (10.7%) had beginning heterotopic ossifications. CONCLUSIONS This study shows the initial clinical results of calcium-phosphate-coated tibia cones showing a good functional outcome. Further research should focus on long-term clinical and radiological follow-up.
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Hamilton DF, Giesinger JM, Giesinger K. Technological developments enable measuring and using patient-reported outcomes data in orthopaedic clinical practice. World J Orthop 2020; 11:584-594. [PMID: 33362994 PMCID: PMC7745490 DOI: 10.5312/wjo.v11.i12.584] [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] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/28/2020] [Revised: 10/30/2020] [Accepted: 11/12/2020] [Indexed: 02/06/2023] Open
Abstract
Patient-reported outcomes measures form the backbone of outcomes evaluation in orthopaedics, with most of the literature now relying on these scoring tools to measure change in patient health status. This patient-reported information is increasingly collected routinely by orthopaedic providers but use of the data is typically restricted to academic research. Developments in electronic data capture and the outcome tools themselves now allow use of this data as part of the clinical consultation. This review evaluates the role of patient reported outcomes data as a tool to enhance daily orthopaedic clinical practice, and documents how develop-ments in electronic outcome measures, computer-adaptive questionnaire design and instant graphical display of questionnaire can facilitate enhanced patient-clinician shared decision making.
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Affiliation(s)
- David F Hamilton
- School of Health and Social Care, Edinburgh Napier University, Edinburgh EH114BN, United Kingdom
| | - Johannes M Giesinger
- University Hospital of Psychiatry II, Medical University of Innsbruck, Innsbruck 6020, Austria
| | - Karlmeinrad Giesinger
- Department of Orthopaedics and Traumatology, Kantonsspital St Gallen, St Gallen 9000, Switzerland
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Weick JW, Bullard J, Green JH, Gagnier JJ. Measures of Hip Function and Symptoms. Arthritis Care Res (Hoboken) 2020; 72 Suppl 10:200-218. [PMID: 33091262 DOI: 10.1002/acr.24231] [Citation(s) in RCA: 4] [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] [Received: 03/05/2020] [Accepted: 04/21/2020] [Indexed: 12/28/2022]
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Lin CC, Yang CC, Yu TC. Comparison of Mid-term Survivorship and Clinical Outcomes between Bipolar Hemiarthroplasty and Total Hip Arthroplasty with Cementless Stem: A Multicenter Retrospective Study. Orthop Surg 2019; 11:221-228. [PMID: 30977594 PMCID: PMC6594502 DOI: 10.1111/os.12440] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/03/2017] [Revised: 04/11/2018] [Accepted: 04/15/2018] [Indexed: 11/30/2022] Open
Abstract
Objectives To compare the clinical outcome between bipolar hemiarthroplasty (BHA) and total hip arthroplasty (THA) using a U2 HA cementless hip stem, and the results of elderly femoral neck fracture patients who underwent BHA with a cementless hip stem. Methods A multicenter retrospective study enrolled 96 BHA and 115 THA cases using U2 HA cementless hip stems with mean age (BHA: 67.9 years; THA: 64.1 years), body height (BHA: 160.4 cm; THA: 160.7 cm) and weight (BHA: 62.7 kg; THA: 64.5 kg) recorded. Mean follow‐up durations were, respectively, 7.1 (BHA) and 7.8 (THA) years. Survivorship analyses and Oxford hip scores were compared. Results Both the BHA and the THA groups revealed high survival rates at 5‐year (100%) and 10‐year (100.0% and 90.1%) follow‐up. The THA group achieved better joint performance and pain relief. The cementless HA stems had survived perfectly for 10 years for elderly femoral neck fracture patients following BHA. Conclusions The U2 HA cementless hip stem provides an effective solution for both BHA and THA surgeries, and for elderly femoral neck fracture patients undergoing BHA. According to the findings of the current study, THA may be inadequate for addressing avascular necrosis, and pain control is a considerable concern for patients who have undergone BHA.
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Affiliation(s)
- Chen-Chiang Lin
- Department of Orthopaedic Surgery, National Taiwan University Hospital (Yulin Branch), Yulin, Taiwan
| | - Chang-Chen Yang
- Department of Orthopaedic Surgery, Tzu-Chi Hospital Dalin Branch, Chiayi, Taiwan
| | - Tzai-Chiu Yu
- Department of Orthopaedic Surgery, Taipei Tzu-Chi Hospital, New Taipei City, Taiwan
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Minator Sajjadi M, Keyhani S, Kazemi SM, Hanafizadeh B, Ebrahimpour A, Banasiri M. Patient Satisfaction Following Total Knee Arthroplasty: Comparison of Short-Term Results in Rheumatoid Arthritis and Osteoarthritis. Arch Bone Jt Surg 2019; 7:61-66. [PMID: 30805417 PMCID: PMC6372268] [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] [Subscribe] [Scholar Register] [Received: 01/29/2018] [Accepted: 04/04/2018] [Indexed: 06/09/2023]
Abstract
BACKGROUND Due to the obvious differences in the natural course of rheumatoid arthritis (RA) and osteoarthritis (OA), different functional outcomes might be expected after Total Knee Arthroplasty (TKA) in these distinct patients. Although several studies have reported the objective outcome of TKA in RA and OA patients, few studies have compared post-operative patient-satisfaction levels. METHODS In this clinical cohort study 171 patients (RA: n=33, OA: n=138) who underwent TKA with posterior stabilizing knee prosthesis were included. The Knee Injury and Osteoarthritis Outcome Score (KOOS) and Oxford Knee Score (OKS) were used to evaluate and compare patients' satisfaction 6 and 12 months after TKA relative to their preoperative state and to make an assessment between two groups. RESULTS Both of patient-reported scoring systems showed a statistically significant improvement for OA and RA patients at 6 and 12 months after surgery, relative to their preoperative scores. The results of the OKS and KOOS did not show statistically significant improvement from 6 to 12 months n RA patients. Unlike RA group, OKS and KOOS revealed further improvement between 6 and 12 months for the osteoarthritic patients. CONCLUSION OA patients had continuous improvement in their satisfaction in the first year after TKA with a gentle upward curve. In contrast, in RA patients, recovery was faster and greater in the first six months after surgery and slowed down in the second six months. Patient-reported outcome scores were not significantly different between two groups at the end of the first year.
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Affiliation(s)
- Mohammadreza Minator Sajjadi
- Taleghani hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
- Akhtar hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
- Shahid Beheshti University of Medical Sciences, Tehran, Iran
- Research performed at Taleghani hospital, Tehran, Iran
| | - Sohrab Keyhani
- Taleghani hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
- Akhtar hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
- Shahid Beheshti University of Medical Sciences, Tehran, Iran
- Research performed at Taleghani hospital, Tehran, Iran
| | - Seyyed Morteza Kazemi
- Taleghani hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
- Akhtar hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
- Shahid Beheshti University of Medical Sciences, Tehran, Iran
- Research performed at Taleghani hospital, Tehran, Iran
| | - Behzad Hanafizadeh
- Taleghani hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
- Akhtar hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
- Shahid Beheshti University of Medical Sciences, Tehran, Iran
- Research performed at Taleghani hospital, Tehran, Iran
| | - Adel Ebrahimpour
- Taleghani hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
- Akhtar hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
- Shahid Beheshti University of Medical Sciences, Tehran, Iran
- Research performed at Taleghani hospital, Tehran, Iran
| | - Mohammad Banasiri
- Taleghani hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
- Akhtar hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
- Shahid Beheshti University of Medical Sciences, Tehran, Iran
- Research performed at Taleghani hospital, Tehran, Iran
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Jovic D, Mulford J, Ogden K, Zalucki N. Diagnosis and management of chronic hip and knee pain in a Tasmanian orthopaedic clinic: a study assessing the diagnostic and treatment planning decisions of an advanced scope physiotherapist. Aust J Prim Health 2019; 25:60-65. [DOI: 10.1071/py18076] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2018] [Accepted: 09/20/2018] [Indexed: 11/23/2022]
Abstract
The aim of this study is to investigate the clinical effectiveness of an advanced practice physiotherapist triaging patients referred from primary care to the orthopaedic clinic with chronic hip and knee pain. An exploratory study design was used to assess 87 consecutive patients referred from general practice in Northern Tasmania. Patients were assessed by both an advanced practice physiotherapist and a consultant orthopaedic surgeon. Diagnostic and treatment decisions were compared, with the orthopaedic consultant decision defined as the gold standard. By using these decisions, over and under referral rates to orthopaedics could be calculated, as well as the surgical conversion rate. Conservative care of patients referred to the orthopaedic clinic with hip and knee pain was limited. The diagnostic agreement between the advanced scope physiotherapist and the orthopaedic surgeon was almost perfect (weighted kappa 0.93 (95% CI 0.87–1.00)), with treatment agreement substantial (weighted kappa 0.75 (95% CI 0.62–0.89)). Under a physiotherapist-led triage service, the surgical conversion rate doubled from 38% to 78%. An advanced physiotherapist assessing and treating patients with chronic hip and knee pain made decisions that match substantially with decisions made by an orthopaedic consultant. A model of care utilising an advanced physiotherapist in this way has the potential to support high-quality orthopaedic care in regional centres.
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Hamilton DF, Loth FL, MacDonald DJ, Giesinger K, Patton JT, Simpson AH, Howie CR, Giesinger JM. Treatment Success Following Joint Arthroplasty: Defining Thresholds for the Oxford Hip and Knee Scores. J Arthroplasty 2018; 33:2392-2397. [PMID: 29691169 DOI: 10.1016/j.arth.2018.03.062] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.8] [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: 02/19/2018] [Revised: 03/21/2018] [Accepted: 03/22/2018] [Indexed: 02/01/2023] Open
Abstract
BACKGROUND Patient-reported outcome scores are the mainstay method for quantifying success following arthroplasty. However, it is unclear when a "successful outcome" is achieved. We calculated threshold values for the Oxford Hip and Knee Score (OHS and OKS) representing achievement of a successful treatment at 12-month follow-up. METHODS Questionnaires were administered to patients undergoing total hip (THA) or knee (TKA) arthroplasty before and 12 months after surgery alongside questions assessing key aspects of treatment success. A composite success criterion was used to perform receiver operator characteristic analysis. Thresholds providing maximum sensitivity and specificity were determined for the total sample and subgroups defined by presurgery scores. RESULTS Data were available for 3203 THA and 2742 TKA patients. Applying the composite treatment success criterion, 67.3% of the TKA and 77.6% of the THA sample reported treatment success. Accuracy for predicting treatment success was high for the OHS and OKS (both areas under the curve, 0.87). For the OHS, a threshold value of 37.5 points showed highest sensitivity and specificity in the total sample, while for the OKS the optimal threshold was 32.5 points. Depending on presurgery scores, optimal thresholds varied between 32.5 and 38.5 for the OHS and 28.5 and 36.5 for the OKS. CONCLUSION This is the first study to apply a composite "success" anchor to the OHS and OKS to evaluate outcome following total joint arthroplasty. Notably fewer patients report a "successful outcome" using a composite outcome threshold than report being "satisfied."
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Affiliation(s)
- David F Hamilton
- Department of Orthopaedics and Trauma, University of Edinburgh, Edinburgh, United Kingdom
| | - Fanny L Loth
- University of Innsbruck, Faculty of Psychology and Sport Science, Innsbruck, Austria
| | - Deborah J MacDonald
- Department of Orthopaedics and Trauma, University of Edinburgh, Edinburgh, United Kingdom
| | | | - James T Patton
- Department of Orthopaedics and Trauma, University of Edinburgh, Edinburgh, United Kingdom
| | - A Hamish Simpson
- Department of Orthopaedics and Trauma, University of Edinburgh, Edinburgh, United Kingdom
| | - Colin R Howie
- Department of Orthopaedics and Trauma, University of Edinburgh, Edinburgh, United Kingdom
| | - Johannes M Giesinger
- Innsbruck Institute of Patient-centered Outcome Research (IIPCOR), Innsbruck, Austria
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Affiliation(s)
- D F Hamilton
- University of Edinburgh, Orthopeadics, FU413 Chancellors Building, 49 Little France Crescent, Edinburgh, EH16 4SB, UK
| | - J M Giesinger
- Innsbruck Institute of Patient Centered Outcome Research, 6020 Innsbruck, Austria
| | - K Giesinger
- Department of Orthopaedic Surgery and Traumatology, Senior Consultant Knee Surgeon, Kantonsspital St Gallen, St Gallen, Switzerland
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Blaney J, Harty H, Doran E, O’Brien S, Hill J, Dobie I, Beverland D. Five-year clinical and radiological outcomes in 257 consecutive cementless Oxford medial unicompartmental knee arthroplasties. Bone Joint J 2017; 99-B:623-631. [DOI: 10.1302/0301-620x.99b5.bjj-2016-0760.r1] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [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: 08/02/2016] [Accepted: 01/13/2017] [Indexed: 12/24/2022]
Abstract
Aims Our aim was to examine the clinical and radiographic outcomes in 257 consecutive Oxford unicompartmental knee arthroplasties (OUKAs) (238 patients), five years post-operatively. Patients and Methods A retrospective evaluation was undertaken of patients treated between April 2008 and October 2010 in a regional centre by two non-designing surgeons with no previous experience of UKAs. The Oxford Knee Scores (OKSs) were recorded and fluoroscopically aligned radiographs were assessed post-operatively at one and five years. Results The median age of the 238 patients was 65.0 years (interquartile range (IQR) 59.0 to 73.0), the median body mas index was 30.0 (IQR 27.5 to 33.0) and 51.7% were male. There were no intra-operative complications. There was a significant improvement in the median OKS at six weeks (34, IQR 31.0 to 37.0), one year (38, IQR 29.0 to 43.0) and five years (37, IQR 27.0 to 42.0) when compared with the pre-operative scores (16, IQR 13.0 to 19.0) (all p = < 0.01). No patient had progressive radiolucent lines or loosening. A total of 16 patients had died by five years. The cumulative survival at five years was 98.8% and the mean survival time was 5.8 years (95% confidence interval 5.6 to 5.9). A total of seven OUKAs (2.7%) were revised; three within five years and four thereafter, between 5.1 and 5.7 years post-operatively. Five (1.9%) had re-operations within five years. Conclusion The proportion of patients requiring revision at five years is lower than that generally reported for UKA. These findings add support for the use of the cementless OUKA outside the design centre. Longer follow-up is required. Cite this article: Bone Joint J 2017;99-B:623–31.
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Affiliation(s)
- J. Blaney
- Primary Joint Unit, Musgrave Park Hospital, Stockmans
Lane, Belfast, Co. Antrim, BT9 7JB, UK
| | - H. Harty
- Primary Joint Unit, Musgrave Park Hospital, Stockmans
Lane, Belfast, Co. Antrim, BT9 7JB, UK
| | - E. Doran
- Primary Joint Unit, Musgrave Park Hospital, Stockmans
Lane, Belfast, Co. Antrim, BT9 7JB, UK
| | - S. O’Brien
- Primary Joint Unit, Musgrave Park Hospital, Stockmans
Lane, Belfast, Co. Antrim, BT9 7JB, UK
| | - J. Hill
- Primary Joint Unit, Musgrave Park Hospital, Stockmans
Lane, Belfast, Co. Antrim, BT9 7JB, UK
| | - I. Dobie
- Primary Joint Unit, Musgrave Park Hospital, Stockmans
Lane, Belfast, Co. Antrim, BT9 7JB, UK
| | - D. Beverland
- Primary Joint Unit, Musgrave Park Hospital, Stockmans
Lane, Belfast, Co. Antrim, BT9 7JB, UK
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Yeoman TF, Smy W, Gaston P. A case control study of cemented acetabular total hip arthroplasty components in patients less than 50 with 5-year minimum follow-up. Hip Int 2017; 27:122-7. [PMID: 28106231 DOI: 10.5301/hipint.5000445] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 07/16/2016] [Indexed: 02/04/2023]
Abstract
BACKGROUND This study investigates the outcomes of cemented sockets in young patients (<50 years) requiring a total hip replacement (THR) compared to older patients (>50 years) having the same procedure, under the same surgeon between June 2005 and May 2009. METHODS Prosthesis survivorship rates, patient outcomes and radiological findings were compared between a consecutive series of 56 young patients (mean 42, range 25-49) and 56 older patients (mean 69, range 53-81) that underwent a primary THR using a cemented Stryker® Exeter™ Contemporary™ flanged cup. The minimum follow-up was 5 years. RESULTS No significant difference was observed between the groups' Oxford Hip Scores (p = 0.078) or satisfaction scores (p = 0.67). Worst case scenario analysis for revision, failure or lost to follow-up showed 94.6% survival in the <50 year olds and 92.9% survival in the >50 year olds at 5 years. This study demonstrates no significant difference in patient outcomes, survivorship or radiographic findings at a minimum of 5 years between patients <50 years old and those >50 years old undergoing THR with a cemented socket. CONCLUSIONS We believe the current trend towards uncemented cups may be driven by marketing rather than by evidence of improved outcomes. Cemented sockets provide very good outcomes for patients of all ages.
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13
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Ahearn N, Metcalfe AJ, Hassaballa MA, Porteous AJ, Robinson JR, Murray JR, Newman JH. The Journey patellofemoral joint arthroplasty: A minimum 5year follow-up study. Knee 2016; 23:900-4. [PMID: 27131405 DOI: 10.1016/j.knee.2016.03.004] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [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] [Received: 11/17/2015] [Revised: 03/17/2016] [Accepted: 03/19/2016] [Indexed: 02/02/2023]
Abstract
BACKGROUND The Journey patellofemoral joint arthroplasty (PFA) was designed to improve patient outcomes following surgical management of patellofemoral joint osteoarthritis. It is based on the asymmetric trochlear geometry of the Genesis II total knee arthroplasty, with Oxinium components, to provide a reliable treatment option in an often young, high demand group of patients. METHODS We report the minimum five year functional outcome and survivorship of the Journey PFA performed at our institution between October 2005 and September 2009. RESULTS A total of 101 Journey PFAs were implanted in 83 patients, and we have complete outcomes for 90 implants (89%). There were 80 implants in female patients, and the mean age at time of surgery was 60years (26 to 86). The median Oxford Knee Score (0 to 48) improved from 18 to 30, and median Western Ontario and McMaster University Osteoarthritis Short Form Index (0 to 60) improved from 22 to 35. There were a total of 12 revisions, with mean time to revision 50months (10 to 99). CONCLUSIONS The Journey PFA gives a good medium-term functional outcome with 88% survivorship at a mean of seven years. This is the largest study of Journey PFA in the literature, and it provides a reliable option for patients with isolated patellofemoral joint osteoarthritis when arthroplasty is considered.
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Affiliation(s)
- Nathanael Ahearn
- Avon Orthopaedic Centre, Southmead Hospital, Bristol BS10 5NB, UK.
| | | | | | | | - James R Robinson
- Avon Orthopaedic Centre, Southmead Hospital, Bristol BS10 5NB, UK
| | - James R Murray
- Avon Orthopaedic Centre, Southmead Hospital, Bristol BS10 5NB, UK
| | - John H Newman
- Avon Orthopaedic Centre, Southmead Hospital, Bristol BS10 5NB, UK
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Hamilton DF, Giesinger JM, MacDonald DJ, Simpson AHRW, Howie CR, Giesinger K. Responsiveness and ceiling effects of the Forgotten Joint Score-12 following total hip arthroplasty. Bone Joint Res 2016; 5:87-91. [PMID: 26965167 PMCID: PMC4852794 DOI: 10.1302/2046-3758.53.2000480] [Citation(s) in RCA: 70] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/21/2023] Open
Abstract
OBJECTIVES To assess the responsiveness and ceiling/floor effects of the Forgotten Joint Score -12 and to compare these with that of the more widely used Oxford Hip Score (OHS) in patients six and 12 months after primary total hip arthroplasty. METHODS We prospectively collected data at six and 12 months following total hip arthroplasty from 193 patients undergoing surgery at a single centre. Ceiling effects are outlined with frequencies for patients obtaining the lowest or highest possible score. Change over time from six months to 12 months post-surgery is reported as effect size (Cohen's d). RESULTS The mean OHS improved from 40.3 (sd 7.9) at six months to 41.9 (sd 7.2) at 12 months. The mean FJS-12 improved from 56.8 (sd 30.1) at six months to 62.1 (sd 29.0) at 12 months. At six months, 15.5% of patients reached the best possible score (48 points) on the OHS and 8.3% obtained the best score (100 points) on the FJS-12. At 12 months, this percentage increased to 20.8% for the OHS and to 10.4% for the FJS-12. In terms of the effect size (Cohen's d), the change was d = 0.10 for the OHS and d = 0.17 for the FJS-12. CONCLUSIONS The FJS-12 is more responsive to change between six and 12 months following total hip arthroplasty than is the OHS, with the measured ceiling effect for the OHS twice that of the FJS-12. The difference in effect size of change results in substantial differences in required sample size if aiming to detect change between these two time points. This has important implications for powering clinical trials with patient-reported measures as the primary outcome.Cite this article: Dr D. F. Hamilton. Responsiveness and ceiling effects of the Forgotten Joint Score-12 following total hip arthroplasty. Bone Joint Res 2016;5:87-91. DOI: 10.1302/2046-3758.53.2000480.
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Affiliation(s)
- D F Hamilton
- Department of Orthopaedics, University of Edinburgh, FU413, Chancellor's Building, 49 Little France Crescent, Edinburgh, EH164SB, UK.
| | - J M Giesinger
- Department of Psychiatry and Psychotherapy, Innsbruck Medical University, Anichstrasse 35, 6020 Innsbruck, Austria
| | - D J MacDonald
- Department of Orthopaedics, University of Edinburgh, FU413, Chancellor's Building, 49 Little France Crescent, Edinburgh, EH164SB, UK
| | - A H R W Simpson
- University of Edinburgh, FU413, Chancellor's Building, 49 Little France Crescent, Edinburgh, EH164SB, UK
| | - C R Howie
- Department of Orthopaedics, University of Edinburgh, FU413, Chancellor's Building, 49 Little France Crescent, Edinburgh, EH164SB, UK
| | - K Giesinger
- Department of Orthopaedics, Kantonsspital St. Gallen, Rorschacherstrasse 95, 9007 St. Gallen, Switzerland
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