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Tripathy SK, Varghese P, Khan S, Neradi D, Jain M, Sen RK. Joint awareness among total hip arthroplasty patients operated through anterior approach versus posterior approach: a systematic review and meta-analysis. Eur J Orthop Surg Traumatol 2024; 34:39-46. [PMID: 37566139 DOI: 10.1007/s00590-023-03674-z] [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] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/02/2023] [Accepted: 08/02/2023] [Indexed: 08/12/2023]
Abstract
PURPOSE The aim of this systematic review and meta-analysis was to compare joint awareness in patients who underwent total hip arthroplasty (THA) via the anterior approach (AA) versus the posterior approach (PA). The hypothesis was that patients who underwent THA via AA would have better forgetfulness of the artificial joint. METHODS A comprehensive search of major literature databases and bibliographic details was conducted to identify studies evaluating the forgotten joint score (FJS-12) in total hip arthroplasty (THA) patients operated through the anterior approach (AA) and posterior approach (PA). Out of 234 studies identified, seven studies met the inclusion criteria for review. The Newcastle-Ottawa Scale was used to evaluate the quality of evidence and the risk of bias in the included studies. The FJS-12 was evaluated at three months, one year, and beyond 2 years. RESULTS The mean FJS-12 at > 2 years was 82.03 in the AA group and 80.32 in the PA group. The forest plot analysis (n = 819 patients) revealed no significant difference in FJS-12 score between these two approaches (MD 2.13, 95% CI [- 1.17, 5.42], p = 0.21; I2 = 60%). However, the joint awareness was significantly lesser in the AA group at 3 months (MD 12.56, 95% CI [9.58, 15.54], p < 0.00001, I2 = 0%) and 1 year (MD 9.55, 95% CI [7.85, 11.24], p < 0.0001, I2 = 0%). CONCLUSIONS After analyzing the available literature, it was found that THA patients operated through the AA approach have significantly lower joint awareness than those operated through the PA approach in the first year of surgery. However, there is no significant difference in joint awareness between these two approaches after 2 years. LEVEL OF EVIDENCE III.
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Affiliation(s)
- Sujit Kumar Tripathy
- Department of Orthopedics, All India Institute of Medical Sciences, Bhubaneswar, 751019, India.
| | - Paulson Varghese
- Department of Orthopedics, All India Institute of Medical Sciences, Bhubaneswar, 751019, India
| | - Shahnawaz Khan
- Department of Orthopedics, All India Institute of Medical Sciences, Bhubaneswar, 751019, India
| | - Deepak Neradi
- Department of Orthopedics, All India Institute of Medical Sciences, Bhubaneswar, 751019, India
| | - Mantu Jain
- Department of Orthopedics, All India Institute of Medical Sciences, Bhubaneswar, 751019, India
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Bakircioglu S, Aksoy T, Caglar O, Mazhar Tokgozoglu A, Atilla B. Joint awareness after fixed and mobile-bearing total knee arthroplasty with minimum 12 years of follow-up: A propensity matched-pair analysis. Knee 2023; 42:130-135. [PMID: 37001329 DOI: 10.1016/j.knee.2023.03.004] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/04/2022] [Revised: 01/27/2023] [Accepted: 03/09/2023] [Indexed: 06/19/2023]
Abstract
BACKGROUND Many comparative articles studied mobile-bearing (MB) and fixed-bearing (FB) total knee arthroplasties (TKAs). Meta-analyses found no difference in survival or biomechanical outcome. This study aimed to compare long-term clinical results between fixed-bearing (FB) and mobile-bearing (MB) total knee arthroplasty (TKA) as well as patients' adaptation to their artificial joints. METHOD TKAs performed with the same surgical protocol divided into categories according to the insert design preferred. 70 MB design TKAs were compared with 70 FB design TKAs utilizing propensity matching for parameters; gender, age, body mass index, coronal plane deformity, range of motion (ROM) and appropriateness criteria. Forgotten Joint Score-12 (FJS-12) was used to assess patients' ability to forget their artificial joints in daily life. RESULTS Patients had a mean follow-up of 15.6 (±2.2) years. No difference was observed between groups for post-operative ROM, WOMAC, Knee Society Knee and Function Scores. The FJS-12 in the MB and FB groups were 66.1 and 72.8, respectively (P = 0.026). There was no significant difference in survival between both designs. CONCLUSION This study suggests that in TKA, joint awareness is higher in MB compared to FB design. FJS-12 appears to be a sensitive measuring tool when comparing two designs and should be implemented in long-term follow-up.
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Affiliation(s)
- Sancar Bakircioglu
- TOBB Economy and Technology University, Department of Orthopedics and Traumatology, Turkey.
| | - Taha Aksoy
- Hacettepe University, Department of Orthopedics and Traumatology, Turkey.
| | - Omur Caglar
- Hacettepe University, Department of Orthopedics and Traumatology, Turkey.
| | | | - Bulent Atilla
- Hacettepe University, Department of Orthopedics and Traumatology, Turkey.
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Itoh M, Itou J, Kuwashima U, Okazaki K. Correlation of patient-reported numbness around surgical scars with patient-reported outcome measures and joint awareness after knee replacement: a cohort study. BMC Musculoskelet Disord 2022; 23:14. [PMID: 34980073 PMCID: PMC8725250 DOI: 10.1186/s12891-021-04971-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [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: 07/26/2021] [Accepted: 12/20/2021] [Indexed: 01/01/2023] Open
Abstract
Background Knee replacement is a very effective and indispensable treatment option for end-stage knee arthritis, and the number of cases has been increasing worldwide. A replaced knee joint without patient joint awareness is thought to be the ultimate goal of artificial knees. Joint awareness reportedly correlates with patient satisfaction. Although numbness around a replaced knee is a minor but common problem, its effect on postoperative outcome is controversial. Joint awareness also is sensitive to subtle abnormalities of the joint, so it must be negatively affected by numbness. Although numbness is minor, it cannot be ignored to further improve knee replacement outcomes. This study investigated the relationship between patient-reported numbness and other patient-reported outcome measures (PROMs), including joint awareness, and kneeling. We developed a numbness score based on a 5-point Likert scale on frequency of numbness, with an intraclass correlation coefficient of 0.76 and higher scores indicating less numbness. Methods The numbness score, New Knee Society Score (KSS), Knee Injury and Osteoarthritis Outcome Score (KOOS), Forgotten Joint Score-12 (FJS-12), and other clinical and radiological data from 311 patients (394 primary knee replacements) were analyzed. Kneeling ability was evaluated by using kneeling-specific items in the KSS (KSS-Kneeling). Results No numbness was found in 170 knees (43.1%), and some degree of numbness was found in the remaining 224 knees (56.9%). The numbness score showed weak-to-moderate correlations with KSS-Symptoms (r = 0.44), KSS-Satisfaction (r = 0.41), KSS-Activities (r = 0.29), and all KOOS subscales (r = 0.23–0.44), and FJS-12 (r = 0.42). Multiple regression analyses suggested that midline incision positively affected the numbness score over the anteromedial incision (p = 0.04) and that a better numbness score (p = 0.001), male sex (p < 0.0001), and better postoperative knee flexion angle (0.04) positively affected kneeling. Conclusions The numbness score positively correlated with PROMs and positively affected kneeling. Knee replacements performed via an anteromedial incision may be at higher risk for numbness. Supplementary Information The online version contains supplementary material available at 10.1186/s12891-021-04971-6.
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Affiliation(s)
- Masafumi Itoh
- Department of Orthopaedic surgery, Tokyo Women's Medical University, 8-1, Kawada-Cho, Shinjuku-ku, Tokyo, 162-8666, Japan
| | - Junya Itou
- Department of Orthopaedic surgery, Tokyo Women's Medical University, 8-1, Kawada-Cho, Shinjuku-ku, Tokyo, 162-8666, Japan
| | - Umito Kuwashima
- Department of Orthopaedic surgery, Tokyo Women's Medical University, 8-1, Kawada-Cho, Shinjuku-ku, Tokyo, 162-8666, Japan
| | - Ken Okazaki
- Department of Orthopaedic surgery, Tokyo Women's Medical University, 8-1, Kawada-Cho, Shinjuku-ku, Tokyo, 162-8666, Japan.
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Tripathy SK, Varghese P, Srinivasan A, Goyal T, Purudappa PP, Sen RK, Chandrappa MH. Joint awareness after unicompartmental knee arthroplasty and total knee arthroplasty: a systematic review and meta-analysis of cohort studies. Knee Surg Sports Traumatol Arthrosc 2021; 29:3478-3487. [PMID: 33078218 DOI: 10.1007/s00167-020-06327-4] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [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: 08/03/2020] [Accepted: 10/06/2020] [Indexed: 02/05/2023]
Abstract
PURPOSE The purpose of this systematic review and meta-analysis is to evaluate the joint awareness after unicompartmental knee arthroplasty (UKA) and total knee arthroplasty (TKA). It was hypothesized that patients with UKA could better forget about their artificial joint in comparison to TKA. METHODS A search of major literature databases and bibliographic details revealed 105 studies evaluating forgotten joint score in UKA and TKA. Seven studies found eligible for this review were assessed for risk of bias and quality of evidence using the Newcastle-Ottawa Scale. The forgotten joint score (FJS-12) was assessed at 6 months, 1 year, and 2 years. RESULTS The mean FJS-12 at 2 years was 82.35 in the UKA group and 74.05 in the TKA group. Forest plot analysis of five studies (n = 930 patients) revealed a mean difference of 7.65 (95% CI: 3.72, 11.57, p = 0.0001; I2 = 89% with p < 0.0001) in FJS-12 at 2 years. Further sensitivity analysis lowered I2 heterogeneity to 31% after exclusion of the study by Blevin et al. (MD 5.88, 95%CI: 3.10, 8.66, p < 0.0001). A similar trend of differences in FJS-12 between the groups was observed at 6 months (MD 32.49, 95% CI: 17.55, 47.43, p < 0.0001) and at 1 year (MD 25.62, 95% CI: 4.26, 46.98, p = 0.02). CONCLUSIONS UKA patients can better forget about their artificial joint compared to TKA patients. LEVEL OF EVIDENCE III.
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Affiliation(s)
- Sujit Kumar Tripathy
- Department of Orthopedics, All India Institute of Medical Sciences, Bhubaneswar, 751019, India.
| | - Paulson Varghese
- Department of Orthopedics, All India Institute of Medical Sciences, Bhubaneswar, 751019, India
| | - Anand Srinivasan
- Department of Pharmacology, All India Institute of Medical Sciences, Bhubaneswar, India
| | - Tarun Goyal
- Department of Orthopedics, All India Institute of Medical Sciences, Bathinda, India
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Kim MS, Koh IJ, Kim CK, Choi KY, Baek JW, In Y. Comparison of implant position and joint awareness between fixed- and mobile-bearing unicompartmental knee arthroplasty: a minimum of five year follow-up study. Int Orthop 2020; 44:2329-2336. [PMID: 32577875 DOI: 10.1007/s00264-020-04662-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/20/2020] [Accepted: 06/11/2020] [Indexed: 10/24/2022]
Abstract
PURPOSE To compare the implant position and patient-reported outcomes (PROs) regarding joint awareness using the Forgotten Joint Score (FJS) following between fixed-bearing (FB) and mobile-bearing (MB) unicompartmental knee arthroplasty (UKA) with a minimum of five years' follow-up. METHODS One hundred fifteen consecutive UKAs (58 FB UKAs and 57 MB UKAs) performed were retrospectively evaluated. We compared the radiographic parameters including component positions and relationships as well as lower extremity alignment. Post-operative clinical outcomes were assessed using Knee Society Score (KSS), the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) score, Tegner activity score, and FJS. RESULTS The MB UKA group showed more convergent componentry relationship between femoral and tibial components (p < 0.001). The joint line of the MB UKA group was restored significantly better (p < 0.05). In addition, the positioning of femoral and tibial components of the MB UKA group showed less deviation from the weight-bearing line (WBL) (p < 0.05). Although there were no differences in KSS, WOMAC, and Tegner activity scores between the groups, the MB UKA group showed significantly better FJS than did the FB UKA group at five years post-operatively (p < 0.05). CONCLUSION The MB UKA group had a more convergent componentry relationship, less deviation from WBL, better joint-line restoration, and reduced joint awareness than did the FB UKA group at five years follow-up.
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Affiliation(s)
- Man Soo Kim
- Department of Orthopaedic Surgery, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, 222, Banpo-daero, Seocho-gu, Seoul, 06591, Republic of Korea
| | - In Jun Koh
- Department of Orthopaedic Surgery, Eunpyeong St. Mary's Hospital, College of Medicine, The Catholic University of Korea, 1021,Tongil Ro, Eunpyeong-gu, Seoul, 03312, Republic of Korea
| | - Chul Kyu Kim
- Department of Orthopaedic Surgery, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, 222, Banpo-daero, Seocho-gu, Seoul, 06591, Republic of Korea
| | - Keun Young Choi
- Department of Orthopaedic Surgery, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, 222, Banpo-daero, Seocho-gu, Seoul, 06591, Republic of Korea
| | - Jong Won Baek
- Department of Orthopaedic Surgery, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, 222, Banpo-daero, Seocho-gu, Seoul, 06591, Republic of Korea
| | - Yong In
- Department of Orthopaedic Surgery, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, 222, Banpo-daero, Seocho-gu, Seoul, 06591, Republic of Korea.
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Ladurner A, Giesinger K, Zdravkovic V, Behrend H. The Forgotten Joint Score-12 as a valuable patient-reported outcome measure for patients after first-time patellar dislocation. Knee 2020; 27:406-413. [PMID: 31926674 DOI: 10.1016/j.knee.2019.12.004] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [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: 04/02/2019] [Revised: 11/13/2019] [Accepted: 12/11/2019] [Indexed: 02/02/2023]
Abstract
BACKGROUND The aim of this study is to assess joint awareness after first-time patellar dislocation using the Forgotten Joint Score-12 (FJS-12) and to compare performance of this measurement tool to acknowledged patient-reported outcome scores. METHODS A retrospective analysis of patients with confirmed first-time patellar dislocation was performed. Patients were assessed with the FJS-12, the Kujala and the WOMAC scores. Reference values for the FJS-12 were obtained from a matched healthy control group with no history of previous knee joint pathology. We calculated Cronbach's alpha, assessed the ceiling effect for all scores, and calculated the Spearman correlation coefficient between them RESULTS: Fifty-six patients (mean follow-up 8.2 years, range 1.6-14.1) with a mean age of 26.4 years were analysed. Compared with the age- and gender-matched control group, the patellar dislocation group showed significantly lower (worse) mean FJS-12 scores (88 vs. 71, P < 0.001). Inter-score correlation between the FJS-12 and the Kujala was high (r = 0.74) and significant (P < 0.001), as well as between FJS-12 and WOMAC (r = 0.81, P < 0.001). Cronbach's alpha of the FJS-12 was 0.92 (95% confidence interval 0.90-0.94). The FJS-12 showed less ceiling effect (16%) compared with the Kujala score (23%) and the WOMAC score (32%). CONCLUSIONS The concept of joint awareness has been successfully applied to a patient population after patellar dislocation. The FJS-12 showed less ceiling effect compared with the Kujala and the WOMAC scores, suggesting the score was able to capture subtle knee problems in patients after patellar dislocation.
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Affiliation(s)
- Andreas Ladurner
- Department of Orthopaedics and Traumatology, Kantonssptial St. Gallen, St. Gallen, Switzerland.
| | - Karlmeinrad Giesinger
- Department of Orthopaedics and Traumatology, Kantonssptial St. Gallen, St. Gallen, Switzerland
| | - Vilijam Zdravkovic
- Department of Orthopaedics and Traumatology, Kantonssptial St. Gallen, St. Gallen, Switzerland
| | - Henrik Behrend
- Department of Orthopaedics and Traumatology, Kantonssptial St. Gallen, St. Gallen, Switzerland
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Taniguchi H, Itoh M, Yoshimoto N, Itou J, Kuwashima U, Okazaki K. Noise after total knee arthroplasty has limited effect on joint awareness and patient-reported clinical outcomes: retrospective study. BMC Musculoskelet Disord 2020; 21:115. [PMID: 32085760 PMCID: PMC7035734 DOI: 10.1186/s12891-020-3134-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [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: 12/05/2019] [Accepted: 02/12/2020] [Indexed: 11/15/2022] Open
Abstract
Background Some patients complain of noise after total knee arthroplasty (TKA). Controversy still exists on how the noise affects the clinical outcomes, including joint awareness, after TKA. The Forgotten Joint Score—12 (FJS-12) measures the clinical outcomes focusing on joint awareness after surgery. The Knee Society Scoring System—2011 (KSS-2011) includes questionnaires for satisfaction, expectation, and functional activities. The aim of this study is to clarify the relationship among FJS-12, KSS-2011, and the noise. Furthermore, the relationship between FJS-12 and KSS-2011 was validated. Methods Using FJS-12 and KSS-2011, 295 knees from 225 patients who underwent TKA were retrospectively evaluated. Noise perception was evaluated by a questionnaire with five grades, a method that follows the questionnaire form of FJS-12 (“Are you aware of the noise of your artificial joint?”; never, almost never, seldom, sometimes, mostly). Correlations among FJS-12, KSS-2011, and noise were analyzed. The patients were divided into four groups based on the mechanism of their implant [cruciate retaining, posterior stabilized, cruciate sacrificed, and bicruciate stabilized (BCS)]. FJS-12, KSS-2011, and noise were compared among the groups. Results A strong correlation was found between FJS-12 and total score of KSS-2011 (0.70; P < 0.001). FJS-12 correlated with KSS-2011 subcategories of “symptoms,” “satisfaction,” and “standard activities,” with correlation coefficients at approximately 0.60. Noise had weak correlations with FJS-12 (0.28; P < 0.001) and KSS-2011 (0.20 P < 0.001). In comparing the TKA mechanisms, BCS had remarkably better KSS-2011 and greater movement range but worse noise scores. Conclusions Noise perception after TKA had limited effect on joint awareness and clinical outcomes. FJS-12 correlated strongly with KSS-2011 and associated with satisfaction, residual symptoms, and daily activities, as assessed by KSS-2011 subscores. Trial registration This study was approved by the Medical Ethical Committee of the Tokyo Women’s Medical University (approval number: 4681 on March 2, 2018).
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Affiliation(s)
- Hiroto Taniguchi
- Department of Orthopaedic Surgery, Yachiyo Medical Center, Tokyo Women's Medical University, Chiba, Japan
| | - Masafumi Itoh
- Department of Orthopaedic Surgery, Tokyo Women's Medical University, 8-1 Kawadacho, Shinjuku, Tokyo, Japan
| | - Nobuyuki Yoshimoto
- Department of Orthopaedic Surgery, Yachiyo Medical Center, Tokyo Women's Medical University, Chiba, Japan
| | - Junya Itou
- Department of Orthopaedic Surgery, Tokyo Women's Medical University, 8-1 Kawadacho, Shinjuku, Tokyo, Japan
| | - Umito Kuwashima
- Department of Orthopaedic Surgery, Tokyo Women's Medical University, 8-1 Kawadacho, Shinjuku, Tokyo, Japan
| | - Ken Okazaki
- Department of Orthopaedic Surgery, Tokyo Women's Medical University, 8-1 Kawadacho, Shinjuku, Tokyo, Japan.
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Loth FL, Liebensteiner MC, Giesinger JM, Giesinger K, Bliem HR, Holzner B. What makes patients aware of their artificial knee joint? BMC Musculoskelet Disord 2018; 19:5. [PMID: 29310652 PMCID: PMC5759839 DOI: 10.1186/s12891-017-1923-4] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [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: 08/08/2017] [Accepted: 12/27/2017] [Indexed: 11/13/2022] Open
Abstract
Background Joint awareness was recently introduced as a new concept for outcome assessment after total knee arthroplasty (TKA). Findings from qualitative and psychometric studies suggest that joint awareness is a distinct concept especially relevant to patients with good surgical outcome and patients at late follow-up time points. The aim of this study was to improve the understanding of the concept of joint awareness by identifying situations in which patients are aware of their artificial knee joint and to investigate what bodily sensations and psychological factors raise a patient’s awareness of her/his knee. In addition, we evaluated the relative importance of patient-reported outcome parameters that are commonly assessed in orthopaedics. Methods Qualitative interviews were conducted with patients being at least 12 months after TKA. The interviews focused on when, where and for what reasons patients were aware of their artificial knee joint. To evaluate the relative importance of ‘joint awareness’ after TKA among nine commonly assessed outcome parameters (e.g. pain or stiffness), we collected importance ratings (‘0’ indicating no importance at all and ‘10’ indicating high importance). Results We conducted interviews with 40 TKA patients (mean age 69.0 years; 65.0% female). Joint awareness was found to be frequently triggered by kneeling on the floor (30%), climbing stairs (25%), and starting up after resting (25%). Patients reported joint awareness to be related to activities of daily living (68%), specific movements (60%), or meteoropathy (18%). Sensations causing joint awareness included pain (45%) or stiffness (15%). Psychological factors raising a patient’s awareness of his/her knee comprised for example feelings of insecurity (15%), and fears related to revision surgeries, inflammations or recurring pain (8%). Patients’ importance ratings of outcome parameters were generally high and did not allow differentiating clearly among them. Conclusions We have identified a wide range of situations, activities, movements and psychological factors contributing to patients’ awareness of their artificial knee joints. This improves the understanding of the concept of joint awareness and of a patient’s perception of his/her artificial knee joint. The diversity of sensations and factors raising patient’s awareness of their joint encourages taking a broader perspective on outcome after TKA.
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Affiliation(s)
- F L Loth
- Institute of Psychology, University of Innsbruck, A-6020, Innsbruck, Austria
| | - M C Liebensteiner
- Department for Orthopaedic Surgery, Medical University Innsbruck, A-6020, Innsbruck, Austria
| | - J M Giesinger
- Innsbruck Institute of Patient-centered Outcome Research (IIPCOR), A-6020, Innsbruck, Austria
| | - K Giesinger
- Department of Orthopaedics and Traumatology, Kantonspital St. Gallen, CH-9007, St. Gallen, Switzerland
| | - H R Bliem
- Institute of Psychology, University of Innsbruck, A-6020, Innsbruck, Austria
| | - B Holzner
- Department of Psychiatry, Psychotherapy and Psychosomatics, Medical University of Innsbruck, Anichstrasse 35, A-6020, Innsbruck, Austria.
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Behrend H, Zdravkovic V, Giesinger JM, Giesinger K. Joint awareness after ACL reconstruction: patient-reported outcomes measured with the Forgotten Joint Score-12. Knee Surg Sports Traumatol Arthrosc 2017; 25:1454-1460. [PMID: 27761622 DOI: 10.1007/s00167-016-4357-x] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [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: 02/03/2016] [Accepted: 10/07/2016] [Indexed: 12/18/2022]
Abstract
PURPOSE To measure joint awareness in patients who have undergone anterior cruciate ligament (ACL) reconstruction and to investigate medium- and long-term results of the procedure. METHODS All patients who had undergone ACL reconstruction with the same arthroscopic surgical technique at our institution between 2011 and 2014 (medium-term follow-up group (Group I)) or between 2000 and 2005 (long-term follow-up group (Group II)) were considered for inclusion in the study. A group of healthy controls were recruited to obtain reference values for the FJS-12 (Forgotten Joint Score-12). Propensity score matching was applied to improve comparability of patients and healthy controls in terms of sex and age. RESULTS Fifty-eight patients of the Group I (mean follow-up 31.5 (SD13.4) months, range 12-54), 57 patients of the Group II (mean follow-up 139 (SD15.2) months, range 120-179), and the healthy control samples (100 individuals) were analysed. Significantly lower FJS-12 was found in both groups (Group I: 71.6 and Group II: 70.1), compared to the two matched control groups (88.1 and 90.0). CONCLUSIONS The concept of joint awareness was successfully applied to evaluate medium- and long-term results of ACL reconstruction. The clinical relevance of this study is that it extends the construct of joint awareness as a patient-reported outcome parameter to ACL reconstruction surgery. LEVEL OF EVIDENCE Level III.
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Affiliation(s)
- Henrik Behrend
- Department of Orthopaedic Surgery and Traumatology, Kantonsspital St. Gallen, 9007, St. Gallen, Switzerland.
| | - Vilijam Zdravkovic
- Department of Orthopaedic Surgery and Traumatology, Kantonsspital St. Gallen, 9007, St. Gallen, Switzerland
| | - Johannes M Giesinger
- Department of Psychiatry and Psychotherapy, Innsbruck Medical University, 6020, Innsbruck, Austria
| | - Karlmeinrad Giesinger
- Department of Orthopaedic Surgery and Traumatology, Kantonsspital St. Gallen, 9007, St. Gallen, Switzerland
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Hiyama Y, Wada O, Nakakita S, Mizuno K. Joint awareness after total knee arthroplasty is affected by pain and quadriceps strength. Orthop Traumatol Surg Res 2016; 102:435-9. [PMID: 27052936 DOI: 10.1016/j.otsr.2016.02.007] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [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: 10/24/2015] [Revised: 02/11/2016] [Accepted: 02/24/2016] [Indexed: 02/02/2023]
Abstract
INTRODUCTION There is a growing interest in the use of patient-reported outcomes to provide a more patient-centered view on treatment. Forgetting the artificial joint can be regarded as the goal in joint arthroplasty. The goals of the study were to describe changes in joint awareness in the artificial joint after total knee arthroplasty (TKA), and to determine which factors among pain, knee range of motion (ROM), quadriceps strength, and functional ability affect joint awareness after TKA. HYPOTHESIS Patients undergoing TKA demonstrate changes in joint awareness and joint awareness is associated with pain, knee ROM, quadriceps strength, and functional ability. PATIENTS AND METHODS This prospective cohort study comprised 63 individuals undergoing TKA, evaluated at 1, 6, and 12 months postoperatively. Outcomes included joint awareness assessed using the Forgotten Joint Score (FJS), pain score, knee ROM, quadriceps strength, and functional ability. RESULTS Fifty-eight individuals completed all postoperative assessments. All measures except for knee extension ROM improved from 1 to 6 months. However, there were no differences in any measures from 6 to 12 months. FJS was affected most greatly by pain at 1 month and by quadriceps strength at 6 and 12 months. DISCUSSION Patients following TKA demonstrate improvements in joint awareness and function within 6 months after surgery, but reach a plateau from 6 to 12 months. Quadriceps strength could contribute to this plateau of joint awareness. LEVEL OF EVIDENCE Prospective cohort study, IV.
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Affiliation(s)
- Y Hiyama
- Department of physical therapy, school of health sciences, Tokyo university of technology, 5-23-22, Nishikamata, Ota-ku, Tokyo, Japan.
| | - O Wada
- Anshin hospital, 1-4-12, Minatojimaminamimachi, Chuo-ku, Kobe, Hyogo, Japan
| | - S Nakakita
- Anshin hospital, 1-4-12, Minatojimaminamimachi, Chuo-ku, Kobe, Hyogo, Japan
| | - K Mizuno
- Anshin hospital, 1-4-12, Minatojimaminamimachi, Chuo-ku, Kobe, Hyogo, Japan
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