A Less Invasive Approach to Periacetabular Osteotomy Improves Patient Reported Outcomes without Compromising Orientation

2017 ◽  
Vol 01 (02) ◽  
pp. 093-098
Author(s):  
Christopher Pelt ◽  
Nathaniel Wingert ◽  
Jill Erickson ◽  
Mike Anderson ◽  
Christopher Peters
Keyword(s):  
Mental Health ◽  
Physical Function ◽  
Patient Reported Outcomes ◽  
Global Mental Health ◽  
Periacetabular Osteotomy ◽  
Consecutive Series ◽  
Invasive Approach ◽  
Less Invasive ◽  
Acetabular Fragment ◽  
Patient Reported

AbstractA less-invasive modification of the approach to periacetabular osteotomy (PAO) has recently been popularized by sparing the rectus femoris origin (RS-PAO). The RS-PAO approach with its lack of intra-articular inspection and associated treatment is novel, and there are few published results on the outcomes following this technique. We report on a consecutive series of RS-PAO cases, including patient reported outcomes (PROs), acetabular fragment reorientation, and complications. We reviewed a consecutive series of 103 patients (103 procedures) who underwent RS-PAO from June 2012 to January 2016 with a mean 2-year follow-up. We collected PROs, radiographic, and clinical outcomes. PROs consisted of PROMIS (Patient Reported Outcomes Measurement Information System) measures covering the domains of physical function, mental health, and a numeric pain score (NPS). Physical function and mental health were reported as standardized T-scores. Appropriate bivariate statistics were used for the analyses. Physical function improved from a preoperative mean of 39.9 (95% confidence interval [CI], 38.0–42.0) to a postoperative value of 50.0 T-score units (95% CI, 47.01–52.7; dav = 1.2). The PROMIS global mental-health T-scores improved from a preoperative median of 45.8 (interquartile range [IQR], 41.1–50.8) to a postoperative value of 53.3 (IQR, 50.8–59.0; p < 0.001, correlation coefficient [r] = 0.77). Pain decreased from a median preoperative value of 6 (IQR, 3–8) to a postoperative value of 2 (IQR, 1–3; p < 0.001, r = 0.71). The postoperative acetabular index (AI) was within the correction goal in 75% of the cases (77/103) and lateral center-edge angle (LCEA) was within goal in 87% (90/103) of the cases. Complications included intraoperative ischial fracture (n = 1), nonunion of the superior ramus (n = 1), ischiofemoral impingement (n = 1), delayed union (n = 1), and wound dehiscence (n = 2). There have been no reoperations for intra-articular pathology. The data demonstrated that using the RS-PAO technique without concomitant intra-articular work allows for appropriate acetabular positioning as well as significant improvement in physical function, mental health, and pain with an acceptable short-term complication profile and low rate of reoperation.

scholarly journals Changes in patient-reported outcomes in light chain amyloidosis in the first year after diagnosis and relationship to NT-proBNP change

2021 ◽  
Vol 11 (2) ◽  
Author(s):  
Anita D’Souza ◽  
Ruta Brazauskas ◽  
Angela Dispenzieri ◽  
Julie Panepinto ◽  
Kathryn E. Flynn
Keyword(s):  
Mental Health ◽  
Physical Function ◽  
Light Chain ◽  
Patient Reported Outcomes ◽  
Social Roles ◽  
Global Mental Health ◽  
First Year ◽  
Al Amyloidosis ◽  
Patient Reported ◽  
Anxiety Depression

AbstractWe conducted a prospective cohort study in newly diagnosed systemic light chain (AL) amyloidosis patients (N = 59) to study patient-reported outcomes (PROs) through the first year. The median age was 68 years with 42% female, 8% Black, and 78% lambda subtype. Organ involvement was cardiac in 66%, renal in 58%, with 25% having 3 or greater organs involved. Between baseline and 3 months, all PROMIS®-29 domain scores worsened by 0.4–4.1 points except anxiety which improved by 2.1 points. By 1 year, scores improved compared to the greatest decline at 3 months, most statistically significant for global physical health, physical function, and fatigue. On stage-adjusted survival analysis, in addition to baseline global physical and mental health, domains measuring physical function, fatigue, anxiety, depression, and social roles were associated with 1-year survival. At 1 year, PROMIS measures were associated with NT-proBNP changes and hematologic response. Among patients with an NT-proBNP response, the improvement was seen in physical function, social roles, global mental health, and anxiety. Among patients with an NT-proBNP progression, worsening was seen with anxiety, depression, sleep, and global mental health. Measuring and tracking PROs in patients with AL amyloidosis is important and these important outcomes can be used as correlative endpoints in clinical care/research.

scholarly journals The PROMIS Global Health Questionnaire Correlates With the QuickDASH in Patients With Upper Extremity Illness

Hand ◽  
2017 ◽  
Vol 13 (1) ◽  
pp. 118-121 ◽  
Author(s):  
Nicky Stoop ◽  
Mariano E. Menendez ◽  
Jos J. Mellema ◽  
David Ring
Keyword(s):  
Mental Health ◽  
Global Health ◽  
Upper Extremity ◽  
Patient Reported Outcomes ◽  
Global Mental Health ◽  
Pearson Correlation ◽  
Measurement Information ◽  
Consistent Finding ◽  
Patient Reported ◽  
Mental Health Subscale

Background: The objective of this study is to evaluate the construct validity of the Patient-Reported Outcomes Measurement Information System (PROMIS) Global Health instrument by establishing its correlation to the Quick-Disabilities of the Arm, Shoulder and Hand (QuickDASH) questionnaire in patients with upper extremity illness. Methods: A cohort of 112 patients completed a sociodemographic survey and the PROMIS Global Health and QuickDASH questionnaires. Pearson correlation coefficients were used to evaluate the association of the QuickDASH with the PROMIS Global Health items and subscales. Results: Six of the 10 PROMIS Global Health items were associated with the QuickDASH. The PROMIS Global Physical Health subscale showed moderate correlation with QuickDASH and the Mental Health subscale. There was no significant relationship between the PROMIS Global Mental Health subscale and QuickDASH. Conclusions: The consistent finding that general patient-reported outcomes correlate moderately with regional patient-reported outcomes suggests that a small number of relatively nonspecific patient-reported outcome measures might be used to assess a variety of illnesses. In our opinion, the blending of physical and mental health questions in the PROMIS Global Health makes this instrument less useful for research or patient care.

scholarly journals The Influence of Preoperative Deformity Severity in Postoperative Patient Reported Outcomes in Adult Acquired Flatfoot

2020 ◽  
Vol 5 (4) ◽  
pp. 2473011420S0002
Author(s):  
Bopha Chrea ◽  
Cesar de Cesar Netto ◽  
Jonathan H. Garfinkel ◽  
Jonathan Day ◽  
Guilherme H. Saito ◽  
...  
Keyword(s):  
Mental Health ◽  
Pain Intensity ◽  
Subtalar Joint ◽  
Patient Reported Outcomes ◽  
Global Mental Health ◽  
Multivariate Regression Analysis ◽  
Pain Interference ◽  
T Score ◽  
Metatarsal Angle ◽  
Patient Reported

Category: Ankle; Hindfoot; Other Introduction/Purpose: Adult acquired flatfoot deformity (AAFD) is a complex deformity. Previous work has demonstrated correlation between postoperative foot alignment and patient-reported outcomes. While this work has provided essential targets for surgeons performing flatfoot reconstruction, there is an absence of data that would enable surgeons to predict which patients are likely to have greater or less improvement after surgery based on their preoperative deformity. Conventional radiographs alone may not provide enough detail to isolate individual elements of the deformity. Weightbearing CT (WBCT) allows for far more precise analysis in this regard. We hypothesized that there would be a set of parameters defining preoperative alignment on WBCT that would predict which patients are at risk for a lower magnitude of postoperative improvement in patient-reported outcomes (PROs). Methods: In this retrospective IRB-approved study, patients that underwent surgical flatfoot reconstruction after having a preoperative standing WBCT were identified. Preoperative WBCT images were evaluated by two independent/blinded observers. Multiple parameters related to preoperative alignment and AAFD severity were measured in the sagittal, coronal and transverse planes. Parameters measured included talus-first metatarsal angle; distances between the floor and the navicular, medial cuneiform and cuboid; subtalar joint horizontal angle; superior talar - inferior talar angle; subtalar joint subluxation; talonavicular uncoverage angle; hindfoot moment arm (HMA); and foot and ankle offset (FAO). Prospectively collected data regarding preoperative and postoperative PROs was evaluated. Six PROs components were assessed: physical function; pain interference, pain intensity, global mental health, global physical health and depression. Multivariate regression analysis and a partition prediction model were used to assess the correlation between preoperative alignment and improvement in PROs. P-values of less than 0.05 were considered significant. Results: A total of 51 patients with a preoperative WBCT and postoperative PROs scores were identified and included. Demographic data is shown in Table 1. Multivariate regression analysis demonstrated that preoperative alignment significantly correlated with improvement in three out six components of PROs: pain interference, pain intensity and global mental health. The strongest predictor of improvement in PROMIS physical function t-score was medial cuneiform to floor distance, for pain interference t-score: cuboid to floor distance, for pain intensity: subtalar joint subluxation, for depression t-score: superior talar - inferior talar angle, and for global physical and mental health t-scores: sagittal talus-first metatarsal angle. Conclusion: Our analysis yielded readily identifiable cutoffs for WBCT measurements, where values above or below were correlated with significant differences in the magnitude of PRO score change. Interestingly, measures of sagittal plane collapse and hindfoot valgus were the most predictive of score changes. This data provides useful information for surgeons counseling patients prior to flatfoot reconstruction. Future work using this data to develop prediction models for postoperative outcomes would be valuable, as would studies using WBCT to evaluate the relationship between postoperative corrected alignment and PROs. Complete results are shown in the attached Table.

Obesity Does Not Affect Patient-Reported Outcomes following Patellofemoral Arthroplasty

2020 ◽  
Author(s):  
Jared C. Tishelman ◽  
Abigail Pyne ◽  
Cynthia A. Kahlenberg ◽  
Jordan A. Gruskay ◽  
Sabrina M. Strickland
Keyword(s):  
Quality Of Life ◽  
Mental Health ◽  
Physical Function ◽  
Patellofemoral Joint ◽  
Patient Reported Outcome Measures ◽  
Consecutive Series ◽  
Patellofemoral Arthroplasty ◽  
Significant Difference ◽  
Patient Reported

AbstractPatellofemoral arthroplasty (PFA) has garnered attention in recent years as an effective alternative to total knee arthroplasty for patients with symptomatic, isolated patellofemoral joint arthritis. Obesity has previously been identified as a risk factor for revision surgery, but its effect on patient-reported outcome measures (PROMs) has not been evaluated. A retrospective review of a consecutive series of PFA surgeries was conducted at a single, specialized orthopedics center in a major urban center. Patients were dichotomized by body mass index (BMI) as obese (O, BMI >30) or nonobese (NO, BMI: 18.5–25). Demographic, surgical information, and PROMs were collected and analyzed accordingly. Seventy-six patients (41 nonobese, 35 obese) were identified. Patients who were obese presented with significantly worse preoperative PROMs regarding knee-specific quality of life, physical function, and MH or mental health (knee injury and osteoarthritis outcome score quality of life [KOOS QoL], NO: 26.2, O: 14.7, p = 0.019; KOOS PF, NO: 38.2, O: 50.5, p = 0.002; Veterans Rand-12 mental health [VR-12 MH], NO: 54.2, O: 47.0, p = 0.033). No significant difference was seen in improvement in knee function scores between patients who were obese or nonobese (KOOS QoL, NO: 39.5, O: 40.6, p = 0.898; KOOS PS [physical function], NO: –17.8, O: –17.3, p = 0.945). Additionally, no difference in the rate of PFA revision was observed and there were no postoperative complications reported. Obese patients with isolated PFA can expect the same improvement in function as nonobese patients following patellofemoral joint arthroplasty. This paper underscores the priority of patient selection in PFA and challenges the notion that surgeons should exclude patients from receiving a PFA on the basis of obesity.

scholarly journals Comparative Effectiveness of Embedded Mental Health Services in Pain Management Clinics vs Standard Care

Pain Medicine ◽  
2019 ◽  
Vol 21 (5) ◽  
pp. 978-991
Author(s):  
Andrea Gillman ◽  
Di Zhang ◽  
Susan Jarquin ◽  
Jordan F Karp ◽  
Jong-Hyeon Jeong ◽  
...  
Keyword(s):  
Mental Health ◽  
Mental Health Services ◽  
Health Services ◽  
Behavioral Medicine ◽  
Physical Function ◽  
Standard Care ◽  
Patient Reported Outcomes ◽  
Pain Treatment ◽  
Common Component ◽  
Patient Reported

Abstract Objective Embedded behavioral medicine services are a common component of multidisciplinary chronic pain treatment programs. However, few studies have studied whether these services are associated with improved treatment outcomes. Methods Using a retrospective, matched, two-cohort study design, we examined patient-reported outcomes (PROs), including Patient-Reported Outcomes Measurement Information System pain, mental health, and physical function measures, collected at every clinic visit in every patient. Changes from baseline through 12 months were compared in those receiving embedded Behavioral Medicine in addition to usual care to a Standard Care group seen in the same pain practice and weighted via propensity scoring. Results At baseline, Behavioral Medicine patients had worse scores on most pain, mental health, and physical health measures and were more likely to be female, a member of a racial minority, and have lower socioeconomic status. Regardless of having a worse clinical pain syndrome at baseline, at follow-up both Behavioral Medicine (N = 451) and Standard Care patients (N = 8,383) showed significant and comparable improvements in pain intensity, physical function, depression, and sleep disturbance. Behavioral Medicine patients showed significantly greater improvements in their global impressions of change than the Standard Care patients. Conclusions Despite worse pain and physical and psychological functioning at baseline, Behavioral Medicine patients showed improvements comparable to patients not receiving these services. Further, Behavioral Medicine patients report higher global impressions of change, indicating that embedded mental health services appear to have the additive value of amplifying the benefits of multimodal pain care.

scholarly journals Comparison of Bone-Patella Tendon-Bone (BTB) and Quadriceps Autograft for ACL Reconstruction

2020 ◽  
Vol 8 (7_suppl6) ◽  
pp. 2325967120S0049
Author(s):  
Daniel Hogan ◽  
Joseph Rund ◽  
Richard Ma ◽  
Aaron Gray ◽  
John Welsh ◽  
...  
Keyword(s):  
Mental Health ◽  
Physical Function ◽  
Acl Reconstruction ◽  
Global Mental Health ◽  
Cruciate Ligament ◽  
Surgical Patient ◽  
Graft Choice ◽  
Patient Reported ◽  
Anterior Cruciate

Objectives: Graft choice for anterior cruciate ligament (ACL) reconstruction remains controversial. Quadriceps autograft has emerged as an alternative graft choice. However, there remains a paucity of comparative outcomes. Our purpose is to compare subjective outcomes and complications of ACL reconstruction using either BTB or quadriceps autograft. Our hypothesis is that there will be no difference in subjective outcome or complications between groups. Methods: Following IRB approval, retrospective review of prospectively collected data identified consecutive cohorts of patients undergoing ACL reconstruction with either BTB or quadriceps autograft. Surgery was performed by a single sports fellowship trained surgeon between 2011-2019. Patients undergoing concomitant osteotomies, cartilage restoration, and other ligament reconstruction procedures were excluded. Pre- and post-surgical patient reported outcomes (PROs) including IKDC, KOOS, PROMIS, SANE, Tegner, and Marx were compared between groups. Complications requiring re-operation (infection, stiffness, reconstruction failure) were recorded. Results were analyzed statistically. Results: 141 patients met inclusion criteria. There were 72 BTB and 69 quadriceps autografts. Mean age was 20.5 years in the BTB group and 20.7 years in the quadriceps group (p=0.9). 28 of 69 (40.6%) BTB and 34 of 72 (47.2%) quadriceps were female. Pre-operative KOOS Pain (64.5, 78.0, p=0.0007), KOOS QOL (29.6, 37.7, p=0.05), IKDC (44.5, 52.6, p=0.05), and PROMIS Physical Function (39.0, 42.7 p=0.04) scores were significantly higher in the BTB cohort. There were no differences in other baseline PROs. At minimum 6-month follow-up (range 6 - 57 months), patients in both quadriceps and BTB autograft cohorts reported statistically significant improvements in all KOOS domains, Tegner (76.4%, p=0.0002; 94.0%, p=0.000000003), IKDC (67.3%, p=0.0000009; 54.0%, p=0.000000009), SANE (69.4%, p=0.0000001; 70.7%, p=0.000000002), PROMIS Mobility T-Score (30.6%, p=0.0000003; 24.6%, p=0.000002), PROMIS Global Physical Health (15.3%, p=0.00002; 14.3%, p=0.00004), PROMIS Physical Function (33.2%, p=0.0000000008; 29.6%, p=0.00000002), PROMIS Pain Interference (-17.9%, p=0.00000002; -20.8%, p=0.00000000007). Post-operative Tegner (4.7, 6.0, p=0.04) and Global Mental Health (55.7, 60.1, p=0.008) scores were significantly higher in the BTB cohort. Complications were low and not significant between groups. Both quadriceps and BTB autograft cohorts required post-operative re-operations (4.4% and 6.9%, p=0.5). Quadriceps had 2 ligament reconstructions (2.9%) and 1 surgery for stiffness (1.4%). BTB group had 3 ligament reconstructions (4.2%) and 2 surgeries for stiffness (2.8%). Conclusion: Patients undergoing either BTB and quadriceps autograft ACL reconstruction demonstrated significant subjective improvements and low rates of complications requiring re-operation. At mid-term follow-up, the BTB cohort had higher activity and mental health scores.

Impact of Preoperative Opioid Use on 2-Year Patient-Reported Outcomes in Knee Surgery Patients

2020 ◽  
Author(s):  
Ali Aneizi ◽  
Patrick M. J. Sajak ◽  
Aymen Alqazzaz ◽  
Tristan Weir ◽  
Cameran I. Burt ◽  
...  
Keyword(s):  
Physical Function ◽  
Patient Reported Outcomes ◽  
Knee Surgery ◽  
The Body ◽  
Pain Interference ◽  
Opioid Use ◽  
Opioid Prescription ◽  
Social Satisfaction ◽  
Patient Reported ◽  
Met Expectations

AbstractThe objectives of this study are to assess perioperative opioid use in patients undergoing knee surgery and to examine the relationship between preoperative opioid use and 2-year postoperative patient-reported outcomes (PROs). We hypothesized that preoperative opioid use and, more specifically, higher quantities of preoperative opioid use would be associated with worse PROs in knee surgery patients. We studied 192 patients undergoing knee surgery at a single urban institution. Patients completed multiple PRO measures preoperatively and 2-year postoperatively, including six patient-reported outcomes measurement information system (PROMIS) domains; the International Knee Documentation Committee (IKDC) questionnaire, numeric pain scale (NPS) scores for the operative knee and the rest of the body, Marx's knee activity rating scale, Tegner's activity scale, International Physical Activity Questionnaire, as well as measures of met expectations, overall improvement, and overall satisfaction. Total morphine equivalents (TMEs) were calculated from a regional prescription monitoring program. Eighty patients (41.7%) filled an opioid prescription preoperatively, and refill TMEs were significantly higher in this subpopulation. Opioid use was associated with unemployment, government insurance, smoking, depression, history of prior surgery, higher body mass index, greater comorbidities, and lower treatment expectations. Preoperative opioid use was associated with significantly worse 2-year scores on most PROs, including PROMIS physical function, pain interference, fatigue, social satisfaction, IKDC, NPS for the knee and rest of the body, and Marx's and Tegner's scales. There was a significant dose-dependent association between greater preoperative TMEs and worse scores for PROMIS physical function, pain interference, fatigue, social satisfaction, NPS body, and Marx's and Tegner's scales. Multivariable analysis confirmed that any preoperative opioid use, but not quantity of TMEs, was an independent predictor of worse 2-year scores for function, activity, and knee pain. Preoperative opioid use and TMEs were neither independent predictors of met expectations, satisfaction, patient-perceived improvement, nor improvement on any PROs. Our findings demonstrate that preoperative opioid use is associated with clinically relevant worse patient-reported knee function and pain after knee surgery.

Understanding quality of life and treatment history of patients with Bertolotti syndrome compared with lumbosacral radiculopathy

2019 ◽  
Vol 31 (2) ◽  
pp. 222-228 ◽  
Author(s):  
Joshua L. Golubovsky ◽  
Arbaz Momin ◽  
Nicolas R. Thompson ◽  
Michael P. Steinmetz
Keyword(s):  
Quality Of Life ◽  
Mental Health ◽  
Propensity Score ◽  
Disc Herniation ◽  
Symptom Onset ◽  
Patient Reported Outcomes ◽  
Lumbosacral Radiculopathy ◽  
Patient Reported ◽  
Age And Sex

OBJECTIVEBertolotti syndrome is a rare spinal condition that causes low-back pain due to a lumbosacral transitional vertebra (LSTV), which is a pseudoarticulation between the fifth lumbar transverse process and the sacral ala. Bertolotti syndrome patients are rarely studied, particularly with regard to their quality of life. This study aimed to examine the quality of life and prior treatments in patients with Bertolotti syndrome at first presentation to the authors’ center in comparison with those with lumbosacral radiculopathy.METHODSThis study was a retrospective cohort analysis of patients with Bertolotti syndrome and lumbosacral radiculopathy due to disc herniation seen at the authors’ institution’s spine center from 2005 through 2018. Diagnoses were confirmed with provider notes and imaging. Variables collected included demographics, diagnostic history, prior treatment, patient-reported quality of life metrics, and whether or not they underwent surgery at the authors’ institution. Propensity score matching by age and sex was used to match lumbosacral radiculopathy patients to Bertolotti syndrome patients. Group comparisons were made using t-tests, Fisher’s exact test, Mann-Whitney U-tests, Cox proportional hazards models, and linear regression models where variables found to be different at the univariate level were included as covariates.RESULTSThe final cohort included 22 patients with Bertolotti syndrome who had patient-reported outcomes data available and 46 propensity score–matched patients who had confirmed radiculopathy due to disc herniation. The authors found that Bertolotti syndrome patients had significantly more prior epidural steroid injections (ESIs) and a longer time from symptom onset to their first visit. Univariate analysis showed that Bertolotti syndrome patients had significantly worse Patient-Reported Outcomes Measurement Information System (PROMIS) mental health T-scores. Adjustment for prior ESIs and time from symptom onset revealed that Bertolotti syndrome patients also had significantly worse PROMIS physical health T-scores. Time to surgery and other quality of life metrics did not differ between groups.CONCLUSIONSPatients with Bertolotti syndrome undergo significantly longer workup and more ESIs and have worse physical and mental health scores than age- and sex-matched patients with lumbosacral radiculopathy. However, both groups of patients had mild depression and clinically meaningful reduction in their quality of life according to all instruments. This study shows that Bertolotti syndrome patients have a condition that affects them potentially more significantly than those with lumbosacral radiculopathy, and increased attention should be paid to these patients to improve their workup, diagnosis, and treatment.

scholarly journals Which patient-reported outcomes do rheumatology patients find important to track digitally? A real-world longitudinal study in ArthritisPower

2021 ◽  
Vol 23 (1) ◽  
Author(s):  
W. Benjamin Nowell ◽  
Kelly Gavigan ◽  
Carol L. Kannowski ◽  
Zhihong Cai ◽  
Theresa Hunter ◽  
...  
Keyword(s):  
Physical Function ◽  
Lupus Erythematosus ◽  
Patient Reported Outcomes ◽  
Treatment Effectiveness ◽  
Time Window ◽  
Joint Stiffness ◽  
Summary Score ◽  
Longitudinal Tracking ◽  
Patient Reported

Abstract Background Patient-reported outcomes (PROs) are increasingly used to track symptoms and to assess disease activity, quality of life, and treatment effectiveness. It is therefore important to understand which PROs patients with rheumatic and musculoskeletal disease consider most important to track for disease management. Methods Adult US patients within the ArthritisPower registry with ankylosing spondylitis, fibromyalgia syndrome, osteoarthritis, osteoporosis, psoriatic arthritis, rheumatoid arthritis, and systemic lupus erythematosus were invited to select between 3 and 10 PRO symptom measures they felt were important to digitally track for their condition via the ArthritisPower app. Over the next 3 months, participants (pts) were given the option to continue tracking their previously selected measures or to remove/add measures at 3 subsequent monthly time points (month [m] 1, m2, m3). At m3, pts prioritized up to 5 measures. Measures were rank-ordered, summed, and weighted based on pts rating to produce a summary score for each PRO measure. Results Among pts who completed initial selection of PRO assessments at baseline (N = 253), 140 pts confirmed or changed PRO selections across m1–3 within the specified monthly time window (28 days ± 7). PROs ranked as most important for tracking were PROMIS Fatigue, Physical Function, Pain Intensity, Pain Interference, Duration of Morning Joint Stiffness, and Sleep Disturbance. Patient’s preferences regarding the importance of these PROs were stable over time. Conclusion The symptoms that rheumatology patients prioritized for longitudinal tracking using a smartphone app were fatigue, physical function, pain, and morning joint stiffness.

scholarly journals Sex differences in outcomes after arthroscopic bankart repair

2020 ◽  
Vol 6 (1) ◽  
pp. e000965
Author(s):  
Natalie A Lowenstein ◽  
Peter J Ostergaard ◽  
Daniel B Haber ◽  
Kirsten D Garvey ◽  
Elizabeth G Matzkin
Keyword(s):  
Mental Health ◽  
Sex Differences ◽  
Patient Reported Outcomes ◽  
Strength Function ◽  
Bankart Repair ◽  
Level Of Evidence ◽  
Arthroscopic Bankart Repair ◽  
Patient Reported ◽  
Males And Females

ObjectivesRisk factors for anterior shoulder dislocation include young age, contact activities and male sex. The influence of sex on patient-reported outcomes of arthroscopic Bankart repair (ABR) is unclear, with few studies reporting potential differences. This study’s purpose was to compare patient-reported outcomes of males and females following ABR.MethodsProspectively collected data was analysed for 281 patients (males: 206, females: 75) after ABR with preoperative, 1-year and 2-year follow-up responses. The Wilcoxon signed-rank and χ2 tests, preoperative, 1 year and 2 year follow-up results were examined to determine differences of scores in males versus females.ResultsNo statistically significant sex differences were observed in Simple Shoulder Test (SST), American Shoulder and Elbow Surgeons (ASES), Visual Analogue Scale (VAS) or Single Assessment Numerical Evaluation (SANE) Scores at 1-year or 2-year follow-up. Females had lower Veterans RAND 12-item health survey (VR-12) mental health subscores at 2-year follow-up (females: 52.3±9.0, males: 55.8±7.6, p=0.0016). Females were more likely to report that treatment had ‘exceeded expectations’ at 2-year follow-up regarding motion, strength, function and normal sports activities.ConclusionResults of study demonstrate that ABR has similar outcomes for both males and females. There were no statistically significant sex-related differences in SST, ASES, VAS or SANE scores following ABR. VR-12 mental health subscores showed a minimal difference at 2-year follow-up, with lower scores in females.Level of evidenceRetrospective cohort study; level II.

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