Does pain and hip function improve 2 years after reverse periacetabular osteotomy? A follow-up study of 74 patients

Abstract Data on outcome in patients with acetabular retroversion (AR) treated with reverse periacetabular osteotomy (reverse PAO) are sparse. The aim of the study was to investigate changes in pain and hip function among patients with AR 2 years after reverse PAO and to examine whether changes in pain were associated with changes in hip function. In addition, to evaluate patient satisfaction and changes in quality of life (QoL). We present a prospective follow-up study with patient-reported outcome data from Aarhus University Hospital in Denmark. Pain at rest and during activity was measured with a Visual Analogue Scale (VAS), hip function with the Hip disability and Osteoarthritis Outcome Score (HOOS) and QoL with the Short-Form 36, pre-operatively and 2 years after reverse PAO in 74 patients. Changes were analysed using paired t-test and multiple linear regressions. Significant and clinically relevant mean improvements in pain and hip function were found. The numbers of responders achieving a minimal clinically important difference varied from 51 to 73%. Positive significant association between changes in pain and changes in hip function were found. Significant mean improvement in QoL was found. The study had a loss to follow-up of 23%. Two years after reverse PAO, patients diagnosed with AR showed significant and clinically relevant mean improvements in pain and hip function. Decreased pain was significantly associated with improved hip function. The majority of patients were satisfied with the result of surgery and QoL was similar to the Danish background population.

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Short-form 6D assessment in compression module of the American College of Phlebology Patient Reported Outcome Venous Registry

Phlebology The Journal of Venous Disease ◽

10.1177/0268355517717425 ◽

2017 ◽

Vol 33 (6) ◽

pp. 425-429 ◽

Cited By ~ 1

Author(s):

Yung-Wei Chi ◽

Blythe Durbin-Johnson ◽

Marlin Schul

Keyword(s):

Short Form ◽

Patient Reported Outcome ◽

Compression Stockings ◽

Test Analysis ◽

Linear Mixed Effects Model ◽

Linear Mixed Effects ◽

Time Period ◽

Patient Reported ◽

Registry Analysis

Objective The goal of this American College of Phlebology Patient Reported Outcome Venous Registry analysis was to examine the clinical efficacy of compression stockings using short-form 6D questionnaire (SF-6D). Method SF-6D scores were modeled over time using linear mixed effects model. Changes of SF-6D score from baseline to the last encounter were examined using a paired t-test. Analysis of variance was used to compare changes from baseline in SF-6D scores between C classifications. All analyses were conducted using SAS software, version 9.4 (SAS Institute, Cary NC). Results Baseline mean SF-6D score was 0.83 and at follow-up, 0.85. Mean SF-6D change was +0.02 points (P = .001) over an average time period of 5.5 months. Patients’ SF-6D scores were estimated to increase by +0.03 points (P = .005) per year of usage of compression stockings. SF-6D score changes across C classifications did not demonstrate significant differences (P = .265). Conclusion There was an improvement of SF-6D score in the registry participants who used circular knit compression stockings.

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Health-related quality-of-life (HRQoL) analysis from a randomized phase II trial of androgen signaling inhibitors with or without androgen deprivation therapy (ADT) for castration-sensitive prostate cancer: LACOG 0415.

Journal of Clinical Oncology ◽

10.1200/jco.2021.39.6_suppl.64 ◽

2021 ◽

Vol 39 (6_suppl) ◽

pp. 64-64

Author(s):

Andrey Soares ◽

Diogo Assed Bastos ◽

Fabio A. B. Schutz ◽

Eduardo Cronemberger ◽

Murilo Luz ◽

...

Keyword(s):

Prostate Cancer ◽

Locally Advanced ◽

Patient Reported Outcome ◽

Abiraterone Acetate ◽

Outcome Data ◽

Rank Test ◽

Emotional Wellbeing ◽

Patient Reported ◽

Related Quality

64 Background: LACOG0415 is a 3-arm randomized trial evaluating ADT with abiraterone acetate plus prednisone (ADT+AAP), apalutamide alone (APA) or apalutamide with AAP (APA+AAP) for patients with locally-advanced, high-risk biochemical recurrence or metastatic castration-sensitive prostate cancer (ASCO 2020). In this trial, ADT+AAP and APA+AAP achieved the primary endpoint of percentage of patients with PSA ≤ 0.2 ng/mL at week 25. Apalutamide alone showed a high PSA decline > 50% rate, but did not achieve the pre-specified PSA threshold. Here we report patient-reported outcome data using Functional Assessment of Cancer Therapy-Prostate (FACT-P). Methods: HRQoL was measured in the overall population using the FACT-P questionnaire, comprising 5 subscales: physical wellbeing (PWB), functional wellbeing (FWB), emotional wellbeing (EWB), social/family wellbeing (SFWB), and prostate cancer subscale (PCS). Scores for each patient were measured at baseline and every four weeks until week 25. Questionnaire completion was defined as ≥ 1 question answered at an assessment time point. Analysis of HRQoL change from baseline and deterioration included only patients with baseline and ≥ 1 postbaseline score. Differences greater than 10-points in FACT-P total score and differences greater than 3-points in PWB, FWB, EWB, SFWB, and PCS scores were considered clinically significant. The time-to-event endpoint was estimated by Kaplan-Meier method and compared by stratified log-rank test. Results: 128 patients were included in LACOG0415 trial and 122 of them completed the HRQoL assessments (ranging from 95.3% at baseline to 79.7% at week 25). FACT-P and all subscales scores were similar for all three arms at baseline. There were no meaningful differences in FACT-P scores at baseline and at week 25 between the 3 arms. The subscales scores also showed no statistically differences at baseline and at week 25. Time to FACT-P deterioration did not show any statistically difference between three arms ( P=0.3371). Conclusions: ADT free alternatives with APA alone or APA+AAP did not show meaningful differences in HRQoL in patients with advanced castration-sensitive prostate cancer compared to ADT+AAP. The short follow-up period limited the ability to explore differences in HRQoL after 25 weeks. Larger studies with longer follow-up are needed to further evaluate HRQoL with ADT-free strategies. Clinical trial information: NCT02867020. [Table: see text]

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Feasibility of Collecting Multiple Patient-Reported Outcome Measures Alongside the Dutch Arthroplasty Register

Journal of Patient Experience ◽

10.1177/2374373519853166 ◽

2019 ◽

Vol 7 (4) ◽

pp. 484-492

Author(s):

Claire Tilbury ◽

Claudia S Leichtenberg ◽

Bart L Kaptein ◽

Lennard A Koster ◽

Suzan H M Verdegaal ◽

...

Keyword(s):

Outcome Measures ◽

Short Form ◽

Response Rates ◽

Patient Reported Outcome Measures ◽

Patient Reported Outcome ◽

Participation Rates ◽

Arthroplasty Register ◽

Patient Reported ◽

Lost To Follow Up

Background: Compliance rates with patient-reported outcome measures (PROMs) collected alongside arthroplasty registries vary in the literature. We described the feasibility of a routinely collected set PROMs alongside the Dutch Arthroplasty Register. Methods: The longitudinal Leiden Orthopaedics Outcomes of OsteoArthritis Study is a multicenter (7 hospitals), observational study including patients undergoing total hip or total knee arthroplasty (THA or TKA). A set of PROMs: Short Form-12, EuroQol 5 Dimensions, Hip/Knee injury and Osteoarthritis Outcome Score, Oxford Hip/Knee Score was collected preoperatively and at 6, 12, 24 months, and every 2 years thereafter. Participation rates and response rates were recorded. Results: Between June 2012 and December 2014, 1796 THA and 1636 TKA patients were invited, of whom 1043 THA (58%; mean age 68 years [standard deviation, SD: 10]) and 970 TKA patients (59%; mean age 71 years [SD 9.5]) participated in the study. At 6 months, 35 THA/38 TKA patients were lost to follow-up. Response rates were 90% for THA (898/1000) and 89% for TKA (827/932) participants. At 1 and 2 years, 8 and 18 THA and 17 and 11 TKA patients were lost to follow-up, respectively. The response rates among those eligible were 87% (866/992) and 84% (812/972) for THA and 84% (771/917) and 83% (756/906) for TKA patients, respectively. The 2-year questionnaire was completed by 78.5% of the included THA patients and by 77.9% of the included TKA patients. Conclusions: About 60% of patients undergoing THA or TKA complete PROMs preoperatively, with more than 80% returning follow-up PROMs. To increase the participation rates, more efforts concerning the initial recruitment of patients are needed.

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Assessing the Attitudes, Awareness, and Behavioral Alterations of Patients Awaiting Total Hip Arthroplasty During the COVID-19 Crisis

Geriatric Orthopaedic Surgery & Rehabilitation ◽

10.1177/2151459320969377 ◽

2020 ◽

Vol 11 ◽

pp. 215145932096937

Author(s):

Stephen Fahy ◽

Joss Moore ◽

Michael Kelly ◽

Shane Irwin ◽

Paddy Kenny

Keyword(s):

Mental Health ◽

Short Form ◽

Hip Osteoarthritis ◽

Surgical Care ◽

Patient Reported Outcome Measures ◽

Patient Reported Outcome ◽

Harris Hip Score ◽

Physical And Mental Health ◽

Patient Reported ◽

Hip Function

Background: COVID-19 has placed a huge burden on healthcare systems which has led to widespread cancellation elective surgical care. Ireland is recovering from the first wave of COVID-19 and as such the expeditious return of elective surgical care is important. This is the first study to examine the attitudes of patients to undergoing total joint arthroplasty during the COVID-19 crisis. Methods: A prospective qualitative study was undertaken in our institution during the week 13/05/2020-20/05/2020. 65 patients completed a questionnaire assessing attitudes, awareness, and behavioral changes associated with COVID-19, a Charlson Comorbidity Index, modified-Harris Hip Score, and a Short Form-12 score. Results: 86% of patients felt that they were at little to no risk of COVID-19 infection. The majority of patients were happy to proceed with surgery at the current level of COVID-19 related threat (86%). Patients with higher mHHS were more likely to postpone their operation than those with lower mHHS scores. Our cohort had low patient reported outcome measures in both mHHS and SF-12, indicating the significant burden of hip osteoarthritis on both physical and mental health. Conclusion: Patients reported a significant disease-related impairment of physical function and subsequent deterioration in mental health as a result of hip osteoarthritis. Patients with worse hip function, as measured by the mHHS are more willing to proceed with surgery than those with superior hip function. This offers a potential mechanism by which to triage patients once elective surgical pathways reopen in the coming months.

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Incidence and risk factors for hardware removal following periacetabular osteotomy and its association with clinical outcomes

Hip International ◽

10.1177/1120700019890852 ◽

2019 ◽

pp. 112070001989085

Author(s):

Cody C Wyles ◽

Joseph M Statz ◽

Mario Hevesi ◽

Brian P Chalmers ◽

Rafael J Sierra ◽

...

Keyword(s):

Periacetabular Osteotomy ◽

Multivariable Analysis ◽

Patient Characteristics ◽

Patient Reported Outcome ◽

Developmental Dysplasia ◽

Hardware Removal ◽

Severe Dysplasia ◽

Patient Reported ◽

Lateral Centre Edge Angle

Background: Periacetabular osteotomy (PAO) can be used for joint preservation in symptomatic developmental dysplasia of the hip (DDH) and femoroacetabular impingement (FAI). 1 of the most common procedures following PAO is hardware removal. The aims of this study were to determine the rate of hardware removal and patient characteristics associated with this outcome following PAO. Methods: Data from a prospectively-collected registry was retrospectively reviewed at one institution managing DDH or FAI patients with PAO from July 2008–December 2015. Patients who completed preoperative and postoperative patient reported outcome (PRO) questionnaires with minimum 1-year follow-up were evaluated, resulting in 221 patients followed for a mean of 2.8 years (range 1.0–7.7 years). There were 80% women, mean age was 25 years and mean body mass index (BMI) was 25 kg/m2. Fully-threaded 4.5-mm screws were used for internal fixation. Results: Hardware removal occurred in 30 patients (13.6%) at a mean of 1.0 years after PAO. Patients undergoing hardware removal were younger (mean age 20.4 vs. 26.3 years), thinner (mean BMI 22.2 vs. 25.1), had less severe dysplasia (DDH patients only: mean lateral centre-edge angle 21.0 vs. 16.2, mean Tönnis angle 12.9 vs. 16.8), and were more likely to have PAO for FAI (33% vs. 11%) compared to patients with retained hardware. At final follow-up, multivariable analysis demonstrated a trend toward inferior patient reported outcomes in the hardware removal group. Conclusions: This study defines the incidence and characteristics of patients undergoing hardware removal after PAO and demonstrates similar outcomes to patients who do not require hardware removal.

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Impaired Quality of Life After Radioiodine Therapy Compared to Antithyroid Drugs or Surgical Treatment for Graves' Hyperthyroidism: A Long-Term Follow-Up with the Thyroid-Related Patient-Reported Outcome Questionnaire and 36-Item Short Form Health Status Survey

Thyroid ◽

10.1089/thy.2018.0315 ◽

2019 ◽

Vol 29 (3) ◽

pp. 322-331 ◽

Cited By ~ 19

Author(s):

Ove Törring ◽

Torquil Watt ◽

Gabriel Sjölin ◽

Kristina Byström ◽

Mirna Abraham-Nordling ◽

...

Keyword(s):

Short Form ◽

Patient Reported Outcome ◽

Antithyroid Drugs ◽

Outcome Questionnaire ◽

Patient Reported ◽

Long Term Follow Up ◽

Impaired Quality

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Does Dynamic Ventral Plate Fixation Provide Adequate Stability for Traumatic Subaxial Cervical Spine Fractures in Mid-term Follow-up?

10.21203/rs.3.rs-97256/v1 ◽

2020 ◽

Author(s):

Siegmund Lang ◽

Carsten Neumann ◽

Lasse Fiedler ◽

Volker Alt ◽

Markus Loibl ◽

...

Keyword(s):

Locking Plate ◽

Sagittal Alignment ◽

Short Form ◽

Patient Reported Outcome ◽

Type B ◽

Cervical Fractures ◽

Sf 36 ◽

Patient Reported ◽

Bony Consolidation

Abstract BackgroundIt remains questionable if the treatment of cervical fractures with dynamic plates in trauma surgery provides adequate stability for fractures with disco-ligamentous injuries. The primary goal of this study was to assess the radiological and mid-term patient-reported outcome of traumatic subaxial cervical fractures treated with a dynamic plate compared to rigid locking plate system.Patients and MethodsPatients, treated with anterior cervical discectomy and fusion (ACDF) between 2001 and 2015, using either a dynamic plate (DP: Mambo™, Ulrich, Germany) or a rigid locking plate (RP: CSLP™, Depuy Synthes, USA), were identified. Only patients with complete radiological follow (pre- and postoperatively and minimum one year after surgery) were included in the study. Next to the sagittal alignment, the sagittal anterior translation and the bony consolidation were evaluated. After at least two years the patient reported outcome measures (PROM) were evaluated using the German Short-Form 36 (SF-36) with the physical components summary (PCS) and mental components summary (MCS), Neck Disability Index (NDI) and the EuroQol in 5 Dimensions (EQ-5D) score.Results33 patients met the in- and exclusion criteria. 26 patients suffered from an AO Type B or C fracture. 13 patients were treated with a dynamic plate and 20 with a rigid locking plate. Both, the sagittal alignment, and the sagittal translation could be sufficiently restored with no differences between the two groups (p ≥ 0.05). No significant loss of reduction could be observed at the follow-up in both groups (p ≥ 0.05). Bony consolidation could be observed in 30 patients (91%) with no significant differences between both groups (DP: 12/13 (92%); RP: 18/20 (90%); (p ≥ 0.05)). In 20 patients PROMs could be evaluated after a mean follow-up of 71.2±25.5 months. No significant differences between DP and RP could be detected in EQ-5D, SF- 36 (PCS and MCS) or NDI (EQ-5D: 72±5; SF-36 PCS 41.9±16.2, MCS 45.4±14.9; NDI: 11±9).ConclusionThe dynamic plate concept provides enough stability without a difference in fusion rates in comparison to rigid locking plates in a population that mostly suffered AO Type B and C fractures.

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Development of the HOOSglobal to Assess Patient-Reported Outcomes in Patients Undergoing Hip Preservation Procedures

The American Journal of Sports Medicine ◽

10.1177/0363546517749585 ◽

2018 ◽

Vol 46 (4) ◽

pp. 940-946 ◽

Cited By ~ 6

Author(s):

Cale A. Jacobs ◽

Michael R. Peabody ◽

Stephen T. Duncan ◽

Ryan D. Muchow ◽

Ryan M. Nunley ◽

...

Keyword(s):

Los Angeles ◽

Short Form ◽

Periacetabular Osteotomy ◽

Patient Reported Outcome ◽

Harris Hip Score ◽

Level Of Evidence ◽

Patient Reported ◽

Orthopaedic Community ◽

Pro Tools ◽

Modified Harris Hip Score

Background: The creation of a single patient-reported outcome (PRO) platform validated across hip preservation, osteoarthritis (OA), and total hip arthroplasty (THA) populations may reduce barriers and streamline the routine collection of PROs in clinical practice. As such, the purpose of this study was to determine if augmenting the Hip disability and Osteoarthritis Outcome Score–Joint Replacement (HOOS, JR) with additional HOOS questions would result in a PRO platform that could be used across a wider spectrum of hip patient populations. Hypothesis: The HOOS, JR would demonstrate a notable ceiling effect, but by augmenting the HOOS, JR with additional HOOS questions, a responsive PRO platform could be created. Study Design: Cohort study (diagnosis); Level of evidence, 2. Methods: Using preoperative and postoperative HOOS responses from a sample of 304 patients undergoing periacetabular osteotomy (PAO), additional items were identified to augment the HOOS, JR. The psychometric properties of a newly created PRO tool (HOOSglobal) were then compared with the HOOS, JR and other PRO instruments developed for patients with hip OA and/or undergoing THA. Results: By augmenting the HOOS, JR with 2 additional questions, the HOOSglobal was more responsive than all other included PRO tools and had significantly fewer maximum postoperative scores than the HOOS, JR ( P < .0001), HOOS–Physical Function Short form ( P < .0001), Western Ontario and McMaster Universities Osteoarthritis Index ( P = .02), University of California, Los Angeles activity scale ( P = .0002), and modified Harris Hip Score ( P = .04). The postoperative HOOSglobal score threshold associated with patients achieving the patient acceptable symptom state (PASS) was 62.5. Conclusion: The HOOSglobal is a valid and responsive PRO tool after PAO and may potentially provide the orthopaedic community with a PRO platform to be used across hip-related subspecialties. For patients undergoing PAO, a postoperative HOOSglobal score ≥62.5 was associated with patients achieving the PASS.

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