scholarly journals Preoperative Mental Health Has a Stronger Association with Baseline Self-Assessed Knee Scores than Defect Morphology in Patients Undergoing Cartilage Repair

Cartilage ◽  
2018 ◽  
Vol 11 (3) ◽  
pp. 309-315
Author(s):  
Jakob Ackermann ◽  
Takahiro Ogura ◽  
Robert A. Duerr ◽  
Alexandre Barbieri Mestriner ◽  
Andreas H. Gomoll
Keyword(s):  
Mental Health ◽  
Multivariate Regression ◽  
Regression Models ◽  
Health Management ◽  
Short Form ◽  
Strong Association ◽  
Patient Characteristics ◽  
International Knee Documentation Committee ◽  
Cartilage Defects ◽  
Bivariate Correlation

ObjectiveThe purpose of this study was to assess potential correlations between the mental component summary of the Short Form–12 (SF-12 MCS), patient characteristics or lesion morphology, and preoperative self-assessed pain and function scores in patients undergoing autologous chondrocyte implantation (ACI).DesignA total of 290 patients underwent ACI for symptomatic cartilage lesions in the knee. One hundred and seventy-eight patients were included in this study as they completed preoperative SF-12, Knee injury and Osteoarthritis Outcome Score (KOOS), Tegner, Lysholm, and International Knee Documentation Committee (IKDC) scores. Age, sex, smoker status, body mass index, Worker’s Compensation, previous surgeries, concomitant surgeries, number of defects, lesion location in the patella, and total defect size were recorded for each patient. Pearson’s correlation and multivariate regression models were used to distinguish associations between these factors and preoperative knee scores.ResultsThe SF-12 MCS showed the strongest bivariate correlation with all KOOS subgroups ( P < 0.001) (except KOOS Symptom; P = 0.557), Tegner ( P = 0.005), Lysholm ( P < 0.001), and IKDC scores ( P < 0.001). In the multivariate regression models, the SF-12 MCS showed the strongest association with all KOOS subgroups ( P < 0.001) (except KOOS Symptom; P = 0.91), Lysholm ( P = 0.001), Tegner ( P = 0.017), and IKDC ( P < 0.001).ConclusionIn patients with symptomatic cartilage defects of the knee, preoperative patient mental health has a strong association with self-assessed pain and functional knee scores. Further studies are needed to determine if preoperative mental health management can improve preoperative symptoms and postoperative outcomes.

scholarly journals Mental Health Has No Predictive Association With Self-Assessed Knee Outcome Scores in Patients After Osteochondral Allograft Transplantation of the Knee

2018 ◽  
Vol 6 (12) ◽  
pp. 232596711881236 ◽  
Author(s):  
Jakob Ackermann ◽  
Takahiro Ogura ◽  
Robert A. Duerr ◽  
Alexandre Barbieri Mestriner ◽  
Andreas H. Gomoll
Keyword(s):  
Mental Health ◽  
Linear Regression ◽  
Functional Outcomes ◽  
Regression Models ◽  
Short Form ◽  
Osteochondral Allograft ◽  
Linear Regression Models ◽  
Bivariate Correlation ◽  
Patient Reported

Background: Patient-reported outcome (PRO) measures are progressively utilized as evaluation tools in preoperative and postoperative assessments in orthopaedic practice. Identifying the potential utility of psychosocial factors to predict patient-reported pain and functional outcomes is of increasing interest to determine which patients will derive the greatest benefit from surgical treatment. Purpose/Hypothesis: The purpose of this study was to determine potential predictive associations between the preoperative 12-Item Short Form Health Survey Mental Component Summary (SF-12 MCS) score, patient characteristics or osteochondral allograft (OCA) morphology, and PROs in patients who underwent OCA transplantation. We hypothesized that poor preoperative mental health is associated with diminished PROs at final follow-up. Study Design: Case-control study; Level of evidence, 3. Methods: A total of 67 patients with a mean follow-up of 2.7 ± 1.0 years (range, 2-6 years) with complete preoperative and at least 24-month postoperative SF-12 MCS, Knee injury and Osteoarthritis Outcome Score (KOOS), Tegner, Lysholm, and International Knee Documentation Committee (IKDC) scores were included in this study. Pearson correlation coefficients and linear regression models were used to distinguish associations between age, sex, smoking status, body mass index, workers’ compensation, previous surgery, concomitant surgery, number of grafts, defect location, total graft size, SF-12 MCS score, and postoperative PRO scores as well as their improvement from baseline (delta). Results: The SF-12 MCS showed significant correlation with the KOOS Activities of Daily Living subscale ( P = .015), KOOS Sport/Recreation subscale ( P = .024), and IKDC ( P = .039). In the multivariable linear regression models, the SF-12 MCS had no predictive association with any PRO measure. Patient sex contributed significantly to the final regression models of the KOOS Sport/Recreation ( P = .042), Tegner score ( P = .024), and Lysholm score ( P = .031). The SF-12 MCS showed no bivariate correlation with changes in any PRO score (delta) ( P > .05). Conclusion: Preoperative mental health status did not predict perceived functional outcomes as assessed by PRO measures at final follow-up. Female sex was negatively correlated with KOOS Sport/Recreation, Tegner, and Lysholm scores.

Effect of the Containment Type on Clinical Outcomes in Osteochondral Lesions of the Talus Treated With Autologous Osteochondral Transplantation

2018 ◽  
Vol 46 (9) ◽  
pp. 2096-2102 ◽  
Author(s):  
Yoshiharu Shimozono ◽  
Johanna C.E. Donders ◽  
Youichi Yasui ◽  
Eoghan T. Hurley ◽  
Timothy W. Deyer ◽  
...  
Keyword(s):  
Magnetic Resonance ◽  
Clinical Outcomes ◽  
Multivariate Regression ◽  
Regression Models ◽  
Short Form ◽  
Osteochondral Lesions ◽  
Osteochondral Transplantation ◽  
Autologous Osteochondral Transplantation ◽  
Type Group

Background: Uncontained-type osteochondral lesions of the talus (OLTs) have been shown to have inferior clinical outcomes after treatment with bone marrow stimulation. While autologous osteochondral transplantation (AOT) is indicated for larger lesions, no study has reported on the prognostic significance of the containment of OLTs treated with the AOT procedure. Purpose: To clarify the effect of the containment of OLTs on clinical and radiological outcomes in patients who underwent AOT for OLTs. Study Design: Case control study; Level of evidence, 3. Methods: A retrospective cohort study comparing patients with contained-type and uncontained-type OLTs was undertaken to include all patients who underwent AOT for the treatment of OLTs between 2006 and 2014. Analyses were performed by grouping the patients according to the containment type. Clinical outcomes were evaluated using the Foot and Ankle Outcome Score (FAOS) and the 12-Item Short Form Health Survey (SF-12) preoperatively and at final follow-up. Magnetic resonance imaging (MRI) at 2 years’ follow-up was evaluated with the modified magnetic resonance observation of cartilage repair tissue (MOCART) score. Multivariate regression models were used to evaluate factors affecting postoperative FAOS, SF-12, and MOCART scores. Results: Ninety-four patients were included: 31 patients with a contained-type OLT and 63 patients with an uncontained-type OLT. The median patient age was 34 years (interquartile range [IQR], 28-48 years) in the contained-type group and 36 years (IQR, 27-46 years) in the uncontained-type group. The median follow-up time was 45 months (IQR, 38-63 months) in the contained-type group and 52 months (IQR, 40-66 months) in the uncontained-type group. The median FAOS and SF-12 scores improved significantly after surgery in both contained-type and uncontained-type lesions ( P < .001). The median postoperative FAOS score of patients with contained-type OLTs was higher than that of patients with uncontained-type OLTs (91.7 vs 85.0, respectively; P = .009), but no significant differences were found between the contained-type and uncontained-type groups for postoperative SF-12 and MOCART scores. The multivariate regression models showed that patients with contained-type OLTs had an approximately 10-point better score on the FAOS compared with patients with uncontained-type OLTs ( P = .006). There was a nonsignificant trend for the rate of cystic occurrence in uncontained-type OLTs to be higher than that of contained-type OLTs (55.6% vs 38.7%, respectively; P = .125). Conclusion: Patients with contained-type OLTs experienced better clinical outcomes than those with uncontained-type OLTs after AOT for the treatment of OLTs. However, the AOT procedure still provided good clinical and MRI outcomes in both contained-type and uncontained-type OLTs at midterm follow-up.

scholarly journals Osteochondral Allograft Transplantation of the Knee in Patients with an Elevated Body Mass Index

Cartilage ◽  
2018 ◽  
Vol 10 (2) ◽  
pp. 214-221 ◽  
Author(s):  
Dean Wang ◽  
Brian J. Rebolledo ◽  
David M. Dare ◽  
Mollyann D. Pais ◽  
Matthew R. Cohn ◽  
...  
Keyword(s):  
Body Mass Index ◽  
Body Mass ◽  
Short Form ◽  
International Knee Documentation Committee ◽  
Osteochondral Allograft ◽  
Cartilage Defects ◽  
Elevated Body Mass Index ◽  
Allograft Transplantation ◽  
Patient Responses

Objective To characterize the graft survivorship and clinical outcomes of osteochondral allograft transplantation (OCA) of the knee in patients with an elevated body mass index (BMI). Design Prospective data on 38 consecutive patients with a BMI ≥30 kg/m2 treated with OCA from 2000 to 2015 were reviewed. Complications, reoperations, and patient responses to validated outcome measures were examined. Failures were defined by any removal/revision of the allograft or conversion to arthroplasty. Results Thirty-one knees in 31 patients (mean age, 35.4 years [range, 17-61 years]; 87% male) met the inclusion criteria. Mean BMI was 32.9 kg/m2 (range, 30-39 kg/m2). Mean chondral defect size was 6.4 cm2 (range, 1.0-15.3 cm2). Prior to OCA, 23 patients (74%) had undergone previous surgery to the ipsilateral knee. Mean duration of follow-up was 4.1 years (range, 2-11 years). After OCA, 5 knees (13%) underwent conversion to unicompartmental (1) or total (4) knee arthroplasty. Two- and 5-year graft survivorship were 87% and 83%, respectively. At final follow-up, clinically significant improvements were noted in the pain (49.3-72.6) and physical functioning (52.9-81.3) subscales of the Short Form–36 ( P ≤ 0.001), International Knee Documentation Committee subjective form (43.5-67.0; P = 0.002), Knee Outcome Survey–Activities of Daily Living (58.2-80.4; P = 0.002), and overall condition subscale of the Cincinnati Knee Rating System (4.7-6.9; P = 0.046). Conclusions OCA can be a successful midterm treatment option for focal cartilage defects of the knee in select patients with a BMI ≥30 kg/m2.

scholarly journals Patients in General Practice in Denmark Referred to Physiotherapists: A Description of Patient Characteristics Based on General Health Status, Diagnoses, and Sociodemographic Characteristics

2001 ◽  
Vol 81 (3) ◽  
pp. 915-923 ◽  
Author(s):  
Carsten Krogh Jørgensen ◽  
Per Fink ◽  
Frede Olesen
Keyword(s):  
Mental Health ◽  
General Practice ◽  
Physical Health ◽  
General Practitioners ◽  
Short Form ◽  
Signs And Symptoms ◽  
Patient Characteristics ◽  
Poor Mental Health ◽  
Medical Outcomes ◽  
Summary Scale

Abstract Background and Purpose. Both musculoskeletal illness and mental illness characterized by somatic symptoms are common in primary care, and it is hypothesized that many patients with musculoskeletal illness have relatively poor mental health. The purpose of this study was to describe the characteristics of patients in general practice in Denmark who are referred to physiotherapists with signs and symptoms of musculoskeletal illness. Subjects and Methods. One hundred ninety-four general practitioners, representing 124 practices, participated in a survey of 2,042 consecutive patients with musculoskeletal illness. Results. The diagnoses were generally poorly defined. Compared with the general population, patients with musculoskeletal illness had markedly poorer physical health and poorer mental health. Patients with poorly defined diagnoses did not differ from patients with well-defined diagnoses in terms of physical health, but they scored lower on the mental health component summary scale of the Danish version of the Medical Outcomes Study 36-Item Short-Form Health Survey (SF-36). Conclusion and Discussion. Of the patients referred to physiotherapists by general practitioners in Denmark, the subgroup with poorly defined diagnoses had lower mental health scores than those with well-defined diagnoses, suggesting that a biopsychosocial approach to care may be appropriate for this group of patients.

The association between race and frequent shunt failure: a single-center study

2013 ◽  
Vol 11 (5) ◽  
pp. 552-557 ◽  
Author(s):  
Robert P. Naftel ◽  
Nicole A. Safiano ◽  
Michael Falola ◽  
Jeffrey P. Blount ◽  
W. Jerry Oakes ◽  
...  
Keyword(s):  
Multivariate Analysis ◽  
Multivariate Regression ◽  
Regression Models ◽  
Univariate Analysis ◽  
Geographic Location ◽  
Patient Characteristics ◽  
Shunt Failure ◽  
Independent Factor ◽  
White Race ◽  
Single Center Study

Object Children experiencing frequent shunt failure consume medical resources and represent a disproportionate level of morbidity in hydrocephalus care. While biological causes of frequent shunt failure may exist, this study analyzed demographic and socioeconomic patient characteristics associated with frequent shunt failure. Methods A survey of 294 caregivers of children with shunt-treated hydrocephalus provided demographic and socioeconomic characteristics. Children experiencing at least 10 shunt failures were considered frequent shunt-failure patients. Multivariate regression models were used to control for variables. Results Frequent shunt failure was experienced by 9.5% of the patients (28 of 294). By univariate analysis, white race (p = 0.006), etiology of hydrocephalus (p = 0.022), years-with-shunt (p < 0.0001), and surgeon (p = 0.02) were associated with frequent shunt failure. Upon multivariate analysis, white race remained the key independent factor associated with frequent shunt failure (OR 5.8, 95% CI 1.2–27.8, p = 0.027). Race acted independently from socioeconomic factors, including income, level of education, and geographic location, and clinical factors, such as etiology of hydrocephalus, surgeon, and years-with-shunt. Additionally, after multivariate analysis surgeon and years-with-shunt remained associated with frequent shunt failure (p = 0.043 and p = 0.0098, respectively), although etiology of hydrocephalus was no longer associated (p = 0.1). Conclusions White race was the primary independent factor associated with frequent shunt failure. Because races use health care differently and the diagnosis of shunt failure is often subjective, a disparity in diagnosis and treatment has arisen. These findings call for objective criteria for the preoperative and intraoperative diagnosis of shunt failure.

Health Literacy, Physical and Mental Health, and Activities of Daily Living Among Older Chinese Adults in Nursing Homes

2018 ◽  
Vol 30 (6) ◽  
pp. 592-599 ◽  
Author(s):  
Yong-Bing Liu ◽  
Ling-Ling Xue ◽  
Hui-Ping Xue ◽  
Ping Hou
Keyword(s):  
Mental Health ◽  
Older Adults ◽  
Health Status ◽  
Health Literacy ◽  
Physical Health ◽  
Daily Living ◽  
Health Management ◽  
Short Form ◽  
Cluster Sampling ◽  
Physical And Mental Health

It is very important to estimate the prevalence of inadequate health literacy and determine whether or not health literacy level differences predict the physical and mental health status of older adults. A cluster sampling method was selected. A total of 1396 older adults were interviewed. Three instruments were included: the Chinese Citizen Health Literacy Questionnaire, Short Form 36, and Activity of Daily Living (ADL) Scale. The health literacy scores were very low (71.74 ± 28.35). The physical and mental health scores were all moderate. The ADLs was ⩾22, which suggests that the ADLs of older adults were poor. The major influencing factors of physical health include health literacy, ADL, alcohol consumption, household income, marital status, and former occupation. The major factors influencing mental health included ADL, former occupation, age, and smoking. Health literacy was associated with physical health, but was not associated with mental health. Improving health literacy could increase health management and health status of older adults.

scholarly journals Variables associated with interprofessional collaboration: a comparison between primary healthcare and specialized mental health teams

2020 ◽  
Vol 21 (1) ◽  
Author(s):  
Nicolas Ndibu Muntu Keba Kebe ◽  
François Chiocchio ◽  
Jean-Marie Bamvita ◽  
Marie-Josée Fleury
Keyword(s):  
Mental Health ◽  
Organizational Support ◽  
Multivariate Regression ◽  
Regression Models ◽  
Knowledge Integration ◽  
Interprofessional Collaboration ◽  
Primary Care Teams ◽  
Specialized Service ◽  
Specialized Mental Health ◽  
Associated Variables

Abstract Background This study has two aims: first, to identify variables associated with interprofessional collaboration (IPC) among a total of 315 Quebec mental health (MH) professionals working in MH primary care teams (PCTs, N = 101) or in specialized service teams (SSTs, N = 214); and second, to compare IPC associated variables in MH-PCTs vs MH-SSTs. Methods A large number of variables acknowledged as strongly related to IPC in the literature were tested. Multivariate regression models were performed on MH-PCTs and MH-SSTs respectively. Results Results showed that knowledge integration, team climate and multifocal identification were independently and positively associated with IPC in both MH-PCTs and MH-SSTs. By contrast, knowledge sharing was positively associated with IPC in MH-PCTs only, and organizational support positively associated with IPC in MH-SSTs. Finally, one variable (age) was significantly and negatively associated with IPC in SSTs. Conclusions Improving IPC and making MH teams more successful require the development and implementation of differentiated professional skills in MH-PCTs and MH-SSTs by care managers depending upon the level of care required (primary or specialized). Training is also needed for the promotion of interdisciplinary values and improvement of interprofessional knowledge regarding IPC.

Patient Characteristics of Possible Responders and Nonresponders to Total Ankle Arthroplasty

2020 ◽  
Vol 41 (8) ◽  
pp. 893-900
Author(s):  
John R. Steele ◽  
Daniel J. Cunningham ◽  
Cynthia L. Green ◽  
Thomas J. Risoli ◽  
James K. DeOrio ◽  
...  
Keyword(s):  
Mental Health ◽  
Rheumatic Disease ◽  
Short Form ◽  
Multivariable Analysis ◽  
Patient Characteristics ◽  
Total Ankle Arthroplasty ◽  
Ankle Arthroplasty ◽  
Sf 36 ◽  
Patient Reported

Background: Characteristics of responders, or those who achieve a clinical improvement above the level of a minimal clinically important difference, have not been defined for total ankle arthroplasty (TAA). The purpose of this study was to determine patient characteristics that distinguish possible responders from possible nonresponders after TAA using criteria established for other arthroplasty surgeries. Methods: Patients undergoing TAA who were enrolled into a prospective study at a single academic center evaluating patient-reported outcomes were included. Patients were characterized as possible responders if the relative or absolute improvement in their 2-year follow-up Short Musculoskeletal Function Assessment (SMFA) function score was at least 50% or 20, respectively, compared with their preoperative score, consistent with Outcome Measures in Rheumatoid Arthritis Clinical Trials and the Osteoarthritis Research Society International (OMERACT-OARSI) responder criteria. Patient factors were then associated with possible responder or nonresponder status and a multivariable analysis was performed. A total of 491 patients with complete data and 2-year follow-up were included in this study. Results: Multivariable analysis demonstrated that a higher baseline 36-Item Short-Form Survey (SF-36) mental component summary (MCS) score (OR [95% CI], 1.02 [1.01, 1.04]; P = .003), indicating better mental health, was associated with being a possible responder to TAA. The presence of rheumatic disease (OR [95% CI], 0.38 [0.22, 0.67]; P = .001) was a significant predictor of being a possible nonresponder. Conclusion: Our data reveal that a higher baseline SF-36 MCS score was associated with increased improvement in SMFA function scores, while rheumatic disease was associated with worse improvement in SMFA function scores after TAA. Patients with rheumatic disease or poor mental health may not achieve as favorable results after TAA and should be counseled appropriately. Level of Evidence: Level III, retrospective comparative study.

Prenatal Predictors of Maternal-infant Attachment

2020 ◽  
Vol 87 (4) ◽  
pp. 265-277
Author(s):  
Grace Branjerdporn ◽  
Pamela Meredith ◽  
Trish Wilson ◽  
Jenny Strong
Keyword(s):  
Mental Health ◽  
Adult Attachment ◽  
Multivariate Regression ◽  
Regression Models ◽  
Perinatal Care ◽  
Occupational Therapists ◽  
Infant Attachment ◽  
Maternal Fetal Attachment ◽  
Fetal Attachment

Background. Increasingly, occupational therapists are working with women in the perinatal period, including supporting the developing mother-child relationship. Purpose. To examine prenatal predictors of maternal-infant attachment (maternal-fetal attachment, sensory patterns, adult attachment, perinatal loss, and mental health) that may provide possible avenues for assessment and intervention by occupational therapists. Method. Women (N = 60) were assessed during pregnancy and within one year postpartum in a cohort study. Independent t-tests, correlations, and multivariate regression models were conducted. Findings. Low threshold maternal sensory patterns, more insecure adult attachment, and poorer quality of maternal-fetal attachment were each correlated with less optimal maternal-infant attachment. Quality of prenatal attachment was the best predictor of overall postnatal attachment in multivariate regression models. Implications. Occupational therapists working in a range of clinical settings (e.g., mental health, substance use, and perinatal care) may work with women during pregnancy to promote their relationship with their developing baby in utero and after birth.

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