scholarly journals Recovery patterns in patients undergoing revision surgery of the primary knee prosthesis

2021 ◽  
Vol 8 (1) ◽  
Author(s):  
W. Y. Liu ◽  
M. C. van der Steen ◽  
R. J. A. van Wensen ◽  
R. W. T. M. van Kempen
Keyword(s):  
Quality Of Life ◽  
Knee Arthroplasty ◽  
Physical Functioning ◽  
Oxford Knee Score ◽  
Good Survival ◽  
Early Improvement ◽  
Revision Knee Arthroplasty ◽  
Patient Reported ◽  
Over Time

Abstract Purpose Despite good survival rates of revised knee prostheses, little is known about recovery trajectories within the first 12 months after surgery. This retrospective observational study explored recovery trajectories in terms of pain, function and quality of life in patients after revision knee arthroplasty over 12 months. Methods Eighty-eight revision knee arthroplasty patients rated changes in daily physical functioning using the anchor question (0: very much worsened; 7: very much improved). Patient reported outcome measures (PROMs) of pain (range 0–10), function (Oxford Knee Score) and quality of life (EQ-5D-3L) were assessed preoperatively, at 3 and 12 months postoperatively. Four recovery trajectories were identified using the anchor question at 3 and 12 months postoperatively: no improvement, late improvement, early improvement, and prolonged improvement. Repeated measures ANOVA was conducted with recovery trajectories as dependent variable and PROM assessments as independent variables. Results Sixty percent reported improvement in daily physical functioning at 12 months postoperatively. Age and reason for revision differed between groups. Pain, function and EQ-5D-3L differed between groups over time. Late and prolonged improvement groups improved on all PROMs at 12 months. The early improvement group did not report improvement in daily physical functioning at 12 months, while improvements in function and pain during activity were observed. Conclusions Different recovery trajectories seem to exist and mostly match PROMs scores over time. Not all patients may experience beneficial outcome of revision knee arthroplasty. These findings are of importance to provide appropriate information on possible recovery trajectories after revision knee arthroplasty to patients. Level of evidence III

scholarly journals Outcomes of the rotating hinge knee in revision total knee arthroplasty with a median follow-up of 6.2 years

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Jake von Hintze ◽  
Mika Niemeläinen ◽  
Harri Sintonen ◽  
Jyrki Nieminen ◽  
Antti Eskelinen
Keyword(s):  
Quality Of Life ◽  
Total Knee Arthroplasty ◽  
Survival Rate ◽  
Knee Arthroplasty ◽  
Revision Total Knee Arthroplasty ◽  
Patient Reported ◽  
Total Knee ◽  
Revision Tka

Abstract Background The purpose of this study was to determine the mid-term clinical, radiographic and health-related quality of life (HRQoL) outcomes and define the survival rate in patients who had undergone revision total knee arthroplasty (TKA) using the single rotating hinged knee (RHK) design. Methods Between January 2004 and December 2013, 125 revision TKAs were performed at our institution using the single RHK implant. We conducted both a retrospective analysis of prospectively collected outcome data of these patients and a prospective follow-up study of all 39 living patients (41 knees). The follow-up phase included an optional extra follow-up visit, PROM questionnaires, and plain radiographs. Results The ten-year Kaplan-Meier survival rate of the revision RHK knees was 81.7% (95% CI 71.9–91.6%) with re-revision for any reason as the endpoint. Overall, 15 knees (12% of the total) underwent re-revision surgery during the follow-up. The median follow-up was 6.2 years (range, 0–12.7 years) post-operatively for the baseline group. One mechanical hinge mechanism-related failure occurred without any history of trauma or infection. At the time of the final follow-up, the majority of patients evinced a fairly good clinical outcome measured with patient-reported outcome measures and none of the components were radiographically loose. Conclusion We found that in patients undergoing complex revision TKA, fairly good functional outcome and quality of life can be achieved using an RHK implant. Further, it seems that in this type of patient cohort, revision TKA using an RHK implant relieves pain more than it improves ability to function. The NexGen® RHK design can be regarded as a suitable option in complex revision TKA.

scholarly journals Quality of life assessments in clinical practice using either the EORTC-QLQ-C30 or the SEIOQL-DW: a randomized study

2021 ◽  
Vol 5 (1) ◽  
Author(s):  
Åsa Kettis ◽  
Hanna Fagerlind ◽  
Jan-Erik Frödin ◽  
Bengt Glimelius ◽  
Lena Ring
Keyword(s):  
Quality Of Life ◽  
Clinical Practice ◽  
Significant Difference ◽  
Patient Reported ◽  
Health Related Qol ◽  
Health Related ◽  
Secondary Outcomes ◽  
The Impact ◽  
Over Time

Abstract Background Effective patient-physician communication can improve patient understanding, agreement on treatment and adherence. This may, in turn, impact on clinical outcomes and patient quality of life (QoL). One way to improve communication is by using patient-reported outcome measures (PROMs). Heretofore, studies of the impact of using PROMs in clinical practice have mostly evaluated the use of standardized PROMs. However, there is reason to believe that individualized instruments may be more appropriate for this purpose. The aim of this study is to compare the effectiveness of the standardized QoL-instrument, the European Organization for Research and Treatment of Cancer Quality of Life C-30 (EORTC-QOL-C30) and the individualized QoL instrument, the Schedule for the Evaluation of Individual Quality of Life-Direct Weighting (SEIQoL-DW), in clinical practice. Methods In a prospective, open-label, controlled intervention study at two hospital out-patient clinics, 390 patients with gastrointestinal cancer were randomly assigned either to complete the EORTC-QOL-C30 or the SEIQoL-DW immediately before the consultation, with their responses being shared with their physician. This was repeated in 3–5 consultations over a period of 4–6 months. The primary outcome measure was patients’ health-related QoL, as measured by FACIT-G. Patients’ satisfaction with the consultation and survival were secondary outcomes. Results There was no significant difference between the groups with regard to study outcomes. Neither intervention instrument resulted in any significant changes in health-related QoL, or in any of the secondary outcomes, over time. This may reflect either a genuine lack of effect or sub-optimization of the intervention. Since there was no comparison to standard care an effect in terms of lack of deterioration over time cannot be excluded. Conclusions Future studies should focus on the implementation process, including the training of physicians to use the instruments and their motivation for doing so. The effects of situational use of standardized or individualized instruments should also be explored. The effectiveness of the different approaches may depend on contextual factors including physician and patient preferences.

275 POSTOPERATIVE COMPLICATIONS DO NOT AFFECT QUALITY OF LIFE AFTER ESOPHAGECTOMY

2020 ◽  
Vol 33 (Supplement_1) ◽  
Author(s):  
E Jezerskyte ◽  
H Laarhoven ◽  
M Sprangers ◽  
W Eshuis ◽  
M Hulshof ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Postoperative Complications ◽  
Term Survival ◽  
Radio Therapy ◽  
Significant Difference ◽  
Patient Reported ◽  
Short And Long Term ◽  
Over Time

Abstract   Despite the attempts to reduce postoperative complication incidence after esophageal cancer surgery, up to 60% of patients endure postoperative complications. These patients often have a reduced health related quality of life (HR-QoL) and it may also have a negative effect on long-term survival. The aim of this study is to investigate the difference in short- and long-term HR-QoL in patients with and without a complicated postoperative course. Methods A retrospective comparative cohort study was performed with data from the Dutch Cancer Registry (IKNL) and QoL questionnaires from POCOP, a longitudinal patient reported outcomes study. All patients with esophageal and gastroesophageal junction (GEJ) cancer after an esophagectomy with or without neoadjuvant chemo(radio) therapy in the period of 2015–2018 were included. Exclusion criteria were palliative surgery, patients with a recurrence, reconstruction with a colonic or jejunal interposition, no reconstruction and emergency surgery. HR-QoL was investigated at baseline and at 3, 6, 9, 12, 18 and 24 months postoperatively between patients with and without complications following an esophagectomy. Results A total of 486 patients were included: 270 with and 216 without postoperative complications. The majority of patients were male (79.8%) with a median age of 66 years (IQR 60–70.25). Significantly more patients had comorbidities in the group with postoperative complications (69.6% vs 57.3%, p = 0.001). A significant difference in HR-QoL over time was found between the two groups in “choked when swallowing” score (p = 0.028). Patients that endured postoperative complications reported more problems with choking when swallowing at 9 months follow-up (mean score 12.9 vs 8.4, p = 0.047). This difference was not clinically relevant with a mean score difference of 4.6 points. Conclusion Postoperative complications do not significantly influence the short- and long-term HR-QoL in patients following an esophagectomy. Only one HR-QoL domain showed difference over time, however, this was not clinically relevant.

Change over time in patient-reported symptoms and quality of life in Edmonton interdisciplinary menopause clinics

2019 ◽  
Vol 26 (9) ◽  
pp. 1031-1037
Author(s):  
Beate C. Sydora ◽  
Nese Yuksel ◽  
Vikas Chadha ◽  
Lori Battochio ◽  
Lori Reich-Smith ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Change Over Time ◽  
Patient Reported ◽  
Over Time

Patient-Reported Outcomes, Quality of Life, and Satisfaction Rates in Young Patients Aged 50 Years or Younger After Total Knee Arthroplasty

2017 ◽  
Vol 32 (2) ◽  
pp. 419-425 ◽  
Author(s):  
Graham Seow-Hng Goh ◽  
Ming Han Lincoln Liow ◽  
Hamid Rahmatullah Bin Abd Razak ◽  
Darren Keng-Jin Tay ◽  
Ngai-Nung Lo ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Total Knee Arthroplasty ◽  
Knee Arthroplasty ◽  
Patient Reported Outcomes ◽  
Young Patients ◽  
Patient Reported ◽  
Total Knee ◽  
Satisfaction Rates

scholarly journals Patient-reported Quality of Life Before and After Total Knee Arthroplasty: A Prospective Multicentre Cohort Study

2021 ◽  
Author(s):  
Jinghui Chang ◽  
Manru Fu ◽  
Peihua Cao ◽  
Changhai Ding ◽  
Dong Wang
Keyword(s):  
Quality Of Life ◽  
Total Knee Arthroplasty ◽  
Knee Arthroplasty ◽  
Family Income ◽  
Knee Function ◽  
Targeted Interventions ◽  
Patient Reported ◽  
Before And After ◽  
Total Knee

Abstract Background: To identify patients’ self-reported health-related quality of life (HRQoL) before and after total knee arthroplasty (TKA) and determine factors contributing to any heterogeneity in HRQoL. Methods: This prospective multicentre study included 404 patients with knee osteoarthritis who underwent TKA between 1 April and 30 December 2019 and in whom HRQoL was assessed preoperatively and at 7 days and 1, 3, and 6 months postoperatively. Sociodemographic characteristics were assessed using a general information questionnaire; disability, using the Knee Injury and Osteoarthritis Outcome Score; pain, using the visual analogue scale (VAS) score; and HRQoL, using the European Quality of Life Five Dimension Five Level (EQ-5D-5L) score. Potential heterogeneity and factors influencing longitudinal changes in HRQoL were analysed using a growth mixture model.Results: The mean EQ-5D-5L score improved from 0.69 preoperatively to 0.90 at 6 months postoperatively. Two types of longitudinal heterogeneity were identified: (1) a group of patients with a small and slow improvement in HRQoL and (2) a group of patients who showed marked and rapid improvement in HRQoL. The main characteristics of the latter group were a monthly family income >2000 yuan, exercising for approximately 30 min daily, and better knee function at baseline. Baseline knee function and change in knee function were significantly associated with the percentage change in HRQoL.Conclusions: HRQoL improved considerably after TKA. However, there was some heterogeneity in the changes in HRQoL depending on certain patient characteristics. Targeted interventions should focus on these differences to optimise the outcomes of TKA.

scholarly journals Are Sarcopenia and Myosteatosis in Elderly Patients with Pelvic Ring Injury Related to Mortality, Physical Functioning and Quality of Life?

2021 ◽  
Vol 10 (21) ◽  
pp. 4874
Author(s):  
Hester Banierink ◽  
Julia J. C. Bombach ◽  
Kaj ten Duis ◽  
Frank F. A. IJpma ◽  
Erik Heineman ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Risk Factors ◽  
Elderly Patients ◽  
Physical Functioning ◽  
Pelvic Ring ◽  
Cox Proportional Hazards ◽  
Pelvic Ring Injury ◽  
Cross Sectional ◽  
Patient Reported

The purpose of this study was to evaluate the prevalence of sarcopenia and/or myosteatosis in elderly patients with pelvic ring injuries and their influence on mortality, patient-perceived physical functioning and quality of life (QoL). A multicenter retrospective cohort study was conducted including elderly patients aged ≥ 65 treated for a pelvic ring injury. Cross-sectional computed tomography (CT) muscle measurements were obtained to determine the presence of sarcopenia and/or myosteatosis. Kaplan–Meier analysis was used for survival analysis, and Cox proportional hazards regression analysis was used to determine risk factors for mortality. Patient-reported outcome measures for physical functioning (SMFA) and QoL (EQ-5D) were used. Multivariable linear regression analyses were used to determine the effect of sarcopenia and myosteatosis on patient-perceived physical functioning and QoL. Data to determine sarcopenia and myosteatosis were available for 199 patients, with a mean follow-up of 2.4 ± 2.2 years: 66 patients (33%) were diagnosed with sarcopenia and 65 (32%) with myosteatosis, while 30 of them (15%) had both. Mortality rates in patients at 1 and 3 years without sarcopenia and myosteatosis were 13% and 21%, compared to 11% and 36% in patients with sarcopenia, 17% and 31% in patients with myosteatosis and 27% and 43% in patients with both. Higher age at the time of injury and a higher Charlson Comorbidity Index (CCI) were independent risk factors for mortality. Patient-reported mental and emotional problems were significantly increased in patients with sarcopenia.

Developing a personalized outcome prediction tool for knee arthroplasty

2020 ◽  
Vol 102-B (9) ◽  
pp. 1183-1193
Author(s):  
Hiba K. Anis ◽  
Gregory J. Strnad ◽  
Alison K. Klika ◽  
Alexander Zajichek ◽  
Kurt P. Spindler ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Knee Arthroplasty ◽  
Outcome Prediction ◽  
Cross Validation ◽  
High Accuracy ◽  
Prediction Tool ◽  
Patient Reported ◽  
One Year ◽  
Mean Square Errors

Aims The purpose of this study was to develop a personalized outcome prediction tool, to be used with knee arthroplasty patients, that predicts outcomes (lengths of stay (LOS), 90 day readmission, and one-year patient-reported outcome measures (PROMs) on an individual basis and allows for dynamic modifiable risk factors. Methods Data were prospectively collected on all patients who underwent total or unicompartmental knee arthroplasty at a between July 2015 and June 2018. Cohort 1 (n = 5,958) was utilized to develop models for LOS and 90 day readmission. Cohort 2 (n = 2,391, surgery date 2015 to 2017) was utilized to develop models for one-year improvements in Knee Injury and Osteoarthritis Outcome Score (KOOS) pain score, KOOS function score, and KOOS quality of life (QOL) score. Model accuracies within the imputed data set were assessed through cross-validation with root mean square errors (RMSEs) and mean absolute errors (MAEs) for the LOS and PROMs models, and the index of prediction accuracy (IPA), and area under the curve (AUC) for the readmission models. Model accuracies in new patient data sets were assessed with AUC. Results Within the imputed datasets, the LOS (RMSE 1.161) and PROMs models (RMSE 15.775, 11.056, 21.680 for KOOS pain, function, and QOL, respectively) demonstrated good accuracy. For all models, the accuracy of predicting outcomes in a new set of patients were consistent with the cross-validation accuracy overall. Upon validation with a new patient dataset, the LOS and readmission models demonstrated high accuracy (71.5% and 65.0%, respectively). Similarly, the one-year PROMs improvement models demonstrated high accuracy in predicting ten-point improvements in KOOS pain (72.1%), function (72.9%), and QOL (70.8%) scores. Conclusion The data-driven models developed in this study offer scalable predictive tools that can accurately estimate the likelihood of improved pain, function, and quality of life one year after knee arthroplasty as well as LOS and 90 day readmission. Cite this article: Bone Joint J 2020;102-B(9):1183–1193.

Sign in / Sign up

Export Citation Format

Share Document