What are the results of revised hip resurfacing arthroplasties?

2020 ◽  
Vol 102-B (10) ◽  
pp. 1289-1296
Author(s):  
Harlan C. Amstutz ◽  
Michel Le Duff
Keyword(s):  
Quality Of Life ◽  
Los Angeles ◽  
Revision Surgery ◽  
Short Form ◽  
Perioperative Complications ◽  
Hip Resurfacing ◽  
Long Term Outcome ◽  
The Mean

Aims Hip resurfacing arthroplasty (HRA) is typically indicated for young and active patients. Due to the longevity of arthroplasty, these patients are likely to undergo revision surgery during their lifetime. There is a paucity of information on the long-term outcome of revision surgeries performed after failed HRA. The aim of our study was to provide survivorship data as well as clinical scores after HRA revisions. Methods A total of 42 patients (43 hips) were revised after HRA at our centre to a variety of devices, including four HRA and 39 total hip arthroplasties (THAs). In addition to perioperative complications, University of California, Los Angeles (UCLA) hip scores and 12-Item Short-Form Health Survey questionnaire (SF-12) quality of life scores were collected at follow-up visits after the primary HRA and after revision surgery. Results The mean follow-up time after revision surgery was 8.3 years (0.3 to 19.1). The mean UCLA pain and function scores post-revision were comparable with the best scores achieved by the patients after the index HRA, but UCLA activity scores were lower after revision. SF-12 physical component scores were comparable between timepoints, but the mental component score decreased after revision. Six patients underwent unilateral re-revision surgery at a mean follow-up time of 7.8 years (0.3 to 13.7). Using the time to any re-revision as endpoint, the Kaplan-Meier survivorship was 85.3% at 13 years. Conclusion Patients undergoing revision after HRA can expect to achieve function and quality of life similar to their best after their primary surgery, while the risk of re-revision is low. Cite this article: Bone Joint J 2020;102-B(10):1289–1296.

scholarly journals Long-term outcome and quality of life after CNS cavernoma resection: eloquent vs. non-eloquent areas

2021 ◽  
Author(s):  
Loay Shoubash ◽  
Jörg Baldauf ◽  
Marc Matthes ◽  
Michael Kirsch ◽  
Matthias Rath ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Short Form ◽  
Preoperative Evaluation ◽  
Patient Counseling ◽  
Surgical Morbidity ◽  
Term Outcome ◽  
Long Term Outcome

AbstractThe aim of this study is to analyze the long-term quality of life after surgery of cavernoma. A monocentric retrospective study was conducted on 69 patients with cavernoma treated microsurgically between 2000 and 2016. The eloquence was adopted from Spetzler-Martin definition. A most recent follow-up was elicited between 2017 and 2019, in which the quality of life (QoL) was evaluated with the Short Form-12 questionnaire (SF12). Forty-one lesions were in eloquent group (EG), 22 in non-eloquent group (NEG), 3 in orbit, and 3 in the spinal cord. Postoperative worsening of the modified Rankin scale (mRS) occurred in 19.5% of cases in EG versus 4.5% in NEG. After a mean follow-up of 6.5 years (SD 4.6), the neurological status was better or unchanged compared to baseline in 85.4% of EG and 100% of NEG. Regarding QoL assessment of 44 patients (EG n = 27, NEG n = 14) attended the last follow-up. Patients after eloquent cavernoma resection reported a non-inferior QoL in most SF12 domains (except for physical role) compared to NEG. However, they reported general health perception inferior to norms, which was affected by the limited physical and emotional roles. At a late follow-up, the surgical morbidity was transient in the NEG and mostly recovered in the EG. The QoL comparison between eloquent and non-eloquent cavernomas created interesting and new data after prolonged follow-up. These results add value for decision-making as well as patient counseling for future encountered cases. Preoperative evaluation of QoL is recommended for future studies to assess QoL dynamics.

Long-Term Outcome after Dynamic Graciloplasty for Treatment of Persistent Fecal Incontinence in Patients with Anorectal Malformations

2018 ◽  
Vol 29 (03) ◽  
pp. 276-281
Author(s):  
Johan Danielson ◽  
Urban Karlbom ◽  
Tomas Wester ◽  
Wilhelm Graf
Keyword(s):  
Quality Of Life ◽  
Fecal Incontinence ◽  
Short Form ◽  
Anorectal Malformations ◽  
Dynamic Graciloplasty ◽  
Term Outcome ◽  
Long Term Outcome

Purpose Dynamic graciloplasty (DGP) has been used to treat severe fecal incontinence since the 1980s. Previous studies have shown an inferior outcome in patients with anorectal malformations (ARMs). Our experience has been that DGP has been appreciated by ARM -patients. The objective of the study was to evaluate the long-term outcome of DGP in our patients with ARM compared with patients with other underlying conditions. Materials and Methods Twenty-three patients operated with DGP at our institution from 1996 to 2010 were sent validated bowel function and quality of life questionnaires. Eighteen of 23 responded. Seven had ARM and 11 had other etiologies of fecal incontinence. The mean follow-up time was 11.6 years (range, 5–17). Results Four of 7 of the patients with ARM and 8 of 11 of patients with other etiologies used their implants at follow-up. The Miller incontinence score was slightly higher for patients with ARMs, but they had less constipation and higher Fecal Incontinence Quality of Life (FIQL)- and 36-Item Short Form Health Survey (SF-36) scores. None of the differences were statistically significant. Conclusion This study cannot confirm earlier reports in which DGP has an inferior outcome in patients with ARM. We therefore believe that the procedure should remain a treatment option for selected patients.

Quality of Life Following Surgical and Conservative Therapy of Pyogenic Spinal Infection: A Study of Long-term Outcome in 210 Patients

2021 ◽  
Author(s):  
Bedjan Behmanesh ◽  
Florian Gessler ◽  
Stephan Duetzmann ◽  
Volker Seifert ◽  
Lutz Weise ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Short Form ◽  
Spinal Infection ◽  
Term Outcome ◽  
Long Term Outcome ◽  
Patient’S Satisfaction ◽  
Conservative Group ◽  
Intergroup Comparison ◽  
The Mean

Abstract Object The management and recommendations for treatment strategies of pyogenic spinal infection are still a highly controversial issue. The purpose of this study was to evaluate patient's quality of life (QoL) after surgical and conservative treatment of spinal infection. Materials and Methods We conducted a retrospective, single-center study. All patients treated between 2009 and 2016 were included in this study. For evaluation of QoL, we recorded each patient's satisfaction according to the 36-Item Short Form Health Survey (SF-36) questionnaire. Scores were compared with a U.S. standard population. Results Two hundred and ten adult patients with spondylodiskitis were identified. Of these, 155 (74%) underwent surgery and 55 (26%) were treated conservatively. The mean overall age was 68.6 (23–98) years. Seventy-two patients were females and 138 patients were males. The mean outcome values in the surgical group did not reach the level of the normative sample in one of eight items, whereas the conservative group revealed a reduced QoL in all items. Intergroup comparison revealed significant differences in all items (p < 0.05). Conclusion In the patient population we investigated, QoL in surgically treated patients was better than that in conservatively managed patients.

scholarly journals Normal Quality of Life after the Cox-Maze Procedure for Atrial Fibrillation

2008 ◽  
Vol 3 (3) ◽  
pp. 142-146 ◽  
Author(s):  
Spencer J. Melby ◽  
Andreas Zierer ◽  
Jordon G. Lubahn ◽  
Marci S. Bailey ◽  
James L. Cox ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Atrial Fibrillation ◽  
Short Form ◽  
Maze Procedure ◽  
Medical Outcomes ◽  
Health Domains ◽  
The Mean

Objective Atrial fibrillation (AF) has been shown in numerous studies to significantly decrease patient's quality of life. The Cox-Maze procedure has excellent long-term efficacy in curing AF. However, it is unknown whether this procedure improves long-term quality of life in these patients. The purpose of this study was to examine late quality of life in patients who underwent a lone Cox-Maze procedure. Methods Between 1987 and 2003, 163 patients underwent a Cox-Maze procedure for lone AF at our institution. Of these, 68 patients agreed and completed the Medical Outcomes Study Short Form 36 Health Survey. Scores from the age-matched general U.S. population were normalized to a mean of 50 and standard deviation of 10 to facilitate comparison. Collected data were compared with the norm-based score for each domain using a one-sample t test. Four patients were removed from the analysis because of AF recurrence. Results There were 52 males (81%). Mean age was 52.6 ± 9.5 years. Preoperatively, 37 patients (58%) had paroxysmal and 25 patients (39%) had persistent or permanent AF. The mean duration of AF before surgery was 9.8 ± 8.2 years. There was no statistical difference in norm-based scores between the Cox-Maze procedure group and the age-matched general U.S. population in any of the eight health domains at a mean follow-up of 8.7 ± 3.7 years. Conclusion Our results suggest that the Cox-Maze procedure cures AF in the majority of patients, and that those patients who are cured had a normal quality of life when compared with the general population at late follow-up.

Effect of Systematic Exercise Rehabilitation on Patients With Knee Osteoarthritis: A Randomized Controlled Trial

Cartilage ◽  
2020 ◽  
pp. 194760352090344
Author(s):  
Jing Chao ◽  
Zhang Jing ◽  
Bai Xuehua ◽  
Yang Peilei ◽  
Gong Qi
Keyword(s):  
Quality Of Life ◽  
Knee Osteoarthritis ◽  
Short Form ◽  
Controlled Trial ◽  
Control Group ◽  
Exercise Rehabilitation ◽  
The Mean ◽  
Cox 2 Inhibitors

Objectives We aimed to compare the outcomes of exercise rehabilitation and conventional treatment in patients with knee osteoarthritis. Methods This trial included a total of 166 patients diagnosed with knee osteoarthritis; they were randomly divided into groups. The experimental group underwent systematic exercise rehabilitation, while the control group received naproxen ( n = 28), diclofenac ( n = 27), or celecoxib ( n = 19). Improvement in symptoms, knee function, and quality of life were compared. SPSS Statistics 24.0 was used for the data analysis. Results The mean age of patients was 56.0 ± 10.5 years, and the average follow-up time was 12 ± 2.3 weeks. No statistically significant differences were seen in age, body mass index, and sex ( P > 0.05) between the groups. The average Western Ontario and MacMaster Universities (WOMAC) scores after treatment were 84.4 ± 15.2, 108.3 ± 3.9, 107.4 ± 5.4, and 107 ± 6.0 in the exercise rehabilitation, diclofenac, naproxen, and celecoxib groups, respectively. The mean Lysholm scores were 60.3 ± 14.9, 41.0 ± 0.1, 43.5 ± 5.3, and 41.7 ± 3.6 in the exercise rehabilitation, diclofenac, naproxen, and celecoxib groups, respectively. The mean SF-36 (Short Form-36 Survey) scores were 105.4 ± 21.5, 82.5 ± 3.7, 84.2 ± 3.5, and 83.7 ± 5.0 in the exercise rehabilitation, naproxen, celecoxib, and diclofenac groups, respectively. The average ranges of knee motion were 125.0 ± 6.2°, 116.4 ± 1.4°, 114.7 ± 1.1°, and 115.7 ± 0.8° after exercise rehabilitation, diclofenac, naproxen, and celecoxib treatments, respectively. These data presented statistical differences between the groups. Conclusion Exercise better improved symptoms and quality of life in patients with knee osteoarthritis over a 12-week follow-up period than that achieved with nonsteroidal anti-inflammatory drugs and COX-2 inhibitors.

scholarly journals Preliminary analysis of quality of life (QOL) before and after surgery for female genital fistula. A prospective cohort study

2018 ◽  
Vol 13 (2) ◽  
Author(s):  
Stacy Saha ◽  
Bea Ambauen-Berger ◽  
Shirajum Munira
Keyword(s):  
Quality Of Life ◽  
Short Form ◽  
Multivariable Analysis ◽  
Post Surgery ◽  
Poor Women ◽  
Health Related Qol ◽  
Health Related ◽  
The Mean

Aims: To describe the characteristics of women who come for repair of FGF, assess their QOL before & after surgery and estimate factors associated with improved quality of life. Methods: All women who came to LAMB for FGF repairin 2016 and 2017 were interviewed on admission and called for a follow-up visit 6 months after successful surgery. Sociodemographic, obstetric, and fistula-related information was collected on admission. Health related QOLwasmeasured using the 36-item short form (SF-36), and perception of stigma and discrimination were assessed on admission and at follow-up. Results: A total of 72 women were included.Mean age was 40.1 years, 49% had no education, and 42% were in the poorest wealth quintile.The mean stigma score (out of 7)went from 3.79 to 1.40 post surgery (p<0.001) and the mean discrimination score (out of 5)went from 2.2 to 0.4 (p<0.001). The mean score for all eight of the general health categories increased significantly after surgery (p<0.01 to 0.001). Poor women started lower but showed evidence of greater improvement in health related QOL compared to richer women (p<0.05)) and some evidence of greater improvement in discrimination (p<0.1). Women with no education had a larger decreasein perceived stigma (p= 0.03) compared to the educated. Conclusions:  Surgery for FGF improves quality of life, with poor women showing greater increase in health related QOL and uneducated women reporting a greater decrease in stigma.  Further multivariable analysis is needed to determine which factors remain associated with improved QOL.

scholarly journals Long-Term Outcome and Quality of Life After Cavernoma Resection: Eloquent vs. Non-Eloquent Areas.

2021 ◽  
Author(s):  
Loay Shoubash ◽  
Jörg Baldauf ◽  
Marc Matthes ◽  
Michael Kirsch ◽  
Matthias Rath ◽  
...  
Keyword(s):  
Quality Of Life ◽  
General Health ◽  
Short Form ◽  
Surgical Morbidity ◽  
Term Outcome ◽  
Long Term Outcome ◽  
Physical Role

Abstract Objective: To analyze the long-term quality of life after surgery of cavernoma.Methods: A monocentric retrospective study was conducted on 69 patients with cavernoma treated microsurgically between 2000 and 2016. The eloquence was adopted from Spetzler-Martin definition. A most recent follow-up was elicited between 2017 and 2019, in which the quality of life (QoL) was evaluated with the Short Form-12 questionnaire (SF12).Results: 41 lesions were in eloquent group (EG), 22 in non-eloquent group (NEG), 3 in orbit and 3 in the spinal cord. Postoperative worsening of the modified Rankin scale (mRS) occurred in 19.5% of cases in EG versus 4.5% in NEG. After a mean follow-up of 6.5 years, the neurological status was better or unchanged compared to baseline in 85.4% of EG and 100% of NEG. 44 patients (EG n =27, NEG n = 14) attended the last follow-up. The EG had mostly comparable QoL results matched to NEG except for the physical role (RP). The study population when compared to the norms, did well on only half of the parameters of SF12. Yet, the general health (GH), vitality, physical (RP) and emotional roles (RE) were significantly inferior.Conclusion: At a late follow-up, the surgical morbidity was transient in the NEG and mostly recovered in the EG. Regarding QoL, Patients after eloquent cavernoma resection reported a non-inferior QoL in most SF12 domains (except for physical role) compared to NEG. However, they reported general health perception inferior to norms, which was affected by the limited physical and emotional roles.

Gamma Knife surgery for hypothalamic hamartomas and epilepsy: patient selection and outcomes

2010 ◽  
Vol 113 (Special_Supplement) ◽  
pp. 207-214 ◽  
Author(s):  
Adib A. Abla ◽  
Andrew G. Shetter ◽  
Steve W. Chang ◽  
Scott D. Wait ◽  
David G. Brachman ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Gamma Knife ◽  
Seizure Frequency ◽  
Gamma Knife Surgery ◽  
Maximum Point ◽  
Long Term Outcome ◽  
Hypothalamic Hamartomas ◽  
The Mean

Object The authors present outcomes obtained in patients who underwent Gamma Knife surgery (GKS) at 1 institution as part of a multimodal treatment of refractory epilepsy caused by hypothalamic hamartomas (HHs). Methods Between 2003 and 2010, 19 patients with HH underwent GKS. Eight patients had follow-up for less than 1 year, and 1 patient was lost to follow-up. The 10 remaining patients (mean age 15.1 years, range 5.7–29.3 years) had a mean follow-up of 43 months (range 18–81 months) and are the focus of this report. Five patients had undergone a total of 6 prior surgeries: 1 transcallosal resection of the HH, 2 endoscopic transventricular resections of the HH, 2 temporal lobectomies, and 1 arachnoid cyst evacuation. In an institutional review board–approved study, postoperative complications and long-term outcome measures were monitored prospectively with the use of a proprietary database. Seven patients harbored Delalande Type II lesions; the remainder harbored Type III or IV lesions. Seizure frequency ranged from 1–2 monthly to as many as 100 gelastic seizures daily. The mean lesion volume was 695 mm3 (range 169–3000 mm3, median 265 mm3). The mean/median dose directed to the 50% isodose line was 18 Gy (range 16–20 Gy). The mean maximum point dose to the optic chiasm was 7.5 Gy (range 5–10 Gy). Three patients underwent additional resection 14.5, 21, and 32 months after GKS. Results Of the 10 patients included in this study, 6 are seizure free (2 after they underwent additional surgery), 1 has a 50%–90% reduction in seizure frequency, 2 have a 50% reduction in seizure frequency, and 1 has observed no change in seizure frequency. Overall quality of life, based on data obtained from follow-up telephone conversations and/or surveys, improved in 9 patients and was due to improvements in seizure control (9 patients), short-term memory loss (3 patients), and behavioral symptoms (5 patients); in 1 patient, quality of life remains minimally affected. Incidences of morbidity were all temporary and included poikilothermia (1 patient), increased depression (1 patient), weight gain/increased appetite (2 patients), and anxiety (1 patient) after GKS. Conclusions Of the approximately 150 patients at Barrow Neurological Institute who have undergone treatment for HH, the authors have reserved GKS for treatment of small HHs located distal from radiosensitive structures in patients with high cognitive function and a stable clinical picture, which allows time for the effects of radiosurgery to occur without further deterioration. The lack of significant morbidity and the clinical outcomes achieved in this study demonstrated a low risk of GKS for HH with results comparable to those of previous series.

scholarly journals Utilization of laser interstitial thermotherapy guided by real-time thermal MRI as an alternative to separation surgery in the management of spinal metastasis

2015 ◽  
Vol 23 (4) ◽  
pp. 400-411 ◽  
Author(s):  
Claudio E. Tatsui ◽  
R. Jason Stafford ◽  
Jing Li ◽  
Jonathan N. Sellin ◽  
Behrang Amini ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Spinal Cord ◽  
Real Time ◽  
Spinal Cord Compression ◽  
Spinal Metastasis ◽  
Cord Compression ◽  
The Mean ◽  
Interstitial Thermotherapy

OBJECT High-grade malignant spinal cord compression is commonly managed with a combination of surgery aimed at removing the epidural tumor, followed by spinal stereotactic radiosurgery (SSRS) aimed at local tumor control. The authors here introduce the use of spinal laser interstitial thermotherapy (SLITT) as an alternative to surgery prior to SSRS. METHODS Patients with a high degree of epidural malignant compression due to radioresistant tumors were selected for study. Visual analog scale (VAS) scores for pain and quality of life were obtained before and within 30 and 60 days after treatment. A laser probe was percutaneously placed in the epidural space. Real-time thermal MRI was used to monitor tissue damage in the region of interest. All patients received postoperative SSRS. The maximum thickness of the epidural tumor was measured, and the degree of epidural spinal cord compression (ESCC) was scored in pre- and postprocedure MRI. RESULTS In the 11 patients eligible for study, the mean VAS score for pain decreased from 6.18 in the preoperative period to 4.27 within 30 days and 2.8 within 60 days after the procedure. A similar VAS interrogating the percentage of quality of life demonstrated improvement from 60% preoperatively to 70% within both 30 and 60 days after treatment. Imaging follow-up 2 months after the procedure demonstrated a significant reduction in the mean thickness of the epidural tumor from 8.82 mm (95% CI 7.38–10.25) before treatment to 6.36 mm (95% CI 4.65–8.07) after SLITT and SSRS (p = 0.0001). The median preoperative ESCC Grade 2 was scored as 4, which was significantly higher than the score of 2 for Grade 1b (p = 0.04) on imaging follow-up 2 months after the procedure. CONCLUTIONS The authors present the first report on an innovative minimally invasive alternative to surgery in the management of spinal metastasis. In their early experience, SLITT has provided local control with low morbidity and improvement in both pain and the quality of life of patients.

Abstract TP295: Stroke Prevention Surgery > Quality of Life and Cognitive Ability to Drive Are Maintained After Surgical Repair of Unruptured Intracranial Aneurysm

Stroke ◽  
2020 ◽  
Vol 51 (Suppl_1) ◽  
Author(s):  
Joan M ODonnell ◽  
Maurizio Manuguerra ◽  
Jemma L Hodge ◽  
Greg Savage ◽  
Michael K Morgan
Keyword(s):  
Quality Of Life ◽  
Intracranial Aneurysm ◽  
Surgical Management ◽  
Cognitive Abilities ◽  
Short Form ◽  
Unruptured Intracranial Aneurysm ◽  
Significant Difference ◽  
Ability To Drive

Background: Studies have questioned the effectiveness of surgery for the management of unruptured intracranial aneurysm (uIA). Few studies have examined the ability to drive and quality of life (QOL) after surgery for uIA. Objective: This study examined the effectiveness of surgical management of uIA by measuring patients’ perceived quality of life and their cognitive abilities related to driving. Methods: Between January 2011 and January 2016 patients with a uIA were assessed using the Quality Metric Short Form 36 (SF36) and the off-road driver screening instrument DriveSafeDriveAware. Reassessments were conducted at the 6-week post-operative follow-up for surgical patients and at 12-month follow-up for surgical and conservatively managed patients. Results: 175 patients enrolled in the study, of which 112(66%) had surgical management of their aneurysm. For the surgical cases who completed all assessments (N=74), there was a trend for the DriveSafe pre-operative mean score of 108 (SD 10.7) to be lower than the 6-week and 12-month post-operative mean scores (111 SD 9.7 and 112 SD 10.2 respectively)(p=0.05). There were no significant changes in DriveAware scores at any epoch or between patient groups nor in the MCS in the surgical group.. There was a significant decline in PCS scores at 6 weeks post-operatively which recovered at 12 months (52 SD 8.1, 46 SD 6.8 and 52 SD 7.1 respectively)( p <0.01). There was no significant difference in 12-month mRS scores between the surgical cases who completed with cases who did not complete all assessments. Conclusion: Surgery for uIA did not affect cognitive abilities for driving at 6 weeks or 12 months after surgery. There was a decline in the QOL in the first months after surgery, however QOL returned to pre-surgical status 12 months after surgery. If the risk of seizures is low and there are no post-operative complications, returning to driving can be recommended.

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