Responsiveness and ceiling effects of the English version of the 12-item International Hip Outcome Tool following hip arthroscopy at minimum one-year follow-up

2020 ◽  
Vol 102-B (8) ◽  
pp. 1010-1015
Author(s):  
Patrick G. Robinson ◽  
Julian F. Maempel ◽  
Iain R. Murray ◽  
Conor S. Rankin ◽  
David F. Hamilton ◽  
...  
Keyword(s):  
Effect Size ◽  
Hip Arthroscopy ◽  
Young Male ◽  
English Version ◽  
Maximum Score ◽  
Ceiling Effects ◽  
Male Patients ◽  
One Year ◽  
Outcome Tool

Aims Responsiveness and ceiling effects are key properties of an outcome score. No such data have been reported for the original English version of the International Hip Outcome Tool 12 (iHOT-12) at a follow-up of more than four months. The aim of this study was to identify the responsiveness and ceiling effects of the English version iHOT-12 in a series of patients undergoing hip arthroscopy for intra-articular hip pathology at a minimum of one year postoperatively. Methods A total of 171 consecutive patients undergoing hip arthroscopy with a diagnosis of femoroacetabular impingement (FAI) under the care of a single surgeon between January 2013 and March 2017 were included. iHOT-12 and EuroQol 5D-5L (EQ-5D-5L) scores were available pre- and postoperatively. Effect size and ceiling effects for the iHOT-12 were calculated with subgroup analysis. Results A total of 122 patients (71.3%) completed postoperative PROMs scores with median follow-up of 24.3 months (interquartile range (IQR) 17.2 to 33.5). The median total cohort iHOT-12 score improved significantly from 31.0 (IQR 20 to 58) preoperatively to 72.5 (IQR 47 to 90) postoperatively (p < 0.001). The effect size (Cohen’s d) was 1.59. In all, 33 patients (27%) scored within ten points (10%) of the maximum score and 38 patients (31.1%) scored within the previously reported minimal clinically important difference (MCID) of the maximum score. Furthermore, nine (47%) male patients aged < 30 years scored within 10% of the maximum score and ten (53%) scored within the previously reported MCID of the maximum score. Conclusion There is a previously unreported ceiling effect of the iHOT-12 at a minimum one-year follow-up which is particularly marked in young, male patients following hip arthroscopy for FAI. This tool may not have the maximum measurement required to capture the true outcome following this procedure. Cite this article: Bone Joint J 2020;102-B(8):1010–1015.

scholarly journals Translation, cross-cultural adaptation, and validation of the Italian language Forgotten Joint Score-12 (FJS-12) as an outcome measure for total knee arthroplasty in an Italian population

2020 ◽  
Vol 21 (1) ◽  
Author(s):  
Valerio Sansone ◽  
Peter Fennema ◽  
Rachel C. Applefield ◽  
Stefano Marchina ◽  
Raffaella Ronco ◽  
...  
Keyword(s):  
Total Knee Arthroplasty ◽  
Internal Consistency ◽  
Knee Arthroplasty ◽  
Effect Size ◽  
Italian Population ◽  
Maximum Score ◽  
Ceiling Effects ◽  
Total Knee ◽  
Test Retest Reliability

Abstract Background With ever-increasing numbers of patients undergoing elective total knee arthroplasty (TKA) and as TKA is performed in increasingly younger patients, patient demands and expectations have also increased. With improved patient outcomes, new PROMs with heightened discriminatory power in well-performing patients are needed. The present study aimed to translate and validate the Italian version of the Forgotten Joint Score (FJS-12) as a tool for evaluating pre-operative through longitudinal post-operative outcomes in an Italian population. Methods In this prospective study, patients with unilateral osteoarthritis, undergoing TKA surgery between May 2015 and December 2017 were recruited to participate in the study. The FJS-12 and WOMAC were collected pre-operatively and at six and 12 months post-operatively. According to the COSMIN checklist, reliability, internal consistency, validity, responsiveness, effect size, and ceiling effects and floor effects were evaluated. Results One hundred twenty patients completed the study, 66 of which participated in the evaluation of test-retest reliability. Good test-retest reliability was found (ICC = 0.90). The FJS-12 also showed excellent internal consistency (Cronbach α = 0.81). Construct validity with the WOMAC, as a measure of the Pearson correlation coefficient, was moderate (r = 0.45 pre-operatively; r = 0.46 at 6 months and r = 0.42 at 12 months post-operatively). From six to 12 months, the change was slightly greater for the WOMAC than for the FJS-12 patients (effect size d = 0.94; d = 0.75, respectively). At 12-months follow-up, the ceiling effects reflecting the maximum score were 12% for the FJS-12 and 6% for the WOMAC; however, scores within 10% of the maximum score were comprised 30% of the FJS-12 scores and 59% for the WOMAC. Conclusion The Italian FJS-12 demonstrated strong measurement properties in terms of reliability, internal consistency, and construct validity in TKA patients. Furthermore, a more detailed look at ceiling effects shows a superior discriminatory capacity when compared to the WOMAC at 12-months follow-up, particularly in better-performing patients. Trial registration clinicaltrials.gov NCT03805490. Registered 18 January 2019 (retrospectively registered).

Lumbar epidural hematoma associated with spondylolyses

2008 ◽  
Vol 8 (2) ◽  
pp. 174-180 ◽  
Author(s):  
Chima O. Ohaegbulam ◽  
Ian F. Dunn ◽  
Pierre d'Hemecourt ◽  
Mark R. Proctor
Keyword(s):  
Epidural Hematoma ◽  
Surgical Intervention ◽  
Relevant Literature ◽  
Young Male ◽  
Active Patient ◽  
Male Patients

✓ This report describes 3 young male patients with multiple lumbar spondylolyses in combination with a symptomatic epidural hematoma. The records of all 3 patients were reviewed for clinical details. All patients were successfully treated without surgical intervention. Initial neuroimaging results for all patients revealed epidural hematomas, and follow-up imaging confirmed resolution of the hematomas. The relevant literature is briefly reviewed to examine the rarity of this combination. Spontaneous epidural hematomas may occur in the setting of spondylolysis, and this diagnosis should be considered when imaging reveals an unusual epidural lesion in a young active patient.

scholarly journals 10-year follow-up of young male patients with mild hypertension.

1990 ◽  
Vol 54 (11) ◽  
pp. 1383-1389 ◽  
Author(s):  
YUZURU SATO ◽  
KUNIO HIWADA ◽  
RUMI TANAKA ◽  
TATSUO KOKUBU
Keyword(s):  
Mild Hypertension ◽  
Young Male ◽  
Male Patients

scholarly journals Clinical Outcomes of Revision Hip Arthroscopy for Synovial Chondromatosis

2021 ◽  
Author(s):  
Guanying Gao ◽  
Hongjie Huang ◽  
Jianquan Wang ◽  
Yingfang Ao ◽  
Yan Xu
Keyword(s):  
Clinical Outcomes ◽  
Revision Surgery ◽  
Hip Arthroscopy ◽  
Synovial Chondromatosis ◽  
Harris Hip Score ◽  
Radiographic Evaluation ◽  
Patient Reported ◽  
Before And After ◽  
Outcome Tool

Abstract Background: Synovial chondromatosis (SC) is a relatively rare disease and there were few studies on causes and clinical outcomes of revision surgery for SC. The purpose of this study was to evaluate clinical outcomes of revision hip arthroscopy for synovial chondromatosis.Methods: We evaluated consecutive patients who underwent revision hip arthroscopy for SC in our hospital between January 2008 and January 2020. Radiographic evaluation was made before and after surgery. Preoperative patient-reported outcomes (PROs) and PROs at final follow-up were obtained, including visual analog scale (VAS) for pain, the International Hip Outcome Tool-12 (iHOT-12) and modified Harris Hip Score (mHHS).Results: A total of 8 patients (mean age, 39.5 years; age range, 27-62 years; 5 males and 3 females) were included in this study. The recurrence rate of hip SC in our hospital was 6.8%. The average follow-up period after surgery was 47.3 months (range, 12–120 months). Before surgery, mean mHHS was 60.6±17.3 (range, 20-77), mean iHOT-12 was 43.8±13.7 (range, 18-69), and mean VAS was 3.1±1.7 (range, 1-7). At the final post-operative follow-up, mean mHHS was 83.8±16.6 (range, 43-91), iHOT-12 was 80.6±19.7 (range, 32-90), and mean VAS was 0.6±1.8 (range, 0-5). All results demonstrated statistically significant improvement (P < 0.05). Recurrence of SC was found in 2 patients 1 year and 4 years after revision hip arthroscopy, respectively.Conclusion: Hip arthroscopy had good clinical outcomes for revision surgery of SC.

Drugs and Delinquency: A Four Year Follow-up of Drug Clinic Patients

1978 ◽  
Vol 132 (1) ◽  
pp. 21-26 ◽  
Author(s):  
Alistair M. Gordon
Keyword(s):  
Educational Attainment ◽  
Hospital Admission ◽  
Clinic Attendance ◽  
Good Outcome ◽  
Prognostic Assessment ◽  
Opiate Use ◽  
Drug History ◽  
Male Patients ◽  
One Year

The addiction and conviction status of 60 male patients, examined at a London drug clinic in 1970 was reassessed at four-year follow-up. Forty-three per cent had become abstinent, 23 per cent remained dependent and 15 per cent had died. Ninety-seven per cent had received a court conviction and 73 per cent were convicted during follow-up. A prognostic assessment was determined in combined terms of continued addiction and continued delinquency. Poor outcome related to a lack of educational attainment, earlier first conviction and regular opiate use on arrival, and was associated during follow-up with an irregular clinic attendance beyond one year, drug conviction and death. Good outcome related to an absence of parental loss and later first conviction, and was associated during follow-up with discharge within one year without hospital admission. Analysis of the data indicates the value of combining forensic information with drug history in prognostic assessment.

Corneal collagen cross-linking for management of keratoconus in patients affected by Tourette syndrome

2020 ◽  
pp. 112067212094510
Author(s):  
Karl Anders Knutsson ◽  
Giorgio Paganoni ◽  
Oriella Ambrosio ◽  
Giulio Ferrari ◽  
Paolo Rama
Keyword(s):  
Visual Acuity ◽  
Tourette Syndrome ◽  
Case Series ◽  
Young Male ◽  
Cross Linking ◽  
Male Patients ◽  
Collagen Cross Linking ◽  
Corneal Collagen

Purpose: To present a series of two patients affected by Tourette syndrome (TS) and progressive keratoconus. Case series: Two young male patients with keratoconus and TS were referred to our center. In both patients eye rubbing was present and in one patient, an ocular tic was present determining blepharospasm. Progression of keratoconus occurred in both cases and corneal collagen cross-linking (CXL) was performed. All treated eyes showed topographic stability with stable refraction and conserved visual acuity, with a follow-up period ranging from 1.5 to 2.5 years. Conclusion: Patients with keratoconus and TS should be observed frequently to document topographical and refractive changes, and in case of progressing disease, CXL should be performed in order to prevent further progression.

scholarly journals Outcomes of periacetabular osteotomy for borderline hip dysplasia in adolescent patients

2020 ◽  
Vol 7 (2) ◽  
pp. 249-255
Author(s):  
Ishaan Swarup ◽  
Ira Zaltz ◽  
Stacy Robustelli ◽  
Ernest Sink
Keyword(s):  
Hip Arthroscopy ◽  
Acetabular Dysplasia ◽  
Periacetabular Osteotomy ◽  
Hip Pain ◽  
Center Edge ◽  
Outcome Scores ◽  
Adolescent Patients ◽  
History Of ◽  
Outcome Tool

Abstract Treatment of borderline acetabular dysplasia (lateral center edge angle ≥18°) remains controversial, and there is a paucity of literature focusing on outcomes in adolescent patients. The purpose of this study was to evaluate the outcomes of a periacetabular osteotomy (PAO) as surgical management of borderline acetabular dysplasia in adolescent patients. We performed a retrospective review of prospectively collected data and included patients ≤ 21 years of age that underwent PAO for borderline acetabular dysplasia. All patients had a minimum of 1-year follow-up. Outcomes were assessed using modified Harris Hip Scores (mHHS), Hip Outcome Scores (HOS) and international Hip Outcome Tool (iHOT-33). Descriptive and univariate statistical analyses were performed. This study included 33 adolescent patients (35 hips) with symptomatic, borderline acetabular dysplasia. The majority of patients was female (32 patients, 97%); half of all patients reported a history of hip pain for over 1 year; and seven patients had previous hip arthroscopy. In addition to PAO, seven hips (20%) underwent a concurrent hip arthroscopy at the time of surgery. There were significant improvements in mean mHHS, HOS-activities of daily living (ADL), HOS-Sport and iHOT-33 scores after surgery (P &lt; 0.01). Minimal clinically important difference in outcome scores was achieved for over 90% of patients at a minimum of 1-year follow-up. Borderline acetabular dysplasia is a major cause of hip pain in adolescent patients. Patients with symptomatic borderline acetabular dysplasia report a significant benefit after a PAO to correct structural hip instability.

Scarf Osteotomy for Hallux Valgus Repair: The Dark Side

2003 ◽  
Vol 24 (1) ◽  
pp. 29-33 ◽  
Author(s):  
J. Chris Coetzee
Keyword(s):  
Hallux Valgus ◽  
Early Recurrence ◽  
Delayed Union ◽  
Dark Side ◽  
Patients Âgés ◽  
Scarf Osteotomy ◽  
Structural Principles ◽  
Male Patients ◽  
One Year

Hypothesis/Purpose: The Scarf osteotomy has gained popularity as treatment of choice in parts of Europe and is based on sound structural principles. The excellent results reported by others could not, however, be reproduced by the author and the results are presented. Methods: From January 1997 to June 1997 the Scarf osteotomy was selected in 20 consecutive patients (12 female and eight male patients, ages 18 to 60, mean: 41 years) with moderate metatarsus primus varus (IMA 13 to 20°) and hallux valgus deformities (less than 40°). The AOFAS Hallux Metatarsophalangeal-Interphalangeal Scale, visual analog scale and patient satisfaction were monitored prior to surgery, six and 12 months post-op. The patients were treated in a short leg cast, non-WB for two weeks followed by four weeks partial WB in a cast shoe. Routine post-bunion rehabilitation followed once the radiological and clinical diagnosis of healing was made. Results: Multiple complications were encountered. The most common was “troughing” of the metatarsal with loss of height. This occurred in seven patients (35%). Other complications include delayed union (5%), rotational malunion (30%), proximal fracture (10%), infection (5%) and early recurrence of deformity in 25%. All 20 patients were available for follow-up at six months, and 19 of 20 at 12 months. The AOFAS score pre-op was a mean of 53. At six months a mean of 54 (19 to 69) and at 12 months 62 (24–100). Forty-five percent (9/20) were unsatisfied at one year and would not recommend the surgery to a friend. Conclusions/Significance: The Scarf osteotomy has multiple potential pitfalls and should probably be reserved for moderate bunions in young people with good bone quality. There are multiple potential problems and the salvage of a failed Scarf osteotomy is difficult.

Outcomes of the six-strand M-Tang repair for zone 2 primary flexor tendon repair in 54 fingers

2017 ◽  
Vol 42 (5) ◽  
pp. 462-468 ◽  
Author(s):  
X. Zhou ◽  
X.R. Li ◽  
J. Qing ◽  
X.F. Jia ◽  
J. Chen
Keyword(s):  
Full Range ◽  
Tendon Repair ◽  
Flexor Tendon Repair ◽  
Level Of Evidence ◽  
Active Motion ◽  
A2 Pulley ◽  
Male Patients ◽  
Early Passive ◽  
One Year

We repaired complete divisions of flexor tendons in zone 2 in 54 fingers using a six-strand core M-Tang repair method. Partial active digital motion started with early passive digital motion carried out first in the first 3–4 weeks after surgery and full range of active motion in later weeks. The patients were followed for 4–27 months. According to Strickland criteria or Tang criteria, 24 (83%) had excellent or good, four fair and one poor results in 28 fingers with follow-up of more than one year. In the other 25 fingers which were followed for less than 12 months, 19 (76%) had excellent and good, four fair and two poor results. There were no repair ruptures. We analysed outcomes against ages, gender, pulley integrity, accompanied injuries and follow-up times. The patients younger than 37 years old, male patients and with their A2 pulley(s) vented there were significantly better outcomes. The patients with longer than one year follow-up had significantly smaller extension deficits than those with less than one year follow-up. Level of evidence: IV

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