Influence of intraoperative reduction quality on functional outcome and quality of life in treatment of tibial plafond fractures: a retrospective case-control study

Abstract Background The aim of the study was to evaluate the impact of reduction quality, using intraoperative 3D imaging, on quality of life and functional outcome in the operative treatment of tibial plafond fractures. Methods A group of patients with tibial plafond fractures was re-examined. The operative treatment was performed between September 2001 and October 2011. The follow-up examination was at least 2 years after the final surgical procedure. Final reduction result was assessed intraoperatively using a mobile 3D C-arm. A categorization with regard to descriptive parameters as well as type and size of joint surface irregularities was performed. Follow-up results were evaluated using: Olerud and Molander (O & M) score, Short-Form-36 (SF-36) score, movement deficit, Kellgren and Lawrence grade of osteoarthritis, and pain intensity. Results 34 patients with operatively treated tibial plafond fracture could be re-examined. Reduction quality had the greatest influence on functional result measured by the O & M score (p = 0.001) and the PCS domain of the SF-36 score (p = 0.018). Significant differences with regard to O & M score (p = 0.000), SF-36 score (p = 0.001 to p = 0.02; without MCS domain), movement deficit (p = 0.001), grade of osteoarthritis (p = 0.005) and pain (p = 0.001) could be verified under consideration of the reduction quality. The group with the anatomically more accurate reduction also showed a better result for clinical follow-up and quality of life. Furthermore, it is not the type of joint surface irregularity that is always decisive, but rather the size. Conclusions Despite other relevant factors, it appears that reduction quality –which can be analyzed with intraoperative 3D imaging– plays the most important role in postoperative quality of life and functional outcome. Corrections should therefore be performed on joint surface irregularities with a size above 2 mm.

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Influence of reduction quality on functional outcome and quality of life in treatment of tibial plafond fractures: a retrospective cohort study

10.21203/rs.2.12099/v3 ◽

2019 ◽

Author(s):

Maxim Privalov ◽

Finn Euler ◽

Holger Keil ◽

Benedict Swartman ◽

Nils Beisemann ◽

...

Keyword(s):

Quality Of Life ◽

Functional Outcome ◽

Joint Surface ◽

Intraoperative 3D Imaging ◽

Tibial Plafond ◽

Sf 36 ◽

Surface Irregularities ◽

Tibial Plafond Fractures

Abstract Background: The aim of the study was to evaluate the impact of reduction quality, using intraoperative 3D imaging, on quality of life and functional outcome in the operative treatment of tibial plafond fractures. Methods: A group of patients with tibial plafond fractures was re-examined. The operative treatment was performed between September 2001 and October 2011. The follow-up examination was at least 2 years after the final surgical procedure. Final reduction result was assessed intraoperatively using a mobile 3D C-arm. A categorization with regard to descriptive parameters as well as type and size of joint surface irregularities was performed. Follow-up results were evaluated using: Olerud and Molander (O & M) score, Short-Form-36 (SF-36) score, movement deficit, Kellgren and Lawrence grade of osteoarthritis, and pain intensity. Results: 34 patients with operatively treated tibial plafond fracture could be re-examined. Reduction quality had the greatest influence on functional result measured by the O & M score (p=0.001) and the PCS domain of the SF-36 score (p=0.018). Significant differences with regard to O & M score (p=0.000), SF-36 score (p=0.001 to p=0.02; without MCS domain), movement deficit (p=0.001), grade of osteoarthritis (p=0.005) and pain (p=0.001) could be verified under consideration of the reduction quality. The group with the anatomically more accurate reduction also showed a better result for clinical follow-up and quality of life. Furthermore, it is not the type of joint surface irregularity that is always decisive, but rather the size. Conclusions: Despite other relevant factors, it appears that reduction quality –which can be analyzed with intraoperative 3D imaging– plays the most important role in postoperative quality of life and functional outcome. Corrections should therefore be performed on joint surface irregularities with a size above 2 mm.

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Influence of reduction quality on functional outcome and quality of life in treatment of tibial plafond fractures: a retrospective cohort study

10.21203/rs.2.12099/v4 ◽

2019 ◽

Author(s):

Maxim Privalov ◽

Finn Euler ◽

Holger Keil ◽

Benedict Swartman ◽

Nils Beisemann ◽

...

Keyword(s):

Quality Of Life ◽

Functional Outcome ◽

Joint Surface ◽

Intraoperative 3D Imaging ◽

Tibial Plafond ◽

Sf 36 ◽

Surface Irregularities ◽

Tibial Plafond Fractures

Abstract Background: The aim of the study was to evaluate the impact of reduction quality, using intraoperative 3D imaging, on quality of life and functional outcome in the operative treatment of tibial plafond fractures. Methods: A group of patients with tibial plafond fractures was re-examined. The operative treatment was performed between September 2001 and October 2011. The follow-up examination was at least 2 years after the final surgical procedure. Final reduction result was assessed intraoperatively using a mobile 3D C-arm. A categorization with regard to descriptive parameters as well as type and size of joint surface irregularities was performed. Follow-up results were evaluated using: Olerud and Molander (O & M) score, Short-Form-36 (SF-36) score, movement deficit, Kellgren and Lawrence grade of osteoarthritis, and pain intensity. Results: 34 patients with operatively treated tibial plafond fracture could be re-examined. Reduction quality had the greatest influence on functional result measured by the O & M score (p=0.001) and the PCS domain of the SF-36 score (p=0.018). Significant differences with regard to O & M score (p=0.000), SF-36 score (p=0.001 to p=0.02; without MCS domain), movement deficit (p=0.001), grade of osteoarthritis (p=0.005) and pain (p=0.001) could be verified under consideration of the reduction quality. The group with the anatomically more accurate reduction also showed a better result for clinical follow-up and quality of life. Furthermore, it is not the type of joint surface irregularity that is always decisive, but rather the size. Conclusions: Despite other relevant factors, it appears that reduction quality –which can be analyzed with intraoperative 3D imaging– plays the most important role in postoperative quality of life and functional outcome. Corrections should therefore be performed on joint surface irregularities with a size above 2 mm.

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Influence of reduction quality on functional outcome and quality of life in treatment of tibial plafond fractures: a retrospective cohort study

10.21203/rs.2.12099/v2 ◽

2019 ◽

Author(s):

Maxim Privalov ◽

Finn Euler ◽

Holger Keil ◽

Benedict Swartman ◽

Nils Beisemann ◽

...

Keyword(s):

Quality Of Life ◽

Functional Outcome ◽

Joint Surface ◽

Intraoperative 3D Imaging ◽

Tibial Plafond ◽

Sf 36 ◽

Surface Irregularities ◽

Tibial Plafond Fractures

Abstract Background: The aim of the study was to evaluate the impact of reduction quality, using intraoperative 3D imaging, on quality of life and functional outcome in the operative treatment of tibial plafond fractures. Methods: A group of patients with tibial plafond fractures was re-examined. The operative treatment was performed between September 2001 and October 2011. The follow-up examination was at least 2 years after the final surgical procedure. Final reduction result was assessed intraoperatively using a mobile 3D C-arm. A categorization with regard to descriptive parameters as well as type and size of joint surface irregularities was performed. Follow-up results were evaluated using: Olerud and Molander (O & M) score, Short-Form-36 (SF-36) score, movement deficit, Kellgren and Lawrence grade of osteoarthritis, and pain intensity. Results: 34 patients with operatively treated tibial plafond fracture could be re-examined. Reduction quality had the greatest influence on functional result measured by the O & M score (p=0.001) and the PCS domain of the SF-36 score (p=0.018). Significant differences with regard to O & M score (p=0.000), SF-36 score (p=0.001 to p=0.02; without MCS domain), movement deficit (p=0.001), grade of osteoarthritis (p=0.005) and pain (p=0.001) could be verified under consideration of the reduction quality. The group with the anatomically more accurate reduction also showed a better result for clinical follow-up and quality of life. Furthermore, it is not the type of joint surface irregularity that is always decisive, but rather the size. Conclusions: Despite other relevant factors, it appears that reduction quality –which can be analyzed with intraoperative 3D imaging– plays the most important role in postoperative quality of life and functional outcome. Corrections should therefore be performed on joint surface irregularities with a size above 2 mm.

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Unicompartmental Knee Arthroplasty: Short-Term Results

Traumatology and Orthopedics of Russia ◽

10.21823/2311-2905-2021-27-1-153-165 ◽

2021 ◽

Vol 27 (1) ◽

pp. 153-165

Author(s):

V. Yu. Murylev ◽

N. E. Erokhin ◽

P. M. Elizarov ◽

G. A. Kukovenko ◽

A. V. Muzychenkov ◽

...

Keyword(s):

Quality Of Life ◽

Functional Outcome ◽

Postoperative Period ◽

Functional Results ◽

Early Postoperative Period ◽

X Rays ◽

Operating Technique ◽

Sf 36 ◽

The Face

Background. Among the methods of surgical treatment of early stages medial knee osteoarthritis in the partial knee replacement (PKR) becomes more and more relevant. The relevance and increasing number of PKR are confirmed by data from various national registers.The aim of the study was to research the early functional results of PKR and to analyze the complications at various stages of the postoperative period.Material and Methods. Study design: a single-center prospective study. The results of 90 operations of PKR in the period from March 2018 to April 2020 are presented. Assessment of knee function and quality of life of patients was performed according to three scalesquestionnaires: KOOS, WOMAC, SF-36, which were filled in preoperatively and then at 3, 6, 9, 12, 18 months. after surgery. Patients within the reporting period provided X-rays and filled in the scales at the face-to-face examination and at remote contact.Results. The most significant improvement of quality of life and median values of the functional results observed after 3 months, and after 18 months. After replacement the best median functional outcome scales KOOS, WOMAC, SF-36 — 79,4 (73,6–84,3); 27,1 (24,8–30,6); 89,1 (85,3–92,6) compared with the functional results obtained before surgery 32,3 (22,8–38,4); 73,6 (63,6–78,8); 35,2 (31,3–42,1); p = 0,027; p = 0.023; p = 0,028, respectively. A negative correlation was obtained between BMI and functional outcome (p = 0.027, R = -0.7).Conclusion. PKR allowed us to achieve an improvement in the quality of life and functional results already in the early postoperative period (from 3 to 18 months after the operation). The improvement of the operating technique, the analysis of errors and the regularity of the performed PKR will improve the results of PKR and minimize the number of complications.

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Midterm Outcome of Total Knee Arthroplasty in East Coast Population of Hospital Tengku Ampuan Afzan Kuantan

IIUM Medical Journal Malaysia ◽

10.31436/imjm.v17i1.868 ◽

2018 ◽

Vol 17 (1) ◽

Author(s):

Mohd Shahidan Noor Rahin ◽

Ahmad Hafiz Dzulkifly ◽

Harris Anwar Ali

Keyword(s):

Quality Of Life ◽

Functional Outcome ◽

East Coast ◽

Knee Prosthesis ◽

Good Health ◽

Midterm Outcome ◽

Sf 36 ◽

Health Domains ◽

Total Knee

Introduction: Total knee replacement (TKR) is an excellent advancement in medical treatment which gives good joint function and pain relief for degenerative diseases of joint since it was introduced in Malaysia since 1970. The purpose of this study was to evaluate the midterm functional outcome of patients undergone TKR using the NexGen LPS Flex prosthesis between January 2005 until April 2006 in primary osteoarthritis patients in our local east coast population. Materials and Methods: Forty six patients, 87% female (n=40) and 13% male (n=6), aged 54 to 81 (mean, 69±5.69) years underwent primary TKR using the hi-flex knee prosthesis (Zimmer) performed by two different surgeons were followed up for a minimal of five years. All used the same technique of surgery, medial parapatellar incision, cruciate substitute and cemented. Assesment were made based on the quality of life outcome score (SF-36) and the Oxford-12 knee scoring system questionnaires. Results: Oxford-12 revealed that patients had mild problems in terms of function and pain with the average function and pain score of 14.35±4.21 and 9.28±3.01 compared to a maximum possible score of 35 and 25 respectively. For eight health domains of SF-36, patients had the highest score (i.e. good health) for role emotional (RE), followed by mental health (MH), and social functioning (SF). This resulted in a higher score for mental component summary (MCS) than physical component summary (PCS). Since a low score of Oxford-12 indicates a better state of health compared to high score for SF-36, negative correlation between them was expected. Conclusion: The NexGen LPS-Flex TKR had good midterm functional outcome. Overall, TKR were found to be effective in terms of improvement in health-related quality-of-life dimensions.

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Characterization of functional outcome and quality of life following subarachnoid hemorrhage in patients treated with and without nicardipine prolonged-release implants

Journal of Neurosurgery ◽

10.3171/2008.2.17670 ◽

2009 ◽

Vol 110 (5) ◽

pp. 955-960 ◽

Cited By ~ 19

Author(s):

Martin Barth ◽

Claudius Thomé ◽

Peter Schmiedek ◽

Christel Weiss ◽

Hidetoshi Kasuya ◽

...

Keyword(s):

Quality Of Life ◽

Subarachnoid Hemorrhage ◽

Functional Outcome ◽

Cerebral Vasospasm ◽

Rating Scale ◽

Karnofsky Performance Scale ◽

Prolonged Release ◽

Sf 36 ◽

Performance Scale

Object The use of nicardipine prolonged-release implants (NPRIs) is associated with a significant improvement in the therapy of patients suffering from aneurysmal subarachnoid hemorrhage (aSAH) regarding the occurrence and severity of cerebral vasospasm, new infarcts, and functional outcome (FO). Because quality of life (QOL) measurements more reliably seem to describe the patient's true condition, the present study was conducted to assess FO and QOL 1 year after aneurysm rupture in patients with and without NPRIs. Methods From the initial series of 32 patients, 18 were assessed 1 year after aSAH (7 of the control and 11 of the NPRI group). The patients underwent neurological investigation, a structured interview followed by a measurement of QOL (Mini-Mental State Examination [MMSE]; 36-Item Short Form Health Survey [SF-36]; and the Hamilton Depression Rating Scale). There were no intergroup differences in the patient characteristics (that is, localization of aneurysm, initial Hunt and Hess grade, or age). Results In addition to the previously reported improvement of the National Institutes of Health Stroke Scale and modified Rankin Scale scores, the NPRI group's Karnofsky Performance Scale and the MMSE scores were markedly to significantly improved (p < 0.05 [Karnofsky Performance Scale] and p = 0.053 [MMSE]). In contrast, anxiety, oblivion, and mild symptoms of depression were equally present in both study groups (p = 0.607 [anxiety]; p = 0.732 [oblivion]; and p = 0.509 [Hamilton Depression Rating Scale]). Furthermore, no intergroup differences were observed in any of the SF-36 domains. The scores in the SF-36 domains of Role-Physical, Vitality, and Role-Emotional were significantly reduced in the NRPI group compared with those observed in an age-matched control population (p < 0.001 [Role-Physical]; p = 0.001 [vitality]; and p = 0.01 [Role-Emotional]). Considering consequent costs, no difference was detectable regarding the duration of in- and outpatient rehabilitation (p = 0.135 and 0.171, respectively) or the Prolo score (p = 0.094). Conclusions Despite FO improvement in terms of a lower incidence of cerebral vasospasm, new infarcts, morbidity in the treatment of aSAH in patients with NPRIs, a patient's QOL seems to be related to the severity of the aSAH itself.

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Outcome of Anterior Cruciate Ligament Reconstruction: A Comparison between Biotransfix Screw and All-Inside Technique

IIUM Medical Journal Malaysia ◽

10.31436/imjm.v16i1.1159 ◽

2017 ◽

Vol 16 (1) ◽

Author(s):

Nik Alyani Nik Abdul Adel ◽

Mohd Shukrimi bin Awang ◽

Zamzuri bin Zakaria

Keyword(s):

Quality Of Life ◽

Anterior Cruciate Ligament ◽

Functional Outcome ◽

Cruciate Ligament ◽

Normal Activity ◽

P Value ◽

Sf 36 ◽

Ikdc Score ◽

Anterior Cruciate

Introduction: Anterior cruciate ligament (ACL) reconstruction has evolved during past decade. All inside technique is introduced aiming for less invasive procedure, bone stock preservation, preservation of tendon at its donor site, better graft positioning and fixation technique. This study is conducted to compare the outcomes of this new technique to the previous biotransfix screw. Materials and method: A cross sectional study was conducted in patients with ACL injury treated with ACL reconstruction surgery in Hospital Sultanah Nur Zahirah, Kuala Terengganu and Hospital Kemaman, Terengganu. Functional outcome with International Knee Documentation Committee (IKDC) score, SF-36 quality of life score and time taken to return to normal activities were evaluated at 18 to 24 months post-operative. Results: Forty patient were recruited, 20 in each group. Of this, 37 were male with age of 25±6.48 years old. 25 were office worker and the rest were field worker. 37.5% were smoker. Patients in biotransfix screw technique operated at 21.3±12.6 months after the injury while those in all inside technique at 17.7±11.9 months(p-value 0.35). BMI was 24.58±4.59. The SF-36 score were similar in both groups with p-value 0.59. Both groups have same IKDC score of 82.99±12.55. Time taken to return to normal activity level was 46.3±19.7 weeks which was similar in both groups(p-value 0.943). Re rupture rate were 10% in biotransfix screw technique and 5% in all inside technique. None of them has any form of infection. There were no correlation between quality of life SF-36 score with age, tobacco use, BMI, duration of injury until operation and occupation of the patient in both techniques. Conclusion: The functional outcome, quality of life and time return to normal activity were similar between patients who had biotransfix screw and all inside technique. There were also no correlations between factors studied with quality of life in both groups.

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The Quality of Life and Functional Outcome of Hindfoot Reconstructive Surgery in Charcot Foot

IIUM Medical Journal Malaysia ◽

10.31436/imjm.v17i1.924 ◽

2018 ◽

Vol 17 (1) ◽

Author(s):

Mohd Hijaz Zainudin ◽

Mohd Adham Shah Ayeop ◽

Aminudin Che Ahmad

Keyword(s):

Quality Of Life ◽

Functional Outcome ◽

Reconstructive Surgery ◽

Cross Sectional Study ◽

Charcot Foot ◽

Cross Sectional ◽

Difficult Condition ◽

Sf 36 ◽

Ankle Surgery

Introduction: Charcot foot problem is devastating and a difficult condition to treat. There are limited data and study regarding the quality of life and functional outcome of Charcot foot being treated surgically. This study evaluates the outcome of Charcot foot treated with reconstructive surgery. Materials and Methods: This is a cross-sectional study that compares the quality of life and functional outcome of patient with Charcot foot pre and post tibio-talar-calcaneal (TTC) arthrodesis surgery at Hospital Tengku Ampuan Afzan and International Islamic University Malaysia Medical Centre between 2016 and 2018. Patients were evaluate using SF-36 scores and AOFAS scores pre and post-operative at average of 6 months (range between 3 to 9 months). Results: Thirty patients had undergone reconstructive foot and ankle surgery using hindfoot arthrodesis nail (HAN) for TTC arthrodesis. The outcome was assessed using paired t-test comparing pre and postoperative for both SF-36 and AOFAS scores. The SF-36 components had significant improvement with a mean of 35 to 45.6 for physical component (PCS) and 46.6 to 52.5 for mental component (MCS) (p<0.0001). The overall AOFAS score had significant improvement from average of 36 to 57.8 out of 100 (p<0.0001). Pain component of AOFAS shows lower score of improvement. Two patients had suffered ulceration post operatively that requires multiple debridement and exostectomy with one patient requires removal of HAN eventually. Conclusions: Tibio-talo-calcaneal arthrodesis using HAN surgery improves the quality of life and functional outcome of Charcot foot.

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Quality of life in patients, suffering localized reno-cellular cancer after operative treatment

Klinicheskaia khirurgiia ◽

10.26779/2522-1396.2019.11-12.56 ◽

2019 ◽

Vol 86 (11-12) ◽

pp. 56-62

Author(s):

O. A. Voylenko ◽

O. A. Kononenko ◽

S. L. Semko ◽

M. V. Pikul ◽

O. E. Stakhovskyi ◽

...

Keyword(s):

Quality Of Life ◽

Operative Treatment ◽

Psychological Health ◽

State Of Health ◽

Role Functioning ◽

Vital Activity ◽

Physical Role ◽

Sf 36

Objective. To rise the efficacy of treatment in patients, suffering localized reno-cellular cancer (LRCC), studying quality of life in patients and determination of optimal procedure of operative treatment. Materials and methods. Of 511 patients, suffering LRCC (T1-T2 N0M0), in whom quality of life was estimated in accordance to the SF-36 questionnaire, renal resection was performed in 422 (82.6%), nephrectomy - 89 (17.4%). The observation duration median have constituted 28.9 mo (from 3 to 131 mo). Results. A patient’s cognition of the oncological disease missing have raised the quality of life self-estimation, predominantly in accordance to indices of psychological component of health after nephrectomy and after renal resection. Comparing the quality of life between the patients’ groups, there was obtained a statistically significant advantage of renal resection over nephrectomy in accordance to five indices of quality of life, including: physical functioning - 75 [65; 85] points after nephrectomy and 80 [70; 90] points after renal resection (p < 0.005); general state of health - 65 [57; 72] and 70 [65; 80] (p < 0.001); vital activity - 65 [55; 70] and 70 [60; 75] (p < 0.005); psychological health - 76 [60; 80] and 80 [68; 88] (p < 0.005); the emotionally-role functioning - 66.7 [66.7; 100] and 100 [66,7; 100] (p < 0.05) points, accordingly. Conclusion. Renal resection has a statistically proven advantage over nephrectomy in accordance to patients’ quality of life, determined, basing on data from the SF-36 questionnaire, predominantly due to better psychological self estimation of the patient’s state of health (p < 0.01). Difference between the investigated groups in accordance to indices of pain intensity, social and physical-role functioning was not established.

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