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

10.21203/rs.2.12099/v1 ◽

2019 ◽

Author(s):

Maxim Privalov ◽

Finn Euler ◽

Holger Keil ◽

Benedict Swartman ◽

Nils Beisemann ◽

...

Keyword(s):

Quality Of Life ◽

Functional Outcome ◽

Operative Treatment ◽

3D Imaging ◽

Joint Surface ◽

Intraoperative 3D Imaging ◽

Tibial Plafond ◽

Sf 36 ◽

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 postoperatively examined. The operative treatment was performed between September 2001 and October 2011 under reduction control using an intraoperative 3D C-arm. A categorization with regard to the type and the size of joint surface irregularities was carried out after intraoperative reduction. Postoperative results were evaluated using: Olerud and Molander (O & M) score, Short-Form-36 (SF-36) score, leg circumference, movement deficit, Kellgren and Lawrence grade of osteoarthritis, and pain intensity. Results 34 patients with osteosynthetically 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), circumferential difference below the knee joint gap (P=0.012), 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 preferred reduction also showed a better result for clinical follow-up and quality of life. 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.

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The effect of surgery in tenosynovial giant cell tumours as measured by patient-reported outcomes on quality of life and joint function

The Bone & Joint Journal ◽

10.1302/0301-620x.101b3.bjj-2018-0804.r1 ◽

2019 ◽

Vol 101-B (3) ◽

pp. 272-280 ◽

Cited By ~ 3

Author(s):

F. G. M. Verspoor ◽

M. J. L. Mastboom ◽

G. Hannink ◽

W. T. A. van der Graaf ◽

M. A. J. van de Sande ◽

...

Keyword(s):

Quality Of Life ◽

Giant Cell ◽

Diffuse Type ◽

Joint Function ◽

Population Means ◽

Sf 36 ◽

Patient Reported ◽

The Impact

Aims The aim of this study was to evaluate health-related quality of life (HRQoL) and joint function in tenosynovial giant cell tumour (TGCT) patients before and after surgical treatment. Patients and Methods This prospective cohort study run in two Dutch referral centres assessed patient-reported outcome measures (PROMs; 36-Item Short-Form Health Survey (SF-36), visual analogue scale (VAS) for pain, and Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC)) in 359 consecutive patients with localized- and diffuse-type TGCT of large joints. Patients with recurrent disease (n = 121) and a wait-and-see policy (n = 32) were excluded. Collected data were analyzed at specified time intervals preoperatively (baseline) and/or postoperatively up to five years. Results A total of 206 TGCT patients, 108 localized- and 98 diffuse-type, were analyzed. Median age at diagnosis of localized- and diffuse-type was 41 years (interquartile range (IQR) 29 to 49) and 37 years (IQR 27 to 47), respectively. SF-36 analyses showed statistically significant and clinically relevant deteriorated preoperative and immediate postoperative scores compared with general Dutch population means, depending on subscale and TGCT subtype. After three to six months of follow-up, these scores improved to general population means and continued to be fairly stable over the following years. VAS scores, for both subtypes, showed no statistically significant or clinically relevant differences pre- or postoperatively. In diffuse-type patients, the improvement in median WOMAC score was statistically significant and clinically relevant preoperatively versus six to 24 months postoperatively, and remained up to five years’ follow-up. Conclusion Patients with TGCT report a better HRQoL and joint function after surgery. Pain scores, which vary hugely between patients and in patients over time, did not improve. A disease-specific PROM would help to decipher the impact of TGCT on patients’ daily life and functioning in more detail. Cite this article: Bone Joint J 2019;101-B:272–280.

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The Impact of Combat Ocular Trauma and Traumatic Brain Injury on Vision- and Health-Related Quality of Life Among U.S. Military Casualties

Military Medicine ◽

10.1093/milmed/usab233 ◽

2021 ◽

Author(s):

Rose K Sia ◽

Denise S Ryan ◽

Daniel I Brooks ◽

Janice M Kagemann ◽

Kraig S Bower ◽

...

Keyword(s):

Quality Of Life ◽

Traumatic Brain Injury ◽

Ocular Trauma ◽

Health Related Quality ◽

Sf 36 ◽

Related Quality ◽

Health Related ◽

Composite Scores

ABSTRACT Purpose The purpose of this study was to assess visual and health-related quality of life (QOL) among U.S. military service members who sustained combat ocular trauma (COT) with or without associated traumatic brain injury (TBI). Methods This was a single-center, prospective observational study of U.S. service members (n = 88) with COT who were treated at Walter Reed National Military Medical Center. Participants completed the National Eye Institute Visual Function Questionnaire (VFQ-25) at enrollment and at follow-up (>1 year) and supplemental surveys: Neurobehavioral Symptom Inventory, the Medical Outcomes 36-item Short Form Survey (SF-36), and Mayo-Portland Adaptability Inventory. Results Initial and follow-up VFQ-25 showed a statistically significant increase in median scores for near activities (initial: 75.0, follow-up 83.3; P = .004) and peripheral vision (initial: 50.0, follow-up: 75.0; P = .009) and in composite scores (initial: 79.5, follow-up: 79.8; P = .022). Comparing those who did (n = 78) and did not (n = 8) have a TBI history, there were no significant differences in median change in VFQ-25 composite scores (with TBI: 2.3 vs. no TBI: 10.7; P = .179). Participants with a TBI history had a significantly lower median SF-36 General Health score (with TBI: 67.5 vs. no TBI: 92.5; P = .009) Conclusions Vision-related QOL of COT patients is generally good in the long term. However, those with both COT and a history of TBI conditions showed significantly worse functioning in several domains than those without TBI. As TBI is a common finding in COT, this association is an important factor impacting this population’s overall clinical presentation and daily functions.

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Better health-related quality of life in kidney transplant patients compared to chronic kidney disease patients with similar renal function

PLoS ONE ◽

10.1371/journal.pone.0257981 ◽

2021 ◽

Vol 16 (10) ◽

pp. e0257981

Author(s):

Jung-Hwa Ryu ◽

Tai Yeon Koo ◽

Han Ro ◽

Jang-Hee Cho ◽

Myung-Gyu Kim ◽

...

Keyword(s):

Quality Of Life ◽

Chronic Kidney Disease ◽

Kidney Disease ◽

Health Related Quality ◽

Sf 36 ◽

Related Quality ◽

Health Related ◽

Over Time

Renal functional deterioration is associated with physical and mental burdens for kidney transplant (KT) and chronic kidney disease (CKD) patients. However, the change in health-related quality of life (HRQOL) over time in KT patients compared to that of native CKD patients has not been evaluated. We addressed this issue using KT patients registered in the KNOW-KT cohort study and patients at CKD stage 1–3 registered in the KNOW-CKD cohort study. HRQOL scores were assessed using the Kidney Disease Quality of Life Short Form at baseline, 2-, and 4-years follow-up in 842 KT patients and at baseline and 5-year follow-up in 1,355 CKD patients. SF-36 scores declined at the 4-year follow-up, whereas CKD-targeted scores showed no change in the KT group. In contrast, CKD-targeted scores as well as SF-36 scores were decreased at the 5-year follow-up in CKD patients. When prognostic factors were analyzed for longitudinal HRQOL data over time, renal functions, diabetes, cardiovascular and cerebrovascular diseases, hemoglobin level, marital status, income, employment, and health care were significant prognostic factors. Furthermore, KT was an independent prognostic factor for better HRQOL. These results highlight that KT can offer a better HRQOL than that of CKD patients, even when renal function is similar.

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Ross procedure and aortic valve repair: long-term echocardiographic outcomes, quality of life and physical activity of different aortic valve surgery procedures

European Heart Journal - Cardiovascular Imaging ◽

10.1093/ehjci/jeaa356.409 ◽

2021 ◽

Vol 22 (Supplement_1) ◽

Author(s):

F Bianco ◽

M Colaneri ◽

V Bucciarelli ◽

FC Surace ◽

FC Iezzi ◽

...

Keyword(s):

Quality Of Life ◽

Physical Activity ◽

Aortic Valve ◽

Aortic Surgery ◽

Ross Procedure ◽

Valve Repair ◽

Sf 36

Abstract Funding Acknowledgements Type of funding sources: None. Background To compare long-term outcomes of aortic valve repair (AVr) and pulmonary autograft replacement (Ross procedure) in terms of echocardiographic parameters, quality of life (QoL), physical activity (PA). Methods In 2005-19, 129 patients (median age 22 [13, 33 IQR], 75% males) underwent aortic surgery in our Department: 40 were Ross (22 years [19, 51 IQR]), 67 AVr (17 years [1, 50 IQR]) and 22 aortic valve replacements (52 years [30, 80 IQR]). We focused on Ross and AVr. Retrospectively, relevant data were collected from medical records and phone re-calls. Physical activity (spontaneous and active) and QoL were assessed utilizing the IPAQ and SF-36 questionnaires. All patients underwent echocardiography pre/post-surgery and the follow-up lasted 12 ± 4 years. Results At the baseline, Ross patients had more aortic stenosis than insufficiency (P = 0.045). At the follow-up, Ross procedures presented more right-ventricle and aortic annulus dilatation (P = 0.002 and P = 0.030, respectively), but higher left-ventricular global longitudinal strain (LV GLS: 18 ± 3.2 % vs. 16 ± 3.3, P = 0.0027). Conversely, AVr experienced more re-do operations (Log-rank P = 0.005). Ross reported better QoL (SF-36: 0.8 ± 0.07 vs. 19 ± 0.4, P-0.045) and were also more active in daily PA (IPAQ ≥ 2500 Mets: 63.8% vs. 6%; P = 0.006). Ross patients practiced more sports activities than AVr (P = 0.011). Conclusions In a relatively small cohort of young and adults post aortic surgery patients, Ross procedures had better prognosis in terms of re-do operations; presented better ventricular function, as assessed by LV GLS. Ross patients had better long-term QoL and showed more spontaneous PA and involvement in sports activity.

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Long-term Neurological Outcome and Quality of Life after World Federation of Neurosurgical Societies Grades IV and V Aneurysmal Subarachnoid Hemorrhage in an Interdisciplinary Treatment Concept

Neurosurgery ◽

10.1093/neuros/nyw138 ◽

2017 ◽

Vol 80 (6) ◽

pp. 967-974 ◽

Cited By ~ 15

Author(s):

Christoph Schwartz ◽

Thomas Pfefferkorn ◽

Caroline Ebrahimi ◽

Caroline Ottomeyer ◽

Gunther Fesl ◽

...

Keyword(s):

Quality Of Life ◽

Functional Outcome ◽

Short Form ◽

Functional Independence ◽

World Federation ◽

Long Term Survivors ◽

Short Form Health

Abstract BACKGROUND: Detailed data on long-term functional outcome of patients with World Federation of Neurosurgical Societies (WFNS) grades IV and V aneurysmal subarachnoid hemorrhages (aSAH) are still scarce. OBJECTIVE: Assessment of long-term outcome of WFNS IV and V aSAH patients. METHODS: Functional outcome and quality of life were assessed by the modified Rankin scale (mRS) and the 36-item short-form health survey in consecutively treated aSAH WFNS IV and V patients between 2005 and 2010. Scores from the 36-item short-form health survey were compared to a healthy German population. Prognostic factors were analyzed by uni- and multivariate models. RESULTS: One hundred and seven eligible patients (median age: 53.0 years) were identified. After interdisciplinary consensus on optimal treatment, aneurysms were obliterated either by clipping (n = 35) or by coiling (n = 72). Ten patients were lost to long-term follow-up; the median clinical follow-up period was 3.2 years for the remaining 97 cases. Twenty-five of 97 died during the acute hospital phase and another 10 patients over the follow-up period leaving 62 long-term survivors. At the end of clinical follow-up, 40/97 patients, including 40/62 of long-term survivors, reached functional independence (mRS ≤ 2). Twelve of 97 patients were moderately (mRS = 3), 10/97 patients were severely disabled (mRS ≥ 4). Younger age (≤ 53 years; P = .001) and radiological absence of cerebral infarction (P = .03) were the strongest predictors for favorable outcome. Quality of life was perceived to be only moderately reduced compared to the healthy control group. CONCLUSION: Poor-grade aSAH is not necessarily associated with poor long-term functional outcome; after aneurysm repair ∼60% of patients survived and among long-term survivors ∼ 60% regained functional independence.

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Abstract P162: The Baseline Ankle Brachial Index (ABI), but Not Change in the ABI, is Associated With 11-Year Change in the SF-36: The San Diego Population Study (SDPS)

Circulation ◽

10.1161/circ.131.suppl_1.p162 ◽

2015 ◽

Vol 131 (suppl_1) ◽

Author(s):

Christina L Wassel ◽

Matthew A Allison ◽

Joachim H Ix ◽

Julie O Denenberg ◽

Dena E Rifkin ◽

...

Keyword(s):

Quality Of Life ◽

Lower Extremity ◽

Physical Functioning ◽

Ankle Brachial Index ◽

Population Based ◽

Component Score ◽

Lower Baseline ◽

Sf 36

Background: Lower extremity peripheral artery disease (PAD) affects approximately 9 million people in the US. Less well-recognized is that PAD, even when asymptomatic, is associated with decreased functional status and quality of life. Previous studies have largely examined associations of the ankle brachial index (ABI) and quality of life in participants with PAD. To our knowledge no studies have examined the impact of ABI and change in ABI on change in quality of life in a population-based setting. Methods: The SDPS is a population-based prospective study that evaluated non-Hispanic White, African-American, Hispanic and Asian men and women for lower extremity PAD at two examinations approximately 11 years apart. Participants completed the SF-36 questionnaire, and 802 participants had ABI and SF-36 data available at both examinations. Analyses were restricted to these participants who also had a baseline ABI<1.4. Growth curve models were used to assess the associations of baseline ABI and change in the ABI with change in the SF-36 physical component score (PCS) and mental component score (MCS) over time. Change in the ABI was defined as (follow-up ABI - baseline ABI)/baseline ABI. Results: Participants were on average 57±9 years of age at baseline, and 69±9 at follow-up. At baseline, nearly 2 percent had ABI≤0.90, and the mean±SD ABI was 1.12±0.10. After adjustment for age, sex, race/ethnicity, BMI, ever smoking, physical activity, hypertension, diabetes, and dyslipidemia, each SD lower baseline ABI was significantly associated with an average change of -0.63 points (95% CI (-0.10, -1.17), p=0.02) on the PCS. This association was marginally significant for the MCS (-0.54 points (0.14, 1.22), p=0.12). Lower baseline ABI was also associated with negative change in two SF-36 subscales, physical functioning (p=0.02) and vitality (p=0.01). Change in the ABI over 11 years was not associated with change in the MCS (p=0.97) or PCS (p=0.41). Results were similar when excluding participants with ABI≤0.90. Conclusions: A lower ABI at baseline is associated with a significantly worse physical functioning quality of life approximately 11 years later. However change in the ABI was not significantly associated with change in quality of life over this time period. Additional studies are warranted in larger samples, especially to confirm the lack of findings for change in ABI.

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