ASSESSMENT OF PATIENT SATISFACTION WITH REHABILITATION MEASURES AFTER LOWER LIMB TOTAL JOINT REPLACEMENT

Aging and osteoarthritis (OA) are associated with a high risk of muscle mass loss, which can lead to physical disability. This study investigated the effectiveness of protein supplementation combined with exercise training (PS + ET) in improving muscle mass and functional outcomes in older adults with lower-limb OA. A comprehensive search of online databases was performed to identify randomized controlled trials (RCTs) on the effectiveness of PS + ET in older adults with hip or knee OA. Meta-analysis and risk of bias assessment of the included RCTs were conducted. Six RCTs were included in this systemic review; they had a median (range/total) Physiotherapy Evidence Database (PEDro) score of 7 (6–9) out of 10, respectively. Five RCTs that enrolled patients who underwent total joint replacement were included in this meta-analysis. The PS + ET group exhibited significant improvements in muscle mass (standard mean difference [SMD] = 1.13, p < 0.00001), pain (SMD = 1.36, p < 0.00001), and muscle strength (SMD = 0.44, p = 0.04). Our findings suggest that PS + ET improves muscle mass, muscle strength, and functional outcomes and reduces pain in older adults with lower-limb OA, particularly in those who have undergone total joint replacement.

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Total Joint Replacement of Ankle, Knee, and Hip: How Do Patients Perceive Their Operative Outcomes at 10 Years?

Foot & Ankle Orthopaedics ◽

10.1177/24730114211022735 ◽

2021 ◽

Vol 6 (3) ◽

pp. 247301142110227

Author(s):

Jayasree Ramaskandhan ◽

Karen Smith ◽

Simon Kometa ◽

Nachiappan Chockalingam ◽

Malik Siddique

Keyword(s):

Patient Satisfaction ◽

Joint Replacement ◽

Total Joint Replacement ◽

Short Form ◽

Case Series ◽

Total Ankle Replacement ◽

Ankle Replacement ◽

Sf 36 ◽

Patient Reported

Background: Patient-reported outcomes (PROMs) are an integral part of national joint registers in measuring outcomes of operative procedures and improving quality of care. There is lack of literature comparing outcomes of total ankle replacement (TAR) to total knee replacement (TKR) and total hip replacement (THR). The aim of this study was to compare PROMs between TAR, TKR, and THR patient groups at 1, 5, and 10 years. Methods: Prospective PROMs from patients who underwent a TAR, TKR, or THR procedure between 2003 and 2010 were studied. Patients were divided into 3 groups based on their index joint replacement (hip, knee, or ankle). Patient demographics (age, gender, body mass index), patient-reported outcome scores (Western Ontario and McMaster Universities Osteoarthritis Index [WOMAC], 36-Item Short Form Health Survey [SF-36]) and patient satisfaction scores (4-point Likert scale) at follow-up were compared between the 3 groups. Results: Data was available on 1797 THR, 2475 TKR, and 146 TAR patients. TAR patients were younger and reported fewer number of comorbidities. All 3 groups improved significantly from preoperative to 10 years for WOMAC scores ( P < .001). For SF-36 scores at 10 years, the THR group (32.2% follow-up) scored the highest for 3 domains ( P = .031) when compared to the TKR group (29.1% follow-up). All 3 groups had similar outcomes for 5 of 8 domains; P < .05). For patient satisfaction, the THR group reported overall 95.1% satisfaction followed by 89.8% for the TKR group and 83.9% in the TAR group (42.4% follow-up). Conclusion: In this cohort with diminishing numbers over the decade of time the patients were followed up we found that patients are equally happy with functional and general health outcomes from total ankle replacement vs other major lower extremity joint replacement. TAR surgery should be considered as a viable treatment option in this patient group. Level of Evidence: Level III, retrospective case series.

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Demography of Total Joint Replacement Surgeries Performed in a Tertiary Care Hospital: A Cross-sectional Survey

Journal of Nepal Medical Association ◽

10.31729/jnma.6949 ◽

2021 ◽

Vol 59 (243) ◽

pp. 1161-1165

Author(s):

Shrawan Kumar Thapa ◽

Manoj Kandel ◽

Sunil Panta ◽

Bishwa Raj Adhikari

Keyword(s):

Knee Replacement ◽

Joint Replacement ◽

Lower Limb ◽

Hip Replacement ◽

Tertiary Care Hospital ◽

Total Joint Replacement ◽

Tertiary Care ◽

Care Hospital ◽

Cross Sectional Survey ◽

Cross Sectional

Introduction: Total joint replacement of hip and knee is considered as one of the most successful orthopedic surgeries in the twenty-first century because of the only solution to end-stage arthritis of these joints. The real burden of the problem is yet to be established in developing countries like Nepal. This study aims to describe the demographic findings of the joint replacement surgeries among total lower limb surgeries in a tertiary care hospital. Methods: This cross-sectional survey was conducted using the hospital records of 73 total joint replacement surgeries of the lower limb in the Department of Orthopedics of a tertiary care hospital from November 2016 to November 2020. Ethical approval was taken from the Institutional Review Committee (reference number: 077/78-011). Convenience sampling was done. Data analysis was done using the Statistical Package for the Social Sciences version 20. Point estimate at 95% Confidence Interval was calculated along with frequency and percentage for binary data. Results: There were 73 total joint replacement of hips and knees. Of which, 32 (43.84%) total hip replacements were done in which one (3.13%) patient had a simultaneous bilateral hip replacement in single-stage and the other one (3.13%) had two-stage bilateral hip replacement. Forty one (56.16%) total knee replacements were done in which 18 (24.65%) had a simultaneous bilateral knee replacement and five (6.85%) had a unilateral knee replacement. Conclusions: Total joint replacements of the hip were more common among the lower limb surgeries.

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Smoking, body weight, physical exercise, and risk of lower limb total joint replacement in a population-based cohort of men

Arthritis & Rheumatism ◽

10.1002/art.30400 ◽

2011 ◽

Vol 63 (8) ◽

pp. 2523-2530 ◽

Cited By ~ 27

Author(s):

George Mnatzaganian ◽

Philip Ryan ◽

Paul E. Norman ◽

David C. Davidson ◽

Janet E. Hiller

Keyword(s):

Body Weight ◽

Physical Exercise ◽

Joint Replacement ◽

Lower Limb ◽

Total Joint Replacement ◽

Population Based

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Outcome Domains and Measures in Total Joint Replacement Clinical Trials: Can We Harmonize Them? An OMERACT Collaborative Initiative

The Journal of Rheumatology ◽

10.3899/jrheum.141201 ◽

2015 ◽

Vol 42 (12) ◽

pp. 2496-2502 ◽

Cited By ~ 22

Author(s):

Jasvinder A. Singh ◽

Michael Dohm ◽

Andrew P. Sprowson ◽

Peter D. Wall ◽

Bethan L. Richards ◽

...

Keyword(s):

Clinical Trial ◽

Clinical Trials ◽

Patient Satisfaction ◽

Joint Replacement ◽

Working Group ◽

Total Joint Replacement ◽

Core Domain ◽

Trial Outcome ◽

Clinical Trial Outcome ◽

Core Domain Set

Objective.To develop a plan for harmonizing outcomes for people undergoing total joint replacement (TJR), to achieve consensus regarding TJR outcome research.Methods.The TJR working group met during the 2014 Outcome Measures in Rheumatology (OMERACT) 12 meeting in Budapest, Hungary. Multiple conference calls preceded the face-to-face meeting. Brief presentations were made during a 1.5-h meeting, which included an overview of published systematic reviews of TJR trials and the results of a recent systematic review of TJR clinical trial outcome domains and measures. This was followed by discussion of potential core set areas/domains for TJR clinical trials (as per OMERACT Filter 2.0) as well as the challenges associated with the measurement of these domains.Results.Working group participants discussed which TJR clinical trial outcome domains/areas map to the inner versus outer core for core domain set. Several challenges were identified with TJR outcomes including how to best measure function after TJR, elucidating the source of the pre- and post-TJR joint pain being measured, joint-specific versus generic quality of life instruments and the importance of patient satisfaction and revision surgery as outcomes. A preliminary core domain set for TJR clinical trials was proposed and included pain, function, patient satisfaction, revision, adverse events, and death. This core domain set will be further vetted with a broader audience.Conclusion.An international effort with active collaboration with the orthopedic community to standardize key outcome domains and measures is under way with the TJR working group. This effort will be further developed with new collaborations.

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