scholarly journals Public Interest in Knee Pain and Knee Replacement during the SARS-CoV-2 Pandemic in Western Europe

2021 ◽  
Vol 10 (5) ◽  
pp. 1067
Author(s):  
Arne Kienzle ◽  
Lara Biedermann ◽  
Evgeniya Babeyko ◽  
Stephanie Kirschbaum ◽  
Georg Duda ◽  
...  
Keyword(s):  
Knee Osteoarthritis ◽  
Knee Pain ◽  
Knee Replacement ◽  
Knee Arthroplasty ◽  
Public Interest ◽  
Western Europe ◽  
Surgical Care ◽  
Number Of Patients ◽  
Primary Knee Arthroplasty ◽  
The Uk

Due to the severe acute respiratory syndrome coronavirus type 2 (SARS-CoV-2) pandemic, a large number of elective knee replacement procedures had to be postponed in both early and late 2020 in most western countries including Germany and the UK. It is unknown how public interest and demand for total knee arthroplasties was affected. Public interest in knee pain, knee osteoarthritis and knee arthroplasty in Germany and the UK was investigated using Google Trend Analysis. In addition, we monitored for changes in patient composition in our outpatient department. As of early March in Germany and of late March in the UK, until the lockdown measures, a 50 to 60% decrease in relative search frequency was observed in all categories investigated compared to the beginning of the year. While public interest for knee pain rapidly recovered, decreased interest for knee osteoarthritis and replacement lasted until the easing of measures. Shortly prior to and during the first lockdown mean search frequency for knee replacement was significantly decreased from 39.7% and 36.6 to 26.9% in Germany and from 47.7% and 50.9 to 23.7% in the UK (Germany: p = 0.022 prior to lockdown, p < 0.001 during lockdown; UK: p < 0.0001 prior to and during lockdown). In contrast, mean search frequencies did not differ significantly from each other for any of the investigated time frames during the second half of 2020 in both countries. Similarly, during the first lockdown, the proportion of patients presenting themselves to receive primary knee arthroplasty compared to patients that had already undergone knee replacement declined markedly from 64.7% to 46.9%. In contrast, patient composition changed only marginally during the lockdown measures in late 2020 in both Germany and the UK. We observed a high level of public interest in knee arthroplasty despite the ongoing pandemic. The absence of a lasting decline in interest in primary knee arthroplasty suggests that sufficient symptom reduction cannot be achieved without surgical care for a substantial number of patients.

scholarly journals Restarting elective orthopaedic services during the COVID-19 pandemic

2020 ◽  
Vol 1 (6) ◽  
pp. 267-271 ◽  
Author(s):  
Justin Chang ◽  
Warran Wignadasan ◽  
Christina Kontoghiorghe ◽  
Babar Kayani ◽  
Sandeep Singh ◽  
...  
Keyword(s):  
Knee Arthroplasty ◽  
Orthopaedic Surgery ◽  
Surgical Care ◽  
Specific Patient ◽  
Number Of Patients ◽  
Primary Knee Arthroplasty ◽  
Patient Consent ◽  
Primary Hip Arthroplasty ◽  
Baseline Characteristics ◽  
Admission Type

Aims As the peak of the COVID-19 pandemic passes, the challenge shifts to safe resumption of routine medical services, including elective orthopaedic surgery. Protocols including pre-operative self-isolation, COVID-19 testing, and surgery at a non-COVID-19 site have been developed to minimize risk of transmission. Despite this, it is likely that many patients will want to delay surgery for fear of contracting COVID-19. The aim of this study is to identify the number of patients who still want to proceed with planned elective orthopaedic surgery in this current environment. Methods This is a prospective, single surgeon study of 102 patients who were on the waiting list for an elective hip or knee procedure during the COVID-19 pandemic. Baseline characteristics including age, ASA grade, COVID-19 risk, procedure type, surgical priority, and admission type were recorded. The primary outcome was patient consent to continue with planned surgical care after resumption of elective orthopaedic services. Subgroup analysis was also performed to determine if any specific patient factors influenced the decision to proceed with surgery. Results Overall, 58 patients (56.8%) wanted to continue with planned surgical care at the earliest possibility. Patients classified as ASA I and ASA II were more likely to agree to surgery (60.5% and 60.0%, respectively) compared to ASA III and ASA IV patients (44.4% and 0.0%, respectively) (p = 0.01). In addition, patients undergoing soft tissue knee surgery were more likely to consent to surgery (90.0%) compared to patients undergoing primary hip arthroplasty (68.6%), primary knee arthroplasty (48.7%), revision hip or knee arthroplasty (0.0%), or hip and knee injections (43.8%) (p = 0.03). Conclusion Restarting elective orthopaedic services during the COVID-19 pandemic remains a significant challenge. Given the uncertain environment, it is unsurprising that only 56% of patients were prepared to continue with their planned surgical care upon resumption of elective services. Cite this article: Bone Joint Open 2020;1-6:267–271.

scholarly journals Restarting elective orthopaedic services during the COVID-19 pandemic

2020 ◽  
Vol 1 (6) ◽  
pp. 267-271 ◽  
Author(s):  
Justin Chang ◽  
Warran Wignadasan ◽  
Christina Kontoghiorghe ◽  
Babar Kayani ◽  
Sandeep Singh ◽  
...  
Keyword(s):  
Knee Arthroplasty ◽  
Orthopaedic Surgery ◽  
Surgical Care ◽  
Specific Patient ◽  
Number Of Patients ◽  
Primary Knee Arthroplasty ◽  
Patient Consent ◽  
Primary Hip Arthroplasty ◽  
Baseline Characteristics ◽  
Admission Type

Aims As the peak of the COVID-19 pandemic passes, the challenge shifts to safe resumption of routine medical services, including elective orthopaedic surgery. Protocols including pre-operative self-isolation, COVID-19 testing, and surgery at a non-COVID-19 site have been developed to minimize risk of transmission. Despite this, it is likely that many patients will want to delay surgery for fear of contracting COVID-19. The aim of this study is to identify the number of patients who still want to proceed with planned elective orthopaedic surgery in this current environment. Methods This is a prospective, single surgeon study of 102 patients who were on the waiting list for an elective hip or knee procedure during the COVID-19 pandemic. Baseline characteristics including age, ASA grade, COVID-19 risk, procedure type, surgical priority, and admission type were recorded. The primary outcome was patient consent to continue with planned surgical care after resumption of elective orthopaedic services. Subgroup analysis was also performed to determine if any specific patient factors influenced the decision to proceed with surgery. Results Overall, 58 patients (56.8%) wanted to continue with planned surgical care at the earliest possibility. Patients classified as ASA I and ASA II were more likely to agree to surgery (60.5% and 60.0%, respectively) compared to ASA III and ASA IV patients (44.4% and 0.0%, respectively) (p = 0.01). In addition, patients undergoing soft tissue knee surgery were more likely to consent to surgery (90.0%) compared to patients undergoing primary hip arthroplasty (68.6%), primary knee arthroplasty (48.7%), revision hip or knee arthroplasty (0.0%), or hip and knee injections (43.8%) (p = 0.03). Conclusion Restarting elective orthopaedic services during the COVID-19 pandemic remains a significant challenge. Given the uncertain environment, it is unsurprising that only 56% of patients were prepared to continue with their planned surgical care upon resumption of elective services. Cite this article: Bone Joint Open 2020;1-6:267–271.

The number of patients “worse than death” while waiting for a hip or knee arthroplasty has nearly doubled during the COVID-19 pandemic

2021 ◽  
pp. 1-9
Author(s):  
Nick D. Clement ◽  
Chloe E. H. Scott ◽  
James R. D. Murray ◽  
Colin R. Howie ◽  
David J. Deehan ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Knee Arthroplasty ◽  
Waiting List ◽  
Control Group ◽  
Health State ◽  
Retrospective Case ◽  
Level Of Evidence ◽  
Number Of Patients ◽  
The Uk

Aims The aim of this study was to assess the quality of life of patients on the waiting list for a total hip (THA) or knee arthroplasty (KA) during the COVID-19 pandemic. Secondary aims were to assess whether length of time on the waiting list influenced quality of life and rate of deferral of surgery. Methods During the study period (August and September 2020) 843 patients (THA n = 394, KA n = 449) from ten centres in the UK reported their EuroQol five dimension (EQ-5D) scores and completed a waiting list questionnaire (2020 group). Patient demographic details, procedure, and date when listed were recorded. Patients scoring less than zero for their EQ-5D score were defined to be in a health state “worse than death” (WTD). Data from a retrospective cohort (January 2014 to September 2017) were used as the control group. Results The 2020 group had a significantly worse EQ-5D score compared to the control group for both THA (p < 0.001) and KA (p < 0.001). Over one-third (35.0%, n = 138/394) of patients waiting for a THA and nearly a quarter (22.3%, n = 100/449) for KA were in a health state WTD, which was significantly greater than the control group (odds ratio 2.30 (95% confidence interval (CI) 1.83 to 2.93) and 2.08 (95% CI 1.61 to 2.70), respectively; p < 0.001). Over 80% (n = 680/843) of the 2020 group felt that their quality of life had deteriorated while waiting. Each additional month spent on the waiting list was independently associated with a decrease in quality of life (EQ-5D: -0.0135, p = 0.004). There were 117 (13.9%) patients who wished to defer their surgery and the main reason for this was health concerns for themselves and or their family (99.1%, n = 116/117). Conclusion Over one-third of patients waiting for THA and nearly one-quarter waiting for a KA were in a state WTD, which was approaching double that observed prior to the pandemic. Increasing length of time on the waiting list was associated with decreasing quality of life. Level of evidence: Level III retrospective case control study

scholarly journals Effectiveness of Different Pain Control Methods in Patients with Knee Osteoarthritis after Knee Arthroplasty

2017 ◽  
Vol 2017 ◽  
pp. 1-9
Author(s):  
Jin-Lain Ming ◽  
Shiao-Pei Hung ◽  
Hui-Mei Huang ◽  
Li-Hua Tseng ◽  
Chiung-Hui Huang ◽  
...  
Keyword(s):  
Postoperative Pain ◽  
Knee Osteoarthritis ◽  
Knee Arthroplasty ◽  
Pain Control ◽  
Longitudinal Research ◽  
Population Aging ◽  
Pain Level ◽  
Number Of Patients ◽  
Group 2 ◽  
Prospective Longitudinal

The number of patients with knee osteoarthritis has increased in tandem with population aging. Consequently, the number of knee arthroplasties has also risen. The postoperative pain is the biggest challenge faced by patients soon after knee arthroplasty; therefore, this study is among different methods for post-knee arthroplasty pain control. A prospective longitudinal research design was employed; 177 adult patients who proposed for primary knee arthroplasty were enrolled and recruited. The patients were divided into conventional Group 1 (n=120) and patient-controlled analgesia (PCA) Group 2 (n=57) according to the treatment methods they received. All patients experience the highest pain level on the day of their surgery; women complained of higher pain levels than men did, while the PCA group had lower postoperative pain. Meanwhile, patients with general anesthesia experienced more pain than those with spinal anesthesia in postoperative period. Patients with a higher postoperative pain index have a smaller optimal knee flexion angle. The PCA group had lower postoperative pain; all patients experienced the highest pain level on the day of their surgery. The results of this study could serve as a reference for nurses where PCA ensures a better postoperative pain control and therefore facilitates recovery and improves the quality of nursing.

Predicting Persistent Unclear Pain Following Primary Total Knee Arthroplasty

2016 ◽  
Vol 18 (6) ◽  
pp. 527-536 ◽  
Author(s):  
Paweł Chodór ◽  
Jacek Kruczyński
Keyword(s):  
Total Knee Arthroplasty ◽  
Knee Pain ◽  
Knee Arthroplasty ◽  
Primary Total Knee Arthroplasty ◽  
Pain Modulation ◽  
Postsurgical Pain ◽  
Number Of Patients ◽  
Chronic Postsurgical Pain ◽  
Total Knee ◽  
Primary Total Knee

Chronic post-surgical pain can be a considerable issue for patients undergoing primary total knee arthroplasty. According to the literature, persistent knee pain is experienced by up to 44% of patients. Most studies on total knee arthroplasty (TKA) outcomes have mainly investigated the biomechanics or function of the operated knee, but chronic pain has never been a primary issue. In recent years several possible predictors of chronic postsurgical pain have been investigated and eventually identified. A younger age, female gender, psychological distress, preoperative pain duration and intensity were all reported to influence chronic postoperative pain rates after total knee arthroplasty. Recently, it has also been hypothesized that preoperative signs of centrally driven hyperalgesia and distorted pain modulation may predict persistent knee pain in some patients. Despite the considerable number of patients suffering from chronic postsurgical pain after TKA, available data is scarce, and well controlled prospective studies are lacking. Predictors of chronic postsurgical pain after total knee arthroplasty have yet to be identified. Thus, this article is aimed at reviewing current knowledge on persistent pain after knee arthroplasty.

scholarly journals The Inverse OARSI-OMERACT Criteria Is a Valid Indicator of the Clinical Worsening of Knee Osteoarthritis: Data from the Osteoarthritis Initiative

2020 ◽  
pp. jrheum.200145
Author(s):  
Jeffrey B. Driban ◽  
Matthew S. Harkey ◽  
Lori Lyn Price ◽  
Grace H. Lo ◽  
Timothy E. McAlindon
Keyword(s):  
Knee Osteoarthritis ◽  
Knee Pain ◽  
Knee Replacement ◽  
Walking Speed ◽  
Cox Model ◽  
Research Society ◽  
Osteoarthritis Initiative ◽  
Osteoarthritis Research Society ◽  
And Function ◽  
Relationship Of

Objective We assessed if the inverse Osteoarthritis Research Society International (OARSI) and Outcome Measures in Rheumatology (OMERACT) criteria relate to concurrent radiographic knee osteoarthritis (KOA) progression and decline in walking speed, as well as future knee replacement. Methods We conducted knee-based analyses of data from the Osteoarthritis Initiative. All knees had symptomatic OA: at least doubtful radiographic KOA (Kellgren-Lawrence grade ≥ 1) and knee pain ≥ 10/100 (Western Ontario and McMaster Universities Osteoarthritis Index pain) at the 12-month visit. The inverse of the OARSI-OMERACT responder criteria depended on knee pain and function, and global assessment of knee impact. We used generalized linear mixed models to assess the relationship of the inverse OARSI‑OMERACT criteria over 2 years (i.e., 12-month and 36-month visits) with worsening radiographic severity (any increase in Kellgren-Lawrence grade from 12 months to 36 months) and decline in self-selected 20-m walking speed of ≥ 0.1m/s (from 12 months to 36 months). We used a Cox model to assess time to knee replacement during the 6 years after the 36-month visit as an outcome. Results Among the 1746 analyzed, 19% met the inverse OARSI-OMERACT criteria. Meeting the inverse OARSI-OMERACT criteria was associated with almost double the odds of experiencing concurrent worsening in radiographic KOA severity (OR 1.89, 95% CI 1.32–2.70) or decline in walking speed (OR 1.82, 95% CI 1.37–2.40). A knee meeting the inverse OARSI-OMERACT criteria was more likely to receive a knee replacement after the 36-month visit (23%) compared with a nonresponder (10%; HR 2.54, 95% CI 1.89–3.41). Conclusion The inverse OARSI-OMERACT criteria for worsening among people with KOA had good construct validity in relation to clinically relevant outcomes.

Hip and knee arthroplasty

2017 ◽  
Vol 11 (1) ◽  
pp. 20-27
Author(s):  
Dominic Marley ◽  
Nomaan Sheikh ◽  
John Taylor ◽  
Amit Kumar
Keyword(s):  
Primary Care ◽  
Knee Pain ◽  
Knee Replacement ◽  
Knee Arthroplasty ◽  
National Joint Registry ◽  
Knee Replacement Surgery ◽  
Joint Registry ◽  
Replacement Surgery ◽  
Knee Replacements ◽  
Hip And Knee Arthroplasty

The incidence of hip and knee replacement surgery has risen dramatically in recent years. The latest National Joint Registry figures indicate that almost 190 000 total hip and knee replacements were performed in 2015. The aim of this article is to discuss the management of hip and knee pain in primary care, the indications for hip and knee arthroplasty and surgical considerations.

The offspring of people with a total knee replacement for severe primary knee osteoarthritis have a higher risk of worsening knee pain over 8 years

2014 ◽  
Vol 75 (2) ◽  
pp. 368-373 ◽  
Author(s):  
Feng Pan ◽  
Changhai Ding ◽  
Tania Winzenberg ◽  
Hussain Khan ◽  
Johanne Martel-Pelletier ◽  
...  
Keyword(s):  
Total Knee Replacement ◽  
Knee Osteoarthritis ◽  
Knee Pain ◽  
Knee Replacement ◽  
Total Knee

scholarly journals Contemporary knee arthroplasty: one fits all or time for diversity?

2021 ◽  
Author(s):  
Johannes Beckmann ◽  
Malin Kristin Meier ◽  
Christian Benignus ◽  
Andreas Hecker ◽  
Emmanuel Thienpont
Keyword(s):  
Personalized Medicine ◽  
Knee Osteoarthritis ◽  
Knee Replacement ◽  
Knee Arthroplasty ◽  
Treatment Options ◽  
Patient Specific ◽  
Partial Knee Arthroplasty ◽  
Limited Series ◽  
Total Knee ◽  
The Individual

Abstract Introduction Total knee arthroplasty (TKA) has historically been the preferred solution for any type of knee osteoarthritis, independently of the number of compartments involved. In these days of patient-specific medicine, mono-compartmental disease could also be approached with a more individualized treatment, such as partial knee arthroplasty (PKA). Off-the-shelf (OTS) implants are often the compromise of averages and means of a limited series of anatomical parameters retrieved from patients and the pressure of cost control by limited inventory. Personalized medicine requires respect and interest for the individual shape and alignment of each patient. Materials and methods A Pubmed and Google Scholar search were performed with the following terms: “patient-specific knee” and “arthroplasty” and “custom implant” and “total knee replacement” and “partial knee replacement” and “patellofemoral knee replacement” and “bicompartmental knee replacement”. The full text of 90 articles was used to write this narrative review. Results Unicondylar, patellofemoral and bicompartmental knee arthroplasty are successful treatment options, which can be considered over TKA for their bone and ligament sparing character and the superior functional outcome that can be obtained with resurfacing procedures. For TKA, where compromises dominate our choices, especially in patients with individual variations of their personal anatomy outside of the standard, a customized implant could be a preferable solution. Conclusion TKA might not be the only solution for every patient with knee osteoarthritis, if personalized medicine wants to be offered. Patient-specific mono-compartmental resurfacing solutions, such as partial knee arthroplasty, can be part of the treatment options proposed by the expert surgeon. Customized implants and personalized alignment options have the potential to further improve clinical outcome by identifying the individual morphotype and respecting the diversity of the surgical population.

scholarly journals Pengaruh Phonophoresis Untuk Menurunkan Nyeri Pasien Osteoarthritis Lutut

2019 ◽  
Vol 4 (2) ◽  
pp. 85-91
Author(s):  
Saifudin Zuhri
Keyword(s):  
Knee Osteoarthritis ◽  
Knee Pain ◽  
Standard Therapy ◽  
Control Group ◽  
Human Beings ◽  
Control Group Design ◽  
Relieve Pain ◽  
Number Of Patients ◽  
Post Test ◽  
Experimental Group

Background: In everyday life activities human beings need prime conditions to create functional motion. One factor that interferes with functional motion is pain. The goal of physiotherapy for people with pain is to relieve pain. Many of the physiotherapy modalities recommended for reducing pain include phonophoresis. But the phonophoresis modality has not been widely implemented in Indonesia. Objective: To determine the effect of phonophoresis on reducing knee pain in patients with knee osteoarthritis. Methods: This study was a pure experiment with a pre-test and post-test with control group design. The study subjects were patients with knee osteoarthritis who met the inclusion and exclusion criteria. From the number of patients who came to the physiotherapy polyclinic of Dr Moewardi Hospital Surakarta, they would be randomized to the experimental group and the control group. The experimental group will get standard therapy at Dr Moewardi Hospital Surakarta plus phonophoresis, while the control group only gets standard therapy from the hospital. The independent variable is the administration of phonophoresis and the dependent variable is a decrease in knee pain. Statistical analysis using t-test. Results: Of Phonophoresis and standard therapy can reduce knee pain. More pain occurs in phonophoresis. Conclusion: Phonophoresis can be selected as a therapy to reduce pain in people with osteoarthritis

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