scholarly journals Return to Sport Activity in the Elderly Patients after Unicompartmental Knee Arthroplasty: A Systematic Review and Meta-Analysis

2020 ◽  
Vol 9 (6) ◽  
pp. 1756
Author(s):  
Rocco Papalia ◽  
Biagio Zampogna ◽  
Guglielmo Torre ◽  
Lorenzo Alirio Diaz Balzani ◽  
Sebastiano Vasta ◽  
...  
Keyword(s):  
Elderly Patients ◽  
Knee Arthroplasty ◽  
Sport Activity ◽  
Case Series ◽  
Return To Sport ◽  
The Elderly ◽  
Series Data ◽  
Return To Sports ◽  
Case Control Studies ◽  
Sport Practice

In patients with knee osteoarthritis, when only medial or lateral compartment of the knee is involved, unicompartimental knee arthroplasty (UKA) is a reliable option for addressing the symptoms and restore function. The main aim of the present review is to systematically collect the available evidence concerning the return to sport activity in the elderly patients after UKA. An electronic search was carried out on the following databases; Pubmed-Medline, Cochrane central, and Scopus, searching for randomized controlled trials, prospective cohort studies, retrospective case-control studies, and case series. Data concerning the evaluation of the return to sport (RTS) and of functional outcomes in the elderly patients after UKA surgery. MINORS score was used to assess the risk of methodological biases. Odds ratios and raw proportions were used to report the pooled effect of UKA on the return to sport in comparative and non-comparative studies, respectively. Same level RTS in elderly patients was of 86% (pooled return proportion 0.86, 95%CI 0.78, 0.94), showing also better relative RTS and time to RTS of patients undergoing UKA, in comparison to those undergoing TKA. Sport-specific RTS showed that higher return rates were observed for low-impact sports, whereas high-impact sports prevented a full return to activities. UKA is a valid and reliable option for elderly patients to satisfactorily resume their sport practice, especially for low impact activities. The rate of return to sports following UKA is higher than TKA.

Return to Sports and Recreational Activity after Unicompartmental Knee Arthroplasty

2007 ◽  
Vol 35 (10) ◽  
pp. 1688-1695 ◽  
Author(s):  
Florian D. Naal ◽  
Michael Fischer ◽  
Alexander Preuss ◽  
Joerg Goldhahn ◽  
Fabian von Knoch ◽  
...  
Keyword(s):  
Knee Arthroplasty ◽  
Unicompartmental Knee Arthroplasty ◽  
Case Series ◽  
Reference Population ◽  
Return To Sports ◽  
Recreational Activity ◽  
Younger Patients ◽  
Recreational Activities ◽  
Unicompartmental Knee ◽  
Sf 36

Background There is a lack of detailed information concerning patients’ sports and recreational activities after unicompartmental knee arthroplasty. Hypothesis Patients treated by unicompartmental knee arthroplasty will be able to return to sports and activity. Study Design Case series; Level of evidence, 4. Methods The authors surveyed 83 patients by postal questionnaires to determine their sporting and recreational activities at a mean follow-up of 18 ± 4.6 months (range, 12-28) after unicompartmental knee arthroplasty. For data analysis, patients were divided into groups of women and men, and older and younger patients (those above and below the median age of the group). The authors also assessed the state of general health (SF-36) of the patients at the time of the survey and compared the results with those of a matched (for age and side-diagnoses) reference population. Results Before surgery, 77 of 83 patients were engaged in an average of 5.0 sports and recreational disciplines; postoperatively, 73 (88%) participated in an average of 3.1 different sports disciplines, resulting in a return to activity rate of 95%. The frequency of activities (sessions per week) was 2.9 preoperatively and remained constant at the time of survey (2.8). The group of older patients (mean age 73.0 y) revealed a significantly higher frequency than the group of younger patients (mean age 57.8 y). The minimum session length decreased from 66 minutes before surgery to 55 minutes after surgery. The most common activities after surgery were hiking, cycling, and swimming. Several high-impact activities, as well as the winter disciplines of downhill- and cross-country skiing had a significant decrease in participating patients. The majority of the patients (90.3%) stated that surgery had maintained or improved their ability to participate in sports or recreational activities. The patients generally scored very high on the SF-36 compared with the matched reference population. Higher SF-36 values in the physical-related domains correlated with an increased level of activity (r = 0.425). The preoperative body mass index showed a weak, negative correlation with the postoperative extent of activities (r = —0.282). Conclusion The majority of patients returned to sports and recreational activity after unicompartmental knee arthroplasty. However, the numbers of different disciplines patients were engaged in decreased as well as the extent of activities. The activities in which most patients participated were primarily low- or midimpact. The patients scored higher on the SF-36 than age-related norms, which might be due to the patient-selection process for unicompartmental knee arthroplasty and geographical differences.

scholarly journals Risk Factors for Age-Related Maculopathy

2009 ◽  
Vol 2009 ◽  
pp. 1-39 ◽  
Author(s):  
Paul P. Connell ◽  
Pearse A. Keane ◽  
Evelyn C. O'Neill ◽  
Rasha W. Altaie ◽  
Edward Loane ◽  
...  
Keyword(s):  
Risk Factors ◽  
Epidemiologic Study ◽  
Case Series ◽  
The Elderly ◽  
Factor H ◽  
Environment Interaction ◽  
Complement Factor ◽  
Case Control Studies ◽  
Cross Sectional ◽  
Age Related

Age-related maculopathy (ARM) is the leading cause of blindness in the elderly. Although beneficial therapeutic strategies have recently begun to emerge, much remains unclear regarding the etiopathogenesis of this disorder. Epidemiologic studies have enhanced our understanding of ARM, but the data, often conflicting, has led to difficulties with drawing firm conclusions with respect to risk for this condition. As a consequence, we saw a need to assimilate the published findings with respect to risk factors for ARM, through a review of the literature appraising results from published cross-sectional studies, prospective cohort studies, case series, and case control studies investigating risk for this condition. Our review shows that, to date, and across a spectrum of epidemiologic study designs, only age, cigarette smoking, and family history of ARM have been consistently demonstrated to represent risk for this condition. In addition, genetic studies have recently implicated many genes in the pathogenesis of age-related maculopathy, including Complement Factor H, PLEKHA 1, and LOC387715/HTRA1, demonstrating that environmental and genetic factors are important for the development of ARM suggesting that gene-environment interaction plays an important role in the pathogenesis of this condition.

scholarly journals Return to Sport after Anatomic and Reverse Total Shoulder Arthroplasty in Elderly Patients: A Systematic Review and Meta-Analysis

2020 ◽  
Vol 9 (5) ◽  
pp. 1576
Author(s):  
Rocco Papalia ◽  
Mauro Ciuffreda ◽  
Erika Albo ◽  
Chiara De Andreis ◽  
Lorenzo Alirio Diaz Balzani ◽  
...  
Keyword(s):  
Systematic Review ◽  
Elderly Patients ◽  
Shoulder Arthroplasty ◽  
Randomized Clinical Trials ◽  
Meta Analysis ◽  
Total Shoulder Arthroplasty ◽  
Case Series ◽  
Return To Sport ◽  
Rate Of Return ◽  
Cochrane Library

The aim of this systematic review and meta-analysis was to evaluate the rate of return to sport in elderly patients who underwent anatomic (ATSA) and reverse (RTSA) total shoulder arthroplasty, to assess postoperative pain and functional outcomes and to give an overview of postoperative rehabilitation protocols. A systematic search in Pubmed-Medline, Cochrane Library, and Google Scholar was carried out to identify eligible randomized clinical trials, observational studies, or case series that evaluated the rate of return to sport after RTSA or ATSA. Six retrospective studies, five case series, and one prospective cohort study were included in this review. The overall rate of return to sport was 82% (95% CI 0.76–0.88, p < 0.01). Patients undergoing ATSA returned at a higher rate (90%) (95% CI 0.80–0.99, p < 0.01) compared to RTSA (77%) (95% CI 0.69–0.85, p < 0.01). Moreover, the results showed that patients returned to sport at the same or a higher level in 75% of cases. Swimming had the highest rate of return (84%), followed by fitness (77%), golf (77%), and tennis (69%). Thus, RTSA and ATSA are effective to guarantee a significative rate of return to sport in elderly patients. A slightly higher rate was found for the anatomic implant.

scholarly journals Return to Sport, integrating the process from conventional rehabilitation up to reconditioning: a narrative review

2021 ◽  
Vol 38 (5) ◽  
pp. 253-260
Author(s):  
Pavel Loeza-Magaña ◽  
Héctor R. Quezada-González ◽  
Pedro I. Arias-Vázquez
Keyword(s):  
Motor Skills ◽  
Meta Analysis ◽  
Sport Activity ◽  
Return To Sport ◽  
Return To Sports ◽  
Sports Performance ◽  
Sports Activity ◽  
Sports Team ◽  
Communication And Coordination ◽  
Sports Activities

Introduction: The process of return to sport after injury, has traditionally been approached in 2 separate stages; first the athlete is treated the medical service through conventional rehabilitation processes and is then referred to the sports team (coach and / or physical trainer) who complete the return to the sport activity. This approach may lack communication and coordination between both teams and may be insufficient for the demands of the current sports environment, causing longer processes of return to sport and greater risk of re-injury. The objective of this manuscript is to document the current models of return to sport, its stages, objectives and contents. Material and method: A comprehensive review of publications was carried out, including observational studies, clinical trials, reviews, consensus, systematic reviews and meta-analysis, related to treatment, rehabilitation, readaptation and return to sport. Results: The description of a model of return to sports of gradual progression that includes 3 stages was found: return to participation, readaptation to sport and return to maximum sports performance. The stage of return to participation aims to eliminate the symptoms and regain the functionality of the athlete in their non-sports activities, through conventional rehabilitation processes. The stage of readaptation to sport aims to achieve asymptomatic performance of training and competition activities, through the rehabilitation of deficiencies caused by the injury and the maintenance and / or development of motor skills with modified training. The stage of return to maximum sports performance includes specific sports training to reach the level of performance prior to the injury. Conclusions: This model could be associated with greater success in returning to sports activity and lower risk of recurrence of the injury.

Injury Pattern in Ligamentous Lisfranc Injuries in Competitive Athletes

2018 ◽  
Vol 40 (2) ◽  
pp. 185-194 ◽  
Author(s):  
David A. Porter ◽  
Adam F. Barnes ◽  
Angela Rund ◽  
Madison T. Walrod
Keyword(s):  
Statistical Significance ◽  
Case Series ◽  
Return To Sport ◽  
Injury Pattern ◽  
Low Energy ◽  
Return To Sports ◽  
Competitive Athlete ◽  
Lisfranc Injury ◽  
Ligament Tear ◽  
Proximal Extension

Background: We report data on the largest cohort to date of patients who sustained a ligamentous Lisfranc injury during sport. To date, the prevalence of concurrent intercuneiform ligament injuries in the competitive athlete with subtle Lisfranc instability has not been reported. Methods: Eighty-two patients (64 males, 18 females) sustained an unstable Lisfranc injury (49 left, 33 right) and met inclusion criteria. Injuries were classified as traditional dislocation (TRAD, first to second TMT ligament tear), medial column dislocation (MCD, second TMT, and medial-middle cuneiform ligament tear), or proximal extension dislocation (PE, first, second, and medial-middle cuneiform ligament tear) and the injury pattern confirmed at surgery. All athletes underwent open reduction with internal fixation (ORIF) of each unstable midfoot segment. Fisher exact tests and 2-tailed t tests were used to analyze statistical significance according to injury pattern, sport, gender difference, hindfoot angle alignment, and injured side ( P < .05). Results: Average age of athletes was 21.0 ± 5.3 years old (range 12-40), and return to sports was 7.5 ± 2.1 months. Injury distribution was as follows: TRAD (n = 40), MCD (n = 17), and PE (n = 23). MCD trended toward a longer return to sport (8.4 ± 3.3 months, P = .074). Football was the most common sport at time of injury (n = 48). Wakeboard athletes (n = 5) were older (31.4 ± 3.2, P = .0002), and MCD tears were more prevalent among them ( P = .061). Basketball (n = 13) players were significantly younger (19.1 ± 2.5 years, P = .028) and returned to sports quicker (5.2 ± 0.7, P = .0002). Return to sport data indicated a typical population for athletes with Lisfranc injury in these sports. Conclusion: Proximal extension disruption (intercuneiform ligament tear) occurred in 50% of these low-energy Lisfranc athletic injuries. MCD and PE may be more prevalent than previously understood. This is the first study to document the extent, pattern, and prevalence of associated intercuneiform ligament tears in the competitive athlete with a low-energy subtle, unstable Lisfranc injury. Level of Evidence: Level IV, retrospective case series.

scholarly journals Perioperative management of elderly patients with osteoarthritis requiring total knee arthroplasty

2021 ◽  
pp. 175045892093694
Author(s):  
Jiang An Lim ◽  
Azeem Thahir
Keyword(s):  
Total Knee Arthroplasty ◽  
Elderly Patients ◽  
Knee Osteoarthritis ◽  
Knee Arthroplasty ◽  
Conservative Management ◽  
Perioperative Management ◽  
Functional Limitation ◽  
Cartilage Degeneration ◽  
The Elderly ◽  
Total Knee

Knee osteoarthritis is a common arthritic disease which mainly affects the elderly (≥65 years old) population. As a result of the cartilage degeneration, it can cause a significant amount of pain and functional limitation. In patients who are refractory to conservative management, total knee arthroplasty is being utilised as the last resort in management. In this review, we discuss the perioperative management of elderly patients with osteoarthritis requiring total knee arthroplasty.

Safety of trastuzumab, alone or in combination, in elderly patients with HER2-positive breast cancer: A 5-year case series.

2012 ◽  
Vol 30 (15_suppl) ◽  
pp. e11056-e11056 ◽  
Author(s):  
Vincenzo Adamo ◽  
Giuseppina R. R. Ricciardi ◽  
Barbara Adamo ◽  
Giuseppa Ferraro ◽  
Tindara Franchina ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Elderly Patients ◽  
Case Series ◽  
The Elderly ◽  
Left Ventricular ◽  
Treatment Withdrawal ◽  
Left Ventricular Ejection ◽  
Breast Cancer Patients ◽  
Her2 Positive ◽  
Her2 Breast Cancer

e11056 Background: Breast cancer (BC) is frequent in the elderly and is burdened by high recurrence and death rates, due mostly to undertreatment. Trastuzumab (T), in combination with chemotherapy (CT) or hormonotherapy (HT), is a well-established treatment strategy for early and advanced HER2-positive (HER2+) breast cancer, but has been poorly studied in the elderly setting due to its infrequency. The aim of our study is to assess the safety of T in elderly patients with HER2+ BC. Methods: Between 2005 and 2010, consecutive HER2+ breast cancer patients of ≥70 years of age referred to two oncology centers and that received T-based therapy were retrospectively reviewed. All patients were treated according to multidimensional geriatric assessment (MGA) and clinical criteria. Results: Of 59 patients, 51 were evaluable with a mean age of 76 years (range 70-86). Trastuzumab was well tolerated overall. Median left ventricular ejection function (LVEF) at baseline was 61% and at the end of treatment was 55%. The most relevant adverse events consisted of only one case (2%) of symptomatic congestive heart failure, which required treatment withdrawal and six (12%) asymptomatic decreases of LVEF (3 pts >15% and 3 pts >10% versus baseline). Mild to moderate hypersensitivity reactions associated with T-containing infusions occurred in 3 patients (5.8%). Hypertension, obesity and previous anthracycline-based treatment and combination with CTs gave a trend towards a higher incidence of toxic events. Previous radiotherapy, concurrent HT and the different T schedules did not influence toxicity. Conclusions: Our data shows a good trastuzumab safety profile in non-frail women age 70 and older. These favourable findings may be related to the limited number of anthracycline pre-treatments, a substantial patient selection by MGA and close cardiologic monitoring. [Table: see text]

scholarly journals Knee mega-prosthesis in the management of complex knee fracture of the elderly : a case series and review of the literature

2021 ◽  
Vol 87 (2) ◽  
pp. 347-351
Author(s):  
Gautier Beckers ◽  
David Mazy ◽  
Philippe Tollet ◽  
Olivier Van Nieuwenhove
Keyword(s):  
Total Knee Arthroplasty ◽  
Knee Arthroplasty ◽  
Rating Scale ◽  
Tumor Resection ◽  
Oxford Knee Score ◽  
Case Series ◽  
The Elderly ◽  
Osteoporotic Bone ◽  
Femur Fractures ◽  
Total Knee

The management of complicated distal femur fractures (DFF) of the elderly continues to pose a challenge. Knee mega-prosthesis are mostly used for Total knee arthroplasty revision and tumor resection surgery but they can be used for the treatment of complex knee fractures. The purpose of the present study is to examine the short- to mid- term outcomes of their use for complex DFF of the elderly. We retrospectively identified 4 patients with DFF AO33C3 on osteoporotic bone treated by total knee arthroplasty from September 2015 to October 2019. The average age at the time of the surgery was 79,5 years (range, 69 to 95 years). All patients were females and underwent a total knee replacement by one senior surgeon, with the OSS TM Orthopaedic Salvage System (Zimmer Biomet, Warsaw, Indiana, USA). Outcome measures included clinical outcome scores, radiological analyses, reoperation rate and complications. At an average follow-up of 2,3 years (range, 0,6 to 4,2 years), the average Western Ontario and McMaster Universities Osteoarthritis index (WOMAC) was 17,25 (range, 7 to 37), the average Oxford knee score was 35,25 (range, 25 to 41) and the average pain Numerical Rating Scale (NRS) was 0,5 (range, 0 to 1). 3 Patients had postoperative anemia but no implant related complications has been reported. Complex DFF of the elderly treated with mega knee arthroplasty exhibit good clinical outcomes scores. The patients should be selected carefully as the complication rate found in the literature remains high.

Return to Sports after Unicompartmental Knee Arthroplasty: Reality or Utopia? A 48-Month Follow-Up Prospective Study

2018 ◽  
Vol 32 (02) ◽  
pp. 186-191 ◽  
Author(s):  
Mirco Lo Presti ◽  
Sergio Cialdella ◽  
Giuseppe Agrò ◽  
Alberto Grassi ◽  
Silvio Caravelli ◽  
...  
Keyword(s):  
Knee Arthroplasty ◽  
Unicompartmental Knee Arthroplasty ◽  
Polyethylene Wear ◽  
Young Patients ◽  
Case Series ◽  
High Impact ◽  
Return To Sports ◽  
Unicompartmental Knee ◽  
Early Loosening

AbstractUnicompartmental knee arthroplasty (UKA) has increased in popularity in the last years, also in younger and more active patients with great expectancies. The purpose of our study was to investigate the change in sports activities before and after medial UKA. We surveyed 53 athletic patients; all underwent cemented medial UKA, to determine not only their subjective and objective evaluation of clinical status with Hospital for Special Surgery (HSS) and visual analog score (VAS) score, but also their sporting and recreational activities at a mean follow-up of 48 ± 6 months (range, 18–56 months). At the last follow-up, 48 of 53 patients were engaged in sports and recreational disciplines, resulting in a return to activity rate of 90%. No early failure and no cases of revision were reported. The frequency of activities (sessions per week) and the time session remained constant at the time of survey. The most common activities after surgery were hiking, cycling, and swimming. Several high-impact activities, as well as skiing and football, had a significant decrease in participating patients. There were no gender-, age- and body mass index (BMI)-related differences. UKA can be considered a viable alternative in relatively young patients with high functional requirements and the correct indications, however, warning the patients about the risks of polyethylene wear and early loosening of the prosthetic components as a result of the resumption of sporting activities in high impact. Level of Evidence Prospective case series, level 4.

scholarly journals Surgical repair techniques, functional outcome, and return to sports after apophyseal avulsion fractures of the ischial tuberosity in adolescents

2021 ◽  
Author(s):  
Raymond Best ◽  
Anorte Meister ◽  
Jochen Huth ◽  
Ulrich Becker ◽  
Malin Meier
Keyword(s):  
Surgical Repair ◽  
Assessment Tool ◽  
Surgical Intervention ◽  
Case Series ◽  
Return To Sport ◽  
Ischial Tuberosity ◽  
Hamstring Injury ◽  
Return To Sports ◽  
Avulsion Fractures ◽  
Patient Related Outcome

Abstract Purpose Among juvenile apophyseal avulsion injuries of the pelvis in adolescents, fractures of the ischial tuberosity are rare but sustainably debilitating. Also because informations on surgical repair options are very sparse and so far limited to general reviews, reports of individual cases or heterogeous small case series, practitioners, patients and their parental environment still feel a comprehensible hesitation regarding operative treatment. Therefore we intended to investigate patient related outcome measurements and return to sports rates after different types of surgical intervention in an own case series, so far unprecendented in its size. Methods Patient data of adolescents that underwent surgical intervention for a displaced apophyseal avulsion fracture of the ischial tuberosity between 01/2015 and 12/2019 in our institution were gathered. Patients were then evaluated using the hamstring injury specific Perth Hamstring Assessment Tool (PHAT). Furthermore the return to sports level in comparison to the particular pre-injury level was rated. Results Eleven adolescents with an acute or chronic mean fragment dislocation of 3.3 cm (SD ± 1.7) underwent surgical intervention in the assigned period. The mean post-operative PHAT score was 86.9 (0–100, SD ± 11.9) and thus good to excellent. The majority of adolescents (10/11) was able to return to their pre-injury sports, whereas 63.6% achieved full or nearly full level. Conclusions Surgical refixation or restoration of aphoyseal avulsion fractures of the ischial tuberosity result in good to excellent outcomes and return to sport rates, irrespective of the type of intervention. Here prompt diagnosis with a timely intervention seems more promising than delayed interventions in chronic cases. Beyond 1.5 cm of fragment displacement affected patients should be counselled for surgical intervention.

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