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1.
Joel J. Gagnier Megan Mullins Hsiaomin Huang Danica Marinac-Dabic Anna Ghambaryan Benjamin Eloff Faisal Mirza Manuel Bayona 《The Journal of arthroplasty》2017,32(5):1688-1697.e7
Background
While clinical research on total knee arthroplasty (TKA) outcomes is prevalent in the literature, studies often have poor methodological and reporting quality. A high-quality patient-reported outcome instrument is reliable, valid, and responsive. Many studies evaluate these properties, but none have done so with a systematic and accepted method. The objectives of this study were to identify patient-reported outcome measures (PROMs) for TKA, and to critically appraise, compare, and summarize their psychometric properties using accepted methods.Methods
MEDLINE, EMBASE, SCOPUS, Web of Science, PsycINFO, and SPORTDiscus were systematically searched for articles with the following inclusion criteria: publication before December 2014, English language, non-generic PRO, and evaluation in the TKA population. Methodological quality and evidence of psychometric properties were assessed with the COnsensus-based standards for the selection of health Status Measurement INstruments (COSMIN) checklist and criteria for psychometric evidence proposed by the COSMIN group and Terwee et al.Results
One-hundred fifteen studies on 32 PROMs were included in this review. Only the Work, Osteoarthritis or joint-Replacement Questionnaire, the Oxford Knee Score, and the Western Ontario and McMaster Universities Arthritis Index had 4 or more properties with positive evidence.Conclusion
Most TKA PROMs have limited evidence for their psychometric properties. Although not all the properties were studied, the Work, Osteoarthritis or joint-Replacement Questionnaire, with the highest overall ratings, could be a useful PROM for evaluating patients undergoing TKA. The methods and reporting of this literature can improve by following accepted guidelines. 相似文献2.
Vincent V.G. An Kevin Phan Brahman S. Sivakumar Ralph J. Mobbs Warwick J. Bruce 《The Journal of arthroplasty》2018,33(1):297-300
Background
The biomechanical relationship between the lumbar spine and the hip is well-documented. It follows that fusing the lumbar spine would have implications on the outcomes of total hip arthroplasty (THA). This study aimed to determine the effect of preexisting lumbar spinal fusion surgery on the outcomes of THA by synthesizing the available evidence via systematic review and meta-analysis.Methods
A systematic review with meta-analysis was performed in accordance to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Electronic searches were performed in 6 different databases for studies comparing outcomes in patients after THA with or without a history of lumbar fusion. Studies were required to report at least one outcome out of dislocation, revision due to hip instability or patient-reported outcomes.Results
Patients with a history of lumbar spinal fusion are at a significantly increased risk of dislocation (relative risk 2.03, P < .00001) and revision (relative risk 3.36, P = .006) after THA. Patient-reported outcomes were also poorer in patients with prior lumbar fusion compared with those without, although meta-analysis could not be performed due to heterogeneity in the outcome measure used between studies.Conclusion
Previous lumbar spinal fusion increases risk of dislocation and revision, and may negatively impacts patient-reported outcomes after THA. Orthopaedic surgeons should pay particular attention to these patients and could use patient-specific planning, instrumentation, and targeted counselling to optimize clinical and subjective outcomes. Future studies could clarify the impact of prior fusion on patient-reported outcomes after THA. 相似文献3.
Olivier Y. Gauthier-Kwan Johanna S. Dobransky Geoffrey F. Dervin 《The Journal of arthroplasty》2018,33(7):2159-2164.e1
Background
Outpatient total knee arthroplasty (TKA) has been made possible with advances in perioperative care and standardized clinical inpatient pathways. While many studies report on benefits of outpatient programs, none explore patient-reported outcome measures. As such, our goals were to compare the short-term quality of recovery; highlight postdischarge hospital resources utilization; and report on 2-year functional outcomes scores.Methods
This was a prospective comparative cohort study of 43 inpatients (43 TKAs) and 43 outpatients (43 TKAs) operated on by a single surgeon between September 28, 2010 and May 5, 2015. All patients were given a diary to complete at 1, 3, 7, 14, and 28 days postoperatively; we collected 90-day complications, readmissions, and emergency department visits; Knee Injury and Osteoarthritis Outcome Score and Western Ontario and McMaster Universities Osteoarthritis Index scores were completed preoperatively and 2 years postoperatively. SPSS (IBM, version 22.0) was used for all statistical analyses.Results
Quality of recovery (QoR-9) was similar in the outpatient TKA group compared with the inpatient group. No statistically significant differences were observed for Knee Injury and Osteoarthritis Outcome Score and Western Ontario and McMaster Universities Osteoarthritis Index subscores (P > .05). There was 1 readmission in both outpatient and inpatient groups. Six inpatients and 8 outpatients returned to the emergency department for any reason within 90 days, with no statistical significance observed between the 2 groups (P = .771).Conclusion
Outpatient TKA in selected patients produced similar short-term and 2-year patient-reported outcome measures and a comparable 90-day postdischarge hospital resource utilization when compared to an inpatient cohort, supporting further investigation into outpatient TKA. 相似文献4.
P.S. Myles O. Boney M. Botti A.M. Cyna T.J. Gan M.P. Jensen H. Kehlet A. Kurz G.S. De Oliveira P. Peyton D.I. Sessler M.R. Tramèr C.L. Wu Paul Myles Michael Grocott Bruce Biccard Jane Blazeby Duminda Wijeysundera 《British journal of anaesthesia》2018,120(4):705-711
Background
Maximising patient comfort during and after surgery is a primary concern of anaesthetists and other perioperative clinicians, but objective measures of what constitutes patient comfort in the perioperative period remain poorly defined. The Standardised Endpoints in Perioperative Medicine initiative was established to derive a set of standardised endpoints for use in perioperative clinical trials.Methods
We undertook a systematic review to identify measures of patient comfort used in the anaesthetic, surgical, and other perioperative literature. A multi-round Delphi consensus process that included up to 89 clinician researchers was then used to refine a recommended list of outcome measures.Results
We identified 122 studies in a literature search, which were the basis for a preliminary list of 24 outcome measures and their definitions. The response rates for Delphi Rounds 1, 2, and 3 were 100% (n=22), 90% (n=79), and 100% (n=13), respectively. A final list of six defined endpoints was identified: pain intensity (at rest and during movement) at 24 h postoperatively, nausea and vomiting (0–6 h, 6–24 h, and overall), one of two quality-of-recovery (QoR) scales (QoR score or QoR-15), time to gastrointestinal recovery, time to mobilisation, and sleep quality.Conclusions
As standardised outcomes will support benchmarking and pooling (meta-analysis) of trials, one or more of these recommended endpoints should be considered for inclusion in clinical trials assessing patient comfort and pain after surgery. 相似文献5.
Tara L. Packham Joy C. MacDermid Susan Michlovitz Edith Cup Lucelle Van de Ven-Stevens 《Journal of hand therapy》2018,31(3):371-380
Study Design
Longitudinal clinical measurement.Introduction
Sensory alterations in the hand can present as both decreased sensation or numbness, and hyperesthesia, including mechanical allodynia and cold intolerance. However, few patient-reported outcomes have been developed and validated for evaluation, particularly for increased sensitivity. The Radboud Evaluation of Sensitivity was developed in the Netherlands for patient-reported evaluation of hand sensitivity in complex regional pain syndrome.Purpose of the Study
The purpose of this study was to translate into English and culturally validate the Radboud Evaluation of Sensitivity for the North American context.Methods
Forward and backward translation, followed by a psychometric evaluation of the synthesized version of the translated tool, was undertaken in a heterogeneous group of persons after hand injury, including nerve injuries, hand trauma, and complex regional pain syndrome.Results
Thirty-six persons completed test-retest reliability testing, yielding an intraclass correlation coefficient of 0.92 (95% CI 0.85 to 0.96) for single measures. Internal consistency was also high at α = 0.96 in a larger sample (n = 56). Although some support for construct validity was generated, several validity hypotheses were not confirmed. Of interest, there appeared to be significant differences in the scores between persons with hypoesthesia as compared with those with hyperesthesia.Conclusions
The Radboud Evaluation of Sensitivity, English version appears to be a reliable tool for the self-reported evaluation of sensory alterations in the hand, including both hypoesthesia and hyperesthesia. More research is needed to add to the extent of and confidence in the validity and responsiveness of this assessment.Level of Evidence
Level II. 相似文献6.
7.
Joy C. MacDermid Kristin Valdes Mike Szekeres Nancy Naughton Lori Algar 《Journal of hand therapy》2018,31(4):511-523
Introduction
The primary purpose of this scoping review was to describe the nature and extent of the published research that assesses the relationship between psychological features and patient-reported outcome following surgery or rehabilitation of upper extremity disease or injury.Methods
Twenty-two included studies were examined for quantitative study design, outcome measure, inclusion/exclusion criteria, follow-up and recruitment strategy. Patient population and psychological assessment tools were examined for validity.Results
Twenty-two studies met the inclusion criteria for this study. Only 7 of the 22 studies were longitudinal and the rest were cross sectional studies. Depression was the most common psychological status of interest and was included in 17 studies. Pain catastrophizing was the psychological status of interest in 5 of the studies. Four studies considered anxiety, 3 considered pain anxiety, 3 considered distress, 2 considered coping, 2 considered catastrophic thinking, and 2 considered fear avoidance beliefs.Discussion
The majority of studies in this review were cross-sectional studies. Cross-sectional studies may not provide conclusive information about cause-and-effect relationships. This review encourages clinicians to be mindful of the psychological implications found in rehabilitation of individuals with upper extremity disease or injury along with being cognizant of choosing appropriate measurement tools that best represent each patient's characteristics and diagnoses.Conclusions
The nature of the research addressing psychological factors affecting outcomes after hand injury focus on negative traits and have limited strength to suggest causation as most have used cross-sectional designs. Stronger longitudinal designs and consideration of positive traits are needed in future studies. 相似文献8.
Utkarsh Anil Ameer M. Elbuluk Jacob Ziegler Ran Schwarzkopf William J. Long 《The Journal of arthroplasty》2018,33(2):337-339.e6
Background
With the establishment of the Hospital Value-Based Purchasing program, the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) score has been incorporated into the calculation of the total performance score, which determines redistribution of up to 2% of Medicare payments. This study aims to assess whether the HCAHPS score correlates with validated outcome measures after total hip arthroplasty.Methods
Data from 63 patients who underwent a total hip arthroplasty and completed both an HCAHPS score and patient-reported outcome measures (PROMs) at our institution during the study period from January 1, 2015 to September 2016 were analyzed. The HCAHPS overall hospital rating scores were correlated with the preoperative to postoperative change in validated PROMs, namely EuroQol-EQ-5D Instrument and Hip Disability and Osteoarthritis Outcome Score.Results
There was no statistically significant correlation between the HCAHPS overall hospital rating score and PROMs.Conclusion
This study shows a lack of correlation between established validated PROMs used in orthopedic surgery, and the HCAHPS survey scores, an important determinant of compensation in the pay-for-performance reimbursement models. 相似文献9.
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11.
Arpit C. Jariwala Avinash Parthasarathy Manish Kiran Linda R. Johnston David I. Rowley 《The Journal of arthroplasty》2017,32(7):2256-2261
Background
Numbness around the surgical scar can be a source of discomfort or dissatisfaction in a proportion of patients undergoing total knee arthroplasty (TKA). Literature reports wide variation in its prevalence and the consequence of numbness on the outcome of TKA is not clear. We investigated the prevalence of numbness, along with contributing factors, and assessed its effect on the functional outcome of TKA.Methods
In total, 258 knees were included in this prospective patient-reported outcome measure case-control study. Demographic details, type and length of incision, pre-operative and 1-year post-operative Knee Society Scores were recorded and compared.Results
The prevalence of numbness at 1 year was 53%, with a female preponderance. Patients older than 70 years were less affected. Discomfort due to numbness was recorded in 8.7% of the patients, 75% of which were female. The length of the incision correlated positively with the presence of numbness. The Knee Society Scores did not correlate with the presence or area of numbness.Conclusion
Our findings indicate a high prevalence of numbness after TKA. Nevertheless, numbness does not affect the functional outcome. 相似文献12.
N. Arpornsujaritkun S. Jirasiritham P. Pootracool W. Tirapanich G. Gesprasert B. Sakulchairungrueng P. Wiwattanathum S. Leelaudomlipi S. Sriphojanart 《Transplantation proceedings》2018,50(8):2461-2464
Background
Dual kidney transplants (DKTs) from expanded criteria donors (ECDs) have been performed in our hospital since 2014. We needed to review our clinical outcome and update criteria to selected ECDs for DKTs.Materials and Methods
Between January 2014 and December 2016, 4 DKTs and 269 deceased donor kidney transplants were performed. The outcome of DKTs was reviewed. The literature was reviewed for surgical technique and indication for DKT.Results
Four DKTs were performed between 2014 and 2016. One-year graft survival rate was 100%. One patient developed delayed graft function. No morbidity or mortality occurred.Conclusions
DKTs in our center were safe and had good outcome with optimized selected criteria. DKT can improve the rate of kidney transplant in a developing country. 相似文献13.
Kees H. Woldendorp Antoine W. de Schipper Anne M. Boonstra Corry K. van der Sluis J. Hans Arendzen Michiel F. Reneman 《Journal of hand therapy》2018,31(4):544-553.e1
Study Design
Psychometric study with 2-week interval.Introduction
Musculoskeletal hand complaints are common among manual workers. Mismatch between anthropometric hand features and tasks can affect the ability to perform hand activities, with an increased risk of complaints. Although screening of these features may improve diagnosis and treatment, no validated screening tool is available. The Practical Hand Evaluation (PHE) screening tool might fill this gap, but its psychometric properties are unknown.Purpose of the Study
To test the reliability of the PHE and to explore the feasibility of item reduction of the PHE.Methods
Right-hand profiles of 117 healthy volunteers (66 women, 51 men; mean age, 22.8 years) were independently assessed 4 times by 6 couples of researchers using the PHE, twice on day 1 and twice 2-3 weeks later. Intrarater and inter-rater reliability (intraclass correlations), standard error of measurement (SEM), potential confounding factors (gender, joint hyperlaxity, and measurement order) affecting the instrument's reliability (limits of agreement), and collinearity between the PHE items were determined (variation inflation factor analysis and hierarchical clustering of correlation coefficients).Results
The intrarater and inter-rater reliabilities of the PHE were good for 12 of 14 items (86%; r = 0.67-0.90). Absolute SEM varied between 2.01 and 9.23 mm. The percentage of shifts of at least 2 classes in a repeated measurement was <15%. Cluster analysis identified 6 clusters of hand items.Discussion
The reliability for nearly all PHE items is good. Measurement errors were substantial relative to variances in the reference population, but not to gender, joint laxity and order of administration. Clustering into 6 seperated clusters of items was possible.Conclusions
The PHE fulfills many of the criteria for screening of anthropometrics of the hand. Its reliability is high. The SEM might be improved with future adaptations toward a digital photographic PHE. Reduction to 6 items seems also possible. 相似文献14.
Thomas M. Lovelock Nigel S. Broughton Cylie M. Williams 《The Journal of arthroplasty》2018,33(1):273-276
Background
The optimal methods of determining outcomes following hip and knee arthroplasty remain controversial. The objectives of this study were to determine the most frequently used outcome measures in randomized controlled trials (RCT) and study protocols registered with clinical trials registries (CTR) on hip and knee arthroplasty.Methods
A systematic search strategy was undertaken to identify the outcome measures used in RCT and CTR following joint arthroplasty. Databases searched included Embase, Ovid MEDLINE (including In-Process), Cochrane Central Register of Controlled Trials, CINAHL Plus, clinicaltrials.gov, ISRCTN registry, and ANZCTR. Differences in the use of outcome measures between RCT and CTR were assessed using logistic regression.Results
There were 291 RCT and 113 CTR on hip arthroplasty and 452 RCT and 184 CTR on knee arthroplasty that met the inclusion criteria. The most popular outcome measures were the Harris Hip Score and the Knee Society Score. Multiple outcome measures were used in greater than 50% of the included studies. The Oxford Hip Score, Oxford Knee Score, EuroQol-5D, and Knee Injury and Osteoarthritis Outcome Score (all P < .001) were used in significantly more CTR than RCT.Conclusion
There is a clear preference for the use of the Harris Hip Score and Knee Society Score, contrary to existing international guidelines and reviews on the topic. Both measures require clinician input, which potentially influences their validity and increases their overall administration cost. Some patient-reported outcome measures, such as the Oxford Hip and Knee Scores, EuroQol-5D, and KOOS, appear to be increasing in popularity. 相似文献15.
Purpose
Anterior cruciate ligament (ACL) repair was first described in the mid 1900's. However, due to poorly selected patients led to unsatisfactory early results. We aim to study the outcome of ACL repair in a carefully selected cohort.Methods
Thirteen consecutive patients of acute Type 1 (proximal ACL avulsion) were treated with arthroscopic ACL repair using a suture pull out technique. At the latest follow-up the patients were evaluated for Lysholm score, KT-1000 measurement and clinical assessment for any laxity.Results
At a mean follow-up of 31.3 months, none of the patients had any subjective laxity. The mean Lysholm score was 95 and instrumented laxity measurement did not reveal any significant laxity compared to the opposite knee.Conclusion
The proximal ACL avulsion has healing potential similar to proximal MCL injuries. Performing microfracture of the lateral wall of the notch optimizes the healing environment by negating the effects of the synovial fluid. Performing ACL repair in a carefully selected patient leads to good short term results and saves the patient of a reconstruction procedure, at least in the immediate future. 相似文献16.
Birmingham Hip Resurfacing vs Total Hip Arthroplasty: A Matched-Pair Comparison of Clinical Outcomes
Victor R. Ortiz-Declet David A. Iacobelli Leslie C. Yuen Itay Perets Austin W. Chen Benjamin G. Domb 《The Journal of arthroplasty》2017,32(12):3647-3651
Background
Birmingham hip resurfacing (BHR) has proven to be a good alternative for younger patients with osteoarthritis. Some have asserted that BHR may yield outcomes which are superior to total hip arthroplasty (THA), and that some studies which failed to show a difference were plagued by ceiling effects and lack of sensitivity of outcome measures. The purpose of this study is to compare outcomes of BHR and THA using the “Forgotten Joint” Score-12 (FJS), a more sensitive score with lesser vulnerability to the ceiling effect.Methods
Patients who underwent BHR were matched to patients who underwent posterior THA by computing a propensity score using 5 covariates: age, body mass index, gender, worker's compensation claims, and previous hip surgery. Surgical outcomes were assessed using 6 patient-reported outcome measures, including the FJS, the visual analog scale for pain, and patient satisfaction.Results
There were 42 patients in the BHR group and 18 patients in the THA group. The FJS was 78.0 for the BHR group and 76.0 for the THA group. The Veterans RAND 12-Item Health Survey Mental Component Summary and Short Form 12 Mental Component Summary were significantly higher in the BHR group. No differences were seen between all other patient-reported outcomes.Conclusion
BHR offers excellent results in young patients that are comparable to THA. As no clinical difference could be shown between BHR and THA, even with the use of the FJS, the choice between BHR and THA should not be based solely on any expectation that either yields superior clinical outcomes compared to the other at short-term follow-up. 相似文献17.
Study Design
Narrative review.Introduction
There are a variety of treatments with demonstrated effectiveness for the management of complex regional pain syndrome (CRPS). However given the variability in symptom presentation in this population, therapists may be unsure what treatments would be most effective for individual clients.Purpose of the Study
To present a brief synthesis of the literature and propose a rehabilitation version of a mechanism-specific management algorithm to guide personalized treatment of CRPS.Methods
A systematic search of the literature was conducted to identify all randomized controlled trials, systematic reviews, and clinical practice guidelines addressing rehabilitation of CRPS. Results were reviewed independently by 2 reviewers and final selection of articles was reached by consensus, Data was extracted using standardized forms, and a single rater gave quality ratings. Both reviewers then used the extracted data to present a synthesis of the evidence categorized by the proposed mechanisms of effect.Results
A total of 111 articles were retrieved and reviewed for inclusion; 49 were selected for data extraction. A synthesis of the key recommendations was compiled into a rehabilitation-specific version of the mechanism-based management algorithm proposed by Gierthmühlen et al (2014).Conclusions
Consideration of mechanism-appropriate rehabilitation interventions may assist therapists to select the most appropriate and effective treatments from the body of evidence supporting rehabilitation of CRPS. 相似文献18.
Hassan Shakeri Manijeh Soleimanifar A.M. Arab Shirin Hamneshin Behbahani 《Journal of hand therapy》2018,31(1):35-41
Study Design
Randomized clinical trial.Introduction
KinesioTape (KT) is a noninvasive method to treat pain and muscular dysfunction.Purpose
To investigate the effect of KT with and without tension on pain intensity, pain pressure threshold, grip strength and disability in individuals with lateral epicondylitis, and myofacial trigger points in forearm muscles.Methods
Thirty women with lateral epicondylitis and myofacial trigger point in forearm muscles were randomly assigned to KT with tension and placebo (KT without tension). The treatment was provided 3 times in one week, and outcome measures were assess pre-post treatment.Results
The mean score of visual analogue scale (VAS) during activity decreased significantly from 6.4 and 6 pretest to 2.53 and 4.66 posttest, respectively, for the KT with and without tension groups. The mean score of Disabilities of the Arm, Shoulder and Hand decreased significantly from 16.82 and 22.79 pretest to 8.65 and 8.29 posttest, respectively, for the KT with and without tension groups. A paired t-test revealed a significant reduction in VAS during activity and Disabilities of the Arm, Shoulder and Hand before and after treatment in both groups (P < .05). Pain pressure threshold, grip strength, and VAS using an algometer revealed no significant differences. The study showed no significant difference in variables immediately after intervention.Discussion
Improvements in functional disability were superior when KT was used with tension, than obtained with a placebo-no tension application.Conclusion
The application of KT produces an improvement in pain intensity and upper extremity disability in subjects with LE and MTP in forearm muscles, and KT with tension was more effective than placebo group.Level of Evidence
NA.Trial Registration Number
100-216. 相似文献19.
Ita Suzana Mat Jais Kai Li Chan Mun Kitt Austin Loke Saleem Abdul Rahim Shian Chao Tay 《Journal of hand therapy》2018,31(1):122-128
Study Design
Cross-sectional study for clinical measurement.Introduction
Most daily tasks require individuals to exert grip strength with torque, which can be challenging for elderly as their strength diminishes with age. We postulate that to assess the functional capacity of an individual, it is important to evaluate the functional grip strength instead of the maximal static grip strength.Purpose of the Study
The objective of this cross-sectional study is to establish normative data for the functional grip strength of elderly aged 60 years and older in the Singapore population.Methods
In this study, 233 healthy subjects aged 60 years and older were recruited. Using a custom-made hand strength measurement device, the following measurements were recorded: grip strength at neutral position, grip strength with resistive pronation torque, and grip strength with resistive supination torque.Results
Grip strengths measured for both genders decreased by 13% and 16% for males and females respectively, when pronation torque was exerted, and with supination torque, the strength decreased by 18% and 17% for males and females respectively.Conclusion
Normative data for the elderly population in Singapore had been established. The findings from this study can complement the existing ergonomic hand data in designing better assistive tools to improve the independent living of elderly.Level of Evidence
NA. 相似文献20.
Nikolaus Johannes Wachter Martin Mentzel Gert D. Krischak Joachim Gülke 《Journal of hand therapy》2018,31(4):524-529