scholarly journals Mid-term Outcomes of Using Custom-Made Implants for Revision Hip Arthroplasty

2019 ◽  
Vol 25 (3) ◽  
pp. 37-46 ◽  
Author(s):  
A. N. Kovalenko ◽  
A. A. Dzhavadov ◽  
I. I. Shubnyakov ◽  
S. S. Bilyk ◽  
A. O. Denisov ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Hip Joint ◽  
High Rate ◽  
Long Term Results ◽  
Porous Coating ◽  
Short Term ◽  
Custom Made ◽  
Acetabular Defects

Introduction. The matter of the replacement of acetabular defects is becoming increasingly relevant today. In their clinic the authors used custom-made implants with trabecular coating for replacement of defects in the acetabulum where and when it was necessary to ensure extended fixation of the component. Purpose — to evaluate short-term clinical and functional outcomes, osteointegration of porous coated custom-made implants, the overall survival of structural components and to identify the causes of failures and complications. Materials and Methods. During the study the authors interviewed and evaluated radiographs of 48 patients operated from October 2015 to June 2018. The patients were interviewed before and after the surgery using the Oxford hip joint scale, quality of life EQ-5D and visual analogue pain scale. Radiographs were evaluated for a period of at least 12 months for the signs of osteointegration. Results. The average OHS scores increased from 14.9 (±7) to 37.6 (±7) (p<0.01). Quality of life according to the EQ-5D index increased from 0.2 (±0.2) to 0.7 (±0.2) (p<0.01). The average value by general health scales: before operations — 49 (±17) and 73 (±18) scores after surgeries (p<0.01). The average VAS pain score decreased from 73 (±10) to 19 (±19) points (p<0.01). Osteointegration was observed in 98 percent of cases. Migration of the implant with fracture of a flange was observed in one case. Conclusions. In the short-term follow up the use of custom-made implants significantly improves hip joint function and the patients’ life quality. Custom-made implants enable primary reliable fixation in case of complex acetabular defects. High rate of osteointegration is observed for custom-made implants with porous coating within at least 12 months. Longer follow-up is needed to evaluate long-term results.

scholarly journals Evaluation of the quality of life dynamics by methods of survival analysis in patients with hip joint ar-throplasty

2021 ◽  
Vol 27 (5) ◽  
pp. 527-531
Author(s):  
A.N. Tkachenko ◽  
◽  
A.A. Korneenkov ◽  
Yu.L. Dorofeev ◽  
D.Sh. Mansurov ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Survival Analysis ◽  
Hip Joint ◽  
Hip Arthroplasty ◽  
Postoperative Period ◽  
Young Patients ◽  
Long Term Results

Abstract. Introduction The study deals with the approaches to the analysis of the dynamics in the course of a long-term postoperative period in patients who underwent hip arthroplasty. Aim To feature the variants in the course of a long-term postoperative period in patients who underwent arthroplasty of the hip joint. Materials and methods 806 patients (age range, 9 to 88 years) suffering from osteoarthritis underwent primary total hip arthroplasty (THA). Statistical analysis was carried out using the R programming language, freely available at https://cran.r-project.org. The probability of maintaining satisfactory quality of life (QoL) at a certain time of observation t (year of observation) was assessed with the Kaplan-Meier method. To compare the likelihood of maintaining a satisfactory QoL level throughout the observation period in several groups (for example, patients of different sexes), the logrank test was used. Results By year 6 of follow-up, the following tendency emerges regarding the age of the patients. The indicators are the best in young patients (up to 44 years old), where the probability of maintaining a satisfactory QoL evaluation was 0.92 (0.84; 0.96). A somewhat lower values were observed in the patients of the middle age group (from 45 to 64 years old) – 0.87 (0.78; 0.92). Excellent and good QoL was found in patients aged 65 and older, 0.83 (0.76; 0.88). Discussion Survival analysis methods have been used for the first time in traumatology and orthopedics. Previous researchers assessed the long-term results of the quality of specialized traumatological and orthopedic care without considering censored observations. Thus, the coverage of the investigated clinical observations averaged 80-85%. Information about 10-15% of cases was excluded from the studies. The proposed method of analysis provides information about all patients. Conclusions Five years following THA, an excellent and good quality of life could be expected in 85 % of patients. Satisfactory and poor levels are observed in 15 % of patients. At 5-year follow-up after THA, the quality of life is worse in older female groups with severe concomitant pathology; however, there are no statistically significant differences. This is a tendency, and requires further study.

Short-Term Morbidity after the Endoscopic Modified Lothrop (Draf-III) Procedure Compared with Draf-IIa

2017 ◽  
Vol 31 (4) ◽  
pp. 265-270 ◽  
Author(s):  
Aria Jafari ◽  
Kathryn R. Tringale ◽  
Bharat A. Panuganti ◽  
Joseph R. Acevedo ◽  
John Pang ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Antibiotic Therapy ◽  
Long Term Results ◽  
Short Term ◽  
Postoperative Visit ◽  
Snot 22 ◽  
Draf Iii ◽  
Clinic Visits

Background The endoscopic modified Lothrop (Draf-III) surgery has improved treatment of recalcitrant frontal sinus disease, with favorable safety and long-term results. However, the short-term clinical and quality-of-life morbidity after Draf-III relative to less-extensive procedures has yet to be investigated. Objective To evaluate the surgical and quality-of-life outcomes, including the burden of follow-up care, in patients who underwent endoscopic modified Lothrop (Draf-III), and compared these results with a less-extensive intervention, the endoscopic frontal sinusotomy (Draf-IIa). Methods A retrospective review of early (<8 weeks) postoperative recovery of patients who underwent Draf-III (2014 to 2016) for chronic rhinosinusitis was conducted and compared with age and radiographically matched Draf-IIa controls. Primary outcomes included perioperative complications, the number of postoperative clinic visits, debridements, and steroid and antibiotic therapy days. Secondary outcomes included the change in the 22-item Sino-Nasal Outcome Test (SNOT-22) scores and/or subscores (domains). Results Thirty-eight patients (19 Draf-III, 19 Draf-IIa) were included. Patients who underwent Draf-III versus Draf-IIa required more postoperative clinic visits (4.9 ±1.7 versus 3.3 ± 0.8; p < 0.05), debridements (4.2 ± 2.0 versus 2.3 ± 0.8; p < 0.05), and antibiotic therapy days (24.4 ± 11.8 versus 15.6 ± 6.3; p < 0.05). The mean (SD) SNOT-22 scores improved for both groups (−12.7 ± 34.5 versus -9.5 ± 20.4; p = 0.74) over the follow-up period, and subscore (domain) analysis demonstrated worsening extranasal symptoms (2.5 ± 3.0 versus -1.5 ± 4.7; p < 0.05) at the first postoperative visit, and less improvement in ear/facial symptoms at the second (−0.5 ± 2.6 versus -3.9 ± 4.7; p = 0.03) and third postoperative visits (−1.1 ± 1.6 versus 3.5 ± 3.3; p = 0.01). Conclusion Draf-III is associated with more postoperative clinic visits, debridements, and antibiotic therapy days. The patients who underwent Draf-III demonstrated worsening of extranasal symptoms at the first postoperative visit and less improvement in the ear/facial score at the second and third visits. Informed consent and counseling patients who may require Draf-III should include a detailed discussion of the burden of postoperative care and recovery.

Cathartic Effect of Suicide Attempts Not Limited to Depression

Crisis ◽  
2003 ◽  
Vol 24 (2) ◽  
pp. 73-78 ◽  
Author(s):  
Yves Sarfati ◽  
Blandine Bouchaud ◽  
Marie-Christine Hardy-Baylé
Keyword(s):  
Quality Of Life ◽  
Depressive Symptoms ◽  
Personality Traits ◽  
Rating Scales ◽  
Suicide Attempts ◽  
World Health ◽  
Life Questionnaire ◽  
Short Term

Summary: The cathartic effect of suicide is traditionally defined as the existence of a rapid, significant, and spontaneous decrease in the depressive symptoms of suicide attempters after the act. This study was designed to investigate short-term variations, following a suicide attempt by self-poisoning, of a number of other variables identified as suicidal risk factors: hopelessness, impulsivity, personality traits, and quality of life. Patients hospitalized less than 24 hours after a deliberate (moderate) overdose were presented with the Montgomery-Asberg Depression and Impulsivity Rating Scales, Hopelessness scale, MMPI and World Health Organization's Quality of Life questionnaire (abbreviated versions). They were also asked to complete the same scales and questionnaires 8 days after discharge. The study involved 39 patients, the average interval between initial and follow-up assessment being 13.5 days. All the scores improved significantly, with the exception of quality of life and three out of the eight personality traits. This finding emphasizes the fact that improvement is not limited to depressive symptoms and enables us to identify the relative importance of each studied variable as a risk factor for attempted suicide. The limitations of the study are discussed as well as in particular the nongeneralizability of the sample and setting.

scholarly journals Does a missed obstetric anal sphincter injury at time of delivery affect short-term functional outcome?

2018 ◽  
Vol 100 (1) ◽  
pp. 26-32 ◽  
Author(s):  
L Ramage ◽  
C Yen ◽  
S Qiu ◽  
C Simillis ◽  
C Kontovounisios ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Anal Sphincter ◽  
Short Form ◽  
Primary Repair ◽  
Obstetric Anal Sphincter Injury ◽  
Short Term ◽  
Sphincter Injury ◽  
Anal Sphincter Injury

Introduction This study aimed to ascertain whether missed obstetric anal sphincter injury at delivery had worse functional and quality of life outcomes than primary repair immediately following delivery. Materials and methods Two to one propensity matching was undertaken of patients presenting to a tertiary pelvic floor unit with ultrasound evidence of missed obstetric anal sphincter injury within 24 months of delivery with patients who underwent primary repair at the time of delivery by parity, grade of injury and time to assessment. Outcomes compared included Birmingham Bowel, Bladder and Urinary Symptom Questionnaire (BBUSQ), Wexner Incontinence Score, Short Form-36, Pelvic Organ Prolapse/Urinary Incontinence Sexual Questionnaire and anorectal physiology results. Results Thirty-two missed anal sphincter injuries were matched two to one with sixty-two patients who underwent primary repair of an anal sphincter defect. Mean time to follow-up was 9.31 ± 6.79 months. Patients with a missed anal sphincter injury had suffered more incontinence, as seen in higher the Birmingham Bowel, Bladder and Urinary Symptom Questionnaire (BBUSQ; 30.56% ± 14.41% vs. 19.75% ± 15.65%, P = 0.002) and Wexner scores (6.00 ± 3.76 vs. 3.67 ± 4.06, P = 0.009). They also had a worse BBUSQ urinary domain score (28.25% ± 14.9% vs. 17.01 ± 13.87%, P = 0.001) and worse physical functioning as measured by the Short Form-36 questionnaire (P = 0.045). There were no differences in other outcomes compared, including anorectal physiology and sexual function. Discussion In the short-term, patients with a missed obstetric anal sphincter injury had significantly worse faecal incontinence and urinary function scores, however quality of life and sexual function were largely comparable between groups. Conclusions Longer-term follow-up is needed to assess the effects of missed obstetric anal sphincter injury over time.

scholarly journals Short-term health-related quality of life in patients with ischaemic stroke after PFO closure

2021 ◽  
Vol 20 (Supplement_1) ◽  
Author(s):  
G Christopoulou ◽  
E Sigala ◽  
D Aragiannis ◽  
E Stamatopoulou ◽  
P Manthou ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Ischaemic Stroke ◽  
Physical Function ◽  
Health Related Quality ◽  
Short Term ◽  
Related Quality ◽  
Health Related ◽  
Pfo Closure

Abstract Funding Acknowledgements Type of funding sources: None. Introduction/Purpose: Patent foramen ovale (PFO) is common in asymptomatic adults and is associated with cryptogenic stroke (CS). We sought to evaluate the impact of PFO closure in health-related quality of life (HRQoL) in PFO patients with CS.  Method In this pilot study, 19 patients (mean age 47 ± 7.7; 13 male) who underwent PFO closure at our center were invited to a short-term clinical follow up (mean follow-up period 6-10 months). All patients had suffered an ischaemic stroke and their disability level was assessed using the Modified Rankin Scale (MRS, no significant disability 63%). HRQoL was assessed using the 36-Item Short Form Survey (SF-36) and the European Quality of Life-5 Dimensions Questionnaire (EQ-5D) preoperatively and at follow-up.  Results Both SF36 and EQ-5D scores improved after the operation as shown by the self-rating scores (20,67% and 40,52% higher scores, respectively). Patients with major mobility problems were more likely to be current smokers (r = 0.481) and those who had lower scores on the MRS scale (r=-0.571) rated higher their scale diagram.  The categories of energy/fatigue (r = 0.459; p = 0.048), social functioning (r = 0.547; p = 0.015) and pain (r = 0.550; p = 0.015) were positively correlated with physical function. Finally, there was a positive correlation between role limitations due to emotional problems and energy/fatigue (r = 0,519; p = 0.023), and between energy/fatigue and emotional well-being (r = 0.519; p = 0,023). Conclusions The results of our study indicate that shortly after PFO, subjects perceive improvements in their QoL. However, it seems that poorly rated physical function was more common in active smokers, and affects patients" social life and their emotional state. Health care professionals should encourage these patients to participate in rehabilitation and psychological support programs postoperatively.

The Impact of Emergency Surgery versus Self-expanding Metallic Stents on Anal Function and Quality of Life in Patients with Complete Obstructing Left-sided Colon Cancer

2021 ◽  
Author(s):  
GanBin Li ◽  
Tao Yu ◽  
Hao-Yu Zhang ◽  
Zhen-Jun Wang ◽  
Guang-Hui Wei ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Colon Cancer ◽  
Regression Analysis ◽  
Short Term ◽  
Anal Function ◽  
Eortc Qlq C30 ◽  
Eortc Qlq ◽  
Better Than

Abstract Background: Emergence surgery (ES) and self-expanding metallic stents (SEMS) are traditional approaches for complete obstructing left-sided colon cancer. A strategy of “stents-chemotherapy-surgery” was applied in our center recently. Studies assessing the anal function and quality of life of patients with complete obstructing left-sided colon cancer are still lacking.Methods: Patients with complete obstructing left-sided colon cancer were included, and three treatment strategies were used, including ES, SEMS, and SEMS followed by neoadjuvant chemotherapy (NAC) for patients with complete obstructing left-sided colon cancer. The Wexner, Vaizey, and low anterior resection syndrome (LARS) scores were used to assess anal function and the EORTC QLQ C30 score was used to assess quality of life. Logistic regression analysis was used to detect risk factors affecting short-term anal function of patients.RESULTS: The Wexner scores were similar among the groups during the follow-up period. The Vaizey (H=18.415, P=0.001) and LARS scores (H=3.660, P=0.04) both revealed that anal function among patients receiving SEMS and NACwas significantly better than patients who underwent ES at the 1-month post-operative follow-up evaluation; no significant difference existed at the 6- and 12-month follow-up evaluations. The EORTC QLQ C30 score revealed that social function of patients receiving SEMS and NAC was also significantly better than patients undergoing ES (H=7.035, P=0.03). Logistic regression analysis suggested that a one-stage stoma in an emergent setting is an independent risk factor for short-term reduction of anal function among patients with complete obstructing left-sided colon cancer (OR=5.238, 95% CI: 1.569~17.484, P=0.007).Conclusion: Compared to ES, SEMS might be able to improve the quality of life and short-term anal function in patients with complete obstructing left-sided colon cancer.

scholarly journals Use of percutaneous microwave ablation for the treatment of bone tumors: a retrospective study of clinical outcomes in 47 patients

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Min-hao Wu ◽  
Ling-fei Xiao ◽  
Fei-fei Yan ◽  
Shi-Liang Chen ◽  
Chong Zhang ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Retrospective Study ◽  
Pain Relief ◽  
Microwave Ablation ◽  
Bone Tumors ◽  
Short Term ◽  
Sf 36 ◽  
Percutaneous Microwave Ablation

Abstract Objective The present study aimed to evaluate the short-term clinical performance and safety of percutaneous microwave ablation (MWA) techniques for the treatment of bone tumors. Methods This single-institution retrospective study investigated 47 cases of bone tumors treated by MWA from June 2015 to June 2018. The study included 26 patients (55.3%) with benign bone tumors and 21 patients (44.7%) with malignant bone tumors. The tumors were located in the spine or sacrum (15, 31.9%), the upper extremities (6, 12.8%), the lower extremities (17, 36.2%) and the pelvis (9, 19.1%). Outcomes regarding clinical efficacy, including pain relief, quality of life, and intervention-related complications, were evaluated before and after MWA using the visual analog scale (VAS) and the 36-item Short-Form Health Survey (SF-36) scoring system. Results Of the 47 patients included in this study, all of them completed follow-up examinations, with a mean follow-up duration of 4.8 ± 1.6 months (range, 2–9 months). Significantly improved VAS and SF-36 scores were recorded after the initial treatment (P<0.001), suggesting that almost 100% of patients experienced pain relief and an improved quality of life following surgery. No major intervention-related complications (e.g., serious neurovascular injury or infection) occurred during or after the treatment. We recorded only three minor posttreatment complications (6.4%, 3/47), which were related to thermal injury that caused myofasciitis and affected wound healing. Conclusion In our study, the short-term efficacy of MWA was considerably favorable, with a relatively low rate of complications. Our results also showed that MWA was effective for pain relief and improved patients’ quality of life, making it a feasible treatment alternative for bone tumors.

scholarly journals Four-rod Technique Stabilization after Pedicle Subtraction Osteotomy (PSO) for the Treatment of Thoracolumbar Hyperkyphosis Secondary to Pott Disease: A Two-Year Follow-Up Case Report

2019 ◽  
Vol 38 (03) ◽  
pp. 219-226
Author(s):  
Alecio Cristino Evangelista Santos Barcelos ◽  
Sterphany Ohana Soares Azevedo Pinto ◽  
Thaise Ellen de Moura Agra Teixeira ◽  
Rayana Ellen Fernandes Nicolau
Keyword(s):  
Quality Of Life ◽  
Case Report ◽  
Short Form ◽  
Spinal Tuberculosis ◽  
Pedicle Subtraction Osteotomy ◽  
High Rate ◽  
Hardware Failure ◽  
Sf 36

AbstractPedicle subtraction osteotomy (PSO) is a powerful tool for the management of sagittal misalignment. However, this procedure has a high rate of implant failure, particularly rod breakages. The four-rod technique diminishes this complication in the lumbar spine. The aim of the present study is to provide a case report regarding PSO and four-rod technique stabilization in the treatment of short-angle hyperkyphosis in the thoracolumbar (TL) junction. The authors describe the case of a patient with TL hyperkyphosis secondary to spinal tuberculosis treated with L1 PSO and fixation with a four-rod technique. There were no major surgical complications. The self-reported quality of life questionnaires (the Short-Form Health Survey 36 [SF-36] and the Oswestry disability index) and radiological parameters were assessed preoperatively, as well as 6, 12 and 24 months after surgery, and they showed considerable and sustained improvements in pain control and quality of life. No hardware failure was observed at the two-year follow-up.

scholarly journals Surgical management of recurrent disc herniations with microdiscectomy and long-term results on life quality: Detailed analysis of 70 cases

2016 ◽  
Vol 7 (01) ◽  
pp. 87-90 ◽  
Author(s):  
Serdal Albayrak ◽  
Sait Ozturk ◽  
Emre Durdag ◽  
Ömer Ayden
Keyword(s):  
Quality Of Life ◽  
Facet Joint ◽  
Lumbar Disc ◽  
Life Quality ◽  
Early Period ◽  
Long Term Results ◽  
Disc Herniations

ABSTRACT Background: Aim of this paper is to recall the surgical technique used in the recurrent lumbar disc herniations (LDHs) and to share our experiences. Materials and Methods: Out of series of 1115 patients who underwent operations for LDH between 2006 and 2013, 70 patients underwent re-operations, which were included in this study. During surgery, lateral decompression performed over the medial facet joint to the superior facet joint border was seen after widening the laminectomy defect, and microdiscectomy was performed. The demographic findings of the patients, their complaints in admission to hospital, the level of operation, the condition of dural injury, the first admission in the prospective analysis, and their quality of life were evaluated through the Oswestry scoring during their postoperative 1st, 3rd, 6th-month and 1st, 3rd, 5th and 7th-year follow-up. In the statical analysis, Friedman test was performed for the comparison of the Oswestry scores and Siegel Castellan test was used for the paired nonparametrical data. A P < 0.05 was considered statistically significant. Results: Considering the Oswestry Index during the follow-ups, the values in the postoperative early period and follow-ups were seen to be significantly lower than those at the time of admission to hospital (P < 0.05). None of the patients, who re-operated by microdiscectomy, presented with iatrogenic instability in 7 years follow-up period. Conclusion: Microdiscectomy performed through a proper technique in the re-operation of recurrent disc herniations eases complaints and improves the quality of life. Long-term follow-ups are required for more accurate results.

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