Aims. Psychological status may be an important predictor of outcome after periacetabular osteotomy (PAO). The aim of this study was to investigate the influence of psychological distress on postoperative health-related
Aims. The primary aim was to assess whether preoperative health-related
Aims. The aims were to assess whether preoperative joint-specific function (JSF) and health-related
Aims. To assess the variation in pre-fracture
Aims. The aim of this study was to describe and compare joint-specific and generic health-related
Aims. We aimed to evaluate the long-term impact of fracture-related infection (FRI) on patients’ physical health and psychological wellbeing. For this purpose,
Aims. Rotator cuff disease (RCD) can considerably decrease
Aims. The overall aim of this study was to determine the impact of deprivation with regard to
Aims. It is well described that patients with bone and joint infections (BJIs) commonly experience significant functional impairment and disability. Published literature is lacking on the impact of BJIs on mental health. Therefore, the aim of this study was to assess health-related
Aims. The primary aim of our study was to assess the influence of age on hip-specific outcome following total hip arthroplasty (THA). Secondary aims were to assess health-related
Aims. To investigate health-related
Objectives. This study investigates the reporting of health-related
Aims. Using tibial shaft fracture participants from a large, multicentre randomized controlled trial, we investigated if patient and surgical factors were associated with health-related
Aims. To identify the responsiveness, minimal clinically important difference (MCID), minimal clinical important change (MIC), and patient-acceptable symptom state (PASS) thresholds in the 36-item Short Form Health Survey questionnaire (SF-36) (v2) for each of the eight dimensions and the total score following total knee arthroplasty (TKA). Methods. There were 3,321 patients undergoing primary TKA with preoperative and one-year postoperative SF-36 scores. At one-year patients were asked how satisfied they were and “How much did the knee arthroplasty surgery improve the
Aims. To evaluate the impact of negative pressure wound therapy (NPWT) on the odds of having deep infections and health-related
Aims. A trial-based comparison of the use of resources, costs and quality
of life outcomes of arthroscopic and open surgical management for
rotator cuff tears in the United Kingdom NHS was performed using
data from the United Kingdom Rotator Cuff Study (UKUFF) randomised
controlled trial. Patients and Methods. Using data from 273 patients, healthcare-related use of resources,
costs and quality-adjusted life years (QALYs) were estimated at
12 months and 24 months after surgery on an intention-to-treat basis
with adjustment for covariates. Uncertainty about the incremental
cost-effectiveness ratio for arthroscopic versus open
management at 24 months of follow-up was incorporated using bootstrapping.
Multiple imputation methods were used to deal with missing data. Results. There were no significant differences between the arthroscopic
and open groups in terms of total mean use and cost of resources
or QALYs at any time post-operatively. Open management dominated
arthroscopic management in 59.8% of bootstrapped cost and effect
differences. The probability that arthroscopic management was cost-effective
compared with open management at a willingness-to-pay threshold
of £20 000 per QALY gained was 20.9%. Conclusion. There was no significant overall difference in the use or cost
of resources or
Aims. Surgical treatment of hip fracture is challenging; the bone is porotic and fixation failure can be catastrophic. Novel implants are available which may yield superior clinical outcomes. This study compared the clinical effectiveness of the novel X-Bolt Hip System (XHS) with the sliding hip screw (SHS) for the treatment of fragility hip fractures. Methods. We conducted a multicentre, superiority, randomized controlled trial. Patients aged 60 years and older with a trochanteric hip fracture were recruited in ten acute UK NHS hospitals. Participants were randomly allocated to fixation of their fracture with XHS or SHS. A total of 1,128 participants were randomized with 564 participants allocated to each group. Participants and outcome assessors were blind to treatment allocation. The primary outcome was the EuroQol five-dimension five-level health status (EQ-5D-5L) utility at four months. The minimum clinically important difference in utility was pre-specified at 0.075. Secondary outcomes were EQ-5D-5L utility at 12 months, mortality, residential status, mobility, revision surgery, and radiological measures. Results. Overall, 437 and 443 participants were analyzed in the primary intention-to-treat analysis in XHS and SHS treatment groups respectively. There was a mean difference of 0.029 in adjusted utility index in favour of XHS with no evidence of a difference between treatment groups (95% confidence interval -0.013 to 0.070; p = 0.175). There was no evidence of any differences between treatment groups in any of the secondary outcomes. The pattern and overall risk of adverse events associated with both treatments was similar. Conclusion. Any difference in four-month health-related
High-grade dysplastic spondylolisthesis is a disabling disorder for which many different operative techniques have been described. The aim of this study is to evaluate Scoliosis Research Society 22-item (SRS-22r) scores, global balance, and regional spino-pelvic alignment from two to 25 years after surgery for high-grade dysplastic spondylolisthesis using an all-posterior partial reduction, transfixation technique. SRS-22r and full-spine lateral radiographs were collected for the 28 young patients (age 13.4 years (SD 2.6) who underwent surgery for high-grade dysplastic spondylolisthesis in our centre (Scottish National Spinal Deformity Service) between 1995 and 2018. The mean follow-up was nine years (2 to 25), and one patient was lost to follow-up. The standard surgical technique was an all-posterior, partial reduction, and S1 to L5 transfixation screw technique without direct decompression. Parameters for segmental (slip percentage, Dubousset’s lumbosacral angle) and regional alignment (pelvic tilt, sacral slope, L5 incidence, lumbar lordosis, and thoracic kyphosis) and global balance (T1 spino-pelvic inclination) were measured. SRS-22r scores were compared between patients with a balanced and unbalanced pelvis at final follow-up.Aims
Methods
We aimed first to summarise minimal clinically important differences
(MCIDs) after total hip (THR) or knee replacement (TKR) in health-related
quality of life (HRQoL), measured using the Short-Form 36 (SF-36).
Secondly, we aimed to improve the precision of MCID estimates by
means of meta-analysis. We conducted a systematic review of English and non-English articles
using MEDLINE, the Cochrane Controlled Trials Register (1960–2011),
EMBASE (1991–2011), Web of Science, Academic Search Premier and
Science Direct. Bibliographies of included studies were searched
in order to find additional studies. Search terms included MCID
or minimal clinically important change, THR or TKR and Short-Form
36. We included longitudinal studies that estimated MCID of SF-36
after THR or TKR.Objectives
Methods