Abstract:
BACKGROUND:Despite the overall effectiveness of total hip arthroplasty (THA), a subset of patients remain dissatisfied with their results because of persistent pain or functional limitations. It is therefore important to develop predictive tools capable of identifying patients at risk for poor outcomes before surgery. QUESTIONS/PURPOSES:The purpose of this study was to use preoperative patient-reported outcome measure (PROM) scores to predict which patients undergoing THA are most likely to experience a clinically meaningful change in functional outcome 1 year after surgery. METHODS:A retrospective cohort study design was used to evaluate preoperative and 1-year postoperative SF-12 version 2 (SF12v2) and Hip Disability and Osteoarthritis Outcome Score (HOOS) scores from 537 selected patients who underwent primary unilateral THA. Minimum clinically important differences (MCIDs) were calculated using a distribution-based method. A receiver operating characteristic analysis was used to calculate threshold values, defined as the levels at which substantial changes occurred, and their predictive ability. MCID values for HOOS and SF12v2 physical component summary (PCS) scores were calculated to be 9.1 and 4.6, respectively. We analyzed the effect of SF12v2 mental component summary (MCS) scores, which measure mental and emotional health, on SF12v2 PCS and HOOS threshold values. RESULTS:Threshold values for preoperative HOOS and PCS scores were a maximum of 51.0 (area under the curve [AUC], 0.74; p < 0.001) and 32.5 (AUC, 0.62; p < 0.001), respectively. As preoperative mental and emotional health improved, which was reflected by a higher MCS score, HOOS and PCS threshold values also increased. When preoperative mental and emotional health were taken into account, both HOOS and PCS threshold values' predictive ability improved (AUCs increased to 0.77 and 0.69, respectively). CONCLUSIONS:We identified PROM threshold values that predict clinically meaningful improvements in functional outcome after THA. Patients with a higher level of preoperative function, as suggested by HOOS or PCS scores above the defined threshold values, are less likely to obtain meaningful improvement after THA. Lower preoperative mental and emotional health decreases the likelihood of achieving a clinically meaningful improvement in function after THA. The results of this study may be used to facilitate discussion between physicians and patients regarding the expected benefit after THA and to support the development of patient-based informed decision-making tools. For example, despite significant disease, patients with high preoperative function, as measured by PROM scores, may choose to delay surgery given the low likelihood of experiencing a meaningful improvement postoperatively. Similarly, patients with notably low MCS scores might best be counseled to address mental health issues before embarking on surgery. LEVEL OF EVIDENCE:Level III, prognostic study.
journal_name
Clin Orthop Relat Resjournal_title
Clinical orthopaedics and related researchauthors
Berliner JL,Brodke DJ,Chan V,SooHoo NF,Bozic KJdoi
10.1007/s11999-015-4350-6subject
Has Abstractpub_date
2016-02-01 00:00:00pages
321-9issue
2eissn
0009-921Xissn
1528-1132pii
10.1007/s11999-015-4350-6journal_volume
474pub_type
杂志文章abstract::Thirty-eight total knee arthroplasties in 36 patients were studied at 4 +/- 2 (mean, +/- SD) years follow-up evaluation. The Hospital for Special Surgery knee score improved from 59 +/- 9 (mean, +/- SD) before surgery to 83 +/- 11 (mean, +/- SD) (p less than 0.0001) at last evaluation. Good or excellent results were a...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:
更新日期:1991-12-01 00:00:00
abstract::Titanium implants are an alternative to stainless steel implants for internal fixation after fracture. The advantages of titanium include decreased implant stiffness, increased bio-compatibility, and diminished stress shielding. However, titanium has been implicated in tendon irritation and adhesions when used in the ...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:10.1097/01.blo.0000205894.98361.29
更新日期:2006-04-01 00:00:00
abstract::The bone mineral content in the shafts of the forearm in 17 women with cervical fracture of the upper end of the femur was low. The cortex of the femoral neck was also lower than normal. Thus women with hip fractures at an early age may have lower than average total skeletal tissue density. This may be due not simply ...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:
更新日期:1977-05-01 00:00:00
abstract::Avulsion of the navicular tuberosity in association with fracture at the calcanecuboid joint is a characteristic pattern of injury resulting from an acute valgus and dorsiflexion stress. Only 22 cases of this unusual injury pattern have been reported, and confusion exists regarding treatment. Recommendations for manag...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章,评审
doi:
更新日期:1993-07-01 00:00:00
abstract::Marlex mesh is a synthetic material which has been used clinically to replace ligamentous structures. It serves as a scaffold for infiltration of the fibroblasts eventually becoming mature fibrocytes. In dogs, almost totally mature fibrocytes appear within the framework of the Marlex mesh prosthesis by the end of 3 mo...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:
更新日期:1978-11-01 00:00:00
abstract:BACKGROUND:Management of the cuff-deficient arthritic shoulder has long been challenging. Early unconstrained shoulder arthroplasty systems were associated with high complication and implant failure rates. The evolution toward the modern reverse shoulder arthroplasty includes many variables of constrained shoulder arth...
journal_title:Clinical orthopaedics and related research
pub_type: 历史文章,杂志文章
doi:10.1007/s11999-010-1733-6
更新日期:2011-09-01 00:00:00
abstract::Development leading to local bone differentiation in response to intramuscular and subcutaneous implantation of demineralized bone matrix has been predominantly investigated in rodents. To investigate bone differentiation by induction in primates, diaphyseal bone was harvested from ten male baboons and chemosterilized...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:
更新日期:1991-08-01 00:00:00
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journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:10.1007/s11999-010-1598-8
更新日期:2011-01-01 00:00:00
abstract::A technique for ipsilateral femoral neck and shaft fracture using the sliding compression hip screw with plate combined with trochanteric antegrade Ender nailing of the femur was applied in two cases. Ender nails can be passed without difficulty past a compression hip screw and the bicortical plating screws. The hip a...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:
更新日期:1986-12-01 00:00:00
abstract:BACKGROUND:To improve ankle stability in patients who have experienced an ankle sprain with residual symptoms of instability and/or objective joint laxity, external supports (such as taping, bracing, and orthotic insoles) are used sometimes. However, available randomized trials have disagreed on whether restraints impr...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章,meta分析
doi:10.1097/CORR.0000000000000946
更新日期:2020-02-01 00:00:00
abstract:BACKGROUND:Lisfranc (tarsometatarsal joint) injuries are relatively rare, accounting for less than 1% of all fractures, and as many as 20% of subtle Lisfranc injuries are missed at the initial patient presentation. An undiagnosed Lisfranc injury can have devastating consequences to the patient. Therefore, any factor th...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:10.1007/s11999-016-5131-6
更新日期:2017-05-01 00:00:00
abstract::A ball-and-socket joint is an unusual disturbance of normal ankle development. Previous reports have noted good function and the absence of osteoarthritic change in ankles with this configuration. A 50-year-old man with no history of injury developed an osteoarthritic ball-and-socket deformity of the ankle joint. Asso...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:
更新日期:1987-02-01 00:00:00
abstract::To study the revascularization pattern of nontraumatic osteonecrosis, superselective angiography of the femoral medical circumflex artery was done twice on 13 hips for which no treatment had been given. Angiographic evaluation of the hips with early-stage osteonecrosis not visible on radiographs showed the absence of ...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:10.1097/00003086-199604000-00019
更新日期:1996-04-01 00:00:00
abstract::The standard of care for femoral fractures is an intramedullary nail, placed in an antegrade approach. This has produced high rates of healing and low complication rates. The use of retrograde nailing for femoral shaft fractures is a relatively new technique, previously described as an extraarticular approach. Forty-o...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:10.1097/00003086-199611000-00013
更新日期:1996-11-01 00:00:00
abstract:BACKGROUND:Bone cancer pain is very common, and patients with this type of pain may be difficult to treat. Development of an experimental model for studying this condition is critical to advancing an understanding of the mechanisms that cause pain in patients with malignant disease. METHODS:A murine model of bone canc...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章,评审
doi:10.1097/01.blo.0000093059.96273.56
更新日期:2003-10-01 00:00:00
abstract::For stabilization of the lower thoracic and lumbar spine, an external spinal skeletal fixation (ESSF) system has been developed and clinically used since 1977. The system consists of two pairs of Schanz screws and an adjustable external fixation device. The Schanz screws are firmly anchored through the pedicles into t...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:
更新日期:1984-10-01 00:00:00
abstract::Previous studies from this laboratory have established the presence of estrogen receptors in the human anterior cruciate ligament. The purpose of this study was to investigate the effects of 17 beta-estradiol on cell proliferation and procollagen levels, as an indicator of collagen synthesis, in the human anterior cru...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:10.1097/00003086-199909000-00030
更新日期:1999-09-01 00:00:00
abstract::This biographical sketch on Themistocles Gluck corresponds to the historic text, The Classic: Report on the positive results obtained by the modern surgical experiment regarding the suture and replacement of defects of superior tissue, as well as the utilization of re-absorbable and living tamponade in surgery (1891),...
journal_title:Clinical orthopaedics and related research
pub_type: 传,历史文章
doi:10.1007/s11999-011-1836-8
更新日期:2011-06-01 00:00:00
abstract:BACKGROUND:Hybrid revision knee component fixation, in which cement is placed in the metaphysis combined with a cementless diaphyseal engaging stem, provides ease of insertion, possibly improved component alignment, and easier removal if required, compared with fully cemented prostheses. The literature suggests the tec...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:10.1007/s11999-010-1569-0
更新日期:2011-03-01 00:00:00
abstract::The literature on the biomechanics of the intervertebral disk is reviewed with emphasis on biomechanical--biochemical--morphological correlative studies. The deficiency of definitive correlative studies is apparent and an appeal is made to interested investigators to fill in the voids in this extremely important area ...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章,评审
doi:10.1097/00003086-197711000-00015
更新日期:1977-11-01 00:00:00
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journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:10.1007/s11999-009-1111-4
更新日期:2010-04-01 00:00:00
abstract::The purpose of the current study was to evaluate the long-term results of the Kinematic I condylar prosthesis with retention of the posterior cruciate ligament. One hundred sixty-eight total knee arthroplasties in 118 patients (mean age, 65.2 years; range, 21-88 years) were inserted with cement, an all-polyethylene pa...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:10.1097/00003086-200107000-00007
更新日期:2001-07-01 00:00:00
abstract::We review a series of empirical studies on the use of simulators and bench models in training technical skills and subsequent retention of those skills. We discuss recent research on the transfer of training from bench models and simulators to the clinical setting and provide a theoretical structure to organize the fi...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章,评审
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更新日期:2006-08-01 00:00:00
abstract::Lauge-Hansen's system of classification of ankle fractures has been of pioneering importance and when correctly employed has improved the results of conservative treatment. Weber's classification scheme introduced by AO is simpler and more suited for surgical than nonoperative therapy. Both systems have deficiencies. ...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:
更新日期:1985-10-01 00:00:00
abstract::Loading of the lunate in patients with Kienböck's disease and a negative ulnar variance provide the rationale for a radial shortening osteotomy. This osteotomy decreases forces transmitted from the radius to the lunate. We retrospectively reviewed 12 patients with Kienböck's disease who had 13 radial shortening osteot...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:10.1097/BLO.0b013e318041d309
更新日期:2007-07-01 00:00:00
abstract::By the use of modern techniques, the nature of the immunological response to bone and cartilage grafts is becoming clear. Fresh bone, whether cancellous or cortical, will elicit a cell-mediated immunological response; removal of the bone marrow has little effect in reducing immunogenicity. Antibodies against cellular ...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:
更新日期:1976-10-01 00:00:00
abstract::The wear of high molecular weight polyethylene sockets was measured on radiographs, over a period of 9 to 10 years, in a group of patients whose ages averaged 73.3 years at the end of the period. The average rate of wear was 0.15 mm/year and 68 per cent of patients followed this pattern. Wear more than 2.5 mm in 10 ye...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:
更新日期:1975-10-01 00:00:00
abstract:BACKGROUND:Revision THA to treat recurrent instability can itself be complicated by recurrent instability, and when this occurs, this problem is difficult to treat. Some patients' THAs will continue to dislocate despite use of a constrained liner. One option in this difficult-to-treat group is conversion to a dual-mobi...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:10.1007/s11999.0000000000000026
更新日期:2018-02-01 00:00:00
abstract::A long-term clinical study of 41 Flatt metallic hinged prostheses inserted in the metacarpophalangeal joints of ten rheumatoid patients was completed to provide a historic and clinical perspective of the ongoing clinical performance of this prosthesis. Postsurgical analysis performed an average of 138 months after ope...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:
更新日期:1984-04-01 00:00:00
abstract:BACKGROUND:Kyphosis in myelomeningocele is a rare and difficult problem. Many strategies have been used with no single procedure universally agreed on. Techniques involving anterior and posterior fixation may provide better fusion. QUESTIONS/PURPOSES:We describe a novel procedure for anteroposterior kyphectomy in pati...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:10.1007/s11999-010-1611-2
更新日期:2011-05-01 00:00:00