Background
The incidence of fracture neck of femur (FNF) has been projected to increase significantly. This study sought to determine the recovery of preinjury functional state following operative treatment of displaced FNF.
Materials and methods
A six-month prospective cohort study was conducted at Kenyatta National Hospital (KNH) and PCEA Kikuyu Mission Hospital (KMH) between November 2008 and May 2009. Sixty patients were enrolled using a pre-tested questionnaire
.
The Western Ontario and McMaster Universities Osteoarthritis index (WOMAC) scores were used. The functional outcome measures included pain, stiffness and activities of daily living (ADL). Stratification and subgroup analysis were done especially based on age. Student's
t
-test and
χ
2
test were used for comparison between variables as appropriate with a
p
< 0.05 being considered statistically significant.
Results
Majority of the patients recruited were males (68%) with a mean age of 51.6 years. Eighty eight percent of the patients had a mean negative early functional outcome score. Hemiarthroplasty (HA) and Total Hip Arthroplasty (THA) had comparable early post-operative functional outcome while Osteosynthesis (OS) had a poorer ADL outcome. Prolonged hospital stay was associated with a poor ADL outcome (
p
= 0.020). Use of the antero-lateral approach to the hip was associated with a better ADL outcome in patients older than 50 years (
p
= 0.007).
Conclusions
At three months post-operatively, most patients have not fully recovered their pre-injury level of function and independence. Both HA and THA are associated with better early functional outcome compared to OS.
Study type
Original research.
We are presenting a case report of a 10-year-old male with a 1 year history of bilateral heel pain. Sever disease is self limiting condition of calcaneal apophysis. It is the most common cause of heel pain in the growing child. There is no documented case of this condition in this region. This case highlights the clinical features of this self limiting disorder as seen in this patient and reviews the current literature.
Objectives:
Golf has been associated with abnormal loading conditions to the knee joint due to the repetitiveness and biomechanical requirements of the golf swing. This study seeks to evaluate the prevalence and factors attributing to symptomatic knee osteoarthritis among professional golfers in Kenya.
Materials and Methods:
Participants included all professional golfers in Kenya above 18 years. Golfer’s demographics and golf-related characteristics were recorded and both knee’s function assessed using the Knee Injury and Osteoarthritis Outcome Score (KOOS). Participants with a KOOS <85% in two or more parameters underwent bilateral plain knee radiographic assessment and graded according to the Kellgren and Lawrence (K&L) classification.
Results:
Fifty participants were recruited. All male, only two were left handed, median age was 41 years (34–49). More than half were found to have a body mass index (BMI) of greater than 25 kg/m2. The average duration of active golf participation was 16.5 years (SD = 4.2). Eighteen out of 100 knees scored <85% in two parameters of the KOOS. According to the K&L, 72% had Grade 2 and above. Duration of active golf involvement (OR – 1.114) and BMI above 25 kg/m2 (OR – 1.107) were found to be positively associated with symptomatic knee osteoarthritis although not statistically significant (P = 0.289 and 0.3481).
Conclusion:
Golf presents a prevalence of symptomatic knee osteoarthritis of 18% comparable to high-impact sports. The associated factors include BMI >25 kg/m2 and longer duration of active golf participation although both not statistically significant.
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