The Value of Patient Activity Level in the Outcome of Total Hip Arthroplasty

Beaulé, Paul E.; Dorey, F; Hoke, Ryan; LeDuff, M.; Amstutz, Harlan C.

doi:10.1016/j.arth.2005.09.004

Cited by 99 publications

(65 citation statements)

References 40 publications

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“…Lastly, we obtained a WOMAC Osteoarthritis Index (Pain, Stiffness, and Function subscales) [7], SF-12 (Mental and Physical Component subscales) [64], and the UCLA Activity Rating Scale [6] functional outcome scores for all patients. Higher scores reflect a higher level of functioning.…”

Section: Methodsmentioning

confidence: 99%

Incidence of Lateral Femoral Cutaneous Nerve Neuropraxia After Anterior Approach Hip Arthroplasty

Goulding

Beaulé

Kim

et al. 2010

Clinical Orthopaedics &Amp; Related Research

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Background Although injury to the lateral femoral cutaneous nerve (LFCN) is a known complication of anterior approaches to the hip and pelvis, no study has quantified its' incidence in anterior arthroplasty procedures. Questions/purposes We therefore defined the incidence, functional impact, and natural history of LFCN neuropraxia after an anterior approach for both hip resurfacing (HR) and primary total hip arthroplasty (THA). Methods We followed 132 patients who underwent an anterior hip approach (55 THA; 77 HR). We administered self-reported questionnaires for sensory deficits of LFCN, neuropathic pain score (DN4), visual analog scale, as well as SF-12, UCLA, and WOMAC scores at one year postoperatively. A subset of 60 patients (30 THA; 30 HR) was evaluated at two time intervals. Results One hundred seven patients (81%) reported LFCN neuropraxia with a mean severity score of 2.32/10 and a mean DN4 score of 2.42/10. Hip resurfacing had a higher incidence of neuropraxia as compared with THA: 91% versus 67%, respectively. No functional limitations were reported on SF-12, WOMAC, or UCLA scores. Of the subset of 60 patients followed over an average of 12 months, 53 (88%) reported neuropraxia at the first followup interval with only three (6%) having complete resolution at second followup. Improvement in DN4 scores was observed over time: 3.6 versus 2.5, respectively. Conclusions Although LFCN neuropraxia was a frequent complication after anterior approach THA, it did not lead to functional limitations in our patients. A decrease in symptoms occurred over time but only a small number of patients reported complete resolution. Level of Evidence Level III, therapeutic study. See Guidelines for Authors for a complete description of levels of evidence.

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Section: Methodsmentioning

confidence: 99%

Incidence of Lateral Femoral Cutaneous Nerve Neuropraxia After Anterior Approach Hip Arthroplasty

Goulding

Beaulé

Kim

et al. 2010

Clinical Orthopaedics &Amp; Related Research

Self Cite

207

145

View full text Add to dashboard Cite

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“…We did not determine the HOOS score preoperatively because it had not yet been published. The patients' level of activity was evaluated using the UCLA score [7]. The patients were asked to indicate his or her current level of activity.…”

Section: Methodsmentioning

confidence: 99%

Custom Cementless Stem Improves Hip Function in Young Patients at 15-year Followup

Flécher

Pearce

Parratte

et al. 2010

Clinical Orthopaedics &Amp; Related Research

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THA in young patients is challenging regarding restoration and survival because patients are young, active, and tend to have disturbed anatomy. We asked whether a three-dimensional custom cementless stem could restore hip function, decrease osteolysis and wear, and enhance stem survival in young patients. We retrospectively reviewed 212 patients (233 hips) younger than 50 years (mean, 40 years) at a followup of 5 to 16 years (mean, 10 years). The Merle D'Aubigné-Postel and Harris hip scores improved at last followup. No thigh pain was recorded for any of the patients; 187 of the 212 patients (88%) had full activity recovery, 206 had full range of motion, and 151 had a score greater than 80 points for all five categories of the Hip disability and Osteoarthritis Outcome score. Five patients had femoral osteolysis not associated with pain. With revision for any reason as an end point, the survivorship was 87% (range, 77%-97%) at 15 years, and considering stem revision only, the survivorship was 93% (confidence interval, 90%-97%) at 15 years. Our data compare favorably with those from series using standard cementless stems at the same followup with a high percentage of patients achieving functional restoration and a low rate of complications.

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“…Patients then completed a questionnaire regarding previous history of diabetes and prediabetes (IFG or IGT), and personal history of other ADA-designated risk factors 9 to prompt diabetes screening, including gestational diabetes, hypertension, hyperlipidemia, vascular disease, and physical inactivity, as measured by the University of California, Los Angeles (UCLA) score. 19 Patient self-reported diagnosis of DM or prediabetes was compared to anesthesia preoperative assessment for confirmation. Finally, insurance status and most recent visit to a PCP were recorded (Figure 1).…”

Section: Preoperative Clinic Visit (Visit 1)mentioning

confidence: 99%

Preoperative “NPO” as an opportunity for diabetes screening

Sheehy¹,

Benca

Glinberg

et al. 2012

Journal of Hospital Medicine

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BACKGROUND:Novel preventive care opportunities, such as in hospitalized patients, may merit further investigation in an Accountable Care Organization (ACO) model. As 40% of patients with diabetes are undiagnosed, diabetes screening is an urgent public health need. Screening fasting preoperative patients may present an effective means to identify patients who might otherwise remain undiagnosed.OBJECTIVE:To pilot an inpatient preventive care strategy for diabetes screening that would ascertain prevalence of unrecognized inpatient diabetes (DM) and impaired fasting glucose (IFG), determine reproducibility of preoperative fasting blood glucose (FBG), and establish feasibility of inpatient preventive screening.DESIGN:Prospective observational study.SETTING:Large Midwestern academic medical center.PATIENTS:Two hundred seventy‐five elective orthopedic patients with a preoperative visit between December 1, 2007 and November 30, 2008. Most patients (96.6%) had seen their primary care provider (PCP) within 12 months, and 100% were insured.MEASUREMENTS:Medical history was recorded, and hemoglobin A1C (Hgb A1C) and FBG were drawn immediately prior to surgery. Patients with preoperative FBG ≥100 mg/dL had FBG drawn 6–8 weeks postoperatively.RESULTS:Twenty‐four percent (67/275) of patients had previously unrecognized DM or IFG by virtue of 2 abnormal values. Sixty‐four percent of patients with FBG ≥100 mg/dL preoperatively remained elevated at ambulatory follow‐up. No patients with new DM or IFG had point‐of‐care glucose checks ordered or had dysglycemia mentioned on discharge summary.CONCLUSIONS:Inpatient undiagnosed DM and IFG is common, even in insured, elective surgery patients with recent primary care visits. Preoperative FBG can be used to screen, but results need to be conveyed to PCPs. Journal of Hospital Medicine 2012; © 2012 Society of Hospital Medicine

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The Value of Patient Activity Level in the Outcome of Total Hip Arthroplasty

Cited by 99 publications

References 40 publications

Incidence of Lateral Femoral Cutaneous Nerve Neuropraxia After Anterior Approach Hip Arthroplasty

Incidence of Lateral Femoral Cutaneous Nerve Neuropraxia After Anterior Approach Hip Arthroplasty

Custom Cementless Stem Improves Hip Function in Young Patients at 15-year Followup

Preoperative “NPO” as an opportunity for diabetes screening

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