Total Joint Arthroplasties: Current Concepts of Patient Outcomes after Surgery

Jones, Chelsea; Beaupré, Lauren A; Johnston, D. W. C.; Suarez‐Almazor, María E.

doi:10.1016/j.rdc.2006.12.008

Cited by 265 publications

(201 citation statements)

References 103 publications

Supporting

Mentioning

189

Contrasting

Unclassified

Order By: Relevance

“…2007), illness perceptions after TKA are not well studied. Illness perceptions based on the self-regulatory model of Leventhal and colleagues (Leventhal et al.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Factors that can predict pain with walking, 12 months after total knee arthroplasty

Lindberg¹,

Miaskowski

Rustøen

et al. 2016

Acta Orthopaedica

View full text Add to dashboard Cite

Background and purpose — Functional limitations after total knee arthroplasty (TKA) are common. In this longitudinal study, we wanted to identify subgroups of patients with distinct trajectories of pain-related interference with walking during the first year after TKA and to determine which demographic, clinical, symptom-related, and psychological characteristics were associated with being part of this subgroup.Patients and methods — Patients scheduled for primary TKA for osteoarthritis (n = 202) completed questionnaires that evaluated perception of pain, fatigue, anxiety, depression, and illness on the day before surgery. Clinical characteristics were obtained from the medical records. Interference of pain with walking was assessed preoperatively, on postoperative day 4, and at 6 weeks, 3 months, and 12 months after TKA.Results — Using growth mixture modeling, 2 subgroups of patients were identified with distinct trajectories of pain-related interference with walking over time. Patients in the Continuous Improvement class (n = 157, 78%) had lower preoperative interference scores and reported a gradual decline in pain-related interference with walking over the first 12 months after TKA. Patients in the Recurrent Interference class (n = 45, 22%) reported a high degree of preoperative pain-related interference with walking, initial improvement during the first 3 months after TKA, and then a gradual increase—returning to preoperative levels at 12 months. Patients in the Recurrent Interference class had higher preoperative pain, fatigue, and depression scores, and poorer perception of illness than the Continuous Improvement class.Interpretation — 1 in 5 patients did not improve in pain-related interference with walking at 12 months after TKA. Future studies should test the efficacy of interventions designed to modify preoperative characteristics.

show abstract

“…2007), illness perceptions after TKA are not well studied. Illness perceptions based on the self-regulatory model of Leventhal and colleagues (Leventhal et al.…”

Section: Discussionmentioning

confidence: 99%

“…The reasons for this variability in TKA outcomes are likely to be multifactorial (Jones et al. 2007, Kauppila et al. 2011).…”

mentioning

confidence: 99%

Factors that can predict pain with walking, 12 months after total knee arthroplasty

Lindberg¹,

Miaskowski

Rustøen

et al. 2016

Acta Orthopaedica

View full text Add to dashboard Cite

show abstract

“…Total knee arthroplasty (TKA) is a highly successful procedure that alleviates pain, improves physical function, and even promotes psychological well-being in patients with advanced Researchosteoarthritis (OA) of the knee1). However, even in the absence of noticeable complications and/or problems, a considerable proportion (range, 10% to 30%) of patients who underwent TKA reports dissatisfaction with their prosthetic knees2,3,4,5,6,7,8,9).…”

Section: Introductionmentioning

confidence: 99%

Patients Still Wish for Key Improvements after Total Knee Arthroplasty

Kim¹,

Bamne

Song

et al. 2015

Knee Surg Relat Res

View full text Add to dashboard Cite

PurposeOur goals were to rigorously document and explore the interrelationships of various parameters in the aftermath of total knee arthroplasty (TKA), including patient characteristics, clinical scores, satisfaction levels, and patient-perceived improvements.Materials and MethodsA questionnaire addressing sociodemographic factors, levels of satisfaction, and "wished-for" improvements was administered to 180 patients at least 1 year post primary TKA. Both satisfaction levels and wished-for improvements were assessed through nine paired parameters. Patients responded using an 11-point visual analogue scale (VAS) and the results were summarized as mean VAS score. Correlations between clinical scores and satisfaction levels and between satisfaction levels and desired improvements were analyzed.ResultsPatient satisfaction levels were only modest (mean score, 4-7) for eight of the nine parameters, including pain relief and restoration of daily living activities, the top two ranked parameters in wished-for improvement while high-flexion activity constituted the top source of discontent. Wished-for improvement was high in seven parameters, the top three being restoration of daily living activities, pain relief, and high-flexion activity. The effects of sociodemographic factors on satisfaction levels and wished-for improvement varied. Satisfaction levels correlated positively with functional outcomes, and satisfaction in pain relief and restoration of daily living activities correlated more often and most strongly with clinical scores.ConclusionsFollowing TKA, patient satisfaction is not high for a number of issues, with improvements clearly needed in restoring daily living activities and relieving pain. Continued efforts to achieve better surgical outcomes should address patient-perceived shortcomings.

show abstract

“…There are different possible confounding factors in the perioperative setting and in the postoperative rehabilitation phase identified in several studies investigating the long-term outcome after hip and knee replacement 34–36. Factors known to be associated with improved short- and medium-term outcomes are a reduced pain level, a better physical function, general health state, emotional and social function, motivation, and self-efficacy 34.…”

Section: Discussionmentioning

confidence: 99%

The improved quality of postoperative analgesia after intrathecal morphine does not result in improved recovery and quality of life in the first 6 months after orthopedic surgery: a randomized controlled pilot study

Foadi

Karst

Frese-Gaul

et al. 2017

JPR

View full text Add to dashboard Cite

Objective In orthopedic surgery, it is well known that the use of intrathecal morphine (ITM) leads to an improved quality of postoperative analgesia. Little is known how this improved analgesia affects the long-term course after surgery. Study design A randomized, double-blind trial. Setting Academic medical center. Subjects Forty-nine patients undergoing total hip or knee replacement surgery in spinal anesthesia. Methods Patients were randomly assigned to receive either 0.1 mg (n=16) or 0.2 mg (n=16) morphine sulfate intrathecally or physiological saline (n=17) added to 3 mL 0.5% isobaric bupivacaine for spinal anesthesia. As a function of the quality of the short-term postoperative analgesia, the effect on recovery and quality of life was evaluated at various time points up to 26 weeks after surgery. Results In both ITM groups, the additionally required postoperative systemic morphine dose was significantly reduced compared with the placebo group ( P =0.004). One week after operation, patients with ITM reported significantly less pain at rest ( P =0.01) compared to the placebo group. At discharge, in comparison with the 0.1 mg ITM and placebo group, the 0.2 mg ITM group showed a higher degree of impairment regarding pain, stiffness, and physical function of the respective joint ( P =0.02). Over the further follow-up period of 6 months after surgery, recovery and the quality of life did not differ significantly between the three study groups ( P >0.2). Conclusion Morphine (0.1 mg) as adjunct to 0.5% bupivacaine for spinal anesthesia is effective to produce a pronounced postoperative analgesia with a beneficial analgesic effect up to 1 week after surgery. With this study design, the different quality of postoperative analgesia had no effect on quality of life and recovery in patients over the 6-month follow-up period. In the medium term, ITM may induce hyperalgesic effects.

show abstract

Total Joint Arthroplasties: Current Concepts of Patient Outcomes after Surgery

Cited by 265 publications

References 103 publications

Factors that can predict pain with walking, 12 months after total knee arthroplasty

Factors that can predict pain with walking, 12 months after total knee arthroplasty

Patients Still Wish for Key Improvements after Total Knee Arthroplasty

The improved quality of postoperative analgesia after intrathecal morphine does not result in improved recovery and quality of life in the first 6 months after orthopedic surgery: a randomized controlled pilot study

Contact Info

Product

Resources

About