Background: Primary knee Osteoarthritis (OA) is the commonest articular disease in middle age and elderly people. Primary total knee replacement (TKR) is a known world-wide standard and definitive treatment of primary...Background: Primary knee Osteoarthritis (OA) is the commonest articular disease in middle age and elderly people. Primary total knee replacement (TKR) is a known world-wide standard and definitive treatment of primary knee OA following failed adequate non-operative management. It is of clinical importance to assess the clinical and functional outcome of TKR to prognosticate the severity of primary knee OA. The new (2011) knee society scoring system (nKSS) is both surgeons and patients’ assessment tool for the treatment outcome of TKR. Study Design: Prospective interventional analytical study. Aim and Objective: The aim of the study was to determine early clinical and functional outcome of primary total knee replacement in patients with primary knee osteoarthritis using nKSS. The objectives were: 1) To determine the pre-operative nKSS and post operative nKSS;2) To determine relationships between pre-operative nKSS and post operative nKSS at 6 weeks, 3, 6, 9 and 12 months;3) To determine the complication rates in patients undergoing primary TKR in the study centre. Methods: A prospective interventional study of 59 patients aged 51 to 70 years who had 67 Total Knee Replacements (TKRs) participated in the study between November 2015 to June 2018 at National Orthopaedics Hospital, Lagos, Nigeria. Patients’ sociodemographic data, pre-operative and post-operative nKSS system were recorded at 6 weeks, 3, 6, 9 and 12 months during follow up. The data were analyzed using Statistical Package for Social Science (SPSS). Results: There were 41 females and 18 males (M:F = 1:2.3). There were total of 67 TKRs with 31 right TKRs, 20 left TKRs and 8 staged bilateral TKRs. The participants’ age ranged from 51 to 70 years with the mean age of 59.5 (±8.5) years. Four patients did not complete the study due to various reasons. The remaining 55 participants completed the study period with progressive improvement of their post-operative nKSS at 6 weeks, 3, 6, 9 and 12 months post-operatively when compared with pre-operative nKSS (P value 0.5). Conclusion: This study revealed improved early clinical and functional outcome of primary total knee replacement in primary knee osteoarthritis using nKSS in all the studied patients. There is no significant negative effect of lower pre-operative nKSS (and its components) on the post-operative nKSS outcome.展开更多
AIM To establish minimum clinically important difference(MCID) for measurements in an orthopaedic patient population with joint disorders.METHODS Adult patients aged 18 years and older seeking care for joint condition...AIM To establish minimum clinically important difference(MCID) for measurements in an orthopaedic patient population with joint disorders.METHODS Adult patients aged 18 years and older seeking care for joint conditions at an orthopaedic clinic took the Patient-Reported Outcomes Measurement Information System Physical Function(PROMIS~? PF) computerized adaptive test(CAT), hip disability and osteoarthritis outcome score for joint reconstruction(HOOS JR), and the knee injury and osteoarthritis outcome score for joint reconstruction(KOOS JR) from February 2014 to April 2017. MCIDs were calculated using anchorbased and distribution-based methods. Patient reports of meaningful change in function since their first clinic encounter were used as an anchor.RESULTS There were 2226 patients who participated with a mean age of 61.16(SD = 12.84) years, 41.6% male, and 89.7% Caucasian. Mean change ranged from 7.29 to 8.41 for the PROMIS~? PF CAT, from 14.81 to 19.68 for the HOOS JR, and from 14.51 to 18.85 for the KOOS JR. ROC cut-offs ranged from 1.97-8.18 for the PF CAT, 6.33-43.36 for the HOOS JR, and 2.21-8.16 for the KOOS JR. Distribution-based methods estimated MCID values ranging from 2.45 to 21.55 for the PROMIS~? PF CAT; from 3.90 to 43.61 for the HOOS JR, and from 3.98 to 40.67 for the KOOS JR. The median MCID value in the range was similar to the mean change score for each measure and was 7.9 for the PF CAT, 18.0 for the HOOS JR, and 15.1 for the KOOS JR.CONCLUSION This is the first comprehensive study providing a wide range of MCIDs for the PROMIS? PF, HOOS JR, and KOOS JR in orthopaedic patients with joint ailments.展开更多
[Objectives]To explore the effects of electroacupuncture combined with rehabilitation training on knee joint function,three-dimensional(3D)gait,and inflammatory markers in patients with knee osteoarthritis(KOA)of cold...[Objectives]To explore the effects of electroacupuncture combined with rehabilitation training on knee joint function,three-dimensional(3D)gait,and inflammatory markers in patients with knee osteoarthritis(KOA)of cold-dampness obstruction syndrome.[Methods]A total of 162 KOA patients admitted to Huadong Hospital Affiliated to Fudan University from January 2021 to May 2023 were enrolled and randomly divided into an electroacupuncture group and a control group,with 81 patients in each group.The control group received routine rehabilitation training,while the electroacupuncture group received electroacupuncture treatment in addition to the same rehabilitation training,both for 4 weeks.The efficacy,syndrome scores,Western Ontario and McMaster Universities Osteoarthritis Index(WOMAC),Lysholm Knee Score(LKS),3D gait parameters,and levels of inflammatory markers were compared between the two groups.[Results]Following treatment,the total effective rate in the electroacupuncture group was 92.59%,which was significantly higher than 77.78%observed in the control group(P<0.05).Additionally,the electroacupuncture group exhibited lower TCM syndrome scores(P<0.05),reduced WOMAC scores,and elevated LKS scores compared to the control group(P<0.05).Gait parameters,including step frequency,step speed,stride length,initial ground contact flexion angle,maximum swing phase extension angle,and support phase extension angle,were all higher in the electroacupuncture group.Additionally,the sagittal plane maximum abduction moment was lower in the electroacupuncture group.Inflammatory markers showed that interleukin-6(IL-6)and tumor necrosis factor-α(TNF-α)were lower in the electroacupuncture group,while transforming growth factor-β1(TGF-β1)was higher(P<0.05).[Conclusions]Electroacupuncture combined with rehabilitation training effectively enhances clinical efficacy,alleviates symptoms,improves knee joint mobility and walking ability,enhances knee function scores,and reduces inflammatory levels,contributing to the rapid recovery of knee joints in KOA patients.展开更多
文摘Background: Primary knee Osteoarthritis (OA) is the commonest articular disease in middle age and elderly people. Primary total knee replacement (TKR) is a known world-wide standard and definitive treatment of primary knee OA following failed adequate non-operative management. It is of clinical importance to assess the clinical and functional outcome of TKR to prognosticate the severity of primary knee OA. The new (2011) knee society scoring system (nKSS) is both surgeons and patients’ assessment tool for the treatment outcome of TKR. Study Design: Prospective interventional analytical study. Aim and Objective: The aim of the study was to determine early clinical and functional outcome of primary total knee replacement in patients with primary knee osteoarthritis using nKSS. The objectives were: 1) To determine the pre-operative nKSS and post operative nKSS;2) To determine relationships between pre-operative nKSS and post operative nKSS at 6 weeks, 3, 6, 9 and 12 months;3) To determine the complication rates in patients undergoing primary TKR in the study centre. Methods: A prospective interventional study of 59 patients aged 51 to 70 years who had 67 Total Knee Replacements (TKRs) participated in the study between November 2015 to June 2018 at National Orthopaedics Hospital, Lagos, Nigeria. Patients’ sociodemographic data, pre-operative and post-operative nKSS system were recorded at 6 weeks, 3, 6, 9 and 12 months during follow up. The data were analyzed using Statistical Package for Social Science (SPSS). Results: There were 41 females and 18 males (M:F = 1:2.3). There were total of 67 TKRs with 31 right TKRs, 20 left TKRs and 8 staged bilateral TKRs. The participants’ age ranged from 51 to 70 years with the mean age of 59.5 (±8.5) years. Four patients did not complete the study due to various reasons. The remaining 55 participants completed the study period with progressive improvement of their post-operative nKSS at 6 weeks, 3, 6, 9 and 12 months post-operatively when compared with pre-operative nKSS (P value 0.5). Conclusion: This study revealed improved early clinical and functional outcome of primary total knee replacement in primary knee osteoarthritis using nKSS in all the studied patients. There is no significant negative effect of lower pre-operative nKSS (and its components) on the post-operative nKSS outcome.
基金National Institute of Arthritis and Musculoskeletal and Skin Diseases of the National Institutes of Health,No.U01AR067138.
文摘AIM To establish minimum clinically important difference(MCID) for measurements in an orthopaedic patient population with joint disorders.METHODS Adult patients aged 18 years and older seeking care for joint conditions at an orthopaedic clinic took the Patient-Reported Outcomes Measurement Information System Physical Function(PROMIS~? PF) computerized adaptive test(CAT), hip disability and osteoarthritis outcome score for joint reconstruction(HOOS JR), and the knee injury and osteoarthritis outcome score for joint reconstruction(KOOS JR) from February 2014 to April 2017. MCIDs were calculated using anchorbased and distribution-based methods. Patient reports of meaningful change in function since their first clinic encounter were used as an anchor.RESULTS There were 2226 patients who participated with a mean age of 61.16(SD = 12.84) years, 41.6% male, and 89.7% Caucasian. Mean change ranged from 7.29 to 8.41 for the PROMIS~? PF CAT, from 14.81 to 19.68 for the HOOS JR, and from 14.51 to 18.85 for the KOOS JR. ROC cut-offs ranged from 1.97-8.18 for the PF CAT, 6.33-43.36 for the HOOS JR, and 2.21-8.16 for the KOOS JR. Distribution-based methods estimated MCID values ranging from 2.45 to 21.55 for the PROMIS~? PF CAT; from 3.90 to 43.61 for the HOOS JR, and from 3.98 to 40.67 for the KOOS JR. The median MCID value in the range was similar to the mean change score for each measure and was 7.9 for the PF CAT, 18.0 for the HOOS JR, and 15.1 for the KOOS JR.CONCLUSION This is the first comprehensive study providing a wide range of MCIDs for the PROMIS? PF, HOOS JR, and KOOS JR in orthopaedic patients with joint ailments.
基金Supported by General Program of the National Natural Science Foundation of China(81973883)Three-Year Action Plan Project for Enhancing Clinical Skills and Clinical Innovation Capabilities of Municipal Hospitals(SHDC2020CR1010A).
文摘[Objectives]To explore the effects of electroacupuncture combined with rehabilitation training on knee joint function,three-dimensional(3D)gait,and inflammatory markers in patients with knee osteoarthritis(KOA)of cold-dampness obstruction syndrome.[Methods]A total of 162 KOA patients admitted to Huadong Hospital Affiliated to Fudan University from January 2021 to May 2023 were enrolled and randomly divided into an electroacupuncture group and a control group,with 81 patients in each group.The control group received routine rehabilitation training,while the electroacupuncture group received electroacupuncture treatment in addition to the same rehabilitation training,both for 4 weeks.The efficacy,syndrome scores,Western Ontario and McMaster Universities Osteoarthritis Index(WOMAC),Lysholm Knee Score(LKS),3D gait parameters,and levels of inflammatory markers were compared between the two groups.[Results]Following treatment,the total effective rate in the electroacupuncture group was 92.59%,which was significantly higher than 77.78%observed in the control group(P<0.05).Additionally,the electroacupuncture group exhibited lower TCM syndrome scores(P<0.05),reduced WOMAC scores,and elevated LKS scores compared to the control group(P<0.05).Gait parameters,including step frequency,step speed,stride length,initial ground contact flexion angle,maximum swing phase extension angle,and support phase extension angle,were all higher in the electroacupuncture group.Additionally,the sagittal plane maximum abduction moment was lower in the electroacupuncture group.Inflammatory markers showed that interleukin-6(IL-6)and tumor necrosis factor-α(TNF-α)were lower in the electroacupuncture group,while transforming growth factor-β1(TGF-β1)was higher(P<0.05).[Conclusions]Electroacupuncture combined with rehabilitation training effectively enhances clinical efficacy,alleviates symptoms,improves knee joint mobility and walking ability,enhances knee function scores,and reduces inflammatory levels,contributing to the rapid recovery of knee joints in KOA patients.
