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Ashley W Blom - One of the best experts on this subject based on the ideXlab platform.
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PAIN AND FUNCTION RECOVERY TRAJECTORIES FOLLOWING Revision Hip Arthroplasty: SHORT-TERM CHANGES AND COMPARISON WITH PRIMARY Hip Arthroplasty IN THE ADAPT COHORT STUDY
2018Co-Authors: Erik Lenguerrand, Michael R Whitehouse, Vikki Wylde, Rachael Gooberman-hill, Ashley W BlomAbstract:Patients report similar or better pain and function before Revision Hip Arthroplasty than before primary Arthroplasty but poorer outcomes after Revision surgery. The trajectory of post-operative re...
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pain and function recovery trajectories following Revision Hip Arthroplasty short term changes and comparison with primary Hip Arthroplasty in the adapt cohort study
Orthopaedic Proceedings, 2018Co-Authors: Erik Lenguerrand, Michael R Whitehouse, Vikki Wylde, Rachael Goobermanhill, Ashley W BlomAbstract:Patients report similar or better pain and function before Revision Hip Arthroplasty than before primary Arthroplasty but poorer outcomes after Revision surgery. The trajectory of post-operative recovery during the first 12 months and any differences by type of surgery have received little attention. We explored the trajectories of change in pain and function after Revision Hip Arthroplasty to 12-months post-operatively and compared them with those observed after primary Hip Arthroplasty.We conducted a single-centre UK cohort study of patients undergoing primary (n = 80) or Revision (n = 43) Hip Arthroplasty. WOMAC pain and function scores and 20-metres walking time were collected pre-operatively, at 3 and 12-months post-operatively. Multilevel regression models were used to chart and compare the trajectories of post-operative change (0–3 months and 3–12 months) between the types of surgery.Patients undergoing primary Arthroplasty had a total Hip replacement (n=74) or Hip resurfacing (n=6). Osteoarthritis...
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pain and function recovery trajectories following Revision Hip Arthroplasty short term changes and comparison with primary Hip Arthroplasty in the adapt cohort study
Journal of Bone and Joint Surgery-british Volume, 2017Co-Authors: Erik Lenguerrand, Michael R Whitehouse, Vikki Wylde, Rachael Goobermanhill, Ashley W BlomAbstract:Patients report similar or better pain and function before Revision Hip Arthroplasty than before primary Arthroplasty but poorer outcomes after Revision surgery. The trajectory of post-operative recovery during the first 12 months and any differences by type of surgery have received little attention. We explored the trajectories of change in pain and function after Revision Hip Arthroplasty to 12-months post-operatively and compared them with those observed after primary Hip Arthroplasty. We conducted a single-centre UK cohort study of patients undergoing primary (n = 80) or Revision (n = 43) Hip Arthroplasty. WOMAC pain and function scores and 20-metres walking time were collected pre-operatively, at 3 and 12-months post-operatively. Multilevel regression models were used to chart and compare the trajectories of post-operative change (0–3 months and 3–12 months) between the types of surgery. Patients undergoing primary Arthroplasty had a total Hip replacement (n=74) or Hip resurfacing (n=6). Osteoarthritis was the indication for surgery in 92% of primary cases. Patients undergoing Revision Arthroplasty had Revision of a total Hip Arthroplasty (n=37), hemiArthroplasty (n=2) or Hip resurfacing (n=4). The most common indication for Revision Arthroplasty was aseptic loosening (n=29); the remaining indications were pain (n=4), aseptic lymphocyte-dominated vasculitis-associated lesion (n=4) or other reasons (n=6). Primary (87%) and Revision arthroplasties (98%) were mostly commonly performed via a posterior surgical approach. The improvements in pain and function following Revision Arthroplasty occurred within the first 3-months following operation (WOMAC-pain, p 0.05) While the pattern of recovery after Revision Arthroplasty was similar to that observed after primary Arthroplasty, improvements in the first 3-months were smaller after Revision compared to primary Arthroplasty (p Patients undergoing Revision Hip Arthroplasty should be informed that the majority of their improvement will occur in the first 3-months following surgery and that the expected improvement will be less marked than that experienced following primary surgery. More research is now required to 1.) identify whether specific in-patient and post-discharge rehabilitation tailored towards patients undergoing Revision Arthroplasty would improve or achieve equivalent outcomes to primary surgery and 2.) whether patients who are achieving limited improvements at 3-months post-operative would benefit from more intensive rehabilitation. This will become all the more important with the increasing volume of Revision surgery and the high expectations of patients who aspire to a disease-free and active life.
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pain and function recovery trajectories following Revision Hip Arthroplasty short term changes and comparison with primary Hip Arthroplasty in the adapt cohort study
PLOS ONE, 2016Co-Authors: Erik Lenguerrand, Michael R Whitehouse, Vikki Wylde, Rachael Goobermanhill, Ashley W BlomAbstract:Background and Purpose Patients report similar or better pain and function before Revision Hip Arthroplasty than before primary Arthroplasty but worse results are reported after Revision surgery than after primary surgery. The trajectory of post-operative recovery during the first months and any differences by type of surgery have received little attention. We explored the trajectories of change in pain and function after Revision Hip Arthroplasty to 12-months post-operatively and compare them with those observed after primary Hip Arthroplasty. Methods This study is a prospective cohort study of patients undergoing primary (n = 80 with 92% for an indication of osteoarthritis) and Revision (n = 43) Hip arthroplasties. WOMAC pain and function scores and walking speed were collected pre-operatively, at 3 and 12-months post-operatively. Multilevel regression models were used to chart and compare the trajectories of change (0–3 months and 3–12 months) between types of surgery. Results The improvements in pain and function following Revision Arthroplasty occurred within the first 3-months with no evidence of further change beyond this initial period. While the pattern of recovery was similar to the one observed after primary Arthroplasty, improvements in the first 3-months were smaller after Revision compared to primary Arthroplasty. Patients listed for Revision surgery reported lower pre-operative pain levels but similar post-operative levels compared to those undergoing primary surgery. At 12-months post-operation patients who underwent a Revision Arthroplasty had not reached the same level of function achieved by those who underwent primary Arthroplasty. Conclusion The post-operative improvements in pain and function are larger following primary Hip Arthroplasty than following Revision Hip Arthroplasty. Irrespectively of surgery type, most of the improvements occur in the first three post-operative months. More research is required to identify whether the recovery following Revision surgery could be improved with specific post-operative interventions.
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The Use of Ceramics as Bone Substitutes in Revision Hip Arthroplasty
Materials, 2009Co-Authors: Michael R Whitehouse, Ashley W BlomAbstract:The number of grafting procedures, including those performed in primary and Revision Hip Arthroplasty, continues to rise around the world. Demand for musculoskeletal donor tissue now outstrips supply. There is no single bone substitute that is ideal for all circumstances. Bone substitutes act as a scaffold and are usually osteoconductive. They are rarely osteoinductive; if they are, a molecular bond is formed between the graft and host bone, improving fixation and longevity. Bone graft substitutes are very rarely osteogenic. There is a growing body of clinical evidence supporting the use of bone graft substitutes in vivo for complex Hip Arthroplasty.
Michael R Whitehouse - One of the best experts on this subject based on the ideXlab platform.
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PAIN AND FUNCTION RECOVERY TRAJECTORIES FOLLOWING Revision Hip Arthroplasty: SHORT-TERM CHANGES AND COMPARISON WITH PRIMARY Hip Arthroplasty IN THE ADAPT COHORT STUDY
2018Co-Authors: Erik Lenguerrand, Michael R Whitehouse, Vikki Wylde, Rachael Gooberman-hill, Ashley W BlomAbstract:Patients report similar or better pain and function before Revision Hip Arthroplasty than before primary Arthroplasty but poorer outcomes after Revision surgery. The trajectory of post-operative re...
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pain and function recovery trajectories following Revision Hip Arthroplasty short term changes and comparison with primary Hip Arthroplasty in the adapt cohort study
Orthopaedic Proceedings, 2018Co-Authors: Erik Lenguerrand, Michael R Whitehouse, Vikki Wylde, Rachael Goobermanhill, Ashley W BlomAbstract:Patients report similar or better pain and function before Revision Hip Arthroplasty than before primary Arthroplasty but poorer outcomes after Revision surgery. The trajectory of post-operative recovery during the first 12 months and any differences by type of surgery have received little attention. We explored the trajectories of change in pain and function after Revision Hip Arthroplasty to 12-months post-operatively and compared them with those observed after primary Hip Arthroplasty.We conducted a single-centre UK cohort study of patients undergoing primary (n = 80) or Revision (n = 43) Hip Arthroplasty. WOMAC pain and function scores and 20-metres walking time were collected pre-operatively, at 3 and 12-months post-operatively. Multilevel regression models were used to chart and compare the trajectories of post-operative change (0–3 months and 3–12 months) between the types of surgery.Patients undergoing primary Arthroplasty had a total Hip replacement (n=74) or Hip resurfacing (n=6). Osteoarthritis...
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pain and function recovery trajectories following Revision Hip Arthroplasty short term changes and comparison with primary Hip Arthroplasty in the adapt cohort study
Journal of Bone and Joint Surgery-british Volume, 2017Co-Authors: Erik Lenguerrand, Michael R Whitehouse, Vikki Wylde, Rachael Goobermanhill, Ashley W BlomAbstract:Patients report similar or better pain and function before Revision Hip Arthroplasty than before primary Arthroplasty but poorer outcomes after Revision surgery. The trajectory of post-operative recovery during the first 12 months and any differences by type of surgery have received little attention. We explored the trajectories of change in pain and function after Revision Hip Arthroplasty to 12-months post-operatively and compared them with those observed after primary Hip Arthroplasty. We conducted a single-centre UK cohort study of patients undergoing primary (n = 80) or Revision (n = 43) Hip Arthroplasty. WOMAC pain and function scores and 20-metres walking time were collected pre-operatively, at 3 and 12-months post-operatively. Multilevel regression models were used to chart and compare the trajectories of post-operative change (0–3 months and 3–12 months) between the types of surgery. Patients undergoing primary Arthroplasty had a total Hip replacement (n=74) or Hip resurfacing (n=6). Osteoarthritis was the indication for surgery in 92% of primary cases. Patients undergoing Revision Arthroplasty had Revision of a total Hip Arthroplasty (n=37), hemiArthroplasty (n=2) or Hip resurfacing (n=4). The most common indication for Revision Arthroplasty was aseptic loosening (n=29); the remaining indications were pain (n=4), aseptic lymphocyte-dominated vasculitis-associated lesion (n=4) or other reasons (n=6). Primary (87%) and Revision arthroplasties (98%) were mostly commonly performed via a posterior surgical approach. The improvements in pain and function following Revision Arthroplasty occurred within the first 3-months following operation (WOMAC-pain, p 0.05) While the pattern of recovery after Revision Arthroplasty was similar to that observed after primary Arthroplasty, improvements in the first 3-months were smaller after Revision compared to primary Arthroplasty (p Patients undergoing Revision Hip Arthroplasty should be informed that the majority of their improvement will occur in the first 3-months following surgery and that the expected improvement will be less marked than that experienced following primary surgery. More research is now required to 1.) identify whether specific in-patient and post-discharge rehabilitation tailored towards patients undergoing Revision Arthroplasty would improve or achieve equivalent outcomes to primary surgery and 2.) whether patients who are achieving limited improvements at 3-months post-operative would benefit from more intensive rehabilitation. This will become all the more important with the increasing volume of Revision surgery and the high expectations of patients who aspire to a disease-free and active life.
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pain and function recovery trajectories following Revision Hip Arthroplasty short term changes and comparison with primary Hip Arthroplasty in the adapt cohort study
PLOS ONE, 2016Co-Authors: Erik Lenguerrand, Michael R Whitehouse, Vikki Wylde, Rachael Goobermanhill, Ashley W BlomAbstract:Background and Purpose Patients report similar or better pain and function before Revision Hip Arthroplasty than before primary Arthroplasty but worse results are reported after Revision surgery than after primary surgery. The trajectory of post-operative recovery during the first months and any differences by type of surgery have received little attention. We explored the trajectories of change in pain and function after Revision Hip Arthroplasty to 12-months post-operatively and compare them with those observed after primary Hip Arthroplasty. Methods This study is a prospective cohort study of patients undergoing primary (n = 80 with 92% for an indication of osteoarthritis) and Revision (n = 43) Hip arthroplasties. WOMAC pain and function scores and walking speed were collected pre-operatively, at 3 and 12-months post-operatively. Multilevel regression models were used to chart and compare the trajectories of change (0–3 months and 3–12 months) between types of surgery. Results The improvements in pain and function following Revision Arthroplasty occurred within the first 3-months with no evidence of further change beyond this initial period. While the pattern of recovery was similar to the one observed after primary Arthroplasty, improvements in the first 3-months were smaller after Revision compared to primary Arthroplasty. Patients listed for Revision surgery reported lower pre-operative pain levels but similar post-operative levels compared to those undergoing primary surgery. At 12-months post-operation patients who underwent a Revision Arthroplasty had not reached the same level of function achieved by those who underwent primary Arthroplasty. Conclusion The post-operative improvements in pain and function are larger following primary Hip Arthroplasty than following Revision Hip Arthroplasty. Irrespectively of surgery type, most of the improvements occur in the first three post-operative months. More research is required to identify whether the recovery following Revision surgery could be improved with specific post-operative interventions.
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The Use of Ceramics as Bone Substitutes in Revision Hip Arthroplasty
Materials, 2009Co-Authors: Michael R Whitehouse, Ashley W BlomAbstract:The number of grafting procedures, including those performed in primary and Revision Hip Arthroplasty, continues to rise around the world. Demand for musculoskeletal donor tissue now outstrips supply. There is no single bone substitute that is ideal for all circumstances. Bone substitutes act as a scaffold and are usually osteoconductive. They are rarely osteoinductive; if they are, a molecular bond is formed between the graft and host bone, improving fixation and longevity. Bone graft substitutes are very rarely osteogenic. There is a growing body of clinical evidence supporting the use of bone graft substitutes in vivo for complex Hip Arthroplasty.
Clive P. Duncan - One of the best experts on this subject based on the ideXlab platform.
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femoral Revision Hip Arthroplasty a comparison of two stem designs
Clinical Orthopaedics and Related Research, 2010Co-Authors: Corey J Richards, Clive P. Duncan, Bassam A. Masri, Donald S. GarbuzAbstract:For various reasons the tapered, fluted, modular titanium (TFMT) stem has become our component of choice over cylindrical, nonmodular cobalt chrome (CNCC) components for THA Revision. We therefore asked whether the TFMT femoral components better achieved three important goals of Revision Arthroplasty than CNCC stems: (1) improving quality of life; (2) avoiding complications; and (3) preserving or restoring femoral bone stock. We compared patients undergoing femoral component Revision Hip Arthroplasty with either a CNCC (N = 105) component or a TFMT (N = 95) component to determine if the increased use of TFMT components is justified. We retrospectively reviewed all patients undergoing Revision total Hip Arthroplasty between January 2000 and March 2006. All eligible patients completed outcome questionnaires (WOMAC, SF-12, Oxford-12, UCLA Activity Score, and Satisfaction Scores). Radiographs were evaluated for loosening and preservation or restoration of the proximal femur host bone. The TFMT and CNCC cohorts were comparable with respect to age, gender, diagnosis, and comorbidities. The TFMT cohort had worse preoperative bone defects (65% Paprosky 3B and 4). The TFMT cohort had higher outcome scores (WOMAC pain, WOMAC stiffness, Oxford-12, and Satisfaction), fewer intraoperative fractures, and better restoration of the proximal femur host bone. Our data suggest the TFMT stem provided improved clinical outcomes (improved quality of life, decreased complications, and preservation of bone stock) than the CNCC stem. Level of Evidence: Level III, therapeutic study. See Guidelines for Authors for a complete description of levels of evidence.
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THE EXPECTATIONS OF PATIENTS UNDERGOING Revision Hip Arthroplasty
2003Co-Authors: Fares S. Haddad, Donald S. Garbuz, G. K. Chambers, T. J. Jagpal, Bassam A. Masri, Clive P. DuncanAbstract:This study was performed to assess the relationsHip between patients’ pre-operative symptoms and their expectations at the time of Revision Hip Arthroplasty. The WOMAC (Western Ontario and McMaster Osteoarthritis Index) scale for osteoarthritis of the Hip and the Short Form 36 (SF-36) general health status scale have both been validated for the assessment of the outcome of Hip Arthroplasty. We prospectively assessed 60 patients using these scales as well as the “expectation WOMAC” that asked the patients to estimate how they expected to feel 6 months after Revision Hip replacement. All the questions were completed prior to informed consent, and were scored form 1 to 5 with increasing severity with a Likert scale. The maximum possible scores for pain, stiffness and difficulty with physical activity were therefore 25, 10 and 85 respectively. The mean preoperative WOMAC score for pain was 13.4 (CI 12.2.-14.6), for stiffness 5.9 (CI 5.6-6.2) and for physical activity 50.9 (CI 47.2-54.6) The mean expectation WOMAC scores for these modalities were 7.4 (CI 6.2-8.6), 3.5 (CI 3.0-4.0) and 28.1 (CI 24.0-32.2.) respectively. Although there was a wide spread of expectations, we were unable to find any significant correlation between the patients’ preoperative pain and The abstracts were prepared by Mr Simon Donell. Correspondence should be addressed to him at the Department of Orthopaedics, Norfolk & Norwich Hospital, Level 4, Centre Block, Colney Lane, Norwich NR4 7UY, United Kingdom. stiffness levels and their expectations for pain and stiffness after Revision Hip Arthroplasty. There was however a statistical association between their preoperative difficulty with physical activity and their expectations for physical activity (r=0.38; p=0.02) There was no significant correlation between the SF-36 scores and the patients’ expectations. The expectations of patients awaiting Revision Hip replacements are high, and do not appear to be closely related to their level of pre-operative disability. Even patients with severe symptoms have high expectations that in some cases may be unrealistic. The use of the “expectation WOMAC” may help us to identify such patients, and to improve patient education and satisfaction.
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The expectations of patients undergoing Revision Hip Arthroplasty.
The Journal of arthroplasty, 2001Co-Authors: Fares S. Haddad, Donald S. Garbuz, G. K. Chambers, T. J. Jagpal, Bassam A. Masri, Clive P. DuncanAbstract:Sixty patients were prospectively assessed using the Western Ontario and McMaster Osteoarthritis Index (WOMAC) scale for osteoarthritis of the Hip and the Short Form 36 (SF-36) general health status scale as well as the expectation WOMAC, which asked patients to estimate how they expected to feel 6 months after Revision Hip Arthroplasty. There was a wide range of expectations, but we were unable to find any significant correlation between the patients' preoperative pain and stiffness levels and their expectations for pain and stiffness after Revision Hip Arthroplasty. There was no significant correlation between the SF-36 scores and the patients' expectations. Our findings suggest that the expectations of patients awaiting Revision Hip arthroplasties are high and are not related closely to the level of preoperative disability.
Erik Lenguerrand - One of the best experts on this subject based on the ideXlab platform.
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PAIN AND FUNCTION RECOVERY TRAJECTORIES FOLLOWING Revision Hip Arthroplasty: SHORT-TERM CHANGES AND COMPARISON WITH PRIMARY Hip Arthroplasty IN THE ADAPT COHORT STUDY
2018Co-Authors: Erik Lenguerrand, Michael R Whitehouse, Vikki Wylde, Rachael Gooberman-hill, Ashley W BlomAbstract:Patients report similar or better pain and function before Revision Hip Arthroplasty than before primary Arthroplasty but poorer outcomes after Revision surgery. The trajectory of post-operative re...
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pain and function recovery trajectories following Revision Hip Arthroplasty short term changes and comparison with primary Hip Arthroplasty in the adapt cohort study
Orthopaedic Proceedings, 2018Co-Authors: Erik Lenguerrand, Michael R Whitehouse, Vikki Wylde, Rachael Goobermanhill, Ashley W BlomAbstract:Patients report similar or better pain and function before Revision Hip Arthroplasty than before primary Arthroplasty but poorer outcomes after Revision surgery. The trajectory of post-operative recovery during the first 12 months and any differences by type of surgery have received little attention. We explored the trajectories of change in pain and function after Revision Hip Arthroplasty to 12-months post-operatively and compared them with those observed after primary Hip Arthroplasty.We conducted a single-centre UK cohort study of patients undergoing primary (n = 80) or Revision (n = 43) Hip Arthroplasty. WOMAC pain and function scores and 20-metres walking time were collected pre-operatively, at 3 and 12-months post-operatively. Multilevel regression models were used to chart and compare the trajectories of post-operative change (0–3 months and 3–12 months) between the types of surgery.Patients undergoing primary Arthroplasty had a total Hip replacement (n=74) or Hip resurfacing (n=6). Osteoarthritis...
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pain and function recovery trajectories following Revision Hip Arthroplasty short term changes and comparison with primary Hip Arthroplasty in the adapt cohort study
Journal of Bone and Joint Surgery-british Volume, 2017Co-Authors: Erik Lenguerrand, Michael R Whitehouse, Vikki Wylde, Rachael Goobermanhill, Ashley W BlomAbstract:Patients report similar or better pain and function before Revision Hip Arthroplasty than before primary Arthroplasty but poorer outcomes after Revision surgery. The trajectory of post-operative recovery during the first 12 months and any differences by type of surgery have received little attention. We explored the trajectories of change in pain and function after Revision Hip Arthroplasty to 12-months post-operatively and compared them with those observed after primary Hip Arthroplasty. We conducted a single-centre UK cohort study of patients undergoing primary (n = 80) or Revision (n = 43) Hip Arthroplasty. WOMAC pain and function scores and 20-metres walking time were collected pre-operatively, at 3 and 12-months post-operatively. Multilevel regression models were used to chart and compare the trajectories of post-operative change (0–3 months and 3–12 months) between the types of surgery. Patients undergoing primary Arthroplasty had a total Hip replacement (n=74) or Hip resurfacing (n=6). Osteoarthritis was the indication for surgery in 92% of primary cases. Patients undergoing Revision Arthroplasty had Revision of a total Hip Arthroplasty (n=37), hemiArthroplasty (n=2) or Hip resurfacing (n=4). The most common indication for Revision Arthroplasty was aseptic loosening (n=29); the remaining indications were pain (n=4), aseptic lymphocyte-dominated vasculitis-associated lesion (n=4) or other reasons (n=6). Primary (87%) and Revision arthroplasties (98%) were mostly commonly performed via a posterior surgical approach. The improvements in pain and function following Revision Arthroplasty occurred within the first 3-months following operation (WOMAC-pain, p 0.05) While the pattern of recovery after Revision Arthroplasty was similar to that observed after primary Arthroplasty, improvements in the first 3-months were smaller after Revision compared to primary Arthroplasty (p Patients undergoing Revision Hip Arthroplasty should be informed that the majority of their improvement will occur in the first 3-months following surgery and that the expected improvement will be less marked than that experienced following primary surgery. More research is now required to 1.) identify whether specific in-patient and post-discharge rehabilitation tailored towards patients undergoing Revision Arthroplasty would improve or achieve equivalent outcomes to primary surgery and 2.) whether patients who are achieving limited improvements at 3-months post-operative would benefit from more intensive rehabilitation. This will become all the more important with the increasing volume of Revision surgery and the high expectations of patients who aspire to a disease-free and active life.
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pain and function recovery trajectories following Revision Hip Arthroplasty short term changes and comparison with primary Hip Arthroplasty in the adapt cohort study
PLOS ONE, 2016Co-Authors: Erik Lenguerrand, Michael R Whitehouse, Vikki Wylde, Rachael Goobermanhill, Ashley W BlomAbstract:Background and Purpose Patients report similar or better pain and function before Revision Hip Arthroplasty than before primary Arthroplasty but worse results are reported after Revision surgery than after primary surgery. The trajectory of post-operative recovery during the first months and any differences by type of surgery have received little attention. We explored the trajectories of change in pain and function after Revision Hip Arthroplasty to 12-months post-operatively and compare them with those observed after primary Hip Arthroplasty. Methods This study is a prospective cohort study of patients undergoing primary (n = 80 with 92% for an indication of osteoarthritis) and Revision (n = 43) Hip arthroplasties. WOMAC pain and function scores and walking speed were collected pre-operatively, at 3 and 12-months post-operatively. Multilevel regression models were used to chart and compare the trajectories of change (0–3 months and 3–12 months) between types of surgery. Results The improvements in pain and function following Revision Arthroplasty occurred within the first 3-months with no evidence of further change beyond this initial period. While the pattern of recovery was similar to the one observed after primary Arthroplasty, improvements in the first 3-months were smaller after Revision compared to primary Arthroplasty. Patients listed for Revision surgery reported lower pre-operative pain levels but similar post-operative levels compared to those undergoing primary surgery. At 12-months post-operation patients who underwent a Revision Arthroplasty had not reached the same level of function achieved by those who underwent primary Arthroplasty. Conclusion The post-operative improvements in pain and function are larger following primary Hip Arthroplasty than following Revision Hip Arthroplasty. Irrespectively of surgery type, most of the improvements occur in the first three post-operative months. More research is required to identify whether the recovery following Revision surgery could be improved with specific post-operative interventions.
Donald S. Garbuz - One of the best experts on this subject based on the ideXlab platform.
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femoral Revision Hip Arthroplasty a comparison of two stem designs
Clinical Orthopaedics and Related Research, 2010Co-Authors: Corey J Richards, Clive P. Duncan, Bassam A. Masri, Donald S. GarbuzAbstract:For various reasons the tapered, fluted, modular titanium (TFMT) stem has become our component of choice over cylindrical, nonmodular cobalt chrome (CNCC) components for THA Revision. We therefore asked whether the TFMT femoral components better achieved three important goals of Revision Arthroplasty than CNCC stems: (1) improving quality of life; (2) avoiding complications; and (3) preserving or restoring femoral bone stock. We compared patients undergoing femoral component Revision Hip Arthroplasty with either a CNCC (N = 105) component or a TFMT (N = 95) component to determine if the increased use of TFMT components is justified. We retrospectively reviewed all patients undergoing Revision total Hip Arthroplasty between January 2000 and March 2006. All eligible patients completed outcome questionnaires (WOMAC, SF-12, Oxford-12, UCLA Activity Score, and Satisfaction Scores). Radiographs were evaluated for loosening and preservation or restoration of the proximal femur host bone. The TFMT and CNCC cohorts were comparable with respect to age, gender, diagnosis, and comorbidities. The TFMT cohort had worse preoperative bone defects (65% Paprosky 3B and 4). The TFMT cohort had higher outcome scores (WOMAC pain, WOMAC stiffness, Oxford-12, and Satisfaction), fewer intraoperative fractures, and better restoration of the proximal femur host bone. Our data suggest the TFMT stem provided improved clinical outcomes (improved quality of life, decreased complications, and preservation of bone stock) than the CNCC stem. Level of Evidence: Level III, therapeutic study. See Guidelines for Authors for a complete description of levels of evidence.
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THE EXPECTATIONS OF PATIENTS UNDERGOING Revision Hip Arthroplasty
2003Co-Authors: Fares S. Haddad, Donald S. Garbuz, G. K. Chambers, T. J. Jagpal, Bassam A. Masri, Clive P. DuncanAbstract:This study was performed to assess the relationsHip between patients’ pre-operative symptoms and their expectations at the time of Revision Hip Arthroplasty. The WOMAC (Western Ontario and McMaster Osteoarthritis Index) scale for osteoarthritis of the Hip and the Short Form 36 (SF-36) general health status scale have both been validated for the assessment of the outcome of Hip Arthroplasty. We prospectively assessed 60 patients using these scales as well as the “expectation WOMAC” that asked the patients to estimate how they expected to feel 6 months after Revision Hip replacement. All the questions were completed prior to informed consent, and were scored form 1 to 5 with increasing severity with a Likert scale. The maximum possible scores for pain, stiffness and difficulty with physical activity were therefore 25, 10 and 85 respectively. The mean preoperative WOMAC score for pain was 13.4 (CI 12.2.-14.6), for stiffness 5.9 (CI 5.6-6.2) and for physical activity 50.9 (CI 47.2-54.6) The mean expectation WOMAC scores for these modalities were 7.4 (CI 6.2-8.6), 3.5 (CI 3.0-4.0) and 28.1 (CI 24.0-32.2.) respectively. Although there was a wide spread of expectations, we were unable to find any significant correlation between the patients’ preoperative pain and The abstracts were prepared by Mr Simon Donell. Correspondence should be addressed to him at the Department of Orthopaedics, Norfolk & Norwich Hospital, Level 4, Centre Block, Colney Lane, Norwich NR4 7UY, United Kingdom. stiffness levels and their expectations for pain and stiffness after Revision Hip Arthroplasty. There was however a statistical association between their preoperative difficulty with physical activity and their expectations for physical activity (r=0.38; p=0.02) There was no significant correlation between the SF-36 scores and the patients’ expectations. The expectations of patients awaiting Revision Hip replacements are high, and do not appear to be closely related to their level of pre-operative disability. Even patients with severe symptoms have high expectations that in some cases may be unrealistic. The use of the “expectation WOMAC” may help us to identify such patients, and to improve patient education and satisfaction.
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The expectations of patients undergoing Revision Hip Arthroplasty.
The Journal of arthroplasty, 2001Co-Authors: Fares S. Haddad, Donald S. Garbuz, G. K. Chambers, T. J. Jagpal, Bassam A. Masri, Clive P. DuncanAbstract:Sixty patients were prospectively assessed using the Western Ontario and McMaster Osteoarthritis Index (WOMAC) scale for osteoarthritis of the Hip and the Short Form 36 (SF-36) general health status scale as well as the expectation WOMAC, which asked patients to estimate how they expected to feel 6 months after Revision Hip Arthroplasty. There was a wide range of expectations, but we were unable to find any significant correlation between the patients' preoperative pain and stiffness levels and their expectations for pain and stiffness after Revision Hip Arthroplasty. There was no significant correlation between the SF-36 scores and the patients' expectations. Our findings suggest that the expectations of patients awaiting Revision Hip arthroplasties are high and are not related closely to the level of preoperative disability.