Integrated nutritional intervention in the elderly after hip fracture. A process evaluation

SummaryBackground & aimsWithin a multicentre randomized controlled trial aimed at improving the nutritional status and increase the speed of recovery of elderly hip fracture patients, we performed a process evaluation to investigate the feasibility of the intervention within the present Dutch health care system.MethodsPatients in the intervention group received nutritional counseling during 10 contacts. Oral nutritional supplements were advised as needed until three months after hip fracture surgery. The intervention was evaluated with respect to dieticians’ adherence to the study protocol, content of nutritional counseling, and patients’ adherence to recommendations given.ResultsWe included 66 patients (mean age of 76, range 55–92 years); 74% women. Eighty-three percent of patients received all 10 contacts as planned, but in 62% of the patients one or more telephone calls had to be replaced by face to face contacts. Nutritional counseling was complete in 91% of contacts. Oral nutritional supplementation was needed for a median period of 76 days; 75% of the patients took the oral nutritional supplements as recommended.ConclusionsNutritional counseling in elderly hip fracture patients through face to face contacts and telephone calls is feasible. However, individual tailoring of the intervention is recommended. The majority of hip fracture patients needed >2 months oral nutritional supplements to meet their nutritional requirements.The trial was registered at clincialtrails.gov as NCT00523575

Management of Periprosthetic Joint Infections (PJIs)

Management of Periprosthetic Joint Infections (PJIs): Management of PJIs discusses periprosthetic joint infection (PJI), a fairly rare occurrence that is nonetheless one of the most serious complications in joint replacement surgery. Intricate interactions between the pathogen, the host, and the implant can result in PJIs which are not only physically devastating for the patient, but also financially crippling for health authorities and insurance companies. Actions taken to minimize the risk of PJIs can be extremely challenging for the orthopaedic community. Consequently, new research, which is detailed in this comprehensive book, is being undertaken to minimize and manage these challenging infections. Provides essential background knowledge on the mechanisms and identification of PJIs Dedicated chapters focus on the complex, but vital eccentricities between PJIs in different areas of the body Contains contributions from a mixture of clinical and academic experts in the field, thus ensuring balanced coverage