743 research outputs found
Patient satisfaction after total knee replacement—still a challenge
During a validation process of the Swedish
Knee Arthroplasty Register (SKAR), living registered patients were sent a questionnaire to ask if they had been reoperated on. This gave an opportunity to pose a simple
four-point question with respect to patient satisfaction
which 95% of patients answered. We analyzed the answers of patients operated on between 1981 and 1995 and
found that only 8% of the patients were dissatisfied regarding their knee arthroplasty 2–17 years postoperatively. The satisfaction rate was constant, regardless of when
the operation had been performed during the 15-year period. The proportion of satisfied patients was affected by
the preoperative diagnosis, patients operated on for a
long-standing disease more often being satisfied than
those with a short disease-duration. There was no difference in proportions of satisfied patients, whether they had
primarily been operated on with a total knee arthroplasty
(TKA) or a medial unicompartmental arthroplasty
(UKA). For TKAs performed with primary patellar resurfacing, there was a higher ratio of satisfied patients
than for TKAs not resurfaced, but this increased ratio diminished with time passed since the primary operation.
Unrevised knees had a higher proportion of satisfied patients than knees that had been subject to revision, and
among patients revised for medial UKA, the proportion
of satisfied patients was higher than among patients revised for TKA.
We conclude that satisfaction after knee arthroplasty
is stable and long-lasting in unrevised cases and that
even after revision most patients are satisfied
Hope for better days: 2 studies aiming to answer the remaining questions around dual mobility cups
Heupfracturen zo snel mogelijk opereren
A recent retrospective study in the Netherlands found no significant association between delayed hip fracture surgery and the occurrence of complications. This argues against the use of the Dutch hospital quality indicator measuring the percentage of patients with hip fracture operated within 24 to 48 hours. However, much larger international prospective studies have shown that delaying surgery results in prolonged duration of pain and hospitalisation and increased rate of complications. There is no evidence that delaying surgery is beneficial for the patient. Therefore, the current Dutch hospital quality indicator for timely initiation of treatment for hip fractures should remain unchanged in the interest of this fragile patient group
Wat is er bekend over de werkzaamheid van 'Sonocur Plus'?
Letter by Dalhuisen with a response from Verhaa
Prognose van de totaleheupprothese
The prognosis of total hip arthroplasty is excellent and as many publications show, the survival of a good type of implant is well above 90 per cent at the 10-year follow-up. The results of the average orthopaedic surgeon may not match those obtained by the experts who have published these results. Therefore, in 1979 a prospective multicentre study was started in Sweden to evaluate the outcome of total hip arthroplasty. This National Hip Register has shown that the outcome is related to type of prosthesis, patient selection and operative technique. The results from one orthopaedic department to another differed considerably. The feedback from the Register resulted in improvements of the overall outcome and decrease of the differences between the orthopaedic departments in Sweden A Dutch National Implant Register is needed
Failure load of patellar tendon grafts at the femoral side: 10- versus 20-mm-bone blocks
The aim of the study was to investigate whether use of short bone blocks is safe in anterior cruciate ligament (ACL) reconstruction. Our hypothesis was that the smaller 10-mm-length bone blocks will fail at lower loads than 20-mm-bone blocks. Ten paired human cadaver knees were randomly assigned to the 10- or 20-mm group (group 1 and 2) and underwent bone-patellar tendon-bone femoral fixation with interference screw. Tensile tests were performed using a tensile testing machine (Instron). Stiffness, failure load and failure mode were recorded. Median stiffness was 72 N/mm (16-103) for 10-mm-bone blocks and 91 N/mm (40-130) for 20-mm-bone blocks. Median failure loads were 402 N (87-546) for 10-mm-long bone block and 456 N (163-636) for 20-mm-bone blocks. There was no statistically significant difference between groups (P = 0.35). All bone-patellar tendon-bone grafts were pulled out of the femoral tunnel with interference screw, due to slippage. We concluded that a 10-mm-long bone block was not significantly weaker than a 20-mm-long bone block. Failure loads of a 10-mm-bone block exceeded loading values at passive and active extension of the knee under normal conditions. Ten millimetre bone blocks offered sufficient fixation strength in ACL reconstruction
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