After total knee arthroplasty, many people are not active enough to maintain their health and fitness: an observational study

AbstractQuestionsWhat proportion of people after total knee arthroplasty adheres to the physical activity regimen recommended for maintenance of health (moderate intensity physical activity for at least 30min on 5 days/week)? What proportion adheres to the activity regimen recommended to improve fitness (vigorous intensity physical activity for at least 20min on 3 days/week)? What factors are associated with adherence to these recommendations?DesignAn observational study.Participants830 adults who underwent a total knee arthroplasty between 2002 and 2006 at University Medical Center Gronigen or Martini Hospital Gronigen, the Netherlands.Outcome measuresThe Short Questionnaire to Assess Health-Enhancing Physical Activity (SQUASH) was used to measure the physical activity behaviour of the participants. These data were analysed as adherence to each recommendation.ResultsThe health recommendation was adhered to by 51% of the participants. The fitness recommendation was adhered to by 53% of participants. Almost half (46%) of the participants fulfilled both recommendations, and 42% did not fulfil either recommendation. Males and more educated participants had higher odds of meeting the health, fitness, and both recommendations. Respondents living with family had higher odds of meeting the fitness recommendation.ConclusionAfter total knee arthroplasty, 42% of people are not active enough to maintain their health and fitness. Physiotherapists should encourage people with a total knee arthroplasty to undertake the recommended exercise regimens to maintain health and fitness, with particular attention to those people with characteristics known to be associated with poor adherence to the recommendations

Correction:Intraoperative fluoroscopic protocol to avoid rotational malalignment after nailing of tibia shaft fractures: introduction of the ‘C-Arm Rotational View (CARV)’ (European Journal of Trauma and Emergency Surgery, (2022), 10.1007/s00068-022-02038-2)

In the Acknowledgements section the following part was missing: On behalf of the Traumaplatform 3D Consortium: L. M. Goedhart, B. de Cort, L. A. M. Hendrickx, M. ter Horst, J. Gorter, R. J. van Luit, P. Nieboer, W. Füssenich, T. Zwerver, R. Koster, J. J. Valk, L. Reinke, J. G. Bleeker, M. Cain, F. J. P. Beeres, G. M. M. J. Kerkhoffs. The original article has been corrected

Translation, Validity, and Reliability of the Dutch Anterior Cruciate Ligament–Quality of Life Questionnaire

Background: The Anterior Cruciate Ligament–Quality of Life (ACL-QoL) questionnaire is a valid and reliable injury-specific instrument to assess the impact of an ACL rupture on the daily life of a patient. Purpose: To translate the ACL-QoL into Dutch (ACL-QoL-NL) and to study its psychometric properties in patients with an ACL rupture. Study Design: Cohort study (diagnosis); Level of evidence, 2. Methods: The original ACL-QoL questionnaire was translated from English to Dutch according to international guidelines. The study population consisted of 122 patients with a confirmed ACL rupture who completed the ACL-QoL-NL as well as 4 questionnaires: the International Knee Documentation Committee subjective score, Knee injury and Osteoarthritis Outcome Score, 36-item Short Form Health Survey, and Lysholm Knee Score. We determined the internal consistency, construct validity, and prevalence of floor and ceiling effects of the ACL-QoL-NL total score as well as its 5 subscales. To determine test-retest reliability, we analyzed the data of 68 patients who had a stable knee condition and who completed the ACL-QoL-NL a second time after a 2-week interval. Results: The confirmatory factor analysis showed that the original structure of the ACL-QoL-NL was confirmed, except for 4 of 31 items. Internal consistency of the total scale and all 5 subscales was good. More than 75% of the predefined hypotheses on the correlations between the ACL-QoL-NL and the 4 questionnaires were met, indicating good construct validity. No significant floor or ceiling effects were observed. Test-retest reliability was good, and no systematic bias between test and retest was found. Standard error of measurement for the total score was 4.8 points out of 100, and the smallest detectable changes at the group and individual levels were 1.6 and 13.2 points, respectively. Conclusion: The ACL-QoL-NL questionnaire was successfully translated from English to Dutch and demonstrated good internal consistency, validity, and reliability, with no presence of floor or ceiling effects

Translation, Validity, and Reliability of the Dutch Anterior Cruciate Ligament–Quality of Life Questionnaire

Background: The Anterior Cruciate Ligament–Quality of Life (ACL-QoL) questionnaire is a valid and reliable injury-specific instrument to assess the impact of an ACL rupture on the daily life of a patient.Purpose: To translate the ACL-QoL into Dutch (ACL-QoL-NL) and to study its psychometric properties in patients with an ACL rupture. Study Design: Cohort study (diagnosis); Level of evidence, 2.Methods: The original ACL-QoL questionnaire was translated from English to Dutch according to international guidelines. The study population consisted of 122 patients with a confirmed ACL rupture who completed the ACL-QoL-NL as well as 4 questionnaires: the International Knee Documentation Committee subjective score, Knee injury and Osteoarthritis Outcome Score, 36-item Short Form Health Survey, and Lysholm Knee Score. We determined the internal consistency, construct validity, and prevalence of floor and ceiling effects of the ACL-QoL-NL total score as well as its 5 subscales. To determine test-retest reliability, we analyzed the data of 68 patients who had a stable knee condition and who completed the ACL-QoL-NL a second time after a 2-week interval.Results: The confirmatory factor analysis showed that the original structure of the ACL-QoL-NL was confirmed, except for 4 of 31 items. Internal consistency of the total scale and all 5 subscales was good. More than 75% of the predefined hypotheses on the correlations between the ACL-QoL-NL and the 4 questionnaires were met, indicating good construct validity. No significant floor or ceiling effects were observed. Test-retest reliability was good, and no systematic bias between test and retest was found. Standard error of measurement for the total score was 4.8 points out of 100, and the smallest detectable changes at the group and individual levels were 1.6 and 13.2 points, respectively.Conclusion: The ACL-QoL-NL questionnaire was successfully translated from English to Dutch and demonstrated good internal consistency, validity, and reliability, with no presence of floor or ceiling effects.</p

Are sarcopenia and myosteatosis in elderly patients with pelvic ring injury related to mortality, physical functioning and quality of life?

The purpose of this study was to evaluate the prevalence of sarcopenia and/or myosteatosis in elderly patients with pelvic ring injuries and their influence on mortality, patient-perceived physical functioning and quality of life (QoL). A multicenter retrospective cohort study was conducted including elderly patients aged ≥ 65 treated for a pelvic ring injury. Cross-sectional computed tomography (CT) muscle measurements were obtained to determine the presence of sarcopenia and/or myosteatosis. Kaplan–Meier analysis was used for survival analysis, and Cox proportional hazards regression analysis was used to determine risk factors for mortality. Patient-reported outcome measures for physical functioning (SMFA) and QoL (EQ-5D) were used. Multivariable linear regression analyses were used to determine the effect of sarcopenia and myosteatosis on patient-perceived physical functioning and QoL. Data to determine sarcopenia and myosteatosis were available for 199 patients, with a mean follow-up of 2.4 ± 2.2 years: 66 patients (33%) were diagnosed with sarcopenia and 65 (32%) with myosteatosis, while 30 of them (15%) had both. Mortality rates in patients at 1 and 3 years without sarcopenia and myosteatosis were 13% and 21%, compared to 11% and 36% in patients with sarcopenia, 17% and 31% in patients with myosteatosis and 27% and 43% in patients with both. Higher age at the time of injury and a higher Charlson Comorbidity Index (CCI) were independent risk factors for mortality. Patient-reported mental and emotional problems were significantly increased in patients with sarcopenia

Can CT-based gap and step-off displacement predict outcome after nonoperative treatment of acetabular fractures?

Aims: The aim of this study was to investigate the association between fracture displacement and survivorship of the native hip joint without conversion to a total hip arthroplasty (THA), and to determine predictors for conversion to THA in patients treated nonoperatively for acetabular fractures. Methods:A multicentre cross-sectional study was performed in 170 patients who were treated nonoperatively for an acetabular fracture in three level 1 trauma centres. Using the post-injury diagnostic CT scan, the maximum gap and step-off values in the weightbearing dome were digitally measured by two trauma surgeons. Native hip survival was reported using Kaplan-Meier curves. Predictors for conversion to THA were determined using Cox regression analysis. Results: Of 170 patients, 22 (13%) subsequently received a THA. Native hip survival in patients with a step-off ≤ 2 mm, &gt; 2 to 4 mm, or &gt; 4 mm differed at five-year follow-up (respectively: 94% vs 70% vs 74%). Native hip survival in patients with a gap ≤ 2 mm, &gt; 2 to 4 mm, or &gt; 4 mm differed at five-year follow-up (respectively: 100% vs 84% vs 78%). Step-off displacement &gt; 2 mm (&gt; 2 to 4 mm hazard ratio (HR) 4.9, &gt; 4 mm HR 5.6) and age &gt; 60 years (HR 2.9) were independent predictors for conversion to THA at follow-up. Conclusion: Patients with minimally displaced acetabular fractures who opt for nonoperative fracture treatment may be informed that fracture displacement (e.g. gap and step-off) up to 2 mm, as measured on CT images, results in limited risk on conversion to THA. Step-off ≥ 2 mm and age &gt; 60 years are predictors for conversion to THA and can be helpful in the shared decision-making process.</p

Cross-cultural adaptation of the Dutch Short Musculoskeletal Function Assessment questionnaire (SMFA-NL): Internal consistency, validity, repeatability and responsiveness

The purpose of this study was to translate and culturally adapt the Dutch version of the Short Musculoskeletal Function Assessment questionnaire (SMFA-NL) and to investigate the internal consistency, validity, repeatability and responsiveness of the translated version. The original SMFA was first translated and culturally adapted from English into Dutch according to a standardised procedure and subsequently tested for clinimetric quality. The study population consisted of 162 patients treated for various musculoskeletal injuries or disorders at the departments of Orthopedics and Traumatology. All respondents filled in the SMFA-NL and the SF-36 and a region-specific questionnaire. To determine repeatability, 87 respondents filled in the SMFA-NL for a second time after a time interval of three to four weeks. To determine responsiveness, 29 respondents who were treated for their injury within three months before the first assessment filled in the SMFA-NL for a second time after two to three months. The following analyses were performed to evaluate clinimetric quality of the SMFA-NL: factor analysis and Cronbach's alpha (internal consistency), floor and ceiling effects, Spearman's Rho (construct validity), intraclass correlation coefficients and the Bland & Altman method (repeatability), and standardised response means (SRM) (responsiveness). Factor analysis demonstrated four subscales of the SMFA-NL. Both the newly identified subscales of the SMFA-NL and the conventional subscales of the SMFA showed good internal consistency. No floor and some ceiling effects were found. Construct validity was good, as high correlations were found between the subscales of the SMFA-NL and the respective subscales of the SF-36 and the region-specific questionnaires. Repeatability of the SMFA-NL subscales was high, with no systematic bias between first and second assessment. Responsiveness of the SMFA-NL was moderate, as small to moderate SRMs were found. We successfully translated and culturally adapted a Dutch version of the Short Musculoskeletal Function Assessment questionnaire (SFMA-NL). This study shows that the SMFA-NL is a valid, reliable and moderately responsive method for the assessment of functional status of patients who have a broad range of musculoskeletal disorders. Furthermore, it will allow for comparison between different patient groups as well as for cross-cultural comparisons. (C) 2011 Elsevier Ltd. All rights reserved

Reliability and Validity of the Dutch Version of the International Physical Activity Questionnaire in Patients After Total Hip Arthroplasty or Total Knee Arthroplasty

<p>STUDY DESIGN: Psychometric assessment.</p><p>OBJECTIVES: To determine test-retest reliability and concurrent validity of the International Physical Activity Questionnaire (IPAQ) in patients after total hip arthroplasty or total knee arthroplasty.</p><p>BACKGROUND: Despite recognized benefits of regular physical activity, little is known about the physical activity level of patients after total hip arthroplasty or total knee arthroplasty. None of the currently used questionnaires is internationally accepted. The IPAQ tries to address this problem, but its validity and reliability in those who have had a total hip arthroplasty or total knee arthroplasty are unknown.</p><p>METHODS: Forty-four patients completed the IPAQ (short and long forms) twice. Test-retest reliability was assessed by Spearman correlation coefficients (r) and intraclass correlation coefficients. Additionally, standard error of measurement and minimal detectable change were calculated. Concurrent validity was determined by an accelerometer. Spearman correlation coefficients were calculated between IPAQ scores and accelerometer data. Bland-Altman analyses were performed for both reliability and validity.</p><p>RESULTS: Fair to good correlation coefficients were found for test-retest reliability of the total and activity scores (r = 0.49-0.81, intraclass correlation coefficient = 0.27-0.71). Standard error of measurement and minimal detectable change were large. For concurrent validity, weak to moderate correlation coefficients were found for total and activity scores (r = -0.07 to 0.54). Systematic bias was found between the IPAQ and accelerometer data, with higher scores on the IPAQ.</p><p>CONCLUSION: Overall, the IPAQ showed fair reliability and weak concurrent validity. These results are in line with previous studies of the reliability and validity of the IPAQ. Due to systematic bias and large standard error of measurement and minimal detectable change, the IPAQ may only be suitable for intergroup comparisons.</p>

Supplemental Material, sj-pdf-1-ojs-10.1177_23259671221123297 - Translation, Validity, and Reliability of the Dutch Anterior Cruciate Ligament–Quality of Life Questionnaire

Supplemental Material, sj-pdf-1-ojs-10.1177_23259671221123297 for Translation, Validity, and Reliability of the Dutch Anterior Cruciate Ligament–Quality of Life Questionnaire by Astrid J. de Vries, Reinoud W. Brouwer, Rianne Huis in t’ Veld, Wybren A. van der Wal, Inge H.F. Reininga and Roy A.G. Hoogeslag in Orthopaedic Journal of Sports Medicine</p