2.One-year Oxford knee scores should be used in preference to 6-month scores when assessing the outcome of total knee arthroplasty
N. D. CLEMENT ; N. NG ; D. MACDONALD ; C. E. H. SCOTT ; C. R. HOWIE
The Journal of Korean Knee Society 2020;32(4):e43-
Purpose:
The primary aim of this study was to assess whether there was a clinically significant difference in the mean Oxford knee score (OKS) between 6 and 12 months after total knee arthroplasty (TKA). The secondary aim was to identify variables associated with a clinically significant change in the OKS between 6 and 12 months.
Methods:
A retrospective cohort study was undertaken using an established arthroplasty database of 1574 primary TKA procedures. Patient demographics, body mass index (BMI), comorbidities, OKS and EuroQoL 5-domain (EQ-5D) score were collected preoperatively and at 6 and 12 months postoperatively. A clinically significant change in the OKS was defined as 5 points or more.
Results:
There was a 1.1-point increase in the OKS between 6 and 12 months postoperatively, which was statistically significant (95% confidence (CI) 0.8–1.3, p < 0.0001). There were 381 (24.2%) patients who had a clinically significant improvement in their OKS from 6 to 12 months. After adjusting for confounding, patients with a lower BMI (p = 0.028), without diabetes mellitus (p < 0.001), a better preoperative OKS (p < 0.001) or a worse 6-month OKS (p < 0.001) were more likely to have a clinically significant improvement. A 6-month OKS < 36 points was a reliable predictor of a clinically significant improvement in the 6-month to 12-month OKS (area under the curve 0.73, 95% CI 0.70–0.75, p < 0.001).
Conclusion
Overall, there was no clinically significant change in the OKS from 6 to 12 months; however, a clinically significant improvement was observed in approximately a quarter of patients and was more likely in those scoring less than 36 points at 6 months. Level of evidence: retrospective diagnostic study, level III.
3.One-year Oxford knee scores should be used in preference to 6-month scores when assessing the outcome of total knee arthroplasty
N. D. CLEMENT ; N. NG ; D. MACDONALD ; C. E. H. SCOTT ; C. R. HOWIE
The Journal of Korean Knee Society 2020;32(4):e43-
Purpose:
The primary aim of this study was to assess whether there was a clinically significant difference in the mean Oxford knee score (OKS) between 6 and 12 months after total knee arthroplasty (TKA). The secondary aim was to identify variables associated with a clinically significant change in the OKS between 6 and 12 months.
Methods:
A retrospective cohort study was undertaken using an established arthroplasty database of 1574 primary TKA procedures. Patient demographics, body mass index (BMI), comorbidities, OKS and EuroQoL 5-domain (EQ-5D) score were collected preoperatively and at 6 and 12 months postoperatively. A clinically significant change in the OKS was defined as 5 points or more.
Results:
There was a 1.1-point increase in the OKS between 6 and 12 months postoperatively, which was statistically significant (95% confidence (CI) 0.8–1.3, p < 0.0001). There were 381 (24.2%) patients who had a clinically significant improvement in their OKS from 6 to 12 months. After adjusting for confounding, patients with a lower BMI (p = 0.028), without diabetes mellitus (p < 0.001), a better preoperative OKS (p < 0.001) or a worse 6-month OKS (p < 0.001) were more likely to have a clinically significant improvement. A 6-month OKS < 36 points was a reliable predictor of a clinically significant improvement in the 6-month to 12-month OKS (area under the curve 0.73, 95% CI 0.70–0.75, p < 0.001).
Conclusion
Overall, there was no clinically significant change in the OKS from 6 to 12 months; however, a clinically significant improvement was observed in approximately a quarter of patients and was more likely in those scoring less than 36 points at 6 months. Level of evidence: retrospective diagnostic study, level III.
4.Golf participation after rotator cuff repair: functional outcomes, rate of return and factors associated with return to play
Thomas R WILLIAMSON ; Patrick G ROBINSON ; Iain R MURRAY ; Andrew D MURRAY ; Julie M MCBIRNIE ; C Michael ROBINSON ; Deborah J MACDONALD ; Nicholas D CLEMENT
Clinics in Shoulder and Elbow 2023;26(2):109-116
Golf is a popular sport involving overhead activity and engagement of the rotator cuff (RC). This study aimed to determine to what level golfers were able to return to golf following RC repair, the barriers to them returning to golf and factors associated with their failure to return to golf. Methods: Patients preoperatively identifying as golfers undergoing RC repair at the study centre from 2012 to 2020 were retrospectively followed up with to assess their golf-playing status, performance and frequency of play and functional and quality of life (QoL) outcomes. Results: Forty-seven golfers (40 men [85.1%] and 7 women [14.9%]) with a mean age of 56.8 years met the inclusion criteria, and 80.1% were followed up with at a mean of 27.1 months postoperatively. Twenty-nine patients (76.3%) had returned to golf with a mean handicap change of +1.0 (P=0.291). Golf frequency decreased from a mean of 1.8 rounds per week preinjury to 1.5 rounds per week postoperatively (P=0.052). The EuroQol 5-dimension 5-level (EQ-5D-5L) index and visual analog scale (EQ-VAS) score were significantly greater in those returning to golf (P=0.024 and P=0.002), although functional outcome measures were not significantly different. The primary barriers to return were ipsilateral shoulder dysfunction (78%) and loss of the habit of play (22%). Conclusions: Golfers were likely (76%) to return to golf following RC repair, including mostly to their premorbid performance level with little residual symptomatology. Return to golf was associated with a greater QoL. Persistent subjective shoulder dysfunction (78%) was the most common barrier to returning to golf. Level of evidence: Level IV.
5.Silent Intracerebral Hemorrhage in Patients Randomized to Stenting or Endarterectomy for Symptomatic Carotid Stenosis
Mandy D MÜLLER ; Lisa M JONGEN ; Aysun ALTINBAS ; Kristine A BLACKHAM ; Paul J NEDERKOORN ; Sumaira MACDONALD ; Rolf JÄGER ; Thomas WOLFF ; Philippe A LYRER ; L Jaap KAPPELLE ; Stephan G WETZEL ; Toby RICHARDS ; Jeroen HENDRIKSE ; Gert J DE BORST ; H Bart VAN DER WORP ; Stefan T ENGELTER ; David J WERRING ; Martin M BROWN ; Leo H BONATI
Journal of Stroke 2019;21(1):116-119
No abstract available.
Carotid Stenosis
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Cerebral Hemorrhage
;
Endarterectomy
;
Humans
;
Stents