Objectives: Physical activity is promoted in patients with hip or knee osteoarthritis (OA), yet little is known about its relationship with symptoms, functional limitations and Quality of Life (QoL... Show moreObjectives: Physical activity is promoted in patients with hip or knee osteoarthritis (OA), yet little is known about its relationship with symptoms, functional limitations and Quality of Life (QoL). We investigated if OA-associated pain, functional limitations and QoL are associated with objectively measured physical activity in patients with end-stage hip/knee OA.Methods: Cross-sectional study including patients scheduled for primary total hip/knee arthroplasty. Patients wore an accelerometer (Activ8) with physical activity assessed over waking hours, and expressed as number of activity daily counts (ADC) per hour, %time spent on physical activity i.e. walking, cycling or running (%PA), and %time spent sedentary (%SB). Pain, functional limitations and joint-specific and general QoL were assessed with the Hip disability/Knee Injury and Osteoarthritis Outcome Score (HOOS/KOOS) and the Short Form (SF)-12. Multivariate linear regression models with the three to Z-scores transformed parameters of physical activity as dependent variables and adjusted for confounding, were conducted. Results: 49 hip and 48 knee OA patients were included. In hip and knee OA patients the mean number of ADC, %PA and %SB were 18.79 +/- 7.25 and 21.19 +/- 6.16, 14 +/- 6.4 and 15 +/- 5.0, and 66 +/- 10.5 and 68 +/- 8.7, respectively. In hip OA, better joint-specific and general QoL were associated with more ADC, (13 0.028; 95%CI:0.007-0.048, 130.041; 95%CI:0.010- 0.071). Also, better general QoL was associated with the %PA (13 0.040, 95%CI:0.007- 0.073). No other associations were found.Conclusion: Whereas QoL was associated with physical activity in hip OA, pain and functional limitations were not related to objectively measured physical activity in patients with end-stage hip or knee OA.(c) 2021 The Authors. Published by Elsevier B.V. This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/). Show less
Tol, F.R. van; Kernkamp, W.A.; Wal, R.J.P. van der; Swen, J.W.A.; Velde, S.K. van de; Arkel, E.R.A. van 2020
Two-stage revision anterior cruciate ligament (ACL) reconstruction is an effective way to revise suboptimal tunnel-placement allowing for proper graft fixation. However, prolonged increased laxity... Show moreTwo-stage revision anterior cruciate ligament (ACL) reconstruction is an effective way to revise suboptimal tunnel-placement allowing for proper graft fixation. However, prolonged increased laxity of the knee may increase the risk of meniscal or chondral injury. It was hypothesized that no additional meniscal or chondral lesions occur in between the two stages of the two-stage revision ACL reconstruction. In this retrospective study, 42 patients undergoing a two-stage revision ACL reconstruction were included. Surgical notes for both stages were screened for meniscal and chondral status, interventions to any concurrent injury, surgery dates, along with basic patient characteristics. In 4 of the 42 patients, a new meniscal tear occurred in between the two stages, of which three required partial meniscectomy during the second stage of the ACL revision. One patient experienced a new small degenerative tear that did not require intervention. Two out of the four menisci that were repaired during the first stage had failed and required partial meniscectomy. No significant difference was found in the time between the two stages with respect to the occurrence of meniscal tears. No significant differences in chondral status were found. In conclusion, approximately 10% of patients developed a new meniscal tear and no difference in macroscopic chondral injury was observed between the first and second stages. Show less
Objectives We aimed first to summarise minimal clinically important differences (MCIDs) after total hip (THR) or knee replacement (TKR) in health-related quality of life (HRQoL), measured using the... Show moreObjectives We aimed first to summarise minimal clinically important differences (MCIDs) after total hip (THR) or knee replacement (TKR) in health-related quality of life (HRQoL), measured using the Short-Form 36 (SF-36). Secondly, we aimed to improve the precision of MCID estimates by means of meta-analysis.Methods We conducted a systematic review of English and non-English articles using MEDLINE, the Cochrane Controlled Trials Register (1960-2011), EMBASE (1991-2011), Web of Science, Academic Search Premier and Science Direct. Bibliographies of included studies were searched in order to find additional studies. Search terms included MCID or minimal clinically important change, THR or TKR and Short-Form 36. We included longitudinal studies that estimated MCID of SF-36 after THR or TKR.Results Three studies met our inclusion criteria, describing a distinct study population: primary THR, primary TKR and revision THR. No synthesis of study results can be given.Conclusions Although we found MCIDs in HRQoL after THR or TKR have limited precision and are not validated using external criteria, these are still the best known estimates of MCIDs in HRQoL after THR and TKR to date. We therefore advise these MCIDs to be used as absolute thresholds, but with caution. Show less
