scholarly journals Association Between Symptom Duration and Patient‐Reported Outcomes Before and After Hip Replacement Surgery

2020 ◽  
Vol 72 (3) ◽  
pp. 423-431 ◽  
Author(s):  
Yiu‐Shing Lau ◽  
Mark Harrison ◽  
Matt Sutton
Keyword(s):  
Hip Replacement ◽  
Patient Reported Outcomes ◽  
Symptom Duration ◽  
Replacement Surgery ◽  
Hip Replacement Surgery ◽  
Patient Reported ◽  
Before And After

scholarly journals Is the use of antidepressants associated with patient-reported outcomes following total hip replacement surgery?

2016 ◽  
Vol 87 (5) ◽  
pp. 444-451 ◽  
Author(s):  
Meridith E Greene ◽  
Ola Rolfson ◽  
Max Gordon ◽  
Kristina Annerbrink ◽  
Henrik Malchau ◽  
...  
Keyword(s):  
Total Hip Replacement ◽  
Hip Replacement ◽  
Patient Reported Outcomes ◽  
Total Hip ◽  
Replacement Surgery ◽  
Hip Replacement Surgery ◽  
Patient Reported

scholarly journals The effects of competition and bundled payment on patient reported outcome measures after hip replacement surgery

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Fanny Goude ◽  
Sverre A. C. Kittelsen ◽  
Henrik Malchau ◽  
Maziar Mohaddes ◽  
Clas Rehnberg
Keyword(s):  
Hip Replacement ◽  
Health Gain ◽  
Patient Reported Outcome Measures ◽  
Patient Reported Outcome ◽  
Economic Incentives ◽  
Bundled Payment ◽  
Treatment Groups ◽  
Replacement Surgery ◽  
Hip Replacement Surgery ◽  
Patient Reported

Abstract Background Competition-promoting reforms and economic incentives are increasingly being introduced worldwide to improve the performance of healthcare delivery. This study considers such a reform which was initiated in 2009 for elective hip replacement surgery in Stockholm, Sweden. The reform involved patient choice of provider, free establishment of new providers and a bundled payment model. The study aimed to examine its effects on hip replacement surgery quality as captured by patient reported outcome measures (PROMs) of health gain (as indicated by the EQ-5D index and a visual analogue scale (VAS)), pain reduction (VAS) and patient satisfaction (VAS) one and six years after the surgery. Methods Using patient-level data collected from multiple national registers, we applied a quasi-experimental research design. Data were collected for elective primary total hip replacements that were carried out between 2008 and 2012, and contain information on patient demography, the surgery and PROMs at baseline and at one- and six-years follow-up. In total, 36,627 observations were included in the analysis. First, entropy balancing was applied in order to reduce differences in observable characteristics between treatment groups. Second, difference-in-difference analyses were conducted to eliminate unobserved time-invariant differences between treatment groups and to estimate the causal treatment effects. Results The entropy balancing was successful in creating balance in all covariates between treatment groups. No significant effects of the reform were found on any of the included PROMs at one- and six-years follow-up. The sensitivity analyses showed that the results were robust. Conclusions Competition and bundled payment had no effects on the quality of hip replacement surgery as captured by post-surgery PROMs of health gain, pain reduction and patient satisfaction. The study provides important insights to the limited knowledge on the effects of competition and economic incentives on PROMs.

scholarly journals Release of Inflammatory Mediators in Association with Collection of Wound Drainage Blood during Orthopaedic Surgery

1995 ◽  
Vol 23 (6) ◽  
pp. 683-686 ◽  
Author(s):  
J. P. Arnold ◽  
M. Haeger ◽  
J. P. Bengtson ◽  
A. Bengtsson ◽  
B. Lisander
Keyword(s):  
Inflammatory Mediators ◽  
Hip Replacement ◽  
Systemic Blood ◽  
Wound Drainage ◽  
Blood Samples ◽  
Replacement Surgery ◽  
Hip Replacement Surgery ◽  
Pmn Elastase ◽  
Before And After ◽  
Pmn Élastase

Ten patients undergoing hip replacement surgery were studied regarding activation of complement and leukocytes in association with collection of wound drainage blood. The blood was collected postoperatively but not reinfused due to the possible risks with reinfusion of blood containing inflammatory mediators. Blood samples for analysis of complement activation (TCC), leukocyte activation (PMN elastase) and cytokines (Interleukin-6) were drawn preoperatively from the patients. Blood samples were also drawn intraoperatively from the wound. Samples were also drawn from the collected wound drainage blood, before and after blood was passed through a microporous filter. There were elevated concentrations of TCC, PMN elastase and IL-6 in the collected wound drainage blood before and after the filter. The filtration did not significantly reduce the concentrations of these factors. In the wound blood the concentrations were higher compared to those found in the systemic blood preoperatively, but lower compared to concentrations found in the collected drainage blood. The study demonstrates that the collection of wound drainage whole blood is associated with activation of complement, release of PMN elastase and cytokines.

The Performance of Cemented Femoral Prosthesis Based on New Gel Materials

2020 ◽  
Vol 12 (8) ◽  
pp. 1194-1204
Author(s):  
Daliang Kong ◽  
Chao Du ◽  
Chuangang Peng
Keyword(s):  
Silk Fibroin ◽  
Hip Replacement ◽  
Sem Analysis ◽  
Femoral Prosthesis ◽  
X Ray Diffraction ◽  
Replacement Surgery ◽  
Hip Replacement Surgery ◽  
Before And After ◽  
Cement Prosthesis

In view of the problems in hip replacement, a new gel material is developed and incorporated into cemented femoral prosthesis. The material precipitates hydroxyapatite (HA) onto silk fibroin (SF) by biomimetic method, namely silk fibroin hydroxyapatite (SF–HA). Through X-ray diffraction (XRD) and scanning electron microscope (SEM) analysis, HA precipitates on SF. Taking the gel time as the standard, 5 groups of gel materials are selected. Through in vitro degradation experiments, the degradation rate of these materials is 45%∼55%. Cell experiments (mouse L929 cells, osteoblasts HO-F) show that these cells have no cytotoxicity and support the growth of osteoblasts. In addition, in the vivo experiment (two groups), one group was treated with gelatin materials and the other group is treated with bone cement prosthesis transplantation directly. Comparing the indexes before and after operation, it proves that the new gel material has great application value in hip replacement surgery.

Patient-Controlled Analgesia versus Patient-Controlled Analgesia plus Continuous Infusion after Hip Replacement Surgery

1996 ◽  
Vol 30 (3) ◽  
pp. 224-227 ◽  
Author(s):  
Maureen A Smythe ◽  
Margie B Zak ◽  
Maureen P O'Donnell ◽  
Randy F Schad ◽  
Carl F Dmuchowski
Keyword(s):  
Adverse Effects ◽  
Pain Intensity ◽  
Continuous Infusion ◽  
Hip Replacement ◽  
Patient Controlled Analgesia ◽  
Teaching Institution ◽  
Replacement Surgery ◽  
Hip Replacement Surgery ◽  
Patient Reported ◽  
To Receive

OBJECTIVE: To compare the efficacy and adverse effect profile of patient-controlled analgesia (PCA) versus PCA plus continuous infusion (PCACI) after hip replacement surgery. DESIGN: Prospective, randomized, open pilot study. SETTING: Large teaching institution. PARTICIPANTS: Thirty-four patients undergoing hip replacement or revision of hip replacement surgery. INTERVENTIONS: Patients were randomized to receive PCA morphine: 1 mg with 6-minute lockout, or PCACI, using the same dose, with a 0.5–1 mg/h continuous infusion. Pain intensity, sedation, narcotic use, injection/attempt ratio (I/A), and adverse effects were assessed. RESULTS: No significant differences in pain intensity were identified. Morphine use was not different between groups: PCA 61.8 ± 35.0 and PCACI 74.2 ± 54.9 mg (p = 0.394). A trend toward an increased 12-hour I/A ratio was evident in the PCACI group: PCA 0.73 ± 0.18 and PCACI 0.86 ± 0.17 (p = 0.073). Patient-reported adverse effects, sedation, and inability to sleep secondary to pain occurred similarly. Eight of 18 PCACI patients required discontinuation of either the continuous infusion mode or of PCA therapy entirely secondary to adverse effects. CONCLUSIONS: When compared with PCA therapy, PCACI was not associated with improved pain control and more patients receiving PCACI required discontinuation of therapy secondary to adverse effects.

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