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n contains supplementary material available at 10.1007/s43465-020-00324-y.
Many factors have been reported to affect postoperative range of knee flexion after total knee arthroplasty (TKA); however, no study has reported the impact of preoperative range of motion of the hip to the postoperative flexion angle of the knee thus far.
Of 38 consecutive patients who underwent posterior-stabilized TKA, we assessed 21 patients after excluding 17 patients who met exclusion criteria. The range of motion of the knee and the hip, age, body-mass index, serum albumin level, HbA1c, Kellgren-Lawrence grade, knee extension strength and radiological femorotibial angle as well as postoperative knee flexion angle at three months were evaluated. The preoperative data and the knee flexion angle at three months after TKA were compared using Spearman's rank correlation coefficient.
Knee flexion angle at three months after TKA was positively correlated with preoperative flexion (
= 0.616,
= 0.007) and external rotation angle (
= 0.576,
= 0.012) of the hip as well as preoperative knee flexion angle (
= 0.797,
= 0.001). There were no correlations between postoperative knee flexion angle and other preoperative data.
Patients with restricted flexion and/or external rotation of the hip may have contractures of Gluteus maximus, Gluteus medius and Tensor fasciae latae, which can cause hypertension of iliotibial tract. It may cause decreased internal rotation of the tibia when the knee is flexed, which affects postoperative knee flexion angle, thus limited flexion and/or external rotation of the hip might restrict knee flexion angle following TKA.
Patients with restricted flexion and/or external rotation of the hip may have contractures of Gluteus maximus, Gluteus medius and Tensor fasciae latae, which can cause hypertension of iliotibial tract. It may cause decreased internal rotation of the tibia when the knee is flexed, which affects postoperative knee flexion angle, thus limited flexion and/or external rotation of the hip might restrict knee flexion angle following TKA.
Non-surgical factors have been found to have significant impact on outcome following Total Knee Arthroplasty (TKA). The study was conducted to know the independent effect of each of the four interacting psychological factors anxiety, depression, pain catastrophizing and kinesiophobia on early outcome following TKA in an Indian population.
104 consecutive patients undergoing TKA were included in the study and followed up at 6weeks, 6months and one year. Preoperatively, Hospital Anxiety and Depression Scale was used to diagnose and quantify anxiety and depression, pain catastrophizing and kinesiophobia were assessed using Pain Catastrophizing Scale and Tampa Scale for Kinesiophobia, respectively. Outcome was assessed on the basis of Knee Society Score and Knee Injury and Osteoarthritis Outcome Score. Regression analysis was done to know independent effect of each factor on outcome scores.
Nine (8.7%) patients were found to have undiagnosed psychopathology. The patients with psychopathologies were found tosion of this article (10.1007/s43465-020-00325-x) contains supplementary material, which is available to authorized users.
The Edinburgh Visual Gait Score (EVGS) is a comprehensive measure of gait abnormalities in children with cerebral palsy (CP) and has good psychometric properties. However, it is cumbersome to administer and requires multiple devices to record and measure its various components. We conducted this study to determine if a smartphone video protocol could be used to improve the usability and reliability of the EVGS for daily use in a clinic setting.
We used a handheld smartphone camera with slow-motion video technology and a motion analysis application to record and measure the EVGS of 30 ambulatory children with spastic CP. We tested the inter- and intra-rater reliability of various components of the EVGS between two observers.
Average age was 7years 3months (range 4-14years). The mean (range) EVGS scores for the trunk, pelvis, hip, knee, ankle, and foot were 1.18 (0-3), 0.68 (0-3), 1.1 (0-4), 3.95 (1.5-7.5), 1.87 (0-4) and 4.13 (2-6.5) respectively. Total score was 12.92 (7-21.5). The mean (SD) scores for Gross Motor Function Classification System (GMFCS) levels II and III were 10.73 (3.86) and 14.96 (4.2) (
< 0.001). The intra-observer and inter-observer reliability using percentage of complete agreement was 65-98.3% and 61.7-92.5% respectively, with kappa values ranging from 0.15 to 0.87. Reliability was more for distal limb segments as compared to proximal segments.
We have described a simple and reliable method for quantitative OGA of children with CP, using smartphone video technology and motion analysis application, which can be performed by every clinician in an office setting.
Level III.
Level III.
Changes in health-related quality of life (HRQOL) of AIS patients coming across both bracing and surgery have not yet reported. These patients received two major clinical interventions and their HRQOL might be different from previous articles. The aim of this study is to evaluate the changes of HRQOL of a specific group of AIS patients who experienced both bracing and surgery.
One hundred and twenty-eight patients requiring surgery with prior bracing treatment were identified from the electronic record. SRS-22 questionnaire was completed at 7 time points crossing both interventions (namely "Before", "Bracing ≤ 1year", "Bracing > 1year", "Pre-op", "Post-op", "Post-op ≤ 1year, and "Post-op 1-2years").
SRS-22 "Function", "Pain" and "Self-image" scores were decreased from "Before" to "Bracing ≤ 1year" when started bracing and raised at "Bracing > 1year". The 3 scores were dropped from "Bracing > 1year" to "Pre-op", particularly on "Self-image". "Function" and "Pain" were significantly dropped from "Pre-op" to "Post-op" and kept raising until "Post-op 1-2years". "Self-image" was improving after "Pre-op". "Mental" was relatively stable along the timeline.
This study described the changes in HRQOL of a specific group of AIS patients. Scores were dropped after the two major clinical interventions and recovered afterwards. Medical professionals were able to plan and provide appropriate supports on the expected changes in HRQOL, especially on function, pain and mental.
This study described the changes in HRQOL of a specific group of AIS patients. Scores were dropped after the two major clinical interventions and recovered afterwards. find more Medical professionals were able to plan and provide appropriate supports on the expected changes in HRQOL, especially on function, pain and mental.
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