The Journal of arthroplasty
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It is not clear whether indicating TKA-surgery is advisable in depressed patients. A prospective cohort of 716 patients undergoing TKA was designed. SF36, KSS, WOMAC and VAS plus 2 satisfaction questions were evaluated. ⋯ Depressed patients obtained great improvement from preoperative at one-year follow-up and even greater than non-depressed patients in some domains. Moreover, satisfaction was similar. Therefore, TKA can be recommended to depressed patients.
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The purpose of this study was to validate the 'Forgotten Joint' score (FJS-12), a 12-item questionnaire designed to analyze the patient's ability to forget the joint in everyday life, in French and to compare the results of this Patient Reported Outcome (PRO) score in patients who had other than total joint arthroplasties. The score was compared in 122 patients that had either medial unicompartmental (N=51), patellofemoral (N=21) or total knee arthroplasty (N=50). After having validated the FJS-12 in French, a similar PRO was observed in unicompartmental and postero-stabilized total knee arthroplasty. Patellofemoral resurfacing had a significantly lower score than the two other types of arthroplasty, which can be explained by a significantly younger and smaller patient group.
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In a retrospective study, we evaluated the clinical outcome of multidisciplinary pain therapy (MPT) in a consecutive series of 40 patients with persistent unexplained pain following THA or TKA. Pain intensity, physical capability and psychological status were assessed before MPT (t1), after 3 weeks (t2) and at a mean follow-up of 32 months (t3). ⋯ Anxiety scores deteriorated between t2 and t3 and showed no difference in the baseline value. The present study suggests that MPT has beneficial short-term and mid-term effects in this subgroup of patients and may avoid exploratory revision surgery.
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Between March 2007 and July 2010, 1000 consecutive fully porous coated hip resurfacing arthroplasties (HRA) were performed by a single surgeon in 871 patients. The average length of follow-up was 3 ± 1 years. Three cases (0.3%) in three patients showed adverse wear related failures. ⋯ Using any failure of any component as the endpoint, the survivorship rate was 98.8% at two years and 97.4% at five years. Excluding the failed cases, all components were radiographically stable; there was only one partial femoral radiolucency seen. The clinical and radiological outcomes of this fully porous coated hip resurfacing were comparable to, if not better than, those reported by others using hybrid fixation methods at five years post-operatively.
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This study assessed the results of 90 one-component revisions for failed hip resurfacing due to adverse reaction to metal wear debris (76 acetabular, 14 femoral). Patients with a femoral head size 40-45 mm (n=33) received a two-piece titanium meshed shell with a cross-linked polyethylene liner and patients with femoral head size 46-54 mm (n=43) received metal-on-metal components. Patients with femoral head size>45 mm who wished a metal-polyethylene bearing received a dual mobility femoral prosthesis. ⋯ Three failures required re-revision; there was one deep infection. There were no dislocations. One-component revision is a reasonable alternative to revision to total hip arthroplasty.