Clinical orthopaedics and related research
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Clin. Orthop. Relat. Res. · May 2021
Multicenter Study Observational StudyWhat Proportion of Patients with Bone and Soft Tissue Tumors Contracted Coronavirus-19 and Died From Surgical Procedures During the Initial Period of the COVID-19 Pandemic? Results From the Multicenter British Orthopaedic Oncology Society Observational Study.
Delivering uninterrupted cancer treatment to patients with musculoskeletal tumors has been essential during the rapidly evolving coronavirus 2019 (COVID-19) pandemic, as delays in management can be detrimental. Currently, the risk of contracting COVID-19 in hospitals when admitted for surgery and the susceptibility due to adjuvant therapies and associated mortality due to COVID-19 is unknown, but knowledge of these potential risks would help treating clinicians provide appropriate cancer care. ⋯ Level III, therapeutic study.
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Clin. Orthop. Relat. Res. · Mar 2021
Multicenter StudyWhat Factors Predict Adverse Discharge Disposition in Patients Older Than 60 Years Undergoing Lower-extremity Surgery? The Adverse Discharge in Older Patients after Lower-extremity Surgery (ADELES) Risk Score.
Adverse discharge disposition, which is discharge to a long-term nursing home or skilled nursing facility is frequent and devastating in older patients after lower-extremity orthopaedic surgery. Predicting individual patient risk allows for preventive interventions to address modifiable risk factors and helps managing expectations. Despite a variety of risk prediction tools for perioperative morbidity in older patients, there is no tool available to predict successful recovery of a patient's ability to live independently in this highly vulnerable population. ⋯ Level III, diagnostic study.
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Clin. Orthop. Relat. Res. · Oct 2020
Multicenter StudyWhat Is the Accuracy of Three Different Machine Learning Techniques to Predict Clinical Outcomes After Shoulder Arthroplasty?
Machine learning techniques can identify complex relationships in large healthcare datasets and build prediction models that better inform physicians in ways that can assist in patient treatment decision-making. In the domain of shoulder arthroplasty, machine learning appears to have the potential to anticipate patients' results after surgery, but this has not been well explored. ⋯ Three different commercially available machine learning techniques were used to train and test models that predicted clinical outcomes after aTSA and rTSA; this device-type comparison was performed to demonstrate how predictive modeling techniques can be used in the near future to help answer unsolved clinical questions and augment decision-making to improve outcomes after shoulder arthroplasty.
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Clin. Orthop. Relat. Res. · Sep 2020
Multicenter StudyA High Proportion of Patients Have Unfulfilled Sexual Expectations After TKA: A Prospective Study.
Most patients have high expectations about restoration of the knee function after TKA, expecting a more active life after retirement. However, 20% to 30% of patients report that their expectations are not met postoperatively. Among those unmet expectations may be the anticipation to engage in sexual activity after surgery, but few studies have evaluated sexual activity after arthroplasty. ⋯ Level II, therapeutic study.
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Clin. Orthop. Relat. Res. · Jul 2020
Multicenter Study Comparative Study Observational StudyWidespread Pain Is Associated with Increased Risk of No Clinical Improvement After TKA in Women.
When conservative treatments do not work, TKA may be the best option for patients with knee osteoarthritis, although a relatively large proportion of individuals do not have clinically important improvement after TKA. Evidence also suggests that women are less likely to benefit from TKA than men, but the reasons are unclear. Widespread pain disproportionately affects women and has been associated with worse outcomes after joint arthroplasty, yet it is unknown if the effect of widespread pain on TKA outcomes differs by patient gender. ⋯ Level III, therapeutic study.