Table of Contents
Preface: Total Joint Arthroplasty C. Allyson Jones Linda C. Li xi
Patient Satisfaction after Total Knee and Hip Arthroplasty Rick L. Lau Rajiv Gandhi Safiyyah Mahomed Nizar Mahomed 349
Patient satisfaction is an important outcome measurement in total knee arthroplasty/total hip arthroplasty surgery. Patient satisfaction can be evaluated from 2 perspectives, determinants of satisfaction and components of satisfaction. In total joint arthroplasty, improvements in satisfaction can be achieved by examining these perspectives. Patient satisfaction is one of the many PROMs (Patient Reported Outcome Measures) used in orthopedic surgery and is an integral part of the growing sentiment to evaluate surgery from the patient's perspective as well as from the surgeon's. The importance of measuring outcomes from the patient perspective is integral to today's patient centered models of care.
Patient-Reported Outcomes for Total Hip and Knee Arthroplasty: Commonly Used Instruments and Attributes of a "Good" Measure Natalie J. Collins Ewa M. Roos 367
Total hip arthroplasty (THA) and total knee arthroplasty (TKA) are effective surgical interventions for relieving pain and improving physical function in patients with end-stage degenerative joint disease. Optimization of surgical outcomes requires selection of suitable patients, as well as postoperative evaluation utilizing appropriate patient-reported outcome measures. This article evaluates patient-reported outcomes frequently used for THA and TKA patients, including disease-specific (HOOS, HOOS-PS, KOOS, KOOS-PS, WOMAC), intervention-specific (Harris Hip Score, Oxford Hip Score, Oxford Knee Score), and generic instruments (EQ-5D, SF-12, SF-36), and provides a guide regarding their suitability for use in such patients based on their characteristics and psychometric properties.
Health-Related Quality of Life After Total Joint Arthroplasty: A Scoping Review C. Allyson Jones Sheri Pohar 395
This review examines recovery after total hip and knee arthroplasty. It aims to (1) provide an overview of the different types of disease-specific, generic, and utility outcome measures used to assess recovery after total hip and knee arthroplasty and (2) summarize reported changes in health-related quality of life after total joint arthroplasty. Disease-specific measures reported large and important changes (assessed with minimally clinically important differences and effect size criteria), primarily for pain and function over short- and long-term recovery. Smaller but important changes were reported with generic and utility measures. Changes were largest in the pain and physical function domains.
Revision Total Hip and Knee Replacement Andrew J. Barnett Andrew D. Toms 431
The number of primary and revision total joint arthroplasty procedures is increasing exponentially with time. It is anticipated that there will be a huge expected demand for revision knee surgery over the next 2 decades. Awareness is needed by both general practitioner and physician for the signs of failure of these implants and when to refer to the surgeon. Unless the surgeon accurately identifies the mode of failure, successful treatment becomes very unlikely. In comparison with primary joint arthroplasty, complication rates after revision surgery are significantly increased, and outcome is less assured.
Minimally Invasive Total Hip and Knee Arthroplasty-Implications for the Elderly Patient Inge H.F. Reininga Martin Stevens Robert Wagenmakers Sjoerd K. Bulstra Inge van den Akker-Scheek 447
Total hip arthroplasty and total knee arthroplasty have proven to be effective surgical procedures for the treatment of hip and knee osteoarthritis. In recent decades, there have been considerable efforts to improve the component designs, modes of fixation, and surgical techniques. Minimally invasive techniques are examples of these developments. Minimally invasive total joint arthroplasty aims at decreasing the surgical incision and minimizing damage to the underlying soft tissue to accelerate postoperative recovery and an earlier return to normal function. The objective here is to report on these recent developments in minimally invasive total joint arthroplasty and their implication for the elderly patient.
Pharmacologic Pain Management Before and After Total Joint Replacement of the Hip and Knee James V. Bono Claire E. Robbins Abdel K. Mehio Mehran Aghazadeh Carl T. Talmo 459
Total knee replacement (TKR)and totel hip replacement (THR) can provide pain relief and restoration of function in individuals with musculoskeletal impairment. The procedures are extremely successful and essentially unrivaled in the treatment of osteoarthritis pain. Demand is expected to increase. Because of these factors, a detailed understanding of perioperative issues in THR and TKR is important to practitioners. Issues include nonoperative measures and pharmacologic strategies. The discussion of pharmacology in joint replacement before, during, and after surgery includes multimodal management and agents such as acetaminophen, nonsteroidal antiinflammatory agents, injections of cortisone or visco-supplementation, and tramadol.
Perioperative Complications Following Total Joint Replacement Carl T. Talmo Mehran Aghazadeh James V. Bono 471
Total joint replacement (TJR) of the hip and knee is an effective procedure resulting in decreased pain and improved function in osteoarthritis patients. TJR is increasing at a significant rate, and increased awareness of potential complications following TJR is of paramount importance to all practitioners. The geriatric patient may be more susceptible to perioperative complications following TJR; therefore, careful preoperative planning, close perioperative monitoring, and the institution of appropriate preventative measures can minimize complications or dampen their impact. Complications to consider in the elderly patient following TJR include infection, thromboembolism, fracture, hip dislocation, and delirium, as well as cardiovascular complications.
Rehabilitation and Total Joint Arthroplasty Marie D. Westby 489
Total joint arthroplasty surgeries are on the rise due to the aging population and the contribution of rising obesity rates to hip and knee osteoarthritis. With the growing demand, greater attention needs to be directed toward identifying cost-effective rehabilitation interventions to optimize outcomes in the long term. Patients' rehabilitation needs should be considered along a continuum with appropriate assessment and management of preoperative health and psychosocial issues and provision of exercise therapy postoperatively. The goal is to help patients adopt or resume physically active lifestyles, maintain their independence, and minimize reductions in functional capacity associated with normal aging.
Physical Activity Participation Among Patients After Total Hip and Knee Arthroplasty Martin Stevens Inge H.F. Reininga Sjoerd K. Bulstra Robert Wagenmakers Inge van den Akker-Scheek 509
Total hip (THA) and knee arthroplasty (TKA) are successful operative interventions, yet little is known about the physical activity behavior of patients after THA/TKA. For older adults, there are beneficial effects of regular physical activity after THA/TKA. The objective of this paper is to review the benefits of physical activity after THA/TKA, the potential negative consequences of physical activity on hip or knee prosthesis, the measurement of physical activity, physical activity behavior, and the current opinion of health care professionals regarding types of physical activities recommended for patients after THA/TKA.
Race/Ethnicity and Use of Elective Joint Replacement in the Management of End-Stage Knee/Hip Osteoarthritis: A Review of the Literature Marissa A. Blum Said A. Ibrahim 521
Osteoarthritis is the most prevalent form of arthritis for which elective knee and hip joint replacement are effective treatment options in the management of end-stage disease. There are marked racial disparities in the utilization of joint arthroplasty. This article reviews the rationale for understanding this disparity, the evidence base that supports the disparity, and some known potential explanations, as well as additional data on racial disparities emerging in research on postarthroplasty outcomes and quality of care. The article concludes with a call for more research examining patient, provider and system-level factors that underlie these disparities.
Index 533
