Predicting clinical outcome and length of sick leave after surgery for lumbar spinal stenosis in Sweden: a multi-register evaluation.

Purpose: Lumbar spinal stenosis (LSS) can be surgically treated, with variable outcome. Studies have linked socioeconomic factors to outcome, but no nation-wide studies have been performed. This register-based study, including all patients surgically treated for LSS during 2008-2012 in Sweden, aimed to determine predictive factors for the outcome of surgery.

A simple visual analog scale for pain is as responsive as the WOMAC, the SF-36, and the EQ-5D in measuring outcomes of revision hip arthroplasty.

Background And Purpose: Little is known about the comparative performance of patient-reported outcome measures in revision hip arthroplasty. We compared the performance of the WOMAC, the SF-36, the EQ-5D, and a pain-related visual analog scale (VAS) in revision hip arthroplasty.

Methods: 45 patients with aseptic prosthetic loosening following primary hip arthroplasty completed the WOMAC, the SF-36, the EQ-5D, and a VAS for pain-at baseline and 2 years after revision.

The six-item CTS symptoms scale and palmar pain scale in carpal tunnel syndrome.

Purpose: To evaluate measurement properties of 2 brief outcome measures for carpal tunnel syndrome: the 6-item carpal tunnel symptoms scale (CTS-6) and the 2-item palmar pain scale (measuring severity of pain in the scar/palm and pain-related activity limitation). Our hypothesis was that the CTS-6 is responsive to change in symptoms after surgical treatment and the pain scale is a valid measure of surgery-related pain.

Methods: This study followed 447 consecutive patients with carpal tunnel syndrome undergoing open release; 308 completed the CTS-6 and the Disabilities of the Arm, Shoulder, and Hand-short form (QuickDASH) before surgery and the CTS-6, QuickDASH, palmar pain scale, and 2 items regarding global rating of change and treatment satisfaction once after surgery (range, 2-13 mo).

Open compared with 2-portal endoscopic carpal tunnel release: a 5-year follow-up of a randomized controlled trial.

Purpose: The purpose of this investigation was to extend the previously reported short-term randomized trial of open and endoscopic carpal tunnel release in patients with carpal tunnel syndrome (CTS) to compare outcomes 5 years after surgery.

Methods: In a single-center randomized controlled trial, 128 patients (25 to 60 years) with clinically diagnosed and electrophysiologically confirmed idiopathic CTS were randomized immediately before surgery to open or 2-portal endoscopic release. The outcome measures included the validated CTS questionnaire's symptom severity and functional status scales (scored from 1 to 5) completed at baseline and 1 year postoperatively.

Long-term cost and effect on quality of life of osteoporosis-related fractures in Sweden.

Background And Purpose: Few economic or quality-of-life studies have investigated the long-term consequences of fragility fractures. This prospective observational data collection study assessed the cost and quality of life related to hip, vertebral, and wrist fracture 13-18 months after the fracture, based on 684 patients surviving 18 months after fracture.

Patients And Methods: Data regarding resource use and quality of life related to fractures was collected using questionnaires at 7 research centers in Sweden.

Carpal tunnel syndrome and keyboard use at work: a population-based study.

Objective: To investigate the relationship between carpal tunnel syndrome (CTS) and keyboard use at work in a general population.

Methods: A health status questionnaire was mailed to 2,465 persons of working age (25-65 years) who were randomly selected from the general population of a representative region of Sweden. The questionnaire required the subjects to provide information about the presence and severity of pain, numbness and tingling in each body region, employment history, and work activities, including average time spent using a keyboard during a usual working day.

Five-year follow-up of socket movements and loosening after revision with impacted morselized allograft bone and cement: a radiostereometric and radiographic analysis.

In 1999, we reported on the 2-year results of a series of 21 first-time socket revisions using impacted morselized allograft bone. Seven still migrated between 1.5 and 2 years.

Outcomes of endoscopic surgery compared with open surgery for carpal tunnel syndrome among employed patients: randomised controlled trial.

Objectives: To compare endoscopic and open carpal tunnel release surgery among employed patients with carpal tunnel syndrome.

Design And Setting: Randomised controlled trial at a single orthopaedic department.

Participants: 128 employed patients aged 25-60 years with clinically diagnosed and electrophysiologically confirmed idiopathic carpal tunnel syndrome.

Costs and quality of life associated with osteoporosis-related fractures in Sweden.

This prospective observational data collection study assessed the cost and quality of life related to hip, vertebral and wrist fracture 1 year after the fracture, based on a patient sample consisting of 635 male and female patients surviving a year after fracture. Data regarding resource use and quality of life related to fractures was collected by questionnaires at baseline, 4 months and 12 months. Information was collected by the use of patients' records, register sources and by asking the patient.

Quality of life after hip revision with impaction bone grafting on a par with that 4 years after primary cemented arthroplasty.

Background: There have been few studies evaluating patient-reported quality of life outcomes after hip revision with impaction bone grafting.

Patients And Methods: The inclusion criteria were aseptic loosening after primary arthroplasty performed for osteoarthrosis, and first-time revision with impacted morselized allograft bone and cemented Exeter stem. During a 4-year period, 35 patients were eligible and all were included.

Activities of daily living decrease similarly in hospital-treated patients with a hip fracture or a vertebral fracture: a one-year prospective study in 151 patients.

Aims: A hip fracture is commonly regarded as the most devastating fragility fracture, as regards both morbidity and mortality, while a vertebral fracture is usually regarded as having lower general morbidity. The purpose of this study was to investigate whether hospitalized patients with a hip or a vertebral fracture experience similar functional deterioration following the fracture as regards activity of daily living (ADL) and experienced quality of life (QOL).

Methods: Eighty-seven women and 22 men, mean age 81 (range 66-96), with a hip fracture and 34 women and 8 men, mean age 81 (range 68-92), with a vertebral fracture were followed up for 12 months.

Hip revision using the Exeter stem, impacted morselized allograft bone and cement: a consecutive 5-year radiostereometric and radiographic study in 15 hips.

Background: Impaction grafting in hip revision surgery is widely used but studies with mid- and long-term follow-up are scarce.

Patients, Methods And Results: A 5-year radiostereometric (RSA) follow-up of 15 hip revisions with the Exeter stem, morselized impacted allograft bone and cement revealed that 3 stems had not migrated between 2 and 5 years after revision, 11 stems had migrated to a minor degree in at least 1 direction, and 1 stem was loose according to RSA but without any radiographic signs of loosening or pain. The pain score was comparable to primary arthroplasties.

Movement pattern of the Exeter femoral stem; a radiostereometric analysis of 22 primary hip arthroplasties followed for 5 years.

Background: The design of the Exeter stem may facilitate distal migration, but radiostereometric analysis (RSA) studies have been limited to 2 years of follow-up.

Patients And Methods: We followed migration of the Exeter femoral stems in 22 primary hip arthroplasties for 5 years with RSA.

Results: All stems migrated distally and the median migration at 2 years was 1.

Chronic upper extremity pain and co-occurring symptoms in a general population.

Objective: To estimate the prevalence of self reported chronic upper extremity pain associated with physical impairment in a general population, and its co-occurrence with chronic upper extremity numbness or tingling and chronic pain at other locations.

Methods: A general health questionnaire was mailed to 3,000 persons (age 25-74 years) who were randomly selected from a general population register.

Results: The response rate was 83%.

Severe carpal tunnel syndrome potentially needing surgical treatment in a general population.

Purpose: To estimate the prevalence of severe carpal tunnel syndrome (CTS) that potentially needs surgical treatment in a general population.

Methods: A health-status questionnaire was mailed to a random general population sample of 3,000 subjects (ages, 25-74 y). The responders who reported numbness and/or tingling in the median nerve distribution in the hands were asked to attend a clinical evaluation at which they completed the validated CTS questionnaire and underwent physical examination and nerve conduction tests.

Hip revision with impacted morselized allografts: unrestricted weight-bearing and restricted weight-bearing have similar effect on migration. A radiostereometry analysis.

Background: No consensus exists as to whether to let patients bear weight or not after revision of a loosened hip prosthesis using morselized and impacted allograft bone and cement. In the original description of the method, the patients were advised not to bear weight for 3 months postoperatively. Theoretically, bone graft remodeling is enhanced by mechanical load, but an increased migration of the prosthesis within the graft can also be anticipated.

Diagnostic properties of nerve conduction tests in population-based carpal tunnel syndrome.

Background: Numerous nerve conduction tests are used for the electrodiagnosis of carpal tunnel syndrome (CTS), with a wide range of sensitivity and specificity reported for each test in clinical studies. The tests have not been assessed in population-based studies. Such information would be important when using electrodiagnosis in epidemiologic research.

Primary care patients with musculoskeletal pain. Value of health-status and sense-of-coherence measures in predicting long-term work disability.

Objective: To investigate long-term sick leave among primary care patients with musculoskeletal disorders and the predictive value of health-status and sense-of-coherence measures.

Methods: Patients aged 17 to 64 years who, during seven weeks, attended one of six primary care centers because of non-traumatic musculoskeletal pain and who completed the SF-36 health questionnaire and the sense of coherence (SOC) scale at baseline and after one year.

Results: Of 189 patients, 36 (19%) were sicklisted for at least three months before and/or after their visit; the most common diagnoses were non-specific soft-tissue or multiple joint, low back, and shoulder pain.

Early complications after one hundred and forty-four consecutive hip revisions with impacted morselized allograft bone and cement.

Background: The use of impacted morselized allograft bone and cement in hip revision arthroplasty has been popular, but studies that specifically address intraoperative and postoperative complications have been scarce.

Methods: All complications that occurred during, and within the first year after, 144 consecutive hip revision arthroplasties (108 stems and 130 sockets) performed with impacted morselized allograft bone and cement were recorded. Clinical and radiographic follow-up evaluation was performed at three months and at one year after surgery for all patients except eight (seven who had died of causes unrelated to the hip surgery and one who had sustained a stroke).