Disparities in functional recovery after dysvascular lower limb amputation are associated with employment status and self-efficacy.

Purpose: Employment status is considered a determinant of health, yet returning to work is frequently a challenge after lower limb amputation. No studies have documented if working after lower limb amputation is associated with functional recovery. The study's purpose was to examine the influence of full-time employment on functioning after lower limb amputation.

Rehabilitation Outcomes for Total Knee Arthroplasties: Continuous Adductor Canal Block Versus Continuous Femoral Nerve Block.

Objective: To determine whether any strength, range of motion (ROM), or functional improvement exists in the adductor canal block (ACB) group after completion of inpatient rehabilitation and following the removal of the continuous block.

Design: Retrospective cohort.

Setting: Inpatient rehabilitation at discharge and outpatient orthopedic clinic for follow-up.

Primary Total Knee Arthroplasty: How Does Residual Patellar Thickness Affect Patient-Oriented Outcomes?

Background: Maintenance of the native patellar thickness has been deemed important for proper clinical outcomes after total knee arthroplasty (TKA). Our objective was to study the effects of the change in patellar thickness on patient-perceived outcomes (PPOs) after TKA. We hypothesized that reestablishing native patellar thickness after TKA results in better PPOs.

Prolonged Conservative Management in Total Joint Arthroplasty: Harming the Patient?

Background: It is important to understand the long-term consequences of postponing total joint arthroplasty until the onset of severe functional impairment. Therefore, the purpose of this investigation was to determine and compare the midterm to long-term postoperative outcomes of patients who underwent total joint arthroplasty with severe vs less severe preoperative functional impairment.

Methods: A total of 105 primary unilateral total hip/knee arthroplasty patients were studied.

Preoperative Glycemic Control on Total Joint Arthroplasty Patient-Perceived Outcomes and Hospital Costs.

Background: The purpose of this study was to determine the influence of preoperative glycemic control in diabetic patients undergoing a primary total hip or knee arthroplasty. We wanted to study patient-perceived outcomes in the medium term, the length of stay, hospital costs, and rate of short-term postoperative complications.

Methods: One hundred twenty consecutive primary total joint arthroplasties (TJAs) performed in type 2 diabetic patients were stratified into 2 groups representing optimal and suboptimal preoperative glycemic control, based on serum levels of glycated hemoglobin (HbA), and those groups compared.

Total Joint Arthroplasty: A Granular Analysis of Outcomes in the Economically Disadvantaged Patient.

Background: Poor patients experience more serious complications and worse outcomes after surgery than higher-income patients. Our objective was to study detailed patient sociodemographic characteristics and preoperative/postoperative patient-oriented outcomes in economically disadvantaged and non-economically disadvantaged primary total joint arthroplasty patients.

Methods: From a consecutive series, 213 economically disadvantaged patients and 1940 non-economically-disadvantaged patients were statistically analyzed.

Celecoxib and heterotopic bone formation after total hip arthroplasty.

We assessed the effectiveness of celecoxib in the prevention of heterotopic ossification (HO) following primary total hip replacement (THR). We studied 170 consecutive THRs. Sixty-three patients received celecoxib after surgery (200mg twice/daily) for 28 days and 84 did not.

Vitamin D insufficiency in patients with THA: prevalence and effects on outcome.

Background: The consequences of vitamin D insufficiency in the elderly remain controversial. The prevalence and potential effects of its chronic insufficiency on quality of life and physical function in patients undergoing THA have received little attention.

Question/purposes: We determined (1) prevalence of preoperative vitamin D insufficiency in patients undergoing THA and (2) relationships of insufficiency to patient-perceived outcomes (PPOs) and hip scores.

Use of a squatting movement as a clinical marker of function after total knee arthroplasty.

Objective: The aims of this study were to evaluate weight bearing during standing and 30- and 60-degree squats approximately 1 wk and 2 mos after surgery and determine whether weight bearing during squatting could be a better clinical marker than standing for identifying perceived functional limitation approximately 1 wk after surgery. A further objective was to determine whether age, body mass index, and number of outpatient visits over the course of rehabilitation predicted weight bearing during a squat approximately 2 mos after surgery.

Design: The percentage of body weight placed over both limbs during stand and 30- and 60-degree squats in 38 patients (25 women and 13 men) who had primary unilateral knee arthroplasty was determined.

Do patient expectations about arthroplasty at initial presentation for hip or knee pain differ by sex and ethnicity?

Background: Many studies show gender and ethnic differences in healthcare utilization and outcomes. Patients' presurgical cognitions regarding surgical outcomes also may vary by gender and ethnicity and play a role in explaining utilization and outcome differences. However, it is unclear whether and to what extent gender and ethnicity play a role in patients' presurgical cognitions.

Mental health and outcomes in primary total joint arthroplasty.

A consecutive series of 640 total joint arthroplasty patients was interviewed before surgery and at a minimum of 2 years following surgery. Statistical analyses were conducted to examine the effect of psychological distress and other patient characteristics on outcomes (Western Ontario and McMaster Universities Osteoarthritis Index, Short Form 36, and Quality of Well-Being index). Before and after surgery, distressed subjects had significantly lower scores than nondistressed subjects for most dependent measures (P range, .

Squatting after primary unilateral total knee arthroplasty: a pilot study examining differences between genders.

Objective: To compare the weight bearing of men and women during standing and squatting after knee replacement surgery for osteoarthritis.

Design: Two-group, single-surgeon study with patients selected consecutively through a sample of convenience. Patients evaluated at first outpatient rehabilitation visit and at discharge from outpatient services.

Knee extensor function before and 1 year after simultaneous bilateral total knee arthroplasty: is there asymmetry between limbs?

One year after unilateral total knee arthroplasty (TKA), there is interlimb knee extensor function asymmetry. In the study reported here, we investigated whether there was knee extensor function "asymmetry" between limbs 1 year after simultaneous bilateral TKA. Fourteen patients volunteered to participate in this study before undergoing simultaneous bilateral TKA secondary to knee osteoarthritis.

Ethnic and racial factors influencing well-being, perceived pain, and physical function after primary total joint arthroplasty.

Background: Studies suggest, even when controlling for disease severity, socioeconomic status, education, and access to care, racial and ethnic minorities receive lower-quality health care and have worse perceived pain and function before and after total joint arthroplasty.

Question/purposes: We evaluated the influence of race and ethnicity on well-being, pain, and function after total joint arthroplasty and determined whether race, ethnicity, sex, and joint involvement influenced perceived function and pain after total joint arthroplasty.

Patients And Methods: We retrospectively reviewed the records of 1749 patients receiving total joint arthroplasty (739 hips and 1010 knees).

Patient perceived outcomes after primary hip arthroplasty: does gender matter?

Background: Total hip arthroplasty (THA) provides high functional scores and long-term survivorship. However, differences in function and disability between men and women before and after arthroplasty are not well understood.

Questions/purposes: We determined if there was a gender difference in patient-perceived functional measures and range of motion in primary THA.

Physical therapy management of a patient with Eagle syndrome.

The purpose of this care report was to describe the physical therapy management of a unique case involving a 50-year-old white female with complaints pertaining to the craniofacial, cervical, thoracic, and brachial regions with known Eagle syndrome as a complicating factor. Intervention consisted of manual therapy and therapeutic exercises. The Craniocervical Flexion Test (CCFT), Neck Disability Index (NDI), and subjective complaints were used as outcome measures.

The effects of the contract-relax-antagonist-contract form of proprioceptive neuromuscular facilitation stretching on postural stability.

To investigate the effects of the contract-relax-antagonist-contract (CRAC) form of proprioceptive neuromuscular facilitation (PNF) stretching, with and without a warm-up, on postural stability. Thirty volunteers (15 men and 15 women, age: 25.17 +/- 5.

Closed-chain exercise after simultaneous bilateral knee replacement surgery: a case report.

The purpose of this case report was to present a method for assessing entire lower extremity performance and describe a Medical Exercise Therapy (MET) training program early after simultaneous bilateral total knee replacement (TKR). We also documented perceived function, mobility, and weight-bearing ability during functional tasks. The patient was a 50-year-old male who underwent a simultaneous bilateral procedure and began physical therapy (PT) 16 days postsurgery.

Delaying knee replacement and implications on early postoperative outcomes: a pilot study.

The goal of this study was to compare outcomes during postoperative rehabilitation between individuals who delayed surgery to those who did not delay surgery. Forty-two patients who underwent unilateral total knee replacement (TKR) were categorized into 2 groups: early surgical (n=30, surgery 324 days prior) and late surgical (n=12, surgery >or=325 days from the initial orthopedic office visit). The KSKS, KSFS, SF-12 PC summary, and AROM for knee extension and flexion were assessed preoperatively.

Fear in arthroplasty surgery: the role of race.

Unlabelled: Understanding the difference in perceived functional outcomes between whites and blacks and the influence of anxiety and pain on functional outcomes after joint arthroplasty may help surgeons develop ways to eliminate the racial and ethnic disparities in outcome. We determined the difference in functional outcomes between whites and blacks and assessed the influence of fear and anxiety in total joint arthroplasty outcomes in 331 patients undergoing primary hip and knee arthroplasty. WOMAC, Quality of Well Being, SF-36, and Pain and Anxiety Symptoms Scale (PASS) were administered pre- and postoperatively (average 5-year followup).

The effects of blood and fat on Morse taper disassembly forces.

Biological debris between modular components using Morse tapers in hip arthroplasty can lead to weakening of the implant construct. We conducted a study to determine the effect of blood and fat within the taper interface. Tapers were divided into groups 1 (clean), 2 (surface covered with blood and fat), and 3 (blood and fat wiped off).

All-Patient Refined Diagnosis-Related Groups in primary arthroplasty.

Our objective was to determine if the All-Patient Refined Diagnosis-Related Groups (APR-DRGs) and other comorbidity scores correlate with pain level, functional abilities, and hospital cost after primary total joint arthroplasty (TJA). Three hundred three patients having TJA were evaluated with average follow-up of 21 months. Western Ontario and McMaster Universities osteoarthritis index, Short-Form 36, and Quality of Well-Being index were administered before and after surgery.

Is postoperative function after hip or knee arthroplasty influenced by preoperative functional levels?

Our objective was to evaluate functional outcomes after surgery in a subgroup of patients presenting for hip and knee surgery who had low functional scores before surgery. One hundred twenty-seven unilateral total hip and knee arthroplasty patients were assessed preoperatively and 3 consecutive years after arthroplasty using: Western Ontario and McMaster University Osteoarthritis Index (WOMAC), Short Form 36 (SF-36), and the Quality of Well-Being index scales. Patients were placed into 2 groups based on preoperative WOMAC function scores; 51 points or more, worse functioning group, and less than 51 points, higher functioning group.

Accuracy of knee range of motion assessment after total knee arthroplasty.

Measurement of knee joint range of motion (ROM) is important to assess after total knee arthroplasty. Our objective was to determine level of agreement and accuracy between observers with different knowledge on total ROM after total knee arthroplasty. Forty-one patients underwent x-ray of active and passive knee ROM (gold standard).

Multimodal pain management and arthrofibrosis.

Pain control after arthroplasty has been a key concern for orthopedic surgeons. After total knee arthroplasty (TKA), a small group of patients developed a painful joint with suboptimal range of motion. Manipulation under anesthesia increases flexion and extension while decreasing pain in most cases.