Patients report inferior quality of care for knee osteoarthritis prior to assessment for knee replacement surgery - a cross-sectional study of 517 patients in Denmark.

Patients report inferior quality of care for knee osteoarthritis prior to assessment for knee replacement surgery - a cross-sectional study of 517 patients in Denmark. Acta Orthop. 2019 Oct 22;:1-6 Authors: Ingelsrud LH, Roos EM, Gromov K, Jensen SS, Troelsen A Abstract Background and purpose - Clinical care pathways for knee osteoarthritis (OA) are not always in line with clinical guidelines. We investigated (1) the patient-perceived quality of OA management, (2) which physiotherapist-delivered treatments patients with knee OA have attempted, and (3) patients' expected subsequent treatment, at the time of referral to an orthopedic surgeon. Patients and methods - This cross-sectional study included all patients with scheduled first-time appointments for knee OA at an orthopedic outpatient clinic from April 2017 to February 2018. Postal questionnaires included the 16-item OsteoArthritis Quality Indicator (OA-QI) questionnaire and questions about physiotherapist-delivered treatment for knee OA. Results - 517 of 627 (82%) eligible patients responded. Responders' (63% female) mean age was 67 years. The mean pass rate for the 16 independent quality indicators was 32% (8-74%). Sub-grouped into 4 categories, pass rates for independent quality indicators ranged from 16-52% regarding information, 9-50% regarding pain and functional assessment, 8-35% regarding referrals, and 16-74% regarding pharmacological treatment. While half of responders felt informed of phys...
Source: Acta Orthopaedica - Category: Orthopaedics Authors: Tags: Acta Orthop Source Type: research

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[Core decompression ("conventional method") in atraumatic osteonecrosis of the hip]. Oper Orthop Traumatol. 2019 Nov 21;: Authors: Benignus C, Lüring C, Beckmann J Abstract OBJECTIVE: Retrograde drilling of a necrotic zone within the femoral head to reduce intraosseous pressure and stimulate revascularization. INDICATIONS: Atraumatic osteonecrosis of the hip ARCO stage I (reversible) and ARCO stage II (potentially reversible) with a medial or central necrotic zone  30%, infections. SURGICAL TECHNIQUE: Supine position. Visualization of the necrotic zo...
Source: Operative Orthopadie und Traumatologie - Category: Orthopaedics Authors: Tags: Oper Orthop Traumatol Source Type: research
CONCLUSION: In a large cross-sectional analysis of knee OA patients scheduled for TKA, 40% of individuals reported having not received core recommended non-surgical treatments. Older individuals, men and those with less education had lower odds of having used recommended non-surgical OA treatments. PMID: 31732554 [PubMed - as supplied by publisher]
Source: J Rheumatol - Category: Rheumatology Authors: Tags: J Rheumatol Source Type: research
Abstract Femoroacetabular impingement is a cause of hip pain in young adults as a result of premature dynamic contact between the femur and acetabulum that occurs within the physiological range of hip motion. Diagnosis is made by patient history, clinical examination and radiographic findings. Cross-sectional imaging with computed tomography and magnetic resonance arthrography may be necessary in selected patients. Femoroacetabular impingement can be treated non-operatively with physiotherapist-led conservative care including analgesia and intra-articular steroid injections. Arthroscopic hip surgery aiming to rest...
Source: British Journal of Hospital Medicine - Category: Internal Medicine Authors: Tags: Br J Hosp Med (Lond) Source Type: research
Authors: Abbassy AA, Trebinjac S, Kotb N Abstract Knee osteoarthritis is a degenerative "wear and tear" disorder affecting mainly population over 50 years old. It can also present in younger people, especially after an injury or as a part of other diseases. While many therapeutic options exist for knee osteoarthritis, none of them has the potential to cure this condition. Cellular Matrix represents a combination of natural non-crosslinked hyaluronic acid (HA), thixotropic cell separation gel, and sodium citrate anticoagulant solution. A combination of Cellular Matrix with autologous platelet-rich plasma (...
Source: Bosnian Journal of Basic Medical Sciences - Category: General Medicine Tags: Bosn J Basic Med Sci Source Type: research
r F Abstract Primary osteoarthritis of the shoulder represents a destructive joint disease with associated synovitis, which in the first line seems to be genetically determined. Clinically, patients suffer from shoulder pain with progressive impairment of both active and passive range of motion. The diagnostics include a clinical examination, imaging by native radiography and magnetic resonance imaging (MRI) for assessment of the rotator cuff. Current classification systems consider the formation of humeral osteophytes, glenoid morphology and loss of humeral sphericity. Non-surgical measures include, apa...
Source: Der Orthopade - Category: Orthopaedics Authors: Tags: Orthopade Source Type: research
CONCLUSIONS: The review found no placebo-or sham-controlled trials of surgery in participants with symptomatic mild to moderate knee osteoarthritis. There was low quality evidence that there may be no evidence of a difference between arthroscopic partial meniscectomy surgery and a home exercise program for the treatment of this condition. Similarly, low-quality evidence from a few small trials indicates there may not be any benefit of arthroscopic surgery over other non-surgical treatments including saline irrigation and hyaluronic acid injection, or one type of surgery over another. We are uncertain of the risk of adverse...
Source: Cochrane Database of Systematic Reviews - Category: General Medicine Authors: Tags: Cochrane Database Syst Rev Source Type: research
This study investigated the effect of the E-SOLAS training program on relevant outcomes of effective training and implementation. Methods: Thirteen physiotherapists from across Ireland were trained via E-SOLAS by using mixed methods, and seven physiotherapists progressed to implementation of the 6-week group-based SOLAS intervention. The effectiveness of E-SOLAS was evaluated using the Kirkpatrick model at the levels of reaction (physiotherapist engagement and satisfaction with E-SOLAS training methods and content), learning (pre- to posttraining changes in physiotherapists’ confidence and knowledge in delivering SOL...
Source: Journal of Medical Internet Research - Category: General Medicine Authors: Source Type: research
CONCLUSIONS: Laterality judgment impairment was shown in CPRS1, upper limb pain, hand and wrist pain, carpal-tunnel syndrome, facial pain, knee osteoarthritis, and leg pain. No conclusions could be drawn in low back pain, due to the low-quality evidence and differing results. There was no impairment in whiplash-associated disorders and nonspecific cervical pain showed conflicting evidence. PMID: 30686110 [PubMed - as supplied by publisher]
Source: Physiotherapy Theory and Practice - Category: Physiotherapy Authors: Tags: Physiother Theory Pract Source Type: research
Purpose: It is estimated that 28 million people experience long term pain in the UK, with this number predicted to increase. A mechanistic approach to assessing both acute and long-term pain may optimise outcomes through enabling personalised management. Quantitative sensory testing (QST) through a range of modalities (pressure, thermal, vibration, and temporal summation) has been used to characterise patient populations (e.g. whiplash and osteoarthritis) and predict outcomes. Whilst reliability studies have shown adequate to good reliability (intra and inter rater) of QST measures, few have evaluated both intra and inter-...
Source: Physiotherapy - Category: Physiotherapy Authors: Tags: O0036 Source Type: research
Purpose: Greater Trochanteric Pain syndrome (GTPS) is a debilitating condition causing lateral hip pain. It affects 23.5% of women and 8% of men between 50-75 years old. Sufferers report comparable quality of life and functional performance to patients with end stage Osteoarthritis of the hip and a significant number of patients with GTPS continue to report symptoms two years after onset. Despite this commonality and burden, understanding of GTPS remains limited, particularly with regards to optimal management strategies.
Source: Physiotherapy - Category: Physiotherapy Authors: Tags: P099 Source Type: research
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