Journal of Personalized Medicine

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11 pages, 1548 KiB

Open AccessArticle

Sterile Silicone Ring Tourniquets in Limb Surgery: A Prospective Clinical Trial in Pediatric Patients Undergoing Orthopedic Surgery

by Kunhyung Bae, Gisu Kim, Amaal M. Aldosari, Yeonji Gim and Yoon Hae Kwak

J. Pers. Med. 2023, 13(6), 979; https://doi.org/10.3390/jpm13060979 - 10 Jun 2023

Viewed by 2104

Abstract

Sterile silicone ring tourniquets (SSRTs) reduce intraoperative bleeding and provide a wide surgical view. Moreover, they reduce the risk of contamination and are cheaper than conventional pneumatic tourniquets. Our study describes the perioperative outcomes of sterile silicone ring tourniquet placement in pediatric patients [...] Read more.

Sterile silicone ring tourniquets (SSRTs) reduce intraoperative bleeding and provide a wide surgical view. Moreover, they reduce the risk of contamination and are cheaper than conventional pneumatic tourniquets. Our study describes the perioperative outcomes of sterile silicone ring tourniquet placement in pediatric patients undergoing orthopedic surgery. We prospectively recruited 27 pediatric patients aged < 18 years who underwent 30 orthopedic surgeries between March and September 2021. Following complete surgical draping, all operations were initiated by placing SSRTs. We investigated the demographic and clinical characteristics of these patients, details of the tourniquet used, and intra- and postoperative outcomes of tourniquet placement. Owing to the narrowness of tourniquet bands and tourniquet placement at the proximal ends of the extremities, wide surgical fields were achieved, without limiting joint range of motion. Bleeding control was effective. Tourniquets were applied and removed rapidly and safely, regardless of limb circumference. None of the patients experienced postoperative pain, paresthesia, skin problems at the application site, surgical site infections, ischemic problems, or deep vein thrombosis. SSRTs effectively reduced intraoperative blood loss and facilitated wide operative fields in pediatric patients with various limb sizes. These tourniquets allow quick, safe, and effective orthopedic surgery for pediatric patients. Full article

(This article belongs to the Special Issue Personalized Medicine in Orthopaedics)

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14 pages, 2780 KiB

Open AccessArticle

Comparing the 30-Day Mortality for Hip Fractures in Patients with and without COVID-19: An Updated Meta-Analysis

by Sojune Hwang, Chiwon Ahn and Moonho Won

J. Pers. Med. 2023, 13(4), 669; https://doi.org/10.3390/jpm13040669 - 15 Apr 2023

Cited by 2 | Viewed by 1177

Abstract

We conducted an updated meta-analysis to evaluate the 30-day mortality of hip fractures during the COVID-19 pandemic and assess mortality rates by country. We systematically searched Medline, EMBASE, and the Cochrane Library up to November 2022 for studies on the 30-day mortality of [...] Read more.

We conducted an updated meta-analysis to evaluate the 30-day mortality of hip fractures during the COVID-19 pandemic and assess mortality rates by country. We systematically searched Medline, EMBASE, and the Cochrane Library up to November 2022 for studies on the 30-day mortality of hip fractures during the pandemic. Two reviewers used the Newcastle–Ottawa tool to independently assess the methodological quality of the included studies. We conducted a meta-analysis and systematic review including 40 eligible studies with 17,753 patients with hip fractures, including 2280 patients with COVID-19 (12.8%). The overall 30-day mortality rate for hip fractures during the pandemic was 12.6% from published studies. The 30-day mortality of patients with hip fractures who had COVID-19 was significantly higher than those without COVID-19 (OR, 7.10; 95% CI, 5.51–9.15; I² = 57%). The hip fracture mortality rate increased during the pandemic and varied by country, with the highest rates found in Europe, particularly the United Kingdom (UK) and Spain. COVID-19 may have contributed to the increased 30-day mortality rate in hip fracture patients. The mortality rate of hip fracture in patients without COVID-19 did not change during the pandemic. Full article

(This article belongs to the Special Issue Personalized Medicine in Orthopaedics)

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16 pages, 2348 KiB

Open AccessArticle

Treatment of Distal Radius Fractures with Bridging External Fixator with Optional Percutaneous K-Wires: What Are the Right Indications for Patient Age, Gender, Dominant Limb and Injury Pattern?

by Carlo Biz, Mariachiara Cerchiaro, Elisa Belluzzi, Elena Bortolato, Alessandro Rossin, Antonio Berizzi and Pietro Ruggieri

J. Pers. Med. 2022, 12(9), 1532; https://doi.org/10.3390/jpm12091532 - 18 Sep 2022

Cited by 3 | Viewed by 2159

Abstract

The aim of this retrospective study was to evaluate the medium-term clinical and functional outcomes of patients with closed, displaced, and unstable, simple or complex, intra- and extra-articular distal radius fractures (DRFs) treated with a bridging external fixator (BEF) and optional K-wires (KWs). [...] Read more.

The aim of this retrospective study was to evaluate the medium-term clinical and functional outcomes of patients with closed, displaced, and unstable, simple or complex, intra- and extra-articular distal radius fractures (DRFs) treated with a bridging external fixator (BEF) and optional K-wires (KWs). AO classification was used to differentiate the injuries radiographically. Clinical-functional outcomes were evaluated using the Patient-Rated Wrist and Hand Evaluation Score (PRWHE Score) and the Quick Disabilities of the Arm Shoulder and Hand Score (QuickDASH). A total of 269 dorsally displaced fractures of 202 female (75%) and 67 male subjects (25%) were included, with a mean follow-up of 58.0 months. Seventy-five patients (28%) were treated by additional KWs. No differences were found comparing the two groups of patients (BEF vs. BEF + KWs) regarding age, sex, and fracture side (dominant vs. non-dominant). PRWHE and QuickDASH scores were lower in the BEF + KWs group compared to the BEF group (p < 0.0001 and p = 0.0007, respectively). Thus, patients treated with KWs had a better clinical outcome. Beta multivariate regression analysis confirmed that patients of the BEF + KWs group exhibited a better PRWHE score but not a better QuickDASH score. Patients treated by the BEF + KWs with the fracture on the dominant site were characterised by better clinical outcomes. Older patients had a better PRWHE score independently from the treatment. Our findings suggest that the use of BEF for DRFs with optional KWs can be indicated in both young and elderly patients of any gender, independent of limb side and fracture pattern. As the best functional results were achieved in the elderly when KWs were added, the combination of BEF and KWs seems to be mainly indicated for the treatment of DRF, also complex, in the elderly population. Full article

(This article belongs to the Special Issue Personalized Medicine in Orthopaedics)

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8 pages, 1685 KiB

Open AccessArticle

The Impact of Hip Dysplasia on CAM Impingement

by Carsten Y. W. Heimer, Chia H. Wu, Carsten Perka, Sebastian Hardt, Friedemann Göhler, Tobias Winkler and Henrik C. Bäcker

J. Pers. Med. 2022, 12(7), 1129; https://doi.org/10.3390/jpm12071129 - 12 Jul 2022

Cited by 2 | Viewed by 1600

Abstract

Predisposing factors for CAM-type femoroacetabular impingement (FAI) include acetabular protrusion and retroversion; however, nothing is known regarding development in dysplastic hips. The purpose of this study was to determine the correlation between CAM-type FAI and developmental dysplastic hips diagnosed using X-ray and rotational [...] Read more.

Predisposing factors for CAM-type femoroacetabular impingement (FAI) include acetabular protrusion and retroversion; however, nothing is known regarding development in dysplastic hips. The purpose of this study was to determine the correlation between CAM-type FAI and developmental dysplastic hips diagnosed using X-ray and rotational computed tomography. In this retrospective study, 52 symptomatic hips were included, with a mean age of 28.8 ± 7.6 years. The inclusion criteria consisted of consecutive patients who suffered from symptomatic dysplastic or borderline dysplastic hips and underwent a clinical examination, conventional radiographs and rotational computed tomography. Demographics, standard measurements and the rotational alignments were recorded and analyzed between the CAM and nonCAM groups. Among the 52 patients, 19 presented with CAM impingement, whereas, in 33 patients, no signs of CAM impingement were noticed. For demographics, no significant differences between the two groups were identified. On conventional radiography, the acetabular hip index as well as the CE angle for the development of CAM impingement were significantly different compared to the nonCAM group with a CE angle of 21.0° ± 5.4° vs. 23.7° ± 5.8° (p = 0.050) and an acetabular hip index of 25.6 ± 5.7 vs. 21.9 ± 7.3 (p = 0.031), respectively. Furthermore, a crossing over sign was observed to be more common in the nonCAM group, which is contradictory to the current literature. For rotational alignment, no significant differences were observed. In dysplastic hips, the CAM-type FAI correlated to a lower CE angle and a higher acetabular hip index. In contrast to the current literature, no significant correlations to the torsional alignment or to crossing over signs were observed. Full article

(This article belongs to the Special Issue Personalized Medicine in Orthopaedics)

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7 pages, 573 KiB

Open AccessArticle

Distal Radius Fracture with Ipsilateral Elbow Dislocation: A Rare but Challenging Injury

by Henrik C. Bäcker, Kathi Thiele, Chia H. Wu, Philipp Moroder, Ulrich Stöckle and Karl F. Braun

J. Pers. Med. 2022, 12(7), 1097; https://doi.org/10.3390/jpm12071097 - 01 Jul 2022

Cited by 2 | Viewed by 3246

Abstract

Distal radius fractures are common and account for approximately 14% to 18% of all adult extremity injuries. On rare occasions, ipsilateral elbow dislocation can be observed additionally. However, this can be missed without careful examination, especially in patients experiencing altered mental status. The [...] Read more.

Distal radius fractures are common and account for approximately 14% to 18% of all adult extremity injuries. On rare occasions, ipsilateral elbow dislocation can be observed additionally. However, this can be missed without careful examination, especially in patients experiencing altered mental status. The aim of this study was to analyze the mechanism, level of injury, demographics, and associated injuries in distal radius fracture with ipsilateral elbow dislocation. Between 2012 and 2019, we searched our trauma database for distal radius fracture with ipsilateral elbow dislocation. All patients older than 18 years old were included. Data on demographics, mechanism of injury, level of energy, and subsequent treatment were collected. A total of seven patients were identified. The mean age in this cohort was 68.7 ± 13.3 years old, and the left side was involved in 71.4% of the patients. Females were affected in 85.7% (n = 6/7) of cases, all of whom suffered from low-energy monotrauma at a mean age of 71.5 ± 12.3 years old. One male patient suffered from high-energy trauma (52 years old). Mainly, posterior elbow dislocations were observed (66.7%; n = 4/6). Distal radius fracture patterns, in accordance with the AO classification, included two C2-, two C3-, one C1-, and one B1-type fractures. In the patient suffering from high-energy trauma, the closed distal radius fracture was classified as type C3. Associated injures included open elbow dislocation, ulnar artery rupture, and damage to the flexor digitorum superficialis. Although distal radius fracture with ipsilateral elbow dislocation is thought to be from high-energy trauma, this study shows that most patients were elderly females suffering from low-energy mechanisms. It is important for clinicians to maintain a high level of suspicion for any concomitant injury in this population. Full article

(This article belongs to the Special Issue Personalized Medicine in Orthopaedics)

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12 pages, 2226 KiB

Open AccessArticle

The Impact of the Laterality on Radiographic Outcomes of the Bernese Periacetabular Osteotomy

by Carsten Y. W. Heimer, Chia H. Wu, Carsten Perka, Sebastian Hardt, Friedemann Göhler and Henrik C. Bäcker

J. Pers. Med. 2022, 12(7), 1072; https://doi.org/10.3390/jpm12071072 - 29 Jun 2022

Cited by 1 | Viewed by 1180

Abstract

The purpose of this study was to compare the pre and postoperative radiographic findings and analyze the complication rate with respect to the laterality in periacetabular osteotomy in right-handed surgeons. Satisfaction rate and radiographic findings were prospectively collected between 2017 and 2019 and [...] Read more.

The purpose of this study was to compare the pre and postoperative radiographic findings and analyze the complication rate with respect to the laterality in periacetabular osteotomy in right-handed surgeons. Satisfaction rate and radiographic findings were prospectively collected between 2017 and 2019 and retrospectively reviewed. For analysis, all measurements of the CT scans were performed by a musculoskeletal fellowship-trained radiologist. Complications were classified into two categories: perioperative or postoperative. All surgeries were performed by three right-hand dominant hip surgeons. A total of 41 dysplastic hips (25 right and 16 left hips) in 33 patients were included. Postoperatively, a significantly lower acetabular index angle on the left side was observed at −2.6 ± 4.3 as compared to the right side at 1.6 ± 6.5 (p < 0.05). The change in Center edge (CE) angle was significantly lower for the left side 13.7 ± 5.5° than on the right side, measured at 18.4 ± 7.3 (p < 0.001); however, the overall CE angle was comparable at 38.5 ± 8.9° without any significant difference between the operated hips (left side at 37.8 ± 6.1° versus right side at 39.0 ± 10.3; p = 0.340). No significant differences in other radiographic measurements or surgical time were observed. For complications, the right side was more commonly affected, which may also explain a higher satisfaction rate in patients who were operated on the left hip with 92.3%. The change in lateral CE angle was significantly lower for the left side and the right hip seems to be predisposed to complications, which correlate with a lower satisfaction rate in right-handed surgeons. Full article

(This article belongs to the Special Issue Personalized Medicine in Orthopaedics)

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12 pages, 38781 KiB

Open AccessArticle

HR-pQCT for the Evaluation of Muscle Quality and Intramuscular Fat Infiltration in Ageing Skeletal Muscle

by Simon Kwoon-Ho Chow, Marloes van Mourik, Vivian Wing-Yin Hung, Ning Zhang, Michelle Meng-Chen Li, Ronald Man-Yeung Wong, Kwok-Sui Leung and Wing-Hoi Cheung

J. Pers. Med. 2022, 12(6), 1016; https://doi.org/10.3390/jpm12061016 - 20 Jun 2022

Cited by 2 | Viewed by 2240

Abstract

Myosteatosis is the infiltration of fat in skeletal muscle during the onset of sarcopenia. The quantification of intramuscular adipose tissue (IMAT) can be a feasible imaging modality for the clinical assessment of myosteatosis, important for the early identification of sarcopenia patients and timely [...] Read more.

Myosteatosis is the infiltration of fat in skeletal muscle during the onset of sarcopenia. The quantification of intramuscular adipose tissue (IMAT) can be a feasible imaging modality for the clinical assessment of myosteatosis, important for the early identification of sarcopenia patients and timely intervention decisions. There is currently no standardized method or consensus for such an application. The aim of this study was to develop a method for the detection and analysis of IMAT in clinical HR-pQCT images of the distal tibia to evaluate skeletal muscle during the ageing process, validated with animal and clinical experimentation. A pre-clinical model of ovariectomized (OVX) rats with known intramuscular fat infiltration was used, where gastrocnemii were scanned by micro-computed tomography (micro-CT) at an 8.4 μm isotropic voxel size, and the images were analyzed using our modified IMAT analysis protocol. IMAT, muscle density (MD), and muscle volume (MV) were compared with SHAM controls validated with Oil-red-O (ORO) staining. Furthermore, the segmentation and IMAT evaluation method was applied to 30 human subjects at ages from 18 to 81 (mean = 47.3 ± 19.2). Muscle-related parameters were analyzed with functional outcomes. In the animal model, the micro-CT adipose tissue-related parameter of IMAT% segmented at −600 HU to 100 HU was shown to strongly associate with the ORO-positively stained area (r = 0.898, p = 0.002). For the human subjects, at an adjusted threshold of −600 to −20 HU, moderate positive correlations were found between MV and MD (r = 0.642, p < 0.001), and between MV and IMAT volume (r = 0.618, p < 0.01). Moderate negative correlations were detected between MD and IMAT% (r = −0.640, p < 0.001). Strong and moderate associations were found between age and MD (r = −0.763, p < 0.01), and age and IMAT (r = 0.559, p < 0.01). There was also a strong correlation between IMAT% and chair rise time (r = 0.671, p < 0.01). The proposed HR-pQCT evaluation protocol for intramuscular adipose-tissue produced MD and IMAT results that were associated with age and physical performance measures, and were of good predictive value for the progression of myosteatosis or sarcopenia. The protocol was also validated on animal skeletal muscle samples that showed a good representation of histological lipid content with positive correlations, further supporting the clinical application for the rapid evaluation of muscle quality and objective quantification of skeletal muscle at the peripheral for sarcopenia assessment. Full article

(This article belongs to the Special Issue Personalized Medicine in Orthopaedics)

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10 pages, 724 KiB

Open AccessArticle

Serum and Synovial Markers in Patients with Rheumatoid Arthritis and Periprosthetic Joint Infection

by Yi Ren, Lara Biedermann, Clemens Gwinner, Carsten Perka and Arne Kienzle

J. Pers. Med. 2022, 12(5), 810; https://doi.org/10.3390/jpm12050810 - 17 May 2022

Cited by 3 | Viewed by 1543

Abstract

Current diagnostic standards for PJI rely on inflammatory markers that are typically elevated in autoimmune diseases, thus making the diagnosis of PJI in patients with rheumatoid arthritis and joint replacement particularly complicated. There is a paucity of data on differentiating PJI from rheumatoid [...] Read more.

Current diagnostic standards for PJI rely on inflammatory markers that are typically elevated in autoimmune diseases, thus making the diagnosis of PJI in patients with rheumatoid arthritis and joint replacement particularly complicated. There is a paucity of data on differentiating PJI from rheumatoid arthritis in patients with previous arthroplasty. In this study, we retrospectively analyzed the cases of 17 patients with rheumatoid arthritis and 121 patients without rheumatoid disease who underwent surgical intervention due to microbiology-positive PJI of the hip or knee joint. We assessed clinical patient characteristics, laboratory parameters, and prosthesis survival rates in patients with and without rheumatoid arthritis and acute or chronic PJI. ROC analysis was conducted for the analyzed parameters. In patients with chronic PJI, peripheral blood CRP (p = 0.05, AUC = 0.71), synovial WBC count (p = 0.02, AUC = 0.78), synovial monocyte cell count (p = 0.04, AUC = 0.75), and synovial PMN cell count (p = 0.02, AUC = 0.80) were significantly elevated in patients with rheumatoid arthritis showing acceptable to excellent discrimination. All analyzed parameters showed no significant differences and poor discrimination for patients with acute PJI. Median prosthesis survival time was significantly shorter in patients with rheumatoid arthritis (p = 0.05). In conclusion, routinely used laboratory markers have limited utility in distinguishing acute PJI in rheumatoid patients. In cases with suspected chronic PJI but low levels of serum CRP and synovial cell markers, physicians should consider the possibility of activated autoimmune arthritis. Full article

(This article belongs to the Special Issue Personalized Medicine in Orthopaedics)

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12 pages, 1621 KiB

Open AccessArticle

Automatic Segmentation for Favourable Delineation of Ten Wrist Bones on Wrist Radiographs Using Convolutional Neural Network

by Bo-kyeong Kang, Yelin Han, Jaehoon Oh, Jongwoo Lim, Jongbin Ryu, Myeong Seong Yoon, Juncheol Lee and Soorack Ryu

J. Pers. Med. 2022, 12(5), 776; https://doi.org/10.3390/jpm12050776 - 11 May 2022

Cited by 1 | Viewed by 2011

Abstract

Purpose: This study aimed to develop and validate an automatic segmentation algorithm for the boundary delineation of ten wrist bones, consisting of eight carpal and two distal forearm bones, using a convolutional neural network (CNN). Methods: We performed a retrospective study using adult [...] Read more.

Purpose: This study aimed to develop and validate an automatic segmentation algorithm for the boundary delineation of ten wrist bones, consisting of eight carpal and two distal forearm bones, using a convolutional neural network (CNN). Methods: We performed a retrospective study using adult wrist radiographs. We labeled the ground truth masking of wrist bones, and propose that the Fine Mask R-CNN consisted of wrist regions of interest (ROI) using a Single-Shot Multibox Detector (SSD) and segmentation via Mask R-CNN, plus the extended mask head. The primary outcome was an improvement in the prediction of delineation via the network combined with ground truth masking, and this was compared between two networks through five-fold validations. Results: In total, 702 images were labeled for the segmentation of ten wrist bones. The overall performance (mean (SD] of Dice coefficient) of the auto-segmentation of the ten wrist bones improved from 0.93 (0.01) using Mask R-CNN to 0.95 (0.01) using Fine Mask R-CNN (p < 0.001). The values of each wrist bone were higher when using the Fine Mask R-CNN than when using the alternative (all p < 0.001). The value derived for the distal radius was the highest, and that for the trapezoid was the lowest in both networks. Conclusion: Our proposed Fine Mask R-CNN model achieved good performance in the automatic segmentation of ten overlapping wrist bones derived from adult wrist radiographs. Full article

(This article belongs to the Special Issue Personalized Medicine in Orthopaedics)

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14 pages, 1847 KiB

Open AccessArticle

Management of Displaced Midshaft Clavicle Fractures with Figure-of-Eight Bandage: The Impact of Residual Shortening on Shoulder Function

by Carlo Biz, Davide Scucchiari, Assunta Pozzuoli, Elisa Belluzzi, Nicola Luigi Bragazzi, Antonio Berizzi and Pietro Ruggieri

J. Pers. Med. 2022, 12(5), 759; https://doi.org/10.3390/jpm12050759 - 07 May 2022

Cited by 2 | Viewed by 2911

Abstract

The treatment of displaced midshaft clavicle fractures (MCFs) is still controversial. The aims of our study were to evaluate clinical and radiological outcomes and complications of patients with displaced MCFs managed nonoperatively and to identify potential predictive factors of worse clinical outcomes. Seventy-five [...] Read more.

The treatment of displaced midshaft clavicle fractures (MCFs) is still controversial. The aims of our study were to evaluate clinical and radiological outcomes and complications of patients with displaced MCFs managed nonoperatively and to identify potential predictive factors of worse clinical outcomes. Seventy-five patients with displaced MCFs were enrolled and treated nonoperatively with a figure-of-eight bandage (F8-B). Initial shortening (IS) and displacement (ID) of fragments were radiographically evaluated at the time of diagnosis and immediately after F8-B application by residual shortening (RS) and displacement (RD). The clavicle shortening ratio was evaluated clinically at last follow-up. Functional outcomes were assessed using Constant (CS), q-DASH, DASH work and DASH sport scores. Cosmetic outcomes and rate of complications were evaluated. Good to very good mid-term clinical results were achieved by using the institutional treatment protocol. Multiple regression identified RS as an independent predictor of shoulder function, while RD affects fracture healing. These findings support the efficacy of our institutional protocol and thus could be useful for orthopedic surgeons during the decision-making process. Full article

(This article belongs to the Special Issue Personalized Medicine in Orthopaedics)

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Review

Jump to: Research

9 pages, 579 KiB

Open AccessReview

App-Based Rehabilitation in Back Pain, a Systematic Review

by Claire Stark, John Cunningham, Peter Turner, Michael A. Johnson and Henrik C. Bäcker

J. Pers. Med. 2022, 12(10), 1558; https://doi.org/10.3390/jpm12101558 - 22 Sep 2022

Cited by 5 | Viewed by 1644

Abstract

Smartphones and their associated applications are used frequently by patients and clinicians alike. Despite the technology being widely accessible, their use to aid in rehabilitation is yet to be adopted. The SARS CoV-2 pandemic has presented an opportunity to expedite their integration given [...] Read more.

Smartphones and their associated applications are used frequently by patients and clinicians alike. Despite the technology being widely accessible, their use to aid in rehabilitation is yet to be adopted. The SARS CoV-2 pandemic has presented an opportunity to expedite their integration given the difficulty patients currently have in accessing healthcare. The aim of this study was to perform a systematic literature review on the use of smartphone rehabilitation applications compared to standard physiotherapy for back pain. We conducted a search of Medline/Pubmed and google databases using the search terms [APP] AND [[Orthopaedic] OR [Neurosurgery]], following the PRISMA guidelines. All prospective studies investigating rehabilitation applications for back pain or following spine surgery were included. A total of nine studies met the inclusion criteria which investigated 7636 patients, of which 92.4% were allocated to the interventional group (n = 7055/7636) with a follow up of 4 weeks to 6 months. All except one study reported on patients experiencing back pain on average for 19.6 ± 11.6 months. The VAS-pain score was presented in all studies without significance between the interventional and control group (p = 0.399 before and p = 0.277 after intervention). Only one research group found significantly higher improvement in PROMs for the application group, whereas the remaining showed similar results compared to the control group. Using application-based rehabilitation programs provides an easily accessible alternative or substitute to traditional physiotherapy for patients with back pain. Given that smartphones are so prevalent in activities in our daily lives, this will enhance and improve rehabilitation if patients are self-dedicated and compliant. Full article

(This article belongs to the Special Issue Personalized Medicine in Orthopaedics)

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9 pages, 514 KiB

Open AccessReview

A Review of Functional Outcomes after the App-Based Rehabilitation of Patients with TKA and THA

by Henrik Constantin Bäcker, Chia H. Wu, Dominik Pförringer, Wolf Petersen, Ulrich Stöckle and Karl F. Braun

J. Pers. Med. 2022, 12(8), 1342; https://doi.org/10.3390/jpm12081342 - 21 Aug 2022

Cited by 4 | Viewed by 1899

Abstract

Following the outbreak of SARS-CoV-2, several elective surgeries were cancelled, and rehabilitation units were closed. This has led to difficulties for patients seeking access to rehabilitation in order to achieve the best possible outcome. New applications with or without sensors were developed to [...] Read more.

Following the outbreak of SARS-CoV-2, several elective surgeries were cancelled, and rehabilitation units were closed. This has led to difficulties for patients seeking access to rehabilitation in order to achieve the best possible outcome. New applications with or without sensors were developed to address this need, but the outcome has not been examined in detail yet. The aim of this study was to perform a systematic literature review on smart phone applications for patients suffering from hip and knee osteoarthritis after arthroplasty. The MEDLINE/PubMed and Google databases were queried using the search term “[APP] AND [ORTHOPEDIC]” according to PRISMA guidelines. All prospective studies investigating rehabilitation applications reporting the functional outcome in hip and knee osteoarthritis after arthroplasty were included. The initial search yielded 420 entries, but only 9 publications met the inclusion criteria, accounting for 1067 patients. In total, 518 patients were in the intervention group, and 549 patients were in the control group. The average follow-up was 9.5 ± 8.1 months (range: 3 to 23.4 months). Overall, significantly lower A-VAS values were observed for the interventional group in the short term (p = 0.002). There were no other significant differences observed between the two groups. Smart phone applications provide an alternative to in-person sessions that may improve access for patients after total joint arthroplasty. Our study found there are significant improvements in the short term by using this approach. In combination with a blue-tooth-enabled sensor for isometric exercises, patients can even receive real-time feedback after total knee arthroplasty. Full article

(This article belongs to the Special Issue Personalized Medicine in Orthopaedics)

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