Comparison of early and late surgical outcomes of patients after total hip arthroplasty in terms of the type of surgical approach and assessment of the level of fitness

Paweł Zieliński, Rafał Trąbka, Jarosław Amarowicz, Mateusz Curyło, Paweł Kamiński, Magdalena Wilk-Frańczuk, Tomasz Maicki

P. Zieliński, R. Trąbka, J. Amarowicz, M. Curyło, P. Kamiński, M. Wilk-Frańczuk, T. Maicki – Comparison of early and late surgical outcomes of patients after total hip arthroplasty in terms of the type of surgical approach and assessment of the level of fitness. Fizjoterapia Polska 2021; 21(4); 190-203

Abstract
Osteoarthritis is the most common form of human joint pathology. It is estimated that it affects about 6% of the world’s population. In addition to the hand and knee joints, the hip joint is one of the most common joints affected by OA.
The study included 59 randomly selected patients (from a group of over 600 people operated in a similar period) of the Orthopaedics and Rehabilitation Department of the Centre for Rehabilitation and Orthopaedics in Krakow, who underwent THA due to advanced degenerative changes using a cementless prosthesis.
The objective of the study was to compare the early and late outcomes of the procedure (patient’s fitness level and subjective assessment) using the anterolateral (according to Watson-Jones) and lateral (McFarland and Osborne as modified by Hardinge) approach.
The obtained results confirm better outcomes in terms of the abduction strength scale (SO%), HHS, VAS, frequency of the Trendelenburg sign and partially mobility (external rotation) in relation to short-term follow-up (especially after 6 and 12 weeks), but not long-term follow-up (after 24 weeks and 11-12 years).
It was found that people who underwent surgery using the lateral approach (according to Hardinge) recover faster than people who underwent surgery with the use of the anterolateral approach (according to Watson-Jones).
Key words:
arthroplasty, osteoarthritis, hip joint
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Shoulder joint function evaluation after reverse total shoulder arthroplasty – preliminary reports

Ewelina Żyżniewska-Banaszak, Magdalena Gębska, Sebastian Sokołowski, Anna Sobczak, Łukasz Kołodziej

E. Żyżniewska-Banaszak, M. Gębska, S. Sokołowski, A. Sobczak, Ł. Kołodziej – Shoulder joint function evaluation after reverse total shoulder arthroplasty – preliminary reports . Fizjoterapia Polska 2021; 21(4); 142-151

Abstract
Introduction. Physiotherapy is an important part of the comprehensive treatment of patients after reverse total shoulder arthroplasty (RTSA). Patients qualified for RTSA struggle with shoulder joint dysfunctions of various aetiologies – most often with irreparable damage to the rotator cuff tendons. The aim of physiotherapy after RTSA is to restore the lost functions of the shoulder joint based on a targeted rehabilitation protocol taking into account the changed biomechanical conditions of the shoulder.
Materials and methods. The study material consisted of 6 patients after RTSA. Patients were examined before the procedure and after rehabilitation with the use of the Constant-Murley Score. The rehabilitation model was implemented on the day before surgery and continued for 12 weeks.
Results. Each patient experienced an improvement in shoulder mobility and a reduction in pain intensity.
Conclusions. Rehabilitation after RTSA improves the functions of the shoulder joint expressed by an increased range of joint mobility, elimination of pain and improved quality of life.
Key words:
shoulder joint, total shoulder arthroplasty, orthopaedics, rehabilitation
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Long-term evaluation of the quality of life of patients with osteoarthritis treated conservatively and surgically

Marcin Świątczak, Aneta Nowicka, Agnieszka Leszczyńska, Agnieszka Przedborska, Magdalena Pruszyńska, Katarzyna Glibov, Jan W. Raczkowski

Marcin Świątczak, Aneta Nowicka, Agnieszka Leszczyńska, Agnieszka Przedborska, Magdalena Pruszyńska, Katarzyna Glibov, Jan W. Raczkowski – Long-term evaluation of the quality of life of patients with osteoarthritis treated conservatively and surgically. Fizjoterapia Polska 2021; 21(3); 198-204

Abstract
Introduction. Osteoarthritis of the hip joint is one of the most common chronic diseases of the locomotor system. Total hip replacement (THR) is a treatment option of choice alongside conservative treatment. The aim of the study was the long-term assessment of the quality of life of patients after total hip replacement surgery and after conservative treatment.
Material and methods. The study group consisted of 35 patients diagnosed with many years of osteoarthritis of the hip who underwent THR with posterolateral surgical approach. The assessment was carried out at the Department of Orthopedics and Traumatology of the University Teaching Hospital WAM – CSW in Łódź. The control group consisted of 15 patients with long-term osteoarthritis of the hip, treated conservatively. Medical data were obtained from the history of the disease and the author’s questionnaire, while the World Health Organization Quality OF Life (WHOQOL) – BREF questionnaire was used to assess the quality of life.
The obtained results were statistically analyzed with the use of MS Office and the Student’s T-test, considering the results below p <0.05 as statistically significant.
Results. The assessment of domains was similar in both groups, the greatest dissonance was observed in the assessments of the somatic and social domains. Based on WHOQOL-BREF questionnaire, the majority of patients in the study group rated the quality of life from 60% to 70% of the maximum value, the highest psychological sphere, the least somatic. In the control group, the social domain obtained 78% of the maximum value, other domains – 74% of the maximum value.
Conclusions. Patients treated conservatively assessed their quality of life higher in all domains than patients who underwent THR. In both studied groups, the “positive” variant of the answer was the most frequently chosen in the WHOQOL-BREF questionnaire.
Key words:
quality of life, osteoarthrotic hip disease, alloplasty
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Total knee arthroplasty: surgical treatment for patients with advanced diseases and extensive deformation of the knee

Jerzy Widuchowski, Damian Kusz, Wojciech Widuchowski, Adam Pierzchała

Jerzy Widuchowski, Damian Kusz, Wojciech Widuchowski, Adam Pierzchała – Total knee arthroplasty: surgical treatment for patients with advanced diseases and extensive deformation of the knee. Fizjoterapia Polska 2004; 4(4); 403-410

Abstract

Total knee arthroplasty has become a common surgical intervention in cases of widespread deformation of the knee joint due to the progress of arthritis or rheumatoid arthritis, and is now considered the method of choice for these patients. TKA is based on removing the destroyed parts of the knee and replacing them with new metal or plastic elements. It is commonly stated that TKA is a process of replacing an old destroyed joint with a new artificial one. In the present study, the authors show the types of knee prostheses and how they are installed. Emphasis is placed on the rules for prosthesis selection in relation to the level of the knee joint disease, especially the level of the destruction of anatomical structures. The authors also present the indications for surgical intervention, as well as preoperative procedures.

Key words:
total knee replacement, arthritis of the knee, rheumatoid arthritis of the knee
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