ABSTRACT
Population is getting older and arthroplasty is getting more common. And the evolution of implants and their better longevity enables arthroplasty to be done for younger patients too. Therefore sexual activity with hip prosthesis is more common. Literature demonstrates a positive effect of total hip arthroplasty for sexual activity. Despite the euphoria due to painfree movement of the joint, the risk of a luxation of prosthesis should not be underestimated. Especially during the first three months after surgery this risk is relatively high. This also makes sexual activity - not only in this time period, a potential risk for hip dislocation. We do recommend written guidelines for patients to be given to them preoperatively. This will allow some privacy.
Subject(s)
Arthroplasty, Replacement, Hip/psychology , Postoperative Complications/prevention & control , Prosthesis Failure , Sexual Behavior/psychology , Adult , Aged , Coitus/psychology , Female , Follow-Up Studies , Humans , Male , Middle Aged , Patient Education as Topic , Postoperative Complications/psychology , Prosthesis Failure/psychologyABSTRACT
UNLABELLED: We evaluated a consecutive series of patients followed at least 1 year after revision total knee arthroplasty. We surveyed patients treated at three referral centers over 5 years. An experienced medical interviewer contacted patients and rated their degree of satisfaction with the original and revision arthroplasties, the reason for the original arthroplasty failure, and their expectations for revision arthroplasty longevity. Surveys were completed on 238 of the 408 patients (58%). All patients' operative reports, clinical records, and radiographs were reviewed to determine the diagnosis at revision, procedure performed, and the most likely cause of failure. Patient satisfaction with the primary procedure directly related to the time to revision. The majority (74%) of patients expected their revision to last longer than their primary arthroplasty regardless of revision diagnosis or how long the primary procedure lasted before revision. The surgeons' failure assessments agreed with the patients' failure assessments only 34% of the time. Although the majority of patients (69%) were satisfied with the results of the revision procedure, most did not agree with their surgeon as to why the original arthroplasty failed, and most had unrealistic expectations regarding revision longevity. LEVEL OF EVIDENCE: Level II, prognostic study. See the Guidelines for Authors for a complete description of levels of evidence.
Subject(s)
Arthroplasty, Replacement, Knee/psychology , Pain, Postoperative/psychology , Patient Satisfaction , Prosthesis Failure/psychology , Reoperation/psychology , Attitude of Health Personnel , Attitude to Health , Counseling , Female , Humans , Male , Pain, Postoperative/surgery , Patients/psychology , Physician-Patient Relations , Physicians/psychology , Prognosis , Surveys and Questionnaires , Time FactorsABSTRACT
Failure of massive knee endoprostheses implanted for malignant tumours of the distal femur in children presents a difficult problem. We present the results of rotationplasty undertaken under these circumstances in four boys. They had been treated initially at a mean age of 9.5 years for a stage-IIB malignant tumour of the distal femur by resection and implantation of a massive knee endoprosthesis. After a mean period of eight years and a mean of four operative procedures, there was failure of the endoprosthesis because of aseptic loosening in two and infection in two. Function was poor with a mean Musculoskeletal Tumor Society score of 7.5/30, and considerable associated psychological problems. At a mean follow-up of 4.5 years after rotationplasty there was excellent function with a mean score of 27.5/30 and resolution of the psychological problems.
Subject(s)
Arthroplasty, Replacement, Knee/adverse effects , Femoral Neoplasms/surgery , Knee Prosthesis/adverse effects , Orthopedic Procedures/methods , Osteosarcoma/surgery , Prosthesis Failure , Reoperation/methods , Adolescent , Adult , Child , Child, Preschool , Humans , Male , Orthopedic Procedures/psychology , Prosthesis Failure/psychology , Recovery of Function , Reoperation/psychology , Reoperation/rehabilitation , Treatment OutcomeABSTRACT
Twenty-five women with breast implants participated in semistructured interviews designed to reveal their "mental models" of the processes potentially causing local (i.e., nonsystemic) problems. The authors analyzed their responses in terms of an "expert model," circumscribing scientifically relevant information. Most of the women interviewed had something to say about most elements in the expert model. Nonetheless, gaps in their mental models undermined decision making about their implants. One woman misunderstood the terms used by the medical community to describe implant failure (e.g., rupture, leak, and bleed). Another exaggerated the implants' vulnerability to direct impacts, such as car accidents. Participants also overestimated their ability to detect localized problems and to select medical remedies. Although they were generally satisfied with their own implants, many participants were dissatisfied with the decision-making processes that lead to their choice. Their interviews are interpreted by the form and content of communications that women with implants need to help them manage their health decisions better.
