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1.
Knee Surg Sports Traumatol Arthrosc ; 29(2): 573-578, 2021 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-32232539

RESUMEN

PURPOSE: Patient-specific instrumentation (PSI) in total knee arthroplasty (TKA) uses individually designed disposable guides to determine intraoperative bone cuts. The manufacturer provides the surgeon with proposed planning which can be modified and should be approved by the surgeon before the guides are produced. This study aims to assess the intra- and inter-observer reliability among preoperative planning by orthopaedic surgeons using PSI. The authors hypothesize a high intra- and inter-observer reliability in planning TKA using PSI. METHODS: Four orthopaedic surgeons modified and approved 40 preoperative MRI-based PSI plannings three times. The surgeons were blinded to their own and each other's results. Intra- and inter-observer reliability was obtained for planned implant size, resection, and position of the implant. RESULTS: Intra-observer reliability Intraclass Correlation Coefficients (ICC) were excellent for femoral and tibial implant size with a range of 0.948-0.995 and 0.919-0.988, respectively. Inter-observer reliability for femoral and tibial implant size showed an ICC range of 0.953-0.982 and 0.839-0.951, respectively. Next to implant size, intra- and inter-observer reliability demonstrated good to an excellent agreement (ICC > 0.75) for 7 out of 12 remaining parameters and 6 out of 12 remaining parameters, respectively. CONCLUSION: Preoperative planning of TKA implant size using MRI-based PSI showed excellent intra- and inter-observer reliability. Further research on the comparison of predicted implant size preoperatively to intraoperative results is needed.


Asunto(s)
Artroplastia de Reemplazo de Rodilla/instrumentación , Prótesis de la Rodilla , Variaciones Dependientes del Observador , Planificación de Atención al Paciente , Diseño de Prótesis , Artroplastia de Reemplazo de Rodilla/métodos , Fémur/cirugía , Humanos , Articulación de la Rodilla/cirugía , Imagen por Resonancia Magnética , Cirujanos Ortopédicos , Tibia/cirugía
2.
Knee Surg Sports Traumatol Arthrosc ; 28(6): 1821-1826, 2020 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-31270591

RESUMEN

PURPOSE: Patient-specific instruments (PSI) are already widespread used in total knee arthroplasty (TKA). Either computed tomography (CT) scans or magnetic resonance imaging (MRI) scans are used pre-operatively to create jigs to guide resection during surgery. This study is a sequel of previous work that showed significantly more radiological outliers for posterior slope when CT-based guides were used. The aim of this study was to assess differences in revision rate and clinical outcome between the two groups at 2-year follow-up. METHODS: At the 2-year follow-up, 124 patients were analysed in this prospective, randomised single-blind study. A survival analysis with revision of the TKA as endpoint was performed. Patients fulfilled four patient-reported outcome measurements (PROMs). Scores on the questionnaires were compared between both groups at the different follow-up visits. RESULTS: At final follow-up, there was no significant difference in the survival rates of the CT- and MRI-based PSI surgery. Postoperatively, the PROMs significantly improved within each group compared with the pre-operative values. There were no significant differences for the PROMs between both groups at the 2-years follow-up. CONCLUSIONS: Although previous results showed more outliers regarding posterior slope for CT-based PSIs, no difference in revision rate or the outcome of PROMs was found at 2-year follow-up. Further research to determine what the influence is of radiological outliers on implant survival and clinical outcomes is necessary. LEVEL OF EVIDENCE: I.


Asunto(s)
Artroplastia de Reemplazo de Rodilla/instrumentación , Artroplastia de Reemplazo de Rodilla/métodos , Análisis de Falla de Equipo , Prótesis de la Rodilla , Imagen por Resonancia Magnética , Cirugía Asistida por Computador/métodos , Tomografía Computarizada por Rayos X , Femenino , Estudios de Seguimiento , Humanos , Articulación de la Rodilla/cirugía , Masculino , Osteoartritis de la Rodilla/cirugía , Medición de Resultados Informados por el Paciente , Estudios Prospectivos , Reoperación , Método Simple Ciego
3.
J Orthop Surg Res ; 14(1): 303, 2019 Sep 05.
Artículo en Inglés | MEDLINE | ID: mdl-31488188

RESUMEN

BACKGROUND: The Single Assessment Numeric Evaluation Method (SANEM) is a holistic patient-reported outcome measure (PROM) that includes all aspects involving the shoulder. It is simple and easy to administer. It consists of only one question, namely how would you rate your shoulder today as a percentage of normal (0 to 100% with 100% being normal)? The purpose of this study was to translate the SANEM in Dutch and to assess its construct validity, reliability, and responsiveness. METHODS: The SANEM was translated into Dutch using forward and backward translation. Hypothesis testing was used to determine construct validity and responsiveness, 75% needed to be confirmed. Previous validated PROMs were used as comparator instrument for testing construct validity. Test-retest reliability (2-week interval), Standard Error of Measurement, and Smallest Detectable Change were calculated as reliability analyses. One year after baseline, we evaluated the responsiveness. RESULTS: One hundred seven patients (55% women) with a mean age of 54 years were included. Of the hypotheses formed in advance to assess construct validity, 67% was confirmed, meaning there was no adequate construct validity and the SANEM cannot replace all other PROMs. With an intraclass correlation coefficient of 0.95, excellent test-retest reliability was found. Of the hypotheses formed in advance to evaluate the responsiveness, 75% was confirmed, indicating the SANEM has good responsiveness. CONCLUSION: Although the SANEM cannot replace all other PROMs, it is a reliable instrument to assess if a patients' shoulder, regarding the whole shoulder, changes over time or stays unchanged. LEVEL OF EVIDENCE: Level II.


Asunto(s)
Evaluación de la Discapacidad , Dimensión del Dolor/normas , Medición de Resultados Informados por el Paciente , Dolor de Hombro/diagnóstico , Traducciones , Adulto , Anciano , Femenino , Humanos , Masculino , Persona de Mediana Edad , Países Bajos/epidemiología , Dimensión del Dolor/métodos , Proyectos Piloto , Rango del Movimiento Articular/fisiología , Dolor de Hombro/epidemiología , Encuestas y Cuestionarios
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