LIVIVO - The Search Portal for Life Sciences

zur deutschen Oberfläche wechseln
Advanced search

Search results

Result 1 - 7 of total 7

Search options

  1. Article ; Online: Mechanisms of bone loss in revision total knee arthroplasty and current treatment options.

    Jabbal, Monu / Simpson, A Hamish Rw / Walmsley, Phil

    Orthopedic reviews

    2023  Volume 15, Page(s) 75359

    Abstract: Purpose: Primary total knee arthroplasty (TKA) is an effective treatment which is increasing in use for both elderly and younger patients. With the overall increasing life span of the general population, the rate of revision TKA is projected to increase ...

    Abstract Purpose: Primary total knee arthroplasty (TKA) is an effective treatment which is increasing in use for both elderly and younger patients. With the overall increasing life span of the general population, the rate of revision TKA is projected to increase significantly over the coming decades. Analyses from the national joint registry of England and Wales support this prediction with an increase in primary TKA of 117% and an increase in revision TKA of 332% being forecast by 2030. Bone loss presents a challenge in revision TKA so an understanding of the aetiology and principles behind this is essential for the surgeon undertaking revision. The purpose of this article is to review the causes of bone loss in revision TKA, discuss the mechanisms of each cause and discuss the possible treatment options.
    Methods: The Anderson Orthopaedic Research Institute (AORI) classification and zonal classification of bone loss are commonly used in assessing bone loss in pre-operative planning and will be used in this review. The recent literature was searched to find advantages and limitations of each commonly used method to address bone loss at revision TKA. Studies with the highest number or patients and longest follow-up period were selected as significant. Search terms were: "aetiology of bone loss", "revision total knee arthroplasty", "management of bone loss".
    Results: Methods for managing bone loss have traditionally been cement augmentation, impaction bone grafting, bulk structural bone graft and stemmed implants with metal augments. No single technique was found to be superior. Megaprostheses have a role as a salvage procedure when the bone loss is deemed to be too significant for reconstruction. Metaphyseal cones and sleeves are a newer treatments with promising medium to long term outcomes.
    Conclusion: Bone loss encountered at revision TKA presents a significant challenge. No single technique currently has clear superiority treatment should be based on a sound understanding of the underlying principles.
    Language English
    Publishing date 2023-05-24
    Publishing country United States
    Document type Journal Article
    ZDB-ID 2508171-8
    ISSN 2035-8164 ; 2035-8164
    ISSN (online) 2035-8164
    ISSN 2035-8164
    DOI 10.52965/001c.75359
    Database MEDical Literature Analysis and Retrieval System OnLINE

    More links

    Kategorien

    Order via subito

    This service is chargeable due to the Delivery terms set by subito. Orders including an article and supplementary material will be classified as separate orders. In these cases, fees will be demanded for each order.

  2. Article ; Online: New quality outcome indicators for bone metastases: expert consensus analysis of patients, their families and specialist healthcare professionals.

    Downie, Samantha / Chohan, Hasnain / Ross, Lauren / McCann, Conor / Hall, Peter / Stillie, Alison / Moran, Matthew / Sudlow, Cathie / Simpson, A Hamish Rw

    BMJ supportive & palliative care

    2024  

    Abstract: Objectives: As workload increases, surgical care for patients with bone metastases is increasingly decentralised, with a shift in management away from primary bone tumour units to local centres. We must ensure that patients have similar outcomes ... ...

    Abstract Objectives: As workload increases, surgical care for patients with bone metastases is increasingly decentralised, with a shift in management away from primary bone tumour units to local centres. We must ensure that patients have similar outcomes regardless of where they receive their treatment. The aim was to develop and validate a set of quality outcome indicators (QOIs) to evaluate treatment success for patients undergoing surgery for bone metastases.
    Methods: Outcome recommendations were adapted from the literature and field tested in a retrospective patient cohort to determine feasibility. The provisional outcome indicators were assessed during a modified RAND/Delphi consensus process by a group of patients, relatives and healthcare professionals with validated targets added.
    Results: 1534 articles were reviewed. 38 quality objectives were extracted and assessed for feasibility using clinical records for 117 patients. 28 provisional outcome indicators proceeded to expert consensus and were reviewed by a group of 22 panellists including 10 patients and 4 relatives/carers. After two rounds, 15 QOIs were generated, with validated targets based on expert consensus. These included specific statements such as 'surgery improves pain and reduces the need for morphine, target: at follow-up, pain is documented in 80% of individuals and 50% of these have reduced need for morphine'.
    Conclusions: The published evidence and guidelines were adapted into a set of outcome indicators validated by patients, their family/carers and healthcare professionals. These can be used to compare care between centres and identify units of excellence in maximising good outcome after surgery for bone metastases.
    Language English
    Publishing date 2024-03-27
    Publishing country England
    Document type Journal Article
    ISSN 2045-4368
    ISSN (online) 2045-4368
    DOI 10.1136/spcare-2023-004698
    Database MEDical Literature Analysis and Retrieval System OnLINE

    More links

    Kategorien

    Order via subito

    This service is chargeable due to the Delivery terms set by subito. Orders including an article and supplementary material will be classified as separate orders. In these cases, fees will be demanded for each order.

    Inter-library loan at ZB MED

    Your chosen title can be delivered directly to ZB MED Cologne location if you are registered as a user at ZB MED Cologne.

  3. Article ; Online: Diagnosis and referral of adults with suspected bony metastases.

    Downie, Samantha / Bryden, Elizabeth / Perks, Fergus / Simpson, A Hamish Rw

    BMJ (Clinical research ed.)

    2021  Volume 372, Page(s) n98

    MeSH term(s) Bone Neoplasms/complications ; Bone Neoplasms/diagnosis ; Bone Neoplasms/secondary ; Critical Pathways/standards ; Fractures, Spontaneous/etiology ; Fractures, Spontaneous/prevention & control ; Humans ; Pain/diagnosis ; Pain/etiology ; Practice Guidelines as Topic ; Primary Health Care/methods ; Primary Health Care/standards ; Referral and Consultation/standards
    Language English
    Publishing date 2021-01-25
    Publishing country England
    Document type Journal Article
    ZDB-ID 1362901-3
    ISSN 1756-1833 ; 0959-8154 ; 0959-8146 ; 0959-8138 ; 0959-535X ; 1759-2151
    ISSN (online) 1756-1833
    ISSN 0959-8154 ; 0959-8146 ; 0959-8138 ; 0959-535X ; 1759-2151
    DOI 10.1136/bmj.n98
    Database MEDical Literature Analysis and Retrieval System OnLINE

    More links

    Kategorien

    In stock of ZB MED Cologne/Königswinter

    Ua VI Zs.10: Show issues Location:
    Je nach Verfügbarkeit (siehe Angabe bei Bestand)
    bis Jg. 2021: Bestellungen von Artikeln über das Online-Bestellformular
    ab Jg. 2022: Lesesaal (EG)

    Order via subito

    This service is chargeable due to the Delivery terms set by subito. Orders including an article and supplementary material will be classified as separate orders. In these cases, fees will be demanded for each order.

  4. Article ; Online: COVID-19: Obesity, deprivation and death.

    Simpson, A Hamish Rw / Simpson, Cameron J / Frost, Helen / Welburn, Susan C

    Journal of global health

    2020  Volume 10, Issue 2, Page(s) 20389

    MeSH term(s) Adult ; Aged ; Aged, 80 and over ; COVID-19/epidemiology ; COVID-19/mortality ; COVID-19/physiopathology ; Comorbidity ; Female ; Humans ; Male ; Middle Aged ; Obesity/epidemiology ; Obesity/mortality ; Obesity/physiopathology ; Pandemics
    Keywords covid19
    Language English
    Publishing date 2020-11-20
    Publishing country Scotland
    Document type Journal Article ; Review
    ZDB-ID 2741629-X
    ISSN 2047-2986 ; 2047-2978
    ISSN (online) 2047-2986
    ISSN 2047-2978
    DOI 10.7189/jogh.10.020389
    Database MEDical Literature Analysis and Retrieval System OnLINE

    More links

    Kategorien

    Order via subito

    This service is chargeable due to the Delivery terms set by subito. Orders including an article and supplementary material will be classified as separate orders. In these cases, fees will be demanded for each order.

  5. Article ; Online: Metastatic bone disease: new quality performance indicator development.

    Downie, Samantha / Cherry, Jennifer / Hall, Peter / Stillie, Alison / Moran, Matthew / Sudlow, Cathie / Simpson, A Hamish Rw

    BMJ supportive & palliative care

    2021  

    Abstract: Objectives: Patients with metastatic bone disease (MBD) should receive the same standard of care regardless of which centre they are treated in. The aim was to develop and test a set of quality performance indicators (QPIs) to evaluate care for patients ...

    Abstract Objectives: Patients with metastatic bone disease (MBD) should receive the same standard of care regardless of which centre they are treated in. The aim was to develop and test a set of quality performance indicators (QPIs) to evaluate care for patients with MBD referred to orthopaedics.
    Methods: QPIs were adapted from the literature and ranked on feasibility and necessity during a modified RAND/Delphi consensus process. They were then validated and field tested in a retrospective cohort of 108 patients using indicator-specific targets set during consensus.
    Results: 2568 articles including six guidelines were reviewed. 43 quality objectives were extracted and 40 proceeded to expert consensus. After two rounds, 18 QPIs for MBD care were generated, with the following generating the highest consensus: 'Patients with high fracture risk should receive urgent assessment' (combined mean 6.7/7, 95% CI 6.5 to 6.8) and 'preoperative workup should include full blood tests including group and save' (combined mean 6.7/7, 95% CI 6.5 to 6.9). In the pilot test, targets were met for 5/18 QPIs (mean 52%, standard deviation 22%). The median deviation from projected target was -14% (interquartile range -11% to -31%, range -74% to 11%). The highest scoring QPI was 'adults with fractures should have surgery within 7 days' (target 80%:actual 92%).
    Conclusions: The published evidence and guidelines were adapted into a set of validated QPIs for MBD care which can be used to evaluate variation in care between centres. These QPIs should be correlated with outcome scores to determine whether they can act as predictors of outcome after surgery.
    Language English
    Publishing date 2021-06-15
    Publishing country England
    Document type Journal Article
    ISSN 2045-4368
    ISSN (online) 2045-4368
    DOI 10.1136/bmjspcare-2021-003025
    Database MEDical Literature Analysis and Retrieval System OnLINE

    More links

    Kategorien

    Order via subito

    This service is chargeable due to the Delivery terms set by subito. Orders including an article and supplementary material will be classified as separate orders. In these cases, fees will be demanded for each order.

    Inter-library loan at ZB MED

    Your chosen title can be delivered directly to ZB MED Cologne location if you are registered as a user at ZB MED Cologne.

  6. Article ; Online: Exploring variation in patient access of post-discharge physiotherapy following total hip and knee arthroplasty under a choice based system in the UK: an observational cohort study.

    Hamilton, David F / Loth, Fanny C / MacDonald, Deborah J / MacFarlane, Gary J / Beard, David J / Simpson, A Hamish Rw / Patton, James T / Howie, Colin R

    BMJ open

    2019  Volume 9, Issue 2, Page(s) e021614

    Abstract: Objectives: To assess a targeted 'therapy as required' model of post-discharge outpatient physiotherapy provision. Specifically, we investigated what proportion of patients accessed post-discharge physiotherapy following total hip arthroplasty (THA) and ...

    Abstract Objectives: To assess a targeted 'therapy as required' model of post-discharge outpatient physiotherapy provision. Specifically, we investigated what proportion of patients accessed post-discharge physiotherapy following total hip arthroplasty (THA) and total knee arthroplasty (TKA), whether accessing therapy was associated with post-arthroplasty patient reported outcomes and whether it was possible to predict which patients would access post-discharge physiotherapy from pre-operative data.
    Design: Prospective, observational, longitudinal cohort study.
    Setting: Single National Health Service orthopaedic teaching hospital in the UK.
    Participants: 1395 patients undergoing total hip arthroplasty and 1374 patients undergoing total knee arthroplasty.
    Primary and secondary outcome measures: Self-reported access of post-discharge physiotherapy, the Oxford Hip or Knee Score, EuroQol 5-dimension questionnaire and post-operative surgical episode satisfaction metric.
    Results: 662 (48.2%) patients with TKA and 493 (35.3%) patients with THA accessed additional post-discharge physiotherapy. Patient-reported outcomes (p<0.001) and surgical episode satisfaction (p=0.001) in both THA and TKA were higher in patients that did not participate in post-discharge physiotherapy. Regression models using pre-operative symptom burden and demographic data predicted post-discharge therapy access with an accuracy of only 17% greater than chance in patients with THA and 7% greater than chance in patients with TKA.
    Conclusions: In a choice-based service model of 'therapy as required' following hip and knee arthroplasty only a third of THA and half of TKA patients accessed post-discharge therapy. Patients who did not access physiotherapy reported greater post-operative outcomes. This variation in the need for post-discharge physiotherapy suggests that targeting of rehabilitation may be a cost-effective model, however it was not possible to reliably predict which patients would access post-discharge physiotherapy from pre-operative data.
    MeSH term(s) Aged ; Arthroplasty, Replacement, Hip/rehabilitation ; Arthroplasty, Replacement, Knee/rehabilitation ; Female ; Health Services Accessibility/statistics & numerical data ; Humans ; Longitudinal Studies ; Male ; Middle Aged ; Patient Satisfaction/statistics & numerical data ; Physical Therapy Modalities/statistics & numerical data ; Prospective Studies ; Surveys and Questionnaires ; United Kingdom
    Language English
    Publishing date 2019-02-20
    Publishing country England
    Document type Journal Article ; Observational Study ; Research Support, Non-U.S. Gov't
    ZDB-ID 2747269-3
    ISSN 2044-6055 ; 2044-6055 ; 2053-3624
    ISSN (online) 2044-6055
    ISSN 2044-6055 ; 2053-3624
    DOI 10.1136/bmjopen-2018-021614
    Database MEDical Literature Analysis and Retrieval System OnLINE

    More links

    Kategorien

    Order via subito

    This service is chargeable due to the Delivery terms set by subito. Orders including an article and supplementary material will be classified as separate orders. In these cases, fees will be demanded for each order.

  7. Article ; Online: Variation in physical development in schoolboy rugby players: can maturity testing reduce mismatch?

    Nutton, Richard W / Hamilton, David F / Hutchison, James D / Mitchell, Martin J / Simpson, A Hamish Rw / Maclean, James G B

    BMJ open

    2012  Volume 2, Issue 4

    Abstract: Objectives: This study set out to pursue means of reducing mismatch in schoolboy rugby players. The primary objective was to determine whether application of previously reported thresholds of height and grip strength could be used to distinguish those ... ...

    Abstract Objectives: This study set out to pursue means of reducing mismatch in schoolboy rugby players. The primary objective was to determine whether application of previously reported thresholds of height and grip strength could be used to distinguish those 15-year-old boys appropriate to play under-18 school rugby from their peers. A secondary objective was to obtain normative data for height, weight and grip strength and to assess the variation within that data of current schoolboy rugby players.
    Design: Cross-sectional cohort study.
    Setting: 3 Scottish schools and 'Regional Assessment Centres' organised by the Scottish Rugby Union.
    Participants: 472 rugby playing youths aged 15 years (Regional Assessment Centres) and 382 schoolboys aged between 12 and 18 years (three schools).
    Outcome measures: Height, weight and grip strength.
    Results: 97% of 15-year-olds achieved the height and grip strength thresholds based on previous reported values. Larger mean values and wide variation of height, weight and grip strength were recorded in the schoolboy cohort. However, using the mean values of the cohort of 17-year-olds as a new threshold, only 7.7% of 15-year-olds would pass these thresholds.
    Conclusions: Large morphological variation was observed in schoolboy rugby players of the same age. Physical maturity tests described in earlier literature as pre-participation screening for contact sports were not applicable to current day 15-year-old rugby players. New criteria were measured and found to be better at identifying those 15-year-old players who had sufficient physical development to play senior school rugby.
    Language English
    Publishing date 2012-07-11
    Publishing country England
    Document type Journal Article
    ZDB-ID 2599832-8
    ISSN 2044-6055 ; 2044-6055
    ISSN (online) 2044-6055
    ISSN 2044-6055
    DOI 10.1136/bmjopen-2012-001149
    Database MEDical Literature Analysis and Retrieval System OnLINE

    More links

    Kategorien

    Order via subito

    This service is chargeable due to the Delivery terms set by subito. Orders including an article and supplementary material will be classified as separate orders. In these cases, fees will be demanded for each order.

To top