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8. Do patients with osteoarthritis lose weight prior to elective joint replacement?

Author

Wall, Christopher J., Lee, Susie S., Ma, Yanru, de Steiger, Richard N., Vertullo, Christopher J., and Kondalsamy‐Chennakesavan, Srinivas

Subjects
*ARTHROPLASTY, *KNEE osteoarthritis, *GENERAL practitioners, *WEIGHT loss, *BODY mass index
Abstract

Background: Obesity is a known risk factor for the development of osteoarthritis and the subsequent need for joint replacement. Weight loss has been shown to reduce pain, disability, and the need for joint replacement, particularly in patients with knee osteoarthritis. The aim of this study was to investigate pre‐operative weight change in patients with hip, knee, and shoulder osteoarthritis at a regional, public hospital in Australia, to identify opportunities for pre‐operative weight‐loss intervention. Methods: A retrospective review of patients who underwent elective primary total hip (THR), knee (TKR), and shoulder (TSR) replacement for osteoarthritis was conducted between December 2019 and December 2022. BMI data were collected at three time points: (1) general practitioner (GP) referral; (2) orthopaedic clinic review; and (3) pre‐admission clinic (PAC) assessment. Results: A total of 496 patients were included in the study, of which 205 underwent THR, 251 underwent TKR, and 40 underwent TSR. The mean patient age was 67 years, and 46.4% were female. At the time of GP referral, the mean body mass index (BMI) was 31.4 kg/m2. Across the study period, only 2% of patients experienced clinically significant weight loss pre‐operatively (≥5% of total body weight). Conclusion: This study has demonstrated that very few patients lose weight prior to undergoing joint replacement in the public sector in Australia. This highlights the need for targeted non‐surgical weight loss interventions for patients currently awaiting joint replacement. [ABSTRACT FROM AUTHOR]

Published
2024
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23. Scapula fractures: interobserver reliability of classification and treatment

Author

Neuhaus, Valentin, Bot, Arjan G. J., Guitton, Thierry G., Ring, David C., Abdel-Ghany, Mahmoud I., Abrams, Jeffrey, Abzug, Joshua M., Adolfsson, Lars E., Balfour, George W., Bamberger, H. Brent, Barquet, Antonio, Baskies, Michael, Batson, W. Arnold, Baxamusa, Taizoon, Bayne, Grant J., Begue, Thierry, Behrman, Michael, Beingessner, Daphne, Biert, Jan, Bishop, Julius, Alves, Mateus Borges Oliveira, Boyer, Martin, Brilej, Drago, Brink, Peter R. G., Brunton, Lance M., Buckley, Richard, Cagnone, Juan Carlos, Calfee, Ryan P., Campinhos, Luiz Augusto B., Cassidy, Charles, Catalano, Louis, Chivers, Karel, Choudhari, Pradeep, Cimerman, Matej, Conflitti, Joseph M., Costanzo, Ralph M., Crist, Brett D., Cross, Brian J., Dantuluri, Phani, Darowish, Michael, De Bedout, Ramon, Decoster, Thomas, Dennison, David G., Denoble, Peter H., Desilva, Gregory, Dienstknecht, Thomas, Duncan, Scott F., Duralde, Xavier A., Durchholz, Holger, Egol, Kenneth, Ekholm, Carl, Elias, Nelson, Erickson, John M., Esparza, J. Daniel Espinosa, Fernandes, C. H., Fischer, Thomas J., Fischmeister, Martin, Jaime, Forigua E., Getz, Charles L., Gilbert, Richard S., Giordano, Vincenzo, Glaser, David L., Gosens, Taco, Grafe, Michael W., Filho, Jose Eduardo Grandi Ribeiro, Gray, Robert R. L., Gulotta, Lawrence V., Gummerson, Nigel William, Hammerberg, Eric Mark, Harvey, Edward, Haverlag, R., Henry, Patrick D. G., Hobby, Jonathan L., Hofmeister, Eric P., Hughes, Thomas, Itamura, John, Jebson, Peter, Jenkinson, Richard, Jeray, Kyle, Jones, Christopher M., Jones, Jedediah, Jubel, Axel, Kaar, Scott G., Kabir, K., Kaplan, F. Thomas D., Kennedy, Stephen A., Kessler, Michael W., Kimball, Hervey L., Kloen, Peter, Klostermann, Cyrus, Kohut, Georges, Kraan, G. A., Kristan, Anze, Loebenberg, Mark I., Malone, Kevin J., Marsh, L., Martineau, Paul A., Mcauliffe, John, Mcgraw, Iain, Mehta, Samir, Merchant, Milind, Metzger, Charles, Meylaerts, S. A., Miller, Anna N., Wolf, Jennifer Moriatis, Murachovsky, Joel, Murthi, Anand, Nancollas, Michael, Nolan, Betsy M., Omara, Timothy, Omid, Reza, Ortiz, Jose A., Overbeck, Joachim P., Page, Richard S., Castillo, Alberto Pérez, Pesantez, Rodrigo, Polatsch, Daniel, Porcellini, G., Prayson, Michael, Quell, M., Ragsdell, Matthew M., Reid, James G., Reuver, J. M., Richard, Marc J., Richardson, Martin, Rizzo, Marco, Rowinski, Sergio, Rubio, Jorge, Guerrero, Carlos G. Sánchez, Satora, Wojciech, Schandelmaier, Peter, Scheer, Johan H., Schmidt, Andrew, Schubkegel, Todd A., Schulte, Leah M., Schumer, Evan D., Sears, Benjamin W., Shafritz, Adam B., Shortt, Nicholas L., Siff, Todd, Silva, Dario Mejia, Smith, Raymond Malcolm, Spruijt, Sander, Stein, Jason A., Pemovska, Emilija Stojkovska, Streubel, Philipp N., Swigart, Carrie, Swiontkowski, Marc, Thomas, George, Tolo, Eric T., Turina, Matthias, Tyllianakis, Minos, Van Den Bekerom, Michel P. J., Van Der Heide, Huub, Van De Sande, M. A. J., Van Eerten, P. V., Verbeek, DIederik O. F., Hoffmann, David Victoria, Vochteloo, A. J. H., Wagenmakers, Robert, Wall, Christopher J., Wallensten, Richard, Wascher, Daniel C., Weiss, Lawrence, Wiater, J. Michael, Wills, Brian P. D., Wint, Jeffrey, Wright, Thomas, Young, Jason P., Zalavras, Charalampos, Zura, Robert D., Zyto, Karol, Orthopedic Surgery and Sports Medicine, Other departments, Other Research, and Graduate School

Subjects
Male, medicine.medical_specialty, Interobserver reliability, Radiography, Fleiss' kappa, Fractures, Bone, New International Classification for Scapular Fractures, OTA/AO fracture classification, reliability, scapula, Female, Humans, Imaging, Three-Dimensional, Observer Variation, Reproducibility of Results, Scapula, Tomography, X-Ray Computed, Surgery, Orthopedics and Sports Medicine, Reliability study, medicine, Ao classification, Reliability (statistics), Orthodontics, business.industry, General Medicine, Reconstructive and regenerative medicine Radboud Institute for Molecular Life Sciences [Radboudumc 10], business, Kappa
Abstract

Item does not contain fulltext OBJECTIVES: There is substantial variation in the classification and management of scapula fractures. The first purpose of this study was to analyze the interobserver reliability of the OTA/AO classification and the New International Classification for Scapula Fractures. The second purpose was to assess the proportion of agreement among orthopaedic surgeons on operative or nonoperative treatment. DESIGN: Web-based reliability study. SETTING: Independent orthopaedic surgeons from several countries were invited to classify scapular fractures in an online survey. PARTICIPANTS: One hundred three orthopaedic surgeons evaluated 35 movies of three-dimensional computerized tomography reconstruction of selected scapular fractures, representing a full spectrum of fracture patterns. MAIN OUTCOME MEASUREMENTS: Fleiss kappa (kappa) was used to assess the reliability of agreement between the surgeons. RESULTS: The overall agreement on the OTA/AO classification was moderate for the types (A, B, and C, kappa = 0.54) with a 71% proportion of rater agreement (PA) and for the 9 groups (A1 to C3, kappa = 0.47) with a 57% PA. For the New International Classification, the agreement about the intraarticular extension of the fracture (Fossa (F), kappa = 0.79) was substantial and the agreement about a fractured body (Body (B), kappa = 0.57) or process was moderate (Process (P), kappa = 0.53); however, PAs were more than 81%. The agreement on the treatment recommendation was moderate (kappa = 0.57) with a 73% PA. CONCLUSIONS: The New International Classification was more reliable. Body and process fractures generated more disagreement than intraarticular fractures and need further clear definitions. 01 maart 2014

Published
2014

24. Rapid Alterations in Diffusion-weighted Images with Anatomic Correlates in a Rodent Model of Status Epilepticus

Author

Wall, Christopher J., Kendall, Edward J., and Obenaus, André

Subjects
nervous system, Brain
Abstract

BACKGROUND AND PURPOSE: Diffusion-weighted MR imaging has emerged as a noninvasive tool for the detection of regional neuronal damage. We hypothesize that changes in diffusion-weighted images will correlate with pathophysiologic alterations caused by pilocarpine-induced status epilepticus. METHODS: MR images of brain tissues were examined in vivo by use of T2- and diffusion-weighted imaging at 3, 6, 12, and 24 hours after pilocarpine-induced seizures. Histologic verification of neuronal damage was also performed after imaging to assess the extent and the time course of neuronal cell death. RESULTS: The piriform cortex, amygdala, and retrosplenial (and somatosensory) cortex displayed significant apparent diffusion coefficient (ADC) decreases 12 hours after seizure initiation. In contrast, an ADC rise of 19% was observed in the hippocampus 24 hours after seizure induction. Histologic data from the piriform cortex and amygdala confirmed severe neuronal loss, whereas hippocampal damage was much less pronounced at 12 hours. Interestingly, very little histologic damage was seen in the retrosplenial cortex. CONCLUSION: This study capitalized on diffusion-weighted imaging as a sensitive technique for the early identification of seizure-induced neuronal damage and differentiation of regional severity of these alterations. Hippocampal neuropathology is slower and longer in duration (∼7 days), while the piriform cortex and amygdala exhibit very rapid neurodegenerative alterations (∼24 hours) after pilocarpine-induced status epilepticus. These histologic changes are reflected in opposing ADC values within these regions.

Published
2000

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