Affect Patient Satisfaction Research Articles

ANALISIS KUALITAS PELAYANAN PENDAFTARAN BPJS TERHADAP KEPUASAN PASIEN RAWAT JALAN DI RSUD DOLOKSANGGUL KECAMATAN DOLOKSANGGUL KABUPATEN HUMBANG HASUNDUTAN TAHUN 2024

Quality health services will provide satisfaction to patients who leave the hospital. Factors that affect patient satisfaction include physical evidence (tangibility), responsiveness (responsiveness), caring attitude (emphaty), assurance (assurance), and reliability (reliability). The purpose of this study is to find out the relationship between patient satisfaction and tangibility, responsiveness, emphaty, assurance, and realibility. This type of research is quantitative research. The population in this study is all outpatient BPJS patients at the Doloksanggul Regional General Hospital. The sample size of the study was 100 respondents using the accidental sampling technique with the slovin formula. The data collection technique was carried out by distributing questionnaires. The analysis used was univariate and bivariate analysis. Tested using the Chi-Square test. The results of the study showed that in the tangibility variable (physical evidence), 85% of respondents rated physical appearance as good and 15% rated it as poor. In the responsiveness variable, 87% of respondents felt a quick response and 13% felt a slow response. On the emphaty variable, the majority of respondents felt 84% concerned while only 16% felt less caring. In the Assurance variable, 88% of respondents felt that they received good security guarantees and 12% felt that they were not good. In terms of reability, 87% of respondents rated reliability as high, while 13% rated it low. Bivariate analysis obtained a p-value of <0.05, which is 0.000 for the variables tangibility, responsiveness, emphaty, assurance and realibility with outpatient satisfaction. Therefore, it can be concluded that there is a significant relationship between the variables of tangibility, responsiveness, emphaty, assurance and realibility with outpatient satisfaction at Doloksanggul Hospital. It is hoped that health workers will continue to maintain the quality of BPJS registered health services so that patient satisfaction is better.

Finite-element investigations on the influence of material selection and geometrical parameters on dental implant performance

Abstract Dental implants provide functional and aesthetically pleasing dental replacements, but their longevity depends on biomechanical factors, physical characteristics, and patient variability. The present study used finite-element analysis to reveal the biomechanical response and potential modes of failure of dental implant systems subjected to normal occlusal loads. A generalized comparative assessment was carried out to measure the effect of the choice of crown material with zirconia, porcelain-fused-to-metal, and ceramic crowns. Such simulations showed complex patterns of stress distribution and deformation in the implant assembly with significant variation due to the mechanical properties of the crown material. Stiffer zirconia crowns magnified stress concentrations by 12.6, 10.8, 11.4, and 9.1% in the implant fixture, crown, cortical bone, and cancellous bone, respectively, compared with more compliant ceramic crowns. Furthermore, the maximal deformation of both the cortical and cancellous bone induced by zirconia crowns was higher by 21.1 and 19.2%, respectively, compared with the ceramic crowns. These results emphasize that the crown material properties are significant for controlling and modulation biomechanical load transfer, which plays a decisive role in the long-term durability and resistance to failure mechanisms such as interfacial debonding, bone resorption, and fatigue cracking. This study provides valuable information for optimizing implant designs and material selection that may improve clinical results, positively affecting patient satisfaction with dental implant therapy.

Dental impact on daily life and oral health in alcohol use disorder patients

ObjectivesIndividuals with Alcohol Use Disorder (AUD) are at a higher risk of developing dental problems. The present study assessed the dental impact on daily performances among AUD patients seeking treatment in a de-addiction centre and correlated it with their clinical dental status using the WHO oral health assessment form (2013). Materials and methodsThis research took place from January to May 2022. A cross-sectional study was carried out to collect data from 103 subjects among alcohol dependents taking treatment in a de-addiction centre of Dakshina Kannada district, Karnataka state. The Dental Impact on Daily Living Questionnaire (DIDL) assessed patients' satisfaction with their teeth, while the WHO Oral Health Assessment Form for Adults was used for dental caries (DMFT) and periodontal status. Data analysis was performed using the jamovi open-source software (version 2.3), employing t-test, chi-square test, hierarchical regression analysis, and Spearman correlation coefficient. ResultsThe study found low yet significant correlations between clinical oral health and dimensions of the DIDL scale. Social class and the number of decayed teeth emerged as significant predictors of the total DIDL score. ConclusionOral health conditions can adversely affect patient satisfaction, emphasizing the need for healthcare providers to consider these findings when offering comprehensive oral healthcare services. Clinical relevanceThis study underscores the necessity of integrating oral healthcare into the overall treatment regime for individuals with Alcohol Use Disorders (AUDs) to improve their quality of life and satisfaction.

The Disaggregated Oswestry Disability Index: What is the Most Predictive Subsection for Patient Satisfaction After Lumbar Surgery?

Retrospective review of cohort studies. To analyze how different ODI subsections and their improvement affect patient satisfaction 2 years after elective lumbar surgery for degenerative lumbar spondylolisthesis (DLS). The Oswestry Disability Index (ODI) is crucial in evaluating outcomes of spinal disorders and provides valuable insights into a patient's preoperative status. There is limited information available on the individual characteristics of its subsections and their relation to postoperative patient satisfaction. Pre- and 2-year postoperative ODI and patient satisfaction were assessed. The analysis included preoperative scores and improvements in each ODI subsection 2 years postoperatively. Satisfaction was rated on a scale of 1 to 5, with scores ≥4 deemed satisfactory. Univariate linear regression and ROC analysis established cutoffs for subsection improvement and postoperative target values to achieve postoperative satisfaction. 265 patients (60% female, 67±8 years) were included. ODI improvement was achieved in 91%, and postoperative patient satisfaction in 73%. Patients with lower postoperative subsection scores and greater differences between pre- and postoperative scores were more likely to be satisfied (all P<0.001). A postoperative subsection target score of ≤1 was associated with patient satisfaction. Change in degree of pain was the most predictive subsection for satisfaction, with an AUC of 0.84 (sensitivity 79%, specificity 86%). Walking (AUC 0.83, sensitivity 87%, specificity 65%), pain intensity (AUC 0.82, sensitivity 79%, specificity 79%), personal care (AUC 0.82, sensitivity 83%, specificity 68%), and standing (AUC 0.82, sensitivity 83%, specificity 83%) all had an AUC greater than 0.80. The postoperative subsection with the lowest predictability was sleeping (AUC 0.69). Pain domains, walking, standing, and personal care were the subsections with the highest predictability for patient satisfaction. These findings on the correlation between different ODI subscales and patient satisfaction are valuable for improving preoperative education, addressing disability, and ensuring postoperative satisfaction.

Comprehensive Analysis of UBE-Related Complications: Prevention and Management Strategies from 4685 Patients.

Unilateral biportal endoscopy (UBE) surgery is a minimally invasive approach for treatment of spinal disorders, which usually requires creation of a working and viewing channel on 1 side. The UBE technique has developed rapidly in China in recent years, and many spine surgeons have started to apply it and have shared the initial clinical research results many times at minimally invasive spine conferences. Unfortunately, these studies actually translated into fewer publications. In addition, most patients have good outcomes after UBE surgery, but a minority still experience UBE surgery-related complications, including epidural hematoma, dural sac tears, retroperitoneal effusions, inadequate decompression, postoperative back pain and headache, early recurrence, iatrogenic spinal instability, anemia, and infection, which can prolong hospital stay and seriously affect patient satisfaction. Therefore, this article reviews the complications of UBE surgery for lumbar degenerative diseases and discusses ways to prevent and handle complications associated with UBE to help spine surgeons make smart treatment decisions.

Satisfaction questionnaire survey after surgical orthodontic treatment in patients with jaw deformities

ObjectiveSurgical orthodontic treatment leads to morphological, functional and psychological changes in patients with jaw deformities. For the evaluation of outcomes of surgical orthodontic treatment from the patient's point of view, a questionnaire survey was performed after treatment and factors affecting patient satisfaction were examined. MethodsA survey by mailing questionnaires that each consisted of 30 items was conducted in 250 patients with jaw deformities who underwent orthognathic surgery in our department during the period from January 2015 to December 2020. Eighty-four patients responded (response rate of 34.0%). The patients who responded included 24 males and 60 females. The mean age at the time of surgery was 26 years. ResultsFifty-four patients complained of morphological abnormalities such as facial appearance and malocclusion, and 30 patients complained of functional disturbances such as masticatory disabilities. Eighty-two patients were satisfied with the outcome of surgery, but there were two patients with postoperative paresthesia and residual facial asymmetry who were not satisfied with the outcome. Improvements were observed in mastication and pronunciation in 74 and 46 patients, respectively. Psychologically, 26 patients showed positive personality changes postoperatively. Thirty-three patients had TMJ symptoms before surgery, and the symptoms were resolved after surgery in 24 of those patients. Two patients developed snoring during sleep after surgery. ConclusionsThis survey showed that most patients with jaw deformities were satisfied with the results of surgical orthodontic treatment.

Analisis waste pada depo rawat jalan dengan menggunakan lean hospital di Rumah Sakit Islam Siti Hajar Mataram

Pharmaceutical installations can provide substantial revenue if managed properly and efficiently. Good or bad service can affect patient satisfaction. For this reason, pharmaceutical installations must improve quality in terms of patient satisfaction, one of which is by reducing waste that occurs in the pharmaceutical service process in hospitals. This study aims to analyze what waste occurs in outpatient depot services to improve service efficiency. This research is descriptive qualitative. Data were obtained through document review, direct observation, interviews. Waste identification uses Value Stream Mapping and Fishbone Diagram to determine the root causes of critical waste that occurs. The results showed that the highest percentage of value added was in the ordinary prescription service of 63.41%, the highest percentage of necessity but non-value added was in the prescription service that required drug distribution from the warehouse unit of 70.79%, and the highest non-value added was in the compounded prescription service process of 36.59%. By using lean hospital, it can be identified that many wastes occur including waiting, transportation, and defects. Increasing service efficiency at the Siti Hajar Mataram Islamic Hospital Outpatient depot can be done by minimizing non-value added activities.

From Filters to Scalpels-Understanding Perceptions of Facial Asymmetry: An AAFPRS Survey.

Facial asymmetries can significantly affect patient satisfaction post-surgery. Social media can impact a patient's perception of their asymmetries. To gather insights into the practices, perceptions, and approaches concerning facial asymmetry among facial plastic surgeons. The aim of this study was to understand the impact of social media on perceptions of facial asymmetry. This is an American Academy of Facial Plastic and Reconstructive Surgeons (AAFPRS) survey consisting of 46 questions that sought to understand facial plastic surgeons' perceptions of facial asymmetry, their consultation process, their patients' perspectives on their own facial asymmetries, and patient satisfaction. The survey was distributed to 1,269 members of AAFPRS across community hospitals, private practices, and academic hospitals. Sixty-seven members completed the survey. The survey revealed that 31% (21) of surgeons face challenges in managing patient expectations regarding facial asymmetry. In addition, 12% (8) of surgeons felt that patients did not initially recognize their own asymmetries. Eighty-seven percent (58) of surgeons emphasize the natural occurrence of asymmetry during consultations to set realistic expectations. This study emphasizes the need for thorough patient education during initial consultations to align expectations with achievable outcomes. Surgeons should explain the natural occurrence of asymmetry clearly and use digital imaging to show patients realistic previews of surgical results.

A study of the crucial Role of Telehealth in Saudi Arabia's Nursing Care Changes

This research investigates how telehealth affects nursing care in Saudi Arabia, with particular attention to how it affects patient satisfaction, healthcare accessibility, and the management of chronic illnesses. The study used a mixed-methods approach to look at the experiences of 300 patients and 200 nurses in both urban and rural settings. It included both qualitative interviews and quantitative surveys. According to the findings, telehealth greatly improves accessibility by removing geographical barriers, and urban nurses use it at a somewhat higher rate than their rural colleagues. The majority of patient satisfaction ratings are positive, which is consistent with other research showing how telehealth can enhance patient experiences. According to the study, telemedicine interventions can effectively manage chronic diseases, including diabetes, as evidenced by a significant decrease in hospital visits and an improvement in medication adherence. Notwithstanding these advantages, considerable impediments were found to include technological hurdles including internet connectivity and digital literacy. The study's conclusions are in line with previous research, highlighting the necessity for continual advancements in technology and education while reiterating the role that telehealth has played in revolutionising healthcare delivery. All things considered, telehealth seems to be a useful instrument for improving nursing care, providing significant advantages and highlighting areas that require further development to reach its full potential in the Saudi healthcare system.

Factors associated with patient satisfaction after arthroscopic rotator cuff repair: do they differ by age?

Several studies have investigated factors affecting patient satisfaction after arthroscopic rotator cuff repair (ARCR); however, it is unknown if these factors vary according to age. Therefore, this study aimed to evaluate the factors associated with satisfaction of ARCR in individuals 70 years and older versus younger patients. Among 319 consecutive patients who underwent ARCR, 173 were included. Patients were divided into an old age group (≥70 years) and a young age group (<70 years), and the two age groups were further divided into satisfied and unsatisfied subgroups. Patient satisfaction was evaluated at the final follow-up visit using a binary question (yes or no). Clinical outcomes were assessed preoperatively and at the final follow-up. Satisfaction rates in the older and younger age groups were 75.41% and 79.47%, respectively. Mean changes in Constant and American Shoulder and Elbow Surgeons scores were significantly different between the satisfied and unsatisfied subgroups (P=0.031 and P=0.012, respectively) in the young patients. In the old patients, there was a significant difference in the mean change in depression subscale of the Hospital Anxiety and Depression Scale (P=0.031) and anxiety subscale of the Hospital Anxiety and Depression Scale (P=0.044) scores between the satisfied and unsatisfied subgroups. Factors affecting patient satisfaction after ARCR differed according to age. Psychological improvement was more important to elderly patients, whereas restoration of function was more important to younger patients. Pain relief was important for both age groups. Level of evidence: III.

Empirical Study on the Relationship Between Quality of Nursing Services and Postoperative Satisfaction of Patients with Acute Appendicitis: Intermediation Based on Information Flows

This study investigated the relationship between nursing care and patient satisfaction, with a specific focus on postoperative satisfaction in patients with acute appendicitis. The shift in China's medical model from a biomedical approach to a biopsychosocial framework emphasizes patient-centered care, with patient satisfaction becoming a key indicator of service quality. The study used a survey-based approach to collect data from 384 patients in hospitals in Guangxi, China. Through statistical analysis, the study explores how the quality of care services, doctor-patient communication processes, and information exchange affect patient satisfaction. The research results show that there is a significant positive correlation between the quality of nursing services and patient satisfaction. In particular, the professional level and effective communication skills of nursing staff significantly improve patient satisfaction. This study provides practical recommendations for enhancing the training process in clinical settings.

Analisis Mutu Pelayanan Kesehatan Masyarakat terhadap Kepuasan Pasien di Puskesmas Bukit Lawang Kabupaten Langkat Tahun 2023

The quality of health services is very important to measure how far the Community Health Center is in providing services to patients by looking at the number of BPJS patient visits at the Bukit Lawang Community Health Center, Langkat Regency, which only reached 82.00% in 2020, 77.9% in 2022 and 76.9% in 2023 compared to the target of 95%. Data from the Bukit Lawang Community Health Center, Langkat Regency for the period 2021-2023 showed fluctuations in the number of BPJS patient visits every month. The purpose of this study was to analyze the effect of the quality of public health services on patient satisfaction at the Bukit Lawang Health Center, Langkat Regency in 2023. The research design used a quantitative method with a cross-sectional study approach. The population in this study were all patients who visited the Bukit Lawang Health Center, Langkat Regency in 2023 with an average number of visits of 292 patients per month, the number of samples of 75 people was obtained using a purposive sampling technique. Data analysis used univariate, bivariate and multivariate analysis with logistic regression tests. The results of the study using the chi-square test showed that the variables reliability, assurance, tangible, empathy and responsiveness had a p-value &lt;0.05. The results of the study using the logistic regression test showed that the variables reliability, empathy and responsiveness had a sig. &lt;0.05 and the variables assurance and tangible had a sig.&gt; 0.05. The conclusion of the study is that the variables that significantly affect patient satisfaction are the variables reliability, empathy and responsiveness and the variable that most significantly affects patient satisfaction is the variable reliability.

Adjunctive treatment of atopic dermatitis with novel at-home handheld narrow-band UVB phototherapy.

While conventional in-office phototherapy has long been utilized as a successful treatment for atopic dermatitis (AD), it is associated with potential barriers including inconvenience, poor adherence, time and financial expense. In this retrospective study, we examine the efficacy, adherence, and patient-satisfaction of using adjunctive at-home, self-administered phototherapy utilizing a novel handheld narrow-band ultraviolet B (NB-UVB) device for the treatment of refractory mild to severe AD. Included AD patients were initially trained on proper use of the device. These patients treated involved areas three times per week for a period of 12weeks. Phototherapy dosing protocol was based on skin type. The cohort included 52 patients, who were aged 20-69 and represented all skin types. They were initially categorized by disease involvement as mild, moderate, and severe. Patients were also queried to self-score their disease severity and level of satisfaction. Compared to baseline, at 12weeks, 48% percent of patients indicated that at least one site was Clear/Almost Clear, 38% stated that more than 50% of body locations were Clear/Almost Clear, and 28% reported that 100% (all) treated sites were Clear/Almost Clear. After using at-home hand-held NB-UVB for the study duration, 67% (35/52) of patients experienced disease improvement. Mean overall satisfaction was extremely high at 4.43 on a 5-point scale. Skin type, age, gender, and disease severity at inception did not significantly affect patient satisfaction scores. Overall adherence rate among participants across all groups was 73%. In this small retrospective study, at-home handheld NB-UVB phototherapy was found to be an effective, well-tolerated, adjunctive treatment method for patients with refractory AD, which was associated with a high level of patient satisfaction and adherence.

BREAST-Q Analysis of Reduction Mammaplasty: Do Postoperative Complications of Breast Reduction Surgery Negatively Affect Patient Satisfaction?

Reduction mammaplasty can provide symptomatic relief to patients suffering from macromastia, however complications such as dehiscence are common. It is unknown if the presence of complications may affect patient reported outcomes. This study aims to (1) determine risk factors for development of complications, and (2) to examine the correlation between postoperative complications and patient reported outcomes in reduction mammaplasty. A single-center retrospective chart review was performed on patients who received reduction mammaplasties (CPT19318) between 1/17-2/23 by thirteen surgeons. Breast cancer cases and oncoplastic reconstructions were excluded. Patients with >1 complication were grouped into the complications cohort. BREAST-Q-survey was used to assess satisfaction. A total of 661 patients were included for analysis, and 131 patients developed at least one complication. Patients in the complication group had significantly higher average ages and body mass indexes, and a higher likelihood of hypertension and diabetes (p<0.01). Among 180 BREAST-Q responders, 41 had at least one complication. There were no significant differences between the two groups across survey outcomes. Although obese patients were more likely to develop infection and require revisions (p<0.01), no significant differences in subgroup analysis of patient-reported outcomes focusing on obese patients were observed. Obesity, hypertension, and diabetes were associated with postoperative complications of reduction mammaplasty. Patients with complications had similar postoperative Breast-Q satisfaction to patients without complications. While risk optimization is critical, patients and surgeons should be reassured that satisfaction may be achieved even in the event of a complication.

The prognosis of iatrogenic saphenous nerve injuries during hamstring tendon harvesting in anterior cruciate ligament reconstruction

PurposeThis study aims to evaluate the long-term outcomes of saphenous nerve (SN) injuries from hamstring tendon harvesting during ACL reconstruction, focusing on clinical results and patient satisfaction after at least two years. Additionally, it investigates the incidence, recovery patterns, and impact of these injuries on functional outcomes, daily activities, and ACL re-rupture rates immediately post-surgery and at final follow-up.Materials and methodsA retrospective review was conducted on patients who had undergone ACL reconstruction with hamstring tendon grafts at a single institution between January 2015 and January 2020. The incidence of SN injuries was assessed immediately after surgery and at final follow-up. Additionally, the recovery rate and time were evaluated, and the impact of these injuries on functional outcomes was measured using the Lysholm Knee Score (LKS) and patient-reported effects on daily activities.ResultsOf the 159 patients analyzed, iatrogenic SN injuries were initially observed in 87 (54.7%) patients post-ACLR. By the final follow-up, paresthesia had resolved in 36 (22.6%) patients within an average of 11.1 months. Persistent SN injuries were recorded in 51 (32.1%) patients, affecting various extents of the infrapatellar branch (IPBSN) and the sartorial branch (SBSN) of the saphenous nerve. Patients with persistent SN injuries experienced a significant impact on daily activities and had lower LKS scores compared to those without injuries or with recovered injuries. Furthermore, a higher re-rupture rate was associated with persistent SN injuries.ConclusionsThe study finds that SN injuries during hamstring graft harvesting for ACL reconstruction are common, with a significant portion of patients experiencing persistent sensory deficits for at least two years postoperatively. These injuries are observed to adversely affect patient satisfaction and functional outcomes and to increase the re-rupture rate.

Cross-Cultural Adaptation of The Indonesian Version Functional Assessment of Denture Instrument as a Measuring Tool for Complete Denture Functional Quality.

Making good quality dentures is necessary to avoid patients' discomfort when adapting to new dentures. Several studies regarding the assessment of the quality of dentures have been carried out in many other countries, such as using the Functional Assessment of Dentures (FAD) by Anastassiadou. However, studies have yet to be conducted in Indonesia. This study aims to obtain a valid and reliable instrument to measure the quality of complete dentures (CDs). This study also aims to find out whether the functional quality of a CD measured with the Indonesian version of the FAD Instrument (PFGT) can affect patient satisfaction in receiving CD treatment (measured with Indonesian version of Patient's Denture Assessment [PDA-Id]) and to find contributing factors to the functional quality of a CD. The study was conducted in two stages. The first stage was a qualitative study using cross-cultural adaptation methods and focus group discussions with experts. The second stage was a quantitative test with a total of 40 subjects for statistical analysis in the form of a kappa test, test-retest, Kuder-Richardson (KR) 20, and a correlation test between PDA-Id and PFG. Multivariate analysis was done to analyze contributing factors to the functional quality of CD. The final instrument was obtained from the qualitative test, which was tested for content and face validation. The interrater kappa test result of 0.828 shows an almost perfect agreement. The results of the intrarater test-retest (0.564; p > 0.05; intraclass correlation coefficient 0.889) showed excellent instrument stability. The results of the internal consistency test with Kuder-Richardson 20 (1.08; KR > 1) showed good internal consistency. The correlation test results between PFGT and PDA-Id (0.044; p < 0.05) showed a positive correlation. Multivariate analysis showed a relationship between the quality of the CD, the length of time the CD was used, and the patient's satisfaction with CD treatment. The PFGT instrument is considered a valid and reliable tool to measure the functional quality of a denture that can distinguish between good and bad quality.

Unraveling patient satisfaction, associated factors, and dissatisfaction reasons in the provision of health care services for rural communities in Bangladesh: A cross-sectional investigation

BackgroundAccess to high-quality healthcare is a fundamental right, but rural communities in Bangladesh face challenges in accessing such services. Patient satisfaction plays a crucial role in healthcare outcomes. Identifying factors influencing satisfaction is vital for targeted interventions. MethodsA cross-sectional investigation was conducted in rural areas of Sirajganj, Rajshahi, Bangladesh, from April to June 2023. Convenient sampling was employed, and face-to-face interviews were conducted using a semi-structured questionnaire. A total of 411 participants were included in the final analysis. Descriptive statistics, as well as bivariate and multivariable logistic regression analyses, were carried out using SPSS software. ResultsMost unmarried participants (mean age: 41.93 ± 14.54 years; age range: 18–88 years) had primary education and a family income below 15,000 BDT. Among them, 80.3 % reported dissatisfaction with treatment. Significant factors linked to dissatisfaction included low education, being a businessman, living in nuclear families, daily physical exercise, difficulty accessing healthcare, average doctor-patient communication, high treatment costs, long waiting times, government hospital services, proximity to healthcare centers, lack of follow-up services, and absence of Telemedicine or M-health services. ConclusionThis study identifies key factors affecting patient satisfaction in rural Bangladesh. Interventions should focus on improving doctor-patient communication, reducing treatment costs and waiting times, enhancing access to healthcare and follow-up services, and incorporating Telemedicine or M-health services. Special attention is needed for businessmen, nuclear family residents, those who exercise daily, and patients using government hospitals or living near healthcare centers, as these groups report higher dissatisfaction.

Ultracongruent Versus Posterior-Stabilized Polyethylene: No Difference in Anterior Knee Pain but Decreased Noise Generation.

Noise generation and anterior knee pain can occur after primary total knee arthroplasty (TKA) and may affect patient satisfaction. Polyethylene design in cruciate-sacrificing implants could be a variable influencing these complications. The purpose of this study was to analyze the effect of polyethylene design on noise generation and anterior knee pain. We prospectively reviewed a cohort of patients who underwent primary TKA between 2014 and 2022 by a single surgeon using either a posterior-stabilized (PS) or ultracongruent (UC) polyethylene of the same implant design. The primary outcomes were measured through a noise generation questionnaire and the Knee Injury and Osteoarthritis Outcome Score-Patellofemoral score. A total of 409 TKA procedures were included, 153 (37.4%) PS and 256 (62.6%) UC. No difference was noted in the Knee Injury and Osteoarthritis Outcome Score-Patellofemoral score between PS and UC designs (71.7 ± 26 versus 74.2 ± 23.2, P = 0.313). A higher percentage of patients in the PS cohort reported hearing (32.7% versus 22.3%, P = 0.020) or feeling noise (28.8 versus 20.3, P = 0.051) coming from their implant. No notable difference was observed in noise-related satisfaction rates. Independent risk factors of noise generation were age (OR, 0.96; P = 0.006) and PS polyethylene (OR, 1.61; P = 0.043). Noise generation was associated with decreased patient-reported outcome measure scores (P < 0.001). While there was no difference in anterior knee pain between PS and UC polyethylene designs, PS inserts exhibit higher rates of noise generation compared with UC. Noise generation had comparable satisfaction but was associated with decreased patient-reported outcome measure scores.

Factors Affecting Patient Satisfaction with Double-Eyelid Blepharoplasty.

Blepharoplasty is a common surgical technique performed in individuals seeking aesthetic enhancement. Thus, it is essential to investigate the factors influencing postoperative satisfaction from the patient's perspective. In this study, patient-rated outcome measure questionnaires were used to identify the factors affecting patient satisfaction after full-incision upper blepharoplasty. This retrospective study analyzed patients who underwent full-incision upper blepharoplasty at an outpatient clinic in China. The questionnaire responses were collected by telephone, text messaging, or email at 6 and 12 months postoperatively. In total, 149 questionnaires were collected. After a mean follow-up of 23.23 months, the patients' overall satisfaction rate was 89.43%. The factors that significantly affected postoperative satisfaction were the patient's education level, the source of referral to the surgeon, the patient's understanding of the surgical risks, application of a cold compress after surgery as recommended, unsatisfactory postoperative double-eyelid width, postoperative bilateral asymmetry, apparent postoperative cicatrices, and postoperative caterpillar-like appearance of the double eyelids. Education level, apparent postoperative cicatrices, and postoperative bilateral asymmetry influenced the patient's satisfaction with the surgical outcome. The patient's understanding of the surgical risks, unsatisfactory postoperative double-eyelid width, postoperative bilateral asymmetry, apparent postoperative cicatrices, and postoperative caterpillar-like appearance influenced the satisfaction of the patient's family and friends. Postoperative bilateral asymmetry, apparent postoperative cicatrices, and a low education level of the patient are independent factors that negatively affect patient satisfaction with the outcome of double-eyelid blepharoplasty. This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

Excellent Results of Large-Diameter Ceramic-On-Ceramic Bearings in Total Hip Arthroplasty at Minimum Ten-Year Follow-Up

BackgroundThis study reports the minimum 10 years results of total hip arthroplasty (THA) performed using a monoblock acetabular component with a large-diameter head ceramic-on-ceramic bearing. MethodsOf the 276 THAs included in this study, there were eleven deaths and 27 patients lost to follow up (11%) during the follow-up, leaving 237 (85%) hips available for review at a mean of 10.5 years (range, 10 to 12) postoperatively. Reoperations, implant revisions, adverse events, clinical outcomes, radiographic evaluation, and whole blood metal ion levels were assessed at the last follow-up. ResultsAfter a minimum of 10 years, implant survivorship was 98.7%. There were 3 revisions (1.3%): one for insufficient acetabular cup primary fixation, one traumatic periprosthetic acetabular fracture, and one probable deep chronic infection. No dislocation or ceramic implant fracture was observed. The mean University of California at Los Angeles activity score, Western Ontario and McMaster Universities Osteoarthritis Index score, and Forgotten Joint Score were 5.6 (2 to 10), 90.1 (9 to 100), and 79.2 (4 to 100), respectively. All patients (100%) were satisfied or very satisfied. Since implantation, 43% of patients reported hearing a squeaking noise from the prosthesis. But all patients who reported squeaking were satisfied with the surgery. The mean titanium level was 2.2 μg/L (1.1 to 5.6). No progressive radiolucent lines, osteolysis, or implant loosening signs were observed at the last radiographic evaluation. ConclusionsA large-diameter head ceramic-on-ceramic THA provides outstanding long-term (minimum 10 years) implant survivorship with unrestricted activity while avoiding implant impingement, liner fracture, and hip instability. Functional outcomes, satisfaction, and joint perception were excellent. Although the incidence of squeaking was high, it did not affect patient satisfaction or function. The systemic titanium levels were low, related to unavoidable passive corrosion of implant surfaces, and did not reveal any indirect signs of trunnionosis.