SF-36 Scoring Research Articles

Laser Hemorrhoidoplasty for Treatment of the Hemorrhoids in Eastern Nepal

Background: Millions worldwide are affected by hemorrhoids (prevalence 2.9%-27.9%), causing symptoms in over 4% of individuals. These anorectal disorders result from enlarged anal hemorrhoidal cushions, often due to constipation. Internal or external, they're graded by prolapse severity, with common symptoms including painless rectal bleeding. Treatment options range from conservative to surgical, with the gold standard, Milligan-Morgan hemorrhoidectomy, associated with postoperative pain. Laser hemorrhoidoplasty, a minimally invasive diode laser approach, shows promise, offering less postoperative pain, shorter hospital stays, and fewer complications than traditional surgical methods.
 Materials and Methods: A prospective observational study of 40 adults undergoing laser hemorrhoidectomy for symptomatic Goligher’s grade II and III hemorrhoids at Nobel Medical College Teaching Hospital, Biratnagar, Nepal, from June 2022 to June 2023. Outcomes included pain scores, bleeding, operative time, postoperative complications, hospital stay length, return-to-work time, and patient satisfaction measured by QOL SF36 scoring.
 Results: Among 40 patients, 16 were male and 24 females, averaging 42.32 ± 12.26 years. Grade III hemorrhoids were found in 31 patients, Grade II in 9. Operative time averaged 17.22 ± 2.14 minutes, with one case of managed intraoperative bleeding. Postoperative symptoms included pain, skin tags, and wound infection, but no reactive bleeding, urinary, or stool/flatus incontinence. Two cases experienced recurrence. Patient satisfaction in general health evaluation scored 65.11 ± 10.35.
 Conclusion: Laser hemorrhoidoplasty is associated with less complications, quicker operative time, quick recovery and similar patient satisfaction when compared to surgical methods of hemorrhoidectomy.

The Study of Quality of Life and It?s Determinants Among Dialysis Patients Using the KDQOL SF-36 Scoring in a Tertiary Care Center in Tamilnadu

The Study of Quality of Life and It?s Determinants Among Dialysis Patients Using the KDQOL SF-36 Scoring in a Tertiary Care Center in Tamilnadu

Autologous collagen-induced chondrogenesis versus microfracture for chondral defects of the knee: Surgical technique and 2-year comparison outcome study

ObjectiveOsteochondral lesions of the knee affect patients from all age groups with arthroscopic microfracture being the current gold standard of treatment of such lesions. Autologous collagen-induced chondrogenesis (ACIC) is a novel procedure that has recently been gaining popularity. This study aims to compare the 6 and 24 month post-operative outcomes between patients undergoing microfracture only and microfracture with ACIC. MethodsPatients from both groups were assessed pre-operatively, at 6 and 24 months post-operatively for functional outcomes using SF-36 and IKDC scoring (International Knee Documentation Committee Subjective Knee Form) ResultsBoth groups showed improved SF-36 and IKDC scores at 6 and 24 months, however patients who underwent ACIC showed better SF-36 mental component and IKDC scores 24 months after surgery. ConclusionThis demonstrates that ACIC is an effective, single-stage, joint-preserving procedure which is comparable, if not better, in treating chondral defects.

Ankle Arthrodesis with Cannulated Screw: Case Series

ABSTRACT Ankle osteoarthritis patients are young and lack of available long last treatment. Ankle arthrodesis remains the gold standard and is the procedure of choice for younger patients who are heavy laborers. These case series evaluate and report five patients undergone ankle arthrodesis at RSUD Dr. Soetomo Surabaya on 2012-2016. The data were collected from patient files, radiographs, and a recent physical examination. The outcome has been assessed with SF-36 score and clinical scoring system Ankle-Hind foot American Foot and Ankle Society. Three male patients and two female patients underwent ankle arthrodesis with cannulated screw, caused by neglected severe ankle dislocation. One patient had open dislocation. Based on SF-36 scoring, the five patients had average score 76,7 with highest and lowest score were 95,9 and 56,7. Based on clinical score ankle-hind foot American Ankle and Foot Society, the average score was 68(51 – 88). The scoring result includes general health, physic, emotional, and social. And clinical scoring ankle-hind foot American Foot and Ankle Society evaluation includes pain, function, and alignment. It shows that there was patient that gains an almost perfect result. Patient with the lowest score also had knee osteoarthritis contralateral from the operated ankle. Early weight bearing on ankle arthrodesis with cannulated screw was the major factor caused unsatisfactory result of this patient. Ankle arthrodesis with cannulated screw has satisfactory result eventhough remain complain on one patient. Nevertheless, ankle arthrodesis with cannulated screw still has an important role in the treatment of choice on ankle reconstruction.Keywords : Ankle arthrodesis, cannulated screw, ankle joint fusion

Functional outcome of operative treatment for pelvic metastatic bone disease from primary thyroid cancer: A case series

BackgroundMetastatic bone disease (MBD) is the most common malignancy of bone. It is estimated that 70 % of all malignant bone tumors are due to metastasis. The functional outcome from pelvic MBD surgical management has been rarely described in the literature contrary to that of the long bones. MethodWe reported three patients that underwent pelvic resection surgery due to pelvic MBD. All of the primary tumors were thyroid cancer. We measure the functional outcome using SF-36 and MSTS (musculoskeletal tumor society) scores after a one-year follow-up. ResultThe SF-36 scoring result was that all of the patients had a remarkable improvement in terms of pain (77.5 %, 100 %, and 100 %). All of the patients also still had proper social functioning (75 %, 100 %, and 100 %) and good emotional well-being (72 %, 92 %, and 88 %). According to the MSTS, the second and third case had an excellent functional outcome; however the first case had poor functional outcome ConclusionSurgery remains the choice of therapy for pelvic MBD that results in alleviation of pain and quality of life improvement.

Brostrom-Like Procedure Augmented with Swivelock Internal Brace for the Reconstruction of Chronic Medial Ankle Ligament Complex

Category:Midfoot/ForefootIntroduction/Purpose:The medial ligaments and joint capsules appear to stretch or rupture under the increasing stress following a tear of the PTT in patients with flat foot often leading to pain, swelling and dysfunctional foot. This study assesses the efficacy of a Brostrom like procedure augmented with Swivelock Internal Brace for the reconstruction of chronic medial ankle ligament complex.Methods:A retrospective study was performed reviewing 15 flat foot patients who presented with pronounced hindfoot pronation collapse of the medial longitudinal arch after injury. The procedures included exploration and direct repair of PTT, deltoid ligament and spring ligament. Our modification included Swivelock Internal Brace enhanced reconstruction of deltoid and spring ligaments, after calcaneal medializing osteotomy. Other additional procedures such as FDL transfer, subtalar arthroereisis and Cotton osteotomy were performed as needed (Fig.1). Weight bearing X-rays of the foot, AOFAS-AH and SF36 scoring were taken before and after surgery.Results:There were 8 males and 7 females among the 15 patients. The age was 29.8±10.1 years old. The follow-up time period was 32.6±11.4 months. Both the AOFAS-AH (52.8±15.2 to 90.4±7.5 and SF-36 (55.4±12.6 to 91.2±6.3 scores improved significantly (p<0.001). Comparing preoperative to postoperative standing radiographs, there was significant improvement in the AP talar first metatarsal angle (25.6±18.4 to 9.5±7.8 degrees（P<0.001), lateral talar first metatarsal angle (18.3±8.4 to +2.6±4.5 degrees（P<0.001）and moment arm on the Saltzman view (+15.2mm±10.8 to +2.5±3.6mm（P=0.003） (Fig.2). No recurrence of pronation deformity or foot arch collapse was observed after surgery.Conclusion:The medial ankle ligaments were attenuated and under the increasing stress following a tear of the PTT in patients of flat foot. Direct repair of the ligaments after rupture usually resulted in low strength and high recurrence. Simultaneous reconstruction of medial ankle ligaments with Swivelock internal brace maintained long term medial ankle stability and the longitudinal arch. This technique protects the repaired tendon and decreased the need for FDL transfer, potentially permitted earlier rehabilitation and improved function compared to traditional techniques.

Are the Beck depression inventory score, SF 36 score and progression of the disease changing with education in chronic kidney disease patients?

Aim: Patient education is important for patients with predialysis chronic renal disease (CKD)because it can delay the progression of the disease to end-stage renal failure.Anxiety and depression may also contribute to the progression of the disease in patients with CKD. We evaluated the influences of education on progression ofCKD, the Short Form 36 Health Survey (SF36), and the Beck Depression Inventory (BDI) in predialysis CKD patients. Material and Methods: 121 patients with nondialysis stage 2-5 CKD were involved in this study. At the start of the study, the SF36 and BDI scoring were performed in all patients and their creatinine clearances were calculated. 31 patients were given education on CKD by the dialysis specialist nurse once a month. At the end of the sixth month, SF36 and BDI were rescored, and their creatinine clearances were recalculated. Results: There were no significant differences between the two groups regarding age, gender, creatinine clearance, and duration of chronic kidney disease. At the end of the sixth month, when the educated and uneducated patients were compared, while the increase of the creatinine level was significant in the two groups, the SF36 and BDI scores were found to be improved significantly in the study group. Conclusion: The results of this study suggested that patient education may improve the SF36 and BDI scores, but it does not affect the progression of the disease for at least six months in duration.

Mid-term Outcomes &amp; Complications Following the Use of an Arthroereisis Implant to Aid in Stage II Flat-Foot Correction in Adults

Category: Hindfoot Introduction/Purpose: The use of an arthroereisis implant to augment a stage II, flat-foot reconstruction in adults has been described and may improve postoperative alignment. Yet, painful hardware has been reported. Additionally, there are no reports of mid-term follow up on these implants. The purpose of this study is to describe the mid-term clinical and radiographic outcomes as well as complications with the use of an arthroereisis implant as an adjunct procedure for patients undergoing surgical correction of a flexible acquired, stage II, flat-foot deformity as compared to controls Methods: With IRB approval, all patients undergoing stage II, flat-foot reconstruction by the senior author were identified from 2010-2015. A search was conducted to identify patients within this group undergoing implantation of an adjunctive arthroereisis implant during reconstruction. A 2:1 match using age and gender was performed to identify controls undergoing flexor digitorum longus transfer, medial calcaneal osteotomy, spring ligament repair, and Strayer lengthening during the study period. Demographic information, patient records, operative reports, and follow-up radiographs were reviewed. Preoperative and final follow-up, AP and lateral, weightbearing, radiographs measuring talo-1st metatarsal angle, talo-2nd metatarsal angle, and talo-navicular coverage angle were reviewed and recorded. Clinical follow-up was performed to administer satisfaction SF-36 scoring, and to determine survivorship. Patients undergoing additional corrective procedures at the initial surgery or incomplete records were excluded. Results: 48 patients, age 49.7 (range, 16-68), were included, 16 patients received an arthroereisis implant, 4 were metallic and 12 were bioabsorbable. Follow-up was conducted at 3.54 years (range, 1.4-6 years). Radiographic analysis demonstrated significant improvement in alignment from preoperative to mid-term follow-up in both groups. In addition, arthroereisis patients had a statistically significant improvement in correction of talo-navicular coverage angle at final follow-up, 5 degrees ± 3.9, compared to controls, 10.6 degrees ± 6.8. Average SF-36 scores at mid-term follow-up were comparable with no significant difference between cases, 74.6 ± 21.8, and controls, 76.1 ± 15.3 p=0.89. Overall, 84% of patients noted good or excellent satisfaction. Complications included one arthroereisis failure from painful hardware (1/16), one infection in the controls (1/32), and an unrelated mortality. Conclusion: Arthroereisis implants as an adjunct to stage II, flat-foot correction result in improved and maintained radiographic alignment with comparable clinical results to controls at mid-term follow-up. Additionally, the use of the implant demonstrates improved talo-navicular coverage on mid-term radiographs. While painful hardware was noted in a metallic implant, bioabsorbable implants have demonstrated few complications and may be a safe adjunct to stage II, flat-foot correction in adults.

Health Related Quality of Life, Anxiety and Depression among Tuberculosis Patients in Kathmandu, Nepal

Background and Objectives: Tuberculosis remains one of the major public health problems in Nepal. This study was carried out to assess the Health related Quality of life and Anxiety- Depression level of Tuberculosis patients in Kathmandu.Material and Methods: A cross-sectional study was conducted at Urban Direct Observation Treatment Short Course center using 150 study populations. Questionnaires containing socio-demographic characteristics, Self Reporting Questionnaire, Short Forms Health Survey, Hamilton Anxiety Rating Scale, and Hamilton Depression Rating Scale. SPSS 20, SF-36 Scoring Software were used for data management.Results: Majority of respondents (57.3%) were male, age group of 21-25 years. Majority of respondents suffered from Extra Pulmonary Tuberculosis, gland TB was in higher prevalence (31.3%). Most of the respondents found to poor HRQoL score where only 1.4% female and 1.7% male’s had above average HRQoL. There was no correlation between anxiety, depression, Mental Component Summary and Physical Component Summary score in pulmonary Tuberculosis patients unlike Extra pulmonary Tuberculosis patients, where there was strong correlation between anxiety and depression (r=0.721, p=0.000). There was negative correlation between PCS and MCS (r= -0.232, p= 0.037). There was no association between gender and PCS score on both types of TB patients. At majority of domain of HRQoL male had higher score than female.Conclusion: Co-morbidities of anxiety and depression in tuberculosis patients impact on health-related quality of life.Janaki Medical College Journal of Medical Sciences (2016) Vol. 4 (1): 13-18

Functional Evaluation of Patients Undergoing Multiple Joint Replacements: A Retrospective Study of 50 Patients with a Minimum of Six Months of Follow-up.

Introduction: Polyarthritis is a challenging condition that an orthopedic surgeon faces in day-to-day practice. Some of the conditions where multiple joints are affected are rheumatoid arthritis, osteoarthritis, and ankylosing spondylitis. Multiple joint afflictions can cause severe impairment in the quality of life, which leads to a significant socioeconomic burden on the family and society. Joint replacement is considered as a treatment when severe joint pain or dysfunction is not alleviated by conservative management. Total joint arthroplasty remains one of the most commonly performed and universally accepted operative interventions for such patients.Materials and methods: Fifty patients were invited into the study. All patients included in the study were 18 years of age and older and had undergone two or more joint replacements with a minimum of six months duration from the last surgery. The data was collected during the preoperative and postoperative periods through patient records and questionnaires. The Short Form 36 Health Survey Questionnaire (SF-36) scores were generated from an online application that is readily available on the official website SF-36 scoring system. The results were compared, analyzed, and tested for significance using the Wilcoxon signed rank test.Results: The highest incidence of multiple joint replacements appears to be in the age-group of 51 - 70 years (52%), the mean age of patients being 51.7 +/- 14.4 years. The ratio of female to male patients was 1.6:1. On comparison of preoperative and postoperative (six months) physical component and mental component scores, the differences were found to be significant (p-value: < 0.01). This finding is irrespective of the diagnosis, gender, or age of the patient.Conclusion: In the study conducted on 50 patients, we found out that multiple joint arthroplasties are fruitful surgeries. The procedures are efficient in reducing the disabilities seen in patients with polyarthritis of various causes and improving the overall quality of life. We strongly recommend multiple joint arthroplasties to patients with severe disability. However, adequate medical management plays an equally important role to improve the overall results. Well-designed and larger studies are required to establish the treatment protocols and order of surgeries in patients with differing causes of polyarthritis.

Initial severity of motor and non-motor disabilities in patients with facial palsy: an assessment using patient-reported outcome measures.

Patients with facial palsy (FP) not only suffer from their facial movement disorder, but also from social and psychological disabilities. These can be assessed by patient-reported outcome measures (PROMs) like the quality-of-life Short-Form 36 Item Questionnaire (SF36) or FP-specific instruments like the Facial Clinimetric Evaluation Scale (FaCE) or the Facial Disability Index (FDI). Not much is known about factors influencing PROMs in patients with FP. We identified predictors for baseline SF36, FaCE, and FDI scoring in 256 patients with unilateral peripheral FP using univariate correlation and multivariate linear regression analyses. Mean age was 52±18years. 153 patients (60%) were female. 90 patients (31%) and 176 patients (69%) were first seen <90 or >90days after onset, respectively, i.e., with acute or chronic FP. House-Brackmann grading was 3.9±1.4. FaCE subscores varied from 41±28 to 71±26, FDI scores from 65±20 to 70±22, and SF36 domains from 52±20 to 80±24. Older age, female gender, higher House-Brackmann grading, and initial assessment >90days after onset were independent predictors for lower FaCE subscores and partly for lower FDI subscores (all p<0.05). Older age and female gender were best predictors for lower results in SF36 domains. Comorbidity was associated with lower SF General health perception and lower SF36 Emotional role (all p<0.05). Specific PROMs reveal that older and female patients and patients with chronic FP suffer particularly from motor and non-motor disabilities related to FP. Comorbidity unrelated to the FP could additionally impact the quality of life of patients with FP.

Semiextended intramedullary nailing of the tibia using a suprapatellar approach: radiographic results and clinical outcomes at a minimum of 12 months follow-up.

To evaluate the clinical and radiographic results associated with the use of a percutaneous suprapatellar (SP) portal and accompanying instrumentation for tibial intramedullary nail (IMN) insertion using a semiextended approach. Prospective, nonrandomized, nonconsecutive study. Level 1 trauma center. From June 2007 to January 2011, 56 fractures (55 patients) underwent intramedullary nailing of a tibia fracture with a semiextended approach through a SP portal. Radiographic and clinical follow-up examinations were performed at a minimum of 1 year after the index procedure. Measurements included bone healing, tibial alignment, knee range of motion, pain drawings, pain scoring (visual analogue scale), functional outcome (Lysholm and SF-36 scoring), evaluation of prenail and postnail insertion arthroscopic images of the patella-femoral (PF) joint (subgroup of study patients), and 1-year follow-up magnetic resonance imaging (MRI) scans (STIR and T2 gradient echo) of the knee to evaluate the PF joint cartilage. MRI scans were reviewed by an independent bone radiologist, whereas arthroscopic images were evaluated by an independent sports medicine fellowship-trained orthopaedic surgeon. Thirty-six patients (37 fractures) were available for follow-up at a minimum of 1 year (range: 12-49 months) after the index procedure. All but 2 fractures healed after the index procedure (94.6%). There was 1 radiographic malunion (2.7%). The mean Lysholm knee score was 82.14. Mean SF-36 physical and mental scores were 40.8 and 46.0, respectively. Mean arc of knee motion was 124.4 degrees for the affected extremity compared with 127.2 degrees for the contralateral knee. One patient (2.7%) complained of mild pain at the scar, but no patient complained of anterior knee pain either at the PF joint or at the anterior proximal tibia. In 13 of 15 patients undergoing an arthroscopic assessment of the PF joint, prenail and postnail insertion, no cartilage changes, or pressure points were seen either at the patella or at the trochlea groove. Two patients had grade II chondromalacia of the trochlea immediately after the procedure, but these did not correspond with either MRI scans or clinical findings at 1 year. When the remainder of the 1-year MRI scans were reviewed, 1 knee (2.7%) in a patient that did not have an arthroscopic examination was found to have grade II chondromalacia in the PF joint, but this did not correlate with the clinical examination, which was normal. This is the first paper to critically document clinical and radiographic results using the percutaneous SP portal with the semiextended approach for IMN of the tibia. Our 1 year results indicate that the procedure resulted in excellent tibial alignment, union, and knee range of motion, with rare sequelae in the PF joint based on immediate arthroscopy and 1-year MRI scans and clinical examinations. Even more interesting was the absence of anterior tibial pain often found when a tibial nail is inserted in a standard fashion.

Semiextended Intramedullary Nailing of the Tibia Using a Suprapatellar Approach

To evaluate the clinical and radiographic results associated with the use of a percutaneous suprapatellar (SP) portal and accompanying instrumentation for tibial intramedullary nail (IMN) insertion using a semiextended approach. Prospective, nonrandomized, nonconsecutive study. Level 1 trauma center. From June 2007 to January 2011, 56 fractures (55 patients) underwent intramedullary nailing of a tibia fracture with a semiextended approach through a SP portal. Radiographic and clinical follow-up examinations were performed at a minimum of 1 year after the index procedure. Measurements included bone healing, tibial alignment, knee range of motion, pain drawings, pain scoring (visual analogue scale), functional outcome (Lysholm and SF-36 scoring), evaluation of prenail and postnail insertion arthroscopic images of the patella-femoral (PF) joint (subgroup of study patients), and 1-year follow-up magnetic resonance imaging (MRI) scans (STIR and T2 gradient echo) of the knee to evaluate the PF joint cartilage. MRI scans were reviewed by an independent bone radiologist, whereas arthroscopic images were evaluated by an independent sports medicine fellowship-trained orthopaedic surgeon. Thirty-six patients (37 fractures) were available for follow-up at a minimum of 1 year (range: 12-49 months) after the index procedure. All but 2 fractures healed after the index procedure (94.6%). There was 1 radiographic malunion (2.7%). The mean Lysholm knee score was 82.14. Mean SF-36 physical and mental scores were 40.8 and 46.0, respectively. Mean arc of knee motion was 124.4 degrees for the affected extremity compared with 127.2 degrees for the contralateral knee. One patient (2.7%) complained of mild pain at the scar, but no patient complained of anterior knee pain either at the PF joint or at the anterior proximal tibia. In 13 of 15 patients undergoing an arthroscopic assessment of the PF joint, prenail and postnail insertion, no cartilage changes, or pressure points were seen either at the patella or at the trochlea groove. Two patients had grade II chondromalacia of the trochlea immediately after the procedure, but these did not correspond with either MRI scans or clinical findings at 1 year. When the remainder of the 1-year MRI scans were reviewed, 1 knee (2.7%) in a patient that did not have an arthroscopic examination was found to have grade II chondromalacia in the PF joint, but this did not correlate with the clinical examination, which was normal. This is the first paper to critically document clinical and radiographic results using the percutaneous SP portal with the semiextended approach for IMN of the tibia. Our 1 year results indicate that the procedure resulted in excellent tibial alignment, union, and knee range of motion, with rare sequelae in the PF joint based on immediate arthroscopy and 1-year MRI scans and clinical examinations. Even more interesting was the absence of anterior tibial pain often found when a tibial nail is inserted in a standard fashion. Therapeutic Level IV. See Instructions for Authors for a complete description of levels of evidence.

Vestibular Compensation following Retrosigmoid Vestibular Schwannoma Surgery

Objectives: Balance problems following vestibular schwannoma (VS) surgery are most apparent in the acute stage and usually improve over time. Persisting vestibular symptoms are related to significant morbidity and decreased quality of life. Methods: Eighty-nine patients undergoing unilateral VS resection via a retrosigmoid approach during 2008-2010 were prospectively analyzed. Definitive assessment of vestibular compensation was performed 24 months postoperatively. Persistent vertigo or spontaneous nystagmus and deviation of subjective visual vertical were classified as non-compensated vestibular pathology. We performed multivariate statistic analysis (Anova) of patient (age, gender), tumor (size – Koos and international classification), preoperative vestibular pathology (ipsilateral/contralateral peripheral, central), and intraoperative (conventional or minimally-invasive approach, tumor adherence, consistency, bleeding, cystic, origo, cerebellar injury) factors. To assess impact of vestibular symptoms on quality of life, we employed Dizziness Handicap Inventory (DHI) and SF36 questionnaires. Results: Twelve of 89 patients undergoing VS surgery suffered from disordered vestibular compensation. Among the factors analyzed, the advanced age seems to be a crucial negative prospective factor of vestibular compensation ( P =0.006) (55 ± 10 years in noncompensated vs. 44 ± 13 years in compensated patients). Disbalance was more prevalent in the group of uncompensated patients ( P = 4 x 10-7). Surprisingly, poor compensation did not correlate with worse DHI and SF36 scoring. Conclusions: Identification of factors that may contribute to a poor vestibular compensation is crucial for both VS management planning and proper postoperative vestibular rehabilitation. Employment of biofeedback and vestibular prehabituation represent promising methods to improve and speed up postoperative vestibular compensation.

Treatment of osteoporoticvertebral compressive fracture with percutaneous vertebroplasty and percutaneouskyphoplasty

：Objective To observe theclinical effect of percutaneous vertebroplasty f PVP)and percutaneous kyphoplasty(PKP)inthe treatment of ostcoporotic vertebral compressive fracture. Methods Forty-two patientswith osteoporotic vertebral compressive fractures were treated with PVP or PKP from August2007 to July 2009.VAS and SF-36 scoring systems were employed to evaluate the Dain andquality of life.X-ray was used to evaluate the vertehral height restoration rate and thekyphosis correction rate.The bone cement leakage was determined based on the Chest X-ray.Results There was staitistical difference on PMMA leakage between PVP and PKP group.VASand SF-36 scores at 2 wePks and 6months after operation were much better than thosecounted before operation in both PVP and PKP groups(P 0.05).At tWO weeks after operation,the heightrestoration rate of the fractured vertebral body(anterior and central column)in the PKPgroup waa better than that in the PVP group(P 0.05).Conclusions In thetreatment of osteoporotic vertebral compressive fracture,PVP and PKP have the similareffect on the pain relief,can refresh the height of the fractured vertebral body andcorrect the kyphotic angel of the fracture level to some extent.PVP has more PMMA leakagethan PKP.

Tibio-talo-calcaneo fusion using a locked intramedullary compressive nail

We present the clinical results and outcomes of 30 consecutive patients (31 ankles) who have undergone tibio-talo-calcaneal arthrodesis using an intramedullary nail to achieve bony union. This was a prospective study and surgery was performed by the senior author in a single hospital. We achieved high levels of satisfaction and outcome via the AOFAS and SF-36 scoring systems. We propose that this method of arthrodesis is reliable and easily reproducible for patients with severe arthritis and bone loss at the ankle and subtalar joints.

Health-related quality of life in patients with anterior cruciate ligament insufficiency undergoing arthroscopic reconstruction: a practice-based Italian normative group in comorbid-free patients

BackgroundHealth-related quality of life (HRQoL) in anterior cruciate ligament (ACL) insufficiency has not been assessed in comorbid-free patients to date. An observational study was therefore conducted on a practice-based sample to test the hypothesis that SF-36 scoring in patients with chronic ACL insufficiency differs from the age- and gender-matched Italian norm.Materials and methodsChronically ACL-insufficient patients with or without meniscal and/or focal chondral lesions were enrolled in the study. Exclusion criteria were acute ACL tear, severe and diffuse chondral lesions, concomitant knee major ligamentous injuries and/or fractures requiring surgery, previous ACL surgery and infectious, neoplastic and inflammatory disease. Knee function was evaluated by International Knee Documentation Committee (IKDC) form, HRQoL with the SF-36 questionnaire, and associated medical comorbidities by a Self-Administered Comorbidity Questionnaire (SCQ).ResultsA total of 316 consecutive patients, 265 males and 51 females (median age 25 years, range 15–52 years) met the inclusion/exclusion criteria. SF-36 norm-based scoring showed that the Physical Functioning, Role Physical, Bodily Pain, and Social Functioning domains were significantly lower than the Italian norm; the Role Emotional domain was also lower than the norm, but the difference was not significant. Conversely, the General Health and Mental Health domains scored significantly higher than the norm; the Vitality domain also exceeded, albeit not significantly, the norm.ConclusionsThe decision-making process leading to ACL reconstruction currently emphasises the evaluation of knee function and patients’ level of activity. The findings in our study, by showing that chronic ACL insufficiency significantly affects HRQoL in otherwise healthy patients, suggest that a multidimensional evaluation including HRQoL in addition to knee function might be integrated into outcome assessment.

Health-related quality of life during the first year after severe brain trauma with and without polytrauma

Objective: The increasing number of patients surviving severe traumatic brain injury (sTBI) but with significant sensorimotor and neuropsychological deficits is a challenge to rehabilitation medicine. So far, most research initiatives have focused on mortality rates, physiological or economic parameters to estimate therapeutic effects of rehabilitation strategies. Investigations on health-related quality of life (HRQoL) after TBI with and without concomitant polytrauma are rare compared to other disorders.Design/patients: A prospective study was conducted to investigate HRQoL using the SF-36 questionnaire in 49 patients with sTBI (Glasgow Coma Scale < 9 for more than 24 hours) with and without concomitant polytrauma 6 and 12 months after injury.Results: The SF-36 score profiles 6 and 12 months after trauma were similar. Scores 12 months after trauma, however, were higher in 7/8 dimensions indicating an improvement over time. Similar observations were made for physical and mental sum scores. There was no difference in the SF-36 scoring pattern between the patients with isolated TBI and the patients with concomitant polytrauma, except for physical functioning after 12 months.Conclusion: While there is significant overall improvement of HRQoL over time, sTBI appears to bear major influence on post-traumatic HRQoL and outcome.

Quality of Life Evaluation After Coronary Artery Bypass Graft Surgery in Patient who Underwent Phase III Rehabilitation Program

Background . Coronary artery bypass graft surgery (CABG) is one of the management for coronary artery disease. Cardiovascular rehabilitation usually conducted for recovery and improved quality of life. Questionnaire was used to evaluate quality of life. One of the quality of life instrument most commonly used is Questionnaire SF-36. So far there isn’t any study to evaluate quality of life in patients post CABG who wish to follow rehabilitation program phase III in Indonesia. Methods and results. This is a cross sectional study conducted in the National Cardiovascular Centre (NCC) - Rehabilitation Division to patients post CABG in phase III rehabilitation program during 2004-2005. Subject was taken in consecutive sampling manner. Questionnaire SF-36 was handed directly or via mail. Validity and reliability test was done for the questionnaire form in Indonesia language. There were 112 patients, 34 patients did rehabilitation program in hospital and 78 were home-based. The characteristics between two groups were similar. Validity test using r product moment from Pearson to every questions in SF-36 showed r =0,53-0.83 > 0,51 (r table) and Cronbach α= 0,855. SF-36 scoring was not significantly different among the two groups (in hospital rehab vs homebased rehab) and also control group (healthy). Conclusions . There were no difference in quality of life and aerobic capacity in patients who performed rehabilitation program phase III in hospital and home-based.

Testing the Equivalence of Translations of Widely Used Response Choice Labels: Results from the IQOLA Project

The similarity in meaning assigned to response choice labels from the SF-36 Health Survey (SF-36) was evaluated across countries. Convenience samples of judges (range, 10 to 117; median = 48) from 13 countries rated translations of response choice labels, using a variation of the Thurstone method of equal appearing intervals. Judges marked a point on a 10-cm line representing the magnitude of a response choice label (e.g., “good” relative to the anchors of “poor” and “excellent”). Ratings were evaluated to determine the ordinal consistency of response choice labels within a response scale; the degree to which differences between adjacent response choice labels were equal interval; and the amount of variance due to response choice label, country, judge, and interaction between response choice label and country. Results confirmed the hypothesized ordering of response choice labels; the percentage of ordinal pairs ranged from 88.7% to 100% (median = 98.2%) across countries and response scales. Examination of the average magnitudes of response choice labels supported the “quasi-interval” nature of the scales. Analysis of variance (ANOVA) results supported the generalizability of response choice magnitudes across countries; labels explained 64% to 77% of the variance in ratings, and country explained 1% to 3%. These results support the equivalence of SF-36 response choice labels across countries. Departures from the assumption of equal intervals, when observed, were similar across countries and were greatest for the two response scales that are recalibrated under standard SF-36 scoring. Results provide justification for scoring translations of individual items using standard SF-36 scoring; whether these items form the same scales in other countries as they do in the United States is evaluated with tests of scaling assumptions.