Medicine and Health Sciences Commons^™

To Develop A Clinically Friendly Multi-Segment Kinematic And Kinetic Foot Model And Test It On Pre-/Post-Hto Patients With Medial Knee Osteoarthritis And Knee Varus, Songlin Zhu

Electronic Thesis and Dissertation Repository

This study aims to develop a clinically useful multi-segment foot model that will enable the analysis of foot kinematics and kinetics in an optical motion capture laboratory setting. This study will also test the new multi-segment foot model on patients with knee osteoarthritis and varus knee alignment that is corrected by high tibial osteotomy (HTO). The multi-segment foot model divides the foot into four functional segments: the hindfoot, midfoot, forefoot and hallux. An X-Z-Y-Cardan angle rotation convention was used to determine intersegmental dorsi/plantar flexion, inversion/eversion, and internal/external rotation. Joint moments, joint powers and medio-longitudinal arch (MLA) height/length ratio were also …

The Cost-Effectiveness Of A Midvastus Versus Standard Medial Parapatellar Surgical Approach For Total Knee Arthroplasty, Ishita Joshi

Electronic Thesis and Dissertation Repository

The minimally invasive midvastus (MMV) surgical approach for total knee arthroplasty (TKA) is a less invasive technique that has been proposed to accelerate recovery over standard TKA, however, advantages are not yet definitively established. We investigated the cost-effectiveness of MMV TKA versus the standard medial parapatellar (MPP) approach for TKA alongside a randomized controlled trial in patients with knee osteoarthritis. Patients reported resource use as well as indirect costs, and health outcomes were measured using the EQ-5D-5L and the Western Ontario and McMaster Universities Osteoarthritis Index over the 12-month study period. The results of our net benefit regression analysis suggest …

Factors Effecting Gait Velocity In Osteoarthritis Knee-An Observational Study., Lisha Gretal D’Silva

Kasturba Medical College, Mangalore Theses and Dissertations

No abstract provided.

Reducing Length Of Stay After Total Hip And Knee Arthroplasty: Assessing Cost-Effectiveness, Caregiver Involvement And Surgical Approach, Bryn O. Zomar

Electronic Thesis and Dissertation Repository

Purpose

The overall purpose of this dissertation was to evaluate factors related to reducing length of stay after total hip and knee arthroplasty (THA and TKA).

Methods

Study 1 was a randomized controlled trial (RCT) to investigate the cost-effectiveness of outpatient THA compared to standard overnight stay. Study 2 was a prospective cohort study to assess patient- and caregiver-related factors and how they may relate to caregiver strain and level of assistance when caring for patients undergoing THA and TKA. Finally, Study 3 was a 2x2 factorial RCT to compare the trajectory of early functional recovery between the medial parapatellar …

Joint Protection Programs For People With Hand Arthritis, Pavlos Bobos

Electronic Thesis and Dissertation Repository

The fact that Joint Protection Programs (JPP) can reduce pain and improve function is based on small, but definitive Randomized Controlled Trials (RCTs), conducted in the 1980s. However, changes over time in the nature of hand use, the rapid expansion of technology, and improvements in our understanding of health literacy mean that these programs are now outdated. Further, problems with adherence to JPP are well documented. The purpose of this thesis was 1) to conduct a scoping review to map all the available evidence around joint protection programs in published and unpublished studies 2) to evaluate the effectiveness of joint …

Quantitative Magnetic Resonance Imaging Of Knee Articular Cartilage And Effusion-Synovitis: The Structural Response To Changes In Joint Loading, Hayden F. Atkinson

Electronic Thesis and Dissertation Repository

Knee osteoarthritis (OA) is a progressive degenerative condition that can affect all tissues within the joint. Methods to measure early changes in joint structures and the effect of interventions are required. The purpose of this thesis was to investigate aspects of quantitative magnetic resonance imaging (MRI) as outcome measures in knee OA studies. Specifically, changes in articular cartilage composition and/or effusion-synovitis were examined in people with or at risk for knee OA and healthy controls, and after altering joint loads.

Chapter 2 is a systematic review that studied articular cartilage composition using MRI T2 and T1ρ relaxation in patients at …

Can Yoga Therapy Help To Decrease Osteoarthritis-Related Pain In Adults With Knee Osteoarthritis?, Justin Mahr

PCOM Physician Assistant Studies Student Scholarship

Objective: The objective of this selective EBM review is to determine whether or not yoga therapy can help to decrease osteoarthritis-related pain in adults with knee osteoarthritis.

Study Design: A review of two randomized controlled trials and one randomized control trial pilot study that were published in English in peer-reviewed journals after 2007.

Data Sources: All articles were selected from peer-reviewed journals and found via PubMed.

Outcome(s) Measured: Patient perception of pain using either a Walking Numerical Rating Scale (WNRS) and/or a Western Ontario and McMaster Universities OA Index scale (WOMAC).

Results: All three studies …

Evaluation Of The Construct Validity Of The Questionnaire To Identify Knee Symptoms Among Individuals Across Canada With Chronic Knee Pain, James Young

Electronic Thesis and Dissertation Repository

The primary purpose of this study was to evaluate the construct validity of the Questionnaire to Identify Knee Symptoms (QuIKS) measurement scale among individuals with chronic knee symptoms consistent with osteoarthritis. Construct validity was assessed using tests of convergent and discriminative validity on 15 pre-specified hypotheses. The secondary objective was to determine the internal consistency reliability of the QuIKS. One hundred and five individuals recruited in select physiotherapy clinics from across Canada were mailed the QuIKS and five other health questionnaires. Fifty-five individuals completed the questionnaire package. While none of the pre-specified construct validity hypotheses were met, nine of the …

Wait Times, Resource Use And Patient-Reported Outcomes For Patients Referred For Total Knee Replacement Surgery, Kate Lebedeva

Electronic Thesis and Dissertation Repository

This prospective cohort study evaluated the usual care pathway for patients referred to total knee arthroplasty (TKA). We measured healthcare resource use, costs and health-related quality of life (HRQoL) over the continuum of care. We also determined the proportion of inappropriate referrals and estimated wait times for initial surgical consultation and TKA. We found that two in five patients referred to specialty care were deemed inappropriate surgical candidates. Prior to referral, few conservative treatment options were tried, and many imaging tests ordered by referring providers were unjustified. Overall, the greatest proportion of costs were borne by the patient or private …

Assessing The Risk Of Falling In Adults One-Year After Total Hip Arthroplasty, William Janes

Electronic Thesis and Dissertation Repository

The purpose of this study was to examine falls prevalence, falls risk factors and knowledge of falls in individuals who have undergone a total hip arthroplasty. There were 135 patients examined at their one-year follow-up appointment for total hip arthroplasty. Our primary outcome, falls prevalence and falls circumstances, found a falls prevalence of 21.5% with identical circumstances to that of average community-dwelling older adults. Female sex, number of prescription medications and multiple joint replacements were found to be significantly associated with the occurrence of falls in the previous year. The Falls Risk for Older People in a Community Setting Questionnaire …

Impact Of Osteoarthritis Self-Efficacy Toolkit On Adults With Osteoarthritis, Connie Hutley Kiser

Walden Dissertations and Doctoral Studies

Over 26 million U.S. citizens have a form of arthritis; osteoarthritis (OA) is the most common form. Self-efficacy (SE) is defined as a psychological construct which identifies an individual's confidence when performing a behavior. SE is deemed a vital judge of self-management (SM) in those with OA. The purpose of this evidence-based practice, quality improvement project was to improve SE in OA patients. The identified gap in nursing practice was the lack of SE in OA patients. The project question asked whether a toolkit with information regarding SE in OA can improve SE of management of disease-associated symptoms in adults …

The Association Between Soft Tissue Releases And Bony Resections Performed During Total Knee Arthroplasty And Patients' Pain And Satisfaction Postoperatively, Matt Carter

Electronic Thesis and Dissertation Repository

Total knee arthroplasty (TKA) is a surgical treatment of degenerative knee conditions such as osteoarthritis to reduce pain and increase function. Intraoperative soft tissue releases (STRs) and bony resections (BRs) are necessary for a balanced and aligned TKA. It is possible that the degree of STRs and BRs is related to final outcome following TKA and thus there may be implications for patient rehabilitation, patient expectations, pain medications, and timelines for recovery. Thus, our primary objective was to examine the association between the number of STRs and BRs performed intraoperatively and patients’ satisfaction and pain at three months. We performed …

Predictors Of Appropriate Referral To Total Knee Arthroplasty: A Validation Study, Samuel J. Malian

Electronic Thesis and Dissertation Repository

Approximately 45% of referrals from primary care physicians to arthroplasty surgeons are inappropriate. Currently, Canadians are waiting over three months for consultation with an arthroplasty surgeon. Reducing the proportion of inappropriate referrals will reduce the wait time to first consultation with an arthroplasty surgeon. This study’s objective was to validate a model that identified patient-reported predictors of appropriate referrals to arthroplasty. We screened 258 patients attending their first consultation with an arthroplasty surgeon. Participants completed the questionnaires prior to their appointment and the surgeon detailed each consultation outcome on a standardized form. We constructed our validation model using the same …

A Model To Reduce The Proportion Of Inappropriate Referrals To Surgery For Patients With Osteoarthritis: A Pilot Study, Laura K. Churchill

Electronic Thesis and Dissertation Repository

A significant proportion of patients referred for total knee arthroplasty are inappropriate candidates for surgery, which warrants remediation of the referral process to reduce wait times for the initial consult. We conducted a prospective feasibility investigation involving 166 patients referred from their general practitioner for a consultation with an orthopaedic surgeon at a joint replacement clinic. The aim of this study was to improve the validity of data collection forms and to improve the feasibility of collecting data in a clinical setting. We also wanted to strengthen our estimate of the sample size to inform the timeline. We were able …

Land-Based Exercise And Its Effect On Quality Of Life Outcomes In Patients With Knee Osteoarthritis: A Systematic Review, Cody R. Buckner, Lindsay C. Martin, Michael L. Soukup

UNLV Theses, Dissertations, Professional Papers, and Capstones

Background: The purpose of this systematic review was to examine effectiveness of land-based exercise interventions for improving quality of life (QOL) of individuals with symptomatic knee osteoarthritis.

Methods: A systematic search included PubMed, CINAHL, Scopus, Academic Search Premier, and the Cochrane Database of Systematic Reviews. Inclusion criteria included land-based exercise interventions aimed to improve lower extremity strength and QOL, published since 2000. Exclusion criteria included OA of joints other than the knee, and aquatic-based and surgical interventions. Studies were evaluated using a modified version of the American Academy of Cerebral Palsy and Developmental Medicine (AACPDM) methodology score.

Results: Level of …

A Two-Hour Basketball Practice Increases Landing Error Scoring System Scores In Female Collegiate Basketball Players, Caroline Wesley

Undergraduate Theses and Capstone Projects

The high rate of knee injuries in women’s athletics has been well documented in recent years. There are multiple factors which contribute to the increased risk of injury in female athletes, including biomechanics when landing. Fatigue has also been examined as a contributing factor to injury, but few studies have utilized actual sport participation as a fatiguing protocol. No study has used the Landing Error Scoring System (LESS) to examine the changes that may result from fatigue. The objective of our study was to use the LESS to examine the effects of a two-hour basketball practice on the landing biomechanics …