Introduction and Hypothesis Hip osteoarthritis (OA) compromises functioning. Total hip replacement (THR) is the indicated treatment and may improve urinary incontinence (UI) and symptoms of overactive bladder (OAB). Objectives Assess UI, OAB symptoms, and quality of life (QoL) impact in preoperative and postoperative periods of women submitted to THR and investigate associated factors. Methods A prospective cohort was conducted with 183 women submitted to THR. The International Consultation on Incontinence Questionnaire—Short Form (ICIQ‐SF), International Consultation on Incontinence Questionnaire—Overactive Bladder (ICIQ‐OAB) and SF‐12 questionnaires were administered pre‐ and 3 and 6 months after surgery. Results Significant improvements were found in UI and QoL 3‐ and 6‐month postoperatively in the overall sample and in the subgroup with preoperative UI. The multivariate regression revealed that the preoperative ICIQ‐SF and ICIQ‐OAB final scores were the best predictors of UI 6‐month postoperatively. The factors the best predicted the occurrence of UI 6‐month following THR were the preoperative ICIQ‐OAB scores and preoperative UI. Each unit of increase in the ICIQ‐OAB increases the chances of UI by 26.9% and preoperative UI increases the chances of postoperative UI by 18.7‐fold. A weak but significant negative correlation was found between the ICIQ‐SF score and the SF‐12 score. Conclusion Significant improvements in UI, OAB and QoL were found at 3‐ and 6‐month postoperatively. Preoperative ICIQ‐SF and ICIQ‐OAB final scores were the best predictors of UI at 6 months after surgery. We found significant association between urinary symptoms and THR, but this association is partially explained by current literature.
Resumo Objetivo Avaliar o tratamento das fraturas de tíbia que evoluíram com perda óssea (traumática ou secundária a infecção) e as complicações ocorridas durante o tratamento com fixador externo e no período imediatamente após sua retirada. Métodos Foram selecionados 40 pacientes tratados entre 2010 e 2017, com a idade média de 33,02 anos, sendo 34 do sexo masculino e 6 do sexo feminino. Todos os pacientes portavam regenerado ósseo da tíbia, foram vítimas de trauma (sobretudo motociclístico), e estavam em seguimento ambulatorial. Resultados Foram obtidos regenerados ósseos da tíbia proximal de até 17 cm e da tíbia distal de 14 cm. O maior transporte trifocal teve a soma do tamanho dos tecidos dos ossos regenerados, medindo 14,5 cm. Como complicações, 29 (72,5%) pacientes tiveram infecção no trajeto dos pinos e fios. Houve 9 (22,5%) casos de refratura, sendo 6 deles tratadas com novo fixador circular, e 2 infecções no osso regenerado. Os pacientes foram submetidos a uma média de 4,72 procedimentos cirúrgicos (2–12), portaram fixador por 20,75 meses (7–55 m.) e permaneceram internados por 53,7 dias (5–183) devido principalmente a complicações de partes moles, a antibioticoterapia intravenosa ou até mesmo a questões sociais. Dois (5%) pacientes apresentaram gonartrose sintomática e outros 2 artrite sintomática do tornozelo. Três apresentaram discrepância de membros inferiores de 3,0; 3,7; e 5,0 cm. Conclusão Apesar de não ser um método de tratamento amplamente disponível, o método de Ilizarov é útil para solucionar a maioria das falhas ósseas da tíbia, independente da sua etiologia.
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