BackgroundTears of the Ligamentum Teres are a common cause of groin pain. Tears of the ligament frequently co-exist alongside other bony or labral intra-articular hip lesions, which are also treated at the time of arthroscopy. For this reason, it is often difficult to assess the effect that debridement alone has on improving patient pain and function. This study aims to assess the short-term outcomes of arthroscopic debridement of isolated Ligamentum Teres tears using a validated patient-reported outcome score – the International Hip Outcome Tool (iHOT-33).MethodsA retrospective review was performed of 35 patients (37 hips) who had an isolated Ligamentum Teres tear treated with arthroscopic radiofrequency debridement between September 2012 and September 2015. Patients with concomitant intra-articular hip pathology (femoroacetabular impingement, labral lesions, hip dysplasia) were excluded from the study. All patients completed the iHOT-33 questionnaire pre-operatively and post-operatively. The mean age was 37.7 years (range 16–67 years) and patients were followed up for a mean period of 17.7 months (range 6–42 months). Thirty-one patients were female and 4 were male.ResultsThirty-seven isolated partial tears were managed with arthroscopic radiofrequency debridement. At follow up, the mean iHOT-33 score improved from 26.9 pre-operatively to 48.0 post-operatively, representing a mean improvement of 21.1 (p < 0.001). The minimum clinically important difference of the iHOT-33 is 6.1 points. Significant improvements were noted in all four sub-sections of the iHOT-33.ConclusionArthroscopic radiofrequency debridement of isolated Ligamentum Teres tears provides short-term benefit in the majority of patients, including significant improvement in sporting function.
The aim of this review was to determine the prevalence of patient-reported outcome measures concerning outcomes of arthroscopic hip surgery. The PubMed database was comprehensively reviewed in March 2016 using the key terms “hip” and “arthroscopy.” A total of 192 eligible studies were identified. The most commonly used patient-reported outcome measures were the modified Harris Hip score (61%) and the Non-arthritic Hip Score (27%). Seventy-one percent of total patient-reported outcome measures articles were published between 2011 and 2015. The modified Harris Hip score, Nonarthritic Hip Score, and Hip Outcome Score remain the most commonly used patient-reported outcome measures in studies concerning outcomes of hip arthroscopy, and this has increased in the past 5 years. [
Orthopedics.
2019; 42(3):e305–e308.]
Patient-reported outcome measures lead to better communication and decision-making between clinicians and patients. Applying a web-based repository system for data collection was previously suggested, but such system is not available. This article introduces the development and implementation of a new web-based application, PROMsBase, in orthopaedics clinical practice. PROMsBase was developed using a web interface, allows access using both desktop and mobile devices. Between 2013 and 2016, a total of 3192 pre-surgery questionnaires were collected. In total, 238 patients completed their post-surgery questionnaire online from home. PROMsBase was well embedded into routine practice without disrupting clinical workflow and overloading clinicians' and researchers' workload. Tablets were not more useful and only 37 per cent of the patients completed the questionnaire online. PROMsBase provided a platform to easily collect and store data in clinical practice. If properly integrated, this could promote better care and communication between providers and patients.
BACKGROUND/OBJECTIVE:
Given the poor overall survival (OR) and progression-free survival (PFS) rates for lung cancers managed with surgical resection, there is a need to identify the prognostic markers that would improve the risk stratification of patients with operable lung cancer to inform treatment decisions. We investigate the prognostic utility of two established inflammation-based scores, the neutrophil–lymphocyte ratio (NLR) and the change in neutrophil–lymphocyte ratio (ΔNLR), throughout the operative period in a prospective cohort of patients with lung cancer who underwent surgical resection.
METHODS:
Demographic, clinical, and treatment details for 345 patients with lung cancer who underwent surgical resection between 2000 and 2019 at multiple centers across Melbourne, Victoria (Australia), were prospectively collected. Preoperative NLR and ΔNLR were calculated after which Cox univariate and multivariate analyses were conducted for OS and PFS against the known prognostic factors.
RESULTS:
Both univariate and multivariate analyses showed that preoperative NLR >4.54, as well as day 1 and day 2 postoperative NLR (
P
< 0.01), was associated with increased risk for postoperative mortality (hazard ratio 1.8;
P
< 0.01) and PFS (
P
< 0.05), whereas ΔNLR was not a significant predictor of OS or PFS.
CONCLUSION:
Elevated NLR among patients with lung cancer who underwent surgical resection was prognostic for poor OS and PFS, whereas ΔNLR was not found to be prognostic for either OS or PFS. Further research may yet reveal a prognostic value for ΔNLR when compared across a greater time period.
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