BACKGROUND. The aim of the study was to evaluate clinical outcomes and broadly defined quality of life in patients with hip osteoarthritis after short stem hip arthroplasty. MATERIAL AND METHODS. The study enrolled patients operated on at the Trauma and Orthopedics Department of St. Luke's Regional Hospital in Tarnów in the years 2008-2010. The experimental group consisted of 67 patients aged 22 to 77 years (average age 54.0 years) who received Proxima short stem implants (DePuy, J&J, USA). The control group consisted of 68 patients, operated on at the same department and in the same period, who were implanted with the ABG II prosthesis with a classic anatomical stem (average age 62.2 years). The average duration of hospital stay was 8 days. Follow-up examinations were scheduled at 6 weeks, 3 months and subsequently once a year. Post-operative outcomes were evaluated with the Harris Hip Score (HHS), WOMAC index and NRS. RESULTS. Analysis of HHS scores in the experimental group showed that 89.6% of the patients demonstrated excellent and good outcomes. The hip range of motion improved significantly after arthroplasty compared to preoperative values. The mean standardized extended WOMAC score was 85.5. Pain intensity in the experimental group decreased significantly after surgery. The mean preoperative NRS score was 6.6 vs. 1.0 after surgery. The outcomes in the control group were also excellent and good, but far worse than those in the experimental group as regards both clinical status and quality of life. A comparison of HHS scores showed statistically significant differences between the groups (p=0.018). The mean WOMAC score in the control group was 77.0, which is a statistically significant difference compared to the figure in the experimental group (p=0.001). Both groups had lower NRS scores after surgery, but the values were significantly worse in the control group (p=0.001). CONCLUSIONS. The outcomes of Proxima short stem arthroplasty in patients with hip osteoarthritis were better than the outcomes of patients who were implanted with the classic anatomical ABG stem. Pain reduction and an increased hip range of motion had the strongest impact on improving patients' quality of life after short stem prosthesis hip arthroplasty.
Introduction Surgical site infections (SSIs) are a predominant form of hospital-acquired infections in surgical wards. The objective of the study was analysis of the incidence of SSI in, both primary and revision, hip and knee arthroplasties. Material and methods: The study was conducted in 2012–2018 in a Trauma and Orthopedics Ward in Tarnów according to the methodology of the Healthcare-Associated Infections Surveillance Network (HAI-Net), European Centre for Disease Prevention and Control (ECDC). Results: The surveillance comprised 2340 surgery patients, including: 1756 Hip Arthroplasties (HPRO) and 584 Knee Arthroplasties (KPRO). In the group of patients under study, 37 cases of SSI were detected, including: 26 cases of SSI after HPRO and 11 cases in KPRO. The average incidence of SSI amounted to 1.6% (1.5% HPRO and 1.9% KPRO) and in-hospital incidence density rates were 1.23 and 1.53 per 1000 patient-days, respectively. Median age of surgical patients in both HPRO and KPRO was 70 years. Women were undergoing arthroplasty surgery more often than men, HPRO (p < 0.05) and KPRO (p < 0.001). Patients with SSI stayed in the ward longer (SSI-HPRO, p < 0.001) (SSI-KPRO p < 0.01). In KPRO operations, the incidence of SSI was higher than expected, calculated according to the Standardized Infection Ratio (SIR). The most common etiologic agents isolated from SSIs in both HPRO and KPRO were coagulase-negative staphylococci. Conclusions: Establishing a thorough surveillance of hospital-acquired infections that takes into consideration epidemiological indicators is indispensable to properly assess the epidemiological situation in the ward. The optimal solution is to carry out long-term and multi-center surveillance in the framework of a uniform program, however, even results of single-center studies provide valuable data indicating challenges and needs in improving patient safety.
INTRODUCTION. Surgical Site Infection (SSI) is the most common clinical form of Healthcare-Associated Infections (HAI) in orthopedic and trauma wards. MATERIAL AND METHOD. A retrospective study was conducted at the Department of Orthopedics and Trauma Surgery in Tarnów in 2012-2018. 3 155 patients treated for bone fractures were analyzed, including 1961 Open Reduction of Fracture (FX) and 1 194 Closed Reduction of Fracture with Internal Fixation (CR) surgeries. The study was conducted in accordance with the methodology recommended by the Surveillance Network (HAI-Net), European Centre for Disease Prevention and Control (ECDC). The aim of the study was to assess the incidence of SSI in patients undergoing the FX and CR procedures. RESULTS. 28 SSIs were identified in the examined ward; 16 SSI cases related to the FX procedure and 12 cases related to CR. The incidence for FX was 0.8% and for CR 1%. In patients with diagnosed SSI, the stay in the ward was longer (p <0.001) than in patients without SSI. In FX operations, the standardized risk index (SIR) did not exceed the value of one. Staphylococcus aureus was the most common organism isolated from materials from patients with SSI. CONCLUSIONS. In the examined period, the median age of women was higher than that of men, which may indicate a higher incidence of fractures in women. Patients with diagnosed SSI had a longer stay in the ward than patients without SSI. The incidence of SSI in FX and CR has been reduced compared to previous studies in the same ward.
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