Resilience in the Orthopaedic Patient

Otlans, Peters; Szukics, Patrick; Bryan, Sean; Tjoumakaris, Fotios P.; Freedman, Kevin B.

doi:10.2106/jbjs.20.00676

Cited by 28 publications

(31 citation statements)

References 73 publications

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“…This can help us arrive at a brief set of questions for identifying and addressing mental health in musculoskeletal care. Similar observations have been made with respect to measures of general resiliency, locus of control, neuroticism [26, 27], and others [3, 11, 25]. The correlations are not as strong as when we specifically measured unhelpful thoughts and distress (such as symptoms of worry or despair), and they are not included in multivariable models.…”

Section: Discussionsupporting

confidence: 73%

Do Unhelpful Thoughts or Confidence in Problem Solving Have Stronger Associations with Musculoskeletal Illness?

Rossano

Salman

Ring

et al. 2021

Clin Orthop Relat Res

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Background Measures of unhelpful thoughts and distress correlate with the intensity of pain and the magnitude of incapability among people seeking musculoskeletal specialty care. In this evolving knowledge area, we want to be sure we have not neglected other important mental health factors. This study addressed how measures of confidence in problem solving as well as past and current ability to achieve goals account for variation in symptoms and capability independent of unhelpful thoughts and distress. Questions/purposes (1) Are measures of confidence in problem solving ability and past and current ability to achieve goals regarding future outcomes associated with variation in capability, independent of measures of symptoms of depression and anxiety (distress) and measures of unhelpful thoughts (worst-case thinking, negative pain thoughts)? (2) Are these measures

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Section: Discussionsupporting

confidence: 73%

Do Unhelpful Thoughts or Confidence in Problem Solving Have Stronger Associations with Musculoskeletal Illness?

Rossano

Salman

Ring

et al. 2021

Clin Orthop Relat Res

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“…More recently, there has been an increasing interest within the surgical community in investigating the psychologic factors that affect patient's ability to recover from surgery. 7 Multiple studies have now highlighted the role resilience plays in the outcomes of patients undergoing orthopaedic surgery ranging from upper extremity arthroplasty to hip fracture repair and spine procedures. 4 , 5 , 7 , 36 , 37 This is the first study to date to demonstrate the impact of resilience on the outcomes of lateral ligament repair and more generally the field of foot and ankle surgery.…”

Section: Discussionmentioning

confidence: 99%

“… 7 Multiple studies have now highlighted the role resilience plays in the outcomes of patients undergoing orthopaedic surgery ranging from upper extremity arthroplasty to hip fracture repair and spine procedures. 4 , 5 , 7 , 36 , 37 This is the first study to date to demonstrate the impact of resilience on the outcomes of lateral ligament repair and more generally the field of foot and ankle surgery. Tokish et al was the first to investigate the role of resilience, as measured by the BRS, within the field of orthopaedics and demonstrate its impact on patients undergoing total shoulder arthroplasty.…”

Section: Discussionmentioning

confidence: 99%

“… 1 – 3 Given these properties, research has begun to emerge investigating the impact of resilience on patients' recovery from orthopaedic surgery. 4 5 6 7 Otlans et al, 7 in a recent review, summarized the growing evidence for the use of resilience to prognosticate clinical outcomes in orthopaedics. Importantly, currently no studies exist in literature describing the impact of resilience on the outcomes of foot and ankle surgery.…”

mentioning

confidence: 99%

“…Importantly, currently no studies exist in literature describing the impact of resilience on the outcomes of foot and ankle surgery. 7 …”

mentioning

confidence: 99%

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Impact of Patient Resilience on Outcomes of Open Brostrom-Gould Lateral Ligament Repair

et al. 2021

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Introduction: Little is known about the factors affecting the intermediate outcomes of the Brostrom-Gould repair as measured by new patient-reported outcome instruments and the impact of patient resilience on postoperative outcomes. This is the first study to investigate the impact of resilience on the outcomes of lateral ligament repair. Methods: Retrospectively, 173 patients undergoing Brostrom-Gould at single institution from January 2013 to June 2020 were identified. Patient characteristics, participation in athletic activities, surgical variables, and complications were recorded. Patient-Reported Outcome Measurement Information System (PROMIS) Pain Interference v1.1 (PI), Physical Function v1.2 (PF), and the Foot Ankle Ability Measure (FAAM) were collected. The Brief Resilience Scale was used to quantify resilience. A linear regression model was constructed to evaluate the independent effect of resilience on each PROMIS and FAAM outcome instrument. Variables were included in the regression model based on an a priori significance threshold of P <0.05 in bivariate analysis. Results: Resilience's independent effect on outcome measures was as follows: PROMIS PF (unstandardized β 8.2, 95% confidence interval [CI] 3.9 to 12.6), PROMIS PI (unstandardized β −4.8, 95% CI −7.9 to −1.7), FAAM Activities of Daily Living (unstandardized β 16.6, 95% CI 8.7 to 24.6), and FAAM Sports (unstandardized β 28.4, 95% CI 15.9 to 40.9). Preoperative participation in athletic activities also had a positive independent effect on multiple outcome metrics including PROMIS PF (unstandardized β 9.4, 95% CI 2.8 to 16.0), PROMIS PI (unstandardized β −5.3, 95% CI −10.0 to −0.582), and FAAM Sport scores (unstandardized β 34.4, 95% CI 15.4 to 53.4). Conclusions: Resilience and patient participation in athletic activities are independent predictors of improved postoperative functional outcomes as measured by PROMIS and FAAM instruments at intermediate term follow-up. Resilient patients and athletes reported markedly higher PF and less pain burden postoperatively. Preoperative quantification of resilience could enable improved prognostication of patients undergoing lateral ligament repair of the ankle.

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Females show worse functional outcome and quality of life compared to males 2 years after meniscus surgery: Data analysis from the German Arthroscopy Registry

Mai,

Hinz

et al. 2024

Knee surg. sports traumatol. arthrosc.

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PurposeThe purpose of this study was to investigate the impact of sex on knee function, activity and quality of life following meniscus surgery using data from the German Arthroscopy Registry.MethodsThis is a retrospective cohort study with data collected between 2017 and 2022. Patient‐reported outcome measures (PROMs), namely Knee Injury and Osteoarthritis Outcome Score (KOOS), EuroQol Visual Analogue Scale (EQ Scale), and Marx Activity Rating Scale (MARS), were collected preoperatively and at 6, 12 and 24 months postoperatively. Data were analysed to examine differences between male and female patients regarding PROMs, pre‐existing conditions, meniscus lesion types and surgical treatments.ResultsA total of 1106 female (36.6%) and 1945 male patients (63.7%) were included. Males were significantly younger than females and had a higher body mass index. Overall, there were four times more medial meniscus lesions (MMLs) (77.5%) than lateral meniscus lesions (LMLs) (27.9%). Degenerative LMLs were more frequent in females, while traumatic LMLs were more common in males. Frequencies of traumatic and degenerative MMLs were similar among males and females. Males had higher absolute KOOS irrespective of treatment or meniscus lesion type. Meniscus repair resulted in similar improvements in ΔKOOS for both sexes, while meniscus resection exhibited higher absolute KOOS for males at each time point. Males generally had higher EQ Scale and MARS than females.ConclusionGreater improvements in knee function, activity and quality of life were observed in males. While MMLs appear to be comparable among sexes, the nature of LML differed significantly. These results may help surgeons to refine patient selection for specific treatments to improve overall clinical outcomes.Level of EvidenceLevel III.

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Resilience in the Orthopaedic Patient

Cited by 28 publications

References 73 publications

Do Unhelpful Thoughts or Confidence in Problem Solving Have Stronger Associations with Musculoskeletal Illness?

Do Unhelpful Thoughts or Confidence in Problem Solving Have Stronger Associations with Musculoskeletal Illness?

Impact of Patient Resilience on Outcomes of Open Brostrom-Gould Lateral Ligament Repair

Females show worse functional outcome and quality of life compared to males 2 years after meniscus surgery: Data analysis from the German Arthroscopy Registry

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