Stages

Reinier Haga Orthopedisch Centrum

van september 2020 tot februari 2023

Leids Universitair Medisch Centrum

De Haagse Hogeschool

Hoofdvraag
Hoe moet een meetinstrument eruit komen te zien om de loopkwaliteit en zelfstandigheid tijdens het lopen, te kunnen kwantificeren bij patiënten met verschillende aandoeningen, zowel in het ziekenhuis als ambulant, om het effect van verschillende interventies te kunnen evalueren?

Doelstelling
Een generiek meetinstrument ontwikkelen, met een hiërarchische
schaalverdeling om de loopkwaliteit en zelfstandigheid bij patiënten te kwantificeren.
Beroepsproduct
Een prototype van het meetinstrument.

Probleemstelling
Het LUMC is opzoek naar een meetinstrument om de loopkwaliteit en zelfstandigheid tijdens het lopen bij patiënten te kwantificeren, om zo het effect van verschillende interventies te kunnen evalueren. Op dit moment wordt de FAC-gebruikt tijdens de klinische evaluatie, echter zegt de FAC-score onvoldoende over de kwaliteit van lopen van de patiënten . De FAC heeft een groot plafond effect.

FOLLOW-UP CARE AFTER TOTAL HIP AND KNEE ARTHROPLASTY:
INSIGHT IN THE NEEDS OF PATIENTS

Introduction
The number of total arthroplasties of the hip (THP) and knee (TKP) is predicted to increase rapidly during the next 20 years. Since the increasing popularity of THPs and TKPs, attention should be paid to the follow-up of joint prostheses. The main goal of follow-up is to identify problems in symptomatic or asymptomatic patients due to infection, osteolysis, bone loss or potential periprosthetic fracture at an early stage, enabling timely intervention to prevent catastrophic failure at a later date. Therefore, the aim of this study was to, evaluate and compare patient satisfaction and experience during the current follow-up frequency with patient preferences for follow-up care after THP or TKP placement.
Material and methods
The design was a multi-centre cohort study, designed to generate data for informational purposes using a patient survey and is being conducted in partnership with the Netherlands Orthopaedic Association (NOV) and the Consortium Orthopaedic Research (CORE), a network for initiating and following up scientific research in the field of orthopaedics. The survey was carried out in 2021 and 2022. Patients were at least 18 years old and underwent THP or TKP between 2005 and 2021. The questionnaire was divided into the following parts in order to assess the patients' perspective and satisfaction with the type and frequency of follow-up after THP and TKP: Information on current follow-up, information on patient preference for follow-up, insight into patient health status, and information on prosthesis history, complaints, and revision surgery. The study is designed to generate data for informative purposes. It is therefore descriptive rather than comparative.

Dataverwerking en analyse - onderzoeksstage

Praktijk en studiebegeleiders

van februari 2023 tot juli 2023

Mr.A.Lagerberg Docent bewegingstechnologie
Mr.H.Faber Docent bewegingstechnologie & mechatronica

Leids Universitair Medisch Centrum

Mr. Dr. P. Dekker Revalidatiearts
Mw. Dr. M. Stijntjes Klinisch technoloog

Reinier Haga Orthopedisch Centrum

Mw. dr. ir. J.H. Pasma Klinisch technoloog
Mw. B. Hesseling Onderzoeker

Results
Completed questionnaires were received from only 140 participants (76 for THP and 64 for TKP), giving a total of 191 prostheses, of which 97 (51.0%) were THPs and 93 (48.9%) were TKPs. Both single and double prostheses were included in these groups. Overall, the majority of participants are mobile: 59 (77.6%) for THP and 43 (68.3%) for TKP. Each group is divided into three subgroups: 110 (57.6%) participants who received their prosthesis between 0 and 5 years ago, 31 (16.2%) participants who received their prosthesis between 6 and 10 years ago, and 50 (26.2%) participants who received their prosthesis more than 10 years ago. 93.9% of the THPs and 80.6% of the TKPs attended a follow-up appointment within 3 months of the prosthesis being placed. 40.2% of THPs and 33.3% of TKPs preferredto attend the follow-up visit only in case of complaint and/or at their own request. For 78.4% of the THPs and 81.7% the follow-up was carried out at the hospital. THP(83.5%) and TKP(83.9%), preferred that the follow up takes place at the hospital. 100% of THPs and 97.8% of TKPs preferred to be supervised by an orthopaedic surgeon and/or a physician assistant. 72.6% of the participants thinks it is important to be checked regularly. 64.6% of the participants were satisfied with the follow-up.
Conclusions
Most patients attend a follow-up appointment within 3 months of the primary THP and TKP; participants were generally satisfied with the frequency of follow-up. In terms of participants' preferences, the preferred times to have a follow-up were within 3 months of prosthesis placement, after 1 year, and at their own request or in the event of complaints.