Pub Date : 2025-05-01Epub Date: 2025-03-19DOI: 10.1016/j.ijotn.2025.101176
Anders Ringnér , Malin Ljung , Anna-Clara Rullander
{"title":"Parents' and nurses’ experiences when children undergo limb lengthening treatment","authors":"Anders Ringnér , Malin Ljung , Anna-Clara Rullander","doi":"10.1016/j.ijotn.2025.101176","DOIUrl":"10.1016/j.ijotn.2025.101176","url":null,"abstract":"","PeriodicalId":45099,"journal":{"name":"International Journal of Orthopaedic and Trauma Nursing","volume":"57 ","pages":"Article 101176"},"PeriodicalIF":1.5,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143697616","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-05-01Epub Date: 2025-04-28DOI: 10.1016/j.ijotn.2025.101186
Larissa Sattler , Elizabeth Puze , Kendal Sands , William Talbot
Background
Enhanced Recovery After Surgery (ERAS) protocols represent an evidence-based approach to perioperative care, though evidence from randomized controlled trials in primary hip and knee arthroplasty remains limited.
Objective
This systematic review aims to synthesize evidence from randomized controlled trials (RCTs) comparing ERAS protocols with standard care for primary hip and knee arthroplasty.
Methods
Four databases were searched following PRISMA guidelines. RCTs comparing ERAS protocols with standard care for primary hip or knee arthroplasty were included. Primary outcome was length of stay (LOS), with secondary outcomes including patient-reported outcomes, functional measures, and complications.
Results
Five RCTs (710 patients) met inclusion criteria. ERAS pathways reduced LOS by an average of 4.7 days compared to standard care. Patients in ERAS protocols demonstrated superior early functional recovery, particularly in the first postoperative week, with improved performance in mobility tests and daily activities. Patient-reported outcomes generally favoured ERAS protocols, though measurement heterogeneity limited synthesis. No studies reported increased complications with ERAS implementation. The role of multidisciplinary teams, particularly nurse coordinators, was identified as an important for protocol success.
Conclusion
This systematic review of RCTs provides strong evidence that ERAS pathways reduce length of stay following primary hip and knee arthroplasty without compromising patient outcomes or safety. While ERAS protocols were associated with improved early functional recovery, heterogeneity in assessment methods limits definitive conclusions.
{"title":"Enhanced recovery pathways improve early outcomes and reduce length of stay in primary hip and knee arthroplasty: A systematic review of randomized controlled trials","authors":"Larissa Sattler , Elizabeth Puze , Kendal Sands , William Talbot","doi":"10.1016/j.ijotn.2025.101186","DOIUrl":"10.1016/j.ijotn.2025.101186","url":null,"abstract":"<div><h3>Background</h3><div>Enhanced Recovery After Surgery (ERAS) protocols represent an evidence-based approach to perioperative care, though evidence from randomized controlled trials in primary hip and knee arthroplasty remains limited.</div></div><div><h3>Objective</h3><div>This systematic review aims to synthesize evidence from randomized controlled trials (RCTs) comparing ERAS protocols with standard care for primary hip and knee arthroplasty.</div></div><div><h3>Methods</h3><div>Four databases were searched following PRISMA guidelines. RCTs comparing ERAS protocols with standard care for primary hip or knee arthroplasty were included. Primary outcome was length of stay (LOS), with secondary outcomes including patient-reported outcomes, functional measures, and complications.</div></div><div><h3>Results</h3><div>Five RCTs (710 patients) met inclusion criteria. ERAS pathways reduced LOS by an average of 4.7 days compared to standard care. Patients in ERAS protocols demonstrated superior early functional recovery, particularly in the first postoperative week, with improved performance in mobility tests and daily activities. Patient-reported outcomes generally favoured ERAS protocols, though measurement heterogeneity limited synthesis. No studies reported increased complications with ERAS implementation. The role of multidisciplinary teams, particularly nurse coordinators, was identified as an important for protocol success.</div></div><div><h3>Conclusion</h3><div>This systematic review of RCTs provides strong evidence that ERAS pathways reduce length of stay following primary hip and knee arthroplasty without compromising patient outcomes or safety. While ERAS protocols were associated with improved early functional recovery, heterogeneity in assessment methods limits definitive conclusions.</div></div>","PeriodicalId":45099,"journal":{"name":"International Journal of Orthopaedic and Trauma Nursing","volume":"57 ","pages":"Article 101186"},"PeriodicalIF":1.5,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143895600","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-05-01Epub Date: 2025-02-27DOI: 10.1016/j.ijotn.2025.101172
Keetie Kremers-van de Hei , Bob Evers , Lotte Weijers , Diederick Duijvesz , Berend Willem Schreurs , Sander Koeter
Background
Postoperative urinary retention is a frequently seen serious complication after surgery. After orthopaedic hip or knee arthroplasty the incidence is relatively high, between 30 and 50% in previous studies. Currently, there is no consensus on the indication for urinary catheterization and a uniform guideline is lacking. This prospective cohort study examined the safety of a modified catheterization protocol with a catheterization threshold of 800 ml instead of 400 ml (usual care) after elective joint arthroplasty using ultrasound bladder scans. The hypothesis was that the incidence of catheterization will be reduced without increasing urinary complications.
Method
We prospectively included 305 patients who were treated according to the local fast track arthroplasty protocol in which a modified catheterization protocol was used. Catheterization was only performed at a scan volume of 800 ml or more. Bladder contents were monitored preoperatively, immediately postoperatively and at outpatient follow-up. Urological scores and complications were monitored. The usual care control group was treated according to the usual care protocol with a threshold for catheterization of 400 ml, these results were published in a previous study.
Results
The incidence of catheterization for urinary retention was significantly lower in patients who were treated with the less invasive protocol than the usual care control group (11.1% versus 48.8%, p < 0.001). The rate of urologic complications was low using the new protocol (4% urinary tract infection and 0.3% pharmacological interventions).
Conclusion
The results of our study provide strong empirical support for modifying catheterization protocols after orthopaedic surgery. A less invasive protocol is safe, provides reduction in workload for nurses, is patient-friendly and reduces costs.
背景术后尿潴留是术后常见的严重并发症。在骨科髋关节或膝关节置换术后,发病率相对较高,在先前的研究中为30 - 50%。目前,关于导尿的指征没有共识,缺乏统一的指南。这项前瞻性队列研究检查了选择性关节置换术后使用超声膀胱扫描将置管阈值改为800ml而不是400ml(常规护理)的改进置管方案的安全性。假设导尿的发生率会降低,而不会增加泌尿系统并发症。方法前瞻性纳入305例采用局部快速通道关节置换术的患者,其中采用改良的置管方案。仅在扫描容积为800毫升或更多时进行导管插入。术前、术后及门诊随访监测膀胱内容物。监测泌尿系统评分和并发症。常规护理对照组按常规护理方案治疗,置管阈值为400ml,这些结果已在既往研究中发表。结果微创治疗组尿潴留导尿发生率明显低于常规治疗组(11.1% vs 48.8%, p <;0.001)。使用新方案的泌尿系统并发症发生率较低(4%尿路感染和0.3%药物干预)。结论本研究结果为骨科术后置管方案的修改提供了有力的实证支持。侵入性较小的方案是安全的,减少了护士的工作量,对患者友好,并降低了成本。
{"title":"A less invasive catheterization protocol for managing urinary retention in patients undergoing hip and knee arthroplasty: A prospective cohort study","authors":"Keetie Kremers-van de Hei , Bob Evers , Lotte Weijers , Diederick Duijvesz , Berend Willem Schreurs , Sander Koeter","doi":"10.1016/j.ijotn.2025.101172","DOIUrl":"10.1016/j.ijotn.2025.101172","url":null,"abstract":"<div><h3>Background</h3><div>Postoperative urinary retention is a frequently seen serious complication after surgery. After orthopaedic hip or knee arthroplasty the incidence is relatively high, between 30 and 50% in previous studies. Currently, there is no consensus on the indication for urinary catheterization and a uniform guideline is lacking. This prospective cohort study examined the safety of a modified catheterization protocol with a catheterization threshold of 800 ml instead of 400 ml (usual care) after elective joint arthroplasty using ultrasound bladder scans. The hypothesis was that the incidence of catheterization will be reduced without increasing urinary complications.</div></div><div><h3>Method</h3><div>We prospectively included 305 patients who were treated according to the local fast track arthroplasty protocol in which a modified catheterization protocol was used. Catheterization was only performed at a scan volume of 800 ml or more. Bladder contents were monitored preoperatively, immediately postoperatively and at outpatient follow-up. Urological scores and complications were monitored. The usual care control group was treated according to the usual care protocol with a threshold for catheterization of 400 ml, these results were published in a previous study.</div></div><div><h3>Results</h3><div>The incidence of catheterization for urinary retention was significantly lower in patients who were treated with the less invasive protocol than the usual care control group (11.1% versus 48.8%, p < 0.001). The rate of urologic complications was low using the new protocol (4% urinary tract infection and 0.3% pharmacological interventions).</div></div><div><h3>Conclusion</h3><div>The results of our study provide strong empirical support for modifying catheterization protocols after orthopaedic surgery. A less invasive protocol is safe, provides reduction in workload for nurses, is patient-friendly and reduces costs.</div></div>","PeriodicalId":45099,"journal":{"name":"International Journal of Orthopaedic and Trauma Nursing","volume":"57 ","pages":"Article 101172"},"PeriodicalIF":1.5,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143579400","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-05-01Epub Date: 2025-02-19DOI: 10.1016/j.ijotn.2025.101165
Sonya Clarke (Dr)
{"title":"The transition of young people to adult services within orthopaedic healthcare -Editorial for May 2025 issue","authors":"Sonya Clarke (Dr)","doi":"10.1016/j.ijotn.2025.101165","DOIUrl":"10.1016/j.ijotn.2025.101165","url":null,"abstract":"","PeriodicalId":45099,"journal":{"name":"International Journal of Orthopaedic and Trauma Nursing","volume":"57 ","pages":"Article 101165"},"PeriodicalIF":1.5,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143474785","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-05-01Epub Date: 2025-04-11DOI: 10.1016/j.ijotn.2025.101180
Ami Hommel , Nina Hummerdal , Lovisa Strålöga , Joan Ostaszkiewicz , Maria Hälleberg-Nyman
Background
Postoperative urine retention can lead to permanent bladder dysfunction. This occurs even though healthcare personnel can access evidence-based guidelines on avoiding urine bladder injuries related to care.
Aim
This study aimed to describe healthcare professionals’ experiences with, and strategies to avoid post-operative urinary retention among hip surgery patients.
Method
A descriptive qualitative study using telephone interviews, were conducted in April to June 2021, with 22 healthcare professionals (13 nurses, 7 nursing assistants and 2 occupational therapists) in 17 orthopaedic wards in Sweden. Qualitative content analysis of interview data was performed.
Results
Five categories were identified: “Knowledge about guidelines regarding bladder monitoring”, “Understanding of patients' prehospital bladder function influences healthcare professionals’ reasoning and actions”, “Strategies are applied to make it easier for the patients to empty their bladder”, “Indwelling catheter is used routinely” and “Short length of stay creates stress”.
Conclusion
To optimise safe patient bladder monitoring after hip surgery, health care professionals need to be more aware of the availability of guidelines about bladder monitoring to adopt consistent monitoring practices, and to have enough time to care for patients.
{"title":"Healthcare professional's management of the risk for postoperative urinary retention in hip surgery patients – a qualitative interview study","authors":"Ami Hommel , Nina Hummerdal , Lovisa Strålöga , Joan Ostaszkiewicz , Maria Hälleberg-Nyman","doi":"10.1016/j.ijotn.2025.101180","DOIUrl":"10.1016/j.ijotn.2025.101180","url":null,"abstract":"<div><h3>Background</h3><div>Postoperative urine retention can lead to permanent bladder dysfunction. This occurs even though healthcare personnel can access evidence-based guidelines on avoiding urine bladder injuries related to care.</div></div><div><h3>Aim</h3><div>This study aimed to describe healthcare professionals’ experiences with, and strategies to avoid post-operative urinary retention among hip surgery patients.</div></div><div><h3>Method</h3><div>A descriptive qualitative study using telephone interviews, were conducted in April to June 2021, with 22 healthcare professionals (13 nurses, 7 nursing assistants and 2 occupational therapists) in 17 orthopaedic wards in Sweden. Qualitative content analysis of interview data was performed.</div></div><div><h3>Results</h3><div>Five categories were identified: “Knowledge about guidelines regarding bladder monitoring”, “Understanding of patients' prehospital bladder function influences healthcare professionals’ reasoning and actions”, “Strategies are applied to make it easier for the patients to empty their bladder”, “Indwelling catheter is used routinely” and “Short length of stay creates stress”.</div></div><div><h3>Conclusion</h3><div>To optimise safe patient bladder monitoring after hip surgery, health care professionals need to be more aware of the availability of guidelines about bladder monitoring to adopt consistent monitoring practices, and to have enough time to care for patients.</div></div>","PeriodicalId":45099,"journal":{"name":"International Journal of Orthopaedic and Trauma Nursing","volume":"57 ","pages":"Article 101180"},"PeriodicalIF":1.5,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143833348","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-05-01Epub Date: 2025-04-01DOI: 10.1016/j.ijotn.2025.101178
Puvaneswari Kanagaraj
Introduction
Rheumatoid Arthritis(RA) can result in significant joint destruction and work disability which needs physical and psychosocial adjustment to deal with pain, and fatigue.
Methods
True experimental parallel arm design with a pre-test post-test wait-listed control group was used to assess the impact of self-management training on Quality of life, medication adherence and self-efficacy among patients with RA. Participants were randomly allocated to the study(70) or control(70)group by simple randomization by the researcher. The study group underwent a self-management training consisting of six sessions over a 12-week period, while the control group received routine care. Importantly, the research assistant responsible for outcome assessment remained blinded to the treatment allocation at 1st, 3rd and 5th month post intervention using Short form- 36, Compliance Questionnaire, Rheumatology and Arthritis self efficacy scale.
Results
The SMT led to significant improvements in QoL-physical components including Pain (p = 0.001, partial eta squared(η²) = 0.372) and General Health (p = 0.001, η² = 0.320). Significant between-group differences were observed for Pain (p = 0.007), while other measures showed no differences. Mental health components also improved significantly in the study group, particularly in Energy (p = 0.001, η² = 0.344). Medication adherence improved initially but stabilized over time. The study group showed significant improvements in self-efficacy for pain, function, and other symptoms (p < 0.009), with large effect sizes and sustained progress.
Conclusion
By empowering patients with knowledge, skills, and confidence to effectively manage their condition, such health educations can contribute significantly improve overall health outcomes.
{"title":"Impact of self-management training on quality of life, medication adherence, and self-efficacy among rheumatoid arthritis patients","authors":"Puvaneswari Kanagaraj","doi":"10.1016/j.ijotn.2025.101178","DOIUrl":"10.1016/j.ijotn.2025.101178","url":null,"abstract":"<div><h3>Introduction</h3><div>Rheumatoid Arthritis(RA) can result in significant joint destruction and work disability which needs physical and psychosocial adjustment to deal with pain, and fatigue.</div></div><div><h3>Methods</h3><div>True experimental parallel arm design with a pre-test post-test wait-listed control group was used to assess the impact of self-management training on Quality of life, medication adherence and self-efficacy among patients with RA. Participants were randomly allocated to the study(70) or control(70)group by simple randomization by the researcher. The study group underwent a self-management training consisting of six sessions over a 12-week period, while the control group received routine care. Importantly, the research assistant responsible for outcome assessment remained blinded to the treatment allocation at 1st, 3rd and 5th month post intervention using Short form- 36, Compliance Questionnaire, Rheumatology and Arthritis self efficacy scale.</div></div><div><h3>Results</h3><div>The SMT led to significant improvements in QoL-physical components including Pain (p = 0.001, partial eta squared(η²) = 0.372) and General Health (p = 0.001, η² = 0.320). Significant between-group differences were observed for Pain (p = 0.007), while other measures showed no differences. Mental health components also improved significantly in the study group, particularly in Energy (p = 0.001, η² = 0.344). Medication adherence improved initially but stabilized over time. The study group showed significant improvements in self-efficacy for pain, function, and other symptoms (p < 0.009), with large effect sizes and sustained progress.</div></div><div><h3>Conclusion</h3><div>By empowering patients with knowledge, skills, and confidence to effectively manage their condition, such health educations can contribute significantly improve overall health outcomes.</div></div>","PeriodicalId":45099,"journal":{"name":"International Journal of Orthopaedic and Trauma Nursing","volume":"57 ","pages":"Article 101178"},"PeriodicalIF":1.5,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143777049","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Military and law enforcement personnel face an increased risk of chronic low back pain (CLBP), yet evidence on the outcomes of surgical treatment in these high-risk groups remains limited. This study aims to evaluate the effect of spinal fusion on quality of life (QOL), disability, and mental health in military and law enforcement personnel with CLBP.
Methods
The study included 39 patients who underwent spinal fusion for CLBP. Quality of life, disability, and mental health were assessed using the 36-Item Short Form Survey (SF-36), Oswestry Disability Index (ODI), and Depression-Anxiety-Stress Scale (DASS-21), respectively. Patients completed the questionnaires preoperatively and two years postoperatively. The primary outcome was the change in scores after surgery. Subgroup analyses were conducted based on sex, marital status, education level, smoking, alcohol consumption, and employment sector.
Results
Significant improvements were observed in seven of eight SF-36 subscales: Physical Health Role Limitation (p = 0.005), Emotional Health Role Limitation (p = 0.008), Energy (p = 0.004), Emotional Well-Being (p = 0.006), Social Function (p = 0.004), Physical Pain (p < 0.001), and General Health (p = 0.005). Physical (p = 0.002) and mental health components (p = 0.002) also improved. ODI decreased significantly (p = 0.014). Finally, improvement was observed only for the stress subcategory of the DASS-21 (p = 0.033). In subgroup analysis, Married patients showed greater improvements in emotional health (p = 0.008), while patients with lower educational levels experienced greater relief in physical pain (p = 0.028) and functionality (p = 0.010).
Conclusions
Spinal fusion in military and law enforcement personnel with CLBP led to significant improvements in QOL and disability, though mental health benefits are more limited.
{"title":"Effect of surgical treatment on mental health, disability and quality of life in active military and law enforcement personnel with non-specific chronic low back pain: A retrospective study","authors":"Christos Karampalis , Stavros Stamiris , Athanasios Sarridimitriou , Dimitrios Stamiris , Elissavet Anestiadou , Panagiotis Kakoulidis , Pavlos Sarafis , Christiana Chatzianestiadou , Pavlos Christodoulou , Vasileios Vrangalas , Maria Malliarou","doi":"10.1016/j.ijotn.2025.101183","DOIUrl":"10.1016/j.ijotn.2025.101183","url":null,"abstract":"<div><h3>Background</h3><div>Military and law enforcement personnel face an increased risk of chronic low back pain (CLBP), yet evidence on the outcomes of surgical treatment in these high-risk groups remains limited. This study aims to evaluate the effect of spinal fusion on quality of life (QOL), disability, and mental health in military and law enforcement personnel with CLBP.</div></div><div><h3>Methods</h3><div>The study included 39 patients who underwent spinal fusion for CLBP. Quality of life, disability, and mental health were assessed using the 36-Item Short Form Survey (SF-36), Oswestry Disability Index (ODI), and Depression-Anxiety-Stress Scale (DASS-21), respectively. Patients completed the questionnaires preoperatively and two years postoperatively. The primary outcome was the change in scores after surgery. Subgroup analyses were conducted based on sex, marital status, education level, smoking, alcohol consumption, and employment sector.</div></div><div><h3>Results</h3><div>Significant improvements were observed in seven of eight SF-36 subscales: Physical Health Role Limitation (p = 0.005), Emotional Health Role Limitation (p = 0.008), Energy (p = 0.004), Emotional Well-Being (p = 0.006), Social Function (p = 0.004), Physical Pain (p < 0.001), and General Health (p = 0.005). Physical (p = 0.002) and mental health components (p = 0.002) also improved. ODI decreased significantly (p = 0.014). Finally, improvement was observed only for the stress subcategory of the DASS-21 (p = 0.033). In subgroup analysis, Married patients showed greater improvements in emotional health (p = 0.008), while patients with lower educational levels experienced greater relief in physical pain (p = 0.028) and functionality (p = 0.010).</div></div><div><h3>Conclusions</h3><div>Spinal fusion in military and law enforcement personnel with CLBP led to significant improvements in QOL and disability, though mental health benefits are more limited.</div></div>","PeriodicalId":45099,"journal":{"name":"International Journal of Orthopaedic and Trauma Nursing","volume":"57 ","pages":"Article 101183"},"PeriodicalIF":1.5,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143874031","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-05-01Epub Date: 2025-04-28DOI: 10.1016/j.ijotn.2025.101187
Mikkel Nicklas Frandsen , Jesper Mehlsen , Claus Varnum , Martin Lindberg-Larsen , Nicolai Bang Foss , Henrik Kehlet
Introduction
Orthostatic intolerance (OI) is a barrier for early mobilization and same-day discharge after total hip arthroplasty (THA), with an estimated 30 % of patients affected within the first 6 h after surgery. Since repeated mobilization is known to be valuable in non-surgical OI conditions, we aimed to evaluate the feasibility of an early standardized repeated mobilization procedure as treatment of postoperative OI after THA.
Methods
This study was a single-arm, two-center hypothesis-generating feasibility study in patients undergoing THA. At first mobilization 4 h after surgery patients were categorized as having orthostatic tolerance (OT) or OI. Patients with OI underwent an hourly standardized repeated mobilization procedure until achieving OT or reaching 8 h post-surgery.
Results
Of 84 patients screened for OI, 25 (30 %) had OI 4 h postoperatively. Four patients left the study before achieving OT. Of the 21 completing the study per protocol, 16 patients achieved OT at 5 h and the remaining 5 achieved OT at 6 h postoperatively.
Discussion
Early repeated mobilization in patients with postoperative OI was feasible and potentially valuable after THA. This hypothesis-generating study calls for future large-scale studies in surgical patients with OI.
{"title":"Feasibility of repeated early mobilization in orthostatic intolerance after total hip arthroplasty","authors":"Mikkel Nicklas Frandsen , Jesper Mehlsen , Claus Varnum , Martin Lindberg-Larsen , Nicolai Bang Foss , Henrik Kehlet","doi":"10.1016/j.ijotn.2025.101187","DOIUrl":"10.1016/j.ijotn.2025.101187","url":null,"abstract":"<div><h3>Introduction</h3><div>Orthostatic intolerance (OI) is a barrier for early mobilization and same-day discharge after total hip arthroplasty (THA), with an estimated 30 % of patients affected within the first 6 h after surgery. Since repeated mobilization is known to be valuable in non-surgical OI conditions, we aimed to evaluate the feasibility of an early standardized repeated mobilization procedure as treatment of postoperative OI after THA.</div></div><div><h3>Methods</h3><div>This study was a single-arm, two-center hypothesis-generating feasibility study in patients undergoing THA. At first mobilization 4 h after surgery patients were categorized as having orthostatic tolerance (OT) or OI. Patients with OI underwent an hourly standardized repeated mobilization procedure until achieving OT or reaching 8 h post-surgery.</div></div><div><h3>Results</h3><div>Of 84 patients screened for OI, 25 (30 %) had OI 4 h postoperatively. Four patients left the study before achieving OT. Of the 21 completing the study per protocol, 16 patients achieved OT at 5 h and the remaining 5 achieved OT at 6 h postoperatively.</div></div><div><h3>Discussion</h3><div>Early repeated mobilization in patients with postoperative OI was feasible and potentially valuable after THA. This hypothesis-generating study calls for future large-scale studies in surgical patients with OI.</div></div>","PeriodicalId":45099,"journal":{"name":"International Journal of Orthopaedic and Trauma Nursing","volume":"57 ","pages":"Article 101187"},"PeriodicalIF":1.5,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143902147","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-05-01Epub Date: 2025-05-15DOI: 10.1016/j.ijotn.2025.101188
Mikkel Nicklas Frandsen , Jesper Mehlsen , Claus Varnum , Martin Lindberg-Larsen , Nicolai Bang Foss , Henrik Kehlet
{"title":"Corrigendum to “Feasibility of repeated early mobilization in orthostatic intolerance after total hip arthroplasty” [International J. Orthopaedic Trauma Nurs. 57 (2025) 101187]","authors":"Mikkel Nicklas Frandsen , Jesper Mehlsen , Claus Varnum , Martin Lindberg-Larsen , Nicolai Bang Foss , Henrik Kehlet","doi":"10.1016/j.ijotn.2025.101188","DOIUrl":"10.1016/j.ijotn.2025.101188","url":null,"abstract":"","PeriodicalId":45099,"journal":{"name":"International Journal of Orthopaedic and Trauma Nursing","volume":"57 ","pages":"Article 101188"},"PeriodicalIF":1.5,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144086800","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-05-01Epub Date: 2025-04-30DOI: 10.1016/j.ijotn.2025.101184
Lingli Peng , Chun Huang
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