Comparison of Long-term Cumulative Survival Rate and Standardized Mortality Ratio After Total Knee Arthroplasty in Patients with Rheumatoid Arthritis and Osteoarthritis | Chapter 8 | Medical Research and Its Applications Vol. 8

 

Background and Objective: Total knee arthroplasty (TKA) is an established surgical procedure that can relieve knee pain, enhance knee function, and improve the patient quality of life. The primary objective of this study is to clarify the long-term cumulative survival rate (CSR) and standardized mortality ratio (SMR) of rheumatoid arthritis (RA) and osteoarthritis (OA) patients who underwent total knee arthroplasty (TKA).

 

Method: Data for 325 RA and OA patients with 460 primary TKAs from 1997 to 2007 were reviewed. We divided the patients into ≤70 years (u70) and ≥71 years (o71) groups. The follow-up duration in the RA group (n=118) was 12.8±4.8 years vs 13.0±4.1 years in the OA group (n=207). The Cumulative Survival Rate was estimated using the Kaplan–Meier method.

 

Results: The SMR of the female RA patients was 1.97 (95%CI 0.96-3.89) after 5 years and 4.59 (95%CI 3.44-6.10) after 20 years. The SMR in female OA patients was 0.41 (95%CI 0.17-0.93) after 5 years and 1.31 (95%CI 0.996-1.73) after 20 years.

 

The 20-year CSR of female RA-o71 patients was lowest with 9.6 (95%CI 0-26). There was no significant difference in CSR between the RA-u70 and OA-o71 groups. The CSR in the OA-u70 group was highest with 77.8 (95%CI 0.62-0.93). Cox proportional hazards model analysis of female patients showed that steroid-use [Hazard ratio (HR) 3.22, 95%CI 1.32-13.46], age (HR 1.09, 95%CI 1.05- 1.30), and rheumatoid factor (HR 1.002, 95%CI 1.00-1.01) were risk factors in the RA-u70 group.

 

In the RA-o71 group, steroid use (HR 4.71, 95%CI 1.35-16.7), age (HR 1.38, 95%CI 1.12-1.71) and C-reactive protein (HR 1.20, 95%CI 1.02-1.41) were risk factors, whereas in the OA group, only age at surgery (HR 1.10, 95%CI 1.033-1.163) was a risk factor.

 

Conclusion: The study concluded that CSR was higher in patients with OA versus RA. SMR of female patients was high in RA and low after 5 years in OA. RA-u70 patients had a similar cumulative survival curve as OA-o71. The CSR of RA-o71 patients was poor. The preoperative factors affecting survival differed between u-70 and o-71 in RA.

 

 

Author(s) Details

Yamashita F
Department of Orthopedic Surgery, Kyoto Shimogamo Hospital, 606-0866 Higashimorigamae-cho 17, Shimogamo, Sakyo-ku, Kyoto, Japan and Department of Rheumatology, Kyoto Shimogamo Hospital, 606-0866 Higashimorigamae-cho 17, Shimogamo, Sakyo-ku, Kyoto, Japan.

Kobayashi M
Department of Orthopedic Surgery, Kyoto Shimogamo Hospital, 606-0866 Higashimorigamae-cho 17, Shimogamo, Sakyo-ku, Kyoto, Japan.

Mizuno Y
Department of Orthopedic Surgery, Kyoto Shimogamo Hospital, 606-0866 Higashimorigamae-cho 17, Shimogamo, Sakyo-ku, Kyoto, Japan.

Funakoshi N.
Department of Orthopedic Surgery, Kyoto Shimogamo Hospital, 606-0866 Higashimorigamae-cho 17, Shimogamo, Sakyo-ku, Kyoto, Japan and Department of Rheumatology, Kyoto Shimogamo Hospital, 606-0866 Higashimorigamae-cho 17, Shimogamo, Sakyo-ku, Kyoto, Japan.

Ito H.

Department of Orthopedic Surgery, Kyoto Shimogamo Hospital, 606-0866 Higashimorigamae-cho 17, Shimogamo, Sakyo-ku, Kyoto, Japan.

Mori D.

Department of Orthopedic Surgery, Kyoto Shimogamo Hospital, 606-0866 Higashimorigamae-cho 17, Shimogamo, Sakyo-ku, Kyoto, Japan.

Funakoshi H.

Department of Orthopedic Surgery, Kyoto Shimogamo Hospital, 606-0866 Higashimorigamae-cho 17, Shimogamo, Sakyo-ku, Kyoto, Japan.

Nishiyama H.

Department of Orthopedic Surgery, Kyoto Shimogamo Hospital, 606-0866 Higashimorigamae-cho 17, Shimogamo, Sakyo-ku, Kyoto, Japan.

Shirai T.

Department of Orthopedic Surgery, Kyoto Shimogamo Hospital, 606-0866 Higashimorigamae-cho 17, Shimogamo, Sakyo-ku, Kyoto, Japan.

Haku S.

Department of Orthopedic Surgery, Kyoto Shimogamo Hospital, 606-0866 Higashimorigamae-cho 17, Shimogamo, Sakyo-ku, Kyoto, Japan.

Shimozono Y.

Department of Orthopedic Surgery, Kyoto Shimogamo Hospital, 606-0866 Higashimorigamae-cho 17, Shimogamo, Sakyo-ku, Kyoto, Japan.

Tukasaki Y.

Department of Orthopedic Surgery, Kyoto Shimogamo Hospital, 606-0866 Higashimorigamae-cho 17, Shimogamo, Sakyo-ku, Kyoto, Japan.

Itoi M.

Department of Orthopedic Surgery, Meiji University of Integrative Medicine, Hiyosi-cho, Nantan-shi, Kyoto, Japan.

Kizaki K.

Department of Orthopedic Surgery, Kyoto Shimogamo Hospital, 606-0866 Higashimorigamae-cho 17, Shimogamo, Sakyo-ku, Kyoto, Japan and Department of Rheumatology, Kyoto Shimogamo Hospital, 606-0866 Higashimorigamae-cho 17, Shimogamo, Sakyo-ku, Kyoto, Japan.

 

Please see the link:- https://doi.org/10.9734/bpi/mria/v8/1016

Long-Term Outcome and Maintenance of Outdoor Walking Ability After Primary Total Knee Arthroplasty for Osteoarthritis Versus Rheumatoid Arthritis: A Retrospective Study | Chapter 13 | Medical Research and Its Applications Vol. 9

 

Objective and Aim: Ambulation is important for maintaining health. It becomes difficult when the knee joint is severely damaged by diseases such as osteoarthritis (OA) or rheumatoid arthritis (RA). We investigated the long-term results and maintenance of outdoor walking ability after total knee arthroplasty (TKA) in patients with osteoarthritis versus rheumatoid arthritis.

 

Methods: We retrospectively reviewed 205 patients with OA (285 knees) and 117 with RA (168 knees) who underwent primary TKA. We investigated the period during which they were able to walk outdoors for more than 10 minutes and the long-term outcomes of TKA. All TKA surgeries were performed via a medial parapatellar approach under general anesthesia by one surgeon at one institution. The mean follow-up durations in the OA and RA groups were 13.0 and 12.8 years, respectively.

 

Results: About 90% of participants in both the OA and RA groups were female. The mean ages at surgery in the OA and RA groups were 72.8 and 65 years, respectively. The cumulative frequencies of outdoor walking ability in the OA and RA groups were 39.3% and 44.1%, respectively, at 15 years, and 21.0% and 27.1%, respectively, at 20 years, with no significant intergroup differences (log-rank test, p=0.3017). The main cause of gait dysfunction was medical disease (55.7% and 61.4% in the OA and RA groups, respectively). The cumulative survival rate for TKA was 97% at 20 years in both groups. The preoperative risk factors for inability to walk outdoors were older age at TKA and consistently severe pain in the OA group, and older age at TKA, higher rheumatoid factor concentration, and oral corticosteroid use in the RA group.

 

Conclusion: There was no significant difference between the OA and RA groups in knee joint function after TKA, even in the long term. The cumulative survival rate for TKA was 97% at 20 years in both the OA and RA groups. TKA improves long-term knee function and has a similar long-term beneficial effect on outdoor walking ability in patients with OA and RA.

 

Author(s) Details

 

Fumiharu Yamashita

Department of Orthopedic Surgery, Kyoto Shimogamo Hospital, Kyoto, Japan and Department of Rheumatology, Kyoto Shimogamo Hospital, Kyoto, Japan.

Yoshitake Tsukasaki

Department of Orthopedic Surgery, Kyoto Shimogamo Hospital, Kyoto, Japan.

Yoshiharu Shimozono

Department of Orthopedic Surgery, Kyoto Shimogamo Hospital, Kyoto, Japan.

Shin Haku

Department of Orthopedic Surgery, Kyoto Shimogamo Hospital, Kyoto, Japan.

Takaaki Shirai

Department of Orthopedic Surgery, Kyoto Shimogamo Hospital, Kyoto, Japan.

Hiroshi Funakoshi

Department of Orthopedic Surgery, Kyoto Shimogamo Hospital, Kyoto, Japan.

Daisuke Mori

Department of Orthopedic Surgery, Kyoto Shimogamo Hospital, Kyoto, Japan.

Hideo Ito

Department of Orthopedic Surgery, Kyoto Shimogamo Hospital, Kyoto, Japan.

Noboru Funakoshi

Department of Orthopedic Surgery, Kyoto Shimogamo Hospital, Kyoto, Japan and Department of Rheumatology, Kyoto Shimogamo Hospital, Kyoto, Japan.

Yasuyuki Mizuno

Department of Orthopedic Surgery, Kyoto Shimogamo Hospital, Kyoto, Japan.

Masahiko Kobayashi

Department of Orthopedic Surgery, Kyoto Shimogamo Hospital, Kyoto, Japan.

Megumi Itoi

Department of Orthopedic Surgery, Meiji University of Integrative Medicine, Nantan-shi, Kyoto, Japan.

Kazuha Kizaki

Department of Orthopedic Surgery, Kyoto Shimogamo Hospital, Kyoto, Japan and Department of Rheumatology, Kyoto Shimogamo Hospital, Kyoto, Japan.

 

Please see the book here:- https://doi.org/10.9734/bpi/mria/v9/1185

 

Long-term Follow-up of BioHorizons® Implants, Placed by Postgraduate Students at the University of Barcelona, Spain | Chapter 2 | Medicine and Medical Research: New Perspectives Vol. 10

The study aimed to evaluate the survival and failure rate, in the short- and medium-term, in addition to its relationship with risk factors, in implants placed by postgraduate students of the Master of Medicine, Surgery, and Oral Implantology course from the University of Barcelona. The success of dental implants is related to both the surgical technique and a series of factors that can contribute to their failure over the short term. Insufficient crestal bone height or width can require regenerative surgeries that sometimes occur simultaneously with implant placement, and can lead to complications, such as soft tissue dehiscence, infections, or insufficient final bone quality. The study was designed by including 192 patients with 422 implants placed between 2015 and 2018. Variables of implant failure were evaluated and related. Failure was split into early failure and late failure. Descriptive statistical parameters were used to evaluate the variables, which included standard deviation and percentage distribution. The chi-squared test was used to compare the qualitative data, with p = 0.05 considered as a significant value, expressed in frequency distribution tables. Qualitative data were compared using the chi-squared test, taking p ≤ 0.05 as a significant value. The comparison of quantitative variables was carried out using the Student’s t-test for independent samples. The survival rate in a period of 6 months to 3 years was 97.87%. The mean age of the patients was (54.5 ± 13), and the largest number of implants were placed in the 51–60 age range. The failure rate was 2.13% (N = 9), 6 failed early and 3 failed after definitive prosthetic loading, with a p value < 0.0001. When comparing the failures according to their location in the anterior/posterior sector of the arch, the anterior sector showed statistically significant results (p = 0.027). Evaluating this risk factor in isolation is difficult, as other factors are in play that when taken in combination, lead to a worse prognosis of success and survival for implants. These include the patient’s systemic condition and smoking habit. Failed implants had a statistically significant relationship when they were placed in the anterior sector and were performed in the early stage. The results showed that the survival and failure rates of implants placed by postgraduate students are similar to those obtained by experienced professionals, being an effective and predictable therapy for partially or edentulous patients.

 

 

Author (s) Details

 

Arianna Graterol-Duran
Faculty of Medicine and Health Sciences, School of Dentistry, University of Barcelona, 08907 Barcelona, Spain.

 

Raùl Ayuso-Montero
Oral Health and Masticatory System Group-IDIBELL, Faculty of Medicine and Health Sciences, School of Dentistry, Odontological Hospital University of Barcelona, University of Barcelona, 08907 Barcelona, Spain.

 

Sonia Egido-Moreno
Faculty of Medicine and Health Sciences, School of Dentistry, University of Barcelona, 08907 Barcelona, Spain.

 

Mónica Blazquez-Hinarejos
Faculty of Medicine and Health Sciences, School of Dentistry, University of Barcelona, 08907 Barcelona, Spain.

 

Antonio Marí-Roig
Department of Clinical Sciences, Faculty of Medicine and Health Sciences, University of Barcelona, 08907 Barcelona, Spain.

 

José López-López
Oral Health and Masticatory System Group-IDIBELL, Faculty of Medicine and Health Sciences, School of Dentistry, Odontological Hospital University of Barcelona, University of Barcelona, 08907 Barcelona, Spain.

 

Please see the book here:- https://doi.org/10.9734/bpi/mmrnp/v10/2469

Dental Implants and Oral Lichen Planus: Review and Protocol | Chapter 13 | New Advances in Medicine and Medical Science Vol. 1

 Oral flowerless plant planus [OLP] is an autoimmune and chronic inflammatory affliction. The aetiology of OLP is still unknown, but it is trusted to be associated with container-mediated invulnerable dysregulation at the level of the basal membrane. Since OLP is a mucosal affliction, it has been suggested to influence the ability of fastening to the titanium surface; and although some environments are considered as risk determinants for dental implants, there are assorted absolute contraindications for this rehabilitation alternative.  Our aim is to present a orderly review that answers the PICO question: rehabilitation with dentures in patients accompanying OLP is a valid treatment alternative with a high endurance rate. The survival of 93,88% rate obtinned  is related to the survival rate of implant restoration in patients outside any pathology or integral condition, which is 92% or 95%, depending on the prosthetic restoration. In order to maintain this extreme survival rate, frequent follow-up assignments and oral cleanliness instructions should be situated to eliminate inflammatory fabric response (fairy-implant mucositis and peri-implantitis). According to the SORT tests, level A can be established in the end that OLP patients can be adjusted with dentures.

Author(s) Details:

Aina Torrejon-Moya,
Oral Medicine, Surgery and Implantology, Faculty of Medicine and Health Sciences (Dentistry), University of Barcelona, Spain.

Constanza Saka-Herrán,
Faculty of Medicine and Health Sciences (Dentistry), University of Barcelona, Barcelona, Spain.

Keila Izquierdo-Gómez,
Department of Odontostomatology, Faculty of Medicine and Health Sciences (Dentistry), University of Barcelona, Oral Health and Masticatory System Group (Bellvitge Biomedical Research Institute) IDIBELL, University of Barcelona, Barcelona, Spain.

Antoni Marí Roig,
Service of the Maxillofacial Surgery Service, University Hospital of Bellvitge, Barcelona-08907 (Spain), Oral Health and Masticatory System Group-IDIBELL (Institut d’Investigació Biomèdica de Bellvitge), Barcelona University, Barcelona-08907, Spain.

Albert Estrugo-Devesa,
Department of Odontostomatology, Faculty of Medicine and Health Sciences (Dentistry), University of Barcelona, Oral Health and Masticatory System Group (Bellvitge Biomedical Research Institute) IDIBELL, University of Barcelona, Barcelona, Spain.

José López López,
Department of Odontostomatology, Faculty of Medicine and Health Sciences (Dentistry), Odontological Hospital University of Barcelona, University of Barcelona Oral Health and Masticatory System Group (Bellvitge Biomedical Research Institute) IDIBELL, University of Barcelona, Barcelona, Spain.

Please see the link here: https://stm.bookpi.org/NAMMS-V1/article/view/10617