Healing beyond the joint: Addressing mental health in periprosthetic joint infection in a prospective longitudinal study.

OBJECTIVE: Periprosthetic joint infection (PJI) is a devastating complication following joint replacement surgeries. While the somatic impacts of PJI have been extensively explored, the influence on mental health remains understudied. This study aimed to longitudinally assess the psychological burden, quality of life, and expectations in individuals undergoing treatment for PJI. METHODS: A prospective study was conducted at a German trauma center between January 2020 and December 2022. Patients diagnosed with PJI (n = 29, mean age 71.4 ± 8.8 years) were assessed at five timepoints, within one week before revision surgery, one month, three, six, and twelve months postoperatively. Outcomes included the ICD-10 symptom-rating (ISR), German Short-Form 36 (SF-36), European Quality of Life 5 Dimensions (EQ-5D), and an expectation questionnaire. RESULTS: Psychological scores exhibited significant upward trends over time. The ISR score increased from 0.55 preoperatively to 0.87 at the 12-month follow-up (p = 0.002), surpassing the clinically relevant threshold. Depression and anxiety scores peaked at 6 months (1.6, p = 0.005) and 12 months (1.12, p = 0.001), respectively. Quality of life, measured by SF-36, showed stable physical component summary scores but declining mental component summary scores. Patients' expectations of returning to normal health consistently decreased (p = 0.009). CONCLUSION: Patients undergoing treatment for PJI experience significant psychological burden, with implications for quality of life and expectations of recovery. The findings underscore the importance of addressing psychological well-being in the management of PJI and emphasize the need for comprehensive care strategies that encompass both somatic and psychological dimensions.

Rasterstereographic Analysis of Lateral Shift in Patients with Lumbar Disc Herniation: A Case Control Study.

OBJECTIVE: Detection of a lateral shift (LS) in patients with diagnosed disc herniation compared to healthy controls. SUMMARY OF BACKGROUND DATA: A specific lateral shift (LS) pattern is observed in patients with disc herniation and low back pain, as shown in earlier studies. METHODS: Rasterstereography (RS) was used to investigate the LS. Thirty-nine patients with lumbar disc herniation diagnosed by radiological assessment and low back pain and/or leg pain (mean age 48.2 years, mean BMI 28.5, 28 males and 11 females) and 36 healthy controls (mean age 47.4 years, mean BMI 25.7, 25 males and 11 females) were analysed. LS, pelvic tilt, pelvic inclination, lordotic angle, and trunk torsion were assessed. RESULTS: The patient group showed a nonsignificant increase in LS, that is, 5.6 mm compared to the healthy controls with 5.0 mm (p = 0.693). However, significant differences were found between groups regarding pelvic tilt in degrees (patients 5.9°, healthy controls 2.0°; p = 0.016), trunk torsion (patients 7.5°, controls 4.5°; p = 0.017), and lordotic angle (patients 27.5°, healthy controls 32.7°; p = 0.022). The correlation between pain intensity and the FFbH-R amounted 0.804 (p = < 0.01), and that between pain intensity and the pain disability index was 0.785 (p < 0.01). DISCUSSION: Although some studies have illustrated LS with disc herniation and low back pain, the present findings demonstrate no significant increase in LS in the patient group compared to healthy controls. CONCLUSION: The patients with lumbar disc herniation did not demonstrate an increased LS compared to healthy controls. Other parameters like pelvic tilt and inclination seemed to be more suitable to identify changes in posture measured by RS in patients with low back pain or disc herniation.

The Validity of Rasterstereography: A Systematic Review.

To investigate and monitor the progression of scoliosis and other spinal deformities in patients following idiopathic scoliosis (IS), non-invasive and radiation-free techniques are recommended because of the need for repeated radiographs. In a clinical setting, spine parameters can be quickly, cheaply and easily assessed using rasterstereography (RS). To assess the validity of the radiation-free technique RS based on surface topography compared with radiographs. MEDLINE, the Cochrane Library and EMBASE were systematically searched for studies which investigate the validity of rasterstereography compared with x-ray measurements. Studies published between January 1, 1990 and July 31, 2013 in English, German and French were included. Studies dealing with magnetic resonance imaging were excluded. Twelve studies with 570 patients were included; these articles were published between 1990 and 2013. The majority of studies investigated patients with IS, but other spinal pathologies included were thoracic hyperkyphosis and Scheuermann's disease. With regard to the quality assessment criteria for the included studies, three out of twelve studies were evaluated using a twelve point scale and two used a scale with eleven points. We conclude that RS facilitates clinical practice by analysing the spinal column. It is completely radiation-free and could help to monitor scoliosis progression.

The association of Raynaud's syndrome with cisplatin-based chemotherapy - a meta-analysis.

BACKGROUND: Vasospastic disorders of the digital circulation such as the Raynaud's syndrome (RS) are known side-effects of treatment of cisplatin-based chemotherapy. The prevalence of RS in patients during treatment with cisplatin-based chemotherapy is not well-defined. OBJECTIVE: The objective of this paper was to assess the prevalence of RS in patients receiving cisplatin-based chemotherapy - a meta-analysis of published data was performed. MATERIAL AND METHODS: The PubMed database of the National Library of Medicine and ISI Web of Knowledge was used for studies dealing with RS and patients receiving cisplatin-based chemotherapy. The studies provided sufficient data to estimate the prevalence of RS in patients receiving cisplatin-based chemotherapy. A forest plot was determined by the revealed prevalences. Statistical analysis was based on methods for a random effects meta-analysis and a finite mixture model for proportions. Publication bias was investigated with the linear regression test (Egger's method). A meta-regression was conducted by the year of publication and latitude. RESULTS: 24 eligible studies, contributing data on 2749 subjects, were included in this meta-analysis. For RS in patients receiving cisplatin-based chemotherapy a pooled prevalence of 24% and 95% CI (0.175, 0.313) was obtained. A mixture model analysis found four latent classes. Statistically, publication bias was not present (p-value 0.74). The meta-regression indicated that the odds ratio increased when the latitude increased, too (p-value 0.011). CONCLUSION: Despite some heterogeneity there is a possible indication of an association between RS and patients receiving cisplatin-based chemotherapy.

The association of Raynaud syndrome with ß-blockers: a meta-analysis.

Vasospastic disorders of the digital circulation such as the Raynaud syndrome (RS) are known side effects of treatment of ß-adrenergic blockade. The prevalence of RS in patients during treatment with ß-blockers is not well defined. The objective of this meta-analysis is to assess the prevalence of RS in patients receiving ß-blockers. A literature search was performed for studies dealing with RS and patients receiving ß-blockers. The studies provided sufficient data to estimate the prevalence of RS in patients receiving ß-blockers. A total of 13 eligible studies, contributing data on 1012 individuals, were included in this meta-analysis. For RS in patients receiving ß-blockers, a pooled prevalence of 14.7% (95% confidence interval 0.076-0.236) were obtained. Statistically publication bias was not present (P = .877). Despite some heterogeneity, there is a possible indication of an association between RS and patients receiving ß-blockers.

The association of Raynaud's syndrome with carpal tunnel syndrome: a meta-analysis.

Carpal tunnel syndrome (CTS) has traditionally been included among the diseases associated with Raynaud's syndrome (RS). The prevalence of RS in patients suffering from CTS is not well defined. The objective of this paper was to assess the prevalence of RS in patients with CTS-a meta-analysis of published data was performed. The PubMed database of the National Library of Medicine and ISI Web of Knowledge was used for studies dealing with RS and CTS. The studies provided sufficient data to estimate the prevalence of RS in patients of CTS. A forest plot was determined by the revealed prevalence. Statistical analysis was based on methods for a random effects meta-analysis and a finite mixture model for proportions. Publication bias was investigated with the linear regression test (Egger's method). A meta-regression was conducted by the year of publication. Eight eligible studies, contributing data on 675 subjects, were included in this meta-analysis. For CTS, a pooled prevalence of 15.5% and 95% CI (95% CI 0.043, 0.318) were obtained. Statistically publication bias was present (P value 0.143). A mixture model analysis found five latent classes. The meta-regression indicated that the estimated prevalence increased when the year of commencement increased, too. Within the decade (1957-1967), the odds ratio increased from 1 (95% CI 1.065, 1.112) to 2.340 (95% CI 1.886, 2.903). Despite some heterogeneity, there is a possible indication of an association between RS and patients with CTS.

The association of Raynaud syndrome with thromboangiitis obliterans--a meta-analysis.

Thromboangiitis obliterans (TAO) has traditionally been included among the diseases associated with Raynaud syndrome (RS). The prevalence of RS in patients with TAO is not well defined. The objective of this meta-analysis is to assess the prevalence of RS in patients with TAO. A literature search was performed for the studies dealing with RS and TAO. The studies provided sufficient data to estimate the prevalence of RS in patients with TAO. A total of 8 eligible studies, contributing data on 851 patients, were included in this meta-analysis. For TAO, a pooled prevalence of 28.1% and 95% confidence interval ([CI] = 0.158, 0.423) were obtained. Statistically publication bias was not present (P = .232). Despite some heterogeneity, there is a possible indication of an association between RS and patients with TAO.

The association of Raynaud's syndrome with rheumatoid arthritis--a meta-analysis.

Rheumatoid arthritis (RA) has traditionally been included among the diseases associated with Raynaud's syndrome (RS). The prevalence of RS in patients with RA is not well defined. The objective of this paper was to assess the prevalence of RS in patients with RA-a meta-analysis of published data was performed. The PubMed database of the National Library of Medicine and ISI Web of Knowledge was used for studies dealing with RS and RA. The studies provided sufficient data to estimate the prevalence of RS in patients with RA. A forest plot was determined by the revealed prevalences. Statistical analysis was based on methods for a random effects meta-analysis and a finite mixture model for proportions. Publication bias was investigated with the linear regression test (Egger's method). A meta-regression was conducted by the year of publication. Twenty-eight eligible studies, contributing data on 3,730 subjects, were included in this meta-analysis. For RA, a pooled prevalence of 12.3% and 95% CI = 0.093-0.157 were obtained. A mixture model analysis found five latent classes. Statistically and graphically, publication bias was present (p = 0.031). In the meta-regression, the estimated prevalence decreased within the observation period (1977-2010) from 11.2% to 9.4%. Despite some heterogeneity, there is a possible indication of an association for RS and patients with RA.

Reproducibility of rasterstereography for kyphotic and lordotic angles, trunk length, and trunk inclination: a reliability study.

STUDY DESIGN: Determination of reliability with 3 investigators using a collective of healthy volunteers. OBJECTIVE: To determine the reliability of rasterstereography 3-dimensional back surface analysis and reconstruction of the spine in healthy test subjects. SUMMARY OF BACKGROUND DATA: Rasterstereography has been in clinical use since 1989 for patients with scoliosis and other spinal deformities and it significantly reduces the need for otherwise indispensable radiographs. The validity of this device has previously been examined in other studies. This study was performed to evaluate the reliability of rasterstereography for clinical application in diagnostic and follow-up examinations. METHODS: Fifty-one healthy volunteers were examined rasterstereographically by 3 investigators. Each investigator made a series of 3 measurements of each participant in which 8 spine parameters including kyphotic angle ICT-ITL (max.), kyphotic angle VP-ITL, kyphotic angle VP-T12, lordotic angle ITL-ILS (max.), lordotic angle ITL-DM, lordotic angle T12-DM, trunk length VP-DM and trunk inclination were measured. Cronbach alpha was calculated. The influence of high or low body mass index on the accuracy of the technique was evaluated as well. RESULTS: Cronbach alpha for the intratester-reliability of the kyphotic angle ICT-ITL (max.) for the 3 investigators has values between 0.921 and 0.992. The intertester-reliability for the same parameter is 0.979 (95% CI). In this study group a meaningful association between body mass index and reliability of the device was not found. CONCLUSION: The reliability revealed very good results, both for intratester and for intertester reliability. The technique is well suited for analysis of the back in standing position. The body mass index has no influence on the reproducibility.