RESUMEN

OBJECTIVE: Detailed assessment of activity before and after total hip arthroplasty (THA) including a long-term followup period is lacking. Our objectives were to evaluate patient activity levels prior to disease onset, prior to THA, and at 5 and 10 years after surgery, and to determine the predictors of high activity 5 years after surgery. METHODS: We included elective primary THAs performed between 1996 and 2012. A cross-sectional analysis compared mean University of California, Los Angeles (UCLA) activity scores over 4 periods: prior to symptom onset of osteoarthritis, prior to surgery, 5 years after surgery, and 10 years after surgery. Analyses of activity levels were performed and stratified by sex, age, body mass index (BMI), American Society of Anesthesiology (ASA) classes, and preoperative activity level. A prospective study was conducted to identify baseline characteristics associated with a high activity level (UCLA score ≥7) 5 years after surgery using logistic regression. RESULTS: The mean UCLA activity scores prior to symptom onset (n = 189), prior to THA (n = 203), 5 years after surgery (n = 1,085), and 10 years after surgery (n = 757) were 6.9, 3.5, 5.7, and 5.5, respectively. Postoperative scores were close to values prior to symptom onset in patients ages ≥55 years, but were lower in those who were younger. High activity was reported by 49% of patients prior to symptom onset, 5% of patients prior to surgery, and 28% of patients at both 5 and 10 years after surgery. The predictors of high activity at 5 years were younger age, male sex, a lower BMI, a lower ASA score, and an active lifestyle prior to surgery. CONCLUSION: Five and 10 years after primary THA, physical activity levels were substantially higher in men and women and in all age categories as compared to before surgery.

Asunto(s)

Artroplastia de Reemplazo de Cadera , Articulación de la Cadera/cirugía , Osteoartritis de la Cadera/cirugía , Anciano , Anciano de 80 o más Años , Fenómenos Biomecánicos , Estudios Transversales , Procedimientos Quirúrgicos Electivos , Femenino , Articulación de la Cadera/fisiopatología , Humanos , Modelos Logísticos , Estudios Longitudinales , Los Angeles , Masculino , Persona de Mediana Edad , Análisis Multivariante , Oportunidad Relativa , Osteoartritis de la Cadera/diagnóstico , Osteoartritis de la Cadera/fisiopatología , Estudios Prospectivos , Sistema de Registros , Factores de Tiempo , Resultado del Tratamiento

RESUMEN

OBJECTIVE: To assess linear growth in patients with persistent oligoarticular juvenile idiopathic arthritis (JIA) treated by intra-articular corticosteroid injections (IACSI). STUDY DESIGN: Data were obtained from a retrospective review of the charts of 95 patients with persistent oligoarticular JIA (69 females). The mean age at first visit was 4.9 ± 3.4 years, with follow-up of 6 ± 3.7 years. The height SDS for chronologic age (z-score) was correlated with the clinical course of the disease and compared among patients treated by IACSI alone (group I) or by a combination of disease-modifying antirheumatic drugs (DMARDs) (group II). RESULTS: Growth retardation was found in 35.8% of patients (Δ z-score <-0.3), including 11.6% with severe growth retardation (Δ z-score <-1.0). Growth retardation was found in a smaller proportion of patients in group I (any growth retardation, 30.6%; severe growth retardation, 6.5%) than in patients in group II (any growth retardation, 44.4%; severe growth retardation, 21.2%; P < .05). Elevated erythrocyte sedimentation rate values (≥ 40 mm/1sth) indicated a significantly higher risk for growth retardation. All other clinical variables had no association with growth retardation. CONCLUSION: A significant proportion of patients with persistent oligoarticular JIA have growth retardation and a minority have severe growth retardation. Only elevated erythrocyte sedimentation rate values were proven to be a good predictor of risk for growth retardation.

Asunto(s)

Artritis Juvenil/complicaciones , Trastornos del Crecimiento/etiología , Adolescente , Edad de Inicio , Antirreumáticos/uso terapéutico , Artritis Juvenil/tratamiento farmacológico , Sedimentación Sanguínea , Estatura , Niño , Preescolar , Femenino , Estudios de Seguimiento , Glucocorticoides/uso terapéutico , Humanos , Lactante , Inyecciones Intraarticulares , Masculino , Estudios Retrospectivos , Triamcinolona Acetonida/uso terapéutico

RESUMEN

BACKGROUND: There is growing concern about physical inactivity in adolescents and young adults. Identifying determinants that are associated with low levels of physical activity and with changes in physical activity levels will help to develop specific prevention strategies. The present study describes the prevalence and potential determinants of physical activity behavior and behavior changes of young adults. The study is based on the Swiss Household Panel (SHP), a longitudinal study assessing social changes in a representative sample of Swiss households since 1999. METHODS: Data is collected yearly using computer-assisted telephone interviews. Information is obtained from each household member over 14 years of age. Participants between 14 and 24 years entering the SHP between 1999 and 2006 were included (N = 3,068). "Inactive" was defined as less than 1 day/week of at least 30 minutes of moderate physical activity, "no sport" as exercising less than once a week. Age, gender, nationality, linguistic region, household income, education, membership in a sport club, reading, and Internet use were included as potential determinants of physical activity behavior and behavior change. RESULTS: In both young men and young women, the prevalence of inactivity, "no sport", and non-membership in a sport club was increasing with age. Women were less active than men of the same age. From one wave to the following, 11.1% of young men and 12.1% of young women became active, and 11.9% of men and 13.7% of women became inactive, respectively (pooled data over all eight waves). Non-membership in a sport club was the strongest predictor for "no sport" (OR(men )6.7 [4.9-8.9]; OR(women )8.1 [5.7-11.4]), but also for being inactive (OR 4.6 [3.5-6.0]; 4.6 [3.3-6.4]). Leaving a sport club (OR 7.8 [4.4-14.0]; 11.9 [5.9-24.1]) and remaining non-member (OR 7.8 [4.7-12.9]; 12.4 [6.4-24.1]) were the strongest predictors of becoming "no sport". Effects for becoming inactive were similar, though smaller (OR 5.9 [3.4-10.5] and 5.1 [2.7-9.6] for leaving a club, OR 5.1 [3.1-8.4] and 6.9 [4.0-11.8] for remaining non-member). CONCLUSIONS: The most important findings were the strong effects of sport club membership on general physical activity. The correlation between sport club membership and exercise was not surprising in its nature, but in its strength.