Orthopaedic surgeons typically use two tests to determine if a patient has recovered from hip surgery: one is a clinical measure of hip function given by the doctor, and the second is a questionnaire patients answer that considers a wide variety of factors in determining the overall success of the surgical procedure.
"We started out simply looking to see if the results of the two tests were correlated; the one doctors give has been used for decades to evaluate hip function, and the other that the patient answers is much newer," says Berton Moed, M.D., chair of the department of orthopaedic surgery at Saint Louis University School of Medicine. "What we found was surprising - the clinical test found good-to-excellent results, while the self-test taken by the same patients showed significantly worse recovery."
The disparity, says Moed, can be explained by a section of questions on the self-test not addressed by the clinical test: those dealing with emotional well-being. A patient's emotional status was the second-most important factor in determining how well he or she thought recovery was going, Moed found. (Mobility was the first.)
"Patients come in for check-ups after their hip surgery and the doctor says, 'Looks like you're doing fabulously,' and they respond, 'No, I'm not. I ache,'" Moed says. "They're not doing well, but why? It appears to have a lot to do with their emotional state. It's the elephant in the exam room - that is, something doctors need to acknowledge is a real issue."
Rather than retool the established clinical test to include an emotional component, Moed says orthopaedic surgeons should make efforts to use both exams for a more comprehensive measure of the patient's recovery.
"Do we need to look at other interventions besides fixing their hip? I think we might have to," he says. "That could include bringing in social workers and psychologists to work with the patients in the areas that surgeons, who often are super subspecialists, may not be able to deal with."
Moed says both underlying depression and new depression brought on by the injury and/or surgery could be to blame for slowing a patient's recovery.
"When an active person is suddenly confined to the bed or to limited activity, it can take a toll," Moed says. "Not being able to do the things one used - and feeling powerless over it - may play a larger role than we thought in how well the patient feels they're recovering."
While Moed says some patients may be taken aback by the suggestion that they see a psychologist after surgery, he thinks developing better and more customized treatment plans has the potential to help patients recover more fully - and not just after hip surgery.
"The number one issue is recognition - we need to acknowledge that there's more going on with patients than what current clinical tests tell us," he says.
Moed and fellow researchers studied 46 patients who had been followed for at least two years after elementary posterior wall fracture surgery. The research is published in the June issue of the Journal of Bone and Joint Surgery.
Established in 1836, Saint Louis University School of Medicine has the distinction of awarding the first medical degree west of the Mississippi River. The school educates physicians and biomedical scientists, conducts medical research, and provides health care on a local, national and international level. Research at the school seeks new cures and treatments in five key areas: cancer, liver disease, heart/lung disease, aging and brain disease, and infectious disease.
Rachel Otto Dixon | EurekAlert!
3D images of cancer cells in the body: Medical physicists from Halle present new method
16.05.2018 | Martin-Luther-Universität Halle-Wittenberg
Better equipped in the fight against lung cancer
16.05.2018 | Friedrich-Alexander-Universität Erlangen-Nürnberg
At the LASYS 2018, from June 5th to 7th, the Laser Zentrum Hannover e.V. (LZH) will be showcasing processes for the laser material processing of tomorrow in hall 4 at stand 4E75. With blown bomb shells the LZH will present first results of a research project on civil security.
At this year's LASYS, the LZH will exhibit light-based processes such as cutting, welding, ablation and structuring as well as additive manufacturing for...
There are videos on the internet that can make one marvel at technology. For example, a smartphone is casually bent around the arm or a thin-film display is rolled in all directions and with almost every diameter. From the user's point of view, this looks fantastic. From a professional point of view, however, the question arises: Is that already possible?
At Display Week 2018, scientists from the Fraunhofer Institute for Applied Polymer Research IAP will be demonstrating today’s technological possibilities and...
So-called quantum many-body scars allow quantum systems to stay out of equilibrium much longer, explaining experiment | Study published in Nature Physics
Recently, researchers from Harvard and MIT succeeded in trapping a record 53 atoms and individually controlling their quantum state, realizing what is called a...
The historic first detection of gravitational waves from colliding black holes far outside our galaxy opened a new window to understanding the universe. A...
A team led by Austrian experimental physicist Rainer Blatt has succeeded in characterizing the quantum entanglement of two spatially separated atoms by observing their light emission. This fundamental demonstration could lead to the development of highly sensitive optical gradiometers for the precise measurement of the gravitational field or the earth's magnetic field.
The age of quantum technology has long been heralded. Decades of research into the quantum world have led to the development of methods that make it possible...
02.05.2018 | Event News
13.04.2018 | Event News
12.04.2018 | Event News
22.05.2018 | Life Sciences
22.05.2018 | Earth Sciences
22.05.2018 | Trade Fair News