International Journal of Orthopaedic and Trauma Nursing最新文献

{"title":"Inspiratory muscle training: A theoretical framework for its selected application in orthopaedic enhancing recovery pathways","authors":"Francesco V. Ferraro ,&nbsp;Rania Edris ,&nbsp;Thomas W. Wainwright","doi":"10.1016/j.ijotn.2025.101193","DOIUrl":"10.1016/j.ijotn.2025.101193","url":null,"abstract":"<div><div>This paper explores a theoretical framework for integrating Inspiratory Muscle Training (IMT) into enhanced recovery pathways, emphasising its potential role in mitigating respiratory decline, reducing hospital stays, and improving functional mobility for selected patients. IMT has shown benefits in high-risk surgical populations, including those with chronic respiratory conditions, obesity, obstructive sleep apnea, and frailty. Standardised screening protocols involving respiratory muscle function tests are recommended to identify suitable candidates, with structured IMT programs ideally commencing 6–8 weeks before surgery. Implementing IMT within an enhanced recovery pathway may enhance the ability for early mobilisation, improve oxygenation, and support the functional recovery of patients. While IMT has demonstrated efficacy in various surgical populations, its specific benefits to orthopaedic patients require further consideration and investigation. Indeed, future research should focus on optimising IMT protocols and assessing patient outcomes in the short-term (e.g. length of stay and complications), and the medium-term (e.g. return to activities of daily living). By incorporating IMT into prehabilitation and rehabilitation protocols, we propose that healthcare systems may be able to improve surgical outcomes and patients’ well<strong>-</strong>being while reducing postoperative complications and healthcare burden for at-risk patients.</div></div>","PeriodicalId":45099,"journal":{"name":"International Journal of Orthopaedic and Trauma Nursing","volume":"58 ","pages":"Article 101193"},"PeriodicalIF":1.5,"publicationDate":"2025-05-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144154742","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}

{"title":"Evaluating pressure injury and time of risk assessment for adults with hip fractures: A retrospective analysis","authors":"Penelope Anderson ,&nbsp;Huaqiong Zhou ,&nbsp;Vicki Patton ,&nbsp;John Taplin","doi":"10.1016/j.ijotn.2025.101195","DOIUrl":"10.1016/j.ijotn.2025.101195","url":null,"abstract":"<div><h3>Background</h3><div>Pressure injuries are a worldwide concern for patients in the acute hospital setting. They are a common hospital-acquired complication and Australian national standards, state policies, and local procedures have been developed to reduce incidence. Risk assessment is purported to be the gold standard in prevention.</div><div>This study examined the association between the time of pressure injury risk assessment, the presence of a pressure injury prevention management plan, and the development of hospital-acquired pressure injury(s) in the high-risk cohort of hip fracture patients at a regional base hospital in New South Wales.</div></div><div><h3>Method</h3><div>A retrospective descriptive study was conducted from routinely collected data, extracted from the electronic medical record and the incident management system. Patients with hospital-acquired pressure injuries were matched to those without and comparisons were made.</div></div><div><h3>Results</h3><div>Four hundred and eighty patients presented with a primary diagnosis of hip fracture. Twenty-four (5 %) developed at least one pressure injury during admission. Eight (33 %) of the study group and four (16.5 %) of the comparison group had a risk assessment completed within 8 h per hospital procedure. There was no correlation between risk assessment within 8 h and development of a pressure injury. Patients who developed pressure injuries were older than those who did not (mean 86 vs 80 years, p = 0.021).</div></div><div><h3>Conclusion</h3><div>There was no correlation between early pressure injury risk assessment and pressure injury development for hip fracture patients. Formal risk assessment by nurses did not prevent pressure injuries in patients with high-risk presentation of hip fracture. Maximum prevention strategies should be routinely implemented by nurses.</div></div>","PeriodicalId":45099,"journal":{"name":"International Journal of Orthopaedic and Trauma Nursing","volume":"58 ","pages":"Article 101195"},"PeriodicalIF":1.5,"publicationDate":"2025-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144167243","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}

{"title":"Patient experiences after surgically treated periprosthetic knee fracture in the distal femur – an explorative qualitative study","authors":"S.K. Risager ,&nbsp;T.A. Pedersen ,&nbsp;B. Viberg ,&nbsp;A. Odgaard ,&nbsp;M. Lindberg-Larsen ,&nbsp;C. Abrahamsen","doi":"10.1016/j.ijotn.2025.101194","DOIUrl":"10.1016/j.ijotn.2025.101194","url":null,"abstract":"<div><h3>Background</h3><div>Periprosthetic knee fractures (PPKF) following total knee arthroplasty (TKA) are rare, but represents a potentially devastating complication. A significant gap in understanding patient experiences related to the surgical treatment and recovery process remains.</div></div><div><h3>Objective</h3><div>The aim of the study was to explore patients' experiences 3–4 months after surgical treatment of a PPKF in the distal femur.</div></div><div><h3>Method</h3><div>This exploratory qualitative study employed semi-structured, open-ended interviews with patients who had undergone surgical treatment for PPKF in the distal femur. Patients were recruited during hospitalization or at follow-up visits, with all approached individuals consenting to participate. Interviews were conducted three to four months post-surgery and data were analyzed thematically.</div></div><div><h3>Results</h3><div>Nine patients were interviewed between spring 2023 and spring 2024. The analysis yielded three themes: 1) Patient expectations of the recovery process, 2) Patient concerns – and consequently a desire for follow-up and information, and 3) The impact of recovery on independence and social life. Each theme was further illuminated with subthemes.</div></div><div><h3>Conclusion</h3><div>This study highlights the major challenges of recovering from PPKFs in the distal femur, including physical pain, psychological stress, and social disruption. Unlike elective TKAs, the sudden nature of PPKFs leaves patients unprepared for the lengthy recovery process, which often leads to frustration and isolation. Dependence on family for daily tasks can intensify the feeling of being a burden. To enhance patients’ recovery experiences and outcomes, clear communication and realistic expectations are essential in addressing these issues.</div></div>","PeriodicalId":45099,"journal":{"name":"International Journal of Orthopaedic and Trauma Nursing","volume":"58 ","pages":"Article 101194"},"PeriodicalIF":1.5,"publicationDate":"2025-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144115048","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}

{"title":"To lose weight or to weight the loss? Insights into the use of the body mass index in preoperative assessment before major orthopaedic surgery","authors":"Matteo Briguglio ,&nbsp;Marialetizia Latella ,&nbsp;Claudio Cordani ,&nbsp;Stefano Petrillo ,&nbsp;Francesco Langella ,&nbsp;Riccardo Cecchinato ,&nbsp;Pedro Berjano ,&nbsp;Fabrizio E. Pregliasco ,&nbsp;Robert G. Middleton ,&nbsp;Thomas W. Wainwright","doi":"10.1016/j.ijotn.2025.101192","DOIUrl":"10.1016/j.ijotn.2025.101192","url":null,"abstract":"<div><div>The ERAS (Enhanced Recovery After Surgery) guidelines in major orthopaedic surgery do not address the issue of managing excess body weight in patients scheduled for hip and knee replacement or lumbar fusion. This aspect is relevant to practice due to the increasing number of obese individuals and to some evidence suggesting higher complication rates in patients with excess weight. There is a debate on whether obesity defined by the body mass index, i.e. the ratio of weight to squared height, can guide surgical eligibility and whether losing excess weight preoperatively can actually lead to better outcomes. In this practice development article, we explore opposing perspectives on the value of a high BMI as an indicator of increased preoperative risk and discuss the potential consequences of losing weight prior to a major orthopaedic surgery. The aim is to promote a conscious management of individuals with excess body fat based on the patient's overall health rather than BMI alone. In the absence of strong evidence on what is best to do, it is reasonable to suggest that any prehabilitation initiatives should not focus on a rigid weight loss mandate but on a multidisciplinary, multimodal, and personalised approach that does not necessarily include a reduction in body weight.</div></div>","PeriodicalId":45099,"journal":{"name":"International Journal of Orthopaedic and Trauma Nursing","volume":"58 ","pages":"Article 101192"},"PeriodicalIF":1.5,"publicationDate":"2025-05-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144098463","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}

{"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":"https://doi.org/10.1016/j.ijotn.2025.101188","url":null,"abstract":"","PeriodicalId":45099,"journal":{"name":"International Journal of Orthopaedic and Trauma Nursing","volume":" ","pages":"101188"},"PeriodicalIF":1.5,"publicationDate":"2025-05-15","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}

{"title":"Summary of best evidence for secondary fracture prevention in postmenopausal osteoporosis patients","authors":"Chenghui Li ,&nbsp;Haiyan Gu ,&nbsp;Tingting Wang ,&nbsp;Qin Xuan ,&nbsp;Hong Gao","doi":"10.1016/j.ijotn.2025.101190","DOIUrl":"10.1016/j.ijotn.2025.101190","url":null,"abstract":"<div><h3>Objective</h3><div>To evaluate and summarize the available evidence for secondary fracture prevention of postmenopausal osteoporosis and provide reference for clinical practice.</div></div><div><h3>Methods</h3><div>UpToDate, BMJ Best Practice, Joanna Briggs Institute, Guidelines International Network, National Guideline Clearing-house, Scottish Intercollegiate Guidelines Network, National Institute for Health and Care Excellence, Yi Mai tong Guidelines Network, the Cochrane Library, PubMed, Web of Science, Embase, SinoMed, CNKI, VIP and Wan Fang database were searched from January 2015 to February 2025. Literature types included clinical decision-making, best practices, guidelines, expert consensus, systematic reviews, evidence summaries and original research.</div></div><div><h3>Results</h3><div>28 literature were included, including 9 guidelines, 6 expert consensus, 6 systematic reviews and 7 randomized controlled trials. The study summarized 20 pieces of evidence on exercise safety, environmental safety, nutrition safety, medication safety, and health education.</div></div><div><h3>Conclusion</h3><div>The 20 recommended pieces of evidence for secondary fracture prevention of postmenopausal osteoporosis offer an evidence-based guide for nurses. However, cultural factors should be considered before applying these internationally sourced recommendations.</div></div>","PeriodicalId":45099,"journal":{"name":"International Journal of Orthopaedic and Trauma Nursing","volume":"58 ","pages":"Article 101190"},"PeriodicalIF":1.5,"publicationDate":"2025-05-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144115049","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}

{"title":"The effect of preoperative education on fear of first mobilization experienced after total knee arthroplasty in individuals","authors":"Ayşegül Kaya İmrek ,&nbsp;Meryem Yilmaz","doi":"10.1016/j.ijotn.2025.101189","DOIUrl":"10.1016/j.ijotn.2025.101189","url":null,"abstract":"<div><h3>Objective</h3><div>Total knee arthroplasty is a surgical intervention performed to reduce pain and movement restriction resulting from advanced joint deformity in individuals diagnosed with osteoarthritis, and to improve their quality of life and functionality. Meeting the preoperative educational needs of individuals undergoing total knee arthroplasty positively impacts postoperative recovery, mobilization, and rehabilitation. In this context, this study was conducted to determine the effect of preoperative education on fear of mobilization experienced after surgery in individuals who have undergone total knee arthroplasty.</div></div><div><h3>Materials and methods</h3><div>This study, was conducted using a single-group pre-test-post-test model, included 36 individuals who underwent total knee arthroplasty. Data were collected preoperatively and postoperatively using a questionnaire, a fear of falling and fall history assessment form, a Visual Analog Scale-10 (VAS-10), and a fall information exchange form.</div></div><div><h3>Results</h3><div>The average age of the 36 participants (27 women [75 %]; 9 men [25 %]) was 65.56 ± 4.39 years. The pre-education level of fear was 5.09 ± 1.57, the post-education level of fear was 3.73 ± 0.68, and the level of fear of pre-mobilization was 4.08 ± 0.81. A statistically significant difference was found between the pre-education and post-education level of fear of mobilization (t = 8.324, p = 0.000), between the post-education level and the level of fear before the first mobilization (t = −22.293, p = 0.000). However, it should be noted that fear of mobilization slightly increased during the postoperative first mobilization compared to after education; this may be related to patients' fear of mobilization, pain or anxiety.</div></div><div><h3>Conclusion</h3><div>The results of this study show that preoperative education provided to individuals undergoing total knee arthroplasty has positive effects on reducing fear of first mobilization experienced after surgery.</div></div>","PeriodicalId":45099,"journal":{"name":"International Journal of Orthopaedic and Trauma Nursing","volume":"57 ","pages":"Article 101189"},"PeriodicalIF":1.5,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143942404","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}

{"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 ,&nbsp;Elizabeth Puze ,&nbsp;Kendal Sands ,&nbsp;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}

{"title":"Feasibility of repeated early mobilization in orthostatic intolerance after total hip arthroplasty","authors":"Mikkel Nicklas Frandsen ,&nbsp;Jesper Mehlsen ,&nbsp;Claus Varnum ,&nbsp;Martin Lindberg-Larsen ,&nbsp;Nicolai Bang Foss ,&nbsp;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}

{"title":"Ijotn 101184:Response letter to comment letter of YJOON-D-24-00130.","authors":"Lingli Peng, Chun Huang","doi":"10.1016/j.ijotn.2025.101184","DOIUrl":"https://doi.org/10.1016/j.ijotn.2025.101184","url":null,"abstract":"","PeriodicalId":45099,"journal":{"name":"International Journal of Orthopaedic and Trauma Nursing","volume":" ","pages":"101184"},"PeriodicalIF":1.5,"publicationDate":"2025-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144003724","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}