Rebecca Willis , Rania Edris , Sally Akehurst , Francesco V. Ferraro
{"title":"Do pre- and post- rehabilitation influence hospital length of stay and patient recovery following total hip replacement in the UK? A systematic scoping review and Delphi study","authors":"Rebecca Willis , Rania Edris , Sally Akehurst , Francesco V. Ferraro","doi":"10.1016/j.ijotn.2025.101209","DOIUrl":"10.1016/j.ijotn.2025.101209","url":null,"abstract":"<div><div>Pre-operative rehabilitation is an effective means of reducing Length of Stay (LoS), but little evidence is available on its influence on Total Hip Replacement (THR) patients. Hence, a review of UK-based experimental studies to evaluate the effect of physical therapy on LoS was performed. Subsequently, a narrative synthesis was employed to develop a three-round Delphi study targeting UK clinicians. The review and Delphi results showed that patients had higher satisfaction with education clinics, but nurse-led assessment and physiotherapist education were not superior to standard pre-operative practices. The Delphi highlighted the challenges and benefits of (p)rehabilitation and provided suggestions for THR best practices. In conclusion, the study shows that there is a lack of evidence on the effectiveness of (p)rehabilitation on LoS; further research is recommended into education, (p)rehabilitation and patient self-efficacy interventions to enhance THR patients' pathways.</div></div>","PeriodicalId":45099,"journal":{"name":"International Journal of Orthopaedic and Trauma Nursing","volume":"58 ","pages":"Article 101209"},"PeriodicalIF":1.5,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144312715","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}
Matteo Briguglio , Marialetizia Latella , Claudio Cordani , Stefano Petrillo , Francesco Langella , Riccardo Cecchinato , Pedro Berjano , Fabrizio E. Pregliasco , Robert G. Middleton , Thomas W. Wainwright
{"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 , Marialetizia Latella , Claudio Cordani , Stefano Petrillo , Francesco Langella , Riccardo Cecchinato , Pedro Berjano , Fabrizio E. Pregliasco , Robert G. Middleton , 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":"2025-08-01","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}
S.K. Risager , T.A. Pedersen , B. Viberg , A. Odgaard , M. Lindberg-Larsen , C. Abrahamsen
{"title":"Patient experiences after surgically treated periprosthetic knee fracture in the distal femur – an explorative qualitative study","authors":"S.K. Risager , T.A. Pedersen , B. Viberg , A. Odgaard , M. Lindberg-Larsen , 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":"2025-08-01","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}
Chenghui Li , Haiyan Gu , Tingting Wang , Qin Xuan , Hong Gao
{"title":"Summary of best evidence for secondary fracture prevention in postmenopausal osteoporosis patients","authors":"Chenghui Li , Haiyan Gu , Tingting Wang , Qin Xuan , 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":"2025-08-01","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}
Sonya Clarke, Shareena Bibi Mohd Arif, Carmen Queiros
{"title":"LITERATURE REVIEWS – Advancing orthopedic and trauma care through high-quality and evidence-based nursing: Impact on patient outcomes and professional practices","authors":"Sonya Clarke, Shareena Bibi Mohd Arif, Carmen Queiros","doi":"10.1016/j.ijotn.2025.101197","DOIUrl":"10.1016/j.ijotn.2025.101197","url":null,"abstract":"","PeriodicalId":45099,"journal":{"name":"International Journal of Orthopaedic and Trauma Nursing","volume":"58 ","pages":"Article 101197"},"PeriodicalIF":1.5,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144242896","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}
Najaf Ahmed Rajpar , Sanya Ashraf Khaskheli , Sabahat Ul Ain Munir Abbasi , Aamna Rehman , Muhammad Salman Nadeem , Hajira Arooj
{"title":"“Collagenase injections versus limited fasciectomy in treating patients with Dupuytren's contracture: A systematic review and meta-analysis”","authors":"Najaf Ahmed Rajpar , Sanya Ashraf Khaskheli , Sabahat Ul Ain Munir Abbasi , Aamna Rehman , Muhammad Salman Nadeem , Hajira Arooj","doi":"10.1016/j.ijotn.2025.101211","DOIUrl":"10.1016/j.ijotn.2025.101211","url":null,"abstract":"<div><h3>Background</h3><div>Dupuytren's contracture is a progressive disorder characterized by palmar fascia thickening, leading to nodules and cords formation. Limited fasciectomy (LF) is the standard surgical treatment, while Collagenase Clostridium Histolyticum (CCH) injection offers a minimally invasive alternative. Despite multiple studies, the comparative efficacy and safety of these approaches remain debated.</div></div><div><h3>Purpose</h3><div>To compare the effectiveness and safety of CCH and LF by analyzing change in extension deficit (ED), recurrence rate, residual contracture, Michigan Hand Questionnaire (MHQ) score, and complications.</div></div><div><h3>Study design</h3><div>Systematic review and meta-analysis of randomized controlled trials (RCTs) and observational studies.</div></div><div><h3>Methods</h3><div>A systematic search was conducted in PubMed, EMBASE, Cochrane, and Scopus. The review followed PRISMA guidelines for transparent reporting. Fifteen studies (RCTs and observational) comparing CCH and LF were included. Data were extracted on MHQ score, change in ED, recurrence rate, residual contracture, and complications. Meta-analysis was performed using RevMan 5.4. Heterogeneity was assessed using Higgins' I<sup>2</sup>. Risk of bias was evaluated with the Newcastle-Ottawa Scale and RoB-2 tool, while certainty of evidence was assessed using GRADEPro.</div></div><div><h3>Results</h3><div>LF resulted in a significantly lower change in ED and lower recurrence rate compared to CCH. However, CCH had higher residual contracture and a lower complication rate. MHQ score improvements were comparable between groups.</div></div><div><h3>Conclusions</h3><div>LF is superior in reducing recurrence and residual contracture but has a higher complication rate. CCH yields greater change in ED. Further research is needed to refine treatment strategies.</div></div>","PeriodicalId":45099,"journal":{"name":"International Journal of Orthopaedic and Trauma Nursing","volume":"58 ","pages":"Article 101211"},"PeriodicalIF":1.5,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144580367","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}
Francesco V. Ferraro , Rania Edris , Thomas W. Wainwright
{"title":"Inspiratory muscle training: A theoretical framework for its selected application in orthopaedic enhancing recovery pathways","authors":"Francesco V. Ferraro , Rania Edris , 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":"2025-08-01","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}
Rong Yan , Wei Liu , Yan He , Xuedan Li , Jie Luo , Huiwen Wang , Suyun Li
{"title":"Development and reliability testing of a symptom assessment scale for postoperative patients with adolescent idiopathic scoliosis","authors":"Rong Yan , Wei Liu , Yan He , Xuedan Li , Jie Luo , Huiwen Wang , Suyun Li","doi":"10.1016/j.ijotn.2025.101213","DOIUrl":"10.1016/j.ijotn.2025.101213","url":null,"abstract":"<div><h3>Background</h3><div>Patients with adolescent idiopathic scoliosis (AIS) often experience pain, fatigue, decreased appetite, anxiety and depression, etc. Previous studies have focused on investigating a single symptom in patients with AIS, ignoring possible synergistic effects between symptoms, or using self-administered questionnaires that have not been scientifically evaluated.</div></div><div><h3>Aims</h3><div>To develop a symptom assessment scale for postoperative patients with AIS and test its reliability and validity.</div></div><div><h3>Methods</h3><div>Using the symptom experience model as the theoretical framework, we constructed a bank of scale items based on literature review and semi-structured interviews; formed the initial scale after 2 rounds of expert correspondence; and supplemented the descriptive definitions of each item through pre-surveys. To test the reliability of the scale, 175 postoperative AIS patients attending the department of spine and orthopedics in a tertiary hospital in Wuhan city were conveniently selected for a formal survey.</div></div><div><h3>Results</h3><div>The scale consisted of 24 items, and 5 common factors were extracted by exploratory factor analysis, with a cumulative variance contribution rate of 67.982 %; the content validity index of the scale was 0.875, and the content validity index of the items was 0.800–1.000; the overall Cronbach's α coefficient of the scale was 0.878, the folding reliability was 0.836, and the retest reliability was 0.947.</div></div><div><h3>Conclusions</h3><div>The symptom assessment scale for postoperative patients with AIS has demonstrated adequate reliability and validity, thus serving as a valid instrument for evaluating the postoperative symptom experience of patients with AIS.</div></div>","PeriodicalId":45099,"journal":{"name":"International Journal of Orthopaedic and Trauma Nursing","volume":"58 ","pages":"Article 101213"},"PeriodicalIF":1.5,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144713754","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":"Determination of the discharge education needs of patients with day hand surgery operation in Turkey","authors":"Ufuk Burak Karcioglu , Gonul Bodur","doi":"10.1016/j.ijotn.2025.101208","DOIUrl":"10.1016/j.ijotn.2025.101208","url":null,"abstract":"<div><h3>Aim</h3><div>The research was conducted to identify the discharge education needs of patients undergoing day surgery for hand surgery.</div></div><div><h3>Method</h3><div>This descriptive and cross-sectional study included patients who underwent day surgery for hand conditions, both emergency and elective, over the course of a year at public hospitals under the Istanbul Provincial Health Directorate, specifically in the Department of Hand Surgery on the European side of Istanbul. The total patient count was 1195. The study sample consisted of 100 patients, determined using the G Power analysis method with an effect size of 2.25, a significance level (α) of 0.05, and a power of 90 %. Data were collected using a \"Patient Identification Form\" and \"The Patient Learning Needs Scale,\" both developed by the researcher.</div></div><div><h3>Results</h3><div>The average age of the patients participating in the study was 41.59 ± 15.53, with the majority being male (55.39 %), married (62.31 %), unemployed (53.85 %), and without chronic diseases (75.38 %). The average score of the \"Patient Learning Needs Scale\" for day surgery hand patients was 156.461 ± 12.133, with the highest average scores in the sub-dimensions \"Treatment and Complications\" being 32.62 ± 3.75. A significant relationship was found between age and the \"Treatment and Complications\" sub-dimension of the PLNS, with a correlation of 0.103 (r = 0.103; p < 0.05). It was determined that male patients had greater learning needs regarding skin care (p < 0.05), and statistically significant differences were found among the educational levels in the sub-dimensions of \"Activities of Daily Living\" \"Community and Follow-up,\" and \"Skin Care\" of the PLNS (p < 0.05). The educational needs of employed patients were higher in all sub-dimensions except \"Treatment and Complications\" and the total score of the scale, with a statistically significant difference found in the \"Situation-Related Emotions\" sub-dimension. Patients who applied to the emergency department had a higher average total score on the PLNS.</div></div><div><h3>Conclusion</h3><div>It has been determined that patients undergoing day surgery for hand surgery have educational needs regarding treatment and complications, medications, skin care, quality of life, and home care during the discharge process. It is recommended that discharge education programs be increased to consider the needs of the patients.</div></div>","PeriodicalId":45099,"journal":{"name":"International Journal of Orthopaedic and Trauma Nursing","volume":"58 ","pages":"Article 101208"},"PeriodicalIF":1.5,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144365252","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}