Biomedical subjects

L A Beaupré

Publications and source records attributed to L A Beaupré.

3 recordsLinked to original sources

PubMed2001

Exercise combined with continuous passive motion or slider board therapy compared with exercise only: a randomized controlled trial of patients following total knee arthroplasty.

BACKGROUND AND PURPOSE: The primary purpose of this randomized controlled trial was to determine which method of mobilization - (1) standardized exercises (SE) and continuous passive motion (CPM), (2) SE and slider board (SB) therapy, using an inexpensive, nontechnical device that requires minimal knee active range of motion (ROM), or (3) SE alone-achieved the maximum degree of knee ROM in the fIrst 6 months following primary total knee arthroplasty (TKA). The secondary purpose was to compare health-related quality of life among these 3 groups. SUBJECTS: The subjects were 120 patients (n=40/group) who received a TEA at a teaching hospital between June 1997 and July 1998 and who agreed to participate in the study. METHODS: Subjects were examined preoperatively, at discharge, and at 3 and 6 months after surgery. The examination consisted of measurement of knee ROM and completion of the Western Ontario and McMaster Universities (WOMAC) Osteoarthritis Index and the Medical Outcomes Study 36-Item Short-Form Health Survey (SF-36). RESULTS: The 3 treatment groups were similar with respect to age, sex, and diagnosis at the start of the study. There were no differences in knee ROM or in WOMAC Osteoarthritis Index or SF-36 scores at any of the measurement intervals. The rate of postoperative complications also was not different among the groups. DISCUSSION AND CONCLUSION: When postoperative rehabilitation regimens that focus on early mobilization of the patient are used, adjunct ROM therapies (CPM and SB) that are added to daily SE sessions are not required. Six months after TEA, patients attain a satisfactory level of knee ROM and function.

Activities of Daily Living↗

PubMed2001

Standard anatomical medullary locking (AML) versus tricalcium phosphate-coated AML femoral prostheses.

OBJECTIVES: To compare the preliminary rate and amount of bony ingrowth and calcar resorption between patients receiving either a standard anatomical medullary locking (AML) or a tricalcium phosphate (TCP)-coated AML femoral prosthesis and to compare preliminary clinical results. DESIGN: A prospective, randomized, double-blind clinical trial. SETTING: An acute care tertiary institution. PATIENTS: Between January 1993 and March 1995, 92 patients underwent primary total hip arthroplasty (THA). They were randomized to 2 groups of 46--a control group or a treatment group. Of the 46 subjects enrolled in each group, no significant differences were seen preoperatively with respect to age, sex, diagnosis, clinical and radiographic assessment. Seventy-one patients were followed up for 24 months. INTERVENTIONS: Insertion of either a standard AML femoral implant (control group) or a TCP-coated AML femoral implant (treatment group). OUTCOME MEASURES: The degree of hypertrophy, calcar atrophy and the number of spot welds on standard postoperative radiographs at 6, 12 and 24 months. Clinically, assessment according to the Société internationale de chirurgie orthopédique et de traumatologie (SICOT) scale and a 100-point visual analogue scale (VAS) for pain. RESULTS: There were no prosthetic stem revisions in either group at the 24-month follow-up. Radiographically, bony ingrowth was not significantly different in the TCP-coated stem, by chi2 analysis of the degree of hypertrophy and number of spot welds present. Also by chi2 analysis, the degree of calcar atrophy was not significantly different between groups. The mean VAS score for pain at 24 months was 12.5 for the control and 12.1 for the treatment group. No significant differences were seen in any of the clinical categories of the SICOT Scale over the 24-month interval. CONCLUSION: The objective of TCP-coating--to increase the rate and amount of bony ingrowth while reducing the rate of calcar resorption in non-cemented THA--was not achieved by 24 months postoperatively in our study.

Arthroplasty, Replacement, Hip↗

PubMed1999

Reducing arthroplasty costs via vendor contracts.

OBJECTIVE: To describe a method of reducing the costs of implants in hip and knee arthroplasty. DESIGN: Implant costs were compared before and after the implementation of a 2-year contract with implant vendors, providing increased volume for decreased implant cost. An additional 20% of arthroplasties could be done outside the contract for research or special purposes. SETTING: A regional health authority involving 2 acute care hospitals. METHOD: Costs were obtained for 942 hip and knee arthroplasties performed in 1993/94 and compared with costs of 1656 hip and knee arthroplasties performed in 1996/97. OUTCOME MEASURES: Implant cost and number of joint arthroplasty procedures performed. RESULTS: A 40% decrease in the cost per implant for primary knee arthroplasty and an 18% decrease in the cost per implant for primary hip arthroplasty were achieved. A rebate, calculated as a percentage of volume used, was received from the vendor to support general orthopedic research and education. A new contract for 3 years has recently been signed with 3 vendors designated as primary vendors for 80% of the volume. CONCLUSION: The vendor-contract economic strategy effectively reduced the cost of hip and knee arthroplasty and may be useful at other centres looking for cost reduction methods that maintain adequate patient care and support clinical research and education.

Arthroplasty, Replacement, Hip↗