How did the treatment modalities effect the kinesiophobia for the treatment of unstable intertrochanteric fractures? Retrospective clinical trial.

Yıl 2021, Cilt: 2 Sayı: 2, 144 - 149, 15.09.2021

Kerim Öner , Ahmet Emre Paksoy

Öz

ABSTRACT
How did the treatment modalities effect the kinesiophobia for the treatment of unstable intertrochanteric fractures? Retrospective clinical trial.
Objectives: Kinesiophobia is the fear of pain and re-injury resulting from movement. It may occure after surgery and affect functional outcomes and patient comfort. In this study, we compared fixation with proximal femoral nail antirotation (PFNA) and hemiarthroplasty, which are two essential methods in treating geriatric unstable intertrochanteric femur fractures, by performing functional evaluation and kinesiophobia measurement.
Patients and Methods: Patients who were treated with PFNA or hemiarthroplasty for AO 31A2 hip fracture in our clinic between January 2017 and May 2019 were retrospectively evaluated. A total of 72 patients (age range 60-89, mean age 75.2 ± 7.7 years) with at least 1 year follow-up were included in the study. Functional evaluation of the patients was done with the Harris Hip Score (HHS), pain evaluation was performed with the Numerical Rating Scale (NRS), and the kinesiophobia measurement was carried out with the Tampa Scale (TSK).
Results: The mean TSK scores in the PFNA and hemiarthroplasty groups were 47.9±4.9 (95% CI 46.4-49.5) and 51.7±5.7 (95% CI 49.6-53.4), respectively (p<0.05). On the other hand, while the mean HHS was 89.1±3.7 (95% CI 87.2-90.3) in the PFNA group, it was 86.2±4.1 (95% CI 84.8-87.6) in the hemiarthroplasty group (p<0.05). The NRS score was 2.81±2.62 in the PFNA group and 3.11±2.81 in the hemiarthroplasty group (p=0.672). There was no correlation between age and TSK, NRS, or HHS scores (p=0.316). However, a significant negative correlation was observed between the HHS and TSK scores (r=-0.77, p<0.01).
Conclusion: Although hemiarthroplasty allows for early mobilization in geriatric unstable intertrochanteric femur fractures, it is associated with higher kinesiophobia levels. Compared to a hemiarthroplasty, fixation with PFNA is more advantageous regarding functional outcomes and kinesiophobia.
Level of evidence: 4, Case-series (and poor-quality cohort and case-control studies)

Anahtar Kelimeler

ıntertrochanteric fractures, Hemiarthroplasty, Kinesiophobia and PFNA, Pain

Kaynakça

• Huang X, Leung F, Liu M, Chen L, Xu Z, Xiang Z. Is helical blade superior to screw design in terms of cut-out rate for elderly trochanteric fractures? A meta-analysis of randomized controlled trials. Eur J Orthop Surg Traumatol 2014;24(8):1461–8.
• Keene GS, Parker MJ, Pryor GA. Mortality and morbidity after hip fractures. Br Med J 1993;307:1248–60. Keene GS, Parker MJ, Pryor GA. Mortality and morbidity after hip fractures. Br Med J 1993;307:1248–60.
• Brunner LC, Eshilian-Oates L, Kuo TY. Hip fractures in adults. Am Fam Physician 2003; 67(3):537–42.
• Ossendorf C, Scheyerer MJ, Wanner GA, Simmen HP, Werner CML. Treatment of femoral neck fractures in elderly patients over 60 years of age - which is the ideal modality of primary joint replacement? Patient Saf Surg 2010;4(1):1–8.
• Jolly A, Bansal R, More AR, Pagadala MB. Comparison of complications and functional results of unstable intertrochanteric fractures of femur treated with proximal femur nails and cemented hemiarthroplasty. J Clin Orthop Trauma 2019;10(2):296–301.
• Yoo J Il, Ha YC, Lim J young, Kang H, Yoon BH, Kim H. Early rehabilitation in elderly after arthroplasty versus internal fixation for unstable intertrochanteric fractures of femur: A systematic review and meta-analysis. J Korean Med Sci 2017;32(5):858–67.
• Kumar P, Rajnish RK, Sharma S, Dhillon MS. Proximal femoral nailing is superior to hemiarthroplasty in AO/OTA A2 and A3 intertrochanteric femur fractures in the elderly: a systematic literature review and meta-analysis. Int Orthop 2020;44(4):623–33.
• Kori SH, Miller RP, Todd DD. Kinesophobia: a new view of chronic pain behaviour. PainManage 1990; 3: 35–43.
• Ferrari S, Striano R, Lucking E, Pillastrini P, Monticone M, Vanti C. Does the awareness of having a lumbar spondylolisthesis influence self-efficacy and kinesiophobia? A retrospective analysis. Arch Physiother 2019;9(1):1–7.
• Bilgin S, Cetin H, Karakaya J, Kose N. Multivariate Analysis of Risk Factors Predisposing to Kinesiophobia in Persons With Chronic Low Back and Neck Pain. J Manipulative Physiol Ther 2019; 42(8):565–571.
• De Vroey H, Claeys K, Shariatmadar K, Weygers I, Vereecke E, Van Damme G. et al. High Levels of Kinesiophobia at Discharge from the Hospital May Negatively Affect the Short-Term Functional Outcome of Patients Who Have Undergone Knee Replacement Surgery. J Clin Med 2020; 9(3):738.
• İnal Ö, Aras B, Salar S. Investigation of the relationship between kinesiophobia and sensory processing in fibromyalgia patients. Somatosens Mot Res 2020;37(2):92–96.
• Kortlever JTP, Karyampudi P, Ottenhoff JSE, Ring D, Vagner GA. Reichel LM. Using the Tampa Scale for Kinesiophobia Short Form in Patients With Upper Extremity Specific Limitations. Hand 2020;22:1-7.
• Miller MB, Roumanis MJ, Kakinami L, Dover GC. Chronic pain patients’ kinesiophobia and catastrophizing are associated with activity intensity at different times of the day. J Pain Res 2020;13:273–84.
• Molyneux J, Herrrington L, Riley B, Jones R. A single-arm, non-randomized investigation into the short-term effects and follow-up of a 4-week lower limb exercise programme on kinesiophobia in individuals with knee osteoarthritis. Physiother Res Int 2020;25(3):1–6.
• Panken AM, Staal JB, Heymans MW. Kinesiophobia is not required to predict chronic low back pain in workers: A decision curve analysis. BMC Musculoskelet Disord 2020; 21(1):1–7.
• Verbrugghe J, Agten A, Stevens S, Eijnde BO, Vandenabeele F, Roussel N. Disability, kinesiophobia, perceived stress, and pain are not associated with trunk muscle strength or aerobic capacity in chronic nonspecific low back pain. Phys Ther Sport 2020;43:77–83.
• Meinberg EG, Agel J, Roberts CS, Karam MD, Kellam JF. Fracture and DislocationClassification Compendium-2018. J Orthop Trauma. 2018;32(1):1-170.
• Harris WH. Traumatic arthritis of the hip after dislocation and acetabular fractures: treatment by mold arthroplasty. An end-result study using a new method of result evaluation. J Bone Joint Surg Am 1969;51:13-17.
• Jensen MP, Karoly P. Handbook of pain assessment. In DC. Turk R. Melzack (Eds), Washington DC: The Guilford Press, 2011, pp. 19–44.
• Kumar DRS, Sultanpurkar DGP, Vikram DKH, Raorane DH. Comparative study between proximal femoral nail and bipolar prosthesis in intertrochanteric fracture femur. Int J Orthop Sci 2018;41(1):708–13.
• Venkataraman D, Pradeep E, prakala MK, Prajin RM. Comparative study of PFNA A2 vs bipolar hemiarthroplasty in unstable senile intertrochanteric fractures. Int J Orthop Sci 2020;6(1):312–6.
• Bansal DK, Dahuja DA, Kaur DR, Singh DJ, Shyam DR. Proximal femur nail vs cemented bipolar prosthesis in unstable intertrochanteric femur fractures in elderly: A prospective study. Int J Orthop Sci 2019;5(2):642–5.
• Korkmaz Ö. Treatment of intertrochanteric femur fractures in the elderly via bipolar hip arthroplasty or proximal femoral nail. South Clin Istanbul Eurasia 2018;29(2):115–9.
• Akpancar S. Treatment of instable intertrochanteric femur fractures: comparison of clinical efficacy and treatment costs of bipolar hemiarthroplasty and proximal femoral nail. Med Sci Int Med J 2019;8(4):887.
• HariPrasad S, Patil SN, Sarath CP, Cecil F. Functional outcome of unstable intertrochanteric femur fracture in elderly osteoporotic patients treated by primary cemented bipolar hemiarthroplasty versus internal fixation with proximal femoral nailing. Int J Orthop Sci 2017;3(4):321–5.
• Sengul YS, Unver B, Karatosun V, Gunal I. Assessment of pain-related fear in patients with the thrust plate prosthesis (TPP): Due to hip fracture and hip osteoarthritis. Arch Gerontol Geriatr 2011;53(2):249-252.
• Archer KR, Abraham CM, Obremskey WT. Psychosocial Factors Predict Pain and Physical Health After Lower Extremity Trauma. Clin Orthop Relat Res 2015;473:3519–26.
• Özkayin N, Okçu G, Aktuʇlu K. Intertrochanteric femur fractures in the elderly treated with either proximal femur nailing or hemiarthroplasty: A prospective randomised clinical study. Injury 2015;46(2): 3-8.
• Duriez P, Devaux T, Chantelot C, Baudrier N, Hery JY, Mainard D. Is arthroplasty preferable to internal fixation for the treatment of extracapsular fracture of the upper femur in the elderly? Orthop Traumatol Surg Res 2016;102(6):689-694.
• Esen E, Dur H, Ataoğlu MB, Ayanoğlu T, Turanlı S. Evaluation of proximal femoral nail-antirotation and cemented, bipolar hemiarthroplasty with calcar replacement in treatment of intertrochanteric femoral fractures in terms of mortality and morbidity ratios. Eklem Hastalik Cerrahisi. 2017;28(1):35-40.
• Ekinci Y, Gürbüz K, Batın S, Kahraman M, Doğar F, Kaya Erten Z. A multicenter intertrochanteric fracture study in the elderly: Hemiarthroplasty versus proximal femoral nailing. Jt Dis Relat Surg. 2020;31(2):209-217.