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OBJECTIVE: To describe temporal changes in treatment, care, and short-term mortality outcomes of geriatric patients during the first wave of the COVID-19 pandemic. DESIGN: Observational study. SETTING AND PARTICIPANTS: Altogether 1785 patients diagnosed with COVID-19 and 6744 hospitalized for non-COVID-19 causes at 7 geriatric clinics in Stockholm from March 6 to July 31, 2020, were included. METHODS: Across admission month, patient vital signs and pharmacological treatment in relationship to risk for in-hospital death were analyzed using the Poisson regression model. Incidence rates (IRs) and incidence rate ratios (IRRs) of death are presented. RESULTS: In patients with COVID-19, the IR of mortality were 27%, 17%, 10%, 8%, and 2% from March to July, respectively, after standardization for demographics and vital signs. Compared with patients admitted in March, the risk of in-hospital death decreased by 29% [IRR 0.71, 95% confidence interval (CI) 0.51-0.99] in April, 61% (0.39, 0.26-0.58) in May, 68% (0.32, 0.19-0.55) in June, and 86% (0.14, 0.03-0.58) in July. The proportion of patients admitted for geriatric care with oxygen saturation

Purpose: Fifteen to twenty percent of patients with a knee arthroplasty are dissatisfied with their replaced joint. This study aimed to describe patients’ experiences of undergoing knee replacement surgery, both total- and unicompartmental knee replacement, and post-operative recovery, and to determine whether expectations of surgery were fulfilled. Methods: Using semi-structured interviews, this study describes twelve patients’ experiences of undergoing knee replacement surgery in the prior year, their post-operative recovery, and whether their expectations of surgery were fulfilled. Qualitative thematic analysis was used. Results: A theme “striving for a silent knee”, and two categories “the bumpy road to recovery” and “the presence of the future” were created. Some participants were not fully restored one year after surgery. Those still in pain had thoughts about the future, from hoping to improve, to accepting living with an aching knee. Those with no pain, did not think about their knee—the knee had become silent. Conclusions: Surgeons often inform patients that the recovery time after a knee arthroplasty is one year, which in light of this study, might be too short. We suggest that a follow-up after one year might identify those who need enhanced physical and psychological support to get the best possible outcome, whether it is to help patients accepting persistent symptoms or to continue striving towards a silent knee.

Background and purpose — There is an increase in demand for primary and revision total knee joint procedures. We studied implant survival and functional outcome of patients operated with a constrained condylar knee (CCK) or a rotating hinge implant (RH) as a primary or a revision total knee arthoplasty (TKA). Patients and methods — We evaluated clinically and radiographically 65 surgical procedures with a mean follow-up time of 5 (2–9) years (40 CCK and 25 RH). There were 24 primary TKAs—due to instability—and 41 revision TKAs, mostly due to aseptic loosening. Mean age at the index operation was 68 (31–88) years. Results — Overall, there were 12 failures, including 8 reoperations due to deep infection. The overall 5-year survival rate with reoperation as the endpoint was 82% (95% CI: 72–99). Radiolucent lines on either the femoral or the tibial side were seen in 36 cases. When comparing the cases that were operated as a primary TKA or as a revision TKA, function, health-related quality of life, and surviv...

Aim : Knee arthroplasties are an increasingly common treatment for osteoarthritis (OA) and the main indication is pain. Previous research states, however, that 15–20% of the operated patients are dissatisfied and 20–30% have persistent pain after surgery. This study is aimed at describing patients’ experiences of living with knee OA when scheduled for surgery and further their expectations for future life after surgery. Methods : We interviewed 12 patients with knee OA scheduled for arthroplasty, using semi-structured qualitative interviews. The interviews were recorded and transcribed verbatim and analyzed using qualitative thematic analysis. Findings : Three categories were formulated with an overriding theme: “It’s not just a knee, but a whole life.” The three categories were “Change from their earlier lives,” “Coping with knee problems,” and “Ultimate decision to undergo surgery.” The main finding was that knee OA affects the whole body and self, ultimately affecting the patients’ lives on many levels. Further findings were that knee OA was considered to be the central focus in the participants’ lives, which limited their level of activity, their ability to function as desired, their quality of life, and their mental well-being. Although surgery was considered to be the only solution, the expectations regarding the outcome differed. Conclusions : The participants were forced to change how they previously had lived their lives resulting in a feeling of loss. Thus, the experienced loss and expectations for future life must be put into the context of the individual’s own personality and be taken into account when treating individuals with knee OA. The experience of living with knee OA largely varies between individuals. This mandates that patients’ assessment should be considered on individual basis with regard to each patient. Key words: Knee osteoarthritis, knee arthroplasty, qualitative research, experiences, expectations, pain (Published: 31 March 2016) Citation: Int J Qualitative Stud Health Well-being 2016, 11: 30193 - http://dx.doi.org/10.3402/qhw.v11.30193