Marianne Westberg, Øystein Tyri Fagerberg, Finnur Snorrason
BACKGROUND AND PURPOSE: The management of acute hematogenous periprosthetic joint infection (AHI) is challenging and the optimal treatment is not clearly defined. The aim of this study was to evaluate the treatment outcome of AHI, and secondarily to investigate potential risk factors that affect outcome. PATIENTS AND METHODS: We retrospectively analyzed 43 consecutive AHIs in a total hip or knee arthroplasty between 2013 and 2020 at a single center. We used the Delphi international consensus criteria to define infection...
March 8, 2023: Acta Orthopaedica
Afrim Iljazi, Michala Skovlund Sørensen, Thea Hovgaard Ladegaard, Søren Overgaard, Michael Mørk Petersen
BACKGROUND AND PURPOSE: Joint stability after hip replacement (HR) in patients with metastatic bone disease (MBD) is of special importance. Dislocation is the second leading cause of implant revision in HR, while survival after MBD surgery is poor with an expected 1-year survival of around 40%. As few studies have investigated the dislocation risk across different articulation solutions in MBD, we conducted a retrospective study on primary HR for patients with MBD treated in our department...
March 6, 2023: Acta Orthopaedica
Erim Özdemir, Martijn F L Kuijpers, B Willem Schreurs, Wim H C Rijnen
BACKGROUND AND PURPOSE: Long-term follow-up of young patients following cemented primary THA is scarce. Therefore, we analyzed the survival of all consecutive primary THAs in patients under 25 years performed at our institute. PATIENTS AND METHODS: All primary THAs performed in patients younger than 25 years in our tertiary care institute between 1988 and 2015 were included (n = 119). Cemented fixation was used in all patients. In the case of acetabular bone deficiencies, reconstruction was performed using impaction bone grafting (IBG)...
February 28, 2023: Acta Orthopaedica
Keerati Chareancholvanich, Suphawat Tantithawornwat, Pakpoom Ruangsomboon, Rapeepat Narkbunnam, Swist Chatmaitri, Chaturong Pornrattanamaneewong
BACKGROUND AND PURPOSE: Local infiltration analgesia (LIA) is one of the effective regimens to reduce pain after total knee arthroplasty (TKA). Epinephrine is a commonly used sympathetic adjunct in LIA. It is expected to enhance the intensity and extend the duration of LIA. The primary aim of the study was to evaluate the efficacy of epinephrine on postoperative pain control after primary TKA. PATIENTS AND METHODS: A total of 80 patients who underwent primary TKA were randomized into an epinephrine (EN) and a control (C) group...
February 28, 2023: Acta Orthopaedica
Katarina Greve, Stina Ek, Erzsébet Bartha, Karin Modig, Margareta Hedström
BACKGROUND AND PURPOSE: Waiting time to surgery is a modifiable risk factor in hip fracture surgery. However, there is no consensus regarding the acceptable duration of waiting time. We used the Swedish Hip Fracture Register RIKSHÖFT and 3 administrative registers to explore the association between time to surgery and adverse outcomes after discharge. PATIENTS AND METHODS: 63,998 patients ≥ 65 years, admitted to a hospital between January 1, 2012, and August 31, 2017 were included...
February 27, 2023: Acta Orthopaedica
Miguel Menendez Garcia, Iñaki Otermin Maya, Julian Librero Lopez, Jorge Gutierrez Dubois, Diego Manrique Cuevas, Jose Ignacio Alaez Cruz, Leyre Azcona Salvatierra, Isabel Ayechu Diaz, Angel M Hidalgo Ovejero
BACKGROUND AND PURPOSE: We aimed to determine whether an extended oral antibiotic prophylaxis protocol may reduce the rate of surgical site infection (SSI) in patients undergoing instrumented spinal fusion. PATIENTS AND METHODS: This retrospective cohort study comprise 901 consecutive patients subjected to spinal fusion between September 2011 and December 2018 with a minimum 1-year follow-up. 368 patients operated on between September 2011 and August 2014 were administered standard intravenous prophylaxis...
February 21, 2023: Acta Orthopaedica
Pakpoom Ruangsomboon, Onlak Ruangsomboon, Chaturong Pornrattanamaneewong, Rapeepat Narkbunnam, Keerati Chareancholvanich
BACKGROUND AND PURPOSE: Robotic-assisted total knee arthroplasty (RATKA) is an alternative surgical treatment method to conventional total knee arthroplasty (COTKA) that may deliver better surgical accuracy. However, its impact on patient outcomes is uncertain. The aim of this systematic review of randomized controlled trials (RCTs) is to evaluate whether RATKA could improve functional and radiological outcomes compared with COTKA in adult patients with primary osteoarthritis of the knee...
February 20, 2023: Acta Orthopaedica
Markus W Frost, Ole Rahbek, Christopher Iobst, Anirejuoritse Bafor, Molly Duncan, Søren Kold
BACKGROUND AND PURPOSE: Intramedullary bone-lengthening nails have become increasingly popular. The 2 most used and successful nails are the FITBONE and the PRECICE nails. Uniform reporting is lacking on complications of intramedullary bone-lengthening nails. The purpose was therefore to assess and categorize the complications of lower limb bone-lengthening nails and investigate risk factors. PATIENTS AND METHODS: We performed a retrospective review of patients operated on with intramedullary lengthening nails at 2 hospitals...
February 17, 2023: Acta Orthopaedica
Anssi Arimaa, Tommi Salminen, Jani Knifsund, Ville Kytö, Petteri Lankinen, Inari Laaksonen
BACKGROUND AND PURPOSE: We aimed to assess the incidence of anterior cruciate ligament reconstruction (ACLR) and concomitant procedures in Finland. PATIENTS AND METHODS: We identified all the patients who underwent ACLR between 2004 and 2018 in Finland using national registry data. Patients with an ICD-10 diagnosis code S83.5 and the NOMESCO operation codes NGE30 or NGE35 were included. We recorded the patient's age, sex, Charlson comorbidity index, and concomitant procedures...
February 2, 2023: Acta Orthopaedica
Maria Sigurdardottir, Martin Ingi Sigurdsson, Yngvi Olafsson, Solveig H Sverrisdottir, Ingibjorg Gunnarsdottir, Emil L Sigurdsson, Sigurbergur Karason
BACKGROUND AND PURPOSE: The aim of this study was to identify the prevalence of modifiable risk factors of surgical site infections (SSI) in patients undergoing primary elective total joint arthroplasty (TJA) receiving conventional preoperative preparation, and to explore their association with infectious outcomes. PATIENTS AND METHODS: Information regarding modifiable risk factors (anemia, diabetes, obesity, nutritional status, smoking, physical activity) was prospectively gathered in patients undergoing primary TJA of hip or knee in 2018-2020 at a single institution with 6 weeks' follow-up time...
February 2, 2023: Acta Orthopaedica
Rasmus T Hansen, Nicolas W Borghegn, Per Hviid Gundtoft, Katrine A Nielsen, Andreas Balslev-Clausen, Bjarke Viberg
BACKGROUND AND PURPOSE: The choice between invasive and non-invasive treatment of diaphyseal forearm fractures in children can be difficult. We investigated the trends in choice of treatment of pediatric diaphyseal forearm fractures over a 20-year period.  Patients and methods: This is a population-based register study with data from 1997 to 2016 retrieved from the Danish National Patient Registry. The primary outcome was choice of primary treatment within 1 week divided into non-invasive treatment (casting only or closed reduction including casting) and invasive (Kirshner wires, intramedullary nailing [IMN], and open reduction internal fixation [ORIF])...
February 1, 2023: Acta Orthopaedica
Samuli Juopperi, Reijo Sund, Toni Rikkonen, Timo Nyyssönen, Heikki Kröger, Ville Turppo, Joonas Sirola
BACKGROUND AND PURPOSE: Studies investigating the effect of spinal surgery on both physical capability (PC) and subjective well-being (SW) are scarce. We aimed to investigate self-reported PC and SW up to 20 years after lumbar spine surgery. PATIENTS AND METHODS: 6,612 postmenopausal Finnish women (47-56 years at baseline [BL]), from the Osteoporosis Risk Factor and Prevention (OSTPRE) study, were followed-up (FU) for 20 years. The Finnish Care Register for Healthcare (CRFH) provided data on surgery in the OSTPRE population on lumbar spinal stenosis (LSS) and lumbar disc herniation (LDH)...
January 25, 2023: Acta Orthopaedica
Lukas Berglund, Cecilia Liu, Johanna Adami, Mårten Palme, Abdul Rashid Qureshi, Li Felländer-Tsai
BACKGROUND AND PURPOSE: Several randomized trials have demonstrated the lack of effect of arthroscopic lavage as treatment for knee osteoarthritis (OA). These results have in turn resulted in a change in Swedish guidelines and reimbursement. We aimed to investigate the use of knee arthroscopies in Sweden between 2002 and 2016. Patient demographics, regional differences, and the magnitude of patients with knee OA undergoing knee arthroscopy were also analyzed. PATIENTS AND METHODS: Trends in knee arthroscopy were investigated using the Swedish Hospital Discharge Register (SHDR) to conduct a nationwide register-based study including all adults (>18 years of age) undergoing any knee arthroscopy between 2002 and 2016...
January 25, 2023: Acta Orthopaedica
Maria C Cöster, Ann Bremander, Anna Nilsdotter
BACKGROUND AND PURPOSE: The EQ-5D is a patientreported outcome measure (PROM). To make priorities and allocate resources between patients and surgical procedures it is necessary to evaluate outcome differences, which is why comparing PROMs between registers is important. We compared EQ-5D data and the follow-up rate for selected diagnoses reported to Swedish orthopedic registers before and 1 year after surgery. PATIENTS AND METHODS: Patients from 5 orthopedic registers (Swespine, Swedish Hip Arthroplasty Register, Swedish Knee Arthroplasty Register, Swedankle, and Swefoot) who, in 2014-2018, underwent surgery in southern Sweden were included in the study...
January 23, 2023: Acta Orthopaedica
Ricardo Sousa, Ana Ribau, Pedro Alfaro, Marc-Antoine Burch, Joris Ploegmakers, Martin McNally, Martin Clauss, Marjan Wouthuyzen-Bakker, Alex Soriano
BACKGROUND AND PURPOSE: A new periprosthetic joint infection (PJI) definition has recently been proposed by the European Bone and Joint Infection Society (EBJIS). The goals of this paper are to evaluate its diagnostic accuracy and compare it with previous definitions and to assess its accuracy in preoperative diagnosis. PATIENTS AND METHODS: We retrospectively evaluated a multicenter cohort of consecutive revision total hip and knee arthroplasties. Cases with minimum required diagnostic workup were classified according to EBJIS, 2018 International Consensus Meeting (ICM 2018), Infectious Diseases Society of America (IDSA), and modified 2013 Musculoskeletal Infection Society (MSIS) definitions...
January 23, 2023: Acta Orthopaedica
Dennis Vinther, Aurelie Mailhac, Ina Trolle Andersen, Søren Overgaard, Stein Atle Lie, Anne Marie Fenstad, Jan-Erik Gjertsen, Ove Furnes, Alma B Pedersen
BACKGROUND AND PURPOSE: There are concerns that bleeding following primary total hip arthroplasty (THA) contributes to prolonged wound drainage and prosthetic joint infection (PJI). We examined whether short (1-5 days), medium (6-14 days), and extended (≥ 15 days) duration of thromboprophylaxis is associated with the 5-year revision rate after THA due to osteoarthritis. PATIENTS AND METHODS: We performed a cohort study based on data from hip arthroplasty and administrative registries in Denmark and Norway (2008-2014)...
December 27, 2022: Acta Orthopaedica
Per Jolbäck, Sebastian Mukka, Kristin Wetterling, Maizar Mohaddes, Anne Garland
BACKGROUND AND PURPOSE: The sex of the surgeon has been proposed to be associated with a disparity in clinical outcomes after different surgical procedures. We investigated the association between surgeon-patient sex discordance and adverse events (AEs) and surgical AEs (SAEs) within 90 days after primary total hip arthroplasty (THA). We also investigated patient-reported satisfaction with surgical outcomes 1 year after the surgery. PATIENTS AND METHODS: We conducted a register-based cohort study including primary THAs performed due to osteoarthritis between 2008 and 2016 at 10 publicly managed hospitals in western Sweden...
December 27, 2022: Acta Orthopaedica
Jantsje H Pasma, Brechtje Hesseling, Nicole De Esch, Hennie Verburg, Dieu D Niesten, Nina M C Mathijssen
BACKGROUND AND PURPOSE: Aseptic loosening, mainly caused by migration, is one of the most common indications for revisions in unicompartmental knee arthroplasty (UKA). In this study, we investigated the early migration of the Persona Partial Knee (PPK, Zimmer Biomet, Warsaw, IN), a cemented medial fixed-bearing unicompartmental knee prosthesis, and evaluated the clinical results. PATIENTS AND METHODS: 26 primary PPKs were implanted. Radiographs were obtained direct postoperatively, at 6 weeks, 6, 12 and 24 months postoperatively...
December 19, 2022: Acta Orthopaedica
Peter Bo Jørgensen, Steffan Tabori-Jensen, Inger Mechlenburg, Morten Homilius, Torben Bæk Hansen, Maiken Stilling
BACKGROUND AND PURPOSE: Dual mobility (DM) articulation total hip arthroplasty (THA) is used increasingly to reduce dislocation risk. We investigated cup fixation, polyethylene (PE) wear, serum chromium and cobalt ions, and their correlation to physical activity in patients with DM cups at 6-year follow-up. PATIENTS AND METHODS: In a patient-blinded RCT, 60 patients with hip osteoarthritis at a median age of 74 years (70-82) were randomly allocated to cemented (n = 30) or cementless hydroxyapatite-coated (n = 30) fixation of Avantage DM THA with a highly-crosslinked vitamin-E PE liner...
December 16, 2022: Acta Orthopaedica
Vesa Saikko, Perttu Neuvonen, Aleksi Reito
BACKGROUND AND PURPOSE: There is concern among clinicians regarding the performance of thin, highly cross-linked polyethylene acetabular liners at high inclination angles that cause edge contact and high contact stresses. We studied ex vivo wear performance of thin, vitamin-E grafted, highly cross-linked polyethylene (Vivacit-E) liners in relation to high acetabular inclination angle. MATERIALS AND METHODS: Wear of Vivacit-E acetabular liners (thickness 4...
December 2, 2022: Acta Orthopaedica
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