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Acta Orthopaedica

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https://read.qxmd.com/read/30762459/high-annual-surgeon-volume-reduces-the-risk-of-adverse-events-following-primary-total-hip-arthroplasty-a-registry-based-study-of-12-100-cases-in-western-sweden
#1
Per Jolbäck, Ola Rolfson, Peter Cnudde, Daniel Odin, Henrik Malchau, Hans Lindahl, Maziar Mohaddes
Background and purpose - Most earlier publications investigating whether annual surgeon volume is associated with lower levels of adverse events (AE), reoperations, and mortality are based on patient cohorts from North America. There is also a lack of adjustment for important confounders in these studies. Therefore, we investigated whether higher annual surgeon volume is associated with a lower risk of adverse events and mortality within 90 days following primary total hip arthroplasty (THA). Patients and methods - We collected information on primary total hip arthroplasties (THA) performed between 2007 and 2016 from 10 hospitals in Western Sweden...
February 14, 2019: Acta Orthopaedica
https://read.qxmd.com/read/30739560/similar-clinical-results-and-early-subsidence-between-the-collum-femoris-preserving-and-the-corail-stem-a-randomized-radiostereometric-study-of-77-hips-with-2-years-follow-up
#2
Liesbeth J Klein, Goran Puretic, Maziar Mohaddes, Johan Kärrholm
Background and purpose - Femoral neck preserving hip replacement has been suggested to improve clinical results and facilitate late revision. We compared the 2-year outcome and radiostereometric pattern of femoral head migration between the Collum Femoris Preserving (CFP) stem and the Corail stem. Patients and methods - 83 patients were randomized to either a CFP stem or a Corail stem. All patients received the same cup. At 2 years clinical outcomes were assessed using validated scoring systems and plain radiographs...
February 11, 2019: Acta Orthopaedica
https://read.qxmd.com/read/30739559/complications-and-readmissions-following-outpatient-total-hip-and-knee-arthroplasty-a-prospective-2-center-study-with-matched-controls
#3
Kirill Gromov, Christoffer Calov Jørgensen, Pelle Baggesgaard Petersen, Per Kjaersgaard-Andersen, Peter Revald, Anders Troelsen, Henrik Kehlet, Henrik Husted
Background and purpose - Outpatient arthroplasty has gained popularity in recent years; however, safety concerns still remain regarding complications and readmissions. In a prospective 2-center study we investigated early readmissions with overnight stay and complications following outpatient total hip (THA) and total knee arthroplasty (TKA) compared with a matched patient cohort with at least 1 postoperative night in hospital. Patients and methods - All consecutive and unselected patients scheduled for THA or TKA at 2 participating hospitals were screened for potential day of surgery (DOS) discharge...
February 11, 2019: Acta Orthopaedica
https://read.qxmd.com/read/30739553/the-design-of-the-cemented-stem-influences-the-risk-of-vancouver-type-b-fractures-but-not-of-type-c-an-analysis-of-82-837-lubinus-spii-and-exeter-polished-stems
#4
Georgios Chatziagorou, Hans Lindahl, Johan Kärrholm
Background and purpose - In total hip replacements, stem design may affect the occurrence of periprosthetic femoral fracture. We studied risk factors for fractures around and distal to the 2 most used cemented femoral stems in Sweden. Patients and methods - This is a register study including all standard primary Lubinus SPII and Exeter Polished stems operated in Sweden between 2001 and 2009. The outcome was any kind of reoperation due to fracture around (Vancouver type B) or distal to the stem (Vancouver type C), with use of age, sex, diagnosis at primary THR, and year of index operation as covariates in a Cox regression analysis...
February 11, 2019: Acta Orthopaedica
https://read.qxmd.com/read/30739551/early-recovery-trajectories-after-fast-track-primary-total-hip-arthroplasty-the-role-of-patient-characteristics
#5
(no author information available yet)
No abstract text is available yet for this article.
February 11, 2019: Acta Orthopaedica
https://read.qxmd.com/read/30739548/an-international-comparison-of-tha-patients-implants-techniques-and-survivorship-in-sweden-australia-and-the-united-states
#6
Elizabeth W Paxton, Guy Cafri, Szilard Nemes, Michelle Lorimer, Johan Kärrholm, Henrik Malchau, Stephen E Graves, Robert S Namba, Ola Rolfson
Background and purpose - International comparisons of total hip arthroplasty (THA) practices and outcomes provide an opportunity to enhance the quality of care worldwide. We compared THA patients, implants, techniques, and survivorship in Sweden, Australia, and the United States. Patients and methods - Primary THAs due to osteoarthritis were identified using Swedish (n = 159,695), Australian (n = 279,693), and US registries (n = 69,641) (2003-2015). We compared patients, practices, and implant usage across the countries using descriptive statistics...
February 11, 2019: Acta Orthopaedica
https://read.qxmd.com/read/30739547/target-site-antibiotic-concentrations-in-orthopedic-trauma-extremity-surgery-is-prophylactic-cefazolin-adequately-dosed-a-systematic-review-and-meta-analysis
#7
Fay R K Sanders, J Carel Goslings, Ron A A Mathôt, Tim Schepers
Background and purpose - The incidence of surgical site infections (SSIs) in trauma/orthopedic surgery varies between different body parts. Antibiotic prophylaxis (e.g., with cefazolin) lowers infection rates in closed fracture surgery and in primary arthroplasty. For prophylactic antibiotics to prevent infections, sufficient concentrations at the target site (location of surgery) are required. However, dosage recommendations and the corresponding efficacy are unclear. This review assesses target site cefazolin concentrations and the effect of variation in dose and location of target site during orthopedic extremity surgery...
February 11, 2019: Acta Orthopaedica
https://read.qxmd.com/read/30739539/varying-but-reduced-use-of-postoperative-mobilization-restrictions-after-primary-total-hip-arthroplasty-in-nordic-countries-a-questionnaire-based-study
#8
Kirill Gromov, Anders Troelsen, Maziar Mohaddes, Ola Rolfson, Ove Furnes, Geir Hallan, Antti Eskelinen, Perttu Neuvonen, Henrik Husted
Background and purpose - Mobilization has traditionally been restricted following total hip arthroplasty (THA) in an attempt to reduce the risk of dislocation and muscle detachment. However, recent studies have questioned the effect and rationale underlying such restrictions. We investigated the use of postoperative restrictions and possible differences in mobilization protocols following primary THA in Denmark (DK), Finland (FIN), Norway (NO), and Sweden (SWE). Patients and methods - All hospitals performing primary THA in the participating countries were identified from the latest national THA registry report...
February 11, 2019: Acta Orthopaedica
https://read.qxmd.com/read/30739526/custom-made-asymmetric-polyethylene-liner-to-correct-tibial-component-malposition-in-total-knee-arthroplasty-a-case-report
#9
Andreas Kappel, Claes Sjørslev Blom, Anders El-Galaly
No abstract text is available yet for this article.
February 11, 2019: Acta Orthopaedica
https://read.qxmd.com/read/30669949/patient-reported-outcomes-after-a-distal-radius-fracture-in-adults-a-3-4-years-follow-up
#10
Roderick H van Leerdam, Floortje Huizing, Frank Termaat, Sanne Kleinveld, Steven J Rhemrev, Pieta Krijnen, Inger B Schipper
Background and purpose - There are few reports on the outcome of distal radius fractures after 1 year. Therefore we investigated the long-term patient-reported functional outcome and health-related quality of life after a distal radius fracture in adults. Patients and methods - We reviewed 823 patients, treated either nonoperatively or operatively in 2012. After a mean follow-up of 3.8 years 285 patients (35%) completed the Patient-Rated Wrist Evaluation (PRWE) and EuroQol-5D. Results - The mean PRWE score was 11...
January 23, 2019: Acta Orthopaedica
https://read.qxmd.com/read/30669948/estonian-hip-fracture-data-from-2009-to-2017-high-rates-of-non-operative-management-and-high-1-year-mortality
#11
Pärt Prommik, Helgi Kolk, Pirja Sarap, Egon Puuorg, Eva Harak, Andres Kukner, Mati Pääsuke, Aare Märtson
Background and purpose - There are no national guidelines for treatment of hip fractures in Estonia and no studies on management. We assessed treatment methods and mortality rates for hip fracture patients in Estonia. Patients and methods - We studied a population-based retrospective cohort using validated data from the Estonian Health Insurance Fund's database. The cohort included patients aged 50 and over with an index hip fracture diagnosis between January 1, 2009 and September 30, 2017. The study generated descriptive statistics of hip fracture management methods and calculated in-hospital, 1-, 3, 6-, and 12-month unadjusted all-cause mortality rates...
January 23, 2019: Acta Orthopaedica
https://read.qxmd.com/read/30669918/superior-fixation-and-less-periprosthetic-stress-shielding-of-tibial-components-with-a-finned-stem-versus-an-i-beam-block-stem-a-randomized-rsa-and-dxa-study-with-minimum-5-years-follow-up
#12
Maiken Stilling, Inger Mechlenburg, Claus Fink Jepsen, Lone Rømer, Ole Rahbek, Kjeld Søballe, Frank Madsen
Background and purpose - The stem on the tibial component of total knee arthroplasty provides mechanical resistance to lift-off, shear forces, and torque. We compared tibial components with finned stems (FS) and I-beam block stems (IS) to assess differences in implant migration. Patients and methods - In a patient-blinded RCT, 54 patients/knees (15 men) with knee osteoarthritis at a mean age of 77 years (70-90) were randomly allocated to receive tibial components with either a FS (n = 27) or an IS (n = 27)...
January 23, 2019: Acta Orthopaedica
https://read.qxmd.com/read/30669912/a-comparative-study-of-intraoperative-frozen-section-and-alpha-defensin-lateral-flow-test-in-the-diagnosis-of-periprosthetic-joint-infection
#13
Irene K Sigmund, Johannes Holinka, Susanna Lang, Sandra Stenicka, Kevin Staats, Gerhard Hobusch, Bernd Kubista, Reinhard Windhager
Background and purpose - For decision-making (aseptic vs. septic), surgeons rely on intraoperatively available tests when a periprosthetic joint infection (PJI) cannot be confirmed or excluded preoperatively. We compared and evaluated the intraoperative performances of the frozen section and the alpha defensin lateral flow test in the diagnosis of PJI. Patients and methods - In this prospective study, consecutive patients with indicated revision surgery after arthroplasty were included. Patients were classified as having PJI using the MusculoSkeletal Infection criteria...
January 23, 2019: Acta Orthopaedica
https://read.qxmd.com/read/30669911/clinical-significance-of-cervical-mri-in-brachial-plexus-birth-injury
#14
Petra Grahn, Tiina Pöyhiä, Antti Sommarhem, Yrjänä Nietosvaara
Background and purpose - Patient selection for nerve surgery in brachial plexus birth injury (BPBI) is difficult. Decision to operate is mostly based on clinical findings. We assessed whether MRI improves patient selection. Patients and methods - 157 BPBI patients were enrolled for a prospective study during 2007-2015. BPBI was classified at birth as global plexus injury (GP) or upper plexus injury (UP). The global plexus injury was subdivided into flail upper extremity (FUE) and complete plexus involvement (CP)...
January 23, 2019: Acta Orthopaedica
https://read.qxmd.com/read/30669910/poor-patient-reported-outcome-after-shoulder-replacement-in-young-patients-with-cuff-tear-arthropathy-a-matched-pair-analysis-from-the-danish-shoulder-arthroplasty-registry
#15
Mette Ammitzboell, Amin Baram, Stig Brorson, Bo Sanderhoff Olsen, Jeppe V Rasmussen
Background and purpose - Reverse shoulder arthroplasty (RSA) has become the treatment of choice for cuff-tear arthropathy. There are, however, concerns about the longevity and the outcome of an eventual revision procedure. Thus, resurfacing hemiarthroplasty (RHA) with extended articular surface has been suggested for younger patients. We compared the patient-reported outcome of these arthroplasty designs for cuff-tear arthropathy. Patients and methods - We included patients operated on because of cuff-tear arthropathy and reported to the Danish Shoulder Arthroplasty Registry (DSR) from January 1, 2006 to December 31, 2013...
January 23, 2019: Acta Orthopaedica
https://read.qxmd.com/read/30669909/equivalent-2-year-stabilization-of-uncemented-tibial-component-migration-despite-higher-early-migration-compared-with-cemented-fixation-an-rsa-study-on-360-total-knee-arthroplasties
#16
Elise K Laende, Janie L Astephen Wilson, Joanna Mills Flemming, Edward R Valstar, C Glen Richardson, Michael J Dunbar
Background and purpose - Thresholds of implant migration for predicting long-term successful fixation of tibial components in total knee arthroplasty have not separated cemented and uncemented fixation. We compared implant migration of cemented and uncemented components at 1 year and as the change in migration from 1 to 2 years. Patients and methods - Implant migration of 360 tibial components measured using radiostereometric analysis was compared at 1 year and as the change in migration from 1 to 2 years in 222 cemented components (3 implant designs) and 138 uncemented components (5 implant designs)...
January 23, 2019: Acta Orthopaedica
https://read.qxmd.com/read/30669897/early-palmar-plate-fixation-of-distal-radius-fractures-may-benefit-patients-aged-50-years-or-older-a-randomized-trial-comparing-2-different-treatment-protocols
#17
Kai Sirniö, Juhana Leppilahti, Pasi Ohtonen, Tapio Flinkkilä
Background and purpose - There is no consensus regarding optimal treatment of displaced distal radius fractures (DRFs). We compared the results of 2 treatment protocols: early palmar plating vs. primary nonoperative treatment of displaced DRFs. Patients and methods - We performed a prospective randomized controlled study including 80 patients aged ≥ 50 years with dorsally displaced DRFs, excluding AO type C3 fractures. Patients were randomized to undergo either immediate surgery with palmar plating (n = 38), or initial nonoperative treatment (n = 42) after successful closed reduction in both groups...
January 23, 2019: Acta Orthopaedica
https://read.qxmd.com/read/30569797/relationship-between-outcome-scores-and-knee-laxity-following-total-knee-arthroplasty-a-systematic-review
#18
Andreas Kappel, Mogens Laursen, Poul T Nielsen, Anders Odgaard
Background and purpose - Instability following primary total knee arthroplasty (TKA) is, according to all national registries, one of the major failure mechanisms leading to revision surgery. However, the range of soft-tissue laxity that favors both pain relief and optimal knee function following TKA remains unclear. We reviewed current evidence on the relationship between instrumented knee laxity measured postoperatively and outcome scores following primary TKA. Patients and methods - We conducted a systematic search of PubMed, Embase, and Cochrane databases to identify relevant studies, which were cross-referenced using Web of Science...
December 20, 2018: Acta Orthopaedica
https://read.qxmd.com/read/30526183/similar-polyethylene-wear-between-cemented-and-cementless-oxford-medial-uka-a-5-year-follow-up-randomized-controlled-trial-on-79-patients-using-radiostereometry
#19
Kristian Horsager, Frank Madsen, Anders Odgaard, Claus Fink Jepsen, Lone Rømer, Per Wagner Kristensen, Bart L Kaptein, Kjeld Søballe, Maiken Stilling
Background and purpose - Hydroxyapatite (HA)-coated implants have been associated with high polyethylene wear in hip arthroplasties. HA coating as a promoter of wear in knee arthroplasties has not been investigated. We compared the wear-rate of the polyethylene bearing for cemented and cementless HA-coated Oxford medial unicondylar knee arthroplasties (UKA). Secondarily, we investigated whether wear-rates were influenced by overhang or impingement of the bearing. Patients and methods - 80 patients (mean age 64 years), treatment-blinded, were randomized to 1 of 3 Oxford medial UKA versions: cemented with double-pegged or single-pegged femoral component or cementless HA-coated with double-pegged femoral component (ratios 1:1:1)...
December 10, 2018: Acta Orthopaedica
https://read.qxmd.com/read/30526179/selective-serotonin-reuptake-inhibitor-use-in-hip-fracture-patients-a-danish-nationwide-prevalence-study
#20
Stine B Bruun, Irene Petersen, Nickolaj R Kristensen, Deirdre Cronin-Fenton, Alma B Pedersen
Background and purpose - Selective serotonin reuptake inhibitors (SSRIs) are often used in the elderly and are associated with adverse effects. Therefore, it is important to ascertain the prevalence of SSRI use in fragile and surgery-treated hip fracture patients. Methods - This population-based prevalence study included Danish hip fracture patients aged ≥ 65 years operated in 2006-2016 (n = 68,607) and matched individuals from the background population (n = 343,020). Using Poisson regression, prevalence risk ratios (PRRs) with 95% confidence intervals (CIs) were estimated to compare hip fracture patients with the general population, and to estimate the association between hip fracture patient characteristics and SSRI prescriptions...
December 10, 2018: Acta Orthopaedica
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