2,341 results match your criteria Acta Orthopaedica[Journal]


Comparison of early migration patterns between a ceramic and polyethylene liner in uncemented Trabecular Titanium cups: a 2-year randomized controlled trial of 52 hips using radiostereometric analysis.

Acta Orthop 2022 04 28;93:451-458. Epub 2022 Apr 28.

Department of Orthopedic Surgery, OLVG, Amsterdam; Department of Orthopedic Surgery, LUMC, Leiden, The Netherlands.

Background And Purpose: Ceramic liners may reduce early stability of uncemented acetabular components due to higher stiffness. However, the bone ingrowth capacities of porous trabecular titanium might compensate for this effect. This prospective randomized trial quantifies migration patterns of the Delta-TT cup, and compares polyethylene and ceramic liners. Read More

View Article and Full-Text PDF

Precision of low-dose CT-based micromotion analysis technique for the assessment of early acetabular cup migration compared with gold standard RSA: a prospective study of 30 patients up to 1 year.

Acta Orthop 2022 04 22;93:459-465. Epub 2022 Apr 22.

Department of Orthopedics, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg; Department of Orthopedics, Sahlgrenska University Hospital, Gothenburg, Sweden.

Background And Purpose: Computed tomography micromotion analysis (CTMA) can be used to determine implant micro-movements using low-dose CT scans. By using CTMA, a non-invasive measurement of joint implant movement is enabled. We evaluated the precision of CTMA in measuring early cup migration. Read More

View Article and Full-Text PDF

Development of an ischemic fracture healing model in mice.

Acta Orthop 2022 04 25;93:466-471. Epub 2022 Apr 25.

Department of Trauma and Reconstructive Surgery, Eberhard Karls University Tübingen, BG Trauma Center Tübingen, Tübingen.

Background And Purpose: In fracture healing, ischemia caused by vascular injuries, chronic vascular diseases, and metabolic comorbidities is one of the major risk factors for delayed union and non-union formation. To gain novel insights into the molecular and cellular pathology of ischemic fracture healing, appropriate animal models are needed. Murine models are of particular interest, as they allow to study the molecular aspects of fracture healing due to the availability of both a large number of murine antibodies and gene-targeted animals. Read More

View Article and Full-Text PDF

Median 10-year whole blood metal ion levels and clinical outcome of ReCap-M2a-Magnum metal-on-metal total hip arthroplasty.

Acta Orthop 2022 04 19;93:444-450. Epub 2022 Apr 19.

Department of Orthopaedics and Traumatology, Turku University Hospital; University of Turku.

Background And Purpose: We have previously reported that the whole blood (WB) chromium (Cr) and cobalt (Co) ion levels decrease in the short term after ReCap-M2a-Magnum large-diameter head (LDH) metal-on-metal (MoM) total hip arthroplasty (THA). This study reports long-term metal ion levels and clinical outcomes after ReCap-Magnum THA.

Patients And Methods: ReCap-M2a-Magnum LDH THA was used in 1,450 patients in our hospital district from 2005 to 2012. Read More

View Article and Full-Text PDF

Poor reliability and reproducibility of 3 different radiographical classification systems for distal ulna fractures.

Acta Orthop 2022 04 18;93:438-443. Epub 2022 Apr 18.

Department of Orthopaedics, Linköping University; Department of Clinical and Experimental Medicine, Linköping University, Sweden.

Background And Purpose: Classification of fractures can be valuable for research purposes but also in clinical work. Especially with  are fractures, such as distal ulna fractures, a treatment algorithm based on a classification can be helpful. We compared 3 different  classification systems of distal ulna fractures and investigated their reliability and reproducibility. Read More

View Article and Full-Text PDF

Postoperative pain as a risk factor for stiff knee following total knee arthroplasty and excellent patientreported outcomes after manipulation under anesthesia.

Acta Orthop 2022 04 14;93:432-437. Epub 2022 Apr 14.

Department of Anesthesiology, Intensive Care and Pain Medicine, University of Helsinki and Helsinki University Hospital.

Background And Purpose: Manipulation under anesthesia (MUA) is the first-choice treatment for stiffness following total knee arthroplasty (TKA) unresponsive to pain management and physiotherapy. Some of the predisposing factors and patient-reported outcome measures (PROMs) following MUA remain poorly studied. We retrospectively investigated the etiological risk factors and the outcomes of MUA. Read More

View Article and Full-Text PDF

Stress fractures of the femoral neck in adults: an observational study on epidemiology, treatment, and reoperations from the Swedish Fracture Register.

Acta Orthop 2022 04 8;93:413-416. Epub 2022 Apr 8.

Department of Surgical and Perioperative Sciences (Orthopedics), Umeå University.

Background And Purpose: Stress fractures of the femoral neck (sFNFs) are uncommon injuries. Studies on sFNFs are rare. We describe the demographics, classification, treatment, reoperation rates, and mortality in a cohort of sFNF patients from the Swedish Fracture Register (SFR). Read More

View Article and Full-Text PDF

Association of perioperative thromboprophylaxis on revision rate due to infection and aseptic loosening in primary total hip arthroplasty - new evidence from the Nordic Arthroplasty Registry Association (NARA).

Acta Orthop 2022 04 8;93:417-423. Epub 2022 Apr 8.

Department of Clinical Epidemiology, Aarhus University Hospital and Department of Clinical Medicine, Aarhus University, Aarhus, Denmark.

Background And Purpose: Results regarding the impact of anticoagulants on revision rate are conflicting. We examined the association between the use of low molecular weight heparin (LMWH) or non-vitamin K oral anticoagulants (NOACs) as thromboprophylaxis after primary total hip arthroplasty (THA) and the revision rate due to infection, aseptic loosening, and all causes.

Patients And Methods: We conducted a cohort study (n = 53,605) based on prospectively collected data from the national hip arthroplasty registries from Denmark and Norway. Read More

View Article and Full-Text PDF

Minor effect of patient education for alcohol cessation intervention on outcomes after acute fracture surgery: a randomized trial of 70 patients.

Acta Orthop 2022 04 12;93:424-431. Epub 2022 Apr 12.

Orthopaedic Department, Hospital of Southern Jutland, University of Southern Denmark, Aabenraa, Denmark; Clinical Health Promotion Centre, WHO-CC, the Parker Institute, Bispebjerg & Frederiksberg Hospital, Copenhagen University Hospitals, Denmark; Clinical Health Promotion Centre, WHO-CC, Department of Health Sciences, Lund University, Lund, Sweden.

Background And Purpose: High alcohol intake is associated with increased risk of postoperative complications. Alcohol cessation intervention is recommended prior to elective surgery. We investigated short- and long-term effects of perioperative intensive alcohol intervention in relation to acute ankle fracture surgery. Read More

View Article and Full-Text PDF

Rapid rise in prevalence of knee replacements and decrease in revision burden over past 3 decades in Finland: a register-based analysis.

Acta Orthop 2022 04 6;93:382-389. Epub 2022 Apr 6.

Hospital Nova of Central Finland, Central Finland Health Care District, Jyväskylä; University of Eastern Finland, Kuopio; 5 SYNLAB Suomi, Helsinki.

Background And Purpose: The prevalence of knee joint replacements (KJR) has been less investigated in situations where the increase in incidence is known. This study investigated the annual and population-based prevalence of KJR and the relationship between the prevalence of KJRs and the incidence of revision surgery.

Patients And Methods: All KJRs performed between 1980 and 2020 were identified from the Finnish Arthroplasty Register (FAR). Read More

View Article and Full-Text PDF

Do changes in outcomes following primary and revision hip replacement differ and relate to markers of socioeconomic status? A 1-year population-based cohort study.

Acta Orthop 2022 04 6;93:397-404. Epub 2022 Apr 6.

Department of Orthopaedic Surgery, Aarhus University Hospital, Aarhus N, Denmark; Department of Clinical Medicine, Aarhus University, Aarhus, Denmark.

Background And Purpose: There is little evidence on improvement after revision total hip replacement (THR). Moreover, improvements may be associated with socioeconomic status (SES). We investigated whether changes in Harris Hip Score (HHS) differ among patients undergoing primary and revision THR, and their association with markers of SES. Read More

View Article and Full-Text PDF

Optimized medial unicompartmental knee arthroplasty outcome: learning from 20 years of propensity score matched registry data.

Acta Orthop 2022 04 6;93:390-396. Epub 2022 Apr 6.

Department of Orthopaedic Surgery, Clinical Orthopaedic Research Hvidovre (CORH), Copenhagen University Hospital Hvidovre, Copenhagen, Denmark.

Background And Purpose: Unicompartmental knee arthroplasty (UKA) has increased in use. We investigated changes to UKA revision risk over the last 20 years compared with total knee arthroplasty (TKA), examined external and patient factors for correlation to UKA revision risk, and described the survival probability for current UKA and TKA practice.

Patients And Methods: All knee arthroplasties reported to the Danish Knee Arthroplasty Register from 1997 to 2017 were linked to the National Patient Register and the Civil Registration System for comorbidity, emigration, and mortality information. Read More

View Article and Full-Text PDF

Incidence and risk factors of intraoperative periprosthetic femoral fractures during primary total hip arthroplasty: 218,423 cases reported to the Norwegian Arthroplasty Register between 1987 and 2020.

Acta Orthop 2022 04 6;93:405-412. Epub 2022 Apr 6.

Department of Orthopaedic Surgery, Stavanger University Hospital, Stavanger.

Background And Purpose: Intraoperative periprosthetic femoral fractures (IPFFs) can occur during primary total hip arthroplasty (THA). We describe the incidence of IPFFs during THA in Norway and estimate potential risk factors that could be associated with IPFF Patients and methods - Data from the Norwegian Arthoplasty Register (1987-2020) was used: 2,268 IPFFs from 218,423 primary THAs in 172,598 patients. The following factors were analyzed: sex, age, diagnosis, previous operation on the same hip, surgical approach, and stem fixation technique. Read More

View Article and Full-Text PDF

Polyethylene liner motion in dual-mobility hip prostheses: static and dynamic radiostereometry in 16 patients 1 year after operation.

Acta Orthop 2022 03 21;93:375-381. Epub 2022 Mar 21.

AutoRSA Research Group, Orthopaedic Research Unit, Aarhus University Hospital, Aarhus, Denmark; Department of Orthopaedic Surgery, Aarhus University Hospital, Aarhus N, Denmark.

Background And Purpose: Dual-mobility hip arthroplasty utilizes a freely rotating polyethylene acetabular liner to protect against dislocation. As liner motion has not been confirmed in vivo, we undertook this using dynamic radiostereometry (RSA).

Patients And Methods: 6 patients with Anatomical Dual Mobility acetabular components were included. Read More

View Article and Full-Text PDF

Long-term clinical and radiological outcomes following surgical treatment for symptomatic pediatric flexible flat feet: a systematic review.

Acta Orthop 2022 03 18;93:367-374. Epub 2022 Mar 18.

Department of Orthopaedics and Trauma, Medical University of Graz, Auenbruggerplatz 5, 8036 Graz.

Background And Purpose: Albeit pediatric flexible flat foot (FFF) is a common condition, only a minority of patients become symptomatic. Long-term outcomes of surgically treated pediatric patients with symptomatic FFF are largely unknown. In this systematic review, studies providing outcomes at a mean follow-up of at least 4 years after the procedure in these patients were analyzed. Read More

View Article and Full-Text PDF

The effect of COVID-19 lockdown on the incidence of emergency department visits due to injuries and the most typical fractures in 4 Finnish hospitals.

Acta Orthop 2022 03 7;93:360-366. Epub 2022 Mar 7.

University of Eastern Finland, School of Medicine, Kuopio; Kuopio Musculoskeletal Research Unit (KMRU), University of Eastern Finland, Kuopio; Kuopio University Hospital, Kuopio.

Background And Purpose: COVID-19 lockdowns have affected personal mobility and behavior worldwide. This study compared the number of emergency department (ED) visits due to injuries and typical low-energy fractures in Finland during the COVID-19 lockdown period in spring 2020 to the reference period in 2019.

Patients And Methods: The data was collected retrospectively from the electronic patient records of 4 hospitals covering 1/5 of the Finnish population. Read More

View Article and Full-Text PDF

How to navigate the landscape of trochanteric hip fracture implants.

Authors:
Frede Frihagen

Acta Orthop 2022 03 7;93:358-359. Epub 2022 Mar 7.

Department of Orthopaedic Surgery, Østfold Hospital Trust, Grålum and Institute of Clinical Medicine, University of Oslo, Oslo, Norway.

View Article and Full-Text PDF

Locking plate osteosynthesis in geriatric shoulder fractures: why do we continue to perform a low-value procedure?

Authors:
Stig Brorson

Acta Orthop 2022 02 24;93:355-357. Epub 2022 Feb 24.

Centre for Evidence-Based Orthopaedics, Department of Orthopaedic Surgery, Zealand University Hospital, Denmark.

View Article and Full-Text PDF
February 2022

Low incidence of clinically relevant bleeding complications after fast-track arthroplasty: a register study of 8,511 arthroplasties.

Acta Orthop 2022 02 24;93:348-354. Epub 2022 Feb 24.

Department of Surgery, Hospital Nova, Central Finland Healthcare District, Jyväskylä, Finland.

Background And Purpose: Fast-track total joint replacement (TJR) has become increasingly common. Routine thromboprophylaxis for pulmonary embolism and deep venous thrombosis prevention lasts from 2 to 5 weeks. This retrospective registry study focused on clinically relevant bleeding complications 90 days after fast-track primary TJR. Read More

View Article and Full-Text PDF
February 2022

Fast-track revision hip arthroplasty: a multicenter cohort study on 1,345 elective aseptic major component revision hip arthroplasties.

Acta Orthop 2022 02 23;93:341-347. Epub 2022 Feb 23.

Centre for Fast-track Hip and Knee Arthroplasty, Copenhagen, Denmark; Section for Surgical Pathophysiology, Rigshospitalet, Copenhagen, Denmark.

Background And Purpose: Data on application of fasttrack/enhanced recovery protocols in revision hip arthroplasty (R-THA) surgery is scarce. We report length of stay (LOS), risk of LOS > 5 days, and readmission ≤ 90 days after revision hip arthroplasty in centers with a well-established fast-track protocol in both primary and revision procedures.

Patients And Methods: This is an observational cohort study from the Centre for Fast-track Hip and Knee Replacement and the Danish Hip Arthroplasty Register. Read More

View Article and Full-Text PDF
February 2022

Study protocol: The SunBurst trial-a register-based, randomized controlled trial on thoracolumbar burst fractures.

Acta Orthop 2022 01 24;93:256-263. Epub 2022 Jan 24.

Department of Clinical Science Intervention and Technology, Karolinska Institutet, K54, Stockholm; Department of Reconstructive Orthopaedics, Karolinska University Hospital, Huddinge, Stockholm.

Background And Purpose: The treatment for patients with thoracolumbar burst fractures without neurological deficit or complete rupture of the posterior ligament complex (PLC) is controversial and includes both surgical and non-surgical options. Current evidence on which treatment is optimal remains inconclusive. In this study we compare surgical with non-surgical treatment. Read More

View Article and Full-Text PDF
January 2022

Rare primary patellar resurfacing does not lead to more secondary patellar resurfacing: analysis of 70,014 primary total knee arthroplasties in the Dutch Arthroplasty Register (LROI).

Acta Orthop 2022 02 14;93:334-340. Epub 2022 Feb 14.

Department of Orthopedic Surgery, Martini Hospital Groningen, Groningen, The Netherlands.

Background And Purpose: Current literature provides no conclusive evidence in support of a patellar resurfacing vs. non-resurfacing regime. Therefore, we compared the incidence of secondary patellar resurfacing among hospitals using 3 different primary patellar resurfacing regimes in the Netherlands. Read More

View Article and Full-Text PDF
February 2022

Ankle fractures in Finland: 118,929 operatively treated between 1987 and 2019.

Acta Orthop 2022 02 11;93:327-333. Epub 2022 Feb 11.

Kuopio Musculoskeletal Research Unit, University of Eastern Finland, Kuopio; University Hospital, Kuopio, Finland.

Background And Purpose: Ankle fractures are one of the most common fractures requiring operative treatment. They occur most commonly in postmenopausal women and younger men and recent studies suggest that the incidence of ankle fractures is increasing. In this registry study, we analyze inpatient data of operatively treated ankle fractures during a period of 33 years from our comprehensive nationwide register data. Read More

View Article and Full-Text PDF
February 2022

Study protocol: Prosthesis versus Active (ProAct) exercise program in patients with glenohumeral osteoarthritis - a multicenter, randomized controlled trial.

Acta Orthop 2022 02 8;93:303-316. Epub 2022 Feb 8.

Department of Orthopaedic Surgery, Aarhus University Hospital, Aarhus N, Denmark; Department of Clinical Medicine, Aarhus University, Aarhus N, Denmark.

Background And Purpose: Total shoulder arthroplasty (TSA) and shoulder exercises are both effective treatments for reducing pain and improving function in glenohumeral osteoarthritis. However, the effectiveness of TSA has not been compared with non-surgical treatment in a randomized controlled trial. We will examine whether TSA followed bystandard postsurgical rehabilitation is superior to a 12-week exercise program in patients with primary glenohumeral OA who are eligible for unilateral TSA. Read More

View Article and Full-Text PDF
February 2022

Similar risk of cancer in patients younger than 55 years with or without a total hip arthroplasty (THA): a population- based cohort study on 18,771 exposed to THA and 87,683 controls.

Acta Orthop 2022 02 8;93:317-326. Epub 2022 Feb 8.

Section of Orthopaedics, Department of Surgical Sciences, Uppsala University Hospital, Sweden; Swedish Arthroplasty Register, Gothenburg, Sweden.

Background And Purpose: Concerns related to a potentially increased risk of cancer after total hip arthroplasty (THA) have frequently surfaced, especially since the novel EU medical device regulation classified cobalt as carcinogenic. We assessed the risk of cancer after THA in a nationwide cohort of patients younger than 55 years at surgery.

Patients And Methods: In this population-based longitudinal cohort study, 18,771 individuals exposed to THA were identified in the Swedish Hip Arthroplasty Registry (SHAR) and compared with 87,683 unexposed individuals who were matched by age, sex, and residence. Read More

View Article and Full-Text PDF
February 2022

Letter to the Editor and reply concerning: Hip development after surgery to prevent hip dislocation in cerebral palsy: a longitudinal register study of 252 children.

Acta Orthop 2022 02 4;93:294-295. Epub 2022 Feb 4.

Lund University, Department of Clinical Sciences, Lund, Orthopedics; Department of Orthopedics, Skane University Hospital, Lund.

View Article and Full-Text PDF
February 2022

Good long-term outcomes of the hip Chiari osteotomy in adolescents and adults with hip dysplasia: a systematic review.

Acta Orthop 2022 02 4;93:296-302. Epub 2022 Feb 4.

Department of Orthopedics, University Medical Center Utrecht, Utrecht.

Background And Purpose: The Chiari osteotomy was a regular treatment for developmental hip dysplasia before it became mostly reserved as a salvage therapy. However, the long-term survival of the Chiari osteotomy has not been systematically investigated. We investigated the survival time of the Chiari osteotomy until conversion to total hip arthroplasty (THA) in patients with primary hip dysplasia, and factors which correlated with survival, complications, and the improvement measured in radiographic parameters. Read More

View Article and Full-Text PDF
February 2022

CT-based micromotion analysis method can assess early implant migration and development of radiolucent lines in cemented glenoid components: a clinical feasibility study.

Acta Orthop 2022 02 1;93:277-283. Epub 2022 Feb 1.

Department of Surgery and Cancer, Imperial College London, St Mary's Hospital, London, UK.

Background And Purpose: CT micromotion analysis (CTMA) has been considered as an alternative to radiostereometry (RSA) for assessing early implant migration of orthopedic implants. We investigated the feasibility of CTMA to assess early migration and the progression of radiolucent lines in shoulder arthroplasties over 24 months using sequential low-dose CT scans.

Patients And Methods: 7 patients were included and underwent 9 primary total shoulder arthroplasties. Read More

View Article and Full-Text PDF
February 2022

The effect of patient and prosthesis factors on revision rates after total knee replacement using a multi-registry meta-analytic approach.

Acta Orthop 2022 02 1;93:284-293. Epub 2022 Feb 1.

Surgical Outcomes and Analysis, Kaiser Permanente, San Diego, CA, USA.

Background And Purpose: Characteristics of patients receiving total knee arthroplasty (TKA) and prostheses used vary between regions and change with time. How these practice variations influence revision remains unclear. We combined registry data for better understanding of the impact of variation, which could potentially improve revision rates. Read More

View Article and Full-Text PDF
February 2022

Late stabilization after initial migration in patients undergoing cemented total knee arthroplasty: a 5-year followup of 2 randomized controlled trials using radiostereometric analysis.

Acta Orthop 2022 01 24;93:271-276. Epub 2022 Jan 24.

Department of Orthopaedics, Hässleholm Hospital, Hässleholm, Sweden and Department of Clinical Sciences, Lund University, Lund, Sweden.

Background And Purpose: In total knee arthroplasty (TKA), metal-backed (MBT) and all-polyethylene (APT) designs have shown comparable implant migration up to 2 years postoperatively using radiostereometric analysis (RSA). However, studies comparing mid-term migration of both designs are lacking. Furthermore, continuously migrating TKAs up to 2 years may continue to migrate or stabilize thereafter. Read More

View Article and Full-Text PDF
January 2022