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    1836 results match your criteria Acta Orthopaedica [Journal]

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    Higher cartilage wear in unipolar than bipolar hemiarthroplasties of the hip at 2 years: A randomized controlled radiostereometric study in 19 fit elderly patients with femoral neck fractures.
    Acta Orthop 2018 May 23:1-6. Epub 2018 May 23.
    b Division of Orthopaedic Surgery , Oslo University Hospital.
    Background and purpose - The use of unipolar hemi-arthroplasties for femoral neck fractures is increasing in some countries due to reports of higher reoperation rates in bipolar prostheses. On the other hand, it has been proposed that bipolar hemiarthroplasties have clinical advantages and less cartilage wear than unipolar hemiarthroplasties. We compared cartilage wear between bipolar and unipolar hemiarthroplasties using radiostereometric analyses (RSA), in patients aged 70 years or older. Read More

    Outcomes following hip and knee replacement in diabetic versus nondiabetic patients and well versus poorly controlled diabetic patients: a prospective cohort study.
    Acta Orthop 2018 May 14:1-7. Epub 2018 May 14.
    a Musculoskeletal Research Unit, Translational Health Sciences, Bristol Medical School, University of Bristol , Bristol.
    Background and purpose - The impact of diabetes and glycemic control before joint replacement on clinical and patient-reported outcomes is unclear. We compared pain, function, complications, and length of hospital stay in diabetic and nondiabetic patients receiving primary total hip (THR) or knee replacement (TKR) and compared these outcomes in patients with poorly controlled versus well-controlled diabetes. Patients and methods - We conducted a prospective cohort study of patients undergoing primary THR (n = 300) or TKR (n = 287) for osteoarthritis. Read More

    Teaching basic trauma: validating FluoroSim, a digital fluoroscopic simulator for guide-wire insertion in hip surgery.
    Acta Orthop 2018 May 10:1-6. Epub 2018 May 10.
    a Institute of Orthopaedics & Musculoskeletal Sciences , University College London , London , UK ;
    Background and purpose - Simulation is an adjunct to surgical education. However, nothing can accurately simulate fluoroscopic procedures in orthopedic trauma. Current options for training with fluoroscopy are either intraoperative, which risks radiation, or use of expensive and unrealistic virtual reality simulators. Read More

    Peri-apatite coating decreases uncemented tibial component migration: long-term RSA results of a randomized controlled trial and limitations of short-term results.
    Acta Orthop 2018 May 9:1-6. Epub 2018 May 9.
    c Department of Orthopaedics , Hässleholm Hospital , Hässleholm , Sweden and Department of Clinical Sciences , Lund University , Lund , Sweden.
    Background and purpose - Biological fixation of uncemented knee prostheses can be improved by applying hydroxyapatite coating around the porous surface via a solution deposition technique called Peri-Apatite (PA). The 2-year results of a randomized controlled trial, evaluating the effect of PA, revealed several components with continuous migration in the second postoperative year, particularly in the uncoated group. To evaluate whether absence of early stabilization is diagnostic of loosening, we now present long-term follow-up results. Read More

    A 2-year RSA study of the Vanguard CR total knee system: A randomized controlled trial comparing patient-specific positioning guides with conventional technique.
    Acta Orthop 2018 May 9:1-7. Epub 2018 May 9.
    d Division of Orthopaedic Surgery , Oslo University Hospital , Oslo.
    Background and purpose - There is some concern regarding the revision rate of the Vanguard CR TKA in 1 registry, and the literature is ambiguous about the efficacy of patient-specific positioning guides (PSPGs). The objective of this study was to investigate the stability of the cemented Vanguard CR Total Knee using 2 different surgical techniques. Our hypothesis was that there is no difference in migration when implanting the Vanguard CR with either PSPGs or conventional technique. Read More

    Migration of all-polyethylene compared with metal-backed tibial components in cemented total knee arthroplasty.
    Acta Orthop 2018 May 1:1-6. Epub 2018 May 1.
    c Department of Orthopaedics , Hässleholm Hospital, Hässleholm , Sweden and Department of Clinical Sciences , Lund University , Lund , Sweden.
    Background and purpose - With a rapidly increasing population in need of total knee arthroplasty (TKA), there is renewed interest in cost-saving all-polyethylene designs. Differences between metal-backed and all-polyethylene designs in initial component migration assessed by radiostereometric analysis (RSA), a proven predictor for late aseptic loosening, have been scantily reported. The purpose of this study was to compare implant migration and clinical outcomes of all-polyethylene tibial components versus metal-backed trays of similar geometrical shape. Read More

    Knee extensor muscle weakness and radiographic knee osteoarthritis progression.
    Acta Orthop 2018 May 1:1-6. Epub 2018 May 1.
    b Institute of Anatomy , Paracelsus Medical University Salzburg and Nuremburg , Salzburg , Austria.
    Background and purpose - Knee extensor (KE) muscle weakness is a modifiable feature commonly observed in individuals with knee osteoarthritis (KOA) and constitutes a potential target for patient-specific interventions. Therefore, in this study, we explored whether KE weakness is associated with radiographic (medial and/or lateral) KOA progression and how this relationship differs depending on frontal plane knee alignment and sex. Patients and methods - We studied 3,075 knees (1,961 participants, 58% female) from the Osteoarthritis Initiative with radiographic Kellgren-Lawrence grade 1-3. Read More

    Osteochondral lesions of the talus.
    Acta Orthop 2018 Apr 11:1-6. Epub 2018 Apr 11.
    a Department of Orthopedic Surgery, Asan Medical Center, College of Medicine , University of Ulsan , Seoul.
    Background and purpose - The frequency of progression of osteoarthritis and persistence of symptoms in untreated osteochondral lesion of the talus (OCL) is not well known. We report the outcome of a nonoperative treatment for symptomatic OCL. Patients and methods - This study included 142 patients with OCLs from 2003 to 2013. Read More

    Bone mineral density changes in the graft after acetabular impaction bone grafting in primary and revision hip surgery.
    Acta Orthop 2018 Jun 11;89(3):302-307. Epub 2018 Apr 11.
    a Department of Orthopedics , Rijnstate Hospital , Arnhem.
    Background and purpose - Impaction bone grafting (IBG) is an established method in hip revision surgery to reconstruct loss of bone stock. There is limited knowledge concerning the actual bone remodelling process within the allograft. We investigated with repeated bone mineral density (BMD) measurements the biological process of bone remodelling in the allograft in vivo. Read More

    Is gain in health-related quality of life after a total hip arthroplasty depended on the comorbidity burden?
    Acta Orthop 2018 Apr 6:1-6. Epub 2018 Apr 6.
    a University Clinic for Hand, Hip and Knee Surgery, Regional Hospital West Jutland, Aarhus University , Holstebro.
    Background and purpose - Using patient-reported health-related quality of life (HRQoL), approximately 10% of patients report some degree of dissatisfaction after a total hip arthroplasty (THA). The preoperative comorbidity burden may play a role in predicting which patients may have limited benefit from a THA. Therefore, we examined whether gain in HRQoL measured with the EuroQol-5D (EQ-5D) at 3 and 12 months of follow-up depended on the comorbidity burden in THA patients Patients and methods - 1,582 THA patients treated at the Regional Hospital West Jutland from 2008 to 2013 were included. Read More

    Threshold values of ankle dorsiflexion and gross motor function in 60 children with cerebral palsy.
    Acta Orthop 2018 Mar 28:1-6. Epub 2018 Mar 28.
    a Department of Orthopedic Surgery and Traumatology , Odense University Hospital.
    Background and purpose - Threshold values defining 3 categories of passive range of motion are used in the Cerebral Palsy follow-Up Program to guide clinical decisions. The aim of this study was to investigate the threshold values by testing the hypothesis that passive range of motion in ankle dorsiflexion is associated with gross motor function and that function differs between the groups of participants in each category. Patients and methods - We analyzed data from 60 ambulatory children (aged 5-9 years) with spastic cerebral palsy. Read More

    Meta-analysis of individual registry results enhances international registry collaboration.
    Acta Orthop 2018 Mar 28:1-5. Epub 2018 Mar 28.
    a Kaiser Permanente , San Diego , CA , USA.
    Background and purpose - Although common in medical research, meta-analysis has not been widely adopted in registry collaborations. A meta-analytic approach in which each registry conducts a standardized analysis on its own data followed by a meta-analysis to calculate a weighted average of the estimates allows collaboration without sharing patient-level data. The value of meta-analysis as an alternative to individual patient data analysis is illustrated in this study by comparing the risk of revision of porous tantalum cups versus other uncemented cups in primary total hip arthroplasties from Sweden, Australia, and a US registry (2003-2015). Read More

    Automated detection and classification of the proximal humerus fracture by using deep learning algorithm.
    Acta Orthop 2018 Mar 26:1-6. Epub 2018 Mar 26.
    j Center for Bionics, Korea Institute of Science and Technology , Seoul , Korea.
    Background and purpose - We aimed to evaluate the ability of artificial intelligence (a deep learning algorithm) to detect and classify proximal humerus fractures using plain anteroposterior shoulder radiographs. Patients and methods - 1,891 images (1 image per person) of normal shoulders (n = 515) and 4 proximal humerus fracture types (greater tuberosity, 346; surgical neck, 514; 3-part, 269; 4-part, 247) classified by 3 specialists were evaluated. We trained a deep convolutional neural network (CNN) after augmentation of a training dataset. Read More

    Incidence of scoliosis in cerebral palsy.
    Acta Orthop 2018 Mar 14:1-5. Epub 2018 Mar 14.
    a Lund University , Department of Clinical Sciences , Lund , Orthopedics.
    Background and purpose - Surveillance of scoliosis in individuals with cerebral palsy (CP) is important for ensuring timely diagnosis and identification of curve progression. We analyzed the incidence of scoliosis in relation to age, sex, and gross motor function in a population-based cohort of individuals with CP. Patients and methods - This was a prospective register study of all 1,025 individuals born 1990-2012 in southern Sweden (1. Read More

    High risk for revision after shoulder arthroplasty for failed osteosynthesis of proximal humeral fractures.
    Acta Orthop 2018 Jun 14;89(3):345-350. Epub 2018 Mar 14.
    d Department of Orthopaedic Surgery , Zealand University Hospital, University of Copenhagen , Køge , Denmark.
    Background and purpose - It is unclear whether previous osteosynthesis is a risk factor for inferior outcome following shoulder arthroplasty for a proximal humeral fracture. We used data from the Danish Shoulder Arthroplasty Registry (DSR) to examine this question. Patients and methods - All 285 patients treated with a shoulder arthroplasty after failed osteosynthesis of a proximal humeral fracture reported to DSR from 2006 to 2013 were included. Read More

    The effect of surgeon's preference for hybrid or cemented fixation on the long-term survivorship of total knee replacement.
    Acta Orthop 2018 Jun 12;89(3):329-335. Epub 2018 Mar 12.
    c Australian Orthopaedic Association National Joint Replacement Registry , SAHMRI , Adelaide , Australia.
    Background and purpose - Recent direct comparative reports suggest that hybrid fixation may have a similar or superior outcome to cemented fixation in total knee replacement (TKR); however, a paucity of long-term data exists. To minimize the confounders of a direct comparison, we performed an instrumental variable analysis examining the revision rate of 2 cohorts of patients based on their surgeon's preference for cemented or hybrid fixation. Methods - Registry data were obtained from 1999 until 2015 for 2 cohorts of patients who received minimally stabilized TKR, defined as those treated by high-volume hybrid fixation preferring surgeons, designated routinely hybrid (RH), and those treated by high-volume cemented fixation preferring surgeons, designated routinely cemented (RC). Read More

    Obesity-related metabolic and endocrine disorders diagnosed during postoperative follow-up of slipped capital femoral epiphysis.
    Acta Orthop 2018 Jun 9;89(3):314-319. Epub 2018 Mar 9.
    d Baltalimani Bone and Joint Diseases Education and Research Hospital , Department of Pediatric Orthopaedics , Turkey.
    Background and purpose - Patients with slipped capital femoral epiphysis (SCFE) are phenotypically overweight or obese and may therefore require clinical follow-up of obesity-related disorders. We evaluated obesity-related disorders such as dyslipidemia, type 2 diabetes mellitus (DM), and vitamin-D deficiency during the postoperative period in patients with SCFE. Patients and methods - 51 patients who were operated and followed-up for SCFE and 62 healthy adolescents without SCFE (control group) were included in this retrospective study. Read More

    Are competing risks models appropriate to describe implant failure?
    Acta Orthop 2018 Jun 9;89(3):256-258. Epub 2018 Mar 9.
    a Musculoskeletal Research Unit, Bristol Medical School, Southmead Hospital , Bristol.
    Background and purpose - The use of competing risks models is widely advocated in the arthroplasty literature due to a perceived bias in comparison of simple Kaplan-Meier estimates. Proponents of competing risk models in the arthroplasty literature appear to be unaware of the subtle but important differences in interpretation of net and crude failure estimated by competing risk and Kaplan-Meier methods respectively. Methods - Using a simple simulation we illustrate the differences between competing risks and Kaplan-Meier methods. Read More

    Low sensitivity of a-defensin (Synovasure) test for intra-operative exclusion of prosthetic joint infection.
    Acta Orthop 2018 Jun 6;89(3):357-359. Epub 2018 Mar 6.
    a Department of Orthopedics , Rijnstate Hospital , Arnhem , The Netherlands.
    Background and purpose - The Synovasure lateral flow test was developed as a rapid test for the detection or exclusion of periprosthetic joint infection (PJI). 3 studies have reported promising results on its diagnostic value in total joint revision surgery. We aimed to assess the sensitivity and specificity of the Synovasure test to exclude infection in patients undergoing revision surgery for suspected early aseptic loosening of a total hip or knee arthroplasty. Read More

    RSA migration of total knee replacements.
    Acta Orthop 2018 Jun 6;89(3):320-328. Epub 2018 Mar 6.
    a Department of Orthopaedics , Leiden University Medical Center , Leiden.
    Purpose - We performed a systematic review and meta-analyses to evaluate the early and long-term migration patterns of tibial components of TKR of all known RSA studies. Methods - Migration pattern was defined as at least 2 postoperative RSA follow-up moments. Maximal total point motion (MTPM) at 6 weeks, 3 months, 6 months, 1 year, 2 years, 5 years, and 10 years were considered. Read More

    Does surgeon experience affect patient-reported outcomes 1 year after primary total hip arthroplasty?
    Acta Orthop 2018 Jun 6;89(3):265-271. Epub 2018 Mar 6.
    a Swedish Hip Arthroplasty Register , Gothenburg.
    Background and purpose - Several studies have reported on the influence of various factors on patient-reported outcomes (PROs) after total hip arthroplasty (THA), but very few have focused on the experience of the surgeon. We investigated any association between surgeons' experience and PROs 1 year after primary THA. Patients and methods - Patient characteristics and surgical data at 10 hospitals in western Sweden were linked with PROs (EQ-5D-3L, Satisfaction Visual Analogue Scale (VAS), Pain VAS). Read More

    Projections of primary hip arthroplasty in Germany until 2040.
    Acta Orthop 2018 Jun 5;89(3):308-313. Epub 2018 Mar 5.
    b Universitätsmedizin Rostock, Orthopädische Klinik und Poliklinik , Rostock , Germany.
    Background and purpose - The number of hip replacements in Germany has increased considerably during the last 2 decades but lately levelled off with no significant increase in operation rates. We analyzed the future trend of hip arthroplasty and projected the number of primary hip replacements that will be performed in Germany until 2040. Patients and methods - We used prevalence data of hip arthroplasty patients from 2010 to 2016 from the nationwide inpatient statistics and population forecasts from the German Federal Bureau of Statistics up to the year 2040. Read More

    Patient-reported symptoms and changes up to 1 year after meniscal surgery.
    Acta Orthop 2018 Jun 5;89(3):336-344. Epub 2018 Mar 5.
    a Research Unit for Musculoskeletal Function and Physiotherapy , Department of Sports Science and Clinical Biomechanics , University of Southern Denmark , Odense.
    Background and purpose - Detailed information on the symptoms and limitations that patients with meniscal tears experience is lacking. This study was undertaken to map the most prevalent self-reported symptoms and functional limitations among patients undergoing arthroscopic meniscal surgery and investigate which symptoms and limitations had improved most at 1 year after surgery. Patients and methods - Patients aged 18-76 years from the Knee Arthroscopy Cohort Southern Denmark (KACS) undergoing arthroscopic meniscal surgery were included in this analysis of individual subscale items from the Knee Injury and Osteoarthritis Outcome Score and 1 question on knee stability. Read More

    Revision surgery of metal-on-metal hip arthroplasties for adverse reactions to metal debris.
    Acta Orthop 2018 Jun 1;89(3):278-288. Epub 2018 Mar 1.
    a Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences , University of Oxford, Nuffield Orthopaedic Centre , Oxford , United Kingdom.
    Background and purpose - The initial outcomes following metal-on-metal hip arthroplasty (MoMHA) revision surgery performed for adverse reactions to metal debris (ARMD) were poor. Furthermore, robust thresholds for performing ARMD revision are lacking. This article is the second of 2. Read More

    A randomized controlled trial on maximal strength training in 60 patients undergoing total hip arthroplasty.
    Acta Orthop 2018 Jun 1;89(3):295-301. Epub 2018 Mar 1.
    c Department of Mental Health, Faculty of Medicine and Health Science , Norwegian University of Science and Technology NTNU , Postbox 8905 MTFS, NO-7491 , Trondheim , Norway.
    Background and purpose - Total hip arthroplasty (THA) patients have reduced muscle strength after rehabilitation. In a previous efficacy trial, 4 weeks' early supervised maximal strength training (MST) increased muscle strength in unilateral THA patients <65 years. We have now evaluated muscle strength in an MST and in a conventional physiotherapy (CP) group after rehabilitation in regular clinical practice. Read More

    Negative effect of zoledronic acid on tendon-to-bone healing.
    Acta Orthop 2018 Jun 1;89(3):360-366. Epub 2018 Mar 1.
    b Institute of Clinical Medicine, Faculty of Medicine, University of Oslo (UIO).
    Background and purpose - Outcome after ligament reconstruction or tendon repair depends on secure tendon-to-bone healing. Increased osteoclastic activity resulting in local bone loss may contribute to delayed healing of the tendon-bone interface. The objective of this study was to evaluate the effect of the bisphosphonate zoledronic acid (ZA) on tendon-to-bone healing. Read More

    No effect of double nerve block of the lateral cutaneous nerve and subcostal nerves in total hip arthroplasty.
    Acta Orthop 2018 Jun 1;89(3):272-277. Epub 2018 Mar 1.
    a Department of Orthopaedic Surgery , Spaarne Gasthuis Hoofdorp.
    Background and purpose - The use of local infiltration anesthesia (LIA) has become one of the cornerstones of rapid recovery protocols in total knee arthroplasty patients during the past decade. In total hip arthroplasty (THR), however, the study results are more variable and LIA has therefore not yet been generally accepted. There is no consensus on which structure should be infiltrated and the cutaneous nerves are generally neglected. Read More

    Comparison between modified Dunn procedure and in situ fixation for severe stable slipped capital femoral epiphysis.
    Acta Orthop 2018 Apr 16;89(2):211-216. Epub 2018 Feb 16.
    c Department of Revision Surgery of Hip Prosthesis and Development of New Implants , Rizzoli Orthopaedic Institute , Bologna , Italy.
    Background and purpose - The best treatment option for severe slipped capital femoral epiphysis (SCFE) is still controversial. We compared clinical and radiographic outcomes of modified Dunn procedure (D) and in situ fixation (S) in severe SCFE. Patients and methods - We retrospectively compared D and S, used for severe stable SCFE (posterior sloping angle (PSA) > 50°) in 29 patients (15 D; 14 S). Read More

    Influence of surgical approach on complication risk in primary total hip arthroplasty.
    Acta Orthop 2018 Jun 16;89(3):289-294. Epub 2018 Feb 16.
    e DePuy Synthes , Raynham , United States.
    Background and purpose - Systematic comparisons of anterior approach (A) versus posterior approach (P) in primary total hip arthroplasty (THA) have largely focused on perioperative outcomes. In this systematic review with meta-analysis, we compared complication risk of A versus P in studies of primary THA with at least 1-year mean follow-up. Patients and methods - We performed a systematic review of prospective and retrospective studies with at least 1-year mean follow-up that reported complications of A and P primary THA. Read More

    9 years' follow-up of 168 pin-fixed supracondylar humerus fractures in children.
    Acta Orthop 2018 Jun 16;89(3):351-356. Epub 2018 Feb 16.
    b Children's Hospital, Helsinki University Central Hospital , Helsinki , Finland.
    Background and purpose - The long-term outcome of pin-fixed supracondylar humerus fractures (SCHF) in children is not well known. We assessed the 7- to 12-year outcome in 168 children. Patients and methods - During 2002-2006, 210 domestic children (age 7 (1-14) years) with SCHF (Gartland III 79%, Gartland II 19%, and flexion type 2%) were pin fixed in Helsinki. Read More

    Migration and clinical outcome of mobile-bearing versus fixed-bearing single-radius total knee arthroplasty.
    Acta Orthop 2018 Apr 16;89(2):190-196. Epub 2018 Feb 16.
    a Department of Orthopaedics , Leiden University Medical Center , Leiden.
    Background and purpose - Mobile-bearing total knee prostheses (TKPs) were developed in the 1970s in an attempt to increase function and improve implant longevity. However, modern fixed-bearing designs like the single-radius TKP may provide similar advantages. We compared tibial component migration measured with radiostereometric analysis (RSA) and clinical outcome of otherwise similarly designed cemented fixed-bearing and mobile-bearing single-radius TKPs. Read More

    Trabecular metal acetabular components in primary total hip arthroplasty.
    Acta Orthop 2018 Jun 5;89(3):259-264. Epub 2018 Feb 5.
    f Swedish Hip Arthroplasty Register , Department of Orthopaedics , Institute of Surgical Sciences, Sahlgrenska University Hospital , Gothenburg , Sweden.
    Background and purpose - Trabecular metal (TM) cups have demonstrated favorable results in acetabular revision and their use in primary total hip arthroplasty (THA) is increasing. Some evidence show that TM cups might decrease periprosthetic infection (PPI) incidence. We compared the survivorship of TM cups with that of other uncemented cups in primary THA, and evaluated whether the use of TM cups is associated with a lower risk of PPI. Read More

    Do dual-mobility cups cemented into porous tantalum shells reduce the risk of dislocation after revision surgery?
    Acta Orthop 2018 Apr 5;89(2):156-162. Epub 2018 Feb 5.
    a Department of Surgical Sciences/Section of Orthopedics , Uppsala University , Uppsala , Sweden.
    Background and purpose - Dual-mobility cups (DMCs) reduce the risk of dislocation and porous tantalum (TM) shells show favorable osseointegration after acetabular revision surgery, yet the combination of these implants has not been studied. We hypothesized that (1) cementing a DMC into a TM shell decreases the risk of dislocation; (2) DMCs cemented into TM shells are not at greater risk of re-revision; (3) liberation of tantalum ions is marginal after use of this combined technique. Patients and methods - We investigated the outcome in 184 hips (184 patients) after acetabular revision surgery with TM shells, fitted either with DMCs (n = 69), or with standard poly-ethylene (PE) liners (n = 115). Read More

    Risk of cancer after primary total hip replacement: The influence of bearings, cementation and the material of the stem.
    Acta Orthop 2018 Apr 1;89(2):234-239. Epub 2018 Feb 1.
    d Institute of Oncology Ljubljana , Ljubljana , Slovenia.
    Background and purpose - Despite the increasing number of total hip replacements (THRs), their systemic influence is still not known. We have studied the influence of specific features of THRs-the bearing surface, the use of bone cement and the material of the stem-on the cancer incidence. Patients and methods - In a retrospective cohort study we identified 8,343 patients with THRs performed at Valdoltra Hospital from September 1, 1997 to December 31, 2009. Read More

    Temporal trends in hip fracture incidence, mortality, and morbidity in Denmark from 1999 to 2012.
    Acta Orthop 2018 Apr 1;89(2):170-176. Epub 2018 Feb 1.
    b Department of Clinical Biochemistry , Bispebjerg Hospital, University of Copenhagen , Denmark.
    Background and purpose - While development in hip fracture incidence and mortality is well examined, none has yet looked at the temporal trends regarding prevalence of co-morbidities. Therefore we investigated changes in incidence of first hip fracture, co-morbidity prevalence, 30 day- and 1-year mortality in hip fracture patients in the Danish population during the period 1999 to 2012. Patients and methods - Patients >18 years admitted with a fractured hip in Denmark between 1996 and 2012 were identified with data for the period 1999-2012 being analyzed regarding prevalence of co-morbidities, incidence, and mortality. Read More

    Avoidable 30-day mortality analysis and failure to rescue in dysvascular lower extremity amputees.
    Acta Orthop 2018 Apr 1;89(2):246-250. Epub 2018 Feb 1.
    a Department of Orthopaedic Surgery , Copenhagen University Hospital Hvidovre.
    Background and purpose - An enhanced treatment program may decrease 30-day mortality below 20% after lower extremity amputations (LEA). The potential and limitations for further reduction are unknown. We analyzed postoperative causes of 30-day mortality, and assessed failure to rescue (FTR) rate in LEA patients who followed an enhanced treatment program. Read More

    Different competing risks models for different questions may give similar results in arthroplasty registers in the presence of few events.
    Acta Orthop 2018 Apr 1;89(2):145-151. Epub 2018 Feb 1.
    a Mathematical Institute, Leiden University , Leiden , The Netherlands.
    Background and purpose - In arthroplasty registry studies, the analysis of time to revision is complicated by the competing risk of death. There are no clear guidelines for the choice between the 2 main adjusted analysis methods, cause-specific Cox and Fine-Gray regression, for orthopedic data. We investigated whether there are benefits, such as insight into different aspects of progression to revision, to using either 1 or both regression methods in arthroplasty registry studies in general, and specifically when the length of follow-up is short relative to the expected survival of the implants. Read More

    Patient injury claims involving fractures of the distal radius.
    Acta Orthop 2018 Apr 22;89(2):240-245. Epub 2018 Jan 22.
    a Department of Orthopaedics and Traumatology , Helsinki University Central Hospital and University of Helsinki , Helsinki.
    Background and purpose - Optimal treatment for distal radius fractures remains controversial, with a significant number of fractures resulting in complications and long-term morbidity. We investigated patient injury claims related to distal radius fractures to detect the critical steps in the treatment leading to avoidable adverse events Patients and methods - We analyzed all compensated patient injury claims in Finland between 2007 and 2011. Claims were collected from the Patient Insurance Center's (PIC) nationwide claim register. Read More

    Cemented total hip replacement in patients under 55 years.
    Acta Orthop 2018 Apr 18;89(2):152-155. Epub 2018 Jan 18.
    a University of Dundee, TORT Centre, Ninewells Hospital , Dundee , Scotland , UK.
    Background and purpose - About 86,000 total hip replacements (THR) have been registered in patients under 55 years in the National Joint Registry of England and Wales (NJR). The use of uncemented implants has increased, despite their outcomes not having been proven to be significantly better than cemented implants in this registry. We determined the implant survivorship and functional outcomes of cemented THR in patients under 55 years at a minimum follow-up of 22 years. Read More

    Spinal metastasis with neurologic deficits.
    Acta Orthop 2018 Apr 12;89(2):229-233. Epub 2017 Dec 12.
    a Section of Orthopedics, Department of Molecular Medicine and Surgery , Karolinska Institute.
    Background and purpose - A significant number of patients with spinal metastases are treated non-surgically, but may need surgical treatment at a later stage due to progression of symptoms. Therefore, we investigated the need for late surgical decompression in patients with spinal metastasis who were initially deemed as non-surgical candidates, as well as the outcome of late surgery. Patients and methods - 116 patients who were referred to the orthopedic oncology department between 2002 and 2011 due to spinal metastasis with neurologic symptoms were deemed to be non-surgical candidates. Read More

    Good inter- and intraobserver reliability for assessment of the slip angle in 77 hip radiographs of children with a slipped capital femoral epiphysis.
    Acta Orthop 2018 Apr 6;89(2):217-221. Epub 2017 Dec 6.
    a Department of Orthopedics , Lund University , Lund , Sweden.
    Background and purpose - The decision on and the outcome of treatment for a slipped capital femoral epiphysis (SCFE) depend on the severity of the slip. In 2015, web-based registration was introduced into the Swedish Pediatric Orthopedic Quality (SPOQ) register. To determine whether the inclusion of commonly used methods in Sweden for radiographic measurement of SCFE (the calcar femorale [CF] method and the Billing method) is justified, we measured the inter- and intraobserver reliability of these 2 measurements. Read More

    Outpatient total hip and knee arthroplasty.
    Acta Orthop 2018 Apr 5;89(2):141-144. Epub 2017 Dec 5.
    d Section of Surgical Pathophysiology, Rigshospitalet , University of Copenhagen , Copenhagen , Denmark.
    As a result of the introduction of fast-track programs, the length of hospital stay after arthroplasty has decreased to a point where some patients meet the discharge criteria on the day of surgery. In several studies, well-established fast-track centers have demonstrated the feasibility of outpatient procedures in selected patients. However, in literature the term "outpatient" is sometimes also used for patients who spend one or more nights in hospital. Read More

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