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Acta Orthopaedica

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https://www.readbyqxmd.com/read/28715928/lack-of-evidence-the-anti-stepwise-introduction-of-metal-on-metal-hip-replacements
#1
Aleksi Reito, Lari Lehtovirta, Olli Lainiala, Keijo Mäkelä, Antti Eskelinen
Background and purpose - Orthopedics and especially joint replacement surgery have had more than their fair share of unsuccessful innovations that have violated widely endorsed principles for the introduction of new surgical innovations. We aimed to investigate (1) the trends in the use of the Birmingham Hip Resurfacing (BHR), the ASR hip resurfacing (ASR HRA) and the ASR XL total hip replacement (ASR XL THR) system with very different market approval processes and (2) whether their use was corroborated by clinical trials published in the peer-reviewed literature...
July 18, 2017: Acta Orthopaedica
https://www.readbyqxmd.com/read/28699417/comparison-of-metal-ion-concentrations-and-implant-survival-after-total-hip-arthroplasty-with-metal-on-metal-versus-metal-on-polyethylene-articulations
#2
Henrik Dahlstrand, André Stark, Marius C Wick, Lucas Anissian, Nils P Hailer, Rüdiger J Weiss
Background and purpose - Large metal-on-metal (MoM) articulations are associated with metal wear and corrosion, leading to increased metal ion concentrations and unacceptable revision rates. There are few comparative studies of 28-mm MoM articulations with conventional metal-on-polyethylene (MoP) couplings. We present a long-term follow-up of a randomized controlled trial comparing MoM versus MoP 28-mm articulations, focused on metal ions and implant survival. Patients and methods - 85 patients with a mean age of 65 years at surgery were randomized to a MoM (Metasul) or a MoP (Protasul) bearing...
July 12, 2017: Acta Orthopaedica
https://www.readbyqxmd.com/read/28699373/recall-and-patient-perceptions-of-hip-precautions-6-weeks-after-total-hip-arthroplasty
#3
George R H Lee, James R Berstock, Michael R Whitehouse, Ashley W Blom
Background and purpose - There is a lack of evidence to support the role of hip precautions in preventing dislocation following total hip arthroplasty (THA). We report an exploratory study which assesses recall, adherence, and the impact of precautions on activities of daily living in the first 6 weeks postoperatively. Patients and methods - We designed a new questionnaire based on the education patients receive and refined by professionals within our multidisciplinary team. 129 patients underwent primary elective THA during the study period and received the questionnaire at 6 weeks postoperatively...
July 12, 2017: Acta Orthopaedica
https://www.readbyqxmd.com/read/28691547/reduced-risk-of-reoperation-after-treatment-of-femoral-neck-fractures-with-total-hip-arthroplasty
#4
Susanne Hansson, Szilard Nemes, Johan Kärrholm, Cecilia Rogmark
Background and purpose - Femoral neck fractures (FNFs) are commonly treated with some kind of arthroplasty, but evidence on whether to use hemiarthroplasty (HA) or total hip arthroplasty (THA) is lacking. HA reduces the risk of dislocation, but may lead to acetabular erosion. THA implies longer surgery and increased bleeding. THA may result in better function and health-related quality of life, but evidence is contradictory. We compared HA and THA and in terms of revision, reoperation and death. Patients and methods - Data were extracted from the Swedish Hip Arthroplasty Register for 11,253 patients with acute FNF receiving cemented HA or THA during 2008-2012...
July 10, 2017: Acta Orthopaedica
https://www.readbyqxmd.com/read/28682145/a-link-between-osteomyelitis-and-il1rn-and-il1b-polymorphisms-a-study-in-patients-from-northeast-brazil
#5
Clinio Alves De Souza, Argos Queiroz Alves De Souza, Maria do Socorro Queiroz Alves De Souza, José Alberto Dias Leite, Maíra Silva De Morais, Sílvia Helena Barem Rabenhorst
Background and purpose - Treatment failure of osteomyelitis can result from genetic susceptibility, highlighting polymorphisms of the interleukin-1 (IL-1) family members, central mediators of innate immunity and inflammation. Polymorphisms are DNA sequence variations that are common in the population (1% or more) and represent multiple forms of a single gene. We investigated the association of IL1RNVNTR (rs2234663) and IL1B-511C > T (rs16944) polymorphisms with osteomyelitis development in patients operated on because of bone trauma...
July 6, 2017: Acta Orthopaedica
https://www.readbyqxmd.com/read/28681679/artificial-intelligence-for-analyzing-orthopedic-trauma-radiographs
#6
Jakub Olczak, Niklas Fahlberg, Atsuto Maki, Ali Sharif Razavian, Anthony Jilert, André Stark, Olof Sköldenberg, Max Gordon
Background and purpose - Recent advances in artificial intelligence (deep learning) have shown remarkable performance in classifying non-medical images, and the technology is believed to be the next technological revolution. So far it has never been applied in an orthopedic setting, and in this study we sought to determine the feasibility of using deep learning for skeletal radiographs. Methods - We extracted 256,000 wrist, hand, and ankle radiographs from Danderyd's Hospital and identified 4 classes: fracture, laterality, body part, and exam view...
July 6, 2017: Acta Orthopaedica
https://www.readbyqxmd.com/read/28681677/improved-outcome-after-hip-fracture-surgery-in-norway
#7
Jan-Erik Gjertsen, Eva Dybvik, Ove Furnes, Jonas M Fevang, Leif I Havelin, Kjell Matre, Lars B Engesæster
Background and purpose - The operative treatment of hip fractures in Norway has changed considerably during the last decade. We used data in the Norwegian Hip Fracture Register to investigate possible effects of these changes on reoperations and 1-year mortality. Patients and methods - 72,741 femoral neck (FFN) fractures and trochanteric fractures in patients 60 years or older were analyzed. The fractures were divided into 5 time periods (2005-2006, 2007-2008, 2009-2010, 2011-2012, 2013-2014). Cox regression models were used to calculate unadjusted and adjusted (age group, sex, and ASA class) relative risks (RRs) of reoperation and of 1-year mortality in the different time periods...
July 6, 2017: Acta Orthopaedica
https://www.readbyqxmd.com/read/28665226/is-a-long-leg-a-risk-for-hip-or-knee-osteoarthritis
#8
Kaj Tallroth, Leena Ristolainen, Mikko Manninen
Background and purpose - 7% of the asymptomatic population has leg-length inequality (LLI) greater than 12 mm. It has been proposed that LLI of >5 mm can be associated with an increased risk of osteoarthritis (OA) of the knee and hip. We studied a possible association between LLI and OA of the knee and hip joint. Patients and methods - We followed 193 individuals (97 women, 96 men) for 29 years. The initial mean age of the participants was 43 (34-54) years, and they had no clinical histories or signs of leg symptoms...
June 30, 2017: Acta Orthopaedica
https://www.readbyqxmd.com/read/28665174/inappropriate-use-of-arthroscopic-meniscal-surgery-in-degenerative-knee-disease
#9
Leander L S Muheim, Oliver Senn, Mathias Früh, Oliver Reich, Thomas Rosemann, Stefan M Neuner-Jehle
Background and purpose - Current evidence suggests that arthroscopic knee surgery has no added benefit compared with non-surgical management in degenerative meniscal disease. Yet in many countries, arthroscopic partial meniscectomy (APM) remains among the most frequently performed surgeries. This study quantifies and characterizes the dynamics of the current use of knee arthroscopies in Switzerland in a distinctively non-traumatic patient group. Methods - We assessed a non-accident insurance plan of a major Swiss health insurance company for surgery rates of APM, arthroscopic debridement and lavage in patients over the age of 40, comparing the years 2012 and 2015...
June 30, 2017: Acta Orthopaedica
https://www.readbyqxmd.com/read/28657407/comorbidity-does-not-predict-long-term-mortality-after-total-hip-arthroplasty
#10
Erik Bülow, Ola Rolfson, Peter Cnudde, Cecilia Rogmark, Göran Garellick, Szilárd Nemes
Background and purpose - In-hospital death following total hip arthroplasty (THA) is related to comorbidity. The long-term effect of comorbidity on all-cause mortality is, however, unknown for this group of patients and it was investigated in this study. Patients and methods - We used data from the Swedish Hip Arthroplasty Register, linked to the National Patient Register from the National Board of Health and Welfare, for patients operated on with THA in 1999-2012. We identified 120,836 THAs that could be included in the study...
June 28, 2017: Acta Orthopaedica
https://www.readbyqxmd.com/read/28657396/preoperative-methylprednisolone-does-not-reduce-loss-of-knee-extension-strength-after-total-knee-arthroplastya-randomized-double-blind-placebo-controlled-trial-of-61-patients
#11
Viktoria Lindberg-Larsen, Thomas Q Bandholm, Camilla K Zilmer, Jens Bagger, Mette Hornsleth, Henrik Kehlet
Background and purpose - Patients undergoing total knee arthroplasty (TKA) face challenges related to postoperative reduction in knee-extension strength. We evaluated whether inhibition of the inflammatory response by a single preoperative dose of methylprednisolone (MP) reduces the pronounced loss of knee-extension strength at discharge after fast-track TKA. Patients and methods - 70 patients undergoing elective unilateral TKA were randomized (1:1) to preoperative intravenous (IV) MP 125 mg (group MP) or isotonic saline IV (group C)...
June 28, 2017: Acta Orthopaedica
https://www.readbyqxmd.com/read/28640672/consistency-in-patient-reported-outcomes-after-total-hip-replacement
#12
Albin Bengtsson, Gabrielle S Donahue, Szilard Nemes, Göran Garellick, Ola Rolfson
Purpose - The primary objective in this study was to describe the patient-reported outcome measures (PROMs) of total hip replacement (THR) patients 6 years after index surgery. Second, we sought to analyze how the preoperative, 1- and 6-year outcomes were associated. Patients and methods - By assessing the Swedish Hip Arthroplasty Register (SHAR), 15,755 patients with complete follow-up were included in the study group. 1-year and 6-year response rates were 93% and 87%. PROMs used by the SHAR include the EQ-5D instrument, and 2 modified visual analogue scales, 1 for pain and 1 for satisfaction...
June 22, 2017: Acta Orthopaedica
https://www.readbyqxmd.com/read/28639846/antibiotic-prophylaxis-is-not-indicated-prior-to-dental-procedures-for-prevention-of-periprosthetic-joint-infections
#13
Willem M H Rademacher, Geert H I M Walenkamp, Dirk Jan F Moojen, Johannes G E Hendriks, Theo A Goedendorp, Frederik R Rozema
Background and purpose - To minimize the risk of hematogenous periprosthetic joint infection (HPJI), international and Dutch guidelines recommended antibiotic prophylaxis prior to dental procedures. Unclear definitions and contradictory recommendations in these guidelines have led to unnecessary antibiotic prescriptions. To formulate new guidelines, a joint committee of the Dutch Orthopaedic and Dental Societies conducted a systematic literature review to answer the following question: can antibiotic prophylaxis be recommended for patients (with joint prostheses) undergoing dental procedures in order to prevent dental HPJI? Methods - The Medline, Embase, and Cochrane databases were searched for randomized controlled trials (RCTs), reviews, and observational studies up to July 2015...
June 22, 2017: Acta Orthopaedica
https://www.readbyqxmd.com/read/28627290/continuous-adductor-canal-block-added-to-local-infiltration-analgesia-lia-after-total-knee-arthroplasty-has-no-additional-benefits-on-pain-and-ambulation-on-postoperative-day-1-and-2-compared-with-lia-alone
#14
Svava Gudmundsdottir, Jonas L Franklin
Background and purpose - The additional effects of a continuous adductor canal block (ACB) compared with a single-dose local infiltration anesthesia (LIA) after total knee arthroplasty (TKA) has not been widely researched. Both methods have good effect individually. We hypothesized that a continuous ACB added to a single-dose LIA would lower pain scores while ambulating on postoperative day 1 (POD1) and postoperative day 2 (POD2). Patients and methods - 69 participants were included in this prospective, randomized, double-blind, placebo-controlled trial...
June 19, 2017: Acta Orthopaedica
https://www.readbyqxmd.com/read/28613966/radiographic-classifications-in-perthes-disease
#15
Stefan Huhnstock, Svein Svenningsen, Else Merckoll, Anthony Catterall, Terje Terjesen, Ola Wiig
Background and purpose - Different radiographic classifications have been proposed for prediction of outcome in Perthes disease. We assessed whether the modified lateral pillar classification would provide more reliable interobserver agreement and prognostic value compared with the original lateral pillar classification and the Catterall classification. Patients and methods - 42 patients (38 boys) with Perthes disease were included in the interobserver study. Their mean age at diagnosis was 6.5 (3-11) years...
June 14, 2017: Acta Orthopaedica
https://www.readbyqxmd.com/read/28612669/classification-systems-for-distal-radius-fractures
#16
Ydo V Kleinlugtenbelt, Sylvester R Groen, S John Ham, Peter Kloen, Robert Haverlag, Maarten P Simons, Vanessa A B Scholtes, Mohit Bhandari, J Carel Goslings, Rudolf W Poolman
Background and purpose - The reliability of conventional radiography when classifying distal radius fractures (DRF) is fair to moderate. We investigated whether reliability increases when additional computed tomography scans (CT) are used. Patients and methods - In this prospective study, we performed pre- and postreduction posterior-anterior and lateral radiographs of 51 patients presenting with a displaced DRF. The case was included when there was a (questionable) indication for surgical treatment and an additional CT was conducted within 5 days...
June 14, 2017: Acta Orthopaedica
https://www.readbyqxmd.com/read/28562150/preoperative-psychosocial-risk-factors-for-poor-outcomes-at-1-and-5-years-after-total-knee-replacement
#17
Vikki Wylde, Lea Trela-Larsen, Michael R Whitehouse, Ashley W Blom
Background and purpose - Psychosocial factors are important risk factors for poor outcomes in the first year after total knee replacement (TKR), however their impact on long-term outcomes is unclear. We aimed to identify preoperative psychosocial risk factors for poor outcomes at 1 year and 5 years after TKR. Patients and methods - 266 patients were recruited prior to TKR surgery. Knee pain and function were assessed preoperatively and at 1 and 5 years postoperative using the WOMAC Pain score, WOMAC Function score and American Knee Society Score (AKSS) Knee score...
May 31, 2017: Acta Orthopaedica
https://www.readbyqxmd.com/read/28492106/higher-risk-of-revision-for-infection-using-systemic-clindamycin-prophylaxis-than-with-cloxacillin
#18
Otto Robertsson, Olof Thompson, Annette W-Dahl, Martin Sundberg, Lars Lidgren, Anna Stefánsdóttir
Background and purpose - Clindamycin has not been compared with other antibiotics for prophylaxis in arthroplasty. Since 2009, the Swedish Knee Arthroplasty Register (SKAR) has been collecting information on the prophylactic antibiotic regime used at every individual operation. In Sweden, when there is allergy to penicillin, clindamycin has been the recommended alternative. We examined whether there were differences in the rate of revision due to infection depending on which antibiotic was used as systemic prophylaxis...
May 11, 2017: Acta Orthopaedica
https://www.readbyqxmd.com/read/28657489/effect-of-platelet-rich-plasma-on-rat-achilles-tendon-healing-is-related-to-microbiota
#19
Franciele Dietrich, Malin Hammerman, Parmis Blomgran, Love Tätting, Vinicius Faccin Bampi, Jefferson Braga Silva, Per Aspenberg
No abstract text is available yet for this article.
August 2017: Acta Orthopaedica
https://www.readbyqxmd.com/read/28562146/time-trends-in-pediatric-fracture-incidence-in-sweden-during-the-period-1950-2006
#20
Vasileios Lempesis, Björn E Rosengren, Jan-Åke Nilsson, Lennart Landin, Carl Johan Tiderius, Magnus K Karlsson
Background and purpose - Pediatric fracture incidence may not be stable. We describe recent pediatric fracture epidemiology and etiology and compare this to earlier data. Patients and methods - The city of Malmö (population 271,271 in 2005) in Sweden is served by 1 hospital. Using the hospital diagnosis registry, medical charts, and the radiographic archive, we identified fractures in individuals <16 years that had occurred during 2005 and 2006. We also retrieved previously collected fracture data from between 1950 and 1994, from the hospital's pediatric fracture database...
August 2017: Acta Orthopaedica
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