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Acta Orthopaedica

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https://www.readbyqxmd.com/read/28640672/consistency-in-patient-reported-outcomes-after-total-hip-replacement
#1
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
#2
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
#3
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
#4
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
#5
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
#6
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/28562146/time-trends-in-pediatric-fracture-incidence-in-sweden-during-the-period-1950-2006
#7
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...
May 31, 2017: Acta Orthopaedica
https://www.readbyqxmd.com/read/28508682/the-risk-of-non-union-per-fracture-current-myths-and-revised-figures-from-a-population-of-over-4-million-adults
#8
Leanora A Mills, Stuart A Aitken, A Hamish R W Simpson
Background and purpose - Fracture non-union remains a major clinical problem, yet there are no data available regarding the overall risk of fractures progressing to non-union in a large population. We investigated the rate of non-union per fracture in a large adult population. Methods - National data collected prospectively over a 5-year period and involving just under 5,000 non-unions were analyzed and compared to the incidence of fracture in the same period. Results and interpretation - The overall risk of non-union per fracture was 1...
May 16, 2017: Acta Orthopaedica
https://www.readbyqxmd.com/read/28492106/higher-risk-of-revision-for-infection-using-systemic-clindamycin-prophylaxis-than-with-cloxacillin
#9
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/28492105/metastatic-spinal-cord-compression-as-the-first-sign-of-malignancy
#10
Johan Wänman, Pawel Grabowski, Helena Nyström, Patrik Gustafsson, Anders Bergh, Anders Widmark, Sead Crnalic
Background and purpose - Metastatic spinal cord compression (MSCC) as the initial manifestation of malignancy (IMM) limits the time for diagnostic workup; most often, treatment is required before the final primary tumor diagnosis. We evaluated neurological outcome, complications, survival, and the manner of diagnosing the primary tumor in patients who were operated for MSCC as the IMM. Patients and methods - Records of 69 consecutive patients (51 men) who underwent surgery for MSCC as the IMM were reviewed...
May 11, 2017: Acta Orthopaedica
https://www.readbyqxmd.com/read/28440704/effect-of-femoral-head-size-and-surgical-approach-on-risk-of-revision-for-dislocation-after-total-hip-arthroplasty
#11
Wierd P Zijlstra, Bas De Hartog, Liza N Van Steenbergen, B Willem Scheurs, Rob G H H Nelissen
Background and purpose - Recurrent dislocation is the commonest cause of early revision of a total hip arthropasty (THA). We examined the effect of femoral head size and surgical approach on revision rate for dislocation, and for other reasons, after total hip arthroplasty (THA). Patients and methods - We analyzed data on 166,231 primary THAs and 3,754 subsequent revision THAs performed between 2007 and 2015, registered in the Dutch Arthroplasty Register (LROI). Revision rate for dislocation, and for all other causes, were calculated by competing-risk analysis at 6-year follow-up...
April 25, 2017: Acta Orthopaedica
https://www.readbyqxmd.com/read/28426262/feasibility-of-outpatient-total-hip-and-knee-arthroplasty-in-unselected-patients
#12
Kirill Gromov, Per Kjærsgaard-Andersen, Peter Revald, Henrik Kehlet, Henrik Husted
Background and purpose - The number of patients who are suitable for outpatient total hip and knee arthroplasty (THA and TKA) in an unselected patient population remains unknown. The purpose of this prospective 2-center study was to identify the number of patients suitable for outpatient THA and TKA in an unselected patient population, to investigate the proportion of patients who were discharged on the day of surgery (DOS), and to identify reasons for not being discharged on the DOS. Patients and methods - All consecutive, unselected patients who were referred to 2 participating centers and who were scheduled for primary THA and TKA were screened for eligibility for outpatient surgery with discharge to home on DOS...
April 20, 2017: Acta Orthopaedica
https://www.readbyqxmd.com/read/28426259/the-sernbo-score-predicts-1-year-mortality-after-displaced-femoral-neck-fractures-treated-with-a-hip-arthroplasty
#13
Carl Mellner, Thomas Eisler, Johannes Börsbo, Cyrus Brodén, Per Morberg, Sebastian Mukka
Background and purpose - Displaced femoral neck fractures (FNFs) are associated with high rates of mortality during the first postoperative year. The Sernbo score (based on age, habitat, mobility, and mental state) can be used to stratify patients into groups with different 1-year mortality. We assessed this predictive ability in patients with a displaced FNF treated with a hemiarthroplasty or a total hip arthroplasty. Patients and methods - 292 patients (median age 83 (65-99) years, 68% female) with a displaced FNF were included in this prospective cohort study...
April 20, 2017: Acta Orthopaedica
https://www.readbyqxmd.com/read/28418269/is-a-hollow-centralizer-necessary-when-using-a-polished-tapered-cemented-femoral-stem
#14
Erik Weber, Christer Olsson, Uldis Kesteris, Gunnar Flivik
Background and purpose - A tapered, polished and collarless stem is normally equipped with a hollow centralizer to prevent the stem from becoming end-bearing in the cement as the stem subsides. In a randomized clinical trial, we evaluated such a stem (MS-30), which was initially introduced with a solid centralizer but was later recommended to be fitted with a hollow centralizer. We hypothesized that while the stem would sink more, it would become rotationally stable and have less retroversion with a hollow centralizer than with a solid centralizer...
April 18, 2017: Acta Orthopaedica
https://www.readbyqxmd.com/read/28403726/gastrocnemius-recession-a-cadaveric-study-of-surgical-safety-and-effectiveness
#15
Eva M Hoefnagels, Stephen M Belkoff, Bart A Swierstra
Background and purpose - Many methods of gastrocnemius lengthening have been described, with different surgical challenges, outcomes, and risks to the sural nerve. Our aims were (1) to locate the gastrocnemius muscular-tendinous junction in relation to the mid-length of the fibula (from here on designated the mid-fibula), (2) to compare the dorsiflexion achieved with dorsal recession or ventral recession, and (3) to determine the risk of injury to the sural nerve during gastrocnemius recession. Methods - In 10 pairs of fresh-frozen adult cadaveric lower extremities transected above the knee, we measured dorsiflexion, performed dorsal or ventral gastrocnemius recession at the mid-fibula, and then measured the increase in dorsiflexion and fasciotomy gap...
April 13, 2017: Acta Orthopaedica
https://www.readbyqxmd.com/read/28375671/outcome-in-design-specific-comparisons-between-highly-crosslinked-and-conventional-polyethylene-in-total-hip-arthroplasty
#16
Per-Erik Johanson, Ove Furnes, Leif Ivar Havelin, Anne Marie Fenstad, Alma B Pedersen, Søren Overgaard, Göran Garellick, Keijo Mäkelä, Johan Kärrholm
Background and purpose - Most registry studies regarding highly crosslinked polyethylene (XLPE) have focused on the overall revision risk. We compared the risk of cup and/or liner revision for specific cup and liner designs made of either XLPE or conventional polyethylene (CPE), regarding revision for any reason and revision due to aseptic loosening and/or osteolysis. Patients and methods - Using the Nordic Arthroplasty Register Association (NARA) database, we identified cup and liner designs where either XLPE or CPE had been used in more than 500 THAs performed for primary hip osteoarthritis...
April 4, 2017: Acta Orthopaedica
https://www.readbyqxmd.com/read/28464756/increased-risk-of-early-and-medium-term-revision-after-post-fracture-total-knee-arthroplasty
#17
Anders El-Galaly, Steffen Haldrup, Alma Becic Pedersen, Andreas Kappel, Michael Ulrich Jensen, Poul Torben Nielsen
Background and purpose - Total knee arthroplasty (TKA) due to posttraumatic fracture osteoarthritis (PTFA) may be associated with inferior prosthesis survival. This study is the first registry-based study solely addressing this issue. Both indications and predictors for revision were identified. Patients and methods - 52,518 primary TKAs performed between 1997 and 2013 were retrieved from the Danish Knee Arthroplasty Register (DKR). 1,421 TKAs were inserted due to PTFA and 51,097 due to primary osteoarthritis (OA)...
June 2017: Acta Orthopaedica
https://www.readbyqxmd.com/read/28464755/limb-lengthening-and-deformity-correction-of-congenital-and-acquired-deformities-in-children-using-the-taylor-spatial-frame
#18
Joachim Horn, Harald Steen, Stefan Huhnstock, Ivan Hvid, Ragnhild B Gunderson
Background and purpose - Hexapod ring fixators such as the Taylor Spatial Frame (TSF) have shown good outcomes. However, there have only been a few studies comparing the use of TSF with various etiologies of the deformity. We compared the use of TSF in congenital and acquired deformities in children. Patients and methods - We reviewed 213 lower extremity reconstructive procedures with the TSF in 192 patients who were operated between October 2000 and October 2015. 128 procedures (67 proximal tibiae, 51 distal femora, and 10 distal tibiae) in 117 children (median age 14 (4-18) years; 59 girls) fulfilled the inclusion criteria...
June 2017: Acta Orthopaedica
https://www.readbyqxmd.com/read/28464754/patient-reported-outcome-after-total-hip-arthroplasty-comparison-between-lateral-and-posterior-approach
#19
Signe Rosenlund, Leif Broeng, Anders Holsgaard-Larsen, Carsten Jensen, Søren Overgaard
Background and purpose - Criticism of the lateral approach (LA) for hip arthroplasty is mainly based on the risk of poor patient-reported outcomes compared to the posterior approach (PA). However, there have been no controlled studies comparing patient-reported outcomes between them. In this randomized controlled trial, we tested the hypothesis that patient-reported outcomes are better in patients who have undergone total hip arthroplasty (THA) with PA than in those who have undergone THA with LA, 12 months postoperatively...
June 2017: Acta Orthopaedica
https://www.readbyqxmd.com/read/28464753/a-radial-head-prosthesis-appears-to-be-unnecessary-in-mason-iv-fracture-dislocation
#20
Jens Nestorson, Per-Olof Josefsson, Lars Adolfsson
Background and purpose - Previous reports on elbow injuries with concomitant comminute radial head fracture are difficult to interpret, since they include an array of different soft-tissue and bony injuries around the elbow. We focused on Mason-IV fracture dislocations of the elbow and retrospectively reviewed 2 treatment options: radial head resection or replacement with a radial head arthroplasty, both in combination with lateral ligament repair. Patients and methods - In Linköping, 18 consecutive patients with Mason-IV fracture dislocation and with a median age of 56 (19-79) years were treated with a radial head arthroplasty...
June 2017: Acta Orthopaedica
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