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Acta Orthopaedica

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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
#1
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
#2
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
#3
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
#4
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
#5
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
#6
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
#7
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
#8
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
#9
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/28350206/normative-data-for-the-lower-extremity-functional-scale-lefs
#10
Siem A Dingemans, Suzanne C Kleipool, Marjolein A M Mulders, Jasper Winkelhagen, Niels W L Schep, J Carel Goslings, Tim Schepers
Background and purpose - The lower extremity functional scale (LEFS) is a well-known and validated instrument for measurement of lower extremity function. The LEFS was developed in a group of patients with various musculoskeletal disorders, and no reference data for the healthy population are available. Here we provide normative data for the LEFS. Methods - Healthy visitors and staff at 4 hospitals were requested to participate. A minimum of 250 volunteers had to be included at each hospital. Participants were excluded if they had undergone lower extremity surgery within 1 year of filling out the questionnaire, or were scheduled for lower extremity surgery...
March 28, 2017: Acta Orthopaedica
https://www.readbyqxmd.com/read/28350203/revision-after-shoulder-replacement-for-acute-fracture-of-the-proximal-humerus
#11
Stig Brorson, Björn Salomonsson, Steen L Jensen, Anne Marie Fenstad, Yilmaz Demir, Jeppe V Rasmussen
Background and purpose - For more than half a century, stemmed hemiarthroplasty (SHA) has been used in the treatment of comminuted and displaced fractures of the proximal humerus. Reverse shoulder arthroplasty (RSA) has been increasingly popular in cases where it is difficult to obtain satisfactory fixation of the tuberosities. We report revision rates and reasons for revision after shoulder arthroplasty for acute fractures of the proximal humerus. Patients and methods - This study was based on a common dataset from the Nordic Arthroplasty Register Association (NARA), which includes data reported to the national shoulder arthroplasty registries in Denmark, Sweden, and Norway...
March 28, 2017: Acta Orthopaedica
https://www.readbyqxmd.com/read/28333575/is-clinical-measurement-of-anatomic-axis-of-the-femur-adequate
#12
Chi-Chuan Wu
Background and purpose - The accuracy of using clinical measurement from the anterior superior iliac spine (ASIS) to the center of the knee to determine an anatomic axis of the femur has rarely been studied. A radiographic technique with a full-length standing scanogram (FLSS) was used to assess the adequacy of the clinical measurement. Patients and methods - 100 consecutive young adult patients (mean age 34 (20-40) years) with chronic unilateral lower extremity injuries were studied. The pelvis and intact contralateral lower extremity images in the FLSS were selected for study...
March 23, 2017: Acta Orthopaedica
https://www.readbyqxmd.com/read/28296531/risk-factors-associated-with-acute-kidney-injury-in-a-cohort-of-20-575-arthroplasty-patients
#13
Pyry Jämsä, Esa Jämsen, Leo-Pekka Lyytikäinen, Jarkko Kalliovalkama, Antti Eskelinen, Niku Oksala
Background and purpose - Patients developing postoperative acute kidney injury (AKI) are at risk of higher morbidity and mortality. In arthroplasty patients, many pre- and perioperative factors are associated with AKI but some of the risk factors are unclear. We report the incidence of postoperative AKI, the conditions associated with it, and survival rates in AKI patients. Patients and methods - We obtained data from 20,575 consecutive hip or knee arthroplasties. Postoperative AKI, occurring within 7 days after the operation, was defined using the risk, injury, failure, loss, and end-stage (RIFLE) criteria...
March 15, 2017: Acta Orthopaedica
https://www.readbyqxmd.com/read/28296518/effect-of-platelet-rich-plasma-on-rat-achilles-tendon-healing-is-related-to-microbiota
#14
Franciele Dietrich, Malin Hammerman, Parmis Blomgran, Love Tätting, Vinicius Faccin Bampi, Jefferson Braga Silva, Per Aspenberg
Background and purpose - In 3 papers in Acta Orthopaedica 10 years ago, we described that platelet-rich plasma (PRP) improves tendon healing in a rat Achilles transection model. Later, we found that microtrauma has similar effects, probably acting via inflammation. This raised the suspicion that the effect ascribed to growth factors within PRP could instead be due to unspecific influences on inflammation. While testing this hypothesis, we noted that the effect seemed to be related to the microbiota. Material and methods - We tried to reproduce our old findings with local injection of PRP 6 h after tendon transection, followed by mechanical testing after 11 days...
March 15, 2017: Acta Orthopaedica
https://www.readbyqxmd.com/read/28296515/risk-preferences-and-attitudes-to-surgery-in-decision-making
#15
Andreas Meunier, Kinga Posadzy, Gustav Tinghög, Per Aspenberg
Background and purpose - There is increasing evidence that several commonly performed surgical procedures provide little advantage over nonoperative treatment, suggesting that doctors may sometimes be inappropriately optimistic about surgical benefit when suggesting treatment for individual patients. We investigated whether attitudes to risk influenced the choice of operative treatment and nonoperative treatment. Methods - 946 Swedish orthopedic surgeons were invited to participate in an online survey. A radiograph of a 4-fragment proximal humeral fracture was presented together with 5 different patient characteristics, and the surgeons could choose between 3 different operative treatments and 1 nonoperative treatment...
March 15, 2017: Acta Orthopaedica
https://www.readbyqxmd.com/read/28290758/similar-1-year-subjective-outcome-after-a-distal-radius-fracture-during-the-10-year-period-2003-2012
#16
Marcus Landgren, Antonio Abramo, Mats Geijer, Philippe Kopylov, Magnus Tägil
Background and purpose - During the last decades, treatment of distal radius fractures (DRFs) has changed, with surgical intervention being more common and with new techniques. We investigated whether this change has influenced the subjective outcome. Here we report, year by year, the 1-year score after a DRF over a 10-year-period, using a patient-reported outcome measure. Patients and methods - Patients aged 18 years or more with a DRF between 2003 and 2012 were prospectively and consecutively registered in a longitudinal outcome database...
March 14, 2017: Acta Orthopaedica
https://www.readbyqxmd.com/read/28290756/denosumab-and-surgery-for-the-treatment-of-perthes-disease-in-a-9-year-old-boy-favorable-course-documented-by-comprehensive-imaging-a-case-report
#17
A Ludwig Meiss, Florian Barvencik, Kornelia Babin, Gerald Eggers-Stroeder
No abstract text is available yet for this article.
March 14, 2017: Acta Orthopaedica
https://www.readbyqxmd.com/read/28290738/increased-risk-of-intraoperative-and-early-postoperative-periprosthetic-femoral-fracture-with-uncemented-stems
#18
Martin Lindberg-Larsen, Christoffer C Jørgensen, Søren Solgaard, Anne G Kjersgaard, Henrik Kehlet
Background and purpose - The use of uncemented fixation in total hip arthroplasty (THA) is increasing. Registry studies have indicated an increased risk of revision of uncemented implants due to early periprosthetic femoral fracture. In this paper, we describe the incidence and predisposing factors for intraoperative and early postoperative (≤ 90 days) periprosthetic femoral fractures after cemented and uncemented THA. Patients and methods - This was a prospective observational study in 8 Danish high-volume centers from February 2010 to November 2013...
March 14, 2017: Acta Orthopaedica
https://www.readbyqxmd.com/read/28287044/no-effect-of-teriparatide-on-migration-in-total-knee-replacement
#19
Håkan Ledin, Lars Good, Torsten Johansson, Per Aspenberg
Background and purpose - Aseptic loosening is a main cause of late revision in total knee replacement (TKR). Teriparatide, a recombinant parathyroid hormone (PTH), stimulates osteoblasts and has been suggested to improve cancellous bone healing in humans. This might also be relevant for prosthesis fixation. We used radiostereometric analysis (RSA) to investigate whether teriparatide influences prosthesis fixation. Early migration as measured by RSA can predict future loosening. Patients and methods - In a randomized controlled trial with blind evaluation, 50 patients with osteoarthritis of the knee were allocated to a teriparatide treatment group (Forsteo, 20 μg daily for 2 months postoperatively) or to an untreated control group...
March 13, 2017: Acta Orthopaedica
https://www.readbyqxmd.com/read/28287004/denosumab-reduces-early-migration-in-total-knee-replacement
#20
Håkan Ledin, Lars Good, Per Aspenberg
Background and purpose - Aseptic loosening is a main cause of late revision in total knee replacement (TKR). Migration of implants as measured by radiostereometric analysis (RSA) can predict future loosening. This migration is associated with bone resorption. Denosumab is a human monoclonal antibody that binds to receptors on osteoclast precursors and osteoclasts. This prevents osteoclast formation, resulting in less bone resorption in cortical and trabecular bone. We investigated whether denosumab can reduce migration of TKR, as measured with RSA...
March 13, 2017: Acta Orthopaedica
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