Acta Orthopaedica最新文献

{"title":"The association between laminar vs turbulent airflow and prosthetic hip joint infections: a prospective nationwide study from the Danish Hip Arthroplasty Register.","authors":"Jacob Moflag Svensson, Anne Helms Andreasen, Espen Jimenez Solem, Søren Overgaard","doi":"10.2340/17453674.2025.44356","DOIUrl":"10.2340/17453674.2025.44356","url":null,"abstract":"<p><strong>Background and purpose: </strong> There is a controversy as to whether operating rooms with laminar airflow (LAF) ventilation are less associated with prosthetic joint infection (PJI) following total hip arthroplasty (THA) than turbulent airflow (TAF) ventilation. We aimed to assess the association of LAF and TAF ventilation with PJI following primary THA.</p><p><strong>Methods: </strong> This prospective cohort study, based on Danish administrative databases, included patients from all Danish hospitals. Patients with a primary THA with at least 365 days of follow-up between 2010 and 2020 were included from the Danish Hip Arthroplasty Register (DHR). The patients were then linked to the Danish microbiology register. The primary outcome was revision due to PJI within 365 days after primary surgery, analyzed with multivariable Cox models and Gray's test comparing LAF with TAF. PJI was defined by either a PJI diagnosis registered in the DHR after revision or 2 or more positive cultures with identical bacteria in the perioperative biopsies taken during revision.</p><p><strong>Results: </strong> Of the 92,152 THAs (78,181 patients) included, 2,328 (2.5%) had revision surgery within 365 days. Of these, 843 (0.91%) were due to PJI (0.92% in LAF, 0.89% in TAF). After adjusting for patient- and surgery-related risk factors, and year of surgery, we found no difference in the PJI hazard between LAF and TAF (HR 0.99; 95% confidence interval 0.78-1.26).</p><p><strong>Conclusion: </strong> Our data indicate that there is no difference in the risk of PJI comparing LAF with TAF ventilation in primary THA in Denmark.</p>","PeriodicalId":6916,"journal":{"name":"Acta Orthopaedica","volume":"96 ","pages":"747-754"},"PeriodicalIF":2.4,"publicationDate":"2025-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12492307/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145211292","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association between perceived stress and the risk of continued opioid use after total hip arthroplasty in patients with osteoarthritis: a Danish registry-based study of 1,727 individuals.","authors":"Nina M Edwards, Heidi A R Jensen, Alma B Pedersen","doi":"10.2340/17453674.2025.44759","DOIUrl":"10.2340/17453674.2025.44759","url":null,"abstract":"<p><strong>Background and purpose: </strong> Continued opioid use persists in up to one-third of patients 12 months after total hip arthroplasty (THA). Psychological factors, including stress, may influence pain and therefore opioid consumption, yet the effect of stress history on opioid use after THA remains unclear. We aimed to examine the association between perceived stress and the risk of continued opioid use following THA in patients with osteoarthritis.</p><p><strong>Methods: </strong> Based on data from the Danish National Health Surveys in 2013 and 2017, a total of 1,727 individuals completed the Perceived Stress Scale and later underwent THA, tracked through the Danish Hip Arthroplasty Registry. All were over the age of 35. Patients were classified by stress level (high vs low stress). Continued opioid use was defined as ≥ 2 opioid prescriptions 1-12 months post-surgery, recorded in the Danish National Prescription Database. Adjusted prevalence differences and adjusted prevalence ratios were calculated using log-binomial regression, controlling for sex, age, comorbidities, and education.</p><p><strong>Results: </strong> Of 258 patients with high stress level, 68 (26%) had continued opioid use, compared with 224 (15%) of the 1,469 patients with a low level. We showed higher ratios in high stress patients (adjusted prevalence difference 9.2; 95% confidence interval [CI] 3.6-14.8, adjusted prevalence ratio 1.5 [CI 1.2-1.9]). Median morphine milligram equivalents (MME) were higher for high stress with a median difference of 1,230 (interquartile range 1,025-3,745).</p><p><strong>Conclusion: </strong> High levels of perceived stress before THA are associated with a higher risk of continued opioid use and greater opioid consumption in the first postoperative year. These findings suggest the potential for preoperative stress screening and targeted interventions to reduce postoperative opioid use.</p>","PeriodicalId":6916,"journal":{"name":"Acta Orthopaedica","volume":"96 ","pages":"740-746"},"PeriodicalIF":2.4,"publicationDate":"2025-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12492309/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145211360","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Serious adverse events, readmission, and mortality after shoulder replacement due to fracture, osteoarthritis, and other indications: a population-based comparison with the general population.","authors":"Josefine Meyer Larsen, Martin Gade Stisen, Pia Kjær Kristensen, Antti P Launonen, Theis Muncholm Thillemann, Inger Mechlenburg","doi":"10.2340/17453674.2025.44796","DOIUrl":"10.2340/17453674.2025.44796","url":null,"abstract":"<p><strong>Background and purpose: </strong> Patients treated with shoulder arthroplasty may risk serious adverse events (SAEs), readmission, and death; however, the literature is inconsistent. Therefore, we aimed to compare the incidence rates of SAEs, readmissions, and mortality at 30 and 90 days following shoulder replacement with those of a matched cohort.</p><p><strong>Methods: </strong> Danish databases were used to include patients treated with a primary shoulder replacement due to fracture, osteoarthritis, cuff tear arthropathy, and other (2006-2021). The shoulder patients were compared (1:10) to a matched cohort from the general population. Incidence rates (IR) and incidence rate ratios (IRR) were calculated and adjusted for age, sex, and comorbidity.</p><p><strong>Results: </strong> The 30-day IR of SAEs was 73.5 for shoulder patients and 14.8 for the matched cohort. The IRR of SAEs was higher for all patient groups compared with the matched cohort and varied between indications for surgery (IRR 3.1-5.9) and remained higher at 90 days (IRR 1.6-3.5). The IR of readmission was 234 per 100,000 person-days at 30 days. The 30-day IR of mortality was 20.2 per 100,000 person-days for shoulder patients and 9.4 per 100,000 person-days for the matched cohort. Compared with the matched cohort the 30-day IRR of mortality was 2.0, with fracture patients having the highest risk of mortality (IRR of 3.5).</p><p><strong>Conclusion: </strong> At 30 and 90 days after surgery, shoulder patients, regardless of surgical indications, had higher rates of SAEs than the matched cohort. The mortality rate was higher for shoulder patients and highest for fracture patients. This information should be included in the shared decision-making process before undergoing shoulder replacement.</p>","PeriodicalId":6916,"journal":{"name":"Acta Orthopaedica","volume":"96 ","pages":"755-762"},"PeriodicalIF":2.4,"publicationDate":"2025-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12492308/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145211369","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Change in compensated patient injuries in the treatment of Achilles tendon rupture: a nationwide analysis from 2000 to 2019.","authors":"Ida Kiviranta, Marjukka Hallinen, Lauri Kaukonen, Elina Ekman, Joel Kostensalo, Päivi Helmiö, Heli Keskinen","doi":"10.2340/17453674.2025.44598","DOIUrl":"10.2340/17453674.2025.44598","url":null,"abstract":"<p><strong>Background and purpose: </strong> Over the last 2 decades, the treatment of Achilles tendon rupture (ATR) has shifted from surgery to non-surgical methods. We aimed to analyze whether this change in treatment methods has had an impact on the number of compensated patient injuries in Finland and the grounds for compensation. We also aimed to investigate where injuries occur along the treatment pathway.</p><p><strong>Methods: </strong> We conducted a retrospective analysis of the Finnish Patient Insurance Centre's insurance charts of compensated patient injuries in the treatment of ATR. Records of all compensated patient injury claims involving ATR from 2 periods in Finland: 2000-2006 (when 65% were treated surgically) and 2013-2019 (when 15% were treated surgically) were reviewed. Data included medical records, expert evaluations, and compensation decisions. Injuries were classified by when they occurred, and key contributing incidents were identified.</p><p><strong>Results: </strong> From 2000-2006 (period 1) and 2013-2019 (period 2), there were 315 patient injury claims related to ATR treatment in Finland. Of these, 126 (40%) were compensated. In both periods, delay in diagnosis was the most common reason for compensation. The number of claims remained the same between the 2 periods, and the ratio of compensated injuries to total cases declined (0.70% to 0.62%, not significant). Between the periods, infection-related claims decreased, while those related to incorrect treatment pathways and surgical errors increased (P = 0.02).</p><p><strong>Conclusion: </strong> The number of patient injuries has not risen in the past decade, while the number of infection injuries has decreased. Most patient injuries were related to a delay in diagnosis.</p>","PeriodicalId":6916,"journal":{"name":"Acta Orthopaedica","volume":"96 ","pages":"735-739"},"PeriodicalIF":2.4,"publicationDate":"2025-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12492441/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145211347","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cost-effectiveness of robotic-assisted versus conventional total knee arthroplasty: an analysis from a middle income country.","authors":"Pakpoom Ruangsomboon, Onlak Ruangsomboon, Wanrudee Isaranuwatchai, Michael G Zywiel, David Mj Naimark","doi":"10.2340/17453674.2025.44753","DOIUrl":"10.2340/17453674.2025.44753","url":null,"abstract":"<p><strong>Background and purpose: </strong> Robotic-assisted total knee arthroplasty (RATKA) can enhance surgical precision. In middle-income countries (MICs), constrained fiscal space and the double burden of rising demand for high-cost technologies and competing public-health priorities-unlike high-income countries with broader fiscal headroom and low-income countries with limited adoption of expensive innovations-make adoption decisions for RATKA particularly challenging. We aimed to evaluate the cost-effectiveness analysis (using a cost-utility framework) of RATKA vs conventional TKA (COTKA) from a societal perspective in Thailand as a MIC.</p><p><strong>Methods: </strong> A discrete event simulation model was employed to compare the cost-effectiveness of unilateral RATKA with COTKA over 4.5 years from a societal perspective, using patient-level data from January 2018 to June 2022 from an arthroplasty center in Thailand. Patients were propensity matched to balance comorbidities. Base case analysis assumed 1 robot performs 434 TKA cases per year with an anticipated lifespan of 12.5 years. We considered direct medical, non-medical, and indirect costs, alongside quality-adjusted life years (QALYs) gained from a societal perspective. We calculated incremental net monetary benefits (INMB) and cost-effectiveness ratios (ICERs) as the main outcome measures. Sensitivity analyses and 10 scenario analyses were performed exploring various possible settings. Threshold analyses determined combinations where RATKA could be cost-effective with positive INMB under the Thai cost-effectiveness threshold of US$4,888 per QALY gained.</p><p><strong>Results: </strong> The base case analysis involved 157 COTKA and 1570 RATKA matched cases with a mean age of 69 (standard deviation 8 years). The lifetime average outcomes per patient were: COTKA-US$5,031.9 and 9.07 QALYs; RATKA-US$5,666.9 and 9.16 QALYs. The incremental (RATKA-COTKA) differences were +US$633.6 (95% credible intervals [CrI] ~592-675) and +0.085 QALYs (CrI ~0.04-0.13), yielding an ICER of US$7,436.6/QALY. RATKA was not cost-effective compared with COTKA, with an INMB of -216.9 US$/patient. The probability of RATKA being cost-effective at the Thai cost-effectiveness threshold was 44.3%. For RATKA to be economically attractive, 1 robot must operate on at least 640 TKA cases/year over 12.5 years. 3 scenarios found RATKA to be cost-effective: (i) maximal robot utilization (850 cases/year); (ii) lowest capital costs (611,060 US$/robot) with high efficacy for RATKA (hazard ratio [HR] 0.6); and (iii) extreme efficacy of RATKA in reducing complications (HR 0.024).</p><p><strong>Conclusion: </strong> In the context of MIC, a broad adoption of RATKA is not economically attractive as treatment of end-stage knee osteoarthritis patients compared with COTKA.</p>","PeriodicalId":6916,"journal":{"name":"Acta Orthopaedica","volume":"96 ","pages":"716-725"},"PeriodicalIF":2.4,"publicationDate":"2025-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12489808/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145205100","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Proximal femoral fractures in children: incidence, complications, and functional outcomes-a population-based study from Finland.","authors":"Sini-Tuuli Koivisto, Ilkka Helenius, Antti Stenroos, Juho-Antti Ahola, Topi Laaksonen","doi":"10.2340/17453674.2025.44752","DOIUrl":"10.2340/17453674.2025.44752","url":null,"abstract":"<p><strong>Background and purpose: </strong> Pediatric proximal femoral fractures are rare and frequently complicated fractures with avascular necrosis (AVN), nonunion, deformity, leg-length discrepancy (LLD), and premature physeal closure (PPC). Our aim was to describe the incidence, complications and functional outcomes.</p><p><strong>Methods: </strong> In this register-based study from a 10-year period (2014-2023) we identified 51 non-pathological proximal femoral fractures from the KIDS Fracture Tool database. Statistical yearbooks of Helsinki were utilized to estimate annual incidence. We used interviews and Oxford Hip Scores (OHS) for functional outcome assessment. If any symptom or functional deficit was described, or if Oxford Hip Score (OHS) was < 41, patients were also invited for clinical examination and radiography.</p><p><strong>Results: </strong> 51 patients with a proximal femoral fracture (31 boys) were identified representing 0.2% (51/21,121) of all child fractures with a population-based annual incidence of 1.7/100,000 children. We interviewed 46/51 of the patients or their guardians via telephone. 6/46 were invited for clinical examination and radiography. Median follow-up of contacted patients was 4 (range 1-9.5) years. Complications occurred in 9/20 patients with collum and trochanteric fractures (pain from osteosynthesis 4, AVN 3, nonunion 1, coxa vara 1, LLD 1, PPC 0) and in 7/31 with subtrochanteric fractures (pain from osteosynthesis 5, misplaced pins 2, angular deformity 1, peri-implant fracture 1). All underwent reoperation. The median OHS was 48 (interquartile range 47-48) at last follow-up. Functional outcomes were impaired in 3 patients. All 3 had AVN.</p><p><strong>Conclusion: </strong> The incidence of non-pathological pediatric proximal femoral fractures is low. Despite frequent complications, impaired functional outcomes concerned only patients with AVN at median 4-year follow-up.</p>","PeriodicalId":6916,"journal":{"name":"Acta Orthopaedica","volume":"96 ","pages":"726-734"},"PeriodicalIF":2.4,"publicationDate":"2025-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12489807/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145205118","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association between preoperative self-rated health and opioid use 12 months after total hip arthroplasty for osteoarthritis: a cohort study using Danish National Health Survey Data.","authors":"Alma B Pedersen, Nina M Edwards, Maaike G J Gademan, Inger Mechlenburg, Heidi A R Jensen, Henrik T Sørensen","doi":"10.2340/17453674.2025.44758","DOIUrl":"10.2340/17453674.2025.44758","url":null,"abstract":"<p><strong>Background and purpose: </strong> We examined the association between preoperative self-rated health (SRH) and opioid use 12 months after total hip arthroplasty (THA) for osteoarthritis.</p><p><strong>Methods: </strong> We identified 381,323 people who answered a question on SRH in the Danish National Health Surveys 2010, 2013, or 2017. Among these, 4,174 people age > 35 years subsequently underwent THA for osteoarthritis. SRH was categorized as poor (\"poor\" or \"fair\" health) or good (\"good,\" \"very good,\" or \"excellent\" health). Opioid use was defined as ≥ 2 prescriptions 1-12 months after THA. We calculated prevalences and prevalence ratios (PR) with 95% confidence intervals (CI) through log-binomial regression, overall and by preoperative opioid use status adjusting for potential confounders. The total morphine milligram equivalent (MME) dose after THA with interquartile range (IQR) was further calculated.</p><p><strong>Results: </strong> 876 (21%) patients rated their health as poor and 3,292 (79%) as good. The prevalence of opioid use among patients with poor SRH was higher than among those with good SRH (PR 2.33, CI 2.05-2.65) (315 [36%] vs 132 [14%]). Similarly, among preoperative non-users, the prevalence was 62 (15%) for patients with poor SRH and 140 (6%) for patients with good SRH (PR 2.20, CI 1.65-2.93), and among preoperative users, the prevalence was 252 (54%) for patients with poor SRH and 299 (31%) for patients with good SRH (PR 1.64, CI 1.44-1.86). The overall median MME dose was higher among patients with poor SRH (2,940, IQR 800-9,610) than among those with good SRH (1,000, IQR 400-3,175) with a median difference of 1,940 (IQR 1,227-2,653).</p><p><strong>Conclusion: </strong> Compared with good preoperative SRH, poor preoperative SRH was associated with higher opioid use 12 months after THA for osteoarthritis.</p>","PeriodicalId":6916,"journal":{"name":"Acta Orthopaedica","volume":"96 ","pages":"708-715"},"PeriodicalIF":2.4,"publicationDate":"2025-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12489806/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145205080","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Response to Letter: Uncertainty and risk of misleading conclusions: an umbrella review of the quality of the evi-dence for ankle arthroscopy.","authors":"Ville Ponkilainen, Valtteri Panula, Juho Laaksonen, Anniina Laurem, Mikko Miettinen, Ville M Mattila, Teemu Karjalainen","doi":"10.2340/17453674.2025.44795","DOIUrl":"https://doi.org/10.2340/17453674.2025.44795","url":null,"abstract":"","PeriodicalId":6916,"journal":{"name":"Acta Orthopaedica","volume":"96 ","pages":"707"},"PeriodicalIF":2.4,"publicationDate":"2025-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145084690","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Letter to the Editor: Uncertainty and risk of misleading conclusions: an umbrella review of the quality of the evidence for ankle arthroscopy.","authors":"Ömer Levent Karadamar, Ali Murat Başak","doi":"10.2340/17453674.2025.44757","DOIUrl":"10.2340/17453674.2025.44757","url":null,"abstract":"","PeriodicalId":6916,"journal":{"name":"Acta Orthopaedica","volume":"96 ","pages":"706"},"PeriodicalIF":2.4,"publicationDate":"2025-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12447632/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145084739","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Risk of perioperative mortality and venous thromboembolism after total hip or knee arthroplasty with recent COVID-19 infection: an observational study from the Kaiser Permanente Northern California Database.","authors":"Aidan T Morrell, Ryland P Kagan, Mackenzie Kelly, Graham J DeKeyser, Andrew L Avins, Lusine X Gigoyan, John S Cox","doi":"10.2340/17453674.2025.44481","DOIUrl":"10.2340/17453674.2025.44481","url":null,"abstract":"<p><strong>Background and purpose: </strong> Limited data exist on venous thromboembolism (VTE) and mortality risk in patients undergoing primary total hip (THA) or knee arthroplasty (TKA) following recent COVID-19 infection. We aimed to evaluate whether the timing of COVID-19 infection affects postoperative VTE and mortality risk after THA or TKA.</p><p><strong>Methods: </strong> Adult Kaiser Permanente Northern California members undergoing elective THA or TKA from 2020-2022 were identified using internal procedure codes. 33,520 patients with or without SARS-CoV-2 within 6 months preoperatively were compared. Multivariate Poisson regression was used to calculate incidence rate ratios (RRs) adjusted for demographics, comorbidities, and Covid vaccination status. The primary outcome was 90-day VTE (deep venous thrombosis or pulmonary embolism). The secondary outcome was 90-day mortality.</p><p><strong>Results: </strong> Among patients with recent COVID-19, the 90-day VTE rate was 0.3%, and the mortality rate was 2.5%. Recent COVID-19 within 6 to 12 weeks preoperatively did not significantly increase 90-day VTE risk (RR 1.0, 95% confidence interval [CI] 0.38-2.8) but was associated with increased 90-day mortality risk (RR 3.1, CI 1.7-5.4).</p><p><strong>Conclusion: </strong> Recent COVID-19 infection did not significantly impact VTE risk after THA or TKA. However, infection within 6 to 12 weeks preoperatively was associated with increased 90-day mortality.</p>","PeriodicalId":6916,"journal":{"name":"Acta Orthopaedica","volume":"96 ","pages":"692-697"},"PeriodicalIF":2.4,"publicationDate":"2025-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12444792/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145079396","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}