Acta Orthopaedica最新文献

{"title":"Angular alignment, rotational profile, and joint range of motion in the lower limb of typically developing children from 7-16 years of age: a cross-sectional study.","authors":"Christian Wong, Michael Mørk Petersen, Trine Henriksen, Ales Jurca, Soeren Boedtker, Andreas Balslev-Clausen, Steen Harsted","doi":"10.2340/17453674.2025.43478","DOIUrl":"https://doi.org/10.2340/17453674.2025.43478","url":null,"abstract":"<p><strong>Background and purpose: </strong> We aimed to update reference intervals for anthropometric parameters for the passive joint range of motion (ROM), rotational profile, and angular alignment of the lower limb in typically developing children (TDC), to compare the association of the variables age, left-right sidedness, body mass index (BMI), and sex.</p><p><strong>Methods: </strong> We conducted a cross-sectional study in a convenience sample of TDC from the 1st, 5th, and 9th grades (6-17 years) in a randomized selection of Danish primary schools. We examined the anthropometric parameters in a non-clinical setting. Descriptive statistics were used to characterize the data. To explore potential differences across the variables, we utilized Bonferroni-corrected Welch's 2-sample t-tests, one-way analysis of means, and univariable linear regression.</p><p><strong>Results: </strong> We analyzed the associations between the variables and the anthropometric parameters in 501 TDC, aged 6 to 17 years. We found a statistically significant, but not clinically meaningful decrease in ROM for the hip, knee, and ankle as well as decreased femoral anteversion and increased tibial torsion with increasing age, but no association with sex or sidedness. However, several associations between BMI and ROM measurements were statistically significant and potentially clinically meaningful, with ROM decreasing by approximately 0.4° to 1.2° per unit increase in BMI, particularly for hip, knee, and ankle flexion movements.</p><p><strong>Conclusion: </strong> Anthropometric parameters remain clinically stable after 7 years of age and are affected only by the BMI but not sex or age. We found a statistically significant but not clinically relevant decrease in torsion and joint ROM with increasing age.</p>","PeriodicalId":6916,"journal":{"name":"Acta Orthopaedica","volume":"96 ","pages":"363-370"},"PeriodicalIF":2.5,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12044830/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143954618","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":"Pooling data for primary total knee implants across national registries: is the same implant used in multiple registries and for the same patient group? An observational study.","authors":"Lotje Hoogervorst, Rob G H H Nelissen, Liza Van Steenbergen, Alma B Pedersen, Eskild Bendix Kristiansen, Martin Lindberg-Larsen, Marina Torre, Enrico Ciminello, Riccardo Valentini, Alexander W Grimberg, Yinan Wu, Perla J Marang-van de Mheen","doi":"10.2340/17453674.2025.43476","DOIUrl":"https://doi.org/10.2340/17453674.2025.43476","url":null,"abstract":"<p><strong>Background and purpose: </strong> Pooling data on the performance of total knee (TK) implants across registries is only possible if the same TK implant is used across multiple registries and if used in patients with similar characteristics. We assessed to what extent specific TK implants: (i) are used across multiple registries or only in a single registry; and (ii) differ in patient characteristics between registries.</p><p><strong>Methods: </strong> All primary TK implants implanted between January 2020 and December 2021 in the Danish, Dutch, German, and Italian registries were included. We determined the number of registries using a specific TK implant (based on combined femoral-tibial component brand name and fixation/congruency/mobile bearing insert/patella usage). Patient characteristics (age/body mass index [BMI]/sex/diagnosis osteoarthritis) were compared across registries for TK implants used in ≥ 2 registries ≥ 100 times.</p><p><strong>Results: </strong> 813 different TK implants (577,351 procedures) were used across the 4 registries, of which 53 TK implants (7%) were used in 1 registry (8,000 procedures). 760 different TK implants (569,351 procedures; 99%) were used in ≥ 2 registries of which 47 different TK implants (393,954 procedures; 68%) were used in ≥ 2 registries and ≥ 100 times. Statistically and clinically significant differences in age for the same TK implant across registries were observed for 29 TK implants (62%) and 3 TK implants (6%), respectively; for other characteristics these were for BMI 30 (64%) and 0 (0%) TK implants; for male proportion 23 (49%) and 17 (36%) TK implants; and for diagnosis of osteoarthritis 42 (89%) and 34 (72%) TK implants, respectively.</p><p><strong>Conclusion: </strong> Most specific TK implants and TK procedures were used across multiple registries, but they were often used in patients with different characteristics. This has an impact on comparing implant performances between registries.</p>","PeriodicalId":6916,"journal":{"name":"Acta Orthopaedica","volume":"96 ","pages":"339-347"},"PeriodicalIF":2.5,"publicationDate":"2025-04-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12006037/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143954973","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":"Factors associated with dislocation after total hip arthroplasties performed for nontraumatic osteonecrosis of the femoral head: a multicenter cohort study of 5,983 hips.","authors":"Seneki Kobayashi, Nobuhiko Sugano, Wataru Ando, Wakaba Fukushima, Kyoko Kondo, Takashi Sakai","doi":"10.2340/17453674.2025.43473","DOIUrl":"https://doi.org/10.2340/17453674.2025.43473","url":null,"abstract":"<p><strong>Background and purpose: </strong> Nontraumatic osteonecrosis of the femoral head (ONFH) patients are at a higher dislocation risk after primary total hip arthroplasties (THAs) than osteoarthrosis patients. It has not been clear how large prosthetic heads should be to reduce dislocation. A nationwide multicenter follow-up cohort study of THAs performed for ONFH aimed to evaluate risk factors associated with dislocation and whether larger head size could reduce the dislocation risk.</p><p><strong>Methods: </strong> A multivariable logistic regression model analyzed factors associated with dislocation in 5,983 THAs performed for ONFH between 1996 and 2022 with a median of 7.1 (0.5-27)-year follow-up. Patient age at surgery was 52 years and BMI was 22.9, as medians. A posterior approach was employed in 59%. The head diameter was 22 mm in 4%, 26 mm in 15%, 28 mm in 24%, 32 mm in 36%, and ≥ 36 mm in 21%.</p><p><strong>Results: </strong> 288 THAs (4.8%) dislocated. Younger (1st quartile, ≤ 41 years) patient age (odds ratio [OR] 1.45 CI [95% confidence interval] 1.02-2.07 vs. 2nd quartile), higher BMI (OR 1.05, CI 1.02-1.08 per 1), posterior approach (OR 3.33, CI 1.96-5.56 vs. anterior or anterolateral approach, OR 2.27 CI 1.59-3.23 vs. lateral approach), and smaller heads were identified as risk factors. However, ≥ 36-mm heads were not different from 32-mm heads (OR 1.06 CI 0.69-1.63).</p><p><strong>Conclusion: </strong> Risk factors associated with dislocation were younger patient age, higher BMI, posterior approach, and smaller heads; however, 32-mm heads were large enough to reduce dislocation.</p>","PeriodicalId":6916,"journal":{"name":"Acta Orthopaedica","volume":"96 ","pages":"348-355"},"PeriodicalIF":2.5,"publicationDate":"2025-04-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12006036/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143955046","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 of femoral retroversion and out-toeing gait with development of hip osteoarthritis and treatment: a systematic review.","authors":"Christos Tsagkaris, Thomas Dreher, Patrick Zingg, Matthias Rüger","doi":"10.2340/17453674.2025.43475","DOIUrl":"https://doi.org/10.2340/17453674.2025.43475","url":null,"abstract":"<p><strong>Background and purpose: </strong> Femoral retroversion (FR) is known to be a predisposing factor for femoro-acetabular impingement and is hypothesized to constitute a risk factor for early osteoarthritis of the hip. We performed a systematic review to comprehensively evaluate the evidence for FR being associated with hip osteoarthritis (OA) and the results of early treatment among adolescents and young adults.</p><p><strong>Methods: </strong> A systematic literature search was conducted in biomedical databases (PubMed, Scopus, Web of Science, Cochrane, Google Scholar) from 1970 to 2023. Inclusion criteria were studies in English or German. Studies were selected based on predefined criteria and according to PRISMA guidelines.</p><p><strong>Results: </strong> Of 37 initial records, 11 studies were included, involving 1,807 patients and 785 cadavers. Most studies were conducted in North America (7), Europe (3), and Australia (1). Diagnostic modalities included clinical examination, radiography, computed tomography, and magnetic resonance imaging. Findings from preclinical and clinical studies suggest an association between FR and hip pain, impingement, and OA. Studies reported that 5-11% of patients requiring total hip replacement exhibited FR and emphasized pain in young adults as a prompt for torsional assessment. However, contradictory results regarding the need for surgical correction were found. Surgery appears effective in relieving hip pain. Concerns exist regarding spontaneous correction at a young age and the risk of overcorrection with surgery.</p><p><strong>Conclusion: </strong> Our review underscores the lack of evidence regarding FR as a risk factor for hip osteoarthritis, and contradictory results regarding the need for surgical correction were found.</p>","PeriodicalId":6916,"journal":{"name":"Acta Orthopaedica","volume":"96 ","pages":"356-362"},"PeriodicalIF":2.5,"publicationDate":"2025-04-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12006038/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143962150","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":"Development of ankle and knee range of motion after isolated gastrocsoleus lengthening in children with cerebral palsy: a register-based longitudinal cohort study.","authors":"Olof Lindén, Henrik Lauge-Pedersen, Gunnar Hägglund, Philippe Wagner","doi":"10.2340/17453674.2025.43387","DOIUrl":"https://doi.org/10.2340/17453674.2025.43387","url":null,"abstract":"<p><strong>Background and purpose: </strong> Outcome after gastrocsoleus lengthening in cerebral palsy (CP) is reported to be influenced by type of lengthening, age, CP subtype, and preoperative range of motion (ROM). We examined the development of ankle and knee ROM after 3 types of isolated gastrocsoleus lengthening.</p><p><strong>Methods: </strong> This is a register-based longitudinal cohort study based on data from the Swedish Cerebral Palsy follow Up Program, of children born 2000-2011 who underwent isolated gastrocsoleus lengthening. ROM development was analyzed using mixed-effects modeling. Event limits were defined as ankle ROM ≤ 0° or ≥ 20° and knee extension deficit ≤ -10° and described in Kaplan-Meier curves and Cox regression analyses. The study protocol was published at clinicaltrials.gov.</p><p><strong>Results: </strong> 184 children were included. The mean differences in ankle ROM 10 years postoperatively between open tendo Achilles lengthening (OTAL) and percutaneous tendo Achilles lengthening (PTAL) was -2.3° (95% confidence interval [CI] -7.4 to 2.7), and between gastrocnemius lengthening (GCL) and PTAL -4.4° (CI -10.4 to 1.5). The adjusted hazard ratio (aHR), adjusted for baseline ROM, Gross Motor Function Classification System level, and CP subtype, comparing ankle event rates between OTAL and PTAL was 2.5 (CI 1.1-5.7). GCL was also associated with a higher event rate compared with PTAL, aHR 2.0 (CI 0.85-4.6). The adjusted mean difference in knee ROM at 10 years between OTAL and PTAL was 5.1° (CI 0.4-9.8), and between GCL and PTAL 1.9° (CI -3.6 to 7.6). Comparing event rates for the knee yielded uncertain results.</p><p><strong>Conclusion: </strong> PTAL appears at least as effective as OTAL and GCL for favorable ankle and knee ROM development in children with CP.</p>","PeriodicalId":6916,"journal":{"name":"Acta Orthopaedica","volume":"96 ","pages":"331-338"},"PeriodicalIF":2.5,"publicationDate":"2025-04-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12006035/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143957670","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":"Relevant treatment outcomes for individuals aged 60 and older with massive rotator cuff tears: a qualitative study with 16 patients.","authors":"Cristina Barrufet, Víctor Zamora, Catalina Lizano-Barrantes, Carlos Torrens, Andrea Burón, Emilio Calvo, Lluis Peidró, Joan Miquel, Raúl Barco, Montse Ferrer","doi":"10.2340/17453674.2025.43474","DOIUrl":"https://doi.org/10.2340/17453674.2025.43474","url":null,"abstract":"<p><strong>Background and purpose: </strong> Qualitative research on individuals with massive rotator cuff tears (MRCT) is scarce. This study aims to identify the perceptions, concerns, and treatment outcomes relevant to individuals with MRCT of the shoulder, as expected before treatment or experienced afterward.</p><p><strong>Methods: </strong> A qualitative study was designed using a hermeneutic phenomenological methodology. Purposive sampling was employed to identify potentially eligible patients (diagnosed with MRCT and aged 60-85 years) in the trauma and orthopedic outpatient clinics of 3 hospitals in Spain. The study employed 2 segmentation criteria: type of treatment and timing (before/after treatment). 16 interviews were conducted to capture the patients' perspective: 9 were semi-structured and 7 were in-depth. Interpretative phenomenological analysis was used, and triangulation was performed by 3 researchers with diverse backgrounds.</p><p><strong>Results: </strong> The mean age of participants (10 women and 6 men) was 71 years, with most having their dominant limb affected. The analysis revealed 4 themes (13 subthemes): MRCT impact on daily living (shoulder-derived functional limitation, pain, and emotional disturbance); treatment outcomes (recovering independence, pain relief, and social participation); clinical management (communication with health professionals, duration of the diagnostic/therapeutic process, and participation in decision-making); and characteristics of the individual (sex, work, and comorbidity). Special unmet needs were identified for women, with more prolonged diagnostic and therapeutic processes while bearing most household responsibilities.</p><p><strong>Conclusion: </strong> Recovering independence and pain relief were the principal outcomes from the perspective of patients with MRCT, and social participation and emotional well-being were closely linked. Measuring these outcomes could improve shared decision-making, while addressing systemic barriers to enhance patient participation.</p>","PeriodicalId":6916,"journal":{"name":"Acta Orthopaedica","volume":"96 ","pages":"322-330"},"PeriodicalIF":2.5,"publicationDate":"2025-04-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11995431/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143955133","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":"Effectiveness of total hip arthroplasty versus non-surgery on patient-reported hip function at 3 months: a target trial emulation study of patients with osteoarthritis.","authors":"Amanda D Klaassen, Wiard Jorritsma, Nienke W Willigenburg, Carina L E Gerritsma, Bas L E F Ten Have, Dirk Jan F Moojen, Maaike G J Gademan, Rolf H H Groenwold, Rudolf W Poolman","doi":"10.2340/17453674.2025.43332","DOIUrl":"https://doi.org/10.2340/17453674.2025.43332","url":null,"abstract":"<p><strong>Background and purpose: </strong> This study introduces an innovative research design in the field of orthopedics, using a target trial emulation approach. We aimed to assess the causal effects of total hip arthroplasty (THA) compared with nonoperative treatment in reducing patient-reported hip disability at 3 months in patients with osteoarthritis, using real-world data.</p><p><strong>Methods: </strong> We emulated a target trial using real-world data of 2 Dutch hospitals between April 2020 and January 2022. Patients diagnosed with hip osteoarthritis and eligible for primary THA were included in the study. During the COVID-19 pandemic, THA was often cancelled due to external factors (i.e., limited operating room capacity, or surgeon unavailable due to quarantine rules), resulting in an arbitrary allocation of patients to THA (n = 132) or non-THA (n = 60). We compared changes in hip disability, measured using the Hip disability and Osteoarthritis Outcome Score Physical function Short form (HOOS-PS), between the THA group at 3 months postoperatively and the non-THA group at ≥3 months post waiting-list. Linear regression analysis, adjusting for potential confounders, was used to compare between-group differences.</p><p><strong>Results: </strong> THA showed preferable outcomes compared with non-THA, indicated by a difference of -33 points (95% confidence interval [CI] -37 to -28) on the HOOS-PS. Patients in the THA group demonstrated a clinically significant improvement in hip function, with a mean change of -27 points (CI -31 to -24), while the control group showed no improvement with a mean change of 7 points (CI 3-11) on the HOOS-PS.</p><p><strong>Conclusion: </strong> THA significantly improves hip function in osteoarthritis patients, surpassing the outcomes observed in the non-surgery group.</p>","PeriodicalId":6916,"journal":{"name":"Acta Orthopaedica","volume":"96 ","pages":"310-316"},"PeriodicalIF":2.5,"publicationDate":"2025-04-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11995426/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143959245","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":"Survival rate and use of revision components in total knee arthroplasty following unicompartmental knee arthroplasty or proximal tibial osteotomy: an analysis of 11,983 procedures from the Dutch Arthroplasty Register.","authors":"Maarten R Huizinga, Astrid J De Vries, Liza N Van Steenbergen, Reinoud W Brouwer","doi":"10.2340/17453674.2025.43333","DOIUrl":"https://doi.org/10.2340/17453674.2025.43333","url":null,"abstract":"<p><strong>Background and purpose: </strong> Unicompartmental osteoarthritis of the knee can be treated with high tibial osteotomy (HTO) or unicompartmental knee arthroplasty (UKA). This study aimed to investigate the use of revision components in total knee arthroplasty (TKA) after HTO or UKA and to investigate the revision-free survival of the 2 groups of TKA at different time points, including reasons for revision.</p><p><strong>Methods: </strong> TKAs after HTO and revision TKAs after failed UKA in the years 2007-2022 were selected from the Dutch Arthroplasty Register. For complexity, the usage of revision components was analyzed. Kaplan-Meier survival analysis was used to estimate survival rate. Multivariable Cox proportional hazards regression analyses were used to estimate the risk of revision, considering potential confounders. Indications of revision were evaluated.</p><p><strong>Results: </strong> 11,983 procedures were analyzed (9,835 HTO-TKA and 2,148 UKA-TKA). In the HTO-TKA group, 3% had revision components in the TKA compared with 22% in the UKA-TKA group (P < 0.001). After 12 years' follow-up the revision-free survival was 90.4% (95% confidence interval [CI] 89.6-91.2) for HTO-TKA and 81.7% (CI 79.3-84.1) for UKA-TKA. The multivariable Cox regression analysis showed that UKA-TKA was a significant risk factor for a revision of the TKA (hazard ratio 2.3, CI 1.8-2.6), compared with HTO-TKA. In both groups the most frequent reason for revision was instability, followed by patellar pain and loosening of the tibial component.</p><p><strong>Conclusion: </strong> TKAs after UKAs had higher use of revision components and a lower survival rate compared with TKAs following an HTO. The choice of surgical treatment should be considered for the young and active patient with unicompartmental knee osteoarthritis.</p>","PeriodicalId":6916,"journal":{"name":"Acta Orthopaedica","volume":"96 ","pages":"317-321"},"PeriodicalIF":2.5,"publicationDate":"2025-04-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11995432/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143965576","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 secondary surgery following surgical treatment of fractures: a nationwide register study on 9,719 adult patients.","authors":"Anders Bo Roennegaard, Signe Steenstrup Jensen, Peter Toft Tengberg, Per Hviid Gundtoft, Bjarke Viberg","doi":"10.2340/17453674.2025.43446","DOIUrl":"https://doi.org/10.2340/17453674.2025.43446","url":null,"abstract":"<p><strong>Background and purpose: </strong> Reports on the risk of secondary surgery in fracture-related surgery are scarce in the literature. The aim of this study was to estimate the risk of any secondary musculoskeletal surgery within 2 years of primary, fracture-related surgery.</p><p><strong>Methods: </strong> We performed a nationwide register study on adult Danish patients surgically treated for fractures in 2016 with 2 years' follow-up. We used cross-linked data from the Danish Fracture Database, the Danish National Patient Registry and the Danish Civil Registration System. Primary outcome was risk of secondary surgery calculated by the cumulative incidence function and presented with 95% confidence intervals (CI) overall and stratified on age, sex, and anatomical area.</p><p><strong>Results: </strong> We included 9,719 adult patients of whom 63% were female and median age was 70 years (20-100). The overall risk of secondary musculoskeletal surgery in the same anatomical area as the primary was 20% (CI 19-21), for reoperation (i.e., pertaining to the initial treatment) 19% (CI 18-20), and for major reoperation (due to complication of the initial treatment) 8% (CI 7-8). Across anatomical areas risk ranged from 4% (CI 1-9) to 69% (CI 66-73) for secondary surgery, from 4% (CI 1-9) to 68% (CI 65-72) for reoperations, and from 2% (CI 0-6) to 26% (CI 19-33) for major reoperation.</p><p><strong>Conclusion: </strong> The risk of experiencing a major postoperative complication that needs surgical treatment is below 10%.</p>","PeriodicalId":6916,"journal":{"name":"Acta Orthopaedica","volume":"96 ","pages":"304-309"},"PeriodicalIF":2.5,"publicationDate":"2025-04-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11995429/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143952352","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":"The accuracy and precision of CT-RSA in arthroplasty: a systematic review and meta-analysis.","authors":"Sjors F Van de Vusse, Nienke N De Laat, Lennard A Koster, Bart L Kaptein","doi":"10.2340/17453674.2025.43334","DOIUrl":"10.2340/17453674.2025.43334","url":null,"abstract":"<p><strong>Background and purpose: </strong> Computed tomography-based radiostereometric analysis (CT-RSA) is an alternative to conventional radiostereometric analysis (RSA) in measuring implant migration, circumventing the need for operative insertion of tantalum markers. The accuracy and precision of different CT-RSA techniques in various joints are still unclear, and the effective radiation dose (ED) of CT-RSA is usually higher than RSA. In this systematic literature review, we aimed to provide an overview of the accuracy, precision, clinical precision, and ED of CT-RSA techniques.</p><p><strong>Methods: </strong> We performed a systematic search in PubMed, Cochrane, and Embase databases. Main search items were \"arthroplasty\" AND \"migration\" AND \"computed tomography.\" We included full-text English papers, using CT for migration analysis (CT-RSA) in human, animal, or synthetic models with arthroplasties, reporting accuracy and/or precision. Eligible studies were screened and reviewed by 2 authors independently. Main outcomes were accuracy, precision, and clinical precision of CT-RSA in 6 degrees of freedom. Secondary outcome was the mean ED. A meta-analysis on (clinical) precision of CT-RSA was performed.</p><p><strong>Results: </strong> 23 studies were included involving 163 patients, 20 human cadaveric, 3 porcine cadaveric, and 7 synthetic models. 6 different CT-RSA techniques were used to study 6 different joint components in cervical disc replacement and shoulder, hip, and knee arthroplasty. CT-RSA accuracy ranged between 0.02 and 0.71 mm and 0.03° and 1.00°. CT-RSA precision ranged between 0.00 and 0.47 mm and 0.00° and 1.09°. Mean precision was 0.15 mm (95% confidence interval [CI] 0.05-0.25) in the acetabulum, 0.13 mm (CI 0.00-0.28) and 0.24° (CI 0.00-0.51) in the proximal femur, and 0.04 mm (CI 0.00-0.08) and 0.07° (CI 0.00-0.15) in the proximal tibia. CT-RSA clinical precision ranged between 0.03 and 1.36 mm and 0.06° and 2.25°. Mean clinical precision was 0.13 mm (CI 0.11-0.16) and 0.26° (CI 0.20-0.32) in the acetabulum. The mean ED of CT-RSA ranged between 0.02 and 5.80 mSv.</p><p><strong>Conclusion: </strong> CT-RSA shows comparable accuracy and precision to standard RSA. CT-RSA seems to be a promising alternative to RSA.</p>","PeriodicalId":6916,"journal":{"name":"Acta Orthopaedica","volume":"96 ","pages":"295-303"},"PeriodicalIF":2.5,"publicationDate":"2025-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11971844/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143750653","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}