Acta Orthopaedica最新文献_第10页

Pediatric hip disorders are not associated with an increased 10-year revision risk after total hip arthroplasty under the age of 55: results from the Dutch Arthroplasty Register. 55岁以下儿童髋关节疾病与全髋关节置换术后10年翻修风险增加无关：荷兰关节置换术登记的结果。

IF 2.5 2区医学

Acta Orthopaedica Pub Date : 2024-08-28 DOI: 10.2340/17453674.2024.41342

Michaël P A Bus, Maaike G J Gademan, Marta Fiocco, Rob G H H Nelissen, Pieter Bas De Witte

{"title":"Pediatric hip disorders are not associated with an increased 10-year revision risk after total hip arthroplasty under the age of 55: results from the Dutch Arthroplasty Register.","authors":"Michaël P A Bus, Maaike G J Gademan, Marta Fiocco, Rob G H H Nelissen, Pieter Bas De Witte","doi":"10.2340/17453674.2024.41342","DOIUrl":"10.2340/17453674.2024.41342","url":null,"abstract":"Background and purpose: Developmental dysplasia (DDH) and Legg-Calvé-Perthes disease (LCPD) are common indications for total hip arthroplasty (THA) at a young age, and may be associated with increased revision risk. We aimed to investigate the 10-year cumulative aseptic cup revision and overall revision risk of THA, and investigated whether these are increased compared with THA for primary osteoarthritis (OA) in patients below 55 years.Methods: All THAs (2007-2019) in patients under the age of 55 for the indications OA, DDH, and LCPD were extracted from the Dutch Arthroplasty register. The 10-year cumulative incidences of aseptic cup failure and overall revision were assessed for the 3 groups, with death as a competing risk. Cox regression analysis was used.Results: 24,263 THAs were identified: 20,645 (85%) for OA, 3,032 (13%) for DDH, and 586 (2%) for LCPD. The 10-year cumulative revision risk for aseptic cup failure was 3.4% (95% confidence interval [CI] 3.0-3.8) for OA, 3.4% (CI 2.4-3.4) for DDH, and 1.7% (CI 0.2-3.1) for LCPD. The 10-year cumulative overall revision risk was 6.0% (CI 5.6-6.5) for OA, 6.0% (CI 4.9-7.2) for DDH, and 5.1% (2.7-7.5) for LCPD. The multivariable Cox regression analysis for aseptic cup failure yielded hazard ratios of 0.7 (0.5-1.2) for DDH, and 0.8 (0.3-2.1) for LCPD compared with OA. No statistically significant differences for overall revision were found.Conclusion: THA performed for DDH or LCDP in patients under the age of 55 was not associated with a statistically significant increased risk of aseptic cup revision or overall revision, compared with THA performed for primary OA in the same age group.","PeriodicalId":6916,"journal":{"name":"Acta Orthopaedica","volume":"95 ","pages":"472-476"},"PeriodicalIF":2.5,"publicationDate":"2024-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11350965/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142078774","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}

引用次数: 0

The effect of pain neuroscience education on chronic postsurgical pain after total knee arthroplasty: a randomized controlled trial. 疼痛神经科学教育对全膝关节置换术后慢性术后疼痛的影响：随机对照试验。

IF 2.5 2区医学

Acta Orthopaedica Pub Date : 2024-08-28 DOI: 10.2340/17453674.2024.41346

Dominique C Baas, Johanna C Van Aalderen-Wichers, Tjeerd H Van der Goot, Ronald J Verhagen

{"title":"The effect of pain neuroscience education on chronic postsurgical pain after total knee arthroplasty: a randomized controlled trial.","authors":"Dominique C Baas, Johanna C Van Aalderen-Wichers, Tjeerd H Van der Goot, Ronald J Verhagen","doi":"10.2340/17453674.2024.41346","DOIUrl":"10.2340/17453674.2024.41346","url":null,"abstract":"Background and purpose: Chronic postsurgical pain after total knee arthroplasty (TKA) is frequent and may be reduced by pain neuroscience education (PNE), teaching people about pain from a neurobiological perspective. This study investigated primarily the effectiveness of 2 individual sessions of PNE versus usual care on pain levels 3 months postoperatively in patients undergoing TKA. Secondary outcomes were physical functioning, stiffness, health-related quality of life, pain catastrophizing, attention to pain, and levels of anxiety and depression.Methods: A prospective single-center, parallel-group randomized controlled trial was undertaken including patients aged 18 years or older scheduled for primary TKA. 68 patients were randomly assigned to PNE or usual care. The primary outcome was the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) pain score 3 months postoperatively. Outcomes were measured preoperatively, at 2 weeks (acute phase), and at 3 and 12 months postoperatively.Results: We found no statistically significant difference (0.4 points; 95% confidence interval [CI] -1.7 to 2.4) in WOMAC pain scores 3 months after TKA between the PNE and control group. We found a statistically significant difference between the 2 groups for attention to pain at 3 months in favor of PNE (P = 0.02).Conclusion: This RCT showed that PNE was not superior to usual care in terms of reducing pain at 3 months after TKA. Attention to pain, as a secondary outcome, was significantly lower in the PNE group compared with usual care. Other secondary outcome measures showed no significant differences.","PeriodicalId":6916,"journal":{"name":"Acta Orthopaedica","volume":"95 ","pages":"485-491"},"PeriodicalIF":2.5,"publicationDate":"2024-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11350964/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142078775","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}

引用次数: 0

Influence of design features and brand of reverse shoulder arthroplasties on survivorship and reasons for revision surgery: results of 5,494 arthroplasties with up to 15 years' follow-up reported to the Norwegian Arthroplasty Register 2007-2022. 反向肩关节置换术的设计特点和品牌对存活率和翻修手术原因的影响：2007-2022年挪威关节置换术登记册上5494例关节置换术长达15年的随访结果。

IF 2.5 2区医学

Acta Orthopaedica Pub Date : 2024-08-27 DOI: 10.2340/17453674.2024.41344

Randi M Hole, Anne Marie Fenstad, Jan-Erik Gjertsen, Geir Hallan, Ove N Furnes

{"title":"Influence of design features and brand of reverse shoulder arthroplasties on survivorship and reasons for revision surgery: results of 5,494 arthroplasties with up to 15 years' follow-up reported to the Norwegian Arthroplasty Register 2007-2022.","authors":"Randi M Hole, Anne Marie Fenstad, Jan-Erik Gjertsen, Geir Hallan, Ove N Furnes","doi":"10.2340/17453674.2024.41344","DOIUrl":"10.2340/17453674.2024.41344","url":null,"abstract":"Background and purpose: We aimed to report the survival of different reverse shoulder arthroplasty (RSA) designs and brands, and factors associated with revision. The secondary aim was to evaluate the reasons for revision.Methods: We included 4,696 inlay and 798 onlay RSAs reported to the Norwegian Arthroplasty Register (NAR) 2007-2022. Kaplan-Meier estimates of survivorship and Cox models adjusted for age, sex, diagnosis, implant design, humeral fixation, and previous surgery were investigated to assess revision risks. The reasons for revision were compared using competing risk analysis.Results: Overall, the 10-year survival rate was 94% (confidence interval [CI] 93-95). At 5 years all brands exceeded 90%. Compared with Delta Xtend (n = 3,865), Aequalis Ascend Flex (HR 2.8, CI 1.7-4.6), Aequalis Reversed II (HR 2.2, CI 1.2-4.2), SMR (HR 2.5, CI 1.3-4.7), and Promos (HR 2.2, CI 1.0-4.9) had increased risk of revision. Onlay and inlay RSAs had similar risk of revision (HR 1.2, CI 0.8-1.8). Instability and deep infection were the most frequent revision causes. Male sex (HR 2.3, CI 1.7-3.1), fracture sequelae (HR 3.1, CI 2.1-5.0), and fractures operated on with uncemented humeral stems had increased risk of revision (HR 3.5, CI 1.6-7.3).Conclusion: We found similar risk of revision with inlay and onlay designs. Some prosthesis brands had a higher rate of revision than the most common implant, but numbers were low.","PeriodicalId":6916,"journal":{"name":"Acta Orthopaedica","volume":"95 ","pages":"463-471"},"PeriodicalIF":2.5,"publicationDate":"2024-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11348804/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142071714","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}

引用次数: 0

Identifying effective candidates for sacro-iliac joint fusion. 确定骶髂关节融合术的有效候选者。

IF 2.5 2区医学

Acta Orthopaedica Pub Date : 2024-08-21 DOI: 10.2340/17453674.2024.41305

Daisuke Kurosawa, Bengt Sturesson

引用次数: 0

Reply to Letter: Identifying effective candidates for sacro-iliac joint fusion. 回信：确定骶髂关节融合术的有效候选者。

IF 2.5 2区医学

Acta Orthopaedica Pub Date : 2024-08-21 DOI: 10.2340/17453674.2024.41306

Paul Gerdhem, Thomas Kibsgård, Engelke Randers

引用次数: 0

Intensive physical activity following total hip arthroplasty increased the revision risk after 15 years: a cohort study of 973 patients from the Geneva Arthroplasty Register. 全髋关节置换术后加强体育锻炼会增加 15 年后的翻修风险：日内瓦关节置换术登记处对 973 名患者进行的队列研究。

IF 2.5 2区医学

Acta Orthopaedica Pub Date : 2024-08-15 DOI: 10.2340/17453674.2024.41192

Elena Zaballa, Stefania D'angelo, Christophe Barea, Georgia Ntani, Didier Hannouche, Cyrus Cooper, Anne Lübbeke, Karen Walker-Bone

{"title":"Intensive physical activity following total hip arthroplasty increased the revision risk after 15 years: a cohort study of 973 patients from the Geneva Arthroplasty Register.","authors":"Elena Zaballa, Stefania D'angelo, Christophe Barea, Georgia Ntani, Didier Hannouche, Cyrus Cooper, Anne Lübbeke, Karen Walker-Bone","doi":"10.2340/17453674.2024.41192","DOIUrl":"10.2340/17453674.2024.41192","url":null,"abstract":"Background and purpose: Younger recipients of total hip arthroplasty (THA) highly prioritize returning to preoperative levels of physical activity (PA). Surgeons have tended to give cautious advice concerning high-impact sports participation, but there have been few long-term studies. The purpose of our study was to investigate the risk of revision arthroplasty in relation to postoperative PA levels.Methods: Patients registered in the Geneva Arthroplasty Register (GAR) who had elective THA when they were aged < 65 years were studied. Postoperative PA was collected prospectively 5-yearly using the UCLA activity scale. Cox proportional hazards models were used to estimate associations between PA and risk of revision THA.Results: Amongst 1,370 eligible subjects, median age at THA 58 years (interquartile range 51-61), UCLA scores were available for 973 (71%). During follow-up over 15 years, there were 79 revisions, giving a cumulative risk of 7.4% (95% confidence interval [CI] 5.8-9.4). After adjusting for covariates, we found an increased risk of revision for each unit increase in postoperative PA (HR 1.2, CI 1.1-1.4), and among people performing the most intensive PA (HR 2.7, CI 1.3-5.6) compared with those who were inactive.Conclusion: The overall risk of revision was small but intensive and moderate PA may be associated with an increased risk of revision.","PeriodicalId":6916,"journal":{"name":"Acta Orthopaedica","volume":"95 ","pages":"446-453"},"PeriodicalIF":2.5,"publicationDate":"2024-08-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11325854/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141981459","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}

引用次数: 0

Less inflammatory response in the direct anterior than in the direct lateral approach in patients with femoral neck fractures receiving a total hip arthroplasty: exploratory results from a randomized controlled trial. 在接受全髋关节置换术的股骨颈骨折患者中，直接前路比直接侧路的炎症反应更少：随机对照试验的探索性结果。

IF 2.5 2区医学

Acta Orthopaedica Pub Date : 2024-08-15 DOI: 10.2340/17453674.2024.41242

John Magne Hoseth, Otto Schnell Husby, Øystein Bjerkestrand Lian, Tor Åge Myklebust, Tommy Frøseth Aae

{"title":"Less inflammatory response in the direct anterior than in the direct lateral approach in patients with femoral neck fractures receiving a total hip arthroplasty: exploratory results from a randomized controlled trial.","authors":"John Magne Hoseth, Otto Schnell Husby, Øystein Bjerkestrand Lian, Tor Åge Myklebust, Tommy Frøseth Aae","doi":"10.2340/17453674.2024.41242","DOIUrl":"10.2340/17453674.2024.41242","url":null,"abstract":"Background and purpose: It is still debatable which is the least invasive approach to the hip joint in arthroplasty for a femoral neck fracture (FNF). We compared the traditional direct lateral approach (DLA) with the direct anterior approach (DAA) regarding creatine kinase (CK), C-reactive protein (CRP), and hemoglobin (Hb).Methods: In a randomized controlled trial, 130 elderly patients with dislocated FNFs treated with total hip arthroplasty (THA) were included. CK, CRP, and Hb were measured preoperatively and on postoperative days 1 to 4 and were compared between the DAA and DLA groups using repeated measures mixed-effect models.Results: The CK level was significantly higher on the 1st postoperative day in the DLA group, 597 U/L (95% confidence interval [CI] 529-666) vs 461 U/L (CI 389-532), estimated mean difference (MD) 136 U/L (CI 38-235). The CRP levels were significantly higher on postoperative days 3 and 4 in the DLA group, 207 mg/L (CI 189-226) vs 161 mg/L (CI 143-180), estimated MD 46 mg/L (CI 19-72) and 162 mg/L (CI 144-181) vs 121 (CI 102-140), estimated MD 41 mg/L (CI 15-68). Blood loss, expressed as difference in Hb, did not differ between the groups.Conclusion: In an elderly population with FNFs, we found that the DAA, compared with the DLA, results in less CK and CRP increase, but no change in Hb.","PeriodicalId":6916,"journal":{"name":"Acta Orthopaedica","volume":"95 ","pages":"440-445"},"PeriodicalIF":2.5,"publicationDate":"2024-08-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11325853/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141981460","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}

引用次数: 0

Discontinuing the recommendation of hip precautions does not increase the risk of early dislocation after primary total hip arthroplasty using 36-mm heads: a population-based study from the Danish Hip Arthroplasty Register. 停止推荐髋关节预防措施并不会增加使用 36 毫米头的初级全髋关节置换术后早期脱位的风险：一项基于丹麦髋关节置换术登记的人群研究。

IF 2.5 2区医学

Acta Orthopaedica Pub Date : 2024-07-18 DOI: 10.2340/17453674.2024.41168

Afrim Iljazi, Michala Skovlund Sørensen, Matilde Winther-Jensen, Søren Overgaard, Michael Mørk Petersen

{"title":"Discontinuing the recommendation of hip precautions does not increase the risk of early dislocation after primary total hip arthroplasty using 36-mm heads: a population-based study from the Danish Hip Arthroplasty Register.","authors":"Afrim Iljazi, Michala Skovlund Sørensen, Matilde Winther-Jensen, Søren Overgaard, Michael Mørk Petersen","doi":"10.2340/17453674.2024.41168","DOIUrl":"10.2340/17453674.2024.41168","url":null,"abstract":"Background and purpose: Dislocation is a severe complication following total hip arthroplasty (THA). Hip precautions have been recommended in the initial postoperative period but evidence supporting this practice is limited. We therefore conducted a population-based study to evaluate the association between discontinuing recommending postoperative hip precautions and the risk of early dislocation.Methods: This is a cohort study with data from the Danish Hip Arthroplasty Register and the Danish National Patient Register. We included patients who underwent primary THA for osteoarthritis in 2004-2019 in public hospitals in the Capital Region of Denmark. The cohort was divided into the hip precautions group, comprising patients operated on between 2004 and 2009, and the no-precautions group operated on between 2014 and 2019. The primary outcome was the difference in the absolute risk of dislocation within 3 months post-surgery. The secondary outcome assessed the same risk within 2 years. We evaluated the difference in absolute risk using absolute risk regression (ARR).Results: The cumulative incidence of dislocation within 3 months was 2.9% (confidence interval [CI] 2.5-3.3) in the hip precautions group and 3.5% (CI 3.1-3.9) in the no-precautions group. The risk of dislocation was higher in the no-precautions group but failed to reach statistical significance in the crude (ARR 1.2, CI 0.9-1.6) and multivariate model (ARR 1.4, CI 0.9-2.2).Conclusion: We found a higher but statistically insignificant increase in the risk of early dislocation in the no-precautions group. The lack of significance in the association may be explained by the increased use of 36-mm femoral heads after the guideline revision.","PeriodicalId":6916,"journal":{"name":"Acta Orthopaedica","volume":"95 ","pages":"407-414"},"PeriodicalIF":2.5,"publicationDate":"2024-07-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11257070/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141632305","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}

引用次数: 0

Staples, tension-band plates, and percutaneous epiphysiodesis screws used for leg-length discrepancy treatment: a systematic review and proportional meta-analysis. 用于治疗腿长不一致的订书钉、张力带钢板和经皮骺端螺钉：系统综述和比例荟萃分析。

IF 2.5 2区医学

Acta Orthopaedica Pub Date : 2024-07-18 DOI: 10.2340/17453674.2024.41104

Maria Tirta, Mette Holm Hjorth, Jette Frost Jepsen, Søren Kold, Ole Rahbek

{"title":"Staples, tension-band plates, and percutaneous epiphysiodesis screws used for leg-length discrepancy treatment: a systematic review and proportional meta-analysis.","authors":"Maria Tirta, Mette Holm Hjorth, Jette Frost Jepsen, Søren Kold, Ole Rahbek","doi":"10.2340/17453674.2024.41104","DOIUrl":"10.2340/17453674.2024.41104","url":null,"abstract":"Background and purpose: The primary aim of this systematic review and meta-analysis was to evaluate the success rate of 3 different epiphysiodesis techniques with implant usage for the treatment of leg-length discrepancy (LLD) in the pediatric population. The secondary aim was to address effectiveness (final LLD) and the reported complications of staples, tension-band plates (TBP), and percutaneous epiphysiodesis screws (PETS).Methods: In this systematic review we searched MEDLINE (PubMed), Embase, Cochrane Library, Web of Science and Scopus for studies on skeletally immature patients with LLD treated with epiphysiodesis with an implant. The extracted outcome categories were effectiveness of epiphysiodesis (LLD measurements pre-/postoperatively, successful/unsuccessful) and complications that were graded on severity.Results: 44 studies (2,184 patients) were included. 455 underwent epiphysiodesis with PETS, 578 patients with TBP, and 1,048 with staples. Successful epiphysiodesis was reported in 76% (95% confidence interval [CI] 61-89) with PETS (9 studies), 67% (CI 54-79) with TBP (10 studies), and 51% (CI 28-65) with Blount staples (8 studies). From pooled analysis, the severe complications rate was 7% for PETS, 17% for TBP, and 16% for Blount staples. Angular deformity was reported in 4% after PETS, 10% after TBP, and 17% after Blount staples.Conclusion: Our results showed that epiphysiodesis with PETS implants was the most successful technique. PETS had a higher success rate, fewer severe complications, and a lower proportion with angular deformity.","PeriodicalId":6916,"journal":{"name":"Acta Orthopaedica","volume":"95 ","pages":"415-424"},"PeriodicalIF":2.5,"publicationDate":"2024-07-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11257069/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141632306","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}

引用次数: 0

Preoperative optimization of modifiable risk factors is associated with decreased superficial surgical site infections after total joint arthroplasty: a prospective case-control study. 前瞻性病例对照研究：术前优化可改变的风险因素与减少全关节成形术后浅表手术部位感染有关。

IF 2.5 2区医学

Acta Orthopaedica Pub Date : 2024-07-17 DOI: 10.2340/17453674.2024.41012

Maria Sigurdardottir, Martin Ingi Sigurdsson, Rafael Daniel Vias, Yngvi Olafsson, Ingibjorg Gunnarsdottir, Emil L Sigurdsson, Sigurbergur Karason

{"title":"Preoperative optimization of modifiable risk factors is associated with decreased superficial surgical site infections after total joint arthroplasty: a prospective case-control study.","authors":"Maria Sigurdardottir, Martin Ingi Sigurdsson, Rafael Daniel Vias, Yngvi Olafsson, Ingibjorg Gunnarsdottir, Emil L Sigurdsson, Sigurbergur Karason","doi":"10.2340/17453674.2024.41012","DOIUrl":"10.2340/17453674.2024.41012","url":null,"abstract":"Background and purpose: The aim of our study was to investigate change in modifiable risk factors following preoperative optimization and whether risk of superficial surgical site infection (SSI) after total joint arthroplasty (TJA) could be reduced.Methods: This is a prospective study of implementation of a preoperative optimization pathway for patients waiting for primary TJA. Information regarding the intervention arm was collected from January 2019 to January 2021, first at decision for operation and then at preoperative assessment 1 week prior to operation. The control arm was included between August 2018 and September 2020 after receiving conventional preoperative preparation and information gathered at preoperative assessment. Follow up occurred 6 weeks postoperatively for both groups. The primary outcome was postoperative superficial SSI.Results: The optimization effort resulted in improvement of weight, anemia, HbA1c, vitamin D, and patient engagement. At preoperative assessment the baseline characteristics of the 2 groups were similar except that the intervention group had substantially more comorbidities. Regarding superficial SSI, association was found with BMI ≥ 30 and HbA1c ≥ 42 mmol/mol in the control group but not in the intervention group. When corrected for differences in ASA classification (reflecting comorbidities), age, and sex, being in the intervention group was associated with lower odds of occurrence of superficial SSI compared with the control group (OR 0.64, 95% confidence interval 0.42-0.97).Conclusion: We showed that preoperative optimization in a structured cooperation between hospital and primary care was associated with a reduced risk of superficial SSI.","PeriodicalId":6916,"journal":{"name":"Acta Orthopaedica","volume":"95 ","pages":"392-400"},"PeriodicalIF":2.5,"publicationDate":"2024-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11253708/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141625628","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}

引用次数: 0