Acta Orthopaedica最新文献

{"title":"Recommendations for physiotherapy and physical activity for children with Legg-Calvé-Perthes disease: a survey of pediatric orthopedic surgeons and physiotherapists in Sweden.","authors":"Louise Melin,&nbsp;Zlatica Rendek,&nbsp;Yasmin D Hailer","doi":"10.2340/17453674.2023.18341","DOIUrl":"https://doi.org/10.2340/17453674.2023.18341","url":null,"abstract":"<p><strong>Background and purpose: </strong>Physiotherapy, restrictions of physical activity, and weightbearing are part of the treatment of children with Legg-Calvé-Perthes disease (LCPD). Prescription practices are widely discussed and vary between pediatric orthopedic surgeons (POSs) and physiotherapists (PTs). The purpose of this study was to identify recommendations for treatment methods in clinical practice to find some consensus and elaborate guidelines.</p><p><strong>Patients and methods: </strong>A web-based questionnaire including 3 cases of LCPD (initial, fragmentation, and reossification stages) was answered by 25 POSs and 19 PTs. They were asked to describe their preferred recommendations for physiotherapy, including stretching, strengthening, weightbearing, and physical activities in relation to, e.g., range of motion (ROM) pain, sex, and disease stage.</p><p><strong>Results: </strong>ROM was considered to be important when recommending physiotherapy; PTs also recognized pain and disease stage. Sex was reported as a factor with low importance. Stretching exercises were recommended for all disease stages. Recommendations for strengthening exercises varied for the initial and fragmentation stages. None of the participants recommended total non-weightbearing. Most restricted trampolining, running, ball sports, and gymnastics in the first 2 stages of the disease and allowed swimming, short walks, cycling, and horse riding without restrictions for all stages.</p><p><strong>Conclusion: </strong>We found high agreement on recommending stretching exercises for all disease stages, but controversies regarding recommendations for strengthening exercises in the initial and fragmentation stages. No non-weightbearing treatment for the affected hip was recommended by any participants at any stage of the disease. There was no clear consensus regarding the appropriate timeline for resuming full activities.</p>","PeriodicalId":6916,"journal":{"name":"Acta Orthopaedica","volume":"94 ","pages":"432-437"},"PeriodicalIF":3.7,"publicationDate":"2023-08-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10436286/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10037712","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":"Surgical approach had minor association with femoral stem migration in total hip arthroplasty: radiostereometric analysis of 61 patients after 5-year follow-up.","authors":"Kristin Haugan,&nbsp;Olav A Foss,&nbsp;Otto S Husby,&nbsp;Vigdis S Husby,&nbsp;Svein Svenningsen,&nbsp;Siri B Winther","doi":"10.2340/17453674.2023.18264","DOIUrl":"https://doi.org/10.2340/17453674.2023.18264","url":null,"abstract":"<p><strong>Background and purpose: </strong>Total hip arthroplasty (THA) is usually performed using 1 of 3 surgical approaches: direct lateral (DLA), posterior (PA), or anterior (AA). AA is different from DLA and PA owing to limited intraoperative visibility of the femoral canal. This could affect stem positioning and therefore migration. We aimed to perform an exploratory radiostereometric analysis (RSA) study with 3 groups for surgical approach assessing stem migration up to 5 years postoperatively.</p><p><strong>Patients and methods: </strong>61 patients with unilateral osteoarthritis of the hip were included. 21 patients were allocated to the DLA, 20 to the PA, and 20 to the AA group. All patients received an uncemented, collarless, double-tapered, fully hydroxyapatite-coated Profemur Gladiator stem. Migration was measured with model-based RSA. Baseline RSA was on day 1 postoperatively. The follow-ups were at day 8, at 5 weeks, and at 3, 6, 12, 24, and 60 months after surgery. Generalized linear mixed models were used to analyze maximum total point motion (MTPM) migrations.</p><p><strong>Results: </strong>Group mean differences in MTPM were 0.4 mm (95% confidence interval [CI] -1.5 to 2.4) for DLA vs. PA, 1.1 mm (CI -1.0 to 3.3) for AA vs. DLA, and 1.6 mm (CI -0.8 to 3.9) for AA vs. PA, when adjusted for sex and age as covariates. 2 stems in the AA group had excessive early migration. For all stems the migrations occurred mainly within 5-week follow-up and then stabilized.</p><p><strong>Conclusion: </strong>At 5-year follow-up, there were no statistically significant differences in stem migration associated with the 3 surgical approaches used in this study.</p>","PeriodicalId":6916,"journal":{"name":"Acta Orthopaedica","volume":"94 ","pages":"410-415"},"PeriodicalIF":3.7,"publicationDate":"2023-08-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/4b/ee/ActaO-94-18264.PMC10416221.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9989531","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 use of antibiotic-loaded bone cement and systemic antibiotic prophylactic use in 2,971,357 primary total knee arthroplasties from 2010 to 2020: an international register-based observational study among countries in Africa, Europe, North America, and Oceania.","authors":"Tesfaye H Leta,&nbsp;Anne Marie Fenstad,&nbsp;Stein Håkon L Lygre,&nbsp;Stein Atle Lie,&nbsp;Martin Lindberg-Larsen,&nbsp;Alma B Pedersen,&nbsp;Annette W-Dahl,&nbsp;Ola Rolfson,&nbsp;Erik Bülow,&nbsp;James A Ashforth,&nbsp;Liza N Van Steenbergen,&nbsp;Rob G H H Nelissen,&nbsp;Dylan Harries,&nbsp;Richard De Steiger,&nbsp;Olav Lutro,&nbsp;Emmi Hakulinen,&nbsp;Keijo Mäkelä,&nbsp;Jinny Willis,&nbsp;Michael Wyatt,&nbsp;Chris Frampton,&nbsp;Alexander Grimberg,&nbsp;Arnd Steinbrück,&nbsp;Yinan Wu,&nbsp;Cristiana Armaroli,&nbsp;Marco Molinari,&nbsp;Roberto Picus,&nbsp;Kyle Mullen,&nbsp;Richard Illgen,&nbsp;Ioan C Stoica,&nbsp;Andreea E Vorovenci,&nbsp;Dan Dragomirescu,&nbsp;Håvard Dale,&nbsp;Christian Brand,&nbsp;Bernhard Christen,&nbsp;Joanne Shapiro,&nbsp;J Mark Wilkinson,&nbsp;Richard Armstrong,&nbsp;Kate Wooster,&nbsp;Geir Hallan,&nbsp;Jan-Erik Gjertsen,&nbsp;Richard N Chang,&nbsp;Heather A Prentice,&nbsp;Elizabeth W Paxton,&nbsp;Ove Furnes","doi":"10.2340/17453674.2023.17737","DOIUrl":"https://doi.org/10.2340/17453674.2023.17737","url":null,"abstract":"<p><strong>Background and purpose: </strong>Antibiotic-loaded bone cement (ALBC) and systemic antibiotic prophylaxis (SAP) have been used to reduce periprosthetic joint infection (PJI) rates. We investigated the use of ALBC and SAP in primary total knee arthroplasty (TKA).</p><p><strong>Patients and methods: </strong>This observational study is based on 2,971,357 primary TKAs reported in 2010-2020 to national/regional joint arthroplasty registries in Australia, Denmark, Finland, Germany, Italy, the Netherlands, New Zealand, Norway, Romania, South Africa, Sweden, Switzerland, the UK, and the USA. Aggregate-level data on trends and types of bone cement, antibiotic agents, and doses and duration of SAP used was extracted from participating registries.</p><p><strong>Results: </strong>ALBC was used in 77% of the TKAs with variation ranging from 100% in Norway to 31% in the USA. Palacos R+G was the most common (62%) ALBC type used. The primary antibiotic used in ALBC was gentamicin (94%). Use of ALBC in combination with SAP was common practice (77%). Cefazolin was the most common (32%) SAP agent. The doses and duration of SAP used varied from one single preoperative dosage as standard practice in Bolzano, Italy (98%) to 1-day 4 doses in Norway (83% of the 40,709 TKAs reported to the Norwegian arthroplasty register).</p><p><strong>Conclusion: </strong>The proportion of ALBC usage in primary TKA varies internationally, with gentamicin being the most common antibiotic. ALBC in combination with SAP was common practice, with cefazolin the most common SAP agent. The type of ALBC and type, dose, and duration of SAP varied among participating countries.</p>","PeriodicalId":6916,"journal":{"name":"Acta Orthopaedica","volume":"94 ","pages":"416-425"},"PeriodicalIF":3.7,"publicationDate":"2023-08-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/f9/55/ActaO-94-17737.PMC10416222.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9984408","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":"No difference in risk of revision due to infection between clindamycin and cephalosporins as antibiotic prophylaxis in cemented primary total knee replacements: a report from the Norwegian Arthroplasty Register 2005-2020.","authors":"Karola Pawloy,&nbsp;Anne Marie Fenstad,&nbsp;Tesfaye Leta,&nbsp;Geir Hallan,&nbsp;Jan-Erik Gjertsen,&nbsp;Håvard Dale,&nbsp;Stein Atle Lie,&nbsp;Ove Furnes","doi":"10.2340/17453674.2023.16907","DOIUrl":"https://doi.org/10.2340/17453674.2023.16907","url":null,"abstract":"<p><strong>Background and purpose: </strong>Systemic antibiotic prophylaxis with clindamycin, which is often used in penicillin- or cephalosporin-allergic patients', has been associated with a higher risk of surgical revision for deep prosthetic joint infection (PJI) than cloxacillin in primary total knee replacement (TKR). We aimed to investigate whether clindamycin increases the risk of surgical revisions due to PJI compared with cephalosporins in primary cemented TKR.</p><p><strong>Patients and methods: </strong>Data from 59,081 TKRs in the Norwegian Arthroplasty Register (NAR) 2005-2020 was included. 2,655 (5%) received clindamycin and 56,426 (95%) received cephalosporins. Cox regression analyses were performed with adjustment for sex, age groups, diagnosis, and ASA score. Survival times were calculated using Kaplan-Meier estimates and compared using Cox regression with revision for PJI as endpoint. The cephalosporins cefalotin and cefazolin were also compared.</p><p><strong>Results: </strong>Of the TKRs included, 1.3% (n = 743) were revised for PJI. 96% (n = 713) had received cephalosporins and 4% (n = 30) clindamycin for perioperative prophylaxis. Comparing cephalosporins (reference) and clindamycin, at 3-month follow-up the adjusted hazard ratio rate (HRR) for PJI was 0.7 (95% confidence interval [CI] 0.4-1.4), at 1 year 0.9 (CI 0.6-1.5), and at 5 years 0.9 (CI 0.6-1.4). Analysis using propensity score matching showed similar results. Furthermore, comparing cefalotin (reference) and cefazolin, HRR was 1.0 (CI 0.8-1.4) at 3 months and 1.0 (CI 0.7-1.3) at 1-year follow-up.</p><p><strong>Conclusion: </strong>We found no difference in risk of revision for PJI when using clindamycin compared with cephalosporins in primary cemented TKRs. It appears safe to continue the use of clindamycin in penicillin- or cephalosporin-allergic patients.</p>","PeriodicalId":6916,"journal":{"name":"Acta Orthopaedica","volume":"94 ","pages":"404-409"},"PeriodicalIF":3.7,"publicationDate":"2023-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/36/1b/ActaO-94-16907.PMC10391533.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9925721","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":"Radiographic reference values of the central knee anatomy in 8-16-year-old children.","authors":"Bjoern Vogt,&nbsp;Emma Hvidberg,&nbsp;Jan Duedal Rölfing,&nbsp;Georg Gosheger,&nbsp;Bjarne Møller-Madsen,&nbsp;Ahmed A Abood,&nbsp;Veronika Weyer-Elberich,&nbsp;Andrea Laufer,&nbsp;Gregor Toporowski,&nbsp;Robert Roedl,&nbsp;Adrien Frommer","doi":"10.2340/17453674.2023.15336","DOIUrl":"https://doi.org/10.2340/17453674.2023.15336","url":null,"abstract":"<p><strong>Background and purpose: </strong>For correction of leg-length discrepancy or angular deformity of the lower limb in skeletally immature patients temporary or permanent (hemi-)epiphysiodesis can be employed. These are reliable treatments with few complications. Recently, radiographic analysis of treatment-related alterations of the central knee anatomy gained interest among pediatric orthopedic surgeons. To date the comparison and adequate interpretation of potential changes of the central knee anatomy is limited due to the lack of defined standardized radiographic references. We aimed to establish new reference values of the central knee anatomy.</p><p><strong>Patients and methods: </strong>A retrospective analysis of calibrated longstanding anteroposterior radiographs of 254 skeletally immature patients with a chronological age ranging from 8 to 16 years was conducted. The following radiographic parameters were assessed: (1) femoral floor angle, (2) tibial roof angle, (3) width at femoral physis, and (4) femoral notch-intercondylar distance.</p><p><strong>Results: </strong>All observed radiographic parameters were normally distributed with a mean age of 12.4 years (standard deviation [SD] 2, 95% confidence interval [CI] 12.2-12.6). Mean femoral floor angle was 142° (SD 6, CI 141.8-142.9), mean tibial roof angle was 144° (SD 5, CI 143.7-144.1), mean width at femoral physis was 73 mm (SD 6, CI 72.8-73.9), and mean femoral notch-intercondylar distance was 8 mm (SD 1, CI 7.5-7.7). The estimated intraclass correlation coefficient values were excellent for all measurements.</p><p><strong>Conclusion: </strong>This study provides new radiographic reference values of the central knee anatomy for children between 8 and 16 years and we suggest considering values within the range of 2 SD as the physiological range.</p>","PeriodicalId":6916,"journal":{"name":"Acta Orthopaedica","volume":"94 ","pages":"393-398"},"PeriodicalIF":3.7,"publicationDate":"2023-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/a7/70/ActaO-94-15336.PMC10388364.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9979550","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":"Revision risk of salvage compared with acute total hip arthroplasty following femoral neck fracture: an analysis from the Dutch Arthroplasty Register.","authors":"Peter P Schmitz,&nbsp;Gerjon Hannink,&nbsp;Matthijs P Somford,&nbsp;B Willem Schreurs,&nbsp;Job L C Van Susante","doi":"10.2340/17453674.2023.17743","DOIUrl":"https://doi.org/10.2340/17453674.2023.17743","url":null,"abstract":"<p><strong>Background and purpose: </strong>There is no consensus on the treatment of patients with femoral neck fractures between internal fixation (IF) or directly treated with a total hip arthroplasty (fracture-THA) in particular for the age group 60-70 years. Failure of IF is not uncommon, resulting in salvage total hip arthroplasty (salvage-THA). The aim of our study was to compare revision rates of salvage-THA with fracture-THA and osteoarthritis (OA)-THA.</p><p><strong>Patients and methods: </strong>Revision rates and reasons for revision were compared. Data collected in the Dutch Arthroplasty Register (LROI) between 2007 and 2018 was used. The study included 4,310 salvage-THAs, 12,159 fracture-THAs, and 274,147 OA-THAs. We performed Kaplan-Meier survival analyses and Cox regression to evaluate THA survival.</p><p><strong>Results: </strong>No statistically significant difference in revision rates between salvage-THAs and fracture-THAs was found (HR 1.0, 95% CI 0.7-1.3) whereas the revision rate was higher compared with OA-THAs (HR 1.3, CI 1.0-1.5). The 5-year revision rate was 5.0% (CI 4.4-5.8) in salvage-THAs, 4.5% (CI 4.1-5.0) in fracture-THAs, and 3.1% (CI 3.0-3.2) in OA-THAs. A higher revision rate for infection was found in salvage-THAs in comparison with fracture-THAs (HR 1.6, CI 1.0-2.3).</p><p><strong>Conclusion: </strong>We found no difference in revision rates for salvage-THAs compared with fracture-THAs. The risk of revision for infection was higher for salvage-THA.</p>","PeriodicalId":6916,"journal":{"name":"Acta Orthopaedica","volume":"94 ","pages":"399-403"},"PeriodicalIF":3.7,"publicationDate":"2023-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/6b/f8/ActaO-94-17743.PMC10388365.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10295155","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":"No difference in the use of revision components and rerevision rate in conversion to total knee replacement following Oxford Partial Knee Microplasty Instrumentation: a registry study of 529 conversions.","authors":"Stephan J Van Langeveld,&nbsp;Stein J Janssen,&nbsp;Koen L M Koenraadt,&nbsp;Joost A A M Van den Hout,&nbsp;Liza N Van Steenbergen,&nbsp;Rutger C I Van Geenen","doi":"10.2340/17453674.2023.15310","DOIUrl":"https://doi.org/10.2340/17453674.2023.15310","url":null,"abstract":"<p><strong>Background and purpose: </strong>Microplasty Instrumentation was introduced to improve Oxford Mobile Partial Knee placement and preserve tibial bone in partial knee replacement (PKR). This might therefore reduce revision complexity. We aimed to assess the difference in use of revision total knee replacement (TKR) tibial components in failed Microplasty versus non-Microplasty instrumented PKRs.</p><p><strong>Patients and methods: </strong>Data on 529 conversions to TKR (156 Microplasty instrumented and 373 non-Microplasty instrumented PKRs) from the Dutch Arthroplasty Register (LROI) between 2007 and 2019 was used. The primary outcome was the difference in use of revision TKR tibial components during conversion to TKR, which was calculated with a univariable logistic regression analysis. The secondary outcomes were the 3-year re-revision rate and hazard ratios calculated with Kaplan-Meier and Cox regression analyses.</p><p><strong>Results: </strong>Revision TKR tibial components were used in 29% of the conversions to TKR after failed Microplasty instrumented PKRs and in 24% after failed non-Microplasty instrumented PKRs with an odds ratio of 1.3 (CI 0.86-2.0). The 3-year re-revision rates were 8.4% (CI 4.1-17) after conversion to TKR for failed Microplasty and 11% (CI 7.8-15) for failed non-Microplasty instrumented PKRs with a hazard ratio of 0.77 (CI 0.36-1.7).</p><p><strong>Conclusion: </strong>There was no difference in use of revision tibial components for conversion to TKR or in re-revision rate after failed Microplasty versus non-Microplasty instrumented PKRs nor in the 3-year revision rate.</p>","PeriodicalId":6916,"journal":{"name":"Acta Orthopaedica","volume":"94 ","pages":"387-392"},"PeriodicalIF":3.7,"publicationDate":"2023-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/31/90/ActaO-94-15310.PMC10388235.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10300341","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":"Intra- and inter-observer agreement in distal radius fracture dislocation measurement of casting position.","authors":"Katriina Paasikallio,&nbsp;Reijo Sund,&nbsp;Simo Miettinen,&nbsp;Sonja Kauranen,&nbsp;Hannu Sorsa,&nbsp;Heikki Kröger,&nbsp;Joonas Sirola","doi":"10.2340/17453674.2023.13707","DOIUrl":"https://doi.org/10.2340/17453674.2023.13707","url":null,"abstract":"<p><strong>Background and purpose: </strong>Most displaced distal radius fractures (DRF) are treated nonoperatively, with reduction and immobilization in a cast. Studies assessing intra- or inter-observer agreement on radiologic measurements of casting position have not been published, which was the aim of our study.</p><p><strong>Patients and methods: </strong>Our study is based on the Kuopio Osteoporosis Risk Factor and Prevention (OSTPRE) study. All detected DRFs during the OSTPRE follow-up were retrieved and based on sample size calculations 50 fractures were randomly selected for the study. 5 independent reviewers measured dislocation parameters and wrist position in a cast from the radiographs. A linear mixed model was used to estimate the concordance correlation coefficient (CCC) and total deviance index (TDI) that were used to evaluate intra- and inter-observer agreement. We used Kappa values to determine intra- and inter-rater agreement on radiographically acceptable reduction of the DRF. Limits of acceptable position were those defined by Finnish Current Care Guidelines.</p><p><strong>Results: </strong>For radial inclination, radial shortening, and dorsal/volar tilt, intra- and inter-observer correlations were high (CCC > 0.76). In addition, measurements of wrist angle in a splint had high correlations (CCC > 0.78), whereas measurement of intra-articular gap and step had poor correlations (CCC < 0.52). The Kappa value for overall agreement on the radiographically acceptable position of the DRF was modest (0.59).</p><p><strong>Conclusion: </strong>Intra- and inter-observer repeatability of casting position of radial inclination, radial shortening, and dorsal/volar tilt were high whereas intra-articular gap and step had poor correlations.</p>","PeriodicalId":6916,"journal":{"name":"Acta Orthopaedica","volume":"94 ","pages":"379-386"},"PeriodicalIF":3.7,"publicationDate":"2023-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/58/fb/ActaO-94-13707.PMC10370410.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9936052","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":"Effects of patient-specific positioning guides (PSPGs) vs. conventional instrumentation on patient-reported outcome in total knee arthroplasty: secondary analysis of a randomized controlled trial after 5 years.","authors":"Sean C S Rivrud,&nbsp;Stephan M Röhrl,&nbsp;Justin A M J Van Leeuwen","doi":"10.2340/17453674.2023.15335","DOIUrl":"https://doi.org/10.2340/17453674.2023.15335","url":null,"abstract":"<p><strong>Background and purpose: </strong>The use of patient-specific positioning guides (PSPGs) in total knee arthroplasty (TKA) has been advocated as a means of improving patient outcomes, but the reception of PSPGs has been mixed. The aim of our study was to compare patient-reported outcomes (KOOS, NRS-11, EQ-5D-3L, EQ-VAS) after TKA using PSPG with conventional instrumentation (CI) to determine whether there is a discernible clinical benefit to using PSPGs.</p><p><strong>Patients and methods: </strong>This multicenter randomized controlled trial (RCT) followed 77 patients who were randomly assigned to 1 of 2 cohorts between September 2011 and January 2014-one receiving TKA with PSPGs (from Materialise NV) and one receiving TKA with CI-with each cohort followed up until 5 years after the operation. The Vanguard Cruciate Retaining Total Knee System and Refobacin Bone Cement R were used in all operations. KOOS was evaluated using confidence intervals, with differences of less than 10 KOOS units between the cohorts interpreted as indicating the absence of a clinically meaningful difference.</p><p><strong>Results: </strong>No significant differences were found in any of the measured clinical outcomes-KOOS, NRS-11, EQ-5D-3L, EQ-VAS, range of motion, or radiolucent lines scoring-between the cohort operated on using PSPG and the cohort operated on using CI after 5 years of follow-up.</p><p><strong>Conclusion: </strong>There was no statistically significant effect of PSPGs on patient-reported outcomes or range of motion in TKA.</p>","PeriodicalId":6916,"journal":{"name":"Acta Orthopaedica","volume":"94 ","pages":"354-359"},"PeriodicalIF":3.7,"publicationDate":"2023-07-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/5d/f7/ActaO-94-15335.PMC10370263.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9883458","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":"CT-based radiostereometric analysis for assessing midfoot kinematics: precision compared with marker-based radiostereometry.","authors":"Magnus Poulsen,&nbsp;Are H Stødle,&nbsp;Lars Nordsletten,&nbsp;Stephan M Röhrl","doi":"10.2340/17453674.2023.16905","DOIUrl":"https://doi.org/10.2340/17453674.2023.16905","url":null,"abstract":"<p><strong>Background and purpose: </strong>3-dimensional midfoot motion is hard to evaluate in clinical practice. We present a new computed tomography (CT)-based radiostereometric analysis (CT-RSA) technique to examine in vivo midfoot kinematics during single-leg stance and compare it with marker-based radiostereometry (RSA).</p><p><strong>Patients and methods: </strong>8 patients were examined with bilateral non- and full-weight-bearing CT images of the midfoot. 1st tarsometatarsal motion was analyzed using a surface-registration technique (CT-RSA). As all patients had unilateral tantalum markers in the 1st cuneiform (C1) and 1st metatarsal (M1), comparison of precision with markerbased RSA was performed. CT-RSA precision was evaluated with surface registration of both C1-M1 bone and C1-M1 tantalum markers, while RSA precision was determined with C1-M1 markers only. Additionally, to remove motion bias, we evaluated intrasegmental CT-RSA precision by comparing proximal with distal part of M1.</p><p><strong>Results: </strong>Under physical load, the primary movement for the 1st tarsometatarsal joint was M1 dorsiflexion (mean 1.4°), adduction (mean 1.4°), and dorsal translation (mean 1.1 mm). CT-RSA precision, using surface bone or markers, was in the range of 0.3-0.7 mm for translation and 0.6-1.6° for rotation. In comparison, RSA precision was in the range of 0.4-0.9 mm for translation and 1.0-1.7° for rotation. Finally, intrasegmental CT-RSA precision was in the range of 0.1-0.2 mm for translation and 0.4-0.5° for rotation.</p><p><strong>Conclusion: </strong>CT-RSA is a valid and precise, non-invasive method to measure midfoot kinematics when compared with conventional RSA.</p>","PeriodicalId":6916,"journal":{"name":"Acta Orthopaedica","volume":"94 ","pages":"366-372"},"PeriodicalIF":3.7,"publicationDate":"2023-07-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/79/5b/ActaO-94-16905.PMC10370411.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9936057","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}