Acta Orthopaedica最新文献

{"title":"How many doses and what type of antibiotic should be used as systemic antibiotic prophylaxis in primary hip and knee arthroplasty? A register-based study on 301,204 primary total and hemi- hip and total knee arthroplasties in Norway 2005-2023.","authors":"Olav Lutro, Marianne Bollestad Tjørhom, Tesfaye Hordofa Leta, Jan-Erik Gjertsen, Geir Hallan, Trond Bruun, Marianne Westberg, Tina Strømdal Wik, Christian Thomas Pollmann, Stein Håkon Lygre, Ove Furnes, Lars Engesæter, Håvard Dale","doi":"10.2340/17453674.2025.43003","DOIUrl":"10.2340/17453674.2025.43003","url":null,"abstract":"<p><strong>Background and purpose: </strong> Guidelines for systemic antibiotic prophylaxis (SAP) in arthroplasty surgery vary worldwide from repeated doses to only 1 preoperatively. We aimed to investigate, primarily whether 4 doses reduced the risk of PJI compared with 1 to 3 doses, and secondarily if there was a difference between types of antibiotics.</p><p><strong>Methods: </strong> Patients reported to the Norwegian Arthroplasty Register and the Norwegian Hip Fracture Register with primary total knee (TKA), total (THA) or hemi- (HA) hip arthroplasty between 2005 and 2023 were included. Cases with 1 to 4 doses of cefalotin (half-life = 45 minutes), cefazolin (90 minutes), cefuroxime (70 minutes), cloxacillin (30 minutes), or clindamycin (180 minutes) were assessed. Primary outcome was 1-year risk of reoperation (adjusted hazard rate ratio; aHRR) for PJI and was estimated by Cox regression analyses. Secondary outcomes were reoperation for PJI and reoperation for any cause with follow-up of up to 19 years. Non-inferiority analyses and propensity score matching with subsequent Kaplan-Meier analyses were performed with a predetermined non-inferiority margin of 15% (aHRR = 1.15).</p><p><strong>Results: </strong> 301,204 cases were included. Of these, 3,388 (1.1%) were reoperated on for PJI within 1 year. The 1-year incidence of reoperation for PJI was 98/9,760 (1.0%) for 1 dose of SAP, 109/10,956 (0.9%) for 2 doses, 178/18,948 (0.9 %) for 3 doses, and 3,003/261,540 (1.0%) for 4 doses. The 1-year risk (aHRR, 95% confidence interval [CI]) of reoperation for PJI was 1.0 (CI 0.8-1.2), 0.9 (CI 0.8-1.2), and 0.9 (CI 0.9-1.1) for 1, 2, and 3 doses, respectively, compared with 4 doses. The 1-year incidence of reoperation for PJI was 2,162/183,964 (1.2%) for cefalotin, 993/91,159 (1.1%) for cefazolin, 35/4,435 (0.8%) for cefuroxime, 85/9,022 (0.9%) for cloxacillin, and 113/12,624 (0.9%) for clindamycin. Compared with cefazolin, cloxacillin (1.2, CI 1.0-1.6) and cefalotin (1.4, CI 1.2-1.5) had a higher risk of reoperation for PJI, whereas cefuroxime (1.0, CI 0.7-1.4) and clindamycin (1.1, CI 0.9-1.3) had a similar risk.</p><p><strong>Conclusion: </strong> 4 doses of SAP did not reduce the risk of PJI compared with 1 to 3 doses in primary arthroplasty as measured against PJI. Cefazolin, the 1st-generation cephalosporin with the longest half-life, showed the lowest risk of PJI.</p>","PeriodicalId":6916,"journal":{"name":"Acta Orthopaedica","volume":"96 ","pages":"217-225"},"PeriodicalIF":2.5,"publicationDate":"2025-03-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11881024/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143555588","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":"Identifying recovery trajectories following primary total shoulder arthroplasty: a cohort study of 3,358 patients from the Dutch Arthroplasty Register.","authors":"Mirthe H W Van Veghel, Liza N Van Steenbergen, Cornelis P J Visser, B Willem Schreurs, Gerjon Hannink","doi":"10.2340/17453674.2025.43085","DOIUrl":"10.2340/17453674.2025.43085","url":null,"abstract":"<p><strong>Background and purpose: </strong>Some patients do not improve after total shoulder arthroplasty (TSA), indicating different recovery trajectories. We aimed to identify recovery trajectories after TSA based on the Oxford Shoulder Score (OSS). Second, we investigated whether recovery trajectories were associated with patient or procedure characteristics.</p><p><strong>Methods: </strong> We included primary anatomical and reversed TSAs (ATSAs/RTSAs) for osteoarthritis (OA) or cuff arthropathy/rupture with preoperative, 3-month, and/or 12-month postoperative OSS, registered between 2016 and 2022 in the Dutch Arthroplasty Register (n = 3,358). We used latent class growth modeling (LCGM) to identify recovery patterns, and multinomial logistic regression analyses to investigate associations between potential risk factors and class membership (odds ratio [OR], 95% confidence interval [CI]).</p><p><strong>Results: </strong> We identified 3 recovery patterns: \"Fast responders\" (59%), \"Steady responders\" (27%), and \"Poor responders\" (14%). Factors associated with \"Steady responders\" vs \"Fast responders\" were female vs male sex (OR 2.0, CI 1.5-2.7), ASA III-IV vs ASA I (OR 1.9, CI 1.2-3.1), Walch A1 vs B2 (OR 1.6, CI 1.1-2.5), and most vs medium socioeconomic deprivation (OR 1.4, CI 1.1-1.9). Factors associated with \"Poor responders\" vs \"Fast responders\" were ASA II vs ASA I (OR 2.0, CI 1.1-3.6), ASA III-IV vs ASA I (OR 3.0, CI 1.6-5.5), Walch A1 vs B2 (OR 2.1, CI 1.3-3.3), previous shoulder surgeries (OR 1.8, CI 1.3-2.4), most vs medium socioeconomic deprivation (OR 1.5, CI 1.2-2.0), RTSA for OA vs ATSA for OA (OR 1.8, CI 1.2-2.7), and RTSA for cuff arthropathy or rupture vs ATSA for OA (OR 2.3, CI 1.5-3.4).</p><p><strong>Conclusion: </strong> 3 recovery trajectories were identified following TSA, which we labelled as \"Fast responders,\" \"Steady responders,\" and \"Poor responders.\" \"Steady responders\" and \"Poor responders\" were more likely to have higher ASA scores, a Walch A1 vs B2 classification, and greater vs medium socioeconomic deprivation than \"Fast responders.\" Moreover, \"Steady responders\" were more likely to be female, while \"Poor responders\" were more likely to have previous shoulder surgeries and RTSA for OA or for cuff arthropathy or rupture than \"Fast responders.\"</p>","PeriodicalId":6916,"journal":{"name":"Acta Orthopaedica","volume":"96 ","pages":"226-234"},"PeriodicalIF":2.5,"publicationDate":"2025-03-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11881023/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143555590","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":"Incidence, treatment, and mortality of ankle fractures: a Danish population-based cohort study.","authors":"Per H Gundtoft, Alma B Pedersen, Bjarke Viberg","doi":"10.2340/17453674.2025.43006","DOIUrl":"10.2340/17453674.2025.43006","url":null,"abstract":"<p><strong>Background and purpose: </strong> Previous studies have shown large variation in the incidence of ankle fractures. Nationwide data covering longer periods is necessary to gain knowledge of the current trends. The aim of this study was to describe the trends in incidence, treatment, and mortality of ankle fracture during a 20-year period.</p><p><strong>Methods: </strong> Ankle fractures in patients ≥ 18 years old were identified in the Danish National Patient Register using the validated diagnosis and surgical procedure codes for ankle fractures. Incidence rates per 100,000 and incidence rate ratio (IRR) are reported with 95% confidence intervals (CI).</p><p><strong>Results: </strong> We identified 155,740 ankle fractures. The overall mean incidence rate during the period 1997-2018 was 164 (CI 163-165) per 100,000 person-years, being 154 (CI 152-155) for men and 203 (CI 202-205) for women. The incidence rate increased from 155 (CI 131-179) during 1997-2006 to 173 (CI 147-199) during 2007-2018, corresponding to an IRR of 1.12 (CI 1.10-1.12). This increase was primarily driven by an increase in women, with an IRR of 1.21 (CI 1.20-1.23) and for patients above 50 years, with an IRR of 1.22 (CI 1.08-1.10). The proportion of patients surgically treated increased from 21% in 1997-2006 to 25% in 2007-2018. The 1-year mortality risk was higher for patients above 65 years with an ankle fracture compared with the general population of the same age, with an IRR of 1.47 (CI 1.42-1.53).</p><p><strong>Conclusion: </strong> The incidence of ankle fracture increased from 1997 to 2018, primarily due to an increased incidence in women and in the elderly population. The proportion of surgically treated patients increased from 21% to 26%. Excess mortality after ankle fracture in patients above 65 years was observed.</p>","PeriodicalId":6916,"journal":{"name":"Acta Orthopaedica","volume":"96 ","pages":"203-208"},"PeriodicalIF":2.5,"publicationDate":"2025-02-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11868812/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143539857","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":"Patient-reported outcome 1 to 4 years after periprosthetic knee fracture: a nationwide cross-sectional matched study.","authors":"Stefan Kastalag Risager, Bjarke Viberg, Charlotte Skov Abrahamsen, Kristine Bollerup Arndt, Anders Odgaard, Martin Lindberg-Larsen","doi":"10.2340/17453674.2025.43083","DOIUrl":"10.2340/17453674.2025.43083","url":null,"abstract":"<p><strong>Background and purpose: </strong> Periprosthetic knee fractures (PPKFs) can be a serious complication after total knee arthroplasty (TKA). We aimed to compare patient-reported outcome (PRO) scores reported between 1 and 4 years after PPKF with a matched uncomplicated TKA control group.</p><p><strong>Methods: </strong> This nationwide cross-sectional matched cohort study included 372 TKA patients with a PPKF occurring from 2019 to 2022 and a control group of 878 uncomplicated TKA patients matched by age, time since TKA, and sex. The study population was derived from the Danish National Patient Register. The patients received questionnaires regarding knee function, quality of life, pain and satisfaction in 2023. The questionnaires included Oxford Knee Score (OKS), the Forgotten Joint Score (FJS), and the EQ-5D-5L Index.</p><p><strong>Results: </strong> The response rate was 48%. Mean OKS was 7 (confidence interval [CI] 5-9) points lower after a PPKF with a score of 30 (standard deviation [SD] 11) in the PPKF group vs 37 (SD 11) in the control group. The FJS was 13 (CI 7-19) points lower after a PPKF with a score of 50 (SD 30) in the PPKF group vs 63 (SD 30) in the control group. Mean EQ-5D-5L Index scores were 0.17 (CI 0.12-0.22) lower after a PPKF with a score of 0.68 (SD 0.25) in the PPKF group vs 0.85 (SD 0.25) in the control group. Additional analysis of patients who completed PROMs 1-2 years compared with 3-4 years after PPKF showed better PRO scores after 3-4 years with an OKS of 32 (SD 12) vs 27 (SD 12), FJS 55 (SD 32) vs 43 (SD 32), and EQ-5D-5L Index of 0.74 (SD 0.34) vs 0.60 (SD 0.34).</p><p><strong>Conclusion: </strong> Following PPKF, patients reported worse knee function, more pain, lower satisfaction, and poorer quality of life than those with uncomplicated TKAs.</p>","PeriodicalId":6916,"journal":{"name":"Acta Orthopaedica","volume":"96 ","pages":"209-216"},"PeriodicalIF":2.5,"publicationDate":"2025-02-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11868926/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143539934","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":"Patient-reported outcomes and complications of a new-generation total knee system: a randomized controlled trial.","authors":"Kristian R L Mortensen, Lina H Ingelsrud, Anders Odgaard, Andreas Kappel, Claus Varnum, Henrik Schrøder, Kirill Gromov, Anders Troelsen","doi":"10.2340/17453674.2025.43004","DOIUrl":"10.2340/17453674.2025.43004","url":null,"abstract":"<p><strong>Background and purpose: </strong> Documentation of new-generation implants' short-term performance could reassure surgeons and patients about their use, while awaiting the long-term outcome. Our aim was to compare the performance of a newer total knee arthroplasty (TKA) system with its predecessor, measured by patient-reported knee function, pain, and complication rate.</p><p><strong>Methods: </strong>We performed a multi-center, randomized, controlled trial (clinicaltrials.gov ID: NCT03073941). 314 patients with primary osteoarthritis were randomized to treatment with a Persona or NexGen cruciate-retaining TKA system and followed for 2 years. The primary outcome was measured with the patient-reported outcome (PRO) Oxford Knee Score (OKS) 2 years post-surgery. Secondary outcomes were the OKS-Activity and Participation questionnaire (OKS-APQ), Forgotten Joint Score (FJS), EQ-5D-3L, and number of complications during the study period. Responder analyses were performed using Patient Acceptable Symptom State (PASS) and Minimal Important Change (MIC) criteria.</p><p><strong>Results: </strong> Primary outcome was available from 289 patients (92%). We found no difference in adjusted mean OKS between the groups 2 years post-surgery (0.1, 95% confidence interval -1.4 to 1.7). We found no significant differences in adjusted mean of secondary PROs, PRO time-weighted averages, proportion of patients with PASS or MIC, or complications 2 years post-surgery.</p><p><strong>Conclusion: </strong> We found no difference in OKS 2 years post-surgery, or in any secondary variables analyzed including complications, between the 2 TKA systems. Short-term safety and performance of the Persona TKA was comparable to its predecessor.</p>","PeriodicalId":6916,"journal":{"name":"Acta Orthopaedica","volume":"96 ","pages":"195-202"},"PeriodicalIF":2.5,"publicationDate":"2025-02-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11862213/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143497793","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":"Nonoperative hip fracture care: how conservative should we be?","authors":"Antony Johansen, Bjarke Viberg","doi":"10.2340/17453674.2025.43190","DOIUrl":"10.2340/17453674.2025.43190","url":null,"abstract":"","PeriodicalId":6916,"journal":{"name":"Acta Orthopaedica","volume":"96 ","pages":"174-175"},"PeriodicalIF":2.5,"publicationDate":"2025-02-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11849164/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143490340","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":"Satisfaction and quality of dying with nonoperative end-of-life care for hospitalized and non-hospitalized frail older patients with (suspected) hip fractures: a combined cohort study.","authors":"Miliaan L Zeelenberg, Sverre A I Loggers, Pieter Joosse, Esther M M Van Lieshout, Taco Gosens","doi":"10.2340/17453674.2025.42998","DOIUrl":"10.2340/17453674.2025.42998","url":null,"abstract":"<p><strong>Background and purpose: </strong> For frail institutionalized hip fracture patients who opt for nonoperative management (NOM), the additional treatment benefits of hospital admission and in-hospital diagnostics are not well evaluated. We aimed to describe and compare treatment satisfaction and quality of dying for patients who refrained from hospitalization after a hip fracture and patients who were treated nonoperatively after a short period of hospitalization.</p><p><strong>Methods: </strong>Both cohorts included very frail institutionalized hip fracture patients. The first group directly started supportive care in their own nursing home after a suspected hip fracture. The second opted for NOM during shared decision-making after admission and diagnostics at the hospital. Primary outcomes were treatment satisfaction and quality of dying measured by the Quality of Dying and Death Questionnaire (QODD). Secondary outcomes included health-related quality of life (EuroQoL-5D-5L and Qualidem), pain, and medication.</p><p><strong>Results: </strong> 20 non-hospitalized and 88 hospitalized patients were included. Overall treatment satisfaction by proxies was high for both the non-hospitalized 9 (interquartile range [IQR] 8-10) and hospitalized patients 8 (IQR 4-9). Quality of dying was rated higher in the non-hospitalized group with QODD 8.3, IQR 6.9-8.6 versus 7.0, IQR 5.7-7.8, and median difference 1.0 (95% confidence interval [CI] 0.1-1.8). Health-related quality of life, measured by the EQ-5D-5L utility score, was low in both groups but higher in non-hospitalized patients (0.30, IQR 0.15-0.32) than in hospitalized patients (0.25, IQR 0.03-0.32, median difference: 0.03, CI -0.03 to 0.09). Both groups reported similar pain levels, but hospitalized patients used higher standardized daily doses of opiates (68 mg vs 39 mg, median difference 24 mg, CI 7-42).</p><p><strong>Conclusion: </strong> Proxies of hospitalized and non-hospitalized patients report high treatment satisfaction after opting for NOM. Non-hospitalization may have a beneficial effect on quality of dying in selected patients who have pre-recorded do-not-hospitalize directives or shared decision-making after a suspected hip fracture.</p>","PeriodicalId":6916,"journal":{"name":"Acta Orthopaedica","volume":"96 ","pages":"167-173"},"PeriodicalIF":2.5,"publicationDate":"2025-02-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11849162/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143490341","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 risk of refracture and malunion in children treated for diaphyseal forearm fractures: a retrospective cohort study.","authors":"Hans-Christen Husum, Ole Rahbek, Per Hviid Gundtoft, Hans Christian Bang, Søren Kold, Jan Duedal Rölfing, Ahmed Abood","doi":"10.2340/17453674.2025.42851","DOIUrl":"10.2340/17453674.2025.42851","url":null,"abstract":"<p><strong>Background and purpose: </strong> The optimal treatment modality for pediatric diaphyseal forearm fractures is debated. While nonoperative treatment and closed reduction reduces the need for surgery and surgical complications, flexible intramedullary nailing (FIN) may reduce refracture and malunion rates. We aimed to compare the relative risk (RR) of refracture and malunion between nonoperative, closed reduction (CR), and surgical treatment in children treated for diaphyseal forearm fractures.</p><p><strong>Methods: </strong> We performed a retrospective cohort study of children treated for a primary diaphyseal forearm fracture over a 9-year period at 2 university hospitals. Risk of refracture and malunion in the year following the fracture across treatment modalities was assessed by a modified Poisson regression while adjusting for the age of the patient at the time of fracture.</p><p><strong>Results: </strong> We included 837 patients for analysis, of whom 4% were treated nonoperatively, 6% were treated with closed reduction, and 90% with FIN. Compared with FIN, the RR of refracture was higher for the nonoperative group (9.8, 95% confidence interval [CI] 5.9-16.3) and CR group (2.5, CI 1.2-5.3). Compared with the FIN group, the nonoperative and CR groups had higher risk of malunion with RR of 15.3 (CI 11.0-21.4) and 8.5 (CI 5.8-12.5) respectively. Of those treated non-surgically, 84% remained without any surgery. In FIN patients, surgical revision due to infection was seen in 1.4% of patients.</p><p><strong>Conclusion: </strong> The risk of refracture and malunion in children treated for diaphyseal forearm fractures was significantly higher for closed reduction and nonoperative treatment compared with FIN treatment.</p>","PeriodicalId":6916,"journal":{"name":"Acta Orthopaedica","volume":"96 ","pages":"189-194"},"PeriodicalIF":2.5,"publicationDate":"2025-02-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11851337/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143490342","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":"Falling rates but projected rising numbers of fractures in elderly Norwegians: a study of fracture rates in the Norwegian patient registry from 2010 to 2021, extrapolated to 2041.","authors":"Jørgen Andvig, Lars G Johnsen, Sara M Nilsen, Gudrun W Bjørnelv, Andreas Asheim","doi":"10.2340/17453674.2024.42634","DOIUrl":"10.2340/17453674.2024.42634","url":null,"abstract":"<p><strong>Purpose: </strong> Our aim was to calculate rates of major fractures by fracture location in elderly Norwegians over the years 2010 to 2021 and thereby estimate the volume of fractures in this population by 2041.</p><p><strong>Methods: </strong> We identified fractures in persons aged 65 years and over from the Norwegian Patient Registry. We summarized age- and sex-specific numbers of fractures and incidence rates by fracture location. Extrapolating adjusted incidence rates combined with population projections from Statistics Norway, we estimated the expected numbers of fracture cases for the following 20 years.</p><p><strong>Results: </strong> The total number of major fractures rose from 22,581 in 2010 to 27,596 in 2021. While the number of hip fractures was relatively stable (8,164 to 8,194 over the period), there were substantial increases in the number of fractures in the upper extremities, spine and pelvis, and lower extremities. Annual changes in incidence rates adjusted for age and sex were 0.6% (95% confidence interval [CI] 0.4-0.7), 1.2% (CI 0.9-1.4), 0.4% (CI 0.1-0.7), and -1.9% (CI -2.0 to -1.7) for upper extremity, spine and pelvis, lower extremity, and hip respectively. Extrapolating trends in incidence rates, we estimate a 64% (95% prediction interval 48-70) overall increase in the number of major fractures by 2041 compared with 2021, primarily due to the aging of the population.</p><p><strong>Conclusion: </strong> Incidence rates of hip fractures decreased over the period, while rates of other major fractures increased. We can expect a substantial increase in the number of fractures over the coming years, primarily due to the expected aging of the population.</p>","PeriodicalId":6916,"journal":{"name":"Acta Orthopaedica","volume":"96 ","pages":"182-188"},"PeriodicalIF":2.5,"publicationDate":"2025-02-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11851338/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143490339","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":"Correlation between a real-time bioparticle detection device and a traditional microbiological active air sampler monitoring air quality in an operating room during elective arthroplasty surgery: a prospective feasibility study.","authors":"Lise-Lott Larsson, Johan Nordenadler, Gunilla Björling, Li Felländer-Tsai, Stergios Lazarinis, Bengt Ljungqvist, Janet Mattsson, Berit Reinmüller, Harald Brismar","doi":"10.2340/17453674.2025.43002","DOIUrl":"10.2340/17453674.2025.43002","url":null,"abstract":"<p><strong>Background and purpose: </strong> The standard method for controlling operating room (OR) air quality is measuring bacteria-carrying particles per volume unit of air: colony forming units (CFU/m3). The result takes at least 2 days after sampling. Another method is real-time measurements of fluorescing bioparticles per unit volume of air (FBP/dm3). We aimed to compare simultaneous measurements of FBP/50 dm3 and CFU/m3 during ongoing arthroplasty surgery.</p><p><strong>Methods: </strong> 18 arthroplasties were performed in a modern OR with turbulent mixed airflow ventilation. The sampling heads of a BioAerosol Monitoring System (BAMS) and a microbiological active air sampler (Sartorius MD8 Air Sampler) were placed next to each other, and 6 parallel 10-minute registrations of FBP/50 dm3 and CFU/m3 were performed for each surgery. Parallel measurements were plotted against each other, Passing-Bablok nonparametric linear regression was performed, and the Spearman correlation coefficient (r) was calculated.</p><p><strong>Results: </strong> The r between FBP ≥ 3 μm/50 dm3 and CFU/m3 sampled for 96 x 10-minute intervals, was 0.70 (95% confidence interval [CI] 0.57-0.79). In the 25th percentile with the lowest 10-minute FBP ≥ 3μm/50 dm3, there were no CFU measurements with ≥ 10 and 4% with ≥ 5 CFU/m3. In the 75th percentile with the highest 10-minute FBP ≥ 3 μm/50 dm3, there were 58% CFU measurements with ≥ 10 and 88% with ≥ 5 CFU/m3. The r between FBP ≥ 3 μm/50 dm3 and CFU/m3 means sampled during 18 operations was 0.87 (CI 0.68-0.95).</p><p><strong>Conclusion: </strong> Low FBP ≥ 3 μm/50 dm3 measured by BAMS indicates low CFU/m3; conversely, high FBP ≥ 3 μm/50 dm3 indicates high CFU/m3. Real-time measurements of FBP ≥ 3 μm/50 dm3 can be used as a supplement to CFU/m3 monitoring OR air bacterial load.</p>","PeriodicalId":6916,"journal":{"name":"Acta Orthopaedica","volume":"96 ","pages":"176-181"},"PeriodicalIF":2.5,"publicationDate":"2025-02-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11849163/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143490359","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}