Acta Orthopaedica最新文献

{"title":"Validity and reliability of the adapted Dutch version of the Brace Questionnaire (BrQ).","authors":"Charles M M Peeters,&nbsp;Joshua M Bonsel,&nbsp;Roelina Munnik-Hagewoud,&nbsp;Adriaan K Mostert,&nbsp;Guido B Van Solinge,&nbsp;Joost P H J Rutges,&nbsp;Mark C Altena,&nbsp;Paul F M Krabbe,&nbsp;G J F Joyce Bos,&nbsp;Chris Faber,&nbsp;Frits-Hein Wapstra,&nbsp;Diederik H R Kempen","doi":"10.2340/17453674.2023.18492","DOIUrl":"https://doi.org/10.2340/17453674.2023.18492","url":null,"abstract":"<p><strong>Background and purpose: </strong>The Brace Questionnaire (BrQ) is a disease-specific health-related quality of life (HRQOL) instrument for measuring perceived health status of scoliosis patients undergoing brace treatment. The purpose of this study is to evaluate the validity and reliability of a translated and culturally adapted Dutch version of the BrQ.</p><p><strong>Patients and methods: </strong>The original Greek BrQ was translated into Dutch and a cross-cultural adaptation and validation processes were conducted. Subsequently, 80 adolescent idiopathic scoliosis (AIS) patients undergoing active brace treatment were included from 4 scoliosis centers to evaluate the validity and reliability of the Dutch version of the BrQ. The questionnaire's floor and ceiling effects, internal consistency, and test-retest reliability were assessed. Concurrent validity was evaluated by comparing the BrQ with the revised Scoliosis Research Society 22-item questionnaire (SRS-22r) scores.</p><p><strong>Results: </strong>The mean total BrQ score was 75.9 (standard deviation [SD] 11.3) and the mean domain scores varied between 3.4 (SD 0.9) and 4.2 (SD 0.7) for the domains \"vitality\" and \"bodily pain,\" respectively. There were no floor and ceiling effects for the total BrQ score. The BrQ showed satisfactory internal consistency in most subdomains with a Cronbach's α ranging between 0.35 for the domain \"general health perception\" and 0.89 for the domain \"self-esteem and aesthetics.\" Excellent test-retest reproducibility was observed for the total BrQ score (ICC 0.91), and the BrQ was successfully validated against the SRS-22r.</p><p><strong>Conclusion: </strong>The translated and culturally adapted Dutch version of the BrQ is a valid and reliable HRQOL instrument for AIS patients undergoing brace treatment.</p>","PeriodicalId":6916,"journal":{"name":"Acta Orthopaedica","volume":"94 ","pages":"460-465"},"PeriodicalIF":3.7,"publicationDate":"2023-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/0c/3d/ActaO-94-18492.PMC10481702.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10177793","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":"Short-stem hip arthroplasty in Australia and the Netherlands: a comparison of 12,680 cases between the Australian Orthopaedic Association National Joint Replacement Registry (AOANJRR) and the Dutch Arthroplasty Register (LROI).","authors":"Mirthe H W Van Veghel,&nbsp;Gerjon Hannink,&nbsp;Peter L Lewis,&nbsp;Carl Holder,&nbsp;Liza N Van Steenbergen,&nbsp;B Willem Schreurs","doi":"10.2340/17453674.2023.18491","DOIUrl":"https://doi.org/10.2340/17453674.2023.18491","url":null,"abstract":"Background and purpose We compared the Australian Orthopaedic Association National Joint Replacement Registry (AOANJRR) and the Dutch Arthroplasty Register (LROI) regarding patient, prosthesis, and procedure characteristics as well as revision rates for uncemented short-stem total hip arthroplasties (THAs). Patients and methods All THAs with an uncemented short-stemmed femoral component performed between 2009 and 2021 were included from the AOANJRR (n = 9,328) and the LROI (n = 3,352). Kaplan–Meier survival analyses and multivariable Schemper’s weighted Cox regression analyses with data from 2009–2021 and 2015–2021 were performed with overall revision as endpoint. Results In Australia, the proportion of male patients (51% vs. 40%), patients with ASA III–IV score (30% vs. 3.7%), BMI ≥ 30.0 (39% vs. 19%), and femoral heads of 36 mm (58% vs. 20%) were higher than in the Netherlands. Short-stem THAs in Australia and the Netherlands had comparable 10-year revision rates (3.4%, 95% confidence interval [CI] 2.9–4.0 vs. 4.8%, CI 3.7–6.3). Multivariable Cox regression analyses with data from 2009–2021 showed a higher risk for revision of short-stem THAs performed in the Netherlands (HR 1.8, CI 1.1–2.8), whereas the risk for revision was comparable (HR 0.9, CI 0.5–1.7) when adjusted for more potential confounders using data from 2015–2021. Conclusion Short-stem THAs in Australia and the Netherlands have similar crude and adjusted revision rates, which are acceptable at 10 years of follow-up.","PeriodicalId":6916,"journal":{"name":"Acta Orthopaedica","volume":"94 ","pages":"453-459"},"PeriodicalIF":3.7,"publicationDate":"2023-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/25/8b/ActaO-94-18491.PMC10473243.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10523573","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":"Major surgery for metastatic bone disease is not a risk for 30-day mortality: a population-based study from Denmark.","authors":"Thea H Ladegaard,&nbsp;Michala S Sørensen,&nbsp;Michael M Petersen","doi":"10.2340/17453674.2023.18394","DOIUrl":"https://doi.org/10.2340/17453674.2023.18394","url":null,"abstract":"<p><strong>Background and purpose: </strong>Surgery for bone metastases in the appendicular skeleton (aBM) is a trade-off between limb function and survival. A previous study from a highly specialized center found that extended surgery is not a risk for 30-day mortality and hypothesized that wide resection and reconstruction might reduce postoperative mortality. The study aimed to investigate whether parameters describing the surgical trauma (blood loss, duration of surgery, and degree of bone resection) pose a risk for 30-day mortality in patients treated with endoprostheses (EPR) or internal fixation (IF) in a population-based cohort.</p><p><strong>Patients and methods: </strong>A population-based cohort having EPR/IF for aBM in the Capital Region of Denmark 2014-2019 was retrospectively assessed. Intraoperative variables and patient demographics were evaluated for association with 30-day mortality by logistic regression analysis. Kaplan-Meier estimate was used to evaluate survival with no loss to follow-up.</p><p><strong>Results: </strong>437 patients had aBM surgery with EPR/IF. No parameters describing the magnitude of the surgical trauma (blood loss/duration of surgery/degree of bone resection) were associated with mortality. Overall 30-day survival was 85% (95% confidence interval [CI] 81-88). Univariate analysis identified ASA group 3+4, Karnofsky score < 70, fast-growth primary cancer, and visceral and multiple bone metastases as risk factors for 30-day mortality. Male sex (OR 2.8, CI 1.3-6.3), Karnofsky score < 70 (OR 4.2, CI 2.1-8.6), and multiple bone metastases (OR 3.4, CI 1.2-9.9) were independent prognostic factors for 30-day-mortality in multivariate analysis.</p><p><strong>Conclusion: </strong>The parameters describing the surgical trauma were not associated with 30-day mortality but, instead, general health status and extent of primary cancer influenced survival post-surgery.</p>","PeriodicalId":6916,"journal":{"name":"Acta Orthopaedica","volume":"94 ","pages":"447-452"},"PeriodicalIF":3.7,"publicationDate":"2023-08-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/cb/74/ActaO-94-18394.PMC10448382.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10101354","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 injury claims for posterior cruciate ligament injury: a nationwide registry study in Finland.","authors":"Kirsi-Maaria Nyrhinen,&nbsp;Teemu Helkamaa,&nbsp;Ville Bister,&nbsp;Arne Schlenzka,&nbsp;Henrik Sandelin,&nbsp;Jerker Sandelin,&nbsp;Arsi Harilainen","doi":"10.2340/17453674.2023.18265","DOIUrl":"https://doi.org/10.2340/17453674.2023.18265","url":null,"abstract":"<p><strong>Background and purpose: </strong>Posterior cruciate ligament (PCL) injuries usually occur in combination with other ligamentous knee injuries. The outcome varies and may be poor due to suboptimal treatment. We investigated claims following PCL injury treatment on a nationwide scale.</p><p><strong>Patients and methods: </strong>All patient PCL injury claims filed in Finland from 1997 to 2015 were collected from the Patient Insurance Centre (PIC) register. We reviewed and analyzed all records to determine the causes of claims. General background data were obtained from the National Care Register for Social Welfare and Health Care (HILMO).</p><p><strong>Results: </strong>We found out from HILMO background data that, during the 19-year study period, 1,891 PCL and 1,380 multiligament reconstructions were performed in 99 different hospitals. The number of PCL injuries treated conservatively is unknown. During this same period, 49 claims arrived at the PIC, and 39/49 of these patients were operated on. 12/49 claims were compensated. Of these 12 claims, 6 were compensated for technical errors and 4 were compensated for diagnostic delays.</p><p><strong>Conclusion: </strong>The number of patient injury claims was few, and compensated claims were even fewer. Technical errors and diagnostic delays were the most common reasons for reimbursement.</p>","PeriodicalId":6916,"journal":{"name":"Acta Orthopaedica","volume":"94 ","pages":"426-431"},"PeriodicalIF":3.7,"publicationDate":"2023-08-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/55/c5/ActaO-94-18265.PMC10436284.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10037714","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":"Fracture pattern and risk factors for reoperation after treatment of 156 periprosthetic fractures around an anatomic cemented hip stem.","authors":"Ali Sattar,&nbsp;Johan Kärrholm,&nbsp;Michael Möller,&nbsp;Georgios Chatziagorou","doi":"10.2340/17453674.2023.18263","DOIUrl":"https://doi.org/10.2340/17453674.2023.18263","url":null,"abstract":"<p><strong>Background and purpose: </strong>The Lubinus SP2 stem has been associated with a very low risk of periprosthetic femoral fractures (PPFFs). We aimed, primarily, to study the radiographic morphology of PPFFs close to a Lubinus SP2 stem. Secondarily, we analyzed whether higher reoperation rate was correlated to the revision method chosen or to the characteristics of the fracture and of the bone.</p><p><strong>Patients and methods: </strong>The study included 156 femoral fractures close to a Lubinus cemented stem. These fractures were treated in 40 hospitals in Sweden between 2006 and 2011 and were followed up until 2019. Data from the Swedish Arthroplasty Register was used. Medical records and radiographs were studied. The fractures were classified according to the Vancouver classification. The fracture location and anatomy were delineated. We also measured the remaining attachment index (RAI) and the canal thickness ratio.</p><p><strong>Results: </strong>Vancouver type C (n = 101) and spiral fractures (n = 67, 41 in Vancouver C and 26 in Vancouver B) were the most common fracture types. 4 fractures were avulsion of the greater trochanter. The remaining 51 fractures occurred around the stem (B1: 25, B2: 16, and B3: 10). B fractures were more commonly reoperated on (18 of 51, 35%) than type C fractures (11 of 101, 11%, P = 0.001). In most femurs with type B3 fracture, the fracture line covered an area only around the stem, but in all B1 and in 11 of 16 B2 fractures, it was extended even distal to the stem. ORIF instead of stem revision in B2 fractures, use of short stems or plates, and inadequate reduction of the fractures were risk factors for subsequent reoperations.</p><p><strong>Conclusion: </strong>The higher reoperation rate in type B fractures, compared with fractures distal to the stem, could be caused by their higher degree of complexity and reduced capacity for healing in the region around the stem.</p>","PeriodicalId":6916,"journal":{"name":"Acta Orthopaedica","volume":"94 ","pages":"438-446"},"PeriodicalIF":3.7,"publicationDate":"2023-08-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/80/42/ActaO-94-18263.PMC10436285.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10422661","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":"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}