Acta Orthopaedica最新文献

{"title":"Comparing incomplete atypical femur fractures in patients with or without bisphosphonate treatment: radiography and bone morphology in a retrospective study of 19 cases.","authors":"Georg Zdolsek, Hans Peter Bögl, Rickard Sand, Aneta Liszka, Anna Fahlgren, Jörg Schilcher","doi":"10.2340/17453674.2025.43899","DOIUrl":"10.2340/17453674.2025.43899","url":null,"abstract":"<p><strong>Background and purpose: </strong> Atypical femur fractures (AFF) are associated with bisphosphonate (BP) treatment, although 10-50% of AFF patients have never used BPs. We aimed to compare the medical history, radiographs, and bone biopsies from the fracture site of patients with AFF with (BP group) and without BP exposure (non-BP group).</p><p><strong>Methods: </strong>Between 2008 and 2021, we included 19 patients aged ≥ 50 years with incomplete AFF. During prophylactic nailing for thigh pain, a biopsy was taken that included the visible fracture line. Medical charts and radiographs were reviewed, and biopsies were analyzed histologically.</p><p><strong>Results: </strong> In the non-BP group (n = 9; mean age 70 years) patients had diseases affecting bone tissue properties (n = 3), pathological structural variations of the femur geometry or a fatigue-type mechanism (n = 3), or no identified causative patho-mechanism (n = 3). In the BP group (n = 10; mean age, 77 years) 2 patients had pathological variations of femur geometry and all used BPs. In the non-BP group, the fracture line was surrounded by bone resorption (n = 6) and cortical irregularities (n = 3), while the fracture line was restricted to a well-defined line in all patients in the BP group. The bone volume fraction (BV/TV) was on average 18% lower (95% confidence interval -35 to -1.2) in the non-BP group.</p><p><strong>Conclusion: </strong> AFF in the non-BP group are associated with bone metabolic diseases or deviations in whole-bone geometry and have a specific radiographic appearance at the fracture site whereas antiresorptive treatment appears to be the predominant etiological factor in the BP group.</p>","PeriodicalId":6916,"journal":{"name":"Acta Orthopaedica","volume":"96 ","pages":"421-428"},"PeriodicalIF":2.5,"publicationDate":"2025-06-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12138533/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144223979","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":"Effect of high-dose dexamethasone on morphine use after periacetabular osteotomy for hip dysplasia: a randomized double-blind placebo-controlled single center trial.","authors":"Viktoria Lindberg-Larsen, Martin Lindberg-Larsen, Ole Ovesen, Stine T Zwisler, Peter Lindholm, Stine Hebsgaard, Robin Christensen, Søren Overgaard","doi":"10.2340/17453674.2025.43903","DOIUrl":"10.2340/17453674.2025.43903","url":null,"abstract":"<p><strong>Background and purpose: </strong> Periacetabular osteotomy (PAO) for hip dysplasia is associated with intensive pain and high opioid consumption. High doses of dexamethasone may reduce this. We aimed to compare the effect of 1 or 2 doses of dexamethasone 24 mg, relative to placebo, on postoperative morphine consumption after PAO.</p><p><strong>Methods: </strong> A 3-group, randomized, double-blind, placebo-controlled trial was undertaken on patients ≥ 18 years, undergoing PAO (ClinicalTrials.gov: NCT03874936). Randomization Group A received 1 preoperative dose of dexamethasone 24 mg and placebo 24 hours later; Group B received 1 dose of intravenous dexamethasone 24 mg preoperatively and a repeated dose 24 hours postoperatively; and Group C received placebo at both time points. The primary endpoint was the difference in least squares mean cumulative postoperative morphine consumption between the combined dexamethasone groups and placebo within 48 hours from baseline. Key secondary outcomes included postoperative pain intensity, nausea and vomiting, antiemetic consumption and Timed Up and Go at 24 and 48 hours postoperatively, and cumulative morphine consumption from 48 hours to day 14 post-operation.</p><p><strong>Results: </strong> 90 patients were randomized to dexamethasone groups (n = 60) and placebo (n = 30); 58 and 28, respectively, completed the trial. Mean age was 31 years and 71 (79%) were females. In the combined dexamethasone group the mean cumulated postoperative morphine consumption within 48 hours was 92 mg vs 95 mg in the placebo group, corresponding to a between-group difference of -3 mg (95% confidence interval -27 to 21; P = 0.8). There were no differences observed between groups for any of the secondary outcomes.</p><p><strong>Conclusion: </strong> High-dose dexamethasone did not reduce postoperative morphine use or improve any of the secondary outcomes after PAO.</p>","PeriodicalId":6916,"journal":{"name":"Acta Orthopaedica","volume":"96 ","pages":"413-420"},"PeriodicalIF":2.5,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12128623/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144214514","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":"Hospital-related healthcare expenditure of impending versus completed pathological femur fractures: a propensity score matched study of 265 patients.","authors":"Tom M De Groot, Michelle R Shimizu, David Shin, Olivier Q Groot, Stein J Janssen, Kevin A Raskin, Eric T Newman, Marco L Ferrone, Santiago A Lozano-Calderon, Joseph H Schwab, Paul C Jutte","doi":"10.2340/17453674.2025.43479","DOIUrl":"10.2340/17453674.2025.43479","url":null,"abstract":"<p><strong>Background and purpose: </strong> The prevalence of metastatic bone disease as well as the accompanying societal costs are expected to increase due to advances in cancer treatment. While the literature suggests that there is economic value in prophylactic stabilization compared with the fixation of completed pathological fractures in long bone metastases, studies are limited by their small sample sizes and insufficient correction for potential confounders. We aimed to evaluate whether prophylactic treatment of an impending femur fracture was associated with lower healthcare costs compared with completed pathologic fractures. We further aimed to compare prophylactic surgical treatment with completed pathological fractures in terms of postoperative complications, discharge disposition, and postoperative length of stay.</p><p><strong>Methods: </strong> This is a retrospective cohort study with propensity score matching (PSM). We included clinical and financial data for 265 patients who received surgery for impending (n = 161) or completed (n = 104) femoral fractures of metastatic lesions, from 2 affiliated urban tertiary care centers between 2016 and 2020 in the United States. After PSM on 13 variables, including demographics and clinical characteristics, 100 impending fractures were matched with 100 completed fractures. The primary outcome was healthcare costs per episode of care, defined as the total cost from admission to 30 days after discharge.</p><p><strong>Results: </strong> We found no difference in total cost of care between patients undergoing prophylactic surgical treatment and patients who underwent surgical treatment for a completed pathological fracture (median difference 44 cost-units [CU], 95% confidence interval [CI] -294 to 262). No differences were seen when dividing total cost into cost during hospital admission (median difference -25 CUs, CI -152 to 159) and 30 days following discharge (median difference 31 CUs, CI -74 to 88). Patients with completed pathologic fractures were more often discharged to rehabilitation facilities (57/100, vs 30/100, P < 0.01).</p><p><strong>Conclusion: </strong> In contrast to earlier findings, we showed no difference in treatment costs between surgical management of impending and completed pathological fractures of femur metastases after adjusting for confounding factors. However, patients with completed pathological fractures were significantly more likely to require discharge to rehabilitation facilities, highlighting potential out-of-hospital costs related to extended rehabilitation, reduced mobility, and loss of independence.</p>","PeriodicalId":6916,"journal":{"name":"Acta Orthopaedica","volume":"96 ","pages":"401-410"},"PeriodicalIF":2.5,"publicationDate":"2025-05-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12118376/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144214515","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":"Reducing surgical trays to cut both carbon emissions and costs in total knee arthroplasty.","authors":"Pim W Van Egmond, Paul Lodder","doi":"10.2340/17453674.2025.43677","DOIUrl":"10.2340/17453674.2025.43677","url":null,"abstract":"<p><strong>Background and purpose: </strong> Operating theatres are significant contributors to hospital waste and carbon emissions. In total knee arthroplasty (TKA), the number of surgical trays - and thus the carbon footprint - may be reduced by accurately estimating the prosthesis size preoperatively. We aimed to develop a predictive model to improve preoperative estimation of femoral prosthesis size and reduce the number of trays used in primary TKA.</p><p><strong>Methods: </strong> We retrospectively reviewed all primary TKA procedures performed between January 2012 and November 2022 at a single teaching hospital in the Netherlands. Using repeated hold-out cross-validation, we developed a prediction model based on routinely available demographic and anthropometric data to predict femoral component size. Rather than minimizing instruments per tray, our strategy focused on reducing the total number of trays. We used the created prediction model in combination with frequency data from our implanted TKAs to tailor surgical trays accordingly. We performed a post-hoc analysis to estimate the carbon emission cut and cost reduction.</p><p><strong>Results: </strong> The best-performing models utilized overlapping tray size ranges, with a practical limit of 3 sizes per tray. The final model predicted the appropriate size range with 97.4% accuracy. This enabled the elimination of 1 tray from the standard surgical setup, reducing total tray use by 11%.</p><p><strong>Conclusion: </strong> Accurate preoperative prediction of femoral prosthesis size facilitates surgical tray reconfiguration. We were able to reach an 11% reduction in total trays used with an estimated 1.03 kgCO2eq and a €29.6 cost reduction per reduced tray.</p>","PeriodicalId":6916,"journal":{"name":"Acta Orthopaedica","volume":"96 ","pages":"394-400"},"PeriodicalIF":2.5,"publicationDate":"2025-05-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12118375/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144214516","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 complications in elective orthopedic surgeries in children and young adults with cerebral palsy: a population-based register study.","authors":"Anna Telléus, Johan Von Heideken, Fredrik Granath, Eva Broström, Gunnar Hägglund, Per Åstrand","doi":"10.2340/17453674.2025.43705","DOIUrl":"10.2340/17453674.2025.43705","url":null,"abstract":"<p><strong>Background and purpose: </strong>Musculoskeletal deformities in cerebral palsy (CP) may be surgically treated, but population-based studies of postoperative complications after these surgeries are rare. The aim of our study was to assess the risk of complications following elective orthopedic surgery in children and young adults with CP.</p><p><strong>Methods: </strong>We performed a register-based cohort study of 1,514 individuals born between 1990 and 2019 who underwent 2,983 orthopedic surgical events between January 1, 1997, and December 31, 2019. Data was obtained from the CP surveillance program CPUP, the Swedish National Patient Register, and the National Cause of Death Register. We used logistic regression to calculate odds ratios (OR) with 95% confidence intervals (CI) for postoperative complications within 90 days, in relation to the Gross Motor Function Classification System (GMFCS) level, anatomic level, and type of surgery (i.e., skeletal vs. soft tissue).</p><p><strong>Results: </strong>13% of all surgical events had at least 1 postoperative complication (6% in soft tissue surgeries, 17% in skeletal surgeries), and 51% of these were related to infection. The complication rate was higher in individuals with GMFCS levels IV and V than in the pooled GMFCS levels I-III. The highest ORs were found in GMFCS level V (7.0, CI 3.7-13.5) vs. GMFCS I and spinal surgery (7.9, CI 3.7-13.5) vs. foot/ankle surgery. The OR for skeletal surgery was 1.6 (CI 1.2-2.1) compared with soft tissue surgery.</p><p><strong>Conclusion: </strong>13% of all surgical events had at least 1 postoperative complication. The risk of complications after elective orthopedic surgery was higher in children with higher GMFCS levels and in skeletal surgery compared with soft tissue surgery.</p>","PeriodicalId":6916,"journal":{"name":"Acta Orthopaedica","volume":"96 ","pages":"387-393"},"PeriodicalIF":2.5,"publicationDate":"2025-05-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12212680/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144214517","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":"Adherence to the RSA and CT-RSA guideline items in clinical prosthesis migration studies: a systematic review.","authors":"Thies J N Van der Lelij, Lennard A Koster, Bart L Kaptein, Rob G H H Nelissen, Perla J Marang-van de Mheen","doi":"10.2340/17453674.2025.43750","DOIUrl":"10.2340/17453674.2025.43750","url":null,"abstract":"<p><strong>Background and purpose: </strong> Standardized reporting on methodology and results in clinical RSA research papers facilitates evaluation of quality and interpretation of results. We aimed to assess the extent to which radiostereometric analysis (RSA) and computed tomography-based RSA (CT-RSA) studies adhered to the items of the new RSA reporting guideline from 2024.</p><p><strong>Methods: </strong> A systematic literature search was performed to identify all clinical RSA studies published between January 2012 and February 2024. Studies were eligible for inclusion if prosthesis migration over time was assessed. The adherence of studies to each applicable guideline item (full, partial, or no) was assessed.</p><p><strong>Results: </strong> 285 studies were included, most of which assessed prosthesis migration in the hip (n = 161) or knee (n = 99). No study reported on all guideline items. The mean (full or partial) adherence of studies to all (applicable) items was 61% (standard deviation [SD] 11). Large variation between the reporting of items was found, ranging from being reported in 1% of the studies to 100%. The least reported items in studies were the mean number and SD of days between surgery and baseline RSA examination (8% of studies), mean number and SD of days between surgery and primary endpoint RSA examination (1%), and consistent- or all-marker method for RSA analysis (3%).</p><p><strong>Conclusion: </strong> Current studies on average reported only 61% of the items from the updated RSA guidelines. Adherence to the guidelines in clinical RSA studies on prosthesis migration should be improved, in order to improve the quality of studies and the interpretation of outcomes on implant migration.</p>","PeriodicalId":6916,"journal":{"name":"Acta Orthopaedica","volume":"96 ","pages":"380-386"},"PeriodicalIF":2.5,"publicationDate":"2025-05-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12118374/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144214512","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":"Corrigendum: The accuracy and precision of CT-RSA in arthroplasty: a systematic review and meta-analysis.","authors":"Sjors F Van de Vusse, Nienke N De Laat, Lennard A Koster, Bart Kaptein","doi":"10.2340/17453674.2025.43900","DOIUrl":"10.2340/17453674.2025.43900","url":null,"abstract":"<p><p>To our unpleasant surprise, we discovered that we have mistakenly included incorrect values in Table 2 (Reported accuracy of CT-RSA) for the paper by De Laat et al. (2024). The paper by De Laat (2024) is from our group as well. In the draft version of the systematic review manuscript, we included data from a draft manuscript of the paper by De Laat. Before publication of De Laat (2024) we updated the values for the RMS error for accuracy in translations and rotations based on an increased number of observations. However, we have overlooked to use the updated values for Table 2 of the systematic review. We are sincerely sorry for this mistake. We believe it is important to be transparent and to ensure a correct link between the systematic review and the paper by De Laat. These requested changes do not alter our conclusions of the systematic review. On behalf of all authors Bart Kaptein.</p>","PeriodicalId":6916,"journal":{"name":"Acta Orthopaedica","volume":"96 ","pages":"411-412"},"PeriodicalIF":2.5,"publicationDate":"2025-05-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12118373/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144214513","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association of socioeconomic inequality and risk of periprosthetic joint infection after total knee arthroplasty: a Danish cohort study of 75,141 cases.","authors":"Marie Anneberg, Anders Troelsen, Per Gundtoft, Alma B Pedersen","doi":"10.2340/17453674.2025.43678","DOIUrl":"10.2340/17453674.2025.43678","url":null,"abstract":"<p><strong>Background and purpose: </strong> Awareness of socioeconomic disparities in outcomes following surgical procedures is increasing. This highlights a critical challenge for clinical practice and public health. We examined whether low socioeconomic position (SEP) was associated with the incidence of revisions due to periprosthetic joint infection (PJI) following total knee arthroplasty (TKA).</p><p><strong>Methods: </strong> This cohort study included 75,141 patients undergoing TKA (2010-2021), identified from the Danish Knee Arthroplasty Registry (DKR). Individual-level SEP information, including wealth, living arrangements, and education, was obtained from Danish social and administrative registries. Revisions due to PJI were identified using a method combining the DKR and microbiology data. We calculated the cumulative incidence of revision due to PJI at 90 days and 2 years, and 2-year hazard ratios (aHRs) of revision due to PJI for lower vs. higher SEP groups, adjusted for age, sex, weight, and Charlson Comorbidity Index scores, with 95% confidence intervals (CI).</p><p><strong>Results: </strong> The incidence of revision due to PJI after 2 years of follow-up was 1.5% (CI 1.3-1.6) for low-wealth patients vs. 1.2% (CI 1.1-1.3) for high-wealth patients (aHR 1.3, CI 1.1-1.5); 1.5% (CI 1.3-1.7) for patients living alone vs. 1.2% (CI 1.1-1.3) for those cohabiting (aHR 1.4, CI 1.2-1.6); and 1.3% (CI 1.1-1.4) for patients with low education vs. 1.2% (CI 1.0-1.4) for those with high education (aHR 1.0, CI 0.8-1.2).</p><p><strong>Conclusion: </strong> Revision due to PJI among low-wealth patients and those living alone versus the corresponding high-SEP group were associated with increased risk of revision due to PJI.</p>","PeriodicalId":6916,"journal":{"name":"Acta Orthopaedica","volume":"96 ","pages":"371-379"},"PeriodicalIF":2.5,"publicationDate":"2025-05-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12087143/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144118498","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":"Angular alignment, rotational profile, and joint range of motion in the lower limb of typically developing children from 7-16 years of age: a cross-sectional study.","authors":"Christian Wong, Michael Mørk Petersen, Trine Henriksen, Ales Jurca, Soeren Boedtker, Andreas Balslev-Clausen, Steen Harsted","doi":"10.2340/17453674.2025.43478","DOIUrl":"https://doi.org/10.2340/17453674.2025.43478","url":null,"abstract":"<p><strong>Background and purpose: </strong> We aimed to update reference intervals for anthropometric parameters for the passive joint range of motion (ROM), rotational profile, and angular alignment of the lower limb in typically developing children (TDC), to compare the association of the variables age, left-right sidedness, body mass index (BMI), and sex.</p><p><strong>Methods: </strong> We conducted a cross-sectional study in a convenience sample of TDC from the 1st, 5th, and 9th grades (6-17 years) in a randomized selection of Danish primary schools. We examined the anthropometric parameters in a non-clinical setting. Descriptive statistics were used to characterize the data. To explore potential differences across the variables, we utilized Bonferroni-corrected Welch's 2-sample t-tests, one-way analysis of means, and univariable linear regression.</p><p><strong>Results: </strong> We analyzed the associations between the variables and the anthropometric parameters in 501 TDC, aged 6 to 17 years. We found a statistically significant, but not clinically meaningful decrease in ROM for the hip, knee, and ankle as well as decreased femoral anteversion and increased tibial torsion with increasing age, but no association with sex or sidedness. However, several associations between BMI and ROM measurements were statistically significant and potentially clinically meaningful, with ROM decreasing by approximately 0.4° to 1.2° per unit increase in BMI, particularly for hip, knee, and ankle flexion movements.</p><p><strong>Conclusion: </strong> Anthropometric parameters remain clinically stable after 7 years of age and are affected only by the BMI but not sex or age. We found a statistically significant but not clinically relevant decrease in torsion and joint ROM with increasing age.</p>","PeriodicalId":6916,"journal":{"name":"Acta Orthopaedica","volume":"96 ","pages":"363-370"},"PeriodicalIF":2.5,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12044830/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143954618","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pooling data for primary total knee implants across national registries: is the same implant used in multiple registries and for the same patient group? An observational study.","authors":"Lotje Hoogervorst, Rob G H H Nelissen, Liza Van Steenbergen, Alma B Pedersen, Eskild Bendix Kristiansen, Martin Lindberg-Larsen, Marina Torre, Enrico Ciminello, Riccardo Valentini, Alexander W Grimberg, Yinan Wu, Perla J Marang-van de Mheen","doi":"10.2340/17453674.2025.43476","DOIUrl":"https://doi.org/10.2340/17453674.2025.43476","url":null,"abstract":"<p><strong>Background and purpose: </strong> Pooling data on the performance of total knee (TK) implants across registries is only possible if the same TK implant is used across multiple registries and if used in patients with similar characteristics. We assessed to what extent specific TK implants: (i) are used across multiple registries or only in a single registry; and (ii) differ in patient characteristics between registries.</p><p><strong>Methods: </strong> All primary TK implants implanted between January 2020 and December 2021 in the Danish, Dutch, German, and Italian registries were included. We determined the number of registries using a specific TK implant (based on combined femoral-tibial component brand name and fixation/congruency/mobile bearing insert/patella usage). Patient characteristics (age/body mass index [BMI]/sex/diagnosis osteoarthritis) were compared across registries for TK implants used in ≥ 2 registries ≥ 100 times.</p><p><strong>Results: </strong> 813 different TK implants (577,351 procedures) were used across the 4 registries, of which 53 TK implants (7%) were used in 1 registry (8,000 procedures). 760 different TK implants (569,351 procedures; 99%) were used in ≥ 2 registries of which 47 different TK implants (393,954 procedures; 68%) were used in ≥ 2 registries and ≥ 100 times. Statistically and clinically significant differences in age for the same TK implant across registries were observed for 29 TK implants (62%) and 3 TK implants (6%), respectively; for other characteristics these were for BMI 30 (64%) and 0 (0%) TK implants; for male proportion 23 (49%) and 17 (36%) TK implants; and for diagnosis of osteoarthritis 42 (89%) and 34 (72%) TK implants, respectively.</p><p><strong>Conclusion: </strong> Most specific TK implants and TK procedures were used across multiple registries, but they were often used in patients with different characteristics. This has an impact on comparing implant performances between registries.</p>","PeriodicalId":6916,"journal":{"name":"Acta Orthopaedica","volume":"96 ","pages":"339-347"},"PeriodicalIF":2.5,"publicationDate":"2025-04-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12006037/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143954973","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}