Acta Orthopaedica最新文献

{"title":"Relevant treatment outcomes for individuals aged 60 and older with massive rotator cuff tears: a qualitative study with 16 patients.","authors":"Cristina Barrufet, Víctor Zamora, Catalina Lizano-Barrantes, Carlos Torrens, Andrea Burón, Emilio Calvo, Lluis Peidró, Joan Miquel, Raúl Barco, Montse Ferrer","doi":"10.2340/17453674.2025.43474","DOIUrl":"https://doi.org/10.2340/17453674.2025.43474","url":null,"abstract":"<p><strong>Background and purpose: </strong> Qualitative research on individuals with massive rotator cuff tears (MRCT) is scarce. This study aims to identify the perceptions, concerns, and treatment outcomes relevant to individuals with MRCT of the shoulder, as expected before treatment or experienced afterward.</p><p><strong>Methods: </strong> A qualitative study was designed using a hermeneutic phenomenological methodology. Purposive sampling was employed to identify potentially eligible patients (diagnosed with MRCT and aged 60-85 years) in the trauma and orthopedic outpatient clinics of 3 hospitals in Spain. The study employed 2 segmentation criteria: type of treatment and timing (before/after treatment). 16 interviews were conducted to capture the patients' perspective: 9 were semi-structured and 7 were in-depth. Interpretative phenomenological analysis was used, and triangulation was performed by 3 researchers with diverse backgrounds.</p><p><strong>Results: </strong> The mean age of participants (10 women and 6 men) was 71 years, with most having their dominant limb affected. The analysis revealed 4 themes (13 subthemes): MRCT impact on daily living (shoulder-derived functional limitation, pain, and emotional disturbance); treatment outcomes (recovering independence, pain relief, and social participation); clinical management (communication with health professionals, duration of the diagnostic/therapeutic process, and participation in decision-making); and characteristics of the individual (sex, work, and comorbidity). Special unmet needs were identified for women, with more prolonged diagnostic and therapeutic processes while bearing most household responsibilities.</p><p><strong>Conclusion: </strong> Recovering independence and pain relief were the principal outcomes from the perspective of patients with MRCT, and social participation and emotional well-being were closely linked. Measuring these outcomes could improve shared decision-making, while addressing systemic barriers to enhance patient participation.</p>","PeriodicalId":6916,"journal":{"name":"Acta Orthopaedica","volume":"96 ","pages":"322-330"},"PeriodicalIF":2.5,"publicationDate":"2025-04-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11995431/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143955133","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":"Effectiveness of total hip arthroplasty versus non-surgery on patient-reported hip function at 3 months: a target trial emulation study of patients with osteoarthritis.","authors":"Amanda D Klaassen, Wiard Jorritsma, Nienke W Willigenburg, Carina L E Gerritsma, Bas L E F Ten Have, Dirk Jan F Moojen, Maaike G J Gademan, Rolf H H Groenwold, Rudolf W Poolman","doi":"10.2340/17453674.2025.43332","DOIUrl":"https://doi.org/10.2340/17453674.2025.43332","url":null,"abstract":"<p><strong>Background and purpose: </strong> This study introduces an innovative research design in the field of orthopedics, using a target trial emulation approach. We aimed to assess the causal effects of total hip arthroplasty (THA) compared with nonoperative treatment in reducing patient-reported hip disability at 3 months in patients with osteoarthritis, using real-world data.</p><p><strong>Methods: </strong> We emulated a target trial using real-world data of 2 Dutch hospitals between April 2020 and January 2022. Patients diagnosed with hip osteoarthritis and eligible for primary THA were included in the study. During the COVID-19 pandemic, THA was often cancelled due to external factors (i.e., limited operating room capacity, or surgeon unavailable due to quarantine rules), resulting in an arbitrary allocation of patients to THA (n = 132) or non-THA (n = 60). We compared changes in hip disability, measured using the Hip disability and Osteoarthritis Outcome Score Physical function Short form (HOOS-PS), between the THA group at 3 months postoperatively and the non-THA group at ≥3 months post waiting-list. Linear regression analysis, adjusting for potential confounders, was used to compare between-group differences.</p><p><strong>Results: </strong> THA showed preferable outcomes compared with non-THA, indicated by a difference of -33 points (95% confidence interval [CI] -37 to -28) on the HOOS-PS. Patients in the THA group demonstrated a clinically significant improvement in hip function, with a mean change of -27 points (CI -31 to -24), while the control group showed no improvement with a mean change of 7 points (CI 3-11) on the HOOS-PS.</p><p><strong>Conclusion: </strong> THA significantly improves hip function in osteoarthritis patients, surpassing the outcomes observed in the non-surgery group.</p>","PeriodicalId":6916,"journal":{"name":"Acta Orthopaedica","volume":"96 ","pages":"310-316"},"PeriodicalIF":2.5,"publicationDate":"2025-04-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11995426/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143959245","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":"Survival rate and use of revision components in total knee arthroplasty following unicompartmental knee arthroplasty or proximal tibial osteotomy: an analysis of 11,983 procedures from the Dutch Arthroplasty Register.","authors":"Maarten R Huizinga, Astrid J De Vries, Liza N Van Steenbergen, Reinoud W Brouwer","doi":"10.2340/17453674.2025.43333","DOIUrl":"https://doi.org/10.2340/17453674.2025.43333","url":null,"abstract":"<p><strong>Background and purpose: </strong> Unicompartmental osteoarthritis of the knee can be treated with high tibial osteotomy (HTO) or unicompartmental knee arthroplasty (UKA). This study aimed to investigate the use of revision components in total knee arthroplasty (TKA) after HTO or UKA and to investigate the revision-free survival of the 2 groups of TKA at different time points, including reasons for revision.</p><p><strong>Methods: </strong> TKAs after HTO and revision TKAs after failed UKA in the years 2007-2022 were selected from the Dutch Arthroplasty Register. For complexity, the usage of revision components was analyzed. Kaplan-Meier survival analysis was used to estimate survival rate. Multivariable Cox proportional hazards regression analyses were used to estimate the risk of revision, considering potential confounders. Indications of revision were evaluated.</p><p><strong>Results: </strong> 11,983 procedures were analyzed (9,835 HTO-TKA and 2,148 UKA-TKA). In the HTO-TKA group, 3% had revision components in the TKA compared with 22% in the UKA-TKA group (P < 0.001). After 12 years' follow-up the revision-free survival was 90.4% (95% confidence interval [CI] 89.6-91.2) for HTO-TKA and 81.7% (CI 79.3-84.1) for UKA-TKA. The multivariable Cox regression analysis showed that UKA-TKA was a significant risk factor for a revision of the TKA (hazard ratio 2.3, CI 1.8-2.6), compared with HTO-TKA. In both groups the most frequent reason for revision was instability, followed by patellar pain and loosening of the tibial component.</p><p><strong>Conclusion: </strong> TKAs after UKAs had higher use of revision components and a lower survival rate compared with TKAs following an HTO. The choice of surgical treatment should be considered for the young and active patient with unicompartmental knee osteoarthritis.</p>","PeriodicalId":6916,"journal":{"name":"Acta Orthopaedica","volume":"96 ","pages":"317-321"},"PeriodicalIF":2.5,"publicationDate":"2025-04-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11995432/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143965576","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":"Risk of secondary surgery following surgical treatment of fractures: a nationwide register study on 9,719 adult patients.","authors":"Anders Bo Roennegaard, Signe Steenstrup Jensen, Peter Toft Tengberg, Per Hviid Gundtoft, Bjarke Viberg","doi":"10.2340/17453674.2025.43446","DOIUrl":"https://doi.org/10.2340/17453674.2025.43446","url":null,"abstract":"<p><strong>Background and purpose: </strong> Reports on the risk of secondary surgery in fracture-related surgery are scarce in the literature. The aim of this study was to estimate the risk of any secondary musculoskeletal surgery within 2 years of primary, fracture-related surgery.</p><p><strong>Methods: </strong> We performed a nationwide register study on adult Danish patients surgically treated for fractures in 2016 with 2 years' follow-up. We used cross-linked data from the Danish Fracture Database, the Danish National Patient Registry and the Danish Civil Registration System. Primary outcome was risk of secondary surgery calculated by the cumulative incidence function and presented with 95% confidence intervals (CI) overall and stratified on age, sex, and anatomical area.</p><p><strong>Results: </strong> We included 9,719 adult patients of whom 63% were female and median age was 70 years (20-100). The overall risk of secondary musculoskeletal surgery in the same anatomical area as the primary was 20% (CI 19-21), for reoperation (i.e., pertaining to the initial treatment) 19% (CI 18-20), and for major reoperation (due to complication of the initial treatment) 8% (CI 7-8). Across anatomical areas risk ranged from 4% (CI 1-9) to 69% (CI 66-73) for secondary surgery, from 4% (CI 1-9) to 68% (CI 65-72) for reoperations, and from 2% (CI 0-6) to 26% (CI 19-33) for major reoperation.</p><p><strong>Conclusion: </strong> The risk of experiencing a major postoperative complication that needs surgical treatment is below 10%.</p>","PeriodicalId":6916,"journal":{"name":"Acta Orthopaedica","volume":"96 ","pages":"304-309"},"PeriodicalIF":2.5,"publicationDate":"2025-04-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11995429/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143952352","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 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 L Kaptein","doi":"10.2340/17453674.2025.43334","DOIUrl":"10.2340/17453674.2025.43334","url":null,"abstract":"<p><strong>Background and purpose: </strong> Computed tomography-based radiostereometric analysis (CT-RSA) is an alternative to conventional radiostereometric analysis (RSA) in measuring implant migration, circumventing the need for operative insertion of tantalum markers. The accuracy and precision of different CT-RSA techniques in various joints are still unclear, and the effective radiation dose (ED) of CT-RSA is usually higher than RSA. In this systematic literature review, we aimed to provide an overview of the accuracy, precision, clinical precision, and ED of CT-RSA techniques.</p><p><strong>Methods: </strong> We performed a systematic search in PubMed, Cochrane, and Embase databases. Main search items were \"arthroplasty\" AND \"migration\" AND \"computed tomography.\" We included full-text English papers, using CT for migration analysis (CT-RSA) in human, animal, or synthetic models with arthroplasties, reporting accuracy and/or precision. Eligible studies were screened and reviewed by 2 authors independently. Main outcomes were accuracy, precision, and clinical precision of CT-RSA in 6 degrees of freedom. Secondary outcome was the mean ED. A meta-analysis on (clinical) precision of CT-RSA was performed.</p><p><strong>Results: </strong> 23 studies were included involving 163 patients, 20 human cadaveric, 3 porcine cadaveric, and 7 synthetic models. 6 different CT-RSA techniques were used to study 6 different joint components in cervical disc replacement and shoulder, hip, and knee arthroplasty. CT-RSA accuracy ranged between 0.02 and 0.71 mm and 0.03° and 1.00°. CT-RSA precision ranged between 0.00 and 0.47 mm and 0.00° and 1.09°. Mean precision was 0.15 mm (95% confidence interval [CI] 0.05-0.25) in the acetabulum, 0.13 mm (CI 0.00-0.28) and 0.24° (CI 0.00-0.51) in the proximal femur, and 0.04 mm (CI 0.00-0.08) and 0.07° (CI 0.00-0.15) in the proximal tibia. CT-RSA clinical precision ranged between 0.03 and 1.36 mm and 0.06° and 2.25°. Mean clinical precision was 0.13 mm (CI 0.11-0.16) and 0.26° (CI 0.20-0.32) in the acetabulum. The mean ED of CT-RSA ranged between 0.02 and 5.80 mSv.</p><p><strong>Conclusion: </strong> CT-RSA shows comparable accuracy and precision to standard RSA. CT-RSA seems to be a promising alternative to RSA.</p>","PeriodicalId":6916,"journal":{"name":"Acta Orthopaedica","volume":"96 ","pages":"295-303"},"PeriodicalIF":2.5,"publicationDate":"2025-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11971844/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143750653","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":"Avoidable injuries in pediatric hand fractures: a 30-year review of compensation claims in Finland.","authors":"Caroline C Dikert, Petra Grahn, Yrjänä Nietosvaara","doi":"10.2340/17453674.2025.43084","DOIUrl":"10.2340/17453674.2025.43084","url":null,"abstract":"<p><strong>Background and purpose: </strong>We aimed to evaluate the risk, causes, and compensation outcomes of avoidable injuries in pediatric hand fractures.</p><p><strong>Methods: </strong> All compensation claims submitted to the Finnish Patient Insurance Centre (PIC) for pediatric hand fracture treatment (< 16 years) in Finland from 1990 to 2019 were reviewed. Data collected included fracture location, compensation rate and reasons, treatment setting, and treating professional specialty. PIC decisions were reassessed. Census population (3.0 x 107) was calculated from national registers, and hand fracture incidence estimated (350/105).</p><p><strong>Results: </strong> Of 101 claims, 71 were compensated as avoidable injuries, encompassing 72 complications by 74 professionals. Compensated claims were most common for finger fractures (43/65), followed by metacarpal (15/20) and scaphoid fractures (14/17). 1 claim involved both a finger and metacarpal fracture, and in 3 claims faults were made by 2 separate professionals. Most injuries occurred in healthcare centers, with general practitioners responsible for 37/74 avoidable injuries. Diagnostic delays led to most compensation (36 cases: 23 lacked initial radiographs, 12 missed fractures on radiographs). Compensation for permanent disability (5-10%) was granted in 8 cases (4 finger and 4 scaphoid fractures) and for cosmetic disability in 21/43 finger fracture cases. PIC decisions were deemed correct in 98/101 cases, with a calculated risk of compensated avoidable injury at 0.1%.</p><p><strong>Conclusion: </strong> The risk of avoidable injuries with permanent sequelae in pediatric hand fractures in Finland is low. Use of diagnostic radiographs is advised in children with hand injuries, especially if scaphoid fractures are suspected.</p>","PeriodicalId":6916,"journal":{"name":"Acta Orthopaedica","volume":"96 ","pages":"290-294"},"PeriodicalIF":2.5,"publicationDate":"2025-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11980813/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143750651","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":"Antibiotic prophylaxis and incidence of infection following elbow arthroplasty: a nationwide study.","authors":"Johan E Wänström, Anne Dettmer, Hanna C Björnsson Hallgren, Björn Salomonsson, Oskar Ljungquist, Lars E Adolfsson","doi":"10.2340/17453674.2025.43288","DOIUrl":"10.2340/17453674.2025.43288","url":null,"abstract":"<p><strong>Background and purpose: </strong>Periprosthetic joint infection (PJI) after elbow arthroplasty is a serious complication. Evidence of the best antibiotic prophylaxis for elbow arthroplasty is lacking. We aimed to investigate the regimens presently used in Sweden, incidence of PJI, and the bacteria most frequently found in elbow PJI.</p><p><strong>Methods: </strong>A questionnaire was sent out to all Swedish units performing elbow arthroplasty in 2019 asking about antibiotic prophylaxis routines. The Swedish Elbow Arthroplasty Register (SEAR) and national inpatient and outpatient registers (NPR) from the National Board of Health and Welfare were searched for procedures related to all primary total- or hemi-elbow arthroplasties performed during 2019-2021. Results of microbiological analyses of the suspected PJI cases were collected from the respective laboratory.</p><p><strong>Results: </strong>Most centers used only cloxacillin (44%) or cloxacillin together with benzylpenicillin (44%), as prophylaxis. 250 primary procedures were performed between 2019 and 2021, and the most used antibiotic prophylaxes were cloxacillin (61%) and cloxacillin with benzylpenicillin (23%). In the NPR, 20 patients (8%) with a diagnosis that could indicate PJI were found and 9 (3.6%) had a confirmed PJI. The most common bacteria were Staphylococcus epidermidis, Cutibacterium acnes, and Staphylococcus aureus.</p><p><strong>Conclusion: </strong>Most centers used cloxacillin antibiotic prophylaxis for elbow arthroplasty. The incidence of PJI was 3.6%. The most frequent diagnosed pathogen was Staphylococcus epidermidis.</p>","PeriodicalId":6916,"journal":{"name":"Acta Orthopaedica","volume":"96 ","pages":"278-282"},"PeriodicalIF":2.5,"publicationDate":"2025-03-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11933823/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143708003","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":"Fractures sustained by slipping on ice or snow: an epidemiological study of 50,500 fractures from the Swedish Fracture Register.","authors":"Henrik Ivdal, Linnea Bergenholtz, Carl Bergdahl, Olof Wolf, Emilia Möller Rydberg","doi":"10.2340/17453674.2025.43186","DOIUrl":"10.2340/17453674.2025.43186","url":null,"abstract":"<p><strong>Background and purpose: </strong>Despite numerous patients sustaining fractures annually due to slipping on ice or snow, descriptive studies are scarce, which may result in less systematic management and prevention. We aimed to analyze fractures in adults sustained by slipping on ice and snow in Sweden using data from the Swedish Fracture Register (SFR).</p><p><strong>Methods: </strong>Data on all patients ≥ 18 years registered in the SFR between January 1, 2015 and December 31, 2022, with a fracture sustained by slipping on ice or snow was extracted. Descriptive statistical analyses were performed.</p><p><strong>Results: </strong>During the study period, 50,500 fractures were registered as sustained by slipping on ice or snow, representing 9% of all registered fractures in the SFR during the same period. 60% of the fractures affected the upper extremity. The mean age at the time of fracture was 61 years (18-105) and almost 70% of fractures were seen in women. The most common fractures were to the wrist (34%), ankle (18%), proximal humerus (11%), and hip (10%).</p><p><strong>Conclusion: </strong>Almost 1 in 10 fractures is sustained by slipping on ice or snow. The most common fractures are related to the wrist and the ankle. The majority of fractures affect the upper extremity, and two-thirds are sustained by women. Protective shoe wear, and better snow and ice clearance, could potentially have a large effect on injury prevention.</p>","PeriodicalId":6916,"journal":{"name":"Acta Orthopaedica","volume":"96 ","pages":"272-277"},"PeriodicalIF":2.5,"publicationDate":"2025-03-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11933825/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143708015","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":"Radiostereometric measurement of implant migration in robotically assisted vs conventional bi-cruciate stabilized cemented total knee arthroplasty: secondary analysis of a randomized controlled trial.","authors":"Øystein Skåden, Ove Nord Furnes, Stein Håkon Låstad Lygre, Irene Ohlen Moldestad, Geir Hallan, Anne Marie Fenstad, Paul Johan Høl, Øystein Johannes Gøthesen","doi":"10.2340/17453674.2025.43081","DOIUrl":"10.2340/17453674.2025.43081","url":null,"abstract":"<p><strong>Background and purpose: </strong>Robotically assisted computer navigation (robotic) has been developed to improve the positioning in total knee arthroplasties (TKAs), attempting to achieve better functional results and longevity of the prostheses. However, the benefit of robotics is still controversial. The aim of our study was to compare migration between robotic and conventional techniques in cemented bi-cruciate stabilized TKAs, using radiostereometric analysis (RSA) based on a secondary analysis of a randomized controlled trial (RCT).</p><p><strong>Methods: </strong>We enrolled 60 TKA patients from one hospital (2020-2021), with osteoarthritis or arthritic disease. The patients were examined up to 24 months after the surgery, to estimate the mechanical stability of the tibial component. The maximum total point motion (MTPM) representing the magnitude of migration, the largest negative (subsidence) and positive (lift-off) value for y-translation, and prosthetic rotations were measured. The migration in the 2 groups was compared and the precision evaluated.</p><p><strong>Results: </strong>51 RSA marked TKAs were available for a comparison of tibial migration between robotically assisted (n = 26) and conventional operations (n = 25). The MTPM in the first year was 0.44 mm and 0.64 mm, and at 24 months 0.46 mm and 0.75 mm, for the conventional and the robotic groups, respectively. The robotic group migrated more than the conventional group at 2 years, 0.21 mm (95% confidence interval [CI] 0.05-0.44; P = 0.01). The overall median MTPM for the investigated implants (both groups) up to 12 months was 0.54 mm (CI 0.44-0.63), and 0.19 mm between 12 and 24 months (CI 0.16-0.22). The magnitude of migration and rotation around the 3 axes was small for both groups, but flexion/extension migration of the tibial component was slightly higher in the robotic group 0.14° (CI 0.00-0.33; P = 0.049).</p><p><strong>Conclusion: </strong>MTPM and flexion/extension migrations of the tibial component were higher for the robotic group, up to 24 months. The overall migration pattern for the bi-cruciate stabilized implant was acceptable.</p>","PeriodicalId":6916,"journal":{"name":"Acta Orthopaedica","volume":"96 ","pages":"283-289"},"PeriodicalIF":2.5,"publicationDate":"2025-03-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11933824/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143707985","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":"Time trends in spine surgery in Italy: a nationwide, population-based study of 1,560,969 records of administrative health data from 2001 to 2019.","authors":"Marina Torre, Andrea Piazzolla, Enrico Ciminello, Tiziana Falcone, Eugenio Carrani, Simona Pascucci, Michela Franzò, Giuseppe Barbagallo, Vincenzo Vitiello, Gustavo Zanoli, Alessia Biondi, Letizia Sampaolo, Veronica Mari, Francesco Langella, Pedro Berjano","doi":"10.2340/17453674.2025.43188","DOIUrl":"10.2340/17453674.2025.43188","url":null,"abstract":"<p><strong>Background and purpose: </strong>The use of spinal implants has increased substantially. Their widespread use raises public health concerns. We aimed to study spinal surgery trends in Italy from 2001 to 2019 and present a mapping for ICD9-CM codes potentially related to spinal diagnoses and procedures.</p><p><strong>Methods: </strong>ICD9-CM codes of interest were selected and mapped to clinically meaningful spinal diagnostic categories and procedure classes. The Italian National Hospital Discharge Records database was then browsed according to these codes. Surgical volumes and trends were described. Population incidence rates (IR) were estimated and provided with 95% confidence intervals (CI). Variations in IRs were reported in terms of incidence rate ratio. The statistical significance of counts and IR time series trends was assessed by using the Cox-Stuart test.</p><p><strong>Results: </strong>1,560,969 spinal procedures were extracted from 209,818,966 admissions registered nationally. The annual number of spinal procedures increased significantly by 67%, from 58,369 in 2001 to 97,636 in 2019 (P < 0.002). 1,040,326 (67%) procedures did not include implants, while 590,643 (33%) used implants, 395,450 (25%) associated with fusions and 125,193 (8%) with non-fusions. Population IRs increased from 100.9 (CI 100.1-101.7) to 163.2 (CI 162.2-164.3) episodes per 100,000 inhabitants. Surgical volumes for non-implant-related procedures remained stable, while implant-related procedures increased significantly, by 420% over the 19 observed years (P = 0.002).</p><p><strong>Conclusion: </strong>Spinal surgical procedures and their population incidence rates increased significantly. Fusions and other implant-related procedures increased substantially for most diagnostic categories. An ICD9-CM mapping for spinal diagnoses and procedures as a reproducible tool for further explorations was presented.</p>","PeriodicalId":6916,"journal":{"name":"Acta Orthopaedica","volume":"96 ","pages":"256-264"},"PeriodicalIF":2.5,"publicationDate":"2025-03-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11971841/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143646704","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}