Acta Orthopaedica最新文献

{"title":"Response to Letter: Staples, tension-band plates, and percutaneous epiphysiodesis screws used for leg-length discrepancy treatment: a systematic review and proportional meta-analysis.","authors":"Maria Tirta, Søren Kold, Ole Rahbek","doi":"10.2340/17453674.2025.43082","DOIUrl":"10.2340/17453674.2025.43082","url":null,"abstract":"","PeriodicalId":6916,"journal":{"name":"Acta Orthopaedica","volume":"96 ","pages":"153"},"PeriodicalIF":2.5,"publicationDate":"2025-02-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11811424/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143381390","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 of constrained condylar and hinged knee implants and mid- to long-term survivorship: a register-based study from the Nordic Arthroplasty Register Association (NARA).","authors":"Jake Von Hintze, Ville Ponkilainen, Annette W-Dahl, Nils P Hailer, Ove Furnes, Anne M Fenstad, Mona Badawy, Alma B Pedersen, Martin Lindberg-Larsen, Mika J Niemeläinen, Keijo Mäkelä, Antti Eskelinen","doi":"10.2340/17453674.2025.42999","DOIUrl":"10.2340/17453674.2025.42999","url":null,"abstract":"<p><strong>Background and purpose: </strong>In complex primary total knee arthroplasty (TKA), constrained condylar knee (CCK) or rotating hinge knee (RHK) designs may be required to provide stability or address bony deficiencies. We analyzed trends in incidence of these designs in primary TKA and evaluated the mid- to long-term survivorship of CCK and RHK in 4 Nordic countries.</p><p><strong>Methods: </strong>From 2000 to 2017, 5,134 CCK and 2,515 RHK primary TKAs were identified from the NARA database. Kaplan-Meier (K-M) survival and flexible parametric survival model (FPSM) analyses were performed to estimate revision risk, expressed as hazard ratio (HR) with 95% confidence intervals (CI), with minimally stabilized (MS) TKA acting as the control group (n = 456,137).</p><p><strong>Results: </strong>The incidence of CCK and RHK implants increased significantly in Finland, while it was moderate in Denmark, Norway, and Sweden. With revision for any reason as the endpoint the 15-year K-M cumulative revision risk for RHK was 13.6% (CI 10.4-16.7) and for CCK it was 11.3% (CI 9.1-13.5). Compared with MS TKA, the hazard ratio for revision was 2.1 (CI 1.8-2.3) for CCK and 2.5 (CI 2.1-2.8) for RHK. Periprosthetic joint infection (PJI) was the most common reason for revision, accounting for 44% of CCK and 47% of RHK cases. After excluding revisions for PJI, the hazard ratio remained high for both designs, at 1.5 (CI 1.3-1.7) for CCK and 1.6 (CI 1.3-2.0) for RHK compared with MS.</p><p><strong>Conclusion: </strong>The incidence of CCK and RHK increased during the study period. Both designs showed consistent 15-year revision risks of 11-14%, with no major differences between them. The higher revision risk compared with MS TKAs may reflect the complexity of the surgeries.</p>","PeriodicalId":6916,"journal":{"name":"Acta Orthopaedica","volume":"96 ","pages":"142-150"},"PeriodicalIF":2.5,"publicationDate":"2025-02-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11806214/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143254047","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":"Arthroplasty registries at a glance: an initiative of the International Society of Arthroplasty Registries (ISAR) to facilitate access, understanding, and reporting of registry data from an international perspective.","authors":"Anne Lübbeke, Lotje A Hoogervorst, Perla J Marang-van de Mheen, Heather A Prentice, Ola Rolfson, Rob G H H Nelissen, Arnd Steinbrück, Gearoid McGauran, Christophe Barea, Kajsa Erikson, Alma B Pedersen, Martyn Porter","doi":"10.2340/17453674.2024.42706","DOIUrl":"10.2340/17453674.2024.42706","url":null,"abstract":"<p><strong>Background and purpose: </strong>The amount of information publicly available from arthroplasty registries is large but could be used more effectively. This project aims to improve the knowledge concerning existing registries to facilitate access, transparency, harmonization, and reporting.</p><p><strong>Methods: </strong>Within the International Society of Arthroplasty Registries (ISAR) we aimed at developing, testing, adopting, and making publicly available a short, standardized registry description with items considered relevant for stakeholders using a cross-sectional study survey. Items were chosen based on a literature review and expert advice, selected by 9 ISAR working group members, tested iteratively in 3 registries, and commented upon by 4 external experts. All 29 ISAR member registries as of July 2023 were invited to participate in the project.</p><p><strong>Results: </strong>Included items covered general descriptive information regarding registries, information related to governance, outcomes, data quality, data access, and registry production. The template was adopted, completed, and made publicly available by 25 of the 29 registries. Of those, 2/3 were national registries. 23 captured both hip and knee arthroplasties and 10 captured shoulder arthroplasties. Most registries had public reporting of data quality, methods, and results. Data was accessible in all but 2 registries, mainly as aggregated data. Important items relevant to registry quality for researchers to consistently indicate in scientific papers include scope, inclusion criteria, outcomes definitions, coverage/completeness, and validation processes.</p><p><strong>Conclusion: </strong>This ISAR initiative implemented a short, standardized description to facilitate appropriate use of orthopedic registry data worldwide relevant for a diverse group of stakeholders including researchers, industry, public health and regulatory agencies.</p>","PeriodicalId":6916,"journal":{"name":"Acta Orthopaedica","volume":"96 ","pages":"116-126"},"PeriodicalIF":2.5,"publicationDate":"2025-01-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11760185/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143062963","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":"Assessment of improvement in functional outcomes between a novel knee replacement design and conventional designs in 240 patients: a randomized controlled trial.","authors":"Tero Irmola, Aleksi Reito, Jarmo Kangas, Antti Eskelinen, Mika Niemeläinen, Ville M Mattila, Teemu Moilanen","doi":"10.2340/17453674.2024.42708","DOIUrl":"10.2340/17453674.2024.42708","url":null,"abstract":"<p><strong>Background and purpose: </strong>The introduction and development of new total knee arthroplasty (TKA) implant designs are industry driven. To date, an adequately powered randomized controlled trial (RCT) to provide evidence of the superiority of novel implant designs over conventional ones is often lacking. The aim of our RCT was to investigate the functional outcomes of a novel TKA implant design compared with 2 conventional TKA designs. Primary outcome was difference in the change in Oxford Knee Score (OKS) at 2 years. Secondary outcomes were Forgotten Joint Score, 15D quality of life questionnaire, UCLA activity score, and complications.</p><p><strong>Methods: </strong>We compared functional outcomes between a novel TKA implant design (Persona CR) and 2 conventional designs (NexGen CR, PFC CR). 240 patients with severe knee osteoarthritis were recruited to a pragmatic, single-center, prospective, parallel-group RCT between September 2015 and August 2018. The duration of follow-up was 2 years.</p><p><strong>Results: </strong>Of 240 randomized patients, 225 were included in the intention-to-treat analysis (mean age 61.8 years; 67.5% females). The OKS exceeded minimal clinical important difference (MCID) from baseline to 2 years in all 3 treatment groups (Persona CR: 18.9 points, PFC CR: 20.3 points, NexGen CR: 19.4 points). At 2 years the difference between Persona CR and PFC CR in the change score was -1.0 (95% confidence interval [CI] -3.6 to 1.7). Similarly, the difference between Persona CR and NexGen CR was -0.9 (CI -3.6 to 1.9). At the time of final follow-up evaluation, OKS was equivalent between groups, as CI excluded between-group differences larger than 4 points.</p><p><strong>Conclusion: </strong>We showed no clinically relevant differences in functional outcomes measured with OKS, 15D, or FJS between the 2 conventional implant designs and the novel implant design at 2-year follow-up.</p>","PeriodicalId":6916,"journal":{"name":"Acta Orthopaedica","volume":"96 ","pages":"127-134"},"PeriodicalIF":2.5,"publicationDate":"2025-01-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11760186/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143063005","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":"Curve progression in non-surgically treated patients with idiopathic scoliosis: a cohort study with 40-year follow-up.","authors":"Casper Dragsted, Lærke Ragborg, Søren Ohrt-Nissen, Thomas Andersen, Martin Gehrchen, Benny Dahl","doi":"10.2340/17453674.2024.42659","DOIUrl":"10.2340/17453674.2024.42659","url":null,"abstract":"<p><strong>Background and purpose: </strong>Treatment of idiopathic scoliosis in childhood aims to prevent curve progression. It is generally accepted that curves > 50° have the highest risk of progression, but less well described is what happens with mild to moderate curves. The aim of this study was to assess long-term curve progression and health-related quality of life (HRQoL) and compare thoracic and thoracolumbar/lumbar (TL/L) curves.</p><p><strong>Methods: </strong>We identified 177 patients diagnosed with a pediatric spinal deformity and treated at our institution from 1972 through 1983. 91 of 129 eligible patients with idiopathic scoliosis completed follow-up (71%). Patient files from treatment/observation in childhood were reviewed including detailed descriptions of radiographs. At follow-up we assessed long standing full-spine radiographs and HRQoL with the Scoliosis Research Society 22 revised questionnaire.</p><p><strong>Results: </strong>Mean follow-up was 41 years (standard deviation [SD] 2.5 years). 21 patients underwent surgery in adolescence or early adulthood leaving 70 patients for analysis of curve progression, of whom 61 had complete radiographs. For patients with a main curve < 25° at the end of treatment in adolescence (n = 19) mean curve progression was 7° (SD 9); for 25-40° curves (n = 26) 16° (SD 13); for 40-50° curves (n =10) 22° (SD 8); and for curves > 50° (n = 6) 17° (SD 6). There was a linear association between main curve size at follow-up and SRS-22r subtotal score (P = 0.003).</p><p><strong>Conclusion: </strong>We found substantial curve progression for patients with main curves > 25° at end of treatment, but with a considerable variation between patients. Curve progression was not associated with curve size at the end of treatment and did not differ significantly between thoracic and TL/L curves. Larger main curve size at follow-up was associated with lower HRQoL.</p>","PeriodicalId":6916,"journal":{"name":"Acta Orthopaedica","volume":"96 ","pages":"110-115"},"PeriodicalIF":2.5,"publicationDate":"2025-01-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11747841/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142998278","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":"Unloader brace or high tibial osteotomy in the treatment of the young patient with medial knee osteoarthritis: a randomized controlled trial.","authors":"Mark Stam, Joost Verschueren, Mark V Van Outeren, Reinoud W Brouwer, Robert D A Gaasbeek, Sorin G Blendea, Eline M Van Es, Max Reijman, Sita M A Bierma-Zeinstra","doi":"10.2340/17453674.2025.42846","DOIUrl":"10.2340/17453674.2025.42846","url":null,"abstract":"<p><strong>Background and purpose: </strong>For medial knee osteoarthritis (OA), operative and nonoperative treatment options are available. Two widely applied unloading therapies are a valgus unloader brace and a high tibial osteotomy (HTO). We aimed to compare the effects of a valgus unloader knee brace with an HTO on knee pain after 1 year in patients with symptomatic medial knee OA.</p><p><strong>Methods: </strong>We recruited patients from 9 Dutch hospitals between August 2014 and February 2019 for an open-labeled multi-center randomized controlled trial (Dutch Trial Register NL4200). Patients aged 18 to 65 years with symptomatic medial compartmental knee OA were randomized to either a valgus unloader brace or an HTO. The primary outcome was the pain subscale of the Knee injury and Osteoarthritis Outcome score (KOOS) after 1 year. Patients were evaluated at 3, 6, 9, 12, and 24 months.</p><p><strong>Results: </strong>51 patients were included in the study, of whom 23 were randomized to the unloader brace and 28 to the HTO. The HTO, compared with the unloader brace, showed a significant and clinically relevant difference at 12 months of follow-up in KOOS pain of -28 (95% confidence interval -43 to -13).</p><p><strong>Conclusion: </strong>We found that, on group level, an HTO is more effective in reducing knee pain than an unloader brace after 12 months.</p>","PeriodicalId":6916,"journal":{"name":"Acta Orthopaedica","volume":"96 ","pages":"102-109"},"PeriodicalIF":2.5,"publicationDate":"2025-01-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11747842/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142998281","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":"Mortality and reoperations following treatment of acetabular fractures in patients ≥ 70 years: a retrospective cohort study of 247 patients.","authors":"Johan Ljungdahl, Björn Hernefalk, Anna Pallin, Anders Brüggemann, Nils P Hailer, Olof Wolf","doi":"10.2340/17453674.2024.42704","DOIUrl":"10.2340/17453674.2024.42704","url":null,"abstract":"<p><strong>Background and purpose: </strong>Evidence for long-term outcomes following acetabular fractures in older adults is limited. We aimed to evaluate mortality, complications, and need for subsequent surgical procedures in operatively and nonoperatively treated older patients with acetabular fractures.</p><p><strong>Methods: </strong>Patients aged ≥ 70 years with acetabular fractures treated at Uppsala University Hospital between 2010 and 2020 were included. Fractures were classified according to Letournel. Local medical records were analyzed and cross-referenced with the Swedish Arthroplasty Register to identify reoperations and delayed arthroplasty procedures. Follow-up time ranged from 2-12 years. Primary outcome was mortality 1 year after injury. Descriptive statistics, survival analysis using the Kaplan-Meier method, and logistic regression models were used.</p><p><strong>Results: </strong>247 patients (67% men) with a median age of 80 years (range 70-102) were included. Most patients were ASA class 3 (67%). 148 (60%) patients were treated operatively. The 1-year mortality was 15% (95% confidence interval [CI] 9-21) in the operatively and 29% (CI 19-37) in the nonoperatively treated group. Difference in adjusted mortality rates between treatments did not reach statistical significance. 20% of patients treated with open reduction internal fixation (ORIF) underwent some form of reoperation. In the nonoperatively treated group, 1% had a delayed THA.</p><p><strong>Conclusion: </strong>The 1-year mortality following acetabular fractures in older people was 21% (CI 15-26), underscoring the frailty of this patient group. ORIF alone was associated with a 20% reoperation rate while the rate of delayed surgical treatment in patients selected for nonoperative treatment was 1%.</p>","PeriodicalId":6916,"journal":{"name":"Acta Orthopaedica","volume":"96 ","pages":"94-101"},"PeriodicalIF":2.5,"publicationDate":"2025-01-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11747840/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142998279","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":"Vascularized fibular grafting following tumor resection demonstrates acceptable long-term outcomes in Denmark: a national retrospective cohort study.","authors":"Christian Lind Nielsen, Daniel Thor Halberg Dybdal, Peter Vester-Glowinski, Lisa Lyngsie Hjalgrim, Pernille Edslev Wendtland, Birgitte Jul Kiil, Michael Melchior Bendtsen, Michael Mørk Petersen, Thomas Baad-Hansen","doi":"10.2340/17453674.2025.42848","DOIUrl":"10.2340/17453674.2025.42848","url":null,"abstract":"<p><strong>Background and purpose: </strong>Vascularized fibular grafting following tumor resection is an essential treatment option in limb salvage surgery. We aimed to evaluate: (I) bone healing, (II) complications and reoperations, (III) limb salvage, and (IV) survival.</p><p><strong>Methods: </strong>We present a retrospective evaluation of a national cohort comprising 27 patients. The indications were 13 cases of Ewing sarcoma, 12 cases of osteosarcoma, and 2 cases of giant cell tumor. The median age at surgery was 16 years (interquartile range [IQR] 10-18), and the median follow-up was 82 months (IQR 32-101). Patients were analyzed overall, as well as in subgroups based on tumor location (upper versus lower extremity) and pathology (osteosarcoma versus Ewing sarcoma).</p><p><strong>Results: </strong>The primary rate of graft union was 63%, and after secondary procedures the overall rate of graft union was 67%, with a median time to union of 13 months (IQR 9-17). The reoperation rate was 74%, while the limb salvage rate was 93%. The 5-year overall survival rate was 81% (95% confidence interval [CI] 61-92). Patients with upper extremity tumors were more likely to attain graft union (risk ratio [RR] 5.5, CI 1.3-31.5) and less likely to undergo multiple reoperations (RR 0.3, CI 0.8-0.9) than patients with lower extremity tumors.</p><p><strong>Conclusion: </strong>Vascularized fibular grafting following tumor resection was associated with a graft union rate of 67%, a high frequency of reoperations, a high limb salvage rate (93%), and a 5-year survival rate of 81%.</p>","PeriodicalId":6916,"journal":{"name":"Acta Orthopaedica","volume":"96 ","pages":"87-93"},"PeriodicalIF":2.5,"publicationDate":"2025-01-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11734533/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142976948","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":"Direct anterior and direct lateral approach in patients with femoral neck fractures receiving a total hip arthroplasty: a randomized controlled trial.","authors":"John Magne Hoseth, Tommy Frøseth Aae, Øystein Bjerkestrand Lian, Tor Åge Myklebust, Otto Schnell Husby","doi":"10.2340/17453674.2025.42847","DOIUrl":"10.2340/17453674.2025.42847","url":null,"abstract":"<p><strong>Background and purpose: </strong>The optimal approach to the hip joint in patients with displaced femoral neck fractures (dFNF) receiving a total hip arthroplasty (THA) remains controversial. We compared the direct lateral approach (DLA) with the direct anterior approach (DAA) primarily on Timed Up and Go (TUG), and secondarily on the Forgotten Joint Score (FJS), the Oxford Hip Score (OHS), EQ5D-5L, and the EQ5D-VAS.</p><p><strong>Methods: </strong>Between 2018 and 2023, we conducted a randomized controlled trial including elderly patients with dFNFs treated with THA. The primary outcome was the difference in TUG at 6 weeks postoperatively. Key secondary outcomes were TUG at 2, 12, and at 52 weeks postoperatively, and FJS, OHS, EQ5D-5L, and EQ5D-VAS at 2, 6, 12, and at 52 weeks postoperatively.</p><p><strong>Results: </strong>130 patients with a mean age of 78.6 (standard deviation 1.2) were allocated to DAA (n = 64) or DLA (n = 66). There was no statistically significant difference in TUG times at 6 weeks postoperatively between the DAA and the DLA, 16.0 s (95% confidence interval [CI] 13.2-18.7) vs 17.8 s (CI 15.1-20.4), estimated mean difference -1.8 s (CI -5.7 to 2.0). However, patients who underwent DAA had a significantly higher FJS at 2, 6, and 12 weeks.</p><p><strong>Conclusion: </strong>Among elderly patients with dFNF we found no difference between DAA or DLA regarding crude mobility as demonstrated with the TUG test, but patients treated with DAA showed better outcomes in the FJS in the early post-fracture period though not at 52 weeks.</p>","PeriodicalId":6916,"journal":{"name":"Acta Orthopaedica","volume":"96 ","pages":"73-79"},"PeriodicalIF":2.5,"publicationDate":"2025-01-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11726854/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142976814","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":"An algorithm for identifying causes of reoperations after orthopedic fracture surgery in health administrative data: a diagnostic accuracy study using the Danish National Patient Register.","authors":"Signe S Jensen, Anders B Rønnegaard, Per H Gundtoft, Søren Kold, Bjarke Viberg","doi":"10.2340/17453674.2024.42633","DOIUrl":"10.2340/17453674.2024.42633","url":null,"abstract":"<p><strong>Background and purpose: </strong>Disease- or procedure-specific registers offer valuable information but are costly and often inaccurate regarding outcome measures. Alternatively, automatically collected data from administrative systems could be a solution, given their high completeness. Our primary aim was to validate a method for identifying secondary surgical procedures (reoperations) in the Danish National Patient Register (DNPR) within the first year following primary fracture surgery. The secondary aim was to evaluate the accuracy of the diagnosis and procedure codes used to determine the causes of these reoperations. Finally, we developed algorithms to enhance precision in identifying the reasons for reoperations.</p><p><strong>Methods: </strong>In a national cohort of 11,551 patients with primary fracture surgery, reoperations were identified through subsequent surgical procedure codes in the DNPR. Each patient record was reviewed to confirm the reoperations and causes. To improve accuracy, a stepwise algorithm was developed for each cause.</p><p><strong>Results: </strong>We identified 2,347 possible reoperations; 2,212 were validated as true reoperations by review of patient record, i.e., a 94% positive predictive value (PPV). However, the coding for the causes of these reoperations was inaccurate. Our algorithm identified major reoperations with a sensitivity/PPV of 89/77%, minor reoperations 99%/89%, infections 77/85%, nonunion 82/56%, early re-osteosynthesis 90/75%, and secondary arthroplasties 95/87%.</p><p><strong>Conclusion: </strong>While the overall reported reoperations in the DNPR had a high PPV, the predefined diagnosis and procedure codes alone were not sufficient to accurately determine the causes of these reoperations. An algorithm was developed for this purpose, yielding acceptable results for all causes except nonunion.</p>","PeriodicalId":6916,"journal":{"name":"Acta Orthopaedica","volume":"96 ","pages":"66-72"},"PeriodicalIF":2.5,"publicationDate":"2025-01-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11726852/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142976702","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}