Acta Orthopaedica最新文献

{"title":"Prevalence of modifiable risk factors in primary elective arthroplasty and their association with infections.","authors":"Maria Sigurdardottir,&nbsp;Martin Ingi Sigurdsson,&nbsp;Yngvi Olafsson,&nbsp;Solveig H Sverrisdottir,&nbsp;Ingibjorg Gunnarsdottir,&nbsp;Emil L Sigurdsson,&nbsp;Sigurbergur Karason","doi":"10.2340/17453674.2023.8480","DOIUrl":"https://doi.org/10.2340/17453674.2023.8480","url":null,"abstract":"<p><strong>Background and purpose: </strong>The aim of this study was to identify the prevalence of modifiable risk factors of surgical site infections (SSI) in patients undergoing primary elective total joint arthroplasty (TJA) receiving conventional preoperative preparation, and to explore their association with infectious outcomes.</p><p><strong>Patients and methods: </strong>Information regarding modifiable risk factors (anemia, diabetes, obesity, nutritional status, smoking, physical activity) was prospectively gathered in patients undergoing primary TJA of hip or knee in 2018-2020 at a single institution with 6 weeks' follow-up time.</p><p><strong>Results: </strong>738 patients (median age 68 years [IQR 61-73], women 57%) underwent TJA (knee 64%, hip 36%). Anemia was detected in 8%, diabetes was present in 9%, an additional 2% had undiagnosed diabetes (HbA1c > 47 mmol/mol), and 8% dysglycemia (HbA1c 42-47 mmol/mol). Obesity (BMI ≥ 30) was observed in 52%. Serum albumin, total lymphocyte count, and vitamin D below normal limits was identified in 0.1%, 18%, and 16%, respectively. Current smokers were 7%. Surgical site complications occurred in 116 (16%), superficial SSI in 57 (8%), progressing to periprosthetic joint infection in 7 cases. Univariate analysis identified higher odds of superficial SSI for BMI ≥ 30 (OR 2.1, 95%CI 1.2-3.8) and HbA1c ≥ 42 mmol/mol (OR 2.2, CI 1.1-4.2), but no association was found with other factors.</p><p><strong>Conclusion: </strong>In a general population undergoing primary TJA an association was found between obesity (52%) and dysglycemia/diabetes (19%) and superficial SSI (8%), which progressed to PJI in 12% of cases, generating a 1% total rate of PJI. Modification of these risk factors might mitigate infectious adverse outcomes.</p>","PeriodicalId":6916,"journal":{"name":"Acta Orthopaedica","volume":"94 ","pages":"38-44"},"PeriodicalIF":3.7,"publicationDate":"2023-02-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/2f/85/ActaO-94-8480.PMC9893833.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9312286","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":"Change in treatment preferences in pediatric diaphyseal forearm fractures: a Danish nationwide register study of 36,244 fractures between 1997 and 2016.","authors":"Rasmus T Hansen, Nicolas W Borghegn, Per Hviid Gundtoft, Katrine A Nielsen, Andreas Balslev-Clausen, Bjarke Viberg","doi":"10.2340/17453674.2023.7132","DOIUrl":"10.2340/17453674.2023.7132","url":null,"abstract":"<p><strong>Background and purpose: </strong>The choice between invasive and non-invasive treatment of diaphyseal forearm fractures in children can be difficult. We investigated the trends in choice of treatment of pediatric diaphyseal forearm fractures over a 20-year period.  Patients and methods: This is a population-based register study with data from 1997 to 2016 retrieved from the Danish National Patient Registry. The primary outcome was choice of primary treatment within 1 week divided into non-invasive treatment (casting only or closed reduction including casting) and invasive (Kirshner wires, intramedullary nailing [IMN], and open reduction internal fixation [ORIF]). The secondary outcomes were further sub-analyses on invasive treatment and age groups.</p><p><strong>Results: </strong>36,244 diaphyseal forearm fractures were investigated, yielding a mean incidence of 172 per 105/year. The proportion of fractures treated invasively increased from 1997 to 2016, from 4% to 23%. The use of Kirschner wires increased from 1% to 9%, IMN increased from 1% to 14%, and ORIF decreased from 2% to 1%. The changes were evident in all age groups but smaller in the 0-3-year age group.</p><p><strong>Conclusion: </strong>We found an increase in invasive treatment of pediatric diaphyseal forearm fractures over the investigated period. A change in invasive methods was also found, as the rate of IMN increased over the investigated period and became the predominant surgical treatment choice.</p>","PeriodicalId":6916,"journal":{"name":"Acta Orthopaedica","volume":"94 ","pages":"32-37"},"PeriodicalIF":2.5,"publicationDate":"2023-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/18/f3/ActaO-94-7132.PMC9893835.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9317830","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":"Physical capability and patient-reported well-being after spinal surgery: a 20-year cohort from the Kuopio Osteoporosis Risk Factor and Prevention study combined with the Finnish Care Register for Health Care.","authors":"Samuli Juopperi,&nbsp;Reijo Sund,&nbsp;Toni Rikkonen,&nbsp;Timo Nyyssönen,&nbsp;Heikki Kröger,&nbsp;Ville Turppo,&nbsp;Joonas Sirola","doi":"10.2340/17453674.2023.7129","DOIUrl":"https://doi.org/10.2340/17453674.2023.7129","url":null,"abstract":"<p><strong>Background and purpose: </strong>Studies investigating the effect of spinal surgery on both physical capability (PC) and subjective well-being (SW) are scarce. We aimed to investigate self-reported PC and SW up to 20 years after lumbar spine surgery.</p><p><strong>Patients and methods: </strong>6,612 postmenopausal Finnish women (47-56 years at baseline [BL]), from the Osteoporosis Risk Factor and Prevention (OSTPRE) study, were followed-up (FU) for 20 years. The Finnish Care Register for Healthcare (CRFH) provided data on surgery in the OSTPRE population on lumbar spinal stenosis (LSS) and lumbar disc herniation (LDH). PC and SW of women with lumbar surgery was compared with that of women without lumbar surgery. A chi-square analysis was conducted to analyze the statistical differences in the distribution of PC and SW. A propensity score-matched control analysis was also performed in addition to analysis of the total populationbased control group.</p><p><strong>Results: </strong>In women without lumbar surgery 94% reported good PC at BL, which decreased to 79% at the 20-year FU. For those with LSS/LDH surgery, 84%/(37/50) reported good PC at BL and 80%/(33/50) at 20-year FU, respectively. Good SW was reported by 48% of the control group at BL, 50% at 10-year FU, and 42% at 20-year FU. Women with LSS/LDH surgery before the 10-year FU reported good SW as follows: (6/50)/38% at BL, (12/48)/39% at 10-year FU, and (9/50)/37% at 20-year FU.</p><p><strong>Conclusion: </strong>Patients with LSS and LDH report lower PC and SW. Lumbar spinal surgery improves PC and SW in the short term, with early LDH surgery showing the greatest benefits whereas late surgery did not. Overall, PC and SW are lower both initially and during the 20-year FU when compared with the age-matched controls except for early LDH surgery.</p>","PeriodicalId":6916,"journal":{"name":"Acta Orthopaedica","volume":"94 ","pages":"19-25"},"PeriodicalIF":3.7,"publicationDate":"2023-01-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/85/f2/ActaO-94-7129.PMC9880765.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9667534","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":"Decreasing incidence of knee arthroscopy in Sweden between 2002 and 2016: a nationwide register-based study.","authors":"Lukas Berglund,&nbsp;Cecilia Liu,&nbsp;Johanna Adami,&nbsp;Mårten Palme,&nbsp;Abdul Rashid Qureshi,&nbsp;Li Felländer-Tsai","doi":"10.2340/17453674.2023.7131","DOIUrl":"https://doi.org/10.2340/17453674.2023.7131","url":null,"abstract":"<p><strong>Background and purpose: </strong>Several randomized trials have demonstrated the lack of effect of arthroscopic lavage as treatment for knee osteoarthritis (OA). These results have in turn resulted in a change in Swedish guidelines and reimbursement. We aimed to investigate the use of knee arthroscopies in Sweden between 2002 and 2016. Patient demographics, regional differences, and the magnitude of patients with knee OA undergoing knee arthroscopy were also analyzed.</p><p><strong>Patients and methods: </strong>Trends in knee arthroscopy were investigated using the Swedish Hospital Discharge Register (SHDR) to conduct a nationwide register-based study including all adults (>18 years of age) undergoing any knee arthroscopy between 2002 and 2016.</p><p><strong>Results: </strong>The total number of knee arthroscopies performed during the studied period was 241,055. The annual surgery rate declined in all age groups, for males and females as well as patients with knee OA. The incidence dropped from 247 to 155 per 105 inhabitants. Over 50% of arthroscopies were performed in metropolitan regions.</p><p><strong>Conclusion: </strong>We showed a dramatic decline in knee arthroscopy. There is variability in the surgery rate between males and females and among the regions of Sweden.</p>","PeriodicalId":6916,"journal":{"name":"Acta Orthopaedica","volume":"94 ","pages":"26-31"},"PeriodicalIF":3.7,"publicationDate":"2023-01-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/0e/7d/ActaO-94-7131.PMC9880875.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9681745","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Patient-reported outcome for 17,648 patients in 5 different Swedish orthopaedic quality registers before and 1 year after surgery: an observational study.","authors":"Maria C Cöster,&nbsp;Ann Bremander,&nbsp;Anna Nilsdotter","doi":"10.2340/17453674.2023.6577","DOIUrl":"https://doi.org/10.2340/17453674.2023.6577","url":null,"abstract":"<p><strong>Background and purpose: </strong>The EQ-5D is a patientreported outcome measure (PROM). To make priorities and allocate resources between patients and surgical procedures it is necessary to evaluate outcome differences, which is why comparing PROMs between registers is important. We compared EQ-5D data and the follow-up rate for selected diagnoses reported to Swedish orthopedic registers before and 1 year after surgery.</p><p><strong>Patients and methods: </strong>Patients from 5 orthopedic registers (Swespine, Swedish Hip Arthroplasty Register, Swedish Knee Arthroplasty Register, Swedankle, and Swefoot) who, in 2014-2018, underwent surgery in southern Sweden were included in the study. Data on the EQ-5D index, individual questions, and the EQ-VAS at baseline and at the 1-year follow-up was compared.</p><p><strong>Results: </strong>17,648 patients had completed the EQ-5D pre- and 1-year postoperatively. The follow-up rate ranged from 32% to 88%. All registers showed a statistical and clinically relevant improvement in the EQ-5D index (mean improvement 0.29-0.39), where patients who underwent hip arthroplasties experienced the largest improvement. The EQ-5D index improvements in patients with foot and ankle surgeries were larger than for patients with knee arthroplasties and spinal surgeries. The dimensions \"self-care\" and \"usual activities\" had the largest change in patients reporting \"some problems.\"</p><p><strong>Conclusion: </strong>All 5 registers showed a clinically relevant improvement 1 year postoperatively regarding the EQ-5D index, supporting continuous resource allocation to these groups of patients and surgical procedures. However, using PROM data to present register differences was challenged by the high number of non-responders.</p>","PeriodicalId":6916,"journal":{"name":"Acta Orthopaedica","volume":"94 ","pages":"1-7"},"PeriodicalIF":3.7,"publicationDate":"2023-01-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/01/df/ActaO-94-6577.PMC9880767.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9667533","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 European Bone and Joint Infection Society definition of periprosthetic joint infection is meaningful in clinical practice: a multicentric validation study with comparison with previous definitions.","authors":"Ricardo Sousa,&nbsp;Ana Ribau,&nbsp;Pedro Alfaro,&nbsp;Marc-Antoine Burch,&nbsp;Joris Ploegmakers,&nbsp;Martin McNally,&nbsp;Martin Clauss,&nbsp;Marjan Wouthuyzen-Bakker,&nbsp;Alex Soriano","doi":"10.2340/17453674.2023.5670","DOIUrl":"https://doi.org/10.2340/17453674.2023.5670","url":null,"abstract":"<p><strong>Background and purpose: </strong>A new periprosthetic joint infection (PJI) definition has recently been proposed by the European Bone and Joint Infection Society (EBJIS). The goals of this paper are to evaluate its diagnostic accuracy and compare it with previous definitions and to assess its accuracy in preoperative diagnosis.</p><p><strong>Patients and methods: </strong>We retrospectively evaluated a multicenter cohort of consecutive revision total hip and knee arthroplasties. Cases with minimum required diagnostic workup were classified according to EBJIS, 2018 International Consensus Meeting (ICM 2018), Infectious Diseases Society of America (IDSA), and modified 2013 Musculoskeletal Infection Society (MSIS) definitions. 2 years' minimum follow-up was required to assess clinical outcome.</p><p><strong>Results: </strong>Of the 472 cases included, PJI was diagnosed in 195 (41%) cases using EBJIS; 188 (40%) cases using IDSA; 172 (36%) using ICM 2018; and 145 (31%) cases using MSIS. EBJIS defined fewer cases as intermediate (5% vs. 9%; p = 0.01) compared with ICM 2018. Specificity was determined by comparing risk of subsequent PJI after revision surgery. Infected cases were associated with higher risk of subsequent PJI in every definition. Cases classified as likely/confirmed infections using EBJIS among those classified as not infected in other definitions showed a significantly higher risk of subsequent PJI compared with concordant non-infected cases using MSIS (RR = 3, 95% CI 1-6), but not using ICM 2018 (RR = 2, CI 1-6) or IDSA (RR = 2, CI 1-5). EBJIS showed the highest agreement between pre-operative and definitive classification (k = 0.9, CI 0.8-0.9) and was better at ruling out PJI with an infection unlikely result (sensitivity 89% [84-93], negative predictive value 90% [85-93]).</p><p><strong>Conclusion: </strong>The newly proposed EBJIS definition emerged as the most sensitive of all major definitions. Cases classified as PJI according to the EBJIS criteria and not by other definitions seem to have increased risk of subsequent PJI compared with concordant non-infected cases. EBJIS classification is accurate in ruling out infection preoperatively.</p>","PeriodicalId":6916,"journal":{"name":"Acta Orthopaedica","volume":"94 ","pages":"8-18"},"PeriodicalIF":3.7,"publicationDate":"2023-01-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/da/47/ActaO-94-5670.PMC9880768.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9667532","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 between duration of anticoagulant thromboprophylaxis and revision rate in primary total hip arthroplasty: a Danish and Norwegian nationwide cohort study.","authors":"Dennis Vinther, Aurelie Mailhac, Ina Trolle Andersen, Søren Overgaard, Stein Atle Lie, Anne Marie Fenstad, Jan-Erik Gjertsen, Ove Furnes, Alma B Pedersen","doi":"10.2340/17453674.2022.6243","DOIUrl":"10.2340/17453674.2022.6243","url":null,"abstract":"<p><strong>Background and purpose: </strong>There are concerns that bleeding following primary total hip arthroplasty (THA) contributes to prolonged wound drainage and prosthetic joint infection (PJI). We examined whether short (1-5 days), medium (6-14 days), and extended (≥ 15 days) duration of thromboprophylaxis is associated with the 5-year revision rate after THA due to osteoarthritis.</p><p><strong>Patients and methods: </strong>We performed a cohort study based on data from hip arthroplasty and administrative registries in Denmark and Norway (2008-2014). The outcome was revision surgery due to PJI, aseptic loosening or any cause, and patient mortality. Adjusted cause-specific hazard ratios (HRs) were analyzed with Cox regression analyses.</p><p><strong>Results: </strong>Among 50,482 THA patients, 8,333 received short, 17,009 received medium, and 25,140 received extended thromboprophylaxis. The HRs for revision due to PJI within 5 years were 1.0 (95%CI 0.7-1.3) and 1.1 (CI 0.9-1.3) for short and extended vs. medium treatment, whereas HR for extended vs. medium prophylaxis was 1.5 (CI 1.2-2.0) within 3 months. The HRs for revision due to aseptic loosening within 5 years were 1.0 (CI 0.7-1.4) and 1.1 (CI 0.9-1.4) for short and extended vs. medium treatment. The HRs for any revision within 5 years were 0.9 (CI 0.8-1.1) and 0.9 (CI 0.8-1.0) for short and extended vs. medium treatment. Extended vs. medium prophylaxis was associated with a decreased 0-3 month mortality. The absolute differences at 5 years were ≤ 1%.</p><p><strong>Conclusion: </strong>Our data suggests no association between duration of anticoagulant thromboprophylaxis and revision rate within 5 years of primary THA. The extended thromboprophylaxis might be associated with early increased revision rate due to PJI but also with lower mortality; however, the clinical relevance of this finding requires further research.</p>","PeriodicalId":6916,"journal":{"name":"Acta Orthopaedica","volume":"93 ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2022-12-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/4b/ab/ActaO-93-6243.PMC9795858.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9311581","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-surgeon sex discordance impacts adverse events but does not affect patient-reported satisfaction after primary total hip arthroplasty: a regional register-based cohort study.","authors":"Per Jolbäck,&nbsp;Sebastian Mukka,&nbsp;Kristin Wetterling,&nbsp;Maizar Mohaddes,&nbsp;Anne Garland","doi":"10.2340/17453674.2022.6228","DOIUrl":"https://doi.org/10.2340/17453674.2022.6228","url":null,"abstract":"<p><strong>Background and purpose: </strong>The sex of the surgeon has been proposed to be associated with a disparity in clinical outcomes after different surgical procedures. We investigated the association between surgeon-patient sex discordance and adverse events (AEs) and surgical AEs (SAEs) within 90 days after primary total hip arthroplasty (THA). We also investigated patient-reported satisfaction with surgical outcomes 1 year after the surgery.</p><p><strong>Patients and methods: </strong>We conducted a register-based cohort study including primary THAs performed due to osteoarthritis between 2008 and 2016 at 10 publicly managed hospitals in western Sweden. Hospital data was linked to the Swedish Arthroplasty Register and a regional patient register. Logistic regression models investigated discordant sex of patients and surgeons on AEs/SAEs and patient-reported satisfaction with the surgical outcome.</p><p><strong>Results: </strong>11,993 primary THAs were included in the study. The proportion of AEs for the concordant group was 7.3% and for the discordant group 6.1%. For SAEs, the proportion was 5.0% for the concordant group and 4.3% for the discordant group. After adjustment the discordant group still had a lower likelihood of an AE or SAE than the concordant group: adjusted odds ratio (aOR) for AE (0.82, 95%CI 0.71-0.95) and for SAE (0.86, CI 0.72-0.99). No association was detected between patient-reported satisfaction and sex discordance.</p><p><strong>Conclusion: </strong>Sex discordance between surgeons and patients is linked to a decreased risk of an AE but not a lower level of patient-reported satisfaction with the surgical outcome.</p>","PeriodicalId":6916,"journal":{"name":"Acta Orthopaedica","volume":"93 ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2022-12-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/bf/4f/ActaO-93-6228.PMC9795824.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9311580","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":"Early migration in unicompartmental knee arthroplasty: a radiostereometric study of 26 patients with 24 months of follow-up.","authors":"Jantsje H Pasma,&nbsp;Brechtje Hesseling,&nbsp;Nicole De Esch,&nbsp;Hennie Verburg,&nbsp;Dieu D Niesten,&nbsp;Nina M C Mathijssen","doi":"10.2340/17453674.2022.5672","DOIUrl":"https://doi.org/10.2340/17453674.2022.5672","url":null,"abstract":"<p><strong>Background and purpose: </strong>Aseptic loosening, mainly caused by migration, is one of the most common indications for revisions in unicompartmental knee arthroplasty (UKA). In this study, we investigated the early migration of the Persona Partial Knee (PPK, Zimmer Biomet, Warsaw, IN), a cemented medial fixed-bearing unicompartmental knee prosthesis, and evaluated the clinical results.</p><p><strong>Patients and methods: </strong>26 primary PPKs were implanted. Radiographs were obtained direct postoperatively, at 6 weeks, 6, 12 and 24 months postoperatively. Migration of the femoral and tibial component was calculated using model-based radiostereophotogrammetric analysis (mRSA) in terms of translations and rotations. Patient-reported outcome measures (PROMs) were also registered.</p><p><strong>Results: </strong>At 24 months postoperatively, we found low migration of both the femoral and tibial component in the first 6 months, after which both components stabilized. Only the rotation of the tibial component about the z-axis did not stabilize. All PROMs improved after 24 months compared with preoperative PROMs.</p><p><strong>Conclusion: </strong>The Persona Partial Knee shows low migration of both the femoral and tibial component and PROMs were improved at 24 months follow-up. Long-term follow-up is needed to investigate the performance of the prosthesis compared with other prostheses.</p>","PeriodicalId":6916,"journal":{"name":"Acta Orthopaedica","volume":"93 ","pages":"914-921"},"PeriodicalIF":3.7,"publicationDate":"2022-12-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/9e/8a/ActaO-93-5672.PMC9772924.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9681220","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":"Cemented and cementless dual mobility cups show similar fixation, low polyethylene wear, and low serum cobalt-chromium in elderly patients: a randomized radiostereometry study with 6 years' follow-up.","authors":"Peter Bo Jørgensen, Steffan Tabori-Jensen, Inger Mechlenburg, Morten Homilius, Torben Bæk Hansen, Maiken Stilling","doi":"10.2340/17453674.2022.5761","DOIUrl":"10.2340/17453674.2022.5761","url":null,"abstract":"<p><strong>Background and purpose: </strong>Dual mobility (DM) articulation total hip arthroplasty (THA) is used increasingly to reduce dislocation risk. We investigated cup fixation, polyethylene (PE) wear, serum chromium and cobalt ions, and their correlation to physical activity in patients with DM cups at 6-year follow-up.</p><p><strong>Patients and methods: </strong>In a patient-blinded RCT, 60 patients with hip osteoarthritis at a median age of 74 years (70-82) were randomly allocated to cemented (n = 30) or cementless hydroxyapatite-coated (n = 30) fixation of Avantage DM THA with a highly-crosslinked vitamin-E PE liner. Cup migration and PE wear were measured with radiostereometric analysis (RSA), chromium and cobalt ions were measured in serum, and physical activity was measured with accelerometers.</p><p><strong>Results: </strong>At 6-year follow-up, proximal cup migration was similar: 0.14 mm (95% CI 0.01-0.28) for cemented cups and 0.21 mm (0.02-0.39) for cementless cups. The PE wear rate from 1- to 6-year follow-up was also similar: 0.06 mm/year (0.04-0.09) for cemented cups and 0.07 mm/year (0.04-0.11) for cementless cups. Serum metal ion levels were undetectable or very low. Physical activity was mainly low intensity and did not correlate to PE wear rate or cup migration.</p><p><strong>Conclusion: </strong>Cemented and cementless DM cups with highly crosslinked vitamin-E infused liners have similar cup migration and PE wear when used for primary THA surgery.</p>","PeriodicalId":6916,"journal":{"name":"Acta Orthopaedica","volume":"93 ","pages":"906-913"},"PeriodicalIF":2.5,"publicationDate":"2022-12-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/8b/4d/ActaO-93-5761.PMC9772923.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9681222","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}