| 1. |
- Angelomenos, Vasileios, et al.
(författare)
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Precision of low-dose CT-based micromotion analysis technique for the assessment of early acetabular cup migration compared with gold standard RSA: a prospective study of 30 patients up to 1 year
- 2022
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Ingår i: Acta Orthopaedica. - : Medical Journals Sweden AB. - 1745-3674 .- 1745-3682. ; 93, s. 459-465
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Tidskriftsartikel (refereegranskat)abstract
- Background and purpose - Computed tomography micromotion analysis (CTMA) can be used to determine implant micro-movements using low-dose CT scans. By using CTMA, a non-invasive measurement of joint implant movement is enabled. We evaluated the precision of CTMA in measuring early cup migration. Standard marker-based radiostereometric analysis (RSA) was used as reference. We hypothesised that CTMA can be used as an alternative to RSA in assessing implant micromotions. Patients and methods - We included 30 patients undergoing total hip arthroplasty (THA). Acetabular cup migration at 1 year was measured with RSA and CTMA. To determine the precision of both methods, 20 double examinations (postoperatively) with repositioning of the patients were performed. The precision was calculated from zero by assuming that there was no motion of the prosthesis between the 2 examinations. Results - The precision of RSA ranged from 0.06 to 0.15 mm for translations and 0.21 degrees to 0.63 degrees for rotations. Corresponding values for CTMA were 0.06 to 0.13 mm and 0.23 degrees to 0.35 degrees. A good level of agreement was found between the methods regarding cup migration and rotation at 1 year. Interpretation - The precision of CTMA in measuring acetabular cup migration and rotation is comparable to marker-based RSA. CTMA could possibly thus be used as an alternative method to detect early implant migration.
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| 2. |
- Aslani, H., et al.
(författare)
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Iranian Joint Registry (Iranian National Hip and Knee Arthroplasty Registry)
- 2016
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Ingår i: Archives of Bone and Joint Surgery-Abjs. - 2345-4644. ; 4:2, s. 192-196
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Tidskriftsartikel (refereegranskat)abstract
- Periodic evaluation and monitoring the health and economic outcome of joint replacement surgery is a common and popular process under the territory of joint registries in many countries. In this article we introduce the methodology used for the foundation of the National Iranian Joint Registry ( IJR) with a joint collaboration of the Social Security Organization (SSO) and academic research departments considering the requirements of the Iran's Ministry of Health and Education.
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| 3. |
- Bergh, Camilla, et al.
(författare)
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Increased risk of revision in patients with non-traumatic femoral head necrosis.
- 2014
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Ingår i: Acta orthopaedica. - : Medical Journals Sweden AB. - 1745-3682 .- 1745-3674. ; 85:1, s. 11-17
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Tidskriftsartikel (refereegranskat)abstract
- Background and purpose Previous studies of patients who have undergone total hip arthroplasty (THA) due to femoral head necrosis (FHN) have shown an increased risk of revision compared to cases with primary osteoarthritis (POA), but recent studies have suggested that this procedure is not associated with poor outcome. We compared the risk of revision after operation with THA due to FHN or POA in the Nordic Arthroplasty Register Association (NARA) database including Denmark, Finland, Norway, and Sweden. Patients and methods 427,806 THAs performed between 1995 and 2011 were included. The relative risk of revision for any reason, for aseptic loosening, dislocation, deep infection, and periprosthetic fracture was studied before and after adjustment for covariates using Cox regression models. Results 416,217 hips with POA (mean age 69 (SD 10), 59% females) and 11,589 with FHN (mean age 65 (SD 16), 58% females) were registered. The mean follow-up was 6.3 (SD 4.3) years. After 2 years of observation, 1.7% in the POA group and 3.0% in the FHN group had been revised. The corresponding proportions after 16 years of observation were 4.2% and 6.1%, respectively. The 16-year survival in the 2 groups was 86% (95% CI: 86-86) and 77% (CI: 74-80). After adjusting for covariates, the relative risk (RR) of revision for any reason was higher in patients with FHN for both periods studied (up to 2 years: RR = 1.44, 95% CI: 1.34-1.54; p < 0.001; and 2-16 years: RR = 1.25, 1.14-1.38; p < 0.001). Interpretation Patients with FHN had an overall increased risk of revision. This increased risk persisted over the entire period of observation and covered more or less all of the 4 most common reasons for revision.
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| 4. |
- Brynjólfsson, Siggeir Fannar, et al.
(författare)
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Long-lived plasma cells in human bone marrow can be either CD191(+) or CD19(-)
- 2017
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Ingår i: Blood Advances. - : American Society of Hematology. - 2473-9529 .- 2473-9537. ; 1:13, s. 835-838
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Tidskriftsartikel (refereegranskat)abstract
- Long-lived plasma cells secreting vaccinia-specific antibodies are detected in human bone marrow >35 years after the eradication of smallpox. Long-lived plasma cells secreting vaccinia-specific antibodies are still able to express the B-lymphocyte antigen CD19.
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| 5. |
- Bunyoz, K. I., et al.
(författare)
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No difference in whole-blood metal ions between 32-mm and 36-to 44-mm femoral heads in metal-on-polyethylene total hip arthroplasty: a 2-year report from a randomised control trial
- 2023
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Ingår i: HIP International. - : SAGE Publications. - 1120-7000 .- 1724-6067. ; 33:2, s. 184-192
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Tidskriftsartikel (refereegranskat)abstract
- Aim: To investigate the effect of femoral head size on blood metal-ion levels caused by taper corrosion in metal-on-polyethylene total hip arthroplasty, comparing 36- to 44-mm heads with 32-mm heads. Methods: In a randomised, controlled, single-blinded trial, 96 patients were allocated to receive either a 32-mm metal head or the largest possible metal head (36-44 mm) that could be accommodated in the thinnest available vitamin E, cross-linked polyethylene insert. Blood metal ion levels were collected at 1- and 2-year follow-ups. Results: At 1-year, metal-ion levels did not differ between the groups. The median (interquartile range) blood-ion levels for the 32-mm versus the 36- to 44-mm group were 0.11 mu g/L (0.08-0.15) versus 0.12 mu g/L (0.08-0.22), p = 0.546, for cobalt, 0.50 mu g/L (0.50-0.59) versus 0.50 mu g/L (0.50-1.20), p = 0.059, for chromium and 1.58 mu g/L (1.38-2.05) versus 1.48 mu g/L (1.14-1.87), p = 0.385, for titanium. At 2 years, there was no difference either and the corresponding values were 0.15 mu g/L (0.12-0.24) versus 0.18 mu g/L (0.12-0.28), p = 0.682 for cobalt, 0.50 mu g/L (0.50-0.50) versus 0.50 mu g/L (0.50-0.57), p = 0.554, for chromium and 1.54 mu g/L (1.16-1.87) versus 1.42 mu g/L (1.01-1.72), p = 0.207 for titanium. Conclusions: The use of the largest possible metal head (36-44 mm) compared to a 32-mm head in metal-on-polyethylene bearings does not appear to elevate blood metal-ion levels up to 2 years postoperatively. As taper corrosion is probably time-dependent, longer-term reports are needed to evaluate the association between large metal heads and blood metal ion levels. Trial registration: ClinicalTrials.gov (reg. ID NCT0231 6704)
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| 6. |
- Bunyoz, Kristine, et al.
(författare)
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The size of the femoral head does not influence metal ion levels after metal-onpolyethylene total hip arthroplasty: a five-year report from a randomized controlled trial
- 2024
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Ingår i: BONE & JOINT JOURNAL. - 2049-4394. ; 106B:3, s. 31-37
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Tidskriftsartikel (refereegranskat)abstract
- Aims In metal-on- polyethylene (MoP) total hip arthroplasty (THA), large metal femoral heads have been used to increase stability and reduce the risk of dislocation. The increased size of the femoral head can, however, lead to increased taper corrosion, with the release of metal ions and adverse reactions. The aim of this study was to investigate the relationship between the size of the femoral head and the levels of metal ions in the blood in these patients. Methods A total of 96 patients were enrolled at two centres and randomized to undergo MoP THA using either a 32 mm metal head or a femoral head of between 36 mm and 44 mm in size, being the largest possible to fit the thinnest available polyethylene insert. The levels of metal ions and patient-reported outcome measures (Oxford Hip Score, University of California, Los Angeles Activity Scale) were recorded at two and five years postoperatively. Results At five years, the median levels of chromium, cobalt, and titanium were 0.5 mu g/l (interquartile range (IQR) 0.50 to 0.62), 0.24 mu g/l (IQR 0.18 to 0.30), and 1.16 mu g/l (IQR 1.0 to 1.68) for the 32 mm group, and 0.5 mu g/l (IQR 0.5 to 0.54), 0.23 mu g/l (IQR 0.17 to 0.39), and 1.30 mu g/l (IQR 1 to 2.05) for the 36 mm to 44 mm group, with no significant difference between the groups (p = 0.825, p = 1.000, p = 0.558). There were increased levels of metal ions at two years postoperatively in seven patients in the 32 mm group, compared with four in the 36 mm to 44 mm group, and at five years postoperatively in six patients in the 32 mm group, compared with seven in the 36 mm to 44 mm group. There was no significant difference in either the OHS (p = 0.665) or UCLA (p = 0.831) scores between patients with or without an increased level of metal ions. Conclusion In patients who underwent MoP THA, we found no differences in the levels of metal ions five years postoperatively between those with a femoral head of 32 mm and those with a femoral head of between 36 mm and 44 mm, and no corrosion-related revisions. As taper corrosion can start after five years, there remains a need for longer-term studies investigating the relationship between the size of the femoral head size and corrosion in patients undergoing MoP THA.
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| 7. |
- Chamat, J., et al.
(författare)
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Avascular necrosis in a patient diagnosed with coxartrosis : Patient med diagnosen koxartros visade sig ha avaskulär nekros. Mindre vanlig orsak till ledsmärta med hög morbiditet
- 2019
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Ingår i: Lakartidningen. - 1652-7518. ; 116
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Tidskriftsartikel (refereegranskat)abstract
- Coxartrosis is a common cause of hip pain among the elderly population. Avascular necrosis (AVN), also known as osteonecrosis, is a disease that most commonly affects the femoral head as a result of decreased blood supply to the bone. The etiology and pathogenesis is still unclear, but there are various traumatic and atraumatic factors that have been suggested as risk factors for AVN. However, almost half of the patients present none of these risk factors. Compared to coxartrosis, AVN typically occurs in a younger population. Initially it can be difficult to differ between these conditions. Plain film radiographic findings are absent in early stages of AVN, but magnetic resonance imaging (MRI) can provide early diagnosis. Thereby, MRI is the golden standard of noninvasive diagnostic evaluation. We present a patient with bilateral AVN that initially was diagnosed with coxartrosis.
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| 8. |
- Cnudde, Peter, 1970, et al.
(författare)
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Association between patient survival following reoperation after total hip replacement and the reason for reoperation: an analysis of 9,926 patients in the Swedish Hip Arthroplasty Register
- 2019
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Ingår i: Acta Orthopaedica. - : Medical Journals Sweden AB. - 1745-3674 .- 1745-3682. ; 90:3, s. 226-230
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Tidskriftsartikel (refereegranskat)abstract
- Background and purpose The association between long-term patient survival and elective primary total hip replacement (THR) has been described extensively. The long-term survival following reoperation of THR is less well understood. We investigated the relative survival of patients undergoing reoperation following elective THR and explored an association between the indication for the reoperation and relative survival.Patients and methods In this observational cohort study we selected the patients who received an elective primary THR and subsequent reoperations during 1999-2017 as recorded in the Swedish Hip Arthroplasty Register. The selected cohort was followed until the end of the study period, censoring or death. The indications for 1st- and eventual 2nd-time reoperations were analyzed and the relative survival ratio of the observed survival and the expected survival was determined.Results There were 9,926 1st-time reoperations and of these 2,558 underwent further reoperations. At 5 years after the latest reoperation, relative survival following 1st-time reoperations was 0.94% (95% CI 0.93-0.96) and 0.90% (CI 0.87-0.92) following 2nd-time reoperations. At 5 years patients with a 1st-time reoperation for aseptic loosening had higher survival than expected; however, reoperations performed for periprosthetic fracture, dislocation, and infection had lower survival.Interpretation The relative survival following 1st- and 2nd-time reoperations in elective THR patients differs by reason for reoperation. The impact of reoperation on life expectancy is more obvious for infection/dislocation and periprosthetic fracture.
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| 9. |
- Cnudde, Peter, 1970, et al.
(författare)
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Cement-in-cement revision of the femoral stem: analysis of 1179 first-time revisions in the Swedish Hip Arthroplasty Register.
- 2017
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Ingår i: The bone & joint journal. - 2049-4408. ; 99-B:4 Supple B, s. 27-32
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Tidskriftsartikel (refereegranskat)abstract
- Compared with primary total hip arthroplasty (THA), revision surgery can be challenging. The cement-in-cement femoral revision technique involves removing a femoral component from a well-fixed femoral cement mantle and cementing a new stem into the original mantle. This technique is widely used and when carried out for the correct indications, is fast, relatively inexpensive and carries a reduced short-term risk for the patient compared with the alternative of removing well-fixed cement. We report the outcomes of this procedure when two commonly used femoral stems are used.We identified 1179 cement-in-cement stem revisions involving an Exeter or a Lubinus stem reported to the Swedish Hip Arthroplasty Register (SHAR) between January 1999 and December 2015. Kaplan-Meier survival analysis was performed.Survivorship is reported up to six years and was better in the Exeter group (91% standard deviation (sd) 2.8% versus 85% sd 5.0%) (p = 0.02). There was, however, no significant difference in the survival of the stem and risk of re-revision for any reason (p = 0.58) and for aseptic loosening (p = 0.97), between revisions in which the Exeter stem (94% sd 2.2%; 98% sd 1.6%) was used compared with those in which the Lubinus stem (95% sd 3.2%; 98% sd2.2%) was used. The database did not allow identification of whether a further revision was indicated for loosening of the acetabular or femoral component or both.The cement-in-cement technique for revision of the femoral component gave promising results using both designs of stem, six years post-operatively. Cite this article: Bone Joint J 2017;99-B(4 Supple B):27-32.
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| 10. |
- Cnudde, Peter, 1970, et al.
(författare)
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Is Preoperative Patient-Reported Health Status Associated with Mortality after Total Hip Replacement?
- 2017
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Ingår i: International Journal of Environmental Research and Public Health. - : MDPI AG. - 1660-4601. ; 14:8
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Tidskriftsartikel (refereegranskat)abstract
- The influence of comorbidities and worse physical status on mortality following total hip replacement (THR) leads to the idea that patient-reported health status may also be a predictor of mortality. The aim of this study was to investigate the relationship between patient-reported health status before THR and the risk of dying up to 5 years post-operatively. For these analyses, we used register data on 42,862 THR patients with primary hip osteoarthritis operated between 2008 and 2012. The relative survival ratio was calculated by dividing the observed survival in the patient group by age-and sex-adjusted expected survival of the general population. Pre-operative responses to the five EQ-5D-3L (EuroQol Group) dimensions along with age, sex, education status, year of surgery, and hospital type were used as independent variables. Results shown that, as a group, THR patients had a better survival than the general population. Broken down by the five EQ-5D-3L dimensions we observed differentiated survival patters. For all dimensions, those reporting extreme problems had higher mortality than those reporting moderate or no problems. In conclusion, worse health status according to the EQ-5-3L before THR is associated with higher mortality up to five years after surgery. EQ-5D-3L responses may be useful in a multifactorial individualized risk assessment before THR.
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