| 1. |
- Vala, Cecilie Hongslo, 1983, et al.
(författare)
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Risk for hip fracture before and after total knee replacement in Sweden
- 2020
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Ingår i: Osteoporosis International. - : Springer Science and Business Media LLC. - 0937-941X .- 1433-2965. ; 31:5, s. 887-895
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Tidskriftsartikel (refereegranskat)abstract
- We studied the risk for hip fracture before and after total knee replacement (TKR) in the entire population in Sweden. Women and men had a low risk for hip fracture before TKR but an increased risk the first year after TKR. Purpose It is known that osteoarthritis is associated with high bone mass. We therefore studied the risk of hip fracture before and after total knee replacement (TKR), risk of different hip fracture types, and risk subdivided in genders and age groups. Methods We followed the total Swedish population born between 1902 and 1952 (n = 4,258,934) during the period 1987-2002 and identified all patients with TKR due to primary OA (n = 39,291), and all patients with hip fracture (n = 195,860) in the Swedish National Inpatient Register. The risk time analyses were based on Poisson regression models. Results The hazard ratio (HR) for hip fracture the last year before TKR was 0.86 (95% CI 0.74 to 1.00) and the first year after 1.26 (95% CI 1.11 to 1.42) compared to individuals without TKR. The HR for femoral neck fracture 0-10 years after TKR was 0.95 (95% CI 0.89 to 1.01) and for trochanteric fracture was 1.13 (95% CI 1.06 to 1.21). The HR for hip fracture in the age group 50-74 was 1.28 (95% CI 1.14 to 1.43) and in the age group 75-90 years was 0.99 (95% CI 0.94 to 1.04) 0-10 years after TKR, compared to individuals without TKR. Conclusion Individuals had a low risk for hip fracture before TKR but an increased risk the first year after TKR. The risk in individuals below age 75 years and for trochanteric fractures was increased after TKR. Possible explanations include changed knee kinematics after a TKR, physical activity level, fall risk, and other unknown factors.
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| 2. |
- Leonardsson, Olof, et al.
(författare)
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Outcome after primary and secondary replacement for subcapital fracture of the hip in 10 264 patients.
- 2009
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Ingår i: The Journal of bone and joint surgery. British volume. - 0301-620X .- 2044-5377. ; 91:5, s. 595-600
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Tidskriftsartikel (refereegranskat)abstract
- Between 1999 and 2005, 10 264 patients who had undergone total hip replacement (THR) for subcapital fracture of the hip were compared with 76 520 in whom THR had been performed for other reasons. All the cases were identified through the Swedish Hip Arthroplasty Register. The THRs performed as primary treatment for fracture were also compared with those done after failure of internal fixation. After seven years the rate of revision was higher in THR after fracture (4.4% vs 2.9%). Dislocation and periprosthetic fracture were the most common causes of revision. The risk was higher in men than in women. The type of femoral component and the surgical approach influenced the risk. After correction for gender, type of component and the surgical approach the revision rates were similar in the primary and secondary fracture THR groups. Total hip replacement is therefore a safe method for both the primary and secondary management of fracture of the hip.
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| 3. |
- Lindgren, J. V., et al.
(författare)
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Patient-reported outcome is influenced by surgical approach in total hip replacement : a study of the Swedish Hip Arthroplasty Register including 42,233 patients
- 2014
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Ingår i: The Bone & Joint Journal. - London, United Kingdom : British Editorial Society of Bone and Joint Surgery. - 2049-4394 .- 2049-4408. ; 96-B:5, s. 590-596
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Tidskriftsartikel (refereegranskat)abstract
- The effects of surgical approach in total hip replacement on health-related quality of life and long-term pain and satisfaction are unknown. From the Swedish Hip Arthroplasty Register, we extracted data on all patients that had received a total hip replacement for osteoarthritis through either the posterior or the direct lateral approach, with complete pre- and one-year post-operative Patient Reported Outcome Measures (PROMs). A total of 42 233 patients met the inclusion criteria and of these 4962 also had complete six-year PROM data. The posterior approach resulted in an increased mean satisfaction score of 15 (sd 19) vs. 18 (sd 22) (p < 0.001) compared with the direct lateral approach. The mean pain score was 13 (sd 17) vs. 15 (sd 19) (p < 0.001) and the proportion of patients with no or minimal pain was 78% vs. 74% (p < 0.001) favouring the posterior approach. The patients in the posterior approach group reported a superior mean EQ-5D index of 0.79 (sd 0.23) vs. 0.77 (sd 0.24) (p < 0.001) and mean EQ score of 76 (sd 20) vs. 75 (sd 20) (p < 0.001). All observed differences between the groups persisted after six years follow-up. Although PROMs after THR in general are very good regardless of surgical approach, the results indicate that some patients operated by the direct lateral approach report an inferior outcome compared with the posterior approach. The large number of procedures and the seemingly sustained differences make it likely these findings are clinically relevant.
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| 4. |
- Ranstam, Jonas, et al.
(författare)
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Statistical analysis of arthroplasty data : I. Introduction and background
- 2011
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Ingår i: Acta orthopaedica. - : Medical Journals Sweden AB. - 1745-3682 .- 1745-3674. ; 82:3, s. 253-257
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Tidskriftsartikel (refereegranskat)abstract
- It is envisaged that guidelines for statistical analysis and presentation of results will improve the quality and value of research. The Nordic Arthroplasty Register Association (NARA) has therefore developed guidelines for the statistical analysis of arthroplasty register data. The guidelines are divided into two parts, this one with an introduction and a discussion of the background to the guidelines, and the second one with a more technical statistical discussion on how specific problems can be handled (Ranstam et al. 2011b, see pages x-y in this issue). This first part contains an overview of implant survival analysis and statistical methods used to evaluate factors with a potential influence on this outcome.
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| 5. |
- Ranstam, Jonas, et al.
(författare)
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Statistical analysis of arthroplasty data : II. Guidelines
- 2011
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Ingår i: Acta orthopaedica. - : Medical Journals Sweden AB. - 1745-3682 .- 1745-3674. ; 82:3, s. 258-67
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Tidskriftsartikel (refereegranskat)abstract
- It is envisaged that guidelines for statistical analysis and presentation of results will improve the quality and value of research. The Nordic Arthroplasty Register Association (NARA) has therefore developed guidelines for the statistical analysis of arthroplasty register data. The guidelines are divided into two parts, one with an introduction and a discussion of the background to the guidelines (Ranstam et al. 2011a, see pages x-y in this issue), and this one with a more technical statistical discussion on how specific problems can be handled. This second part contains (1) recommendations for the interpretation of methods used to calculate survival, (2) recommendations on howto deal with bilateral observations, and (3) a discussion of problems and pitfalls associated with analysis of factors that influence survival or comparisons between outcomes extracted from different hospitals.
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| 6. |
- Shareghi, Bita, et al.
(författare)
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Wear of Vitamin E-Infused Highly Cross-Linked Polyethylene at Five Years
- 2017
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Ingår i: Journal of Bone and Joint Surgery-American Volume. - : Ovid Technologies (Wolters Kluwer Health). - 0021-9355 .- 1535-1386. ; 99:17, s. 1447-1452
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Tidskriftsartikel (refereegranskat)abstract
- Background: In an earlier study with a 2-year follow-up of uncemented cups, we had reported low femoral-head penetration of vitamin E-infused highly cross-linked polyethylene liners (E1) compared with highly cross-linked liners without vitamin E (ArComXL). We studied the penetration rate of E1 compared with that of ArComXL, with a focus on changes occurring between 2 and 5 years after total hip arthroplasty. Methods: In this randomized controlled study, we performed radiostereometric analysis of the penetration rate up to 5 years in 63 hips. Results: During the total period of observation, the median proximal penetration for E1, 0.13 mm (mean, 0.11 mm [95% confidence interval (CI), 0.08 to 0.14 mm]), was lower than that for ArComXL, 0.20 mm (mean, 0.22 mm [95% CI, 0.17 to 0.26 mm]). The median proximal penetration rate between 2 and 5 years was 0.02 mm/yr (mean, 0.01 mm/yr [95% CI, 0.01 to 0.02 mm/yr]) for E1 and 0.04 mm/yr (mean, 0.04 mm/yr [95% CI, 0.03 to 0.05 mm/yr) for ArComXL. The corresponding median total (i.e., 3-dimensional resultant) penetration rates were 0.04 mm/yr (mean, 0.04 mm/yr [95% CI, 0.03 to 0.05 mm/yr]) for E1 and 0.07 mm/yr (mean, 0.08 mm/yr [95% CI, 0.06 to 0.10 mm/yr]) for ArComXL. Conclusions: From years 2 to 5, we observed increased penetration in both groups. The penetration rate was higher for ArComXL, resulting in more proximal and total penetration at 5 years than for E1. Level of Evidence: Therapeutic Level I. See Instructions for Authors for a complete description of levels of evidence.
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| 7. |
- Valstar, E. R., et al.
(författare)
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Guidelines for standardization of radiostereometry (RSA) of implants
- 2005
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Ingår i: Acta Orthop. - : Medical Journals Sweden AB. - 1745-3674 .- 1745-3682. ; 76:4, s. 563-572
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Tidskriftsartikel (refereegranskat)abstract
- There is a need for standardization of radiostereometric (RSA) investigations to facilitate comparison of outcome reported from different research groups. In this document, 6 research centers have agreed upon standards for terminology, description and use of RSA arrangement including radiographic set-up and techniques. Consensus regarding minimum requirements for marker stability and scatter, choice of coordinate systems, and preferred way of describing prosthetic micromotion is of special interest. Some notes on data interpretation are also presented. Validation of RSA should be standardized by preparation of protocols for assessment of accuracy and precision. Practical issues related to loading of the joint by weight bearing or other conditions, follow-up intervals, length of follow-up, radiation dose, and the exclusion of patients due to technical errors are considered. Finally, we present a checklist of standardized output that should be included in any clinical RSA paper.This document will form the basis of a detailed standardization protocol under supervision of ISO and the European Standards Working Group on Joint Replacement Implants (CEN/TC 285/WG4). This protocol will facilitate inclusion of RSA in a standard protocol for implant testing before it is released for general use. Such a protocol-also including other recognized clinical outcome parameters-will reduce the risk of implanting potentially inferior prostheses on a large scale.
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| 8. |
- Kärrholm, Johan, 1951, et al.
(författare)
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Effects on work resumption of a co-operation project in vocational rehabilitation. Systematic, multi-professional, client-centred and solution-oriented co-operation
- 2006
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Ingår i: Disabil Rehabil. - : Informa UK Limited. - 0963-8288 .- 1464-5165. ; 28:7, s. 457-67
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Tidskriftsartikel (refereegranskat)abstract
- PURPOSE: The present aim was to evaluate the effect of systematic multi-professional co-ordinated rehabilitation (the Stockholm Co-operation Project) on the number of days' sick leave during the first and second half-years after the rehabilitation co-ordination period, compared to the year before. Another aim was to evaluate the economic effects at national level. METHOD: A matched-pairs design was used. The study group was based on 64 rehabilitees employed by a public employer in Stockholm, who took part in a systematic multi-professional co-operation project. To obtain pairs, the 64 individuals were individually matched with 64 people who received conventionally organised rehabilitation. Thus, there were 128 subjects altogether. RESULTS: The study group had substantially less sick leave days per month than the comparison group during the second half-year after the rehabilitation co-ordination period. The effect was even greater in a subgroup with more previous sick leave. During the first half-year after the intervention the comparison group had relatively more sick leave. No effect was found for a subgroup with less previous sick leave. The economic benefit of the intervention was estimated to 1,278 euros per month and person based on the whole group, and to 2,405 euros per month and person based on those with more sick leave. CONCLUSIONS: People who undergo co-ordinated rehabilitation have more working days after the intervention period than those with conventional rehabilitation. This way for rehabilitation actors to co-operate gives better outcomes for rehabilitation cases with long previous sick leave, but not for cases with less previous sick leave. It also generates economic gains at several levels.
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| 9. |
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| 10. |
- Axelsson, Peter, 1963, et al.
(författare)
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New Methods to Assess Forearm Torque and Lifting Strength: Reliability and Validity
- 2018
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Ingår i: Journal of Hand Surgery-American Volume. - : Elsevier BV. - 0363-5023. ; 43:9
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Tidskriftsartikel (refereegranskat)abstract
- Purpose To determine the repeatability and validity of new methods designed to objectively measure forearm torque and lifting strength in a clinical setting. Methods Twenty-eight healthy volunteers, 19 women and 9 men, were tested for lifting strength and forearm torque with the Kern and Baseline dynamometers. Two raters tested each participant on 3 occasions in the standing position. One of the raters also examined 15 subjects, 3 times, for forearm torque in the seated position and for lifting strength and forearm torque by the Work Simulator II, Baltimore Therapeutic Equipment (BTE II). Intraclass correlation coefficients (ICC) model 2,1 was used to calculate ICCs for intra- and intenater reliability. The same ICC model and Bland-Altman plots were used to analyze the validity and agreement between the new test methods and the BTE II equipment and for comparison between tests performed in the standing and seated positions. Results Intra- and interrater reliability for forearm torque measurements with both the Baseline and the BTE II demonstrated ICCs between 0.88 and 0.96. The comparison between the Baseline and the BTE equipment yielded lower ICCs of 0.74 to 0.88 but they were still substantial and in good agreement. The ICCs for torques recorded in the standing and seated position were 0.89 to 0.96. Lifting strength, measured in 3 different positions of forearm rotation, yielded ICC values between 0.84 and 0.96 for both raters and with both the Kern and the BTE II instruments. Similarly, comparisons between the Kern and the BTE II methods showed ICC values between 0.91 and 0.95. Conclusions Both the Baseline and the Kern dynamometers demonstrated excellent intra- and interrater repeatability. Except for forearm torque test in direction of pronation, which had a slightly lower ICC of 0.74, our new methods were valid when the BTE II was used as the reference standard. Assessments in the standing or seated position for torque measurements made little difference. Thus, we found the quality of measurements performed with our new methods sufficient for future studies of forearm torque and lifting strength. Copyright (C) 2018 by the American Society for Surgery of the Hand. All rights reserved.
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