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- Lacny, Sarah, et al.
(författare)
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Competing risks methods are recommended for estimating the cumulative incidence of revision arthroplasty for health care planning purposes
- 2021
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Ingår i: Orthopedics. - : SLACK, Inc.. - 0147-7447 .- 1938-2367. ; 44:4, s. 549-555
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Forskningsöversikt (refereegranskat)abstract
- Cumulative incidence of revision provides a measure of the failure rate of joint replacements and can be used to project demand for revisions. The most commonly applied survival analysis method (Kaplan-Meier [KM]) does not account for competing risks (eg, death). The authors compared the cumulative incidence function (CIF), a competing risks method, with the KM method through application to population-based cohorts. They measured time to revision, death, or censoring for unilateral total hip arthroplasty (THA; n=12,496) and total knee arthroplasty (TKA; n=19,172) cohorts in administrative databases in Alberta and TKAs (n=80,177) in the Swedish Knee Arthroplasty Register. The authors compared relative differences between the KM and CIF. They fitted Cox, Fine and Gray, and Royston and Parmar regression models and compared coefficients, standard errors, and P values. On sensitivity analysis, the authors included staged bilateral operations. Kaplan-Meier estimates exceeded the CIF at each time point. The magnitude of overestimation increased with follow-up time and was greatest for the Swedish cohort. At 5 years, relative differences between KM and CIF estimates for the Alberta THA and TKA and Swedish TKA cohorts were 1.8%, 2.3%, and 3.8%, respectively. These differences increased to 3.1%, 5.8%, and 8.2%, respectively, at 9 years, reaching 39.1% at 20 years (Swedish cohort). On sensitivity analysis (including staged bilateral operations), the Fine and Gray subdistribution hazard ratio differed from the Cox and Royston and Parmar hazard ratios. When the frequency of competing risks is high, competing risks methods are recommended to obtain accurate cumulative incidence estimates for informing health care planning and decision making.
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- Siebrecht, Maikel A.N., et al.
(författare)
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Platelet concentrate increases bone ingrowth into porous hydroxyapatite
- 2002
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Ingår i: Orthopedics. - 0147-7447 .- 1938-2367. ; 25:2, s. 169-172
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Tidskriftsartikel (refereegranskat)abstract
- Platelets contain growth factors that are believed to stimulate early fracture repair. Autologous platelets can be sequestered, concentrated, and mixed with thrombin to yield a so-called autologous growth factor gel, which might enhance bone repair or bone graft incorporation. The effect of this platelet concentrate on total tissue and bone ingrowth into porous coralline hydroxyapatite was studied in a bone chamber rat model. Chambers with the platelet concentrate showed a significant increase in bone and total tissue ingrowth distance compared to untreated controls, indicating a platelet concentrate might enhance the clinical performance of porous hydroxyapatite in bone replacement.
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- Striano, Brendan M, et al.
(författare)
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Displaced Supracondylar Humerus Fractures in Toddlers
- 2020
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Ingår i: Orthopedics. - : SLACK, Inc.. - 1938-2367 .- 0147-7447. ; 43:5, s. 421-424
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Tidskriftsartikel (refereegranskat)abstract
- Gartland type III fracture is the most troublesome type of supracondylar humerus fracture. These injuries most often occur in school age children, but they are seen in pediatric patients of all ages. The goal of this study was to analyze toddlers with Gartland type III fractures to identify clinically significant differences compared with older children. A retrospective cohort study was conducted with 94 toddlers (<3 years) and 378 older children (3 to 12 years). Factors including demographics, mechanism of injury, additional injuries, location of trauma, pin configuration, postoperative complications, follow-up time, and compliance with the treatment plan were collected and compared. The study included 94 toddlers (59% girls, 2.11±0.64 years) and 378 older children (48% girls, 6.32±1.89 years), chosen at random, who were treated between 2000 and 2015. Among toddlers, fractures were more likely to occur at home (P<.001) and to be the result of suspected nonaccidental trauma (P<.001). Older children had more additional injuries (P<.001), but were no more likely to have an open fracture (P=.59) or a flexion-type fracture (P=.42). Older children were more likely to undergo open reduction (P=.03), whereas toddlers were more likely to be treated with a medial pin (P<.001). Toddlers experienced more cubitus varus (P<.001) and loss of reduction (P=.02). No difference was found in length of follow-up (P=.83) or compliance with the treatment plan (P=.11). This study provides novel insights into clinical differences between toddlers and older children with Gartland type III fractures. Knowledge of these differences can facilitate the delivery of targeted, age-specific care for patients with type III supracondylar humerus fractures. [Orthopedics. 2020;43(5);e421-e424.].
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- Wohlfart, Olivia, et al.
(författare)
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Internationalization of the Sport Management Labor Market and Curriculum Perspectives : Insights From Germany, Norway, and Spain
- 2020
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Ingår i: Sport Management Education Journal. - Champaign : Human Kinetics. - 1938-6974 .- 2163-2367. ; 14:2, s. 129-141
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Tidskriftsartikel (refereegranskat)abstract
- This study applies “Europeanness” to the analysis of internationalization in the sport management labor market and which changes this trend necessitates for sport management curricula. The authors employed an analysis of 30 semistructured interviews with key informants from Germany, Norway, and Spain. The results reveal various effects of internationalization on the sport sector and highlight the richness and diversity in the three countries. Sport management graduates need to possess a diverse set of competencies for successfully starting their careers. In addition to subject-specific knowledge, generic competencies such as the ability to work in a team, being able to communicate in diverse languages, and having intercultural skills are important. The article discusses knowledge of international sport organizations, their governance, global trends, and intercultural and language competencies, as well as international sport event management as identified themes and proposes specific curriculum changes to promote educational outcomes of sport management programs.
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