| 1. |
- Schilcher, Jörg, 1978-
(författare)
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Epidemiology, Radiology and Histology of Atypical Femoral Fractures : Development of understanding
- 2013
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Ingår i: Acta Orthopaedica. - Linköping : Linköping University Electronic Press. - 1745-3674 .- 1745-3682. ; 84:S352, s. 1-26
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Bisphosphonates have been used successfully in the prevention of osteoporosis-related fractures for over two decades. Only recently an association between bisphosphonate use and femoral insufficiency fractures – atypical femoral fractures – has been found.Bone remodeling is necessary to maintain a healthy skeleton. With age this process can get out of balance and bone resorption can outweigh formation of new bone. This can lead to osteoporosis and fractures that occur after minor trauma. Almost half of all women 50 years of age or older will suffer an osteoporosis related fracture during their remaining life. Bisphosphonates inhibit bone resorption, and after some years of treatment an increase in bone mass can be noted. This increase in bone mass can reduce fracture risk by as much as half. However, bisphosphonate use seems associated with the development of femoral insufficiency fractures, so called atypical femoral fractures. This thesis aimed to estimate the risk of atypical femoral fractures in the population and its association with bisphosphonate use. It also describes the radiographic and histologic features of these fractures in order to improve our understanding of the pathophysiological background.Study 1) All women 55 years of age and older, who had sustained a femoral shaft fracture during 2008, were identified through the Swedish National Patient Register. Radiographs of 1234 women were reviewed, and 59 patients with atypical fractures and 263 control patients with common femoral shaft fractures were identified. Atypical femoral fractures were defined by their stress fracture-like appearance. In a cohort analysis, we estimated an age-adjusted relative risk of 47 for bisphosphonate users to suffer an atypical femoral fracture compared to non-users. A total of 78% of the patients with an atypical fracture and 10% of the controls had received bisphosphonates, corresponding to a multivariable-adjusted odds ratio of 33. The risk was independent of coexisting conditions and of concurrent use of other drugs with known effects on bone. These results indicate that bisphosphonate use is strongly associated with atypical femoral fractures. The absolute risk is low and benefits of treatment will outweigh the risks.Study 2) A transverse fracture line and a small but visible callus reaction are well established radiographic features of stress fractures. Radiographs from 59 atypical fracture patients and 218 control patients from Study 1 were re-reviewed to measure fracture angles and to detect callus reactions. The majority of the patients with a transverse fracture angle used bisphosphonates. Fracture angle and callus reaction had a high specificity to detect bisphosphonate treatment. When an oblique fracture line was chosen to define atypical femoral fractures in the cohort from Study 1, the association of atypical femoral fractures to bisphosphonate use became attenuated. Therefore, a correct case definition of atypical femoral fractures is necessary for adequate risk calculations.Study 3) Bone biopsies from 8 patients with atypical femoral fractures were obtained during surgical fixation. The histological analysis of the fracture site itself showed a thin fracture line running perpendicular to the long axis of the femur. Despite ongoing remodeling in the bone adjacent to the fracture gap, no healing occurred within the gap itself. Necrotic material in the gap suggests that strains within the gap might prohibit ingrowth of cells necessary for healing. This mechanism of inhibited healing might share similarities with that of stress fractures in athletes. Although it is highly likely that bisphosphonates play a causative role, the pathogenesis of these fractures is still unclear. It may involve a reduced capacity for targeted remodeling.
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| 2. |
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| 3. |
- Axelsson, Paul, et al.
(författare)
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Radiostereometry in lumbar spine research.
- 2006
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Ingår i: Acta Orthopaedica. Supplementum. - : Medical Journals Sweden AB. - 1745-3690 .- 1745-3674 .- 1745-3682. ; 77:323, s. 3-42
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Forskningsöversikt (refereegranskat)
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| 4. |
- Berg, S
(författare)
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On total disc replacement
- 2011
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Ingår i: Acta orthopaedica. Supplementum. - : Medical Journals Sweden AB. - 1745-3704 .- 1745-3674 .- 1745-3682. ; 82:343, s. 5-
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Tidskriftsartikel (refereegranskat)
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| 5. |
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| 6. |
- Hansson, Bengt-Göran, et al.
(författare)
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Overview of 345 Supplements published 1934-2011.
- 2012
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Ingår i: Acta Orthopaedica. Supplementum. - : Medical Journals Sweden AB. - 1745-3704 .- 1745-3674 .- 1745-3682. ; 83:348, s. 1-23
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Tidskriftsartikel (refereegranskat)
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| 7. |
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| 8. |
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| 9. |
- Aagaard, Knut, et al.
(författare)
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High incidence of acute full-thickness rotator cuff tears. A population-based prospective study in a Swedish Community.
- 2015
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Ingår i: Acta Orthopaedica. - : Medical Journals Sweden AB. - 1745-3682 .- 1745-3674. ; 86:5, s. 558-562
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Tidskriftsartikel (refereegranskat)abstract
- Background and purpose - Epidemiological studies of full-thickness rotator cuff tears (FTRCTs) have mainly investigated degenerative lesions. We estimated the population-based incidence of acute FTRCT using a new diagnostic model. Patients and methods - During the period November 2010 through October 2012, we prospectively studied all patients aged 18-75 years with acute onset of pain after shoulder trauma, with limited active abduction, and with normal conventional radiographs. 259 consecutive patients met these inclusion criteria. The patients had a median age of 51 (18-75) years. 65% were males. The patients were divided into 3 groups according to the clinical findings: group I, suspected FTRCT; group II, other specific diagnoses; and group III, sprain. Semi-acute MRI was performed in all patients in group I and in patients in group III who did not recover functionally. Results - We identified 60 patients with FTRCTs. The estimated annual incidence of MRI-verified acute FTRCT was 16 (95% CI: 11-23) per 105 inhabitants for the population aged 18-75 years and 25 (CI: 18-36) per 105 inhabitants for the population aged 40-75 years. The prevalence of acute FTRCT in the study group was 60/259 (23%, CI: 18-28). The tears were usually large and affected more than 1 tendon in 36 of these 60 patients. The subscapularis was involved in 38 of the 60 patients. Interpretation - Acute FTRCTs are common shoulder injuries, especially in men. They are usually large and often involve the subscapularis tendon.
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| 10. |
- Abbott, Allan, et al.
(författare)
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Analgesic prescriptions received by patients before commencing the BOA model of care for osteoarthritis: a Swedish national registry study with matched reference and clinical guideline benchmarking
- 2022
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Ingår i: Acta Orthopaedica. - : Medical Journals Sweden AB. - 1745-3674 .- 1745-3682. ; 93, s. 51-58
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Tidskriftsartikel (refereegranskat)abstract
- Background and purpose - Swedish clinical guidelines for osteoarthritis (OA) prioritize patient education, exercise, and-if necessary-weight reduction before considering adjunct pharmacological intervention. Contrariwise, we investigated the proportion and type of dispensed analgesic prescriptions in Sweden received by patients during 3 years before commencing non-pharmacological primary care interventions for OA (2008-2016) compared with the general population. Furthermore, we analyzed the proportion of analgesic prescriptions dispensed before (2008-2012) compared with after (2012-2016) guideline publication in terms of concordance with clinical guideline recommendations. Patients and methods - Patients with hip or knee OA (n = 72,069) from the Better Management of OA national quality register receiving non-pharmacological interventions in primary care between 2008 and 2016 were included (OA cohort). An age, sex, and residence matched reference cohort (n = 216,207) was formed from the Swedish Total Population Register. Based on a period 3 years prior to inclusion in the OA cohort, Swedish Prescribed Drug Register data was linked to both the OA and reference cohorts. Results - Compared with the reference cohort, a distinctly larger proportion of the OA cohort had dispensed prescriptions for most types of analgesics, increasing exponentially each year prior to commencing non-pharmacological intervention. Since guideline publication, the proportion of the OA cohort having no dispensed prescription analgesics prior to non-pharmacological primary care intervention concordantly increased by 5.0% (95% CI 4.2-5.9). Furthermore, dispensed prescriptions concordantly decreased for non-selective NSAIDs -8.6% (CI -9.6 to -7.6), weak opioids -6.8% (CI -7.7 to -5.9), glucosamine -9.5% (CI -9.8 to -8.8). and hyaluronic acid -1.6% (CI -1.8 to -1.5) but discordantly increased for strong opioids 2.8% (CI 2.1-3.4) and glucocorticoid intra-articular injection for hip OA 2.1% (CI 1.0-3.1). Interpretation - In Sweden, dispensed prescription of analgesics commonly occurred before initiating non-pharmacological primary care interventions for OA but reduced modestly after guideline publication, which prioritizes non-pharmacological before pharmacological interventions. Additional modest improvements occurred in the stepped-care prioritization of analgesic prescription types. However, future strategies are required to curb an increase of strong opioids prescription for OA and glucocorticoid intra-articular injection for hip OA.
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| 11. |
- Abdulghani, Saba, et al.
(författare)
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The influence of initial pressurization and cup introduction time on the depth of cement penetration in an acetabular model.
- 2007
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Ingår i: Acta Orthopaedica. - : Medical Journals Sweden AB. - 1745-3682 .- 1745-3674. ; 78:3, s. 333-339
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Tidskriftsartikel (refereegranskat)abstract
- Background Acetabular cementation during total hip arthroplasty is considered difficult mainly due to the appearance and anatomy of the acetabulum. Improved cementation technique has been shown to improve the longevity of acetabular components. Method We designed a ceramic model to investigate the effect of varying the initial cement pressurization and cup introduction times on the depth of cement penetration. 4 groups were prepared, 2 of which involved varying initial cement pressurization and cup introduction times. Group 3 involved initial cement pressurization with no cup introduction, while group 4 involved cup introduction with no prior cement pressurization. Results and interpretation Most cement penetration occurred in the early pressurization phase, and we conclude that a relatively early and longer cement pressurization time and late cup introduction are positive factors for increased cement penetration in the acetabulum model.
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| 12. |
- Abramo, Antonio, et al.
(författare)
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Evaluation of a treatment protocol in distal radius fractures: a prospective study in 581 patients using DASH as outcome.
- 2008
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Ingår i: Acta Orthopaedica. - : Medical Journals Sweden AB. - 1745-3682 .- 1745-3674. ; 79:3, s. 376-385
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND AND PURPOSE: Distal radius fractures are most often treated nonoperatively, but sometimes they are treated surgically when deemed unstable. Based on the literature, a consensus protocol for treatment has been developed in southern Sweden to aid clinicians in their decision making. We evaluated the results of this protocol prospectively using a validated outcome instrument (DASH) in a large consecutive and population based series of unselected patients. METHODS: 581 patients were treated according the protocol. Age, sex, fracture side, and type of treatment were registered. The subjective outcome was measured by DASH. 133 patients were operated. RESULTS: 75% of the patients returned the questionnaire. The median DASH score at 3 months was 18.3 and at 12 months it was 7.5. All treatment groups had low DASH scores at the final follow-up. Reduced, nonoperated fractures had a worse score (11.6) than undisplaced (4.2) or operated fractures (6.0). Age was the only other predictor, with older patients having a worse score. A correlation was found between the short-version 11-item QuickDASH questionnaire and the full 30-item DASH, both at 3 months (r = 0.98) and at 1 year (r = 0.97) (p< 0.001 for both). INTERPRETATION: Most patients have residual symptoms at 3 months after the fracture but are normalized at 1 year. Good final subjective result was achieved with the proposed protocol regardless of initial severity and treatment of the fracture, as indicated by a low median DASH score in all groups. There was correlation between QuickDASH and the full DASH, and the former could be used in future studies.
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| 13. |
- Abramo, Antonio, et al.
(författare)
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Open reduction and internal fixation compared to closed reduction and external fixation in distal radial fractures A randomized study of 50 patients
- 2009
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Ingår i: Acta Orthopaedica. - : Medical Journals Sweden AB. - 1745-3682 .- 1745-3674. ; 80:4, s. 478-485
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Tidskriftsartikel (refereegranskat)abstract
- Background and purpose In unstable distal radial fractures that are impossible to reduce or to maintain in reduced position, the treatment of choice is operation. The type of operation and the choice of implant, however, is a matter of discussion. Our aim was to investigate whether open reduction and internal fixation would produce a better result than traditional external fixation. Methods 50 patients with an unstable or comminute distal radius fracture were randomized to either closed reduction and bridging external fixation, or open reduction and internal fixation using the TriMed system. The primary outcome parameter was grip strength, but the patients were followed for 1 year with objective clinical assessment, subjective outcome using DASH, and radiographic examination. Results At 1 year postoperatively, grip strength was 90% (SD 16) of the uninjured side in the internal fixation group and 78% (17) in the external fixation group. Pronation/supination was 150 degrees (15) in the internal fixation group and 136 degrees (20) in the external fixation group at 1 year. There were no differences in DASH scores or in radiographic parameters. 5 patients in the external fixation group were reoperated due to malunion, as compared to 1 in the internal fixation group. 7 other cases were classified as radiographic malunion: 5 in the external fixation group and 2 in the internal fixation group. Interpretation Internal fixation gave better grip strength and a better range of motion at 1 year, and tended to have less malunions than external fixation. No difference could be found regarding subjective outcome.
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| 14. |
- Abramo, Antonio, et al.
(författare)
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Osteotomy of dorsally displaced malunited fractures of the distal radius: no loss of radiographic correction during healing with a minimally invasive fixation technique and an injectable bone substitute.
- 2008
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Ingår i: Acta Orthopaedica. - : Medical Journals Sweden AB. - 1745-3682 .- 1745-3674. ; 79:2, s. 262-268
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND AND PURPOSE: Malunion after a distal radius fracture can be treated with an osteotomy of the distal radius. Often autologous iliac crest bone graft is used to fill the gap, but this is associated with donor site morbidity. Instead of bone graft, we have used a slow-resorbing bone substitute in combination with a minimally invasive fixation technique. PATIENTS AND METHODS: 25 consecutive patients with a dorsal malunion after a distal radius fracture underwent an osteotomy. A TriMed buttress pin and a radial pin plate were used for fixation, and Norian SRS as bone substitute. The patients were followed for a minimum of 1 year and range of motion, grip strength, DASH scores, and the radiographic correction were measured. RESULTS: Forearm rotation improved from 137 degrees to 155 degrees , flexion/extension from 102 degrees to 120 degrees , and radioul-nar deviation from 32 degrees to 43 degrees . Grip strength increased from 62% of the contralateral hand to 82%. DASH scores decreased from 36 to 23. Radiographically, all osteotomies but 1 healed and the radiographic correction achieved was consistent over the first year. INTERPRETATION: Osteotomy of the distal radius is effective in increasing motion and grip strength after a malunited distal radial fracture. Patient satisfaction is high and subjective results measured with DASH are good. Using a bone substitute, the operation can be performed as an outpatient procedure and donor-site pain avoided. No loss of the radiographic correction achieved was noted during osteotomy healing.
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| 15. |
- Abul-Kasim, Kasim, et al.
(författare)
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The rate of screw misplacement in segmental pedicle screw fixation in adolescent idiopathic scoliosis.
- 2011
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Ingår i: Acta Orthopaedica. - : Medical Journals Sweden AB. - 1745-3682 .- 1745-3674. ; 82, s. 50-55
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Tidskriftsartikel (refereegranskat)abstract
- Background and purpose There are no reports in the literature on the influence of learning on the pedicle screw insertion. We studied the effect of learning on the rate of screw misplacement in patients with adolescent idiopathic scoliosis treated with segmental pedicle screw fixation. Method We retrospectively evaluated low-dose spine computed tomography of 116 consecutive patients (aged 16 (12-24) years, 94 females) who were operated during 4 periods over 2005-2009 (group 1: patients operated autumn 2005-2006; group 2: 2007; group 3: 2008; and group 4: 2009). 5 types of misplacement were recorded: medial cortical perforation, lateral cortical perforation, anterior cortical perforation of the vertebral body, endplate perforation, and perforation of the neural foramen. Reslts 2,201 pedicle screws were evaluated, with an average of 19 screws per patient. The rate of screw misplacement for the whole study was 14%. The rate of lateral and medial cortical perforation was 7% and 5%. There was an inverse correlation between the occurrence of misplacement and the patient number, i.e. the date of operation (r = -0.35; p < 0.001). The skillfulness of screw insertion improved with reduction of the rate of screw misplacement from 20% in 2005-2006 to 11% in 2009, with a breakpoint at the end of the first study period (34 patients). Interpretation We found a substantial learning curve; cumulative experience may have contributed to continued reduction of misplacement rate.
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| 16. |
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| 17. |
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| 18. |
- Adolfsson, Lars, et al.
(författare)
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Elbow hemiarthroplasty for acute reconstruction of intraarticular distal humerus fractures : A preliminary report involving 4 patients
- 2006
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Ingår i: Acta Orthopaedica. - : Medical Journals Sweden AB. - 1745-3674 .- 1745-3682. ; 77:5, s. 785-787
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Tidskriftsartikel (refereegranskat)abstract
- We treated 4 female patients (mean age 80) with complex intraarticular acute fracture of the distal humerus with a Kudo humeral component, i.e. a hemiarthroplasty. All fractures were considered impossible to treat with open reduction and internal fixation. At mean 10 (3-14) months, 3 patients had an excellent result and 1 a good result according to the Mayo elbow performance score. We conclude that a hemiarthroplasty may be a valuable alternative in eldery patients with complex fractures of the distal humerus. Copyright© Taylor & Francis 2006.
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| 19. |
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| 20. |
- Affas, Fatin, et al.
(författare)
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Pain control after total knee arthroplasty : a randomized trial comparing local infiltration anesthesia and continuous femoral block
- 2011
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Ingår i: Acta Orthopaedica. - New York : Taylor & Francis. - 1745-3674 .- 1745-3682. ; 82:4, s. 441-447
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND AND PURPOSE: Pain after total knee arthroplasty (TKA) is usually severe, and epidural analgesia or femoral nerve block has been considered to be an effective pain treatment. Recently, local infiltration analgesia (LIA) has become increasingly popular but the outcome of this method regarding the analgesic effect has not been fully evaluated. We compared local infiltration analgesia and femoral block with regard to analgesia and morphine demand during the first 24 h after TKA.METHODS: 40 patients undergoing TKA under spinal anesthesia were randomized to receive femoral nerve block (group F) or peri- and intraarticular infiltration analgesia (group LIA) with a mixture containing ropivacaine, ketorolac, and epinephrine. All patients had access to intravenous patient-controlled analgesia (PCA) with morphine postoperatively. Pain intensity at rest and upon movement was assessed on a numeric rating scale (0-10) on an hourly basis over 24 h if the patients were awake.RESULTS: The average pain at rest was marginally lower with LIA (1.6) than with femoral block (2.2). Total morphine consumption per kg was similar between the 2 groups. Ancillary analysis revealed that 1 of 20 patients in the LIA group reported a pain intensity of > 7 upon movement, as compared to 7 out of 19 in the femoral block group (p = 0.04).INTERPRETATION: Both LIA and femoral block provide good analgesia after TKA. LIA may be considered to be superior to femoral block since it is cheaper and easier to perform.
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| 21. |
- Agholme, Fredrik, et al.
(författare)
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Anti-sclerostin antibody and mechanical loading appear to influence metaphyseal bone independently in rats
- 2011
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Ingår i: Acta Orthopaedica. - : Taylor and Francis. - 1745-3674 .- 1745-3682. ; 82:5, s. 628-632
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Tidskriftsartikel (refereegranskat)abstract
- Background and purpose: Sclerostin is produced by osteocytes and is an inhibitor of bone formation. Thus, inhibition of sclerostin by a monoclonal antibody increases bone formation and improves fracture repair. Sclerostin expression is upregulated in unloaded bone and is downregulated by loading. We wanted to determine whether an anti-sclerostin antibody would stimulate metaphyseal healing in unloaded bone in a rat model.Methods: 10-week-old male rats (n = 48) were divided into 4 groups, with 12 in each. In 24 rats, the right hind limb was unloaded by paralyzing the calf and thigh muscles with an injection of botulinum toxin A (Botox). 3 days later, all the animals had a steel screw inserted into the right proximal tibia. Starting 3 days after screw insertion, either anti-sclerostin antibody (Scl-Ab) or saline was given twice weekly. The other 24 rats did not receive Botox injections and they were treated with Scl-Ab or saline to serve as normal-loaded controls. Screw pull-out force was measured 4 weeks after insertion, as an indicator of the regenerative response of bone to trauma.Results: Unloading reduced the pull-out force. Scl-Ab treatment increased the pull-out force, with or without unloading. The response to the antibody was similar in both groups, and no statistically significant relationship was found between unloading and antibody treatment. The cancellous bone at a distance from the screw showed changes in bone volume fraction that followed the same pattern as the pull-out force.Interpretation: Scl-Ab increases bone formation and screwfixation to a similar degree in loaded and unloaded bone.
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| 22. |
- Agholme, Fredrik, et al.
(författare)
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Wnt signaling and orthopedics, an overview
- 2011
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Ingår i: ACTA ORTHOPAEDICA. - : Informa Healthcare. - 1745-3674 .- 1745-3682. ; 82:2, s. 125-130
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Tidskriftsartikel (refereegranskat)abstract
- Wnt signaling is a ubiquitous system for intercellular communication, with multiple functions during development and in homeostasis of the body. It comprises several ligands, receptors, and inhibitors. Some molecules, such as sclerostin, appear to have bone-specific functions, and can be targeted by potential drugs. Now, ongoing clinical trials are testing these drugs as treatments for osteoporosis. Animal studies have also suggested that these drugs can accelerate fracture healing and implant fixation. This brief overview focuses on currently available information on the effects of manipulations of Wnt signaling on bone healing.
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| 23. |
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| 24. |
- Ali, Abdulemir, et al.
(författare)
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Dissatisfied patients after total knee arthroplasty
- 2014
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Ingår i: Acta Orthopaedica. - : Medical Journals Sweden AB. - 1745-3674 .- 1745-3682. ; 85:3, s. 229-233
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Tidskriftsartikel (refereegranskat)abstract
- Background and purpose - In 2003, an enquiry by the Swedish Knee Arthroplasty Register (SKAR) 2-7 years after total knee arthroplasty (TKA) revealed patients who were dissatisfied with the outcome of their surgery but who had not been revised. 6 years later, we examined the dissatisfied patients in one Swedish county and a matched group of very satisfied patients. Patients and methods - 118 TKAs in 114 patients, all of whom had had their surgery between 1996 and 2001, were examined in 2009-2010. 55 patients (with 58 TKAs) had stated in 2003 that they were dissatisfied with their knees and 59 (with 60 TKAs) had stated that they were very satisfied with their knees. The patients were examined clinically and radiographically, and performed functional tests consisting of the 6-minute walk and chair-stand test. All the patients filled out a visual analog scale (VAS, 0-100 mm) regarding knee pain and also the Hospital and Anxiety and Depression scale (HAD). Results - Mean VAS score for knee pain differed by 30 mm in favor of the very satisfied group (p < 0.001). 23 of the 55 patients in the dissatisfied group and 6 of 59 patients in the very satisfied group suffered from anxiety and/or depression (p = 0.001). Mean range of motion was 11 degrees better in the very satisfied group (p < 0.001). The groups were similar with regard to clinical examination, physical performance testing, and radiography. Interpretation - The patients who reported poor response after TKA continued to be unhappy after 8-13 years, as demonstrated by VAS pain and HAD, despite the absence of a discernible objective reason for revision.
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| 25. |
- Ali, Abdulemir, et al.
(författare)
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Doubtful effect of continuous intraarticular analgesia after total knee arthroplasty.
- 2015
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Ingår i: Acta Orthopaedica. - : Medical Journals Sweden AB. - 1745-3682 .- 1745-3674. ; 86:3, s. 373-377
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Tidskriftsartikel (refereegranskat)abstract
- Background and purpose - Local infiltration analgesia (LIA) is well established for effective postoperative pain relief in total knee arthroplasty (TKA). To prolong the effect of LIA, infusion pumps with local intraarticular analgesia can be used. We evaluated the effect of such an infusion pump for the first 48 h postoperatively regarding pain, knee function, length of stay (LOS) in hospital, and complications. Patients and methods - 200 patients received peroperative LIA and a continuous intraarticular elastomeric infusion pump set at 2 mL/h. The patients were randomized either to ropivacaine (7.5 mg/mL) or to NaCl (9 mg/mL) in the pump. Visual analog scale (VAS) pain (0-100 mm), analgesic consumption, side effects of medicine, range of motion (ROM), leg-raising ability, LOS, and complications during the first 3 months were recorded. Results - On the first postoperative day, the ropivacaine group had lower VAS pain (33 vs. 40 at 12 noon and 36 vs. 43 at 8 p.m.; p = 0.02 and 0.03, respectively), but after that all recorded variables were similar between the groups. During the first 3 months, the ropivacaine group had a greater number of superficial and deep surgical wound infections (11 patients vs. 2 patients, p = 0.02). There were no other statistically significant differences between the groups. Interpretation - Continuous intraarticular analgesia (CIAA) with ropivacaine after TKA has no relevant clinical effect on VAS pain and does not affect LOS, analgesic consumption, ROM, or leg-raising ability. There may, however, be a higher risk of wound-healing complications including deep infections.
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