| 1. |
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| 2. |
- Kesteris, Uldis, et al.
(författare)
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Polyethylene wear and synovitis in total hip arthroplasty: a sonographic study of 48 hips
- 1999
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Ingår i: Journal of Arthroplasty. - 0883-5403. ; 14:2, s. 138-143
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Tidskriftsartikel (refereegranskat)abstract
- Forty-six patients (48 hips), operated on with cemented total hip arthroplasty (THA) because of arthrosis, were examined radiographically and sonographically at 10-year follow-up. Polyethylene wear of acetabular cups was measured on conventional non-weight-bearing pelvic radiographs, and the volume of polyethylene debris was calculated. Radiographic signs of loosening were identified. The capsular distance (ie, thickness of the synovium or synovial contents) was measured sonographically. We found a significant correlation between increased volumetric wear and increased capsular distance. Hips with radiographically loose acetabular components had significantly greater volumetric wear and capsular distance than those without signs of acetabular loosening. This relationship was not observed in hips with radiographically loose femoral components. In cemented THA, the volume of polyethylene wear debris and the thickness of the synovium and the synovial contents are related. In the event of radiographic loosening of the acetabular component, they are both increased.
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| 3. |
- Lewold, Stefan, et al.
(författare)
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Oxford meniscal bearing knee versus the Marmor knee in unicompartmental arthroplasty for arthrosis. A Swedish multicenter survival study
- 1995
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Ingår i: Journal of Arthroplasty. - 0883-5403. ; 10:6, s. 722-731
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Tidskriftsartikel (refereegranskat)abstract
- In the Swedish Knee Arthroplasty Study, all 699 Oxford meniscal bearing cemented unicompartmental prostheses (Biomet, Bridgend, UK) were identified and analyzed regarding failure pattern and compared with all Marmor prostheses (Smith & Nephew Richards, Orthez, France) and with a time-, age-, and sex-matched subset of Marmor prostheses using survival statistics expressed as cumulative revision rates. After 1 year there was already a higher rate, and after 6 years the rate of the Oxford group was more than twice that of the Marmor group. There were 50 revisions in the Oxford group: dislocating meniscus in 16, loosening of the femoral component in 6, tibial component in 4, both components in 4, contralateral arthrosis in 10, infection in 4, and technical failure with instability, pain, and/or impingement of the meniscal bearing anterior in the femoral condyle in 6. It is still unclear if the design with the sliding menisci will, in the long turn, reduce wear and loosening, thereby compensating for the initially inferior results. It is recommended that until this question is clarified, the Oxford knee should be used on a limited scale for long-term comparative studies only.
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| 4. |
- Robertsson, Otto, et al.
(författare)
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Intracapsular pressure and pain in coxarthrosis
- 1995
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Ingår i: Journal of Arthroplasty. - 0883-5403. ; 10:5, s. 632-635
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Tidskriftsartikel (refereegranskat)abstract
- Intracapsular hip pressure was measured before surgery in 17 patients (18 hips) with coxarthrosis. The results were correlated to pain as registered on a visual analog scale. With the hip in extension, the pressure was 49.5 mmHg (SD, 40.2); in 45 degrees of flexion, it was 21.3 mmHg (SD, 14.6); in extension and inward rotation, it was 105.7 mmHg (SD, 76.0); and in extension and outward rotation, it was 40.8 mmHg (SD, 32.0). A small amount, 0.7 mL (SD, 1.14), of joint fluid was aspirated following pressure registration. Pressure correlated significantly to pain at night, when starting to walk, and on walking. It is suggested that the increase in intracapsular hip pressure is a cause of pain in coxarthrosis, with subsequent limitation of movement and joint contracture.
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| 5. |
- Sanzén, Lennart, et al.
(författare)
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Radiographic wear assessment in a total knee prosthesis. 5- to 9-year follow-up study of 158 knees
- 1996
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Ingår i: Journal of Arthroplasty. - 0883-5403. ; 11:6, s. 738-742
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Tidskriftsartikel (refereegranskat)abstract
- One hundred fifty-eight Porous-Coated Anatomic (Howmedica, Rutherford, NJ) primary total knee prostheses were evaluated clinically and radiographically to measure the remaining thickness of the plastic insert. Anteroposterior radiographs were taken with the beam guided parallel to the tibial plate by a fluoroscope. The knees were forced into varus and valgus, and the heights of the medial and lateral joint spaces, respectively, were measured with a digitizing table. Plastic insert wear could be calculated after correction with a magnification error factor, established by dividing the projected width of the tibial plate by the true size of the used component. After a mean follow-up period of 84 months (range, 58-116 months), wear was significantly higher for patients with osteoarthritis than rheumatoid arthritis and was 1.4 mm versus 0.7 mm medially (P < .0001) and 0.7 mm versus 0.4 mm laterally (P = .01). Wear was not correlated to thickness of the plastic insert or length of follow-up period. Young age or varus alignment contributed slightly to the amount of wear.
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| 6. |
- Toksvig-Larsen, Søren, et al.
(författare)
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The Porous-Coated Anatomic Total Knee Experience. Special Emphasis on Complications and Wear
- 1996
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Ingår i: Journal of Arthroplasty. - 0883-5403. ; 1:11, s. 11-17
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Tidskriftsartikel (refereegranskat)abstract
- One hundred sixty knees in 141 patients with the Primary Porous-Coated Anatomic prosthesis (Howmedica, Rutherford, NJ) were evaluated after a follow-up period of 5.6 years (range, 1–10 years). One hundred six knees were in the latest follow-up evaluation, including clinical examination and a defined standing radiograph with a follow-up period of 6.3 years (range, 3–10 years). Survivorship analysis regarding the cumulative revision rate (including completion with a patellar component) was 0.88 at the 8-year and 0.84 at the 10-year follow-up examination. The clinical result was satisfying/good, with a mean Hospital for Special Surgery score of 83 (range, 39–97). Five percent had thinning greater than 30% of the tibial component. The wear was calculated to be 1.0 mm (range, 0–9 mm), including three revised tibial components with heavy wear. Excluding the revised cases, the wear was 0.7 mm.
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| 7. |
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| 8. |
- Önsten, Ingemar, et al.
(författare)
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Improved radiographic survival of the Charnley prosthesis in rheumatoid arthritis and osteoarthritis. Results of new versus old operative techniques in 402 hips
- 1994
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Ingår i: Journal of Arthroplasty. - : Elsevier BV. - 0883-5403. ; 9:1, s. 3-8
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Tidskriftsartikel (refereegranskat)abstract
- Two hundred one consecutive, primary, noninfected Charnley (Thackray, Leeds) hip arthroplasties, implanted from 1968 to 1985 due to adult-onset rheumatoid arthritis, were matched in pairs with respect to year of operation, age, and sex with 201 Charnley prostheses implanted due to osteoarthritis. The 10-year survival estimate for nonrevisions was 95% in the rheumatoid group and 89% in the osteoarthritic group. Using definite radiographic loosening as a determinant, the 7-year survival rate for stems increased from 80% to 96% for both groups after the introduction of new cementing techniques, and the relative risk for stem loosening was decreased to one fifth. In the rheumatoid arthritis group, the 7-year radiographic socket survival increased from 87% to 96%, an increase ascribed to the overall effect of the introduction of flanged sockets, bone-grafts in acetabular protrusion, the rejection of the pilot hole technique, and improvements in the cement handling technique. In the osteoarthritis group the radiographic socket survival rate at 7 years was 97% and at 10 years was 95%.
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| 9. |
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| 10. |
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| 11. |
- Mikhail, W. E., et al.
(författare)
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Femoral bone regeneration subsequent to impaction grafting during hip revision : histologic analysis of a human biopsy specimen
- 1999
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Ingår i: The Journal of Arthroplasty. - Philadelphia, USA : Elsevier. - 0883-5403 .- 1532-8406. ; 14:7, s. 849-953
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Tidskriftsartikel (refereegranskat)abstract
- Cemented revision with impaction grafting shows encouraging early clinical results; postoperative biopsy specimens taken from the proximal femur in humans have demonstrated viable trabecular and cortical bone. Human radiographic studies also illustrate density changes within the proximal femur, consistent with remodeling of bone-graft. In an animal experiment, bone incorporation was shown in the proximal femur, but graft lysis was reported around the distal portion of the implant. We report on a patient who sustained a traumatic femoral fracture at the level of the tip of the femoral component 27 months after revision with impaction grafting and a collarless polished taper stem. At the time of open reduction and internal fixation of the fracture, we obtained circumferential biopsy specimens from the fracture site. Three distinct zones could be identified histologically: i) an inner zone consisting of bone-cement, fibrous tissue, and partially necrotic trabeculae with evidence of bone remodeling; ii) a middle zone consisting of viable trabecular bone and probable neocortex formation with fewer particles of bone-cement; and iii) an outer zone with viable cortex. Fibrous tissue was present around some of the incorporating bone-graft fragments, but no continuous fibrous membrane was present. Cement particles were identified, but no polyethylene debris was found by light microscopy. Biopsy specimens from the distal aspect of the prosthesis may not reflect changes seen proximally, but based on the available tissue, this case illustrated histological evidence of bone-graft remodeling after impaction grafting. These results are consistent with our expectations based on radiographic findings and clinical results.
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| 12. |
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| 13. |
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| 14. |
- Stigbrand, Hampus, et al.
(författare)
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A 2-to 16-Year Clinical Follow-Up of Revision Total Hip Arthroplasty Using a New Acetabular Implant Combined With Impacted Bone Allografts and a Cemented Cup
- 2018
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Ingår i: The Journal of Arthroplasty. - : CHURCHILL LIVINGSTONE INC MEDICAL PUBLISHERS. - 0883-5403 .- 1532-8406. ; 33:3, s. 815-822
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Tidskriftsartikel (refereegranskat)abstract
- Background: Treatment of acetabular bone loss with impaction bone grafting (IBG) at revision total hip arthroplasty is highly dependent on mechanical stability and graft compression for clinical success. Here, we describe a new technique to further compress and stabilize the acetabular graft bed with a thin, perforated titanium shell.Methods: We retrospectively analyzed 170 cases of acetabular revision arthroplasty 7 years (standard deviation 2.8) after IBG combined with a graft-compressing titanium shell implant. The patients were reviewed by clinical score and radiography. Three patients were lost to follow-up. The medical journals of the 33 deceased cases were reviewed for any reoperation. Of the 170 cases, 74 had a cavitary acetabular bone defect, 93 had combined segmental and cavitary bone defects, and 3 had a pelvic dissociation. Bone graft incorporation was assessed and correction of the hip center of rotation was calculated. Results: Five cases (3%) were reoperated for mechanical loosening. One more was assessed as loose but asymptomatic and was not planned for revision. There were 3 reoperations for recurrent dislocation, 2 for deep infection and 1 for technical error. Reoperation for any reason, as the end point of survivorship, showed a survival rate of 92% after 10 years. Hip score according to Merle, d'Aubigne, and Postel increased from 10.8 (preoperatively) to 16.4 at follow-up. The clinical and radiological results were excellent.Conclusion: IBG combined with the compressing shell results in excellent results for this challenging condition.
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| 15. |
- Ainslie-Garcia, Margaret, et al.
(författare)
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International Delphi Study on Wound Closure and Dressing Management in Joint Arthroplasty: Part 1: Total Knee Arthroplasty.
- 2024
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Ingår i: The Journal of arthroplasty. - 0883-5403 .- 1532-8406. ; 39:4, s. 878-883
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Tidskriftsartikel (refereegranskat)abstract
- The purpose of this modified Delphi study was to obtain consensus on wound closure and dressing management in total knee arthroplasty (TKA).The Delphi panel included 20 orthopaedic surgeons from Europe and North America. There were 26 statements identified using a targeted literature review. Consensus was developed for the statements with up to three rounds of anonymous voting per topic. Panelists ranked their agreement with each statement on a five-point Likert scale. An a priori threshold of ≥ 75% was required for consensus.All 26 statements achieved consensus after three rounds of anonymous voting. Wound closure-related interventions that were recommended for use in TKA included: 1) closing in semi-flexion versus extension (superior range of motion); 2) using aspirin for venous thromboembolism prophylaxis over other agents (reduces wound complications); 3) barbed sutures over non-barbed sutures (lower wound complications, better cosmetic appearances, shorter closing times, and overall cost savings); 4) mesh-adhesives over other skin closure methods (lower wound complications, higher patient satisfaction scores, lower rates of readmission); 5) silver-impregnated dressings over standard dressings (lower wound complications, decreased infections, fewer dressing changes); 6) in high-risk patients, negative pressure wound therapy over other dressings (lower wound complications, decreased reoperations, fewer dressing changes); and 7) using triclosan-coated over non-antimicrobial-coated sutures (lower risks of surgical site infection).Using a modified Delphi approach, the panel achieved consensus on 26 statements pertaining to wound closure and dressing management in TKA. This study forms the basis for identifying critical evidence supported by clinical practice for wound management to help reduce variability, advance standardization, and ultimately improve outcomes during TKA. The results presented here can serve as the foundation for knowledge, education, and improved clinical outcomes for surgeons performing TKAs.
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| 16. |
- Ainslie-Garcia, Margaret, et al.
(författare)
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International Delphi Study on Wound Closure and Incision Management in Joint Arthroplasty Part 2: Total Hip Arthroplasty.
- 2024
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Ingår i: The Journal of arthroplasty. - 0883-5403 .- 1532-8406. ; 39:6, s. 1524-1529
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Tidskriftsartikel (refereegranskat)abstract
- This modified Delphi study aimed to develop a consensus on optimal wound closure and incision management strategies for total hip arthroplasty (THA). Given the critical nature of wound care and incision management in influencing patient outcomes, this study sought to synthesize evidence-based best practices for wound care in THA procedures.An international panel of 20 orthopedic surgeons from Europe, Canada, and the United States evaluated a targeted literature review of 18 statements (14 specific to THA and 4 related to both THA and total knee arthroplasty). There were 3 rounds of anonymous voting per topic using a modified 5-point Likert scale with a predetermined consensus threshold of ≥ 75% agreement necessary for a statement to be accepted.After 3 rounds of voting, consensus was achieved for all 18 statements. Notable recommendations for THA wound management included (1) the use of barbed sutures over non-barbed sutures (shorter closing times and overall cost savings); (2) the use of subcuticular sutures over skin staples (lower risk of superficial infections and higher patient preferences, but longer closing times); (3) the use of mesh-adhesives over silver-impregnated dressings (lower rate of wound complications); (4) for at-risk patients, the use of negative pressure wound therapy over other dressings (lower wound complications and reoperations, as well as fewer dressing changes); and (5) the use of triclosan-coated sutures (lower risk of surgical site infection) over standard sutures.Through a structured modified Delphi approach, a panel of 20 orthopedic surgeons reached consensus on all 18 statements pertaining to wound closure and incision management in THA. This study provides a foundational framework for establishing evidence-based best practices, aiming to reduce variability in patient outcomes and to enhance the overall quality of care in THA procedures.
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| 17. |
- Al-Amiry, Bariq Sh. 1976-, et al.
(författare)
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The Influence of Radiological Severity and Symptom Duration of Osteoarthritis on Postoperative Outcome After Total Hip Arthroplasty : A Prospective Cohort Study
- 2018
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Ingår i: The Journal of Arthroplasty. - : CHURCHILL LIVINGSTONE INC MEDICAL PUBLISHERS. - 0883-5403 .- 1532-8406. ; 33:2, s. 436-440
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Tidskriftsartikel (refereegranskat)abstract
- Background: We aimed to investigate the influence of preoperative radiological severity and symptom duration of hip osteoarthritis (OA) on the postoperative functional outcome, quality of life, as well as abductor muscle strength after total hip arthroplasty (THA). Methods: In this prospective cohort study, we studied 250 patients. Preoperatively, we evaluated the function with the Western Ontario and McMaster Universities Osteoarthritis (WOMAC) index and quality of life with euroqol-5D (EQ-5D). At 1 year after THA, the same scores and also hip abductor muscle strength were measured in 222 patients. We divided the cohort twice, first according to the radiological OA severity [Kellgren-Lawrence classification (KL)] and then according to the OA symptom duration. We investigated whether the preoperative KL class and symptom duration influenced the 1-year WOMAC (primary outcome measure) or EQ-5D and abductor muscle strength (secondary outcome measures). Results: The crude results showed that KL class and symptom duration had no influence (P = .90 and P = .20, respectively) on the 1-yearWOMAC. Younger age, male gender, and lower body mass index were associated with a better function. Regarding 1-year EQ-5D, the crude results showed that body mass index and KL class had no influence (P = .83 and P = .39, respectively). The adjusted results showed that only age and gender influenced the postoperative EQ-5D. No influence of the tested factors was found on the 1-year abductor muscle strength. Conclusion: Preoperative radiological OA severity and symptom duration had no influence on the outcome of THA and should probably not affect the decision about timing the operative intervention.
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| 18. |
- Ali, Abdulemir, et al.
(författare)
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Preoperative Anxiety and Depression Correlate With Dissatisfaction After Total Knee Arthroplasty : A Prospective Longitudinal Cohort Study of 186 Patients, With 4-Year Follow-Up
- 2017
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Ingår i: Journal of Arthroplasty. - : Elsevier BV. - 0883-5403. ; 32:3, s. 767-770
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: After more than 4 decades experience of total knee arthroplasty (TKA), there is still a group of patients who are not satisfied with the outcome. In spite of the improvement of many aspects around the procedure, for unexplainable reasons, patient dissatisfaction is still approximately the same. We conducted this study to analyze correlations between preoperative psychological aspects and dissatisfaction after TKA.METHODS: A total of 186 patients were operated with a primary TKA. Patients filled out the Hospital Anxiety and Depression Scale, Visual Analog Pain Scale (0-100), and Knee injury and Osteoarthritis Outcome Score preoperatively and 4 years postoperatively. Four years postoperatively, the patients also scored their satisfaction degree with the outcome of the surgery.RESULTS: Of 186 patients, 27 (15%) reported that they were dissatisfied or uncertain with the result of their TKA 4 years postoperatively. Sixteen of those 27 patients had reported anxiety/depression preoperatively compared with 11 of 159 (7%) in the satisfied or very satisfied groups. Patients with preoperative anxiety or depression had more than 6 times higher risk to be dissatisfied compared with patients with no anxiety or depression (P < .001). Patients with deep prosthetic infection had 3 times higher risk to be dissatisfied with the operation outcome (P = .03). Dissatisfied patients had 1-day longer hospital stay compared with the satisfied group (P < .001).CONCLUSION: Preoperative anxiety and/or depression is an import predictor for dissatisfaction after TKA. Psychological assessment and treatment preoperatively might improve degree of satisfaction.
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| 19. |
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| 20. |
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| 21. |
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| 22. |
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| 23. |
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| 24. |
- Bergvinsson, Halldor, et al.
(författare)
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Polyethylene Wear With Ceramic and Metal Femoral Heads at 5 Years : A Randomized Controlled Trial With Radiostereometric Analysis
- 2020
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Ingår i: Journal of Arthroplasty. - : Elsevier BV. - 0883-5403. ; 35:12, s. 3769-3776
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Tidskriftsartikel (refereegranskat)abstract
- Background: A common bearing combination in total hip arthroplasty today is a metal femoral head articulating with polyethylene in the cup. Ceramic heads are thought to be more resistant to third-body damage, and have better wettability and decreased surface roughness, which taken together have been suggested to result in less polyethylene wear. The purpose of this study is to compare the initial creep deformation and follow wear pattern, using radiostereometric analysis, of ceramic and metal femoral heads that articulate with a modern highly cross-linked polyethylene cup liner. Methods: Fifty patients with primary osteoarthritis and scheduled for an uncemented total hip arthroplasty were randomized 1:1 to either a ceramic (BIOLOX delta) or a metal (CoCr) femoral head. The patients were followed up for 5 years with repeated radiostereometric analysis examinations (postoperatively, then at 14 days, 3, 12, 24, and 60 months), as well as a hip-specific outcome questionnaire. Results: During the first 3 months both groups showed expected creep within the liner of 0.12 mm (standard deviation 0.03) for the ceramic and 0.08 mm (standard deviation 0.02) for the metal heads. Between 3 months and 5 years there was very little wear of the liner in either group, corresponding to 0.003 mm/y for ceramic and 0.007 mm/y for metal heads. There was no difference in cup migration or clinical outcome between the groups and no cups were revised. Conclusion: With the introduction of modern highly cross-linked polyethylene, the ceramic head demonstrates no superiority when it comes to either early deformation or polyethylene wear compared with the metal head.
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| 25. |
- Bjerke, Joakim, et al.
(författare)
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Compensatory strategies for muscle weakness during stair ascent in subjects with total knee arthroplasty
- 2014
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Ingår i: The Journal of Arthroplasty. - : Elsevier. - 0883-5403 .- 1532-8406. ; 29:7, s. 1499-1502
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Tidskriftsartikel (refereegranskat)abstract
- Subjects with total knee arthroplasty (TKA) exhibit decreased quadriceps and hamstring strength. This may bring about greater relative effort or compensatory strategies to reduce knee joint moments in daily activities. To study gait and map out the resource capacity, knee muscle strength was assessed by maximal voluntary concentric contractions, and whole body kinematics and root mean square (RMS) electromyography (EMG) of vastus lateralis and semitendinosus were recorded during stair ascent in 23 unilateral TKA-subjects ~19months post-operation, and in 23 healthy controls. Muscle strength and gait velocity were lower in the TKA group, but no significant group differences were found in RMS EMG or forward trunk lean. The results suggest that reduced walking velocity sufficiently compensated for reduced knee muscle strength.
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| 26. |
- Bjerke, Joakim, et al.
(författare)
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Peak knee flexion angles during stair descent in TKA patients
- 2014
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Ingår i: The Journal of Arthroplasty. - : Elsevier. - 0883-5403 .- 1532-8406. ; 29:4, s. 707-711
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Tidskriftsartikel (refereegranskat)abstract
- Reduced peak knee flexion during stair descent (PKSD) is demonstrated in subjects with total knee arthroplasty (TKA), but the underlying factors are not well studied. 3D gait patterns during stair descent, peak passive knee flexion (PPKF), quadriceps strength, pain, proprioception, demographics, and anthropometrics were assessed in 23 unilateral TKA-subjects ~ 19 months post-operatively, and in 23 controls. PKSD, PPKF and quadriceps strength were reduced in the TKA-side, but also in the contralateral side. A multiple regression analysis identified PPKF as the only predictor (57%) to explain the relationship with PKSD. PPKF was, however sufficient for normal PKSD. Deficits in quadriceps strength in TKA-group suggest that strength is also contributing to smaller PKSD. Increased hip adduction at PKSD may indicate both compensatory strategy and reduced hip strength.
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| 27. |
- Callary, Stuart A, et al.
(författare)
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The 6-Year Migration Characteristics of a Hydroxyapatite-Coated Femoral Stem A Radiostereometric Analysis Study
- 2012
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Ingår i: The Journal of Arthroplasty. - : Elsevier. - 0883-5403 .- 1532-8406. ; 27:7, s. 1344-1348
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Tidskriftsartikel (refereegranskat)abstract
- A prospective cohort of 30 patients undergoing primary total hip arthroplasty for treatment of osteoarthritis was enrolled in a study to characterize the migration behavior of a clinically successful cementless stem. At 6 years, the mean subsidence of the stem was 0.63 mm (range, -0.33 to 3.68 mm); the mean rotation into retroversion was 1.41° (range, -1.33° to 7.48°). No stems had additional subsidence of more than 0.25 mm between 6 months and 6 years. The resultant mean subsidence between 2 and 6 years was 0.03 mm, which is below the limit measurable by radiostereometric analysis. The data demonstrate that subsidence of this cementless stem occurs within the first 6 months, after which there is persistent stabilization.
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| 28. |
- Carlsson, Lars, 1952, et al.
(författare)
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Minimally invasive surgery vs conventional exposure using the Miller-Galante unicompartmental knee arthroplasty: a randomized radiostereometric study
- 2006
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Ingår i: J Arthroplasty. - 0883-5403. ; 21:2, s. 151-6
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Tidskriftsartikel (refereegranskat)abstract
- Forty-one patients were randomized to a cemented Miller-Galante unicompartmental (Zimmer, Warsaw, Ind) knee arthroplasty inserted with either minimally invasive surgery or with a standard exposure. Clinical data and conventional radiographs were recorded and patients were followed with radiostereometric analysis to measure migration rate of the tibial component. The rehabilitation of patients operated through a small incision was faster, and there was a significant difference in days of hospitalization (P = .03). No statistical significant difference was found between the 2 groups regarding clinical or radiographic data. The Hospital for Special Surgery score was 96 and 92, respectively, for the minimally invasive surgery and conventional group at 2 years. The limb alignment was equal in both groups with a mean femorotibial axis of 182 degrees after surgery. The rate of migration for tibial components was very small, with a maximal total point motion of 0.8 mm for both groups after 2 years follow-up.
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| 29. |
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| 30. |
- Catani, F, et al.
(författare)
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The stability of the cemented tibial component of total knee arthroplasty
- 2004
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Ingår i: Journal of Arthroplasty. - : Elsevier BV. - 0883-5403. ; 19:6, s. 775-782
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Tidskriftsartikel (refereegranskat)abstract
- Micromotion of the tibial component in 40 knee arthroplasties for gonarthrosis was studied rising Roentgen stereophotogrammetric analysis. The stability of this component was assessed for 2 years' postoperatively. in all arthroplasties, an attempt was made to reconstruct the preoperative posterior slope. Posterior cruciate-retaining (CR) and posterior-stabilized (PS) components showed at 2 years a maximum total point motion of 0.6 +/- 0.4 mm and 0.7 +/- 0.5 mm, respectively. Whereas 92.5% of the implants were determined to be stable, 1 of the CR group and 2 of the PS group displayed migration between the first and the second year of at least 0.2 mm. A negative correlation between subsidence of the tibial component at 2 years of follow-up and the difference between preoperative and postoperative tibial slope was found. Consequently, we suggest that restoring the original posterior slope of the tibial plateau must be a goal of tibial component implantation.
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| 31. |
- Chen, Antonia, et al.
(författare)
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Prevention of Late PJI
- 2014
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Ingår i: The Journal of Arthroplasty. - : Elsevier BV. - 0883-5403 .- 1532-8406. ; 29:2, s. 119-128
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Tidskriftsartikel (refereegranskat)
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| 32. |
- Dahlstrand, Henrik, et al.
(författare)
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Elevated serum concentrations of cobalt, chromium, nickel, and manganese after metal-on-metal alloarthroplasty of the hip : a prospective randomized study
- 2009
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Ingår i: The Journal of Arthroplasty. - : Elsevier BV. - 0883-5403 .- 1532-8406. ; 24:6, s. 837-845
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Tidskriftsartikel (refereegranskat)abstract
- In this prospective randomized study, we investigate metal ion concentrations and clinical outcome 2 years after metal-on-metal (28 patients) or metal-on-polyethylene (26 patients) hip arthroplasty with 28-mm modular heads. Metal ion concentrations in patient serum were analyzed by high-resolution plasma mass spectrometry. The clinical outcome was almost identical in both groups with respect to the Harris hip score and the Medical Outcome Study Short Form-36; and on plain radiography, no signs of loosening occurred in any group. In the metal-on-metal group, concentrations of all investigated ions increased significantly when compared with preoperative values: cobalt, 15.3-fold (95% confidence interval [CI], 9.4-21.2); chromium, 5.2-fold (CI, 3.5-7.0); nickel, 2.1-fold (CI, 1.2-3.0); and manganese, 1.6-fold (CI, 1.3-2.0). In the metal-on-polyethylene group, a smaller but significant increase in the concentrations of cobalt and nickel occurred, whereas concentrations of the other ions did not change significantly.
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| 33. |
- Digas, Georgios, 1963, et al.
(författare)
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Fluoride-containing acrylic bone cement in total hip arthroplasty. Randomized evaluation of 97 stems using radiostereometry and dual-energy x-ray absorptiometry
- 2005
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Ingår i: J Arthroplasty. - : Elsevier BV. - 0883-5403. ; 20:6, s. 784-92
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Tidskriftsartikel (refereegranskat)abstract
- Ninety patients (97 hips) scheduled for total hip arthroplasty were stratified to fixation of the femoral component using fluoride-containing cement or Palacos with gentamicin. Whole polyethylene Reflection and press-fit Trilogy cups were used. All patients received Spectron EF stem. The micromotions of the stem were measured with radiostereometric analysis and the periprosthetic bone mineral density with automatic and manual dual-energy x-ray absorptiometry (DEXA) analysis. At 2 years, the choice of cement did not influence the subsidence or rotations of the stem. The DEXA analysis revealed more loss of periprosthetic bone mineral density in fluoride cement group. We speculate that forming of fluorapatite crystals, toxic effects of the fluoride, or lower radiopacity of the fluoride cement might explain this finding. According to our study with 2-year of follow-up, there is no obvious advantage of addition of fluoride to acrylic bone cement when used to fixate the femoral component in total hip arthroplasty.
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| 34. |
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| 35. |
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| 36. |
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| 37. |
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| 38. |
- Eriksson, Bengt I., 1946, et al.
(författare)
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Efficacy of fondaparinux for thromboprophylaxis in hip fracture patients
- 2004
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Ingår i: J Arthroplasty. - 0883-5403. ; 19:7 Suppl 2, s. 78-81
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Tidskriftsartikel (refereegranskat)abstract
- Fondaparinux efficacy for thromboprophylaxis was evaluated in predefined high-risk hip fracture patients. Patients received fondaparinux 2.5 mg for 7 days following surgery; 656 patients were randomized double blind to receive placebo or continue fondaparinux regimen for 21 additional days. Primary efficacy was venous thromboembolism (VTE) based on bilateral venography during the double-blind period. Total VTE was 1.4% (3 of 208 patients) for extended prophylaxis and 35% (77 of 220 patients) for short-term prophylaxis (P = 0.001), relative risk reduction (RRR) of 96%. Major bleeding occurred in 2% (8 of 327 patients) with extended prophylaxis and in 0.6% (2 of 329 patients) with short-term prophylaxis (P =.063). Risk of VTE was continued following short course fondaparinux in hip fracture patients, but was significantly reduced by extending prophylaxis, without significant risk of major bleeding.
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| 39. |
- Flivik, Gunnar, et al.
(författare)
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Improved acetabular pressurization gives better cement penetration : In vivo measurements during total hip arthroplasty
- 2004
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Ingår i: The Journal of Arthroplasty. - : Elsevier BV. - 0883-5403 .- 1532-8406. ; 19:7, s. 911-918
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Tidskriftsartikel (refereegranskat)abstract
- During total hip arthroplasty, the intraoperative cementation pressure was measured inside one of the acetabular anchorage holes. Patients were randomized to pressurization of cement with either a conventional pressurizer or a sequential method including individual pressurization of each anchorage hole. The pressure was correlated to the cement penetration measured on digital radiographs. The early peak pressures were higher for the sequential method, resulting in a significantly better penetration of 2.8 mm compared with 0.7 mm with the conventional pressurizer. We found a strong correlation between early peak cementation pressures and cement penetration into the cancellous bone of the anchoring holes, indicating a cause-effect relationship at this early stage. The highest peak pressures were achieved during the later cup insertion, but these pressures did not correlate with the cement penetration. We conclude that conventional methods for cement pressurization in the acetabulum may not be optimal. © 2004 Elsevier Inc. All rights reserved.
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| 40. |
- Ghanem, Elie, et al.
(författare)
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Wound management
- 2014
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Ingår i: Journal of Arthroplasty. - : Elsevier BV. - 0883-5403. ; 29:2 suppl., s. 84-92
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Tidskriftsartikel (refereegranskat)
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| 41. |
- Goldvasser, Dov, et al.
(författare)
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A New Technique for Measuring Wear in Total Hip Arthroplasty Using Computed Tomography
- 2012
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Ingår i: The Journal of Arthroplasty. - : Elsevier. - 0883-5403 .- 1532-8406. ; 27:9, s. 1636-1640
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Tidskriftsartikel (refereegranskat)abstract
- Accurately estimating polyethylene wear in 3 dimensions, without the need for additional procedures or equipment, is of significant interest. We investigated the use of a high-resolution clinical computed tomographic (CT) scanner to estimate femoral head displacement relative to the cup as an indirect method of estimating polyethylene wear. A hip phantom was used to simulate the 3-dimensional displacement of a femoral head. The phantom was imaged in a high-resolution CT scanner. The mean difference between the true phantom displacement as positioned by micrometers and the calculated displacement based on the CT images was as follows: for the x-axis, 0 mm (SD, 0.213; SE, 0.058); y-axis, 0.039 mm (SD, 0.035; SE, 0.026); and z-axis, 0.039 mm (SD, 0.051; SE, 0.020).
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| 42. |
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| 43. |
- Hansson, Ulrik, et al.
(författare)
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Histologic reactions to particulate wear debris in different mesenchymal tissues : Studies on the nonreplaced compartment from revised uni-knees
- 2004
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Ingår i: The Journal of Arthroplasty. - : Elsevier BV. - 0883-5403 .- 1532-8406. ; 19:4, s. 481-487
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Tidskriftsartikel (refereegranskat)abstract
- The interface between bone and artificial-joint implants consists of soft tissue. This tissue varies from fibrocartilage to loose fibrous tissue. Tissues that resemble those can be found in normal joints. Sixteen knees with unicompartmental knee prostheses, revised because of excessive wear of the tibial insert, were studied. Synovium, synovial fluid, cartilage, and bone from the nonreplaced compartment were studied with light microscopy. We found wear particles and reactions to those in all tissues except cartilage. In the subchondral bone, we found osteolytic-like processes undermining the cartilage peripherally. Our conclusion from these findings is that the histologic composition of the bone-implant interface might be an important factor regarding the reaction of the tissue to wear particles and, thus, component fixation. © 2004 Elsevier Inc. All rights reserved.
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| 44. |
- Heijbel, Siri, et al.
(författare)
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Patient-Reported Anxiety or Depression Increased the Risk of Dissatisfaction Despite Improvement in Pain or Function Following Total Knee Arthroplasty : A Swedish Register-Based Observational Study of 8,745 Patients
- 2024
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Ingår i: Journal of Arthroplasty. - 0883-5403 .- 1532-8406.
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Tidskriftsartikel (refereegranskat)abstract
- Background: Remaining pain and functional limitations may cause dissatisfaction in patients after total knee arthroplasty (TKA). Furthermore, anxiety and depression are associated with remaining postoperative symptoms and dissatisfaction. We investigated if patient-reported anxiety or depression increased the risk of dissatisfaction 1 year after TKA in patients who improved in pain or function. Methods: Data on primary TKAs due to osteoarthritis between 2017 and 2019 were obtained from the Swedish Knee Arthroplasty Register. Out of 14,120 patients, 9,911 completed the Knee injury and Osteoarthritis Outcome Score and satisfaction rate with the result of the surgery. According to the Outcome Measures in Rheumatology—Osteoarthritis Research Society International criteria patients were classified as responders (improved in pain or function) or nonresponders. Anxiety and depression were assessed through EuroQol-5 Dimension 3 levels. Log-linear regression models estimated the risk ratios (RRs) for dissatisfaction in all patients and stratified by age groups (< 65, 65 to 74, and > 74 years). There were 8,745 patients who were classified as responders whereas 11% were defined as dissatisfied. The proportion of patients who reported anxiety or depression was 35% preoperatively and 17% postoperatively. Results: Anxiety or depression increased the risk of dissatisfaction preoperatively (RR 1.23, 95% confidence interval = 1.09 to 1.40) and postoperatively (RR 2.65, confidence interval 2.33 to 3.00). Patients younger than 65 years reported preoperative anxiety or depression to a greater extent but did not have an increased risk of dissatisfaction. Conclusions: Patient-reported anxiety or depression preoperatively and postoperatively are important and potentially treatable factors to consider, as they were found to increase the risk of dissatisfaction after TKA despite improvements in pain or function.
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| 45. |
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| 46. |
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| 47. |
- Jensen, Claus L., et al.
(författare)
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Revision Total Knee Arthroplasty With the Use of Trabecular Metal Cones A Randomized Radiostereometric Analysis With 2 Years of Follow-Up
- 2012
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Ingår i: Journal of Arthroplasty. - : Elsevier BV. - 0883-5403. ; 27:10, s. 1820-1826
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Tidskriftsartikel (refereegranskat)abstract
- "Trabecular Metal Cone" (TM Cone) (Zimmer, Inc, Warsaw, Ind) for reconstruction of bone loss in the proximal tibia during revision total knee arthroplasty is now optional. Forty patients were randomized to receive revision total knee arthroplasty with or without TM Cone (No TM Cone). The Anderson Orthopaedic Research Institute bone loss classification and NexGen revision system were used. Radiostereometric analysis was performed with 24 months of follow-up. Maximum total point motion: stable migration was seen in the TM Cone group. No statistically significant difference was found. Segment motion analysis at 24 months showed the same net direction of rotation for the groups around the y-, z-axis and around the x-, y-axis for translation. Tibial revision implants with TM Cone result in an early stable situation with less irregular migration pattern than revision without TM Cone.
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| 48. |
- Johansson, Torsten, et al.
(författare)
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Blood loss after total hip replacement : A prospective randomized study between wound compression and drainage
- 2005
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Ingår i: The Journal of Arthroplasty. - : Elsevier BV. - 0883-5403 .- 1532-8406. ; 20:8, s. 967-971
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Tidskriftsartikel (refereegranskat)abstract
- A randomized, controlled study compared the effects of wound compression with drainage after primary total hip arthroplasty. In 51 patients, an inflatable cuff was placed over the wound underneath a girdle (System Calmed, Calmed AB, Askim, Sweden). Control patients had wound drainage (n = 54). Preoperative and intraoperative variables did not differ between groups. Total blood loss was calculated using hemoglobin balance, with compression it was 1510 ± 656 mL (mean ± SD) and in controls 1695 ± 712 mL (P = .13). However, less blood was transfused in the compression group (P = .05). Wound infection was seen in 2 patients with compression and in 3 controls. Deep venous thrombosis occurred in 3 controls. Wound discharge was more frequent in controls (19/54 vs 8/51, P = .04). Thus, wound compression had no obvious negative effects and reduced wound discharge and need for transfusion. It may replace drainage after total hip arthroplasty. © 2005 Elsevier Inc. All rights reserved.
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| 49. |
- Johansson, Torsten
(författare)
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Untitled - Reply
- 2006
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Ingår i: The Journal of Arthroplasty. - : Elsevier BV. - 0883-5403 .- 1532-8406. ; 21:5
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Annan publikation (övrigt vetenskapligt/konstnärligt)
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| 50. |
- Kesteris, Uldis, et al.
(författare)
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Contamination of polyethylene cups with polymethyl methacrylate particles: an experimental study
- 2001
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Ingår i: Journal of Arthroplasty. - : Elsevier BV. - 0883-5403. ; 16:7, s. 905-908
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Tidskriftsartikel (refereegranskat)abstract
- The articulating surfaces of 6 ultra-high molecular weight polyethylene cups were exposed to curing polymethyl methacrylate (PMMA) bone-cement and examined with scanning electron microscopy and laser ablation inductively coupled plasma mass spectrometry (LA-ICPMS). Three of the cups were exposed to blood and bone-cement, and the rest were exposed to bone-cement only. After removal of the bone-cement bulk, PMMA particles were found and identified in all 6 cups. The particles were verified by identifying zirconium with energy-dispersive x-ray fluorescence spectroscopy in 5 cups and with LA-ICPMS in 1 cup. The degree of surface contamination was estimated with LA-ICPMS. The number of zirconium-containing particles detected was on average 10 to 20/mm2. PMMA bone-cement left in polyethylene cups during polymerization can contaminate the articulating surface with adherent PMMA particles.
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