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The effect of fixat...
The effect of fixation type on the survivorship of contemporary total knee arthroplasty in patients younger than 65 years of age : a register-based study of 115,177 knees in the Nordic Arthroplasty Register Association (NARA) 2000–2016
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- Niemeläinen, Mika J. (author)
- University of Tampere
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- Mäkelä, Keijo T. (author)
- Finnish National Institute for Health and Welfare,Turku University Hospital
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- Robertsson, Otto (author)
- Skåne University Hospital
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- W-Dahl, Annette (author)
- Lund University,Lunds universitet,Ortopedi, Lund,Sektion III,Institutionen för kliniska vetenskaper, Lund,Medicinska fakulteten,Orthopaedics (Lund),Section III,Department of Clinical Sciences, Lund,Faculty of Medicine,Skåne University Hospital
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- Furnes, Ove (author)
- Haukeland University Hospital,University of Bergen
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- Fenstad, Anne M. (author)
- Haukeland University Hospital
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- Pedersen, Alma B. (author)
- Aarhus University Hospital
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- Schrøder, Henrik M. (author)
- Naestved Hospital
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- Reito, Aleksi (author)
- University of Tampere
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- Eskelinen, Antti (author)
- Finnish National Institute for Health and Welfare,University of Tampere
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(creator_code:org_t)
- 2020-01-13
- 2020
- English 7 s.
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In: Acta Orthopaedica. - : Medical Journals Sweden AB. - 1745-3674 .- 1745-3682. ; 91:2, s. 184-190
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Abstract
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- Background and purpose — Cemented fixation is regarded as the gold standard in total knee arthroplasty (TKA). Among working-age patients, there has been controversy regarding the optimal fixation method in TKA. To address this issue, we conducted a register-based study to assess the survivorship of cemented, uncemented, hybrid, and inverse hybrid TKAs in patients aged < 65 years. Patients and methods — We used the Nordic Arthroplasty Register Association data of 115,177 unconstrained TKAs performed for patients aged < 65 years with primary knee osteoarthritis over 2000–2016. Kaplan–Meier (KM) survival analysis with 95% confidence intervals (CI) and Cox multiple-regression model with adjustment for age, sex, and nation were used to compare fixation methods in relation to revision for any reason. Results — The 10-year KM survivorship of cemented TKAs was 93.6% (95% CI 93.4–93.8), uncemented 91.2% (CI 90.1–92.2), hybrid 93.0% (Cl 92.2–93.8), and inverse hybrid 96.0% (CI 94.1–98.1). In the Cox model, hybrid TKA showed decreased risk of revision after 6 years’ follow-up compared with the reference group (cemented) (hazard ratio [HR] 0.5 [CI 0.4–0.8]), while uncemented TKAs showed increased risk of revision both < 1 year (HR 1.4 [1.1–1.7]) and > 6 years’ (HR 1.3 [1.0–1.7]) follow-up compared to the reference. Interpretation — Both cemented and hybrid TKAs had 10-year survival rates exceeding 92–>93% in patients aged < 65 years. Cemented TKA, however, was used in the vast majority (89%) of the operations in the current study. As it performs reliably in the hands of many, it still deserves the status of gold standard for TKA in working-age patients.
Subject headings
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Ortopedi (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Orthopaedics (hsv//eng)
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- art (subject category)
- ref (subject category)
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- By the author/editor
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Niemeläinen, Mik ...
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Mäkelä, Keijo T.
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Robertsson, Otto
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W-Dahl, Annette
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Furnes, Ove
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Fenstad, Anne M.
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show more...
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Pedersen, Alma B ...
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Schrøder, Henrik ...
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Reito, Aleksi
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Eskelinen, Antti
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show less...
- About the subject
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- MEDICAL AND HEALTH SCIENCES
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MEDICAL AND HEAL ...
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and Clinical Medicin ...
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and Orthopaedics
- Articles in the publication
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Acta Orthopaedic ...
- By the university
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Lund University