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10-year results of a new low-monomer cement: follow-up of a randomized RSA study.

https://arctichealth.org/en/permalink/ahliterature119286
Source
Acta Orthop. 2012 Dec;83(6):604-8
Publication Type
Article
Date
Dec-2012
Author
Per Söderlund
Jon Dahl
Stephan Röhrl
Bo Nivbrant
Kjell G Nilsson
Author Affiliation
Institution of Surgery and Perioperative Sciences and Department of Orthopedics, Umeå University, Umeå, Sweden. per.soderlund@orthop.umu.se
Source
Acta Orthop. 2012 Dec;83(6):604-8
Date
Dec-2012
Language
English
Publication Type
Article
Keywords
Aged
Arthroplasty, Replacement, Hip - adverse effects - methods
Bone Cements - chemistry - therapeutic use
Confidence Intervals
Female
Follow-Up Studies
Hip Prosthesis
Humans
Male
Middle Aged
Prospective Studies
Prosthesis Design
Prosthesis Failure
Range of Motion, Articular - physiology
Risk assessment
Statistics, nonparametric
Sweden
Time Factors
Titanium
Treatment Outcome
Abstract
The properties and performance of a new low-monomer cement were examined in this prospective randomized, controlled RSA study. 5-year data have already been published, showing no statistically significant differences compared to controls. In the present paper we present the 10-year results.
44 patients were originally randomized to receive total hip replacement with a Lubinus SPII titanium-aluminum-vanadium stem cemented either with the new Cemex Rx bone cement or with control bone cement, Palacos R. Patients were examined using RSA, Harris hip score, and conventional radiographs.
At 10 years, 33 hips could be evaluated clinically and 30 hips could be evaluated with RSA (16 Cemex and 14 Palacos). 9 patients had died and 4 patients were too old or infirm to be investigated. Except for 1 hip that was revised for infection after less than 5 years, no further hips were revised before the 10-year follow-up. There were no statistically significant clinical differences between the groups. The Cemex cement had magnitudes of migration similar to or sometimes lower than those of Palacos cement. In both groups, most hips showed extensive radiolucent lines, probably due to the use of titanium alloy stems.
At 10 years, the Cemex bone cement tested performed just as well as the control (Palacos bone cement).
Notes
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PubMed ID
23116438 View in PubMed
Less detail

18 years of results with cemented primary hip prostheses in the Norwegian Arthroplasty Register: concerns about some newer implants.

https://arctichealth.org/en/permalink/ahliterature147752
Source
Acta Orthop. 2009 Aug;80(4):402-12
Publication Type
Article
Date
Aug-2009
Author
Birgitte Espehaug
Ove Furnes
Lars B Engesaeter
Leif I Havelin
Author Affiliation
The Norwegian Arthroplasty Register, Department of Orthopaedic Surgery, Haukeland University Hospital, Bergen, Norway. birgitte.espehaug@helse-bergen.no
Source
Acta Orthop. 2009 Aug;80(4):402-12
Date
Aug-2009
Language
English
Publication Type
Article
Keywords
Arthroplasty, Replacement, Hip - adverse effects - methods
Bone Cements
Cementation
Follow-Up Studies
Hip Prosthesis - adverse effects
Humans
Norway
Outcome Assessment (Health Care)
Prosthesis Failure
Registries
Time Factors
Abstract
Few studies have compared the long-term survival of cemented primary total hip arthroplasties (THAs), and several prostheses have been used without adequate knowledge of their endurance. We studied long-term outcome based on data in the Norwegian Arthroplasty Register.
The 10 most used prosthesis brands in 62,305 primary Palacos or Simplex cemented THAs reported to the Register from 1987 through 2007 were included. Survival analyses with revision as endpoint (for any cause or for aseptic loosening) were performed using Kaplan-Meier and multiple Cox regression with time-dependent covariates. Revision rate ratios (RRs) were estimated for the follow-up intervals: 0-5, 6-10, and > 10 years.
5 prosthesis brands (cup/stem combinations) (Charnley, Exeter, Titan, Spectron/ITH, Link IP/Lubinus SP; n = 24,728) were investigated with 0-20 year follow-up (inserted 1987-1997). After 18 years, 11% (95% CI: 10.6-12.1) were revised for any cause and 8.4% (7.7-9.1) for aseptic loosening. Beyond 10 years of follow-up, the Charnley cup had a lower revision rate due to aseptic loosening than Exeter (RR = 1.8) and Spectron (RR = 2.4) cups. For stems, beyond 10 years we did not find statistically significant differences comparing Charnley with Titan, ITH, and SP stems, but the Exeter stem had better results (RR = 05). 10 prosthesis brands (9 cups in combination with 6 stems; n = 37,577) were investigated with 0-10 years of follow-up (inserted from 1998 through 2007). The Charnley cup had a lower revision rate due to aseptic loosening than all cups except the IP. Beyond 5 years follow-up, the Reflection All-Poly cup had a 14 times higher revision rate. For stems, beyond 5 years the Spectron-EF (RR = 6.1) and Titan (RR = 5.5) stems had higher revision rates due to aseptic loosening than Charnley. The analyses also showed a marked improvement in Charnley results between the periods 1987-1997 and 1998-2007.
We observed clinically important differences between cemented prosthesis brands and identified inferior results for previously largely undocumented prostheses, including the commonly used prosthesis combination Reflection All-Poly/ Spectron-EF. The results were, however, satisfactory according to international standards.
Notes
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PubMed ID
19857178 View in PubMed
Less detail

[Accelerated course in hip arthroplasty]

https://arctichealth.org/en/permalink/ahliterature61715
Source
Ugeskr Laeger. 2001 Dec 3;163(49):6912-6
Publication Type
Article
Date
Dec-3-2001
Author
S. Rasmussen
M U Kramhøft
K P Sperling
J H Pedersen
I B Falck
E M Pedersen
H. Kehlet
Author Affiliation
Privathospitalet Hamlet, Frederiksberg. sten.rasmussen@dadlnet.dk
Source
Ugeskr Laeger. 2001 Dec 3;163(49):6912-6
Date
Dec-3-2001
Language
Danish
Publication Type
Article
Keywords
Aged
Aged, 80 and over
Arthroplasty, Replacement, Hip - adverse effects - nursing - rehabilitation
Denmark
English Abstract
Female
Humans
Length of Stay
Male
Patient Discharge
Physical Therapy Modalities
Postoperative Care - methods
Preoperative Care - methods
Prospective Studies
Recovery of Function
Rehabilitation Nursing - methods
Research Support, Non-U.S. Gov't
Abstract
INTRODUCTION: The aim of the study was to assess the results of a well-defined rehabilitation programme after hip arthroplasty. METHODS: The effects of a revised, optimised, perioperative care programme with continuous epidural analgesia, oral nutrition, and physiotherapy were assessed in 60 patients before intervention and 60 patients after intervention. RESULTS: The hospital stay was reduced from nine to six days (p
PubMed ID
11766505 View in PubMed
Less detail

Accelerated perioperative care and rehabilitation intervention for hip and knee replacement is effective: a randomized clinical trial involving 87 patients with 3 months of follow-up.

https://arctichealth.org/en/permalink/ahliterature86594
Source
Acta Orthop. 2008 Apr;79(2):149-59
Publication Type
Article
Date
Apr-2008
Author
Larsen Kristian
Sørensen Ole Gade
Hansen Torben B
Thomsen Per B
Søballe Kjeld
Author Affiliation
The Musculoskeletal Research Unit, Department of Orthopedics, Holstebro Regional Hospital, Holstebro, Denmark. fekl2004@msn.com
Source
Acta Orthop. 2008 Apr;79(2):149-59
Date
Apr-2008
Language
English
Publication Type
Article
Keywords
Aged
Arthroplasty, Replacement, Hip - adverse effects - rehabilitation
Arthroplasty, Replacement, Knee - adverse effects - rehabilitation
Early Ambulation
Female
Follow-Up Studies
Humans
Length of Stay
Male
Middle Aged
Osteoarthritis, Hip - diagnosis - surgery
Osteoarthritis, Knee - diagnosis - surgery
Patient Readmission
Perioperative Care - methods
Quality of Life
Time Factors
Treatment Outcome
Abstract
BACKGROUND: Approximately 12,000 hip and knee replacements were performed in Denmark in 2005. Accelerated perioperative interventions are currently implemented, but there is conflicting evidence regarding the effect. We therefore performed an efficacy study of an accelerated perioperative care and rehabilitation intervention in patients receiving primary total hip replacement, and both total and unicompartmental knee replacement. METHODS: A randomized clinical trial was undertaken in which 87 patients were randomized to either a control group receiving the current perioperative procedure, or an intervention group receiving a new accelerated perioperative care and rehabilitation procedure. Outcome measures were length of stay (LOS) in hospital, and gain in quality of life (QOL) using EQ-5D from baseline to 3-month follow-up. RESULTS: Mean LOS was reduced (p
PubMed ID
18478482 View in PubMed
Less detail

[Accelerated recovery program after hip fracture surgery]

https://arctichealth.org/en/permalink/ahliterature61643
Source
Ugeskr Laeger. 2002 Dec 30;165(1):29-33
Publication Type
Article
Date
Dec-30-2002
Author
Sten Rasmussen
Billy B Kristensen
Susanne Foldager
Lis Myhrmann
Henrik Kehlet
Author Affiliation
Ortopaedkirurgisk afdeling, Vejle Sygehus, DK-7300 Vejle. sten.rasmussen@dadlnet.dk
Source
Ugeskr Laeger. 2002 Dec 30;165(1):29-33
Date
Dec-30-2002
Language
Danish
Publication Type
Article
Keywords
Aged
Arthroplasty, Replacement, Hip - methods - rehabilitation
Comparative Study
Denmark
Early Ambulation - methods
English Abstract
Female
Hip Fractures - rehabilitation - surgery
Humans
Length of Stay - statistics & numerical data
Male
Middle Aged
Postoperative Care - methods
Preoperative Care - methods
Prospective Studies
Recovery of Function
Research Support, Non-U.S. Gov't
Retrospective Studies
Abstract
INTRODUCTION: A multimodal approach to minimise the effect of the surgical stress response can reduce complications and hospital stay after abdominal surgery and hip arthroplasty. The aim of the study was to assess the results of a well-defined rehabilitation programme after hip fracture. MATERIAL AND METHODS: In an open intervention study, we entered 200 consecutive patients with hip fracture allowing full weight-bearing after operative treatment. The effect of a revised, optimised perioperative care programme with continuous epidural analgesia, early oral nutrition, oxygen supplementation, restricted volume and transfusion therapy, and intensive physiotherapy and mobilisation was assessed (n = 100) and compared with the conventional perioperative treatment programme before the intervention (n = 100). The median age was 82 (56-96) years in the control group and 82 (63-101) years in the accelerated multimodal perioperative treatment group. RESULTS: The median hospital stay was reduced from 21 (range 1-162, mean 32) to 11 (range 1-100, mean 17) days. The total use of days in hospital was reduced from 3211 to 1667. There were fewer complications, whereas the need for home care after discharge was unchanged. CONCLUSION: An accelerated clinical pathway with focus on pain relief, oral nutrition, and rehabilitation may reduce hospital stay and improve recovery after hip fracture.
PubMed ID
12529945 View in PubMed
Less detail

[Accelerated versus conventional hospital stay in total hip and knee arthroplasty III: patient satisfaction]

https://arctichealth.org/en/permalink/ahliterature81877
Source
Ugeskr Laeger. 2006 May 29;168(22):2148-51
Publication Type
Article
Date
May-29-2006
Author
Husted Henrik
Hansen Hans Christian
Holm Gitte
Bach-Dal Charlotte
Rud Kirsten
Andersen Kristoffer Lande
Kehlet Henrik
Author Affiliation
H:S Hvidovre Hospital, Ortopaedkirurgisk Afdeling, Hvidovre. henrikhusted@dadlnet.dk
Source
Ugeskr Laeger. 2006 May 29;168(22):2148-51
Date
May-29-2006
Language
Danish
Publication Type
Article
Keywords
Age Factors
Arthroplasty, Replacement, Hip - rehabilitation - statistics & numerical data
Arthroplasty, Replacement, Knee - rehabilitation - statistics & numerical data
Comorbidity
Denmark
Early Ambulation
Female
Humans
Length of Stay - statistics & numerical data
Male
Patient Discharge - statistics & numerical data
Patient satisfaction
Questionnaires
Registries
Abstract
INTRODUCTION: The goal of this study was to evaluate patient satisfaction with the hospital stay in relation to the length of stay for patients operated on with primary total hip- and knee-arthroplasty (THA and TKA). MATERIALS AND METHODS: According to the National Register on Patients, the three departments with the shortest and the three departments with the longest postoperative hospital stay at the end of 2003 were chosen for evaluation. The patients, operated on with THA or TKA from September 2004 to April 2005, from the selected departments answered a questionnaire regarding satisfaction with elected parts of their stay, co-morbidity, sex and age. RESULTS: The patients from the departments with the shortest stay were not younger nor had they less co-morbidities than patients from departments with longer stays. Apart from staying a significantly shorter time, they were either as satisfied--or sometimes more satisfied--with all parts of their stay compared to patients from the departments with longer hospital stay. CONCLUSION: Patients in accelerated stays are not less satisfied with their hospital stay (or any part of it) compared to patients with longer and more conventional hospital stays. These results support the implementation of fast-track total hip- and knee arthroplasty.
PubMed ID
16768952 View in PubMed
Less detail

[Accelerated versus conventional hospital stay in total hip and knee arthroplasty II: organizational and clinical differences].

https://arctichealth.org/en/permalink/ahliterature168857
Source
Ugeskr Laeger. 2006 May 29;168(22):2144-8
Publication Type
Article
Date
May-29-2006
Author
Henrik Husted
Hans Christian Hansen
Gitte Holm
Charlotte Bach-Dal
Kirsten Rud
Kristoffer Lande Andersen
Henrik Kehlet
Author Affiliation
H:S Hvidovre Hospital, Ortopaedkirurgisk Afdeling, Hvidovre. henrikhusted@dadlnet.dk
Source
Ugeskr Laeger. 2006 May 29;168(22):2144-8
Date
May-29-2006
Language
Danish
Publication Type
Article
Keywords
Arthroplasty, Replacement, Hip - nursing - rehabilitation - statistics & numerical data
Arthroplasty, Replacement, Knee - nursing - rehabilitation - statistics & numerical data
Denmark
Early Ambulation - statistics & numerical data
Focus Groups
Hospital Departments - organization & administration - statistics & numerical data
Humans
Interviews as Topic
Length of Stay
Orthopedics - organization & administration - statistics & numerical data
Patient Discharge - statistics & numerical data
Physician's Practice Patterns
Registries
Abstract
The goal of this study was to evaluate hospital stays for patients operated on with primary total hip- and knee-arthroplasty (THA and TKA) in order to identify important logistical and clinical areas for the duration of the hospital stay.
According to the National Register on Patients, the three departments with the shortest and the three departments with the longest postoperative hospital stay at the end of 2003 were chosen for evaluation. This took place from late 2004 to mid 2005, and all written material and 25 journals from each department were evaluated, and interviews with the heads of the departments as well as the staff were conducted. The logistical set-up and the clinical treatment/pathway were examined in an attempt to identify logistical and clinical factors acting as improvements or barriers for quick rehabilitation and subsequent discharge.
Departments with short hospital stay were characterised by both logistical (homogenous entities, regular staff, high continuity, using more time on and up-to-date information including expectations of a short stay, functional discharge criteria) and clinical features (multi-modal pain treatment, early mobilization and discharge when criteria were met) facilitating quick rehabilitation and discharge.
Implementation of logistical and clinical features, as shown in this study in all departments, are expected to increase rehabilitation and reduce the length of hospital stay.
PubMed ID
16768951 View in PubMed
Less detail

Acetabular dysplasia at the age of 1 year in children with neonatal instability of the hip.

https://arctichealth.org/en/permalink/ahliterature106433
Source
Acta Orthop. 2013 Oct;84(5):483-8
Publication Type
Article
Date
Oct-2013
Author
Daniel Wenger
Henrik Düppe
Carl-Johan Tiderius
Author Affiliation
Department of Orthopaedics , Malmö, Skåne University Hospital , Sweden.
Source
Acta Orthop. 2013 Oct;84(5):483-8
Date
Oct-2013
Language
English
Publication Type
Article
Keywords
Acetabulum - abnormalities
Arthroplasty, Replacement, Hip - statistics & numerical data
Cohort Studies
Early Diagnosis
Female
Hip Dislocation, Congenital - diagnosis - radiography - surgery
Humans
Infant
Joint Instability - congenital - prevention & control - surgery
Male
Observer Variation
Referral and Consultation - statistics & numerical data
Sex Distribution
Sweden
Treatment Outcome
Abstract
As much as one-third of all total hip arthroplasties in patients younger than 60 years may be a consequence of developmental dysplasia of the hip (DDH). Screening and early treatment of neonatal instability of the hip (NIH) reduces the incidence of DDH. We examined the radiographic outcome at 1 year in children undergoing early treatment for NIH.
All children born in Malm? undergo neonatal screening for NIH, and any child with suspicion of instability is referred to our clinic. We reviewed the 1-year radiographs for infants who were referred from April 2002 through December 2007. Measurements of the acetabular index at 1 year were compared between neonatally dislocated, unstable, and stable hips.
The incidence of NIH was 7 per 1,000 live births. The referral rate was 15 per 1,000. 82% of those treated were girls. The mean acetabular index was higher in dislocated hips (25.3, 95% CI: 24.6-26.0) than in neonatally stable hips (22.7, 95% CI: 22.3-23.2). Girls had a higher mean acetabular index than boys and left hips had a higher mean acetabular index than right hips, which is in accordance with previous findings.
Even in children who are diagnosed and treated perinatally, radiographic differences in acetabular shape remain at 1 year. To determine whether this is of clinical importance, longer follow-up will be required.
Notes
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PubMed ID
24171679 View in PubMed
Less detail

Acetabular reconstruction with impaction bone grafting and cemented polyethylene socket in total hip revision arthroplasty.

https://arctichealth.org/en/permalink/ahliterature276221
Source
Scand J Surg. 2015 Dec;104(4):267-72
Publication Type
Article
Date
Dec-2015
Author
I. Kostensalo
M. Seppänen
P. Virolainen
J. Mokka
M. Koivisto
K T Mäkelä
Source
Scand J Surg. 2015 Dec;104(4):267-72
Date
Dec-2015
Language
English
Publication Type
Article
Keywords
Acetabulum - surgery
Adult
Aged
Aged, 80 and over
Arthroplasty, Replacement, Hip - adverse effects - mortality
Bone Cements
Bone Transplantation - methods
Female
Finland - epidemiology
Follow-Up Studies
Humans
Male
Middle Aged
Osteoarthritis, Hip - surgery
Polyethylene
Postoperative Complications
Prosthesis Design
Prosthesis Failure
Reconstructive Surgical Procedures - methods
Reoperation
Retrospective Studies
Survival Rate - trends
Treatment Outcome
Abstract
Bone deficiency in revision total hip arthroplasty is a challenge to the surgeon. One option for restoration of the bone stock is impaction bone grafting and use of a cemented socket. The aim of this study was to evaluate the mid-term clinical outcome of impaction bone grafting and cemented socket revisions.
A total of 59 patients (60 hips) underwent revision arthroplasty with impaction bone grafting and application of a cemented socket on the acetabular side in the Turku University Hospital from 1999 to 2004. The study end-point was re-revision for any reason. The cumulative percentages for survival were followed and estimated with Kaplan-Meier curves. Associations between occurrence of re-revision and potential risk factors were analyzed with logistic regression. Results were quantified by odd ratios and 95% confidence intervals. The mean age of the patients was 69 years (33% male). A total of 3% of the patients had a class I Paprosky acetabular defect, 38% had class II, and 55% had class III.
The overall survival rate was 73%. The mean follow-up time was 7 years. The most common reason for re-revision was aseptic loosening of the acetabular component (13 patients, 81% of re-revisions). Cox's regression analysis did not identify any risk factors for re-revision.
Our results were inferior compared to some previous studies. Impaction bone grafting of acetabular defects in revision total hip arthroplasty may not always provide a reliable bone stock in long-term.
PubMed ID
25681057 View in PubMed
Less detail

Adaptive Bone Remodeling of the Femoral Bone After Tumor Resection Arthroplasty With an Uncemented Proximally Hydroxyapatite-Coated Stem.

https://arctichealth.org/en/permalink/ahliterature274138
Source
J Clin Densitom. 2016 Apr-Jun;19(2):202-7
Publication Type
Article
Author
Mikkel R Andersen
Michael M Petersen
Source
J Clin Densitom. 2016 Apr-Jun;19(2):202-7
Language
English
Publication Type
Article
Keywords
Absorptiometry, Photon - methods
Adult
Aged
Arthroplasty, Replacement, Hip - adverse effects - instrumentation - methods
Biocompatible Materials - pharmacology
Bone Density
Bone Neoplasms - pathology - surgery
Bone remodeling
Denmark
Durapatite - pharmacology
Female
Femur - radiography - surgery
Follow-Up Studies
Hip Prosthesis
Humans
Male
Middle Aged
Osteoporosis - diagnosis - etiology - prevention & control
Postoperative Complications - diagnosis - prevention & control
Prosthesis Design
Sarcoma, Ewing - pathology - surgery
Abstract
Loss of bone stock and stress shielding is a significant challenge in limb salvage surgery. This study investigates the adaptive bone remodeling of the femoral bone after implantation of a tumor prosthesis with an uncemented press fit stem. We performed a prospective 1 yr follow-up of 6 patients (mean age: 55 (26-78) yr, female/male=3/3) who underwent bone tumor resection surgery of the proximal femur (n=3) or distal femur (n=3). Reconstruction was done using a Global Modular Replacement System (Stryker® Orthopaedics, Mahwah, NJ) tumor prosthesis, and all patients received a straight-fluted 125-mm uncemented press-fit titanium alloy stem with hydroxyapatite coating of the proximal part of the stem. Measurements of bone mineral density (BMD; g/cm2) were done postoperatively and after 3, 6, and 12 mo in the part of the femur bone containing the Global Modular Replacement System stem using dual-energy X-ray absorptiometry. BMD was measured in 3 regions of interest (ROIs) in the femur bone. Nonparametric analysis of variance (Friedman test) for evaluation of changes in BMD over time. BMD decreased in all 3 ROIs with time. In ROI 1 (p=0.01), BMD decreased by 10% after 3 mo and ended with a total decrease of 14% after 1 yr. In ROI 2 (p=0.006), BMD was decreased by 6% after 3 and 6 mo; after 1 yr of follow-up, BMD was 9% below the postoperative value. In ROI 3 (p=0.009), BMD decreased by 6% after 3 and 6 mo; after 1 yr of follow-up, BMD was 8% below the postoperative value. A bone loss of 8%-9% during the first postoperative year was seen along the femoral stem, but in the bone containing the hydroxyapatite-coated part of the stem, the decrease in BMD was 14%, thus indicating that stress shielding of this part of the bone may play a role for the adaptive bone remodeling.
PubMed ID
25843447 View in PubMed
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