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5-year outcome after transcatheter aortic valve implantation.

https://arctichealth.org/en/permalink/ahliterature117830
Source
J Am Coll Cardiol. 2013 Jan 29;61(4):413-9
Publication Type
Article
Date
Jan-29-2013
Author
Stefan Toggweiler
Karin H Humphries
May Lee
Ronald K Binder
Robert R Moss
Melanie Freeman
Jian Ye
Anson Cheung
David A Wood
John G Webb
Author Affiliation
St. Paul's Hospital, University of British Columbia, Vancouver, British Columbia, Canada.
Source
J Am Coll Cardiol. 2013 Jan 29;61(4):413-9
Date
Jan-29-2013
Language
English
Publication Type
Article
Keywords
Aged
Aged, 80 and over
Aortic Valve - physiopathology - surgery - ultrasonography
Aortic Valve Stenosis - diagnosis - epidemiology - physiopathology - surgery
Canada - epidemiology
Equipment Failure Analysis - statistics & numerical data
Female
Heart Valve Prosthesis Implantation - adverse effects - methods - mortality - statistics & numerical data
Humans
Male
Outcome and Process Assessment (Health Care)
Postoperative Period
Prognosis
Prosthesis Design
Prosthesis Failure - etiology
Risk factors
Severity of Illness Index
Survival Rate
Survivors - statistics & numerical data
Time Factors
Treatment Outcome
Abstract
The purpose of this study was to investigate the 5-year outcome following transcatheter aortic valve implantation (TAVI).
Little is known about long-term outcomes following TAVI.
The 5-year outcomes following successful TAVI with a balloon-expandable valve were evaluated in 88 patients. Patients who died within 30 days after TAVI were excluded.
Mean aortic valve gradient decreased from 46 ± 18 mm Hg to 10 ± 4.5 mm Hg after TAVI and 11.8 ± 5.7 mm Hg at 5 years (p for post-TAVI trend = 0.06). Mean aortic valve area increased from 0.62 ± 0.17 cm(2) to 1.67 ± 0.41 cm(2) after TAVI and 1.40 ± 0.25 cm(2) at 5 years (p for post-TAVI trend
PubMed ID
23265333 View in PubMed
Less detail

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

10-year survival of total ankle arthroplasties: a report on 780 cases from the Swedish Ankle Register.

https://arctichealth.org/en/permalink/ahliterature129819
Source
Acta Orthop. 2011 Dec;82(6):655-9
Publication Type
Article
Date
Dec-2011
Author
Anders Henricson
Jan-Åke Nilsson
Ake Carlsson
Author Affiliation
Department of Orthopedics , Falun Central Hospital and Center for Clinical Research Dalarna, Falun, Sweden. anders.henricson@ltdalarna.se
Source
Acta Orthop. 2011 Dec;82(6):655-9
Date
Dec-2011
Language
English
Publication Type
Article
Keywords
Adolescent
Adult
Aged
Aged, 80 and over
Arthroplasty, Replacement, Ankle - adverse effects - methods
Cementation
Female
Follow-Up Studies
Humans
Joint Prosthesis - adverse effects
Male
Middle Aged
Outcome Assessment (Health Care)
Prosthesis Design
Prosthesis Failure
Registries
Reoperation
Retrospective Studies
Risk factors
Sweden
Young Adult
Abstract
There is an ongoing need to review large series of total ankle replacements (TARs) for monitoring of changes in practice and their outcome. 4 national registries, including the Swedish Ankle Register, have previously reported their 5-year results. We now present an extended series with a longer follow-up, and with a 10-year survival analysis.
Records of uncemented 3-component TARs were retrospectively reviewed, determining risk factors such as age, sex, and diagnosis. Prosthetic survival rates were calculated with exchange or removal of components as endpoint-excluding incidental exchange of the polyethylene meniscus.
Of the 780 prostheses implanted since 1993, 168 (22%) had been revised by June 15, 2010. The overall survival rate fell from 0.81 (95% CI: 0.79-0.83) at 5 years to 0.69 (95% CI: 0.67-0.71) at 10 years. The survival rate was higher, although not statistically significantly so, during the latter part of the period investigated. Excluding the STAR prosthesis, the survival rate for all the remaining designs was 0.78 at 10 years. Women below the age of 60 with osteoarthritis were at a higher risk of revision, but age did not influence the outcome in men or women with rheumatoid arthritis. Revisions due to technical mistakes at the index surgery and instability were undertaken earlier than revisions for other reasons.
The results have slowly improved during the 18-year period investigated. However, we do not believe that the survival rates of ankle replacements in the near future will approach those of hip and knee replacements-even though improved instrumentation and design of the prostheses, together with better patient selection, will presumably give better results.
Notes
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Cites: Foot Ankle Int. 2010 Dec;31(12):1048-5621189204
Cites: Foot Ankle Int. 2011 May;32(5):S493-50221733457
Cites: Clin Orthop Relat Res. 2004 Jul;(424):73-915241146
PubMed ID
22066551 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
Cites: J Bone Joint Surg Br. 2003 Jan;85(1):45-5112585576
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Cites: Acta Orthop Scand Suppl. 1980;185:1-2086938104
Cites: J Bone Joint Surg Br. 1990 Nov;72(6):971-92246300
Cites: Clin Orthop Relat Res. 1992 Sep;(282):53-631516329
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Cites: J Arthroplasty. 2003 Oct;18(7):925-3014566751
PubMed ID
19857178 View in PubMed
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The AAA with a challenging neck: outcome of open versus endovascular repair with standard and fenestrated stent-grafts.

https://arctichealth.org/en/permalink/ahliterature88967
Source
J Endovasc Ther. 2009 Apr;16(2):137-46
Publication Type
Article
Date
Apr-2009
Author
Chisci Emiliano
Kristmundsson Thorarinn
de Donato Gianmarco
Resch Timothy
Setacci Francesco
Sonesson Björn
Setacci Carlo
Malina Martin
Author Affiliation
Vascular and Endovascular Surgery Unit, University of Siena, Italy. e.chisci@gmail.com
Source
J Endovasc Ther. 2009 Apr;16(2):137-46
Date
Apr-2009
Language
English
Publication Type
Article
Keywords
Aged
Aged, 80 and over
Aortic Aneurysm, Abdominal - mortality - radiography - surgery
Aortography - methods
Blood Vessel Prosthesis
Blood Vessel Prosthesis Implantation - adverse effects - instrumentation - mortality
Female
Humans
Italy
Kaplan-Meiers Estimate
Male
Middle Aged
Odds Ratio
Prosthesis Design
Prosthesis Failure
Reoperation
Retrospective Studies
Risk assessment
Stents
Sweden
Time Factors
Tomography, X-Ray Computed
Treatment Outcome
Abstract
PURPOSE: To compare the outcome of endovascular aneurysm repair (EVAR) versus conventional open repair (OR) in patients with a short, angulated or otherwise challenging proximal neck. METHODS: The definition of a challenging proximal neck was based on diameter (>or=28 mm), length (or=60 degrees ), shape (reverse tapered or bulging), and thrombus lining (>50%). Between January 2005 and December 2007, 187 consecutive patients (159 men; mean age 73 years, range 48-92) operated for asymptomatic abdominal aortic aneurysm (AAA) were identified as having challenging proximal neck morphology. Of these, 61 patients were treated with OR at center I (group A), 71 with standard EVAR (group B; 45 center I, 29 center II) and 52 with fenestrated EVAR (group C) at center II. Clinical examination and computed tomography were performed at 1 month and yearly thereafter. RESULTS: There was no statistically significant difference between groups A, B, and C regarding primary technical success rate, 30-day mortality, or late AAA-related mortality. The mean length of follow-up was 19.5 months (range 0-40). Freedom from reintervention at 3 years was 91.8%, 79.7%, and 82.7% for groups A, B, and C, respectively (p = 0.042). The only statistically significant difference between standard and fenestrated EVAR was a higher incidence of late sac expansion [9 (12.2%) versus 1 (1.9%), p = 0.036] in the standard stent-graft group. Reinterventions were more frequent after EVAR (p = NS), but open reinterventions were more common after OR. Reinterventions after EVAR were related to the presence of an angulated (p = 0.039) or short neck (p = 0.024). CONCLUSION: The results of EVAR and OR were similar for AAAs with a challenging proximal neck. Endovascular reinterventions were more frequent after EVAR, particularly in patients with an angulated or short neck. Open reinterventions were more common after OR. More patients and long-term data are needed to confirm these findings.
Notes
Comment In: J Endovasc Ther. 2009 Apr;16(2):147-819456195
PubMed ID
19456190 View in PubMed
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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

Acrylic bone cements: clinical developments and current status: Scandinavia.

https://arctichealth.org/en/permalink/ahliterature177419
Source
Orthop Clin North Am. 2005 Jan;36(1):55-61, vi
Publication Type
Article
Date
Jan-2005
Author
Lars Lidgren
Otto Robertson
Author Affiliation
Department of Orthopedics, Lund University Hospital, SE-221 85, Lund, Sweden. lars.lidgren@ort.lu.se
Source
Orthop Clin North Am. 2005 Jan;36(1):55-61, vi
Date
Jan-2005
Language
English
Publication Type
Article
Keywords
Anti-Bacterial Agents - administration & dosage
Arthroplasty, Replacement
Bone Cements - therapeutic use
Drug Delivery Systems
Humans
Joint Prosthesis - adverse effects
Polymethyl Methacrylate - therapeutic use
Prosthesis Failure
Prosthesis-Related Infections - prevention & control
Scandinavia
Abstract
This article focuses on bone cement, the cementing technique used, and their influence on aseptic loosening and infection of acrylic and joint implants--Scandinavian view.
PubMed ID
15542123 View in PubMed
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Acute obstruction by Pannus in patients with aortic medtronic-hall valves: 30 years of experience.

https://arctichealth.org/en/permalink/ahliterature107029
Source
Ann Thorac Surg. 2013 Dec;96(6):2123-8
Publication Type
Article
Date
Dec-2013
Author
Vegard Skalstad Ellensen
Knut Sverre Andersen
Nicola Vitale
Einar Skulstad Davidsen
Leidulf Segadal
Rune Haaverstad
Author Affiliation
Section of Cardiothoracic Surgery, Department of Heart Disease, Haukeland University Hospital, Bergen, Norway. Electronic address: vegard.ellensen@helse-bergen.no.
Source
Ann Thorac Surg. 2013 Dec;96(6):2123-8
Date
Dec-2013
Language
English
Publication Type
Article
Keywords
Acute Disease
Adult
Aortic Valve - surgery - ultrasonography
Aortic Valve Insufficiency - surgery - ultrasonography
Aortic Valve Stenosis - epidemiology - etiology
Echocardiography
Female
Follow-Up Studies
Heart Valve Prosthesis
Humans
Incidence
Male
Middle Aged
Norway - epidemiology
Prosthesis Design
Prosthesis Failure
Retrospective Studies
Survival Rate - trends
Abstract
Acute dysfunction of mechanical aortic valve prostheses is a life-threatening adverse event. Pannus overgrowth, which is fibroelastic hyperplasia originating from the periannular area, is one cause of dysfunction. The aim of this study was to determine the annual incidence of readmittance resulting from acute obstruction caused by pannus during 30 years of observation in patients with Medtronic-Hall aortic valve prostheses and to analyze the risk factors associated with pannus development.
From 1982 to 2004, 1,187 patients in our department underwent aortic valve replacement with Medtronic-Hall mechanical monoleaflet valve prostheses. As of December 31, 2012, 27 of these patients (2.3%) had presented with acute valve dysfunction caused by pannus obstruction.
The annual incidence of pannus was 0.7 per 1,000. The median time from the primary operation to prosthetic dysfunction was 11.1 years (range, 1.2 to 26.8 years). Of the 20 patients who underwent reoperation, 2 died. Seven patients died before reoperation. Women had a higher risk for the development of obstructing pannus, and patients with pannus obstruction were younger. Valve size was not an independent risk factor.
Women and younger patients are at higher risk for pannus development. When acute dysfunction by pannus is suspected in a mechanical aortic valve, an immediate echocardiogram and an emergency aortic valve replacement should be carried out because of the potential of a fatal outcome.
Notes
Comment In: Ann Thorac Surg. 2013 Dec;96(6):212824296182
PubMed ID
24070701 View in PubMed
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Adverse events in spine surgery in Sweden: a comparison of patient claims data and national quality register (Swespine) data .

https://arctichealth.org/en/permalink/ahliterature129817
Source
Acta Orthop. 2011 Dec;82(6):727-31
Publication Type
Article
Date
Dec-2011
Author
Annica Ohrn
Anders Olai
Hans Rutberg
Per Nilsen
Hans Tropp
Author Affiliation
Department of Medical and Health Sciences, Linköping University, Sweden. annica.ohrn@lio.se
Source
Acta Orthop. 2011 Dec;82(6):727-31
Date
Dec-2011
Language
English
Publication Type
Article
Keywords
Disability Evaluation
Dura Mater - injuries
Female
Humans
Insurance Claim Review
Male
Orthopedic Procedures - adverse effects - methods - standards
Outcome Assessment (Health Care)
Prosthesis Failure
Quality Assurance, Health Care
Registries
Reoperation
Spinal Diseases - surgery
Spinal Nerves - injuries
Spine - surgery
Surgical Wound Infection - etiology
Sweden
Abstract
Our knowledge of complications and adverse events in spinal surgery is limited, especially concerning incidence and consequences. We therefore investigated adverse events in spine surgery in Sweden by comparing patient claims data from the County Councils' Mutual Insurance Company register with data from the National Swedish Spine Register (Swespine).
We analyzed patient claims (n = 182) to the insurance company after spine surgery performed between 2003 and 2005. The medical records of the patients filing these claims were reviewed and compared with Swespine data for the same period.
Two-thirds (119/182, 65%) of patients who claimed economic compensation from the insurance company were registered in Swespine. Of the 210 complications associated with these 182 claims, only 74 were listed in Swespine. The most common causes of compensated injuries (n = 139) were dural lesions (n = 40) and wound infections (n = 30). Clinical outcome based on global assessment, leg pain, disability, and quality of health was worse for patients who claimed economic compensation than for the total group of Swespine patients.
We found considerable under-reporting of complications in Swespine. Dural lesions and infections were not well recorded, although they were important reasons for problems and contributed to high levels of disability. By analyzing data from more than one source, we obtained a better understanding of the patterns of adverse events and outcomes after spine surgery.
Notes
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PubMed ID
22066564 View in PubMed
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Age and waiting time as predictors of outcome after total hip replacement for osteoarthritis.

https://arctichealth.org/en/permalink/ahliterature13932
Source
Rheumatology (Oxford). 2002 Nov;41(11):1261-7
Publication Type
Article
Date
Nov-2002
Author
A-K Nilsdotter
L S Lohmander
Author Affiliation
Department of Orthopedics, Halmstad County Hospital, Halmstad, Sweden.
Source
Rheumatology (Oxford). 2002 Nov;41(11):1261-7
Date
Nov-2002
Language
English
Publication Type
Article
Keywords
Age Factors
Aged
Aged, 80 and over
Comparative Study
Female
Follow-Up Studies
Hip Prosthesis
Humans
Male
Middle Aged
Osteoarthritis, Hip - diagnosis - surgery
Postoperative Period
Predictive value of tests
Preoperative Care
Prospective Studies
Prosthesis Failure
Research Support, Non-U.S. Gov't
Risk assessment
Severity of Illness Index
Sex Factors
Statistics, nonparametric
Sweden
Time Factors
Treatment Outcome
Waiting Lists
Abstract
OBJECTIVE: To investigate in a prospective study the relationship between age, pre-operative status, waiting time and post-operative outcome in patients assigned for unilateral total hip replacement (THR) due to osteoarthritis (OA). METHOD: One hundred and forty-eight patients (mean age 71 yr) with primary OA of the hip were investigated pre-operatively and 3, 6 and 12 months post-operatively with the Medical Outcomes Study 36-Item Short Form Health Survey (SF-36) and the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC). For 56 of the patients an additional evaluation was made when they were placed on the waiting list. RESULTS: One hundred and twenty-four patients fulfilled the study criteria (age 50 yr or over and unilateral THR for OA during the study period). Before surgery there were no differences in the WOMAC or SF-36 subscales (except mental health) between patients aged over and under 72 yr. Post-operatively, the younger patients reached a better score than the older patients. There were no differences in pre-operative status or post-operative outcome between the patients who had been on the waiting list more than and less than 3 months. Most pain relief after hip replacement was obtained by 3 months, while it took at least 1 yr to reach the full benefit in improved function. Ninety per cent of the patients had improved by at least 10 points on a 100-point scale for pain and function at 12 months. CONCLUSION: The age of the patients assigned for THR did not determine their pre-operative status. However, younger patients gained more function post-operatively than older patients and reached higher absolute mean SF-36 values, except for pain. An average difference in time on the waiting list of 3 months did not result in a difference in post-operative outcome. At least 1 yr is required for the average OA patient to gain the full benefit of the THR.
PubMed ID
12421998 View in PubMed
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