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  • NLM标题： Acta Orthop
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共1399条结果
  • 1.

    【2hr】Less gap imbalance with restricted kinematic alignment than with mechanically aligned total knee arthroplasty: simulations on 3-D bone models created from CT-scans

    包量

    机译 与机械对准的全膝关节置换术相比，运动对准受限的间隙失衡更少：通过CT扫描创建的3-D骨模型模拟
    摘要：Background and purpose — Mechanical alignment techniques for total knee arthroplasty (TKA) introduce significant anatomic alteration and secondary ligament imbalances. We propose a restricted kinematic alignment (rKA) protocol to minimize these issues and improve TKA clinical outcomes.
  • 2.

    【2hr】Routine radiographic follow-up is not necessary after physeal fractures of the distal tibia in children

    包量

    机译 儿童胫骨远端骨干骨折后无需常规影像学随访
    摘要：Background and purpose — Unnecessary radiographic and clinical follow-ups are common in treatment of pediatric fractures. We hypothesized that follow-up radiographs are unnecessary to monitor union of physeal fractures of the distal tibia.
  • 3.

    【2hr】Femoral and pelvic osteotomies for severe hip displacement in nonambulatory children with cerebral palsy: a prospective population-based study of 31 patients with 7 years’ follow-up

    包量

    机译 非活动性脑瘫患儿股骨和骨盆截骨术治疗严重髋关节置换：一项基于人群的前瞻性研究，对31例患者进行了7年的随访
    摘要：Background and purpose — There is no consensus regarding the optimal treatment of hip displacement in children with cerebral palsy (CP). This prospective study assessed the outcome of femoral and pelvic osteotomies for severe hip displacement in nonambulatory children and analyzed prognostic factors for outcome.
  • 4.

    【2hr】Functional ambulation without lower-leg muscles or nerves — a case report with video

    包量

    机译 无小腿肌肉或神经的功能性下肢活动-带有视频的病例报告
    • 作者：John Parenti
    • 刊名：Acta Orthopaedica
    • 2019年第6期
    摘要：Our orthopedic service was called for an urgent consultation concerning a 56-year-old man who had been admitted to Intensive Care some 36 hours earlier because of syncope, cyanosis, profound orthostatic hypotension, severe hemoconcentration, and acute bilateral leg pain. His medical history was unremarkable, and the tentative diagnosis given was polycythemia of unknown etiology leading to venous thromboembolism, with a distributive shock pattern consistent with sepsis. In the wake of aggressive IV hydration while intubated, swelling and tenseness had developed in his lower extremities secondary to massive thrombosis in all limbs.
  • 5.

    【2hr】An unexpected complication of nonoperative treatment for tibial posterior ­malleolus fracture: bony entrapment of tibialis posterior tendon – a case report

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    机译 胫骨后小神经节骨折非手术治疗的意外并发症：胫骨后肌腱的骨性包埋–病例报告
    摘要：A 41-year-old patient was referred to our center because of right medial ankle pain increasing for 3 months. He had, 10 years ago, had a displaced lateral malleolus fracture with an associated non-displaced posterior malleolus fracture but without a medial malleolus fracture. A fibular osteosynthesis without medial or posterior exploration was done at another hospital. Postoperatively, the patient remained non-weightbearing for 6 weeks with a cast. The patient recovered completely and returned to work as a fireman 4 months after the initial injury. The fibular osteosynthesis material was removed 1 year after the surgery.
  • 6.

    【2hr】Erratum

    包量

    机译 勘误表
    • 作者：
    • 刊名：Acta Orthopaedica
    • 2019年第6期
    摘要：Low revision rate despite poor functional outcome after stemmed hemiarthroplasty for acute proximal humeral fractures: 2,750 cases reported to the Danish Shoulder Arthroplasty Registry
  • 7.

    【2hr】Centenarian hip fracture patients: a nationwide population-based cohort study of 507 patients

    包量

    机译 百岁老人髋部骨折患者：507名患者的全国性队列研究
    摘要：Background and purpose — Several studies suggest a global increase of centenarians during the 21st century. We describe temporal trends of hip fracture incidence and mortality in this group and compare these patients with a group of younger hip fracture patients with regards to comorbidities and mortality.
  • 8.

    【2hr】Marker-based versus model-based radiostereometric analysis of total knee arthroplasty migration: a reanalysis with comparable mean outcomes despite distinct types of measurement error

    包量

    机译 基于标记物与基于模型的全膝关节置换术的放射线立体测量分析：尽管测量误差类型不同，但重新分析的平均结局可比
    摘要：Background and purpose — Pooling data of studies evaluating total knee arthroplasty migration using radiostereometric analysis (RSA) may be compromised when the RSA method used would influence estimated differences between groups. We therefore reanalyzed a marker-based RSA study with model-based RSA to assess possible limitations of each RSA method, including insert micromotions in modular TKA and their effect on estimated group differences.
  • 9.

    【2hr】Patient-reported outcome after hip dislocation in primary total hip arthroplasty is virtually unknown: a systematic literature review

    包量

    机译 系统性文献综述初次全髋关节置换术中髋关节脱位后患者报告的结果实际上是未知的
    摘要：
  • 10.

    【2hr】Early recovery trajectories after fast-track primary total hip arthroplasty: the role of patient characteristics

    包量

    机译 快速全髋关节置换术后的早期康复轨迹：患者特征的作用
    摘要：Background and purpose — Little is known about heterogeneity in early recovery after primary total hip arthroplasty (THA). Therefore, we characterized subgroups of patients according to their hip function trajectory during the first 6 weeks after THA in a fast-track setting.Patients and methods — 94 patients (median age 65 years [41–82], 56 women) from a single hospital participated in a diary study. Patients recorded their severity of hip problems (Oxford Hip Score, OHS) weekly for 6 weeks after THA. Latent class growth modelling (LCGM) was used to identify patients with the same hip function trajectory and to compare these subgroups on patient characteristics.Results — LCGM revealed a fast (n = 17), an average (n = 53), and a slow (n = 24) recovery subgroup. Subgroups differed on the estimated weekly growth rate during the first 2 weeks (fast: 9.5; average: 5.3; slow: 2.7), with fewer differences between groups in the last 4 weeks (fast: 0.90; average: 2.0; slow: 1.7). Patients in the slow recovery group could be characterized as women of older age (mean age =69) who rated their health as lower preoperatively, needed more assistance during recovery, and were less satisfied with the outcomes of the surgery.Interpretation — We identified distinct recovery trajectories in the first 6 weeks after fast-track primary THA which were associated with patient characteristics.
  • 11.

    【2hr】Myocardial infarction following fast-track total hip and knee arthroplasty—incidence, time course, and risk factors: a prospective cohort study of 24,862 procedures

    包量

    机译 快速全髋和膝关节置换术后的心肌梗塞—发病率，时程和危险因素：一项针对24,862例手术的前瞻性队列研究
    摘要：Background and purpose — Acute myocardial infarction (MI) is a leading cause of mortality following total hip and knee arthroplasty (THA/TKA). The reported 30-day incidence of MI varies from 0.3% to 0.9%. However, most data derive from administration and insurance databases or large RCTs with potential confounding factors. We studied the incidence of and potential modifiable risk factors for postoperative MI in a large, multicenter optimized “fast-track” THA/TKA setting.Patients and methods — A prospective cohort study was conducted on consecutive unselected elective primary unilateral THA and TKA, using prospective information on comorbidities and complete 90-day follow-up from the Danish National Patient Registry. Evaluation of discharge summaries and medical records was undertaken in cases of suspected MI. Logistic regression analyses were carried out for identification of preoperative risk factors.Results — Of 24,862 procedures with a median length of stay 2 (IQR 2–3) days, 30- and 90-day incidence of MI was 31 (0.12%) and 48 (0.19%). Preoperative risk factors for MI ≤30 days were age >85 years (OR 7.4, 95% CI 2.3–24), insulin-dependent diabetes mellitus (IDDM) (3.6, CI 1.1–12), cardiovascular disease (2.4, CI 1.1–5.0) and hypercholesterolemia (2.3, CI 1.1–5.1). Of 31 patients with MI ≤30 days 9 were treated with vasopressors for intraoperative hypotension and 27 had postoperative anemia.Interpretation — Fast-track THA and TKA had a low 30-day MI incidence. Focus on patients with age >85, IDDM, cardiovascular disease, and hypercholesterolemia may further reduce the 30-day incidence of MI. The role of postoperative anemia and intraoperative hypotension are other areas for further improvement
  • 12.

    【2hr】Time of admission and mortality after hip fracture: a detailed look at the weekend effect in a nationwide study of 55,211 hip fracture patients in Norway

    包量

    机译 髋部骨折后的入院时间和死亡率：挪威55,211例髋部骨折患者的全国研究详细分析了周末的影响
    摘要：Background and purpose — There are numerous studies on the weekend effect for hip fracture patients, with conflicting results. We analyzed time of admission and discharge, and the association with mortality and length of hospital stay in more detail.Patients and methods — We used data from 61,211 surgically treated hip fractures in 55,211 patients, admitted to Norwegian hospitals 2008–2014. All patients were aged 50 years or older. Data were analyzed with Cox and Poisson regression.Results — Mortality within 30 days did not differ substantially by day of admission, although admissions on Sundays and holidays had a slightly increased mortality. The hazard ratios were 1.1 (95% confidence interval [CI] 0.97–1.2) for Sundays, and 1.2 (CI 0.98–1.4) for holidays, relative to Mondays. For patients admitted between 6:00 am and 7:00 am the hazard ratio was 1.4 (CI 1.1–1.8) relative to patients admitted between 2:00 pm and 3:00 pm. Discharges during weekends and holidays were associated with a substantial higher mortality than weekday discharges. Patients admitted from Friday to Sunday generally stayed in hospital for a shorter time than patients admitted during other days.Interpretation — Our results indicate that the discussion on weekday versus weekend admission effects might have distracted attention from other important factors, such as time of day of admission, and day of discharge from hospital treatment.
  • 13.

    【2hr】Low-molecular-weight heparin for hip fracture patients treated with osteosynthesis: should thromboprophylaxis start before or after surgery? An observational study of 45,913 hip fractures reported to the Norwegian Hip Fracture Register

    包量

    机译 低分子肝素用于接受骨合成治疗的髋部骨折患者：应该在手术之前或之后开始预防血栓形成吗？挪威臀部骨折登记处报告的45,913例髋部骨折的观察性研究
    摘要：Background and purpose — Controversies exist regarding thromboprophylaxis in orthopedic surgery. We studied whether the thromboprophylaxis in hip fracture patients treated with osteosynthesis should start preoperatively or postoperatively. Data were extracted from the nationwide Norwegian Hip Fracture Register (NHFR). The risks of postoperative deaths, reoperations, and intraoperative bleeding were studied within 6 months after surgery.Patients and methods — After each operation for hip fracture in Norway the surgeon reports information on the patient, the fracture, and the operation to the NHFR. Cox regression analyses were performed with adjustments for age group, ASA score, sex, duration of surgery, and year of surgery. During the period 2005–2016, 96,599 hip fractures were reported to the register. Only osteosyntheses where low-molecular-weight heparin (LMWH) were given and with known information on preoperative start of the prophylaxis were included in the analyses. Dalteparin and enoxaparin were used in 58% and 42% of the operations respectively (n = 45,913).Results — Mortality (RR =1.01, 95% CI 0.97–1.06) and risk of reoperation (RR =0.99, CI 0.90–1.08) were similar comparing preoperative and postoperative start of LMWH. Postoperative start reduced the risk of intraoperative bleeding complications compared with preoperative start (RR =0.67, CI 0.51–0.90).Interpretation — The initiation of LMWH did not influence the mortality or the risk of reoperation in hip fracture patients treated with osteosynthesis. Postoperative start of LMWH could possibly decrease the risk of intraoperative bleeding.
  • 14.

    【2hr】Does the physical activity profile change in patients with hip dysplasia from before to 1 year after periacetabular osteotomy?

    包量

    机译 从髋臼周围截骨术前到术后1年，髋关节发育不良患者的身体活动状况是否发生变化？
    摘要：Background and purpose — Knowledge of physical activity profiles among patients with hip dysplasia is lacking. We investigated whether patients with hip dysplasia change physical activity profile from before to 1 year after periacetabular osteotomy. Furthermore, we investigated associations between change in accelerometer-based physical activity and change in self-reported participation in preferred physical activities (PA).Patients and methods — Physical activity was objectively measured at very low to high intensity levels with accelerometer-based sensors. Subjectively, PA was recorded with Copenhagen Hip and Groin Outcome Score (HAGOS) in 77 patients. Associations between the 2 were analyzed with simple linear regression analyses.Results — Changes in accelerometer-based physical activity ranged from –2.2 to 4.0% points at all intensity levels from baseline to 1-year follow-up. These changes represent very small effect sizes (–0.16 to 0.14). In contrast, self-reported PA showed a statistically and clinically relevant increase of 22 (CI 14–29) HAGOS PA points 1 year post-surgery. Associations between change in accelerometer-based physical activity and change in self-reported PA were, however, not statistically significant and correspond to a percentage change in physical activity of only –0.87% to 0.65% for a change of 10 HAGOS PA points.Interpretation — Patients with hip dysplasia do not seem to change physical activity profile 1 year post-surgery if measured with objective accelerometer-based sensors. This is interesting as self-reported PA indicates that patients’ ability to participate in physical activity increases, suggesting that this increased self-reported participatory capacity is not manifested as increased objectively measured physical activity.
  • 15.

    【2hr】Validated repeatability of patient-reported outcome measures following primary total hip replacement: a mode of delivery comparison study with randomized sequencing

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    机译 首次全髋置换术后患者报告的结局指标的可验证重复性：采用随机测序的分娩比较研究模式
    摘要：Background and purpose — Patient-reported outcome measures (PROMs) are used to understand better the outcomes after total hip replacement (THR). These are administered in different settings using a variety of methods. We investigated whether the mode of delivery of commonly used PROMs affects the reported scores, 1 year after THR.Patients and methods — A prospective test–retest mode comparison study with randomized sequence was done in 66 patients who had undergone primary THR. PROMs were administered by 4 modes: self-administration, face-to-face interview, telephone interview, and postal questionnaire. PROMs included: Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), Oxford Hip Score (OHS), EQ5D-3L (EQ5D), and Self-Administered Patient Satisfaction Scale (SAPS). Linear regression was used to estimate relationships between the mean scores for PROMs by mode. Individual paired differences by mode were calculated, relationships between modes were identified, and results adjusted by time delay and participant age.Results — There was no statistically significant difference between the mean PROM scores recorded for each mode of delivery for each score. Statistically significant differences in the individual paired differences were detected between modes for the WOMAC stiffness subscale, OHS, EQ5D, and SAPS. OHS difference in individual paired means between face-to-face and telephone interview exceeded the minimal clinically important difference.Interpretation — PROMs mode of administration can affect the recorded results. Modes should not be mixed and may not be comparable between studies. It should not be assumed that different modes will obtain the same results and where not already established this should be checked by researchers before use.
  • 16.

    【2hr】18F-FDG-PET uptake in non-infected total hip prostheses

    包量

    机译 未感染的全髋关节假体摄取18F-FDG-PET
    摘要：Background and purpose — 18F-fluorodeoxyglucose positron emission tomography (FDG-PET) can be used in the diagnostic work-up of a patient with suspected periprosthetic joint infection (PJI) but, due to a lack of accurate interpretation criteria, this technique is not routinely applied. Since the physiological uptake pattern of FDG around a joint prosthesis is not fully elucidated, we determined the physiological FDG uptake in non-infected total hip prostheses.Patients and methods — Patients treated with primary total hip arthroplasty (1995–2016) who underwent a FDG-PET/CT for an indication other than a suspected PJI were retrospectively evaluated. Scans were both visually and quantitatively analyzed. Semi-quantitative analysis was performed by calculating maximum and peak standardized uptake values (SUVmax and SUVpeak) by volume of interests (VOIs) at 8 different locations around the prosthesis.Results — 58 scans from 30 patients were analyzed. In most hips, a diffuse heterogeneous uptake pattern around the prosthesis was observed (in 32/38 of the cemented prostheses, and in 16/20 of the uncemented prostheses) and most uptake was located around the neck of the prosthesis. The median SUVmax in the cemented group was 2.66 (95% CI 2.51–3.10) and in the uncemented group 2.87 (CI 2.65–4.63) (Median difference = –0.36 [CI –1.2 to 0.34]). In uncemented prostheses, there was a positive correlation in time between the age of the prosthesis and the FDG uptake (rs = 0.63 [CI 0.26–0.84]).Interpretation — Our study provides key data to develop accurate interpretation criteria to differentiate between physiological uptake and infection in patients with a prosthetic joint.
  • 17.

    【2hr】Higher mid-term revision rates of posterior stabilized compared with cruciate retaining total knee arthroplasties: 133,841 cemented arthroplasties for osteoarthritis in the Netherlands in 2007–2016

    包量

    机译 与十字形保留全膝关节置换术相比，后固定术的中期中期翻修率更高：2007–2016年，荷兰骨关节炎的水泥固定置换术为133,841例
    摘要：Background and purpose — The preference for a cruciate retaining (CR) or posterior stabilized (PS) TKA (total knee arthroplasty) system varies greatly between Dutch hospitals, independent of patient characteristics. We examined mid-term revision rates for men and women of different age categories.Patients and methods — We included all 133,841 cemented fixed-bearing primary CR or PS TKAs for osteoarthritis reported in the Dutch Arthroplasty Register (LROI) in 2007–2016. Revision procedures were defined as minor when only insert and/or patella were revised and as major when fixed components (tibia and femur) were revised or removed. 8-year all-cause revision rates of CR and PS TKAs were calculated using competing-risk analyses. Cox-regression analyses were performed, adjusted for age at surgery, sex, ASA -score, and previous operations.Results — PS TKAs were 1.5 (95% CI 1.4–1.6) times more likely to be revised within 8 years of the primary procedure, compared with CR TKAs. When stratified for sex and age category, 8-year revision rate of PS TKAs in men <60 years was 13% (CI 11–15), compared to 7.2% (CI 6.1–8.5) of CR TKAs. Less prominent differences were found in older men and women. For men <60 years differences were found for minor (CR 1.8% (CI 1.4-2.5); PS 3.7% (CI 3.0–4.7)) and major revisions (CR 4.2% (CI 3.3–5.3); PS 7.0% (CI 5.6–8.7)).Interpretation — Patients who received a cemented fixed-bearing primary PS TKA for osteoarthritis are more likely to undergo either a minor or a major revision within 8 years. This is especially prominent for younger men.
  • 18.

    【2hr】Blood cytokine pattern and clinical outcome in knee arthroplasty patients: comparative analysis 5 years after standard versus “hypoallergenic” surface coated prosthesis implantation

    包量

    机译 膝关节置换术患者的血细胞因子模式和临床结果：标准与“低变应原性”表面涂层假体植入5年后的比较分析
    摘要：Background and purpose — Metal sensitivity might provoke complications after arthroplasty. Correspondingly, coated “hypoallergenic” implants are of interest but long-term follow-up data are missing. Thus, we assessed immunological and clinical parameters in such patients.Patients and methods — 5 years’ follow-up data were obtained from 3 centers, which used either a standard total knee replacement (TKR) or the identical implant with multilayer surface zirconium nitride based coating. Of the 196 patients (mean age 68 years (44–84), 110 females) 97 had arthroplasty with a coated surface, and 99 were treated by a standard TKR of the same type. Investigations were Knee Society Score (KSS), Knee injury and Osteoarthritis Outcome Score (KOOS), radiographic analysis, and cytokine measurement in peripheral blood. Pro- and anti-inflammatory cytokines were evaluated by cytometric beads assay and RT-PCR.Results — Survival rate (Kaplan–Meier) was 98% for coated and 97% for uncoated implants after 5 years. Mechanical axis and KSS pain score (42 vs. 41 (0–50)) were comparable. Most serum cytokine levels were comparable, but mean interleukin-8 and interleukin-10 levels were higher in the group with an uncoated implant. IL-8: 37 (SD 7.5) pg/mL vs. 1.1 (SD 4.3) (p < 0.001); IL-10: 3.6 (SD 2.5) vs. 0.3 (SD 1.8) pg/mL (p < 0.001).Interpretation — There was similar clinical outcome 5 years after standard and surface-coated TKR. In peripheral blood there was an increased pro-inflammatory status, i.e., significant elevation of IL-8 and the anti-inflammatory IL-10, after standard uncoated prosthesis. Any long-term effects of these cytokine changes are unknown.
  • 19.

    【2hr】Pelvic obliquity and measurement of hip displacement in children with cerebral palsy

    包量

    机译 脑瘫患儿的骨盆倾斜度和髋关节位移的测量
    摘要：Background and purpose — Pelvic obliquity, common in individuals with cerebral palsy (CP), changes the muscle force vector on the hip joint and probably affects the risk of hip dislocation. We evaluated a new method for measurement of hip displacement in CP that takes the pelvic obliquity into account: the pelvic adjusted migration percentage (PAMP).Children and methods — From the Swedish surveillance program for cerebral palsy (CPUP), the first pelvic radiograph of 268 children <18 years in southern Sweden during a 3-year period were evaluated. Pelvic obliquity, PAMP, and the migration percentage (MP) were measured. 50 radiographs were randomly selected for analysis of interrater reliability by three raters using the intraclass correlation coefficient (ICC). The correlations between PAMP/MP and pelvic obliquity were analyzed with Pearson correlation coefficients.Results — The interrater reliability for all 3 measurements was high (ICCs 0.88–0.97). The correlation between the high side of the pelvic obliquity and the difference between right and left hip displacement was higher for PAMP (r = 0.70) than for MP (r = 0.41).Interpretation — The new PAMP measurement showed high interrater reliability and a higher correlation with pelvic obliquity than MP. We suggest the use of PAMP at least in hips with a pelvic obliquity exceeding 5°.
  • 20.

    【2hr】Knee joint sagittal plane movement in cerebral palsy: a comparative study of 2-dimensional markerless video and 3-dimensional gait analysis

    包量

    机译 大脑性瘫痪的膝关节矢状面运动：二维无标记视频和三维步态分析的比较研究
    摘要：Background and purpose — Gait analysis is indicated in children with cerebral palsy (CP) to identify and quantify gait deviations. One particularly difficult-to-treat deviation, crouch gait, can progress in adolescence and ultimately limit the ability to ambulate. An objective quantitative assessment is essential to early identify progressive gait impairments in children with CP. 3-dimensional gait analysis (3D GA) is considered the gold standard, although it is expensive, seldom available, and unnecessarily detailed for screening and follow-up. Simple video assessments are time-consuming when processed manually, but more convenient if used in conjunction with video processing algorithms; this has yet been validated in CP. We validate a 2-dimensional markerless (2D ML) assessment of knee joint flexion/extension angles of the gait cycle in children and young adults with CP.Patients and methods — 18 individuals, mean age 15 years (6.5–28), participated. 11 had bilateral, 3 unilateral, 3 dyskinetic, and 1 ataxic CP. In the Gross Motor Function Classification System, 6 were at level I, 11 at level II, and 1 at level III. We compared 2D ML, using a single video camera with computer processing, and 3D GA.Results — The 2D ML method overestimated the knee flexion/extension angle values by 3.3 to 7.0 degrees compared with 3D GA. The reliability within 2D ML and 3D GA was mostly good to excellent.Interpretation — Despite overestimating, 2D ML is a reliable and convenient tool to assess knee angles and, more importantly, to detect changes over time within a follow-up program in ambulatory children with CP.
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