Background/objectives: The redirection or reshaping of the acetabulum might be warranted to attain a concentric and stable hip in children with developmental dysplasia of the hip (DDH). The aim of this study is to assess the late clinical and radiological results, and to determine the number of patients requiring secondary surgery or a total hip arthroplasty at a long-term follow-up.
Methods: Our institution performed 99 Salter osteotomies on 76 patients without underlying neuromuscular conditions over a 21-year period, from 1981 to 2002.
Aims: Tibial fixation in revision total knee arthroplasty (rTKA) can present surgical challenges. It has been suggested that appropriate fixation in at least two of the three anatomical zones (epiphysis, metaphysis, and diaphysis) is essential for implant survival. However, supporting clinical data are lacking.
View Article and Find Full Text PDFJ Arthroplasty
January 2025
Background: Periprosthetic joint infections (PJIs) can lead to higher re-revision rates and even higher mortality rates that may be associated with the responsible microorganism. We evaluated microorganisms that cause early PJIs in primary total hip and knee arthroplasty (THA and TKA) and examined mortality as well as PJI re-revision rates after these PJIs, using a combined dataset from the Dutch Arthroplasty Register and the Dutch National Nosocomial Surveillance Network (PREZIES). Secondly, the most common microorganisms that cause PJIs were described according to patient and implant survival.
View Article and Find Full Text PDFBackground: Arthroplasty registers underreport the incidence of periprosthetic joint infections (PJIs). We validated the incidence of reported PJIs in total hip arthroplasties (THAs) and total knee arthroplasties (TKAs) in the Dutch Arthroplasty Register (LROI) using data from the Dutch National Nosocomial Surveillance Network (PREZIES).
Methods: All primary THAs and TKAs from the LROI and all primary THAs and TKAs performed in consenting hospitals from PREZIES between 2012 and 2018 were matched on date of birth, date of surgery, sex, hospital, and type of procedure (THA n = 91,208; TKA n = 80,304).
Background: Hemiarthroplasty (HA) for hip fractures can be performed with a unipolar or bipolar head. We describe the use of unipolar and bipolar HA after a hip fracture in the Netherlands and determined revision rates and risk factors.
Methods: All HAs for an acute hip fracture registered in the Dutch Arthroplasty Register (LROI) during 2007 to 2021 were included; 44,127(88%) unipolar and 6,013(12%) bipolar HAs.
Background: Revision knee arthroplasty (R-KA) is rising globally. Technical difficulty of R-KA varies from liner exchange to full revision. Centralization has been shown to reduce mortality and morbidity rates.
View Article and Find Full Text PDFBackground: Femoral head size and surgical approach might affect the revision rate for dislocation and for any other reason after total hip arthroplasty (THA). We penetrated this question based on registry data with up to 9-year follow-up.
Methods: 269,280 primary THAs documented in the Dutch Arthroplasty Registry (LROI) between 2007 and 2019 were included.
Background: Joint arthroplasty registries have incorporated patient-reported outcomes (PROs) to evaluate outcomes from a patients' perspective to improve total hip arthroplasty (THA). To draw valid conclusions on PROs, a minimum response rate (RR) of 60% is advised. This study investigated (1) if the quality of THA health care based on PROs improved over the years in the Netherlands, (2) if RRs improved over the years, and (3) difference in PROs over the years in hospitals with RR ≥ 60% compared to RR < 60%.
View Article and Find Full Text PDFAims: This study aimed to investigate the estimated change in primary and revision arthroplasty rate in the Netherlands and Denmark for hips, knees, and shoulders during the COVID-19 pandemic in 2020 (COVID-period). Additional points of focus included the comparison of patient characteristics and hospital type (2019 vs COVID-period), and the estimated loss of quality-adjusted life years (QALYs) and impact on waiting lists.
Methods: All hip, knee, and shoulder arthroplasties (2014 to 2020) from the Dutch Arthroplasty Register, and hip and knee arthroplasties from the Danish Hip and Knee Arthroplasty Registries, were included.
Background: The digital transformation in health care has been accelerated by the COVID-19 pandemic. Video consultation has become the alternative for hospital consultation. It remains unknown how to select patients suitable for video consultation.
View Article and Find Full Text PDFBackground: Clinical observations revealed higher rates of aseptic loosening for hybrid fixated rotating hinge knee implants compared to fully cemented ones. We hypothesize that the use of a fully cemented fixation technique had a higher survival rate for aseptic loosening compared to a hybrid fixation technique in a rotating hinge knee implant.
Methods: All procedures of patients who were treated with the RT-PLUS rotating hinge knee implant (Smith & Nephew, Memphis, TN) between 2010 and 2018 were included.
Background and purpose - From previous studies, we know that clinical outcomes of revision total knee arthroplasty (rTKA) differ among reasons for revision. Whether the prevalence of repeat rTKAs is different depending on the reason for index rTKA is unclear. Therefore, we (1) compared the repeat revision rates between the different reasons for index rTKA, and (2) evaluated whether the reason for repeat rTKA was the same as the reason for the index revision.
View Article and Find Full Text PDFBackground and purpose - Collaborations between arthroplasty registries are important in order to create the possibility of detecting inferior implants early and improve our understanding of differences between nations in terms of indications and outcomes. In this registry study we compared patient and procedure characteristics, and revision rates in the Nordic Arthroplasty Register Association (NARA) database and the Dutch Arthroplasty Register (LROI).Patients and methods - All total hip arthroplasties (THAs) performed in 2010-2016 were included from the LROI (n = 184,862) and the NARA database (n = 290,823), which contains data from Denmark, Norway, Sweden, and Finland.
View Article and Find Full Text PDFIn Specific cases, curative treatment of a prosthetic joint infection (PJI) cannot be accomplished due to the increased risk of major complications after prosthetic joint revision surgery. In these patients, antibiotic suppressive therapy (AST) is often used to control the infection. To describe the clinical outcome of patients with a PJI after hip replacement treated with AST.
View Article and Find Full Text PDFIn the Dutch Arthroplasty Register (LROI), the product and batch number of prosthetic components and cement are registered for traceability. Registration of the product number provides opportunities to extend the information about a specific prosthesis. All product numbers used from the beginning of the registration in 2007 were characterized to develop and maintain an implant library.
View Article and Find Full Text PDFBackground and purpose - Impaction bone grafting (IBG) is an established method in hip revision surgery to reconstruct loss of bone stock. There is limited knowledge concerning the actual bone remodelling process within the allograft. We investigated with repeated bone mineral density (BMD) measurements the biological process of bone remodelling in the allograft in vivo.
View Article and Find Full Text PDFBackground: Staphylococcal species account for more than 50% of periprosthetic joint infections (PJI) and antimicrobial therapy with rifampin-based combination regimens has been shown effective. The present study evaluates the safety and efficacy of clindamycin in combination with rifampin for the management of staphylococcal PJI.
Methods: In this retrospective cohort study, patients were included who received clindamycin-rifampin combination therapy to treat a periprosthetic hip or knee infection by Staphylococcus aureus or coagulase-negative staphylococci.
After the low friction arthroplasty by John Charnley was no longer confined to specialized hospitals but commonplace in the general orthopedic practice, the issue remained how to most optimally reach the hip. The names of the authors of these approaches remain in a lot of cases connected to the approach. By evaluating the original articles in which the approaches are described we ascertain the original description and technique.
View Article and Find Full Text PDFPurpose: Acetabular deficiencies in young patients can be restored in several ways during total hip arthroplasty. Currently, cementless cups are most frequently used. Impaction bone grafting of acetabular defects is a more biological approach, but is it cost-effective in young patients on the long term?
Methods: We designed a decision model for a cost-utility analysis of a cemented cup with acetabular impaction bone grafting versus an uncemented cup, in terms of cost per quality-adjusted life year (QALY) for the young adult with acetabular bone deficiency, in need for a primary total hip arthroplasty.
Introduction: This retrospective analysis evaluates 10 patients with a late infection of a cemented total hip arthroplasty (THA) treated with two-stage revision with retention of the original well-fixed femoral cement mantle.
Methods: Clinical, laboratory, and radiological outcomes were evaluated. The average age at the first-stage revision procedure was 61.
Acetabular impaction bone grafting (IBG) in combination with a cemented cup in revision total hip arthroplasty (THA) is a proven and well-recognised technique which has been used in clinical practice for more than 35 years. Nowadays, with cemented prostheses tending to lose a larger part of the THA market every year in primary and revision cases, and many young surgeons being only trained in implanting uncemented prostheses, this technique is considered by many as technically demanding and time consuming, making its use less appealing. Despite this image and many new innovative techniques using uncemented implants in acetabular revisions over the last 25 years, IBG with a cemented cup is still one of the few techniques that really can reconstitute bone and respects human biology.
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