Can KOOS-PS be replaced with a simple anchor question in patients after total knee arthroplasty?: an agreement study of 2,478 primary surgeries.

Background And Purpose:  Physical function and pain are the most important outcomes following total knee arthroplasty (TKA). These can be evaluated by patient-reported outcome measures (PROMs), or by an anchor question. The primary aim of the study was to evaluate whether a simple anchor question can replace KOOS-PS in assessing postoperative knee function until 1-year follow-up, evaluated by analyzing the agreement between the 2 methods using the diagnostic odds ratio (DOR).

Patient-reported outcomes the first thirty days after fast-track primary total hip arthroplasty. A prospective cohort study using a web-based registration tool for postoperative follow-up.

Introduction: The documentation on patient reported outcomes the first weeks at home following total hip arthroplasty (THA) is sparse. Length of hospital stay after THA is substantially reduced. Therefore, knowledge on whether patients are managing their own postoperative rehabilitation early after discharge is important, in order to give the patients realistic preoperative information, to modify expectations and enable patients to monitor their own rehabilitation process.

The extent of first-time THA revision is not associated with patient-reported outcomes at 1-year follow-up: a study of 426 aseptic revisions.

Background And Purpose: Studies evaluating pain and patient-reported outcome measures (PROMs) related to type of revision total hip arthroplasty (rTHA) are sparse. Our aim was to compare pain, physical function, quality of life, and patient satisfaction among different types of aseptic rTHA at 1-year follow-up.

Patients And Methods: We performed a retrospective study from an institutional registry with 426 primary THAs scheduled for rTHA in a fast-track setting between 2012 and 2021.

Physical activity in the first postoperative week in 132 knee arthroplasty patients randomized to 3 different analgesic regimens.

Background: The aim of this study was to investigate whether objectively recorded physical activity in the first week after surgery in total knee arthroplasty patients differed between patients allocated to 3 different analgesic regimens.

Methods: A total of 132 total knee arthroplasty patients wore activity monitors 24 hours a day from day 1 after surgery for 6 consecutive days. The time mobilized (stepping/standing) and the number of steps were recorded.

Higher Dissatisfaction Rate Following Revision Compared With Primary Total Knee Arthroplasty: 1-Year Follow-up of 2151 Primary and 235 Aseptic Revision Surgeries.

Postoperative patient satisfaction is related to preoperative expectations. Information regarding expected results following surgery is therefore important. This study evaluated patient-reported outcome measures (PROMs) and patient satisfaction up to 1 year after primary and aseptic revision total knee arthroplasty (TKA).

The indication for aseptic revision TKA does not influence 1-year outcomes: an analysis of 178 full TKA revisions from a prospective institutional registry.

Background And Purpose: Outcomes following revision total knee arthroplasty (TKA) may depend on the indication for revision surgery. We compared pain, patient-reported outcome measures (PROMs), and patient satisfaction among different indications for an aseptic TKA revision.

Patients And Methods: This was a retrospective study of prospective data from an institutional registry of 178 primary TKAs revised between 2012 and 2020.

Intraoperatively local infiltration anesthesia in hemiarthroplasty patients reduces the needs of opioids: a randomized, double-blind, placebo-controlled trial with 96 patients in a fast-track hip fracture setting.

Background and purpose - Local infiltration analgesia (LIA) is commonly used as a component in multimodal analgesia. Pain management directed towards hip fracture patients operated on with hemiarthroplasty is often based on knowledge regarding pain treatment following elective surgery. In this elderly patient population, it is of value to clarify whether adding local infiltration analgesia (LIA) to the postoperative analgesic regimen might reduce postoperative pain or have an opioid-reducing effect.

Patient-reported outcome after primary and aseptic revision hip arthroplasty: 1-year follow-up of 3,559 primary and 406 revision THAs in an institutional registry.

Background and purpose - Patient-reported outcomes (PROMs) after primary total hip arthroplasty (THA) and revision THA are important information in the preoperative shared decision-making process. We present 1-year results on pain, function, and quality of life following primary and revision THA. Patients and methods - From 2010 to 2018, 3,559 primary THA and 406 revision THAs were included in our institutional quality registry.

30-day mortality in patients after hip fracture surgery: A comparison of the Charlson Comorbidity Index score and ASA score used in two prediction models.

Objective: To compare the Charlson Comorbidity Index (CCI) and American Society of Anesthesiologists (ASA) Physical Status Classification used in two prediction models for 30-day mortality after hip fracture surgery.

Study Design And Setting: Data from 3651 patients (mean age: 83 years) from a Norwegian University Hospital were retrospectively obtained and randomly divided into two cohorts: a model cohort (n = 1825) to develop two prediction models with CCI and ASA as the main predictors, and a validation cohort (n = 1826) to assess the predictive ability of both models. A receiver operating characteristic (ROC) curve determined the best model to predict mortality.

Tapentadol vs oxycodone for postoperative pain treatment the first 7 days after total knee arthroplasty: a randomized clinical trial.

Pain after total knee arthroplasty is a prevalent condition. This study compared the effectiveness of tapentadol extended-release (ER) 50 mg × 2, oxycodone controlled-release (CR) 10 mg × 2, and placebo, as added to a multimodal analgesic regime both in-hospital and at home the first week after total knee arthroplasty. The study was randomized and blinded for investigators, staff, outcome assessors, and patients.

Pain and load progression following an early maximal strength training program in total hip- and knee arthroplasty patients.

Purpose: Total hip arthroplasty (THA) and total knee arthroplasty (TKA) patients significantly increase muscle strength after maximal strength training (MST) initiated soon after surgery. Owing to severe postoperative pain, knee patients are anticipated to be more limited in performing heavy load exercises than hip patients. The aim of the present study was to describe pain and load progression during early MST in THA and TKA patients.

Increased Muscle Strength Limits Postural Sway During Daily Living Activities in Total Hip Arthroplasty Patients.

Objective: The aim of the study was to investigate the effect of maximal strength training on postural sway after total hip arthroplasty, performed before and after a battery of physical performance tests that resemble daily living activities.

Design: This study is an exploratory study based on data from a 3-mo randomized controlled trial involving 54 total hip arthroplasty patients performing maximal strength training or conventional rehabilitation. At 3, 6, and 12 mos postoperatively, postural sway was evaluated in two gait tests; ie, one test before and one test after conducting a battery of physical performance tests.

Muscular strength and function after total hip arthroplasty performed with three different surgical approaches: one-year follow-up study.

Background: Surgical approach influences short-term muscular strength, and leg-strength asymmetry has been demonstrated after total hip arthroplasty (THA). We evaluated muscular strength, physical function and patient-reported outcome measures (PROMs) up to 12 months postoperatively, in patients operated on using 3 different surgical approaches.

Methods: 60 patients scheduled for primary THA were allocated to the direct lateral (DLA), posterior (PA) or anterior (AA) approach.

A randomized controlled trial on maximal strength training in 60 patients undergoing total hip arthroplasty.

Background and purpose - Total hip arthroplasty (THA) patients have reduced muscle strength after rehabilitation. In a previous efficacy trial, 4 weeks' early supervised maximal strength training (MST) increased muscle strength in unilateral THA patients <65 years. We have now evaluated muscle strength in an MST and in a conventional physiotherapy (CP) group after rehabilitation in regular clinical practice.

Load transfer in the proximal femur and primary stability of a cemented and uncemented femoral stem: An experimental study on cadaver femurs.

There are principally two fixation methods in total hip arthroplasty, cemented and uncemented. Both methods have in general good long-time survival. Studies comparing cemented and uncemented femoral stems indicate that the cemented stems perform somewhat better, at least in the elderly population.

Deformation pattern and load transfer of an uncemented femoral stem with modular necks. An experimental study in human cadaver femurs.

Background: Modular necks in hip arthroplasty allow variations in neck-shaft angles, neck version and neck lengths and have been introduced to improve accuracy when reconstructing the anatomy and hip joint biomechanics. Periprosthetic bone resorption may be a consequence of stress shielding in the proximal femur after implantation of a femoral stem. The purpose of this study was to investigate the deformation pattern and load transfer of an uncemented femoral stem coupled to different modular necks in human cadaver femurs.

A biomechanical comparison of composite femurs and cadaver femurs used in experiments on operated hip fractures.

Fourth generation composite femurs (4GCFs, models #3406 and #3403) simulate femurs of males <80 years with good bone quality. Since most hip fractures occur in old women with fragile bones, concern is raised regarding the use of standard 4GCFs in biomechanical experiments. In this study the stability of hip fracture fixations in 4GCFs was compared to human cadaver femurs (HCFs) selected to represent patients with hip fractures.

Locking plates and their effects on healing conditions and stress distribution: A femoral neck fracture study in cadavers.

Background: Implants are used to stabilize femoral neck fractures to achieve successful fracture healing, but there is still a high rate of fracture non-unions. We compared micromotions in femurs with fractured femoral necks stabilized with three screws with or without a locking plate. We also investigated whether osteoporosis was associated with micromotion magnitudes, and explored the influence of implants on load distribution in the upper femur.

Small and similar amounts of micromotion in an anatomical stem and a customized cementless femoral stem in regular-shaped femurs. A 5-year follow-up randomized RSA study.

Background And Purpose: High primary stability is important for long-term survival of uncemented femoral stems. Different stem designs are currently in use. The ABG-I is a well-documented anatomical stem with a press-fit design.

Initial stability of an uncemented femoral stem with modular necks. An experimental study in human cadaver femurs.

Background: Uncemented implants are dependent upon initial postoperative stability to gain bone ingrowth and secondary stability. The possibility to vary femoral offset and neck angles using modular necks in total hip arthroplasty increases the flexibility in the reconstruction of the geometry of the hip joint. The purpose of this study was to investigate and evaluate initial stability of an uncemented stem coupled to four different modular necks.

The effect of interlocking parallel screws in subcapital femoral-neck fracture fixation: a cadaver study.

Background: A new locking-plate for femoral-neck fractures that provides angular stability to three screws in an inverted triangle configuration was evaluated. The plate is not fixed to the lateral cortex and therefore represents a new treatment principle.

Methods: Twelve pairs of cadaver femurs (mean T-score -1,95 (range -4,5-0)) with subcapital femoral-neck fractures angulating 60° were randomly allocated to fracture-fixation using either three individual screws or three interlocked screws.

Shortening of an anatomical stem, how short is short enough? An in vitro study of load transfer and primary stability.

An anatomical stem should be short enough to avoid distal locking and distal load transfer but long enough to ensure adequate primary stability of the stem. In this in vitro study, the cortical strains in the femur and the primary stability of the stem were measured after insertion of Anatomic Benoist Girard-I anatomical stems with gradually reduced stem length in six human cadaver femurs in order to find the optimal stem length. A shortening of 40-50 mm, corresponding to a stem extending 30-40 mm below the lesser trochanter, did not affect stem stability but nearly normalized the load distribution in the lower metaphysis and upper diaphysis.

The migration pattern of the Charnley femoral stem: a five-year follow-up RSA study in a well-functioning patient group.

Background: Implant stability is considered vital to long-time implant survival in total hip arthroplasty (THA), since loose implants are reported to be a major cause of hip revision. There is an association between early implant micromotion and increased risk of revision. More implant-specific data are needed to establish acceptable levels of early implant movement.

Biomechanical femoral neck fracture experiments--a narrative review.

Introduction: Orthopaedic implants can be introduced in clinical practice if equivalency to an already approved implant can be demonstrated. A preclinical laboratory test can in theory provide the required evidence. Due to the lack of consensus on the optimum design of biomechanical experiments, setups vary considerably.