The incidence of venous thromboembolism is low when risk stratification-based thromboprophylaxis is used after fast-track hip and knee arthroplasty.

Background: The optimal length of thromboprophylaxis after total hip or knee arthroplasty (THA and TKA) is unknown. Fast-track protocols have improved patient care and led to shorter immobilization and length of stay (LOS) after THA and TKA, thereby diminishing venous thromboembolism (VTE) risk. Here, we investigated risk stratification-based thromboprophylaxis after fast-track THA and TKA.

From Emergency Room to Operating Room: Multidisciplinary Simulation Training in Emergency Laparotomy for Ruptured Abdominal Aortic Aneurysm - Learning Outcomes and Costs.

Background: Opportunities to practice emergency laparotomy (EL) and open surgical repair (OSR) for a ruptured abdominal aortic aneurysm (rAAA) are limited. While simulation-based training (SBT) is effective in educating healthcare professionals in medical emergencies, SBT specifically in EL and OSR for rAAA is scarce. It takes a team to diagnose a patient with massive abdominal bleeding, such as in rAAA, to organize primary care, and to provide definite treatment without unnecessary delays.

Health-related quality of life influences surgical decisions in patients with rotator cuff disease.

Aims: Rotator cuff disease (RCD) can considerably decrease quality of life. Here, we investigated whether health-related quality of life (HRQoL) influences the need for surgery in patients with RCD.

Methods: We performed an analysis of 417 patients with symptomatic RCD who were recruited from two hospitals between June 2008 and December 2014 to be randomized to receive non-surgical or surgical treatment.

Early Predictors of Recovery From Nonoperatively Treated Achilles Tendon Rupture: 1 Year Follow-Up Study.

Purpose: To investigate early structural and mechanical predictors of plantarflexor muscle strength and the magnitude of Achilles tendon (AT) nonuniform displacement at 6 and 12 months after AT rupture.

Methods: Thirty-five participants (28 males and 7 females; mean ± SD age 41.7 ± 11.

A Low Cost Emergency Laparotomy Task Trainer for Major Abdominal Bleeding: An Option for Surgical Residents to Learn Lifesaving Basic Surgical Skills.

Objective: To instantly stop life threatening abdominal bleeding (e.g., a ruptured abdominal aneurysm), every surgeon should be familiar with the principles of emergency laparotomy (EL) and aortic clamping.

Risk stratification-based thromboprophylaxis does not affect mortality after fast-track hip and knee arthroplasty.

Background And Purpose: Use of thromboprophylaxis effectively prevents pulmonary embolism (PE) and deaths after total hip and knee arthroplasty (THA and TKA). The optimum length of thromboprophylaxis is not known and has traditionally been based on the type of operation. Nowadays, a more individualized approach is preferred.

Surgery with locking plate or hemiarthroplasty versus nonoperative treatment of 3-4-part proximal humerus fractures in older patients (NITEP): An open-label randomized trial.

Background: Proximal humerus fractures (PHFs) are common fractures, especially in older female patients. These fractures are commonly treated surgically, but the consensus on the best treatment is still lacking.

Methods And Findings: The primary aim of this multicenter, randomized 3-arm superiority, open-label trial was to assess the results of nonoperative treatment and operative treatment either with locking plate (LP) or hemiarthroplasty (HA) of 3- and 4-part PHF with the primary outcome of Disabilities of the Arm, Shoulder, and Hand (DASH) at 2-year follow-up.

Complications and secondary operations after non-operative and operative treatment of tibial plateau fractures: a population-based study of 562 patients with mean follow-up of 7 years.

Introduction: The incidence of tibial plateau fractures (TPF) is 1% of all fractures and increases with age. Whether non-operatively or operatively treated, complications (infection, malalignment, loss of reduction and delayed union or nonunion) and post-traumatic osteoarthritis are not uncommon, and the risk for complications has generally been assumed to rise with age. This study investigated all post-TPF complications and secondary surgery after non-operative and operative treatment.

Evaluation of the changes in incidence and patient age of knee arthroscopy along with changes in time between knee arthroscopy and arthroplasty between 1998 and 2018: a nationwide register study.

Background: Recent evidence has led to guidelines to refrain from recommending knee arthroscopy for patients with an osteoarthritis diagnosis. The aim of this study was to evaluate the latest changes in the incidence of arthroscopic surgery for degenerative knee disease, changes in the ages of those patients and the delay between knee arthroscopy and arthroplasty, in Finland between 1998 and 2018.

Method: The data for were collected from the Finnish National Hospital Discharge Register (NHDR).

Resuscitative endovascular balloon occlusion of the aorta (REBOA) may also have a place outside major trauma centers - A case report from a Finnish rural hospital.

The recent adoption of endovascular and hybrid methods in the management of massive bleeding following trauma to the torso and junctional areas has been a major advance in trauma care. Resuscitative endovascular balloon occlusion of the aorta (REBOA) is one tool to tackle immediate exsanguination in such cases. To take advantage of such methods, rapid femoral artery access is crucial.

Venous thromboembolism is rare after total hip and knee joint arthroplasty with long thromboprophylaxis in Finnish fast-track hospitals.

Introduction: Pharmacological thromboprophylaxis effectively prevents venous thromboembolism (VTE) after total knee (TKA) and total hip arthroplasty (THA). Less is known about the influence of fast-track arthroplasty on VTE risk. We conducted a register-based study to determine the incidence of VTE after fast-track TKA and THA in Finland using long thromboprophylaxis.

The influence of primary treatment approach on outcomes in patients with osteochondral fracture after patellar dislocation: a case series.

Background: We characterized the relation of primary treatment approaches to the need of later surgical interventions and the outcomes of patellar dislocation in patients with patellofemoral osteochondral fracture (OCF).

Methods: Overall, 134 patients with OCF were categorized in two groups according to treatment approach: primary surgery (operation within 90 days from injury) and conservative treatment. Data on surgical procedures, OCF characteristics, and patellofemoral anatomy were retrospectively collected.

Effects of a home-based, exergaming intervention on physical function and pain after total knee replacement in older adults: a randomised controlled trial.

Objectives: To investigate the effects of 4 months of customised, home-based exergaming on physical function and pain after total knee replacement (TKR) compared with standard exercise protocol.

Methods: In this non-blinded randomised controlled trial, 52 individuals aged 60-75 years undergoing TKR were randomised into an exergaming (intervention group, IG) or a standard exercising group (control group, CG). Primary outcomes were physical function and pain measured before and after (2 months and 4 months) surgery using the Oxford Knee Score (OKS) and Timed Up and Go (TUG) test.

Adverse events are not increased by controlled delay in surgery of acute upper extremity fractures.

Management of the operative treatment of fractures is challenged by daily variation in patient flow. For upper limb fractures there has recently been an increasing tendency to temporarily discharge the patient to wait for a daytime operation to be performed during the next few days. The objective of this study was to study the safety of controlled delay in surgery.

Effectiveness of Gamification in Knee Replacement Rehabilitation: Protocol for a Randomized Controlled Trial With a Qualitative Approach.

Background: Exergames can provide encouraging exercise options. Currently, there is limited evidence regarding home-based exergaming in the postoperative phase of total knee replacement (TKR).

Objective: This study aimed to investigate the effects of a 4-month postoperative home-based exergame intervention with an 8-month follow-up on physical function and symptoms among older persons undergoing TKR compared with home exercise using a standard protocol.

An Automatic Method for Assessing Spiking of Tibial Tubercles Associated with Knee Osteoarthritis.

Efficient and scalable early diagnostic methods for knee osteoarthritis are desired due to the disease's prevalence. The current automatic methods for detecting osteoarthritis using plain radiographs struggle to identify the subjects with early-stage disease. Tibial spiking has been hypothesized as a feature of early knee osteoarthritis.

Cross-cultural adaptation and validation of the Kerlan-Jobe Orthopaedic Clinic shoulder and elbow score in Finnish-speaking overhead athletes.

Background: The Kerlan-Jobe Orthopaedic Clinic Shoulder and Elbow score (KJOC) is developed to evaluate the shoulder and elbow function in overhead athletes. To date, the score has not been adapted into Finnish language. The aim of this study was to perform a cross-cultural adaptation of the Kerlan-Jobe Orthopaedic Clinic Shoulder and Elbow score (KJOC) into Finnish language and evaluate its validity, reliability, and responsiveness in overhead athletes.

DeepFake knee osteoarthritis X-rays from generative adversarial neural networks deceive medical experts and offer augmentation potential to automatic classification.

Recent developments in deep learning have impacted medical science. However, new privacy issues and regulatory frameworks have hindered medical data sharing and collection. Deep learning is a very data-intensive process for which such regulatory limitations limit the potential for new breakthroughs and collaborations.

Decreased burden of revision hip replacements despite substantial rise in prevalence: a register-based analysis in Finland.

Background And Purpose: While the incidence of THR operations has been established, little is known about the prevalence or the ratio of the annual number of revision THRs to the total number of THRs in the general population. By combining data from nationwide registers, we calculated the annual prevalence of THRs and the revision burden caused by THR survivors in Finland.

Patients And Methods: All primary THRs performed between 1980 and 2020 were identified from the Finnish Arthroplasty Register (FAR).

Translation and psychometric validation of the Finnish version of the Patient Scar Assessment Scale for use in patients with burn scars.

Background: The aim of this study was to create a Finnish scar assessment scale by translating and evaluating the psychometric properties of the Patient Scar Assessment Scale (PSAS), a part of the Patient and Observer Scar Assessment Scale (POSAS), with burn patients to enable its use in burn care.

Methods: The translation process followed international guidelines with forward and backward translations and cognitive debriefing with patients. Psychometric validation was performed with adult patients with burns who had been treated at the Helsinki Burn Centre between 2006 and 2017 with skin grafting following the excision of deep second- or third-degree burns.

Evidence for the in vivo existence and mobilisation of myeloid angiogenic cells and pericyte-like cells in wound patients after skin grafting.

Myeloid angiogenic cells (MACs) and pericyte-like cells, derived from peripheral blood mononuclear cells (MNCs) by in vitro culturing, are suggested as relevant cell types for angiogenesis and tissue repair. However, the in vivo existence and relevance of these cells has so far remained unknown. Our aim was thus to study, if MACs and pericyte-like cells exist in circulation during the wound healing of skin graft patients, and to evaluate the cellular features of wound repair.

Movement characteristics during customized exergames after total knee replacement in older adults.

Introduction: There is limited understanding of how older adults can reach kinematic goals in rehabilitation while performing exergames and conventional exercises, and how similar or different the kinematics during exergaming are when compared with conventional therapeutic exercise with similar movement. The aim of this study was to describe the movement characteristics performed during exercise in custom-designed exergames and conventional therapeutic exercises among patients who have undergone unilateral total knee replacement (TKR). In addition, the secondary aim was to assess the relation of these exercise methods, and to assess participants' perceived exertion and knee pain during exergaming and exercising.

Effect of national COVID-19 lockdown on the incidence of muscle, tendon and ligament injuries and related surgical procedures in the working-aged Finnish population.

Introduction: The effect of lockdown on the incidence of fractures and severe injuries has been widely studied, whereas studies regarding muscle, tendon, and ligament injuries have not received as much attention. The aim of the study was to investigate the effect of the lockdown and later regional regulations due to the COVID pandemic on the incidence of muscle, tendon, and ligament injuries and related surgical procedures.

Materials And Methods: This study focuses on the working-age population in the catchment areas of three major Finnish hospitals.

In vivo localized gastrocnemius subtendon representation within the healthy and ruptured human Achilles tendon.

The Achilles tendon (AT) is composed of three distinct in-series elastic subtendons, arising from different muscles in the triceps surae. Independent activation of any of these muscles is thought to induce sliding between the adjacent AT subtendons. We aimed to investigate displacement patterns during voluntary contraction (VOL) and selective transcutaneous stimulation of medial (MG) and lateral (LG) gastrocnemius between ruptured and healthy tendons and to examine the representative areas of AT subtendons.

Outcomes following the operative treatment of intra-articular fracture combined with medial patellofemoral ligament reconstruction after patellar dislocation.

Purpose: We examine the outcomes following operative treatment of intra-articular fracture combined with medial patellofemoral ligament (MPFL) reconstruction after patella dislocation.

Methods: Patients were retrospectively identified from medical records using diagnostic and surgical procedure codes. Radiological anatomical parameters and bony abnormalities of injured knees were assessed from magnetic resonance images (MRI).