Implant-Related Complications and Mortality After Use of Short or Long Gamma Nail for Intertrochanteric and Subtrochanteric Fractures: A Prospective Study with Minimum 13-Year Follow-up.

Background: The purpose of this study was to evaluate the rates of implant-related complications and mortality after treatment of an intertrochanteric or subtrochanteric fracture with a short or long Gamma nail.

Methods: Between September 1998 and August 2003, 644 patients at 2 centers treated with a long or short Gamma nail for a hip fracture were prospectively enrolled in this study. These patients were followed until they reached 1 of the study end points, which included death, a reoperation directly related to the Gamma nail, or the end date of the study.

The role of femoral offset and abductor lever arm in total hip arthroplasty.

Background: In order to create a well-functioning total hip arthroplasty (THA), it is important to restore femoral off-set and thus the abductor lever arm. The aim of this study was to investigate the clinical effect of increasing the abductor lever arm to and beyond the anatomical native lever arm in minimally invasive total hip arthroplasty performed through a direct anterior approach.

Materials And Methods: We compared the lever arm of the operated hip to the lever arm of the contralateral native hip on radiographs in 148 patients following THA.

Unchanging incidence of hip fracture in southeastern norway.

Purpose: The aim of this study was to ascertain trends in the incidence of hip fracture in southeastern Norway by comparing the hip fracture incidence for the years 2008 to 2010 to that of a study from 1998 to 2003 in the same area.

Methods: We determined the number of hip fractures for the geographical area of Ostfold county, and the age- and gender-specific incidence per 100 000, with 95% confidence intervals, was calculated. Use of bisphosphonates was determined by extracting data from public databases.

Comparison of cemented and uncemented fixation in total knee arthroplasty.

As a result of reading this article, physicians should be able to :1. Understand the rationale behind using uncemented fixation in total knee arthroplasty.2.

Evaluating comorbidities in total hip and knee arthroplasty: available instruments.

Each year millions of patients are treated for joint pain with total joint arthroplasty, and the numbers are expected to rise. Comorbid disease is known to influence the outcome of total joint arthroplasty, and its documentation is therefore of utmost importance in clinical evaluation of the individual patient as well as in research. In this paper, we examine the various methods for obtaining and assessing comorbidity information for patients undergoing joint replacement.

American Society of Anesthesiologist Physical Status score may be used as a comorbidity index in hip fracture surgery.

Comorbidities affect outcome, but there is no consensus which comorbidity instrument is best in orthopedic surgery. We assessed whether the American Society of Anesthesiologists Physical Status score (ASA) predicts long-term mortality after hip fracture. We followed 1635 patients for 5 to 10 years after operative treatment of hip fracture.

No differences in outcomes between cemented and uncemented acetabular components after 12-14 years: results from a randomized controlled trial comparing Duraloc with Charnley cups.

Background: Even though there are multiple studies documenting the outcome of the Charnley low-friction arthroplasty as well as abundant studies on uncemented arthroplasties, there is a dearth of comparative studies of the uncemented acetabular component and a cemented component. In this study we aimed to document the long-term clinical and radiographic outcome as well as component survival in a randomized controlled trial.

Materials And Methods: Two hundred fifteen patients (240 hips) were randomly allocated to receive a cemented Charnley cup or uncemented Duraloc 1200 cup.

Learning curves in hip fracture surgery.

The aim of this study was to identify and characterise learning curves in hip fracture surgery. Operating times were collected and related to the number of procedures done by residents performing closed reduction and internal fixation using cannulated screws for intracapsular fractures of the hip and cephalomedullary nailing for trochanteric fractures, as well as hemiarthroplasty for displaced intracapsular fractures. The mean operating times decreased significantly for all four procedures studied, though at different rates.

Patients with bilateral procedures can be included in total hip arthroplasty research without biasing results.

We explored the influence of bilaterality on the results of a trial of cemented vs uncemented acetabular components. Harris hip scores after 6 months, 2 years, 5 years, and 10 years were analyzed in 240 arthroplasties in 215 patients. Thus, 190 cases in 190 patients were compared to 50 cases in 25 patients.

Outcome of undisplaced and moderately displaced femoral neck fractures.

Background: The optimal treatment for femoral neck fracture is a matter of controversy. We compared the outcome of displaced fractures with good healing potential (moderately displaced fractures) to the outcome of undisplaced fractures treated by internal fixation with 2 parallel screws.

Methods: In a consecutive series of hip fracture patients, the rates of reoperation and mortality for 225 undisplaced fractures were compared to those for 241 moderately displaced fractures.

Outcome after treatment of complications of Gamma nailing: a prospective study of 554 trochanteric fractures.

Background: A high reoperation rate has been the main reason why Gamma nailing should not be recommended for routine use in the treatment of trochanteric fractures. We compared the outcome after reoperation to the outcome after primary surgery with Gamma nailing.

Methods: In a series of 554 patients, we compared the outcome in 52 patients who were reoperated with that in 502 patients who had no reoperations.

Hemiarthroplasty in worst cases is better than internal fixation in best cases of displaced femoral neck fractures: a prospective study of 683 patients treated with hemiarthroplasty or internal fixation.

Background: Studies have shown that the degree of initial displacement and also comminution of the femoral calcar, size of the head and varus angulation are prognostic of failure in displaced femoral neck fracture. We have applied these radiographic criteria in order to select patients who would benefit from internal fixation as opposed to primary hemiarthroplasty, and this prospective study was conducted in order to monitor the results of this strategy.

Methods: 683 displaced fractures of the femoral neck were treated with internal fixation or primary hemiarthroplasty based on the proposed radiographic criteria in a prospective consecutive study, and the patients were followed for 1-6 years.

Low interobserver reliability of radiographic signs predicting healing disturbance in displaced intracapsular fracture of the femoral neck.

We determined the interobserver agreement of 3 radiographic signs previously shown to predict a disturbance in healing of femoral neck fractures. 6 orthopedic surgeons evaluated 32 radiographs for the presence of comminution of the femoral calcar, varus displacement in excess of 30 degrees and a small head fragment. They also classified the radiographs with Garden's method and determined the presence or absence of displacement.