The incidence of knee arthroplasty for primary osteoarthritis grows rapidly among baby boomers: a population-based study in Finland.

Objective: Total knee arthroplasty (TKA) is a commonly used treatment for severe primary knee osteoarthritis (OA) that is refractory to conservative treatment. Despite the presumed increase in the use of this treatment modality in younger patients, there are few published data concerning this. The aim of our study was to examine the changes in the age- and sex-standardized incidence of TKA and unicondylar knee arthroplasty (UKA) in Finland during 1980-2006 and to identify factors that might affect the incidence during this period.

Results of 3,668 primary total hip replacements for primary osteoarthritis in patients under the age of 55 years.

Background And Purpose: In a previous study based on the Finnish Arthroplasty Register, the survival of cementless stems was better than that of cemented stems in younger patients. However, the survival of cementless cups was poor due to osteolysis. In the present study, we analyzed population-based survival rates of the cemented and cementless total hip replacements in patients under the age of 55 years with primary osteoarthritis in Finland.

Cemented versus cementless total hip replacements in patients fifty-five years of age or older with rheumatoid arthritis.

Background: results obtained from single-center studies indicate that a cemented total hip replacement is the treatment of choice for the management of patients over fifty-five years of age with rheumatoid arthritis. The aim of this study was to analyze population-based survival rates for cemented and cementless total hip replacements in patients aged fifty-five years or over with rheumatoid arthritis in Finland.

Methods: between 1980 and 2006, a total of 6000 primary total hip replacements performed for the management of rheumatoid arthritis in patients who were fifty-five years of age or older were entered in the Finnish Arthroplasty Registry.

Early results of 827 trabecular metal revision shells in acetabular revision.

We evaluated the survival of 827 acetabular revisions with Trabecular Metal Revision Shell using data from a nationwide arthroplasty register. The mean age of the patients was 69.1 years.

Results of total knee replacement with a cruciate-retaining model for severe valgus deformity--a study of 48 patients followed for an average of 9 years.

The objectives of the present study were to find out the results and the factors affecting survival after primary knee arthroplasty with a cruciate-retaining prosthesis in severe valgus deformity. Forty-eight patients (52 knees) participated in the current follow-up study. All patients were followed at least 5 years or to first revision.

A retrospective comparative study of mortality and causes of death among patients with metal-on-metal and metal-on-polyethylene total hip prostheses in primary osteoarthritis after a long-term follow-up.

Background: All patients with total hip arthroplasty (THA), especially those with metal-on-metal (MM) THA, are exposed to metallic particles and ions, which may cause total or site-specific mortality. We analyzed the causes of total and site-specific mortality among a cohort of patients with MM and with metal-on-polyethylene (MP) THA after a long follow-up time.

Methods: Standardized mortality ratios (SMR) of total and site-specific causes of death were calculated for 579 patients with MM (McKee-Farrar) and 1585 patients with MP (Brunswik, Lubinus) THA for primary osteoarthritis.

Total ankle replacement: a population-based study of 515 cases from the Finnish Arthroplasty Register.

Background And Purpose: Although total ankle replacement (TAR) is a recognized procedure for treatment of the painful arthritic ankle, the best choice of implant and the long-term results are still unknown. We evaluated the survival of two TAR designs and factors associated with survival using data from the nationwide arthroplasty registry in Finland.

Methods: 573 primary TARs were performed during the period 1982-2006 because of rheumatic, arthritic, or posttraumatic ankle degeneration.

Cementless total hip arthroplasty for primary osteoarthritis in patients aged 55 years and older.

Background: Cemented total hip arthroplasty has been the treatment of choice for elderly patients with osteoarthritis. We analyzed survival rates of the most common cementless designs used in this age group in Finland.

Patients And Methods: Inclusion criteria permitted 10,310 replacements (8 designs) performed in patients aged 55 years or older to be selected for evaluation.

Cancer risk is not increased after conventional hip arthroplasty.

Background And Purpose: Wear debris from conventional total hip arthroplasty (THA) induces chromosomal aberrations and DNA damage, which may promote cancerogenesis. A long latent period is required for solid tumors. We therefore re-analyzed a large THA cohort for cancer.

Total elbow arthroplasty in rheumatoid arthritis: a population-based study from the Finnish Arthroplasty Register.

Background And Purpose: Although total elbow arthroplasty (TEA) is a recognized procedure for the treatment of the painful arthritic elbow, the choice of implant is still obscure. We evaluated the survival of different TEA designs and factors associated with survival using data from a nationwide arthroplasty register.

Methods: 1,457 primary TEAs for rheumatoid elbow destruction were performed during 1982 to 2006 in one hospital specialized in the treatment of rheumatoid arthritis (n = 776) and in 19 other hospitals (n = 681).

The effect of waiting time on health-related quality of life, pain, and physical function in patients awaiting primary total hip replacement: a randomized controlled trial.

Objective: This prospective randomized study assessed the effect of waiting time (WT) on health outcomes in Finnish patients admitted to hospital for primary total hip replacement (THR).

Methods: A total of 395 consecutive patients with a need for a primary THR because of osteoarthritis and who were placed on the waiting list between August 2002 and November 2003. After placement on the waiting list, the patients were randomly assigned to a short WT ( View Article and Find Full Text PDF

Total hip arthroplasty for primary osteoarthritis in patients fifty-five years of age or older. An analysis of the Finnish arthroplasty registry.

Background: According to the long-term results obtained from the Scandinavian arthroplasty registries, cemented total hip replacement has been the treatment of choice for osteoarthritis of the hip in elderly patients. The aim of the present study was to analyze population-based survival rates of the cemented and cementless total hip replacements performed for primary osteoarthritis in patients fifty-five years of age or older in Finland.

Methods: From 1980 to 2004, a total of 50,968 primary total hip replacements that met our criteria were entered in the Finnish Arthroplasty Registry.

Comparison of survival and cost-effectiveness between unicondylar arthroplasty and total knee arthroplasty in patients with primary osteoarthritis: a follow-up study of 50,493 knee replacements from the Finnish Arthroplasty Register.

Background And Purpose: Both unicondylar arthroplasty (UKA) and total knee arthroplasty (TKA) are commonly used for the treatment of unicompartmental osteoarthritis (OA) of the knee. The long-term survivorship and cost-effectiveness of these two treatments have seldom been compared on a nationwide level, however. We therefore compared the survival of UKA with that of TKA and conducted a cost-benefit analysis comparing UKA with TKA in patients with primary OA.

Medial unicompartmental knee arthroplasty with Miller-Galante II prosthesis: mid-term clinical and radiographic results.

Aim: The purpose of our study was to evaluate retrospectively the mid-term results of the Miller-Galante II (Zimmer, Warsaw, USA) unicondylar knee arthoplasty (UKA).

Method: The study included 46 patients with medial UKAs. Mean follow-up time was 7.

Is longer waiting time associated with health and social services utilization before treatment? A randomized study.

Objective: To determine whether longer waiting time for major joint replacement is associated with health and social services utilization before treatment.

Methods: When placed on the waiting list, patients were randomized to short ( View Article and Find Full Text PDF

Evaluating waiting time effect on health outcomes at admission: a prospective randomized study on patients with osteoarthritis of the knee joint.

Aims: To evaluate the effect of waiting on health-related quality of life (HRQoL), pain and physical function in patients awaiting primary total knee replacement (TKR) due to osteoarthritis.

Methods: Some 438 patients awaiting TKR were randomized to a short waiting time (WT) group (< or =3 months) or a non-fixed WT group. In the final assessment, 310 patients (213 women) with a mean age of 68 years were included.

Unicondylar knee replacement for primary osteoarthritis: a prospective follow-up study of 1,819 patients from the Finnish Arthroplasty Register.

Background: The choice and use of unicondylar knee arthroplasty (UKA) has gone through a nation wide resurgence at the start of the 21st century in Finland. We evaluated the population-based survival of UKA in patients with primary osteoarthritis (OA) in Finland, and the factors affecting their survival.

Method: The Finnish Arthroplasty Register was established in 1980.

Effectiveness of hip or knee replacement surgery in terms of quality-adjusted life years and costs.

Background: Concurrent head-to-head comparisons of healthcare interventions regarding cost-utility are rare. The concept of favorable cost-effectiveness of total hip or knee arthroplasty is thus inadequately verified.

Patients And Methods: In a trial involving several thousand patients from 10 medical specialties, 223 patients who were enrolled for hip or knee replacement surgery were asked to fill in the 15D health-related quality of life (HRQoL) survey before and after operation.

The effect of co-morbidities on health-related quality of life in patients placed on the waiting list for total joint replacement.

Background: Co-morbidity is a powerful predictor of health care outcomes and costs, as well as an important cofounder in epidemiologic studies. The effect of co-morbidities is generally related to mortality or complications. This study evaluated the association between co-morbidity and health-related quality of life (HRQoL) in patients awaiting total joint replacement.

Total hip arthroplasty for rheumatoid arthritis in younger patients: 2,557 replacements in the Finnish Arthroplasty Register followed for 0-24 years.

Background: The results of total hip arthroplasty (THA) in young patients with rheumatoid arthritis (RA) have been reported in only a few studies. On a nationwide level, the outcome of THA in these patients is unknown. We evaluated the population-based survival of THA in patients under 55 years of age with RA and factors affecting the survival.

Plantar heel pain and its 3-mode 4-stage treatment.

The most common cause for heel pain is plantar fasciitis. The diagnosis can usually be made by clinical examination, but sometimes ENMG (electroneuromyography), ultrasound, and magnetic resonance imaging examinations are helpful. Other reasons for heel pain, e.

Malignant tumors at the site of total hip prosthesis. Analytic review of 46 cases.

During the years 1974 to 2003, a total of 46 cases of malignant tumors at the site of total hip arthroplasty, 41 sarcomas, 4 lymphomas, and 1 epidermoid carcinoma, have been reported in the Western literature. Soft tissue sarcomas occurred in 31 and bone sarcomas in 10 cases. Malignant fibrous histiocytoma was the most common in 20 (65%) of all soft tissue sarcomas.