Publications by authors named "Troelsen A"
Background And Purpose: In contemporary medial unicompartmental knee arthroplasty (mUKA), non-lateral patellofemoral osteoarthritis (PFOA) is not considered a contraindication. However, we still lack knowledge on the association of PFOA severity on patient reported outcome measures (PROMs) after mUKA. We aimed to examine the association between PFOA severity and PROM-score changes after mUKA.
View Article and Find Full Text PDFBackground: The INtensive diet versus Knee Arthroplasty (INKA) trial is a randomised trial assessing weight loss as an alternative to knee arthroplasty (KA) in obese patients with severe knee osteoarthritis (OA) awaiting KA (NCT05172843). The external validity of the INKA trial may be hampered if the patients who participate differ from those who decline participation.
Objective: To compare baseline characteristics between patients who enrol in the INKA trial and those who decline participation (i.
Background: Medially congruent (MC) bearings aim at promoting medial pivoting after total knee arthroplasty (TKA), as the congruency provides further constraint for the medial femoral compartment. However, this design difference could alter intra-articular force distribution, potentially compromising fixation of the tibia implant. The aim of this study was to compare migration, measured with radiostereometric analysis (RSA), of an MC to a more traditional cruciate retaining (CR) TKA system.
View Article and Find Full Text PDFArticle Synopsis
- This study evaluates the effectiveness of ICD-10 codes in identifying postoperative complications (PCs) compared to manually reviewing electronic health records (EHRs) using data from 11,827 surgical cases in Denmark.
- Manual curation identified 1,047 PCs, while ICD-10 codes only captured 439, showing a low accuracy of about 20.8% for ICD-10 in detecting these complications.
- The study highlights that PCs significantly increase healthcare resource usage and costs, with findings indicating annual additional costs of €25.5 million, far exceeding estimates based on ICD-10 codes, underscoring the need for better detection methods for surgical quality assessment.
Article Synopsis
- There is limited research on the optimal indications for lateral unicompartmental knee arthroplasty (UKA), in contrast to the more established guidelines for medial UKA, due to differences in anatomy, osteoarthritis types, movement patterns, and surgical techniques.
- A systematic review examined 38 cohort studies to identify common indications and contraindications for lateral UKA, reporting that it is mainly performed for primary lateral osteoarthritis and identifying key contraindications.
- While some agreement on indications was found, the study indicates there is no strong consensus on the best practices for lateral UKA, highlighting the need for clearer, evidence-based guidelines in future research.
Article Synopsis
- This study analyzed the effects of age on outcomes for patients undergoing medial unicompartmental knee arthroplasty (mUKA), revealing that contemporary practices no longer limit eligibility based on age.
- A total of 782 patients were evaluated, showing significant improvements in knee function across all age groups after surgery, with no notable differences in the overall outcomes based on age.
- However, patients aged 55 to < 65 years experienced less improvement in specific measures of joint awareness and participation, but overall satisfaction was high across all age categories, supporting the current approach of not using age as a restriction for mUKA.
Article Synopsis
- This study investigates potential biases in both human readings of medical images and AI tools trained on human data, specifically focusing on knee osteoarthritis grading.
- Researchers used a dataset of 50 patients for external validation and a larger cohort of 8,273 to analyze the performance of an FDA-approved AI tool.
- Findings indicated that the AI tool displayed non-uniformity in disease grading, showing discrepancies of 20-22% and 13.6% in different patient datasets, but its overall accuracy was comparable to experienced radiologists without evidence of age or sex bias.
Using at least 20% medial unicompartmental knee arthroplasty is associated with improved patient-reported outcome measures across all knee arthroplasty patients.
Julie Kristine Steen Møller Kristine Ifigenia Bunyoz Cecilie Henkel Christian Bredgaard Jensen Kirill Gromov
Knee Surg Sports Traumatol Arthrosc
October 2024
Article Synopsis
- The study aimed to understand how the distribution of knee arthroplasties performed by orthopaedic surgeons affects patient outcomes, specifically focusing on patient-reported outcome measures (PROMs) after surgery.
- A total of 2,256 knee arthroplasties were analyzed, with PROMs assessed at various time points to compare outcomes based on surgical groups defined by their proportion of medial unicompartmental knee arthroplasties (UKAs).
- Results showed that the group of surgeons performing at least 20% medial UKA had significantly better PROM improvements at 3 and 12 months post-surgery, suggesting that a higher proportion of this type of procedure is beneficial for patient outcomes.
Article Synopsis
- Total knee arthroplasty (TKA) can lead to inflammation and significant pain, and this study explores how pain catastrophizing impacts acute postoperative pain and inflammatory markers (CRP) associated with TKA.
- The research involved 119 patients and included analyses of pain and CRP levels at 24 and 48 hours post-surgery to assess correlations.
- Findings indicate no significant relationship between preoperative or postoperative CRP levels and pain experienced or pain catastrophizing, suggesting that CRP may not be a reliable marker for assessing acute pain after TKA in patients treated with preoperative glucocorticoids.
Article Synopsis
- MRI scans are being used more frequently to assess knee osteoarthritis and plan for unicompartmental knee arthroplasty (UKA), especially since many patients have scans prior to seeing their surgeons.
- The study analyzed 100 knees with specific criteria to evaluate cartilage damage, osteophytes, meniscal issues, and ACL status, with decisions for UKA based on surgical inspections rather than MRI alone.
- Findings showed significant cartilage loss in the medial compartment, varying conditions of the ACL, and some osteophyte presence, stressing that while MRI confirms bone-on-bone disease, further understanding of additional findings is necessary for better patient outcomes.
Article Synopsis
- * A total of 85 lateral UKAs were performed, with patient-reported outcomes showing stable results post-surgery, indicating no negative impact due to the surgeons' initial learning curve.
- * The findings suggest that surgeons with experience in medial UKA can safely and effectively start a lateral UKA practice, achieving high implant survival rates and consistent patient satisfaction over time.
Article Synopsis
- This study evaluated factors that predict pain levels for patients after total knee arthroplasty, focusing on the days 2-7 post-surgery.
- It analyzed data from 227 patients to determine how preoperative and early postoperative factors, like pain levels and demographics, influence pain outcomes.
- Findings indicated that pain measured 24 hours after surgery is a strong predictor of pain during days 2-7, while preoperative pain only had a weak correlation.
Article Synopsis
- The study explores the link between pain catastrophizing (a psychological condition) and acute pain levels after unicompartmental knee arthroplasty (UKA), contrasting with prior research on total knee arthroplasty.
- Conducted as a prospective observational study, it involved 125 UKA patients, evaluating their postoperative pain through a diary at various intervals after surgery.
- Findings revealed that while 31% were predicted high-pain responders, preoperative pain catastrophizing did not correlate significantly with higher pain during the first week post-surgery.
Article Synopsis
- - Emerging evidence indicates that quantitative sensory testing (QST) could be useful in predicting how well patients with knee osteoarthritis (OA) will respond to pain relief treatments.
- - This systematic review analyzed various studies from 2000 to 2023, focusing on different treatment methods for OA, and found that QST predicted treatment outcomes in a significant percentage of surgical (81%), pharmaceutical (100%), and exercise-based therapies (50%).
- - The findings suggest that while there is a weak-to-moderate correlation between QST results and treatment success, some patients with OA may be particularly sensitive to pain and may not respond well to standard treatment options.
Article Synopsis
- * The research included over 56,000 primary total knee arthroplasties (TKAs) performed from 2010 to 2018, analyzing the identification and reporting of PJI cases through sensitivity, specificity, and predictive values.
- * Findings indicated that DKR had a sensitivity of only 58% for PJI revisions, with the cumulative incidence of PJI at 0.8% for DKR, 0.9% for HAIBA, and 1
Article Synopsis
- The study aimed to evaluate the effectiveness of natural language processing (NLP) in identifying postoperative complications (pneumonia, urinary tract infection, sepsis, septic shock) compared to traditional administrative data methods.* -
- Data from 17,486 surgical cases across 18 hospitals in Denmark showed that NLP significantly outperformed administrative data, achieving high accuracy rates (receiver operating characteristic areas ranged from 0.989 to 0.998) for identifying these complications.* -
- The findings suggest that NLP can provide more precise detection of postoperative complications, potentially matching manual curation, and could be a useful tool for real-time monitoring in healthcare settings.*
Article Synopsis
- * Symptoms of OI mainly included dizziness and heat sensations, but no patients stopped mobilization early due to these symptoms.
- * There were no notable differences in factors like fluid balance, bleeding, or pain between patients with and without OI, indicating that OI does not significantly affect immediate post-surgery recovery outcomes.
Article Synopsis
- The study investigates the minimal important change (MIC) in patient-reported outcomes for knee and hip scores (OKS/OHS) at various post-surgery times (3, 12, and 24 months) following knee or hip arthroplasty.
- Using data from a public hospital over several years, it analyzed responses from patients to identify how much improvement is meaningful to them.
- Results showed that MIC thresholds varied depending on the time since surgery, with values increasing between 3 and 12 months but remaining stable from 12 to 24 months, indicating consistent improvement in patient-reported outcomes over time.
Article Synopsis
- Medial unicompartmental knee arthroplasty (mUKA) has become more accessible for end-stage anteromedial osteoarthritis (AMOA) patients, with nearly 50% now eligible due to updated criteria.
- Recent studies indicate that mUKA offers advantages like shorter hospital stays, cost-effectiveness, and similar functional outcomes to total knee arthroplasty (TKA), along with lower revision rates when usage exceeds 20-30%.
- Denmark shows a significantly higher rate of mUKA procedures compared to other countries, likely due to their national alliances and improved surgical education, which can guide better practices in knee arthroplasty worldwide.
Article Synopsis
- - The study explored patient attitudes towards day-case hip and knee surgeries, aiming to identify the characteristics that influence these attitudes and improve the information provided by surgeons during consultations.
- - Out of 5,322 patients surveyed, 41.8% showed interest in day-case surgery while 37.5% were not interested; factors like age, sex, and mental health conditions such as anxiety/depression played a role in influencing their attitudes.
- - A significant portion of those initially uncertain about day-case surgery changed their attitude by their next surgical procedure, indicating that experiences and information can impact patient preferences.
Article Synopsis
- The study aimed to explore the relationship between the size of the femoral head in metal-on-polyethylene total hip arthroplasty and the levels of metal ions in the blood of patients.
- A total of 96 patients were divided into two groups based on femoral head size (32 mm vs. 36-44 mm), with metal ion levels measured at two and five years post-surgery, along with patient-reported outcomes.
- Results showed no significant differences in metal ion levels or patient outcome scores between the two groups at five years, suggesting that increasing femoral head size may not lead to higher metal ion levels in this context.
Article Synopsis
- The study aimed to determine the proportion of hip and knee arthroplasty patients eligible for day-case surgery in Denmark and to see if eligibility changed over time.
- Researchers analyzed data from the Danish National Patient Register covering patients from January 2010 to March 2020, finding that 48% of patients were eligible for day-case surgery, with a slight decline in eligibility over the years.
- Despite nearly half of patients qualifying for same-day discharge, only about 8% were actually discharged on the day of surgery in 2019, indicating a significant opportunity for increasing day-case procedures.
Article Synopsis
- - The study aimed to compare polyethylene wear in total hip arthroplasty (THA) using large metal heads with thin Vitamin E-doped cross-linked polyethylene (VEPE) liners versus standard 32-mm metal heads.
- - Results showed no significant difference in head penetration or rates of periacetabular radiolucencies between the two groups after 5 years, although the intervention group reported higher physical activity levels.
- - Overall, the use of large metal heads in thin VEPE liners did not lead to increased wear or mechanical failures in the long term following THA.
Article Synopsis
- The study investigated the indication of "pain without loosening" as a reason for knee arthroplasty revisions in Danish patients, aiming to identify any hidden indications that may improve data quality in the Danish Knee Arthroplasty Register.
- A total of 104 patients were reviewed, confirming "pain without loosening" as the primary reason in 103 cases, while also uncovering 44 hidden indications like malposition of components and stiffness.
- The findings highlight that while "pain without loosening" is recognized, other significant causes need documentation in registers, with a notable concern regarding the frequency of early arthrosis grades prior to surgery possibly contributing to unexplained knee pain.