Abstract:
BACKGROUND AND PURPOSE:Hip fracture (HF) in frail elderly patients is associated with poor physical recovery and death. There is often postoperative blood loss and the hemoglobin (Hb) threshold for red blood cell (RBC) transfusions in these patients is unknown. We investigated whether RBC transfusion strategies were associated with the degree of physical recovery or with reduced mortality after HF surgery. PATIENTS AND METHODS:We enrolled 284 consecutive post-surgical HF patients (aged ≥ 65 years) with Hb levels < 11.3 g/dL (7 mmol/L) who had been admitted from nursing homes or sheltered housing. Allocation was stratified by residence. The patients were randomly assigned to either restrictive (Hb < 9.7 g/dL; < 6 mmol/L) or liberal (Hb < 11.3 g/dL; < 7 mmol/L) RBC transfusions given within the first 30 days postoperatively. Follow-up was at 90 days. RESULTS:No statistically significant differences were found in repeated measures of daily living activities or in 90-day mortality rate between the restrictive group (where 27% died) and the liberal group (where 21% died). Per-protocol 30-day mortality was higher with the restrictive strategy (hazard ratio (HR) = 2.4, 95% CI: 1.1-5.2; p = 0.03). The 90-day mortality rate was higher for nursing home residents in the restrictive transfusion group (36%) than for those in the liberal group (20%) (HR = 2.0, 95% CI: 1.1-3.6; p = 0.01). INTERPRETATION:According to our Hb thresholds, recovery from physical disabilities in frail elderly hip fracture patients was similar after a restrictive RBC transfusion strategy and after a liberal strategy. Implementation of a liberal RBC transfusion strategy in nursing home residents has the potential to increase survival.
journal_name
Acta Orthopjournal_title
Acta orthopaedicaauthors
Gregersen M,Borris LC,Damsgaard EMdoi
10.3109/17453674.2015.1006980subject
Has Abstractpub_date
2015-06-01 00:00:00pages
363-72issue
3eissn
1745-3674issn
1745-3682journal_volume
86pub_type
杂志文章,随机对照试验abstract:BACKGROUND AND PURPOSE:Cementless total hip arthroplasty is currently favored by many orthopedic surgeons. The design of the porous surface is critically important for long-term fixation. We examined the clinical and radiographic outcome of the cementless titanium hip implant with a bottom coating of apatite-wollastoni...
journal_title:Acta orthopaedica
pub_type: 杂志文章
doi:10.3109/17453674.2012.736173
更新日期:2012-12-01 00:00:00
abstract:BACKGROUND AND PURPOSE:Resurfacing total hip arthroplasty (RTHA) may preserve the femoral neck bone stock postoperatively. Bone mineral density (BMD) may be affected by the hip position, which might bias longitudinal studies. We investigated the dependency of BMD precision on type of ROI and hip position. METHOD:We DX...
journal_title:Acta orthopaedica
pub_type: 杂志文章
doi:10.3109/17453674.2010.480935
更新日期:2010-06-01 00:00:00
abstract::Background and purpose - Functional limitations after total knee arthroplasty (TKA) are common. In this longitudinal study, we wanted to identify subgroups of patients with distinct trajectories of pain-related interference with walking during the first year after TKA and to determine which demographic, clinical, symp...
journal_title:Acta orthopaedica
pub_type: 杂志文章
doi:10.1080/17453674.2016.1237440
更新日期:2016-12-01 00:00:00
abstract::Background and purpose - Total ankle replacement (TAR) is gaining popularity for treatment of end-stage ankle arthritis. Large patient-centered outcome studies are, however, few. Here, we report data from the Swedish Ankle Registry. Patients and methods - We examined outcomes after primary TAR in patients from the Swe...
journal_title:Acta orthopaedica
pub_type: 杂志文章
doi:10.1080/17453674.2017.1366405
更新日期:2017-12-01 00:00:00
abstract:BACKGROUND AND PURPOSE:In unstable distal radial fractures that are impossible to reduce or to maintain in reduced position, the treatment of choice is operation. The type of operation and the choice of implant, however, is a matter of discussion. Our aim was to investigate whether open reduction and internal fixation ...
journal_title:Acta orthopaedica
pub_type: 杂志文章,随机对照试验
doi:10.3109/17453670903171875
更新日期:2009-08-01 00:00:00
abstract:BACKGROUND AND PURPOSE:Following metal-on-metal hip arthroplasty (THA), immunological reactions including changes in lymphocyte populations, aseptic loosening, and lymphocytic pseudotumors occur. We hypothesized that changes in lymphocyte subpopulations would be associated with elevated metal ion concentrations. METHO...
journal_title:Acta orthopaedica
pub_type: 杂志文章,随机对照试验
doi:10.3109/17453674.2010.548028
更新日期:2011-02-01 00:00:00
abstract::Background and purpose - Modular-neck hip stems have been identified with corrosion-related problems from the neck-stem junction. We report an ongoing varus deformity of modular-neck hip stems with simultaneous metal ion release observed during a study comparing the migration of modular vs. standard hip stems. Patient...
journal_title:Acta orthopaedica
pub_type: 杂志文章
doi:10.1080/17453674.2020.1853387
更新日期:2020-12-10 00:00:00
abstract:BACKGROUND AND PURPOSE:Tourniquet-related nerve injuries remain a concern in orthopedic surgery. The cuff pressures used today are generally lower, and therefore a decreasing incidence of peripheral nerve injuries might also be expected. However, there have been few neurophysiological studies describing the outcome aft...
journal_title:Acta orthopaedica
pub_type: 杂志文章,随机对照试验
doi:10.3109/17453674.2013.782525
更新日期:2013-04-01 00:00:00
abstract::Background and purpose - Knee extensor (KE) muscle weakness is a modifiable feature commonly observed in individuals with knee osteoarthritis (KOA) and constitutes a potential target for patient-specific interventions. Therefore, in this study, we explored whether KE weakness is associated with radiographic (medial an...
journal_title:Acta orthopaedica
pub_type: 杂志文章
doi:10.1080/17453674.2018.1464314
更新日期:2018-08-01 00:00:00
abstract::Background and purpose - Uncemented stems are increasingly used in revision hip arthroplasty, but only a few studies have analyzed the outcomes of uncemented and cemented revision stems in large cohorts of patients. We compared the results of uncemented and cemented revision stems. Patients and methods - 1,668 uncemen...
journal_title:Acta orthopaedica
pub_type: 杂志文章
doi:10.1080/17453674.2019.1624336
更新日期:2019-10-01 00:00:00
abstract:BACKGROUND AND PURPOSE:Current techniques for epiphysiodesis involve opening of cortical windows; use of staples, screws, and tension devices; and fusion with curettes or drills. Complications may have serious consequences. There is a need for a more reliable, precise, and less traumatic procedure that overcomes the kn...
journal_title:Acta orthopaedica
pub_type: 杂志文章
doi:10.3109/17453674.2014.939014
更新日期:2014-09-01 00:00:00
abstract:BACKGROUND:Total hip replacement is increasingly used in active, relatively healthy elderly patients with fractures of the femoral neck. Dislocation of the prosthesis is a severe complication, and there is still controversy regarding the optimal surgical approach and its influence on stability. We analyzed factors infl...
journal_title:Acta orthopaedica
pub_type: 杂志文章
doi:10.3109/17453670902930024
更新日期:2009-04-01 00:00:00
abstract:BACKGROUND AND PURPOSE:In recent years several different plate designs for internal fixation of fractures of the distal radius have been developed. However, few biomechanical studies have been performed to compare these new implants. The purpose of this study was to compare the mechanical properties of 5 different comm...
journal_title:Acta orthopaedica
pub_type: 杂志文章
doi:10.3109/17453670902947440
更新日期:2009-04-01 00:00:00
abstract:BACKGROUND:The advent of highly crosslinked polyethylene has allowed the re-evaluation of the use of femoral heads larger than 32 mm for metal-on-polyethylene total hip arthroplasties. However, the effect of larger heads on the frictional torque of highly crosslinked polyethylene is unknown. METHODS:We performed an in...
journal_title:Acta orthopaedica
pub_type: 杂志文章
doi:10.1080/17453670610012881
更新日期:2006-10-01 00:00:00
abstract::Perspective Orthopaedic training in the United Kingdom has changed little from the Halstedian apprenticeship model of graduated responsibility, with the mantra "see one, do one, teach one". Whilst still relevant in surgical teaching, the current and ongoing disruption to surgical training secondary to the coronavirus ...
journal_title:Acta orthopaedica
pub_type: 杂志文章
doi:10.1080/17453674.2020.1845437
更新日期:2020-11-11 00:00:00
abstract::Background and purpose - Hip resurfacing (HR) is a treatment option promoted for hip arthritis in young and active patients. However, adverse reactions to metal are a concern and the search for non-metallic bearing options proceeds. We present the first clinical study performed in patients using a newly developed hydr...
journal_title:Acta orthopaedica
pub_type: 杂志文章
doi:10.1080/17453674.2017.1376526
更新日期:2018-02-01 00:00:00
abstract:BACKGROUND AND PURPOSE:We have previously reported that the first 10 years of hip arthroplasty in Lithuania resulted in a higher cumulative revision rate than that observed in Sweden. We thus compared the corresponding results after introduaction of total knee replacement in Lithuania. METHODS:The 10-year revision rat...
journal_title:Acta orthopaedica
pub_type: 杂志文章
doi:10.1080/17453670902804984
更新日期:2009-02-01 00:00:00
abstract:BACKGROUND:We have previously reported that 6 months of oral treatment with clodronate reduced the migration of the NexGen total knee prosthesis during the first postoperative year, as measured by radiostereometry (RSA). We now report the 4-year results. METHODS:This was a double-blind randomized study, using RSA with...
journal_title:Acta orthopaedica
pub_type: 杂志文章,随机对照试验
doi:10.1080/17453670610013213
更新日期:2006-12-01 00:00:00
abstract:BACKGROUND:Overweight and a high level of physical activity are known risk factors for loosening of a total hip arthroplasty (THA) due to primary osteoarthritis. We wanted to investigate how these factors, together with age and sex, affect the risk of revision surgery. PATIENTS AND METHODS:We matched data from the Nor...
journal_title:Acta orthopaedica
pub_type: 杂志文章
doi:10.1080/17453670610013493
更新日期:2007-02-01 00:00:00
abstract:BACKGROUND:Aseptic loosening is the major cause of implant failure. In cemented hip arthroplasty, failure of the acetabular side is mainly due to lysis caused by wear particles. By using an implant with low wear characteristics and by enhancing acetabular fixation using an uncemented implant, we aimed to reduce acetabu...
journal_title:Acta orthopaedica
pub_type: 杂志文章
doi:10.1080/17453670710014103
更新日期:2007-08-01 00:00:00
abstract:BACKGROUND AND PURPOSE:External fixators allowing movement during fracture healing are commonly used for treatment of unstable distal radius fractures. The dynamic Dynawrist fixator with the distal pins in metacarpal bone may avoid fixation problems in comminuted fractures and may reduce the risk of nerve injury. We co...
journal_title:Acta orthopaedica
pub_type: 杂志文章,随机对照试验
doi:10.1080/17453670902807433
更新日期:2009-02-01 00:00:00
abstract:BACKGROUND:Since the osteogenic potential of bone marrow derived mesenchymal stem cells (BMSCs) becomes reduced with passage, establishment of culture condition that permit the rapid expansion of BMSCs while retaining their potential for differentiation is needed for clinical application. Bone morphogenetic proteins st...
journal_title:Acta orthopaedica
pub_type: 杂志文章
doi:10.1080/17453670710013816
更新日期:2007-04-01 00:00:00
abstract:UNLABELLED:BACKGROUND AND PURPOSE Analgesics can have undesirable effects. We assessed whether a single preoperative dose of 120 mg etoricoxib reduces the need for additional opioids after therapeutic arthroscopic knee surgery. METHODS A double-blind, placebo-controlled study was performed at a single center. 66 patien...
journal_title:Acta orthopaedica
pub_type: 杂志文章,随机对照试验
doi:10.3109/17453674.2012.747053
更新日期:2012-12-01 00:00:00
abstract::Background and purpose - The number of primary, highly constrained knee arthroplasty implants has increased with a theoretically increased risk of early failure. Therefore we analyzed the risk of all revision following total knee arthroplasty (TKA) in patients receiving a hinged or condylar constrained knee (CCK) comp...
journal_title:Acta orthopaedica
pub_type: 杂志文章
doi:10.1080/17453674.2019.1627638
更新日期:2019-10-01 00:00:00
abstract:BACKGROUND AND PURPOSE:Bones used in mechanical studies are frequently harvested from human cadavers that have been embalmed in a buffered formaldehyde solution. It has been reported that formaldehyde fixation or freezing hardly affects the mechanical properties of bone after a storage period of several weeks. However,...
journal_title:Acta orthopaedica
pub_type: 杂志文章
doi:10.1080/17453670810016759
更新日期:2008-10-01 00:00:00
abstract:BACKGROUND AND PURPOSE:We have previously shown that during the first 2 years after total hip arthroplasty (THA), periprosthetic bone resorption can be prevented by 6 months of risedronate therapy. This follow-up study investigated this effect at 4 years. PATIENTS AND METHODS:A single-center, double-blind, randomized ...
journal_title:Acta orthopaedica
pub_type: 杂志文章,随机对照试验
doi:10.3109/17453674.2015.1041846
更新日期:2015-01-01 00:00:00
abstract:BACKGROUND:In some countries, commercially available antibiotic powder-loaded acrylic bone cement is routinely used in joint replacement, while, in others, "off-label" formulations are used in selected procedures (where the antibiotic powder is blended manually with the powder of a plain cement in the operating room/th...
journal_title:Acta orthopaedica
pub_type: 杂志文章
doi:10.1080/17453670610012700
更新日期:2006-08-01 00:00:00
abstract:BACKGROUND AND PURPOSE:Following transtibial amputation, a rigid dressing of plaster of Paris has been reported to have advantages over a soft dressing regarding wound healing and reduction of edema, but use of the former may be limited by difficulties in application and in gaining access to the wound. An easily applic...
journal_title:Acta orthopaedica
pub_type: 杂志文章,随机对照试验
doi:10.1080/17453670710015265
更新日期:2008-06-01 00:00:00
abstract::Background and purpose - Up to 20% of patients are dissatisfied after total knee arthroplasty (TKA), mainly because of pain and restricted physical function. We developed a prediction model for 6-month knee range of motion, knee pain, and walking limitations in patients undergoing TKA surgery. Patients and methods - W...
journal_title:Acta orthopaedica
pub_type: 杂志文章
doi:10.1080/17453674.2018.1560647
更新日期:2019-04-01 00:00:00
abstract:BACKGROUND AND PURPOSE:This randomized study compared clinical results after surgery for posttraumatic shoulder instability with either an anatomical repair or an older, less anatomical but commonly used method. The less anatomical procedure has been considered quicker and less demanding, but it has been questioned reg...
journal_title:Acta orthopaedica
pub_type: 杂志文章,随机对照试验
doi:10.3109/17453670902988345
更新日期:2009-06-01 00:00:00