Abstract:
:Background and purpose - Patient-specific instrumentation (PSI) for total knee arthroplasty (TKA) has been introduced to improve alignment and reduce outliers, increase efficiency, and reduce operation time. In order to improve our understanding of the outcomes of patient-specific instrumentation, we conducted a meta-analysis. Patients and methods - We identified randomized and quasi-randomized controlled trials (RCTs) comparing patient-specific and conventional instrumentation in TKA. Weighted mean differences and risk ratios were determined for radiographic accuracy, operation time, hospital stay, blood loss, number of surgical trays required, and patient-reported outcome measures. Results - 21 RCTs involving 1,587 TKAs were included. Patient-specific instrumentation resulted in slightly more accurate hip-knee-ankle axis (0.3°), coronal femoral alignment (0.3°, femoral flexion (0.9°), tibial slope (0.7°), and femoral component rotation (0.5°). The risk ratio of a coronal plane outlier (> 3° deviation of chosen target) for the tibial component was statistically significantly increased in the PSI group (RR =1.64). No significance was found for other radiographic measures. Operation time, blood loss, and transfusion rate were similar. Hospital stay was significantly shortened, by approximately 8 h, and the number of surgical trays used decreased by 4 in the PSI group. Knee Society scores and Oxford knee scores were similar. Interpretation - Patient-specific instrumentation does not result in clinically meaningful improvement in alignment, fewer outliers, or better early patient-reported outcome measures. Efficiency is improved by reducing the number of trays used, but PSI does not reduce operation time.
journal_name
Acta Orthopjournal_title
Acta orthopaedicaauthors
Huijbregts HJ,Khan RJ,Sorensen E,Fick DP,Haebich Sdoi
10.1080/17453674.2016.1193799subject
Has Abstractpub_date
2016-08-01 00:00:00pages
386-94issue
4eissn
1745-3674issn
1745-3682journal_volume
87pub_type
杂志文章,评审abstract:BACKGROUND AND PURPOSE:Total knee replacements (TKRs) are being increasingly performed in patients aged < or = 65 years who often have high physical demands. We investigated the relation between age of the patient and prosthesis survival following primary TKR using nationwide data collected from the Finnish Arthroplast...
journal_title:Acta orthopaedica
pub_type: 杂志文章
doi:10.3109/17453674.2010.501747
更新日期:2010-08-01 00:00:00
abstract:BACKGROUND AND PURPOSE:There is continuing confusion among practitioners with regard to the optimal choice of anesthetic type for repair of hip fractures. We investigated whether type of anesthetic was associated with short-term mortality after hip fracture surgery. PATIENTS AND METHODS:We conducted a retrospective co...
journal_title:Acta orthopaedica
pub_type: 杂志文章
doi:10.3109/17453674.2015.1128781
更新日期:2016-01-01 00:00:00
abstract:BACKGROUND AND PURPOSE:Optical coherence tomography (OCT) is a light-based imaging technique suitable for depiction of thin tissue layers such as articular cartilage. Quantification of results and direct comparison with a reference standard is needed to confirm the role of OCT in cartilage evaluation. MATERIALS AND ME...
journal_title:Acta orthopaedica
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abstract:BACKGROUND AND PURPOSE:Operative findings during revision of metal-on-metal hip arthroplasty (MOMHA) vary widely and can involve massive soft tissue and bone disruption. As a result, planning of theater time and resources is difficult, surgery is challenging, and outcomes are often poor. We describe our experience with...
journal_title:Acta orthopaedica
pub_type: 杂志文章
doi:10.3109/17453674.2013.797313
更新日期:2013-06-01 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 AND PURPOSE:Substantial bone loss in revision total knee arthroplasty (TKA) is a challenging problem. We studied whether impaction bone grafting provides long-term restoration of bone stock in the treatment of major bone defects in revision surgery of rotational and hinged knee arthroplasties (LINK Endo-Mode...
journal_title:Acta orthopaedica
pub_type: 杂志文章
doi:10.3109/17453674.2013.814012
更新日期:2013-08-01 00:00:00
abstract:BACKGROUND AND PURPOSE:Recent literature suggests that the incidence and treatment modalities of distal radius fractures have been changing over the past 2 decades in the developed world. We examined the epidemiology of adult distal radius fractures in Iceland in 2004 and compared it with an Icelandic study from 1985 a...
journal_title:Acta orthopaedica
pub_type: 杂志文章
doi:10.3109/17453674.2011.606074
更新日期:2011-08-01 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 AND PURPOSE:The first generations of total ankle replacements (TARs) showed a high rate of early failure. In the last decades, much progress has been made in the development of TARs, with the newer generation showing better results. We evaluated TARs implanted with rheumatoid arthritis (RA) or juvenile infla...
journal_title:Acta orthopaedica
pub_type: 杂志文章
doi:10.3109/17453670903153568
更新日期:2009-08-01 00:00:00
abstract:BACKGROUND AND PURPOSE:Hip resurfacing arthroplasty is being used more and more frequently. The small ratio in size between the resurfaced femoral head and the relatively thick femoral neck raises the question of whether the range of motion is sufficient, particularly with regard to the high mobility required by younge...
journal_title:Acta orthopaedica
pub_type: 杂志文章
doi:10.1080/17453670810016803
更新日期:2008-12-01 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 AND PURPOSE:(18)F-FDG PET is a widely used tool for molecular imaging of oncological, cardiovascular, and neurological disorders. We evaluated (18)F-FDG microPET as an implant osteomyelitis imaging tool using a Staphylococcus aureus-induced peroperative implant infection in rabbits. METHODS:Intramedullary t...
journal_title:Acta orthopaedica
pub_type: 杂志文章
doi:10.3109/17453674.2014.900894
更新日期:2014-06-01 00:00:00
abstract::Background and purpose - A 2-stage revision is the most common treatment for late deep prosthesis-related infections and in all cases of septic loosening. However, there is no consensus about the optimal interval between the 2 stages. Patients and methods - We retrospectively studied 120 deep infections of total hip (...
journal_title:Acta orthopaedica
pub_type: 杂志文章
doi:10.3109/17453674.2016.1142305
更新日期:2016-08-01 00:00:00
abstract:BACKGROUND AND PURPOSE:We previously evaluated a new uncemented femoral stem designed for elderly patients with a femoral neck fracture and found stable implant fixation and good clinical results up to 2 years postoperatively, despite substantial periprosthetic bone mineral loss. We now present the medium-term follow-u...
journal_title:Acta orthopaedica
pub_type: 杂志文章
doi:10.3109/17453674.2014.931195
更新日期:2014-08-01 00:00:00
abstract::Matrix metalloproteinases (MMPs) and related enzymes (ADAMs, ADAMTS) and their inhibitors control matrix turnover and function. Recent advances in our understanding of musculoskeletal conditions such as tendinopathy, arthritis, Dupuytren's disease, degenerative disc disease, and bone and soft tissue healing suggest th...
journal_title:Acta orthopaedica
pub_type: 杂志文章,评审
doi:10.3109/17453670903448257
更新日期:2009-12-01 00:00:00
abstract::Background and purpose - There is a lack of information on any associations between the functional outcome and age and diagnosis in patients who have undergone shoulder arthroplasty. We therefore evaluated the functional outcome in "young" and "old" patients treated with either hemiarthroplasty (HA) or total shoulder ...
journal_title:Acta orthopaedica
pub_type: 杂志文章
doi:10.1080/17453674.2017.1280656
更新日期:2017-06-01 00:00:00
abstract:BACKGROUND AND PURPOSE:There are limited population-based data on utilization, outcomes, and trends in total knee arthroplasty (TKA). The purpose of this study was to examine TKA utilization and short-term outcomes in a pre-paid health maintenance organization (HMO), and to determine whether rates and revision burden c...
journal_title:Acta orthopaedica
pub_type: 杂志文章
doi:10.1080/17453670810016902
更新日期:2008-12-01 00:00:00
abstract::Background and purpose - Patients having a total knee arthroplasty (TKA) after a previous high tibial osteotomy (HTO) constitute a minor group among those undergoing primary TKA for knee osteoarthritis (OA). There have been few reports on whether such patients differ pre- and postoperatively from those who undergo TKA...
journal_title:Acta orthopaedica
pub_type: 杂志文章
doi:10.1080/17453674.2016.1195663
更新日期:2016-08-01 00:00:00
abstract:BACKGROUND:No data exist regarding mortality rate in young patients with a first-time anterior shoulder dislocation. A cohort of 255 patients aged 12-40 years had a primary anterior shoulder dislocation during the years 1978 and 1979. After 10 years, 9 of the patients had died--which is a high figure for this cohort of...
journal_title:Acta orthopaedica
pub_type: 杂志文章
doi:10.1080/17453670710014617
更新日期:2007-12-01 00:00:00
abstract:BACKGROUND AND PURPOSE:There is increasing awareness that non-steroidal anti-inflammatory drugs (NSAIDs), and especially the cyclooxygenase-2 (COX-2) selective ones, may retard bone healing. We have used NSAIDs (indomethacin for at least 7 days) to prevent heterotopic ossification after acetabular reconstructions using...
journal_title:Acta orthopaedica
pub_type: 杂志文章
doi:10.1080/17453670710015562
更新日期:2008-08-01 00:00:00
abstract::Background and purpose - The uncemented Symax hip stem has shown early proximal ingrowth as result of the BONIT-hydroxyapatite (HA) coating and the distal DOTIZE surface treatment. We evaluated 2-year postoperative radiostereometric analysis (RSA) migration of the Symax hip stem in THA patients. We also investigated t...
journal_title:Acta orthopaedica
pub_type: 杂志文章,随机对照试验
doi:10.1080/17453674.2019.1709956
更新日期:2020-04-01 00:00:00
abstract:BACKGROUND:Degree of satisfaction with a knee arthroplasty is said to be correlated to reduced pain and better function. During a validation of the Swedish Knee Arthroplasty Register in 1997, previously operated patients were asked how satisfied they were with their knee. A subgroup of "satisfied" patients was identifi...
journal_title:Acta orthopaedica
pub_type: 杂志文章
doi:10.1080/17453670510045372
更新日期:2005-12-01 00:00:00
abstract::Background and purpose - Although the results of primary total hip replacements (THRs) are generally excellent, sometimes serious complications arise. Some of these severe complications are considered to be patient injuries. We analyzed primary THR-related patient injuries in a nationwide setting. Patients and methods...
journal_title:Acta orthopaedica
pub_type: 评论,杂志文章
doi:10.3109/17453674.2015.1135662
更新日期:2016-06-01 00:00:00
abstract::Background and purpose - Femoral neck fractures are commonly treated with cemented or uncemented hemiarthroplasties (HA). We evaluated differences in mortality and revision rates in this fragile patient group.Patients and methods - From January 1, 2007 until December 31, 2016, 22,356 HA procedures from the Dutch Arthr...
journal_title:Acta orthopaedica
pub_type: 杂志文章
doi:10.1080/17453674.2020.1752522
更新日期:2020-08-01 00:00:00
abstract::Background and purpose - Several surgical approaches are used in primary total hip arthroplasty (THA). In this randomized controlled trial we compared gait, risk of fall, self-reported and clinical measurements between subjects after direct superior approach (DSA) versus posterolateral approach (PL) for THA. Patients ...
journal_title:Acta orthopaedica
pub_type: 杂志文章
doi:10.1080/17453674.2020.1865633
更新日期:2021-01-07 00:00:00
abstract:BACKGROUND AND PURPOSE:Loss of bone stock remains a challenge in revision hip surgery. Grafting with allograft is well established, but there are problems with availability, cost, infection, antigenicity, reproducibility, and stability of the created construct. BoneSave is a biphasic porous ceramic consisting of sinter...
journal_title:Acta orthopaedica
pub_type: 杂志文章
doi:10.3109/17453674.2013.824801
更新日期:2013-08-01 00:00:00
abstract:BACKGROUND AND PURPOSE:No prospective surveillance systems have been available for monitoring the outcome of cruciate ligament surgery in Scandinavia (Denmark, Norway, and Sweden). In the present paper we describe the Scandinavian ACL registries including their main function, similarities, and preliminary baseline resu...
journal_title:Acta orthopaedica
pub_type: 杂志文章
doi:10.3109/17453670903350107
更新日期:2009-10-01 00:00:00
abstract::Background and purpose-Nonunion is common in femoral fractures. Previous studies suggested that the systemic immune response after trauma can interfere with fracture healing. Therefore, we investigated whether there is a relation between peripheral blood cell counts and healing of femur fractures. Patients and methods...
journal_title:Acta orthopaedica
pub_type: 杂志文章
doi:10.1080/17453674.2018.1501974
更新日期:2018-10-01 00:00:00
abstract:BACKGROUND AND PURPOSE:The Norwegian Cruciate Ligament Register (NCLR) was founded in 2004. The purpose of the NCLR is to provide representative and reliable data for future research. In this study we evaluated the development of the registration rate in the NCLR. METHODS:The Norwegian Patient Register (NPR) and the e...
journal_title:Acta orthopaedica
pub_type: 杂志文章
doi:10.3109/17453674.2012.678800
更新日期:2012-04-01 00:00:00
abstract::Background and purpose - Early postoperative mortality is relatively high after total hip arthroplasty (THA) that has been performed due to femoral neck fracture. However, this has rarely been investigated after adjustment for medical comorbidity and comparison with the mortality in an age-matched population. We there...
journal_title:Acta orthopaedica
pub_type: 杂志文章,多中心研究
doi:10.1080/17453674.2016.1234869
更新日期:2016-12-01 00:00:00