Abstract：
BACKGROUND:High tibial osteotomy (HTO) and unicompartmental arthroplasty (UKA) are reconstructive surgeries advocated for younger patients. In case of failure or progression of osteoarthritis, they can both be converted to a total knee arthroplasty (TKA). QUESTIONS/PURPOSES:We used registry data to answer if the risks of revision for TKAs after previous HTOs and UKAs differ and how these compare with that of de novo TKAs. Furthermore, we wanted to examine the extent of stemmed/revision implants being used for the conversions. METHODS:We identified HTOs performed during 1998 to 2007 with the help of the inpatient and outpatient care registries of the Swedish National Board of Health and Welfare and gathered relevant information from hospital records. The Swedish Knee Arthroplasty Register was then examined to find all de novo TKAs, TKAs performed after HTO, and TKAs performed after UKA through the end of 2012. RESULTS:For 920 TKAs after previous UKA and 356 TKAs after previous closed-wedge HTOs, we found the risk of revision significantly higher than for the 118,229 de novo TKAs (risk ratio, 2.8; confidence interval [CI], 2.2-3.5; p<0.001, and 1.7 CI, 1.1-2.6; p<0.001, respectively), whereas for the 482 open-wedge osteotomies, the difference was not significant (risk ratio, 1.2; CI, 0.8-1.8; p=0.44). Stemmed implants were used in 663 of the 117,566 primary de novo TKAs (0.6%), in 22 of the 809 HTO conversions (4%) and in 136 of the 920 UKA conversions (17%). CONCLUSIONS:TKAs after previous reconstructive surgery carry an increased risk for revision. However, our findings do not mitigate against the use of UKA and HTO in selected cases. LEVEL OF EVIDENCE:Level III, therapeutic study. See the Guidelines for Authors for a complete description of levels of evidence.
journal_name
Clin Orthop Relat Resjournal_title
Clinical orthopaedics and related researchauthors
Robertsson O,W-Dahl Adoi
10.1007/s11999-014-3712-9subject
Has Abstractpub_date
2015-01-01 00:00:00pages
90-3issue
1eissn
0009-921Xissn
1528-1132journal_volume
473pub_type
杂志文章abstract：:A posterior cruciate ligament avulsion fracture (PCLAF) of the knee can be repaired through a large approach. A new technique based on internal fixation under arthroscopic control employed a posterolateral puncture. The fracture was reduced and the osseous fragment transfixed using a new forceps guide. The osseous fra...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：
更新日期：1988-12-01 00:00:00
abstract：:Although compression plate fixation of diaphyseal long bone fractures is accepted treatment, surgical exposure and plate position in relation to the periosteum are controversial. Histologic, roentgenographic, and biomechanical methods were applied to investigate quality and chronology of healing in radial and ulnar fr...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：
更新日期：1983-05-01 00:00:00
abstract：:To understand the mechanism of injury and classify fractures of the talus requires knowledge of the anatomy of the hindfoot, its function and the nature of the traumatic forces. The talus has an irregular shape with articular surfaces for tibia, fibula, calcaneus and navicular. It functions as a complex universal join...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：
更新日期：1976-11-01 00:00:00
abstract：:Osteolysis is defined as the process of progressive destruction of periprosthetic bony tissue, characterized on serial radiographs as progressive radiolucent lines and/or cavitation at the implant-bone or cement-bone interface. Without proper treatment, osteolysis may progress to aseptic loosening and catastrophic fai...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章,评审
doi：
更新日期：2004-10-01 00:00:00
abstract：:A bolt-plate device for fixation of distal thoracic and proximal lumbar vertebral bodies has proved effective in a variety of surgical situations. The instrumentation is designed to obtain the optimum conditions for the healing of cancellous bone, namely, rigid immobilization and, if possible, close apposition of surf...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：
更新日期：1986-02-01 00:00:00
abstract：:Total knee arthroplasty can be performed with acceptably low risk in the elderly patient. The risk for postoperative complications is significantly higher than in younger patients, however. Pain relief is the principle indication for this procedure in elderly patients. ...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：
更新日期：1994-02-01 00:00:00
abstract：:Pseudoallescheria boydii, a fungus often isolated from soil, commonly causes a mycetoma. Successful treatment involves resection of the infected area and appropriate antifungal chemotherapy. In vitro sensitivity of P. boydii to miconazole is usually demonstrated, but resistance to amphotericin B and 5-fluorocytosine i...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：
更新日期：1987-02-01 00:00:00
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journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：
更新日期：1977-10-01 00:00:00
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journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：
更新日期：1997-11-01 00:00:00
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journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章,评审
doi：10.1097/00003086-199810000-00026
更新日期：1998-10-01 00:00:00
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journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：
更新日期：1992-09-01 00:00:00
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journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：10.1007/s11999-008-0567-y
更新日期：2009-07-01 00:00:00
abstract：:A way to prevent polyethylene wear in total hip replacements is to use metal-on-metal bearings. The cup design of these bearings may be a metal inlay in a polyethylene cup. However, these metal inlays are relatively thin and may deform on loading. The purpose of the current study was to determine whether these potenti...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：10.1097/00003086-200211000-00052
更新日期：2002-11-01 00:00:00
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journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：
更新日期：1987-12-01 00:00:00
abstract：BACKGROUND:Patient-specific CT-based instrumentation may reduce implant malpositioning and improve alignment in TKA. However, it is not known whether this innovation is an advance that benefits patients. QUESTIONS/PURPOSES:We evaluated (1) the precision of patient-specific TKA by comparing the incidence of outliers in...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章,随机对照试验
doi：10.1007/s11999-013-3206-1
更新日期：2013-12-01 00:00:00
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journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：10.1007/s11999-013-2790-4
更新日期：2013-05-01 00:00:00
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journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：10.1097/00003086-199703000-00012
更新日期：1997-03-01 00:00:00
abstract：:We present two clinical cases and four museum specimens of a type of lateral clavicle fracture dislocation that has not been detailed in any of the commonly accepted classification systems. With this injury, the major clavicular element is displaced downward and backward into the supraspinatus outlet and may cause sym...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：10.1097/01.blo.0000176555.05105.df
更新日期：2005-10-01 00:00:00
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journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：10.1097/00003086-197503000-00016
更新日期：1975-01-01 00:00:00
abstract：:Radiocarpal fracture-dislocation was associated with fracture of the distal articular surface of the radius in five patients (six extremities). Closed manipulation resulted in satisfactory reduction of both the dorsal dislocation of the carpus on the distal radius and displaced articular fracture fragment(s) in two of...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：
更新日期：1985-07-01 00:00:00
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journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：
更新日期：1977-07-01 00:00:00
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journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：10.1007/s11999-015-4369-8
更新日期：2015-10-01 00:00:00
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journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：
更新日期：1994-08-01 00:00:00
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journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：10.1097/01.blo.0000160819.10767.88
更新日期：2005-07-01 00:00:00
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journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章,评审
doi：
更新日期：1992-08-01 00:00:00
abstract：:Recent technologic advances in bone mineral densitometry have resulted in increasingly precise and accurate methods of estimating bone mineral density. Dual-photon absorptiometry has been made obsolete by the introduction of dual-energy radiography, a development that is likely to result in more widespread use of dens...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章,评审
doi：
更新日期：1991-10-01 00:00:00
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journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：10.1097/00003086-200203000-00036
更新日期：2002-03-01 00:00:00
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journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章,meta分析,评审
doi：10.1007/s11999-016-5002-1
更新日期：2017-01-01 00:00:00
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journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：
更新日期：1987-06-01 00:00:00
abstract：:Tumoral calcinosis is the deposition of calcium crystals and salts in the periarticular soft tissues. It commonly is seen as a complication of renal dialysis or in patients with a hereditary disposition. Occasionally, it is seen as an isolated condition with no known cause. Tumoral calcinosis usually affects adults an...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章,评审
doi：
更新日期：2005-07-01 00:00:00
