Although patients improved over the 2-year follow-up regardless of initial treatment, those undergoing decompressive surgery reported greater improvement regarding leg pain, back pain, and overall disability. The relative benefit of initial surgical treatment diminished over time, but outcomes of surgery remained favorable at 2 years. Longer follow-up is needed to determine if these differences persist.

Background Balancing the relative advantages and disadvantages of unicompartmental knee arthroplasties (UKAs) against those for TKAs can be challenging. Survivorship is one important end point; arthroplasty registers repeatedly report inferior midterm survival rates, but longer-term data are sparse. Comparing survival directly by using arthroplasty register survival reports also may be inadequate because of differences in indications, implant designs, and patient demographics in patients having UKAs and TKAs. Questions/purposes The aims of this study were to assess the survivorship of UKA in the context of one large, northern European registry, and to compare the rates of survivorship with those of cemented TKAs performed for primary knee osteoarthritis during the same 27-year period. Methods From the Finnish Arthroplasty Register, we obtained the data for 4713 patients undergoing UKAs for primary osteoarthritis (mean age, 63.5 years; minimum followup, 0 years; mean, 6.0 years; range, 0-24 years) who had surgical revision between 1985 and 2011. From this cohort, we calculated the Kaplan-Meier survivorship for revision performed for any reason and compared it with the survivorship of 83,511 patients (mean age, 69.5 years; minimum followup 0 years; mean, 6.4 years; range, 0-27 years) with TKAs treated for primary osteoarthritis during the same period. Data were adjusted for age and sex in a comparative analysis.

Previous studies from single centres or single-surgeon series report good early and midterm results for high tibial osteotomy (HTO) in the treatment of osteoarthritis of the knee. However, the survivorship of HTO at a national level is unknown. This registry-based study included 3195 high HTOs performed between 1987 and 2008. Kaplan-Meier analysis revealed an overall survivorship of 89% (95% confidence interval (CI) 88 to 90) at five years and 73% (95% CI 72 to 75) at ten years, when conversion to total knee replacement was taken as the endpoint. Females and patients aged > 50 years had worse survivorship than males or patients aged ≤ 50 years (hazard ratio (HR) 1.26 (95% CI 1.11 to 1.43) and HR 1.41 (95% CI 1.23 to 1.64), respectively). The survivorship of HTOs performed between 1998 to 2008 was worse than for those performed between 1987 and 1997.

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In 24 patients with total hip replacement using a short anatomic femoral stem, bone mineral density (BMD) was measured after a 7-year follow-up using dual-energy X-ray absorptiometry. The contralateral side was used as a control. The BMD on the side of the prosthesis was lower by a mean of 7% than that on the control side. The difference was greatest in the area of the calcar and laterally and proximally around the stem. BMD at the metaphyseal and diaphyseal areas were the same as on the contralateral side. The bone loss around the proximal aspect of the stem may be related to the proximal porous coating. It is concluded that stress shielding can be diminished by appropriate design of the femoral component.Résumé Chez 24 patients avec arthroplastie de la hanche utilisant une tige fémorale anatomique courte on a mesuré les densités minérales osseuses (DMO) par absorptiométrie biénergétique aux rayons X après un suivi de 7 ans. Le côté controlatéral a été utilisé comme té-moin. Du côté de la prothèse, la DMO était en moyenne 7% plus faible que du côté témoin. La plus forte diffé-rence fut enregistrée dans la région du calcar et latérale-ment autour de la partie proximale de la tige. Les DMO des zones métaphysaires et diaphysaires n'étaient pas différentes de celles enregistrées du côté contralateral. La perte osseuse autour de la partie proximale de la tige est peut-être due à l'enrobage poreux proximal. La conclusion est que le report de contrainte peut être réduit par la conception de la tige prothétique.

Tibiotalocalcaneal arthrodesis with a compressive retrograde intramedullary nail is an effective and safe procedure for patients with severe malalignment or arthrosis of the hindfoot. It is essentially a salvage procedure, and most patients benefit from it, but excellent results are rare.

Previous studies have described technical difficulties during the TKA procedure after HTO, but they have found no adverse effects on the outcome. Our study supports previous research, and despite the slightly higher revision rate, TKA after HTO provides satisfactory results when compared to routine primary TKAs.