Catastrophic failure of an uncemented acetabular component due to high wear and osteolysisAn analysis of 154 Omnifit prostheses with mean 6-year follow-up

Schewelov, Thord von; Sanzén, Lennart; Önsten, Ingemar; Carlsson, Åke

doi:10.1080/00016470410001213

Cited by 76 publications

(77 citation statements)

References 22 publications

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“…We used a population-based design and registries that have been proven valuable for quality development and research (Pedersen et al 2004, 2012). We are, however, aware of several limitations in our study.…”

Section: Discussionmentioning

confidence: 99%

Risk of re-admission, reoperation, and mortality within 90 days of total hip and knee arthroplasty in fast-track departments in Denmark from 2005 to 2011

2014

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Purpose To compare the risks of re-admission, reoperation, and mortality within 90 days of surgery in orthopedic departments with well-documented fast-track arthroplasty programs with those in all other orthopedic departments in Denmark from 2005 to 2011.Methods We used the Danish hip and knee arthroplasty registers to identify patients with primary total hip arthroplasty or total knee arthroplasty. Information about re-admission, reoperation, and mortality within 90 days of surgery was obtained from administrative databases. The fast-track cohort consisted of 6 departments. The national comparison cohort consisted of all other orthopedic departments. Regression methods were used to calculate relative risk (RR) of adverse events, adjusting for age, sex, type of fixation, and comorbidity. Cohorts were divided into 3 time periods: 2005–2007, 2008–2009, and 2010–2011.Results 79,098 arthroplasties were included: 17,284 in the fast-track cohort and 61,814 in the national cohort. Median length of stay (LOS) was less for the fast-track cohort in all 3 time periods (4, 3, and 3 days as opposed to 6, 4, and 3 days). RR of re-admission due to infection was higher in the fast-track cohort in 2005–2007 (1.3, 95% CI: 1.1–1.6) than in the national cohort in the same time period. This was mainly due to urinary tract infections. RR of re-admission due to a thromboembolic event was lower in the fast-track cohort in 2010–2011 (0.7, CI: 0.6–0.9) than in the national cohort in the same time period. No differences were seen in the risk of reoperation and mortality between the 2 cohorts during any time period.Interpretation The general reduction in LOS indicates that fast-track arthroplasty programs have been widely implemented in Denmark. At the same time, it appears that dedicated fast-track departments have been able to optimize the fast-track program further without any rise in re-admission, reoperation, and mortality rates.

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Section: Discussionmentioning

confidence: 99%

Risk of re-admission, reoperation, and mortality within 90 days of total hip and knee arthroplasty in fast-track departments in Denmark from 2005 to 2011

2014

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“…The cup/liner incongruity of the two-piece acetabular designs seems to be a common denominator in most brands (Barrack et al 1997, Malchau et al 1997, Puolakka et al 2001a, Young et al 2002, Blacha 2004, von Schewelov et al 2004). This problem is accentuated in our study because of the large proportion of Biomet cups.…”

Section: Discussionmentioning

confidence: 99%

Total hip arthroplasty for rheumatoid arthritis in younger patients: 2,557 replacements in the Finnish Arthroplasty Register followed for 0–24 years

et al. 2006

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Background The results of total hip arthroplasty (THA) in young patients with rheumatoid arthritis (RA) have been reported in only a few studies. On a nationwide level, the outcome of THA in these patients is unknown. We evaluated the population-based survival of THA in patients under 55 years of age with RA and factors affecting the survival.Patients Between 1980 and 2003, 2,557 primary THAs performed for RA in patients less than 55 years of age were reported to the Finnish Arthroplasty Register.Results Proximally circumferentially porous-coated uncemented stems had a 15-year survival rate of 89% (95% CI 83-94) with aseptic loosening as endpoint. The risk of stem revision due to aseptic loosening was higher with cemented stems than with proximally porouscoated uncemented stems implanted during the same period (RR 2.4; p < 0.001). In contrast, Cox regression analysis showed that the risk of cup revision was significantly higher for all uncemented cup concepts than for all-polyethylene cemented cups with any cup revision as endpoint. There were no significant differences in survival between the THR concepts.Interpretations Uncemented proximally circumferentially porous-coated stems and cemented all-polyethylene cups are currently the implants of choice for young patients with RA.

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“…20 Accordingly, we anticipated increased NTx values as a response to the observed osteolysis, but were unable to obtain urine samples before the index operation to establish baseline metabolism. Thus, the magnitude of the increase in the individual patient is not known in our material.…”

Section: Discussionmentioning

confidence: 99%

Cross-linked N-telopeptide of type I collagen (NTx) in urine as a predictor of periprosthetic osteolysis

2006

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Periprosthetic osteolysis is often nonsymptomatic and hard to visualize by conventional radiography. Cross-linked N-telopeptide of type I collagen (NTx), a marker of osteoclast mediated bone resorption, has been suggested to evaluate local particulate-induced osteolysis in patients operated on with a total hip prosthesis. Urine specimens were sampled after hip joint replacement in 160 patients. NTx was analyzed by a commercially available ELISA kit. Osteolysis was identified in the acetabulum and confirmed at operation. Using analysis of covariance to correct for differences in age, gender, and time after operation, NTx (mean SD) was 36 AE 12 BCE/nM creatinine in patients with osteolysis (n ¼ 33) and 27 AE 13 BCE/nM creatinine in patients without osteolysis (n ¼ 127) (p ¼ 0.003). Eighteen hips of 38 (47%), demonstrating an annual wear of more than 0.2 mm and an NTx value above 29 BCE/nM creatinine, had been revised due to osteolysis. The osteolysis prevalence in this group was increased 10 times (CI 4-23, p < 0.05). Indeed, NTx release and annual wear were both associated with increased prevalence of osteolysis, however, independently of each other. NTx seems a feasible marker of periprosthetic osteolysis. A preoperative baseline NTx level is likely needed for its use as a predictor of periprosthetic osteolysis in individual cases. ß

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Catastrophic failure of an uncemented acetabular component due to high wear and osteolysisAn analysis of 154 Omnifit prostheses with mean 6-year follow-up

Cited by 76 publications

References 22 publications

Risk of re-admission, reoperation, and mortality within 90 days of total hip and knee arthroplasty in fast-track departments in Denmark from 2005 to 2011

Risk of re-admission, reoperation, and mortality within 90 days of total hip and knee arthroplasty in fast-track departments in Denmark from 2005 to 2011

Total hip arthroplasty for rheumatoid arthritis in younger patients: 2,557 replacements in the Finnish Arthroplasty Register followed for 0–24 years

Cross-linked N-telopeptide of type I collagen (NTx) in urine as a predictor of periprosthetic osteolysis

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