Problems in all-cause revision analyses in total joint replacement research?

I had a chance to collaborate with Nordic Arthroplasty Register Association in a study published in the Acta Orthopaedica last year. Study was titled “The effect of fixation type on the survivorship of contemporary total knee arthroplasty in patients younger than 65 years of age: a register-based study of 115,177 knees in the Nordic Arthroplasty […]

It´s all about explained variation in the periprosthetic joint infections

I showed this slide in my clinic meeting presentation which was about periprosthetic joint infections. Infection rates were very high in the early years of modern total joint replacement surgery in 1960s. Today, the risk of deep infection after a total hip or knee replacement surgery is something close to 1%. This major improvement is […]

Implications of binomial distribution in the daily orthopaedic practice

Deep infection is a devastating complication in the orthopaedic surgery. It usually requires a revision surgery and a risk for further complications increases greatly. Functional outcome is usually much worse after deep infection compared to uneventful primary surgery especially if removal of implants is required to eridicate the infection. Deep infection are often systematically recorded […]

Arthroscopy 15 weeks before TKR surgery?

This post could be also titled “Why we dichotomize: Part XXIXCM”, but I´ll focus on the subject matter. Gu et al. investigated how prior knee arthroscopy affects the subsequent total knee replacement surgery. They concluded: This study suggests that an interval of at least 36 weeks should be maintained between the 2 procedures to minimize […]

Mesenchymal stem cells outperforming total knee replacement

Tan et al. published a meta-analysis about mesencymal stem cells in the tretment of osteoarhritis. They reported pooled estimates as follows: The standardized mean differences (SMDs) for the visual analog scale (VAS) for pain at rest and upon exertion were –1.48 (95% CI, –1.85 to –1.11) and –2.25 (95% CI, –2.64 to –1.85), respectively. This […]

A little prediction

A week ago Mortensen et al. published a study protocol investigating medial unicompartmental versus total knee arthroplasty for anteromedial tibio-femoral osteoarthritis. This study setting is very interesting. Both total knee replacement (TKR) and unicompartmental knee replacement (UKR) can be used to treat medial sided knee osteoarthritis. Mortensen et al. nicely sum up both pros and […]