Acta orthopaedica
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Both unicondylar arthroplasty (UKA) and total knee arthroplasty (TKA) are commonly used for the treatment of unicompartmental osteoarthritis (OA) of the knee. The long-term survivorship and cost-effectiveness of these two treatments have seldom been compared on a nationwide level, however. We therefore compared the survival of UKA with that of TKA and conducted a cost-benefit analysis comparing UKA with TKA in patients with primary OA. ⋯ At a nationwide level, UKA had significantly poorer long-term survival than TKA. What is more, UKA did not even have a theoretical cost benefit over TKA in our study. Based on these results, we cannot recommend widespread use of UKA in treatment of unicompartmental OA of the knee.
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There is a lack of national epidemiological data on the characteristics of patients with tibial shaft fractures. We therefore analyzed data on Swedish patients with tibial shaft fractures in this nationwide population study based on data from 1998 through 2004. ⋯ This nationwide study of tibial shaft fractures shows a falling off of fracture incidence, a finding that can be used to advantage by healthcare providers.
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The classification and treatment of thoracolumbar injuries remain controversial. The Spine Trauma Study Group (STSG) has developed a classification system that has prognostic significance and helps guide treatment decisions. ⋯ A severity score is used in conjunction with the classification system to help guide treatment decisions. This classification system has been shown to have good inter- and intra-observer reliability.
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Comparative Study
Inferior outcome after intraoperative femoral fracture in total hip arthroplasty: outcome in 519 patients from the Danish Hip Arthroplasty Registry.
Intraoperative femoral fracture is a well known complication of primary total hip arthroplasty (THA). Experimental studies have indicated that intraoperative fractures may affect implant survival. Very few clinical data are available, however. ⋯ Intraoperative fractures increase the relative risk of revision during the first 6 postoperative months. Thus, patients should be informed about the risk of revision after sustaining an intraoperative femoral fracture. Furthermore, initiatives aimed at reducing the risk of revision in the first 6 months following THA should be considered in patients with intraoperative fractures, including immediate change to a larger stem with distal fixation and restricted weight bearing.