March 2022

Dear NOF members and others interested in Acta Orthopaedica,

This March Newsletter includes information on the forthcoming NOF Congress, how to join our mailing list,  5 selected article highlights, and a clickable list of the 14 latest publications.

Best regards,

Anders Rydholm

Editor-in-chief

 

Nordic Orthopaedic Federation (NOF) Congress

 

The NOF 2022 Congress will be held on 11-13 May 2022 in Vilnius; Lithuania. Click on the button below for more information regarding registration.  

 
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Selected Highlights

A model-based radiostereometric analysis (RSA) randomized control trial evaluating the stability of the cementless Taperloc hip stem: the TapHip study2-year follow-up RSA and PROMs results

Ruben Y Kok, Lennard A Koster, Bart L Kaptein, Marta Fiocco, Stefan B Keizer

Acta Orthop 2022; 212-221.

Even minor design changes can have detrimental effects on previously well-functioning implants. This 4-armed RCT from the Netherlands investigates whether modifications to the commonly used Taperloc stem affect its initial stability. Using model-based RSA, the authors find initial subsidence of all stems that is followed by stabilization after 2 years. Slightly higher but statistically non-significant subsidence of the distally reduced designs with narrower stems is observed. Thus, the introduced design changes to the Taperloc stem have seemingly not affected this implants’ stability.

Nils Hailer

 

Worse patient-reported outcomes and higher risk of reoperation and adverse events after total hip replacement in patients with opioid use in the year before surgery: a Swedish register-based study on 80,483 patients

Johan Simonsson, Erik Bülow, Karin Svensson Malchau, Fredrik Nyberg, Urban Berg, Ola Rolfson

Acta Orthop 2022; 93: 190-197.

It has been well documented that patients with higher use of opioids in the preoperative period are at greater risk of complications and early reoperation. They also have a higher rate of residual pain after surgery. Nevertheless, 18% of 80,483 patients from the Swedish Hip Arthroplasty Register operated on in 2008–2016 with total hip replacement due to osteoarthritis had ≥ 4 opioid prescriptions filled in the year before surgery, and this was associated with a higher risk of revision, adverse events, and worse patient-reported outcomes. With recent guidelines and reviews indicating a very limited effect of opioids on pain and function in chronic pain, treatment of pain with opioids should be avoided in osteoarthritis patients. Assessment of opioid use should be included in the risk stratification of the individual patient eligible for total hip replacement, just as smoking, obesity, or other comorbidities are.

Bart Swierstra

 

Repeated metal ion measurements and long-term outcome of Durom/MMC total hip arthroplasty

Sakari Pietiläinen, Erno Smedberg, Inari Laaksonen, Mikko S Venäläinen, Petteri Lankinen, Keijo T Mäkelä

Acta Orthop 2022; 93: 241-248.

The EU Commission has decided, after receiving guidance from the European Chemicals Agency (ECHA) in October 2021, to raise the concern level for Cobalt contained in medical devices. The concerns have arisen mainly in patients with metal-on-metal bearing joint replacements. The presence of cobalt and other metals, such as chromium, in orthopaedic implants generates conflicting evidence related to potentially hazardous effects in patients.

In this study, the authors studied 249 patients with Durom and MMC cups with 9-12 years follow up time. Whole Blood (WB) Co and Cr ion levels were measured over time. The 10-year survival of Durom THA was 82%, and that of MMC THA 89% for any revision reason as endpoint. WB Cr levels decreased over time, and Co levels remained unchanged at long-term follow-up. Despite this the authors recommend continuing the follow-up of these devices which is also in line with ECHAS increased level of concern.

Li Felländer-Tsai

 

Vitamin E infused highly cross-linked cemented cups in total hip arthroplasty show good wear pattern and stabilize satisfactorily: a randomized, controlled RSA trial with 5-year follow-up

Halldor Bergvinsson, Vasilis Zampelis, Martin Sundberg, Jon Tjörnstrand, Gunnar Flivik

Acta Orthop 2022; 93: 249-255.

Vitamin E infused highly cross-linked polyethylene (VEPE) has been introduced in order to enhance oxidative resistance in highly cross-linked polyethylene cups in total hip arthroplasty. Bergvinsson et al. compared wear and fixation of cemented VEPE-cups and ultra-high molecular weight polyethylene-cups with radiostereometric analysis, in a RCT of 48 patients for 5 years. Both cups showed initial creep during the 1st 3 months; thereafter the wear gradually continued but was statistically significantly less for the VEPE cups. There was no difference in migration of the cups, nor in clinical results. The importance of this study is that earlier concerns about the stability of VEPE-cups could not been confirmed. The question if VEPE is also superior to highly cross-linked polyethylene without vitamin E has not been addressed in this study.

Bart Swierstra

 

Continuous periprosthetic bone loss but preserved stability for a collum femoris-preserving stem: follow-up of a prospective cohort study of 21 patients with dualenergy X-ray absorptiometry and radiostereometric analysis with minimum 8 years of follow-up

Andreas Nyström, Demostenis Kiritopoulos, Hans Mallmin, Stergios Lazarinis

Acta Orthop 2022; 93: 206-211.

Short femoral hips stems have been introduced to prevent proximal femoral bone loss which could increase the risk of aseptic implant loosening, periprosthetic fractures, or both. Because different stem designs within the group of short or ultra-short stems have resulted in different patterns of bone remodeling and because the long-term clinical implications of

periprosthetic BMD loss remain unclear, further studies are necessary to evaluate these issues. Nyström et al. examined prospectively periprosthetic bone mineral density by dual-energy X-ray absorptiometry and implant stability by radiostereometric analysis in 21 CFP stems. They found stable fixation but continuous bone loss up to 8 years postoperatively. It is reassuring that this new stem design did not cause early loosening but at the same time proximal periprosthetic bone loss could not be prevented by this stem.

Bart Swierstra

 

Latest publications

Clinical observational study
Socioeconomic status and use of analgesic drugs before and after primary hip arthroplasty: a population-based cohort study of 103,209 patients during 1996–2018
André N Klenø, Martin B Stisen, Nina M Edwards, Inger Mechlenburg, Alma B Pedersen

Acta Orthop 2022; 93: 171-178.

Clinical observational study
Risk of total knee replacement after proximal tibia fracture: a register-based study of 7,701 patients
Valtteri S Tapper, Konsta J Pamilo, Jaason J Haapakoski, Alar Toom, Juha Paloneva

Acta Orthop 2022; 93: 179-184.

National/international register study
Worse patient-reported outcomes and higher risk of reoperation and adverse events after total hip replacement in patients with opioid use in the year before surgery: a Swedish register-based study on 80,483 patients
Johan Simonsson, Erik Bülow, Karin Svensson Malchau, Fredrik Nyberg, Urban Berg, Ola Rolfson

Acta Orthop 2022; 93: 190-197.

Randomized clinical trial
A model-based radiostereometric analysis (RSA) randomized control trial evaluating the stability of the cementless Taperloc hip stem: the TapHip study 2-year follow-up RSA and PROMs results
Ruben Y Kok, Lennard A Koster, Bart L Kaptein, Marta Fiocco, Stefan B Keizer

Acta Orthop 2022; 93: 212-221.

Non-randomized clinical study
A comparison of 3 different methods for assessment of skeletal age when treating leg-length discrepancies: an inter- and intra-observer study
Anne Berg Breen, Harald Steen, Are Pripp, Ragnhild Gunderson, Hilde Kristine Sandberg Mentzoni, Else Merckoll, Wajeeha Zaidi, Mikael Lambert, Ivan Hvid, Joachim Horn

Acta Orthop 2022; 93: 222-228.

National/international register study
Surveillance of atypical femoral fractures in a nationwide fracture register
Hans Peter Bögl, Georg Zdolsek, Lukas Barnisin, Michael Möller, Jörg Schilcher

Acta Orthop 2022; 93: 229-233.

Non-randomized clinical study
Increased failure rates after the introduction of the TFNA proximal femoral nail for trochanteric fractures: implant related or learning curve effect?
Peter P Schmitz, Gerjon Hannink, Joey Reijmer, Matthijs P Somford, Job L C van Susante

Acta Orthop 2022; 93: 234-240.

Non-randomized clinical study
Repeated metal ion measurements and long-term outcome of Durom/MMC total hip arthroplasty
Sakari Pietiläinen, Erno Smedberg, Inari Laaksonen, Mikko S Venäläinen, Petteri Lankinen, Keijo T Mäkelä

Acta Orthop 2022; 93: 241-248.

Randomized clinical trial
Vitamin E infused highly cross-linked cemented cups in total hip arthroplasty show good wear pattern and stabilize satisfactorily: a randomized, controlled RSA trial with 5-year follow-up
Halldor Bergvinsson, Vasilis Zampelis, Martin Sundberg, Jon Tjörnstrand, Gunnar Flivik

Acta Orthop 2022; 93: 249-255.

Study protocol, Registered report
Study protocol: The SunBurst trial—a register-based, randomized controlled trial on thoracolumbar burst fractures
Simon Blixt, Sebastian Mukka, Peter Försth, Olof Westin, Paul Gerdhem, on behalf of the SunBurst study group

Acta Orthop 2022; 93: 256-263.

Randomized clinical trial
Late stabilization after initial migration in patients undergoing cemented total knee arthroplasty: a 5-year followup of 2 randomized controlled trials using radiostereometric analysis
Shaho Hasan, Bart L Kaptein, Perla J Marang-van de Mheen, Koen T van Hamersveld, Rob G H H Nelissen, Sören Toksvig-Larsen

Acta Orthop 2022; 93: 271-276.

Non-randomized clinical study
CT-based micromotion analysis method can assess early implant migration and development of radiolucent lines in cemented glenoid components: a clinical feasibility study
Cyrus Brodén, Peter Reilly, Monica Khanna, Ravi Popat, Henrik Olivecrona, Dylan Griffiths, Olof Sköldenberg, Roger Emery

Acta Orthop 2022; 93: 277-283.

 
Volume 93
 
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