 | | 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. |
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| Best regards,
Anders Rydholm
Editor-in-chief |
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| 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. | | | | | | | | Join our mailing list | This monthly newsletter should have been forwarded to you as a NOF member by your national society head (Denmark, Estonia, Finland, Iceland, Lithuania, Norway, Sweden, the Netherlands). This mode of distribution can, however, be slow or unreliable due to outdated contact information. An alternate way to ensure that you receive this newsletter directly as it is published is to join our mailing list by clicking on the link below. | | | | | |
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| | | | | 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 |
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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 |
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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 |
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