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Orthopaedic Proceedings
Vol. 86-B, Issue SUPP_III | Pages 305 - 305
1 Mar 2004
Torkki M Malmivaara A Seitsalo S Hoikka V Laippala P Paavolainen P
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Aims: Hallux valgus operations cannot always be carried out immediately due to long waiting lists. Effect of waiting for hallux valgus surgery has not been under investigation in a randomized controlled study. Methods: 209 consecutive patients (mean age 48 years, 93% female) with a painful hallux valgus were randomized in three groups: immediate operation or one year waiting time with or without foot orthoses. The follow-up period was 2 years. Main outcome measure was pain intensity during walking (VAS 0 to 100). Results: During the þrst year 64/71, 0/69 and 4/69 patients were operated in surgery, orthosis and no-orthosis groups, respectively, and during the two-year follow-up 66, 43 and 48, respectively. At one-year follow-up the pain was least intensive in surgery group. At two year follow-up the pain intensity was similar in all groups. The satisfaction with treatment was the best in the surgery group and orthosis group as was the fact also with the cosmetic disturbances. The total costs of care were similar in all groups. Conclusion: Immediate operation is superior to delayed operation or foot orthoses, as the beneþt from surgery is obtained already during the þrst follow-up year. If this, however, because of limited operative capacity is not possible, one year waiting, with or without orthois, does not jeopardize the results.


The Journal of Bone & Joint Surgery British Volume
Vol. 77-B, Issue 3 | Pages 369 - 373
1 May 1995
Savilahti S Myllyneva I Lindholm T Pajamaki K Nevalainen J Laippala P

We report the clinical outcome and survival of 100 total hip arthroplasties with Link RS cementless hip prostheses after a mean of 63 months (51 to 93). The average preoperative Merle d'Aubigne hip score was 9.4 points and the average score at the latest follow-up was 15.3 points. Thirteen prostheses have been revised and seven await revision. Survivorship analysis based on intention to revise showed only 68% survival at seven years (95% CI 53% to 81%). The survivals of femoral and acetabular components verified to be loose at surgery were 78% and 89% respectively at seven years. A number of other patients have pain and it seems likely that there will be substantial reduction in these survival figures in the future.