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Orthopaedic Proceedings
Vol. 100-B, Issue SUPP_12 | Pages 41 - 41
1 Oct 2018
Robertsson O Sundberg M W-Dahl A Lidgren L
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Background

The modern modular implants allow surgeons to combine different combinations of components within the same brand of which some may have completely different design.

During 1999–2012 the same cemented femur component was used together with a cemented stemmed tibia baseplate and also against a cemented pegged tibia baseplate. We decided to compare the revision rate of total knee arthroplasties (TKAs) using these two tibia baseplates.

Methods

This is a register study. During 1999–2012, 32,429 cemented, CR TKA's of a specific brand were reported to the Swedish Knee Arthroplasty Register (SKAR). The part numbers for the femur, tibia and insert (in modular implants) were available in 99.2% of cases. The most common combination used the cemented CR femur against a cemented stemmed baseplate in 50.3% of cases while the same CR femur was used against a cemented pegged baseplate in 8.3% of cases, mainly at two hospitals. In order to make the material more comparable, only patients having osteoarthritis (OA) were included and only TKAs using two types of regular constraint inserts and in which the patella had been left un-resurfaced. Chi-Square test was used to investigate gender distribution in the groups and t-test for the mean age at surgery. Kaplan Meier analysis and the log-rank test were used to evaluate the risk of revision until the end of 2016. A p-value <0.05 was considered statistically significant.


The Bone & Joint Journal
Vol. 96-B, Issue 9 | Pages 1222 - 1226
1 Sep 2014
W-Dahl A Sundberg M Lidgren L Ranstam J Robertsson O

We identified a group of patients from the Swedish Arthroplasty Register who reported no relief of pain or worse pain one year after a total knee replacement (TKR). A total of two different patient-reported pain scores were used during this process. We then evaluated how the instruments used to measure pain affected the number of patients who reported no relief of pain or worse pain, and the relative effect of potential risk factors.

Between 2008 and 2010, 2883 TKRs were performed for osteoarthritis in two Swedish arthroplasty units. After applying exclusion criteria, 2123 primary TKRs (2123 patients) were included in the study. The Knee injury and Osteoarthritis Outcome Score (KOOS) and a Visual Analogue Scale (VAS) for knee pain were used to assess patients pre-operatively and one year post-operatively.

Only 50 of the 220 patients (23%) who reported no pain relief on either the KOOS pain subscale or the VAS for knee pain did so with both of these instruments. Patients who reported no pain relief on either measure tended to have less pain pre-operatively but a higher degree of anxiety. Charnley category C was a predictor for not gaining pain relief as measured on a VAS for knee pain.

The number of patients who are not relieved of pain after a TKR differs considerably depending on the instrument used to measure pain.

Cite this article: Bone Joint J 2014;96-B:1222–6.


Bone & Joint Research
Vol. 3, Issue 7 | Pages 217 - 222
1 Jul 2014
Robertsson O Ranstam J Sundberg M W-Dahl A Lidgren L

We are entering a new era with governmental bodies taking an increasingly guiding role, gaining control of registries, demanding direct access with release of open public information for quality comparisons between hospitals. This review is written by physicians and scientists who have worked with the Swedish Knee Arthroplasty Register (SKAR) periodically since it began. It reviews the history of the register and describes the methods used and lessons learned.

Cite this article: Bone Joint Res 2014;3:217–22.