The primary objective of this registry-based study was to compare patient-reported outcomes of cementless and cemented medial unicompartmental knee arthroplasty (UKA) during the first postoperative year. The secondary objective was to assess one- and three-year implant survival of both fixation techniques. We analyzed 10,862 cementless and 7,917 cemented UKA cases enrolled in the Dutch Arthroplasty Registry, operated between 2017 and 2021. Pre- to postoperative change in outcomes at six and 12 months’ follow-up were compared using mixed model analyses. Kaplan-Meier and Cox regression models were applied to quantify differences in implant survival. Adjustments were made for patient-specific variables and annual hospital volume.Aims
Methods
Patellofemoral arthroplasty (PFA) has experienced significant
improvements in implant survivorship with second generation designs.
This has renewed interest in PFA as an alternative to total knee
arthroplasty (TKA) for younger active patients with isolated patellofemoral
osteoarthritis (PF OA). We analysed the cost-effectiveness of PFA We used a Markov transition state model to compare cost-effectiveness
between PFA and TKA. Simulated patients were aged 60 (base case)
and 50 years. Lifetime costs (2015 United States dollars), quality-adjusted
life year (QALY) gains and incremental cost-effectiveness ratio
(ICER) were calculated from a healthcare payer perspective. Annual rates
of revision were derived from the National Joint Registry for England,
Wales, Northern Ireland and the Isle of Man. Deterministic and probabilistic
sensitivity analysis was performed for all parameters against a
$50 000/QALY willingness to pay. Aims
Patients and Methods
The recognition of hips at risk of displacement
in children with cerebral palsy (CP) is a difficult problem for
the orthopaedic surgeon. The Gross Motor Function Classification
System (GMFCS) and head–shaft angle (HSA) are prognostic factors
for hip displacement. However, reference values for HSA are lacking.
This study describes and compares the development of HSA in normal
hips and children with CP. We selected 33 children from a retrospective cohort with unilateral
developmental dysplasia of the hip (DDH) (five boys, 28 girls) and
50 children (35 boys, 15 girls) with CP with GMFCS levels II to
V. HSA of normal developing hips was measured at the contralateral
hip of unilateral DDH children (33 hips) and HSA of CP children
was measured in both hips (100 hips). Measurements were taken from
the radiographs of the children at age two, four and seven years.
The normal hip HSA decreased by 2° per year (p <
0.001). In children
with CP with GMFCS levels II and III HSA decreased by 0.6° (p =
0.046) and 0.9° (p = 0.049) per year, respectively. The HSA did
not alter significantly in GMFCS levels IV and V. Between the ages of two and eight years, the HSA decreases in
normal hips and CP children with GMFCS level, II to III but does
not change in GMFCS levels IV to V. As HSA has a prognostic value
for hip displacement, these reference values may help the orthopaedic
surgeon to predict future hip displacement in children with CP. Cite this article:
