ACTA ORTHOPAEDICA（前身为 ACTA ORTHOPAEDICA SCANDINAVICA）提供具有基础研究兴趣的原创文章，以及骨科和相关子学科领域的临床研究。自从该杂志于 1930 年由一群斯堪的纳维亚整形外科医生创立以来，该杂志一直面向国际读者出版。 ACTA ORTHOPAEDICA 归北欧骨科联合会所有，是该联合会的官方出版物。

Acta Orthopaedica, formerly known as Acta Orthopaedica Scandinavica, is a professional journal aimed at an international audience. It publishes original articles related to basic research as well as clinical studies in the field of orthopedics and its related subspecialties. Since its establishment in 1930 by a group of Scandinavian orthopedic surgeons, the journal has served as the official publication of the Nordic Orthopedic Federation, providing a high-quality platform for academic exchange among researchers worldwide.

《Acta Orthopaedica》（前身为《Acta Orthopaedica Scandinavica》）是一份面向国际读者的专业期刊，致力于发表与基础研究相关的原创文章，以及骨科及其相关子学科的临床研究。自1930年由一群斯堪的纳维亚整形外科医生创办以来，该期刊一直是北欧骨科联合会的官方出版物，旨在为全球的研究者提供高质量的学术交流平台。

Acta Orthopaedica

Background and purpose — Enhanced recovery programs have reduced length of stay (LOS) after hip and knee arthroplasty (THA/TKA). Although risk factors disposing to prolonged LOS are well documented, there is limited information on the role of weekday of surgery. This study analyzed the role of weekday of surgery and other potential risk factors for LOS > 2 days. Patients and methods — We included 10,576 unselected consecutive procedures between January 2016 and August 2017 within a multicenter fast-track THA/TKA collaboration with prospective collection of preoperative characteristics. We used multiple regression analysis of potential risk factors for LOS > 2 days followed by construction of a simple risk score from 0 to 15 points based on the calculated odds ratios. Results — Mean LOS was 1.9 (SD 1.8) days, with 80% of patients having surgery from Monday to Wednesday. Of these, 17% (95% CI 16–18) had a LOS > 2 days vs. 19% (CI 17–21) in those operated on Thursday and Friday. Patients were scheduled evenly throughout the week regardless of risk of LOS > 2 days and despite the fact that 38% (CI 35–40) of patients with ≥ 6 points (16% of the total population) had a LOS > 2 days compared with 14% (CI 13–14) in those with < 6 points. In these "high-risk" patients, the fraction with LOS > 2 days increased when having surgery on Thursdays or Fridays (43% CI 38–49) compared with Monday to Wednesday (37% CI 34–39). Interpretation — A detailed preoperative risk assessment may be helpful to plan the weekday of surgery in order to decrease LOS and weekend hospitalization.

Christoffer C Jørgensen

Kirill Gromov

Pelle B Petersen

Henrik Kehlet

Influence of day of surgery and prediction of LOS &gt; 2 days after fast-track hip and knee replacement

快速通道髋膝关节置换术后手术日对住院时间大于2天的影响及预测

Background and purpose Very few studies have focused on patient characteristics that influence length of stay (LOS) in fast-track total hip (THR) and knee arthroplasty (TKR). The aim of this prospective study was to identify patient characteristics associated with LOS and patient satisfaction after total hip and knee replacement surgery.

Henrik Husted

Gitte Holm

Steffen Jacobsen

Predictors of length of stay and patient satisfaction after hip and knee replacement surgery: Fast-track experience in 712 patients

髋膝关节置换术后住院时间和患者满意度的预测因素：712例快速康复经验

Background and purpose — Patient satisfaction is important in fast-track total hip and knee replacement (THR, TKR). We assessed: (1) how satisfied patients were with the treatment; (2) factors related to overall satisfaction; and (3) whether there was a difference between THR and TKR regarding length of stay (LOS) and patient satisfaction.Patients and methods — In this follow-up study, a consecutive series of 445 patients undergoing THR and TKR completed a questionnaire 2 weeks after discharge. LOS and short-term patient satisfaction with the fast-track management were measured. Patient satisfaction was measured using a numerical rating scale (NRS; 0–10).Results — For THR, the median satisfaction score was 9–10 and for TKR it was 8.5–10 in all parameters. Older THR patients had higher overall satisfaction. No association was found between overall satisfaction following THR or TKR and sex comorbidity, or LOS. THR patients had shorter mean LOS than TKR patients, even though the median LOS was 2 days for both groups. THR patients were more satisfied than TKR patients in the first weeks after discharge.Interpretation — Patient satisfaction is high following fast-track THR and TKR, with scores ranging from 8.5 to 10 on the NRS. A qualitative investigation of the first weeks after discharge is required to learn more about how to improve the experience of recovery.

Kirsten Specht

Per Kjaersgaard-Andersen

Niels Wedderkopp

Birthe D Pedersen

High patient satisfaction in 445 patients who underwent fast-track hip or knee replacement

445例接受快速通道髋关节或膝关节置换术患者的高满意度

Background and purpose — Biological patches can be used to augment rotator cuff tendon repair in an attempt to improve healing and reduce rates of re-rupture. However, little is known about the in vivo tissue response to these patches. We assessed native rotator cuff tissue response after surgical repair and augmentation with 2 commercially available extracellular matrix (ECM) patches. Patients and methods — Patients underwent a rotator cuff repair augmented with either GraftJacket (Wright Medical), Permacol (Zimmer Biomet), or no patch (Control), applied using an onlay technique. A sample of supraspinatus tendon was collected intraoperatively and 4 weeks post-surgery, using ultrasound-guided biopsy. Histology and immunohistochemistry were performed on all samples. Results — The Permacol group (n = 3) and GraftJacket group (n = 4) demonstrated some changes in native tendon ECM compared with the control group (n = 3). Significant disruption of the extracellular matrix of the repaired native supraspinatus, underlying both patches, was observed. The patches did not generally increase cellularity, foreign body giant cell count, or vascularity compared to the control group. 1 patient in the Permacol group had an adverse tissue immune response characterized by extensive infiltration of IRF5+, CD68+, and CD206+ cells, suggesting involvement of macrophages with a pro-inflammatory phenotype. No significant differences in protein expression of CD4, CD45, CD68, CD206, BMP7, IRF5, TGFß, and PDPN were observed among the groups. Interpretation — Histological and immunohistochemical analysis of native tendon tissue after patch augmentation in rotator cuff repair raises some concerns about a lack of benefit and potential for harm from these materials.

Mustafa S Rashid

Richard D J Smith

Navraj Nagra

Kim Wheway

Bridget Watkins

Sarah Snelling

Stephanie G Dakin

Andrew J Carr

Rotator cuff repair with biological graft augmentation causes adverse tissue outcomes

生物移植物增强的肩袖修复导致不良组织结果

Background and purpose: The low radiation biplanar X-ray imager (EOS imaging, Paris, France) scans patients in a weight-bearing position, provides calibrated images, and limits radiation, an asset for serial radiostereometric analysis (RSA) studies. RSA in vivo precision values have not been published for this type of imaging system, thus the goal of this study was to assess the precision of RSA in vivo utilizing a low radiation biplanar imager.Patients and methods: At a mean of 5 years post-surgery (range 1.4–7.5 years), 15 total knee arthroplasty (TKA) participants (mean age 67 years at the time of imaging, 12 female, 3 male) with RSA markers implanted during index surgery were scanned twice at the same visit in the EOS imager. Precision of marker-based analysis was calculated by comparing the position of the implant relative to the underlying bone between the 2 examinations.Results: The 95% limit of precision was 0.11, 0.04, and 0.15 mm along the x, y, and z axes, respectively and 0.15°, 0.20°, and 0.14° around the same axes.Conclusion: This precision study has shown an in vivo RSA precision of ≤ 0.15 mm and ≤ 0.20°, well within published uniplanar values for conventional arthroplasty RSA, with the added benefit of weight-bearing imaging, a lower radiation dose, and without the need for a reference object during the scan.

Jennifer K Hurry

Alan J Spurway

Elise K Laende

Saad Rehan

Janie L Astephen Wilson

Michael J Dunbar

Ron El-Hawary

A low-dose biplanar X-ray imager has RSA level precision in total knee arthroplasty

低剂量双平面X射线成像仪在全膝关节置换术中具有RSA级精度

Ville Ponkilainen

Anniina Laurema

Ville M Mattila

Teemu Karjalainen

Acta Orthop

Response to Letter: Regional variation in low-value musculoskeletal surgery: a nationwide study from the Finnish Care Register

对来信的回应：低价值肌肉骨骼手术的区域差异：基于芬兰医疗登记系统的全国性研究

Christopher W Digiovanni

C Niek Van Dijk

Mark Glazebrook

Helka Koivu

Mikko Hautamäki

Anssi Härkönen

Masato Takao

Manfred Thomas

Marko Mykkänen

James W Stone

Alastair Younger

Letter to the Editor: Regional variation in low-value musculoskeletal surgery: a nationwide study from the Finnish Care Register

致编辑的信：低价值肌肉骨骼手术的区域差异：基于芬兰医疗登记系统的全国性研究

Background and purpose: In total knee arthroplasty (TKA), an insert with ball-in-socket (BS) medial conformity (MC) and posterior cruciate ligament (PCL) retention restores kinematics closer to native than an insert with intermediate (I) MC. However, high medial conformity might compromise baseplate stability as indicated by maximum total point motion (MTPM). Using the BS MC insert with PCL retention, we aimed to determine whether (i) the baseplate is stable as indicated by mean MTPM &lt; 0.5 mm, (ii) baseplate stability is not strongly correlated to varus baseplate alignment, and (iii) baseplate stability, clinical outcome scores, and flexion are comparable with that of an I MC insert cohort which has demonstrated high stability, clinical outcome scores, and flexion.Methods: Unrestricted kinematic alignment (unKA) TKA was performed on a cohort of 35 patients using a cemented baseplate. Biplanar radiographs acquired at timepoints up to 12 months were processed with model-based radiostereometric analysis (RSA) software to determine MTPM.Results: At 1 year, mean MTPM of 0.35 mm was significantly below 0.5 mm (P &lt; 0.001). MTPM was not strongly correlated to varus baseplate alignment up to 9° (r = 0.12, 95% confidence interval –0.22 to 0.44). Equivalence analyses revealed that MTPM, Forgotten Joint Score, Oxford Knee Score, and maximum flexion for the sBS MC insert were comparable with the I MC insert.Conclusion: Using the new BS MC insert with PCL retention, the tibial baseplate was stable at the group level at 1 year. Baseplate stability was not strongly related to varus baseplate and limb alignment. Comparable patient-reported outcome scores and maximum flexion/extension at 1 year were shown between the 2 insert designs.

Abigail E Niesen

Pranav A Tirumalai

Stephen M Howell

Maury L Hull

A new tibial insert design with ball-in-socket medial conformity and posterior cruciate ligament retention has low tibial baseplate migration after unrestricted kinematically aligned total knee arthroplasty: a cohort study using radiostereometric analysis

一种新型胫骨垫片设计：球窝式内侧贴合与后交叉韧带保留在无限制运动学对线全膝关节置换术后表现出较低的胫骨基板迁移：一项采用放射立体测量分析的队列研究

Background and purpose: Major lower extremity amputation (MLEA) is associated with complications that may prolong length of hospital stay (LOS) and increase the risk of readmission. We primarily aimed to examine the LOS and risk of readmissions after MLEA in Denmark. Secondarily we investigated the time trends.Methods: Using Danish National Patient Registry data, this observational study analyzed 11,205 first-time MLEAs (35% transtibial amputations, 65% transfemoral amputations) performed between January 1, 2010 and December 31, 2021. Total LOS included pre- and postoperative nights. The first readmission within 30 days and 90 days post-discharge was analyzed.Results: The median total LOS after a transtibial amputation was 19 days (interquartile range [IQR] 11–30), and decreased from 28 days (IQR 17–41) in 2010 to 14 days (IQR 9–23) in 2021. The median total LOS after a transfemoral amputation was 13 days (IQR 8–22) and decreased from 16 days (IQR 9–27) in 2010 to 11 days (IQR 7–18) in 2021. Post-discharge readmission risks within 30 days were 27% (95% confidence interval [CI] 24–28) for transtibial amputations and 23% (CI 22–24) for transfemoral amputations, with corresponding 90-day risks of 40% (CI 39–42) and 35% (CI 34–36), respectively. The 30-day risk of readmission increased in both groups.Conclusion: We observed that MLEA patients’ hospital admissions lasted 2–3 weeks and decreased over the study period. A readmission risk of 23–27% within 30 days and 35–40 % within 90 days post-discharge was observed. Readmissions risk increased for both initial transtibial and transfemoral amputations over the study period.

Anna Trier Heiberg Brix

Katrine Hass Rubin

Tine Nymark

Hagen Schmal

Martin Lindberg-Larsen

Length of hospital stay and readmissions after major lower extremity amputation: a Danish nationwide registry study

大范围下肢截肢术后住院时长与再入院率：一项丹麦全国性登记研究

Background and purpose: Despite evolving management strategies for atypical cartilaginous tumors (ACT)—shifting from radical resection to intralesional curettage and “wait-and-scan” approaches—there remains no universal consensus on optimal treatment. We primarily aimed to evaluate disease-specific and progression-free survival following intralesional curettage and adjuvant phenol treatment of ACTs. Secondary aims included assessing surgical complications, the need for additional interventions, and an overview of long-term follow-up.Methods: This retrospective cohort study of 388 ACT patients was conducted at a tertiary referral center from 2000 to 2019. Comprehensive data collection included demographics, tumor characteristics, and follow-up outcomes.Results: Residual disease was observed in 14% (n = 53) of cases, with continued growth on sequential imaging in one-fourth (n = 13 of 53). Postoperative fractures occurred in 10% (n = 37) after a mean of 7 months, and 16% (n = 61) required a second surgery due to pain or joint movement limitations. There was no malignant progression or mortality observed.Conclusion: We found that curettage for ACT is not associated with mortality or malignant progression but does carry risks of complications and residual disease. This raises important questions regarding the necessity of surgical intervention. Further research is needed to refine the treatment approach for ACT.

Claire H J Scholte

Michiel A J Van de Sande

Robert J P Van der Wal

Demien Broekhuis

Kirsten Van Langevelde

Desirée M J Dorleijn

Clinical outcome of curettage in atypical cartilaginous tumors of the long bones: a descriptive cohort study

长骨非典型软骨肿瘤刮除术的临床结果：一项描述性队列研究

Abbreviation	Acta Orthop.
Journal Impact	2.39
Quartiles(Global)	ORTHOPEDICS(Q1)

ISSN	1745-3674, 1745-3682
h-index	131

Publication Information	Publisher: Medical Journals Sweden AB，Publishing cycle: Bimonthly，Journal Type: journal，Open Access Journals: Yes
Basic data	Year of publication: 2004，Proportion of original research papers: 94.50%，Self Citation Rate:8.00%， Gold OA Rate: 98.28%
Journal Fees	$Details
Average review cycle	网友分享经验：偏慢,4-8周
Average recruitment ratio	网友分享经验：较易

Acta Orthopaedica

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Influence of day of surgery and prediction of LOS > 2 days after fast-track hip and knee replacement