Fredag den 25. oktober
13:00 – 14:30
Chairmen: Ole Rahbek / Steen Lund Jensen
Katja Maretty-Nielsen, Ninna Aggerholm-Pedersen, Akmal Safwat, Peter Holmberg Jørgensen, Alma Pedersen, Johnny Keller
Department of Experimental Clinical Oncology, Aarhus University Hospital; Department of Oncology, Aarhus University Hospital; Department of Orthopaedic Surgery, Aarhus University Hospital; Department of Clinical Epidemiology, Aarhus University Hospital
Background: Previous registry-based studies of soft
tissue sarcoma (STS) have identified a
number of possible prognostic factors;
however the majority of these include highly
selected populations, with unclear validity of
data, and insufficient statistical methods.
Purpose / Aim of Study: The aim of this study was to identify
prognostic factors in a validated, population-
based 30-year series of STS treated at a
single institution, using a more advanced
statistical approach with cubic spline
regression and competing risk.
Materials and Methods: Between 1979 and 2008, 1065 adult patients
were treated at the Sarcoma Centre of
Aarhus University Hospital for a non-
metastatic STS in the extremities or trunk.
The endpoints were local recurrence and
disease-specific mortality. Prognostic
factors were analyzed uni- and
multivariately using a competing risk
proportional hazard model, with inclusion of
continuous variables as cubic splines.
Findings / Results: It was proper to analyze age, duration of
symptoms, and tumor size as cubic splines.
The 5-year local recurrence rate was 15%.
Independent favorable prognostic factors for
local recurrence were small size,
intracompartmental location, grade 1,
wide/radical excision, duration of symptoms
<13 months or >30 months (vs. 3 months),
and radiotherapy. The 5-year disease-
specific mortality rate was 23%. Important
favorable prognostic factors for disease-
specific mortality were small size,
subcutaneous location, grade 1, wide/radical
excision, and radiotherapy.
Conclusions: It is important to use continuous non-linear
variables and competing risk analyses in
prognostic studies. In this population-based,
validated series of adult, non-metastatic
STS; duration of symptoms, tumor size,
depth, compartmentalization, grade, surgical
margin, and radiotherapy were important
independent prognostic factors.
Jeannette Penny, Ming Ding, Ole Ovesen, Jens Erik Varmarken, Søren Overgaard
Dept. of orthopeadics, OUH/Næstved
Background: Continuous migration measured by RSA
is a predictor for failure. The ASR
resurfacing implant was withdrawn due
to excessive failure rates but showed
initial femoral component stability.
Purpose / Aim of Study: We aimed to investigate the initial implant
stability for the cup as an explanation for
the high revision rate, and to compare it
to another metal on metal cup.
Materials and Methods: 36 patients with primary OA from a RCT
received either an ASR (n=19) or an
M2a-Magnum Cup (n=17) without
markers. RSA images were obtained
within 3 days of surgery, at 8 w, 6 m, 1
and 2 years. A model based RSA
system calculated migration.
ANOVA analysed movement over time
as well as difference between implants
Findings / Results: Initial movement was noted, especially
for the M2a-Magnum cup, where the 2
year mean (sd) X translation was -0.307
(0.53)mm (p = 0.01), Y translation was
0.282 (0.36)mm (p < 0.001) and Z
translation was -0.343 (0.63)mm p =
After 2 years the ASR cup displayed a
mean X translation of -0.115 (0.60) mm
(p = 0.82), Y translation of 0.075 (0.14)
mm (p = 0.01) and Z translation of 0.438
(0.88)mm (p = 0.04)
The implants had a similar pattern for X
and Y with slightly more movement for
M2a-Magnum in the X translations (p<
0.01) On the Z axis the implants
displayed movement in opposite
At two years 4 ASR and 5 M2aMagnum
migrated above 1 mm in one axis.
Conclusions: The early migration of both cups were
low - for the ASR implant particularly at
the Y axis, where the mean 0.075 mm is
well below the limit of 0.2mm suggested
as an acceptable threshold. The M2a-
Magnum cup has migration rates just
above that, but longer clinical follow up
is needed to establish if this cup has
greater risk of revision. Continuous
migration is not likely to explain failure of
neither the cup nor the femoral side of
the ASR hip.
Andreas E B Hermann, Anders Holsgaard-Larsen, Bo Zerahn, Steen Mejdahl, Søren Overgaard
Department of Orthopaedic Surgery, Herlev University Hospital; Orthopedic Research Unit, Department of Orthopaedic Surgery and Traumatology , Odense University Hospital; Department of Clinical. Physiology and Nuclear Medicine, Herlev University Hospital
Background: Hip Osteoarthritis (OA) is associated
with pain, functional deterioration and
loss of muscle function. Progressive
explosive-type resistance training (RT)
is effective in improving muscle
strength and functional performance in
healthy elderly. In hip OA patients the
effects prior to THA remain unknown.
Purpose / Aim of Study: To investigate the effect of RT in hip
OA patients scheduled for THA on i)
self-reported outcomes and ii) muscle
function, physical function and body
Materials and Methods: RCT. Eighty patients (age 70.4 ± 7.6
years, BMI 27.8±4.6, 70% females
(n=52)) diagnosed with hip OA and
scheduled for primary THA were
randomized into two groups: 1) The
intervention group (IG) received
supervised RT twice a week for 10
weeks; 4 leg/hip exercises of 3 series
each (~80% of 1 repetition maximum).
2) The control group (CG)
received ‘care as usual’.
Outcomes: Primary; Hip Osteoarthritis
Outcome Score (HOOS), secondary;
leg extension power, functional tests,
body composition (DXA). Adjusted
between group changes from baseline
to follow-up (2-5 days prior to surgery)
were analyzed as intention-to-treat
using multilevel regression.
Findings / Results: For HOOS ADL the IG scored 9.7
points 95%CI [4.3;15.2] higher
compared to CG at follow-up
(p=0.001). For the remaining 4 HOOS
subscales IG performed significantly
better than CG (p<0.03). IG had higher
leg muscle power (p<0.0001); better
function (gait speed, stair-climb, sit-
stand) (p<0.0001) and increased lean
body mass (p=0.013) compared to CG.
RT was well accepted in IG
Conclusions: For the first time it is shown that Hip
OA patients scheduled for THA can
comply with RT and significantly
improve self-reported function and pain
and muscle function, functional
capacity and lean body mass. The
present intervention prior to surgery
holds promise for an optimized post-
Peter Bo Jørgensen, Søren Bie Bogh, Kjeld Søballe, Henrik Sørensen, Anders Odgaard, Inger Mechlenburg
Orthopaedic Research Unit, Aarhus University Hospital; Department of Sports Science, Aarhus University; Orthopaedic Department, Aarhus University Hospital
Background: Background: Muscle atrophy and decreased
muscle strength is documented in early
stages of knee osteoarthritis and increases
with progression. Within the first weeks
after Unicompartmental Knee Arthroplasty
(UKA) an additional decrease in muscle
strength is found.
Purpose / Aim of Study: Purpose: To investigate the effect of early
progressive resistance training (PRT) after
Materials and Methods: Materials and Methods: 53 patients (26
male), median age 66 years, scheduled
for UKA were randomized to either 8
weeks supervised PRT (n=29) or 8
weeks standard home exercise (HE)
program (n=24). The PRT was initiated
within the first week after UKA and
performed 2/week for 8 weeks in training
machines (relative load from 15-8
Repetition Maximum). Before and 2
months after UKA leg muscle power,
spatio-temporal parameters, functional
capacity and Knee injury and
Osteoarthritis Outcome Score (KOOS)
Findings / Results: Results: 8 patients dropped out (6 PRT).
Patients in the PRT group participated in
mean 11 out of 16 training sessions. Max
leg power improved 0.24 [0.05;0.43]
W/kg in the PRT group and was
unchanged -0.01 [-0.23;0.26] W/kg in the
HE group. Self-selected walking speed
increased for PRT 0.6 [0.42;0.67] km/h
and for HE 0.5 [0.17;0,79]km/h. 6 min
walking speed increased for PRT 0.35
[0.09;0.61] km/h and for HE 0.27
[-0.20;0.75] km/h. Asymmetry of walking
pattern was equal to preoperative values
for both groups. Pelvic rotations in step
test increased significantly for both
groups. KOOS increased in all sub-
scores for both groups (p=0.53-0.92).
For all the mentioned tests there was no
differences between the groups (p=
Conclusions: Conclusion: We found no additional effect of
early PRT compared to HE in this patient
group when tested 8 weeks after surgery.
However, adherence to PRT was fairly low
and 20% dropped out.
Nanna H. Sillesen, Audrey Nebergall, Poul T. Nielsen, Mogens B. Laursen, Anders Troelsen, Henrik Malchau
Harris Orthopaedic Laboratory, MGH + Department of Orthopedics, Hvidovre Hospital. , Massachusetts General Hospital, Boston, MA, USA. + Copenhagen University Hospital, Hvidovre, Denmark; Harris Orthopaedic Laboratory, MGH, Boston, Massachusetts General Hospital, Boston, MA,; Department of Orthopaedics, Aalborg University Hospital, Aalborg University Hospital, Aalborg, Denmark; Department of Orthopedics, CORH, Hvidovre Hospital, Copenhagen., Copenhagen Univeristy Hospital, Hvidovre, Denmark; Harris Orthopaedic Laboratory, Massachusetts General Hospital, Boston, MA,
Background: Vitamin E diffusion into highly cross-linked
polyethylene (VEPE) is a method for
enhancing long-term oxidative stability of hip
arthroplasty liners. Early clinical outcome is
important to document that there are no
detrimental effects of new developments.
Purpose / Aim of Study: The purpose of this study was to evaluate in
vivo wear properties of VEPE and the
stability of a porous-titanium coated
acetabular cup using Radiostereometric
Materials and Methods: 144 patients were recruited into a
prospective 5 years RSA study at 2 centers.
All patients received porous-titanium coated
cups and either VEPE or non-vitamin E
medium cross-linked liners (XLPE). Cobalt-
chrome or ceramic femoral heads were
used, 32mm or 36mm. At Center1 the
acetabulum was under reamed by 1 mm and
at Center2 it was reamed size-to-size.
Findings / Results: There was no statistically significant
difference (p=0.203) in femoral head
penetration into the VEPE liners at 3
years comparing the 32mm metal heads
(-0.002±0.02mm) with the 32mm ceramic
heads (-0.04±0.06mm). There was no
difference (p=0.087) in head penetration
into VEPE liners at Center1 compared
with XLPE liners at Center2
(0.02±0.05mm); however there was
significantly less wear in VEPE than
XLPE liners at 3 years at Center2
One year median proximal cup migration
at Center1 (0.14±0.03mm) was
significantly lower than at Center2
(0.38±0.06mm) (p=0.001). Median cup
migration at Center1 remained stable at 3
years (0.15±0.05mm); however Center 2
showed significant continual migration at
3 years (0.45±0.09mm) (p≤0.002).
Conclusions: This study provides the first multicenter in
vivo wear measurement of VEPE liners using
RSA. The 3year follow-up shows VEPE
results indicating low liner penetration
regardless of head material or size and low
amount of early cup-movement.
Michel E.H. Boeckstyns, Allan Ibsen Sørensen, Joaquin Fores Vineta, Birgitta Rosén, Xavier Navarro, Christian Krarup
Clinic for Hand Surgery , Gentofte Hospital; Clinic for Hand Surgery, Rigshospitalet; Orthopedic Surgery, Hospital Clínic, University of Barcelona; Hand Surgery, Skåne University Hospital, Malmö; , Institute of Neurosciences of the Independent University of Barcelona; Neurophysiology, Rigshospitalet
Background: Currently there are no randomized studies
or studies reporting on motor recovery
after nerve repair with collagen conduits in
Purpose / Aim of Study: Hypothesis: Collagen Nerve Conduits, for
repair of traumatic nerve lesions in
humans, is associated with reinnervation
and recovery of sensory and motor
functions that are at least equivalent to
conventional repair (direct suture or nerve
Materials and Methods: In a prospective randomized trial, acute
section of the ulnar or median nerves were
repaired with a collagen nerve conduit or
with conventional microsurgical techniques.
Electrophysiological tests and hand
function using a standardized clinical
evaluation instrument were compared after
12 and 24 months using a one-way and a
two-way ANOVA with repair type and
nerve type as factors.
Findings / Results: 44 total nerve lacerations were included.
There were no infections, extrusions or
other local adverse reaction. 32 patients
with 33 nerve lesions attended the 24-
month follow-up. There were no differences
in electrophysiological tests.When
compared at 12 and 24 months there was
a general further recovery of both motor
conduction parameters (P<0.01) and
sensory conduction parameters (P<0.05).
At one-way ANOVA there was no
difference between sensory, discomfort or
total hand function scores. The two-way
ANOVA test showed significant differences
in clinical motor recovery according to
nerve (median doing better than ulnar).The
type of repair in itself had no influence on
sensory or motor function after 24 months.
Conclusions: The Collagen Nerve Guide Conduit, for
repair of traumatic nerve lesions in humans
is associated with reinnervation of the
denervated organs and recovery of
sensory and motor functions that are
equivalent to conventional repair, but it was
not superior.The procedure is safe in the
Haider Ghalib Majeed, Torben Bæk Hansen
Department of Orthopedic Surgery, Regional Hospital Holstebro
Background: Cup failure is a recognized problem in total
trapeziometacarpal (TM) joint prosthesis,
probably due to several individual factors.
The cup design may have an important
effect on the primary pressfit fixation and
secondary bony fixation of non-cemented
cups influencing on cup migration and overall
Purpose / Aim of Study: The purpose of this study is to compare two
different designs in non-cemented cups and
the possible effect on prosthesis survival,
revision rates and overall patient’s
Materials and Methods: In a prospective study, two consecutive
groups of patients were included. The
two groups were operated with two
completely different cup types and
designs (cup with collar versus cup
The DASH score, hands grip strength,
and radiological control was measured in
predefined time points (preoperative, 3,
12, and 24 months postoperative).
Twenty-two patients were included in
each group. First group (8 males/14
females) were operated with MOTEC
prosthesis (cup with collar). The mean
age was 61 (45-73). The second group
(5 males/17 females) were operated with
Elektra prosthesis (cup without collar).
The mean age was 59 (46-74).
Findings / Results: After 24 months the revision rate in the
MOTEC group was 41% (9/22), versus 0%
(0/22) in the Elektra group (p-value= 0.02).
Adding radiological loosening after 24
months, 13 cups in the MOTEC group were
revised or radiologically loose versus 1 cup
in the Elektra group (p<0.01).
There were no significant differences in
clinical results between the two groups in
the patients without radiological loosening.
Conclusions: Cup design has a significant role in the
overall prosthesis survival and overall
revision rate after 24 months. The MOTEC
cup design seems to be a failure compared
to the Elektra cup.