Session 1: Hip / Knee
Onsdag den 21. oktober
09:00 – 10:30
Lokale: Reykjavik
Chairmen: Per Kjærsgaard / Thomas Jakobsen
1. Risk factors for early periprosthetic fractures following primary cementless THA
Ann Buhl Bersang, Anders Troelsen, Kalemose Thomas , Husted Henrik, Gromov Kirill
Orthopaedic department, Hvidovre Hospital
Background: The use of cementless fixation for
primary THA has increased world wide,
which can be considered paradoxal as
registry data suggest inferior survival of
cementless THA. Periprosthetic
fracture is one of the main
complications following cementless
THA.
Purpose / Aim of Study: In this retrospective cohort study we 1)
investigate risk and 2) identify pre-and
intraoperative risk factors for early
periprosthetic fracture following
primary cementless THA.
Materials and Methods: 1,255 unselected and consecutive
patients undergoing primary THA
between July 2010 and May 2014
were identified. Patients with missing
data or patients operated with other
implants than a standard cementless
THA were excluded, leaving 1,183
patients for analysis. Patient
demographics were recorded. Level of
preoperative arthritis, Dorr type and
cortical index were recorded on
preoperative xrays. Varus/Valgus
placement of the stem and canal fill
were recorded postoperatively. Early
periprosthetic fractures (< 1 year) were
identified. Regression analysis was
performed to identify risk factors for
early periprosthetic fracture.
Findings / Results: 37 (3.1%) early periprosthetic fractures
were identified. 28 (76%) occurred in
females. Mean age was 72.7 years.
Median time until fracture was 16 days
(1-102). 10 (37%) of all fractures
occurred in patients >80 years old. 8
fractures occurred in Dorr type C
femurs (21.6%). Patients with Dorr
type C femurs had a 7.5 OR (95%CI
(1.6-35.0)) for early periprosthetic
fractures. Varus/Valgus placement of
the stem (1.1 OR (95%CI(0.9-1.2))
and canal fill (1.1 OR (95%CI(1.0-1.2))
were not identified as predictors of
early periprosthetic fracture.
Conclusions: Dorr type C is an independent risk
factor for early periprosthetic fracture.
Surgeons should be aware of this and
considerer cemented arthroplasty in
those patients.
2. Is patient-reported outcome after total hip arthroplasty influenced by type of bearings?
Claus Varnum, Alma B. Pedersen, Per Kjærsgaard-Andersen, Søren Overgaard
Department of orthopaedic surgery, Vejle Hospital; Department of clinical epidemiology, Aarhus University Hospital; Department of orthopedic surgery and traumatology, Odense University Hospital
Background: The outcome of total hip arthroplasty (THA)
has traditionally been assessed in prosthetic
survivorship and complications. Patient-
reported outcome (PRO) is recognized as a
very important tool for evaluating the
outcome after THA.
Purpose / Aim of Study: We aimed to compare PRO scores from
patients having ceramic-on-ceramic (CoC)
and metal-on-metal (MoM) to scores from
patients with metal-on-polyethylene (MoP)
THA.
Materials and Methods: We identified 4,212 patients matched on
sex, age, and year of surgery operated
during 2002 to 2009 from the Danish Hip
Arthroplasty Registry with no revision.
450 patients were excluded due to death,
protection against inquiry from
researchers, unknown address, hip
resurfacing arthroplasty, and dual
mobility cup. In total, 3,762 patients
received the following PROs: The hip
disability and osteoarthritis outcome
score (HOOS), EQ-5D, and UCLA
activity score. Of these, further 145
patients were excluded due to confirmed
revision surgery. 3,082 patients
responded (response rate 85%).
Univeriate linear regression was used to
compare mean age between the
bearings groups. Multivariate linear
regression was used to compare mean
values of PRO subscale scores within
the three groups.
Findings / Results: Among responders, 1,393 (45%) had CoC,
512 (17%) MoM, and 1,177 (38%) MoP
THA. There was a similar distribution of sex
within the three bearing groups. Patients
with CoC and MoM bearings were
significantly younger (mean age 65.7 and
65.5 years, respectively) than patients with
MoP bearings (mean age 67.4 years). No
significant difference in mean scores was
found in the 5 HOOS subscales, EQ-5D
index, EQ VAS, or UCLA activity score
between patients with CoC, MoM, and MoP
THA.
Conclusions: We found no association of CoC, MoM, and
MoP bearings on PRO after THA.
3. Promising migration Pattern in a 2 year RSA follow-up of the short Primoris Femoral Stem
Janus Duus Christiansen, Michael Ulrich Jensen, Ashir Ejaz, Poul Torben Nielsen, Mogens Berg Laursen
Northern Ortopaedic Division, Aalborg University Hospital
Background: In order to save proximal bone stock in primary total
hip arthroplasty (THA), short femoral stems are
introduced.
Purpose / Aim of Study: Designed for perfect fit within the femoral neck, the
Primoris® femoral stem has been released for
clinical studies in coherence with stepwise
introduction of new implants. This is the preliminary
report of the Radio Stereometric Analysis (RSA)
results after 2 year follow-up (FU).
Materials and Methods: We carried out a prospective cohort study of 52
patients scheduled for surgery with the femoral
neck-preserving Primoris® stem. Migration was
analyzed by RSA, and clinical results recorded using
the Harris hip score, UCLA activity score, WOMAC,
EQ5D health questionnaire and Oxford Hip scores.
Findings / Results: 2 patients were excluded intra-operatively and 1
patient was revised due to aseptic loosening 3
months postoperatively. 4 patients were excluded
from the RSA analysis due to technical issues,
leaving 44 patients for analysis. RSA showed minor
micro motions of the stem: Mean subsidence was
0.35 mm (precision: 0.10) and mean rotation around
the longitudinal axis was 0.10º (precision: 0.64) after
2 years.
Conclusions: The stems showed migrations characteristic for
stable uncemented implants. Long term follow up will
be performed in future years.
4. Surgical Selection Bias may influence results presented in current literature after two-stage revision of chronic peri-prosthetic hip joint infection.
Jeppe Lange, Alma B. Pedersen, Anders Troelsen, Kjeld Søballe
Orthopaedic Surgery, Regional Hospital Silkeborg; Clinical Epidemiology, Aarhus University Hospital
Background: Currently, the gold-standard treatment
for hip periprosthetic joint infection
(PJI) is two-stage revision. However,
advocates for the one-stage revision
strategy argue that current literature
is biased in the selection of two-stage
revision.
Purpose / Aim of Study: We wanted to investigate the potential
presence of surgical selection bias in
patients undergoing two-stage revision
in chronic hip PJI.
Materials and Methods: We identified patients in the National
Patient Register from 2003-2008 at 11
orthopaedic departments. A manual review
of the medical records verified 130
patients with a treatment performed for
a chronic hip PJI. We divided the
patients, into two groups based on the
revision strategy chosen. 82 patients
constituted one group and was
characterized by having a
re-implantation performed in a two-stage
revision. The remaining 48 were not
treated using a two-stage revision
Findings / Results: Patients in the two-stage group were
younger (mean age 68, 95% CI: 66-71 vs.
76, 95% CI: 72-80; p-value <0.001) and
had better overall health as indicated
by the surrogate health markers ASA
score (median score 2, IQR: 0 vs.
median 2, IQR: 1; p-value <0.001) and
CCS Score (median score 0, IQR 1 vs.
median 1, IQR 1; p-value 0.005).
Patients not re-implanted had a crude
68% higher risk of dying in the
follow-up period compared to patients
undergoing two-stage revision.After
adjusting for selected confounding
variables the risk of dying remained
25% higher, although not found to be
statistically significant
Conclusions: When discussing the optimal treatment
strategy, surgeons must keep in mind
that 1-in-3 of all chronic hip PJI are
not treated with a two-stage revision.
We also found a significant difference
between our established groups
indicating that patients undergoing
re-implantation are a selected group of
patients
5. The association between gender and the familial prevalence of hip dysplasia in Danish patients with hip dysplasia
Rima El Jashi, Maria Biehl Gustafson, Mette Bjørn Nielsen, Jens Michael Hertz, Kjeld Søballe, Inger Mechlenburg
Department of Orthopaedic Surgery , Aarhus University Hospital, Denmark ; Department of Clinical Genetics, Odense University Hospital; Department of Orthopaedic Surgery, Aarhus University Hospital, Denmark ; Department of Orthopaedic Surgery, Centre of Research in Rehabilitation (CORIR), Department of Clini, Aarhus University Hospital and Aarhus University, Denmark
Background: The development of hip dysplasia is
associated with several risk factors. One of
the risk factors is gender and 80% of
patients with symptomatic hip dysplasia are
females. Another risk factor is familial
prevalence of hip dysplasia. Studies
indicate that the risk of hip dysplasia is
increased with familial prevalence of hip
dysplasia. However, little is known about the
association between the familial prevalence
and gender and development of hip
dysplasia.
Purpose / Aim of Study: The aim of the study was to estimate the
prevalence and genealogy degree of family
history in Danish patients with hip dysplasia
operated with periacetabular osteotomy
(PAO) and furthermore, to assess the
association of gender and family history in
the same group of patients.
Materials and Methods: A cross-sectional study of 676 patients
drawn from a clinical database of patients
operated with a PAO at Aarhus University
hospital from 1998 to 2014. Information on
gender operated hip side and age was
collected from the clinical PAO database,
and information on familial prevalence was
collected through questionnaires. The
association between gender and familial
prevalence of hip dysplasia was presented
as the prevalence proportions ratio (PPR),
tested by χ2 test. Stratification was
conducted for the variables age and
operated hip side, and tested for statistical
significance.
Findings / Results: Familial prevalence of hip dysplasia was
30% (95% CI 27; 34), with 73% reporting
1st degree relatives. Females had 32%
increased risk of familial prevalence of hip
dysplasia compared to men, but this
difference in risk was not statistically
significant (p=0.10).
Conclusions: Females had increased familial prevalence
of hip dysplasia compared to men, but the
increased prevalence was not statistically
significant probably due to the low power of
the study.
6. Validation of the prosthetic joint infection diagnosis in the danish hip arthroplasty register
Per Hviid Gundtoft, Alma Becic Pedersen, Henrik Carl Schønheyder, Søren Overgaard
1. Ortopædkirurgisk 2: Ortopædkirurgisk 3: Klinisk Institut, 1: Kolding Sygehus 2: Odense University Hospital 3: Sydddansk Universitet; Klinisk Epidemiologisk, Aarhus Universitetshospital; Klinisk Mikrobiologisk, Aalborg Universitetshospital; 1: Ortopædkirurgisk 2: Klinisk Institut, 1: Odense Universitetshospital 2: Sydddansk Universitet
Background: The Danish Hip Arthroplasty Register
(DHR) is a national database on total
hip arthroplasties (THAs) with a high
completeness and validity of
registration for primary procedures.
Purpose / Aim of Study: The aim was to validate the registration
in DHR for revisions due to Prosthetic
Joint Infection (PJI).
Materials and Methods: We identified a cohort of patients in
the DHR who underwent primary THA from
January 1, 2005 to December 31, 2012 and
followed these patients until first-time
revision, death, emigration or December
31, 2012. The PJI-diagnosis registered
was tested against a gold standard
encompassing information from
microbiology, prescription, clinical
biochemistry registries and clinical
findings retrieved from medical records.
We estimated the sensitivity,
specificity, positive predictive value
(PPV) and negative predictive value
(NPV) with 95% confidence interval for
PJI in DHR alone and in combination with
microbiology registries.
Findings / Results: Out of 37,828 primary THAs, 1,382 were
registered with any revision, 232 of
which were due to PJI. For PJI revisions
in DHR, the sensitivity was 67.0% (CI:
61.0 - 72.6), specificity 95.2% (CI:
93.8 - 96.4), PPV 77.2% (CI: 71.2 -
82.4), and NPV 92.3% (CI: 90.7 - 93.8).
Combining DHR with microbiology
registries led to a notable increase in
the sensitivity for PJI revision to
90.3% (CI: 86.1 - 93.5) and likewise for
specificity 99.6% (CI: 99.1 - 99.9), PPV
98.4% (CI: 95.9 - 99.6) and NPV 98.5%
(CI: 97.6 - 99.1).
Conclusions: Only two thirds of PJI revisions were
captured in DHR and the PPV was moderate
(77%). However, combining DHR with
microbiology registries improved the
accuracy remarkably.
7. The suitability of dynamic RSA for evaluation of dual-mobility liner motion
Peter Bo Jørgensen, Bart L. Kaptein, Maiken Stilling
Orthopaedic Research, Aarhus University Hospital; Dept. of Orthopaedic Surgery, Leiden University Medical Center
Background: Dual-mobility hip prostheses have
potential benefits in terms of increased
hip joint mobility, decreased
dislocation risk, and less polyethylene
wear. The shape, material and
surroundings of the polyethylene
component, complicates recording of the
essential in-vivo liner motion.
Purpose / Aim of Study: To assess the feasibility of in-vivo
liner motion recording using dynamic RSA
in a phantom set-up.
Materials and Methods: The phantom set-up consisted of a
Sawbones® pelvis and extremity, and was
prepared with a Restoration ADM® cup
(Stryker Inc.) size 56. A matching liner
was prepared with 12 1-mm tantalum beads
in four unique groups and a 28 mm
ceramic femoral head (Biolox) and a CoCr
femoral stem. The phantom was positioned
supine with 45 degrees flexion in the
hip for dynamic stereometric recordings
at 5 fps through a 10 cm acrylic layer,
with a set-up (tubes and calibration
box) tilted in a 45 degree
cranial/caudal angle during external and
internal rotation in the hip joint. A
marker-model of the polyethylene
tantalum-beads was combined from
multiple RSA-recordings using visual
validation and computed clustering. A
CAD model of the ADM cup and stem was
registered to the contour of the implant
in the stereoradiographs and relative
angles of the liner and femoral
component were evaluated with respect to
the ADM cup.
Findings / Results: Of 12 polyethylene bead-markers we
obtained a model of 10 markers (83%).
The relative angle varied between
polyethylene liner and cup (>8 deg.) and
between polyethylene liner and the
femoral component (>20 deg.) during
internal-external rotation.
Conclusions: Liner- and stem motion in a
dual-mobility hip implant was quantified
in a phantom set-up by use of dynamic
RSA. In-vivo measurement of polyethylene
motions in the dual-mobility implant is
expected to work well.
8. Improved diagnostic accuracy of prosthetic joint infection (PJI) by combining culture of sonication fluid and tissue samples from revision total hip (THA) and knee arthroplasty (TKA)
Christen Ravn, Michael Kemp, Per Kjærsgaard-Andersen, Søren Overgaard
Dep. of Orthopaedic Surgery and Traumatology, Institute of Clinical Research, Odense University Hospital and University of Southern Denmark; Dep. of Clinical Microbiology and Institute of Clinical Research, Odense University Hospital and University of Southern Denmark; Dep. of Orthopaedic Surgery, Vejle Hospital
Background: Culture-negative PJI is challenging and occurs in 60-
80 % of THA and TKA revisions suspected for deep
infection. Culture of dislodged biofilm bacteria in
sonication fluid (cSF) from explanted implant
materials has been reported to increase the
diagnostic sensitivity in comparison to conventional
culture of periprosthetic tissue samples (cPT)
(Trampuz, 2007. NEJM).
Purpose / Aim of Study: To compare the diagnostic accuracy of cPT alone
with a combination of cPT and cSF in revision of THA
and TKA.
Materials and Methods: We prospectively analyzed explanted prosthetic
materials from consecutive THA and TKA revision
surgery performed at Odense University Hospital
and Vejle Hospital during one year. The prostheses
were sonicated for one minute due to the Trampuz-
protocol (NEJM, 2007). cSF was considered positive
with >20 colonies/ml. Conventional cPT was
performed due to best practice and considered
positive with identical bacterial findings in 3/5 tissue
samples. We defined PJI by different criteria incl.
microbiology, and/or a combination of biochemistry
and clinical findings.
Findings / Results: Revision of 214 THA (131) and TKA (83) were
indicated by aseptic loosening (73), deep infection
(57) and ‘other indications’ (84). PJI was defined in
56 cases and microbial diagnosis was achieved in 41
and 48 cases by either cPT or cSF. Bacterial
findings were similar in all concordant cases.
Sensitivity and specificity of cPT alone was 0.73 and
1.00 respectively. The combination of cPT and cSF
gave a microbial diagnosis in 53 PJI-cases;
sensitivity 0.93 and specificity 0.95 (p<0.05).
Conclusions: The combination of cPT and cSF significantly
increased the sensitivity of culture-based methods
for PJI-diagnosis leaving only 3/56 PJI-cases
culture-negative. Sonication is useful for detecting
surface-attached bacteria living as biofilm on
prosthetic implants.
9. Laminar airflow reduces microbial air contamination in comparison to turbulent airflow during simulated total hip arthroplasty (THA)
Christen Ravn, Anders Overgaard, Niels B. Knudsen, Jørn Toftum, Lars Henrik Frich, Søren Overgaard
Dep. of Orthopaedic Surgery and Traumatology, Institute of Clinical Research, Odense University Hospital and University of Southern Denmark; Dep. of Orthopaedic Surgery, Herlev University Hospital; Fournais Energi Aps, ; Dep. Of Civil Engineering, Technical University of Denmark
Background: It has been debated whether type of ventilation
system LAF versus TAP can influence the risk of
deep infection following THA and TKA. Moreover,
choice of ventilation system is of debate in
construction of hospitals
Purpose / Aim of Study: To compare the number of airborne bacteria and
particles under laminar airflow (LAF) vs turbulent
airflow (TAF) with 100% or 50% reduced fresh air
exchange in simulated THA
Materials and Methods: We conducted 32 simulated operations under 4
conditions: LAF or TAF with either full (n=8+8) or
50% reduced (n=8+8) air exchange. Microbial
contamination was determined by Microbiological
Active Sampler (MAS-100), and colony-forming units
(CFU) per m3 air were counted after 2 days
incubation. Airborne particulate (0.5-10 µm) was
sampled with light scattering particle analyzer (MET-
1). Large particle sizes (>5 µm) must not exceed a
2.900/m3-threshold for cleanroom operations
Findings / Results: Microbial air concentration (mean CFU/m3 ±SD) with
LAF under full and 50% reduced air exchange were
0.4±0.8 and 0.4±0.4 respectively, whereas air
contamination under TAF conditions had significantly
higher values of 7.6±2.0 and 10.3±8.1, respectively
(p<0.05)
Large (>5 µm) airborne particulate (mean no./m3
±SD) with LAF under full and 50% reduced air
exchange were 1.581±2.841 and 1.018±1.084
respectively, whereas particulate under TAF
conditions were 7.923±5.151 and 6.157±2.439
(p>0.05). The number of particles measured under
TAF conditions exceeded the threshold for
cleanroom operations in 12/16 simulated operations
Conclusions: Microbial air contamination was significantly lower
under LAF ventilation compared to TAF during
simulated THA under both full and 50% reduced air
exchange in modern operating theatres. These
findings indicate that LAF may reduce the airborne
microbial risk factor of surgical site infection in
comparison to TAF
10. How accurate are common biochemical and microbiological tests towards a multi-criteria definition of prosthetic joint infection (PJI) for revision total hip (THA) and knee arthroplasty (TKA)?
Christen Ravn, Michael Kemp, Per Kjærsgaard-Andersen, Søren Overgaard
Dep. of Orthopaedic Surgery and Traumatology, Institute of Clinical Research, Odense University Hospital and University of Southern Denmark; Dep. of Clinical Microbiology and Institute of Clinical Research, Odense University Hospital and University of Southern Denmark; Dep. of Orthopaedic Surgery, Vejle Hospital
Background: A certain diagnosis of PJI is sometimes difficult to
achieve when clinical, biochemical and
microbiological findings are ambiguous. Seemingly
there is no Danish consensus for a PJI definition as
proposed by the International Consensus Meeting
(Parvizi, 2013. BJJ)
Purpose / Aim of Study: We suggest a PJI definition incl. pre-operative C-
reactive protein (CRP) as well as culture of intra-
operative joint fluid (JF) and periprosthetic tissue
samples (PT) from patients undergoing revision
surgery in order to determine the diagnostic
accuracy of each parameter
Materials and Methods: Revision of 214 THA (131) and TKA (83) were
indicated by aseptic loosening (73), deep
infection (57) and other (84). We analyzed CRP,
JF- and PT-culture and defined PJI by either 1-4:
1. Presence of a sinus tract
2. Culture of identical microorganisms in ≥3/5 PT
3. Culture of identical or microorganisms in 2/5
PT in combination with either
-a JF cultured with an identical organism OR
-b Elevated CRP (threshold >100mg/l at 0-90
postoperative days; >10mg/l after 90 days)
4. Minor criteria (required 3/4):
-a Culture-positive PT (≥1/5)
-b Culture-positive JF
-c Purulence of JF
-d Elevated CRP
Results are presented as number of test-positive
PJI-cases (sensitivity / specificity)
Findings / Results: PJI was found in 56 cases according to our definition
criteria 1-4. CRP was elevated in 32 cases (0.60 /
0.85). JF-aspiration was dry in 35 and culture-
negative in 136 cases. JF-culture gave a microbial
diagnosis in 37 PJI-cases (0.70 / 0.96). PT-culture
with a diagnostic threshold at 3/5 positive samples
gave a microbial diagnosis in 41 PJI-cases (0.73 /
1.00)
Conclusions: Diagnostic accuracy of each parameter showed no
tests exceed 0.75 leaving every fourth PJI-cases
without a bacterial diagnosis. Thus in order to
increase sensitivity we suggest introducing new
validated diagnostic tools.
11. Serious renal and urological complications in fast-track primary total hip and knee arthroplasty
Lars Bjerregaard, Christoffer Jørgensen, Henrik Kehlet
Section for Surgical Pathophysiology and the Lundbeck Foundation Centre for Fast-track Hip and Knee , Rigshospitalet, Copenhagen University, Denmark.
Background: The fast-track methodology has reduced
overall medical complications after total
hip (THA) and knee arthroplasty (TKA).
However, limited data exists on renal
and urological (RU) complications.
Purpose / Aim of Study: To study the incidence and
consequences of serious RU
complications in otherwise
uncomplicated elective fast-track THA
and TKA, resulting in length of stay
(LOS) > 4 days or a 30-day readmission.
Materials and Methods: A detailed, observational study of
prospectively collected pre-operative
data with complete 30-day follow-up
based on the Danish National Patient
Registry and review of medical charts in
a large cohort of 8,804 fast-track THA
and TKA from 7 Danish high-volume
orthopaedic departments, with similar
standardised fast-track protocols.
Findings / Results: Of 8,804 procedures, 0.6 % developed
serious RU complications resulting in 38
LOS >4 days and 17 readmissions.
Acute kidney injury (AKI), defined as an
increase in serum creatinine by ¡Ý 0.3
mg/dl or ¡Ý 1.5 times baseline, accounted
for 43 cases (0.5 %), and was most
frequently explained by dehydration. Of
the 43 patients with AKI, 25 (58 %) had
a preoperative estimated glomerular
filtration rate < 60 mmol/ml. and 16 of
these (64 %) had received a NSAID as
postoperative pain treatment. 7 cases
(0.1 %) were due to urological
complications, mainly haematuria after
bladder catheterisation, and 5 patients
(0.1 %) developed postoperative
urosepsis or pyelonephritis.
Conclusions: The overall incidence of serious RU
complications after fast-track THA and
TKA was low (0.6 %). Of these, 78 %
were AKI, most often due to
dehydration, pre-existing kidney disease
and NSAID treatment, calling for an
increased focus on perioperative fluid
management and optimisation of the
perioperative care of patients with pre-
existing kidney disease.
12. When to catheterise after fast-track total hip (THA) and knee arthroplasty (TKA) – a RCT on bladder volumes of 500 vs. 800 ml
Lars Stryhn Bjerregaard, Ulla Hornum, Charlotte Troldborg, Bogø Stina, Per Bagi, Henrik Kehlet
Section for Surgical Pathophysiology and the Lundbeck Foundation Centre for Fast-track Hip and Knee , Rigshospitalet, Copenhagen university; Department of Orthopaedics, Aalborg University Hospital, Farsø; Department of Urology, Rigshospitalet
Background: A bladder volume of 500 ml is a
commonly used catheterisation threshold
for treating POUR after THA and TKA,
but this threshold is without evidential
support.(1,2)
Purpose / Aim of Study: The purpose was, in a RCT to compare
two bladder volumes (500 vs. 800 ml) as
catheterisation threshold.
Materials and Methods: We included 800 adult patients (2x400),
planned for fast track THA or TKA and
who had given their informed written
consent. 721 patients completed the
study.
Bladder scans were performed at 2
hours intervals until the first voluntary
micturition. All patients completed a
preoperative questionnaire on voiding
difficulties, which were repeated at 30
days follow-up.
Main outcome was the proportion of
patients needing postoperative
catheterisation. Secondary outcomes
included the incidences of UTI and
voiding difficulties within the 30 days
follow-up period.
Findings / Results: 114 of 355 patients (32.1 %) were
catheterised in the 500 mL group
compared to 49 of 366 patients (13.4 %)
in the 800 mL group (p < 0.0001). The
need for repeated catheterisation was
4.5 % vs. 0.8 % respectively. Follow-up
data on the incidences of UTI and PO
voiding difficulties will be presented at
the conference.
Conclusions: Our results show that increasing the
catheterisation threshold to a bladder
volume of 800 mL reduces the need for
postoperative catheterisation. This first
large RCT on the topic may serve as
basis for future evidence based
guidelines on perioperative urinary
bladder management in fast track THA
and TKA.
References
1. Bjerregaard LS, Bagi P, Kehlet H.
Postoperative urinary retention (POUR)
in fast-track total hip and knee
arthroplasty. Acta Orthop 2014;85:8-10.
2. Bjerregaard LS, Bogo S, Raaschou S
et al. Incidence of and risk factors for
postoperative urinary retention in fast-
track hip and knee arthroplasty. Acta
Orthop 2015;86:183-8.