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Article ; Online: Editorial: Different, yet strong together: the Nordic Arthroplasty Register Association (NARA).

Mäkelä, Keijo / Hailer, Nils P

2021 Volume 92, Issue 6, Page(s) 635–637

MeSH term(s)	Arthroplasty, Replacement, Hip ; Arthroplasty, Replacement, Knee ; Biomedical Research ; Forecasting ; Humans ; International Cooperation ; Registries ; Scandinavian and Nordic Countries
Language	English
Publishing date	2021-07-07
Publishing country	England
Document type	Editorial
ZDB-ID	2180677-9
ISSN	1745-3682 ; 1745-3674
ISSN (online)	1745-3682
ISSN	1745-3674
DOI	10.1080/17453674.2021.1947006
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Article ; Online: Register-based randomized trials: the new power-tool in orthopedic research?

Hailer, Nils P / Furnes, Ove / Mäkelä, Keijo / Overgaard, Søren

Acta orthopaedica

2023 Volume 94, Page(s) 490–492

MeSH term(s)	Humans ; Randomized Controlled Trials as Topic ; Orthopedics ; Orthopedic Procedures
Language	English
Publishing date	2023-09-29
Publishing country	Sweden
Document type	Journal Article
ZDB-ID	2180677-9
ISSN	1745-3682 ; 1745-3674
ISSN (online)	1745-3682
ISSN	1745-3674
DOI	10.2340/17453674.2023.19661
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Article ; Online: Radiological outcome of hallux valgus deformity correction with metatarsal osteotomy from a single-center cohort - Best results achieved by foot and ankle surgeons.

Erjanti, Tuuli / Keskinen, Heli / Rissanen, Tiia / Mäkelä, Keijo / Lankinen, Petteri / Laaksonen, Inari / Koivu, Helka

Foot and ankle surgery : official journal of the European Society of Foot and Ankle Surgeons

2023 Volume 30, Issue 1, Page(s) 32–36

Abstract: Background: To evaluate the radiological outcome, especially undercorrection of hallux valgus deformity correction with first metatarsal osteotomy.: Patients and methods: 439 1st metatarsal osteotomies including 241 distal (55 %), 175 midshaft (40 %), ...

Abstract	Background: To evaluate the radiological outcome, especially undercorrection of hallux valgus deformity correction with first metatarsal osteotomy. Patients and methods: 439 1st metatarsal osteotomies including 241 distal (55 %), 175 midshaft (40 %), and 23 proximal (5 %) were available for analysis with median follow-up time was 48 days (range 27-990 days). Results: The postoperative HVA was normal in 237 (54 %), mild in 110 (25 %), moderate in 87 (20 %), and severe in 5 (1 %) of the cases. BMI (p = 0.0127), sex (p = 0.0004), preoperative HVA (p = 0.0028), and surgeons experience (p < 0.0001) were associated with radiological outcome, whereas age, hospital, and type of osteotomy had no effect. Foot and ankle surgeons achieved normal postoperative HVA in 76 %, general orthopedic surgeons in 41 %, and residents in 47 % of the operations. Conclusion: Radiological undercorrection was common. As foot and ankle surgeons achieved best radiological correction, hallux valgus deformity should be operated by specialists.
MeSH term(s)	Humans ; Metatarsal Bones/diagnostic imaging ; Metatarsal Bones/surgery ; Hallux Valgus/diagnostic imaging ; Hallux Valgus/surgery ; Ankle ; Treatment Outcome ; Retrospective Studies ; Osteotomy ; Orthopedic Surgeons
Language	English
Publishing date	2023-09-01
Publishing country	France
Document type	Journal Article
ZDB-ID	1424533-4
ISSN	1460-9584 ; 1268-7731
ISSN (online)	1460-9584
ISSN	1268-7731
DOI	10.1016/j.fas.2023.08.004
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Article: Incidence and Treatment Trends of Achilles Tendon Ruptures in Finland: A Nationwide Study.

Leino, Oskari / Keskinen, Heli / Laaksonen, Inari / Mäkelä, Keijo / Löyttyniemi, Eliisa / Ekman, Elina

Orthopaedic journal of sports medicine

2022 Volume 10, Issue 11, Page(s) 23259671221131536

Abstract: Background: Global reports indicate rising Achilles tendon rupture (ATR) incidence. In recent decades, the optimal treatment for this injury has been widely studied. Alongside the cumulating comparative evidence regarding the optimal method of treatment, ...

Abstract	Background: Global reports indicate rising Achilles tendon rupture (ATR) incidence. In recent decades, the optimal treatment for this injury has been widely studied. Alongside the cumulating comparative evidence regarding the optimal method of treatment, nonoperative treatment has increased in popularity compared with operative treatment. Purpose: To determine the current incidence of ATRs and their treatment in Finland and how these have changed from 1997 to 2019. Study design: Descriptive epidemiology study. Methods: Two national registers (the National Hospital Discharge Register and the Finnish Register of Primary Health Care Visits) were used to identify all ATR cases and operations to treat them; the incidence was calculated based on the annual adult population size. Results: During the study period, ATR incidence increased from 17.3 to 32.3 per 100,000 person-years. The increase in incidence seemed to plateau starting in the second half of the study period. The rise in ATR incidence occurred in both sexes and all age groups but most markedly among the elderly. The incidence of operative treatment decreased from 13.6 to 4.9 per 100,000 person-years. This decline was observed from 2008 onward and in all age groups. Conclusion: The incidence of ATRs increased and the use of operative treatment decreased. The decreasing trend of operative treatment is in line with other international reports and resonates with the current literature about the optimal treatment of ATRs.
Language	English
Publishing date	2022-11-08
Publishing country	United States
Document type	Journal Article
ZDB-ID	2706251-X
ISSN	2325-9671
ISSN	2325-9671
DOI	10.1177/23259671221131536
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Article: Strength Measurements and Results of Surgical Treatment of Complete Rectus Femoris Mid-substance Rupture: A Case Report.

Kartio, Anna A / Jokela, Aleksi M / Valle, Xavier / Pruna, Ricard / Mäkelä, Keijo / Lempainen, Lasse L

Journal of orthopaedic case reports

2022 Volume 12, Issue 4, Page(s) 19–22

Abstract: Introduction: Rectus femoris injuries are common in sports requiring sprinting and kicking, especially in football. In addition to sports injuries, rectus femoris injuries can occur during physically active daily living and physical work. Most muscle ... ...

Abstract	Introduction: Rectus femoris injuries are common in sports requiring sprinting and kicking, especially in football. In addition to sports injuries, rectus femoris injuries can occur during physically active daily living and physical work. Most muscle injuries heal well by conservative treatment, but more severe ruptures often require surgical treatment, especially in athletes. Some ruptures can cause so severe functional loss of the muscle that it causes problems also in everyday life. Complete rectus femoris mid-substance rupture is a rare injury type, which tends to recover poorly and cause significant functional deficit. Descriptions of this injury type are mainly lacking in the literature and there is no consensus on the management of these injuries. To the best of our knowledge, this is the first report of this kind in the literature including strength measurements pre- and post-operatively. Case report: We report a case of a 48-year-old Caucasian man who suffered a complete rectus femoris mid-substance rupture at physically active work. The injury mechanism was slipping on an asphalt ramp, leading to rapid eccentric contraction of rectus femoris involving knee flexion and hip extension. The rupture was treated surgically and the muscle strength of quadriceps femoris was measured pre- and postoperatively. Conclusion: This case report showed that muscle strength in knee extension recovers well after an operative treatment of complete rectus femoris mid-substance rupture. Therefore, it can be concluded that operative treatment is beneficial for this specific injury type. This case report brings important and objective evidence on the relevance of surgical treatment in these injuries that are mainly lacking the consensus about the best treatment methods. To the best of our knowledge, this case report is also the first one which indirectly shows the value of isolated rectus femoris muscle in the whole quadriceps muscle group.
Language	English
Publishing date	2022-11-11
Publishing country	India
Document type	Case Reports
ZDB-ID	2658169-3
ISSN	2250-0685
ISSN	2250-0685
DOI	10.13107/jocr.2022.v12.i04.2748
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Article ; Online: Long-term blood metal ion levels and clinical outcome after Birmingham hip arthroplasty.

Pietiläinen, Sakari / Lindström, Miro / Laaksonen, Inari / Venäläinen, Mikko S / Lankinen, Petteri / Mäkelä, Keijo T

Scandinavian journal of surgery : SJS : official organ for the Finnish Surgical Society and the Scandinavian Surgical Society

2022 Volume 111, Issue 1, Page(s) 14574969211066197

Abstract: Background and objective: Our aim was to assess long-term metal ion level changes and clinical outcome in patients with a Birmingham hip arthroplasty.: Methods: For the purpose of this study, we identified all BHR hip resurfacing arthroplasty (HRA) ... ...

Abstract	Background and objective: Our aim was to assess long-term metal ion level changes and clinical outcome in patients with a Birmingham hip arthroplasty. Methods: For the purpose of this study, we identified all BHR hip resurfacing arthroplasty (HRA) and total hip arthroplasty (THA) operations performed in Turku University Hospital. A random coefficient model was used to compare the change between the first and last metal ion measurement. A Kaplan-Meier estimator was used to assess the survivorship of the BHR HRA and BHR THA with metal related adverse events (pseudotumor, elevated metal ions above the safe upper limit, revision due to metallosis), or revision due to any reason as endpoints with 95% confidence intervals (CIs). Results: BHR HRA was used in 274 hips (233 patients). In addition, we identified 38 BHR-Synergy THAs (38 patients). Operations were performed between 2003 and 2010. Median follow-up time was 14 years for BHR HRA (range: 0.6-17) and 11 years for BHR THA (range: 4.7-13). In the BHR HRA group, geometric means of Cr and Co levels decreased from 2.1 to 1.6 ppb and 2.4 to 1.5 ppb, respectively, during a 3.0-year measurement interval. Metal ion levels in the BHR THA group did not show notable increase. The survivorship of BHR HRA was 66% in 16 years and 34% for BHR THA at 12 years for any metal-related adverse event. Conclusions: Patients with a Birmingham hip device do not seem to benefit from frequent repeated metal ion measurements. The amount of patients with metal-related adverse events was relatively high, but many of them did not require surgery.
MeSH term(s)	Arthroplasty, Replacement, Hip ; Hip Prosthesis ; Humans ; Ions ; Metal-on-Metal Joint Prostheses/adverse effects ; Prosthesis Design ; Prosthesis Failure ; Reoperation
Chemical Substances	Ions
Language	English
Publishing date	2022-02-15
Publishing country	England
Document type	Journal Article
ZDB-ID	2077691-3
ISSN	1799-7267 ; 1457-4969
ISSN (online)	1799-7267
ISSN	1457-4969
DOI	10.1177/14574969211066197
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Article ; Online: Repeated metal ion measurements and long-term outcome of Durom/MMC total hip arthroplasty.

Pietiläinen, Sakari / Smedberg, Erno / Laaksonen, Inari / Venäläinen, Mikko S / Lankinen, Petteri / Mäkelä, Keijo T

Acta orthopaedica

2022 Volume 93, Page(s) 241–248

Abstract: Background and purpose - Data regarding long-term behavior of metal ion levels in metal-on-metal total hip arthroplasty (MoM THA) patients is scarce. Therefore, we assessed whether there is any change in whole blood (WB) chromium (Cr), and cobalt (Co) ... ...

Abstract	Background and purpose - Data regarding long-term behavior of metal ion levels in metal-on-metal total hip arthroplasty (MoM THA) patients is scarce. Therefore, we assessed whether there is any change in whole blood (WB) chromium (Cr), and cobalt (Co) ion measurements in Durom and MMC MoM THA patients over time. The secondary aim was to report the clinical outcomes using these devices in a single district. Patients and methods - Durom and MMC cups were used in 249 MoM THAs from 2005 to 2011 in our district. Median follow-up time was 12 years for Durom THA (interquartile range [IQR] = 3) and 9 years for MMC THA (IQR = 1). A random coefficient model was used to compare individual differences in repeated WB Cr and Co ion measurements. The Kaplan-Meier estimator was used to analyze implant survival with any reason for revision as the endpoint. Results - Geometric means of Cr in Durom THA and MMC THA patients decreased from 2.2 ppb (geometric standard deviation [SD] = 1.9) to 1.5 ppb (geometric SD = 2.5, p< 0.001) and from 1.8 ppb (geometric SD = 1.8) to 1.1 ppb (geometric SD = 2.8, p = 0.01) respectively. The geometric means of Co values remained unchanged. The 10-year survival of Durom THA was 82%, and that of MMC THA 89% for any revision reason as endpoint. Interpretation - WB Cr levels decreased over time, and Co levels remained unchanged at long-term follow-up. Despite this we recommend continuing the follow-up of these devices due to relatively low implant survival.
MeSH term(s)	Arthroplasty, Replacement, Hip/methods ; Chromium ; Cobalt ; Hip Prosthesis/adverse effects ; Humans ; Metal-on-Metal Joint Prostheses/adverse effects ; Metals ; Prosthesis Design
Chemical Substances	Metals ; Chromium (0R0008Q3JB) ; Cobalt (3G0H8C9362)
Language	English
Publishing date	2022-01-19
Publishing country	Sweden
Document type	Journal Article
ZDB-ID	2180677-9
ISSN	1745-3682 ; 1745-3674
ISSN (online)	1745-3682
ISSN	1745-3674
DOI	10.2340/17453674.2022.1444
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Article: Surface Electric Fields Increase Human Osteoclast Resorption through Improved Wettability on Carbonate-Incorporated Apatite

Bergara-Muguruza, Leire / Mäkelä, Keijo / Yrjälä, Tommi / Salonen, Jukka / Yamashita, Kimihiro / Nakamura, Miho

ACS applied materials & interfaces. 2021 Dec. 03, v. 13, no. 49

2021

Abstract: Osteoclast-mediated bioresorption can be an efficient means of incorporating the dissolution of biomaterials in the bone remodeling process. Because of the compositionally and structurally close resemblance of biomaterials with the natural mineral phases ...

Abstract	Osteoclast-mediated bioresorption can be an efficient means of incorporating the dissolution of biomaterials in the bone remodeling process. Because of the compositionally and structurally close resemblance of biomaterials with the natural mineral phases of the bone matrix, synthetic carbonate-substituted apatite (CA) is considered as an ideal biomaterial for clinical use. The present study therefore investigated the effects of electrical polarization on the surface characteristics and interactions with human osteoclasts of hydroxyapatite (HA) and CA. Electrical polarization was found to improve the surface wettability of these materials by increasing the surface free energy, and this effect was maintained for 1 month. Analyses of human osteoclast cultures established that CA subjected to a polarization treatment enhanced osteoclast resorption but did not affect the early differentiation phase or the adherent morphology of the osteoclasts as evaluated by staining. These data suggest that the surface characteristics of the CA promoted osteoclast resorption. The results of this work are expected to contribute to the future design of cell-mediated bioresorbable biomaterials capable of resorption by osteoclasts and of serving as a scaffold for bone regeneration.
Keywords	Gibbs free energy ; biocompatible materials ; humans ; hydroxyapatite ; osteoclasts ; resorption ; wettability
Language	English
Dates of publication	2021-1203
Size	p. 58270-58278.
Publishing place	American Chemical Society
Document type	Article
ISSN	1944-8252
DOI	10.1021/acsami.1c14358
Database	NAL-Catalogue (AGRICOLA)

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Article ; Online: Surface Electric Fields Increase Human Osteoclast Resorption through Improved Wettability on Carbonate-Incorporated Apatite.

Bergara-Muguruza, Leire / Mäkelä, Keijo / Yrjälä, Tommi / Salonen, Jukka / Yamashita, Kimihiro / Nakamura, Miho

ACS applied materials & interfaces

2021 Volume 13, Issue 49, Page(s) 58270–58278

Abstract	Osteoclast-mediated bioresorption can be an efficient means of incorporating the dissolution of biomaterials in the bone remodeling process. Because of the compositionally and structurally close resemblance of biomaterials with the natural mineral phases of the bone matrix, synthetic carbonate-substituted apatite (CA) is considered as an ideal biomaterial for clinical use. The present study therefore investigated the effects of electrical polarization on the surface characteristics and interactions with human osteoclasts of hydroxyapatite (HA) and CA. Electrical polarization was found to improve the surface wettability of these materials by increasing the surface free energy, and this effect was maintained for 1 month. Analyses of human osteoclast cultures established that CA subjected to a polarization treatment enhanced osteoclast resorption but did not affect the early differentiation phase or the adherent morphology of the osteoclasts as evaluated by staining. These data suggest that the surface characteristics of the CA promoted osteoclast resorption. The results of this work are expected to contribute to the future design of cell-mediated bioresorbable biomaterials capable of resorption by osteoclasts and of serving as a scaffold for bone regeneration.
MeSH term(s)	Apatites/chemistry ; Apatites/metabolism ; Electricity ; Humans ; Materials Testing ; Osteoclasts/chemistry ; Osteoclasts/metabolism ; Surface Properties ; Wettability
Chemical Substances	Apatites ; carboapatite (55326-60-8)
Language	English
Publishing date	2021-12-03
Publishing country	United States
Document type	Journal Article
ISSN	1944-8252
ISSN (online)	1944-8252
DOI	10.1021/acsami.1c14358
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Article ; Online: Novel Biomarkers for Diagnosing Periprosthetic Joint Infection from Synovial Fluid and Serum.

Keemu, Hannes / Vaura, Felix / Maksimow, Anu / Maksimow, Mikael / Jokela, Aleksi / Hollmén, Maija / Mäkelä, Keijo

JB & JS open access

2021 Volume 6, Issue 2

Abstract: Background: Synovial fluid bacterial culture is the cornerstone of confirmation or exclusion of periprosthetic joint infection (PJI). The aim of this study was to assess synovial fluid and serum biomarker patterns of patients with total joint ... ...

Abstract	Background: Synovial fluid bacterial culture is the cornerstone of confirmation or exclusion of periprosthetic joint infection (PJI). The aim of this study was to assess synovial fluid and serum biomarker patterns of patients with total joint arthroplasty (TJA), and the association of these patterns with PJI. Methods: Synovial fluid and serum samples were collected from 35 patients who were admitted to the Arthroplasty Unit of the Department of Orthopaedics and Traumatology at Turku University Hospital. Of the 25 patients who were included in the study, 10 healthy patients with an elective TJA for osteoarthritis served as the control group, and 15 patients who were admitted due to clinical suspicion of PJI with local redness, swelling, wound drainage, pain, and/or fever and who had a positive synovial fluid bacterial culture served as the study group. Logistic regression was used to assess the ability of 37 biomarkers (including cytokines, chemokines, and growth factors) with commercially available tests to detect PJIs. Results: In synovial fluid, the concentrations of sTNF-R1 and sTNF-R2 (soluble tumor necrosis factor receptors 1 and 2) and BAFF (B-cell activating factor, also known as TNFSF13B) were significantly higher in the PJI group (p < 0.002). In serum, the sTNF-R1 concentration was significantly higher in the PJI group, whereas the TWEAK (tumor necrosis factor-like weak inducer of apoptosis) and osteocalcin concentrations were significantly lower (p < 0.002). The sensitivity for detecting PJI using synovial fluid was 1.00 for sTNF-R2, 0.93 for sTNF-R1, and 0.87 for BAFF/TNFSF13B. The specificity of all 3 synovial markers was 1.00. The sensitivity using serum was 0.80 for TWEAK, 0.73 for sTNF-R1, and 0.80 for osteocalcin. The specificity of all 3 serum markers was 1.00. Conclusions: Synovial sTNF-R2 is a promising new biomarker for detecting PJI. We are not aware of any previous reports of the use of sTNF-R2 in PJI diagnosis. More research is needed to assess the clinical importance of our findings. Level of evidence: Diagnostic Level II. See Instructions for Authors for a complete description of levels of evidence.
Language	English
Publishing date	2021-04-20
Publishing country	United States
Document type	Journal Article
ISSN	2472-7245
ISSN (online)	2472-7245
DOI	10.2106/JBJS.OA.20.00067
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