PhD-student: Kristine Bollerup Arndt, MD, Department of Orthopaedic Surgery and traumatology, Odense University Hospital
Supervisor: Martin Lindberg-Larsen. Senior Consultant, PhD, Ass Professor. Orthopaedic research unit. Department of Orthopaedic Surgery and traumatology, Odense University Hospital. Department of Clinical Research, University of Southern Denmark
Co-supervisor: Henrik M Schrøder. Senior Consultant, Ass Professor. Department of Orthopaedic Surgery. Naestved Hospital
Co-supervisor: Anders Troelsen, Senior Consultant, PhD, DMSc, Professor, Department of Orthopaedic Surgery, Copenhagen University Hospital, Hvidovre
Abstract
The hypothesis of this PhD-thesis is that revisions of knee arthroplasties performed on the indication ”pain without loosening” are performed in unsatisfied patients, where no certain knee pathology has been found, hence leading to poorer patient outcome after surgery. The aim of this thesis is to investigate prosthesis survival after revision of knee arthroplasties performed on the indication ”pain without loosening”. Furthermore, to analyze the analgesic consumption of the patients before and after surgery, to evaluate patient reported outcome and to validate the indication. Five studies are planned combining data from the Danish Knee Arthroplasty Register (DKR), the Nordic Arthroplasty Register Association (NARA), the Danish National Patient Register (DNPR), The Danish National Database of Reimbursed Prescriptions (DNDRP), patient records and radiographs. Focus group interviews have been performed in patients scheduled for revision knee arthroplasty surgery to ensure that the specific studies and research questions are relevant also in a patient perspective.
Study 1 will investigate the incidence and survivorship of revisions registered on the indication “pain without loosening” compared with revisions registered on the better established indication “aseptic loosening” nationwide in Denmark.
Study 2 will investigate the use of the various indications for revision including “pain” in the Scandinavian countries by analyzing data from NARA in the two periods 1997-2007 and 2008-2018.
Study 3 will assess the use of opioids and other analgesics one year before and after revision surgery on the indications; “pain without loosening” versus “aseptic loosening”.
Study 4 will evaluate patient reported outcome measurements (PROM’s) using Oxford Knee Score (OKS), EQ-5D and American Knee Society Score (KSS).
Study 5 will analyze patient records and radiographs of patients revised on the indication “pain without loosening”, screen for other possible indications hidden in this category, and hopefully improve the future registration of indications in DKR.