What Are the Frequency, Associated Factors, and Mortality of Amputation and Arthrodesis After a Failed Infected TKA? View Full Text


Ontology type: schema:ScholarlyArticle      Open Access: True


Article Info

DATE

2017-12

AUTHORS

Min-Sun Son, Edmund Lau, Javad Parvizi, Michael A. Mont, Kevin J. Bozic, Steven Kurtz

ABSTRACT

BACKGROUND: For patients with failed surgical treatment of an infected TKA, salvage operations such as arthrodesis or above-knee amputation (AKA) may be considered. Clinical and institutional factors associated with AKA and arthrodesis after a failed TKA have not been investigated in a large-scale population, and the utilization rate and trend of these measures are not well known. QUESTIONS/PURPOSES: (1) How has the frequency of arthrodesis and AKA after infected TKA changed over the last 10 years? (2) What clinical or institutional factors are associated with patients undergoing arthrodesis or AKA? (3) What is the risk of mortality after arthrodesis or AKA? METHODS: The Medicare 100% National Inpatient Claims Database was used to identify 44,466 patients 65 years of age or older who were diagnosed with an infected TKA and who underwent revision between 2005 and 2014 based on International Classification of Diseases, 9th Revision, Clinical Modification codes. Overall, 1182 knee arthrodeses and 1864 AKAs were identified among the study population. One year of data before the index infection-related knee revision were used to examine patient demographic, institutional, and clinical factors, including comorbidities, hospital volumes, and surgeon volumes. We developed Cox regression models to investigate the risk of arthrodesis, AKA, and death as outcomes. In addition, the year of the index revision was included as a covariate to determine if the risk of subsequent surgical interventions was changing over time. The risk of mortality was also assessed as the event of interest using a similar multivariate Cox model for each patient group (arthrodesis, AKA) in addition to those who underwent additional revisions but who did not undergo either of the salvage procedures. RESULTS: The number of arthrodesis (hazard ratio [HR], 0.90, p < 0.001) and amputation (HR, 0.95, p < 0.001) procedures showed a declining trend. Clinical factors associated with arthrodesis included acute renal failure (HR, 1.22 [1.06-1.41], p = 0.006), obesity (HR, 1.58 [1.35-1.84], p < 0.001), and having additional infection-related revisions (HR for 2+ additional revisions, 1.36 [1.13-1.64], p = 0.001). Higher Charlson comorbidity score (HR for a score of 5+ versus 0, 2.56 [2.12-3.14], p < 0.001), obesity (HR, 1.14 [1.00-1.30], p = 0.044), deep vein thrombosis (HR, 1.34 [1.12-1.60], p = 0.001), and additional revisions (HR for 2+ additional revisions, 2.19 [1.91-2.49], p < 0.001) were factors associated with AKA, which in turn was an independent risk factor for mortality. The risk of death increased with amputation after adjusting for age, comorbidities, and other factors (HR, 1.28 [1.20-1.37], p < 0.001), but patients who received arthrodesis did not show a change in mortality compared with the patients who did not receive arthrodesis or amputation (HR, 1.00 [0.91-1.10], p = 0.971). CONCLUSIONS: The findings of this study suggest that clinicians may be more aggressively attempting to preserve the knee even in the face of chronic prosthetic joint infection but also show that a greater number of revisions is associated with a greater risk of subsequent AKA or arthrodesis. The results also suggest that recommending centers with a high volume of joint arthroplasties may be a way to reduce the risk of the salvage procedures. LEVEL OF EVIDENCE: Level III, therapeutic study. More... »

PAGES

2905-2913

References to SciGraph publications

  • 2010-08. Revision Total Knee Arthroplasty Infection: Incidence and Predictors in CLINICAL ORTHOPAEDICS AND RELATED RESEARCH®
  • 2012-01. Reinfection after two-stage revision for periprosthetic infection of total knee arthroplasty in INTERNATIONAL ORTHOPAEDICS
  • 2011-04. Functional Ability After Above-the-knee Amputation for Infected Total Knee Arthroplasty in CLINICAL ORTHOPAEDICS AND RELATED RESEARCH®
  • 2012-10. Better Function for Fusions Versus Above-the-knee Amputations for Recurrent Periprosthetic Knee Infection in CLINICAL ORTHOPAEDICS AND RELATED RESEARCH®
  • 2014-08. Arthrodesis of the knee following failed arthroplasty in KNEE SURGERY, SPORTS TRAUMATOLOGY, ARTHROSCOPY
  • 2010-01. Prosthetic Joint Infection Risk after TKA in the Medicare Population in CLINICAL ORTHOPAEDICS AND RELATED RESEARCH®
  • Identifiers

    URI

    http://scigraph.springernature.com/pub.10.1007/s11999-017-5285-x

    DOI

    http://dx.doi.org/10.1007/s11999-017-5285-x

    DIMENSIONS

    https://app.dimensions.ai/details/publication/pub.1083916472

    PUBMED

    https://www.ncbi.nlm.nih.gov/pubmed/28236080


    Indexing Status Check whether this publication has been indexed by Scopus and Web Of Science using the SN Indexing Status Tool
    Incoming Citations Browse incoming citations for this publication using opencitations.net

    JSON-LD is the canonical representation for SciGraph data.

    TIP: You can open this SciGraph record using an external JSON-LD service: JSON-LD Playground Google SDTT

    [
      {
        "@context": "https://springernature.github.io/scigraph/jsonld/sgcontext.json", 
        "about": [
          {
            "id": "http://purl.org/au-research/vocabulary/anzsrc-for/2008/1103", 
            "inDefinedTermSet": "http://purl.org/au-research/vocabulary/anzsrc-for/2008/", 
            "name": "Clinical Sciences", 
            "type": "DefinedTerm"
          }, 
          {
            "id": "http://purl.org/au-research/vocabulary/anzsrc-for/2008/11", 
            "inDefinedTermSet": "http://purl.org/au-research/vocabulary/anzsrc-for/2008/", 
            "name": "Medical and Health Sciences", 
            "type": "DefinedTerm"
          }, 
          {
            "inDefinedTermSet": "https://www.nlm.nih.gov/mesh/", 
            "name": "Aged", 
            "type": "DefinedTerm"
          }, 
          {
            "inDefinedTermSet": "https://www.nlm.nih.gov/mesh/", 
            "name": "Aged, 80 and over", 
            "type": "DefinedTerm"
          }, 
          {
            "inDefinedTermSet": "https://www.nlm.nih.gov/mesh/", 
            "name": "Amputation", 
            "type": "DefinedTerm"
          }, 
          {
            "inDefinedTermSet": "https://www.nlm.nih.gov/mesh/", 
            "name": "Arthrodesis", 
            "type": "DefinedTerm"
          }, 
          {
            "inDefinedTermSet": "https://www.nlm.nih.gov/mesh/", 
            "name": "Arthroplasty, Replacement, Knee", 
            "type": "DefinedTerm"
          }, 
          {
            "inDefinedTermSet": "https://www.nlm.nih.gov/mesh/", 
            "name": "Data Mining", 
            "type": "DefinedTerm"
          }, 
          {
            "inDefinedTermSet": "https://www.nlm.nih.gov/mesh/", 
            "name": "Databases, Factual", 
            "type": "DefinedTerm"
          }, 
          {
            "inDefinedTermSet": "https://www.nlm.nih.gov/mesh/", 
            "name": "Female", 
            "type": "DefinedTerm"
          }, 
          {
            "inDefinedTermSet": "https://www.nlm.nih.gov/mesh/", 
            "name": "Humans", 
            "type": "DefinedTerm"
          }, 
          {
            "inDefinedTermSet": "https://www.nlm.nih.gov/mesh/", 
            "name": "Knee Joint", 
            "type": "DefinedTerm"
          }, 
          {
            "inDefinedTermSet": "https://www.nlm.nih.gov/mesh/", 
            "name": "Knee Prosthesis", 
            "type": "DefinedTerm"
          }, 
          {
            "inDefinedTermSet": "https://www.nlm.nih.gov/mesh/", 
            "name": "Limb Salvage", 
            "type": "DefinedTerm"
          }, 
          {
            "inDefinedTermSet": "https://www.nlm.nih.gov/mesh/", 
            "name": "Male", 
            "type": "DefinedTerm"
          }, 
          {
            "inDefinedTermSet": "https://www.nlm.nih.gov/mesh/", 
            "name": "Medicare", 
            "type": "DefinedTerm"
          }, 
          {
            "inDefinedTermSet": "https://www.nlm.nih.gov/mesh/", 
            "name": "Practice Patterns, Physicians'", 
            "type": "DefinedTerm"
          }, 
          {
            "inDefinedTermSet": "https://www.nlm.nih.gov/mesh/", 
            "name": "Proportional Hazards Models", 
            "type": "DefinedTerm"
          }, 
          {
            "inDefinedTermSet": "https://www.nlm.nih.gov/mesh/", 
            "name": "Prosthesis-Related Infections", 
            "type": "DefinedTerm"
          }, 
          {
            "inDefinedTermSet": "https://www.nlm.nih.gov/mesh/", 
            "name": "Reoperation", 
            "type": "DefinedTerm"
          }, 
          {
            "inDefinedTermSet": "https://www.nlm.nih.gov/mesh/", 
            "name": "Risk Assessment", 
            "type": "DefinedTerm"
          }, 
          {
            "inDefinedTermSet": "https://www.nlm.nih.gov/mesh/", 
            "name": "Risk Factors", 
            "type": "DefinedTerm"
          }, 
          {
            "inDefinedTermSet": "https://www.nlm.nih.gov/mesh/", 
            "name": "Time Factors", 
            "type": "DefinedTerm"
          }, 
          {
            "inDefinedTermSet": "https://www.nlm.nih.gov/mesh/", 
            "name": "Treatment Outcome", 
            "type": "DefinedTerm"
          }, 
          {
            "inDefinedTermSet": "https://www.nlm.nih.gov/mesh/", 
            "name": "United States", 
            "type": "DefinedTerm"
          }
        ], 
        "author": [
          {
            "affiliation": {
              "alternateName": "Exponent (United States)", 
              "id": "https://www.grid.ac/institutes/grid.418983.f", 
              "name": [
                "Exponent Inc, 149 Commonwealth Drive, 94025, Menlo Park, CA, USA"
              ], 
              "type": "Organization"
            }, 
            "familyName": "Son", 
            "givenName": "Min-Sun", 
            "id": "sg:person.01067254521.03", 
            "sameAs": [
              "https://app.dimensions.ai/discover/publication?and_facet_researcher=ur.01067254521.03"
            ], 
            "type": "Person"
          }, 
          {
            "affiliation": {
              "alternateName": "Exponent (United States)", 
              "id": "https://www.grid.ac/institutes/grid.418983.f", 
              "name": [
                "Exponent Inc, 149 Commonwealth Drive, 94025, Menlo Park, CA, USA"
              ], 
              "type": "Organization"
            }, 
            "familyName": "Lau", 
            "givenName": "Edmund", 
            "id": "sg:person.0637200521.93", 
            "sameAs": [
              "https://app.dimensions.ai/discover/publication?and_facet_researcher=ur.0637200521.93"
            ], 
            "type": "Person"
          }, 
          {
            "affiliation": {
              "alternateName": "Thomas Jefferson University", 
              "id": "https://www.grid.ac/institutes/grid.265008.9", 
              "name": [
                "Rothman Institute at Thomas Jefferson University, Philadelphia, PA, USA"
              ], 
              "type": "Organization"
            }, 
            "familyName": "Parvizi", 
            "givenName": "Javad", 
            "id": "sg:person.01357752371.70", 
            "sameAs": [
              "https://app.dimensions.ai/discover/publication?and_facet_researcher=ur.01357752371.70"
            ], 
            "type": "Person"
          }, 
          {
            "affiliation": {
              "alternateName": "Cleveland Clinic", 
              "id": "https://www.grid.ac/institutes/grid.239578.2", 
              "name": [
                "Cleveland Clinic, Cleveland, OH, USA"
              ], 
              "type": "Organization"
            }, 
            "familyName": "Mont", 
            "givenName": "Michael A.", 
            "id": "sg:person.01154533100.76", 
            "sameAs": [
              "https://app.dimensions.ai/discover/publication?and_facet_researcher=ur.01154533100.76"
            ], 
            "type": "Person"
          }, 
          {
            "affiliation": {
              "alternateName": "The University of Texas at Austin", 
              "id": "https://www.grid.ac/institutes/grid.89336.37", 
              "name": [
                "Dell Medical School at The University of Texas at Austin, Austin, TX, USA"
              ], 
              "type": "Organization"
            }, 
            "familyName": "Bozic", 
            "givenName": "Kevin J.", 
            "id": "sg:person.0657450510.00", 
            "sameAs": [
              "https://app.dimensions.ai/discover/publication?and_facet_researcher=ur.0657450510.00"
            ], 
            "type": "Person"
          }, 
          {
            "affiliation": {
              "name": [
                "Exponent, Inc, Philadelphia, PA, USA"
              ], 
              "type": "Organization"
            }, 
            "familyName": "Kurtz", 
            "givenName": "Steven", 
            "id": "sg:person.015345622677.84", 
            "sameAs": [
              "https://app.dimensions.ai/discover/publication?and_facet_researcher=ur.015345622677.84"
            ], 
            "type": "Person"
          }
        ], 
        "citation": [
          {
            "id": "https://doi.org/10.1302/0301-620x.88b2.17058", 
            "sameAs": [
              "https://app.dimensions.ai/details/publication/pub.1001570017"
            ], 
            "type": "CreativeWork"
          }, 
          {
            "id": "sg:pub.10.1007/s11999-010-1308-6", 
            "sameAs": [
              "https://app.dimensions.ai/details/publication/pub.1002665156", 
              "https://doi.org/10.1007/s11999-010-1308-6"
            ], 
            "type": "CreativeWork"
          }, 
          {
            "id": "https://doi.org/10.1007/s11999-010-1308-6", 
            "sameAs": [
              "https://app.dimensions.ai/details/publication/pub.1002665156"
            ], 
            "type": "CreativeWork"
          }, 
          {
            "id": "sg:pub.10.1007/s00264-011-1267-x", 
            "sameAs": [
              "https://app.dimensions.ai/details/publication/pub.1006302606", 
              "https://doi.org/10.1007/s00264-011-1267-x"
            ], 
            "type": "CreativeWork"
          }, 
          {
            "id": "sg:pub.10.1007/s11999-012-2322-7", 
            "sameAs": [
              "https://app.dimensions.ai/details/publication/pub.1008175045", 
              "https://doi.org/10.1007/s11999-012-2322-7"
            ], 
            "type": "CreativeWork"
          }, 
          {
            "id": "sg:pub.10.1007/s11999-012-2322-7", 
            "sameAs": [
              "https://app.dimensions.ai/details/publication/pub.1008175045", 
              "https://doi.org/10.1007/s11999-012-2322-7"
            ], 
            "type": "CreativeWork"
          }, 
          {
            "id": "https://doi.org/10.1007/s11999-012-2322-7", 
            "sameAs": [
              "https://app.dimensions.ai/details/publication/pub.1008175045"
            ], 
            "type": "CreativeWork"
          }, 
          {
            "id": "https://doi.org/10.1016/j.arth.2015.02.044", 
            "sameAs": [
              "https://app.dimensions.ai/details/publication/pub.1012883300"
            ], 
            "type": "CreativeWork"
          }, 
          {
            "id": "https://doi.org/10.1093/cid/cis803", 
            "sameAs": [
              "https://app.dimensions.ai/details/publication/pub.1019433089"
            ], 
            "type": "CreativeWork"
          }, 
          {
            "id": "https://doi.org/10.1016/j.arth.2016.02.062", 
            "sameAs": [
              "https://app.dimensions.ai/details/publication/pub.1020845557"
            ], 
            "type": "CreativeWork"
          }, 
          {
            "id": "sg:pub.10.1007/s00167-013-2539-3", 
            "sameAs": [
              "https://app.dimensions.ai/details/publication/pub.1029517935", 
              "https://doi.org/10.1007/s00167-013-2539-3"
            ], 
            "type": "CreativeWork"
          }, 
          {
            "id": "sg:pub.10.1007/s11999-010-1577-0", 
            "sameAs": [
              "https://app.dimensions.ai/details/publication/pub.1032386589", 
              "https://doi.org/10.1007/s11999-010-1577-0"
            ], 
            "type": "CreativeWork"
          }, 
          {
            "id": "sg:pub.10.1007/s11999-010-1577-0", 
            "sameAs": [
              "https://app.dimensions.ai/details/publication/pub.1032386589", 
              "https://doi.org/10.1007/s11999-010-1577-0"
            ], 
            "type": "CreativeWork"
          }, 
          {
            "id": "https://doi.org/10.1007/s11999-010-1577-0", 
            "sameAs": [
              "https://app.dimensions.ai/details/publication/pub.1032386589"
            ], 
            "type": "CreativeWork"
          }, 
          {
            "id": "sg:pub.10.1007/s11999-009-1013-5", 
            "sameAs": [
              "https://app.dimensions.ai/details/publication/pub.1034154654", 
              "https://doi.org/10.1007/s11999-009-1013-5"
            ], 
            "type": "CreativeWork"
          }, 
          {
            "id": "https://doi.org/10.1007/s11999-009-1013-5", 
            "sameAs": [
              "https://app.dimensions.ai/details/publication/pub.1034154654"
            ], 
            "type": "CreativeWork"
          }, 
          {
            "id": "https://doi.org/10.1007/s11999-009-1013-5", 
            "sameAs": [
              "https://app.dimensions.ai/details/publication/pub.1034154654"
            ], 
            "type": "CreativeWork"
          }, 
          {
            "id": "https://doi.org/10.1016/j.arth.2016.01.010", 
            "sameAs": [
              "https://app.dimensions.ai/details/publication/pub.1034275594"
            ], 
            "type": "CreativeWork"
          }, 
          {
            "id": "https://doi.org/10.1016/j.arth.2014.11.014", 
            "sameAs": [
              "https://app.dimensions.ai/details/publication/pub.1035280529"
            ], 
            "type": "CreativeWork"
          }, 
          {
            "id": "https://doi.org/10.1007/s11999-009-0945-0", 
            "sameAs": [
              "https://app.dimensions.ai/details/publication/pub.1043129423"
            ], 
            "type": "CreativeWork"
          }, 
          {
            "id": "https://doi.org/10.1007/s11999-009-0945-0", 
            "sameAs": [
              "https://app.dimensions.ai/details/publication/pub.1043129423"
            ], 
            "type": "CreativeWork"
          }, 
          {
            "id": "https://doi.org/10.1007/s11999-009-0945-0", 
            "sameAs": [
              "https://app.dimensions.ai/details/publication/pub.1043129423"
            ], 
            "type": "CreativeWork"
          }, 
          {
            "id": "https://doi.org/10.1097/00003086-198911000-00020", 
            "sameAs": [
              "https://app.dimensions.ai/details/publication/pub.1060163368"
            ], 
            "type": "CreativeWork"
          }, 
          {
            "id": "https://doi.org/10.1097/00003086-198911000-00020", 
            "sameAs": [
              "https://app.dimensions.ai/details/publication/pub.1060163368"
            ], 
            "type": "CreativeWork"
          }, 
          {
            "id": "https://doi.org/10.1097/00003086-198911000-00020", 
            "sameAs": [
              "https://app.dimensions.ai/details/publication/pub.1060163368"
            ], 
            "type": "CreativeWork"
          }, 
          {
            "id": "https://doi.org/10.1097/00003086-198911000-00020", 
            "sameAs": [
              "https://app.dimensions.ai/details/publication/pub.1060163368"
            ], 
            "type": "CreativeWork"
          }, 
          {
            "id": "https://doi.org/10.1097/00003086-199402000-00025", 
            "sameAs": [
              "https://app.dimensions.ai/details/publication/pub.1060165551"
            ], 
            "type": "CreativeWork"
          }, 
          {
            "id": "https://doi.org/10.1097/00003086-199402000-00025", 
            "sameAs": [
              "https://app.dimensions.ai/details/publication/pub.1060165551"
            ], 
            "type": "CreativeWork"
          }, 
          {
            "id": "https://doi.org/10.1097/00003086-199402000-00025", 
            "sameAs": [
              "https://app.dimensions.ai/details/publication/pub.1060165551"
            ], 
            "type": "CreativeWork"
          }, 
          {
            "id": "https://doi.org/10.1097/00003086-200111000-00003", 
            "sameAs": [
              "https://app.dimensions.ai/details/publication/pub.1060168938"
            ], 
            "type": "CreativeWork"
          }, 
          {
            "id": "https://doi.org/10.1097/00003086-200111000-00003", 
            "sameAs": [
              "https://app.dimensions.ai/details/publication/pub.1060168938"
            ], 
            "type": "CreativeWork"
          }, 
          {
            "id": "https://doi.org/10.1097/00003086-200111000-00003", 
            "sameAs": [
              "https://app.dimensions.ai/details/publication/pub.1060168938"
            ], 
            "type": "CreativeWork"
          }, 
          {
            "id": "https://doi.org/10.2106/00004623-200306000-00003", 
            "sameAs": [
              "https://app.dimensions.ai/details/publication/pub.1068895631"
            ], 
            "type": "CreativeWork"
          }, 
          {
            "id": "https://doi.org/10.2106/00004623-200606000-00009", 
            "sameAs": [
              "https://app.dimensions.ai/details/publication/pub.1068897314"
            ], 
            "type": "CreativeWork"
          }, 
          {
            "id": "https://doi.org/10.2106/00004623-200706000-00010", 
            "sameAs": [
              "https://app.dimensions.ai/details/publication/pub.1068897861"
            ], 
            "type": "CreativeWork"
          }, 
          {
            "id": "https://doi.org/10.2106/jbjs.i.01477", 
            "sameAs": [
              "https://app.dimensions.ai/details/publication/pub.1068901871"
            ], 
            "type": "CreativeWork"
          }, 
          {
            "id": "https://doi.org/10.2106/jbjs.i.01477", 
            "sameAs": [
              "https://app.dimensions.ai/details/publication/pub.1068901871"
            ], 
            "type": "CreativeWork"
          }, 
          {
            "id": "https://doi.org/10.2106/jbjs.i.01477", 
            "sameAs": [
              "https://app.dimensions.ai/details/publication/pub.1068901871"
            ], 
            "type": "CreativeWork"
          }, 
          {
            "id": "https://doi.org/10.2106/jbjs.l.00520", 
            "sameAs": [
              "https://app.dimensions.ai/details/publication/pub.1068903145"
            ], 
            "type": "CreativeWork"
          }, 
          {
            "id": "https://doi.org/10.2106/jbjs.l.00520", 
            "sameAs": [
              "https://app.dimensions.ai/details/publication/pub.1068903145"
            ], 
            "type": "CreativeWork"
          }, 
          {
            "id": "https://doi.org/10.2106/jbjs.l.00520", 
            "sameAs": [
              "https://app.dimensions.ai/details/publication/pub.1068903145"
            ], 
            "type": "CreativeWork"
          }, 
          {
            "id": "https://doi.org/10.2106/jbjs.n.00834", 
            "sameAs": [
              "https://app.dimensions.ai/details/publication/pub.1068903882"
            ], 
            "type": "CreativeWork"
          }, 
          {
            "id": "https://doi.org/10.2106/jbjs.n.00834", 
            "sameAs": [
              "https://app.dimensions.ai/details/publication/pub.1068903882"
            ], 
            "type": "CreativeWork"
          }, 
          {
            "id": "https://doi.org/10.2106/jbjs.n.00834", 
            "sameAs": [
              "https://app.dimensions.ai/details/publication/pub.1068903882"
            ], 
            "type": "CreativeWork"
          }, 
          {
            "id": "https://doi.org/10.3928/01477447-20100722-42", 
            "sameAs": [
              "https://app.dimensions.ai/details/publication/pub.1071720534"
            ], 
            "type": "CreativeWork"
          }, 
          {
            "id": "https://doi.org/10.3928/01477447-20100722-42", 
            "sameAs": [
              "https://app.dimensions.ai/details/publication/pub.1071720534"
            ], 
            "type": "CreativeWork"
          }
        ], 
        "datePublished": "2017-12", 
        "datePublishedReg": "2017-12-01", 
        "description": "BACKGROUND: For patients with failed surgical treatment of an infected TKA, salvage operations such as arthrodesis or above-knee amputation (AKA) may be considered. Clinical and institutional factors associated with AKA and arthrodesis after a failed TKA have not been investigated in a large-scale population, and the utilization rate and trend of these measures are not well known.\nQUESTIONS/PURPOSES: (1) How has the frequency of arthrodesis and AKA after infected TKA changed over the last 10 years? (2) What clinical or institutional factors are associated with patients undergoing arthrodesis or AKA? (3) What is the risk of mortality after arthrodesis or AKA?\nMETHODS: The Medicare 100% National Inpatient Claims Database was used to identify 44,466 patients 65 years of age or older who were diagnosed with an infected TKA and who underwent revision between 2005 and 2014 based on International Classification of Diseases, 9th Revision, Clinical Modification codes. Overall, 1182 knee arthrodeses and 1864 AKAs were identified among the study population. One year of data before the index infection-related knee revision were used to examine patient demographic, institutional, and clinical factors, including comorbidities, hospital volumes, and surgeon volumes. We developed Cox regression models to investigate the risk of arthrodesis, AKA, and death as outcomes. In addition, the year of the index revision was included as a covariate to determine if the risk of subsequent surgical interventions was changing over time. The risk of mortality was also assessed as the event of interest using a similar multivariate Cox model for each patient group (arthrodesis, AKA) in addition to those who underwent additional revisions but who did not undergo either of the salvage procedures.\nRESULTS: The number of arthrodesis (hazard ratio [HR], 0.90, p < 0.001) and amputation (HR, 0.95, p < 0.001) procedures showed a declining trend. Clinical factors associated with arthrodesis included acute renal failure (HR, 1.22 [1.06-1.41], p = 0.006), obesity (HR, 1.58 [1.35-1.84], p < 0.001), and having additional infection-related revisions (HR for 2+ additional revisions, 1.36 [1.13-1.64], p = 0.001). Higher Charlson comorbidity score (HR for a score of 5+ versus 0, 2.56 [2.12-3.14], p < 0.001), obesity (HR, 1.14 [1.00-1.30], p = 0.044), deep vein thrombosis (HR, 1.34 [1.12-1.60], p = 0.001), and additional revisions (HR for 2+ additional revisions, 2.19 [1.91-2.49], p < 0.001) were factors associated with AKA, which in turn was an independent risk factor for mortality. The risk of death increased with amputation after adjusting for age, comorbidities, and other factors (HR, 1.28 [1.20-1.37], p < 0.001), but patients who received arthrodesis did not show a change in mortality compared with the patients who did not receive arthrodesis or amputation (HR, 1.00 [0.91-1.10], p = 0.971).\nCONCLUSIONS: The findings of this study suggest that clinicians may be more aggressively attempting to preserve the knee even in the face of chronic prosthetic joint infection but also show that a greater number of revisions is associated with a greater risk of subsequent AKA or arthrodesis. The results also suggest that recommending centers with a high volume of joint arthroplasties may be a way to reduce the risk of the salvage procedures.\nLEVEL OF EVIDENCE: Level III, therapeutic study.", 
        "genre": "research_article", 
        "id": "sg:pub.10.1007/s11999-017-5285-x", 
        "inLanguage": [
          "en"
        ], 
        "isAccessibleForFree": true, 
        "isPartOf": [
          {
            "id": "sg:journal.1007212", 
            "issn": [
              "0009-921X", 
              "1528-1132"
            ], 
            "name": "Clinical Orthopaedics and Related Research\u00ae", 
            "type": "Periodical"
          }, 
          {
            "issueNumber": "12", 
            "type": "PublicationIssue"
          }, 
          {
            "type": "PublicationVolume", 
            "volumeNumber": "475"
          }
        ], 
        "name": "What Are the Frequency, Associated Factors, and Mortality of Amputation and Arthrodesis After a Failed Infected TKA?", 
        "pagination": "2905-2913", 
        "productId": [
          {
            "name": "readcube_id", 
            "type": "PropertyValue", 
            "value": [
              "ec23dd62a8fdebc1350473fec6ec2456e230bbd92232a87097663fc616072059"
            ]
          }, 
          {
            "name": "pubmed_id", 
            "type": "PropertyValue", 
            "value": [
              "28236080"
            ]
          }, 
          {
            "name": "nlm_unique_id", 
            "type": "PropertyValue", 
            "value": [
              "0075674"
            ]
          }, 
          {
            "name": "doi", 
            "type": "PropertyValue", 
            "value": [
              "10.1007/s11999-017-5285-x"
            ]
          }, 
          {
            "name": "dimensions_id", 
            "type": "PropertyValue", 
            "value": [
              "pub.1083916472"
            ]
          }
        ], 
        "sameAs": [
          "https://doi.org/10.1007/s11999-017-5285-x", 
          "https://app.dimensions.ai/details/publication/pub.1083916472"
        ], 
        "sdDataset": "articles", 
        "sdDatePublished": "2019-04-11T10:32", 
        "sdLicense": "https://scigraph.springernature.com/explorer/license/", 
        "sdPublisher": {
          "name": "Springer Nature - SN SciGraph project", 
          "type": "Organization"
        }, 
        "sdSource": "s3://com-uberresearch-data-dimensions-target-20181106-alternative/cleanup/v134/2549eaecd7973599484d7c17b260dba0a4ecb94b/merge/v9/a6c9fde33151104705d4d7ff012ea9563521a3ce/jats-lookup/v90/0000000349_0000000349/records_113655_00000004.jsonl", 
        "type": "ScholarlyArticle", 
        "url": "https://link.springer.com/10.1007%2Fs11999-017-5285-x"
      }
    ]
     

    Download the RDF metadata as:  json-ld nt turtle xml License info

    HOW TO GET THIS DATA PROGRAMMATICALLY:

    JSON-LD is a popular format for linked data which is fully compatible with JSON.

    curl -H 'Accept: application/ld+json' 'https://scigraph.springernature.com/pub.10.1007/s11999-017-5285-x'

    N-Triples is a line-based linked data format ideal for batch operations.

    curl -H 'Accept: application/n-triples' 'https://scigraph.springernature.com/pub.10.1007/s11999-017-5285-x'

    Turtle is a human-readable linked data format.

    curl -H 'Accept: text/turtle' 'https://scigraph.springernature.com/pub.10.1007/s11999-017-5285-x'

    RDF/XML is a standard XML format for linked data.

    curl -H 'Accept: application/rdf+xml' 'https://scigraph.springernature.com/pub.10.1007/s11999-017-5285-x'


     

    This table displays all metadata directly associated to this object as RDF triples.

    294 TRIPLES      21 PREDICATES      79 URIs      44 LITERALS      32 BLANK NODES

    Subject Predicate Object
    1 sg:pub.10.1007/s11999-017-5285-x schema:about N029a19edc0de467bba2a32fb87d852fd
    2 N0a38826eb4be486b9242d8dba15ea3e2
    3 N1f82729cb36b4b36af7c33c86024c3c6
    4 N2790e97bdad3481882a846778ade749a
    5 N3e2e2c42bb9b4558b332e628ed4af9cd
    6 N477c3a8def4d43038ab40b4fb60faa42
    7 N568c561a998c4c0db03def252ab407c0
    8 N5dc5fe35bf2a47e4bc31ef081b80d42f
    9 N5e9289ae3e4d4602ae59deb40f4f488e
    10 N614b2a46be7545d5a0bcc0526f9b7979
    11 N659dc9d9fa464206ac7f270f674eb266
    12 N6fac1ee1796242a198b02a5456a8d9cc
    13 N765dd209422743049144b63e02cdd6e2
    14 N80f74e60ba304ae1a77b937cf2881662
    15 N9f74e85860aa460fb0d35e07443f1eec
    16 Na88404ef90a34665b2c16e23a66628be
    17 Naa083bc60d054f9e9a7c5b492846a09a
    18 Nd1becd8db188475ea3217d7f089f287b
    19 Nd7fc5f641a79401682c34c6784a71618
    20 Ned106d112b6f4abf8d5bf6b63af6a5a6
    21 Nf246af04cd48490da8683c1e509c52c5
    22 Nf6e2effbc3ea4dcf91f205dffbf8777a
    23 Nfb47c1a70f6b4ee38caf480e7d2b9945
    24 anzsrc-for:11
    25 anzsrc-for:1103
    26 schema:author Nab8779ad2f5c4f40b0f002319110b005
    27 schema:citation sg:pub.10.1007/s00167-013-2539-3
    28 sg:pub.10.1007/s00264-011-1267-x
    29 sg:pub.10.1007/s11999-009-1013-5
    30 sg:pub.10.1007/s11999-010-1308-6
    31 sg:pub.10.1007/s11999-010-1577-0
    32 sg:pub.10.1007/s11999-012-2322-7
    33 https://doi.org/10.1007/s11999-009-0945-0
    34 https://doi.org/10.1007/s11999-009-1013-5
    35 https://doi.org/10.1007/s11999-010-1308-6
    36 https://doi.org/10.1007/s11999-010-1577-0
    37 https://doi.org/10.1007/s11999-012-2322-7
    38 https://doi.org/10.1016/j.arth.2014.11.014
    39 https://doi.org/10.1016/j.arth.2015.02.044
    40 https://doi.org/10.1016/j.arth.2016.01.010
    41 https://doi.org/10.1016/j.arth.2016.02.062
    42 https://doi.org/10.1093/cid/cis803
    43 https://doi.org/10.1097/00003086-198911000-00020
    44 https://doi.org/10.1097/00003086-199402000-00025
    45 https://doi.org/10.1097/00003086-200111000-00003
    46 https://doi.org/10.1302/0301-620x.88b2.17058
    47 https://doi.org/10.2106/00004623-200306000-00003
    48 https://doi.org/10.2106/00004623-200606000-00009
    49 https://doi.org/10.2106/00004623-200706000-00010
    50 https://doi.org/10.2106/jbjs.i.01477
    51 https://doi.org/10.2106/jbjs.l.00520
    52 https://doi.org/10.2106/jbjs.n.00834
    53 https://doi.org/10.3928/01477447-20100722-42
    54 schema:datePublished 2017-12
    55 schema:datePublishedReg 2017-12-01
    56 schema:description BACKGROUND: For patients with failed surgical treatment of an infected TKA, salvage operations such as arthrodesis or above-knee amputation (AKA) may be considered. Clinical and institutional factors associated with AKA and arthrodesis after a failed TKA have not been investigated in a large-scale population, and the utilization rate and trend of these measures are not well known. QUESTIONS/PURPOSES: (1) How has the frequency of arthrodesis and AKA after infected TKA changed over the last 10 years? (2) What clinical or institutional factors are associated with patients undergoing arthrodesis or AKA? (3) What is the risk of mortality after arthrodesis or AKA? METHODS: The Medicare 100% National Inpatient Claims Database was used to identify 44,466 patients 65 years of age or older who were diagnosed with an infected TKA and who underwent revision between 2005 and 2014 based on International Classification of Diseases, 9th Revision, Clinical Modification codes. Overall, 1182 knee arthrodeses and 1864 AKAs were identified among the study population. One year of data before the index infection-related knee revision were used to examine patient demographic, institutional, and clinical factors, including comorbidities, hospital volumes, and surgeon volumes. We developed Cox regression models to investigate the risk of arthrodesis, AKA, and death as outcomes. In addition, the year of the index revision was included as a covariate to determine if the risk of subsequent surgical interventions was changing over time. The risk of mortality was also assessed as the event of interest using a similar multivariate Cox model for each patient group (arthrodesis, AKA) in addition to those who underwent additional revisions but who did not undergo either of the salvage procedures. RESULTS: The number of arthrodesis (hazard ratio [HR], 0.90, p < 0.001) and amputation (HR, 0.95, p < 0.001) procedures showed a declining trend. Clinical factors associated with arthrodesis included acute renal failure (HR, 1.22 [1.06-1.41], p = 0.006), obesity (HR, 1.58 [1.35-1.84], p < 0.001), and having additional infection-related revisions (HR for 2+ additional revisions, 1.36 [1.13-1.64], p = 0.001). Higher Charlson comorbidity score (HR for a score of 5+ versus 0, 2.56 [2.12-3.14], p < 0.001), obesity (HR, 1.14 [1.00-1.30], p = 0.044), deep vein thrombosis (HR, 1.34 [1.12-1.60], p = 0.001), and additional revisions (HR for 2+ additional revisions, 2.19 [1.91-2.49], p < 0.001) were factors associated with AKA, which in turn was an independent risk factor for mortality. The risk of death increased with amputation after adjusting for age, comorbidities, and other factors (HR, 1.28 [1.20-1.37], p < 0.001), but patients who received arthrodesis did not show a change in mortality compared with the patients who did not receive arthrodesis or amputation (HR, 1.00 [0.91-1.10], p = 0.971). CONCLUSIONS: The findings of this study suggest that clinicians may be more aggressively attempting to preserve the knee even in the face of chronic prosthetic joint infection but also show that a greater number of revisions is associated with a greater risk of subsequent AKA or arthrodesis. The results also suggest that recommending centers with a high volume of joint arthroplasties may be a way to reduce the risk of the salvage procedures. LEVEL OF EVIDENCE: Level III, therapeutic study.
    57 schema:genre research_article
    58 schema:inLanguage en
    59 schema:isAccessibleForFree true
    60 schema:isPartOf N45e4cc4d38624f0bbe81a604a33ad806
    61 Nd4710237db204341b2a7847cb3a7e1a0
    62 sg:journal.1007212
    63 schema:name What Are the Frequency, Associated Factors, and Mortality of Amputation and Arthrodesis After a Failed Infected TKA?
    64 schema:pagination 2905-2913
    65 schema:productId N45016004daaa4b93b8eca4c08f52c1f3
    66 N50395eff9c6243c2841b3288f00aeb9e
    67 N7bd06dea3c8f49ab8c25974442031ae1
    68 N930a91f14e564026be7b83b63107d132
    69 Nc2404efe29394c50a5f0ee60bdc23367
    70 schema:sameAs https://app.dimensions.ai/details/publication/pub.1083916472
    71 https://doi.org/10.1007/s11999-017-5285-x
    72 schema:sdDatePublished 2019-04-11T10:32
    73 schema:sdLicense https://scigraph.springernature.com/explorer/license/
    74 schema:sdPublisher Nc258915ef7044de2a9474cd1bc56209a
    75 schema:url https://link.springer.com/10.1007%2Fs11999-017-5285-x
    76 sgo:license sg:explorer/license/
    77 sgo:sdDataset articles
    78 rdf:type schema:ScholarlyArticle
    79 N029a19edc0de467bba2a32fb87d852fd schema:inDefinedTermSet https://www.nlm.nih.gov/mesh/
    80 schema:name Treatment Outcome
    81 rdf:type schema:DefinedTerm
    82 N0a38826eb4be486b9242d8dba15ea3e2 schema:inDefinedTermSet https://www.nlm.nih.gov/mesh/
    83 schema:name Female
    84 rdf:type schema:DefinedTerm
    85 N0c13cf0c0ae04af0917ac4aba9403762 rdf:first sg:person.01154533100.76
    86 rdf:rest N17f62778d26040fe8a23caa4a8278434
    87 N17f62778d26040fe8a23caa4a8278434 rdf:first sg:person.0657450510.00
    88 rdf:rest Nc9f3447f752e4301a14521d5aed58ec0
    89 N1f82729cb36b4b36af7c33c86024c3c6 schema:inDefinedTermSet https://www.nlm.nih.gov/mesh/
    90 schema:name Limb Salvage
    91 rdf:type schema:DefinedTerm
    92 N2790e97bdad3481882a846778ade749a schema:inDefinedTermSet https://www.nlm.nih.gov/mesh/
    93 schema:name Humans
    94 rdf:type schema:DefinedTerm
    95 N3e2e2c42bb9b4558b332e628ed4af9cd schema:inDefinedTermSet https://www.nlm.nih.gov/mesh/
    96 schema:name Databases, Factual
    97 rdf:type schema:DefinedTerm
    98 N45016004daaa4b93b8eca4c08f52c1f3 schema:name pubmed_id
    99 schema:value 28236080
    100 rdf:type schema:PropertyValue
    101 N45e4cc4d38624f0bbe81a604a33ad806 schema:volumeNumber 475
    102 rdf:type schema:PublicationVolume
    103 N477c3a8def4d43038ab40b4fb60faa42 schema:inDefinedTermSet https://www.nlm.nih.gov/mesh/
    104 schema:name Risk Assessment
    105 rdf:type schema:DefinedTerm
    106 N50395eff9c6243c2841b3288f00aeb9e schema:name dimensions_id
    107 schema:value pub.1083916472
    108 rdf:type schema:PropertyValue
    109 N5205b09d05f64bb3bfd231419edaf26b rdf:first sg:person.0637200521.93
    110 rdf:rest Nacc1693483ed4099a790ab87a31dc763
    111 N568c561a998c4c0db03def252ab407c0 schema:inDefinedTermSet https://www.nlm.nih.gov/mesh/
    112 schema:name Proportional Hazards Models
    113 rdf:type schema:DefinedTerm
    114 N5dc5fe35bf2a47e4bc31ef081b80d42f schema:inDefinedTermSet https://www.nlm.nih.gov/mesh/
    115 schema:name Male
    116 rdf:type schema:DefinedTerm
    117 N5e9289ae3e4d4602ae59deb40f4f488e schema:inDefinedTermSet https://www.nlm.nih.gov/mesh/
    118 schema:name Medicare
    119 rdf:type schema:DefinedTerm
    120 N614b2a46be7545d5a0bcc0526f9b7979 schema:inDefinedTermSet https://www.nlm.nih.gov/mesh/
    121 schema:name Aged, 80 and over
    122 rdf:type schema:DefinedTerm
    123 N659dc9d9fa464206ac7f270f674eb266 schema:inDefinedTermSet https://www.nlm.nih.gov/mesh/
    124 schema:name Knee Joint
    125 rdf:type schema:DefinedTerm
    126 N6fac1ee1796242a198b02a5456a8d9cc schema:inDefinedTermSet https://www.nlm.nih.gov/mesh/
    127 schema:name Arthrodesis
    128 rdf:type schema:DefinedTerm
    129 N765dd209422743049144b63e02cdd6e2 schema:inDefinedTermSet https://www.nlm.nih.gov/mesh/
    130 schema:name Aged
    131 rdf:type schema:DefinedTerm
    132 N7bd06dea3c8f49ab8c25974442031ae1 schema:name nlm_unique_id
    133 schema:value 0075674
    134 rdf:type schema:PropertyValue
    135 N80f74e60ba304ae1a77b937cf2881662 schema:inDefinedTermSet https://www.nlm.nih.gov/mesh/
    136 schema:name Practice Patterns, Physicians'
    137 rdf:type schema:DefinedTerm
    138 N930a91f14e564026be7b83b63107d132 schema:name readcube_id
    139 schema:value ec23dd62a8fdebc1350473fec6ec2456e230bbd92232a87097663fc616072059
    140 rdf:type schema:PropertyValue
    141 N9f74e85860aa460fb0d35e07443f1eec schema:inDefinedTermSet https://www.nlm.nih.gov/mesh/
    142 schema:name Reoperation
    143 rdf:type schema:DefinedTerm
    144 Na88404ef90a34665b2c16e23a66628be schema:inDefinedTermSet https://www.nlm.nih.gov/mesh/
    145 schema:name Arthroplasty, Replacement, Knee
    146 rdf:type schema:DefinedTerm
    147 Naa083bc60d054f9e9a7c5b492846a09a schema:inDefinedTermSet https://www.nlm.nih.gov/mesh/
    148 schema:name Time Factors
    149 rdf:type schema:DefinedTerm
    150 Nab8779ad2f5c4f40b0f002319110b005 rdf:first sg:person.01067254521.03
    151 rdf:rest N5205b09d05f64bb3bfd231419edaf26b
    152 Nacc1693483ed4099a790ab87a31dc763 rdf:first sg:person.01357752371.70
    153 rdf:rest N0c13cf0c0ae04af0917ac4aba9403762
    154 Nc2404efe29394c50a5f0ee60bdc23367 schema:name doi
    155 schema:value 10.1007/s11999-017-5285-x
    156 rdf:type schema:PropertyValue
    157 Nc258915ef7044de2a9474cd1bc56209a schema:name Springer Nature - SN SciGraph project
    158 rdf:type schema:Organization
    159 Nc9f3447f752e4301a14521d5aed58ec0 rdf:first sg:person.015345622677.84
    160 rdf:rest rdf:nil
    161 Nd1becd8db188475ea3217d7f089f287b schema:inDefinedTermSet https://www.nlm.nih.gov/mesh/
    162 schema:name Knee Prosthesis
    163 rdf:type schema:DefinedTerm
    164 Nd4710237db204341b2a7847cb3a7e1a0 schema:issueNumber 12
    165 rdf:type schema:PublicationIssue
    166 Nd7fc5f641a79401682c34c6784a71618 schema:inDefinedTermSet https://www.nlm.nih.gov/mesh/
    167 schema:name Prosthesis-Related Infections
    168 rdf:type schema:DefinedTerm
    169 Ned106d112b6f4abf8d5bf6b63af6a5a6 schema:inDefinedTermSet https://www.nlm.nih.gov/mesh/
    170 schema:name Data Mining
    171 rdf:type schema:DefinedTerm
    172 Nf1f7e91e82bc43f485ff5a7a48f7e218 schema:name Exponent, Inc, Philadelphia, PA, USA
    173 rdf:type schema:Organization
    174 Nf246af04cd48490da8683c1e509c52c5 schema:inDefinedTermSet https://www.nlm.nih.gov/mesh/
    175 schema:name Risk Factors
    176 rdf:type schema:DefinedTerm
    177 Nf6e2effbc3ea4dcf91f205dffbf8777a schema:inDefinedTermSet https://www.nlm.nih.gov/mesh/
    178 schema:name Amputation
    179 rdf:type schema:DefinedTerm
    180 Nfb47c1a70f6b4ee38caf480e7d2b9945 schema:inDefinedTermSet https://www.nlm.nih.gov/mesh/
    181 schema:name United States
    182 rdf:type schema:DefinedTerm
    183 anzsrc-for:11 schema:inDefinedTermSet anzsrc-for:
    184 schema:name Medical and Health Sciences
    185 rdf:type schema:DefinedTerm
    186 anzsrc-for:1103 schema:inDefinedTermSet anzsrc-for:
    187 schema:name Clinical Sciences
    188 rdf:type schema:DefinedTerm
    189 sg:journal.1007212 schema:issn 0009-921X
    190 1528-1132
    191 schema:name Clinical Orthopaedics and Related Research®
    192 rdf:type schema:Periodical
    193 sg:person.01067254521.03 schema:affiliation https://www.grid.ac/institutes/grid.418983.f
    194 schema:familyName Son
    195 schema:givenName Min-Sun
    196 schema:sameAs https://app.dimensions.ai/discover/publication?and_facet_researcher=ur.01067254521.03
    197 rdf:type schema:Person
    198 sg:person.01154533100.76 schema:affiliation https://www.grid.ac/institutes/grid.239578.2
    199 schema:familyName Mont
    200 schema:givenName Michael A.
    201 schema:sameAs https://app.dimensions.ai/discover/publication?and_facet_researcher=ur.01154533100.76
    202 rdf:type schema:Person
    203 sg:person.01357752371.70 schema:affiliation https://www.grid.ac/institutes/grid.265008.9
    204 schema:familyName Parvizi
    205 schema:givenName Javad
    206 schema:sameAs https://app.dimensions.ai/discover/publication?and_facet_researcher=ur.01357752371.70
    207 rdf:type schema:Person
    208 sg:person.015345622677.84 schema:affiliation Nf1f7e91e82bc43f485ff5a7a48f7e218
    209 schema:familyName Kurtz
    210 schema:givenName Steven
    211 schema:sameAs https://app.dimensions.ai/discover/publication?and_facet_researcher=ur.015345622677.84
    212 rdf:type schema:Person
    213 sg:person.0637200521.93 schema:affiliation https://www.grid.ac/institutes/grid.418983.f
    214 schema:familyName Lau
    215 schema:givenName Edmund
    216 schema:sameAs https://app.dimensions.ai/discover/publication?and_facet_researcher=ur.0637200521.93
    217 rdf:type schema:Person
    218 sg:person.0657450510.00 schema:affiliation https://www.grid.ac/institutes/grid.89336.37
    219 schema:familyName Bozic
    220 schema:givenName Kevin J.
    221 schema:sameAs https://app.dimensions.ai/discover/publication?and_facet_researcher=ur.0657450510.00
    222 rdf:type schema:Person
    223 sg:pub.10.1007/s00167-013-2539-3 schema:sameAs https://app.dimensions.ai/details/publication/pub.1029517935
    224 https://doi.org/10.1007/s00167-013-2539-3
    225 rdf:type schema:CreativeWork
    226 sg:pub.10.1007/s00264-011-1267-x schema:sameAs https://app.dimensions.ai/details/publication/pub.1006302606
    227 https://doi.org/10.1007/s00264-011-1267-x
    228 rdf:type schema:CreativeWork
    229 sg:pub.10.1007/s11999-009-1013-5 schema:sameAs https://app.dimensions.ai/details/publication/pub.1034154654
    230 https://doi.org/10.1007/s11999-009-1013-5
    231 rdf:type schema:CreativeWork
    232 sg:pub.10.1007/s11999-010-1308-6 schema:sameAs https://app.dimensions.ai/details/publication/pub.1002665156
    233 https://doi.org/10.1007/s11999-010-1308-6
    234 rdf:type schema:CreativeWork
    235 sg:pub.10.1007/s11999-010-1577-0 schema:sameAs https://app.dimensions.ai/details/publication/pub.1032386589
    236 https://doi.org/10.1007/s11999-010-1577-0
    237 rdf:type schema:CreativeWork
    238 sg:pub.10.1007/s11999-012-2322-7 schema:sameAs https://app.dimensions.ai/details/publication/pub.1008175045
    239 https://doi.org/10.1007/s11999-012-2322-7
    240 rdf:type schema:CreativeWork
    241 https://doi.org/10.1007/s11999-009-0945-0 schema:sameAs https://app.dimensions.ai/details/publication/pub.1043129423
    242 rdf:type schema:CreativeWork
    243 https://doi.org/10.1007/s11999-009-1013-5 schema:sameAs https://app.dimensions.ai/details/publication/pub.1034154654
    244 rdf:type schema:CreativeWork
    245 https://doi.org/10.1007/s11999-010-1308-6 schema:sameAs https://app.dimensions.ai/details/publication/pub.1002665156
    246 rdf:type schema:CreativeWork
    247 https://doi.org/10.1007/s11999-010-1577-0 schema:sameAs https://app.dimensions.ai/details/publication/pub.1032386589
    248 rdf:type schema:CreativeWork
    249 https://doi.org/10.1007/s11999-012-2322-7 schema:sameAs https://app.dimensions.ai/details/publication/pub.1008175045
    250 rdf:type schema:CreativeWork
    251 https://doi.org/10.1016/j.arth.2014.11.014 schema:sameAs https://app.dimensions.ai/details/publication/pub.1035280529
    252 rdf:type schema:CreativeWork
    253 https://doi.org/10.1016/j.arth.2015.02.044 schema:sameAs https://app.dimensions.ai/details/publication/pub.1012883300
    254 rdf:type schema:CreativeWork
    255 https://doi.org/10.1016/j.arth.2016.01.010 schema:sameAs https://app.dimensions.ai/details/publication/pub.1034275594
    256 rdf:type schema:CreativeWork
    257 https://doi.org/10.1016/j.arth.2016.02.062 schema:sameAs https://app.dimensions.ai/details/publication/pub.1020845557
    258 rdf:type schema:CreativeWork
    259 https://doi.org/10.1093/cid/cis803 schema:sameAs https://app.dimensions.ai/details/publication/pub.1019433089
    260 rdf:type schema:CreativeWork
    261 https://doi.org/10.1097/00003086-198911000-00020 schema:sameAs https://app.dimensions.ai/details/publication/pub.1060163368
    262 rdf:type schema:CreativeWork
    263 https://doi.org/10.1097/00003086-199402000-00025 schema:sameAs https://app.dimensions.ai/details/publication/pub.1060165551
    264 rdf:type schema:CreativeWork
    265 https://doi.org/10.1097/00003086-200111000-00003 schema:sameAs https://app.dimensions.ai/details/publication/pub.1060168938
    266 rdf:type schema:CreativeWork
    267 https://doi.org/10.1302/0301-620x.88b2.17058 schema:sameAs https://app.dimensions.ai/details/publication/pub.1001570017
    268 rdf:type schema:CreativeWork
    269 https://doi.org/10.2106/00004623-200306000-00003 schema:sameAs https://app.dimensions.ai/details/publication/pub.1068895631
    270 rdf:type schema:CreativeWork
    271 https://doi.org/10.2106/00004623-200606000-00009 schema:sameAs https://app.dimensions.ai/details/publication/pub.1068897314
    272 rdf:type schema:CreativeWork
    273 https://doi.org/10.2106/00004623-200706000-00010 schema:sameAs https://app.dimensions.ai/details/publication/pub.1068897861
    274 rdf:type schema:CreativeWork
    275 https://doi.org/10.2106/jbjs.i.01477 schema:sameAs https://app.dimensions.ai/details/publication/pub.1068901871
    276 rdf:type schema:CreativeWork
    277 https://doi.org/10.2106/jbjs.l.00520 schema:sameAs https://app.dimensions.ai/details/publication/pub.1068903145
    278 rdf:type schema:CreativeWork
    279 https://doi.org/10.2106/jbjs.n.00834 schema:sameAs https://app.dimensions.ai/details/publication/pub.1068903882
    280 rdf:type schema:CreativeWork
    281 https://doi.org/10.3928/01477447-20100722-42 schema:sameAs https://app.dimensions.ai/details/publication/pub.1071720534
    282 rdf:type schema:CreativeWork
    283 https://www.grid.ac/institutes/grid.239578.2 schema:alternateName Cleveland Clinic
    284 schema:name Cleveland Clinic, Cleveland, OH, USA
    285 rdf:type schema:Organization
    286 https://www.grid.ac/institutes/grid.265008.9 schema:alternateName Thomas Jefferson University
    287 schema:name Rothman Institute at Thomas Jefferson University, Philadelphia, PA, USA
    288 rdf:type schema:Organization
    289 https://www.grid.ac/institutes/grid.418983.f schema:alternateName Exponent (United States)
    290 schema:name Exponent Inc, 149 Commonwealth Drive, 94025, Menlo Park, CA, USA
    291 rdf:type schema:Organization
    292 https://www.grid.ac/institutes/grid.89336.37 schema:alternateName The University of Texas at Austin
    293 schema:name Dell Medical School at The University of Texas at Austin, Austin, TX, USA
    294 rdf:type schema:Organization
     




    Preview window. Press ESC to close (or click here)


    ...