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hip replacement posterior

Angelo Graceffa, Pier Francesco Indelli, Leonardo Latella, Paolo Poli, Alexander Fulco, Massimiliano Marcucci
PURPOSE: historically, the original CLS Spotorno Stem has demonstrated excellent survival. The design of this stem was recently modified, resulting in the introduction of a shorter, modular version (CLS Brevius). The purpose of the current study was to evaluate the functional, radiological and survivorship outcomes of the cementless CLS Brevius Stem in a multi-surgeon, single center, consecutive series study at two years post-surgery. METHODS: the Authors performed 170 total hip arthroplasties in 155 patients using the shorter, triple-taper stem design (CLS Brevius)...
July 2016: Joints
Wan Chin Lee, Felicia Yanyan Luo, Katherine Kai Qian Tiong, Nicholas Wai Kit Chia, Lisa Mui Hiong Tham, Tien Jin Tan
Conventional radiographs play an important role as a first line imaging modality in the assessment for suspected hip fractures in the majority of trauma centres. The routinely performed radiographic projections in our emergency department for patients with clinically suspected hip fractures include antero-posterior (AP) and cross-table lateral views of the affected hip. Certain clinical scenarios which include the presence of significant pain of the injured lower limb, a large patient habitus, as well as pre-existing patient morbidity which would limit the range of motion of the lower limbs, for example the presence of prior joint replacement surgery or lower limb contractures, may however preclude proper positioning of the patient to obtain an optimal cross-table lateral view of the affected hip...
August 24, 2016: Emergency Radiology
Yvonne R A Kerkhoff, Nienke M Kosse, Wieneke P Metsaars, Jan Willem K Louwerens
BACKGROUND: Total ankle arthroplasty is an accepted alternative to arthrodesis of the ankle. However, complication and failure rates remain high. Long-term results of the Scandinavian Total Ankle Replacement (STAR) are limited, with variable complication and failure rates observed. This prospective study presents the long-term survivorship and postoperative complications of the STAR prosthesis. METHODS: Between May 1999 and June 2008, 134 primary total ankle arthroplasties were performed using the STAR prosthesis in 124 patients...
December 2016: Foot & Ankle International
Sebastian P Boelch, Martin C Jordan, Rainer H Meffert, Hendrik Jansen
PURPOSE: Treating acetabular fractures with open reduction and internal fixation (ORIF) may lead to poorer outcomes in older patients. As data for osteoporotic acetabular fractures are limited, we compared primary total hip replacement (THR) with ORIF for treating osteoporotic acetabular fractures, including those with posterior column instability. METHODS: All patients with osteoporotic acetabular fractures, treated with ORIF or primary THR from 2005 to 2015, were assessed retrospectively for clinical and radiologic outcomes...
August 10, 2016: International Orthopaedics
Jonathan P Goldstein, George M Babikian, Adam J Rana, Johanna A Mackenzie, Andrew Millar
BACKGROUND: Total hip replacement (THR) must be managed in a more sustainable manner. More cost-effective surgical techniques and the centralization/regionalization of services are two solutions. The former requires an assessment of newer minimally invasive and muscle-sparing surgical techniques. The latter necessitates an effective volume-outcome (VO) relationship. Prior studies have failed to evaluate and control for the VO relation. OBJECTIVE: The objective of this study was to evaluate the relative cost and outcome effectiveness of two minimally invasive and one muscle-sparing techniques while evaluating and controlling for a potentially endogenous VO relation...
December 2016: Applied Health Economics and Health Policy
Yasuharu Nakashima, Takuaki Yamamoto, Jun-Ichi Fukushi, Goro Motomura, Satoshi Hamai, Yusuke Kohno, Yukihide Iwamoto
BACKGROUND: Avascular necrosis of the femoral head (AVN) is the most serious complication after unstable slipped capital femoral epiphysis (SCFE), and is often unsalvageable. We report a minimum 10 years of clinical results for transtrochanteric rotational osteotomy of the femoral head (TRO) for AVN. METHODS: This study included 7 patients (7 hips) with a mean age at surgery of 13.3 years, and the follow-up period was 15.8 years. All patients had prior treatment via closed reduction and pinning of the unstable SCFE, and showed severely collapsed femoral heads...
July 22, 2016: Journal of Orthopaedic Science: Official Journal of the Japanese Orthopaedic Association
Victor Chang, Robert H Blackwell, Ryan M Yau, Stephanie Besser, Joslyn M Albright, Gopal N Gupta, Paul C Kuo, Anai N Kothari
BACKGROUND: With more hospital consolidations as an inevitable part of our future health care ecosystem, we investigated the relationship between hospital consolidations and operative outcomes. METHODS: Using the Health Care Cost and Utilization Project State Inpatient Database (Florida and California), the American Hospital Association Annual Survey Database, and Medicare's Case Mix Index data, we identified 19 hospitals that consolidated between 2007 and 2013 and propensity matched them with 19 independent hospitals, using patient and hospital characteristics...
November 2016: Surgery
Sergio Gabarre, Antonio Herrera, Elena Ibarz, Jesús Mateo, Jorge Gil-Albarova, Luis Gracia
A comparative study between two stems (Linea Anatomic and Minihip) has been performed in order to analyse the differences in their biomechanical behaviour, concerning stem micromotions and load transmission between stem and bone. From the corresponding finite element models, a parametric study was carried out to quantify ranges of micromotions taking into account: friction coefficient in the stem-bone interface, press-fit and two types of gait cycle. Micromotions were evaluated for each stem at six different levels along repeated gait cycles...
2016: PloS One
A Schäffler, T Freude, F Stuby, D Höntzsch, J Veltkamp, U Stöckle, B König
Introduction: There have been significant increases in the number of acetabular fractures in elderly patients with primarily ventral pathology and medial protrusion of the femoral head. We have developed the "acetabulum wing plate", which is designed to facilitate repositioning, with its anatomically precontoured structure, and which offers full support of the quadrilateral surface, thus counteracting the force of the femoral head pushing inwards. Conventional plate osteosynthesis only provides insufficient support to the medial surface...
October 2016: Zeitschrift Für Orthopädie und Unfallchirurgie
Matthew F Gornet, Vaneet Singh, Francine W Schranck, Anastasia K Skipor, Joshua J Jacobs
STUDY DESIGN: Prospective longitudinal study. OBJECTIVE: The serum titanium (Ti) concentrations were examined in patients implanted with a PRESTIGE LP™ Cervical Disc System (Medtronic, Inc., Memphis, TN). The metal-on-metal disc with ball-in-trough articulation is made of titanium alloy/titanium carbide composite (Ti-6Al-4 V/TiC). SUMMARY OF BACKGROUND DATA: Cervical disc arthroplasty (CDA) provides a motion-preserving treatment alternative to anterior cervical discectomy and fusion for degenerative cervical disc disease...
June 17, 2016: Spine
Kandhari V K, Desai M M, Bava S S, Wade R N
INTRODUCTION: Chances of avascular necrosis of acetabulum are rare as it enjoys a rich blood supply. But cases of post - traumatic avascular necrosis of acetabulum following fracture of posterior column have been well documented. Importance of identifying and suspecting the avascular necrosis of acetabulum is essential in cases of failed fixation of fracture acetabulum, previously operated using extensile approach to acetabulum; either extended anterior ilio - femoral or tri - radiate approach...
October 2015: Journal of Orthopaedic Case Reports
Kyeong-Hyeon Park, Ji-Wan Kim, Chang-Wug Oh, Joon-Woo Kim, Jong-Keon Oh, Hee-Soo Kyung
INTRODUCTION: Reduction is urgently required in cases of traumatic hip dislocation to decrease the risk of avascular necrosis of the femoral head. However, successful reduction may not always be feasible for hip dislocations associated with femoral head fractures. This irreducibility may provoke further incidental fractures of the femoral neck with resultant Pipkin type III injuries. The purpose of this study was to describe an appropriate treatment strategy for irreducible femoral head fracture-dislocations...
August 2016: Archives of Orthopaedic and Trauma Surgery
Umatheepan Balasubramaniam, Michelle Dowsey, Francis Ma, Anthony Dunin, Peter Choong
BACKGROUND: With the evolution of total hip joint replacement techniques, there has been a trend towards minimally invasive surgery. The anterior approach (AA) to total hip arthroplasty has been widely associated with less soft tissue damage. The aim of our study was to compare clinical and 1-year functional outcomes for AA hip arthroplasty versus a posterior approach (PA). METHOD: We retrospectively reviewed 92 (50 anterior and 42 posterior) total hip replacements performed at our centre between 2006 and 2011...
July 2016: ANZ Journal of Surgery
Cengiz Sen, Kerem Bilsel, Mehmet Elmadag, Taner Gunes, Baransel Saygi
INTRODUCTION: Total hip replacement in patients with developmental dysplasia of the hip (DDH) is a difficult technical procedure for surgeons to perform because of the potential for these patients to have severe anomalies in their bones and soft tissues. MATERIALS AND METHODS: We performed acetabuloplasty in 54 hips from 44 patients by reaming the posterior wall of the native acetabulum and medialising the acetabular component to restore the anatomic centre of hip rotation using a small cup without bone grafting...
July 25, 2016: Hip International: the Journal of Clinical and Experimental Research on Hip Pathology and Therapy
Patrick Studer, Dennis Kosuge, Mark Rickman, Lucian B Solomon
The superior gluteal neurovascular bundle is at risk of injury in certain types of acetabular fractures and the associated surgery. This article describes the versatility of an extended posterior approach, previously described for complex revision total hip replacement (the Adelaide approach) and for the treatment of acetabular fractures that allows a wide exposure of the ilium through identification, protection, and mobilization of the superior gluteal neurovascular bundle.
August 2016: Journal of Orthopaedic Trauma
Joseph D Maratt, Joel J Gagnier, Paul D Butler, Brian R Hallstrom, Andrew G Urquhart, Karl C Roberts
BACKGROUND: The direct anterior approach (DAA) for total hip arthroplasty (THA) has rapidly become popular, but there is little consensus regarding the risks and benefits of this approach in comparison with a modern posterior approach (PA). METHODS: A total of 2147 patients who underwent DAA THA were propensity score matched with patients undergoing PA THA on the basis of age, gender, body mass index, and American Society of Anesthesia classification using data from a state joint replacement registry...
September 2016: Journal of Arthroplasty
Nathan S Artz, Curtis N Wiens, Matthew R Smith, Diego Hernando, Alexey Samsonov, Scott B Reeder
PURPOSE: To develop a multiband radiofrequency (RF) excitation strategy for simultaneous excitation of multiple RF offsets to accelerate fully phase-encoded imaging near metallic prostheses. METHODS: Multiband RF excitation was designed and incorporated into a spectrally resolved fully phase-encoded (SR-FPE) imaging scheme. A triband (-6, 0, 6 kHz) acquisition was compared with three separate single-band acquisitions at the corresponding RF offsets with a phantom containing the head of a hip prosthesis...
March 28, 2016: Magnetic Resonance in Medicine: Official Journal of the Society of Magnetic Resonance in Medicine
Rogério Naim Sawaia, Antonio Felipe Martensen Galvão, Fernando Machado Oliveira, Guilherme Rondinelli Secunho, Geraldo Vilela Filho
OBJECTIVE: The aim of this study was to present a minimally invasive anterolateral access route and to ascertain whether this enables total hip replacement without compromising the quality of the implant positioning, while maintaining the integrity of the gluteus muscles. METHOD: A retrospective study was conducted on 260 patients (186 females and 74 males) with an average age of 62 years. There were 18 bilateral cases, totaling 278 hips. All the patients had osteoarthritis and had undergone non-cemented total hip arthroplasty (metal-metal or metal-polyethylene) between October 2004 and December 2007...
March 2011: Revista Brasileira de Ortopedia
Alan H Daniels, Satoshi Kawaguchi, Alec G Contag, Farbod Rastegar, Garrett Waagmeester, Paul A Anderson, Melanie Arthur, Robert A Hart
OBJECTIVE Beginning in 2008, the Centers for Medicare and Medicaid Service (CMS) determined that certain hospital-acquired adverse events such as surgical site infection (SSI) following spine surgery should never occur. The following year, they expanded the ruling to include deep vein thrombosis (DVT) and pulmonary embolism (PE) following total joint arthroplasty. Due to their ruling that "never events" are not the payers' responsibility, CMS insists that the costs of managing these complications be borne by hospitals and health care providers, rather than billings to health care payers for additional care required in their management...
August 2016: Journal of Neurosurgery. Spine
Ta-I Wang, Hui-Yi Chen, Chun-Hao Tsai, Horng-Chaung Hsu, Tsung-Li Lin
BACKGROUND: Retractor placement is a leading cause of intraoperative nerve injury during total hip replacement (THR) surgery. The sciatic nerve, femoral nerve, and superior gluteal nerve are most commonly affected. This study aimed to identify the distances from bony landmarks in the hip to the adjacent nerves on magnetic resonance imaging (MRI) and the associations between anatomical factors and these distances that would guide the placement of retractors during THR surgery, in order to minimize the risk of nerve injury...
2016: Journal of Orthopaedic Surgery and Research
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