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Hip precautions

Jorge Chahla, Jacob D Mikula, Jason M Schon, Chase S Dean, Kimi D Dahl, Travis J Menge, Eduardo Soares, Travis Lee Turnbull, Robert F LaPrade, Marc J Philippon
BACKGROUND: Hip capsulotomy is routinely performed during arthroscopic surgery to achieve adequate exposure of the joint. Iatrogenic instability can result after hip arthroscopic surgery because of capsular insufficiency, which can be avoided with effective closure of the hip capsule. There is currently no consensus in the literature regarding the optimal quantity of sutures upon capsular closure to achieve maximal stability postoperatively. PURPOSE/HYPOTHESIS: The purpose of this study was to determine the failure torques of 1-, 2-, and 3-suture constructs for hip capsular closure to resist external rotation and extension after standard anterosuperior interportal capsulotomy (12 to 3 o'clock)...
September 22, 2016: American Journal of Sports Medicine
Vidyadhar V Upasani, Oliver Birke, Kevin E Klingele, Michael B Millis
BACKGROUND: The modified Dunn procedure facilitates femoral capital realignment for slipped capital femoral epiphysis (SCFE) through a surgical hip dislocation approach. Iatrogenic postoperative hip instability after this procedure has not been studied previously; however, we were concerned when we observed several instances of this serious complication, and we wished to study it further. QUESTIONS/PURPOSES: The purpose of this study was to evaluate the frequency, timing, and clinical presentation (including complications) associated with iatrogenic instability after the modified Dunn procedure for SCFE...
September 20, 2016: Clinical Orthopaedics and related Research
Toby O Smith, Paul Jepson, Andrew Beswick, Gina Sands, Avril Drummond, Edward T Davis, Catherine M Sackley
BACKGROUND: Total hip arthroplasty (THA) is one of the most common orthopaedic operations performed worldwide. Painful osteoarthritis of the hip is the primary indication for THA. Following THA, people have conventionally been provided with equipment, such as raised toilet seats and chairs, and educated to avoid activities that could cause the hip joint to be in a position of flexion over 90 degrees, or adduction or rotation past the midline. These aspects of occupational therapy have been advocated to reduce the risks of prosthesis dislocation...
2016: Cochrane Database of Systematic Reviews
T O Smith, C M Sackley
BACKGROUND: Total hip replacement (THR) is one of the most common orthopaedic procedures in the United Kingdom (UK). Historically, people following THR have been provided with hip precautions and equipment such as: raised toilet seats and furniture rises, in order to reduce the risks of dislocation post-operation. The purpose of this study was to determine current practices in the provision of these interventions in the UK for people following primary THR. METHODS: A 27-question, self-administered online survey was developed and distributed to UK physiotherapists and occupational therapists involved in the management of people following primary THR (target respondents)...
2016: BMC Musculoskeletal Disorders
A Kornuijt, D Das, T Sijbesma, W van der Weegen
AIMS: In order to prevent dislocation of the hip after total hip arthroplasty (THA), patients have to adhere to precautions in the early post-operative period. The hypothesis of this study was that a protocol with minimal precautions after primary THA using the posterolateral approach would not increase the short-term (less than three months) risk of dislocation. PATIENTS AND METHODS: We prospectively monitored a group of unselected patients undergoing primary THA managed with standard precautions (n = 109, median age 68...
May 2016: Bone & Joint Journal
Kerstin Radtke, T Tetzlaff, B Vaske, M Ettinger, L Claaßen, T Flörkemeier, H Windhagen, G von Lewinski
BACKGROUND: Periprosthetic Joint Infection (PJI) poses a great challenge to patients, surgeons and health care systems. Comorbid diseases and patient-related risk factors are poorly understood. OBJECTIVE: The purpose of this study was to evaluate patient-related risk factors for PJI after primary and after revision Total Hip Arthroplasty (THA). METHODS: In the present study, data was collected from 566 patients who underwent primary or revision THA between July 2011 and June 2012 in an established arthroplasty center (Endocert certified endoprosthesis center, EPZmax)...
September 14, 2016: Technology and Health Care: Official Journal of the European Society for Engineering and Medicine
Carlos Suarez-Ahedo, S Pavan Vemula, Christine E Stake, Zachary A Finley, Timothy J Martin, Chengcheng Gui, Benjamin G Domb
The role of radiofrequency energy (RFE) devices has been minimally studied in hip arthroscopy. The purpose of this study was to determine the role of RFE devices in hip arthroscopy through a systematic review of the literature. We searched the PubMed database using the following Medical Subject Heading terms: hip arthroscopy, hip radiofrequency, thermal capsulorrhaphy, thermal chondroplasty and radiofrequency debridement. Two authors independently reviewed the literature and included articles based on predetermined inclusion criteria...
December 2015: Journal of Hip Preservation Surgery
Ramsis F Ghaly, Tatiana Tverdohleb, Kenneth D Candido, Nebojsa Nick Knezevic
BACKGROUND: Spinal cord stimulation is currently approved to treat chronic intractable pain of the trunk and limbs. However, such implantable electronic devices are vulnerable to external electrical currents and magnetic fields. Within the hospitals and modern operating rooms (ORs), there is an abundance of electrical devices and other types of equipment that could interfere with such devices. Despite the increasing number of patients with neuromodulation implantable devices, there are no written guidelines available or consensus of cautions for such patients undergoing unrelated surgery...
2016: Surgical Neurology International
Joanne Guay, Martyn J Parker, Pushpaj R Gajendragadkar, Sandra Kopp
BACKGROUND: The majority of people with hip fracture are treated surgically, requiring anaesthesia. OBJECTIVES: The main focus of this review is the comparison of regional versus general anaesthesia for hip (proximal femoral) fracture repair in adults. We did not consider supplementary regional blocks in this review as they have been studied in another review. SEARCH METHODS: We searched the Cochrane Central Register of Controlled Trials (CENTRAL; the Cochrane Library; 2014, Issue 3), MEDLINE (Ovid SP, 2003 to March 2014) and EMBASE (Ovid SP, 2003 to March 2014)...
February 22, 2016: Cochrane Database of Systematic Reviews
Kelly L Adler, P Christopher Cook, Paul R Geisler, Yi-Meng Yen, Brian D Giordano
CONTEXT: Successful treatment of nonarthritic hip pain in young athletic individuals remains a challenge. A growing fund of clinical knowledge has paralleled technical innovations that have enabled hip preservation surgeons to address a multitude of structural variations of the proximal femur and acetabulum and concomitant intra-articular joint pathology. Often, a combination of open and arthroscopic techniques are necessary to treat more complex pathomorphologies. Peri- and postoperative recovery after such procedures can pose a substantial challenge to the patient, and a dedicated, thoughtful approach may reduce setbacks, limit morbidity, and help optimize functional outcomes...
January 2016: Sports Health
Scott W Cheatham, Keelan R Enseki, Morey J Kolber
CONTEXT: Hip arthroscopy has become an increasingly popular option for active individuals with recalcitrant hip pain. Conditions that may be addressed through hip arthroscopy include labral pathology, femoral acetabular impingement, capsular hyperlaxity, ligamentum teres tears, and the presence of intra-articular bodies. Although the body of literature examining operative procedures has grown, there is a paucity of evidence specifically on the efficacy of postoperative rehabilitation programs...
November 2015: Journal of Sport Rehabilitation
Matthias Wienroth, Pauline McCormack, Thomas J Joyce
Hip implants have provided life-changing treatment, reducing pain and improving the mobility and independence of patients. Success has encouraged manufacturers to innovate and amend designs, engendering patient hopes in these devices. However, failures of medical implants do occur. The failure rate of the Articular Surface Replacement metal-on-metal hip system, implanted almost 100,000 times world-wide, has re-opened debate about appropriate and timely implant governance. As commercial interests, patient hopes, and devices' governance converge in a socio-technical crisis, we analyse the responses of relevant governance stakeholders in the United Kingdom between 2007 and 2014...
2014: Life Sciences, Society and Policy
Lara Barnsley, Leslie Barnsley, Richard Page
PURPOSE: Total hip arthroplasty (THA) is a common and effective treatment of hip osteoarthritis. Activity restrictions known as hip precautions are widely practiced in rehabilitation post THA, aiming to foster healing and prevent hip dislocation. The focused clinical question was: Does the application of hip precautions in patients post THA versus unrestricted activities significantly decrease the risk of prosthetic dislocation? METHODS: A comprehensive literature search was conducted for randomized controlled trials or cohort studies with a comparative group and minimum 6 months follow-up, with dislocation as an end point...
September 2015: Geriatric Orthopaedic Surgery & Rehabilitation
Michael K Merz, John J Christoforetti, Benjamin G Domb
Hip arthroscopy is an increasingly common procedure, particularly for the treatment of femoroacetabular impingement. Various complications have been previously reported, and the authors sought to further evaluate the safety of this procedure. This study was conducted to identify the incidence of femoral neck fracture as well as treatment and outcomes after arthroscopic femoroplasty. In April 2013, a survey was administered to 28 established hip arthroscopists regarding the breadth of their experience, including the total number of hip arthroscopies and proximal femoroplasties performed and the number of postoperative femoral neck fractures...
August 2015: Orthopedics
Brock Polnaszek, Jacquelyn Mirr, Rachel Roiland, Andrea Gilmore-Bykovskyi, Melissa Hovanes, Amy Kind
OBJECTIVES: To assess the quality and explore the potential impact of the communication of physical therapy (PT) recommendations in hospital discharge summaries/orders for high-risk subacute care populations, specifically targeting recommendations for (1) maintenance of patient safety, (2) assistance required for mobility, and (3) use of assistive devices. DESIGN: Medical record abstraction of retrospective cohort comparing discharge recommendations made by inpatient PT to orders included in written hospital discharge summaries/orders, the primary form of hospital-to-subacute care communication...
November 2015: Archives of Physical Medicine and Rehabilitation
Vikas M Agashe, Hitendra Patil, Manit K Gundavda
INTRODUCTION: Prescription drug abuse is a major health problem across the globe. Various complications associated with repeated injection of pentazocine are reported in the literature, including skin fibrosis, skin abscesses and ulceration, abnormal skin pigmentation and fibrous myopathy. CASE REPORT: We present a case of 48 year male with history of pentazocine abuse. Patient developed multiple abscesses in both lower limbs with polymicrobial infection, one of them being mycobacterium tuberculosis...
January 2015: Journal of Orthopaedic Case Reports
Asser Sallam, Christian M Ziegler, Volkmar Jansson, Bernhard Heimkes
BACKGROUND: The aim of this investigation is the development of primarily healthy hips in children who have required orthoses/protheses over the long term due to ipsilateral distally located deformities of the leg. These children show ipsilateral in-toeing gait and Duchenne's limping followed by a coxa valga antetorta and facultative hip decentration. A practical question is whether these hips are in danger of decompensation. An additional theoretical question is how the external shape and internal architecture changes if a primarily healthy hip is underused...
August 2015: Journal of Children's Orthopaedics
Seung-Hoon Baek, Won Keun Kim, Jun Young Kim, Shin-Yoon Kim
BACKGROUND: Ceramic-on-ceramic bearing couples are theoretically attractive in total hip arthroplasty (THA) because of low wear, but concerns regarding ceramic fracture and squeaking have arisen. Improved material properties of newer alumina matrix composite (AMC) materials, known as Delta ceramics, may reduce these risks. In addition, the use of thinner liners and larger femoral heads may be helpful clinically to lower the rate of dislocation. However, limited short-term clinical results are available and intermediate-term effects are unclear...
December 2015: Clinical Orthopaedics and related Research
Andrew Yun, Emmanuel N Koli, John Moreland, Richard Iorio, John F Tilzey, J Wesley Mesko, Gwo-Chin Lee, Mark Froimson
BACKGROUND: Polyethylene liner dissociation is a rare but catastrophic event in total hip arthroplasty (THA), and certain implant designs are known to be at greater risk. Although the DePuy Pinnacle (Warsaw, IN, USA) modular acetabular construct has an excellent record of fixation and wear, an unexpectedly high number of liner dissociations has been noted. QUESTIONS/PURPOSES: The purposes of this study were (1) to characterize the clinical parameters observed in a large group of patients who have experienced liner dissociations with the DePuy Pinnacle acetabular component; (2) to describe the radiographic findings in this group of patients; and (3) to calculate a minimum frequency of this complication...
February 2016: Clinical Orthopaedics and related Research
Jeffrey S Grzybowski, Philip Malloy, Catherine Stegemann, Charles Bush-Joseph, Joshua David Harris, Shane J Nho
CONTEXT: Rehabilitation following hip arthroscopy is an integral component of the clinical outcome of the procedure. Given the increase in quantity, complexity, and diversity of procedures performed, a need exists to define the role of rehabilitation following hip arthroscopy. OBJECTIVES: (1) To determine the current rehabilitation protocols utilized following hip arthroscopy in the current literature, (2) to determine if clinical outcomes are significantly different based on different post-operative rehabilitation protocols, and (3) to propose the best-available evidence-based rehabilitation program following hip arthroscopy...
2015: Frontiers in Surgery
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