scoliosis,total hip arthroplasty,total knee arthroplasty

PURPOSE: The spine, hip, and knee are anatomically and biomechanically connected. Total hip arthroplasty (THA) and total knee arthroplasty (TKA) are commonly employed to treat degenerative changes in the hip and knee, while fusion is used for spine degeneration. Spine deformity correction results in changes in sagittal alignment and pelvic parameters, and patients with stiff spines have higher rates of THA dislocation and revision due to instability. The goal of this study was to determine the prevalence of total joint arthroplasty (TJA) in adult spinal deformity (ASD) patients at our institution...

We describe the first case of a 62-year-old female symptomatic patient with multiple comorbidities presenting with coronal limb malalignment due to scoliosis and osteoarthritis who underwent a combined total hip arthroplasty and biplane opening wedge osteotomy of the distal femur in one procedure. It is essential to realize that in patients who present with multiple comorbidities, combining different established procedures should be considered as a therapeutic option. We detail the operative procedure, preoperative considerations, and postoperative rehabilitation...

We report a rare case of a rigid spinal deformity with severe pelvic obliquity (PO) resulting from hip ankylosis caused by childhood tuberculosis (TB). A 66-year-old woman presented with left knee pain, chronic low back pain, and fatigability during walking. She presented with leg length discrepancy (LLD) due to an ankylosed right hip joint, severe PO, and secondary lumbar scoliosis. Total hip arthroplasty (THA) and adductor tendonectomy were performed prior to spine surgery, and posterior spinal correction and fusion were performed from T10 to the pelvis...

OBJECTIVE: Although the health impact of adult symptomatic lumbar scoliosis (ASLS) is substantial, these patients often have other orthopedic problems that have not been previously quantified. The objective of this study was to assess disease burden of other orthopedic conditions in patients with ASLS based on a retrospective review of a prospective multicenter cohort. METHODS: The ASLS-1 study is an NIH-sponsored prospective multicenter study designed to assess operative versus nonoperative treatment for ASLS...

BACKGROUND: Ischemic necrosis of the proximal femur resulting in coxa vara is a severe iatrogenous complication of the treatment of developmental dysplasia of the hip (DDH). Severe relative overgrowth of the greater trochanter and reduction of the neck result in insufficiency of hip abductors. Unequal limb length causes obliquity of the pelvis, compensatory scoliosis of the lumbar spine and valgus deformity of the ipsilateral knee. The purpose of this study was to investigate the effect of valgus intertrochanteric osteotomy in patients with coxa vara older than 30 years...

Complications of orthopedic and spine operations can be life threatening. Proper patient selection, careful planning of patient care, and prophylactic measures are important determinants of a successful outcome. After elective orthopedic surgery such as total joint replacement, the intensivist should be aware of potential systemic complications common to any major surgical intervention (pneumonia, pulmonary embolism, sepsis, myocardial infarction) and also of procedure-specific problems (cement-related cardiac events, fat embolism) and local complications (neurovascular injuries)...

BACKGROUND: Preoperative autologous blood donation (PABD) has been shown to decrease allogeneic blood transfusion requirements in major elective surgery. Changes in transfusion practice motivated an examination of blood use from 1993 to 2000 of patients participating in the Héma-Québec PABD program. STUDY DESIGN AND METHODS: Blood donation and transfusion, type of surgery, and demographic characteristics were prospectively entered into a computer database for patients participating in the Héma-Québec PABD program...

The Medical Outcomes Study Short Form-36 was used preoperatively and 2 years postoperatively to compare patients' self reported assessment of health and function between 151 patients who had primary total hip replacement and 49 patients who had total hip revision, 149 patients who had primary total knee replacements, 41 patients who had lumbar laminectomy, and 43 patients who had scoliosis surgery. Primary total hip arthroplasty and lumbar laminectomy posted equivalent followup scores. Primary total hip arthroplasty showed significant improvements in physical function and health perception when compared with revision total hip arthroplasty; all other health parameters were similar...