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X-D Wu, W Xu, M Tian, Q Cheng, W Huang
Previous studies have demonstrated that revision of total hip arthroplasty consumes considerably more resources than the primary procedure. Worse, patients who need revision procedures are more likely to have radiographic evidence of acetabular and femoral bone loss than those undergone primary total hip arthroplasty. Many techniques have been introduced to manage different conditions of acetabular deficiencies. We describe a rare case of a 67-year-old man with severe acetabular bone loss, which was caused by a long-term loose acetabular component and was successfully managed by cup-on-cup technique...
August 16, 2018: Annals of the Royal College of Surgeons of England
A M Khan, M Rafferty, J S Daurka
Introduction The aim of this study was to determine the trends in national practice regarding total hip arthroplasty compared with hemiarthroplasty in fractured neck of femur between 2010 and 2016. Materials and methods A retrospective review was conducted of NHS Digital data (England) between 2010 and 2016. 'Emergency' neck of femur fracture admissions, hemiarthroplasties and total hip arthroplasties were included. Elective total hip arthroplasties, revisions and prostheses relocations were excluded. Annual percentages for each operation were calculated...
August 16, 2018: Annals of the Royal College of Surgeons of England
Imre W K Kouw, Bart B L Groen, Joey S J Smeets, Irene Fleur Kramer, Janneau M X van Kranenburg, Rachél Nilwik, Jan A P Geurts, René H M Ten Broeke, Martijn Poeze, Luc J C van Loon, Lex B Verdijk
OBJECTIVES: Short successive periods of skeletal muscle disuse have been suggested to substantially contribute to the observed loss of skeletal muscle mass over the life span. Hospitalization of older individuals due to acute illness, injury, or major surgery generally results in a mean hospital stay of 5 to 7 days, during which the level of physical activity is strongly reduced. We hypothesized that hospitalization following elective total hip arthroplasty is accompanied by substantial leg muscle atrophy in older men and women...
August 11, 2018: Journal of the American Medical Directors Association
Mitchell C Weiser, Kelvin Y Kim, Afshin A Anoushiravani, Richard Iorio, Roy I Davidovitch
BACKGROUND: Interest in outpatient/same-day discharge (SDD) total hip arthroplasty (THA) has been increasing over the last several years. There is considerable debate in the literature regarding the complication and readmission rates of these patients. To evaluate and validate the safety and efficacy of our institutional SDD THA care pathway, we compared the outcomes of patients undergoing SDD THA with patients who had a similar comorbidity profile and underwent inpatient THA. METHODS: A retrospective review was conducted on 164 patients who underwent SDD THA from January 2015 to September 2016...
July 21, 2018: Journal of Arthroplasty
Sebastian Butscheidt, Menard Moritz, Thorsten Gehrke, Klaus Püschel, Michael Amling, Michael Hahn, Tim Rolvien
BACKGROUND: Total hip arthroplasty (THA) is frequently accompanied by acetabular bone loss, which constitutes a major challenge in revision procedures. Structural allografts can be implanted to restore a stable osseous foundation for the acetabular prosthesis. As previous studies were limited to clinical data or included very few cases, the extent to which the graft bone is incorporated over time has remained unclear. METHODS: Thirteen acetabula were retrieved post mortem, and the incorporation properties of the bone allografts were analyzed using a hierarchical approach of imaging techniques including contact radiography, high-resolution peripheral quantitative computed tomography (HR-pQCT), histological analysis of undecalcified specimens, and quantitative backscattered electron imaging (qBEI)...
August 15, 2018: Journal of Bone and Joint Surgery. American Volume
Robert L Buly, Branden R Sosa, Lazaros A Poultsides, Elaine Caldwell, S Robert Rozbruch
BACKGROUND: Version abnormalities of the femur can cause pain and hip joint damage due to impingement or instability. A retrospective clinical review was conducted on patients undergoing a subtrochanteric derotation osteotomy for either excessive anteversion or retroversion of the femur. METHODS: A total of 55 derotation osteotomies were performed in 43 patients: 36 females and 7 males. The average age was 29 years (range, 14 to 59 years). The osteotomies were performed closed with an intramedullary saw...
August 13, 2018: Journal of the American Academy of Orthopaedic Surgeons
Shane R Hess, Laura A Lahaye, Andrew C Waligora, Adam P Sima, William A Jiranek, Gregory J Golladay
Intrathecal morphine (ITM) can be useful for postoperative analgesia following lower extremity joint arthroplasty, but concerns exist regarding potential dose-related side effects. In this study, we examined the safety and efficacy of ITM in patients undergoing lower extremity joint arthroplasty. We hypothesized that there would be (1) direct relationship between dosing and side effects, and (2) an inverse relationship between ITM dosing and 24-hour postoperative opioid requirement.
August 13, 2018: European Journal of Orthopaedic Surgery & Traumatology: Orthopédie Traumatologie
Karim Z Masrouha, John J Callaghan, José A Morcuende
Background: Patients with Legg-Calvé-Perthes Syndrome (LCPS) are at an increased risk for developing osteoarthritis of the hip and undergoing total hip arthroplasty (THA) at an early age. Importantly, this younger age may put them at a higher risk for failure and revision surgery. The purpose of the study was to assess the clinical and radiographic outcomes as well as implant failure rate and risk for revision surgery at an average 20 years follow up. Methods: Data from LCPS patients treated with THA were collected including age, gender, operative date, revision date, as well as reason for and type of revision...
2018: Iowa Orthopaedic Journal
Mengcun Chen, Daniel J Gittings, Shuhua Yang, Xianzhe Liu
Background: Treatment of Crowe IV developmental dysplasia of the hip (DDH) with total hip arthroplasty (THA) reconstructs the true acetabulum, which improves hip biomechanics and function. However, restoration of the native acetabulum may lead to limb lengthening and traction neuropraxia. The purpose of this study is to describe the short term results of a retrospectively reviewed series of patients with Crowe IV DDH treated with THA using a titanium mesh cup, cemented liner, and subtrochanteric femoral shortening osteotomy...
2018: Iowa Orthopaedic Journal
J Joseph Gholson, Brandon G Wilkinson, Timothy S Brown, Yubo Gao, S Blake Dowdle, John J Callaghan
Introduction: Systemic Lupus Erythematosus (SLE) has been associated with increased complications following hip and knee arthroplasty. The Purpose of this study was to determine the extent to which SLE is a risk factor in outcomes following total joint arthroplasty (TJA). Methods: The nationwide inpatient sample was used to identify a cohort of 505,841 patients who had a total hip arthroplasty (THA) or total knee arthroplasty (TKA) between 2009-2011. Of these patients, 2,284 patients (0...
2018: Iowa Orthopaedic Journal
Robert A Burnett, Robert Westermann, Nicholas Bedard, Steve Liu, John J Callaghan
Background: A rare complication of hip arthroscopy is the development of a ganglion cyst. These cysts can affect structures surrounding the hip joint. In some cases, the femoral artery may be involved, leading to claudication or a pulsatile mass that can resemble an aneurysm. Case Description: We present the case of a 62 year-old male who complains of 3 months of right hip pain. Workup reveals a degenerative labrum with cam impingement. After a discussion of various treatment options, the patient elected for arthroscopy to correct the impingement...
2018: Iowa Orthopaedic Journal
Jie-Feng Huang, Xian-Jun Jiang, Jian-Jian Shen, Ying Zhong, Pei-Jian Tong, Xiao-Hong Fan
BACKGROUND: The Unified Classification System (UCS) for Periprosthetic femoral fractures (PPFF) still has some limitations. METHODS: We retrieved 18 previous classifications for PPFF based on systematic review of the literature, and also retrospectively analyzed 402 cases with PPFF. 46 cases (11.4%) were identified as beyond the classification scope of the original UCS. RESULTS: We modified the UCS as follows: (1) add two new B2 subtypes: B2PALT/B2PAGT (i...
August 10, 2018: Journal of Orthopaedic Science: Official Journal of the Japanese Orthopaedic Association
Martin Olach, Pascal Gerhard, Karlmeinrad Giesinger, Christoph Lampert, Johannes B Erhardt
INTRODUCTION: The use of hip arthroscopy (HA) has substantially increased over the last decade. However, while the benefits of HA after 1 year in patients with femoroacetabular impingement (FAI) are well documented, long-term data on the progression of osteoarthritis (OA) or patient-reported outcomes (PROMs) are lacking. OBJECTIVES: To evaluate long-term clinical and radiological outcomes after HA. MATERIALS AND METHODS: Preoperative clinical records, operative notes, and radiographs from all patients who underwent HA at our hospital between 1998 and 2006 were reviewed...
August 13, 2018: Archives of Orthopaedic and Trauma Surgery
J A Nicholson, C E H Scott, J Annan, I Ahmed, J F Keating
AIM: The aim of this study was to evaluate the long-term clinical outcomes and complications following an acetabular fracture associated with a posterior hip dislocation compared to those without dislocation. PATIENTS & METHODS: A retrospective cohort study of 113 patients (mean age 42 (14-95), 77% male) with acetabular fracture dislocations compared to 367 patients with acetabular fractures without dislocation (mean age 54 (16-100), 66% male) treated from 1988 to 2010...
July 29, 2018: Injury
Michael M Morlock, Emilie C Dickinson, Klaus-Peter Günther, Dennis Bünte, Valerie Polster
BACKGROUND: Taper corrosion in total hip arthroplasty for bearings with metal heads against polyethylene has developed from an anecdotal observation to a clinical problem. Increased taper wear and even gross taper failure have been reported for one particular design. It is hypothesized that corrosion of the female head taper results in taper widening, allowing the cobalt-chromium head to turn on the stem and wear down the softer titanium alloy by abrasive wear, ultimately causing failure...
July 24, 2018: Journal of Arthroplasty
Rahul Goel, Patrick Buckley, Emily Sterbis, Javad Parvizi
BACKGROUND: Two-stage exchange arthroplasty is the preferred treatment for chronic periprosthetic joint infection following total hip arthroplasty (THA). These patients are at high risk of substantial blood loss and perioperative blood transfusion. Our study aimed at determining risk factors for blood transfusion during a 2-stage exchange for infected THA. METHODS: Medical records of 297 patients with infected THA who underwent 2-stage exchange arthroplasty from 1997 to 2016 were reviewed...
July 2, 2018: Journal of Arthroplasty
Barbara Bordini, Susanna Stea, Francesco Castagnini, Luca Busanelli, Federico Giardina, Aldo Toni
PURPOSE: Periprosthetic hip infection (PHI) is a devastating complication. The association between PHI and bearing surfaces as well as patient-related factors has been recently investigated, with contradictive outcomes. The dataset of Emilia-Romagna region Registry for Orthopaedic Prosthetic Implants (RIPO) has been assessed to investigate, if the bearing choice influenced the risk of septic loosening occurrence. METHODS: RIPO data about 39,206 cementless total hip arthroplasties (THA), collected since 2003, were analysed...
August 11, 2018: International Orthopaedics
Armin Pallaver, Lukas Zwicky, Lilianna Bolliger, Hans Bösebeck, Isabella Manzoni, Sabine Schädelin, Peter E Ochsner, Martin Clauss
INTRODUCTION: In revision total hip arthroplasty (THA), the cancellous bone is normally completely removed out of the femoral canal during stem extraction. This situation is comparable to primary THA following the shape-closed concept, with some authors advocating to remove the metaphyseal cancellous bone to enhance press-fit stability ("French paradox"). The aim of this study was to investigate the long-term outcome, regarding survival and radiological results, of a cemented straight stem when used for revision THA and to compare these results to the results of the same stem in primary THA...
August 11, 2018: Archives of Orthopaedic and Trauma Surgery
Derek Rutherford, Lindsey Buckingham, Janice Moreside, Ivan Wong, Glen Richardson
BACKGROUND: Knee function is impaired in individuals with moderate hip osteoarthritis. How this extends to those undergoing total hip arthroplasty is unknown despite the common requirement for knee arthroplasty in this population. The study purpose was to determine whether sagittal plane knee joint movements and quadriceps and hamstring activation patterns differ between individuals with either moderate or severe unilateral hip osteoarthritis, and between ipsilateral and contralateral knees...
August 8, 2018: Clinical Biomechanics
Dietmar Dammerer, David Putzer, Bernhard Glodny, Johannes Petersen, Ferdi Arrich, Martin Krismer, Rainer Biedermann
PURPOSE: Occult intra-operative periprosthetic acetabular fracture is a seldom-reported complication of primary total hip arthroplasty (THA). It may potentially be associated with cup instability and implant loosening. The present study aimed to investigate clinical consequences of this complication. METHODS: Between 2003 and 2012, a total of 3390 cementless total hip arthroplasties (THA) were performed at our institution. Their medical histories were retrospectively reviewed to identify all patients who received a thin-layer computer tomography (CT) scan of the pelvis including the acetabulum within the first 30 post-operative days...
August 10, 2018: International Orthopaedics
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