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Revision hip

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
Marie Reisener, Carsten Perka
Background: Culture-negative periprosthetic joint infections (CN PJI) have not been well studied, and due to the lack of consensus on PJI, especially with culture-negative infections, there are considerable uncertainties. Due to the challenging clinical issue of CN PJI the aim of this systematic review is to describe incidence, diagnosis, and treatment outcomes based on the current literature on CN PJI. Hypothesis: The review is designed to assess the formal hypothesis that CN PJI of the hip and knee have a poorer outcome when compared with culture-positive ones...
2018: BioMed Research International
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
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
Robert W Westermann, Matthew C Bessette, T Sean Lynch, James Rosneck
Introduction: Arthroscopic management of the hip capsule has become a topic of debate in recent literature. Few comparative studies exist to help establish clear treatment recommendations. Methods: Utilizing the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, a systematic review of the literature was conducted using PubMed, CINAHL, EMBASE, sportDiscus (EBSCO) and Cochrane Central Register of Controlled Trials databases by two independent investigators...
2018: Iowa Orthopaedic Journal
Ernesto Muñoz-Mahamud, Ignacio Molinas, Luis Lozano, Jordi Bosch, Laura Morata, Andrés Combalia, Álex Soriano, Guillem Bori
INTRODUCTION: Identification of microorganisms is critical for correct management of an infected arthroplasty. Our hypothesis is that the culture yield depends on the location around the prosthesis from which samples are obtained. METHODS: This prospective study included 298 revisions of the hip (123) and knee (175). We compared the yield of the intraoperative samples obtained, which included synovial fluid (two), neosynovium (two), and periprosthetic membrane (two)...
August 10, 2018: Journal of the American Academy of Orthopaedic Surgeons
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
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
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
Hong-Man Cho, Jae-Woong Seo, Hyun-Ju Lee, Kyu-Bok Kang, Jung-Ryul Kim, Ho-Wook Wee
OBJECTIVE: There is limited literature concerning the outcomes and role of THA as a surgical option for amputee patients. The aim of this study is to determine the mid-to long-term survival and complication rates of cementless total hip arthroplasty (THA) in patients with contralateral below knee amputations. METHODS: A retrospective review of 54 patients with below knee amputation were perfomed who underwent THA for osteoarthritis of the contralateral hip over a 5-year period between 1999 and 2014...
August 7, 2018: Acta Orthopaedica et Traumatologica Turcica
M Betsch, M Tingart, A Driessen, V Quack, B Rath
BACKGROUND: Avascular necrosis of the femoral head is a progressive perfusion disorder of the hip joint. Progress in avascular necrosis causes structural damage to the affected joint, often requiring total hip replacement. AIM: This article is intended to give the reader an overview of the current literature on total hip replacement of patients with an avascular necrosis of the femoral head. RESULTS: Before 1990, patients with avascular necrosis of the femoral head had significantly higher revision rates after total hip replacement...
August 9, 2018: Der Orthopäde
Zhisen Gao, Xiang Li, Yinqiao Du, Yawen Peng, Wenming Wu, Yonggang Zhou
BACKGROUND The aim of this study was to investigate the success rate of fungal peri-prosthetic joint infection treated by 2-stage revision and related factors of treatment failure to offer a better treatment protocol. MATERIAL AND METHODS We reviewed 18 joints (13 knees and 5 hips) of 17 patients (10 women and 7 men) diagnosed with fungal peri-prosthetic joint infection from January 2000 to June 2015 at our institute. The mean follow-up was 65.1 months (range, 25-129 months). All joints were treated with complete debridement, implantation of antifungal-loaded cement spacers, at least 6 weeks of parenteral antifungal agents, and delayed reimplantation...
August 10, 2018: Medical Science Monitor: International Medical Journal of Experimental and Clinical Research
Gannon L Curtis, Muhammad B Tariq, David P Brigati, Mhamad Faour, Carlos A Higuera
BACKGROUND: The OrthoMiDaS (Orthopedic Minimal Data Set) Episode of Care (OME) database was developed in an effort to advance orthopedic outcome measurements on a national scale. This study was designed to evaluate if the OME data capture system would increase the quality of data collected in the context of primary and revision total hip arthroplasty (THA) compared to conventional operative notes. METHODS: This study includes data from the first 100 primary THAs and 100 revision THAs performed by 15 surgeons at a single institution from January through April 2016...
July 17, 2018: Journal of Arthroplasty
Frederick E Sieber, Karin J Neufeld, Allan Gottschalk, George E Bigelow, Esther S Oh, Paul B Rosenberg, Simon C Mears, Kerry J Stewart, Jean-Pierre P Ouanes, Mahmood Jaberi, Erik A Hasenboehler, Tianjing Li, Nae-Yuh Wang
Importance: Postoperative delirium is the most common complication following major surgery in older patients. Intraoperative sedation levels are a possible modifiable risk factor for postoperative delirium. Objective: To determine whether limiting sedation levels during spinal anesthesia reduces incident delirium overall. Design, Setting, and Participants: This double-blind randomized clinical trial (A Strategy to Reduce the Incidence of Postoperative Delirum in Elderly Patients [STRIDE]) was conducted from November 18, 2011, to May 19, 2016, at a single academic medical center and included a consecutive sample of older patients (≥65 years) who were undergoing nonelective hip fracture repair with spinal anesthesia and propofol sedation...
August 8, 2018: JAMA Surgery
Sandro Giannini, Antonio Mazzotti, Deianira Luciani, Giada Lullini, Giuseppe Tedesco, Isabella Andreoli, Matteo Cadossi, Cesare Faldini
OBJECTIVE: To compare the effectiveness in wound healing of negative pressure wound therapy (NPWT) versus a standard dressing in patients who underwent hip or knee revision surgery. METHOD: Participating patients scheduled for hip and knee prosthetic revision were randomised into two groups: one receiving standard povidone-iodine gauze and patch wound dressing (control group) and the other NPWT over the sutured wound area (NPWT group). Patients were evaluated by means of ASEPSIS score, occurrence of blisters, visual analogue scale (VAS) and dressing changes seven days after surgery...
August 2, 2018: Journal of Wound Care
De Li, Chenglong Wang, Zhuokai Li, Hui Wang, Jiye He, Junfeng Zhu, Yuehui Zhang, Chao Shen, Fei Xiao, Yuan Gao, Xiang Zhang, Yang Li, Peng Wang, Jianping Peng, Guiquan Cai, Bin Zuo, Yuehua Yang, Yun Shen, Weidong Song, Xiaoling Zhang, Lei Shen, Xiaodong Chen
Aseptic loosening is mainly caused by wear debris generated by friction that can increase the expression of receptor activation of nuclear factor (NF)-κB (RANKL). RANKL has been shown to support the differentiation and maturation of osteoclasts. Although autophagy is a key metabolic pathway for maintaining the metabolic homeostasis of cells, no study has determined whether autophagy induced by Al2 O3 particles is involved in the pathogenesis of aseptic loosening. The aim of this study was to evaluate RANKL levels in patients experiencing aseptic loosening after total hip arthroplasty (THA) and hip osteoarthritis (hOA) and to consequently clarify the relationship between RANKL and LC3II expression...
August 6, 2018: Cell Death & Disease
Gyorgy Kocsis, Charlie J Payne, Angus Wallace, Donal McNally
INTRODUCTION: Glenoid component wear and loosening is the Achilles heel of total shoulder replacement. Analysis of failed, revised implants might give an insight into the causes of component failure. Volumetric assessment of conventional total shoulder replacement glenoid liner wear rate and scanning electron microscopy was accomplished in this study for the purpose. Coherence scanning interferometry (white light scanner) 3D images were acquired. This method requires no physical contact, ionising radiation or extensive surface preparation...
August 3, 2018: Medical Engineering & Physics
Sophie Moerman, Nina M C Mathijssen, Wim E Tuinebreijer, Anne J H Vochteloo, Rob G H H Nelissen
Background and purpose - In the Netherlands about 40% of hip fractures are treated with a hemiarthroplasty (HA) or a total hip arthroplasty (THA). Although these procedures are claimed to have fewer complications than osteosynthesis (i.e., reoperation), complications still occur. Analyses of data from national registries with adequate completeness of revision surgery are important to establish guidelines to diminish the risk for revision. We identified risk factors for revision. Patients and methods - All patients older than 50 years of age with a hip fracture treated with arthroplasty by orthopedic surgeons and registered in the (national) Dutch arthroplasty register (LROI) were included in the study...
August 6, 2018: Acta Orthopaedica
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