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Revision hip

Rebecca L Johnson, Matthew P Abdel, Ryan D Frank, Alanna M Chamberlain, Elizabeth B Habermann, Carlos B Mantilla
BACKGROUND: Frailty and disability from arthritis are closely intertwined and little is known about the impact of frailty on total hip arthroplasty (THA) outcomes. We hypothesized that higher preoperative frailty is associated with more adverse events following THA. METHODS: All patients (≥50 years) undergoing unilateral primary or revision THA at a single institution from 2005 through 2016 were included. We analyzed the association of frailty (measured by a frailty deficit index) with postoperative outcomes in hospital, within 90 days, and within 1 year using multivariable logistic and Cox regression, adjusting for age...
September 25, 2018: Journal of Arthroplasty
Yu Takeda, Shigeo Fukunishi, Shoji Nishio, Yuki Fujihara, Shinichi Yoshiya
RATIONALE: Total hip arthroplasty (THA) concomitant with subtrochanteric femoral shortening osteotomy for Crowe type IV dysplastic hip has been reported. However, the combination of subtrochanteric femoral osteotomy and revision THA has only been mentioned in one case report. PATIENT CONCERNS: A 67-year-old female had a history of congenital dislocation of both hips. DIAGNOSES: Right hip was diagnosed the aseptic loosening of THA with extremely high replacement of the acetabular component...
October 2018: Medicine (Baltimore)
Zhi-Wei Kang, Yao-Hui Zhang, Zi-Quan Yang
As a mature technology gradually, the total hip arthroplasty has been known and conducted by more and more orthopedic surgeons. However, it also increased the number of hip revisions. The reasons for revision of hip mainly include: unstable, infection, aseptic loosening prosthesis, prosthesis peripheral fracture, liner wear and so on, and the acetabulum bone defect and the choice of acetabular prosthesis have been perplexing surgeons. In this paper, we summarise classification and reconstruction of acetabulum bone defect in hip revision oprations, compare the advantages and disadvantages of all kinds of classification, on this basis can have more than one bone grafting mode and the choice of the acetabulum prosthesis for reconstruction of acetabulum, then expound the ways of material sources, bone grafting modes and complex acetabulum bone defect reconstruction as well as the choice of the ways of fixed prosthesis, providing the basis for clinical doctors to deal with all kinds of acetabulum bone defect and the choice of the acetabulum prosthesis, guiding patient specific therapy more precisely...
September 25, 2018: Zhongguo Gu Shang, China Journal of Orthopaedics and Traumatology
L Busanelli, F Castagnini, B Bordini, S Stea, P P Calderoni, A Toni
BACKGROUND: Reconstructions in case of acetabular bone loss in hip revision arthroplasty are challenging. A few techniques have been proposed, with inconstant outcomes. Biological reconstructions using bone allografts may address the acetabular bone loss and restore the hip anatomy. Aim of this work was the description of the surgical technique and the evaluation of the outcomes using a regional arthroplasty register. MATERIALS AND METHODS: Minor or massive bone allografting was performed in hip revision arthroplasties in a tertiary center...
October 16, 2018: Musculoskeletal Surgery
Eva Lehtonen, Harshadkumar Patel, Sierra Phillips, Martim Correia Pinto, Sameer Naranje, Ashish Shah
INTRODUCTION/AIM: Recent comparisons of suture versus metal staple skin closure on the rates of wound complications in orthopaedic surgeries have yielded conflicting results. Several studies have since started to approach this question based on anatomic location, comparing suture versus staple closure in total hip and knee arthroplasty and acetabulum fracture surgery. Ankle fractures are one of the most commonly treated fractures by orthopaedic surgeons with unique challenges to skin closure due to the lack of subcutaneous support...
August 22, 2018: Foot
Neil P Sheth, Joshua C Rozell, Wayne G Paprosky
As the demand for total hip arthroplasty (THA) continues to increase, the burden of revision THA is also expected to increase. Although the quality of polyethylene has improved markedly, osteolysis continues to be a risk for older designs and younger, active patients. Although progressive but typically asymptomatic in early stages, osteolysis can result in component failure and complicate revision surgery. Serial radiographs are paramount for monitoring progression. Although select cases may be treated with observation, surgery should be considered based on age, activity level, and projected life span...
October 15, 2018: Journal of the American Academy of Orthopaedic Surgeons
Priscella Chan, Angela Hsu, Jenna Godfrey, Selina S Silva, Rachel Y Goldstein, Deirdre Ryan, Paul D Choi, Robert M Kay
This study compared the outcomes of four salvage procedures in treating painful dislocated hips in patients with cerebral palsy: Schanz osteotomy, Girdlestone, Castle, and McHale procedures. A retrospective review of cerebral palsy patients treated between 1990 and 2014 with minimum 6-month follow-up was carried out. Of 69 hips (62 patients), there were 36 McHales, 24 Castles, four Girdlestones, and five Schanz procedures at a mean age of 13.9 years. All four procedures provided pain relief. Proximal femoral migration was similar following the procedures, but heterotopic ossification was more common after the Castle procedure...
October 15, 2018: Journal of Pediatric Orthopedics. Part B
Syed S Ahmed, Rajesh Bawale, Sunil Jain, Srinivas Samsani
No abstract text is available yet for this article.
December 2018: Journal of Orthopaedics
Timothy L Norman, Jordan E Denen, Austin J Land, Devan M Kienitz, Thomas A Fehring
BACKGROUND: Total hip arthroplasty is performed with modular parts. Either a metal or ceramic ball is fastened to the trunnion of a femoral stem via a Morse taper. This implant scenario has been successful. However, recently larger (36 mm or greater) metal heads have become more popular as a means to reduce the incidence of hip joint dislocation. Today, a number of clinical failures have occurred due to mechanically assisted crevice corrosion at the head (taper) stem (trunnion) interface necessitating revision surgery...
September 22, 2018: Journal of Arthroplasty
Hosam E Matar, Paula Stritch, Nicholas Emms
Interprosthetic femur fractures between total hip and total knee replacements are challenging injuries with rising incidence. Stability of the either implants, quality, and quantity of remaining bone as well as patients' comorbidities play an important role in operative management. Open reduction and internal fixation, advanced revision arthroplasty techniques, and megaprostheses are available options. In more complex cases, custom-made implants maybe necessary to achieve immediate weight-bearing and restore function...
2018: Journal of Long-term Effects of Medical Implants
Jan Zajc, Jožef Predan, Nenad Gubeljak, Andrej Moličnik, Samo K Fokter
The authors report on a case of modular femoral neck fracture which appeared 21 months after revision of acetabular component. The revision surgery was performed 8 years after the primary total hip arthroplasty due to aseptic loosening of the acetabular component. During acetabular revision, the primary implanted short (S, - 3.5 mm) femoral head was also exchanged with extra-long (XL, + 7.0 mm) femoral head fitting the modular femoral neck with a longer lever arm. Numerical analysis has shown that this has resulted in a 19...
October 13, 2018: European Journal of Orthopaedic Surgery & Traumatology: Orthopédie Traumatologie
Manish Kiran, Konstantinos G Makridis, Catherine Armstrong, Birender Kapoor, Gunasekaran Kumar, Viju Peter
BACKGROUND: Modular neck implants are used to improve precision in total hip arthroplasty. However, the presence of an additional interface at the neck-stem junction may result in increased wear and raised metal ion levels. We present a comparative analysis of functional outcomes and blood titanium (Ti), cobalt (Co), and chromium (Cr) levels between the ML taper with Kinectiv technology (MLKT) and ML taper uncemented titanium stems. METHODS: Two hundred hips were included in this prospective study...
September 21, 2018: Journal of Arthroplasty
Annett Klinder, Sarah Zaatreh, Martin Ellenrieder, Sylvio Redanz, Andreas Podbielski, Tobias Reichel, Hans Bösebeck, Wolfram Mittelmeier, Rainer Bader
Two-stage revision arthroplasty is the treatment of choice for periprosthetic infection, a serious complication after knee or hip arthroplasty. Our prospective clinical trial aimed to investigate the concentrations of gentamicin and vancomycin in wound exudate and tissue in two-stage revision arthroplasty. Wound exudate and periprosthetic membrane samples were collected from 18 patients (10 hip and eight knee patients), who were due for two-stage treatment after a periprosthetic joint infection. Samples were taken during insertion of antibiotic-impregnated spacers and after their removal...
October 12, 2018: Journal of Biomedical Materials Research. Part B, Applied Biomaterials
Sherrie L Aspinall, Sydney P Springer, Xinhua Zhao, Francesca E Cunningham, Carolyn T Thorpe, Todd P Semla, Ronald I Shorr, Joseph T Hanlon
OBJECTIVES: To examine the association between central nervous system (CNS) medication dosage burden and risk of serious falls, including hip fractures, in individuals with a history of a recent fall. DESIGN: Nested case-control study. SETTING: Veterans Health Administration (VHA) Community Living Centers (CLCs). PARTICIPANTS: CLC residents aged 65 and older with a history of a fall or hip fracture in the year before a CLC admission between July 1, 2005, and June 30, 2009...
October 11, 2018: Journal of the American Geriatrics Society
Masaki Takao, Hidetoshi Hamada, Takashi Sakai, Nobuhiko Sugano
The purpose of this chapter is to review current evidence on indications, techniques, and outcomes of computer-navigated surgical treatment of pelvic ring injuries and acetabular fractures, particularly computer-navigated screw fixation.Iliosacral screw fixation of pelvic ring injury using navigation is attracting attention because the biomechanical stabilization of posterior pelvic ring disruption is of primary importance and is widely indicated because it does not require complete reduction of the fracture site...
2018: Advances in Experimental Medicine and Biology
Markus Weber, Lena Witzmann, Jan Wieding, Joachim Grifka, Tobias Renkawitz, Benjamin Craiovan
PURPOSE: In revision hip arthroplasty, custom-made implants are one option in patients with acetabular Paprosky III defects. METHODS: In a retrospective analysis, we identified 11 patients undergoing cup revision using a custom-made implant. The accuracy of the intended position of the implant was assessed on post-operative 3D CT and compared to the pre-operative 3D planning in terms of inclination, anteversion, and centre of rotation. In addition, the accuracy of post-operative plain radiographs for measuring implant position was evaluated in relation to the 3D CT standard...
October 10, 2018: International Orthopaedics
Matthew Barrett, Anoop Prasad, Louis Boyce, Sebastian Dawson-Bowling, Pramod Achan, Steven Millington, Sammy A Hanna
The increasing prevalence of obesity has resulted in a marked increase in the number of total hip arthroplasties (THAs) carried out in patients with a high body mass index (BMI).THA in morbidly obese patients is often technically challenging owing to the associated co-morbidities and anatomical factors. Furthermore, the long-term clinical and functional outcomes of the procedure in these patients are not clear.The aim of this systematic review was to compare the long-term failure rate and functional outcomes of THA in morbidly obese versus non-obese patients...
September 2018: EFORT Open Reviews
Maria C Inacio, Michelle Lorimer, David C Davidson, Richard N De Steiger, Peter L Lewis, Stephen E Graves
BACKGROUND: Despite wide adoption of hydroxyapatite (HA)-coated femoral stems in THA, no studies have found differences in the risk of revision surgery with its use or investigated the interaction of different prosthesis designs with stem coating. QUESTIONS/PURPOSES: The purpose of this study was to evaluate the risk of revision in THAs with HA-coated stems compared with non-HA-coated. To achieve this purpose, we asked: (1) What is the difference in risk of revision of THAs with HA-coated femoral stems compared with non-HA-coated using an aggregate analysis? (2) What is the difference in risk of revision of THAs with HA-coated femoral stems compared with non-HA-coated for five prosthesis types that used the same femoral and acetabular component combination but where the femoral stem had both a HA and non-HA coating option? METHODS: The Australian Orthopaedic Association National Joint Replacement Registry analyzed cementless primary THA registered between September 1, 1999, and December 31, 2014...
October 9, 2018: Clinical Orthopaedics and related Research
Giuseppe Rollo, Giuseppe Rinonapoli, Paolo Pichierri, Michele Bisaccia, Auro Caraffa, Luigi Meccariello
Introduction: Trochanteric fractures of the femur are common in elderly individuals with osteoporosis. The use of cephalomedullary nails is increasing, and they are now the most commonly used fixation devices, especially for the treatment of unstable trochanteric fractures. The nail breakage is not the most common complication of intramedullary nailing. Many scientific papers report nail breakage in a specific location: through the lag screw hole, the nail shaft, or the distal locking hole...
2018: Case Reports in Orthopedics
George Grammatopoulos, Wade Gofton, Zaid Jibri, Matthew Coyle, Johanna Dobransky, Cheryl Kreviazuk, Paul R Kim, Paul E Beaulé
BACKGROUND: Many patients undergo both THA and spinal arthrodesis, and those patients may not fare as well as those who undergo one procedure but not the other. The mechanisms of how spinal arthrodesis affects patient function after THA remain unclear. QUESTIONS/PURPOSES: The aims of our study were to (1) determine how patient-reported outcome measures (PROMs), including the Oxford hip score as well as dislocations and complications compare after THA between patients with and without spinal arthrodesis; (2) characterize sagittal pelvic changes in these patients that occur when moving between different functional positions and test for differences between patients with and without spinal arthrodesis; and (3) assess whether differences in sagittal pelvic dynamics are associated with PROMs, complications, and dislocations after THA...
May 30, 2018: Clinical Orthopaedics and related Research
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