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Clinical Outcomes hip

Till D Lerch, Eduardo N Novais, Florian Schmaranzer, Kai Ziebarth, Simon D Steppacher, Moritz Tannast, Klaus A Siebenrock
BACKGROUND: Prophylactic pinning of the asymptomatic and normal-appearing contralateral hip in patients with unilateral slipped capital femoral epiphysis (SCFE) remains controversial. Understanding the minimal 10-year clinical, functional, and radiographic outcomes of the contralateral asymptomatic hip in unilateral SCFE may be helpful in the decision regarding whether the benefits associated with potentially preventing a SCFE are outweighed by the risk of additional surgery. QUESTIONS/PURPOSES: Among patients with SCFE treated with prophylactic pinning of the asymptomatic and contralateral hip, we sought (1) to determine the complications and reoperations; (2) to evaluate the development of cam deformities and the frequency and severity of osteoarthritis progression; and (3) to characterize hip pain and function as measured by the Harris hip score (HHS) and the Hip Disability and Osteoarthritis Outcome Score (HOOS) at minimal 10-year followup...
December 13, 2018: Clinical Orthopaedics and related Research
Cedric Maillot, Anthony Leong, Ciara Harman, Alberto Morelli, Richard Mospan, Justin Cobb, Charles Rivière
BACKGROUND: The kinematic alignment (KA) technique for total knee arthroplasty (TKA) is an emerging implant positioning philosophy that aims to restore constitutional knee anatomy to improve knee kinematics. At present, the KA technique aims to reconstruct native femorotibial (FT) joint alignment, however there is still insufficient consideration towards the inter-individual trochlear anatomy variability. Poor trochlear restoration may compromise clinical outcomes. Our study aimed at assessing the anatomical relationship between the native trochlea and other FT anatomical parameters...
December 10, 2018: Knee
Chan-Woo Park, Hyeon-Jun Eun, Sung-Hak Oh, Hyun-Jun Kim, Seung-Jae Lim, Youn-Soo Park
BACKGROUND: There is a lack of understanding on relationship between the femoral geometry and outcomes of total hip arthroplasty (THA). We investigated clinical and radiographic outcomes of THA using a cementless tapered wedge stem in patients with Dorr type A proximal femoral morphology and compared with those of type B femurs at a minimum follow-up of 5 years. METHODS: We analyzed 1089 hips (876 patients) that underwent THA using an identical cementless tapered wedge stem...
November 13, 2018: Journal of Arthroplasty
Johanne Martel-Pelletier, Emmanuel Maheu, Jean-Pierre Pelletier, Ludmila Alekseeva, Ouafa Mkinsi, Jaime Branco, Pierre Monod, Frédéric Planta, Jean-Yves Reginster, François Rannou
BACKGROUND AND AIMS: Although osteoarthritis (OA) is managed mainly in primary care, general practitioners (GPs) are not always trained in its diagnosis, which leads to diagnostic delays, unnecessary resource utilization, and suboptimal patient outcomes. METHODS: To address this situation, an International Rheumatologic Board (IRB) of 8 experts from 3 continents developed guidelines for the diagnosis of OA in primary care. The focus was three major topologies: hip, knee, and hand/finger OA...
December 11, 2018: Aging Clinical and Experimental Research
Marcos Jordan, Xavier Aguilera, José Carlos González, Pablo Castillón, Mónica Salomó, José Antonio Hernández, Leonardo Ruiz, José Maria Mora, Pilar Camacho-Carrasco, Salvi Prat-Fabregat, Alba Bosch, Ainhoa Rodriguez-Arias, María José Martínez-Zapata
INTRODUCTION: We assessed the efficacy of fibrin sealant (FS) and tranexamic acid (TXA) administered topically in patients with a hip fracture treated with prosthetic replacement. MATERIALS AND METHODS: Parallel, multicentre, open label, randomised, clinical trial. We compared three interventions to reduce blood loss: (1) 10 ml of FS, (2) 1 g of topical TXA, both administered at the end of the surgery, and (3) usual haemostasis (control group). The main outcome was blood loss collected in drains...
December 11, 2018: Archives of Orthopaedic and Trauma Surgery
Fuzhen Yuan, Zewen Sun, Haijun Wang, Yourong Chen, Jiakuo Yu
PURPOSE: A cutting guide technique for patella resurfacing in total knee arthroplasty was expected to result in less patellofemoral syndromes. The aim of this study was to identify differences in the patellofemoral function, clinical outcomes, and radiographic parameters between the freehand and cutting guide patellar resection techniques in patients undergoing total knee arthroplasty. METHODS: A prospective randomized controlled trial was conducted. The study was registered in a public trials registry (International Standard Randomized Trial No...
December 11, 2018: International Orthopaedics
Philip P Roessler, Max Jaenisch, Manuel Kuhlmann, Miriam Wacker, P Johannes Wagenhäuser, Sascha Gravius, Dieter C Wirtz
PURPOSE: Acetabular revision of failed total hip arthroplasty (THA) is often associated with severe bone loss. Therefore, a variety of revision implant systems has been developed during recent years, with the augment-and-modular-cage system being one of the newest additions to this portfolio. Together with biologic downsizing by means of impaction bone grafting, this uncemented system promises a high modularity and versatility to treat all acetabular defects up to Paprosky types IIIa and IIIb without pelvic discontinuity...
December 11, 2018: International Orthopaedics
Filippo Casella, Fabio Favetti, Gabriele Panegrossi, Matteo Papalia, Francesco Falez
INTRODUCTION: In the last three decades, total hip replacement in young patient became a habitual procedure. Principles of bone preservation are pushing many surgeons to implant conservative femoral components in patient younger than 65 years. Despite an overall good survivorship and clinical outcomes of conservative implants, failed cases are reported and the need to revise a conservative femoral component became an occasional procedure (with high prevalence of failed resurfacing implants)...
December 11, 2018: International Orthopaedics
Z Esmaeilinezhad, S Babajafari, Z Sohrabi, M-H Eskandari, S Amooee, R Barati-Boldaji
BACKGROUND AND AIMS: Polycystic Ovarian Syndrome is a common reproductive, endocrine, and metabolic disease in women. Pomegranate juice, known as a rich source of phytochemicals with high antioxidant activity, enriched with probiotic may improve PCOS. METHODS AND RESULTS: A randomized, controlled, triple-blinded, parallel trial study was performed in PCOS patients (n = 92). Three treatment groups (23 patients each) received 2 L of synbiotic pomegranate juice (SPJ), pomegranate juice (PJ), and synbiotic beverage (SB) weekly...
July 17, 2018: Nutrition, Metabolism, and Cardiovascular Diseases: NMCD
W A M van Lieshout, C D Martijn, B T J van Ginneken, R J van Heerwaarden
INTRODUCTION: Medial closing wedge high tibial osteotomy (CWHTO) for valgus deformity correction was first described by Coventry whom performed an additional reefing of the medial collateral ligament (MCL) to prevent instability postoperative. In our clinic the additional reefing procedure has never been performed and instability has not been reported routinely by patients. Using instrumented laxity testing, pre- and postoperative valgus and varus knee laxity can be measured objectively...
December 10, 2018: Journal of Experimental Orthopaedics
Ali Assaf, Jonathan R Manara, Kar H Teoh, Aled R Evans
BACKGROUND: There has been a shift from cemented to uncemented hip arthroplasty. One popular uncemented combination is the R3 acetabular cup with Polarstem, having the lowest revision rate in the UK National Joint Registry. However, there are no medium-term clinical outcomes on this combination in the literature. The aim of this study is to review our centre's outcomes with this combination using conventional bearings with a minimum of 7-year follow-up. METHODS: Using our centre's arthroplasty database, we identified all patients that underwent a total hip arthroplasty using these implants from August 2009 to December 2010...
December 8, 2018: European Journal of Orthopaedic Surgery & Traumatology: Orthopédie Traumatologie
A Otto, I J Banke, J Mehl, K Beitzel, A B Imhoff, B Scheiderer
INTRODUCTION: Avulsions of the lesser femoral trochanter are rare injuries in the adolescent population. An acute avulsion causes severe functional impairment with compromised hip flexion. Recent literature reports the superiority of surgical treatment for apophyseal avulsion fractures of the pelvis in adolescents. Unfortunately, there are no guidelines for an evidence-based treatment of lesser trochanter avulsions established. We present the cases of two adolescent athletes treated operatively...
December 10, 2018: Archives of Orthopaedic and Trauma Surgery
Avinash Kumar Rai, Rajesh Goel, Chirag Bhatia, Sumer Singh, Srikiran Thalanki, Ashwin Gondane
Purpose: The purpose of this study is to describe a method of inserting cement in the femoral head before fixation with dynamic hip screw to prevent screw cut out due to osteoporosis and to evaluate its clinical outcome in these patients. Materials and Methods: In this prospective study, 30 patients aged 60 years and older with intertrochanteric fracture were included. Bone mineral density was measured. After reaming of the femoral head and neck with a triple reamer and polymethyl methacrylate, bone cement was introduced into the femoral head using a customized nozzle and a barrel fitted on a cement gun...
December 2018: Hip & Pelvis
Irfan Qadir, Saeed Ahmad, Atiq Uz Zaman, Chirag Muhammad Khan, Shahzad Ahmad, Amer Aziz
Purpose: This study was performed to assess the clinical and radiological outcomes following one-stage hip reconstruction, consisting of open reduction femoral shortening and pelvic osteotomy, for neglected developmental dislocation of the hip (DDH). Materials and Methods: This is a retrospective analysis of 77 hips in 65 patients (46 females and 19 males; 12 had bilateral dislocations), operated at a Ghurki Trust Teaching Hospital in Pakistan between 2013 and 2015...
December 2018: Hip & Pelvis
Cheon-Gon Park, Taek-Rim Yoon, Kyung-Soon Park
Purpose: Internal fixation using compression hip screws (CHS) and traction tables placing patients in the supine position is a gold standard option for treating intertrochanteric fractures; however, at our institution, we approach this treatment with patients in a lateral decubitus position. Here, the results of 100 consecutive elderly (i.e., ≥45 years of age) patients who underwent internal fixation with CHS in lateral decubitus position are analyzed. Materials and Methods: Between March 2009 and May 2011, 100 consecutive elderly patients who underwent internal fixation with CHS for femoral intertrochanteric fracture were retrospectively reviewed...
December 2018: Hip & Pelvis
Joong-Myung Lee, Young-Suk Sim, Dae-Sung Choi
Purpose: This is a report on the outcomes associated with a consecutive series of 1,000 cementless hip arthroplasties utilizing the Bencox® hip stem-the first Korean-developed hip prosthesis. Materials and Methods: A consecutive series of 1,000 hip arthroplasties using the Bencox® hip stem were analyzed, starting from its initial release (September 2006) until June 2014. Patients in this consecutive series underwent surgery for fractures (n=552), arthritis (n=155), avascular necrosis (n=209), and revisions (n=84)...
December 2018: Hip & Pelvis
Jun-Shik Kim
In Western patient populations, the reported incidence of imaging-demonstrated deep vein thrombosis (DVT) after total hip arthroplasty (THA) is as high as 70% without prophylaxis. The reported rates of symptomatic pulmonary embolism (PE) after THA in recent studies range from 0.6% to 1.5%, and the risk of fatal PE ranges from 0.11% to 0.19% in the absence of prophylaxis. Predisposing factors to DVT in western patients include advanced age, previous venous insufficiency, osteoarthritis, obesity, hyperlipidemia, dietary and genetic factors...
December 2018: Hip & Pelvis
Joel R Narveson, Matthew D Haberl, C Nathan Vannatta, Daniel I Rhon
Background/Purpose: Femoroacetabular impingement Syndrome (FAIS) and the often-associated acetabular labral tears (ALTs) are challenging to treat and consensus to guide effective management is lacking. Recent guidelines suggest physical therapy is beneficial, yet the guidance for specific interventions is unclear. The purpose of highlighting these cases was to describe the outcomes and the clinical reasoning process driving conservative management of subjects with FAIS and ALTs that were deemed surgical candidates...
December 2018: International Journal of Sports Physical Therapy
John H Harp
Background: Airborne microbe-carrying particles in the operating-room environment during total joint replacement are a risk factor for periprosthetic joint infection. The present study focuses on a simple environmental test, based on practices used in aseptic cleanrooms, to quantify the deposition of microbe-carrying particles onto the sterile field. Methods: Settle plates are exposed Petri dishes. A settle plate test system and sampling plan were developed from current practices used in aseptic manufacturing...
September 25, 2018: JB & JS open access
Anne Postler, Andres Luque Ramos, Jens Goronzy, Klaus-Peter Günther, Toni Lange, Jochen Schmitt, Angela Zink, Falk Hoffmann
Objective: Osteoarthritis (OA) is highly prevalent throughout the world, especially in the elderly population, and is strongly associated with patients' frailty. However, little is known about the prevalence and treatment of OA in elderly patients in routine clinical care in Germany. Materials and methods: As a part of Linking Patient-Reported Outcomes with CLAIms Data for Health Services Research in Rheumatology (PROCLAIR), a cross-sectional study using claims data from a large Germany statutory health insurance (BARMER) was conducted...
2018: Clinical Interventions in Aging
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