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Painful total hip

Maria De Santis, Berardo Di Matteo, Emanuele Chisari, Gilberto Cincinelli, Peter Angele, Christian Lattermann, Giuseppe Filardo, Nicolò Danilo Vitale, Carlo Selmi, Elizaveta Kon
Introduction: Osteoarthritis (OA) is a degenerative joint disease characterized by articular cartilage degradation, subchondral damage, and bone remodelling, affecting most commonly weight-bearing joints, such as the knee and hip. The loss of cartilage leads to joint space narrowing, pain, and loss of function which could ultimately require total joint replacement. The Wnt/ β catenin pathway is involved in the pathophysiology of OA and has been proposed as a therapeutic target. Endogenous and pharmacological inhibitors of this pathway were recently investigated within innovative therapies including the use of platelet-rich plasma (PRP) and mesenchymal stem cells (MSCs)...
2018: BioMed Research International
Joe Iwanaga, Seif Eid, Emily Simonds, Maia Schumacher, Marios Loukas, R Shane Tubbs
INTRODUCTION: The piriformis muscle is clinically implicated in pain disorders, posterior approaches for total hip arthroplasty, and iatrogenic injury to the muscle and the surrounding nerves. The piriformis muscle has been said to receive innervation from L5 to S3 ventral rami with most sources using S1 and S2 ventral rami as the most common innervation this muscle. However, descriptions of the nerve in the literature are vague. Therefore, the aim of this study was to clarify the anatomy of the nerve supply to the piriformis muscle...
November 8, 2018: Clinical Anatomy
Pengfei Zhao, Jing Hao
OBJECTIVE: to investigate the safety and long-term efficacy of core decompression with synthetic calcium-sulfate bone grafting on non-traumatic osteonecrosis of the femoral head. METHOD: a total of 76 patients with non-traumatic osteonecrosis of the femoral head were admitted to our hospital from February 2012 to November 2014 and included in the study. All the patients were treated by core decompression with synthetic calcium-sulfate bone grafting. After treatment, the patients were followed-up for 12 months...
October 2018: Médecine Sciences: M/S
Jorge A Padilla, Hayeem L Rudy, Jonathan A Gabor, Scott Friedlander, Richard Iorio, Raj J Karia, James D Slover
BACKGROUND: Incorporating patient-reported outcomes (PROs) is paramount to the creation of a value-based healthcare system that prioritizes patient-centered care in total joint arthroplasty. The relationship between global assessment PROs such as Patient-Reported Outcome Measurement Information System (PROMIS) and joint-specific PROs for hip and knee, such as short form variations of Knee Injury and Osteoarthritis Outcome Score (KOOS-JR) and Hip Injury and Osteoarthritis Outcome Score (HOOS-JR), has yet to be assessed...
October 13, 2018: Journal of Arthroplasty
Nur Canbolat, Mehmet Ilke Buget, Nukhet Sivrikoz, Demet Altun, Suleyman Kucukay
BACKGROUND AND OBJECTIVES: Neutrophil to lymphocyte ratio is a simple, cost-effective and easily applicable inflammation indicator that is being used frequently in mortality, morbidity and prognosis studies in the recent years. We evaluated the relationship between neutrophil to lymphocyte ratio and postoperative pain in patients undergoing total hip arthroplasty and total knee arthroplasty. MATERIAL AND METHODS: We included 101 patients who preferred spinal anesthesia and intravenous patient-controlled analgesia in accordance and divided them into two groups, total hip arthroplasty and total knee arthroplasty...
November 3, 2018: Revista Brasileira de Anestesiologia
Shiqi Cao, Jia Cao, Sirui Li, Wei Wang, Qirong Qian, Yu Ding
BACKGROUND: To translate and cross-culturally adapt the Copenhagen Hip and Groin Outcome Score (HAGOS) into a Simplified Chinese version (HAGOS-C) and evaluate the reliability, validity, and responsiveness of the HAGOS-C in total hip arthroplasty (THA) patients. METHODS: The cross-cultural adaptation was performed according to the internationally recognized guidelines of the American Academy of Orthopaedic Surgeons Outcome Committee. A total of 192 participants were recruited in this study...
November 6, 2018: Journal of Orthopaedic Surgery and Research
Rebecca Moyer, Brent Lanting, Jacquelyn Marsh, Abdulaziz Al-Jurayyan, Laura Churchill, James Howard, Lyndsay Somerville
BACKGROUND: Total hip arthroplasty is recommended by clinical practice guidelines for improving pain in patients with severe hip osteoarthritis, yet functional limitations may persist postoperatively. The effects of the surgical approach on postoperative gait biomechanics may influence these limitations after total hip arthroplasty but are currently not well established. The purpose of this study was to investigate the differences in postoperative gait biomechanical differences, at early and late follow-up, in patients with hip osteoarthritis who underwent total hip arthroplasty using different surgical approaches...
November 6, 2018: JBJS Reviews
Tarun Goyal
PURPOSE: Femoroacetabular impingement and its surgical treatment have not been described before in osteonecrosis of femoral head. We present here outcomes of 15 patients with femoroacetabular impingement secondary to osteonecrosis of femoral head. This results from partial collapse of femoral head, particularly in the anterosuperior region, secondary to osteonecrosis. With subsequent remodelling, periphery of the femoral head flattens and osteophytes form in this area. All these patients were managed with open/arthroscopic osteochondroplasty of femoral head...
2018: SICOT-J
Jan Maca, Jan Neiser, Lenka Grasslova, Michaela Trlicova, Dana Streitova, Renata Zoubkova
AIMS: Patient-controlled analgesia (PCA) is usually considered a better option for pain management compared to conventional analgesia. The beneficial effect of PCA has been assessed in a number of studies; however, the results are inconsistent. The goal of this study was to compare of patient-controlled epidural analgesia (PCEA) to conventional epidural analgesia after total hip replacement (THR). METHODS: This prospective study was performed at the Department of Anesthesia and Intensive Care Medicine at a tertiary university hospital...
November 6, 2018: Biomedical Papers of the Medical Faculty of the University Palacký, Olomouc, Czechoslovakia
Natalie L Leong, Ian M Clapp, William H Neal, Edward Beck, Charles A Bush-Joseph, Shane J Nho
PURPOSE: To determine whether patients who have pain in other major joints or the spine have poorer postsurgical outcomes than patients without comorbid orthopaedic pain. METHODS: We performed a review of a prospectively maintained institutional surgical registry of patients who underwent hip arthroscopy between January 1, 2012, and July 16, 2015, by a single surgeon, with a minimum of 2 years of postoperative follow-up. A musculoskeletal morbidity (MSM) score was assigned to each patient preoperatively based on the presence of pain in other joints and the spine (grade 1, hip only; grade 2, hip and other major joints without spine; grade 3, hip with spine; and grade 4, hip and other major joints with spine)...
November 2, 2018: Arthroscopy: the Journal of Arthroscopic & related Surgery
Sanjib D Adhikary, Anthony J Short, Kariem El-Boghdadly, Mena J Abdelmalak, Ki Jinn Chin
Background and Aims: Cadaveric studies have shown that injectate from transmuscular quadratus lumborum block (QLB) can spread to the lumbar plexus. Our aim was to compare analgesic efficacy of transmuscular QLB with lumbar plexus block (LPB) for patients undergoing total hip arthroplasty (THA). Material and Methods: Thirty patients receiving transmuscular QLB were propensity score matched with 30 patients receiving LPB for age, sex, ASA score, BMI, operative time, preoperative oxycodone, and intraoperative opioid use...
July 2018: Journal of Anaesthesiology, Clinical Pharmacology
Rebecca Mellor, Kim Bennell, Alison Grimaldi, Philippa Nicolson, Jessica Kasza, Paul Hodges, Henry Wajswelner, Bill Vicenzino
OBJECTIVE: To compare the effects of a programme of load management education plus exercise, corticosteroid injection use, and no treatment on pain and global improvement in individuals with gluteal tendinopathy. DESIGN: Prospective, three arm, single blinded, randomised clinical trial. SETTING: Brisbane and Melbourne, Australia. PARTICIPANTS: Individuals aged 35-70 years, with lateral hip pain for more than 3 months, at least 4/10 on the pain numerical rating scale, and gluteal tendinopathy confirmed by clinical diagnosis and MRI; and with no corticosteroid injection use in previous 12 months, current physiotherapy, total hip replacement, or neurological conditions...
November 2018: British Journal of Sports Medicine
Qing-Yu Zhang, Zi-Rong Li, Fu-Qiang Gao, Wei Sun
Objective: To propose a new definition of the pericollapse stage of osteonecrosis of the femoral head (ONFH) and review its significance in disease diagnosis and treatment selection. Data Sources: A search for eligible studies was conducted in three electronic databases including PubMed, Cochrane Library, and Embase up to August 10, 2018, using the following keywords: "osteonecrosis", "prognosis", and "treatment". Study Selection: Investigations appraising the clinical signs, symptoms, and imaging manifestations in different stages of ONFH were included...
November 5, 2018: Chinese Medical Journal
Allison M Hunter, Alan Hsu, Ashish Shah, Sameer M Naranje
Though rare, there are documented failures of femoral prosthesis due to corrosion of the head-neck interface in total hip arthroplasty (THA), a phenomenon known as trunnionosis. This wear can result in metallosis, whereby metal debris scatters the surrounding soft tissues. We present on a 58-year-old female who presented with increase in hip and back pain 10 years following right THA using a metal-on-polyethylene construct with a large femoral head (44 mm). Aspiration withdrew metallic fluid, and intraoperative findings showed corrosion of the head-neck taper with surrounding metallosis and pseudocapsule formation...
October 29, 2018: European Journal of Orthopaedic Surgery & Traumatology: Orthopédie Traumatologie
Josef Maxwell Gutman, Kelvin Kim, Ran Schwarzkopf, Ilya Kister
Background: Hip and knee replacements for osteoarthritis are established procedures for improving joint pain and function, yet their safety in patients with multiple sclerosis (MS) is unknown. Patients with MS face unique surgical challenges due to underlying neurologic dysfunction. Current literature on arthroplasty in MS is limited to case reports focusing on adverse events. Methods: Of 40 identified patients who underwent hip or knee replacement, 30 had sufficient data for inclusion...
September 2018: International Journal of MS Care
Mingqing Li, Can Xu, Jie Xie, Yihe Hu, Hua Liu
BACKGROUND: This retrospective study investigated the relative benefits of using a collum femoris-preserving prosthesis or ribbed stem during total hip arthroplasty (THA). METHODS: The clinical results were compared of patients who underwent THA, between January 2010 and December 2012, with either a CFP prosthesis or a ribbed stem (66 and 75 patients, respectively, aged 43.4 ± 10.8 and 42.3 ± 9.8 years). Patients were assessed using the Harris Hip Score (HHS), Western Ontario and McMaster University Osteoarthritis Index (WOMAC), 12-Item Short Form Health Survey (SF-12), and physical component summary (PCS) score...
October 29, 2018: Journal of Orthopaedic Surgery and Research
Cheol Lee, Juhwan Lee, Gilho Lee, Hayeong Lee, Eunnim Koh, Jihyo Hwang
Pregabalin and dexmedetomidine have been introduced to manage postoperative pain. This study evaluated the effect of the 2 drugs combined on pain in patients undergoing total knee or hip arthroplasty. A total of 124 patients undergoing total knee or hip arthroplasty under spinal anesthesia were randomly assigned to either group C (n=31, placebo), group P (n=33, pregabalin), group PD (n=29, pregabalin and dexmedetomidine), or group D (n=31, dexmedetomidine). One hour before spinal anesthesia, patients received 150 mg of pregabalin or placebo orally, and a bolus dose of 0...
October 26, 2018: Orthopedics
Michael-Alexander Malahias, Kulapat Chulsomlee, Fritz Thorey
Several studies have reported that minimally- invasive total hip arthroplasty (MISTHA) may significantly reduce postoperative pain and results in faster postoperative rehabilitation when compared with the traditional lateral or posterior approach. Regarding bilateral hip osteoarthritis, there is still no consensus whether simultaneous bilateral MIS-THA can be established as the treatment of choice. Therefore, we searched the international databases of Pubmed, Medline, and Cochrane Database of Systematic Reviews using the key words minimally invasive bilateral total hip arthroplasty ...
September 5, 2018: Orthopedic Reviews
Fatih Kucukdurmaz, Mohamed Sukeik, Javad Parvizi
BACKGROUND: Proponents of the direct anterior approach (DAA) for THAs suggest earlier recovery with no increased complications whereas opponents suggest higher complication rates. METHODS: We conducted a meta-analysis of randomized controlled trials (RCTs) to compare the outcomes of the DAA versus other surgical approaches in primary THAs. RESULTS: We identified 18 RCTs suitable for detailed extraction of the data. The RCTs included a total of 1661 patients with a mean age of 62 years (range 55-69)...
October 22, 2018: Surgeon: Journal of the Royal Colleges of Surgeons of Edinburgh and Ireland
Elahe Faraji, Mostafa Allami, Nafiseh Feizollahi, Amir Karimi, Amir Yavari, Mohammadreza Soroush, Majid Moudi
BACKGROUND: The aim of the study was to identify health concerns of veterans with high-level lower extremity amputations. METHODS: Through a cross-sectional study, general practitioners, an orthopedic specialist, psychologists, psychiatrists, physiotherapist and prosthetists examined 100 veterans using a short-form health-related quality of life questionnaire (SF-36) that assessed their ability to perform activities of daily living (ADL), instrumental activities of daily living (IADL) and life satisfaction (SWLS) after hip disarticulation or hemi-pelvectomy amputations...
October 26, 2018: Military Medical Research
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