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Painful total hip

Elspeth Will, Nicholas Magill, Rebecca Arnold, Megan Davies, Gary Doherty, Charlie Fairhurst, Andreas Roposch, Claire Lundy, Fabian Norman-Taylor
AIM: To assess whether preoperative botulinum neurotoxin A (BoNT-A) affects pain after major hip surgery for children with bilateral cerebral palsy (CP). METHOD: This was a randomized, parallel arms, placebo-contolled trial. Children with hypertonic CP aged 2 to 15 years awaiting bony hip surgery at a tertiary hospital were randomized to receive either BoNT-A or placebo injections into the muscles of the hip on a single occasion immediately before surgery. The primary outcome was the paediatric pain profile (PPP), which was assessed at baseline and weekly for 6 weeks...
January 15, 2019: Developmental Medicine and Child Neurology
P Sirtori, G M Peretti, M Ulivi, R Ciliberto, M D Lombardo, F Verdoni, G Michielon, L Mangiavini
Total Hip Arthroplasty (THA) is considered the most successful treatment for advanced hip osteoarthritis. Different surgical approaches for THA are available and they have shown excellent outcomes in the long-term follow-ups. However, few studies have analyzed the functional outcomes in the first days after a THA surgery. The purpose of this study was to compare the early functional outcomes between two different surgical techniques: a minimally invasive direct anterior approach (mini-DAA) and a postero-lateral approach (PL)...
November 2018: Journal of Biological Regulators and Homeostatic Agents
Fan Wu, Xiang Fang, Zhigang Lang, Hongyuan Liu, Yan Xiong, Wenli Zhang, Yi Luo, Chongqi Tu, Hong Duan
Objective: To investigate the procedure and effectiveness of total femoral replacement for treating femur malignant tumor. Methods: The clinical data of 9 patients with femoral malignant tumors who underwent total femoral replacement between July 2013 and March 2017 were retrospectively analyzed. There were 5 males and 4 females, aged 16-75 years with an average of 44.8 years. The disease duration ranged from 2 to 6 months with an average of 3.5 months. There were 5 cases of osteosarcoma (3 cases were staged as Enneking ⅡB, 2 cases were staged as Enneking Ⅲ), 1 case of malignant fibrosarcoma (staged as Enneking ⅡB), 1 case of chondrosarcoma (staged as Enneking ⅠB), 2 cases of femoral muti-metastasis of lung cancer with pathological fracture...
January 1, 2019: Chinese Journal of Reparative and Reconstructive Surgery
Gregory R Galakatos
The direct anterior approach to the hip for total joint arthroplasty has been suggested to have several advantages compared to other popular approaches through its use of a natural intramuscular and intra-nervous interval. Recent emphasis on tissue sparing and minimally invasive outpatient joint replacements has given rise to a significant increase in the utilization of direct anterior total hip arthroplasty (DAA). Proponents of this approach cite improved recovery times, lower pain levels, improved patient satisfaction as well as improved accuracy on both implant placement/alignment and leg length restoration...
November 2018: Missouri Medicine
Lili Xiang, Binghuai Lu
BACKGROUND: Hip replacement is generally conducted in those with prolonged arthritis pain or hip fractures, and postoperative infection is a serious complication. Mycoplasma hominis, belonging to mycoplasma species, exists mainly in the genitourinary tract. M. hominis infection after total hip replacement was rarely documented in literature. CASE PRESENTATION: A 59-year-old male was febrile after left total hip replacement. Empiric therapy with cefepime for suspected infection was ineffective...
January 14, 2019: BMC Infectious Diseases
Yale A Fillingham, Dipak B Ramkumar, David S Jevsevar, Adolph J Yates, Stefano A Bini, Henry D Clarke, Emil Schemitsch, Rebecca L Johnson, Stavros G Memtsoudis, Siraj A Sayeed, Alexander P Sah, Craig J Della Valle
No abstract text is available yet for this article.
January 2019: Regional Anesthesia and Pain Medicine
Patrick Doiron-Cadrin, Dahlia Kairy, Pascal-André Vendittoli, Véronique Lowry, Stéphane Poitras, François Desmeules
PURPOSE: Prolonged wait times for total hip and knee arthroplasty have deleterious effects on functional status for the awaiting patients. Telerehabilitation interventions can optimize the delivery of perioperative care. This pilot single-blind randomized controlled trial evaluates the feasibility and the potential impact on pain and disability of a telerehabilitation prehabilitation program, compared to in-person prehabilitation or usual care. MATERIAL AND METHODS: Thirty-four patients awaiting a total hip or knee arthroplasty were randomly assigned to (1) an in-person 12-week prehabilitation program, (2) a tele-prehabilitation program or (3) usual care...
January 13, 2019: Disability and Rehabilitation
Lorcan McGonagle, Lila Convery-Chan, Penelope DeCruz, Samantha Haebich, Daniel P Fick, Riaz J K Khan
BACKGROUND: A substantial proportion of patients undergoing lower limb arthroplasty are of working age. This study aims to identify when patients return to work (RTW) and if they return to normal hours and duties, and to identify which factors influence postoperative RTW. The hypothesis is that there is no difference in time of RTW between the different types of surgery, and no difference in time of RTW based on the physical demands of the job. MATERIALS AND METHODS: Consecutive patients aged < 65 years who had undergone unilateral primary total hip arthroplasty (THA), total knee arthroplasty (TKA), or medial unicompartmental knee arthroplasty (UKA) from 2015 to 2017 were sent a questionnaire...
January 14, 2019: Journal of Orthopaedics and Traumatology: Official Journal of the Italian Society of Orthopaedics and Traumatology
Majid Shahbazi Moheb Seraj, Javad Sarrafzadeh, Nader Maroufi, Ismail Ebrahimi Takamjani, Amir Ahmadi, Hossein Negahban
Background: Static and dynamic postures of lumbopelvic in low back pain (LBP) are considered as two important aspects of clinical assessment and management of LBP. Thus, the focus of the current study was to compare the posture and compensatory strategy of hip and lumbar region during trunk flexion between LBP subgroupsand health subjects. LBP cases are subdivided into active extension pattern (AEP) and flexion pattern (FP) based on O'Sullivan's classification system (OCS). Methods: This work was a cross-sectional study involving 72 men, 21 low back pain patients with FP and 31 low back pain patients with AEP and 20 healthy groups...
November 2018: Archives of Bone and Joint Surgery
Alex H S Harris, Alfred C Kuo, Yingjie Weng, Amber W Trickey, Thomas Bowe, Nicholas J Giori
BACKGROUND: Existing universal and procedure-specific surgical risk prediction models of death and major complications after elective total joint arthroplasty (TJA) have limitations including poor transparency, poor to modest accuracy, and insufficient validation to establish performance across diverse settings. Thus, the need remains for accurate and validated prediction models for use in preoperative management, informed consent, shared decision-making, and risk adjustment for reimbursement...
January 7, 2019: Clinical Orthopaedics and related Research
Martin Schwarze, Winfried Häuser, Gabriele Schmutzer, Elmar Brähler, Nicholas A Beckmann, Marcus Schiltenwolf
INTRODUCTION: Up to 64% of the general population reports experiencing chronic pain, with the hip being one of the most frequent sites. An association has been shown between chronic back pain, obesity and depression. To date, a similar association has not been investigated with chronic hip pain. METHODS: A total of 2,515 subjects were chosen as a representative cross-section of the German population. Each was provided with a questionnaire that included the Regional Pain Scale, European Organization for Research and Treatment of Cancer Quality of Life Questionnaire (EORTC QLQ-C30), Beck Depression Inventory-Primary Care and Winkler social class index...
January 8, 2019: Musculoskeletal Care
Hui Zhang, Qing Fan, Junfeng Zhang, Bin Wu, Xiaofeng Wang, Yu Zhang, Aizhong Wang
BACKGROUND: Emergence agitation (EA) is a common postoperative issue in children that causes self-injury, increases stress on healthcare team members, and even leads to postoperative maladaptive behavioral changes in children. Clear answers regarding a 'gold standard' for prevention of EA are not available. Pain is regarded as an important causative factor of EA, and ultrasound-guided lumbar plexus block is a safe and efficient anesthetic method that can provide satisfactory pain relief in pediatric hip surgery...
January 7, 2019: Trials
Sivashankar Chandrasekaran, Nader Darwish, Brian H Mu, Danil A Rybalko, Itay Perets, Carlos Suarez-Ahedo, Edwin O Chaharbakhshi, Ajay C Lall, Benjamin G Domb
PURPOSE: To report clinical outcomes of arthroscopic labral reconstruction in the hip at minimum 2-year follow-up in comparison to a pair-matched labral repair group. METHODS: Patients were included in this study if they underwent labral reconstruction during hip arthroscopy and had minimum 2-year follow-up data available. Exclusion criteria were active workers' compensation claims or previous ipsilateral hip surgery or conditions. Reconstruction patients were matched 1:2 to patients that underwent arthroscopic labral repair but otherwise met all inclusion and exclusion criteria...
January 3, 2019: Arthroscopy: the Journal of Arthroscopic & related Surgery
Zaira S Chaudhry, Hytham S Salem, Sommer Hammoud, John P Salvo
PURPOSE: To compare outcomes of hip arthroplasty in patients with and without a history of hip arthroscopy through a systematic review. METHODS: A comprehensive search of the PubMed (MEDLINE) and Cochrane Central databases was performed using combinations of the keywords "hip," "arthroscopy," "arthroscopic," "arthroplasty," "replacement," and "conversion" in December 2017. Level I through III studies directly comparing outcomes of total or resurfacing hip arthroplasty between patients with and without a history of hip arthroscopy were included in this review if they reported at least 1 outcome measure...
January 3, 2019: Arthroscopy: the Journal of Arthroscopic & related Surgery
Lyall Ashberg, Leslie C Yuen, Mary R Close, Itay Perets, Mitchell R Mohr, Edwin O Chaharbakhshi, Benjamin G Domb
PURPOSE: This study analyzed minimum 2-year hip arthroscopy outcomes in rheumatoid arthritis (RA) patients and non-RA control patients. It also examined whether disease-modifying antirheumatic drugs (DMARDs) affected RA patient outcomes. We hypothesized that patients with RA undergoing hip arthroscopy would have lower reported outcome scores. METHODS: Data were prospectively collected on all hip arthroscopies performed from 2009-2013. The indications for surgery were patients with hip pain and with physical examination and imaging studies confirming intra-articular pathology in whom conservative management had failed...
January 3, 2019: Arthroscopy: the Journal of Arthroscopic & related Surgery
Lyall Ashberg, Mary R Close, Itay Perets, Edwin O Chaharbakhshi, John P Walsh, Mitchell R Mohr, Benjamin G Domb
PURPOSE: To determine whether the presence of femoral head (FH) lesions affects patient-reported outcomes (PROs) of patients undergoing hip arthroscopy for labral tears. METHODS: Data were prospectively collected and retrospectively reviewed for all patients who underwent hip arthroscopy for labral tears at our institution from April 2008 to March 2011. Patients with FH lesions were matched to those without (control) for age, body mass index, sex, and lateral center-edge angle...
January 3, 2019: Arthroscopy: the Journal of Arthroscopic & related Surgery
Sivashankar Chandrasekaran, Nader Darwish, Ashraf H Darwish, Carlos Suarez-Ahedo, Parth Lodhia, Benjamin G Domb
PURPOSE: The purpose of this study was to conduct a matched pair analysis to determine the effect of prior lumbar spine surgery (LSS) on clinical outcomes of hip arthroscopy. METHODS: Data were prospectively collected on all patients undergoing hip arthroscopy during the study period from April 2008 to December 2012. Patients were excluded if they had previous hip conditions or had undergone prior hip surgery. Patients in the LSS group (history of LSS) were matched in a 1:1 ratio to a control group (no history of LSS) according to age ±5 years, gender, body mass index categories, Tönnis grade, and labral treatment...
January 3, 2019: Arthroscopy: the Journal of Arthroscopic & related Surgery
Khaled M Yaghmour, Yuhan Peng, Emanuele Chisari, Wasim Khan, Stephen M McDonnell
Von Willebrand disease is the commonest bleeding disorder encountered in the medical and surgical field. As a result of the repetitive bleeding into the joints many patients suffer from arthropathy that can cause a significant amount of pain and functional limitation. Total joint arthroplasty is being utilised as the last resort in managing these patients; however, the presence of von Willebrand disease raises a number of dilemmas. In this review, we look at the effects of von Willebrand disease on joints and the perioperative management of von Willebrand disease patients undergoing total joint arthroplasty...
January 2, 2019: Journal of Perioperative Practice
Luke Law, Christine L Hunt, Andre J van Wijnen, Ahmad Nassr, A Noelle Larson, Jason S Eldrige, William D Mauck, Mathew J Pingree, Juan Yang, Casey W Muir, Patricia J Erwin, Mohamad Bydon, Wenchun Qu
Background: The use of mesenchymal stem cells (MSCs) in clinical applications for the treatment of musculoskeletal disease is steadily increasing in office-based practice. The so-called "first generation" of MSCs is defined as autologous stem cells that have undergone minimal manipulation and are used for a homologous purpose. Systematic reviews of the clinical trials completed to date of such MSCs enable practitioners to better understand what is currently known about the outcomes and side effects of such treatments...
December 29, 2018: Pain Medicine: the Official Journal of the American Academy of Pain Medicine
Georgios Kyriakopoulos, Lazaros Poultsides, Panayiotis Christofilopoulos
Total hip arthroplasty through an anterior approach has been increasing in popularity amongst surgeons and patients.Anterior approach hip arthroplasty seems to offer improved early outcomes in terms of pain, rehabilitation and length of stay.No difference in long-term outcomes has been shown between anterior and posterior or lateral approaches.Proper formal training, utilization of fluoroscopy and adequate experience can mitigate risks of complications and improve early and medium-term outcomes. Cite this article: EFORT Open Rev 2018;3:574-583...
November 2018: EFORT Open Reviews
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