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Total Hip

X Q Wang, C S Wu, S Sun, J Wang, W Li, W Zhang
Objective: To investigate the situation of hip dislocation with the application of "femur first" principle and "combined anteversion technique" during total hip arthroplasty. Methods: A retrospective analysis has been done on the clinical data about 104 patients(133 hips)who were diagnosed as hip disease and were treated with total hip arthroplasty by the doctors from the Department of Joint Orthorpaedics of Shandong Provincial Hospital Affiliated to Shandong University from June 2014 to June 2016, and all the prostheses applied in the operation were cementless ones...
April 1, 2018: Zhonghua Wai Ke za Zhi [Chinese Journal of Surgery]
Chi Zhang, Bo Xu, Guanzhao Liang, Xianshang Zeng, Chen Yang, Fan Zhang, Zi Wan, Weiguang Yu, Deng Chen, Zhe Ge, Xinchao Zhang
Objective This study was performed to evaluate the efficacy of rivaroxaban versus nadroparin for preventing deep venous thrombosis (DVT) in elderly patients with osteoporosis undergoing initial total hip arthroplasty (THA) for femoral neck fractures. Methods Prospectively maintained databases were reviewed to retrospectively compare elderly patients with osteoporosis who underwent initial THA for femoral neck fractures from 2007 to 2015. The patients received peroral rivaroxaban at 10 mg/day for 2 weeks or subcutaneous injections of nadroparin at 0...
January 1, 2018: Journal of International Medical Research
Adolph J Yates
The Center for Disease Control and Prevention recently released their 2017 Guideline for the Prevention of Surgical Site Infection. One of their recommendations is the ordering of a single dose of preoperative prophylactic antibiotics with no subsequent postoperative dosing; this recommendation includes perioperative antibiotics for patients undergoing total joint arthroplasty. At this time, the American Association of Hip and Knee Surgeons (AAHKS) does not agree with this recommendation vis-a-vis total joint arthroplasty because it contradicts current international standards of care with limited evidence and study...
March 2018: Arthroplasty Today
Florian F Dibra, Hernan A Prieto, Chancellor F Gray, Hari K Parvataneni
Background: Hip osteoarthritis typically manifests with groin or thigh pain. Other atypical pain patterns, including knee pain, have been described. Except for 2 case reports, there is no literature on this subject. Methods: From our institutional database, between 2011 and 2016, we identified 21 patients who were referred for treatment of knee pain but ultimately diagnosed with hip pathology as the cause of their pain. This group was evaluated for duration of symptoms prior to diagnosis, previous interventions, presence of walking aids, and symptom resolution after treatment of the hip pathology...
March 2018: Arthroplasty Today
Allicia Imada, Nathaniel Nelms, David Halsey, Michael Blankstein
Background: Following total knee and hip arthroplasty, patient progress can be assessed with patient-reported outcome measures (PROMs) and performance-based outcome measures (PBOMs). The American Joint Replacement Registry 2016 guide recommends collecting several measures, including Patient Reported Outcome Measure Information System Global, Knee Injury and Osteoarthritis Outcome Score Jr, and Hip Injury and Osteoarthritis Outcome Score Jr. This study aimed to assess the current and anticipated use of PROMs and PBOMs by New England physical therapists...
March 2018: Arthroplasty Today
Blair S Ashley, Paul Maxwell Courtney, Daniel J Gittings, Jenna A Bernstein, Gwo Chin Lee, Eric L Hume, Atul F Kamath
Background: The validated Arthroplasty Risk Score (ARS) predicts the need for postoperative triage to an intensive care setting. We hypothesized that the ARS may also predict hospital length of stay (LOS), discharge disposition, and episode-of-care cost (EOCC). Methods: We retrospectively reviewed a series of 704 patients undergoing primary total hip and knee arthroplasty over 17 months. Patient characteristics, 90-day EOCC, LOS, and readmission rates were compared before and after ARS implementation...
March 2018: Arthroplasty Today
Chong Meng Lee, Malkit K Dhillon, Mohd Amin Sulaiman
Background: The use of navigation for total knee arthroplasty (TKA) improves limb alignment in the coronal and sagittal planes. However, similar improvements in femoral and tibial component rotation have not yet been realized using currently available systems. Methods: We developed a modified navigated TKA technique in which femoral rotation was set using the resected tibial plane as the reference with the aim of achieving a rectangular flexion gap. Limb alignment was assessed in a cohort of 30 knees using the navigation system...
March 2018: Arthroplasty Today
Colin D Canham, Christopher P Walsh, Stephen J Incavo
Simultaneous prosthetic joint infection of ipsilateral hip and knee arthroplasties is often accompanied by significant bone loss and presents a challenging reconstructive problem. Two-stage reconstruction is favored and requires the placement of a total femur spacer, which is not a commercially available device. We describe a surgical technique, reporting on 2 cases in which a customized total femur antibiotic impregnated spacer was created by combining an articulating knee spacer and an articulating hip spacer with a reinforced cement dowel construct connecting the 2 spacers...
March 2018: Arthroplasty Today
Pablo Sanz-Ruiz, Jose Antonio Calvo-Haro, Manuel Villanueva-Martinez, Jose Antonio Matas-Diez, Javier Vaquero-Martín
Bone cement spacers loaded with antibiotic are the gold standard in septic revision. However, the management of massive bone defects constitutes a surgical challenge, requiring the use of different nails, expensive long stems, or cement-coated tumor prostheses for preparing the spacer. In most cases, the knee joint must be sacrificed. We describe a novel technique for preparing a biarticular total femur spacer with the help of a trochanteric nail coated with antibiotic loaded cement, allowing mobility of the hip and knee joints and assisted partial loading until second step surgery...
March 2018: Arthroplasty Today
Ahmed Siddiqi, Carl T Talmo, James V Bono
Dislodgment of trial femoral heads and migration into the pelvis during total hip arthroplasty is a rarely reported complication with limited published cases. There are three primary mechanisms of femoral head separation: dislodgement during reduction attempt, disassociation from anterior dislocation while assessing anterior stability, and during dislocation after implant trialing. If the trial femoral migrates beyond the pelvic brim, it is safer to finish the total hip arthroplasty and address the retained object after repositioning or in a planned second procedure with a general surgeon...
March 2018: Arthroplasty Today
Andrew Konopitski, Anthony Boniello, Patrick Wang, Mitesh Shah, Andrew Old, Kevin Gingrich
We present a unique case of bladder perforation occurring intraoperatively during primary total hip arthroplasty. It is suspected that the patient's aberrant bladder anatomy, with idiopathic erosion of the quadrilateral space, predisposed the patient to bladder injury. Several preoperative risk factors for bladder injury were identified in the literature. These factors include cemented acetabular components, previous history of hip arthroplasty, history of pelvic trauma or intrapelvic surgery, and poor bone quality...
March 2018: Arthroplasty Today
Erin Honcharuk, Stephen Kayiaros, Lee E Rubin
Addressing acetabular bone defects can be difficult and depends on the amount of bone loss. Augments, either with bone or highly porous metals, are options that still allow the use of a hemispherical cup. Almost all previous research and publication on acetabular augments have focused on revision hip arthroplasty utilizing either a modified lateral or a posterolateral surgical approach. We describe 3 cases of augmenting acetabular bone defects through a direct anterior approach for primary total hip arthroplasty...
March 2018: Arthroplasty Today
Swati Chopra, Michael Taunton, Kenton Kaufman
Muscle activation following total hip arthroplasty with a direct anterior approach has not previously been reported in the literature. This case report details the electromyography outcome of a 60-year-old male patient with unilateral direct anterior approach-total hip arthroplasty during walking and stair activities. Outcome reports the continuation of altered muscle activation 12 months postoperatively, even with a good clinical outcome.
March 2018: Arthroplasty Today
Jeffrey B Stambough, J Bohannon Mason, Aldo M Riesgo, Thomas K Fehring
Consensus regarding femoral stem fixation options in revision total knee arthroplasty remains controversial. Tapered, modular, fluted titanium (TMFT) stems have an excellent track record in total hip arthroplasty for their ability to provide axial and rotational stability in situations of compromised host bone. We present 3 successfully treated cases in which the Food & Drug Administration granted permission to use custom TMFT stems in situations of failed femoral fixation in multiple revised knees. These stems hold promise to achieve stable fixation in revision total knee arthroplasty where host metadiaphyseal bone is deficient...
March 2018: Arthroplasty Today
Yukio Nakamura, Mikio Kamimura, Akio Morikawa, Akira Taguchi, Takako Suzuki, Hiroyuki Kato
Background: The aim of this study was to evaluate the effects of denosumab in patients with osteoporosis (OP) and non-metastatic breast cancer following treatment of 1) surgery, 2) surgery and aromatase inhibitors, and 3) surgery, aromatase inhibitors, and anti-cancer agents, compared with those in primary OP patients. Patients and methods: In this retrospective 24-month study, patients were divided into the primary OP group (34 cases) or OP receiving breast cancer treatment group (breast cancer group; 17 cases)...
2018: Therapeutics and Clinical Risk Management
Rasha Babiker, Khalifa Elmusharaf, Michael B Keogh, Amal M Saeed
BACKGROUND: There is a strong association between cardiometabolic risk and adipose tissue dysfunction with great consequences on type 2 diabetic patients. Visceral Adiposity Index (VAI) is an indirect clinical marker of adipose tissue dysfunction. Gum Arabic (GA) is a safe dietary fiber, an exudate of Acacia Senegal. Gum Arabic had shown lipid lowering effect in both humans and animals. The aim of this trial was to determine the effect of GA supplementation on anthropometric obesity marker, Visceral Adiposity Index (VAI) and blood pressure in patients with type 2 diabetes mellitus...
March 20, 2018: Lipids in Health and Disease
Hirotaka Iijima, Kanako Shimoura, Tomoki Aoyama, Masaki Takahashi
BACKGROUND: Stair climbing was suggested to be the first affected task in individuals with knee osteoarthritis (OA). RESEARCH QUESTION: This review aimed to identify consistent kinematic, kinetic, and spatiotemporal alterations of stair climbing exhibited by individuals with knee OA. METHODS: A literature search published until September 2017 was conducted in PubMed, PEDro, CINAHL, and Cochrane CENTRAL. Reviewer extracted data in accordance with the Cochrane Handbook...
March 8, 2018: Gait & Posture
Andrew S Chung, Joshua W Hustedt, Robert Walker, Clifford Jones, Jason Lowe, George V Russell
OBJECTIVES: Low serum albumin levels (hypoalbuminemia) have classically been used to identify malnutrition. The effect of increasing severity of malnutrition on postoperative outcomes in patients undergoing hip fracture surgery has not been well delineated on a large scale. DESIGN: Retrospective. SETTING: Multicenter. PATIENT/PARTICIPANTS: A total of 12,373 patients undergoing hip fracture surgery from 2006 to 2013 National Surgery Quality Improvement Project data were identified...
April 2018: Journal of Orthopaedic Trauma
Neha Dewan, Joy C MacDermid, Ruby Grewal, Karen Beattie
In a prospective cohort of 113 patients followed 4 years after distal radius fracture (DRF), 24% of patients experienced a subsequent fall and 19% experienced a subsequent fracture. People with poor balance, greater fracture-specific pain/disability, low bone density, and prior falls had nearly a three times higher risk of subsequent falls. PURPOSE: To determine the extent to which modifiable risk factors alone or in combination with bone mineral density (BMD) and non-modifiable risk factors predict subsequent falls and osteoporotic (OP) fractures after distal radius fracture (DRF)...
March 20, 2018: Archives of Osteoporosis
Tudor Borza, Mary K Oerline, Ted A Skolarus, Edward C Norton, Justin B Dimick, Bruce L Jacobs, Lindsey A Herrel, Chad Ellimoottil, John M Hollingsworth, Andrew M Ryan, David C Miller, Vahakn B Shahinian, Brent K Hollenbeck
OBJECTIVE: To evaluate the effect of Medicare Shared Savings Program accountable care organizations (ACOs) on hospital readmission after common surgical procedures. SUMMARY BACKGROUND DATA: Hospital readmissions following surgery lead to worse patient outcomes and wasteful spending. ACOs, and their associated hospitals, have strong incentives to reduce readmissions from 2 distinct Centers for Medicare and Medicaid Services policies. METHODS: We performed a retrospective cohort study using a 20% national Medicare sample to identify beneficiaries undergoing 1 of 7 common surgical procedures-abdominal aortic aneurysm repair, colectomy, cystectomy, prostatectomy, lung resection, total knee arthroplasty, and total hip arthroplasty-between 2010 and 2014...
March 19, 2018: Annals of Surgery
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