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Revision hip replacement

Jiri Gallo, Michal Svoboda, Jana Zapletalova, Jitka Proskova, Jarmila Juranova
BACKGROUND: The diagnosis of prosthetic joint infection (PJI) is still a challenge in some patients after total joint replacement. Interleukin-6 (IL-6) strongly participates in the arrangement of the host-bacteria response. Therefore, increased levels of IL-6 should accompany every PJI. PURPOSE: The aim of the study was to show diagnostic characteristics of serum IL-6 for the diagnosis of prosthetic joint infection (PJI). We also compared the diagnostic values of serum IL-6 with synovial IL-6 (sIL-6) and synovial C-reactive protein (sCRP)...
2018: PloS One
M N Baig, Abdul Halim Dzufar, Colin G Murphy, Bill Curtin
Lateral femoral prosthesis perforation is an uncommon periprosthetic fracture. Periprosthetic fractures may be fixed with open reduction and internal fixation, or with revision arthroplasty, depending on the type of fracture, the condition of the host bone in the proximal femur, the stability of the implant, and occasionally the medical co-morbidities of the patient. Proximal femoral replacement is a complex and challenging procedure but provides a better chance of early mobilisation. We describe a case of treating a 71-year-old woman who presented with an unusual type of periprosthetic fracture, treated with a revision arthroplasty procedure using a proximal femur replacement...
April 17, 2018: Curēus
Lane Koenig, Chaoling Feng, Fang He, Jennifer T Nguyen
BACKGROUND: After the first year in the Comprehensive Care for Joint Replacement (CJR) model, hospitals must repay Medicare for spending above a target price. Hospitals are incentivized to reduce spending in a 90-day episode and generate internal cost savings through, for example, the use of lower-cost implants. METHODS: We used a Markov model to compare quality-adjusted life-years and lifetime costs of total hip arthroplasty, under Medicare fee-for-service (baseline) and under alternative revision rate assumptions (prospective CJR scenarios)...
June 15, 2018: Journal of Arthroplasty
Mohammad Al-Ashqar, Adeel Aqil, Hannah Phillips, Hassaan Sheikh, Simon Harrison, Sameh Sidhom, Gautam Chakrabarty, Ravinder Dimri
Introduction The 'weekend effect' is said to occur when patient outcomes are adversely affected by the day of the week on which they present to hospital or have surgery. However, it is uncertain whether such a phenomenon exists for elective orthopaedic surgery. We investigated whether there is a 'weekend effect' in elective orthopaedic patients. Methods Retrospectively collected data were obtained from our institution's electronic patient records. We collected demographic and International Statistical Classification of Diseases and Related Health Problems tenth revision coding data for all included patients...
June 18, 2018: Annals of the Royal College of Surgeons of England
Veera Venkata Satyanarayana Eethakota, Vinod Vaishnav, Linda Johnston, Rami Abboud, Weijie Wang
BACKGROUND AND PURPOSE: Currently it is not clear whether age is a factor affecting revisions in total hip replacement (THR) and hip resurfacing (HR). This study aimed to investigate which of THR or HR has a higher risk in terms of revision and complication within similar age groups. METHODS: A systemic review was performed for published literature research databases and local data and compared the two procedures under the condition that both groups of patients were age matched...
June 12, 2018: Surgeon: Journal of the Royal Colleges of Surgeons of Edinburgh and Ireland
Hilary Koech, Joshua M Lawrenz, Daniel R Mesko, Robert M Molloy
Revision total hip arthroplasty in the setting of severe femoral bone loss can be challenging, with salvage options often limited to modular tapered stems, allograft prosthetic composites, and megaprostheses. This case highlights a 79-year-old woman with 2 years of thigh pain who is 8 years status post a revision proximal femoral allograft prosthetic composite reconstruction. Radiographs demonstrated significant stem subsidence into the femoral condyle. In an attempt to avoid a total femoral replacement and spare her functioning native knee, a tibial cone was used in conjunction with a proximal femoral replacement to structurally fill the flaring femoral canal and serve as a stable pedestal for the megaprosthesis body and provide the potential for biologic ingrowth...
June 2018: Arthroplasty Today
Yeong J Lau, Shashank Sarmah, Johan D Witt
INTRODUCTION: 3rd generation ceramic bearings were introduced in total hip arthroplasty (THA) with the potential to have better mechanical strength and wear properties than their predecessors. At present, there are few studies looking at the long-term results of this latest generation of ceramic bearings. The purpose of our study was to investigate the long-term clinical and radiographic results of 3rd generation ceramic-on-ceramic THA and the incidence of ceramic specific complications such as squeaking and bearing surface fracture...
March 2018: Hip International: the Journal of Clinical and Experimental Research on Hip Pathology and Therapy
Pablo Mariani, Martin A Buttaro, Pablo A Slullitel, Fernando M Comba, Gerardo Zanotti, Pablo Ali, Francisco Piccaluga
INTRODUCTION: Hip revision surgery is associated with a high probability of the necessity for a blood transfusion. Different studies support the use of tranexamic acid (TXA) to decrease the rate of transfusions in primary hip surgery. Nevertheless, the use of this drug in hip revision surgery has not yet been widely accepted. The aim of our study was to establish the rate of blood transfusion with and without TXA in hip revision surgery. METHODS: We retrospectively studied 125 hip revision surgery patients operated on between 2011 and 2014...
March 2018: Hip International: the Journal of Clinical and Experimental Research on Hip Pathology and Therapy
Muhammad Umar, Noman Jahangir, Qasim Malik, Steven Kershaw, Keith Barnes, Syam Morapudi
Introduction: Metal on Metal (MoM) hip arthroplasty saw a new era of popularity with development of its second generation bearing surfaces, in the first decade of this century. However, by the end of that decade, concerns had been raised due to metal debris related complications.We aimed to determine the survival of MoM stemmed hip replacement in younger population. We also studied the rate of revision related to adverse reaction to metal debris (ARMD) along with reviewing the clinical and radiological progress of MoM hip arthroplasty in younger age (<55 yrs) group...
June 2018: Journal of Orthopaedics
Jitesh Rajpaul, Mahomed Noor Rasool
Aim: The aim of this study was to determine whether computer assisted surgery (CAS) can provide a more accurate, reproducible technique to achieve equal leg lengths in total hip arthroplasty (THA) and to compare the clinical outcome with conventional on table judgement of leg lengths in unilateral total hip replacement. Methods: A collective review of the literature was undertaken utilizing applicable databases. Research criteria were the following: (1) Developing and developed country studies, (2) level II, III, IV and V studies, (3) human subjects only, (4) period of study from 1996 to 2017 - English text only...
June 2018: Journal of Orthopaedics
Michael C Wyatt, David C Kieser, Mark A Kemp, Gavin McHugh, Chris M A Frampton, Gary J Hooper
BACKGROUND: Femoral component offset influences the torque forces exerted on a femoral stem and may therefore adversely affect femoral component survival. This study investigated the influence of femoral component offset on revision rates for primary total hip replacements (THR) registered on the New Zealand Joint Registry (NZJR). METHODS: There were 106,139 primary THRs registered, resulting in 4960 revisions for any cause. There were 46,242 THRs performed using the five commonest femoral components listed on the NZJR...
June 1, 2018: Hip International: the Journal of Clinical and Experimental Research on Hip Pathology and Therapy
Ryan D Ross, Youping Deng, Rui Fang, Nicholas B Frisch, Joshua J Jacobs, Dale R Sumner
Peri-implant osteolysis is commonly diagnosed after substantial bone loss has occurred, making revision surgery more challenging. The goal of the current study was to identify urinary biomarkers that differentiate total hip replacement patients who eventually develop osteolysis from patients who do not. We used a repository of 24-h urine samples collected prior to surgery and annually thereafter in 26 patients, 16 who developed osteolysis, and 10 who did not. We examined the markers at radiographic diagnosis, annually for 6 years preceding diagnosis, at the first post-operative sampling point, and pre-operatively...
June 5, 2018: Journal of Orthopaedic Research: Official Publication of the Orthopaedic Research Society
Douglas A Zaruta, Bowen Qiu, Andrew Y Liu, Benjamin F Ricciardi
PURPOSE OF REVIEW: Prosthetic joint infection is one the most common causes of revision surgery after hip or knee replacement. Debridement and implant retention (DAIR) is one method of treating these infections; however, significant controversy exists. The purpose of our review was to describe current knowledge about indications, intraoperative/postoperative patient management, and outcomes of DAIR. RECENT FINDINGS: Patient selection affects the success of DAIR...
June 5, 2018: Current Reviews in Musculoskeletal Medicine
Evelyn Patricia Murphy, Christopher Fenelon, Shane Russell, Finbarr Condon
Instability or recurrent dislocations are a common reason for revision of total hip replacements (THRs). Dual-mobility constructs can help improve stability by increasing the femoral head jump distance. These constructs are used to decrease the risk of re-revision in the setting of recurrent dislocation. This case describes an unusual case of irreducible dislocation of a re-revision THR due to intraprosthetic dislocation. The patient required open reduction and revision of this construct to a tripolar implant...
June 4, 2018: BMJ Case Reports
Cyrus R Mehta, Alex Constantinidis, Moussa Farhat, Mayuran Suthersan, Edward Graham, Andrew Kanawati
BACKGROUND: Iatrogenic injury to the femoral neurovascular bundle is not uncommon during primary and revision total hip replacement (THR) and can result in permanent weakness, pain and poor function. Prevention of injury to these structures relies on a sound knowledge of their relationships to the hip joint. METHODS: We studied 115 consecutive hip magnetic resonance imaging (MRI) results in order to identify objective relationships between these structures and the hip joint that can be used intraoperatively...
June 4, 2018: Journal of Orthopaedic Surgery and Research
Anthony B McWilliams, Anastasios Lampropoulos, Martin H Stone
BACKGROUND: We discuss the surgical results of revision surgery for patients with refractory symptomatic leg length inequality (LLI) after primary hip replacement. METHODS: This is a retrospective review of 21 patients who underwent revision for LLI after primary total hip replacement. All of them were referred to a tertiary clinic between 2006 and 2015. Leg length was measured, to the nearest mm, using Woolson's validated X-ray technique which references to centre of femoral rotation, the acetabular teardrop and the midpoint of the lesser trochanter...
June 1, 2018: Hip International: the Journal of Clinical and Experimental Research on Hip Pathology and Therapy
Michael J DeRogatis, Paul S Issack
No abstract text is available yet for this article.
May 2018: JBJS Reviews
Faizan Iqbal, Asmat Ullah, Sajid Younus, Akram Aliuddin, Osama Bin Zia, Naveed Khan
PURPOSE: To assess the functional outcome of acute primary total hip replacement in the management of complex acetabular fractures. MATERIALS AND METHODS: This prospective observational study was conducted in orthopedic department of Liaquat National Hospital and Medical College, Karachi. The study was approved by the Ethics review committee of hospital (0190-2016). Patients who encountered between January 2010 to January 2016 were entered. Fifty-four patients with acetabular fractures with certain indications (marginal impaction or significant comminution (> 3 fragments) of the articular surface of the acetabulum, full-thickness articular injury to the femoral head, an associated femur neck fracture, or preexisting symptomatic osteoarthritis) were treated with primary total hip replacement...
May 29, 2018: European Journal of Orthopaedic Surgery & Traumatology: Orthopédie Traumatologie
Douglas S Hancock, Paul K Sharplin, Peter D Larsen, Fredrick Ts Phillips
AIM: To assess early radiological and functional outcomes of revision hip surgery with a cementless press-fit design femoral stem. METHODS: A retrospective review of 48 consecutive revision total hip replacements using the RECLAIM revision hip system, between October 2012 and August 2015. Radiographic assessment was undertaken with serial anteroposterior (AP) X-rays of the pelvis. Risk factors for subsidence were evaluated. Prospective clinical follow up was performed on 21 patients to assess functional outcomes...
May 1, 2018: Hip International: the Journal of Clinical and Experimental Research on Hip Pathology and Therapy
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