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Revision hip replacement

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https://www.readbyqxmd.com/read/29234657/social-profile-and-cost-analysis-of-deep-infection-following-total-hip-replacement-surgery
#1
Vera Lucia Frazão, Helder de Souza Miyahara, Ricardo Akihiro Kirihara, Ana Lucia Lei Munhoz Lima, Alberto Tesconi Croci, José Ricardo Negreiros Vicente
Objective: To characterize the socio-economic and demographic profile of patients undergoing surgery for revision total hip arthroplasty regarding the diagnosis of deep prosthetic infection. Methods: Twenty patients were retrospectively studied, admitted in the period between 2009 and 2010 by the Hip Surgery Group with the diagnosis of deep prosthetic infection, whose proposed treatment was surgical. This study was carried out in the presence of the patient by completing two forms applied by the social worker of the Group...
November 2017: Revista Brasileira de Ortopedia
https://www.readbyqxmd.com/read/29228956/analysis-of-bearing-wear-whole-blood-and-synovial-fluid-metal-ion-concentrations-and-histopathological-findings-in-patients-with-failed-asr-hip-resurfacings
#2
Lari Lehtovirta, Aleksi Reito, Jyrki Parkkinen, Harry Hothi, Johann Henckel, Alister Hart, Antti Eskelinen
BACKGROUND: Adverse Reaction to Metal Debris (ARMD) is still a major reason for revision surgeries in patients with metal-on-metal (MoM) hip replacements. ARMD consists of a wide range of alterations in periprosthetic tissues, most important of which are metallosis, inflammation, pseudotumors and necrosis. Studies investigating histopathological findings and their association to implant wear or indirect measures of wear have yielded inconsistent results. Therefore, we aimed to investigate bearing surface wear volume, whole blood and synovial fluid metal ion concentrations, histopathological findings in periprosthetic tissues and their associations...
December 11, 2017: BMC Musculoskeletal Disorders
https://www.readbyqxmd.com/read/29208013/patients-and-surgeons-provide-endorsement-of-core-domains-for-total-joint-replacement-clinical-trials
#3
Anh Hoang, Susan M Goodman, Iris Y Navarro-Millán, Lisa A Mandl, Mark P Figgie, Mathias P Bostrom, Douglas E Padgett, Peter K Sculco, Alexander S McLawhorn, Jasvinder A Singh
BACKGROUND: Our objective in this study was to examine whether stakeholders further endorse the core domain set proposed by the Outcome Measures in Rheumatology Trials (OMERACT) total joint replacement (TJR) working group. METHODS: We emailed a survey to 3810 hip/knee arthroplasty patients and 49 arthroplasty surgeons at a high-volume arthroplasty center to rate the importance of each core domain (i.e., pain, function, patient satisfaction, revision surgery, adverse events, and death) and two additional domains (i...
December 6, 2017: Arthritis Research & Therapy
https://www.readbyqxmd.com/read/29192730/3-phase-technicium-99m-bone-scanning-in-patients-with-pain-in-the-hip-region-after-cemented-total-hip-replacement-a-multicentre-series-of-100-cases
#4
Daniel S Hill, Soulat Naim, Roy J Powell, Denis Kinsella, Andrew D Toms, Jonathan Howell
INTRODUCTION: The aim of this study was to assess the benefit of a Technetium-99M (HDP) 3-phase bone scan (TPBS) as an additional diagnostic test in the evaluation of pain in the hip region following cemented total hip replacement (THR) surgery. METHODS: A retrospective study over a 24-month period was performed comprising 100 patients investigated with a TPBS. Investigations were summarised and analysed, and were classified as entirely normal, possibly abnormal, and definitely abnormal...
November 21, 2017: Hip International: the Journal of Clinical and Experimental Research on Hip Pathology and Therapy
https://www.readbyqxmd.com/read/29192728/overestimation-of-the-risk-of-revision-with-kaplan-meier-presenting-the-long-term-outcome-of-total-hip-replacement-in-older-patients
#5
Kalliopi Lampropoulou-Adamidou, Theofilos S Karachalios, George Hartofilakidis
INTRODUCTION: The purpose of the present study was (i) to review the long-term outcome of cemented Charnley total hip replacements (THRs) performed by 1 surgeon (GH), 20 to 42 years ago, in patients ≥60 years, using both the Kaplan-Meier (KM) and the cumulative incidence (CI) methods, and (ii) to compare the estimations of the 2 statistical methods. METHODS: We evaluated the outcome of 306 consecutive primary cemented THRs that were performed in 265 patients. The final clinical, radiographic assessment and satisfaction of living patients were also included...
December 1, 2017: Hip International: the Journal of Clinical and Experimental Research on Hip Pathology and Therapy
https://www.readbyqxmd.com/read/29192727/which-is-the-best-bearing-surface-for-primary-total-hip-replacement-a-new-zealand-joint-registry-study
#6
Paul Sharplin, Michael C Wyatt, Alaistair Rothwell, Chris Frampton, Gary Hooper
INTRODUCTION: We have investigated the revision rates of all bearing surface combinations for primary total hip replacement (THR) registered on the New Zealand Joint Registry (NZJR) to determine which coupling has been the most durable and successful over the last 16 years. METHODS: There were 106,139 primary THRs registered, resulting in 4,960 revisions for any cause. We examined all-cause revision rates, reasons for revision and performed survival analyses. RESULTS: Ceramic-on-highly cross-linked polyethylene (CoPx) had the lowest all-cause revision rate of 0...
December 1, 2017: Hip International: the Journal of Clinical and Experimental Research on Hip Pathology and Therapy
https://www.readbyqxmd.com/read/29181352/a-case-report-of-dual-incision-technique-for-total-femur-arthroplasty-as-a-salvage-procedure-in-infected-non-unions
#7
Aniruddh Agrawal, Vinod Agrawal, Sandeepkumar Yadav, Shushil K Soni, Sawan Kumar Pawar
Introduction: Total femur arthroplasty (TFA) is a rare salvage limb procedure which serves as an effective alternative to limb amputation. Most commonly, it is indicated for oncologic orthopedic cases, and very few cases of a purely traumatic history for TFA have been documented. The decision to perform this complex procedure involves paying careful attention to reconstructive needs and functional expectations of the patient. Alternatives to this procedure are quite detrimental and include hip disarticulation and above-the-knee amputation...
July 2017: Journal of Orthopaedic Case Reports
https://www.readbyqxmd.com/read/29180271/reconstructive-techniques-for-revision-and-limb-salvage-surgery-in-persons-with-haemophilia
#8
C Carulli, M Zago, A R Rizzo, M Innocenti
Haemophilia is an inherited haemorrhagic disease characterized by the lack of coagulative factors associated nowadays mostly to musculoskeletal complications, particularly severe secondary arthritis in specific joints. Recurrent traumatic or spontaneous joint bleeding, induce severe arthropathy at a young age that can be treated only by joint replacement. Total knee or hip arthroplasty in young subjects may fail earlier due to wear or infections and in the haemophilic population, this means bone loss, pseudo tumours and the need of revision or even limb salvage surgery...
October 2017: Journal of Biological Regulators and Homeostatic Agents
https://www.readbyqxmd.com/read/29166684/-implantation-of-a-modular-distal-femoral-replacement-with-compressive-osseointegration-as-a-salvage-procedure-in-a-complex-femoral-posttraumatic-setting
#9
Anna Janine Schreiner, Peter Marten de Zwart, Christian Arnscheidt, Ulrich Stöckle, Björn Gunnar Ochs
Background Large bone defects and losses play a crucial role in both tumour surgery and in complex primary and revision total knee replacement. The established options of cemented or uncemented long intramedullary stems are limited by large bone defects and are at risk from relatively high exposure to aseptic loosening. There is no general valid agreement on implant fixation of the distal femur. A further option is the cementless fixation method with compressive osseointegration, based on the so-called Wolff law of bone remodelling...
November 22, 2017: Zeitschrift Für Orthopädie und Unfallchirurgie
https://www.readbyqxmd.com/read/29151013/decreasing-the-incidence-of-surgical-site-infections-following-joint-replacement-surgery
#10
Lorraine Hutzler, Jarrett Williams
OBJECTIVE: Despite the generalized use of prophylactic antibiotics in orthopaedic surgery, Surgical Site Infections (SSIs) are still a major source of morbidity, mortality, and hospital cost. This is due in part to the increasing prevalence of antibiotic resistant organisms. METHODS: A review of local epidemiology, the importance of an antibiotic stewardship program, patient optimization, and risk stratification options to reduce SSIs. RESULTS: The proportion of revisions due to infection is projected to rise rapidly over the next 25 years...
December 2017: Bulletin of the Hospital for Joint Diseases
https://www.readbyqxmd.com/read/29145281/cup-revision-involving-retention-of-a-fixed-but-malpositioned-acetabular-component-in-patients-with-poor-general-conditions
#11
Weiping Su, Min Zeng, Yihe Hu, Jianxi Zhu, Long Wang, Jie Xie
This study evaluated the surgical technique and outcomes of cup revision involving retention of a fixed but malpositioned acetabular component in patients with poor general conditions.Between 2007 and 2013, we performed cup revision on 12 hips while retaining a fixed (either cemented or uncemented) but malpositioned acetabular component. Indications for this technique were: malpositioned but fixed acetabular shell; sufficient space for the insertion of the prosthesis; and patients with poor general conditions...
November 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29136258/ultra-short-versus-conventional-uncemented-stems-for-hip-replacement-in-octogenarians
#12
Young-Hoo Kim, Jang-Won Park, Jun-Shik Kim
The aim of this study was to determine how an ultra-short anatomic uncemented stem vs a diaphyseal filling five-eighths porous coated uncemented femoral stem (conventional stem) affects the survival of primary total hip arthroplasties in octogenarians. The current study consisted of 52 patients (55 hips) in the ultra-short stem group (mean age, 85.5±5.3 years) and 61 patients (72 hips) in the diaphyseal (conventional) stem group (mean age, 84.1±4.8 years). The predominant diagnosis was osteoarthritis, followed by osteonecrosis of the femoral head, in both groups...
November 11, 2017: Orthopedics
https://www.readbyqxmd.com/read/29135673/myocardial-cobalt-levels-are-elevated-in-the-setting-of-total-hip-arthroplasty
#13
Cody C Wyles, T Carson Wright, Melanie C Bois, Md Shahrier Amin, Ahmed Fayyaz, Sarah M Jenkins, Saranya P Wyles, Patrick L Day, David L Murray, Robert T Trousdale, Nandan S Anavekar, William D Edwards, Joseph J Maleszewski
BACKGROUND: Arthroplasty implants commonly contain elemental metal that may undergo wear-related release. Recently, cases of hip implant-associated myocardial injury have been reported. However, we are not aware of any previous study that has systematically measured myocardial metal levels or examined the relationship with total hip arthroplasty (THA). METHODS: Archives of our institution were queried for autopsies of individuals who had undergone THA between 1990 and 2013...
November 15, 2017: Journal of Bone and Joint Surgery. American Volume
https://www.readbyqxmd.com/read/29135666/total-hip-arthroplasty-with-use-of-the-cementless-zweym%C3%A3-ller-alloclassic-system-a-concise-follow-up-at-a-minimum-of-25-years-of-a-previous-report
#14
Ana Cruz-Pardos, Eduardo García-Rey, Eduardo García-Cimbrelo
We previously reported the 10 to 13-year follow-up results for 104 total hip replacements with the Zweymüller Alloclassic stem and a threaded cup in 94 patients. The present study is a clinical and radiographic outcome update after a minimum follow-up of 25 years. Four patients (4 hips) were lost and 46 patients (50 hips) died, leaving 44 patients (50 hips) available for follow-up. Since our previous report, 7 cups and 2 stems were revised. At 20 years, the probability of survival of any component was 84.1% (95% confidence interval [CI], 73...
November 15, 2017: Journal of Bone and Joint Surgery. American Volume
https://www.readbyqxmd.com/read/29109884/natural-remission-of-major-periprosthetic-osteolysis-following-total-hip-arthroplasty-with-metal-on-metal-bearings
#15
Tatsuya Tamaki, Kazuhiro Oinuma
The natural course of adverse events following the use of metal-on-metal (MoM) bearings in total hip arthroplasty (THA) is not well known. In this article, we report the case of a patient with asymptomatic major acetabular osteolysis following MoM THA that diminished gradually without any surgical intervention. A 58-year-old male underwent one-stage bilateral MoM THA for bilateral osteoarthritis. Four years after THA, major acetabular osteolysis developed in his right hip without any local or systemic symptoms...
2017: Case Reports in Orthopedics
https://www.readbyqxmd.com/read/29107499/clinical-outcome-of-massive-endoprostheses-used-for-managing-periprosthetic-joint-infections-of-the-hip-and-knee
#16
Abtin Alvand, George Grammatopoulos, Floris de Vos, Matthew Scarborough, Ben Kendrick, Andrew Price, Roger Gundle, Duncan Whitwell, William Jackson, Adrian Taylor, Christopher L M H Gibbons
BACKGROUND: Endoprosthetic replacement (EPR) is an option for management of massive bone loss resulting from infection around failed lower limb implants. The aim of this study is to determine the mid-term outcome of EPRs performed in the treatment of periprosthetic joint infection (PJI) and infected failed osteosyntheses around the hip and knee joint and identify factors that influence it. METHODS: We retrospectively reviewed all hip and knee EPRs performed between 2007 and 2014 for the management of chronic infection following complex arthroplasty or fracture fixation...
October 5, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/29107492/is-rapid-recovery-hip-and-knee-replacements-possible-and-safe-in-the-octogenarian-patient
#17
Paul K Edwards, James R Kee, Simon C Mears, C Lowry Barnes
BACKGROUND: Rapid recovery programs are now aimed to reduce costs of hip and knee arthroplasties by discharging patients directly home, shortening hospital length of stay (LOS), and reducing readmission rates. Although patients aged 80 years and older are included in the Medicare bundle, little work has been performed to determine if older patients can safely participate in rapid recovery programs. METHODS: We retrospectively reviewed 2482 patients undergoing primary and revision total hip and knee arthroplasties (THA and TKA) who all participated in a multifaceted rapid recovery program...
October 6, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/29098919/current-methods-of-preventing-aseptic-loosening-and-improving-osseointegration-of-titanium-implants-in-cementless-total-hip-arthroplasty-a-review
#18
Dragos Apostu, Ondine Lucaciu, Cristian Berce, Dan Lucaciu, Dan Cosma
Hip osteoarthritis is the most common joint disorder, and is represented by a degenerative process, resulting in pain and functional impairment. If conservative treatment for hip osteoarthritis fails, the only remaining option is hip arthroplasty. Despite good survival of implants, loosening of components is the most common complication. This leads to revision surgeries, which are technically demanding, expensive, and result in a low satisfaction rate. Uncemented hip replacements require proper osseointegration for increased survival...
January 1, 2017: Journal of International Medical Research
https://www.readbyqxmd.com/read/29098102/compression-of-the-femoral-vessels-by-a-pseudotumor-after-metal-on-metal-total-hip-arthroplasty
#19
Yasuaki Tamaki, Tomohiro Goto, Takahiko Tsutsui, Tomoya Takasago, Keizo Wada, Koichi Sairyo
Here we present a case of pseudotumor following total hip arthroplasty (THA) that resulted in a circulatory disturbance caused by compression of the femoral vasculature. A 63-year-old man presented with pain, swelling, and redness of the left leg 5 years after primary metal-on-metal THA using the AML-Plus stem, Pinnacle® acetabular cup, and 36 mm diameter Ultamet™ metal head system (DePuy Orthopaedics, Warsaw, IN). Enhanced computed tomography and magnetic resonance imaging revealed a large cystic lesion extending from the left hip anteriorly to the intrapelvic region and compressing the left femoral vessels...
2017: Case Reports in Orthopedics
https://www.readbyqxmd.com/read/29097396/choice-of-implant-combinations-in-total-hip-replacement-systematic-review-and-network-meta-analysis
#20
REVIEW
José A López-López, Rachel L Humphriss, Andrew D Beswick, Howard H Z Thom, Linda P Hunt, Amanda Burston, Christopher G Fawsitt, William Hollingworth, Julian P T Higgins, Nicky J Welton, Ashley W Blom, Elsa M R Marques
Objective To compare the survival of different implant combinations for primary total hip replacement (THR). Design Systematic review and network meta-analysis. Data sources Medline, Embase, The Cochrane Library, ClinicalTrials.gov, WHO International Clinical Trials Registry Platform, and the EU Clinical Trials Register.Review methods Published randomised controlled trials comparing different implant combinations. Implant combinations were defined by bearing surface materials (metal-on-polyethylene, ceramic-on-polyethylene, ceramic-on-ceramic, or metal-on-metal), head size (large ≥36 mm or small <36 mm), and fixation technique (cemented, uncemented, hybrid, or reverse hybrid)...
November 2, 2017: BMJ: British Medical Journal
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