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functional outcome after revision hip arthroplasty

Victoire Bouveau, Thomas-Xavier Haen, Joel Poupon, Christophe Nich
BACKGROUND: Function after revision total hip arthroplasty (THA) in failed metal-on-metal (MoM) hip resurfacing arthroplasty (HRA) is variable, but post-operative complication rates are reportedly high. We hypothesized HRA conversion to THA using the direct anterior approach (DAA) would be associated with optimal outcome. METHODS: Seventeen MoM-HRAs in 15 patients (seven males, eight females) were revised through the DAA. The mean age was 45 years (28-59 yrs)...
March 8, 2018: International Orthopaedics
Anita Vijapura, Harlan B Levine, Michele Donato, Mark A Hartzband, Melissa Baker, Gregg R Klein
The immunosuppressive regimens required for hematopoietic stem cell transplantation predispose recipients to complications, including avascular necrosis. Cancer-related comorbidities, immunosuppression, and poor bone quality theoretically increase the risk for perioperative medical complications, infection, and implant-related complications in total joint arthroplasty. This study reviewed 20 primary total hip arthroplasties for avascular necrosis in 14 patients. Outcomes were assessed at routine clinical visits and Harris hip scores were calculated...
February 16, 2018: Orthopedics
Andreas Toepfer, Norbert Harrasser, Isabel Petzschner, Florian Pohlig, Ulrich Lenze, Ludger Gerdesmeyer, Ruediger von Eisenhart-Rothe, Heinrich Mühlhofer, Christian Suren
BACKGROUND: Several surgical options for the reconstruction of massive bone defects have been described and include biologic methods with autografts and allografts, and the use of tumor endoprostheses (total femoral replacement, TFR). Several types of modular TFR are available, but nevertheless unpredictable outcomes and high complication rates have been described from most authors. The present study aims to compare results after TFR performed with modular total femur prosthesis MML (Fa...
January 16, 2018: European Journal of Medical Research
J Girard, A Lons, N Ramdane, S Putman
BACKGROUND: Hip resurfacing arthroplasty (HRA) is an alternative to total hip arthroplasty (THA) for the treatment of hip osteoarthritis in patients younger than 50 years. Data on revision rates after HRA are conflicting. The National Institute for Health and Care Excellence (NICE) recommends performing only those hip arthroplasty procedures associated with 10-year revision rates no greater than 5% (0.5% per year). Follow-up studies can rapidly determine whether this criterion is met...
December 22, 2017: Orthopaedics & Traumatology, Surgery & Research: OTSR
J Vanlommel, L Vanlommel, B Molenaers, J P Simon
BACKGROUND: Multiple Ephiphyseal Dysplasia (MED) is a rare autosomal dominant skeletal dysplasia that causes deformation of the epiphysis of the involved joints. The hips are invariably affected and symptoms due to incapacitating early onset degenerative hip disease often begin between the second and fourth decade of life. Literature regarding the clinical and radiographical outcomes after total hip arthroplasty in this young population are very scarce. HYPOTHESIS: In patients with multiple epiphyseal dysplasia and early onset degenerative hip disease, hybrid total hip arthroplasty is a safe and reliable procedure...
December 21, 2017: Orthopaedics & Traumatology, Surgery & Research: OTSR
Daud Tai Shan Chou, Ben Davis
CASE: A traumatic nondisplaced periprosthetic trochanteric fracture around a well-fixed and functioning Birmingham Hip Resurfacing prosthesis was managed with a reconstruction intramedullary nail. The surgical procedure provided excellent pain relief, and the patient was able to mobilize with crutches the day after surgery. Follow-up at 1 year confirmed excellent clinical and radiographic results. CONCLUSION: In a patient with a previously well-functioning hip resurfacing prosthesis, internal fixation rather than revision hip arthroplasty can offer good clinical and radiographic outcomes...
January 2017: JBJS Case Connector
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
Guo-Liang Wu, Ji-Liang Zhai, Bin Feng, Yan-Yan Bian, Chi Xu, Xi-Sheng Weng
OBJECTIVE: To report the results of mid-term to long-term follow-up after primary total hip arthroplasty (THA) in hemophiliacs and to hypothesize that THA can provide satisfactory outcomes in these patients. METHODS: Twenty-four primary THA performed in 21 hemophilia patients between 2002 and 2012 were reviewed retrospectively, including 20 cases of hemophilia A and 1 case of hemophilia B. The standard lateral approach was used for all implantations. Substitution therapy for factor VIII and activated prothrombin complex concentrates were administered to patients with hemophilia A and B, respectively...
November 2017: Orthopaedic Surgery
Gaetano Caruso, Lorenzo Milani, Tedi Marko, Vincenzo Lorusso, Mattia Andreotti, Leo Massari
BACKGROUND: The treatment of periprosthetic femoral fractures is a great challenge for the orthopedic surgeon and requires a knowledge of bone fracture fixation as well as skills and experience in revision surgery. The aim of this retrospective study was to evaluate the functional and radiological outcomes of periprosthetic femoral fractures surgically treated in our department from 2010 to 2016. MATERIALS AND METHODS: This study involved 73 patients with a periprosthetic femoral fracture after total hip arthroplasty or hemiarthroplasty...
November 25, 2017: European Journal of Orthopaedic Surgery & Traumatology: Orthopédie Traumatologie
Kwanchai Pituckanotai, Alisara Arirachakaran, Harit Tuchinda, Chinundorn Putananon, Nitiphol Nualsalee, Kittipong Setrkraising, Jatupon Kongtharvonskul
Postoperative dislocation is a challenging complication after total hip arthroplasty (THA) that affects patient outcome worldwide. Instability is one of the main complications with rates exceeding 20% in some series. Currently, alternative acetabular components are available with dual mobility (DMTHA) bearing surfaces and larger femoral head size that may reduce the risk of dislocation, yet provide the functional benefit of standard single mobility (STHA) bearing surface THA. However, whether STHA, big femoral head (BTHA) and DMTHA should be used is still controversial...
November 8, 2017: European Journal of Orthopaedic Surgery & Traumatology: Orthopédie Traumatologie
Adam Tucker, Michael Warnock, Sinead McDonald, Laurence Cusick, Andrew P Foster
Cephalomedullary nail (CMN) failure is a rare entity following hip fracture treatment. However, it poses significant challenges for revision surgery, both mechanically and biologically. Nail failure rates have been reported at < 2%; however, no published studies have reported revision surgery procedures and their respective outcomes. We present a regional experience, with outcomes, of the revision options. We identified 20 fatigued CMNs that underwent four different revision procedures. Mean age was 73 ± 15...
October 17, 2017: European Journal of Orthopaedic Surgery & Traumatology: Orthopédie Traumatologie
E Šťastný, T Trč, J Frýdl, Z Kopečný, T Philippou, J Lisý
INTRODUCTION The purpose of our paper is to evaluate the mid-term to long-term results and to confirm the basic criteria of a high-quality revision implant: safe bridging of bone defects, achievement of reliable primary fixation of revision acetabular cup, achievement of good secondary stability with documentable osteointegration of cup and demonstration of remodelling of transplanted bone tissue in the area of defects and in spaces between the implant ribs. MATERIAL AND METHODS Altogether 36 patients (38 cups) were evaluated who had undergone revision hip arthroplasty in the period from 2004 to 2010...
2017: Acta Chirurgiae Orthopaedicae et Traumatologiae Cechoslovaca
Sebastian Mukka, Björn Knutsson, Ammar Majeed, Arkan S Sayed-Noor
Background and purpose - The direct lateral (DL) approach to the hip for femoral neck fractures (FNF) has been shown to reduce the rate of dislocation and reoperations. We evaluate the effect of transition from the posterolateral (PL) to DL approach on reoperation and dislocation rates and patients' reported outcome. Patients and methods - In a prospective cohort study between 2012 and 2015, we enrolled 362 patients (median age 83 years, 70% women, mean follow-up 25 months) with a displaced FNF. The first group of 146 patients were operated using the PL and the second group of 216 patients with a DL approach, after change of our routines...
December 2017: Acta Orthopaedica
Wael Salama, Paolo Ditto, Shazly Mousa, Abdelrahman Khalefa, Ahmed Sleem, Laura Ravera, Alessandro Masse
INTRODUCTION: The outcomes of total hip arthroplasty (THA) for the treatment of posttraumatic arthritis after acetabular fractures were inferior to those after primary non-traumatic THA. METHODS: This study was performed in academic level I trauma center. From January 2011 to December 2014, a consecutive series of 21 patients (9 females), with average age of 56.7 years (range 29-75 years) who had posttraumatic hip joint arthritis after acetabular fractures, were included in our study...
August 1, 2017: European Journal of Orthopaedic Surgery & Traumatology: Orthopédie Traumatologie
Yanguo Qin, Xuezhou Li, Shangjun Chen, Liang Liu, Zhongli Gao, Jincheng Wang, Jianlin Xiao
BACKGROUND: The acetabular component orientation during total hip arthroplasty (THA) impacts future hip function and early revision. Correcting pelvic obliquity may improve outcomes. OBJECTIVE: To correct pelvic obliquity in the lateral position by applying a gradienter and plumb during THA using fluoroscopy. METHODS: Fifty patients undergoing THA were randomized and divided into 2 groups. In controls, acetabular components were placed using traditional methods...
July 21, 2017: Technology and Health Care: Official Journal of the European Society for Engineering and Medicine
Hiroyuki Makita, Marcel Kerboull, Yutaka Inaba, Taro Tezuka, Tomoyuki Saito, Luc Kerboull
BACKGROUND: The purpose of this study is to review our experience with Kerboull reinforcement device combined with bulk allograft for management of severe acetabular defects. METHODS: We investigated the results of revision total hip arthroplasty (THA) in 65 hips of 59 patients (10 male, 49 female) with Paprosky type 3A or 3B acetabular bone defects. Functional outcome was assessed using the Merle d'Aubigne hip score. Post-operative radiographs were examined for evidence of cup loosening...
November 2017: Journal of Arthroplasty
Leo Massari, Alessandro Bistolfi, Pier Paolo Grillo, Alda Borré, Gaetano Gigliofiorito, Carlotta Pari, Andrea Francescotto, Piermario Tosco, Davide Deledda, Laura Ravera, Araldo Causero
INTRODUCTION: Trabecular Titanium is an advanced cellular solid structure, composed of regular multiplanar hexagonal interconnected cells that mimic the morphology of the trabecular bone. This biomaterial demonstrated improved mechanical properties and enhanced osteoinduction and osteoconduction in several in vitro and in vivo studies. The aim of this study was to assess Trabecular Titanium osseointegration by measuring periacetabular changes in bone mineral density (BMD) with dual-emission X-ray absorptiometry (DEXA)...
November 21, 2017: Hip International: the Journal of Clinical and Experimental Research on Hip Pathology and Therapy
Matthieu Zingg, Morgan Gauthier, Didier Hannouche
Total hip replacement can provide pain relief and restore function in patients suffering from hip arthritis, including in those under the age of 50. However, shortened implant longevity in this age group has been a concern because the clinical results after revision surgery are inferior to those after primary hip arthroplasty. Technical choices (approach, implants, type of fixation and bearing couple) must be made to maximise longevity based on published data and thoroughly discussed with the patient. Finally, long term results (clinical outcome and implant longevity) associated with this surgery are such that it appears unnecessary to postpone the surgery once the indication is established...
December 14, 2016: Revue Médicale Suisse
Stephen M Petis, Kevin I Perry, Mark W Pagnano, Daniel J Berry, Arlen D Hanssen, Matthew P Abdel
BACKGROUND: Prolonged retention of an antibiotic spacer is occasionally chosen during treatment of periprosthetic joint infections after total hip arthroplasty (THA) and total knee arthroplasty (TKA). The purpose of our study was to evaluate the outcome of extended spacer retention. METHODS: We reviewed 1106 cases of periprosthetic joint infection after THA (n = 308) and TKA (n = 798) and identified 17 (5.5%) retained hip and 34 (4.3%) retained knee spacers. Most patients (35 of 51, 69%) underwent spacer retention because they were medically unfit for further surgery...
November 2017: Journal of Arthroplasty
Simon J M Parker, George Grammatopoulos, Owain L I Davies, Karen Lynch, Tom C B Pollard, Antonio J Andrade
BACKGROUND: Hip arthroscopy is increasingly being used in joint preservation surgery with clear benefits in the treatment of prearthritic conditions. A number of patients, however, will still go on to require subsequent hip arthroplasty, and at present, little evidence exists determining the impact that prior hip arthroscopy may have on the outcomes of a subsequent arthroplasty. METHODS: Using prospectively collated data, we identified 35 patients who had a hip arthroplasty (22 total hip arthroplasties and 13 hip resurfacing arthroplasties) after prior ipsilateral hip arthroscopy (cases)...
May 18, 2017: Journal of Arthroplasty
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