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Anterior hip arthroplasty

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https://www.readbyqxmd.com/read/28222211/the-learning-curve-for-the-direct-anterior-approach-for-total-hip-arthroplasty-a-single-surgeon-s-first-500-cases
#1
James M Hartford, Michael J Bellino
BACKGROUND: Concerns arise over the early complications encountered during the learning curve for the direct anterior approach for total hip arthroplasty. PURPOSE: The purpose of this study is to examine the learning experience of a single surgeon in adapting this approach. METHODS: The 1st 500 primary total hip arthroplasties are reviewed. The patients were evaluated out to 3 months. Rates of major complications, reoperations, periprosthetic fractures, heterotopic ossification, leg length discrepancies and lateral femoral cutaneous nerve deficits were identified for each of 100 patients...
February 17, 2017: Hip International: the Journal of Clinical and Experimental Research on Hip Pathology and Therapy
https://www.readbyqxmd.com/read/28218378/screw-hole-clusters-in-acetabular-cups-a-morphological-study-of-optimal-positioning-of-screw-holes
#2
Xinghua Yin, Yixin Zhou, Qiheng Tang, Dejin Yang, Hao Tang, Xingjian Huang
BACKGROUND: Rigid and safe transacetabular screw fixation in total hip arthroplasty (THA) is achieved by pursuing deeper bone stock and avoiding injuries to the neurovascular structures, but these efforts can be restricted by the distribution of screw-holes on cups by the manufacturer. We therefore tried to determine: (i) optimal screw-hole positions on cups to allow anatomical placement of screws; (ii) rationality of the basic 3-screw-hole cluster on commercial cups; and (iii) the optimum method for placing commercial cups in accordance with acetabular anatomy...
February 15, 2017: Hip International: the Journal of Clinical and Experimental Research on Hip Pathology and Therapy
https://www.readbyqxmd.com/read/28218372/chronological-changes-in-functional-cup-position-at-10-years-after-total-hip-arthroplasty
#3
Yusuke Okanoue, Masahiko Ikeuchi, Shogo Takaya, Masashi Izumi, Koji Aso, Teruhiko Kawakami
PURPOSE: This study aims to clarify the chronological changes in functional cup position at a minimum follow-up of 10 years after total hip arthroplasty (THA), and to identify the risk factors influencing a significant difference in functional cup position during the postoperative follow-up period. METHODS: We evaluated the chronological changes in functional cup position at a minimum follow-up of 10 years after THA in 58 patients with unilateral hip osteoarthritis...
February 15, 2017: Hip International: the Journal of Clinical and Experimental Research on Hip Pathology and Therapy
https://www.readbyqxmd.com/read/28188487/management-and-radiographic-outcomes-of-femoral-head-fractures
#4
John A Scolaro, Geoffrey Marecek, Reza Firoozabadi, James C Krieg, Milton Lee Chip Routt
BACKGROUND: Femoral head fractures are uncommon injuries. Small series constitute the majority of the available literature. Surgical approach and fracture management is variable. The purpose of this study was to evaluate the incidence, method of treatment, and outcomes of consecutive femoral head fractures at a regional academic Level I trauma center. MATERIALS AND METHODS: A retrospective review of a prospective database was performed over a 13-year period. All AO/OTA 31C femoral head fractures were identified...
February 10, 2017: Journal of Orthopaedics and Traumatology: Official Journal of the Italian Society of Orthopaedics and Traumatology
https://www.readbyqxmd.com/read/28186870/total-hip-arthroplasty-via-the-direct-anterior-approach-with-kerboull-type-acetabular-reinforcement-device-for-an-elderly-female-with-factor-xi-deficiency
#5
Kei Sano, Yasuhiro Homma, Tomonori Baba, Jun Ando, Mikio Matsumoto, Hideo Kobayashi, Takahito Yuasa, Kazuo Kaneko
We present a case of successful and uncomplicated total hip arthroplasty with an acetabular reinforcement device in an elderly patient with hip osteoarthritis already diagnosed with factor XI deficiency, which is a very rare bleeding disorder and at high risk of post-operative haemorrhage, and it poses a substantial challenge to surgeons as a consequence of the specific risks of infection and fixation failure. Moreover, bone fragility in elderly patient increases potential risk of adverse event. Fresh frozen plasma was used to supplement factor XI activity...
2017: SICOT-J
https://www.readbyqxmd.com/read/28184276/segregation-for-reduction-of-regulated-medical-waste-in-the-operating-room-a-case-report
#6
Helen Ki Shinn, Youngyoen Hwang, Byung-Gun Kim, Chunwoo Yang, WonJu Na, Jang-Ho Song, Hyun Kyoung Lim
One-third of all hospital-regulated medical waste (RMW) comes from the operating room (OR), and it considerably consists of disposable packaging and wrapping materials for the sterilization of surgical instruments. This study sought to identify the amount and type of waste produced by ORs in order to reduce the RMW so as to achieve environmentally-friendly waste management in the OR. We performed an initial waste segregation of 4 total knee replacement arthroplasties (TKRAs) and 1 total hip replacement arthroplasty, and later of 1 extra TKRA, 1 laparoscopic anterior resection of the colon, and 1 pelviscopy (with radical vaginal hysterectomy), performed at our OR...
February 2017: Korean Journal of Anesthesiology
https://www.readbyqxmd.com/read/28165592/selection-of-a-surgical-approach-for-total-hip-arthroplasty-according-to-the-depth-to-the-surgical-site
#7
Takaaki Ohmori, Tamon Kabata, Toru Maeda, Yoshitomo Kajino, Tadashi Taga, Kazuhiro Hasegawa, Daisuke Inoue, Takashi Yamamoto, Tomoharu Takagi, Hiroyuki Tsuchiya
BACKGROUND: The surgical depths of approaches for total hip arthroplasty (THA) have not been reported previously. In this study, we investigate the relationships between the distances to the centre of the femoral head in different approaches and body mass index (BMI). METHODS: The study included patients with normal hip joints who presented to our hospital. We used the pelvic coordinate system relative to the anterior pelvic plane and the femur coordinate system relative to the posterior condylar plane...
February 4, 2017: Hip International: the Journal of Clinical and Experimental Research on Hip Pathology and Therapy
https://www.readbyqxmd.com/read/28148659/variation-in-functional-pelvic-tilt-in-patients-undergoing-total-hip-arthroplasty
#8
J Pierrepont, G Hawdon, B P Miles, B O' Connor, J Baré, L R Walter, E Marel, M Solomon, S McMahon, A J Shimmin
AIMS: The pelvis rotates in the sagittal plane during daily activities. These rotations have a direct effect on the functional orientation of the acetabulum. The aim of this study was to quantify changes in pelvic tilt between different functional positions. PATIENTS AND METHODS: Pre-operatively, pelvic tilt was measured in 1517 patients undergoing total hip arthroplasty (THA) in three functional positions - supine, standing and flexed seated (the moment when patients initiate rising from a seated position)...
February 2017: Bone & Joint Journal
https://www.readbyqxmd.com/read/28137262/direct-anterior-approach-for-total-hip-arthroplasty-with-a-novel-mobile-traction-table-a-prospective-cohort-study
#9
Junichi Nakamura, Shigeo Hagiwara, Sumihisa Orita, Ryuichiro Akagi, Takane Suzuki, Masahiko Suzuki, Kazuhisa Takahashi, Seiji Ohtori
BACKGROUND: The purpose of this prospective cohort study was to clarify the safety and efficacy of total hip arthroplasty via the direct anterior approach in the supine position with a novel mobile traction table. METHODS: The first experience of consecutive surgeries by a single surgeon using the direct anterior approach with a traction table is described with a two-year follow-up period. Of 121 patients, 100 patients without previous hip surgeries, severe deformity, or cemented implants were divided into two groups comprising the first 50 patients and the second 50 patients...
January 31, 2017: BMC Musculoskeletal Disorders
https://www.readbyqxmd.com/read/28118808/spontaneous-healing-of-lateral-femoral-cutaneous-nerve-injury-and-improved-quality-of-life-after-total-hip-arthroplasty-via-a-direct-anterior-approach
#10
Yu Ozaki, Yasuhiro Homma, Tomonori Baba, Kei Sano, Asuka Desroches, Kazuo Kaneko
PURPOSE: How the symptomatology of lateral femoral cutaneous nerve (LFCN) injury changes after total hip arthroplasty (THA) via direct anterior approach (DAA) is not known. Our hypothesis was that the symptoms of LFCN injury after THA via DAA in longer follow-up periods would resolve spontaneously, leading to an improved quality of life (QOL). The aims of this study were to investigate how the symptom LFCN injury changed after DAA-THA, and how those changes affected QOL. METHODS: We investigated the incidence of LFCN injury after DAA-THA using self-reported questionnaires at two time points (initial survey: August 2014, present survey: August 2015)...
January 2017: Journal of Orthopaedic Surgery
https://www.readbyqxmd.com/read/28115797/osteolysis-in-total-hip-arthroplasty-after-head-and-inlay-revision-surgery
#11
Lorenz Pisecky, Günter Hipmair, Bernhard Schauer, Nikolaus Böhler
Wear debris seems to be the most likely reason for osteolysis in THA. The aim was to show the influence of head and acetabular liner revision surgery on osteolytic zones around the femoral component. Can head and inlay revision surgery reduce the size of the osteolytic zones around the femoral component? Which patients could benefit? 47 patients (51 hips), who had undergone THA head and inlay revision surgery between 1999 and 2011, were reviewed. The mean lifetime for the prosthesis was 15.1 years (8-26, standard deviation 4...
March 2017: Journal of Orthopaedics
https://www.readbyqxmd.com/read/28109271/influence-of-surgical-approach-on-heterotopic-ossification-after-total-hip-arthroplasty-is-minimal-invasive-better-a-case-control-study
#12
Maya Hürlimann, Filippo-Franco Schiapparelli, Niccolo Rotigliano, Enrique Testa, Felix Amsler, Michael T Hirschmann
BACKGROUND: Heterotopic ossification (HO) is a well-known complication after total hip arthroplasty (THA). Recently, the trend is to operate THA minimally invasive being less traumatic than standard approaches and promising a faster return to activity. The purpose of the study was to investigate if minimal invasive surgery (MIS), leads also to less HO after THA. METHODS: This retrospective study included 134 consecutive patients undergoing THA. In 42 (31.3%) patients a standard modified anterolateral (STD-Watson-Jones), in 28 (20...
January 21, 2017: BMC Musculoskeletal Disorders
https://www.readbyqxmd.com/read/28108172/the-accuracy-of-digital-templating-for-primary-total-hip-arthroplasty-is-there-a-difference-between-direct-anterior-and-posterior-approaches
#13
Shai S Shemesh, Jonathan Robinson, Aakash Keswani, Michael J Bronson, Calin S Moucha, Darwin Chen
BACKGROUND: The direct anterior approach (DAA) has gained recent popularity for total hip arthroplasty (THA), as it provides immediate feedback on cup position and limb length using fluoroscopy. The purpose of this study is to evaluate any differences in the accuracy of digital templating for preoperative planning of THA, performed with 2 different surgical approaches: DAA using a radiolucent table with intraoperative fluoroscopy and the posterior approach (PA). METHODS: One hundred thirty-one consecutive patients (148 hips) underwent a THA by a single surgeon, using the same cup and stem designs...
December 27, 2016: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28099299/direct-anterior-approach-risk-factor-for-early-femoral-failure-of-cementless-total-hip-arthroplasty-a-multicenter-study
#14
R Michael Meneghini, Addison S Elston, Antonia F Chen, Michael M Kheir, Thomas K Fehring, Bryan D Springer
BACKGROUND: The direct anterior approach for total hip arthroplasty (THA) is marketed with claims of superiority over other approaches. Femoral exposure can be technically challenging and potentially lead to early failure. We examined whether surgical approach is associated with early THA failure. METHODS: A retrospective review of 478 consecutive early revision THAs performed within 5 years after the primary THAs at 3 academic centers from 2011 through 2014 was carried out...
January 18, 2017: Journal of Bone and Joint Surgery. American Volume
https://www.readbyqxmd.com/read/28097253/practical-implications-of-the-lumbar-spine-and-its-function-on-total-hip-arthroplasty
#15
EDITORIAL
Vincent Vinh Gia An, Brahman Shankar Sivakumar, Yadin David Levy, Jim Pierrepont, Warwick James Bruce
Correct component placement is of significant importance to ensure optimal outcomes in total hip arthroplasty (THA). Traditionally, the Lewinnek plane has been referenced as an adequate "safe zone", formed between the anterior superior iliac spines and public tubercles to optimize acetabular orientation. However, recent evidence shows that the positioning of this plane may vary due to the biomechanical relationship between the lumbar spine and hip. Therefore, the plane acquired intraoperatively may not accurately recreate the actual functional plane and acetabular orientation encountered outside of the intraoperative environment...
December 2016: Journal of Spine Surgery (Hong Kong)
https://www.readbyqxmd.com/read/28089468/obtain-a-outcome-benefits-of-tranexamic-acid-in-hip-arthroplasty-a%C3%A2-randomized-double-blinded-controlled-trial
#16
Andrew Fraval, Peter Effeney, Lena Fiddelaers, Belinda Smith, Ben Towell, Phong Tran
BACKGROUND: We examined whether the blood conserving effect of tranexamic acid (TXA) in total hip arthroplasty using the direct anterior approach, translates to an effect on functional outcomes in the perioperative period. METHODS: We conducted a single-center, randomized, double-blinded, placebo-controlled trial. One hundred one patients were randomized to receive either TXA or an equivalent volume of normal saline. The primary outcome measure was thigh swelling...
December 8, 2016: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28087159/the-direct-anterior-approach-for-complex-primary-total-hip-arthroplasty-the-extensile-acetabular-approach-on-a-regular-operating-room-table
#17
Ben Molenaers, Ronald Driesen, Guy Molenaers, Kristoff Corten
BACKGROUND: The direct anterior approach on a regular operating room table has been reported with low dislocation rates. This might be beneficial for complex primary total hip arthroplasty (THA) such as in patients with cerebral palsy or following femoral or pelvic osteotomies. Extending the approach is often required to overcome problems such as acetabular deformities or severe contractures. METHODS: We retrospectively evaluated the results and complications of 29 patients with 37 complex primary THA in which an extensile approach was used...
December 22, 2016: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28059869/a-longitudinal-supra-inguinal-fascia-iliaca-compartment-block-reduces-morphine-consumption-after-total-hip-arthroplasty
#18
Matthias Desmet, Kris Vermeylen, Imré Van Herreweghe, Laurence Carlier, Filiep Soetens, Stijn Lambrecht, Kathleen Croes, Hans Pottel, Marc Van de Velde
BACKGROUND AND OBJECTIVES: The role of a fascia iliaca compartment block (FICB) for postoperative analgesia after total hip arthroplasty (THA) remains questionable. High-dose local anesthetics and a proximal injection site may be essential for successful analgesia. High-dose local anesthetics may pose a risk for local anesthetic systemic toxicity. We hypothesized that a high-dose longitudinal supra-inguinal FICB is safe and decreases postoperative morphine consumption after anterior approach THA...
January 3, 2017: Regional Anesthesia and Pain Medicine
https://www.readbyqxmd.com/read/28024885/heterotopic-ossification-in-primary-total-hip-arthroplasty-using-the-direct-anterior-vs-direct-lateral-approach
#19
Pouya Alijanipour, Ripal P Patel, Tejal U Naik, Javad Parvizi
BACKGROUND: The formation and severity of heterotopic ossification (HO) may be influenced by type of surgical approach. Our hypothesis was that because of differences in soft tissue dissection, differences exist in HO formation in primary total hip arthroplasty using direct anterior (DA) vs direct lateral (DL) approach. METHODS: A total of 1482 consecutive patients with DL (736) or DA (746) approach and similar perioperative care protocol during 2009-2011 were retrospectively studied...
November 22, 2016: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28012048/segmental-acetabular-rim-defects-bone-loss-oversizing-and-press-fit-cup-in-total-hip-arthroplasty-evaluated-with-a-probabilistic-finite-element-analysis
#20
Farid Amirouche, Giovanni F Solitro, Amit Walia, Mark Gonzalez, Aimee Bobko
PURPOSE: Management of segmental rim defects and bone mineral density (BMD) loss in the elderly prior to total hip replacement is unclear within classification systems for acetabular bone loss. In this study, our objectives were (1) to understand how a reduction in BMD in the elderly affects the oversizing of a press-fit cup for primary fixation and (2) to evaluate whether the location of the segmental defect affected cup fixation. METHODS: A finite element (FE) model was used to simulate and evaluate cup insertion and fixation in the context of segmental rim defects...
December 23, 2016: International Orthopaedics
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