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Anterior hip arthroplasty

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https://www.readbyqxmd.com/read/29783889/the-external-obturator-footprint-as-a-landmark-in-total-hip-arthroplasty-through-a-direct-anterior-approach-a-ct-based-analysis
#1
Hannes A Rüdiger, Benjamin Fritz, Franco M Impellizzeri, Michael Leunig, Christian W Pfirrmann, Reto Sutter
BACKGROUND: Anatomical landmarks for templating of total hip arthroplasty (THA) that are visible both during surgery and on radiographs are rare. If surgery is performed through a direct anterior approach the external obturator tendon (EO) is consistently visible. To use this point as a reference the exact position and dimensions of the footprint need to be known. AIM: To determine the location and dimension of the EO footprint on pelvic radiographs by correlating the EO anatomy in CT scans with conventional radiographs...
May 1, 2018: Hip International: the Journal of Clinical and Experimental Research on Hip Pathology and Therapy
https://www.readbyqxmd.com/read/29781289/a-randomised-trial-comparing-spatio-temporal-gait-parameters-after-total-hip-arthroplasty-between-the-direct-anterior-and-direct-lateral-surgical-approaches
#2
Bryn O Zomar, Dianne Bryant, Susan Hunter, James L Howard, Edward M Vasarhelyi, Brent A Lanting
INTRODUCTION: Total hip arthroplasty (THA) is a successful procedure for relieving symptoms of severe osteoarthritis. Surgical approach is a key factor in early recovery and although controversial, little has been written about the direct anterior (DA) approach using objective early measures. METHODS: 78 participants were prospectively enrolled to undergo a THA through either a DA or direct lateral (DL) surgical approach. Outcome measures were collected preoperatively and at discharge from the hospital, and 2-, 6- and 12-weeks...
May 1, 2018: Hip International: the Journal of Clinical and Experimental Research on Hip Pathology and Therapy
https://www.readbyqxmd.com/read/29772949/lack-of-consensus-on-optimal-acetabular-cup-orientation-because-of-variation-in-assessment-methods-in-total-hip-arthroplasty-a-systematic-review
#3
Thom E Snijders, Koen Willemsen, Steven M van Gaalen, Rene M Castelein, Harrie Weinans, Arthur de Gast
INTRODUCTION: Dislocation is one of the main reasons for revision of total hip arthroplasty but dislocation rates have not changed in the past decades, compromising patients' well-being. Acetabular cup orientation plays a key role in implant stability and has been widely studied. This article investigates whether there is a consensus on optimal cup orientation, which is necessary when using a navigation system. METHODS: A systematic search of the literature in the PubMed, Embase and Cochrane databases was performed (March 2017) to identify articles that investigated the direct relationship between cup orientation and dislocation, including a thorough evaluation of postoperative cup orientation assessment methods...
May 1, 2018: Hip International: the Journal of Clinical and Experimental Research on Hip Pathology and Therapy
https://www.readbyqxmd.com/read/29762111/direct-anterior-approach-has-lower-deep-infection-frequency-than-less-invasive-direct-lateral-approach-in-primary-total-hip-arthroplasty
#4
Sean A Sutphen, Keith R Berend, Michael J Morris, Adolph V Lombardi
Debate continues over the direct anterior (DA) approach. The purpose of this study is to compare the frequency of deep infection between a DA approach and a less invasive direct lateral (LIDL) approach in a large consecutive series of primary total hip arthroplasty (THA). The authors identified 5702 primary THAs performed between 2007 and 2014. DA approach was used in 3540 hips and LIDL in 2162. Patient records were reviewed. Statistical analysis of reoperation, infection- or wound-related complication, and deep infection was performed...
2018: Journal of Surgical Orthopaedic Advances
https://www.readbyqxmd.com/read/29753876/electromyographic-study-of-hip-muscles-involved-in-total-hip-arthroplasty-surprising-results-using-the-direct-anterior-minimally-invasive-approach
#5
Jules Bernard, Fredson Razanabola, Julien Beldame, Stéphane Van Driessche, Helena Brunel, Thomas Poirier, Jean Matsoukis, Fabien Billuart
BACKGROUND: The functional and clinical benefit of minimally invasive total hip arthroplasty (THA) is well-known, but the literature reports impaired gait and posture parameters as compared to the general population, especially following use of the anterior minimally invasive approach, which has more severe impact on posture than the posterior approach. The reasons for this impairment, however, remain unexplained. We therefore conducted a surface electromyography (sEMG) study of the hip muscles liable to be affected by arthroplasty surgery: gluteus maximus (GMax), gluteus medius (GMed, tensor fasciae latae (TFL), and sartorius (S)...
May 10, 2018: Orthopaedics & Traumatology, Surgery & Research: OTSR
https://www.readbyqxmd.com/read/29746626/cutibacterium-avidum-colonization-in-the-groin-is-associated-with-obesity-a-potential-risk-factor-for-hip-periprosthetic-joint-infection-pji
#6
Laura Böni, Stefan P Kuster, Bianka Bartik, Reinhard Zbinden, Patrick O Zingg, Yvonne Achermann
Background: An increase in the incidence of hip periprosthetic joint infections (PJIs) caused by Cutibacterium avidum has recently been detected after implantation of hip arthroplasties with an anterior surgical approach. We raised the question of whether skin colonization with C. avidum differs between the anterior and the lateral thigh as areas of surgical incision fields. Methods: Between February and June 2017, we analyzed skin scrapings from the groin and the anterior and lateral thigh in all patients undergoing a primary hip arthroplasty...
May 9, 2018: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
https://www.readbyqxmd.com/read/29742932/are-there-more-wound-complications-or-infections-with-direct-anterior-approach-total-hip-arthroplasty
#7
Christophe Tissot, Matthias Vautrin, Anais Luyet, Olivier Borens
INTRODUCTION: Compared to a lateral or posterior approach (PA), the direct anterior approach (DAA) does permit a better muscle preservation for total hip arthroplasty (THA). However, there is concern whether this advantage come with increased wound complication and infection leading to reoperation or sometimes major procedures. METHOD: We retrospectively reviewed all patients who underwent primary THA through the PA between January 2009 and April 2013 ( n = 796) and through the DAA between January 2011 and April 2013 ( n = 399) at our institution with a minimum of 2 years follow up regarding all wound complications and all infections...
May 1, 2018: Hip International: the Journal of Clinical and Experimental Research on Hip Pathology and Therapy
https://www.readbyqxmd.com/read/29739249/incidence-risk-factors-and-prognosis-of-transient-pseudosubluxation-after-total-hip-arthroplasty
#8
Yong-Han Cha, Woo-Lam Jo, Young-Kyun Lee, Yong-Chan Ha, Javad Parvizi, Kyung-Hoi Koo
INTRODUCTION: Pseudosubluxation is a transient separation of the prosthetic femoral head from the acetabular liner during the anaesthetic period after total hip arthroplasty (THA). However, little is known about the frequency, pathomechanism, risk factors or natural history. METHODS: To determine the incidence, direction of the displacement, risk factors and subsequent instability of pseudosubluxation, we evaluated 1099 primary cementless THAs (943 patients), which were performed during 8 years at one institution...
May 1, 2018: Hip International: the Journal of Clinical and Experimental Research on Hip Pathology and Therapy
https://www.readbyqxmd.com/read/29729934/is-direct-anterior-approach-a-credible-option-for-severely-obese-patients-undergoing-total-hip-arthroplasty-a-matched-control-retrospective-clinical-study
#9
Alexander Antoniadis, Dimitris Dimitriou, Andreas Flury, Gregor Wiedmer, Julian Hasler, Naeder Helmy
BACKGROUND: Severely obese patients present a significant challenge for arthroplasty surgeons because of their body habitus. Up to date, there is no clear consensus on the safety of the direct anterior approach (DAA) in obese patients undergoing total hip arthroplasty. Therefore, the purpose of the present study was to determine whether DAA is a credible option in severely obese regarding complication rates, clinical outcomes, and component positioning. METHODS: Obese patients with a body mass index ≥ 35 kg/m2 (n = 129) who received total hip arthroplasty with DAA in our institution were matched for gender and age with nonobese patients with body mass index ≤ 25 kg/m2 (n = 125)...
April 11, 2018: Journal of Arthroplasty
https://www.readbyqxmd.com/read/29720218/the-anteroposterior-axis-of-the-tibia-is-adjusted-to-approximately-a-right-angle-to-the-anterior-pelvic-plane-in-the-standing-position-in-patients-with-hip-dysplasia-similar-to-normal-subjects-a-cross-sectional-study
#10
Norio Imai, Dai Miyasaka, Hayato Suzuki, Kazuki Tsuchiya, Tomoyuki Ito, Izumi Minato, Naoto Endo
BACKGROUND: We previously described that the anteroposterior (AP) axis of the tibia is approximately perpendicular to the transverse axis of the anterior pelvic plane (APP) in the standing position in healthy subjects. The purpose of this study was to investigate the rotational alignment between the APP and clinical epicondylar axis and the AP axis of the tibia relative to pelvic coordination in the standing position in normal subjects and in women with developmental dysplasia of the hip (DDH) to aid decision making for surgeons in the alignment of implants in total hip or knee arthroplasty...
May 2, 2018: Journal of Orthopaedic Surgery and Research
https://www.readbyqxmd.com/read/29713415/spinopelvic-alignment-and-low-back-pain-after-total-hip-replacement-arthroplasty-in-patients-with-severe-hip-osteoarthritis
#11
Yawara Eguchi, Satoshi Iida, Chiho Suzuki, Yoshiyuki Shinada, Tomoko Shoji, Kazuhisa Takahashi, Seiji Ohtori
Study Design: Retrospective observational study. Purpose: We examined change in lumbrosacral spine alignment and low back pain (LBP) following total hip arthroplasty (THA) in patients with severe hip osteoarthritis (OA). Overview of Literature: Severe hip osteoarthritis has been reported to cause spine alignment abnormalities and low back pain, and it has been reported that low back pain is improved following THA. Methods: Our target population included 30 patients (29 female, mean age 63...
April 2018: Asian Spine Journal
https://www.readbyqxmd.com/read/29656970/predictability-of-pelvic-tilt-during-total-hip-arthroplasty-using-a-traction-table
#12
Paul S Roettges, Jack R Hannallah, Jordan L Smith, John T Ruth
BACKGROUND: Pelvic positioning during total hip arthroplasty (THA) affects functional position of the acetabular component. We sought to evaluate whether preoperative pelvic tilt correlated with intraoperative pelvic tilt while positioned on a traction table for direct anterior THA and furthermore to evaluate whether there was a consistent and predictable effect on pelvic tilt while positioned for surgery. METHODS: We evaluated the sagittal spinopelvic preoperative standing and supine pelvic tilt radiographic measurements as compared with intraoperative measurements of 25 patients...
March 16, 2018: Journal of Arthroplasty
https://www.readbyqxmd.com/read/29651575/assessment-of-pelvic-tilt-in-anteroposterior-radiographs-by-means-of-tilt-ratios
#13
T Schwarz, A Benditz, H-R Springorum, J Matussek, G Heers, M Weber, T Renkawitz, J Grifka, B Craiovan
INTRODUCTION: In anteposterior (AP) radiographs, cup position in total hip arthroplasty and acetabular anatomy in hip-preserving surgery are highly influenced by pelvic tilt. The sagittal rotation of the anterior pelvic plane is an important measurement of pelvic tilt during hip surgery. Thus, correct evaluation of cup position and acetabular parameters requires the assessment of pelvic tilt in AP radiographs. METHODS: Changes in pelvic tilt inversely change the height of the lesser pelvis and the obturator foramen in AP radiographs...
April 12, 2018: Archives of Orthopaedic and Trauma Surgery
https://www.readbyqxmd.com/read/29628686/treatment-options-for-chronic-pelvic-discontinuity
#14
REVIEW
Mark D Hasenauer, Wayne G Paprosky, Neil P Sheth
Chronic pelvic discontinuity is a distinct and unique challenge seen during revision total hip arthroplasty (THA) in which the superior ilium is separated from the inferior ischiopubic segment through the acetabulum, rendering the anterior and posterior columns discontinuous. The operative management of acetabular bone loss in revision THA is one of the most difficult challenges today. Common treatment options include cage reconstruction with bulk acetabular allograft, custom triflange acetabular component, a cup-cage construct, jumbo acetabular cup with porous metal augments, or acetabular distraction with a porous tantalum shell with or without modular porous augments...
January 2018: Journal of Clinical Orthopaedics and Trauma
https://www.readbyqxmd.com/read/29622494/evaluation-of-the-learning-curve-when-transitioning-from-posterolateral-to-direct-anterior-hip-arthroplasty-a-consecutive-series-of-1000-cases
#15
Andrea H Stone, Udai S Sibia, Ryan Atkinson, Timothy R Turner, Paul J King
BACKGROUND: The direct anterior approach (DAA) for primary hip replacement has been gaining more attention and widespread use in recent years. There are a number of published studies evaluating the learning curve when a surgeon changes technique; these studies typically look at complications during the initial cases. This study examines procedure and total operating room (OR) time along with all complications for a surgeon transitioning from the posterolateral approach (PA) to DAA. METHODS: A retrospective review of a single surgeon series of 1000 initial DAA procedures...
March 8, 2018: Journal of Arthroplasty
https://www.readbyqxmd.com/read/29615378/intraoperative-psoas-compartment-block-vs-preoperative-fascia-iliaca-block-for-pain-control-after-direct-anterior-total-hip-arthroplasty-a-randomized-controlled-trial
#16
Clayton R Perry, Adam M Fahs, Michael D Kurdziel, Denise M Koueiter, Randy J Fayne, James J Verner
BACKGROUND: Modern joint arthroplasty protocols place an emphasis on minimizing patient-reported postoperative pain while minimizing opioid consumption. The use of multimodal pain management protocols has been reported to improve patient outcomes and satisfaction after total hip arthroplasty. METHODS: In a prospective, single-surgeon trial, 50 patients undergoing primary direct anterior approach total hip arthroplasty were randomized to receive a preoperative fascia iliaca compartment block (FICB) or an intraoperative surgeon-delivered psoas compartment block (PCB)...
January 31, 2018: Journal of Arthroplasty
https://www.readbyqxmd.com/read/29613926/motor-evoked-potential-analysis-of-femoral-nerve-status-during-the-direct-anterior-approach-for-total-hip-arthroplasty
#17
Tetsuro Ishimatsu, Koichi Kinoshita, Jun Nishio, Jun Tanaka, Satohiro Ishii, Takuaki Yamamoto
BACKGROUND: During the direct anterior approach for total hip arthroplasty, a retractor is placed on the anterior wall of the acetabulum to retract the iliopsoas muscle. This step with the retractor has been reported to put the patient at risk for femoral nerve damage. The present study aimed to clarify the effects of the anterior acetabular retractor on the status of the femoral nerve during the direct anterior approach on the basis of transcranial motor-evoked potential (MEP) analysis...
April 4, 2018: Journal of Bone and Joint Surgery. American Volume
https://www.readbyqxmd.com/read/29606894/a-new-mini-navigation-tool-allows-accurate-component-placement-during-anterior-total-hip-arthroplasty
#18
Javad Parvizi, Jessica R Benson, Jeffrey M Muir
Introduction: Computer-assisted navigation systems have been explored in total hip arthroplasty (THA) to improve component positioning. While these systems traditionally rely on anterior pelvic plane registration, variances in soft tissue thickness overlying anatomical landmarks can lead to registration error, and the supine coronal plane has instead been proposed. The purpose of this study was to evaluate the accuracy of a novel navigation tool, using registration of the anterior pelvic plane or supine coronal plane during simulated anterior THA...
2018: Medical Devices: Evidence and Research
https://www.readbyqxmd.com/read/29582118/reverse-total-shoulder-arthroplasty-using-helical-blade-to-optimize-glenoid-fixation-and-bone-preservation-preliminary-results-in-thirty-five-patients-with-minimum-two-year-follow-up
#19
Sebastien Zilber, Eleonora Camana, Peter Lapner, Emil Haritinian, Laurent Nove Josserand
PURPOSE: Glenoid loosening is a common cause of reverse total shoulder arthroplasty (RTSA) failure, and grafting of the glenoid is often required for revision due to bone loss due to the central peg in most glenoid baseplates. Helical blades have been used in the hip to optimize bone fixation in proximal femoral fracture. This study presents the initial results of specifically designed helical blade in the shoulder to optimize glenoid bone fixation and preservation as part of RTSA. METHODS: Thirty-five patients underwent RTSA with glenoid helical blade fixation...
March 26, 2018: International Orthopaedics
https://www.readbyqxmd.com/read/29576639/total-hip-arthroplasty-by-the-direct-anterior-approach-using-a-neck-preserving-stem-safety-efficacy-and-learning-curve
#20
Aditya Khemka, Omar Mograby, Sarah J Lord, Zelda Doyle, Munjed Al Muderis
Background: The concept of femoral neck preservation in total hip replacement (THR) was introduced in 1993. It is postulated that retaining cortical bone of the femoral neck offers triplanar stability, uniform stress distribution, and accommodates physiological anteversion. However, data on safety, efficacy and learning curve are lacking. Materials and Methods: We prospectively assessed all patients who were operated for a THR with a short neck preserving stem (MiniHip) between 2012 and 2014...
March 2018: Indian Journal of Orthopaedics
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