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Anterior hip arthroplasty

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https://www.readbyqxmd.com/read/28097253/practical-implications-of-the-lumbar-spine-and-its-function-on-total-hip-arthroplasty
#1
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
#2
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
#3
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
#4
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
#5
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
#6
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
https://www.readbyqxmd.com/read/28002219/do-transcortical-screws-in-a-locking-plate-construct-improve-the-stiffness-in-the-fixation-of-vancouver-b1-periprosthetic-femur-fractures-a-biomechanical-analysis-of-2-different-plating-constructs
#7
Jasjit Lochab, Andrew Carrothers, Edwin Wong, Stewart McLachlin, Wassim Aldebeyan, Richard Jenkinson, Cari Whyne, Markku T Nousiainen
OBJECTIVES: This biomechanical study compared Vancouver B1 periprosthetic femur fractures fixed with either a locking plate and anterior allograft strut construct or an equivalent locking plate with locking attachment plates construct in paired cadaveric specimens. METHODS: After 9 pairs of cadaveric femora were implanted with a cemented primary total hip arthroplasty, an oblique osteotomy was created distal to the cement mantle. Femora underwent fixation with either: (1) a locking plate with anterior strut allograft (locking compression plating (LCP)-Allograft) or (2) a locking plate with 2 locking attachment plates (LAPs) (LCP-LAP)...
January 2017: Journal of Orthopaedic Trauma
https://www.readbyqxmd.com/read/27973946/effect-of-soft-tissue-impingement-on-range-of-motion-during-posterior-approach-total-hip-arthroplasty-an-in-vivo-measurement-study
#8
Nobuo Nakamura, Yuki Maeda, Makoto Hamawaki, Takashi Sakai, Nobuhiko Sugano
PURPOSE: While implant impingement and bony impingement have been recognized as causes of poor outcomes in total hip arthroplasty (THA), reports of soft-tissue impingement are rare. To clarify the issue, the effect of anterior capsule resection on hip range of motion (ROM) was quantitatively measured in vivo during posterior approach THA using a CT-based hip navigation system. MATERIALS AND METHODS: For 47 patients (51 hips), hip ROM was measured intraoperatively before and after resection of the anterior hip capsule, and the difference was compared...
December 2016: Comput Assist Surg (Abingdon)
https://www.readbyqxmd.com/read/27965176/effect-of-acetabular-component-positioning-on-functional-outcomes-in-primary-total-hip-arthroplasty
#9
Prateek Goyal, Adrian Lau, Douglas D Naudie, Matthew G Teeter, Brent A Lanting, James L Howard
BACKGROUND: Acetabular component positioning is crucial to a successful total hip arthroplasty (THA). This study evaluated the effect of absolute acetabular component position as well as acetabular position relative to bony anatomy on patient-reported functional outcomes after primary THA. METHODS: Primary, press fit, hemispherical metal-on-polyethylene THA performed between 2003 and 2011 were analyzed. Western Ontario and McMaster Osteoarthritis Index (WOMAC), Harris Hip Score (HHS), Short Form-12 scores, and radiographs between 2 and 3 years after the index procedure were assessed...
August 26, 2016: Journal of Arthroplasty
https://www.readbyqxmd.com/read/27943417/ultrasound-guided-suprainguinal-fascia-iliaca-technique-provides-benefit-as-an-analgesic-adjunct-for-patients-undergoing-total-hip-arthroplasty
#10
W Michael Bullock, Suraj M Yalamuri, Stephen H Gregory, David B Auyong, Stuart A Grant
Analgesia after total hip arthroplasty is often accomplished by the fascia iliaca compartment block, traditionally performed below the inguinal ligament, to anesthetize both femoral and lateral femoral cutaneous nerves. The course of the lateral femoral cutaneous nerve below the inguinal ligament is variable as opposed to consistent above the inguinal ligament in the pelvis. In this case series including 5 patients, we demonstrate that an ultrasound-guided suprainguinal fascia iliaca approach would consistently anesthetize the lateral femoral cutaneous nerve along with anterior cutaneous femoral nerve branches and provide cutaneous analgesia after total hip arthroplasty, as shown by decreased opioid consumption...
December 10, 2016: Journal of Ultrasound in Medicine: Official Journal of the American Institute of Ultrasound in Medicine
https://www.readbyqxmd.com/read/27922457/daily-physical-activity-in-total-hip-arthroplasty-patients-undergoing-different-surgical-approaches-a-cohort-study
#11
Monika Engdal, Olav A Foss, Kristin Taraldsen, Vigdis S Husby, Siri B Winther
OBJECTIVE: Muscle weakness due to trauma from the surgical approach is anticipated to affect the ability of the patient to undertake daily physical activity early after total hip arthroplasty (THA). The objective of this study was to compare daily physical activity on days 1 to 4 after discharge, in patients following THA performed by 1 of 3 surgical approaches. DESIGN: A cohort study included 60 hip osteoarthritis patients, scheduled for THA, allocated to direct lateral approach, posterior approach, or anterior approach...
December 2, 2016: American Journal of Physical Medicine & Rehabilitation
https://www.readbyqxmd.com/read/27914663/outcome-of-alternative-approach-to-displaced-acetabular-fractures
#12
K S Park, C K Chan, G W Lee, H W Ahn, T R Yoon
INTRODUCTION: Anatomical reduction of displaced acetabular fracture is not without its' limitations and complications. This study is conducted to assess clinical and radiological outcomes as well as complications of treating displaced acetabular fractures with emphasis on anatomical reduction in weight-bearing area, mainly the posterior column, and imperfect reduction of the anterior column is acceptable. However, stability of both columns is mandatory. METHODS: It was a retrospective study carried out in a Level 1 arthroplasty and trauma centre...
November 27, 2016: Injury
https://www.readbyqxmd.com/read/27896435/course-of-pelvic-lift-during-total-hip-arthroplasty
#13
Steffen Brodt, Dimitri Nowack, Linda Krakow, Christoph Windisch, Georg Matziolis
INTRODUCTION: The position of the cup makes a major contribution to the success of total hip arthroplasty (THA). In conventional implantation of the prosthesis without navigation, the surgeon relies on the spatial position of the pelvis. However, iatrogenic manipulation of the pelvis during different surgical steps constantly changes the position of the pelvis during the operation. The position of the pelvis is substantial for the correct placement of the cup. The objective of this study was to investigate and visualize the course of this pelvic lift and correlate it to certain surgical steps...
November 28, 2016: Archives of Orthopaedic and Trauma Surgery
https://www.readbyqxmd.com/read/27886357/anterior-iliopsoas-impingement-due-to-a-malpositioned-acetabular-component-effective-relief-by-surgical-cup-reorientation
#14
Benjamin Schoof, Oliver Jakobs, Stefan Schmidl, Christian Lausmann, Florian Fensky, Johannes Beckmann, Thorsten Gehrke, Matthias Gebauer
BACKGROUND: Determining the aetiology of persistent pain following total hip arthroplasty (THA) can be challenging. Impingement of the iliopsoas muscle due to a malpositioned acetabular component after THA might be a potential cause of postoperative groin pain. METHODS: We retrospectively analysed the data of 12 consecutive patients from our orthopaedic department who underwent cup revision for painful iliopsoas impingement after primary THA. RESULTS: Thorough physical examination as well as radiological assessment of the included patients revealed that malpositioning of the acetabular component provoked iliopsoas impingement...
November 22, 2016: Hip International: the Journal of Clinical and Experimental Research on Hip Pathology and Therapy
https://www.readbyqxmd.com/read/27886354/a-retrospective-analysis-of-the-merits-and-challenges-associated-with-simultaneous-bilateral-tha-using-the-direct-anterior-approach
#15
Matthew L Brown, Johannes F Plate, David C Holst, Daniel N Bracey, Matthew W Bullock, Jason E Lang
INTRODUCTION: 15%-20% of patients presenting for total hip arthroplasty (THA) have bilateral disease. While simultaneous bilateral THA is of interest to patients and surgeons, debate persists regarding its merits. The majority of previous reports on simultaneous bilateral THA involve patients in the lateral decubitus position, which require repositioning, prepping and draping, and exposure of a fresh wound to pressure and manipulation for the contralateral THA. The purpose of this study was to compare complications, component position, and financial parameters for simultaneous versus staged bilateral THAs using the direct anterior approach (DAA)...
November 14, 2016: Hip International: the Journal of Clinical and Experimental Research on Hip Pathology and Therapy
https://www.readbyqxmd.com/read/27876253/the-impact-of-surgical-technique-on-patient-reported-outcome-measures-and-early-complications-after-total-hip-arthroplasty
#16
Udai S Sibia, Timothy R Turner, James H MacDonald, Paul J King
BACKGROUND: This study examines patient and surgeon reported outcome measures, complications during index admission, length of stay (LOS), and discharge disposition in a series of total hip replacements (THR) performed via the direct anterior (DA) or posterolateral (PL) approach. METHODS: Five surgeons performed 2698 total hip replacements (1457 DA vs 1241 PL) between January 2010 and June 2015. Complications during index admission were recorded using billing and claims data...
November 1, 2016: Journal of Arthroplasty
https://www.readbyqxmd.com/read/27867519/force-plate-analyses-of-balance-following-a-balance-exercise-program-during-acute-post-operative-phase-in-individuals-with-total-hip-and-knee-arthroplasty-a-randomized-clinical-trial
#17
Pankaj Jogi, Aleksandra Zecevic, Tom J Overend, Sandi J Spaulding, John F Kramer
OBJECTIVES: Typical rehabilitation programs following total hip arthroplasty and total knee arthroplasty include joint range of motion and muscle-strengthening exercises. Balance and balance exercises following total hip arthroplasty and total knee arthroplasty have not received much attention. The purpose of this study was to determine whether an intervention of balance exercises added to a typical rehabilitation program positively affects patients' balance. METHODS: A total of 63 patients were provided with outpatient physical therapy at their home...
2016: SAGE Open Medicine
https://www.readbyqxmd.com/read/27858241/repeated-posterior-dislocation-of-total-hip-arthroplasty-after-spinal-corrective-long-fusion-with-pelvic-fixation
#18
Hiroki Furuhashi, Daisuke Togawa, Hiroshi Koyama, Hironobu Hoshino, Tatsuya Yasuda, Yukihiro Matsuyama
PURPOSE: Several reports have indicated that anterior dislocation of total hip arthroplasty (THA) can be caused by spinal degenerative changes with excessive pelvic retroversion. However, no reports have indicated that posterior dislocation can be caused by fixed pelvic anteversion after corrective spine surgery. We describe a rare case experiencing repeated posterior THA dislocation that occurred at 5 months after corrective spinal long fusion with pelvic fixation. METHODS: A 64-year-old woman had undergone bilateral THA at 13 years before presenting to our institution...
November 17, 2016: European Spine Journal
https://www.readbyqxmd.com/read/27853816/total-hip-arthroplasty-using-direct-anterior-approach-and-dual-mobility-cup-safe-and-efficient-strategy-against-post-operative-dislocation
#19
Cécile Batailler, Camdon Fary, Pierre Batailler, Elvire Servien, Philippe Neyret, Sébastien Lustig
AIM: We hypothesize that a dual mobility cup can be safely used via the direct anterior approach, without increasing the risk of complications or incorrect positioning. MATERIALS AND METHODS: This retrospective study compared 201 primary total hip arthroplasties using a dual mobility cup performed via direct anterior approach without a traction table, to 101 arthroplasties performed via posterolateral approach. Implant positioning, function scores, and early complications were recorded...
November 16, 2016: International Orthopaedics
https://www.readbyqxmd.com/read/27846875/the-design-of-a-randomised-controlled-trial-to-evaluate-the-cost-effectiveness-of-the-posterolateral-versus-the-direct-anterior-approach-for-tha-polada-trial
#20
K Rykov, I H F Reininga, B A S Knobben, M S Sietsma, B L E F Ten Have
BACKGROUND: Total hip arthroplasty (THA) is one of the most successful orthopaedic procedures. Because of the increasing number of THAs, a growing demand for faster recovery and a greater emphasis on cost-effectiveness, minimally invasive THAs have been introduced in the last decades. The direct anterior approach is a minimally invasive, tissue-sparing approach in which intermuscular planes are used. Theoretically, this approach should result in a faster recovery of physical functioning and higher health-related quality of life...
November 15, 2016: BMC Musculoskeletal Disorders
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