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Anterior hip arthroplasty

Valérie A Zeller, Valérie-Anne Letembet, Vanina A Meyssonnier, Beate Heym, Jean-Marc Ziza, Simon D Marmor
BACKGROUND: Cutibacterium spp. (formerly Propionibacterium) are slow-growing cutaneous anaerobic commensals, rarely reported in prosthetic joint infections (PJIs). We describe epidemiological, clinical, biological, and radiological characteristics of 15 Cutibacterium avidum PJIs, their treatments, and outcomes. METHODS: This study is an observational, monocenter study (January 2004 to April 2017), with comparison of C avidum vs Cutibacterium acnes (n = 40) PJI characteristics...
February 12, 2018: Journal of Arthroplasty
Akio Kanda, Kazuo Kaneko, Osamu Obayashi, Atsuhiko Mogami, Itaru Morohashi
INTRODUCTION: In total hip arthroplasty via a direct anterior approach, the femur must be elevated at the time of femoral implant placement. For adequate elevation, division of the posterior soft tissues is necessary. However, if we damage and separate the posterior muscle tissue, we lose the benefits of the intermuscular approach. Furthermore, damage to the posterior soft tissue can result in posterior dislocation. We investigate that protecting the posterior soft tissue increases the joint stability in the early postoperative period and results in a lower dislocation rate...
March 9, 2018: European Journal of Orthopaedic Surgery & Traumatology: Orthopédie Traumatologie
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
Pascal Moreau
For many years the Hueter anterior approach has been performed exclusively in Paris. Robert and Jean Judet described it for the first time in 1950 in relation to total hip arthroplasty. They started using an orthopaedic surgery table in 1985. The approach was only taught within the capital's orthopaedic units and was relatively unknown before. In the last 10 years there has been widespread renewed interest in this approach which preserves the muscles. The technique is described in detail with its tricks and risks...
March 6, 2018: European Journal of Orthopaedic Surgery & Traumatology: Orthopédie Traumatologie
Hiroki Shimodaira, Keiji Tensho, Yusuke Akaoka, Suguru Koyama, Masaaki Maruyama, Hiroyuki Kato, Naoto Saito
BACKGROUND: The acetabular fossa is thought to be located in the center of the acetabulum, and acetabular reaming in total hip arthroplasty is conventionally performed in the center of the fossa. However, the actual location of the fossa and the influence that hypoplasia or deformity may have on the position of the fossa are unknown. We hypothesized that the fossa is located in the center of the acetabulum, regardless of hypoplasia or deformity. METHODS: Fifty patients with normal hips (normal hip group), 50 patients with dysplasia who underwent rotational acetabular osteotomy (dysplastic hip group), and 46 patients with osteoarthritis who underwent total hip arthroplasty (osteoarthritic hip group) were evaluated by computed tomography (CT) imaging...
March 7, 2018: Journal of Bone and Joint Surgery. American Volume
Daniel A Maranho, Kathryn A Williams, Michael B Millis, Young-Jo Kim, Eduardo N Novais
BACKGROUND: The treatment of hip dysplasia in patients with Down syndrome is challenging. We investigated the clinical, functional, and radiographic outcomes of periacetabular osteotomy (PAO) as well as factors associated with its failure at a minimum of 5 years of follow-up. METHODS: Between 1992 and 2011, 19 patients with Down syndrome (26 hips) underwent PAO at a mean age of 16.2 ± 4.7 years. Hip pain and function were assessed with use of the modified Harris hip score (HHS) and the Gross Motor Function Classification System (GMFCS)...
March 7, 2018: Journal of Bone and Joint Surgery. American Volume
Rinne M Peters, Loes W A H van Beers, Liza N van Steenbergen, Julius Wolkenfelt, Harmen B Ettema, Bas L E F Ten Have, Paul C Rijk, Martin Stevens, Sjoerd K Bulstra, Rudolf W Poolman, Wierd P Zijlstra
BACKGROUND: Patient-reported outcome measures (PROMs) are used to evaluate the outcome of total hip arthroplasty (THA). We determined the effect of surgical approach on PROMs after primary THA. METHODS: All primary THAs, with registered preoperative and 3 months postoperative PROMs were selected from the Dutch Arthroplasty Register. Based on surgical approach, 4 groups were discerned: (direct) anterior, anterolateral, direct lateral, and posterolateral approaches...
March 1, 2018: Journal of Arthroplasty
Christopher R James, Blake E Peterson, Julia R Crim, James L Cook, Brett D Crist
BACKGROUND: Direct anterior approach total hip arthroplasty (THA) with fluoroscopic assistance is growing in popularity. Variables such as pelvic tilt, c-arm technique, and patient positioning can affect the perceived fluoroscopic view. This study evaluates the effect of these variables on the position of the acetabular component. METHODS: Forty-one hips in 40 patients undergoing direct anterior arthroplasty THA with fluoroscopic assistance underwent routine postoperative radiographs and postoperative pelvic computed tomography scan...
February 1, 2018: Journal of Arthroplasty
HaiYan Zhao, MaoYing Xiang, YaYi Xia, Xiaojun Shi, Fu-Xing Pei, PengDe Kang
BACKGROUND: Tranexamic acid (TXA), delivered intravenously or topically, has been shown to reduce blood loss, the need for transfusion, and relevant healthcare costs when administered in primary standard total hip arthroplasty (THA). Whether the same is true of oral TXA is unclear, the purpose of this study was to determine if oral tranexamic acid is equivalent to intravenous TXA in the case of patients undergoing THA via the direct anterior approach. METHODS: In this prospective randomized controlled trial, 120 patients undergoing primary THA by the direct anterior approach were randomized to receive oral TXA (two doses of 20 mg/kg), intravenous TXA (two doses of 15 mg/kg), or no TXA...
February 28, 2018: International Orthopaedics
Jonathan D Bartlett, John E Lawrence, Vikas Khanduja
PURPOSE: To determine: (1) What is the proximity of the lateral femoral cutaneous nerve (LFCN) to the anterior portal (AP) used in supine hip arthroscopy? (2) What is the proximity of the LCFN to the incision in the minimally invasive anterior approach (MIAA) for total hip arthroplasty? (3) What effect does lateralizing the AP have on the likelihood of nerve injury? (4) What branching patterns are observable in the LFCN? METHODS: Forty-five hemipelves were dissected...
February 23, 2018: Arthroscopy: the Journal of Arthroscopic & related Surgery
Casey A Myers, Peter J Laz, Kevin B Shelburne, Dana L Judd, Daniel N Huff, Joshua D Winters, Jennifer E Stevens-Lapsley, Paul J Rullkoetter
BACKGROUND: Component alignment is an important consideration in total hip arthroplasty. The impact of changes in alignment on muscle forces and joint contact forces during dynamic tasks are not well understood, and have the potential to influence surgical decision making. The objectives of this study were to assess the impact of femoral head/stem and cup component placement on hip muscle and joint contact forces during tasks of daily living and to identify which alignment parameters have the greatest impact on joint loading...
February 14, 2018: Clinical Biomechanics
Loes Janssen, Karolina A P Wijnands, Dennis Janssen, Michiel W H E Janssen, Jan W Morrenhof
BACKGROUND: Some studies have revealed an increased risk of early aseptic loosening of cementless stems in THA when inserted through an anterior or anterolateral approach compared with a posterior approach, whereas approach does not appear to be a risk factor in others. Stem design, whether "anatomic" (that is, stems with a curved lateral profile or an obtuse angle at the proximal-lateral portion of the stem) or "shoulder" (that is, straight with a proximal shoulder), may also be associated with a differential risk of aseptic loosening in cementless THA depending on the surgical approach used, but if so, this risk is not well characterized...
February 23, 2018: Clinical Orthopaedics and related Research
Carlos J Marques, Tobias Martin, Franziska Fiedler, Mathias Weber, Viktor Breul, Frank Lampe, Josef Kozak
OBJECTIVES: Pelvic tilt is the angle between the anterior pelvic plane and the coronal plane. It affects cup positioning in total hip arthroplasty. The primary objective of this study was to test the intra- and inter-rater reliability of a navigated smart device-based ultrasound system for pelvic tilt assessment. The secondary objective was to test the inter-rater variability of the measurements on a hip phantom. METHODS: A repeated-measures design was used. Two raters measured the pelvic tilt of 12 symptom-free young adults in upright and supine positions...
February 26, 2018: Journal of Ultrasound in Medicine: Official Journal of the American Institute of Ultrasound in Medicine
Kyu-Jin Cho, Kyung-Soon Park, Taek-Rim Yoon
PURPOSE: The aim of this study was to evaluate the effectiveness of our technique on further collapse of the femoral head in Association Research Circulation Osseous (ARCO) stage II, patient's functional improvements, and analyze the survival rate of the affected hip. METHODS: Between June 2007 and March 2015, 24 hips diagnosed with osteonecrosis of the femoral head (ONFH) were treated with our muscle pedicle bone grafting (MPBG) technique using anterior one-third of gluteus medius attached to the greater trochanter...
February 24, 2018: International Orthopaedics
Yuta Nakanishi, Takafumi Hiranaka, Masahiro Shirahama, Masafumi Uesugi, Kenjiro Okimura, Masanori Tsubosaka, Yousaku Shibata, Yuuichi Hida, Takaaki Fujishiro, Harunobu Uemoto
BACKGROUND: Despite the fact that multiple screw fixation is a common option of surgical treatment for femoral neck fractures, there is a paucity of precise morphological study of the femoral neck. To identify appropriate positions and spacing of hip screws for multiple-screw femoral neck fracture fixation, proximal femur morphology in Japanese patients was studied. METHOD: One hundred hips in fifty knee arthroplasty candidates were studied. Following full limb CT, defined slices were created and anatomical variables measured...
February 16, 2018: Journal of Orthopaedic Science: Official Journal of the Japanese Orthopaedic Association
Larry E Miller, Joseph S Gondusky, Atul F Kamath, Friedrich Boettner, John Wright, Samir Bhattacharyya
Background and purpose - Systematic comparisons of anterior approach (A) versus posterior approach (P) in primary total hip arthroplasty (THA) have largely focused on perioperative outcomes. In this systematic review with meta-analysis, we compared complication risk of A versus P in studies of primary THA with at least 1-year mean follow-up. Patients and methods - We performed a systematic review of prospective and retrospective studies with at least 1-year mean follow-up that reported complications of A and P primary THA...
February 16, 2018: Acta Orthopaedica
Marc R Angerame, Thomas K Fehring, John L Masonis, J Bohannon Mason, Susan M Odum, Bryan D Springer
BACKGROUND: In an era of innovation in surgical approaches for total hip arthroplasty (THA), there is concern for increasing trends of early failure. The purpose of this study is to evaluate the incidence of early failure of primary THA stratified by surgical approach. METHODS: A retrospective review was performed on consecutive primary THAs completed from 2007 to 2014 at a high-volume center. THAs were stratified by surgical approach. Only the direct anterior (DAA) and posterior approaches (PA) were included...
February 2, 2018: Journal of Arthroplasty
Brad L Penenberg, Sanjum P Samagh, Sean S Rajaee, Antonia Woehnl, William W Brien
BACKGROUND: Obtaining the ideal acetabular cup position in total hip arthroplasty remains a challenge. Advancements in digital radiography and image analysis software allow the assessment of the cup position during the surgical procedure. This study describes a validated technique for evaluating cup position during total hip arthroplasty using digital radiography. METHODS: Three hundred and sixty-nine consecutive patients undergoing total hip arthroplasty were prospectively enrolled...
February 7, 2018: Journal of Bone and Joint Surgery. American Volume
Austin J Ramme, Nina D Fisher, Jonathan Egol, Gregory Chang, Jonathan M Vigdorchik
Background: Digital templating systems foster patient-specific measurements for preoperative planning. Questions/Purposes: We aim (1) to verify the accuracy of a templating system, (2) to describe the effects of scaling marker position on the accuracy of digital templating of the hip, and (3) to provide a practical guide for scaling marker position using patient body mass index (BMI). Methods: A scaling sphere was placed in five positions along the anterior-posterior axis of an acetabular implant and pelvis phantom, and x-rays were obtained...
February 2018: HSS Journal: the Musculoskeletal Journal of Hospital for Special Surgery
Thomas J Wilson, Grant M Kleiber, Ryan M Nunley, Susan E Mackinnon, Robert J Spinner
OBJECTIVE The sciatic nerve, particularly its peroneal division, is at risk for injury during total hip arthroplasty (THA), especially when a posterior approach is used. The majority of the morbidity results from the loss of peroneal nerve-innervated muscle function. Approximately one-third of patients recover spontaneously. The objectives of this study were to report the outcomes of distal decompression of the peroneal nerve at the fibular tunnel following sciatic nerve injury secondary to THA and to attempt to identify predictors of a positive surgical outcome...
February 2, 2018: Journal of Neurosurgery
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