Total Hip Arthroplasty in Post-Traumatic Avascular Necrosis

AbstractGunshot wound (GSW) injuries around the hip joint can lead to debilitating post-traumatic arthritis, requiring a technically demanding primary total hip arthroplasty (THA). These surgeries are often complicated by bullet debris, extensive scaring, prior operations, and altered local anatomy. Although most literature focuses on acute management of GSW around the hip, a few reports detail the mid-term outcomes of GSW patients with primary THA for post-traumatic arthritis. The purpose of this study was to assess the outcomes and complications associated with THA in nine patients with secondary arthritis due to prior GSW injuries. At a mean follow-up of 35 months (range 12–60 months), significant improvement was shown in hip function, activity, and pain levels, and was similar to the outcomes of 18 patients who underwent primary THA for degenerative joint disease. While technically demanding, THA seems to reduce pain and improve function safely and effectively for patients with GSW-induced hip arthritis.

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Total Hip Arthroplasty in Patients with Avascular Necrosis of the Entire Femur

The Journal of the Korean Orthopaedic Association ◽

10.4055/jkoa.2019.54.3.281 ◽

2019 ◽

Vol 54 (3) ◽

pp. 281

Author(s):

Seung Rim Yi ◽

Se Hyuk Im ◽

Sang Hoon Park

Keyword(s):

Total Hip Arthroplasty ◽

Avascular Necrosis ◽

Hip Arthroplasty ◽

Total Hip

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Comorbidities and indications for total hip arthroplasty at a tertiary care center in Saudi Arabia

MOJ Orthopedics & Rheumatology ◽

10.15406/mojor.2020.12.00519 ◽

2021 ◽

Vol 12 (3) ◽

pp. 59-63

Author(s):

Bandar M Hetaimish ◽

Eyad A Alakkas ◽

Khalid F Alharbi ◽

Abdulrahman M Alradadi ◽

Habib Y Aletani ◽

...

Keyword(s):

Saudi Arabia ◽

Postoperative Complications ◽

Total Hip Arthroplasty ◽

Chronic Diseases ◽

Hip Arthroplasty ◽

Common Indication ◽

Total Hip ◽

Tertiary Center ◽

Duration Of Surgery ◽

Post Traumatic

Objectives: Total hip arthroplasty (THA) is one of the most effective orthopedic interventions for the treatment of patients with advanced‑ stage hip disease. However, reports regarding indications for primary THA in Saudi Arabia are limited. We aimed to evaluate primary indications for THA and identify associated chronic diseases and postoperative complications in THA patients at a tertiary hospital in Saudi Arabia. These are important to provide knowledge on types of hip diseases and variables that may affect the outcome of this intervention in the Saudi population. Methods: This is a retrospective cohort study of THA cases performed between 2010 and 2019 at a tertiary center in Saudi Arabia. Retrieved data include patients’ ages at the time of surgery, chronic diseases, presurgical diagnosis, site and duration of surgery, and postoperative complications. Results: We identified 83 patients who had undergone primary THA; in regard to comorbidities, 32.5% and 30.1% had hypertension and diabetes mellitus, respectively. The most common indication for THA was degenerative hip osteoarthritis (50.6%), followed by post-traumatic arthritis (22.9%) and hip avascular necrosis (20.5%). Conclusion: Despite the high rate of trauma and accidents in Saudi Arabia, degenerative osteoarthritis remains the most common indication for primary THA. Post-traumatic osteoarthritis is identified as the second major indication for THA.

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A study of 120 cases of total hip arthroplasty in avascular necrosis head of femur and degenerative diseases of the hip joint

Tropical Journal of Medical Research ◽

10.4103/1119-0388.152544 ◽

2015 ◽

Vol 18 (1) ◽

pp. 10

Author(s):

Jaswinder PalSingh Walia ◽

Sargun Singh ◽

AvinashChander Gupta ◽

Khushpreet Kaur ◽

Naveen Mittal

Keyword(s):

Total Hip Arthroplasty ◽

Avascular Necrosis ◽

Hip Joint ◽

Hip Arthroplasty ◽

Degenerative Diseases ◽

Total Hip

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Accurate and Reliable Diagnosis of Avascular Necrosis of the Femoral Head From Total Hip Arthroplasty Specimens Requires Pathologic Examination

American Journal of Clinical Pathology ◽

10.1093/ajcp/aqaa153 ◽

2020 ◽

Author(s):

Josephine K Dermawan ◽

Andrew Goldblum ◽

John D Reith ◽

Scott E Kilpatrick

Keyword(s):

Risk Factors ◽

Total Hip Arthroplasty ◽

Avascular Necrosis ◽

Hip Arthroplasty ◽

Preoperative Diagnosis ◽

Joint Disease ◽

Pathologic Examination ◽

Total Hip ◽

Radiology Reports ◽

Reliable Diagnosis

Abstract Objectives To evaluate the necessity of pathologic examination for confirming the diagnosis of avascular necrosis (AVN). Methods We retrospectively reviewed consecutive nonfractured total hip arthroplasty cases (n = 1,722), comparing operative diagnoses and radiologic data with final histologic diagnoses, focusing specifically on AVN. Results Among 199 histologically confirmed cases of AVN, 62 (31%) had a preoperative diagnosis of osteoarthritis/degenerative joint disease (OA/DJD); 58 of the latter patients had radiology reports, but only two (3%) documented AVN. Patients with AVN preoperatively diagnosed as OA/DJD were significantly older (mean, 65 years) than patients with AVN correctly diagnosed clinically (mean, 52 years; P < .00001). Among 163 cases with a preoperative diagnosis of AVN, 26 (16%) were confirmed as OA/DJD; the radiology report incorrectly diagnosed AVN in 17 (65%) patients. These latter patients also were significantly older (mean, 60 years) than patients with AVN correctly diagnosed clinically (P = .0008). Patients with a preoperative clinical and/or radiologic diagnosis of AVN were more likely to be younger and have known AVN risk factors. Conclusions Accurate and reliable diagnosis of AVN requires pathologic examination, especially among older patients without known risk factors. Prompt diagnosis may lead to behavioral changes in affected patients that reduce the risk of subsequent lesions.

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