Monitoring the one year postoperative infection rate after primary total hip replacement

Purpose: Muscle-sparing approaches for total hip replacement (THR) involve learning curves. This study aimed to clarify changes in invasiveness and infection rate with changes in approach. Methods: One surgeon changed the approach of THR from Dall’s approach (Dall) to anterolateral modified Watson-Jones approach (OCM). Another changed from Dall to a direct anterior approach (DAA). Another 3 surgeons changed from posterolateral approach (PL) to OCM. Subjects were 150 cases, comprising the last 25 cases with conventional approaches and the first 25 cases with new approaches (Dall to OCM: 25 + 25; Dall to DAA: 25 + 25; PL to OCM: 25 + 25 cases). Differences in operative time, bleeding volume, hospital stay, haemoglobin (Hb), white blood cell count, lymphocyte count, creatine kinase (CK) and C-reactive protein (CRP) were investigated. Results: In the change from Dall to OCM, only hospital stay decreased. In the change from Dall to DAA, hospital stay and CRP decreased, but bleeding volume increased. In the change from PL to OCM, operative time, CRP and CK decreased, but Hb also decreased. Cases with lymphocyte count <1000/μL or lymphocytes comprising <10% of total white blood cells at around day 4 after surgery were defined as latent infection cases. In these cases, operative time was longer, Hb was lower and CK was higher. Conclusion: Introducing muscle-sparing approaches improved many markers of invasiveness, but some items deteriorated. In the early stages of introducing a new approach, choosing cases without obesity and without high muscle volume may reduce the risk of infection.

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Use of a Silver Nylon Dressing Following Total Hip and Knee Arthroplasty Decreases the Postoperative Infection Rate

JAAOS Global Research and Reviews ◽

10.5435/jaaosglobal-d-17-00034 ◽

2017 ◽

Vol 1 (7) ◽

pp. e034 ◽

Cited By ~ 1

Author(s):

Ashley J. Tisosky ◽

Otatade Iyoha-Bello ◽

Nicholas Demosthenes ◽

Giovanni Quimbayo ◽

Tara Coreanu ◽

...

Keyword(s):

Infection Rate ◽

Knee Arthroplasty ◽

Postoperative Infection ◽

Total Hip ◽

Hip And Knee Arthroplasty ◽

Postoperative Infection Rate

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Preoperative gait adaptations persist one year after surgery in clinically well-functioning total hip replacement patients

Journal of Biomechanics ◽

10.1016/j.jbiomech.2007.05.020 ◽

2007 ◽

Vol 40 (15) ◽

pp. 3432-3437 ◽

Cited By ~ 120

Author(s):

Kharma C. Foucher ◽

Debra E. Hurwitz ◽

Markus A. Wimmer

Keyword(s):

Total Hip Replacement ◽

Hip Replacement ◽

Total Hip ◽

One Year

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Increased one-year risk of symptomatic venous thromboembolism following total hip replacement

Journal of Bone and Joint Surgery - British Volume ◽

10.1302/0301-620x.94b12.29358 ◽

2012 ◽

Vol 94-B (12) ◽

pp. 1598-1603 ◽

Cited By ~ 13

Author(s):

A. B. Pedersen ◽

S. P. Johnsen ◽

H. T. Sørensen

Keyword(s):

Venous Thromboembolism ◽

Total Hip Replacement ◽

Hip Replacement ◽

Total Hip ◽

One Year

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Profiles of Biomarkers of Excess Alcohol Consumption in Patients Undergoing Total Hip Replacement: Correlation with Function

The Scientific World JOURNAL ◽

10.1100/2011/364685 ◽

2011 ◽

Vol 11 ◽

pp. 1804-1811 ◽

Cited By ~ 3

Author(s):

Paul J. Jenkins ◽

Andrew D. Duckworth ◽

Francis P. C. Robertson ◽

Colin R. Howie ◽

James S. Huntley

Keyword(s):

Total Hip Replacement ◽

Hip Replacement ◽

Alcohol Misuse ◽

Future Research ◽

Total Hip ◽

Increased Risk ◽

Functional Scores ◽

Hip Function ◽

One Year ◽

General Physical

Aims. Patients who misuse alcohol may be at increased risk of surgical complications and poorer function following hip replacement. Identification and intervention may lead to harm reduction and improve the outcomes of surgery. The aim of this study was to determine the prevalence of biomarker elevation in patients undergoing hip replacement and to investigate any correlation with functional scores and complications.Methods. We performed a retrospective study that examined the profile of biomarkers of alcohol misuse in 1049 patients undergoing hip replacement.Results. Gamma-glutamyltransferase was elevated in 150 (17.6%), and mean corpuscular volume was elevated in 23 (4%). At one year general physical health was poorer where there was elevation ofγGT, and the mental health and hip function was poorer with elevation of MCV. There were no differences in complications.Discussion. Raised biomarkers can alert clinicians to potential problems. They also provide an opportunity to perform further investigation and offer intervention. Future research should focus on the use in orthopaedic practice of validated screening questionnaires and more sensitive biomarkers of alcohol misuse.Conclusion. This study demonstrates a potential substantial proportion of unrecognised alcohol misuse that is associated with poorer functional scores in patients after total hip replacement.

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SECTION II GENERAL ORTHOPAEDICS Postoperative Infection after Total Hip Replacement with Special Reference to Air Contamination in the Operating Room

Clinical Orthopaedics and Related Research ◽

10.1097/00003086-197209000-00020 ◽

1972 ◽

Vol 87 (9) ◽

pp. 167 ◽

Cited By ~ 285

Author(s):

JOHN CHARNLEY

Keyword(s):

Special Reference ◽

Operating Room ◽

Total Hip Replacement ◽

Hip Replacement ◽

Postoperative Infection ◽

Air Contamination ◽

Total Hip

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Revision of a BFX total hip replacement stem using a Kyon stem and a head adaptor in two dogs

Veterinary and Comparative Orthopaedics and Traumatology ◽

10.3415/vcot-16-05-0070 ◽

2017 ◽

Vol 30 (01) ◽

pp. 81-87

Author(s):

Sara Bazzo ◽

Aldo Vezzoni ◽

Luca Vezzoni

Keyword(s):

Total Hip Arthroplasty ◽

Hip Replacement ◽

Cementless Stem ◽

Total Hip ◽

Stem Revision ◽

Press Fit ◽

Bone Integration ◽

One Year ◽

The One ◽

Stem Stability

SummaryObjective: To report revision of BFX cementless press-fit stem loosening with a Kyon cementless stem and a head adaptor in two dogs.Methods: Total hip arthroplasty stem revision was performed in two dogs with loosening of a previously implanted Biomedtrix press-fit BFX stem. Both dogs had a well-integrated BFX cup and single stage revision was performed using a standard Kyon stem and a head adaptor in order to couple with a 17 mm head and maintain the BFX cup.Results: Revisions resulted in a stable functional prosthesis with successful bone integration at the one-year postoperative reevaluation.Conclusions: Use of a Kyon stem with a head adaptor may be a successful option to provide immediate stem stability for revision of a loosened BFX stem with a properly osseo integrated cup.

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Early surgical outcomes after total hip replacement in systemic lupus erythematosus patients

Rheumatology Science and Practice ◽

10.47360/1995-4484-2020-451-455 ◽

2020 ◽

Vol 58 (4) ◽

pp. 451-455

Author(s):

V. V. Mukhanov ◽

S. A. Makarov ◽

M. A. Makarov ◽

T. V. Popkova

Keyword(s):

Systemic Lupus Erythematosus ◽

Pain Intensity ◽

Total Hip Replacement ◽

Lupus Erythematosus ◽

Surgical Outcomes ◽

Hip Replacement ◽

Systemic Lupus ◽

Total Hip ◽

Hip Function ◽

One Year

Objective. To analyze early surgical outcomes after total hip replacement in systemic lupus erythematosus (SLE) patients.Subjects and Methods. The study included 42 SLE patients with femoral head osteonecrosis (ON) undergoing 59 total hip replacement (THR) surgeries at the traumatology and orthopedics department of VA Nasonova Research Institute of Rheumatology during 1998-2013 yy. All patients were thoroughly evaluated at baseline and one year after surgery using the Systemic Lupus Erythematosus Disease Activity Index 2000 (SLEDAI-2K), damage index (DI) of the Systemic Lupus International Collaborating Clinics/American College of Rheumatology (SLICC/ACR) to assess the degree of irreversible organ damage, Harris hip function scale, and VAS for pain intensity to assess early results of THR procedure.Results. Significant improvement of pain intensity was documented based on VAS assessments, as well as hip function improvement from 40,0±14,9 (13,8 – 82,7) to 80,8±12 (46,7-96,0) scores based on Harris scale, improvement of SLE activity based on SLEDAI-2K assessment: from 0 -20 scores (median 4[4;8]) at baseline to 0 – 43 scores (median 0[0;4]) at one year, and DI – from 0-12 (median 3[2;5]) to 0 -15 scores one year after THR procedure. Complications including dislocation of femoral component, peroneal nerve paralysis, periprosthetic fracture, venous thrombosis, and delayed wound healing were documented totally in 10,2% of patients. No post-surgery deaths occurred.Conclusion. The results obtained are indicative of better pain control and improved hip function following THR in SLE patients.

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