scholarly journals Pain and rehabilitation after total hip arthroplasty are approach dependent: a multisurgeon, single-center, prospective cohort study

2021 ◽  
Author(s):  
Alexander Zimmerer ◽  
Mona Steinhaus ◽  
Erdmann Sickmüller ◽  
Benjamin Ulmar ◽  
Matthias Hauschild ◽  
...  
Keyword(s):  
Cohort Study ◽  
Hip Arthroplasty ◽  
Posterior Approach ◽  
Lateral Approach ◽  
Walking Distance ◽  
Surgical Approaches ◽  
Inpatient Stay ◽  
Single Center ◽  
The Third

Abstract Purpose The aim of this study was to assess perioperative pain and mobilization after total hip arthroplasty (THA) using three different surgical approaches. Methods This was a multisurgeon, prospective, single-center cohort study. A total of 188 patients who underwent hip arthroplasty (THA) between February 2019 and April 2019 were analyzed according to the surgical approach used (direct anterior, lateral, and posterior approach). Outcome parameters were the daily walking distance during the inpatient stay, the pain level according to the visual analog scale (VAS) at rest and motion during the inpatient stay and at 6-week follow-up and the modified Harris Hips Score (mHHS) preoperatively and at 6 weeks. Results The walking distance within the groups increased significantly during the inpatient stay (p < 0.001). The DAA and posterior approach patients had a significantly longer walking distance than the lateral approach patients on the third postoperative day (DAA vs. lateral, p = 0.02; posterior vs. lateral 3, p = 0.03). DAA and posterior approach patients reported significantly less pain during motion on the third postoperative day and at 6-week follow-up than the lateral approach patients (3 postoperative day: DAA vs. lateral, p = 0.011; posterior vs. lateral, p = 0.04; 6 weeks control: DAA vs. lateral, p = 0.001; Posterior vs. lateral 3, p = 0.005). The mHHS demonstrated significant improvement within each group. However, lateral approach patients reported significantly less improvement than the DAA and posterior approach patients (DAA vs. lateral, p = 0.007; posterior vs. lateral, p = 0.021). Conclusion This study analyzed perioperative pain progression and short-term rehabilitation after THA according to the different surgical approaches. Direct anterior and posterior approaches have shown comparable improvements in pain, walking distance, and mHHS. Whether this effect persists over a longer period of time must be clarified in future studies. Study design Prospective cohort study, level of evidence, 2.

scholarly journals Acute femoral fracture does not compromise the outcome of total hip arthroplasty : 5 year results from a single center cohort study in 2,782 patients

2021 ◽  
Vol 87 (2) ◽  
pp. 332-338
Author(s):  
Stefan B.T. Bolder ◽  
Elsa A. Spaans ◽  
Joost A.A.M. Van den Hout ◽  
Robert Wagenmakers ◽  
Koen L.M. Koenraadt
Keyword(s):  
Cohort Study ◽  
Total Hip Arthroplasty ◽  
Femoral Neck ◽  
Hip Arthroplasty ◽  
Femoral Fracture ◽  
Primary Diagnosis ◽  
Single Center ◽  
Fracture Group ◽  
Neck Fracture

National arthroplasty registries reveal a higher risk of revision for periprosthetic fracture and dislocation after total hip arthroplasty (THA) in patients with a femoral neck fracture compared to those with osteoarthritis (OA). Since these registries may con- tain confounding factors, we conducted a single center cohort study comparing survival and reason for failure between THA for an acute femoral neck fracture and OA using the same hip prosthesis after a minimum follow-up of 2 years. We retrospectively analyzed 2782 patients who had undergone THA with an Accolade TMZF stem and a Trident cup between March 2009 and September 2014. Primary diagnosis before THA was osteoarthritis (OA group : n=2610) or acute femoral fracture (Fracture group : n=172). Patients in both groups were operated on by the same hip surgeons. Effect of diagnosis on THA survival was analyzed using Cox-regression analysis. Chi-square tests were used to illustrate the different reasons for revision between the groups. Mean follow-up was 4.6 years (2-7.6). A total of 100 revisions were performed. The revision risk was comparable between the OA and Fracture group (HR=1.04, 95% CI :0.46-2.39). No differences were found between the OA and Fracture group with respect to the occurrence of periprosthetic fractures (0.8% vs. 0.6%, p=0.71) and revisions for dislocation (0.6% vs. 1.2%, p=0.38). We found no difference in outcome or reason for revision between THA for OA or femoral neck frac- ture. Using an implant with a proven ODEP rating and having experienced hip surgeons carry out the procedures may be more important than the primary diagnosis.

scholarly journals Camptodactyly-Arthropathy-Coxa Vara-Pericarditis Syndrome Resembling Juvenile Idiopathic Arthritis: A Single-Center Experience from Southern Turkey

2021 ◽  
pp. 1-6
Author(s):  
Rabia Miray Kisla Ekinci ◽  
Sibel Balci ◽  
Haldun Dogan ◽  
Serdar Ceylaner ◽  
Celal Varan ◽  
...  
Keyword(s):  
Juvenile Idiopathic Arthritis ◽  
Pericardial Effusion ◽  
Early Onset ◽  
Joint Space ◽  
Coxa Vara ◽  
Single Center ◽  
The Third ◽  
Single Center Experience ◽  
Southern Turkey

Camptodactyly-arthropathy-coxa vara-pericarditis (CACP) syndrome, caused by biallelic pathogenic mutations in the <i>PRG4</i> gene, is characterized by early-onset camptodactyly, noninflammatory arthropathy, coxa vara deformity, and rarely, pericardial effusion. Herein, we report 3 patients with CACP syndrome from 2 unrelated families. All patients are female, born to consanguineous parents, and had camptodactyly since the first years of their lives. Two patients had a prior diagnosis of juvenile idiopathic arthritis. Hip changes were present in 2 patients, and 2 of 3 patients had undergone surgery for camptodactyly. Routine echocardiographic evaluations were normal during the 2-year follow-up. This paper represents the third study including CACP patients from Turkey. Clinically, all 3 patients resembled juvenile idiopathic arthritis cases and received unnecessary medication. There is also an ongoing need for improving awareness of CACP and an effective treatment focusing on the lubrication of the joint space in CACP patients.

scholarly journals Six-minute walk distance predicts hospitalization in elderly peritoneal dialysis patients: a single-center prospective cohort study

2021 ◽  
Vol 7 (1) ◽  
Author(s):  
Hiroki Yabe ◽  
Yuto Imoto ◽  
Ayaka Onoyama ◽  
Sayaka Ito ◽  
Kenichi Kono ◽  
...  
Keyword(s):  
Cohort Study ◽  
Peritoneal Dialysis ◽  
Muscle Strength ◽  
Lower Extremity ◽  
Exercise Intolerance ◽  
Single Center ◽  
Walk Distance ◽  
Walk Speed ◽  
Lower Extremity Muscle

Abstract Background The risk of adverse events associated with peritoneal dialysis (PD) in elderly patients has not been thoroughly investigated. The purpose of this study was to assess the association between physical function and hospitalization in elderly PD patients. Methods This is a single-center prospective observational cohort study. Thirty-three aged patients (74.8 ± 5.9 years) participated in a 6-min walk distance, short physical performance battery (SPPB), lower extremity muscle strength, and 10-m walk speed. All subjects were followed until hospitalization to the end of the follow-up period. Results The 6-min walk distance was 332 ± 112.5 m; SPPB was 11 (8.3–12) points; the lower extremity muscle strength was 36.6 ± 9.6%; 10-m walk speed was 1.1± 0.2 m/s. During the follow-up, 19 patients (57.5%) were hospitalized. In the Kaplan-Meier survival analysis and log-rank test, a lower 6-min walk distance and PD vintage were significantly associated with hospitalization (p<0.05). After adjustment for PD vintage in Cox proportional analysis, the 6-min walk distance remained associated with hospitalization (95% confidence interval, 0.98–0.99). Conclusion Lower exercise tolerance assessed by the 6-min walk distance was significantly associated with hospitalization in elderly PD patients. Our findings indicate that measurement and intervention of exercise intolerance are essential to predict the clinical outcomes of elderly PD patients. Trial registration This study was prospectively registered at inception in the UMIN Clinical Trials Registry under identification number UMIN000038405.

A prospective randomised comparison of earlier function after total hip arthroplasty with a mini posterior approach or supercapsular percutaneously-assisted total hip approach: a gait analysis study

2021 ◽  
pp. 112070002110184
Author(s):  
Andrey A Korytkin ◽  
Younes M El Moudni ◽  
Yana S Novikova ◽  
Kirill A Kovaldov ◽  
Ekaterina A Morozova
Keyword(s):  
Total Hip Arthroplasty ◽  
Gait Analysis ◽  
Hip Arthroplasty ◽  
Posterior Approach ◽  
Gait Velocity ◽  
Harris Hip Score ◽  
Kinematic Parameters ◽  
Gait Patterns ◽  
Total Hip

Background: The supercapsular percutaneously-assisted total hip (SuperPATH) approach is a muscle sparing surgical technique for total hip arthroplasty (THA). The literature reports good clinical and functional results of the SuperPATH technique in the short term. We aimed to compare early outcomes and gait analysis of THA using the mini posterior approach (MPA) and supercapsular percutaneously-assisted total hip (SuperPATH) approach. Methods: 44 patients who underwent THA, were randomly allocated to either MPA or SuperPATH. The data were then collected prospectively (preoperatively and postoperatively at 6 weeks). Plain anteroposterior radiographs of the pelvis and instrumental gait analysis were obtained. The visual analogue scale (VAS), Harris Hip Score (HHS) and Hip disability and Osteoarthritis Outcome Scores (HOOS) were used to assess functional and clinical outcomes. Results: No significant difference was found in patients’ surgical outcomes. Patients in the SuperPATH group had less pain according to the VAS score at follow-up than the MPA group ( p < 0.01). There was also a significant improvement in HHS and HOOS scores for all patients ( p < 0.001) with the SuperPATH group showing superior changes. The comparison of mean differences in gait velocity between preoperative and 6 weeks postoperative result, revealed improvement in the SuperPATH group over the MPA group ( p = 0.06). Limping was more persistent in the MPA group. Kinematic parameters demonstrated improved hip joint excursion slightly higher in the MPA group. There was no significant improvement in kinetic and kinematic parameters at different walking moments for all patients at 6 weeks compared to preoperative gait patterns. Conclusions: SuperPATH and MPA both show excellent results. This study reveals that the SuperPATH technique was associated with lower postoperative pain levels, and higher physical function and quality of life. Improved functional outcomes allowed earlier postoperative rehabilitation and faster recovery. Specific improvement in gait patterns were identified with nonsignificant differences between the 2 approaches at 6 weeks follow-up.

Effectiveness of Infection Preventive Behaviors on COVID-19-Like Illness Symptoms During the Winter Third Wave of the Epidemic in Japan: A 2-Month Follow-up Nationwide Cohort Study

2021 ◽  
pp. 101053952110644
Author(s):  
Shoichi Shimizu ◽  
Tomohiro Ishimaru ◽  
Masako Nagata ◽  
Ayako Hino ◽  
Seiichiro Tateishi ◽  
...  
Keyword(s):  
Cohort Study ◽  
Face Mask ◽  
Hand Washing ◽  
Third Wave ◽  
Multiple Logistic Regression ◽  
Regression Analyses ◽  
Preventive Behaviors ◽  
The Third ◽  
Room Ventilation

Although multilayered strategies including preventive behaviors should be adopted to mitigate coronavirus disease 2019 (COVID-19) transmission, evidence on the effectiveness of preventive behaviors against COVID-19 remains limited. This Internet-based prospective cohort study collected baseline data in November 2020 and follow-up data in February 2021, during the third wave of the epidemic in Japan. Among the 19 941 included participants, the percentages reporting that they always used a face mask, practiced hand washing/disinfection, gargling, and ensuring proper room ventilation were 85.4%, 36.0%, 51.1%, and 44.6%, respectively. Multiple logistic regression analyses revealed that less frequently practicing hand washing/disinfection (odds ratio [OR] = 1.20, 95% confidence interval [CI]: 1.10-1.32), gargling (OR = 1.20, 95% CI: 1.10-1.30), and ensuring proper room ventilation (OR = 1.38, 95% CI: 1.26-1.52) were significantly associated with self-reported COVID-19-like illness (CLI). These results suggest that personal preventive behaviors may be effective in reducing CLI, even when universal masking is practiced.

SHALL IT BE BETTER, AS AN APPROACH FOR THR, POSTERIORLY OR LATERALLY; A CLINICO-FUNCTIONAL AND GAIT ANALYTICAL OUTCOME ANALYSIS, IN A PROSPECTIVE STUDY, IN THE SOUTH-INDIAN POPULATION.

2021 ◽  
pp. 71-75
Author(s):  
Arun Kumar C ◽  
Ganashree S ◽  
Arivoli S ◽  
Aswath C A ◽  
Rakesh Kumar B ◽  
...  
Keyword(s):  
Prospective Study ◽  
Total Hip Replacement ◽  
Hip Replacement ◽  
Posterior Approach ◽  
Lateral Approach ◽  
Harris Hip Score ◽  
South Indian Population ◽  
Total Hip ◽  
South Indian

Introduction: Hip resurfacing arthroplasty (HRA) or Total hip replacement (THR), as it is popularly called, attempts to mollify these basic clinical problems, in patients with a hip arthritic problem, which may be of a sequela to age-related degeneration, osteonecrosis, systemic disorder like Rheumatoid arthritis (RA) or Ankylosing spondylosis (AS) or as a result of trauma and or an old infection. The basic pathology, is an unfavourable and abrading hip diarthrodial joint. The endeavour of the study was, to establish the efcacy of the Posterior vs Lateral approach for THA/THR, by studying their outcomes in primary THR. This prospective study was undertaken at Che Materials And Methods: ttinad Hospital and Research Institute (CARE), Kelambakkam, Chengalpattu district, Tamilnadu, In the Department of Orthopaedics from Jan 2017 to Dec 2020 (48 months). The Functional outcome of hip surgery was measured using the Harris Hip Score, Oxford hip score and the WOMAC. Rivermead visual gait analysis (RVGA) method was used post-operatively to assess the gait. The Biomechanical outcomes of Abductor Gait Component, were individually assessed by EMG studies. The Harris Hip Score, The Oxford Hip S Results: core and WOMAC score, when the lateral approach was compared to the posterior approach pre-op and post-op in the 12 months minimum follow-up period, the laterally approached group faired better. The VAS score was equivocal. The comprehensive RVGA assessment also showed marginally better results for the laterally approached group as was the case with the Trendelenburg test score. The EMG studies for the Gluteus Maximus, Medius and the lateral rotators of hip also favoured the outcomes for the laterally approach hips. The supremacy of the Lateral Approach, ove Conclusion: r Posterior Approach, cannot be adjudged in a short-term follow-up study. It is thus opined that the Lateral Approach may be statistically and data wise superior, but the patient satisfaction, which is a major factor, is almost the same in both the approach groups. The follow-up needs to be atleast for a decade for us to be able to come to any meaningful conclusion. With regards to surgery like the Total hip replacement, which have a longevity factor exceeding 10 years, studies have to be followed up for periods in excess of 10 years.

scholarly journals Lower Dislocation Rate Following Total Hip Arthroplasty via Direct Anterior Approach than via Posterior Approach: Five-Year-Average Follow-Up Results

2015 ◽  
Vol 9 (1) ◽  
pp. 157-162 ◽  
Author(s):  
Sachiyuki Tsukada ◽  
Motohiro Wakui
Keyword(s):  
Total Hip Arthroplasty ◽  
Hip Arthroplasty ◽  
Anterior Approach ◽  
Posterior Approach ◽  
Direct Anterior Approach ◽  
Dislocation Rate ◽  
Rank Test ◽  
Consecutive Series ◽  
Total Hip

Objective: The aim of the study was to compare the dislocation rate between total hip arthroplasty (THA) via direct anterior approach (DAA) and via posterior approach (PA). Methods: We compared a consecutive series of 139 THAs via DAA with 177 THAs via PA. All study patients received ceramic-on-ceramic bearing surfaces and similar uncemented prostheses. Dislocation-free survival after THA was estimated using the Kaplan–Meier survival method and compared between groups using the log-rank test. Results: In the DAA group, none of 139 hips experienced dislocations in five-year-average follow-up. In the PA group, seven hips experienced dislocations among 177 hips (4 %). The dislocation was significantly less in the DAA group compared to the PA group (p = 0.033). Conclusion: The dislocation rate of THA via DAA was significantly less than that of THA via PA.

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