Does Hepatitis C Affect the Clinical and Patient-Reported Outcomes of Primary Total Hip Arthroplasty at Midterm Follow-Up?

Background: Patients with pincer-type femoroacetabular impingement are commonly treated with arthroscopic reduction of acetabular depth as measured by the lateral center-edge angle (LCEA). The optimal amount of rim reduction has not been established, although large resections may increase contact pressures through the hip. A recent publication demonstrated inferior surgical outcomes in patients with acetabular overcoverage as compared with normal acetabular coverage. Casual observation of our database suggested equivalent improvements, prompting a similar analysis. Purpose: To analyze patient-reported outcomes after hip arthroscopy for femoroacetabular impingement in patients with acetabular overcoverage who were matched with controls with normal coverage, as well as to analyze associations with reduction in LCEA. Study Design: Cohort study; Level of evidence, 3. Methods: Data were collected prospectively from patients with a minimum 2-year follow-up after receiving hip arthroscopy for femoroacetabular impingement by a single surgeon. Cases were reviewed to identify those with pincer-type morphology (LCEA >40°) and matched according to sex, age, chondral damage, and surgery date in a 1:1 ratio with controls with an LCEA of 25° to 40°. The surgical goal was to reduce the LCEA to the upper end of the normal range with minimal rim resection, usually 35° to 37°. Radiographic measurements of coverage, intraoperative findings, procedures, and patient-reported outcomes were recorded, including the 12-Item International Hip Outcome Tool, Non-arthritic Hip Score, Hip Disability and Osteoarthritis Outcome Score, visual analog scale for pain, rates of revision or reoperation, and conversion to total hip arthroplasty. Results: A total of 114 hips (93 patients) for the pincer group were matched 1:1 from 616 hips (541 patients) for the control group. The pincer group (mean ± SD age, 34.5 ± 12.2 years) did not differ in age, body mass index, or follow-up from controls. LCEA was reduced in both groups pre- to postoperatively: the pincer group from 44.0° ± 2.8° to 34.2° ± 3.5° and the controls from 32.9° ± 3.9° to 31.0° ± 3.0°. No differences in improvement were observed: iHOT-12 improved by 35.7 points in both groups ( P = .9 for analysis of variance interaction) and Nonarthritic Hip Score by 22.3 points ( P = .6). From all eligible surgical procedures, 2-year follow up rates were 2.5% and 2.6% for the pincer and control cohorts, respectively, and 1.2% and 0.3% for conversion to total hip arthroplasty. Conclusion: Arthroscopic management of acetabular overcoverage can achieve excellent results, equivalent to arthroscopy for other causes of symptomatic femoroacetabular impingement. A key finding was smaller rim resections producing a mean postoperative LCEA of 34.2° with a small standard deviation.

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Patient-Reported Outcomes Can Be Used to Streamline Post-Total Hip Arthroplasty Follow-Up to High-Risk Patients

The Journal of Arthroplasty ◽

10.1016/j.arth.2017.05.033 ◽

2017 ◽

Vol 32 (11) ◽

pp. 3319-3321

Author(s):

Jie J. Yao ◽

Hilal Maradit Kremers ◽

Cathy D. Schleck ◽

Dirk R. Larson ◽

Jasvinder A. Singh ◽

...

Keyword(s):

High Risk ◽

Total Hip Arthroplasty ◽

Hip Arthroplasty ◽

Patient Reported Outcomes ◽

Total Hip ◽

High Risk Patients ◽

Patient Reported ◽

Risk Patients

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Patient-Reported Outcomes and Outcome Predictors after Primary Total Hip Arthroplasty: Results from the Dresden Hip Surgery Registry

Hip International ◽

10.5301/hipint.5000300 ◽

2015 ◽

Vol 26 (1) ◽

pp. 73-81 ◽

Cited By ~ 8

Author(s):

Elisabeth Haase ◽

Christian Kopkow ◽

Franziska Beyer ◽

Jörg Lützner ◽

Stephan Kirschner ◽

...

Keyword(s):

Total Hip Arthroplasty ◽

Hip Arthroplasty ◽

Patient Reported Outcomes ◽

Hip Surgery ◽

Outcome Predictors ◽

Total Hip ◽

Patient Reported ◽

Primary Total Hip Arthroplasty

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Preoperative Opioid Use Negatively Affects Patient-reported Outcomes After Primary Total Hip Arthroplasty

Journal of the American Academy of Orthopaedic Surgeons ◽

10.5435/jaaos-d-18-00658 ◽

2019 ◽

Vol 27 (22) ◽

pp. e1016-e1020 ◽

Cited By ~ 12

Author(s):

Bryant E. Bonner ◽

Tiffany N. Castillo ◽

David W. Fitz ◽

John Z. Zhao ◽

Christian Klemt ◽

...

Keyword(s):

Total Hip Arthroplasty ◽

Hip Arthroplasty ◽

Patient Reported Outcomes ◽

Opioid Use ◽

Total Hip ◽

Patient Reported ◽

Primary Total Hip Arthroplasty

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Three-year results of a polycarbonate urethane acetabular bearing in total hip arthroplasty

Hip International ◽

10.1177/1120700019836426 ◽

2019 ◽

Vol 30 (3) ◽

pp. 303-308

Author(s):

Stefan Lazic ◽

Catherine Kellett ◽

Irrum Afzal ◽

Rajan Mohan ◽

Vijay Killampalli ◽

...

Keyword(s):

Total Hip Arthroplasty ◽

Hip Arthroplasty ◽

Patient Reported Outcomes ◽

Prospective Observational Study ◽

Total Hip ◽

Polycarbonate Urethane ◽

Patient Reported ◽

Term Data

Background: Polycarbonate urethane (PCU) is a bearing surface with a lower modulus of elasticity than polyethylene or ceramic and is thought to more closely replicate the tribology of native hyaline cartilage. The purpose of this study was to determine the clinical outcomes with the use of PCU in elective total hip arthroplasty (THA). Methods: We carried out a prospective observational study in which 157 patients underwent elective THA with a metal-on-PCU hip system. Patients had radiographic follow-up at 6 months and 3 years after surgery. Oxford Hip Scores and EuroQol scores were obtained annually and Harris Hip Scores were obtained at 6 months and 3 years after surgery. Results: 180 hips were implanted, of which, 149 hips reached 3-year review with no revisions. There was an increase in Harris Hip Scores, Oxford Hip Scores and EuroQol scores ( p < 0.001). 12 patients (12 hips) reported painless hip squeaking. There were no dislocations and no other adverse events were reported. Conclusion: Our results showed satisfactory survivorship and improvements in patient reported outcomes with metal on PCU THA. Long-term data are still being collected to confirm these findings. We recommend further tribological research into the squeaking phenomenon we observed.

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Imageless computer assisted navigation in ceramic-on-ceramic total hip arthroplasty vs. manual approach: a single-centre retrospective study

10.29007/9gpf ◽

2019 ◽

Author(s):

John McLoughlin ◽

Mo Mathew ◽

Stephen Grant

Keyword(s):

Total Hip Arthroplasty ◽

Hip Arthroplasty ◽

Patient Reported Outcomes ◽

Statistical Significance ◽

Computer Assisted ◽

Total Hip ◽

Patient Reported ◽

Cup Positioning

Background: Acetabular cup positioning is vital to the long-term survivorship of total hip arthroplasty (THA). Malalignment has been linked to dislocation, wear and osteolysis. Although there are many studies demonstrating the reduction in variability of cup positioning with computer-assisted techniques, there are relatively few reporting long-term patient reported outcomes and revision rates. Aim: The aim of this study was to review whether those patients who underwent navigated THA had better long-term survivorship or better patient reported outcomes. Methods: We compared revision rates and Oxford hip scores of 152 THAs (47 navigated and 105 non-navigated) performed at a single site between 2003 and 2008, with a minimum follow-up of 10 years. Results: 9 of the non-navigated and none of the navigated hips were revised at 10 year follow-up (p=0.057). There were no observable differences in 10-year Oxford hip scores between the navigated and non-navigated hips, 44.82 and 43.38 respectively. Conclusion: With respect to the rate of revision, although statistical significance was not achieved, it can be shown from our data that there was a clinically significant reduction in revision rates with navigated vs. non-navigated techniques. More data with higher patient numbers in the navigated cohort may be required to validate the results of our study.

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The usefulness of dual mobility cups in primary total hip arthroplasty patients at a risk of dislocation

Scientific Reports ◽

10.1038/s41598-022-04774-2 ◽

2022 ◽

Vol 12 (1) ◽

Author(s):

Nam Hoon Moon ◽

Min Uk Do ◽

Jung Shin Kim ◽

Jae Seung Seo ◽

Won Chul Shin

Keyword(s):

Postoperative Complications ◽

Total Hip Arthroplasty ◽

Hip Arthroplasty ◽

Harris Hip Score ◽

Dual Mobility ◽

Total Hip ◽

Early Results ◽

Patient Reported ◽

Primary Total Hip Arthroplasty

AbstractThis study aimed to evaluate the early results of primary total hip arthroplasty (THA) using dual mobility (DM) cups in patients at a risk of dislocation and compare them with that of fixed bearing (FB) THA. This retrospective study included patients who had undergone primary THA between January 2016 and December 2018 and were at a risk of dislocation. A propensity score-matched analysis was conducted for 63 THA procedures with vitamin-E infused highly cross-linked polyethylene (VEPE) DM bearing and 63 THA procedures performed with FB from the same manufacturer for a mean follow-up period of 3.1 and 3.5 years, respectively. The radiologic outcomes at the last follow-up and incidence of postoperative complications were evaluated and compared statistically between the two groups. The modified Harris hip score (mHHS) was used to assess patient-reported outcomes. Postoperative dislocation occurred in 4 cases (6.3%) in the FB group, but did not occur in the DM group (p = 0.042). There was no difference in the radiologic outcomes and postoperative complications between the two groups. The mHHS at the last follow-up showed satisfactory outcomes in both the groups (DM group, 90.5; FB group, 88.1), without a statistical difference between the groups. The early results of THA using VEPE DM bearing showed better outcomes than that of THA with FB for patients at a risk of dislocation. A longer follow-up period is recommended to assess the stability and overall outcomes.

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Outcomes after Total Hip Arthroplasty in Young Patients with Osteonecrosis of the Hip

Hip International ◽

10.5301/hipint.5000457 ◽

2017 ◽

Vol 27 (3) ◽

pp. 286-292 ◽

Cited By ~ 15

Author(s):

Ishaan Swarup ◽

Marisa Shields ◽

Erik N. Mayer ◽

Chelsea J. Hendow ◽

Jayme C. Burket ◽

...

Keyword(s):

Total Hip Arthroplasty ◽

Hip Arthroplasty ◽

Patient Reported Outcomes ◽

Young Patients ◽

Implant Survival ◽

Total Hip ◽

Time Of Surgery ◽

Patient Reported

Background Osteonecrosis of the hip is a clinical, radiographic, and pathologic entity that commonly affects young patients. This study evaluates long-term implant survival and patient-reported outcomes after primary total hip arthroplasty (THA) in patients with osteonecrosis aged 35 or younger. Methods A retrospective study with prospective follow-up was conducted at a major academic medical center. Chart review was performed to identify young THA patients with osteonecrosis, and follow-up surveys were conducted to determine implant survival and patient-reported outcomes. Kaplan-Meier survival analysis was performed to evaluate implant survival, and the hip disability and osteoarthritis outcome score (HOOS) was used to describe patient-reported outcomes. Results The study included 135 patients (204 THAs) with a mean time to follow-up of 14 years. In this group, 10-year implant survival was 86% and 20-year implant survival was 66%. Implant survival was longer in male patients (p = 0.02) and patients that were over the age of 25 at the time of surgery (p = 0.03). The mean HOOS scores at follow-up were 87 for pain, symptoms, and ADLs, and 77 for sports. All HOOS measures were lower in patients that underwent a revision THA, and HOOS-Pain and HOOS-Sport scores were lower in patients that were over the age of 25 at the time of surgery (p<0.05). Conclusions Young patients with osteonecrosis have good implant survival and long-term outcomes after THA. Patient factors and implant characteristics should be considered when predicting implant survival and outcomes after THA in young patients with osteonecrosis.

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Dual Mobility Cups Present Promising Outcomes in Primary Total Hip Arthroplasty Patients At A Risk of Dislocation

10.21203/rs.3.rs-688254/v1 ◽

2021 ◽

Author(s):

Nam Hoon Moon ◽

Min Uk Do ◽

Jung Shin Kim ◽

Jae Seung Seo ◽

Won Chul Shin

Keyword(s):

Postoperative Complications ◽

Total Hip Arthroplasty ◽

Hip Arthroplasty ◽

Harris Hip Score ◽

Dual Mobility ◽

Total Hip ◽

Early Results ◽

Patient Reported ◽

Primary Total Hip Arthroplasty

Abstract Introduction This study aimed to evaluate the early results of primary total hip arthroplasty (THA) using dual mobility (DM) cups in patients at a risk of dislocation and compare them with that of fixed bearing (FB) THA. Materials and methods This retrospective study included patients who had undergone primary THA between January 2016 and December 2018 and were at a risk of dislocation. A propensity score-matched analysis was conducted for 63 THA procedures with vitamin-E infused highly cross-linked polyethylene (VEPE) DM bearing and 63 THA procedures performed with FB from the same manufacturer for a mean follow-up period of 3.1 and 3.5 years, respectively. The radiologic outcomes at the last follow-up and incidence of postoperative complications were evaluated and compared statistically between the two groups. The modified Harris hip score (mHHS) was used to assess patient-reported outcomes. Results Postoperative dislocation occurred in 4 cases (6.3%) in the FB group, but did not occur in the DM group (p = 0.042). There was no difference in the radiologic outcomes and postoperative complications between the two groups. The mHHS at the last follow-up showed satisfactory outcomes in both the groups (DM group, 90.5; FB group, 88.1), without a statistical difference between the groups. Conclusion The early results of THA using VEPE DM bearing showed better outcomes than that of THA with FB for patients at a risk of dislocation. A longer follow-up period is recommended to assess the stability and overall outcomes.

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Implant Survival and Clinical Outcomes of Total Hip Arthroplasty in Adolescent and Young Adult Patients

The Journal of Hip Surgery ◽

10.1055/s-0041-1729871 ◽

2021 ◽

Author(s):

Lauren Zeitlinger ◽

Anthony Gemayel ◽

Patrick Whitlock ◽

Joel Sorger

Keyword(s):

Young Adult ◽

Total Hip Arthroplasty ◽

Hip Arthroplasty ◽

Patient Reported Outcomes ◽

Adult Patients ◽

Total Hip ◽

Patient Reported ◽

Hip Disease ◽

End Stage

AbstractTotal hip arthroplasty (THA) in pediatric patients is controversial with concern for high failure rates, and lack of promising outcomes as compared with the adult population. Increased survivorship of implants invites the potential for improved function and quality of life in young adults. Although THA is now an option for end-stage symptomatic hip disease in young patients, outcomes with contemporary techniques and implants have yet to be reported.Following the institutional review board approval, a retrospective chart review of 25 patients (29 hips) with end-stage hip disease at a single institution from 2010 to 2017 was performed. All patients underwent THA with noncemented, contemporary THA with highly cross-linked polyethene liners. Clinical, radiographic, and patient-reported outcomes were obtained including any postoperative complications, revisions, evidence of loosening or wear, and lastly, Western Ontario & McMaster Universities Osteoarthritis Index, Harris Hip Scores, Non-Arthritic Hip scores, and International Hip Outcome Tool. With a minimum follow-up duration of 2 years, there were no revisions or evidence of loosening or wear on follow-up radiographs. All patients underwent noncemented THA with metal or ceramic on highly cross-linked polyethylene liners. Six patients accounting for seven THAs completed patient-reported outcomes: two reporting excellent outcomes, four good outcomes, and one failed outcome. With advancing techniques and strategies, treatment options for hip pathology in the pediatric population are growing. We present favorable outcomes 2 years post-procedure, suggesting THA as a potential option for end-stage hip disease in pediatric and young adult patients.

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