Obesity Increases the Risk of Postoperative Complications and Revision Rates Following Primary Total Hip Arthroplasty: An Analysis of 131,576 Total Hip Arthroplasty Cases

2018 ◽  
Vol 33 (7) ◽  
pp. 2287-2292.e1 ◽  
Author(s):  
Elke Jeschke ◽  
Mustafa Citak ◽  
Christian Günster ◽  
Andreas M. Halder ◽  
Karl-Dieter Heller ◽  
...  
2022 ◽  
Vol 12 (1) ◽  
Author(s):  
Nam Hoon Moon ◽  
Min Uk Do ◽  
Jung Shin Kim ◽  
Jae Seung Seo ◽  
Won Chul Shin

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.


2021 ◽  
Author(s):  
Nam Hoon Moon ◽  
Min Uk Do ◽  
Jung Shin Kim ◽  
Jae Seung Seo ◽  
Won Chul Shin

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.


2019 ◽  
Vol 03 (02) ◽  
pp. 062-067
Author(s):  
Dhanur Damodar ◽  
Ajit Vakharia ◽  
Erik Zachwieja ◽  
Rushabh Vakharia ◽  
Victor Hernandez ◽  
...  

AbstractHypothyroidism is common, and the incidence has been increasing annually in the United States. Abnormalities in thyroid hormone can have several effects on the endocrine, immune, and musculoskeletal systems of the body. The influence of hypothyroidism on outcomes following primary total hip arthroplasty (THA) is not well reported. The authors hypothesized that hypothyroidism was associated with a higher risk of postoperative complications and 90-day costs following primary THA. A retrospective review from 2005 to 2014 was performed using the Medicare Standard Analytical Files from the Pearl Diver database. Utilizing International Classification of Disease 9th revision (ICD-9) codes, the authors identified patients who underwent THA. Patients with a concurrent diagnosis of hypothyroidism were matched by age, gender, and Charlson's comorbidity index (CCI) to a control group. Ninety-day postoperative complications, readmission rates, complications related to implants, and cost of care were compared and assessed following primary THA between matched cohorts. Statistical analysis was performed using the programming language R (University of Auckland) to calculate odds ratios (OR) along with their respective 95% confidence intervals (95% CI), and p-values. A total of 383,898 patients underwent primary THA. Among them, 191,949 patients were diagnosed with hypothyroidism and 191,949 patients without hypothyroidism. Hypothyroidism was associated with greater odds of postoperative complications (p < 0.001), 90-day readmission rates (p < 0.001), implant related complications (p < 0.001), and total global 90-day episode of care cost (U.S. $17,549.96 vs. $16,645.01; p < 0.001). This study demonstrated an increased risk of postoperative complications (medical or implant related), increased readmission rates, and higher costs among patients with hypothyroidism following primary THA. Surgeons should counsel patients and determine strategies to medically optimize patients to mitigate risk and decrease cost.


2019 ◽  
Vol 34 (3) ◽  
pp. 422-425 ◽  
Author(s):  
Matthew J. Grosso ◽  
Alexander L. Neuwirth ◽  
Venkat Boddapati ◽  
Roshan P. Shah ◽  
H. John Cooper ◽  
...  

Open Medicine ◽  
2008 ◽  
Vol 3 (2) ◽  
pp. 207-213
Author(s):  
Valér Džupa ◽  
Pavel Pazdírek ◽  
Vladimír Pacovský ◽  
Jan Bartoníček ◽  
Jiří Skála-Rosenbaum

AbstractThe number of complications after primary total hip arthroplasty for displaced intracapsular fractures of the femoral neck is higher than that after operations for osteoarthritis. The aim of this study is to evaluate the number of complications and mid-term functional and radiological findings of patients after primary THA for displaced intracapsular fractures of the femoral neck. Between 1995 and 1998, we operated on a total of 89 patients for acute displaced intracapsular fractures of the femoral neck, i.e. Garden Type 3 and 4. In all the patients we evaluated intraoperative and early postoperative complications. We reviewed clinical and radiological results in 65 patients. The only intraoperative complication was abruption of the greater trochanter. Early postoperative complications occurred in 13 patients (15%). The specific complications, THA dislocation, occurred in 3 patients. Non-specific complications were recorded in 10 patients. No delayed healing of the surgical wound, neural lesion or early, delayed or late infection was recorded. Of 65 patients followed-up for an average of 78 months (range, 62–109 months), 8 patients underwent revision surgery. Of 57 patients with primary THA, very good and good clinical results according to the Harris Hip Score were recorded in 48 patients (84%) and poor results in only 2 patients (4%). Nine of 57 followed-up patients showed radiological signs of loosening (16%). The radiolucent line could be seen in 3 patients in the region of the cup, in 1 patient in the region of the femoral component and in 5 patients in both components. Clinical complaints that would result in indication for reimplantation were recorded in none of the mentioned patients. Number of complications, functional results and resumption of full self-reliance by patients after THA for an intracapsular fracture of the femoral neck are so positive that we consider the indication of THA for a displaced femoral neck fracture fully justified.


2013 ◽  
Vol 7 (1) ◽  
pp. 169-171 ◽  
Author(s):  
Mustafa Citak ◽  
Till Orla Klatte ◽  
Akos Zahar ◽  
Kimberly Day ◽  
Daniel Kendoff ◽  
...  

Background and Purpose: Total hip arthroplasty (THA) is a safe and reliable surgical procedure. However, THA also has intra- and postoperative complications. A dreaded and frustrating intraoperative complication during total hip arthroplasty is dislocation of the femoral trial head from the neck into the pelvis. Methods: Here, we report on the case of a 71-year old female patient with osteoarthritis of the left hip. Total hip arthroplasty was performed in a lateral position through a standard posterior approach. During intraoperative trial reduction, the femoral trial head dissociated from the taper and dislocated into the psoas compartment. Several unsuccessful attempts, including an additional ventral approach, were made to immediately retrieve the femoral trial head. Results and interpretation: Postoperative a Computerized Tomography (CT) was performed to locate the trial head, a secondary explorative laparotomy was undertaken to retrieve it. The retrieval of the femoral trial head should be performed in a planned second surgical procedure to avoid possible complications during the manipulation necessary for retrieval.


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