scholarly journals Patient Characteristics Influence Revision Rate of Total Hip Arthroplasty: American Society of Anesthesiologists Score and Body Mass Index Were the Strongest Predictors for Short-Term Revision After Primary Total Hip Arthroplasty

2020 ◽  
Vol 35 (1) ◽  
pp. 188-192.e2 ◽  
Author(s):  
Rinne M. Peters ◽  
Liza N. van Steenbergen ◽  
Roy E. Stewart ◽  
Martin Stevens ◽  
Paul C. Rijk ◽  
...  
Keyword(s):  
Body Mass Index ◽  
Total Hip Arthroplasty ◽  
Hip Arthroplasty ◽  
Revision Rate ◽  
Patient Characteristics ◽  
Short Term ◽  
Total Hip ◽  
American Society ◽  
American Society Of Anesthesiologists ◽  
Primary Total Hip Arthroplasty

Safety of vitamin E-infused highwall liners for routine use in primary total hip arthroplasty: single centre, short-term follow-up of 1221 cases

2020 ◽  
pp. 112070002096964
Author(s):  
Kirill Gromov ◽  
Nanna H Sillesen ◽  
Thomas Kallemose ◽  
Henrik Husted ◽  
Henrik Malchau ◽  
...  
Keyword(s):  
Patient Safety ◽  
Vitamin E ◽  
Total Hip Arthroplasty ◽  
Hip Arthroplasty ◽  
Single Centre ◽  
Short Term ◽  
Total Hip ◽  
Arthroplasty Registry ◽  
Primary Total Hip Arthroplasty

Background: Introduction of new implants should be monitored closely to capture any signs of compromising patient safety. Vitamin E infused highly-crosslinked polyethylene liners (VEPE) offer the potential for reduced wear. Highwall liners have been hypothesised to result in increased wear and potential liner fractures. The aim of this study was to determine the 3–7-year follow-up of highwall VEPE for primary total hip arthroplasty (THA), focusing on liner-related complications. Methods: We included 1221 consecutive THA operations from July 2010 to May 2014 with minimum follow-up of 3 (3.1–6.8) years Data collected included demographics, implant data, complications, reoperations, and deaths. Data were cross-referenced with the Danish Hip Arthroplasty Registry in order to ensure validity and completeness. Acetabular shell position was measured using Martell Hip Analysis Suite in a subgroup of 931 THAs. Results: Cumulative stem revision and shell revision at 3-year follow-up was 3.4% and 0.4% respectively. There were no revisions due to liner failure. Reason for revision included 11 dislocations, 15 soft-tissue revisions for infection, 44 stem revisions of which 34 were periprosthetic fractures and 13 shell revisions of which 6 were combined shell and stem revisions. Conclusion: Early follow-up of VEPE liners for primary THA have not shown any revisions associated with liner failure. Continued monitoring of new materials are necessary to capture any signs of compromised patient safety.

scholarly journals Early recovery trajectories after fast-track primary total hip arthroplasty: the role of patient characteristics

2018 ◽  
Vol 89 (6) ◽  
pp. 597-602 ◽  
Author(s):  
Jarry T Porsius ◽  
Nina M C Mathijssen ◽  
Lisette C M Klapwijk-Van Heijningen ◽  
Jeroen C Van Egmond ◽  
Marijke Melles ◽  
...  
Keyword(s):  
Total Hip Arthroplasty ◽  
Hip Arthroplasty ◽  
Fast Track ◽  
Patient Characteristics ◽  
Early Recovery ◽  
Total Hip ◽  
Primary Total Hip Arthroplasty

scholarly journals Specific knowledge and resilience affect short-term outcome in patients following primary total hip arthroplasty

2021 ◽  
Author(s):  
Alexander Bumberger ◽  
Katharina Borst ◽  
Madeleine Willegger ◽  
Gerhard M. Hobusch ◽  
Reinhard Windhager ◽  
...  
Keyword(s):  
Total Hip Arthroplasty ◽  
Functional Outcome ◽  
Outcome Measures ◽  
Hip Arthroplasty ◽  
Short Term ◽  
Specific Knowledge ◽  
Specific Patient ◽  
Total Hip ◽  
Patient Reported ◽  
Primary Total Hip Arthroplasty

Abstract Purpose The aim of the present study was to investigate the potential associations between specific knowledge, resilience and patient-reported outcome measures (PROMS) following primary total hip arthroplasty (THA). Methods In a cross-sectional prospective study, consecutive patients following primary THA were included at a rehabilitation center. A novel knowledge score and the validated Connor Davidson Resilience Scale (CD-RISC) were utilized to assess patients’ specific knowledge and resilience, respectively. Additionally, patients completed a qualitative questionnaire regarding the information they had received. The Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), as well as the University of California and Los Angeles Score (UCLA) served as primary outcome measures. Stepwise multiple regression analysis was performed to identify potential predictors of outcome. Results A total of 103 patients at a mean age of 67.5 years (SD 10.5, 38–88) were included in the analysis at a median of 55.5 days (IQR 43–81) following primary THA. The mean knowledge and resilience scores were 3.8 (SD 1.6, 0–7) and 69.5 (SD 18.5, 0–100), respectively. Forty-seven percent of patients were afraid of harming their prosthesis and these patients had up to 59% worse WOMAC scores (p < 0.001). WOMAC scores on admission to rehabilitation were predicted by resilience and knowledge scores (R2 = 0.106, p = 0.036). UCLA scores at the time of admission were predicted by knowledge scores (R2 = 0.078, p = 0.007). Conclusion The present study demonstrated that patients with a feeling of uncertainty had an inferior short-term functional outcome following primary THA. Moreover, it could be shown that higher specific knowledge and resilience are associated with a better functional outcome according to validated PROMS. While these findings need to be prospectively validated in future studies, specific patient knowledge and resilience may have a direct impact on the outcome of primary THA.

scholarly journals Safety and Efficacy of Hemispherical with Flattened Pole Dual-Mobility Acetabular Cup in Primary Hip Arthroplasty: The SYMCOR-1 study

2020 ◽  
Author(s):  
Nicolas Bonin ◽  
Gilles Estour ◽  
Jean-Emmanuel Gedouin ◽  
Olivier Guyen ◽  
Frederic Christopher Daoud
Keyword(s):  
Total Hip Arthroplasty ◽  
Hip Arthroplasty ◽  
Cobalt Chromium ◽  
Acetabular Cup ◽  
Short Term ◽  
Dual Mobility ◽  
Safety And Efficacy ◽  
Total Hip ◽  
Primary Total Hip Arthroplasty

Abstract Background: This study estimated the short-term clinical safety and efficacy of hemispherical with flattened pole cobalt-chromium metal-back with porous outer hydroxyapatite coating dual-mobility acetabular cup (HFPC-DM-HA) in primary total hip arthroplasty.Methods: Single-center retrospective observational cohort study of consecutive patients undergoing total hip arthroplasty with a HFPC-DM-HA 2 years prior to study start. Prospective 2-year follow-up with letter and phone questionnaires.Results: Sampling frame: 361 patients including 59 patients (16.3%) in the cohort. 6 patients (10%) lost to follow-up. Median age 77.5 years (range: 67 ; 92), 32% female, median BMI 25.2 kg.m-2 (18.4 to 56.8). Clinical indications: Primary THA in all patients, resulting from primary osteoarthritis in 80% of them. Median follow-up 3.0 years (2.7 to 4.1). Primary endpoint: 2-year implant survival rate: 97% [87, 99]. Prosthetic dislocation: 0%. Secondary endpoint: Modified HHS (pain & functional subscore) improved from baseline 39.7 [34.6, 44.7] to 75.8 [72.1, 79.6] at 1-year and to 86.7 [83.7, 89.7] at 2-year follow-up (p<0.0001).Conclusions: The authors deemed the short-term outcomes of this acetabular cup in primary total hip arthroplasty to be satisfactory.Study registration: clinicaltrials.gov NCT04209374.

scholarly journals Low Transfusion Rate Attainable in Anterior Approach Total Hip Arthroplasty Utilizing a Modern Protocol

2021 ◽  
Vol 11 ◽  
Author(s):  
Joseph Gondusky ◽  
Benjamin Campbell ◽  
Christian Coulson
Keyword(s):  
Total Hip Arthroplasty ◽  
Blood Loss ◽  
Hip Arthroplasty ◽  
Anterior Approach ◽  
Operative Time ◽  
Transfusion Rate ◽  
Total Hip ◽  
Estimated Blood Loss ◽  
American Society ◽  
American Society Of Anesthesiologists

Background: Transfusion is a known risk of total hip arthroplasty (THA).  It has been associated with a multitude of medical complications and increased cost.  Prior studies report transfusion rates associated with THA, with wide variation, but most cannot differentiate the surgical approach utilized.  The anterior approach (AA) for THA has been associated with increased operative time, complications, and blood loss, but little data exists regarding the actual transfusion rate associated with the approach. Methods: We performed a retrospective review of 390 consecutive, elective, primary unilateral AA THA procedures.  Patient demographic, clinical and perioperative data was analyzed.  A modern perioperative pathway, including a simple protocol to limit blood loss, is defined. Results: The group consisted of a typical inpatient arthroplasty population, with wide ranges of age, body mass index (BMI), and health status.  The average age was 64.05 years (+ 10.67, range 27-94).  BMI averaged 29.76 kg/m2 (+ 5.98, range 16-47).  The majority of patients were American Society of Anesthesiologists (ASA) class 2 (45.6%) or 3 (50.3%), with 10 patients ASA 4 (2.6%).  Average preoperative hemoglobin was 13.48 g/dL (+ 1.47, range 9.1-18.2).  Operative time averaged 91.22 minutes (+ 14.2).  83.3% of patients received a spinal anesthetic.  Most patients were discharged on postoperative day one (93.1%) to home (99%).  Estimated blood loss averaged 264mL (+ 95.19, range 100-1000).  No patient required perioperative transfusion or readmission for symptomatic anemia within 30 days postoperative.  Conclusion:  A modern protocol we utilize and define is capable of limiting blood loss and transfusion risk in anterior approach total hip arthroplasty. 

scholarly journals Outcome in Patients with High Body Mass Index following Primary Total Hip Arthroplasty

2015 ◽  
Vol 2015 ◽  
pp. 1-4
Author(s):  
Zuned Hakim ◽  
Claire Rutherford ◽  
Elizabeth Mckiernan ◽  
Tony Helm
Keyword(s):  
Body Mass Index ◽  
Total Hip Arthroplasty ◽  
Body Mass ◽  
Hip Arthroplasty ◽  
Rank Correlation ◽  
High Body Mass Index ◽  
Total Hip ◽  
Significant Difference ◽  
Using Data ◽  
Primary Total Hip Arthroplasty

Obesity is becoming a critical problem in the developed world and is associated with an increased incidence of osteoarthritis of the hip. The Oxford Hip Score was used to determine if Body Mass Index (BMI) is an independent factor in determining patient outcome following primary total hip arthroplasty (THA). Using data from 353 operations we found that patients with BMI ≥ 30 had an absolute score that was lower preoperatively and postoperatively compared to those with a BMI < 30. There was no difference in pre- and postoperative point score change within each group; Kendall’s rank correlation was 0.00047 (95% CI, −0.073 to 0.074 (p=0.99)) and demonstrated no trend. There was no statistically significant difference in change between those with BMI ≥ 30 and < 30 (p=0.65). We suggest that those with a higher BMI be considered for THA as they can expect the same degree of improvement as those with a lower BMI. Given the on-going increase in obesity these findings could be significant for the future of THA.

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