scholarly journals Imageless navigation total hip arthroplasty – an evaluation of operative time

SICOT-J ◽  
2018 ◽  
Vol 4 ◽  
pp. 18 ◽  
Author(s):  
Epaminondas Markos Valsamis ◽  
David Ricketts ◽  
Adnan Hussain ◽  
Amir-Reza Jenabzadeh
Keyword(s):  
Total Hip Arthroplasty ◽  
Hip Arthroplasty ◽  
Operative Time ◽  
Statistical Tools ◽  
New Techniques ◽  
Total Hip ◽  
Total Hip Replacements ◽  
Imageless Navigation ◽  
Significant Difference ◽  
Hip Replacements

Introduction: Imageless navigation has been successfully integrated in knee arthroplasty but its effectiveness in total hip arthroplasty (THA) has been debated. It has consistently been shown that navigation adds significant time and cost to the operation. Further, the relative success of traditional hip replacements has impeded the adoption of new techniques. Methods: We compared the operative time between fifty total hip replacements with and without the use of imageless navigation by a single senior surgeon in a retrospective study. We employed standard statistical tools to compare the two methods. A correlation-based analysis was used to delimit the “learned” phase of imageless navigation to make comparisons meaningful. Results: Contrary to what has previously been reported, there was no significant difference between operative time in navigated, when compared to traditional operations (p = 0.498). Only fourteen operations were required to delimit the learning phase of this operation. Discussion: This is the first study that demonstrates no added operative time when using imageless navigation in THA, achieved with an improved workflow. The results also demonstrate a very reasonable learning curve.

Decreasing Incidence of Postoperative Ileus Following Total Hip Arthroplasty: A 17-Year Retrospective Review of 31,619 Total Hip Replacements at One Institution

2019 ◽  
Vol 03 (02) ◽  
pp. 089-092
Author(s):  
Bob Nguyen ◽  
Olivia J. Bono ◽  
James V. Bono
Keyword(s):  
Total Hip Arthroplasty ◽  
Hip Arthroplasty ◽  
Postoperative Ileus ◽  
Length Of Hospital Stay ◽  
Fiscal Year ◽  
Total Hip ◽  
Total Hip Replacements ◽  
Revision Tha ◽  
Hip Replacements ◽  
Preventable Complication

AbstractIleus following total hip arthroplasty (THA) is a clinically and financially significant postoperative complication that has not been extensively described in the orthopaedic joint literature. Ileus has been found to occur in 0.7 to 4.0% of patients after total joint arthroplasty and as high as 5.6% in patients after revision THA.1,2,3 In a 17-year period (2001 Fiscal Year through 2017 Fiscal Year) at one institution, the authors found an incidence of 0.674% (213/31619) following THA. In addition, the incidence of ileus following THA has drastically declined over this 17-year period, from 1.822% (19/1043) in 2001 to 0.099% (3/3036) in 2017. This decrease may be attributed to a reduction in narcotic use postoperatively, earlier ambulation following surgery, and reduction in length of hospital stay. Though postoperative ileus is not yet a preventable complication, recognition of risk factors may permit earlier intervention to ameliorate some of the morbidity associated with this condition.

scholarly journals Infectious complications of hip arthroplasty

2021 ◽  
Vol 5 (3) ◽  
pp. 313-320
Author(s):  
Vitalii M. Pidhaietskyi ◽  
Georgii V. Gayko ◽  
Roman A. Kozak ◽  
Taras V. Nizalov
Keyword(s):  
Total Hip Arthroplasty ◽  
Hip Arthroplasty ◽  
Infectious Complications ◽  
Statistical Research ◽  
Internal Organs ◽  
Surgical Interventions ◽  
Total Hip ◽  
Total Hip Replacements ◽  
Hip Replacements ◽  
Periprosthetic Infections

The objective of the research is to study the causes and outcomes of infectious complications after total hip arthroplasty. The background of the research is the analysis of outcomes of 364 patients with complications after total hip arthroplasty; 369 cases, from 2005 to 2018. The infectious complications accounted for 21.7% (80 cases). The work involves clinical, radiological, microbiological, and statistical research methods. As a result of research causes of suppurative complications after total hip arthroplasty were: chronic infectious diseases of internal organs (t=3.37, p=0.001), instability of prosthetic components (t=3.14, p=0.002), over two previous surgical interventions involving the affected joint (t=2.43, p=0.005). In the treatment of periprosthetic infections, sanitizing interventions without the prosthetic components’ removal appeared efficient within only up to 3 weeks. If the sanitizing interventions were inconclusive, the double-stage revision prosthetics appeared adequate in a reliable number of cases (t = 11.2, p = 0.0028), namely 24, which amounted to 92.3%. In conclusion, it was concluded that the causes of periprosthetic infections were: diseases of the internal organs, instability of the components, over two surgical operations involving the same joint. The development of various complications after total hip replacements demands surgical revision procedures.

scholarly journals Which one is more affected by navigation-assisted cup positioning in total hip arthroplasty: Anteversion or inclination? A retrospective matched-pair cohort study in Asian physique

2018 ◽  
Vol 26 (2) ◽  
pp. 230949901878075 ◽  
Author(s):  
Kwang Jun Oh ◽  
Byung Kag Kim ◽  
Myung Il Jo ◽  
Byung Mun Ahn
Keyword(s):  
Total Hip Arthroplasty ◽  
Hip Arthroplasty ◽  
Matched Pair ◽  
Mean Deviation ◽  
Acetabular Cup ◽  
Total Hip ◽  
Imageless Navigation ◽  
Significant Difference ◽  
Matching Criteria ◽  
Cup Positioning

Introduction: The purpose of this study was to compare acetabular cup positioning using an imageless navigation-assisted total hip arthroplasty (THA) to a case-matched control group using the conventional technique in Asian physique. Methods: Case matching controlled study using retrospectively collected data for THAs was done. Matching criteria were gender, age ± 5 years, and body mass index ± 5 kg/m2. Thirty patients who had navigation THAs were manually matched to a conventional group of 30 patients. After measuring anteversion and inclination on 3-D CT, final cup anteversion was calculated using the mathematical formula (anteversion = arctan [tan (anatomic anteversion) × sin (inclination)]). Results: No significant difference was observed between mean inclination ( p = 0.420), anteversion ( p = 0.697), and the mean deviation from 15° for anteversion ( p = 0.649). However, there was a statistical significant difference for mean deviation from 40° for inclination ( p = 0.027). There was a significant difference in the percentage of correctly placed acetabular cup in safe zones with inclination ( p = 0.039). Conclusions: Although soft tissue overlying the pubic tubercle interfered with registration of the bony landmark and thereby induced inaccuracy of anteversion angles in the navigation group, the use of imageless navigation-assisted technique increases the placement within the safe zone for inclination and enhances the accuracy and the precision of inclination of the acetabular cup relative to the conventional THA rather than anteversion. This finding may be due to the effect of the patient’s physique on the anterior pelvic plane (APP)-based reference system of imageless navigation.

Measuring leg length and offset with an imageless navigation system during total hip arthroplasty: is it really accurate?

2009 ◽  
Vol 5 (2) ◽  
pp. 192-197 ◽  
Author(s):  
Tobias Renkawitz ◽  
Tibor Schuster ◽  
Thomas Herold ◽  
Holger Goessmann ◽  
Ernst Sendtner ◽  
...  
Keyword(s):  
Total Hip Arthroplasty ◽  
Hip Arthroplasty ◽  
Navigation System ◽  
Leg Length ◽  
Total Hip ◽  
Imageless Navigation

scholarly journals Short-stem total hip arthroplasty is not associated with an earlier return to work compared to a straight-stem design

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Georg Hauer ◽  
Maria Smolle ◽  
Sabrina Zaussinger ◽  
Joerg Friesenbichler ◽  
Andreas Leithner ◽  
...  
Keyword(s):  
Total Hip Arthroplasty ◽  
Sick Leave ◽  
Return To Work ◽  
Hip Arthroplasty ◽  
Short Stem ◽  
Multivariate Linear Regression Analysis ◽  
Stem Design ◽  
Total Hip ◽  
Straight Stem ◽  
Significant Difference

AbstractReturn to work (RTW) has been specifically identified as a high priority in patients undergoing total hip arthroplasty (THA). This investigation sought to assess the effect of the stem design on patients’ RTW. Secondly, the study aimed to identify risk factors that lead to a delayed RTW. Questionnaires inquiring about RTW, employment history, educational level, type of work, physical demands and joint awareness were administered by post. Further data were collected from patients’ hospital records. 176 patients who underwent THA using a short-stem and 97 patients using a straight-stem design were compared. The median return to work time was 10 weeks [IQR 7–14 weeks], with no significant difference between the two groups (short stems vs. straight stems; 10 [IQR 7–14] vs. 11 [7.5–13.5] weeks; p = 0.693). In the multivariate linear regression analysis, self-employment vs. employee (p = 0.001), dimension of preoperative workload (p = 0.001), preoperative sick leave (p < 0.001), and hospital length of stay (LOS) (p < 0.001) independently affected the period until work was resumed. The Forgotten-Joint-Score-12 showed no significant difference between the two groups. The data show that the majority of THA patients can expect to resume work and stem design has no impact on RTW. Employees with preoperative sick leave, prolonged hospital LOS and low workload are at higher risk for a delayed RTW.

scholarly journals An MRI-Based Patient-Specific Computational Framework for the Calculation of Range of Motion of Total Hip Replacements

2021 ◽  
Vol 11 (6) ◽  
pp. 2852
Author(s):  
Maeruan Kebbach ◽  
Christian Schulze ◽  
Christian Meyenburg ◽  
Daniel Kluess ◽  
Mevluet Sungu ◽  
...  
Keyword(s):  
Range Of Motion ◽  
Internal Rotation ◽  
Computer Aided Design ◽  
External Rotation ◽  
Patient Specific ◽  
Computational Framework ◽  
Total Hip ◽  
Total Hip Replacements ◽  
Significant Difference ◽  
Hip Replacements

The calculation of range of motion (ROM) is a key factor during preoperative planning of total hip replacements (THR), to reduce the risk of impingement and dislocation of the artificial hip joint. To support the preoperative assessment of THR, a magnetic resonance imaging (MRI)-based computational framework was generated; this enabled the estimation of patient-specific ROM and type of impingement (bone-to-bone, implant-to-bone, and implant-to-implant) postoperatively, using a three-dimensional computer-aided design (CAD) to visualize typical clinical joint movements. Hence, patient-specific CAD models from 19 patients were generated from MRI scans and a conventional total hip system (Bicontact® hip stem and Plasmacup® SC acetabular cup with a ceramic-on-ceramic bearing) was implanted virtually. As a verification of the framework, the ROM was compared between preoperatively planned and the postoperatively reconstructed situations; this was derived based on postoperative radiographs (n = 6 patients) during different clinically relevant movements. The data analysis revealed there was no significant difference between preoperatively planned and postoperatively reconstructed ROM (∆ROM) of maximum flexion (∆ROM = 0°, p = 0.854) and internal rotation (∆ROM = 1.8°, p = 0.917). Contrarily, minor differences were observed for the ROM during maximum external rotation (∆ROM = 9°, p = 0.046). Impingement, of all three types, was in good agreement with the preoperatively planned and postoperatively reconstructed scenarios during all movements. The calculated ROM reached physiological levels during flexion and internal rotation movement; however, it exceeded physiological levels during external rotation. Patients, where implant-to-implant impingement was detected, reached higher ROMs than patients with bone-to-bone impingement. The proposed framework provides the capability to predict postoperative ROM of THRs.

scholarly journals Revision Rates After Surgical Treatment for Femoral Neck Fractures: Results of 2-Year Follow-up

Medicina ◽  
2013 ◽  
Vol 49 (3) ◽  
pp. 22
Author(s):  
Jaunius Kurtinaitis ◽  
Narūnas Porvaneckas ◽  
Giedrius Kvederas ◽  
Tomas Butėnas ◽  
Valentinas Uvarovas
Keyword(s):  
Total Hip Arthroplasty ◽  
Femoral Neck ◽  
Internal Fixation ◽  
Hip Arthroplasty ◽  
Revision Surgery ◽  
Femoral Neck Fractures ◽  
Total Hip ◽  
Significant Difference ◽  
Surgery Rates

Background and Objective. Intracapsular fractures of the femoral neck account for a major share of fractures in the elderly. Open reduction and internal fixation has been shown to have a higher rate of revision surgery than arthroplasty. The aim of this study was to assess and compare the rates of revision surgery performed after internal fixation and primary total hip arthroplasty. Material and Methods. Between 2004 and 2006, 681 intracapsular femoral neck fractures in 679 consecutive patients were treated with internal fixation or total hip arthroplasty at our institution. Revision surgery rates were evaluated at 1-, 3-, 6-, 12-, and 24-month follow-up. Results. There was no significant difference in the ratio of internal fixation to total hip arthroplasty during 2004–2006 (P=0.31). The mean rate of total hip arthroplasty was 19.1% with a lower rate being among patients younger than 60 years. Revision surgery rates at the 2-year followup were higher in the internal fixation group compared with total hip arthroplasty group (28.9% vs. 7.0%, P<0.001). Patients who underwent internal fixation were at a 4-fold greater risk of having revision surgery at the 2-year follow-up than those who underwent total hip arthroplasty (odds ratio, 4.11; 95% CI, 1.95–8.65; P<0.001). Age was a significant risk factor for revision surgery after total hip arthroplasty (hazard ratio, 0.93; 95% CI, 0.87–0.98; P=0.02), but not significant after the internal fixation (P=0.86). Conclusions. Higher revision surgery rates after internal fixation favors arthroplasty as a primary choice of treatment for the femoral neck fractures.

scholarly journals Total hip arthroplasty for high-riding hips: A retrospective analysis of 79 cases and proposal of a new classification

2020 ◽  
Vol 28 (2) ◽  
pp. 230949902092416
Author(s):  
İsmail Demirkale ◽  
Yüksel Uğur Yaradılmış ◽  
Ahmet Ateş ◽  
Murat Altay
Keyword(s):  
Total Hip Arthroplasty ◽  
Hip Arthroplasty ◽  
Classification System ◽  
Operating Time ◽  
Limb Length Discrepancy ◽  
Harris Hip Score ◽  
Level Of Evidence ◽  
Total Hip ◽  
Significant Difference ◽  
Functional Scores

Purpose: Total hip arthroplasty (THA) for high-riding hips is a complex procedure and the requirement for subtrochanteric osteotomy (STO) is an important decision that needs to be taken preoperatively. STO renders this complex surgery even more complicated and there are no guidelines to determine the STO requirement. In this study, the outcomes of THA for patients with high-riding hips were evaluated and a practical classification system is proposed to predict any osteotomy requirement. Methods: A retrospective evaluation was made of 79 hips of 76 patients who underwent THA for high-riding hip dysplasia. The amount of shortening in patients with STO and in patients without STO was compared. All patients were evaluated in respect of Harris hip score, operating time, erythrocyte suspension need, and actual limb length discrepancy. Preoperative radiographs were classified into four types according to the ratio of the distance between the lesser trochanter and the ischial tuberosity with pelvic height (LT-IT/P) to grade the degree of dislocation. Results: The mean follow-up was 30 ± 6.54 months. STO was applied to 47 (60%) hips and not to 32 (40%). There was no statistically significant difference between the groups in respect of the functional scores. STO prolonged the operating time and increased the need for blood transfusion ( p = 0.026, p < 0.001, respectively). When the LT-IT/P index was <0.19 (type 1), no additional surgical approach was required for reduction, at 0.19–0.29 (type 2), the head can be safely reduced with additional reduction methods, and when >0.3 (type 3), a shortening osteotomy will most likely be required. The rate of complications is increased if LT-IT/P is >0.4 (type 4). Conclusion: STO adjunct to THA increases the rate of complications. This practical classification system may guide the surgeon in the decision of whether an STO should be added to the procedure or not. Level of evidence: Level III, clinical trial

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