Influence of Training of Orthopaedic Surgeons on Clinical Outcome after Total Hip Arthroplasty in a High Volume Endoprosthetic Centre

2018 ◽  
Vol 157 (01) ◽  
pp. 48-53 ◽  
Author(s):  
Katrin Osmanski-Zenk ◽  
Susanne Finze ◽  
Robert Lenz ◽  
Rainer Bader ◽  
Wolfram Mittelmeier
Keyword(s):  
Total Hip Arthroplasty ◽  
Clinical Outcome ◽  
Hip Arthroplasty ◽  
High Volume ◽  
Harris Hip Score ◽  
Orthopaedic Surgeons ◽  
Total Hip ◽  
Sf 36 ◽  
Euroqol 5D

Zusammenfassung Hintergrund Ziel der Studie ist die Überprüfung, ob sich die postoperative Ergebnisqualität und die Komplikationswahrscheinlichkeit hüftendoprothetischer Eingriffe signifikant bei Operateuren in Weiterbildung von denen der sog. Hauptoperateure im Rahmen der EndoCert-Struktur unterscheiden. Material und Methoden Eingeschlossen wurden 192 Patienten, die mit einer primären Hüftendoprothese versorgt wurden. Zur Evaluierung der Ergebnisqualität wurden präoperativ und 12 Monate postoperativ der Harris-Hip-Score, WOMAC, SF-36 und der EuroQol-5D abgefragt. Zudem wurden als Komplikationen die vom EndoCert-System definierten Qualitätsindikatoren erfasst. Ergebnisse Signifikante Verbesserungen der postoperativen Score-Werte in Abhängigkeit von der Qualifikation des verantwortlichen Operateurs konnten sowohl bei Senior-/Hauptoperateuren als auch bei Ärzten in Weiterbildung festgestellt werden. Sofern ein Operateur in Facharztweiterbildung von einem Senior-/Hauptoperateur assistiert wird, ist kein Anstieg des peri- und postoperativen Komplikationsrisikos zu verzeichnen. Dagegen ergeben sich signifikante Unterschiede hinsichtlich einer verlängerten OP-Dauer. Schlussfolgerung Durch die Umsetzung des EndoCert-Verfahrens wird sichergestellt, dass die postoperative Ergebnisqualität und die Komplikationswahrscheinlichkeit nach künstlichem Hüftgelenkersatz nicht von der Qualifikation des Erstoperateurs abhängig sind.

Responsiveness of the Harris Hip Score and the SF-36: five years after total hip arthroplasty

2009 ◽  
Vol 18 (8) ◽  
pp. 1053-1060 ◽  
Author(s):  
Hon-Yi Shi ◽  
Lih-Wen Mau ◽  
Je-Ken Chang ◽  
Jun-Wen Wang ◽  
Herng-Chia Chiu
Keyword(s):  
Total Hip Arthroplasty ◽  
Hip Arthroplasty ◽  
Harris Hip Score ◽  
Total Hip ◽  
Sf 36

Periacetabular Bone Densitometry after Total Hip Arthroplasty with Highly Porous Titanium Cups: A 2-Year Follow-Up Prospective Study

2017 ◽  
Vol 27 (6) ◽  
pp. 551-557 ◽  
Author(s):  
Leo Massari ◽  
Alessandro Bistolfi ◽  
Pier Paolo Grillo ◽  
Alda Borré ◽  
Gaetano Gigliofiorito ◽  
...  
Keyword(s):  
Total Hip Arthroplasty ◽  
Functional Recovery ◽  
Hip Arthroplasty ◽  
Harris Hip Score ◽  
Radiographic Evaluation ◽  
Mineral Density ◽  
Cellular Solid ◽  
Total Hip ◽  
Sf 36

Introduction Trabecular Titanium is an advanced cellular solid structure, composed of regular multiplanar hexagonal interconnected cells that mimic the morphology of the trabecular bone. This biomaterial demonstrated improved mechanical properties and enhanced osteoinduction and osteoconduction in several in vitro and in vivo studies. The aim of this study was to assess Trabecular Titanium osseointegration by measuring periacetabular changes in bone mineral density (BMD) with dual-emission X-ray absorptiometry (DEXA). Methods 89 patients (91 hips) underwent primary total hip arthroplasty (THA) with acetabular Trabecular Titanium cups. Clinical (Harris Hip Score (HHS), SF-36) and radiographic assessment were performed preoperatively, and postoperatively at 7 days and at 3, 6, 12 and 24 months. DEXA analysis was performed only postoperatively, using the BMD values measured at 7 days as baselines. Results After an initial decrease from baseline to 6 months, BMD increased and progressively stabilised in all 3 regions of interest (ROIs). Median (IQR) HHS and SF-36 increased from 48 (39-62) and 49 (37-62) preoperatively to 99 (96-100) and 86 (79-92) at 24 months, indicating a considerable improvement in terms of pain relief, functional recovery and quality of life. BMD patterns and radiographic evaluation showed evident signs of periacetabular bone remodelling and osseointegration; all cups were stable at the final follow-up without radiolucent lines, loosening or osteolysis. No revisions were performed. Conclusions After an initial reduction in periacetabular BMD, all 3 ROIs exhibited stabilisation or slight recovery. Although clinical outcomes and functional recovery proved satisfactory, longer follow-ups are necessary to assess this cup long-term survivorship.

scholarly journals Radiographic and Clinical Outcomes in Total Hip Arthroplasty Utilizing a Porous Acetabular Shell Developed with Additive Manufacturing

10.29007/bhs9 ◽  
2019 ◽  
Author(s):  
Michael Masini ◽  
Alana Levine ◽  
Alice Cruz
Keyword(s):  
Additive Manufacturing ◽  
Total Hip Arthroplasty ◽  
Clinical Outcomes ◽  
Hip Arthroplasty ◽  
Harris Hip Score ◽  
Total Hip ◽  
Early Results ◽  
Post Market ◽  
Euroqol 5D ◽  
Acetabular Shell

This is a prospective data collection across seven centers in a non-randomized, post- market study where an additive manufactured cementless acetabular shell was used in primary total hip arthroplasty. There was a total of 254 hips/246 patients across seven centers. Clinical outcomes including all-cause survivorship, the Harris Hip Score (HHS), Lower Extremity Activity Scale (LEAS), Veterans Rand 12 (VR-12), EuroQol 5D (EQ- 5D) and radiographs were collected pre- and postoperatively. Radiographs were analyzed for presence of radiolucencies, migration and overall cup stability. All-cause survival rate was 99.61% and there were no reported radiolucencies greater than 2mm for any zone. There was a reduction in radiolucencies from the 6-week to 1-year postoperative timeframe. All cups reviewed at 1-year were stable with no radiolucencies in 96% of hips. These early results demonstrate the favorable properties of this shell and the use of additive manufacturing in orthopaedic surgery.

Capsular resection versus capsular repair in direct anterior approach for total hip arthroplasty: a randomized controlled trial

2021 ◽  
Vol 103-B (2) ◽  
pp. 321-328
Author(s):  
Frans-Jozef Vandeputte ◽  
Jens Vanbiervliet ◽  
Cigdem Sarac ◽  
Ronald Driesen ◽  
Kristoff Corten
Keyword(s):  
Total Hip Arthroplasty ◽  
Hip Arthroplasty ◽  
Anterior Approach ◽  
Direct Anterior Approach ◽  
Harris Hip Score ◽  
Anterior Capsule ◽  
Total Hip ◽  
Implant Positioning ◽  
Sf 36 ◽  
One Year

Aims Optimal exposure through the direct anterior approach (DAA) for total hip arthroplasty (THA) conducted on a regular operating theatre table is achieved with a standardized capsular releasing sequence in which the anterior capsule can be preserved or resected. We hypothesized that clinical outcomes and implant positioning would not be different in case a capsular sparing (CS) technique would be compared to capsular resection (CR). Methods In this prospective trial, 219 hips in 190 patients were randomized to either the CS (n = 104) or CR (n = 115) cohort. In the CS cohort, a medial based anterior flap was created and sutured back in place at the end of the procedure. The anterior capsule was resected in the CR cohort. Primary outcome was defined as the difference in patient-reported outcome measures (PROMs) after one year. PROMs (Harris Hip Score (HHS), Hip disability and Osteoarthritis Outcome Score (HOOS), and Short Form 36 Item Health Survey (SF-36)) were collected preoperatively and one year postoperatively. Radiological parameters were analyzed to assess implant positioning and implant ingrowth. Adverse events were monitored. Results At one year, there was no difference in HSS (p = 0.728), HOOS (Activity Daily Life, p = 0.347; Pain, p = 0.982; Quality of Life, p = 0.653; Sport, p = 0.994; Symptom, p = 0.459), or SF-36 (p = 0.338). Acetabular component inclination (p = 0.276) and anteversion (p = 0.392) as well as femoral component alignment (p = 0.351) were similar in both groups. There were no dislocations, readmissions, or reoperations in either group. The incidence of psoas tendinitis was six cases in the CS cohort (6%) and six cases in the CR cohort (5%) (p = 0.631). Conclusion No clinical differences were found between resection or preservation of the anterior capsule when performing a primary THA through the DAA on a regular theatre table. In case of limited visibility during the learning curve, it might be advisable to resect a part of the anterior capsule. Cite this article: Bone Joint J 2021;103-B(2):321–328.

Relationship between self-reported and performance-based tests in assessment of patients with total hip arthroplasty

2018 ◽  
Vol 28 (5) ◽  
pp. 566-570 ◽  
Author(s):  
Nuray Elibol ◽  
Bayram Unver ◽  
Vasfi Karatosun ◽  
Izge Gunal
Keyword(s):  
Total Hip Arthroplasty ◽  
Hip Arthroplasty ◽  
Harris Hip Score ◽  
Performance Tests ◽  
Walk Test ◽  
Stand Test ◽  
Total Hip ◽  
Sit To Stand ◽  
Sf 36 ◽  
And Performance

Purpose: The aim of our study was to investigate the relationship between self-reported and performance-based tests in the assessment of patients with total hip arthroplasty (THA). Methods: Ninety four patients (35 males, 59 females) were included in the study with mean age 57.1 ± 14.6 years. Patients performed four performance tests (Timed “Up & Go” Test, Sit to Stand Test, Self-paced Walk Test and Stair Test) and two self-reported measurements (Harris Hip Score [HHS] and SF-36 [36-Item Short Form Health Survey]) were preferred to assess patients. Results: There were varying correlations between performance tests and subscales of the SF-36 including physical function, energy/fatigue, pain, general health. Strong correlation was found between HHS and Timed “Up and Go”( r = −0.59, p < 0.001), self-paced walk test ( r = −0.58, p < 0.001). Moderate correlation was found between HHS and sit to stand test ( r = −0.406, p < 0.001), stair test ( r = 0.32, p < 0.001). Conclusions: There were especially moderate-to-strong correlations between self-reported measurements and performance-based tests in the evaluation of patients with THA. Therefore, outcomes assessment after THA may include self-reported measurements or performance-based tests.

scholarly journals Mid-term results of bilateral synchronous total hip arthroplasty for bony ankylosis in patients with ankylosing spondylitis

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Lei Han ◽  
Renfu Quan ◽  
Zhenle Pei ◽  
Guoping Cao ◽  
Yungen Hu ◽  
...  
Keyword(s):  
Ankylosing Spondylitis ◽  
Total Hip Arthroplasty ◽  
Hip Arthroplasty ◽  
Harris Hip Score ◽  
Heterotopic Bone ◽  
Heterotopic Bone Formation ◽  
Total Hip ◽  
Vas Score ◽  
Mid Term Results ◽  
Bony Ankylosis

Abstract Background Total hip arthroplasty (THA) for bony ankylosis is technically challenging in patients with ankylosing spondylitis (AS). This study aimed to determine the mid-term results of bilateral synchronous THA for bony ankylosis in patients with AS. Methods Nineteen cases of bony ankylosis in patients with AS who received bilateral synchronous THA were included in this study (17 males and 2 females, mean age 49.2 years). Disease duration was 5–38 years (mean 18 years and 6 months). All patients received cementless THA. Intraoperative blood loss, visual analog scale (VAS) score, and complications were assessed. Harris hip scores evaluated the clinical effect. Results Patients were followed up for 62–98 months (mean 82.5 months). VAS score decreased from 7.42 ± 0.92 to 2.42 ± 0.83, Harris hip score improved from 21.8 ± 7.2 to 80.3 ± 6.5, and the flexion-extension range of the hip improved from 0 to 142.3 ± 6.2°. One patient with septum bronchiale had a fracture intraoperatively and was treated with wire strapping. One patient had a traction injury of the femoral nerve postoperatively and recovered 1 year after the operation. Loosening and subsidence were not observed in all patients. Heterotopic bone formation was noted in 3 patients. No complications such as joint dislocation, acute infection, and deep vein thrombosis were found. Conclusion Bilateral synchronous THA was effective for bony ankylosis of the hip in patients with AS because it improved patients’ quality of life and had satisfactory mid-term outcomes.

scholarly journals Excellent Functional Outcome and Quality of Life after Primary Cementless Total Hip Arthroplasty (THA) Using an Enhanced Recovery Setup

2021 ◽  
Vol 10 (4) ◽  
pp. 621
Author(s):  
Franziska Leiss ◽  
Julia Sabrina Götz ◽  
Günther Maderbacher ◽  
Matthias Meyer ◽  
Jan Reinhard ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Patient Satisfaction ◽  
Total Hip Arthroplasty ◽  
Functional Outcome ◽  
Hip Arthroplasty ◽  
Enhanced Recovery ◽  
Harris Hip Score ◽  
Total Hip ◽  
Cementless Total Hip Arthroplasty

Background: Total hip arthroplasty combined with the concept of enhanced recovery is of continued worldwide interest, as it is reported to improve early functional outcome and treatment quality without increasing complications. The aim of the study was to investigate functional outcome and quality of life 4 weeks and 12 months after cementless total hip arthroplasty in combination with an enhanced recovery concept. Methods: A total of 109 patients underwent primary cementless Total Hip Arthroplasty (THA) in an enhanced recovery concept and were retrospectively analyzed. After 4 weeks and 12 months, clinical examination was analyzed regarding function, pain and satisfaction; results were evaluated using Harris Hip score, Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), EQ-5D-5L, EQ-VAS and subjective patient-related outcome measures (PROMs). Preoperatively, HADS (Hospital Anxiety and Depression Scale) was collected. A correlation analysis of age, American Society of Anesthesiologists (ASA), HADS and comorbidities (diabetes mellitus, art. hypertension, cardiovascular disease) with WOMAC, Harris Hip score (HHS) and EQ-5D was performed. Results: Patients showed a significant improvement in Harris Hip score 4 weeks and 12 months postoperatively (p < 0.001). WOMAC total score, subscale pain, subscale stiffness and subscale function improved significantly from preoperative to 12 months postoperative (p < 0.001). EQ-5D showed a significant improvement preoperative to postoperative (p < 0.001). The influence of anxiety or depression (HADS-A or HADS-D) on functional outcome could not be determined. There was a high patient satisfaction postoperatively, and almost 100% of patients would choose enhanced recovery surgery again. Conclusion: Cementless THA with the concept of enhanced recovery improves early clinical function and quality of life. PROMs showed a continuous improvement over a follow-up of 12 months after surgery. PROMs can help patients and surgeons to modify expectations and improve patient satisfaction.

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.

Sign in / Sign up

Export Citation Format

Share Document