scholarly journals Bilateral Cemented Custom-Made Total Hip Arthroplasty in Paget's Disease with Femoral Cortical Thickening and Canal Narrowing

Joints ◽  
2021 ◽  
Author(s):  
Riccardo D'Ambrosi ◽  
Luca Ballini ◽  
Federico Valli ◽  
Stefano Guarino ◽  
Maurizio Rubino ◽  
...  
Keyword(s):  
Total Hip Arthroplasty ◽  
Hip Arthroplasty ◽  
Paget’S Disease ◽  
Well Being ◽  
Paget's Disease ◽  
Femoral Canal ◽  
Total Hip ◽  
Custom Made ◽  
Patient Reported ◽  
One Year

AbstractIn this report, we present a case of a 57-year-old man complaining of pain in both his hips. Clinically, the patient reported lameness and reduction in the range of motion of the hips. Radiographic imaging showed a very narrow medullary femoral canal, confirmed by a computed tomography scan. In consideration of the narrowness of the femoral canal and cortex thickening, and due to the rarity of the clinical case, we opted to use a custom-made prosthesis. We performed total hip arthroplasty, initially on the right side. One year later, we repeated the procedure on the left side. One year after the last surgery, the patient reported well-being and continuous improvement in walking, with no complications. This case report highlights the features and the critical issues related to this kind of surgery in patients affected by Paget's disease of the bone and the importance of custom-made implants in challenging cases.

Cemented versus Cementless Total Hip Arthroplasty in Paget's Disease of Bone: A Systematic Review

2017 ◽  
Vol 01 (02) ◽  
pp. 087-092
Author(s):  
James Cashman ◽  
Keith Synnott ◽  
John O'Byrne ◽  
Frank Lyons ◽  
Eoghan Hurley
Keyword(s):  
Total Hip Arthroplasty ◽  
Aseptic Loosening ◽  
Clinical Outcomes ◽  
Hip Arthroplasty ◽  
Paget’S Disease ◽  
Paget's Disease ◽  
Paget’S Disease Of Bone ◽  
Paget's Disease Of Bone ◽  
Total Hip ◽  
Cementless Total Hip Arthroplasty

AbstractThe purpose of this study is to systematically review the clinical evidence for the use of cemented and cementless total hip arthroplasty (THA) in Paget's disease of bone (PDB), and to ascertain whether any difference exists in clinical outcomes between the two implant types. MEDLINE, EMBASE, and the Cochrane Library databases were searched in accordance with the preferred reporting items for systematic reviews and meta-analyses (PRISMA) guidelines. The quality of the studies was assessed using the methodological index for nonrandomized studies (MINORS) checklist. The reported clinical outcomes were evaluated using risk ratio (RR) with a p < 0.05 considered as statistically significant. Thirteen clinical studies with 444 primary THAs were included in this review. Cementless THA resulted in lower rates of aseptic loosening and lower rates of revision due to aseptic loosening (p < 0.05), but there was no overall statistically significant increase in the incidence of revision in the cemented THAs (p = 0.21). The postoperative Harris hip score was similar between both the groups. Also, the presence of heterotrophic ossification was similar in both the groups. Functional outcomes and survivorship were equivalent using either cementless or cemented components, with a similar rate of overall revisions. However, cementless components resulted in a decreased incidence of aseptic loosening and revision due to aseptic loosening. The current literature consists of a low level of evidence, level IV, which limits the conclusion of this study.

scholarly journals Cementless total hip arthroplasty in Paget’s disease of bone: a retrospective review

2009 ◽  
Vol 34 (8) ◽  
pp. 1103-1109 ◽  
Author(s):  
Julien Wegrzyn ◽  
Vincent Pibarot ◽  
Roland Chapurlat ◽  
Jean-Paul Carret ◽  
Jacques Béjui-Hugues ◽  
...  
Keyword(s):  
Total Hip Arthroplasty ◽  
Hip Arthroplasty ◽  
Retrospective Review ◽  
Paget’S Disease ◽  
Paget's Disease ◽  
Paget’S Disease Of Bone ◽  
Paget's Disease Of Bone ◽  
Total Hip ◽  
Cementless Total Hip Arthroplasty

Paget's disease involving the hip joint, prevalence, radiological patterns and total hip arthroplasty

Bone ◽  
1995 ◽  
Vol 17 (1) ◽  
pp. 99
Author(s):  
C. Moragues-Pastor ◽  
J. Cabo-Cabo ◽  
J.M. Nolla-Solø ◽  
M. Contreras-Martín ◽  
J. Valverde-García ◽  
...  
Keyword(s):  
Total Hip Arthroplasty ◽  
Hip Joint ◽  
Hip Arthroplasty ◽  
Paget’S Disease ◽  
Paget's Disease ◽  
Total Hip ◽  
Radiological Patterns

Uncemented total hip arthroplasty in paget's disease of the hip: A report of 5 cases with 5-year follow-up

1999 ◽  
Vol 14 (7) ◽  
pp. 872-876 ◽  
Author(s):  
William J. Hozack ◽  
Scott A. Rushton ◽  
Christopher Carey ◽  
Durgadas Sakalkale ◽  
Richard H. Rothman
Keyword(s):  
Total Hip Arthroplasty ◽  
Hip Arthroplasty ◽  
Paget’S Disease ◽  
Paget's Disease ◽  
Total Hip ◽  
Uncemented Total Hip Arthroplasty

scholarly journals Clinical and radiological outcomes of total hip arthroplasty in patients affected by Paget’s disease: a combined registry and single-institution retrospective observational study

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Alberto Di Martino ◽  
Maria Antonietta Rita Coppola ◽  
Barbara Bordini ◽  
Niccolò Stefanini ◽  
Giuseppe Geraci ◽  
...  
Keyword(s):  
Total Hip Arthroplasty ◽  
Hip Arthroplasty ◽  
Paget’S Disease ◽  
Paget's Disease ◽  
Harris Hip Score ◽  
Autologous Blood Transfusion ◽  
Transfusion Rate ◽  
Safe Procedure ◽  
Single Institution ◽  
Total Hip

Abstract Background Total hip arthroplasty (THA) in patients with Paget’s disease can be associated with technical difficulties related to deformities and altered mechanical bone properties, and hypervascularity leads to significative intra-operative bleeding. The purpose of this registry and single-institution study was to investigate overall survival and causes of failure of THA in pagetic patients, together with an analysis of the clinical and radiological complications. Material and methods Registry-based survival and complication analysis, type of fixation, intra- and post-operative complications, clinical (pharmacological history, blood transfusions, Harris hip score [HHS]) and radiographic (cup orientation, stem axial alignment, osteolysis around the cup and the stem and heterotopic ossification [HO]) data were reviewed. Results In total, 66 patients (27 males and 39 females, mean age at surgery 71.1 years for males and 74.8 years for female) from the registry study presented a 10-year survival of 89.5%. In the institutional study, involving 26 patients (14 males and 12 females, 69 years average) and 29 THAs, hip function improved significantly. Average cup orientation was 40.5°, while varus stem alignment was 13.8%. In total, 52% of hips had heterotopic ossifications. Peri-acetabular osteolysis was in 13.8% of implants and in 45% of hips was found around the stem. Allogenic and autologous blood transfusion rate were 68.2% and 31.8%, respectively, with an average transfusion of 2 units of blood (range 1–6 units). HHS improved by an average of 34 points, with excellent result in 64.3% of patients. Two implants failed, one due to traumatic ceramic head fracture 64 months after surgery, and one due to mobilization of the cup on the second post-operative day. Conclusion THA surgery in Paget’s patients is a safe procedure, and implant survival is only partly affected by bone remodelling and choice of fixation. The post-operative functional outcome is largely similar to that of other patients. Bleeding-related complications are the main complications; a careful pharmacological strategy should be recommended to decrease the risk of transfusions and of HO development. Level of evidence Level III

scholarly journals Intrapelvic Pseudotumor Causing Neuropathy and Vascular Obstruction After Revision Total Hip Arthroplasty: A Case Report

2021 ◽  
Vol 11 ◽  
Author(s):  
Matthew Sweet ◽  
Tyler Snoap ◽  
Bernard Roehr ◽  
Jason Roberts
Keyword(s):  
Total Hip Arthroplasty ◽  
Hip Arthroplasty ◽  
Neurovascular Compression ◽  
Complication Rates ◽  
Ilioinguinal Approach ◽  
Total Hip ◽  
Patient Reported ◽  
Revision Tha ◽  
One Year ◽  
Component Loosening

Background: There is a growing body of recent literature regarding the occurrence of pseudotumors associated with modular junctions and various bearing surfaces after total hip arthroplasty (THA). Revision surgery is often technically challenging and high complication rates have been reported. The optimal management of these patients and outcomes after operative treatment remain poorly understood. Methods: We report the case of a 77-year-old male with progressive unilateral lower extremity swelling, pain, and neuropathy 9 years after revision THA for polyethylene liner wear. Imaging and biopsy confirmed a massive intrapelvic pseudotumor exerting compressive effects. Radiographs demonstrated extensive femoral and pelvic osteolysis without evidence of component loosening. Debulking of the intrapelvic portion of the pseudotumor was performed via the lateral window of the ilioinguinal approach with component retention. Results: Debulking of the intrapelvic mass resulted in resolution of symptoms. One year postoperatively the patient reported pain free ambulation using a walker and no recurrence of symptoms. Radiographs demonstrated stable THA components in comparison with preoperative films. Discussion and Conclusion: This case demonstrates a rare finding of intrapelvic pseudotumor causing neurovascular compression after revision THA. Clinicians should be aware of intrapelvic pseudotumor as a possible cause of limb swelling and neuropathy, and that debulking of the mass is a potential treatment option in the setting of well-fixed implants.

scholarly journals Total hip arthroplasty in patients with Paget’s disease of bone: A systematic review

2017 ◽  
Vol 8 (4) ◽  
pp. 357 ◽  
Author(s):  
Sammy A Hanna ◽  
Sebastian Dawson-Bowling ◽  
Steven Millington ◽  
Rej Bhumbra ◽  
Pramod Achan
Keyword(s):  
Systematic Review ◽  
Total Hip Arthroplasty ◽  
Hip Arthroplasty ◽  
Paget’S Disease ◽  
Paget's Disease ◽  
Paget’S Disease Of Bone ◽  
Paget's Disease Of Bone ◽  
Total Hip

Three and a half years’ experience with outpatient total hip arthroplasty

2020 ◽  
Vol 102-B (1) ◽  
pp. 82-89 ◽  
Author(s):  
Michel J. Coenders ◽  
Nina M. C. Mathijssen ◽  
Stephan B. W. Vehmeijer
Keyword(s):  
Total Hip Arthroplasty ◽  
Hip Arthroplasty ◽  
Anterior Approach ◽  
Patient Reported Outcome Measures ◽  
Patient Reported Outcome ◽  
Outpatient Setting ◽  
Total Hip ◽  
Study Results ◽  
Patient Reported ◽  
One Year

Aims The aim of this study was to report our experience at 3.5 years with outpatient total hip arthroplasty (THA). Methods In this prospective cohort study, we included all patients who were planned to receive primary THA through the anterior approach between 1 April 2014 and 1 October 2017. Patient-related data and surgical information were recorded. Patient reported outcome measures (PROMs) related to the hip and an anchor question were taken preoperatively, at six weeks, three months, and one year after surgery. All complications, readmissions, and reoperations were registered. Results Of the 647 THA patients who had surgery in this period through the anterior approach, 257 patients (39.7%) met the inclusion criteria and were scheduled for THA in an outpatient setting. Of these, 40 patients (15.6%) were admitted to the hospital, mainly because of postoperative nausea and/or dizziness. All other 217 patients were able to go home on the day of surgery. All hip-related PROMs improved significantly up to 12 months after surgery, compared with the scores before surgery. There were three readmissions and two reoperations in the outpatient cohort. There were no complications related to the outpatient THA protocol. Conclusion These study results confirm that outpatient THA can be performed safe and successfully in a selected group of patients, with satisfying results up to one year postoperatively, and without outpatient-related complications, readmissions, and reoperations. Cite this article: Bone Joint J 2020;102-B(1):82–89

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