scholarly journals Cementing does not increase the immediate postoperative risk of death after total hip arthroplasty or hemiarthroplasty: a hospital-based study of 10,677 patients

2019 ◽  
Vol 90 (3) ◽  
pp. 270-274 ◽  
Author(s):  
Elina Ekman ◽  
Inari Laaksonen ◽  
Kari Isotalo ◽  
Antti Liukas ◽  
Tero Vahlberg ◽  
...  
Keyword(s):  
Total Hip Arthroplasty ◽  
Hip Arthroplasty ◽  
Total Hip ◽  
Risk Of Death ◽  
Postoperative Risk

Total Hip Arthroplasty in 6690 Patients with Inflammatory Arthritis: Effect of Medical Comorbidities and Age on Early Mortality

2016 ◽  
Vol 43 (7) ◽  
pp. 1320-1327 ◽  
Author(s):  
Rüdiger J. Weiss ◽  
Göran Garellick ◽  
Johan Kärrholm ◽  
Nils P. Hailer
Keyword(s):  
Total Hip Arthroplasty ◽  
Hip Arthroplasty ◽  
Inflammatory Arthritis ◽  
Cox Proportional Hazards ◽  
Early Mortality ◽  
Socioeconomic Background ◽  
Medical Comorbidities ◽  
Total Hip ◽  
Risk Of Death ◽  
Increased Risk

Objective.We analyzed early mortality after total hip arthroplasty (THA) in patients with inflammatory arthritis (IA), adjusting for medical comorbidities and socioeconomic background.Methods.Data on 6690 patients with IA who underwent THA during 1992–2012 were extracted from the Swedish Hip Arthroplasty Register. Data on comorbidity, measured using the Charlson Comorbidity Index (CCI), and socioeconomic data were gathered from the Swedish National Inpatient Register and Statistics Sweden. The CCI was divided into low (0), moderate (1–2), and high (> 2). Cox proportional hazards models were fitted to calculate adjusted HR of early mortality, with 95% CI.Results.Twenty-five patients (0.4%) died within 0–90 days, giving a 90-day unadjusted survival rate of 99.6% (CI 99.5–99.8). Comorbidity was associated with an increased risk of death within 90 days postoperatively [high vs low CCI: adjusted HR 9.0 (CI 1.6–49.9)]. There was a trend toward lower risk of death during the period 1999–2005, although patients operated on during this period had more comorbidities than those operated on from 1992 to 1998. A large proportion of patients was re-admitted to hospital within 90 days after the index procedure (30.2%), but rarely for cardiovascular reasons.Conclusion.Medical comorbidity and an age above 75 years are associated with a substantial increase in the risk of early death after THA in patients with IA. Awareness of potential risk factors may alert clinicians and thus improve perioperative care.

Effect of operative time on complications following primary total hip arthroplasty: analysis of the NSQIP database

2020 ◽  
pp. 112070002094970
Author(s):  
Mark Sikov ◽  
Matthew Sloan ◽  
Neil P Sheth
Keyword(s):  
Total Hip Arthroplasty ◽  
Length Of Stay ◽  
Hip Arthroplasty ◽  
Operative Time ◽  
Complication Rates ◽  
Improvement Program ◽  
Perioperative Morbidity ◽  
Total Hip ◽  
Risk Of Death ◽  
Increased Risk

Background: Long operative times in total hip arthroplasty (THA) have been shown to be associated with increased risk of revision as well as perioperative morbidity. This study assesses the effect of extended operative times on complication rates following primary THA using the most recent national data. Methods: The National Surgical Quality Improvement Program (NSQIP) database (2008–2016) was queried for primary THA. Groups were defined by operative time 1 standard deviation (1 SD) above the mean. Univariate, propensity score-matched, and multivariate logistic regression analyses were performed to evaluate outcomes. Results: Data was available for 135,013 THA patients. Among these groups, mean operative time in the extended operative time group was 166 minutes (compared with 82 minutes). Patients undergoing longer operative times were 3.8 years younger, had a 1.5 kg/m2 higher body mass index and had a 0.5 day longer mean length of stay. Propensity matching identified 16,123 pairs for analysis in the 1 SD group. Longer operative time led to 173% increased risk of major medical morbidity, 140% increased likelihood of length of stay greater than 5 days, 59% increased risk of reoperation, 45% increased risk of readmission, and a 30% decreased likelihood of return to home postoperatively. There was no increased risk of death within 30 days. Conclusion: Long operative times were associated with increases in multiple postoperative complications, but not mortality. Surgeons should be advised to take steps to minimise operative time by adequate preoperative planning and optimal team communication.

MR Imaging with Metal Artifact Reduction to Differentiate between Patients with and without Infected Total Hip Arthroplasty

2018 ◽  
Author(s):  
Benedikt Schwaiger ◽  
Alexandra Gersing ◽  
Daniela Muenzel ◽  
Julia Dangelmaier ◽  
Peter Prodinger ◽  
...  
Keyword(s):  
Total Hip Arthroplasty ◽  
Mr Imaging ◽  
Hip Arthroplasty ◽  
Artifact Reduction ◽  
Metal Artifact ◽  
Metal Artifact Reduction ◽  
Total Hip

Plasma Prekallikrein Activity in Patients with Total Hip Arthroplasty

1987 ◽  
Vol 58 (04) ◽  
pp. 1040-1042
Author(s):  
J J M L Hoffmann ◽  
J H J P M Kortmann
Keyword(s):  
Total Hip Arthroplasty ◽  
Hip Arthroplasty ◽  
Hip Prosthesis ◽  
Contact System ◽  
Factor Xii ◽  
Total Hip ◽  
Activity Factor ◽  
Patient Groups ◽  
Kallikrein Activity

SummaryThe behaviour of the contact system was studied in 40 patients with total hip arthroplasty, by measuring plasma prekallikrein, spontaneous kallikrein activity and factor XII. In the literature it had been shown that patients with complications from this operation had decreased prekallikrein and increased kallikrein activity (M. Nakahara. Acta orthop scand 1982; 53: 591-6). In the present study, comprising patients with and without pain and proven loosening of the hip prosthesis, these findings could only partially be confirmed. Patients with a loosened prosthesis had significantly lower prekallikrein (mean 0.78 ± 0.28 U/ml; p <0.01) than patients without problems, but no detectable kallikrein activity in plasma. Patients with pain but no loosening had normal prekallikrein (1.04 ±0 0.26 U/ml) and also no demonstrable kallikrein activity. Factor XII was normal in all patient groups. It is concluded that decreased prekallikrein is limited to patients with a loosened hip prosthesis, with or without pain.

A Comparative Analysis of Patient Satisfaction following Total Knee Arthroplasty and Total Hip Arthroplasty Using the Forgotten Joint Score

2020 ◽  
Vol 04 (02) ◽  
pp. 084-089
Author(s):  
Vivek Singh ◽  
Stephen Zak ◽  
Ran Schwarzkopf ◽  
Roy Davidovitch
Keyword(s):  
Total Knee Arthroplasty ◽  
Patient Satisfaction ◽  
Total Hip Arthroplasty ◽  
Knee Arthroplasty ◽  
Hip Arthroplasty ◽  
Demographic Data ◽  
Demographic Differences ◽  
Total Hip ◽  
Forgotten Joint Score ◽  
Total Knee

AbstractMeasuring patient satisfaction and surgical outcomes following total joint arthroplasty remains controversial with most tools failing to account for both surgeon and patient satisfaction in regard to outcomes. The purpose of this study was to use “The Forgotten Joint Score” questionnaire to assess clinical outcomes comparing patients who underwent a total hip arthroplasty (THA) with those who underwent a total knee arthroplasty (TKA). We conducted a retrospective review of patients who underwent primary THA or TKA between September 2016 and September 2019 and responded to the Forgotten Joint Score-12 (FJS-12) questionnaire at least at one of three time periods (3, 12, and 21 months), postoperatively. An electronic patient rehabilitation application was used to administer the questionnaire. Collected variables included demographic data (age, gender, race, body mass index [BMI], and smoking status), length of stay (LOS), and FJS-12 scores. t-test and chi-square were used to determine significance. Linear regression was used to account for demographic differences. A p-value of less than 0.05 was considered statistically significant. Of the 2,359 patients included in this study, 1,469 underwent a THA and 890 underwent a TKA. Demographic differences were observed between the two groups with the TKA group being older, with higher BMI, higher American Society of Anesthesiologists scores, and longer LOS. Accounting for the differences in demographic data, THA patients consistently had higher scores at 3 months (53.72 vs. 24.96; p < 0.001), 12 months (66.00 vs. 43.57; p < 0.001), and 21 months (73.45 vs. 47.22; p < 0.001). FJS-12 scores for patients that underwent THA were significantly higher in comparison to TKA patients at 3, 12, and 21 months postoperatively. Increasing patient age led to a marginal increase in FJS-12 score in both cohorts. With higher FJS-12 scores, patients who underwent THA may experience a more positive evolution with their surgery postoperatively than those who had TKA.

Patient Activity after Total Hip Arthroplasty: A Comparison of Three Different Bearing Surfaces

2013 ◽  
Vol 23 (4) ◽  
pp. 315-321 ◽  
Author(s):  
Johannes F. Plate ◽  
Kimona Issa ◽  
Craig Wright ◽  
Bartlomiej W. Szczech ◽  
Bhaveen H. Kapadia ◽  
...  
Keyword(s):  
Total Hip Arthroplasty ◽  
Hip Arthroplasty ◽  
Total Hip
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