ACTIVITY LEVEL, ABDUCTOR STRENGTH, AND MOMENT ARM AFTER TOTAL HIP ARTHROPLASTY

Background: The management of degenerative hip diseases in young patients remains a challenge. Despite the improvement of hip-preserving procedures, total hip arthroplasty (THA) may be required in some instances. In addition, young patients undergoing THA have high expectations concerning their postoperative level of activity. Purpose: (1) to define the sports activity level and the return to sports after THA, (2) to describe the modification or initiation of new sports disciplines, and (3) to report the clinically meaningful outcomes after THA in patients younger than 40 years. Methods: A total of 36 patients (40 hips) were prospectively analyzed at a midterm follow-up of 3.9 years. The modified Harris Hip Score (mHHS); the Visual Analog Scale (VAS) for pain; the University of California, Los Angeles (UCLA) activity scale; and sports and recreational activity levels were assessed via questionnaire. The minimal clinically important difference (MCID) was determined by calculating half of the standard deviation, and the substantial clinical benefit (SCB) as well as patient acceptable symptomatic state (PASS), were calculated by the anchor method for the mHHS. Results: At the final follow-up, there was a significant improvement in mHHS (34.1 to 92.6; p < 0.0001), UCLA (3.2 to 7.6; p < 0.0001), and VAS for pain (8 to 1; p < 0.0001). More patients were active in sports at follow-up than before surgery (44% to 92%, p < 0.0001). In addition, the duration and frequency of sports activities showed a significant increase (p < 0.0001). The MCID, SCB and PASS for mHHS were 89% and 58%, respectively. No revision surgery had to be performed. Conclusion: This study showed that a large proportion of patients under 40 years of age who underwent THA increased their physical activity. Eighty-six percent of the patients were highly active, with a UCLA score ≥ 7. Furthermore, the reported MCID, SCB, and PASS for mHHS were achieved by more than 80% of patients.

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Hip and Groin Injuries in Professional Basketball Players: Impact on Playing Career and Quality of Life After Retirement

Sports Health A Multidisciplinary Approach ◽

10.1177/1941738119838274 ◽

2019 ◽

Vol 11 (3) ◽

pp. 218-222 ◽

Cited By ~ 6

Author(s):

Seper Ekhtiari ◽

Moin Khan ◽

Tyrrell Burrus ◽

Kim Madden ◽

Joel Gagnier ◽

...

Keyword(s):

Quality Of Life ◽

Total Hip Arthroplasty ◽

Hip Arthroplasty ◽

Groin Pain ◽

Activity Level ◽

Basketball Players ◽

Professional Basketball ◽

Total Hip ◽

Increased Risk

Background: Professional basketball players are at increased risk of hip and groin pain. Epidemiologic data exist on the prevalence of hip and groin issues among players in the National Basketball Association (NBA), but little is known about how these injuries affect athletes after retirement. Hypothesis: A high proportion of retired NBA athletes would have hip and/or groin pain. Study Design: Cross-sectional survey. Level of Evidence: Level 4. Methods: A survey was developed through an interdisciplinary focus group. The survey was developed to capture data regarding demographics, collegiate and professional athletic injuries, and current quality of life and musculoskeletal health. The questionnaire was electronically distributed to all members of the National Basketball Players Association using SurveyMonkey (N = 900). Results: A total of 108 (12%) retired NBA players completed the survey. More than one-third (36.3%) of athletes report currently experiencing hip and/or groin pain, and 17.6% had received injections for hip or groin conditions since retiring from the NBA. Since retiring, 14.7% of respondents had undergone total hip arthroplasty. The median Tegner activity level scale was 3 out of 10. Nearly one-third (32.4%) of athletes report moderate to severe problems with mobility, and close to half (48%) had moderate to extreme pain/discomfort. Conclusion: Hip and groin injuries are common among NBA athletes, affecting players throughout their careers and into retirement. A subset of athletes may exist in whom intra-articular hip pathology is not appropriately identified and treated while playing in the NBA. Clinical Relevance: Retired NBA athletes are at high risk of hip and groin pain after retirement and are more likely to require total hip arthroplasty compared with the general population.

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Impact of Individual Anatomy on the Benefit of cup Medialisation in Total Hip Arthroplasty

Hip International ◽

10.5301/hipint.5000392 ◽

2016 ◽

Vol 26 (6) ◽

pp. 537-542 ◽

Cited By ~ 8

Author(s):

Alexandre Terrier ◽

Valérie Parvex ◽

Hannes A. Rüdiger

Keyword(s):

Total Hip Arthroplasty ◽

Hip Arthroplasty ◽

Gluteus Medius ◽

Femoral Anteversion ◽

Patient Specific ◽

Moment Arm ◽

Total Hip ◽

Moment Arms ◽

The Moment ◽

Anatomical Parameters

Introduction In total hip arthroplasty, cup medialisation with compensatory increase of femoral offset has been proposed to increase the moment arms of abductor muscles. However, this technique is associated with a loss of acetabular bone stock. Previous data indicates that the potential benefit is not constant among patients and is likely related to patient anatomy. Method Therefore, to be able to select patients who would benefit most from this technique, we measured several anatomical parameters of the pelvis and femur in 15 patients; and evaluated correlations between them and the changes of moment arms associated with cup medialisation. The anatomical measurements were performed on 3-D reconstructions of preoperative CT scans. The moment arms of the gluteus medius and gluteus minimus were calculated for an abduction and flexion movement using patient-specific finite element models. Results 6 anatomical parameters were correlated with muscle moment arm variations after cup medialisation. This effect was not systematic for either muscles or movements. Among all parameters, femoral anteversion was the most important parameter in explaining the effect of cup medialisation. Discussion Patients with small femoral anteversion or low-riding greater trochanter benefit more from cup medialisation in terms of moment arm increase in abduction motion.

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Trends in Total Hip Arthroplasty in Young Patients - Results from a Regional Register

Hip International ◽

10.5301/hipint.5000485 ◽

2017 ◽

Vol 27 (5) ◽

pp. 443-448 ◽

Cited By ~ 10

Author(s):

Amit Kumar ◽

Benjamin V. Bloch ◽

Colin Esler

Keyword(s):

Total Hip Arthroplasty ◽

Hip Arthroplasty ◽

Young Patients ◽

Activity Level ◽

Arthroplasty Register ◽

Total Hip ◽

The United Kingdom ◽

Acetabular Fixation ◽

Hip Arthroplasties ◽

The Ideal

Introduction In the United Kingdom, over 83,000 primary total hip arthroplasties (THAs) were performed last year, of which 20% are in patients under the age of 60 years. These patients generally have a longer life expectancy and a higher activity level than an older cohort, which may potentially translate to higher revision rates. Methods We reviewed our Trent regional arthroplasty register to assess current surgical practice in younger patients undergoing total hip arthroplasty. The results were compared to a previous study published in 2005. Results Between 2010 and 2012, 1,097 primary THAs were performed on patients aged 54 or less. There was an equal cohort of males to females with a mean age of 46 years of patients undergoing THA. Osteoarthritis was the commonest aetiology for patients having surgery. Reviewing the components used there were 32 different femoral and 30 different acetabular types along with 70 different combinations of components. There were 608 uncemented THAs, 313 hybrid THRs, 98 cemented THAs, 67 resurfacing arthroplasties and 11 reverse hybrid THAs. Discussion The majority of implants were uncemented in both femur and acetabulum with consultants performing most of the procedures. There is a clear preference for uncemented femoral and acetabular fixation in the younger patient, and the trend towards uncemented components has increased over the last 10 years amongst the same surgeons. There continues to be a wide variety of cup and stem usage along with many different combinations of components, with no consensus on the ideal combination.

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