Total Hip Arthroplasty for Avascular Necrosis and Degenerative Osteoarthritis of the Hip

1997 ◽  
Vol 341 ◽  
pp. 62???68 ◽  
Author(s):  
Theodore A. Xenakis ◽  
Alexandros E. Beris ◽  
Konstantinos K. Malizos ◽  
Theodosios Koukoubis ◽  
John Gelalis ◽  
...  
2009 ◽  
Vol 62 (5-6) ◽  
pp. 236-240 ◽  
Author(s):  
Slavica Jandric

Introduction Periarticular muscles have a significant role in keeping the mobility and integrity of the hip joint. The aim of this article was to investigate the effects of the total hip arthroplasty and early rehabilitation on the muscle strength. Patients Three groups of examined persons (matched in relation to musculosceletal conditions, sex, age and occupation) were included in the investigation. The first group (40 of the involved hip) and the second group (with 33 involved hips) were groups of patients with late-stage of osteoarthritis of the hip. The first group of patients was managed conservatively and the second group operatively (total cemented hip endoprosthesis was performed). The third group was control group with 123 healthy hips. Material and methods The maximal voluntary isometric strength was measured with dynamometer. The muscle strength was tested in all three groups: in the first group of patients at the beginning and at the end of the therapy and in patients of the second group 6?3 months postoperatively. Results A significant improvement of the muscle strength was noted for the flexors (t=2.45, p<0.05), musculus tensor fasciae latae (t=2.35, p<0.05), extensors (t=2.85, p<0.01), adductors (t=3.02, p<0.01), external rotators (t=3.1, p<0.01), m. gluteus medius (t=5.28, p<0.001) and internal rotators (t=5.77, p<0.001) after total hip arthroplasty and early rehabilitation in comparison to the conservatively treated group. Conclusion The muscle strength in the patients with osteoarthritis of the hip after arthroplasty was significantly higher than after rehabilitation for all hip muscles but did not reach values of the strength of the muscles in the corresponding control group.


2015 ◽  
Vol 18 (1) ◽  
pp. 10
Author(s):  
Jaswinder PalSingh Walia ◽  
Sargun Singh ◽  
AvinashChander Gupta ◽  
Khushpreet Kaur ◽  
Naveen Mittal

SICOT-J ◽  
2019 ◽  
Vol 5 ◽  
pp. 35
Author(s):  
Frank Van Praet ◽  
Michiel Mulier

Introduction: Total Hip Arthroplasty (THA) in the treatment of primary osteoarthritis of the hip has evolved to a very safe and cost-effective intervention with revision rates below 5% after 10 years. To this day, however, controversy remains on whether or not to cement the acetabular cup. Methods: A comprehensive PubMed search of the English literature for studies published between 2007 and 2018 was performed. Studies comparing the clinical (revision rate, functionality), radiological (wear) or economic (cost) differences between cemented (cemented stem with cemented cup) and hybrid (cemented stem with uncemented cup) prostheses for primary osteoarthritis of the hip were identified as eligible. Results: A total of 1032 studies were identified whereof twelve were included for qualitative synthesis. All studies concerning the risk of revision were based on registry data, covering a total of 365,693 cups. Cemented prostheses had a similar or lower risk of revision compared to hybrid prostheses in every study, but performed slightly worse on functionality and quality of life. While cemented prostheses were the cheapest option, hybrids were the most cost-effective. Discussion: The widespread preference for cementless fixation of the acetabulum cannot be explained by a superior survival of cementless or hybrid models. Irrespective of age, cemented fixation of the acetabulum remains the gold standard to which other techniques should be compared.


Author(s):  
Josephine K Dermawan ◽  
Andrew Goldblum ◽  
John D Reith ◽  
Scott E Kilpatrick

Abstract Objectives To evaluate the necessity of pathologic examination for confirming the diagnosis of avascular necrosis (AVN). Methods We retrospectively reviewed consecutive nonfractured total hip arthroplasty cases (n = 1,722), comparing operative diagnoses and radiologic data with final histologic diagnoses, focusing specifically on AVN. Results Among 199 histologically confirmed cases of AVN, 62 (31%) had a preoperative diagnosis of osteoarthritis/degenerative joint disease (OA/DJD); 58 of the latter patients had radiology reports, but only two (3%) documented AVN. Patients with AVN preoperatively diagnosed as OA/DJD were significantly older (mean, 65 years) than patients with AVN correctly diagnosed clinically (mean, 52 years; P &lt; .00001). Among 163 cases with a preoperative diagnosis of AVN, 26 (16%) were confirmed as OA/DJD; the radiology report incorrectly diagnosed AVN in 17 (65%) patients. These latter patients also were significantly older (mean, 60 years) than patients with AVN correctly diagnosed clinically (P = .0008). Patients with a preoperative clinical and/or radiologic diagnosis of AVN were more likely to be younger and have known AVN risk factors. Conclusions Accurate and reliable diagnosis of AVN requires pathologic examination, especially among older patients without known risk factors. Prompt diagnosis may lead to behavioral changes in affected patients that reduce the risk of subsequent lesions.


Author(s):  
Vijaya Bhaskar Reddy ◽  
N. Brahma Chary ◽  
Kacham Nikitha

<p class="abstract"><strong>Background: </strong>Normal hip joint is subjected to many stresses during daily activities performed by an individual. Since it is one of the major weight bearing joints of the body, its normal function is necessary for daily activities. Avascular necrosis (AVN) of the femoral head is one of the common causes of painful hip in a young adult. Core decompression, fibular sturt graft can be considered in early stages, total hip arthroplasty in later stages of AVN of femoral head.</p><p class="abstract"><strong>Methods:</strong> This is a retrospective study of 30 patients following uncemented total hip replacement, who were operated between August 2017 and March 2020 at MNR medical college and hospital, Sangareddy. They were followed up for a minimum period of 1 year and evaluated using Harris hip scoring system. Harris hip score is designed specifically for measuring functional outcomes in hip arthroplasty.</p><p class="abstract"><strong>Results: </strong>There was a significant improvement in function as measured with the Harris hip score. The overall preoperative Harris hip score was 43, which remarkably improved to 89 postoperatively. The results observed, showed that all patients had good to excellent results, (Harris hip score ≥0) thus showing a good degree of pain relief, improvement in function and range of motion.</p><p class="abstract"><strong>Conclusions: </strong>Although the use of total hip arthroplasty in young patients will more likely necessitate future revision surgery, the consistent relief of pain and good functional results have made this procedure an attractive treatment choice for the debilitating arthritis resulting from osteonecrosis of the femoral head.  </p>


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