It is not yet established whether occupational therapy for people after total hip arthroplasty is effective in improving outcomes or reducing the risk of adverse events

AbstractHospital adverse events remain a significant issue; even “minor events” may lead to increased costs. However, to the best of our knowledge, no previous investigation has compared perioperative events between the first and second hip in staged bilateral total hip arthroplasty (THA). In the current study, we perform such a comparison. A retrospective chart review was performed on a consecutive series of 172 patients (344 hips) who underwent staged bilateral THAs performed by two surgeons at a single institution (2010–2016). Based on chronological order of the staged arthroplasties, two groups were set apart: first-staged THA and second-staged THA. Baseline-demographics, length of stay (LOS), discharge disposition, hospital adverse events, and hospital transfusions were compared between groups. Statistical analyses were performed using independent t-tests, Fisher's exact test, and/or Pearson's chi-squared test. The mean time between staged surgeries was 465 days. There were no significant differences in baseline demographics between first-staged THA and second-staged THA groups (patients were their own controls). The mean LOS was significantly longer in the first-staged THA group than in the second (2.2 vs. 1.8 days; p < 0.001). Discharge (proportion) to a facility other than home was noticeably higher in the first-staged THA group, although not statistically significant (11.0 vs. 7.6%; p = 0.354). The rate of hospital adverse events in the first-staged THA group was almost twice that of the second (37.2 vs. 20.3%; p = 0.001). There were no significant differences in transfusion rates. However, these were consistently better in the second-staged THA group. When compared with the first THA, our findings suggest overall shorter LOS and fewer hospital adverse events following the second. Level of Evidence Level III.

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Epidemiology of Adverse Events after Total Hip Arthroplasty in Medicare Beneficiaries from 2002-2007

The Journal of Arthroplasty ◽

10.1016/j.arth.2010.01.025 ◽

2010 ◽

Vol 25 (3) ◽

pp. e17 ◽

Cited By ~ 1

Author(s):

James I. Huddleston ◽

Yun Wang ◽

James H. Herndon ◽

William J. Maloney

Keyword(s):

Total Hip Arthroplasty ◽

Adverse Events ◽

Hip Arthroplasty ◽

Medicare Beneficiaries ◽

Total Hip

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Surgical Approach May Influence Survival of Large-Diameter Head Metal-on-Metal Total Hip Arthroplasty: A 6- to 10-Year Follow-Up Study

BioMed Research International ◽

10.1155/2017/4209634 ◽

2017 ◽

Vol 2017 ◽

pp. 1-7

Author(s):

Chih-Chien Hu ◽

Tsan-Wen Huang ◽

Shih-Jie Lin ◽

Po-Chun Lin ◽

Feng-Chih Kuo ◽

...

Keyword(s):

Total Hip Arthroplasty ◽

Adverse Events ◽

Hip Arthroplasty ◽

Surgical Approach ◽

Large Diameter ◽

Harris Hip Score ◽

Total Hip ◽

Metal On Metal ◽

Tissue Reactions

Large-diameter head (LDH) metal-on-metal (MoM) total hip arthroplasty (THA) has lost popularity because of metal allergy or ALTRs (adverse local tissue reactions) in the past decade. Whether the surgical approach may influence the survival of LDH-MoM-THA has not been reported. From 2006 to 2009, we performed 96 LDH-MoM-THAs on 80 patients using an in situ head-neck assembly technique through a modified Watson-Jones approach. With a mean follow-up of 8.4 years (range, 6.3–10.1 years), the implant survival rate was 100%. All patients were satisfied with the results and the Harris Hip Score improved from 52 points to 98 points. No ALTRs were found, but 17.7% of the 96 hips (17 adverse events) experienced adverse events related to the cup, including 5 cases of outlier cup malposition, 11 cases of inadequate cup seating, and 1 acetabular fracture. The tissue tension that was improved by a muscle-sparing approach might lessen the chance of microseparation or edge-loading that is taken as the major risk for early implant failure. Further investigation of whether these LDH-MoM-THAs would fail or not would require a longer follow-up or even retrieval analysis in the future.

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High annual surgeon volume reduces the risk of adverse events following primary total hip arthroplasty: a registry-based study of 12,100 cases in Western Sweden

Acta Orthopaedica ◽

10.1080/17453674.2018.1554418 ◽

2019 ◽

Vol 90 (2) ◽

pp. 153-158 ◽

Cited By ~ 6

Author(s):

Per Jolbäck ◽

Ola Rolfson ◽

Peter Cnudde ◽

Daniel Odin ◽

Henrik Malchau ◽

...

Keyword(s):

Total Hip Arthroplasty ◽

Adverse Events ◽

Hip Arthroplasty ◽

Surgeon Volume ◽

Total Hip ◽

Primary Total Hip Arthroplasty

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A comparison of accuracy and safety between stem-first and cup-first total hip arthroplasty: a prospective randomised controlled trial

Hip International ◽

10.1177/11207000211039767 ◽

2021 ◽

pp. 112070002110397

Author(s):

Kentaro Iwakiri ◽

Yoichi Ohta ◽

Yukihide Minoda ◽

Akio Kobayashi ◽

Hiroaki Nakamura

Keyword(s):

Randomised Controlled Trial ◽

Total Hip Arthroplasty ◽

Adverse Events ◽

Hip Arthroplasty ◽

Operative Time ◽

Controlled Trial ◽

Total Hip ◽

Combined Anteversion ◽

Secondary Outcomes ◽

Randomised Controlled

Background: The combined anteversion theory to prevent impingement in total hip arthroplasty (THA) has been proposed. However, because stem-anteversion is influenced by the native femoral anteversion and the stem flexion/extension angle, it is often difficult to adjust stem anteversion during surgery. Therefore, the stem-first (combined anteversion) technique may be useful to adjust and achieve appropriate cup anteversion during surgery with respect to the implanted stem anteversion angle. However, the technique may adversely affect cup or stem angle accuracy and result in intra-operative bleeding, post-operative adverse events, and prolonged operative time. It is inconclusive whether either the stem-first or cup-first technique is safe or accurate. Therefore, this study assessed the accuracy and safety of stem-first THA compared to those of cup-first THA. Materials and methods: This prospective randomised controlled trial analysed 114 patients who were randomly divided into 2 groups (stem-first group: n = 57, cup-first group (control group): n = 57). Primary outcomes included cup and stem angle, the discrepancies from the targeted angle and combined anteversion (evaluated via CT at 3 months postoperatively). Secondary outcomes included intraoperative blood loss, operative time, WOMAC, and adverse events. Results: There were no significant differences in age, gender, BMI or in the primary and secondary outcomes between the 2 groups. Conclusions: Performing stem-first in THA did not adversely affect cup and stem angle accuracy, or result in intraoperative bleeding, prolongation of operative time, or postoperative adverse events. Thus, performing stem-first may be advantageous for achieving combined anteversion theory. Trial registration: University Hospital Medical Information Network (UMIN) registration number UMIN000025189.

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What Can We Expect Following Anterior Total Hip Arthroplasty on a Regular Operating Table? A Validation Study of an Artificial Intelligence Algorithm to Monitor Adverse Events in a High-Volume, Nonacademic Setting

The Journal of Arthroplasty ◽

10.1016/j.arth.2019.07.039 ◽

2019 ◽

Vol 34 (10) ◽

pp. 2260-2266 ◽

Cited By ~ 2

Author(s):

Casper Van de Meulebroucke ◽

Joris Beckers ◽

Kristoff Corten

Keyword(s):

Artificial Intelligence ◽

Total Hip Arthroplasty ◽

Adverse Events ◽

Hip Arthroplasty ◽

Validation Study ◽

High Volume ◽

Operating Table ◽

Total Hip ◽

Intelligence Algorithm ◽

Artificial Intelligence Algorithm

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Perioperative protocol to reduce blood transfusions in ankylosing spondylitis patients undergoing total hip arthroplasty

10.21203/rs.3.rs-813983/v1 ◽

2021 ◽

Author(s):

Yu Huang ◽

Xiao Huang ◽

Fulin Li ◽

Wenwen Huang ◽

Dong Yin

Keyword(s):

Ankylosing Spondylitis ◽

Total Hip Arthroplasty ◽

Blood Transfusion ◽

Adverse Events ◽

Hip Arthroplasty ◽

Transfusion Rate ◽

Blood Management ◽

Total Hip ◽

Group A ◽

Group B

Abstract Introduction: Although tranexamic acid (TXA) can reduce bleeding during total hip arthroplasty (THA), the amount of perioperative bleeding is greater in patients with ankylosing spondylitis (AS); So blood management is more challenging. Patient Blood Management (PBM) program can improve AS patients care and reduce health costs in THA. The purpose of this study is to assess the effects of PMB program on allogeneic transfusion rate, length of hospital stay(LOS), hospitalization expenses and adverse events. Methods : We conducted a retrospective observational study of patients with AS who underwent THA. All patients were treated with tranexamic acid before and after operation. Our PBM program included preoperative evaluation, preoperative acute normovolemic hemodilution and intraoperative recovery autotransfusion. We compared results between the group of patients before and the one after the PBM program implementation. Result: We included 68 as patients who underwent total hip arthroplasty before PBM program from January 2013 to December 2015 (group A) and 84 as patients who underwent total hip arthroplasty after PBM program from January 2016 to December 2019 (group B). In the comparison of intraoperative blood transfusion volume, intraoperative blood transfusion rate and total blood transfusion rate between the two groups, the group B was significantly lower than the group A (P ≤ 0.05); The length of stay and hospitalization expenses of the group B were lower than the group A (P ≤ 0.05). No adverse events were recorded. Conclunsions: Our PMB program can reduce allogeneic blood transfusion, hospital stay and hospitalization expenses, without risking patients to higher number of com- plications in AS patients undergoing THA.

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