scholarly journals Comparative Outcomes Assessment: Hip Hemiarthroplasty as an Alternative to THA in Patients with Surgically Pristine Acetabulum—Is There Still a Role?

2013 ◽  
Vol 2013 ◽  
pp. 1-6
Author(s):  
Thomas B. Pace ◽  
Brad Prather ◽  
Brian Burnikel ◽  
Brayton Shirley ◽  
Stephanie Tanner ◽  
...  
Keyword(s):  
Overall Survival ◽  
Survival Rate ◽  
Total Hip Arthroplasty ◽  
Hip Arthroplasty ◽  
Groin Pain ◽  
Long Term Results ◽  
Overall Survival Rate ◽  
Total Hip ◽  
Group 2 ◽  
Group 1

This is a retrospective review of 243 hip arthroplasties treated with either hemiarthroplasty (61 surgeries-Group 1) or total hip arthroplasty (182 surgeries-Group 2). The mid- to long-term results of relatively similar, predominately young patient cohorts were assessed annually via radiographs and the Harris Hip Scores for pain and clinical function. Groin pain persisted in 16.4% of Group 1 and 5.5% of Group 2 (). Thigh pain persisted in 11.5% of Group 1 and 2.2% of Group 2 (). Complications in Group 1 were 4/61 including 2 revisions with an overall survival rate of 96.7% versus Group 2 complication rate of 29/182 with 15 revisions and an overall survival rate of 91.8%. There were no cases of acetabular protrusio in Group 1, but 2 cases (1%) in Group 2 had cup loosening or osteolysis. Two cases were revised in Group 1 (3.2%). Both were undersized femoral stems. The fifteen revisions (8.2%) in Group 2 included loose stem (1), instability (8), infections (3), cup loosening (2), and accelerated polyethylene wear (1). Hemiarthroplasty has a higher incidence of thigh and groin pain but fewer complications compared with total hip arthroplasty.

scholarly journals Prospective study comparing functional outcomes and revision rates between hip resurfacing and total hip arthroplasty: preliminary results for 2 years

2013 ◽  
Vol 5 (3) ◽  
pp. 20 ◽  
Author(s):  
Régis Pailhé ◽  
Nicolas Reina ◽  
Etienne Cavaignac ◽  
Akash Sharma ◽  
Valérie Lafontan ◽  
...  
Keyword(s):  
Total Hip Arthroplasty ◽  
Hip Arthroplasty ◽  
Functional Outcomes ◽  
Hip Resurfacing ◽  
Harris Hip Score ◽  
Preliminary Results ◽  
Total Hip ◽  
Group 2 ◽  
Group 1

There is a need of independent prospective studies about modern generation of hip resurfacing implants. The aim of this propective observational study was to compare the functional outcomes and revision rates with hip resurfacing arthroplasty and total hip arthroplasty and to present the preliminary results at 2 years. Patients included were recruited prospectively in the <em>Partial Pelvic Replacement Hip Project </em>by a single surgeon between January 2007 and January 2010. Patients were assessed with the Harris Hip Score (HHS) and Postel-Merle d’Aubigné (MDA) score and Devane Score. The end point of the study was reoperation for any cause related to the prosthesis. At a mean follow up of 38.6 months there were a total of 142 patients with hip resurfacing (group 1) [100 Durom® (Zimmer Inc., Warsaw, IN, USA) and 42 Birmingham Hip Resurfacing® (Smith &amp; Nephew, Memphis, TN, USA)] and 278 patients with total hip arthroplasty (group 2). The results showed significantly greater gain of HHS, MDA and Devane score with hip resurfacing procedures. However, considering all the complications, the rate was significantly higher in group 16.4% <em>vs</em> 1.79% in group 2 (P&lt;0.0001). In group 1 we observed 6 complications only concerned males with Durom® implants. The follow up of this cohort is still on going and may deliver more information on the evolution of these results in time.

scholarly journals Higher incidence of aseptic loosening caused by a lower canal filling ratio with a modified modular stem in total hip arthroplasty

2020 ◽  
Vol 15 (1) ◽  
Author(s):  
Kyosuke Kobayashi ◽  
Kenichi Kidera ◽  
Masaru Itose ◽  
Tetsuhiko Motokawa ◽  
Ko Chiba ◽  
...  
Keyword(s):  
Survival Rate ◽  
Total Hip Arthroplasty ◽  
Aseptic Loosening ◽  
Hip Arthroplasty ◽  
Filling Ratio ◽  
Long Term Results ◽  
Stable Fixation ◽  
Total Hip ◽  
Modular Prosthesis

Abstract Purpose Although a cementless modular prosthesis has shown reliable results, cases of unstable fixation and revision due to aseptic loosening were observed in our institute. The purpose of this study was to clarify the causes of unstable fixation of the prosthesis. Methods A total of 144 patients (154 hips) who underwent total hip arthroplasty using the modular prosthesis were retrospectively investigated. For the cohort study, 97 patients (104 hips) were included. The femoral component survival rate and sleeve fixation were assessed at a minimum follow-up of 5 years. Patients were divided into 2 groups, including stable and unstable fixation groups, by sleeve fixation. Clinical and radiographic outcomes were compared. Results The Kaplan-Meier survival rate at 9 years was 93% with revision for any reason as the endpoint in study cohort. The reasons for revision were recurrent dislocation (1 hip) and aseptic loosening of the stem (5 hips). A total of 88 hips (84.6%) showed stable fixation, and 16 hips (15.4%) showed unstable fixation at final follow-up. There was no significant difference in clinical outcomes between the 2 groups at final follow-up. The canal flare index was significantly higher, and the canal filling ratio was significantly lower in the unstable fixation group. Conclusion Although the modified modular prosthesis was useful for treating anatomically difficult patients, we need to pay attention to both proximal/distal mismatch of the intramedullary canal and the canal filling ratio to achieve stable fixation and good long-term results.

Pharmacological reduction of bleeding during hip endoprosthetic replacement

2012 ◽  
Vol 153 (41) ◽  
pp. 1607-1612 ◽  
Author(s):  
Tamás de Jonge
Keyword(s):  
Total Hip Arthroplasty ◽  
Blood Loss ◽  
Tranexamic Acid ◽  
Hip Arthroplasty ◽  
Red Cells ◽  
Postoperative Blood Loss ◽  
Total Hip ◽  
Group 2 ◽  
Primary Total Hip Arthroplasty ◽  
Group 1

Introduction: Endoprosthetic replacement of the large joints is accompanied by major bleeding. During the last few years several authors reported the perioperative administration of tranexamic acid and its beneficial effect on reducing the blood loss. Objectives: In the present study, the author studied the effect of intravenously administered tranexamic acid in patients undergoing primary total hip arthroplasty in order to examine whether this treatment could reduce postoperative blood loss, the amount of transfused packed red cells, and the cost of the blood saving and/or transfusion. Methods: The author compared retrospectively the data of 104 patients undergoing primary total hip arthroplasty between April, 2010 and December, 2011. 54 patients were administered tranexamic acid (Group 1) and 50 patients were treated without tranexamic acid (Group 2). The amount of postoperative bleeding, haemoglobin, hematocrit, red blood cell count, and the number of units of the transfused packed red cells were recorded. Cost effectiveness of treatment with tranexamic acid was calculated. Results: Postoperative blood loss in Group 1 was 732 ml (210–1280 ml), and in Group 2 1092 ml (420–2640 ml). Ten of the 54 patients in Group 1 had to be transfused, and the all-over need was 20 units of packed red cells. 49 of the 50 patients in Group 2 received 98 units of allogenic blood. Thromboembolic complication was not observed in connection with the use of tranexamic acid. The reduction of blood loss with the application of tranexamic acid and the transfused packed red cells cost in average 5,180 HUF per patient in Group 1 and 15,850 HUF in Group 2. Conclusions: Intravenous administration of tranexamic acid reduces effectively the transfusion rate and the blood loss in the postoperative period in patients undergoing primary total hip arthroplasty. More than 1.5 million HUF and 240 units of packed red cells could be yearly saved with the introduction of this simple, safe and cheap method of drug administered blood conservation. Orv. Hetil., 2012, 153, 1607–1612.

scholarly journals The Accuracy of Acetabular Cup Placement in Primary Total Hip Arthroplasty Using an Image-free Navigation System

2021 ◽  
Author(s):  
Yohei Naito ◽  
Masahiro Hasegawa ◽  
Shine Tone ◽  
Hiroki Wakabayashi ◽  
Akihiro Sudo
Keyword(s):  
Total Hip Arthroplasty ◽  
Hip Arthroplasty ◽  
Navigation System ◽  
Control Group ◽  
Navigation Systems ◽  
Total Hip ◽  
Navigation Group ◽  
The Mean ◽  
Group 2 ◽  
Group 1

Abstract Background: Intraoperative navigation systems have been shown to improve the accuracy of acetabular component insertion in total hip arthroplasty (THA). The purpose of this study was to investigate the accuracy of cup orientation in primary THA using an image-free navigation system.Methods: A total of 107 consecutive cementless THAs using an image-free navigation system were performed from February 2017 to March 2020 (the navigation group). As a control group, 77 retrospective consecutive cases who underwent THAs with manual implant-techniques between February 2012 and April 2017 were included. Postoperative cup radiographic inclination and radiographic anteversion relative to the functional pelvic plane were assessed using a 3D-template system after computed tomography (CT) examination.Results: The mean absolute errors of the postoperative measured angles from the target angles in inclination were 3.4°±3.0° in the navigation group and 8.4°±6.6° in the control group (p<0.001). The mean absolute errors in anteversion were 5.1° ± 3.6° in the navigation group and 10.8° ± 6.5° in the control group (p<0.001). The percentage of cups inside the Lewinnek safe zone was 93% in the navigation group and 44% in the control group (p<0.001). The mean absolute values of navigation error were 3.3° ± 2.8° in inclination and 5.8° ± 4.9° in anteversion. Among the cases of osteoarthritis, the inclination error was significantly higher in Crowe group 2 to 4 than in Crowe group 1 (5.1° ± 3.5° and 3.0° ± 2.5°, respectively, p<0.05). The percentage of hips with inclination error over 10° in Crowe group 2 to 4 was significantly higher than in Crowe group 1 (17% and 1%, respectively, p<0.05).Conclusions: The image-free navigation system improved the accuracy of cup orientation. The accuracy of cup position was less in Crowe group 2 to 4 than in Crowe group 1.

scholarly journals Invasive Electromagnetic Field Treatment in Osteonecrosis of the Femoral Head: A Prospective Cohort Study

2014 ◽  
Vol 8 (1) ◽  
pp. 125-129 ◽  
Author(s):  
C. Windisch ◽  
W. Kolb ◽  
E. Röhner ◽  
M. Wagner ◽  
A. Roth ◽  
...  
Keyword(s):  
Electromagnetic Field ◽  
Total Hip Arthroplasty ◽  
Hip Arthroplasty ◽  
Bone Grafting ◽  
Harris Hip Score ◽  
Total Hip ◽  
Group 2 ◽  
Modified Harris Hip Score ◽  
Group 1

Introduction : The purpose of this prospective cohort study was to compare the surgical treatment of non-ONFH in adulthood by curettage and bone grafting with treatment by curettage and bone grafting in combination with invasive electromagnetic field treatment using Magnetodyn®. This was assessed by examining whether electromagnetic field treatment has a positive additive effect on the clinical parameters modified Harris Hip Score according to Haddad, Cook and Brinker, Merle d'Aubigné hip score and visual analogue scale, and on the subsequent need for treatment by total hip arthroplasty. Materials and Methodology : The prospective, non-randomised study included 35 patients with unilateral or bilateral osteonecrosis of the femoral head. These were divided into two groups according to the surgical treatment regime and assessed over a 12-month follow-up period. The study group (Group 1) comprised 19 patients (14 men and 5 women) with a total of 22 non-ONFH, who underwent minimally invasive curettage, bone grafting and electromagnetic field treatment (Magnetodyn®) by implantation of a bipolar induction screw. The control group (Group 2) comprised 16 patients (12 men and 4 women) with a total of 18 non-ONFH, who underwent minimally invasive curettage and bone grafting without Magnetodyn® therapy. At the initial pre-operative examination and the 6 and 12-month follow-up, all patients were assessed by clinical examination and radiological monitoring, and by bilateral hip MRI. The clinical evaluation was based on the modified Harris Hip Score according to Haddad, Cook and Brinker, the Merle d`Aubigné hip score and the visual analogue scale (VAS). Results : At the time of follow-up, total hip arthroplasty (THA) had been performed in four patients in Group 1 (18%). In Group 2, four patients (22%) had received a THA (n.s.). Both procedures led to an improvement in the clinical scores (Harris Hip Score, Merle d`Aubigné score and VAS), although no significant difference was observed. Conclusion : The authors conclude that electromagnetic field treatment with Magnetodyn®, using the special signal protocol applied here, as an adjunct to curettage and autologous bone grafting to treat non-ONFH, does not produce better clinical results and does not offer better prophylaxis for the avoidance of total hip arthroplasty over all ARCO stages.

scholarly journals An Intensive Perioperative Regimen of Pregabalin and Celecoxib Reduces Pain and Improves Physical Function Scores Six Weeks after Total Hip Arthroplasty: A Prospective Randomized Controlled Trial

2013 ◽  
Vol 18 (3) ◽  
pp. 127-132 ◽  
Author(s):  
Nicole ME Carmichael ◽  
Joel Katz ◽  
Hance Clarke ◽  
Deborah Kennedy ◽  
Hans J Kreder ◽  
...  
Keyword(s):  
Total Hip Arthroplasty ◽  
Physical Function ◽  
Hip Arthroplasty ◽  
Test Performance ◽  
Controlled Trial ◽  
Total Hip ◽  
Significant Difference ◽  
Group 2 ◽  
Poor Outcomes ◽  
Group 1

BACKGROUND: Despite the success of total hip arthroplasty (THA), some patients experience persistent pain and poor function after surgery. Predictors of poor outcomes include the presence of significant pre- and postoperative pain. Patients undergoing THA often experience severe, longstanding pain before surgery that may compromise the outcome of the procedure.OBJECTIVES: To evaluate the effects of administering pregabalin and celecoxib for two weeks before and three weeks after THA in patients with moderate to severe pain before surgery. The aim was to determine whether patients with well-controlled pain both before surgery and in the acute postoperative period experience less pain and better physical function six weeks after THA.METHODS: A randomized, double-blinded, placebo-controlled pilot study was conducted. Group 1 received pregabalin (75 mg twice per day) and celecoxib (100 mg twice per day) for 14 days before THA and for three weeks after discharge. Group 2 received a placebo for the same duration. All patients received pregabalin and celecoxib 2 h before surgery and while in the hospital.RESULTS: On the morning of surgery, patients in group 1 reported less pain at rest (mean [± SD] pain intensity measured on a visual analogue scale [VAS] 2.1±1.4) compared with group 2 (3.3±1.9; P=0.04). Patients in group 1 experienced less pain 3 h to 4 h postoperation (P<0.001). There was no difference in morphine consumption between the two groups. Six weeks after THA, movement-evoked pain was lower in group 1 (VAS 0.8±0.6) compared with group 2 (VAS 2.0±1.3; P=0.01). Group 1 reported better physical function, measured using the Western Ontario and McMaster University Osteoarthritis Index questionnaire score (P=0.04). There was no significant difference in 6 min walk test performance between the two groups.CONCLUSION: Intensive pain control with pregabalin and celecoxib improves pain and physical function after THA.

Paclitaxel and Carboplatin, Alone or With Irradiation, in Advanced or Recurrent Endometrial Cancer: A Phase II Study

2001 ◽  
Vol 19 (20) ◽  
pp. 4048-4053 ◽  
Author(s):  
Paul J. Hoskins ◽  
Kenneth D. Swenerton ◽  
Judith A. Pike ◽  
Frances Wong ◽  
Peter Lim ◽  
...  
Keyword(s):  
Overall Survival ◽  
Survival Rate ◽  
Survival Time ◽  
Area Under The Curve ◽  
Overall Survival Rate ◽  
Free Survival ◽  
Group 3 ◽  
Endometrial Cancers ◽  
Group 2 ◽  
Group 1

PURPOSE: To evaluate the efficacy of carboplatin plus paclitaxel in primarily advanced or recurrent endometrial cancers. PATIENTS AND METHODS: Four distinct patient groups received carboplatin (area under the curve, 5 to 7) plus paclitaxel 175 mg/m2 for 3 hours at 4-week intervals: group 1 (n = 21), patients with primarily advanced, nonpapillary serous cancers; group 2 (n = 20), the same as group 1 but with papillary serous cancers; group 3 (n = 18), recurrent, nonpapillary serous cancers; and group 4 (n = 4), recurrent, papillary serous cancers. Involved-field irradiation was used in groups 1 and 2 for those with radioencompassable disease. RESULTS: Sixty-three patients were treated. Response rates to chemotherapy in the assessable patients in the four groups were 78% (95% confidence interval [CI], 51% to 100%); 60% (95% CI, 35% to 85%), 56% (95% CI, 34% to 78%), and 50%, respectively. Nineteen patients (90%) in group 1 also were irradiated, and the median failure-free survival time for all 21 patients was 23 months, with a 62% 3-year overall survival rate. Eleven patients (55%) in group 2 were irradiated, and the median failure-free survival time for all 18 patients was 18 months, with a 39% 3-year overall survival rate. The median failure-free interval in the patients in group 3 was 6 months, with a 15-month median overall survival time. Toxicity was manageable, reversible, and predominantly hematologic. Two patients developed neutropenic fever, and three patients, including these two, were hospitalized for complications. CONCLUSION: Carboplatin-paclitaxel is an efficacious, low-toxicity regimen for managing primarily advanced or recurrent endometrial cancers.

Total hip arthroplasty after acetabular fracture: does initial treatment make any difference to the outcome? A 5- to 23-year follow-up with clinical and radiological analysis

2019 ◽  
Vol 30 (3) ◽  
pp. 339-346 ◽  
Author(s):  
Eduardo García-Rey ◽  
Rossella Sirianni ◽  
Eduardo García-Cimbrelo ◽  
Laurent Sedel
Keyword(s):  
Total Hip Arthroplasty ◽  
Hip Arthroplasty ◽  
Acetabular Fracture ◽  
Initial Treatment ◽  
Acetabular Reconstruction ◽  
Total Hip ◽  
The Mean ◽  
Group 2 ◽  
Group 1

Purpose: To determine if initial treatment affects the outcome of total hip arthroplasty (THA) after acetabular fracture. Methods: 49 patients (49 hips) initially treated non-operatively followed some months later by THA in conjunction with acetabular reconstruction (Group 1) and 29 patients (29 hips) who had undergone THA after a previous osteosynthesis (Group 2) were assessed. The mean follow-up was 11.7 (range 5–23) years. Results: 3 acetabular components were revised for aseptic loosening in Group 1 and 2 in Group 2. The survival rate for cup loosening at 16 years was 90.6% (95% confidence interval [CI], 78.1–100) for Group 1 and 94.1% (95% CI, 86.5–100) for Group 2 ( p = 0.76). There were 2 sciatic palsies in Group 2 after osteosynthesis. The mean preoperative clinical score and postoperative range of mobility were better in Group 1. There were more heterotopic ossifications in Group 2. Conclusion: Despite the good results found in both groups, THA after previous osteosynthesis for acetabular fractures had more complications than a primary THA in conjunction with acetabular reconstruction.

scholarly journals The accuracy of acetabular cup placement in primary total hip arthroplasty using an image-free navigation system

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Yohei Naito ◽  
Masahiro Hasegawa ◽  
Shine Tone ◽  
Hiroki Wakabayashi ◽  
Akihiro Sudo
Keyword(s):  
Total Hip Arthroplasty ◽  
Hip Arthroplasty ◽  
Navigation System ◽  
Control Group ◽  
Navigation Systems ◽  
Total Hip ◽  
Navigation Group ◽  
The Mean ◽  
Group 2 ◽  
Group 1

Abstract Background Intraoperative navigation systems have been shown to improve the accuracy of acetabular component insertion in total hip arthroplasty (THA). The purpose of this study was to investigate the accuracy of cup orientation in primary THA using an image-free navigation system. Methods A total of 107 consecutive cementless THAs using an image-free navigation system were performed from February 2017 to March 2020 (the navigation group). As a control group, 77 retrospective consecutive cases who underwent THAs with manual implant-techniques between February 2012 and April 2017 were included. Postoperative cup radiographic inclination and radiographic anteversion relative to the functional pelvic plane were assessed using a 3D-template system after computed tomography (CT) examination. Results The mean absolute errors of the postoperative measured angles from the target angles in inclination were 3.4° ± 3.0° in the navigation group and 8.4° ± 6.6° in the control group (p < 0.001). The mean absolute errors in anteversion were 5.1° ± 3.6° in the navigation group and 10.8° ± 6.5° in the control group (p < 0.001). The percentage of cups inside the Lewinnek safe zone was 93% in the navigation group and 44% in the control group (p < 0.001). The mean absolute values of navigation error were 3.3° ± 2.8° in inclination and 5.8° ± 4.9° in anteversion. Among the cases of osteoarthritis, the inclination error was significantly higher in Crowe group 2 to 4 than in Crowe group 1 (5.1° ± 3.5° and 3.0° ± 2.5°, respectively, p < 0.05). The percentage of hips with inclination error over 10° in Crowe group 2 to 4 was significantly higher than in Crowe group 1 (17 and 1%, respectively, p < 0.05). Conclusions The image-free navigation system improved the accuracy of cup orientation. The accuracy of cup position was less in Crowe group 2 to 4 than in Crowe group 1.

3rd generation ceramic-on-ceramic cementless total hip arthroplasty: a minimum 10-year follow-up study

2018 ◽  
Vol 28 (2) ◽  
pp. 133-138 ◽  
Author(s):  
Yeong J. Lau ◽  
Shashank Sarmah ◽  
Johan D. Witt
Keyword(s):  
Total Hip Arthroplasty ◽  
Hip Arthroplasty ◽  
Senior Author ◽  
Long Term Results ◽  
Abduction Angle ◽  
Wear Properties ◽  
Total Hip ◽  
Ceramic On Ceramic

Introduction: 3rd generation ceramic bearings were introduced in total hip arthroplasty (THA) with the potential to have better mechanical strength and wear properties than their predecessors. At present, there are few studies looking at the long-term results of this latest generation of ceramic bearings. The purpose of our study was to investigate the long-term clinical and radiographic results of 3rd generation ceramic-on-ceramic THA and the incidence of ceramic specific complications such as squeaking and bearing surface fracture. Methods: The database of the senior author (J.D.W.) was reviewed. A total of 126 hip replacements performed in 108 patients (average age 39.6 years) with an average follow-up of 12.1 years (10-16 years) was identified. Clinical notes and plain radiographs were reviewed. To measure function, patients were contacted and an Oxford Hip Questionnaire was completed. Patients were also directly questioned about the presence of squeaking or any other sounds from the hip. Radiographs were evaluated for signs of wear, osteolysis, loosening and heterotopic ossification. The abduction angle of the acetabular component was measured. Results: The average Oxford Hip Score was 39.8 out of 48. Survivorship at 10 years was 94.6% (95% CI) with revision for any cause as the endpoint. There was 1 femoral head fracture, no osteolysis, no squeaking and no detectable wear. Conclusions: The good clinical and radiographic results for this series of patients are similar to other recent long-term studies looking at 3rd generation ceramic-on-ceramic THA. The results compare favourably with other bearing surfaces. The lack of osteolysis associated with this articulation is encouraging and may also make it a good choice for younger patients requiring total hip replacement.

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