Total hip arthroplasty in Cambodia – Our experience of two hundred and fifty six consecutive total hip arthroplasties in a low-income country & the challenge of service delivery in this setting

2022 ◽  
pp. 004947552110476
Author(s):  
J Shelton ◽  
S Dorman ◽  
K Long ◽  
H Oy ◽  
O Ngiep ◽  
...  
Keyword(s):  
Aseptic Loosening ◽  
Low Income ◽  
Primary Outcome ◽  
Secondary Outcome ◽  
Complication Rates ◽  
Total Hip ◽  
Low Income Country ◽  
Stem Fracture ◽  
Physical Case ◽  
Hip Arthroplasties

The Children's Surgical Centre has performed 256 THAs since 2007, We aim to assess the outcome of arthroplasty in a LMIC. Primary outcome: all cause of re-operation, Secondary outcome: any other complication. A retrospective review of all consecutive THA since 2007 was conducted. Electronic and physical case notes were reviewed. Statistical analysis was performed using MedCalc. 256 THA. Mean age: 43, gender M2:1F. Common pathologies include (1) AVN (44%), (2) OA (11%) and (3) DDH (11%). Revision rate 13%. Time to revision was 2.8 years (0–9). Common revision reasons: (1) stem fracture (5.8%), (2) aseptic loosening (4.8%) and (3) infection (2.7%). Complications were identified in 85 patients (33.2%). Common complications included (1) aseptic loosening (10.5%) (2) stem fracture (5.8%) and (3) dislocation (5.8%). Patients at CSC benefit from THA, the complication rates at CSC are declining suggesting the apex of the ‘learning curve’ has passed. Cheap poorly manufactured implants continue to cause catastrophic failure.

Aseptic Loosening of Metal-on-Metal (MOM) Total Hip Arthroplasties (THA) with Large-Diameter Heads

2013 ◽  
pp. 141-151
Author(s):  
Christoph H. Lohmann ◽  
G. Singh ◽  
G. Goldau ◽  
T. Müller ◽  
B. Feuerstein ◽  
...  
Keyword(s):  
Aseptic Loosening ◽  
Large Diameter ◽  
Total Hip ◽  
Metal On Metal ◽  
Hip Arthroplasties

scholarly journals The Role of Oxidative Stress in Aseptic Loosening of Total Hip Arthroplasties

2014 ◽  
Vol 29 (4) ◽  
pp. 843-849 ◽  
Author(s):  
Marla J. Steinbeck ◽  
Lauren J. Jablonowski ◽  
Javad Parvizi ◽  
Theresa A. Freeman
Keyword(s):  
Oxidative Stress ◽  
Aseptic Loosening ◽  
Total Hip ◽  
Hip Arthroplasties

Survival of Hydroxy Apatite-Coated Cups: Acetabular Screws Involve a Lower Rate of Revision Surgery due to Aseptic Loosening

2017 ◽  
Vol 27 (2) ◽  
pp. 153-161 ◽  
Author(s):  
Luis Natera ◽  
Marius Valera ◽  
Esther Moya Gómez ◽  
Natalia Ibañez ◽  
Xavier Crusi ◽  
...  
Keyword(s):  
Aseptic Loosening ◽  
Revision Surgery ◽  
Statistical Relationship ◽  
Hydroxy Apatite ◽  
Multicentric Study ◽  
Total Hip ◽  
Hip Arthroplasties ◽  
The Relationship

Background It is believed that the path of acetabular screws may represent a shuttle between hydroxyapatite (HA) particles and the liner. The aim was to assess the relationship between acetabular screws and revision surgery for aseptic loosening in total hip arthroplasties (THAs). Material and methods A retrospective multicentric study was performed. Patients older than 18 years and patients who underwent THA with both the stem and cup HA-coated were included. The rate of revision-surgery considering only aseptic loosening was calculated. The proportion of cases in which acetabular screws were used was registered, as well as the proportion of cups that showed osteolysis. The statistical relationship between acetabular screws and osteolysis, as well as acetabular screws and revision-surgery for aseptic loosening were assessed. Results There were 749 cases. Mean age 62.1 (45–84) years. Mean follow-up 14.19 (8.9-16.7) years. Revision surgery was performed in 12.8% (96/749) of the cups. 73.95% (71/96) of the revised cups showed aseptic loosening. The overall 15-year survival of the cups considering only aseptic loosening was 84.4%. Acetabular screws were used in 47.5% (356/749) of the cups. Acetabular screws were used in 40.44% (55/136) of the cups that showed osteolysis. The use of acetabular screws was associated with less osteolysis (p = 0.006). Acetabular screws were used in 35.21% (25/71) of the cups that were revised for aseptic loosening. The use of acetabular screws was associated with a lower rate of revision surgery (p = 0.020). Conclusions In THA with the stem and cup HA-coated, the use of acetabular screws is associated with a lower rate of revision surgery.

scholarly journals 166 Dual Mobility for Total Hip Arthroplasty Revision Surgery: A Systematic Review and Metanalysis

2021 ◽  
Vol 108 (Supplement_2) ◽  
Author(s):  
P Antinolfi ◽  
V Pace ◽  
G Placella ◽  
G Bettinelli ◽  
V Salini
Keyword(s):  
Total Hip Arthroplasty ◽  
Aseptic Loosening ◽  
Risk Ratio ◽  
Hip Arthroplasty ◽  
Dislocation Rate ◽  
Current Evidence ◽  
Secondary Outcome ◽  
Dual Mobility ◽  
Total Hip ◽  
Significant Difference

Abstract Dual Mobility (DM) implants provide greater stability especially in Revision Total Hip Arthroplasty (R-THA) when compared to primary THA. Aim: to identify the current evidence regarding outcomes of DM in R-THA when compared to fixed-bearing (FB) implants. Review in accordance with PRISMA guidelines. Structured electronic searches. Primary outcome measure: dislocation rate following R-THA. Secondary outcome measures: implant survival, aseptic loosening, infection rate. Studies' methodology quality assessed using MINORS criteria. All articles published from 2016 to December 2019 included. 1777 R-THAs were reported (49.9% with DM acetabular component, 50.1% with FB component). Sample size: 67-426 patients. Mean age: 57-73. Mean follow-up period: 12-60 months. Significant risk ratio of 1.08 [1.05, 1.12] (95% CI, I2 = 37%, P < 0.00001) with statistically significant difference between the two groups in favour of DM implant. Statistically significant difference in favour of DM group with respect to dislocation rate (risk ratio 0.22, 95% CI; P < 0.00001) and aseptic loosening (risk ratio 0.51, 95% CI; P < 0.05). No statistical difference between the groups on risk ratio for infection 0.94 (95% CI; P = 0.85). DM implants are beneficial in R-THA when compared to FB implants. However, one needs to balance the benefits of using DM implant considering the patient’s clinical conditions and the costs involved.

scholarly journals A higher degree of polyethylene irradiation is associated with a reduced risk of revision for aseptic loosening in total hip arthroplasties using cemented acetabular components

2020 ◽  
Vol 9 (9) ◽  
pp. 563-571
Author(s):  
Edward T. Davis ◽  
Joseph Pagkalos ◽  
Branko Kopjar
Keyword(s):  
Aseptic Loosening ◽  
Cox Regression ◽  
Cox Model ◽  
Statistical Modelling ◽  
Patient Characteristics ◽  
Study Data ◽  
Total Hip ◽  
Risk Of Death ◽  
Hip Arthroplasties ◽  
Reduced Risk

Aims To investigate the effect of polyethylene manufacturing characteristics and irradiation dose on the survival of cemented and reverse hybrid total hip arthroplasties (THAs). Methods In this registry study, data from the National Joint Registry of England, Wales, Northern Ireland and the Isle of Man (NJR) were linked with manufacturing data supplied by manufacturers. The primary endpoint was revision of any component. Cox proportional hazard regression was a primary analytic approach adjusting for competing risk of death, patient characteristics, head composition, and stem fixation. Results A total of 290,770 primary THAs were successfully linked with manufacturing characteristics. Overall 4,708 revisions were analyzed, 1,260 of which were due to aseptic loosening. Total radiation dose was identified as a risk factor and included in the Cox model. For statistical modelling of aseptic loosening, THAs were grouped into three categories: G1 (no radiation); G2 ( > 0 to < 5 Mrad); and G3 ( ≥ 5 Mrad). G1 had the worst survivorship. The Cox regression hazard ratio for revision due to aseptic loosening for G2 was 0.7 (95% confidence interval (CI) 0.58 to 0.83), and for G3 0.4 (95% CI 0.30 to 0.53). Male sex and uncemented stem fixation were associated with higher risk of revision and ceramic heads with lower risk. Conclusion Polyethylene irradiation was associated with reduced risk of revision for aseptic loosening. Radiation doses of ≥ 5 Mrad were associated with a further reduction in risk. Cite this article: Bone Joint Res 2020;9(9):563–571.

scholarly journals Survival at 11 to 21 years for 779 Metasul® metal-on-metal total hip arthroplasties

2020 ◽  
Vol 28 (2) ◽  
pp. 230949902092626
Author(s):  
Roger Erivan ◽  
Guillaume Villatte ◽  
Stéphane Millerioux ◽  
Aurélien Mulliez ◽  
Stéphane Descamps ◽  
...  
Keyword(s):  
Survival Rate ◽  
Aseptic Loosening ◽  
Surface Coating ◽  
P Value ◽  
Level Of Evidence ◽  
Total Hip ◽  
Metal On Metal ◽  
Hip Arthroplasties ◽  
Oxford Score

Background: Total hip arthroplasties (THAs) bearing is one of the most important factors for hip replacement because THA survival depends on it. Metal-on-metal (MoM) bearing has lower wear than metal-on-polyethylene but lot of aseptic loosening decrease utilization. We analyze the survival rate of 28 mm Metasul® bearings after a mean follow-up of 12.9 years. Methods: The main objective of this study was to evaluate the survival of the MoM. We evaluate 779 consecutive THAs performed between January 1995 and December 2005 for primary osteoarthritis, congenital dysplasia classified Crowe I, or rheumatoid arthritis. Survival rate was calculated by the Kaplan–Meir method. The association between survival and age, gender, body mass index (BMI), and surface coating was investigated with a proportional odds model. The clinical assessment included Oxford score. Results: Six hundred fifty-two THAs were reviewed. Sixty-two revisions (9.5%) were performed including 34 aseptic loosening and 11 deep infections. The survival for prosthesis with any reason at 20 years was 87% (confidence interval (CI) 83–90.2) for aseptic loosening at 20 years was 90.1% (CI 87–93.8). There was no association with age, BMI, and surface coating. Gender was significant with lower aseptic loosening for men, hazard ratio = 0.45, p value = 0.035. Oxford score was 57 ± 6.7 (19–60). Conclusion: The survival rate of Metasul was well and seems to be like our clinical finding. However, radiographic aseptic loosening without surgery is not included in the survival rate. The Oxford score was very good with a lot of patients with asymptomatic hip. Level of Evidence: Level IV/Retrospective study

scholarly journals Total Hip Arthroplasty in a Low-Income Country

2019 ◽  
Vol 4 (4) ◽  
pp. e0027
Author(s):  
Simon Matthew Graham ◽  
Nicholas Howard ◽  
Chipiliro Moffat ◽  
Nicholas Lubega ◽  
Nyengo Mkandawire ◽  
...  
Keyword(s):  
Total Hip Arthroplasty ◽  
Hip Arthroplasty ◽  
Low Income ◽  
Income Country ◽  
Total Hip ◽  
Low Income Country
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