Incidence, risk factors and prognosis of transient pseudosubluxation after total hip arthroplasty

Introduction: Pseudosubluxation is a transient separation of the prosthetic femoral head from the acetabular liner during the anaesthetic period after total hip arthroplasty (THA). However, little is known about the frequency, pathomechanism, risk factors or natural history. Methods: To determine the incidence, direction of the displacement, risk factors and subsequent instability of pseudosubluxation, we evaluated 1099 primary cementless THAs (943 patients), which were performed during 8 years at one institution. Immediately after THA, postoperative radiographs were obtained for all hips. If a subluxation was noted, the operated hip was examined by fluoroscope within 1 hour of the detection and repeat radiographs were taken on the postoperative day 1. Results: The pseudosubluxation was identified in 2.6% (28/1059). All of the 28 heads subluxed anteriorly and reduced in flexion-internal rotation. In multivariate analysis: (1) operative decrease of the femoral offset (odds ratio; 1.161 (95% confidence interval [CI]; 1.077–1.251), p = 0.001); and (2) medialisation of acetabular cup (odds ratio; 3.402 (95% CI; 1.482–7.813), p = 0.009) were found as risk factors for pseudosubluxation. None of the 28 hips dislocated during 3- to 8-year follow-up. Conclusions: Our results provide information about the incidence, risk factors and natural history of pseudosubluxation after primary THA. Surgeons should be aware of the risk of pseudosubluxation when performing THA in patients with coxa vara, who have a large femoral offset, and in those with dysplastic or deficient acetabulum, who have a lateral centre of rotation.

Download Full-text

Incidence, Risk Factors, and Nomogram of Transfusion and Associated Complications in Nonfracture Patients following Total Hip Arthroplasty

BioMed Research International ◽

10.1155/2020/2928945 ◽

2020 ◽

Vol 2020 ◽

pp. 1-11

Author(s):

Yuanhe Wang ◽

Cui Wang ◽

Chuan Hu ◽

Bo Chen ◽

Jianyi Li ◽

...

Keyword(s):

Risk Factors ◽

Total Hip Arthroplasty ◽

Hip Arthroplasty ◽

Operating Characteristic ◽

Characteristic Curve ◽

Area Under The Curve ◽

Related Factors ◽

Total Hip ◽

Incidence Risk ◽

Single Predictor

The incidence, risk factors, and associated complications of perioperative transfusion in nonfracture patients following total hip arthroplasty (THA) are unclear. The aim of the present research was to study the predictors of transfusion risk in nonfracture patients following THA and develop a nomogram. One thousand six hundred and thirty-five patients who underwent THA due to nonfracture disease in our institution between September 2013 and July 2017 were included. Independent predictors of transfusion were identified by univariate, LASSO, and multivariate analyses. A nomogram was established based on independent predictors. In addition, a prospective cohort was used to validate the nomogram. The area under the receiver operating characteristic curve was utilized to evaluate the discrimination of the nomogram. Calibration and decision curve analyses were established to evaluate the nomogram. In addition, the association between perioperative transfusion and 30- and 90-day complications was studied. The incidence of transfusion was 15.78%, and 10 independent predictors were confirmed. The areas under the curve of the nomogram were 0.834 and 0.867 in the training and validation cohorts, respectively. Moreover, the area under the curve of the nomogram was significantly higher than that of any single predictor in both the training and validation cohorts. Calibration curve and decision curve analyses in both the training and validation cohorts showed good performance of the nomogram. In addition, perioperative transfusion was identified as an independent risk factor for both 30- and 90-day complications. Generally, ten transfusion-related factors for nonfracture patients following THA were identified. A validated nomogram was established, and several adverse events were confirmed to be associated with transfusion.

Download Full-text

Incidence, Risk Factors, and Outcome of Ceramic-On-Ceramic Bearing Breakage in Total Hip Arthroplasty

The Journal of Arthroplasty ◽

10.1016/j.arth.2021.03.021 ◽

2021 ◽

Author(s):

Wayne Hoskins ◽

Sophia Rainbird ◽

Yi Peng ◽

Michelle Lorimer ◽

Stephen E. Graves ◽

...

Keyword(s):

Risk Factors ◽

Total Hip Arthroplasty ◽

Hip Arthroplasty ◽

Total Hip ◽

Ceramic Bearing ◽

Incidence Risk ◽

Ceramic On Ceramic

Download Full-text

Epidemiological Study of Femoral Head Osteonecrosis

Revista de Chimie ◽

10.37358/rc.17.5.5593 ◽

2017 ◽

Vol 68 (5) ◽

pp. 974-976

Author(s):

Alexandru Patrascu ◽

Liliana Savin ◽

Dan Mihailescu ◽

Victor Grigorescu ◽

carmen Grierosu ◽

...

Keyword(s):

Risk Factors ◽

Femoral Head ◽

Total Hip Arthroplasty ◽

Hip Arthroplasty ◽

Young Patients ◽

Head Group ◽

Bipolar Hemiarthroplasty ◽

Aseptic Necrosis ◽

Total Hip ◽

Femoral Head Osteonecrosis

In recent years, there has been an increase in the number of studies on the etiology of femoral head necrosis. We retrospectively reviewed all patients diagnosed with aseptic necrosis of the femoral in the period of 2010-2015. We recorded a total of 230 cases diagnosed with aseptic necrosis of the femoral head, group was composed of 65.7% men and 34.3% women, risk factors identified was 19.13% (post-traumatic), 13.91% (glucocorticoids), 26.52% (alcohol), 3.47% (another cause) and in 36 95% of the cases no risk factors were found. The results of the study based on the type of surgery performed on the basis of stages of disease progression, 8 patients (3.48%) benefited from osteotomy, 28 patients (12.17%) benefited of bipolar hemiarthroplasty prosthesis and 188 patients (81.74%) benefited of total hip arthroplasty. Osteonecrosis of the femoral head is characteristic to young patients between the age of 30-50 years old. Predisposing factors, alcohol and corticosteroid therapy remains an important cause of the disease. Total hip arthroplasty remains the best option for the patients with osteonecrosis of the femoral head.

Download Full-text

Value of 3D Preoperative Planning for Primary Total Hip Arthroplasty Based on Biplanar Weightbearing Radiographs

BioMed Research International ◽

10.1155/2019/1932191 ◽

2019 ◽

Vol 2019 ◽

pp. 1-7 ◽

Cited By ~ 6

Author(s):

Y. Knafo ◽

F. Houfani ◽

B. Zaharia ◽

F. Egrise ◽

I. Clerc-Urmès ◽

...

Keyword(s):

Total Hip Arthroplasty ◽

Hip Arthroplasty ◽

Preoperative Planning ◽

Femoral Stem ◽

Leg Length ◽

Femoral Offset ◽

Postoperative Result ◽

Total Hip ◽

Planning Software ◽

Navigated Surgery

Two-dimensional (2D) planning on standard radiographs for total hip arthroplasty may not be sufficiently accurate to predict implant sizing or restore leg length and femoral offset, whereas 3D planning avoids magnification and projection errors. Furthermore, weightbearing measures are not available with computed tomography (CT) and leg length and offset are rarely checked postoperatively using any imaging modality. Navigation can usually achieve a surgical plan precisely, but the choice of that plan remains key, which is best guided by preoperative planning. The study objectives were therefore to (1) evaluate the accuracy of stem/cup size prediction using dedicated 3D planning software based on biplanar radiographic imaging under weightbearing and (2) compare the preplanned leg length and femoral offset with the postoperative result. This single-centre, single-surgeon prospective study consisted of a cohort of 33 patients operated on over 24 months. The routine clinical workflow consisted of preoperative biplanar weightbearing imaging, 3D surgical planning, navigated surgery to execute the plan, and postoperative biplanar imaging to verify the radiological outcomes in 3D weightbearing. 3D planning was performed with the dedicated hipEOS® planning software to determine stem and cup size and position, plus 3D anatomical and functional parameters, in particular variations in leg length and femoral offset. Component size planning accuracy was 94% (31/33) within one size for the femoral stem and 100% (33/33) within one size for the acetabular cup. There were no significant differences between planned versus implanted femoral stem size or planned versus measured changes in leg length or offset. Cup size did differ significantly, tending towards implanting one size larger when there was a difference. Biplanar radiographs plus hipEOS planning software showed good reliability for predicting implant size, leg length, and femoral offset and postoperatively provided a check on the navigated surgery. Compared to previous studies, the predictive results were better than 2D planning on conventional radiography and equal to 3D planning on CT images, with lower radiation dose, and in the weightbearing position.

Download Full-text

CT-based automated planning of acetabular cup for total hip arthroplasty (THA) based on hybrid use of two statistical atlases

International Journal of Computer Assisted Radiology and Surgery ◽

10.1007/s11548-016-1428-x ◽

2016 ◽

Vol 11 (12) ◽

pp. 2253-2271 ◽

Cited By ~ 4

Author(s):

Yoshiyuki Kagiyama ◽

Itaru Otomaru ◽

Masaki Takao ◽

Nobuhiko Sugano ◽

Masahiko Nakamoto ◽

...

Keyword(s):

Total Hip Arthroplasty ◽

Hip Arthroplasty ◽

Automated Planning ◽

Acetabular Cup ◽

Total Hip

Download Full-text

Assessment of an Orthopaedic Templating Software Package for Uncemented Total Hip Arthroplasty

The Journal of Hip Surgery ◽

10.1055/s-0040-1716575 ◽

2020 ◽

Vol 4 (04) ◽

pp. 155-157

Author(s):

Michael Newman ◽

David Hartwright

Keyword(s):

Total Hip Arthroplasty ◽

Hip Arthroplasty ◽

Acetabular Cup ◽

Total Hip ◽

Pelvic Radiograph ◽

Uncemented Total Hip Arthroplasty ◽

Femoral Stems ◽

Hip Arthroplasties ◽

Acetabular Components ◽

Insight Into

AbstractThe aim of this study was to assess a large, single-surgeon dataset of uncemented total hip arthroplasties that had been templated using software. This assessment compared preoperative templated predictions with what was implanted with regard to (1) femoral prosthesis size and (2) acetabular cup size. The operation notes for two types of uncemented total hip arthroplasty performed by a single surgeon between January 9, 2008, and March 21, 2019, were assessed. The data were refined so that only those that were fully templated on a correctly calibrated pelvic radiograph were included. This provided a total of 153 cases. The predicted software template was compared with actual implanted component sizes. With regard to the femoral stems, the templating software was exactly correct in 45.75% of cases and was accurate to within one size in 87.59% of cases. With regard to the acetabular component, the templating software was exactly correct in 52.94% of cases and was accurate to within one size (2 mm) in 86.94% of cases. Templating software offers an accurate prediction of the size of uncemented femoral and acetabular components. In addition, the benefits of templating include cognitive rehearsal, insight into potentially challenging aspects of surgery, and highlighting intraoperative issues where there is a large intraoperative deviation from what is templated. This study demonstrates the congruence and reproducibility of templating software when compared with other smaller studies performed in the literature.

Download Full-text