Effect of marital status on patient-reported outcomes following total hip arthroplasty: a matched analysis with minimum 2-year follow-up

2019 ◽  
pp. 112070001986401
Author(s):  
Ajay C Lall ◽  
Garrett R Schwarzman ◽  
Muriel R Battaglia ◽  
Sarah L Chen ◽  
David R Maldonado ◽  
...  
Keyword(s):  
Marital Status ◽  
Hip Arthroplasty ◽  
Patient Reported Outcomes ◽  
Psychosocial Support ◽  
Short Form ◽  
Harris Hip Score ◽  
Never Married ◽  
Total Hip ◽  
Patient Reported

Introduction: Mental health and patient expectation have been identified as key predictors of recovery following THA; however, there is limited literature examining the effects of social support and marital status on patient-reported outcomes (PROs). Methods: Data were prospectively collected and retrospectively reviewed for patients who underwent THA between July 2008 and January 2016. Patients were included if they underwent primary THA during this period and if they had documented preoperative marital status of married, divorced, or never married. Married patients were group matched to non-married patients (divorced or never married) with similar sex, age, body mass index (BMI), gender distribution, and frequency of surgical approach. Results: There were 414 married patients and 98 non-married patients who were eligible and had minimum 2-year follow-up. Mean PROs were significantly worse in the non-married group than the married group for the following measures: modified Harris Hip Score ( p = 0.002), Harris Hip Score ( p = 0.002), Forgotten Joint Score ( p = 0.04), and the physical portions of the Veterans RAND ( p = 0.025) and Short Form ( p = 0.02) surveys. Conclusions: Our study demonstrated inferior absolute PRO scores at latest follow-up for patients who were non-married compared to married following THA. These results show that while total hip replacement may still yield clinical benefit in all patients, non-married patients may ultimately achieve an inferior functional status, and expectations should be adjusted accordingly. Physicians should assess levels of psychosocial support in their patients prior to undergoing hip arthroplasty in order to optimise results.

Importance of Retaining Sufficient Acetabular Depth: Successful 2-Year Outcomes of Hip Arthroscopy for Patients With Pincer Morphology as Compared With Matched Controls

2020 ◽  
Vol 48 (10) ◽  
pp. 2471-2480 ◽  
Author(s):  
Claudia R. Brick ◽  
Catherine J. Bacon ◽  
Matthew J. Brick
Keyword(s):  
Total Hip Arthroplasty ◽  
Femoroacetabular Impingement ◽  
Hip Arthroplasty ◽  
Hip Arthroscopy ◽  
Patient Reported Outcomes ◽  
Control Group ◽  
Total Hip ◽  
Patient Reported ◽  
Acetabular Overcoverage

Background: Patients with pincer-type femoroacetabular impingement are commonly treated with arthroscopic reduction of acetabular depth as measured by the lateral center-edge angle (LCEA). The optimal amount of rim reduction has not been established, although large resections may increase contact pressures through the hip. A recent publication demonstrated inferior surgical outcomes in patients with acetabular overcoverage as compared with normal acetabular coverage. Casual observation of our database suggested equivalent improvements, prompting a similar analysis. Purpose: To analyze patient-reported outcomes after hip arthroscopy for femoroacetabular impingement in patients with acetabular overcoverage who were matched with controls with normal coverage, as well as to analyze associations with reduction in LCEA. Study Design: Cohort study; Level of evidence, 3. Methods: Data were collected prospectively from patients with a minimum 2-year follow-up after receiving hip arthroscopy for femoroacetabular impingement by a single surgeon. Cases were reviewed to identify those with pincer-type morphology (LCEA >40°) and matched according to sex, age, chondral damage, and surgery date in a 1:1 ratio with controls with an LCEA of 25° to 40°. The surgical goal was to reduce the LCEA to the upper end of the normal range with minimal rim resection, usually 35° to 37°. Radiographic measurements of coverage, intraoperative findings, procedures, and patient-reported outcomes were recorded, including the 12-Item International Hip Outcome Tool, Non-arthritic Hip Score, Hip Disability and Osteoarthritis Outcome Score, visual analog scale for pain, rates of revision or reoperation, and conversion to total hip arthroplasty. Results: A total of 114 hips (93 patients) for the pincer group were matched 1:1 from 616 hips (541 patients) for the control group. The pincer group (mean ± SD age, 34.5 ± 12.2 years) did not differ in age, body mass index, or follow-up from controls. LCEA was reduced in both groups pre- to postoperatively: the pincer group from 44.0° ± 2.8° to 34.2° ± 3.5° and the controls from 32.9° ± 3.9° to 31.0° ± 3.0°. No differences in improvement were observed: iHOT-12 improved by 35.7 points in both groups ( P = .9 for analysis of variance interaction) and Nonarthritic Hip Score by 22.3 points ( P = .6). From all eligible surgical procedures, 2-year follow up rates were 2.5% and 2.6% for the pincer and control cohorts, respectively, and 1.2% and 0.3% for conversion to total hip arthroplasty. Conclusion: Arthroscopic management of acetabular overcoverage can achieve excellent results, equivalent to arthroscopy for other causes of symptomatic femoroacetabular impingement. A key finding was smaller rim resections producing a mean postoperative LCEA of 34.2° with a small standard deviation.

Hip resurfacing arthroplasty and total hip arthroplasty in the same patient: which do they prefer?

2019 ◽  
pp. 112070001988292 ◽  
Author(s):  
Tyler E Calkins ◽  
Linda I Suleiman ◽  
Chris Culvern ◽  
Sulaiman Alazzawi ◽  
Gregory S Kazarian ◽  
...  
Keyword(s):  
Total Hip Arthroplasty ◽  
Hip Arthroplasty ◽  
Hip Resurfacing ◽  
Contralateral Side ◽  
Harris Hip Score ◽  
Hip Resurfacing Arthroplasty ◽  
Total Hip ◽  
Resurfacing Arthroplasty ◽  
Patient Reported

Introduction: Hip resurfacing arthroplasty (HRA) is an alternative to conventional total hip arthroplasty (THA) with potential advantages of preserving femoral bone stock and the ability to participate in higher impact activities. This study compares outcomes, satisfaction and preference in patients who underwent HRA in 1 hip and THA on the contralateral side. Methods: 62 Patients with an HRA in 1 hip and a contralateral THA were retrospectively identified at 3 centres, consisting of 38 males and 24 females with 53 patients (85.5%) undergoing HRA first. A survey regarding satisfaction and preference for each procedure and outcome scores were obtained. Results: Patients were younger (51.5 vs. 56.6 years, p = 0.002) and had longer follow-up on the HRA hip (11.0 vs. 6.0 years, p < 0.001). HRA was associated with larger increase in Harris Hip Score from preoperative to final follow-up (35.8 vs. 30.6, p = 0.035). 18 Patients (29.0%) preferred HRA, 19 (30.6%) preferred THA and 25 (40.3%) had no preference ( p = 0.844). When asked what they would choose if they could only have 1 surgery again, 41 (66.1%, p < 0.001) picked HRA. Overall satisfaction ( p = 0.504), willingness to live with their HRA versus THA for the rest of their life ( p = 0.295) and recommendation to others ( p = 0.097) were similar. Conclusions: Although HRA is associated with risks related to metal-on-metal bearings, it showed greater increase in patient-reported outcomes and a small subjective preference amongst patients who have undergone both conventional and resurfacing arthroplasty.

Patient-Reported Outcomes Can Be Used to Streamline Post-Total Hip Arthroplasty Follow-Up to High-Risk Patients

2017 ◽  
Vol 32 (11) ◽  
pp. 3319-3321
Author(s):  
Jie J. Yao ◽  
Hilal Maradit Kremers ◽  
Cathy D. Schleck ◽  
Dirk R. Larson ◽  
Jasvinder A. Singh ◽  
...  
Keyword(s):  
High Risk ◽  
Total Hip Arthroplasty ◽  
Hip Arthroplasty ◽  
Patient Reported Outcomes ◽  
Total Hip ◽  
High Risk Patients ◽  
Patient Reported ◽  
Risk Patients

Three-year results of a polycarbonate urethane acetabular bearing in total hip arthroplasty

2019 ◽  
Vol 30 (3) ◽  
pp. 303-308
Author(s):  
Stefan Lazic ◽  
Catherine Kellett ◽  
Irrum Afzal ◽  
Rajan Mohan ◽  
Vijay Killampalli ◽  
...  
Keyword(s):  
Total Hip Arthroplasty ◽  
Hip Arthroplasty ◽  
Patient Reported Outcomes ◽  
Prospective Observational Study ◽  
Total Hip ◽  
Polycarbonate Urethane ◽  
Patient Reported ◽  
Term Data

Background: Polycarbonate urethane (PCU) is a bearing surface with a lower modulus of elasticity than polyethylene or ceramic and is thought to more closely replicate the tribology of native hyaline cartilage. The purpose of this study was to determine the clinical outcomes with the use of PCU in elective total hip arthroplasty (THA). Methods: We carried out a prospective observational study in which 157 patients underwent elective THA with a metal-on-PCU hip system. Patients had radiographic follow-up at 6 months and 3 years after surgery. Oxford Hip Scores and EuroQol scores were obtained annually and Harris Hip Scores were obtained at 6 months and 3 years after surgery. Results: 180 hips were implanted, of which, 149 hips reached 3-year review with no revisions. There was an increase in Harris Hip Scores, Oxford Hip Scores and EuroQol scores ( p < 0.001). 12 patients (12 hips) reported painless hip squeaking. There were no dislocations and no other adverse events were reported. Conclusion: Our results showed satisfactory survivorship and improvements in patient reported outcomes with metal on PCU THA. Long-term data are still being collected to confirm these findings. We recommend further tribological research into the squeaking phenomenon we observed.

scholarly journals Total hip arthroplasty after hip joint gunshot injury

2019 ◽  
Vol 27 (3) ◽  
pp. 230949901987311 ◽  
Author(s):  
Ozhan Pazarci ◽  
Seyran Kilinc ◽  
Yalkin Camurcu ◽  
Okay Bulut
Keyword(s):  
Total Hip Arthroplasty ◽  
Hip Joint ◽  
Hip Arthroplasty ◽  
Short Form ◽  
Gunshot Injury ◽  
Harris Hip Score ◽  
Joint Region ◽  
Total Hip ◽  
The Mean

Background: Gunshot injury of the hip joint was reported to constitute 2–17% of all extremity firearm injuries. However, there are few studies in the literature related to gunshot injuries of the hip joint. The aim of the current study was to present the results of 10 cases treated with arthroplasty following a gunshot injury to the hip joint together with the recommended treatment algorithm. Methods: Patients with a previous medical history of hip joint region gunshot injury who underwent total hip arthroplasty were retrospectively evaluated. Those with incomplete medical records or who were lost to follow-up were excluded. Patients were classified according to the severity of the previous gunshot injury to the hip joint region. Harris hip score (HHS) and Short Form-12 quality of life score were the main outcome measurements. Postoperative complications encountered during follow-up were recorded. Results: The mean age of the patients at the time of surgery was 29.9 years. The mean preoperative HHS was 25.2 points and it was 65.8 at the final follow-up. Patients with bullet fragments in the hip joint, classified as group 1, had better HHS, whereas those with contaminated hip joint with intestinal flora, classified as group 3, had worst HHS. Conclusion: Hip arthroplasty after hip joint gunshot injury is a good treatment choice in young patients to reduce pain and regain functions. However, very high infection rates can be seen in patients with accompanying intestinal injury.

scholarly journals Imageless computer assisted navigation in ceramic-on-ceramic total hip arthroplasty vs. manual approach: a single-centre retrospective study

10.29007/9gpf ◽  
2019 ◽  
Author(s):  
John McLoughlin ◽  
Mo Mathew ◽  
Stephen Grant
Keyword(s):  
Total Hip Arthroplasty ◽  
Hip Arthroplasty ◽  
Patient Reported Outcomes ◽  
Statistical Significance ◽  
Computer Assisted ◽  
Total Hip ◽  
Patient Reported ◽  
Cup Positioning

Background: Acetabular cup positioning is vital to the long-term survivorship of total hip arthroplasty (THA). Malalignment has been linked to dislocation, wear and osteolysis. Although there are many studies demonstrating the reduction in variability of cup positioning with computer-assisted techniques, there are relatively few reporting long-term patient reported outcomes and revision rates. Aim: The aim of this study was to review whether those patients who underwent navigated THA had better long-term survivorship or better patient reported outcomes. Methods: We compared revision rates and Oxford hip scores of 152 THAs (47 navigated and 105 non-navigated) performed at a single site between 2003 and 2008, with a minimum follow-up of 10 years. Results: 9 of the non-navigated and none of the navigated hips were revised at 10 year follow-up (p=0.057). There were no observable differences in 10-year Oxford hip scores between the navigated and non-navigated hips, 44.82 and 43.38 respectively. Conclusion: With respect to the rate of revision, although statistical significance was not achieved, it can be shown from our data that there was a clinically significant reduction in revision rates with navigated vs. non-navigated techniques. More data with higher patient numbers in the navigated cohort may be required to validate the results of our study.

scholarly journals The usefulness of dual mobility cups in primary total hip arthroplasty patients at a risk of dislocation

2022 ◽  
Vol 12 (1) ◽  
Author(s):  
Nam Hoon Moon ◽  
Min Uk Do ◽  
Jung Shin Kim ◽  
Jae Seung Seo ◽  
Won Chul Shin
Keyword(s):  
Postoperative Complications ◽  
Total Hip Arthroplasty ◽  
Hip Arthroplasty ◽  
Harris Hip Score ◽  
Dual Mobility ◽  
Total Hip ◽  
Early Results ◽  
Patient Reported ◽  
Primary Total Hip Arthroplasty

AbstractThis study aimed to evaluate the early results of primary total hip arthroplasty (THA) using dual mobility (DM) cups in patients at a risk of dislocation and compare them with that of fixed bearing (FB) THA. This retrospective study included patients who had undergone primary THA between January 2016 and December 2018 and were at a risk of dislocation. A propensity score-matched analysis was conducted for 63 THA procedures with vitamin-E infused highly cross-linked polyethylene (VEPE) DM bearing and 63 THA procedures performed with FB from the same manufacturer for a mean follow-up period of 3.1 and 3.5 years, respectively. The radiologic outcomes at the last follow-up and incidence of postoperative complications were evaluated and compared statistically between the two groups. The modified Harris hip score (mHHS) was used to assess patient-reported outcomes. Postoperative dislocation occurred in 4 cases (6.3%) in the FB group, but did not occur in the DM group (p = 0.042). There was no difference in the radiologic outcomes and postoperative complications between the two groups. The mHHS at the last follow-up showed satisfactory outcomes in both the groups (DM group, 90.5; FB group, 88.1), without a statistical difference between the groups. The early results of THA using VEPE DM bearing showed better outcomes than that of THA with FB for patients at a risk of dislocation. A longer follow-up period is recommended to assess the stability and overall outcomes.

scholarly journals Eleven Year Results of Total Hip Arthroplasty in Patients with Secondary Osteoarthritis Due to Slipped Capital Femoral Epiphysis

2013 ◽  
Vol 7 (1) ◽  
pp. 158-162 ◽  
Author(s):  
Benjamin Schoof ◽  
Mustafa Citak ◽  
Padhraig F O’Loughlin ◽  
Daniel Kendoff ◽  
Carl Haasper ◽  
...  
Keyword(s):  
Total Hip Arthroplasty ◽  
Health Survey ◽  
Hip Arthroplasty ◽  
Short Form ◽  
Slipped Capital Femoral Epiphysis ◽  
Harris Hip Score ◽  
Secondary Osteoarthritis ◽  
Total Hip ◽  
Patient Cohort

Background: Total hip arthroplasty (THA) in patients with a history of Slipped Capital Femoral Epiphysis (SCFE), is typically indicated to address the consequent deformity of the proximal femur and/or acetabulum. It can be a challenging procedure for the orthopaedic surgeon. Previous studies have focused on prevention of osteoarthritis post-SCFE. However, there is a paucity of data on the outcomes of total hip arthroplasty in patients with osteoarthritis secondary to SCFE. This study was performed to assess the mid-term results of total hip arthroplasty in this patient cohort. Materials and Methods: All patients with secondary osteoarthritis due to slipped capital femoral epiphysis, treated with total hip arthroplasty between 1987 and 2005, were included in this retrospective study (n=30). Thirty patients (17 male, 13 female) met the inclusion criteria with one patient lost to follow-up and one unrelated death one year before follow up examination, thereby leaving 28 patients (32 hips) eligible for the study with a mean follow-up time period of 11.2 years. The Harris Hip Score (HHS) and MOS 36 short form health survey (SF36) were determined preoperatively and at most recent follow-up for all patients. Complications were also noted for all cases. Results: The mean Harris Hip Score increased significantly from 47 (32-59; SD=8.3) to 92.3 (65-100; SD=8.2) (p<0.0001). The SF-36 health survey showed an improvement of quality-of-life in all sub-scales. Overall, revision surgery was required in six cases (19 %). Aseptic loosening, leading to implant removal, was noted in five cases. A single-stage revision to address infection was performed in one case. The cumulative survival rate at latest follow-up was 81 %. No other complications were encountered during the study. Conclusions: Despite a higher failure rate, compared to total hip arthroplasty in the treatment of primary osteoarthritis, total hip arthroplasty can be considered a feasible option for patients with secondary osteoarthritis of the hip due to slipped capital femoral epiphysis. The current study demonstrates good outcomes in patients treated with a cementless column-preserving prosthesis, which is of particular relevance for this young patient cohort. However, further clinical prospective randomized studies are warranted to provide more definitive evidence.

Outcomes after Total Hip Arthroplasty in Young Patients with Osteonecrosis of the Hip

2017 ◽  
Vol 27 (3) ◽  
pp. 286-292 ◽  
Author(s):  
Ishaan Swarup ◽  
Marisa Shields ◽  
Erik N. Mayer ◽  
Chelsea J. Hendow ◽  
Jayme C. Burket ◽  
...  
Keyword(s):  
Total Hip Arthroplasty ◽  
Hip Arthroplasty ◽  
Patient Reported Outcomes ◽  
Young Patients ◽  
Implant Survival ◽  
Total Hip ◽  
Time Of Surgery ◽  
Patient Reported

Background Osteonecrosis of the hip is a clinical, radiographic, and pathologic entity that commonly affects young patients. This study evaluates long-term implant survival and patient-reported outcomes after primary total hip arthroplasty (THA) in patients with osteonecrosis aged 35 or younger. Methods A retrospective study with prospective follow-up was conducted at a major academic medical center. Chart review was performed to identify young THA patients with osteonecrosis, and follow-up surveys were conducted to determine implant survival and patient-reported outcomes. Kaplan-Meier survival analysis was performed to evaluate implant survival, and the hip disability and osteoarthritis outcome score (HOOS) was used to describe patient-reported outcomes. Results The study included 135 patients (204 THAs) with a mean time to follow-up of 14 years. In this group, 10-year implant survival was 86% and 20-year implant survival was 66%. Implant survival was longer in male patients (p = 0.02) and patients that were over the age of 25 at the time of surgery (p = 0.03). The mean HOOS scores at follow-up were 87 for pain, symptoms, and ADLs, and 77 for sports. All HOOS measures were lower in patients that underwent a revision THA, and HOOS-Pain and HOOS-Sport scores were lower in patients that were over the age of 25 at the time of surgery (p<0.05). Conclusions Young patients with osteonecrosis have good implant survival and long-term outcomes after THA. Patient factors and implant characteristics should be considered when predicting implant survival and outcomes after THA in young patients with osteonecrosis.

scholarly journals Ceramic-on-metal bearing in short stem total hip arthroplasty: ions, functional and radiographic evaluation at mid-term follow-up

2020 ◽  
Vol 30 (2_suppl) ◽  
pp. 52-58
Author(s):  
Michela Saracco ◽  
Giulio Maccauro ◽  
Andrea Urbani ◽  
Domenico Ciavardelli ◽  
Silvia Persichilli ◽  
...  
Keyword(s):  
Total Hip Arthroplasty ◽  
Metal Ions ◽  
Hip Arthroplasty ◽  
Short Form ◽  
Hip Osteoarthritis ◽  
Short Stem ◽  
Harris Hip Score ◽  
Radiographic Evaluation ◽  
Total Hip

Introduction: The aim of this study is to evaluate clinical, radiographic and laboratory results of ceramic-on-metal (CoM) (hybrid hard bearing) in total hip arthroplasty (THA), associated with a short stem implant. Methods: From a cohort of 37 patients suffering from primary or secondary hip osteoarthritis who underwent THA using CoM bearing, 19 were suitable for this study. All procedures were performed by the same surgeon using a posterior-lateral approach. All patients were compared clinically using the Harris Hip Score (HHS), Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), visual analogue scale (VAS), 12-item Short Form Health Survey (SF12F/M), and radiographically (offset, CD angle, limb length discrepancy, cup inclination and anteversion, subsidence, osseointegration, heterotopic ossification). Blood samples were collected in order to evaluate chromium (Cr) and cobalt (Co) ions level. Radiographic evaluations were carried out by 3 different blinded surgeons. A statistical analysis was performed. Results: At a mean follow-up of 97 (73–125) months all implanted stems were well-positioned and osseointegrated. Clear improvements were observed for clinical scores comparing preoperative and postoperative values. Radiographic evaluation showed a good ability to restore proper articular geometry. Cr ion analysis revealed values below the safety threshold except for 1 case. Serum levels of Co were below the threshold in all patients. There was a statistically significant correlation only between Cr metal ions and length of follow-up. Conclusions: CoM bearing has proven to be reliable and safe at a mean 8-year follow-up for patients in whom the components were correctly implanted. The rise of blood metal ions was minimal and involved neither systemic or local toxicity nor influenced clinical results.

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