Outcomes of total hip arthroplasty in haemodialysis and renal transplant patients: systematic review

2019 ◽  
pp. 112070001987783 ◽  
Author(s):  
Ravi Popat ◽  
Adam M Ali ◽  
Ian P Holloway ◽  
Khaled M Sarraf ◽  
Sammy A Hanna
Keyword(s):  
Systematic Review ◽  
Renal Failure ◽  
Renal Transplantation ◽  
Renal Transplant ◽  
Total Hip Arthroplasty ◽  
Functional Outcome ◽  
Hip Arthroplasty ◽  
Revision Rate ◽  
Deep Infection ◽  
Transplant Patients

Background: Chronic renal failure is increasing in prevalence and reported to have deleterious effects on the outcome of total hip arthroplasty (THA). Aim: To investigate the clinical and functional outcomes of THA in patients receiving haemodialysis or who have previously undergone renal transplantation. Methods: Systematic review of the literature using bibliographic databases up to July 2018 to determine the functional outcome, complications and revision rates of THA in patients receiving haemodialysis for end-stage renal failure and those with a previous renal transplant. Results: 25 studies were identified with a total of 797 THAs. 166 patients (20.8%) were receiving haemodialysis and 631 patients (79.2%) had undergone transplantation. All studies reported a marked improvement in hip function following THA. There were 27 failures (15.7% revision rate) in the haemodialysis group and 101 failures (16.0% revision rate) in the transplant group. The revision rate for cemented implants was higher in haemodialysis versus transplant patients (23% vs. 15%), with the converse being true for uncemented implants (3.8% vs. 6.9%). The deep infection rate was higher in the haemodialysis group (10.8% vs. 2.1%). Conclusions: Patients receiving haemodialysis or with a history of renal transplantation can expect good functional outcome following THA. However, the revision rate and deep infection rate are higher than would be expected in patients receiving THA for primary OA. Aseptic loosening is the most common reason for revision. Uncemented implants appear to be associated with lower failure rates both in haemodialysis patients and those who have had a transplant.

Operative approach influences functional outcome after DAIR for infected total hip arthroplasty

2020 ◽  
Vol 102-B (12) ◽  
pp. 1662-1669
Author(s):  
Christian T. Pollmann ◽  
Jan-Erik Gjertsen ◽  
Håvard Dale ◽  
Truls M. Straume-Næsheim ◽  
Eva Dybvik ◽  
...  
Keyword(s):  
Patient Satisfaction ◽  
Total Hip Arthroplasty ◽  
Functional Outcome ◽  
Hip Arthroplasty ◽  
Posterior Approach ◽  
Deep Infection ◽  
Operative Approach ◽  
Function Score ◽  
Womac Function ◽  
Approach Group

Aims To compare the functional outcome, health-related quality of life (HRQoL), and satisfaction of patients who underwent primary total hip arthroplasty (THA) and a single debridement, antibiotics and implant retention (DAIR) procedure for deep infection, using either the transgluteal or the posterior surgical approach for both procedures. Methods The study was registered at clinicaltrials.gov (ID: NCT03161990) on 15 May 2017. Patients treated with a single DAIR procedure for deep infection through the same operative approach as their primary THA (either the transgluteal or the posterior approach) were identified in the Norwegian Arthroplasty Register and given a questionnaire. Median follow-up after DAIR by questionnaire was 5.5 years in the transgluteal group (n = 87) and 2.5 years in the posterior approach group (n = 102). Results Patients in the posterior approach group were less likely to limp after the DAIR procedure (17% vs 36% limped all the time; p = 0.005), had a higher mean Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) function score (80 vs 71; p = 0.013), and were more likely to achieve a patient acceptable symptom state for the WOMAC function score (76% vs 55%; p = 0.002). In a multivariable analysis, the point estimate for the increase in WOMAC function score using the posterior approach was 10.2 (95% CI 3.1 to 17.2; p = 0.005), which is above the minimal clinically important improvement. The patients in the posterior approach group also reported better mean HRQoL scores and were more likely to be satisfied with their hip arthroplasty (77% vs 55%; p = 0.001). Conclusion In patients treated with a single, successful DAIR procedure for deep infection of a primary THA, the use of the posterior approach in both primary surgery and DAIR was associated with less limping, better functional outcome, better HRQoL, and higher patient satisfaction compared with cases where both were performed using the transgluteal approach. The observed differences in functional outcome and patient satisfaction were clinically relevant. Cite this article: Bone Joint J 2020;102-B(12):1662–1669.

Cementless Total Hip Arthroplasty in Renal Transplant Patients

2012 ◽  
Vol 22 (5) ◽  
pp. 516-520 ◽  
Author(s):  
Byung-Ho Lim ◽  
Seung-Jae Lim ◽  
Young-Wan Moon ◽  
Youn-Soo Park
Keyword(s):  
Renal Transplant ◽  
Total Hip Arthroplasty ◽  
Hip Arthroplasty ◽  
Total Hip ◽  
Cementless Total Hip Arthroplasty ◽  
Transplant Patients ◽  
Renal Transplant Patients

Total hip arthroplasty in hemodialysis and renal transplant patients

2008 ◽  
Vol 18 (1) ◽  
pp. 51-57 ◽  
Author(s):  
S. García-Ramiro ◽  
F. Cofán ◽  
P.L. Esteban ◽  
J. Riba ◽  
X. Gallart ◽  
...  
Keyword(s):  
Renal Transplant ◽  
Total Hip Arthroplasty ◽  
Hip Arthroplasty ◽  
Total Hip ◽  
Transplant Patients ◽  
Renal Transplant Patients

scholarly journals Low evidence for implementation of well-documented implants regarding risk of early revision: a systematic review on total hip arthroplasty

2021 ◽  
Vol 6 (1) ◽  
pp. 3-8
Author(s):  
Patrick Butler ◽  
Josef Gorgis ◽  
Bjarke Viberg ◽  
Søren Overgaard
Keyword(s):  
Systematic Review ◽  
Total Hip Arthroplasty ◽  
Hip Arthroplasty ◽  
Revision Rate ◽  
Learning Curves ◽  
Eligibility Criteria ◽  
Total Hip ◽  
Early Revision ◽  
Total Knee ◽  
Post Hoc

When introducing an implant, surgeons are subjected to steep learning curves, which may lead to a heightened revision rate. Stepwise introduction revolutionized implant introduction but lacks a last step. No guidelines exist for the introduction of a well-documented implant not previously used in a department. This is problematic according to the European Union’s legislated tendering process, potentially leading to increased revisions. In this systematic review, the introduction of a well-documented total hip arthroplasty implant to experienced surgeons is explored amid concerns of higher revision rate. Literature search strategies were deployed in the Embase and Medline databases, revealing a total of 14,612 articles. Using the Covidence software (Cochrane, London), two reviewers screened articles for inclusion. No articles were found that fulfilled our eligibility criteria. A post hoc analysis retrieved two national register-based studies only missing information about the surgeon’s knowledge of the introduced implant. None of the introduced implants decreased the revision rate and around 30% of the introduced implants were associated with a higher revision rate. The review showed that no data exist about revision rates when introducing well-documented implants. In continuation thereof, the introduction of well-documented implants might also be associated with increased revision rates, as has been shown for total knee arthroplasty. We therefore suggest that special attention should be focused on changes of implants in departments, which can be achieved by way of specific registration in national registers. Cite this article: EFORT Open Rev 2021;6:3-8. DOI: 10.1302/2058-5241.6.200047

Systematic review of primary total hip arthroplasty using titanium-titanium modular-neck prostheses: the true risk of revision

2020 ◽  
pp. 112070002091687 ◽  
Author(s):  
Johnathan R Lex ◽  
Matthew D Welch ◽  
Abbas See ◽  
Thomas C Edwards ◽  
Nikolaos A Stavropoulos ◽  
...  
Keyword(s):  
Systematic Review ◽  
Total Hip Arthroplasty ◽  
Hip Arthroplasty ◽  
Revision Rate ◽  
Case Series ◽  
Harris Hip Score ◽  
Modular Neck ◽  
Total Hip ◽  
Primary Total Hip Arthroplasty

Aims: Modular-neck femoral implants are used to enable more variability in femoral neck version, offset and length. It has been reported that these implants carry a higher rate of revision. The aim of this review was to assess the overall and cause-specific revision rate of titanium-titanium alloy modular-neck implants in primary total hip arthroplasty (THA). Methods: A systematic review was conducted following PRISMA guidelines and utilising multiple databases. All results were screened for eligibility. Studies published from 2000 onwards, using a current-generation, titanium-titanium, modular-neck implant were included. Overall and cause-specific revision rates were analysed, comparing to fixed-neck prostheses where applicable. Results: 920 studies were screened. After applying exclusion criteria, 23 were assessed in full and 14 included. These consisted of 12 case series and 2 joint registry analyses. 21,841 patients underwent a modular-neck implant with a weighted mean follow-up of 5.7 years, mean age of 62.4 years, and average body mass index (BMI) of 28.4kg/m2. The overall revision rate was 3.95% and 2.98% for modular and fixed-neck prostheses, respectively. For studies with >5 years follow-up the mean revision rate was 3.08%. There was no difference in cause-specific revision rates by implant design. Mean improvement in Harris Hip Score was 41.9. Conclusions: At medium-term, revision rates for titanium-titanium primary modular-neck THA are acceptable. These prostheses are a sensible management option in patients with considerable anatomical hip deformity not amenable to correction with standard fixed-neck implants. Patients of male gender, high BMI and requiring prostheses with a larger neck, offset or head are at higher risk of implant failure.

Total hip arthroplasty in hemodialysis and renal transplant patients

2008 ◽  
Vol 18 (1) ◽  
pp. 51-57 ◽  
Author(s):  
S. Garcia-Ramiro ◽  
F. Cofan ◽  
P.L. Esteban ◽  
Josep Riba ◽  
Xavier Gallart ◽  
...  
Keyword(s):  
Renal Transplant ◽  
Total Hip Arthroplasty ◽  
Hip Arthroplasty ◽  
Total Hip ◽  
Transplant Patients ◽  
Renal Transplant Patients

scholarly journals Total hip arthroplasty in sickle cell disease: a systematic review

2020 ◽  
Vol 5 (3) ◽  
pp. 180-188
Author(s):  
Eustathios Kenanidis ◽  
Konstantinos Kapriniotis ◽  
Panagiotis Anagnostis ◽  
Michael Potoupnis ◽  
Panayiotis Christofilopoulos ◽  
...  
Keyword(s):  
Systematic Review ◽  
Sickle Cell Disease ◽  
Total Hip Arthroplasty ◽  
Sickle Cell ◽  
Hip Arthroplasty ◽  
Revision Rate ◽  
Intraoperative Complications ◽  
Femoral Fractures ◽  
Cell Disease ◽  
Transfusion Reactions

Total hip arthroplasty (THA) in sickle cell disease (SCD) patients can be a challenging procedure. This systematic review evaluated the revision rate, functional outcomes and complications of THA in sicklers. A systematic search was conducted according to the PRISMA guidelines, using four search engines from inception to May 2019. Fifteen studies with 971 THAs were included. There were 437 cemented and 520 uncemented THAs. There were 164 revision THAs (16.8%); 52 uncemented and 105 cemented THAs. Forty-two infections were recorded; 16 infections for cemented and 23 for uncemented THAs. Fifty-seven cups, 26 stems, eight cup/stem with aseptic loosening that were more frequently cemented were reported. The 28 unspecified aseptic loosening cases were more frequently uncemented THAs. All studies demonstrated the functional improvement of patients. There were 109 medical complications (14.3%). Sickle cell crises (SCC) and transfusion reactions were most usually recorded. Forty-six intraoperative complications (4.7%) were reported; 18 femoral fractures, four acetabular and 18 femoral perforations. Seventeen femoral fractures occurred during uncemented THA. THA in SCD is still related to a high risk of complications. The outcomes in properly selected sicklers have been improved. Perioperative adequate hydration, warming, oxygen supply and transfusion protocols are mandated to prevent SCC and transfusion reactions. The surgeon must be prepared to deal with a high rate of intraoperative fractures and have different implant options readily available. No definite conclusion can be made regarding the best fixation mode. Cemented implants demonstrated a higher revision rate and uncemented implants a higher risk for intraoperative complications. Cite this article: EFORT Open Rev 2020;5:180-188. DOI: 10.1302/2058-5241.5.190038

scholarly journals Total hip arthroplasty in patients with neuromuscular imbalance

2018 ◽  
Vol 100-B (1_Supple_A) ◽  
pp. 17-21 ◽  
Author(s):  
S. Konan ◽  
C. P. Duncan
Keyword(s):  
Systematic Review ◽  
Pain Relief ◽  
Total Hip Arthroplasty ◽  
Functional Outcome ◽  
Hip Arthroplasty ◽  
Bone Stock ◽  
Indication For Surgery ◽  
Technical Problems ◽  
Total Hip ◽  
Muscular Imbalance

Patients with neuromuscular imbalance who require total hip arthroplasty (THA) present particular technical problems due to altered anatomy, abnormal bone stock, muscular imbalance and problems of rehabilitation.In this systematic review, we studied articles dealing with THA in patients with neuromuscular imbalance, published before April 2017. We recorded the demographics of the patients and the type of neuromuscular pathology, the indication for surgery, surgical approach, concomitant soft-tissue releases, the type of implant and bearing, pain and functional outcome as well as complications and survival.Recent advances in THA technology allow for successful outcomes in these patients. Our review suggests excellent benefits for pain relief and good functional outcome might be expected with a modest risk of complication.Cite this article: Bone Joint J 2018;100-B(1 Supple A):17–21.

Total Hip Arthroplasty in Very Young Bone Marrow Transplant Patients

2015 ◽  
Vol 24 (02) ◽  
Author(s):  
Cameron K. Ledford ◽  
Alexander R. Vap ◽  
Michael P. Bolognesi ◽  
Samuel S. Wellman
Keyword(s):  
Bone Marrow ◽  
Total Hip Arthroplasty ◽  
Bone Marrow Transplant ◽  
Hip Arthroplasty ◽  
Marrow Transplant ◽  
Total Hip ◽  
Transplant Patients
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