Surgical repair for abductor lesion after revision total hip arthroplasty: a systematic review

2019 ◽  
Vol 30 (4) ◽  
pp. 380-390 ◽  
Author(s):  
Alberto Di Martino ◽  
Giuseppe Geraci ◽  
Niccolò Stefanini ◽  
Fabrizio Perna ◽  
Antonio Mazzotti ◽  
...  
Keyword(s):  
Total Hip Arthroplasty ◽  
Hip Arthroplasty ◽  
Vastus Lateralis ◽  
Surgical Techniques ◽  
Case Series ◽  
Revision Total Hip Arthroplasty ◽  
Retrospective Case ◽  
Total Hip ◽  
Late Dislocation ◽  
Functional Scores

Background: Abductor mechanism lesions represent a severe complication after revision total hip arthroplasty (rTHA). The resulting abductor insufficiency can cause limping, pain, instability, and a higher rate of failure, thus requiring further revision surgery. In case of severe degeneration and retraction of the abductor mechanism, several different surgical treatments are needed. Aim: To systematically review all studies reporting on surgical treatment of severe abductor lesion after rTHA, focusing on surgical techniques, and clinical and functional results. Method: Scientific databases were accessed in December 2018 to identify studies addressing the surgical management of severe abductor disruption after rTHA. The PRISMA guidelines were followed. Data were extracted from the identified articles and summarised. Only data about patients with symptoms of abductor insufficiency after rTHA were included in the database. Results: 9 retrospective studies were included, all being retrospective case series reporting on a total of 92 patients. Several surgical strategies have been described and performed: a repair using a synthetic mesh was reported in 1 study; 2 studies reported on local muscle transfer (gluteus maximus transfer or advancement); vastus lateralis advancement was described in 4 studies while in 2 studies the injury was repaired with the use of an allograft. Overall positive results have been reported in terms of pain reduction, while poor to mild functional scores with persistent limping have often been observed in the postoperative period. Conclusions: The short follow-up time of the reviewed studies is inadequate to uncover any late dislocation, implant failure or different complications related to abductor mechanism reconstruction.

scholarly journals Total hip arthroplasty in patients of post polio residual paralysis: A retrospective case series

2017 ◽  
Vol 51 (4) ◽  
pp. 434 ◽  
Author(s):  
FranciscoBorja Sobrón ◽  
Álvaro Martínez-Ayora ◽  
Manuel Cuervas-Mons ◽  
Tania Quevedo ◽  
Rafael Laguna ◽  
...  
Keyword(s):  
Total Hip Arthroplasty ◽  
Hip Arthroplasty ◽  
Case Series ◽  
Residual Paralysis ◽  
Retrospective Case ◽  
Total Hip ◽  
Retrospective Case Series

scholarly journals INCISIONAL NEGATIVE-PRESSURE WOUND THERAPY IN REVISION TOTAL HIP ARTHROPLASTY DUE TO INFECTION

2018 ◽  
Vol 26 (5) ◽  
pp. 300-304 ◽  
Author(s):  
Helder de Souza Miyahara ◽  
Felipe Ribeiro Serzedello ◽  
Leandro Ejnisman ◽  
Ana Lúcia Lei Munhoz Lima ◽  
José Ricardo Negreiros Vicente ◽  
...  
Keyword(s):  
Total Hip Arthroplasty ◽  
Hip Arthroplasty ◽  
Negative Pressure ◽  
Negative Pressure Wound Therapy ◽  
Case Series ◽  
Wound Complications ◽  
Revision Total Hip Arthroplasty ◽  
Wound Therapy ◽  
Level Of Evidence ◽  
Total Hip

ABSTRACT Objective: To present our institution's experience with negative-pressure wound therapy (NPWT) as an adjuvant in wound healing of patients who have undergone revision total hip arthroplasty (THA) due to septic loosening in the presence of active fistula. Methods: We prospectively assessed patients presenting with THA infection, associated with the presence of fistula, treated with a PICO® device for NPWT, in combination with the standard treatment for prosthesis infection in our institution. Resolution of the infectious process and healing of the surgical wound without complications were considered an initial favorable outcome. Results: We assessed 10 patients who used PICO® in our department. No complications were identified in association with the use of the NPWT device. The mean follow-up of the patients after use of the device was 12.7 months. Only one patient progressed with fistula reactivation and recurrence of infection. Conclusion: NPWT can be used in wound complications and infection following THA procedures safely and with promising results. Randomized prospective studies should be conducted to confirm its effectiveness. Level of Evidence IV, Case Series.

scholarly journals Trochanteric osteotomy in revision total hip arthroplasty

2020 ◽  
Vol 5 (8) ◽  
pp. 477-485
Author(s):  
Kavin Sundaram ◽  
Ahmed Siddiqi ◽  
Atul F. Kamath ◽  
Carlos A. Higuera-Rueda
Keyword(s):  
Total Hip Arthroplasty ◽  
Hip Arthroplasty ◽  
Vastus Lateralis ◽  
Revision Total Hip Arthroplasty ◽  
Trochanteric Osteotomy ◽  
Transfemoral Approach ◽  
Total Hip ◽  
Aseptic Revision ◽  
Extensile Approach ◽  
Trochanteric Slide

Trochanteric osteotomy is a technique that allows expanded exposure and access to the femoral canal and acetabulum for a number of indications. There has been renewed interest in variants of this technique, including the trochanteric slide osteotomy (TSO), extended trochanter osteotomy (ETO), and the transfemoral approach, for both septic and aseptic revision total hip arthroplasty (THA). Osteotomy fixation is crucial for achieving union, and wire and cable-plate systems are the most common techniques. TSO involves the creation of a greater trochanter fragment with preserved abductor attachment proximally and vastus lateralis attachment distally. This technique may be particularly useful in the setting of abductor deficiency or when augmented acetabular exposure is needed. ETO is a posterior-laterally based extensile approach that has been successfully utilized for aseptic and septic indications; most series report a greater than 90% rate of union. The transfemoral approach, as known as the Wagner osteotomy, is an extensile femoral approach and is more anterior-based than the alternate posterior-based ETO. It may be particularly useful for anterior-based approaches and anterior femoral remodelling; rates of union after this approach in most reports have been close to 100%. Cite this article: EFORT Open Rev 2020;5:477-485. DOI: 10.1302/2058-5241.5.190063

scholarly journals Detection of total hip arthroplasty at airport securities

2020 ◽  
Vol 7 (1) ◽  
pp. 48
Author(s):  
Ashok Raju Gottemukkala ◽  
Praful Kilaru ◽  
Pushpak Reddy Chada ◽  
Rahul Suna ◽  
Maryada Venkatwar Reddy ◽  
...  
Keyword(s):  
Total Hip Arthroplasty ◽  
Hip Arthroplasty ◽  
Case Series ◽  
High Volume ◽  
Airport Security ◽  
Inclusion Criteria ◽  
Retrospective Case ◽  
Security Screening ◽  
Total Hip ◽  
Post Surgery

<p class="abstract"><strong>Background:</strong> In era of increased air travel, airport security screening measures has been increased. A lot of anxiety to the patient, that may trigger an alarm at airport securities post-surgery. The purpose of this study is to find out experiences of patients after total hip arthroplasty (THA) passing through airport security.  </p><p class="abstract"><strong>Methods:</strong> A retrospective case series of 269 THA patients in a single high-volume center from January 2016 to June 2018, who had passed through airport security and met inclusion criteria. Patient were contacted during their regular follow ups or via phone. The patients were asked for alarm trigger, perceived inconvenience, whether security officials asked to show documentation regarding prosthesis, and any extra screening procedures check measures.<strong></strong></p><p class="abstract"><strong>Results:</strong> Out of 269 patients, 52 patients met inclusion criteria travelling by airplane. 27 patients reported alarm trigger. 7 patients had to undergo additional security check measures. 43% of the patients believed that having their THA increased the inconvenience while traveling.  </p><p class="abstract"><strong>Conclusions:</strong> This study provides information to surgeons regarding airport travel post THA. Patients can be counselled regarding the inconvenience and to be prepared for delays in airport and to be prepared to present documentation of their prosthesis.</p>

scholarly journals Total Hip Arthroplasty in Octogenarians: A Local Retrospective Case Series

2018 ◽  
Vol 52 (6) ◽  
Author(s):  
Peter B. Bernardo ◽  
Clint P. Guitarte
Keyword(s):  
Total Hip Arthroplasty ◽  
Femoral Neck ◽  
Hip Arthroplasty ◽  
Case Series ◽  
Femoral Stem ◽  
Femoral Neck Fractures ◽  
Retrospective Case ◽  
Total Hip ◽  
Retrospective Case Series

With improving healthcare, the number of Filipino octogenarians is increasing. Projected population of octogenarians as reported by the Philippine National Statistics Office will increase by 28% to 3,227,253 by year 2040 (from 2015: 912,817). This is a multicenter retrospective case series involving 24 patients (1 patient with surgery on 2 hips), with an average age at the time of surgery of 82 years old (range: 80-88 years old) who underwent total hip arthroplasty during the period 2007-2016. Indications for total hip arthroplasty included 12 cases of degenerative osteoarthritis, 8 cases of displaced femoral neck fractures, 4 cases of untreated femoral neck fractures, and 1 case of subtrochanteric fracture with hip arthritis. Of the 24 patients, 21 were females and 3 were males. Of the 25 hips, 19 were treated with cemented total hip, 5 with hybrid implants, and 1 with calcar replacing cemented femoral stem. Average follow-up was 36 months (range: 6-87 months). All patients were able to ambulate and return to premorbid function. There were no intraoperative or postoperative complications encountered. Revision rate was zero percent as of last follow-up. Clinical/functional results were assessed using the Harris Hip Scoring system. The results of this study affirm that primary total hip arthroplasty is a viable treatment option for active octogenarians with end-stage arthritis and hip fractures.

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