Recovery of activity level following total hip arthroplasty in patients less than 60 years of age

2020 ◽  
pp. 112070002091191 ◽  
Author(s):  
Kazuhiro Takeuchi ◽  
Shingo Hashimoto ◽  
Tomoyuki Matsumoto ◽  
Shinya Hayashi ◽  
Koji Takayama ◽  
...  
Keyword(s):  
Femoral Head ◽  
Total Hip Arthroplasty ◽  
Return To Work ◽  
Hip Arthroplasty ◽  
Daily Activity ◽  
Work Rate ◽  
Activity Level ◽  
Ucla Activity Score ◽  
Large Femoral Head ◽  
Total Hip

Background: Total hip arthroplasty (THA) is a useful treatment for pain relief and functional improvement. THA indications now include younger, more active patients, with improved implant design and bearing materials. We aimed to investigate daily activity level and return to work after THA, about which limited information is available. Moreover, differences in patient background and clinical parameters including size of femoral head and surgical approach were evaluated. Methods: A multicentre survey was carried out in patients below 60 years, undergoing THA between 2007 and 2012, at least 1 year after surgery. Primary THA patients with osteoarthritis, avascular necrosis, rheumatoid arthritis, hip dysplasia, and no history of postoperative complications were included. The questionnaire included daily activity and occupation levels before and after surgery. University of California, Los Angeles (UCLA) activity score and occupational classification index were defined, and statistical analysis was performed. Results: The mean preoperative UCLA score in 204 patients was 4.55 which improved to 6.17 after surgery. Pre- as well as postoperative UCLA scores in males were significantly higher than that in females. No differences were observed in other parameters. Return to work rate in males was 94.4%; significantly higher than that in females (52.3%). Younger patients with large head THA were more likely to return to work. Conclusions: Most patients showed improved activity levels. Satisfaction levels were higher in young males with large femoral head size. Patients with a higher preoperative work level are expected to have a higher return to work rate.

scholarly journals Fracture of the Modular Neck in Total Hip Arthroplasty

2015 ◽  
Vol 2015 ◽  
pp. 1-4 ◽  
Author(s):  
A. Hernandez ◽  
A. Gargallo-Margarit ◽  
V. Barro ◽  
I. Gallardo-Calero ◽  
A. Sallent
Keyword(s):  
Femoral Head ◽  
Total Hip Arthroplasty ◽  
Hip Arthroplasty ◽  
Tissue Reaction ◽  
Activity Level ◽  
Modular Neck ◽  
Large Femoral Head ◽  
Total Hip ◽  
History Of ◽  
Revision Prosthesis

Modularity of the components in total hip arthroplasty has had an increase in popularity in the last decades. We present the case of a 53-year-old man with a history of avascular necrosis of the femoral head due to a hypophyseal adenoma. A total hip modular arthroplasty was implanted. Three and a half years after the surgery the patient attended the emergency room due to acute left hip pain with no prior traumatism. Radiological examination confirmed a fracture of the modular neck. A revision surgery was performed finding an important pseudotumoral well-organized periprosthetic tissue reaction. Through an extended trochanteric osteotomy the femoral component was removed, and a straight-stem revision prosthesis implanted. There are several potential advantages when using modularity in total hip arthroplasty that surgeons may benefit from, but complications have arisen and must be addressed. Various circumstances such as large femoral head with a long varus neck, corrosion, patient’s BMI, and activity level may participate in creating the necessary environment for fatigue failure of the implant.

scholarly journals Is large femoral head a better option than a conventional femoral head primary total hip arthroplasty in Indian population

2021 ◽  
Vol 7 (2) ◽  
pp. 295
Author(s):  
Hiranya Kumar Seenappa ◽  
Karthik Mittemari Naraynamurthy ◽  
Rasiq Rashid ◽  
Shivraj Nadagouda ◽  
Vamshhikrishna Chand
Keyword(s):  
Femoral Head ◽  
Total Hip Arthroplasty ◽  
Hip Arthroplasty ◽  
Harris Hip Score ◽  
Age Group ◽  
Neck Of Femur ◽  
Large Femoral Head ◽  
Total Hip ◽  
Modified Harris Hip Score ◽  
Primary Total Hip Arthroplasty

<p class="abstract"><strong>Background: </strong>Study aimed to assess and compare the functional outcome in patients underwent the large femoral head THA and conventional femoral head THA.</p><p class="abstract"><strong>Methods:</strong> It is a comparative prospective cross sectional study conducted among the patients undergoing primary total hip arthroplasty through postero-lateral approach at department of orthopaedics Vydehi institute of medical sciences, Bengaluru during the period of July 2017 to July 2019. Patients aged between 18-80years of both genders undergoing Primary THA for Osteoarthritis (OA), Rheumatoid Arthritis (RA), Ankylosing Spondylitis (AS), Post traumatic arthritis, Avascular necrosis (AVN), Acute fracture neck of femur, Non-union fracture neck of femur (NOF). Patients undergoing primary total hip arthroplasty in Intertrochanteric fracture, Acetabular fracture and patients undergoing Revision Hip Arthroplasty were excluded from study. Patients were grouped as the ones treated with large femoral head THA and conventional femoral head THA.</p><p class="abstract"><strong>Results: </strong>This series consisted of 36 patients with 44 diseased hips treated with primary total hip arthroplasty (THA). Out of 36 patients, 9 patients (25%) belonged to an age group of below 30 years of age, 10 patients (27.8%) belonged to the age group between 31-40 years of age, 8 patients (22.2%) belonged to the age group 41-51 years of age and 9 patients (25%) belonged to age group of 51-60 years of age. The mean level of Modified Harris Hip score and improvement of movements in all planes was found to be statistically significantly in the patients treated with large femoral head primary THA compared to those treated with conventional method. (p&lt;0.001)</p><p class="abstract"><strong>Conclusions: </strong>Study has shown improved functional outcome (Modified harris hip score) and range of movement in the patients treated with the large femoral head primary THA as compared to those treated with a conventional femoral head.</p>

scholarly journals Effect of Femoral Head Size, Subject Weight, and Activity Level on Acetabular Cement Mantle Stress Following Total Hip Arthroplasty

2019 ◽  
Vol 37 (8) ◽  
pp. 1771-1783 ◽  
Author(s):  
Jose‐Francisco Del‐Valle‐Mojica ◽  
Teresa Alonso‐Rasgado ◽  
David Jimenez‐Cruz ◽  
Colin G Bailey ◽  
Tim N Board
Keyword(s):  
Femoral Head ◽  
Total Hip Arthroplasty ◽  
Hip Arthroplasty ◽  
Cement Mantle ◽  
Activity Level ◽  
Head Size ◽  
Femoral Head Size ◽  
Total Hip

Free Vascularized Fibular Grafting Preserves Athletic Activity Level in Patients with Osteonecrosis

2012 ◽  
Vol 2 (1) ◽  
pp. 40-43
Author(s):  
VJ Sabesan ◽  
DM Pedrotty ◽  
JR Urbaniak ◽  
G Gahreeb ◽  
JM Aldridge
Keyword(s):  
Femoral Head ◽  
Total Hip Arthroplasty ◽  
Hip Arthroplasty ◽  
Patient Population ◽  
Activity Level ◽  
Athletic Activity ◽  
Total Hip ◽  
Athletic Ability ◽  
Fibular Grafting ◽  
Free Vascularized Fibular Grafting

ABSTRACT Background Athletic patients with osteonecrosis of the femoral head have few desirable therapeutic options that preserve athletic ability. A total hip arthroplasty for this young and active patient population would be catastrophic for patients’ chances of returning to vigorous athletic endeavors. Therefore, other therapeutic alternatives must be considered prior to enlisting this patient population for a total hip arthroplasty. Materials and methods We retrospectively evaluated 15 patients (19 hips) who presented at an average age of 28.5 years (12-46) and stages 2 (6/19), 3 (2/19), 4 (9/19) and 5 (2/19) of osteonecrosis of the femoral head (ONFG). All patients were participating in strenuous athletic activity and were treated with free vascularized fibular autografting (FVFG) to the femoral head. Results Postoperative evaluation of pain symptoms and functional activity showed improvements in all patients. The average follow-up time was 8 years. Harris hip scores significantly increased from an average preoperative score of 72.5 to an average postoperative score of 94. Seventy-five percent of patients were able to return to their sport after recovery and all patients reported being satisfied with the procedure and would repeat their decision to have surgery. Three patients’ hips were converted to arthroplasty at 3, 11 and 17 years post-FVFG. Conclusion Our results demonstrate FVFG as a successful treatment in athletes with osteonecrosis of the femoral head. This procedure has the potential to reduce pain, increase activity and allow most to return to their sport, an achievement often not possible with other treatment options. Sabesan VJ, Pedrotty DM, Urbaniak JR, Gahreeb G, Aldridge III JM. Free Vascularized Fibular Grafting Preserves Athletic Activity Level in Patients with Osteonecrosis. The Duke Orthop J 2012;2(1):40-43.

A comparison of the effect of large and small metal-on-metal bearings in total hip arthroplasty on metal ion levels and the incidence of pseudotumour

2018 ◽  
Vol 100-B (8) ◽  
pp. 1018-1024 ◽  
Author(s):  
W. Ando ◽  
H. Yasui ◽  
K. Yamamoto ◽  
K. Oinuma ◽  
H. Tokunaga ◽  
...  
Keyword(s):  
Femoral Head ◽  
Total Hip Arthroplasty ◽  
Clinical Outcome ◽  
Hip Arthroplasty ◽  
Metal Ion ◽  
Conventional Group ◽  
Harris Hip Score ◽  
Ucla Activity Score ◽  
Large Femoral Head ◽  
Metal On Metal

Aims The purpose of this study was to compare two different types of metal-on-metal (MoM) bearing for total hip arthroplasty (THA): one with a large femoral head (38 mm to 52 mm) and the other with a conventional femoral head (28 mm or 32 mm). We compared clinical outcome, blood metal ion levels, and the incidence of pseudotumour in the two groups. Patients and Methods Between December 2009 and December 2011, 62 patients underwent MoM THA with a large femoral head (Magnum group) and 57 patients an MoM THA with a conventional femoral head (conventional group). Clinical outcome was assessed using the Harris Hip score, University of California, Los Angeles (UCLA) activity score and EuroQol-5D (EQ-5D). Blood metal ion levels were measured and MRI scans were analyzed at a minimum of five years postoperatively. Results No acetabular component was implanted with more than 50° of inclination in either group. The Harris Hip Score, UCLA activity score, and EQ-5D improved postoperatively in both groups; no significant clinical differences were noted between the groups. The blood cobalt ion levels in the conventional group continued to rise postoperatively to five years while reaching a plateau at two years postoperatively in the Magnum group. At five years, the mean cobalt ion level of 1.16 μg/l (sd 1.32) in the Magnum group was significantly lower than the 3.77 μg/l (sd 9.80) seen in the conventional group (p = 0.0015). The incidence of moderate to severe pseudotumour was 4.7% in the Magnum group and 20.6% in the conventional group. There were no dislocations in the Magnum group and two in the conventional group. One patient in the Magnum group underwent revision for pseudotumour at 4.7 years postoperatively. Conclusion At five years, a well-positioned large head MoM THA has a significantly lower level of metal ion release and a lower incidence of moderate to severe pseudotumour than a MoM bearing of conventional size. Cite this article: Bone Joint J 2018;100-B:1018–24.

scholarly journals Cup-To-Neck Contact and Range of Motion after Total Hip Arthroplasty with Large Head Diameters: An Original Three-Dimensional Combined Gait and Videofluoroscopy Analysis

2020 ◽  
Vol 10 (8) ◽  
pp. 2695
Author(s):  
Claudio Belvedere ◽  
Giada Lullini ◽  
Maurizio Ortolani ◽  
Andrea Ensini ◽  
Stefano Durante ◽  
...  
Keyword(s):  
Femoral Head ◽  
Total Hip Arthroplasty ◽  
Gait Analysis ◽  
Range Of Motion ◽  
Hip Arthroplasty ◽  
Three Dimensional ◽  
Motor Tasks ◽  
Large Femoral Head ◽  
Total Hip ◽  
Limited Range Of Motion

After a total hip arthroplasty, a limited range of motion and lower-limb disability continue to be observed, with these being mainly associated with the implant design and the head-to-neck ratio. Larger diameters of the head bearings were assumed to provide better stability, a larger range of motion, and smaller risks of dislocation and stem-to-liner impingement. However, these claims have never been demonstrated in real patients. The specific aim of this study was to assess, via multi-instrumental analysis, whether the range of motion of a replaced hip is limited by the stem-to-liner contact in patients with large femoral head diameters. Twenty-three patients with a total hip arthroplasty were evaluated at their one-year follow-ups using clinical and instrumental examinations. A combined three-dimensional gait analysis of the full body and videofluoroscopy analysis of the replaced hip were performed during the execution of standard, i.e., daily living, and more demanding motor tasks. The latter were meant to reach the extreme range of motion at the replaced hip site, thus revealing possible stem-to-liner contact. An original technique based on imaging and computer-aided design (CAD) models of the prosthesis components was developed to calculate the stem-to-liner distance. Excellent clinical scores were observed in the study. The gait analysis showed that the range of motion of the replaced hip in the sagittal plane, averaged over all patients, ranged from 28° to 78° in standard activities. In more demanding tasks, single peaks were as high as 110°, 39°, and 60° in the sagittal, frontal, and transverse anatomical planes, respectively. In all motor tasks, the stem-to-liner distances ranged from 8.7 to 13.0 mm on average, with one outlier minimum distance being 2.2 mm. This study shows that, even in demanding motor tasks and with an extreme range of motion, the hip joint replaced with large femoral head diameters did not experience impingement between the prosthesis components.

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