The influence of anterior and posterior knot placement on hip function after total hip arthroplasty using a modified Dall’s approach: a prospective non-randomised comparative study

2020 ◽  
pp. 112070002097778
Author(s):  
Hiroaki Hara ◽  
Hiroshi Fujita ◽  
Yuki Okutani ◽  
Masanao Kataoka ◽  
Hideto Harada ◽  
...  
Keyword(s):  
Regression Analysis ◽  
Total Hip Arthroplasty ◽  
Hip Arthroplasty ◽  
Positive Impact ◽  
Japanese Orthopaedic Association ◽  
Randomised Study ◽  
Total Hip ◽  
Patient Demographics ◽  
Hip Disease ◽  
Hip Function

Background: The direct lateral modified Dall’s approach for total hip arthroplasty (THA) provides an excellent vision of the hip joint by osteotomising the greater trochanter (GT). A robust method for the reattachment of osteotomised fragments is essential to prevent complications around the GT. Ultra-high molecular weight polyethylene cables are reported to be useful for reattachment; but the optimal suture method of these cables is unknown. The purpose of this study was to investigate the influence of the knot position on hip function after primary THA. Methods: In a prospective non-randomised study 216 primary THA were included, being scheduled for an operation with a modified Dall’s approach. They were divided into 2 groups, anterior (A) and posterior (P) according to the knot position for the GT. Hip function was assessed using the Japanese Orthopaedic Association Hip Disease Evaluation Questionnaire (JHEQ), pain visual analogue scale (VAS), satisfaction VAS and Merle d’Aubigne-Postel hip score at 3 and 6 months postoperatively. A logistic regression analysis was used to investigate factors influenced by the knot position. Results: Patient demographics were comparable between the 2 groups. Differences of the knot position did not affect the radiological failure rate of GT reattachment. Regression analysis showed a significantly positive impact on pain VAS and flexion range at 6 months postoperatively for posterior knot position. Conclusions: For the reattachment of osteotomised fragments, the posterior knot may be superior to the anterior knot.

scholarly journals Preoperative factors predicting the severity of BMD loss around the implant after Total hip Arthroplasty

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Akira Morita ◽  
Naomi Kobayashi ◽  
Hyonmin Choe ◽  
Taro Tezuka ◽  
Shota Higashihira ◽  
...  
Keyword(s):  
Regression Analysis ◽  
Total Hip Arthroplasty ◽  
Hip Arthroplasty ◽  
Multivariate Regression ◽  
Japanese Orthopaedic Association ◽  
Harris Hip Score ◽  
Lateral Side ◽  
Mineral Density ◽  
Total Hip ◽  
Preoperative Factors

Abstract Background Stress shielding after total hip arthroplasty (THA) leads to loss of bone mineral density (BMD) around the femoral implants, particularly in the proximal area. Loss of BMD around the implant is likely to occur within 1 year after THA; however, its severity depends on patient characteristics. This study evaluated preoperative factors correlated with the severity of zone 7 BMD loss after THA. Methods This retrospective cohort study included 48 patients who underwent primary THA from October 2011 to December 2015. All patients underwent implantation of a Zweymüller-type femoral component without any postoperative osteoporosis medications. The objective variable was a change in zone 7 BMD after 1 year. Factors evaluated included age, body mass index, Japanese Orthopaedic Association score, Harris Hip Score, Canal Flare Index (CFI), and lumbar BMD on the frontal and lateral sides. Univariate and multivariate regression analyses identified factors correlated with loss of zone 7 BMD. Results Univariate regression analysis identified CFI (P = 0.003) and preoperative lumbar BMD on the anterior-posterior (P = 0.003) and lateral (P < 0.001) sides as being correlated with loss of zone 7 BMD. Multivariate regression analysis identified CFI (P = 0.014) and lumbar BMD on the lateral side (P < 0.001) as being correlated independently with loss of zone 7 BMD. Conclusion Lower preoperative lumbar BMD on the lateral side and lower CFI were correlated with zone 7 BMD loss after THA. Patients with these characteristics should be monitored carefully for severe BMD loss after THA.

scholarly journals Preoperative Risk Factors for Dissatisfaction After Total Hip Arthroplasty Among Patients With Osteonecrosis of the Femoral Head

2020 ◽  
Author(s):  
Genta Takemoto ◽  
Taisuke Seki ◽  
Yusuke Osawa ◽  
Yasuhiko takegami ◽  
Taiki Kusano ◽  
...  
Keyword(s):  
Risk Factors ◽  
Femoral Head ◽  
Total Hip Arthroplasty ◽  
Hip Arthroplasty ◽  
Short Form ◽  
Japanese Orthopaedic Association ◽  
Evaluation Questionnaire ◽  
Total Hip ◽  
Preoperative Risk Factors ◽  
Hip Disease

Abstract Background: The objective of this study was to investigate the preoperative risk factors for dissatisfaction after total hip arthroplasty for osteonecrosis of the femoral head.Methods: A total of 71 patients (91 hips) with osteonecrosis of the femoral head who underwent total hip arthroplasty surgery in our hospital were included. The degree of satisfaction was evaluated using a visual analogue scale one year after the total hip arthroplasty. The patients were divided into two groups: the satisfied group (S group; visual analogue scale score > 20 mm) and the dissatisfied group (D group; visual analogue scale score < 20 mm). The results of the preoperative quality-of-life self-assessments, including the Short Form-36 and Japanese Orthopaedic Association Hip Disease Evaluation Questionnaire, were compared between the satisfied and dissatisfied groups. Multivariate analysis was performed to examine the independent preoperative risk factors.Results: There were 49 patients (64 hips) and 22 patients (27 hips) in the S and D groups, respectively. Patient age was significantly higher in the D group, and the movement and mental scores obtained with the Japanese Orthopaedic Association Hip Disease Evaluation Questionnaire and the Mental Component Summary scores of the Short Form-36 were significantly lower. However, there were no between-group differences in the pain score obtained with the Japanese Orthopaedic Association Hip Disease Evaluation Questionnaire and the Physical Component Summary and Role/Social Component Summary scores of the Short Form-36. Multivariate analysis showed that age and mental score obtained with the Japanese Orthopaedic Association Hip Disease Evaluation Questionnaire were independent risk factors.Conclusions: Preoperative age and mental score obtained with the Japanese Orthopaedic Association Hip Disease Evaluation Questionnaire strongly affected satisfaction levels observed one year after total hip arthroplasty in patients with osteonecrosis of the femoral head.

scholarly journals Clinical assessment after total hip arthroplasty using the Japanese Orthopaedic Association Hip-Disease Evaluation Questionnaire

2015 ◽  
Vol 12 ◽  
pp. S31-S36 ◽  
Author(s):  
Kiyokazu Fukui ◽  
Ayumi Kaneuji ◽  
Tanzo Sugimori ◽  
Toru Ichiseki ◽  
Tadami Matsumoto ◽  
...  
Keyword(s):  
Total Hip Arthroplasty ◽  
Hip Arthroplasty ◽  
Clinical Assessment ◽  
Japanese Orthopaedic Association ◽  
Evaluation Questionnaire ◽  
Total Hip ◽  
Hip Disease

Comparison of Polyethylene Wear between Highly Crosslinked and Annealed UHMWPE and Conventional UHMWPE against Ceramic Heads in Total Hip Arthroplasty

2012 ◽  
Vol 529-530 ◽  
pp. 279-284 ◽  
Author(s):  
Taishi Sato ◽  
Yasuharu Nakashima ◽  
Mio Akiyama ◽  
Takuaki Yamamoto ◽  
Taro Mawatari ◽  
...  
Keyword(s):  
Femoral Head ◽  
Total Hip Arthroplasty ◽  
Hip Arthroplasty ◽  
Polyethylene Wear ◽  
Wear Rates ◽  
Head Penetration ◽  
Total Hip ◽  
Patient Demographics ◽  
Ceramic Femoral Head ◽  
Implantation Period

The purpose of this study was to examine the effects of ceramic femoral head material on the wear of annealed, crosslinked ultra-high molecular weight polyethylene (UHMWPE) (XLPE) in total hip arthroplasty compared to non-crosslinked conventional UHMWPE (CPE). XLPE was fabricated by crosslinking with 60 kGy irradiation and annealing. Femoral heads made from zirconia and alumina ceramics, and cobalt-chrome (CoCr) of 22 mm or 26 mm diameter were used. In this study, the femoral head penetration into the cup was measured digitally on radiographs of 70 hips with XLPE and 50 hips with CPE. The average follow-up periods were 6.1 and 12.7 years, respectively. The steady wear rate of XLPE was significantly lower than those of CPE (0.002 versus 0.08 mm/year, respectively). Zirconia displayed increased wear rates compared to alumina in CPE; however, there was no difference among head materials in XLPE (0.0028, 0.011 and 0.009 mm/year for zirconia, alumina and CoCr, respectively). Neither head size or implantation period impacted XLPE wear. In contrast to CPE, XLPE displayed low wear rates surpassing the effects of varying femoral head material, size, implantation period and patient demographics.

scholarly journals Patient- and Surgery-Related Factors that Affect Patient-Reported Outcomes after Total Hip Arthroplasty

2018 ◽  
Vol 7 (10) ◽  
pp. 358 ◽  
Author(s):  
Toshiyuki Kawai ◽  
Masanao Kataoka ◽  
Koji Goto ◽  
Yutaka Kuroda ◽  
Kazutaka So ◽  
...  
Keyword(s):  
Regression Analysis ◽  
Total Hip Arthroplasty ◽  
Hip Arthroplasty ◽  
Activity Score ◽  
Harris Hip Score ◽  
Related Factors ◽  
Ucla Activity Score ◽  
Factors Associated ◽  
Total Hip ◽  
Patient Reported

Patient-reported outcome measures (PROMs) are used to assess satisfaction after total hip arthroplasty (THA); however, the factors that determine these PROMs remain unclear. This study aimed to identify the patient- and surgery-related factors that affect patient satisfaction after THA as indicated by the Oxford Hip Score (OHS). One-hundred-and-twenty patients who underwent primary THA were included. Various patient-related factors, including clinical scores, and surgery-related factors were examined for potential correlations with the OHS at 3, 6, and 12 months post-THA. Univariate regression analysis showed that higher preoperative University of California Los Angeles (UCLA) activity score (p = 0.027) and better preoperative OHS (p = 0.0037) were correlated with better OHS at 3 months post-THA. At 6 months post-THA, the factors associated with better OHS were higher preoperative UCLA activity score (p = 0.039), better preoperative OHS (p = 0.0006), and use of a cemented stem (p = 0.0071). At 12 months post-THA, the factors associated with better OHS were higher preoperative UCLA activity score (p = 0.0075) and better preoperative OHS (p < 0.0001). Multivariate regression analysis showed that the factors significantly correlated with better OHS were female sex (p = 0.011 at 3 months post-THA), osteoarthritis (p = 0.043 at 6 months), higher preoperative OHS (p < 0.001 at 3 and 12 months, p = 0.018 at 6 months), higher preoperative Harris Hip Score (p = 0.001 at 3 months), higher preoperative UCLA activity score (p = 0.0075 at 3 months), and the use of a cemented femoral component (p = 0.012 at 6 months). Patient- and surgery-related factors affecting post-THA PROMs were identified, although the effect of these factors decreased over time.

Primary Total Hip Arthroplasty for Gunshot Injury-Induced Secondary Arthritis of the Hip: What Are the Outcomes?

2017 ◽  
Vol 01 (04) ◽  
pp. 200-204 ◽  
Author(s):  
Roby Abraham ◽  
Joseph Scollan ◽  
Patrick Mixa ◽  
Denis Cherkalin ◽  
Jeffrey Varghese ◽  
...  
Keyword(s):  
Total Hip Arthroplasty ◽  
Hip Arthroplasty ◽  
Degenerative Joint Disease ◽  
Joint Disease ◽  
Total Hip ◽  
Hip Function ◽  
Post Traumatic ◽  
Traumatic Arthritis ◽  
Primary Total Hip Arthroplasty

AbstractGunshot wound (GSW) injuries around the hip joint can lead to debilitating post-traumatic arthritis, requiring a technically demanding primary total hip arthroplasty (THA). These surgeries are often complicated by bullet debris, extensive scaring, prior operations, and altered local anatomy. Although most literature focuses on acute management of GSW around the hip, a few reports detail the mid-term outcomes of GSW patients with primary THA for post-traumatic arthritis. The purpose of this study was to assess the outcomes and complications associated with THA in nine patients with secondary arthritis due to prior GSW injuries. At a mean follow-up of 35 months (range 12–60 months), significant improvement was shown in hip function, activity, and pain levels, and was similar to the outcomes of 18 patients who underwent primary THA for degenerative joint disease. While technically demanding, THA seems to reduce pain and improve function safely and effectively for patients with GSW-induced hip arthritis.

Intraprosthetic Dislocation of Modular Dual-Mobility Total Hip Arthroplasty Components During Closed Reduction: A Report of Two Cases

2017 ◽  
Vol 01 (04) ◽  
pp. 205-210
Author(s):  
Ovninder Johal ◽  
Blake Eyberg ◽  
Russell Meldrum ◽  
J. Walker
Keyword(s):  
Total Hip Arthroplasty ◽  
Hip Arthroplasty ◽  
Closed Reduction ◽  
Hip Dislocation ◽  
Dual Mobility ◽  
Total Hip ◽  
Unique Mode ◽  
Mode Of Failure ◽  
Hip Disease ◽  
Intraprosthetic Dislocation

AbstractDual-mobility bearing total hip arthroplasty offers several advantages over traditional prosthesis designs in the treatment of degenerative hip disease. Over decades of use, they have shown proven benefits in both durability and stability. However, despite their practical and theoretical advantages, they present a unique mode of failure not seen with other implants. In this report, the authors present two patients who sustained intraprosthetic dislocation of their dual-mobility total hip arthroplasty components during closed reduction of a hip dislocation.

Total Hip Arthroplasty for Congenital Hip Disease

2004 ◽  
Vol 86 (2) ◽  
pp. 242-250 ◽  
Author(s):  
George Hartofilakidis ◽  
Theofilos Karachalios
Keyword(s):  
Total Hip Arthroplasty ◽  
Hip Arthroplasty ◽  
Total Hip ◽  
Hip Disease

scholarly journals Comparison of Combined Lumbosacral Plexus and T12 Paravertebral Nerve Blocks With General Anesthesia in Older Adults Undergoing Primary Total Hip Arthroplasty: A Retrospective, Propensity Score–Matched Cohort Study

2020 ◽  
Vol 11 ◽  
pp. 215145932097653
Author(s):  
Li Min ◽  
Chen Chen ◽  
Yuan Yan ◽  
Shen Jiang ◽  
Yang Linyi ◽  
...  
Keyword(s):  
Total Hip Arthroplasty ◽  
Propensity Score ◽  
General Anesthesia ◽  
Hip Arthroplasty ◽  
Perioperative Complications ◽  
Lumbosacral Plexus ◽  
Cardiac Events ◽  
Nerve Blocks ◽  
Total Hip ◽  
Hip Disease

Background: Total Hip Arthroplasty(THA) is a surgical treatment for hip disease. A large amount of evidence has been reported on comparing outcomes of neuraxial(spinal or epidural) anesthesia and general anesthesia. However, it is unclear whether nerve blocks(NB) as main anesthesia technique compared with general anesthesia(GA) for THA could reduce perioperative complications. We conducted a retrospective evaluation of NB and GA, using a propensity score-matched analysis(PSMA). Methods: A total of 902 patients older than 60 years old with hip disease undergoing primary THA received combined lumbosacral plexus and T12 paravertebral nerve blocks (n = 143) or GA (n = 759) at our institution from 2012 to 2018.Binary logistic regression was used for comparison of the primary outcomes(the incidence of delirium) and the secondary outcomes(the percentage of postoperative hemoglobin(>10g/dl), transfusion(>2 units), major cardiac events(MACE), postoperative pulmonary complications (PPC) and 30-day mortality) in the matched cohorts.Statistical analysis was performed using SPSS v 23.0. Results: Both cohorts were balanced in all included parameters after PSMA. The incidence of delirium was lower (OR 0.233,95% CI 0.064-0.845, p = 0.030) in NB group in matched cohorts. In the unmatched and matched cohorts, the percentage of Hb(>10g/dl) was higher in GA group but the incidence of transfusion(>2 units) was higher in NB group. No difference was found in the incidence of 30-day mortality in the unmatched and matched cohorts. In the unmatched cohorts, the incidence of PPC was higher and LOS was longer in NB cohort, but no difference was observed in the matched cohorts. Conclusion: In patients older than 60 years old receiving primary THA, NB could be associated with a lower incidence of delirium.

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