scholarly journals Complications following 250 cemented modular hip hemiarthroplasties

2018 ◽  
Vol 108 (4) ◽  
pp. 321-328 ◽  
Author(s):  
E. Ekman ◽  
H. Nurmi ◽  
A. Reito ◽  
J. Paloneva

Background and Aims: Hemiarthroplasty is a common method of treating displaced femoral neck fractures, especially among elderly non-active patients with frailty syndrome. Complications arising from the use of a modern, modular hemiendoprosthesis via a posterior approach have been poorly reported in this population. The aim of this study was to evaluate complications and mortality associated with the use of Lubinus sp II cemented, unipolar hemiarthroplasty prosthesis and posterior approach during a 9-year follow-up. Material and Methods: All patients (244) who received hemiarthroplasty due to an acute fracture of the femoral neck in Central Finland Hospital, Jyvaskyla, Finland, during 2007 and 2008 were included. Patient records were retrospectively reviewed for intraoperative and postoperative complications. Results and Conclusion: Women composed 70% (n = 171) of the study population. Mean age was 83 years for women and 80 years for men. A total of 31 (12%) complications were found in 30 patients. These were 12 dislocations (5% of all patients), 5 (2%) periprosthetic fractures, 2 (0.8%) superficial and 5 (2%) deep infections, 1 (0.4%) protrusion of the prosthesis, 2 (0.8%) intraoperative fractures, and 2 (0.8%) partial sciatic nerve palsies. Conversion to total hip replacement was performed in 9 cases (4%) and a reoperation was required in 15 (6%) cases. Mortality rate at 9 years was 78% (95% confidence interval = 72%–83%). The overall rate of complications was acceptable although mortality was high in this comorbid patient population. The need for conversion to total hip arthroplasty and reoperation is low.

2021 ◽  
Vol 49 (5) ◽  
pp. 030006052110122
Author(s):  
Wenlu Liu ◽  
Huanyi Lin ◽  
Xianshang Zeng ◽  
Meiji Chen ◽  
Weiwei Tang ◽  
...  

Objective To compare the clinical outcomes of primary metal-on-metal total hip replacement (MoM-TR) converted to uncemented total hip replacement (UTR) or cemented total hip replacement (CTR) in patients with femoral neck fractures (AO/OTA: 31B/C). Methods Patient data of 234 UTR or CTR revisions after primary MoM-TR failure from March 2007 to January 2018 were retrospectively identified. Clinical outcomes, including the Harris hip score (HHS) and key orthopaedic complications, were collected at 3, 6, and 12 months following conversion and every 12 months thereafter. Results The mean follow-up was 84.12 (67–100) months for UTR and 84.23 (66–101) months for CTR. At the last follow-up, the HHS was better in the CTR- than UTR-treated patients. Noteworthy dissimilarities were correspondingly detected in the key orthopaedic complication rates (16.1% for CTR vs. 47.4% for UTR). Statistically significant differences in specific orthopaedic complications were also detected in the re-revision rate (10.3% for UTR vs. 2.5% for CTR), prosthesis loosening rate (16.3% for UTR vs. 5.9% for CTR), and periprosthetic fracture rate (12.0% for UTR vs. 4.2% for CTR). Conclusion In the setting of revision of failed primary MoM-TR, CTR may demonstrate advantages over UTR in improving functional outcomes and reducing key orthopaedic complications.


2021 ◽  
pp. 71-75
Author(s):  
Arun Kumar C ◽  
Ganashree S ◽  
Arivoli S ◽  
Aswath C A ◽  
Rakesh Kumar B ◽  
...  

Introduction: Hip resurfacing arthroplasty (HRA) or Total hip replacement (THR), as it is popularly called, attempts to mollify these basic clinical problems, in patients with a hip arthritic problem, which may be of a sequela to age-related degeneration, osteonecrosis, systemic disorder like Rheumatoid arthritis (RA) or Ankylosing spondylosis (AS) or as a result of trauma and or an old infection. The basic pathology, is an unfavourable and abrading hip diarthrodial joint. The endeavour of the study was, to establish the efcacy of the Posterior vs Lateral approach for THA/THR, by studying their outcomes in primary THR. This prospective study was undertaken at Che Materials And Methods: ttinad Hospital and Research Institute (CARE), Kelambakkam, Chengalpattu district, Tamilnadu, In the Department of Orthopaedics from Jan 2017 to Dec 2020 (48 months). The Functional outcome of hip surgery was measured using the Harris Hip Score, Oxford hip score and the WOMAC. Rivermead visual gait analysis (RVGA) method was used post-operatively to assess the gait. The Biomechanical outcomes of Abductor Gait Component, were individually assessed by EMG studies. The Harris Hip Score, The Oxford Hip S Results: core and WOMAC score, when the lateral approach was compared to the posterior approach pre-op and post-op in the 12 months minimum follow-up period, the laterally approached group faired better. The VAS score was equivocal. The comprehensive RVGA assessment also showed marginally better results for the laterally approached group as was the case with the Trendelenburg test score. The EMG studies for the Gluteus Maximus, Medius and the lateral rotators of hip also favoured the outcomes for the laterally approach hips. The supremacy of the Lateral Approach, ove Conclusion: r Posterior Approach, cannot be adjudged in a short-term follow-up study. It is thus opined that the Lateral Approach may be statistically and data wise superior, but the patient satisfaction, which is a major factor, is almost the same in both the approach groups. The follow-up needs to be atleast for a decade for us to be able to come to any meaningful conclusion. With regards to surgery like the Total hip replacement, which have a longevity factor exceeding 10 years, studies have to be followed up for periods in excess of 10 years.


2020 ◽  
pp. 112070002090468
Author(s):  
Ilari Kuitunen ◽  
Antti Eskelinen ◽  
Eerik T Skyttä ◽  
Heini Huhtala ◽  
Miia Artama

Background: Few previous studies have analysed the possible teratogenic effect of maternal total hip replacement (THR) on congenital anomalies. The aim of this study was to estimate the risk of major congenital anomalies in the offspring of women with THR. Furthermore, we compared the risks based on type of implant (metal-on-metal [MoM]/non-MoM). Methods: The study population for this register-based cohort study was gathered from six Finnish national registers. All fertile-aged females who underwent THR from 1980 to 2007 and three reference females for each THR patient without THR were selected. THR operation day was the start of the follow-up for both groups. Information on pregnancies, induced abortions (IA) and congenital anomalies was gathered for the years 1987–2007 and the proportions of congenital anomalies were compared. Results: In the THR group, 2429 women had 256 pregnancies, 205 (80.1%) deliveries and 51 (19.9%) IAs. In the reference group, 7276 women had 1670 pregnancies, 1443 (86.4%) deliveries and 236 (13.6%) IAs. There was no difference in the incidence of major anomalies between the THR (3.5%, n = 9) and the reference group (3.6%, n = 60), p = 0.91. In the THR group, there was no difference in the risk of major anomalies between the patients with a MoM-THR (10.5%, 2/19) and those with a non-MoM (2.9%, 7/241) (OR 3.93, 95% confidence interval 0.76–20.2; p = 0.13). Conclusions: Reassuringly, maternal THR does not appear to increase the risk of major congenital anomalies or pregnancies ending due to suspected foetal anomalies. Studies with larger study populations are needed to further assess the risk of anomalies in the offspring of women having MoM-THR.


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