scholarly journals Evaluation of version of acetabular component following total hip replacement on conventional radiograph and computed tomography

2020 ◽  
Vol 27 (2) ◽  
pp. 179-185
Author(s):  
Manish Raj ◽  
Ashish Jaiman ◽  
Rajesh Kumar Chopra
Keyword(s):  
Computed Tomography ◽  
Ct Scan ◽  
Total Hip Replacement ◽  
Gold Standard ◽  
Hip Replacement ◽  
Regression Line ◽  
Patient Positioning ◽  
Acetabular Version ◽  
Total Hip ◽  
Significant Difference

Background/Purpose: Total hip replacement (THR) is considered as one of the most successful orthopedic procedures. However, improperly placed components can lead to instability and accelerated wear. Acetabular cup inclination can be very well accessed by anteroposterior pelvis X-rays; for acetabular version assessment, computed tomography (CT) scan is the gold standard. CT scan is not readily available at many centers and the surgeon has to rely on X-ray methods for evaluation of acetabular version to audit results and to predict behavior of the surgical intervention. This prospective study was undertaken to compare Woo and Morrey’s and ischiolateral methods of assessment of acetabular version on cross-table lateral radiographs with CT assessment and to assess the validity of radiographic methods with respect to CT scan method. Material and methods: A prospective follow-up study was conducted for 18 months’ duration (October 2016 to March 2018) on 30 adult patients who underwent THR surgery. Cross-table lateral radiograph was obtained at 3 and 6 weeks in the postoperative period. Two observers made each observation at two different points of time. CT scan was performed at 3 weeks. Version as measured by radiographs and CT scan was recorded. Results: The major overlap in the distribution of the values of the Woo and Morrey method suggests that there is no significant difference between the observations. Distribution of the values of the ischiolateral view and the CT scan value distributions have a very small overlap and hence suggest a strong significant difference between the two. Conclusion: In this study, Woo and Morrey’s method and ischiolateral method of assessment of acetabular version were compared with CT assessment. We found that in Woo and Morrey’s method, values were comparable to CT scan values, when put on regression line. However, in situation of change in patient positioning, namely hip stiffness in contralateral hip, measurement of component changed in series of radiography due to differences in pelvis tilt. So, in these circumstances, we can use ischiolateral method which can give consistent measurement. But it will not be in concordance with CT scan values and Woo and Morrey values, as represented in regression line. The high intra-class correlation coefficients for both intra- and inter-observer reliability indicated that the angle measured with these methods is consistent and reproducible for multiple observers. CT, however, be considered as gold standard for measurement owing to control over pelvic rotation and/or tilt/patient positioning.

Acetabular version and long posterior wall cup in total hip replacement

2008 ◽  
Vol 18 (1) ◽  
pp. 11-16 ◽  
Author(s):  
P. Chandran ◽  
M. Azzabi ◽  
A. Lister ◽  
M. Andrews ◽  
M.H. Stone
Keyword(s):  
Total Hip Replacement ◽  
Hip Replacement ◽  
Posterior Wall ◽  
Acetabular Version ◽  
Total Hip

Radiographic Assessment of Biomechanical Parameters following hip Resurfacing and Cemented Total Hip Arthroplasty

2009 ◽  
Vol 19 (3) ◽  
pp. 251-256 ◽  
Author(s):  
Curtis Robb ◽  
Richard Harris ◽  
Kevin O'dwyer ◽  
Nadim Aslam
Keyword(s):  
Total Hip Replacement ◽  
Hip Arthroplasty ◽  
Hip Replacement ◽  
Hip Resurfacing ◽  
Leg Length ◽  
Femoral Offset ◽  
Normal Side ◽  
Total Hip ◽  
Significant Difference ◽  
Joint Reaction Forces

Resurfacing hip arthroplasty and total hip replacement both aim to restore anatomical parameters. Leg length and offset discrepancy can result in altered joint reaction forces, and are associated with increased wear, dislocation, and decreased patient satisfaction. This study assesses the accuracy of leg length and offset restoration after either a Birmingham Hip Resurfacing (BHR) or a cemented total hip replacement (THR). Standardised antero-posterior radiography was performed on two groups of 30 patients with unilateral primary osteoarthritis undergoing either a cemented total hip or resurfacing. The normal contra-lateral hip was used as the control. Leg length and offset were measured pre-operatively with no significant difference between the two groups. Cup offset, femoral offset, total offset and leg length of the prosthesis and normal side were measured by two observers and mean measurements were analysed by a paired t test. Leg lengths in each group did not differ significantly from the normal side, THR 0.53 mm (95% CI -2.4 to 3.4 mm) but BHR implantation did result in mean leg shortening of -1.9 mm (95% CI -4.5 mm to 0.6 mm). Cup offset differed significantly from normal anatomy in both groups, as did femoral and total offset for the total hip replacement group. However, femoral offset was restored in the Birmingham resurfacing group. When the THR group was compared against the BHR group we found no difference between restoration of leg lengths (p = 0.21) and cup offset (p = 0.30) but femoral (p = 0.0063) and total offset (p = 0.03) were restored more accurately with a BHR.

Use of telephone interviews to follow up patients after total hip replacement

2005 ◽  
Vol 11 (4) ◽  
pp. 211-214 ◽  
Author(s):  
Sanjeev Sharma ◽  
Ravi Shah ◽  
Kingsley Paul Draviraj ◽  
M S Bhamra
Keyword(s):  
Total Hip Replacement ◽  
Hip Replacement ◽  
Harris Hip Score ◽  
Face To Face ◽  
Total Hip ◽  
Telephone Interviews ◽  
Significant Difference ◽  
The Mean ◽  
The Individual

We studied the feasibility of telephone interviews to assess hip function in patients who had had a total hip replacement. One hundred patients attending the orthopaedic clinic for follow-up after undergoing total hip replacement were studied. A modified Harris hip score was used. Since range of motion and deformity cannot be assessed by telephone, only pain and function were assessed. The maximum possible score was 100. Patients attending follow-up clinics were contacted by telephone one to two weeks prior to their appointment and a telephone assessment was completed. This was then compared with a face-to-face assessment in the subsequent clinic. The mean hip score obtained with the telephone interview was 85.2 and the mean hip score at face-to-face assessment was 86.1. The mean of the differences between the individual scores was −0.9 (SD 5.5). This difference was not significant ( P=0.11). Only three patients had a clinically significant difference (>20 points) between the two methods. Telephone questionnaires may be a useful adjunct to face-to-face assessment for patient follow-up after total hip replacement.

Bed Exercises following Total Hip Replacement: 1 Year follow-up of a Single-Blinded Randomised Controlled Trial

2009 ◽  
Vol 19 (3) ◽  
pp. 268-273 ◽  
Author(s):  
Toby O. Smith ◽  
Charles J.V. Mann ◽  
Allan Clark ◽  
Simon T. Donell
Keyword(s):  
Total Hip Replacement ◽  
Hip Replacement ◽  
Short Form ◽  
Controlled Trial ◽  
Education Programme ◽  
Total Hip ◽  
Significant Difference ◽  
Group A ◽  
Group B ◽  
Randomised Controlled

This paper presents the results of a study assessing whether bed exercises after primary THR (total hip replacement) improves function or quality of life, during the first post-operative year. Sixty patients undergoing primary THR were randomised to receive either a gait re-education programme and bed exercises (Group A) or a gait re-education programme without bed exercises (Group B) post-operatively. The Iowa level of assistance Scale (ILOA) and Short Form-12 Health Survey (SF-12) were assessed at baseline, 3 days, 6 weeks and 1 year post-operatively. There was no statistically significant difference in either ILOA or SF-12 after 1 year between Group A or B. There was no evidence of a subgroup effect by either the surgical approach or prosthesis fixation in either ILOA or SF-12.

scholarly journals Precision and accuracy of pre-surgical planning of non-cemented total hip replacement with calibrated digital images and acetates

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Luis Fernando Useche Gómez ◽  
Hernando Gaitán-Lee ◽  
María Alejandra Duarte ◽  
Patrick Dennis Halley ◽  
Alejandro Romero Jaramillo ◽  
...  
Keyword(s):  
Total Hip Replacement ◽  
Gold Standard ◽  
Hip Replacement ◽  
Surgical Planning ◽  
Femoral Stem ◽  
Accurate Estimation ◽  
Hybrid Technique ◽  
Level Of Evidence ◽  
Total Hip ◽  
Replacement Procedure

Abstract Background When approaching a joint replacement procedure, pre-surgical planning is essential to predict an accurate estimation of implant size and position. There are currently two methods to achieve it, analog and digital. The present study aims to demonstrate how the hybrid technique is accurate and precise for pre-surgical planning in a non-cemented total hip replacement. Methods Concordance-type study is used against a gold standard, as well as inter- and intra-observer consistency evaluation of two orthopedic surgeons and two orthopedic surgery residents. Accuracy was calculated with the intra-class correlation coefficient (ICC). Afterwards, the same calculation was done considering a margin of error with one size more and one less. Results Thirty-eight patients were included in the study: 19 women and 19 men. Twenty-two prostheses (57.89%) were right-sided and 16 were left (42.11%). Twelve prostheses (31.57%) were Stryker and 26 Johnson & Johnson (68.43%). Acetabular cup correlation compared with the gold standard was moderate: ICC reported 0.45 (95% CI, 0.15–0.76). When adjusted by ± 1 size, ICC was 0.48 (95% CI, 0.18–0.79). On the other hand, results from the femoral stem reported ICC 0.85 (95% CI, 0.07–0.98). When adjusted by ± 1 size, ICC was 0.86 (95% CI, 0.06–0.99). Conclusions Hybrid templating is a reliable substitute for analog or digital planning. It is quick, inexpensive, accurate, and better results are observed in the femoral component regardless the level of expertise of the evaluator. Level of evidence Grade IV

scholarly journals Prosthetic liner wear in total hip replacement: a longitudinal 13-year study with computed tomography

2018 ◽  
Vol 47 (6) ◽  
pp. 883-887 ◽  
Author(s):  
Lars Weidenhielm ◽  
Henrik Olivecrona ◽  
Gerald Q. Maguire ◽  
Marilyn E. Noz
Keyword(s):  
Computed Tomography ◽  
Total Hip Replacement ◽  
Hip Replacement ◽  
Total Hip

Ultrasonographic Screening of Deep Venous Thrombosis in Patients Undergoing Total Hip Replacement

1993 ◽  
Vol 3 (2) ◽  
pp. 39-45
Author(s):  
F Ravasi ◽  
V. Sansone ◽  
P. Gifuni
Keyword(s):  
Venous Thrombosis ◽  
Deep Venous Thrombosis ◽  
Total Hip Replacement ◽  
Gold Standard ◽  
Hip Replacement ◽  
Standard Procedure ◽  
Lower Limbs ◽  
Total Hip ◽  
Specificity And Sensitivity ◽  
Asymptomatic Patients

The incidence of deep venous thrombosis (DVT) after total hip replacement is estimated to be up to 45%. Venography is widely accepted as the gold standard procedure for diagnosis of DVT. With the purpose of detecting the presence of DVT in asymptomatic patients operated on for primary hip replacement, we adopted Real-time B-Mode ultrasonography in order to evaluate its specificity and sensitivity in 68 patients. A venography was performed in all the cases in order to obtain a gold standard to compare with sonography. Sensitivity and specificity of sonography for femoral thrombosis were 71.4% and 97.6% respectively. Ultrasounds were not able to detect thrombosis of the calf veins but the risk of an evolution to worse pulmonary embolism is quite insignificant at this level. We suggest the use of B-mode ultrasonography for DVT screening of lower limbs in all the patients undergoing total hip replacement.

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