scholarly journals Midterm results of revision total hip arthroplasty for migrated bipolar hemiarthroplasty in patients with hip osteoarthritis using cementless cup with the rim-fit technique

2020 ◽  
Vol 28 (3) ◽  
pp. 230949902095431
Author(s):  
Takeyuki Tanaka ◽  
Taizo Kaneko ◽  
Ryo Hidaka ◽  
Kazuaki Hashikura ◽  
Hisatoshi Ishikura ◽  
...  
Keyword(s):  
Total Hip Arthroplasty ◽  
Hip Arthroplasty ◽  
Hip Osteoarthritis ◽  
Harris Hip Score ◽  
Bipolar Hemiarthroplasty ◽  
Revision Total Hip Arthroplasty ◽  
Implant Loosening ◽  
Midterm Results ◽  
Total Hip ◽  
Cementless Cup

Purpose: The results of reamed bipolar hemiarthroplasty (BHA) in patients with hip osteoarthritis (OA) are reported to be unfavorable. Acetabular reaming for sufficient bony coverage caused bipolar head migration into the superomedial direction, and most patients required revision surgeries. Several methods are applicable to treat decreased bone stock. This study aimed to investigate the midterm results of revision surgeries using the cementless cup with the rim-fit technique. Methods: Between 1996 and 2014, acetabular revision surgeries using the cementless cup with the rim-fit technique were performed in 86 hips (74 patients). We evaluated radiographic outcomes, including positional change of the rotation center of the artificial femoral head, presence of implant loosening, and filling of the initial gap. We also evaluated clinical outcomes, including the Harris hip score (HHS), and postoperative complications. Results: The average positional changes from BHA to prerevision surgeries were 8.0 mm superiorly and 4.1 mm medially. The average changes from prerevision to postrevision surgeries were 3.7 mm inferiorly and 2.4 mm laterally. No implant loosening was found in all cases; the initial gap between the acetabular host bone and the acetabular cup was filled in 53 (93%) among 57 hips. The average HHS improved from 65.9 before revision surgeries to 83.8 in the latest follow-up. Dislocation and postoperative periprosthetic fracture occurred in two and five hips, respectively; no cases required rerevision surgeries. Conclusion: There were favorable midterm results of the revision total hip arthroplasty for migrated BHA in patients with hip OA using cementless cup with the rim-fit technique.

scholarly journals Cementless one-stage bilateral total hip arthroplasty in osteoarthritis patients: functional outcomes and complications

2017 ◽  
Vol 9 (2) ◽  
Author(s):  
Afshin Taheriazam ◽  
Amin Saeidinia
Keyword(s):  
Total Hip Arthroplasty ◽  
Hip Arthroplasty ◽  
Functional Outcomes ◽  
Hip Osteoarthritis ◽  
Harris Hip Score ◽  
Superficial Infection ◽  
Total Hip ◽  
One Stage ◽  
The Mean ◽  
Hardinge Approach

Total hip arthroplasty (THA) is one of the successful and cost-benefit surgical treatments. One-stage bilateral THA (BTHA) has a large number of advantages, although there are concerns about the higher complications in this procedure. Aim of our study was to evaluate the complications and outcomes of cementless one-stage BTHA in osteoarthritis patients. A total of 147 patients from 2009 till 2012, underwent one-stage BTHA in Milad and Erfan hospitals, Tehran, Iran. A prospective analysis of the functional outcomes and complications of one-stage BTHA through Hardinge approach in patients with osteoarthritis was performed. We evaluated all patients clinically and radiologically with serial followups. A clinical hip score based upon the modified Harris Hip Score (MHHS) was performed preoperatively and again postoperatively. During the period of study 89 men (60.5%) and 58 women (39.4%) with a mean age of 54.67±7.08 years at the time of presentation were recruited. The mean surgical time was 2.8±0.25 hrs. The mean hospital stay was 3.83±0.65 days. Hemoglobin level decreased significantly after operation (P=0.038). There was two deep venous thromboses, one superficial infection and one temporal proneal palsy but no pulmonary embolism, dislocation, periprosthetic fracture or heterotrophic ossification. The mean preoperative MHHS score was 41.64±5.42 in patients. MHHS score improved to 89.26±4.68 in the last followup (P=0.0001). Our results recommended the use of cementless one-stage BTHA through Hardinge approach in patients with bilateral hip osteoarthritis.

Mid-term results with a neck-preserving femoral stem for total hip arthroplasty

2018 ◽  
Vol 28 (2_suppl) ◽  
pp. 28-34
Author(s):  
Giampaolo Rinaldi ◽  
Dario Capitani ◽  
Fabio Maspero ◽  
Valentina Scita
Keyword(s):  
Total Hip Arthroplasty ◽  
Functional Recovery ◽  
Hip Arthroplasty ◽  
Femoral Stem ◽  
Hip Osteoarthritis ◽  
Primary Stability ◽  
Harris Hip Score ◽  
Short Neck ◽  
Term Survival ◽  
Total Hip

Introduction: This prospective study aims to evaluate the mid-term clinical and radiological performance of a new short, neck-preserving femoral stem in total hip arthroplasty (THA). Patients and methods: 178 consecutive patients (190 hips) underwent THA from November 2008 to July 2016. Mean follow-up is 62.4 months. Women make up 41% of the cohort at a mean age of 50 ± 4 years, with primary hip osteoarthritis as the main complaint. All patients underwent radiological evaluation using the modified Gruen method, and clinical assessment via the Harris Hip Score (HHS), preoperatively and at 1, 6, 12, 24, 60, 80 and 106 months post-op. Results: A mean HHS increase (from 50 ± 12 points preoperatively to 96 ± 4 at 62 months), together with painless articular improvement, was present at 6 months postoperatively indicating early functional recovery. Effective osteointegration and primary stability were present on radiographic analysis, without evidence of stress shielding or stem mal-positioning: subsidence amounting to <1 mm was present in 40% of implants immediately after surgery, with subsequent stabilisation within 6 months in all cases. Metaphyseal trabecular re-orientation in absence of symptomatic cortical hypertrophy or progressive radiolucency indicates physiological load transfer in the proximal femur. Stem-related revision surgery was necessary for 1.05% of all implants due to fracture and infection. No loosening, dislocations or mechanical failures were reported. Conclusions: All patients show excellent functional recovery and clinical outcomes at 62 months, demonstrating the role optimal primary stability and physiological joint reconstruction play in ensuring stable secondary fixation and long-term survival of a short, neck-preserving stem.

scholarly journals Structural and Morselized Allografting Combined with a Cementless Cup for Acetabular Defects in Revision Total Hip Arthroplasty: A 4- to 14-Year Follow-Up

2018 ◽  
Vol 2018 ◽  
pp. 1-7 ◽  
Author(s):  
Hou-Tsung Chen ◽  
Cheng-Ta Wu ◽  
Tsan-Wen Huang ◽  
Hsin-Nung Shih ◽  
Jun-Wen Wang ◽  
...  
Keyword(s):  
Total Hip Arthroplasty ◽  
Hip Arthroplasty ◽  
Type Ii ◽  
Revision Total Hip Arthroplasty ◽  
Total Hip ◽  
Press Fit ◽  
Cementless Cup ◽  
Revision Tha ◽  
Acetabular Defects

Using morselized and structural allograft to restore bone stock for massive acetabular bone defect in revision total hip arthroplasty (THA) is an appealing procedure. However, concerns about inability to achieve long-term stability following allograft resorption remained. From 2003 to 2012, 59 hips in 58 patients undergoing revision THA for Paprosky type II or III acetabular defects were retrospectively reviewed. The acetabular defects were managed with deep-frozen morselized and structural allografts, and a press-fit cementless cup along with supplementary screws. Clinical outcomes and radiographic results were analyzed with a mean follow-up of 8.7 years. The clinical successful rate was 100% for hips with Paprosky type II defect, 95.2% for IIIA defect, and 92.8% for IIIB defect. Three hips with type III defect failed at 4, 7, and 9 years, respectively. Harris Hip Score improved significantly from 60.1 preoperatively to 91.3 at the latest follow-up. All hips with good clinical results showed trabecular bridging in the allograft-host bone interface. Deep-frozen structural and morselized allograft in combination with a press-fit cementless cup represented a viable option to reconstruct acetabular defects in revision THA.

scholarly journals Intracavitary and Extracavitary Iliac Extended Fixation Using Porous Metal Augments for Paprosky Type 3 Acetabular Defects in Revision Total Hip Arthroplasty: A Minimum 2 Years Follow-up

2019 ◽  
Author(s):  
Hao Tang ◽  
Yixin Zhou ◽  
Zhuyi Ma ◽  
Yong Huang ◽  
Shengjie Guo
Keyword(s):  
Total Hip Arthroplasty ◽  
Hip Arthroplasty ◽  
Porous Metal ◽  
Harris Hip Score ◽  
Revision Total Hip Arthroplasty ◽  
Total Hip ◽  
Fixation Group ◽  
Acetabular Defects ◽  
Type 3

Abstract Background: We proposed a new concept of “iliac extended fixation” in revision total hip arthroplasty (THA) as fixation extending superiorly 2 cm beyond the original acetabular rim with porous metal augments, which was further classified into intracavitary and extracavitary fixation. This study reports the minimum 2 years outcome of the iliac extended fixation technique in patients with Paprosky type 3 acetabular defects. Methods: Thirty two revision THA patients were retrospectively reviewed who underwent reconstruction with the concept of iliac extended fixation from 2014 to 2016 in our hospital. Patients were assessed using the Harris Hip Score (HHS) and the Western Ontario and McMaster Universities Osteoarthritis Index score (WOMAC). In addition, radiographs were assessed and patient reported satisfaction was collected. Results: At an average follow-up of 40 months (range 25 – 64 months), the postoperative HHS and WOMAC scores were significantly improved at the last follow-up (p < 0.001). The postoperative horizontal and vertical locations of the COR were significantly improved from the preoperative measurements (p < 0.05). Two (6.3 %) patients were dissatisfied with the outcome. The extracavitary iliac extended fixation group had significantly more horizontal screws fixation (4.6 ± 25.7° vs 41.9 ± 37.8°, p < 0.001) and higher rate of osteointegration in zone 1A (91.7% vs 50.0%, p = 0.023) than the intracavitary iliac extended fixation group. Conclusions: Intracavitary and extracavitary iliac extended fixation with porous metal augments and cementless cups are effective in reconstructing severe superior acetabular bone defects, with promising short-term clinical and radiographic outcome.

scholarly journals Evaluation of results of primary cementless total hip arthroplasty in osteoarthritis

2017 ◽  
Vol 4 (2) ◽  
pp. 612
Author(s):  
Arshad Bashir ◽  
Qazi Manan ◽  
Faisal Younis Shah ◽  
Hayat Ahmad Khan ◽  
Mohammad Iqbal Wani ◽  
...  
Keyword(s):  
Total Hip Arthroplasty ◽  
Hip Arthroplasty ◽  
Functional Disability ◽  
Tertiary Care ◽  
Hip Osteoarthritis ◽  
Harris Hip Score ◽  
Total Hip ◽  
Cementless Total Hip Arthroplasty ◽  
Radiographic Outcomes ◽  
Clinical And Radiological Outcome

Background: Total hip arthroplasty involves removal of diseased bone and soft tissue from both femoral and acetabular side and replacing it with mechanical components. It is one of the most successful surgical procedures. It relieves pain and functional disability experienced by patients with moderate to severe osteoarthritis of the hip, improving their quality of life. The success of THA is its ability to relieve the pain, while maintaining both mobility and stability of the joint. The purpose of this study was to evaluate the results of primary cementless total hip arthroplasty in patients with hip osteoarthritis.Methods: This study was done in a tertiary care teaching hospital. Thirty patients with hip osteoarthritis who were treated with cementless total hip arthroplasty were included in the study. This was a prospective study with a minimum of 12 months follow up (maximum of 25 months). The patients’ pre-operative and post-operative pain and functional status was compared using Harris hip score.Results: Excellent or good pain relief and function was obtained in 83.33% of cases. The mean total pre-operative Harris Hip Score was 32.93 which improved to 88.967 post-operatively. There was a statistically significant improvement in all parameters except absence of deformity. The most common complication was persistent anterior thigh pain that occurred in two patients.Conclusions: Our study suggests that the current generation of cementless implants provide satisfactory clinical and radiographic outcomes. Though the study was not free of complications, the overall clinical and radiological outcome showed encouraging results.

Bilateral total hip arthroplasty: one-stage versus two-stage procedure

2018 ◽  
Vol 29 (2) ◽  
pp. 141-146 ◽  
Author(s):  
Afshin Taheriazam ◽  
Gholamreza Mohseni ◽  
Ali A Esmailiejah ◽  
Farshad Safdari ◽  
Hashem Abrishamkarzadeh
Keyword(s):  
Total Hip Arthroplasty ◽  
Hospital Stay ◽  
Hip Arthroplasty ◽  
Functional Outcomes ◽  
Peroneal Nerve ◽  
Hip Osteoarthritis ◽  
Harris Hip Score ◽  
Total Hip ◽  
Hip Disease ◽  
Hardinge Approach

Background: Despite several studies, controversy has prevailed over the rate of complications following 1-stage and 2-stage bilateral total hip arthroplasty (THA). In the current study, we compare the complications and functional outcomes of 1-stage and 2-stage procedures. Methods: One hundred and eighty patients (ASA class I or II) with bilateral hip osteoarthritis were assigned randomly to two equal groups. The two groups were matched in terms of age and sex. All of the surgeries were performed via the Hardinge approach using uncemented implants. In 2-stage procedures, surgeries were performed with a 6-month to 1-year interval. All patients were evaluated 1 year postoperatively. Results: The Harris Hip Score (HHS) averaged 84.1 and 82.6 in 1-stage and 2-stage groups, respectively ( p = 0.528). The hospital stay was significantly longer in the 2-stage group (9.8 days vs. 4.9 days). The cumulative haemoglobin drop and the number of transfused blood units were the same. One patient in each group developed symptomatic deep venous thrombosis which was managed successfully. There was no patient with perioperative death, pulmonary embolism, infection, dislocation, periprosthetic fracture or heterotrophic ossification. No patient required reoperation. Two patients in the 1-stage group developed unilateral temporary peroneal nerve palsy, which was resolved after 3–4 months. Conclusion: 1-stage bilateral THA can be used successfully for patients with bilateral hip disease without increasing the rate of complications. Functional and clinical outcomes are comparable and hospital stay is significantly shorter.

Revision Total Hip Arthroplasty for Pelvic Osteolysis With Well-Fixed Cementless Cup

2007 ◽  
Vol 22 (7) ◽  
pp. 987-992 ◽  
Author(s):  
Jun-Dong Chang ◽  
Je-Hyun Yoo ◽  
Mina Hur ◽  
Sang-Soo Lee ◽  
Yung-Khee Chung ◽  
...  
Keyword(s):  
Total Hip Arthroplasty ◽  
Hip Arthroplasty ◽  
Revision Total Hip Arthroplasty ◽  
Total Hip ◽  
Cementless Cup ◽  
Pelvic Osteolysis
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