Functional and radiographical results of asymmetrically reconstructed total hip arthroplasty in patients with bilateral dysplastic arthritic hips with one hip Crowe II–III and the other Crowe IV: a retrospective cohort study

Abstract Background The study aimed to evaluate the functional and radiographical results of asymmetrically reconstructed total hip arthroplasty in patients with bilateral dysplastic arthritic hips with one hip Crowe II–III and the other hip Crowe IV. Materials and methods From April 2006 to April 2019, we evaluated 23 patients who had a reconstruction of one Crowe II–III hip with high hip center (HHC) and the other Crowe IV hip at the anatomical position (H group). The radiographic and clinical outcomes were compared with those of a control group of 19 patients with bilateral dysplasia who had one Crowe IV hip and the contralateral hip both reconstructed in the anatomical position (A group). Medical records and radiographs were reviewed, and a complete follow-up was conducted for all patients. Results The mean vertical center of rotation (V-COR) and horizontal center of rotation (H-COR) in the H group were 30.6 ± 5.8 mm and 30.0 ± 5.5 mm, respectively. In the A group, the corresponding values were 14.0 ± 4.3 mm and 23.0 ± 2.3 mm, respectively. A significant difference was found in terms of V-COR and H-COR between the two groups, and no significant difference was shown regarding the cup inclination, abductor lever arm (ALA), ALA ratio, and leg length discrepancy (LLD). Three patients of the H group and four patients of the A group exhibited LLD > 10 mm. All seven patients who had LLD > 10 mm underwent the shortening subtrochanteric osteotomy (SSTO) of the Crowe IV hip. Subgroup analysis based on the presence and absence of SSTO showed that the LLD of the SSTO group was greater than that of the non-SSTO group in both groups, but the difference was only statistically significant in the A group. At the last follow-up, the mean Harris Hip Scores significantly improved in the two groups, and there was no revision during the follow-up period. In the H group, four patients presented with a slight limp and three patients with a moderate limp, while it was six patients and one patient in the A group, respectively. Conclusions Asymmetrical reconstruction in patients with bilateral dysplastic arthritic hips with one hip Crowe II–III and the other Crowe IV is acceptable and comparable when compared with bilateral anatomical reconstruction. Level of evidence III, retrospective observational study. Trial registration Chinese Clinical Trail Registry. ChiCTR2000033848

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32-mm ceramic-on-ceramic total hip arthroplasty versus 28-mm ceramic bearings: 5- to 15-year follow-up study

Hip International ◽

10.1177/1120700018760971 ◽

2018 ◽

Vol 29 (1) ◽

pp. 65-71 ◽

Cited By ~ 3

Author(s):

Yoshitoshi Higuchi ◽

Taisuke Seki ◽

Yukiharu Hasegawa ◽

Yasuhiko Takegami ◽

Daigo Morita ◽

...

Keyword(s):

Total Hip Arthroplasty ◽

Hip Arthroplasty ◽

Harris Hip Score ◽

Total Hip ◽

Kaplan Meier ◽

Significant Difference ◽

Average Patient ◽

The Mean ◽

Ceramic On Ceramic

Introduction: This study aimed to compare the clinical and radiographic results of 28-mm ceramic-on-ceramic (CoC) total hip arthroplasty (THA) to those of 32-mm CoC during a 5- to 15-year follow-up period. Methods: 107 joints (95 women and 6 men) underwent 28-mm CoC, and 60 (49 women and 7 men) underwent 32-mm CoC. The average patient age at the time of surgery was 56.1 and 55.7 years in the 28-mm and 32-mm CoC groups, respectively. Clinical and radiologic measurements of all patients were analysed. Results: The mean preoperative Harris hip score (HHS) was similar in the 2 groups (28-mm, 58.9; and 32-mm, 58.5). However, at final follow-up, the mean HHS of the 32-mm CoC (91.8) was significantly better than that of the 28-mm CoC (88.2) ( p = 0.003), as were the ranges of motion (ROM) for flexion (98.3 ± 13.5° vs. 87.3 ± 19.3°, p < 0.001) and abduction (27.8 ± 14.9° vs. 22.1 ± 19.3°, p = 0.007). The mean wear rate was 0.0044 mm/year for the 28-mm CoC and 0.0044 mm/year for the 32-mm CoC. No ceramic fractures were found in the 2 groups. One joint in the 28-mm CoC (0.9%) required revision owing to progressive osteolysis. Kaplan-Meier survival at 10 years, with implant loosening or revision THA as the endpoint, was 98.3% for 28-mm CoC and 100% for 32-mm CoC ( p = 0.465). Conclusion: There was no significant difference in ceramic-related complications between the 2 groups. Our study demonstrated that the 32-mm and 28-mm CoC are safe and are associated with good clinical outcomes.

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Revision Rates After Surgical Treatment for Femoral Neck Fractures: Results of 2-Year Follow-up

Medicina ◽

10.3390/medicina49030022 ◽

2013 ◽

Vol 49 (3) ◽

pp. 22

Author(s):

Jaunius Kurtinaitis ◽

Narūnas Porvaneckas ◽

Giedrius Kvederas ◽

Tomas Butėnas ◽

Valentinas Uvarovas

Keyword(s):

Total Hip Arthroplasty ◽

Femoral Neck ◽

Internal Fixation ◽

Hip Arthroplasty ◽

Revision Surgery ◽

Femoral Neck Fractures ◽

Total Hip ◽

Significant Difference ◽

Surgery Rates

Background and Objective. Intracapsular fractures of the femoral neck account for a major share of fractures in the elderly. Open reduction and internal fixation has been shown to have a higher rate of revision surgery than arthroplasty. The aim of this study was to assess and compare the rates of revision surgery performed after internal fixation and primary total hip arthroplasty. Material and Methods. Between 2004 and 2006, 681 intracapsular femoral neck fractures in 679 consecutive patients were treated with internal fixation or total hip arthroplasty at our institution. Revision surgery rates were evaluated at 1-, 3-, 6-, 12-, and 24-month follow-up. Results. There was no significant difference in the ratio of internal fixation to total hip arthroplasty during 2004–2006 (P=0.31). The mean rate of total hip arthroplasty was 19.1% with a lower rate being among patients younger than 60 years. Revision surgery rates at the 2-year followup were higher in the internal fixation group compared with total hip arthroplasty group (28.9% vs. 7.0%, P<0.001). Patients who underwent internal fixation were at a 4-fold greater risk of having revision surgery at the 2-year follow-up than those who underwent total hip arthroplasty (odds ratio, 4.11; 95% CI, 1.95–8.65; P<0.001). Age was a significant risk factor for revision surgery after total hip arthroplasty (hazard ratio, 0.93; 95% CI, 0.87–0.98; P=0.02), but not significant after the internal fixation (P=0.86). Conclusions. Higher revision surgery rates after internal fixation favors arthroplasty as a primary choice of treatment for the femoral neck fractures.

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5-Year Clinical and Radiographic Results of the Direct Anterior Approach for Total Hip Arthroplasty Using a Collared Cementless Femoral Short-Stem Prosthesis

Journal of Clinical Medicine ◽

10.3390/jcm11020346 ◽

2022 ◽

Vol 11 (2) ◽

pp. 346

Author(s):

Ali Darwich ◽

Kim Pankert ◽

Andreas Ottersbach ◽

Marcel Betsch ◽

Sascha Gravius ◽

...

Keyword(s):

Total Hip Arthroplasty ◽

Clinical Outcome ◽

Hip Arthroplasty ◽

Anterior Approach ◽

Hip Osteoarthritis ◽

Direct Anterior Approach ◽

Short Stem ◽

Total Hip ◽

The Mean

The aim of this study was to investigate the radiological and clinical outcome of the direct anterior approach (DAA) in total hip arthroplasty (THA) using a collared cementless femoral short-stem. This retrospective study included 124 patients with 135 THAs operated from 2014 to 2016 using a collared cementless triple tapered hydroxyapatite-coated femoral short-stem (AMIStem H Collared®, Medacta International, Castel San Pietro, Switzerland) implanted with a DAA. Follow-up was performed at three months, 12 months, and five years. Clinical outcome was assessed using the hip osteoarthritis outcome score (HOOS) and radiological analysis was done using conventional radiographs, which included evaluation of the femur morphology based on Dorr classification, of radiolucencies based on the Gruen zone classification and of stem subsidence. The mean age was 67.7 ± 11.3 years and the mean body mass index (BMI) was 27.4 ± 4.4 kg/m2. The stem survival rate at five years was 99.1% with one revision due to recurrent dislocations. Mean HOOS score improved from 40.9 ± 18.3 preoperatively to 81.5 ± 19.7 at three months, 89.3 ± 10.9 at 12 months, and 89.0 ± 14.0 at five years (all with p < 0.001). No significant correlations were found between age, femoral bone morphology, BMI and HOOS, and the appearance of relevant radiolucencies.

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Early to medium-term outcomes of uncemented ceramic-bearing total hip arthroplasty in teenagers for paediatric hip conditions

The Bone & Joint Journal ◽

10.1302/0301-620x.102b11.bjj-2020-0668.r1 ◽

2020 ◽

Vol 102-B (11) ◽

pp. 1491-1496

Author(s):

Pranai K. Buddhdev ◽

Ivor S. Vanhegan ◽

Tahir Khan ◽

Aresh Hashemi-Nejad

Keyword(s):

Total Hip Arthroplasty ◽

Hip Arthroplasty ◽

Femoral Stem ◽

Adolescent And Young Adult ◽

Medium Term ◽

Total Hip ◽

Custom Made ◽

The Mean ◽

Custom Made Prostheses

Aims Despite advances in the treatment of paediatric hip disease, adolescent and young adult patients can develop early onset end-stage osteoarthritis. The aims of this study were to address the indications and medium-term outcomes for total hip arthroplasty (THA) with ceramic bearings for teenage patients. Methods Surgery was performed by a single surgeon working in the paediatric orthopaedic unit of a tertiary referral hospital. Databases were interrogated from 2003 to 2017 for all teenage patients undergoing THA with a minimum 2.3 year follow-up. Data capture included patient demographics, the underlying hip pathology, number of previous surgeries, and THA prostheses used. Institutional ethical approval was granted to contact patients for prospective clinical outcomes and obtain up-to-date radiographs. In total, 60 primary hips were implanted in 51 patients (35 female, 16 male) with nine bilateral cases. The mean age was 16.7 years (12 to 19) and mean follow-up was 9.3 years (2.3 to 16.8). Results The most common indication for teenage hip arthroplasty was avascular necrosis secondary to slipped upper femoral epiphysis (31%; n = 16). Overall, 64% of patients (n = 33) had undergone multiple previous operations. The survival at follow-up was 97%; two patients required revision for aseptic loosening (one femoral stem, one acetabular component). Both patients had fused hips noted at the time of arthroplasty. A further two patients had radiolucent lines but were asymptomatic. At latest follow-up the mean Oxford Hip Score was 44 (31 to 48) and a Visual Analogue Scale measurement of 1.5, indicating satisfactory function. Conclusion Operating on this cohort can be complicated by multiple previous surgeries and distorted anatomy, which in some cases require custom-made prostheses. We have demonstrated a good outcome with low revision rate in this complex group of patients. Cite this article: Bone Joint J 2020;102-B(11):1491–1496.

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Mid-Term Results of Ceramic-on-Ceramic Total Hip Arthroplasty with Sandwich Cup

Key Engineering Materials ◽

10.4028/www.scientific.net/kem.309-311.1357 ◽

2006 ◽

Vol 309-311 ◽

pp. 1357-1362

Author(s):

Masahiro Hasegawa ◽

Akihiro Sudo ◽

Atsumasa Uchida

Keyword(s):

Total Hip Arthroplasty ◽

Hip Arthroplasty ◽

Hip Dislocation ◽

Clinical Results ◽

Total Hip ◽

The Mean ◽

Acetabular Components ◽

Mid Term Results ◽

Ceramic On Ceramic

In ceramic-on-ceramic total hip arthroplasty (THA), modular acetabular component with a sandwich insertion was developed and evaluated mid-term clinical results. 35 hips had undergone cementless ceramic-on-ceramic THA with sandwich cup (Kyocera, Kyoto, Japan). The mean duration of follow-up was 5 years. 6 hips had undergone component revisions. The reasons for revision included infection in 1 hip, dislocation with loosening in 2 hips, alumina liner fractures in 2 hips, and cup dissociation in 1 hip. All femoral and acetabular components showed no loosening in the unrevised hips at the time of the last follow-up. None of the 29 unrevised hips had osteolysis.

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Total Hip Arthroplasty Using Imageless Computer-Assisted Navigation—2-Year Follow-Up of a Prospective Randomized Study

Journal of Clinical Medicine ◽

10.3390/jcm9061620 ◽

2020 ◽

Vol 9 (6) ◽

pp. 1620

Author(s):

Richard Lass ◽

Boris Olischar ◽

Bernd Kubista ◽

Thomas Waldhoer ◽

Alexander Giurea ◽

...

Keyword(s):

Total Hip Arthroplasty ◽

Clinical Outcome ◽

Hip Arthroplasty ◽

Important Determinant ◽

Randomized Study ◽

Prospective Randomized Study ◽

Computer Assisted ◽

Total Hip ◽

Significant Difference

The purpose of this study is to compare computer-assisted to manual implantation-techniques in total hip arthroplasty (THA) and to find out if the computer-assisted surgery is able to improve the clinical and functional results and reduce the dislocation rate in short-terms after THA. We performed a concise minimum 2-year follow-up of the patient cohort of a prospective randomized study published in 2014 and evaluated if the higher implantation accuracy in the navigated group can be seen as an important determinant of success in total hip arthroplasty. Although a significant difference was found in mean postoperative acetabular component anteversion and in the outliers regarding inclination and anteversion (p < 0.05) between the computer-assisted and the manual-placed group, we could not find significant differences regarding clinical outcome or revision rates at 2-years follow-up. The implantation accuracy in the navigated group can be regarded as an important determinant of success in THA, although no significant differences in clinical outcome could be detected at short-term follow-up. Therefore, further long-term follow-up of our patient group is needed.

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Acetabular reconstruction using a composite layer of impacted cancellous allograft bone and cement: minimum 5-year follow-up study

Hip International ◽

10.1177/1120700020941407 ◽

2020 ◽

pp. 112070002094140

Author(s):

Kanai Garala ◽

Tarek Boutefnouchet ◽

Rishanthanan Amblawaner ◽

Trevor Lawrence

Keyword(s):

Total Hip Arthroplasty ◽

Hip Arthroplasty ◽

Bone Grafting ◽

Composite Layer ◽

Acetabular Reconstruction ◽

Total Hip ◽

Patient Reported ◽

The Mean ◽

Composite Bone

Background: Revision total hip arthroplasty (rTHA) is often complex and has a less reliable outcome than primary total hip arthroplasty. Acetabular reconstruction remains a challenge because of the variable amount of bone loss. This study describes and evaluates a novel technique of acetabular reconstruction using composite bone grafting. Patients and methods: Between June 2005 and January 2012, 108 consecutive patients underwent revision hip arthroplasty in which the acetabular component was revised using composite bone grafting. Of these, 24 were lost to follow-up leaving 84 in the study with a minimum 5-year follow-up. There were 54 women and 30 men with a mean age of 70.1 (31–91) years. All patients were assessed clinically and radiologically after a minimum of 5 years. The primary outcome measures were rate of re-revision, patient-reported outcomes and radiological evidence of loosening. Results: The mean follow-up after revision surgery was 6.9 years (5–10). At operation, 60 patients had an acetabular defect of AAOS stage 3 or more. There was no evidence of loosening in 69 revision acetabular components; 12 showed evidence of non-progressive loosening and 3 patients underwent a re-revision procedure (2 for infection, 1 recurrent dislocation). The mean postoperative Hip Disability and Osteoarthritis Outcome Score (HOOS) was 89.11/100 (95% CI, 87.8–90.5). Scores were significantly improved in patients with a more extensive preoperative defect ( p = 0.006). The overall patient satisfaction rate at final follow-up was very high. Conclusions: Composite impaction grafting using a layered cement and bone graft technique can give satisfactory clinical and radiological outcomes in the medium- to long-term.

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Salvaging Unstable or Recurrent Dislocating Total Hip Arthroplasty with the Constrained Acetabular Component

Journal of Orthopaedic Surgery ◽

10.1177/230949900201000210 ◽

2002 ◽

Vol 10 (2) ◽

pp. 165-169 ◽

Cited By ~ 15

Author(s):

DA Stanton ◽

WJ Bruce ◽

JA Goldberg ◽

W Walsh

Keyword(s):

Total Hip Arthroplasty ◽

Acetabular Component ◽

Hip Arthroplasty ◽

Recurrent Dislocation ◽

Total Hip ◽

Hip Replacements ◽

The Mean ◽

Acetabular Components ◽

Constrained Acetabular Component

Purpose. To review cases of implantation of constraining acetabular components for unstable or recurrent dislocating total hip arthroplasty at the Department of Orthopaedics, Concord Hospital, Sydney. Methods. A retrospective analysis was performed on prospectively collected data of 13 consecutively enrolled patients. Results. From 1989 to 2000, 13 constraining acetabular components were implanted into 13 patients as a revision procedure. The surgical approach for the implantation of the constrained liner was posterolateral in 11 cases; a modified Hardinge approach was applied in 2 cases. The mean clinical follow-up duration was 43 months (range, 14–121 months) and the mean age at the time of surgery was 73 years (range, 52–84 years). No patients were lost to follow-up. Indications for using the constrained acetabular component were recurrent dislocation in revision hip replacements (n=8), and intra-operative instability (n=5). There were no episodes of dislocation of the constrained arthroplasty. In 7 cases, the constrained component was implanted into a previously well-fixed shell. Conclusion. We recommend the judicious use of the constrained component in cases of hip instability during or after total hip arthroplasty when other methods are not successful.

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Augmented Rehabilitation Program for Young Patients Following Total Hip Arthroplasty- Feasibility Study

10.21203/rs.3.rs-510945/v1 ◽

2021 ◽

Author(s):

Ahmed M. Negm ◽

Milad Yavarai ◽

Gian S. Jhangri ◽

Robert Haennel ◽

C. Allyson Jones

Keyword(s):

Physical Activity ◽

Total Hip Arthroplasty ◽

Hip Arthroplasty ◽

Intervention Group ◽

Young Patients ◽

Rehabilitation Program ◽

Control Group ◽

Total Hip ◽

Significant Difference

Abstract Background: The increase rate seen in total hip arthroplasty (THA) for younger patients (< 60) has implications for future rehabilitation demands for primary and revision THA surgery. The primary objective is to examine the feasibility of a study comparing a 6-week post-operative rehabilitation program to usual care in patients ≤ 60 years undergoing elective unilateral THA. The secondary objectives are: 1) to explore the effect of a 6-week post-operative rehabilitation program designed for THA patients ≤ 60 years on physical activity (PA), function and participants’ satisfaction compared to age- and sex-matched control group received usual postoperative care at 12-week post-THA. 2) to examine the correlation between physical activity and self-reported pain and function.Methods: In this study, a cohort of THA candidates were recruited during their 6-week postoperative visit to their surgeons at a central intake clinic. The out-patient rehabilitation program, which was designed to improve function and increase activity, consisted of 12 structured exercise classes (2 hrs/class) on land and water over 6 weeks. Physical activity was assessed using Sense Wear Pro ArmbandTM [SWA]. Participants completed the Hip Osteoarthritis Outcome Score (HOOS), and THA satisfaction questionnaire before and immediately after the intervention.Results: Of the 24 participants recruited, 14 participants received the augmented rehabilitation, and 10 participants were in the control group. All the study participants in the control and intervention groups completed the baseline and follow-up assessments without adverse events. Thirteen out of the fourteen intervention group participants completed at least 80% of the intervention sessions. The intervention group took significantly more steps/day (mean difference = 2,440 steps/day, 95% CI= 1678, 4712) (p<0.05), at the follow-up compared to baseline. The intervention group had a higher mean change of number of weekly PA bouts than the control group. Within the intervention group, all HOOS subscales were significantly higher at the follow-up compared to baseline. However, the ADL subscale was the only significant difference seen with the control group.Conclusion: The study intervention and assessments were feasible and safe in patients ≤ 60 years undergoing elective unilateral THA.

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A follow-up study of hip arthroplasty in patients with chronic renal failure on dialysis

10.21203/rs.3.rs-20254/v1 ◽

2020 ◽

Author(s):

Sang Min Lee ◽

Kuen Tak Suh ◽

Won Chul Shin ◽

Young Kwang Oh ◽

Seung Hun Woo

Keyword(s):

Renal Failure ◽

Chronic Renal Failure ◽

Total Hip Arthroplasty ◽

Clinical Outcomes ◽

Hip Arthroplasty ◽

Bipolar Hemiarthroplasty ◽

Acetabular Cup ◽

Total Hip ◽

The Mean

Abstract Background Although hip arthroplasty has become increasingly common, its radiological and clinical outcomes in chronic renal failure patients remain unclear. This study analyzed the outcomes of hip arthroplasty in patients with chronic renal failure undergoing dialysis. Methods Of 2,364 hips undergoing total hip arthroplasty or bipolar hemiarthroplasty between January 2003 and December 2017, data pertaining of 37 hips of patients with chronic renal failure undergoing dialysis (16 men, 21 women) were retrospectively examined. We analyzed the radiological and clinical outcomes of hip arthroplasty, as well as the occurrence of local and general complications (particularly the time of their occurrence) during follow-up and their association with dialysis duration. Results The mean patient age was 60.6 ± 13.5 years, and the mean follow-up duration was 36.6 ± 27.2 months. The mean T-value indicating bone mineral density was -2.62 ± 1.15, with osteoporosis noted in 20 cases. Except for 1 case with infection-induced change in acetabular cup tilt, all cases of total hip arthroplasty with cementless acetabular cup implant exhibited excellent radiographic outcomes. The cementless proximally coated femoral stem was used in all 25 cases of total hip arthroplasty and 7 out of 12 cases of bipolar hemiarthroplasty. Changes in the alignment of femoral stems, subsidence, osteolysis, and loosening were not observed. On clinical assessment, 33 patients received an “excellent” or “good” Harris hip score. Within 1 year postoperatively, complications developed in 18 patients, and some patients exhibited more than 1 complication. More than 1 year after surgery, general complications developed in 12 patients; however, no patient experienced local complications.Conclusions Hip arthroplasty in chronic renal failure patients on dialysis showed excellent radiological and satisfactory clinical outcomes; however, it may be associated with various postoperative complications. Therefore, meticulous preoperative treatment planning and overall postoperative management are required to reduce the risk of complications.

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