scholarly journals Influence of the knot position on the union of the greater trochanter after bipolar hip arthroplasty via the modified Dall approach: a prospective non-randomized study

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Masanao Kataoka ◽  
Hiroshi Fujita ◽  
Hiroaki Hara ◽  
Hideto Harada ◽  
Yuki Okutani ◽  
...  
Keyword(s):  
Elderly Patients ◽  
Randomized Study ◽  
Type A ◽  
Research Review ◽  
Bipolar Hemiarthroplasty ◽  
Greater Trochanter ◽  
Posterior Group ◽  
Significant Difference ◽  
The Status ◽  
Neck Fracture

Abstract Background In our institute, all elderly patients with displaced femoral neck fracture were treated with cemented bipolar hemiarthroplasty (BHA) using the modified Dall approach. To our knowledge, there are no reports on the knot position of the greater trochanter reattachment. The aim of this study was to determine influence of two knot positions (anterior or posterior) on the complications of the greater trochanter. Methods This is a prospective non-randomized study conducted on 95 elderly patients (95 hips) from September 2013 to December 2017. The knot position was changed from anterior to posterior alternately. The X-ray images obtained immediately after the operation were compared with those obtained at 3 months postoperatively; thereafter, the status of the greater trochanter was classified into three types: type A, no apparent shifting and fracture; type C, over 1-mm shifting of the fragment; and type F, fracture of the greater trochanter. Results Regarding age at operation, sex, BMI, size of the greater trochanteric fragment, stem type, and surgeon, there was no significant difference between two groups. In the anterior group, 34 hips (72.3%), 5 hips (10.6%), and 8 hips (17.0%) were classified under type A, C, and F, respectively. In the posterior group, 44 hips (91.7%), 1 hip (2.1%), and 3 hips (6.3%) were classified under type A, C, and F, respectively. There were significantly fewer greater trochanteric complications in the posterior group. Conclusions The posterior knot position improved the union of the greater trochanter after BHA compared with the anterior knot position. Trial registration We had approved IRB at our hospital clinical research review committee. Retrospectively registered.

scholarly journals Influence of the knot position on the union of the greater trochanter after bipolar hip arthroplasty via the modified Dall approach: A prospective non-randomized study

2020 ◽  
Author(s):  
Masanao Kataoka ◽  
Hiroshi Fujita ◽  
Hiroaki Hara ◽  
Hideto Harada ◽  
Yuki Okutani ◽  
...  
Keyword(s):  
Elderly Patients ◽  
Randomized Study ◽  
Type A ◽  
Research Review ◽  
Bipolar Hemiarthroplasty ◽  
Greater Trochanter ◽  
Posterior Group ◽  
Significant Difference ◽  
The Status ◽  
Neck Fracture

Abstract Background: In our institute, all elderly patients with displaced femoral neck fracture were treated with cemented bipolar hemiarthroplasty (BHA) using the modified Dall approach. To our knowledge, there are no reports on the knot position of the greater trochanter reattachment. The aim of this study was to determine influence of two knot positions (anterior or posterior) on the complications of the greater trochanter.Methods: This is a prospective non-randomized study conducted on 95 elderly patients (95 hips) from September 2013 to December 2017. The knot position was changed from anterior to posterior alternately. The X-ray images obtained immediately after the operation were compared with those obtained at 3 months postoperatively; thereafter, the status of the greater trochanter was classified into three types: type A, no apparent shifting and fracture; type C, over 1-mm shifting of the fragment; and type F, fracture of the greater trochanter.Results: Regarding age at operation, sex, BMI, size of the greater trochanteric fragment, stem type, and surgeon, there was no significant difference between two groups. In the anterior group, 34 hips (72.3%), 5 hips (10.6%), and 8 hips (17.0%) were classified under type A, C, and F, respectively. In the posterior group, 44 hips (91.7%), 1 hip (2.1%), and 3 hips (6.3%) were classified under type A, C, and F, respectively. There were significantly fewer greater trochanteric complications in the posterior group. Conclusions: The posterior knot position improved the union of the greater trochanter after BHA compared with the anterior knot position.Trial registration: We had approved IRB at our hospital clinical research review committee. Retrospectively registered.

scholarly journals Influence of the Knot Position on the Union of the Greater Trochanter after Bipolar Hip Arthroplasty via the Modified Dall Approach: A Prospective Non-Randomized Study

2020 ◽  
Author(s):  
Masanao Kataoka ◽  
Hiroshi Fujita ◽  
Hiroaki Hara ◽  
Hideto Harada ◽  
Yuki Okutani ◽  
...  
Keyword(s):  
Elderly Patients ◽  
Randomized Study ◽  
Type A ◽  
Trial Registration ◽  
Research Review ◽  
Bipolar Hemiarthroplasty ◽  
Greater Trochanter ◽  
Posterior Group ◽  
Significant Difference ◽  
Neck Fracture

Abstract Background: In our institute, all elderly patients with displaced femoral neck fracture were treated with cemented bipolar hemiarthroplasty (BHA) using the modified Dall approach. To our knowledge, there are no reports on the knot position of the greater trochanter reattachment. The aim of this study was to determine influence of two knot positions (anterior or posterior) on the complications of the greater trochanter.Methods: This is a prospective non-randomized study conducted on 95 elderly patients (95 hips) from September 2013 to December 2017. The knot position was changed from anterior to posterior alternately. The X-ray images obtained immediately after the operation were compared with those obtained at 3 months postoperatively; thereafter, the status of the greater trochanter was classified into three types: type A, no apparent shifting and fracture; type C, over 1-mm shifting of the fragment; and type F, fracture of the greater trochanter.Results: Regarding age at operation, sex, BMI, size of the greater trochanteric fragment, stem type, and surgeon, there was no significant difference between two groups. In the anterior group, 34 hips (72.3%), 5 hips (10.6%), and 8 hips (17.0%) were classified under type A, C, and F, respectively. In the posterior group, 44 hips (91.7%), 1 hip (2.1%), and 3 hips (6.3%) were classified under type A, C, and F, respectively. There were significantly fewer greater trochanteric complications in the posterior group. Conclusions: The posterior knot position improved the union of the greater trochanter after BHA compared with the anterior knot position.Trial registration: We have no trial registration but we had approved IRB at our hospital clinical research review committee. Retrospectively registered.

scholarly journals Is limited aortic resection more justified in elderly patients with type A acute aortic dissection?

2020 ◽  
Author(s):  
Wei Qin ◽  
Cunhua Su ◽  
Liangpeng Li ◽  
Michael Carmichael ◽  
Fuahua Huang ◽  
...  
Keyword(s):  
Aortic Dissection ◽  
Elderly Patients ◽  
Acute Aortic Dissection ◽  
Group Versus ◽  
Type A ◽  
Surgical Approaches ◽  
Elephant Trunk ◽  
Aortic Repair ◽  
Aortic Replacement ◽  
Significant Difference

Abstract Objective This study compared limited aortic repair (ascending, and /or hemi-arch replacement) versus extended-arch repair (ascending, arch and proximal descending aortic replacement) used for patients aged 65 or older, who had type A acute aortic dissection (AAD), analyzing the influence of the extent of aortic repair on outcomes. Methods From January, 2001 to December, 2015, 103 patients aged 65 or older underwent operation due to type A AAD in Nanjing First Hospital. The cohort was divided into two subgroups according to the surgical approaches, including limited aortic replacement (LAR, n = 41) and total arch replacement + stent elephant trunk implantation (TAR + SET, n = 62). Results There was no significant difference in gender, age, hypertension, diabetes, smoking, PCI history, atrial fibrillation, pericardial effusion, aortic valve insufficiency (≥ moderate), shock situation before operation, and Euro-score II between the two groups except limb malperfusion and tear location. The cross-clamp time, CPB time, intubation time, ICU stay time and hospital time were all significantly less in the LAR group than in the TAR + SET group. A total of 89 patients were discharged home successfully after operation, with a difference of hospital mortality (P = 0.04). The overall survival rates at 5-year follow-up were 82.5 ± 6.0% in LAR group and 75.2 ± 5.6% in TAR + SET group, but with no difference (p = 0.151). The freedom from adverse aortic events at 5-year was 84.3 ± 6.5% in LAR group versus 97.9 ± 2.1% in TAR + SET group, with a statistical difference (p = 0.03). Conclusion These findings support limited aortic resection is acceptable for elderly patients with type A AAD if surgical principles allow.

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