scholarly journals The top 100 most cited articles on total hip arthroplasty: a bibliometric analysis

2019 ◽  
Vol 14 (1) ◽  
Author(s):  
Wenchao Zhang ◽  
Ning Tang ◽  
Xiaopeng Li ◽  
Daniel M. George ◽  
Guangxu He ◽  
...  
Keyword(s):  
Network Analysis ◽  
Total Hip Arthroplasty ◽  
Hip Arthroplasty ◽  
Western Europe ◽  
Citation Count ◽  
Level Of Evidence ◽  
Total Hip ◽  
Surgical Methods ◽  
The Usa ◽  
High Degree

Abstract Background Over the past few decades, more and more articles about total hip arthroplasty have been published. We noticed, however, little is known about the characteristics and qualities of these studies. Methods The databases of Web of Science Core Collection, BIOSIS Citation Index, MEDLINE, etc. were utilized for the identification of articles published from 1990 to May 2019. Total hip arthroplasty–related articles were identified, and the 100 most cited articles were selected for subsequent analysis of citation count, citation density (citations/article age), authorship, theme, geographic distribution, time-related flux, level of evidence, and network analysis. Results The selected 100 articles were published mainly in the 1990s (46%) and 2000s (47%) with almost equal amount. Citations per article ranged from 994 to 191. Leading countries were the USA followed by Canada, England, and Sweden, all located in North America and Western Europe. The most highlighted study themes were postoperative thrombosis and surgical methods and materials. The most common level of evidence was level III (35%). The network analysis connoted that radiography, acetabulum, reoperation, and bone cement had a high degree of centrality in the 1990s, while cement had a high degree of centrality in the 2000s and 2010s. Conclusions The time, area, and theme distribution of the top 100 most cited articles in the total hip arthroplasty have been thoroughly analyzed. It is noticeable that postoperative thromboembolism currently plays a major role in the field of total hip arthroplasty researches. However, most of them focus on the effectiveness of different treatments and drugs; little is known about its underlying mechanisms and influencing factors.

scholarly journals Are the First and Second Hip in Staged Bilateral Total Hip Arthroplasty Equal? A Hospital Adverse Event and Perioperative Risk Comparison

2021 ◽  
Author(s):  
Jesus M. Villa ◽  
Tejbir S. Pannu ◽  
Carlos A. Higuera ◽  
Juan C. Suarez ◽  
Preetesh D. Patel ◽  
...  
Keyword(s):  
Total Hip Arthroplasty ◽  
Adverse Events ◽  
Hip Arthroplasty ◽  
Retrospective Chart Review ◽  
Consecutive Series ◽  
Level Of Evidence ◽  
Exact Test ◽  
Total Hip ◽  
Discharge Disposition ◽  
The Mean

AbstractHospital adverse events remain a significant issue; even “minor events” may lead to increased costs. However, to the best of our knowledge, no previous investigation has compared perioperative events between the first and second hip in staged bilateral total hip arthroplasty (THA). In the current study, we perform such a comparison. A retrospective chart review was performed on a consecutive series of 172 patients (344 hips) who underwent staged bilateral THAs performed by two surgeons at a single institution (2010–2016). Based on chronological order of the staged arthroplasties, two groups were set apart: first-staged THA and second-staged THA. Baseline-demographics, length of stay (LOS), discharge disposition, hospital adverse events, and hospital transfusions were compared between groups. Statistical analyses were performed using independent t-tests, Fisher's exact test, and/or Pearson's chi-squared test. The mean time between staged surgeries was 465 days. There were no significant differences in baseline demographics between first-staged THA and second-staged THA groups (patients were their own controls). The mean LOS was significantly longer in the first-staged THA group than in the second (2.2 vs. 1.8 days; p < 0.001). Discharge (proportion) to a facility other than home was noticeably higher in the first-staged THA group, although not statistically significant (11.0 vs. 7.6%; p = 0.354). The rate of hospital adverse events in the first-staged THA group was almost twice that of the second (37.2 vs. 20.3%; p = 0.001). There were no significant differences in transfusion rates. However, these were consistently better in the second-staged THA group. When compared with the first THA, our findings suggest overall shorter LOS and fewer hospital adverse events following the second. Level of Evidence Level III.

scholarly journals Comparison of short-term outcomes of anterolateral supine approach and posterolateral approach for primary total hip arthroplasty: a retrospective study

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Taku Ukai ◽  
Goro Ebihara ◽  
Masahiko Watanabe
Keyword(s):  
Total Hip Arthroplasty ◽  
Hospital Stay ◽  
Clinical Outcomes ◽  
Hip Arthroplasty ◽  
External Rotation ◽  
Posterolateral Approach ◽  
Level Of Evidence ◽  
Total Hip ◽  
Hip Flexion ◽  
Primary Total Hip Arthroplasty

Abstract Background This study aims to evaluate postoperative pain and functional and clinical outcomes of anterolateral supine (ALS) and posterolateral (PL) approaches for primary total hip arthroplasty. Materials and methods We retrospectively examined the joints of 110 patients who underwent primary total hip arthroplasty (THA). The ALS group was compared with the PL group using the pain visual analog scale (VAS) and narcotic consumption as pain outcomes. Functional outcomes included postoperative range of motion (ROM) of hip flexion, day on which patients could perform straight leg raising (SLR), day on which patients began using a walker or cane, duration of hospital stay, rate of transfer, and strength of hip muscles. Clinical outcomes included pre and postoperative Harris Hip Scores. Results No significant differences were found in the pain VAS scores or narcotic consumption between the two groups. The PL group could perform SLR earlier than the ALS group (P < 0.01). The ALS group started using a cane earlier (P < 0.01) and had a shorter hospital stay (P < 0.01) than the PL group. Degrees of active ROM of flexion at postoperative day (POD) 1 were significantly lower in the ALS group than in the PL group (P < 0.01). Regarding hip muscle strength, hip flexion was significantly weaker in the ALS group than in the PL group until 1-month POD (P < 0.01). External rotation from 2 weeks to 6 months postoperatively was significantly weaker in the PL group than in the ALS group (P < 0.01). Conclusion The ALS approach was more beneficial than the PL approach because ALS enabled better functional recovery of the strength of external rotation, improved rehabilitation, and involved a shorter hospital stay. Level of Evidence Level IV retrospective observational study.

scholarly journals Total hip arthroplasty for high-riding hips: A retrospective analysis of 79 cases and proposal of a new classification

2020 ◽  
Vol 28 (2) ◽  
pp. 230949902092416
Author(s):  
İsmail Demirkale ◽  
Yüksel Uğur Yaradılmış ◽  
Ahmet Ateş ◽  
Murat Altay
Keyword(s):  
Total Hip Arthroplasty ◽  
Hip Arthroplasty ◽  
Classification System ◽  
Operating Time ◽  
Limb Length Discrepancy ◽  
Harris Hip Score ◽  
Level Of Evidence ◽  
Total Hip ◽  
Significant Difference ◽  
Functional Scores

Purpose: Total hip arthroplasty (THA) for high-riding hips is a complex procedure and the requirement for subtrochanteric osteotomy (STO) is an important decision that needs to be taken preoperatively. STO renders this complex surgery even more complicated and there are no guidelines to determine the STO requirement. In this study, the outcomes of THA for patients with high-riding hips were evaluated and a practical classification system is proposed to predict any osteotomy requirement. Methods: A retrospective evaluation was made of 79 hips of 76 patients who underwent THA for high-riding hip dysplasia. The amount of shortening in patients with STO and in patients without STO was compared. All patients were evaluated in respect of Harris hip score, operating time, erythrocyte suspension need, and actual limb length discrepancy. Preoperative radiographs were classified into four types according to the ratio of the distance between the lesser trochanter and the ischial tuberosity with pelvic height (LT-IT/P) to grade the degree of dislocation. Results: The mean follow-up was 30 ± 6.54 months. STO was applied to 47 (60%) hips and not to 32 (40%). There was no statistically significant difference between the groups in respect of the functional scores. STO prolonged the operating time and increased the need for blood transfusion ( p = 0.026, p < 0.001, respectively). When the LT-IT/P index was <0.19 (type 1), no additional surgical approach was required for reduction, at 0.19–0.29 (type 2), the head can be safely reduced with additional reduction methods, and when >0.3 (type 3), a shortening osteotomy will most likely be required. The rate of complications is increased if LT-IT/P is >0.4 (type 4). Conclusion: STO adjunct to THA increases the rate of complications. This practical classification system may guide the surgeon in the decision of whether an STO should be added to the procedure or not. Level of evidence: Level III, clinical trial

scholarly journals PROSPECTIVE STUDY OF ASPIRIN FOR THROMBOEMBOLISM PROPHYLAXIS IN TOTAL HIP ARTHROPLASTY

2018 ◽  
Vol 26 (2) ◽  
pp. 86-90
Author(s):  
RAUL CARNEIRO LINS ◽  
EPITÁCIO LEITE ROLIM FILHO ◽  
FERNANDO DE SANTA CRUZ OLIVEIRA ◽  
SAULO MONTEIRO DOS SANTOS ◽  
TALE LUCAS VIEIRA ROLIM ◽  
...  
Keyword(s):  
Venous Thromboembolism ◽  
High Risk ◽  
Total Hip Arthroplasty ◽  
Prospective Study ◽  
Hip Arthroplasty ◽  
Postoperative Bleeding ◽  
Thromboembolism Prophylaxis ◽  
Level Of Evidence ◽  
Total Hip ◽  
Post Procedure

ABSTRACT Objectives: To evaluate the effectiveness of aspirin as prophylaxis for deep venous thrombosis (DVT) in patients undergoing total hip arthroplasty (THA), and to analyze the incidence of bleeding during the post-operative period. Methods: This prospective study carried out in 2017 consisted of 37 patients indicated for THA with high risk for DVT. Immediately after the procedure, aspirin, elastic compression socks and early deambulation were initiated. Doppler ultrasound was performed in the legs 6 days and 6 weeks post-procedure to rule out venous thromboembolism. Hematometric variables and clinical criteria were used to detect bleeding. Results: The incidence of VTE (venous thromboembolism) 6 days post-procedure was 21.6%. By 6 weeks post-procedure, it dropped to 8.1%, (p = 0.102). Only 2.7% were diagnosed with VTE, 6 days and also 6 weeks post-procedure. Within the immediate postoperative period, hemoglobin was lower (p < 0.001), in contrast to 6 weeks after surgery, when it returned to baseline levels. Conclusion: Aspirin was an effective chemical prophylaxis for venous thromboembolism in high-risk patients who underwent THA. There was no clinical record of postoperative bleeding and hematometric levels suggested that there was no chronic bleeding. Level of Evidence II; Prospective study.

Mobility Limitation After Surgery for Degenerative Pathology of the Ankle, Hindfoot, and Midfoot vs Total Hip Arthroplasty

2020 ◽  
Vol 41 (5) ◽  
pp. 501-507
Author(s):  
Gregory Kurkis ◽  
Amalie Erwood ◽  
Samuel David Maidman ◽  
Wesley J. Manz ◽  
Ehab Nazzal ◽  
...  
Keyword(s):  
Total Hip Arthroplasty ◽  
Hip Arthroplasty ◽  
Mobility Limitation ◽  
Foot And Ankle ◽  
Level Of Evidence ◽  
Total Hip ◽  
Ankle Surgery ◽  
Significant Difference ◽  
Postoperative Mobility ◽  
The Difference

Background: Surgery for degenerative foot and ankle conditions often results in a lengthy recovery. Current outcome measures do not accurately assess postoperative mobility, especially in older patients. The Life-Space Assessment (LSA), a questionnaire quantifying patients’ mobility after a medical event, was used in this study to assess perioperative mobility in total hip arthroplasty (THA) and foot and ankle surgery patients. We hypothesized that patients undergoing elective foot and ankle surgery would have greater postoperative mobility limitation than THA patients. Methods: Preoperative, 3-month, and 6-month postoperative LSA data were collected from THA and foot and ankle cohorts. Twelve-month postoperative data were obtained for the foot and ankle group as well. Patient demographics were recorded, and data were analyzed using a Mann-Whitney U test. Results: Twenty-eight degenerative foot and ankle operative patients and 38 THA patients met inclusion criteria. Only patients aged ≥60 years were included in this study. The mean preoperative LSA score was lower in the foot and ankle group (68.8) compared with THA (74.0), although the difference was not statistically significant ( P = .602). THA patients showed a significant increase in LSA score from preoperative (74) to 6 months postoperation (95.9) ( P = .003); however, foot and ankle patients showed no significant difference between preoperative (68.8) and 6-month (61.2) scores ( P = .468). Twelve months postoperatively, foot and ankle patients showed improvement in LSA score (88.3) compared with preoperation ( P = .065). Conclusion: Compared with THA, recovery of mobility after foot and ankle surgery was slower. THA patients exhibited improved mobility as early as 3 months after surgery, whereas foot and ankle patients did not show full improvement until 12 months. This work will assist the foot and ankle specialist in educating patients about challenges in mobility during their recovery from surgery. Level of Evidence: Level II, prospective cohort study.

scholarly journals Efficacy of a simple intraoperative stem-anteversion measuring device in total hip arthroplasty

2020 ◽  
Author(s):  
Kentaro Iwakiri ◽  
Yoichi Ohta ◽  
Yohei Ohyama ◽  
Yukihide Minoda ◽  
Akio Kobayashi ◽  
...  
Keyword(s):  
Total Hip Arthroplasty ◽  
Hip Arthroplasty ◽  
Three Dimensional ◽  
Computer Assisted ◽  
Level Of Evidence ◽  
Measuring Device ◽  
Correction Angle ◽  
Assisted Navigation ◽  
Total Hip ◽  
Flexion Extension

Abstract Background Background: Stem anteversion is important in reducing postoperative complications in total hip arthroplasty (THA). THA utilizing the combined-anteversion theory requires stem anteversion angle (SAA) measurement intraoperatively; however, intraoperative SAA estimation is difficult for surgeons without computer-assisted navigation system. We evaluated the accuracy of the SAA measured intraoperatively using a newly developed device by comparing the three-dimensional measurements using postoperative computed tomography (CT).Materials & Methods In 127 hips in 127 patients who underwent unilateral THA at our hospital, we used our newly developed device that can be easily attached to rasping broach handles for measuring the SAA intraoperatively, which required the addition of the correction angle obtained in the preoperative epicondylar view. Postoperative SAA and its discrepancies from the measured intraoperative SAA with or without adding the correction angle were compared between the groups to evaluate the usefulness of the device.Results The intraoperative SAA measured by the device was 17.93 ± 7.53°. The true SAA measured on postoperative CT was 26.40 ± 9.73°. The discrepancy between the intraoperative SAA and true SAA was 8.94 ± 5.44° (without the correction angle), and 4.93 ± 3.85° (with the correction angle). Accuracy with a discrepancy of <5 degrees was achieved in 77 (60.6%) and <10 degrees was achieved in 113 (89.0%). The accuracy was unaffected by the stem placement angle (varus/valgus, or flexion/extension), or ipsilateral knee osteoarthritis.Conclusion The SAA measuring device, easily attachable to various rasping handles, is useful to measure the intraoperative SAA in a simple, economical, and noninvasive manner during THA.Level of Evidence Therapeutic Level IV.

scholarly journals The short-term outcome of hip revision arthroplasty with Trabecular Metal™ components and augments

2020 ◽  
Vol 19 (3) ◽  
Author(s):  
L Noconjo ◽  
MB Nortje
Keyword(s):  
Total Hip Arthroplasty ◽  
Hip Arthroplasty ◽  
Revision Arthroplasty ◽  
Revision Hip Arthroplasty ◽  
Trabecular Metal ◽  
Short Term ◽  
Level Of Evidence ◽  
Term Outcome ◽  
Hip Revision ◽  
Total Hip

ABSTRACT BACKGROUND: Highly porous Trabecular Metal™ acetabular components are increasingly being used in revision hip arthroplasty as they facilitate ingrowth, provide a useful mechanism to deal with bone loss and may decrease the risk of infection. The purpose of this audit was to describe: 1) the total number of hip arthroplasty surgeries over Ave years, the ratio of revision to primary hip arthroplasty and indications for revision; 2) the short-term outcomes of revision hip arthroplasty with Trabecular Metal™ components and augments METHODS: A retrospective folder and radiograph review of all patients who had revision total hip arthroplasty (THA) at a tertiary level hospital from February 2012 to February 2017 was done RESULTS: There were 979 THAs performed over the period - 863 (87%) primary THAs, and 116 (12%) hip revision cases performed in 107 patients. Of the 116 (107 patients) hip revisions, there were seven (6%) re-revisions in Ave patients. The indications for revision were aseptic loosening 67 (59%), septic loosening 11 (10%), liner wear 18 (16%), periprosthetic fracture Ave (4%), other 15 (13%). Trabecular Metal™ was used for revision in 16 hips (14 patients), which is 14% of the total 116 revisions. There were ten females and four males with an average age of 61 years. The average duration of follow-up in this group was 18.5 months (1.5-39.2). In these 16 Trabecular Metal™ hips, there were three (19%) early failures of fixation due to technical errors CONCLUSION: In our institution, 12% of the arthroplasty is revision surgery. The indications for revision are similar to published literature. Trabecular Metal™ revisions had a 19% early failure rate due to technical error Level of evidence: Level 4 Keywords: Trabecular Metal™, augments, total hip arthroplasty, revision hip arthroplasty

scholarly journals Total hip arthroplasty in patients with severe hip dysplasia and congenital pubic diastasis: report of two cases

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Christian Goetze ◽  
Filippo Migliorini ◽  
Christian Dominik Peterlein
Keyword(s):  
Total Hip Arthroplasty ◽  
Hip Arthroplasty ◽  
Hip Dysplasia ◽  
Bladder Exstrophy ◽  
Case Series ◽  
Hip Osteoarthritis ◽  
Cementless Stem ◽  
Level Of Evidence ◽  
Total Hip ◽  
Pubic Diastasis

Abstract Background Congenital bladder exstrophy is a rare malformation which is often associated with pubic diastasis and hip dysplasia. We reported the case two patients who underwent total hip arthroplasty (THA) due to advanced osteoarthritis combined with large congenital pubic diastasis (> 10 cm). Case presentation The first patient, a 39 years old woman with a pubic diastase and severe hip dysplasia on both sides was treated with a primary two-staged bilateral THA. Both hips were treated with a cementless osteoconductive cup (TM, Zimmer-Biomet) and a cementless stem (Alloclassic SL, Zimmer-Biomet). A 10° elevated rim liner of the cup was used in order to avoid dislocation. The main problem was represented by the fixation of the cup, given the retroverted acetabulum along with the elevated rotation centre due to the dysplastic hips. In the case two, a 52 years woman presented dysplastic osteoarthritis of the left hip. A conventional hemispherical cup (Alloclassic-Allofit, Zimmer-Biomet) was placed in the retroverted acetabulum combined with a cementless stem (Fitmore A, Zimmer-Biomet) attached at the metaphyseal proximal femur bone. Conclusion Our results suggest that THA may be a good strategy to manage advanced hip osteoarthritis in patients with dysplasia and congenital pubic diastasis. Level of evidence IV, case series.

The Effect of Femoral Malrotation in Offset Templating for Total Hip Arthroplasty: A Cadaveric Study and Curvilinear Analysis

2021 ◽  
Author(s):  
H. Del Schutte ◽  
Sergio M. Navarro ◽  
Hashim Shaikh ◽  
William R. Barfield ◽  
Jeffrey Conrad ◽  
...  
Keyword(s):  
Total Hip Arthroplasty ◽  
Internal Rotation ◽  
Hip Arthroplasty ◽  
Proximal Femur ◽  
External Rotation ◽  
Femoral Rotation ◽  
Level Of Evidence ◽  
Total Hip ◽  
Femoral Malrotation ◽  
Cadaveric Model

AbstractTechniques allow assessment of preoperative offset in hip arthroplasty. This study assessed femoral rotation in preoperative offset templating using a cadaveric model. Ten femurs were imaged at degrees of rotation. Offset was measured. A generalizable equation predicting change in offset was derived with a curvilinear model. Statistically significant differences at rotational positions were found. For 30 degrees of internal rotation, 2.1 mm change in adjusted mean offset existed; for 30 degrees of external rotation, 8.4 mm change existed. Improved awareness of malrotation of the proximal femur and templating adjustments may improve total hip arthroplasty outcomes. This study reflects level of evidence III.

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