Etoricoxib is safe and effective in preventing heterotopic ossification after primary total hip arthroplasty

Abstract Background Heterotopic ossifications are a common complication after total hip arthroplasty. Low-dose radiation therapy and non-steroidal anti-inflammatory drugs have proven to effectively reduce the rate of heterotopic ossification after total hip arthroplasty. However, a low number of studies describe an equal efficiency of etoricoxib. This work shows first results on the examination of a larger group with 194 subjects to analyze efficiency and rate of side effects under treatment with etoricoxib. Methods Clinical examinations were performed the day before surgery and after at least 12 months. The survey of clinical and functional outcome was done with Harris Hip Score (HHS). Conventional antero-posterior radiographs and second plane in frog leg position were assessed. Results In total, 14 undesirable side effects (7.4%) and only four early terminations of therapy (2.1%) were documented. A complete 1-year follow-up examination including radiographs could be done in 143 subjects (79.4%). Only 28 subjects (19.6%) developed heterotopic ossifications from which 92.9% were classified in type 1 and 7.1% in type 2 using the method described by Brooker. The results do not show correlations with body mass index, extended treatment (more than ten days), or clinical and functional outcome (measured by “Harris Hip Score”). However, male subjects show a significantly higher rate of heterotopic ossifications. Conclusions The investigations presented in this study confirm a good efficiency of etoricoxib for the prevention of heterotopic ossifications in comparison with classical methods such as radiation or drug therapy and show a low rate of undesirable side effects.

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Excellent Functional Outcome and Quality of Life after Primary Cementless Total Hip Arthroplasty (THA) Using an Enhanced Recovery Setup

Journal of Clinical Medicine ◽

10.3390/jcm10040621 ◽

2021 ◽

Vol 10 (4) ◽

pp. 621

Author(s):

Franziska Leiss ◽

Julia Sabrina Götz ◽

Günther Maderbacher ◽

Matthias Meyer ◽

Jan Reinhard ◽

...

Keyword(s):

Quality Of Life ◽

Patient Satisfaction ◽

Total Hip Arthroplasty ◽

Functional Outcome ◽

Hip Arthroplasty ◽

Enhanced Recovery ◽

Harris Hip Score ◽

Total Hip ◽

Cementless Total Hip Arthroplasty

Background: Total hip arthroplasty combined with the concept of enhanced recovery is of continued worldwide interest, as it is reported to improve early functional outcome and treatment quality without increasing complications. The aim of the study was to investigate functional outcome and quality of life 4 weeks and 12 months after cementless total hip arthroplasty in combination with an enhanced recovery concept. Methods: A total of 109 patients underwent primary cementless Total Hip Arthroplasty (THA) in an enhanced recovery concept and were retrospectively analyzed. After 4 weeks and 12 months, clinical examination was analyzed regarding function, pain and satisfaction; results were evaluated using Harris Hip score, Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), EQ-5D-5L, EQ-VAS and subjective patient-related outcome measures (PROMs). Preoperatively, HADS (Hospital Anxiety and Depression Scale) was collected. A correlation analysis of age, American Society of Anesthesiologists (ASA), HADS and comorbidities (diabetes mellitus, art. hypertension, cardiovascular disease) with WOMAC, Harris Hip score (HHS) and EQ-5D was performed. Results: Patients showed a significant improvement in Harris Hip score 4 weeks and 12 months postoperatively (p < 0.001). WOMAC total score, subscale pain, subscale stiffness and subscale function improved significantly from preoperative to 12 months postoperative (p < 0.001). EQ-5D showed a significant improvement preoperative to postoperative (p < 0.001). The influence of anxiety or depression (HADS-A or HADS-D) on functional outcome could not be determined. There was a high patient satisfaction postoperatively, and almost 100% of patients would choose enhanced recovery surgery again. Conclusion: Cementless THA with the concept of enhanced recovery improves early clinical function and quality of life. PROMs showed a continuous improvement over a follow-up of 12 months after surgery. PROMs can help patients and surgeons to modify expectations and improve patient satisfaction.

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Study of functional outcome of total hip arthroplasty in a series of cases of hip pathologies done in rural population

International Journal of Research in Orthopaedics ◽

10.18203/issn.2455-4510.intjresorthop20163755 ◽

2016 ◽

Vol 2 (4) ◽

pp. 269

Author(s):

Rahul Kadam ◽

Pankaj Bansal ◽

Abhay Chhallani

Keyword(s):

Total Hip Arthroplasty ◽

Functional Outcome ◽

Hip Arthroplasty ◽

Rural Population ◽

Harris Hip Score ◽

Controlled Study ◽

Walking Ability ◽

Total Hip ◽

Medical College

Background: The objective of the study was to assess the functional outcome of total hip arthroplasty (THA) done in a series of cases of hip pathologies rural population.Methods: A retrospective randomized controlled study conducted in 50 cases of hip arthritis (38 males and 12 females) treated with uncemented THA for an average follow-up of 2 years at department of orthopedics MGM Medical College, Kamothe, Navi Mumbai. Harris hip scoring system was used for the functional scoring and the postoperative radiographs were assessed by Gruen zones for the femoral component and DeLee and Charnley zones for the acetabular component. All patients were evaluated pre operatively and post operatively 3 months 6 months, 12months, 2years with Harris Hip score.Results: 81% of our patients scored 85 points or better for a rating of excellent by Harris hip score system. 90% patients had little /no pain post operatively, whereas walking ability improved and was unlimited in 80% of the patients post operatively. Harris hip score improved from 40 to 80. 80.5% -excellent, 13.80% -good, 5.7% -fair results. Poor results were not seen in any patient.Conclusions: THR provided excellent pain relief, adequate stability, and remarkable range of motion in severely painful, refractory hip. A significant improvement was seen at two year follow-up.

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A prospective study on functional outcome of uncemented total hip arthroplasty in patients with inflammatory arthropathies

International Journal of Research in Orthopaedics ◽

10.18203/issn.2455-4510.intjresorthop20201520 ◽

2020 ◽

Vol 6 (3) ◽

pp. 622

Author(s):

Girish Marappa ◽

Vishwanath Muttagaduru Shivalingappa ◽

Nuthan Jagadeesh ◽

Arjun Mandri

Keyword(s):

Total Hip Arthroplasty ◽

Prospective Study ◽

Functional Outcome ◽

Hip Arthroplasty ◽

Inflammatory Arthritis ◽

Posterolateral Approach ◽

Harris Hip Score ◽

Total Hip ◽

Uncemented Total Hip Arthroplasty ◽

A Prospective Study

Background: Although medical management has improved the outcome and may have reduced the need for surgery, total hip arthroplasty (THA) is often required to manage pain and restore function and mobility. The successful functional outcome of THA in patients with inflammatory arthropathies is essential in understanding the need for THA, and its benefits in those undergoing it. Objective of the study is to evaluate the functional outcome of total hip arthroplasty in patients suffering from inflammatory arthritis using Harris hip score (HHS) and to assess the post operative complication in these patients.Methods: In a prospective study conducted on patients with inflammatory arthritis treated with THA between a study period of January 2018 to January 2020. All the patients after assessing them clinically and radiologically were operated with uncemented THA through posterolateral approach. Functional outcomes of hip were evaluated using HHS at various intervals.Results: In this study, patients were followed up to 24 months. About 46.7% of patients were diagnosed with rheumatoid arthritis, 33.3% of patients were diagnosed with ankylosing spondylitis, 20% of patients were diagnosed with sero negative arthritis. 90% of patients had no limb length discrepancy, no other post-operative complications were noted. The final functional outcome of hip according to HHS were 13.3% of excellent, 56.7% good results and 30% of fair results.Conclusions: This study concludes that THA in patients with inflammatory arthritis with restricted activities of life had improved in short term follow up and ease of rehabilitation and return to function.

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Subtrochanteric femoral shortening for hip centre restoration in complex total hip arthroplasty with functional outcome

Bone & Joint Open ◽

10.1302/2046-3758.15.bjo-2020-0023.r1 ◽

2020 ◽

Vol 1 (5) ◽

pp. 152-159

Author(s):

A. T. Oommen ◽

V. J. Chandy ◽

Christo Jeyaraj ◽

Madhavi Kandagaddala ◽

T. D. Hariharan ◽

...

Keyword(s):

Total Hip Arthroplasty ◽

Septic Arthritis ◽

Functional Outcome ◽

Hip Arthroplasty ◽

Short Form ◽

Harris Hip Score ◽

Total Hip ◽

Femoral Shortening ◽

The Mean ◽

Centre Of Rotation

Aims Complex total hip arthroplasty (THA) with subtrochanteric shortening osteotomy is necessary in conditions other than developmental dysplasia of the hip (DDH) and septic arthritis sequelae with significant proximal femur migration. Our aim was to evaluate the hip centre restoration with THAs in these hips. Methods In all, 27 THAs in 25 patients requiring THA with femoral shortening between 2012 and 2019 were assessed. Bilateral shortening was required in two patients. Subtrochanteric shortening was required in 14 out of 27 hips (51.9%) with aetiology other than DDH or septic arthritis. Vertical centre of rotation (VCOR), horizontal centre of rotation, offset, and functional outcome was calculated. The mean followup was 24.4 months (5 to 92 months). Results The mean VCOR was 17.43 mm (9.5 to 27 mm) and horizontal centre of rotation (HCOR) was 24.79 mm (17.2 to 37.6 mm). Dislocation at three months following acetabulum reconstruction required femoral shortening for offset correction and hip centre restoration in one hip. Mean horizontal offset was 39.72 (32.7 to 48.2 mm) compared to 42.89 (26.7 to 50.6 mm) on the normal side. Mean Harris Hip Score (HHS) of 22.64 (14 to 35) improved to 79.43 (68 to 92). Mean pre-operative shortening was 3.95 cm (2 to 8 cm). Residual limb length discrepancy was 1.5 cm (0 to 2 cm). Sciatic neuropraxia in two patients recovered by six months, and femoral neuropraxia in one hip recovered by 12 months. Mean Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) was 13.92 (9 to 19). Mean 12-item short form survey (SF-12) physical scores of 50.6 and mental of 60.12 were obtained. Conclusion THA with subtrochanteric shortening is valuable in complex hips with high dislocation. The restoration of the hip centre of rotation and offset is important in these hips. Level of evidence IV Femoral shortening useful in conditions other than DDH and septic sequelae. Restoration of hip centre combined with offset to be planned and ensured.

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Heterotopic ossification in primary total hip arthroplasty using the posterolateral compared to the direct lateral approach

Archives of Orthopaedic and Trauma Surgery ◽

10.1007/s00402-021-03783-6 ◽

2021 ◽

Author(s):

J. H. J. van Erp ◽

J. R. A. Massier ◽

S. Truijen ◽

J. E. J. Bekkers ◽

T. E. Snijders ◽

...

Keyword(s):

Total Hip Arthroplasty ◽

Heterotopic Ossification ◽

Hip Arthroplasty ◽

Rating Scale ◽

Lateral Approach ◽

Posterolateral Approach ◽

Harris Hip Score ◽

Total Hip ◽

Direct Lateral Approach

Abstract Purpose Total hip arthroplasty (THA) is a successful procedure. However, in time, heterotopic ossification (HO) can form due to, amongst others, soft tissue damage. This can lead to pain and impairment. This study compares the formations of HO between patients who underwent either THA with the posterolateral approach (PA) or with the direct lateral approach (DLA). Our hypothesis is that patients who underwent THA with a PA form less HO compared to THA patients who underwent DLA. Methods In this prospective cohort study, 296 consecutive patients were included who underwent THA. A total of 127 patients underwent THA with the PA and 169 with the DLA. This was dependent on the surgeon’s preference and experience. More than 95% of patients had primary osteoarthritis as the primary diagnosis. Clinical outcomes were scored using the Numeric Rating Scale (NRS) and Harris Hip Score (HHS), radiological HO were scored using the Brooker classification. Follow-up was performed at 1 and 6 years postoperatively. Results Two hundred and fifty-eight patients (87%) completed the 6-year follow-up. HO formation occurred more in patients who underwent DLA, compared to PA (43(30%) vs. 21(18%), p = 0.024) after 6 years. However, the presence of severe HO (Brooker 3–4) was equal between the DLA and PA (7 vs. 5,p = 0.551). After 6 years the HHS and NRS for patient satisfaction were statistically significant higher after the PA (95.2 and 8.9, respectively) compared to the DLA (91.6 and 8.5, respectively) (p < 0.001 and p = 0.003, respectively). The NRS for load pain was statistically significant lower in the PA group (0.5) compared to the DLA group (1.2) (p = 0.004). The NRS for rest pain was equal: 0.3 in the PA group and 0.5 in the DLA group. Conclusion THA with the PA causes less HO formation than the DLA. Trial registration Registrated as HipVit trial, NL 32832.100.10, R-10.17D/HIPVIT 1. Central Commission Human-Related research (CCMO) Registry.

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Functional Outcome Of primary Total Hip Arthroplasty using Harris Hip Score in Arthritic Hip

Europasian Journal of Medical Sciences ◽

10.46405/ejms.v2i2.78 ◽

2020 ◽

Vol 2 (2) ◽

pp. 4-10

Author(s):

Suman Babu Marahatta ◽

Dirgha Raj RC ◽

Kapil Mani KC ◽

Arun Sigdel

Keyword(s):

Total Hip Arthroplasty ◽

Blood Loss ◽

Functional Outcome ◽

Hip Arthroplasty ◽

Operative Time ◽

Harris Hip Score ◽

Intraoperative Blood Loss ◽

Total Hip ◽

Primary Total Hip Arthroplasty

Introduction: Total hip arthroplasty (THA) is a well-established procedure for advanced arthritis of the hip joint. It significantly improves the quality of life by relieving pain and improving functional disability. The objective of this study was to evaluate the clinical and functional outcome of primary total hip arthroplasty using the Harris Hip Score. Method: Prospective study was conducted in Civil Service Hospital. Out of 145 THA performed from Jan 2014 to Dec 2018, the first 100 cases that fulfilled the inclusion criteria were analyzed. Patient demographic and site, operative indication, and pre-operative Harris Hip Score was documented. Operative time, total intraoperative blood loss, and complications were noted. Patients were followed in 3 weeks, 6 weeks, 3 months, 6 months, and yearly. In each visit, clinical evaluation using Harris Hip Score and radiological evaluation was done and documented. The duration of follow up ranged from 12 months to 4.5 years. Results: Age varied from 21 to 75 years, 59% were male and 41% female, right side involvement was seen in 55% and left side in 45%. The major indication for surgery was avascular necrosis 46% and primary osteoarthritis in 24%. The average operative time was 65 minutes and the average intraoperative blood loss was 655 ml. Pre-operative Harris Hip Score ranged from 25 to 59 with a mean of 45.5. The mean Harris hip score in last follow up increased to 90.5 with a minimum of 76 and a maximum of 97. Our study found that 85% had excellent, 9% had good and 6% had fair results. Complications include 2% dislocation, 1% infection, 1% greater trochanter avulsion and 1% screw irritation. Conclusion: Primary THA is a safe and effective procedure. It improves pain and function hence improving the activity of daily living and has fewer complications.

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Subtrochanteric femoral shortening for hip centre restoration in complex total hip arthroplasty with functional outcome

Bone & Joint Open ◽

10.1302/2633-1462.15.bjo-2020-0023.r1 ◽

2020 ◽

Vol 1 (5) ◽

pp. 152-159

Author(s):

A. T. Oommen ◽

V. J. Chandy ◽

Christo Jeyaraj ◽

Madhavi Kandagaddala ◽

T. D. Hariharan ◽

...

Keyword(s):

Total Hip Arthroplasty ◽

Septic Arthritis ◽

Functional Outcome ◽

Hip Arthroplasty ◽

Short Form ◽

Harris Hip Score ◽

Total Hip ◽

Femoral Shortening ◽

The Mean ◽

Centre Of Rotation

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SKOR FUNGSIONAL HIP (HARRIS HIP SCORE) PADA PASIEN OSTEOARTHRITIS (OA) HIP JOINT DENGAN DEFEK ACETABULUM YANG DILAKUKAN TOTAL HIP ARTHROPLASTY (THR) DAN ACETABULOPLASTY

Biomedika ◽

10.23917/biomedika.v10i2.7018 ◽

2018 ◽

Vol 10 (2) ◽

Author(s):

S Bawono ◽

I Maryanto ◽

M Idulhaq

Keyword(s):

Total Hip Arthroplasty ◽

Range Of Motion ◽

Functional Outcome ◽

Hip Joint ◽

Hip Arthroplasty ◽

Weight Bearing ◽

Long Term Results ◽

Harris Hip Score ◽

Total Hip ◽

Function Range

ABSTRAKTotal hip arthroplasty (THA) merupakan pilihan bagi hampir semua pasien dengan kelainan sendi panggul yang menyebabkan ketidaknyamanan dan gangguan fungsi. Hasil jangka panjang yang baik dikarenakan perangkat endoprosthetic tersebut mampu memberikan kemampuan menahan beban, mempertahankan fungsi, rentang gerak dan stabilitas. Peneliti mencoba untuk mengevaluasi skor hip fungsional pasien osteoarthritis pinggul dengan defek pada acetabulum yang dilakukan tindakan THA dengan acetabuloplasty di Rumah Sakit Ortopedi X, Surakarta, sejak Januari - September 2016. Kemudian kami evaluasi untuk fungsional hip pasien sebelum dan sesudah operasi menggunakan Harris Hip Skor (HHS). Berdasarkan data yang diperoleh didapat jumlah sampel perempuan 18 pasien dan laki-laki 14 pasien. Pada karekter umur rentang umur sampel antara 49 tahun sampai 66 tahun. Penilaian skor HHS sebelum operasi memiliki rentang nilai 20,8 sampai dengan 69,4. Hasil pengukuran skor HHS terhadap sampel yang dilakukan setelah tindakan operasi adalah sebagai berikut Fair 9 pasien, Good 13 pasien, dan Excellent 10 pasien. Hasil penelitian dapat disimpulkan bahwa THA dan Acetabuloplasty memberikan hasil terapi terbaik pada pasien Osteoarthritis dengan defek acetabulum, meliputi kemampuan menahan beban tubuh, fungsi , rentang gerak dan stabilitas sendi.Kata Kunci: Osteoartritis Hip, Defek Acetabulum, THA, Total Hip Artroplasty, Acetabuloplasty, Harris Hip Score ABSTRACTTotal hip arthroplasty (THA) is an option for almost all patients with hip joint abnormalities that cause discomfort and disruption of significant function. This is because of good long-term results that the endoprosthetic device gives regarding the ability of weight-bearing, function, range of motion and stability of hip joint. We try to evaluate the functional hip score of hip osteoarthritis patients with defects in the acetabulum, performed THA with acetabuloplasty in X Orthopaedic Hospital since January until September 2016. Then we evaluated for patient’s functional outcome before and after operation using Harris Hip Score (HHS). From 32 patients were reviewed and identified, there were 18 females and 14 males, mean age was 57,5 y.o (range 49-66 y.o). All had primary THA and Acetabuloplasty. There were 10 patients have excellent functional outcome(90-100 based on Harris Hip Score/HHS), 13 patients have good functional outcome (80-0), 9 patients have fair functional outcome (70 – 79), no patient have poor functional outcome (60 – 69) and have failed functional outcome (below 60). In this study we concluded that THA and acetabuloplasty gives best treatment for osteoarthritis patient with acetabular defects , regarding the ability of weight-bearing, function, range of motion and stability of hip joint. Keyword : Osteoartritis Hip, Acetabular Defect, THA, Total Hip Arthroplasty,Acetabuloplasty, Harris Hip’s Score

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