The association between cannabis use disorder and the outcome following primary total hip arthroplasty

2021 ◽  
Vol 103-B (7 Supple B) ◽  
pp. 111-115
Author(s):  
Rushabh M. Vakharia ◽  
Angelo Mannino ◽  
Hytham S. Salem ◽  
Martin W. Roche ◽  
Che Hang J. Wong ◽  
...  
Keyword(s):  
Total Hip Arthroplasty ◽  
Hip Arthroplasty ◽  
Cannabis Use ◽  
Hospital Length Of Stay ◽  
Medical Complications ◽  
Control Group ◽  
Study Group ◽  
Cannabis Use Disorder ◽  
Total Hip ◽  
Primary Total Hip Arthroplasty

Aims Although there is increasing legalization of the use of cannabis in the USA, few well-powered studies have evaluated the association between cannabis use disorder and outcomes following primary total hip arthroplasty (THA). Thus, the aim of this study was to determine whether patients who use cannabis and undergo primary THA have higher rates of in-hospital length of stay (LOS), medical complications, implant-related complications, and costs. Methods Using an administrative database, patients with cannabis use disorder undergoing primary THA were matched to a control group in a 1:5 ratio by age, sex, and various medical comorbidities. This yielded 23,030 patients (3,842 in the study group matched with 19,188 in the control group). The variables which were studied included LOS, 90-day medical complications, two-year implant-related complications, and 90-day costs of care. Mann-Whitney U tests were used to compare LOS and costs. Multivariate logistic regression analyses were used to calculate the odds ratios (ORs) of developing complications. Results We found that patients in the study group had a significantly longer mean LOS compared with the controls (four days vs three days; p < 0.0001).The study group also had a significantly higher incidence and odds of developing medical (23.0 vs 9.8%, OR 1.6; p < 0.0001) and implant-related complications (16 vs 7.4%, OR 1.6; p < 0.0001) and incurred significantly higher mean 90-day costs ($16,938.00 vs $16,023.00; p < 0.0001). Conclusion With the increasing rates of cannabis use, these findings allow orthopaedic surgeons and other healthcare professionals to counsel patients with cannabis use disorder about the possible outcomes following their THA, with increased hospital stays, complications, and costs. Cite this article: Bone Joint J 2021;103-B(7 Supple B):111–115.

Efficacy of Tranexamic Acid Application for Blood Loss Reduction in Total Hip Arthroplasty

2010 ◽  
Vol 17 (1) ◽  
pp. 29-34
Author(s):  
R M Tikhilov ◽  
I I Shubnyakov ◽  
M I Mokhanna ◽  
D G Pliev ◽  
A A Myasoedov ◽  
...  
Keyword(s):  
Total Hip Arthroplasty ◽  
Tranexamic Acid ◽  
Hip Arthroplasty ◽  
Main Group ◽  
Control Group ◽  
Total Hip ◽  
Joint Pathology ◽  
Daily Dose ◽  
Blood Loss Reduction ◽  
Primary Total Hip Arthroplasty

Prospective study of tranexamic acid use results (native preparation Tranexam) in primary total hip arthroplasty was performed during the period from March to October 2009. The study involved 159 patients (55 men, 104 women) with various hip joint pathology (79 patients - main group, 80 patients - control group). Mean age of patients made up 55.7 years (17 - 80 years). In patients from the main group 15 mg/kg Tranexam was injected just prior to operation with reinjection of the same dose in 6 hours. In control group etamsylate (750 mg 30 minutes prior to incision with reintroduction in 4 - 6 hours, daily dose up to 1500 mg) was applied. The results of the analysis showed reliable (p

Lumbar fusion involving the sacrum increases dislocation risk in primary total hip arthroplasty

2019 ◽  
Vol 101-B (2) ◽  
pp. 198-206 ◽  
Author(s):  
C. G. Salib ◽  
N. Reina ◽  
K. I. Perry ◽  
M. J. Taunton ◽  
D. J. Berry ◽  
...  
Keyword(s):  
Total Hip Arthroplasty ◽  
Hip Arthroplasty ◽  
Lumbar Fusion ◽  
Statistical Significance ◽  
Control Group ◽  
Total Hip ◽  
Significant Difference ◽  
Anterior Pelvic Tilt ◽  
Postoperative Dislocation ◽  
Primary Total Hip Arthroplasty

AimsConcurrent hip and spine pathologies can alter the biomechanics of spinopelvic mobility in primary total hip arthroplasty (THA). This study examines how differences in pelvic orientation of patients with spine fusions can increase the risk of dislocation risk after THA.Patients and MethodsWe identified 84 patients (97 THAs) between 1998 and 2015 who had undergone spinal fusion prior to primary THA. Patients were stratified into three groups depending on the length of lumbar fusion and whether or not the sacrum was involved. Mean age was 71 years (40 to 87) and 54 patients (56%) were female. The mean body mass index (BMI) was 30 kg/m2(19 to 45). Mean follow-up was six years (2 to 17). Patients were 1:2 matched to patients with primary THAs without spine fusion. Hazard ratios (HR) were calculated.ResultsDislocation in the fusion group was 5.2% at one year versus 1.7% in controls but this did not reach statistical significance (HR 1.9; p = 0.33). Compared with controls, there was no significant difference in rate of dislocation in patients without a sacral fusion. When the sacrum was involved, the rate of dislocation was significantly higher than in controls (HR 4.5; p = 0.03), with a trend to more dislocations in longer lumbosacral fusions. Patient demographics and surgical characteristics of THA (i.e. surgical approach and femoral head diameter) did not significantly impact risk of dislocation (p > 0.05). Significant radiological differences were measured in mean anterior pelvic tilt between the one-level lumbar fusion group (22°), the multiple-level fusion group (27°), and the sacral fusion group (32°; p < 0.01). Ten-year survival was 93% in the fusion group and 95% in controls (HR 1.2; p = 0.8).ConclusionLumbosacral spinal fusions prior to THA increase the risk of dislocation within the first six months. Fusions involving the sacrum with multiple levels of lumbar involvement notably increased the risk of postoperative dislocation compared with a control group and other lumbar fusions. Surgeons should take care with component positioning and may consider higher stability implants in this high-risk cohort.

Tall-Statured Patients Have Similar Outcomes to Normal Height Patients after Primary Total Hip Arthroplasty

2020 ◽  
Vol 04 (02) ◽  
pp. 060-065
Author(s):  
Ahmed Siddiqi ◽  
Jared A. Warren ◽  
Michael Groover ◽  
Daniel Santana ◽  
Hiba K. Anis ◽  
...  
Keyword(s):  
Postoperative Complications ◽  
Total Hip Arthroplasty ◽  
Hip Arthroplasty ◽  
Retrospective Chart Review ◽  
Hospital Length Of Stay ◽  
Control Group ◽  
Control Cohort ◽  
Level Of Evidence ◽  
Normal Height ◽  
Total Hip

AbstractTotal hip arthroplasty (THA) has been proven to be a safe and efficacious operation; however, there is a paucity of literature on outcomes in patients in the 99th percentile for height. The objectives of this study were to identify differences in (1) implant selection, (2) operative times, (3) intraoperative and postoperative complications, (4) 90-day readmission, (5) all cause reoperation rates, and (6) hospital length of stay (LOS), in tall-statured patients compared with a matched control cohort. An electronic research request was used to identify 12,850 patients who underwent THA from January 2012 to December 2016 with minimum 1-year follow-up at a single health care system for retrospective chart review. Patients were identified in the 99th percentile for height (193 cm for males and 177 cm for females) and then matched to controls based on gender, race, age, body mass index, and Charlson comorbidity index. A total of 260 THA patients (2%) were identified in the 99th percentile for height. The tall-statured patients were then matched to 248 patients of normal stature. The exclusion criteria was met by 172 tall-statured patients and 165 normal-statured patients. Final analysis comprised of 86 tall-statured patients (100 THA) and 83 matched normal-statured patients (92 THA). Baseline demographics information and the outcomes of interest were then compared. The mean height of the female patients in the tall cohort was 181.01 ± 2.51 cm compared with 166.6 ± 6.98 cm for the control group (p < 0.001), while it was 195.25 ± 4.03 cm for male patients in the tall cohort and 174.11 ± 4.63 cm for the control cohort (p < 0.001). Tall-statured patients had larger acetabular cups (p < 0.001) and femoral head (p = 0.046) components. There were no differences in reoperation (p = 0.282), 90-day readmissions (p = 0.862), intraoperative fractures (p = 0.228), postoperative complications (p = 0.678), operative times (p = 0.890), and LOS (p = 0.099) between the tall-statured and normal-statured patients. Patients that are in the 99th percentile for height have similar outcomes to patients that are of normal height. The level of evidence of this study is level 3.

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