Intra-articular steroid injection for osteoarthritis of the hip prior to total hip arthroplasty

Introduction Periarticular muscles have a significant role in keeping the mobility and integrity of the hip joint. The aim of this article was to investigate the effects of the total hip arthroplasty and early rehabilitation on the muscle strength. Patients Three groups of examined persons (matched in relation to musculosceletal conditions, sex, age and occupation) were included in the investigation. The first group (40 of the involved hip) and the second group (with 33 involved hips) were groups of patients with late-stage of osteoarthritis of the hip. The first group of patients was managed conservatively and the second group operatively (total cemented hip endoprosthesis was performed). The third group was control group with 123 healthy hips. Material and methods The maximal voluntary isometric strength was measured with dynamometer. The muscle strength was tested in all three groups: in the first group of patients at the beginning and at the end of the therapy and in patients of the second group 6?3 months postoperatively. Results A significant improvement of the muscle strength was noted for the flexors (t=2.45, p<0.05), musculus tensor fasciae latae (t=2.35, p<0.05), extensors (t=2.85, p<0.01), adductors (t=3.02, p<0.01), external rotators (t=3.1, p<0.01), m. gluteus medius (t=5.28, p<0.001) and internal rotators (t=5.77, p<0.001) after total hip arthroplasty and early rehabilitation in comparison to the conservatively treated group. Conclusion The muscle strength in the patients with osteoarthritis of the hip after arthroplasty was significantly higher than after rehabilitation for all hip muscles but did not reach values of the strength of the muscles in the corresponding control group.

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To cement or not to cement acetabular cups in total hip arthroplasty: a systematic review and re-evaluation

SICOT-J ◽

10.1051/sicotj/2019032 ◽

2019 ◽

Vol 5 ◽

pp. 35

Author(s):

Frank Van Praet ◽

Michiel Mulier

Keyword(s):

Total Hip Arthroplasty ◽

Hip Arthroplasty ◽

English Literature ◽

Cost Effective ◽

Acetabular Cup ◽

Qualitative Synthesis ◽

Osteoarthritis Of The Hip ◽

Total Hip ◽

Primary Osteoarthritis ◽

Cemented Stem

Introduction: Total Hip Arthroplasty (THA) in the treatment of primary osteoarthritis of the hip has evolved to a very safe and cost-effective intervention with revision rates below 5% after 10 years. To this day, however, controversy remains on whether or not to cement the acetabular cup. Methods: A comprehensive PubMed search of the English literature for studies published between 2007 and 2018 was performed. Studies comparing the clinical (revision rate, functionality), radiological (wear) or economic (cost) differences between cemented (cemented stem with cemented cup) and hybrid (cemented stem with uncemented cup) prostheses for primary osteoarthritis of the hip were identified as eligible. Results: A total of 1032 studies were identified whereof twelve were included for qualitative synthesis. All studies concerning the risk of revision were based on registry data, covering a total of 365,693 cups. Cemented prostheses had a similar or lower risk of revision compared to hybrid prostheses in every study, but performed slightly worse on functionality and quality of life. While cemented prostheses were the cheapest option, hybrids were the most cost-effective. Discussion: The widespread preference for cementless fixation of the acetabulum cannot be explained by a superior survival of cementless or hybrid models. Irrespective of age, cemented fixation of the acetabulum remains the gold standard to which other techniques should be compared.

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Risk of intraarticular steroid injection before total hip arthroplasty

Current Orthopaedic Practice ◽

10.1097/bco.0b013e3182847788 ◽

2013 ◽

Vol 24 (2) ◽

pp. 185-188 ◽

Cited By ~ 4

Author(s):

Stephen Croft ◽

Peter Rockwood

Keyword(s):

Total Hip Arthroplasty ◽

Hip Arthroplasty ◽

Steroid Injection ◽

Total Hip

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Does Previous Intra-Articular Steroid Injection Increase the Risk of Joint Infection Following Total Hip Arthroplasty or Total Knee Arthroplasty? A Meta-Analysis

Medical Science Monitor ◽

10.12659/msm.890750 ◽

2014 ◽

Vol 20 ◽

pp. 1878-1883 ◽

Cited By ~ 22

Author(s):

Wei Tian

Keyword(s):

Total Knee Arthroplasty ◽

Total Hip Arthroplasty ◽

Knee Arthroplasty ◽

Hip Arthroplasty ◽

Steroid Injection ◽

Meta Analysis ◽

Joint Infection ◽

Total Hip ◽

Total Knee

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A cost-effectiveness analysis of total hip arthroplasty for osteoarthritis of the hip

JAMA ◽

10.1001/jama.275.11.858 ◽

1996 ◽

Vol 275 (11) ◽

pp. 858-865 ◽

Cited By ~ 55

Author(s):

R. W. Chang

Keyword(s):

Cost Effectiveness ◽

Total Hip Arthroplasty ◽

Hip Arthroplasty ◽

Cost Effectiveness Analysis ◽

Osteoarthritis Of The Hip ◽

Total Hip ◽

Effectiveness Analysis

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A Cost-Effectiveness Analysis of Total Hip Arthroplasty for Osteoarthritis of the Hip

Survey of Anesthesiology ◽

10.1097/00132586-199702000-00017 ◽

1997 ◽

Vol 41 (1) ◽

pp. 15???16

Author(s):

ROWLAND W. CHANG ◽

JAMES M. PELLISSIER ◽

GORDON B. HAZEN

Keyword(s):

Cost Effectiveness ◽

Total Hip Arthroplasty ◽

Hip Arthroplasty ◽

Cost Effectiveness Analysis ◽

Osteoarthritis Of The Hip ◽

Total Hip ◽

Effectiveness Analysis

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Iliopsoas pathology after total hip arthroplasty: a young person’s complication

The Bone & Joint Journal ◽

10.1302/0301-620x.103b2.bjj-2020-1318.r1 ◽

2021 ◽

Vol 103-B (2) ◽

pp. 305-308

Author(s):

Matthew Howell ◽

Fraser J. Rae ◽

Aman Khan ◽

Graeme Holt

Keyword(s):

Total Hip Arthroplasty ◽

Hip Arthroplasty ◽

Groin Pain ◽

Steroid Injection ◽

Case Series ◽

Leg Length ◽

Younger Patients ◽

Total Hip ◽

Active Flexion ◽

The Mean

Aims Iliopsoas pathology is a relatively uncommon cause of pain following total hip arthroplasty (THA), typically presenting with symptoms of groin pain on active flexion and/or extension of the hip. A variety of conservative and surgical treatment options have been reported. In this retrospective cohort study, we report the incidence of iliopsoas pathology and treatment outcomes. Methods A retrospective review of 1,000 patients who underwent THA over a five-year period was conducted, to determine the incidence of patients diagnosed with iliopsoas pathology. Outcome following non-surgical and surgical management was assessed. Results In all, 24 patients were diagnosed as having developed symptomatic iliopsoas pathology giving an incidence of 2.4%. While the mean age for receiving a THA was 65 years, the mean age for developing iliopsoas pathology was 54 years (28 to 67). Younger patients and those receiving THA for conditions other than primary osteoarthritis were at a higher risk of developing this complication. Ultrasound-guided steroid injection/physiotherapy resulted in complete resolution of symptoms in 61% of cases, partial resolution in 13%, and no benefit in 26%. Eight out of 24 patients (who initially responded to injection) subsequently underwent surgical intervention including tenotomy (n = 7) and revision of the acetabular component (n = 1). Conclusion This is the largest case series to estimate the incidence of iliopsoas pathology to date. There is a higher incidence of this condition in younger patients, possibly due to the differing surgical indications. Arthoplasty for Perthes' disease or developmental dysplasia of the hip (DDH) often results in leg length and horizontal offset being increased. This, in turn, may increase tension on the iliopsoas tendon, possibly resulting in a higher risk of psoas irritation. Image-guided steroid injection is a low-risk, relatively effective treatment. In refractory cases, tendon release may be considered. Patients should be counselled of the risk of persisting groin pain when undergoing THA. Cite this article: Bone Joint J 2021;103-B(2):305–308.

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