scholarly journals Robotic arm-assisted versus manual total hip arthroplasty

2021 ◽  
Vol 10 (1) ◽  
pp. 22-30
Author(s):  
Nicholas D. Clement ◽  
Paul Gaston ◽  
Allison Bell ◽  
Philip Simpson ◽  
Gavin Macpherson ◽  
...  
Keyword(s):  
Patient Satisfaction ◽  
Total Hip Arthroplasty ◽  
Functional Outcome ◽  
Hip Arthroplasty ◽  
Health Improvement ◽  
Leg Length ◽  
Total Hip ◽  
Oxford Hip Score ◽  
Five Dimension ◽  
Safe Zones

Aims The primary aim of this study was to compare the hip-specific functional outcome of robotic assisted total hip arthroplasty (rTHA) with manual total hip arthroplasty (mTHA) in patients with osteoarthritis (OA). Secondary aims were to compare general health improvement, patient satisfaction, and radiological component position and restoration of leg length between rTHA and mTHA. Methods A total of 40 patients undergoing rTHA were propensity score matched to 80 patients undergoing mTHA for OA. Patients were matched for age, sex, and preoperative function. The Oxford Hip Score (OHS), Forgotten Joint Score (FJS), and EuroQol five-dimension questionnaire (EQ-5D) were collected pre- and postoperatively (mean 10 months (SD 2.2) in rTHA group and 12 months (SD 0.3) in mTHA group). In addition, patient satisfaction was collected postoperatively. Component accuracy was assessed using Lewinnek and Callanan safe zones, and restoration of leg length were assessed radiologically. Results There were no significant differences in the preoperative demographics (p ≥ 0.781) or function (p ≥ 0.383) between the groups. The postoperative OHS (difference 2.5, 95% confidence interval (CI) 0.1 to 4.8; p = 0.038) and FJS (difference 21.1, 95% CI 10.7 to 31.5; p < 0.001) were significantly greater in the rTHA group when compared with the mTHA group. However, only the FJS was clinically significantly greater. There was no difference in the postoperative EQ-5D (difference 0.017, 95% CI -0.042 to 0.077; p = 0.562) between the two groups. No patients were dissatisfied in the rTHA group whereas six were dissatisfied in the mTHA group, but this was not significant (p = 0.176). rTHA was associated with an overall greater rate of component positioning in a safe zone (p ≤ 0.003) and restoration of leg length (p < 0.001). Conclusion Patients undergoing rTHA had a greater hip-specific functional outcome when compared to mTHA, which may be related to improved component positioning and restoration of leg length. However, there was no difference in their postoperative generic health or rate of satisfaction. Cite this article: Bone Joint Res 2021;10(1):22–30.

The Impact of Leg Length Discrepancy on Patient Satisfaction and Functional Outcome Following Total Hip Arthroplasty

2013 ◽  
Vol 28 (8) ◽  
pp. 1408-1414 ◽  
Author(s):  
Michael R. Whitehouse ◽  
Natalija S. Stefanovich-Lawbuary ◽  
Luke R. Brunton ◽  
Ashley W. Blom
Keyword(s):  
Patient Satisfaction ◽  
Total Hip Arthroplasty ◽  
Functional Outcome ◽  
Hip Arthroplasty ◽  
Leg Length Discrepancy ◽  
Leg Length ◽  
Total Hip ◽  
Length Discrepancy ◽  
The Impact

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

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.

The effect of precautions on early dislocations post total hip arthroplasty: a retrospective cohort study

2018 ◽  
Vol 28 (5) ◽  
pp. 485-490 ◽  
Author(s):  
Felix C Allen ◽  
Daniel L Skinner ◽  
Jane Harrison ◽  
Giles H Stafford
Keyword(s):  
Patient Satisfaction ◽  
Total Hip Arthroplasty ◽  
Hip Arthroplasty ◽  
Recent Literature ◽  
Dislocation Rate ◽  
Electronic Database ◽  
Total Hip ◽  
Oxford Hip Score ◽  
Hip Precautions ◽  
Primary Total Hip Arthroplasty

Introduction: The efficacy of hip precautions in preventing dislocation post total hip arthroplasty (THA) has been questioned in recent literature. From 2014 our centre ceased routinely prescribing them due to lack of evidence. We investigate the effect of stopping these precautions on dislocation rate, patient satisfaction and Oxford hip score (OHS). Methods: Patients who underwent primary total hip arthroplasty prior to this change in protocol ( n = 2551) and for 1 year subsequently ( n = 673) were identified. Operative records were used to identify key demographic and operative data. Incidence of dislocation, OHS and patient satisfaction were extracted from the centre’s electronic database. Subset analysis of those patients dislocating within 6 weeks was performed. Results: Rate of dislocation at 6 weeks in those prescribed and not prescribed precautions was 0.71% and 0.89% respectively ( p = 0.618). At 1 year this rose to 1.25% and 1.49% ( p = 0.406). Satisfaction ( p = 0.332) and OHS ( p = 0.441) at 1 year was not significantly different between cohorts. Conclusions: Cessation of prescribing routine hip precautions post primary THA does not appear to significantly affect overall dislocation rate, patient satisfaction or functional status at 1 year post-operatively.

Retrospective Clinical and Radiological Outcomes of Total Hip Arthroplasty in 51 Patients After a Mean 8.2 Years Using the Nanos® Short-stem Prosthesis

2021 ◽  
Vol 39 ◽  
Author(s):  
Christian Fischer ◽  
◽  
Julia Dietz ◽  
Karl-Stefan Delank ◽  
Alexander Zeh ◽  
...  
Keyword(s):  
Patient Satisfaction ◽  
Total Hip Arthroplasty ◽  
Hip Arthroplasty ◽  
Survival Rates ◽  
Short Stem ◽  
Harris Hip Score ◽  
Leg Length ◽  
Total Hip ◽  
The Mean

Introduction: Over the past several years, femoral short-stem hip implants have become more popular as a treatment option in the field of primary hip arthroplasty for younger and more active patients. Current data on clinical outcomes and the implant survival rates in patients with short-stem implants cover a maximum of five to six years. The aim of this study was to assess the survival rates, as well as clinical and functional outcomes, in total hip arthroplasty (THA) using the Nanos® short-stem implant (Smith & Nephew, Marl, Germany) over a follow-up period exceeding 5 y. Materials and Methods: This single-center retrospective study included the first 100 patients who were treated at the Department of Orthopedics at the University Hospital Halle (Saale) between January 2008 and February 2009. Ultimately, the complete data of 51 patients (54 hips) were reviewed. The follow-up period was from May to November 2017. We evaluated patient satisfaction regarding pain and function using a grading system. The Harris Hip Score and Forgotten Joint Score were obtained to evaluate functional outcome after THA. Postoperative radiographic evaluation included the measurement of leg-length discrepancy, changes in the shaft axis, femoral offset and horizontal or vertical center of rotation. Potential postoperative shaft angulation or axial shaft migration was also determined. Radiographic images were checked for radiolucent lines and heterotopic ossification using the classification systems outlined by Green and Brooker. Results: The average follow-up was 97.8 months (8.2 y). The mean patient age at follow-up was 68 y and the body mass index was 28.2 kg/m2. The mean Harris hip score at follow-up was 92.0 and the Forgotten Joint Score was 91.7 %. Survey results showed that patient satisfaction and pain perception were rated very good. No significant change in leg length was observed (mean: 0.1 mm shortening). Overall, a rather varus stem positioning was detected postoperatively (mean: 3.1°). The femoral offset was slightly reduced on average in the entire patient group (mean: -1.8 mm). In the horizontal plane, lateralization of the center of rotation was detected overall (mean: 0.7 mm). In the vertical plane, cranialization was noted (mean: 1.4 mm). The CCD angle did not change. There was no further stem migration postoperatively. Radiolucent lines occurred in 10 cases in Gruen zones 1 and 7. Heterotopic ossification occurred in stages 1 to 3 according to the Brooker classification system. We found no cases of aseptic loosening or other reasons for revision. Conclusion: The outcomes after a mean follow-up of 97.8 months (8.2 y) showed that high levels of patient satisfaction and functional outcome can be achieved with the use of a short-stem endoprosthesis. Sufficient restoration of the patient's individual anatomy paired with high survival rates makes this short-stem prosthesis a reliable implant in total hip arthroplasty.

A Comparative Analysis of Patient Satisfaction following Total Knee Arthroplasty and Total Hip Arthroplasty Using the Forgotten Joint Score

2020 ◽  
Vol 04 (02) ◽  
pp. 084-089
Author(s):  
Vivek Singh ◽  
Stephen Zak ◽  
Ran Schwarzkopf ◽  
Roy Davidovitch
Keyword(s):  
Total Knee Arthroplasty ◽  
Patient Satisfaction ◽  
Total Hip Arthroplasty ◽  
Knee Arthroplasty ◽  
Hip Arthroplasty ◽  
Demographic Data ◽  
Demographic Differences ◽  
Total Hip ◽  
Forgotten Joint Score ◽  
Total Knee

AbstractMeasuring patient satisfaction and surgical outcomes following total joint arthroplasty remains controversial with most tools failing to account for both surgeon and patient satisfaction in regard to outcomes. The purpose of this study was to use “The Forgotten Joint Score” questionnaire to assess clinical outcomes comparing patients who underwent a total hip arthroplasty (THA) with those who underwent a total knee arthroplasty (TKA). We conducted a retrospective review of patients who underwent primary THA or TKA between September 2016 and September 2019 and responded to the Forgotten Joint Score-12 (FJS-12) questionnaire at least at one of three time periods (3, 12, and 21 months), postoperatively. An electronic patient rehabilitation application was used to administer the questionnaire. Collected variables included demographic data (age, gender, race, body mass index [BMI], and smoking status), length of stay (LOS), and FJS-12 scores. t-test and chi-square were used to determine significance. Linear regression was used to account for demographic differences. A p-value of less than 0.05 was considered statistically significant. Of the 2,359 patients included in this study, 1,469 underwent a THA and 890 underwent a TKA. Demographic differences were observed between the two groups with the TKA group being older, with higher BMI, higher American Society of Anesthesiologists scores, and longer LOS. Accounting for the differences in demographic data, THA patients consistently had higher scores at 3 months (53.72 vs. 24.96; p < 0.001), 12 months (66.00 vs. 43.57; p < 0.001), and 21 months (73.45 vs. 47.22; p < 0.001). FJS-12 scores for patients that underwent THA were significantly higher in comparison to TKA patients at 3, 12, and 21 months postoperatively. Increasing patient age led to a marginal increase in FJS-12 score in both cohorts. With higher FJS-12 scores, patients who underwent THA may experience a more positive evolution with their surgery postoperatively than those who had TKA.

scholarly journals Value of 3D Preoperative Planning for Primary Total Hip Arthroplasty Based on Biplanar Weightbearing Radiographs

2019 ◽  
Vol 2019 ◽  
pp. 1-7 ◽  
Author(s):  
Y. Knafo ◽  
F. Houfani ◽  
B. Zaharia ◽  
F. Egrise ◽  
I. Clerc-Urmès ◽  
...  
Keyword(s):  
Total Hip Arthroplasty ◽  
Hip Arthroplasty ◽  
Preoperative Planning ◽  
Femoral Stem ◽  
Leg Length ◽  
Femoral Offset ◽  
Postoperative Result ◽  
Total Hip ◽  
Planning Software ◽  
Navigated Surgery

Two-dimensional (2D) planning on standard radiographs for total hip arthroplasty may not be sufficiently accurate to predict implant sizing or restore leg length and femoral offset, whereas 3D planning avoids magnification and projection errors. Furthermore, weightbearing measures are not available with computed tomography (CT) and leg length and offset are rarely checked postoperatively using any imaging modality. Navigation can usually achieve a surgical plan precisely, but the choice of that plan remains key, which is best guided by preoperative planning. The study objectives were therefore to (1) evaluate the accuracy of stem/cup size prediction using dedicated 3D planning software based on biplanar radiographic imaging under weightbearing and (2) compare the preplanned leg length and femoral offset with the postoperative result. This single-centre, single-surgeon prospective study consisted of a cohort of 33 patients operated on over 24 months. The routine clinical workflow consisted of preoperative biplanar weightbearing imaging, 3D surgical planning, navigated surgery to execute the plan, and postoperative biplanar imaging to verify the radiological outcomes in 3D weightbearing. 3D planning was performed with the dedicated hipEOS® planning software to determine stem and cup size and position, plus 3D anatomical and functional parameters, in particular variations in leg length and femoral offset. Component size planning accuracy was 94% (31/33) within one size for the femoral stem and 100% (33/33) within one size for the acetabular cup. There were no significant differences between planned versus implanted femoral stem size or planned versus measured changes in leg length or offset. Cup size did differ significantly, tending towards implanting one size larger when there was a difference. Biplanar radiographs plus hipEOS planning software showed good reliability for predicting implant size, leg length, and femoral offset and postoperatively provided a check on the navigated surgery. Compared to previous studies, the predictive results were better than 2D planning on conventional radiography and equal to 3D planning on CT images, with lower radiation dose, and in the weightbearing position.

scholarly journals Staged reconstruction of unilateral neglected hip dislocation through total hip arthroplasty and subsequent intramedullary femoral lengthening

2021 ◽  
Author(s):  
Bjoern Vogt ◽  
Christoph Theil ◽  
Georg Gosheger ◽  
Adrien Frommer ◽  
Burkhard Moellenbeck ◽  
...  
Keyword(s):  
Total Hip Arthroplasty ◽  
Hip Arthroplasty ◽  
Plate Fixation ◽  
Hip Dislocation ◽  
Leg Length ◽  
Total Hip ◽  
Femoral Lengthening ◽  
Shortening Osteotomy ◽  
Successful Approach ◽  
Staged Reconstruction

Abstract Background and purpose Total hip arthroplasty (THA) is a successful approach to treat unilateral symptomatic neglected hip dislocation (NHD). However, the extensive leg length discrepancy (LLD) can hereby only be partially corrected. In case of residual LLD of more than 2 cm, subsequent femoral lengthening can be considered. Patients/material/methods Retrospective analysis of clinical data and radiographs of five patients (age 38.1 (28–51) years) with unilateral NHD who underwent THA with (n  = 3) or without (n = 2) subtrochanteric shortening osteotomy (SSO) and secondary intramedullary femoral lengthening through a retrograde magnetically-driven lengthening nail (follow-up 18.4 (15–27) months). Results LLD was 51.0 (45–60) mm before and 37.0 (30–45) mm after THA. Delayed bone union at one SSO site healed after revision with autologous bone grafting and plate fixation. Subsequent lengthening led to leg length equalisation in all patients. Complete consolidation was documented in all lengthened segments. Conclusion Staged reconstruction via THA and secondary femoral lengthening can successfully be used to reconstruct the hip joint and equalise LLD. The specific anatomical conditions have to be taken into consideration when planning treatment, and patients ought to be closely monitored.

Changes in patient-perceived leg length discrepancy following total hip arthroplasty

2021 ◽  
Author(s):  
Kentaro Iwakiri ◽  
Yoichi Ohta ◽  
Takashi Fujii ◽  
Yukihide Minoda ◽  
Akio Kobayashi ◽  
...  
Keyword(s):  
Total Hip Arthroplasty ◽  
Hip Arthroplasty ◽  
Leg Length Discrepancy ◽  
Leg Length ◽  
Total Hip ◽  
Length Discrepancy
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