scholarly journals Cemented Exeter total hip arthroplasty with a 32 mm head on highly crosslinked polyethylene

2019 ◽  
Vol 8 (6) ◽  
pp. 275-287 ◽  
Author(s):  
N. D. Clement ◽  
M. Bardgett ◽  
K. Merrie ◽  
S. Furtado ◽  
R. Bowman ◽  
...  
Keyword(s):  
Bone Mineral Density ◽  
Patient Satisfaction ◽  
Total Hip Arthroplasty ◽  
Functional Outcome ◽  
Hip Arthroplasty ◽  
Age Groups ◽  
Age Group ◽  
Mineral Density ◽  
Sf 36 ◽  
Stem Migration

Objectives Our primary aim was to describe migration of the Exeter stem with a 32 mm head on highly crosslinked polyethylene and whether this is influenced by age. Our secondary aims were to assess functional outcome, satisfaction, activity, and bone mineral density (BMD) according to age. Patients and Methods A prospective cohort study was conducted. Patients were recruited into three age groups: less than 65 years (n = 65), 65 to 74 years (n = 68), and 75 years and older (n = 67). There were 200 patients enrolled in the study, of whom 115 were female and 85 were male, with a mean age of 69.9 years (sd 9.5, 42 to 92). They were assessed preoperatively, and at three, 12 and, 24 months postoperatively. Stem migration was assessed using Einzel-Bild-Röntgen-Analyse (EBRA). Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), Harris Hip Score (HHS), Hip Disability and Osteoarthritis Outcome Score (HOOS), EuroQol-5 domains questionnaire (EQ-5D), short form-36 questionnaire (SF-36,) and patient satisfaction were used to assess outcome. The Lower Extremity Activity Scale (LEAS), Timed Up and Go (TUG) test, and activPAL monitor (energy expelled, time lying/standing/walking and step count) were used to assess activity. The BMD was assessed in Gruen and Charnley zones. Results Mean varus/valgus tilt was -0.77⁰ and axial subsidence was -1.20 mm. No significant difference was observed between age groups (p ⩾ 0.07). There was no difference according to age group for postoperative WOMAC (p ⩾ 0.11), HHS (p ⩾ 0.06), HOOS (p ⩾ 0.46), EQ-5D (p ⩾ 0.38), patient satisfaction (p ⩾ 0.05), or activPAL (p ⩾ 0.06). Patients 75 years and older had a worse SF-36 physical function (p = 0.01) and physical role (p = 0.03), LEAS score (p < 0.001), a shorter TUG (p = 0.01), and a lower BMD in Charnley zone 1 (p = 0.02). Conclusion Exeter stem migration is within normal limits and is not influenced by age group. Functional outcome, patient satisfaction, activity level, and periprosthetic BMD are similar across all age groups. Cite this article: N. D. Clement, M. Bardgett, K. Merrie, S. Furtado, R. Bowman, D. J. Langton, D. J. Deehan, J. Holland. Cemented Exeter total hip arthroplasty with a 32 mm head on highly crosslinked polyethylene: Does age influence functional outcome, satisfaction, activity, stem migration, and periprosthetic bone mineral density? Bone Joint Res 2019;8:275–287. DOI: 10.1302/2046-3758.86.BJR-2018-0300.R1.

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.

scholarly journals The Lasting Effect of Discontinuing Zoledronic Acid On Periprosthetic Bone Mineral Density Five Years After Total Hip Arthroplasty

2021 ◽  
Author(s):  
Allen Herng Shouh Hsu ◽  
Chun-Hsien Yen ◽  
Yu-Der Lu ◽  
Feng-Chih Kuo ◽  
Cheng-Ta Wu ◽  
...  
Keyword(s):  
Bone Mineral Density ◽  
Renal Function ◽  
Zoledronic Acid ◽  
Total Hip Arthroplasty ◽  
Hip Arthroplasty ◽  
Control Group ◽  
Mineral Density ◽  
Short Term ◽  
Periprosthetic Bone ◽  
Lasting Effect

Abstract Background: Previous study has shown that a short-term use of zoledronic acid (ZA) after cementless total hip arthroplasty (THA) significantly increases bone mineral density (BMD) over the proximal femur and inhibits bone turnover markers (BTMs) after two years. However, could the discontinuation of ZA have a lasting effect is of interest.Method: This is an extension study of a two-year prospective randomized controlled trial on 54 cementless THA treated with either two doses of ZA or placebo. We compared BTMs [alkaline phosphatase (ALP); osteocalcin (OC); procollagen 1 intact N-terminal propeptide (P1NP)], serum calcium, renal function, radiological findings, and functional outcomes (Harris hip score and UCLA activity score) from baseline to 5 years post-THA in 49 patients, and periprosthetic BMD of the seven Gruen zones in 19 patients.Result: All patients had well-functioning hip prostheses, normal renal function, and normal serum calcium levels at 5-year follow-up. At the fifth year, the BMD levels were not statistically different between the two groups, but the change in BMD from baseline (BMD change ratios) in ZA group were significantly increased in zone 2, 4, and 6 as compared with control group. Parallel to that, in ZA group, levels of ALP were significantly lower at the fifth year; OC were significantly lower at the second and the fifth year; P1NP were significantly lower from 6 weeks to 2 years as compared with those in control group.Conclusion: This study demonstrates the lasting effect of a two-dose ZA given within one year after THA on bone metabolism and periprosthetic BMD at five years. The short-term dosing of ZA followed by a 4-year drug holiday had no adverse events and resulted in significant inhibition of periprosthetic bone loss and BTMs.Trial Registration:This extension study on a randomized, open label, single-center clinical trial was conducted under Institutional Review Board of Chang Gung Memorial Hospital Protocol Records 98-1150A3; 105-1296C1; 105-7004D, and was registered July 19th, 2016 on public registry ClinicalTrials.gov trial registration number NCT02838121.

scholarly journals Preventing Loss of Femoral Periprosthetic Bone Mineral Density in Cementless Total Hip Arthroplasty Using a Tapered Wedge Stem in Patients With Osteoporosis Treated With Denosumab: a Retrospective, Cohort Study

2021 ◽  
Author(s):  
Keiji Kamo ◽  
Hiroaki Kijima ◽  
Koichiro Okuyama ◽  
Tetsuya Kawano ◽  
Nobutoshi Seki ◽  
...  
Keyword(s):  
Bone Mineral Density ◽  
Total Hip Arthroplasty ◽  
Bone Mineral ◽  
Hip Arthroplasty ◽  
Stress Shielding ◽  
Control Group ◽  
Mineral Density ◽  
Total Hip ◽  
Cementless Total Hip Arthroplasty ◽  
Periprosthetic Bone Mineral Density

Abstract Background: Bone mineral density (BMD) of the proximal femur around the stem decreases due to stress shielding after cementless total hip arthroplasty (THA). When severe stress shielding occurs, the risk of periprosthetic femoral fractures increases, and this bone loss can also increase the difficulty of future revision THA. Denosumab is known to improve the quality and strength of cortical bone in the proximal femurs of patients with osteoporosis. The purpose of this study was to investigate whether denosumab prevents loss of proximal femoral periprosthetic BMD in cementless THA using a tapered wedge stem in patients with osteoporosis.Methods: Sixty-three consecutive patients who had undergone unilateral primary THA using a tapered wedge stem were included in this retrospective study. Twenty-four patients who received denosumab for osteoporosis were the denosumab group, and the 39 without denosumab were the control group. At 2 weeks, 6 months, and 12 months after THA, bone turnover markers and femoral periprosthetic BMD were measured.Results: BMD in zone 1 was significantly increased from baseline at both 6 and 12 months after THA in the denosumab group and significantly decreased in the control group. BMD in zone 7 was significantly decreased compared to baseline at both 6 and 12 months after THA in the control group, but not in the denosumab group. The use of denosumab for THA patients with osteoporosis was independently related to preventing loss of periprosthetic BMD of the femur at 12 months after surgery in zones 1 and 7 on multivariate analysis.Conclusions: Denosumab significantly increased proximal femoral periprosthetic BMD in zone 1 and prevented loss of BMD in zone 7 in patients with osteoporosis after cementless THA using a tapered wedge stem at both 6 and 12 months after surgery.

scholarly journals Bone mineral density is not related to heterotopic ossification after total hip arthroplasty

2011 ◽  
Vol 36 (6) ◽  
pp. 1163-1166 ◽  
Author(s):  
Kunihiko Okano ◽  
Kiyoshi Aoyagi ◽  
Makoto Osaki ◽  
Satoru Motokawa ◽  
Tomoko Matsumoto
Keyword(s):  
Bone Mineral Density ◽  
Total Hip Arthroplasty ◽  
Heterotopic Ossification ◽  
Bone Mineral ◽  
Hip Arthroplasty ◽  
Mineral Density ◽  
Total Hip
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