scholarly journals Bilateral total hip arthroplasty in ankylosing spondylitis: a systematic review

2019 ◽  
Vol 4 (7) ◽  
pp. 476-481 ◽  
Author(s):  
David Lin ◽  
Alexander Charalambous ◽  
Sammy A. Hanna
Keyword(s):  
Systematic Review ◽  
Ankylosing Spondylitis ◽  
Total Hip Arthroplasty ◽  
Hip Arthroplasty ◽  
Fixation Method ◽  
Harris Hip Score ◽  
Total Hip ◽  
Class 1 ◽  
Hip Disease ◽  
Average Patient

Ankylosing Spondylitis (AS) can commonly involve the hip joint and cause significant mobility problems. Total hip arthroplasty (THA) on a single side alone will not restore mobility in patients with bilateral disease. We performed a systematic review of the available literature to determine the changes in objective outcome measures and complications of bilateral THA in patients with advanced AS. Four studies, a total of 114 THAs, were included in the study. The average patient age was 32.9 years and the average follow-up time was 59.5 months. All studies reported a significant improvement in hip function, patient satisfaction and patient mobility following bilateral THA. Harris Hip Score (HHS) improved by a mean of 60.6 points post-operatively. Complications included five intra-operative fractures (4.4%) and three transient nerve palsies (2.6%). There were two dislocations (1.8%) that were successfully managed with closed reduction. Seven hips required revision, with the most common cause being aseptic loosening. Twelve hips (10.5%) developed heterotopic ossification consistent with Brooker Class 1 or 2 with no reports of re-ankylosis. This review suggests that bilateral THA is a safe and effective treatment of advanced hip disease in AS. Attention must be paid to the highly demanding technical aspects of this procedure to reduce the risk of significant complications. Debate still exists on the ideal prosthesis, fixation method and approach to use but this review presents data from several series of uncemented prostheses that have good post-operative results. Cite this article: EFORT Open Rev 2019;4:476-481. DOI: 10.1302/2058-5241.4.180047

scholarly journals Mid-term results of bilateral synchronous total hip arthroplasty for bony ankylosis in patients with ankylosing spondylitis

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Lei Han ◽  
Renfu Quan ◽  
Zhenle Pei ◽  
Guoping Cao ◽  
Yungen Hu ◽  
...  
Keyword(s):  
Ankylosing Spondylitis ◽  
Total Hip Arthroplasty ◽  
Hip Arthroplasty ◽  
Harris Hip Score ◽  
Heterotopic Bone ◽  
Heterotopic Bone Formation ◽  
Total Hip ◽  
Vas Score ◽  
Mid Term Results ◽  
Bony Ankylosis

Abstract Background Total hip arthroplasty (THA) for bony ankylosis is technically challenging in patients with ankylosing spondylitis (AS). This study aimed to determine the mid-term results of bilateral synchronous THA for bony ankylosis in patients with AS. Methods Nineteen cases of bony ankylosis in patients with AS who received bilateral synchronous THA were included in this study (17 males and 2 females, mean age 49.2 years). Disease duration was 5–38 years (mean 18 years and 6 months). All patients received cementless THA. Intraoperative blood loss, visual analog scale (VAS) score, and complications were assessed. Harris hip scores evaluated the clinical effect. Results Patients were followed up for 62–98 months (mean 82.5 months). VAS score decreased from 7.42 ± 0.92 to 2.42 ± 0.83, Harris hip score improved from 21.8 ± 7.2 to 80.3 ± 6.5, and the flexion-extension range of the hip improved from 0 to 142.3 ± 6.2°. One patient with septum bronchiale had a fracture intraoperatively and was treated with wire strapping. One patient had a traction injury of the femoral nerve postoperatively and recovered 1 year after the operation. Loosening and subsidence were not observed in all patients. Heterotopic bone formation was noted in 3 patients. No complications such as joint dislocation, acute infection, and deep vein thrombosis were found. Conclusion Bilateral synchronous THA was effective for bony ankylosis of the hip in patients with AS because it improved patients’ quality of life and had satisfactory mid-term outcomes.

Changes in sexual activity of male patients with ankylosing spondylitis undergoing total hip arthroplasty

2018 ◽  
Vol 29 (3) ◽  
pp. 310-315 ◽  
Author(s):  
Jun Fu ◽  
Xiang Li ◽  
Kan Liu ◽  
Jiying Chen ◽  
Ming Ni ◽  
...  
Keyword(s):  
Ankylosing Spondylitis ◽  
Total Hip Arthroplasty ◽  
Sexual Activity ◽  
Hip Arthroplasty ◽  
Harris Hip Score ◽  
Clinical Parameters ◽  
Total Hip ◽  
Flexion Extension ◽  
Before And After ◽  
Male Patients

Introduction: Sexual activity is often an important component of life. To date, no studies have examined sexual activity before and after total hip arthroplasty (THA) in male patients with ankylosing spondylitis (AS). The purpose of the current study was to evaluate the effect of THA on sexual activity and to explore the most commonly reported and comfortable coital position for male AS patients with hip involvement. Methods: Data from 31 male AS patients who underwent THA for hip involvement were retrospectively reviewed. Information from the International Index of Erectile Function (IIEF), the Harris Hip Score (HHS) and other clinical parameters was collected and monitored over time. We compared the above-mentioned parameters before surgery and 2 years after surgery and analysed the correlation between changes on the IIEF and changes in clinical parameters. Results: The domain and total scores of the IIEF, except EF, were significantly higher after surgery than were those before surgery ( p < 0.05). There was a significant positive correlation between changes on the IIEF and improvement in flexion-extension range of motion (ROM), adduction-abduction ROM and HHS ( p < 0.05). Most patients (26/31, 83.9%) resumed sexual activity 5–12 weeks after surgery. The pre- and postoperative distributions of the most commonly reported and comfortable position were not significantly different (p > 0.05). Conclusions: Successful THA may improve sexual activity in male AS patients with hip involvement. Changes in hip ROM show the most significant correlation with improvement in sexual activity. Resumption of sexual activity occurs within 5–12 postoperative weeks.

scholarly journals 32-mm ceramic-on-ceramic total hip arthroplasty versus 28-mm ceramic bearings: 5- to 15-year follow-up study

2018 ◽  
Vol 29 (1) ◽  
pp. 65-71 ◽  
Author(s):  
Yoshitoshi Higuchi ◽  
Taisuke Seki ◽  
Yukiharu Hasegawa ◽  
Yasuhiko Takegami ◽  
Daigo Morita ◽  
...  
Keyword(s):  
Total Hip Arthroplasty ◽  
Hip Arthroplasty ◽  
Harris Hip Score ◽  
Total Hip ◽  
Kaplan Meier ◽  
Significant Difference ◽  
Average Patient ◽  
The Mean ◽  
Ceramic On Ceramic

Introduction: This study aimed to compare the clinical and radiographic results of 28-mm ceramic-on-ceramic (CoC) total hip arthroplasty (THA) to those of 32-mm CoC during a 5- to 15-year follow-up period. Methods: 107 joints (95 women and 6 men) underwent 28-mm CoC, and 60 (49 women and 7 men) underwent 32-mm CoC. The average patient age at the time of surgery was 56.1 and 55.7 years in the 28-mm and 32-mm CoC groups, respectively. Clinical and radiologic measurements of all patients were analysed. Results: The mean preoperative Harris hip score (HHS) was similar in the 2 groups (28-mm, 58.9; and 32-mm, 58.5). However, at final follow-up, the mean HHS of the 32-mm CoC (91.8) was significantly better than that of the 28-mm CoC (88.2) ( p = 0.003), as were the ranges of motion (ROM) for flexion (98.3 ± 13.5° vs. 87.3 ± 19.3°, p < 0.001) and abduction (27.8 ± 14.9° vs. 22.1 ± 19.3°, p = 0.007). The mean wear rate was 0.0044 mm/year for the 28-mm CoC and 0.0044 mm/year for the 32-mm CoC. No ceramic fractures were found in the 2 groups. One joint in the 28-mm CoC (0.9%) required revision owing to progressive osteolysis. Kaplan-Meier survival at 10 years, with implant loosening or revision THA as the endpoint, was 98.3% for 28-mm CoC and 100% for 32-mm CoC ( p = 0.465). Conclusion: There was no significant difference in ceramic-related complications between the 2 groups. Our study demonstrated that the 32-mm and 28-mm CoC are safe and are associated with good clinical outcomes.

Bilateral total hip arthroplasty: one-stage versus two-stage procedure

2018 ◽  
Vol 29 (2) ◽  
pp. 141-146 ◽  
Author(s):  
Afshin Taheriazam ◽  
Gholamreza Mohseni ◽  
Ali A Esmailiejah ◽  
Farshad Safdari ◽  
Hashem Abrishamkarzadeh
Keyword(s):  
Total Hip Arthroplasty ◽  
Hospital Stay ◽  
Hip Arthroplasty ◽  
Functional Outcomes ◽  
Peroneal Nerve ◽  
Hip Osteoarthritis ◽  
Harris Hip Score ◽  
Total Hip ◽  
Hip Disease ◽  
Hardinge Approach

Background: Despite several studies, controversy has prevailed over the rate of complications following 1-stage and 2-stage bilateral total hip arthroplasty (THA). In the current study, we compare the complications and functional outcomes of 1-stage and 2-stage procedures. Methods: One hundred and eighty patients (ASA class I or II) with bilateral hip osteoarthritis were assigned randomly to two equal groups. The two groups were matched in terms of age and sex. All of the surgeries were performed via the Hardinge approach using uncemented implants. In 2-stage procedures, surgeries were performed with a 6-month to 1-year interval. All patients were evaluated 1 year postoperatively. Results: The Harris Hip Score (HHS) averaged 84.1 and 82.6 in 1-stage and 2-stage groups, respectively ( p = 0.528). The hospital stay was significantly longer in the 2-stage group (9.8 days vs. 4.9 days). The cumulative haemoglobin drop and the number of transfused blood units were the same. One patient in each group developed symptomatic deep venous thrombosis which was managed successfully. There was no patient with perioperative death, pulmonary embolism, infection, dislocation, periprosthetic fracture or heterotrophic ossification. No patient required reoperation. Two patients in the 1-stage group developed unilateral temporary peroneal nerve palsy, which was resolved after 3–4 months. Conclusion: 1-stage bilateral THA can be used successfully for patients with bilateral hip disease without increasing the rate of complications. Functional and clinical outcomes are comparable and hospital stay is significantly shorter.

scholarly journals Primary total hip arthroplasty in patients with rheumatoid arthritis

2006 ◽  
Vol 53 (4) ◽  
pp. 117-120 ◽  
Author(s):  
B.M. Gluscevic ◽  
B.D. Kraljevic ◽  
V.A. Jovanovic ◽  
P.B. Stosic ◽  
D.M. Milosavljevic ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Total Hip Arthroplasty ◽  
Aseptic Loosening ◽  
Hip Joint ◽  
Hip Arthroplasty ◽  
Fixation Method ◽  
Harris Hip Score ◽  
Total Hip ◽  
And Function

Total hip arthroplasty has become a successful way of treating the painful and destroyed hip joint in the patient with rheumatoid arthritis( RA). Two hundred twenty(135 cemented and 85 noncemented) total hip arthroplasties we were performed in 180 patients with rheumatoid arthritis. The average age was 48,61 years and the average follow-up was 8,4 years. Clinical evaluation was based on a Harris hip score that showed significant improvement in pain and function preoperatively compared with pain and function at follow-up. There were two deep infections requiring removal of the prosthesis. Four cemented acetabular cups and one cemented femoral component were revised due to aseptic loosening. Three acetabular rings were revised due to aseptic loosening. The relatively inferior results of total hip arthroplasty among RA patients is due not only to fixation method, but also to the poorer bone quality and weakening musculature. The results in these patients suggest that cement less total hip arthroplasty might become a successful way of treating the destroyed hip joint in the patient with rheumatoid arthritis.

scholarly journals Mid-Term Results of Bilateral Synchronous Total Hip Arthroplasty for Bone Ankylosis in Patients With Ankylosing Spondylitis

2020 ◽  
Author(s):  
Lei HAN ◽  
Renfu Quan ◽  
Zhenle Pei ◽  
Guoping Cao ◽  
Jingjing Liu ◽  
...  
Keyword(s):  
Ankylosing Spondylitis ◽  
Total Hip Arthroplasty ◽  
Hip Arthroplasty ◽  
Harris Hip Score ◽  
Heterotopic Bone ◽  
Heterotopic Bone Formation ◽  
Total Hip ◽  
Vas Score ◽  
Mid Term Results ◽  
Bony Ankylosis

Abstract Background: Total hip arthroplasty (THA) for bony ankylosis is technically challenging in patients with ankylosing spondylitis (AS). This study aimed to determine the mid-term results of bilateral synchronous THA for bony ankylosis in patients with AS. Methods: Nineteen cases of bony ankylosis in patients with AS who received bilateral synchronous THA were included in this study (17 males and 2 females, mean age 49.2 years). Disease duration was 5–38 years (mean 18 years and 6 months). All patients received cementless THA. Intraoperative blood loss, visual analogue scale (VAS) score, and complications were assessed. Harris hip scores evaluated the clinical effect. Results: Patients were followed up for 62–98 months (mean 82.5 months). VAS score decreased from 7.42±0.92 to 2.42±0.83, Harris hip score improved from 21.8±7.2 to 80.3±6.5, and the flexion-extension range of the hip improved from 0°to 142.3±6.2°. One patient with septum bronchiale had a fracture intraoperatively and was treated with wire strapping. One patient had a traction injury of the femoral nerve postoperatively and recovered 1 year after the operation. Loosening and subsidence were not observed in all patients. Heterotopic bone formation was noted in 3 patients. No complications such as joint dislocation, acute infection, and deep vein thrombosis were found. Conclusion：Bilateral synchronous THA was effective for bony ankylosis of the hip in patients with AS because it improved patients’ quality of life, and had satisfactory mid-term outcomes.

scholarly journals Total Hip Arthroplasty in Systemic Lupus Erythematosus: A Systematic Review

2015 ◽  
Vol 2015 ◽  
pp. 1-8 ◽  
Author(s):  
John W. Kennedy ◽  
Wasim Khan
Keyword(s):  
Systematic Review ◽  
Systemic Lupus Erythematosus ◽  
Total Hip Arthroplasty ◽  
Hip Arthroplasty ◽  
Lupus Erythematosus ◽  
Postoperative Outcomes ◽  
Harris Hip Score ◽  
Systemic Lupus ◽  
Total Hip

The prognosis of systemic lupus erythematosus (SLE) has greatly improved in recent years, resulting in an increased number of patients reporting musculoskeletal complications such as osteonecrosis of the femoral head. Total hip arthroplasty (THA) can be utilised to alleviate the pain associated with this; however postoperative outcomes in patients with SLE are uncertain. A systematic review of the literature was conducted to identify articles presenting results of THA in SLE, and nine suitable papers were found. All papers were level IV evidence. Pooling the results, a total of 162 patients underwent 214 total hip arthroplasties. Mean follow-up was 72.5 months. The mean Harris Hip Score improved from 45.5 preoperatively to 88.6 and last follow-up. Seventeen percent of patients experienced at least one complication. Superficial wound infection occurred in 3.3%. Revision was required in 2.8% of cases. The mortality rate was 18.5% however no deaths were attributable to undergoing THA. Given the paucity of data present in the literature, more studies are required to adequately assess the postoperative outcomes of THA in patients with SLE, particularly complication rates.

Outcomes After Arthroscopic Hip Labral Reconstruction: A Systematic Review and Meta-analysis

2019 ◽  
Vol 48 (7) ◽  
pp. 1748-1755 ◽  
Author(s):  
Michael D. Rahl ◽  
Collin LaPorte ◽  
Gabrielle K. Steinl ◽  
Michaela O’Connor ◽  
T. Sean Lynch ◽  
...  
Keyword(s):  
Systematic Review ◽  
Total Hip Arthroplasty ◽  
Hip Arthroplasty ◽  
Meta Analysis ◽  
Joint Disease ◽  
Harris Hip Score ◽  
Total Hip ◽  
Proper Patient Selection ◽  
Surgeon Experience ◽  
Patient Reported

Background: The acetabular labrum is critical to maintenance of hip stability and has been found to play a key role in preservation of the hip fluid seal. For irreparable labral damage, arthroscopic labral reconstruction is an evolving technique that has been shown to decrease hip pain and restore function. Purpose: To provide a comprehensive review of current literature for arthroscopic hip labral reconstruction, with a focus on determining if outcomes differ between autograft or allograft tissue. Study Design: Systematic review and meta-analysis. Methods: PubMed and Scopus online databases were searched with the key terms “hip,”“labrum,”“reconstruction,” and “graft” in varying combinations. Procedures performed, complications, failures, and functional outcome measures were included in this analysis. The inverse variance method was used to calculate pooled estimates and 95% CIs. Results: Eight studies with 537 hips were included. Mean age was 37.4 years (95% CI, 34.5-40.4 years), and mean follow-up time was 29 months (95% CI, 26-33 months). Survivorship after autograft reconstruction ranged from 75.7% to 100%, as compared with 86.3% to 90.0% in the allograft cohort. In the autograft cohort, failures included 0% to 13.2% conversion to total hip arthroplasty and 0% to 11.0% revision hip arthroscopy. Failures in the allograft cohort included 0% to 12.9% total hip arthroplasty conversion, 0% to 10.0% revision arthroscopy, and 0% to 0.8% open revision surgery. Based on 6 studies, the modified Harris Hip Score improved by a mean 29.0 points after labral reconstruction ( P < .0001). Conclusion: Arthroscopic hip labral reconstruction results in clinically significant improvements in patient-reported outcomes. Our analysis indicates that there are no significant differences in outcomes based on graft type alone. A number of factors may determine graft choice, including patient preference, surgeon experience, operative time, morbidity, and cost. Proper patient selection based on age and severity of degenerative joint disease will also optimize outcomes after labral reconstruction.

Systematic review of primary total hip arthroplasty using titanium-titanium modular-neck prostheses: the true risk of revision

2020 ◽  
pp. 112070002091687 ◽  
Author(s):  
Johnathan R Lex ◽  
Matthew D Welch ◽  
Abbas See ◽  
Thomas C Edwards ◽  
Nikolaos A Stavropoulos ◽  
...  
Keyword(s):  
Systematic Review ◽  
Total Hip Arthroplasty ◽  
Hip Arthroplasty ◽  
Revision Rate ◽  
Case Series ◽  
Harris Hip Score ◽  
Modular Neck ◽  
Total Hip ◽  
Primary Total Hip Arthroplasty

Aims: Modular-neck femoral implants are used to enable more variability in femoral neck version, offset and length. It has been reported that these implants carry a higher rate of revision. The aim of this review was to assess the overall and cause-specific revision rate of titanium-titanium alloy modular-neck implants in primary total hip arthroplasty (THA). Methods: A systematic review was conducted following PRISMA guidelines and utilising multiple databases. All results were screened for eligibility. Studies published from 2000 onwards, using a current-generation, titanium-titanium, modular-neck implant were included. Overall and cause-specific revision rates were analysed, comparing to fixed-neck prostheses where applicable. Results: 920 studies were screened. After applying exclusion criteria, 23 were assessed in full and 14 included. These consisted of 12 case series and 2 joint registry analyses. 21,841 patients underwent a modular-neck implant with a weighted mean follow-up of 5.7 years, mean age of 62.4 years, and average body mass index (BMI) of 28.4kg/m2. The overall revision rate was 3.95% and 2.98% for modular and fixed-neck prostheses, respectively. For studies with >5 years follow-up the mean revision rate was 3.08%. There was no difference in cause-specific revision rates by implant design. Mean improvement in Harris Hip Score was 41.9. Conclusions: At medium-term, revision rates for titanium-titanium primary modular-neck THA are acceptable. These prostheses are a sensible management option in patients with considerable anatomical hip deformity not amenable to correction with standard fixed-neck implants. Patients of male gender, high BMI and requiring prostheses with a larger neck, offset or head are at higher risk of implant failure.

scholarly journals Mid-term results of bilateral synchronous total hip arthroplasty for bony ankylosis in patients with ankylosing spondylitis

2020 ◽  
Author(s):  
Lei Han ◽  
Jing Jing Liu ◽  
Zhen le Pei ◽  
Guo ping Cao ◽  
Yun gen Hu ◽  
...  
Keyword(s):  
Ankylosing Spondylitis ◽  
Total Hip Arthroplasty ◽  
Hip Arthroplasty ◽  
Harris Hip Score ◽  
Heterotopic Bone ◽  
Heterotopic Bone Formation ◽  
Total Hip ◽  
Vas Score ◽  
Mid Term Results ◽  
Bony Ankylosis

Abstract Background: Total hip arthroplasty (THA) for bony ankylosis is technically challenging in patients with ankylosing spondylitis (AS). This study aimed to determine the mid-term results of bilateral synchronous THA for bony ankylosis in patients with AS.Methods: Nineteen cases of bony ankylosis in patients with AS who received bilateral synchronous THA were included in this study (17 males and 2 females, mean age 49.2 years). Disease duration was 5–38 years (mean 18 years and 6 months). All patients received cementless THA. Intraoperative blood loss, visual analogue scale (VAS) score, and complications were assessed. Harris hip scores evaluated the clinical effect.Results: Patients were followed up for 62–98 months (mean 82.5 months). VAS score decreased from 7.42±0.92 to 2.42±0.83, Harris hip score improved from 21.8±7.2 to 80.3±6.5, and the flexion-extension range of the hip improved from 0°to 142.3±6.2°. One patient with septum bronchiale had a fracture intraoperatively and was treated with wire strapping. One patient had a traction injury of the femoral nerve postoperatively and recovered 1 year after the operation. Loosening and subsidence were not observed in all patients. Heterotopic bone formation was noted in 3 patients. No complications such as joint dislocation, acute infection, and deep vein thrombosis were found.Conclusion： Bilateral synchronous THA was effective for bony ankylosis of the hip in patients with AS because it improved patients’ quality of life, and had satisfactory mid-term outcomes.

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