scholarly journals Low evidence for implementation of well-documented implants regarding risk of early revision: a systematic review on total hip arthroplasty

2021 ◽  
Vol 6 (1) ◽  
pp. 3-8
Author(s):  
Patrick Butler ◽  
Josef Gorgis ◽  
Bjarke Viberg ◽  
Søren Overgaard
Keyword(s):  
Systematic Review ◽  
Total Hip Arthroplasty ◽  
Hip Arthroplasty ◽  
Revision Rate ◽  
Learning Curves ◽  
Eligibility Criteria ◽  
Total Hip ◽  
Early Revision ◽  
Total Knee ◽  
Post Hoc

When introducing an implant, surgeons are subjected to steep learning curves, which may lead to a heightened revision rate. Stepwise introduction revolutionized implant introduction but lacks a last step. No guidelines exist for the introduction of a well-documented implant not previously used in a department. This is problematic according to the European Union’s legislated tendering process, potentially leading to increased revisions. In this systematic review, the introduction of a well-documented total hip arthroplasty implant to experienced surgeons is explored amid concerns of higher revision rate. Literature search strategies were deployed in the Embase and Medline databases, revealing a total of 14,612 articles. Using the Covidence software (Cochrane, London), two reviewers screened articles for inclusion. No articles were found that fulfilled our eligibility criteria. A post hoc analysis retrieved two national register-based studies only missing information about the surgeon’s knowledge of the introduced implant. None of the introduced implants decreased the revision rate and around 30% of the introduced implants were associated with a higher revision rate. The review showed that no data exist about revision rates when introducing well-documented implants. In continuation thereof, the introduction of well-documented implants might also be associated with increased revision rates, as has been shown for total knee arthroplasty. We therefore suggest that special attention should be focused on changes of implants in departments, which can be achieved by way of specific registration in national registers. Cite this article: EFORT Open Rev 2021;6:3-8. DOI: 10.1302/2058-5241.6.200047

scholarly journals Correction: systematic review: do patient expectations influence treatment outcomes in total knee and total hip arthroplasty?

2013 ◽  
Vol 11 (1) ◽  
pp. 72
Author(s):  
Tsjitske M Haanstra ◽  
Tobias van den Berg ◽  
Raymond W Ostelo ◽  
Rudolf W Poolman ◽  
Elise P Jansma ◽  
...  
Keyword(s):  
Systematic Review ◽  
Total Hip Arthroplasty ◽  
Treatment Outcomes ◽  
Hip Arthroplasty ◽  
Patient Expectations ◽  
Total Hip ◽  
Total Knee

Preoperative psychosocial factors predicting patient’s functional recovery after total knee or total hip arthroplasty: a systematic review

2017 ◽  
Vol 32 (4) ◽  
pp. 512-525 ◽  
Author(s):  
Anouck N Bletterman ◽  
Marcella E de Geest-Vrolijk ◽  
Johanna E Vriezekolk ◽  
Maria W Nijhuis-van der Sanden ◽  
Nico LU van Meeteren ◽  
...  
Keyword(s):  
Systematic Review ◽  
Total Hip Arthroplasty ◽  
Psychosocial Factors ◽  
Functional Recovery ◽  
Hip Arthroplasty ◽  
Total Hip ◽  
Total Knee

scholarly journals The Influence of Preoperative Physical Activity on Postoperative Outcomes of Knee and Hip Arthroplasty Surgery in the Elderly: A Systematic Review

2020 ◽  
Vol 9 (4) ◽  
pp. 969 ◽  
Author(s):  
Sebastiano Vasta ◽  
Rocco Papalia ◽  
Guglielmo Torre ◽  
Ferruccio Vorini ◽  
Giuseppe Papalia ◽  
...  
Keyword(s):  
Physical Activity ◽  
Systematic Review ◽  
Total Hip Arthroplasty ◽  
Hip Arthroplasty ◽  
Postoperative Recovery ◽  
Postoperative Outcomes ◽  
Range Of Movement ◽  
Total Hip ◽  
Functional Scores ◽  
Total Knee

Total hip arthroplasty (THA) and total knee arthroplasty (TKA) represent two of the most common procedures in orthopedic surgery. The growing need to avoid physical impairment in elderly patients undergoing this kind of surgery puts the focus on the possibility to undertake a preoperative physical activity program to improve their fit and physical health at the time of surgery. A systematic review has been carried out with online databases including PubMed-Medline, Cochrane Central and Google Scholar. The aim was to retrieve available evidence concerning preoperative physical activity and exercise, before total knee or total hip arthroplasty in patients older than 65 years, and to clarify the role of this practice in improving postoperative outcomes. Results of the present systematic analysis showed that, for TKA, most of the studies demonstrated a comparable trend of postoperative improvement of Visual Analogue Scale (VAS), range of movement (ROM) and functional scores, and those of quality of life. There is insufficient evidence in the literature to draw final conclusions on the topic. Prehabilitation for patients undergoing TKA leads to shorter length of stay but not to an enhanced postoperative recovery. Concerning THA, although currently available data showed better outcomes in patients who underwent prehabilitation programs, there is a lack of robust evidence with appropriate methodology.

scholarly journals Persistent postoperative opioid use after total hip or knee arthroplasty: A systematic review and meta-analysis

2021 ◽  
Author(s):  
Hui Ping Tay ◽  
Xinyi Wang ◽  
Sujita W Narayan ◽  
Jonathan Penm ◽  
Asad E Patanwala
Keyword(s):  
Systematic Review ◽  
Total Knee Arthroplasty ◽  
Total Hip Arthroplasty ◽  
Knee Arthroplasty ◽  
Hip Arthroplasty ◽  
Meta Analysis ◽  
Cochrane Central Register ◽  
Opioid Use ◽  
Total Hip ◽  
Total Knee

Abstract Disclaimer In an effort to expedite the publication of articles related to the COVID-19 pandemic, AJHP is posting these manuscripts online as soon as possible after acceptance. Accepted manuscripts have been peer-reviewed and copyedited, but are posted online before technical formatting and author proofing. These manuscripts are not the final version of record and will be replaced with the final article (formatted per AJHP style and proofed by the authors) at a later time. Purpose To identify the proportion of patients with continued opioid use after total hip or knee arthroplasty. Methods This systematic review and meta-analysis searched Embase, MEDLINE, the Cochrane Central Register of Controlled Trials, and International Pharmaceutical Abstracts for articles published from January 1, 2009, to May 26, 2021. The search terms (opioid, postoperative, hospital discharge, total hip or knee arthroplasty, and treatment duration) were based on 5 key concepts. We included studies of adults who underwent total hip or knee arthroplasty, with at least 3 months postoperative follow-up. Results There were 30 studies included. Of these, 17 reported on outcomes of total hip arthroplasty and 19 reported on outcomes of total knee arthroplasty, with some reporting on outcomes of both procedures. In patients having total hip arthroplasty, rates of postoperative opioid use at various time points were as follows: at 3 months, 20% (95% CI, 13%-26%); at 6 months, 17% (95% CI, 12%-21%); at 9 months, 19% (95% CI, 13%-24%); and at 12 months, 16% (95% CI, 15%-16%). In patients who underwent total knee arthroplasty, rates of postoperative opioid use were as follows: at 3 months, 26% (95% CI, 19%-33%); at 6 months, 20% (95% CI, 17%-24%); at 9 months, 23% (95% CI, 17%-28%); and at 12 months, 21% (95% CI, 12%-29%). Opioid naïve patients were less likely to have continued postoperative opioid use than those who were opioid tolerant preoperatively. Conclusion Over 1 in 5 patients continued opioid use for longer than 3 months after total hip or knee arthroplasty. Clinicians should be aware of this trajectory of opioid consumption after surgery.

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 Systematic review: Do patient expectations influence treatment outcomes in total knee and total hip arthroplasty?

2012 ◽  
Vol 10 (1) ◽  
pp. 152 ◽  
Author(s):  
Tsjitske M Haanstra ◽  
Tobias van den Berg ◽  
Raymond W Ostelo ◽  
Rudolf W Poolman ◽  
Ilse P Jansma ◽  
...  
Keyword(s):  
Systematic Review ◽  
Total Hip Arthroplasty ◽  
Treatment Outcomes ◽  
Hip Arthroplasty ◽  
Patient Expectations ◽  
Total Hip ◽  
Total Knee
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