scholarly journals Comparison of the accuracy of 2D and 3D templating methods for planning primary total hip replacement: a systematic review and meta-analysis

2022 ◽  
Vol 7 (1) ◽  
pp. 70-83
Author(s):  
Habeeb Bishi ◽  
Joshua B V Smith ◽  
Vipin Asopa ◽  
Richard E Field ◽  
David H Sochart ◽  
...  
Keyword(s):  
Total Hip Replacement ◽  
Hip Replacement ◽  
Reliable Method ◽  
Randomized Trials ◽  
List Type ◽  
Total Hip ◽  
Significant Difference ◽  
Implant Size ◽  
Meta Analyses ◽  
2D And 3D

There are advocates of both two-dimensional (2D) and three-dimensional (3D) templating methods for planning total hip replacement. The aim of this study was to compare the accuracy of implant size prediction when using 2D and 3D templating methods for total hip arthroplasty, as well as to compare the inter- and intra-observer reliability in order to determine whether currently available methods are sufficiently reliable and reproducible. Medline, EMBASE and PubMed were searched to identify studies that compared the accuracy of 2D and 3D templating for total hip replacement. Results were screened using the PRISMA flowchart and included studies were assessed for their level of evidence using the Oxford CEBM criteria. Non-randomized trials were critically appraised using the MINORS tool, whilst randomized trials were assessed using the CASP RCT checklist. A series of meta-analyses of the data for accuracy were also conducted. Ten studies reported that 3D templating is an accurate and reliable method of templating for total hip replacement. Six studies compared 3D templating with 2D templating, all of which concluded that 3D templating was more accurate, with three finding a statistically significant difference. The meta-analyses showed that 3D CT templating is the most accurate method. This review supports the hypothesis that 3D templating is an accurate and reliable method of preoperative planning, which is more accurate than 2D templating for predicting implant size. However, further research is needed to ascertain the significance of this improved accuracy and whether it will yield any clinical benefit.

scholarly journals Evaluation of version of acetabular component following total hip replacement on conventional radiograph and computed tomography

2020 ◽  
Vol 27 (2) ◽  
pp. 179-185
Author(s):  
Manish Raj ◽  
Ashish Jaiman ◽  
Rajesh Kumar Chopra
Keyword(s):  
Computed Tomography ◽  
Ct Scan ◽  
Total Hip Replacement ◽  
Gold Standard ◽  
Hip Replacement ◽  
Regression Line ◽  
Patient Positioning ◽  
Acetabular Version ◽  
Total Hip ◽  
Significant Difference

Background/Purpose: Total hip replacement (THR) is considered as one of the most successful orthopedic procedures. However, improperly placed components can lead to instability and accelerated wear. Acetabular cup inclination can be very well accessed by anteroposterior pelvis X-rays; for acetabular version assessment, computed tomography (CT) scan is the gold standard. CT scan is not readily available at many centers and the surgeon has to rely on X-ray methods for evaluation of acetabular version to audit results and to predict behavior of the surgical intervention. This prospective study was undertaken to compare Woo and Morrey’s and ischiolateral methods of assessment of acetabular version on cross-table lateral radiographs with CT assessment and to assess the validity of radiographic methods with respect to CT scan method. Material and methods: A prospective follow-up study was conducted for 18 months’ duration (October 2016 to March 2018) on 30 adult patients who underwent THR surgery. Cross-table lateral radiograph was obtained at 3 and 6 weeks in the postoperative period. Two observers made each observation at two different points of time. CT scan was performed at 3 weeks. Version as measured by radiographs and CT scan was recorded. Results: The major overlap in the distribution of the values of the Woo and Morrey method suggests that there is no significant difference between the observations. Distribution of the values of the ischiolateral view and the CT scan value distributions have a very small overlap and hence suggest a strong significant difference between the two. Conclusion: In this study, Woo and Morrey’s method and ischiolateral method of assessment of acetabular version were compared with CT assessment. We found that in Woo and Morrey’s method, values were comparable to CT scan values, when put on regression line. However, in situation of change in patient positioning, namely hip stiffness in contralateral hip, measurement of component changed in series of radiography due to differences in pelvis tilt. So, in these circumstances, we can use ischiolateral method which can give consistent measurement. But it will not be in concordance with CT scan values and Woo and Morrey values, as represented in regression line. The high intra-class correlation coefficients for both intra- and inter-observer reliability indicated that the angle measured with these methods is consistent and reproducible for multiple observers. CT, however, be considered as gold standard for measurement owing to control over pelvic rotation and/or tilt/patient positioning.

Radiographic Assessment of Biomechanical Parameters following hip Resurfacing and Cemented Total Hip Arthroplasty

2009 ◽  
Vol 19 (3) ◽  
pp. 251-256 ◽  
Author(s):  
Curtis Robb ◽  
Richard Harris ◽  
Kevin O'dwyer ◽  
Nadim Aslam
Keyword(s):  
Total Hip Replacement ◽  
Hip Arthroplasty ◽  
Hip Replacement ◽  
Hip Resurfacing ◽  
Leg Length ◽  
Femoral Offset ◽  
Normal Side ◽  
Total Hip ◽  
Significant Difference ◽  
Joint Reaction Forces

Resurfacing hip arthroplasty and total hip replacement both aim to restore anatomical parameters. Leg length and offset discrepancy can result in altered joint reaction forces, and are associated with increased wear, dislocation, and decreased patient satisfaction. This study assesses the accuracy of leg length and offset restoration after either a Birmingham Hip Resurfacing (BHR) or a cemented total hip replacement (THR). Standardised antero-posterior radiography was performed on two groups of 30 patients with unilateral primary osteoarthritis undergoing either a cemented total hip or resurfacing. The normal contra-lateral hip was used as the control. Leg length and offset were measured pre-operatively with no significant difference between the two groups. Cup offset, femoral offset, total offset and leg length of the prosthesis and normal side were measured by two observers and mean measurements were analysed by a paired t test. Leg lengths in each group did not differ significantly from the normal side, THR 0.53 mm (95% CI -2.4 to 3.4 mm) but BHR implantation did result in mean leg shortening of -1.9 mm (95% CI -4.5 mm to 0.6 mm). Cup offset differed significantly from normal anatomy in both groups, as did femoral and total offset for the total hip replacement group. However, femoral offset was restored in the Birmingham resurfacing group. When the THR group was compared against the BHR group we found no difference between restoration of leg lengths (p = 0.21) and cup offset (p = 0.30) but femoral (p = 0.0063) and total offset (p = 0.03) were restored more accurately with a BHR.

Use of telephone interviews to follow up patients after total hip replacement

2005 ◽  
Vol 11 (4) ◽  
pp. 211-214 ◽  
Author(s):  
Sanjeev Sharma ◽  
Ravi Shah ◽  
Kingsley Paul Draviraj ◽  
M S Bhamra
Keyword(s):  
Total Hip Replacement ◽  
Hip Replacement ◽  
Harris Hip Score ◽  
Face To Face ◽  
Total Hip ◽  
Telephone Interviews ◽  
Significant Difference ◽  
The Mean ◽  
The Individual

We studied the feasibility of telephone interviews to assess hip function in patients who had had a total hip replacement. One hundred patients attending the orthopaedic clinic for follow-up after undergoing total hip replacement were studied. A modified Harris hip score was used. Since range of motion and deformity cannot be assessed by telephone, only pain and function were assessed. The maximum possible score was 100. Patients attending follow-up clinics were contacted by telephone one to two weeks prior to their appointment and a telephone assessment was completed. This was then compared with a face-to-face assessment in the subsequent clinic. The mean hip score obtained with the telephone interview was 85.2 and the mean hip score at face-to-face assessment was 86.1. The mean of the differences between the individual scores was −0.9 (SD 5.5). This difference was not significant ( P=0.11). Only three patients had a clinically significant difference (>20 points) between the two methods. Telephone questionnaires may be a useful adjunct to face-to-face assessment for patient follow-up after total hip replacement.

Bed Exercises following Total Hip Replacement: 1 Year follow-up of a Single-Blinded Randomised Controlled Trial

2009 ◽  
Vol 19 (3) ◽  
pp. 268-273 ◽  
Author(s):  
Toby O. Smith ◽  
Charles J.V. Mann ◽  
Allan Clark ◽  
Simon T. Donell
Keyword(s):  
Total Hip Replacement ◽  
Hip Replacement ◽  
Short Form ◽  
Controlled Trial ◽  
Education Programme ◽  
Total Hip ◽  
Significant Difference ◽  
Group A ◽  
Group B ◽  
Randomised Controlled

This paper presents the results of a study assessing whether bed exercises after primary THR (total hip replacement) improves function or quality of life, during the first post-operative year. Sixty patients undergoing primary THR were randomised to receive either a gait re-education programme and bed exercises (Group A) or a gait re-education programme without bed exercises (Group B) post-operatively. The Iowa level of assistance Scale (ILOA) and Short Form-12 Health Survey (SF-12) were assessed at baseline, 3 days, 6 weeks and 1 year post-operatively. There was no statistically significant difference in either ILOA or SF-12 after 1 year between Group A or B. There was no evidence of a subgroup effect by either the surgical approach or prosthesis fixation in either ILOA or SF-12.

scholarly journals Comparative study between outcome of noncemented and cemented total hip replacement

2021 ◽  
Vol 8 (5) ◽  
pp. 1512
Author(s):  
M. Tofayel Hossain ◽  
M. Asaduzzaman ◽  
M. Wahidur Rahman ◽  
Subir Hossain
Keyword(s):  
Statistical Analysis ◽  
Total Hip Replacement ◽  
Hip Replacement ◽  
Social Scientist ◽  
Computer Software ◽  
Total Hip ◽  
Significant Difference ◽  
Group A ◽  
Group B ◽  
Age Range

Background: To resolve the damage and pain in the joint in the hip, total hip replacement (THR) is used. There are some methods used to give THR, but cemented and noncemented THR are common to improve the result of the cemented THR as patients face some complications after replacement. In this study we compared the outcome of the noncemented and cemented THR. The aim of this study was to compare the outcome of noncemented and cemented THR and find out the favorable outcome.Methods: This was a randomized, comparative type of observational study and was conducted in the Department of Orthopedics of National Institute of Traumatology and Orthopaedic Rehabilitation, Bangladesh during the period from 2019 to 2020 on 60 patients, of which 2 groups were made with 30 patients in each group. The age range was less than 50 to more than 70. In group-A cemented THR was done and in group-B noncemented THR was done. Percentage was calculated to find out the proportion of the findings. Further statistical analysis of the results was done by computer software devised in the statistical packages for social scientist (SPSS-23) and MS excel.Results: After comparing outcomes, we saw that most of the patients get better result at the 2nd revision conducted in 6th months. There was no significant difference between the results of the two groups.Conclusions: Though noncemented THR had better result in pain and infection occurrence after treatment, the instability is higher comparing cemented THR. Besides, patients cemented THR also had many complications after treatment.

scholarly journals Laser Projector Method for Measuring Postoperative Acetabular Anteversion After Total Hip Replacement

2021 ◽  
Author(s):  
Wei-Cheng Chen ◽  
Tai-Yin Wu ◽  
Kuan-Yu Chi ◽  
Pei-Wei Weng ◽  
Yu-min Huang ◽  
...  
Keyword(s):  
Total Hip Replacement ◽  
Hip Replacement ◽  
Statistical Significance ◽  
Control Group ◽  
Acetabular Anteversion ◽  
Remote Areas ◽  
Total Hip ◽  
Laser Projector ◽  
Ellipse Method ◽  
Significant Difference

Abstract Introduction For patients undergoing total hip replacement (THR), measuring the postoperative acetabular anteversion precisely plays a pivotal role in the prognosis because anteversion of acetabulum cup determines the range of motion and stability after the THR. To date, the documented techniques for the accurate assessment encompass methods of two-dimensional (2D) and three-dimensional (3D). Our team has developed several 2D methods for precisely measuring acetabular anteversion after the THR, namely the trigonometric, the protractor, and the computerized ellipse method. Despite multiple commercially available assessing tools, most mandate computerized equipment with corresponding software that is frequently in shortage in remote areas and developing countries. Therefore, we attempted to invent a laser projector that is able to measure the acetabular anteversion directly on the traditional plain film and to examine its validity and consistency by comparison with the Elliversion software.Methods We invented a portable laser projector incorporating the ellipse method for the measurement of postoperative acetabular anteversion. We retrospectively collected 50 postoperative pelvis radiographs including acetabulum from our institution. One investigator first measured the anteversion of included radiographs through Elliversion software as the control group. Subsequently, two operators independently used the laser projector for measurements in two separate periods with 1-day intervals as the experimental group. Our analysis was comprised of intra- and inter-group comparisons, which investigated the consistency and validity, respectively, by using two-sample student’s t-test. P-value < 0.05 suggests statistical significance. Results There was no significant difference in measuring the anteversion through laser projectors between two operators (MD, -0.12; 95% CI, -0.52 to 0.27; p=0.54). The estimated effect in the anteversion measurement between the Elliversion and laser projector was also comparable (MD, -0.17; 95% CI, -0.38 to 0.04; p=0.12).Conclusions Our study reported the consistency and validity of this laser projector as there is no significant difference in both intra- and inter-observer reliability, demonstrating real-time, intuitive, and convenient product design comparing to Elliversion. Most importantly, we look forward to helping elevate clinical acumen when doctors provide care to patients after THR, especially in remote areas.

scholarly journals Is there a difference in physical activity levels in patients before and up to one year after unilateral total hip replacement? A systematic review and meta-analysis

2016 ◽  
Vol 31 (5) ◽  
pp. 639-650 ◽  
Author(s):  
Thomas M Withers ◽  
Sarah Lister ◽  
Catherine Sackley ◽  
Allan Clark ◽  
Toby O Smith
Keyword(s):  
Physical Activity ◽  
Total Hip Replacement ◽  
Hip Replacement ◽  
Meta Analysis ◽  
Activity Levels ◽  
Total Hip ◽  
Significant Difference ◽  
Physical Activity Levels ◽  
One Year

Objective: To determine the difference in physical activity levels before and up to one year after unilateral primary total hip replacement. Data sources: A search was performed on 13 July 2016. Studies were eligible for inclusion if they presented preoperative and up to one year postoperative measures of physical activity for patients who had undergone unilateral primary total hip replacement. Review methods: Any article that used a measure of physical activity pre and up to one year post-unilateral primary total hip replacement. Data was synthesised using a meta-analysis with 95% confidence intervals (CI), if appropriate. The Critical Appraisal Skills Programme cohort study checklist was used to assess the quality of evidence. Results: From 6024 citations, 17 studies were selected: Nine studies were analysed in a meta-analysis and eight studies were analysed qualitatively. The quality of the evidence was ‘low’ to ‘moderate’. There was no statistically significant difference in physical activity pre- to post-total hip replacement when assessed using: movement-related activity (mean difference (MD): −0.08; 95% CI: 1.60, 1.44; I2 = 0%; n = 77), percentage of 24-hours spent walking (MD: −0.21; 95% CI: −1.36, 0.93; I2 = 12%; n = 65), 6-minute walk test (MD: −60.85; 95% CI: −122.41, 0.72; I2 = 84%; n = 113) or the cardiopulmonary exercise test (MD: −0.24; 95% CI: −1.36, 0.87; I2 = 0%; n = 76). Conclusion: There is no statistically significant difference in physical activity levels before and up to one year after unilateral primary total hip replacement. However, the low to moderate methodological quality of the included articles should be taken into consideration when drawing conclusions.

scholarly journals An 18-year comparison of hybrid total hip replacement and Birmingham hip resurfacing in active young patients

2019 ◽  
Vol 29 (6) ◽  
pp. 630-637 ◽  
Author(s):  
Sam C Jonas ◽  
Michael R Whitehouse ◽  
Simon Bick ◽  
Gordon C Bannister ◽  
Richard P Baker
Keyword(s):  
Total Hip Replacement ◽  
Hip Replacement ◽  
Hip Resurfacing ◽  
Lower Mortality ◽  
Total Hip ◽  
Birmingham Hip Resurfacing ◽  
Significant Difference ◽  
Active Patients

Aim: To compare the long-term clinical and radiological results of metal-on-polyethylene hybrid total hip replacement (THA) with metal-on-metal Birmingham hip resurfacing (BHR) in young, active patients. Patients and methods: From the 1st consecutive 63 hips in young, active patients who underwent BHR by the senior author, 54 (51 patients) were matched to patients who had undergone THA with regard to age, gender, body mass index and preoperative levels of activity. Radiologically, all hips were assessed for migration and osteolysis, THAs for polyethylene wear and BHRs for a pedestal sign. Patient-reported outcomes, mortality and revision rates were compared. Results: The mean follow-up of the patients with a hybrid THR was 19.9 years and for those with a BHR, 17.6 years. 13 patients with a hybrid THR and 5 with a BHR had died. 1 hybrid THR and 3 BHRs were lost to follow-up. The revision rate of the hybrid THRs was 14/54 and of the BHRs 6/54. Log rank comparison of Kaplan-Meier survival estimates demonstrated a significantly lower mortality in the BHR group ( p = 0.039; hazard ratio [HR] = 0.37 [95% CI, 0.15–0.95]) but a non-significant difference in revision rates ( p = 0.067; HR = 0.43 [95% CI, 0.18–1.06]). The BHRs recorded superior OHS ( p = 0.03), UCLA ( p = 0.0096), and EuroQol visual analogue scores ( p = 0.03). Significantly more BHRs had run, played sport and undertaken heavy manual labour in the month preceding follow-up. Conclusion: After 18 years, patients with BHRs remained more active with a lower mortality rate but demonstrated no significant difference in revision rates. Both groups demonstrated progressive radiological changes at long-term follow-up.

Performance While Crossing Obstacles in Patients With Total Hip Replacement: Comparing Pre-Operation and Post-Operation Performance

2009 ◽  
Author(s):  
Susan Chang ◽  
Shiuann Sheng Lee ◽  
Hsieh Ching Chen ◽  
Jen Suh Chern ◽  
Shih Shan Chen
Keyword(s):  
Total Hip Replacement ◽  
Hip Replacement ◽  
Healthy Adult ◽  
Initial Study ◽  
Rehabilitation Program ◽  
Recovery Stage ◽  
Total Hip ◽  
3D Motion Analysis ◽  
Obstacle Clearance ◽  
Significant Difference

This study investigated the performance the patients with total hip replacement (THR) and healthy adult whiling crossing obstacles. By using a 3D motion analysis system and force plates, we measured the parameters of: (1) toe-obstacle clearance, (2) heel-obstacle clearance, (3) distance between toe and obstacle before crossing, and (4) between heel and obstacle after crossing. In the healthy adult, the results revealed that except the TD of the trailing leg (p = 0.001), other parameters were no significant difference in every crossing condition. Although the THR-patient also showed insignificant different before operation, but in the phase of 2 weeks after the operation, he could only execute the 10 cm crossing condition because of the self-perceived range of motion limitation of the hip surgery, and the performance was unsatisfied. Until the recovery stage in 6 weeks after the operation, the subject could execute all crossing activities, and there was significant difference in toe-obstacle clearance (p = 0.006) while the obstacle height changed, but the other parameters did not show difference significant, and the performances were almost near the healthy adult, with a stable crossing pattern. This study was the initial study on THR-patient, we hope that we can understand the recovery stage of these groups, and base on these results to set up better rehabilitation program after operation, and finally prevent fall in daily life.

The Efficacy of Pre-Operative Home Visits for Total Hip Replacement Clients

2003 ◽  
Vol 70 (4) ◽  
pp. 226-232 ◽  
Author(s):  
Annette Rivard ◽  
Sharon Warren ◽  
Don Voaklander ◽  
Allyson Jones
Keyword(s):  
Hospital Stay ◽  
Total Hip Replacement ◽  
Hip Replacement ◽  
Service Providers ◽  
Length Of Hospital Stay ◽  
Care Practice ◽  
Total Hip ◽  
True Value ◽  
Home Based ◽  
Significant Difference

Background. There is increasing realization among health care administrative decision makers and service providers that we must measure the true value of expensive services by demonstrating the achievement of identified goals. Purpose. The objective of this study was to determine whether clients who received the home-based intervention for a hip arthroplasty would result in a more timely discharge home from hospital. Method. Two hundred and eight clients receiving a total hip replacement at two acute care hospitals comprised the sample. One hospital included the more costly home-based pre-operative teaching by an occupational therapist as part of its protocol while the other provided comparative occupational therapy intervention within its hospital based pre-admission clinic. Discharge disposition and length of hospital stay were measured. Results. Though no significant difference in either of these outcomes was found, a number of issues were raised indicating the complexity of resource allocation to this client population and the importance of the qualitative dimensions of care. Practice Implications. The location for pre-operative teaching for total hip replacements was not found to impact the length of hospital stay nor whether clients are discharged directly home.

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