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.

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 A study to assess functional outcome of cemented and uncemented total hip replacement in a tertiary care center

2019 ◽  
Vol 5 (5) ◽  
pp. 828
Author(s):  
Kunal Ajitkumar Shah ◽  
Mohan Madhav Desai
Keyword(s):  
Functional Outcome ◽  
Total Hip Replacement ◽  
Hip Replacement ◽  
Cost Effective ◽  
Harris Hip Score ◽  
Total Hip ◽  
Vas Score ◽  
Group A ◽  
The Difference ◽  
Group B

<p class="abstract"><strong>Background:</strong> Total hip replacement (THR) is the most successful and cost effective treatment with aim of pain relief and functional rehabilitation for hip disorders. As the implant designs of THR have evolved over time, the functional outcome and survivorship has improved. Even after so many advancements, it remains unclear that which implants are better, uncemented or cemented. Hence, we took up this study to analyze which of the uncemented or cemented THR have better functional outcome.</p><p class="abstract"><strong>Methods:</strong> This was a longitudinal study conducted during 2014 to 2018. Hundred cases were randomized into groups of 50 each. All patients with age between 55-80 years in whom THR was indicated were included in the study. Uncemented THR was done in Group A and cemented THR was done in Group B. Patients were followed up at 12 weeks, 6 months, 12 months, and 3 years. At follow-up, functional examination in terms of visual analogue scale (VAS) score and Harris hip score (HHS) was done.<strong></strong></p><p class="abstract"><strong>Results:</strong> The mean age of patients in Group A (uncemented) and Group B (cemented) was 62.5 years and 60 years respectively. We found that the difference of VAS score and HHS between Group A and B was statistically significant at 12 weeks and 6 months. The difference of VAS and HHS scores between Group A and B at 12 months and 3 years was not significant.</p><p class="abstract"><strong>Conclusions:</strong> We conclude that cemented THR has better functional outcome at short term. They are cost effective option at age ≥55-60 years.</p>

scholarly journals Effect of hydrokinesitherapy on the rehabilitation outcome in patients after total hip replacement

2020 ◽  
Vol 51 (4) ◽  
pp. 232-239
Author(s):  
Dragana Dragičević-Cvjetković ◽  
Slavko Manojlović ◽  
Monika Gligić
Keyword(s):  
Total Hip Replacement ◽  
Hip Replacement ◽  
Rehabilitation Program ◽  
Postoperative Rehabilitation ◽  
Rehabilitation Outcome ◽  
Total Hip ◽  
Womac Index ◽  
Group A ◽  
Group B

Background/Aim: Total hip replacement is considered as one of the most successful treatment methods in orthopaedic surgery of the 20th century, since it significantly improves the quality of life of the individuals with coxarthrosis. Protocols and the organisation of the postoperative rehabilitation differ significantly around the world. The aim of this study was to investigate the effect of hydrokinesitherapy on the rehabilitation outcome in patients after total hip replacement under in-patient conditions. Methods: This prospective clinical trial included a total of 100 patients of both genders , average age 59.11 ± 8.85 years, which were admitted to the in-patient post-operative rehabilitation after total hip replacement. Patients were randomised in two groups: group A (n = 50) that was subjected to rehabilitation program with hy-drokinesiherapy and group B (n = 50) that was subjected to rehabilitation program only. The parameters registered were: the range of movement in the operated hip, the circumference of the femoral musculature and the Western Ontario and McMas-ter Universities Osteoarthritis Indeks (WOMAC index) at admittance and discharge from in-patient rehabilitation. Results: The average values of hip flexion with extended knee, extension and external hip rotation were significantly better in group A (p < 0.05). The values of the circumference of the femoral musculature and WOMAC index in patients from group A were significantly better on discharge compared to the admission. Also, this group had a statistically significantly better values of the circumference of the femoral musculature and value of WOMAC index at discharge compared to patients from group B (p < 0.05). Conclusion: Hydrokinesitherapy as a part of the protocol for postoperative rehabilitation in patients after total hip replacement leads to a faster improvement of the functional status of the operated hip and patient's quality of life.

scholarly journals The Applications of Dexmedetomidine Given Composite Dezocine Spinal Anesthesia in Patients Undergoing Total Hip Replacement Surgery

2018 ◽  
Vol 2 (1) ◽  
Author(s):  
Jiang Ting Ting
Keyword(s):  
Spinal Anesthesia ◽  
Total Hip Replacement ◽  
Hip Replacement ◽  
Elective Surgery ◽  
Total Hip ◽  
Replacement Surgery ◽  
Hip Replacement Surgery ◽  
High Incidence ◽  
Group A ◽  
Group B

Objective: Objective: To evaluate the applications of dexmedetomidine given composite dezocine spinal anesthesia in patients undergoing total hip replacement surgery. Methods: 120 cases ASA Ⅰ ~ Ⅱ grade elective surgery THA patients were divided into group A (n=40), group B (n=40), C group (n=40) from June 2015 to June 2016.Group A were routined with endotracheal intubation operation；Group B were gap into the line L 2-3 spinal anesthesia, anesthesia after a fixed pumping 0.2 mg dezocine a mixture of 3 ml ； Group C were threatmented with dextrose infusion 3μg Mi Ding mixture 3.5 ml. The levels of mean arterialpressure (MAP ), heart rate (HR), oxygen saturation (SPO 2 ), end-tidal carbon dioxide (PETCO 2 ) and other hemodynamic parameters and plasma epinephrine (E), norepinephrine (NE), malondialdehyde (MDA) of three groups before and after 10 min of anesthesia 5min(T 0 ), of anesthesia (T 1 ), at the start of surgery (T 2 ), 1 Xiaoshi (T 3 ) after completion of anesthesia, the end of the surgery (T 4 ).The anesthetic complications occur of three groups were compared. Results: The levels of MAP, HR, SPO 2 , PETCO 2 , E, NE, MDA in T 1 ~ T 4 time were increased than T 0 stage (P<0.05).The levels of MAP, HR, SPO 2 , PETCO 2 , E, NE, MDA in T 1 ~ T 4 time of Groups A were increased than Groups B，Group C (P<0.05).The levels of MAP, HR, SPO 2 , PETCO 2 , E, NE, MDA in T 1 ~ T 4 time of Groups A and Groups B were compared. The cognitive disorders, nausea, vomiting, restlessness, chills, a high incidence of respiratory depression of Group A were higher than Group B, Group C (P<0.05),will high incidence of respiratory depression of Group B were higher than Groups C (P<0.05). Conclusion: dexmedetomidine given composite dezocine spinal anesthesia can effectively stabilize hemodynamics THA patients and reduce patient stress and blood vessels, its low incidence of postoperative complications, worthy of promotion application.

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.

scholarly journals Comparison of the anatomical and functional success of fascia and perichondrium grafts in transcanal endoscopic type 1 tympanoplasty

2019 ◽  
Vol 48 (1) ◽  
Author(s):  
Kadir Özdamar ◽  
Alper Sen
Keyword(s):  
Retention Rates ◽  
Success Rates ◽  
Temporal Muscle ◽  
Type 1 Tympanoplasty ◽  
Significant Difference ◽  
The Status ◽  
Group A ◽  
Group B ◽  
Age Range

Abstract Background There are no studies in the literature, comparing the functional and anatomical successes of the use of fascial and perichondrial grafts in endoscopic type 1 tympanoplasties. Objectives To compare the anatomical and functional outcomes of grafting with the fascia of the temporalis muscle and with the perichondrium of the tragal cartilage in patients undergoing primary transcanal type 1 tympanoplasty with endoscopy. Methods We enrolled a total of 151 patients (80 females and 71 males with a mean age of 26.0 ± 9.3 years in the age range between 18-57) with MERI scores ranging from 1 to 3 and who underwent a transcanal endoscopic type 1 tympanoplasty without tympanomeatal flap elevation. The patients were assigned to two groups according to the type of the graft used. The patients were assigned to either the tragal cartilage perichondrium group (Group A) or the fascia of the temporal muscle (Group B). The groups were compared according to the pre- and postoperative air-bone gaps and to the status of the tympanic membrane. Results There were no statistically significant differences in the distribution of the age, gender, localization, MERI scores, the duration of the operation, and the size of the perforation (all p values> 0.05). The pre-operative air-bone gap values of Group A and B did not show a statistically significant difference (p = 0.073). The postoperative improvement in the air-bone gap value did not demonstrate a significant difference between Group A and B (p = 0.202). The graft retention rates were 94.9 and 97.2% in Group A and in Group B respectively. There were no statistically significant differences between the two groups in terms of the graft retention success rates (p = 0.743). Conclusion Perichondrium and fascia were suitable for use in endoscopic tympanoplasties.

Therapeutic Superiority and Safety of Combined Hydroxyurea with Recombinant Human Erythropoietin Over Hydroxyurea in B-Thalassemia Intermedia Patients

Blood ◽  
2012 ◽  
Vol 120 (21) ◽  
pp. 252-252
Author(s):  
Mohsen Saleh Elalfy ◽  
Amira Adly ◽  
Yassmine Elhanawy
Keyword(s):  
Adverse Events ◽  
Short Form ◽  
Single Agent ◽  
Random Allocation ◽  
Thalassemia Intermedia ◽  
Transfusion Requirements ◽  
Significant Difference ◽  
Group A ◽  
Group B ◽  
Age Range

Abstract Abstract 252 Background: Both Hydroxyurea (HU) as a single agent or in combination with Erythropoietin (rHuEPO) became a therapeutic option for β-Thalassemia intermedia(TI) over last 2 decades. However superiority and safety of combination therapy over HU alone needs further evaluation. Aim: to assess the increase of hemoglobin levels in TI patients by at least 1g/dl above baseline during therapy using combined HUO and rHuEPO compared to single HUO therapy, also to report decline in transfusion requirements, quality of life (QoL), and any drug related adverse events. Patients and methods: An interventional prospective randomized open-labeled study; was approved from the local ethical committee and was registered in the Clinical Trials. Goverment (NCT01624038 ). Eighty Patients 18 years or less will be assigned into one of 2 groups using a random allocation method. Group A: Forty TI patients (age range: 5–18 years) considered as interventional arm 1 and received combined daily HUO (25 mg/kg/day orally) and rHuEPO (1000 IU/kg/week subcutaneously divided in three times/week). Group B: Forty TI patients (age range: 4–18 years) considered as arm 2 (control arm) and received daily single HUO therapy of 25 mg/kg/day. Both groups were followed up both clinically and laboratory for a mean period of one year with assessment of transfusion requirements, blood pressure weekly, liver and renal functions, Hemoglobin (Hb), HbF monthly, basal serum erythropiotin levels and QoL was assessed at study entry and end using the Medical Outcomes Study 36-Item Short Form Health Survey (SF-36). Diagnosis of TI was based on both genetic mutations and absence of transfusion during the 1st 2 years of life. Exclusion criteria were: evidence of active hepatitis (ALT>5 times) or renal impairment. Results: There were a significant improvement in the QoL in 80% and 60% of patients on combined compared to single therapy(p<0.05). There was a significant increase in both Hb and HbF (p <0.001), and the increments were strongly correlated (r =0.84; p <0.001) in both groups more in group A patients. The median Hb level in groups A and B during the study was 9.1 and 7.9 g/dL, respectively (p=0.03). In 68% (n=27) of TI patients group (A) were responded by a 0.5–3 g/dl increase in Hb level. There was significant difference between the 2 groups as only 20% (n=8) of patients in group B show intended improvement in their hemoglobin levels (p<0.01). In studied thalassemics 40%(n=16) of group A compared to 15%(n=6) of group B (p=0.01) became transfusion independent with 20% in group A showed decrease in their transfusion requirements with significant decrease in transfusion index compared to group B thalassemics (p<0.001). There was no significant change in absolute Hb-F, and serum ferritin levels during treatment. splenectomized patients and those with serum EPO less than 500 mU/mL, and intial HbF% > 40% had best response to combined therapy. Side effects from rHuEPO included bone pain in 2 patients, headache in 4 patients, however no uncontrolled hypertension was reported. Gastrointestinal irritation was observed in 3 patients and resolved when the dose was given at bedtime. No renal or hepatic toxicity were reported. A single case of mild neutropenia was reported and recovered within one week of temporary discontinuation Conclusions: Hu was effective in management of TI however combination with erythropiotin had an additive therapeutic effect and was well tolerated with no further serious adverse events. Disclosures: No relevant conflicts of interest to declare.

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.

Accuracy of Femoral Templating in Reproducing Anatomical Femoral Offset in Total Hip Replacement

2007 ◽  
Vol 17 (3) ◽  
pp. 155-159 ◽  
Author(s):  
H. Davies ◽  
J. Foote ◽  
R.F. Spencer
Keyword(s):  
Total Hip Replacement ◽  
Hip Replacement ◽  
Rank Order ◽  
Computer Software ◽  
X Rays ◽  
Femoral Offset ◽  
Total Hip ◽  
Crucial Component ◽  
Best Fitting ◽  
The Uk

Restoration of hip biomechanics is a crucial component of successful total hip replacement. Preoperative templating is recommended to ensure that the size and orientation of implants is optimised. We studied how closely natural femoral offset could be reproduced using the manufacturers' templates for 10 femoral stems in common use in the UK. A series of 23 consecutive preoperative radiographs from patients who had undergone unilateral total hip replacement for unilateral osteoarthritis of the hip was employed. The change in offset between the templated position of the best-fitting template and the anatomical centre of the hip was measured. The templates were then ranked according to their ability to reproduce the normal anatomical offset. The most accurate was the CPS-Plus (Root Mean Square Error 2.0 mm) followed in rank order by: C stem (2.16), CPT (2.40), Exeter (3.23), Stanmore (3.28), Charnley (3.65), Corail (3.72), ABG II (4.30), Furlong HAC (5.08) and Furlong modular (7.14). A similar pattern of results was achieved when the standard error of variability of offset was analysed. We observed a wide variation in the ability of the femoral prosthesis templates to reproduce normal femoral offset. This variation was independent of the seniority of the observer. The templates of modern polished tapered stems with high modularity were best able to reproduce femoral offset. The current move towards digitisation of X-rays may offer manufacturers an opportunity to improve template designs in certain instances, and to develop appropriate computer software.

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.

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