scholarly journals Functional outcomes and complications of simultaneous bilateral total hip arthroplasty in Asian population

2020 ◽  
Vol 6 (2) ◽  
pp. 369
Author(s):  
Ram Prasad Meena ◽  
Utsav Shetty ◽  
Sadaram Bhishnoi ◽  
Ramkhiladi Meena
Keyword(s):  
Total Hip Arthroplasty ◽  
Hospital Stay ◽  
Hip Arthroplasty ◽  
Functional Outcomes ◽  
Cost Benefit ◽  
Asian Population ◽  
Anterolateral Approach ◽  
Total Hip ◽  
One Stage ◽  
The Mean

<p class="abstract"><strong>Background:</strong> Total hip arthroplasty (THA) is one of the most successful and cost-benefit surgical treatments. However, there are concerns about the safety of the procedure and higher complications. We aimed to evaluate the complications and outcomes of one-stage bilateral total hip arthroplasty (BTHA) with anterolateral approach.</p><p class="abstract"><strong>Methods:</strong> A total of 24 patients from February 2014 to October 2019 underwent BTHA in Government Medical College and Attached Group of Hospitals, Kota. A prospective analysis of the functional outcomes and complications was performed. All surgeries were performed via anterolateral approach. All patients were followed up till 1.5 years post-operative.<strong></strong></p><p class="abstract"><strong>Results:</strong> During period of study 16 men and 8 women with a mean age of 40.12±2.52 years at the time of presentation were entered. The mean surgical time was 112±6 mins. The mean hospital stay was 7 days. Hemoglobin level decreased significantly after operation (p=0.046) mean of 10.83±0.3 mg/dl. There was no reported patient with perioperative death, deep venous thrombosis, pulmonary embolism, infection, dislocation, periprosthetic fracture or heterotrophic ossification. The mean preoperative MHHS score was 45.93±5.33 in patients. MHHS score improved to 92.06±2.47 in the last follow-up (p=0.0001).</p><p class="abstract"><strong>Conclusions:</strong> Our results recommend the use of one-stage BTHA through anterolateral approach in cases indicating bilateral THA without increase in rate of complications. Functional and clinical outcomes are comparable and hospital stay is significantly shorter.</p>

scholarly journals Cementless one-stage bilateral total hip arthroplasty in osteoarthritis patients: functional outcomes and complications

2017 ◽  
Vol 9 (2) ◽  
Author(s):  
Afshin Taheriazam ◽  
Amin Saeidinia
Keyword(s):  
Total Hip Arthroplasty ◽  
Hip Arthroplasty ◽  
Functional Outcomes ◽  
Hip Osteoarthritis ◽  
Harris Hip Score ◽  
Superficial Infection ◽  
Total Hip ◽  
One Stage ◽  
The Mean ◽  
Hardinge Approach

Total hip arthroplasty (THA) is one of the successful and cost-benefit surgical treatments. One-stage bilateral THA (BTHA) has a large number of advantages, although there are concerns about the higher complications in this procedure. Aim of our study was to evaluate the complications and outcomes of cementless one-stage BTHA in osteoarthritis patients. A total of 147 patients from 2009 till 2012, underwent one-stage BTHA in Milad and Erfan hospitals, Tehran, Iran. A prospective analysis of the functional outcomes and complications of one-stage BTHA through Hardinge approach in patients with osteoarthritis was performed. We evaluated all patients clinically and radiologically with serial followups. A clinical hip score based upon the modified Harris Hip Score (MHHS) was performed preoperatively and again postoperatively. During the period of study 89 men (60.5%) and 58 women (39.4%) with a mean age of 54.67±7.08 years at the time of presentation were recruited. The mean surgical time was 2.8±0.25 hrs. The mean hospital stay was 3.83±0.65 days. Hemoglobin level decreased significantly after operation (P=0.038). There was two deep venous thromboses, one superficial infection and one temporal proneal palsy but no pulmonary embolism, dislocation, periprosthetic fracture or heterotrophic ossification. The mean preoperative MHHS score was 41.64±5.42 in patients. MHHS score improved to 89.26±4.68 in the last followup (P=0.0001). Our results recommended the use of cementless one-stage BTHA through Hardinge approach in patients with bilateral hip osteoarthritis.

scholarly journals In hospital cost assessment and prevalence of Total Hip Arthroplasty in China: A 10-years real-world study

2020 ◽  
Author(s):  
Mingcheng Yuan ◽  
Hirose Shakya ◽  
Hao-Yang Wang ◽  
Zhenyu Luo ◽  
Ke Xiao ◽  
...  
Keyword(s):  
Total Hip Arthroplasty ◽  
Hospital Stay ◽  
Hip Arthroplasty ◽  
Hospital Cost ◽  
Hospital Costs ◽  
Labor Cost ◽  
Total Charge ◽  
Strongly Correlated ◽  
Total Hip ◽  
The Mean

Abstract Background: The rising costs of total hip arthroplasty (THA) have resulted in a substantial economic burden to the people of China and Chinese health-care system. The objective of this study was to assess the in-hospital costs associated with primary total hip arthroplasty and efforts to contain these costs by ascertaining factors responsible for the rise in cost.Methods: In-hospital costs of 8111 patients (3878 male and 42337female) who underwent elective primary unilateral hip arthroplasty were extracted from our institution between January 2009 and December 2018 and reviewed. The number of yearly procedures was recorded. All hospital related charges were categorized into 9 groups based on hospital-based supplies and services. The correlation between total in hospital cost and 9 groups were assessed using Pearson’s coefficient. The same method was used for correlating hospital stay and bed charge.Results: The substantial rise in yearly procedure volume was observed. The number of procedures had risen from 306 in 2009 to 1024 in 2018, an incidence increased by more than threefold. The average cost for THAs procedure was ¥53468.03 ± 4833 in 2009 that rose by approximately 10% in 2018 (¥58593.62 ± 4801). The mean cost observed over the study period was ¥62980.21 ± 6314.673. The charges analyzed in all categories expect the hospital bed cost increased during the study period. The joint implant was the most expensive supply item contributing ~ 75% of the total in-hospital cost. Labor cost covered only ~ 10% and bed charge 0.93% of the total charge. The rise in total in-hospital cost strongly correlated with increase in implant cost (Pearson’s correlation (r) = 0.908, α > 0.05). The mean total hospital stays declined from 16.11 ± 8.19 days in 2009 to 6.13 ± 2.65 days in 2018. The mean post-operative stay had also reduced from 9.12 ± 4.88 to a third (3.01 ± 1.80) during the same period. The hospital cost and bed charge also strongly correlated (r = 0.931, α > 0.05)Conclusions: The number of hip arthroplasty procedures performed annually in China is growing rapidly. An incidence rose by threefold over 10-year period in the present study and we predict an unprecedented rise in the incidence in coming years due to an aging population and improving economic conditions in China. The hospital stay was significantly reduced and early discharge within 3 days postoperatively was a noteworthy outcome. Implant cost remained the largest single expense. As a result, some patients who are medical candidates for total joint arthroplasty, may not have access to care due to relatively high financial barrier. Hence it is important to note that significant patient benefits may be realized by efforts to reduce the cost of the prosthesis in China.

scholarly journals Total hip arthroplasty in patients with slipped capital femoral epiphysis: a systematic analysis of 915 cases

2021 ◽  
Vol 12 (4) ◽  
Author(s):  
Eustathios Kenanidis ◽  
Panagiotis Kakoulidis ◽  
Sousana Panagiotidou ◽  
Andreas Leonidou ◽  
Panagiotis Lepetsos ◽  
...  
Keyword(s):  
Total Hip Arthroplasty ◽  
Hip Arthroplasty ◽  
Hip Replacement ◽  
Functional Outcomes ◽  
Slipped Capital Femoral Epiphysis ◽  
Cochrane Library ◽  
Systematic Analysis ◽  
Total Hip ◽  
Ovid Medline ◽  
The Mean

There is limited evidence on the outcomes of Total Hip Arthroplasty (THA) in Slipped Capital Femoral Epiphysis (SCFE) patients. This systematic review aims to evaluate the current literature in terms of survival rate, functional outcomes, complications and types of implants of THA in SCFE patients. Following the established methodology of PRISMA guidelines, PubMed, Cochrane library, ScienceDirect and Ovid MEDLINE were systematically searched from inception to September 2018. The search criteria used were: (“total hip arthroplasty’’ OR ‘’total hip replacement’’ OR “hip arthroplasty’’ OR ‘’hip replacement’’) AND (‘’slipped capital femoral epiphysis’’ OR ‘’slipped upper femoral epiphysis’’ OR ‘’femoral epiphysis’’). Ten studies were finally included in the analysis and were qualitatively appraised using the Newcastle-Ottawa tool. Variables were reported differently between studies. The sample size varied from 12 to 374 THAs. A total of 877 patients undergone 915 THAs. The mean reported follow-up ranged from 4.4 to 15.2 years and the mean patients’ age at the time of THA from 26 to 50 years. Four studies specified the type of implants used, with 62% being uncemented, 24% hybrid (uncemented cup/cemented stem) and 14% cemented. All but three studies reported the mean survival of implants that ranged from 64.9% to 94.8%. A limited number of complications were mentioned. There was a tendency for more favorable functional outcomes in modern studies. Modern THA-studies in SCFE patients showed improvement of survivorship, clinical outcomes and patient satisfaction. Future higher-quality studies are necessary to estimate long-term postoperative outcomes better.

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 Management of the Infected Hip Arthroplasty by Two-Stage Reimplantation

2003 ◽  
Vol 46 (3) ◽  
pp. 113-115 ◽  
Author(s):  
Karel Karpaš ◽  
Pavel Šponer
Keyword(s):  
Total Hip Arthroplasty ◽  
Hip Arthroplasty ◽  
Harris Hip Score ◽  
Two Stage ◽  
Total Hip ◽  
Female Patients ◽  
One Stage ◽  
The Mean ◽  
Two Stages

The aim of this study is to present our experience with two-stage reimplantation in the management of the infected hip arthroplasty. Between January 1993 and December 2001 the replacement of the total hip arthroplasty in two stages was performed in 18 patients. There were 7 male and 11 female patients and the average age was 62 years. The mean follow-up after revision was 3.5 years. The mean postoperative Harris Hip Score averaged 78 (50–96) points. None of 18 patients had a recurrence of the infection. Two-stage reconstruction of the infected hip is preferred to one-stage exchange arthroplasty at our department because of higher rate of eradication of the infection.

scholarly journals Sequential Bilateral Total Hip Arthroplasty Through a Minimally Invasive Anterior Approach is Safe to Perform

2017 ◽  
Vol 11 (1) ◽  
pp. 1417-1422 ◽  
Author(s):  
Gerasimos Petridis ◽  
Martin Nolde
Keyword(s):  
Total Hip Arthroplasty ◽  
Minimally Invasive ◽  
Hospital Stay ◽  
Hip Arthroplasty ◽  
Perioperative Complications ◽  
Length Of Hospital Stay ◽  
Harris Hip Score ◽  
Invasive Approach ◽  
Total Hip ◽  
The Mean

Background: Sequential bilateral total hip arthroplasty (THA) has the potential advantages of a single operative intervention with a single hospital stay, alongside reduced costs and total rehabilitation times. Its use has been limited, however, by a theoretical increase in perioperative complications. Objective: The purpose of this study was to assess functional outcomes and complications in patients undergoing sequential bilateral THA performed using anterior minimally invasive surgery (AMIS). We hypothesized that sequential bilateral THA yields favorable clinical outcome and is safe to perform. Methods: Two surgical centres conducted a retrospective observational analysis of 130 patients (77 females) with a mean age of 57 (range, 35-77) years, all of whom were treated by one surgeon and followed up for 24 months. Results: The mean length of hospital stay length was 8.4 (range, 6–18) days. The mean operative time was 162 (range, 92–185) minutes, the mean intraoperative blood loss was 499.1ml, and the mean preoperative and postoperative hemoglobin levels were 14.3 g/dl and 11.3 g/dl, respectively. No perioperative complications or deaths were recorded. The Harris Hip Score (HHS) improved from 44.5 ±13.7 preoperatively to 98.9 ± 1.0 at final follow-up. Also the High Activity Arthroplasty Score (HAAS) and the Questions on Life Satisfaction (FLZ) score improved significantly. Conclusion: This retrospective analysis suggests that, in selected patients, sequential bilateral THA via an anterior minimally invasive approach appears to be a valid alternative to two-stage bilateral THA. Further studies are warranted.

scholarly journals One-stage bilateral total hip arthroplasty: Functional outcomes and complications in 112 patients

2012 ◽  
Vol 98 (6) ◽  
pp. S120-S123 ◽  
Author(s):  
C. Trojani ◽  
T. d’Ollonne ◽  
D. Saragaglia ◽  
C. Vielpeau ◽  
M. Carles ◽  
...  
Keyword(s):  
Total Hip Arthroplasty ◽  
Hip Arthroplasty ◽  
Functional Outcomes ◽  
Total Hip ◽  
One Stage

scholarly journals Outpatient Total Hip Arthroplasty: A Meta-Analysis

2021 ◽  
Vol 11 (15) ◽  
pp. 6853
Author(s):  
Filippo Migliorini ◽  
Lucio Cipollaro ◽  
Francesco Cuozzo ◽  
Francesco Oliva ◽  
Andrea Valerio Marino ◽  
...  
Keyword(s):  
Total Hip Arthroplasty ◽  
Hip Arthroplasty ◽  
Meta Analysis ◽  
Readmission Rates ◽  
Total Hip ◽  
Vein Thrombosis ◽  
Outpatient Group ◽  
Operative Planning ◽  
The Mean ◽  
And Gender

Introduction: Outpatient total hip arthroplasty (THA) is increasingly popular. This meta-analysis investigated the potential advantages of outpatient regimes for THA. Methods: This study followed the PRISMA guidelines. PubMed, Web of Science, Google Scholar, Embase, and Scopus databases were accessed in June 2021. All clinical studies investigating outpatient THA were considered. The outcomes of interest were pain, infection, mortality, revision, dislocation, readmission rates, and deep vein thrombosis (DVT). Results: Data from 102,839 patients were included. A total of 52% (153,168 of 102,839 patients) were women. The mean age of patients was 62.6 ± 4.6 years, the mean BMI was 29.1 ± 1.8 kg/m2. Good comparability was found in age, BMI, and gender (p > 0.1). No difference was found in pain (p = 0.4), infections (p = 0.9), mortality (p = 0.9), rate of revision (p = 0.1), dislocation (p = 0.9), and readmission (p = 0.8). The outpatient group demonstrated a greater rate of DVT (OR 3.57; 95% CI 2.47 to 5.18; p < 0.0001). Conclusions: In selected patients, outpatient THA can be performed safely with optimal outcomes comparable with inpatient THA. Clear and comprehensive pre-operative planning should involve a multi-disciplinary group composed of orthopaedic surgeons, anaesthesia and rehabilitation specialists, and physiotherapists. Each centre performing outpatient THA should implement continuous homecoming welfare activity, to supervise physiotherapy and monitor anticoagulant therapy.

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