Conventional total hip arthroplasty for degenerative joint disease in patients between the ages of forty and sixty years.

AbstractGunshot wound (GSW) injuries around the hip joint can lead to debilitating post-traumatic arthritis, requiring a technically demanding primary total hip arthroplasty (THA). These surgeries are often complicated by bullet debris, extensive scaring, prior operations, and altered local anatomy. Although most literature focuses on acute management of GSW around the hip, a few reports detail the mid-term outcomes of GSW patients with primary THA for post-traumatic arthritis. The purpose of this study was to assess the outcomes and complications associated with THA in nine patients with secondary arthritis due to prior GSW injuries. At a mean follow-up of 35 months (range 12–60 months), significant improvement was shown in hip function, activity, and pain levels, and was similar to the outcomes of 18 patients who underwent primary THA for degenerative joint disease. While technically demanding, THA seems to reduce pain and improve function safely and effectively for patients with GSW-induced hip arthritis.

Download Full-text

Degenerative Lumbar Spine Disease, Not Fusion, May Be a Risk Factor for Instability after Total Hip Arthroplasty

The Journal of Hip Surgery ◽

10.1055/s-0040-1719114 ◽

2020 ◽

Vol 4 (04) ◽

pp. 193-200

Author(s):

Daniel K. Witmer ◽

Evan R. Deckard ◽

R. Michael Meneghini

Keyword(s):

Lumbar Spine ◽

Total Hip Arthroplasty ◽

Hip Arthroplasty ◽

Spine Fusion ◽

Joint Disease ◽

Total Hip ◽

Female Sex ◽

Lumbar Spine Fusion ◽

Radiographic Measurements ◽

Acetabular Protrusio

AbstractDislocation rates after total hip arthroplasty (THA) in patients with fixed spinopelvic motion have been reported as high as 20%. Few studies exist specifically for lumbar spine degenerative joint disease (DJD) and its relationship to THA instability. There were two study objectives: (1) report the incidence of lumbar spine DJD and previous lumbar spine fusion and (2) evaluate the relationship of these two conditions and other potential risk factors to postoperative dislocation after THA. We retrospectively reviewed 818 consecutive THAs performed by a single surgeon utilizing a posterior approach. Comprehensive medical chart and radiographic review was performed to identify patients with lumbar spine DJD and lumbar spine fusion. Radiographic measurements, patient factors, surgical factors, and incidences of dislocation also were recorded. Eight hundred and twelve THAs were analyzed. There were 10 dislocations (1.2%, 10/812). Lumbar spine DJD and previous lumbar spine fusion occurred in 33.4% (271/812) and 5.9% (48/812) of patients, respectively. Lumbar spine DJD, acetabular protrusio, and female sex were significant predictors of dislocation using a Firth penalized maximum likelihood estimation specifically for rare events (area under receiver-operator characteristic curve = 0.91, 95% confidence interval 0.86, 0.96). Interestingly, only 2 of 10 dislocations had a previous lumbar spine fusion. Lumbar spine DJD, acetabular protrusio, and female sex were significant predictors of dislocation, while lumbar spine fusion was largely unrelated. This study used data available to most practicing surgeons and provides useful information for counseling patients preoperatively.

Download Full-text

Accurate and Reliable Diagnosis of Avascular Necrosis of the Femoral Head From Total Hip Arthroplasty Specimens Requires Pathologic Examination

American Journal of Clinical Pathology ◽

10.1093/ajcp/aqaa153 ◽

2020 ◽

Author(s):

Josephine K Dermawan ◽

Andrew Goldblum ◽

John D Reith ◽

Scott E Kilpatrick

Keyword(s):

Risk Factors ◽

Total Hip Arthroplasty ◽

Avascular Necrosis ◽

Hip Arthroplasty ◽

Preoperative Diagnosis ◽

Joint Disease ◽

Pathologic Examination ◽

Total Hip ◽

Radiology Reports ◽

Reliable Diagnosis

Abstract Objectives To evaluate the necessity of pathologic examination for confirming the diagnosis of avascular necrosis (AVN). Methods We retrospectively reviewed consecutive nonfractured total hip arthroplasty cases (n = 1,722), comparing operative diagnoses and radiologic data with final histologic diagnoses, focusing specifically on AVN. Results Among 199 histologically confirmed cases of AVN, 62 (31%) had a preoperative diagnosis of osteoarthritis/degenerative joint disease (OA/DJD); 58 of the latter patients had radiology reports, but only two (3%) documented AVN. Patients with AVN preoperatively diagnosed as OA/DJD were significantly older (mean, 65 years) than patients with AVN correctly diagnosed clinically (mean, 52 years; P < .00001). Among 163 cases with a preoperative diagnosis of AVN, 26 (16%) were confirmed as OA/DJD; the radiology report incorrectly diagnosed AVN in 17 (65%) patients. These latter patients also were significantly older (mean, 60 years) than patients with AVN correctly diagnosed clinically (P = .0008). Patients with a preoperative clinical and/or radiologic diagnosis of AVN were more likely to be younger and have known AVN risk factors. Conclusions Accurate and reliable diagnosis of AVN requires pathologic examination, especially among older patients without known risk factors. Prompt diagnosis may lead to behavioral changes in affected patients that reduce the risk of subsequent lesions.

Download Full-text

Treatment of traumatic coxo-femoral luxation by cemented total hip arthroplasty

Veterinary and Comparative Orthopaedics and Traumatology ◽

10.1055/s-0038-1632820 ◽

2004 ◽

Vol 17 (04) ◽

pp. 198-203 ◽

Cited By ~ 19

Author(s):

A. Pozzi ◽

M.P. Kowaleski ◽

J. Dyce ◽

K.A. Johnson

Keyword(s):

Total Hip Arthroplasty ◽

Hip Arthroplasty ◽

Force Plate ◽

Joint Disease ◽

Vertical Force ◽

Total Hip ◽

Cumulative Function ◽

Plate Analysis ◽

External Trauma ◽

Cemented Total Hip Arthroplasty

SummarySurgical procedures such as total hip arthroplasty (THA) or femoral head and neck excision may be indicated as a treatment for traumatic coxo-femoral luxation that is complicated by pre-existing joint disease, concurrent fractures or recurrent luxation. The purpose of our study was to evaluate outcome after treatment of traumatic coxo-femoral luxation by THA. Medical records of dogs undergoing cemented THA from 1996 to 2002 were reviewed. Inclusion criteria were coxofemoral luxation resulting from severe external trauma and radiographic follow-up of at least 3 months. Ten dogs (12 THA) met the criteria for inclusion. Complications included THA luxation (n = 1) and a non-displaced peri-prosthetic femoral fracture (n = 1) that healed without further surgery. Median cumulative function scores from client questionnaires after THA were not significantly different in dogs with previously normal (8, range: 7-10), (n = 5) and dysplastic (9, range: 7–16), (n = 5) hips (P = 0.410). Six dogs were available for re-examination and force plate analysis at greater than 6 months post-THA, and none of these dogs had any visible lameness. Peak vertical force (% BWt) showed a trend towards being less in THA (60.8±5.1) than non-operated (68.1±6.1) hindlimbs (P = 0.057), whereas vertical impulse (% BWt x sec) was similar in THA (9.1±1.6) and non-operated (9.8±1.2) hindlimbs (P = 0.286). Our findings indicate that THA can be a successful treatment for traumatic coxo-femoral luxation, irrespective of the dysplastic status of the joint prior to injury.

Download Full-text

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

The American Journal of Sports Medicine ◽

10.1177/0363546519878147 ◽

2019 ◽

Vol 48 (7) ◽

pp. 1748-1755 ◽

Cited By ~ 6

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.

Download Full-text

Clinical Result of Total Hip Arthroplasty in Long-term Dialysis Patients with Hip Joint Disease

Orthopedics & Traumatology ◽

10.5035/nishiseisai.54.798 ◽

2005 ◽

Vol 54 (4) ◽

pp. 798-803

Author(s):

Keiichi Tsuda ◽

Hiroshi Enomoto ◽

Shinichi Harada ◽

Kunihiko Okano ◽

Makoto Osaki ◽

...

Keyword(s):

Total Hip Arthroplasty ◽

Hip Joint ◽

Hip Arthroplasty ◽

Clinical Result ◽

Joint Disease ◽

Dialysis Patients ◽

Total Hip

Download Full-text

In VitroBioactivity Study of RGD-Coated Titanium Alloy Prothesis for Revision Total Hip Arthroplasty

BioMed Research International ◽

10.1155/2016/8627978 ◽

2016 ◽

Vol 2016 ◽

pp. 1-7 ◽

Cited By ~ 1

Author(s):

Zhentao Man ◽

Dan Sha ◽

Shui Sun ◽

Tao Li ◽

Bin Li ◽

...

Keyword(s):

Total Hip Arthroplasty ◽

Hip Arthroplasty ◽

Vascular Tissue ◽

Cell Attachment ◽

Ti6al4v Alloy ◽

Joint Disease ◽

Host Bone ◽

Common Procedure ◽

Total Hip ◽

Revision Tha

Total hip arthroplasty (THA) is a common procedure for the treatment of end-stage hip joint disease, and the demand for revision THA will double by 2026. Ti6Al4V (Titanium, 6% Aluminum, and 4% Vanadium) is a kind of alloy commonly used to make hip prothesis. To promote the osseointegration between the prothesis and host bone is very important for the revision THA. The peptide Arg-Gly-Asp (RGD) could increase cell attachment and has been used in the vascular tissue engineering. In this study, we combined the RGD with Ti6Al4V alloy using the covalent cross-linking method to fabricate the functional Ti6Al4V alloy (FTA). The distribution of RGD oligopeptide on the FTA was even and homogeneous. The FTA scaffolds could promote mouse osteoblasts adhesion and spreading. Furthermore, the result of RT-qPCR indicated that the FTA scaffolds were more beneficial to osteogenesis, which may be due to the improvement of osteoblast adhesion by the RGD oligopeptide coated on FTA. Overall, the FTA scaffolds developed herein pave the road for designing and building more efficient prothesis for osseointegration between the host bone and prothesis in revision THA.

Download Full-text

Result of cementless total hip arthroplasty in a patient with osteopoikilosis, hip dysplasia and advanced osteoarthritis: a case report

BMC Musculoskeletal Disorders ◽

10.1186/s12891-021-04258-w ◽

2021 ◽

Vol 22 (1) ◽

Author(s):

Yao-Yuan Chang ◽

Wei-Hsin Lin

Keyword(s):

Total Hip Arthroplasty ◽

Hip Arthroplasty ◽

Developmental Dysplasia ◽

Hip Pain ◽

Joint Disease ◽

Long Term Results ◽

Harris Hip Score ◽

Total Hip ◽

Cementless Total Hip Arthroplasty

Abstract Background Osteopoikilosis (OPK) is a rare benign sclerosing bone dysplasia and is often incidentally found on plain radiography. OPK generally does not require treatment. Nevertheless, osteonecrosis or degenerative joint disease can occur in the setting of OPK, and little is known with regard to the longevity of arthroplasty prostheses implanted into OPK-bearing bones. Case presentation A 55-year-old male presented with progressive right hip pain in 2012. He was diagnosed with coexisting osteopoikilosis and developmental dysplasia of the right hip with advanced osteoarthritis after a series of imaging studies including radiographs, magnetic resonance imaging (MRI), and bone scan. A cementless total hip arthroplasty was performed to treat his right hip pain. Radiographs at eight-year follow-up showed the prosthetic components were well-fixed. Harris hip score of the patient’s right hip was 93. The patient can walk without assistance and work as a construction worker. Conclusion Cementless arthroplasty can be considered in patients with hip arthropathies and co-existing osteopoikilosis. Continued follow-up is required to establish the long-term results.

Download Full-text