scholarly journals A simple angle-measuring instrument for measuring cemented stem anteversion during total hip arthroplasty

2019 ◽  
Author(s):  
Ryo Mitsutake ◽  
Hiromasa Tanino ◽  
Yasuhiro Nishida ◽  
Masaru Higa ◽  
Hiroshi Ito
Keyword(s):  
Total Hip Arthroplasty ◽  
Correlation Coefficient ◽  
Hip Arthroplasty ◽  
Measurement Accuracy ◽  
Measuring Instrument ◽  
Total Hip ◽  
Angle Measuring ◽  
Cemented Stem ◽  
The Mean ◽  
The Relationship

Abstract Background During total hip arthroplasty (THA), the accurate placement of the femoral components is an important determinant of the success of the procedure. This study assessed the accuracy of cemented stem placement using a new angle-measuring instrument. The primary objective was to investigate the accuracy of the intraoperative measurements of cemented stem anteversion obtained using the angle-measuring instrument. Our secondary objective was to evaluate the accuracy of stem positioning performed using the angle-measuring instrument. Methods We compared the intraoperative stem anteversion measurements obtained using the angle-measuring instrument with postoperative stem anteversion measurements obtained using computed tomography in 149 hips (measurement accuracy). We also compared the target angle and postoperative stem anteversion in 105 hips (implantation accuracy). Results The mean amount of intraoperative stem anteversion was 37.9°±10.1°, and the mean amount of postoperative stem anteversion was 37.0°±10.4°. The mean measurement accuracy was 0.9°±6.1°, and the absolute measurement accuracy was 4.9°±3.7°. The correlation coefficient for the relationship between the intraoperative and postoperative stem anteversion measurements was 0.824 (p=0.000). The mean amount of target angle was 37.4°±7.6°, and the mean amount of postoperative stem anteversion was 35.9°±9.1°. The mean implantation accuracy was 1.4°±5.6°, and the mean absolute implantation accuracy was 4.3°±3.6°. The correlation coefficient for the relationship between the intraoperative and postoperative stem anteversion measurements was 0.824 (p=0.000). Conclusions The angle-measuring instrument is expected to allow cemented stems to be placed accurately, simply, and less invasively during THA and at significant cost savings.

scholarly journals A Simple Angle-Measuring Instrument for Measuring Cemented Stem Anteversion during Total Hip Arthroplasty

2020 ◽  
Author(s):  
Ryo Mitsutake ◽  
Hiromasa Tanino ◽  
Yasuhiro Nishida ◽  
Masaru Higa ◽  
Hiroshi Ito
Keyword(s):  
Total Hip Arthroplasty ◽  
Correlation Coefficient ◽  
Hip Arthroplasty ◽  
Measurement Accuracy ◽  
Measuring Instrument ◽  
Target Angle ◽  
Angle Measuring ◽  
Cemented Stem ◽  
The Mean ◽  
The Relationship

Abstract Background During total hip arthroplasty (THA), the accurate placement of the femoral components is an important determinant of the success of the procedure. This study assessed the accuracy of cemented stem placement using a new angle-measuring instrument. The primary objective was to investigate the accuracy of the intraoperative measurements of cemented stem anteversion obtained using the angle-measuring instrument. Our secondary objective was to evaluate the accuracy of stem positioning performed using the angle-measuring instrument. Methods We compared the intraoperative stem anteversion measurements obtained using the angle-measuring instrument with postoperative stem anteversion measurements obtained using computed tomography in 149 hips (measurement accuracy). We also compared the target angle and postoperative stem anteversion in 105 hips (implantation accuracy). Results The mean amount of intraoperative stem anteversion was 37.9°±10.1°, and the mean amount of postoperative stem anteversion was 37.0°±10.4°. The mean measurement accuracy was 0.9°±6.1°, and the absolute measurement accuracy was 4.9°±3.7°. The correlation coefficient for the relationship between the intraoperative and postoperative stem anteversion measurements was 0.824 (p=0.000). The mean amount of target angle was 37.4°±7.6°, and the mean amount of postoperative stem anteversion was 35.9°±9.1°. The mean implantation accuracy was 1.4°±5.6°, and the mean absolute implantation accuracy was 4.3°±3.6°. The correlation coefficient for the relationship between the target angle and postoperative stem anteversion was 0.795 (p=0.000). Conclusions The angle-measuring instrument measured intraoperative stem anteversion accurately, and cemented stem was implanted accurately during THA with the angle-measuring instrument.

scholarly journals A Simple Angle-Measuring Instrument for Measuring Cemented Stem Anteversion during Total Hip Arthroplasty

2020 ◽  
Author(s):  
Ryo Mitsutake ◽  
Hiromasa Tanino ◽  
Yasuhiro Nishida ◽  
Masaru Higa ◽  
Hiroshi Ito
Keyword(s):  
Total Hip Arthroplasty ◽  
Correlation Coefficient ◽  
Hip Arthroplasty ◽  
Measurement Accuracy ◽  
Measuring Instrument ◽  
Target Angle ◽  
Angle Measuring ◽  
Cemented Stem ◽  
The Mean ◽  
The Relationship

Abstract Background During total hip arthroplasty (THA), the accurate placement of the femoral components is an important determinant of the success of the procedure. This study assessed the accuracy of cemented stem placement using a new angle-measuring instrument. The primary objective was to investigate the accuracy of the intraoperative measurements of cemented stem anteversion obtained using the angle-measuring instrument. Our secondary objective was to evaluate the accuracy of stem positioning performed using the angle-measuring instrument. Methods We compared the intraoperative stem anteversion measurements obtained using the angle-measuring instrument with postoperative stem anteversion measurements obtained using computed tomography in 149 hips (measurement accuracy). We also compared the target angle and postoperative stem anteversion in 105 hips (implantation accuracy). Results The mean amount of intraoperative stem anteversion was 37.9°±10.1°, and the mean amount of postoperative stem anteversion was 37.0°±10.4°. The mean measurement accuracy was 0.9°±6.1°, and the absolute measurement accuracy was 4.9°±3.7°. The correlation coefficient for the relationship between the intraoperative and postoperative stem anteversion measurements was 0.824 (p=0.000). The mean amount of target angle was 37.4°±7.6°, and the mean amount of postoperative stem anteversion was 35.9°±9.1°. The mean implantation accuracy was 1.4°±5.6°, and the mean absolute implantation accuracy was 4.3°±3.6°. The correlation coefficient for the relationship between the target angle and postoperative stem anteversion was 0.795 (p=0.000). Conclusions The angle-measuring instrument measured intraoperative stem anteversion accurately, and cemented stem was implanted accurately during THA with the angle-measuring instrument.

scholarly journals A simple angle-measuring instrument for measuring cemented stem anteversion during total hip arthroplasty

2020 ◽  
Vol 21 (1) ◽  
Author(s):  
Ryo Mitsutake ◽  
Hiromasa Tanino ◽  
Yasuhiro Nishida ◽  
Masaru Higa ◽  
Hiroshi Ito
Keyword(s):  
Total Hip Arthroplasty ◽  
Hip Arthroplasty ◽  
Measuring Instrument ◽  
Total Hip ◽  
Angle Measuring ◽  
Cemented Stem

scholarly journals Mid-Term Outcomes of Cemented Stem and Subtrochanteric Shortening Derotational Osteotomy in Total Hip Arthroplasty for Crowe IV Developmental Dysplasia

2021 ◽  
Author(s):  
Zhe-Yu Huang ◽  
Jing Ling ◽  
Zhi-Min Zeng ◽  
Zheng-Lin Di ◽  
Jun-Hui Zhang ◽  
...  
Keyword(s):  
Total Hip Arthroplasty ◽  
Hip Arthroplasty ◽  
Cement Leakage ◽  
Developmental Dysplasia ◽  
Harris Hip Score ◽  
Total Hip ◽  
Derotational Osteotomy ◽  
Femoral Shortening ◽  
Cemented Stem ◽  
The Mean

Abstract Background Performing total hip arthroplasty (THA) in patients with Crowe IV developmental dysplasia of the hip (DDH) is technically challenging. Subtrochanteric shortening osteotomy is typically required for placing the acetabular component within the anatomic hip center. However, the outcomes of subtrochanteric osteotomy using cemented components are not widely reported. This study aimed to evaluate the outcomes of cemented stem THA with subtrochanteric femoral shortening and transverse derotational osteotomy in patients with Crowe IV DDH.Methods We retrospectively evaluated data of patients with Crowe IV DDH who underwent cemented stem THA with subtrochanteric femoral shortening and transverse derotational osteotomy between 2010 and 2018. Patients who underwent surgery at the hip joint were excluded. Data regarding pre- and postoperative clinical and radiological parameters were collected and reviewed.Results Among 14 patients included (14 hips), the mean age was 60.4 (range, 47–73) years. The mean Harris hip score improved from 40.7 to 87.7. The mean limb length discrepancy reduced from 52 mm to 12.7 mm. No neurologic deficits were noted. The mean osteotomy union time was 10.6 months. Delayed union and postoperative dislocation were observed in one and two patients, respectively. Cement leakage into the osteotomy gap was observed in one patient. No revisions were required. No signs of loosening or migration were observed. Conclusions Cemented stem THA combined with subtrochanteric femoral shortening and transverse derotational osteotomy is safe and effective for the treatment of patients with Crowe IV DDH. The cemented femoral component showed promising mid-term follow up results. However, cement leakage affects bone healing. Osteotomy and cementing should be performed meticulously.Trial Registration: Retrospectively registered

scholarly journals Relationship Between the Accuracy of Acetabular Cup Angle and Body Mass Index in Posterolateral Total Hip Arthroplasty With CT-Based Navigation: A Retrospective Case-Control Study

2020 ◽  
Author(s):  
Hisatoshi Ishikura ◽  
Masaki Nakamura ◽  
Hanae Nishino ◽  
Shigeru Nakamura ◽  
Takeyuki Tanaka ◽  
...  
Keyword(s):  
Body Mass Index ◽  
Total Hip Arthroplasty ◽  
Body Mass ◽  
Hip Arthroplasty ◽  
Acetabular Cup ◽  
Total Hip ◽  
Significant Difference ◽  
The Mean ◽  
Navigation Errors ◽  
The Relationship

Abstract Background: Precise acetabular cup placement is essential for successful total hip arthroplasty (THA). In obese patients, its accuracy is often difficult to achieve because of the thickness of the soft tissues. This study aimed to determine the relationship between the accuracy of acetabular cup angle and body mass index (BMI) in posterolateral THA using the computed tomography-based navigation (CT-navi) system.Methods: We retrospectively reviewed 145 consecutive primary THAs using the CT-navi system between January 2015 and January 2018. All surgeries were performed using cementless cups employing the posterolateral approach with the patient in the decubitus position. We compared the radiographic inclination and anteversion obtained from the angle displayed on the CT-navi screen with those measured by the postoperative CT using the three-dimensional templating software. We evaluated the relationship between the extent of errors and correlation with BMI. Statistical analyses were performed using the Student’s t-test and Spearman’s rank coefficient test.Results: In non-overweight patients (BMI < 25, 88 hips), the mean navigation errors for inclination were 2.8 ± 2.2° and for anteversion were 2.6 ± 2.3°. Meanwhile, in overweight patients (BMI ≥ 25, 57 hips), the mean navigation errors were 2.6 ± 2.4° for inclination and 2.4 ± 2.4° for anteversion. We found no significant difference between overweight and non-overweight patients in both inclination and anteversion. The Spearman’s rank correlation coefficients were -0.04 for inclination and -0.11 for anteversion, showing no correlation between the extent of errors and BMI.Conclusions: In posterolateral THA, CT-navi can aid the precise placement of the acetabular cup irrespective of a patient’s BMI.Trial registration: This trial was retrospectively registered and approved by the institutional ethics committee of Teikyo University. The registration number is 17-190, and the date of approval was March 1, 2018. URL of trial registry is: https://www.teikyo-u.ac.jp/application/files/7015/8432/1341/2016_all_syounin_1.pdf

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.

scholarly journals A Novel Measurement Using Digital Radiography to Minimize Fluoroscopy in Total Hip Arthroplasty

2021 ◽  
Author(s):  
Andrew G. Yun ◽  
Marilena Qutami ◽  
Kory B. Dylan Pasko
Keyword(s):  
Femoral Head ◽  
Total Hip Arthroplasty ◽  
Radiation Exposure ◽  
Hip Arthroplasty ◽  
Fluoroscopy Time ◽  
Lesser Trochanter ◽  
Total Hip ◽  
Preoperative Templating ◽  
The Mean ◽  
Templating Technique

AbstractPreoperative templating for total hip arthroplasty (THA) is fraught with uncertainty. Specifically, the conventional measurement of the lesser trochanter to the center (LTC) of the femoral head used in preoperative planning is easily measured on a template but not measurable intraoperatively. The purpose of this study was to examine the utility of a novel measurement that is reproducible both on templating and in surgery as a more accurate and practical guide. We retrospectively reviewed 201 patients with a history of osteoarthritis who underwent primary THA. For preoperative templating, the distance from the top of the lesser trochanter to the equator (LeTE) of the femoral head was measured on a calibrated digital radiograph with a neutral pelvis. This measurement was used intraoperatively to guide the choice of the trial neck and head. As with any templating technique, the goal was to construct a stable, impingement-free THA with equivalent leg lengths and hip offset. In evaluating this novel templating technique, the primary outcomes measured were the number of trial reductions and the amount of fluoroscopic time, exposures, and radiation required to obtain a balanced THA reconstruction. Using the LeTE measurement, the mean number of trial reductions was 1.21, the mean number of intraoperative fluoroscopy images taken was 2.63, the mean dose of radiation exposure from fluoroscopy was 0.02 mGy, and the mean fluoroscopy time per procedure was 0.6 seconds. In hips templated with the conventional LTC prior to the LeTE, the mean fluoroscopy time was 0.9 seconds. There was a statistically significant difference in fluoroscopy time (p < 0.001). The LeTE is a reproducible measurement that transfers reliably from digital templating to surgery. This novel preoperative templating metric reduces the fluoroscopy time and consequent radiation exposure to the surgical team and may minimize the number of trial reductions.

scholarly journals Are the First and Second Hip in Staged Bilateral Total Hip Arthroplasty Equal? A Hospital Adverse Event and Perioperative Risk Comparison

2021 ◽  
Author(s):  
Jesus M. Villa ◽  
Tejbir S. Pannu ◽  
Carlos A. Higuera ◽  
Juan C. Suarez ◽  
Preetesh D. Patel ◽  
...  
Keyword(s):  
Total Hip Arthroplasty ◽  
Adverse Events ◽  
Hip Arthroplasty ◽  
Retrospective Chart Review ◽  
Consecutive Series ◽  
Level Of Evidence ◽  
Exact Test ◽  
Total Hip ◽  
Discharge Disposition ◽  
The Mean

AbstractHospital adverse events remain a significant issue; even “minor events” may lead to increased costs. However, to the best of our knowledge, no previous investigation has compared perioperative events between the first and second hip in staged bilateral total hip arthroplasty (THA). In the current study, we perform such a comparison. A retrospective chart review was performed on a consecutive series of 172 patients (344 hips) who underwent staged bilateral THAs performed by two surgeons at a single institution (2010–2016). Based on chronological order of the staged arthroplasties, two groups were set apart: first-staged THA and second-staged THA. Baseline-demographics, length of stay (LOS), discharge disposition, hospital adverse events, and hospital transfusions were compared between groups. Statistical analyses were performed using independent t-tests, Fisher's exact test, and/or Pearson's chi-squared test. The mean time between staged surgeries was 465 days. There were no significant differences in baseline demographics between first-staged THA and second-staged THA groups (patients were their own controls). The mean LOS was significantly longer in the first-staged THA group than in the second (2.2 vs. 1.8 days; p < 0.001). Discharge (proportion) to a facility other than home was noticeably higher in the first-staged THA group, although not statistically significant (11.0 vs. 7.6%; p = 0.354). The rate of hospital adverse events in the first-staged THA group was almost twice that of the second (37.2 vs. 20.3%; p = 0.001). There were no significant differences in transfusion rates. However, these were consistently better in the second-staged THA group. When compared with the first THA, our findings suggest overall shorter LOS and fewer hospital adverse events following the second. Level of Evidence Level III.

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.

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