scholarly journals Intracavitary and Extracavitary Iliac Extended Fixation Using Porous Metal Augments for Paprosky Type 3 Acetabular Defects in Revision Total Hip Arthroplasty: A Minimum 2 Years Follow-up

2019 ◽  
Author(s):  
Hao Tang ◽  
Yixin Zhou ◽  
Zhuyi Ma ◽  
Yong Huang ◽  
Shengjie Guo
Keyword(s):  
Total Hip Arthroplasty ◽  
Hip Arthroplasty ◽  
Porous Metal ◽  
Harris Hip Score ◽  
Revision Total Hip Arthroplasty ◽  
Total Hip ◽  
Fixation Group ◽  
Acetabular Defects ◽  
Type 3

Abstract Background: We proposed a new concept of “iliac extended fixation” in revision total hip arthroplasty (THA) as fixation extending superiorly 2 cm beyond the original acetabular rim with porous metal augments, which was further classified into intracavitary and extracavitary fixation. This study reports the minimum 2 years outcome of the iliac extended fixation technique in patients with Paprosky type 3 acetabular defects. Methods: Thirty two revision THA patients were retrospectively reviewed who underwent reconstruction with the concept of iliac extended fixation from 2014 to 2016 in our hospital. Patients were assessed using the Harris Hip Score (HHS) and the Western Ontario and McMaster Universities Osteoarthritis Index score (WOMAC). In addition, radiographs were assessed and patient reported satisfaction was collected. Results: At an average follow-up of 40 months (range 25 – 64 months), the postoperative HHS and WOMAC scores were significantly improved at the last follow-up (p < 0.001). The postoperative horizontal and vertical locations of the COR were significantly improved from the preoperative measurements (p < 0.05). Two (6.3 %) patients were dissatisfied with the outcome. The extracavitary iliac extended fixation group had significantly more horizontal screws fixation (4.6 ± 25.7° vs 41.9 ± 37.8°, p < 0.001) and higher rate of osteointegration in zone 1A (91.7% vs 50.0%, p = 0.023) than the intracavitary iliac extended fixation group. Conclusions: Intracavitary and extracavitary iliac extended fixation with porous metal augments and cementless cups are effective in reconstructing severe superior acetabular bone defects, with promising short-term clinical and radiographic outcome.

scholarly journals Intracavitary and Extracavitary Iliac Extended Fixation Using Porous Metal Augments for Paprosky Type 3 Acetabular Defects in Revision Total Hip Arthroplasty: A Minimum 2 Years Follow-up

2019 ◽  
Author(s):  
Hao Tang ◽  
Yixin Zhou ◽  
Zhuyi Ma ◽  
Yong Huang ◽  
Shengjie Guo
Keyword(s):  
Total Hip Arthroplasty ◽  
Hip Arthroplasty ◽  
Porous Metal ◽  
Harris Hip Score ◽  
Revision Total Hip Arthroplasty ◽  
Total Hip ◽  
Fixation Group ◽  
Acetabular Defects ◽  
Type 3

Abstract Background: We proposed a new concept of “iliac extended fixation” in revision total hip arthroplasty (THA) as fixation extending superiorly 2 cm beyond the original acetabular rim with porous metal augments, which was further classified into intracavitary and extracavitary fixation. This study reports the minimum 2 years outcome of the iliac extended fixation technique in patients with Paprosky type 3 acetabular defects. Methods: Thirty two revision THA patients were retrospectively reviewed who underwent reconstruction with the concept of iliac extended fixation from 2014 to 2016 in our hospital. Patients were assessed using the Harris Hip Score (HHS) and the Western Ontario and McMaster Universities Osteoarthritis Index score (WOMAC). In addition, radiographs were assessed and patient reported satisfaction was collected. Results: At an average follow-up of 40 months (range 25 – 64 months), the postoperative HHS and WOMAC scores were significantly improved at the last follow-up (p < 0.001). The postoperative horizontal and vertical locations of the COR were significantly improved from the preoperative measurements (p < 0.05). Two (6.3 %) patients were dissatisfied with the outcome. The extracavitary iliac extended fixation group had significantly more horizontal screws fixation (4.6 ± 25.7° vs 41.9 ± 37.8°, p < 0.001) and higher rate of osteointegration in zone 1A (91.7% vs 50.0%, p = 0.023) than the intracavitary iliac extended fixation group. Conclusions: Intracavitary and extracavitary iliac extended fixation with porous metal augments and cementless cups are effective in reconstructing severe superior acetabular bone defects, with promising short-term clinical and radiographic outcome.

scholarly journals Structural and Morselized Allografting Combined with a Cementless Cup for Acetabular Defects in Revision Total Hip Arthroplasty: A 4- to 14-Year Follow-Up

2018 ◽  
Vol 2018 ◽  
pp. 1-7 ◽  
Author(s):  
Hou-Tsung Chen ◽  
Cheng-Ta Wu ◽  
Tsan-Wen Huang ◽  
Hsin-Nung Shih ◽  
Jun-Wen Wang ◽  
...  
Keyword(s):  
Total Hip Arthroplasty ◽  
Hip Arthroplasty ◽  
Type Ii ◽  
Revision Total Hip Arthroplasty ◽  
Total Hip ◽  
Press Fit ◽  
Cementless Cup ◽  
Revision Tha ◽  
Acetabular Defects

Using morselized and structural allograft to restore bone stock for massive acetabular bone defect in revision total hip arthroplasty (THA) is an appealing procedure. However, concerns about inability to achieve long-term stability following allograft resorption remained. From 2003 to 2012, 59 hips in 58 patients undergoing revision THA for Paprosky type II or III acetabular defects were retrospectively reviewed. The acetabular defects were managed with deep-frozen morselized and structural allografts, and a press-fit cementless cup along with supplementary screws. Clinical outcomes and radiographic results were analyzed with a mean follow-up of 8.7 years. The clinical successful rate was 100% for hips with Paprosky type II defect, 95.2% for IIIA defect, and 92.8% for IIIB defect. Three hips with type III defect failed at 4, 7, and 9 years, respectively. Harris Hip Score improved significantly from 60.1 preoperatively to 91.3 at the latest follow-up. All hips with good clinical results showed trabecular bridging in the allograft-host bone interface. Deep-frozen structural and morselized allograft in combination with a press-fit cementless cup represented a viable option to reconstruct acetabular defects in revision THA.

scholarly journals Midterm outcome of fourth-generation ceramic-on-ceramic bearing surfaces in revision total hip arthroplasty

2018 ◽  
Vol 26 (2) ◽  
pp. 230949901878391 ◽  
Author(s):  
Jun-Dong Chang ◽  
In-Sung Kim ◽  
Sameer Ajit Mansukhani ◽  
Vishwas Sharma ◽  
Sang-Soo Lee ◽  
...  
Keyword(s):  
Total Hip Arthroplasty ◽  
Hip Arthroplasty ◽  
Fourth Generation ◽  
Harris Hip Score ◽  
Revision Total Hip Arthroplasty ◽  
Acetabular Cup ◽  
Total Hip ◽  
Revision Tha ◽  
Ceramic On Ceramic

Purpose: The purpose of this study is to evaluate the clinical and radiologic outcomes after revision total hip arthroplasty (THA) using fourth-generation ceramic-on-ceramic (CoC) bearing surfaces. Methods: A total of 52 revision THAs (28 men and 19 women) using the fourth-generation CoC bearing surfaces were retrospectively evaluated. Both acetabular cup and femoral stem were revised in all cases. The mean follow-up period was 7.3 years (range, 4.0–9.9 years). The clinical results with Harris hip score (HHS), Western Ontario McMaster Osteoarthritis Index (WOMAC), and radiologic outcomes were evaluated. Results: At the final follow-up examination, the average HHS was 90.4 (range, 67–100). The average WOMAC pain and physical function score were 2.8 (range, 0–12) and 16.4 (range, 0–42), respectively. Complications were observed in 10 hips (19.2%). However, there were no bearing surface-related complications, and no cases of dislocation and squeaking. Retroacetabular pelvic osteolysis without cup loosening was observed in one hip at the final follow-up. However, no hip showed radiographic signs of cup loosening, vertical or horizontal acetabular cup migrations, and changes of inclinations during the follow-up period. Conclusion: Our data showed that clinical and radiologic outcomes after revision THA using fourth-generation CoC bearing were favorable. Hence, revision THA with the use of CoC bearing surfaces can be preferentially considered. Further studies with long-term follow-up data are warranted.

scholarly journals High survivorship of highly cross-linked polyethylene in revision Total hip Arthroplasty: a minimum 10-year follow-up study

Arthroplasty ◽  
2019 ◽  
Vol 1 (1) ◽  
Author(s):  
Seung-Jae Lim ◽  
Ingwon Yeo ◽  
Chan-Woo Park ◽  
Kyung-Jae Lee ◽  
Byung-Woo Min ◽  
...  
Keyword(s):  
Total Hip Arthroplasty ◽  
Hip Arthroplasty ◽  
Polyethylene Liner ◽  
Harris Hip Score ◽  
Revision Total Hip Arthroplasty ◽  
Revision Thas ◽  
Total Hip ◽  
The Mean

Abstract Purpose Highly cross-linked polyethylene has been introduced to decrease osteolysis secondary to polyethylene wear debris generation. However, few long-term data on revision total hip arthroplasty (THA) using highly cross-linked polyethylene liners are available. The objective of this study was to determine long-term outcomes of a highly cross-linked polyethylene liner in revision THA. Materials & methods We evaluated 63 revision THAs performed in 63 patients using a highly cross-linked polyethylene liner between April 2000 and February 2005. Of these, nine died and four were lost to follow-up. Thus, the final study cohort consisted of 50 patients (50 hips), including 26 males and 24 females with a mean age of 53 years (range, 27–75 years). Mean follow-up was 11 years (range, 10–14 years). Results The mean Harris hip score improved from 44 points preoperatively to 85 points at the final follow-up. No radiographic evidence of osteolysis was found in any hip. The mean rate of polyethylene liner wear was 0.029 mm/year (range, 0.003 to 0.098 mm/year). A total of 5 hips (10%) required re-revision arthroplasty, including one cup loosening, one recurrent dislocation, and three deep infections. Kaplan-Meier survivorship with an end point of re-revision for any reason was 91.1% and for aseptic cup loosening was 97.9% at 11 years. Conclusion At a minimum of 10 years, the highly cross-linked polyethylene liners showed excellent clinical performance and implant survivorship, and were not associated with osteolysis in our patients with revision THAs.

A prospective randomised comparison of earlier function after total hip arthroplasty with a mini posterior approach or supercapsular percutaneously-assisted total hip approach: a gait analysis study

2021 ◽  
pp. 112070002110184
Author(s):  
Andrey A Korytkin ◽  
Younes M El Moudni ◽  
Yana S Novikova ◽  
Kirill A Kovaldov ◽  
Ekaterina A Morozova
Keyword(s):  
Total Hip Arthroplasty ◽  
Gait Analysis ◽  
Hip Arthroplasty ◽  
Posterior Approach ◽  
Gait Velocity ◽  
Harris Hip Score ◽  
Kinematic Parameters ◽  
Gait Patterns ◽  
Total Hip

Background: The supercapsular percutaneously-assisted total hip (SuperPATH) approach is a muscle sparing surgical technique for total hip arthroplasty (THA). The literature reports good clinical and functional results of the SuperPATH technique in the short term. We aimed to compare early outcomes and gait analysis of THA using the mini posterior approach (MPA) and supercapsular percutaneously-assisted total hip (SuperPATH) approach. Methods: 44 patients who underwent THA, were randomly allocated to either MPA or SuperPATH. The data were then collected prospectively (preoperatively and postoperatively at 6 weeks). Plain anteroposterior radiographs of the pelvis and instrumental gait analysis were obtained. The visual analogue scale (VAS), Harris Hip Score (HHS) and Hip disability and Osteoarthritis Outcome Scores (HOOS) were used to assess functional and clinical outcomes. Results: No significant difference was found in patients’ surgical outcomes. Patients in the SuperPATH group had less pain according to the VAS score at follow-up than the MPA group ( p < 0.01). There was also a significant improvement in HHS and HOOS scores for all patients ( p < 0.001) with the SuperPATH group showing superior changes. The comparison of mean differences in gait velocity between preoperative and 6 weeks postoperative result, revealed improvement in the SuperPATH group over the MPA group ( p = 0.06). Limping was more persistent in the MPA group. Kinematic parameters demonstrated improved hip joint excursion slightly higher in the MPA group. There was no significant improvement in kinetic and kinematic parameters at different walking moments for all patients at 6 weeks compared to preoperative gait patterns. Conclusions: SuperPATH and MPA both show excellent results. This study reveals that the SuperPATH technique was associated with lower postoperative pain levels, and higher physical function and quality of life. Improved functional outcomes allowed earlier postoperative rehabilitation and faster recovery. Specific improvement in gait patterns were identified with nonsignificant differences between the 2 approaches at 6 weeks follow-up.

Excellent Clinical and Radiographic Outcomes with Direct Superior Total Hip Arthroplasty with a Minimum of Two-Year Follow Up

2021 ◽  
Author(s):  
Moritz Sharabianlou ◽  
Prerna Arora ◽  
Derek Amanatullah
Keyword(s):  
Total Hip Arthroplasty ◽  
Functional Recovery ◽  
Hip Arthroplasty ◽  
Case Series ◽  
Harris Hip Score ◽  
Timed Up And Go ◽  
Total Hip ◽  
Radiologic Evaluation ◽  
Superior Approach

This study aims to establish the midterm safety and performance for the direct superior approach to minimally invasive surgery total hip arthroplasty (MIS-THA). We used a unicentric, single-surgeon, retrospective, consecutive case series analysis of the first 40 patients who received primary unilateral direct superior MIS-THA. Special attention was given to functional recovery by measuring Harris Hip Score (HHS) and timed-up-and-go (TUG) with a mean follow up of 2.2 ± 0.4 years. A radiologic evaluation was performed. HHS and TUG improved significantly at three months and one year (p < 0.001). All components were placed within the Lewinnek safe zone with no change position or signs of loosening at two years. With a minimum of two years of follow up, the direct superior approach appears to be safe without any obvious or consistent postoperative complications—clinically or radiographically—with excellent functional recovery. Additionally, our subgroup analysis supported no late learning curve effect.

Revision Total Hip Arthroplasty Using Acetabular Reinforcement Ring - Midterm Follow-up Result -

2011 ◽  
Vol 23 (3) ◽  
pp. 213
Author(s):  
Sang Joon Kwak ◽  
Young Soo Chun ◽  
Kee Hyung Rhyu ◽  
Dong Bum Huh ◽  
Myung Chul Yoo ◽  
...  
Keyword(s):  
Total Hip Arthroplasty ◽  
Hip Arthroplasty ◽  
Revision Total Hip Arthroplasty ◽  
Total Hip ◽  
Reinforcement Ring ◽  
Acetabular Reinforcement Ring

scholarly journals A 10-Year Follow-Up of Two-Incision and Modified Watson-Jones Total Hip Arthroplasty in Patients with Osteonecrosis of the Femoral Head

2017 ◽  
Vol 2017 ◽  
pp. 1-7
Author(s):  
Shih-Jie Lin ◽  
Tsan-Wen Huang ◽  
Po-Chun Lin ◽  
Feng-Chih Kuo ◽  
Kuo-Ti Peng ◽  
...  
Keyword(s):  
Femoral Head ◽  
Total Hip Arthroplasty ◽  
Hip Arthroplasty ◽  
Functional Outcomes ◽  
Large Scale ◽  
Operation Time ◽  
Harris Hip Score ◽  
Total Hip ◽  
Radiographic Parameters

Long-term data and information indicating whether minimally invasive surgery (MIS) approaches are safe and effective with total hip arthroplasty (THA) are lacking. Between 2004 and 2006, 75 patients with alcohol-related osteonecrosis of the femoral head (ONFH) who underwent 75 THAs with the two-incision approach were studied. The medical records, radiographic parameters, and functional outcomes were collected prospectively. All data were compared with those for matched patients who underwent a modified Watson-Jones (WJ) approach. THA using the two-incision approach was associated with longer operation time, more blood loss, more lateral femoral cutaneous nerve injury, and more periprosthetic femoral fractures (p<0.05for all four) than the modified WJ approach. The Harris Hip Score (HHS) and Western Ontario and McMaster University Osteoarthritis Index (WOMAC) increased significantly from the period preoperatively to 6 weeks postoperatively and thereafter up to the last follow-up in both groups. However, there were no significant differences in terms of radiographic parameters and functional outcomes between the two groups throughout the study period. Both the two-incision and the modified WJ approach provided satisfactory results and survival rates at a mean follow-up of 10.8 years. A prospective, randomized, large-scale cohort study is still warranted for evidence-based recommendations.

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