scholarly journals Total Hip Arthroplasty After Failed Less Invasive Hip Preservation Surgery for Osteonecrosis of the Femoral Head: A Systematic Review and Meta-analysis

2021 ◽  
Author(s):  
liang mo ◽  
Jianxiong Li ◽  
Zhangzheng Wang ◽  
Fayi Huang ◽  
Pengfei Xin ◽  
...  
Keyword(s):  
Femoral Head ◽  
Total Hip Arthroplasty ◽  
Blood Loss ◽  
Hip Arthroplasty ◽  
Operative Time ◽  
Meta Analysis ◽  
Harris Hip Score ◽  
Cochrane Library ◽  
Intraoperative Blood Loss ◽  
Total Hip

Abstract BackgroundLess invasive hip-preserving surgery (LIHP) is an effective treatment in delaying total hip arthroplasty (THA) for young patients with osteonecrosis of the femoral head (ONFH). But the success rate of it was not as effective as expected and were significantly reduced with the advancement of the diseases stages. Therefore, it is essential to analysis the impact of LIHP on subsequent THA.MethodsThe search language was restricted to Chinese and English, and the references of included studies were also searched. Chinese databases including CNKI, Wan-Fang databases and VIP, and English databases including PubMed, Embase and Cochrane library were searched by the computer from the inception of each database to 23rd May 2021. The outcome indicators were extracted from the included literature and analyzed by Cochrane Collaboration Review Manager software (RevMan version 5.4). The quality of the studies was scored using the Newcastle-Ottawa scale (NOS).ResultsA total of nine articles met the inclusion and were included in this meta-analysis, two of them were published in Chinese and the remaining studies were published in English. Results showed that the LIHP group has longer operative time (SMD=17.31, 95%CI=6.29 to 28.32, p=0.002), more intraoperative blood loss (SMD=79.90, 95%CI=13.92 to 145.87, p=0.02) and higher rate of varus or valgus femoral stem (OR=4.17, 95%CI=1.18 to 14.71, p=0.03) compared to primary THA group. The risk of intraoperative fracture was higher in the prior LIHP THA group compared with primary THA group but the difference was not statistically significant (OR=5.88, 95%CI=0.93 to 37.05, p=0.06). While there was no significant difference in cup anteversion angle (SMD=-0.10, 95%CI=-0.61 to 0.41, p=0.70), cup inclination angle (SMD=0.58, 95%CI=-0.05 to 1.22, p=0.07), postoperative Harris Hip Score (HHS) (SMD=-0.01, 95%CI=-0.43 to 0.46, p=0.96) and survivorship (OR=1.38, 95%CI=0.34 to 5.55, p=0.65) between THA groups with and without prior LIHP.ConclusionAlthough the prior LIHP increased the difficulty of the conversion to THA with longer operative time, more intraoperative blood loss, and higher rate of intraoperative fracture, it does not detrimentally affect the clinical results of subsequent THA in the mid-term following-up.

scholarly journals Functional Outcome Of primary Total Hip Arthroplasty using Harris Hip Score in Arthritic Hip

2020 ◽  
Vol 2 (2) ◽  
pp. 4-10
Author(s):  
Suman Babu Marahatta ◽  
Dirgha Raj RC ◽  
Kapil Mani KC ◽  
Arun Sigdel
Keyword(s):  
Total Hip Arthroplasty ◽  
Blood Loss ◽  
Functional Outcome ◽  
Hip Arthroplasty ◽  
Operative Time ◽  
Harris Hip Score ◽  
Intraoperative Blood Loss ◽  
Total Hip ◽  
Primary Total Hip Arthroplasty

Introduction: Total hip arthroplasty (THA) is a well-established procedure for advanced arthritis of the hip joint. It significantly improves the quality of life by relieving pain and improving functional disability. The objective of this study was to evaluate the clinical and functional outcome of primary total hip arthroplasty using the Harris Hip Score. Method: Prospective study was conducted in Civil Service Hospital. Out of 145 THA performed from Jan 2014 to Dec 2018, the first 100 cases that fulfilled the inclusion criteria were analyzed.  Patient demographic and site, operative indication, and pre-operative Harris Hip Score was documented. Operative time, total intraoperative blood loss, and complications were noted. Patients were followed in 3 weeks, 6 weeks, 3 months, 6 months, and yearly. In each visit, clinical evaluation using Harris Hip Score and radiological evaluation was done and documented. The duration of follow up ranged from 12 months to 4.5 years. Results: Age varied from 21 to 75 years, 59% were male and 41% female, right side involvement was seen in 55% and left side in 45%. The major indication for surgery was avascular necrosis 46% and primary osteoarthritis in 24%. The average operative time was 65 minutes and the average intraoperative blood loss was 655 ml. Pre-operative Harris Hip Score ranged from 25 to 59 with a mean of 45.5. The mean Harris hip score in last follow up increased to 90.5 with a minimum of 76 and a maximum of 97. Our study found that 85% had excellent, 9% had good and 6% had fair results. Complications include 2% dislocation, 1% infection, 1% greater trochanter avulsion and 1% screw irritation. Conclusion: Primary THA is a safe and effective procedure. It improves pain and function hence improving the activity of daily living and has fewer complications.

scholarly journals Vitamin E-Enhanced Liners in Primary Total Hip Arthroplasty: A Systematic Review and Meta-Analysis

2021 ◽  
Vol 2021 ◽  
pp. 1-10
Author(s):  
Qian-Yue Cheng ◽  
Bin-Fei Zhang ◽  
Peng-Fei Wen ◽  
Jun Wang ◽  
Lin-Jie Hao ◽  
...  
Keyword(s):  
Vitamin E ◽  
Femoral Head ◽  
Total Hip Arthroplasty ◽  
Hip Arthroplasty ◽  
Revision Rate ◽  
Meta Analysis ◽  
Harris Hip Score ◽  
Head Penetration ◽  
Total Hip ◽  
Femoral Head Penetration

Objective. Adding vitamin E to highly cross-linked polyethylene liners is frequently performed in clinical practice, aiming at reducing liner wear, increasing liner survival, and delaying revision surgery. This study is aimed at evaluating the revision rate, total femoral head penetration, and postoperative clinical function of highly cross-linked polyethylene liners with and without vitamin E in total hip arthroplasty. Methods. We conducted a systematic literature search to identify the use of highly cross-linked vitamin E liners compared to other liners in patients who received total hip arthroplasty (THA) before April 2021. The study quality assessment and data collection were conducted by two independent reviewers. Studies were artificially grouped, and vitamin E-enhanced liners (VE-PE) were compared with vitamin E-free liners (non-VE-PE). Analyses were executed using Review Manager version 5.4.1. Results. From the preliminary screening of 568 studies, fourteen studies met the research criteria. Compared to non-VE-PE, using VE-PE reduced the all-cause revision rate ( odds   ratio = 0.54 ; 95% confidence interval (CI) 0.40, 0.73; P < 0.0001 ). The total femoral head penetration of the VE-PE was lower than that of the non-VE-PE ( mean   difference = − 0.10 ; 95% CI -0.17, -0.03; P = 0.007 ). However, there was no difference in clinical function, including the Harris Hip Score and EuroQol Five-Dimension Questionnaire scores. Conclusion. Compared to the liners without vitamin E, the addition of vitamin E to liners could reduce the all-cause revision rate by approximately 46% in the short-term follow-up. In addition, even though addition of vitamin E could also slow down femoral head penetration, there is no contribution to clinical function.

scholarly journals Assessment of the Learning Curve of Supercapsular Percutaneously Assisted Total Hip Arthroplasty in an Asian Population

2020 ◽  
Vol 2020 ◽  
pp. 1-7
Author(s):  
Pengfei Lei ◽  
Zhan Liao ◽  
Jiang Peng ◽  
Guang Li ◽  
Qian Zhou ◽  
...  
Keyword(s):  
Total Hip Arthroplasty ◽  
Blood Loss ◽  
Hip Arthroplasty ◽  
Learning Curves ◽  
Harris Hip Score ◽  
Intraoperative Blood Loss ◽  
Total Hip ◽  
Significant Difference ◽  
Group A ◽  
Group B

The supercapsular percutaneously assisted total hip (SuperPATH) approach is a microinvasive approach that was developed to minimize surgical disruption of soft tissue during routine total hip arthroplasty (THA). This study was aimed at assessing early outcomes and learning curves of the SuperPATH approach in one Chinese hospital’s experience. Early outcomes of the first consecutive 78 SuperPATH cases (80 hips) performed by the same surgeon were evaluated. The patients were divided into 4 groups according to the surgical order. The incision, intraoperative blood loss, hospital stay, Harris hip score, and complication occurrence in each group were evaluated. Learning curves were assessed using operative time and intraoperative blood loss as surrogates. The operation time and intraoperative blood loss of groups A and B were more than those of groups C and D, and the difference was statistically significant (P<0.05); however, there was no statistically significant difference between the two groups (group A vs. group B, P=0.426; group A vs. group B, P=0.426). There was no statistically significant difference in terms of incision length and hospital stay, and Harris hip score at the last follow-up was increased with statistically significant difference when compared with that preoperatively among the 4 groups. One case of periprosthetic fracture occurred in group A. No other complication, such as joint dislocation, sciatic nerve injury, prosthesis loosening, periprosthetic infection, and deep vein thromboembolism, occurred in the 4 groups. In summary, for surgeons who are familiar with the standard posterolateral approach, they could achieve more familiarity with SuperPATH after 40 cases of surgery.

scholarly journals Assessment of the Learning Curve of Supercapsular Percutaneously-assisted Total Hip Arthroplasty in an Asian Population

2020 ◽  
Author(s):  
Pengfei Lei ◽  
Zhan Liao ◽  
Jiang Peng ◽  
Guang Li ◽  
Qian Zhou ◽  
...  
Keyword(s):  
Total Hip Arthroplasty ◽  
Blood Loss ◽  
Hip Arthroplasty ◽  
Learning Curves ◽  
Harris Hip Score ◽  
Intraoperative Blood Loss ◽  
Total Hip ◽  
Significant Difference ◽  
Group A ◽  
Group B

Abstract Background: The supercapsularpercutaneously-assisted total hip (SuperPATH) approach is a micro-invasive approach that was developed to minimize surgical disruption of soft-tissue during routine total hip arthroplasty (THA). This study aimed to assess early outcomes and learning curves of the SuperPATHapproachin one Chinese hospital’s experience.Methods: Early outcomes of the first consecutive 78SuperPATH cases (80 hips) performed by same surgeon were evaluated. The patients were divided into 4 groups according to the surgical order. The incision, intraoperative blood loss, hospital stay, Harris hip score and complications occurrence in each group were evaluated. Learning curves were assessed using operative time and intraoperative blood loss as surrogates.Results:The operation time and intraoperative blood loss of group A and B was more than that of group C and D, and the difference was statistically significant (P<0.05), however there was no statistically significant difference between the two groups (group A vs. group B, P=0.426; group A vs. group B, P=0.426).There was no statistically significant difference in terms of incision length and hospital stay and Harris hip score at the last follow-up was increased with statistically significant difference when compared with that of preoperative among the 4 groups. One case of periprosthetic fracture occurred in group A. No other complication, such as joint dislocation, sciatic nerve injury, prosthesis loosening, periprosthetic infection and deep vein thromboembolism, occurred in 4 groups.Conclusion:In summary, for surgeons who familiar with the standard posterolateral approach, they could achieve more familiar with SuperPATH after 40 case of surgery.

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.

scholarly journals Is large femoral head a better option than a conventional femoral head primary total hip arthroplasty in Indian population

2021 ◽  
Vol 7 (2) ◽  
pp. 295
Author(s):  
Hiranya Kumar Seenappa ◽  
Karthik Mittemari Naraynamurthy ◽  
Rasiq Rashid ◽  
Shivraj Nadagouda ◽  
Vamshhikrishna Chand
Keyword(s):  
Femoral Head ◽  
Total Hip Arthroplasty ◽  
Hip Arthroplasty ◽  
Harris Hip Score ◽  
Age Group ◽  
Neck Of Femur ◽  
Large Femoral Head ◽  
Total Hip ◽  
Modified Harris Hip Score ◽  
Primary Total Hip Arthroplasty

<p class="abstract"><strong>Background: </strong>Study aimed to assess and compare the functional outcome in patients underwent the large femoral head THA and conventional femoral head THA.</p><p class="abstract"><strong>Methods:</strong> It is a comparative prospective cross sectional study conducted among the patients undergoing primary total hip arthroplasty through postero-lateral approach at department of orthopaedics Vydehi institute of medical sciences, Bengaluru during the period of July 2017 to July 2019. Patients aged between 18-80years of both genders undergoing Primary THA for Osteoarthritis (OA), Rheumatoid Arthritis (RA), Ankylosing Spondylitis (AS), Post traumatic arthritis, Avascular necrosis (AVN), Acute fracture neck of femur, Non-union fracture neck of femur (NOF). Patients undergoing primary total hip arthroplasty in Intertrochanteric fracture, Acetabular fracture and patients undergoing Revision Hip Arthroplasty were excluded from study. Patients were grouped as the ones treated with large femoral head THA and conventional femoral head THA.</p><p class="abstract"><strong>Results: </strong>This series consisted of 36 patients with 44 diseased hips treated with primary total hip arthroplasty (THA). Out of 36 patients, 9 patients (25%) belonged to an age group of below 30 years of age, 10 patients (27.8%) belonged to the age group between 31-40 years of age, 8 patients (22.2%) belonged to the age group 41-51 years of age and 9 patients (25%) belonged to age group of 51-60 years of age. The mean level of Modified Harris Hip score and improvement of movements in all planes was found to be statistically significantly in the patients treated with large femoral head primary THA compared to those treated with conventional method. (p&lt;0.001)</p><p class="abstract"><strong>Conclusions: </strong>Study has shown improved functional outcome (Modified harris hip score) and range of movement in the patients treated with the large femoral head primary THA as compared to those treated with a conventional femoral head.</p>

The effect of bearing surface on risk of periprosthetic joint infection in total hip arthroplasty

2018 ◽  
Vol 100-B (2) ◽  
pp. 134-142 ◽  
Author(s):  
A. T. Hexter ◽  
S. M. Hislop ◽  
G. W. Blunn ◽  
A. D. Liddle
Keyword(s):  
Total Hip Arthroplasty ◽  
Hip Arthroplasty ◽  
Periprosthetic Joint Infection ◽  
Observational Studies ◽  
Meta Analysis ◽  
Joint Infection ◽  
Risk Of Bias ◽  
Cochrane Library ◽  
Bearing Surface ◽  
Total Hip

Aims Periprosthetic joint infection (PJI) is a serious complication of total hip arthroplasty (THA). Different bearing surface materials have different surface properties and it has been suggested that the choice of bearing surface may influence the risk of PJI after THA. The objective of this meta-analysis was to compare the rate of PJI between metal-on-polyethylene (MoP), ceramic-on-polyethylene (CoP), and ceramic-on-ceramic (CoC) bearings. Patients and Methods Electronic databases (Medline, Embase, Cochrane library, Web of Science, and Cumulative Index of Nursing and Allied Health Literature) were searched for comparative randomized and observational studies that reported the incidence of PJI for different bearing surfaces. Two investigators independently reviewed studies for eligibility, evaluated risk of bias, and performed data extraction. Meta-analysis was performed using the Mantel–Haenzel method and random-effects model in accordance with methods of the Cochrane group. Results Our search strategy revealed 2272 studies, of which 17 met the inclusion criteria and were analyzed. These comprised 11 randomized controlled trials and six observational studies. The overall quality of included studies was high but the observational studies were at high risk of bias due to inadequate adjustment for confounding factors. The overall cumulative incidence of PJI across all studies was 0.78% (1514/193 378). For each bearing combination, the overall incidence was as follows: MoP 0.85% (1353/158 430); CoP 0.38% (67/17 489); and CoC 0.53% (94/17 459). The meta-analysis showed no significant difference between the three bearing combinations in terms of risk of PJI. Conclusion On the basis of the clinical studies available, there is no evidence that bearing choice influences the risk of PJI. Future research, including basic science studies and large, adequately controlled registry studies, may be helpful in determining whether implant materials play a role in determining the risk of PJI following arthroplasty surgery. Cite this article: Bone Joint J 2018;100-B:134–42.

Outcomes of total hip arthroplasty using dualmobility cups for femoral neck fractures: a systematic review and meta-analysis

2020 ◽  
pp. 112070002092665
Author(s):  
Syed H Mufarrih ◽  
Nada Q Qureshi ◽  
Bassam Masri ◽  
Shahryar Noordin
Keyword(s):  
Systematic Review ◽  
Total Hip Arthroplasty ◽  
Femoral Neck ◽  
Hip Arthroplasty ◽  
Meta Analysis ◽  
Mortality Rates ◽  
Femoral Neck Fractures ◽  
Cochrane Library ◽  
Total Hip ◽  
The Mean

Objectives: Femoral neck fractures (FNFs), with up to 15% mortality, are prominent orthopaedic emergencies. After treating FNFs, dislocation is another challenge increasing morbidity, mortality and treatment costs substantially. The emerging dual-mobility cup (DMC) may decrease dislocation rates following total hip arthroplasty (THA) for FNFs. We performed a systematic review of literature reporting dislocation and mortality rates with DMC-THA for the treatment of FNFs. Methods: 2 authors independently searched PubMed (MEDLINE), Google Scholar and Cochrane library for studies reporting dislocation and mortality rates for FNFs treated with DMC-THA since inception up to January 2019. Data on outcomes of interest was extracted from all studies and assessed for eligibility for a meta-analysis. Results: Out of 522 search results, 18 studies were included in the systematic review and 4 in the meta-analysis. The mean rate of dislocation following DMC-THA for FNFs was found to be 1.87% ± 2.11, with a 1-year mortality rate of 14.0% ± 10.55. Results of meta-analysis showed that dislocation and 1-year postoperative mortality rates were significantly lower for DMC-THA with a risk ratio 0.31 (95% CI, 0.16–0.59; I2 = 0%, p  = 0.0003) and 0.55 (0.40, 0.77; I2 = 0%, p = 0.003) respectively when compared to biploar hemiathroplasty (BHA). Conclusions: The mean dislocation and mortality rates in DMC-THA are lower than previously reported rates for THA with single cup and comparable to unipolar and bipolar hemiarthroplasty. Further research involving randomised control trials to assess differences in outcomes, longevity and cost-effectiveness needs to be conducted to make recommendations for the use of DMC in treating FNFs.

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