scholarly journals Hip Arthroplasty in Two Patients With Congenital Pubic Diastasis and Severe Dysplastic Hips

Author(s):  
Christian Götze ◽  
Christian-Dominik Peterlein

Abstract Background: Congenital pubic diastasis in combination with a dysplastic situation of the hip is a rather rare malformation. Two cases of young female patients prompted us to report the results of total hip arthroplasty (THA) due to secondary osteoarthritis. Our treatment strategy and short- as well in one case long-term results are described in regard to the rather rare literature. Methods: We describe a case of a 39 -year-old female patient with a pubic diastase and severe hip dysplasia on both sides treated with a primary total hip arthroplasty (THA). High overweight of more than 275 pounds, diabetes mellitus and multiple prior operation aggravate the operative procedure. Main problem based on the fixation strategy of the cup in this retroverted acetabulum presented in CT-analysis with elevated rotation center due to the dysplastic situation. In the other case a 52-year old female lady presented dysplastic osteoarthritis of the left hip. Results: In the first case both hips were treated with a cementless osteoconductive cup (TM, Zimmer-Biomet) and a cementless stem (Alloclassic SL, Zimmer-Biomet). A 10° elevated rim liner of the cup was used in order to avoid dislocation. Both hips were 9 and 8.5 years postoperative radiologically still in place without any signs of loosening. There was an improvement of quality of life documentated with an amelioration of the Harris Hip Score from preoperative 14 points to 68 points. In the second case a conventional hemispherical cup (Alloclassic-Allofit, Zimmer-Biomet) was placed in the retroverted acetabulum combined with a cementless stem (Fitmore A, Zimmer-Biomet) attached at the metaphseal proximal femur bone. 6 months postoperative, the patient was free of symptoms with an increased quality of life. Conclusion: Sufficient long-term results highlight the possiblity of total hip arthroplasty of patients with osteoarthritis even in congenital pubic diastasis. Retroversion of the dysplastic acetabulum, rotation of the posterior part of the pelvis and instability of the pelvic ring in these circumstances might be the most feared aspects in the treatment of these rare cases.

2021 ◽  
Vol 10 (4) ◽  
pp. 621
Author(s):  
Franziska Leiss ◽  
Julia Sabrina Götz ◽  
Günther Maderbacher ◽  
Matthias Meyer ◽  
Jan Reinhard ◽  
...  

Background: Total hip arthroplasty combined with the concept of enhanced recovery is of continued worldwide interest, as it is reported to improve early functional outcome and treatment quality without increasing complications. The aim of the study was to investigate functional outcome and quality of life 4 weeks and 12 months after cementless total hip arthroplasty in combination with an enhanced recovery concept. Methods: A total of 109 patients underwent primary cementless Total Hip Arthroplasty (THA) in an enhanced recovery concept and were retrospectively analyzed. After 4 weeks and 12 months, clinical examination was analyzed regarding function, pain and satisfaction; results were evaluated using Harris Hip score, Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), EQ-5D-5L, EQ-VAS and subjective patient-related outcome measures (PROMs). Preoperatively, HADS (Hospital Anxiety and Depression Scale) was collected. A correlation analysis of age, American Society of Anesthesiologists (ASA), HADS and comorbidities (diabetes mellitus, art. hypertension, cardiovascular disease) with WOMAC, Harris Hip score (HHS) and EQ-5D was performed. Results: Patients showed a significant improvement in Harris Hip score 4 weeks and 12 months postoperatively (p < 0.001). WOMAC total score, subscale pain, subscale stiffness and subscale function improved significantly from preoperative to 12 months postoperative (p < 0.001). EQ-5D showed a significant improvement preoperative to postoperative (p < 0.001). The influence of anxiety or depression (HADS-A or HADS-D) on functional outcome could not be determined. There was a high patient satisfaction postoperatively, and almost 100% of patients would choose enhanced recovery surgery again. Conclusion: Cementless THA with the concept of enhanced recovery improves early clinical function and quality of life. PROMs showed a continuous improvement over a follow-up of 12 months after surgery. PROMs can help patients and surgeons to modify expectations and improve patient satisfaction.


2017 ◽  
Vol 19 (5) ◽  
pp. 0-0 ◽  
Author(s):  
Anna Świtoń ◽  
Ewa Wodka-Natkaniec ◽  
Łukasz Niedźwiedzki ◽  
Tadeusz Gaździk ◽  
Tadeusz Niedźwiedzki

Background. Coxarthrosis is a chronic musculoskeletal condition that causes severe pain and considerable limi­tation of the patient’s motor performance. Total hip arthroplasty is one of the most common and effective methods used in the treatment of advanced degenerative changes. The aim of the present study was to evaluate the activity and quality of life of patients after unilateral total hip arthroplasty. Material and methods. The study was conducted in a group of 189 patients who had undergone unilateral total hip arthroplasty. Goniometry was used to determine the range of motion of both hip joints. Patients’ physical ability and pain severity were assessed based on the Harris Hip Score (HHS) questionnaire. Results. The examination of the range of motion in the lower extremities revealed statistically significant diffe­rences in flexion (p<0.01), abduction (p=<0.01), adduction (p<0.01) and external rotation (p<0.01) between the operated and the healthy extremity. The greatest limitation of motion was demonstrated for external rotation (<14°). Approximately 14% of the patients were not able to perform this motion in their healthy hip joint, while 17.5% of them could not do so in the affected hip joint. Analysis of HHS results (mean = 79 pts) revealed that more than 50% of the patients described their functional ability and quality of life as good and excellent. It was demonstrated that 54% of patients did not suffer from pain, whereas minor or mild pain was noted in 35%. Conclusions: 1. A subjective clinical assessment of patients after total hip arthroplasty showed that their quality of life had improved. 2. It is necessary to perform physiotherapy after total hip arthroplasty, on both the operated and healthy side. 3. Exacerbation of pain and impaired activity in patients after total hip arthroplasty were associated with the female sex to a considerable extent.


2011 ◽  
Vol 12 (1) ◽  
Author(s):  
Massimo Mariconda ◽  
Olimpio Galasso ◽  
Giovan Giuseppe Costa ◽  
Pasquale Recano ◽  
Simone Cerbasi

2020 ◽  
Vol 37 (1) ◽  
Author(s):  
Engin Çarkçı ◽  
Ayse Esin Polat ◽  
Yusuf Öztürkmen ◽  
Tolga Tüzüner

Objective: In this study we aimed to investigate the long-term clinical and radiological results, revision rates and causes, and the rate of implant survival in total hip arthroplasty performed using CLS® expansion cup and Spotorno® cementless femoral stem. Methods: Clinical results of total hip arthroplasty performed on 131 hips of 114 patients in Istanbul Training and Research Hospital between 1993 and 2003 were retrospectively evaluated according to the Harris Hip Score. Revision rates were determined and implant survival rates were identified using the Kaplan-Meier estimator. Results: Of the patients, 39 were males and 75 were females. The average age of the patients at surgery was 48.7±11.3 years. Patients were followed up for a mean period of 13.9±2.4 years. The mean Harris Hip Score was 34.35±6.09 preoperatively and 88.20±7.11 at the final follow-up (p<0.001). The Kaplan-Meier survivorship estimate for the cup at 13.9 years, taking revision for any reason as the end point was 95.6% (95% CI), while the 15th and 17th year survival rates were 90% and 85%, respectively. Conclusion: In total hip arthroplasty using a cementless expansive acetabular cup, a 95.6% survival rate is achieved after an average of 14 years, whereas the rate decreases to 85% after 17 years. Even if the incidence of cup breakage is reduced with proper implantation, particle disease and periacetabular osteolysis remains a problem for the long-term survival. doi: https://doi.org/10.12669/pjms.37.1.3089 How to cite this:Carkci E, Polat AE, Ozturkmen Y, Tuzuner T. Long-Term results of total Hip Arthroplasty performed using a cementless expansive Acetabular Cup and Spotorno Femoral Stem. Pak J Med Sci. 2021;37(1):52-58. doi: https://doi.org/10.12669/pjms.37.1.3089 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


2018 ◽  
Vol 42 (6) ◽  
pp. 1259-1264 ◽  
Author(s):  
Xavier Flecher ◽  
Matthieu Ollivier ◽  
Pascal Maman ◽  
Sébastien Pesenti ◽  
Sébastien Parratte ◽  
...  

2003 ◽  
Vol 13 (3) ◽  
pp. 167-176 ◽  
Author(s):  
K. Knahr ◽  
R. Jagsch ◽  
I. Kryspin-Exner

The aim of the study was to evaluate the clinical and psychological situation of total hip arthroplasty (THA) patients before and one year and five years after surgery. Data of 101 patients were available for the one-year and of 69 patients for the five-year follow-up. Quality of Life (QoL) data were collected using the Nottingham Health Profile (NHP), functional capacity comprised patient's self-assessment (Functional Outcome Questionnaire Hannover, FFbH) and surgeon's assessment (Harris Hip Score, HHS). While all dimensions of QoL and functional capacity except social isolation showed significant improvement at the one-year follow-up, only pain scores showed further improvement at the five-year evaluation. Implantation of THA is accompanied by significant increases in QoL and functional capacity. Stabilised scores were found at the five-year evaluation while significant increases could be observed after one year.


2017 ◽  
Vol 28 (3) ◽  
pp. 330-335 ◽  
Author(s):  
Hendrik A. Zuiderbaan ◽  
Dennis Visser ◽  
Inger N. Sierevelt ◽  
Janine Penders ◽  
Jeanette Verhart ◽  
...  

Introduction: The purpose of the present study is to report the long-term clinical results of an uncemented total hip arthroplasty (THA) using a Metasul metal-on-metal (MoM) 28-mm bearing and to evaluate the long-term serum cobalt levels. Methods: At an average of 12.6 years following primary THA, we retrospectively reviewed the clinical results of the first 116 consecutive patients (128 THAs) in our institution who underwent 28-mm Metasul MoM THA. Of the 78 patients who were able to visit our outpatient clinic, serum cobalt levels were evaluated. Results: The overall survival rate of the cohort was 96.1% (95% confidence interval [CI], 93.2-99.6), 12.6 years (95% CI, 12.3-12.7 years) following surgery. 3 patients had undergone revision due to aseptic loosening of the stem and 2 patients sustained a periprosthetic fracture. The average modified Harris Hip Score was 90 (72-97) and the average Oxford Hip Score was 56 (48-60), representing both excellent outcome scores. The average serum cobalt of the entire cohort was 20.1 nmol/L (range 8.5-227.7 nmol/L). Serum cobalt levels of patients with a bilateral MoM THA were significantly higher (35.0 nmol/l, p<0.01). No relation between serum cobalt levels, subjective outcome, radiolucent lines on radiographs and survivorship of the implant was noted. Conclusions: Long-term results of the metasul MoM bearing articulation in THA seem to be excellent, although cobalt serum levels should be monitored closely.


Author(s):  
Manish Sharma ◽  
Ramesh Kumar Sen ◽  
Sameer Aggarwal ◽  
Mahesh Prakash

Background: Acetabular fractures are complex orthopaedic injuries and require a fair amount of expertise for management. Although undisplaced acetabular fractures can be managed by nonoperative means, displaced acetabular fractures need operative intervention for reduction and stabilization. Methods: The study was carried as a retrospective study, from February 2013 to July 2014. After getting the approval from the Ethics Committee of the Institute (Annexure I) and the consent from the patients the study was conducted on 49 patients who underwent Total Hip Arthroplasty after fracture acetabulum. Results: On evaluation, patients at short term follow up had good clinical outcome on the basis of Harris hip score. The Harris hip scores improved progressively in the patients at 2-4 years follow up having mean HHS of 92 which further increased to 97 in patients who were followed up after 4 years. The patients at short term follow up of up to 2 years had comparatively lower quality of life scores when compared to the follow up at 2-4 years. The patients followed up after 4 years had the best quality of life. Conclusion: We concluded that total hip arthroplasty after acetabulum fracture, as a result of good quality of reconstruction, a good functional outcome leads to improved quality of life in the patients. Keywords: Hip, Arthroplasty, Reconstruction.


2019 ◽  
Vol 25 (3) ◽  
pp. 25-33
Author(s):  
V. V. Danilyak ◽  
V. V. Klyuchevsky ◽  
M. A. Molodov ◽  
E. V. Goryunov ◽  
K. V. Marchenkova

Relevance. The RM Classic monoblock titanium-coated polyethylene cup is widely used in the total hip arthroplasty. However, so far in Russia there has been no analysis of follow-up over 10 years for a limited number of patients in a single hospital. The aim of the study was to evaluate the long-term outcomes of total hip replacement with RM Classic acetabular component. Materials and Methods. The outcomes of 328 total hip arthroplasties (289 patients operated in the period from 1997 to 2007) with RM Classic cups were evaluated in a monocentral retrospective clinical study. The average follow-up period was 14.4 years. Revision procedure due to aseptic loosening, polyethylene wear or osteolysis was considered as the end point of the study. Results. 9 revisions during the short and medium follow-up periods (up to 10 years) were associated with malpositioning of RM Classic components and errors in surgical technique. The indications for later revision THA (19 cases) were polyethylene wear and aseptic loosening. Only in one case they were combined with pelvic bone osteolysis with the formation of III a defect according to W.G. Paprosky classification. Within 15 years the Kaplan-Meier survivorship of RM Classic cup was 92.5%. There was a statistically significant difference of the survival curves in the ceramic-on-poly against metal-on-poly bearings: 94.9% and 79.4%, respectively. The average Harris Hip Score was 88.6. Conclusion. RM Classic uncemented monoblock cup has proven its high efficiency and survival in 15 years follow-up period and over.


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