scholarly journals Laser Projector Method for Measuring Postoperative Acetabular Anteversion After Total Hip Replacement

2021 ◽  
Author(s):  
Wei-Cheng Chen ◽  
Tai-Yin Wu ◽  
Kuan-Yu Chi ◽  
Pei-Wei Weng ◽  
Yu-min Huang ◽  
...  
Keyword(s):  
Total Hip Replacement ◽  
Hip Replacement ◽  
Statistical Significance ◽  
Control Group ◽  
Acetabular Anteversion ◽  
Remote Areas ◽  
Total Hip ◽  
Laser Projector ◽  
Ellipse Method ◽  
Significant Difference

Abstract Introduction For patients undergoing total hip replacement (THR), measuring the postoperative acetabular anteversion precisely plays a pivotal role in the prognosis because anteversion of acetabulum cup determines the range of motion and stability after the THR. To date, the documented techniques for the accurate assessment encompass methods of two-dimensional (2D) and three-dimensional (3D). Our team has developed several 2D methods for precisely measuring acetabular anteversion after the THR, namely the trigonometric, the protractor, and the computerized ellipse method. Despite multiple commercially available assessing tools, most mandate computerized equipment with corresponding software that is frequently in shortage in remote areas and developing countries. Therefore, we attempted to invent a laser projector that is able to measure the acetabular anteversion directly on the traditional plain film and to examine its validity and consistency by comparison with the Elliversion software.Methods We invented a portable laser projector incorporating the ellipse method for the measurement of postoperative acetabular anteversion. We retrospectively collected 50 postoperative pelvis radiographs including acetabulum from our institution. One investigator first measured the anteversion of included radiographs through Elliversion software as the control group. Subsequently, two operators independently used the laser projector for measurements in two separate periods with 1-day intervals as the experimental group. Our analysis was comprised of intra- and inter-group comparisons, which investigated the consistency and validity, respectively, by using two-sample student’s t-test. P-value < 0.05 suggests statistical significance. Results There was no significant difference in measuring the anteversion through laser projectors between two operators (MD, -0.12; 95% CI, -0.52 to 0.27; p=0.54). The estimated effect in the anteversion measurement between the Elliversion and laser projector was also comparable (MD, -0.17; 95% CI, -0.38 to 0.04; p=0.12).Conclusions Our study reported the consistency and validity of this laser projector as there is no significant difference in both intra- and inter-observer reliability, demonstrating real-time, intuitive, and convenient product design comparing to Elliversion. Most importantly, we look forward to helping elevate clinical acumen when doctors provide care to patients after THR, especially in remote areas.

Low-Dose Heparin and Deep-Vein Thrombosis after Total Hip Replacement

1976 ◽  
Vol 36 (01) ◽  
pp. 157-164 ◽  
Author(s):  
P. M Mannucci ◽  
Luisa E. Citterio ◽  
N Panajotopoulos
Keyword(s):  
Deep Vein Thrombosis ◽  
Total Hip Replacement ◽  
Hip Replacement ◽  
Low Dose ◽  
Control Group ◽  
Total Hip ◽  
Vein Thrombosis ◽  
Dose Heparin ◽  
Deep Vein ◽  
Low Dose Heparin

SummaryThe effect of subcutaneous low-dose heparin on postoperative deep-vein thrombosis (D. V. T.) (diagnosed by the 125I-labelled fibrinogen test) has been investigated in a trial of 143 patients undergoing the operation of total hip replacement. Two randomized studies were carried out: in one the scanning for D.V.T. was carried out daily for 7 days post operatively and in the other for 15 days. In both, the incidence of D.V.T. was significantly lower in the heparin-treated patients (P<0.005). Bilateral D.V.T. was also prevented (P<0.05), through the extension of D.V.T. to the distal veins of the thigh was not significantly reduced. Heparin treatment was, however, followed by a higher incidence of severe postoperative bleeding (P< 0.02) and wound haematoma formation (P< 0.005), and the postoperative haemoglobin was significantly lower than in the control group (P<0.005). A higher number of transfused blood units was also needed by the heparin treated patients (P<0.001).

scholarly journals Balance a few years after total hip replacement

2019 ◽  
Author(s):  
Agnieszka Wareńczak ◽  
Przemysław Lisiński
Keyword(s):  
Total Hip Replacement ◽  
Hip Replacement ◽  
Dynamic Balance ◽  
Berg Balance Scale ◽  
Step Test ◽  
Control Group ◽  
Timed Up And Go ◽  
Total Hip ◽  
Functional Reach ◽  
Functional Reach Test

Abstract Background: The aim of the study was to conduct a long-term evaluation of whether total hip replacement permanently affects the quality of postural reactions and body balance. Material and methods: The unilateral Total Hip Replacement (THR) group consisted of 30 subjects (mean age: 69.4). The control group consisted of 30 healthy subjects (mean age: 68.8). The force platform and functional tests such as Timed Up and Go, 3m walk test, Functional Reach Test, 30s Chair Stand Test, Step Test and Berg Balance Scale were used to assess dynamic balance. Results: Subjects from the study group exhibited significantly increased time (p=0.002) and distance (p=0.012) in the tests performed on the force platform compared to the control group. We also observed worse balance and functional test scores in the THR group: Timed Up and Go test (p<0.001), 3m walk test (p<0.001), Functional Reach Test (p=0.003), 30s Chair Stand Test (p=0.002) and Step Test (operated leg: p<0.001, non-operated leg: p=0.002). The results obtained in the Berg Balance Scale tests were not significantly different between the groups (p=0.597). Conclusions: Our research shows that total hip replacement permanently impairs patients’ dynamic balance and functionality in certain lower-extremity activities. Keywords: balance, total hip replacement, gait, muscle strength

Modification of Pelvic Orientation after Total Hip Replacement in Primary Osteoarthritis

2009 ◽  
Vol 19 (3) ◽  
pp. 257-263 ◽  
Author(s):  
Elhadi Sariali ◽  
Jean Yves Lazennec ◽  
Frederic Khiami ◽  
Michel Gorin ◽  
Yves Catonne
Keyword(s):  
Healthy Volunteers ◽  
Range Of Motion ◽  
Total Hip Replacement ◽  
Hip Replacement ◽  
Sacral Slope ◽  
X Rays ◽  
Acetabular Anteversion ◽  
Total Hip ◽  
Pelvic Inclination ◽  
Primary Osteoarthritis

The acetabular anteversion angle varies according to the position of the pelvis. The objective goal of our study was to investigate changes in pelvic orientation after total hip replacement for primary osteoarthritis. We studied 89 patients who underwent total hip replacement for primary unilateral osteoarthritis. Lateral pelvic X-rays that included the hips were performed pre-operatively and one year post-operatively. Reference values were calculated by carrying out the same analysis in 100 asymptomatic healthy volunteers. Pelvic orientation was analyzed using the sacral slope. Patients having surgery for osteoarthritis had a decreased pelvic range of motion pre-operatively and post-operatively when compared to healthy volunteers. Post-operatively, this range of motion increased by 3° but remained lower than the norm. Compared to asymptomatic healthy volunteers, patients affected by osteoarthritis had a posterior pelvic extension that decreased post-operatively but did not return to norm. This post-operative pelvic inclination generates a significant decrease in the final cup anteversion and thus may predispose to posterior dislocation. As this post-operative alteration to pelvic orientation cannot be anticipated, computer-aided surgery for cup positioning may not improve the accuracy of the acetabular anteversion in some patients.

scholarly journals Evaluation of version of acetabular component following total hip replacement on conventional radiograph and computed tomography

2020 ◽  
Vol 27 (2) ◽  
pp. 179-185
Author(s):  
Manish Raj ◽  
Ashish Jaiman ◽  
Rajesh Kumar Chopra
Keyword(s):  
Computed Tomography ◽  
Ct Scan ◽  
Total Hip Replacement ◽  
Gold Standard ◽  
Hip Replacement ◽  
Regression Line ◽  
Patient Positioning ◽  
Acetabular Version ◽  
Total Hip ◽  
Significant Difference

Background/Purpose: Total hip replacement (THR) is considered as one of the most successful orthopedic procedures. However, improperly placed components can lead to instability and accelerated wear. Acetabular cup inclination can be very well accessed by anteroposterior pelvis X-rays; for acetabular version assessment, computed tomography (CT) scan is the gold standard. CT scan is not readily available at many centers and the surgeon has to rely on X-ray methods for evaluation of acetabular version to audit results and to predict behavior of the surgical intervention. This prospective study was undertaken to compare Woo and Morrey’s and ischiolateral methods of assessment of acetabular version on cross-table lateral radiographs with CT assessment and to assess the validity of radiographic methods with respect to CT scan method. Material and methods: A prospective follow-up study was conducted for 18 months’ duration (October 2016 to March 2018) on 30 adult patients who underwent THR surgery. Cross-table lateral radiograph was obtained at 3 and 6 weeks in the postoperative period. Two observers made each observation at two different points of time. CT scan was performed at 3 weeks. Version as measured by radiographs and CT scan was recorded. Results: The major overlap in the distribution of the values of the Woo and Morrey method suggests that there is no significant difference between the observations. Distribution of the values of the ischiolateral view and the CT scan value distributions have a very small overlap and hence suggest a strong significant difference between the two. Conclusion: In this study, Woo and Morrey’s method and ischiolateral method of assessment of acetabular version were compared with CT assessment. We found that in Woo and Morrey’s method, values were comparable to CT scan values, when put on regression line. However, in situation of change in patient positioning, namely hip stiffness in contralateral hip, measurement of component changed in series of radiography due to differences in pelvis tilt. So, in these circumstances, we can use ischiolateral method which can give consistent measurement. But it will not be in concordance with CT scan values and Woo and Morrey values, as represented in regression line. The high intra-class correlation coefficients for both intra- and inter-observer reliability indicated that the angle measured with these methods is consistent and reproducible for multiple observers. CT, however, be considered as gold standard for measurement owing to control over pelvic rotation and/or tilt/patient positioning.

scholarly journals Aspirin-Persantin Prophylaxis in Elective total hip Replacement

1977 ◽  
Author(s):  
A.J. Silvergleid ◽  
R. Bernstein ◽  
D.S. Burton ◽  
J.B. Tanner ◽  
J.F. Silverman ◽  
...  
Keyword(s):  
Total Hip Replacement ◽  
Hip Replacement ◽  
Treated Group ◽  
Control Group ◽  
Double Blind ◽  
Total Hip ◽  
Blind Area ◽  
Effective Prophylaxis ◽  
Clinically Significant ◽  
To Receive

A prospective, double-blind clinical study was performed to evaluate the combination of dipyridamole(Persantin)225 mg/day and acetyl salicyclic acid (ASA) 1 g/day prophylaxis of post-operative venous thromboembolism in elective total hip replacement. Patients were stratified according to age, and randomly assigned to receive drug or placebo. All patients were followed with 125I-labelledfibrinogen scanning for one week post-operatively, or until fully mobile. Venography was performed in 67/129 patients; in 27 patients the venogram was obtained to confirm a positive fibrinogen scan, in 40 patients an elective venogram was obtained on the 7th post-operative day to evaluate the operated thigh (a blind area for scanning). Thrombosis (by scan or venogram) was found in 16/66(24%) in the control group, and in 21/63(33%) in the treated group. Overall incidence was 37/129 (29%). Correlation of scan with venography was 90%. There were no clinically significant pulmonary emboli in either group. We conclude that the combination of ASA and dipridamole as given in this study is not effective prophylaxis in elective total hip replacement.

scholarly journals 130 Impact of Balance Training in Virtual Reality on Body Balance in Patients after Total HIP Replacement

2019 ◽  
Vol 48 (Supplement_4) ◽  
pp. iv28-iv33
Author(s):  
Anna Hadamus ◽  
Dariusz Białoszewski ◽  
Aleksandra Justyna Kowalska ◽  
Edyta Urbaniak ◽  
Rafał Boratyński ◽  
...  
Keyword(s):  
Virtual Reality ◽  
Total Hip Replacement ◽  
Hip Replacement ◽  
Control Group ◽  
Forward Movement ◽  
Body Balance ◽  
Total Hip ◽  
Vr Training ◽  
The Impact ◽  
Experimental Group

Abstract Introduction Virtual Reality (VR) training is becoming an increasingly popular form of exercise aiding in re-education of body balance. Many reports have demonstrated its effectiveness, greater patient involvement in exercise and better outcomes compared to traditional rehabilitation [1]. The aim of this study was to assess the impact of the additional training in VR on body balance in patients after total hip replacement. Material and Methods 56 patients randomly assigned to an experimental group (30 people) and a control group (26 people) was included in the study. All patients had undergone THR within 2 to 12 weeks before the beginning of the study. The control group underwent standard post-operative rehabilitation, while a VR training programme was used in the experimental group as an additional rehabilitation tool. Balance was assessed with the VBC system and the AMTi AccuSway plate. The results were considered significant for p &lt;0.05. Results CoP displacement in the frontal plane was reduced in both groups in tests with eyes closed (p&lt;0.05). Other parameters in standing tests remain the same. The maximum forward deflection test has shown a significant increase in the range of forward movement in the experimental group (p &lt;0.05). In the control group, the duration of the forward movement phase was reduced, but the range remained the same. The rhythmic sway test showed an increase in the average speed of movements in the experimental group (p &lt;0.05). There were no changes in the control group. Conclusions 1. Postural stability training in VR primarily involves dynamic aspects of the maintenance of balance. 2. Improvement in functional tests may indicate a better clinical outcome of rehabilitation in patients who have additionally trained in VR. 3. The improvement obtained in static tests most probably results from improvement in muscle strength and static stability resulting from the rehabilitation.

A Comparative Study of the Effectiveness of a Preoperative Education Programme for Total Hip Replacement Patients

1995 ◽  
Vol 58 (12) ◽  
pp. 526-531 ◽  
Author(s):  
Nicola J Spalding
Keyword(s):  
Total Hip Replacement ◽  
Hip Replacement ◽  
Direct Consequence ◽  
Education Programme ◽  
Control Group ◽  
Preoperative Education ◽  
Total Hip ◽  
Quasi Experimental ◽  
Postoperative Morphine ◽  
Experimental Group

This study examined some effects of providing preoperative education to patients prior to their hospital admission for a total hip replacement. The preoperative education programmes are organised and presented by an occupational therapist with the assistance of a physiotherapist, an anaesthetist, an orthopaedic nurse and a dietician. The content includes information on preparation for surgery, what to expect of admission, surgery and rehabilitation, and how to prepare for discharge. A quasi-experimental design was used to compare a group of patients who had attended an education programme with, as control, a group of patients who had not. The variables Investigated were length of hospitalisation, morphine usage, mobility independence and discharge preparation. The results showed that the patients in the experimental group had a mean of 4 days' less hospitalisation than the control group, required less postoperative morphine and achieved mobility independence sooner. The control patients' lack of knowledge of what to expect from their surgery was evident from the lack of preparation for their discharge home. Large financial savings were then calculated as a direct consequence.

scholarly journals Better before–better after: efficacy of prehabilitation for older patients with osteoarthritis awaiting total hip replacement—a study protocol for a randomised controlled trial in South-Eastern Norway

BMJ Open ◽  
2019 ◽  
Vol 9 (12) ◽  
pp. e031626 ◽  
Author(s):  
Odd-Einar Svinøy ◽  
Astrid Bergland ◽  
May Arna Risberg ◽  
Are Hugo Pripp ◽  
Gunvor Hilde
Keyword(s):  
Randomised Controlled Trial ◽  
Total Hip Replacement ◽  
Hip Replacement ◽  
Older Patients ◽  
Controlled Trial ◽  
Intervention Group ◽  
Control Group ◽  
Total Hip ◽  
Hospital Referral ◽  
Randomised Controlled

IntroductionHealth professions need to prepare for the increase of older patients with osteoarthritis requiring health services including those requiring total joint arthroplasty (TJA). The primary objective of this study is to assess the effect of a tailored prehabilitation programme of older patients awaiting primary surgery for total hip replacement on physical function measured by walking speed within 1 week after intervention as well as 6 weeks and 3 months after TJA surgery.Methods and analysisThis is a single-blinded randomised controlled trial. The participants are 70 years or older, scheduled for primary total hip replacement due to late stage osteoarthritis. The intervention group will receive patient education and exercise for 6–12 weeks. The control group will receive care as usual. The primary outcome is gait speed. Secondary outcomes are lower body strength, mobility, aerobic capacity, activity of daily living, length of stay at the hospital, referral to an inpatient rehabilitation clinic, pain, quality of life and cost-effectiveness. Estimated sample size is 150 participants randomised into the two arms. The data will be analysed following the intention-to-treat principle with methods for repeated measurements.Ethics and disseminationThe project proposal has been approved by The Regional Committee for Medical Research Ethics in South Norway (ref no. 2018/503). The results will be published in peer-reviewed articles.Trial registration numberNCT03602105

Radiographic Assessment of Biomechanical Parameters following hip Resurfacing and Cemented Total Hip Arthroplasty

2009 ◽  
Vol 19 (3) ◽  
pp. 251-256 ◽  
Author(s):  
Curtis Robb ◽  
Richard Harris ◽  
Kevin O'dwyer ◽  
Nadim Aslam
Keyword(s):  
Total Hip Replacement ◽  
Hip Arthroplasty ◽  
Hip Replacement ◽  
Hip Resurfacing ◽  
Leg Length ◽  
Femoral Offset ◽  
Normal Side ◽  
Total Hip ◽  
Significant Difference ◽  
Joint Reaction Forces

Resurfacing hip arthroplasty and total hip replacement both aim to restore anatomical parameters. Leg length and offset discrepancy can result in altered joint reaction forces, and are associated with increased wear, dislocation, and decreased patient satisfaction. This study assesses the accuracy of leg length and offset restoration after either a Birmingham Hip Resurfacing (BHR) or a cemented total hip replacement (THR). Standardised antero-posterior radiography was performed on two groups of 30 patients with unilateral primary osteoarthritis undergoing either a cemented total hip or resurfacing. The normal contra-lateral hip was used as the control. Leg length and offset were measured pre-operatively with no significant difference between the two groups. Cup offset, femoral offset, total offset and leg length of the prosthesis and normal side were measured by two observers and mean measurements were analysed by a paired t test. Leg lengths in each group did not differ significantly from the normal side, THR 0.53 mm (95% CI -2.4 to 3.4 mm) but BHR implantation did result in mean leg shortening of -1.9 mm (95% CI -4.5 mm to 0.6 mm). Cup offset differed significantly from normal anatomy in both groups, as did femoral and total offset for the total hip replacement group. However, femoral offset was restored in the Birmingham resurfacing group. When the THR group was compared against the BHR group we found no difference between restoration of leg lengths (p = 0.21) and cup offset (p = 0.30) but femoral (p = 0.0063) and total offset (p = 0.03) were restored more accurately with a BHR.

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