scholarly journals Changes in Body Weight After Total Hip Arthroplasty: Short-term and Long-term Effects

2012 ◽  
Vol 92 (5) ◽  
pp. 680-687 ◽  
Author(s):  
Nienke Paans ◽  
Martin Stevens ◽  
Robert Wagenmakers ◽  
Jan van Beveren ◽  
Klaas van der Meer ◽  
...  
Keyword(s):  
Body Weight ◽  
Total Hip Arthroplasty ◽  
Body Mass ◽  
Hip Arthroplasty ◽  
Hip Osteoarthritis ◽  
Term Effect ◽  
Short Term ◽  
Preoperative Body Mass Index ◽  
Total Hip

Background Elevated body weight is associated with hip osteoarthritis (OA) and subsequently with total hip arthroplasty (THA). Patients with hip OA who are overweight often mention their restricted mobility as a factor that thwarts their attempts to be physically active and lose weight. There is some evidence that THA increases physical activity, but none for losing body weight after THA. Objective The purpose of this study was to analyze the short-term (1-year) and long-term (4.5-year) effects of a THA on body weight. Design This was an observational, multicenter cohort study. Methods For the short-term effect, all patients (N=618) were analyzed; for the long-term effect, a random subgroup (n=100) was analyzed. Preoperative and postoperative body weight and height were self-reported. Patients were categorized according to their preoperative body mass index (BMI <25 kg/m2=normal weight, 25–30 kg/m2=overweight, >30 kg/m2=obese). Clinical relevancy was set at a minimum of 5% weight loss compared with baseline. Results The mean age of the study group was 70 years (SD=8), 74% were women, and mean preoperative body mass was 79 kg (SD=14). One year after THA, a significant decrease in body weight of 1% and 3.4% occurred for the overweight and obese BMI categories, respectively. After 4.5 years, a significant decrease in body weight of 6.4% occurred for the obese BMI category. Limitations Height and weight—and thus BMI—were self-reported. Conclusion Patients in the overweight and obese groups showed a decrease, albeit not clinically relevant, in body weight after 1 year. After 4.5 years, a decrease that was relevant clinically was observed in the patients who were obese. It can be concluded that no clinically relevant reduction of weight occurred after THA, except in the long term for patients who were obese.

Total hip arthroplasty in patients with osteoporosis

2019 ◽  
Vol 30 (4) ◽  
pp. 370-379
Author(s):  
Theofilos S Karachalios ◽  
Antonios A Koutalos ◽  
George A Komnos
Keyword(s):  
Total Hip Arthroplasty ◽  
Hip Arthroplasty ◽  
Femoral Fractures ◽  
Hip Osteoarthritis ◽  
Osteoporosis Treatment ◽  
Term Survival ◽  
Bone Implant ◽  
Total Hip ◽  
High Prevalence

There is a high prevalence of osteoporosis in patients undergoing total hip arthroplasty. There are several clinically relevant questions related to the management of such cases: the effect of ageing; the initial osseointegration of implants, especially when cementless THA is used; the effect of medical osteoporosis treatment on bone-implant interface; the incidence of intraoperative and late periprosthetic fractures, and the long-term survival of both cemented and cementless total hip arthroplasty performed for proximal femoral fractures and hip osteoarthritis. A critical review of the literature is presented in an attempt to draw practical conclusions.

Patient Weight more than Body Mass Index Influences Total Hip Arthroplasty Long Term Survival

2011 ◽  
Vol 21 (6) ◽  
pp. 694-699 ◽  
Author(s):  
Francesco Traina ◽  
Barbara Bordini ◽  
Marcello De Fine ◽  
Aldo Toni
Keyword(s):  
Body Mass Index ◽  
Body Weight ◽  
Total Hip Arthroplasty ◽  
Body Mass ◽  
Hip Arthroplasty ◽  
Implant Survival ◽  
Term Survival ◽  
Long Term Survival ◽  
Implant Survivorship

The effect of obesity on the long-term survival of total hip arthroplasty remains under discussion. Reviewing meta-analyses of large cohort studies a high body mass index has been correlated with a higher incidence of complications but not univocally with a lower implant survival rate. It has been suggested that body weight rather than body mass index might be a better parameter to evaluate prosthesis outcome. We reviewed 27,571 patients retrospectively with primary arthritis as a preoperative diagnosis. Patients were divided into 4 categories based on their body mass index, or into two groups based on the body weight (<80 kg and 80 kg). Implant survivorship was estimated with use of the Cox proportional hazards model with revision for aseptic loosening as the end point. Results were stratified for sex and implant tribology. When body mass index was used the 10 years implant survival in obese versus non-obese patients was not statistically different (p=0.058), but when body weight was used a statistically different implant survivorship was found for men (p=0.009). Therefore, weight rather than than body mass index influences survival of hip prostheses, and should be used as the discriminant parameter for further studies.

Revision Rates for Metal-on-Metal Hip Resurfacing and Metal-on-Metal Total Hip Arthroplasty – A Systematic Review

2016 ◽  
Vol 26 (6) ◽  
pp. 515-521 ◽  
Author(s):  
Sofie-Amalie L. Ras Sørensen ◽  
Henrik L. Jørgensen ◽  
Sune L. Sporing ◽  
Jes B. Lauritzen
Keyword(s):  
Total Hip Arthroplasty ◽  
Hip Arthroplasty ◽  
Odds Ratio ◽  
Revision Rate ◽  
Hip Resurfacing ◽  
Short Term ◽  
Total Hip ◽  
Metal On Metal ◽  
Pubmed Database

Purpose To compare revision rates of metal-on-metal (MoM) hip resurfacing (HRS) and MoM total hip arthroplasty (THA), as well as the primary causes for revisions. Methods The PubMed database was queried for potentially relevant articles addressing MoMTHA and MoMHRS, a total of 51 articles were included. Results The review includes a total number of 5,399 MoMHRS and 3,244 THA prosthesis and the reasons for prosthesis failure were divided into 7 categories and the main causes discussed. The overall MoMTHA revision rate was 4.7% after 6.9 years. MoMHRS revision rate was 5.9% after 5.7 years. The odds ratio was 1.25 (1.03:1.53) 95% CI (p = 0.03) (MoMHRS vs. MoMTHA). The studies of hip prostheses were separated into 2 categories of short- and long-term (more or less than 5 years). Short-term revision rate for MoMTHA was 4.5% after 4.8 years, and for MoMHRS 4.0% after 4.2 years. The odds ratio was 1.09 (0.82:1.43) 95% CI (0 = 0.56) (MoMTHA vs. MoMHRS). Long-term revision rate for MoMTHA was 5.2% after 7.7 years and 8.2% after 7.6 years for MoMHRS. The odds ratio was 1.58 (1.53:1.96) 95% CI (p = 0.0001) (MoMHRS vs. MoMTHA). Revision causes were divided into 7 main categories. The most common cause for revision for both MoMTHA and MoMHRS was loosening 47.6% vs. 37.7%, fracture (MoMTHA 7.69%; MoMHRS 19.62%), metal reactions (MoMTHA 7.69%; MoMHRS 26.92%) infection (MoMTHA 12.08%; MoMHRS 6.54%), instability (MoMTHA 9.13%; MoMHRS 2.69%), manufacturer defect 6.73% for MoMTHA and nonreported for MoMHRS, and miscellaneous (MoMTHA 7.69%; MoMHRS 6.54%) was stated. Interpretation The comparison of MoMHRS and MoMTHA revision rates showed no difference in the short term, however in the longer term, the revision rate of MoMHRS was significantly higher than for MoMTHA. The linear increase in revision rate of MoMHRS may indicate a progression in failure.

scholarly journals Risk Factors for the Development of Nerve Palsy Following Primary Total Hip Arthroplasty

2018 ◽  
Vol 12 (1) ◽  
pp. 164-172 ◽  
Author(s):  
Shunsuke Kawano ◽  
Motoki Sonohata ◽  
Masaru Kitajima ◽  
Masaaki Mawatari
Keyword(s):  
Risk Factors ◽  
Body Mass Index ◽  
Body Weight ◽  
Femoral Head ◽  
Total Hip Arthroplasty ◽  
Body Mass ◽  
Hip Arthroplasty ◽  
Nerve Palsy ◽  
Hip Dislocation ◽  
Total Hip

Background:Nerve palsy following total hip arthroplasty (THA) is a complication that worsens the functional prognosis. The present study analyzed the risk factors of nerve palsy following THA.Methods:The subjects of this study included 6,123 cases in which primary THA was performed under spinal anesthesia with cementless implants used in the posterolateral approach.Results:Fourteen cases (0.22%) developed nerve palsy following THA, all of which involved palsy of the entire peroneal nerve region. The diagnoses included osteoarthritis due to subluxation (n=6), complete hip dislocation (n=3), osteonecrosis of the femoral head (n=2), primary osteoarthritis (n=1), osteoarthritis due to trauma (n=1), and multiple osteochondromatosis (n=1). Recovery from nerve palsy was confirmed in 10 cases; the longest recovery period was three years. A univariate analysis revealed significant differences in the osteoarthritis due to subluxation, osteonecrosis of the femoral head, complete hip dislocation, body weight and body mass index. However, none of the factors remained significant in multivariate analysis. Peroneal (ischiadic) nerve palsy following THA occurred in patients with osteonecrosis of the femoral head, complete hip dislocation, low body weight and a low body mass index. However, there were no cases of nerve palsy after the introduction of THA combined with shortening osteotomy of the femur for complete hip dislocation. patients.Conclusion:It is necessary to pay attention to direct pressure in cases of lower body weight and lower BMI because compression of the sciatic nerve during surgery and compression of the fibular head are considered to be risk factors.

Clinical, functional and radiographic outcomes after revision total hip arthroplasty with tapered fluted modular or non-modular stems: a systematic review

2021 ◽  
pp. 112070002110043
Author(s):  
Antonios A Koutalos ◽  
Sokratis Varitimidis ◽  
Konstantinos N Malizos ◽  
Theofilos Karachalios
Keyword(s):  
Total Hip Arthroplasty ◽  
Hip Arthroplasty ◽  
Revision Rate ◽  
Clinical Results ◽  
Fracture Rate ◽  
Revision Total Hip Arthroplasty ◽  
Term Survival ◽  
Total Hip ◽  
Radiographic Outcomes

Purpose: The aim of the study was to systematically evaluate clinical outcomes of tapered fluted stems, either monoblock or modular, in revision total hip arthroplasty. Methods: PubMed, EMBASE and Web of Science and Cochrane databases were systematically searched by 2 researchers. Clinical studies reporting primarily on survival and re-revision rates, and secondarily on subsidence, dislocation, intraoperative fractures, periprosthetic fractures and infection were included. 2 investigators assessed the quality of the studies. Results: 46 studies were included in this review, reporting on 4601 stem revisions. The pooled re-revision rate was 5.1% and long-term survival ranged from 75% to 98.5%. No differences were observed between monoblock and modular stems regarding re-revision rate, dislocation rate, periprosthetic fracture rate or infection rates. Monoblock stems exhibited more subsidence and modular stems displayed more intraoperative fractures. Conclusions: Satisfactory results can be obtained with the use of tapered fluted end-bearing stems. Monoblock stems offer the same clinical results as modular stems.

scholarly journals Long-term clinical and radiological outcome in patients with severe Legg-Calvé-Perthes disease after Chiari pelvic osteotomy: a mean of 14 years follow-up

2021 ◽  
pp. 112070002098815
Author(s):  
Dammerer Dietmar ◽  
Braito Matthias ◽  
Peter Ferlic ◽  
Kaufmann Gerhard ◽  
Juana Kosiol ◽  
...  
Keyword(s):  
Total Hip Arthroplasty ◽  
Hip Joint ◽  
Hip Arthroplasty ◽  
Pelvic Osteotomy ◽  
Perthes Disease ◽  
Total Hip ◽  
Joint Incongruence ◽  
Chiari Pelvic Osteotomy

Introduction: The Chiari pelvic osteotomy (CPO) has been recommended as a salvage procedure to improve head coverage in case of hip joint incongruence in paediatric hip disease. In this study, we aimed to assess the long-term results of CPO for severe Legg-Calvé-Perthes disease (LCPD). Methods: A total of 39 patients who underwent a CPO at our department between 1995 and 2010 were prospectively followed both radiologically (Stulberg classification) and clinically (Harris Hip Score [HHS], conversion into total hip arthroplasty). In this study, we retrospectively reviewed the cases of 12 hips (12 patients, 3 girls, 8 left hips) treated by CPO for severe LCPD (Catterall grade 3 or 4) with hip joint incongruence. Mean follow-up was 14.0 (range 7.6–21.3) years. Results: Mean age at surgery was 10.2 (range 8.2–17.8) years. Additional femoral osteotomy was performed in 8 patients. A good radiological result (Stulberg I or II) was achieved in 2 patients, a fair result (Stulberg III) in 4 patients, and a poor outcome (Stulberg IV or V) in 6 patients. Mean postoperative HHS averaged 93 (range 65–100) points. An excellent functional outcome (HHS 90–100 points) was achieved in 9 patients. No patient underwent total hip arthroplasty during follow-up. Postoperative limb-length discrepancy was found in 3 patients. Conclusions: CPO for severe LCPD with hip joint incongruence resulted in good long-term clinical outcome in about ⅔ of our patients after a mean of 14 years. Our results suggest that CPO can still be considered as a salvage joint-conserving procedure in this selected group of younger patients.

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