Bicentric Bipolar Prosthesis in Non-Traumatic Hip Pathologies: Maximum 10 Years Follow Up

Introduction: Introduction of bipolar prosthesis was basically made for the treatment of fresh fracture neck of femur in elderly, but with advancement in design and techniques its use has been increased to various non-traumatic hip pathologies.Objective: To assess clinical and radiological outcome of BHU bicentric bipolar hip prosthesis in treatment of non-traumatic hip pathology.Methodology: This longitudinal study was done in 30 cases of various hip conditions, during the period of March 2002 to March 2012. All patients had secondary osteoarthritis of hip with abnormal acetabulum following advanced tubercular arthritis, rheumatoid arthritis, ankylosing spondylitis and avascular necrosis of femoral head. Primary bipolar hemi-replacement arthroplasty was done in all the cases using Banaras Hindu University (BHU) bicentric bipolar hip prosthesis. Each patient was assessed radiologically for movement and fraction of it occurring at various components of prosthesis and clinically for functional outcome using modified Harris hip score for the maximum of 10 years.Results: There were 17 males and 13 females (n=30), aged between 31-60 years. Three and half years following surgery, (n=12) 100% patients were able to squat and sit crossed legged. At four and half years follow-up, (n=7) 100% patient had excellent result when assessed by modified Harris hip score. Radiologically, by the end of 10 years (n=1) all the movements of hip occurred at inner bearing while the outer bearing was fixed to acetabulum.Conclusion: This intermediate term follow-up study suggests that the use of BHU bicentric bipolar hip prosthesis for bipolar hemireplacement is associated with be

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Does Juvenile Idiopathic Arthritis Affect the Course of Legg–Calvé–Perthes Disease? A Case-Control Study with a Mean Follow-Up of 8 Years

Children ◽

10.3390/children8111014 ◽

2021 ◽

Vol 8 (11) ◽

pp. 1014

Author(s):

Julien Roß ◽

Ivan Foeldvari ◽

Kara L. Krajewski ◽

Sebastian Butscheidt ◽

Frank Timo Beil ◽

...

Keyword(s):

Juvenile Idiopathic Arthritis ◽

Excellent Result ◽

Retrospective Chart Review ◽

Case Control ◽

Perthes Disease ◽

Harris Hip Score ◽

Control Group ◽

Modified Harris Hip Score ◽

Control Study

Background: This study aimed to determine the clinical and radiological course in children who had Legg–Calvé–Perthes disease (LCPD) associated with juvenile idiopathic arthritis (JIA). Methods: In a retrospective chart review between 2007 and 2019, eight consecutive JIA patients diagnosed with concomitant LCPD were identified and compared with a case-control group of 10 children with LCPD only. Results: LCPD was diagnosed at a mean age of 8.1 years (3.0–14.7) in children with JIA as compared to 6.1 years (2.9–10.0) in controls. According to the modified Harris Hip Score (mHHS), four children with JIA and all controls had an excellent result. Regarding the fragmentation severity and the duration of each stage, we found no differences using the lateral pillar and modified Elizabethtown classification. Five hips were classified as Stulberg I/II, two hips as Stulberg III, and one hip as Stulberg V with no evidence of hip dysplasia or severe overcoverage in either group. Conclusions: The radiological outcome of LCPD did not differ between both groups, while the clinical outcome was slightly better in controls. Physicians should be aware that children with LCPD may have JIA too. In suspicious cases, further investigations are recommended, and patients should be referred to pediatric rheumatologists.

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Hemiarthroplasty for intra-capsular fracture neck of femur in elderly patients: a prospective observational study

International Journal of Research in Orthopaedics ◽

10.18203/issn.2455-4510.intjresorthop20173119 ◽

2017 ◽

Vol 3 (5) ◽

pp. 991

Author(s):

Abhishek Kalantri ◽

Sunil Barod ◽

Dilip Kothari ◽

Archana Kothari ◽

Ashok Nagla ◽

...

Keyword(s):

Elderly Patients ◽

Road Traffic ◽

Excellent Result ◽

Operative Procedure ◽

Functional Results ◽

Harris Hip Score ◽

Neck Of Femur ◽

Mortality And Morbidity ◽

Fracture Neck Of Femur

Background: Hip fractures in older patients are associated with impaired mobility, excess morbidity and mortality, and loss of independence. This study was aimed at evaluating the outcome of hemiarthroplasty, by assessing the quality of life and degree of function in the operated limb.Methods: Out of 30 patients treated in this manner, all cases were available for follow-up period of 6 months. Patients of age 60 years and above, diagnosed with fracture neck of femur, were included in the study.Results: Majority of patients belongs to age group 60-69 years was 56.7% Females were more common 56.7% than males in the present study. About 13.3% patients sustained the injury due to a fall from a height and 23.3% due to a road traffic accident. About 20 patients (60%) had a stay of less than 20 days in hospital. In our study Harris hip score, at end of six month ranged from 35 to 94.6. At final 6 months follow-up by Harris hip scoring system, 53.33% had excellent result, 33.3% had good results, 16.67% had fair results and 6.67% had poor results. Conclusions: We conclude that hemiarthroplasty for fracture neck of femur is a good option in elderly patients. The mortality and morbidity are not high, operative procedure is simple, complications are less disabling. Early functional results are satisfactory.

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Evaluation of functional outcome of displaced fracture neck of femur in elderly treated with cemented bipolar prosthesis by modified Harris hip score

International Journal of Research in Orthopaedics ◽

10.18203/issn.2455-4510.intjresorthop20211610 ◽

2021 ◽

Vol 7 (3) ◽

pp. 561

Author(s):

Shivakumar B. Kerakkanavar ◽

Deepak P. Kaladagi ◽

Nagesh B. Sanakal ◽

Pundaleekappa S. Kaladagi ◽

Praveenkumar A. Hongal

Keyword(s):

Elderly Patients ◽

Functional Outcome ◽

Hip Prosthesis ◽

Limb Lengthening ◽

Harris Hip Score ◽

Neck Of Femur ◽

Fracture Neck Of Femur ◽

Femur Fractures ◽

Modified Harris Hip Score ◽

Displaced Fracture

Background: The current research was conducted to determine the functional outcome of the displaced fracture neck of femur in elderly patients treated with cemented bipolar hip prosthesis.Methods: The present research was a prospective study of 44 cases of displaced fracture neck of femur admitted to our institute between October 2017 and October 2019. Cases were chosen on the basis of inclusion and exclusion criteria. Cases were surgically treated with cemented bipolar hip hemiarthroplasty and functional findings were recorded with modified Harris hip score.Results: In our series of 44 cases there were 30 females and 14 males, with a maximum age of 92 years, minimum age of 65 years, and the average age was 72.72 years. At one-year follow-up, the average modified Harris hip score was 86.75% (maximum score of 95 and a minimum score of 66), overall, 20 patients (45.46%) achieved excellent, 16 patients (36.36%) achieved good, 5 patients (11.36%) achieved fair and 3 patients (6.82%) achieved poor results. 81.82% of the patients returned to the pre-fracture level of activity and independent ambulation. Patients had few complications like limb length discrepancy, 36.3% of patients had limb lengthening between 1 to 1.5 cm.Conclusions: In elderly patients with displaced neck femur fractures, cemented bipolar hip prosthesis provides good functional outcome. However further study for a longer period in a larger sample with a direct comparison between the cemented versus uncemented groups is required.

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Superiority of fixed stem bipolar prosthesis over Austin Moore prosthetic in fracture neck femur

International Journal of Research in Orthopaedics ◽

10.18203/issn.2455-4510.intjresorthop20182415 ◽

2018 ◽

Vol 4 (4) ◽

pp. 577 ◽

Cited By ~ 1

Author(s):

Mohd Abdul Naser ◽

Ritesh Pathak ◽

Ather Ahmad

Keyword(s):

Elderly Patients ◽

Weight Bearing ◽

Harris Hip Score ◽

Neck Of Femur ◽

Non Union ◽

Medical College ◽

Bipolar Prosthesis ◽

Bipolar Group ◽

Fracture Neck Femur ◽

Modified Harris Hip Score

Background: Hemi arthroplastyis a better option in treatment of fracture neck femur as it eliminates avascular necrosis of femoral head and non-union. It allows immediate weight bearing to return elderly patients to activity which helps in avoiding complications of recumbency and inactivity. The decision to perform hemi arthroplasty using a unipolar or bipolar prosthesis is a controversial issue. Both the prosthesis can be used even in remote areas both are cost effectives, good results can be achieved by general orthopaedic surgeons and post-operatively, it can be well adapted by Indian population. This study was done to compare the efficiency of Austin Moore’s prosthesis (AMP) and bipolar prosthesis for the management of intra capsular fracture neck femur in elderly patients.Methods: Patient’s above 60 years with fracture neck of femur were included. In all total 140 patients were randomly allocated for treatment by either AMP or bipolar prosthesis, in the department of Orthopaedics, IIMSR Medical College, Badnapur, Jalna between March 2014 to March 2017. The patients were followed up at 6 weeks, 12 weeks, 6 months and 1year. Functional outcome was assessed and compared with modified Harris hip score.Results: Modified Harris hip score was better with bipolar group as compared to AMP group. Functional activities like use of public transport were better with bipolar group. Complications like acetabular erosion were rare in bipolar group as comparison to AMP group.Conclusions: Fixed stem bipolar prosthesis is a superior option as compared to Austin Moore’s prosthesis.

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

International Journal of Research in Orthopaedics ◽

10.18203/issn.2455-4510.intjresorthop20210622 ◽

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

Background: Study aimed to assess and compare the functional outcome in patients underwent the large femoral head THA and conventional femoral head THA.Methods: 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.Results: 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<0.001)Conclusions: 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.

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Functional Outcome of Intracapsular Femoral Neck Fractures Treated by Bipolar Hemiarthroplasty

10.53350/pjmhs21155988 ◽

2021 ◽

Vol 15 (5) ◽

pp. 988-991

Author(s):

Zamir Hussain Tunioi ◽

Rizwan Ali Jhatiyal ◽

M Azeem Akhund ◽

M Kashif Abbasi ◽

L Das Maheshwari ◽

...

Keyword(s):

Femoral Neck ◽

Functional Outcome ◽

Femoral Neck Fractures ◽

University Hospital ◽

Harris Hip Score ◽

Bipolar Hemiarthroplasty ◽

Neck Of Femur ◽

Cross Sectional ◽

Average Hospital

Aim: To evaluate the functional outcome of bipolar hemiarthroplasty in intracapsular fracture neck of femur. Study design: Descriptive cross sectional study. Place and duration of study: Department of Orthopaedic Surgery & Traumatology, Peoples Medical University Hospital, Shaheed Benazir Abad from 1st December 2017 to 31st December 2020. Methodology: Sixty six cases of intracapsular femoral neck fractures with age ranging from 50 year to 75 year of either gender who were ambulatory before injury were included; while basicervical, younger than 50 years, with neuromuscular disorder, unfit for surgery, open fracture, bilateral injuries, osteoarthritis of hip, Rheumatoid, Gouty, pathological fractures, bedridden & who did not give consent for study, were excluded from the study. Functional outcome assessed by Harris hip score & data analyzed by SPSS version 23. Results: Twenty six (59.09%) were male and 40 (40.91%) were female with mean age of 64.3±7.77 year. Average time from injury to hospital arrival was 14.7±6.8 hours. Average time from hospitalization to surgery was 4.67±2.23 days. Average time of surgery was 55.67±9.9 minutes. Average hospital stay was 9.7±4.3 days. The average time of follow-up was 18.45±7.63 months. Conclusion: Bipolar implant is safe, effective, reliable, stable and cost effective implant for intracpsular fracture of femoral neck in elderly populace. The 66.66% of patients have satisfactory Harris hip score in follow up duration of 18.45±7.63 months. Keywords: Functional, Outcome, Femoral neck fractures, FNF, Bipolar, Hemiarthroplasty, HHS

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Clinical and Radiographic Presentation of Capsular Iatrogenic Hip Instability After Previous Hip Arthroscopy

The American Journal of Sports Medicine ◽

10.1177/0363546520949821 ◽

2020 ◽

Vol 48 (12) ◽

pp. 2927-2932

Author(s):

Dillon C. O’Neill ◽

Alexander J. Mortensen ◽

Peter C. Cannamela ◽

Stephen K. Aoki

Keyword(s):

Hip Arthroscopy ◽

Daily Living ◽

Patient Reported Outcomes ◽

Harris Hip Score ◽

Hip Instability ◽

Computer Adaptive Test ◽

Adaptive Test ◽

Patient Reported ◽

Modified Harris Hip Score

Background: The clinical and radiographic features of iatrogenic hip instability following hip arthroscopy have been described. However, the prevalence of presenting symptoms and associated imaging findings in patients with hip instability has not been reported. Purpose: To detail the prevalence of clinical and magnetic resonance arthrogram (MRA) findings in a cohort of patients with isolated hip instability and to determine midterm patient-reported outcomes in this patient population. Study Design: Case series; Level of evidence, 4. Methods: We retrospectively reviewed patients from 2014 to 2016 who underwent an isolated capsular repair in the revision hip arthroscopy setting. Patients were excluded if they underwent any concomitant procedures, such as labral repair, reconstruction, femoral osteoplasty, or any other related procedure. Several clinical data points were reviewed, including painful activities, mechanical symptoms, subjective instability, Beighton scores, axial distraction testing (pain, toggle, and apprehension), and distractibility under anesthesia. Patient-reported outcomes—including modified Harris Hip Score, Hip Outcome Score–Sports Subscale, Patient-Reported Outcome Measurement Information System (PROMIS) Physical Function Computer Adaptive Test, and a return patient hip questionnaire—were collected pre- and postoperatively. Pre-revision radiographs were obtained, and lateral center-edge angle and alpha angle were measured on anteroposterior and frog-leg lateral views, respectively. Pre-revision MRAs were reviewed and evaluated for capsular changes. Capsular changes were defined as follows: 0, normal; 1, capsular redundancy; 2, focal capsular rent; and 3, gross extravasation of fluid from the capsule. Results: A total of 31 patients met inclusion criteria (5 male, 26 female; 14 right and 17 left hips). The mean age of patients was 36 years (range, 20-58 years). Overall, 27 (87%) reported hip pain with activities of daily living, and 31 (100%) experienced pain with sports or exercise. In addition, 24 (77%) had at least 1 positive finding on axial distraction testing. All patients had evidence of capsular changes on review of pre-revision MRAs. Out of 31 patients, 23 (74%) were available for follow-up at a minimum of 3.3 years and a mean ± SD of 4.6 ± 0.8 years. On average, modified Harris Hip Score improved by 20.3, Hip Outcome Score–Sports Subscale by 25.1, and PROMIS Physical Function Computer Adaptive Test by 6.4. Additionally, 20 (87%) patients reported improved or much improved physical ability, and 18 (78%) reported improved or much improved pain. Conclusion: The current study suggests that patients with hip instability demonstrate high rates of pain with activities of daily living and exercise, positive findings on axial distraction testing, and evidence of capsular changes on magnetic resonance imaging. Furthermore, these patients improve with revision surgery for capsular repair at midterm follow-up.

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Return to Sport Rates and Functional Outcomes Following Bilateral Hip Arthroscopy in High-Level Athletes

Orthopaedic Journal of Sports Medicine ◽

10.1177/2325967120s00435 ◽

2020 ◽

Vol 8 (7_suppl6) ◽

pp. 2325967120S0043

Author(s):

Benjamin Domb ◽

Cynthia Kyin ◽

Jacob Shapira ◽

David Maldonado ◽

Ajay Lall ◽

...

Keyword(s):

Hip Arthroscopy ◽

Patient Reported Outcomes ◽

Return To Sport ◽

Harris Hip Score ◽

Complication Rates ◽

Professional Athlete ◽

Patient Reported ◽

High Level ◽

Modified Harris Hip Score

Objectives: To determine the rate of return to sport (RTS) in high-level athletes undergoing bilateral hip arthroscopy and report minimum 1-year patient-reported outcomes (PROs) for this cohort. We hypothesized that RTS rates, as well as sport-specific PROs, will be lower than the rates and scores previously reported in the literature for unilateral hip arthroscopy. Methods: Data were prospectively collected on all patients undergoing hip arthroscopy at our institution from November 2011 to July 2018. Patients were included if they underwent bilateral hip arthroscopy and were either a high school, collegiate, or professional athlete prior to their first surgery. RTS was defined as a patient’s return to competitive participation in their respective sport. Additional PROs, including modified Harris Hip Score (mHHS), nonarthritic hip score (NAHS), and Hip Outcome Score-Sports Specific Subscale (HOS-SSS), as well as complication rates and future surgeries were documented and compared for all patients. Results: A total of 87 patients met inclusion criteria, for which follow-up was available for 82 (94.3%). At latest follow-up, 44 (53.7%) patients returned to sport. Of patients returning, 56% did so at the same level or higher. The most common reasons for not returning to sport were due to graduation/lifestyle change (47.4%) and hip symptoms (44.7%). Patients returning to sport had significantly higher PROs at latest follow-up relative to those who did not return, including for mHHS (93.7 vs. 87.5), NAHS (94.4 vs. 88.2), HOS-SSS (90.9 vs. 78.2) (P < 0.05). Rates of achieving PASS and MCID for mHHS were not significantly different. However, for HOS-SSS, patients who returned had significantly higher rates of achieving the MCID and PASS. Conclusion: Rates of RTS after bilateral hip arthroscopy are lower than those after unilateral hip arthroscopy. When comparing patients that returned to sports and those who did not return, we show that although both groups show a significant improvement in PROs following surgery, those that returned to sport achieved significantly higher scores in all outcome measures. In addition, patients returning to sports showed a significantly higher rate of attaining MCID and PASS scores for the HOS-SSS, possibly attesting to the validity of this score and its thresholds.

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Reconstruction of Paprosky III defects with double-trabecular metal cups in acetabular revision at five-year follow-up

10.21203/rs.2.23126/v1 ◽

2020 ◽

Author(s):

Xianghong Zhang ◽

Jia Wan ◽

Wanchun Wang ◽

Fuming Li ◽

Libiao Qiu ◽

...

Keyword(s):

Los Angeles ◽

Bone Grafting ◽

Short Form ◽

Limb Length Discrepancy ◽

Acetabular Revision ◽

Harris Hip Score ◽

Trabecular Metal ◽

Modified Harris Hip Score ◽

Acetabular Defects

Abstract Background: Acetabular revision is often difficult to manage because of severe bone loss, especially for Paprosky type Ⅲ defects. Our present study aimed to assess the strategy of double-trabecular metal cups in acetabular revision.Methods: Fifteen patients (15 hips) underwent acetabular revision using double-cup technique alone or in combination with impacting bone grafting between January 2008 and May 2015. Preoperative and the latest follow-up clinical and radiographic scores were recorded and compared.Results: No patients were lost to follow up, and no patients underwent re-revision for loosening or any other reasons at the mean follow-up duration of 66 (range 55-105) months. We discovered 3 patients (3/15) with the early dislocation within the first year after the surgery and 2 patients (2/15) with delayed wound healing. The comparison between preoperative and the latest follow-up results showed the records of modified Harris Hip Score, University of California, Los Angeles activity score, Short Form 36, limb-length discrepancy and hip center of rotation were significantly improved.Conclusions: The application of double-cup technique alone or in combination with impacting bone grafting is an effective and reliable treatment option for Paprosky type Ⅲ acetabular defects without pelvic discontinuity.

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Return to Play After Hip Arthroscopy Among Tennis Players: Outcomes with Minimum Five-Year Follow-up

10.21203/rs.2.14819/v2 ◽

2019 ◽

Author(s):

David R. Maldonado ◽

Mitchell J. Yelton ◽

Philip J. Rosinsky ◽

Jacob Shapira ◽

Mitchell Meghpara ◽

...

Keyword(s):

Hip Arthroscopy ◽

Arthroscopic Surgery ◽

Return To Sport ◽

Return To Play ◽

Harris Hip Score ◽

Tennis Players ◽

Labral Tears ◽

Patient Reported ◽

Modified Harris Hip Score

Abstract Background: Playing tennis is associated with various movements that can lead to labral injuries and may require arthroscopic surgery. While hip arthroscopies have demonstrated good outcomes in athletes, there is limited literature reporting Patient Reported Outcomes (PROs) and return to play in competitive or recreational tennis players after hip arthroscopic surgery. Therefore, the purpose of the present study was to (1) report minimum five-year PROs and return to sport in tennis players who underwent hip arthroscopic surgery and (2) compare outcomes between recreational and competitive tennis players. Methods: Data for patients who underwent hip arthroscopy surgery in the setting of femoroacetabular impingement (FAI) and labral tears between March 2009 and January 2014 and who played tennis at any level within one-year of surgery were retrospectively reviewed. Patients with preoperative and minimum five-year postoperative scores for the following PROs were included: modified Harris Hip Score (mHHS), Non-Arthritic Hip Score (NAHS), Hip Outcome Score-Sport Specific Subscale (HOS-SSS), and visual analog scale (VAS) for pain. Patients with preoperative Tönnis osteoarthritis Grade >1, Workers’ Compensation claims, age > 60 years old, or previous ipsilateral hip surgeries or conditions were excluded. Patient Acceptable Symptomatic State (PASS) and Minimal Clinically Important Difference (MCID) for mHHS and HOS-SSS were calculated. Results: Of 28 patients, 31 hips met all inclusion and exclusion criteria of which 28 (90.3%) had minimum 5-year follow-up (mean: 72.8 ± 13.9 months). There were 3 professional, 3 collegiate, 2 high school, 2 organized amateur, and 18 recreational level tennis players. All PROs significantly improved at latest follow-up: mHHS from 67.0 to 86.7 (P < 0.001), NAHS from 65.9 to 87.2 (P < 0.001), HOS-SSS from 50.0 to 77.9 (P = 0.009), and VAS from 5.4 to 1.8 (P < 0.001). There was a 75.0% return to sport rate. Additionally, 66.7% of patients achieved MCID and 83.3% achieved PASS for mHHS, and 63.6% achieved MCID and 58.3% achieved PASS for HOS-SSS. Conclusion: Regardless of the level of participation, tennis players who underwent hip arthroscopic surgery reported statistically significant PRO improvements. A favorable rate of return to sport was also achieved.

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