Balance and functional disorders in geriatric patients after total hip prosthesis removal

2021 ◽  
pp. 1-6
Author(s):  
Aleksandra Truszczyńska-Baszak ◽  
Justyna Drzał-Grabiec ◽  
Adam Tarnowski
Keyword(s):  
Postural Stability ◽  
Hip Prosthesis ◽  
Harris Hip Score ◽  
Control Group ◽  
Functional Disorders ◽  
Foot Pressure ◽  
Stability Parameters ◽  
Balance Test ◽  
Total Hip ◽  
Prosthesis Removal

BACKGROUND: One of the most difficult complications of total hip arthroplasty is an infection in the area of the implant with an incidence of 0.5% to 2.5% resulting in the most severe situation in prosthesis removal. OBJECTIVE: The aim of the study was to assess postural stability and functional disorders in patients after hip prosthesis removal. METHODS: A group of 15 patients after hip prosthesis removal was compared to a control group of 15 healthy persons who were age-matched without any symptoms of degenerative disorders in the lower spine and lower extremities. The static balance test was conducted on a bi-modular stabilometric platform, registering the movement of the centre of foot pressure. The functional state of the patients was assessed on the basis of the Harris Hip Score (HHS). RESULTS: Patients had poor functional result (HSS mean 62.29 ± 12.92 points). Obtained results of postural stability of patients showed huge difficulties maintaining stability and showed statistically significant differences in a majority of the analysed parameters. CONCLUSIONS: Several stability parameters showed significantly worse results in patients after hip prosthesis removal. Special attention should be paid and focused physiotherapy should be undertaken for patients with a stability disorder and functional status to prevent falls and improve functioning.

Assessment of postural stability using the Zebris Platform in women above the age of 60

2020 ◽  
Vol 30 (92) ◽  
pp. 13-18
Author(s):  
Janusz Jaworski ◽  
Ewelina Kołodziej
Keyword(s):  
Physical Activity ◽  
Comparative Analysis ◽  
Postural Stability ◽  
Balance Control ◽  
Regular Physical Activity ◽  
Foot Pressure ◽  
Stability Parameters ◽  
Younger Women ◽  
Centre Of Foot Pressure ◽  
Ellipse Area

Introduction. Balance control and body posture stability disorders progressing with age are caused by the involutionary changes in the function of the motor and nervous systems. However, it is indicated that regular physical activity, also in older adulthood, may have a positive effect on maintaining the functions of individual systems at an optimal level. Study aim: The aim of the study was to assess the postural stability of women above the age of 60 who declare active lifestyles. Material and Methods. The research involved 24 women, who were arbitrarily divided into 3 groups according to their calendar age. The younger group consisted of 14 women below the age of 70 years ( x _ = 65.08; SD = 2.82), whereas the older group comprised 10 older adults, above the age of 70 ( x _ = 73.62; SD = 2.74). The scope of the study included evaluation of selected postural stability parameters: 95% of the ellipse area covered by the moving COP, statokinesiogram path length, mean speed regarding displacement of the centre of foot pressure, total left and total right foot pressure. The examinations were performed in June 2018 using the Zerbis FDM-S dynamographic platform. The research material collected in this way was subjected to statistical analysis. Basic descriptive statistics were calculated and normality of the distribution of variables was verified using the Shapiro- Wilk test. The Student’s t-test for independent variables or Mann-Whitney’s U-test (depending on the distribution) were used to determine the significance of differences concerning the analysed parameters of postural stability between the groups studied. Furthermore, for 95% of the ellipse area covered by the moving COP, statokinesiogram path and mean speed of the displacement of the centre of foot pressure and standardised profiles were calculated for both chronological age groups. Standardisation of the results was performed using means and standard deviations of the entire material (T scale). Results. The results of the study indicate a higher level of postural stability among women from the younger group. However, comparative analysis did not reveal any statistically significant intergroup differences. Mean point scores on the T scale in the group of younger women for the 3 variables ranged from 50.98 to 51.60 points, whereas for older women, this was from 48.90 to 48.98 points. The differences between characteristics in the group of younger women totalled ca. 0.62 points, while in the older group, this value was 0.08 points. Conclusions. comparative analysis allowed to show that postural stability indices in women above 70 decreased compared to the results obtained for the younger group. Regular physical activity may be one of the significant factors in the prevention of postural stability regression.

scholarly journals Subchondral drilling for chondral flaps reduces the risk of total hip arthroplasty in femoroacetabular impingement surgery at minimum five years follow-up

2018 ◽  
Vol 29 (2) ◽  
pp. 191-197 ◽  
Author(s):  
Pascal C Haefeli ◽  
Moritz Tannast ◽  
Martin Beck ◽  
Klaus A Siebenrock ◽  
Lorenz Büchler
Keyword(s):  
Los Angeles ◽  
Total Hip Arthroplasty ◽  
Femoroacetabular Impingement ◽  
Hip Arthroplasty ◽  
Hip Dislocation ◽  
Harris Hip Score ◽  
Control Group ◽  
Total Hip ◽  
Tönnis Grade

Introduction: The best treatment of acetabular chondral flaps during surgery for femoroacetabular impingement (FAI) is unknown. We asked if subchondral drilling improves clinical and radiographic outcome and if there are factors predicting failure. Methods: We treated 79 patients with symptomatic FAI and acetabular chondral flaps with surgical hip dislocation between January 2000 and December 2007. Exclusion of all patients with previous hip pathology or trauma resulted in 62 patients (80 hips). The chondral flap was slightly debrided in 43 patients/51 hips (control group). In 28 patients/29 hips (study group), additional osseous drilling was performed. 4 patients (5 hips, 6%) were lost to follow-up. Mean follow-up was 9 years (5–13 years). The groups did not differ in demographic data, radiographic parameters or follow-up. Clinical outcome was assessed with the Merle d’Aubigné score, modified Harris Hip Score and University of California Los Angeles activity score and progression of osteoarthritis with the Tönnis grade. Results: No patient underwent conversion to total hip arthroplasty (THA) in the drilling group compared to 7 patients (8 hips, 16%) in the control group ( p = 0.005); in the remaining hips, clinical scores and progression of Tönnis grade did not differ. Increased acetabular coverage, age and body mass index were univariate predictive factors for conversion to THA. No drilling was as an independent predictive factor for conversion to THA (hazard ratio 58.07, p = 0.009). Conclusion: Subchondral drilling under acetabular chondral flaps during surgical treatment of FAI is an effective procedure to reduce the rate of conversion to THA.

scholarly journals Postural Stability in Adolescent Girls with Progressive Idiopathic Scoliosis

2019 ◽  
Vol 2019 ◽  
pp. 1-5 ◽  
Author(s):  
Marzena Wiernicka ◽  
Tomasz Kotwicki ◽  
Ewa Kamińska ◽  
Dawid Łochyński ◽  
Mateusz Kozinoga ◽  
...  
Keyword(s):  
Idiopathic Scoliosis ◽  
Adolescent Girls ◽  
Postural Stability ◽  
Path Length ◽  
Center Of Pressure ◽  
Mean Amplitude ◽  
Growth Spurt ◽  
Control Group ◽  
Stability Parameters ◽  
Progressive Form

The aim of this work was to analyze postural stability of girls having progressive form of idiopathic scoliosis and undergoing specific period of the adolescent growth spurt. Twenty-seven girls, aged 13.4 ± 1.2 years, presenting structural idiopathic scoliosis, thoracic or thoracolumbar pattern, radiological Cobb angle 41.7 ± 17.4° (study group) and 37 healthy girls (control group) were included. The groups were sex, age, height, weight, and BMI matched. Postural stability examination was performed using two stabilometric platforms with visual control (eyes open) at three stages: (1) both legs’ stance, (2) left leg stance, and (3) right leg stance. The Center of Pressure (COP) sway path length, the area and the displacement amplitude were compared. For the double stance, no difference in postural stability parameters between the groups was found. However, for the right leg stance, the total sway path length was longer (p=0.04) and the mean amplitude of the lateral COP displacement was increased (p=0.03) in the scoliotic group. In conclusion, for double stance, the adolescent girls with progressive form of idiopathic scoliosis revealed fair postural stability compared to control group. An impaired postural control was observed during right leg stance.

Total Hip Arthroplasty after Vascularized Fibular Grafting

2012 ◽  
Vol 2 (1) ◽  
pp. 12-17
Author(s):  
Thomas P Vail ◽  
Apostolos Dimitroulias ◽  
Jeff Hodrick ◽  
Rusty Brand ◽  
Nicholas Viens ◽  
...  
Keyword(s):  
Total Hip Arthroplasty ◽  
Acetabular Component ◽  
Hip Arthroplasty ◽  
Perioperative Complications ◽  
Harris Hip Score ◽  
Control Group ◽  
Total Hip ◽  
Uncemented Total Hip Arthroplasty ◽  
Significant Difference ◽  
Fibular Grafting

ABSTRACT Background Vascularized fibular grafting has been reported as a successful joint preserving surgery for patients with femoral head osteonecrosis. Few reports exist regarding the outcomes associated with total hip arthroplasty after failed vascularized fibular grafting. This study aims to highlight the early results and complications associated with this procedure. Materials and methods We retrospectively reviewed charts and radiographs of 30 patients (38 hips) who underwent conversion of prior vascularized fibular grafting to an uncemented total hip arthroplasty utilizing modern bearings (highly cross-linked polyethylene-on-metal or metal-on-metal). Mean follow-up was 41 months. A control group of 15 osteonecrosis patients (19 hips) was used who had a history of total hip arthroplasty without previous surgery. Outcome measures used were perioperative complications, clinical and radiological findings. Results The prior vascularized fibular grafting group had longer surgical times and more perioperative complications (calcar fracture and persistent wound drainage requiring early reoperation). In the prior vascularized fibular grafting group there were two cases requiring revision for aseptic loosening (one femoral and one acetabular component) and three cases of asymptomatic radiographic loosening (two femoral and one acetabular component). Furthermore, three patients reported symptoms of trochanteric bursitis. None of the above complications were seen in the control group. There was one dislocation in each group; and both were treated successfully with closed reduction. There was no significant difference between the two groups in the final postoperative Harris Hip Score (HHS). Conclusion Despite an increased complication rate, comparable clinical outcomes can be expected after conversion of vascularized fibular grafting to total hip arthroplasty. Dimitroulias A, Hodrick J, Brand R, Viens N, Attarian DE Vail TP, Bolognesi MP. Total Hip Arthroplasty after Vascularized Fibular Grafting. The Duke Orthop J 2012; 2(1):12-17.

scholarly journals The Impact of a Vestibular-Stimulating Exercise Regime on Postural Stability in People with Visual Impairment

2015 ◽  
Vol 2015 ◽  
pp. 1-8 ◽  
Author(s):  
Ida Wiszomirska ◽  
Katarzyna Kaczmarczyk ◽  
Michalina Błażkiewicz ◽  
Andrzej Wit
Keyword(s):  
Visual Impairment ◽  
Postural Stability ◽  
Control Group ◽  
Stability Parameters ◽  
Static Tests ◽  
Balance System ◽  
Eyes Closed ◽  
Exercise Regime ◽  
The Stability ◽  
The Impact

The aim of the study was to assess the impact of a vestibular-stimulating exercise regime on postural stability in individuals with visual impairment. The study group consisted of 70 people, including 28 persons (15 female and 13 male) with visual impairment and 42 (21 female and 21 male) without visual impairment. Each individual in the group with visual impairment was medically qualified for a 3-month training program. The research methodology included medical examination, anthropometric tests, and stabilometry tests on a Biodex Balance System SD (BBS). The tests were conducted twice: once before the start of training and again after 3 months of rehabilitation. The group with visual impairment showed significantly worse postural stability results than the control group for most of the stability parameters evaluated (OSI, APSI, and MLSI). Differences were noted between the groups with and without visual impairment for dynamic tests in women and for static tests in men. After training, the two groups showed roughly similar results for the stabilometry test with eyes closed. We conclude that exercises stimulating the vestibular system with head and body movements should be recommended for individuals with visual impairments to achieve better balance retention.

scholarly journals Effects of early home-based strength and sensory-motor training after total hip arthroplasty: study protocol for a randomized controlled trial

2021 ◽  
Author(s):  
Pika Krištof Mirt ◽  
Vojko Strojnik ◽  
Gregor Kavčič ◽  
Rihard Trebše
Keyword(s):  
Total Hip Arthroplasty ◽  
Strength Training ◽  
Hip Arthroplasty ◽  
Harris Hip Score ◽  
Control Group ◽  
Motor Training ◽  
Postoperative Phase ◽  
Total Hip ◽  
Home Based ◽  
Sensory Motor

Abstract BackgroundTotal hip arthroplasty (THA) is very effective in alleviating pain, but functional deficits persist up to a year following surgery. Regardless of standard physiotherapy programs, significant additional muscular atrophy and weakness occurs. Deficits in strength have serious adverse consequences for these patients with respect to physical function, the maintenance of independence and the requirement for revision surgery. Progressive resistance training in rehabilitation following THA has been shown to significantly enhance muscle strength and function. The fundamental principle is to progressively overload the exercised muscle as it becomes stronger. Different strength training protocols have been used at different times in the postoperative phase, in group or individual practices, with major differences being in center-based and home-based programs with or without supervision. The primary objectives of our study are to evaluate whether an early postoperative home-based strength training protocol is feasible for all elective THA patients, does not cause major adverse effects and can improve patient functional outcomes at 3 months and 1 year following surgery.Methods/DesignThis study is a prospective multicenter randomized clinical trial to be conducted in the orthopedic departments of two Slovenian hospitals. In each hospital, 124 patients aged 60 or older with unilateral osteoarthritis, an ASA score between 1 and 3, signed informed consent form, and no terminal illness disabling rehabilitation participation will be randomly assigned to the intervention or control group. THA with an anterior approach will be performed. All patients will receive current standard physiotherapy during hospitalization. Patients in the intervention group will also learn strength and sensory-motor training exercises. Upon discharge all will receive USB drives with exercise videos, written exercise instructions and a training diary. Physiotherapists will perform the assessments (physical tests and the maximal voluntary isometric contraction assessment), and patients will fill out outcome assessment questionnaires (the Harris Hip Score and 36-Item Short Form Health Survey) at baseline and 1, 3 and 12 months after surgery.DiscussionThe main purpose of our study is to design a new standardized rehabilitation protocol with videos that will be effective, safe and accessible to all Slovenian THA patients.Trial registrationClinicalTrials.gov ID: NCT04061993. Protocol ID: PRT_PhD. Record Verification April 2021. https://clinicaltrials.gov/ct2/show/NCT04061993

scholarly journals Metal Ion Release, Clinical and Radiological Outcomes in Large Diameter Metal-on-Metal Total Hip Arthroplasty at Long-Term Follow-Up

Diagnostics ◽  
2020 ◽  
Vol 10 (11) ◽  
pp. 941
Author(s):  
Assunta Pozzuoli ◽  
Antonio Berizzi ◽  
Alberto Crimì ◽  
Elisa Belluzzi ◽  
Anna Chiara Frigo ◽  
...  
Keyword(s):  
Total Hip Arthroplasty ◽  
Hip Arthroplasty ◽  
Metal Ion ◽  
Local Level ◽  
Harris Hip Score ◽  
Control Group ◽  
Ion Release ◽  
Total Hip ◽  
Metal On Metal ◽  
Metal Ion Release

Total hip arthroplasty (THA) with metal-on-metal (MoM) bearings have shown problems of biocompatibility linked to metal ion release at the local level causing an adverse reaction to metal debris (ARMD) and at a systemic level. The aim of this study was to evaluate clinical and radiological outcomes, and metal ion concentrations in the blood and urine of patients who underwent THA with the LIMA Met-Met hip system. Patients with ceramic-on-ceramic (CoC) bearings were included as a control group. In this study, 68 patients were enrolled: 34 with MoM THAs and 34 with CoC THAs. Patients were evaluated clinically (Harris Hip Score, SF-36) and radiologically at a median of 7.4 years after surgery. Whole blood and urinary cobalt and chromium levels were also assessed. Both types of implants were comparable in terms of clinical and functional results. Ion levels were significantly higher in the MoM group compared with CoC group 7 years after surgery. No correlations were found between metal ion levels and patient demographics, functional and radiological outcomes, and prosthesis features. Patient monitoring is thus advised to establish if prosthesis revision is necessary, especially in the case of MoM THA.

scholarly journals Our experience of total hip arthroplasty in adolescents with consequences of acute hematogenous osteomyelitis

2021 ◽  
Vol 9 (2) ◽  
pp. 163-174
Author(s):  
Khisrav D. Imomov ◽  
Vladimir E. Baskov ◽  
Valentin A. Neverov ◽  
Pavel I. Bortulev
Keyword(s):  
Total Hip Arthroplasty ◽  
Hip Arthroplasty ◽  
Functional Results ◽  
Social Adaptation ◽  
Harris Hip Score ◽  
Control Group ◽  
Total Hip ◽  
Hematogenous Osteomyelitis ◽  
Acute Hematogenous Osteomyelitis ◽  
Before And After

BACKGROUND: Currently, the number of adolescents with terminal stages of coxarthrosis of various origins who underwent total hip joint arthroplasty has increased, as the use of modern implant models with a long service life has narrowed the age limit and expanded the indications for this intervention. AIM: This study aimed to assess the effectiveness of total hip arthroplasty in adolescents with stage 3 coxarthrosis caused by acute hematogenous osteomyelitis. MATERIALS AND METHODS: The study analyzed preoperative data and postoperative clinical, radiological, and functional examination data of 40 patients aged 1318 (15 1.2) years with stage 3 coxarthrosis caused by acute hematogenous osteomyelitis. The study group was composed of 21 (52.5%) boys and 19 (47.5%) girls. The control group consisted of 32 patients with stage 3 post-traumatic coxarthrosis, aged 1218 (15.4 1.7) years, of which 14 (43.75%) were girls and 18 (56.25%) were boys. RESULTS: The long-term functional results were evaluated using the Harris hip score (14). The average Harris hip scores before and after arthroplasty were 44.87 5.65 and 80 7.61 (p 0.05), respectively. In the comparison group, the mean Harris hip scores before and after surgery were 33.73 4.28 and 89.47 5.60 points, respectively (p 0.05). The postoperative follow-up duration was 5 3 M SD (95% confidence interval) years. No complications were observed in the early and late postoperative periods. CONCLUSIONS: In adolescents, total hip arthroplasty is an effective surgical treatment for complications of acute hematogenous osteomyelitis. It quickly provides attainable, stable, and favorable outcomes, which improve the quality of life and social adaptation of adolescents.

scholarly journals Revision hip arthroplasty by Waldemar Link custom-made total hip prosthesis

2010 ◽  
Vol 67 (2) ◽  
pp. 179-182
Author(s):  
Ivica Medenica ◽  
Milan Lukovic ◽  
Dragan Radoicic
Keyword(s):  
Hip Arthroplasty ◽  
Hip Prosthesis ◽  
Bone Defects ◽  
Harris Hip Score ◽  
Bone Stock ◽  
Total Hip Prosthesis ◽  
Pelvic Discontinuity ◽  
Total Hip ◽  
Number Of Patients ◽  
Custom Made

Background. The number of patients undergoing hip arthroplasty revision is constantly growing. Especially, complex problem is extensive loss of bone stock and pelvic discontinuity that requires reconstruction. Case report. The paper presented a 50-year old patient, who ten years ago underwent a total cement artrhroplasty of the left hip. A year after the primary operation the patient had difficulties in walking without crutches. Problems intensified in the last five years, the patient had severe pain, totally limited movement in the left hip and could not walk at all. Radiographically, we found loose femoral component, massive loss of bone stock of proximal femur, acetabular protrusion and a consequent pelvic discontinuity. Clinically, a completely disfunctional left hip joint was registered (Harris hip score - 7.1). We performed total rearthroplasty by a custom- made Waldemar Link total hip prosthesis with acetabular antiprotrusio cage and compensation of bone defects with a graft from the bone bank. A year after the operation, we found clinically an extreme improvement in Harris hip score - 87.8. Radiographically, we found stability of implanted components, a complete graft integration and bone bridging across the site of pelvic discontinuity. Conclusion. Pelvic discontinuity and massive loss of proximal femoral bone stock is a challenging and complex entity. Conventional prostheses cannot provide an adequate fixation and stability of the hip. Application of custom-made prosthesis (measured specifically for a patient) and additional alografting bone defects is a good method in revision surgery after unsuccessful hip arthroplasty with extensive bone defects.

scholarly journals Serum cobalt concentrations remain at low levels at a minimum of 20 years following metal-on-metal total hip arthroplasty

2020 ◽  
Vol 9 (3) ◽  
pp. 146-151 ◽  
Author(s):  
Wenzel Waldstein ◽  
Ulrich Koller ◽  
Bernhard Springer ◽  
Paul Kolbitsch ◽  
Wolfram Brodner ◽  
...  
Keyword(s):  
Total Hip Arthroplasty ◽  
Hip Arthroplasty ◽  
Harris Hip Score ◽  
Controlled Study ◽  
Control Group ◽  
Total Hip ◽  
Metal On Metal ◽  
Low Levels ◽  
Serum Cobalt

Aims Second-generation metal-on-metal (MoM) articulations in total hip arthroplasty (THA) were introduced in order to reduce wear-related complications. The current study reports on the serum cobalt levels and the clinical outcome at a minimum of 20 years following THA with a MoM (Metasul) or a ceramic-on-polyethylene (CoP) bearing. Methods The present study provides an update of a previously published prospective randomized controlled study, evaluating the serum cobalt levels of a consecutive cohort of 100 patients following THA with a MoM or a CoP articulation. A total of 31 patients were available for clinical and radiological follow-up examination. After exclusion of 11 patients because of other cobalt-containing implants, 20 patients (MoM (n = 11); CoP (n = 9)) with a mean age of 69 years (42 to 97) were analyzed. Serum cobalt levels were compared to serum cobalt levels five years out of surgery. Results The median cobalt concentration in the MoM group was 1.04 μg/l (interquartile range (IQR) 0.64 to 1.70) at a mean of 21 years (20 to 24) postoperatively and these values were similar (p = 0.799) to cobalt levels at five years. In the CoP control group, the median cobalt levels were below the detection limit (< 0.3 μg/l; median 0.15 μg/l, IQR 0.15 to 0.75) at 20 years. The mean Harris Hip Score was 91.4 points (61 to 100) in the MoM group and 92.8 points (63 to 100) in the CoP group. Conclusion This study represents the longest follow-up series evaluating the serum cobalt levels after 28 mm head MoM bearing THA and shows that serum cobalt concentrations remain at low levels at a mean of 21 years (20 to 24) after implantation. Cite this article: Bone Joint Res. 2020;9(3):145–150.

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