scholarly journals TO EVALUATE EFFECT OF HORIZONTAL HIP OFFSET AND LEG LENGTH RECONSTRUCTION ON FUNCTIONAL OUTCOME OF TOTAL HIP REPLACEMENT

Author(s):  
Harshit Jain ◽  
Hemraj Saini

Background: For total hip replacement besides long term durability a optimal postoperative functional outcome is essential.so aim of this study was to determine the combined influence of hip geometry reconstruction on the clinical outcome following primary total hip replacement for unilateral osteoarthritis. Methods: A hospital based prospective study was carried out on 60 cases of unilateral osteoarthritis with normal contralateral hip. We prospectively assessed the clinical outcome and radiographic parameters for hip geometry reconstruction using validated measurements for the operated hip compared to the contralateral native hip with primary unilateral THA. The correlation of reconstruction parameters was investigated using a multivariate polynomial regression model for the dependent variable ?HHS (difference between the Harris hip scores preoperatively and 6 months postoperatively). Target zones for hip reconstruction were investigated for an association with superior clinical outcome. Results: The regression model demonstrated a significant correlation for the ?HHS and both hip offset (HO) reconstruction and leg length difference. Patients with accurate to slightly increased HO reconstruction combined with balanced leg length demonstrated a significantly higher ?HHS than patients outside this zone. Conclusion: HO and leg length reconstruction demonstrated an additive effect on clinical outcome and surgeons should aim for high accuracy in the reconstruction of both factor. Keyword: Hip offset, total hip arthoplasty, harris hip score

Author(s):  
Kunal Ajitkumar Shah ◽  
Mohan Madhav Desai

<p class="abstract"><strong>Background:</strong> Total hip replacement (THR) is the most successful and cost effective treatment with aim of pain relief and functional rehabilitation for hip disorders. As the implant designs of THR have evolved over time, the functional outcome and survivorship has improved. Even after so many advancements, it remains unclear that which implants are better, uncemented or cemented. Hence, we took up this study to analyze which of the uncemented or cemented THR have better functional outcome.</p><p class="abstract"><strong>Methods:</strong> This was a longitudinal study conducted during 2014 to 2018. Hundred cases were randomized into groups of 50 each. All patients with age between 55-80 years in whom THR was indicated were included in the study. Uncemented THR was done in Group A and cemented THR was done in Group B. Patients were followed up at 12 weeks, 6 months, 12 months, and 3 years. At follow-up, functional examination in terms of visual analogue scale (VAS) score and Harris hip score (HHS) was done.<strong></strong></p><p class="abstract"><strong>Results:</strong> The mean age of patients in Group A (uncemented) and Group B (cemented) was 62.5 years and 60 years respectively. We found that the difference of VAS score and HHS between Group A and B was statistically significant at 12 weeks and 6 months. The difference of VAS and HHS scores between Group A and B at 12 months and 3 years was not significant.</p><p class="abstract"><strong>Conclusions:</strong> We conclude that cemented THR has better functional outcome at short term. They are cost effective option at age ≥55-60 years.</p>


2019 ◽  
Vol 34 (12) ◽  
pp. 3106-3113 ◽  
Author(s):  
Felix Stief ◽  
Stefan van Drongelen ◽  
Marco Brenneis ◽  
Timur Tarhan ◽  
Benjamin Fey ◽  
...  

2018 ◽  
Vol 4 (2.8) ◽  
pp. 1015-1017
Author(s):  
Dr. Lokesh Gupta ◽  
Dr. Mukand Lal ◽  
Dr. Vineet Aggarwal ◽  
Dr. Lakshya Prateek Rathor

2021 ◽  
Vol 49 (5) ◽  
pp. 030006052110122
Author(s):  
Wenlu Liu ◽  
Huanyi Lin ◽  
Xianshang Zeng ◽  
Meiji Chen ◽  
Weiwei Tang ◽  
...  

Objective To compare the clinical outcomes of primary metal-on-metal total hip replacement (MoM-TR) converted to uncemented total hip replacement (UTR) or cemented total hip replacement (CTR) in patients with femoral neck fractures (AO/OTA: 31B/C). Methods Patient data of 234 UTR or CTR revisions after primary MoM-TR failure from March 2007 to January 2018 were retrospectively identified. Clinical outcomes, including the Harris hip score (HHS) and key orthopaedic complications, were collected at 3, 6, and 12 months following conversion and every 12 months thereafter. Results The mean follow-up was 84.12 (67–100) months for UTR and 84.23 (66–101) months for CTR. At the last follow-up, the HHS was better in the CTR- than UTR-treated patients. Noteworthy dissimilarities were correspondingly detected in the key orthopaedic complication rates (16.1% for CTR vs. 47.4% for UTR). Statistically significant differences in specific orthopaedic complications were also detected in the re-revision rate (10.3% for UTR vs. 2.5% for CTR), prosthesis loosening rate (16.3% for UTR vs. 5.9% for CTR), and periprosthetic fracture rate (12.0% for UTR vs. 4.2% for CTR). Conclusion In the setting of revision of failed primary MoM-TR, CTR may demonstrate advantages over UTR in improving functional outcomes and reducing key orthopaedic complications.


2016 ◽  
Vol 136 (9) ◽  
pp. 1317-1323 ◽  
Author(s):  
N. D. Clement ◽  
R. S. Patrick-Patel ◽  
D. MacDonald ◽  
S. J. Breusch

2021 ◽  
pp. 71-75
Author(s):  
Arun Kumar C ◽  
Ganashree S ◽  
Arivoli S ◽  
Aswath C A ◽  
Rakesh Kumar B ◽  
...  

Introduction: Hip resurfacing arthroplasty (HRA) or Total hip replacement (THR), as it is popularly called, attempts to mollify these basic clinical problems, in patients with a hip arthritic problem, which may be of a sequela to age-related degeneration, osteonecrosis, systemic disorder like Rheumatoid arthritis (RA) or Ankylosing spondylosis (AS) or as a result of trauma and or an old infection. The basic pathology, is an unfavourable and abrading hip diarthrodial joint. The endeavour of the study was, to establish the efcacy of the Posterior vs Lateral approach for THA/THR, by studying their outcomes in primary THR. This prospective study was undertaken at Che Materials And Methods: ttinad Hospital and Research Institute (CARE), Kelambakkam, Chengalpattu district, Tamilnadu, In the Department of Orthopaedics from Jan 2017 to Dec 2020 (48 months). The Functional outcome of hip surgery was measured using the Harris Hip Score, Oxford hip score and the WOMAC. Rivermead visual gait analysis (RVGA) method was used post-operatively to assess the gait. The Biomechanical outcomes of Abductor Gait Component, were individually assessed by EMG studies. The Harris Hip Score, The Oxford Hip S Results: core and WOMAC score, when the lateral approach was compared to the posterior approach pre-op and post-op in the 12 months minimum follow-up period, the laterally approached group faired better. The VAS score was equivocal. The comprehensive RVGA assessment also showed marginally better results for the laterally approached group as was the case with the Trendelenburg test score. The EMG studies for the Gluteus Maximus, Medius and the lateral rotators of hip also favoured the outcomes for the laterally approach hips. The supremacy of the Lateral Approach, ove Conclusion: r Posterior Approach, cannot be adjudged in a short-term follow-up study. It is thus opined that the Lateral Approach may be statistically and data wise superior, but the patient satisfaction, which is a major factor, is almost the same in both the approach groups. The follow-up needs to be atleast for a decade for us to be able to come to any meaningful conclusion. With regards to surgery like the Total hip replacement, which have a longevity factor exceeding 10 years, studies have to be followed up for periods in excess of 10 years.


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