scholarly journals The Symmetry and Predictive Factors in Two-Stage Bilateral Hip Replacement Procedures

Symmetry ◽  
2021 ◽  
Vol 13 (8) ◽  
pp. 1472
Author(s):  
Krystian Kazubski ◽  
Łukasz Tomczyk ◽  
Mariusz Ciszewski ◽  
Jarosław Witkowski ◽  
Paweł Reichert ◽  
...  
Keyword(s):  
Total Hip Arthroplasty ◽  
Total Hip Replacement ◽  
Hip Arthroplasty ◽  
Hip Replacement ◽  
Two Stage ◽  
Total Hip ◽  
Second Surgery ◽  
Prosthetic Head ◽  
The Mean ◽  
Second Procedure

Background: Approximately 10–25% of total hip replacement patients undergo a bilateral procedure. The purpose of this study was to compare selected parameters associated with the first and second hip arthroplasty in patients undergoing two-stage treatment due to bilateral hip osteoarthritis and establish the predictive factors for the second procedure. Methods: This study compared the data on bilateral total hip replacement surgeries conducted in the period between 2017 and 2021 (42 patients). The following parameters from the first and second procedure were compared: the prosthetic stem, head, and insert cup size; type of cup insert; duration of anesthesia; duration of hospitalization; and the number of complications. Results: The mean duration of hospital stay at the time of the first total hip arthroplasty was 5.83 days and 5.4 days during the second stay. The mean stem sizes used during the first and second total hip replacement procedures were 7.11 and 7.09, respectively. The mean sizes of endoprosthetic cups used at the first and second total hip replacement procedures were 52.64 and 53.04, respectively. There were no significant differences between the mean prosthetic head size at the first and second surgery. The cup type used during the first and second surgery showed no difference. The mean duration of anesthesia used during the first and second total hip replacement surgery was 108.09 min and 104.52 min, respectively. We recorded a mean of 0.07 complications per patient at the first surgery and 0.02 at the second surgery. Conclusions: Our study results showed symmetry duration of anesthesia, length of hospital stay, number of complications per patient, stem size, prosthetic head size, cup insert size, and cup insert type at the first and second surgery in patients with two-stage bilateral total hip arthroplasty. We observed a strong correlation between the stem sizes of the first and second hip endoprostheses. There was also a strong correlation between the cup sizes used during the first and second surgery.

scholarly journals Total hip arthroplasty in patients with acetabular fractures

2021 ◽  
Vol 27 (5) ◽  
pp. 620-627
Author(s):  
A.A. Pronskikh ◽  
◽  
K.N. Kharitonov ◽  
A.A. Korytkin ◽  
S.V Romanova ◽  
...  
Keyword(s):  
Total Hip Arthroplasty ◽  
Total Hip Replacement ◽  
Hip Arthroplasty ◽  
Hip Replacement ◽  
Harris Hip Score ◽  
Acetabular Fractures ◽  
Total Hip ◽  
Post Traumatic ◽  
The Mean

Abstract. Introduction Total hip replacement is the most effective technique for the consequences of acetabular fractures. The study includes the literature review on the outcomes of total hip replacement (THR) in patients with post-traumatic coxarthrosis. Material and methods The search was performed via databases of PUBMED, SCOPUS, Google Scholar, Cochrane library, E-library and publications using the keywords “acetabulum”, “fracture”, “total hip arthroplasty” and “post-traumatic arthritis” published between 1995 and 2020. The exclusion criteria were a series of less than 10 patients, a follow-up period of less than 12 months. Abstracts of the meetings and review articles published either in Russian or in English were included in the study. Patients' demographic data, surgical characteristics and outcomes were reviewed. Results Total 1,843 publications were reviewed and the analysis included data from 20 studies with the total number of 1,184 cases reviewed. Surgical treatments of the patients were performed between 1984 and 2018. The follow–up period averaged to 5.5 ± 1.19 years (range, 2 to 18 years). The mean age of the patients was 56.4 ± 12.7 years. The mean interval from an injury to total hip arthroplasty was 8 ± 2.7 years. The mean Harris Hip Score was 39.4 ± 11 prior to surgery and 86.2 ± 22 postoperatively. The most common postoperative complications were heterotopic ossification (28.9 ± 10 %), aseptic loosening (8.15 ± 1.82 %) and periprosthetic joint infection (7.89+1.86 %). Complications that required revision surgery were noted in 13.47 ± 2.91 % cases. Conclusion THR in patients who sustained acetabular fractures is challenging, and bone grafts or acetabular augments would be needed to address an acetabular defect of any localization.

A Proximal Referencing System for the Charnley Low Friction Arthroplasty

2002 ◽  
Vol 12 (3) ◽  
pp. 303-307
Author(s):  
M.D.A. Fletcher ◽  
J.C.J. Webb ◽  
T. Maung
Keyword(s):  
Soft Tissue ◽  
Total Hip Arthroplasty ◽  
Total Hip Replacement ◽  
Hip Arthroplasty ◽  
Surgical Approach ◽  
Hip Replacement ◽  
Recurrent Dislocation ◽  
Soft Tissue Balance ◽  
Low Friction ◽  
Total Hip

Dislocation is a serious complication of total hip arthroplasty occurring in up to 9% of cases. Recurrent dislocation accounts for 4% of revisions in the Swedish Hip Arthroplasty Study. Soft tissue balancing is one of the factors, independent of the surgical approach used, that is involved in producing a stable total hip replacement. We describe a proximal referencing system for use with the Charnley low friction arthrosplasty (LFA), which optimises this factor. The dislocation rate, using this method, is 0.3% (in 333 cases performed by a single surgeon over a 5 year period). This system should prove valuable to orthopaedic surgeons in training, ensuring they achieve correct soft tissue balance in total hip arthroplasty.

Spatial component position in total hip arthroplasty: Accuracy and repeatability with a new CT method

2003 ◽  
Vol 44 (1) ◽  
pp. 84-91
Author(s):  
H. Olivecrona ◽  
L. Weidenhielm ◽  
L. Olivecrona ◽  
M. E. Noz ◽  
G. Q. Maguire ◽  
...  
Keyword(s):  
Total Hip Arthroplasty ◽  
Hip Arthroplasty ◽  
Spherical Surface ◽  
Spatial Relationship ◽  
Component Position ◽  
Total Hip ◽  
Percent Difference ◽  
Prosthetic Head ◽  
The Mean ◽  
Accuracy And Repeatability

Purpose: 3D detection of centerpoints of prosthetic cup and head after total hip arthroplasty (THA) using CT. Material and Methods: Two CT examinations, 10 min apart, were obtained from each of 10 patients after THA. Two independent examiners placed landmarks in images of the prosthetic cup and head. All landmarking was repeated after 1 week. Centerpoints were calculated and compared. Results: Within volumes, all measurements of centerpoints of cup and head fell, with a 95% confidence, within one CT-voxel of any other measurement of the same object. Across two volumes, the mean error of distance between center of cup and prosthetic head was 1.4 mm (SD 0.73). Intra- and interobserver 95% accuracy limit was below 2 mm within and below 3 mm across volumes. No difference between intra- and interobserver measurements occurred. A formula for converting finite sets of point landmarks in the radiolucent tread of the cup to a centerpoint was stable. The percent difference of the landmark distances from a calculated spherical surface was within one CT-voxel. This data was normally distributed and not dependent on observer or trial. Conclusion: The true 3D position of the centers of cup and prosthetic head can be detected using CT. Spatial relationship between the components can be analyzed visually and numerically.

scholarly journals Surgical management of avascular necrosis of femoral head in young adults treated with uncemented total hip replacement

2021 ◽  
Vol 7 (6) ◽  
pp. 1166
Author(s):  
Vijaya Bhaskar Reddy ◽  
N. Brahma Chary ◽  
Kacham Nikitha
Keyword(s):  
Femoral Head ◽  
Total Hip Arthroplasty ◽  
Avascular Necrosis ◽  
Total Hip Replacement ◽  
Hip Arthroplasty ◽  
Hip Replacement ◽  
Daily Activities ◽  
Harris Hip Score ◽  
Total Hip ◽  
Uncemented Total Hip Replacement

<p class="abstract"><strong>Background: </strong>Normal hip joint is subjected to many stresses during daily activities performed by an individual. Since it is one of the major weight bearing joints of the body, its normal function is necessary for daily activities. Avascular necrosis (AVN) of the femoral head is one of the common causes of painful hip in a young adult. Core decompression, fibular sturt graft can be considered in early stages, total hip arthroplasty in later stages of AVN of femoral head.</p><p class="abstract"><strong>Methods:</strong> This is a retrospective study of 30 patients following uncemented total hip replacement, who were operated between August 2017 and March 2020 at MNR medical college and hospital, Sangareddy. They were followed up for a minimum period of 1 year and evaluated using Harris hip scoring system. Harris hip score is designed specifically for measuring functional outcomes in hip arthroplasty.</p><p class="abstract"><strong>Results: </strong>There was a significant improvement in function as measured with the Harris hip score. The overall preoperative Harris hip score was 43, which remarkably improved to 89 postoperatively. The results observed, showed that all patients had good to excellent results, (Harris hip score ≥0) thus showing a good degree of pain relief, improvement in function and range of motion.</p><p class="abstract"><strong>Conclusions: </strong>Although the use of total hip arthroplasty in young patients will more likely necessitate future revision surgery, the consistent relief of pain and good functional results have made this procedure an attractive treatment choice for the debilitating arthritis resulting from osteonecrosis of the femoral head.  </p>

scholarly journals Total hip arthroplasty in patients with slipped capital femoral epiphysis: a systematic analysis of 915 cases

2021 ◽  
Vol 12 (4) ◽  
Author(s):  
Eustathios Kenanidis ◽  
Panagiotis Kakoulidis ◽  
Sousana Panagiotidou ◽  
Andreas Leonidou ◽  
Panagiotis Lepetsos ◽  
...  
Keyword(s):  
Total Hip Arthroplasty ◽  
Hip Arthroplasty ◽  
Hip Replacement ◽  
Functional Outcomes ◽  
Slipped Capital Femoral Epiphysis ◽  
Cochrane Library ◽  
Systematic Analysis ◽  
Total Hip ◽  
Ovid Medline ◽  
The Mean

There is limited evidence on the outcomes of Total Hip Arthroplasty (THA) in Slipped Capital Femoral Epiphysis (SCFE) patients. This systematic review aims to evaluate the current literature in terms of survival rate, functional outcomes, complications and types of implants of THA in SCFE patients. Following the established methodology of PRISMA guidelines, PubMed, Cochrane library, ScienceDirect and Ovid MEDLINE were systematically searched from inception to September 2018. The search criteria used were: (“total hip arthroplasty’’ OR ‘’total hip replacement’’ OR “hip arthroplasty’’ OR ‘’hip replacement’’) AND (‘’slipped capital femoral epiphysis’’ OR ‘’slipped upper femoral epiphysis’’ OR ‘’femoral epiphysis’’). Ten studies were finally included in the analysis and were qualitatively appraised using the Newcastle-Ottawa tool. Variables were reported differently between studies. The sample size varied from 12 to 374 THAs. A total of 877 patients undergone 915 THAs. The mean reported follow-up ranged from 4.4 to 15.2 years and the mean patients’ age at the time of THA from 26 to 50 years. Four studies specified the type of implants used, with 62% being uncemented, 24% hybrid (uncemented cup/cemented stem) and 14% cemented. All but three studies reported the mean survival of implants that ranged from 64.9% to 94.8%. A limited number of complications were mentioned. There was a tendency for more favorable functional outcomes in modern studies. Modern THA-studies in SCFE patients showed improvement of survivorship, clinical outcomes and patient satisfaction. Future higher-quality studies are necessary to estimate long-term postoperative outcomes better.

scholarly journals Anterior Subluxation after Total Hip Replacement Confirmed by Radiographs: Report of Two Cases

2011 ◽  
Vol 2011 ◽  
pp. 1-4
Author(s):  
Conor P. McGrory ◽  
Brian J. McGrory
Keyword(s):  
Femoral Head ◽  
Total Hip Arthroplasty ◽  
Total Hip Replacement ◽  
Hip Arthroplasty ◽  
Hip Replacement ◽  
Rare Complication ◽  
Unusual Complication ◽  
Total Hip ◽  
Anterior Subluxation

Demonstrable anterior subluxation of the femoral head after a total hip arthroplasty is a rare complication and is usually transient. Both a case of recurrent subluxation and a case of chronic subluxation are described in this paper, each one presenting with unexpected femoral head eccentricity in the acetabulum on radiograph. We show how this unusual complication can be successfully identified and treated.

scholarly journals Limb-Sparing Using Total Hip Arthroplasty in a Dog with Femoral Head Osteosarcoma

2017 ◽  
Vol 45 ◽  
pp. 6
Author(s):  
Fernando Yoiti Kitamura Kawamoto ◽  
Aflailton Zeponi ◽  
Wanderley Severo Dos Santos Júnior ◽  
Luís Guilherme De Faria ◽  
Guilherme Galhardo Franco ◽  
...  
Keyword(s):  
Femoral Head ◽  
Local Recurrence ◽  
Total Hip Arthroplasty ◽  
Head And Neck ◽  
Total Hip Replacement ◽  
Hip Arthroplasty ◽  
Proximal Femur ◽  
Hip Replacement ◽  
Appendicular Skeleton ◽  
Total Hip

Background: Osteosarcoma (OSA) is the most common primary bone tumor of the appendicular skeleton of dogs. It mainly affects the metaphyseal region of long bones in large and giant breed dogs.The markedly aggressive and metastatic character of the disease leads to an invariably poor to unfavorable prognosis.Although amputation is commonly performed, different surgical techniques may be used to preserve the limb. The most common methods of limb preserving surgeries involve the use of endoprosthesis and allogeneic or autologous grafts. This report describes the successful use of total hip replacement to treat a 3-year-old male dog, with OSA in the femoral head and neck.Case: This report describes the successful use of total hip replacement to treat a 3-year-old male dog, with OSA in the femoral head and neck. The OSA stage IA located in the femoral head and neck was resected and treated through the limb-sparing. The bone defect and joint function was reconstructed with total hip arthroplasty technique using a cementless hip prosthesis. The result of the histopathological analysis of the excised bone tissue showed a minimally productive osteoblastic osteosarcoma. To date, the patient shows satisfactory movement rate and motion range, with no pain to palpation and without lameness in that limb. The radiographic follow-up after 24 months showed no local recurrence, metastasis pulmonary or complications related to the implant. Total hip arthroplasty resulted in safe recovery of orthopedic signs associated with osteosarcoma of the femoral head and neck, effectively acting as a limb preserving surgery after 32 months.Discussion: The limb-sparing procedure is an option to control local tumors that has become more popular among owners that do not accept the amputation of the limb. Similarly, it is a good alternative when another condition may interfere with the other limbs or may require amputation of another limb. The size and the potential for weight gain of the dog in this study could compromise its ambulation later, and it was a factor in the decision for the limb-sparing surgery. The allografts can be used to reconstruct the proximal femur, but they were not considered a viable option for this patient because of the reported complications, including graft fracture, non-union with the host bone and collapse of subchondral bone. The hip region does not allow the realization of arthrodesis because this joint is highly mobile, so the use of prosthetics as described is ideal for the preservation of joint biomechanics. Furthermore, the implant provides rapid postoperative recovery and immediate stability. Mean survival times were not significantly different between the limb-sparing and amputation techniques without adequate chemotherapy. In this case, despite the recommendation, the patient was monitored continuously without the association of adjuvant treatments according to the owner’s choice. The complications related with the use of cortical allograft, endoprosthesis, and pasteurized autograft include infection (31-60%), local recurrence (15-28%) or implant failure (11-40%). The implant luxation is the most common non-traumatic acute complication in the short term after limb-sparing surgery of proximal femur in humans and total hip replacement in dogs. To date, no complications have been observed after the procedure was performed. In conclusion, preservation of limbs in cases of osteosarcoma is favorable depending on the degree of involvement, but it requires specific techniques according to the location, to improve the quality of life and animal survival. In this case, the total hip arthroplasty for initial osteosarcoma in the femoral head and neck got an unexpected result, especially given the nature of osteosarcoma, limitations of wide excision with this approach and lack of adjuvant therapy.

scholarly journals Total hip arthroplasty in children who have undergone arthroplasty with demineralized bone-cartilage allocups

2017 ◽  
Vol 5 (1) ◽  
pp. 13-20 ◽  
Author(s):  
Vladimir E. Baskov ◽  
Valentin A. Neverov ◽  
Pavel I. Bortulev ◽  
Andrey I. Krasnov ◽  
Dmitry B. Barsukov ◽  
...  
Keyword(s):  
Total Hip Arthroplasty ◽  
Total Hip Replacement ◽  
Acetabular Component ◽  
Hip Joint ◽  
Hip Arthroplasty ◽  
Hip Replacement ◽  
Pelvic Bone ◽  
Total Hip ◽  
Medical Histories ◽  
Demineralized Bone

Introduction. Treating children with degenerative dystrophic diseases of the hip joint has become one of the most acute problems in contemporary orthopedics. Until recently, we performed arthroplasty by demineralized bone-cartilage allocups (DBCA) in the Clinic of the Hip Joint Pathology of the Turner Scientific and Research Institute for Children’s Orthopedics for patients showing clinical and radiological signs of irreversible destruction of the hip joint; we carried out this procedure to preserve the function of the lower limb. However, over the last 8 years, we have changed our protocol for children older than 12 years of age and have replaced DBCA with total hip replacement. In a number of cases, total hip replacement was performed after a previous intervention involving arthroplasty with DBCA. Objective. To determine the technical peculiarities of total hip replacement after a previous intervention involving arthroplasty with DBCA. Material and methods. We analyzed the results of treatment involving various types of hip pathology in 13 children (100%) aged between 15 and 16 years [8 girls (61.5%) and 5 boys (38.5%)]. The medical histories of all 13 children (100%) showed repeated operations on the hip joint, ultimately resulting in arthroplasty with DBCA. All 13 children (100%) underwent a total hip replacement. Upon hip replacement, all 13 patients (100%) showed a pronounced thinning and hardening of the edges and the bottom of the acetabulum, which created some difficulties in the process of acetabular component implantation. The transformation of DBCA was not evident in any of the 13 cases (100%). Results. During the observation period of 3–5 years following total hip arthroplasty, all 13 cases (100%) showed recovery in the range of motion and absence of pain. An important criterion for evaluating the quality of care was the complete social and domestic adaptation of all 13 children (100%) during the period from 6 to 9 months following total hip replacement surgery. Conclusions. The main feature of the implementation of total hip replacement, following a previous intervention involving arthroplasty with DBCA, was a pronounced deficit of the pelvic bone in the joint component. This significantly complicated the subsequent implantation of the acetabular prosthesis component, and in some cases required the use of a cemented acetabular component. Our experience suggests that patients under 11 years of age who show clinical and radiological signs of coxarthrosis can be treated with arthroplasty with DBCA in order to save the lost function of the hip joint and maintain the function of the periarticular muscles.

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