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

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.

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Cementless one-stage bilateral total hip arthroplasty in osteoarthritis patients: functional outcomes and complications

Orthopedic Reviews ◽

10.4081/or.2017.6897 ◽

2017 ◽

Vol 9 (2) ◽

Cited By ~ 2

Author(s):

Afshin Taheriazam ◽

Amin Saeidinia

Keyword(s):

Total Hip Arthroplasty ◽

Hip Arthroplasty ◽

Functional Outcomes ◽

Hip Osteoarthritis ◽

Harris Hip Score ◽

Superficial Infection ◽

Total Hip ◽

One Stage ◽

The Mean ◽

Hardinge Approach

Total hip arthroplasty (THA) is one of the successful and cost-benefit surgical treatments. One-stage bilateral THA (BTHA) has a large number of advantages, although there are concerns about the higher complications in this procedure. Aim of our study was to evaluate the complications and outcomes of cementless one-stage BTHA in osteoarthritis patients. A total of 147 patients from 2009 till 2012, underwent one-stage BTHA in Milad and Erfan hospitals, Tehran, Iran. A prospective analysis of the functional outcomes and complications of one-stage BTHA through Hardinge approach in patients with osteoarthritis was performed. We evaluated all patients clinically and radiologically with serial followups. A clinical hip score based upon the modified Harris Hip Score (MHHS) was performed preoperatively and again postoperatively. During the period of study 89 men (60.5%) and 58 women (39.4%) with a mean age of 54.67±7.08 years at the time of presentation were recruited. The mean surgical time was 2.8±0.25 hrs. The mean hospital stay was 3.83±0.65 days. Hemoglobin level decreased significantly after operation (P=0.038). There was two deep venous thromboses, one superficial infection and one temporal proneal palsy but no pulmonary embolism, dislocation, periprosthetic fracture or heterotrophic ossification. The mean preoperative MHHS score was 41.64±5.42 in patients. MHHS score improved to 89.26±4.68 in the last followup (P=0.0001). Our results recommended the use of cementless one-stage BTHA through Hardinge approach in patients with bilateral hip osteoarthritis.

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Outcomes of total hip arthroplasty using dualmobility cups for femoral neck fractures: a systematic review and meta-analysis

Hip International ◽

10.1177/1120700020926652 ◽

2020 ◽

pp. 112070002092665

Author(s):

Syed H Mufarrih ◽

Nada Q Qureshi ◽

Bassam Masri ◽

Shahryar Noordin

Keyword(s):

Systematic Review ◽

Total Hip Arthroplasty ◽

Femoral Neck ◽

Hip Arthroplasty ◽

Meta Analysis ◽

Mortality Rates ◽

Femoral Neck Fractures ◽

Cochrane Library ◽

Total Hip ◽

The Mean

Objectives: Femoral neck fractures (FNFs), with up to 15% mortality, are prominent orthopaedic emergencies. After treating FNFs, dislocation is another challenge increasing morbidity, mortality and treatment costs substantially. The emerging dual-mobility cup (DMC) may decrease dislocation rates following total hip arthroplasty (THA) for FNFs. We performed a systematic review of literature reporting dislocation and mortality rates with DMC-THA for the treatment of FNFs. Methods: 2 authors independently searched PubMed (MEDLINE), Google Scholar and Cochrane library for studies reporting dislocation and mortality rates for FNFs treated with DMC-THA since inception up to January 2019. Data on outcomes of interest was extracted from all studies and assessed for eligibility for a meta-analysis. Results: Out of 522 search results, 18 studies were included in the systematic review and 4 in the meta-analysis. The mean rate of dislocation following DMC-THA for FNFs was found to be 1.87% ± 2.11, with a 1-year mortality rate of 14.0% ± 10.55. Results of meta-analysis showed that dislocation and 1-year postoperative mortality rates were significantly lower for DMC-THA with a risk ratio 0.31 (95% CI, 0.16–0.59; I2 = 0%, p = 0.0003) and 0.55 (0.40, 0.77; I2 = 0%, p = 0.003) respectively when compared to biploar hemiathroplasty (BHA). Conclusions: The mean dislocation and mortality rates in DMC-THA are lower than previously reported rates for THA with single cup and comparable to unipolar and bipolar hemiarthroplasty. Further research involving randomised control trials to assess differences in outcomes, longevity and cost-effectiveness needs to be conducted to make recommendations for the use of DMC in treating FNFs.

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Functional outcomes and complications of simultaneous bilateral total hip arthroplasty in Asian population

International Journal of Research in Orthopaedics ◽

10.18203/issn.2455-4510.intjresorthop20200740 ◽

2020 ◽

Vol 6 (2) ◽

pp. 369

Author(s):

Ram Prasad Meena ◽

Utsav Shetty ◽

Sadaram Bhishnoi ◽

Ramkhiladi Meena

Keyword(s):

Total Hip Arthroplasty ◽

Hospital Stay ◽

Hip Arthroplasty ◽

Functional Outcomes ◽

Cost Benefit ◽

Asian Population ◽

Anterolateral Approach ◽

Total Hip ◽

One Stage ◽

The Mean

Background: Total hip arthroplasty (THA) is one of the most successful and cost-benefit surgical treatments. However, there are concerns about the safety of the procedure and higher complications. We aimed to evaluate the complications and outcomes of one-stage bilateral total hip arthroplasty (BTHA) with anterolateral approach.Methods: A total of 24 patients from February 2014 to October 2019 underwent BTHA in Government Medical College and Attached Group of Hospitals, Kota. A prospective analysis of the functional outcomes and complications was performed. All surgeries were performed via anterolateral approach. All patients were followed up till 1.5 years post-operative.Results: During period of study 16 men and 8 women with a mean age of 40.12±2.52 years at the time of presentation were entered. The mean surgical time was 112±6 mins. The mean hospital stay was 7 days. Hemoglobin level decreased significantly after operation (p=0.046) mean of 10.83±0.3 mg/dl. There was no reported patient with perioperative death, deep venous thrombosis, pulmonary embolism, infection, dislocation, periprosthetic fracture or heterotrophic ossification. The mean preoperative MHHS score was 45.93±5.33 in patients. MHHS score improved to 92.06±2.47 in the last follow-up (p=0.0001).Conclusions: Our results recommend the use of one-stage BTHA through anterolateral approach in cases indicating bilateral THA without increase in rate of complications. Functional and clinical outcomes are comparable and hospital stay is significantly shorter.

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Total hip arthroplasty in patients with acetabular fractures

Genij Ortopedii ◽

10.18019/1028-4427-2021-27-5-620-627 ◽

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.

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

Symmetry ◽

10.3390/sym13081472 ◽

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.

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Outpatient Total Hip Arthroplasty: A Meta-Analysis

Applied Sciences ◽

10.3390/app11156853 ◽

2021 ◽

Vol 11 (15) ◽

pp. 6853

Author(s):

Filippo Migliorini ◽

Lucio Cipollaro ◽

Francesco Cuozzo ◽

Francesco Oliva ◽

Andrea Valerio Marino ◽

...

Keyword(s):

Total Hip Arthroplasty ◽

Hip Arthroplasty ◽

Meta Analysis ◽

Readmission Rates ◽

Total Hip ◽

Vein Thrombosis ◽

Outpatient Group ◽

Operative Planning ◽

The Mean ◽

And Gender

Introduction: Outpatient total hip arthroplasty (THA) is increasingly popular. This meta-analysis investigated the potential advantages of outpatient regimes for THA. Methods: This study followed the PRISMA guidelines. PubMed, Web of Science, Google Scholar, Embase, and Scopus databases were accessed in June 2021. All clinical studies investigating outpatient THA were considered. The outcomes of interest were pain, infection, mortality, revision, dislocation, readmission rates, and deep vein thrombosis (DVT). Results: Data from 102,839 patients were included. A total of 52% (153,168 of 102,839 patients) were women. The mean age of patients was 62.6 ± 4.6 years, the mean BMI was 29.1 ± 1.8 kg/m2. Good comparability was found in age, BMI, and gender (p > 0.1). No difference was found in pain (p = 0.4), infections (p = 0.9), mortality (p = 0.9), rate of revision (p = 0.1), dislocation (p = 0.9), and readmission (p = 0.8). The outpatient group demonstrated a greater rate of DVT (OR 3.57; 95% CI 2.47 to 5.18; p < 0.0001). Conclusions: In selected patients, outpatient THA can be performed safely with optimal outcomes comparable with inpatient THA. Clear and comprehensive pre-operative planning should involve a multi-disciplinary group composed of orthopaedic surgeons, anaesthesia and rehabilitation specialists, and physiotherapists. Each centre performing outpatient THA should implement continuous homecoming welfare activity, to supervise physiotherapy and monitor anticoagulant therapy.

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A Novel Measurement Using Digital Radiography to Minimize Fluoroscopy in Total Hip Arthroplasty

The Journal of Hip Surgery ◽

10.1055/s-0041-1728760 ◽

2021 ◽

Author(s):

Andrew G. Yun ◽

Marilena Qutami ◽

Kory B. Dylan Pasko

Keyword(s):

Femoral Head ◽

Total Hip Arthroplasty ◽

Radiation Exposure ◽

Hip Arthroplasty ◽

Fluoroscopy Time ◽

Lesser Trochanter ◽

Total Hip ◽

Preoperative Templating ◽

The Mean ◽

Templating Technique

AbstractPreoperative templating for total hip arthroplasty (THA) is fraught with uncertainty. Specifically, the conventional measurement of the lesser trochanter to the center (LTC) of the femoral head used in preoperative planning is easily measured on a template but not measurable intraoperatively. The purpose of this study was to examine the utility of a novel measurement that is reproducible both on templating and in surgery as a more accurate and practical guide. We retrospectively reviewed 201 patients with a history of osteoarthritis who underwent primary THA. For preoperative templating, the distance from the top of the lesser trochanter to the equator (LeTE) of the femoral head was measured on a calibrated digital radiograph with a neutral pelvis. This measurement was used intraoperatively to guide the choice of the trial neck and head. As with any templating technique, the goal was to construct a stable, impingement-free THA with equivalent leg lengths and hip offset. In evaluating this novel templating technique, the primary outcomes measured were the number of trial reductions and the amount of fluoroscopic time, exposures, and radiation required to obtain a balanced THA reconstruction. Using the LeTE measurement, the mean number of trial reductions was 1.21, the mean number of intraoperative fluoroscopy images taken was 2.63, the mean dose of radiation exposure from fluoroscopy was 0.02 mGy, and the mean fluoroscopy time per procedure was 0.6 seconds. In hips templated with the conventional LTC prior to the LeTE, the mean fluoroscopy time was 0.9 seconds. There was a statistically significant difference in fluoroscopy time (p < 0.001). The LeTE is a reproducible measurement that transfers reliably from digital templating to surgery. This novel preoperative templating metric reduces the fluoroscopy time and consequent radiation exposure to the surgical team and may minimize the number of trial reductions.

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Are the First and Second Hip in Staged Bilateral Total Hip Arthroplasty Equal? A Hospital Adverse Event and Perioperative Risk Comparison

The Journal of Hip Surgery ◽

10.1055/s-0041-1729868 ◽

2021 ◽

Author(s):

Jesus M. Villa ◽

Tejbir S. Pannu ◽

Carlos A. Higuera ◽

Juan C. Suarez ◽

Preetesh D. Patel ◽

...

Keyword(s):

Total Hip Arthroplasty ◽

Adverse Events ◽

Hip Arthroplasty ◽

Retrospective Chart Review ◽

Consecutive Series ◽

Level Of Evidence ◽

Exact Test ◽

Total Hip ◽

Discharge Disposition ◽

The Mean

AbstractHospital adverse events remain a significant issue; even “minor events” may lead to increased costs. However, to the best of our knowledge, no previous investigation has compared perioperative events between the first and second hip in staged bilateral total hip arthroplasty (THA). In the current study, we perform such a comparison. A retrospective chart review was performed on a consecutive series of 172 patients (344 hips) who underwent staged bilateral THAs performed by two surgeons at a single institution (2010–2016). Based on chronological order of the staged arthroplasties, two groups were set apart: first-staged THA and second-staged THA. Baseline-demographics, length of stay (LOS), discharge disposition, hospital adverse events, and hospital transfusions were compared between groups. Statistical analyses were performed using independent t-tests, Fisher's exact test, and/or Pearson's chi-squared test. The mean time between staged surgeries was 465 days. There were no significant differences in baseline demographics between first-staged THA and second-staged THA groups (patients were their own controls). The mean LOS was significantly longer in the first-staged THA group than in the second (2.2 vs. 1.8 days; p < 0.001). Discharge (proportion) to a facility other than home was noticeably higher in the first-staged THA group, although not statistically significant (11.0 vs. 7.6%; p = 0.354). The rate of hospital adverse events in the first-staged THA group was almost twice that of the second (37.2 vs. 20.3%; p = 0.001). There were no significant differences in transfusion rates. However, these were consistently better in the second-staged THA group. When compared with the first THA, our findings suggest overall shorter LOS and fewer hospital adverse events following the second. Level of Evidence Level III.

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Activity Levels and Functional Outcomes of Young Patients Undergoing Total Hip Arthroplasty

Orthopedics ◽

10.3928/01477447-20141023-55 ◽

2014 ◽

Vol 37 (11) ◽

pp. e983-e992 ◽

Cited By ~ 14

Author(s):

Tennison L. Malcolm ◽

Caleb R. Szubski ◽

Amy S. Nowacki ◽

Alison K. Klika ◽

Joseph P. Iannotti ◽

...

Keyword(s):

Total Hip Arthroplasty ◽

Hip Arthroplasty ◽

Functional Outcomes ◽

Young Patients ◽

Activity Levels ◽

Total Hip

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A 10-Year Follow-Up of Two-Incision and Modified Watson-Jones Total Hip Arthroplasty in Patients with Osteonecrosis of the Femoral Head

BioMed Research International ◽

10.1155/2017/8915104 ◽

2017 ◽

Vol 2017 ◽

pp. 1-7

Author(s):

Shih-Jie Lin ◽

Tsan-Wen Huang ◽

Po-Chun Lin ◽

Feng-Chih Kuo ◽

Kuo-Ti Peng ◽

...

Keyword(s):

Femoral Head ◽

Total Hip Arthroplasty ◽

Hip Arthroplasty ◽

Functional Outcomes ◽

Large Scale ◽

Operation Time ◽

Harris Hip Score ◽

Total Hip ◽

Radiographic Parameters

Long-term data and information indicating whether minimally invasive surgery (MIS) approaches are safe and effective with total hip arthroplasty (THA) are lacking. Between 2004 and 2006, 75 patients with alcohol-related osteonecrosis of the femoral head (ONFH) who underwent 75 THAs with the two-incision approach were studied. The medical records, radiographic parameters, and functional outcomes were collected prospectively. All data were compared with those for matched patients who underwent a modified Watson-Jones (WJ) approach. THA using the two-incision approach was associated with longer operation time, more blood loss, more lateral femoral cutaneous nerve injury, and more periprosthetic femoral fractures (p<0.05for all four) than the modified WJ approach. The Harris Hip Score (HHS) and Western Ontario and McMaster University Osteoarthritis Index (WOMAC) increased significantly from the period preoperatively to 6 weeks postoperatively and thereafter up to the last follow-up in both groups. However, there were no significant differences in terms of radiographic parameters and functional outcomes between the two groups throughout the study period. Both the two-incision and the modified WJ approach provided satisfactory results and survival rates at a mean follow-up of 10.8 years. A prospective, randomized, large-scale cohort study is still warranted for evidence-based recommendations.

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