Pre-Operative Planning of Total Hip Arthroplasty on Dysplastic Acetabuli

2016 ◽  
Vol 27 (1) ◽  
pp. 55-59 ◽  
Author(s):  
Dror Lakstein ◽  
Zachary Tan ◽  
Nugzar Oren ◽  
Tatu Johannes Mäkinen ◽  
Allan E. Gross ◽  
...  
Keyword(s):  
Total Hip Arthroplasty ◽  
Hip Arthroplasty ◽  
Weighted Kappa ◽  
Valuable Insight ◽  
High Porosity ◽  
Total Hip ◽  
Structural Support ◽  
Operative Planning ◽  
Type 3 ◽  
Dysplastic Hip

Background When performing total hip arthroplasty (THA) on a dysplastic hip, proper positioning of the acetabular component may not allow for more than 70% coverage. Structural support in the form of an autograft or a high porosity metal augment may be necessary. The purpose of the study was to investigate the value of pre-operative templating and deformity classification in predicting cup coverage and the need for structural support. Methods 65 cases of THA for DDH were retrospectively analysed. 2 observers independently classified each dysplastic hip according to Hartofilakidis and determined the extent of cup coverage via templating software on pre-operative digital AP pelvic radiographs. Results Weighted kappa interobserver agreement was 0.68 for cup coverage and 0.76 for Hartofilakidis type. Structural support was necessary in 10 hips. No structural support was necessary in Hartofilakidis type 1, dysplasia cases. However, 27-30% of cases with type 2 or type 3 dysplasia required structural support. All cases with templated cup coverage of 65% or less required structural support. Templated coverage within 65-75% and over 75% resulted in 20% and 10% of patients receiving structural augmentation, respectively. Conclusions Pre-Operative planning for THA in the setting of hip dysplasia is crucial and can provide valuable insight to the need for column augmentation. However, the 3-D severity of the deformity may be underestimated in the 2-D radiographs.

scholarly journals Cup Positioning in True or False Acetabulum in Total Hip Arthroplasty: Which one is More Effective: A Randomized Clinical Trial on Patients with Crowe type 3 and 4 Dysplastic Hip

2021 ◽  
Author(s):  
Mehdi Motififard ◽  
Saeed Hatami ◽  
Moslem Rafiee ◽  
Arash Toghyani ◽  
Ali Andalib
Keyword(s):  
Clinical Trial ◽  
Total Hip Arthroplasty ◽  
Hip Arthroplasty ◽  
Harris Hip Score ◽  
Open Label ◽  
Mean Values ◽  
Total Hip ◽  
Study Results ◽  
Type 3 ◽  
Dysplastic Hip

Abstract Background and objectives: Hip dysplasia is a common hip disease which could be diagnosed in different ages and Total hip arthroplasty (THA) is a common surgical procedure for dysplastic hip in adults. Cup placement in patients with false acetabulum formation could be performed in true or false acetabulum. The current study aimed at evaluating and comparing the effectiveness of these two procedures in patients with Crowe type 3 or 4 dysplastic hip underwent THA. Methods: In this randomized open label parallel group clinical trial 67 patients/71 hips with crowe type 3 or 4 dysplastic hip undergoing THA were assigned to Group 1: patients with cup placement in true acetabulum or group 2: patients with cup placement in false acetabulum. Severity of pain was assessed using visual analogue scale (VAS), range of motion (ROM), limb discrepancy, gait ability, need for repeated joint replacement and also Harris hip score. Data were collected and analyzed using SPSS software version 20.Results: 67 patients/71hips entered the current study with the mean age of 50.51± 9.94 years. Two study groups were comparable in terms of basic characteristics (P> 0.05). No significant differences were observed between two groups regarding mean values of VAS, ROM, limb discrepancy and Harris hip score (P> 0.05). Conclusion: Cup placements in true or false acetabulum showed comparable effectiveness on all studied main orthopedics outcomes which are clinically important. We recommend more clinical trial studies with larger sample size for confirming our study results.

scholarly journals Outpatient Total Hip Arthroplasty: A Meta-Analysis

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.

Effects of surgeon experience and patient characteristics on accuracy of digital pre-operative planning in total hip arthroplasty

2020 ◽  
Vol 44 (10) ◽  
pp. 1951-1956
Author(s):  
Ittai Shichman ◽  
Shai Factor ◽  
Or Shaked ◽  
Samuel Morgan ◽  
Nissan Amzallag ◽  
...  
Keyword(s):  
Total Hip Arthroplasty ◽  
Hip Arthroplasty ◽  
Patient Characteristics ◽  
Total Hip ◽  
Surgeon Experience ◽  
Operative Planning

scholarly journals Intracavitary and Extracavitary Iliac Extended Fixation Using Porous Metal Augments for Paprosky Type 3 Acetabular Defects in Revision Total Hip Arthroplasty: A Minimum 2 Years Follow-up

2019 ◽  
Author(s):  
Hao Tang ◽  
Yixin Zhou ◽  
Zhuyi Ma ◽  
Yong Huang ◽  
Shengjie Guo
Keyword(s):  
Total Hip Arthroplasty ◽  
Hip Arthroplasty ◽  
Porous Metal ◽  
Harris Hip Score ◽  
Revision Total Hip Arthroplasty ◽  
Total Hip ◽  
Fixation Group ◽  
Acetabular Defects ◽  
Type 3

Abstract Background: We proposed a new concept of “iliac extended fixation” in revision total hip arthroplasty (THA) as fixation extending superiorly 2 cm beyond the original acetabular rim with porous metal augments, which was further classified into intracavitary and extracavitary fixation. This study reports the minimum 2 years outcome of the iliac extended fixation technique in patients with Paprosky type 3 acetabular defects. Methods: Thirty two revision THA patients were retrospectively reviewed who underwent reconstruction with the concept of iliac extended fixation from 2014 to 2016 in our hospital. Patients were assessed using the Harris Hip Score (HHS) and the Western Ontario and McMaster Universities Osteoarthritis Index score (WOMAC). In addition, radiographs were assessed and patient reported satisfaction was collected. Results: At an average follow-up of 40 months (range 25 – 64 months), the postoperative HHS and WOMAC scores were significantly improved at the last follow-up (p < 0.001). The postoperative horizontal and vertical locations of the COR were significantly improved from the preoperative measurements (p < 0.05). Two (6.3 %) patients were dissatisfied with the outcome. The extracavitary iliac extended fixation group had significantly more horizontal screws fixation (4.6 ± 25.7° vs 41.9 ± 37.8°, p < 0.001) and higher rate of osteointegration in zone 1A (91.7% vs 50.0%, p = 0.023) than the intracavitary iliac extended fixation group. Conclusions: Intracavitary and extracavitary iliac extended fixation with porous metal augments and cementless cups are effective in reconstructing severe superior acetabular bone defects, with promising short-term clinical and radiographic outcome.

scholarly journals Digital Two Dimensional (2D) Implant Design for Pre-operative Planning in Total Hip Arthroplasty

2012 ◽  
Vol 4 (1) ◽  
pp. 67-77 ◽  
Author(s):  
Azrulhizam Shapi'i ◽  
◽  
Riza Sulaiman ◽  
Mohammad Khatim Hasan ◽  
Anton Satria Prabuwono ◽  
...  
Keyword(s):  
Total Hip Arthroplasty ◽  
Hip Arthroplasty ◽  
Implant Design ◽  
Two Dimensional ◽  
Total Hip ◽  
Operative Planning

scholarly journals In vitro and in vivo evaluations of the fully porous Ti6Al4V acetabular cups fabricated by a sintering technique

RSC Advances ◽  
2019 ◽  
Vol 9 (12) ◽  
pp. 6724-6732 ◽  
Author(s):  
Ji Li ◽  
Wei Li ◽  
Zhongli Li ◽  
Yuxing Wang ◽  
Ruiling Li ◽  
...  
Keyword(s):  
Mechanical Properties ◽  
Total Hip Arthroplasty ◽  
Pore Size ◽  
Hip Arthroplasty ◽  
High Porosity ◽  
Total Hip ◽  
Large Pore ◽  
Large Pore Size

The fully porous Ti6Al4V cup fabricated by the sintered technique showed high porosity, large pore size with good mechanical properties. It may be effective in achieving in vivo stability after the total hip arthroplasty.

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