Total Hip Arthroplasty
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2022 ◽  
Vol 12 (1) ◽  
Nam Hoon Moon ◽  
Min Uk Do ◽  
Jung Shin Kim ◽  
Jae Seung Seo ◽  
Won Chul Shin

AbstractThis study aimed to evaluate the early results of primary total hip arthroplasty (THA) using dual mobility (DM) cups in patients at a risk of dislocation and compare them with that of fixed bearing (FB) THA. This retrospective study included patients who had undergone primary THA between January 2016 and December 2018 and were at a risk of dislocation. A propensity score-matched analysis was conducted for 63 THA procedures with vitamin-E infused highly cross-linked polyethylene (VEPE) DM bearing and 63 THA procedures performed with FB from the same manufacturer for a mean follow-up period of 3.1 and 3.5 years, respectively. The radiologic outcomes at the last follow-up and incidence of postoperative complications were evaluated and compared statistically between the two groups. The modified Harris hip score (mHHS) was used to assess patient-reported outcomes. Postoperative dislocation occurred in 4 cases (6.3%) in the FB group, but did not occur in the DM group (p = 0.042). There was no difference in the radiologic outcomes and postoperative complications between the two groups. The mHHS at the last follow-up showed satisfactory outcomes in both the groups (DM group, 90.5; FB group, 88.1), without a statistical difference between the groups. The early results of THA using VEPE DM bearing showed better outcomes than that of THA with FB for patients at a risk of dislocation. A longer follow-up period is recommended to assess the stability and overall outcomes.

2022 ◽  
pp. oemed-2021-107970
Elena Zaballa ◽  
Georgia Ntani ◽  
E Clare Harris ◽  
Anne Lübbeke ◽  
Nigel K Arden ◽  

ObjectivesTo investigate the rates of return to work and workability among working-age people following total hip arthroplasty (THA).MethodsParticipants from the Geneva Arthroplasty Registry and the Clinical Outcomes for Arthroplasty Study aged 18–64 years when they had primary THA and with at least 5 years’ follow-up were mailed a questionnaire 2017–2019. Information was collected about preoperative and post-THA employment along with exposure to physically demanding activities at work or in leisure. Patterns of change of job were explored. Survival analyses using Cox proportional hazard models were created to explore risk factors for having to stop work because of difficulties with the replaced hip.ResultsIn total, 825 returned a questionnaire (response 58%), 392 (48%) men, mean age 58 years, median follow-up 7.5 years post-THA. The majority (93%) of those who worked preoperatively returned to work, mostly in the same sector but higher rates of non-return (36%–41%) were seen among process, plant and machine operatives and workers in elementary occupations. 7% reported subsequently leaving work because of their replaced hip and the risk of this was strongly associated with: standing >4 hours/day (HR 3.81, 95% CI 1.62 to 8.96); kneeling/squatting (HR 3.32, 95% CI 1.46 to 7.55) and/or carrying/lifting ≥10 kg (HR 5.43, 95% CI 2.29 to 12.88).ConclusionsIt may be more difficult to return to some (particularly physically demanding) jobs post-THA than others. Rehabilitation may need to be targeted to these types of workers or it may be that redeployment or job change counselling are required.

Matthias Luger ◽  
Sandra Feldler ◽  
Lorenz Pisecky ◽  
Jakob Allerstorfer ◽  
Tobias Gotterbarm ◽  

Abstract Purpose Varus positioning of the femoral stem can affect the hip offset (HO). The critical trochanter angle (CTA) was introduced in 2019 as a novel geometric angle, to predict varus stem alignment in cementless straight stem THA. The aim of this study was to evaluate the applicability of the CTA as a predictor for stem alignment in THA with a cementless neck resecting short stem. Patients and methods In this retrospective study, 106 patients (index surgery 2014–2019) with unilateral THA and a morphologically healthy contralateral hip as a reference (Kellgren–Lawrence ≤ 1) were included. A cementless short stem with meta-diaphyseal fixation and press-fit cup was implanted in all cases. Stem alignment, CCD angle, CTA and offset reconstruction were measured on preoperative and 3 months postoperative AP radiographs of the pelvis. Results Preoperative lower CTA and lower CCD angle were positively correlated (r = 0.472; p < 0.001). Higher varus stem alignment is correlated with lower CTA (r = − 0.384; p < 0.001) and lower CCD angle (r = − 0.474; p < 0.001). A CTA of 23.1° or lower showed a sensitivity of 59.1% and a specificity of 87.1% (AUC: 0.733) and a CCD angle of 132.75° or lower a sensitivity of 68.2% and a specificity of 80.6% (AUC: 0.77) for a varus stem alignment > 3°. Conclusion The CTA is also applicable in cementless THA with a neck resecting short stem to evaluate risk of intraoperative varus stem positioning. The CCD angle shows higher sensitivity with marginally lower specificity. Therefore, the CTA is not superior in predicting varus stem alignment in short-stem THA. Level of evidence IV.

2022 ◽  
Umile Giuseppe Longo ◽  
Giuseppe Salvatore ◽  
Sergio De Salvatore ◽  
Giulia Santamaria ◽  
Anna Indiveri ◽  

Abstract Background: Patient’s satisfaction after surgery was traditionally assessed by pre, and post-surgical scores and Patient-Reported Outcome Measures (PROMs) scales. Patients treated by Total hip arthroplasty (THA) usually perform well; therefore, it is useful to have a PROMs’ scale with a low ceiling effect as the Forgotten Joint Score-12 (FJS-12). PROMs have to be validated in the local language to be used. This study aims to perform a psychometric validation of the Italian version of FJS-12 in a group of consecutive patients treated by THA.Methods: Each patient completed both the Italian version of FJS-12 and Western Ontario and McMaster University Osteoarthritis Index (WOMAC) in preoperative evaluation, after two weeks and 1 month, 3 months and 6 months postoperative follow-up. The reliability, internal consistency, test-retest reliability, and measurement error were evaluated.Results: 53 patients were included. Cronbach’s α between 0.6 and 0.9 indicated good internal consistency for the FJS-12. The test-retest reliability was acceptable. The Pearson correlation coefficient between the FJS-12 and WOMAC was 0.238 (P=0.087) at baseline, r = 0.637 (P < 0.001) at 1 month, r = 0.490 (P < 0.001) at 3 months and r = 0.572 (P < 0.001) at 6 months. The ceiling effect was above the acceptable range (15%) for FJS-12 in 1 month (26.4%) and WOMAC in 6 months follow-up (24.5%).Conclusions: An excellent test-retest reliability, a good internal consistency, and a good validity by medium-high correlation with the WOMAC were assessed for FJS-12. However, the responsiveness for the FJS-12 score was not assessed.

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