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Sheng Xu, Jerry Yongqiang Chen, Qishi Zheng, Ngai Nung Lo, Shi-Lu Chia, Keng Jin Darren Tay, Hee Nee Pang, Luming Shi, Edwin Shih Yen Chan, Seng Jin Yeo
INTRODUCTION: Blood loss in Total Joint Arthroplasty can be significant and often under-estimated. This study aims to investigate the safety and efficacy of different routes of tranexamic acid (TXA) administration in reducing blood transfusion after Total Hip Arthroplasty (THA) and Total Knee Arthroplasty (TKA). The secondary aim is to find the safest and most efficacious route and dose of TXA. MATERIAL AND METHODS: PubMed, Embase, Cochrane library, China National Knowledge Infrastructure, and OpenGrey were systemically searched for randomised controlled trials investigating the efficacy and/or safety of TXA for THA and/or TKA...
February 11, 2019: Thrombosis Research
Jaime J Morales De Cano, Llorenç Guillamet, Arturo Perez Pons
Objectives: Severe pelvic deficiency presents a difficult problem in hip arthroplasty. Specifically, the goals are to restore the pelvic bone stock, place the acetabular component in the correct anatomical position, and optimize joint stability. Currently, many surgical techniques have been developed for prosthetic revision surgery for acetabular complex defects, but no consensus has been reached on the best treatment. The objective of this study was to review mid-term cases of severe bone defect (Paprosky type III) treated with a bone allograft and ring Bursch-Schneider anti-protrusion cage (BSAC)...
January 2019: Acta Ortopedica Brasileira
Nicolas Reina, Christopher G Salib, Kevin I Perry, Arlen D Hanssen, Daniel J Berry, Matthew P Abdel
BACKGROUND: Proper component positioning in total hip arthroplasty (THA) is crucial for implant fixation and hip stability. The purpose of this study is to assess if neutral coronal stem alignment (0° ± 3°) improved long-term survivorship in uncemented femoral components. METHODS: Between 2005 and 2010, 1028 primary THAs were performed with 2 contemporary dual-tapered, proximally coated uncemented stem types. Alignment was measured immediately postoperatively and at most recent follow-up...
January 31, 2019: Journal of Arthroplasty
Braden M McKnight, Nicholas A Trasolini, Lawrence D Dorr
The stability of a total hip arthroplasty relies on proper positioning of the acetabular cup. Recent research has shown that this cup position is more dynamic than previously thought. The 3-dimensional orientation of the acetabular cup changes when the pelvis tilts anteriorly or posteriorly. These changes in pelvic tilt are directly related to the biomechanics of the lumbosacral junction. In normal physiology, the lumbar spine straightens with sitting and more lordotic with standing. This directly translates to posterior or anterior pelvic tilt due to the rigid sacroiliac attachments...
January 24, 2019: Journal of Arthroplasty
Chi Xu, Timothy L Tan, Ji-Ying Chen
BACKGROUND: The significance of a positive culture at reimplantation remains an important topic of consideration given the lack of clear metrics for when reimplantation can be performed. The purpose of this study is thus to investigate the (1) association between a positive culture during reimplantation and failure following 2-stage exchange arthroplasty and the (2) influence of prolonged antibiotics on these patients. METHODS: We retrospectively reviewed 117 patients undergoing 2-stage exchange hip arthroplasty from 2012 to 2016...
January 24, 2019: Journal of Arthroplasty
Nicholas M Hernandez, Rafael J Sierra, Robert T Trousdale
BACKGROUND: Constrained liners are used to treat recurring total hip arthroplasty dislocations in certain patients. Little is known about the fate of constrained liner revisions. The aim of this study is to evaluate the rate and survivorship free of revision for mechanical failure of constrained liners in patients who were revised to their first, second, and third constrained liners. METHODS: From 1989 to 2016, using our institution's total joint registry, we identified 554 revisions to a first constrained liner...
January 31, 2019: Journal of Arthroplasty
Willem Paul Gielis, Jakob van Oldenrijk, Nick Ten Cate, Vanessa A B Scholtes, Carel H Geerdink, Rudolf W Poolman
BACKGROUND: Femoral prosthesis design may impact the frequency of mid-thigh pain. We compared current, incidental, and persistent mid-thigh pain between the short-stem, Collum Femoris femur prosthesis, and the wedge shaped straight-stem, Zweymüller femur prosthesis and studied the associations between demographics, radiographic measurements, and mid-thigh pain. METHODS: We contacted patients from a randomized controlled trial who underwent uncemented total hip arthroplasty (THA) for hip osteoarthritis at a mean follow-up of 44 months (range 24-64 months)...
January 23, 2019: Journal of Arthroplasty
Oren I Feder, Mostafa H El Dafrawy, Carol D Morris
No abstract text is available yet for this article.
March 2019: Journal of Shoulder and Elbow Surgery
J Eschweiler, F Migliorini, H Siebers, M Tingart, B Rath
BACKGROUND: Providing the hip with an endoprosthesis is one of the most common orthopedic interventions in Germany. The long-term success of such a procedure depends on the consideration of the loads due to muscle and joint forces in the planning and operative care. Patient-specific information of forces acting in vivo is not available to the surgeon in clinical routine today. This is where biomechanical modeling comes in. PROCEDURES: A field of activity of biomechanical modeling is the development of methods and procedures for the precise analysis and simulation of endoprosthetic supplies...
February 15, 2019: Der Orthopäde
Rodrigo F Cruz-Guerrero, José M Jiménez-Ávila, Arelhi C González-Cisneros, Adrián H Rivera-Villa, Félix A Sánchez-Chávez, Myrna R Rincón-Gómez, René Morales-De Los Santos, Ángel O Rivera-Villa, José M Pérez-Atanasio
Objective: Establish whether the use of starch in hip arthroplasty is a risk factor for excessive surgical bleeding and requirement of red blood cell transfusion. Method: Analytical observational retrospective study in 240 patients who underwent primary total hip arthroplasty from January 2015 to January 2016. Two groups were formed: starch (94 patients) and non-starch (146 patients). Age, sex, body mass index, preoperative and postoperative hemoglobin, red cell transfusion and surgical bleeding was analyzed...
2019: Cirugia y Cirujanos
Jasmene Uppal, Brent Burbridge, Terra Arnason
Osteonecrosis, also known as avascular necrosis, is a condition that causes significant morbidity and loss of function. It is a common complication seen with supraphysiological steroid use. Early diagnosis is critical as it impacts prognosis. We report a 20-year-old man who developed bilateral osteonecrosis of the hip following 6 years of low-dose steroid replacement therapy for panhypopituitarism secondary to a transsphenoidal resection of a growth hormone-secreting pituitary macroadenoma. The patient presented with several weeks of right-sided hip pain and significant loss of function...
February 13, 2019: BMJ Case Reports
Ashton H Goldman, Rafael J Sierra, Robert T Trousdale, David G Lewallen, Daniel J Berry, Matthew P Abdel
BACKGROUND: As revision implants and techniques have evolved and improved, understanding why contemporary revision total hip arthroplasties (THAs) fail is important to direct further improvement and innovation. As such, the goals of this study are to determine the implant survivorship of contemporary revision THAs, as well as the most common indications for re-revision. METHODS: We retrospectively reviewed 2589 aseptic revision THAs completed at our academic institution between 2005 and 2015 through our total joint registry...
January 23, 2019: Journal of Arthroplasty
Qiaojie Wang, Karan Goswami, Noam Shohat, Arash Aalirezaie, Jorge Manrique, Javad Parvizi
BACKGROUND: Whether prolonged operative time is an independent risk factor for subsequent surgical site infection (SSI) and periprosthetic joint infection (PJI) following total joint arthroplasty (TJA) remains a clinically significant and underexplored issue. The aim of this study is to investigate the association between operative time and the risk of subsequent SSI and PJI in patients undergoing primary TJA. METHODS: We retrospectively reviewed 17,342 primary unilateral total knee arthroplasty and total hip arthroplasty performed at a single institution between 2005 and 2016, with a minimum follow-up of 1 year...
January 18, 2019: Journal of Arthroplasty
Vito Pavone, Claudia de Cristo, Antonio Di Stefano, Luciano Costarella, Gianluca Testa, Giuseppe Sessa
BACKGROUND: Periprosthetic femoral fractures (PFFs) following total hip arthroplasty are becoming more prevalent and management of these fractures is often demanding. The surgeon has to assess in detail implant loosening, bone loss and type of fracture. The aim of the study is to identify the suitability of a treatment algorithm, based on the Vancouver classification that takes into account the activity and comorbidity of each patient. PATIENTS AND METHODS: This study retrospectively assessed 38 patients who were surgically treated for a PFF around total hip arthroplasty between 2010 and 2014...
February 2, 2019: Injury
Antonio Klasan, Thomas Neri, Ludwig Oberkircher, Dominik Malcherczyk, Thomas Jan Heyse, Christopher Bliemel
BACKGROUND: The direct anterior approach (DAA) has gained popularity in total hip arthroplasty (THA) over the past decade. A large number of studies have compared the DAA to other approaches with inclusion of a learning curve phase. The aim of this study was to compare the complication rate and bleeding between the DAA and the anterolateral approach after the learning curve phase. METHODS: For this retrospective, single-institutional study, propensity score matching was performed, from an initial cohort of 1408 patients receiving an elective THA...
February 14, 2019: BMC Musculoskeletal Disorders
Chen Yang, Xiulan Han, Jie Wang, Zheng Yuan, Tao Wang, Mingdong Zhao, Guowei Han
OBJECTIVE: To compare medium-term clinical and radiological outcomes of primary unilateral uncemented (UN) or cemented (CE) femoral component total hip arthroplasty (THA) in elderly patients with osteoporosis. METHODS: Consecutive patients with osteoporosis who underwent primary unilateral UN or CE THAs at our institution from 2006 to 2013 were retrospectively reviewed. All consecutive procedures were managed by high-volume surgeons, using UN or CE THA approaches...
February 14, 2019: Journal of International Medical Research
Sean Iain Docking, Jill Cook, Stephanie Chen, Jennie Scarvell, Wes Cormick, Paul Smith, Angela Fearon
BACKGROUND: It has been suggested that imaging findings play a role in directing treatment for Greater Trochanteric Pain Syndrome. Structural diagnoses associated with Greater Trochanter Pain Syndrome include gluteal tendinosis, and partial- or full-thickness gluteal tendon tears. However, few studies have compared imaging to confirmed tendon pathology observed during surgery. OBJECTIVE: To investigate the ability of magnetic resonance and ultrasound imaging to identify the presence of a pathological gluteus medius tendon in comparison to surgical and histological findings...
February 7, 2019: Musculoskeletal Science & Practice
Iker Uriarte, Oscar L Casado-Verdugo, José F Larruscain
The Judet polymethylmethacrylate hip hemiarthroplasty can be considered a major step in the development of the current total hip replacement. It was designed by the Judet brothers and first implanted in 1946. Although initial results were encouraging, the procedure was abandoned years later because of breakages and wear of the acrylic material. The authors present the case of an 85-year-old man in whom a Judet prosthesis was implanted 65 years ago after a traumatic injury of the left hip. He continued to work for 35 years after the arthroplasty and remained free of pain for an additional 5 years...
February 14, 2019: Orthopedics
Richard Capra, Stefano A Bini, Dawn E Bowden, Katherine Etter, Matt Callahan, Richard T Smith, Thomas Parker Vail
Optimizing surgical instrumentation may contribute to value-based care, particularly in commonly performed procedures. We report our experience in implementing a perioperative efficiency program in 2 types of orthopedic surgery (primary total-knee arthroplasty, TKA, and total-hip arthroplasty, THA).A comparative before-and-after study with 2 participating surgeons, each performing both THA and TKA, was conducted. Our objective was to evaluate the effect of surgical tray optimization on operating and processing time, cost, and waste associated with preparation, delivery, and staging of sterile surgical instruments...
February 2019: Medicine (Baltimore)
Per Jolbäck, Ola Rolfson, Peter Cnudde, Daniel Odin, Henrik Malchau, Hans Lindahl, Maziar Mohaddes
Background and purpose - Most earlier publications investigating whether annual surgeon volume is associated with lower levels of adverse events (AE), reoperations, and mortality are based on patient cohorts from North America. There is also a lack of adjustment for important confounders in these studies. Therefore, we investigated whether higher annual surgeon volume is associated with a lower risk of adverse events and mortality within 90 days following primary total hip arthroplasty (THA). Patients and methods - We collected information on primary total hip arthroplasties (THA) performed between 2007 and 2016 from 10 hospitals in Western Sweden...
February 14, 2019: Acta Orthopaedica
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