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Revision hip

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
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
Ichiro Yoshii, Kenichi Kitaoka, Kyuichi Hashimoto
BACKGROUND: Second osteoporotic fracture of the hip is a serious comorbidity that can directly cause mortality. Preventing its occurrence is particularly important in Japan, given its rapidly aging society. Here, the clinical characteristics of such recurrence were evaluated using the data of the Clinical Pathway with Regional Alliance (CPRA). METHODS: CPRA for hip fracture started in 2007 and has allowed intranet-based data sharing since July 2011. Data from this alliance, such as number of second cases, duration from initial fracture, Functional Impairment Measure (FIM), revised Hasegawa Dementia Scale (HDS-R) score, muscle force and range of motion of hip joint, and gait status (GS) were collected and statistically evaluated...
February 13, 2019: Journal of Orthopaedic Science: Official Journal of the Japanese Orthopaedic Association
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
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
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
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
Libor Necas, Maros Hrubina, Marian Melisik, Zoltan Cibula, Michal Chmurny, Matej Daniel, Boris Steno
INTRODUCTION: The aim of this study has been to present outcomes after cementless arthroplasty for developmental dysplasia Crowe type IV of the hip, with transverse subtrochanteric shortening osteotomy and using the S-ROM stem. METHODS: We evaluated radiographs, functional scores and complications in a consecutive series of 23 patients (28 hips) with high dislocation of the hip. The average age of patients at surgery was 49.9 (range 22-68) years. The operations were performed between 2007 and 2013...
February 13, 2019: European Journal of Orthopaedic Surgery & Traumatology: Orthopédie Traumatologie
Hamed Vahedi, Arash Aalirezaie, Gabriella Rolo, Javad Parvizi
BACKGROUND: The optimal treatment for patients with symptomatic hip dysplasia presenting with labral tear is unknown. Although femoroacetabular osteoplasty (FAO) has excellent outcome for most femoroacetabular impingement patients, the presence of concomitant hip dysplasia has been implicated as an adverse prognostic factor. This study evaluated the outcome of FAO in a group of dysplastic hips and compared the outcome to a cohort of patients without dysplasia. METHODS: Seventy-three patients (38 males, 35 females) with hip dysplasia who underwent FAO between 2007 and 2015 were identified...
January 18, 2019: Journal of Arthroplasty
Jessica L H Phillips, Alexander J Rondon, Chris Vannello, Yale A Fillingham, Matthew S Austin, P Maxwell Courtney
BACKGROUND: As alternative payment models increase in popularity for total joint arthroplasty (TJA), providers and hospitals now share the financial risk associated with unexpected readmissions. While studies have identified postacute care as a driver for costs in a bundle, the fiscal burden associated with specific causes of readmission is unclear. The purpose of this study is to quantify the additional costs associated with each of the causes of readmission following primary TJA. METHODS: We reviewed a consecutive series of primary TJA patients at our institution from 2015 to 2016 using claims data from the Centers for Medicare and Medicaid Services and Medicare Advantage patients from a single private insurer...
January 23, 2019: Journal of Arthroplasty
Tyler A Luthringer, Jonathan M Vigdorchik
BACKGROUND: A large body of evidence has confirmed that patients with spinal deformity, lumbar fusion, and abnormal spinopelvic mobility are at significantly increased risk for instability, dislocation, and revision after total hip arthroplasty (THA). METHODS: Achieving a stable construct in patients with pre-existing spine disease requires an understanding of basic spinopelvic parameters and the compensatory mechanisms associated with abnormal spinopelvic motion...
January 18, 2019: Journal of Arthroplasty
Fabio D'Angelo, Davide Tanas, Enrico Gallazzi, Luigi Zagra
INTRODUCTION: Failures due to adverse reaction to metal debris (ARMD) have become an area of common focus among surgeons performing hip replacements. Several authors have reported data on the prevalence of these masses, in both symptomatic and asymptomatic patients after either large-diameter head metal-on-metal (MoM) total hip arthroplasty (THA) or hip resurfacing arthroplasty, with a large variability of rate. To our knowledge, few data are reported on the association of this lesion with the use of small-head diameter MoM...
November 2018: Hip International: the Journal of Clinical and Experimental Research on Hip Pathology and Therapy
Daniele Munegato, Marco Bigoni, Romeo Sotiri, Antongiulio Bruschetta, Robert J Omeljaniuk, Marco Turati, Rossi Andrea, Giovanni Zatti
INTRODUCTION: This study evaluates mid-term results of acetabular revision using a hemispherical acetabular cup in Trabecular Titanium with a cage construct. METHODS: We reviewed 36 acetabular revisions performed with the Delta Revision TT cup in 34 patients (mean age = 75, range: 45-92 years). Acetabular defect types (Paprosky classification) included (1) 2B ( n = 5), (2) 2C ( n = 7), (3) 3A ( n = 15), and (4) 3B ( n = 9). Morcellised bone allografts were used in 24 cases, and synthetic bone used in 11...
November 2018: Hip International: the Journal of Clinical and Experimental Research on Hip Pathology and Therapy
Giampaolo Rinaldi, Dario Capitani, Fabio Maspero, Valentina Scita
INTRODUCTION: This prospective study aims to evaluate the mid-term clinical and radiological performance of a new short, neck-preserving femoral stem in total hip arthroplasty (THA). PATIENTS AND METHODS: 178 consecutive patients (190 hips) underwent THA from November 2008 to July 2016. Mean follow-up is 62.4 months. Women make up 41% of the cohort at a mean age of 50 ± 4 years, with primary hip osteoarthritis as the main complaint. All patients underwent radiological evaluation using the modified Gruen method, and clinical assessment via the Harris Hip Score (HHS), preoperatively and at 1, 6, 12, 24, 60, 80 and 106 months post-op...
November 2018: Hip International: the Journal of Clinical and Experimental Research on Hip Pathology and Therapy
Nicola Santori
PURPOSE: Choice of the best mini invasive surgical approach for total hip replacement remains a controversial topic. The posterior approach is traditionally associated with a higher dislocation rate and the obligation of postoperative restrictions. Soft tissue repair reduces the risk of dislocation yet, posterior closure it is often challenging because of capsular and external rotator contractures. In this article, an original procedure of capsular lengthening and tension-free closure is described and the results of a retrospective single surgeon series of minimally invasive posterior total hip replacement (THR) with capsular repair are presented...
November 2018: Hip International: the Journal of Clinical and Experimental Research on Hip Pathology and Therapy
Giuseppe Solarino, Andrea Piazzolla, Lorenzo Moretti, Giovanni Vicenti, Biagio Moretti
BACKGROUND: Ceramic-on-ceramic (CoC) is currently a viable bearing combination in primary total hip arthroplasty (THA) and, due to its mechanical properties, it can be used in young patients requiring a long-lasting implant. The aim of this study is to report the results of a series of CoC THAs at a minimum 20 years follow-up. METHODS: A retrospective study was conducted on the 1st 100 consecutive alumina-on-alumina arthroplasties performed by a single surgeon on 51 females and 40 males with an average age of 60...
November 2018: Hip International: the Journal of Clinical and Experimental Research on Hip Pathology and Therapy
Mattia Loppini, Paolo Schiavi, Antonello Della Rocca, Francesco Traverso, Federico Della Rocca, Giuseppe Mazziotta, Franco Astore, Guido Grappiolo
INTRODUCTION: Modular reconstruction systems based on trabecular metal (TM) prosthetic components have been increasingly used in the last decade for the management of severe acetabular bone defects. The aim of this study was to assess the clinical and radiographic outcomes of double-cup technique for the management of Paprosky type III defects without pelvic discontinuity. METHODS: A retrospective review was performed for all patients undergoing acetabular reconstruction with 2 TM cups at a tertiary referral centre between 2010 and 2015...
November 2018: Hip International: the Journal of Clinical and Experimental Research on Hip Pathology and Therapy
Luca Gala, Francesca Boisio, Filippo Calanna, Fiorello Lonati, Bruno M Marelli
INTRODUCTION: Total hip arthroplasty (THA) is 1 of the most common procedures in orthopaedic surgery. Different options and implants are currently available. Uncemented hip cups need primary stability for bone ingrowth, the use of screws is required when the desired stability is not achieved. Another option is the use of a hemispherical threaded cup with enhanced primary stability. The purpose of our study was to compare the results of a 3rd-generation threaded cup versus a press-fit cup with a long track record...
November 2018: Hip International: the Journal of Clinical and Experimental Research on Hip Pathology and Therapy
Loris Perticarini, Mario Mosconi, Marta Medetti, Laura Caliogna, Francesco M Benazzo
BACKGROUND: The new double-conical tapered stem is a novel cementless modular system, which is indicated for both primary and revision surgeries. It has been designed with different angles at the proximal (5°) and distal sections (1° 36') in order to obtain optimal fixation by proximal and distal fit and fill of the femoral canal. AIM: The aim of this prospective study was to evaluate the short-term clinical and radiographic outcomes of primary and revision hip surgery with the new double-conical stem...
November 2018: Hip International: the Journal of Clinical and Experimental Research on Hip Pathology and Therapy
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