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Painful total hip

Anum Lalani, Yuo-Yu Lee, Michael Pitta, Geoffrey H Westrich, Stephen Lyman
BACKGROUND: Patient-reported outcome measures (PROMs) help assess therapeutic effectiveness. This study assessed the effect of advanced age on the Hip Disability and Osteoarthritis Outcome Score (HOOS) and Lower Extremity Activity Scale (LEAS) after total hip arthroplasty (THA). METHODS: A prospective cohort of patients underwent primary THA at our institution between May 2007 and December 2011. Exposure was age at the time of surgery and outcomes were HOOS and LEAS scores 2 and 5 years postsurgery...
February 20, 2019: Journal of Arthroplasty
Jeffrey D Hassebrock, Aaron J Krych, Benjamin G Domb, Bruce A Levy, Matthew R Neville, David E Hartigan
PURPOSE: To determine the degree of correlation of radiographic measurements, degree of correlation of intraoperative pathology, and difference in outcomes between sides of patients requiring staged bilateral hip arthroscopy. METHODS: Two high-volume hip preservation centers retrospectively reviewed hip preservation databases for staged bilateral hip arthroscopies conducted between 2008 and 2015. Patients were separated into those who presented with bilateral hip pain and those that presented with unilateral pain and developed contralateral pain >2 years later...
April 9, 2019: Arthroscopy: the Journal of Arthroscopic & related Surgery
Chen-Chiang Lin, Chang-Chen Yang, Tzai-Chiu Yu
OBJECTIVES: To compare the clinical outcome between bipolar hemiarthroplasty (BHA) and total hip arthroplasty (THA) using a U2 HA cementless hip stem, and the results of elderly femoral neck fracture patients who underwent BHA with a cementless hip stem. METHODS: A multicenter retrospective study enrolled 96 BHA and 115 THA cases using U2 HA cementless hip stems with mean age (BHA: 67.9 years; THA: 64.1 years), body height (BHA: 160.4 cm; THA: 160.7 cm) and weight (BHA: 62...
April 12, 2019: Orthopaedic Surgery
Joseph M Statz, Nicholas C Duethman, Robert T Trousdale, Michael J Taunton
BACKGROUND: Superficial wound dehiscence after total hip arthroplasty (THA) performed through the direct anterior approach (DAA) can be treated with superficial irrigation and debridement (I&D). The incidence and treatment of this complication has been described, but there are little data on the outcomes after a superficial I&D have not been described. The purpose of this paper was to examine the clinical outcomes of DAA THAs requiring postoperative superficial I&D. METHODS: A retrospective review of 1573 THAs performed using the DAA were identified utilizing a prospectively collected, single-institution joint registry...
March 12, 2019: Journal of Arthroplasty
Matthew J Dietz, Adam E Klein, Brock A Lindsey, Stephen T Duncan, Jennifer M Eicher, Jonathan D Gillig, Brett R Smith, G Daxton Steele
BACKGROUND: Posterior hip precautions have been routinely prescribed to decrease dislocation rates. The purpose of this study was to determine whether the absence of hip precautions improved early recovery after total hip arthroplasty via the posterolateral approach. METHODS: Patients undergoing total hip arthroplasty via the posterolateral approach at 3 centers were enrolled. Patients meeting the selection criteria were randomized to standard hip precautions (SHP) or no hip precautions (NHP) for 6 weeks following surgery...
March 13, 2019: Journal of Arthroplasty
Yu-Chun Chen, Wen-Cheng Huang, Hsuan-Kan Chang, Jiing-Feng Lirng, Jau-Ching Wu
Degenerative spinal deformity (DSD) has become a prevalent cause of disability and pain among the aging population worldwide. Though surgery has emerged as a promising option for DSD, the natural course, outcomes, and effects of surgery on DSD have remained elusive. This cohort study used a national database to comprehensively follow up patients of DSD for all-cause mortality, respiratory problems, and hip fracture-related hospitalizations. All patients were grouped into an operation or a non-operation group for comparison...
April 10, 2019: Journal of Clinical Medicine
Chulin Chewakidakarn, Anuchit Nawatthakul, Methasit Suksintharanon, Varah Yuenyongviwat
INTRODUCTION: Femoral neck fracture is common in the elderly, especially in the era of aging populations. Septic arthritis of the hip after femoral neck fracture is a rare complication. There are limited reports on this complication especially in patients without a severe medical condition and there is no consensus on the method of treatment of this complication. CASE PRESENTATION: A 75-year-old male had right hip pain for two weeks after falling on his right hip...
April 4, 2019: International Journal of Surgery Case Reports
Ahmad H Alghadir, Shahnawaz Anwer, Bibhuti Sarkar, Ashis K Paul, Dilshad Anwar
BACKGROUND: Previous studies reported the beneficial effects of walking in individual with mild to moderate knee osteoarthritis (OA). The current study aimed to compare the effect of 6-week retro versus forward walking program versus control group on pain, functional disability, quadriceps muscle strength and physical performance in individuals with knee OA. METHODS: A three-arm single-blinded, randomized, controlled trial and intention-to-treat analysis was conducted in outpatient physiotherapy department, King Saud University, Saudi Arabia...
April 9, 2019: BMC Musculoskeletal Disorders
Thomas Key, Charles Kimberley, Robert Rietz, Stuart William Roy
A 92-year-old woman with previous total hip replacement presented with sudden onset of atraumatic hip pain and inability to weight bear. In the absence of radiographic signs of fracture, loosening or biochemical evidence of infection a CT scan of the pelvis and hips was performed, which showed psoas thickening. MRI identified two separate collections related to the psoas and greater trochanteric regions. Ultrasound-guided aspiration was performed to rule out infection and demonstrated a haematoma. In contrast to previously reported cases caused by anticoagulant therapy or inherited coagulopathy, this case was secondary to single antiplatelet agent treatment alone...
April 8, 2019: BMJ Case Reports
Ryan McGrath, Soham Al Snih, Kyriakos Markides, Orman Hall, Mark Peterson
BACKGROUND: Many adults are living longer with health conditions in the United States. Understanding the disability-adjusted life years (DALYs) for such health conditions may help to inform healthcare providers and their patients, guide health interventions, reduce healthcare costs, improve quality of life, and increase longevity for aging Americans. The purpose of this study was to determine the burden of 10 health conditions for a nationally-representative sample of adults aged 50 years and older in the United States...
April 8, 2019: BMC Geriatrics
Yildiz Analay Akbaba, Ata Can, Fahri Erdogan
BACKGROUND: The optimal rehabilitation program for patients with post-total hip arthroplasty (THA) after developmental dysplasia of the hip (DDH) remains unclear. OBJECTIVE: The aim of the present study was to evaluate the clinical outcomes, to define a postoperative rehabilitation program, and to report the complication rate of THA in patients with DDH. METHODS: DDH hips (n= 89) were recruited. The transverse proximal femoral shortening osteotomy was applied to all patients...
March 29, 2019: Journal of Back and Musculoskeletal Rehabilitation
Peter J Smitham, Tania A Carbone, Scott M Bolam, Young S Kim, Stuart A Callary, Kerry Costi, Donald W Howie, Jacob T Munro, Lucian B Solomon
BACKGROUND: The aim of this study is to assess the outcomes of 52 consecutive Vancouver B2 peri-prosthetic fractures around cemented polished double-tapered stems treated by open reduction and internal fixation in 2 trauma centers in 2 countries. METHODS: Outcomes included modified Harris Hip Score (mHHS), Harris Pain Score, and return to pre-injury mobility. Fracture healing was assessed; implant subsidence measured and complications including re-operations reported...
March 8, 2019: Journal of Arthroplasty
Mantu Jain, Prabhas Ranjan Tripathy, Chitta Ranjan Mohanty
Herpes zoster is a clinical manifestation of reactivation of varicella-zoster virus (VZV) that lies dormant in the dorsal root ganglia after a past primary infection. It can be associated with severe pain, a crop of vesicles in typical dermatomal distribution but the neuralgic pain persists long, making the patient uncomfortable and often disturbing patient's sleep. There are cases reported after trauma or post surgeries that are mainly related to organ transplant or malignancy. In the literature, there is a solitary report of VZV infection along the sciatic nerve post ipsilateral hip and contralateral knee joint replacement...
April 5, 2019: BMJ Case Reports
Weiming Wang, Yan Liu, Jie Zhao, Ruimin Jiao, Zhishun Liu
INTRODUCTION: Plantar heel pain syndrome(PHPS) is a common cause of heel pain. It may worsen a patient's quality of life, and potentially lead to knee, hip or lower back problems. Previous studies have shown that electroacupuncture (EA) and manual acupuncture (MA) are effective treatments for relieving pain in patients with PHPS. However, little evidence supports the use of one intervention over the other. METHODS AND ANALYSIS: A total of 92 patients diagnosed with PHPS will be recruited and randomly assigned to an EA group or an MA group at a ratio of 1:1...
April 3, 2019: BMJ Open
Hironobu Ueshima, Noriko Tanaka, Hiroshi Otake
BACKGROUND AND OBJECTIVES: Lumbar plexus block (LPB) is an effective perioperative analgesic therapy for patients undergoing total hip arthroplasty (THA). However, the analgesic efficacy of intermittent administration compared with continuous infusion of LPB in patients remains unclear. METHODS: Forty adult patients who underwent THA were randomly divided into two groups: continuous infusion group (6 mL/hour continuous infusion of levobupivacaine [0.125%] in LPB, n=20) and intermittent infusion group (12 mL of levobupivacaine [0...
April 3, 2019: Regional Anesthesia and Pain Medicine
Geoffrey H Westrich, George A Birch, Ahava R Muskat, Douglas E Padgett, Enrique A Goytizolo, Mathias P Bostrom, David J Mayman, Yi Lin, Jacques T YaDeau
BACKGROUND: Multimodal analgesia including acetaminophen is increasingly popular for analgesia after total hip arthroplasty (THA). Intravenous (IV) administration of acetaminophen has pharmacokinetic benefits, but unclear clinical advantages. The authors hypothesized that IV acetaminophen would reduce pain with activity, opioid usage, or opioid-related side effects, compared to oral acetaminophen. METHODS: In this double-blinded, randomized, controlled trial, 154 THA patients received either IV or oral acetaminophen as part of a comprehensive opioid-sparing multimodal analgesia strategy...
March 6, 2019: Journal of Arthroplasty
Patrick Schlitt, Mitchell Freedman, Timothy L Tan, Joshua Minori, Jake T Schroeder, Javad Parvizi
BACKGROUND: Psychological distress is presumed to be an important factor that can adversely impact the outcome of orthopaedic procedures. The Distress and Risk Assessment Method (DRAM) is an evaluation tool which assesses psychological distress in patients with low back pain. The purpose of this prospective study was to assess the influence of preoperative psychological distress, as determined by the DRAM score, on the functional outcomes of total joint arthroplasty (TJA). MATERIALS AND METHODS: A prospective study of 61 TJAs was performed at a single institution...
April 4, 2019: Hip International: the Journal of Clinical and Experimental Research on Hip Pathology and Therapy
Rajrishi Sharma, Irafan Abdulla, Lewis Fairgrieve-Park, Saboura Mahdavi, Brian Burkart, Jeffrey Bakal
BACKGROUND: Total hip arthroplasty (THA) offers an effective method of pain relief and restoration of function for patients with end-stage arthritis. The anterior approach (AA) claims to benefit patients with decreased pain, increased mobilisation and decreasing length of hospital stay (LOS). In a socialised healthcare platform we questioned whether the AA, compared to posterior (PA) and lateral (LA) approaches, can decrease the cost burden. METHODS: Using a retrospective matched cohort study, we matched 69 AA patients to 69 LA and 69 PA patients for age ( p = 0...
April 2, 2019: Hip International: the Journal of Clinical and Experimental Research on Hip Pathology and Therapy
Ferid Krupić, Kemal Grbić, Mirza Bišćević, Mahir Jašarević, Svemir Čustović, Sebastian S Mukka
Aim To explore the experiences of anaesthesia nurses in assessing postoperative pain in patients undergoing total hip and/or knee arthroplasty. Methods Data were collected through four focus group interviews (FGI) using the critical incident technique (CIT). The participants were six men and 12 women, all registered nurses with further education in anaesthesia with at least five-year experience of caring for patients on a postoperative ward. Results Maintaining communication with orthopaedic patients, different ways to assess pain, the assessment of unresponsive patients, using pain assessment scales and different work circumstances influencing their use, were stated as the main problems the nurses emphasize while assessing the pain of patients...
August 1, 2019: Medicinski Glasnik
Amanda Larsson, Ola Rolfson, Johan Kärrholm
Background and purpose - Total hip arthroplasty (THA) is performed mainly because of pain. To evaluate the result after surgery, different questionnaires measuring the patient-reported outcome regarding quality of life are used. Forgotten Joint Score (FJS), designed to chart postoperative symptoms, was developed to find subtle differences between patients who report that their operated hip is "very good" or "excellent." We evaluated whether FJS provides additional information compared with the Oxford Hip Score (OHS) and ceiling and floor effects with use of these instruments...
April 1, 2019: Acta Orthopaedica
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