Painful total hip

INTRODUCTION: Total hip arthroplasty implant choice profoundly affects survivorship, complications, and failure modes. This study evaluates the long-term (average 18 year) outcomes of ceramic-on-ceramic hip arthroplasty using uncemented shells and stems. Despite an impressive 20-year cumulative percent revision (CPR) of 5.9%, the hydroxyapatite proximally coated femoral components evaluated in this study have seen declining use since 2003. METHODS: A review of 349 consecutive total hip arthroplasties from 1999 to 2007 were matched to 272 cases with registry data...

OBJECTIVE: To explore associations between hip muscle strength and cartilage defects (presence and severity) on magnetic resonance imaging (MRI) in young adults with hip/groin pain participating in sub-elite football. DESIGN: Sub-elite football players with hip/groin pain (> 6 months) completed assessments of isometric hip strength and functional task performance. Hip cartilage defects were assessed using the Scoring Hip Osteoarthritis with MRI (SHOMRI) tool...

The use of uncemented stems in hip arthroplasty has been increasing, even in osteoporotic patients. The major concerns of uncemented hip-stems, however, are peri-prosthetic fracture, thigh pain, and proximal femoral stress-/strain-shielding. In this study, a novel design of uncemented hip-stem is proposed that will reduce such concerns, improve osseointegration, and benefit both osteoporotic and arthritic patients. The stem has a central titanium alloy core surrounded by a set of radial buttresses that are partly porous titanium, as is the stem tip...

UNLABELLED: Osteoarthritis is a disabling pathology characterized by joint pain and stiffness. A prevalence of coxarthrosis of 7.4% is reported in our country. Total hip joint replacement is indicated in advanced stages, a procedure that is not free of complications, the most frequent being prosthetic dislocation, which can be prevented with dual mobility systems. The following study aims to determine the rate of complications and clinical outcomes in dual mobility systems in primary coxarthrosis...

OBJECTIVE: The aim of this study was to assess the effects of two different applications of transcutaneous electrical nerve stimulation (TENS) on the reduction of postoperative acute pain after hip fracture surgery. PATIENTS AND METHODS: In this study, 120 patients undergoing hip surgery were divided into three groups. The first group received patient-controlled analgesia (PCA) with epidural fentanyl and additional medications. The second group received lumbar plexus and sciatic nerve transcutaneous electrical nerve stimulation (LS-TENS) along with the same medication protocol as the first group...

BACKGROUND: In the post-epidemic era, Acquired Immune Deficiency Syndrome (AIDS) remains one of the most prevalent and detrimental infectious diseases worldwide. The incidence of osteonecrosis of the femoral head (ONFH) in AIDS patients is 100 times higher than that in healthy individuals. Although Total Hip Arthroplasty (THA) is ultimately necessary for most patients, there is still a dearth of evidence regarding its safety and efficacy in Chinese AIDS patients. METHODS: The clinical data of 49 patients who met the inclusion and exclusion criteria were retrospectively analyzed...

CASE: We present an unusual case of bilateral femoral neck fatigue fractures in a 28-year-old pregnant woman at the 18th week of gestation successfully treated through operative intervention involving consecutive total hip arthroplasty and internal fixation within the same procedure, resulting in favorable clinical outcomes. CONCLUSION: Current clinical practices suggest that a restricted use of plain radiographs, even those involving the pelvis in pregnant women carries a minimal risk to the fetus and is not contraindicated...

Post-traumatic hip arthritis presents a challenging condition characterized by degenerative changes in the hip joint following traumatic injury. Total hip arthroplasty (THA) is a cornerstone in managing this condition, offering significant pain relief, functional improvement, and enhanced quality of life. This comprehensive review aims to synthesize existing literature to elucidate the outcomes of THA in post-traumatic hip arthritis, exploring factors influencing surgical success and identifying areas for further research...

Prosthetic joint infection (PJI) remains a significant complication following joint arthroplasty, necessitating prompt recognition and intervention to optimize patient outcomes. This case report describes a 65-year-old male who presented with persistent pain, swelling, and purulent discharge from the right hip, three years post-bipolar hemiarthroplasty following a road traffic accident. Clinical examination revealed signs suggestive of PJI, prompting surgical intervention with total hip arthroplasty. Postoperatively, the patient experienced resolution of symptoms and satisfactory recovery...

BACKGROUND: The long-term radiological outcomes after the treatment of neonatal hip instability (NHI) in developmental dysplasia of the hip are unclear. Therefore, the prevalence of acetabular dysplasia at a mean age of 18 years after treatment was investigated. The relationship between acetabular dysplasia and hip discomfort has also been poorly established. Therefore, the differences in pain, hip-related quality of life (QOL), and hip impingement tests in hips with and without acetabular dysplasia were assessed...

PURPOSE: Depression is a notable contributor to suboptimal outcomes after total joint arthroplasty (TJA). We conducted a systematic review of comparative studies to review the available evidence of interventions that affected depression scores and/or outcomes for patients undergoing TJA. METHODS: EMBASE, Ovid MEDLINE, PubMed, and Scopus were reviewed systematically from inception until November 15, 2022. Studies that were relevant for this review included comparative studies between patients who received an intervention within 3 months before or after their primary total hip or knee arthroplasty procedure...

BACKGROUND: The proximal femoral nail anti-rotation (PFNA) with cement enhancement enhances the anchorage ability of internal fixation in elderly with osteoporotic intertrochanteric fracture. However, whether it is superior to hemiarthroplasty is still controversial. The present study aimed to determine which treatment has better clinical outcomes among older patients. METHODS: We retrospectively analyzed 102 elderly patients with osteoporosis who developed intertrochanteric fractures and underwent PFNA combined with cement-enhanced internal fixation (n = 52, CE group), and hemiarthroplasty (n = 50, HA group) from September 2012 to October 2018...

BACKGROUND: 3D multi-spectral imaging (MSI) of metal implants necessitates relatively long scan times. OBJECTIVE: We implemented a fast isotropic 3D MSI technique at 3 T and compared its image quality and clinical utility to non-isotropic MSI in the evaluation of hip implants. METHODS: Two musculoskeletal radiologists scored images from coronal proton density-weighted conventional MAVRIC-SL and an isotropic MAVRIC-SL sequence accelerated with robust-component-analysis on a 3-point scale (3: diagnostic, 2: moderately diagnostic, 1: non-diagnostic) for overall image quality, metal artifact, and visualization around femoral and acetabular components...

Introduction The Chiari osteotomy enlarges the acetabulum to increase coverage of the femoral head. It is performed as a salvage procedure on a noncongruent, yet in-place, hip. This study aims to assess the clinical and radiographic outcomes of Chiari pelvic osteotomy for treating hip dysplasia in children. Methods This is a case series conducted in the pediatric orthopedic trauma department of the Centre Hospitalier Universitaire Hassan II, Fez, Morocco, over a 10-year period from January 2011 to December 2020...

Introduction: The demipointe dance position puts the ankle at high risk of overuse injury and posteromedial ankle pain due to increased ankle valgus forces. Previous work has shown that creating lower limb external rotation intrinsic to demipointe with hip external rotation reduces foot pronation that causes ankle valgus stress. Therefore, the purpose of this work was to examine long axis rotation kinematics of the hip, knee, and ankle as well as the ankle joint contact forces in demipointe to better understand the biomechanical impact(s) of the specific cue to increase hip external rotation in this position...

BACKGROUND: To determine the association between socioeconomic status and patient-reported outcome measures in a Dutch cohort who have undergone total hip arthroplasty (THA) or total knee arthroplasty (TKA). METHODS: A retrospective national registry study of all patients who underwent primary THA or TKA between 2014-2020 in the Netherlands was performed. Linear mixed-effects regression models were used to assess the association between SES and PROMs for THA and TKA patients separately...

BACKGROUND: Total pelvic exenteration is the ultimate solution for rectovesicovaginal fistula caused by radiation therapy, yet total pelvic exenteration frequently causes intraoperative complications and postoperative complications. These complications are responsible for the dysfunction of lower extremities, impaired quality of life, and even the high long-term morbidity rate, thus multidisciplinary cooperation and early intervention for prevention of complications are necessary. Physical therapy was found to reduce the postoperative complications and promote rehabilitation, yet the effect on how physiotherapy prevents and treats complications after total pelvic exenteration and pelvic lymphadenectomy remains unclear...

BACKGROUND: This study aimed to assess the association between the disease process of hip osteoarthritis and total hip arthroplasty (THA) outcomes; this is a critical issue, as rapid progression has been postulated to be responsible for patient dissatisfaction post-THA. METHODS: This retrospective case-control study included 255 patients who underwent THA and completed a mean follow-up duration of 42.1 months (range, 24.0 to 77.0). We classified patients into those who had (n = 26) and did not have (n = 229) rapidly progressive osteoarthritis of the hip (RPOA), defined as a narrowing rate of joint space ≥ 2 mm yearly or a ≥ 50% loss within 12 months, excluding any other cause of a destructive arthropathy...

PURPOSE: To evaluate patient-reported outcomes (PROs) and survivorship at mid-term follow-up after hip arthroscopy (HA) for femoroacetabular impingement syndrome (FAIS) in patients with and without preoperative lower back pain (LBP). METHODS: Patients with self-endorsed preoperative LBP who underwent HA for FAIS with mid-term follow-up were identified and propensity matched 1:1 to patients without back pain by age, sex, and body mass index. PROs collected preoperatively and at postoperative years 1, 2, and 5 included: Hip Outcome Score Activities of Daily Living (HOS-ADL) and Sports Subscale (HOS-SS), International Hip Outcome Score 12 (iHOT-12), modified Harris Hip Score (mHHS), Visual Analog Scale (VAS) for Pain...

BACKGROUND: The effectiveness of a high level of physical activity in maintaining physical function in patients with hip osteoarthritis has not been adequately examined. OBJECTIVE: This study aimed to determine whether self-reported physical activity is associated with physical function and walking ability in female patients with hip osteoarthritis. METHODS: This was a multicenter cross-sectional study. The dependent variables were the lower-limb range of motion and muscle strength, and walking ability...