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C E Pinzón-Florez, K M Vélez Cañas, D M Díaz Quijano
INTRODUCTION AND OBJECTIVE: Tranexamic acid (TXA) is an antifibrinolytic drug used to reduce bleeding in mortality risk situations such as trauma. Our objective was to conduct a systematic literature review to evaluate the effectiveness and safety of TXA in reducing bleeding in hip arthroplasty. MATERIAL AND METHODS: A systematic literature review and meta-analysis of primary studies similar to controlled trials was performed. Literature was searched in MEDLINE, Embase, Cochrane, LILACS, SciELO and Google Scholar...
May 2015: Revista Española de Anestesiología y Reanimación
Xiaohui Liu, Yueju Liu, Shuo Pan, Huijian Cao, Dahai Yu
BACKGROUND: Most surgeons do not fix the lesser trochanter when managing femoral intertrochanteric fractures with intramedullary nails. We have not found any published clinical studies on the relationship between the integrity of the lesser trochanter and surgical outcomes of intertrochanteric fractures treated with intramedullary nails. The purpose of this study was to evaluate the impact of the integrity of the lesser trochanter on the surgical outcome of intertrochanteric fractures...
December 2015: BMC Musculoskeletal Disorders
A J R Palmer, V Ayyar-Gupta, S J Dutton, I Rombach, C D Cooper, T C Pollard, D Hollinghurst, A Taylor, K L Barker, E G McNally, D J Beard, A J Andrade, A J Carr, S Glyn-Jones
AIMS: Femoroacetabular Junction Impingement (FAI) describes abnormalities in the shape of the femoral head-neck junction, or abnormalities in the orientation of the acetabulum. In the short term, FAI can give rise to pain and disability, and in the long-term it significantly increases the risk of developing osteoarthritis. The Femoroacetabular Impingement Trial (FAIT) aims to determine whether operative or non-operative intervention is more effective at improving symptoms and preventing the development and progression of osteoarthritis...
November 2014: Bone & Joint Research
Hai-Bo Si, Yi Zeng, Fei Cao, Fu-Xing Pei, Bin Shen
INTRODUCTION: The outcomes of using a ceramic-on-ceramic (CoC) vs ceramic-on-polyethylene (CoP) bearing surface for primary total hip arthroplasty (THA) are much debated. We performed a systematic review and meta-analysis of randomised controlled trials (RCTs) to compare and evaluate the outcomes of these 2 bearing surfaces. MATERIALS AND METHODS: Electronic databases (PubMed/Medline, CENTRAL, Embase and Web of Science) were systematically searched for RCTs investigating the association between bearing surfaces and outcomes following primary THA...
May 2015: Hip International: the Journal of Clinical and Experimental Research on Hip Pathology and Therapy
Peter Nordström, Yngve Gustafson, Karl Michaëlsson, Anna Nordström
OBJECTIVE: To investigate relation between inpatient length of stay after hip fracture and risk of death after hospital discharge. SETTING: Population ≥50 years old living in Sweden as of 31 December 2005 with a first hip fracture the years 2006-12. PARTICIPANTS: 116,111 patients with an incident hip fracture from a closed nationwide cohort. MAIN OUTCOME MEASURE: Death within 30 days of hospital discharge in relation to hospital length of stay after adjustment for multiple covariates...
February 20, 2015: BMJ: British Medical Journal
Christopher Jones, Adeel Aqil, Susannah Clarke, Justin P Cobb
BACKGROUND: Short femoral stems for uncemented total hip arthroplasty have been introduced as a safe alternative to traditional longer stem designs. However, there has been little biomechanical examination of the effects of stem length on complications of surgery. This study aims to examine the effect of femoral stem length on torsional resistance to peri-prosthetic fracture. MATERIALS AND METHODS: We tested 16 synthetic and two paired cadaveric femora. Specimens were implanted and then rapidly rotated until fracture to simulate internal rotation on a planted foot, as might occur during stumbling...
September 2015: Journal of Orthopaedics and Traumatology: Official Journal of the Italian Society of Orthopaedics and Traumatology
Peter Cram, Raphael Philip Rush
No abstract text is available yet for this article.
2015: BMJ: British Medical Journal
Devon J Ryan, Hiroyuki Yoshihara, Daisuke Yoneoka, Kenneth A Egol, Joseph D Zuckerman
OBJECTIVES: To empirically define a "delay" for hip fracture surgery based on clinical outcomes, and to identify patient demographics and hospital factors contributing to surgical delay. DESIGN: Retrospective database analysis. SETTING: Hospital discharge data. PATIENTS/PARTICIPANTS: A total of 2,121,215 patients undergoing surgical repair of hip fracture in the National Inpatient Sample between 2000 and 2009...
August 2015: Journal of Orthopaedic Trauma
Hervé Hourlier, Nicolas Reina, Peter Fennema
INTRODUCTION: A randomised, double-blind clinical trial was conducted comparing the efficacy of tranexamic acid (TXA) as a single intravenous bolus or a continuous infusion to patients undergoing total knee arthroplasty (TKA). Study hypothesis was that a second dose of TXA would not offer any clinical benefits over the single infusion. MATERIALS AND METHODS: One hundred and six patients were randomised to a single intraoperative dose of 30 mg/kg tranexamic acid (OS group, n = 54), or to a loading dose of 10 mg/kg tranexamic acid followed 2 h later by a continuous 2 mg/kg/h infusion for 20 h (OD group, n = 52)...
April 2015: Archives of Orthopaedic and Trauma Surgery
Hal David Martin, Ian James Palmer
The history and physical examination of the hip is the key component for evaluation of patients presenting with hip pain. As our understanding of the anatomy and biomechanics of the normal hip vs the pathologic hip advances, the physical examination progresses as well. As with the shoulder and knee examinations, there are critical steps that form the basis of the examination of the hip joint. This hip examination contains 21 steps, which compares well with the shoulder 20 step exam and the knee 33 step exam...
September 2013: Current Reviews in Musculoskeletal Medicine
Hongwei Gao, Zhonghao Liu, Deguo Xing, Mingzhi Gong
BACKGROUND: Treatment of displaced femoral neck fractures includes internal fixation and arthroplasty. However, whether arthroplasty or internal fixation is the primary treatment for displaced femoral neck fractures in elderly patients remains a subject for debate. The literature contains conflicting evidence regarding rates of mortality, revision surgery, major postoperative complications, and function in elderly patients with displaced femoral neck fractures treated either by internal fixation or arthroplasty (either hemiarthroplasty or THA)...
June 2012: Clinical Orthopaedics and related Research
Toby O Smith, Debbie Sexton, Charles Mann, Simon Donell
OBJECTIVE: To compare the clinical outcomes of staples versus sutures in wound closure after orthopaedic surgery. DESIGN: Meta-analysis. DATA SOURCES: Medline, CINAHL, AMED, Embase, Scopus, and the Cochrane Library databases were searched, in addition to the grey literature, in all languages from 1950 to September 2009. Additional studies were identified from cited references. Selection criteria Two authors independently assessed papers for eligibility...
March 16, 2010: BMJ: British Medical Journal
J S Daurka, A K Malik, D A Robin, J D Witt
The inherent challenges of total hip replacement (THR) in children include the choice of implant for the often atypical anatomical morphology, its fixation to an immature growing skeleton and the bearing surface employed to achieve a successful long-term result. We report the medium-term results of 52 consecutive uncemented THRs undertaken in 35 paediatric patients with juvenile idiopathic arthritis. The mean age at the time of surgery was 14.4 years (10 to 16). The median follow-up was 10.5 years (6 to 15)...
December 2012: Journal of Bone and Joint Surgery. British Volume
D S Angadi, S Brown, E J P Crawfurd
The aim of this prospective randomised study was to compare the clinical and radiological results of a cemented all-polyethylene Ultima acetabular component with those of a cementless porous-coated acetabular component (PFC) following total hip replacement (THR). A total of 287 patients received either a polyethylene acetabular component (group A) or a cobalt-chromium porous-coated component (group B) with an identical cemented femoral component and 28 mm cobalt-chromium head, thus making it the largest study of its type...
December 2012: Journal of Bone and Joint Surgery. British Volume
Connie Y Chang, Ambrose J Huang, William E Palmer
Serial radiographs are the mainstay in the longitudinal assessment of hip implants. The prosthesis, periprosthetic bone, and juxta-articular soft tissues are inspected for fracture, periosteal reaction, stress shielding, calcar resorption, osteolysis, bony remodeling, metallic debris, and heterotopic ossification. Comparison radiographs best confirm implant migration, subsidence, and aseptic loosening. Infection, particle disease, reaction to metal, and mechanical impingement are important causes of postsurgical pain, but in their earliest stages they may be difficult to diagnose using radiographs...
February 2015: Seminars in Musculoskeletal Radiology
Shuang Guo, Junying Sun, Guochun Zha, Shzoquan Wei, Qifeng Lu
OBJECTIVE: To investigate the effects of the femoral head size on the linear wear rate of highly cross-linked polyethylene (HXLPE) liner in total hip arthroplasty (THA). METHODS: A retrospective analysis was performed on the clinical data of 41 patients (43 hips) who underwent primary THA with HXLPE liner and different sizes of femoral heads between January 2004 and December 2007 for hip diseases. There were 22 males (23 hips) and 19 females (20 hips) with a mean age of 60...
November 2014: Chinese Journal of Reparative and Reconstructive Surgery
Dongcai Hu, Kai Tie, Xiao Yang, Yang Tan, Mohammed Alaidaros, Liaobin Chen
BACKGROUND: In recent years, the choice of ceramic-on-ceramic (COC) and metal-on-polyethylene (MOP) in primary total hip arthroplasty (THA) remains controversial. The purpose of this study was to compare the reliability and durability of COC with that of MOP bearing surfaces in THA. METHODS: Based on prospective randomized controlled trials (RCTs) searched from Pubmed, Embase, Web of Science, and Cochrane central database, we performed a meta-analysis for comparing clinical and radiographic outcomes of COC with those of MOP...
February 3, 2015: Journal of Orthopaedic Surgery and Research
Mue Daniel, Salihu Mohammed, Awonusi Francis, Yongu William, Kortor Joseph, Elachi Cornilius
BACKGROUND: Fractured neck of femur is a frequent and severe injury in elderly patients with consequent high morbidity and mortality. Hemiarthroplasty is an established treatment modality for displaced intracapsular femoral neck fractures in elderly patients above 60 years. This study analysed the early functional outcome and complications of Austin Moore endoprosthesis in elderly patients above 60 years with fractured neck of femur. MATERIALS AND METHODS: Retrospective data were obtained over a 5 year period from January 2007 to December 2012...
January 2015: Nigerian Medical Journal: Journal of the Nigeria Medical Association
Paul F Lachiewicz, Elizabeth S Soileau
BACKGROUND: Femoral revision using fully coated femoral components offers distinct advantages in patients with notable bone loss. With the increasing concerns being raised about the problems of stem modularity, the results and complications of revision arthroplasty using devices with limited modularity are important. QUESTIONS/PURPOSES: We therefore asked: (1) What is the frequency of infection, aseptic loosening, and reoperations after use of these components? (2) What is the frequency of intraoperative fracture of the femur when using these components and are there any identifiable factors related to these fractures? (3) What is the 10-year survivorship of these components, and are there any identifiable factors related to survival and rerevision? METHODS: We retrospectively reviewed prospectively obtained data on 96 patients undergoing 104 revisions with fully coated components of two different manufacturers; six patients had died (6%) and six were lost to followup (6%) before 2 years...
February 2015: Clinical Orthopaedics and related Research
2015-01-29 21:44:09
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