Improving planning and post-operative assessment for Total Hip Arthroplasty (original) (raw)
Related papers
Anatomical and Functional Preliminary Results of Total Non-Cemented Hip Prostheses
Open Journal of Orthopedics, 2017
The aim of this work was to assess the preliminary anatomical and functional results of patients to establish prospects. Materials and method: We report here the preliminary results of a retrospective mono-centric, homogeneous and continuous series, of 21 non-cemented total hip implants, implanted from January 2011 to December 2014. The mean follow-up time was 24 months. The patients were evaluated by Harris's hip at the last follow-up. Results: The mean age of the intervention was 30 years. In our series, we observed a male predominance (60% of cases). Clinically, the Harris score varied significantly from 52.6 ± 11.4 pre-operatively to 85.1 ± 5.1 during the last follow-up visit. Among the items in the score, pain was the parameter that showed the greatest improvement. Thigh pain was observed in only one patient operated on the two sides. At the level of radiology, the femoral implant showed great stability. Bone resorption was suspected in 14 cases (66.66%), and confirmed in 4 cases (19.04%) with excellent bone remodeling, illustrated by the Engh and Massin scores. A loosening and a prosthetic dislocation was observed in a patient (4.76%). Any heterotopic ossification was observed. Conclusion: Our study confirmed good clinical and radiological results of the non-cemented hip prosthesis series in young patients. The rates of aseptic loosening, acetabular edges or osteolysis are low and stable over time.
Demographic biases found in scoring instruments of total hip arthroplasty
The Journal of Arthroplasty, 1996
Four hip scoring systems were used in evaluating 200 adult subjects who had no prior history of injury, pathologic condition, or treatment of the hips, knees, lower extremities, or spine. All subjects were in the age range typical of a total hip arthroplasty candidate (average age, 65 years; range, 50-100 years). In addition to a physical examination, complete demographic data were collected on each subject. Data were recorded on standardized flow sheets so that hip scores could be calculated; scores were normalized by dividing the observed scores by the maximum possible score. The average normalized total hip scores were Harris hip score, 90.8%; modified Harris hip score, 91.9%; Merle D'Aubigne score, 93.9%; and Hospital for Special Surgery hip rating, 87.5%. Demographic variables that had a significant negative correlation with hip scores included advanced age (particularly past age 85), an income below the poverty level, and the presence of two or more major medical conditions. Differences in hip scores between different study groups that have not been matched for various clinically relevant factors ("case mix") are at least as likely to represent differences in the patient populations as differences in surgical technique or implant design. Hip scores may decline over the course of a I0-to 20-year follow-up period due to the change in a patient's age and/or medical condition rather than any factor relating to the hip arthroplasty. Key words: hip scoring system, total hip arthroplasty, demographics biases.
To study the clinical outcome of total hip Arthroplasty
IP Innovative Publication Pvt. Ltd., 2017
Introduction: Total hip Arthroplasty is a surgical procedure, which relives pain related to hip joint. The success of Total Hip Arthroplasty is its ability to relieve the pain associated with hip joint pathology, while maintaining the mobility and stability of the hip joint. This study was undertaken to assess the Clinical outcome of the Total hip Arthroplasty in our institution. Material & Methods: Retrospective and prospective study was carried out on 500 patients of Total Hip Replacement. All patients underwent a standard clinical and laboratory evaluation that includes briefly information about age, sex, address, clinical history and routine investigation which were done pre operatively. X-Ray of hip joint with AP view was done. Pre-op Range of Motion, deformities and its values were recorded for the study by clinical evaluation and Modified Harris hip scoring was done preoperatively and postoperatively with follow up at 4 weeks, 6 months, 1 year and at yearly intervals. Results: This study was conducted on patients with age ranging from 20 to 75 years with a mean age of 40.50 ±12.15 years at the time of surgery. The main indication for surgery was AVN in 360 patients (72%). The mean total pre-operative harris hip score score was 49.74. The maximum score being, 73 and the minimum, being 37. Post operatively the total mean score was 85.12, with the 65 being the minimum and 96 being the maximum. The most common complication was stress shielding (24%). Acetabular component loosening was seen in 2% cases and femoral stem loosening was found in 12% cases. Calcar resorption was present in 8% cases. Conclusion: In conclusion, Total hip Arthroplasty with or without cement gives good clinical and functional outcomes and is determined by multiple factors, like indication for total hip Arthroplasty, placement of prosthesis, and the operative technique. The results of the procedure must be evaluated in long-term studies. Our study suggests that the Total Hip Replacement can provide satisfactory clinical outcomes after short term duration of follow-up.
Outcomes following total hip arthroplasty: A review of the registry data
Indian Journal of Orthopaedics
While total hip arthroplasty remains one of the most reliable procedures with excellent, cost-effective outcomes, there remains controversy in the choice of implant in terms of method of fixation, bearing surface, and size of the femoral head, especially in the younger population. This review looks at the possible information base that surgeons can explore before choosing the implant that they are comfortable with. It also looks at the findings of various registries, which readers can use in the process of informed consent. We have provided certain recommendations with specific reference to the method of fixation, bearing surface, and head size that can be backed by the available registry data. However, the information provided should be used only after considering local, financial, and patient-specific issues that surgeons encounter on a daily basis during their practice.
1999
Prospective, randomized studies must be performed when new surgical techniques or implants are evaluated. In this study, a new implant system was compared with the Charnley prosthesis, which over the years has been the most used hip implant in Sweden. Between 1985 and i989, 410 hips were randomized to treatment with a Chamley or a Spectron total hip arthroplasty: 206 Chamley and 204 Spectron prostheses were implanted. The patients were operated on by a standardized procedure using a contemporary cementing technique. The patients were followed prospectively by an independent observer after l, 3, 5 to 6, and l0 years. Harris Hip Score and patient satisfaction were recorded in the outcome evaluation. A total of 144 patients with 164 hips were deceased, and 15 patients (8 Charnley and 7 Spectron) have required a revision. Nine hips were revised because of aseptic loosening (5 Charnley stems and 4 Spectron metal-backed cups). The Charnley stem as well as the metal-backed Spectron cup had a higher risk for revision because of aseptic loosening. The Chamley ogee cup and the Spectron stein have performed remarkably well with no revision of these components. Seven Chamley prostheses dislocated, but no dislocation was recorded in the Spectron group. Survivorship calculations with a mean follow-up of 10 years revealed an overall ii-year survivorship of 94.5% _+ 3.4% (Charnley, 93.2% + 5.8%; Spectron, 95.9% +-_ 3.0%). The clinical outcome did not differ between the 2 systems. The overall results in this old population, using a contemporary surgical technique, illustrate that cemented hip arthroplasty is an excellent treatment alternative for elderly patients.
Acta Orthopaedica, 1999
155 patients (171 hips) with a mean age of 50 years (24-64) were randomized to uncemented PCA (84 hips) or Harris-Galante type I (87 hips) total hip arthroplasty. Clinical and radiographic evaluations were done regularly. The improvements in the Harris hip and pain scores did not differ. Osteolysis developed in 5 PCA and 17 Harris-Galante hips. 13 hips in the PCA and 16 in the Harris-Galante (HG) group were revised because of mechanical failures and 1 hip (HG) because of infection after a mean follow-up of 9 years. Decreased 10-year survival rate, based on revision as end-point, was noted for the PCA (85%), compared with the Hams-Galante cup (99%).
European Spine Journal, 2023
Introduction This registry study aims to assess the prevalence and demographic characteristics of patients with lumbar spine (LS) surgical procedures who undergo total hip arthroplasty (THA), to compare the long-term survival and causes of failure of THA in patients who previously underwent LS fusion and non-fusion surgical procedures, and to evaluate the risk of undergoing a revision LS surgery after THA. Materials and methods Patients who underwent LS surgery followed by THA were identified by cross-referencing data from the Orthopedic Prosthetic Implants Registry and the Regional Hospital Discharge Database. Three groups of THA patients were identified: patients who underwent previous lumbar surgery with fusion (LS fusion-THA), without fusion (LS non-fusion-THA), and a control group with only THA (No LS surgery-THA). Demographic data, THA survival, number and causes of failure, and data on revision procedures on THA and LS were collected. Results Of the total of 79,984 THA, 2.2% of patients had a history of LS procedures. THA only patients showed better results, while patients in the LS fusion-THA group had worse implant survival at 5-year follow-up. In the LS fusion-THA and LS non-fusion-THA, mechanical THA failures were more frequent in the first two years after implantation. There were no differences between groups regarding the risk of undergoing LS revision surgery. Conclusions LS surgery negatively affects THA survivorship. In patients who previously underwent LS fusion and non-fusion surgical procedures, most THA failure occurs in the first two years after implant. The study contributes to the understanding of the relationship between the hip and the LS and provides useful guidance for clinical practice.
PLoS ONE, 2013
Background: The number of prosthesis brands used for hip replacement has increased rapidly, but there is little evidence on their effectiveness. We compared patient-reported outcomes, revision rates, and mortality for the three most frequently used brands within each prosthesis type: cemented (Exeter V40 Contemporary, Exeter V40 Duration and Exeter V40 Elite Plus Ogee), cementless (Corail Pinnacle, Accolade Trident, and Taperloc Exceed), and hybrid (Exeter V40 Trilogy, Exeter V40 Trilogy, and CPT Trilogy).
Hip disease and the prognosis of total hip replacements
Journal of Bone and Joint Surgery-british Volume, 2001
W e studied the rates of revision for 53 698 primary total hip replacements (THRs) in nine different groups of disease. Factors which have previously been shown to be associated with increased risk of revision, such as male gender, young age, or certain types of uncemented prosthesis, showed important differences between the diagnostic groups. Without adjustment for these factors we observed an increased risk of revision in patients with paediatric hip diseases and in a small heterogeneous 'other' group, compared with patients with primary osteoarthritis. Most differences were reduced or disappeared when an adjustment for the prognostic factors was made. After adjustment, an increased relative risk (RR) of revision compared with primary osteoarthritis was seen in hips with complications after fracture of the femoral neck (RR = 1.3, p = 0.0005), in hips with congenital dislocation (RR = 1.3, p = 0.03), and in the heterogenous 'other' group. The analyses were also undertaken in a more homogenous subgroup of 16 217 patients which had a Charnley prosthesis implanted with high-viscosity cement. The only difference in this group was an increased risk for revision in patients who had undergone THR for complications after fracture of the femoral neck (RR = 1.5, p = 0.0005).