scholarly journals No consensus on cementless fixation currently being the most cost‐effective mode of implant fixation in younger total hip arthroplasty patients

2021 ◽  
Vol 75 (9) ◽  
Author(s):  
Hidde D. Veldman ◽  
Robin T. A. L. Bot ◽  
Ide C. Heyligers ◽  
Tim A. E. J. Boymans ◽  
Mickaël Hiligsmann
Keyword(s):  
Total Hip Arthroplasty ◽  
Hip Arthroplasty ◽  
Cost Effective ◽  
Cementless Fixation ◽  
Implant Fixation ◽  
Total Hip

scholarly journals No association between serum metal ions and implant fixation in large-head metal-on-metal total hip arthroplasty

2014 ◽  
Vol 85 (4) ◽  
pp. 355-362 ◽  
Author(s):  
Mette Holm Hjorth ◽  
Kjeld Søballe ◽  
Stig Storgaard Jakobsen ◽  
Nina Dyrberg Lorenzen ◽  
Inger Mechlenburg ◽  
...  
Keyword(s):  
Total Hip Arthroplasty ◽  
Metal Ions ◽  
Hip Arthroplasty ◽  
Implant Fixation ◽  
Total Hip ◽  
Large Head ◽  
Metal On Metal

scholarly journals Identification of Critical Genes and lncRNAs in Osteolysis after Total Hip Arthroplasty and Osteoarthritis by RNA Sequencing

2021 ◽  
Vol 2021 ◽  
pp. 1-13
Author(s):  
Guang Yang ◽  
Kai Tang ◽  
Li Qiao ◽  
Yixin Li ◽  
Shui Sun
Keyword(s):  
Total Hip Arthroplasty ◽  
Effective Treatment ◽  
Rna Sequencing ◽  
Hip Arthroplasty ◽  
Specific Interaction ◽  
Cost Effective ◽  
Common Complication ◽  
Total Hip ◽  
Cost Effective Treatment ◽  
Coexpression Networks

Total hip arthroplasty (THA) is a cost-effective treatment for osteoarthritis (OA), and osteolysis is a common complication of THA. This study was aimed at exploring the relevant molecular biomarkers for osteolysis after THA. We performed RNA sequence to identify and characterize expressed mRNAs and lncRNAs in OA and osteolysis. Differentially expressed mRNAs (DEmRNAs) and lncRNAs (DElncRNAs) in OA and osteolysis were acquired, as well as shared DEmRNAs/DElncRNAs in OA and osteolysis and osteolysis-specific DEmRNAs/DElncRNAs. Then, shared and osteolysis-specific DElncRNA-DEmRNA coexpression networks were constructed to further investigate the function of DElncRNAs and DEmRNAs in OA and osteolysis. In total, 343 DEmRNAs and 25 DElncRNAs in OA, 908 DEmRNAs and 107 DElncRNAs in osteolysis, and 406 DEmRNAs and 46 DElncRNAs between OA and osteolysis were acquired. A total of 136 shared DEmRNAs and 9 shared DElncRNAs in OA and osteolysis and 736 osteolysis-specific DEmRNAs and 103 osteolysis-specific DElncRNAs were acquired. Then, 128 shared DElncRNA-DEmRNA coexpression pairs and 522 osteolysis-specific DElncRNA-DEmRNA coexpression pairs were identified. The present study highlighted the roles of four interaction pairs, including two shared lncRNA-mRNA interaction pairs in OA and osteolysis (AC111000.4 and AC016831.6), which may function in the immune process of OA and osteolysis by regulating CD8A and CD8B, respectively, and two osteolysis-specific interaction pairs (AC090607.4-FOXO3 and TAL1-ABALON), which may play an important role in osteoclastogenesis.

scholarly journals One-Stage Bilateral Total Hip Arthroplasty. Modern Representations and Our Experience

2020 ◽  
Vol 106 (3) ◽  
pp. 52-62
Author(s):  
O.M. Kosiakov ◽  
P.V. Bulych ◽  
K.O. Hrebennikov ◽  
A.V. Myloserdov ◽  
Ye. V. Tuz ◽  
...  
Keyword(s):  
Total Hip Arthroplasty ◽  
Hip Arthroplasty ◽  
Surgical Intervention ◽  
Joint Damage ◽  
Cost Effective ◽  
Modern Medicine ◽  
Postoperative Rehabilitation ◽  
Surgical Interventions ◽  
Total Hip ◽  
One Stage

Summary. Relevance. Total hip arthroplasty remains one of the most successful and cost-effective surgical interventions in modern medicine. This is proven by the ever-growing number of total arthroplasties worldwide, which reached 650,000 implantations in Europe only in 2018. In 2024, this number is expected to be 730,000 [1]. According to experts, from 15 to 25 percent of patients need a bilateral procedure [2, 8]. The experience of our Center allows us to recommend a successful one-stage replacement of both hip joints for patients with a number of medical and social comorbidities. Objective. The study is set out to highlight the possibilities of performing simultaneous bilateral arthroplasty of the hip joint in a group of patients with bilateral joint damage, as well as to substantiate the economic, medical and social benefits of this surgical intervention. Materials and Methods. We have analyzed the data from publications of our foreign colleagues. We also present our own observations – more than 100 cases over the past 11 years (2008-2019). Results. Based on data from foreign publications and our own observations, the undoubted advantages, features and limitations of this type of surgical intervention are shown. Complex cases of bilateral joint damage and the results of one-stage surgical treatment have been demonstrated. Conclusions. One-stage bilateral hip arthroplasty is the method of choice for symmetric lesions and should take its rightful place in the arsenal of modern orthopedics clinics. We continue to advocate simultaneous bilateral hip replacement for a selected group of healthy patients ≤65 years old. Thoughtful preoperative planning, surgical intervention lasting up to 90 minutes on each joint, careful postoperative monitoring, strictly controlled prevention of thromboembolic complications and active postoperative rehabilitation provide our patients with quick and safe functional recovery.

scholarly journals To cement or not to cement acetabular cups in total hip arthroplasty: a systematic review and re-evaluation

SICOT-J ◽  
2019 ◽  
Vol 5 ◽  
pp. 35
Author(s):  
Frank Van Praet ◽  
Michiel Mulier
Keyword(s):  
Total Hip Arthroplasty ◽  
Hip Arthroplasty ◽  
English Literature ◽  
Cost Effective ◽  
Acetabular Cup ◽  
Qualitative Synthesis ◽  
Osteoarthritis Of The Hip ◽  
Total Hip ◽  
Primary Osteoarthritis ◽  
Cemented Stem

Introduction: Total Hip Arthroplasty (THA) in the treatment of primary osteoarthritis of the hip has evolved to a very safe and cost-effective intervention with revision rates below 5% after 10 years. To this day, however, controversy remains on whether or not to cement the acetabular cup. Methods: A comprehensive PubMed search of the English literature for studies published between 2007 and 2018 was performed. Studies comparing the clinical (revision rate, functionality), radiological (wear) or economic (cost) differences between cemented (cemented stem with cemented cup) and hybrid (cemented stem with uncemented cup) prostheses for primary osteoarthritis of the hip were identified as eligible. Results: A total of 1032 studies were identified whereof twelve were included for qualitative synthesis. All studies concerning the risk of revision were based on registry data, covering a total of 365,693 cups. Cemented prostheses had a similar or lower risk of revision compared to hybrid prostheses in every study, but performed slightly worse on functionality and quality of life. While cemented prostheses were the cheapest option, hybrids were the most cost-effective. Discussion: The widespread preference for cementless fixation of the acetabulum cannot be explained by a superior survival of cementless or hybrid models. Irrespective of age, cemented fixation of the acetabulum remains the gold standard to which other techniques should be compared.

scholarly journals Subcuticular sutures versus staples for skin closure after primary hip arthroplasty

2021 ◽  
Vol 87 (1) ◽  
pp. 55-64
Author(s):  
Hany Elbardesy ◽  
Rehan Gul ◽  
Shane Guerin
Keyword(s):  
Total Hip Arthroplasty ◽  
Systematic Reviews ◽  
Hip Arthroplasty ◽  
Meta Analysis ◽  
Random Effect ◽  
Cost Effective ◽  
Skin Closure ◽  
Patient’S Satisfaction ◽  
Total Hip ◽  
Significant Difference

High-quality and cost-effective health care are highly recommended especially in joint replacement surgeries, particularly in total hip arthroplasty. Therefore, it is indispensable for orthopaedic surgeons to spot the potential areas of quality improvement. Evaluating the efficacy of the different ways of skin closure is an unacknowledged topic. We performed this study following both the Preferred Reporting Items for Systematic Reviews and Meta- analyses Statement (PRISMA) and the Cochrane Handbook for systematic reviews and meta-analysis. Articles were from any country, written in any language. We included all randomised control trials and retrospective cohort studies undergoing primary total hip arthroplasty who either received staples or subcuticular sutures for skin closure. The primary outcome was the incidence of wound infection. Secondary outcomes included length of stay (LOS), time to skin closure, total cost, and patient’s satisfaction. We included five studies in our cumulative meta- analysis. We conducted them using Review Manager V.5.0. We computed the risk ratio as a measure of the treatment effect, taking into account heterogeneity. We used Random-effect models. Primary skin closure with subcuticular sutures had insignificant marginal advantages for wound infections, LOS, and wound oozing. On the contrary, staples were more cost- effective and had less time for closure with higher patient’s satisfaction. Except for closure time and patient satisfaction , no significant difference between the two groups. The use of staples after THA may have several slight clinical advantages over the subcuticular sutures. However, owing to the complexities associated with wound closure, future clinical and laboratory studies assessing their complication outlines must be examined before an optimum technique can be determined.

scholarly journals Which is the most appropriate strategy for nasal screening and Staphylococcus aureus decolonization in total hip arthroplasty patients?

2020 ◽  
Author(s):  
Hisahiro Tonotsuka ◽  
Hajime Sugiyama ◽  
Ayano Amagami ◽  
Keigo Yonemoto ◽  
Ryuichi Sato ◽  
...  
Keyword(s):  
Risk Factors ◽  
Staphylococcus Aureus ◽  
Total Hip Arthroplasty ◽  
Hip Arthroplasty ◽  
Average Cost ◽  
Smoking Habit ◽  
Cost Effective ◽  
Effective Strategy ◽  
Total Hip ◽  
Cost Effective Strategy

Abstract Background: To reduce periprosthetic joint infection after total hip arthroplasty (THA), several nasal screening and decolonization strategies for methicillin-resistant Staphylococcus aureus (MRSA) and methicillin-sensitive Staphylococcus aureus (MSSA) have been performed. These include universal decolonization (UD; i.e., no screening and decolonization for all patients), universal screening and target decolonization (US; i.e., screening for all patients and decolonization for bacterial positive patients), and target screening and decolonization (TS; i.e., screening and decolonization for high-risk populations only). Although TS is the most cost-effective strategy, useful risk factors must be identified. The purpose of this study was to evaluate the presence of predictive factors that enable the TS strategy to be successfully implemented and to compare the costs of each strategy.Methods: A total of 1654 patients scheduled for primary or revision THA (1464 women, 190 men; mean age 64 years) were screened prior to surgery for bacterial colonization of the nasal mucosa. Risk factors for positive MRSA and MRSA/MSSA tests were analyzed according to the following parameters: sex, age ≥80 years, body mass index ≥30 kg/m2, antibiotic use within 3 years, corticosteroid use, serum albumin <3.5 g/dL, glomerular filtration rate <50 mL/min, presence of brain, thyroid, cardiac or pulmonary disease, diabetes, asthma, and smoking habit. The average cost of each strategy was calculated.Results: In total, 29 patients (1.8%) tested positive for MRSA and 445 (26.9%) tested positive for MRSA/MSSA. No parameters were identified as independent risk factors for MRSA and only female sex was identified as a risk factor for MRSA/MSSA (p=0.003; odds ratio: 1.790; 95% confidence interval: 1.210-2.640). The average cost of each strategy for eradicating MRSA was 1641.3 yen for UD, 285.8 yen for US, and 252.3 yen for TS.Conclusions: No useful predictive parameters for implementing the TS strategy were identified. Based on cost implications, US is the most cost-effective strategy for THA patients.

Bariatric Surgery Prior to Total Hip Arthroplasty Is Cost-Effective in Morbidly Obese Patients

2020 ◽  
Vol 35 (7) ◽  
pp. 1766-1775.e3 ◽  
Author(s):  
Ajay Premkumar ◽  
Drake G. Lebrun ◽  
Sreetha Sidharthan ◽  
Caitlin L. Penny ◽  
Emily R. Dodwell ◽  
...  
Keyword(s):  
Bariatric Surgery ◽  
Total Hip Arthroplasty ◽  
Hip Arthroplasty ◽  
Cost Effective ◽  
Morbidly Obese ◽  
Obese Patients ◽  
Total Hip

scholarly journals The effect of the hip joint endoprosthesis length after a total hip arthroplasty: A biomechanical study

2019 ◽  
Vol 26 (1) ◽  
pp. 61-66 ◽  
Author(s):  
Andreas-Foivos Smyris ◽  
Vassiliki T. Potsika ◽  
Ioannis-Ilias K. Farmakis ◽  
Nikolaos Tachos ◽  
Dimitrios I. Fotiadis ◽  
...  
Keyword(s):  
Total Hip Arthroplasty ◽  
Hip Arthroplasty ◽  
Cost Effective ◽  
Normal Weight ◽  
Biomechanical Study ◽  
Stem Length ◽  
Fourth Generation ◽  
Stem Size ◽  
Total Hip ◽  
Hip Joint Endoprosthesis

Background/purpose: Total hip arthroplasty is a safe, cost-effective surgical intervention which restores mobility and alleviates pain from most kinds of hip arthritis. The proposed biomechanical study evaluates the effect of the stem size on the mechanical environment of the hip and its association with aseptic loosening. Methods: Medium left, fourth-generation, composite femoral models were used, and different prosthesis dimensions were examined. Fourteen strain gages were placed at specific positions on the femur. Load cycles were programmed to simulate single-leg stance of gait of a normal-weight subject. Results: Microstrains in the anterior and posterior region of the femur shaft were found to decrease with increasing the stem length, while no specific tendency was observed in the regions of the great and lesser trochanteric as well as in the medial and lateral femur. Conclusion: This study indicates that shorter implants are subjected to higher strains distally to the pertrochanteric area.

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