scholarly journals Anaesthesia for Hip Replacement in Ankylosing Spondylitis

1986 ◽  
Vol 79 (8) ◽  
pp. 457-459 ◽  
Author(s):  
F W Wittmann ◽  
P A Ring

Thirteen total hip replacements in 8 patients with ankylosing spondylitis are reviewed. Complications of the disease which can lead to anaesthetic difficulties are discussed, and the importance of a preoperative visit and the value of indirect laryngoscopy emphasized. As intubation problems may occur, especially in undiagnosed cases, equipment for emergency intubation should always be readily available. The results fully justify the operation.

2012 ◽  
Vol 24 (06) ◽  
pp. 549-555 ◽  
Author(s):  
Ching-Ho Wu ◽  
Cheng-Chung Lin ◽  
Tung-Wu Lu ◽  
Lih-Seng Yeh

Total hip replacement (THR) has been one of the main choices in treating dysplasia and other disabling conditions of the coxofemoral joint of large-breed dogs. Quantitative data of the three-dimensional (3D) morphology of the native normal acetabulum will be helpful for better design and implantation of prosthetic components. However, 3D orientation and morphological parameters of the native acetabulum in large-breed dogs are rarely reported. The purposes of the study were to measure the values of the 3D morphological parameters of the native acetabulum in Labrador Retriever dogs, namely acetabular orientation in relation to the pelvis, as well as the radius, angle between ventral and dorsal rims, and the distance from the center to the dorsal rim of the acetabulum using a 3D CT-derived model. The data will be useful for developing a more accurate guideline for improving current THR designs and for more accurate placement of the acetabulum component during THR surgery.


2021 ◽  
Vol 108 (Supplement_6) ◽  
Author(s):  
M Ahmed ◽  
S Radha

Abstract Total hip replacements have been performed in the UK since the 1960s, with over 280000 primary hip replacements being conducted between January 2017 – December 2019. The formation of pseudotumours is an uncommon and an unusual long-term complication of total hip replacements. Formed by galvanic corrosion of the metal prosthesis, patients can display an array of symptoms. We herein report a rare presentation of unilateral leg oedema in an elderly female, mimicking deep vein thrombosis. Despite normal metal ion levels, radiological investigations revealed an irregular cystic mass extending into the iliac fossa compressing the neurovascular bundle in the groin. The patient underwent complex revision hip surgery with dual mobility hip replacement and an Exeter stem with excision of the pseudotumour. This case highlights the importance of appropriate workup for these patients and the involvement of a multidisciplinary team.


Author(s):  
Lin Wang ◽  
Graham Isaac ◽  
Ruth Wilcox ◽  
Alison Jones ◽  
Jonathan Thompson

Evaluation and prediction of wear play a key role in product design and material selection of total hip replacements, because wear debris is one of the main causes of loosening and failure. Multifactorial clinical or laboratory studies are high cost and require unfeasible timeframes for implant development. Simulation using finite element methods is an efficient and inexpensive alternative to predict wear and pre-screen various parameters. This article presents a comprehensive literature review of the state-of-the-art finite element modelling techniques that have been applied to evaluate wear in polyethylene hip replacement components. A number of knowledge gaps are identified including the need to develop appropriate wear coefficients and the analysis of daily living activities.


2002 ◽  
Vol 17 (3-4) ◽  
pp. 93-97
Author(s):  
M. T. Barrellier

Background: Despite use of the anti-thrombotic prophylaxis, clinical thrombo-embolic events and fatal pulmonary embolism are still observed after total hip replacement. To reduce these complications, two strategies have been adopted: to prolong the use of low-molecular-weight heparins (LMWH) to 35 days or to screen patients systematically before discharge, using duplex ultrasonography, following the short-course prophylactic treatment. Objective: To assess, based on published literature, the relative costs and benefits of these two strategies for prophylaxis following total hip arthroplasty. Method: The author identified relevant papers in this field from his own resources and from medical literature databases. Synthesis: Prolonging LMWH treatment to a total of 35 days represents a direct cost in France of approximately £340 per patient, or for 100000 total hip replacements per year, an annual budget of £34 000000. If this strategy attained maximum efficacy, it would avoid 150 fatal pulmonary embolisms. The direct cost would therefore be at least £227000 per life saved. A systematic single duplex ultrasound examination before discharge from hospital would cost £76 per patient, or for 100 000 arthroplasties a total annual budget in France of £7 600000. If this approach achieved maximum efficacy, preventing the 150 fatal pulmonary embolisms corresponding to 100000 total hip replacements, the minimum direct cost would be £50 300 per life saved. Conclusion: Duplex screening may be more effective and lest costly than prolongation of prophylactic treatment using LMWH. This deduction needs to be confirmed by complex cost-benefit studies using clinical end-points.


2013 ◽  
Vol 95 (3) ◽  
pp. 88-91
Author(s):  
J Lloyd ◽  
I Starks ◽  
T Wainwright ◽  
R Middleton

Metal-on-metal (MoM) hip resurfacings (HRs) and large head total hip replacements (LHTHRs) were perceived by many as a surgical revolution, with clear advantages over the traditional metal-on-polyethylene total hip replacement (THR). This is especially the case for younger, active individuals in whom conventional THR has been associated with higher rates of aseptic loosening. In addition to less bearing surface wear, frequently cited advantages for HR include the preservation of femoral bone stock, lower dislocation rates, and superior function and activity scores.


Volume 2 ◽  
2004 ◽  
Author(s):  
Siegfried V. N. Jaecques ◽  
Cezar Pastrav ◽  
Georges Van der Perre

Vibration analysis can be used as a more sensitive alternative to conventional techniques for the detection of loosening of total hip replacement (THR) components. The vibration modes of the human femur and of selected THR prosthetic stems were studied by experimental modal analysis using a CADA-X system and by finite element simulation using MARC/Mentat software. Two hypotheses were formulated: (1) the differences between the vibrational behavior of an intact femur and of the system formed by a femur and an implanted prosthesis will increase with increasing complexity of the mode shapes of the system; (2) when a prosthesis is implanted in a femur, the vibration modes of the prosthesis will be more affected by this interaction than the modes of the femur. After confirming these hypotheses, a method for per-operative assessment of the fixation quality of a THR stem was derived, based on the frequency shifts of the vibration modes of the system.


1978 ◽  
Vol 7 (2) ◽  
pp. 107-110 ◽  
Author(s):  
H. S. Dobbs

The paper reports on the incidence of fracture of the femoral component of total hip replacements in patients at the Royal National Orthopaedic Hospital over the period 1963-1976. The average incidence of fracture was approximately 0.2 per cent per year for air melt air cast cobalt chrome components. For vacuum melt vacuum cast components there were no fractures, but because of the small number of insertions with a long follow-up period, this result could have been fortuitous. There was a suggestion that the fracture rate increased with time, but even 0.2 per cent is considered too high.


2012 ◽  
Vol 94 (3) ◽  
pp. 193-198 ◽  
Author(s):  
GH Stafford ◽  
SC Charman ◽  
MJ Borroff ◽  
C Newell ◽  
JK Tucker

INTRODUCTION This paper describes, for the first time, the outcomes of patients undergoing total hip replacement for acute fractured neck of femur (#NOF) as recorded by the National Joint Registry of England and Wales (NJR). METHODS In the NJR we identified 1,302 of 157,232 Hospital Episode Statistics linked patients who had been recorded as having a total hip replacement for acute #NOF between April 2003 and November 2008. RESULTS The revision rate at five years for fully uncemented components was 4.1% (95% confidence interval [Cl]: 2.2-7.3%), for hybrid it was 2.2% (95% Cl: 0.9%-5.3%) and for fully cemented components 0.9% (95% Cl: 0.4-2.0%). Five-year revision rates were increased for those whose operations were performed via a posterior versus a lateral approach. The Kaplan-Meier estimate of 30-day mortality was 1.4% (95% Cl: 1.0-2.4%), which is over double the 30-day mortality rate for total hip replacement identified by the Office for National Statistics. The mean length of stay was also increased for those undergoing total hip replacements for #NOF compared with non-emergency indications. CONCLUSIONS Our data suggest that total hip replacements for acute #NOF give comparable results with total hip replacements for other indications.


2017 ◽  
Vol 56 (205) ◽  
pp. 158-162
Author(s):  
Pankaj Chand ◽  
Sushil Rana Magar ◽  
Bishnu Babu Thapa ◽  
Bikal Shrestha

Introduction: Total hip replacement is one of the most widely performed and amongst the most successful orthopedic procedures performed worldwide. Even though it is a common orthopedic procedure in developed nations, it is performed only in selected centers in Nepal.  This study will review the functional outcome of total hip replacements carried out in Shree Birendra Hospital. Methods: We reviewed the records of total hip replacements, which were carried out in Shree Birendra Hospital, Kathmandu. Twenty-one hips were cemented and nineteen were uncemented.  Cases were followed up in six weeks, twelve weeks, six months and every year from then on. Outcome in terms of Harris hip score of 40 osteoarthritic hips were measured pre-operatively as well as post-operatively. Results: The mean age of the patients was 50.63 years (range 22-79 years). The commonest reason for the replacement was primary osteoarthritis of the hip. Thirty-nine patients underwent unilateral total hip replacement while in one patient both hips were replaced. The mean Harris hip score for the forty hips that were available at the latest follow-up examination at an average of five years (range two to six and a half years) after the operation was 85.2 ± 7.65 points as compared to the pre-operative mean Harris hip score of 32.38 ± 3.4. Conclusions: Based on improved Harris hip scores, we believe that THR is a good option in patients with end stage arthritis of the hip. Keywords: cemented; primary osteoarthritis; total hip replacement.


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