scholarly journals Two-staged surgical treatment of hip septic arthritis

2014 ◽  
Vol 95 (1) ◽  
pp. 112-115
Author(s):  
H G Ismailov ◽  
A F Mazdykov ◽  
B A Shushaniya
Keyword(s):  
Surgical Treatment ◽  
Septic Arthritis ◽  
Hip Arthroplasty ◽  
Scar Tissue ◽  
Mineral Density ◽  
Functional Rehabilitation ◽  
Partial Load ◽  
Femoral Shortening ◽  
Septic Coxitis ◽  
Staged Treatment

Hip arthritis (coxitis) is the inflammatory process in the hip, requiring complicated and lengthy treatment. At some cases it is associated with serious complications, up to patient’s disability due to the femoral head destruction. The treatment goal is to halt inflammation for further hip arthroplasty and functional rehabilitation. Arthroplasty is performed using the commercially available cement antibiotic-impregnated articulating spacers. The article reviews a number of clinical examples of two-staged surgical treatment of hip septic arthritis using articulating spacers with further hip arthroplasty. Experts, including native specialists, in the periodicals and clinical practice question the effectiveness of two-staged treatment. The experience of effective use of commercially available bone cement antibiotic-impregnated articulating spacers is presented. The method allows to halt the inflammation, to avoid the significant femoral shortening and acetabulum filling by scar tissue, to preserve hip function and provides the patient an opportunity to move with a partial load on the operated limb while waiting for the arthroplasty, as well as improves the conditions for hip implant consolidation. After suppressing the inflammation, the described method, providing a moderate load on the affected bone, enhances the bone mineral density increase both of femur and acetabulum. Two-staged treatment of septic coxitis decreases the risk for infective complications after the total hip replacement.

scholarly journals MODERN TREATMENT APPROACHES IN PATIENTS AFTER HIP ARTHROPLASTY BASED ON ASSESSMENT OF MINERAL METABOLISM IN DIFFERENT SKELETAL SEGMENTS

2015 ◽  
Vol 18 (1) ◽  
pp. 14-17
Author(s):  
I R Gafarov ◽  
R R Yakupov ◽  
T B Minasov ◽  
T E Hairov ◽  
A R Trubin ◽  
...  
Keyword(s):  
Hip Arthroplasty ◽  
Medical Technology ◽  
Mineral Metabolism ◽  
System Level ◽  
Control Group ◽  
Bone Homeostasis ◽  
Mineral Density ◽  
Functional Rehabilitation ◽  
Positive Effect

The results of a comparative study (study group included 35 patients after hip arthroplasty, control group - 36 patients) of mineral monitoring in different skeletal segments showed that a deficit in bone mineral density is formed in operated limb and is reflected at the system level leading to various forms of suppression of bone homeostasis, which subsequently impairs the quality of life. The efficiency of the use of calcium salts in combination with alfacalcidol, and in conjunction with an active functional rehabilitation after hip arthroplasty based on clinical and radiological monitoring. Such a scheme has a positive effect on treatment outcomes when using this medical technology.

scholarly journals Subtrochanteric femoral shortening for hip centre restoration in complex total hip arthroplasty with functional outcome

2020 ◽  
Vol 1 (5) ◽  
pp. 152-159
Author(s):  
A. T. Oommen ◽  
V. J. Chandy ◽  
Christo Jeyaraj ◽  
Madhavi Kandagaddala ◽  
T. D. Hariharan ◽  
...  
Keyword(s):  
Total Hip Arthroplasty ◽  
Septic Arthritis ◽  
Functional Outcome ◽  
Hip Arthroplasty ◽  
Short Form ◽  
Harris Hip Score ◽  
Total Hip ◽  
Femoral Shortening ◽  
The Mean ◽  
Centre Of Rotation

Aims Complex total hip arthroplasty (THA) with subtrochanteric shortening osteotomy is necessary in conditions other than developmental dysplasia of the hip (DDH) and septic arthritis sequelae with significant proximal femur migration. Our aim was to evaluate the hip centre restoration with THAs in these hips. Methods In all, 27 THAs in 25 patients requiring THA with femoral shortening between 2012 and 2019 were assessed. Bilateral shortening was required in two patients. Subtrochanteric shortening was required in 14 out of 27 hips (51.9%) with aetiology other than DDH or septic arthritis. Vertical centre of rotation (VCOR), horizontal centre of rotation, offset, and functional outcome was calculated. The mean followup was 24.4 months (5 to 92 months). Results The mean VCOR was 17.43 mm (9.5 to 27 mm) and horizontal centre of rotation (HCOR) was 24.79 mm (17.2 to 37.6 mm). Dislocation at three months following acetabulum reconstruction required femoral shortening for offset correction and hip centre restoration in one hip. Mean horizontal offset was 39.72 (32.7 to 48.2 mm) compared to 42.89 (26.7 to 50.6 mm) on the normal side. Mean Harris Hip Score (HHS) of 22.64 (14 to 35) improved to 79.43 (68 to 92). Mean pre-operative shortening was 3.95 cm (2 to 8 cm). Residual limb length discrepancy was 1.5 cm (0 to 2 cm). Sciatic neuropraxia in two patients recovered by six months, and femoral neuropraxia in one hip recovered by 12 months. Mean Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) was 13.92 (9 to 19). Mean 12-item short form survey (SF-12) physical scores of 50.6 and mental of 60.12 were obtained. Conclusion THA with subtrochanteric shortening is valuable in complex hips with high dislocation. The restoration of the hip centre of rotation and offset is important in these hips. Level of evidence IV Femoral shortening useful in conditions other than DDH and septic sequelae. Restoration of hip centre combined with offset to be planned and ensured.

scholarly journals Subtrochanteric femoral shortening for hip centre restoration in complex total hip arthroplasty with functional outcome

2020 ◽  
Vol 1 (5) ◽  
pp. 152-159
Author(s):  
A. T. Oommen ◽  
V. J. Chandy ◽  
Christo Jeyaraj ◽  
Madhavi Kandagaddala ◽  
T. D. Hariharan ◽  
...  
Keyword(s):  
Total Hip Arthroplasty ◽  
Septic Arthritis ◽  
Functional Outcome ◽  
Hip Arthroplasty ◽  
Short Form ◽  
Harris Hip Score ◽  
Total Hip ◽  
Femoral Shortening ◽  
The Mean ◽  
Centre Of Rotation

Aims Complex total hip arthroplasty (THA) with subtrochanteric shortening osteotomy is necessary in conditions other than developmental dysplasia of the hip (DDH) and septic arthritis sequelae with significant proximal femur migration. Our aim was to evaluate the hip centre restoration with THAs in these hips. Methods In all, 27 THAs in 25 patients requiring THA with femoral shortening between 2012 and 2019 were assessed. Bilateral shortening was required in two patients. Subtrochanteric shortening was required in 14 out of 27 hips (51.9%) with aetiology other than DDH or septic arthritis. Vertical centre of rotation (VCOR), horizontal centre of rotation, offset, and functional outcome was calculated. The mean followup was 24.4 months (5 to 92 months). Results The mean VCOR was 17.43 mm (9.5 to 27 mm) and horizontal centre of rotation (HCOR) was 24.79 mm (17.2 to 37.6 mm). Dislocation at three months following acetabulum reconstruction required femoral shortening for offset correction and hip centre restoration in one hip. Mean horizontal offset was 39.72 (32.7 to 48.2 mm) compared to 42.89 (26.7 to 50.6 mm) on the normal side. Mean Harris Hip Score (HHS) of 22.64 (14 to 35) improved to 79.43 (68 to 92). Mean pre-operative shortening was 3.95 cm (2 to 8 cm). Residual limb length discrepancy was 1.5 cm (0 to 2 cm). Sciatic neuropraxia in two patients recovered by six months, and femoral neuropraxia in one hip recovered by 12 months. Mean Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) was 13.92 (9 to 19). Mean 12-item short form survey (SF-12) physical scores of 50.6 and mental of 60.12 were obtained. Conclusion THA with subtrochanteric shortening is valuable in complex hips with high dislocation. The restoration of the hip centre of rotation and offset is important in these hips. Level of evidence IV Femoral shortening useful in conditions other than DDH and septic sequelae. Restoration of hip centre combined with offset to be planned and ensured.

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