scholarly journals The effects of pulsed low frequency magnetic field in early rehabilitation of patients with cementless total hip arthroplasty

2006 ◽  
Vol 134 (9-10) ◽  
pp. 414-419
Author(s):  
Aleksandar Djurovic ◽  
Mirjana Zivotic-Vanovic ◽  
Dejan Popovic
Keyword(s):  
Magnetic Field ◽  
Total Hip Arthroplasty ◽  
Hip Arthroplasty ◽  
Low Frequency ◽  
Early Rehabilitation ◽  
Cementless Total Hip Arthroplasty ◽  
Frequency Magnetic Field ◽  
Group A ◽  
High Doses ◽  
Group B

Introduction: Early rehabilitation of patients with cementless total hip arthroplasty (cTHA) includes different physical modalities and pulsed low frequency magnetic field (PLFMF), which effects have not been explored yet. Objective: To investigate the effects of PLFMF which was applied in different doses in early rehabilitation of patients with cTHA. Method: Prospective, controlled, clinical study included 90 patients, divided in three groups with 30 patients each. First two groups were treated with high (group A) or low (group B) doses of PLFMF, in addition to kinesitherapy. Control group C was treated only with kinesitherapy. Study was completed in three weeks. Results: Subjects of group A had significantly lower pain than group B (p<0.01) and group C (p<0.001) subjects in the first postoperative week. Pain in group B subjects was significantly lower than in group C in all three postoperative weeks (p<0.01). In relation to other two groups, subjects of group A had higher hip Harris score values at the end of the third postoperative week (p<0.05), and they were faster on 10-meter distance at the end of the first postoperative week (p<0.01). Conclusion: PLFMF used in low and high doses for patients with cTHA had significant effects on pain abatement, especially at higher doses. Improvement of function was earlier and more manifested in the group treated with high doses of PLFMF.

scholarly journals Cementless total hip arthroplasty for three different degrees of hip involved secondary to ankylosing spondylitis: an analysis of 195 hips

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Ping Mou ◽  
Hua Li ◽  
An-Jing Chen ◽  
Zheng Ji ◽  
Xin-Yi Dai ◽  
...  
Keyword(s):  
Total Hip Arthroplasty ◽  
Hip Arthroplasty ◽  
Short Form ◽  
Total Hip ◽  
Cementless Total Hip Arthroplasty ◽  
Hip Function ◽  
Group A ◽  
Group B ◽  
And Function

Abstract Background Hip involved secondary to ankylosis spondylitis (AS) had a huge influence on hip function. Cementless total hip arthroplasty (THA) can improve hip function. However, no previous study compared the outcomes of THA for AS patients with three different degrees of hip involvement. Methods The 195 hips were retrospectively analyzed and divided into non-ankylosed group (group A, 94 hips), fibrous ankylosed group (group B, 49 hips), and bony ankylosed group (group C, 52 hips). postoperative range of motion (ROM), harris hip scores (HHS), the short-form 12 health survey (SF-12), length of stay (LOS), cost, radiological assessments, and complications were compared. Results The follow-up time was (79.4 ± 29.5) months for group A, (80.6 ± 28.9) months for group B, and (79.1 ± 28.9) months for group C (P = 0.966). Group A had the best postoperative hip ROM (P < 0.001), while group A and B can realize better HHS than group C (P < 0.001). The three groups had similar SF-12 postoperatively. For group A, LOS and cost for unilateral procedure were the least than that for group B and C (P = 0.003 and P = 0.001). Similar radiological assessments were achieved for three groups. 1 hip in group A encountered delay union of wound. 1 hip in group C encountered delay union of wound and dislocation and another patient encountered femoral fracture intraoperatively. 12 hips (12.8%) in group A, 6 hips (12.2%) in group B, and 6 hips (11.5%) in group C encountered asymptomatic heterotopic ossification (P = 0.977). Conclusion For AS patients with hip involvement, THA can improve hip ROM and function. THA for the non-ankylosed hip can realize the better hip function and postoperative ROM than ankylosed hip.

A Randomised, Controlled Clinical Study on Total Hip Arthroplasty Using 4 Different Bearings: Results after 10 Years

2016 ◽  
Vol 27 (1) ◽  
pp. 96-103
Author(s):  
Arne Borgwardt ◽  
Bo Zerahn ◽  
Sandra D. Fabricius ◽  
Tine H. Bertelsen ◽  
Henrik Daugaard ◽  
...  
Keyword(s):  
Clinical Study ◽  
Total Hip Arthroplasty ◽  
Hip Arthroplasty ◽  
Total Hip ◽  
Metal On Metal ◽  
Group A ◽  
Group B ◽  
Randomised Controlled ◽  
Group D ◽  
Controlled Clinical Study

Purpose To compare 4 different bearings in total hip arthroplasty (THA) in a randomised controlled clinical study on clinical performance. Methods 393 patients with osteoarthritis of the hip or avascular necrosis were included and allocated to 1 of the head-and-cup couples zirconia-on-polyethylene (group A), metal-on-metal (group B), zirconia-on-polyethylene with the liner moulded into the shell (group C), or alumina-on-alumina (group D). In the individual case the surgeon could choose other implants if indicated. Results 299 patients were operated with the allocated prosthesis. The estimated cumulated prosthesis survival percentages and 95% confidence interval after 10 years were: group A 84.6 (75.8-93.4); group B 95.0 (89.5-100); group C 93.2 (86.7-99.7); group D 66.1 (54.5-77.7). The patients' physical function was significantly improved and remained equally good in all 4 groups, however slightly declining with ageing. The luxation rate was initially high, and equal between the groups, but was reduced by improving the surgical procedure introducing capsule repair by reinsertion of the short external hip rotators. Conclusions The metal-on-metal or zirconia-on-polyethylene prostheses had high 10-year survival percentages. The longevity of these bearing couples by themselves was not related to the combination of materials. The zirconia-on-polyethylene prosthesis with the liner mounted peroperatively possibly exhibited cases of backside wear which the corresponding bearing couple with moulded polyethylene (Asian) did not. The alumina-on-alumina bearing performed poorly - it was redesigned after our study initiation and later withdrawn from the market.

scholarly journals High Hip Center Technique in Total Hip Arthroplasty for Crowe Type II-III Developmental Dysplasia: Results of Midterm Follow-up

2020 ◽  
Author(s):  
Junmin Shen ◽  
Jingyang Sun ◽  
Haiyang Ma ◽  
Yinqiao Du ◽  
Tiejian Li ◽  
...  
Keyword(s):  
Total Hip Arthroplasty ◽  
Confidence Interval ◽  
Hip Arthroplasty ◽  
Developmental Dysplasia ◽  
Harris Hip Score ◽  
Group A ◽  
The Mean ◽  
Group B ◽  
Dysplasia Of The Hip

Abstract Background: High hip center technique is still controversial about the survivorship of prothesis and postoperative complications. We aimed to show the utility of high hip center technique used in patients with Crowe II-III developmental dysplasia of the hip at the midterm follow-up and evaluated the clinical and radiographic results between different heights of hip center.Methods: We retrospectively evaluated 69 patients (85 hips) with Crowe II-III dysplasia who underwent a high hip center cementless total hip arthroplasty at a mean follow up of 8.9 years (range, 6.0-14.1years). The patients were divided into two groups according to the height of hip center, respectively group A (≥22mm and <28mm) and group B (≥28mm). Radiographic, functional and survivorship outcomes were evaluated.Results: The mean location of the hip center from the inter-teardrop was 25.1mm vertically and 30.0mm horizontally in the group A, and 33.1mm vertically and 31.4mm horizontally in the group B. There were no statistically significant differences between two groups in postoperative femoral offset, abductor lever arm, leg length discrepancy and cup inclination. At the final follow up, the mean WOMAC and Harris hip score were significantly improved in both groups. Of the 85 hips, 7 hips (8.2%) showed a positive Trendelenburg sign. Additionally, 6 patients (8.7%) presented with a limp. No significant differences were shown regarding the Harris hip score, WOMAC score, Trendelenburg sign and limp between two groups. The Kaplan-Meier implants survivorship rates at the final follow-up for all-causes revisions in the group A and group B were similar (96.7% [95% confidence interval, 90.5%-100%] and 96.2% [95% confidence interval, 89.0%-100%], respectively).Conclusions: The high hip center technique is a valuable alternative to achieve excellent midterm results for Crowe II-III developmental dysplasia of the hip. Further, we reported good results and could not demonstrate any significant differences in outcomes or survivorship between the groups with differing degrees of HHC in our study, however the relatively small sample size must be considered and larger comparative studies are required to confirm the value of high hip center technique.

scholarly journals Octyl-2-cyanoacrylate tissue adhesive without subcuticular suture for wound closure after total hip arthroplasty: a prospective observational study on thirty-two cases with controls for 3 months follow-up

2020 ◽  
Vol 15 (1) ◽  
Author(s):  
Li-Shen Wang ◽  
Xin-Yu Wang ◽  
Hao-tian Tu ◽  
Yi-Fan Huang ◽  
Xin Qi ◽  
...  
Keyword(s):  
Total Hip Arthroplasty ◽  
Hip Arthroplasty ◽  
Tissue Adhesive ◽  
Wound Complications ◽  
Subcuticular Suture ◽  
Total Hip ◽  
Skin Staples ◽  
Significant Difference ◽  
Group A ◽  
Group B

Abstract Background Whether using tissue adhesive alone after subcutaneous suture can close the skin incision with safety as well as cosmetic appearance after total hip arthroplasty was not clear. Methods A prospective study was conducted. The same surgical methods were consistent throughout the entire study. After implanting prosthesis, the joint capsule was reconstructed. Fascial and subcutaneous layer were respectively closed by continuous running barbed suture. Patients were randomized allocated to group A with octyl-2-cyanoacrylate tissue adhesive alone, to group B with tissue adhesive after continuous subcuticular suture, or to group C with skin staples. Time of closure, drainage, pain, wound complications, and cosmesis were compared. All data were analyzed statistically. Results There was no significant difference in drainage, Visual Analog Scale score or early wound complications between the three groups. However, there was significant difference in time of closure (P = 0.013). In pairwise comparison, time of closure in groups A and B was significantly longer than those in group C (P = 0.001 and P = 0.023, respectively); time of closure in group A was significantly shorter than those in group B (P = 0.003). Patient and Observer Scar Assessment Scale total scores were not significantly different at 6 weeks and 3 months postoperatively (P = 0.078 and P = 0.284, respectively). Conclusion Tissue adhesive without subcuticular suture was similar with a combination of subcuticular suture and tissue adhesive as well skin staples in terms of safety and cosmetic appearance after total hip arthroplasty.

scholarly journals Using the anterior capsule of the hip joint to protect the tensor fascia lata muscle during direct anterior total hip arthroplasty: a randomized prospective trial

2019 ◽  
Author(s):  
Gongyin Zhao ◽  
Ruixia Zhu ◽  
Shijie Jiang ◽  
Nanwei Xu ◽  
Hongwei Bao ◽  
...  
Keyword(s):  
Total Hip Arthroplasty ◽  
Hip Joint ◽  
Hip Arthroplasty ◽  
Anterior Approach ◽  
Prospective Trial ◽  
Direct Anterior Approach ◽  
Anterior Capsule ◽  
Total Hip ◽  
Group A ◽  
Group B

Abstract Background The direct anterior approach for total hip arthroplasty (THA) has specific advantages, but injury to the tensor fasciae lata muscle (TFLM) remains a concern. This injury in part negates some of the advantages of the intermuscular approach, because injury of the muscle fibers of the TFLM can lead to less satisfactory clinical results. Thus, in this study, we propose an intraoperative method to protect the TFLM and demonstrate its feasibility.Methods Fifty-six patients undergoing THA by the direct anterior approach were divided randomly into two groups. In group A, the TFLM was protected by an autogenous tissue “pad” created from the anterior capsule of the joint that was rotated to protect the TFLM from direct contact with the retractors needed to expose the joint space. In group B, the operation was carried out in the typical fashion with no other protection of the TFLM except the attempt by the surgeons to consciously avoid compressive injury of the TFLM. We evaluated the magnitude of changes in the muscle cross-sectional area (MSCA) and fatty atrophy (FA) early and postoperatively between groups by magnetic resonance imaging. The differences in blood hemoglobin and serum levels of myoglobin, lactate dehydrogenase (LDH), and creatine phosphokinase (CPK) were compared at 8, 24, and 48 h, postoperatively. Postoperative drainage volume and pain evaluated by visual analogue scores (VAS) were compared between the two groups.Results LDH, CPK and myoglobin in group B were significantly higher than those in group A at 8, 24, and 48 hours after the surgery. (p<0.05) Compared to the group A, the decrease of hemoglobin in group B displayed significantly at 24 and 48 hours after surgery. (P<0.05) The significantly increased MSCA and FA of TFLM were demonstrated in group B. The PDV and VAS in group B were significantly higher compared with those in group A. (P<0.05)Conclusions Using the anterior capsule of the hip joint as an autogenous, protective capsular tissue pad to limit the trauma to the TFLM during a direct anterior approach to THA is an effective method to protect the TFLM and improve the clinical effect.

scholarly journals Methods of the physical medicine therapy in prevention of heterotopic ossification after total hip arthroplasty

2006 ◽  
Vol 63 (9) ◽  
pp. 807-811 ◽  
Author(s):  
Mirjana Kocic ◽  
Milica Lazovic ◽  
Zoran Kojovic ◽  
Milorad Mitkovic ◽  
Sasa Milenkovic ◽  
...  
Keyword(s):  
Soft Tissue ◽  
Total Hip Arthroplasty ◽  
Heterotopic Ossification ◽  
Hip Arthroplasty ◽  
Nonsteroidal Antiinflammatory Drugs ◽  
Antiinflammatory Drugs ◽  
Postoperative Rehabilitation ◽  
Total Hip ◽  
Group A ◽  
Group B

Background/aim: In the prevention of periarticular heterotopic ossification (HO), a common complication after total hip arthroplasty (THA), nonsteroidal antiinflammatory drugs (NSAID) and irradiation are used. Some theories presume that local hypoxia of the soft tissue causes HO. The aim of this study was to investigate if the early use of pulsed electromagnetic fields (PEMF) could prevent this ossification since it accelerates the circulation and oxigenation of soft tissue. Methods. The study included three groups of the patients with primary THA. The group C consisted of 66 patients/79 hips who had only kinesitherapy in postoperative rehabilitation. The group B consisted of 117 patients/ 131 hips who had PEMF and interferential current (IC) which, on average, started on the 14th day after the surgery combined with the standard kinesitherapy. The group A consisted of 117 patients/131 hips who had PEMF from the third postoperative day and IC from, on average, the 14th postoperative day with the standard kinesitherapy. The classification of HO was done on a standard AP roentgenograms of the hips, taken at least one year after the surgery. Results. The overall HO was seen in 50.63% of the group C patients, in 43.51% of the B group and in 16.67% of the group A. Severe HO (III and IV class according to Brooker) was seen in 26.58% of the group C patients and in 6.10% of the group B, but none in the group A. Conclusion. According to the obtained results an early treatment with PEMF could prevent severe HO and reduce the overall HO.

scholarly journals Perioperative protocol to reduce blood transfusions in ankylosing spondylitis patients undergoing total hip arthroplasty

2021 ◽  
Author(s):  
Yu Huang ◽  
Xiao Huang ◽  
Fulin Li ◽  
Wenwen Huang ◽  
Dong Yin
Keyword(s):  
Ankylosing Spondylitis ◽  
Total Hip Arthroplasty ◽  
Blood Transfusion ◽  
Adverse Events ◽  
Hip Arthroplasty ◽  
Transfusion Rate ◽  
Blood Management ◽  
Total Hip ◽  
Group A ◽  
Group B

Abstract Introduction: Although tranexamic acid (TXA) can reduce bleeding during total hip arthroplasty (THA), the amount of perioperative bleeding is greater in patients with ankylosing spondylitis (AS); So blood management is more challenging. Patient Blood Management (PBM) program can improve AS patients care and reduce health costs in THA. The purpose of this study is to assess the effects of PMB program on allogeneic transfusion rate, length of hospital stay(LOS), hospitalization expenses and adverse events. Methods : We conducted a retrospective observational study of patients with AS who underwent THA. All patients were treated with tranexamic acid before and after operation. Our PBM program included preoperative evaluation, preoperative acute normovolemic hemodilution and intraoperative recovery autotransfusion. We compared results between the group of patients before and the one after the PBM program implementation. Result: We included 68 as patients who underwent total hip arthroplasty before PBM program from January 2013 to December 2015 (group A) and 84 as patients who underwent total hip arthroplasty after PBM program from January 2016 to December 2019 (group B). In the comparison of intraoperative blood transfusion volume, intraoperative blood transfusion rate and total blood transfusion rate between the two groups, the group B was significantly lower than the group A (P ≤ 0.05); The length of stay and hospitalization expenses of the group B were lower than the group A (P ≤ 0.05). No adverse events were recorded. Conclunsions: Our PMB program can reduce allogeneic blood transfusion, hospital stay and hospitalization expenses, without risking patients to higher number of com- plications in AS patients undergoing THA.

scholarly journals High Hip Center Technique in Total Hip Arthroplasty for Crowe Type II-III Developmental Dysplasia: Results of Midterm Follow-up

2020 ◽  
Author(s):  
Junmin Shen ◽  
Yonggang Zhou ◽  
Jingyang Sun ◽  
Haiyang Ma ◽  
Yinqiao Du ◽  
...  
Keyword(s):  
Total Hip Arthroplasty ◽  
Confidence Interval ◽  
Hip Arthroplasty ◽  
Developmental Dysplasia ◽  
Harris Hip Score ◽  
Total Hip ◽  
Group A ◽  
Group B ◽  
Dysplasia Of The Hip

Abstract Background: High hip center technique is still controversial about the survivorship of prothesis and postoperative complications. We aimed to show the utility of high hip center technique used in patients with Crowe II-III developmental dysplasia of the hip at the midterm follow-up and evaluated the clinical and radiographic results between different heights of hip center.Methods: We retrospectively evaluated 69 patients (85 hips) with Crowe II-III dysplasia who underwent a high hip center cementless total hip arthroplasty at a mean follow up of 8.9 years (range, 6.0-14.1years). The patients were divided into two groups according to the height of hip center, respectively group A (≥22mm and <28mm) and group B (≥28mm). Radiographic, functional and survivorship outcomes were evaluated.Results: There were no statistically significant differences between two groups in horizontal distance, offset, abductor lever arm, leg length discrepancy and cup inclination. At the final follow up, the mean WOMAC and Harris hip score were significantly improved in both groups. Of the 85 hips, 7 hips (8.2%) showed a positive Trendelenburg sign. Besides, 6 patients (8.7%) presented with a limp. No significant differences were shown regarding the Harris hip score, WOMAC score, Trendelenburg sign and limp between two groups. The Kaplan-Meier implants survivorship rates at the final follow-up for all-causes revisions in group A and group B were similar (96.7% [95% confidence interval, 90.5%-100%] and 96.2% [95% confidence interval, 89.0%-100%], respectively).Conclusions: The high hip center technique is a valuable alternative to achieve excellent midterm results for Crowe II-III developmental dysplasia of the hip.

The effectiveness and influencing factors of the ‘Y’ line technique in reducing the leg length discrepancy after total hip arthroplasty

2021 ◽  
Author(s):  
Wenshu Jin ◽  
Huaqiang Sun ◽  
Xudong Duan ◽  
Yange Gu ◽  
zhang zhao ◽  
...  
Keyword(s):  
Total Hip Arthroplasty ◽  
Hip Arthroplasty ◽  
Lower Limb ◽  
Limb Length ◽  
Leg Length Discrepancy ◽  
Leg Length ◽  
X Ray ◽  
Length Discrepancy ◽  
Group A ◽  
Group B

Abstract Objective: To introduce a surgical technique (the ‘Y’ line technique) which is to control the leg length discrepancy (LLD) after total hip arthroplasty.Methods: A total of 350 patients were selected; 134 patients who were used the ‘Y’ line technique to control lower limb length were included in Group A and 166 patients treated with free hand methods to control lower limb length were included in Group B. 50 patients who were taken standard anteroposterior X-ray of bilateral hips preoperatively and used the ‘Y’ line technique during the operation were included in Group C. Results: The postoperative LLD of the three groups was statistically significant (p < 0.001). There were significant differences statistically in comparison between any two groups (P<0.01). Severe unequal length rates of the lower extremities (LLD > 10 mm) were 5.97% (8/134) in Group A, 14.3% (24/166) in Group B and 0% (0/50) in Group C – the difference was statistically significant (p < 0.001). There were significant differences between Group A and Group B, Group B and Group C (P < 0.05), but there was no significant difference between Group A and Group C (P = 0.078).Conclusion: The ‘Y’ line technique, which does not increase the operation time, can effectively reduce postoperative LLD. Insufficient internal rotation of the healthy lower extremity and the low projection position in the preoperative anteroposterior X-ray of bilateral hips were important factors affecting the accuracy of the ‘Y’ line technique.

The Influence of Laser Therapy and Magnetotherapy on the Function and Quality of Life Patients with Rheumatoid Artritis of Hand Joints

2020 ◽  
Vol 62 (3) ◽  
pp. 149-153
Author(s):  
Amanda Maria Kostro ◽  
Agnieszka Dakowicz ◽  
Diana Moskal-Jasińska ◽  
Anna Kuryliszyn-Moskal
Keyword(s):  
Quality Of Life ◽  
Magnetic Field ◽  
Physical Therapy ◽  
Range Of Motion ◽  
Laser Therapy ◽  
Low Frequency ◽  
Hand Joints ◽  
Frequency Magnetic Field ◽  
Group A

Introduction: Rheumatoid arthritis is a chronic, inflammatory, systemic complex disease involving joints and periarticular tissues, leading to disability and premature death. The most common and earliest locations of the inflammatory process involves hands. In addition to pharmacotherapy, therapeutic management includes physiotherapy, psychotherapy and patient education. Among the physical therapy methods, the role of laser therapy and magnetotherapy in achieving analgesic effects and improving functions is emphasized. AIM: The aim of the study was to compare the impact of low frequency magnetic field and laser therapy on pain reduction, quality of life and function improvement as well as range of motion hands joints in patients with RA. Material and Methods: The study involved 30 outpatient in the Rehabilitation Clinic of the University Clinical Hospital in Bialystok. Among all patients they were selected into two groups in which they were applied accordingly in the first group a laser stimulation and in the second group a low frequency magnetic field. There were performed 10 treatments in each group with a Saturday - Sunday break. Before and after rehabilitation was conducted a physical and subjective examination, which used: pain examination (VAS scale, Laitinen questionnaire), examination of hand range of motion and functional evaluation according to questionnaires: bMHQ, DASH, AIMS-2. Results: After used of physical therapy in both groups the results were obtained that pain was decreased. Moreover, the magnetotherapy improved the range of motion as well as the quality of life and functionality of patients measured according to the questionnaires: Laitinen, Breif MHQ, DASH, AIMS-2 more favorably than laser therapy. Conclusions: Both treatment: laser therapy and magnetotherapy provide an analgesic effect in patients with RA. It has been shown that magnetotherapy is more effective in improving hand joints mobility and patient’s quality of live.

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