scholarly journals Prospective Short-Term and Return-to-Sports Results of a Novel Uncemented Short-Stem Hip Prosthesis with Metaphyseal Anchorage

2020 ◽  
Vol 9 (6) ◽  
pp. 1972
Author(s):  
Robert Breuer ◽  
Rainer Fiala ◽  
Nina Schrenk ◽  
Thomas M. Tiefenboeck
Keyword(s):  
Los Angeles ◽  
Total Hip Arthroplasty ◽  
Hip Arthroplasty ◽  
Activity Level ◽  
Short Stem ◽  
Harris Hip Score ◽  
Return To Sports ◽  
Short Term ◽  
Total Hip

Short-stem hip prostheses were developed to treat active patients requiring total hip arthroplasty (THA). This study provides short-term data about a short-stem total hip arthroplasty system. Functional and radiological outcomes as well as return to sports and activity level were assessed. A series of 55 patients was primarily included. Data were available for 47 patients at an average follow-up of 38 ± 4.6 months. The back-to-sports analysis showed a 98% return-to-sports rate (46/47 patients). The average time for return to sports was 13 weeks (± 8) postoperatively. Five patients (10.6%) were more active postoperatively. The Harris Hip Score (HHS) improved from 34.8 (±9.4) preoperatively to 94.7 (±8.4, p ≤ 0.001) and the University of California, Los Angeles (UCLA) score improved from 4.5 (±1.8) to 6.9 (±1.9) (p ≤ 0.001). The High Activity Arthroplasty Score (HAAS) was 12 (±3.6) at 3-year follow-up. Pre- and postoperative UCLA and postoperative HHS and HAAS scores had a positive influence on the return-to-sports rate (p ≤ 0.05). The collection of radiographic data during all postoperative follow-ups showed no signs of radiolucent lines or bone fissures. The complication rate was at 5%. Short-stem systems are equaling conventional prostheses and offer benefits regarding soft tissue and bone stock preservation. Fast recovery and return to sports can be achieved.

scholarly journals Sports Activity and Patient-Related Outcomes after Cementless Total Hip Arthroplasty in Patients Younger than 40 Years

2021 ◽  
Vol 10 (20) ◽  
pp. 4644
Author(s):  
Luis Navas ◽  
Jasmin Faller ◽  
Sebastian Schmidt ◽  
Marcus Streit ◽  
Matthias Hauschild ◽  
...  
Keyword(s):  
Los Angeles ◽  
Total Hip Arthroplasty ◽  
Hip Arthroplasty ◽  
Young Patients ◽  
Activity Level ◽  
Harris Hip Score ◽  
Return To Sports ◽  
Sports Activity ◽  
Total Hip

Background: The management of degenerative hip diseases in young patients remains a challenge. Despite the improvement of hip-preserving procedures, total hip arthroplasty (THA) may be required in some instances. In addition, young patients undergoing THA have high expectations concerning their postoperative level of activity. Purpose: (1) to define the sports activity level and the return to sports after THA, (2) to describe the modification or initiation of new sports disciplines, and (3) to report the clinically meaningful outcomes after THA in patients younger than 40 years. Methods: A total of 36 patients (40 hips) were prospectively analyzed at a midterm follow-up of 3.9 years. The modified Harris Hip Score (mHHS); the Visual Analog Scale (VAS) for pain; the University of California, Los Angeles (UCLA) activity scale; and sports and recreational activity levels were assessed via questionnaire. The minimal clinically important difference (MCID) was determined by calculating half of the standard deviation, and the substantial clinical benefit (SCB) as well as patient acceptable symptomatic state (PASS), were calculated by the anchor method for the mHHS. Results: At the final follow-up, there was a significant improvement in mHHS (34.1 to 92.6; p < 0.0001), UCLA (3.2 to 7.6; p < 0.0001), and VAS for pain (8 to 1; p < 0.0001). More patients were active in sports at follow-up than before surgery (44% to 92%, p < 0.0001). In addition, the duration and frequency of sports activities showed a significant increase (p < 0.0001). The MCID, SCB and PASS for mHHS were 89% and 58%, respectively. No revision surgery had to be performed. Conclusion: This study showed that a large proportion of patients under 40 years of age who underwent THA increased their physical activity. Eighty-six percent of the patients were highly active, with a UCLA score ≥ 7. Furthermore, the reported MCID, SCB, and PASS for mHHS were achieved by more than 80% of patients.

scholarly journals Subchondral drilling for chondral flaps reduces the risk of total hip arthroplasty in femoroacetabular impingement surgery at minimum five years follow-up

2018 ◽  
Vol 29 (2) ◽  
pp. 191-197 ◽  
Author(s):  
Pascal C Haefeli ◽  
Moritz Tannast ◽  
Martin Beck ◽  
Klaus A Siebenrock ◽  
Lorenz Büchler
Keyword(s):  
Los Angeles ◽  
Total Hip Arthroplasty ◽  
Femoroacetabular Impingement ◽  
Hip Arthroplasty ◽  
Hip Dislocation ◽  
Harris Hip Score ◽  
Control Group ◽  
Total Hip ◽  
Tönnis Grade

Introduction: The best treatment of acetabular chondral flaps during surgery for femoroacetabular impingement (FAI) is unknown. We asked if subchondral drilling improves clinical and radiographic outcome and if there are factors predicting failure. Methods: We treated 79 patients with symptomatic FAI and acetabular chondral flaps with surgical hip dislocation between January 2000 and December 2007. Exclusion of all patients with previous hip pathology or trauma resulted in 62 patients (80 hips). The chondral flap was slightly debrided in 43 patients/51 hips (control group). In 28 patients/29 hips (study group), additional osseous drilling was performed. 4 patients (5 hips, 6%) were lost to follow-up. Mean follow-up was 9 years (5–13 years). The groups did not differ in demographic data, radiographic parameters or follow-up. Clinical outcome was assessed with the Merle d’Aubigné score, modified Harris Hip Score and University of California Los Angeles activity score and progression of osteoarthritis with the Tönnis grade. Results: No patient underwent conversion to total hip arthroplasty (THA) in the drilling group compared to 7 patients (8 hips, 16%) in the control group ( p = 0.005); in the remaining hips, clinical scores and progression of Tönnis grade did not differ. Increased acetabular coverage, age and body mass index were univariate predictive factors for conversion to THA. No drilling was as an independent predictive factor for conversion to THA (hazard ratio 58.07, p = 0.009). Conclusion: Subchondral drilling under acetabular chondral flaps during surgical treatment of FAI is an effective procedure to reduce the rate of conversion to THA.

scholarly journals Does robotic-arm assisted total hip arthroplasty benefit short-term clinical outcomes? A pair match-controlled study

10.29007/455b ◽  
2018 ◽  
Author(s):  
Itay Perets ◽  
John Walsh ◽  
Brian Mu ◽  
Yosif Mansor ◽  
Leslie Yuen ◽  
...  
Keyword(s):  
Total Hip Arthroplasty ◽  
Clinical Outcomes ◽  
Hip Arthroplasty ◽  
Harris Hip Score ◽  
Controlled Study ◽  
Robotic Assistance ◽  
Short Term ◽  
Total Hip ◽  
Significant Difference

Recent advances have made robotic assistance a viable option in total hip arthroplasty (THA). However, the clinical outcomes of this procedure relative to THA without robotic assistance have yet to be reported. This study presents short-term outcomes of robotically assisted THA compared to a pair-matched control group of patients that underwent THA without robotic assistance.Data were prospectively collected on all THAs performed from July 2011 to January 2015. Patients were included if they underwent primary THA treating idiopathic osteoarthritis and were eligible for minimum two-year follow-up. Outcomes were measured using Harris Hip Score (HHS), the Forgotten Joint Score (FJS-12), pain on a visual analog scale (VAS), and satisfaction from 0-10. Patients that underwent THA with robotic assistance were matched 1:1 with THA patients without robotic assistance for age, sex, BMI, and approach.There were 85 patients in each study group. There were no significant differences in the demographic factors matched for. Both HHS and FJS-12 were significantly higher in the robotic assistance group at minimum two-year follow-up. VAS was lower in the robotic assistance group, but this was not statistically significant (p = 0.12). There was a not a significant difference in patient satisfaction. There was no significant difference in the rate of postoperative complications or subsequent revisions between groups.Robotically assisted THA is safe and may lead to superior short-term outcomes compared to THA without robotic assistance.

scholarly journals Ceramic-on-metal bearing in short stem total hip arthroplasty: ions, functional and radiographic evaluation at mid-term follow-up

2020 ◽  
Vol 30 (2_suppl) ◽  
pp. 52-58
Author(s):  
Michela Saracco ◽  
Giulio Maccauro ◽  
Andrea Urbani ◽  
Domenico Ciavardelli ◽  
Silvia Persichilli ◽  
...  
Keyword(s):  
Total Hip Arthroplasty ◽  
Metal Ions ◽  
Hip Arthroplasty ◽  
Short Form ◽  
Hip Osteoarthritis ◽  
Short Stem ◽  
Harris Hip Score ◽  
Radiographic Evaluation ◽  
Total Hip

Introduction: The aim of this study is to evaluate clinical, radiographic and laboratory results of ceramic-on-metal (CoM) (hybrid hard bearing) in total hip arthroplasty (THA), associated with a short stem implant. Methods: From a cohort of 37 patients suffering from primary or secondary hip osteoarthritis who underwent THA using CoM bearing, 19 were suitable for this study. All procedures were performed by the same surgeon using a posterior-lateral approach. All patients were compared clinically using the Harris Hip Score (HHS), Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), visual analogue scale (VAS), 12-item Short Form Health Survey (SF12F/M), and radiographically (offset, CD angle, limb length discrepancy, cup inclination and anteversion, subsidence, osseointegration, heterotopic ossification). Blood samples were collected in order to evaluate chromium (Cr) and cobalt (Co) ions level. Radiographic evaluations were carried out by 3 different blinded surgeons. A statistical analysis was performed. Results: At a mean follow-up of 97 (73–125) months all implanted stems were well-positioned and osseointegrated. Clear improvements were observed for clinical scores comparing preoperative and postoperative values. Radiographic evaluation showed a good ability to restore proper articular geometry. Cr ion analysis revealed values below the safety threshold except for 1 case. Serum levels of Co were below the threshold in all patients. There was a statistically significant correlation only between Cr metal ions and length of follow-up. Conclusions: CoM bearing has proven to be reliable and safe at a mean 8-year follow-up for patients in whom the components were correctly implanted. The rise of blood metal ions was minimal and involved neither systemic or local toxicity nor influenced clinical results.

scholarly journals Recreational activity after cementless total hip arthroplasty in patients older than 75 years

2021 ◽  
Author(s):  
Alexander Zimmerer ◽  
Luis Navas ◽  
Stefan Kinkel ◽  
Stefan Weiss ◽  
Matthias Hauschild ◽  
...  
Keyword(s):  
Los Angeles ◽  
Total Hip Arthroplasty ◽  
Hip Arthroplasty ◽  
Activity Level ◽  
Activity Levels ◽  
Recreational Activity ◽  
Total Hip ◽  
Cementless Total Hip Arthroplasty ◽  
Related Quality

Abstract Introduction This retrospective study aimed to compare activity levels before and at mid-term follow-up after primary cementless total hip arthroplasty (THA) in patients older than 75 years. Materials and methods A cohort of 79 patients with a mean age at surgery of 78 years (range 76–84 years) was evaluated 6.3 years (range 4–8 years) after cementless THA due to osteoarthritis and was followed up with a questionnaire to determine their activity level. Pre- and post-operative recreational activities were assessed at routine follow-up using the University of California, Los Angeles activity score, and the Schulthess Clinic sports and activity questionnaire. Post-operative health-related quality of life was measured using Veterans Rand 12-item survey (VR-12). Results Six years after THA, 72% of preoperatively active patients had returned to activity. Comparing activity preoperatively (before the onset of symptoms) and 6 years after THA, the number of disciplines and session length has decreased significantly. A significant decline in high-impact activities was observed, while participation in low-impact activities significantly increased. Conclusion The majority of patients maintained a recreational activity level in the mid-term after primary cementless THA. However, a change in disciplines toward low-impact activities was observed.

ASSESSMENT OF THE QUALITY OF RECONSTRUCTION IN TOTAL HIP ARTHROPLASTY DONE IN PATIENTS AFTER ACETABULUM FRACTURE

2020 ◽  
Vol 4 (1) ◽  
Author(s):  
Manish Sharma ◽  
Ramesh Kumar Sen ◽  
Sameer Aggarwal ◽  
Mahesh Prakash
Keyword(s):  
Quality Of Life ◽  
Total Hip Arthroplasty ◽  
Hip Arthroplasty ◽  
Harris Hip Score ◽  
Acetabular Fractures ◽  
Short Term ◽  
Total Hip ◽  
Acetabulum Fracture

Background: Acetabular fractures are complex orthopaedic injuries and require a fair amount of expertise for management. Although undisplaced acetabular fractures can be managed by nonoperative means, displaced acetabular fractures need operative intervention for reduction and stabilization. Methods: The study was carried as a retrospective study, from February 2013 to July 2014. After getting the approval from the Ethics Committee of the Institute (Annexure I) and the consent from the patients the study was conducted on 49 patients who underwent Total Hip Arthroplasty after fracture acetabulum. Results: On evaluation, patients at short term follow up had good clinical outcome on the basis of Harris hip score. The Harris hip scores improved progressively in the patients at 2-4 years follow up having mean HHS of 92 which further increased to 97 in patients who were followed up after 4 years. The patients at short term follow up of up to 2 years had comparatively lower quality of life scores when compared to the follow up at 2-4 years. The patients followed up after 4 years had the best quality of life. Conclusion: We concluded that total hip arthroplasty after acetabulum fracture, as a result of good quality of reconstruction, a good functional outcome leads to improved quality of life in the patients. Keywords: Hip, Arthroplasty, Reconstruction.

Retrospective Clinical and Radiological Outcomes of Total Hip Arthroplasty in 51 Patients After a Mean 8.2 Years Using the Nanos® Short-stem Prosthesis

2021 ◽  
Vol 39 ◽  
Author(s):  
Christian Fischer ◽  
◽  
Julia Dietz ◽  
Karl-Stefan Delank ◽  
Alexander Zeh ◽  
...  
Keyword(s):  
Patient Satisfaction ◽  
Total Hip Arthroplasty ◽  
Hip Arthroplasty ◽  
Survival Rates ◽  
Short Stem ◽  
Harris Hip Score ◽  
Leg Length ◽  
Total Hip ◽  
The Mean

Introduction: Over the past several years, femoral short-stem hip implants have become more popular as a treatment option in the field of primary hip arthroplasty for younger and more active patients. Current data on clinical outcomes and the implant survival rates in patients with short-stem implants cover a maximum of five to six years. The aim of this study was to assess the survival rates, as well as clinical and functional outcomes, in total hip arthroplasty (THA) using the Nanos® short-stem implant (Smith & Nephew, Marl, Germany) over a follow-up period exceeding 5 y. Materials and Methods: This single-center retrospective study included the first 100 patients who were treated at the Department of Orthopedics at the University Hospital Halle (Saale) between January 2008 and February 2009. Ultimately, the complete data of 51 patients (54 hips) were reviewed. The follow-up period was from May to November 2017. We evaluated patient satisfaction regarding pain and function using a grading system. The Harris Hip Score and Forgotten Joint Score were obtained to evaluate functional outcome after THA. Postoperative radiographic evaluation included the measurement of leg-length discrepancy, changes in the shaft axis, femoral offset and horizontal or vertical center of rotation. Potential postoperative shaft angulation or axial shaft migration was also determined. Radiographic images were checked for radiolucent lines and heterotopic ossification using the classification systems outlined by Green and Brooker. Results: The average follow-up was 97.8 months (8.2 y). The mean patient age at follow-up was 68 y and the body mass index was 28.2 kg/m2. The mean Harris hip score at follow-up was 92.0 and the Forgotten Joint Score was 91.7 %. Survey results showed that patient satisfaction and pain perception were rated very good. No significant change in leg length was observed (mean: 0.1 mm shortening). Overall, a rather varus stem positioning was detected postoperatively (mean: 3.1°). The femoral offset was slightly reduced on average in the entire patient group (mean: -1.8 mm). In the horizontal plane, lateralization of the center of rotation was detected overall (mean: 0.7 mm). In the vertical plane, cranialization was noted (mean: 1.4 mm). The CCD angle did not change. There was no further stem migration postoperatively. Radiolucent lines occurred in 10 cases in Gruen zones 1 and 7. Heterotopic ossification occurred in stages 1 to 3 according to the Brooker classification system. We found no cases of aseptic loosening or other reasons for revision. Conclusion: The outcomes after a mean follow-up of 97.8 months (8.2 y) showed that high levels of patient satisfaction and functional outcome can be achieved with the use of a short-stem endoprosthesis. Sufficient restoration of the patient's individual anatomy paired with high survival rates makes this short-stem prosthesis a reliable implant in total hip arthroplasty.

Cementless total hip arthroplasty in young patients under the age of 30: a minimum 10-year follow-up

2018 ◽  
Vol 28 (5) ◽  
pp. 507-513 ◽  
Author(s):  
Eun Ho Shin ◽  
Kyoung Ho Moon
Keyword(s):  
Total Hip Arthroplasty ◽  
Hip Arthroplasty ◽  
Young Patients ◽  
Revision Arthroplasty ◽  
Activity Level ◽  
Head Size ◽  
Harris Hip Score ◽  
Total Hip ◽  
The Mean

Purpose: The purpose of this study was to evaluate the clinical and radiologic outcomes of young patients (under the age of 30) who received a total hip arthroplasty (THA) and in whom patients had been followed for more than 10 years. Materials and methods: This retrospective study was conducted for 51 hips (44 patients) that had undergone THA. The mean age for the index operation was 25.71 years, and the mean follow-up period was 13.7 years. Clinical outcomes were evaluated by Harris hip score (HHS), activity level, and complications. Radiographic evaluations were assessed according to osteolysis, loosening, and polyethylene wear. Results: The average HHS improved from 67.47 pre-operatively to 97.42 at the final follow-up ( p < 0.001). The activity level changed from 1.92 pre-operatively to 1.33 at the final follow-up ( p < 0.001). Ten cases had undergone revision arthroplasty within the follow-up period, and the overall survival rate was 80.4% at the final follow-up with revision for any reason as the end point. Polyethylene liners were used in all revision cases ( p = 0.003). Patients with modular stem had a higher failure rate than patients with a fully porous coated stem ( p < 0.001). Furthermore, a small diameter head size was associated with a higher risk of revision surgery ( p = 0.003). Complications such as dislocations were found in three hips. Conclusion: Cementless THA yields encouraging clinical and radiological results in young and active patients under the age of 30. However, the bearing surface, type of stem, and head size influenced component durability and revision rate.

Safety of vitamin E-infused highwall liners for routine use in primary total hip arthroplasty: single centre, short-term follow-up of 1221 cases

2020 ◽  
pp. 112070002096964
Author(s):  
Kirill Gromov ◽  
Nanna H Sillesen ◽  
Thomas Kallemose ◽  
Henrik Husted ◽  
Henrik Malchau ◽  
...  
Keyword(s):  
Patient Safety ◽  
Vitamin E ◽  
Total Hip Arthroplasty ◽  
Hip Arthroplasty ◽  
Single Centre ◽  
Short Term ◽  
Total Hip ◽  
Arthroplasty Registry ◽  
Primary Total Hip Arthroplasty

Background: Introduction of new implants should be monitored closely to capture any signs of compromising patient safety. Vitamin E infused highly-crosslinked polyethylene liners (VEPE) offer the potential for reduced wear. Highwall liners have been hypothesised to result in increased wear and potential liner fractures. The aim of this study was to determine the 3–7-year follow-up of highwall VEPE for primary total hip arthroplasty (THA), focusing on liner-related complications. Methods: We included 1221 consecutive THA operations from July 2010 to May 2014 with minimum follow-up of 3 (3.1–6.8) years Data collected included demographics, implant data, complications, reoperations, and deaths. Data were cross-referenced with the Danish Hip Arthroplasty Registry in order to ensure validity and completeness. Acetabular shell position was measured using Martell Hip Analysis Suite in a subgroup of 931 THAs. Results: Cumulative stem revision and shell revision at 3-year follow-up was 3.4% and 0.4% respectively. There were no revisions due to liner failure. Reason for revision included 11 dislocations, 15 soft-tissue revisions for infection, 44 stem revisions of which 34 were periprosthetic fractures and 13 shell revisions of which 6 were combined shell and stem revisions. Conclusion: Early follow-up of VEPE liners for primary THA have not shown any revisions associated with liner failure. Continued monitoring of new materials are necessary to capture any signs of compromised patient safety.

A prospective randomised comparison of earlier function after total hip arthroplasty with a mini posterior approach or supercapsular percutaneously-assisted total hip approach: a gait analysis study

2021 ◽  
pp. 112070002110184
Author(s):  
Andrey A Korytkin ◽  
Younes M El Moudni ◽  
Yana S Novikova ◽  
Kirill A Kovaldov ◽  
Ekaterina A Morozova
Keyword(s):  
Total Hip Arthroplasty ◽  
Gait Analysis ◽  
Hip Arthroplasty ◽  
Posterior Approach ◽  
Gait Velocity ◽  
Harris Hip Score ◽  
Kinematic Parameters ◽  
Gait Patterns ◽  
Total Hip

Background: The supercapsular percutaneously-assisted total hip (SuperPATH) approach is a muscle sparing surgical technique for total hip arthroplasty (THA). The literature reports good clinical and functional results of the SuperPATH technique in the short term. We aimed to compare early outcomes and gait analysis of THA using the mini posterior approach (MPA) and supercapsular percutaneously-assisted total hip (SuperPATH) approach. Methods: 44 patients who underwent THA, were randomly allocated to either MPA or SuperPATH. The data were then collected prospectively (preoperatively and postoperatively at 6 weeks). Plain anteroposterior radiographs of the pelvis and instrumental gait analysis were obtained. The visual analogue scale (VAS), Harris Hip Score (HHS) and Hip disability and Osteoarthritis Outcome Scores (HOOS) were used to assess functional and clinical outcomes. Results: No significant difference was found in patients’ surgical outcomes. Patients in the SuperPATH group had less pain according to the VAS score at follow-up than the MPA group ( p < 0.01). There was also a significant improvement in HHS and HOOS scores for all patients ( p < 0.001) with the SuperPATH group showing superior changes. The comparison of mean differences in gait velocity between preoperative and 6 weeks postoperative result, revealed improvement in the SuperPATH group over the MPA group ( p = 0.06). Limping was more persistent in the MPA group. Kinematic parameters demonstrated improved hip joint excursion slightly higher in the MPA group. There was no significant improvement in kinetic and kinematic parameters at different walking moments for all patients at 6 weeks compared to preoperative gait patterns. Conclusions: SuperPATH and MPA both show excellent results. This study reveals that the SuperPATH technique was associated with lower postoperative pain levels, and higher physical function and quality of life. Improved functional outcomes allowed earlier postoperative rehabilitation and faster recovery. Specific improvement in gait patterns were identified with nonsignificant differences between the 2 approaches at 6 weeks follow-up.

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