Outcomes after Total Hip Arthroplasty in Young Patients with Osteonecrosis of the Hip

2017 ◽  
Vol 27 (3) ◽  
pp. 286-292 ◽  
Author(s):  
Ishaan Swarup ◽  
Marisa Shields ◽  
Erik N. Mayer ◽  
Chelsea J. Hendow ◽  
Jayme C. Burket ◽  
...  
Keyword(s):  
Total Hip Arthroplasty ◽  
Hip Arthroplasty ◽  
Patient Reported Outcomes ◽  
Young Patients ◽  
Implant Survival ◽  
Total Hip ◽  
Time Of Surgery ◽  
Patient Reported

Background Osteonecrosis of the hip is a clinical, radiographic, and pathologic entity that commonly affects young patients. This study evaluates long-term implant survival and patient-reported outcomes after primary total hip arthroplasty (THA) in patients with osteonecrosis aged 35 or younger. Methods A retrospective study with prospective follow-up was conducted at a major academic medical center. Chart review was performed to identify young THA patients with osteonecrosis, and follow-up surveys were conducted to determine implant survival and patient-reported outcomes. Kaplan-Meier survival analysis was performed to evaluate implant survival, and the hip disability and osteoarthritis outcome score (HOOS) was used to describe patient-reported outcomes. Results The study included 135 patients (204 THAs) with a mean time to follow-up of 14 years. In this group, 10-year implant survival was 86% and 20-year implant survival was 66%. Implant survival was longer in male patients (p = 0.02) and patients that were over the age of 25 at the time of surgery (p = 0.03). The mean HOOS scores at follow-up were 87 for pain, symptoms, and ADLs, and 77 for sports. All HOOS measures were lower in patients that underwent a revision THA, and HOOS-Pain and HOOS-Sport scores were lower in patients that were over the age of 25 at the time of surgery (p<0.05). Conclusions Young patients with osteonecrosis have good implant survival and long-term outcomes after THA. Patient factors and implant characteristics should be considered when predicting implant survival and outcomes after THA in young patients with osteonecrosis.

Three-year results of a polycarbonate urethane acetabular bearing in total hip arthroplasty

2019 ◽  
Vol 30 (3) ◽  
pp. 303-308
Author(s):  
Stefan Lazic ◽  
Catherine Kellett ◽  
Irrum Afzal ◽  
Rajan Mohan ◽  
Vijay Killampalli ◽  
...  
Keyword(s):  
Total Hip Arthroplasty ◽  
Hip Arthroplasty ◽  
Patient Reported Outcomes ◽  
Prospective Observational Study ◽  
Total Hip ◽  
Polycarbonate Urethane ◽  
Patient Reported ◽  
Term Data

Background: Polycarbonate urethane (PCU) is a bearing surface with a lower modulus of elasticity than polyethylene or ceramic and is thought to more closely replicate the tribology of native hyaline cartilage. The purpose of this study was to determine the clinical outcomes with the use of PCU in elective total hip arthroplasty (THA). Methods: We carried out a prospective observational study in which 157 patients underwent elective THA with a metal-on-PCU hip system. Patients had radiographic follow-up at 6 months and 3 years after surgery. Oxford Hip Scores and EuroQol scores were obtained annually and Harris Hip Scores were obtained at 6 months and 3 years after surgery. Results: 180 hips were implanted, of which, 149 hips reached 3-year review with no revisions. There was an increase in Harris Hip Scores, Oxford Hip Scores and EuroQol scores ( p < 0.001). 12 patients (12 hips) reported painless hip squeaking. There were no dislocations and no other adverse events were reported. Conclusion: Our results showed satisfactory survivorship and improvements in patient reported outcomes with metal on PCU THA. Long-term data are still being collected to confirm these findings. We recommend further tribological research into the squeaking phenomenon we observed.

scholarly journals Imageless computer assisted navigation in ceramic-on-ceramic total hip arthroplasty vs. manual approach: a single-centre retrospective study

10.29007/9gpf ◽  
2019 ◽  
Author(s):  
John McLoughlin ◽  
Mo Mathew ◽  
Stephen Grant
Keyword(s):  
Total Hip Arthroplasty ◽  
Hip Arthroplasty ◽  
Patient Reported Outcomes ◽  
Statistical Significance ◽  
Computer Assisted ◽  
Total Hip ◽  
Patient Reported ◽  
Cup Positioning

Background: Acetabular cup positioning is vital to the long-term survivorship of total hip arthroplasty (THA). Malalignment has been linked to dislocation, wear and osteolysis. Although there are many studies demonstrating the reduction in variability of cup positioning with computer-assisted techniques, there are relatively few reporting long-term patient reported outcomes and revision rates. Aim: The aim of this study was to review whether those patients who underwent navigated THA had better long-term survivorship or better patient reported outcomes. Methods: We compared revision rates and Oxford hip scores of 152 THAs (47 navigated and 105 non-navigated) performed at a single site between 2003 and 2008, with a minimum follow-up of 10 years. Results: 9 of the non-navigated and none of the navigated hips were revised at 10 year follow-up (p=0.057). There were no observable differences in 10-year Oxford hip scores between the navigated and non-navigated hips, 44.82 and 43.38 respectively. Conclusion: With respect to the rate of revision, although statistical significance was not achieved, it can be shown from our data that there was a clinically significant reduction in revision rates with navigated vs. non-navigated techniques. More data with higher patient numbers in the navigated cohort may be required to validate the results of our study.

Implant Survival and Patient-Reported Outcomes After Total Hip Arthroplasty in Young Patients

2018 ◽  
Vol 33 (9) ◽  
pp. 2893-2898 ◽  
Author(s):  
Ishaan Swarup ◽  
Yuo-yu Lee ◽  
Yu-fen Chiu ◽  
Ryan Sutherland ◽  
Marisa Shields ◽  
...  
Keyword(s):  
Total Hip Arthroplasty ◽  
Hip Arthroplasty ◽  
Patient Reported Outcomes ◽  
Young Patients ◽  
Implant Survival ◽  
Total Hip ◽  
Patient Reported

Importance of Retaining Sufficient Acetabular Depth: Successful 2-Year Outcomes of Hip Arthroscopy for Patients With Pincer Morphology as Compared With Matched Controls

2020 ◽  
Vol 48 (10) ◽  
pp. 2471-2480 ◽  
Author(s):  
Claudia R. Brick ◽  
Catherine J. Bacon ◽  
Matthew J. Brick
Keyword(s):  
Total Hip Arthroplasty ◽  
Femoroacetabular Impingement ◽  
Hip Arthroplasty ◽  
Hip Arthroscopy ◽  
Patient Reported Outcomes ◽  
Control Group ◽  
Total Hip ◽  
Patient Reported ◽  
Acetabular Overcoverage

Background: Patients with pincer-type femoroacetabular impingement are commonly treated with arthroscopic reduction of acetabular depth as measured by the lateral center-edge angle (LCEA). The optimal amount of rim reduction has not been established, although large resections may increase contact pressures through the hip. A recent publication demonstrated inferior surgical outcomes in patients with acetabular overcoverage as compared with normal acetabular coverage. Casual observation of our database suggested equivalent improvements, prompting a similar analysis. Purpose: To analyze patient-reported outcomes after hip arthroscopy for femoroacetabular impingement in patients with acetabular overcoverage who were matched with controls with normal coverage, as well as to analyze associations with reduction in LCEA. Study Design: Cohort study; Level of evidence, 3. Methods: Data were collected prospectively from patients with a minimum 2-year follow-up after receiving hip arthroscopy for femoroacetabular impingement by a single surgeon. Cases were reviewed to identify those with pincer-type morphology (LCEA >40°) and matched according to sex, age, chondral damage, and surgery date in a 1:1 ratio with controls with an LCEA of 25° to 40°. The surgical goal was to reduce the LCEA to the upper end of the normal range with minimal rim resection, usually 35° to 37°. Radiographic measurements of coverage, intraoperative findings, procedures, and patient-reported outcomes were recorded, including the 12-Item International Hip Outcome Tool, Non-arthritic Hip Score, Hip Disability and Osteoarthritis Outcome Score, visual analog scale for pain, rates of revision or reoperation, and conversion to total hip arthroplasty. Results: A total of 114 hips (93 patients) for the pincer group were matched 1:1 from 616 hips (541 patients) for the control group. The pincer group (mean ± SD age, 34.5 ± 12.2 years) did not differ in age, body mass index, or follow-up from controls. LCEA was reduced in both groups pre- to postoperatively: the pincer group from 44.0° ± 2.8° to 34.2° ± 3.5° and the controls from 32.9° ± 3.9° to 31.0° ± 3.0°. No differences in improvement were observed: iHOT-12 improved by 35.7 points in both groups ( P = .9 for analysis of variance interaction) and Nonarthritic Hip Score by 22.3 points ( P = .6). From all eligible surgical procedures, 2-year follow up rates were 2.5% and 2.6% for the pincer and control cohorts, respectively, and 1.2% and 0.3% for conversion to total hip arthroplasty. Conclusion: Arthroscopic management of acetabular overcoverage can achieve excellent results, equivalent to arthroscopy for other causes of symptomatic femoroacetabular impingement. A key finding was smaller rim resections producing a mean postoperative LCEA of 34.2° with a small standard deviation.

Patient-Reported Outcomes Can Be Used to Streamline Post-Total Hip Arthroplasty Follow-Up to High-Risk Patients

2017 ◽  
Vol 32 (11) ◽  
pp. 3319-3321
Author(s):  
Jie J. Yao ◽  
Hilal Maradit Kremers ◽  
Cathy D. Schleck ◽  
Dirk R. Larson ◽  
Jasvinder A. Singh ◽  
...  
Keyword(s):  
High Risk ◽  
Total Hip Arthroplasty ◽  
Hip Arthroplasty ◽  
Patient Reported Outcomes ◽  
Total Hip ◽  
High Risk Patients ◽  
Patient Reported ◽  
Risk Patients

Total Hip Arthroplasty in Young Patients with Post-Traumatic Arthritis of the Hip

2017 ◽  
Vol 27 (6) ◽  
pp. 546-550 ◽  
Author(s):  
Ishaan Swarup ◽  
Ryan Sutherland ◽  
Jayme C. Burket ◽  
Mark P. Figgie
Keyword(s):  
Patient Reported Outcomes ◽  
Young Patients ◽  
Implant Survival ◽  
Long Term Outcomes ◽  
Patient Reported ◽  
Revision Tha ◽  
Post Traumatic ◽  
Traumatic Arthritis

Background Post-traumatic arthritis of the hip is a degenerative condition that commonly affects young patients. In this study, we evaluate long-term implant survival and patient-reported outcomes after primary total hip arthroplasty (THA) in patients aged 35 or younger with post-traumatic arthritis of the hip. Methods We conducted a retrospective study with follow-up. A chart review was performed to identify young patients with post-traumatic arthritis of the hip treated with primary THA. Follow-up surveys were conducted to determine implant survival and patient-reported outcomes. Implant survival was assessed using Kaplan-Meier survival analysis, and patient outcomes were determined using the hip disability and osteoarthritis outcome score (HOOS). Results We studied 42 patient s (44 THAs) with a mean time to follow-up of 14 years. The 10-year implant survival rate was 87% and 20-year implant survival rate was 41%. Implant survival did not differ based on patient age, gender, implant type, bearing surface, or use of cement for implant fixation (p>0.05). The mean HOOS scores at follow-up were 87 for pain, 85 for symptoms, 89 for ADLs, and 76 for sports. HOOS scores were significantly worse in patients that had undergone revision THA (p<0.05). Conclusions Young patients with post-traumatic arthritis of the hip have good long-term outcomes after THA. However, revision THA is predictive of worse long-term outcomes.

Sign in / Sign up

Export Citation Format

Share Document