scholarly journals Soft tissue reinforcement with a Leeds-Keio artificial ligament in revision surgery for dislocated total hip arthroplasty

2017 ◽  
Vol 28 (3) ◽  
pp. 324-329 ◽  
Author(s):  
Shigeo Aota ◽  
Shin-ichi Kikuchi ◽  
Hironori Ohashi ◽  
Naoko Kitano ◽  
Michiyuki Hakozaki ◽  
...  
Keyword(s):  
Soft Tissue ◽  
Total Hip Arthroplasty ◽  
Hip Joint ◽  
Hip Arthroplasty ◽  
Fibrous Tissue ◽  
Recurrent Dislocation ◽  
Harris Hip Score ◽  
Total Hip ◽  
Revision Tha

Introduction: Since dislocation after total hip arthroplasty (THA) greatly diminishes patient’s quality of life, the THA frequently needs revision. However, it is common for the dislocation not to heal even after reconstruction, but rather to become intractable. Methods: The 17 patients with dislocated THA, mean age of 71 years (range 51-87 years), who underwent a revision THA together with soft tissue reinforcement with a Leeds-Keio (LK) ligament were enrolled. The purposes of reinforcement with LK ligament were to restrict the internal rotation of the hip joint, and to encourage the formation of fibrous tissue in the posterior acetabular wall to stabilise the femoral head. We determined the success rate of surgical treatment for dislocation, the Harris Hip Score (HHS), a factor of recurrent dislocation. Results: There was no recurrent dislocation in 82% of the cases (14 joints) during the mean postoperative follow-up period of 63.5 months (15-96 months). The HHS was 82 ± 18 points preoperatively and 82 ± 14 points postoperatively. Recurrent dislocation after this surgical procedure occurred in 2 hips with breakage of the LK ligaments, and intracapsular dislocation in 1 hip with loosening of the LK ligament. Conclusions: Although the risk of recurrent dislocation still exists with this procedure, when performed to provide reinforcement with an LK ligament for dislocated THA it may be useful in intractable cases with soft tissue defects around the hip joint.

Activity and Quality of Life after Total Hip Arthroplasty

2017 ◽  
Vol 19 (5) ◽  
pp. 0-0 ◽  
Author(s):  
Anna Świtoń ◽  
Ewa Wodka-Natkaniec ◽  
Łukasz Niedźwiedzki ◽  
Tadeusz Gaździk ◽  
Tadeusz Niedźwiedzki
Keyword(s):  
Quality Of Life ◽  
Total Hip Arthroplasty ◽  
Range Of Motion ◽  
Hip Joint ◽  
Hip Arthroplasty ◽  
External Rotation ◽  
Harris Hip Score ◽  
Joint Analysis ◽  
Total Hip

Background. Coxarthrosis is a chronic musculoskeletal condition that causes severe pain and considerable limi­tation of the patient’s motor performance. Total hip arthroplasty is one of the most common and effective methods used in the treatment of advanced degenerative changes. The aim of the present study was to evaluate the activity and quality of life of patients after unilateral total hip arthroplasty. Material and methods. The study was conducted in a group of 189 patients who had undergone unilateral total hip arthroplasty. Goniometry was used to determine the range of motion of both hip joints. Patients’ physical ability and pain severity were assessed based on the Harris Hip Score (HHS) questionnaire. Results. The examination of the range of motion in the lower extremities revealed statistically significant diffe­rences in flexion (p<0.01), abduction (p=<0.01), adduction (p<0.01) and external rotation (p<0.01) between the operated and the healthy extremity. The greatest limitation of motion was demonstrated for external rotation (<14°). Approximately 14% of the patients were not able to perform this motion in their healthy hip joint, while 17.5% of them could not do so in the affected hip joint. Analysis of HHS results (mean = 79 pts) revealed that more than 50% of the patients described their functional ability and quality of life as good and excellent. It was demonstrated that 54% of patients did not suffer from pain, whereas minor or mild pain was noted in 35%. Conclusions: 1. A subjective clinical assessment of patients after total hip arthroplasty showed that their quality of life had improved. 2. It is necessary to perform physiotherapy after total hip arthroplasty, on both the operated and healthy side. 3. Exacerbation of pain and impaired activity in patients after total hip arthroplasty were associated with the female sex to a considerable extent.

scholarly journals Excellent Functional Outcome and Quality of Life after Primary Cementless Total Hip Arthroplasty (THA) Using an Enhanced Recovery Setup

2021 ◽  
Vol 10 (4) ◽  
pp. 621
Author(s):  
Franziska Leiss ◽  
Julia Sabrina Götz ◽  
Günther Maderbacher ◽  
Matthias Meyer ◽  
Jan Reinhard ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Patient Satisfaction ◽  
Total Hip Arthroplasty ◽  
Functional Outcome ◽  
Hip Arthroplasty ◽  
Enhanced Recovery ◽  
Harris Hip Score ◽  
Total Hip ◽  
Cementless Total Hip Arthroplasty

Background: Total hip arthroplasty combined with the concept of enhanced recovery is of continued worldwide interest, as it is reported to improve early functional outcome and treatment quality without increasing complications. The aim of the study was to investigate functional outcome and quality of life 4 weeks and 12 months after cementless total hip arthroplasty in combination with an enhanced recovery concept. Methods: A total of 109 patients underwent primary cementless Total Hip Arthroplasty (THA) in an enhanced recovery concept and were retrospectively analyzed. After 4 weeks and 12 months, clinical examination was analyzed regarding function, pain and satisfaction; results were evaluated using Harris Hip score, Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), EQ-5D-5L, EQ-VAS and subjective patient-related outcome measures (PROMs). Preoperatively, HADS (Hospital Anxiety and Depression Scale) was collected. A correlation analysis of age, American Society of Anesthesiologists (ASA), HADS and comorbidities (diabetes mellitus, art. hypertension, cardiovascular disease) with WOMAC, Harris Hip score (HHS) and EQ-5D was performed. Results: Patients showed a significant improvement in Harris Hip score 4 weeks and 12 months postoperatively (p < 0.001). WOMAC total score, subscale pain, subscale stiffness and subscale function improved significantly from preoperative to 12 months postoperative (p < 0.001). EQ-5D showed a significant improvement preoperative to postoperative (p < 0.001). The influence of anxiety or depression (HADS-A or HADS-D) on functional outcome could not be determined. There was a high patient satisfaction postoperatively, and almost 100% of patients would choose enhanced recovery surgery again. Conclusion: Cementless THA with the concept of enhanced recovery improves early clinical function and quality of life. PROMs showed a continuous improvement over a follow-up of 12 months after surgery. PROMs can help patients and surgeons to modify expectations and improve patient satisfaction.

scholarly journals Dynamics of hip joint effusion after posterior soft tissue repair in total hip arthroplasty

2006 ◽  
Vol 30 (4) ◽  
pp. 233-236 ◽  
Author(s):  
Sarunas Tarasevicius ◽  
Uldis Kesteris ◽  
Romas Jonas Kalesinskas ◽  
Hans Wingstrand
Keyword(s):  
Soft Tissue ◽  
Total Hip Arthroplasty ◽  
Hip Joint ◽  
Hip Arthroplasty ◽  
Tissue Repair ◽  
Joint Effusion ◽  
Soft Tissue Repair ◽  
Total Hip ◽  
Posterior Soft Tissue

scholarly journals Nonunion of the bone fragments during total hip replacement with T. Paavilainen osteotomy — causes of failure

2020 ◽  
Vol 8 (2) ◽  
pp. 119-128
Author(s):  
Alexandr I. Avdeev ◽  
Igor A. Voronkevich ◽  
Dmitrii G. Parfeev ◽  
Anton N. Kovalenko ◽  
David G. Pliev ◽  
...  
Keyword(s):  
Total Hip Arthroplasty ◽  
Hip Joint ◽  
Hip Arthroplasty ◽  
Hip Dislocation ◽  
Greater Trochanter ◽  
Total Hip ◽  
Shortening Osteotomy ◽  
History Of ◽  
Bone Fragments

Background. Conservative treatment options for hip dysplasia and hip dislocation in early childhood allow for good results in cases of a timely diagnosis. The preferred treatment option for patients with hip dislocation in adulthood is total hip joint replacement. The shortening osteotomy, proposed by T. Paavilainen, allows the surgeon to restore the difference in the lengths of the lower extremities during arthroplasty of the hip joint. However, according to the results of the Paavilainen technique, as presented by Russian orthopedic surgeons, the problem of nonunion of the greater trochanter fragment with the diaphysis of the femur remains unresolved, as evidenced by a massive group of clinical cases. Aim. The aim of this study was to identify factors affecting the consolidation of bone fragments after osteotomy of the greater trochanter, according to T. Paavilainen, during total hip arthroplasty and evaluate their significance after fixation with cerclage screws in comparison with a special trochanteric fork-plate. Materials and methods. The present study includes 208 cases that were treated at the Russian Scientific Research Institute of Traumatology and Orthopedics named after R.R. Vreden from 2003 to 2019 using various fixation techniques of the greater trochanter fragment. Patients were divided into two groups depending on their type of fixation. The quality of consolidation of a greater trochanter fragment with the femur was assessed during a follow-up period of six months or longer. The fragment of the greater trochanter was divided into the part that was not in contact with the diaphysis, or A, and the part that was in contact with the diaphysis, or B. We assessed the effect of the absolute value of the contact between fragments, the B/A ratio, the distance between the points of insertion of the screws into the diaphyseal part of the femur, the quality of the bone by the modified Barnet-Nordin index, and the history of previous surgical interventions on this joint on the consolidation. Results. When the part of the greater trochanter was in contact with the diaphysis of the femur (B) was less than 3.5 cm, the risk ratio of nonunion of the greater trochanter fragment with the diaphysis of the femur increased. Also, a significant factor is the index of the contact of the greater trochanter fragment (B/A less than 1) with the diaphysis of the femur using the T. Paavilainen technique. In addition, the presence of surgical intervention in the hip joint history significantly increases the relative risk (RR) of nonunion of the greater trochanter fragment with the diaphysis of the femur with this method of shortening osteotomy of the femur. Conclusion. In the absence of timely diagnosis and conservative treatment of children with hip dislocation, reconstructive-plastic techniques on the hip joint do not allow the achievement of proper results and increase the complexity of total hip arthroplasty. According to the results of this study, the absolute value of the contact between fragments (B), the index of the greater trochanter contact with the diaphysis of the femur, and the history of previous surgical intervention on this joint are objective tools for the prognostic assessment of the probability of fragment unions during total hip arthroplasty with the T. Paavilainen technique.

Total Hip Arthroplasty

2019 ◽  
pp. 83-95
Author(s):  
Sydney E. Rose ◽  
Julio A. Gonzalez-Sotomayor
Keyword(s):  
Quality Of Life ◽  
Total Hip Arthroplasty ◽  
General Anesthesia ◽  
Hip Joint ◽  
Hip Arthroplasty ◽  
Total Hip ◽  
Severe Arthritis ◽  
And Cartilage ◽  
Anesthesia Spinal

This chapter discusses the goals, procedure, and potential outcomes of total hip arthroplasty (THA). Patients may be candidates for a THA when they have severe arthritis of their hip(s) (degeneration of cartilage covering the ends of the bones creating the hip joint). Arthritic hip pain is often progressive and gets worse as the cartilage continues to deteriorate. Typically, at the time a patient seeks hip arthroplasty, his or her quality of life has become very compromised. In a total hip arthroplasty, damaged bone and cartilage of the hip joint are removed and replaced with prosthetic components. THA can be performed under neuraxial anesthesia (spinal or epidural) or general anesthesia or a combination of both.

Midterm outcomes of total hip arthroplasty with a modular Birmingham head

2019 ◽  
pp. 112070001987738 ◽  
Author(s):  
Duncan W Cushnie ◽  
Brent A Lanting ◽  
Richard McCalden ◽  
Douglas DR Naudie ◽  
James L Howard
Keyword(s):  
Soft Tissue ◽  
Total Hip Arthroplasty ◽  
Hip Arthroplasty ◽  
Femoral Stem ◽  
Tissue Reaction ◽  
Harris Hip Score ◽  
Total Hip ◽  
Tissue Reactions ◽  
Clinical Records

Introduction: Birmingham Hip Resurfacing (BHR) implants may be combined with a conventional femoral stem to create a modular metal-on-metal total hip arthroplasty (BHR MoM THA). There is little outcome data regarding this construct. This study examines midterm outcomes of BHR MoM THA compared to oxidised zirconium total hip arthroplasty (THA). Methods: A retrospective institutional review identified all patients receiving BHR MoM THA between April 2005 and February 2011 and a matched control cohort of zirconium THA patients. Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), Harris Hip Score (HHS), and SF-12 Health status scores were obtained. Revisions and complications were collected from clinical records. Radiographs were assessed for evidence of component malposition, loosening, osteolysis, or heterotopic ossification. Results: 63 modular BHR MoM THA were identified in 61 patients (36 with BHR cups, 27 with R3 cups) and 63 zirconium THA in 58 matched controls. Mean follow-up was 58 months. 14 BHR MoM THA hips (22.2%) were revised (4 infections, 1 dislocation, 9 soft tissue reactions) compared to 3 (4.8%) zirconium THA (all infections). At latest follow-up, 18.4% of surviving BHR MoM THA hips were painful compared to 0.5% of zirconium THA controls ( p < 0.001). WOMAC, HHS, and SF-12 did not differ significantly between surviving members of the 2 groups. Discussion: BHR MoM THA demonstrated a high revision rate, largely for adverse local soft tissue reaction and pain. Among those not revised, many reported some residual pain despite similar quality of life measures to those who received zirconium THA.

A Proximal Referencing System for the Charnley Low Friction Arthroplasty

2002 ◽  
Vol 12 (3) ◽  
pp. 303-307
Author(s):  
M.D.A. Fletcher ◽  
J.C.J. Webb ◽  
T. Maung
Keyword(s):  
Soft Tissue ◽  
Total Hip Arthroplasty ◽  
Total Hip Replacement ◽  
Hip Arthroplasty ◽  
Surgical Approach ◽  
Hip Replacement ◽  
Recurrent Dislocation ◽  
Soft Tissue Balance ◽  
Low Friction ◽  
Total Hip

Dislocation is a serious complication of total hip arthroplasty occurring in up to 9% of cases. Recurrent dislocation accounts for 4% of revisions in the Swedish Hip Arthroplasty Study. Soft tissue balancing is one of the factors, independent of the surgical approach used, that is involved in producing a stable total hip replacement. We describe a proximal referencing system for use with the Charnley low friction arthrosplasty (LFA), which optimises this factor. The dislocation rate, using this method, is 0.3% (in 333 cases performed by a single surgeon over a 5 year period). This system should prove valuable to orthopaedic surgeons in training, ensuring they achieve correct soft tissue balance in total hip arthroplasty.

Cementation of a dual-mobility cup into a well-fixed cementless shell in patients with high risk of dislocation undergoing revision total hip arthroplasty

2019 ◽  
pp. 112070001987361 ◽  
Author(s):  
Jesús Moreta ◽  
Iker Uriarte ◽  
Xabier Foruria ◽  
Ioar Urra ◽  
Urko Aguirre ◽  
...  
Keyword(s):  
High Risk ◽  
Total Hip Arthroplasty ◽  
Aseptic Loosening ◽  
Hip Arthroplasty ◽  
Recurrent Dislocation ◽  
Revision Total Hip Arthroplasty ◽  
Dual Mobility ◽  
Total Hip ◽  
Revision Tha

Background: Cementation of polyethylene liners into well-fixed cementless metal shells has become an option during revision total hip arthroplasty (THA). We report the results of cementing a dual-mobility (DM) component into a stable acetabular shell in high-risk patients undergoing revision THA. Methods: A single-centre series of 10 patients undergoing revision THA with a DM cup cemented into an existing well-fixed shell between 2012 and 2016 were retrospectively reviewed. Failure due to aseptic loosening or instability and implant survival at last follow-up were analysed. The average age was 79.2 years and mean follow-up was 3.5 years. Indications were recurrent hip dislocation in 8 cases and intraoperative instability with moderate abductor insufficiency in 2 cases. In cases with recurrent dislocation, the aetiology of instability was classified by Wera type. Results: At the latest follow-up, Harris Hip Scores had improved from 49.3 preoperatively to 71.3 postoperatively ( p = 0.098). In the 8 patients with recurrent dislocation, 4 cases (50%) had an unclear aetiology (Wera type 6), 2 (25%) abductor deficiency (Wera type 3) and 2 (25%) late polyethylene wear (type 5). Postoperative recurrent dislocation occurred in 1 hip (10%). No cases of intraprosthetic dislocation, aseptic loosening of the previous shell or dissociation at the cement-cup interface were identified. Conclusion: Although the follow-up of this series is short, cementation of a DM cup into a previous well-fixed socket seems to be a viable option to treat and prevent instability after revision THA, without providing constraint at the cement-cup interface.

scholarly journals Treatment of secondary hip arthritis from shell fragment and gunshot injury in the Syrian civil war

2020 ◽  
Vol 15 (1) ◽  
Author(s):  
Raif Özden ◽  
Serkan Davut ◽  
Yunus Doğramacı ◽  
Aydıner Kalacı ◽  
İbrahim Gökhan Duman ◽  
...  
Keyword(s):  
Civil War ◽  
Total Hip Arthroplasty ◽  
Hip Joint ◽  
Hip Arthroplasty ◽  
Harris Hip Score ◽  
Total Hip ◽  
Hip Arthritis ◽  
Syrian Civil War ◽  
Shell Fragment ◽  
The Mean

Abstract Background In gunshot and shell fragment injuries to the hip joint, orthopedic intervention includes wound assessment and care, osteosynthesis of fractures, and avoiding of infection and osteoarthritis. Individuals injured in the Syrian civil war were frequently transferred to the authors’ institution in neighboring city. Orthopedic trauma exposures were determined in approximately 30% of these patients. The aim of this study was to evaluate the outcomes of the patients with secondary hip arthritis due to prior gunshot and shell fragment (shrapnel) injuries who underwent primary total hip arthroplasty. Methods This retrospective study reviewed 26 patients (24 males, 2 females) who underwent hip arthroplasty due to prior gunshot and shell fragment injuries from November 2013 to January 2019. For all patients, the Harris Hip Score (HHS) was evaluated preoperatively and after surgery. Results Mean age was 31.5 (range, 19–48) years. The mean preoperative HHS was 52.95 points, and the mean postoperative HHS was 79.92 points at the final follow-up after surgery. Patients with shell fragment injuries to the hip joint had higher infection rates, but it is not statistically significant. Conclusions An anatomic reduction of the fracture may not be possible in these cases as a result of significant bone and/or cartilage loss. Total hip arthroplasty can be done after gunshot- and shell fragment-related posttraumatic arthritis. It is an effective treatment choice to reduce pain and improve function, but the surgeon must be very careful because of high rate of infection.

scholarly journals Treatment of Secondary Hip Arthritis from Shell Fragment and Gunshot Injury in the Syrian Civil War

2020 ◽  
Author(s):  
Raif Özden ◽  
Serkan Davut ◽  
Yunus Doğramacı ◽  
Aydıner Kalacı ◽  
İbrahim Gökhan Duman ◽  
...  
Keyword(s):  
Civil War ◽  
Total Hip Arthroplasty ◽  
Hip Joint ◽  
Hip Arthroplasty ◽  
Harris Hip Score ◽  
Total Hip ◽  
Hip Arthritis ◽  
Syrian Civil War ◽  
Shell Fragment ◽  
The Mean

Abstract Background: In gunshot and shell fragment injuries to the hip joint, orthopaedic intervention includes wound assessment and care, osteosynthesis of fractures, and avoiding of infection and osteoarthritis. Individuals injured in the syrian civil war were frequently transferred to the author's institution in neighboring city. Orthopaedic trauma exposures were determined in approximately 30% of these patients. The aim of this study was to evaluate the outcomes of the patients with secondary hip arthritis due to prior gunshot and shell fragment (shrapnel) injuries who underwent primary total hip arthroplasty. Methods: This retrospective study reviewed 26 patients (24 males, 2 females) who underwent hip arthroplasty due to prior gunshot and shell fragment injuries from November 2013 to January 2019. For all patients Harris Hip Score (HHS) were evaluated preoperatively and after surgery. Results: Mean age was 31,5 (range, 19-48) years. The mean preoperative HHS was 52.95 points and the mean postoperative HHS was 79.92 points at the final follow-up after surgery. Patients with shell fragment injuries to the hip joint, had higher infection rates but it is not statistically significant.Conclusions: An anatomic reduction of the fracture may not be possible in these cases as a result of significant bone and/or cartilage loss. Total hip arthroplasty can be done after gunshot and shell fragment related posttraumatic arthritis. It is efective treatment choice to reduce pain and improve function but the surgeon must be very carefull because of high rate of infection.

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