Isolated acetabular liner exchange with a highly crosslinked polyethylene (HXLPE) component is an option to address polyethylene wear and osteolysis following total hip arthroplasty (THA) in the presence of a well-fixed acetabular shell. The liner can be fixed either with the original locking mechanism or by being cemented within the acetabular component. Whether the method used for fixation of the HXLPE liner has any bearing on the long-term outcomes is still unclear. Data were retrieved for all patients who underwent isolated acetabular component liner exchange surgery with a HXLPE component in our institute between August 2000 and January 2015. Patients were classified according to the fixation method used (original locking mechanism (n = 36) or cemented (n = 50)). Survival and revision rates were compared. A total of 86 revisions were performed and the mean duration of follow-up was 13 years.Aims
Methods
The aim of this study was to evaluate the survival of a collarless, straight, hydroxyapatite-coated femoral stem in total hip arthroplasty (THA) at a minimum follow-up of 20 years. We reviewed the results of 165 THAs using the Omnifit HA system in 138 patients, performed between August 1993 and December 1999. The mean age of the patients at the time of surgery was 46 years (20 to 77). Avascular necrosis was the most common indication for THA, followed by ankylosing spondylitis and primary osteoarthritis. The mean follow-up was 22 years (20 to 31). At 20 and 25 years, 113 THAs in 91 patients and 63 THAs in 55 patients were available for review, respectively, while others died or were lost to follow-up. Kaplan-Meier analysis was performed to evaluate the survival of the stem. Radiographs were reviewed regularly, and the stability of the stem was evaluated using the Engh classification.Aims
Methods
In total knee arthroplasty (TKA), both intravenous (IV) and/or intra-articular (IA) administration of tranexamic acid (TXA) were showed to reduce blood loss. Moreover, research suggesting TXA decreases postoperative knee swelling, but it is unknown whether this results in improved postoperative rehabilitation outcome. Thus, the aim of this study was to evaluate whether combined IV and IA administration of TXA would associate with improved early rehabilitation outcomes. In this institutional review board approved randomized controlled trial, 179 patients scheduled for unilateral TKA were randomized to one of three regimens: (1) IA administration of 1gm TXA at end of procedure only, (2) additional preoperative IV dose of 15 mg/kg 30min before tourniquet inflation, and (3) additional postoperative dose 4hrs after preoperative dose. Primary outcomes included knee range of motion, Knee Society Score (KSS) at 6-month postoperatively, haemoglobin drop at day-2 post-operatively, and transfusion rate. Secondary outcome was venous thromboembolism (VTE) complications. Baseline characteristics were comparable between the allocation groups. Patients in regimen (3) showed statistically significant better knee extension range (6.2°, 5.9°, 2.9°, p=0.01), and KSS (88.5, 89.9, 93.0, p=0.02) at 6-month postoperatively, and lesser drop in haemoglobin at day-2 post-operatively (2.72, 2.47, 1.75 g/dL, p=0) when compared with patients in other regimens. No patients required transfusion, or complicated by VTE. The combined administration of IA and IV TXA, including both preoperative and postoperative doses, associated with statistically significantly improved early rehabilitation outcomes. The improvement may be related to higher haemoglobin level and decreased knee swelling in patients having regimen (3). For any reader queries, please contact
