Aims. The aim of this study was to estimate the clinical and economic burden of dislocation following
Aims. The Forgotten Joint Score-12 (FJS-12) is a validated patient-reported outcome measure (PROM) tool designed to assess artificial prosthesis awareness during daily activities following total hip arthroplasty (THA). The patient-acceptable symptom state (PASS) is the minimum cut-off value that corresponds to a patient’s satisfactory state-of-health. Despite the validity and reliability of the FJS-12 having been previously demonstrated, the PASS has yet to be clearly defined. This study aims to define the PASS of the FJS-12 following
The aim of our study was to investigate the effect of asymmetric crosslinked polyethylene liner use on the risk of revision of cementless and hybrid total hip arthroplasties (THAs). We undertook a registry study combining the National Joint Registry dataset with polyethylene manufacturing characteristics as supplied by the manufacturers. The primary endpoint was revision for any reason. We performed further analyses on other reasons including instability, aseptic loosening, wear, and liner dissociation. The primary analytic approach was Cox proportional hazard regression.Aims
Methods
Total hip arthroplasty (THA) is the only successful treatment for patients in whom the hip joint is destroyed by inflammatory arthritis. Due to the effects of both the disease and its treatment elevated rates of complications and of aseptic loosening have been described. Whether with modern uncemented hip prostheses the results can be improved is not fully known. Therefore, we decided to carry out a prospective study.
At the introduction of a new press-fit acetabular component a prospective study on the results of uncemented THA was started. From 1995 to 1999 85 primary THAs were carried out in 72 patients (57 women, 15 men) suffering from inflammatory arthritis. Diagnosis: RA 76, adult-onset Still 4, JIA 3, miscellaneous 2. Mean age at operation was 60 years (SD 15. 9). Clinically, the Harris Hip Score was used for evaluation. Radiographically, the Larsen classification was used and at follow-up radiolucencies and signs of migration were registered. The implants used in this study were the EPF-PLUS® acetabular component and the SL-PLUS® femoral component (PLUS Endoprothetik AG, Rotkreuz-CH). The EPF-PLUS® acetabular component is a novel modular press-fit cup. Its shell has a triple radius profile on cross-section, thereby creating a gradual lowering of the polar part of the cup. This produces a small gap of about 2 mm. between the acetabulum and the pole of the cup. Therefore, forces are mainly transmitted to the peripheral part of the acetabulum, leading to an enhanced primary stability. Originally, the shell had a gritblasted surface for osseointegration. Since 1996, the outer surface of the cup has been coated with a ground layer of pure titanium and a superficial layer of a crystalline hydroxyapatite (Ti-HA). The gritblasted version was used in 14 hips (1995–1996), the Ti-HA coated version in 71 hips. In 68 hips the cup was implanted by press-fit fixation, in 17 screws were added.
Larsen classification was as follows: 0-1: 6; 3: 17; 4: 60; 5: 2. At follow-up, 5 patients (6 THAs) were deceased. Deep infection required revision in one hip. Another revision was carried out for recurrent dislocations. One grit-blasted cup developed late subsidence and was revised almost 4 years postoperatively. One Ti-HA coated cup failed early due to severe acetabular bone loss. Finally, one femoral component developed a varus tilt and became symptomatic 2 years after implantation, requiring revision. In all 62 patients with 74 THAs in follow-up cup and stem are functioning well, both clinically and radiographically. Harris Hip Score increased from 36. 6 (SD 17. 7) to 87. 9 (SD 11. 8).
The medium-term results of the EPF®-PLUS cup show that its primary stability is good and that, as the polar gap rapidly disappears, osseointegration is secure. Only severe acetabular deficiency appears to be a contra-indication for this implant. Also, the SL-PLUS® stem performs well in inflammatory arthritis.
Arthrofibrosis is a relatively frequent complication after total knee arthroplasty. Although stiffness after total hip arthroplasty (THA), because of formation of heterotopic ossification or other causes, is not uncommon, to the authors’ best knowledge, arthrofibrosis after THA has not been described. The aim of this study is to describe the arthrofibrosis of the hip after
Abstract. Background. Although tantalum is a well recognised implant material used for revision arthroplasty, little is known regarding the use of the same in
Aim. Prosthetic joint infection (PJI) is a serious complication following total hip arthroplasty (THA) entailing increased mortality, decreased quality of life, and high healthcare costs. In 2009 a nationwide, multidisciplinary infection control program was launched in Sweden, PRISS, which aimed to reduce the PJI burden by 50%. The primary aim was to investigate whether the PRISS project reduced PJI incidence after
Periprosthetic femur fracture (PFF) is a major complication following total hip arthroplasty (THA) that carries significant morbidity, mortality, and economic burden. Currently, uncemented stems are highly preferred in
Aims. As our population ages, the number of octogenarians who will require a total hip arthroplasty (THA) rises. In a value-based system where operative outcomes are linked to hospital payments, it is necessary to assess the outcomes in this population. The purpose of this study was to compare outcomes of elective,
Detection of clinical situations are the most difficult for
Total hip arthroplasty (THA) is one of the most successful and effective treatments for advanced hip osteoarthritis (OA). Over the last 5 years, Canada has seen a 17.8% increase in the number of hip replacements performed annually, and that number is expected to grow along with the aging Canadian population. However, the rise in THA surgery is associated with an increased number of patients at risk for the development of an infection involving the joint prosthesis and adjacent deep tissue – periprosthetic joint infections (PJI). Despite improved hygiene protocols and novel surgical strategies, PJI remains a serious complication. No previous population-based studies has investigated PJI risk factors using a time-to-event approach and none have focused exclusively on patients undergoing THA for primary hip OA. The purpose of this study is to determine risk factors for PJI after
Aims. Tranexamic acid (TXA) is now commonly used in major surgical operations including orthopaedics. The TRAC-24 randomized control trial (RCT) aimed to assess if an additional 24 hours of TXA postoperatively in primary total hip (THA) and total knee arthroplasty (TKA) reduced blood loss. Contrary to other orthopaedic studies to date, this trial included high-risk patients. This paper presents the results of a cost analysis undertaken alongside this RCT. Methods. TRAC-24 was a prospective RCT on patients undergoing TKA and THA. Three groups were included: Group 1 received 1 g intravenous (IV) TXA perioperatively and an additional 24-hour postoperative oral regime, Group 2 received only the perioperative dose, and Group 3 did not receive TXA. Cost analysis was performed out to day 90. Results. Group 1 was associated with the lowest mean total costs, followed by Group 2 and then Group 3. The differences between Groups 1 and 3 (-£797.77 (95% confidence interval -1,478.22 to -117.32) were statistically significant. Extended oral dosing reduced costs for patients undergoing THA but not TKA. The reduced costs in Groups 1 and 2 resulted from reduced length of stay, readmission rates, emergency department attendances, and blood transfusions. Conclusion. This study demonstrated significant cost savings when using TXA in
The benefit of using acetabular screws in
To estimate the clinical and economic burden of
Introduction. With the widespread legalization of cannabis across the United States, well-powered studies evaluating the impact of cannabis use disorder on outcomes following
Aims. Femoral bone preparation using compaction technique has been shown to preserve bone and improve implant fixation in animal models. No long-term clinical outcomes are available. There are no significant long-term differences between compaction and broaching techniques for
Objectives. High failure rates of metal-on-metal hip arthroplasty implants have highlighted the need for more careful introduction and monitoring of new implants and for the evaluation of the safety of medical devices. The National Joint Registry and other regulatory services are unable to detect failing implants at an early enough stage. We aimed to identify validated surrogate markers of long-term outcome in patients undergoing
The last two decades have seen remarkable technological advances in total hip arthroplasty (THA) implant design. Porous ingrowth surfaces and highly crosslinked polyethylene (HXLPE) have been expected to dramatically improve implant survivorship. The purpose of the present study was to evaluate survival of contemporary cementless acetabular components following
With the introduction of highly crosslinked polyethylene (HXLPE) in total hip arthroplasty (THA), orthopaedic surgeons have moved towards using larger femoral heads at the cost of thinner liners to decrease the risk of instability. Several short and mid-term studies have shown minimal liner wear with the use HXLPE liners, but the safety of using thinner HXPLE liners to maximize femoral head size remains uncertain and concerns that this may lead to premature failure exist. Our objective was to analyze the outcomes for