Background: Joint replacements are being performed on ever younger patients at a time when average expectancy of life is continuing to rise. Any reduction in the strength and mass of periprosthetic bone could threaten the longevity of implant by predisposing to loosening and migration of prosthesis, periprosthetic fracture and problems in revision arthroplasty. Aims &
Objectives: This study aims to analyse the femoral periprosthetic stress-shielding following unilateral cementless
Background: Joint replacements are being performed on ever younger patients at a time when average expectancy of life is continuing to rise. Any reduction in the strength and mass of periprosthetic bone could threaten the longevity of implant by predisposing to loosening and migration of prosthesis, periprosthetic fracture and problems in revision arthroplasty. Aims &
Objectives: This study aims to analyse and compare prospectively the femoral periprosthetic stress-shielding around 4/5th and 1/3rd porous coated cementless femoral stems in patients undergoing unilateral cementless
Abstract. Objectives. Hip instability following
The objectives of our study were to compare patient reported outcome measures between manual and robotic-assisted
This meta analysis address the relationship between infection developing after
Surgical management of acetabular fractures in older patients remains controversial. The purpose of this study is to compare outcomes of primary THA with outcomes after THA for acute acetabular fractures (aTHA) as well as outcomes following delayed THA (dTHA) following prior acetabular fracture. We analyzed data from a large, national administrative claims database containing diagnostic, procedural, and demographic records from over 157 million patients. We identified all patients undergoing primary total hip arthroplasty THA continuously enrolled in the database at least 2 years prior and after the index procedure. Patients with an initial diagnostic code for acetabular fracture occurring the same day as the THA were classified as acute acetabular fractures. Patients with an initial acetabular fracture diagnostic code occurring at least 6 months before THA were classified as chronic acetabular fractures. The comparator group was patients undergoing THA with no history of acetabular fracture. There were 426,734 patients undergoing primary THA, 235 patients undergoing aTHA and 1,255 patients undergoing dTHA. Patients with an aTHA had higher complication rates, including revisions (9.8% vs 5.6%,), dislocations (8.9% vs 6.4%), and periprosthetic fracture (5.1% vs 2.3%) compared to dTHA. After adjusting for age, sex, region, and comorbidities, receiving an aTHA increased the odds of revision (OR = 3.65 [95% CI: 2.30–5.49]), dislocation (OR = 4.09 [95% CI: 2.53–6.27]), and periprosthetic fracture (OR = 4.29 [95% CI: 2.26–7.36]) compared to primary THA. Receiving a dTHA significantly increased the odds of revision (adjusted OR = 1.80 [95% CI: 1.40–2.27]), dislocation (adjusted OR = 2.50 [95% CI: 1.97–3.13]), and periprosthetic fracture (adjusted OR = 1.99 [95% CI: 1.34–2.83]) compared to primary THA. Patients undergoing aTHA in the treatment of an acetabular fracture have significantly increased rates of revision, periprosthetic fracture, and dislocation compared to dTHA and primary THA.
Abstract. Cemented
Obesity is a known risk factor for developing osteoarthritis and is also associated with an increased risk of developing complications post
Patients who are Jehovah's witnesses do not accept blood transfusions. Thus,
It is not unusual for patients prior to their
The purpose of our study is to examine the outcome of patients undergoing outpatient
As
Dislocation after
Our unit historically performed
The current evidence favors replacement for the treatment of displaced femoral neck fractures in the older patients. Controversies remain whether
Dual mobility (DM)
Aims. Our study aimed to 1) Describe the changes in spinopelvic mobility when transitioning from standing, to ‘relaxed-seated’ and thereafter to ‘deep-seated’ position and 2) Determine the change in spinopelvic mobility types 1 year post-THA compared to preoperatively. Methods. This prospective diagnostic cohort study followed 100 consecutive patients 1 year post-THA. Preoperatively and one year postoperatively, radiographic measurements were performed for the lumbar-lordosis-angle, pelvic tilt and pelvic-femoral-angle on lateral radiographs in the standing, ‘relaxed-seated’ and ‘deep-seated’ position (torso maximally leaning forward). Patients were classified according to their spinopelvic mobility type, according to the change in PT between the standing and relaxed-seated position (stiff:ΔPT<±10°, normal:10°≤ΔPT≤30°, hypermobile:ΔPT>±30°). Results. Compared to preoperatively, when moving from a standing to a relaxed-seated position, hip flexion increased by 10°±18, leading to less posterior pelvic tilt by 6°±11 and reduced lumbar spine flexion by 6°±11 (all p<0.001). Similarly, when moving from the standing to deep-seated position, hip flexion improved by a mean of 8°±22, leading to reduced lumbar spine flexion by a mean of 5°±8, whereas the change in pelvic tilt did not change compared to preoperatively (p=0.016, p<0.001, p=0.46). The distribution of spinopelvic mobility types 1 year postoperatively was significantly different compared to preoperatively, as the percentage of patients with stiff spinopelvic mobility increased from 16% to 43% (p<0.001). Conclusion. Hip flexion improved by 10° on average 1 year after
Background. Increasing evidence suggests a link between the bearing surface used in
Local anatomical abnormalities vary in congenital hip disease patients. Authors often present early to mid-term