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The Bone & Joint Journal
Vol. 100-B, Issue 2 | Pages 143 - 151
1 Feb 2018
Bovonratwet P Malpani R Ottesen TD Tyagi V Ondeck NT Rubin LE Grauer JN

Aims

The aim of this study was to compare the rate of perioperative complications following aseptic revision total hip arthroplasty (THA) in patients aged ≥ 80 years with that in those aged < 80 years, and to identify risk factors for the incidence of serious adverse events in those aged ≥ 80 years using a large validated national database.

Patients and Methods

Patients who underwent aseptic revision THA were identified in the 2005 to 2015 National Surgical Quality Improvement Program (NSQIP) database and stratified into two age groups: those aged < 80 years and those aged ≥ 80 years. Preoperative and procedural characteristics were compared. Multivariate regression analysis was used to compare the risk of postoperative complications and readmission. Risk factors for the development of a serious adverse event in those aged ≥ 80 years were characterized.


Orthopaedic Proceedings
Vol. 93-B, Issue SUPP_IV | Pages 459 - 459
1 Nov 2011
Tyagi V Oh KJ
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Background: The purpose of this study was to assess the stability of short hip stem postoperatively using the radiographic parameters and a novel scoring system based on the unique fixation mechanism of the short hip stem system.

Materials and Methods: Postoperative radiographic analysis was done for 31 total hip arthroplasties performed using Metha® short hip stem prosthesis. The Metha® short hip stem system (B. Braun Aesculap; Tuttlingen, Germany) design provides a unique fixation mechanism, with support at the medial calcar region, lateral neck, and dorso-lateral cortical contact distally.

Additionally the modular design offers increased options and variations. We assessed the stability of stem by using a novel scoring system conceptually based on the unique fixation characteristics of the short stem design and included surgeon controlled variables like position and sitting of stem, dorso-lateral cortical contact and filling ratio of stem. The system also incorporated unmodifiable patient specific variables that ultimately render additional stability to the cementless stems in long run.

Results: The positioning of stem was within normal range in all cases in terms of anteroposterior and lateral CCD angles and horizontal offset. The mean filling ratio of stem were 93.48%±4.38% (range 82–100%). 82.75% hips had acceptable sitting of the short stem at the osteotomy site at proximal end of femur. None of the hips showed any amount of subsidence, except one with a static first follow-up subsidence of 2mm. Using our scoring system all hips showed good to excellent results, with mean score of 44.29±3.83 (range 38–50, maximum score 50).

Conclusion: Our scoring system acts as valuable tool for radiological assessment of Metha® short stem postoperatively. Furthermore, in future longer follow-up studies are required to correlate the scoring system with the longevity and stability of the endoprosthesis.