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Bone & Joint Research
Vol. 13, Issue 6 | Pages 294 - 305
17 Jun 2024
Yang P He W Yang W Jiang L Lin T Sun W Zhang Q Bai X Sun W Guo D

Aims

In this study, we aimed to visualize the spatial distribution characteristics of femoral head necrosis using a novel measurement method.

Methods

We retrospectively collected CT imaging data of 108 hips with non-traumatic osteonecrosis of the femoral head from 76 consecutive patients (mean age 34.3 years (SD 8.1), 56.58% male (n = 43)) in two clinical centres. The femoral head was divided into 288 standard units (based on the orientation of units within the femoral head, designated as N[Superior], S[Inferior], E[Anterior], and W[Posterior]) using a new measurement system called the longitude and latitude division system (LLDS). A computer-aided design (CAD) measurement tool was also developed to visualize the measurement of the spatial location of necrotic lesions in CT images. Two orthopaedic surgeons independently performed measurements, and the results were used to draw 2D and 3D heat maps of spatial distribution of necrotic lesions in the femoral head, and for statistical analysis.


Orthopaedic Proceedings
Vol. 101-B, Issue SUPP_12 | Pages 22 - 22
1 Oct 2019
Ayers DC Zheng H Yang W Franklin PD
Full Access

Introduction

US payers offer incentives to hospitals to report patient-reported outcomes measures (PROMs) for total hip arthroplasty (THA). We report THA norms for pre-op and one-year PROMs in a large multi-center cohort and compare global, hip specific scores, and abbreviated PROM measures acceptable to meet payer requirements. The HOOS 12 is a new form of the HOOS containing 12 questions that allows separate determination of pain and ADL sub-scores in addition to the total score.

Methods

Between 2011–2015, 7895 primary elective THA patients enrolled in the FORCE-TJR research consortium from over 200 surgeons in 28 states. Patients completed pre-op demographics, clinical risks, PROMs, and one-year outcomes. Over 95% completed pre-op PROMs; 83% post-op. Generic and hip specific (HOOS full and HOOS-12 sub-scores, and HOOS JR global) PROMs were compared.


Orthopaedic Proceedings
Vol. 100-B, Issue SUPP_13 | Pages 65 - 65
1 Oct 2018
Ayers DC Zheng H Lemay C Yang W Franklin PD
Full Access

Introduction

Historically, US arthroplasty revision rates are based on CMS data that cannot verify initial surgery date in patients under 65 years or laterality of revision. We calculated US one-year revision rates for primary total hip replacement (THR) using a representative cohort. Reasons for revision were documented.

Methods

A multi-center cohort from US surgeons in 28 states collected sociodemographic data; medical, emotional, musculoskeletal comorbidities; BMI; and patient-reported pain and function (SF36, HOOS) for elective THR patients. Cases in 2011–2013 were matched with CMS data to ascertain 1 year revision through 2014. Predictors of revision were identified. Chart reviews to verify reasons for revision were performed.


The Journal of Bone & Joint Surgery British Volume
Vol. 87-B, Issue 6 | Pages 770 - 775
1 Jun 2005
Hsieh P Shih C Chang Y Lee MS Yang W Shih H

We have carried out in 24 patients, a two-stage revision arthroplasty of the hip for infection with massive bone loss. We used a custom-made, antibiotic-loaded cement prosthesis as an interim spacer. Fifteen patients had acetabular deficiencies, eight had segmental femoral bone loss and one had a combined defect.

There was no recurrence of infection at a mean follow-up of 4.2 years (2 to 7). A total of 21 patients remained mobile in the interim period. The mean Merle D’Aubigné and Postel hip score improved from 7.3 points before operation to 13.2 between stages and to 15.8 at the final follow-up. The allograft appeared to have incorporated into the host bone in all patients. Complications included two fractures and one dislocation of the cement prosthesis.

The use of a temporary spacer maintains the function of the joint between stages even when there is extensive loss of bone. Allograft used in revision surgery after septic conditions restores bone stock without the risk of recurrent infection.


The Journal of Bone & Joint Surgery British Volume
Vol. 85-B, Issue 6 | Pages 818 - 821
1 Aug 2003
Hsieh P Chen L Lee M Chen C Yang W Shih C

We retrospectively reviewed 45 hip arthroplasties which were performed over a period of 20 years in 38 patients with cirrhosis of the liver. There was a high perioperative 30-day complication rate (26.7%). Advanced cirrhosis was associated with a higher risk of complications (p = 0.004) as also was increased age, a high level of creatinine, a low level of albumin, a low platelet count, ascites, encephalopathy and an increased operative blood loss. The survival of the prosthesis at five years was 77.8% and infection was a major cause of failure.

In view of the high rate of early complications and the limited longevity of the prosthesis, surgeons who perform hip arthroplasty on such patients should counsel them appropriately preoperatively.