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Orthopaedic Proceedings
Vol. 101-B, Issue SUPP_12 | Pages 36 - 36
1 Oct 2019
Bedard NA Brown TS Lewallen DG Trousdale RT Berry DJ Abdel MP
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Introduction

Many surgeons are reluctant to use a constrained liner at the time of acetabular component revision given concerns this might result in early acetabular component loosening. We hypothesized that with appropriate initial implant stabilization of highly porous acetabular components with supplemental screw fixation, constrained liners could be safely used at the time of acetabular revision.

Methods

We retrospectively identified 148 revision total hip arthroplasties (THAs) where a constrained liner of one design was cemented into a newly placed highly porous acetabular component fixed with supplemental screws (mean 5 screws). Mean age at revision THA was 69 years, with 68% being female. The most common indications for revision were two-stage re-implantation (33%), recurrent dislocation (30%), and aseptic loosening (22% acetabular; 9% acetabular/femoral component). Mean follow-up was 8 years.


Orthopaedic Proceedings
Vol. 100-B, Issue SUPP_13 | Pages 27 - 27
1 Oct 2018
Callaghan JJ DeMik DE Bedard NA Dowdle SB Elkins J Brown TS Gao Y
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Purpose

Obesity has previously been demonstrated to be an independent risk factor for increased complications following total hip (THA) and total knee arthroplasty (TKA). The purpose of this study was to compare the effects of obesity and BMI to determine whether the magnitude of the effect was similar for both procedures.

Materials & Methods

We queried the American College of Surgeons National Surgical Quality Improvement Program (ACS NSQIP) database to identify patients who underwent primary THA or TKA between 2010 and 2014. Patients were stratified by procedure and classified as non-obese, obese, or morbidly obese according to BMI. Thirty-day rates of wound complications, deep infection, total complications, and reoperation were compared using univariate and multivariate logistic regression analyses.


Orthopaedic Proceedings
Vol. 100-B, Issue SUPP_13 | Pages 15 - 15
1 Oct 2018
Petis SM Brown TS Pagnano MW Sierra RJ Trousdale RT Taunton MJ
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Introduction

The influence of surgical approach for total hip arthroplasty (THA) on scar healing and scar perception is unknown. The purpose of this study was to evaluate patients’ perception of their scar following direct anterior (DA) or posterior approach (PA) for THA utilizing validated scar assessment scales.

Methods

Fifty DA and 58 PA THA patients underwent scar assessment using the Patient Observer Scar Assessment Scale (POSAS) and Stony Brook Scar Evaluation Scales (SBSES). Patients were included if they had at least 1-year follow-up, and had no previous surgery or intervention (i.e. radiation) around the assessed hip. The mean age was different between the cohorts (DA 67 vs PA 62 years, p=0.03). Other variables including gender, BMI, Charlson Comorbidity Index, steroid use, diabetes, and smoking were similar (p>0.05 for all comparisons). All patients had subcuticular running closure, secured with skin adhesive glue. Mean time from THA to scar assessment was 3.1 and 3.6 years for the DA and PA groups, respectively (p=0.18).


The Bone & Joint Journal
Vol. 100-B, Issue 9 | Pages 1157 - 1161
1 Sep 2018
Brown TS Fehring KA Ollivier M Mabry TM Hanssen AD Abdel MP

Aims

Recurrent infection following two-stage revision total hip arthroplasty (THA) for prosthetic joint infection (PJI) is a devastating complication. The purpose of this study was to report the survival of repeat two-stage revision hip arthroplasty, describe complications, and identify risk factors for failure.

Patients and Methods

We retrospectively identified 19 hips (19 patients) that had undergone repeat two-stage revision THA for infection between 2000 to 2013. There were seven female patients (37%) and the mean age was 60 years (30 to 85). Survival free from revision was assessed via Kaplan–Meier analysis. The patients were classified according to the Musculoskeletal Infection Society (MSIS) system, and risk factors for failure were identified. Mean follow-up was four years (2 to 11).


The Bone & Joint Journal
Vol. 100-B, Issue 1_Supple_A | Pages 22 - 30
1 Jan 2018
Brown TS Salib CG Rose PS Sim FH Lewallen DG Abdel MP

Aims

Reconstruction of the acetabulum after resection of a periacetabular malignancy is technically challenging and many different techniques have been used with varying success. Our aim was to prepare a systematic review of the literature dealing with these techniques in order to clarify the management, the rate of complications and the outcomes.

Patients and Methods

A search of PubMed and MEDLINE was conducted for English language articles published between January 1990 and February 2017 with combinations of key search terms to identify studies dealing with periacetabular resection with reconstruction in patients with a malignancy. Studies in English that reported radiographic or clinical outcomes were included. Data collected from each study included: the number and type of reconstructions, the pathological diagnosis of the lesions, the mean age and follow-up, gender distribution, implant survivorship, complications, functional outcome, and mortality. The results from individual studies were combined for the general analysis, and then grouped according to the type of reconstruction.