Aims. This study aimed to describe practice variation in the use of total hip arthroplasty (THA) for older patients with
Aims. The aim of this study was to compare the early postoperative mortality and morbidity in older patients with a fracture of the
Aims. The aim of this study was to investigate the potentially increased risk of dislocation in patients with neurological disease who sustain a
Aims. To evaluate the rate of dislocation following dual mobility total hip arthroplasty (DM-THA) in patients with displaced
Aims. Total hip arthroplasty (THA) with dual-mobility components (DM-THA) has been shown to decrease the risk of dislocation in the setting of a displaced
Aims. Despite few good-quality studies on the subject, total hip arthroplasty (THA) is increasingly being performed for displaced intracapsular fractures of the
Aims. Dislocation is the most common indication for further surgery following total hip arthroplasty (THA) when undertaken in patients with a
Aims. Various surgical techniques have been described for total hip arthroplasty (THA) in patients with Crowe type III dislocated hips, who have a large acetabular bone defect. The aim of this study was to evaluate the long-term clinical results of patients in whom anatomical reconstruction of the acetabulum was performed using a cemented acetabular component and autologous bone graft from the
Aims. Patients who sustain
Aims. While interdisciplinary protocols and expedited surgical treatment improve the management of hip fractures in the elderly, the impact of such interventions on patients specifically undergoing arthroplasty for a
Aims. Monocyte-lymphocyte ratio (MLR) or neutrophil-lymphocyte ratio (NLR) are useful for diagnosing periprosthetic joint infection (PJI), but their diagnostic values are unclear for screening fixation-related infection (FRI) in patients for whom conversion total hip arthroplasty (THA) is planned after failed internal fixation for
Aims. Dual-mobility acetabular components (DMCs) have improved total hip arthroplasty (THA) stability in
Aims. The aim of this study was to clarify the factors that predict the development of avascular necrosis (AVN) of the femoral head in children with a fracture of the
The aim of this study was to determine the impact of hospital-level service characteristics on hip fracture outcomes and quality of care processes measures. This was a retrospective analysis of publicly available audit data obtained from the National Hip Fracture Database (NHFD) 2018 benchmark summary and Facilities Survey. Data extraction was performed using a dedicated proforma to identify relevant hospital-level care process and outcome variables for inclusion. The primary outcome measure was adjusted 30-day mortality rate. A random forest-based multivariate imputation by chained equation (MICE) algorithm was used for missing value imputation. Univariable analysis for each hospital level factor was performed using a combination of Tobit regression, Siegal non-parametric linear regression, and Mann-Whitney U test analyses, dependent on the data type. In all analyses, a p-value < 0.05 denoted statistical significance.Aims
Methods
Surgical interventions consisting of internal
fixation (IF) or total hip replacement (THR) are required to restore
patient mobility after hip fractures. Conventionally, this decision
was based solely upon the degree of fracture displacement. However,
in the last ten years, there has been a move to incorporate patient
characteristics into the decision making process. Research demonstrating
that joint replacement renders superior functional results when compared
with IF, in the treatment of displaced
The aim of this study was to assess the effect of time to surgical intervention from admission on mortality and morbidity for patients with hip fractures. MEDLINE and Embase were searched from inception to June 2020. Reference lists were manually assessed to identify additional papers. Primary comparative research studies that recruited patients aged over 60 years, with non-pathological primary proximal femoral fractures that were treated surgically, were included. Studies that did not include a group operated on within 24 hours or which reported time to surgery in calendar days were excluded. Two investigators extracted data on study characteristics, methods, and outcomes. The pre-defined primary outcome was 30-day mortality. Secondary outcomes were complications and mortality at other time points. Relative risks (RRs) with 95% confidence intervals (CIs) were aggregated and were grouped by study-level characteristics.Aims
Methods
The aim of this study to compare 30-day survival and recovery of mobility between patients mobilized early (on the day of, or day after surgery for a hip fracture) and patients mobilized late (two days or more after surgery), and to determine whether the presence of dementia influences the association between the timing of mobilization, 30-day survival, and recovery. Analysis of the National Hip Fracture Database and hospital records for 126,897 patients aged ≥ 60 years who underwent surgery for a hip fracture in England and Wales between 2014 and 2016. Using logistic regression, we adjusted for covariates with a propensity score to estimate the association between the timing of mobilization, survival, and recovery of walking ability.Aims
Methods
During hip resurfacing arthroplasty, excessive valgus positioning or surgical technique can result in notching of the
The results of meta-analysis show a revision rate of 33% for internal fixation of displaced fractures of the
Aims. The aims of this study were to evaluate the abductor function in moderate and severe slipped capital femoral epiphysis (SCFE), comparing the results of a corrective osteotomy at the base of the
Aims. The optimal management of intracapsular fractures of the femoral
neck in independently mobile patients remains open to debate. Successful
fixation obviates the limitations of arthroplasty for this group
of patients. However, with fixation failure rates as high as 30%,
the outcome of revision surgery to salvage total hip arthroplasty
(THA) must be considered. We carried out a systematic review to
compare the outcomes of salvage THA and primary THA for intracapsular
fractures of the
Aims. The primary aim of this prognostic study was to identify baseline
factors associated with physical health-related quality of life
(HRQL) in patients after a
A total of 20 pairs of fresh-frozen cadaver femurs were assigned to four alignment groups consisting of relative varus (10° and 20°) and relative valgus (10° and 20°), 75 composite femurs of two neck geometries were also used. In both the cadaver and the composite femurs, placing the component in 20° of valgus resulted in a significant increase in load to failure. Placing the component in 10° of valgus had no appreciable effect on increasing the load to failure except in the composite femurs with varus native
The cause of fracture of the
We have investigated whether early anatomical open reduction and internal fixation (ORIF) reduces the incidence of complications of fracture of the
Several different designs of hemiarthroplasty are used to treat intracapsular fractures of the proximal femur, with large variations in costs. No clinical benefit of modular over monoblock designs has been reported in the literature. Long-term data are lacking. The aim of this study was to report the ten-year implant survival of commonly used designs of hemiarthroplasty. Patients recorded by the Australian Orthopaedic Association National Joint Replacement Registry (AOANJRR) between 1 September 1999 and 31 December 2020 who underwent hemiarthroplasty for the treatment of a hip fracture with the following implants were included: a cemented monoblock Exeter Trauma Stem (ETS), cemented Exeter V40 with a bipolar head, a monoblock Thompsons prosthesis (Cobalt/Chromium or Titanium), and an Exeter V40 with a Unitrax head. Overall and age-defined cumulative revision rates were compared over the ten years following surgery.Aims
Methods
There have been several studies examining the
association between the morphological characteristics seen in acetabular
dysplasia and the incidence of the osteoarthritis (OA). However, most studies focus mainly on acetabular morphological
analysis, and few studies have scrutinised the effect of femoral
morphology. In this study we enrolled 36 patients with bilateral
acetabular dysplasia and early or mid-stage OA in one hip and no
OA in the contralateral hip. CT scans were performed from the iliac
crest to 2 cm inferior to the tibial tuberosity, and the morphological
characteristics of both acetabulum and femur were studied. . In addition, 200 hips in 100 healthy volunteer Chinese adults
formed a control group. The results showed that the dysplastic group
with OA had a significantly larger
Our aim in this pilot study was to evaluate the fixation of, the bone remodelling around, and the clinical outcome after surgery of a new, uncemented, fully hydroxyapatite-coated, collared and tapered femoral component, designed specifically for elderly patients with a fracture of the
The cortical strains on the
Aims. Displaced
We have developed a hollow perforated cannulated screw. One or more of these was implanted percutaneously in 11 patients with an osteolytic metastasis in the
The aim of this study was to determine the comorbid risk factors for failure in young patients who undergo fixation of a displaced fracture of the
Between April 1999 and April 2004, 3497 Birmingham hips were inserted by 89 surgeons. Fracture of the
The aim of our study was to investigate whether placing of the femoral component of a hip resurfacing in valgus protected against spontaneous fracture of the
1. Stress fractures of the
Traumatic posterior dislocation of the hip associated with a fracture of the posterior acetabular wall and of the
The aim of this study was to analyse the functional outcome after a displaced intracapsular fracture of the
This review summarises the evidence for the treatment
of displaced fractures of the
Aims. Our aim was to prepare a systematic review and meta-analysis
to compare the outcomes of cemented and cementless hemiarthroplasty
of the hip, in elderly patients with a fracture of the
Aims. The aim of this study was to compare the functional and radiological
outcomes in patients with a displaced fracture of the hip who were
treated with a cemented or a cementless femoral stem. Patients and Methods. A four-year follow-up of a randomized controlled study included
141 patients who underwent surgery for a displaced femoral neck
fracture. Patients were randomized to receive either a cemented
(n = 67) or a cementless (n = 74) stem at hemiarthroplasty (HA;
n = 83) or total hip arthroplasty (THA; n = 58). Results. Early differences in functional outcome, assessed using the Harris
Hip Score, the Short Musculoskeletal Functional Assessment score
and EuroQol-5D, with better results in cemented group, deteriorated
over time and there were no statistically significant differences
at 48 months. Two (3%) patients in the cemented group and five (6.8%)
in the cementless group underwent further surgery for a periprosthetic
fracture. This difference was statistically significant (p = 0.4).
No patient underwent further surgery for instability or infection
between one and four years postoperatively. The mortality and the
radiological outcomes were similar in both groups. Conclusion. Patients with a displaced
We have studied the effect of shortening of the
The major advantage of hip resurfacing is the decreased amount of bone resection compared with a standard total hip replacement. Fracture of the
We undertook a randomised controlled trial to
compare bipolar hemiarthroplasty (HA) with a novel total hip replacement
(THR) comprising a polycarbonate–urethane (PCU) acetabular component
coupled with a large-diameter metal femoral head for the treatment
of displaced fractures of the
1. A method is described for measuring blood flow to the head of the femur after fracture of the
Cases are reported of two men who sustained bilateral hip injuries while undergoing convulsive therapy and of one woman who sustained bilateral hip injuries during a uraemic convulsion. A further twenty-three previously unreported cases are analysed, sixteen of which were of simultaneous bilateral
Aims. Our aim was to examine the Elixhauser and Charlson comorbidity indices, based on administrative data available before surgery, and to establish their predictive value for mortality for patients who underwent hip arthroplasty in the management of a
Aims. We aimed to quantify the relative contributions of the medial
femoral circumflex artery (MFCA) and lateral femoral circumflex
artery (LFCA) to the arterial supply of the head and neck of the
femur. Materials and Methods. We acquired ten cadaveric pelvises. In each of these, one hip
was randomly assigned as experimental and the other as a matched
control. The MFCA and LFCA were cannulated bilaterally. The hips
were designated LFCA-experimental or MFCA-experimental and underwent
quantitative MRI using a 2 mm slice thickness before and after injection
of MRI-contrast diluted 3:1 with saline (15 ml Gd-DTPA) into either
the LFCA or MFCA. The contralateral control hips had 15 ml of contrast
solution injected into the root of each artery. Next, the MFCA and
LFCA were injected with a mixture of polyurethane and barium sulfate
(33%) and their extra-and intra-arterial course identified by CT
imaging and dissection. Results. The MFCA made a greater contribution than the LFCA to the vascularity
of the femoral head (MFCA 82%, LFCA 18%) and neck (MFCA 67%, LFCA
33%). However, the LFCA supplied 48% of the anteroinferior femoral
neck overall. Conclusion. This study clearly shows that the MFCA is the major arterial
supply to the femoral head and neck. Despite this, the LFCA supplies
almost half the anteroinferior aspect of the
In a series of 450 patients over 70 years of age with displaced fractures of the
1. Seventy patients with impacted fractures of the
The incidence and long-term outcome of undisplaced fatigue fractures of the
Nutritional osteomalacia is a metabolic bone disorder common among the Asian female immigrant population in the United Kingdom. We describe the case of a female of Asian origin, who was found to have a unilateral undisplaced pseudofracture of the
Fractures of the hip are common, often occurring
in frail elderly patients, but also in younger fit healthy patients following
trauma. They have a significant associated mortality and major social
and financial implications to patients and health care providers.
Many guidelines are available for the management of these patients,
mostly recommending early surgery for the best outcomes. As a result,
healthcare authorities now put pressure on surgical teams to ‘fast
track’ patients with a fracture of the hip, often misquoting the
available literature, which in itself can be confusing and even
conflicting. This paper has been written following an extensive review of
the available literature. An attempt is made to clarify what is
meant by early surgery (expeditious Cite this article:
In a prospective, randomised trial, we compared the use of three Ullevaal hip screws with that of two Hansson hook-pins in 278 patients with fractures of the
We compared the clinical and radiological outcomes
of two cementless femoral stems in the treatment of patients with
a Garden III or IV fracture of the
A study of a collected series of
We report a series of 50 patients under 70 years of age who had an ununited
1. A technique of transarticular nailing for subcapital and transcervical fractures of the
1. Various types of fracture of the
Fractures of the
1. At necropsy the arterial distribution within the head and
We describe a method of internal fixation for
We studied the rate of revision in 84 consecutive total hip replacements performed for failed osteosynthesis of
We report retrospective and prospective studies to identify the causes of fracture of the
Aims. The objective of this study was to investigate bone healing after
internal fixation of displaced
We adduce the following conclusions from our experience of using this spring-loaded compression screw on completely displaced medial fractures of the
We report the outcome of 39 patients who underwent
a modified Pauwels’ intertrochanteric osteotomy for nonunion of
a
In this study 201 elderly patients with
The treatment algorithms for displaced fractures of the
The aim of this study was to try to elucidate the increased susceptibility of the
United Kingdom National Institute for Health
and Clinical Excellence guidelines recommend the use of total hip replacement
(THR) for displaced intracapsular fractures of the femoral neck
in cognitively intact patients, who were independently mobile prior
to the injury. This study aimed to analyse the risk factors associated
with revision of the implant and mortality following THR, and to
quantify risk. National Joint Registry data recording a THR performed
for acute fracture of the
Anteversion of the
1. Thirty-seven specimens of the proximal third of the human femur were subjected to cyclically varying loads applied in a physiological direction to the femoral head, having maximum values of from four to thirteen times body weight. 2. Ten of these specimens sustained subcapital fractures of the
The best treatment for a fractured
1. Senile osteoporosis is one of the common causes of morbidity in old people. Its distribution in European and American populations has been deduced from epidemiological studies of its major complications, such as fractures of the vertebrae and the
The best treatment for the active and lucid elderly patient with a displaced intracapsular fracture of the
A clinical, radiological and histopathological study of femoral heads from 125 patients with fracture of the
Seven patients with stress fractures of the
We compared the reoperation rate after internal fixation for minimally displaced or impacted intracapsular fractures of the
The case histories of 361 subcapital fractures of the
1. A method is described for determining the presence or absence of a circulation within the femoral head after fracture of the
The design and use of a prong plate for the treatment of displaced fractures of the
We reviewed the seven- to ten-year results of our previously reported prospective randomised controlled trial comparing total hip replacement and hemiarthroplasty for the treatment of displaced intracapsular fracture of the
1. Three cases are reported of avascular necrosis of the head of the femur after undisplaced fractures of the
Fifty-six patients with ununited intracapsular fractures of the
Using data from the Norwegian Hip Fracture Register,
8639 cemented and 2477 uncemented primary hemiarthroplasties for
displaced fractures of the
Aims. Surgical site infection can be a devastating complication of
hemiarthroplasty of the hip, when performed in elderly patients
with a displaced fracture of the
1. Aching pain in the thigh, hip or buttock in an elderly person should lead to radiological examination of the hip region. In patients who have been subjected to irradiation for pelvic neoplasms a spontaneous fracture should be strongly suspected and the patient kept under close review, even if the first radiograph is negative. 2. Patients with spontaneous fractures of the
Twenty-one post-irradiation fractures of the
We performed dynamic MRI of the femoral head within 48 hours of injury on 22 patients with subcapital fracture of the
We reviewed the records and radiographs from 10 hospitals to identify 50 patients with rheumatoid arthritis (RA) who had sustained 52
1. Fracture of the
A method of nailing the
Neglected fractures of the
1. Experimental work with piglets supports the theory that diminished blood supply to the femoral head not only causes necrosis of the epiphysis but also a decrease in cartilage cell production in the germinal layer of the epiphysial plate, thus causing decreased longitudinal bone growth. Appositional growth continues in the metaphysis because its blood supply remains intact or, at least, is less impaired. The resulting disturbance of the normal remodelling must lead to a short wide neck such as occurs in Legg-Perthes' disease. 2. Measurements were made of the length and width of the
We performed curettage and bone grafting of amyloid cysts of the
We have reviewed our experience of four iatrogenic
1. A method of internal fixation of displaced subcapital fractures of the
In a prospective study, 170 impacted
We describe a series of 20 patients with ununited fractures of the
We evaluated the outcome of treatment of nonunion
of an intracapsular fracture of the