The purpose of this study was to validate the diagnosis of periprosthetic
joint infection (PJI) in the Danish Hip Arthroplasty Register (DHR). We identified a cohort of patients from the DHR who had undergone
primary total hip arthroplasty (THA) since 1 January 2005 and followed
them until first-time revision, death, emigration or until 31 December
2012. Revision for PJI, as registered in the DHR, was validated against
a benchmark which included information from microbiology databases,
prescription registers, clinical biochemistry registers and clinical
records. We estimated the sensitivity, specificity, positive predictive
value (PPV) and negative predictive value (NPV) for PJI in the DHR
alone and in the DHR when combined with microbiology databases.Aims
Patients and Methods
We identified 1305 femoral impaction bone grafting revisions using the Exeter stem performed between 1989 and 2002 in 30 hospitals throughout Sweden. There were 1188 patients with a mean age of 71 years (29 to 94) followed up for between five and 18 years. The participating departments reported 70 further revisions in total, of which 57 could also be identified on the Swedish
Using a regional arthroplasty register, we assessed the outcome, at five years, of 1198 primary Charnley total hip replacements (THRs) undertaken across a single health region in England in 1990. An independent clinical and radiological assessment was completed for 497 operations, carried out in 18 different hospitals, under the care of 56 consultants and by differing grades of surgeon. The overall number of failures in this group was 44 (8.9%). We found that the risk of failure in patients operated on by a consultant whose firm carried out 60 or more THRs in 1990 was 25% of that of patients under the care of a consultant whose firm undertook less than 30, adjusting for a number of patient, surgeon and hospital characteristics (16% v 4%; p <
0.001 for linear trend). Our study shows that the early outcome of hip replacement surgery varies with the number of replacements undertaken by the consultant firm. A
The aim of this study was to estimate time to arthroplasty among patients with hip and knee osteoarthritis (OA), and to identify factors at enrolment to first-line intervention that are prognostic for progression to surgery. In this longitudinal register-based observational study, we identified 72,069 patients with hip and knee OA in the Better Management of Patients with Osteoarthritis Register (BOA), who were referred for first-line OA intervention, between May 2008 and December 2016. Patients were followed until the first primary arthroplasty surgery before 31 December 2016, stratified into a hip and a knee OA cohort. Data were analyzed with Kaplan-Meier and multivariable-adjusted Cox regression.Aims
Methods
Femoral stems with exchangeable (modular) necks were introduced
to offer surgeons an increased choice when determining the version,
offset and length of the femoral neck during total hip arthroplasty
(THA). It was hoped that this would improve outcomes and reduce
complications, particularly dislocation. In 2010, the Australian Orthopaedic
Association National Joint Replacement Registry (AOANJRR) first
reported an increased rate of revision after primary THA using femoral
stems with an exchangeable neck. The aim of this study was to provide
a more comprehensive up-to-date analysis of primary THA using femoral
stems with exchangeable and fixed necks. The data included all primary THA procedures performed for osteoarthritis
(OA), reported to the AOANJRR between 01 September 1999 and 31 December
2014. There were 9289 femoral stems with an exchangeable neck and
253 165 femoral stems with a fixed neck. The characteristics of
the patients and prostheses including the bearing surface and stem/neck
metal combinations were examined using Cox proportional hazard ratios
(HRs) and Kaplan-Meier estimates of survivorship. Aims
Materials and Methods
Degenerative problems of the hip in patients
with childhood and adult onset neuromuscular disorders can be challenging
to treat. Many orthopaedic surgeons are reluctant to recommend total
hip replacement (THR) for patients with underlying neuromuscular
disorders due to the perceived increased risks of dislocation, implant loosening,
and lack of information about the functional outcomes and potential
benefits of these procedures in these patients. Modular femoral
components and alternative bearings which facilitate the use of
large femoral heads, constrained acetabular components and perhaps
more importantly, a better understanding about the complications
and outcomes of THR in the patient with neuromuscular disorders,
make this option viable. This paper will review the current literature
and our experience with THR in the more frequently encountered neuromuscular
disorders. Cite this article:
