Aims. Osteoporosis can determine
Hip resurfacing arthroplasty (HRA) is typically indicated for young and active patients. Due to the longevity of arthroplasty, these patients are likely to undergo revision surgery during their lifetime. There is a paucity of information on the long-term outcome of revision surgeries performed after failed HRA. The aim of our study was to provide survivorship data as well as clinical scores after HRA revisions. A total of 42 patients (43 hips) were revised after HRA at our centre to a variety of devices, including four HRA and 39 total hip arthroplasties (THAs). In addition to perioperative complications, University of California, Los Angeles (UCLA) hip scores and 12-Item Short-Form Health Survey questionnaire (SF-12) quality of life scores were collected at follow-up visits after the primary HRA and after revision surgery.Aims
Methods
Custom flange acetabular components (CFACs) are a patient-specific option for addressing large acetabular defects at revision total hip arthroplasty (THA), but patient and implant characteristics that affect survivorship remain unknown. This study aimed to identify patient and design factors related to survivorship. A retrospective review of 91 patients who underwent revision THA using 96 CFACs was undertaken, comparing features between radiologically failed and successful cases. Patient characteristics (demographic, clinical, and radiological) and implant features (design characteristics and intraoperative features) were collected. There were 74 women and 22 men; their mean age was 62 years (31 to 85). The mean follow-up was 24.9 months (Aims
Patients and Methods
Pre-operative planning for total hip replacement
(THR) is challenging in hips with severe acetabular deformities, including
those with a hypoplastic acetabulum or severe defects and in the
presence of arthrodesis or ankylosis. We evaluated whether a Rapid
Prototype (RP) model, which is a life-sized reproduction based on
three-dimensional CT scans, can determine the feasibility of THR
and provide information about the size and position of the acetabular component
in severe acetabular deformities. THR was planned using an RP model
in 21 complex hips in five men (five hips) and 16 women (16 hips)
with a mean age of 47.7 years (24 to 70) at operation. An acetabular
component was implanted successfully and THR completed in all hips.
The acetabular component used was within 2 mm of the predicted size
in 17 hips (80.9%). All of the acetabular components and femoral
stems had radiological evidence of bone ingrowth and stability at
the final follow-up, without any detectable wear or peri-prosthetic
osteolysis. The RP model allowed a simulated procedure pre-operatively
and was helpful in determining the feasibility of THR pre-operatively,
and to decide on implant type, size and position in complex THRs. Cite this article:
The use of joint-preserving surgery of the hip
has been largely abandoned since the introduction of total hip replacement.
However, with the modification of such techniques as pelvic osteotomy,
and the introduction of intracapsular procedures such as surgical
hip dislocation and arthroscopy, previously unexpected options for
the surgical treatment of sequelae of childhood conditions, including
developmental dysplasia of the hip, slipped upper femoral epiphysis
and Perthes’ disease, have become available. Moreover, femoroacetabular
impingement has been identified as a significant aetiological factor
in the development of osteoarthritis in many hips previously considered to
suffer from primary osteoarthritis. As mechanical causes of degenerative joint disease are now recognised
earlier in the disease process, these techniques may be used to
decelerate or even prevent progression to osteoarthritis. We review
the recent development of these concepts and the associated surgical
techniques. Cite this article:
The technical advances in arthroscopic surgery
of the hip, including the improved ability to manage the capsule
and gain extensile exposure, have been paralleled by a growth in
the number of conditions that can be addressed. This expanding list
includes symptomatic labral tears, chondral lesions, injuries of
the ligamentum teres, femoroacetabular impingement (FAI), capsular
laxity and instability, and various extra-articular disorders, including snapping
hip syndromes. With a careful diagnostic evaluation and technical
execution of well-indicated procedures, arthroscopic surgery of
the hip can achieve successful clinical outcomes, with predictable
improvements in function and pre-injury levels of physical activity
for many patients. This paper reviews the current position in relation to the use
of arthroscopy in the treatment of disorders of the hip. Cite this article:
