The aim of this study was to determine whether total hip arthroplasty (THA) for chronic hip pain due to unilateral primary osteoarthritis (OA) has a beneficial effect on cognitive performance. A prospective cohort study was conducted with 101 patients with end-stage hip OA scheduled for THA (mean age 67.4 years (SD 9.5), 51.5% female (n = 52)). Patients were assessed at baseline as well as after three and months. Primary outcome was cognitive performance measured by d2 Test of Attention at six months, Trail Making Test (TMT), FAS-test, Rivermead Behavioural Memory Test (RBMT; story recall subtest), and Rey-Osterrieth Complex Figure Test (ROCF). The improvement of cognitive performance was analyzed using repeated measures analysis of variance.Aims
Methods
We report on 397 consecutive revision total hip
replacements in 371 patients with a mean clinical and radiological follow-up
of 12.9 years (10 to 17.7). The mean age at surgery was 69 years
(37 to 93). A total of 28 patients (8%) underwent further revision,
including 16 (4%) femoral components. In all 223 patients (56%,
233 hips) died without further revision and 20 patients (5%, 20
hips) were lost to follow-up. Of the remaining patients, 209 (221
hips) were available for clinical assessment and 194 (205 hips)
for radiological review at mean follow-up of 12.9 years (10 to 17.7). The mean
The purpose of this study was to examine the
complications and outcomes of total hip replacement (THR) in super-obese
patients (body mass index (BMI) >
50 kg/m. 2. ) compared
with class I obese (BMI 30 to 34.9 kg/m. 2. ) and normal-weight
patients (BMI 18.5 to 24.9 kg/m. 2. ), as defined by the
World Health Organization. A total of 39 THRs were performed in 30 super-obese patients
with a mean age of 53 years (31 to 72), who were followed for a
mean of 4.2 years (2.0 to 11.7). This group was matched with two
cohorts of normal-weight and class I obese patients, each comprising
39 THRs in 39 patients. Statistical analysis was performed to determine differences
among these groups with respect to complications and satisfaction
based on the Western Ontario and McMaster Universities (WOMAC) osteoarthritis
index, the
Prior studies have identified that malseating of a modular dual mobility liner can occur, with previous reported incidences between 5.8% and 16.4%. The aim of this study was to determine the incidence of malseating in dual mobility implants at our institution, assess for risk factors for liner malseating, and investigate whether liner malseating has any impact on clinical outcomes after surgery. We retrospectively reviewed the radiographs of 239 primary and revision total hip arthroplasties with a modular dual mobility liner. Two independent reviewers assessed radiographs for each patient twice for evidence of malseating, with a third observer acting as a tiebreaker. Univariate analysis was conducted to determine risk factors for malseating with Youden’s index used to identify cut-off points. Cohen’s kappa test was used to measure interobserver and intraobserver reliability.Aims
Methods
In developmental dysplasia of the hip (DDH),
a bone defect is often observed superior to the acetabulum after
the reconstruction at the level of the true acetabulum during total
hip replacement (THR). However, the essential amount of uncemented
acetabular component coverage required for a satisfactory outcome
remains controversial. The purpose of this study was to assess the
stability and function of acetabular components with a lack of coverage >
30% (31% to 50%). A total of 760 DDH patients underwent THR with
acetabular reconstruction at the level of the true floor. Lack of
coverage above the acetabular component of >
30% occurred in 56
patients. Intra-operatively, autogenous morcellised bone grafts
were used to fill the uncovered portion. Other than two screws inserted through
the acetabular shell, no additional structural supports were used
in these hips. In all, four patients were lost to follow-up. Therefore,
52 patients (52 hips, 41 women and 11 men) with a mean age of 60.1
years (42 to 78) were available for this study at a mean of 4.8
years (3 to 7). There were no instances of prosthesis revision or
marked loosening during the follow-up. The
The practice of removing a well-fixed cementless
femoral component is associated with high morbidity. Ceramic bearing
couples are low wearing and their use minimises the risk of subsequent
further revision due to the production of wear debris. A total of
165 revision hip replacements were performed, in which a polyethylene-lined acetabular
component was revised to a new acetabular component with a ceramic
liner, while retaining the well-fixed femoral component. A titanium
sleeve was placed over the used femoral trunnion, to which a ceramic
head was added. There were 100 alumina and 65 Delta bearing couples
inserted. . The mean
In this prospective study a total of 80 consecutive
Chinese patients with Crowe type I or II developmental dysplasia of
the hip were randomly assigned for hip resurfacing arthroplasty
(HRA) or total hip replacement (THR). Three patients assigned to HRA were converted to THR, and three
HRA patients and two THR patients were lost to follow-up. This left
a total of 34 patients (37 hips) who underwent HRA and 38 (39 hips)
who underwent THR. The mean follow-up was 59.4 months (52 to 70)
in the HRA group and 60.6 months (50 to 72) in the THR group. There was
no failure of the prosthesis in either group. Flexion of the hip
was significantly better after HRA, but there was no difference
in the mean post-operative
There has been a marked increase in the number of hip arthroscopies performed over the past 16 years, primarily in the management of femoroacetabular impingement (FAI). Insights into the pathoanatomy of FAI, and high-level evidence supporting the clinical effectiveness of arthroscopy in the management of FAI, have fuelled this trend. Arthroscopic management of labral tears with repair may have superior results compared with debridement, and there is now emerging evidence to support reconstructive options where repair is not possible. In situations where an interportal capsulotomy is performed to facilitate access, data now support closure of the capsule in selective cases where there is an increased risk of postoperative instability. Preoperative planning is an integral component of bony corrective surgery in FAI, and this has evolved to include computer-planned resection. However, the benefit of this remains controversial. Hip instability is now widely accepted, and diagnostic criteria and treatment are becoming increasingly refined. Instability can also be present with FAI or develop as a result of FAI treatment. In this annotation, we outline major current controversies relating to decision-making in hip arthroscopy for FAI. Cite this article:
Between 1965 and 1973 a total of 808 McKee-Farrar metal-on-metal cemented total hip arthroplasties were performed in the Norfolk and Norwich Hospital. Of these, 230 surviving arthroplasties have been reviewed at average follow-up of 13.9 years. There were good or excellent results in 49% of the arthroplasties as judged by the
After failed acetabular fractures, total hip arthroplasty (THA) is a challenging procedure and considered the gold standard treatment. The complexity of the procedure depends on the fracture pattern and the initial fracture management. This study’s primary aim was to evaluate patient-reported outcome measures (PROMs) for patients who underwent delayed uncemented acetabular THA after acetabular fractures. The secondary aims were to assess the radiological outcome and the incidence of the associated complications in those patients. A total of 40 patients underwent cementless acetabular THA following failed treatment of acetabular fractures. The postoperative clinical and radiological outcomes were evaluated for all the cohort.Aims
Methods
Bone marrow-derived mesenchymal stem cells obtained from bone marrow aspirate concentrate (BMAC) with platelet-rich plasma (PRP), has been used as an adjuvant to hip decompression. Early results have shown promise for hip preservation in patients with osteonecrosis (ON) of the femoral head. The purpose of the current study is to examine the mid-term outcome of this treatment in patients with precollapse corticosteroid-induced ON of the femoral head. In all, 22 patients (35 hips; 11 males and 11 females) with precollapse corticosteroid-induced ON of the femoral head underwent hip decompression combined with BMAC and PRP. Mean age and BMI were 43 years (SD 12) and 31 kg/m² (SD 6), respectively, at the time of surgery. Survivorship free from femoral head collapse and total hip arthroplasty (THA) and risk factors for progression were evaluated at minimum five-years of clinical follow-up with a mean follow-up of seven years (5 to 8).Aims
Methods
We have carried out a blind, prospective study of 50 consecutive patients undergoing replacement arthroplasty of the hip using two different approaches. Clinical assessment, including the
The results of primary total hip arthroplasty for sub-capital femoral neck fracture in previously normal hips are reported. Thirty-seven patients aged 70 or less at the time of surgery were reviewed at an average follow-up of 56 months. Eighteen (49%) had undergone or were awaiting revision surgery. A further four (11%) had definite radiological signs of loosening.
This study uses prospective registry data to compare early patient outcomes following arthroscopic repair or debridement of the acetabular labrum. Data on adult patients who underwent arthroscopic labral debridement or repair between 1 January 2012 and 31 July 2019 were extracted from the UK Non-Arthroplasty Hip Registry. Patients who underwent microfracture, osteophyte excision, or a concurrent extra-articular procedure were excluded. The EuroQol five-dimension (EQ-5D) and International Hip Outcome Tool 12 (iHOT-12) questionnaires were collected preoperatively and at six and 12 months post-operatively. Due to concerns over differential questionnaire non-response between the two groups, a combination of random sampling, propensity score matching, and pooled multivariable linear regression models were employed to compare iHOT-12 improvement.Aims
Methods
We have reviewed 97 consecutive primary hip replacements with a cemented femoral component and a porous-ingrowth acetabular component at a minimum five-year follow-up (average 6.5 years). The average
In a prospective trial we studied 176 consecutive patients having a primary total hip arthroplasty to compare the quality of life before and after operation in non-obese and obese groups. We used a modified
The benefit of arthroscopy of the hip in the
treatment of femoroacetabular impingement (FAI) in terms of quality
of life (QoL) has not been reported. We prospectively collected
data on 612 patients (257 women (42%) and 355 men (58%)) with a
mean age at the time of surgery of 36.7 years (14 to 75) who underwent
arthroscopy of the hip for FAI under the care of a single surgeon.
The minimum follow-up was one year (mean 3.2 years (1 to 7)). The
responses to the modified
We reviewed the outcome, at a mean follow-up of 14 months, of 21 two-column fractures of the acetabulum treated by operation through one or two non-extensile approaches. Eighteen procedures resulted in reduction of the articular surfaces to within 3 mm. The blood loss and operating time when two combined non-extensile approaches were used were similar to those reported for extended acetabular approaches. The incidence of heterotopic ossification which limited joint motion was low, and the average