The most effective surgical approach for total hip arthroplasty
(THA) remains controversial. The direct anterior approach may be
associated with a reduced risk of dislocation, faster recovery,
reduced pain and fewer surgical complications. This systematic review
aims to evaluate the current evidence for the use of this approach
in THA. Following the Cochrane collaboration, an extensive literature
search of PubMed, Medline, Embase and OvidSP was conducted. Randomised
controlled trials, comparative studies, and cohort studies were
included. Outcomes included the length of the incision, blood loss,
operating time, length of stay, complications, and gait analysis.Aims
Materials and Methods
During the 11-year-period from 1970 to 1980, 799
We have evaluated in vitro the accuracy of percutaneous and ultrasound registration as measured in terms of errors in rotation and version relative to the bony anterior pelvic plane in computer-assisted
We have assessed the relative value of various outcome measures after THR, by the analysis of follow-up data from over 2000 patients. They had been reviewed clinically and radiologically six months after operation, at one year, and then every two years, some for 16 years. At each review their pain level, stiffness and opinion of progress were scored and a radiograph taken. We found that pain level was the most informative outcome as a predictor of revision and correlated well with the patients’ opinions. We made a comparison between the six types of implant in the series, using survival analysis and log-rank testing with different pain levels as endpoints. This analysis revealed differences which were not detected by survival analysis using the traditional endpoint of revision. We therefore recommend the use of different levels of pain as the main outcome measures after
In this study of 41 patients, we used proteomic, Western blot and immunohistochemical analyses to show that several reactive oxygen species scavenging enzymes are expressed differentially in patients with primary osteoarthritis and those with non-loosening and aseptic loosening after
To analyse the value and accuracy of preoperative planning for
Most published randomised controlled trials which
compare the rates of wear of conventional and cross-linked (XL) polyethylene
(PE) in
We have assessed the effect of different regimes of antibiotic prophylaxis on the survival of total hip implants, comparing antibiotics administered both systemically and in the bone cement, systemically only, in the bone cement only and with no antibiotics given. We studied 10 905 primary cemented
A case is reported of a patient who presented with a soft-tissue tumour at the site of a
Exchange operation is recommended as the treatment of choice for most deep infections involving a
Dislocation remains a major concern after
Aseptic loosening is a major cause of failure of
The aim of this study was to assess the efficacy of non-selective
and selective non-steroidal anti-inflammatory drugs (NSAIDs) in
preventing heterotopic ossification (HO) after total hip arthroplasty
(THA). A thorough and systematic literature search was conducted and
29 studies were found that met inclusion criteria. Data were extracted
and statistical analysis was carried out generating forest plots.Aims
Methods
We present the 5.6- to 7.6-year results of our first 118 hydroxyapatite (HA)-coated
Numerous intravascular bony spicules were found at necropsy in both lungs of an 84-year-old patient who had undergone
A prospective study of 120 consecutive
Fracture of the polyethylene acetabular cup is a rare late complication of
1. Nine cases of stress fracture of the pelvis after
From 1982 to 1987, we randomised prospectively 413 patients requiring primary total hip replacements to receive either a Stanmore or Charnley prosthesis. They were reviewed by an independent observer in an attempt to correlate a number of factors including femoral head size with longevity. There were 213 Stanmore hips and 200 Charnley prostheses. At five to ten years (mean 6.5) 76 patients had died and 16 arthroplasties had required revision. Seven were radiologically loose in asymptomatic patients. There was only one case of deep infection. We found no difference statistically in the clinical outcome or in the revision rate of 4% in the two types of prosthesis. The revision rate was greater for trainees than for senior operating surgeons, and there were recognisable technical errors in seven of the nine Stanmore, and four of the seven Charnley replacements which required revision. Retrospective radiological analysis of a random subset of 51 Charnley and 57 Stanmore femoral components showed no difference in femoral subsidence, but in 14 patients who had had bilateral replacements with one femoral component of each type, there was greater early subsidence of the Stanmore prosthesis. Our results confirm that conventional cemented
The early diagnosis of aseptic loosening of a