We studied the safety of combining the postoperative use of a non-steroidal anti-inflammatory drug with low-dose heparin. In a double-blind, placebo-controlled clinical trial we reviewed the complications in 235 patients after total hip replacement, all treated with low-dose heparin and either indomethacin or a placebo. The incidence and type of complications in the two groups were nearly equal; indomethacin-treated patients had no increase in complications related to bleeding. Postoperative bleeding into drains was marginally greater in the indomethacin group, although the difference was not statistically significant. We conclude that treatment with indomethacin and low-dose heparin after
A study of the natural history and aetiology of deep vein thrombosis in 499 patients after total hip replacement is presented. Deep vein thrombosis was diagnosed by scanning the leg for 125Iodine-labelled fibrinogen for a period of 14 to 18 days and by ascending phlebography. It has been shown that deep vein thrombosis occurs ater than in patients who have undergone abdominal operations, and the risk period is longer. The peak of onset of thrombosis is on the fourth day after the
Roentgen stereophotogrammetry was used to measure the migration of the centre of the femoral head in 84 cemented Lubinus SP I
In 1988 we reported a ten-year review of 83 surviving patients from a group of 135 (146 prostheses) who had undergone primary hip replacement using the Stanmore prosthesis. We have now reviewed 44 of these patients at 15 to 16 years. Four patients had undergone revision, but the other 40 were all satisfied with the result of their
Of 142 Chiari pelvic osteotomies for osteoarthritis in dysplastic hips, most performed by Chiari himself, we were able to review 82 and obtain information about 18 by questionnaire. All patients were over 30 years of age at operation; follow-up averaged 15.5 years. Twenty hips had undergone secondary total hip replacement. The outcome was good in 75%, fair in 9% and poor in 16%. High osteotomies all gave good results, and the result also depended on adequate medialisation. Statistics were worse for patients over 44 years of age at the time of operation. For osteoarthritis secondary to hip dysplasia, the Chiari pelvic osteotomy is an alternative procedure to early
This study reports the mid-term results of total hip arthroplasty (THA) performed using a monoblock acetabular component with a large-diameter head (LDH) ceramic-on-ceramic (CoC) bearing. Of the 276 hips (246 patients) included in this study, 264 (96%) were reviewed at a mean of 67 months (48 to 79) postoperatively. Procedures were performed with a mini posterior approach. Clinical and radiological outcomes were recorded at regular intervals. A noise assessment questionnaire was completed at last follow-up.Aims
Patients and Methods
During the years 1971 to 1975, 378 Charnley low-friction arthroplasties of the hip were performed on 278 patients with rheumatoid arthritis. The average age at operation was thirty-nine years. The follow-up time ranged from one to six years (mean two and a half years). Forty per cent of patients were receiving steroids at the time of operation. The most common complications were loosening of the prosthesis (3.4%), perforation of the femoral cortex and fracture. Deep infection occurred in 0.7%, dislocation in 0.7%, and thromboembolic episodes in 1.3%. Ninety-five per cent of patients were free of pain at follow-up compared to 84% who were severely handicapped by pain before operation. In addition, the increased mobility in 98.5% of patients and their improved independence makes
Fracture of the odontoid process (OP) in the elderly is associated with mortality rates similar to those of hip fracture. The aim of this study was to identify variables that predict mortality in patients with a fracture of the OP, and to assess whether established hip fracture scoring systems such as the Nottingham Hip Fracture Score (NHFS) or Sernbo Score might also be used as predictors of mortality in these patients. We conducted a retrospective review of patients aged 65 and over with an acute fracture of the OP from two hospitals. Data collected included demographics, medical history, residence, mobility status, admission blood tests, abbreviated mental test score, presence of other injuries, and head injury. All patients were treated in a semi-rigid cervical orthosis. Univariate and multivariate analysis were undertaken to identify predictors of mortality at 30 days and one year. A total of 82 patients were identified. There were 32 men and 50 women with a mean age of 83.7 years (67 to 100).Aims
Patients and Methods
We studied the pattern of . 99m. Tc-methylene diphosphonate uptake around uncemented femoral components in 44 asymptomatic
We measured polyethylene wear in 231 porous-coated uncemented acetabular cups. We divided the hips into two groups according to the fixation of the femoral component, by cementing (n = 97) or press-fit (n = 134). Follow-up was from three to five years. The patients in two sub-groups were matched for weight, diagnosis, sex, age and length of follow-up. The linear wear rate of cups articulated with uncemented femoral components (0.22 mm/year) was significantly higher than the wear rate (0.15 mm/year) of cups articulated within cemented femoral components (p <
0.05). These results can be compared with previously reported wear rates of 0.08 mm/year for cemented all-polyethylene cups and 0.11 mm/year for cemented metal-backed cups. The higher wear rates of uncemented arthroplasties could jeopardize the long-term results of this type of
Fifty-four cobalt-chrome alloy femoral heads were retrieved at revision surgery or at post-mortem; 23 came from uncemented, eight from hybrid and 23 from cemented
The results of conventional
We report the 12 to 74 month results of our mark I saddle prosthesis after its use as a salvage device for gross loss of pelvic bone stock in 76 patients with failed
The effect of hypobaric spinal anaesthesia or narcotic-halothane-relaxant general anaesthesia on the incidence of postoperative deep vein thrombosis was studied in 140 elective total hip replacements in a prospective randomised manner. Deep vein thrombosis was diagnosed using impedance plethysmography and the 125I fibrinogen uptake test, combined, in selected cases, with ascending contrast venography. The overall incidence of deep vein thrombosis was 20%. Nine patients (13%) developed deep vein thrombosis in the spinal group and nineteen (27%) in the general anaesthetic group (p less than 0.05). The incidences of proximal thrombosis and of bilateral thrombi were also less with spinal anaesthesia than with general anaesthesia. It is concluded that spinal anaesthesia reduces the risks of postoperative thromboembolism in
The purpose of this study was to establish if the Bateman prosthesis functions as a bipolar device moving primarily at the inner metal-on-polyethylene bearing as originally proposed, or as a unipolar hemiarthroplasty moving at the outer metal-on-cartilage surface as has recently been suggested. One hundred hips were examined at one year follow-up; 78 were examined again at two to four years. The replacement was performed for arthritis in 76 hips and for femoral neck fracture in 24. Movement was assessed both with and without weight-bearing. In 80% of the arthritis group the prosthesis functioned as a bipolar
The aim of this study was to evaluate the accuracy of implant placement when using robotic assistance during total hip arthroplasty (THA). A total of 20 patients underwent a planned THA using preoperative CT scans and robotic-assisted software. There were nine men and 11 women (n = 20 hips) with a mean age of 60.8 years (Aims
Patients and Methods
All surgical operations have the potential for contamination, and the equipment used can harbour bacteria. We collected samples from 100 elective primary hip and knee arthroplasties. These showed rates of contamination of 11.4% for the sucker tips, 14.5% for light handles, 9.4% for skin blades and 3.2% for the inside blades used during surgery; 28.7% of gloves used for preparation were also contaminated. Of the samples taken from the collection bags used during
The purpose of this study was to examine whether leg-length discrepancy (LLD) following unilateral total hip arthroplasty (THA) affects the incidence of contralateral head collapse and subsequent THA in patients with bilateral osteonecrosis, and to determine factors associated with subsequent collapse. We identified 121 patients with bilateral non-traumatic osteonecrosis who underwent THA between 2003 and 2011 to treat a symptomatic hip, and who also exhibited medium-to-large lesions (necrotic area ≥ 30%) in an otherwise asymptomatic non-operated hip. Of the 121 patients, 71 were male (59%) and 50 were female (41%), with a mean age of 51 years (19 to 71) at the time of initial THA. All patients were followed for at least five years and were assessed according to the presence of a LLD (non-LLD Aims
Patients and Methods