Cementing in arthroplasty for hip fracture is associated with improved postoperative function, but may have an increased risk of early mortality compared to uncemented fixation. Quantifying this mortality risk is important in providing safe patient care. This study investigated the association between cement use in arthroplasty and mortality at 30 days and one year in patients aged 50 years and over with hip fracture. This retrospective cohort study used linked data from the Australian Hip Fracture Registry and the National Death Index. Descriptive analysis and Kaplan-Meier survival curves tested the unadjusted association of mortality between cemented and uncemented procedures. Multilevel logistic regression, adjusted for covariates, tested the association between cement use and 30-day mortality following arthroplasty. Given the known institutional variation in preference for cemented fixation, an instrumental variable analysis was also performed to minimize the effect of unknown confounders. Adjusted Cox modelling analyzed the association between cement use and mortality at 30 days and one year following surgery.Aims
Methods
Aims. Achieving accurate implant positioning and restoring native hip biomechanics are key surgeon-controlled technical objectives in
Ceramic-on-metal (CoM) is a relatively new bearing
combination for
Version of the femoral stem is an important factor
influencing the risk of dislocation after
Aims. The primary objective of this study was to develop a validated classification system for assessing iatrogenic bone trauma and soft-tissue injury during
Aims. Iliopsoas impingement occurs in 4% to 30% of patients after undergoing
Aims. A significant reduction in wear at five and ten years was previously reported when comparing Durasul highly cross-linked polyethylene with nitrogen-sterilized Sulene polyethylene in
Aims.
Aims. The aim of this study was to explore the functional results in a fitter subgroup of participants in the Hip Fracture Evaluation with Alternatives of
Aims. Manual impaction, with a mallet and introducer, remains the standard method of installing cementless acetabular cups during
Aims. Leg length discrepancy (LLD) is a common pre- and postoperative issue in
Aims. Implant waste during
The orientation of the acetabular component can
influence both the short- and long-term outcomes of total hip replacement
(THR). We performed a prospective, randomised, controlled trial
of two groups, comprising of 40 patients each, in order to compare
freehand introduction of the component with introduction using the transverse
acetabular ligament (TAL) as a reference for anteversion. Anteversion
and inclination were measured on pelvic radiographs. With respect to anteversion, in the freehand group 22.5% of the
components were outside the safe zone With respect to inclination, in the freehand group 37.5% of the
components were outside the safe zone The transverse acetabular ligament may be used to obtain the
appropriate anteversion when introducing the acetabular component
during THR, but not acetabular component inclination. Cite this article:
Revision of a cemented hemiarthroplasty of the
hip may be a hazardous procedure with high rates of intra-operative complications.
Removing well-fixed cement is time consuming and risks damaging
already weak bone or perforating the femoral shaft. The cement-in-cement
method avoids removal of intact cement and has shown good results
when used for revision total hip arthroplasty (THA). The use of
this technique for the revision of a hemiarthroplasty to THA has
not been previously reported. A total of 28 consecutive hemiarthroplasties (in 28 patients)
were revised to a THA using an Exeter stem and the cement-in-cement
technique. There were four men and 24 women; their mean age was
80 years (35 to 93). Clinical and radiographic data, as well as
operative notes, were collected prospectively and no patient was
lost to follow-up. Four patients died within two years of surgery. The mean follow
up of the remainder was 70 months (25 to 124). Intra-operatively
there was one proximal perforation, one crack of the
femoral calcar and one acetabular fracture. No femoral components
have required subsequent revision for aseptic loosening or are radiologically loose. Four patients with late complications (14%) have since undergone
surgery (two for a peri-prosthetic fracture, and one each for deep
infection and recurrent dislocation) resulting in an overall major
rate of complication of 35.7%. The cement-in-cement technique provides reliable femoral fixation
in this elderly population and may reduce operating time and rates
of complication. Cite this article:
Aims. Computer-assisted 3D preoperative planning software has the potential to improve postoperative stability in
Aims. This study aimed to assess the carbon footprint associated with
Aims. Young adults undergoing
Aims. Adult patients with history of childhood infection pose a surgical challenge for
Aims. The volume of ambulatory
Aims. Obesity is associated with an increased risk of hip osteoarthritis, resulting in an increased number of
Aims. The aim of this study was to evaluate the reliability and validity of a patient-specific algorithm which we developed for predicting changes in sagittal pelvic tilt after
Aims. Osteoporosis is common in
Large ceramic femoral heads offer several advantages
that are potentially advantageous to patients undergoing both primary
and revision total hip replacement. Many high-quality studies have
demonstrated the benefit of large femoral heads in reducing post-operative instability.
Ceramic femoral heads may also offer an advantage in reducing polyethylene wear
that has been reported Cite this article: Bone Joint J 2013;95-B, Supple A:63–6.
Aims. A revision for periprosthetic joint infection (PJI) in
Aims. Traditionally,
Aims. Patients with femoral neck fractures (FNFs) treated with
Aims. Osteoporosis can determine surgical strategy for
Aims. Although CT is considered the benchmark to measure femoral version, 3D biplanar radiography (hipEOS) has recently emerged as a possible alternative with reduced exposure to ionizing radiation and shorter examination time. The aim of our study was to evaluate femoral stem version in postoperative
Aims. This study was designed to develop a model for predicting bone mineral density (BMD) loss of the femur after
Aims. The primary aim of this study was to compare the hip-specific functional outcome of robotic assisted
Aims. Precise implant positioning, tailored to individual spinopelvic biomechanics and phenotype, is paramount for stability in
Aims. Pelvic discontinuity is a rare but increasingly common complication of
Aims. The primary aim of our study was to assess the influence of age on hip-specific outcome following
Aims.
Aims. We aimed to evaluate the long-term outcome of highly cross-linked polyethylene (HXLPE) cemented acetabular components and assess whether any radiolucent lines (RLLs) which arose were progressive. Methods. We retrospectively reviewed 170 patients who underwent 187
Aims.
Aims. Spinopelvic mobility plays an important role in functional acetabular component position following
Aims. There is evidence that morbidly obese patients have more intra- and postoperative complications and poorer outcomes when undergoing
Aims. The aim of this study was to determine whether
Aims. It is not known whether preservation of the capsule of the hip positively affects patient-reported outcome measures (PROMs) in
Aims. The current study aimed to compare robotic arm-assisted (RA-THA), computer-assisted (CA-THA), and manual (M-THA)
Aims. The aim of this study was to identify the minimal clinically important difference (MCID), minimal important change (MIC), minimal detectable change (MDC), and patient-acceptable symptom state (PASS) in the Forgotten Joint Score (FJS) according to patient satisfaction six months following
Aims. It is important to analyze objectively the hammering sound in cup press-fit technique in
Aims. It is important to analyze objectively the hammering sound in cup press-fit technique in
Aims. After failed acetabular fractures,
Aims. This study aims to answer the following questions in patients with hip osteoarthritis (OA) who underwent
Aims. Pelvic incidence (PI) is a position-independent spinopelvic parameter traditionally used by spinal surgeons to determine spinal alignment. Its relevance to the arthroplasty surgeon in assessing patient risk for
Aims. Lateral femoral cutaneous nerve (LFCN) injury is a potential complication after the direct anterior approach for
Aims. The aim of this study was to examine whether socioeconomic status (SES) is associated with a higher risk of infections following