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The push-through total femoral prosthesis for revision of a total hip or knee replacement with extreme bone loss.
IF 1.3 4区 医学
HIP International Pub Date : 2024-09-24 DOI: 10.1177/11207000241282111
Sancar Bakircioglu, Abdulkadir M Bulut, Melih Oral, Omur Çağlar, Bulent Atilla, A Mazhar Tokgözoğlu
{"title":"The push-through total femoral prosthesis for revision of a total hip or knee replacement with extreme bone loss.","authors":"Sancar Bakircioglu, Abdulkadir M Bulut, Melih Oral, Omur Çağlar, Bulent Atilla, A Mazhar Tokgözoğlu","doi":"10.1177/11207000241282111","DOIUrl":"https://doi.org/10.1177/11207000241282111","url":null,"abstract":"<p><strong>Purpose: </strong>The aim of the present study was to assess outcomes of using the push-through total femoral prothesis (PTTF) for revision total hip replacement with extreme bone loss.</p><p><strong>Methods: </strong>10 consecutive patients who received PTTF between 2012 and 2018 for revision hip arthroplasty were included in the study. Primary functional outcomes were assessed using Harris Hip Score (HHS), Toronto Extremity Salvage Score (TESS) and Musculoskeletal Tumor Society (MSTS) scores. Range of motion, complications, and ambulatory status were also recorded to assess secondary outcomes.</p><p><strong>Results: </strong>2 of 10 patients underwent surgery with PTTF for both knee and hip arthroplasty revision. The mean time between index surgery and PTTF was 15 years (3-32 yrs). Acetabular components were revised in 6 of 10 patients during PTTF application. After a mean follow-up of 5.9 years, hip dislocations occurred in 3 patients. All of the dislocated hips were ones with retained conventional non-constrained acetabular bearings. Patient satisfaction was high (MSTS: 67%, HHS: 61.2%, TESS 64.6%) despite high re-operation rate (40%) and minor postoperative problems.</p><p><strong>Conclusions: </strong>PTTF should be considered for hip and knee arthroplasty revision procedures in patients with an extreme bone defect. Consistent usage of constrained liners should be considered to avoid hip dislocation, which was our main problem following the procedure.</p>","PeriodicalId":12911,"journal":{"name":"HIP International","volume":null,"pages":null},"PeriodicalIF":1.3,"publicationDate":"2024-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142307647","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
The L1 spino-pelvic (L1SP) angle: a simplified approach for the assessment of the PI-LL mismatch in hip surgery. L1 脊柱-骨盆(L1SP)角:评估髋关节手术中 PI-LL 错位的简化方法。
IF 1.3 4区 医学
HIP International Pub Date : 2024-09-23 DOI: 10.1177/11207000241282984
A Mounir Boudali, Yuan Chai, John E Farey, Jonathan Vigdorchik, William L Walter
{"title":"The L1 spino-pelvic (L1SP) angle: a simplified approach for the assessment of the PI-LL mismatch in hip surgery.","authors":"A Mounir Boudali, Yuan Chai, John E Farey, Jonathan Vigdorchik, William L Walter","doi":"10.1177/11207000241282984","DOIUrl":"https://doi.org/10.1177/11207000241282984","url":null,"abstract":"<p><strong>Introduction: </strong>Pelvic incidence - lumbar lordosis (PI-LL) mismatch is often considered when assessing spinopelvic alignment in the sagittal plane. The mismatch is conventionally obtained by measuring 2 separate angles on lateral spinopelvic radiographs. This study describes a simplified approach for assessing spinopelvic mobility and measuring the PI-LL mismatch through the evaluation of the L1-spinopelvis angle (L1SP).</p><p><strong>Methods: </strong>96 standing lateral radiographs were obtained from consecutive patients presenting for total hip arthroplasty between November 2020 and July 2021. 3 operators were recruited to annotate landmarks on digital radiographs. Correlation analysis and error analysis were applied. Measurement reproducibility was assessed using intraclass correlation coefficient (ICC).</p><p><strong>Results: </strong>The correlation coefficients of the 3 variables were respectively 0.87 for PI, 0.94 for LL, and 0.96 for L1SP. The normalised root mean square error between the 2 measurement sets was 9.96% for PI, 5.97% for LL, and 4.41% for L1SP. The absolute error was 3.49° ± 4.63° for PI, 3.23° ± 3.78° for LL, 2.68° ± 3.19° for PI-LL conventional, and 2.35° ± 2.88° for PI-LL via L1SP, respectively. In terms of reproducibility, measurement of L1SP outperformed that of PI and LL (ICC = 0.97 versus 0.83 and 0.93, respectively).</p><p><strong>Conclusion: </strong>The simplified L1SP method, through the measurement of a single angle, produced similar measurements to the conventional PI-LL method. The measurement repeatability between operators was improved using the L1SP method. From a clinical practice perspective, both methods are equivalent. The new method is readily reproducible using commercially available PACS software during preoperative templating.</p>","PeriodicalId":12911,"journal":{"name":"HIP International","volume":null,"pages":null},"PeriodicalIF":1.3,"publicationDate":"2024-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142285865","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Assessment of radiological and functional outcomes of complex acetabulum fracture managed with combined anterior and posterior approach in a single anaesthetic setting: a retrospective study. 在单一麻醉环境下采用前后联合方法处理复杂髋臼骨折的放射学和功能效果评估:一项回顾性研究。
IF 1.3 4区 医学
HIP International Pub Date : 2024-09-23 DOI: 10.1177/11207000241280571
Dharmendra Kumar, Narendra Singh Kushwaha, Mayank Mahendra, Sharad Verma, Ankit Sriwastava, Ashish Kumar, Kshitiz Arora, Vineet Sharma
{"title":"Assessment of radiological and functional outcomes of complex acetabulum fracture managed with combined anterior and posterior approach in a single anaesthetic setting: a retrospective study.","authors":"Dharmendra Kumar, Narendra Singh Kushwaha, Mayank Mahendra, Sharad Verma, Ankit Sriwastava, Ashish Kumar, Kshitiz Arora, Vineet Sharma","doi":"10.1177/11207000241280571","DOIUrl":"https://doi.org/10.1177/11207000241280571","url":null,"abstract":"<p><strong>Background: </strong>Appropriate selection of surgical approach for associated fractures of the acetabulum that involves both columns is still elusive. Therefore, present study aimed to assess the quality of life of complex acetabulum fracture managed with combined anterior and posterior approach (dual approach) as well as the association of postoperative reduction and patient reported outcomes.</p><p><strong>Material and methods: </strong>This retrospective study was performed on 42 associated acetabular fracture patients with involvement of both columns, who were treated with a dual approach including combined anterior modified ilio-inguinal approach in combination with posterior Kocher-Langenbeck (K-L) approach in a single anaesthetic session having minimum two years follow-up. Postoperative reduction and radiological outcomes were assessed using Matta criteria. Functional outcome was assessed by a score system developed by Merle d'Aubigné-Postel. Patient-reported outcomes were assessed using the 36-Item Short Form Survey (SF-36).</p><p><strong>Results: </strong>The mean age of participants was 47.9 ± 11.95 years and mean follow-up period was 2.8 ± 0.49 years. Anatomical reduction was achieved in 32 (76.19%) cases in postoperative period. 8 (19.04%) cases had congruent and 2 (4.76%) had incongruent reduction. Radiological and functional outcome was excellent/good <i>n</i> = 35 (83.33%) cases. Patient-reported outcome on domains physical function and role physical showed a significant improvement between 6 to 24 months period (<i>p</i> < 0.001).</p><p><strong>Conclusions: </strong>The dual approach for complex acetabulum fracture with mid-term follow-up showed good to excellent radiological and functional outcomes. A significant improvement in patient-reported outcomes on Physical function and Role physical domains of SF-36 was also seen over the follow-up period.</p>","PeriodicalId":12911,"journal":{"name":"HIP International","volume":null,"pages":null},"PeriodicalIF":1.3,"publicationDate":"2024-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142285861","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
The management of anticoagulated fragility femoral fracture patients. 抗凝股骨脆性骨折患者的管理。
IF 1.3 4区 医学
HIP International Pub Date : 2024-09-23 DOI: 10.1177/11207000241282303
Muhamed M Farhan-Alanie, William G P Eardley
{"title":"The management of anticoagulated fragility femoral fracture patients.","authors":"Muhamed M Farhan-Alanie, William G P Eardley","doi":"10.1177/11207000241282303","DOIUrl":"https://doi.org/10.1177/11207000241282303","url":null,"abstract":"<p><p>Approximately 20% of patients sustaining a fragility femur fracture use an anticoagulant, and over 30% use an antiplatelet medication, both of which can result in surgical delay. Previously confined to fractures of the proximal femur, performance assessment, outcome and surgical delay is now assessed for all fractures of the femur in older patients, including those involving implants. This narrative review draws together all literature pertaining to anticoagulation and antiplatelet management in older patients with a fracture of the femur to address 5 key points: prevalence of anticoagulant and antiplatelet use; analysis of management protocols; collation of national guidelines; comparison of perioperative management; timing of surgery and perioperative outcomes.Our review found that the prevalence of fragility femur fracture patients taking anticoagulant and antiplatelet medication ranges from 20-40% and 25-35% respectively. More anticoagulated patients are taking direct oral anticoagulants compared to vitamin k antagonists with growing implications for variation in practice and delays to surgery.Several national guidelines exist although these are characterised by marked variation, there is little standardisation, and none are generalised across all fragility femur fractures.Expedited surgery within 36 hours of admission in patients taking an anticoagulant or antiplatelet medication is safe and has been demonstrated in fractures of the proximal femur across many small number studies although no such evidence exists in non-proximal femur fractures despite this population sharing similar characteristics. There is a need for all fractures of the femur in older people to be considered when researching and assessing performance in this population to prevent needless variation and delay.</p>","PeriodicalId":12911,"journal":{"name":"HIP International","volume":null,"pages":null},"PeriodicalIF":1.3,"publicationDate":"2024-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142285866","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Patient-reported outcomes in total hip arthroplasty for patients with anatomically contoured femoral heads. 采用解剖学轮廓股骨头进行全髋关节置换术的患者报告结果。
IF 1.3 4区 医学
HIP International Pub Date : 2024-09-19 DOI: 10.1177/11207000241282985
Perry L Lim, Andrew A Freiberg, Christopher M Melnic, Hany S Bedair
{"title":"Patient-reported outcomes in total hip arthroplasty for patients with anatomically contoured femoral heads.","authors":"Perry L Lim, Andrew A Freiberg, Christopher M Melnic, Hany S Bedair","doi":"10.1177/11207000241282985","DOIUrl":"https://doi.org/10.1177/11207000241282985","url":null,"abstract":"<p><strong>Introduction: </strong>Iliopsoas tendinitis after total hip arthroplasty (THA) has become more prevalent with the increased use of large-diameter femoral heads impinging on native surrounding tissues. Anatomically contoured heads (ACH) are soft-tissue-friendly femoral heads created to minimise this issue. This retrospective study assesses iliopsoas tendinitis prevalence and re-operations in primary THAs with ACH, while determining the minimal clinically important difference (MCID) achievement and improvement with 5 patient-reported outcome measures (PROMs).</p><p><strong>Methods: </strong>We conducted a retrospective analysis of 53 ACHs from January 2020 to July 2023. Patients who completed Hip Injury and Osteoarthritis Outcome Score-Physical Function Short Form (HOOS-PS), Patient-Reported Outcomes Measurement Information System (PROMIS) Physical Function Short Form 10a (PF SF-10a), PROMIS Global Health (GH)-Mental, or PROMIS GH-Physical, and pain score questionnaires were identified. PROM scores were collected preoperatively and at 3-month and 1-year postoperative intervals. Comparisons using chi-square and ANOVA tests were applied.</p><p><strong>Results: </strong>The rates of achieving MCID and improvement within the first year were (69.2 vs. 76.9%) for PROMIS GH-Physical, (38.5 vs. 46.2%) for PROMIS GH-Mental, (71.4 vs. 92.9%) for HOOS-PS, (80.0 vs. 80.0%) for PROMIS PF SF-10a, and (74.0 vs. 91.7%) for pain scores. PROM scores at 3 months and 1 year significantly varied across all categories, except for PROMIS GH-Mental. No patients had iliopsoas tendinitis, dislocations, or re-operations.</p><p><strong>Discussion: </strong>ACH implants may alleviate anterior hip pain, while maintaining comparable strength and bio-compatibility to conventional femoral heads. This study underscores the early safety and potential of ACH implants in reducing iliopsoas tendinitis and impingement.</p>","PeriodicalId":12911,"journal":{"name":"HIP International","volume":null,"pages":null},"PeriodicalIF":1.3,"publicationDate":"2024-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142285863","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Revision rates of one new and two established hemiarthroplasty heads: a comparative cohort study from the Swedish Arthroplasty Register. 一个新的半关节成形术头和两个已成形的半关节成形术头的翻修率:来自瑞典关节成形术登记处的一项队列比较研究。
IF 1.3 4区 医学
HIP International Pub Date : 2024-09-19 DOI: 10.1177/11207000241282081
Cecilia Rogmark, Jonatan Nåtman, Sören Overgaard, Maziar Mohaddes
{"title":"Revision rates of one new and two established hemiarthroplasty heads: a comparative cohort study from the Swedish Arthroplasty Register.","authors":"Cecilia Rogmark, Jonatan Nåtman, Sören Overgaard, Maziar Mohaddes","doi":"10.1177/11207000241282081","DOIUrl":"https://doi.org/10.1177/11207000241282081","url":null,"abstract":"<p><strong>Introduction: </strong>The anatomical Lubinus SPII-stem is commonly used in hemi-arthroplasty for femoral neck fractures (FNF), combined with either the bipolar Variocup, the Unipolar Head (UH) and a newly introduced unipolar Modular Trauma Head (MTH). Similar constructs like the MTH are reported to have risk of corrosion and wear. This is the first publication evaluating the MTH.</p><p><strong>Aim: </strong>To describe the revision rate of the SPII-stems/heads which were divided into 3 groups (Variocup, UH, MTH). The head types are compared by their rate of revision at 2 years, due to any cause and to dislocation. Revision and mortality rates up to 10 years are reported.</p><p><strong>Methods: </strong>This observational cohort study based on prospectively registered data from the Swedish Arthroplasty Register included 33,059 patients with hemiarthroplasty 2005-2021 due to FNF. SPII-stems combined with Variocup (<i>n =</i> 7,281), UH (<i>n =</i> 23,980), MTH (<i>n =</i> 1,798) were included. The follow-up ended at 10 years for Variocup and UH, for MTH at 2 years. Kaplan-Meier survival analyses was used, with a 95% confidence interval (CI). Patients were censored at death or at the end of the study (31 December 2021).</p><p><strong>Results: </strong>The 2-year revision rate regardless of cause was similar between the groups: after Variocup 3.5% (CI, 3.1-4.0), UH 3.1% (CI, 2.9-3.4), MTH 3.5% (CI, 2.6-4.5).At 10 years, the Variocup and UH had similar revision rates; 4.6% (CI, 4.0-5.2) and 5.0% (CI, 4.4-5.6).For revision due to dislocation at 2 years Variocup 2.3% (CI, 1.9-2.7) had an inferior outcome compared to UH 1.5% (CI, 1.3-1.7). The MTH had an intermediate outcome, 1.7% (CI, 1.0-2.3). Variocup had a higher dislocation related revision rate, until the 10th year.The 2-year-mortality was 36% (CI, 35-37) after Variocup, 43% (CI, 42-43) after UH and 44% (CI, 41-47) after MTH.</p><p><strong>Conclusions: </strong>The hemi-heads have comparable revision rates within 2 and 10 years. The new MTH performs similar to the standard UH. The bipolar Variocup is associated with more revisions due to dislocation.</p>","PeriodicalId":12911,"journal":{"name":"HIP International","volume":null,"pages":null},"PeriodicalIF":1.3,"publicationDate":"2024-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142285864","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
6-year follow-up on migration outcomes: a randomised clinical trial of cemented vitamin E-stabilised highly crosslinked versus standard polyethylene cup in total hip arthroplasty 对移位结果的 6 年随访:全髋关节置换术中粘接维生素 E 稳定型高交联聚乙烯髋臼杯与标准聚乙烯髋臼杯的随机临床试验
IF 1.5 4区 医学
HIP International Pub Date : 2024-09-18 DOI: 10.1177/11207000241267971
Olof Sköldenberg, Sebastian Mukka, Martin Magneli
{"title":"6-year follow-up on migration outcomes: a randomised clinical trial of cemented vitamin E-stabilised highly crosslinked versus standard polyethylene cup in total hip arthroplasty","authors":"Olof Sköldenberg, Sebastian Mukka, Martin Magneli","doi":"10.1177/11207000241267971","DOIUrl":"https://doi.org/10.1177/11207000241267971","url":null,"abstract":"Background:In a previous study we have shown that a cemented vitamin E-doped highly cross-linked polyethylene (VEPE) compared to a conventional polyethylene cup in total hip arthroplasty (THA) has a slightly higher proximal migration but significantly lower wear rates up to 2 years after surgery. In this follow-up study we investigated the same cohort at 6 years.Methods:This was a double-blinded, non-inferiority, randomised controlled trial on patients with osteoarthritis, with a mean age of 66 years. Patients were randomly assigned to receive either the conventional polyethylene cup or the VEPE cup in a 1:1 ratio. The primary endpoint was proximal implant migration of the cup measured with radiostereometric analysis (RSA). Secondary endpoints included wear rate of the cup and patient-reported outcome measurements (PROM).Results:At the 6-year follow-up, 25 patients (11 controls, 14 VEPE) were available for RSA measurements, and we found no statistically significant difference in proximal migration between the VEPE and control groups. The wear rate was significantly lower in the VEPE group compared to controls, 0.03 mm/year and 0.07 mm/year, respectively with a mean difference 0.04 mm, (95% CI, 0.02–0.06 mm). There were no cup revisions and no difference in PROM between the groups.Conclusions:Based on our 6-year results, the VEPE group exhibited no statistical or clinically relevant difference compared to the control group, and the wear rate was significantly lower in the VEPE group. The use of a cemented vitamin E-doped highly cross-linked cup is a good option in total hip arthroplasty.","PeriodicalId":12911,"journal":{"name":"HIP International","volume":null,"pages":null},"PeriodicalIF":1.5,"publicationDate":"2024-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142267469","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Does the calcar femorale affect the position of uncemented short stems? 股骨髁是否会影响非骨水泥短茎的位置?
IF 1.3 4区 医学
HIP International Pub Date : 2024-09-16 DOI: 10.1177/11207000241277687
Jan Weidner, Michael Wyatt, Martin Beck
{"title":"Does the calcar femorale affect the position of uncemented short stems?","authors":"Jan Weidner, Michael Wyatt, Martin Beck","doi":"10.1177/11207000241277687","DOIUrl":"https://doi.org/10.1177/11207000241277687","url":null,"abstract":"<p><strong>Background and purpose: </strong>Metaphyseal-stabilised short stems rely on sufficient metaphyseal fixation and are inserted by following the medial cortex. This type of stem is used extensively in our institution, and we observed on occasion unintended implant positioning with an increased distance between the implant and the medial cortex. A bony structure within the proximal femur which was first described in 1874 and named the calcar femorale, coincides with this phenomenon.The aim of this study was to investigate the impact of the calcar femorale on the position of a metaphyseal-stabilised short stem.</p><p><strong>Patients and methods: </strong>The frequency of cases with an increased distance between medial cortex and the implanted short stem was analysed in 52 consecutive patients. Additionally, we performed an anatomical CT study with 60 cadaveric femora to obtain more detailed information on the anatomy of the calcar femorale. Detailed measurements regarding the calcar femorale and its relationship to the proximal femur were obtained. From this, we derived implications for the implantation of a short stem prosthesis.</p><p><strong>Results: </strong>In 50% of all cases, we found an increased gap between the stem and the medial cortex. An increased gap did not significantly affect stem size, position, or subsidence rate, but in cases with an increased gap we found fewer stems with a radiologically optimum fit. The calcar could be identified in all 60 cadavers. The calcar femorale angle showed a high correlation with the mechanical antetorsion (0.87, <i>p</i> = 0.02) and the functional antetorsion (0.86, <i>p</i> = 0.05) of the femur.</p><p><strong>Conclusions: </strong>The calcar femorale is a consistent anatomical structure which may be the cause for an increased gap medial to the short stem in 50% of our cases. It limits the intramedullary space and influences both stem size and orientation. The CF angle which correlates with femoral antetorsion may influence the anteversion of the stem.</p>","PeriodicalId":12911,"journal":{"name":"HIP International","volume":null,"pages":null},"PeriodicalIF":1.3,"publicationDate":"2024-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142285862","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Long-term outcomes of acetabular impaction grafting with cemented cups and trabecular metal for revision hip arthroplasty: a follow-up study 用骨水泥杯和小梁金属进行髋臼内陷移植翻修髋关节置换术的长期效果:一项随访研究
IF 1.5 4区 医学
HIP International Pub Date : 2024-09-10 DOI: 10.1177/11207000241266939
Mark Curtin, Shane P Russell, Rayyan S Mirdad, Shane C Irwin, Fiachra E Rowan, Eric L Masterson, Finbarr Condon
{"title":"Long-term outcomes of acetabular impaction grafting with cemented cups and trabecular metal for revision hip arthroplasty: a follow-up study","authors":"Mark Curtin, Shane P Russell, Rayyan S Mirdad, Shane C Irwin, Fiachra E Rowan, Eric L Masterson, Finbarr Condon","doi":"10.1177/11207000241266939","DOIUrl":"https://doi.org/10.1177/11207000241266939","url":null,"abstract":"Introduction:Revision hip arthroplasty in the presence of complex acetabular deficiencies is challenging. Cement, allograft, reconstruction rings and porous trabecular metal now provide versatile options for acetabular fixation and restoration of acetabular offset. We compare acetabular impaction bone grafting (AIBG) and trabecular metal (TM) cups at long-term follow-up.Methods:53 patients who underwent revision hip arthroplasty were retrospectively reviewed from local joint registry data. 36 patients were revised using AIBG and 17 with TM. Median clinical follow-up was 9.57 (2.46–18.72) years and 9.65 (7.22–12.46) years, respectively. 82% of the TM group and 63% of the AIBG group were ⩾ Paprosky 2C. Re-revision was considered failure. Radiographs demonstrating 5 mm of femoral head migration and 5° of acetabular component inclination change were considered loose.Results:Patients receiving AIBG were younger (68 vs. 74 years) with a longer interval from initial arthroplasty to revision (17 vs. 13 years). Revisions in both groups were indicated most commonly for failed cementing (AIBG 88.9% vs. TM 70.5%). No TM reconstructions underwent re-revision, with only 1 failing at 6.3 years, compared with 9 AIBG re-revisions. When revising for sepsis, 33% of AIBG revisions failed.Conclusions:AIBG demonstrated high failure rates at long-term follow-up when compared to TM constructs. We recommend the use of AIBG in small cavitary defects only. We strongly advise against its use in the setting of significant bony defects and for prosthetic joint infection.","PeriodicalId":12911,"journal":{"name":"HIP International","volume":null,"pages":null},"PeriodicalIF":1.5,"publicationDate":"2024-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142178005","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Relation of native acetabular anteversion to the orientation of transverse acetabular ligament 原生髋臼前倾角与髋臼横韧带方向的关系
IF 1.5 4区 医学
HIP International Pub Date : 2024-09-10 DOI: 10.1177/11207000241267705
Michal Kuchař, Ondřej Pelc, Alexander Morávek, Petr Henyš, Axel Heinemann, Benjamin Ondruschka, Tomáš Kučera
{"title":"Relation of native acetabular anteversion to the orientation of transverse acetabular ligament","authors":"Michal Kuchař, Ondřej Pelc, Alexander Morávek, Petr Henyš, Axel Heinemann, Benjamin Ondruschka, Tomáš Kučera","doi":"10.1177/11207000241267705","DOIUrl":"https://doi.org/10.1177/11207000241267705","url":null,"abstract":"Background:Precise positioning of the acetabular component during total hip replacement is the key to achieving optimal implant function and ensuring long-term patient comfort. However, different anatomical variations, degenerative changes, dysplasia, and other diseases make it difficult. In this study, we discuss a method based on the three-dimensional direction of the transverse ligament, predicting native acetabular anteversion with higher accuracy.Methods:Angular positions of the acetabulum and direction of the transverse ligament were automatically calculated from routine computed tomography data of 270 patients using a registration algorithm. The relationship between acetabular angles and ligament direction and their relationship with sex, age, and pelvic tilt were sought. These relationships were then modelled using multilinear regression.Results:Including the direction of the transverse ligament in the sagittal and transverse planes as a regressor in the multilinear model explained the variation in acetabular anteversion (R<jats:sup>2</jats:sup> = 0.76 for men, R<jats:sup>2</jats:sup> = 0.63 for women; standard deviation in prediction: men, 3.92° and women, 4.00°).Conclusions:The results indicate that the ligament was suitable as a guidance structure almost insensitive to the ligament in the sagittal and transverse planes must be considered. Estimation based on the direction in only 1 plane was not sufficiently accurate. The operative acetabular inclination was not correlated with the direction of the ligament. The correlations were higher in men than in women.","PeriodicalId":12911,"journal":{"name":"HIP International","volume":null,"pages":null},"PeriodicalIF":1.5,"publicationDate":"2024-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142178004","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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