HIP International最新文献

{"title":"1-year outcomes of robotic-assisted, computer-assisted, and manual total hip arthroplasty after the learning curve.","authors":"Periklis Giannakis, Jashvant Poeran, Juliet E Rowe, Sophia T Zhuang, Crispiana Cozowicz, Jiabin Liu, Stavros G Memtsoudis, Alexander S McLawhorn, Robert G Marx, Alejandro Gonzalez Della Valle, Lazaros Poultsides","doi":"10.1177/11207000261438113","DOIUrl":"https://doi.org/10.1177/11207000261438113","url":null,"abstract":"<p><strong>Introduction: </strong>While comparisons exist between manual (MA-THA), computer-assisted (CA-THA), and robotic-assisted total hip arthroplasty (RA-THA), they have not considered surgeon/hospital learning curves. Therefore, we compared surgical outcomes between MA-THA/CA-THA/RA-THA among hospitals with ⩾1 year of RA-THA experience.</p><p><strong>Methods: </strong>In this retrospective study (2016-2023, Premier Healthcare Database), we included adults undergoing elective MA-THA/CA-THA/RA-THA for non-traumatic/non-neoplastic diagnoses. Our primary outcome was any mechanical complication within 1-year follow-up; secondary outcomes included any infection within 1 year. We conducted pairwise mixed-effects logistic regression and reported odds ratios (OR) and 95% confidence intervals (CI).</p><p><strong>Results: </strong>Among 75,966 MA-THAs, 6,207 CA-THAs and 17,497 RA-THAs, odds of any mechanical complication within 1-year were: CA-THA versus MA-THA (OR 0.63, CI 0.52-0.75; <i>p</i> < 0.001), RA-THA versus MA-THA (OR 0.81, CI 0.73-0.90; <i>p</i> < 0.001) and RA-THA versus CA-THA (OR 1.44, CI 1.14-1.82; <i>p</i> = 0.003). Differences between RA-THA and CA-THA were primarily due to higher odds of mechanical loosening (OR 2.40, CI 1.19-4.85; <i>p</i> = 0.015) with RA-THA. Dislocation was less likely with RA-THA compared to MA-THA (OR 0.57, CI 0.44-0.72; <i>p</i> < 0.001). CA-THA (OR 0.46 CI 0.34-0.63; <i>p</i> < 0.001) and RA-THA (OR 0.83 CI 0.71-0.97; <i>p</i> = 0.022) were associated with significantly lower odds of infection within 1 year compared to MA-THA. RA-THA was associated with higher odds of infection within 1 year compared to CA-THA (OR 2.11 CI 1.43-3.09; <i>p</i> < 0.001).</p><p><strong>Conclusions: </strong>With up to 1-year follow-up, CA-THA was associated with the lowest odds for mechanical complications, primarily due to mechanical loosening and infection.</p>","PeriodicalId":12911,"journal":{"name":"HIP International","volume":" ","pages":"11207000261438113"},"PeriodicalIF":1.1,"publicationDate":"2026-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147837153","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}

{"title":"Prevalence and associated risk factors for hypovitaminosis D in patients scheduled for primary total hip arthroplasty in Germany.","authors":"Jan Oberfeld, Lisa Wiederhold, Miledi Hoxha, Tizian Heinz, Maximilian Rudert, Felix Hochberger, Manuel Weissenberger, Konstantin Horas","doi":"10.1177/11207000261437108","DOIUrl":"https://doi.org/10.1177/11207000261437108","url":null,"abstract":"<p><strong>Background: </strong>Hypovitaminosis D is widespread in orthopaedic patients and may influence outcomes following joint arthroplasty. However, data specifically addressing vitamin D status in patients undergoing primary total hip arthroplasty (THA) remain limited. This study aimed to determine the prevalence of hypovitaminosis D and identify associated risk factors in a large German THA cohort.</p><p><strong>Methods: </strong>In this prospective single-centre study, 679 consecutive patients scheduled for primary THA due to osteoarthritis were evaluated over a 12-month period. Preoperative serum 25-hydroxyvitamin D (25[OH]D), parathyroid hormone, and calcium levels were measured. Vitamin D status was categorised as deficiency (⩽19 ng/mL), insufficiency (20-29 ng/mL), or sufficiency (⩾30 ng/mL). Associations between vitamin D status and demographic, clinical, and seasonal variables were analysed using χ² tests, ANOVA, and multivariable linear and logistic regression models.</p><p><strong>Results: </strong>The mean serum 25(OH)D level was 26.0 ± 13.2 ng/mL, and hypovitaminosis D was present in 66,3% of patients (33.9% deficiency, 32.4% insufficiency). Season of sampling showed no significant influence on vitamin D levels. In multivariable analysis, preoperative vitamin D supplementation was the strongest positive predictor of higher 25(OH)D levels (B = +16.1 ng/mL; <i>p</i> < 0.001), while higher BMI category (B = -1.64 ng/mL per category; <i>p</i> < 0.001) and male sex (B = -2.45 ng/mL; <i>p</i> = 0.010) were independently associated with lower levels. Logistic regression confirmed reduced odds of vitamin D sufficiency among men (OR 0.59; <i>p</i> = 0.007) and with increasing BMI category (OR 0.74; <i>p</i> = 0.002). Vitamin D status was not associated with smoking, comorbidity burden, season, or functional scores (WOMAC, EuroQol).</p><p><strong>Conclusions: </strong>Hypovitaminosis D is highly prevalent in German patients undergoing primary THA, independent of season. Obesity and male sex are significant risk factors, whereas supplementation is strongly protective. Routine preoperative assessment and targeted optimisation of vitamin D levels, particularly in high-risk subgroups, may represent a simple, cost-effective component of arthroplasty prehabilitation. Further research is needed to determine whether correcting vitamin D deficiency translates to improved postoperative outcomes.</p>","PeriodicalId":12911,"journal":{"name":"HIP International","volume":" ","pages":"11207000261437108"},"PeriodicalIF":1.1,"publicationDate":"2026-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147837237","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}

{"title":"MRI at 5 years predicts upsloping acetabular sourcil at skeletal maturity in developmental dysplasia of the hip.","authors":"Takashi Koura, Tomonori Tetsunaga, Kazuki Yamada, Tomohiro Inoue, Ryuichiro Okuda, Yasutaka Masada, Tomoko Tetsunaga, Yuki Okazaki, Toshifumi Ozaki","doi":"10.1177/11207000261436397","DOIUrl":"https://doi.org/10.1177/11207000261436397","url":null,"abstract":"<p><strong>Introduction: </strong>Acetabular sourcil morphology has been linked to hip instability and pain. We investigated whether MRI findings at age 5 years predict sourcil morphology at skeletal maturity in developmental dysplasia of the hip (DDH).</p><p><strong>Methods: </strong>We retrospectively reviewed 71 surgically treated hips that were followed to skeletal maturity. On final anteroposterior radiographs, the sourcil was classified as type A (downsloping), type B (horizontal), or type C (upsloping). Coronal MRI at 5 years was used to measure bony, cartilaginous, and labral acetabular indices and centre-edge angles, and the labral junction obliquity angle (LJOA). Predictors of type C morphology were assessed using multivariable logistic regression and ROC analyses.</p><p><strong>Results: </strong>At 5 years, radiographic acetabular index and centre-edge angle did not differ among sourcil types. In contrast, hips that developed type C morphology showed smaller cartilaginous and labral centre-edge angles and a smaller LJOA on MRI. In multivariable analysis, a smaller cartilaginous centre-edge angle and a smaller LJOA independently predicted type C morphology. Optimal cutoff values were 23° for the cartilaginous centre-edge angle (AUC 0.902) and 89° for the labral junction obliquity angle (AUC 0.964).</p><p><strong>Conclusion: </strong>MRI at age 5 years may help identify DDH hips at risk of developing an upsloping sourcil at skeletal maturity.</p>","PeriodicalId":12911,"journal":{"name":"HIP International","volume":" ","pages":"11207000261436397"},"PeriodicalIF":1.1,"publicationDate":"2026-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147837149","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}

{"title":"Increased cross-sectional area of the gluteus maximus after hip arthroscopy for femoroacetabular impingement correlates with patient-reported outcomes.","authors":"Michael R Moore, Brittany DeClouette, Larry Chen, Thomas Hoffmeister, Garrett L Ruff, Jairo Triana, Christopher J Burke, Daniel L Kaplan, Thomas Youm","doi":"10.1177/11207000261419797","DOIUrl":"https://doi.org/10.1177/11207000261419797","url":null,"abstract":"<p><strong>Introduction: </strong>The purpose of this study was to conduct an analysis of the cross-sectional area (CSA) of hip musculature before and after hip arthroscopy (HA) for femoroacetabular impingement (FAI). The hypothesis was that there will be a significant increase in the CSA of analysed hip muscles that will correlate with increases in PROs following surgery.</p><p><strong>Methods: </strong>This is a single-centre, single-surgeon, retrospective analysis performed between August 2011 and February 2022. All hips that had a preoperative MRI within 1 year of their date of surgery and ≥1 postoperative MRI >2 months after surgery were included. Cross-sectional areas of the gluteus maximus, gluteus medius, gluteus minimus, iliopsoas, pectineus, sartorius, rectus femoris and tensor fascia lata muscles were measured by 1 blinded researcher and results were checked for reliability by a musculoskeletal radiologist. Normally distributed continuous variables between cohorts were compared using the independent samples <i>t</i>-test.</p><p><strong>Results: </strong>89 hips met criteria to be included in the analysis. The cohort had an average age of 35.8 ± 15.7 years, was 66.3% female, and had an average BMI of 23.3 ± 8.1 kg/m². The mean time between surgery and postoperative MRI was 14.8 ± 8.3 months. There was a significant difference between preoperative and postoperative hip muscle CSA for gluteus maximus (4298.6 ± 883.6 mm² vs. 4384.6 ± 967.6 mm², <i>p</i> < 0.01) and gluteus minimus (1037.0 ± 199.2 mm² vs. 1074.9 ± 202.3 mm², <i>p</i> < 0.001). A linear regression found that an increase in the change in CSA of the gluteus maximus (β = 3.237, <i>p</i> = 0.037) significantly predicted an increase in mHHS at 1 year when controlling for time between surgery and post-op MRI.</p><p><strong>Conclusions: </strong>Gluteus maximus and minimus muscles demonstrated significantly increased CSA after HA for FAI patients. Change in CSA was positively correlated with PROs for the gluteus maximus at 1-year follow-up. These findings underscore the clinical significance of muscle adaptations following hip arthroscopy for FAI.</p>","PeriodicalId":12911,"journal":{"name":"HIP International","volume":" ","pages":"11207000261419797"},"PeriodicalIF":1.1,"publicationDate":"2026-04-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147769927","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}

{"title":"Initial stability and bone response at 6 months post-operation in the Avenir complete stem: a comparative study by femoral canal shape.","authors":"Musashi Ima, Tamon Kabata, Daisuke Inoue, Yu Yanagi, Takahiro Iyobe, Naoya Fujimaru, Satoru Demura","doi":"10.1177/11207000251410505","DOIUrl":"https://doi.org/10.1177/11207000251410505","url":null,"abstract":"<p><strong>Objective: </strong>To compare the initial postoperative fixation and bone response at 6 months among different femoral canal morphologies in patients implanted with a specific fully hydroxyapatite-coated femoral stem.</p><p><strong>Methods: </strong>This study included 95 hip joints of patients who underwent primary total hip arthroplasty between 19 October 2020 and 20 October 2023 (17 male and 78 female). Femoral canal shapes were categorised into Dorr types A, B, and C using the canal flare index.</p><p><strong>Results: </strong>Dorr types A, B, and C were observed in 17, 76, and 25 cases, respectively, and averaged -0.17 ± 1.99°, 0.71 ± 2.24°, and 1.57 ± 1.25°, respectively in the coronal plane, indicating a trend toward varus insertion. The medullary cavity occupancy rate was highest in Dorr type C (17.6 ± 9.81%). The bone contact rates were higher in Zones 3 and 7 for Dorr type C than for types A and B. At 6 months, spot welds indicative of fixation appeared in all cases, with Dorr type A showing an absence of spot welds in Zones 1 and 7, suggesting a risk of distal fixation.</p><p><strong>Conclusions: </strong>Although the implant generally provides satisfactory fixation, the risk of malalignment and distal fixation associated with specific femoral canal morphologies should be carefully considered.</p>","PeriodicalId":12911,"journal":{"name":"HIP International","volume":" ","pages":"11207000251410505"},"PeriodicalIF":1.1,"publicationDate":"2026-04-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147769407","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}

{"title":"Is there a place for routine use of cemented acetabular fixation in primary total hip arthroplasty for osteoarthritis? Equivalence demonstrated in an analysis of 96,574 cases from the Australian Orthopaedic Association National Joint Replacement Registry.","authors":"Richard J Hanly, Sarah L Whitehouse, Carl Holder, Richard de Steiger, Christopher J Wall, A John Timperley, Ross W Crawford, Dirk van Bavel","doi":"10.1177/11207000261430706","DOIUrl":"https://doi.org/10.1177/11207000261430706","url":null,"abstract":"<p><strong>Introduction/aim: </strong>This study utilises Australian Orthopaedic Association National Joint Replacement Registry (AOANJRR) data to compare survivorship of total hip arthroplasty (THA) with cemented and cementless acetabular fixation. To minimise confounders, only cases using cemented polished tapered stems with metal heads and highly cross-linked polyethylene (XLPE) liners for primary diagnosis of osteoarthritis were included.</p><p><strong>Methods: </strong>AOANJRR data were analysed from 01 September 1999 to 31 December 2022. The study population included all primary conventional THA performed for osteoarthritis using a cemented polished tapered stem with a bearing surface of metal head articulating with XLPE. These procedures were divided into two groups: procedures with either cemented or cementless acetabular fixation. The analyses were undertaken using Kaplan-Meier estimates of survivorship and hazard ratios (HR) from Cox proportional hazards models. Results were stratified by age and 3 surgeon volume groups: ⩽10, 10-25, and >25 procedures per surgeon per year.</p><p><strong>Results: </strong>There were 96,574 THAs performed for osteoarthritis using a cemented polished tapered stem included. Of these, 5,926 used cemented and 90,648 used cementless acetabular fixation. There was no difference in the rate of revision when cemented acetabular were compared to cementless acetabular procedures (HR 1.01; 95% CI, 0.86-1.18; <i>p</i> = 0.916). The most common reasons for revision surgery were similar for both fixation methods and included periprosthetic fracture, dislocation/instability and infection. There were no differences in the rate of revision when procedures were stratified by age or surgeon volume.</p><p><strong>Conclusions: </strong>For patients undergoing a primary THA for osteoarthritis there is no difference in the rate of revision between cemented or cementless acetabular fixation when utilising a cemented polished stem with modern bearing surfaces. The authors advocate the use of cemented acetabular fixation as a viable alternative and emphasise the need for continued teaching of the skills required to ensure the technique is not lost for future generations of orthopaedic surgeons.</p>","PeriodicalId":12911,"journal":{"name":"HIP International","volume":" ","pages":"11207000261430706"},"PeriodicalIF":1.1,"publicationDate":"2026-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147645017","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}

{"title":"The terrible 2s: twice the risk of inpatient complications in 2nd geriatric hip fractures.","authors":"Carolyn F Herbosa, Christopher Pettit, Abhishek Ganta, Kenneth Egol, Sanjit Konda","doi":"10.1177/11207000251398425","DOIUrl":"https://doi.org/10.1177/11207000251398425","url":null,"abstract":"<p><strong>Purpose: </strong>To characterise differences in baseline demographics, outcomes, and cost between 1st and 2nd (contralateral) hip fracture hospitalisations in the same patient that occur within 5 years of each other.</p><p><strong>Methods: </strong>A retrospective review of operatively treated hip fractures was performed at an academic medical centre.</p><p><strong>Inclusion criteria: </strong>age ⩾65 years, presence of a first and second, contralateral hip fracture with OTA 31A/B classification within 5 years of the hip fracture. Analysis was based on the chronological order of their fracture - 1st hip fracture versus 2nd hip fracture. Comparison of patients' demographics, postoperative complications, 90-day readmission rates, 1-year mortality, discharge location, and direct inpatient hospitalisation costs were compared. Major complications were defined as: sepsis, acute respiratory failure, myocardial infarction, stroke, pulmonary embolus, or death.</p><p><strong>Results: </strong>A total of 78 patients' 1st hip fracture hospitalisation was compared to their 2nd hip fracture hospitalisation. Mean time to 2nd hip fracture was 589.9 ± 508.4 days and mean age was 84.2 ± 8.2 years. More second hip fracture patients were household ambulators (47% vs. 26%, <i>p</i> = 0.012) and assistive device users (87% vs. 50%, <i>p</i> = 0.001). Second hip fracture patient also trended towards being sicker (CCI 2.1 ± 1.9 vs. 1.6 ± 1.6, <i>p</i> = 0.062; STTGMA: 2.4% ± 5.9% vs. 1.2% ± 0.2.0%, <i>p</i> = 0.081). The 2nd hip fracture cohort also trended to having more major complications (21% vs. 10%, <i>p</i> = 0.05) and more minor complications (58% vs. 44%, <i>p</i> = 0.08). There were no other differences in outcomes and hospitalisation cost.</p><p><strong>Conclusions: </strong>Patients who sustain a 2nd contralateral hip fracture within 5 years of their first hip fracture demonstrate a trend towards having more major and minor inpatient complications There are otherwise comparable hospital quality measures and cost profile during their 2nd hip fracture hospitalisation compared to their 1st hip fracture hospitalisation. Resources should be allocated to minimise the risk of complications in 2nd hip fracture patients.</p>","PeriodicalId":12911,"journal":{"name":"HIP International","volume":" ","pages":"11207000251398425"},"PeriodicalIF":1.1,"publicationDate":"2026-04-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147633363","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}

{"title":"Total hip arthroplasty rehabilitation through a mobile application: a retrospective observational study.","authors":"Joaquín Zambrano-Martín, Jesus Moreta, Antonia Gómez-Conesa, Roberto Méndez-Sánchez, Miguel Mendoza-Puente","doi":"10.1177/11207000261423149","DOIUrl":"https://doi.org/10.1177/11207000261423149","url":null,"abstract":"<p><strong>Introduction: </strong>Postoperative rehabilitation following total hip arthroplasty is important for optimising functional recovery and pain relief. This study compares a mobile application providing functional recovery exercises and pain management education with in-person physical therapy in patients undergoing total hip arthroplasty.</p><p><strong>Methods: </strong>A retrospective study was conducted with 2 cohorts (<i>n</i> = 94) matched using propensity score matching. The App group (<i>n</i> = 47) used a mobile app for postoperative follow-up, while the control group (<i>n</i> = 47) received conventional follow-up. Functional outcomes (Harris Hip Score [HHS], Merle D'Aubigné [MDP], WOMAC) and pain intensity (visual analogue scale [VAS]) were assessed preoperatively, at one month, and 3 months post-intervention.</p><p><strong>Results: </strong>Both groups showed significant improvements in all measurements compared to preoperative values. However, the App group showed significant improvements compared to the control group in the following outcome: HHS at 3 months (<i>P</i> = 0.02), improved MDP mobility (<i>P</i> = 0.02) and walking ability (<i>P</i> <i><</i> 0.0001), and lower VAS pain scores at one month (<i>P</i> = 0.004) and 3 months (<i>P</i> = 0.01).</p><p><strong>Conclusions: </strong>The mobile app program with recovery exercises and pain management is more effective than in-person physiotherapy in improving function and reducing pain after total hip arthroplasty.</p><p><strong>Registration: </strong>The study was registered with the US National Institutes of Health (NIH) under the number: NCT06606158. https://clinicaltrials.gov/study/NCT06606158.</p>","PeriodicalId":12911,"journal":{"name":"HIP International","volume":" ","pages":"11207000261423149"},"PeriodicalIF":1.1,"publicationDate":"2026-04-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147633325","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}

{"title":"Outcomes following Birmingham hip resurfacing at a minimum of 10 years follow-up: an observational study.","authors":"Kunal Mohan, Martin Davey, Enda Gavin, Ken Kaar, William Curtin, Colin Murphy","doi":"10.1177/11207000251390405","DOIUrl":"https://doi.org/10.1177/11207000251390405","url":null,"abstract":"<p><strong>Background: </strong>The role of the Birmingham Hip Resurfacing (BHR) implant in modern arthroplasty remains controversial. The purpose of this study was to evaluate the functional outcomes, radiological outcomes and revision rates following BHR in a single institution at a minimum of 10 years follow-up.</p><p><strong>Materials and methods: </strong>An observational study was undertaken evaluating patient demographics & surgical details. The overall revision rate was quantified, and postoperative functional status was defined using the modified Harris Hip Score (mHHS). Implant survivorship was illustrated utilising a Kaplan-Meier estimator plot. A further subgroup analysis was undertaken comparing those with a unilateral BHR (Group 1), bilateral BHRs (Group 2) and those who have underwent a unilateral BHR and contralateral non-MoM total hip arthroplasty (THA) (Group 3).</p><p><strong>Results: </strong>126 BHR procedures undertaken in 103 patients with a mean follow-up of 15.3 years were suitable for inclusion. This cohort consisted of 109 males (86.5%), with a mean age of 56.7 years (SD ± 8.3) at time of index BHR. 8 BHRs (6.3%) had been revised at a mean of 11.2 years (SD ± 5.4) following index BHR at time of follow-up, with an overall implant survival rate of 97% and 94% at 10 and 15 years postoperatively. In the remaining BHR cases the mean MHHS, cobalt and chromium levels at time of most recent follow-up were 85.2 (SD ± 17.6), 50 nmol/L and 42.2 nmol/L respectively. No significant difference was identified between Groups 1, 2 and 3 in regards overall revision rates, functional outcomes, radiological changes and serum metal ion levels.</p><p><strong>Conclusions: </strong>BHR is associated with acceptable revision rates, functional outcomes and serum metal ion levels at a minimum of 10 years follow-up. BHR may potentially be considered as a viable alternative to THA in the carefully selected younger patient when undertaken in units with appropriate surgical expertise and follow-up.</p>","PeriodicalId":12911,"journal":{"name":"HIP International","volume":" ","pages":"11207000251390405"},"PeriodicalIF":1.1,"publicationDate":"2026-04-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147633292","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}

{"title":"Is combined gluteus maximus and tensor fascia latae transfer for irreparable hip abductor tears superior to gluteus maximus transfer alone? A systematic review and meta-analysis.","authors":"Sean C Clark, Seungjun Lee, Terence L Thomas, Mario Hevesi, Rafael J Sierra, Graham S Goh","doi":"10.1177/11207000261425168","DOIUrl":"https://doi.org/10.1177/11207000261425168","url":null,"abstract":"<p><strong>Background: </strong>Chronic hip abductor insufficiency remains a challenging problem to treat and can result in significant disability in some patients. Tendon transfers involving the gluteus maximus (GM) or combined GM with tensor fascia latae (GM+TFL) are common options for surgical reconstruction. The purpose of this systematic review was to compare clinical outcomes, complications, and revisions rates of patients who underwent GM transfer or GM+TFL transfer for irreparable hip abductor tears.</p><p><strong>Methods: </strong>PubMed (MEDLINE), Scopus (EMBASE, MEDLINE, COMPENDEX), and Cochrane databases were used to conduct a systematic review of articles from inception to February 2025. A total of 18 studies were included (11 GM transfer, 7 GM+TFL transfer). Demographics, hip setting (native hip, primary total hip arthroplasty [THA], revision THA), patient-reported outcome measures, presence of Trendelenburg gait, abduction strength, complication rates, and revision rates were analysed.</p><p><strong>Results: </strong>A total of 207 patients (208 hips) underwent GM transfer, while 55 patients (55 hips) underwent GM+TFL transfer. Meta-analyses demonstrated that both techniques yielded significant preoperative to postoperative improvements in modified Harris Hip Scores/Harris Hip Scores and Visual Analogue Scale pain scores (<i>p</i> < 0.001). In total, 33.9% of patients who underwent GM transfer had a persistent Trendelenburg gait postoperatively, compared to 48.1% of those who underwent GM+TFL transfer. The complication rate was 16.8% (23/137) for patients who underwent GM transfer and 2.7% (1/37) for those who underwent GM+TFL transfer; while revision rates were 5.9% (9/152) and 3.6% (2/55), respectively.</p><p><strong>Conclusions: </strong>Both GM and GM+TFL transfers yielded comparable outcomes in patients with chronic hip abductor insufficiency not amendable to primary repair. The complication rate was substantially higher in patients who underwent GM transfer, whereas revision rates were comparably low for both techniques. In particular, a sizeable proportion of patients continued to exhibit a persistent Trendelenburg gait postoperatively following both surgical techniques, highlighting the complexity of this pathology.PROSPERO registration number:CRD420251002466.</p>","PeriodicalId":12911,"journal":{"name":"HIP International","volume":" ","pages":"11207000261425168"},"PeriodicalIF":1.1,"publicationDate":"2026-04-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147616169","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}