HIP International最新文献

{"title":"Comparing femoral head visualisation of modified medial hip approach versus Smith-Petersen approach: a cadaveric anatomical study.","authors":"Paween Tangchitphisut, Theerachai Apivatthakakul, Thanawat Buranaphatthana","doi":"10.1177/11207000251344824","DOIUrl":"https://doi.org/10.1177/11207000251344824","url":null,"abstract":"<p><strong>Background: </strong>Femoral head fractures are a specific type of hip fracture that typically result from high-energy trauma. Surgical intervention is generally required for most displaced femoral head fractures. The anterior-based approach, particularly the Smith-Petersen approach (SPA), is a commonly recommended surgical approach for fixation in these cases. However, the fracture fragments of the femoral head usually occur at the anteromedial region. As a result, the medial hip approach (MHA) might serve as an alternative and suitable option for femoral head fractures and intra-articular pathology.</p><p><strong>Purpose: </strong>This study aimed to determine and compare the visualisation area of the femoral head between the modified-medial hip approach (MHA) and the Smith-Petersen approach (SPA).</p><p><strong>Methods: </strong>14 fresh frozen cadavers were included in the study, with each hip being approached using both the modified MHA and SPA techniques. Measurements of area and localisation were performed to ideally simulate the intraoperative visualisation perspective of the surgeon for each approach.</p><p><strong>Results: </strong>The findings demonstrated that the modified-MHA approach provided superior exposure of the medial and posterior aspects of the femoral head compared to the SPA.</p><p><strong>Conclusions: </strong>The MHA may be considered as a viable alternative for the treatment of femoral head fractures and intra-articular pathologies.</p>","PeriodicalId":12911,"journal":{"name":"HIP International","volume":" ","pages":"11207000251344824"},"PeriodicalIF":1.3,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144198958","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 statistical fragility of arthroplasty versus fixation for femoral neck fractures: a systematic review of randomised controlled trials.","authors":"Auston R Locke, Avanish Yendluri, John J Corvi, John K Cordero, Michael N Megafu, Anya Wang, Steven J Yacovelli, David A Forsh, Calin S Moucha, Paul Tornetta, Robert L Parisien","doi":"10.1177/11207000251343279","DOIUrl":"https://doi.org/10.1177/11207000251343279","url":null,"abstract":"<p><strong>Background: </strong>In the setting of femoral neck fractures, hip arthroplasty and internal fixation are considered as treatment interventions depending on the patient's age and fracture characteristics. In this study, we utilised the fragility index (FI), reverse fragility index (rFI), and fragility quotient (FQ) to evaluate the robustness of statistical outcomes reported in randomised controlled trials (RCTs) evaluating arthroplasty versus fixation in the treatment of femoral neck fractures.</p><p><strong>Methods: </strong>Pubmed, Embase, and MEDLINE were queried from 2010 to present for RCTs reporting dichotomous outcomes where intervention arms were stratified as arthroplasty versus fixation for femoral neck fractures. The FI and rFI were calculated by outcome event reversals until the significance of the outcome was altered for significant and nonsignificant outcomes, respectively. FQ was calculated as the FI divided by the study sample size. Subgroup analysis was performed based on type of arthroplasty versus fixation and outcome type.</p><p><strong>Results: </strong>985 RCTs were screened with 9 studies included in the analysis comprising 30 total outcomes. The median FI across all outcomes was 5 (IQR 2-10.75) with an associated FQ of 0.039 (IQR 0.019-0.059). For 14 significant outcomes, the median FI was 4.5 (IQR 2.5-12.5) with an associated FQ of 0.045 (IQR 0.020-0.098). Across 16 nonsignificant outcomes, the median rFI was 5.5 (IQR 2.0-8.5) with an associated FQ of 0.039 (IQR 0.017-0.049). In 11/30 (36.67%) of study outcomes, the number of patients lost to follow-up was greater than or equal to the median FI. The studies evaluating hip hemiarthroplasty versus fixation were the most fragile with a median FQ of 0.018 (IQR 0.014-0.069) across 10 outcomes from 4 RCTs. The 4 studies evaluating total hip arthroplasty versus fixation were the least fragile with a median FQ of 0.049 (0.024-0.059) across 15 outcomes. 1 study evaluated either THA or HA versus fixation and reported 5 outcomes with a median FQ of 0.039 (IQR 0.039-0.044). The RCTs assessing arthroplasty versus fixation for non-displaced fractures were found to be more fragile (median FQ 0.016) compared to the RCTs looking at displaced fractures (median FQ 0.042). By outcome type, the median FI's were 4 (IQR 2-11), 6 (IQR 2-6), 16 (IQR 10-16), and 5 (IQR 3.5-6.5) for failure/reoperation, complications/adverse events, mortality, and \"other\", respectively.</p><p><strong>Conclusions: </strong>The statistical findings reported in RCTs comparing arthroplasty to fixation for femoral neck fractures exhibit considerable fragility, suggesting that minor changes in patient follow-up or outcome occurrences could significantly impact results. To enhance the interpretation of comparative trials in orthopaedic trauma we advocate for the routine inclusion of FI and FQ alongside <i>p</i>-values.</p>","PeriodicalId":12911,"journal":{"name":"HIP International","volume":" ","pages":"11207000251343279"},"PeriodicalIF":1.3,"publicationDate":"2025-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144110252","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":"Arthroscopic iliopsoas release following hip arthroplasty surgery: a successful procedure but beware of instability!","authors":"Alistair I W Mayne, Awf Al-Shahwani, Lucie Gosling, Peter Wall, Angelos Politis, Callum McBryde","doi":"10.1177/11207000251339063","DOIUrl":"https://doi.org/10.1177/11207000251339063","url":null,"abstract":"<p><strong>Background: </strong>Iliopsoas impingement after total hip replacement is an uncommon, but well recognised cause of residual groin pain. The primary aim of this study was to review patient outcomes following arthroscopic iliopsoas release. Secondary outcome was to determine the incidence of postoperative instability and review the literature on this complication.</p><p><strong>Methods: </strong>A retrospective cohort study of all arthroscopic THR iliopsoas release procedures performed from 2012 until 2022 was undertaken. All patients had completed a minimum of 12 months of conservative treatment and had undergone a preoperative ultrasound-guided diagnostic steroid injection.Postoperatively, patients were classified into 3 categories at their 12-month clinical review: complete relief of symptoms; incomplete relief of symptoms but significant improvement; and no/minimal benefit. Any complications were documented and reviewed.</p><p><strong>Results: </strong>30 patients were included (31 hips); there were 14 males and 16 females. Mean age was 53.4 (range 34-77) years. 21 patients had a THR, 7 patients had a hip resurfacing, 1 patient had bilateral hip resurfacings and underwent bilateral release, and 1 patient had a revision THR. 2 patients were lost to follow-up, leaving 29 hips for inclusion in the study. Patients underwent arthroscopic release a median of 48 months following primary THR (range 12-180 months). At 12-month follow-up, 13 patients (44.8%) had complete relief of symptoms, 9 patients (31.0%) had incomplete relief of symptoms but significant improvement, and 7 patients (24.1) had no improvement.3 patients (10.3%) had frank anterior dislocation of their THR in the early postoperative period.</p><p><strong>Conclusions: </strong>The majority of patients with persistent iliopsoas tendinitis following hip arthroplasty had significant improvement in symptoms with arthroscopic iliopsoas release. However, the series highlights the potential for postoperative instability and we would advise caution with regards to excessive capsular resection, as well as caution with postoperative physiotherapy in the immediate postoperative period.</p>","PeriodicalId":12911,"journal":{"name":"HIP International","volume":" ","pages":"11207000251339063"},"PeriodicalIF":1.3,"publicationDate":"2025-05-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144093429","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":"Bone marrow aspirate concentrate adjunct for acetabular labral tear repair: a systematic review and meta-analysis.","authors":"Seth Spicer, Hanna Brancaccio, Ashley Sundin, Jamie Bono, John DesRochers, Brandon Goodwin, Nicholas Averell, Seungkyu Park, Alexandra Goodwin, William DiCiurcio, Richard Jermyn","doi":"10.1177/11207000251337403","DOIUrl":"https://doi.org/10.1177/11207000251337403","url":null,"abstract":"<p><strong>Background: </strong>The objective of this study was to determine the effect of bone marrow aspirate concentrate (BMAC) on long-term patient outcomes when used as an adjuvant to acetabular repair of the labrum.</p><p><strong>Methods: </strong>A systematic review and meta-analysis were completed following PRISMA 2020 guidelines. Included in the analysis were controlled studies which assessed functional outcomes via the International Hip Outcome Tool-33 (iHOT-33) 12 or 24 months after acetabular repair with BMAC adjunct. Four studies totaling 315 participants were analysed.</p><p><strong>Results: </strong>Pooled effect sizes for iHOT-33 scores were not significantly different between control and treatment groups at 12 (<i>p</i> <i>=</i> 0.14, Cohen's D ≏ 0.79) or 24 months (<i>p</i> <i>=</i> 0.30, Cohen's D ≏ 0.56).</p><p><strong>Conclusions: </strong>Non-significant trends in favor of BMAC augmentation were found in this study. However, the trends reported are promising and warrant further investigation with further randomised controlled trials.</p>","PeriodicalId":12911,"journal":{"name":"HIP International","volume":" ","pages":"11207000251337403"},"PeriodicalIF":1.3,"publicationDate":"2025-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144077433","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":"Mayo conservative hip stem for proximal femoral bone preservation in developmental dysplasia of the hip in young patients: a median follow-up of more than 10 years.","authors":"Masanori Nishi, Takashi Atsumi, Yasushi Yoshikawa, Ryosuke Nakanishi, Minoru Watanabe, Tsubasa Ishikawa, Yuki Usui, Tokito Tatsuo, Yoshifumi Kudo","doi":"10.1177/11207000251338196","DOIUrl":"https://doi.org/10.1177/11207000251338196","url":null,"abstract":"<p><strong>Purpose: </strong>Studies on short-stem total hip arthroplasty (THA) in young patients with developmental dysplasia of the hip (DDH) are limited, with no studies on long-term outcomes. Our study aimed to investigate whether the Mayo conservative hip stem demonstrates favourable mid- to long-term outcomes in these patients.</p><p><strong>Methods: </strong>This retrospective study included 42 patients (50 joints) with DDH aged <55 years who underwent THA using the Mayo conservative hip stem and excluded those with a follow-up period <5 years. Radiographic evaluation involved comparison of the immediate postoperative anteroposterior images with those at the final follow-up. Clinical evaluations utilised the Japanese Orthopaedic Association (JOA) hip score and major postoperative complications, including revision surgery.</p><p><strong>Results: </strong>The mean age of the patients was 48.8 years, with a median follow-up of 11 years. According to the Crowe classification, 35, 11, and 4 cases were classified as Types I, II, and III, respectively. According to the Dorr classification, 29 and 21 cases were classified as Types A and B, respectively. Radiographically, spot welds were observed in 98% of joints in zones 2 or 6, whereas stress shielding was evident in 94% (zone 1) and 54% (zone 7) of the joints. Stem sinking ⩾3 mm was observed in 2 joints. No periprosthetic femoral fractures, dislocations, or infections were observed.</p><p><strong>Conclusions: </strong>The Mayo conservative stem in young patients with DDH resulted in favourable mid- to long-term outcomes, including stability and bone preservation. The stem is an effective treatment strategy for these patients.</p>","PeriodicalId":12911,"journal":{"name":"HIP International","volume":" ","pages":"11207000251338196"},"PeriodicalIF":1.3,"publicationDate":"2025-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144077437","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":"Os acetabuli is an indirect radiographic sign of femoral retroversion.","authors":"Pablo A Slullitel, Marcos Latorre, Francisco Principe, Felipe Patterson, Gerardo Zanotti, Fernando Comba, Martin A Buttaro","doi":"10.1177/11207000251335223","DOIUrl":"https://doi.org/10.1177/11207000251335223","url":null,"abstract":"<p><strong>Background: </strong>To report the association between os acetabuli and relevant radiologic measurements in a series of surgically treated hip preservation patients.</p><p><strong>Methods: </strong>We retrospectively reviewed 654 hips who underwent preservation surgery between 2012 and 2019, identifying 50 cases with os acetabuli (7.64%). We included 300 hips (277 patients) with radiographs and CT-scans obtained during preoperative assessment, after which the cohort was divided into two groups (with and without os acetabuli). Mean age of the study population was 35 (interquartile range [IQR] 28-42) years old, with 192 (62%) being males. 2 observers measured demographic and radiologic variables. A mixed-effects logistic regression tested the ability of radiologic measurements to predict the presence of os acetabuli.</p><p><strong>Results: </strong>No between-group differences were found in terms of sex (156/250 vs. 36/50 males, <i>p =</i> 0.197), alpha angle (64 ± 13° vs. 65 ± 14°, <i>p =</i> 0.372), Tönnis angle (8 ± 7° vs. 7 ± 7°, <i>p =</i> 0.152), neck-shaft angle (132 ± 6° vs. 131 ± 5°, <i>p =</i> 0.199) and CT-acetabular version (16 ± 7° vs. 15 ± 6°, <i>p =</i> 0.221). Significant differences were found in terms of age (34 ± 9 vs. 39 ± 7 years, <i>p =</i> 0.002), lateral centre-edge angle (LCEA) (31 ± 9° vs. 34 ± 7°, <i>p =</i> 0.045), anterior wall index (AWI) (0.45 [IQR 0.37-0.54] vs 0.5 [IQR 0.39-0.6], <i>p =</i> 0.046), CT-femoral version (17 ± 5° vs. 8 ± 4°, <i>p <</i> 0.001), cross-over sign (96/250 vs. 28/50, <i>p =</i> 0.032) and baseline diagnosis (184/250 vs. 44/50 FAIs, <i>p =</i> 0.043), with the os acetabuli-group being older, with more FAI diagnosis/cross-over sign, and with higher LCEA, higher AWI, and a lower femoral version. After adjusting for confounders, only CT-femoral version (odds ratio 0.32; 95% CI. 0.14-0.73, <i>p <</i> 0.007) was associated with presence of os acetabuli.</p><p><strong>Conclusions: </strong>Presence of acetabular rim fragments was significantly associated with a lower femoral version. Above 20° of femoral version, the likelihood of os acetabuli was almost zero. Treatment of os acetabuli (i.e., fixation vs. removal) should be adjusted for the underlying diagnosis.</p>","PeriodicalId":12911,"journal":{"name":"HIP International","volume":" ","pages":"11207000251335223"},"PeriodicalIF":1.3,"publicationDate":"2025-05-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143984204","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 role of pain catastrophising on subjective function and pain following total hip arthroplasty: a prospective comparative study of 531 patients with 2-year follow-up.","authors":"Margot B Aalders, Jelle P van der List, Lucien C M Keijser, Olivier P P Temmerman, Joyce L Benner","doi":"10.1177/11207000251325230","DOIUrl":"10.1177/11207000251325230","url":null,"abstract":"<p><strong>Background and purpose: </strong>Considering dissatisfaction rates of around 10% after total hip arthroplasty (THA), this study aimed to investigate the role of pain catastrophising (PC) on functional outcomes, pain, and quality of life following THA in a large prospective study. PC is the tendency to focus on and exaggerate painful stimuli combined with a decreased ability to deal with pain.</p><p><strong>Patients and methods: </strong>A prospective comparative study was performed with 531 patients undergoing primary unilateral THA between 2019 and 2020. Patients were considered PC with a preoperative score ⩾30 on the PC Scale, resulting in 57 (11%) PC-patients. Patient-reported outcome measures (PROMs) were collected preoperatively, at 3 months, 1 year, and 2 years postoperatively and consisted of Hip disability and Osteoarthritis Outcome Score-Physical Function (HOOS-PS), Oxford Hip Score (OHS), pain (NRS), and quality of life (EQ-5D), including minimal clinical important differences (MCIDs) and patient acceptable symptom state (PASS), as well as length of stay and aseptic revisions.</p><p><strong>Results: </strong>PC-patients reported inferior preoperative scores on all PROMs and had longer hospital stay (<i>p</i> = 0.02). Although PC-patients had more improvement in all scores and a higher proportion generally reached MCID, they still reported lower OHS, more pain, and lower EQ-5D at 2-year follow-up (all <i>p</i> < 0.03), and fewer PC-patients reached PASS for OHS and EQ-5D at final follow-up. No difference in aseptic revisions was seen (<i>p</i> = 0.95).</p><p><strong>Conclusions: </strong>PC-patients had worse preoperative subjective function and more pain. Although they showed more improvement than non-PC patients at all outcomes, less patients reached PASS for OHS and EQ-5D at 2-year follow-up.</p>","PeriodicalId":12911,"journal":{"name":"HIP International","volume":" ","pages":"290-300"},"PeriodicalIF":1.3,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12069825/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143624418","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Can customised total hip arthroplasty without femoral shortening osteotomy improve functional outcome and long-term stem survivorship in developmental dysplasia of the hip?","authors":"Arthur Barbaret, Philippe Laisne, Xavier Flecher, Christophe Jacquet, Jean-Noel Argenson","doi":"10.1177/11207000251331192","DOIUrl":"10.1177/11207000251331192","url":null,"abstract":"<p><strong>Aims: </strong>Total hip arthroplasty (THA) combined with a shortening osteotomy of the femur has proved to be an effective treatment for patients with developmental dysplasia of the hip (DDH). Advances in surgical technique and implant design have led to the introduction of customised THA, without the inconvenience of femoral shortening osteotomy, as an alternative option.The purpose of this retrospective study was to determine if customised THA without femoral shortening osteotomy improves the functional outcome and long-term survivorship in total hip arthroplasty for DDH.</p><p><strong>Methods: </strong>We carried out a retrospective analysis of 77 hips in 62 patients with DDH of all Crowe types who had been treated by customised THA without shortening osteotomy and who had a minimum of 20 years follow-up. Clinical evaluation was undertaken using the Harris Hip Score (HHS) at 6 weeks postoperatively and at final follow-up. Kaplan-Meier survivorship analysis was carried out with femoral revision due to aseptic loosening as the endpoint.</p><p><strong>Results: </strong>The average HHS score at the 6 weeks postoperative assessment (86 ± 13) showed a significant improvement from the preoperative assessment (49 ± 22 points) as did the final follow-up examination (82 ± 12). The mean postoperative leg-length discrepancy was 7 ± 11 mm (-20-80 mm). 5 transient (6%) nerve palsies (1 sciatic and 4 femoral) were identified. The stem was revised in 12 hips (16%), 9(12%) for aseptic loosening at 4, 16, 70, 96, 165, 176, 177, 191 and 235 months, 2 (3%) for fracture and 1 (1%) for late infection.The Kaplan-Meier survivorship analysis at 20-year follow-up was 88% (95% confidence interval [0.81-0.96]). 7 patients (9 hips) were lost to follow-up (12%). 10 patients (11 hips) died during the study period (14%) but according to their general physician, none had undergone revision hip surgery.</p><p><strong>Conclusions: </strong>Customised THA with 3-dimensional planning and a custom-made femoral stem may improve functional outcomes and long-term survivorship after THA for DDH.</p>","PeriodicalId":12911,"journal":{"name":"HIP International","volume":" ","pages":"308-314"},"PeriodicalIF":1.3,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143961712","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":"Preoperative psychotherapy for primary total hip arthroplasty patients: an evaluation of its modifiability on readmissions and implant complications in patients who have depression.","authors":"Adam M Gordon, Patrick Nian, Joydeep Baidya, Michael A Mont","doi":"10.1177/11207000251317655","DOIUrl":"https://doi.org/10.1177/11207000251317655","url":null,"abstract":"<p><strong>Introduction: </strong>Few studies have evaluated nonpharmacologic interventions, including preoperative psychotherapy, in patients who have depression. We studied whether psychotherapy visits prior to total hip arthroplasty (THA) in patients with depression were associated with lower: (1) readmissions; and (2) implant complications in patients who have depression.</p><p><strong>Methods: </strong>A nationwide database was queried from 2010 to 2021. Patients who had depression were 1:1 propensity score matched based on those who had (<i>n</i> <i>=</i> 16,143) and did not have (<i>n</i> <i>=</i> 16,140) preoperative psychotherapy visits within 3 months of primary THA. These depression patients were 1:5 ratio-matched to a control cohort of patients without comorbid depression (<i>n</i> <i>=</i> 80,627). A 90-day and 2-year follow-up surveillance period was used to evaluate readmissions and implant complications, respectively. Logistic regression models computed the odds ratios (OR) of psychotherapy on readmissions and implant complications. Patients without comorbid depression served as the reference cohort. <i>p</i>-Values less than 0.001 were significant.</p><p><strong>Results: </strong>Of patients who had depression, a stepwise increase in odds of readmissions occurred for patients who had psychotherapy (6.2 vs. 5.0%, OR 1.25; <i>p</i> < 0.0001) and did not have psychotherapy (6.7 vs. 5.0%, OR 1.36; <i>p</i> < 0.0001) compared to patients who did not have depression. Compared to patients who did not have depression, patients who had depression and did not have psychotherapy experienced greater odds of aseptic loosening (1.7 vs. 0.7%, OR 2.31; <i>p</i> <i><</i> 0.0001), periprosthetic fractures (0.5 versus 0.2%, OR 2.44; <i>p</i> < 0.0001), dislocations (3.7 vs. 1.6%, OR 2.39; <i>p</i> < 0.0001), periprosthetic joint infections (PJIs) (3.1 vs. 1.7%, OR 1.93; <i>p</i> < 0.0001), and all-cause THA revisions (3.6 vs. 1.5%, OR 2.44; <i>p</i> < 0.0001).</p><p><strong>Discussion: </strong>Preoperative psychotherapy may provide a modifiable benefit among patients who had depression for 2-year implant complications. This intervention may aid arthroplasty surgeons in optimising patients potentially at higher risk for adverse events.</p>","PeriodicalId":12911,"journal":{"name":"HIP International","volume":"35 3","pages":"239-246"},"PeriodicalIF":1.3,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144077438","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":"Long-term impact of physical activity and sports participation on implant integrity in resurfacing hip arthroplasty versus total hip arthroplasty: a systematic review.","authors":"Jordan J Levett, Abdulrhman Alnasser, Anthony Teoli, Simon Martel, Shawn Robbins, Olga L Huk, David J Zukor, John Antoniou","doi":"10.1177/11207000251315941","DOIUrl":"10.1177/11207000251315941","url":null,"abstract":"<p><strong>Objectives: </strong>Total hip arthroplasty (THA) and resurfacing hip arthroplasty (RHA) offer promising therapeutic solutions to physically active patients with hip osteoarthritis (OA). The impact of physical activity on long-term implant integrity in this population remains unknown. This systematic review compares the impact of physical activity and sports participation on implant integrity in THA versus RHA.</p><p><strong>Methods: </strong>A comprehensive search of Medline, Embase (both via Ovid), Scopus, and CINAHL was conducted from inception to May 2023 following the Cochrane Handbook for Systematic Reviews of Interventions. Data were reported in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. The quality of included studies was assessed using the Newcastle-Ottawa Scale. Implant integrity was measured either radiographically, via serum metal ion levels or revision rates.</p><p><strong>Results: </strong>A total of 16 studies with 4676 patients (THA: 3146; RHA: 1530) met the inclusion criteria. The median age at surgery was 60 years (range 49 to 86) in THA and 54 (range 49-61) years in RHA. At a median follow-up of 7.1 (range 4.8-13.1) years in THA and 10 (range 2.8-11.7) years in RHA, 3 studies out of 12, including 65.7% of the patients who underwent THA, and 2 studies out of 5, including 30.1% of the patients who underwent RHA, demonstrated that increased physical activity was associated with poor implant survivorship.</p><p><strong>Conclusions: </strong>Patients undergoing THA or RHA should be counselled to participate in moderate physical activity and may benefit from avoiding sports that exert an excessive load on their implants. On average, the quality of the studies was moderate. The outcome measures used to quantify physical activity and implant integrity are heterogenous.</p>","PeriodicalId":12911,"journal":{"name":"HIP International","volume":" ","pages":"264-272"},"PeriodicalIF":1.3,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12069826/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143414042","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}