HIP International最新文献

{"title":"The effect of acetabular shell and liner design on posterior horizontal dislocation distance in modern dual-mobility implants.","authors":"Nathaniel T Ondeck, Drake G LeBrun, Shammodip Roy, Ahmad Faizan, Geoffrey H Westrich","doi":"10.1177/11207000251329269","DOIUrl":"10.1177/11207000251329269","url":null,"abstract":"<p><strong>Background: </strong>The posterior horizontal dislocation distance (PHDD) is a 3-dimensional jump distance measurement that is relevant to the risk of dislocation. There are a number of dual-mobility (DM) constructs with varying designs available. The present study identifies design factors associated with increased PHDD and evaluates the PHDD of 3 DM implants.</p><p><strong>Methods: </strong>3 different computer-aided implant designs were virtually implanted within a 3-dimensional CT-derived pelvic model. Each design represented an analogue of a DM system (MDM, OR3O, and G7) according to specific variations in acetabular liner rim build-up and femoral head centre location. The effective head diameters and PHDD values were calculated for each size acetabular shell and DM design.</p><p><strong>Results: </strong>The positive rim build-up design (MDM) showed higher PHDD values as compared to the other 2 hemispherical rim designs with no build-up, across all studied shell sizes. Specifically, the MDM design analogue had 16.4-29.0% greater PHDD values than the OR3O design analog and 15.2-30.5% greater PHDD values than the G7 design analogue The effect of a sfemoral head centre location relative to the liner head centre (OR3O) was negated by a larger effective head diameter to shell diameter ratio of the G7 design, resulting in similar PHDD values.</p><p><strong>Conclusions: </strong>Design parameters affect the PHDD values of DM cups. The use of an elevated rim was associated with greater PHDD values. A medialised femoral head centre should also improve PHDD values, but the effect was nullified due to consecutive lower effective head diameters.</p>","PeriodicalId":12911,"journal":{"name":"HIP International","volume":" ","pages":"258-263"},"PeriodicalIF":1.3,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143763689","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":"Epidemiology, treatment, and mortality of femoral neck fractures in patients over the age of 65 years: a nationwide retrospective cohort study of 83,789 cases in Turkey.","authors":"Mehmet Demirel, Murat Birinci, Ömer S Hakyemez, Nesrullah Azboy, İzzet Bingöl, Naim Ata, M Mahir Ülgü, Şuayip Birinci, Mustafa O Ayvalı, İbrahim Azboy, Cengiz Şen","doi":"10.1177/11207000241312887","DOIUrl":"10.1177/11207000241312887","url":null,"abstract":"<p><strong>Background: </strong>A population-based study delineating the epidemiologic, clinical, and treatment characteristics of femoral neck fractures (FNFs) in elderly patients has not yet been conducted in Turkey. In this nationwide study, the epidemiologic, clinical, and treatment characteristics of patients aged ⩾65 years with FNFs who underwent osteosynthesis, hemiarthroplasty (HA), or total hip arthroplasty (THA) were examined.</p><p><strong>Methods: </strong>Patients aged ⩾65 years with FNFs were identified in this retrospective, nationwide study. Then, the patients who underwent osteosynthesis or total/hemiarthroplasty from 2016 to 2021 were included. All the outcome variables were collected from patient medical records stored in the e-health database of the Republic of Turkey Ministry of Health.</p><p><strong>Results: </strong>A total of 83,789 FNFs treated surgically were analysed. Osteosynthesis was performed on 21,130 FNFs (25.2%), HA on 56,378 FNFs (67.3%), and THA on 6281 FNFs (7.5%). From 2016 to 2021, the overall revision rates for THA and HA were 14.6% (914/5367 patients) and 5.9% (3301/53,077 patients), respectively. The rate of revision prosthetic surgery was significantly higher after THA than after HA (<i>p</i> <i><</i> 0.001). Mortality rates at 1 year were 25% (<i>n</i> = 5293) for osteosynthesis, 14.7% (<i>n</i> = 924) for THA, and 71.1% (<i>n</i> <i>=</i> 40,109) for HA (<i>p</i> = 0.001). The multivariate model of 1-year postoperative mortality revealed 7 independent predictors: male sex (odds ratio [OR] 1.694; 95% confidence interval [CI], 1.640-1.751), use of a cemented femoral stem (OR 1.182; 95% CI, 1.117-1.250), acute myocardial infarction (AMI) (OR 1.317; 95% CI, 1.240-1.400), cerebrovascular accident (CVA) (OR 1.379; 95% CI, 1.333-1.425), chronic liver disease (CLD) (OR 2.188; 95% CI, 1.802-2.489), diabetes mellitus (DM) (OR, 1.160; 95% CI, 1.122-1.200), and age >81.50 years (OR 2.654; 95% CI, 2.569-2.742).</p><p><strong>Conclusions: </strong>Our study suggested that a hemiarthroplasty is the most common treatment modality for FNF followed by osteosynthesis (25.2%) and THA (7.5%) in Turkey. Revision rates after THA for FNF are concerning. The 1-year mortality rates are highest after HA, followed by osteosynthesis and THA. Male sex, cemented fixation, CVA, CLD, liver failure, DM, and age >81.50 are the independent predictive factors for postoperative 1-year mortality in this specific group of patients.</p>","PeriodicalId":12911,"journal":{"name":"HIP International","volume":" ","pages":"278-289"},"PeriodicalIF":1.3,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143046603","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":"Reducing variability in apparent operative inclination (AOI) during total hip arthroplasty: comparing the ball in cage mechanical alignment device to a digital inclinometer.","authors":"Christopher W Goodland, Andrew Crone, Mark Robinson, Roslyn S Cassidy, Janet C Hill, Caroline Wither, Paul N Karayiannis, David E Beverland","doi":"10.1177/11207000251323235","DOIUrl":"https://doi.org/10.1177/11207000251323235","url":null,"abstract":"<p><strong>Introduction: </strong>When operating in lateral decubitus apparent operative inclination (AOI) is the angle between the handle of the acetabular cup introducer and the theatre floor. A digital inclinometer has demonstrated optimal control of AOI. This study aims to compare the deviation from a target AOI with a novel autoclavable ball-in-cage mechanical alignment guide (MAG) as compared to a digital inclinometer.</p><p><strong>Methods: </strong>90 primary total hip arthroplasty cases performed in lateral decubitus using a posterior approach were included. The ball-in-cage mechanical alignment guide on a standard Pinnacle cup introducer handle was used to achieve the target AOI of 35° ± 2.5°. Final AOI was measured with a digital inclinometer. These readings were compared to a published historical series of 90 patients using a digital inclinometer.</p><p><strong>Results: </strong>The ball-in-cage MAG mean inclination was 35.0° (range 32.5-37.4°), with 100% falling within target. This compared to a mean inclination of 34.0° (range 27.5-37.5°), with the digital inclinometer where 87.8% fell within target. However, the range of postoperative radiographic inclination for the ball-in-cage MAG was 23.4-53.9° with 31.1% being outside a ±5° target.</p><p><strong>Conclusions: </strong>These results indicate that this simple autoclavable ball-in-cage MAG consistently achieves an intraoperative AOI within target range. In isolation this does not guarantee a postoperative radiographic inclination within target range.</p>","PeriodicalId":12911,"journal":{"name":"HIP International","volume":"35 3","pages":"253-257"},"PeriodicalIF":1.3,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144077576","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":"Systematic measurement of spino-pelvic alignment as a simple strategy to reduce the dislocation rate in primary hip arthroplasties.","authors":"Federico Burgo, Diego Mengelle, Enzo Skerly, Bruno Terrarossa, Mateo Lazzari, M Del Rosario Dall Armellina, Agustín Davies","doi":"10.1177/11207000251319969","DOIUrl":"10.1177/11207000251319969","url":null,"abstract":"<p><strong>Background: </strong>The incorporation of spinopelvic alignment measurement in the planning of primary hip arthroplasties is a simple and low-cost method whose isolated impact on reducing dislocation rates has not been clearly established.</p><p><strong>Aim: </strong>The objective was to estimate the probability of dislocation and its occurrence rate by comparing 2 demographically similar populations, 1 with the measurement incorporated and the other without it. Additionally, the modification and distribution of surgical practices and indications aimed at reducing the risk of dislocations were compared.</p><p><strong>Methods: </strong>A before-and-after study with prospective registry and retrospective control group was designed. We compared 693 patients (prospective registry) with the incorporation of spinopelvic alignment measurement in preoperative planning versus 341 from a previous period who constituted the control group (retrospective registry). All had a minimum follow-up of 2 years.</p><p><strong>Results: </strong>The dislocation rate significantly decreased from 3.2% to 0.7%, with an OR of 0.22 for dislocation in the intervention group. There was a significant increase in the use of dual-mobility components in patients with complete misalignment and stems with extended offset in patients with partial misalignment.</p><p><strong>Conclusions: </strong>In conclusion, the incorporation of spinopelvic alignment measurement in preoperative planning is an accessible method for any medical centre that contributed to modifying surgical practices, ultimately leading to a significant reduction in the dislocation rate.</p>","PeriodicalId":12911,"journal":{"name":"HIP International","volume":" ","pages":"247-252"},"PeriodicalIF":1.3,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143994177","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":"Medial opening wedge valgus intertrochanteric osteotomy for femoral neck nonunion: a femoral anatomy-preserving surgical approach.","authors":"Boopalan Ramasamy, Kaushik Bhowmick, Anand Ashok, Abel Livingston, Viju D Varghese","doi":"10.1177/11207000251324118","DOIUrl":"10.1177/11207000251324118","url":null,"abstract":"<p><strong>Background: </strong>Valgus osteotomy is a femoral head-preserving surgery to treat femoral neck non-union in young, active patients. The traditional approach, however, causes medialisation of the femoral shaft during valgus correction, which alters femoral anatomy and complicates conversion to total hip arthroplasty if head osteosynthesis fails. This study aims to outline a novel surgical technique, medial opening wedge valgus intertrochanteric osteotomy (VITO), and evaluate its clinical and radiographic outcomes, focusing on restoring hip biomechanics and improving union rates.</p><p><strong>Methods: </strong>Between 2007 and 2022, this technique was used in 18 cases (mean age :39; range :16-51 years). There were 14 males and 4 females. In 10 cases,non-union was due to failed internal fixation, while in 8 cases, it was due to neglected fractures. Treatment outcomes were evaluated by assessing union, pre- and postoperative neck-shaft angle (NSA) correction, and functional outcomes by the Harris Hip Score (HHS).</p><p><strong>Results: </strong>16 out of 18 patients were available for follow-up. The average duration of non-union was 10.7 (range 1-60) months, and the mean follow-up was 64 (range 24-140) months. All achieved successful union, with an average neck shaft angle correction of 16°. 3 patients were converted to total hip arthroplasty (THA) due to implant failure. Complications included 3 cases of avascular necrosis (AVN). Despite these complications, 62% of patients had excellent HHS, while 19% had good HHS. The mean HHS improved from 46(preoperative) to 92 (postoperative).</p><p><strong>Conclusions: </strong>The medial opening wedge VITO is an effective technique for restoring hip biomechanics and achieving high union rates in patients with femoral neck non-union. This technique preserves proximal femoral anatomy, facilitating easier conversion to THA when necessary.</p>","PeriodicalId":12911,"journal":{"name":"HIP International","volume":" ","pages":"301-307"},"PeriodicalIF":1.3,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143604618","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":"Constrained acetabular liners in total hip arthroplasty: analysis of 265 primary and revision cases from the Dutch Arthroplasty Register (2007-2022).","authors":"Jetze Visser, Mirthe H W van Veghel, Liza N van Steenbergen, Bart A Swierstra, Esther M Bloemheuvel, B Willem Schreurs","doi":"10.1177/11207000251331147","DOIUrl":"10.1177/11207000251331147","url":null,"abstract":"<p><strong>Introduction: </strong>Constrained acetabular liners (CALs) are predominantly used as a salvage procedure in patients with a severe risk for dislocation after total hip arthroplasty (THA). However, the constrained design of CALs bears the risk of impingement with subsequent loosening or failure of the integrity of the implant. We investigated the use and survival of CALs in primary and revision THA in the Dutch Arthroplasty Register (LROI).</p><p><strong>Methods: </strong>Use of CAL in THAs was extracted from the LROI in the period 2007-2022. 423,773 primary THAs and 52,706 revision THAs have been registered, of which 29 CALs were implanted in primary THA and 236 CALs in revision THA. Patient characteristics and survival of the CAL placed in primary and revision THA were separately analysed.</p><p><strong>Results: </strong>Of the CALs placed in primary THA, no revisions of the implant occurred during a median follow-up of 5.4 years (interquartile range [IQR] 4.0-12.4). The CALs in revision THA were most frequently used for cases with recurrent dislocation (183/236). Median follow-up was 4.8 (IQR 2.3-8.2) years. The re-revision rate was 10% (95% CI, 6.6-14) at 5-year follow-up and 12% (CI, 8.1-17) at 9-year follow-up. The most frequently registered reason for re-revision was dislocation (<i>n</i> = 19, 70%).</p><p><strong>Conclusions: </strong>In the Netherlands there is a relatively low use of CALs in primary as well as revision THA. The survival rate of CALs is acceptable, with recurrent dislocation as the main reason for re-revision. The use of CALs should be reserved for specific cases with high risk for dislocation.</p>","PeriodicalId":12911,"journal":{"name":"HIP International","volume":" ","pages":"273-277"},"PeriodicalIF":1.3,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12069818/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143763685","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":"Evaluating the necessity of pre-transfusion testing in primary total hip arthroplasty: a systematic review and meta-analysis.","authors":"Jorge H Nuñez, Berta Escudero, Juan Diego Montenegro, Ernesto Guerra Farfán, Agusti Bartra-Ylla, Francesc Angles-Crespo","doi":"10.1177/11207000251317891","DOIUrl":"10.1177/11207000251317891","url":null,"abstract":"<p><strong>Introduction: </strong>The unnecessary over-ordering of routine pre-transfusion tests (blood typing, screening, and cross-matching) for surgical cases results in substantial avoidable costs and imposes an undue burden on transfusion services. This study specifically focuses on conducting a systematic review of the literature to assess the necessity of routine pre-transfusion tests before total hip arthroplasty (THA) and aims to provide a comprehensive summary of the outcomes associated with this practice.</p><p><strong>Methods: </strong>A systematic review and meta-analysis were conducted to analyse the study's characteristics, assess the prevalence of over-ordering, defined as ordering more routine pre-transfusion tests than clinically necessary, examine transfusion rates, and evaluate potential cost savings to the healthcare system.</p><p><strong>Results: </strong>The study included 12,178 patients. Pooled results revealed an 88.1% over-ordering pre-transfusion test rate (95% CI, 0.80-0.96; <i>p</i> < 0.001) among patients undergoing primary THA. The pooled prevalence of hospital transfusion rate was 11.9%, with a percentage of intraoperative transfusion of 0.4% (95% CI, 0.001-0.007; <i>p</i> = 0.007). There were statistically significant differences in preoperative haemoglobin (Hb) levels between patients not requiring 14.1 g/dl (95% CI, 13.2-14.9; <i>p</i> < 0.001) and those needing transfusion 11.9 g/dl (95% CI, 10.9-12.9; <i>p</i> < 0.001) (<i>p</i> < 0.001). The per-patient total cost savings ranged from 2.10 to 191.27 dollars.</p><p><strong>Conclusions: </strong>Our findings indicate that routine pretransfusion testing for all patients undergoing primary THA may be unnecessary. We recommend restricting pre-transfusion test orders to patients with preoperative haemoglobin levels below 12 g/dl specifically in the context of unilateral primary THA, always considering individual patient and surgical risk factors. This focused approach has the potential to yield substantial cost savings for healthcare systems and transfusion services by mitigating the unnecessary over-ordering of pre-transfusion tests associated with these surgical procedures.</p>","PeriodicalId":12911,"journal":{"name":"HIP International","volume":" ","pages":"226-238"},"PeriodicalIF":1.3,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143648336","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 of the dislocated hip hemiarthroplasty: a multi-centre study.","authors":"Gareth Chan, Keegan Curlewis, Rahmeh Aladwan, Samantha E Hook, Benedict A Rogers, David M Ricketts, Philip Stott","doi":"10.1177/11207000251326038","DOIUrl":"10.1177/11207000251326038","url":null,"abstract":"<p><strong>Introduction: </strong>Hip hemiarthroplasties are performed in medically frail and/or comorbid patients who sustain a displaced intracapsular hip fracture. Dislocations occur in approximately 0.6-5.0% patients and are associated with worse outcomes, including mortality when compared against a similar cohort of patients who do not suffer a dislocation of their hemiarthroplasty.This study aimed to quantify the outcomes from the management of dislocated hip hemiarthroplasties in a cohort of contemporaneously used implants and the associated 1-year mortality.</p><p><strong>Methods: </strong>A retrospective review of a prospectively collected database of 4116 consecutive patients treated with a cemented hip hemiarthroplasty, in which 63 dislocations were identified was performed.The outcomes of the management of each dislocation were quantified, including the number of dislocations sustained after a preceding successful closed reduction. 1-year mortality was ascertained and stratified for each treatment option.</p><p><strong>Results: </strong>63 patients with a dislocation of a cemented hip hemiarthroplasty performed for an intracapsular hip fracture were included. Closed reduction was unsuccessful in 72% of (31/43) patients who had a closed reduction of their first dislocation. Failure rates of a second closed reduction increased to 76.9% and 100.0% with a third closed reduction.1-year mortality rate after a dislocation was 46.0% for all patients and lowest in the cohort of patients who were treated with a revision arthroplasty (27.3%).</p><p><strong>Conclusions: </strong>Closed reduction of dislocated hip hemiarthroplasty is associated with a high failure rate, especially after a second dislocation. Consideration should be made to perform a revision procedure after a second dislocation with a high suspicion for soft tissue repair failure and/or infection.</p>","PeriodicalId":12911,"journal":{"name":"HIP International","volume":" ","pages":"315-322"},"PeriodicalIF":1.3,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144063507","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":"Postoperative posterior pelvic tilt progression is a risk factor for cup revision after total hip arthroplasty with a conventional polyethylene liner: a 25-year follow-up study.","authors":"Hideki Ueyama, Mitsuyoshi Yamamura, Junichiro Koyanagi, Kenji Fukunaga, Susumu Takemura, Suguru Nakamura, Hiroshi Kagiyama","doi":"10.1177/11207000251326473","DOIUrl":"https://doi.org/10.1177/11207000251326473","url":null,"abstract":"<p><strong>Background: </strong>Whether postoperative posterior pelvic tilt progression is an independent risk factor for cup revision after total hip arthroplasty (THA) with a conventional polyethylene (PE) liner is unclear. This long-term follow-up study assessed the association between posterior pelvic tilt and cup revision after THA using the porous-coated anatomic (PCA) total hip system.</p><p><strong>Methods: </strong>This retrospective cohort study included 94 patients who underwent THA using the PCA total hip system and participated in postoperative follow-up for a mean of 25 years. The Japanese Orthopaedic Association (JOA) hip score was the clinical outcome, and prosthetic alignment and the change in pelvic tilt were measured as radiological outcomes. Prosthetic survival rates for revision as the endpoint were evaluated, and risk factors for cup revision were identified using a multivariate logistic regression analysis.</p><p><strong>Results: </strong>The JOA hip score improved significantly (<i>p <</i> 0.001) after THA (before THA: 41 ± 6.3 points; after THA: 86 ± 8.9 points). The postoperative posterior pelvic tilt progressed 3.6 ± 3.2°. Survival rates of the cup and stem at 27 years postoperatively were 60.8% and 87.5%, respectively (<i>p <</i> 0.001). The main reason for revision (81% of all revisions) was aseptic loosening. Postoperative posterior pelvic tilt progression was an independent risk factor for cup revision (odds ratio, 1.53; 95% confidence interval, 1.06-2.20; <i>p =</i> 0.022).</p><p><strong>Conclusions: </strong>When the PCA total hip system was used, the stem exhibited good longevity during a mean follow-up period of 25 years; however, the cup was vulnerable because of aseptic loosening. Postoperative posterior pelvic tilt progression was an independent risk factor for cup revision.</p>","PeriodicalId":12911,"journal":{"name":"HIP International","volume":" ","pages":"11207000251326473"},"PeriodicalIF":1.3,"publicationDate":"2025-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143663343","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":"Hydroxyapatite-coated total primary hip replacement: 28-year follow-up survivorship.","authors":"Manel Fa-Binefa, Julia Serra, Esther Moya, Xavier Crusi, Ignasi Gich-Saladich, Marius Valera","doi":"10.1177/11207000241306004","DOIUrl":"10.1177/11207000241306004","url":null,"abstract":"<p><strong>Background: </strong>Survival at 25 years' follow-up for total hip arthroplasty (THA) has been reported at 5%-77%, with hydroxyapatite (HA) coating, due to its osteo-conductive properties, used to enhance implant fixation and survival. The progressive increase in life expectancy raises doubts regarding HA-coated THA survival and THA revision surgery risk. The aim of our study was to retrospectively analyse survival for primary uncemented fully HA-coated THA after 28 years' follow-up.</p><p><strong>Methods: </strong>Our cohort survival study of the JRI Furlong HA-coated system retrospectively included patients aged 18-75 years who had undergone THA between 1992 and 1998 at our centre and who were followed up according to clinical records by orthopaedic surgeons to 2022. Data on THA revision surgery and its causes, follow-up, and death were analysed using Kaplan-Meier survival and Cox regression modelling.</p><p><strong>Results: </strong>The cohort included 196 patients (268 hips) followed up to a maximum of 27.5 years (mean 15.54 (SD 6.01) years) with 62 patients (88 hips) >25 years. THA revision surgery was performed in 7.5% of cases, occurring a mean of 11.1 years following primary surgery. Aseptic loosening accounted for 4.4% of these revisions, affecting both the acetabular component (2.2%) and the femoral stem (1.3%). THA survival at 15 years', 20 years', and 27.5 years' follow-up was 95.5%, 88.3%, and 79.3%, respectively. According to the log-rank and Cox regression analysis, no significant relationships were found.</p><p><strong>Conclusions: </strong>Furlong HA-coated stem provides excellent long-term bone fixation for a long-term follow-up over 27.5 years with an aseptic loosening stem revision rate of 1.3%.</p>","PeriodicalId":12911,"journal":{"name":"HIP International","volume":" ","pages":"159-166"},"PeriodicalIF":1.3,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142931582","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}