HIP InternationalPub Date : 2025-01-01Epub Date: 2024-08-22DOI: 10.1177/11207000241270205
Halil Bulut, Maria Jose Maestre, Daniel Tomey
{"title":"Predictors and risk factors of pulmonary embolism after total hip arthroplasty: an NSQIP study.","authors":"Halil Bulut, Maria Jose Maestre, Daniel Tomey","doi":"10.1177/11207000241270205","DOIUrl":"10.1177/11207000241270205","url":null,"abstract":"<p><strong>Introduction: </strong>Pulmonary embolism (PE) is a well-known contributor to morbidity after total hip arthroplasty (THA). Considerable efforts have been invested in reducing PE occurrence through pharmacological and perioperative interventions. Nonetheless, the effectiveness of these strategies in reducing the incidence and overall mortality associated with pulmonary embolism events remains a matter of debate. Therefore, identifying risky patients has been gaining importance.</p><p><strong>Methods: </strong>We utilised data from the National Surgical Quality Improvement Program (NSQIP) participant usage file (PUF) database spanning the years 2016 to 2021. All preoperative parameters were analysed with chi-square afterwards, meaningful ones were run with logistic regression test.</p><p><strong>Results: </strong>A study examined factors influencing pulmonary embolism (PE) prevalence in 235,393 total hip arthroplasty patients. Univariate analysis identified significant associations between PE and female gender, diabetes, smoking, dyspnea, CHF, COPD, hypertension (HT), bleeding disorders, disseminated cancer, steroid use, and functional health status. Multivariate analysis revealed male gender as protective, while COPD, hypertension, and disseminated cancer increased PE risk. Notably, smoking appeared protective. PE patients had higher return-to-operation rates (41.7% vs. 2.2%) but similar 30-day mortality (0.2% vs. 0.04%), though mortality's odds ratio was not significant.</p><p><strong>Conclusions: </strong>Our findings suggest that certain patient characteristics, such as COPD and metastatic malignancy, significantly influence the likelihood of PE development.</p>","PeriodicalId":12911,"journal":{"name":"HIP International","volume":" ","pages":"70-75"},"PeriodicalIF":1.3,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142017239","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}
HIP InternationalPub Date : 2025-01-01Epub Date: 2024-11-19DOI: 10.1177/11207000241295604
Øystein E Karlsen, Finnur Snorrason, Marianne Westberg
{"title":"A prospective multicentre study of 82 prosthetic joint infections treated with a standardised debridement and implant retention (DAIR) protocol followed by 6 weeks of antimicrobial therapy: favourable results.","authors":"Øystein E Karlsen, Finnur Snorrason, Marianne Westberg","doi":"10.1177/11207000241295604","DOIUrl":"10.1177/11207000241295604","url":null,"abstract":"<p><strong>Introduction: </strong>Prosthetic joint infection (PJI) is a much-feared complication in total joint arthroplasty. Debridement, antibiotics, irrigation and implant retention (DAIR) is often the preferred treatment in acute PJIs, but with varying results. The primary aim of this study was to evaluate the outcome of a high quality DAIR procedure performed according to a consistently applied surgical protocol in early postoperative and acute haematogenous PJIs in hip and knee, and secondary to study risk factors associated with failure.</p><p><strong>Methods: </strong>We performed a prospective multicentre study to evaluate the effect of a standardised protocol-based surgical management (DAIR) emphasising a thorough debridement, followed by 6 weeks of antimicrobial therapy. Empiric parenteral antimicrobial treatment was administered until the results of susceptibility tests were available. No suppressive antimicrobial therapy was given after the 6-week treatment-period. Primary outcome measure was infection control at the 2-year follow-up.</p><p><strong>Results: </strong>A total of 99 patients from 8 Norwegian hospitals were found eligible and included in the study, and 82 patients were finally analysed. 69 of 82 patients (84% [CI, 76-92%]) were successfully treated with this treatment protocol. We found a reduced success rate when patients were treated with a DAIR procedure following an infected revision arthroplasty compared with an infected primary arthroplasty (11/17 (65 %) versus 58/65 (89 %), respectively (<i>p</i> = 0.02).</p><p><strong>Conclusions: </strong>The success rate of a standardised DAIR procedure with a 6-week antimicrobial treatment was good in PJI following primary arthroplasties. The success rate following PJI in revision arthroplasty was poor, and other treatment options should be considered.</p>","PeriodicalId":12911,"journal":{"name":"HIP International","volume":" ","pages":"62-69"},"PeriodicalIF":1.3,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142675360","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":"Hounsfield unit values are useful for predicting early outcomes after acetabular fractures: a retrospective study.","authors":"Taku Ukai, Miyu Tamaki, Masato Sato, Masahiko Watanabe","doi":"10.1177/11207000241292026","DOIUrl":"10.1177/11207000241292026","url":null,"abstract":"<p><strong>Background: </strong>Acetabular fractures are among the most challenging orthopaedic fractures, and a high total hip arthroplasty (THA) conversion rate has been reported in older patients with acetabular fractures. Bone quality is a poor prognostic factor after acetabular fracture fixation and has been assessed using computed tomography (CT). However, the relationship between Hounsfield unit (HU) values measured using CT and early acetabular fracture outcomes remains unknown. This study aimed to elucidate the effect of HUs on early acetabular fracture outcomes.</p><p><strong>Methods: </strong>50 consecutive patients who underwent open reduction and internal fixation for acetabular fractures were included. The mean follow-up duration was 24 months. 27 hips had elementary fractures and 23 had associated fractures. The reduction quality assessed using CT was as follows: anatomical, 13 hips; imperfect, 10 hips; and poor, 27 hips. Secondary hip osteoarthritis was observed in 5 patients (10%), and the surgery was converted to THA in 1 patient (2%). The HU values of the fifth vertebral body and the unaffected side of the femoral head were measured. The fracture type, radiological secondary hip osteoarthritis, conversion to THA, and postoperative displacement gap were recorded.</p><p><strong>Results: </strong>The unaffected femoral head HU values in elementary fractures (250.5 ± 50.5) were significantly higher than those in associated fractures (221.5 ± 48) (<i>p</i> <i><</i> 0.047). The HU values of the fifth vertebral body and the unaffected femoral head were significantly correlated with the postoperative residual displacement gap and were significantly lower in those with secondary osteoarthritis than in those without it. The cut-off value for predicting early osteoarthritic change after an acetabular fracture was approximately 180.</p><p><strong>Conclusions: </strong>The HU values were correlated with the fracture type, postoperative displacement gap, and early osteoarthritic change after acetabular fractures and are clinically useful prognostic factors for early acetabular fracture outcomes.</p>","PeriodicalId":12911,"journal":{"name":"HIP International","volume":" ","pages":"106-112"},"PeriodicalIF":1.3,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142618990","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}
HIP InternationalPub Date : 2025-01-01Epub Date: 2024-09-30DOI: 10.1177/11207000241283775
Julia E Todderud, Lauren Holbrook, David F Scott
{"title":"Clinical outcomes and complications of a non-modular dual-mobility acetabular device, minimum 2 years follow-up.","authors":"Julia E Todderud, Lauren Holbrook, David F Scott","doi":"10.1177/11207000241283775","DOIUrl":"10.1177/11207000241283775","url":null,"abstract":"<p><strong>Introduction: </strong>Non-modular dual-mobility (DM) acetabular bearing constructs are becoming more popular due to their potential advantages for addressing range of motion (ROM) and stability. The objective of this post-market clinical study was to assess clinical outcomes, including patient satisfaction, pain and function, survivorship, and component positioning, in patients ⩾2 years after primary THA using non-modular DM acetabular components.</p><p><strong>Methods: </strong>This retrospective, multicentre study evaluated complications and functional outcomes in recipients of non-modular DM acetabular constructs at least 2 years post-THA. Our primary outcomes included the dislocation rate and mean Hip disability and Osteoarthritis Outcomes Score (HOOS). Secondary outcomes included radiographic measurements, patient satisfaction, Forgotten Joint Score (FJS), Harris Hip Score (HHS), and survivorship.</p><p><strong>Results: </strong>316 eligible patients enrolled in this study across 3 sites, including 168 men (53%) and 148 women (47%). The cohort averaged 5.37 years post-THA (range 2.2-10.1 years) at the study visit. The mean FJS, HHS, and HOOS were good to excellent, with values of 82.3, 90.7, and 92.0, respectively. Patient satisfaction averaged 4.68, between \"Very Good\" (4) and \"Excellent\" (5). Minimal radiolucent lines (RLL) surrounded the acetabulum. More RLL surrounded the femur, but most lines were less than 1 mm (4.7% of the study population). There were few adverse events (4 events, 1.3%). Three revisions were performed (0.9%), with one patient requiring removal of the acetabular cup.</p><p><strong>Discussion: </strong>The high mid- to long-term survivorship and low to no dislocation and reoperation rates indicate this acetabular DM device is a viable option for THA patients. The patient metrics reflect satisfaction, alleviated pain, and restored function with a low risk of adverse outcomes.</p>","PeriodicalId":12911,"journal":{"name":"HIP International","volume":" ","pages":"76-82"},"PeriodicalIF":1.3,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142345496","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}
HIP InternationalPub Date : 2025-01-01Epub Date: 2024-12-09DOI: 10.1177/11207000241300695
Dae-Woong Ham, Gil Won Choi, Yi Sack Yoo, Chul-Ho Kim
{"title":"Predictive value of preoperative gluteus and iliacus muscle volumes for patient-reported outcomes following total hip replacement: a three-dimensional volumetric analysis.","authors":"Dae-Woong Ham, Gil Won Choi, Yi Sack Yoo, Chul-Ho Kim","doi":"10.1177/11207000241300695","DOIUrl":"10.1177/11207000241300695","url":null,"abstract":"<p><strong>Introduction: </strong>This study aimed to investigate the relationship between hip muscle mass and patient-reported outcomes (PROs) after total hip arthroplasty (THA) surgery for hip disease using 3D volumetric measurements of the gluteus muscle group and iliac muscle.</p><p><strong>Materials and methods: </strong>Between January 2020 and December 2021, 85 patients who had undergone unilateral THA for osteoarthritis or osteonecrosis of the femoral head were enrolled. Using a 3D modeler program, automatically generated 3D reconstructed images of the hip muscles were obtained, and volumetric measurements were performed. Both unadjusted and height (m<sup>2</sup>)-adjusted muscle volumes of the gluteus maximus (unadjusted volume: GmaxV; adjusted volume: GmaxI), gluteus medius (unadjusted volume: GmedV; adjusted volume: GmedI), gluteus minimus (unadjusted volume: GminV; adjusted volume: GminI), and iliacus (unadjusted volume: IliacV; adjusted volume: IliacI) muscles were measured on the affected side and both sides. Pearson correlation analysis between muscle volumes and postoperative 12-month PROs were performed.</p><p><strong>Results: </strong>The preoperative Gmax volume on the affected side was significantly associated with post-operative PROs, especially mHHS (GmaxV: <i>p</i> = 0.026; GmaxI: <i>p</i> = 0.005) and UCLA scores (GmaxV: <i>p</i> = 0.006; GmaxI: <i>p</i> = 0.002). For measurements on both sides, Gmed volume was the sole index showing a significant correlation with postoperative UCLA scores (GmedV: <i>p</i> = 0.023; GmedI: <i>p</i> = 0.043).</p><p><strong>Conclusions: </strong>The current study suggests that preoperative gluteus muscle volume may have predictive value for postoperative PROs of hip disease patients who have undergone THA surgery.</p>","PeriodicalId":12911,"journal":{"name":"HIP International","volume":" ","pages":"18-24"},"PeriodicalIF":1.3,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142793912","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}
HIP InternationalPub Date : 2025-01-01Epub Date: 2024-10-07DOI: 10.1177/11207000241283801
Thomas J Berault, John M Wyatt, Aaron A Olsen, Clark Mantooth, George C Balazs, Ashton H Goldman, Vanna J Rocchi
{"title":"The inferior sacral iliac line as a horizontal reference plane in paediatric pelvic radiographs.","authors":"Thomas J Berault, John M Wyatt, Aaron A Olsen, Clark Mantooth, George C Balazs, Ashton H Goldman, Vanna J Rocchi","doi":"10.1177/11207000241283801","DOIUrl":"10.1177/11207000241283801","url":null,"abstract":"<p><strong>Background: </strong>While often used, Hilgenreiner's line may not always be a reliable reference plane following triple innominate pelvic osteotomy or trauma to the triradiate cartilage. The inferior sacral-iliac line is a horizontal line connecting the sclerotic corners of the inferior sacral-iliac joints. This is a consistent landmark in the ossifying infant pelvis as well as the fully developed adult pelvis. The goal of this study was to determine if there is a difference in measurements between the inferior sacral-iliac line and Hilgenreiner's line in order to identify an alternative horizontal reference plane.</p><p><strong>Methods: </strong>3 reviewers (fellowship-trained paediatric orthopaedic surgeon, junior orthopaedic resident, senior orthopaedic resident) reviewed 100 paediatric non-osteotomized pelvises. The difference between Hilgenreiner's line and the inferior sacral-iliac line were measured and reported. Measurements were repeated a minimum of 48 hours apart, resulting in 600 comparisons between Hilgenreiner's line and the inferior sacral-iliac line. The standard error of measurement was calculated to assess the variation in measurements between each individual observer and the group as a whole.</p><p><strong>Results: </strong>The mean standard error of measurement between Hilgenreiner's line and the inferior sacral-iliac line was 0.44° (95% CI, ± 0.86). Reviewers 1-3 demonstrated a mean standard error of measurement of 0.38, 0.28, and 0.35 (95% CI, ± 0.74, 0.55, and 0.86) respectively. There was no statistically significant difference between reviewers (<i>p</i> > 0.05). Intra-observer reliability for reviewers 1, 2, and 3 was 0.64 (0.47-0.76), 0.75 (0.63-0.83), and 0.54 (0.32-0.69) respectively, with an inter-observer reliability of 0.42 (0.20-0.60) degrees.</p><p><strong>Conclusions: </strong>In this proof-of-concept study, the inferior sacral-iliac line was found to be an appropriate alternative to Hilgenreiner's line that is easily identifiable for all levels of orthopaedic training. Future inferior sacral-iliac line studies should demonstrate the reliability of multiple acetabular measurements, both pre- and post-osteotomy.</p>","PeriodicalId":12911,"journal":{"name":"HIP International","volume":" ","pages":"102-105"},"PeriodicalIF":1.3,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142380690","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}
HIP InternationalPub Date : 2025-01-01Epub Date: 2024-11-12DOI: 10.1177/11207000241289589
Biagio Zampogna, Augusto Ferrini, Andrea Zampoli, Giuseppe Rocco Talesa, Simone Giusti, Giuseppe Francesco Papalia, Ferruccio Vorini, Rocco Papalia
{"title":"Total hip arthroplasty in patients under 35 years: a systematic review of the last 2 decades studies.","authors":"Biagio Zampogna, Augusto Ferrini, Andrea Zampoli, Giuseppe Rocco Talesa, Simone Giusti, Giuseppe Francesco Papalia, Ferruccio Vorini, Rocco Papalia","doi":"10.1177/11207000241289589","DOIUrl":"10.1177/11207000241289589","url":null,"abstract":"<p><strong>Background: </strong>Patients with total hip arthroplasty (THA) under the age of 35 represent a small and heterogeneous group of 1% of all THA performed. This systematic review aims to analyse the diagnosis, implant type, complications, and long-term results in these patients.</p><p><strong>Methods: </strong>A search was performed on PubMed, Scopus, and Cochrane Library up to 31 July 2023. We included observational prospective and retrospective studies published in the last 20 years, which evaluated diagnosis, implant types, long-term results, and return to sports in patients ⩽35 years who underwent THA. We excluded case reports, case series, and studies with <35 patients. We extracted age, diagnosis, surgical information, follow-up, complications, revision rate, implant survival, and clinical outcomes for each study. The methodology of the included studies was evaluated using the MINORS score.</p><p><strong>Results: </strong>18 studies with 1955 patients and 2383 THAs were included. Osteonecrosis (40.6%), posterior approach (81%), the uncemented press-fit implants (73.4%), metal-polyethylene bearings (31.3%) were the most frequently found items. All the clinical outcomes reported improvement from the preoperative to postoperative. The most frequent complication was aseptic loosening (4.3%). The survival rate was 92.4% at a mean follow-up of 10 years.</p><p><strong>Conclusions: </strong>THA is a good option for specific hip diseases in the young, but aseptic loosening still is the major point of concern.</p>","PeriodicalId":12911,"journal":{"name":"HIP International","volume":" ","pages":"92-101"},"PeriodicalIF":1.3,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142618991","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}
HIP InternationalPub Date : 2024-12-18DOI: 10.1177/11207000241307309
Sonal Mahindroo, Samantha Ferraro, Amil Agarwal, Amy Zhao, Avilash Das, Jordan S Cohen, Savyasachi C Thakkar, Gregory J Golladay
{"title":"Identifying 10-year cumulative incidence and risk of revision following total hip arthroplasty in patients with and without a diagnosis of human immunodeficiency virus.","authors":"Sonal Mahindroo, Samantha Ferraro, Amil Agarwal, Amy Zhao, Avilash Das, Jordan S Cohen, Savyasachi C Thakkar, Gregory J Golladay","doi":"10.1177/11207000241307309","DOIUrl":"https://doi.org/10.1177/11207000241307309","url":null,"abstract":"<p><strong>Introduction: </strong>Prior studies have shown human immunodeficiency virus (HIV) may be a risk factor for early revision following THA, but little data exists looking at long-term implant survivorship. Therefore, the purpose of this study was to compare the 10-year cumulative incidence rate for revision following THA in patients with and without HIV.</p><p><strong>Methods: </strong>A retrospective cohort analysis of patients with HIV undergoing elective THA was conducted using a national database. Patients were stratified into asymptomatic HIV (AHIV) and acquired immune deficiency syndrome (AIDS) cohorts. These patients were propensity-score matched to a group of elective THA patients without HIV based on age, gender, and Charlson Comorbidity Index (CCI) at a 1:2 ratio. Kaplan-Meier and Cox Proportional Hazards Regression Analyses were used to assess cumulative incidence and risk of revisions within 10-years of the index procedure.</p><p><strong>Results: </strong>In total, 678 patients were at-risk at the 10-year mark. There were no differences in 10-year risk of revision THA, amongst patients with HIV when compared to matched and unmatched controls (<i>p</i> > 0.05 for all). Patients with HIV did have an increased risk of periprosthetic joint infection (PJI) following THA when compared to the unmatched control (<i>p</i> = 0.001).</p><p><strong>Discussion: </strong>Surgeons and patients can be reassured of comparable 10-year revision rates in patients with and without HIV. However, as these patients are at increased risk for PJI and PPF, especially those with AIDS, when compared to the general population, surgeons should consider PJI prophylactic modalities in this patient population.</p>","PeriodicalId":12911,"journal":{"name":"HIP International","volume":" ","pages":"11207000241307309"},"PeriodicalIF":1.3,"publicationDate":"2024-12-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142846300","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}
HIP InternationalPub Date : 2024-12-17DOI: 10.1177/11207000241305073
Sadia Afzal, Mohannad Basil Ammori, Ghazal Hodhody, James Kennedy, Lee Hoggett, Tim Board
{"title":"Prosthetic hip dislocation: a pilot multicentre observational study.","authors":"Sadia Afzal, Mohannad Basil Ammori, Ghazal Hodhody, James Kennedy, Lee Hoggett, Tim Board","doi":"10.1177/11207000241305073","DOIUrl":"https://doi.org/10.1177/11207000241305073","url":null,"abstract":"<p><strong>Background: </strong>Total hip arthroplasty is one of the most successful and cost-effective interventions for improving quality of life. Dislocation is a well-recognised complication with a significant health and economic burden. The aim of this study was to establish the current management practices for patients presenting with a prosthetic hip dislocation. This was measured through the primary outcome of definitive management, either in the form of revision surgery or the consideration for this through a referral pathway. The secondary outcome measured the number of dislocations per patient resulting in consideration for definitive management.</p><p><strong>Methods: </strong>Between January and July 2019, 186 patients who sustained a prosthetic hip dislocation were identified from 13 separate institutions. Data were retrospectively collected including patient demographics, co-morbidities, details of the arthroplasty, number of dislocations, and management, both in the acute setting and after discharge.</p><p><strong>Results: </strong>149 patients who sustained 200 dislocations were included. The median (interquartile range) interval between primary total hip arthroplasty and first dislocation was 6 (0-13) years. An urgent reduction was achieved either in the emergency department or operating theatre in 3 (1.5%) and 188 (94%) cases, respectively, and 2 (1%) underwent urgent revision. Only 55 patients (36.9%) received definitive management, either in the form of revision surgery or consideration for this. The number of dislocations was the only independent predictor of definitive management (<i>p</i> = 0.001, odds ratio [OR] 1.332; 95% confidence intervals 1.130-1.570).</p><p><strong>Conclusions: </strong>There is a lack of consensus regarding the definitive management of patients with prosthetic hip dislocation. Our study highlights the need for a standardised pathway for the management of this complication. We aim to expand this study to a national level to propose a data-driven management algorithm for prosthetic hip dislocations.</p>","PeriodicalId":12911,"journal":{"name":"HIP International","volume":" ","pages":"11207000241305073"},"PeriodicalIF":1.3,"publicationDate":"2024-12-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142835328","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}
HIP InternationalPub Date : 2024-12-17DOI: 10.1177/11207000241305977
Ilya Bendich, Yu-Fen Chiu, Nana Sarpong, Alejandro Gonzalez Della Valle, Edwin Su, Alexander McLawhorn
{"title":"Robotic-assistance and computer-navigation have similar rates of intraoperative fracture and return to the operating room within 1 year to fluoroscopy-only direct anterior total hip arthroplasty.","authors":"Ilya Bendich, Yu-Fen Chiu, Nana Sarpong, Alejandro Gonzalez Della Valle, Edwin Su, Alexander McLawhorn","doi":"10.1177/11207000241305977","DOIUrl":"https://doi.org/10.1177/11207000241305977","url":null,"abstract":"<p><strong>Introduction: </strong>The use of technology in direct anterior approach (DAA) total hip arthroplasty (THA) is expanding. Although the use of computer-navigation (CN-THA) and robotics (RA-THA) has previously demonstrated improved component positioning, it is important to understand whether its use is associated with differences in intraoperative complications or early return to the operating room when compared to fluoroscopy-only (manual-THA) DAA THA.</p><p><strong>Methods: </strong>3433 DAA THAs (226 RA-THA, 1007 CN-THA, 2200 manual-THA) performed at a single institution were retrospectively reviewed. Cohorts were adjusted for age, sex, BMI, femoral fixation, history of spine fusion, and Charlson Co-morbidity Index (CCI) using Inverse Probability of Treatment Weight (IPTW). Operative times were identified. Intraoperative fractures and re-operations within 1 year were identified via chart review.</p><p><strong>Results: </strong>There were no statistically significant differences in intraoperative fracture among the cohorts (0.4% RA-THA, 0.4% CN-THA, 0.4% manual-THA; p > 0.529). There were also no statistically significant differences (<i>p</i> > 0.589) among the cohorts in rates of return to the operating room within 1 year for postoperative fracture (0.0% RA-THA, 0.4% CN-THA, 0.4% manual-THA), dislocation (0.0% RA-THA, 0.0% CN-THA, 0.1% manual-THA), infection (0.4% RA-THA, 0.7% CN-THA, 0.5% manual-THA), or other aetiologies (0.0% RA-THA, 0.2% CN-THA, 0.1% manual-THA).</p><p><strong>Conclusions: </strong>This study did not find a statistically significant difference in intraoperative fracture or re-operations within 1 year between DAA THA performed with RA, CN, or manual techniques. The introduction of technology to THA is not associated with increase in reoperations within one-year.</p>","PeriodicalId":12911,"journal":{"name":"HIP International","volume":" ","pages":"11207000241305977"},"PeriodicalIF":1.3,"publicationDate":"2024-12-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142835353","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}