HIP International最新文献

{"title":"Impact of primary surgical approach on revision approach for isolated head-liner exchange in total hip arthroplasty.","authors":"Jonathan Liu, Mohammad Daher, Noah Gilreath, Jared Sain, Nathaniel Smith, Matthew Quinn, Stephen Kayiaros, Valentin Antoci, Eric M Cohen","doi":"10.1177/11207000251362135","DOIUrl":"10.1177/11207000251362135","url":null,"abstract":"<p><strong>Introduction: </strong>Isolated femoral head and polyethylene liner exchange is commonly performed with varying surgical approaches used for the primary THA (pTHA) and the revision THA (rTHA). The purpose of this study is to investigate the prevalence and postoperative outcomes associated with concordance and discordance in isolated head-liner exchange.</p><p><strong>Methods: </strong>A retrospective chart review from May 2016 to November 2023 was performed for all patients at 2 institutions who underwent isolated head-liner exchange. 175 patients had minimum 1-year follow-up with complete information regarding surgical approach and outcomes. 175 included were grouped based on their pTHA approach including posterior approach (PA), anterolateral (AL), and direct anterior (DA), and their subsequent rTHA approach. Demographics and postoperative outcomes were compared between groups. Chi-square tests were used to measure associations between surgical approaches and postoperative complications, with a <i>p</i>-value of <0.05 signifying statistical significance.</p><p><strong>Results: </strong>Our study included 175 patients with isolated head-liner exchange, with a mean age of 68.5 ± 10.4 years. Of the 175 patients, 100 (57.1%) received primary THA via the posterior approach (PA), with 68.0% having concordant revisions. For the anterolateral (AL) and direct anterior (DA) primary approaches, 91.1% and 94.7% of revisions were concordant, respectively. Indication for revision differed by approach, particularly within the PA group, where instability favoured concordant revisions, and metallosis favoured discordant revisions. There was no significant difference in perioperative outcomes between concordant and discordant approaches, except the concordant group had more EBL, higher rates of transfusions, reoperations, and discharge to skilled nursing facilities (SNF).</p><p><strong>Conclusions: </strong>In pTHA cohort, patients with PA approach were more likely to undergo head-liner exchange with a discordant approach via DA or AL. As no significant associations were found in any combination of discordant approaches with postoperative complications, surgeons should choose their head-liner approach without significant concern for discordance.</p>","PeriodicalId":12911,"journal":{"name":"HIP International","volume":" ","pages":"517-522"},"PeriodicalIF":1.1,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144951789","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":"Conventional single articulation constrained liners in revision hip arthroplasty: risk factors for failure and their combinations.","authors":"Rashid M Tikhilov, Nikolai N Efimov, Igor I Shubnyakov, Maksim Y Goncharov, Dmitrii V Stafeev, Vitalii V Karelkin","doi":"10.1177/11207000241282398","DOIUrl":"10.1177/11207000241282398","url":null,"abstract":"<p><strong>Background: </strong>Constrained liners (CLs) have been used in revision total hip arthroplasty (rTHA) with varying results. Relatively few studies have identified specific risk factors for failure. This study aimed to assess implant survivorship and complication rates, identify risk factors for constraint-related complications, and assess the effect of multiple factors present in a single case.</p><p><strong>Methods: </strong>We conducted a retrospective analysis of 101 rTHAs for various aseptic indications and as second-stage procedures for periprosthetic joint infection (PJI) utilising 2 models of conventional single-articulation CLs. We excluded 8 cases in which the liners were removed early due to PJI and assessed the risk factors for constraint-related complications in the remaining 93 cases. The mean follow-up duration for complication-free cases was 6.5 years (range 4.7-10.5 years).</p><p><strong>Results: </strong>The incidences of dislocation of a prosthetic head and loosening of the acetabular component were 19.8% and 5.0%, respectively. We also observed 8 cases where the locking ring of the liner was dislodged without dislocation (1 case required re-revision). The presence of factors related to impingement (cup retention, smaller internal diameter CLs, signs of probable impingement from the femoral side) was associated with higher rates of constraint-related complications. The presence of factors related to soft-tissue stabilisers did not increase the rate of complications. The simultaneous presence of multiple impingement-related risk factors resulted in worse outcomes.</p><p><strong>Conclusions: </strong>CLs may be less effective for treating or preventing instability related to impingement. CLs should be used with caution or avoided when multiple impingement-related risk factors are present.</p>","PeriodicalId":12911,"journal":{"name":"HIP International","volume":" ","pages":"437-444"},"PeriodicalIF":1.1,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142380689","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 results of the Burch-Schneider antiprotrusio cage: a single-centre follow-up of 144 cases after a minimum of 5 years.","authors":"Thomas Stark, Karl Stoffel, Thomas Ilchmann, Brigitta Gahl, Lukas Zwicky, Peter E Ochsner, Martin Clauss","doi":"10.1177/11207000251362177","DOIUrl":"https://doi.org/10.1177/11207000251362177","url":null,"abstract":"<p><strong>Background: </strong>Although the Burch-Schneider antiprotrusio cage (BS-APC) has been reported to be reliable, long-term data for this implant are scarce. We thus aimed to investigate survival and radiological results for revision total hip arthroplasty with the BS-APC in patients with major bone deficiency (55% AAOS defect grade 3, 39% grade 4) who had a minimum follow-up of 5 years (mean 10.2 years).</p><p><strong>Methods: </strong>144 revisions in 140 patients were performed due to aseptic loosening (<i>n</i> <i>=</i> 74), infection (<i>n</i> = 50), or other reasons (<i>n</i> = 20). Survival analysis was performed with death as a competing risk. Clinical follow-up was performed at 1, 2, and 5 years and every 5 years thereafter.</p><p><strong>Results: </strong>77 patients died during follow-up, 25 within the first 5 years. 12 BS-APCs were re-revised for infection (<i>n</i> = 5), aseptic loosening (<i>n</i> = 5), or instability (<i>n</i> = 2). The cumulative incidence for aseptic re-revision of BS-APCs was 4.3% at 10 years (95% CI, 1.8-10.1%), and the cumulative risk of death was 73.3% (95% CI, 62.4-83.2%). Radiological changes occurred in 26 of 87 radiologically examined hips, of which 8 cases were revised.</p><p><strong>Conclusions: </strong>We found excellent mid- and long-term survival of the BS-APC in acetabular revision with major bone deficiencies, in accordance with or superior to most literature reports, which might be explained by strict adherence to surgical technique.</p>","PeriodicalId":12911,"journal":{"name":"HIP International","volume":" ","pages":"11207000251362177"},"PeriodicalIF":1.1,"publicationDate":"2025-08-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144872882","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 direct anterior approach in total hip arthroplasty may be associated with lower short-term mortality compared to various other approaches: a Dutch arthroplasty register study comprising 379,108 procedures.","authors":"Roderick J M Vossen, Gaby V Ten Noever de Brauw, Jore H Willems, Rienk Eshuis, Inger N Sierevelt, Anneke Spekenbrink-Spooren, Hendrik A Zuiderbaan","doi":"10.1177/11207000251365201","DOIUrl":"10.1177/11207000251365201","url":null,"abstract":"<p><strong>Background: </strong>The association between primary total hip arthroplasty (THA) approaches and short-term mortality rates remained unexplored. This study aimed to compare short-term mortality rates between the direct anterior (DAA), posterolateral (PL), anterolateral (AL) and direct lateral (DL) approaches and determine associated factors.</p><p><strong>Methods: </strong>A registry study was conducted using data from 2007 to 2023 of the Dutch Arthroplasty Register. 30- and 90-day mortality were compared between approaches using the chi-square test and the logistic regression analysis to adjust for confounders (age, sex, patient's physical status [ASA] classification, fixation method, body mass index [BMI] and smoking status). Multivariate regression models were used to determine factors associated with short-term mortality. Sensitivity analyses for time periods (2007-2012, 2013-2017, 2018-2023) were performed.</p><p><strong>Results: </strong>The study comprised 379,108 patients (mean age 69.9 ± 9.5, male 33.8%). The AL, PL and DL approaches demonstrated a significantly larger likelihood for 30-day mortality compared to the DAA after adjusting for confounders (DAA: reference; AL: OR 2.32 [1.52-3.57], <i>p</i> < 0.001; PL: OR 1.79 [1.36-2.36], <i>p</i> < 0.001; DL: OR 2.78 [1.69-4.57], <i>p</i> < 0 .001). In ASA I-II patients, likelihood for 90-day mortality for the AL, PL and DL approaches was significantly higher than the DAA approach (DAA: reference; AL: OR 2.293, <i>p</i> < 0.001; PL: OR 1.963, <i>p</i> < 0.001; DL: OR 2.016, <i>p</i> < 0.001). In ASA III-IV patients, differences were not significant, except when comparing the DL to the DAA approach (OR 1.484, <i>p</i> = 0.011). Increased age, male sex, surgical approach and cemented fixation were significantly associated with 30- and 90-day mortality.</p><p><strong>Conclusions: </strong>Findings were suggestive that the DAA provides a reduced likelihood for short-term mortality compared to the PL, AL and DL, after adjusting for confounding factors. Differences in mortality rate were more substantial in healthy patients and remained similar irrespective of time periods. Increased age, male sex, surgical approach, and cemented fixation increased likelihood on short-term mortality.</p>","PeriodicalId":12911,"journal":{"name":"HIP International","volume":" ","pages":"11207000251365201"},"PeriodicalIF":1.1,"publicationDate":"2025-08-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144872883","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 sustained benefits of gram-negative antimicrobial prophylaxis in total hip arthroplasty: a 10-year retrospective analysis.","authors":"Itay Ashkenazi, Weston Buehring, Armin Arshi, Vinay K Aggarwal, Joseph A Bosco, Ran Schwarzkopf","doi":"10.1177/11207000251364214","DOIUrl":"https://doi.org/10.1177/11207000251364214","url":null,"abstract":"<p><strong>Background: </strong>10 years after changing our institution's total hip arthroplasty (THA) preoperative antibiotic prophylactic protocol by adding gram-negative (GN) coverage, this study aimed to assess the impact of adding GN specific coverage (GNSC) prior to THA on periprosthetic joint infection (PJI) rates.</p><p><strong>Methods: </strong>This was a retrospective case-control study of 14,598 patients who underwent primary, elective THA between July 2012 and January 2022, with minimum 1-year follow-up. All patients were under perioperative antibiotic protocol that included GNSC with either weight-based gentamicin or aztreonam (+GNSC) and were compared to a historical control group of patients for which the antibiotic prophylactic protocol did not include GNSC (-GNSC). PJI and nephrotoxicity rates, as well as the severity of nephrotoxicity according to the RIFLE criteria, were compared between the study populations and 4122 controls.</p><p><strong>Results: </strong>Proportions of GN-related PJIs among culture-positive (13.70 vs. 26.53%, <i>p</i> = 0.076) and all PJIs (10.64 vs. 26.53%, <i>p</i> = 0.014) were lower for +GNSC patients, while the proportion of PJIs caused by a gram-positive bacteria were similar between groups (87.67 vs. 83.67%, <i>p</i> = 0.532). While the +GNSC group have significantly higher rates of nephrotoxicity (2.87 vs. 1.78%, <i>p</i> = 0.003), the rates of kidney injury (0.39 vs. 0.39%, <i>p</i> = 0.998) and kidney failure (0.17 vs. 0.16%, <i>p</i> = 0.567), which are the two more severe forms of nephrotoxicity, were comparable between the groups.</p><p><strong>Conclusions: </strong>The addition of gentamicin or aztreonam prior to THA reduces the incidence of GN-related PJIs. Increased nephrotoxicity rates were limited to the mildest form, usually associated with reversibility and favourable outcomes.</p>","PeriodicalId":12911,"journal":{"name":"HIP International","volume":" ","pages":"11207000251364214"},"PeriodicalIF":1.1,"publicationDate":"2025-08-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144872884","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 treatment of hip subspinous impingement: a real clinical improvement in the midterm?","authors":"Jorge Martin-Lozoya, Miguel Cañones-Martin, Javier Sanz-Reig, Mohamed Sadiq, Jesús Mas-Martinez, Marc Tey-Pons, Ricardo Larrainzar Garijo, Oliver Marín-Peña","doi":"10.1177/11207000251360663","DOIUrl":"https://doi.org/10.1177/11207000251360663","url":null,"abstract":"<p><strong>Background: </strong>There is a limited literature available describing the various diagnostic modalities and treatment options for the management of subspine impingement (SSI). We developed a study to evaluate the clinical improvement at 1 year and 5 years, with iHOT 33 and HOS hip scores.</p><p><strong>Questions: </strong>(1) Do patients with subspine compression improve with arthroscopic treatment clinically at short-term follow-up (1 year); (2) Is the improvement maintained in the mid-term (5 years)?</p><p><strong>Methods: </strong>43 young patients (21-65 years) with subspine compression (prominent anterior inferior iliac spine) treated arthroscopically between January 2010 and December 2021 were included. Patients completed the iHOT33, HOS-SPORT and HOS-ADL questionnaires before surgery, 1 year and 5 years follow-up. We evaluated pre- and postoperative differences at 1 year and at 5 years. Minimum clinically significant difference (MCID) and the substantial clinical benefit (SCB) were used to establish clinical improvement.</p><p><strong>Results: </strong>Mean age was 37.38 years and 66% were males. Almost 75% and 70% of our patients exceed the MCID and the SCB respectively in all the questionnaires after 1 year follow-up. However, at 5 years follow-up, nearly 70% and 65% of the patients exceeded MCID and SCB respectively, therefore producing a slight worsening in the medium term.</p><p><strong>Conclusions: </strong>We demonstrate that arthroscopic treatment of subspine impingement is effective. However, larger sample size and longer follow-up period are necessary to analyse long-term results to demonstrate this treatment as the \"gold standard\".</p>","PeriodicalId":12911,"journal":{"name":"HIP International","volume":" ","pages":"11207000251360663"},"PeriodicalIF":1.1,"publicationDate":"2025-08-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144872881","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":"Dual-taper modular stems: aseptic lymphocytic vasculitis-associated lesions (ALVAL): revision rates and outcome in a single hospital series.","authors":"Pascal Kouyoumdjian, Jad Mansour, Francois Bauzou, Jeffrey Michaud, Remy Coulomb","doi":"10.1177/11207000251356413","DOIUrl":"https://doi.org/10.1177/11207000251356413","url":null,"abstract":"<p><strong>Background: </strong>Dual-taper modular stems have been linked to implant failure due to aseptic lymphocytic vasculitis-associated lesions (ALVAL), yet data on revision outcomes remain limited. This study assessed the survival rate of modular stems revised for ALVAL and compared outcomes with a non-revised control group.</p><p><strong>Methods: </strong>A retrospective analysis of 233 total hip arthroplasties (THA) with ABGII dual-taper modular stems (2007-2011) was conducted, with follow-up until 2024. 39 THA (16.7%) underwent revision for ALVAL, confirmed by intraoperative histology. The control group included unrevised patients with ⩾1-year follow-up. Pre-revision assessments included Harris Hip Score (HHS), radiographs, MARS-MRI, and cobalt/chromium ion levels. Revision was indicated for disabling pain, cobalt >5 µg/L, or progressive effusion/pseudotumours. Outcomes included HHS, complications, and Kaplan-Meier survival analysis.</p><p><strong>Results: </strong>Revisions for ALVAL (39 THA, 16.7%) were primarily due to groin pain (64.1%), MRI effusion (79.5%), and elevated cobalt levels (46.2%). The median time to revision was 4 years postoperatively, with a mean time to revision of 2.4 years. Of 21 unipolar revisions 10 hips (27.1%) had a had a dislocation, bipolar revisions (18 hips) had none (<i>p</i> <0.001).At 5, 10, and 15 years, overall revision-free survival was 88.8%, 80.3%, and 75.2%, respectively, while survival free from revision specifically due to ALVAL, confirmed by histological findings, was 91.4%, 83.7%, and 83.1%. 3 hips were re-revised for periprosthetic fractures. After ALVAL revision the HHS improved from 77.6 to 87.7 (<i>p</i> <0.001) but remained lower than in the non-revised controls (<i>p</i> = 0.002). 25.6% of the revised patients had persistent pain.</p><p><strong>Conclusions: </strong>ALVAL-related revisions led to improvement in the HHS but did not reach the levels of non-revied control. Revision with dual-mobility cups reduced the dislocation risk.</p>","PeriodicalId":12911,"journal":{"name":"HIP International","volume":" ","pages":"11207000251356413"},"PeriodicalIF":1.1,"publicationDate":"2025-07-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144729904","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":"Wound complications after total hip arthroplasty: a prospective, randomised controlled trial comparing staples with sutures.","authors":"Wouter H Mallee, Anne E Wijsbek, Matthias U Schafroth, Julius Wolkenfelt, Dominique C Baas, Ton M J S Vervest","doi":"10.1177/1120700020939075","DOIUrl":"10.1177/1120700020939075","url":null,"abstract":"<p><strong>Objective: </strong>Does the use of staples or sutures for wound closure have a lower surgical site infection rate in patients receiving primary total hip arthroplasty (THA)?</p><p><strong>Design: </strong>Prospective, randomised controlled multicentre trial.</p><p><strong>Methods: </strong>535 patients undergoing THA were included and randomised into 2 groups: 268 wounds were closed with staples, and 267 with sutures. Primary outcome was surgical site infection (SSI). Secondary outcomes were prosthetic joint infection (PJI), other wound complications (dehiscence, necrosis and prolonged drainage) and duration of admittance. Follow-up occurred at 2, 6, and 12 weeks, and at 1 year.</p><p><strong>Results: </strong>There were no significant demographic differences between the 2 groups. SSI occurred more frequently when wounds were closed with staples (4% compared to 1% with sutures; OR 2.8; CI, 0.885-0.952; <i>p</i> = 0.057). SSI was treated with oral antibiotics. The staples group showed significantly more wound complications (17% compared to 5%; OR 3.943, CI 2.073-7.498; <i>p</i> = 0.000). Wound discharge was significantly prolonged in the staples group (<i>n</i> = 40, compared to <i>n</i> = 12 in the sutures group; OR 3.728; CI, 1.909-7.281; <i>p</i> = 0.000). There was no significant difference in PJI (<i>p</i> = 0.364).</p><p><strong>Conclusions: </strong>In this large RCT comparing staples with sutures after THA, the use of staples is associated with a nearly 3 times greater risk of SSI (OR 2.8; <i>p</i> = 0.057). Staples significantly prolong wound discharge. The use of sutures for wound closure after THA is advised.<b>Trial registration:</b> Staples Or Sutures trial (S.O.S. trial) http://www.trialregister.nl/trialreg/admin/rctview.asp?TC=3946, NTR3946.</p>","PeriodicalId":12911,"journal":{"name":"HIP International","volume":" ","pages":"326-331"},"PeriodicalIF":1.3,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38132910","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 SKY is the limit - a novel system for interpreting radiolucent lines around CORAIL uncemented total hip arthroplasty stems: a proof-of-concept study.","authors":"James E Miller, Ibrahim Inzarul Haq, Elizabeth Hedge, Paul Saunders, Muhamed M Farhan-Alanie, Siew Wan Hee, Ajay Chourasia, Prasad Rao, Steve K Young","doi":"10.1177/11207000251345995","DOIUrl":"10.1177/11207000251345995","url":null,"abstract":"<p><strong>Background: </strong>The presence of radiolucent lines (RLLs) around total hip replacement (THR) stems correlates with stem failure. However, the zone this occurs in is significant. The widely adopted Gruen Zone classification has disadvantages and is unlikely to be reflective of uncemented biomechanics. We propose a simpler system for describing these changes and introduce its relevance clinically.</p><p><strong>Methods: </strong>In a single-centre retrospective study CORAIL THR stems implanted between 2010 and 2013 were analysed. On postoperative radiographs 2 parallel \"SKY\" lines divided the stem bone interface into 3 zones A, B and C. 1 year and 5 years postoperative radiographs were reviewed by 5 surgeons for the presence and location of RLLs. The revision rates of the UK's National Joint Registry were correlated with the presence of RLLs.</p><p><strong>Results: </strong>1113 stems were included.331 (29.7%) had RLLs, 273 (24.5%) in zone A only, 50 (4.5%) in zones A and B and 8 (0.7%) in all 3 zones A, B and C. In absence of RRLs in zone A, no RLLs were identified in the other zones. 73% RRLs appeared in the first postoperative year, the remaining at 5 years follow-up.1.8% (20 of 1113) stems were revised. The revision rate for stems with RLLs in zone A alone was 2.9%, with RLLs in zone A and B it was 12% and with RLLs in all 3 zones it was 12.5%.The odds of revision were 4.7 times higher (<i>p =</i> 0.007) with RLLs in Zone A and 6.6 times higher (<i>p <</i> 0.001) with RLLs in Zones B and C compared to those without.</p><p><strong>Conclusions: </strong>The SKY lines can be used to classify RLLs and predict the risk of revision for the CORAIL stem. Stems with RLLs progressing beyond the first SKY line from zone A into Zone B-C should be considered higher risk for revision and hence followed-up closely for signs of failure. Absence of RLLs or RLLs in Zone A only can be discharged to patient-initiated follow-up.</p>","PeriodicalId":12911,"journal":{"name":"HIP International","volume":" ","pages":"344-352"},"PeriodicalIF":1.3,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144247548","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":"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":"377-383"},"PeriodicalIF":1.3,"publicationDate":"2025-07-01","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}