HIP International最新文献

{"title":"Same same but different: Introduction of a classification system in calcar-guided short-stem total hip arthroplasty.","authors":"Karl P Kutzner","doi":"10.1177/11207000241286259","DOIUrl":"10.1177/11207000241286259","url":null,"abstract":"<p><strong>Background: </strong>The concept of calcar-guided short-stem THA (ssTHA) has largely emerged over the last decade, especially in Europe, and today modern calcar-guided short stems are among the most successful primary femoral implants in terms of complications and revision rates as indicated by multiple registry data. The philosophy originally comprised an individualised reconstruction of the hip anatomy by following the calcar of the femoral neck providing bone- and soft-tissue-sparing characteristics. However, as the stem design allows either metaphyseal fixation alone or additional diaphyseal anchoring, depending on the stem alignment and indication, distinct knowledge is required regarding the implantation technique, the broad variation of positioning and fixation and its potential clinical consequences.</p><p><strong>Aim: </strong>To report on and highlight the characteristics of different ways of performing calcar-guided ssTHA as well as to introduce a classification in order to systematically account for the variety of strategies and the respective implications on the type of fixation.</p><p><strong>Surgical technique: </strong>Already when templating preoperatively, surgeons need to weigh up the different fixation types taking into account a number of patient-related factors. Intraoperatively, by individually controlling the level of osteotomy, the intended type of anchorage can be implemented. Intraoperative radiography to confirm the result, is mandatory.</p><p><strong>Results: </strong>Despite numerous options of stem alignment, depending on the patient's anatomy, the bone quality or the indication for operation, a total of 4 categories were identified to characterise different fixation strategies in calcar-guided ssTHA.</p><p><strong>Conclusions: </strong>The classification system should be used for the preoperative determination of the intended type of anchorage. Whenever a short-stem philosophy with metaphyseal fixation (Type I (M)) is possible, it should be pursued.</p>","PeriodicalId":12911,"journal":{"name":"HIP International","volume":" ","pages":"54-61"},"PeriodicalIF":1.3,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11667953/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142710045","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":"Air arthrography: a safe technique for intra-articular hip injections.","authors":"Shannon Tse, Ashley K Chut, Jonathan Hutt","doi":"10.1177/11207000241301036","DOIUrl":"10.1177/11207000241301036","url":null,"abstract":"<p><strong>Introduction: </strong>Diagnosing the specific causes of young adult hip pain remains challenging due to non-specific symptoms. Fluoroscopy-guided injections are useful for confirming intra-articular hip pain and differentiating it from extra-articular pathology. When performing injections, accurate needle placement into the hip joint is critical. Traditionally, a contrast agent is used to confirm intra-articular positioning. Air arthrograms are an alternative technique that avoids adverse reactions to contrast, which may compromise interpretation of results, as well as being more cost-effective. This study presents the air arthrography technique for intra-articular hip injections, and assesses outcomes and complications in a consecutive patient cohort.</p><p><strong>Methods: </strong>A retrospective review was performed on patients who underwent an air arthrography guided intra-articular hip injection at a single institution between April 2019 and September 2022. We identified 352 hips in 294 patients. Patient records were evaluated for complications from the injection or any subsequent hip surgery.</p><p><strong>Results: </strong>Mean age at time of injection was 38 years (±14.7 SD) for 216 females and 78 males. Mean follow-up time post injection was 138 days (IQR = 46-186). Results showed a 2.56% complication rate, primarily attributed to steroid flares, all of which resolved without further intervention. 102 patients proceeded to subsequent hip surgery; the mean time from injection to procedure was 341 days (IQR = 194-456) and the mean follow-up post subsequent procedure was 346 days (IQR = 87-531). There were no infective complications following the injections or any subsequent procedures.</p><p><strong>Conclusions: </strong>This is the first study that evaluates longer-term patient outcomes following air arthrography guided injections with or without subsequent surgery. Our results demonstrate that the use of air arthrograms is a reliable, safe, and cost-effective method for intra-articular hip injections, without the additional risks posed by contrast media.</p>","PeriodicalId":12911,"journal":{"name":"HIP International","volume":" ","pages":"4-8"},"PeriodicalIF":1.3,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142750681","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":"Transition from straight lateral to direct anterior approach in total hip arthroplasty: a retrospective single-centre study.","authors":"Lambert C E Visser, Noa H M Ponds, Ellie B M Landman, Stijn A A N Bolink","doi":"10.1177/11207000241285388","DOIUrl":"10.1177/11207000241285388","url":null,"abstract":"<p><strong>Introduction: </strong>The muscle-sparing direct anterior approach (DAA) for total hip arthroplasty (THA) has gained popularity for reduced postoperative pain and faster rehabilitation. The aim of this study was to evaluate the potential benefits of transitioning from straight lateral approach (SLA) THA to DAA THA, and investigate whether these benefits outweigh potential disadvantages of the DAA learning curve.</p><p><strong>Method: </strong>Patients undergoing surgery between 2015 and 2020 (<i>n</i> = 2275) were categorised into three periods: pre-transition period (2015-2016) utilizing SLA exclusively, transition period (2017-2018) incorporating both SLA and DAA, and post-transition period (2019-2020) employing only DAA. The Hip disability and Osteoarthritis Outcome Score - Physical function Short-form (HOOS-PS) was recorded pre-surgery and one-year post-surgery. Furthermore, complications, blood loss, duration of surgery and length of stay were compared between groups.</p><p><strong>Results: </strong>A larger improvement in HOOS-PS score was found for DAA in comparison with SLA (37.13 ± 18.62 vs. 32.55 ± 22.83; <i>p</i> < 0.001). Significant improvements were found for the DAA group regarding duration of surgery (70:02 ± 15:54 min vs. 79:47 ± 15:03 min; <i>p</i> < 0,001) and length of stay (1.68 ± 1.80 days vs. 3.39 ± 1.85 days; <i>p</i> < 0,001) compared to the SLA group. Total number of complications was higher for SLA (<i>n</i> = 87 (9.2%)) compared to DAA (<i>n</i> = 77 (6.5%); <i>p</i> = 0.018), with more femoral fractures for SLA (<i>n</i> = 35 (3.7%) vs. <i>n</i> = 6 (0.5%); <i>p</i> < 0.001) whereas more dislocations were found for DAA (<i>n</i> = 24 (2.0)% vs. <i>n</i> = 7 (0.7%); <i>p</i> = 0.017). More specifically, a higher number of dislocations occurred during the DAA transition period when compared to the SLA pre-transition period (<i>n</i> = 12 (2.7%) vs. <i>n</i> = 4 (0.6%); <i>p</i> = 0.008).</p><p><strong>Conclusions: </strong>Transitioning from SLA to DAA for THA improves patient-reported outcomes but does not seem to result in a higher overall complication rate. Suggesting the advantages of the DAA outweigh the potential disadvantages of the learning curve.</p>","PeriodicalId":12911,"journal":{"name":"HIP International","volume":" ","pages":"25-32"},"PeriodicalIF":1.3,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142739417","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":"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}

{"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}

{"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}

{"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 (m²)-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}

{"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}

{"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}