HIP International最新文献

{"title":"Comparative performance of the risk analysis index versus traditional frailty measures in predicting outcomes following revision total hip arthroplasty for mechanical prosthetic complications.","authors":"Cameron J Sabet, Bhav Jain, Jad Lawand, Bill Young, Dang Nguyen, Bara M Hammadeh, Mohammad D Alfawareh","doi":"10.1177/11207000261458685","DOIUrl":"10.1177/11207000261458685","url":null,"abstract":"<p><strong>Background: </strong>Frailty assessment has become increasingly important in predicting surgical outcomes, particularly in complex revision procedures. Among patients undergoing revision total hip arthroplasty (rTHA) for mechanical prosthetic complications, optimal frailty stratification remains poorly defined. This study compared the Risk Analysis Index (RAI) and the modified 5-item frailty index (mFI-5) in predicting postoperative outcomes within this high-risk population.</p><p><strong>Methods: </strong>We conducted a retrospective cohort study of 5631 adult patients undergoing rTHA for mechanical prosthetic complications using data from the 2015-2021 American College of Surgeons National Surgical Quality Improvement Program (ACS-NSQIP). Frailty was assessed using RAI and mFI-5, calculated via published algorithms. Primary outcomes were 30-day all-cause mortality and non-home discharge. Secondary outcomes included major complications, minor complications, unplanned readmission, reoperation, and extended length of stay (LOS >4 days). Discriminative performance was evaluated using receiver operating characteristic curves and area under the curve (AUC) analysis, with bootstrap resampling (100 iterations) for internal validation.</p><p><strong>Results: </strong>Mean patient age was 66.80 ± 11.57 years with 57.61% female. Overall, 30-day mortality was 0.4% with major complications occurring in 2.4%. RAI demonstrated superior discrimination for mortality (AUC 0.822) compared to mFI-5 (0.688, <i>p</i> < 0.001). For non-home discharge, RAI achieved AUC 0.735 versus mFI-5 0.607 (<i>p</i> < 0.001). RAI showed strong performance for extended length of stay (AUC 0.624) and minor complications (AUC 0.652), significantly outperforming mFI-5 across multiple outcome measures.</p><p><strong>Conclusion: </strong>The Risk Analysis Index significantly outperforms the mFI-5 across key outcomes following revision total hip arthroplasty for mechanical prosthetic complications. Its multidomain structure, which captures age, functional dependence, comorbidities, and acute physiological stress, makes it a superior tool for surgical risk stratification, discharge planning, and identifying high-risk patients who may benefit from targeted perioperative optimisation.</p>","PeriodicalId":12911,"journal":{"name":"HIP International","volume":" ","pages":"826-833"},"PeriodicalIF":1.3,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148368158","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":"Optimising spherical periacetabular osteotomy: a strategy to minimise leg shortening.","authors":"Toru Nishiwaki, Hisatoshi Ishikura, Yuji Masuyama, Sho Fujita","doi":"10.1177/11207000261458622","DOIUrl":"10.1177/11207000261458622","url":null,"abstract":"<p><strong>Background: </strong>Spherical periacetabular osteotomy (SPO) preserves pelvic structures but can cause leg shortening due to the upward and outward shift of the centre of rotation. Modified preoperative planning aims to medially shift the acetabular fragment's highest point to reduce leg shortening. This study investigated the fixation state of the rotated bone fragment in SPO, its relationship with leg length, and strategies to prevent leg shortening.</p><p><strong>Methods: </strong>Between February 2019 and August 2023, 57 joints in 52 patients undergoing SPO were examined. The postoperative acetabular movement was classified as \"contact\" or \"non-contact\" based on whether the proximal osteotomy surfaces of the rotated and host bone made direct contact on postoperative computed tomography scans. Radiographic assessments included leg length, centre-edge (CE) angle, and acetabular roof obliquity (ARO), measured on standardised anteroposterior pelvic radiographs before and after surgery.</p><p><strong>Results: </strong>Average correction angles were 24° for CE and 23° for ARO, with an average leg length change of -1.3 mm (range -14.5-9.7 mm). Contact-type fixation minimised leg shortening, with an average change of 0.3 mm (range -4.7-9.7 mm), and demonstrated better ARO correction. In contrast, non-contact fixation resulted in greater leg shortening, with an average change of -6.1 mm (range -14.5-4.9 mm).</p><p><strong>Conclusions: </strong>Contact-type fixation effectively reduced leg shortening and stabilised bone fragments. Conversely, non-contact types allowed greater correction angles but led to increased leg shortening due to instability. Enhanced fixation methods are recommended for non-contact cases to maintain stability.</p>","PeriodicalId":12911,"journal":{"name":"HIP International","volume":" ","pages":"842-849"},"PeriodicalIF":1.3,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148519972","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":"Comparative evaluation of locked and unlocked blade proximal femoral nail antirotation implants in the treatment of trochanteric fractures based on reduction quality and clinical success criteria.","authors":"Ali Can Çiçek, Vahit Yıldız","doi":"10.1177/11207000261465877","DOIUrl":"10.1177/11207000261465877","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to compare the reduction quality and clinical outcomes of locked and unlocked blade variants of the proximal femoral nail antirotation (PFNA) system in the treatment of trochanteric fractures in patients aged >65 years with similar demographic and clinical profiles.</p><p><strong>Methods: </strong>A total of 314 patients treated for trochanteric fractures between 2013 and 2020 were retrospectively analyzed. Patients were grouped according to whether locked (<i>n</i> = 160) or unlocked (<i>n</i> = 164) blade PFNA implants were used. Baseline characteristics including age, gender, comorbidities, and fracture type were similar across groups. Surgical parameters, radiological measurements, postoperative complications, and clinical outcomes (Harris Hip Score, Visual Analog Scale) were compared. The use of unlocked blade implants was gradually replaced by locked blade implants after 2017 due to changes in reimbursement regulations.</p><p><strong>Results: </strong>The locked group had significantly longer operation time and greater intraoperative bleeding. No significant difference was found in reduction quality between groups (<i>p</i> > 0.05). Radiologically, Parker ratio AP was higher in the locked group, whereas type apex distance, calcar-referenced distance, and cervical angle difference were greater in the unlocked group (<i>p <</i> 0.05). VAS was higher in the locked group at 6 weeks (<i>p <</i> 0.05). Postoperative complications were more frequent in the locked group, although nonunion rates were not significantly different (<i>p</i> <i>></i> 0.05). Long-term clinical scores showed no significant difference (<i>p</i> <i>></i> 0.05). The unlocked group had significantly longer follow-up duration (<i>p <</i> 0.05).</p><p><strong>Conclusions: </strong>While both implant types provided comparable clinical and radiological outcomes, the unlocked PFNA group showed advantages in terms of surgical efficiency and lower complication rates.</p>","PeriodicalId":12911,"journal":{"name":"HIP International","volume":" ","pages":"857-867"},"PeriodicalIF":1.3,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148701200","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 rehabilitation through a mobile application: a retrospective observational study.","authors":"Joaquín Zambrano-Martín, Jesus Moreta, Antonia Gómez-Conesa, Roberto Méndez-Sánchez, Miguel Mendoza-Puente","doi":"10.1177/11207000261423149","DOIUrl":"10.1177/11207000261423149","url":null,"abstract":"<p><strong>Introduction: </strong>Postoperative rehabilitation following total hip arthroplasty is important for optimising functional recovery and pain relief. This study compares a mobile application providing functional recovery exercises and pain management education with in-person physical therapy in patients undergoing total hip arthroplasty.</p><p><strong>Methods: </strong>A retrospective study was conducted with 2 cohorts (<i>n</i> = 94) matched using propensity score matching. The App group (<i>n</i> = 47) used a mobile app for postoperative follow-up, while the control group (<i>n</i> = 47) received conventional follow-up. Functional outcomes (Harris Hip Score [HHS], Merle D'Aubigné [MDP], WOMAC) and pain intensity (visual analogue scale [VAS]) were assessed preoperatively, at one month, and 3 months post-intervention.</p><p><strong>Results: </strong>Both groups showed significant improvements in all measurements compared to preoperative values. However, the App group showed significant improvements compared to the control group in the following outcome: HHS at 3 months (<i>P</i> = 0.02), improved MDP mobility (<i>P</i> = 0.02) and walking ability (<i>P</i> <i><</i> 0.0001), and lower VAS pain scores at one month (<i>P</i> = 0.004) and 3 months (<i>P</i> = 0.01).</p><p><strong>Conclusions: </strong>The mobile app program with recovery exercises and pain management is more effective than in-person physiotherapy in improving function and reducing pain after total hip arthroplasty.</p><p><strong>Registration: </strong>The study was registered with the US National Institutes of Health (NIH) under the number: NCT06606158. https://clinicaltrials.gov/study/NCT06606158.</p>","PeriodicalId":12911,"journal":{"name":"HIP International","volume":" ","pages":"775-782"},"PeriodicalIF":1.3,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147633325","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":"Determining the incidence of abductor tears in total hip arthroplasty via direct lateral approach: a prospective analysis.","authors":"Elizabeth A Abe, Alec M Giakas, Matthew B Sherman, Gregory K Deirmengian, Eric B Smith, James J Purtill","doi":"10.1177/11207000261417954","DOIUrl":"10.1177/11207000261417954","url":null,"abstract":"<p><strong>Introduction: </strong>Each surgical approach for primary THA has unique advantages. The direct lateral approach (DLA) offers increased visualisation of the gluteus medius and minimus tendons and, consequently, has been suggested to facilitate management of intraoperatively identified abductor tears. However, there remains a paucity of data exploring the frequency of abductor tears in patients undergoing primary THA via DLA. The purpose of this prospective study was to: (1) report the incidence of abductor tears in the DLA patients; and (2) identify risk factors for abductor tears in patients undergoing primary THA.</p><p><strong>Methods: </strong>All patients undergoing primary THA for osteoarthritis via the DLA by 3 high-volume, fellowship-trained arthroplasty surgeons from September 2023 to March 2024 were enrolled. Data on patient demographics and preoperative functional outcome scores were collected. The location, size, and tissue quality for patients with an abductor tear intraoperatively was also recorded. Receiver operating characters (ROC) curve analysis was utilised to determine abductor tear risk factors.</p><p><strong>Results: </strong>Of the 346 patients included in the analysis, 63 (18.2%) had an abductor tear. There was no difference in BMI, laterality, and preoperative functional outcome scores between groups. However, patients with an abductor tear were more likely to be older (70.1 ± 7.9 versus 65.0 ± 9.5 years, <i>p</i> < 0.001), Women (68.3% vs. 31.7%, <i>p</i> = 0.027), and have a higher age-adjusted Charlson comorbidity index score (4.0 ± 1.7 vs. 3.3 ± 1.9, <i>p</i> = 0.002). Using ROC curve analysis, patients 68 years of age or older were 2.99 times more likely to have a tear identified. Of all tears, 87.3% of tears were at the anterior aspect of the greater trochanter with a mean size of 26.6 ± 12.1 by 12.9 ± 11.5 mm.</p><p><strong>Conclusions: </strong>In the present study, the incidence of abductor tears in patients undergoing primary THA via the DLA was 18.2%. Future studies are needed to compare the implications of abductor tears encountered in primary THA.</p>","PeriodicalId":12911,"journal":{"name":"HIP International","volume":" ","pages":"738-744"},"PeriodicalIF":1.3,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147365022","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 morphometric variability of the acetabular labrum: Insights for personalised hip labral reconstruction.","authors":"Bruno Capurro-Soler, Sebastian Gonzalez-VonderMeden, Wilson Pizarro-Geraldo, Safa Gursoy, Baris Kocaoglu, Jorge Chahla, Shane Nho","doi":"10.1177/11207000261469470","DOIUrl":"10.1177/11207000261469470","url":null,"abstract":"<p><strong>Background/objectives: </strong>The acetabular labrum plays a key role in hip biomechanics, reducing contact pressure and peak stress on articular cartilage. In femoroacetabular impingement (FAI), injuries often require surgical intervention. While anatomical repair restores function, irreparable cases necessitate labral reconstruction with grafts. Despite advancements, detailed morphometric studies remain limited. This study analyses labral morphometry, focusing on regional and sex-based differences to optimise graft selection.</p><p><strong>Materials and methods: </strong>18 adult hip specimens were included after screening for normal hip morphometry on fluoroscopy (Wiberg 25-40°, alpha angle <55°, preserved joint space; Tönnis <2) and verification of intact labral and chondral structures after dissection. Morphometric measurements included labrum height (anterior,superior,posterior), acetabular diameter, anterior superior iliac spine (ASIS) distance, and transverse ligament (TAL) width. Specimens were analysed regionally and stratified by sex. Statistical comparisons identified morphometric differences.</p><p><strong>Results: </strong>Labrum height was greatest in the posterior (7.49 ± 0.95 mm), followed by the superior (6.78 ± 0.91 mm) and anterior (5.60 ± 0.71 mm) regions. Statistically significant (<i>p <</i> 0.05) sex-based differences were observed in all measurements. Males exhibited greater labral height in the superior (7.19 ± 1.02 mm vs. 6.29 ± 0.91 mm), posterior (7.38 ± 0.66 mm vs. 6.93 ± 0.70 mm), and anterior (5.49 ± 1.03 mm vs. 5.03 ± 0.71 mm) regions. Additionally, males had larger transverse ligament width (7.04 ± 0.68 mm vs. 6.66 ± 0.63 mm), ASIS distance (285.73 ± 7.12 mm vs. 275.88 ± 9.24 mm), and acetabular diameter(54.35 ± 2.76 mm vs. 50.29 ± 4.97 mm).</p><p><strong>Conclusions: </strong>The acetabular labrum shows progressive height variation - posterior > superior > anterior - with males exhibiting approximately 1 mm greater dimensions across all regions. These anatomical differences should guide graft selection and surgical planning to optimise patient-specific hip preservation and outcomes.</p>","PeriodicalId":12911,"journal":{"name":"HIP International","volume":" ","pages":"850-856"},"PeriodicalIF":1.3,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148759763","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":"Optimising femoral head extraction to preserve the tensor fasciae latae in direct anterior hip arthroplasty: a technical note.","authors":"Chatchapol Ongkosit","doi":"10.1177/11207000261460817","DOIUrl":"10.1177/11207000261460817","url":null,"abstract":"<p><strong>Background: </strong>The direct anterior approach (DAA) in total hip arthroplasty is widely recognised for its muscle-sparing advantages; however, it remains associated with a notable risk of injury to the tensor fasciae latae muscle (TFL), particularly during femoral head extraction.</p><p><strong>Methods: </strong>This report introduces a structured, stepwise extraction technique specifically designed to minimise TFL trauma during DAA procedures. The method utilises a Schanz pin and a corkscrew, prioritising controlled longitudinal traction while minimising lateral shear forces to preserve the structural integrity of the TFL.</p><p><strong>Results: </strong>A total of 63 hip arthroplasties were performed, including 31 total hip arthroplasties (THAs) and 32 bipolar hemiarthroplasties (BHAs). In the THA group, the mean patient age was 51.15 ± 12 (range 36-73) years. Of these, 23 hips were classified as Ficat and Arlet stage III and 8 as stage IV. The TFL damage score during femoral head extraction was 0 in 28 hips and 1 in 3 hips. In the BHA group, the mean patient age was 76.14 ± 6.8 (range 70-87) years, and the TFL damage score was 0 in all cases.</p><p><strong>Conclusions: </strong>This approach is straightforward, reproducible, and safe, offering a practical adjunct for optimizing soft tissue preservation in routine DAA hip arthroplasty.</p>","PeriodicalId":12911,"journal":{"name":"HIP International","volume":" ","pages":"819-825"},"PeriodicalIF":1.3,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148520025","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":"Favourable outcomes of fast-track hip arthroplasty using the direct superior approach, but no clinically superior postoperative PROMs compared to the posterolateral approach.","authors":"Baukje Dijkstra, Tammo Brouwer, Kim de Jong, Wierd Zijlstra","doi":"10.1177/11207000261426922","DOIUrl":"10.1177/11207000261426922","url":null,"abstract":"<p><strong>Background: </strong>In comparison to the traditional posterolateral approach (PLA) for total hip arthroplasty (THA), the direct superior approach (DSA) is an alternative, less invasive posterior approach. Its minimally-invasiveness could make the DSA suitable for implementation in fast-track surgery. This study evaluated outcomes of a fast-track protocol including the DSA and compared patient-reported outcome measures (PROMs) to national data of the PLA.</p><p><strong>Methods: </strong>A single-surgeon series of 50 primary THA patients who underwent fast-track DSA surgery with short-acting articaine spinal anaesthesia were retrospectively reviewed. Length of hospital stay (LOS), postoperative in-hospital pain (0-10 NRS rest/activity), patient satisfaction (1-10 NRS), adverse events and PROMs until 1 year post-surgery were collected. Data of 858 matched THAs of the PLA from the Dutch Arthroplasty Register was used for a comparison of PROMs.</p><p><strong>Results: </strong>Median LOS was 2 (range 1-7) days. Overall mean in-hospital pain scores were 1.6 ± 0.9 (rest) and 2.2 ± 0.9 (activity). Patient satisfaction score (only available in <i>n</i> = 10, 20%) was 8.6 ± 1.3 on average. A dislocation occurred in 1 patient. Compared to baseline, all PROMs scores improved after 3 and 12 months of follow-up. PROMs scores of the fast-track DSA group were better than the national PLA averages at each time point, including the baseline assessment. However, between-group differences were small and not significant.</p><p><strong>Conclusions: </strong>Fast-track THA surgery using the DSA and short-acting articaine spinal anaesthesia demonstrated a short LOS, low in-hospital pain scores and few serious complications. Postoperative PROMs scores were good, but not clinically superior to nationwide PLA outcomes.</p>","PeriodicalId":12911,"journal":{"name":"HIP International","volume":" ","pages":"756-765"},"PeriodicalIF":1.3,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147616208","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 conversion of hip resurfacing arthroplasty to total hip arthroplasty with acetabular component revision.","authors":"Mitchell F Kennedy, Cameron Bussey-Sutton, Sophia S Antonioli, Scott Marwin, Ran Schwarzkopf, William Macaulay","doi":"10.1177/11207000261433542","DOIUrl":"10.1177/11207000261433542","url":null,"abstract":"<p><strong>Background: </strong>Hip resurfacing arthroplasty (HRA) is a femoral bone-preserving alternative to total hip arthroplasty (THA) for younger, active patients. However, complications such as fractures, loosening, and metal wear can require conversion to THA. In some cases, revision of both the acetabular and femoral components is required.</p><p><strong>Methods: </strong>We conducted a retrospective review of 15 patients who underwent conversion of HRA to THA at a single, academic tertiary care centre between January 2011 and April 2024. Demographic data, surgical details, implant characteristics, and indications for conversion were collected. Postoperative outcomes including complications, reoperations, and revisions were investigated. Revision-free survival was estimated using Kaplan-Meier analysis.</p><p><strong>Results: </strong>The mean age was 53.2 years and mean time to conversion was 6.7 years. Indications for conversion included adverse reaction to metal debris (ARMD; n = 6), mechanical loosening (<i>n</i> = 3), component positioning and impingement (<i>n</i> = 3), periprosthetic fracture (<i>n</i> = 1), osteolysis/wear (<i>n</i> = 1), and prosthetic joint infection (PJI; n = 1). Common reasons for acetabular cup revision included ARMD (<i>n</i> = 6), loosening (<i>n</i> = 4), and positioning (<i>n</i> = 3). Dual-mobility (DM) constructs were used in 11 cases (73.3%). There were no dislocations. There was 1 90-day readmission due to persistent wound drainage which underwent debridement, antibiotics, and implant retention (DAIR) 14 days post-conversion. The average follow-up duration after the conversion procedure was 6.1 years. Kaplan-Meier analysis demonstrated 93% revision-free survival at one-year, which remained stable through 13 years.</p><p><strong>Conclusions: </strong>In this study of 15 both-component HRA conversions, we observed 93% revision-free survivorship at mid-term follow-up. While the small cohort size limits definitive conclusions, our findings suggest that revision of the acetabulum during conversion, particularly with dual-mobility constructs, may be an effective strategy to mitigate instability and manage metal-on-metal failure in appropriate patients. Further research with larger cohorts is warranted to confirm our findings.</p>","PeriodicalId":12911,"journal":{"name":"HIP International","volume":" ","pages":"705-712"},"PeriodicalIF":1.3,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147971776","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 paediatric patients with cerebral palsy: mid- to long-term outcomes of a retrospective cohort.","authors":"Alexandra M Stein, Pierre Mary, Thomas Demoures, Reda Kabaj, Raphael Vialle, Mathilde Gaumé","doi":"10.1177/11207000261472391","DOIUrl":"https://doi.org/10.1177/11207000261472391","url":null,"abstract":"<p><strong>Introduction: </strong>Total hip arthroplasty (THA) is commonly performed in adults with excellent outcomes. Its use in the paediatric population remains rare due to concerns regarding potential damage to the growth plate, pelvic biomechanical changes during growth, leg-length discrepancies, and implant longevity. Although modern prostheses have an estimated lifespan of approximately 30 years, durability remains a major concern in young patients. However, in selected cases, particularly in spastic patients suffering from chronic painful hip dislocation, medical options may be exhausted, and conservative surgical procedures may no longer be effective. The aim of this study was to evaluate the mid- to long-term outcomes of paediatric patients with cerebral palsy who underwent THA.</p><p><strong>Methods: </strong>This retrospective single-centre study included 22 paediatric patients with cerebral palsy who underwent THA. Clinical outcomes were analysed according to patient characteristics and prosthetic factors. The primary outcome was chronic pain relief, defined as absence of pain at the last follow-up. Secondary outcomes included postoperative complications and rehospitalisation within 90 days of surgery.</p><p><strong>Results: </strong>The mean age at surgery was 15.6 years. The mean follow-up duration was 11.1 ± 3.7 years. Preoperative chronic pain was present in all patients except 1, who was non-communicative; in this case, the surgical indication was based on radiographic evidence of hip dislocation. The overall complication rate was 22% (<i>n</i> = 5), including 2 dislocations, 1 trochanteric nonunion, 1 intraoperative distal femoral fracture requiring plate fixation, and 1 femoral component loosening at 10-year follow-up. No postoperative infections were observed. Rehospitalisation within 3 months occurred in 13.6% of patients (<i>n</i> = 3).</p><p><strong>Discussion: </strong>THA in paediatric patients with cerebral palsy appears to provide substantial pain relief with acceptable complication rates. Mid- to long-term outcomes are encouraging in this challenging population.</p>","PeriodicalId":12911,"journal":{"name":"HIP International","volume":" ","pages":"11207000261472391"},"PeriodicalIF":1.3,"publicationDate":"2026-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148840226","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}