HIP International最新文献

{"title":"A prospective cohort study on the effect of low back pain in patients undergoing total hip arthroplasty.","authors":"Ansu T John, Sumant Samuel, Abel Livingston, Thomas Matthai, Alfred J Daniel","doi":"10.1177/11207000251348644","DOIUrl":"https://doi.org/10.1177/11207000251348644","url":null,"abstract":"<p><strong>Background: </strong>Evaluation of patients with hip arthritis for total hip arthroplasty (THA) may be confounded by concomitant low back pain (LBP).</p><p><strong>Purpose: </strong>To study the prevalence and outcome of LBP in THA patients. To evaluate the outcome of THA in patients with dysfunctional low back pain (DLBP).</p><p><strong>Methods: </strong>In patients undergoing THA, low back pain was assessed with the Roland Morris Disability Questionnaire (RMDQ) and Numerical Pain Rating Scale (NPRS) scores preoperatively and 1 year postoperatively. Patients were categorised as suffering from DLBP if their RMDQ score was >4. Hip function was assessed using the modified Harris Hip Score (mHHS).</p><p><strong>Results: </strong>26 of 79 (33%) patients had DLBP before THA. At 1 year follow-up, 19 of them either no longer suffered from DLBP (RMDQ ⩽ 4) or at least had improvement in their RMDQ scores ⩾ 5 suggesting discerning clinical improvement. The mean NPRS scores for LBP at one year also improved (1.5 vs. 0.7, <i>p</i> <i><</i> 0.01). The mean mHHS at 1 year in patients without DLBP was significantly higher than those with DLBP (85.15 vs. 75.81, <i>p</i> <i>=</i> 0.003) implying that patients without DLBP had better hip outcomes following THA.</p><p><strong>Conclusions: </strong>DLBP improves considerably after THA. The outcome of THA may be adversely affected by the presence of DLBP.</p>","PeriodicalId":12911,"journal":{"name":"HIP International","volume":" ","pages":"11207000251348644"},"PeriodicalIF":1.3,"publicationDate":"2025-06-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144309876","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 value-based evaluation of cefazolin and vancomycin for prosthetic joint infection prophylaxis in total hip arthroplasty.","authors":"Victoria E Bergstein, Lauren C Lesser, Walter L Taylor, Aaron I Weinblatt, William J Long","doi":"10.1177/11207000251348434","DOIUrl":"https://doi.org/10.1177/11207000251348434","url":null,"abstract":"<p><strong>Background: </strong>The most cost-effective intravenous antibiotic prophylaxis for preventing prosthetic joint infection (PJI) in total hip arthroplasty (THA) has been a matter of debate. The aim of this study was to compare the cost differential between cefazolin and vancomycin as prophylactic options with a particular focus on costs associated with PJI management.</p><p><strong>Methods: </strong>Using previously published data on PJI rates associated with cefazolin and vancomycin, we modelled the cost of each prophylactic option. This model included unit prices for each drug obtained from our hospital's pharmacy service, as well as the labor costs associated with the hour-long period required for vancomycin administration. Cost of PJI accounted for the price of a 2-stage septic THA revision procedure. National projections were obtained to account for future THA volume.</p><p><strong>Results: </strong>The average per-patient cost associated with cefazolin PJI prophylaxis was $1025.59, accounting for a PJI rate of 0.75%. The average per-patient cost associated with vancomycin PJI prophylaxis was $2710.82, accounting for a 1.47% PJI rate. The annual cost difference could amount to $2.4 billion by 2040 given projections of THA incidence.</p><p><strong>Conclusions: </strong>The per-patient cost associated with vancomycin PJI prophylaxis is 164% higher than that associated with cefazolin due to increased cost of primary treatment, labor costs associated with prolonged infusion time, and most importantly differential PJI rates (number needed to treat = 1.39). In an era of value-based care, the use of cefazolin has been consistently shown to be the gold standard for THA PJI prophylaxis and is associated with significant cost advantages.</p>","PeriodicalId":12911,"journal":{"name":"HIP International","volume":" ","pages":"11207000251348434"},"PeriodicalIF":1.3,"publicationDate":"2025-06-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144309877","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 role of pain catastrophising on subjective function and pain following total hip arthroplasty: a prospective comparative study of 531 patients with 2-year follow-up.","authors":"Margot B Aalders, Jelle P van der List, Lucien C M Keijser, Olivier P P Temmerman, Joyce L Benner","doi":"10.1177/11207000251325230","DOIUrl":"10.1177/11207000251325230","url":null,"abstract":"<p><strong>Background and purpose: </strong>Considering dissatisfaction rates of around 10% after total hip arthroplasty (THA), this study aimed to investigate the role of pain catastrophising (PC) on functional outcomes, pain, and quality of life following THA in a large prospective study. PC is the tendency to focus on and exaggerate painful stimuli combined with a decreased ability to deal with pain.</p><p><strong>Patients and methods: </strong>A prospective comparative study was performed with 531 patients undergoing primary unilateral THA between 2019 and 2020. Patients were considered PC with a preoperative score ⩾30 on the PC Scale, resulting in 57 (11%) PC-patients. Patient-reported outcome measures (PROMs) were collected preoperatively, at 3 months, 1 year, and 2 years postoperatively and consisted of Hip disability and Osteoarthritis Outcome Score-Physical Function (HOOS-PS), Oxford Hip Score (OHS), pain (NRS), and quality of life (EQ-5D), including minimal clinical important differences (MCIDs) and patient acceptable symptom state (PASS), as well as length of stay and aseptic revisions.</p><p><strong>Results: </strong>PC-patients reported inferior preoperative scores on all PROMs and had longer hospital stay (<i>p</i> = 0.02). Although PC-patients had more improvement in all scores and a higher proportion generally reached MCID, they still reported lower OHS, more pain, and lower EQ-5D at 2-year follow-up (all <i>p</i> < 0.03), and fewer PC-patients reached PASS for OHS and EQ-5D at final follow-up. No difference in aseptic revisions was seen (<i>p</i> = 0.95).</p><p><strong>Conclusions: </strong>PC-patients had worse preoperative subjective function and more pain. Although they showed more improvement than non-PC patients at all outcomes, less patients reached PASS for OHS and EQ-5D at 2-year follow-up.</p>","PeriodicalId":12911,"journal":{"name":"HIP International","volume":" ","pages":"290-300"},"PeriodicalIF":1.3,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12069825/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143624418","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":"Can customised total hip arthroplasty without femoral shortening osteotomy improve functional outcome and long-term stem survivorship in developmental dysplasia of the hip?","authors":"Arthur Barbaret, Philippe Laisne, Xavier Flecher, Christophe Jacquet, Jean-Noel Argenson","doi":"10.1177/11207000251331192","DOIUrl":"10.1177/11207000251331192","url":null,"abstract":"<p><strong>Aims: </strong>Total hip arthroplasty (THA) combined with a shortening osteotomy of the femur has proved to be an effective treatment for patients with developmental dysplasia of the hip (DDH). Advances in surgical technique and implant design have led to the introduction of customised THA, without the inconvenience of femoral shortening osteotomy, as an alternative option.The purpose of this retrospective study was to determine if customised THA without femoral shortening osteotomy improves the functional outcome and long-term survivorship in total hip arthroplasty for DDH.</p><p><strong>Methods: </strong>We carried out a retrospective analysis of 77 hips in 62 patients with DDH of all Crowe types who had been treated by customised THA without shortening osteotomy and who had a minimum of 20 years follow-up. Clinical evaluation was undertaken using the Harris Hip Score (HHS) at 6 weeks postoperatively and at final follow-up. Kaplan-Meier survivorship analysis was carried out with femoral revision due to aseptic loosening as the endpoint.</p><p><strong>Results: </strong>The average HHS score at the 6 weeks postoperative assessment (86 ± 13) showed a significant improvement from the preoperative assessment (49 ± 22 points) as did the final follow-up examination (82 ± 12). The mean postoperative leg-length discrepancy was 7 ± 11 mm (-20-80 mm). 5 transient (6%) nerve palsies (1 sciatic and 4 femoral) were identified. The stem was revised in 12 hips (16%), 9(12%) for aseptic loosening at 4, 16, 70, 96, 165, 176, 177, 191 and 235 months, 2 (3%) for fracture and 1 (1%) for late infection.The Kaplan-Meier survivorship analysis at 20-year follow-up was 88% (95% confidence interval [0.81-0.96]). 7 patients (9 hips) were lost to follow-up (12%). 10 patients (11 hips) died during the study period (14%) but according to their general physician, none had undergone revision hip surgery.</p><p><strong>Conclusions: </strong>Customised THA with 3-dimensional planning and a custom-made femoral stem may improve functional outcomes and long-term survivorship after THA for DDH.</p>","PeriodicalId":12911,"journal":{"name":"HIP International","volume":" ","pages":"308-314"},"PeriodicalIF":1.3,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143961712","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":"Preoperative psychotherapy for primary total hip arthroplasty patients: an evaluation of its modifiability on readmissions and implant complications in patients who have depression.","authors":"Adam M Gordon, Patrick Nian, Joydeep Baidya, Michael A Mont","doi":"10.1177/11207000251317655","DOIUrl":"https://doi.org/10.1177/11207000251317655","url":null,"abstract":"<p><strong>Introduction: </strong>Few studies have evaluated nonpharmacologic interventions, including preoperative psychotherapy, in patients who have depression. We studied whether psychotherapy visits prior to total hip arthroplasty (THA) in patients with depression were associated with lower: (1) readmissions; and (2) implant complications in patients who have depression.</p><p><strong>Methods: </strong>A nationwide database was queried from 2010 to 2021. Patients who had depression were 1:1 propensity score matched based on those who had (<i>n</i> <i>=</i> 16,143) and did not have (<i>n</i> <i>=</i> 16,140) preoperative psychotherapy visits within 3 months of primary THA. These depression patients were 1:5 ratio-matched to a control cohort of patients without comorbid depression (<i>n</i> <i>=</i> 80,627). A 90-day and 2-year follow-up surveillance period was used to evaluate readmissions and implant complications, respectively. Logistic regression models computed the odds ratios (OR) of psychotherapy on readmissions and implant complications. Patients without comorbid depression served as the reference cohort. <i>p</i>-Values less than 0.001 were significant.</p><p><strong>Results: </strong>Of patients who had depression, a stepwise increase in odds of readmissions occurred for patients who had psychotherapy (6.2 vs. 5.0%, OR 1.25; <i>p</i> < 0.0001) and did not have psychotherapy (6.7 vs. 5.0%, OR 1.36; <i>p</i> < 0.0001) compared to patients who did not have depression. Compared to patients who did not have depression, patients who had depression and did not have psychotherapy experienced greater odds of aseptic loosening (1.7 vs. 0.7%, OR 2.31; <i>p</i> <i><</i> 0.0001), periprosthetic fractures (0.5 versus 0.2%, OR 2.44; <i>p</i> < 0.0001), dislocations (3.7 vs. 1.6%, OR 2.39; <i>p</i> < 0.0001), periprosthetic joint infections (PJIs) (3.1 vs. 1.7%, OR 1.93; <i>p</i> < 0.0001), and all-cause THA revisions (3.6 vs. 1.5%, OR 2.44; <i>p</i> < 0.0001).</p><p><strong>Discussion: </strong>Preoperative psychotherapy may provide a modifiable benefit among patients who had depression for 2-year implant complications. This intervention may aid arthroplasty surgeons in optimising patients potentially at higher risk for adverse events.</p>","PeriodicalId":12911,"journal":{"name":"HIP International","volume":"35 3","pages":"239-246"},"PeriodicalIF":1.3,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144077438","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 impact of physical activity and sports participation on implant integrity in resurfacing hip arthroplasty versus total hip arthroplasty: a systematic review.","authors":"Jordan J Levett, Abdulrhman Alnasser, Anthony Teoli, Simon Martel, Shawn Robbins, Olga L Huk, David J Zukor, John Antoniou","doi":"10.1177/11207000251315941","DOIUrl":"10.1177/11207000251315941","url":null,"abstract":"<p><strong>Objectives: </strong>Total hip arthroplasty (THA) and resurfacing hip arthroplasty (RHA) offer promising therapeutic solutions to physically active patients with hip osteoarthritis (OA). The impact of physical activity on long-term implant integrity in this population remains unknown. This systematic review compares the impact of physical activity and sports participation on implant integrity in THA versus RHA.</p><p><strong>Methods: </strong>A comprehensive search of Medline, Embase (both via Ovid), Scopus, and CINAHL was conducted from inception to May 2023 following the Cochrane Handbook for Systematic Reviews of Interventions. Data were reported in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. The quality of included studies was assessed using the Newcastle-Ottawa Scale. Implant integrity was measured either radiographically, via serum metal ion levels or revision rates.</p><p><strong>Results: </strong>A total of 16 studies with 4676 patients (THA: 3146; RHA: 1530) met the inclusion criteria. The median age at surgery was 60 years (range 49 to 86) in THA and 54 (range 49-61) years in RHA. At a median follow-up of 7.1 (range 4.8-13.1) years in THA and 10 (range 2.8-11.7) years in RHA, 3 studies out of 12, including 65.7% of the patients who underwent THA, and 2 studies out of 5, including 30.1% of the patients who underwent RHA, demonstrated that increased physical activity was associated with poor implant survivorship.</p><p><strong>Conclusions: </strong>Patients undergoing THA or RHA should be counselled to participate in moderate physical activity and may benefit from avoiding sports that exert an excessive load on their implants. On average, the quality of the studies was moderate. The outcome measures used to quantify physical activity and implant integrity are heterogenous.</p>","PeriodicalId":12911,"journal":{"name":"HIP International","volume":" ","pages":"264-272"},"PeriodicalIF":1.3,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12069826/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143414042","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":"The effect of acetabular shell and liner design on posterior horizontal dislocation distance in modern dual-mobility implants.","authors":"Nathaniel T Ondeck, Drake G LeBrun, Shammodip Roy, Ahmad Faizan, Geoffrey H Westrich","doi":"10.1177/11207000251329269","DOIUrl":"10.1177/11207000251329269","url":null,"abstract":"<p><strong>Background: </strong>The posterior horizontal dislocation distance (PHDD) is a 3-dimensional jump distance measurement that is relevant to the risk of dislocation. There are a number of dual-mobility (DM) constructs with varying designs available. The present study identifies design factors associated with increased PHDD and evaluates the PHDD of 3 DM implants.</p><p><strong>Methods: </strong>3 different computer-aided implant designs were virtually implanted within a 3-dimensional CT-derived pelvic model. Each design represented an analogue of a DM system (MDM, OR3O, and G7) according to specific variations in acetabular liner rim build-up and femoral head centre location. The effective head diameters and PHDD values were calculated for each size acetabular shell and DM design.</p><p><strong>Results: </strong>The positive rim build-up design (MDM) showed higher PHDD values as compared to the other 2 hemispherical rim designs with no build-up, across all studied shell sizes. Specifically, the MDM design analogue had 16.4-29.0% greater PHDD values than the OR3O design analog and 15.2-30.5% greater PHDD values than the G7 design analogue The effect of a sfemoral head centre location relative to the liner head centre (OR3O) was negated by a larger effective head diameter to shell diameter ratio of the G7 design, resulting in similar PHDD values.</p><p><strong>Conclusions: </strong>Design parameters affect the PHDD values of DM cups. The use of an elevated rim was associated with greater PHDD values. A medialised femoral head centre should also improve PHDD values, but the effect was nullified due to consecutive lower effective head diameters.</p>","PeriodicalId":12911,"journal":{"name":"HIP International","volume":" ","pages":"258-263"},"PeriodicalIF":1.3,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143763689","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Epidemiology, treatment, and mortality of femoral neck fractures in patients over the age of 65 years: a nationwide retrospective cohort study of 83,789 cases in Turkey.","authors":"Mehmet Demirel, Murat Birinci, Ömer S Hakyemez, Nesrullah Azboy, İzzet Bingöl, Naim Ata, M Mahir Ülgü, Şuayip Birinci, Mustafa O Ayvalı, İbrahim Azboy, Cengiz Şen","doi":"10.1177/11207000241312887","DOIUrl":"10.1177/11207000241312887","url":null,"abstract":"<p><strong>Background: </strong>A population-based study delineating the epidemiologic, clinical, and treatment characteristics of femoral neck fractures (FNFs) in elderly patients has not yet been conducted in Turkey. In this nationwide study, the epidemiologic, clinical, and treatment characteristics of patients aged ⩾65 years with FNFs who underwent osteosynthesis, hemiarthroplasty (HA), or total hip arthroplasty (THA) were examined.</p><p><strong>Methods: </strong>Patients aged ⩾65 years with FNFs were identified in this retrospective, nationwide study. Then, the patients who underwent osteosynthesis or total/hemiarthroplasty from 2016 to 2021 were included. All the outcome variables were collected from patient medical records stored in the e-health database of the Republic of Turkey Ministry of Health.</p><p><strong>Results: </strong>A total of 83,789 FNFs treated surgically were analysed. Osteosynthesis was performed on 21,130 FNFs (25.2%), HA on 56,378 FNFs (67.3%), and THA on 6281 FNFs (7.5%). From 2016 to 2021, the overall revision rates for THA and HA were 14.6% (914/5367 patients) and 5.9% (3301/53,077 patients), respectively. The rate of revision prosthetic surgery was significantly higher after THA than after HA (<i>p</i> <i><</i> 0.001). Mortality rates at 1 year were 25% (<i>n</i> = 5293) for osteosynthesis, 14.7% (<i>n</i> = 924) for THA, and 71.1% (<i>n</i> <i>=</i> 40,109) for HA (<i>p</i> = 0.001). The multivariate model of 1-year postoperative mortality revealed 7 independent predictors: male sex (odds ratio [OR] 1.694; 95% confidence interval [CI], 1.640-1.751), use of a cemented femoral stem (OR 1.182; 95% CI, 1.117-1.250), acute myocardial infarction (AMI) (OR 1.317; 95% CI, 1.240-1.400), cerebrovascular accident (CVA) (OR 1.379; 95% CI, 1.333-1.425), chronic liver disease (CLD) (OR 2.188; 95% CI, 1.802-2.489), diabetes mellitus (DM) (OR, 1.160; 95% CI, 1.122-1.200), and age >81.50 years (OR 2.654; 95% CI, 2.569-2.742).</p><p><strong>Conclusions: </strong>Our study suggested that a hemiarthroplasty is the most common treatment modality for FNF followed by osteosynthesis (25.2%) and THA (7.5%) in Turkey. Revision rates after THA for FNF are concerning. The 1-year mortality rates are highest after HA, followed by osteosynthesis and THA. Male sex, cemented fixation, CVA, CLD, liver failure, DM, and age >81.50 are the independent predictive factors for postoperative 1-year mortality in this specific group of patients.</p>","PeriodicalId":12911,"journal":{"name":"HIP International","volume":" ","pages":"278-289"},"PeriodicalIF":1.3,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143046603","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Systematic measurement of spino-pelvic alignment as a simple strategy to reduce the dislocation rate in primary hip arthroplasties.","authors":"Federico Burgo, Diego Mengelle, Enzo Skerly, Bruno Terrarossa, Mateo Lazzari, M Del Rosario Dall Armellina, Agustín Davies","doi":"10.1177/11207000251319969","DOIUrl":"10.1177/11207000251319969","url":null,"abstract":"<p><strong>Background: </strong>The incorporation of spinopelvic alignment measurement in the planning of primary hip arthroplasties is a simple and low-cost method whose isolated impact on reducing dislocation rates has not been clearly established.</p><p><strong>Aim: </strong>The objective was to estimate the probability of dislocation and its occurrence rate by comparing 2 demographically similar populations, 1 with the measurement incorporated and the other without it. Additionally, the modification and distribution of surgical practices and indications aimed at reducing the risk of dislocations were compared.</p><p><strong>Methods: </strong>A before-and-after study with prospective registry and retrospective control group was designed. We compared 693 patients (prospective registry) with the incorporation of spinopelvic alignment measurement in preoperative planning versus 341 from a previous period who constituted the control group (retrospective registry). All had a minimum follow-up of 2 years.</p><p><strong>Results: </strong>The dislocation rate significantly decreased from 3.2% to 0.7%, with an OR of 0.22 for dislocation in the intervention group. There was a significant increase in the use of dual-mobility components in patients with complete misalignment and stems with extended offset in patients with partial misalignment.</p><p><strong>Conclusions: </strong>In conclusion, the incorporation of spinopelvic alignment measurement in preoperative planning is an accessible method for any medical centre that contributed to modifying surgical practices, ultimately leading to a significant reduction in the dislocation rate.</p>","PeriodicalId":12911,"journal":{"name":"HIP International","volume":" ","pages":"247-252"},"PeriodicalIF":1.3,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143994177","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Reducing variability in apparent operative inclination (AOI) during total hip arthroplasty: comparing the ball in cage mechanical alignment device to a digital inclinometer.","authors":"Christopher W Goodland, Andrew Crone, Mark Robinson, Roslyn S Cassidy, Janet C Hill, Caroline Wither, Paul N Karayiannis, David E Beverland","doi":"10.1177/11207000251323235","DOIUrl":"https://doi.org/10.1177/11207000251323235","url":null,"abstract":"<p><strong>Introduction: </strong>When operating in lateral decubitus apparent operative inclination (AOI) is the angle between the handle of the acetabular cup introducer and the theatre floor. A digital inclinometer has demonstrated optimal control of AOI. This study aims to compare the deviation from a target AOI with a novel autoclavable ball-in-cage mechanical alignment guide (MAG) as compared to a digital inclinometer.</p><p><strong>Methods: </strong>90 primary total hip arthroplasty cases performed in lateral decubitus using a posterior approach were included. The ball-in-cage mechanical alignment guide on a standard Pinnacle cup introducer handle was used to achieve the target AOI of 35° ± 2.5°. Final AOI was measured with a digital inclinometer. These readings were compared to a published historical series of 90 patients using a digital inclinometer.</p><p><strong>Results: </strong>The ball-in-cage MAG mean inclination was 35.0° (range 32.5-37.4°), with 100% falling within target. This compared to a mean inclination of 34.0° (range 27.5-37.5°), with the digital inclinometer where 87.8% fell within target. However, the range of postoperative radiographic inclination for the ball-in-cage MAG was 23.4-53.9° with 31.1% being outside a ±5° target.</p><p><strong>Conclusions: </strong>These results indicate that this simple autoclavable ball-in-cage MAG consistently achieves an intraoperative AOI within target range. In isolation this does not guarantee a postoperative radiographic inclination within target range.</p>","PeriodicalId":12911,"journal":{"name":"HIP International","volume":"35 3","pages":"253-257"},"PeriodicalIF":1.3,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144077576","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}