HIP International最新文献

{"title":"Acetabular erosion after bipolar hip hemiarthroplasty for femoral neck fracture in elderly patients: a retrospective study.","authors":"George A Macheras, Dimitrios Pallis, Konstantinos Tsivelekas, Margarita M Ampadiotaki, Panagiotis Lepetsos, Dimitrios Tzefronis, Konstantinos Kateros, Stamatios A Papadakis","doi":"10.1177/11207000231208666","DOIUrl":"10.1177/11207000231208666","url":null,"abstract":"<p><strong>Background: </strong>The choice between total hip arthroplasty (THA) and hemiarthroplasty (HA) to treat displaced femoral neck fractures, particularly among the elderly, is still controversial. Acetabular erosion consists of a late multifactorial process that may happen after hip HA resulting in significant postoperative burden. This study aims to investigate the impact of acetabular erosion progress after hip HA in patients over 70 years old.</p><p><strong>Materials and methods: </strong>This is a 5-year (2013-2018) retrospective study including consecutive series of patients >70 years who were treated with bipolar hip HA for femoral neck fractures. Patients were categorised into 3 groups for analysis (A = 70-75 years, B = 75-80 years, C = >80 years). The study enrolled a total number of 813 patients who met the inclusion criteria. We assessed acetabular erosion through radiological examinations and measured functional deterioration using the modified Harris Hip Score (mHHS) at 6 and 12 months follow-up. Our comprehensive investigation extended over a maximum period of 5 years. The correlation of patients' characteristics and HA features on erosion progress was assessed.</p><p><strong>Results: </strong>There were no significant differences in sex distribution, injury side, BMI, ASA score, bipolar head diameter, mHHS and leg-length discrepancy among the groups (<i>p</i> > 0.05). During the follow-up period, acetabular erosion with consequential conversion to THA was observed in 6.13%, 4.22% and 1.96% for Groups A, B and C respectively (<i>p</i> = 0.009). A statistically significant difference of acetabular erosion was observed in Group A compared to patients of Group C.</p><p><strong>Conclusions: </strong>Age constitutes a significant factor of acetabular wear after HA in the elderly. The higher rate of acetabular wear in patients <75 years suggests that THA is a more viable option, as HA is for patients >80 years old.</p>","PeriodicalId":12911,"journal":{"name":"HIP International","volume":null,"pages":null},"PeriodicalIF":1.5,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71480905","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 outcomes in Ehlers-Danlos patients: data from the Statewide Planning and Research Cooperative System","authors":"Ittai Shichman, Vinaya Rajahraman, Utkarsh Anil, Charles C Lin, Joshua C Rozell, Ran Schwarzkopf","doi":"10.1177/11207000241234030","DOIUrl":"https://doi.org/10.1177/11207000241234030","url":null,"abstract":"Introduction:Ehlers-Danlos syndromes (EDS) are genetic connective tissue disorders affecting multiple organ systems that frequently result in connective tissue hyperlaxity and early osteoarthritis. Short- and long-term outcomes after primary total hip arthroplasty (THA) in this patient population remain poorly characterised. The primary purpose of this study is to compare postoperative outcomes and survivorship after primary THA in patients with and without EDS.Methods:The New York Statewide Planning and Research Cooperative System (SPARCS) database was queried for all patients undergoing primary elective THA between September 2009 and December 2020. Patients with EDS were identified using ICD9 and ICD10 diagnosis codes. Given the relatively low incidence of EDS in this patient population, the cohort was propensity-matched 1:10 to patients without diagnosis of EDS based on demographics characteristics and medical comorbidities as measured by the Elixhauser Comorbidity Index.Results:A total of 66 THA patients with and 660 without EDS were included in each group after 1:10 propensity-matching. There were no significant differences in baseline characteristics or THA indications. Early postoperative outcomes such as length of hospital stay and discharge disposition were similar. Emergency Room visits and inpatient readmission rates at 3 months postoperatively did not significantly differ between groups. Patients with EDS had a higher overall revision rate compared to those without (15.0% vs. 3.2%, p &lt; 0.001). Revision free survival after primary THA in patients with EDS was significantly lower than those without EDS at 9-year follow-up. Cox proportional hazard regression demonstrated EDS patients had 7-times higher risk of revision (hazard ratio [HR] 7.43; 95% CI, 3.46–16.00; p &lt; 0.001). Lastly, revision due to instability insignificantly trended higher in the EDS cohort (HR 2.29; 95% CI, 0.95–5.49; p = 0.063).Conclusions:EDS patients undergoing primary THA have increased rate of all cause revision and demonstrate decreased revision free survival compared to non-EDS THA patients.","PeriodicalId":12911,"journal":{"name":"HIP International","volume":null,"pages":null},"PeriodicalIF":1.5,"publicationDate":"2024-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140560734","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":"Reliability of the transverse acetabular ligament as a landmark for functional cup anteversion in total hip arthroplasty","authors":"Shivan S Jassim, Tejasvi Bhatia, Jack R D McMahon, Jim W Pierrepont, Stephen J McMahon","doi":"10.1177/11207000241243035","DOIUrl":"https://doi.org/10.1177/11207000241243035","url":null,"abstract":"Background:The transverse acetabular ligament (TAL) can be a useful and reproducible landmark in the orientation of the acetabular cup in total hip arthroplasty (THA). Its role in guiding cup orientation when aiming to implant in a functional anteversion orientation is unclear. The aim of this study was to assess the relationship between the TAL and the planned acetabular cup anteversion when implanted in a function orientation.Material and Methods:In a retrospective study the anteversion of the TAL in the contralateral un-replaced hip was measured in CT scans of patients undergoing THA and compared to the functional cup anteversion using the patient-specific spinopelvic parameters. Comparative measurements of the native acetabular version were made from the superior rim to the inferior rim and at 10 mm intervals between the 2, all in reference to the anterior pelvic plane.Results:96 hips were measured. The mean TAL anteversion angle was 17.2° ± 4.5°. The mean planned acetabular cup anteversion angle was 26.3° ± 4.7°. Pearson’s correlation coefficient of this measurement with the TAL was −0.03 ( p = 0.769). There was a significant difference between the planned acetabular cup anteversion and the measurement of the TAL ( p &lt; 0.0001).Conclusions:If cups are implanted parallel to the TAL, almost 80% will be &gt;5° different to targeted functional cup version. It should be aimed to implant cups with more anteversion than the TAL indicates.","PeriodicalId":12911,"journal":{"name":"HIP International","volume":null,"pages":null},"PeriodicalIF":1.5,"publicationDate":"2024-04-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140560227","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":"Incidence of avascular necrosis of native femur following hip transposition surgery for periacetabular malignancies: a single-centre experience","authors":"Neha Nischal, Vineet Kurisunkal, Lee Jeys, Mark Davies, Rajesh Botchu","doi":"10.1177/11207000241241288","DOIUrl":"https://doi.org/10.1177/11207000241241288","url":null,"abstract":"Background:Hip transposition surgery after surgical resection of large pelvic tumours is a well-established alternate to endoprosthetic reconstruction. The major goals of surgery are to ensure adequate resection margins with limb salvation, albeit with acceptable levels of morbidity. While surveillance is aimed at diagnosing local recurrence or distant metastasis primarily, other complications may occasionally be seen. The aim of this study was to assess incidence of avascular necrosis (AVN) in the preserved native femoral heads after hip transposition surgery for periacetabular malignancies, also known as hanging hip surgery.Patients and methods:Patient records and follow-up imaging of 22 patients who had undergone hanging hip surgery from 1999 to 2020 were retrospectively analysed to assess for any probable causes of AVN.Results:Of the 22 patients, 5 (22.7%) had developed AVN on follow-up with a mean time of onset of about 10.5 months from surgery (5 months–2 years). A review of the patient demographics, surgical notes, preoperative management did not offer any clues as to the cause of AVN in these patients. Osteopenia was the most common radiological finding (59%) in most patients, but this also did not herald AVN onset.Conclusions:The theory that loss of major vascular supply to the femoral head from capsular disruption during hip transposition surgery would lead to AVN in most patients did not hold true as AVN occurred in a small number of patients.","PeriodicalId":12911,"journal":{"name":"HIP International","volume":null,"pages":null},"PeriodicalIF":1.5,"publicationDate":"2024-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140560731","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":"Patient-reported outcome differences for navigated and robot-assisted total hip arthroplasty frequently do not achieve clinically important differences: a systematic review","authors":"Kyle W Lawrence, Vinaya Rajahraman, Morteza Meftah, Joshua C Rozell, Ran Schwarzkopf, Armin Arshi","doi":"10.1177/11207000241241797","DOIUrl":"https://doi.org/10.1177/11207000241241797","url":null,"abstract":"Introduction:Total hip arthroplasty (THA) using computer-assisted navigation (N-THA) and robot-assisted surgery (RA-THA) has been increasingly adopted to improve implant positioning and offset/leg-length restoration. Whether clinically meaningful differences in patient-reported outcomes (PROMs) compared to conventional THA (C-THA) are achieved with intraoperative technology has not been established. This systematic review aimed to assess whether published relative PROM improvements with technology use in THA achieved minimal clinically important differences (MCIDs).Methods:PubMed/MEDLINE/Cochrane Library were systematically reviewed for studies comparing PROMs for primary N-THA or RA-THA with C-THA as the control group. Relative improvement differences between groups were compared to established MCID values. Reported clinical and radiographic differences were assessed. Review of N-THA and RA-THA literature yielded 6 ( n = 2580) and 10 ( n = 2786) studies, respectively, for analyses.Results:Statistically significant improvements in postoperative PROM scores were reported in 2/6 (33.3%) studies comparing N-THA with C-THA, though only 1 (16.7%) reported clinically significant relative improvements. Statistically significant improvements in postoperative PROMs were reported in 6/10 (60.0%) studies comparing RA-THA and C-THA, though none reported clinically significant relative improvements. Improved radiographic outcomes for N-THA and RA-THA were reported in 83.3% and 70.0% of studies, respectively. Only 1 study reported a significant improvement in revision rates with RA-THA as compared to C-THA.Conclusions:Reported PROM scores in studies comparing N-THA or RA-THA to C-THA often do not achieve clinically significant relative improvements. Future studies reporting PROMs should be interpreted in the context of validated MCID values to accurately establish the clinical impact of intraoperative technology.","PeriodicalId":12911,"journal":{"name":"HIP International","volume":null,"pages":null},"PeriodicalIF":1.5,"publicationDate":"2024-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140560700","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":"Valgus-impacted subcapital neck of femur fractures: a systematic review, meta-analysis with cost analysis of fixation <i>in-situ</i> versus nonoperative management.","authors":"Herv Vidakovic, David Kieser, Gary Hooper, Chris Frampton, Michael Wyatt","doi":"10.1177/11207000231210240","DOIUrl":"10.1177/11207000231210240","url":null,"abstract":"<p><strong>Background: </strong>The management of the valgus-impacted neck of femur fracture (AO/OTA 31-B1) remains contentious. The objective of this study was to determine whether operative intervention is cost-effective.</p><p><strong>Methods: </strong>We conducted a systematic review using electronic databases (Medline, Embase, Cochrane, Ebsco, Scholar) identifying studies published in the English language concerning valgus-impacted neck of femur fractures until June 2022. Additional studies were identified through hand searches of major orthopaedic journals, and bibliographies of major orthopaedic textbooks. MeSH terms (hip fracture and femoral neck fracture) and keywords (undisplaced, valgus-impacted, valgus, subcapital, Garden) connected by the Boolean operators \"AND\" and \"OR\" were used to identify studies. 2 reviewers independently extracted the data using standardised forms and recording spreadsheet. Methodological validity prior to inclusion in the review using standardized critical appraisal instruments from the Joanna Briggs Institute Meta-analysis of Statistics Assessment and Review Instrument. Meta-analysis was undertaken. Outcome measures were rate of displacement, avascular necrosis, non-union, mortality and requirement of further operative intervention. A cost utility analysis was then conducted to compare the 2 groups on the basis of the cost of initial treatment and the potential requirement of secondary intervention to hemiarthroplasty.</p><p><strong>Results: </strong>47 studies met the inclusion criteria. Meta-analysis data demonstrated a significant difference in the displacement rate of 22.8% and 2.8% between the nonoperative and internal fixation groups respectively (<i>p</i> = 0.05). The overall incidence of further operative intervention for each group was 23% and 10% respectively. There was no significant difference with respect to avascular necrosis, mortality or union rates. The cost utility analysis revealed nonoperative management to be approximately 60% more costly than initial internal fixation when the costs of subsequent surgery were included.</p><p><strong>Conclusions: </strong>This meta-analysis of the existing literature concludes that whilst nonoperative management is possible for valgus impacted neck of femur fractures, it is associated with higher complication rates and greater expense than management by internal fixation.</p>","PeriodicalId":12911,"journal":{"name":"HIP International","volume":null,"pages":null},"PeriodicalIF":1.3,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10935617/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138803192","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":"Spinal fusion and total hip arthroplasty: why timing is important.","authors":"Nequesha S Mohamed, Christopher G Salib, Oliver C Sax, Ethan A Remily, Scott J Douglas, Ronald E Delanois","doi":"10.1177/11207000231197420","DOIUrl":"10.1177/11207000231197420","url":null,"abstract":"<p><strong>Background: </strong>There is increasing debate among orthopaedic surgeons over the temporal relationship between lumbar spinal fusion (LSF) and total hip arthroplasty (THA) for patients with hip-spine syndrome. Few large studies have directly compared the results of patients who undergo LSF prior to THA (LSF-THA) to those who undergo LSF after THA (THA-LSF). The current study matched THA patients with a prior LSF to patients who underwent LSF after THA to assess: 90-day and 1-year (1) medical/surgical complications; and (2) revisions.</p><p><strong>Methods: </strong>We queried a national, all-payer database to identify all patients undergoing THA between 2010 and 2018 (<i>n</i> = 716,084). The LSF-THA patients and THA-LSF patients were then matched 1:1 on age, sex, Charleson Comorbidity Index, and obesity. Medical/surgical complications and revisions at 90 days and 1 year were recorded. Categorical and continuous variables were analysed utilising <i>t</i>-tests and chi-square, respectively.</p><p><strong>Results: </strong>LSF-THA patients experienced significantly more postoperative dislocations at 90 days and 1 year compared to THA-LSF patients (<i>p</i> = 0.048 and <i>p</i> < 0.001). There were a similar number of revisions performed for LSF-THA and THA-LSF patients at both 90 days and 1 year (<i>p</i> = 0.183 and <i>p</i> = 0.426). Furthermore, at 1 year, LSF-THA patients experienced more pneumonia (<i>p</i> = 0.005) and joint infection (<i>p</i> = 0.020).</p><p><strong>Conclusions: </strong>Prior LSF has been demonstrated to increase the risk of postoperative dislocation in patients undergoing THA. The results of the present study demonstrate increased dislocations with LSF-THA compared to THA-LSF. For \"hip spine syndrome\" patients requiring both LSF and THA, it may be more beneficial to undergo THA prior to LSF. Arthroplasty surgeons may wish to collaborate with spinal surgeons to ensure optimal outcomes for this group of patients.</p>","PeriodicalId":12911,"journal":{"name":"HIP International","volume":null,"pages":null},"PeriodicalIF":1.5,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10167650","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":"Grit and postoperative opioid use after total joint arthroplasty.","authors":"Andrew J Ernst, Avery M Briggs, Rebecca Spooner, George C Balazs, Ashton H Goldman","doi":"10.1177/11207000231176507","DOIUrl":"10.1177/11207000231176507","url":null,"abstract":"<p><strong>Introduction: </strong>Perioperative multimodal protocols following total joint replacements have significantly decreased the amount of perioperative and postoperative opioids. Further identification of those requiring more or less opioids through individualisation, may further aid in reducing the amount prescribed. Therefore, the purpose of the study was to evaluate whether a patient's grit, the measurable psychological strength of character to persevere during hardship, measured by postoperative opioid consumption.</p><p><strong>Methods: </strong>Consecutive patients who had undergone either primary or revision total knee arthroplasty (TKA) or total hip arthroplasty (THA) from February 2019 to August 2020 at our institution logged their opioid use for the first 2 weeks postoperatively, detailing the type, dosage, and number of narcotics they consumed. Those who completed their logs and a grit questionnaire had their average morphine equivalent dose (MED) and grit score calculated. Analysis was then performed to evaluate if any association existed between these 2 variables.</p><p><strong>Results: </strong>There was no correlation between grit score and postoperative opioid consumption in the first 2 weeks following discharge after total joint arthroplasty. A total of 144 patients were eligible to participate and a total of 86 patients met inclusion criteria, 48 patients in the TKA group and 38 in the THA group. Of all patients, 63% were male. The average MED was 95.5 for THAs and 192 for TKAs. The average grit score was 4.23 for THAs and 4.19 for TKAs.</p><p><strong>Conclusions: </strong>There is not an apparent association between grit score and postoperative opioid consumption in the first 2 weeks after total joint arthroplasty. General psychological resiliency may not be an important predictor of postoperative opioid use with modern postoperative protocols.</p>","PeriodicalId":12911,"journal":{"name":"HIP International","volume":null,"pages":null},"PeriodicalIF":1.5,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9580201","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":"Fewer native and periprosthetic femoral fracture patients receive an orthogeriatric review and expedited surgery compared to hip fracture patients.","authors":"Muhamed M Farhan-Alanie, Sam C Jonas, Daniel Gallacher, Michael R Whitehouse, Tim Js Chesser","doi":"10.1177/11207000231198459","DOIUrl":"10.1177/11207000231198459","url":null,"abstract":"<p><strong>Introduction: </strong>Disproportionate emphasis has been attributed to hip fracture over other femoral fractures through implementation of Best Practice Tariff (BPT).This retrospective comparative observational cohort study aimed to evaluate the epidemiology of native and periprosthetic femoral fractures and establish any disparities in their management relative to hip fractures.</p><p><strong>Methods: </strong>All patients ⩾60 years admitted with a native or periprosthetic femoral fracture during July 2016-June 2018 were identified using our hospital database. Results were compared to National Hip Fracture Database data over the same period.</p><p><strong>Results: </strong>58 native femoral, 87 periprosthetic and 1032 hip fractures were identified. (46/58) 79% and 76/87 (89%) of native and periprosthetic femoral fractures were managed operatively. Surgery was performed <36 hours for 34/46 (74%) of native femoral and 33/76 (43%) of periprosthetic fractures compared to 826/1032 (80%) for hips. Median time to surgery was longer in periprosthetic femoral than hip fracture patients (44.7 vs. 21.6 hours; <i>p</i> <i><</i> 0.0001). Orthogeriatrician review occurred in 24/58 (41%) and 48/87 (55%) of native and periprosthetic fractures compared to 1017/1032 (99%) for hips (<i>p</i> <i><</i> 0.0001). One year mortality was 35%, 20% and 26% for native femoral, periprosthetic and hip fracture patients. Cox proportional hazard ratio was higher for native femoral than hip fracture patients (1.75; 95% CI, 1.12-2.73).</p><p><strong>Conclusions: </strong>This study demonstrates large disparities in management of other femoral and periprosthetic fractures compared to hip fractures, specifically time to surgery and orthogeriatrician review. This may have resulted in the comparatively higher mortality rate of native femoral fracture patients. Expansion of the BPT to include the whole femur is likely to improve outcomes.</p>","PeriodicalId":12911,"journal":{"name":"HIP International","volume":null,"pages":null},"PeriodicalIF":1.5,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10935621/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10289895","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":"Improvements in networking processes for hip or knee revision arthroplasty: a silver lining of the COVID-19 pandemic.","authors":"Urjit Chatterji, Darren Puttock, Amin Kheiran, Darren Sandean, Gary Mundy, Dipen Menon, Andrew Brown","doi":"10.1177/11207000231200824","DOIUrl":"10.1177/11207000231200824","url":null,"abstract":"<p><strong>Background: </strong>Improvements in outcomes following hip and knee revision arthroplasties have been demonstrated following the introduction of specialised orthopaedic services in the form of 'hub and spoke' networking models. In light of the COVID-19 pandemic, these networks have undergone some inevitable adaptations. We investigated the impact of recent adaptations on the performance of our regional revision arthroplasty network.</p><p><strong>Methods: </strong>A retrospective review of all referrals that were discussed at our regional revision arthroplasty meeting, over 2 separate phases, was undertaken. Phase 1 included data between March 2018 and April 2019, representing an interval prior to COVID-19 pandemic. Phase-2 included data between September 2020 and March 2021 (during COVID-19 pandemic). Data were collected from East Midland South Orthopaedic Network (EMSSON) database and included data relating to indication and time to revision surgery, surgeon's proposal plan, network proposal plan, and executed definitive plan. We compared and analysed network performance between 2 phases.</p><p><strong>Results: </strong>In phase 1, 99 cases were discussed in EMSSON meetings, equating to 35.7% of the region's revision arthroplasty volume, according to the National Joint Registry (NJR) records. Plan alterations were recommended in 48/99 cases (48.5%), of which 41/48 (85.4%) were adhered to. Phase 2 included 98 discussed cases, equating to 81.6% of the region's revision arthroplasty volume. Plan alterations were recommended in 20/98 cases (20.4%), all of which were adhered to (100%). Adherence to recommended adaptations showed significant improvement (<i>p</i> < 0.03).</p><p><strong>Conclusions: </strong>Based upon our observations, a greater volume and proportion of revision arthroplasty cases are now being discussed. Adherence to MDT recommendations has significantly improved following the described adaptations. The number of recommended adaptations to management plans have decreased, indicating an educational value of the network.Overall, these findings demonstrate a trend towards NHS England's target of 100% of revision arthroplasty cases undergoing MDT discussion.</p>","PeriodicalId":12911,"journal":{"name":"HIP International","volume":null,"pages":null},"PeriodicalIF":1.5,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10229979","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}