HIP International最新文献

{"title":"Prediction of key abnormal biochemical parameters in femoral neck fractures: an AI approach.","authors":"Long Li","doi":"10.1177/11207000251400682","DOIUrl":"10.1177/11207000251400682","url":null,"abstract":"<p><strong>Purpose: </strong>This study aims to develop machine learning models to predict perioperative biochemical abnormalities in femoral neck fracture patients, optimising treatment strategies and enhancing outcomes.</p><p><strong>Methods: </strong>A retrospective analysis was performed on a local clinical registry dataset, which included patients undergoing femoral neck fracture surgery from 2023 to 2024. The study focused on analysing preoperative and postoperative potassium, haemoglobin, and albumin concentrations. 6 ML algorithms were developed for prediction. Model interpretability was revealed using the control variable method, and robustness was enhanced through external data validation.</p><p><strong>Results: </strong>A total of 220 patients who completed the questionnaire and clinical tests were included in the study. Additionally, external data validation was performed on 15 patients beyond the initial cohort. Among the 6 ML algorithms used to predict biochemical indicators in patients with femoral neck fractures, SVR achieved the best performance in predicting preoperative potassium concentration K*, with an R² of 0.792 and an MAE of 0.335 mmol/L. Additionally, XGBoost showed good performance in predicting K, HGB*, HGB, ALB*, and ALB, with particularly excellent results in predicting HGB, achieving an R² of 0.943 and an MAE of only 0.478 g/L [* preoperative concentration].</p><p><strong>Conclusions: </strong>This study developed several ML-based predictive models that effectively assess changes in perioperative biochemical parameters in patients with femoral neck fractures. The interpretability heatmap clearly indicated the clinical features most influential on each biochemical parameter, such as the close relationship between K* and creatinine, which aligns with kidney regulation mechanisms and existing physiological knowledge. External data validation further demonstrated the model's robustness, suggesting that the model is applicable not only to the existing dataset but also to a broader clinical population. Overall, the proposed model provides an effective tool for perioperative management, with promising potential for clinical practice to help optimise treatment strategies and improve patient outcomes and quality of life.</p>","PeriodicalId":12911,"journal":{"name":"HIP International","volume":" ","pages":"616-626"},"PeriodicalIF":1.3,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145933154","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 risk of prosthetic joint infection with oxidised zirconium-on-polyethylene components in total hip arthroplasty: a comparison to conventional bearings.","authors":"Benjamin C Schaffler, Jack Zhong, Chien-Cheng Chen, Leo M Nherera, Thorsten M Seyler, Ran Schwarzkof","doi":"10.1177/11207000251410114","DOIUrl":"10.1177/11207000251410114","url":null,"abstract":"<p><strong>Introduction: </strong>Oxidised zirconium-on-polyethylene (OxZroP) total hip arthroplasty prostheses are increasing in popularity as an alternative to other bearing types. The surface characteristics and wear properties of OxZroP result in less metal and polyethylene wear which may be protective against microbiological seeding of the synovial joint space. The purpose of this study was to compare the rates of infection and inflammatory diagnoses between THAs using OxZroP heads with ceramic-on-polyethylene (CoP) and metal-on-polyethylene (MoP) designs.</p><p><strong>Methods: </strong>This study queried the Premier PINC AI Healthcare Database (PHD) (Premier Inc.) for all primary total hip arthroplasties from 2017 to 2022. Infection-related ICD10 codes were collected at 30 days, 3, 6, 12 months and 2 years postoperatively. Positive results were noted to be either PJI-related diagnosis codes, or the combination of an arthroplasty-related code with infection-related procedure codes. The rates of infection/inflammatory reaction were reported.</p><p><strong>Results: </strong>OxZroP THA bearings demonstrated a decreased rate of prosthetic joint infection or inflammatory reaction diagnoses, at up to 2 years post-surgery, compared to MoP bearings an effect that was maintained when cross-referenced with imaging procedure codes. When compared to CoP hips OxZroP demonstrated lower odds reduction of infection or inflammatory reaction with diagnosis codes at up to 6 months, however, showed equal odds to CoP at later timepoints.</p><p><strong>Conclusions: </strong>OxZroP bearings for primary total hip arthroplasty demonstrated a reduced odds ratio of prosthetic joint infection and inflammatory-related diagnoses than ceramic-on-polyethylene bearings before 6 months and maintained lower odds than metal-on-polyethylene bearings at up to 2 years. Further studies are needed to obtain longer-term follow-up and understand the mechanism for this observed reduction in prosthetic joint infection and inflammatory-related diagnoses.</p>","PeriodicalId":12911,"journal":{"name":"HIP International","volume":" ","pages":"550-557"},"PeriodicalIF":1.3,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146112986","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":"Relationship of wound cosmesis with patient-reported outcome measures following total hip arthroplasty.","authors":"Sho Masuda, Yukihide Minoda, Hideki Ueyama, Yohei Ohyama, Ryo Sugama, Hidetomi Terai","doi":"10.1177/11207000261453861","DOIUrl":"https://doi.org/10.1177/11207000261453861","url":null,"abstract":"<p><strong>Background: </strong>Although a few studies have assessed cosmetic outcomes following total hip arthroplasty (THA), none have investigated their association with hip-specific patient-reported outcome measures (PROMs). This study aimed to investigate the relationship between cosmetic outcomes and PROMs following THA.</p><p><strong>Methods: </strong>We included 139 cases of primary THAs for osteoarthritis of the hip with a follow-up period of at least 1 year. Cosmetic outcomes were evaluated using the Patient Scar Assessment Scale (PSAS) from the Patient and Observer Scar Assessment Scale. PROMs were assessed using the Forgotten Joint Score-12 (FJS-12) and Japanese Orthopaedic Association Hip Disease Evaluation Questionnaire (JHEQ). Correlations between cosmetic outcomes and PROMs were analysed.</p><p><strong>Results: </strong>The mean follow-up period after THA was 24 months. The PSAS total score was negatively correlated with the FJS-12 total score (r = -0.430, <i>p</i> < 0.001) and JHEQ total score (r = -0.243, <i>p</i> = 0.004). Among the JHEQ subscales, negative correlations were observed with the pain (r = -0.221, <i>p</i> = 0.009) and mental (r = -0.288, <i>p</i> < 0.001) subscales.</p><p><strong>Conclusions: </strong>Better cosmetic outcomes were associated with better PROMs after THA. However, the direction and clinical importance of the association remain unclear and warrant further investigation.</p>","PeriodicalId":12911,"journal":{"name":"HIP International","volume":" ","pages":"11207000261453861"},"PeriodicalIF":1.3,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148368206","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":"Mid- to long-term outcomes of short stem total hip arthroplasty in patients younger than 55 years: a systematic review and meta-analysis.","authors":"Mohamed Elbanna, Vikramman Vignaraja, Jonathon Kyriakides, Stamatios Tsamados, Thomas L Lewis, Mohit Bansal, Zameer Shah","doi":"10.1177/11207000261449733","DOIUrl":"https://doi.org/10.1177/11207000261449733","url":null,"abstract":"<p><strong>Background: </strong>Short-stem total hip arthroplasty (THA) aims to preserve proximal femoral bone stock and promote physiological load transfer compared to conventional cementless stems. This design is particularly relevant for younger, active patients, in whom long-term implant survival and bone preservation are critical.</p><p><strong>Objective: </strong>To systematically review and meta-analyse the functional and radiological outcomes of short-stem THA in young patients.</p><p><strong>Methods: </strong>A systematic search of Medline, Embase, PubMed, and the Cochrane Library was conducted to May 2025 following PRISMA guidelines. Eligible studies included patients with mean age <55 years and ⩾4.5 years mean follow-up. Primary outcome was Harris Hip Score (HHS) or modified Harris Hip score (mHHS); secondary outcomes were complications, survivorship, and radiological findings.</p><p><strong>Results: </strong>32 studies involving 4082 hips (mean age 46.7 years, mean follow-up 8.6 years) were included. Mean HHS improved from 45.3 to 93.8. Complications were infrequent, including intraoperative fracture (1.6%), dislocation (0.6%), and infection (0.4%). Radiological changes, including osteolysis (1.3%), heterotopic ossification (1.9%), and stem subsidence ⩾2 mm (0.7%), were uncommon. Stem survivorship free from aseptic loosening was 99.7%. The overall revision rate was 1.6%. Subgroup analyses indicated better outcomes and lower revision rates with posterolateral approaches and ceramic-on-ceramic bearings.</p><p><strong>Conclusions: </strong>Short-stem total hip arthroplasty in patients younger than 55 years appears to be associated with excellent mid- to long-term functional outcomes, low complication rates, and high implant survivorship. While these findings suggest that short stems are a safe and durable option for young, active patients, substantial heterogeneity across studies and the limited randomised evidence warrant cautious interpretation. These findings are hypothesis-generating and warrant confirmation in adequately powered prospective studies.PROSPERO registration:No: CRD420251046310.</p>","PeriodicalId":12911,"journal":{"name":"HIP International","volume":" ","pages":"11207000261449733"},"PeriodicalIF":1.3,"publicationDate":"2026-06-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148294831","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":"Factors associated with substantial preoperative haemaglobin decline in hip fracture patients: a propensity-matched analysis of 1935 cases.","authors":"Nadav Graif, Adnan Abdel Latif, Yaniv Warschawski, Etay Elbaz, Tomer Ben-Tov, Nimrod Snir, Amal Khoury, Itay Ashkenazi","doi":"10.1177/11207000261453342","DOIUrl":"https://doi.org/10.1177/11207000261453342","url":null,"abstract":"<p><strong>Introduction: </strong>Hip fractures are associated with substantial blood loss occurring both pre- and intraoperatively. While intraoperative bleeding has been extensively studied, less is known about preoperative haemaglobin decline and its determinants. This study aims to identify factors associated with substantial preoperative blood loss in hip fracture patients and assess its clinical implications.</p><p><strong>Materials and methods: </strong>We retrospectively analysed 1935 hip fracture patients treated at a single tertiary centre between 2019 and 2024. Haemoglobin (Hb) was measured at Emergency Department admission and before surgery. Preoperative Hb decline (ΔHb), used as a surrogate marker for blood loss, was calculated, and patients were categorised into those with substantial (⩾2 g/dL) versus non-substantial (<2 g/dL) preoperative Hb decline. Multivariate regression identified factors associated with substantial preoperative blood loss. Propensity score matching (1:1) was performed to compare clinical outcomes between groups.</p><p><strong>Results: </strong>Substantial preoperative Hb drop occurred in 49.1% of patients. In multivariate analysis, extracapsular fracture type was strongly associated with preoperative blood loss (OR 1.86; 95% CI, 1.54-2.26; <i>p</i> < 0.001), as was advanced age (OR: 1.65 for age >85 vs <65, <i>p</i> = 0.041) and prolonged time to surgery 24-48h (OR: 1.52, 95% CI: 1.06-2.16, <i>p</i> = 0.022). In the propensity-matched cohort (768 patients in each group), substantial preoperative blood loss was associated with higher transfusion rates (17.8% vs 8.1%, <i>p</i> < 0.001) and longer hospital stays (10.8 vs 8.7 days, <i>p</i> < 0.001).</p><p><strong>Conclusions: </strong>Extracapsular fracture type, advanced age (>85 years), and prolonged time to surgery (>24 hours) were independently associated with substantial preoperative Hb decline in hip fracture patients. Substantial preoperative Hb decline was associated with increased transfusion requirements and prolonged hospitalisation. These findings may help identify high-risk patients in whom targeted preoperative haemostatic strategies and closer Hb monitoring warrant further investigation.</p>","PeriodicalId":12911,"journal":{"name":"HIP International","volume":" ","pages":"11207000261453342"},"PeriodicalIF":1.1,"publicationDate":"2026-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148211112","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 in patients undergoing primary total hip arthroplasty with history of prior hip arthroscopy.","authors":"Zoe Alpert, Farouk Khury, Mark Kurapatti, Catherine Di Gangi, Ran Schwarzkopf, Diren Arsoy","doi":"10.1177/11207000261447423","DOIUrl":"https://doi.org/10.1177/11207000261447423","url":null,"abstract":"<p><strong>Introduction: </strong>As the number of total hip arthroscopies performed rises, further research is needed on the impact hip arthroscopy (HA) may have on total hip arthroplasty (THA). This study aimed to compare clinical and patient-reported outcomes of THA in patients with and without a history of HA.</p><p><strong>Methods: </strong>We retrospectively reviewed 167 patients who underwent unilateral, primary THA following ipsilateral HA from 2012 to 2024 (HA, <i>n</i> = 167). Patients were propensity matched 3:1 to THA patients without history of ipsilateral HA (NHA, <i>n</i> = 448) based on age, sex, race, smoking status, American Society of Anesthesiologists score, body mass index, and Charlson Comorbidity Index. Perioperative data, rates of complications and reoperation/revisions, Hip disability and Osteoarthritis Outcome Score, Joint Replacement (HOOS, JR), and Patient-Reported Outcomes Measurement Information System (PROMIS) scores were collected. Logistic regression was used to assess if the likelihood of reoperation was related to prior HA and surgical approach.</p><p><strong>Results: </strong>Patients with history of HA had longer mean follow-up duration (4.2 vs. 2.2 years, <i>p</i> < 0.001), lengths of stay (<i>p</i> = 0.013) and shorter operative times (<i>p</i> < 0.001). HA patients had higher dislocation and post-THA arthroscopy rates (<i>p</i> = 0.006; <i>p</i> = 0.020). Time to return to operation room was longer in the HA group compared to NHA cohort (334.1 vs. 104.4 days, <i>p</i> = 0.019). HA was associated with increased rates of reoperation due to dislocation (adjusted odds ratio 7.89, 95% CI, 1.68-36.9, <i>p</i> = 0.009). Surgical approach for THA was not associated with postoperative dislocation rate. Patient-reported outcomes were not different among the 2 cohorts.</p><p><strong>Conclusions: </strong>In our study, THA patients with history of HA experienced increased rates of dislocation and return to operation room. These findings highlight a need for increased clinical awareness. These findings may inform intraoperative and postoperative modifications to increase prosthetic hip stability. Additionally, this knowledge can have implications for insurance billing and payments, as these cases are coded as primary THA but may present with more complexity or worse outcomes.</p>","PeriodicalId":12911,"journal":{"name":"HIP International","volume":" ","pages":"11207000261447423"},"PeriodicalIF":1.1,"publicationDate":"2026-06-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148156249","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":"Analysis of clinical, radiological, and functional outcomes of robotic-arm assisted total hip arthroplasty (Mako®) at Hospital Clínico San Carlos.","authors":"Alberto Francés-Borrego, Eduardo Valentín-Bravo, Sergio Llanos-Sanz, Jesus Vicente-García, Andres Bartrina-Tarrio, Alberto Rodríguez-González","doi":"10.1177/11207000261447249","DOIUrl":"https://doi.org/10.1177/11207000261447249","url":null,"abstract":"<p><strong>Objective: </strong>To analyse the clinical, radiological, and functional outcomes of robotic-arm assisted total hip arthroplasty (RA-THA) with a mean follow-up of 2 years at Hospital Clínico San Carlos, Madrid.</p><p><strong>Materials and methods: </strong>A prospective descriptive study was conducted including patients who underwent RA-THA using the Mako system (Stryker) between October 2021 and March 2024. All procedures were performed by 4 dedicated hip surgeons, excluding each surgeon's learning curve. Demographic, clinical, functional, and radiological parameters were analysed. Mean follow-up exceeded 24 months.</p><p><strong>Results: </strong>A total of 226 patients were included (52% male, 48% female), with a mean age of 64.9 ± 12.9 years. Mean follow-up was 27.1 (range 12-36) months.Preoperative diagnoses were primary hip osteoarthritis in 88.5%, developmental dysplasia in 5.8%, avascular necrosis in 3.1%, post-traumatic osteoarthritis in 1.8%, and subcapital fracture nonunion in 0.4%.Mean operative time was 87.9 ± 23.4 minutes. Intraoperative complications included 11 technical events related to marker loss (4.86%), 6 greater trochanter fractures (2.6%), and 2 calcar fractures (0.8%).Mean acetabular component positioning was 43.1 ± 3.4° of inclination and 14.2 ± 3.8° of anteversion. Native femoral offset was preserved, with a mean difference of 1.8 ± 4.5 mm. Planned limb-length discrepancy accuracy was 90% within ±5 mm. Modified Harris Hip Score (mHHS) improved from a preoperative mean of 51.7 to 87.9 at 1 year (<i>p</i> < 0.001).During follow-up, 5 neurological complications were recorded, 5 postoperative greater trochanter fractures, and 5 infections (2.2%), all successfully treated. 1 traumatic dislocation (0.4%) occurred without revision surgery.</p><p><strong>Conclusions: </strong>Robotic-arm assisted THA achieves high accuracy and precision in implant positioning and limb-length restoration, with a low dislocation rate. Operative time, complication rates, and short- to mid-term functional outcomes fall within the ranges previously reported in the literature for conventional techniques. Long-term studies are required to determine the impact of robotic assistance on implant survivorship.</p>","PeriodicalId":12911,"journal":{"name":"HIP International","volume":" ","pages":"11207000261447249"},"PeriodicalIF":1.1,"publicationDate":"2026-06-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148156203","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":"Mechano-biological mechanisms of femoral head collapse in osteonecrosis: a multiscale zonal analysis.","authors":"Ajeesh M Kurup, Rajesh Kumar Bhushan, Saroj Kumar, Amit Kumar, Naveen Kumar, Ramesh Kumar Sen, Navin Kumar","doi":"10.1177/11207000261445607","DOIUrl":"https://doi.org/10.1177/11207000261445607","url":null,"abstract":"<p><strong>Introduction: </strong>Osteonecrosis of the femoral head (ONFH) is a progressive disorder characterised by vascular compromise, osteocyte loss, and regional structural deterioration that ultimately leads to femoral head collapse. Because ONFH affects the femoral head heterogeneously, understanding zone-specific structural and mechanical alterations is essential for clarifying mechanisms of structural failure.</p><p><strong>Methods: </strong>15 femoral heads obtained during total hip arthroplasty were analyzed using a patient-matched multiscale approach. Trabecular cores from necrotic, sclerotic, and preserved regions within the same femoral heads were evaluated using micro-computed tomography, uniaxial compression testing, nanoindentation, Fourier-transform infrared spectroscopy, x-ray diffraction, and histology to assess microarchitecture, mechanical behaviour, mineral composition, and osteocyte viability.</p><p><strong>Results: </strong>Compared with the sclerotic zone, the necrotic zone exhibited pronounced trabecular deterioration, with bone volume fraction (BV/TV) reduced by 55.35% (<i>p</i> < 0.001), apparent elastic modulus reduced by 60.25% (<i>p</i> < 0.001) and mineral/matrix ratio reduced by 51.70% (<i>p</i> < 0.001). In contrast, the sclerotic zone demonstrated increased trabecular density and stiffness but reduced post-yield deformation, indicating a stiff yet brittle mechanical phenotype. These findings reveal a mechanical paradox in which dense sclerotic bone surrounds structurally compromised necrotic tissue.</p><p><strong>Conclusions: </strong>This zonal heterogeneity in microarchitecture, composition, and mechanical behavior may generate stiffness gradients within the femoral head and may contribute to localised stress concentration and mechanical imbalance during ONFH progression. These findings provide a mechano-biological framework for understanding femoral head failure and highlight the importance of considering zonal bone quality in evaluating structural collapse.</p>","PeriodicalId":12911,"journal":{"name":"HIP International","volume":" ","pages":"11207000261445607"},"PeriodicalIF":1.1,"publicationDate":"2026-06-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148149338","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":"Dislocation is associated with increased mortality following revision total hip arthroplasty for periprosthetic hip fractures.","authors":"Samuel B Morgan, Michael Nitikman, Alexander Mavromatis, Wade Gofton, Simon Garceau, George Grammatopoulos","doi":"10.1177/11207000261441541","DOIUrl":"https://doi.org/10.1177/11207000261441541","url":null,"abstract":"<p><strong>Introduction: </strong>Prevalence of periprosthetic fractures (PPFs) is continuously increasing. This study aimed to: (1) report on outcomes following revision THA (r-THA) for PPFs; (2) identify factors associated with mortality; and (3) report on the performance of modular tapered fluted stems (MFTs) as the revision stem-type of choice.</p><p><strong>Methods: </strong>This is a retrospective, consecutive case series of all femoral PPFs treated with r-THA at an academic, tertiary-referral centre between 2008 and 2023. Patients managed solely with open reduction internal fixation (ORIF) were excluded. Demographic and clinical data were collected from electronic medical records. Radiographic analysis was used to assess canal filling ratio, fracture union, stem subsidence, stability and survivorship. Primary outcomes measured included reoperations and mortality as well as stem survivorship free of re-revision at latest follow-up.</p><p><strong>Results: </strong>96 patients/hips satisfied criteria (mean age: 76 years; 62% female). Most (83%) underwent rTHA for Vancouver B2 fractures. Dislocation post rTHA was detected in 10% of patients. 29% of patients required reoperation. Mortality rates at 30 days and 1 year were 4% and 10%, respectively. Patient- (higher Charlson Comorbidity Index [CCI] 1.70 ± 1.49 vs. 0.80 ± 1.57, <i>p</i> = 0.02) and surgical- (dislocation post-rTHA - 30%, [OR 4.8] <i>p</i> = 0.03) factors were associated with 1-year mortality. MFTs (<i>n</i> = 83) demonstrated a 2-year and 5-year all-cause re-revision survivorships of 95.2% (95% CI, 87.9-99.7) and 94.0% (95% CI, 79.0-97.0), respectively.</p><p><strong>Conclusions: </strong>Postoperative mortality following rTHA for PPF is associated with patient and surgical factors. While we did not establish a causal relationship, as dislocation is associated with increased mortality, surgeons should strongly consider the use of dual-mobility or constrained liner bearings at revision when conversion of acetabular bearing surface is possible. MFTs are a reliable option when used during rTHA for an indication of PPF.</p>","PeriodicalId":12911,"journal":{"name":"HIP International","volume":" ","pages":"11207000261441541"},"PeriodicalIF":1.1,"publicationDate":"2026-05-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148029673","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":"Similar performance with electrochemically deposited hydroxyapatite coating versus plasma porous spray in press-fit acetabular components for primary total hip arthroplasty: a randomised controlled study of early outcomes with DEXA.","authors":"David Liu, Danè Turner, Joseph Cadman, Richard Appleyard","doi":"10.1177/11207000261445564","DOIUrl":"https://doi.org/10.1177/11207000261445564","url":null,"abstract":"<p><strong>Background: </strong>Hydroxyapatite (HA) is an osteo-inductive material commonly added to the surface of components to enhance bone implant fixation; however, clinical studies have demonstrated inferior performance of HA coated acetabular cups in total hip arthroplasty. This study aims to compare the performance of a contemporary acetabular cup either with or without electrochemically deposited HA.</p><p><strong>Methods: </strong>50 patients were randomised to receive an acetabular cup either with plasma porous spray (PPS) or an electrochemically deposited HA coating during primary THA for osteoarthritis. Acetabular bone remodelling behaviour adjacent to the cup was assessed using dual energy x-ray absorptiometry (DEXA) scans by a blinded observer at 6 weeks, 3, 6 and 12 months. Patient-reported outcomes and satisfaction were recorded at the same time points.</p><p><strong>Results: </strong>No significant differences in periacetabular BMD changes over time between the 2 different cup types was observed. Both cohorts showed significant improvement in PROMs over 12 months postoperatively with no significant difference in satisfaction. There were no revisions or component loosening in either group up to 12 months.</p><p><strong>Conclusions: </strong>This study found similar clinical performance and acetabular BMD changes for both porous plasma and electrochemically deposited HA coated cups in primary THA up to 12 months postoperatively.</p>","PeriodicalId":12911,"journal":{"name":"HIP International","volume":" ","pages":"11207000261445564"},"PeriodicalIF":1.1,"publicationDate":"2026-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147981534","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}