The Journal of Hip Surgery最新文献

{"title":"Periprosthetic Hip Heterotopic Ossification after Electrocution","authors":"Gloria S Coden, Kurt V. Johnson, Olivia Bono, James V. Bono","doi":"10.1055/s-0044-1782513","DOIUrl":"https://doi.org/10.1055/s-0044-1782513","url":null,"abstract":"\u0000 Background Heterotopic ossification is not only a common occurrence following total hip arthroplasty, but also may follow burn injuries. Uncommonly, this entity may become symptomatic when associated with a hip replacement and even less commonly presents in a delayed fashion years after the procedure.\u0000 Case Presentation We describe a case in which symptomatic periprosthetic heterotopic ossification was identified years after total hip replacement, but only months following an electrical injury.\u0000 Conclusion Patients with prosthetic joint replacements may be at risk for symptomatic periprosthetic heterotopic ossification following an electrocution event due to electrical conduction through the prosthesis and surrounding tissues.","PeriodicalId":427844,"journal":{"name":"The Journal of Hip Surgery","volume":" 3","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-05-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140991984","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Weekend versus Weekday Procedures for Total Hip Arthroplasties","authors":"Shawn Okpara, Abdullah N Ghali, David A. Momtaz, Tucker Cushing, Travis Kotzur, Albert Han, Parker Mitchell, Adam Pearl, Varun Bora, A. Seifi, Khaled Saleh","doi":"10.1055/s-0043-1771247","DOIUrl":"https://doi.org/10.1055/s-0043-1771247","url":null,"abstract":"Abstract The “weekend effect” is the phenomenon that claims increased adverse outcomes for weekend procedures compared to weekday procedures. However, there is significant controversy regarding such disparities in elective orthopaedic surgeries. With the increasing demand for hip arthroplasty projected over the next 20 years, it is important to investigate a possible “weekend effect” to optimize outcomes and cost-effectiveness. In this study, we investigate the association between weekday versus weekend total hip arthroplasty (THA) and postoperative outcomes using the Healthcare Cost and Utilization Project (HCUP) data. We performed a retrospective analysis of the HCUP database between 2002 and 2020 comparing THAs done Monday to Friday versus THAs done Saturday to Sunday. Data collected included patient demographics and comorbidities, hospital length of stay, admission to procedure time, discharge disposition, mortality, and outcome data through postoperative day 30. THAs performed on weekends were associated with significantly increased length of stay, total charges, admission-to-procedure time, and mortality compared to those on weekdays. Our findings suggest that the development of nationwide programs to standardize care and weekend case management for THA patients can potentially help reduce health care costs, improve operative outcomes, and reduce the discrepancy between weekend and weekday surgeries.","PeriodicalId":427844,"journal":{"name":"The Journal of Hip Surgery","volume":"02 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"130634917","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Salvage Options for the Failed Total Hip Arthroplasty (THA)","authors":"A. Brash, Joseph X. Robin, David N. Kugelman, R. Schwarzkopf","doi":"10.1055/s-0043-1769082","DOIUrl":"https://doi.org/10.1055/s-0043-1769082","url":null,"abstract":"Abstract Total hip arthroplasty (THA) has been referred to as the operation of the century given its success and predictable improvement in quality of life. With the increase in number of THAs performed every year, there is a concomitant rise in the incidence of revision and re-revision surgeries. Failure of THA and revision hip arthroplasty may occur due to a variety of reasons, often in older patients with multiple comorbidities. Revision procedures in this setting are associated with worse outcomes as they are often complicated by limited bone stock and poor soft tissue and bone quality, making reconstruction more challenging. The purpose of this review is to discuss modern techniques for limb salvage following failed THA in the setting of significant bone loss. These include proximal femur replacement, total femur replacement, hip resection arthroplasty, and hip disarticulation.","PeriodicalId":427844,"journal":{"name":"The Journal of Hip Surgery","volume":"65 1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-11-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"124339069","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Determining Clinically Meaningful Outcomes after Isolated Acetabuloplasty in the Context of Age and Arthritic Severity: A Retrospective Review of Prospectively Collected Data","authors":"Fernando A. Huyke-Hernández, Sanjum P Samagh, Mahad M. Hassan, Vehniah K. Tjong, M. Terry","doi":"10.1055/s-0042-1757328","DOIUrl":"https://doi.org/10.1055/s-0042-1757328","url":null,"abstract":"Outcomes after isolated acetabuloplasty in mixed-type femoroacetabular impingement (FAI) patients can be favorable but are relatively unknown in the context of clinically important outcome variables (CIOVs) such as minimum clinically important difference and patient acceptable symptomatic state (PASS). Prognostic roles of age and osteoarthritis (OA) in hip arthroscopy are still unclear. We aimed to evaluate isolated acetabuloplasty outcomes including CIOVs while controlling for age and arthritis.This was a retrospective review of prospectively collected data. We analyzed patients with available 1-year follow-up for Patient-Reported Outcome Measurement Information System (PROMIS) scales for Physical Function (PF) and Pain Interference (PI). Patients were divided into two age groups (< 40 years old vs. ≥ 40 years old) and two Outerbridge arthritis grade groups (grade 0–I vs. grade II–IV). Demographic, radiographic, and surgical characteristics as well as revision surgeries and complications were extracted. Our outcome was the proportion of patients that achieved values over literature-reported CIOV thresholds for PROMIS-PF and PROMIS-PI.A total of 63 patients of 96 eligible (65.6%) had minimum 1-year data. Characteristics were comparable between patients aged younger than 40 and 40 and over as well as between grade 0 to I and grade II to IV patients. Overall, average PROMIS-PF and PROMIS-PI scores improved. Approximately 81.0% of patients reached values over CIOV threshold (71.4% for PROMIS-PF, 54.0% for PROMIS-PI), with 44.4% reporting these outcomes for both PROMIS-PF and PROMIS-PI. Approximately 30.2% of patients reported values over PASS threshold for both PROMIS-PF and PROMIS-PI, with 25.4% of patients achieving values above all CIOV thresholds. Only one patient required revision surgery. When evaluating the effect of age while controlling for OA severity and vice versa, there were no significant outcome differences (p > 0.615). When comparing patients reporting values above CIOV threshold versus those that did not, there were no differences in age (41.2 ± 13.0 [37.7, 44.8] vs. 45.9 ± 13.2 [38.4, 53.4], p = 0.265) or Outerbridge grade distribution (p = 0.177).This study uses CIOVs to describe clinically meaningful isolated acetabuloplasty outcomes for mixed-type FAI. Most patients over a wide spectrum of age and OA achieved favorable clinically meaningful outcomes following surgery. Isolated acetabuloplasty can alleviate symptomatology in mixed-type FAI patients on a case-by-case basis.","PeriodicalId":427844,"journal":{"name":"The Journal of Hip Surgery","volume":"46 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-11-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"116554972","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Imageless, Computer-Assisted Navigation Improves Acetabular Component Positioning Precision in Revision Total Hip Arthroplasty","authors":"J. Dundon, W. Paprosky, R. Schwarzkopf, Brian T Barlow, J. Vigdorchik","doi":"10.1055/s-0042-1756275","DOIUrl":"https://doi.org/10.1055/s-0042-1756275","url":null,"abstract":"Instability and dislocation can occur in up to one in four cases following revision total hip arthroplasty (THA), and optimal placement of components is critical in avoiding re-revision. Computer-assisted navigation can improve accuracy and precision of component placement in primary THA; however, its role in revision surgery is not defined. The purpose of our study was to evaluate the effect of computer-assisted navigation on component placement in revision THA. This study was a retrospective, multicenter cohort of 128 patients (69 imageless navigation, 59 conventional) who underwent revision THA between March 2017 and January 2019. An imageless computer navigation device was utilized in 69 of the 128 patients. Acetabular component placement and the proportion placed in a functional safe zone were compared between navigation-assisted and conventional THA groups. Mean anteversion increased significantly in both the navigation group (18.6 ± 8.5 degrees vs. 21.6 ± 7.8 degrees, p = 0.03) and the control group (19.4 ± 9.6 degrees vs. 21.2 ± 9.8 degrees, p = 0.03). Postoperatively, the proportion of acetabular components within the safe zone in the navigation group (inclination: 88%, anteversion: 84%) was mildly improved over the control group (83 and 69%, respectively). Variance in inclination improved significantly in both the control (50.6 vs. 112.4 degrees, p = 0.002) and navigation (46.2 vs. 141.1 degrees, p < 0.001) groups. Anteversion variance worsened in the control group (96.3 vs. 87.6 degrees, p = 0.36) but the navigation group showed improvement (61.2 vs. 72.7 degrees, p = 0.25). Postoperative variance was significantly better in the navigation group compared to the control group (p = 0.04). Utilizing imageless navigation in revision THAs results in more consistent placement of the acetabular component as compared to nonnavigated revision surgeries.","PeriodicalId":427844,"journal":{"name":"The Journal of Hip Surgery","volume":"1 3 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"116872231","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cement Beads at First Stage Improve Femoral Endosteal Recovery: A Comparative Study of Revision and Primary Taper Slip Femoral Components","authors":"J. Shelton, M. Khaliq, Jonathan A. Barrow, Sophie McGran, A. Hamer","doi":"10.1055/s-0042-1757327","DOIUrl":"https://doi.org/10.1055/s-0042-1757327","url":null,"abstract":"Debate continues about the merits of nonarticulating cement beads versus articulating cement spacers. This unit believes beads promote femoral endosteal bone regeneration producing an environment conducive to cementing at second stage. This article assesses the femoral cement mantle of matched primary and revision cemented taper slip stems (CTSSs). We performed a retrospective cohort study of all second stage CTSSs then selected a randomized group from primary joints from the arthroplasty database. The two revision hip fellows assessed the initial postop radiograph for femoral cement quality using the Barrack grading system. Results were analyzed using SPSS for interobserver reliability and quality of cementing. A total of 105 patients were identified as having received a CTSS at second stage and 105 primaries randomly selected. The average age was 81 years in the revision group and 79 years in the primary group. The revision group contained 54% female patients and the primary group contained 56%. In the primary group 73% on anteroposterior (AP) were grade A and 65% on lateral. In the revision group 77% on AP were grade A and 76% on the lateral. The interclass correlation coefficient showed good correlation between assessors. Only the lateral cementing demonstrated a significant difference between groups in favor of the revision group. This article suggests that the use of beads at first stage followed by a cemented femoral prosthesis at second stage will have equal to, or slightly better cementing than those receiving a primary hip replacement. We believe that cement can have additional benefits in second stage revisions such as further delivery of antibiotics into the effective joint space. As revision surgeons we aim to foster as many options as possible for the subsequent reconstruction. The major limitation of this study is the low number of articulating spacers used in this institution.","PeriodicalId":427844,"journal":{"name":"The Journal of Hip Surgery","volume":"246 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"122196911","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Can Pelvic Orientation Be Accurately Predicted Using One Radiographic View Alone?","authors":"J. Vigdorchik, Thomas Bieganowski, Thomas H. Christensen, M. O’Sullivan, A. Buckland, R. Schwarzkopf","doi":"10.1055/s-0042-1756279","DOIUrl":"https://doi.org/10.1055/s-0042-1756279","url":null,"abstract":"Pelvic positioning during total hip arthroplasty (THA) can affect the functional position of the acetabular component. A comprehensive understanding of pelvic orientation before THA is necessary to allow for proper cup positioning and mitigate the risks of postoperative complications. Measurements using anteroposterior (AP) radiographs have been described as an effective means of accurately predicting pelvic functional orientation. The purpose of our study was to describe the accuracy of assessing pelvic tilt using AP radiographs alone. An online survey was created and sent to a cohort of fellowship-trained adult reconstruction (AR) surgeons. The survey consisted of 65 standing AP pelvis radiographs. Participants were asked to score each radiograph as (1) anterior pelvic tilt more than 10 degrees, (2) posterior pelvic tilt more than 10 degrees, or (3) neutral. Responses were then compared with measurements of pelvic tilt made on lateral standing pelvic radiographs. Demographic data, such as country of practice, surgical volume, surgical approach, familiarity with spinopelvic mobility, and planning with spinopelvic mobility were evaluated. Categorical variables were compared using chi-squared analysis and analysis of variance. Continuous variables were assessed using unpaired, two-tailed Student's t-tests. A total of 45 surgeons completed the survey. The average correct predictive value of pelvic tilt between all surgeons was 53.2%. Of the responding surgeons, 51.2% performed greater than 100 cases per year. Fifty percent of surgeons reported that they were “not so familiar” or “somewhat familiar” with the principles of spinopelvic mobility. Also, 43.5% of surgeons reported that they did not routinely use spinopelvic mobility principles in THA planning. Pelvic orientation before THA is poorly predicted in our cohort of surveyed fellowship-trained AR surgeons with standing AP pelvis radiographs alone. Given the limited understanding of these principles within our cohort, preoperative evaluation of spinopelvic parameters with AP radiographs may require supplementation with lateral pelvic views to ensure detailed assessment and accurate preoperative planning. This is a prospective survey study and reflects level of evidence II.","PeriodicalId":427844,"journal":{"name":"The Journal of Hip Surgery","volume":"38 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-10-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"124871083","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Nerve Palsy following Total Hip Arthroplasty: A Review of the Current Literature","authors":"Jonathan M Salandra, Marisa Deliso, Alex Tang, Conner J. Robbins, J. Rao","doi":"10.1055/s-0042-1757326","DOIUrl":"https://doi.org/10.1055/s-0042-1757326","url":null,"abstract":"The incidence of postoperative nerve palsy following total hip arthroplasty (THA) is reported to be 1 to 2%. The most common injury is to the sciatic nerve, but other nerve palsies including the femoral, obturator, and pudendal nerves, have been implicated. There is also an increased risk of nerve palsy following THA in female patients, those who undergo revision procedures, and those with a previous history of developmental hip dysplasia. The prognosis for recovery for each nerve palsy is directly correlated to the extent of nerve damage. Prevention is always the best form of treatment for these conditions, and one method by which this may be accomplished is through electromyography and other variations of intraoperative observation.","PeriodicalId":427844,"journal":{"name":"The Journal of Hip Surgery","volume":"17 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"126693043","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Smoking Status Trends between Primary Total Hip Arthroplasty Patients and the General Population from 2012 to 2021","authors":"Ekenedilichukwu Nwakoby, Thomas Bieganowski, Vivek Singh, Utkarsh Anil, R. Schwarzkopf, Claudette M. Lajam","doi":"10.1055/s-0043-1769084","DOIUrl":"https://doi.org/10.1055/s-0043-1769084","url":null,"abstract":"Abstract Smoking is associated with an increased risk of complications, higher opioid use, and mortality following primary elective total hip arthroplasty (THA). Interventions for smoking cessation have been enhanced since value-based care was initiated in 2013. It remains unclear whether surgical optimization has influenced the proportion of smokers undergoing THA over time. Our study examines trends in the yearly proportions of smokers for primary elective THA versus patients having annual physical examinations (APEs). We retrospectively reviewed all patients of 18 years of age or older who underwent primary elective THA and those who had an APE at our institution between January 2012 and December 2021. The electronic medical record was queried for baseline demographics and documented smoking status. Linear regression analysis was used to determine trend significance. In total, 12,524 primary THA patients were matched in a 1:5 ratio to 62,630 APE patients using nearest-neighbor matching. Our analysis demonstrated significantly higher proportions of documented current and former smokers within the THA group at each time point compared with the APE group. The rate of current smokers undergoing THA demonstrated a downward trend that was not significant. There was a significant upward trend in documented current smokers presenting for an APE. Although there has been a decrease in active smokers undergoing THA at our institution over the past decade, this trend is not significant. Therefore, it remains unclear whether smoking cessation interventions have influenced patients undergoing primary THA. Continued vigilance in smoking cessation strategies is warranted, and improved documentation of smoking status may enhance our current understanding of whether optimization efforts are successful. Level III Evidence  Retrospective cohort study.","PeriodicalId":427844,"journal":{"name":"The Journal of Hip Surgery","volume":"43 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-10-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"133612090","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Bikini Approach is Safe and Effective for Direct Anterior Approach THA","authors":"Travis R. Weiner, Alexander L. Neuwirth, J. Geller, R. Shah, T. Hickernell, H. Cooper","doi":"10.1055/s-0043-1769085","DOIUrl":"https://doi.org/10.1055/s-0043-1769085","url":null,"abstract":"Abstract Conventional incision orientation for direct anterior approach (DAA) total hip arthroplasty (THA) is longitudinal, paralleling fibers of the tensor fascia latae. Alternatively, a “bikini” incision can be oriented along Langer's lines. We sought to determine if there were any differences in surgical site complications (SSCs), mechanical complications, or reoperation between longitudinal and bikini DAA. We retrospectively reviewed 420 consecutive primary DAA THA by a single surgeon over a 2-year period. The surgeon was experienced with both incision orientations. Complications were recorded by chart review. Chi-square tests were used to examine for differences between categorical variables and t -tests for continuous variables. Longitudinal incisions were used in 320 patients (76.2%) while bikini incisions were used in 100 patients (23.8%). Women were significantly more likely to have a bikini incision (39.1% vs. 5.8%; p  < 0.00001). Across the entire cohort, patients undergoing THA through either longitudinal or bikini incision had comparable rates of SSCs (4.7% vs. 5.0%; p  = 0.90). With longitudinal incisions, SSCs were more likely to occur in obese patients compared with nonobese patients (8.3% vs. 3.1%; p  = 0.04). With bikini incisions, there was no difference in the rate of SSCs between obese and nonobese patients (4.0% vs. 5.3%; p  = 0.79). There were no differences in mechanical complications or rates of reoperation (0.3% vs. 0.0%; p  = 0.58). Both longitudinal and bikini incisions are safe and effective ways to perform the DAA for primary THA, with no differences in rates of SSCs, mechanical complications, or reoperation. For obese patients in this series, the bikini incision was associated with a lower rate of SSCs but requires future study due to dissimilar study groups.","PeriodicalId":427844,"journal":{"name":"The Journal of Hip Surgery","volume":"30 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-10-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"127358602","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}