Hip & pelvis最新文献_第10页

Ultra-Short Bone Conserving Cementless Femoral Stem. 超短保骨无水泥股骨干。

Hip & pelvis Pub Date : 2021-12-01 DOI: 10.5371/hp.2021.33.4.181

Young-Hoo Kim

引用次数: 4

A Higher Altitude Is Associated with Increased Incidence of Infections following Primary Total Hip Arthroplasty. 海拔较高与初次全髋关节置换术后感染发生率增加有关。

Hip & pelvis Pub Date : 2021-12-01 DOI: 10.5371/hp.2021.33.4.219

Nabil Z Khan, Stefan N Hamaway, Miriam D Weisberg, Andrew R Horn, Rushabh M Vakharia, Afshin E Razi

{"title":"A Higher Altitude Is Associated with Increased Incidence of Infections following Primary Total Hip Arthroplasty.","authors":"Nabil Z Khan, Stefan N Hamaway, Miriam D Weisberg, Andrew R Horn, Rushabh M Vakharia, Afshin E Razi","doi":"10.5371/hp.2021.33.4.219","DOIUrl":"https://doi.org/10.5371/hp.2021.33.4.219","url":null,"abstract":"Purpose: The purpose of this study was to evaluate whether patients undergoing primary total hip arthroplasty (THA) at a higher elevation have higher rates of: 1) in-hospital length of stay (LOS); 2) surgical site infections (SSIs); 3) periprosthetic joint infections (PJIs); and 4) costs.Materials and methods: The Medicare claims database was used to identify patients who underwent primary THA at an altitude higher than 4,000 feet (ft). High-altitude patients were matched to patients who underwent primary THA at an altitude less than 100 ft, yielding 24,958 and 124,765 patients respectively. Outcomes that were assessed included in-hospital LOS, SSIs, PJIs, and costs of care. A P-value less than 0.001 was considered statistically significant.Results: Patients in the study group had significantly longer in-hospital LOS (4 days vs 3 days, P<0.0001). In addition, patients in the study group had a significantly higher incidence and odds of developing SSIs (1.16% vs 0.86%; odds ratio [OR], 1.34; P<0.0001) and PJIs (0.91% vs 0.58%; OR, 1.56; P<0.0001) within 90-days following the index procedure, compared to matched controls. Higher altitude patients incurred higher day of surgery ($16,139.76 vs $15,279.42; P<0.0001) and 90-day costs ($18,647.51 vs $16,401.62; P<0.0001).Conclusion: This study demonstrated that primary THA procedures performed at an elevation higher than 4,000 ft are associated with longer in-hospital LOS, higher rates of SSIs, PJIs, and costs of care. Orthopedists and other healthcare professionals can use this information to provide adequate education for these patients regarding the potential complications that may occur following their procedure.","PeriodicalId":73239,"journal":{"name":"Hip & pelvis","volume":"33 4","pages":"219-224"},"PeriodicalIF":0.0,"publicationDate":"2021-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/90/1e/hp-33-219.PMC8654588.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39837409","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

A Review and Description of Acetabular Impaction Bone Grafting: Updating the Traditional Technique. 髋臼嵌塞植骨技术综述与进展:对传统技术的更新。

Hip & pelvis Pub Date : 2021-12-01 DOI: 10.5371/hp.2021.33.4.173

Aun H Mirza, Shahzad Sadiq

引用次数: 1

Assessment of the Bone Mineral Density and Microstructure of the Human Femoral Head according to Different Tip-apex Distances Can Guide the Treatment of Intertrochanteric Hip Fractures. 不同尖端距离对人股骨头骨密度和显微结构的评价可指导股骨粗隆间骨折的治疗。

Hip & pelvis Pub Date : 2021-12-01 DOI: 10.5371/hp.2021.33.4.190

Quan-Hu Shen, JiWoong Baik, YeYeon Won

{"title":"Assessment of the Bone Mineral Density and Microstructure of the Human Femoral Head according to Different Tip-apex Distances Can Guide the Treatment of Intertrochanteric Hip Fractures.","authors":"Quan-Hu Shen, JiWoong Baik, YeYeon Won","doi":"10.5371/hp.2021.33.4.190","DOIUrl":"https://doi.org/10.5371/hp.2021.33.4.190","url":null,"abstract":"Purpose: We analyzed the microstructure and bone mineral density (BMD) of the trabecular bone in the femoral head of patients with osteoporosis.Materials and methods: Sixteen femoral heads with osteoporotic femoral neck fractures underwent micro-computed tomography scanning. In each tip-apex distance (TAD) of 15, 20, and 25 mm, five regions of interest (ROIs) were extracted from the central, anterior, posterior, superior, and inferior sections. A total of 15 ROIs were extracted from TADs of 15, 20, and 25 mm. The measurement parameters included BMD, percent bone volume: bone volume/total volume (BV/TV), trabecular thickness (Tb.Th), trabecular number (Tb.N), structural model index (SMI), and degree of anisotropy (DOA).Results: The lowest BMD and BV/TV values were observed in the inferior region and differed significantly from those in other regions (P<0.05). Lower Tb.Th and Tb.N values were observed in the inferior region compared with those in the central region (P<0.05). The highest SMI value was observed in the inferior region (P<0.05). With TAD of 15 and 20 mm, the DOA values in the inferior region were lower than those in the anterior region (P<0.05). Lower BMD and BV/TV values were observed in the anterior, central, and inferior regions of TAD of 15 mm compared with those in the corresponding regions of TAD of 25 mm (P<0.05).Conclusion: Positioning the lag screw between TAD of 20 to 25 mm and in the inferior region is recommended, and TAD of less than 15 mm is not recommended.","PeriodicalId":73239,"journal":{"name":"Hip & pelvis","volume":"33 4","pages":"190-199"},"PeriodicalIF":0.0,"publicationDate":"2021-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/f6/f5/hp-33-190.PMC8654587.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39749271","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 2

Elimination of Routine Urinalysis before Elective Orthopaedic Surgery Reduces Antibiotic Utilization without Impacting Catheter-associated Urinary Tract Infection or Surgical Site Infection Rates. 择期骨科手术前取消常规尿分析可减少抗生素的使用，同时不影响导尿管相关尿路感染或手术部位感染率。

Hip & pelvis Pub Date : 2021-12-01 DOI: 10.5371/hp.2021.33.4.225

Brian L Hollenbeck, Megan Hoffman, Christopher J Fang, Kevin Counterman, Susan Cohen, Christine A Bell

{"title":"Elimination of Routine Urinalysis before Elective Orthopaedic Surgery Reduces Antibiotic Utilization without Impacting Catheter-associated Urinary Tract Infection or Surgical Site Infection Rates.","authors":"Brian L Hollenbeck, Megan Hoffman, Christopher J Fang, Kevin Counterman, Susan Cohen, Christine A Bell","doi":"10.5371/hp.2021.33.4.225","DOIUrl":"https://doi.org/10.5371/hp.2021.33.4.225","url":null,"abstract":"Purpose Routine preoperative urinalysis has been the standard of care for the orthopedic population for decades, regardless of symptoms. Studies have demonstrated antibiotic overuse and low concordance between bacteria cultured from the surgical wound and the urine. Testing and treatment of asymptomatic urinary tract colonization before total joint arthroplasty (TJA) is unnecessary and increases patient risk. We investigated reducing antibiotic use by (1) modifying testing algorithms to target patients at risk, (2) modifying reflex to culture criteria, and (3) providing treatment guidelines. Materials and Methods A pre-post study was conducted to determine identify the impact of eliminating universal urinalysis prior to TJA on surgical site infection (SSI) and catheter-associated urinary tract infection (CAUTI) rates and number of antibiotic prescriptions. Patients who underwent primary hip or knee TJA or spinal fusions from February 2016 to March 2018 were included. Patient data was collected for pre- and post-practice change period (February 2016-October 2016 and August 2017-March 2018). Patient demographics, urinalysis results, cultures, and prescriptions were analyzed retrospectively from every tenth chart in the pre-period and prospectively on all patients in the post-period. Results A total of 4,663 patients were studied. There was a 96% decrease in urinalyses performed (P<0.0001), and a 93% reduction rate in antibiotic utilization (P<0.001). No significant difference in SSI and CAUTI rates was observed (P>0.05). Conclusion The elimination of routine urinalysis before orthopedic surgery resulted in a reduction in antibiotic utilization with no significant change in the SSI or CAUTI rates. Cost savings resulted from reduced antibiotic usage.","PeriodicalId":73239,"journal":{"name":"Hip & pelvis","volume":"33 4","pages":"225-230"},"PeriodicalIF":0.0,"publicationDate":"2021-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/98/13/hp-33-225.PMC8654593.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39837410","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 1

Usefulness of Synthetic Osteoconductive Bone Graft Substitute with Zeta Potential Control for Intramedullary Fixation with Proximal Femur Nail Antirotation in Osteoporotic Unstable Femoral Intertrochanteric Fracture. 带Zeta电位控制的人工骨导电性骨移植物在骨质疏松性不稳定股骨粗隆间骨折股骨近端钉抗旋髓内固定中的应用。

Hip & pelvis Pub Date : 2021-12-01 DOI: 10.5371/hp.2021.33.4.211

Tae-Woo Sung, Ein-Seong Lee, Ok-Gul Kim, Ki-Seong Heo, Won Yong Shon

{"title":"Usefulness of Synthetic Osteoconductive Bone Graft Substitute with Zeta Potential Control for Intramedullary Fixation with Proximal Femur Nail Antirotation in Osteoporotic Unstable Femoral Intertrochanteric Fracture.","authors":"Tae-Woo Sung, Ein-Seong Lee, Ok-Gul Kim, Ki-Seong Heo, Won Yong Shon","doi":"10.5371/hp.2021.33.4.211","DOIUrl":"https://doi.org/10.5371/hp.2021.33.4.211","url":null,"abstract":"Purpose This study was conducted in order to examine the usefulness of osteoconductive bone substitutes with zeta potential control (geneX® ds; Biocomposites, England) by comparing the complications and radiographic evaluation with or without geneX® ds augmentation for internal fixation with proximal femur nail antirotation (PFNA) for treatment of osteoporotic unstable intertrochanteric fractures. Materials and Methods A retrospective study of 101 patients who underwent fixation with PFNA in osteoporotic unstable intertrochanteric fractures was conducted from December 2015 to August 2020. The radiographic evaluation and complication rates were compared between patients with geneX® ds (Group A: 41 cases) and those without geneX® ds (Group B: 60 cases). Results In radiological valuation, the degree of blade sliding from the time immediately after surgery to one year after surgery was 1.4±1.2 mm and 5.8±2.7 mm in Group A and Group B, respectively (P<0.001). During the same time frame, a significant difference of 2.3±2.2° and 7.4±3.1° , respectively (P<0.001), in varus collapse, was observed for Group A and Group B. Conclusion Among patients fixed with PFNA for treatment of unstable intertrochanteric fractures, less blade sliding and varus collapse was observed for those with geneX® ds augmentation compared to those without it. In addition, there was no increase in the incidence of complications. The authors believe it can be regarded as a safe and effective additive for intramedullary fixation for treatment of unstable intertrochanteric fractures.","PeriodicalId":73239,"journal":{"name":"Hip & pelvis","volume":"33 4","pages":"211-218"},"PeriodicalIF":0.0,"publicationDate":"2021-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/ca/c9/hp-33-211.PMC8654589.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39837408","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 2

C-reactive Protein Level, Admission to Intensive Care Unit, and High American Society of Anesthesiologists Score Affect Early and Late Postoperative Mortality in Geriatric Patients with Hip Fracture. c反应蛋白水平、入住重症监护病房和美国麻醉医师学会高分影响老年髋部骨折患者术后早期和晚期死亡率

Hip & pelvis Pub Date : 2021-12-01 DOI: 10.5371/hp.2021.33.4.200

Mehmet Ekinci, Serkan Bayram, Erol Gunen, Kemal Arda Col, Ahmet Mucteba Yildirim, Murat Yilmaz

{"title":"C-reactive Protein Level, Admission to Intensive Care Unit, and High American Society of Anesthesiologists Score Affect Early and Late Postoperative Mortality in Geriatric Patients with Hip Fracture.","authors":"Mehmet Ekinci, Serkan Bayram, Erol Gunen, Kemal Arda Col, Ahmet Mucteba Yildirim, Murat Yilmaz","doi":"10.5371/hp.2021.33.4.200","DOIUrl":"https://doi.org/10.5371/hp.2021.33.4.200","url":null,"abstract":"Purpose: The main purpose of this study is to evaluate prognostic factors that affected the patients' early (<30 days) and late (six months, one year, and overall) postoperative mortality following hip fracture surgery.Materials and methods: This retrospective study included 515 patients older than 75 years old with surgically treated osteoporotic hip fracture. The demographic data, American Society of Anesthesiologists (ASA) classification, type of anesthesia, duration of hospital stay, and history of intensive care unit (ICU) stay were collected. An analysis of laboratory values was also performed to determine their relationship with mortality. The primary outcome was survival, determined as the time from the surgery to death or the end of the study. The patients were divided into four groups according to survival time: at the first month, six months, first year, and overall survival. An analysis of demographic and laboratory values was performed to determine their validity as prognostic factors for each group.Results: Postoperative C-reactive protein (CRP) level showed an independent association with a poor survival at the first month. ASA classification, admission to the ICU, and preoperative CRP levels showed an independent association with a poor survival for the first six months. Preoperative CRP level showed an independent association with a poor survival for the first year. ASA classification, admission to the ICU, and the preoperative CRP levels showed an independent association with a poor overall survival.Conclusion: CRP level, a high ASA classification, and postoperative ICU admission were related to poorer overall survival rate following hip fracture surgery in the elderly.","PeriodicalId":73239,"journal":{"name":"Hip & pelvis","volume":"33 4","pages":"200-210"},"PeriodicalIF":0.0,"publicationDate":"2021-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/bf/54/hp-33-200.PMC8654590.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39837407","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 3

The Association of Alcohol Use Disorder with Perioperative Complications following Primary Total Hip Arthroplasty. 初次全髋关节置换术后酒精使用障碍与围手术期并发症的关系

Hip & pelvis Pub Date : 2021-12-01 DOI: 10.5371/hp.2021.33.4.231

Andrew R Horn, Keith B Diamond, Mitchell K Ng, Rushabh M Vakharia, Michael A Mont, Orry Erez

{"title":"The Association of Alcohol Use Disorder with Perioperative Complications following Primary Total Hip Arthroplasty.","authors":"Andrew R Horn, Keith B Diamond, Mitchell K Ng, Rushabh M Vakharia, Michael A Mont, Orry Erez","doi":"10.5371/hp.2021.33.4.231","DOIUrl":"https://doi.org/10.5371/hp.2021.33.4.231","url":null,"abstract":"Purpose Alcohol use disorder is a leading mental health disorder in the United States. Few studies evaluating the association of alcohol use disorder following primary total hip arthroplasty (THA) have been reported. Therefore, the purpose of this study was to determine whether patients with alcohol use disorder undergoing primary THA have higher rates of: 1) in-hospital lengths of stay (LOS); 2) complications (medical/implant-related); and 3) costs. Materials and Methods Using a nationwide claims database from January 1st, 2005 to March 31st, 2014, patients with alcohol use disorder undergoing primary THA were identified and matched to a comparison group according to age, sex, and various comorbidities, resulting in 230,467 patients who were included in the study (n=38,416) and a matched-cohort (n=192,051). Outcomes of interest included comparison of LOS, 90-day medical and 2-year implant-related complications, and costs. A P-value less than 0.002 was considered statistically significant. Results Patients with alcohol use disorder had longer in-hospital LOS (4 days vs 3 days; P<0.0001) as well as higher frequency and odds ratio (OR) of 90-day medical (45.94% vs 12.25%; OR, 2.89; P<0.0001) and 2-year implant-related complications (17.71% vs 8.46%; OR, 1.97; P<0.0001). Patients in the study group incurred higher 90-day costs of care ($17,492.63 vs $14,921.88; P<0.0001). Conclusion With the growing prevalence of alcohol use disorder in the United States, the current investigation can be utilized to evaluate the need for interventions prior to THA which can potentially minimize the rates of morbidity and mortality within this population.","PeriodicalId":73239,"journal":{"name":"Hip & pelvis","volume":"33 4","pages":"231-238"},"PeriodicalIF":0.0,"publicationDate":"2021-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/ac/52/hp-33-231.PMC8654594.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39837411","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 4

Pulmonary Embolism after Core Decompression of the Femoral Head Using Injectable Bone Graft Substitute: A Case Report. 可注射骨移植物替代股骨头核心减压术后肺栓塞一例报告。

Hip & pelvis Pub Date : 2021-09-01 Epub Date: 2021-09-06 DOI: 10.5371/hp.2021.33.3.167

Oriol Pujol, Marius Aguirre, Alberto Gargallo, María-Luz Uria, Luis Riera, Daniel Pacha

引用次数: 2

The Effect of Intraoperative Radiographs on Component Position and Leg Length during Routine Posterior Approach Total Hip Arthroplasty. 术中x线片对常规后路全髋关节置换术中假体位置和腿长的影响。

Hip & pelvis Pub Date : 2021-09-01 Epub Date: 2021-09-06 DOI: 10.5371/hp.2021.33.3.128

Nicholas M Brown, James F McDonald, Robert A Sershon, Robert H Hopper

{"title":"The Effect of Intraoperative Radiographs on Component Position and Leg Length during Routine Posterior Approach Total Hip Arthroplasty.","authors":"Nicholas M Brown, James F McDonald, Robert A Sershon, Robert H Hopper","doi":"10.5371/hp.2021.33.3.128","DOIUrl":"https://doi.org/10.5371/hp.2021.33.3.128","url":null,"abstract":"Purpose: Accurate component placement and restoration of patient anatomy are critical in total hip arthroplasty (THA) surgery. Although intraoperative radiographs are sometimes utilized, it is unclear whether this practice can improve accuracy.Materials and methods: This study evaluated acetabular cup abduction, anteversion, leg length, and offset among 100 posterior approach THAs performed without imaging (No X-ray group) and compared them to a subsequent series of 100 THAs where an intraoperative radiograph was taken with the trial components in place (X-ray group). THAs were performed using a posterior approach by a single, experienced surgeon whose goal was to place the cup at 45° of abduction and 30° of anteversion. Supine anteroposterior pelvic digital radiographs taken at the first (nominal 4-week) postoperative visit were used for measurements.Results: Slight differences in cup abduction (47°±6° vs 44°±6°, respectively, P=0.003) and anteversion angle (35°±6° vs 31°±6°, respectively, P<0.001) were observed between the X-ray and No X-ray groups; however, a similar proportion of cups within 10° of the target angles was observed (76% vs 83%, respectively, P=0.22). No difference in offset measurements (1.1±6.6 mm vs 0.3±6.9 mm, respectively, P=0.42) or leg lengths (0.3±3.8 mm vs 0.3±4.8 mm, respectively, P=0.94) was observed between the X-ray and No X-ray groups; however, the X-ray group showed less leg length variation (P=0.05).Conclusion: In this study, the routine use of intraoperative radiographs was not associated with improved implant positioning for uncomplicated primary THA.","PeriodicalId":73239,"journal":{"name":"Hip & pelvis","volume":"33 3","pages":"128-139"},"PeriodicalIF":0.0,"publicationDate":"2021-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/d0/94/hp-33-128.PMC8440128.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39440290","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 5