Herijaona Manasse, Thomas Daoulas, Amboara S Rohimpitiavana, Gaëtan Duval Solofomalala, Frederic Dubrana, Henri Jean-Claude Razafimahandry
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In these contexts, patients generally consult us with severe impairments that require significant technical adaptations, as well as adaptation to available resources and local conditions.</p><p><strong>Aim: </strong>To describe the results and difficulties encountered following difficult THR in the study center.</p><p><strong>Methods: </strong>This bi-centric retrospective study was conducted over a 10-year period (2013-2023) and included 50 patients operated on for difficult THR. The mean age of the patients was 37.8 years. Surgical difficulties were recorded from operative reports, and the strategies employed to overcome these difficulties were analyzed, taking into account the types of implants used.</p><p><strong>Results: </strong>At last follow-up, functional results were considered good to excellent according to the Postel-Merle d'Aubigné score, with significant improvement after surgery (<i>P</i> < 0.005). Mean operative time was 177 minutes (range: 90-290 minutes), with a mean blood loss of 568 mL (range: 200-900 mL). The short-term and medium-term post-operative complication rate was 6%.</p><p><strong>Conclusion: </strong>Even in difficult conditions, THR can produce favorable results through careful planning, adaptation of techniques and targeted approaches to overcoming challenges.</p>","PeriodicalId":47843,"journal":{"name":"World Journal of Orthopedics","volume":"16 7","pages":"105111"},"PeriodicalIF":2.3000,"publicationDate":"2025-07-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12278278/pdf/","citationCount":"0","resultStr":"{\"title\":\"Surgical techniques and outcomes of difficult total hip replacements: A challenge in a low-income country.\",\"authors\":\"Herijaona Manasse, Thomas Daoulas, Amboara S Rohimpitiavana, Gaëtan Duval Solofomalala, Frederic Dubrana, Henri Jean-Claude Razafimahandry\",\"doi\":\"10.5312/wjo.v16.i7.105111\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>Difficult total hip replacements (THRs) are hip arthroplasties performed on patients with compromised or severely altered bone or soft tissue. 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引用次数: 0
摘要
背景:困难全髋关节置换术(thr)是对骨骼或软组织受损或严重改变的患者进行的髋关节置换术。在低收入国家,难以获得THR指征是很常见的,在这些国家,获得医疗服务往往被推迟。在这些情况下,患者通常会向我们咨询严重的损伤,需要进行重大的技术调整,以及适应现有资源和当地条件。目的:描述研究中心实施困难THR的效果和遇到的困难。方法:本双中心回顾性研究为期10年(2013-2023),包括50例手术治疗难治性THR患者。患者平均年龄37.8岁。从手术报告中记录手术困难,并考虑所使用植入物的类型,分析克服这些困难的策略。结果:最后随访,根据Postel-Merle d' aubign评分,功能结果为良至优,术后显著改善(P < 0.005)。平均手术时间177分钟(范围:90-290分钟),平均失血量568 mL(范围:200-900 mL)。术后中短期并发症发生率为6%。结论:即使在困难的条件下,通过精心规划、技术调整和有针对性的方法来克服挑战,THR也可以产生良好的结果。
Surgical techniques and outcomes of difficult total hip replacements: A challenge in a low-income country.
Background: Difficult total hip replacements (THRs) are hip arthroplasties performed on patients with compromised or severely altered bone or soft tissue. Difficult THR indications are common in low-income countries, where access to care is often delayed. In these contexts, patients generally consult us with severe impairments that require significant technical adaptations, as well as adaptation to available resources and local conditions.
Aim: To describe the results and difficulties encountered following difficult THR in the study center.
Methods: This bi-centric retrospective study was conducted over a 10-year period (2013-2023) and included 50 patients operated on for difficult THR. The mean age of the patients was 37.8 years. Surgical difficulties were recorded from operative reports, and the strategies employed to overcome these difficulties were analyzed, taking into account the types of implants used.
Results: At last follow-up, functional results were considered good to excellent according to the Postel-Merle d'Aubigné score, with significant improvement after surgery (P < 0.005). Mean operative time was 177 minutes (range: 90-290 minutes), with a mean blood loss of 568 mL (range: 200-900 mL). The short-term and medium-term post-operative complication rate was 6%.
Conclusion: Even in difficult conditions, THR can produce favorable results through careful planning, adaptation of techniques and targeted approaches to overcoming challenges.