Latest journal articles about hip arthroplasty and reconstruction from Journal of Arthroplasty, The Bone & Joint Journal, Journal of Bone and Joint Surgery, Clinical Orthopaedics and Related Research, Acta Orthopaedica, Orthopedic Clinics of North, America, Journal of Orthopaedic Surgery and Research, Orthopedics

Related Articles Treatment of Femoral Head Osteonecrosis in the United States: 16-year Analysis of the Nationwide Inpatient Sample. Clin Orthop Relat Res. 2013 Aug 14; Authors: Johnson AJ, Mont MA, Tsao AK, Jones LC Abstract BACKGROUND: Many surgical interventions are used to treat osteonecrosis of the femoral head. The instance and distribution of these various procedures may give some insight into the practicing community's understanding of the efficacy of these treatments. We therefore sought to determine trends in the types and numbers of procedures performed for atraumatic osteonecrosis from 1992 through 2008 in the United States. QUESTIONS/PURPOSES: (1) How has the overall incidence of surgical treatment for atraumatic osteonecrosis changed over this time period; and (2) how has the percentage of THA performed for osteonecrosis (compared with joint-preserving procedures) changed over this time period? METHODS: The Nationwide Inpatient Sample database was used to collect information for all patients who had an International Classification of Diseases, 9(th) Revision diagnosis of hip osteonecrosis between 1992 and 2008. Procedures were collated according to frequency, and trends were analyzed for joint-preserving and joint-replacing procedures. RESULTS: The total number of procedures performed over this time period for osteonecrosis of the hip increased from 3570 procedures to 6400 procedures per year. In 1992, 75% (n = 2678) of

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Related Articles Hip Dysplasia Is More Severe in Charcot-Marie-Tooth Disease Than in Developmental Dysplasia of the Hip. Clin Orthop Relat Res. 2013 Aug 14; Authors: Novais EN, Bixby SD, Rennick J, Carry PM, Kim YJ, Millis MB Abstract BACKGROUND: Patients with Charcot-Marie-Tooth disease may develop hip dysplasia. Hip geometry in these patients has not been well described in the literature. QUESTIONS/PURPOSES: We compared the hip morphometry in Charcot-Marie-Tooth hip dysplasia (CMTHD) and developmental dysplasia of the hip (DDH) in terms of extent of (1) acetabular dysplasia and subluxation, (2) acetabular anteversion and osseous support, (3) coxa valga and femoral version, and (4) osteoarthritis. METHODS: Fourteen patients with CMTHD (19 hips; mean age, 23 years) presenting for periacetabular osteotomy were matched to 45 patients with DDH (45 hips; mean age, 21 years) based on age, sex, and BMI. We assessed acetabular dysplasia and subluxation using lateral center-edge angle (LCEA), anterior center-edge angle (ACEA), and acetabular roof angle of Tönnis (TA) on plain pelvic radiographs and acetabular volume, area of femoral head covered by acetabulum, and percentage of femoral head covered by acetabulum on three-dimensional CT reconstruction models. Acetabular version and bony support, femoral version, and neck-shaft angle were measured on two-dimensional axial CT scans. Hip osteoarthritis was graded radiographically according to Tönnis

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Related Articles Peak Knee Flexion Angles During Stair Descent in TKA Patients. J Arthroplasty. 2013 Aug 9; Authors: Bjerke J, Ohberg F, Nilsson KG, Foss OA, Stensdotter AK Abstract Reduced peak knee flexion during stair descent (PKSD) is demonstrated in subjects with total knee arthroplasty (TKA), but the underlying factors are not well studied. 3D gait patterns during stair descent, peak passive knee flexion (PPKF), quadriceps strength, pain, proprioception, demographics, and anthropometrics were assessed in 23 unilateral TKA-subjects ~19months post-operatively, and in 23 controls. PKSD, PPKF and quadriceps strength were reduced in the TKA-side, but also in the contralateral side. A multiple regression analysis identified PPKF as the only predictor (57%) to explain the relationship with PKSD. PPKF was, however sufficient for normal PKSD. Deficits in quadriceps strength in TKA-group suggest that strength is also contributing to smaller PKSD. Increased hip adduction at PKSD may indicate both compensatory strategy and reduced hip strength. PMID: 23937925 [PubMed - as supplied by publisher]Read more... http://www.ncbi.nlm.nih.gov/pubmed/23937925?dopt=Abstract

Related Articles Surgeon Delivered Psoas Compartment Block in Total Hip Arthroplasty. J Arthroplasty. 2013 Aug 9; Authors: Green C, Byrne AM, O'Loughlin P, Molony D, Harmon D, Masterson E Abstract Total hip arthroplasty is associated with significant postoperative pain. A psoas compartment block is superior to other regional techniques in analgesia post THA. However, traditional methods of delivery are associated with serious complications. We present a technique of a surgeon delivered lumbar plexus block through injection at the portion of the iliopsoas seen intraoperatively. We randomised fifty-three consecutive patients into two groups. The group that received the block had an increased period prior to requesting supplementary analgesia and lower overall pain scores. There were no adverse effects. We have demonstrated the analgesic efficacy of Psoas Compartment Block performed during surgical access for total hip arthroplasty. This technique should be considered in the analgesic regimen for total hip arthroplasty. PMID: 23937924 [PubMed - as supplied by publisher]Read more... http://www.ncbi.nlm.nih.gov/pubmed/23937924?dopt=Abstract

Related Articles Dexamethasone Reduces Length of Hospitalization and Improves Postoperative Pain and Nausea After Total Joint Arthroplasty: A Prospective, Randomized Controlled Trial. J Arthroplasty. 2013 Aug 9; Authors: Backes JR, Bentley JC, Politi JR, Chambers BT Abstract Controlling postoperative pain and nausea after total joint arthroplasty remains an important challenge. We conducted a prospective, randomized controlled trial with 120 patients to determine if the addition of perioperative dexamethasone to a multimodal regimen improves antiemetic and analgesic control, enhances mobility, and shortens hospital length of stay after total hip and knee arthroplasty. Patients administered 10mg of intravenous dexamethasone intraoperatively consumed less daily rescue anti-emetic and analgesic medication, reported superior VAS nausea and pain scores, ambulated further distances, and had a significantly shorter length of stay compared to the control group (P<0.05). A second, 24-hour postoperative dose of 10mg intravenous dexamethasone provided significant additional pain and nausea control and further reduced length of stay (P<0.05). No adverse events were detected with the administration of the intraoperative and/or postoperative dexamethasone. PMID: 23937923 [PubMed - as supplied by publisher]Read more... http://www.ncbi.nlm.nih.gov/pubmed/23937923?dopt=Abstract

Related Articles Correlation Between Stress Shielding and Clinical Outcomes After Total Hip Arthroplasty with Extensively Porous Coated Stems. J Arthroplasty. 2013 Aug 9; Authors: Kwon DG, Lee TJ, Kang JS, Moon KH Abstract Relations between stress shielding and the clinical outcomes of total hip arthroplasty(THA) remain topics of debate. This study was performed on 51 patients that underwent unilateral primary THA with an extensively porous coated stem. Contralateral normal femurs were used as controls. Dual energy x-ray absorptiometry data was used to quantify bone mineral density(BMD) on proximal femurs. Clinical outcomes were estimated by using Harris hip scores (HHSs). BMD in operated sides were lower than in control sides. HHS and pain scores were not related to BMD changes. An extensively porous coated stem can be used for THA and that concerns regarding the effects of stress shielding of the proximal femur are unwarranted. PMID: 23937922 [PubMed - as supplied by publisher]Read more... http://www.ncbi.nlm.nih.gov/pubmed/23937922?dopt=Abstract