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 Unplanned Hip Arthroplasty Imposes Clinical and Cost Burdens on Treating Institutions. Clin Orthop Relat Res. 2013 Aug 9; Authors: Kamath AF, Austin DC, Derman PB, Israelite CL Abstract BACKGROUND: Emergent surgery has been shown to be a risk factor for perioperative complications. Studies suggest that patient morbidity is greater with an unplanned hip arthroplasty, although it is controversial whether unplanned procedures also result in higher patient mortality. The financial impact of these procedures is not fully understood, as the costs of unplanned primary hip arthroplasties have not been studied previously. QUESTIONS/PURPOSES: We asked: (1) What are the institutional costs associated with unplanned hip arthroplasties (primary THA, hemiarthroplasty, revision arthroplasty, including treatment of periprosthetic fractures, dislocations, and infections)? (2) Does timing of surgery (urgent/unplanned versus elective) influence perioperative outcomes such as mortality, length of stay, or need for advanced care? (3) What diagnoses are associated with unplanned surgery and are treated urgently most often? (4) Do demographics and insurance status differ between admission types (unplanned versus elective hip arthroplasty)? METHODS: We prospectively followed all 419 patients who were admitted to our Level I trauma center in 2011 for procedures including primary THA, hemiarthroplasty, and revision arthroplasty, including the treatment of

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Related Articles Celecoxib and Heterotopic Bone Formation After Total Hip Arthroplasty. J Arthroplasty. 2013 Aug 5; Authors: Lavernia CJ, Contreras JS, Villa JM, Rossi MD Abstract We assessed the effectiveness of celecoxib in the prevention of heterotopic ossification (HO) following primary total hip replacement (THR). We studied 170 consecutive THRs. Sixty-three patients received celecoxib after surgery (200mg twice/daily) for 28 days and 84 did not. HO was more common in non-celecoxib patients than in the celecoxib-group at 3, 6, and 12 months (P =0.005, 0.004 and 0.01, respectively). At 1 year, fewer celecoxib recipients had Brooker classes II or III. None of the celecoxib patients developed HO Brooker class IV, while 2% in the non-celecoxib group did. No patient discontinued treatment or had revision for aseptic loosening. A short course of celecoxib for pain aids in the prevention of HO after primary THR, and could be a useful and safe option that does not interfere with anticoagulation. PMID: 23927909 [PubMed - as supplied by publisher]Read more... http://www.ncbi.nlm.nih.gov/pubmed/23927909?dopt=Abstract

Related Articles Oversized Cups as a Major Risk Factor of Postoperative Pain After Total Hip Arthroplasty. J Arthroplasty. 2013 Aug 5; Authors: Odri GA, Padiolleau GB, Gouin FT Abstract After total hip arthroplasty (THA) some patients have persistent postoperative pain (POP). Some of these POP are anterior and are caused by an anterior iliopsoas impingement (AIPI). We have hypothesized that oversized implanted cups could be responsible for POP and especially AIPI. We screened 237 patients who had a primary THA and compared the size difference (ΔS) between the native femoral head and the implanted cup, in patients with and without POP. Median ΔS was 2mm [-6; 11mm] and patients with POP had a significantly increased ΔS (P<0.0001). The threshold above which pain was significantly more frequent was ΔS≥6mm. Odds ratio was 14.4 for POP and 26 for AIPI pain when ΔS ≥6mm. PMID: 23927907 [PubMed - as supplied by publisher]Read more... http://www.ncbi.nlm.nih.gov/pubmed/23927907?dopt=Abstract

Related Articles Limb-length discrepancy after hip arthroplasty. J Bone Joint Surg Am. 2013 Aug 7;95(15):1426-36 Authors: Ng VY, Kean JR, Glassman AH Abstract ➤ Limb-length discrepancy is a common condition found in the general population and elderly individuals with osteoarthritis.➤ All aspects of total hip arthroplasty are interconnected, and making adjustments in one can affect several others.➤ Intraoperative imaging with trial or final components in place is helpful to rule out excessive limb-length discrepancy and to confirm proper component sizing and position in difficult primary total hip arthroplasty or revision situations. PMID: 23925749 [PubMed - in process]Read more... http://www.ncbi.nlm.nih.gov/pubmed/23925749?dopt=Abstract

Related Articles Surgical treatment of hip abductor tendon tears. J Bone Joint Surg Am. 2013 Aug 7;95(15):1420-5 Authors: Davies JF, Stiehl JB, Davies JA, Geiger PB Abstract BACKGROUND: Greater trochanteric pain syndrome is a common orthopaedic condition related to underlying bursitis, but it may reflect gluteal tendinopathy with tendon disruption from the greater trochanter. Our goal was to evaluate our clinical experience with surgical repair of these tears. METHODS: We retrospectively evaluated a consecutive series of twenty-two patients (twenty-three hips) with a tear of the hip abductor tendons who underwent surgical reconstruction and were followed for a minimum of five years. The preoperative evaluation revealed chronic lateral hip pain, a positive Trendelenburg sign, and a tear documented by magnetic resonance imaging (MRI). The tears were defined intraoperatively with a four-tiered scheme that accounted for the dimension of the tear ranging from partial-thickness undersurface tears to complete tears of the gluteus muscle tendon insertion.

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Related Articles What Is Normal Femoral Head/Neck Anatomy? An Analysis of Radial CT Reconstructions in Adolescents. Clin Orthop Relat Res. 2013 Aug 7; Authors: Jamali AA, Mak W, Wang P, Tai L, Meehan JP, Lamba R Abstract BACKGROUND: Cam morphology in femoroacetabular impingement has been implicated in the development of osteoarthritis. The alpha angle and femoral head/neck offset are widely used to determine femoral head asphericity. To our knowledge, no study has evaluated the alpha angle circumferentially using three-dimensional imaging in a population of healthy individuals of adolescent age. QUESTIONS/PURPOSES: We sought to (1) determine normal values for the alpha angle in adolescents, (2) define the location along the neck with the highest alpha angle, and (3) determine normal femoral head and neck radii and femoral head/neck offset. METHODS: Fifty CT scans from a database of scans obtained for reasons not related to hip pain were studied. The average age of the subjects was 15 years (range, 14-16 years). Alpha angle and femoral head/neck offset were measured circumferentially.

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