Hip

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 The Efficacy of Periarticular Multimodal Drug Injection for Postoperative Pain Management in Total Knee or Hip Arthroplasty. J Arthroplasty. 2013 Aug 1; Authors: Jiang J, Teng Y, Fan Z, Khan MS, Cui Z, Xia Y Abstract The efficacy of periarticular multimodal drug injection (PMDI) to reduce pain after total knee or hip arthroplasty (TKA or THA) still remains controversial. Our study aimed at evaluating the efficacy of PMDI after TKA or THA. A fully recursive literature search was conducted to identify relevant randomized controlled trials. Ultimately, 21 studies were included in the analysis. Pooled results showed that the PMDI group had better pain relief, less opioid consumption, larger range of motion, and lower rates of nausea and vomiting than the placebo group. No significant difference was seen in regard to the length of hospital stay between the two groups. In conclusion, PMDI should be recommended for the pain management after TKA or THA. PMID: 23910819 [PubMed - as supplied by publisher]Read more... http://www.ncbi.nlm.nih.gov/pubmed/23910819?dopt=Abstract

Related Articles Are Morbidly Obese Patients Undergoing Total Hip Arthroplasty at an Increased Risk For Component Malpositioning? J Arthroplasty. 2013 Jul 30; Authors: Elson LC, Barr CJ, Chandran SE, Hansen VJ, Malchau H, Kwon YM Abstract Acetabular cup positioning is a critical factor in determining adverse clinical outcomes in THA. This evaluation was performed to determine if morbid obesity (BMI ≥35kg/m(2)) is a contributing risk factor to cup malpositioning. Two groups of patients were obtained from a local arthroplasty registry and match-controlled for gender, age, and diagnosis (n=211 morbidly obese; n=211 normal). Intraoperative data and postoperative AP pelvis and cross-table lateral radiographs were obtained for each patient. The Martell Hip Analysis Suite was used to calculate cup positioning (successful positioning defined as 30°-45° of abduction, and 5°-25° of anteversion), as well as varus-valgus alignment of the femoral stem. There was a significant correlation between morbid obesity with respect to underanteversion; using multivariate analysis, there was a trend toward a combined underanteversion/overabduction of the acetabular cup. Of all variables considered, high BMI was the most significant risk factor leading to malpositioning. PMID: 23910510 [PubMed - as supplied by publisher]Read more... http://www.ncbi.nlm.nih.gov/pubmed/23910510?dopt=Abstract

Related Articles The correlation of wear with histological features after failed hip resurfacing arthroplasty. J Bone Joint Surg Am. 2013 Jun 19;95(12):e81 Authors: Grammatopoulos G, Pandit H, Kamali A, Maggiani F, Glyn-Jones S, Gill HS, Murray DW, Athanasou N Abstract BACKGROUND: Tissue necrosis and a macrophage and perivascular lymphocytic infiltrate are commonly seen in periprosthetic tissues around metal-on-metal hip resurfacing implants, including pseudotumors associated with these implants. The purpose of the present study was to correlate pathological changes in periprosthetic tissues with clinical findings and the amount of implant-derived metal wear. METHODS: We analyzed morphological changes in the periprosthetic soft tissues around fifty-six failed metal-on-metal hip resurfacing implants. The most common reason for failure was the presence of a symptomatic pseudotumor (n = 45). The extent of necrosis and the nature of the inflammatory cell infiltrate, including aseptic lymphocyte-dominated vasculitis-associated lesion (ALVAL), was evaluated semiquantitatively. Bearing surface wear was determined for all patients. Prostheses were considered to be highly worn if the total linear wear rate was ≥4 μm/yr.

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Related Articles Polyethylene wear and osteolysis after cementless total hip arthroplasty with alumina-on-highly cross-linked polyethylene bearings in patients younger than thirty years of age. J Bone Joint Surg Am. 2013 Jun 19;95(12):1088-93 Authors: Kim YH, Park JW, Patel C, Kim DY Abstract BACKGROUND: We asked whether cementless total hip arthroplasties that made use of alumina-on-highly cross-linked polyethylene bearings would improve hip score and functional activity and reduce the prevalence of polyethylene wear, osteolysis, and aseptic loosening. METHODS: Consecutive primary total hip arthroplasties were performed in fifty patients (a total of sixty hips among thirty-four men and sixteen women) who were younger than thirty years of age. The average age at the time of the index arthroplasty was 28.3 years (range, twenty-one to twenty-nine years). The average follow-up was 10.8 years (range, ten to twelve years). Osteolysis and polyethylene wear rates were evaluated with use of radiography and computed tomography. RESULTS: The mean Harris hip score, which was 38 points (range, 6 to 45 points) preoperatively, had improved to 95 points (range, 85 to 100 points) at a mean follow-up time of 10.8 years. The mean penetration (and standard error of the mean) of the polyethylene liner was 0.031 ± 0.004 mm per year. No hip had osteolysis or aseptic loosening.

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Related Articles Outcomes of open reduction for developmental dysplasia of the hip: does bilateral dysplasia have a poorer outcome? J Bone Joint Surg Am. 2013 Jun 19;95(12):1081-6 Authors: Wang TM, Wu KW, Shih SF, Huang SC, Kuo KN Abstract BACKGROUND: The purpose of this study was to compare the outcomes of surgical treatment in children of walking age with unilateral and bilateral developmental dysplasia of the hip (DDH). METHODS: We examined the records of fifty-six children of walking age with bilateral dysplasia and 156 children of walking age with unilateral dysplasia treated with open reduction and pelvic osteotomy with or without femoral osteotomy from 1990 to 2000. The minimum duration of follow-up was five years. The mean age at surgery was thirty-four months in the bilateral group and twenty-five months in the unilateral group. Preoperative radiographs were evaluated to determine the Tönnis grade of the dislocation and the acetabular index, and the latest radiographs were evaluated to determine the Severin classification. The Kalamchi and MacEwen classification was used to assess osteonecrosis, and the McKay classification was used to assess the clinical outcome at the time of the latest follow-up. For the statistical analyses, we selected the worse side in patients in the bilateral group as the index hip if the outcome was asymmetrical and the left hip if the outcome was symmetrical. The Fisher exact and Student t tests were used for comparisons of outcomes

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Related Articles Lateral femoral wall thickness: A reliable predictor of post-operative lateral wall fracture in intertrochanteric fractures. Bone Joint J. 2013 Aug 1;95-B(8):1134-1138 Authors: Hsu CE, Shih CM, Wang CC, Huang KC Abstract

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