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 Economic Impact of Tranexamic Acid in Healthy Patients Undergoing Primary Total Hip and Knee Arthroplasty. J Arthroplasty. 2013 Jul 22; Authors: Gillette BP, Maradit Kremers H, Duncan CM, Smith HM, Trousdale RT, Pagnano MW, Sierra RJ Abstract

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Related Articles Range of Motion in a Modular Femoral Stem System with a Variety of Neck Options. J Arthroplasty. 2013 Jul 23; Authors: Hariri S, Chun S, Cowan JB, Bragdon C, Malchau H, Rubash HE Abstract Modular femoral stem systems decouple leg length, offset, and version. The hip ROM and type of impingement for 162 femoral head/neck combinations were measured at four extreme hip positions in a Sawbones pelvis and femur to identify constructs that lead to early impingement. Hip ROM increased in all positions with increasing head size and neck length. We identified a new type of impingement created by the build-up of the proximal femoral stem: femoral stem on acetabular liner impingement. Seventy percent of neutral neck options achieved our definition of acceptable ROM. In general, when utilizing a modular femoral stem, surgeons can minimize impingement by choosing the longest femoral neck that does not over-lengthen the limb, using the largest femoral head accommodated by the cup, and avoiding neck version unless the cup or stem is malaligned. PMID: 23886407 [PubMed - as supplied by publisher]Read more... http://www.ncbi.nlm.nih.gov/pubmed/23886407?dopt=Abstract

Related Articles Topical Tranexamic Acid Reduces Blood Loss and Transfusion Rates in Total Hip and Total Knee Arthroplasty. J Arthroplasty. 2013 Jul 22; Authors: Konig G, Hamlin BR, Waters JH Abstract The objective of this study was to determine if tranexamic acid (TXA) applied topically reduced postoperative bleeding and transfusion rates after primary total hip arthroplasty (THA) and primary total knee arthroplasty (TKA). Two hundred and ninety consecutive patients from a single surgeon were enrolled. In TKA, TXA solution was injected into the knee after closure of the arthrotomy. In THA, the joint was bathed in TXA solution at three points during the procedure. In both THA and TKA the TXA solution was at a concentration of 3 g TXA per 100 mL saline. The mean blood loss was significantly higher in the non-TXA patients in both TKA and THA groups. Postoperative transfusions decreased dramatically with TXA, dropping from 10% to 0%, and from 15% to 1%, in the TKA and THA groups, respectively. Topical application of TXA significantly reduces postoperative blood loss and transfusion risk in TKA and THA. PMID: 23886406 [PubMed - as supplied by publisher]Read more... http://www.ncbi.nlm.nih.gov/pubmed/23886406?dopt=Abstract

Related Articles Multiple Cultures and Extended Incubation for Hip and Knee Arthroplasty Revision: Impact on Clinical Care. J Arthroplasty. 2013 Jul 22; Authors: Dehaan A, Huff T, Schabel K, Doung YC, Hayden J, Barnes P Abstract The impact on patient care of introducing a protocol of obtaining 5 or more intra-operative separate tissue biopsies that were cultured for 10days was assessed for hip and knee arthroplasty revision. The charts of seventy-three patients undergoing 77 cases of revision arthroplasty were reviewed one year post-operatively. When compared to the prior standard of obtaining only one intra-operative culture, the protocol changed the microbiological diagnosis in 26/77 cases (34%, 95% Confidence Interval (CI): 23-45%) and antibiotic treatment in 23/77 cases (30%, 95% CI: 20-41%). In addition, the protocol had a predictive value of joint sterility in culture negative cases of 95% (95% CI: 85-99%). This data demonstrated the new protocol significantly changed patient care, and suggests that 1 or 2 cultures are insufficient. Adopting a similar protocol should be considered by surgeons and institutions as a new minimum standard for management of prosthetic joint infections. PMID: 23886405 [PubMed - as supplied by publisher]Read more... http://www.ncbi.nlm.nih.gov/pubmed/23886405?dopt=Abstract

Related Articles Durable Fixation Achieved With Medialized, High Hip Center Cementless THAs for Crowe II and III Dysplasia. Clin Orthop Relat Res. 2013 Jul 25; Authors: Nawabi DH, Meftah M, Nam D, Ranawat AS, Ranawat CS Abstract BACKGROUND: A high hip center total hip arthroplasty (THA) for dysplasia allows more complete socket coverage by native bone at the expense of abnormal hip biomechanics. Despite poor results with cemented components, intermediate-term results with cementless cups at a high hip center have been promising, but there are few reports at long-term followup without bone graft. QUESTIONS/PURPOSES: The purpose of this study was to examine (1) survivorship; 2) radiographic results; and 3) hip scores at a minimum of 10 years for patients treated with high hip center cementless THA for Crowe II and III dysplasia without bone graft. METHODS: We reviewed charts and radiographs of 32 patients with Crowe II or III dysplasia who were treated with high hip center cementless THA; at a mean followup of 12 years (range, 10-21 years), 23 patients (27 hips) were available for review. We sought to medialize cups to the inner table to achieve bony coverage of > 75%. At final followup, the WOMAC and Harris hip scores were recorded. Radiographic analysis including computerized wear evaluation was performed. Radiographic parameters were compared with a control group of 23 patients with Crowe I dysplasia who had cementless cups placed at an

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Related Articles Do Jumbo Cups Cause Hip Center Elevation in Revision THA? A Computer Simulation. Clin Orthop Relat Res. 2013 Jul 25; Authors: Nwankwo C, Dong NN, Heffernan CD, Ries MD Abstract BACKGROUND: Acetabular revision THA with use of a large (jumbo) cup is an effective treatment for many cavitary and segmental peripheral bone defects. However, the jumbo cup may result in elevation of the hip center and protrusion through the anterior acetabular wall as a result of the oversized geometry of the jumbo cup compared with the physiologic acetabulum. QUESTIONS/PURPOSES: The purpose of this computer simulation was to determine how much elevation of the hip center and anterior wall protrusion occurs in revision THA with use of a jumbo cup technique in which the inferior edge of the jumbo cup is placed at the inferior acetabular rim and the superior edge of the jumbo cup is placed against host bone at the superior margin of a posterosuperior bone defect. METHODS: Two hundred sixty-five pelvic CT scans were analyzed by custom CT analytical software. The computer simulated oversized reaming. The vertical and anterior reamer center shifts were measured, and anterior column bone removal was determined. RESULTS: The computer simulation demonstrated that the hip center shifted 0.27 mm superiorly and 0.02 mm anteriorly, and anterior column bone removal increased 0.86 mm for every 1-mm increase in reamer diameter.

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