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 CORR Insights(®): Hip Resurfacing Does Not Improve Proprioception Compared With THA. Clin Orthop Relat Res. 2013 Jul 25; Authors: Pitto RP PMID: 23884800 [PubMed - as supplied by publisher]Read more... http://www.ncbi.nlm.nih.gov/pubmed/23884800?dopt=Abstract

Related Articles The 2013 Frank Stinchfield Award: Diagnosis of Infection in the Early Postoperative Period After Total Hip Arthroplasty. Clin Orthop Relat Res. 2013 Jul 25; Authors: Yi PH, Cross MB, Moric M, Sporer SM, Berger RA, Della Valle CJ Abstract BACKGROUND: Diagnosis of periprosthetic joint infection (PJI) can be difficult in the early postoperative period after total hip arthroplasty (THA) because normal cues from the physical examination often are unreliable, and serological markers commonly used for diagnosis are elevated from the recent surgery. QUESTIONS/PURPOSES: The purposes of this study were to determine the optimal cutoff values for erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), synovial fluid white blood cell (WBC) count, and differential for diagnosing PJI in the early postoperative period after primary THA. METHODS: We reviewed 6033 consecutive primary THAs and identified 73 patients (1.2%) who underwent reoperation for any reason within the first 6 weeks postoperatively. Thirty-six of these patients were infected according to modified Musculoskeletal Infection Society criteria. Mean values for the diagnostic tests were compared between groups and receiver operating characteristic curves generated along with an area under the curve (AUC) to determine test performance and optimal cutoff values to diagnose infection. RESULTS: The best test for the diagnosis of PJI was the synovial fluid WBC count

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Related Articles Improved Survival of Uncemented versus Cemented Femoral Stems in Patients Aged < 70 Years in a Community Total Joint Registry. Clin Orthop Relat Res. 2013 Jul 20; Authors: Wechter J, Comfort TK, Tatman P, Mehle S, Gioe TJ Abstract BACKGROUND: Aseptic loosening of the femoral stem remains a significant reason for revision in total hip arthroplasty (THA). Although stem fixation methods have changed over time, there is relatively little evidence supporting cemented or uncemented stems as more durable constructs. QUESTIONS/PURPOSES: We examined whether there was a difference in survival to revision between cemented and uncemented THA stems (1) for any reason; (2) for aseptic loosening or loosening related to wear/osteolysis; (3) based on patient age groupings (as a proxy for patient activity level); and (4) based on procedural timeframe groupings between cemented and uncemented stems. METHODS: A total of 6498 primary cemented and uncemented THAs were registered in our community total joint replacement registry between 1991 and 2011. Analysis was performed to compare age, sex, procedural timeframe, and diagnosis for both groups. Our primary outcome was revision of the stem component for aseptic loosening or loosening secondary to wear/osteolysis. Analyses were done using Wilcoxon rank sum tests, Pearson's chi-square tests, Kaplan Meier methods, and Cox regression. RESULTS: After adjusting for age, sex, primary

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Related Articles Correlation of Aspiration Results With Periprosthetic Sepsis in Revision Total Hip Arthroplasty. J Arthroplasty. 2013 Jul 18; Authors: Chalmers PN, Sporer SM, Levine BR Abstract A retrospective chart review was performed of all patients who had undergone revision total hip arthroplasty with a synovial aspiration with greater than 100 WBC since the institution of our electronic medical record. Infection was defined using a combination of criteria. A diagnosis of periprosthetic sepsis was established in 52 of the 253 included hips. No significant differences existed with respect to gender, age, BMI, Deyo-Charlson Comorbidity Index, or the cause of initial hip degeneration. Using receiver-operating characteristic curves accuracy was maximized for WBC of 745 or segmented cell count of 73.5% with a sensitivity of 98%, specificity of 37%, negative predictive value of 99% and accuracy of 50%. Application of the current American Academy of Orthopaedic Surgery Clinical Practice Guidelines (AAOS CPG) thresholds revealed a similar accuracy of 49%. PMID: 23871708 [PubMed - as supplied by publisher]Read more... http://www.ncbi.nlm.nih.gov/pubmed/23871708?dopt=Abstract

Related Articles Extramedullary Guides Versus Portable, Accelerometer-Based Navigation for Tibial Alignment in Total Knee Arthroplasty: A Randomized, Controlled Trial. J Arthroplasty. 2013 Jul 18; Authors: Nam D, Cody EA, Nguyen JT, Figgie MP, Mayman DJ Abstract Extramedullary (EM) tibial alignment guides have demonstrated a limited degree of accuracy in total knee arthroplasty (TKA). The purpose of this study was to compare the tibial component alignment obtained using a portable, accelerometer-based navigation device versus EM alignment guides. One hundred patients were enrolled in this prospective, randomized controlled study to receive a TKA using either the navigation device, or an EM guide. Standing AP hip-to-ankle and lateral knee-to-ankle radiographs were obtained at the first, postoperative visit. 95.7% of tibial components in the navigation cohort were within 2° of perpendicular to the tibial mechanical axis, versus 68.1% in the EM cohort (P<0.001). 95.0% of tibial components in the navigation cohort were within 2° of a 3° posterior slope, versus 72.1% in the EM cohort (P=0.007). A portable, accelerometer-based navigation device decreases outliers in tibial component alignment compared to conventional, EM alignment guides in TKA. PMID: 23871707 [PubMed - as supplied by publisher]Read more... http://www.ncbi.nlm.nih.gov/pubmed/23871707?dopt=Abstract

Related Articles Treatment of Pseudotumors After Metal-on-Metal Hip Resurfacing Based on Magnetic Resonance Imaging, Metal Ion Levels and Symptoms. J Arthroplasty. 2013 Jul 18; Authors: van der Weegen W, Sijbesma T, Hoekstra HJ, Brakel K, Pilot P, Nelissen RG Abstract Peri-prosthetic pseudotumor formation can be a severe complication following Metal-on-Metal hip resurfacing arthroplasty (MoMHRA), with limited data on the optimal management of this complication. The aims of this study were (1) to evaluate the prevalence and severity of pseudotumors in a consecutive cohort of 248 MoMHRA (214 patients, mean follow-up 4.6years, range: 1 - 8.2), and (2) to present a clinical guideline for their treatment based on severity grading with Metal Artefact Reduction Sequence Magnetic Resonance Imaging, metal ion levels and symptoms. Pseudotumor prevalence was 36.3%: 61 mild, 25 moderate and four were graded severe. Five revisions followed, all in symptomatic patients with elevated metal ion levels. Pseudotumor severity grading allowed us to be conservative with revision surgery for mild and moderate MoM disease. PMID: 23871706 [PubMed - as supplied by publisher]Read more... http://www.ncbi.nlm.nih.gov/pubmed/23871706?dopt=Abstract