Challenges in implementing a total hip arthroplasty program in a developing country: Our experience at Monkole Hospital in the Democratic Republic of Congo.

Background And Objectives: Total hip arthroplasty (THA) is an effective surgery for treating hip osteoarthritis, but access is limited in Sub-Saharan Africa due to multiple challenges. This article describes the implementation of a THA program at Monkole Hospital in the Democratic Republic of Congo, focusing on the technical challenges and surgical complications. The objective is to share our experience to assist other professionals and organizations in similar settings.

Cemented vs cementless stems for revision arthroplasties due to Vancouver B2 periprosthetic hip fracture.

Purpose: According to Vancouver classification, B2 type fractures are most often treated with removal of the loose stem and implantation of a long stem that bypasses the fracture site. However, there is a controversy about the stem fixation that should be used: cemented or cementless. Hence, this study aims to compare cemented and cementless stems in prosthetic revision due to Vancouver B2 (VB2) periprosthetic hip fracture.

Vancouver B2 periprosthetic hip fractures treatment: fix or replace? A retrospective study comparing both techniques.

Introduction: Vancouver B2 periprosthetic hip fractures involve stem stability and they have been classically treated with revision surgery. Crucial factors such as age, clinical comorbidities and functional status are often neglected. The current study aims to compare clinical outcomes between patients treated with open reduction and internal fixation (ORIF) or femoral stem exchange.

Fused hip conversion to total hip arthroplasty with the direct anterior approach: surgical technique on a regular surgical table under fluoroscopic guidance.

Purpose: Conversion of a fused hip to a total hip arthroplasty (THA) is technically challenging due to the loss of anatomical references. Here, a reproducible technique using the direct anterior approach (DAA) with a regular surgical table under fluoroscopic guidance is described, which has several advantages over traditional such as lateral or posterior approaches.

Methods: There were reported 11 cases of ankylosis hip that were converted to THA using the same surgical technique protocol.

[Translated article] Validation of the Spanish version of the modified Harris score.

Background And Objectives: Modified Harris Hip Score (HHS) is one of the most used scales in the assessment of patients with hip pathology. Although a Spanish cross-cultural adaptation has been recently published, there are many studies supporting its validity yet. Therefore, the aim of this study is to validate the newly adapted Spanish version of the HHS (ES-EHM), comparing it with the WOMAC scale.

Validation of the Spanish version of the modified Harris score.

Background And Objectives: Modified Harris Hip Score (HHS) is one of the most used scales in the assessment of patients with hip pathology. Although a Spanish cross-cultural adaptation has been recently published, there are many studies supporting its validity yet. Therefore, the aim of this study is to validate the newly adapted Spanish version of the HHS (ES-EHM), comparing it with the WOMAC scale.

Total hip arthroplasty associated with transverse subtrochanteric shortening osteotomy and conical stem fixation in Crowe type IV hip dysplasia.

Purpose: Total hip arthroplasty (THA) in high-dislocated hip dysplasia is a surgical challenge, presenting difficulties in the biomechanical reconstruction of the hip. The purpose of the present study is to analyze clinical and radiological outcomes of a series of patients with Crowe type IV hip dysplasia who underwent a THA with transverse subtrochanteric shortening osteotomy and conical stem fixation in our Hip surgery unit.

Methods: This non-interventional retrospective study included all patients diagnosed with Crowe type IV hip dysplasia who underwent a THA using a subtrochanteric shortening osteotomy and uncemented conical stem fixation between January 1, 2008, and December 31, 2015.

Simultaneous ipsilateral knee dislocation and hip fracture: A case report.

Hip fracture is one of the main causes of medical attendance in trauma centers. By contrast, knee dislocation is a challenging and limb-threatening injury. We report a case of a 68-year-old male who sustained a simultaneous ipsilateral hip fracture and knee dislocation after a low-energy fall.

Iliopsoas impingement after total hip arthroplasty: Does the CT-scan have any role? Our Algorithm proposal.

Introduction: The first surgical option considered in managing iliopsoas impingement following THA is endoscopic/arthroscopic iliopsoas tenotomy, because of its low risk and minimal invasiveness. Acetabular revision is a much more aggressive surgery, recommended only in cases of substantial cup malposition. However, there are no clear indications for this procedure.

Cross-cultural adaptation for the Spanish population of the modified Harris score for functional and symptomatic hip joint assessment.

Background And Objectives: The modified Harris hip score, is one of the most widely used scales for the functional assessment of hip pathology of the patients. However, there is no cross-cultural adaptation for the Spanish society. Therefore, this study aims to obtain a cross-cultural adaptation of the modified Harris hip score for the Spanish population.

Is routine blood typing and screening necessary before primary total hip or knee arthroplasty in the 21st century?

Background: Blood loss warranting transfusion is a relatively rare complication of major-joint arthroplasty procedures like total knee arthroplasty (TKA) and total hip arthroplasty (THA). Despite this rarity, pre-transfusion testing (blood typing, screening, and cross-matching) has become routine. We sought to determine if such routine testing is necessary for patients who undergo a primary TKA or THA by (1) measuring the current rate of intraoperative transfusions in primary TKA and THA patients, (2) identifying risk factors for transfusions, and (3) calculating the costs of such blood typing and screening.

Can we trust combined anteversion and Lewinnek safe zone to avoid hip prosthesis dislocation?

Introduction: Dislocation is one of the most common complications after primary total hip arthroplasty (THA). Combined anteversion (CA) is currently considered one of the most important measures of stability for THA. Thus, the aim of this study is to determine the association between a correct CA after THA and hip prosthesis dislocation, and to analyze the reliability of the Lewinnek safe zone parameters.

Restoring hip biomechanics during the learning curve of a novice surgeon: Direct anterior approach vs posterior approach.

Introduction: It remains controversial whether the direct anterior approach (DAA) or the posterior approach (PA) allows better restoration of hip biomechanics after total hip arthroplasty (THA). Besides, it is not certain which approach is best for a novice surgeon to avoid implant malposition, neither during the learning curve nor once the curve plateau has been reached.

Methods: We performed a retrospective cohort study of THAs operated on between 2014 and 2019 by a single novice surgeon (DAA, n = 187; PA, n = 184).

A comparative of a single novice surgeon's direct anterior approach and posterior approach learning curves in total hip arthroplasty: a retrospective cohort study.

Introduction: The purpose of the present study was to compare a novice surgeon's learning curves with the direct anterior approach and posterior approach in total hip arthroplasty.

Methods: A consecutive series of 376 total hip arthroplasties performed from November 2014 to September 2019 in a level-one healthcare center by a single surgeon (V.B) were retrospectively studied.

Direct anterior approach provides better functional outcomes when compared to direct lateral approach in hip hemiarthroplasty following femoral neck fracture.

Purpose: This study aims to compare the differences between direct anterior approach (DAA) and direct lateral approach (DLA) in hip hemiarthroplasty (HHA) after displaced femoral neck fracture (FNF) in early functional outcome, hospital length of stay, morbidity and mortality rates.

Methods: This non-interventional retrospective study, carried out at a tertiary trauma centre within the Spanish National Health System, included all patients who underwent a bipolar HHA between 1st January 2018 and 31st December 2019 performed by 2 of our hip unit surgeons.

Results: A total of 94 patients were included (40 in DAA group and 54 in DLA group).

Simultaneous bilateral dual mobility total hip arthroplasty dislocation in a patient with hepatic encephalopathy: A case report.

Introduction And Importance: Dislocation is a severe complication after total hip arthroplasty (THA). It is one of the most common reasons for failure and revision surgery. This is the first case of a documented simultaneous bilateral dual mobility (DM) THA dislocation.

Core Decompression Combined with Implantation of Autologous Bone Marrow Concentrate with Tricalcium Phosphate Does Not Prevent Radiographic Progression in Early Stage Osteonecrosis of the Hip.

Backgroud: Untreated osteonecrosis of the femoral head ultimately leads to secondary coxarthrosis. The aim of this study was to determinate if the core decompression of the femoral head combined with implantation of autologous bone marrow concentrate with tricalcium phosphate could be used to prevent radiographic progression of early stage osteonecrosis of the hip. We also sought to determine whether this treatment improved clinical outcomes and reduced the need for total hip arthroplasty.

Effect of Allogeneic Cell-Based Tissue-Engineered Treatments in a Sheep Osteonecrosis Model.

Osteonecrosis of the femoral head (ONFH) is defined as a tissue disorder and successive subchondral bone collapse resulting from an ischemic process, which may progress to hip osteoarthritis. Cell therapy with multipotent bone marrow mesenchymal stromal cells (BM-MSC) of autologous origin appears to be safe and has shown regenerative potential in previous preclinical and clinical studies. The use of allogeneic cells is far more challenging, but may be a promising alternative to use of autologous cells.

Early dislocation in primary total hip arthroplasty using a posterior approach with repair of capsule and external rotators.

Objective: To determine the incidence of dislocation after primary total hip arthroplasty using a posterior approach with repair of capsule and transosseous external rotators.

Material And Method: Historical cohort study between January 2009 and December 2015 of all the cases of dislocation of primary total hip arthroplasty operated using a posterior approach with repair of capsule and transosseous external rotators. Demographic and clinical data concerning the patient, surgery and dislocation were collected and analyzed.

Ischiofemoral Impingement Syndrome: Outcomes of Endoscopic Resection of the Lesser Trochanter.

Ischiofemoral impingement syndrome is a rare clinical entity characterized by chronic groin, buttock or hip pain associated with radiographic evidence of narrowing of the space between the lesser femoral trochanter and the ischial tuberosity. Introduction of magnetic resonance imaging to the clinical practice as well as the establishment of the radiological definition of the abnormal ischiofemoral distance has led to an increasing interest in this condition. Ischiofemoral impingement syndrome is a poorly understood disorder of chronic pain, especially regarding its treatment.

Bilateral insufficiency hip fractures after bariatric surgery.

Bariatric surgery is one of the most common surgeries within developed countries due to the increase in morbid obesity that has been observed in the past decades. The short-term alterations in the metabolism of calcium and vitamin D are well known after these procedures; however, the clinical and biochemical consequences may not be detected for years or even remain undiagnosed. We present the first case of bilateral insufficiency hip fracture after years of bariatric surgery.

Fracture of the Modular Neck in Total Hip Arthroplasty.

Modularity of the components in total hip arthroplasty has had an increase in popularity in the last decades. We present the case of a 53-year-old man with a history of avascular necrosis of the femoral head due to a hypophyseal adenoma. A total hip modular arthroplasty was implanted.

Bernese Periacetabular Osteotomy in a Hip Extra-Articular Resection Followed by Reconstruction Using an Extracorporeal Irradiated Acetabulum Autograft with Megaprosthesis, for Proximal Femur Osteosarcoma in a Pediatric Patient.

Osteosarcoma is the most common primary malignant tumour of bone. The oncologic surgery of a proximal femur osteosarcoma affecting the hip joint can be very challenging. We present an 8-year-old boy with a 5-month history of right hip pain.

Industrially prefabricated cement spacers: do vancomycin- and gentamicin-impregnated spacers offer any advantage?

Background: Industrially preformed antibiotic-loaded cement spacers are useful to facilitate the second stage of two-stage exchange arthroplasty for infected THAs and TKAs. However, whether gentamicin alone or a combination of antibiotics (such as vancomycin and gentamicin) is more effective is not known.

Questions/purposes: We therefore sought to compare industrially prefabricated spacers containing either gentamicin or gentamicin and vancomycin with respect to (1) infection control, (2) complications, and (3) quality of life, pain, and patient satisfaction.