Changes of spino-pelvic characteristics post-THA are independent of surgical approach: a prospective study.

Aims: Spinopelvic characteristics change after THA. Whether this change varies between approaches, is of interest for pre-op cup orientation planning. The aims of this study were to (1) Characterize changes in standing PT amongst patients with hip osteoarthritis treated with THA; (2) Test whether certain patient-related factors may predict PT change; and (3) Assess the association between surgical approach and PT change.

"Intra-operative assessment of leg length discrepancy with anterior approach total hip replacement: a comparison between standard table, position table with and without intra-operative radiographs".

Purpose: Post-operative LLD is a major concern after THA. The anterior approach on a standard table allows surgeons for a direct control of the leg length. Intra-operative radiography (IR) helps in assessment of hip biomechanics and anatomic parameters.

Achieving cup target as per spinopelvic assessment is associated with improved THA outcome: a prospective, multicentre study.

Background: Different methods can help to optimise sagittal cup orientation in total hip arthroplasty (THA) based on individual spinopelvic characteristics. This study aimed to: (1) assess how often combined sagittal index (CSI) and hip-spine-classification targets were achieved post THA; (2) compare anteversion/inclination between cups in-/outside optimal CSI zone; and (3) determine association with outcome.

Methods: This is a multicentre, prospective, case-cohort study of 435 primary THA for osteoarthritis (53% females; age: 65 ± 12 years; follow-up: 2.

Spine-Abductor Syndrome: Novel Associations Between Lumbar Spine Disease and Hip Gluteal Muscle Pathology.

Background: Risk factors for gluteal tears include age-related deterioration, female sex, and increased body mass index. As the literature that supports the sagittal relationship between the lumbar spine and the hip is increasing, there may be a parallel relationship between the perturbations in spinopelvic alignment caused by lumbar spine disease and gluteal muscle tears. Because no prior studies other than single-institution series have reported on this phenomenon, we investigated spine-abductor syndrome at the population level.

Mapping at Early and Late Stages of Infection in a Clinically Representative Hip Prosthetic Joint Infection Rat Model.

Prosthetic joint infection (PJI) continues to be a devastating complication following total joint replacement surgeries where is the main offending organism. To improve our understanding of the disease pathogenesis, a histological analysis of infected peri-implant tissue in a hip PJI rat model was utilized to assess spread and tissue reaction at early and late stages of infection. Sprague-Dawley rats were used and received a left cemented hip hemiarthroplasty using a 3D-printed titanium femoral stem.

Patient Factors Associated with 10-Year Survival After Arthroplasty for Hip Fracture: A Population-Based Study in Ontario, Canada.

Background: The aim of this study was to describe long-term (10-year) patient survival after arthroplasty for hip fracture and to determine what patient factors are associated with that outcome.

Methods: We performed a retrospective cohort analysis of patients ≥60 years old who underwent either hemiarthroplasty or total hip arthroplasty for femoral neck fracture between 2002 and 2009. We used routinely collected, validated health-care databases linked through ICES (formerly known as the Institute for Clinical Evaluative Sciences).

Can we identify abnormal pelvic tilt using pre-THA anteroposterior pelvic radiographs?

Background: Patients with increased pelvic tilt (PT) are at risk for instability following total hip arthroplasty (THA). Identification of increased PT using anteroposterior (AP) pelvic radiographs could avoid additional spinopelvic radiographs. This study aimed to (1) describe which AP pelvic parameters most accurately estimate sagittal PT, and (2) determine thresholds for these parameters that can identify patients with increased PT.

External validation of a model using health administrative data to predict acetabular fracture probability: Brief report.

Analyses using population-based health administrative data can return erroneous results if case identification is inaccurate ("misclassification bias"). An acetabular fracture (AF) prediction model using administrative data decreased misclassification bias compared to identifying AFs using diagnostic codes. This study measured the accuracy of this AF prediction model in another hospital.

Do 3-dimensional Spinopelvic Characteristics Normalize After THA? A Prospective, Comparative Study Using Motion Capture Analysis.

Background: Spinopelvic stiffness (primarily in the sagittal plane) has been identified as a factor associated with inferior patient-reported outcomes (PROs) and increased dislocation risk after THA. Incorporating preoperative spinopelvic characteristics into surgical planning has been suggested to determine a patient-specific cup orientation that minimizes dislocation risk. Sagittal plane radiographic analysis of static postures indicates that patients exhibit a degree of normalization in their spinopelvic characteristics after THA.

Mid to long-term survivorship of hip arthroplasty in patients 40 years and younger.

Background: Etiology of hip osteoarthritis (OA) and survival of hip arthroplasty in the young (below 40-years-old) remains poorly described. Furthermore, joint survivorship mid to long-term and PROMs according to the etiology are unclear. The study aims were to 1) identify the indications for arthroplasty in the below 40-years-old cohort; 2) define hip arthroplasty outcomes in the young and 3) test whether patients with sequelae of pediatrics hip disease have inferior outcome compared to other patients.

How to Best Identify Acetabular Retroversion on Radiographs: Thresholds to Guide Clinical Practice.

Background: Acetabular retroversion is associated with impingement and instability. An adequate interpretation of acetabular version and coverage on radiographs is essential to determine the optimal treatment strategy (periacetabular osteotomy vs hip arthroscopic surgery). The crossover sign (COS) has been associated with the presence of acetabular retroversion, and the anterior wall index (AWI) and posterior wall index (PWI) assess anteroposterior acetabular coverage.

The relationship of pain catastrophizing with postoperative patient-reported outcome measures in adults with pre-arthritic hip disease.

The association between preoperative pain catastrophizing and postoperative patient-reported outcome measures of patients with pre-arthritic hip disease was evaluated. All patients scheduled for joint-preserving surgeries of the hip (JPSH) at our institution were approached. Patient demographics (age, sex, body mass index (BMI)), pain intensity (Numeric Pain Scale (NPS)) and pain catastrophizing (Pain Catastrophizing Scale (PCS)) were collected preoperatively.

Change in cup orientation from supine to standing posture: a prospective cohort study of 419 total hip arthroplasties.

Background And Purpose: Arthroplasty surgeons traditionally assess cup orientation after total hip arthroplasty (THA) on supine radiographs. Contemporary hip-spine analyses provide information on standing, functional cup orientation. This study aims to (i) characterize cup orientations when supine and standing; (ii) determine orientation differences between postures; and (iii) identify factors associated with magnitude of orientation differences.

How Does Radiographic Acetabular Morphology Change Between the Supine and Standing Positions in Asymptomatic Volunteers?

Background: The radiographic appearance of the acetabulum differs between the supine and standing positions in patients with hip conditions. The pelvis undergoes a change in tilt when transitioning between positions, resulting in variations in version and acetabular coverage. However, the extent of these variations in well-functioning volunteers without compensatory patterns caused by pain is unknown.

The Relationship of Cup Inclination and Anteversion in the Coronal Plane with Ante-Inclination in the Sagittal Plane: Exposing the Fallacy of Cup Safe Zones.

Background: This study aimed to establish an equation for calculating cup ante-inclination (AI) from radiographic cup inclination and anteversion, to validate this equation in a total hip arthroplasty (THA) cohort, and to test whether achieving previously described radiographic cup inclination and anteversion targets would also satisfy sagittal cup AI targets.

Methods: A mathematical equation linking cup AI, radiographic inclination (RI), and anteversion (RA) was determined: tan(AI) = tan(RA)/cos(RI). Supine and standing anteroposterior and lateral radiographs of 440 consecutive THAs were assessed to measure cup RI and RA and spinopelvic parameters, including cup AI, using a validated software tool.

Fellowship Training in Arthroplasty Improves Treatment Success of Debridement, Antibiotics, and Implant Retention for Periprosthetic Knee Infections.

Background: Debridement, antibiotics, and implant retention (DAIR) is a well-accepted surgical strategy for periprosthetic joint infection (PJI) following total knee arthroplasty (TKA). DAIR in TKA may be incorrectly thought of as a "simple" procedure not requiring formal specialized training in arthroplasty. Currently, there are no studies comparing the risk of treatment failure based on surgeon fellowship training.

Impact of Offset and Leg Length on Functional Outcomes Post-Total Hip Arthroplasty: How Accurate Should Coronal Reconstruction Be?

Background: Accurate hip reconstruction is associated with improved biomechanical behavior following total hip arthroplasty (THA). However, whether this is associated with improved patient-reported outcomes (PROs) is unknown.

Hypothesis/purpose: This study aimed to: 1) describe the ability to reconstruct coronal geometry during THA without advanced technology; 2) assess whether restoration of global offset (GO) and leg length (LL) is associated with improved PROs; and 3) investigate whether increased femoral offset (FO) to compensate for reduced acetabular offset (AO) influences PROs.

National Institute of Health and Care Excellence Guidelines for Displaced Intracapsular Hip Fractures: Examining Satisfaction With the Guidelines and Effects on Outcomes.

Background: The objectives of the study were to: (1) evaluate satisfaction with the new 2023 National Institute of Health and Care Excellence (NICE) criteria for selecting total hip arthroplasty (THA) over hemiarthroplasty and surgical recommendations for treatment of displaced intracapsular hip fractures; (2) describe why THA is performed when NICE criteria are not met; and (3) determine whether satisfaction with these guidelines is associated with improved outcomes.

Methods: A retrospective chart review of patients who had a displaced intracapsular hip fracture treated with THA at a single tertiary academic center between 2010 and 2022 was performed. Preoperative patient characteristics were reviewed to determine if the indication for THA met NICE criteria.

Lower Rates of Reoperation Following Partial or Complete Revision Arthroplasty Compared to Debridement, Antibiotics, and Implant Retention for Early Postoperative and Acute Hematogenous Periprosthetic Hip Infection.

Background: This study aimed to: 1) compare treatment outcomes between debridement, antibiotics, and implant retention (DAIR) and partial or complete revision arthroplasty (RA) for early postoperative and acute hematogenous total hip arthroplasty periprosthetic joint infection (PJI) and 2) identify factors associated with treatment outcome.

Methods: The study consisted of a retrospective cohort of patients who underwent surgery for PJI between 2004 and 2021. There were 76 patients (74.

Revision total hip arthroplasty for periprosthetic fracture: epidemiology, outcomes, and factors associated with success.

The aging population and the increasing number of patients with primary total hip arthroplasties (THA) has equated to an increased incidence of periprosthetic fractures (PPF) of the hip. These injuries are a significant source of patient morbidity and mortality, placing a financial burden on healthcare systems worldwide. As the volume of PPF is expected to along with the growing volume of primary and revision THA, it is important to understand the outcomes and factors associated with treatment success.