A new single-incision, soft tissue sparing approach to total hip arthroplasty: a case report.

Over the past decade, the development of modified instrumentation and navigation assistance (permitting in-situ bone excision) have stimulated advances in minimally invasive total hip arthroplasty techniques. These techniques have been developed with an objective to reduce perioperative morbidity, hospitalization expenses, and total rehabilitation time. Furthermore, a concomitant increase in the promotion of these techniques by both industry and orthopaedic surgeons themselves has fueled patient demand.

Efficacy of antibiotic-impregnated cement in total hip replacement.

Background And Purpose: Antibiotic-impregnated cement is used as a spacer or during re-implantation surgery for the treatment of infected total hip arthroplasties. The routine use of antibiotic-impregnated cement during primary or uninfected revision total hip arthroplasty remains controversial. With this meta-analysis of the published literature, we intended to assess efficacy and safety in the use of antibiotic-impregnated cement for uninfected arthroplasty.

Gait analysis of patients with resurfacing hip arthroplasty compared with hip osteoarthritis and standard total hip arthroplasty.

Patients with standard total hip arthroplasties may have reduced hip abduction and extension moments when compared with normal nonosteoarthritic hips. In comparison, patients after resurfacing total hip arthroplasty appear to have a near-normal gait. The authors evaluated temporal-spatial parameters, hip kinematics, and kinetics in hip resurfacing patients compared with patients with unilateral osteoarthritic hips and unilateral standard total hip arthroplasties.

Clinical experience using a minimally invasive surgical approach for total knee arthroplasty: early results of a prospective randomized study compared to a standard approach.

There has been recent attention concerning minimally invasive techniques for knee arthroplasty. It is not clear whether these complicated techniques can be reproduced across multiple centers and for all surgeons. This prospective, randomized, multicenter study was carried out to assess safety and efficacy of a minimally invasive total knee arthroplasty.

Surgical treatment of osteonecrosis of the hip.

Various surgical procedures are used in patients with osteonecrosis of the hip. Patients with precollapse of the femoral head are generally treated with head-preserving procedures (core decompression, various bone grafting techniques, and osteotomies), whereas those with collapse of the femoral head and/or arthritis may require arthroplasty. The arthroplasty options available include limited femoral resurfacing arthroplasty, metal-on-metal resurfacing arthroplasty, or total hip replacement.

Hip resurfacing arthroplasty.

Hip resurfacing arthroplasty is a type of hip replacement that involves capping the femoral head and preserving bone of the proximal femur. Metal-on-metal surface replacements have been manufactured since the early 1990s. Recent studies indicate excellent clinical results with low failure rates at 1- to 5-year follow-up.

Sports activity after total hip and knee arthroplasty : specific recommendations concerning tennis.

Lower extremity total joint arthroplasties are among the most successful operations in orthopaedics. Presently, it appears that some patients wish to not only have general functions restored, but also desire the opportunity to return or continue on a high level of activity. This review summarises the literature concerning athletic activity, and tennis in particular, in relation to lower extremity total joint arthroplasties.

Reductions in blood loss with use of a bipolar sealer for hemostasis in primary total knee arthroplasty.

Fifty primary total knee arthroplasties were performed in a prospective, randomized study comparing the use of a bipolar sealer device versus conventional electrocautery as the method of hemostasis. Both cohorts were evaluated for intraoperative blood loss, transfusion rate, postoperative drainage, hemoglobin levels, and Knee Society scores. A significant reduction in postoperative and total blood loss was found (p = 0.

Resurfacing hip arthroplasty: comparison of a minimally invasive versus standard approach.

Unlabelled: Metal-on-metal total hip resurfacing recently has gained popularity as a femoral-bone-preserving procedure. There has been a concomitant upsurge in demand by patients and the surgical community for the use of minimally invasive techniques for hip arthroplasty procedures. The fundamental questions are whether these techniques can lead to better short-term outcomes without leading to increased operative times, blood loss, transfusion requirements, length of stay, and clinical and/or radiographic complications.

The appropriate use of patellofemoral arthroplasty: an analysis of reported indications, contraindications, and failures.

Unlabelled: Patellofemoral arthroplasty is going through a recent resurgence in interest with various new designs being introduced for general orthopaedic use. With this renewed enthusiasm for the procedure, it is important to understand the various indications and contraindications for using patellofemoral arthroplasty devices with the expectation that proper patient selection will improve outcome. Our purpose was to analyze the appropriate usage of these prostheses based on published historical results.

Use of constrained acetabular liners in total hip arthroplasty.

The use of constrained acetabular liners is indicated when soft-tissue tensioning techniques such as femoral neck lengthening, component repositioning, and use of lateralized acetabular liner are ineffective. It is most commonly used as a salvage procedure in revision situations. However, a locking acetabular insert may be used for primary THAs in patients with joint or soft-tissue laxity, neuromuscular disease, or intraoperative instability.

Minimally invasive total knee arthroplasty.

Currently, minimally invasive total knee arthroplasty is defined as an incision length of < 14 cm. However, the length of the incision is not the primary influence on potential postoperative benefits to the patient and should not be the only characteristic of the minimally invasive approach for knee arthroplasty. Some other factors that should also be included in this definition are: 1.

Core decompression of the femoral head for osteonecrosis using percutaneous multiple small-diameter drilling.

Osteonecrosis is a disease with a wide ranging etiology and poorly understood pathogenesis seen commonly in young patients. Core decompression has historically been used in patients with small-sized or medium-sized precollapse lesions in an attempt to forestall disease progression. Typically, an 8-10 mm wide cannula trephine is used to do this procedure.

The diagnosis and treatment of nontraumatic osteonecrosis of the femoral head.

Osteonecrosis of the femoral head is a potentially debilitating disease that frequently affects young patients in the third through fifth decades of life. If untreated, this disease will result in total destruction of the hip joint; therefore, early diagnosis and intervention are essential to optimize outcome. Although the etiology of osteonecrosis of the femoral head is poorly understood, awareness of well-established risk factors and associated disorders can assist in early detection and possible prevention of hip joint destruction.

Use of cancellous bone chips and demineralized bone matrix in the treatment of acetabular osteolysis: preliminary 2-year follow-up.

Twenty patients (20 hips) who had cementless acetabular revision arthroplasty and were treated with cancellous bone chips mixed with demineralized bone matrix to fill the cavitary defects were studied. At 2-years' follow-up, the grafts were fully incorporated in 18 patients. In addition, the mean Harris Hip Score increased to 89 points from a mean preoperative score of 29 points for the surviving hips.

Outcome of nonvascularized bone grafting for osteonecrosis of the femoral head.

Osteonecrosis is a disease with a wide-ranging etiology and poorly understood pathogenesis seen commonly in young patients. Various head-preserving procedures have been used for this disease to avert the need for total hip replacement. These include various vascularized and nonvascularized bone grafting procedures.