Purpose: The purpose of the present study was to investigate the results of total hip arthroplasty (THA) using the Bicontact D stem with a minimum 10 year follow-up that focused on patients with developmental dysplasia of the hip (DDH).
Methods: One hundred five patients with osteoarthritis due to DDH who underwent primary THA were included in this study. The mean final follow-up period was 12.
Eur J Orthop Surg Traumatol
April 2020
Purpose: Combined anteversion (CA) technique (stem-first procedure) is generally accepted as the optimal technique to attain an appropriate CA value in total hip arthroplasty (THA). However, cup anteversion is strongly influenced by the native femoral anteversion. Accordingly, anterior protrusion of the cup in the acetabulum might occur.
View Article and Find Full Text PDFKerboull-type acetabular support rings (KT) and allogenic bone graft were used for severe periacetabular bone loss with primary and revision total hip arthroplasty (THA). The purpose of this case-control study is to evaluate the risk factors related to poor outcomes of surgery.Sixty patients underwent primary THA and revision THA using allogenic bone graft with KT for large acetabular deficiency.
View Article and Find Full Text PDFBackground: Postoperative pain is a significant concern of patients before surgery. Multimodal pain management is an effective method of pain control after major orthopedic surgery. Acetaminophen is the most commonly used analgesic for the management of pain.
View Article and Find Full Text PDFPurpose: In the combined anteversion (CA) technique for total hip arthroplasty (THA) with a cementless stem, cup anteversion is strongly influenced by the native femoral anteversion. It is hypothesized that in cases with large native femoral anteversion, cup anteversion can be decreased, and anterior cup protrusion from the anterior edge of the acetabulum could occur due to the achievement of optimal CA. In this study, the accuracy of CA in THA with the CA technique using imageless navigation and the relationship between the protrusion of the anterior edge of cup and optimum CA was retrospectively evaluated.
View Article and Find Full Text PDFRationale: Total hip arthroplasty (THA) concomitant with subtrochanteric femoral shortening osteotomy for Crowe type IV dysplastic hip has been reported. However, the combination of subtrochanteric femoral osteotomy and revision THA has only been mentioned in one case report.
Patient Concerns: A 67-year-old female had a history of congenital dislocation of both hips.
Purpose: The purpose of this study was to examine the accuracy of implant orientation and leg length in total hip arthroplasty (THA) with an image-free navigation system based on a comparison of the intraoperative navigation and postoperative CT evaluations.
Material And Methods: A consecutive series of 111 patients (118 hips) who underwent THA using the current version of the image-free navigation system constituted the basic study population. Subsequently, a total of 101 patients (108 hips) meeting the inclusion and exclusion criteria were selected as study subjects for the analysis.
In association with the growing interests in pain management, several modalities to control postoperative pain have been proposed and examined for the efficacy in the recent studies. Various modes of peripheral nerve block have been proposed and the effectiveness and safety have been examined for each of those techniques. We have described our clinical experiences, showing that continuous femoral nerve block could provide a satisfactory analgesic effect after total hip arthroplasty (THA) procedure.
View Article and Find Full Text PDFBackground: The number of hemodialysis patients has been progressively increasing in our country. On the other hand, chronic hip arthropathy associated with long-term hemodialysis is a devastating problems affecting patients' quality of life. In our previous study, we proposed a classification system for radiological abnormalities seen in hemodialysis-related hip lesions.
View Article and Find Full Text PDFThe aim of this study was to examine the clinical characteristics of patients who required revision and the rate of early complications after revision for metal-on-metal total hip arthroplasty (MOM THA) and metal-on-polyethylene total hip arthroplasty (MOP THA). Matched cohorts were selected by retrospective review from a single-center database of revision THAs for failed MOM and MOP THAs from 2010 to 2014. A total of 140 hips in 140 patients comprised the study population; 39 revisions were performed for failed MOM THAs (MOM group), and 101 revisions were performed for failed MOP THAs (MOP group).
View Article and Find Full Text PDFImplant positioning is one of the critical factors that influences postoperative outcome of total hip arthroplasty (THA). Malpositioning of the implant may lead to an increased risk of postoperative complications such as prosthetic impingement, dislocation, restricted range of motion, polyethylene wear, and loosening. In 2012, the intraoperative use of smartphone technology in THA for improved accuracy of acetabular cup placement was reported.
View Article and Find Full Text PDFImplant positioning is one of the critical factors influencing postoperative outcomes in total hip arthroplasty (THA). Several studies have reported that the postoperative antetorsion (AT) measurement for the femoral stem inserted without navigation showed wide variability. The current authors developed a simple instrument, the Gravity-guide (G-guide), for intraoperative assessment of stem AT and adjustment.
View Article and Find Full Text PDFSynovial osteochondromatosis of the hip is a rare condition, and the surgical treatment approach for this condition requires complete removal of loose bodies combined with synovectomy. While these, procedures are generally accepted as the optimal treatment method, this is still controversial topic. Recent studies have reported that open surgical procedures remain acceptable for synovial osteochondromatosis of the hip.
View Article and Find Full Text PDFA 47-year-old man underwent ceramic cup arthroplasty when he was 22 years old. Revision total hip arthroplasty was performed 25 years later because of limited range of motion without implant loosening. Histologic examination revealed that the femoral head and ceramic implant were well fixed through a thin fibrous membrane.
View Article and Find Full Text PDFPurpose: In total hip arthroplasty (THA), combined anteversion (CA) is used as a parameter for assessment of overall prosthetic alignment. The purpose of this study was to comparatively examine the CA value in patients who underwent primary THA using the image-free navigation system either with a cup-first or stem-first technique.
Methods: Eighty-three hips undergoing primary THA using the OrthoPilot® image-free navigation system (B.
Thirty-six patients who underwent primary unilateral total hip arthroplasty (THA) were randomly allocated to 4 groups with different pain control protocols; continuous femoral nerve block (FNB group), single-shot caudal epidural block with morphine (EB group), intravenous patient-controlled analgesia with fentanyl (IV-PCA group), and systemic administration of nonsteroidal anti-inflammatory drugs (NSAIDs group). Postoperative pain was assessed using the numerical rating scale (NRS) scores and the analgesic effect was compared among the groups. The NRS upon arrival at the recovery room and 6 hours after surgery in the FNB, EB, and IV-PCA groups were significantly lower than that in the NSAIDs group.
View Article and Find Full Text PDFBackground: Major vascular injury is one of the most devastating complications in total hip arthroplasty (THA). Risk for intraoperative vascular injury is increased when the normal vascular anatomy is distorted by previous surgery or dislocation with displacement. Therefore, an appreciation of the vascular anatomy in relation to the anticipated surgical field is critical to avoid this complication during preoperative assessment for a complicated THA.
View Article and Find Full Text PDFBackground: Proximal femoral fractures are common in elderly patients. Recently, use of regional blockade has gained popularity as a means of relieving pain among this patient population. Among the procedures, fascia iliaca compartment block (FICB) is believed to be advantageous because of its safety and efficacy.
View Article and Find Full Text PDFThe transverse acetabulum ligament (TAL) has been used as an intraoperative anatomical landmark to position the acetabulum cup in total hip arthroplasty (THA). However, the validity of the use of TAL has not been clarified. The purpose of this study was to examine the orientation of the cup component aligned with the TAL in cadaveric study.
View Article and Find Full Text PDFIn total hip arthroplasty (THA), combined anteversion (CA), the sum of cup anteversion (AV) and stem antetorsion (AT) are used as parameters to assess the appropriateness of overall prosthetic alignment. In this study, we evaluated the CA value based on the post-operative computed tomography (CT) measurements in our patient population who underwent THA using the OrthoPilot™ image-free navigation system (B/BRAUN-Aesculap, Tuttlingen, Germany). During surgery, cup alignment was adjusted with the use of the navigation system while the positioning of the femoral stem was arbitrarily adjusted by the surgeon.
View Article and Find Full Text PDFAlthough rarely encountered, major vascular injury is a serious complication of total hip arthroplasty (THA). We report the case of an 85-year-old woman who sustained a deep femoral artery injury associated with a superficial femoral artery thrombosis during revision of a dislocated bipolar hemiarthroplasty to a THA. Altered anatomy due to migration of the femoral head was thought to be one of the factors leading to this complication.
View Article and Find Full Text PDFVarious types of hip lesion associated with long-term haemodialysis have been observed. We present a new radiological classification system of haemodialysis-related hip arthropathy. In total, 103 hip lesions were analyzed in 84 patients undergoing haemodialysis for more than ten years.
View Article and Find Full Text PDFBackground: Adjustment of leg length discrepancy is an important factor influencing the outcome of total hip arthroplasty (THA). However, leg length discrepancy after THA has been reported to be associated with inferior clinical outcome in previous studies. A new version of the imageless navigation software "OrthoPilot THAplus" has been developed to assess the leg length adjustment and offset value.
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