Total Hip Replacement is one of the most common operations performed in the developed world today. An increasingly ageing population means that the numbers of people undergoing this operation is set to rise. There are a numerous number of prosthesis on the market and it is often difficult to choose between them. It is therefore necessary to have a good understanding of the basic scientific principles in Total Hip Replacement and the evidence base underpinning them. This paper reviews the relevant anatomical and biomechanical principles in THA. It goes on to elaborate on the structural properties of materials used in modern implants and looks at the evidence base for different types of fixation including cemented and uncemented components. Modern bearing surfaces are discussed in addition to the scientific basis of various surface engineering modifications in THA prostheses. The basic science considerations in component alignment and abductor tension are also discussed. A brief discussion on modular and custom designs of THR is also included. This article reviews basic science concepts and the rationale underpinning the use of the femoral and acetabular component in total hip replacement.
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http://dx.doi.org/10.2174/1874325001004010169 | DOI Listing |
Arthroplast Today
February 2025
Levitetz Department of Orthopaedic Surgery, Cleveland Clinic Florida, Weston, FL, USA.
Background: For reimbursement purposes, current coding fails to reflect the true complexity and resource utilization of hospital encounters for surgeries performed to treat periprosthetic total hip arthroplasty (THA) infection. Therefore, when compared to aseptic revisions, we sought to determine (1) Is length of stay (LOS) longer for septic surgeries? (2) Are septic procedures more expensive? and (3) How do different surgical procedures for infection compare with aseptic revisions on hospital LOS and charges?
Methods: Retrospective chart review of 596 unilateral THA reoperations (473 patients) performed at a single institution (January 2015 to November 2020). Demographics, professional (ie, physicians), and technical (ie, room, implants) hospital charges per case were compared between 6 different surgery types: (1) aseptic revision (control; n = 364); (2) debridement, antibiotics, and implant retention (n = 11); (3) explantation (n = 145); (4) spacer exchange (n = 7); (5) 2-stage reimplantation (n = 59); and (6) 1-stage reimplantation (n = 10).
Backgrounds: Breech presentation, family history, and physical examination are the most recognized risk factors for DDH, which form the basis of selective screening. However, this approach can lead to late diagnosis, invasive treatments, and complications. This study analyzes the effectiveness of selective screening and identifies additional factors related to DDH.
View Article and Find Full Text PDFOTA Int
March 2025
Orthopaedic Trauma Institute, Institute for Global Orthopaedics and Traumatology, Department of Orthopaedic Surgery, University of California San Francisco, San Francisco, CA.
Purpose: With life expectancies increasing worldwide, there is a concomitant rise in the incidence of fragility fractures. As such, low-income and lower-middle-income countries (LICs and LMICs) will be faced with increased incidences of hip fractures. The care of these fractures is adversely affected by various factors that include under-resourced healthcare systems and large socioeconomic disparities, which disproportionately affect patient care in these regions relative to high-income countries.
View Article and Find Full Text PDFPlast Reconstr Surg Glob Open
January 2025
Plastic Surgery Service, University Hospital Miguel Enriquez, Havana, Cuba.
Background: An attractive waist-hip ratio leads to a favorable aesthetic appearance in women and can be achieved through the (ORUS) technique, which consists of the controlled fracture of the floating ribs through a small incision in the back based on an umbrella's functioning (open-semiclosed).
Methods: The ORUS technique was performed on 120 patients between 18 and 50 years of age. Patients were grouped according to the surgical procedure performed: ORUS (11 patients), ORUS + liposuction (n = 87), and ORUS + abdominoplasty (n = 22).
J Orthop Surg Res
January 2025
Department of Orthopedics, Pidu District People's Hospital, The Third Affiliated Hospital of Chengdu Medical College, Chengdu, 611730, China.
Background: The Clinical Frailty Scale (CFS) is a tool to assess the overall health of older adults. There are few reports of CFS and prognosis of ankle fracture. The objective of this study was to determine the predictive power of the CFS for adverse clinical and radiographic outcomes after surgery in elderly patients with trimalleolar fractures.
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