Background: Failed intertrochanteric fractures in elderly patients are surgical challenge with limited options. Hip arthroplasty is a good salvage procedure even though it involves technical issues such as implant removal, bone loss, poor bone quality, trochanteric nonunion and difficulty of surgical exposure.
Materials And Methods: 30 patients of failed intertrochanteric fractures where hip arthroplasty was done between May 2008 and December 2011 were included in study. 13 were males and 17 were females with average age of 67.3 years. There were 2 cemented bipolar arthroplasties, 19 uncemented bipolar, 4 cemented total hip arthroplasty and 5 uncemented total hip arthroplasties. 16 patients had a trochanteric nonunion, which was treated by tension band principles. Total hip was considered where there was acetabular damage due to the penetration of implant.
Results: The average followup was 20 months (range 6-48 months). Patients were followed up from 6 to 48 months with average followup of 20 months. None of the patients were lost to followup. There was no dislocation. All patients were ambulatory at the final followup.
Conclusion: A predictable functional outcome can be achieved by hip arthroplasty in elderly patients with failed intertrochanteric fractures. Though technically demanding, properly performed hip arthroplasty can be a good salvage option for this patient group.
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http://dx.doi.org/10.4103/0019-5413.121581 | DOI Listing |
Int J Comput Assist Radiol Surg
January 2025
Department of Orthopaedic Surgery, Ehime University Graduate School of Medicine, Matsuyama, Japan.
Purpose: Identifying muscles linked to postoperative physical function can guide protocols to enhance early recovery following total hip arthroplasty (THA). This study aimed to evaluate the association of preoperative pelvic and thigh muscle volume and quality with early physical function after THA in patients with unilateral hip osteoarthritis (HOA).
Methods: Preoperative Computed tomography (CT) images of 61 patients (eight males and 53 females) with HOA were analyzed.
Orthopadie (Heidelb)
January 2025
Klinik für Orthopädie und Unfallchirurgie, Universitätsklinikum Freiburg, Medizinische Fakultät, Albert-Ludwigs-Universität Freiburg, Freiburg, Deutschland.
Background: Patients who have had prior injections, surgeries such as arthroscopies, and have existing osteosynthetic implants in the hip and knee have an increased risk of periprosthetic infections when undergoing hip (THA) or total knee arthroplasty (TKA).
Osteosynthesis: For patients with osteosynthetic implants in the knee joint, a two-stage procedure (implant removal followed by TKA) is recommended based on the available literature and the high colonization rates. A two-stage procedure is also recommended for patients with hip implants.
Popul Health Manag
January 2025
Department of Anesthesiology, New York Presbyterian/Weill Cornell Hospital, New York, USA.
Total hip arthroplasty (THA) is a widely performed surgical procedure in the United States, but disparities in THA outcomes related to hospital-level factors, such as safety-net burden, are underexplored. This study expands on previous research by analyzing multicenter, multistate data from 2015 to 2020 to investigate the impact of hospital safety-net burden-defined as the proportion of services billed to Medicaid and uninsured patients-on THA outcomes. This study is a retrospective analysis using data from the State Inpatient Databases for Florida, Kentucky, Maryland, New York, Washington, New Jersey, and North Carolina.
View Article and Find Full Text PDFArthroplast Today
February 2025
Department of Orthopaedic Surgery, McLaren-Flint, Flint, MI, USA.
Background: Reducing unnecessary emergency department (ED) visits following joint arthroplasty is an important goal. Literature suggests 30-day visit rates range between 4% and 15%, with only 20%-25% of these admitted for care. Low admissions suggest an opportunity to reduce unnecessary postarthroplasty ED visits.
View Article and Find Full Text PDFCureus
January 2025
Department of Orthopaedic Surgery, Faculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University, Okayama, JPN.
Introduction Implant technology for total hip arthroplasty (THA) was developed to improve hip function and patient satisfaction. Actis (DePuy Synthes, Warsaw, IN, USA) is a short fit-and-fill titanium stem, with a medial-collared and triple-taper (MCTT) geometry, that is fully coated with hydroxyapatite (HA). We evaluated the radiographic and clinical outcomes of the Actis Total Hip System during a mean follow-up of five years.
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