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Total hip arthroplasty (THA) represents a meticulously standardized procedure with highly satisfactory results for surgeons and patients alike. Anyhow, due to rare diseases, anatomic varieties or in posttraumatic situations, the restauration of a normal hip joint anatomy and physiological kinematics can become a big challenge for the treating surgeon. This article gives an overview of the variety of these challenging conditions (including developmental hip dysplasia, osteopetrosis, skeletal dysplasia, Paget's disease and extraarticular deformities) and with a selection of complex cases it should give the reader some thought-provoking impulses considering the management of complex primary THA cases. This includes with the choice of implant, intraoperative characteristics, certain pitfalls and postoperative considerations alike. As a result, it should minimize the risk for complications in these complex cases without minimizing the patient's expectations in a nearly normal hip function and painless movement.
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http://dx.doi.org/10.1055/a-0736-3649 | DOI Listing |
J Orthop Sci
December 2024
The School of Clinical Medicine, Fujian Medical University, Fuzhou, Fujian, China; Department of Orthopaedic Surgery, Fuzhou Second Hospital, Fuzhou, Fujian, China.
Background: Hip fracture affects millions of persons and is associated with excess morbidity and mortality. More knowledge is needed to regard the prolonged effects of intensive exercise in relatively frail hip fracture patients. In this meta-analysis, we want to determine whether intensity strength training in patients after hip fracture is superior to general exercises in improving physical function.
View Article and Find Full Text PDFPract Neurol
December 2024
Neurology Department, Lancashire Teaching Hospitals NHS Foundation Trust, Preston, UK.
We describe a woman with stiff-person syndrome (SPS), whose muscle spasms resulted in sequential bilateral femoral neck fractures. Orthopaedic fixation of the first fracture was complicated by increased muscle spasm, fracture nonunion and ultimately metalwork fracture. SPS was diagnosed following the fracture of the contralateral femoral neck, neurology assessment and detection of high-titre antibodies to glutamic acid decarboxylase.
View Article and Find Full Text PDFCureus
November 2024
Orthopedics and Traumatology, Instituto de Seguridad y Servicios Sociales para los Trabajadores del Estado, Puebla, MEX.
Background: Venous thromboembolism (VTE) is a significant complication following total knee arthroplasty (TKA) and total hip arthroplasty (THA). Aspirin has gained attention as a cost-effective, safe alternative to traditional anticoagulants like enoxaparin, but comparative data on efficacy and safety remain limited.
Methods: This randomized controlled trial compared the efficacy of aspirin and enoxaparin in preventing VTE following TKA and THA.
J Clin Orthop Trauma
January 2025
St John of God Subiaco and Midland Hospitals, Subiaco, 6008, WA, Australia.
Introduction: Total knee arthroplasty (TKA) in severe varus deformity still remains a challenge. Alternative alignment TKA aims to improve outcomes and satisfaction. The purpose of this study is to report on the outcomes of a functionally aligned TKA in severe varus deformity.
View Article and Find Full Text PDFJt Dis Relat Surg
January 2025
Adnan Menderes Üniversitesi Tıp Fakültesi Ortopedi ve Travmatoloji Anabilim Dalı, 09010 Efeler, Aydın, Türkiye.
Objectives: The aim of this study was to measure the reliability of the expanded and revised Melbourne Cerebral Palsy Hip Classification System (r-MCPHCS) across different medical specialties.
Patients And Methods: Anteroposterior pelvic radiographs of a total of 44 patients (20 males, 24 females; median 16.7 years; range, 12 to 32 years) with cerebral palsy (CP) were analyzed between January 2005 and December 2020.
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