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GERONTOLOGY AND GERIATRICS (125 journals)                     

Showing 1 - 122 of 122 Journals sorted alphabetically
Activities, Adaptation & Aging     Hybrid Journal   (Followers: 6)
Advances in Alzheimer's Disease     Open Access   (Followers: 8)
Advances in Geriatrics     Open Access   (Followers: 4)
Advances in Gerontology     Partially Free   (Followers: 9)
Advances in Parkinson's Disease     Open Access   (Followers: 2)
Age and Ageing     Hybrid Journal   (Followers: 106)
Aging & Mental Health     Hybrid Journal   (Followers: 40)
Aging and Cancer     Open Access   (Followers: 2)
Aging and Health Research     Open Access   (Followers: 1)
Aging Clinical and Experimental Research     Hybrid Journal   (Followers: 3)
Aging Medicine     Open Access   (Followers: 1)
Aging, Neuropsychology, and Cognition     Hybrid Journal   (Followers: 41)
Alzheimer's & Dementia     Hybrid Journal   (Followers: 50)
Alzheimer's & Dementia: Diagnosis, Assessment & Disease Monitoring     Open Access   (Followers: 5)
Alzheimer's & Dementia: Translational Research & Clinical Interventions     Open Access   (Followers: 5)
American Journal of Alzheimer's Disease and Other Dementias     Hybrid Journal   (Followers: 21)
American Journal of Geriatric Psychiatry     Hybrid Journal   (Followers: 19)
Anales en Gerontología     Open Access  
Angewandte GERONTOLOGIE Appliquée     Full-text available via subscription  
Annual Review of Gerontology and Geriatrics     Hybrid Journal   (Followers: 14)
Arthritis und Rheuma     Hybrid Journal  
Australasian Journal On Ageing     Hybrid Journal   (Followers: 12)
Australian Ageing Agenda     Full-text available via subscription   (Followers: 5)
B&G Bewegungstherapie und Gesundheitssport     Hybrid Journal   (Followers: 2)
Biogerontology     Hybrid Journal   (Followers: 1)
BMC Geriatrics     Open Access   (Followers: 17)
Canadian Geriatrics Journal     Open Access   (Followers: 6)
Canadian Journal on Aging     Hybrid Journal   (Followers: 17)
Clinical Gerontologist     Hybrid Journal   (Followers: 3)
Clinics in Geriatric Medicine     Full-text available via subscription   (Followers: 6)
Current Geriatrics Reports     Hybrid Journal   (Followers: 1)
Current Gerontology and Geriatrics Research     Open Access   (Followers: 11)
Dementia and Geriatric Cognitive Disorders     Full-text available via subscription   (Followers: 36)
Dementia and Geriatric Cognitive Disorders Extra     Open Access   (Followers: 19)
Drugs & Aging     Full-text available via subscription   (Followers: 9)
European Geriatric Medicine     Full-text available via subscription   (Followers: 3)
European Journal of Ageing     Hybrid Journal   (Followers: 16)
European Review of Aging and Physical Activity     Open Access   (Followers: 11)
Experimental Aging Research: An International Journal Devoted to the Scientific Study of the Aging Process     Hybrid Journal   (Followers: 2)
Experimental Gerontology     Hybrid Journal   (Followers: 5)
Frontiers in Aging Neuroscience     Open Access   (Followers: 21)
Gait & Posture     Hybrid Journal   (Followers: 17)
Generations     Full-text available via subscription   (Followers: 3)
Geriatric Care     Open Access   (Followers: 4)
Geriatric Medicine in General Practice     Full-text available via subscription   (Followers: 8)
Geriatric Orthopaedic Surgery Rehabilitation     Open Access   (Followers: 5)
Geriatrics     Open Access   (Followers: 3)
Geriatrics & Gerontology International     Hybrid Journal   (Followers: 11)
Geriatrie up2date     Hybrid Journal  
Geriatrie-Report : Forschung und Praxis in der Altersmedizin     Full-text available via subscription  
Gerodontology     Hybrid Journal   (Followers: 2)
Gerokomos     Open Access   (Followers: 1)
Geron     Full-text available via subscription  
Gerontologia     Open Access  
Gerontology     Full-text available via subscription   (Followers: 22)
Gerontology & Geriatrics Education     Hybrid Journal   (Followers: 8)
Gerontology and Geriatric Medicine     Open Access   (Followers: 5)
GeroPsych: The Journal of Gerontopsychology and Geriatric Psychiatry     Hybrid Journal   (Followers: 5)
GeroScience : Official Journal of the American Aging Association (AGE)     Hybrid Journal   (Followers: 8)
Global Journal of Geriatrics Nursing     Open Access   (Followers: 4)
Hip International     Hybrid Journal  
I Advance Senior Care     Full-text available via subscription  
Immunity & Ageing     Open Access   (Followers: 9)
Innovation in Aging     Open Access   (Followers: 1)
International Journal of Ageing and Later Life     Open Access   (Followers: 1)
International Journal of Aging and Human Development     Full-text available via subscription   (Followers: 11)
International Journal of Alzheimer's Disease     Open Access   (Followers: 8)
JMIR Aging     Open Access  
Journal for Healthcare Quality     Hybrid Journal   (Followers: 28)
Journal of Adult Protection, The     Hybrid Journal   (Followers: 16)
Journal of Aging and Environment     Hybrid Journal   (Followers: 4)
Journal of Aging and Health     Hybrid Journal   (Followers: 28)
Journal of Angiogenesis Research     Open Access   (Followers: 2)
Journal of Applied Gerontology     Hybrid Journal   (Followers: 18)
Journal of Elder Abuse & Neglect     Hybrid Journal   (Followers: 6)
Journal of Frailty & Aging     Hybrid Journal  
Journal of Geriatric Cardiology     Open Access   (Followers: 3)
Journal of Geriatric Mental Health     Open Access   (Followers: 6)
Journal of Geriatric Oncology     Hybrid Journal   (Followers: 2)
Journal of Geriatric Physical Therapy     Hybrid Journal   (Followers: 14)
Journal of Geriatrics     Open Access   (Followers: 1)
Journal of Geriatrics and Palliative Care     Open Access   (Followers: 5)
Journal of Gerontological Social Work     Hybrid Journal   (Followers: 14)
Journal of Mid-life Health     Open Access  
Journal of Military and Veterans Health     Full-text available via subscription   (Followers: 7)
Journal of Parkinsonism and Restless Legs Syndrome     Open Access   (Followers: 2)
Journal of Parkinson’s Disease and Alzheimer’s Disease     Open Access   (Followers: 1)
Journal of Prevention of Alzheimer's Disease     Hybrid Journal   (Followers: 1)
Journal of Religion Spirituality & Aging     Hybrid Journal   (Followers: 7)
Journal of Social Work in End-of-Life & Palliative Care     Hybrid Journal   (Followers: 22)
Journal of the American Geriatrics Society     Hybrid Journal   (Followers: 67)
Journal of the Indian Academy of Geriatrics     Open Access   (Followers: 4)
Maturitas     Hybrid Journal   (Followers: 10)
Medycyna Wieku Podeszłego (Geriatric Medicine)     Open Access  
Mortality: Promoting the interdisciplinary study of death and dying     Hybrid Journal   (Followers: 9)
Neurodegenerative Diseases     Full-text available via subscription   (Followers: 1)
Neuroembryology and Aging     Full-text available via subscription   (Followers: 1)
NOVAcura     Hybrid Journal  
npj Aging and Mechanisms of Disease     Open Access   (Followers: 1)
npj Parkinson's Disease     Open Access   (Followers: 4)
Nursing Older People     Full-text available via subscription   (Followers: 9)
OA Elderly Medicine     Open Access  
Paediatrics & Child Health in General Practice     Full-text available via subscription   (Followers: 5)
Palliative Care & Social Practice     Open Access   (Followers: 3)
Parkinson's Disease     Open Access   (Followers: 12)
Pathobiology of Aging & Age-related Diseases     Open Access  
Physical & Occupational Therapy in Geriatrics     Hybrid Journal   (Followers: 56)
Quality in Ageing and Older Adults     Hybrid Journal   (Followers: 44)
Quality of Life Research     Hybrid Journal   (Followers: 20)
RASP - Research on Ageing and Social Policy     Open Access   (Followers: 4)
Revista Española de Geriatría y Gerontología     Full-text available via subscription  
Senex: Yaşlılık Çalışmaları Dergisi / Senex: Journal of Aging Studies     Open Access  
The Aging Male     Hybrid Journal   (Followers: 2)
The Gerontologist     Hybrid Journal   (Followers: 23)
The Journals of Gerontology : Series A     Hybrid Journal   (Followers: 22)
Topics in Geriatric Rehabilitation     Hybrid Journal   (Followers: 15)
Translational Medicine of Aging     Open Access  
Work, Aging and Retirement     Open Access   (Followers: 4)
Working with Older People     Hybrid Journal   (Followers: 40)
Zeitschrift fur Gerontologie und Geriatrie     Hybrid Journal   (Followers: 1)
Zeitschrift für Gerontopsychologie und -psychiatrie     Full-text available via subscription   (Followers: 1)
Zeitschrift für Palliativmedizin     Hybrid Journal  

           

Similar Journals
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Hip International
Journal Prestige (SJR): 0.817
Citation Impact (citeScore): 1
Number of Followers: 0  
 
  Hybrid Journal Hybrid journal (It can contain Open Access articles)
ISSN (Print) 1120-7000 - ISSN (Online) 1724-6067
Published by Sage Publications Homepage  [1174 journals]
  • Revision total hip arthroplasty for aseptic loosening compared with
           primary total hip arthroplasty for osteoarthritis: long-term clinical,
           functional and quality of life outcome data

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      Authors: Antonios A Koutalos, Sokratis Varitimidis, Konstantinos N Malizos, Theofilos Karachalios
      Abstract: HIP International, Ahead of Print.
      Purpose:The aim of this study was the comparative assessment of long-term clinical (subjective and objective), functional and quality of life outcome data between primary and revision THA.Methods:122 patients (130 hips) who underwent cementless revision THA of both components (TMT cup, Wagner SL stem, Zimmer Biomet) for aseptic loosening only (Group A) were compared to a matched group of 100 patients (100 hips) who underwent cementless primary THA for osteoarthritis (Synergy stem, R3 cup, Smith & Nephew) (Group B). Outcomes were evaluated with survival analysis curves, Harris Hip Score (HHS), WOMAC, Oxford Hip Score (OHS), Short-Form Health Survey (SF-12) and EQ-5D-5L scales. Mobility was assessed with walking speed, Timed Up And Go Test (TUG), Parker Mobility Score, Lower Extremity Functional Scale (LEFS) and UCLA scores.Results:At a mean follow-up of 11.1 (8–17) years a cumulative success rate of 96% (95% CI, 96–99%) in Group A and 98% (95% CI, 97–99%) in Group B with operation for any reason as an endpoint was recorded. Statistically significant differences between groups were developed for WOMAC (Mann-Whitney U-test, p = 0.014), OHS (Mann-Whitney U-test, p = 0.020) and physical component of SF-12 scores (Mann-Whitney U-test, p = 0.029) only. Group A had less improvement in function as compared with group B. In Group A, in multiple regression analysis, patients’ cognition (p = 0.001), BMI (p = 0.007) and pain (p = 0.022) were found to be independent factors influencing functional recovery (WOMAC). Similarly, pain (p = 0.03) was found to influence quality of life (EQ-5D-5).Conclusions:In the long term, revision THA shows satisfactory but inferior clinical, functional, and quality of life outcomes when compared to primary THA. Residual pain, BMI and cognitive impairment independently affect functional outcomes.
      Citation: HIP International
      PubDate: 2022-07-28T11:12:26Z
      DOI: 10.1177/11207000221115354
       
  • Analysis of factors affecting the time for implantation of a total hip
           arthroplasty in patients with symptomatic primary and secondary hip
           osteoarthritis

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      Authors: Leon D Becker, Thilo Floerkemeier, Alexander Derksen, Michael Schwarze, Stefan Budde, Henning Windhagen, Nils Wirries
      Abstract: HIP International, Ahead of Print.
      Background:Many studies have identified factors associated with an unfavourable clinical outcome or an early conversion to total hip arthroplasty (THA) after joint-preserving treatment. We analysed the effect and reliability of different factors on the age at which THA becomes necessary.Methods:Hip joint radiographs of 2485 cases were evaluated using the lateral centre-edge angle (LCEA) and acetabulum angle (ACA) as well as the alpha angle to describe the femoral head shapes. Regressions were performed using patient’s age at the time of THA and body mass index (BMI) as well as LCEA and ACA. Multiple linear regressions were used to create a formula comprising factors that significantly correlated with patient age at the time of joint replacement surgery.Results:The BMI, LCEA, and ACA showed significant correlations with the age of THA implantation (p 
      Citation: HIP International
      PubDate: 2022-07-25T10:31:03Z
      DOI: 10.1177/11207000221114618
       
  • A propensity score-matched comparison of patient satisfaction following
           periacetabular osteotomy or total hip arthroplasty for developmental
           dysplasia of the hip in an Asian cohort

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      Authors: Tetsunari Harada, Satoshi Hamai, Kyohei Shiomoto, Daisuke Hara, Goro Motomura, Yasuharu Nakashima
      Abstract: HIP International, Ahead of Print.
      Background:No studies have compared patient satisfaction between periacetabular osteotomy (PAO) and total hip arthroplasty (THA) for osteoarthritis (OA) secondary to developmental dysplasia of the hip (DDH) in Asian cohorts.Methods:Multivariate analyses were applied to determine whether patient demographics and postoperative patient-reported outcomes were correlated with postoperative patient satisfaction in 737 DDH patients (251 PAO and 486 THA patients). Additionally, postoperative patient satisfaction, Oxford Hip Score (OHS), University of California-Los Angeles (UCLA) activity score, and sports participation were compared between propensity-matched PAO and THA patients for OA secondary to DDH (Kellgren-Lawrence grade II: 32 PAO and 16 THA patients, grade III: 20 PAO and 40 THA patients).Results:Of the 737 patients, 663 patients (90%) were postoperatively satisfied. Multivariate analysis demonstrated that THA was positively correlated with patient satisfaction. Furthermore, high postoperative OHS-pain, OHS-ADL, and UCLA scores were positively correlated with satisfaction. In propensity-matched PAO and THA patients, PAO elicited greater patient satisfaction than THA for KL grade II OA secondary to DDH, with comparable postoperative OHS (including the pain and ADL subscale), UCLA score, and sports participation rate. In contrast, THA resulted in better satisfaction and OHS-pain for KL grade III OA secondary to DDH, with comparable postoperative OHS-ADL, UCLA score, and sports participation rate in the 2 surgeries.Conclusions:Both PAO and THA procedures offer distinct patient satisfaction advantages based on preoperative OA severity. These findings can assist in the clinical decision-making process for the surgical treatment of middle-aged patients with symptomatic DDH.
      Citation: HIP International
      PubDate: 2022-07-25T04:28:14Z
      DOI: 10.1177/11207000221114272
       
  • A comparison of hemiarthroplasty versus dynamic hip screw fixation for
           intertrochanteric femoral fractures: a systematic review

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      Authors: Alex K Chowdhury, Oliver Townsend, Max R Edwards
      Abstract: HIP International, Ahead of Print.
      Introduction:Intertrochanteric fractures are predominantly treated by dynamic hip screw (DHS) fixation. However, recent evidence has found acceptable clinical results following hemiarthroplasty for these fractures. Thus, a systematic review was conducted to compare hemiarthroplasty with DHS fixation for intertrochanteric fractures.Methods:A computerised search was performed, using the databases Medline, EMBASE, CINAHL and the Cochrane Central Register of Controlled Trials, with supplementation from Google Scholar and appropriate reference lists. Studies with comparative data comparing clinical outcomes of hemiarthroplasty versus DHS fixation were included. Data were extracted and quality assessment of the papers performed by 2 reviewers.Results:320 articles were independently reviewed by the investigators. A total of 10 studies met the inclusion criteria, comprising 2 randomised controlled trials and 8 cohort designs. 7 of the studies assessed unstable fracture patterns. There was no difference in operating time (SMD −1.169 min; 95% CI, −0.657 to 0.689) or blood transfusion volume (SMD−0.110 units; 95% CI, −0.520 to 0.891) between modalities. There was also no difference in length of stay (SMD −0.778 days; 95% CI, −0.606 to 0.336), mortality (RR 0.942; 95% CI, 0.749–1.183) or major complications. Hemiarthroplasty conferred significantly better Harris Hip Scores at 12 months (SMD 12.3; 95% CI, 0.0135–2.789) and allowed earlier weight-bearing than DHS fixation.Discussion:Qualitative and quantitative compilation of the included studies demonstrates hemiarthroplasty to result in better functional scores and a quicker time to weight-bearing than DHS fixation for intertrochanteric fractures. Results are comparable for other major parameters, including operative time, length of stay and mortality. Thus, hemiarthroplasty is a suitable alternative to DHS fixation for unstable intertrochanteric fractures in elderly patients.
      Citation: HIP International
      PubDate: 2022-07-18T04:18:14Z
      DOI: 10.1177/11207000221112579
       
  • Quadratus lumborum block for postoperative pain management in patients
           undergoing total hip arthroplasty: a systematic review and meta-analysis

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      Authors: Aaron Gazendam, Meng Zhu, Luc Rubinger, Yaping Chang, Steve Phillips, Mohit Bhandari
      Abstract: HIP International, Ahead of Print.
      Background:The use of quadratus lumborum nerve blocks (QLB) for pain control following elective total hip arthroplasty (THA) has increased substantially in recent years. The objective of this systematic review and meta-analysis was to compare outcomes from randomised controlled trials (RCTs) utilising QLBs following elective THA.Methods:MEDLINE, EMBASE, and Cochrane databases were searched for RCTs perioperative QLBs for THA. Quantitative synthesis was conducted for pain scores, opioid consumption and adverse events.Results:A total of 7 RCTs with 429 patients undergoing THA were included. No differences in pain scores were demonstrated between QLBs and control interventions. Subgroup analysis demonstrated no differences between QLBs and sham procedures or active comparators. No differences in postoperative opioid consumption between QLB and control interventions was found. In trials reporting adverse events, they were rare and similar between groups. Overall, the certainty of the evidence was graded as low or very lowConclusions:The current literature suggests that a QLB for THA does not reduce pain or opioid consumption compared to sham or active comparators.
      Citation: HIP International
      PubDate: 2022-07-18T04:16:14Z
      DOI: 10.1177/11207000221111309
       
  • Long-term changes in blood metal ion levels in patients with hip
           resurfacing implants: implications for patient surveillance after
           10 years follow-up

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      Authors: Aleksi Reito, Olli Lainiala, Fiona Berryman, David J Dunlop, Antti Eskelinen, Gulraj S Matharu
      Abstract: HIP International, Ahead of Print.
      Background:Studies investigating changes in blood metal ion levels during the second decade of the implant lifetime in MoM hip resurfacing patients are scarce.Methods:Patients implanted with either Birmingham Hip Resurfacing (BHR) or Articular Surface Replacement (ASR) hip resurfacings with>10 years follow-up and repeated blood metal ion measurements were identified at 2 large specialist European arthroplasty centres. After excluding patients with initial metal ion levels>7 ppb, the proportion of patients with an increase in blood metal ion levels above previously validated implant-specific thresholds (cobalt 2.15 ppb for unilateral implants, cobalt or chromium 5.5 ppb for bilateral) was assessed.Results:We included 2743 blood metal ion measurements from 457 BHR patients (555 hips) and 216 ASR patients (263 hips). Of patients with initial metal ion levels below implant specific thresholds, increases in cobalt or chromium level, respectively, to above these thresholds during the second decade were seen as follows: unilateral BHR (cobalt = 15.6%), unilateral ASR (cobalt = 13.8%), bilateral BHR (cobalt = 8.2%, chromium = 11.8%), bilateral ASR (cobalt = 8.5%, chromium = 4.3%). Measurement-to-measurement changes exceeding +2.15 ppb or +5.5 ppb were, however, uncommon during the second decade. Subgroup results with small diameter (
      Citation: HIP International
      PubDate: 2022-07-18T04:14:50Z
      DOI: 10.1177/11207000221104396
       
  • Causes and predictors of failed same-day home discharge following primary
           hip and knee total joint arthroplasty: a Canadian perspective

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      Authors: Aaron M Gazendam, Daniel Tushinski, Mansi Patel, Kamal Bali, Danielle Petruccelli, Mitchell Winemaker, Justin DeBeer, Leslie Gillies, Katie Best, Jennifer Fife, Thomas J Wood
      Abstract: HIP International, Ahead of Print.
      Purpose:Same-day home (SDH) discharge in total joint arthroplasty (TJA) has increased in popularity in recent years. The objective of this study was to evaluate the causes and predictors of failed discharges in planned SDH patients.Methods:A consecutive cohort of patients who underwent total knee (TKA) or total hip arthroplasty (THA) that were scheduled for SDH discharge between 01 April 2019 and 31 March 2021 were retrospectively reviewed. Patient demographics, causes of failed discharge, perioperative variables, 30-day readmissions and 6-month reoperation rates were collected. Multivariate regression analysis was undertaken to identify independent predictors of failed discharge.Results:The cohort consisted of 527 consecutive patients. 101 (19%) patients failed SDH discharge. The leading causes were postoperative hypotension (20%) and patients who were ineligible for the SDH pathway (19%). 2 individual surgeons, later operative start time (OR 1.3; 95% CI, 1.15–1.55; p = 0.001), ASA class IV (OR 3.4; 95% CI, 1.4–8.2; p = 0.006) and undergoing a THA (OR 2.0; 95% CI, 1.2–3.1, p = 0.004) were independent predictors of failed SDH discharge. No differences in age, BMI, gender, surgical approach or type of anaesthetic were found (p > 0.05). The 30-day readmission or 6-month reoperation were similar between groups (p > 0.05).Conclusions:Hypotension and inappropriate patient selection were the leading causes of failed SDH discharge. Significant variability existed between individual surgeons failed discharge rates. Patients undergoing a THA, classified as ASA IV or had a later operative start time were all more likely to fail SDH discharge.
      Citation: HIP International
      PubDate: 2022-07-18T04:14:16Z
      DOI: 10.1177/11207000221111101
       
  • Complications and predictors of morbidity for hip fracture surgery in
           patients with chronic liver disease

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      Authors: Hannah J Szapary, Rubén Monárrez, Nathan H Varady, Philip Hanna, Antonia F Chen, Edward K Rodriguez
      Abstract: HIP International, Ahead of Print.
      Background:Despite the fact that patients with chronic liver disease (CLD) are at increased risk of complications after a fracture of the hip, there remains little information about the risk factors for acute postoperative complications and their overall outcome.The aim of this study was to describe inpatient postoperative complications and identify predictors of postoperative morbidity.Methods:Patients with CLD who had been treated for a fracture of the hip between April 2005 and August 2019 were identified from a retrospective search of an intramural trauma registry based in the Northeastern United States. Medical records were reviewed for baseline demographics, preoperative laboratory investigations, and outcomes.Results:The trauma registry contained 110 patients with CLD who had undergone surgery for a fracture of the hip. Of these, patients with a platelet-count of ⩽100,000/µL were 3.81 (95% CI, 1.59–9.12) times more likely to receive a transfusion than those with a platelet-count of>100,000/µL. Those with a Model for End-stage Liver Disease (MELD) score of>9 were 5.54 (2.33–13.16) times more likely to receive a transfusion and 3.97 (1.06–14.81) times more likely to develop postoperative delirium than those with a MELD score of ⩽9.Of patients without chronic kidney disease, those with a creatinine of ⩾1.2 mg/dL were 6.80 (1.79–25.87) times more likely to develop acute renal failure (ARF) than those with a creatinine of
      Citation: HIP International
      PubDate: 2022-07-15T04:11:45Z
      DOI: 10.1177/11207000221112923
       
  • Sex-specific differences in 30-day outcomes following primary total hip
           replacement in 86,684 patients

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      Authors: Harman Chaudhry, Seper Ekhtiari, Bheeshma Ravi, Veronica Wadey, Sebastian Tomescu, John Murnaghan, Raman Mundi
      Abstract: HIP International, Ahead of Print.
      Introduction:Although differential outcomes based on sex are widespread in medicine and surgery, evaluation of sex-specific differences in the field of orthopaedic surgery in general – and arthroplasty in particular – are lacking. We hypothesised that morbidly obese male and female patients would have differing risks of surgical complications following primary total hip replacement.Methods:We reviewed data contained within the American College of Surgeons National Quality Improvement Program (ACS-NSQIP) database from 2015 through 2018, inclusive. A multivariable binary logistic regression model was used to determine the adjusted odds ratios (OR) of relevant variables on primary and secondary outcomes.Results:A total of 86,684 patients undergoing THR were identified, of whom 9972 patients (4095 male and 5877 female) were morbidly obese. Among morbidly obese patients, odds of surgical site infection were higher in females than males within 30 days of surgery (adjusted OR 1.40; 95% CI, 1.10–1.79; p = 0.007). This comprised the odds of both superficial infection (1.8% vs. 1.1%, adjusted OR 1.67; 95% CI, 1.16–2.40; p = 0.006) and deep infection (1.9% vs. 1.4%, adjusted OR 1.22; 95% CI, 0.88–1.68; p = 0.24). Unexpected return to the operating room (i.e., reoperation) within 30 days of the surgical procedure was also higher among females than males (4.2% vs. 3.1%, adjusted OR 1.38, 95% CI, 1.10–1.71, p = 0.005). There were no differences between male and female patients in the non-obese cohort.Conclusions:Among patients with morbid obesity, the risk of surgical site infection and reoperation within the first 30 days is greater in women as compared to men. Future research must address whether this early increased risk among morbidly obese women persists in the longer term, and whether it results in compromised function or quality of life.
      Citation: HIP International
      PubDate: 2022-07-15T04:07:32Z
      DOI: 10.1177/11207000221110786
       
  • Total hip arthroplasty using an alkali- and heat-treated titanium
           Zweymüller stem with no trochanteric shoulder: results at 5-year
           follow-up

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      Authors: Sachiyuki Tsukada, Motohiro Wakui
      Abstract: HIP International, Ahead of Print.
      Background:A trochanteric shoulder is 1 of the characteristics of the original Zweymüller femoral stem for total hip arthroplasty (THA). There have been few clinical reports of THA using recently available versions of Zweymüller-type stems with eliminated trochanteric shoulder.Methods:82 consecutive THAs with a Zweymüller-type stem without trochanteric shoulder were analyzed. The stem was made of alkali- and heat-treated titanium, straight, tapered, with rectangular cross-section. Survivorship was estimated with the Kaplan-Meier method.Results:76 of 82 hips (92.7%) were followed for more than 5 years or until revision. 35 of 82 hips (42.7%), were revised and the predominant reason for revision was aseptic loosening of the femoral stem (34 of 35 hips, 97.1%). Survival with revision for any reason as the endpoint was 71.3% (95% CI, 51.8% to 80.1%) at 5 years.Conclusions:The survival of the modified Zweymüller-type stem with no trochanteric shoulder was unacceptably low.
      Citation: HIP International
      PubDate: 2022-07-11T03:57:43Z
      DOI: 10.1177/11207000221111739
       
  • Trabecular metal augments in severe malignancy-associated acetabular bone
           loss

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      Authors: Christopher M Melnic, Mehdi S Salimy, Shayan Hosseinzadeh, Michael A Moverman, Hany S Bedair, Santiago A Lozano-Calderón, Kevin A Raskin
      Abstract: HIP International, Ahead of Print.
      Introduction:Acetabular reconstruction is a challenging problem in orthopaedic oncology, especially in extended defects (Paprosky Type 3A and Type 3B). In revision total hip arthroplasty (THA), 1 option is trabecular metal (TM) augments with a porous metal acetabular component. This study evaluated the use of TM augments in periacetabular malignant bone disease.Methods:15 patients were identified from our institutional database from 2000 to 2020 with either Paprosky Type 3A or Type 3B acetabular bone loss due to periacetabular malignancies that underwent at least 1 complex THA reconstruction with TM augments. Postoperative complications were documented, and clinical and radiographic outcomes were analysed. Radiological loosening or revision of the acetabular component were defined as endpoints.Results:There were 7 primary and 8 metastatic cancer patients. 5 were Type 3A and 10 were Type 3B defects after tumour resection. The average follow-up time was 23.8 (range 1.5–47) months. 1 patient required revision for acetabular component loosening after 7 months from the initial implantation. An additional 4 patients required surgical intervention for infection, they had stable TM augments at latest follow-up.Conclusion:TM augments with a porous metal acetabular component may be an alternative to the traditional cemented constructs.
      Citation: HIP International
      PubDate: 2022-07-11T03:57:09Z
      DOI: 10.1177/11207000221110787
       
  • Ambulation on hip fracture postoperative day 1: a marker for better
           outcomes following hip fracture surgery in patients 55 years or older

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      Authors: Nina D Fisher, Rown Parola, Andrew S Bi, Sanjit R Konda, Kenneth A Egol
      Abstract: HIP International, Ahead of Print.
      Purpose:The purpose of this study was to investigate if early postoperative ambulation metrics affect hospital quality measures and 1-year outcomes in operative hip fracture patients.Methods:A consecutive series of hip fracture patients [OTA/AO 31A, 31B, 32A-C] who underwent operative treatment were reviewed for demographic and clinical data. Chart review was performed to determine participation with physical therapy [PT] and ambulation distance on postoperative day (POD) 1, 3, and 5. POD1 ambulators and non-ambulators were statistically compared. Outcome correlates of postoperative ambulation distance were investigated by univariate and multivariate linear and logistic regression.Results:1044 patients were identified with 546 (52.3%) able to ambulate on POD1. Those able to ambulate on POD1 were significantly younger (78.4 ± 10.9 vs. 82.1 ± 10.4, p 
      Citation: HIP International
      PubDate: 2022-07-01T03:13:08Z
      DOI: 10.1177/11207000221107853
       
  • The short external rotators in the anterior approach hip arthroplasty: do
           the tendons heal or not' A prospective MRI study

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      Authors: Wouter Eilander, Eeke van der Velden, Matthijs van Harten, Paulien van Kampen, Tom Hogervorst
      Abstract: HIP International, Ahead of Print.
      Introduction:Release of some of the short external rotator tendons may be needed in the direct anterior approach (DAA) for Total Hip Arthroplasty (THA). It is unknown if these tendons heal. The purpose of this prospective study is to examine short external rotator tendon healing after release and the associated effect on muscle volume. In addition, we examined the relation with external rotation force and patient reported outcome measures (PROMs).Methods:In 21 DAA THA patients, preoperative MRI was compared with postoperative MRI at 6 weeks and 12 months. PROMs and rotation force of both hips were assessed. Tendon integrity and muscle volume of the obturator internus and piriformis were assessed on MRI using dedicated software.Results:In 5 patients all tendons remained intact, in 4 patients only the conjoined tendon was released and in 12 patients both the conjoined and piriformis were released. Obturator externus remained intact in all patients. In patients with tendon release, mean volume of obturator internus and piriformis muscle decreased 27% (SD 11) and 23% (SD 16) 6 weeks after surgery, respectively. Released tendons and muscle volume loss did not recover 12 months after surgery. We found no relation between tendon release and hip rotation force or PROMs.Conclusions:We found absent tendon healing and muscle volume loss when the conjoined or piriformis tendons were released. Although we found no relation between tendon detachment and hip force or PROMs, we have adapted our operative technique to make it more preserving for the piriformis.
      Citation: HIP International
      PubDate: 2022-06-29T04:44:59Z
      DOI: 10.1177/11207000221107551
       
  • Effect of limited range of motion of the hip joint and leg-length
           discrepancy on gait trajectory: an experiment to reproduce the asymmetric
           gait that occurs in patients with osteoarthritis of the hip joint

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      Authors: Katsuhiko Maezawa, Masahiko Nozawa, Motoshi Gomi, Hironobu Sato, Akito Hayashi, Yuichiro Maruyama, Munehiko Sugimoto, Muneaki Ishijima
      Abstract: HIP International, Ahead of Print.
      Purpose:Although some symptoms that often occur with hip joint osteoarthritis (OA) may be involved in the appearance of gait disturbance, the main cause has not been identified. We hypothesised that the abnormalities in gait trajectory of patients with hip joint OA are mainly caused by limited range of motion of the hip joint or the presence of leg-length discrepancy, or both. To investigate this hypothesis, we examined whether the abnormal gait trajectory in patients with hip joint OA can be reproduced in healthy individuals by asking them to wear a hip orthosis and shoe orthotic (insole).Methods:We recruited 2 groups of participants: patients with hip joint OA (OA group, 38 patients) and healthy individuals who imitated patients with OA of the hip joint by wearing a hip orthosis or shoe orthotic (10-mm or 20-mm insole) or both (simulated OA group, 6 individuals). For gait analysis, we used a portable, wearable gait analyser with inertial sensors to evaluate 3-dimensional (3D) changes in gait trajectory.Results:In the OA group, the patterns of gait trajectories that were drawn on the 3 planes (coronal, sagittal, and horizontal planes) could be roughly divided into 3 types. The gait trajectories that were drawn when wearing a hip orthosis in the simulated OA group were very similar to 1 of the 3 patterns of gait trajectory that occurs in the OA group.Conclusions:We were able to reproduce the abnormal gait trajectory that is observed in ⅓ of patients with hip OA in healthy individuals, so we propose that an extreme reduction in hip joint ROM is 1 of the causes of abnormal gait pattern in patients with OA of the hip joint. A difference in leg length of 20 mm alone has little effect on gait trajectory.
      Citation: HIP International
      PubDate: 2022-06-29T04:39:17Z
      DOI: 10.1177/11207000221102849
       
  • Anatomic acetabular reconstruction with femoral head autograft for
           developmental dysplasia of the hip (DDH) with a minimum follow-up of
           10 years

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      Authors: Zirvecan Güneş, Şenol Bekmez, Ömür Çağlar, Ahmet Mazhar Tokgözoğlu, Bülent Atilla
      Abstract: HIP International, Ahead of Print.
      Background:DDH with coxarthrosis causes significant deformity and bone deficiency. Various reconstructive techniques have been proposed to treat developmental dysplasia of the hip. However, the existing literature has not yet reached a consensus on the best technique regarding long-term survival.Objectives:This study aims to evaluate the long-term survival of uncemented hydroxyapatite (HA) coated acetabular components augmented with a femoral head autograft.Methods:We retrospectively reviewed the cases of 31 hips in 29 patients (24 female, 5 male, mean age 45.06 years) treated with HA-coated cementless components and femoral head autograft between 2000-2008 with a minimum follow-up of 10 years. Graft resorption, cup loosening and the anatomical hip centre were determined. Functional outcomes were calculated using the Harris Hip Scoring system. The survival of the acetabular component was evaluated using the Kaplan-Meier method.Results:In 24 hips (77,4%), we reconstructed the hip centre anatomically. The remaining cups had variable deviations from the anatomical rotation centre. Only one patient required revision due to loosening. Survival analysis revealed 96.8% survival at 10 years. The mean Harris Hip Score was 39.23 preoperatively and 84.77 at final follow-up. There was no statistical correlation between revision and any of the measured parameters.Discussion:Acetabular reconstruction with a femoral head autograft allows for anatomical cup positioning, early structural support and increases bone stock for future revisions. Although our prior cemented cup study showed that anatomical cup orientation is critical, this study demonstrated the absence of a correlation between implant failure and cup positioning, suggesting that HA-coated cementless cups are more stable and forgiving.Conclusions:HA-coated acetabular cups augmented with femoral head autograft provided long-term, reliable and durable cup fixation in dysplastic hips of young adults.
      Citation: HIP International
      PubDate: 2022-06-27T03:55:24Z
      DOI: 10.1177/11207000221099580
       
  • Intra-articular corticosteroids associated with increased risk of total
           hip arthroplasty at 5 years

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      Authors: Morgan L Angotti, Robert A Burnett, Syed Khalid, E Bailey Terhune, Craig J Della Valle
      Abstract: HIP International, Ahead of Print.
      Background:Intra-articular corticosteroid injections are commonly administered for hip pain. However, guidelines are conflicting on their efficacy, particularly in patients without arthritis. This study assessed for an association of corticosteroid injections and the incidence of total hip arthroplasty at 5 years.Methods:Patients with a diagnosis of hip pain without femoroacetabular osteoarthritis who were administered an intra-articular corticosteroid injection of the hip within a 2-year period were identified from the Mariner PearlDiver database. Patient were matched to patients with a diagnosis of hip pain who did not receive an injection. 5-year incidence of total hip arthroplasty was compared between matched patients who received an intra-articular corticosteroid injection and those who did not.Results:2,540,154 patients diagnosed with hip pain without femoroacetabular arthritis were identified. 25,073 (0.9%) patients received a corticosteroid injection and were matched to an equal number of control patients. The incidence of total hip arthroplasty (THA) at 5-year-follow up was significantly higher for the corticosteroid cohort compared to controls (1.1% vs. 0.5%; p 
      Citation: HIP International
      PubDate: 2022-06-20T04:19:43Z
      DOI: 10.1177/11207000221107225
       
  • A comparison of mortality rates following revision hip arthroplasty for
           periprosthetic fracture, infection or aseptic loosening

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      Authors: Jonathan A Barrow, Hiren M Divecha, Graham R Hastie, Henry Wynn Jones, Tim N Board
      Abstract: HIP International, Ahead of Print.
      Background:Mortality following revision hip surgery for periprosthetic fracture (PPF) is comparable to neck of femur fractures. Our institution provides a regional “PPF Service”. The aim of this study was to determine the time to surgery and mortality rate for PPF, compared to revision for infection or aseptic loosening.Methods:Revision arthroplasty procedures performed for PPF, infection or aseptic loosening between January 2014 and December 2015 were identified. Comparisons were made between the 3 groups for baseline demographics, admission to higher-level care, length of stay, complications and mortality.Results:There were 37 PPF, 71 infected and 221 aseptic revisions. PPF had a higher proportion of females (65% vs. 39% in infection and 53% in aseptic; p = 0.031) and grade 3 and 4 ASA patients (p = 0.006). Median time to surgery for PPF was 8 days (95% CI, 6–16). Single-stage procedures were performed in 84% of PPF, 42% of infections and 99% of aseptic revisions (p 
      Citation: HIP International
      PubDate: 2022-06-16T04:16:40Z
      DOI: 10.1177/11207000221104184
       
  • The periacetabular osteotomy: angulation of the supraacetabular osteotomy
           for quantification of correction

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      Authors: Armando Hoch, Geraldine Grossenbacher, Anna Jungwirth-Weinberger, Tobias Götschi, Philipp Fürnstahl, Patrick O Zingg
      Abstract: HIP International, Ahead of Print.
      Background:Malcorrection of the acetabular fragment in periacetabular osteotomy (PAO) is associated with inferior outcomes. 2-dimensional radiographic parameters are being used for intraoperative verification of a satisfactory result. After reorientation of the fragment, the acetabular version must be verified with an intraoperative radiograph. In the case of an unsatisfactory correction, a reorientation would be required. A slim and radiation-free intraoperative navigation method to directly quantify the correction is highly desirable.Aim:To find out whether the measurable angulation of the supraacetabular osteotomy can be used for this purpose.Methods:To determine the angulation, 13 consecutive patients who underwent a PAO were investigated. The preoperative and postoperative standard radiographs as well as CT scans were available. The surgically produced alteration of radiographic parameters was correlated to tilting and spreading of the supraacetabular osteotomy planes.Results:Tilting of the supraacetabular osteotomy planes correlates strongly to alteration of the lateral centre-edge angle (LCEA) and the acetabular index (ACI), whereas spreading of the same planes showed also a strong correlation, but to the LCEA only. 1° of tilting resulted in a 0.2° alteration of the LCEA and a 0.5° alteration of the ACI, whereas 1° of spreading resulted in a 0.5° alteration of the LCEA.Conclusions:This study shows that the measurable angulation of the supraacetabular osteotomy planes can be used to monitor the three-dimensional reorientation of the acetabular fragment in PAO. As long as sophisticated modalities are lacking, this technique offers an easy way to intraoperatively navigate the correction in PAO.
      Citation: HIP International
      PubDate: 2022-06-08T04:04:39Z
      DOI: 10.1177/11207000221103079
       
  • The modern Burch-Schneider antiprotrusio cage for the treatment of
           acetabular defects: is it still an option' A systematic review

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      Authors: Michael-Alexander Malahias, Michail Sarantis, Ioannis Gkiatas, Seong J Jang, Alex Gu, Fritz Thorey, Michael M Alexiades, Vasileios S Nikolaou
      Abstract: HIP International, Ahead of Print.
      Background:A number of papers have been published about the clinical performance of modern rough-blasted titanium Burch-Schneider antiprotrusio cages (BS-APCs) for the treatment of acetabular bone defects. However, no systematic review of the literature has been published to date.Methods:The US National Library of Medicine (PubMed/MEDLINE), EMBASE, and the Cochrane Database of Systematic Reviews were queried for publications using keywords pertinent to Burch-Schneider antiprotrusio cage, revision THA, and clinical outcomes.Results:8 articles were found to be suitable for inclusion in the present study in which 374 cases (370 patients) had been treated with modern BS-APCs. Most acetabular bone defects were type 3 according to the Paprosky classification (type 2C: 18.1%, 3A: 51%, and 3B: 28.9%). The overall re-revision rate for the 374 acetabular reconstructions with modern BS-APCs was 11.5% (43 cases). The short-term survival rate of the modern BS-APC construct was 90.6% (339 out of 374 cases), while the mid-term survival rate was 85.6% (320 out of 374 cases), and the long-term survival rate 62% (54 out of 87 cases). The most common reasons for revision were aseptic loosening (5.6%), periprosthetic joint infection (3.8%), dislocation (2.7%), and acetabular periprosthetic fracture (1.9%).Conclusions:There was moderate quality evidence to show that the use of modern rough blasted titanium BS-APCs in cases of acetabular bone loss has an unacceptably high failure rate (38%). Given that antiprotrusio cages do not provide any biological fixation, we would not recommend the routine use of modern BS-APCs in complex revision THA cases. By contrast, the satisfactory short- to mid-term outcome of modern BS-APCs in combination with their low cost compared to highly porous acetabular implants, make us feel that BS-APCs might still be used in selected elderly or low-demand patients without severe superomedial acetabular bone loss.
      Citation: HIP International
      PubDate: 2022-06-06T05:10:17Z
      DOI: 10.1177/11207000221099817
       
  • Systematic review and meta-analysis on SuperPATH approach versus
           conventional approaches for hip arthroplasty

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      Authors: Vinay M Joseph, Mathias Nagy, Timothy N Board
      Abstract: HIP International, Ahead of Print.
      Aim:The SuperPATH approach has been in practice for almost a decade. There is no systematic review to date comparing the novel SuperPATH approach with conventional approaches. Therefore, it is important to conduct an up-to-date review to evaluate the benefits and drawbacks of the SuperPATH approach in comparison to widely accepted traditional approaches.Our primary aim was to compare the newer SuperPATH approach with the traditional approaches to the hip in terms of functional outcome and radiological parameters. We also aimed to identify any potential complications of the SuperPATH approach as it is a new surgical technique lacking any published sytematic reviews.Materials and methods:The review was conducted in accordance with the steps detailed in the Cochrane Handbook for Systematic reviews of intervention and will be reported bearing in mind the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. PICO terms were independently searched in multiple databases. Studies that compared SuperPATH with traditional approaches were included in the analysis.Results:7 studies including a total of 730 patients were available for final analysis. 3 studies were randomised control trials, 2 were prospective cohort studies and 2 were non-randomised case control studies.Patients in the SuperPATH group were discharged earlier (2 days difference in weighted mean). The operative time was 5 minutes longer (84.46 vs. 78.99) and there was a marginal decrease in blood loss (38 ml lesser) in the SuperPATH approach. VAS Score and HHS at the end of 1 year was comparable in both study groups. Cup abduction angle and anteversion angles were acceptable and comparable in both groups.Conclusions:The SuperPATH approach shows minimal improvement in length of hospital stay and blood loss with no significant improvement in pain or functional outcome score. There are no major complications reported and the radiological parameters are comparable.
      Citation: HIP International
      PubDate: 2022-06-06T05:08:57Z
      DOI: 10.1177/11207000221099862
       
  • Effect of psoas and gluteus medius muscles attenuation on hip fracture
           type

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      Authors: Mustafa Yerli, Ali Yüce, Mustafa B Ayaz, Tahsin O Bayraktar, Nazım Erkurt, Süleyman S Dedeoğlu, Yunus İmren, Hakan Gürbüz
      Abstract: HIP International, Ahead of Print.
      Introduction:Sarcopenia is defined as a progressive loss of muscle mass and function with increased age. The measurement of muscle mass and attenuation on the axial computed tomography (CT) scan has been reported to be a good indicator for sarcopenia in previous literature. This study aimed to compare muscle mass between the intertrochanteric fracture and femoral neck fracture groups by accurately measuring muscle mass around the hip joint using a CT scan.Methods:The cases were matched according to age and gender on a 1-to-1 basis. As a result, a total of 400 patients, 200 patients in each group with the same age and gender characteristics, were included in the study. At the disc of L4-L5 level, the cross-sectional area (CSA) of the psoas muscle was evaluated, and at the disc of L5-S1 level, the CSA of the psoas, iliacus and gluteus medius muscles were evaluated. In addition, attenuation was evaluated using the average Hounsfield Unit (HU) for the specific area.Results:The mean age of 400 patients (262 females, 138 male) included in the study was 78.49 ± 7.67 years. It was observed that the mean HU values of the patients in the femoral neck fracture group were significantly higher than the intertrochanteric fracture group (p 
      Citation: HIP International
      PubDate: 2022-06-06T05:08:46Z
      DOI: 10.1177/11207000221101169
       
  • Cemented acetabular components combined with trabecular metal augments
           provide excellent long-term survivorship for severe acetabular bone loss

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      Authors: Kanai Garala, Mohammed abbas Remtulla, Raghav Verma, Trevor Lawrence
      Abstract: HIP International, Ahead of Print.
      Background:Acetabular bone loss is a challenging problem for revision hip surgeons. This study aimed to explore long-term outcomes of patients who have undergone cemented acetabular revision in conjunction with trabecular metal augmentation and impaction bone grafting in cases with significant segmental bone loss.Methods:All patients who underwent cemented acetabular revision requiring impaction bone grafting and trabecular metal augments with a minimum Paprosky score of 2B and minimum follow up of 5 years were identified. Pre- and postoperative WOMAC scores were compared. An assessment of pre- and postoperative hip centre of rotation was performed and compared to native centre of rotation. Immediate postoperative centre of rotation was then compared to radiographs at latest follow up to measure for migration of acetabular components.Results:42 patients were identified. Mean age was 53 years old with 7 males and 35 female patients. Mean follow-up was 9.5 years. Preoperative WOMAC score was 30 and there was an increase to 90 (p 
      Citation: HIP International
      PubDate: 2022-06-06T05:08:16Z
      DOI: 10.1177/11207000221102848
       
  • Outcomes analysis of anterior and lateral approach for open repair of hip
           abductor tendons

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      Authors: Francisco Requicha, Suzanne M Edwards, Mark S Rickman, Andrew S Comley
      Abstract: HIP International, Ahead of Print.
      Background:Gluteal tendons tears are increasingly being recognised as a cause of recalcitrant trochanteric pain, but there is a paucity of robust studies analysing the type of tears, results and predictors of outcome.Methods:Patients with gluteal tendon tears resistant to conservative treatment who underwent isolated open repair (IR) or total hip arthroplasty and concomitant repair (THA+repair) with a minimum 1-year follow-up were retrospectively assessed separately. Type of tear, surgical approach, and fixation methods were registered. Complications and postoperative outcomes were analysed: visual analogue scale (VAS) of pain, VAS satisfaction, and activity level. Univariate regressions and multivariable models were developed.Results:90 cases were included: 62 cases underwent IR and 28 cases THA+repair, with an average follow-up of 3.9 years and 2.6 years, respectively. 13 complications were found (n = 5 IR, n = 8 THA+repair), including 9 re-operations (n = 4 IR, n = 5 THA+repair). Mean VAS pain score was 3.02 (SD 2.74) for the IR and 2.32 (SD 2.43) for THA+repair group. Mean VAS satisfaction was 7.09 (SD 3.07) and 7.68 (SD 2.71) for the IR and THA+repair group, respectively. In the IR group 61.4% returned to all pre-injury activities, whereas in the THA+repair group 79% did. Full-thickness tears had higher VAS pain scores (p = 0.0175), and there was trend (p > 0.05) towards higher complications, re-tears and lower VAS satisfaction in this type of tears in both groups. No statistically significant differences were found in outcomes when comparing THA+repair through direct anterior (DAA) with lateral approach (LA).Conclusions:Isolated gluteal tendon repair or THA+repairs seem to be safe procedures with high levels of satisfaction at short- to mid-term follow-up. The presence of a full-thickness tear is a predictor of inferior outcomes.
      Citation: HIP International
      PubDate: 2022-06-06T05:07:59Z
      DOI: 10.1177/11207000221103440
       
  • Increased risk of high-grade heterotopic ossification using direct lateral
           approach versus a muscle-sparing anterolateral approach to the hip:
           radiological results from a randomised trial in patients with a femoral
           neck fracture treated with hemiarthroplasty

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      Authors: Raymond A Tellefsen, Terje Ugland, Maria M Bjørndal, Stein Ugland, Are Hugo Pripp, Lars Nordsletten
      Abstract: HIP International, Ahead of Print.
      Background and purpose:Hemiarthroplasty is a common treatment in patients with displaced femoral neck fracture. Due to positive claims of less pain, earlier mobilisation and favourable functional outcome, the anterior approaches to the joint are gaining in popularity. This randomised controlled trial investigated if component placement and heterotopic ossification differed between a muscle sparing anterior approach and a direct lateral approach.Patients and methods:150 patients operated with an uncemented hemiarthroplasty, were randomised to anterolateral or direct lateral approach and assessed postoperatively radiologically. Measurements included leg-length discrepancy, femoral offset, femoral stem position, canal fill ratio and the presence of heterotopic ossification after 12 months.Results:There was an increased risk of high-grade heterotopic ossification in the direct lateral approach (p 
      Citation: HIP International
      PubDate: 2022-05-19T05:33:14Z
      DOI: 10.1177/11207000221097639
       
  • Understanding the 30-day mortality burden after revision total hip
           arthroplasty

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      Authors: Pedro J Rullán, Melissa N Orr, Ahmed K Emara, Alison K Klika, Robert M Molloy, Nicolas S Piuzzi
      Abstract: HIP International, Ahead of Print.
      Background:Revision total hip arthroplasty (THA) is a challenging procedure that burdens the healthcare system. Despite being associated with worse outcomes relative to its primary counterpart, postoperative mortality after revision THA remains ill-defined. The present study aimed to (1) establish the overall 30-day mortality rate after revision THA and (2) explore the mortality rate stratified by age, comorbidity burden, and aseptic versus septic failure.Methods:The American College of Surgeons – National Surgical Quality Improvement Program (ACS-NSQIP) database was retrospectively reviewed for all patients who underwent revision THA from 2011 to 2019. A total of 23,501 patients were identified and grouped into mortality (n = 161) and mortality-free (n = 23,340) cohorts. Patient demographics, comorbidities, and aseptic/septic failure were evaluated.Results:The overall 30-day mortality was 0.69%. The mortality rate by age group (normalised per 1000 patients) was 0 (18–39 years [Y]), 0.67 (40–49 Y), 1.10 (50–59 Y), 2.58 (60–69 Y), 6.15 (70–79 Y) 19.32 (80–89 Y), and 58.22 (90+Y) (p 
      Citation: HIP International
      PubDate: 2022-05-17T04:50:59Z
      DOI: 10.1177/11207000221094543
       
  • Dislocation risk after robotic arm-assisted total hip arthroplasty: a
           comparison of anterior, lateral and posterolateral approaches

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      Authors: Andrea Marcovigi, Dario Sandoni, Luigi Ciampalini, Piergiuseppe Perazzini, Francesco Zambianchi, William J Hozack, Fabio Catani
      Abstract: HIP International, Ahead of Print.
      Aims:Dislocation is a major cause of early failure after THA and is highly influenced by surgical approach and component positioning. Robotic-arm assisted arthroplasty has been developed in an attempt to improve component positioning and reduce postoperative complications.The purpose of this study was to compare the rate of dislocation after robotic total hip arthroplasty through 3 different surgical approaches.Materials and methods:All patients who had undergone robotic arm-assisted THA at 3 centres between 2014 and 2019 were reviewed. After applying exclusion criteria, 1059 patients were included in the study. An anterior approach was used in 323 patients, a lateral approach in 394 and a posterior approach in 342 patients.Episodes of dislocation were recorded after 6 months follow-up. Stem anteversion, cup anteversion, cup inclination and combined anteversion were collected using the integrated navigation system.Cumulative incidence (CI), incidence rate (IR) and risk ratio (RR) were calculated with a confidence interval of 95%.Results:3 cases of dislocation (2 posterior approach, 1 anterior approach) were recorded, with a dislocation rate of 0.28% and an IR of 0.14%.The rate of placement of the cup in the Lewinnek safe zone was 82.2% for the posterior approach, 82.0% for the lateral approach and 95.4% for the anterior approach.The rate of placement in the combined version safe zone was 98.0% for the posterior approach, 73.0% for the lateral approach and 47.1% for the anterior approach.The incidence rate of dislocation was 0.30% for the anterior approach, 0.34% for the posterior approach and 0% for the lateral approach.Conclusions:The robotic arm-assisted technique is associated with a low risk of dislocation. The combined version technique appears to be a reliable way to reduce the risk of dislocation through the posterolateral approach but does not appear to be essential when using the lateral and anterior approaches.
      Citation: HIP International
      PubDate: 2022-05-04T03:02:06Z
      DOI: 10.1177/11207000221094513
       
  • A 24-year single-centre experience with Collum Femoris Preserving stem:
           clinical and radiological results in young and elderly population

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      Authors: Matteo Formica, Lorenzo Mosconi, Luca Cavagnaro, Francesco Chiarlone, Emanuele Quarto, Maddalena Lontaro-Baracchini, Andrea Zanirato
      Abstract: HIP International, Ahead of Print.
      Objective:The primary aim was to evaluate the long-term follow-up of Collum Femoris Preserving (CFP) stem, specifically focusing on stem survivorship, complications, as well as on clinical and radiological results. The secondary study objective is an age-based sub-analysis (
      Citation: HIP International
      PubDate: 2022-04-25T03:52:14Z
      DOI: 10.1177/11207000221093248
       
  • Outcomes of isolated head-liner exchange versus full acetabular component
           revision in aseptic revision total hip arthroplasty

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      Authors: Elyse J Berlinberg, Mackenzie A Roof, Morteza Meftah, William J Long, Ran Schwarzkopf
      Abstract: HIP International, Ahead of Print.
      Introduction:Isolated head and liner exchange in aseptic revision total hip arthroplasty (rTHA) is an appealing option rather than full acetabular component revision; however, early outcome reports suggest high rates of complications requiring re-revision. This study seeks to compare the outcomes of these procedures.Methods:This retrospective study assessed 124 head and liner exchanges and 59 full acetabular cup revisions conducted at a single center between 2011 and 2019 with at least 2 years of follow-up. Baseline demographics did not vary by group. Mean follow-up was 3.7 (range 2.0–8.6) years.Results:In the head and liner exchange group, re-revision-free survivorship at 2 years was 79% for all-causes and 84% for aseptic reasons. In the full acetabular revision group, it was 80% for all causes (p> 0.99) and 83% for aseptic reasons (p> 0.99). The 2-year survivorship of head and liner exchange was non-inferior to that of full acetabular revision, correcting for surgical indication and history of prior revision (adj-OR 0.1.39, 95% CI, 0.62–3.28, p = 0.99). A best-fit multivariable model found that revision for instability (adj-OR=3.03, 95% CI 1.40–6.66, p = 0.005), prior revision (adj-OR 2.15; 95% CI, 0.87–5.32; p = 0.10), current smoking (adj-OR 2.07; 95% CI, 0.94–4.57; p = 0.07), and obesity (adj-OR 0.58; 95% CI, 0.24–1.36; p = 0.22) were associated with failure within 2 years.Conclusions:In this analysis, 2-year outcomes for isolated head and liner exchange were non-inferior to full acetabular component revision. A future randomised prospective study should be conducted to better assess the optimal approach to revision in an aseptic failed hip arthroplasty.
      Citation: HIP International
      PubDate: 2022-04-19T10:18:02Z
      DOI: 10.1177/11207000221092127
       
  • Measurement of safe acetabular medial wall defect size in revision hip
           arthroplasty with a porous cup

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      Authors: Katarina Barbaric Starcevic, Goran Bicanic, Zeljko Alar, Matija Sakoman, Damir Starcevic, Domagoj Delimar
      Abstract: HIP International, Ahead of Print.
      Introduction:The majority of acetabular revisions can be performed with an uncemented, porous acetabular component with or without bone grafting. These are contained acetabular defects, with an intact acetabular rim (Paprosky type I and II). As defects of the medial wall of the acetabulum are a challenge situation revision surgery, we performed this biomechanical study on a pig pelvis model with contained acetabular defects to determine the size of medial wall defect at which the acetabular cup will have sufficient primary stability.Materials and methods:In 24 pig pelvis models, different diameter of medial wall defects were created, followed by acetabular component placement. The acetabulum externally loaded, and the force at a level in which the acetabular component remains stable for each diameter of defect, or at which point the acetabular cup moves into the pelvis for>2 mm.Results:In the models with acetabular medial wall defects of 10 and 20 mm, 2 mm acetabular displacement occurred under a force between 1000 and 1500 N. In those with a medial wall defect of 25 mm, the force that caused acetabular instability was between 700 and 1000 N. In the models with 30 mm of medial wall defect all acetabular components were unstable under a force of 700 N.Conclusions:According to our results, acetabular component should be stable if the defect of the medial wall of the acetabulum is less than 68% of the diameter of the acetabular component or if the uncovered surface area of the acetabular component is not greater than 27%, and the force
      Citation: HIP International
      PubDate: 2022-04-19T09:41:47Z
      DOI: 10.1177/11207000221080706
       
  • Accuracy of digital templating in uncemented primary total hip
           arthroplasty: which factors are associated with accuracy of preoperative
           planning'

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      Authors: Andrew Adamczyk, Pierre Laboudie, Hamid Nessek, Paul R Kim, Wade T Gofton, Robert Feibel, George Grammatopoulos
      Abstract: HIP International, Ahead of Print.
      Background:Preoperative planning is a fundamental step for successful total hip arthroplasty (THA). Studies have highlighted the accuracy of preoperative digital templating for estimating acetabular cup and stem size. Stem design such as single-wedge metadiaphyseal (Type 1 stem) versus mid-short stem (microplasty) and surgical approach (anterior, direct lateral or posterior) have not been well investigated as predictors of THA templating accuracy.Methods:204 patients (220 hips) who had undergone elective THA between November 2016 and December 2019 and presented a saved preoperative template were retrospectively reviewed. Templates from 5 different surgeons were involved in the analysis. 3 different approaches were used: direct lateral (DL), posterior (PA), direct anterior (DAA). 2 different stem designs were used: single-wedge metadiaphyseal and single-wedge mid-short (Biomet Taperloc Microplasty), while the acetabular component remained the same. Bivariate and multivariate regression analyses were performed to determine predictors of accuracy.Results:Femoral component size templating accuracy was significantly improved when using the single-wedge mid-short stem (Taperloc Microplasty) design when performing bivariate analysis. Although accuracy of cup sizing was not affected by approach, precision was significantly better in the PA group (p 
      Citation: HIP International
      PubDate: 2022-04-19T09:40:27Z
      DOI: 10.1177/11207000221082026
       
  • Earlier functional recovery and discharge from hospital for THA patients
           operated on via direct superior compared to standard posterior approach: a
           retrospective frequency-matched case-control study

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      Authors: Eustathios Kenanidis, George Paparoidamis, Vasileios F Pegios, Panagiotis Anagnostis, Michael Potoupnis, Eleftherios Tsiridis
      Abstract: HIP International, Ahead of Print.
      Background:The direct superior hip approach (DSA) has been less researched than other approaches in the literature. We retrospectively compared the early postoperative and functional outcomes of patients with hip osteoarthritis undergoing total hip arthroplasty (THA) via DSA with a matched control group using a standard posterior approach (SPA).Methods:The DSA group comprised 100 THAs performed via DSA by a senior surgeon between January 2018 and May 2019. Patients with primary osteoarthritis and ASA score ⩽3 who were eligible for surgery were included. The DSA group was compared to a matched cohort of 100 patients operated on with a SPA in the same period by another chief surgeon. Patients were matched for age, sex, and ASA score. All patients received the same postoperative chemoprophylaxis, pain management and physiotherapy. 2 independent attending arthroplasty surgeons assessed the incision length, operative time, blood loss, hospital stay, and complications. VAS, HHS, and HOOS scores were also evaluated for a year postoperatively.Results:Mean incision length and hospital stay were significantly lower in the DSA group. DSA patients had non-significantly lower intraoperative blood loss, transfusion needs, and postoperative pain than SPA patients. Mean operation time and complication rate did not differ between groups. The DSA group demonstrated significantly greater functional scores than the SPA group at the first postoperative month. No differences in scores were recorded following the third month.Conclusions:The DSA approach may provide earlier functional recovery and hospital discharge for THA patients compared with SPA. DSA was equivalent to SPA concerning pain and blood loss, showing minimal complication rates.
      Citation: HIP International
      PubDate: 2022-04-19T09:37:47Z
      DOI: 10.1177/11207000221086506
       
  • Dual-mobility constructs versus large femoral head bearings in primary and
           revision total hip arthroplasty: a systematic review and meta-analysis of
           comparative studies

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      Authors: Wayne Hoskins, Laura McDonald, Harry Claireaux, Roger Bingham, Xavier Griffin
      Abstract: HIP International, Ahead of Print.
      Background:Both dual-mobility (DM) constructs and large femoral head bearings (⩾36 mm) reduce dislocation following total hip arthroplasty (THA). There is limited research comparing DM with large bearings.Methods:A systematic review of published literature was performed including studies that compared DM with large femoral head bearings in primary or revision THA according to PRISMA guidelines. The primary outcome was revision surgery for dislocation. The secondary outcome was all-cause revision surgery. Other complications were recorded. 2 authors independently selected studies, performed data extraction, and risk of bias assessment. Treatment effects were assessed using odds ratios and data were pooled using a fixed-effect model, where appropriate.Results:9 studies, all retrospective, met the final inclusion criteria. 2722 patients received DM and 9,789 large femoral head bearings. The difference in the odds of revision surgery for dislocation (OR 0.67; 95% CI, 0.45–1.01; p = 0.06) and aseptic loosening are unclear (OR 0.61; 95% CI, 0.36–1.05; p = 0.07); including important benefits and no difference. There was a benefit favouring DM for the risk of all-cause revision (OR 0.70; 95% CI, 0.56–0.86; p = 0.001), revision for fracture (OR 0.49; 95% CI, 0.29–0.81; p = 0.005) and dislocation not requiring revision (OR 0.29; 95% CI, 0.14–0.57; p < 0.001). The estimate in the difference in the odds of revision surgery for infection was imprecise (OR 0.78; 95% CI, 05.1–1.20; p = 0.26).Conclusions:This study provides evidence that there may be clinically relevant benefits of DM constructs over large femoral head bearings. Prospective randomised studies are warranted given these findings.
      Citation: HIP International
      PubDate: 2022-04-19T09:34:47Z
      DOI: 10.1177/11207000221082927
       
  • Two-stage strategy in end-stage hip periprosthetic joint infection:
           utility of industrially prefabricated custom-made antibiotic spacers

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      Authors: Matías Vicente, Inca Vilar, Rosa Fraile Soriano, Irina Capó, Pablo S Corona
      Abstract: HIP International, Ahead of Print.
      Purpose:Use of prefabricated mobile spacers in end-stage cases of hip periprosthetic joint infection (HPJI) is hindered when large bone defects exist. In such cases, prefabricated custom-made antibiotic spacers (P-CMAS) offer an alternative. Such spacers are individually designed according to the size and anatomical characteristics of the bone defect. The purpose of this study is to describe and evaluate the use of such patient-specific spacers in a two-stage strategy to treat end-stage HPJI cases, and to report on clinical outcomes.Methods:A retrospective study identified all patients with end-stage HPJIs from January 2015 through December 2019, treated using a P-CMAS. Primary outcome: infection eradication rate. Secondary outcomes: spacer-related complications and patient satisfaction. Minimum follow-up: 12 months after the second-stage surgery.Results:A total of 7 end-stage cases (mean of 6.7 previous surgical procedures) were included. Mean bone defect size was 191.57 (range 47–304) mm. Polymicrobial infection was detected in 42.86% of these cases. During the spacer stage there were no periprosthetic fractures, spacer dislocations or breakages, nor spacer-drug-related complications. All patients proceeded with the second stage uneventfully, with an average time between stages of 178 (range 119–326) days. In 5 cases a total femur arthroplasty was the reconstructive procedure performed. After a mean follow-up of 27.29 (range 14–49) months the infection was clinically eradicated in all patients, despite their difficult-to-treat scenarios.Conclusions:Industrially custom-made spacers offer an effective and safe option in performing 2-stage exchange arthroplasty in cases of end-stage HPJI with extensive bone defects.
      Citation: HIP International
      PubDate: 2022-04-19T09:26:07Z
      DOI: 10.1177/11207000221075356
       
  • The 45-year evolution of the Mathys RM monoblock cups: have the paradigm
           shifts been worthwhile'

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      Authors: Michael Foxall-Smith, Michael C Wyatt, Christopher Frampton, David Kieser, Gary Hooper
      Abstract: HIP International, Ahead of Print.
      Introduction:The Robert Mathys (RM) monoblock uncemented cup is a design less commonly used in primary total hip replacement. It’s purported advantages over modular cemented cups are: (1) its modulus of elasticity approximating bone, thus mimicking load transmission and the biomechanical behaviour of the cup to better match stresses on the acetabulum, leading to bone-preservation; and (2) as a 1-piece cup there is absence of a mobile interface between a liner and shell, preventing backside wear. Since its inception in 1983 there have been 3 major design changes: the RM Classic, the RM Pressfit, and the RM Vitamys with the most modern polyethylene (vitamin E).Methods:In a retrospective cohort study of the New Zealand Joint Registry, all designs of RM acetabular cup were reviewed. Data were included from1998 to 2018. All-cause revision rates, reasons for revision and the Oxford Hip Score (OHS) were assessed.Results:In total 13,272 acetabular cups were included. The all-cause revision rates did not differ between the designs. Revision rates for aseptic loosening in the RM Vitamys were lower, but the follow-up was shorter and more larger heads were used. There was no difference in the OHS.Conclusion:All implant designs were safe. The use of larger heads led to a decrease in revisions due to dislocation. It has to be waited out whether the RM Vitamys performs superior in the long-term due to the highly cross-linked polyethylene.
      Citation: HIP International
      PubDate: 2022-04-19T09:24:07Z
      DOI: 10.1177/11207000211067507
       
  • The risk of hospital readmission, revision, and intra- and postoperative
           complications between direct anterior versus posterior approaches in
           primary total hip arthroplasty: a stratified meta-analysis and a
           probability based cost projection

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      Authors: Mohamed E Awad, Brendan J Farley, Gamal Mostafa, Hussein F Darwiche, Khaled J Saleh
      Abstract: HIP International, Ahead of Print.
      Introduction:This study presents stratified meta-analysis and projected cost per case analysis of direct anterior approach (DAA) versus posterior approach (PA) in total hip arthroplasty (THA) to determine the best surgical approach and guarantee hip joint longevity.Methods:Several online databases were searched for clinical trials comparing DAA and PA in primary THA. The stratified analysis was conducted to test for confounding and biases across the different types of included trials. The average cost and probability were used to determine projected added costs of medical and surgical management for complications.Results:30 clinical trials included 11,562 patients who underwent THA. Almost 50% of these patients performed DAA. As compared to PA, both non-stratified and stratified analyses demonstrated that DAA has a significant higher incidence of the overall intra- and postoperative complications (non-stratified, OR 1.64; p = 0.003) (stratified, OR 4.12; p = 0.005), nerve injury (non-stratified, OR 22.0; p 
      Citation: HIP International
      PubDate: 2022-04-19T08:19:15Z
      DOI: 10.1177/11207000211066454
       
  • Comparison of total hip arthroplasty outcomes between hemodialysis and
           renal transplant patients

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      Authors: Seth Ahlquist, Samuel T Kim, Peter P Hsiue, Peyman Benharash, Danielle Y Ponzio, Christos Photopoulos, Erik N Zeegen, Alexandra I Stavrakis
      Abstract: HIP International, Ahead of Print.
      Introduction:Total hip arthroplasty (THA) in end-stage renal disease (ESRD) patients is associated with increased complications. Controversy exists whether elective THA should be performed while these patients are on haemodialysis (HD) or following renal transplant (RT). This study seeks to compare THA outcomes in HD versus RT patients.Methods:A national database was retrospectively reviewed using ICD codes to identify all HD and RT patients who underwent primary THA from 2010 to 2018. Demographics, comorbidities, and hospital factors were compared between cohorts using Wald and chi-square tests. The primary outcome was in-hospital mortality, while secondary outcomes included length of stay (LOS), non-home discharge, cost, readmission, and medical/surgical complications. Multivariate regression was used to determine independent associations. Significance was determined with a 2-tailed p-value of 0.05.Results:11,133 patients underwent THA, 61.6% HD and 39.4% RT patients. RT patients were younger, had fewer comorbidities, and more likely to have private insurance. After adjusting for these differences, RT patients had a lower rate of mortality (OR 0.31, p = 0.01), complications (OR 0.54, p 
      Citation: HIP International
      PubDate: 2022-04-19T07:20:55Z
      DOI: 10.1177/11207000221091994
       
  • Early mobilisation after pain relief for conservative management for
           intertrochanteric fractures: a pandemic enforced innovation and its
           results

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      Authors: Laxmanan Prakash, Shabir A Dhar
      Abstract: HIP International, Ahead of Print.
      Background:The COVID pandemic challenged the orthopaedic mind on several fronts. 1 of them was in the management of intertrochanteric fractures. A subset of these patients refused surgical intervention during the pandemic for related reasons. Faced with the goal of early verticalisation, the senior author used pain relief as a method to facilitate early mobilisation in 23 patients with peritrochanteric fractures.Methods:23 patients with stable intertrochanteric fractures received a β 6 distal sodium channel block (DSCB) and were allowed to walk from day 1 without surgery, traction or spica. The goal was to prevent complications of recumbency in this subset of patients. The basic idea of immediate mobilisation from the time of fracture was based on Sarmiento’s sausage theory.Results:All the fractures united. There were no major complications. No shortening was seen in more than 50% cases and the shortening did not exceed 2 cm in any case. All patients were satisfied with the outcome and had good to excellent Harris Hip Scores.Conclusions:The block and walk method is a surprisingly satisfactory method of treatment for stable intertrochanteric fractures. It circumvents the risks of surgery whilst allowing immediate mobilisation preventing complications associated with the other modalities of fracture management.
      Citation: HIP International
      PubDate: 2022-04-19T07:19:55Z
      DOI: 10.1177/11207000221085490
       
  • The outcomes of total hip arthroplasty in patients with and without
           multiple sclerosis: a retrospective cohort study

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      Authors: David H Mai, Michael E Blackowicz, Ilya Kister, Ran Schwarzkopf
      Abstract: HIP International, Ahead of Print.
      Background:Multiple sclerosis (MS) is a neuroinflammatory disease with debilitating manifestations that may predispose patients to hip fracture and osteoarthritis, and may affect recovery from total hip arthroplasty (THA). With increased longevity of MS patients and growth in demand for arthroplasty in this population, it is important to understand outcomes of THA in patients with MS.Aim:We sought to compare outcomes of THA among persons with MS and without MS.Methods:International Classification of Diseases, Ninth Revision Procedure Coding System (ICD-9-PCS) codes for hip arthroplasty (815.1) were used to identify all patients in the New York Statewide Planning and Research Cooperative System (SPARCS) database who underwent THA between 2000 and 2014. Patients with MS, the primary exposure, were identified using ICD-9-Clinical Modification (CM) code 340. The study outcomes of length of stay (days), discharge disposition, index admission mortality, 90-day readmission, 1-year revision arthroplasty, and 1-year all-cause mortality were evaluated using multivariable regression analyses inclusive of basic demographics, admission source, disposition, payer, comorbidity, and socioeconomic status (SES).Results:Compared to patients without MS, those with MS had marginally longer lengths of stay (mean ratio [MR] 1.05; 95% confidence interval [CI], 1.01–1.10; p = 0.0142), higher risk for institutional discharge disposition (odds ratio [OR] 2.03; 95% CI, 1.54–2.70; p 
      Citation: HIP International
      PubDate: 2022-04-19T07:18:43Z
      DOI: 10.1177/11207000221084034
       
  • Higher femoral anteversion restoration accuracy after total hip
           arthroplasty with a proximally fixed anatomic stem than with a generic
           straight double-tapered stem

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      Authors: Elhadi Sariali, Hugues Pascal Moussellard
      Abstract: HIP International, Ahead of Print.
      Background:Femoral antetorsion in uncemented hip replacement hardly can be modified and the restoration of the anatomic anteversion might be difficult with standard stems. We compared femoral anteversion restoration of a generic straight stem with a proximally fixed anatomic stem that included a dual sagittal curvature and a proximal torsion. It was hypothesised that the restoration of the anteversion was more accurate with the anatomic stem.Patients and methods:In this comparative study data were collected prospectively of 80 consecutive patients with total hip arthroplasty for primary osteoarthritis. In the first 40 patients (Group I) a cementless proximally fixed anatomic stem with 15° antetorsion of the shaft and a dual sagittal curvature was used. Its design was based on a database of 3D CT images of 600 hips. For comparison a cementless generic straight double-tapered stem was implanted in the next 40 patients (Group II). All operations were performed by one experienced surgeon. All patients had a preoperative 3D planning. A low-dose CT scan was performed at 3 months postoperatively to determine the postoperative stem anteversion.Results:The demographics were similar in both groups. In group I the mean postoperative femoral anteversion was similar to the preoperative one (22.1° ± 10.2° vs. 20.4° ± 9°; p = 0.2). In Group II, the mean postoperative femoral anteversion was lower (12.9° ± 10.8°, vs. 18.3° ± 12°; p = 0.02).Conclusions:Uncemented standard femoral stems tend to reduce femoral anteversion. The used anatomic stem restored femoral anteversion better. The clinical impact of this finding has to be proven.
      Citation: HIP International
      PubDate: 2022-04-19T07:17:31Z
      DOI: 10.1177/11207000221078920
       
  • A high body mass index tilts the pelvis caudally in the lateral decubitus
           position for total hip arthroplasty

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      Authors: Yuki Okutani, Masanao Kataoka, Hideto Harada, Takahide Kunishita, Hayato Ryoki, Ryuzo Arai
      Abstract: HIP International, Ahead of Print.
      Background:Accurate cup placement is essential for obtaining excellent outcomes in total hip arthroplasty (THA). We evaluated the pelvic lateral tilt of the patient (which affects the incline of the acetabular cup in THA) and investigated the factors affecting it.Methods:We reviewed the medical records of THA procedures performed at our hospital between October 2015 and January 2021 for which an anteroposterior pelvic radiograph was always taken preoperatively once the patient was placed in the lateral decubitus position. These radiographs were used to measure the lateral pelvic tilt in each case. We analysed whether patient factors (sex, body mass index [BMI], range of motion of abduction or adduction in both hips, surgical history of both hips, and lumbar Cobb angle) influenced the tilt.Results:We reviewed 363 cases (341 primary, 22 revision). The mean pelvic lateral tilt was 4.1°, and the operated hip was located on the caudal side compared to the unoperated hip. Statistical analyses revealed that the patient BMI and surgical history of the operated and unoperated hips significantly influenced tilt.Conclusions:The pelvis in the lateral decubitus position leaned 4.1° to the caudal side, most commonly due to a high BMI. Surgeons should consider this when performing acetabular cup implantation in THA.
      Citation: HIP International
      PubDate: 2022-03-21T05:43:25Z
      DOI: 10.1177/11207000221084627
       
  • Primary total hip arthroplasty in patients older than 90 years of age –
           a retrospective matched cohort study

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      Authors: Mark Kurapatti, Vaidehi Patel, Jerry Arraut, Christian Oakley, Joshua C Rozell, Ran Schwarzkopf
      Abstract: HIP International, Ahead of Print.
      Introduction:Advanced age is considered a major risk factor for postoperative complications in total hip arthroplasty (THA). Consequently, older patients undergoing THA may require more detailed pre-procedural examinations and more healthcare resources postoperatively than younger patients. The purpose of this study was to compare discharge parameters and complication rates of THA in patients ⩾90 years old to those
      Citation: HIP International
      PubDate: 2022-03-09T06:16:09Z
      DOI: 10.1177/11207000221082251
       
  • Reconstruction with a cage outlives patients with metastatic disease
           involving the acetabulum

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      Authors: Sarah J Shiels, Oliver Gosling, Sanchit A Mehendale, Richard P Baker
      Abstract: HIP International, Ahead of Print.
      Aim:The aim of this study was to determine whether patients treated with a caged reconstruction for metastatic acetabular disease would have a construct survival superior to that of their life expectancy.Patients and methods:We undertook a retrospective study, in a single centre in the United Kingdom, reviewing outcomes for 19 patients (20 hips) treated with a cage reconstruction for metastatic disease of their acetabulum over 6 years. Inclusion criteria were those with an impending fracture of the acetabulum, metastatic dissociation, fracture of the acetabulum and or femur and those whose life expectancy was considered by the oncology team to be >6 months.Results:In all patients the Restoration GAP II acetabular cage (Stryker, Howmedica Osteonics Corp, NJ, USA) was used in conjunction with a cemented acetabular cup and cemented femoral stem. The mean age at the time of surgery was 68 (44–87) years with breast cancer being the most common primary malignancy (31%) followed by prostate cancer (26%).Radiological survivorship estimates were 94.1% (95% CI, 99.2–65.0) at 12 and 24 months, 70.6% (95% CI, 93.6–16.0) at 36 months and 35.3% (95% CI, 78.2–1.2) at 48 months. There were 3 radiological failures of the implant due to disease progression. Complications occurred in 3 patients with 2 developing deep infection which was treated with suppressive antibiotic therapy following aspiration of the hip. 1 patient suffered a hip dislocation following trauma which was successfully reduced closed and no further intervention was required.Conclusions:This study represents the first published case series of the use of the GAP II cage in patients with metastatic acetabular disease. The construct generally outlives the patient and hence is suitable for the treatment of acetabular metastases.
      Citation: HIP International
      PubDate: 2022-03-03T11:32:17Z
      DOI: 10.1177/11207000211068098
       
  • The American College of Surgeons National Surgical Quality Improvement
           Program surgical risk calculator is not reliable in predicting
           complications and length of stay after primary total hip arthroplasty at
           an institution implementing clinical pathways

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      Authors: Giovani Manhabusqui Pacífico Jr, Maria-Roxana Viamont-Guerra, Eliane Antonioli, Isabela Dias Paião, Mo Saffarini, Rodrigo Pereira Guimarães
      Abstract: HIP International, Ahead of Print.
      Introduction:The authors aimed to: (1) determine how length of stay (LOS) and complication rates changed over the past 10 years, in comparison to values estimated by the ACS-NSQIP surgical risk calculator, at a single private institution open to external surgeons; and (2) determine preoperative patient factors associated with complications.Methods:We retrospectively assessed 1018 consecutive patients who underwent primary elective THA over 10 years. We excluded 87 with tumours and 52 with incomplete records. Clinical data of the remaining 879 were used to determine real LOS and rate of 9 adverse events over time, as well as to estimate these values using the risk calculator. Its predictive reliability was represented on receiver operating characteristic curves. Multivariable analyses were performed to determine associations of complications with age, sex, ASA score, diabetes, hypertension, heart disease, smoking and BMI.Results:Over the 10-year period, real LOS and real complication rates decreased considerably, while LOS and complication rates estimated by the surgical risk calculator had little or no change. The difference between real and estimated LOS decreased over time. The overall estimated and real rates of any complication were respectively 3.3% and 2.8%. The risk calculator had fair reliability for predicting any complications (AUC 0.72). Overall estimated LOS was shorter than the real LOS in 764 (86.9%) patients. Multivariable analysis revealed risks of any complication to be greater in patients aged ⩾75 (OR = 4.36, p = 0.002), and with hypertension (OR = 3.13, p = 0.016).Conclusions:Since the implementation of clinical pathways at our institution, real LOS and complication rates decreased considerably, while LOS and complication rates estimated by the surgical risk calculator had little or no change. The difference between real and estimated LOS decreased over time, which could lead some clinicians to reconsider their discharge criteria, knowing that advanced age and hypertension increased risks of encountering complications.
      Citation: HIP International
      PubDate: 2022-02-04T07:41:39Z
      DOI: 10.1177/11207000211069522
       
  • Pelvic tilt and functional acetabular position after total hip
           arthroplasty: an EOS 2D/3D radiographic study

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      Authors: Mattia Loppini, Alessandro Pisano, Riccardo Ruggeri, Antonello Della Rocca, Guido Grappiolo
      Abstract: HIP International, Ahead of Print.
      Purpose:In total hip arthroplasty (THA), the functional anatomy of the spinopelvic unit should be taken into account to provide the correct functional positioning of the implant. The relationship between the spine and the pelvis in the sagittal plane is represented by pelvic tilt (PT). The sacral slope (SS) has been proposed as a more reliable parameter than the anterior pelvic plane (APP) to express the PT. This study investigated the relationship between the APP and the SS; and the relationship between the APP and the SS, respectively, with the postoperative acetabular orientation.Methods:45 patients undergoing primary THA were prospectively enrolled. The EOS 2D/3D system was used to perform the radiographic evaluation before and 3 months after surgery. The following parameters were measured in both standing and sitting position: SS, APP, acetabular anteversion (AA) and inclination (AI).Results:The SS values did not show any correlation with the values of the APP angle. The changes of the SS in the transition from the standing to the sitting position significantly correlated with the changes of the AA (r = −0.61; p 
      Citation: HIP International
      PubDate: 2022-01-25T03:53:10Z
      DOI: 10.1177/11207000211073668
       
  • Subtrochanteric osteotomy in the management of femoral maltorsion results
           in anteroposterior malcorrection of the greater trochanter: computed
           simulations of 3D surface models of 100 cadavers

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      Authors: Andreas Flury, Fabian Aregger, Stefan Rahm, Armando Hoch, Patrick O Zingg
      Abstract: HIP International, Ahead of Print.
      Aim:The purpose of this study was to investigate the greater trochanter’s (GT) behaviour in simulated subtrochanteric osteotomy.Materials and methods:Measurement of functional and anatomical femoral torsion, and position of the GT and lesser trochanter was performed using 3-dimensional (3D) surface models of 100 cadaveric femora. Femoral torsion between 2° and 22° was defined as normal, femora with 22° of femoral torsion were assigned to the low- and high-torsion group. Subtrochanteric osteotomy was simulated to normalise torsional deformities to 12°.Results:With subtrochanteric osteotomy, functional torsion was simultaneously corrected while adjusting anatomical torsion (R2 = 0.866, p 
      Citation: HIP International
      PubDate: 2022-01-24T05:18:03Z
      DOI: 10.1177/11207000211071046
       
  • The effect of a postoperative local anaesthetic pain pump in anterior
           total hip arthroplasty: a randomised control trial

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      Authors: Maya Keeka, Phong Tran, Oren Tirosh
      Abstract: HIP International, Ahead of Print.
      Introduction:This project aims to determine if an addition of a local anaesthetic pain pump for 48 hours postoperatively effects verbal pain scores (VRS), opioid usage and length of stay (LOS) after anterior approach total hip arthroplasty (THA).Methods:This was a single-centre, single-surgeon, randomised, parallel-group study with balanced randomisation involving 108 patients. Randomisation and blinding were computer generated into 2 groups: local infiltration anaesthetic (LIA) only (Control Group) and LIA+ continuous postoperative infusion of local anaesthetic for 48 hours via a pain pump (Intervention Group). Postoperatively VRS (first 30 minutes, 1 hour, 2 hours and every 4 hours postoperatively up to 48 hours), opioid consumption, length of hospital admission, antiemetic and laxative usage were recorded. Statistical analysis utilised independent sample t-tests and repeated ANOVA.Results:Demographics and duration of surgery were similar across both cohorts. On average, compared to the control group, the intervention group required 2 mg less of opioid consumption over 48 hours (p = 0.41). VRS between the 2 groups showed no statistically significant difference. Scores ranged from 0 to 7, with an average of 1.28 in the intervention group and 1.29 in the control group (p = 0.31). 9 patients in the intervention group and 10 in the control group required antiemetics. There was no difference in the LOS or postoperative constipation. No complications or adverse events occurred.Conclusions:Our study has shown the addition of a continuous postoperative infusion of local anaesthetic for 48 hours post an anterior THA had no effect on VRS, opioid consumption, LOS and antiemetic usage.
      Citation: HIP International
      PubDate: 2022-01-24T05:10:45Z
      DOI: 10.1177/11207000211069860
       
  • Revision of double-tapered, titanium, fully hydroxyapatite-coated femoral
           stems: ease of extraction and subsequent reconstruction

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      Authors: Graham R Hastie, Soheil G Asle, Anil Gambhir, Tim N Board
      Abstract: HIP International, Ahead of Print.
      Background:Fully hydroxyapatite coated, double-tapered, titanium stems are the most commonly used uncemented implants in the UK with survivorship reported at 96.3% at 23 years however there is no literature on the consequences of revision. We aimed to explore the reasons for failure, ease of stem extraction, extent of bone loss and complexity of the subsequent reconstruction.Methods:Between December 2012 and March 2019, 104 cases requiring removal of the Corail® stem (DePuy Synthes, Warsaw, IN, USA) were identified from the National Joint Registry (NJR) and our local revision database. Indication for revision, surgical/reconstruction technique, complications and follow-up data were reviewed.Results:The common reasons for revision were aseptic loosening 45.2%, infection 23.5%, instability 4.8% and peri-prosthetic fracture 12.5%. Removal of the implant without extended trochanteric osteotomy (ETO) was achieved in 94.2% of cases. Of those revised for aseptic loosening 23% were proximal, 38% were proximal/mid stem and 38% all zones. Significant bone loss is not a common feature of the failure of this stem with 95% graded as a Paprosky grade 2 or less. In terms of reconstruction, 69.2% were revised to a primary cemented stem.Conclusions:In the majority of cases revision can be achieved without an ETO and reconstruction possible using a primary stem as significant bone loss is not a common feature of failure of this stem design. We conclude that this stem is safe to use in younger patients who may outlast any type of primary implant and would inevitably face revision in their lifetime.
      Citation: HIP International
      PubDate: 2022-01-21T03:11:19Z
      DOI: 10.1177/11207000211069774
       
  • Higher risk of 2-year cup revision of ceramic-on-ceramic versus
           ceramic-on-polyethylene bearing: analysis of 33,454 primary press-fit
           total hip arthroplasties registered in the Dutch Arthroplasty Register
           (LROI)

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      Authors: Justin van Loon, Inger N Sierevelt, Anneke Spekenbrink-Spooren, Kim TM Opdam, Rudolf W Poolman, Gino MMJ Kerkhoffs, Daniël Haverkamp
      Abstract: HIP International, Ahead of Print.
      Background and purpose:The influence of bearing on short-term revision in press-fit total hip arthroplasty (THA) remains under-reported. The aim of this study was to describe 2-year cup revision rates of ceramic-on-ceramic (CoC) and ceramic-on-polyethylene (CoPE).Patients and methods:Primary press-fit THAs with one of the three most used cups available with both CoC or CoPE bearing recorded in the Dutch Arthroplasty Register (LROI) were included (2007–2019). Primary outcome was 2-year cup revision for all reasons. Secondary outcomes were: reasons for revision, incidence of different revision procedures and use of both bearings over time.Results:2-year Kaplan-Meier cup revision rate in 33,454 THAs (12,535 CoC; 20,919 CoPE) showed a higher rate in CoC (0.67% [95% CI, 0.54–0.81]) compared to CoPE (0.44% [95% CI, 0.34–0.54]) (p = 0.004). Correction for confounders (age, gender, cup type, head size) resulted in a hazard ratio (HR) of 0.64 [95%CI, 0.48–0.87] (p = 0.019). Reasons for cup revision differed only by more cup revision due to loosening in CoC (26.2% vs.1 3.2%) (p = 0.030). For aseptic loosening a revision rate of 0.153% [95% CI, 0.075–0.231] was seen in CoC and 0.058% [95%CI 0.019–0.097] in CoPE (p = 0.007). Correction for head size resulted in a HR of 0.475 [95% CI, 0.197–1.141] (p = 0.096). Incidence of different revision procedures did not differ between bearings. Over time the use of CoPE has increased and CoC decreased.Conclusions:A higher 2-year cup revision rate in press-fit THA was observed in CoC compared to CoPE. Cup loosening was the only significantly different reason for revision and seen more often in CoC and mostly aseptic. Future randomised controlled trials need to confirm causality, since the early cup revision data provided has the potential to be useful when choosing the bearing in press-fit THA, when combined with other factors like bone quality and patient and implant characteristics.
      Citation: HIP International
      PubDate: 2022-01-03T05:42:10Z
      DOI: 10.1177/11207000211064975
       
 
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