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Total hip replacement in adult patients with severe Kashin Beck disease of the hip

Total hip replacement in adult patients with severe Kashin Beck disease of the hip

Total hip replacement is a successful surgical proced- ure that could improve joint function and relieve pain involving the late stages of hip OA in adult patients. Good long-term survival has been reported for cemen- ted and cementless total hip replacement implants in studies in America [32, 33]. Studies have shown that most patients achieved good results, with some showing a 100 % survival rate [22]. All the replacement proce- dures in our study were performed for the treatment of serious KBD hip with K-L grade IV. All the patients obtained good clinical results within 2 years postopera- tively, and no change in the prosthesis positioning or radiographic evidence of prosthesis loosening was found at the last follow-up (range: 2 – 7 years), which is similar to the results of the aforementioned reports [22, 32, 33]. Only one case experienced a severe pelvic osteolytic lesion (zone 1) complicated with femoral osteolysis (zone 7) at 6 years postoperatively. This patient success- fully received impacted allograft bone croutons and had worn polyethylene components replaced.
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Cost effectiveness of Birmingham Hip Resurfacing compared to Total Hip Replacement

Cost effectiveness of Birmingham Hip Resurfacing compared to Total Hip Replacement

representing perfect health and a value of 0.0 representing death (35). Arthritis has consistently been shown to have a utility value near 0.7 and hip replacement has been shown to increase quality of life weightings close to normal values (36). A major source of input for the decision analytic model regarding utility information is the HIP project. In the HIP SF-36 scores were obtained to measure quality of life. To facilitate the use of SF-36 scores in CUA, equations were constructed which use results from the SF-36 to predict a preference-based summery score(SF-6D) (37-40). Preference-based measures of health can be used to derive utility values. Utilities can be used to calculate QALYs by multiplying the utility value with the expected life years. The QALY therefore quantifies both health-related QoL and life expectancy, and allows comparison across interventions (37). Mean baseline utility scores of 0.608 in the MoM BHR group and 0.570 in the CoC THR group were observed in HIP. A baseline correction was applied to make groups comparable.
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Incidence of hip replacement among national health insurance enrollees in Taiwan

Incidence of hip replacement among national health insurance enrollees in Taiwan

In order to survey the results of hip replacement surgery, we analyzed 105,688 cases of registry for contracted med- ical facilities and inpatient expenditures by admissions from NHI research database between 1996 and 2004, on the basis of the International Classification of Disease, Ninth Revision, Clinical Modification (ICD-9-CM) code for THR (81.51), partial hip replacement (PHR) (81.52) and revision of hip replacement (including PHR and THR) (81.53) listed as the major operation. These cases included 38,349 cases of primary THR, 55,884 cases of primary PHR and 11,455 cases of revision of hip replace- ment. We excluded 51 cases (26 cases of primary THR and 25 cases of primary PHR) which aged less than 16 years old. The insurance data was registered by physicians before operation. The data of inpatient expenditures con- tained six categories including personal information, date of inpatient, diagnosis, operation, expenditures, and hos- pital information. The items including patient identity, date of operation, birthday, gender, diagnosis, and treat- ment were used in this study. We compared the patient identity between primary operation (PHR and THR) and revision of hip replacement, and found there were 1,201 and 1,905 cases of revision from the failure of primary PHR and THR originally enrolled in the database, respec- tively. Survival of primary hip replacement was estimated for each disease by the Kaplan-Meier method [6]. The start date of follow-up was defined as the date of operation. The end-point of survival was defined as the date of revi- sion. For the statistical analyses, we used the software SPSS 10.0 (SPSS Inc. Chicago, Illinois).
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What do we tell patients about elective total hip replacement in the UK?: an analysis of patient literature

What do we tell patients about elective total hip replacement in the UK?: an analysis of patient literature

Although it would seem that patient information leaf- lets are given to people following elective THR routinely [4], little previous research has studied the quality or value of this information. This is of particular interest in view of the increasing number of operations, and the overall reduction in length of stay. Length of stay for pri- mary hip replacement has reduced in recent years with an average UK length of stay of 11 days during 1998–99 [12], compared with 8 days in 2002 [13]. Shorter stay would appear to reduce the time available for clinical staff to address patients’ knowledge and understanding and thus the adequacy of written information may be important. Therefore the aim of this study was to evalu- ate hip precaution literature given to people undergoing a THR by occupational therapists.
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The impact of surgeon handedness in total hip replacement

The impact of surgeon handedness in total hip replacement

Component placement and minimisation of leg length inequality (LLI) are key determinants of functional outcome in Total Hip Replacement (THR). Orthopaedic surgeons operate on both sides of patients bodies yet the effect of surgeon handedness on outcome has not been studied. The spatial position of the patient and surgeon will differ depending on which side of the body the THR is being performed, thus a surgeon s handedness may influence the technical level they are able to operate at, depending on whether they operate on a left or right limb. During THR for a right-handed surgeon performing a right-sided joint acetabular preparation is lead by the dominant right hand whilst femoral preparation is performed by the non-dominant left hand; during a left THR this relationship will be reversed. We use dominant side to be a right T(R for a right-handed surgeon and a left THR for a left-handed surgeon. This proposed relationship should be unaffected by patient position or surgical approach. The purpose of this study was to investigate whether surgeon handedness had any influence on THR component positioning based on post-operative radiographs. We present the early data from analysis of 160 cases in the first study to consider this potentially important factor.
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Surgical treatment of unstable intertrochanteric fractures by bipolar hip replacement or total hip replacement in elderly osteoporotic patients

Surgical treatment of unstable intertrochanteric fractures by bipolar hip replacement or total hip replacement in elderly osteoporotic patients

Hip replacement, compared with other fixation tech- niques, permits a more rapid recovery with immediate weight-bearing and facilitates nursing care during hospi- talization and at home, especially in the first postopera- tive month. The clinical evaluation confirmed that the patients were able to regain a degree autonomy, even at 1 month, with progressive improvement in 3 months. All obtained a good level of function, given their age. The last available follow-up showed good function of the operated limb, despite a decline in general function asso- ciated with the natural physical or mental aging process. Radiographs showed that implants remained in place over time. All fractures were well healed. Unreduced fractures of the lesser trochanter were not problematic for the patients.
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Hip disability and osteoarthritis outcome score (HOOS) – validity and responsiveness in total hip replacement

Hip disability and osteoarthritis outcome score (HOOS) – validity and responsiveness in total hip replacement

Hip replacement is above all surgery for relieving pain and improving physical function [28]. In the present study the HOOS subscale Pain showed the highest responsiveness (Table 5). The difference in responsiveness between the younger and older group of patients was less for the sub- scale Pain than the subscale Activity of Daily Living. This finding is in concordance with a previous study where the age of the patient seemed to be more important for improvement postoperatively for physical function than for pain [20]. In other words, pain is the most serious problem in this group of patients independent of age. Nevertheless, there is a great improvement concerning Sport and Recreation Function as well as Hip Related Quality of Life (Figure 1), most pronounced in the
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Hip muscle power recovery after hip replacement using anterior-based muscle-sparing approach in elderly femoral neck fracture: a prospective study in 40 patients

Hip muscle power recovery after hip replacement using anterior-based muscle-sparing approach in elderly femoral neck fracture: a prospective study in 40 patients

All patients were treated with hip replacement through ABMS and were placed in supine position on extension surgi- cal table. The ipsilateral shoulder was in 90° forward flexion and adduction position to increase working space during operation. Prophylactic antibiotic was given 30 min before operation. The operative leg was prepared in sterile fashion. All implants were manufactured by Depuy-Synthes Company (Warsaw, IN, USA). The Corail-cementless, Corail- cemented, and C-stem design were selected depending on degree of osteoporosis and bony geometry. Self-centering bipolar head with 28 mm inner-femoral head diameter and the cementless PINNACLE acetabulum cup were used in hemiarthroplasty and THA, respectively. PALACOS bone cement was used if needed.
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Hip surgeons and leg length inequality after primary hip replacement.

Hip surgeons and leg length inequality after primary hip replacement.

Ensuring equal leg lengths during hip replacement surgery is technically difficult. Fortunately the majority of patients who have leg length inequlity (LLI) following total hip replacement (THR) are unaware of it or tolerate it well, but occasionally patients can be very distressed by even a relatively small difference in leg lengths following surgery. Post THR LLI is now a well- recognised complication and a common cause for litigation against surgeons after THR. Despite universal agreement that LLI should be minimized at the time of surgery, there is currently no agreement as to what is a clinically acceptable LLI after primary hip replacement. There is a broad consensus in the literature that any residual LLI of less than 10mm on AP radiographs is clinically acceptable, but there is no agreement over an upper limit that would be considered clearly unacceptable [1]. There are no universally employed surgical techniques which reliably solve this problem and there is no
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Revision hip replacement for recurrent Hydatid disease of the pelvis: a case report and review of the literature

Revision hip replacement for recurrent Hydatid disease of the pelvis: a case report and review of the literature

manifestations as only this method offers hope of perma- nent cure [10]. Therapeutic dilemmas could arise in cases of extended disease with many muscles or muscle layers in different sites of the body which are communi- cating via fistulas. Communication between lesions should always be suspected and revealed, even if primary and daughter cysts are distant. Complete surgical treat- ment should include the primary lesion, the daughter cysts and the communicating fistulas as a whole speci- men. Bony pelvis is a difficult location for radical surgical excision of the Hydatid cyst and the morbidity of a Hind- quarter amputation can be considerable. Subtotal exci- sion of the cyst and joint replacement is an acceptable option based on our case report. Subtotal excision of the Hydatid cyst of the pelvis and a hip replacement can be durable providing adequate function. Patients should be carefully monitored for cyst recurrence and compo- nent loosening. Loose components due to recurrent cysts can be successfully revised to provide good clinical outcome.
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Hip precautions after hip operation (HippityHop): protocol for a before and after study evaluating hip precautions following total hip replacement

Hip precautions after hip operation (HippityHop): protocol for a before and after study evaluating hip precautions following total hip replacement

Elective total hip replacement (THR) is a common surgical procedure with more than 83,000 operations performed in England, Wales and Northern Ireland in 2015 (National Joint Registry (NJR), 2016). Dislocation of the hip is one of the most recognised complications following THR, with incidence rates reported ranging from less than 1% to greater than 15% (Restrepo et al., 2011). The reasons for hip dislocation after surgery are multifactorial, with contributing factors from the patient, the implant, and the surgeon (Brooks, 2013). Patient factors include age, gender, medical comorbidities, weak musculature, and ligament laxity (Blom et al., 2008; Brooks, 2013). The prosthesis design and selection of head diameter can influence the risk of dislocation (Blom et al., 2008), alongside the positioning of the prosthesis components (Patel et al., 2007). Surgical experience and variations in surgical approach, are considered the most controversial factors that influence the risk of dislocation (D’Angelo et al., 2008).
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Fractures in the elderly: when is hip replacement a necessity?

Fractures in the elderly: when is hip replacement a necessity?

Abstract: As the world’s population ages, hip fractures pose a significant health care problem. Hip fractures in the elderly are associated with impaired mobility, and increased morbidity and mortality. Associated conditions, such as osteoporosis, medical comorbidity, and dementia, pose a significant concern and determine optimal treatment. One-year mortality rates currently range from 14% to 36%, and care for these patients represents a major global economic burden. The incidence of hip fractures is bimodal in its distribution. Young adult hip fractures are the result of high energy trauma, and the larger peak seen in the elderly population is secondary to low-energy injuries. The predilection for the site of fracture at the neck of femur falls into two major subgroups. Pertrochanteric fractures occur when the injury is extracapsular and the blood supply to the head of femur is unaffected. The management of this group involves internal fixation through a sliding hip screw device or intramedullary fixation device, both of which have good results. The other group of patients who sustain an intracapsular fracture at the femoral neck are at increased risk of nonunion and osteonecrosis. Recent papers in the literature have shown better functional outcomes with a primary hip replacement over other treatment modalities. This article reviews the current literature and indications for a primary total hip replacement in these patients.
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Original Article Intra-articular steroid injections and risk of infection following total hip replacement or total knee replacement: a meta-analysis of cohort studies

Original Article Intra-articular steroid injections and risk of infection following total hip replacement or total knee replacement: a meta-analysis of cohort studies

Articles were considered included in this study if they met the following criteria: (a) study population: adult patients with total knee replacement or total hip replacement; (b) com- parison intervention: with and without intra- articular steroid injection; (c) outcome mea- sure: the rates of infection after replacement; (d) study design: cohort study. When the same population was reported in several publica- tions, only the most informative or complete study was included to avoid duplication of information.

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What do we tell patients about elective total hip replacement in the UK? An analysis of patient literature

What do we tell patients about elective total hip replacement in the UK? An analysis of patient literature

We confirmed that no ethics or R&D permissions were needed from our University Ethics office who regarded this study as a service evaluation. Patient information leaflets were collected as part of a national survey of oc- cupational therapy hip precautions following elective total hip replacement. The details of this study have been published elsewhere [4] however, in summary, 263 questionnaires were posted to UK occupational thera- pists to identify their current day to day practice in pri- mary THR. Of the responses, 174 (66%) questionnaires were analysed. 170 (97.7%) occupational therapists said they supplied their patients with written information and 121 (70%) enclosed copies of the leaflets they rou- tinely gave to patients pre and/or post THR.
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Issues Related to Hip Replacement

Issues Related to Hip Replacement

This study employed a mixed method to make the inquiry. This is to say that a mix of qualitative and quantitative methods was used. The quantitative part was used to draw important findings from the data collected and plot graphs. The quantitative method was used to analyze and make vital inferences regarding the findings. Foremost, a review of the literature was done and the most common complications associated with hip replacement noted. These complications included blood clots, dislocation, fracture, differing leg lengths, and infection. A group of people who have had an experience with hip replacement surgical process (25) was then recruited. Also, ten medical practitioners, who interact in one way or another with hip fracture patients, were also included as part of the study sample.
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Investigation in failure analysis and materials selection in total hip replacement prosthesis

Investigation in failure analysis and materials selection in total hip replacement prosthesis

The rate of primary total hip replacement is increasing over the past decades and expected to rise more in the future. It is estimated that there will be nearly 100,000 revision hip procedures in United States by 2030 (Kurtz S et al 2007). The percentage of which each type of failure mode occurs varies from study to study and depends on numerous factors such as patient’s age, gender, type of implants, etc… Based on the research and analysis of Bozic et al. (2009) who used The Healthcare Cost and Utilization Project Nationwide Inpatient Sample database of 51,345 revision THR procedures from October 2005 to December 2006 in the United States, the most common cause for revision surgery were instability and dislocation (accounting for 22.5%), followed by aseptic loosening (19.7%) and periprosthetic infection (18.4%). Similar studies also reported that instability contributed to 35%, aseptic loosening to 30%, osteolysis and wear to 12%, infection to 12% and periprosthetic fracture to 2% of the revisions (Springer BD et al 2009).
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Does total hip replacement impact on postural stability?

Does total hip replacement impact on postural stability?

subjects with advanced hip arthritis contribute to gait dis- orders and increased risk of falls [8, 9]. Arnold and Faulk- ner [10] reported the occurrence of one fall over the previous year among as many as 45% of subjects with hip joint osteoarthritis [10]. Furthermore, it was shown that these disorders were still seen for at least one year after joint replacement [5]. The latest studies have shown im- paired balance in the quiet standing position in patients with osteoarthritis of the hip [9]. It is known that total hip replacement (THR) results in the trauma of periarticular tissues [11] and the destruction or injury of the surround- ing receptors responsible for sensing movement and joint position. It raises the question whether deficits of balance still occur after THR.
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Femoral stem wear in cemented total hip replacement

Femoral stem wear in cemented total hip replacement

Abstract: The great success of cemented total hip replacement to treat patients with end- stage osteoarthritis and osteonecrosis has been well documented. However, its long-term survivorship has been compromised by progressive development of aseptic loosening, and few hip prostheses could survive beyond 25 years. Aseptic loosening is mainly attributed to bone resorption which is activated by an in-vivo macrophage response to particulate debris generated by wear of the hip prosthesis. Theoretically, wear can occur not only at the articulating head–cup interface but also at other load-bearing surfaces, such as the stem– cement interface. Recently, great progress has been made in reducing wear at the head–cup interface through the introduction of new materials and improved manufacture; consequently femoral stem wear is considered to be playing an increasingly significant role in the overall wear of cemented total hip replacement. In this review article, the clinical incidences of femoral stem wear are comprehensively introduced, and its significance is highlighted as a source of generation of wear debris and corrosion products. Additionally, the relationship between femoral stem surface finish and femoral stem wear is discussed and the primary attempts to reproduce femoral stem wear through in-vitro wear testing are summarized. Furthermore, the initiation and propagation processes of femoral stem wear are also proposed and a better understanding of the issue is considered to be essential to reduce femoral stem wear and to improve the functionality of cemented total hip replacement.
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Clinical and Radiological Outcome Analysis of Total Hip Replacement.

Clinical and Radiological Outcome Analysis of Total Hip Replacement.

He was admitted at our department and underwent all necessary investigations. He was examined for limb length discrepancy, fixed deformities, active and passive range of movements at the affected hip, distal neurovascular deficit, status of other joints and any focus of infection (skin,dental and urinary tract). His was subjected to preoperative Harris Hip Scoring system analysis. He was diagnosed to have neck of femur fracture. He was assessed for suitable anaesthesia for total hip replacement of left side hip after a fair trial of conservative management and obtain consent for THR to improve in quality of life.
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Study, Measuring and Vibration Data Analysis for Hip Replacement Patient during Daily Activities

Study, Measuring and Vibration Data Analysis for Hip Replacement Patient during Daily Activities

The older age people are usually suffering from big medical problems due to failure in hip joint, this lead to artificial hip replacement surgery. These troubles give a big engorgement to study, measure and analyze the vibration data and heart straining muscle with patient of replaced artificial hip joint in order to reduce the effect of vibration using different damping unit. This work investigates the frequency, acceleration, and heart straining muscle which will be measured at foot, knee, and hip joint in the patient leg of artificial replacement hip with different damping units. The suggested vibration measurement system was used to measure vibration in the patient leg with artificial replacement hip as a case study. This patient is of age, weight, length and leg length of 26 years, 85 kg, 175 cm and 98 cm respectively. The results showed that the acceleration in X- direction in case without using any damping unit will be (6.07, 1.18, and 0.25) g for (foot, knee, and hip) respectively. These values manifested that there is reduction in the acceleration with 80.5%, and 95.8%, for knee, and hip) respectively in comparison with foot acceleration. Also result exhibited that the best reduction in acceleration is recorded in the case of using the athletic shoe + air ground + silicon as a damping unit with a value of 63.4%, while the best reduction in the heart straining muscle is recorded using the athletic shoe + silicon as a damping unit with 51.1%
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