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Query: UNIPROT:P50502 (Hip)
 7,003 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

This chapter is a brief and incomplete overview of a rapidly changing field. The following points are helpful for the management of hip arthroplasty patients. There is no clinically significant difference between warfarin and enoxaparin prophylaxis in terms of efficacy (venographic or clinical events) and safety. Hip arthroplasty patients should receive warfarin or enoxaparin for at least 7 to 10 days postoperatively. There is a high rate of postdischarge venographic DVT even if prophylaxis is used for 7 to 10 days after surgery. There is a 2% rate of postdischarge symptomatic DVT if prophylaxis is used for 7 to 10 days after surgery. There is a 0.1% rate of postdischarge fatal PE at 90 days postoperatively if prophylaxis is used for 7 to 10 days after surgery. The value of routine predischarge surveillance for DVT is not clear at this moment.
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PMID:Prevention and treatment of venous thromboembolic disease complications in primary hip arthroplasty patients. 957 34

In order to prevent fatal pulmonary embolism, TED stockings, foot pumps and early mobilisation on the second post-operative day are used at our centre. Only patients deemed to be high risk (previous DVT/PE or obese) are given clexane as inpatients and warfarin for six weeks post-op. From the hospital database 1137 primary total hip replacements and 1017 primary total knee re-placements were identified and the figures were confirmed with the theatre implant order books. The cause of death for those patients on the database, now deceased, was obtained from the coroner. Where a postmortem had not been performed the patient was assumed to have died of a PE. Within three months of surgery, a fatal PE rate of 0.09% (95% CI 0.00-0.26%) following hip replacement and 0.20% (95% CI 0.00-0.46%) after knee replacement was found. Thirty-four patients had been discharged on warfarin according to the pharmacy records. We would therefore not recommend the routine use of chemical thromboprophylaxis following joint replacement.
Hip Int
PMID:Fatal pulmonary embolism following hip and knee replacement. A study of 2153 cases using routine mechanical prophylaxis and selective chemoprophylaxis. 1921 78

Few studies about how heterotopic ossification (HO) affects functional outcome after metal-on-metal total hip resurfacing (MOMHR) have been reported. The purpose of this study was to evaluate the incidence and clinical significance of HO after MOMHR. We retrospectively reviewed 122 consecutive patients, who underwent MOMHR from June 2006 to October 2008, with adequate follow-up information. All patients had four weeks of aspirin (325 mg twice a day) for DVT prophylaxis and two weeks of celecoxib (400 mg once a day) for pain control. All data were collected prospectively including radiographs and functional scores preoperatively, at three months and at one year postoperatively. An independent musculoskeletal radiologist, using the Brooker classification, reviewed radiographs. Unbalanced ANOVA analyses were performed to evaluate the effect of HO on outcome. The overall incidence of HO at three months was 62.1% (grade 1: 39.8%, grade 2: 20.4%, grade 3: 1.9%) and 75% at one year (grade 1: 41.7%, grade 2: 27.8%, grade 3: 5.5%). There were no significant differences in the functional status scores among Brooker grade 0 to 3 groups at three months and one year follow-up. The incidence of HO after MOMHR was 62.1% at three months and 75% at one year despite a post-operative regimen of aspirin and celecoxib. We found no evidence that predominantly Brooker grade 1 or 2 HO affected the clinical outcome at three months or one year when compared across all Brooker classes of patients.
Hip Int
PMID:Clinical significance of heterotopic ossification after metal-on-metal total hip resurfacing. 2453 36

Dual mobility implant designs minimise the risk of dislocation without sacrificing range of motion. Between 1st September 2008 and 31st July 2011, 5 institutions examined early clinical outcomes of a new dual mobility bearing hip system implanted in 485 primary THAs in 452 patients. Patient demographics were 46% female, a mean age of 67 years and a mean BMI of 30. Complications at a minimum of 2 years after surgery included 1 femur fracture, 1 DVT and 4 unrelated deaths. There were no dislocations. For functional outcomes, Harris Hip Scores increased from 41 to 86 (p<0.001), while VAS pain scores decreased from 5.9 to 0.7 (p<0.001). Minimal complications, excellent early clinical outcomes and the absence of early dislocations demonstrate the improved stability of this dual mobility implant system.
Hip Int
PMID:Lack of early dislocation following total hip arthroplasty with a new dual mobility acetabular design. 2565 40

The aim of the study was to review the results of total hip replacement (THR) in relatively fit and mobile patients with Garden 3 and 4 fractures of the neck of femur. Forty-one patients who underwent THR for displaced intracapsular hip fractures from 1993 to 2001 were reviewed. Only those patients with three years or more follow-up were reviewed. Average follow-up was 5.8 years (3-9.6 years). Complications encountered were: minor wound dehiscence (1), DVT (3), pulmonary embolism (1), dislocation (1), per-operative femur fracture (1), periprosthetic fracture following repeat fall (2), stem loosening (1). Average Harris Hip score at follow-up was 91 (66-100). We recommend total hip replacement as the primary treatment in relatively fit and mobile patients with displaced intracapsular fractures of the hip. (Hip International 2005; 15: 33-7).
Hip Int
PMID:Primary total hip replacement for acute displaced subcapital femoral fractures with a minimal three-year follow-up. 2822 80

Various therapeutic methods are available to treat patients with intertrochantric fracture, which is usually caused by falling down. This complication is usually observed among the elderly, particularly old women. The choice of the proper therapeutic method depends on many factors including patient's condition, type of fracture, and the amount of movement. Hip arthroplasty is one of these therapeutic methods, which have certain advantages and disadvantages. Immediate resumption of walking with the ability of weight toleration and absence of complications such as aseptic necrosis are some advantages of this method. Sixtyeight elderly patients with pertrochanteric fracture who had resorted to Iranian Army's hospitals and had undergone arthroplasty. These cases were examined with due comparison with historical and external controls. Variables such a type of operation, age, post-operation pain, the pace of resuming walking ability, embolism, surgical site infection, bedsore and DVT were studied and compared against standard operation. The results achieved through assessment of variables showed a significant difference with standard operation in terms of variables such as post-operative movement ability, pain scale in various times, surgical complications, embolism, surgical site infection, bedsore, and DVT. Post-operative pain within the first 3 months following it are some complications with not much attention is paid to them, but they are important complications which can cause many negative and influential effects on patients. Arthroplasty is more expensive than standard operation and the patient may initially feel more pain.
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PMID:Studying the effects of primary arthroplasty on post-treatment results among elderly patients with pertrochanteric fracture. 2944 Nov 91