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

The anatomical deformities encountered in osteoarthritis (OA) secondary to developmental dysplasia of the hip (DDH) may lead to some technical difficulties when performing total hip arthroplasty. The aim of this study is to present our experience in anatomical analysis of OA following DDH and its treatment using cementless THA with a customized stem and a reinforcement ring. In anatomic X-rays and CT-scan studies of 83 hips with osteoarthritis following DDH, a great individual variability was shown despite the subluxation class considered with a reduced mediolateral and anteroposterior dimensions of the intramedullary femoral canal in all groups. Greater anteversion (ranging from 2 to 80) in all the DDH groups and a femoral neck shaft angle increased only for femora of class II were found. Another group of 116 luxations of the hip was clinically followed. Clinical outcome was found to be not correlated with the severity of luxation. The problems encountered to restore the center of rotation in THA for DDH correlated well with the severity of dislocation. The postoperative limp was correlated with a vertical position of the acetabular component of more than 35 mm from the interteardrop line. Taking into consideration hip revision for stem or acetabular replacement, the cumulative survival rate was 94.7%+/-2.7% at 12 years. Cementless custom stem is certainly a step forward in the future of hip arthroplasty in a young and active population with DDH to probably include in a preoperative and intraoperative computer assisted surgery.
Hip Int 2007
PMID:Cementless total hip arthroplasty using custom stem and reinforcement ring in hip osteoarthritis following developmental dysplasia. 1919 93

Total hip arthroplasty is the procedure of choice for most adult patients with symptomatic arthrosis secondary to developmental dysplasia (DDH), but it requires complex reconstructive techniques, is usually performed in young patients, and has an increased risk of complications. THA is indicated in presence of severe pain and when osteotomy is contraindicated. The complexity of surgery is related to the degree of dysplasia. Anatomic abnormalities in the acetabulum and femur are the cause of the complexity and complications of this procedure. Acetabular bone deficiency requires reconstructive techniques before implanting the cup at the anatomic acetabular location, such as bone autograft augmentation, implanting the cup at higher level of the hip center and cup medialization. Femoral shortening and special cemented or uncemented stems are currently used to avoid intraoperative complications. While a cemented stem needs metaphyseal femoral shortening, subtrochanteric shortening requires a cementless stem. Because of these patients' age, alternative bearing surfaces, such as alumina-on-alumina couples are recommended when possible. Although the long-term results of total hip arthroplasty in DDH are inferior to those in a general population, the results show a high level of pain relief and functional improvement.
Hip Int 2007
PMID:Cemented femoral stems in patients with DDH. 1919 94

We evaluated early clinical results and radiographic findings of MIS THA using 2-incsion approach and mini-posterior approach. A consecutive series of 35 patients (40 hips) with 2-incision THA and a consecutive series of 35 patients (36 hips) with mini-posterior THA performed in the same period were evaluated. The patient groups were not randomised. At the mean follow-up of 20.2 months (range, 12-36 months), the 2-incision group had significantly earlier ambulation, driving ability and return to work. However, it had significantly more operative time, blood loss, blood transfusion and complications. Regarding radiographic findings of 2-incision group and mini-posterior group, the mean radiographic acetabular abduction of was 46.7 degrees (89% was within 35- 55) and 44.8 degrees (84% was within 35-55), respectively. The femoral stem was in neutral position in 80% and 83%, respectively. There was no statistical difference of the implant position between groups. Although MIS 2-incison THA provided faster, early ambulation than the mini-posterior THA, surgeons have to weigh the advantages and disadvantages of this technique including, increased operative time, blood loss and their familiarity with similar standard incisions and landmarks.
Hip Int 2006
PMID:Early outcomes following minimally invasive total hip arthroplasty using a two-incision approach versus a mini-posterior approach. 1921 24

We sought to determine whether a non-originating surgeon early in his experience with the MIS two-incision technique for THA could place components with appropriate accuracy. Thirty five consecutive hip replacements performed between July of 2003 and March of 2004 using the two-incision technique were closely matched by height and weight with an equal number of control small incision arthroplasties. The two-incision surgeries were performed after the surgeons twentieth case and prior to the surgeons fifty sixth two-incision case. We assessed immediate postoperative films for leg length discrepancy and acetabular position, and compared the two groups by chi squared analysis. Both leg length accuracy and abduction angle were significantly superior with the two-incision technique. No arthroplasty performed with the two-incision technique had a leg length discrepancy of more than 10 mm, versus five in the control group (p<0.025). The abduction of one cup fell outside the 35-49 range in the two-incision group, while ten did so in the control group (p<0.01). With this study, we have shown that a non-originating surgeon early in his experience with the MIS two-incision technique can place acetabular components and equalise leg lengths with superior precision. We believe the fluoroscopic control and supine position greatly enhance the surgeons accuracy, and more than compensate for the potentially decreased direct vision with this technique.
Hip Int 2006
PMID:Improved accuracy of acetabular component position and leg lengths with the two-incision total hip replacement technique. 1921 25

The purpose of this study was to describe the surgical technique and to investigate results of a modified two-incision total hip replacement using either intraoperative fluoroscopy or imageless navigation. Twenty-nine patients (30 hips) with a minimum follow-up of one year were enrolled in this study. The patients were evaluated at 3, 6, 12 weeks, 6 months, and 1-year. The functional recovery as represented by the Harris hip score and WOMAC scale were better in the fluoroscopy group of patients at the early postoperative stage (3 wks). Thereafter, both groups showed rapid recovery with no difference in scores. Injury to the lateral femoral cutaneous nerve was the most commonly seen complication and it occurred in 6 hips (fluoroscopy 2; imageless 4). The symptoms were transient and resolved in 6 months in all 6 cases. This study demonstrated that the role of intraoperative fluoroscopy could safely be replaced by an imageless navigation system for the MIS-2 THA.
Hip Int 2006
PMID:Two-incision total hip replacement: Intra-operative fluoroscopy versus imageless navigation for cup placement. 1921 27

The purpose of the review is to report the modified Smith-Peterson technique for use with minimal invasive total hip arthroplasty (MIS THA) with supine patient positioning. The modified Smith-Peterson technique allows for direct visualisation of the acetabulum and is an internerval approach. The MIS anterior approach with supine patient positioning offers a complete intermuscular and internervous access to the hip joint. The use of this technique yields a reduction of muscular trauma, intraoperative bloodloss, and postoperative rehabilitation. The reduction of soft tissue trauma may lead to minimal postoperative pain. While cosmesis is never a reason for using MIS, it does yield great patient satisfaction. The MIS anterior approach with supine patient positioning is a safe and reproducible method, offering an alternative option in MIS THA.
Hip Int 2006
PMID:The minimal invasive surgery anterior approach with supine patient positioning: a step-wise introduction of technique. 1921 29

The objective of this study was to show model-based economic consequences of minimal invasive surgery total hip arthroplasty (MIS THA). The model is based on hospital and rehabilitation costs and lowering of loss of productivity. This study used conventional THA data from Switzerland and cost-effectiveness MIS THA analysis from the United States. According to our model, a total of 42.1 70.1 million can be saved annually in Switzerland when using MIS THA instead of conventional THA. Annual savings of 7,8 12,9 million result from the significantly shorter hospital stay. The savings potential for rehabilitation costs is 10,5 17,5 million annually. In addition, the productivity loss for the economy is lowered by 23.8 39.7 million annually. According to this economic study we recommend the introduction of MIS techniques in THA. MIS THA surgical techniques may allow the reduction of healthcare costs. Despite the promising economic advantages of MIS THA, clinical studies are necessary to prove long-term benefits.
Hip Int 2006
PMID:Cost-benefit analysis of MIS THA: Model-based analysis of the consequences for Switzerland. 1921 30

The purpose of this prospective randomised study is to compare the early clinical results of the metal-on-metal hip resurfacing to metal-on-metal THA. Two hundred and ten hips were randomised between August 2003 and January 2006 (191 subjects). One hundred and two hips were implanted with an uncemented titanium tapered stem, and an uncemented titanium acetabular component and 28 mm metal-on-metal bearing (THA group) and 103 hips received a hybrid metal-on-metal surface replacement arthroplasty (SRA group). No significant difference was found with the WOMAC or Merle dAubign-Postel scales. However, a significantly higher activity level was found in the SRA group (UCLA score 6.3 versus 7.1, p= 0.037) and a greater percentage of the SRA patients returned to heavy or moderate activities at one - year postoperatively (72% versus 39%, p=0.007). No patient in either group presented with thigh pain one year after surgery. Both techniques present similar complication rates (0.15). This study supports the theory of better functional recovery in the short-term favouring the SRA when compared to THA. The clear benefit of surface replacement arthroplasty over THA is proximal femoral bone preservation. However, the long term survivorship of the SRA will determine the real value of the theoretical advantage.
Hip Int 2006
PMID:A prospective randomized clinical trial comparing metal-on-metal total hip arthroplasty and metal-on-metal total hip resurfacing in patients less than 65 years old. 1921 33

A randomized controlled trial was performed to compare the cemented Stanmore metal-on-metal (Biomet, Warsaw, Indiana) total hip arthroplasty (THA; 102 hips) to the cemented Stanmore metal-on-polyethylene (Biomet) THA (98 hips). The primary outcome was clinical performance. Radiological performance, serum cobalt analysis, and prosthetic survival were secondary outcome measures. At a mean follow-up of 5.6 years, 5 patients were lost to follow-up, 18 died, and 4 were revised (3 metal-on- metal, 1 metal-on-polyethylene). Harris Hip Scores improved from 48 to 90 in the metal-on-metal patients (P<.001) and from 46 to 87 in the metal-on-polyethylene patients (P<.001). Oxford Hip Scores changed from 40 to 19 in the metal-on-metal group (P<.001) and from 40 to 18 in the metal-on-polyethylene group (P<.001). For both Harris and Oxford Hip Scores, there was no significant difference between the 2 groups. Five-year survival with revision for any reason was 97% (95% CI 93%-100%) in the metal-on-metal group and 99% (95% CI 97%-100%) in the metal-on-polyethylene group. All revisions were indicated for aseptic loosening (metal-on-metal: 3 cup revisions; metal-on-polyethylene: 1 total revision). At 5-year follow-up, cemented metal-on-metal THA showed no clinical superiority over metal-on-polyethylene THA.
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PMID:No superiority of cemented metal-on-metal vs metal-on-polyethylene THA at 5-year follow-up. 1963 56

The management of osteoarthritis of the hip in young active patients is challenging. We compared the functional outcomes and activity levels following hip resurfacing and uncemented THA in young active patients matched for age, gender and activity levels. Mean follow-up period was five years (4-7 years). Within each group there was a statistically significant improvement in the mean University of California at Los Angeles (UCLA) and Oxford Hip Score (OHS) scores following surgery. This study found no statistically significant difference in the levels of function (p= 0.82) or activity pursued (p= 0.60) after surgery between uncemented THA and hip resurfacing. The potential complications unique to hip resurfacing may be avoided by the use of uncemented THA which in itself has longer follow-up compared to resurfacing.
Hip Int
PMID:Resurfacing and uncemented arthroplasty for young hip arthritis: functional outcomes at 5 years. 1987 77


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