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Casale M, Toro G, Porcelli F, Quota A, Rosso R, Spadola V, Arcioni F, Campisi S, Roberti D, Perrotta S. Long-term outcomes of avascular necrosis in sickle cell disease using joint-specific patient-reported outcome measures: Results from a multicentre study. Br J Haematol 2024. [PMID: 39344565 DOI: 10.1111/bjh.19802] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2024] [Accepted: 09/19/2024] [Indexed: 10/01/2024]
Abstract
Avascular necrosis (AVN) is a prevalent and progressive complication in young patients with sickle cell disease (SCD), but no study evaluated the long-term subjective and objective outcome measures. Oxford hip score (OHS) and Oxford shoulder scores (OSS) are validated joint-specific patient-reported outcome measures (PROMs). In this prospective multicentre study, 47 SCD patients with pre-existing diagnosis of AVN occurred at a median age of 35.9 (24.2-47.6) filled out the OHS and OSS at median follow-up of 9.4 years (4.5-12.9). No patient died after diagnosis of AVN. Hip AVN was present in 34 (72%) patients, with bilateral involvement in 25 (74%); 26 (59%) underwent total hip arthroplasty (THA) at a median age of 34.6 (22.6-49.5); and 4 (15%) required re-surgery. OHS revealed moderate to severe impairment both in patients underwent THA and no hip surgery. Shoulder AVN was present in 13 (6%) patients and OSS revealed mild to moderate impairment. A high rate of compromised joint function and pain was observed 10 years after diagnosis of AVN regardless of the type of treatment, outlying the need to improve the management of this sickle-related complication. OHS and OSS are validated joint-specific PROMs easy to use in all SCD centres.
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Affiliation(s)
- Maddalena Casale
- Department of Woman, Child and General and Specialized Surgery, University of Campania 'Luigi Vanvitelli', Naples, Italy
| | - Giuseppe Toro
- Department of Medical and Surgical Specialties and Dentistry, University of Campania 'Luigi Vanvitelli', Naples, Italy
| | - Federica Porcelli
- Department of Woman, Child and General and Specialized Surgery, University of Campania 'Luigi Vanvitelli', Naples, Italy
| | | | - Rosamaria Rosso
- Talassemia Unit, AOU Policlinico G.Rodolico-San Marco di Catania, Catania, Italy
| | - Vincenzo Spadola
- Thalassemia Centre, Hospital "Giovanni Paolo II" Ragusa, Ragusa, Italy
| | | | - Saveria Campisi
- Thalassemia Unit, Hospital "Umberto Primo" Siracusa, Siracusa, Italy
| | - Domenico Roberti
- Department of Woman, Child and General and Specialized Surgery, University of Campania 'Luigi Vanvitelli', Naples, Italy
| | - Silverio Perrotta
- Department of Woman, Child and General and Specialized Surgery, University of Campania 'Luigi Vanvitelli', Naples, Italy
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Migliorini F, Maffulli N, Memminger MK, Simeone F, Rath B, Huber T. Clinical relevance of patient-reported outcome measures in patients who have undergone total hip arthroplasty: a systematic review. Arch Orthop Trauma Surg 2024:10.1007/s00402-024-05579-w. [PMID: 39316103 DOI: 10.1007/s00402-024-05579-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/22/2024] [Accepted: 09/11/2024] [Indexed: 09/25/2024]
Abstract
INTRODUCTION In orthopaedic research, it is crucial to determine changes that are statistically significant and clinically meaningful. One approach to accomplish this is by calculating the Minimal Clinically Important Difference (MCID), the Clinically Important Differences (CID), the Minimum Detectable Change (MDC), the Minimal Important Change (MIC), and the Patient Acceptable Symptom State (PASS) values. These tools assist medical professionals in comprehending the patient's viewpoint, enabling them to establish treatment objectives that align with patients' desires and expectations. The present systematic review investigated the MCID, MIC, CID, MDC, and PASS of the most used PROMs to assess patients who have undergone THA. METHODS This systematic review followed the 2020 PRISMA guidelines. Web of Science, Embase, and PubMed were accessed in March 2024 without time constraints or additional filters. All the clinical investigations which evaluated data tools (MCID, MIC, CID, MDC, and PASS) to assess the clinical relevance of PROMs in THA were accessed. Articles in Spanish, Italian, German, and English were eligible. Studies with levels of evidence I to III were eligible. RESULTS Data from 100,824 patients were collected. All relevant demographic data were analysed and summarised. In addition, the MCID, MIC, CID, MDC and PASS of the COMI, HOOS, SF-36, OHS, Oxford-12, PROMIS-PF, SF-12, and WOMAC scores for THA were determined. CONCLUSION Current evidence recommends to collect MCIDs based on anchors routinely. These values should be used as complementary tools to determine the clinical effectiveness of a treatment instead of solely relying on statistically significant improvements. LEVEL OF EVIDENCE Level IV, systematic review and meta-analysis.
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Affiliation(s)
- Filippo Migliorini
- Department of Life Sciences, Health, and Health Professions, Link Campus University, 00165, Rome, Italy
- Department of Orthopedics and Trauma Surgery, Academic Hospital of Bolzano (SABES-ASDAA), 39100, Bolzano, Italy
| | - Nicola Maffulli
- Department of Trauma and Orthopaedic Surgery, Faculty of Medicine and Psychology, University La Sapienza, 00185, Rome, Italy.
- School of Pharmacy and Bioengineering, Faculty of Medicine, Keele University, Stoke on Trent, ST4 7QB, UK.
- Centre for Sports and Exercise Medicine, Barts and the London School of Medicine and Dentistry, Mile End Hospital, Queen Mary University of London, London, E1 4DG, UK.
| | - Michael Kurt Memminger
- Department of Orthopedics and Trauma Surgery, Academic Hospital of Bolzano (SABES-ASDAA), 39100, Bolzano, Italy
| | - Francesco Simeone
- Department of Orthopedics and Trauma Surgery, Academic Hospital of Bolzano (SABES-ASDAA), 39100, Bolzano, Italy
| | - Björn Rath
- Department of Orthopaedic, Clinic of Wels-Grieskirchen, 4600, Wels, Austria
| | - Thorsten Huber
- Department of Orthopaedic, Clinic of Wels-Grieskirchen, 4600, Wels, Austria
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Axenhus M, Salemyr M, Mukka S, Magnéli M, Sköldenberg O. Long-term follow-up of bone density changes in total hip arthroplasty: comparative analysis from a randomized controlled trial of a porous titanium construct shell vs. a porous coated shell. INTERNATIONAL ORTHOPAEDICS 2024:10.1007/s00264-024-06289-z. [PMID: 39243289 DOI: 10.1007/s00264-024-06289-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/13/2024] [Accepted: 08/20/2024] [Indexed: 09/09/2024]
Abstract
PURPOSE Periacetabular bone loss poses a considerable challenge in the longevity and stability of acetabular implants used in total hip arthroplasty (THA). Innovations in implant design, specifically the introduction of three-dimensional (3D) porous titanium constructs, might reduce bone resorption. The purpose of this study was to build upon our previous randomized controlled trial, which found no change in periacetabular bone loss between a 3D porous none-hydroxyapatite coated titanium cup and a standard porous hydroxyapatite coated cup over a two year follow-up period by extending the follow-up duration to ten years post-surgery. METHODS This was a single-centre, long-term follow-up study conducted over a ten year period in patients who had previously participated in a randomized controlled trial comparing a 3D porous titanium construct shell (PTC group) with a standard porous hydroxyapatite coated titanium shell (PC-group). The primary outcome measured was the change in bone mineral density (BMD) within four specific periacetabular zones, alongside overall bone loss, which was assessed through BMD in the lumbar spine at two, six and ten years postoperatively. Secondary outcomes included clinical outcome measures. RESULTS In total, 18 in the PTC and 20 in the PC group were analysed for the primary endpoint up to ten years. The mean bone mineral density in zones 1-4 was 3.7% higher in the PTC group than in the PC group at six years postoperatively and 12.0% higher at ten years. Clinical outcomes, and the frequency of adverse events did not differ between the groups. CONCLUSIONS The PTC group displayed superior long-term bone preservation compared to the PC group while maintaining similar clinical outcomes up to ten years postoperatively. Although with a small sample size, our findings suggest that porous titanium cups have the potential to minimize BMD loss around the cup which could contribute to improving THA outcomes and implant durability.
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Affiliation(s)
- Michael Axenhus
- Division of Orthopaedics, Department of Clinical Sciences at Danderyd Hospital, Karolinska Institutet, Entrévägen 2, 182 88, Danderyd, Stockholm, Sweden.
| | - Mats Salemyr
- Division of Orthopaedics, Department of Clinical Sciences at Danderyd Hospital, Karolinska Institutet, Entrévägen 2, 182 88, Danderyd, Stockholm, Sweden
| | - Sebastian Mukka
- Department of Diagnostics and Intervention (Orthopaedics), Umeå University, Umeå, Sweden
| | - Martin Magnéli
- Division of Orthopaedics, Department of Clinical Sciences at Danderyd Hospital, Karolinska Institutet, Entrévägen 2, 182 88, Danderyd, Stockholm, Sweden
| | - Olof Sköldenberg
- Division of Orthopaedics, Department of Clinical Sciences at Danderyd Hospital, Karolinska Institutet, Entrévägen 2, 182 88, Danderyd, Stockholm, Sweden
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Andronic O, Germann C, Jud L, Imhoff FB, Fröhlich S, Scherr J, Spörri J, Zingg PO. How useful are indirect radiographic measurements of hip instability in borderline hip dysplasia? An MRI-based comparison to a healthy cohort. INTERNATIONAL ORTHOPAEDICS 2024; 48:2007-2015. [PMID: 38684549 PMCID: PMC11246315 DOI: 10.1007/s00264-024-06202-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/12/2024] [Accepted: 04/22/2024] [Indexed: 05/02/2024]
Abstract
PURPOSE Symptomatic hips with borderline hip dysplasia (BHD) morphology pose a challenge in differentiating stable from unstable hips. The current study aims to compare indirect radiographic signs of instability in a symptomatic BHD population to those in a healthy cohort. METHODS The study group consisted of patients with a lateral centre-edge angle (LCEA) with values 18° ≤ LCEA < 25° who underwent corrective periacetabular osteotomy (PAO) and reported an improvement in patient-reported outcome measures (PROMs). The comparison group consisted of a healthy cohort of athletes who did not complain of any hip-related symptoms and who had normal values of their hip morphological parameters (LCEA, acetabular index (AI°), alpha angle (α°), femoral version, acetabular version). Indirect signs of instability consisting of the femoro-epiphyseal acetabular roof index (FEAR), iliocapsularis-to-rectus-femoris (IC/RF) ratio and labral dimensions (height-to-length ratio) were assessed in both groups. Partial Pearson correlation, logistic multiple regression analysis and Receiver-Operating Characteristic (ROC) curve analysis were performed to determine correlations, as well as the sensitivity and specificity of these signs to differentiate between healthy hips and BHD. RESULTS On binary logistic multiple regression analysis, the FEAR Index was the only independent predictor to differentiate between BHD and healthy hips (p < 0.001). The IC/RF ratio did not achieve significance. The calculated area under the curve (AUC) was 0.93 (0.87 - 0.99, CI 95%, p < 0.001) for the FEAR Index and 0.81 (0.70 - 0.92, CI 95%, p < 0.001) for the height-length ratio. Using the predefined cut-off values (dysplastic-FEAR Index ≥ 5° or labral height-to-length ratio ≤ 0.5), 27% sensitivity/100% specificity and 20% sensitivity/ 100% specificity, were achieved. ROC analysis provided the following new thresholds: FEAR Index ≥ -5° (73% sensitivity/97% specificity); labral height-to-length ratio ≤ 0.8 (70% sensitivity, 79% specificity). CONCLUSION In our cohort, the FEAR index was an independent parameter that could differentiate between borderline dysplastic and asymptomatic hips. The previously published values for both the FEAR index and labral hypertrophy ratio had a poor sensitivity in differentiating symptomatic unstable BHD from healthy hips. The cut-off values of ≥ -5° (FEAR index) and ≤ 0.8 (labral height-to-length ratio) provided acceptable sensitivity and specificity when comparing to morphological healthy hips.
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Affiliation(s)
- Octavian Andronic
- Department of Orthopaedics, Balgrist University Hospital, University of Zurich, 8008, Zurich, Switzerland.
| | - Christoph Germann
- Department of Radiology, Balgrist University Hospital, University of Zurich, Zurich, Switzerland
| | - Lukas Jud
- Department of Orthopaedics, Balgrist University Hospital, University of Zurich, 8008, Zurich, Switzerland
| | - Florian B Imhoff
- Department of Orthopaedics, Balgrist University Hospital, University of Zurich, 8008, Zurich, Switzerland
| | - Stefan Fröhlich
- Sports Medical Research Group, Balgrist University Hospital, University of Zurich, Zurich, Switzerland
- University Centre for Prevention and Sports Medicine, Balgrist University Hospital, University of Zurich, Zurich, Switzerland
| | - Johannes Scherr
- Sports Medical Research Group, Balgrist University Hospital, University of Zurich, Zurich, Switzerland
- University Centre for Prevention and Sports Medicine, Balgrist University Hospital, University of Zurich, Zurich, Switzerland
| | - Jörg Spörri
- Sports Medical Research Group, Balgrist University Hospital, University of Zurich, Zurich, Switzerland
- University Centre for Prevention and Sports Medicine, Balgrist University Hospital, University of Zurich, Zurich, Switzerland
| | - Patrick O Zingg
- Department of Orthopaedics, Balgrist University Hospital, University of Zurich, 8008, Zurich, Switzerland
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Di Martino A, Brunello M, Villari E, D'Agostino C, Cosentino M, Bordini B, Rivera F, Faldini C. Stem revision vs. internal fixation in Vancouver B2/B3 periprosthetic hip fractures: systematic review and metanalysis. Arch Orthop Trauma Surg 2024; 144:3787-3796. [PMID: 39105834 PMCID: PMC11417062 DOI: 10.1007/s00402-024-05469-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/04/2024] [Accepted: 07/18/2024] [Indexed: 08/07/2024]
Abstract
INTRODUCTION Vancouver B2 and B3 periprosthetic fractures (PFF) are associated with stem instability and often require a demanding stem implant revision (SR) or internal fixation (ORIF). This latter surgery is increasingly performed in the last few years instead of SR, but it is unclear which is the best treatment to manage PFF patients. The aim of this study is the compare the outcomes of B2/B3 PFF managed by either ORIF or SR, by performing a systematic review and meta-analysis of current literature. MATERIALS AND METHODS Cochrane Database, PubMed, Google Scholar and MEDLINE were examined to find out relevant publications dealing with the different outcomes of SR vs. ORIF in B2/B3 PFF of the hip. The effect model (EM) was calculated using Cohen´s d index. RESULTS Fifteen studies were included, reporting on a total of 1629 patients (564 ORIF and 1065 SR). The pooled random EM estimates for reoperation was 0.87 (95% CI, 0.39-1.96; I2 = 78%) in favor of ORIF surgery; EM for complications was 1.01 (95% CI, 0.45-2.27; I2 = 85%) without difference among procedures. The EM for transfusion was 0.72 (95% CI, 0.46-1.12; I2 = 62%) in favor of fixation. CONCLUSION ORIF and SR were both suitable and effective options in PFF patients, being associated to similar complications rates. Our results show that ORIF performance in PFF patients is associated to significantly less in blood loss, surgical time and in-hospital stay. These advantages are particularly appealing in patients with multiple comorbidities.
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Affiliation(s)
- Alberto Di Martino
- I Orthopedic and Traumatology Department, IRCCS Istituto Ortopedico Rizzoli, Bologna, 40136, Italy.
- Department of Biomedical and Neurimotor Science-DIBINEM, University of Bologna, Bologna, 40136, Italy.
| | - Matteo Brunello
- I Orthopedic and Traumatology Department, IRCCS Istituto Ortopedico Rizzoli, Bologna, 40136, Italy
- Department of Biomedical and Neurimotor Science-DIBINEM, University of Bologna, Bologna, 40136, Italy
| | - Eleonora Villari
- I Orthopedic and Traumatology Department, IRCCS Istituto Ortopedico Rizzoli, Bologna, 40136, Italy
- Department of Biomedical and Neurimotor Science-DIBINEM, University of Bologna, Bologna, 40136, Italy
| | - Claudio D'Agostino
- I Orthopedic and Traumatology Department, IRCCS Istituto Ortopedico Rizzoli, Bologna, 40136, Italy
- Department of Biomedical and Neurimotor Science-DIBINEM, University of Bologna, Bologna, 40136, Italy
| | - Monica Cosentino
- Medical Technology Laboratory, IRCCS Istituto Ortopedico Rizzoli, Bologna, 40136, Italy
| | - Barbara Bordini
- Medical Technology Laboratory, IRCCS Istituto Ortopedico Rizzoli, Bologna, 40136, Italy
| | - Fabrizio Rivera
- Department of Orthopedic Trauma, SS Annunziata Hospital, Savigliano, 12038, Italy
| | - Cesare Faldini
- I Orthopedic and Traumatology Department, IRCCS Istituto Ortopedico Rizzoli, Bologna, 40136, Italy
- Department of Biomedical and Neurimotor Science-DIBINEM, University of Bologna, Bologna, 40136, Italy
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Min M, Xing C, Xu P, Wei X, Fan L. Case report: Formation and recurrence of inflammatory pseudotumor after metal-on-metal hip arthroplasty. Front Med (Lausanne) 2024; 11:1422230. [PMID: 39055697 PMCID: PMC11269118 DOI: 10.3389/fmed.2024.1422230] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2024] [Accepted: 06/17/2024] [Indexed: 07/27/2024] Open
Abstract
The metal-on-metal (MoM) artificial hip joint is a prosthesis used in early hip arthroplasty, particularly for hip resurfacing and total hip arthroplasty. However, abrasion and corrosion of MoM bearings result in the production of metal ions, such as cobalt and chromium, thereby inducing several complications such as inflammatory pseudotumor, aseptic inflammation, and allergy to metal ions (delayed type IV hypersensitivity). In this case report, we present a patient who was hospitalized for recurrence of a mass in the right inguinal area. In 2010, the patient underwent right MoM total hip arthroplasty for right femoral head necrosis and exhibited a good postoperative recovery. In 2019, the patient experienced pain in the right hip with activity limitation without any evident triggers, and a palpable mass was observed in the right inguinal area. A large periprosthetic mass was resected under general anesthesia, and the patient recovered well after the operation. Based on post-surgery imaging and pathological examinations, the mass was diagnosed as a periprosthetic inflammatory pseudotumor. In 2021, the inflammatory pseudotumor recurred at the same site. He then underwent right total hip revision surgery under epidural anesthesia and recovered well after surgery. No recurrence was noted at moderate follow-up. The incidence of inflammatory pseudotumors is high in MoM hip arthroplasty. Early revision is necessary in patients who meet the indications for revision, while regular postoperative follow-up is crucial.
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Affiliation(s)
| | | | | | | | - Lei Fan
- Department of Orthopedics, The Second Affiliated Hospital of Nanjing Medical University, Nanjing, China
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Yadav NK, Pradhan P, Pratap Singh MA, Kumar S, Yadav A. Evaluation of the Tensor Fascia Lata Muscle Pedicle Bone Grafting Technique in the Management of Avascular Necrosis of the Femoral Head: An Observational Clinical Study. Cureus 2024; 16:e64902. [PMID: 39156323 PMCID: PMC11330687 DOI: 10.7759/cureus.64902] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2023] [Accepted: 07/19/2024] [Indexed: 08/20/2024] Open
Abstract
BACKGROUND Osteonecrosis of the hip is defined as necrosis of the bone tissue due to some form of vascular insult, subsequently leading to the collapse of the femoral head and secondary osteoarthritis, which leads to pain and impaired joint function. This disease is widely known to affect middle-aged groups; however, in the Indian population, even younger people are more commonly affected. The disease has a debilitating effect on the activities of daily living (ADL) and the productivity of individuals and has financial consequences. With the increased utilization of magnetic resonance imaging (MRI) in society, the disease is diagnosed in its early stages. Hip-preserving surgery like tensor fascia lata (TFL) muscle pedicle iliac bone grafting should be given a chance to preserve the native femoral head. METHODOLOGY At a tertiary care teaching hospital in Gorakhpur, India, an observational clinical study was carried out. This study comprised 40 patients, ages 18-50 years, with femoral head osteonecrosis (stages II and III of the Ficat-Arlet staging system), who came to our institute's orthopedic outpatient department. Patients were treated with multiple drillings, curettage, and cheilectomy of the femoral head, in addition to TFL muscle pedicle bone grafting. The Harris hip score (HHS) was utilized to assess the clinical results, and the radiological assessment focused on signs of revascularization. RESULT In our study, the most prevalent age group was 20-30 years (67.5%), with a male predominance (85%). Among our cohort of 40 patients, the HHS indicated excellent outcomes (90-100) in 14 cases (35%), good outcomes (80-89) in 19 cases (47.5%), fair outcomes (70-79) in six cases (15%), and poor outcomes (<70) in one case (2.5%), at the time of the final follow-up. The final follow-up period varied from one to 10 years. CONCLUSION TFL muscle pedicle bone grafting procedure provides excellent clinical and radiological outcomes, especially in young patients in whom femoral head-preserving surgery is preferred over total hip arthroplasty. This procedure is effective in both early and advanced stages of femoral head osteonecrosis, provided there are no arthritic changes. It reduces symptoms and improves functional outcomes.
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Affiliation(s)
- Navin Kumar Yadav
- Department of Orthopaedics, Baba Raghav Das Medical College, Gorakhpur, IND
| | - Pavan Pradhan
- Department of Orthopaedics, Baba Raghav Das Medical College, Gorakhpur, IND
| | | | - Surendra Kumar
- Department of Orthopaedics, Baba Raghav Das Medical College, Gorakhpur, IND
| | - Ashok Yadav
- Department of Orthopaedics, Baba Raghav Das Medical College, Gorakhpur, IND
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Alsaleem M, Al Abdrabalnabi HA, Al Furaikh BF, Althafar NA. Total Hip Arthroplasty Following the Girdlestone Procedure in a Sickle Cell Disease Patient. Cureus 2024; 16:e65240. [PMID: 39184743 PMCID: PMC11342144 DOI: 10.7759/cureus.65240] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/24/2024] [Indexed: 08/27/2024] Open
Abstract
Sickle cell disease often leads to avascular necrosis (AVN) of the hip joint, resulting in joint pain and restricted range of motion. In cases where traditional treatments like total hip arthroplasty or core decompression may not suffice, the Girdlestone procedure, involving the resection of the femoral head, is considered. This case study centers on a 19-year-old male nursing student with sickle cell disease who underwent a Girdlestone procedure at 16 years of age, seeking relief from hip pain and limited mobility. However, the procedure led to leg length discrepancy and reduced hip function. Subsequent total hip arthroplasty successfully converted the prior procedure into a stable joint, improving the patient's range of motion and eliminating pain. The comprehensive surgical approach, including soft tissue releases and postoperative rehabilitation, significantly enhanced the patient's quality of life, emphasizing the importance of total hip arthroplasty as a superior intervention post-Girdlestone procedure.
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Affiliation(s)
- Mohammad Alsaleem
- Orthopedic Surgery, Al Moosa Specialist Hospital, Al-Ahsa, SAU
- Orthopedic Surgery, King Fahad Hospital in Al Hofuf, Al-Ahsa, SAU
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Alrashdi N, Motl R, Aguiar E, Lein Jr D, Perumean-Chaney S, Ryan M, Ithurburn M. Pre- and Post-Operative Pain Intensity and Physical Activity Levels in Individuals with Acetabular Dysplasia Undergoing Periacetabular Osteotomy: A Prospective Cohort Study. Int J Sports Phys Ther 2024; 19:692-703. [PMID: 38835978 PMCID: PMC11144661 DOI: 10.26603/001c.117403] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2023] [Accepted: 04/12/2024] [Indexed: 06/06/2024] Open
Abstract
Background Acetabular dysplasia (AD) causes pain, limited function, and development of early hip osteoarthritis. Periacetabular osteotomy (PAO) is a surgical treatment for AD that aims to reposition the acetabulum to reduce pain and improve function. Purpose To examine pain recovery and physical activity (PA) before and during the six months after PAO. Study Design Case series, prospective. Methods Individuals with AD scheduled for PAO were enrolled. Pain intensity was evaluated before PAO and at one week and one, three, and six months following PAO. PA levels was evaluated before and six months following PAO using accelerometers (time spent in sedentary behavior, light PA, moderate-to-vigorous PA [MVPA], and daily steps) and the International Physical Activity Questionnaire (IPAQ; time spent in walking and in MVPA). Pain improvements was examined over time following PAO using a repeated-measures one-way ANOVA as well as improvements in PA levels before and six months after PAO using paired-sample t tests. In addition, time spent in MVPA was qualitatively summarized at each time point (before and six months after PAO) measured by both the accelerometers and IPAQ. Results Out of 49 screened participants, 28 were enrolled, and 23 individuals (22 females; age=23.1±7.9 years) completed both study visits. Compared to pre-PAO pain, participants reported significant improvements in pain at one month and onward following PAO (p\<0.011). However, PA levels at six months following PAO did not differ from pre-PAO PA levels (p>0.05). Qualitatively, participants reported spending more time in MVPA recorded by the IPAQ (pre-PAO=73.3±150.2 mins/day; six-months after PAO=121.2±192.2 mins/day), compared with MVPA recorded by accelerometers (pre-PAO=22.6±25.2 mins/day; six-months after PAO=25.0±21.4 mins/day). Conclusions Individuals with AD reported significant pain reduction at one month and up to six months after PAO, but PA levels did not change six months after PAO compared to baseline testing. Future studies should consider examining longitudinal pain recovery and PA improvements over longer periods of time with larger samples of individuals with AD undergoing PAO and identifying modifiable factors to minimize pain and increase PA participation. Level of Evidence III.
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Affiliation(s)
- Naif Alrashdi
- 1. Department of Physical Therapy and Health Rehabilitation, College of Applied Medical Sciences, Majmaah University, Majmaah, 11952, Kingdom of Saudi ArabiaMajmaah University
| | - Robert Motl
- KinesiologyUniversity of Illinois at Chicago
| | | | | | | | - Michael Ryan
- Hip CenterAndrews Institute for Orthopaedics & Sports Medicine
| | - Matthew Ithurburn
- American Sports Medicine InstituteAmerican Sports Medicine Institute
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Gökşen A, Çaylak R, Çekok FK, Kahraman T. Translation, cross-cultural adaptation, reliability, and convergent and known-group validity of the Turkish full version of the Hip Disability and Osteoarthritis Outcome Score in patients with hip osteoarthritis. Arch Rheumatol 2024; 39:180-193. [PMID: 38933727 PMCID: PMC11196225 DOI: 10.46497/archrheumatol.2024.10197] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2023] [Accepted: 08/31/2023] [Indexed: 06/28/2024] Open
Abstract
Objectives The study aimed to culturally adapt the full version of the Hip Disability and Osteoarthritis Outcome Score (HOOS) into Turkish and evaluate its reliability and validity. Patients and methods Patients with hip osteoarthritis were included in the methodological crosscultural adaptation study between May 2022 and December 2022. We translated and adapted the HOOS into a Turkish version and validated it in a cohort of native Turkish-speaking patients with hip osteoarthritis. The HOOS includes five subscales named symptoms, pain, activities of daily living (ADL), sport and recreation (Sport/Rec), and quality of life (QoL). The psychometric properties of the Turkish HOOS were assessed. The reliability was investigated using test-retest reliability (intraclass correlation coefficient; ICC) and internal consistency methods (Cronbach's alpha). The convergent validity of the Turkish HOOS was evaluated by testing the predefined hypotheses using the correlations with the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) and the European Quality of Life Scale (EQ-5D-3L), a generic QoL scale. Results A total of 202 patients (131 females, 71 males; mean age: 55.2±9.7 years; range, 50 to 70 years) were recruited for the study. Cronbach's alpha values for each subscale of the HOOS were as follows: symptoms=0.76, pain=0.94, ADL=0.96, Sport/Rec=0.87, QoL=0.78, and total score=0.98, indicating it has high internal consistency. For all subscales and total score of the HOOS, the ICC values were between 0.77 and 0.86, indicating good to excellent test-retest reliability. All correlations between each subscale and total score of the Turkish HOOS, WOMAC, and EQ-5D-3L were moderate to strong. Therefore, 23 predefined hypotheses out of 24 were confirmed with a confirmation rate of 96%, indicating the Turkish version of the HOOS had adequate convergent validity. Conclusion This study shows that the Turkish version of the HOOS has a convergent and knowngroup validity, internal consistency, and test-retest reliability. It can be used to assess the patient's perception of their hip and associated difficulties, as well as their symptoms and functional limitations.
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Affiliation(s)
- Ayşenur Gökşen
- Department of Physiotherapy and Rehabilitation, Faculty of Health Sciences, Tarsus University, Mersin, Türkiye
| | - Remzi Çaylak
- Acıbadem Adana Ortopedia Hospital, Adana, Türkiye
| | - Fatma Kübra Çekok
- Department of Physiotherapy and Rehabilitation, Faculty of Health Sciences, Tarsus University, Mersin, Türkiye
| | - Turhan Kahraman
- Department of Health Professions, Faculty of Health and Education, Manchester Metropolitan University, Manchester, United Kingdom
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11
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Miley EN, Pickering MA, Cheatham SW, Larkins LW, Cady AC, Baker RT. Longitudinal Analysis and Latent Growth Modeling of the Modified Hip Dysfunction and Osteoarthritis Outcome Score for Joint Replacement (HOOS-JR). Healthcare (Basel) 2024; 12:1024. [PMID: 38786432 PMCID: PMC11121473 DOI: 10.3390/healthcare12101024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2024] [Revised: 05/07/2024] [Accepted: 05/13/2024] [Indexed: 05/25/2024] Open
Abstract
The Hip Dysfunction and Osteoarthritis Outcome Score for Joint Replacement (HOOS-JR) was developed as a short-form survey to measure progress after total hip arthroplasty (THA). However, the longitudinal validity of the scale structure pertaining to the modified five-item HOOS-JR has not been assessed. Therefore, the purpose of this study was to evaluate the structural validity, longitudinal invariance properties, and latent growth curve (LGC) modeling of the modified five-item HOOS-JR in a large multi-site sample of patients who underwent a THA. A longitudinal study was conducted using data from the Surgical Outcome System (SOS) database. Confirmatory factor analyses (CFAs) were conducted to assess the structural validity and longitudinal invariance across five time points. Additionally, LGC modeling was performed to assess the heterogeneity of the recovery patterns for different subgroups of patients. The resulting CFAs met most of the goodness-of-fit indices (CFI = 0.964-0.982; IFI = 0.965-0.986; SRMR = 0.021-0.035). Longitudinal analysis did not meet full invariance, exceeding the scalar invariance model (CFIDIFF = 0.012; χ2DIFF test = 702.67). Partial invariance requirements were met upon release of the intercept constraint associated with item five (CFIDIFF test = 0.010; χ2DIFF = 1073.83). The equal means model did not pass the recommended goodness-of-fit indices (CFIDIFF = 0.133; χ2DIFF = 3962.49). Scores significantly changed over time, with the highest scores identified preoperatively and the lowest scores identified at 2- and 3-years postoperatively. Upon conclusion, partial scalar invariance was identified within our model. We identified that patients self-report most improvements in their scores within 6 months postoperatively. Females reported more hip disability at preoperative time points and had faster improvement as measured by the scores of the modified five-item HOOS-JR.
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Affiliation(s)
- Emilie N. Miley
- Department of Orthopaedic Surgery and Sports Medicine, University of Florida, Gainesville, FL 32607, USA;
| | - Michael A. Pickering
- Department of Movement Sciences, University of Idaho, Moscow, ID 83844, USA; (M.A.P.); (S.W.C.); (L.W.L.)
| | - Scott W. Cheatham
- Department of Movement Sciences, University of Idaho, Moscow, ID 83844, USA; (M.A.P.); (S.W.C.); (L.W.L.)
| | - Lindsay W. Larkins
- Department of Movement Sciences, University of Idaho, Moscow, ID 83844, USA; (M.A.P.); (S.W.C.); (L.W.L.)
| | - Adam C. Cady
- Kaiser Permanente, Woodland Hills, CA 91367, USA;
| | - Russell T. Baker
- WWAMI Medical Education Program, University of Idaho, Moscow, ID 83844, USA
- Idaho Office of Underserved and Rural Medical Research, University of Idaho, Moscow, ID 83844, USA
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12
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Ibrahim MAA, Elgahel MM, Gouda SA, Hassaan MM, Khired ZA, Aljonaid M, Rohayem M. Modified one third tubular plate (spring plate) augmented with reconstruction plates for treatment of comminuted posterior wall acetabular fractures, Short to midterm outcomes of 24 patients. Orthop Rev (Pavia) 2024; 16:116902. [PMID: 38751451 PMCID: PMC11093749 DOI: 10.52965/001c.116902] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/15/2024] [Accepted: 03/24/2024] [Indexed: 05/18/2024] Open
Abstract
The most common form of acetabular fracture is believed to be the posterior wall; its incidence ranges from 25% to 47%. Managing such fractures has been difficult in the past and until recently. To obtain a favorable functional outcome, an accurate diagnosis and a well-executed treatment strategy are essential. Objective To evaluate the clinical and functional outcomes of employing a spring plate augmented by a traditional 3.5 mm reconstruction plate for the treatment of comminuted posterior wall acetabular fractures. Patients and Methods A prospective case series was performed on 24 patients with comminuted fractures of the posterior wall. After an average of 6 days, the patients underwent surgery. Eighteen patients were fixed with one spring plate, six patients were fixed with two spring plates, and all were reinforced with a 3.5-mm reconstruction plate. Each case was followed once every three months until the fracture healed and then regularly every six months thereafter. Results There were 21 men and 3 women. The average follow-up period was 14 months, and the median age was 34.5 years. The main reason for injuries was motor vehicle collisions. The mean operation time was 107.5 min. The clinical results were evaluated by the MAP and m HHS, and the means were 10.2 (5-12) and 86 (64-96), respectively. Only two patients developed avascular necrosis and were treated by total hip replacement, another three (12.5%) had mild arthritis. Conclusion Comminuted acetabulum posterior wall fractures can be stabilized with spring plates. It could be used in conjunction with the primary reconstruction plate as a viable alternative for stable and anatomical reduction. High patient satisfaction and good functional results make this approach effective.
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Affiliation(s)
| | | | | | | | | | - Maamon Aljonaid
- orthopedic departmentking Faisal specialty hospital& research center-Madina, Saudi Arabia
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13
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Chen S, Fu K, Cai Q, Feng Y, He H, Gao Y, Zhu Z, Jin D, Sheng J, Zhang C. Development of a risk-predicting score for hip preservation with bone grafting therapy for osteonecrosis. iScience 2024; 27:109332. [PMID: 38500832 PMCID: PMC10946322 DOI: 10.1016/j.isci.2024.109332] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2023] [Revised: 12/02/2023] [Accepted: 02/21/2024] [Indexed: 03/20/2024] Open
Abstract
Identification and differentiation of appropriate indications on hip preserving with bone grafting therapy remains a crucial challenge in the treatment of osteonecrosis of the femoral head (ONFH). A prospective cohort study on bone grafting therapy for ONFH aimed to evaluate hip survival rates, and to establish a risk scoring derived from potential risk factors (multivariable model) for hip preservation. Eight variables were identified to be strongly correlated with a decreased rate of hip survival post-therapy, and a comprehensive risk scoring was developed for predicting hip-preservation outcomes. The C-index stood at 0.72, and the areas under the receiver operating characteristics for the risk score's 5- and 10-year hip failure event predictions were 0.74 and 0.72, respectively. This risk score outperforms conventional methods in forecasting hip preservation. Bone grafting shows sustained benefits in treating ONFH when applied under the right indications. Furthermore, the risk scoring proves valuable as a decision-making tool, facilitating risk stratification for ONFH treatments in future.
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Affiliation(s)
- Shengbao Chen
- Institute of Microsurgery on Extremities, and Department of Orthopedic Surgery, Shanghai Sixth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, National Center for Orthopaedics, Shanghai 200233, China
| | - Kai Fu
- Institute of Microsurgery on Extremities, and Department of Orthopedic Surgery, Shanghai Sixth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, National Center for Orthopaedics, Shanghai 200233, China
| | - Qianying Cai
- Institute of Microsurgery on Extremities, and Department of Orthopedic Surgery, Shanghai Sixth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, National Center for Orthopaedics, Shanghai 200233, China
| | - Yong Feng
- Institute of Microsurgery on Extremities, and Department of Orthopedic Surgery, Shanghai Sixth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, National Center for Orthopaedics, Shanghai 200233, China
| | - Haiyan He
- Institute of Microsurgery on Extremities, and Department of Orthopedic Surgery, Shanghai Sixth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, National Center for Orthopaedics, Shanghai 200233, China
| | - Yun Gao
- Institute of Microsurgery on Extremities, and Department of Orthopedic Surgery, Shanghai Sixth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, National Center for Orthopaedics, Shanghai 200233, China
| | - Zhenzhong Zhu
- Institute of Microsurgery on Extremities, and Department of Orthopedic Surgery, Shanghai Sixth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, National Center for Orthopaedics, Shanghai 200233, China
| | - Dongxu Jin
- Institute of Microsurgery on Extremities, and Department of Orthopedic Surgery, Shanghai Sixth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, National Center for Orthopaedics, Shanghai 200233, China
| | - Jiagen Sheng
- Institute of Microsurgery on Extremities, and Department of Orthopedic Surgery, Shanghai Sixth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, National Center for Orthopaedics, Shanghai 200233, China
| | - Changqing Zhang
- Institute of Microsurgery on Extremities, and Department of Orthopedic Surgery, Shanghai Sixth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, National Center for Orthopaedics, Shanghai 200233, China
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14
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Rose-Dulcina K, Gasparutto X, Djebara AE, Gauthier M, Zingg M, Lübbeke A, Armand S, Hannouche D. Reliability of the Harris Hip limping sub-score in patients undergoing total hip arthroplasty. INTERNATIONAL ORTHOPAEDICS 2024; 48:991-996. [PMID: 38217721 PMCID: PMC10933184 DOI: 10.1007/s00264-023-06082-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/18/2023] [Accepted: 12/22/2023] [Indexed: 01/15/2024]
Abstract
PURPOSE In patients undergoing total hip arthroplasty, limping is a significant symptom, often assessed with the limping sub-score of the Harris Hip Score. However, the reliability of this sub-score has not been specifically investigated. The purpose of this study is to investigate the intra- and inter-rater reliability of this sub-score. METHODS Thirty patients undergoing THA were recruited and performed a gait analysis before surgery and three months after surgery. In addition, 30 asymptomatic participants were included. In total, 90 visits were analysed in this study. The HHS limping sub-score was assessed for each visit using a video (front and back view side-by-side) of a ten metre walk at a self-selected speed. Two orthopaedic surgeons evaluated the limping of each video in two different grading sessions with a one week delay. To avoid recall bias, the patient's number identity was randomized and different for each grading session and each rater. The weighted Cohen's Kappa coefficient was used to quantify the intra- and inter-reliability. The reliability of three components was studied: the presence of limping, its severity, and the compensation type. RESULTS For all components, the agreement for intra-rater reliability ranged from moderate to strong and from none to moderate for the inter-rater reliability. CONCLUSION These results do not encourage the use of HHS-limping sub-score for data involving different raters in both clinical and research contexts. It calls for improved consensus on limping definitions or the creation of objective measures.
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Affiliation(s)
- Kevin Rose-Dulcina
- Kinesiology Laboratory, Geneva University Hospitals and University of Geneva, Geneva, Switzerland.
| | - Xavier Gasparutto
- Kinesiology Laboratory, Geneva University Hospitals and University of Geneva, Geneva, Switzerland
| | - Az-Eddine Djebara
- Division of Orthopaedics and Trauma Surgery, Geneva University Hospitals and University of Geneva, Geneva, Switzerland
| | - Morgan Gauthier
- Division of Orthopaedics and Trauma Surgery, Geneva University Hospitals and University of Geneva, Geneva, Switzerland
| | - Matthieu Zingg
- Division of Orthopaedics and Trauma Surgery, Geneva University Hospitals and University of Geneva, Geneva, Switzerland
| | - Anne Lübbeke
- Division of Orthopaedics and Trauma Surgery, Geneva University Hospitals and University of Geneva, Geneva, Switzerland
- Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, UK
| | - Stéphane Armand
- Kinesiology Laboratory, Geneva University Hospitals and University of Geneva, Geneva, Switzerland
| | - Didier Hannouche
- Division of Orthopaedics and Trauma Surgery, Geneva University Hospitals and University of Geneva, Geneva, Switzerland
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15
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Zhu H, You M, Wei J, Fang S. Orem's Self-Care Model of Nursing Care: A Retrospective Study with Elders After Hip Arthroplasty. Nurs Sci Q 2024; 37:148-153. [PMID: 38491876 DOI: 10.1177/08943184231224470] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/18/2024]
Abstract
This retrospective study investigates the effectiveness of a nursing intervention based on Orem's self-care model of nursing with elderly patients with femoral head necrosis who underwent total hip arthroplasty. Postoperative outcomes in the intervention and control groups were assessed by the visual analog scale (VAS), Barthel index, and Harris Hip Score (HHS). Participants in the intervention group had significantly better outcomes in terms of VAS, Barthel index, and HHS. The occurrence of pneumonia was significantly different between the groups. Those who underwent Orem's self-care model of nursing intervention were highly satisfied with their status postoperatively compared with the control group.
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Affiliation(s)
- Huixin Zhu
- Nursing Department, National Regional Medical Center, Binhai Campus of the First Affiliated Hospital, Fujian Medical University, Fuzhou, Fujian, China
- Department of Surgical Care Center, the First Affiliated Hospital of Fujian Medical University, Fuzhou, Fujian, China
| | - Mengqiang You
- Department of Sports Medicine, National Regional Medical Center, Binhai Campus of the First Affiliated Hospital, Fujian Medical University, Fuzhou, Fujian, China
| | - Jie Wei
- Department of Sports Medicine, National Regional Medical Center, Binhai Campus of the First Affiliated Hospital, Fujian Medical University, Fuzhou, Fujian, China
| | - Shanhong Fang
- Department of Sports Medicine, National Regional Medical Center, Binhai Campus of the First Affiliated Hospital, Fujian Medical University, Fuzhou, Fujian, China
- Department of Orthopedic Surgery, the First Affiliated Hospital, Fujian Medical University, Fuzhou, Fujian, China
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16
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Weenders SGM, Merfort R, Eschweiler J, Hildebrand F, Gruner A, Heller KD. Ten-year follow-up and clinical outcome of a metaphyseal anchoring short hip stem prosthesis: a retrospective single-centre analysis. INTERNATIONAL ORTHOPAEDICS 2024; 48:419-426. [PMID: 37672119 DOI: 10.1007/s00264-023-05958-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/22/2023] [Accepted: 08/24/2023] [Indexed: 09/07/2023]
Abstract
PURPOSE Short stems for total hip arthroplasty are an alternative to traditional conventional long stems. Short stems are designed to facilitate minimal-invasive surgery, improve bone-stock preservation, and mimic a physiological load distribution. However, there is little evidence of the long-term outcome of short stems. This study aims to analyze the ten year survival rates and clinical outcome of one specific metaphyseal short hip stem implant. METHODS We retrospectively analyzed the patient records of the patients who underwent a total hip arthroplasty with a monoblock partial collum sparing metaphyseal short hip stem prosthesis in 2008 and 2009 in our clinic. Patients were contacted, and clinical follow-up was recorded using the German version of the modified Harris Hip Score. Furthermore, complications, revision surgery, and post-operative radiographs were analyzed. RESULTS Data from 339 primary implantations in 322 patients were retrieved. The mean follow-up was 10.6 years. Seven patients underwent a revision. The ten year survival rate with any revision surgery as the endpoint was 97.5%. The mean modified Harris Hip Score was 86 points (range 30 to 91 points). Five patients had an intraoperative fracture of the femur (1.6%). Two patients (0.6%) had a dislocation of the hip. The stem tip-to-cortex distance, measured in the anterior posterior view, was 2.6 mm (range 0 to 8.3 mm). CONCLUSION The ten year survival rate of our used monoblock partial collum sparing metaphyseal short hip stem implant is comparable to traditional stems for total hip arthroplasty.
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Affiliation(s)
- S G M Weenders
- Clinic for Orthopaedic Surgery, Herzogin Elisabeth Hospital, Leipzigerstraße 24, 38124, Braunschweig, Germany.
| | - R Merfort
- Department of Orthopaedics, Trauma and Reconstructive Surgery, University Hospital RWTH Aachen, Aachen, Germany
| | - J Eschweiler
- Department of Orthopaedics, Trauma and Reconstructive Surgery, University Hospital RWTH Aachen, Aachen, Germany
| | - F Hildebrand
- Department of Orthopaedics, Trauma and Reconstructive Surgery, University Hospital RWTH Aachen, Aachen, Germany
| | - A Gruner
- Clinic for Orthopaedic Surgery, Herzogin Elisabeth Hospital, Leipzigerstraße 24, 38124, Braunschweig, Germany
| | - K D Heller
- Clinic for Orthopaedic Surgery, Herzogin Elisabeth Hospital, Leipzigerstraße 24, 38124, Braunschweig, Germany
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17
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Bialaszewski R, Gaddis J, Laboret B, Bergman E, Mulligan EP, LaCross J, Stewart A, Wells J. Perceived outcomes of periacetabular osteotomy. Bone Jt Open 2024; 5:53-59. [PMID: 38240364 PMCID: PMC10797643 DOI: 10.1302/2633-1462.51.bjo-2023-0093.r1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/22/2024] Open
Abstract
Aims Social media is a popular resource for patients seeking medical information and sharing experiences. periacetabular osteotomy (PAO) is the gold-standard treatment for symptomatic acetabular dysplasia with good long-term outcomes. However, little is known regarding the perceived outcomes of PAO on social media. The aims of this study were to describe the perceived outcomes following PAO using three social media platforms: Facebook, Instagram, and X (formerly known as Twitter). Methods Facebook, Instagram, and X posts were retrospectively collected from 1 February 2023. Facebook posts were collected from the two most populated interest groups: "periacetabular osteotomy" and "PAO Australia." Instagram and X posts were queried using the most popular hashtags: #PAOwarrior, #periacetabularosteotomy, #periacetabularosteotomyrecovery, #PAOsurgery, and #PAOrecovery. Posts were assessed for demographic data (sex, race, location), perspective (patient, physician, professional organization, industry), timing (preoperative vs postoperative), and perceived outcome (positive, negative, neutral). Results A total of 1,054 Facebook posts, 1,003 Instagram posts, and 502 X posts were consecutively assessed from 887 unique authors. The majority (63.3%) of these posts were from patients in the postoperative period, with a median of 84 days postoperatively (interquartile range 20 to 275). The longest follow-up timeframe postoperatively was 20 years. Regarding perceived outcomes, 52.8% expressed satisfaction, 39.7% held neutral opinions, and 7.5% were dissatisfied. Most dissatisfied patients (50.9%) reported pain (chronic or uncontrolled acute) as an attributing factor. Conclusion Most PAO-perceived surgical outcomes on social media had a positive tone. Findings also indicate that a small percentage of patients reported negative perceived outcomes. However, dissatisfaction with PAO primarily stemmed from postoperative pain. Social media posts from other sources (physicians, hospitals, professional organizations, etc.) trend towards neutrality. Healthcare providers must consider the social media narratives of patients following PAO, as they may reveal additional outcome expectations and help improve patient-centred care, create informed decision-making, and optimize treatment outcomes.
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Affiliation(s)
- Ryan Bialaszewski
- The University of Texas Rio Grande Valley School of Medicine, Edinburg, Texas, USA
| | - John Gaddis
- The University of Texas Rio Grande Valley School of Medicine, Edinburg, Texas, USA
| | - Bretton Laboret
- University of Texas Southwestern Medical Center, Dallas, Texas, USA
| | | | | | | | - Adina Stewart
- Baylor Scott & White Hip Preservation Center and Comprehensive Hip Center, McKinney, Texas, USA
| | - Joel Wells
- Baylor Scott & White Hip Preservation Center and Comprehensive Hip Center, McKinney, Texas, USA
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Zhao Y, Sun W, Wang C, Xie X, Feng G. Comparison of clinical outcomes of supercapsular percutaneously-assisted approach total hip arthroplasty versus conventional posterior approach for total hip arthroplasty in adults: a systematic review and meta-analysis. BMC Musculoskelet Disord 2024; 25:25. [PMID: 38166873 PMCID: PMC10759432 DOI: 10.1186/s12891-023-07126-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/16/2023] [Accepted: 12/16/2023] [Indexed: 01/05/2024] Open
Abstract
OBJECTIVE This meta-analysis was aimed to compare the postoperative clinical outcomes between the supercapsular percutaneously assisted total hip (SuperPATH, SP) and conventional posterior/posterolateral approach (PA) for total hip arthroplasty in patients who have failed conservative treatment for hip-related disorders. METHODS PRISMAP guidelines were followed in this systematic review. CNKI, Wanfang, PubMed, Embase, Cochrane, Web of Science databases and the reference list grey literature were searched for studies according to the search strategy. Endnote (version 20) was used to screen the searched studies according to the inclusion and exclusion criterias and extract the data from the eligible studied. RR and 95% CI were used for dichotomous variables and MD and 95% CI were used for continuous variables. All analyses and heterogeneity of outcomes were analysed by Review Manage (version 5.4). Publication bias of included studies was analysed by Stata (version 16.0). RESULTS Thirty-six randomized control studies were included. Compared to PA group, SP group had a shorter incision length, less intraoperative blood loss, a shorter length of hospital stay and do activities earlier. Hip function (HHS) was significantly improved within three months postoperatively. Pain of hip (VAS) was significantly reduced within one month postoperatively. The state of daily living (BI) was significantly improved within three months. Patients' overall health status (SF-36) improved significantly postoperatively. There was no difference in postoperative complications between the two approaches. PA had a shorter operative time and a higher accuracy of prosthesis placement. CONCLUSION The advantages of SuperPATH include accelerated functional recovery and less trauma associated with surgery. However, it required a longer operative time and implantation of the prosthesis was less accurate than that of PA.
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Affiliation(s)
- Yize Zhao
- Department of Orthopedic Surgery and Orthopedic Research Institute, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Wenchen Sun
- Anhui Medical University, Hefei, Anhui, China
| | - Chen Wang
- Anhui Medical University, Hefei, Anhui, China
| | - Xinyi Xie
- Anhui Medical University, Hefei, Anhui, China
| | - Ganjun Feng
- Department of Orthopedic Surgery and Orthopedic Research Institute, West China Hospital, Sichuan University, Chengdu, Sichuan, China.
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Qoreishy M, Movahedinia M, Keyhani S, Salehi B, Goodarzi M, Naghibi B. Evaluation of changes in radiographic spinopelvic parameters after primary total hip arthroplasty and its relationship with short-term patient function. EUROPEAN JOURNAL OF ORTHOPAEDIC SURGERY & TRAUMATOLOGY : ORTHOPEDIE TRAUMATOLOGIE 2024; 34:225-230. [PMID: 37428225 DOI: 10.1007/s00590-023-03639-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/16/2022] [Accepted: 06/29/2023] [Indexed: 07/11/2023]
Abstract
PURPOSE Total hip arthroplasty (THA) is commonly used worldwide in pelvic osteoarthritis treatment. This surgery can change the spinopelvic parameters, which in turn affects the performance of the patients after surgery. However, the relationship between functional disability following THA and spinopelvic alignment is not completely understood. The limited available studies have also been conducted on the population with spinopelvic malalignments. This study aimed to examine the changes in spinopelvic parameters after primary THA in patients with normal preoperative spinopelvic characteristics and the association of these parameters with the performance, gender, and age of the patients after THA. METHODS Fifty-eight eligible patients with unilateral primary hip osteoarthritis (HOA) scheduled for total hip arthroplasty between February and September 2021 were studied. Spinopelvic parameters including pelvic incidence (PI), sacral slope (SS), and pelvic tilt (PT) were measured before surgery and three months after surgery, and the relationship between these parameters and patients' performance (Harris hip score) was assessed. Also, the relationship between the age and gender of the patients with these parameters was evaluated. RESULTS The mean age of study participants was 46.03 ± 14.25. Three months after THA, sacral slope decreased with the mean difference of 4.31 ± 10.26 degrees (p = 0.002) and Harris hip score (HHS) increased by 19.41 ± 26.55 points (p < 0.001). With increasing age in patients, the mean SS and PT decreased. Among the spinopelvic parameters, SS (β = 0.11) had a greater effect than PT on postoperative HHS changes and among the demographic parameters, age (β = -0.18) had a greater effect on HHS changes than gender. CONCLUSION Spinopelvic parameters are associated with age, gender, and patient's function after THA as sacral slope decreased and HHS increased after THA, and aging is accompanied by lowering of PT and SS.
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Affiliation(s)
- Mohamad Qoreishy
- Orthopedic Department, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Mohamad Movahedinia
- Orthopedic Department, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Sohrab Keyhani
- Bone Joint and Related Tissues Research Center, Akhtar Orthopedic Hospital, Shahid Beheshti University of Medical Sciences, Sharifi Manesh Street, Shariati Street, Tehran, Iran
| | - Bentolhoda Salehi
- Medicine Faculty, Kerman University of Medical Sciences, Kerman, Iran
| | - Mitra Goodarzi
- Bone Joint and Related Tissues Research Center, Akhtar Orthopedic Hospital, Shahid Beheshti University of Medical Sciences, Sharifi Manesh Street, Shariati Street, Tehran, Iran
| | - Bahram Naghibi
- Bone Joint and Related Tissues Research Center, Akhtar Orthopedic Hospital, Shahid Beheshti University of Medical Sciences, Sharifi Manesh Street, Shariati Street, Tehran, Iran.
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Kokic T, Pavic R, Vuksanic M, Jelica S, Sumanovac A, Banic T, Ostović H, Sklempe Kokic I. Effects of Electromyographic Biofeedback-Assisted Exercise on Functional Recovery and Quality of Life in Patients after Total Hip Arthroplasty: A Randomized Controlled Trial. J Pers Med 2023; 13:1716. [PMID: 38138943 PMCID: PMC10744500 DOI: 10.3390/jpm13121716] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2023] [Revised: 12/07/2023] [Accepted: 12/13/2023] [Indexed: 12/24/2023] Open
Abstract
The goal of the trial was to examine the effects of adding electromyographic biofeedback (EMG-BF) to the conventional program of physiotherapy after total hip arthroplasty (THA) on functional recovery and quality of life. The trial was designed as a prospective, interventional, single-blinded randomized controlled study. Ninety patients were randomized into an experimental group (EG) (n = 45; mean age 63.9 ± 8.8) and control group (CG) (n = 45; mean age 63.9 ± 9). All patients received 21 days of physiotherapy which consisted of therapeutic exercise (land-based and aquatic), electrotherapy, and education. Electromyographic biofeedback was added to a portion of the land-based exercise in EG. The Hip Disability and Osteoarthritis Outcome Score (HOOS), Numeric Rating Scale (NRS), Short Form Health Survey-36 (SF-36), use of a walking aid, 30 s chair stand test (CST) as well as the Timed Up and Go (TUG) test were used for outcome measurement. A higher proportion of the participants in both groups did not need a walking aid after the intervention (p < 0.05). All participants improved their 30 s CST and TUG results (p < 0.001), as well as their NRS and HOOS scores (p < 0.05). No significant differences between the groups were found. There were no additional benefits from adding EMG-BF to the conventional physiotherapy protocol.
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Affiliation(s)
- Tomislav Kokic
- Faculty of Medicine, Josip Juraj Strossmayer University of Osijek, 31000 Osijek, Croatia
- Orthopaedics and Trauma Department, General County Hospital Vinkovci, 32100 Vinkovci, Croatia
- Faculty of Kinesiology Osijek, Josip Juraj Strossmayer University of Osijek, 31000 Osijek, Croatia
| | - Roman Pavic
- Faculty of Medicine, Josip Juraj Strossmayer University of Osijek, 31000 Osijek, Croatia
- Clinical Hospital of Traumatology, University Hospital Centre “Sestre Milosrdnice”, 10000 Zagreb, Croatia
| | - Matko Vuksanic
- Bizovacke Toplice Rehabilitation Hospital, 31222 Bizovac, Croatia
- Department of Health Studies, College of Applied Sciences “Lavoslav Ruzicka” in Vukovar, 32000 Vukovar, Croatia
| | - Stjepan Jelica
- Department of Health Studies, College of Applied Sciences “Lavoslav Ruzicka” in Vukovar, 32000 Vukovar, Croatia
| | - Antun Sumanovac
- Faculty of Medicine, Josip Juraj Strossmayer University of Osijek, 31000 Osijek, Croatia
- Orthopaedics and Trauma Department, General County Hospital Vinkovci, 32100 Vinkovci, Croatia
| | - Tihomir Banic
- Faculty of Medicine, University of Zagreb, 10000 Zagreb, Croatia
- Department of Surgery, University Hospital Centre Zagreb, 10000 Zagreb, Croatia
| | - Helena Ostović
- Faculty of Medicine, Josip Juraj Strossmayer University of Osijek, 31000 Osijek, Croatia
- Clinical Department of Anesthesiology, Reanimatology and Intensive Care Medicine, University Hospital Dubrava, 10000 Zagreb, Croatia
| | - Iva Sklempe Kokic
- Faculty of Kinesiology Osijek, Josip Juraj Strossmayer University of Osijek, 31000 Osijek, Croatia
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21
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Jurewicz A, Dziedziejko V, Rać M, Białecka M, Safranow K, Kurzawski M, Malinowski D, Bosiacki M, Leźnicka K, Bohatyrewicz A, Białecka M, Droździk M, Machoy-Mokrzyńska A. Level of Disability after Total Hip Replacement in Patients with Some COMT Gene Polymorphism. J Clin Med 2023; 12:7652. [PMID: 38137720 PMCID: PMC10743937 DOI: 10.3390/jcm12247652] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2023] [Revised: 12/05/2023] [Accepted: 12/11/2023] [Indexed: 12/24/2023] Open
Abstract
BACKGROUND The COMT gene encodes the enzyme catechol-O-methyltransferase, which is a key modulator of dopaminergic and adrenergic neurotransmission. Hip osteoarthritis is accompanied by reduced mobility and some level of disability. In our study, we analyzed the association between some COMT gene polymorphisms and reduced mobility in patients after total hip replacement (THR). METHODS The operative procedures were performed on 195 patients with symptomatic and radiologically advanced hip osteoarthritis. In the postoperative follow-up, we assessed hip function with the Harris Hip Score (HHS) and the degree of disability with the Oswestry Disability Index (ODI). These procedures were repeated three times at defined intervals (one week, six weeks, and six months) after the total hip replacement. Genomic DNA was extracted from peripheral blood. SNPs in the COMT genes rs4680:A>G, rs6269:A>G, rs4633:C>T, and rs4818:C>G were genotyped. RESULTS Our findings suggest an association between COMT gene variability and the level of disability measured by the Oswestry Disability Index (ODI) in patients after total hip replacement (THR). CONCLUSIONS A higher number of COMT G alleles (rs4818) is an independent factor in a significant reduction in disability degree at both one week and six months after total hip replacement (THR), regardless of age or gender.
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Affiliation(s)
- Alina Jurewicz
- Department of Specialistic Nursing, Pomeranian Medical University, Żołnierska St. 48, 71-210 Szczecin, Poland;
| | - Violetta Dziedziejko
- Department of Biochemistry and Medical Chemistry, Pomeranian Medical University, Al. Powstańców Wielkopolskich 72 St., 70-111 Szczecin, Poland; (V.D.); (K.S.)
| | - Monika Rać
- Department of Biochemistry and Medical Chemistry, Pomeranian Medical University, Al. Powstańców Wielkopolskich 72 St., 70-111 Szczecin, Poland; (V.D.); (K.S.)
| | - Marta Białecka
- Department of Pharmacology, Pomeranian Medical University, Al. Powstańców Wielkopolskich 72 St., 70-111 Szczecin, Poland; (M.B.); (M.K.); (D.M.); (M.D.)
| | - Krzysztof Safranow
- Department of Biochemistry and Medical Chemistry, Pomeranian Medical University, Al. Powstańców Wielkopolskich 72 St., 70-111 Szczecin, Poland; (V.D.); (K.S.)
| | - Mateusz Kurzawski
- Department of Pharmacology, Pomeranian Medical University, Al. Powstańców Wielkopolskich 72 St., 70-111 Szczecin, Poland; (M.B.); (M.K.); (D.M.); (M.D.)
| | - Damian Malinowski
- Department of Pharmacology, Pomeranian Medical University, Al. Powstańców Wielkopolskich 72 St., 70-111 Szczecin, Poland; (M.B.); (M.K.); (D.M.); (M.D.)
| | - Mateusz Bosiacki
- Department of Functional Diagnostics and Physical Medicine, Pomeranian Medical University in Szczecin, Żołnierska St. 54, 71-210 Szczecin, Poland;
| | - Katarzyna Leźnicka
- Faculty of Physical Education, Gdansk University of Physical Education and Sport, K. Górskiego St. 1, 80-336 Gdansk, Poland;
| | - Andrzej Bohatyrewicz
- Department of Orthopedics, Traumatology and Musculoskeletal Oncology, Pomeranian Medical University, Unii Lubelskiej St. 1, 71-252 Szczecin, Poland;
| | - Monika Białecka
- Department of Pharmacology, Pomeranian Medical University, Al. Powstańców Wielkopolskich 72 St., 70-111 Szczecin, Poland; (M.B.); (M.K.); (D.M.); (M.D.)
| | - Marek Droździk
- Department of Pharmacology, Pomeranian Medical University, Al. Powstańców Wielkopolskich 72 St., 70-111 Szczecin, Poland; (M.B.); (M.K.); (D.M.); (M.D.)
| | - Anna Machoy-Mokrzyńska
- Department of Pharmacology, Pomeranian Medical University, Al. Powstańców Wielkopolskich 72 St., 70-111 Szczecin, Poland; (M.B.); (M.K.); (D.M.); (M.D.)
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22
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Lal JV, Tontanahal S, Francis J, Philip KM, Lj R, Kurian BT. Functional Outcome of Varus Derotation Osteotomy in Legg-Calve-Perthes Disease: Can It Be Justified in Late-Presenting Disease? Cureus 2023; 15:e49788. [PMID: 38161572 PMCID: PMC10757815 DOI: 10.7759/cureus.49788] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/21/2023] [Indexed: 01/03/2024] Open
Abstract
BACKGROUND Legg-Calve-Perthes disease (LCPD) in children older than seven years has often been associated with accelerated progress and poor outcome. The results of varus derotation osteotomy (VDRO) of the proximal femur in this cohort are not consistently predictable. This study was aimed at assessing the functional outcome of VDRO for hip containment in children with late-presenting LCPD. MATERIALS AND METHODS A quasi-prospective observational study was conducted to determine the functional outcomes of children with late-presenting unilateral LCPD who underwent VDRO between 2016 and 2021, with a minimum follow-up of two years. A retrospective chart review followed by a patient/parent-reported outcome measure using the Paediatric Outcome Data Collection Instrument (PODCI) was utilised. RESULTS Thirteen children were included in this study, with a mean age of 8.30 years (range: 7-12 years; SD: -1.493). Three children were in the early stages of the disease, modified Elizabethtown I and IIA (1 and 2, respectively). The majority of the children were in Stage IIB of the modified Elizabethtown staging (n=6), followed by Stage IIIA (n=4). The two children presenting in Stage IV of the disease were excluded from the analysis. The mean standardised and normative PODCI scores for transfer and mobility were 98.23 and 48.03, respectively. The mean standardised and normative PODCI scores for sports and physical were 93.15 and 49.76, respectively. Neither of the scores showed a statistically significant difference between the late and early stages of the disease (Transfer and Basic Mobility Scale: Standardised (p=0.273), Normative (p=0.268); Sports and Physical Functioning Scale: Standardised (p=0.618), Normative (p=0.631)). However, a higher mean PODCI score was noted for the early stages. There was no statistically significant difference between the median score and the duration since surgery. However, there was a moderate negative correlation between the time scores and the times since surgery for the late stages of the disease, viz. Stage IIB and IIIA (Transfer and Basic Mobility Scale: Standardised (-0.445), Normative (-0.450); Sports and Physical Functioning Scale: Standardised (-0.228), Normative (-0.228)). This correlation, however, did not reach a statistical significance. CONCLUSION VDRO can be regarded as a functionally rewarding option for femoral head containment in late-presenting LCPD across the evolutionary stages of the disease.
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Affiliation(s)
- Jaya V Lal
- Orthopaedics, St. John's Medical College Hospital, Bangalore, IND
| | - Sagar Tontanahal
- Orthopaedics, St. John's Medical College Hospital, Bangalore, IND
| | - Joseph Francis
- Orthopaedics, St. John's Medical College Hospital, Bangalore, IND
| | - Kevin M Philip
- Orthopaedics, St. John's Medical College Hospital, Bangalore, IND
| | - Ramesh Lj
- Orthopaedics, Dr. Chandramma Dayananda Sagar Institute of Medical Education and Research, Bangalore, IND
| | - Binu T Kurian
- Orthopaedics, St. John's Medical College Hospital, Bangalore, IND
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23
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Lin H, Lai C, Zhou Z, Wang C, Yu X. Femoral Neck System vs. four cannulated screws in the treatment of Pauwels III femoral neck fracture. J Orthop Sci 2023; 28:1373-1378. [PMID: 36229352 DOI: 10.1016/j.jos.2022.09.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/15/2021] [Revised: 07/15/2022] [Accepted: 09/04/2022] [Indexed: 02/09/2023]
Abstract
OBJECTIVE To compare the clinical efficacy of the Femoral Neck System (FNS) vs. four cannulated screws in Pauwels III femoral neck fractures. METHODS This retrospective study included patients with newly occurred type Pauwels III femoral neck fracture treated at author' Hospital of between January 2017 and February 2021. The patients received FNS (n = 27) or four cannulated screws (control group, n = 31). The operation time, blood loss, fracture healing time, incidence of complications (such as short femoral neck, necrosis of femoral head, nonunion of fracture, and failure of internal fixation withdrawal), and hip Harris score at the last follow-up were analyzed. RESULTS The operation time, blood loss, and fracture healing time were not significantly different between the two groups (all P > 0.05). In the FNS group, three and one patients were with femoral neck shortening and femoral head necrosis, respectively, while no fracture nonunion or failure of internal fixation withdrawal occurred. In the control group, seven, two, one, and two patients were with femoral neck shortening, femoral head necrosis, nonunion, and internal fixation failure, respectively. The cumulative complication incidence was 14.8% and 38.7% in the FNS and control groups (P = 0.042). The excellent and good rates of the hip Harris score at the last follow-up were 92.6% and 71.0% in the FNS and control groups, respectively (P = 0.036). CONCLUSION The study suggested that the clinical efficacy of FNS was better than internal fixation using four cannulated screws in treating Pauwels III type femoral neck fracture.
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Affiliation(s)
- Hongkuan Lin
- Department of Orthopedics, Mindong Hospital of Fujian Medical University, Fu'an, Fujian 355000, PR China.
| | - Caosheng Lai
- Department of Orthopedics, Mindong Hospital of Fujian Medical University, Fu'an, Fujian 355000, PR China
| | - Zhiping Zhou
- Department of Orthopedics, Mindong Hospital of Fujian Medical University, Fu'an, Fujian 355000, PR China
| | - Chaoqiang Wang
- Department of Orthopedics, Mindong Hospital of Fujian Medical University, Fu'an, Fujian 355000, PR China
| | - Xinlin Yu
- Department of Orthopedics, Mindong Hospital of Fujian Medical University, Fu'an, Fujian 355000, PR China
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24
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You M, Wang W, Zhou K, Li J, Chen G. The Influence of Compensatory Pelvic Tilt on Patient-reported Outcome Measurements in FAI Patients Who Received Arthroscopic Treatment. Orthop Surg 2023; 15:2848-2854. [PMID: 37675759 PMCID: PMC10622263 DOI: 10.1111/os.13855] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/03/2023] [Revised: 07/11/2023] [Accepted: 07/20/2023] [Indexed: 09/08/2023] Open
Abstract
OBJECTIVE Pelvic compensation is common in femoroacetabular impingement (FAI) patients to reduce symptoms and increase range of motion. However, little attention was given to the postoperative clinical effect of pelvic compensation. Therefore, this study aims to compare the outcomes between pelvic compensation and normal pelvic position in femoroacetabular impingement (FAI) patients after hip arthroscopy. METHODS The retrospective study was conducted from January 2019 to June 2022, recruited consecutive patients who were diagnosed with FAI and received subsequent arthroscopic treatment. All patients completed an X-ray in the anterior-posterior standing position before and 4 weeks after surgery. Patients with pelvic compensation were compared with those who did not. Functional outcomes included hip disability and osteoarthritis outcome score (HOOS), modified Harris (mHHS) score, and lower-extremity activity scale (LEAS). Secondary outcomes included the EuroQol Five Dimensions Questionnaire (EQ-5D) and patient satisfaction. The intraclass correlation coefficient (ICC) was used to analyze interobserver and intraobserver reliability. RESULTS Ninety patients with a mean age of 39.40 years were included in the study. No significant compensation changes were noted within groups after the elimination of impingement. The functional scores showed no significant difference between groups (p(HOOS) = 0.352, p(mHHS) = 0.183, p(LEAS) = 0.865). The EQ-5D revealed statistically better performance in usual activities in the compensatory group (p = 0.044). There are no significant between-group differences in patients' satisfaction evaluations. CONCLUSION As assessed by Patient-Reported Outcome Measures (PROMs), patients with compensatory pelvic tilt demonstrated similar clinical outcomes without extra adverse events to patients with normal pelvic positioning in short-term follow-ups. Furthermore, compensatory pelvic tilt did not significantly enhance the range of motion or functional outcome at short-term follow-ups.
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Affiliation(s)
- Mingke You
- Sports Medicine CenterWest China Hospital, Sichuan UniversityChengduChina
| | - Weijia Wang
- Institute of RehabilitationSichuan University, West China HospitalChengduChina
| | - Kai Zhou
- Sports Medicine CenterWest China Hospital, Sichuan UniversityChengduChina
| | - Jian Li
- Sports Medicine CenterWest China Hospital, Sichuan UniversityChengduChina
| | - Gang Chen
- Sports Medicine CenterWest China Hospital, Sichuan UniversityChengduChina
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25
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Davis TP. Metal-on-Metal Hip Arthroplasty: A Comprehensive Review of the Current Literature. Cureus 2023; 15:e48238. [PMID: 37929272 PMCID: PMC10624517 DOI: 10.7759/cureus.48238] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/02/2023] [Indexed: 11/07/2023] Open
Abstract
Metal-on-metal (MoM) total hip arthroplasty has been widely used since the end of the 20th century, although rates have now decreased due to concerns regarding adverse reactions and failure rates. The MoM implant has been replaced with other materials, such as ceramic-on-ceramic (CoC) and metal-on-polyethylene (MoP). This literature review looks at the past and present use of MoM prostheses to assess whether the turn away from MoM use is justified. Online literature searches were performed on PubMed, Ovid Medical Literature Analysis and Retrieval System Online (MEDLINE), and Web of Science online databases using the search terms "MoM and (ARMD and ALVAL)" (ARMD: adverse reaction to metal debris; ALVAL: aseptic lymphocyte-dominant vasculitis-associated lesion). A total of 64 relevant titles were included in the review. Although risk factors for adverse reactions and the causes of ARMD are generally agreed upon, more work is required to further understand the specific thresholds of blood metal ion levels that can be used to consistently identify ARMD and excessive metal wear-debris in patients who have not had their MoM implants revised. Metal-on-metal devices are not an acceptable option for total hip arthroplasties (THAs) in their current formulation due to the high rate and risk of ARMD. Some MoM hip resurfacing operations are appropriate for very carefully selected patients who are fully aware of the risks posed by the implant. It is recommended that device-specific thresholds for metal ion levels be developed to identify patients at risk of ARMD locally and systemically while using auxiliary tools to assist diagnosis, such as metal artefact reduction sequences (MARS)-MRI and hip scoring tools. Further work should investigate device-specific blood metal ion levels, the systemic effects of raised metal ion concentrations secondary to MoM arthroprosthetic wear, and the potential risks of ARMD caused by wear from tapered stems (including the implications this has for patients with CoC and MoP prostheses).
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Affiliation(s)
- Timothy P Davis
- Department of Anatomy, University of Nottingham Medical School, Nottingham, GBR
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26
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Skotidis E, Bekas K, Kechagias I, Tsakonas-Ntervakos I, Galanakos SP, Kateros K. Dislocation of Total Hip Arthroplasty of Femoral Neck Fracture in the Elderly: A Narrative Review. Cureus 2023; 15:e46307. [PMID: 37916228 PMCID: PMC10616716 DOI: 10.7759/cureus.46307] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/30/2023] [Indexed: 11/03/2023] Open
Abstract
Femoral neck fracture (FNF) is a common and devastating injury in the elderly population. The incidence of FNF is expected to increase in the future, particularly in the aging population. The displaced intracapsular FNF is replaced with a reconstruction prosthesis. These treatment options typically include hemiarthroplasty (HA) or total hip arthroplasty (THA). Dislocation after THA can be a significant complication, leading to increased hospital costs and patient dissatisfaction. This narrative review aims to investigate the potential risk factors for dislocation following THA after FNF. A systematic literature search was conducted, and 21 studies met the inclusion criteria. The studies included a total of 1703 patients who underwent THA after FNF. The majority of the patients were women, and the average age of participants was 76.2 years. The studies were primarily conducted by the orthopedic and traumatology departments. The surgical approach used for THA varied, with the anterior approach being associated with lower dislocation rates compared to the posterior approach. The analysis of surgical volume revealed that high-volume hospitals had lower dislocation rates compared to low-volume hospitals. Eight studies reported postoperative Harris Hip Scores (HHS), with higher HHS scores correlating with lower dislocation rates. Body mass index (BMI) was mentioned in 11 studies, and a normal BMI range was associated with lower dislocation rates compared to the overweight group. Rehabilitation protocols, particularly early initiation of physiotherapy, showed promising results in reducing dislocation rates. Additionally, the type of prosthesis used in the acetabulum was found to influence dislocation rates, with dual mobility cups demonstrating lower rates compared to single cups. In conclusion, several factors may contribute to the risk of dislocation following THA after FNF. These include the surgical approach, surgical volume, postoperative HHS scores, BMI, rehabilitation protocols, and the type of acetabular cup used. Further research is needed to better understand these risk factors and develop strategies to minimize dislocation rates and improve patient outcomes.
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Affiliation(s)
- Emmanouil Skotidis
- First Orthopaedic Department, G. Gennimatas General Hospital, Athens, GRC
| | - Kyriakos Bekas
- First Orthopaedic Department, G. Gennimatas General Hospital, Athens, GRC
| | - Ioannis Kechagias
- First Orthopaedic Department, G. Gennimatas General Hospital, Athens, GRC
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27
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Mirghaderi P, Ghaseminejad-Raeini A, Azarboo A, Mirghaderi R, Ravanbod H, Mortazavi SJ. Cross-Cultural Adaptation and Validation of the Persian Version of the Harris Hip Score. Arthroplast Today 2023; 23:101180. [PMID: 37712073 PMCID: PMC10498405 DOI: 10.1016/j.artd.2023.101180] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/10/2023] [Revised: 06/10/2023] [Accepted: 07/01/2023] [Indexed: 09/16/2023] Open
Abstract
Background The Persian language, also known as Farsi, is a pluricentric language spoken in Iran, Afghanistan, and Tajikistan by about 140 million people. This study aims to translate the Harris hip score (HHS) into Persian with cross-cultural adaptation and to evaluate its validity and reliability. Methods One hundred fifty-six total hip arthroplasty patients completed the Persian version of the HHS, Western Ontario and McMaster Universities Osteoarthritis Index, Forgotten Joint Score, and visual analog scale (VAS) for pain and satisfaction postoperatively. Using Cronbach's alpha (α) coefficient, internal consistency was evaluated. Correlations (Spearman's Rho) were used to assess validity. A test-retest reliability assessment of the Persian HHS was conducted (n = 47) using the intraclass correlation coefficient. Content validity was evaluated using the floor and ceiling effects of the HHS. Results The final translation of the Persian HHS was approved to be used. The preoperative and postoperative Cronbach's alpha were 0.71 and 0.70, respectively, and showed acceptable internal consistency. The intraclass correlation coefficient was excellent (0.869, P < .001). Insignificant ceiling effects (13.5%) and no floor effects (0) were observed. The HHS score was significantly and strongly correlated with Western Ontario and McMaster Universities Osteoarthritis Index (r = 0.696, P < .001), VAS pain (r = 0.654, P < .001), VAS satisfaction (r = 0.634, P < .001), and Forgotten Joint Score (r = 0.648, P < .001). Conclusions The Persian HHS demonstrated excellent reliability and validity properties. Accordingly, Persian HHS may be a helpful tool for assessing patients undergoing total hip arthroplasty.
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Affiliation(s)
- Peyman Mirghaderi
- Surgical Research Society (SRS), Students' Scientific Research Center, Tehran University of Medical Sciences, Tehran, Iran
- Joint Reconstruction Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Amirhossein Ghaseminejad-Raeini
- Surgical Research Society (SRS), Students' Scientific Research Center, Tehran University of Medical Sciences, Tehran, Iran
- Joint Reconstruction Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Alireza Azarboo
- Surgical Research Society (SRS), Students' Scientific Research Center, Tehran University of Medical Sciences, Tehran, Iran
- Joint Reconstruction Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Reza Mirghaderi
- Surgical Research Society (SRS), Students' Scientific Research Center, Tehran University of Medical Sciences, Tehran, Iran
- Joint Reconstruction Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Hadi Ravanbod
- Department of Orthopedic Surgery, Al-Zahra Hospital, Isfahan University of Medical Sciences, Isfahan, Iran
| | - S.M. Javad Mortazavi
- Joint Reconstruction Research Center, Tehran University of Medical Sciences, Tehran, Iran
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28
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Sambe HG, Yasir M, Man RK, Gogikar A, Nanda A, Janga LSN, Hamid P. Comparing Intra-articular Platelet-Rich Plasma With Hyaluronic Acid for the Treatment of Hip Osteoarthritis: A Systematic Review and Meta-Analysis. Cureus 2023; 15:e47919. [PMID: 37905161 PMCID: PMC10613513 DOI: 10.7759/cureus.47919] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2023] [Accepted: 10/28/2023] [Indexed: 11/02/2023] Open
Abstract
Hip osteoarthritis (HOA), a prevalent condition among those aged 55 years and above, is a significant cause of joint pain and functional impairment and it contributes to the overall burden of chronic pain experienced by the elderly population. While platelet-rich plasma (PRP) and hyaluronic acid (HA) injections have emerged as innovative therapeutic approaches for managing osteoarthritis, their effectiveness in HOA remains a subject of contention. Therefore, the objective of this review was to assess the efficacy of PRP versus HA in terms of pain relief and functional outcomes for the management of HOA. We searched PubMed, Cochrane Library, and Google Scholar databases from 2013 to 2023 to identify pertinent randomized controlled trials (RCTs). A total of seven trials (478 participants) were included. The selected studies underwent quality assessment using the updated Cochrane risk of bias tool. The pain and functional outcomes were examined using measures of the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) pain scale, visual analog scale (VAS), and Harris hip score (HHS). In the meta-analysis, standard mean differences (SMDs) along with 95% confidence intervals (CIs) to estimate overall effect magnitudes for continuous outcomes were extracted. Statistical significance was determined using p-values below 0.05. At six months, the PRP group experienced a significantly lower standard mean WOMAC pain score (SMD = -0.38, CI = -0.64 - 0.13; p = 0.03). No significant differences in WOMAC pain scores were noted at one to two months (SMD = 0.09, CI = -0.24, 0.43; p = 0.59), and at 12 months (SMD = -0.85, CI = -1.81, 0.12; p = 0.09). Similarly, for VAS, patients on PRP showed a slight improvement in their VAS scores at six months (SMD = -0.50, CI = -0.89, -0.12; p < 0.01). However, no significant differences in VAS between the PRP groups and the HA groups were observed at one to two months (SMD = -0.22, CI = -0.49, 0.04; p = 0.10) and at 12 months (SMD = -0.22, CI: -0.63, 0.19; p = 0.29). In terms of hip dysfunction, there was no statistically significant standard mean difference in HHS between the PRP and HA groups at six months (SMD = 0.02, CI = -0.40, 0.44; p = 0.93), and at 12 months (SMD = -0.31, CI = -0.32, 0.22; p = 0.73). This review and meta-analysis provide insights into emerging treatments for HOA, especially considering that PRP shows potential benefits and safety for patients with HOA during mid-term follow-up in a 12-month period. Nevertheless, it is necessary to conduct research that includes high-quality designs and larger sample sizes to validate the comparative efficacy of these treatments.
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Affiliation(s)
- Hembashima G Sambe
- Surgery, California Institute of Behavioral Neurosciences and Psychology, Fairfield, USA
| | - Mohamed Yasir
- Internal Medicine, California Institute of Behavioral Neurosciences and Psychology, Fairfield, USA
| | - Ruzhual K Man
- Internal Medicine, California Institute of Behavioral Neurosciences and Psychology, Fairfield, USA
| | - Amaresh Gogikar
- Internal Medicine, California Institute of Behavioral Neurosciences and Psychology, Fairfield, USA
| | - Ankita Nanda
- Medicine, California Institute of Behavioral Neurosciences and Psychology, Fairfield, USA
| | | | - Pousette Hamid
- Neurology, California Institute of Behavioral Neurosciences and Psychology, Fairfield, USA
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LiuFu JF, Lv XM, Yang ZY, Kang YF, Xie S, Shan XF, Cai ZG. The effect of anterior superior iliac spine preservation on donor site morbidity and function after harvesting a vascularized iliac bone flap. Head Neck 2023; 45:2544-2554. [PMID: 37530710 DOI: 10.1002/hed.27478] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2023] [Revised: 07/04/2023] [Accepted: 07/25/2023] [Indexed: 08/03/2023] Open
Abstract
BACKGROUND The purpose of this study was to investigate the effect of anterior superior iliac spine (ASIS) preservation on donor site morbidity and function after harvesting a vascularized iliac bone flap (VIBF). METHODS Patients who underwent jaws reconstruction with VIBF were divided into a maintaining the anterior superior iliac spine (MASIS) group and a not maintaining the anterior superior iliac spine (NMASIS) group. Pain, tenderness, sensory deficit, gait disturbance, and function of the donor site were evaluated before and after the operation. RESULTS Thirty-three patients were included in this study, of which 18 were in the MASIS group. The incidence of sensory deficit in the MASIS group was significantly lower than that in the NMASIS group (50.0% vs. 86.7%, p = 0.010). Pain, tenderness, gait disturbance, and function did not differ statistically between the two groups. CONCLUSION Except for sensory deficit, ASIS preservation has minimal impact on donor site morbidity and function.
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Affiliation(s)
- Jian-Feng LiuFu
- Department of Oral and Maxillofacial Surgery, Peking University School and Hospital of Stomatology & National Center for Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Research Center of Oral Biomaterial and Digital Medical Devices, Beijing, China
| | - Xiao-Ming Lv
- Department of Oral and Maxillofacial Surgery, Peking University School and Hospital of Stomatology & National Center for Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Research Center of Oral Biomaterial and Digital Medical Devices, Beijing, China
| | - Zong-Yan Yang
- Department of Oral and Maxillofacial Surgery, Peking University School and Hospital of Stomatology & National Center for Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Research Center of Oral Biomaterial and Digital Medical Devices, Beijing, China
| | - Yi-Fan Kang
- Department of Oral and Maxillofacial Surgery, Peking University School and Hospital of Stomatology & National Center for Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Research Center of Oral Biomaterial and Digital Medical Devices, Beijing, China
| | - Shang Xie
- Department of Oral and Maxillofacial Surgery, Peking University School and Hospital of Stomatology & National Center for Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Research Center of Oral Biomaterial and Digital Medical Devices, Beijing, China
| | - Xiao-Feng Shan
- Department of Oral and Maxillofacial Surgery, Peking University School and Hospital of Stomatology & National Center for Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Research Center of Oral Biomaterial and Digital Medical Devices, Beijing, China
| | - Zhi-Gang Cai
- Department of Oral and Maxillofacial Surgery, Peking University School and Hospital of Stomatology & National Center for Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Research Center of Oral Biomaterial and Digital Medical Devices, Beijing, China
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Liu Y, Li C, Zhang Z, Lu X, Zhang H. Ochronotic arthropathy effectively treated with total hip and total knee arthroplasty: a case report. Front Med (Lausanne) 2023; 10:1212580. [PMID: 37795417 PMCID: PMC10546056 DOI: 10.3389/fmed.2023.1212580] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2023] [Accepted: 09/06/2023] [Indexed: 10/06/2023] Open
Abstract
Ochronosis is a rare autosomal recessive disorder of tyrosine metabolism characterized by multilevel spinal degeneration and arthritis of large weight-bearing joints, which is referred to as ochronotic arthropathy. In this case report, we describe diagnosis and treatment of ochronotic arthropathy in a patient who underwent total hip arthroplasty (THA) and total knee arthroplasty (TKA). The Harris hip score was 26 preoperatively and 45, 68, 76, 90, 92, and 94 at 1, 3, 6, 9, 11, and 14 months, respectively, postoperatively. The forgotten joint score (FJS) of the hip was 27.8, 52.8, 81.1, 89.0, 90.6, and 92.4 at 1, 3, 6, 9, 11, and 14 months, respectively, postoperatively. TKA was performed 8 months after THA. The Knee Society Score was 36 before TKA and 74, 82, and 90 at 1, 3, and 6 months, respectively, after TKA. The FJS of the knee was 36.6, 63.9, and 84.5 at 1, 3, and 6 months, respectively, after TKA. The patient's knee range of motion returned to normal, with significant reduction in pain and improved satisfaction levels after TKA. THA and TKA can achieve good clinical outcomes in patients with ochronosis accompanied by severe joint pain.
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Affiliation(s)
- Yikai Liu
- Department of Joint Surgery, The Affiliated Hospital of Qingdao University, Qingdao, China
| | - Chenkai Li
- Department of Orthopedics, Peking Union Medical College, Beijing, China
| | - Zian Zhang
- Department of Joint Surgery, The Affiliated Hospital of Qingdao University, Qingdao, China
| | - Xinzhe Lu
- Department of Joint Surgery, The Affiliated Hospital of Qingdao University, Qingdao, China
| | - Haining Zhang
- Department of Joint Surgery, The Affiliated Hospital of Qingdao University, Qingdao, China
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Morris EJ, Gray K, Gibbons PJ, Grayson J, Sullivan J, Amorim AB, Burns J, McKay MJ. Evaluating the Use of PROMs in Paediatric Orthopaedic Registries. CHILDREN (BASEL, SWITZERLAND) 2023; 10:1552. [PMID: 37761513 PMCID: PMC10528097 DOI: 10.3390/children10091552] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/14/2023] [Revised: 09/04/2023] [Accepted: 09/07/2023] [Indexed: 09/29/2023]
Abstract
Patient-reported outcome measures (PROMs) provide structured information on the patient's health experience and facilitate shared clinical decision-making. Registries that collect PROMs generate essential information about the clinical course and efficacy of interventions. Whilst PROMs are increasingly being used in adult orthopaedic registries, their use in paediatric orthopaedic registries is not well known. The purpose of this systematic review was to identify the frequency and scope of registries that collect PROMs in paediatric orthopaedic patient groups. In July 2023, six databases were systematically searched to identify studies that collected PROMs using a registry amongst patients aged under 18 years with orthopaedic diagnoses. Of 3190 identified articles, 128 unique registries were identified. Three were exclusively paediatric, 27 were majority paediatric, and the remainder included a minority of paediatric patients. One hundred and twenty-eight registries collected 72 different PROMs, and 58% of these PROMs were not validated for a paediatric population. The largest group of orthopaedic registries collected PROMs on knee ligament injuries (21%). There are few reported dedicated orthopaedic registries collecting PROMs in paediatric populations. The majority of PROMs collected amongst paediatric populations by orthopaedic registries are not validated for patients under the age of 18 years. The use of non-validated PROMs by registries greatly impedes their utility and impact. Dedicated orthopaedic registries collecting paediatric-validated PROMs are needed to increase health knowledge, improve decision-making between patients and healthcare providers, and optimise orthopaedic management.
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Affiliation(s)
- Eleanor J. Morris
- Sydney School of Health Sciences, Faculty of Medicine and Health, The University of Sydney, Sydney 2006, Australia; (E.J.M.); (J.G.); (J.S.); (A.B.A.); (M.J.M.)
- Sydney Children’s Hospitals Network, The Children’s Hospital at Westmead, Sydney 2145, Australia;
| | - Kelly Gray
- Department of Health Sciences, Faculty of Medicine, Health and Human Sciences, Macquarie University, Sydney 2109, Australia;
| | - Paul J. Gibbons
- Sydney Children’s Hospitals Network, The Children’s Hospital at Westmead, Sydney 2145, Australia;
| | - Jane Grayson
- Sydney School of Health Sciences, Faculty of Medicine and Health, The University of Sydney, Sydney 2006, Australia; (E.J.M.); (J.G.); (J.S.); (A.B.A.); (M.J.M.)
| | - Justin Sullivan
- Sydney School of Health Sciences, Faculty of Medicine and Health, The University of Sydney, Sydney 2006, Australia; (E.J.M.); (J.G.); (J.S.); (A.B.A.); (M.J.M.)
| | - Anita B. Amorim
- Sydney School of Health Sciences, Faculty of Medicine and Health, The University of Sydney, Sydney 2006, Australia; (E.J.M.); (J.G.); (J.S.); (A.B.A.); (M.J.M.)
| | - Joshua Burns
- Sydney School of Health Sciences, Faculty of Medicine and Health, The University of Sydney, Sydney 2006, Australia; (E.J.M.); (J.G.); (J.S.); (A.B.A.); (M.J.M.)
- Sydney Children’s Hospitals Network, Paediatric Gait Analysis Service of New South Wales, Sydney 2145, Australia
| | - Marnee J. McKay
- Sydney School of Health Sciences, Faculty of Medicine and Health, The University of Sydney, Sydney 2006, Australia; (E.J.M.); (J.G.); (J.S.); (A.B.A.); (M.J.M.)
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Soriano KKJ, Hartwell MJ, Nguyen TQ, Flores SE, Zhang AL. Hypermobile Patients With Femoroacetabular Impingement Syndrome Can Be Effectively Treated Utilizing Hip Arthroscopy With Periportal Capsulotomy Closure: A Matched Cohort Analysis Compared to Patients Without Joint Hypermobility. Arthroscopy 2023; 39:2026-2034. [PMID: 36965542 DOI: 10.1016/j.arthro.2023.03.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/22/2022] [Revised: 03/01/2023] [Accepted: 03/03/2023] [Indexed: 03/27/2023]
Abstract
PURPOSE To assess the 2-year outcomes of arthroscopic treatment with periportal capsulotomy closure for femoroacetabular impingement syndrome (FAIS) in patients with generalized ligamentous laxity (GLL). METHODS A retrospective analysis was performed from a prospectively collected database of FAIS patients undergoing hip arthroscopy. FAIS patients with GLL were identified as having Beighton score ≥4. FAIS patients with GLL were treated with arthroscopic labral repair, osteochondroplasty, via periportal capsulotomy with subsequent capsular closure. These patients were matched by age, sex, and body mass index (BMI) with a cohort of FAIS patients without GLL who underwent the same procedure via periportal capsulotomy without capsular closure. Preoperatively, and 2 years postoperatively, patients completed patient-reported outcomes (PRO) scores, including the Hip Disability and Osteoarthritis Outcome Score (HOOS), 12-item Short-Form survey (SF-12) and the visual analog scale (VAS). RESULTS Forty patients (5 male, 35 female) with FAIS and GLL were included (age: 29.7 ± 9.0; BMI: 23.3 ± 4.1). FAIS patients with GLL demonstrated similar significant PRO score improvements compared to a matched cohort of FAIS patients without GLL at 2 years after surgery (VAS Pain: (-)2.5 ± 3.0, (-)2.7 ± 2.7; SF-12 PCS: 17.7 ± 14.2, 16.7 ± 15.0; HOOS-Symptoms: 26.3 ± 24.0, 20.6 ± 18.1; HOOS-Pain: 29.8 ± 20.4, 24.4 ± 9.0; HOOS-ADL: 24.9 ± 18.4, 22.0 ± 19.9; HOOS-Sports: 43.6 ± 26.1, 33.1 ± 29.8; and HOOS-QOL: 44.2 ± 27.6, 41.7 ± 27.1, respectively). Both cohorts achieved minimal clinically important differences (MCID) for each HOOS subscore at equivalent high rates (70-88%). CONCLUSIONS Patients with GLL in the setting of FAIS can be effectively treated with arthroscopy via periportal capsulotomy and capsular closure. These patients demonstrate significant improvements in PRO scores at 2 years, similar to normal laxity FAIS patients undergoing arthroscopic treatment via periportal capsulotomy without capsular closure. LEVEL OF EVIDENCE Level III, retrospective comparative therapeutic trial.
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Affiliation(s)
- Kylen K J Soriano
- Department of Orthopaedic Surgery, University of California-San Francisco, San Francisco, California, U.S.A
| | - Matthew J Hartwell
- Department of Orthopaedic Surgery, University of California-San Francisco, San Francisco, California, U.S.A
| | - Thu Quynh Nguyen
- Department of Orthopaedic Surgery, University of California-San Francisco, San Francisco, California, U.S.A
| | - Sergio E Flores
- Department of Orthopaedic Surgery, University of California-San Francisco, San Francisco, California, U.S.A
| | - Alan L Zhang
- Department of Orthopaedic Surgery, University of California-San Francisco, San Francisco, California, U.S.A.
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Kushwaha NS, Singh A, Saroj AK, Verma A, Ansari KA. Protrusio acetabuli in tubercular hip: Outcome of femoral head as autologous bone graft used during total hip replacement. J Clin Orthop Trauma 2023; 44:102247. [PMID: 37822476 PMCID: PMC10562844 DOI: 10.1016/j.jcot.2023.102247] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/26/2023] [Revised: 09/05/2023] [Accepted: 09/14/2023] [Indexed: 10/13/2023] Open
Abstract
Purpose Here we present a study of a tuberculosis hip protrusion with a large acetabular defect treated by total hip replacement using a novel technique without the use of any protrusio ring, wire mesh, or cage. To our knowledge, such a technique has not been described in the literature previously. Methodology 25 patients with a past treatment history of hip tuberculosis came to our medical college with complaints of worsening pain in the hip joint and limping. The hip pain and limping were progressive in nature and became more severe, and his affected lower limb shortened. Results The average AK distance (horizontal distance between Kohlar line and the medial acetabular border) before surgery was 8 mm (range: 1-16). For the acetabular implant, the mean abduction angle was 45° (range: 41-48), and the mean anteversion angle was 18° (range: 13-24). The average preoperative shortening for limb length inequality was 4 mm (range: 0-11). The average HHS (Harris Hip Score) during follow-up was 87.6 points. Conclusion In TB hip protrusio, an autograft of the femur head is used to fill the acetabular defect and provide a good approach for these patients without any extra economic burden or complications as seen in a metallic ring or cage.
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Affiliation(s)
| | - Arpit Singh
- Department of orthopaedics, K.G. Medical University, Lucknow, India
| | - Atul Kumar Saroj
- Department of orthopaedics, Dr SLP Autonomous State Medical College, Pratapgarh, India
| | - Ashutosh Verma
- Department of orthopaedics, K.G. Medical University, Lucknow, India
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Qian H, Wang X, Wang P, Zhang G, Liu J, Dang X, Guo J, Liu R. Changes in Anxiety and Depression After THA in Patients with Ankylosing Spondylitis and the Affecting Factors. Ther Clin Risk Manag 2023; 19:675-684. [PMID: 37601141 PMCID: PMC10439721 DOI: 10.2147/tcrm.s415564] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2023] [Accepted: 07/25/2023] [Indexed: 08/22/2023] Open
Abstract
Objective Hip ankylosis is a prevalent condition in patients with Ankylosing spondylitis (AS) that can significantly impact their psychological well-being. This study aimed to investigate the impact of Total Hip Arthroplasty (THA) on anxiety and depression among AS patients. Methods 62 AS patients undergoing primary THA were recruited and separated into two groups based on preoperative hip motion. The 40 patients with hip mobility of 0° were assigned to group A, and others were assigned to group NA. Self-rating Anxiety Scale (SAS), Self-rating Depression scale (SDS), Harris hip scores (HHS) and 36-Item Short Form Survey (SF-36) were obtained one week before and there, six and twelve months after THA. Results The study found that AS patients in group A had significantly higher levels of anxiety and depression (SAS score = 75.05±2.79, SDS index score = 0.74±0.02) compared to group B (SAS score = 54.58±3.35, SDS index score= 0.64±0.03, P=0.01). However, both groups showed significant improvements in anxiety and depression scores from there to twelve months after THA (P<0.001). Correlation analyses revealed that the improvement in group NA was associated with hip pain relief (p<0.001), while the improvement in group A was related to joint function, disease duration, age at THA and spine imaging lesions (p<0.001). Conclusion Some degree of anxiety and depression was present in both groups of AS patients. Levels of depression and anxiety were higher in patients with combined hip ankylosis. And their improvement was associated with improved hip function and quality of life after THA. Hip pain relief played a significant role in patients without hip joint ankylosis. The impact of the degree of lesion on spinal imaging on psychological status needs to be considered in both groups.
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Affiliation(s)
- Hang Qian
- Department of Orthopedics, The Second Affiliated Hospital, Xi’an Jiaotong University, Xi’an, People’s Republic of China
| | - Xu Wang
- Department of Orthopedics, The Second Affiliated Hospital, Xi’an Jiaotong University, Xi’an, People’s Republic of China
| | - Pengbo Wang
- Department of Orthopedics, The Second Affiliated Hospital, Xi’an Jiaotong University, Xi’an, People’s Republic of China
| | - Guangyang Zhang
- Department of Orthopedics, The Second Affiliated Hospital, Xi’an Jiaotong University, Xi’an, People’s Republic of China
| | - Jun Liu
- Department of Orthopedics, The Second Affiliated Hospital, Xi’an Jiaotong University, Xi’an, People’s Republic of China
| | - Xiaoqian Dang
- Department of Orthopedics, The Second Affiliated Hospital, Xi’an Jiaotong University, Xi’an, People’s Republic of China
| | - Jianbin Guo
- Department of Orthopedics, Honghui Hospital, Xi’an Jiaotong University, Xi’an, People’s Republic of China
| | - Ruiyu Liu
- Department of Orthopedics, The Second Affiliated Hospital, Xi’an Jiaotong University, Xi’an, People’s Republic of China
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Nunley B, Mulligan EP, Chhabra A, Fey NP, Wells J. Relationships between self-perceived and clinical expression of pain and function differ based on the underlying pathology of the human hip. BMC Musculoskelet Disord 2023; 24:635. [PMID: 37550652 PMCID: PMC10405504 DOI: 10.1186/s12891-023-06768-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/15/2023] [Accepted: 07/31/2023] [Indexed: 08/09/2023] Open
Abstract
BACKGROUND Patient-reported outcomes are commonly used to assess patient symptoms. The effect of specific hip pathology on relationships between perceived and objectively measured symptoms remains unclear. The purpose of this study was to evaluate differences of function and pain in patients with FAIS and DDH, to assess the correlation between perceived and objective function, and to determine the influence of pain on measures of function. METHODS This prospective cross-sectional study included 35 pre-operative patients (60% female) with femoroacetabular impingement syndrome (FAIS) and 37 pre-operative patients (92% female) with developmental dysplasia of the hip (DDH). Objectively measured function (6-min walk [6MWT], single leg hop [SLHT], Biodex sway [BST], hip abduction strength [HABST], and STAR excursion balance reach [STAR] tests), patient-reported function (UCLA Activity, Hip Outcome Score [HOS], Short Form 12 [SF-12], and Hip Disability and Osteoarthritis Outcome Score [HOOS]), and patient-reported pain (HOOS Pain, visual analogue scale (VAS), and a pain location scale) were collected during a pre-surgical clinic visit. Between-group comparisons of patient scores were performed using Wilcoxon Rank-Sum tests. Within-group correlations were analyzed using Spearman's rank correlation coefficients. Statistical correlation strength was defined as low (r = ± 0.1-0.3), moderate (r = ± 0.3-0.5) and strong (r > ± 0.5). RESULTS Patients with DDH reported greater pain and lower function compared to patients with FAIS. 6MWT distance was moderately-to-strongly correlated with a number of patient-reported measures of function (FAIS: r = 0.37 to 0.62, DDH: r = 0.36 to 0.55). Additionally, in patients with DDH, SLHT distance was well correlated with patient reported function (r = 0.37 to 0.60). Correlations between patient-reported pain and objectively measured function were sparse in both patient groups. In patients with FAIS, only 6MWT distance and HOOS Pain (r = -0.53) were significantly correlated. In patients with DDH, 6MWT distance was significantly correlated with VAS Average (r = -0.52) and Best (r = -0.53) pain. CONCLUSION Pain is greater and function is lower in patients with DDH compared to patients with FAIS. Moreover, the relationship between pain and function differs between patient groups. Understanding these differences is valuable for informing treatment decisions. We recommend these insights be incorporated within the clinical continuum of care, particularly during evaluation and selection of surgical and therapeutic interventions.
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Affiliation(s)
- Brandon Nunley
- Department of Biomedical Engineering, The University of Texas at Austin, Austin, TX, USA
| | | | - Avneesh Chhabra
- Department of Radiology, UT Southwestern Medical Center, Dallas, TX, USA
| | - Nicholas P Fey
- Walker Department of Mechanical Engineering, The University of Texas at Austin, Austin, TX, USA
| | - Joel Wells
- Department of Orthopedic Surgery, Baylor Scott & White Medical Center, 301 N. Washington Ave, Dallas, TX, 75246, USA.
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Woerner M, Voelkl K, Bliemel C, Ferner F, Weber M, Renkawitz T, Grifka J, Craiovan B. Comparison of two joint-preserving treatments for osteonecrosis of the femoral head: core decompression and core decompression with additional cancellous bone grafting. J Int Med Res 2023; 51:3000605231190453. [PMID: 37585739 PMCID: PMC10416661 DOI: 10.1177/03000605231190453] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2022] [Accepted: 07/11/2023] [Indexed: 08/18/2023] Open
Abstract
OBJECTIVE Femoral head necrosis (FHN) affects mostly young and active people. The most common operative therapy is core decompression (CD) with optional cancellous bone grafting (CBG). Because little information is available on the long-term results of these procedures, we investigated the effectiveness of CD and CD + CBG in patients with ARCO stage II FHN in terms of postoperative pain, range of motion, patient-reported outcome measures (Harris Hip Score, Hip Disability and Osteoarthritis Outcome Score, EuroQol 5D, and Short Form 36 Questionnaire), and disease progression. METHODS We retrospectively compared 11 patients treated with CD alone 48.0 months (range, 26.3-68.5 months) postoperatively versus 11 patients treated with CD + CBG 69.2 months (range, 38.0-92.9 months) postoperatively. All patients were assessed according to a routine clinical protocol involving a clinical examination, questionnaires, and radiological imaging (X-ray and magnetic resonance imaging). RESULTS The clinical and radiological results showed no significant differences between the two groups. Both interventions demonstrated equal results according to clinical scores. CONCLUSIONS Our data may encourage application of the less invasive technique of CD alone without CBG, which is more surgically demanding. Further prospective studies with longer follow-up are necessary to clarify the risk factors for therapy failure.
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Affiliation(s)
- Michael Woerner
- Klinikum Bamberg, Klinik für Orthopädie und Unfallchirurgie, Buger Strasse 80, Bamberg
- Universitätsklinikum Regensburg Klinik für Orthopädie, Kaiser-Karl V-Allee 3, Bad Abbach
- Universitätsklinikum Regensburg, Klinik für Orthopädie, Kaiser-Karl V-Allee 3, Bad Abbach
| | - Korbinian Voelkl
- Universitätsklinikum Regensburg Klinik für Orthopädie, Kaiser-Karl V-Allee 3, Bad Abbach
| | - Christopher Bliemel
- Universitätsklinikum Marburg, Klinik für Orthopädie und Unfallchirurgie, Baldingertrasse, Marburg
| | - Felix Ferner
- Klinikum Lichtenfels, Klinik für Orthopädie und Unfallchirurgie, Professor-Arneth-Straße 2b, Lichtenfels
| | - Markus Weber
- Universitätsklinikum Regensburg, Franz-Josef-Strauß-Allee 11, Regensburg
| | - Tobias Renkawitz
- Universitätsklinikum Heidelberg, Klinik für Orthopädie, Schlierbacher Landstraße 200a, Heidelberg
| | - Joachim Grifka
- Universitätsklinikum Regensburg Klinik für Orthopädie, Kaiser-Karl V-Allee 3, Bad Abbach
| | - Benjamin Craiovan
- Universitätsklinikum Regensburg Klinik für Orthopädie, Kaiser-Karl V-Allee 3, Bad Abbach
- Universitätsklinikum Marburg, Klinik für Orthopädie und Unfallchirurgie, Baldingertrasse, Marburg
- Universitätsklinikum Regensburg, Klinik für Orthopädie, Kaiser-Karl V-Allee 3, Bad Abbach
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Vallim FCDM, Cruz HAD, Silva CFB, Abreu CSGD, Rodrigues RC, Cunha MG. Modified Dunn Technique for Unstable Slipped Capital Femoral Epiphysis: A Midterm Single Center Experience. Rev Bras Ortop 2023; 58:e632-e638. [PMID: 37663178 PMCID: PMC10468245 DOI: 10.1055/s-0042-1758362] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2022] [Accepted: 09/12/2022] [Indexed: 09/05/2023] Open
Abstract
Objective To evaluate the safety and reproducibility of the surgery for unstable slipped capital femoral epiphysis (SCFE) through the modified Dunn technique in a single center cohort from Brazil. Methods We retrospectively analyzed a cohort of patients submitted to this procedure by a single surgeon who was a hip preservation specialist. Demographic data and radiographic angles were evaluated for the relative risk (RR) of avascular necrosis (AVN) using a log-binomial regression model with simple and random effects. Results Among the 30 patients (30 hips) with a mean age of 11.79 years at the time of the operation, there were 17 boys and 18 left hips, which were operated on in a mean of 11.5 days after the slip. The mean follow-up was of 38 months. The preoperative Southwick angle averaged 60.69° against 4.52° postoperatively ( p < 0.001). A larger preoperative slip angle was associated with the development of AVN (RR: 1.05; 95% confidence interval [95%CI]: 1.02-1.07; p < 0.01). The overall AVN rate was of 26.7%. Function was good or excellent in 86% of uncomplicated hips, and poor in 87.5% of the partients who developed AVN, as graded by the Harris Hip Score. There was no statistical relationship between epiphyseal bleeding and AVN development ( p = 0.82). Conclusion The modified Dunn technique is associated with restoration of the femoral alignment and function after unstable SCFE, when uncomplicated. Moreover, it was shown to be reproducible in our population, with a rate of 26% of femoral head necrosis.
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Affiliation(s)
| | - Henrique Abreu da Cruz
- Médico Ortopedista, Especialista em Cirurgião Ortopédico Pediátrico, Hospital Estadual da Criança, Rio de Janeiro, RJ, Brasil
| | | | - Caroline Sandra Gomes de Abreu
- Médico Ortopedista, Especialista em Cirurgião Ortopédico Pediátrico, Hospital Estadual da Criança, Rio de Janeiro, RJ, Brasil
| | - Ricardo Carneiro Rodrigues
- Médico Ortopedista, Especialista em Cirurgião Ortopédico Pediátrico, Hospital Estadual da Criança, Rio de Janeiro, RJ, Brasil
| | - Marcio Garcia Cunha
- Médico Ortopedista, Chefe da Ortopedia Pediátrica, Hospital Estadual da Criança, Rio de Janeiro, RJ, Brasil
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Bruschetta A, Palco M, Fenga D, Giuca G, Holzer LA, Alito A, Cacciola G, De Meo F, Cavaliere P. How to Manage Metallosis: A Retrospective Cohort Analysis after Revision Hip Surgery. J Clin Med 2023; 12:4809. [PMID: 37510924 PMCID: PMC10381485 DOI: 10.3390/jcm12144809] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2023] [Revised: 07/13/2023] [Accepted: 07/17/2023] [Indexed: 07/30/2023] Open
Abstract
BACKGROUND Adverse local tissue reactions to metal debris are due to a metal-on-metal bearing complication caused by micromotions at modular interfaces that induce corrosion of the protective oxide layer. This process could lead to wear, fretting, and abrasion with the release of metal ions locally and systemically, which may cause adverse local reactions in nearby tissues. The aim of this study is to describe a series of patients with painful local adverse tissue reactions secondary to corrosion at the modular neck-body interface, to document the clinical presentation, diagnostic workup, and surgical findings of our research, and to search for a possible correlation between metallosis and infection. METHODS A retrospective study of patients with adverse local tissue reactions due to metal surface corrosion was performed. Blood samples were collected to identify erythrocyte sedimentation rate, C reactive protein, and procalcitonin, and a magnetic resonance imaging protocol was performed. RESULTS Serum cobalt and chromium levels of the 43 patients tested were significantly higher on average. However, both erythrocyte sedimentation rate and C-reactive protein were significantly elevated. Magnetic resonance imaging showed adverse reactions to metal debris with large soft tissue masses and surrounding tissue damage. CONCLUSIONS Corrosion in hip prosthesis can lead to the release of metal ions and debris locally and systemically, resulting in local soft tissue changes. A "tumor-like" debridement can reduce this complication.
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Affiliation(s)
| | - Michelangelo Palco
- Department of Orthopaedic and Traumatology, Casa di Cura Caminiti, 89018 Villa San Giovanni, Italy
| | - Domenico Fenga
- Section of Orthopaedics and Traumatology, Department of Biomedical Sciences and Morphological and Functional Images, University of Messina, 98122 Messina, Italy
| | - Gabriele Giuca
- Section of Orthopaedics and Traumatology, Department of Biomedical Sciences and Morphological and Functional Images, University of Messina, 98122 Messina, Italy
| | - Lukas A Holzer
- Perth Orthopaedic and Sports Medicine Centre, Perth, WA 6005, Australia
| | - Angelo Alito
- Department of Biomedical, Dental Sciences and Morphological and Functional Images, University of Messina, 98122 Messina, Italy
| | - Giorgio Cacciola
- Orthopaedic Institute of Southern Italy "Franco Scalabrino", 98165 Messina, Italy
| | - Federico De Meo
- Orthopaedic Institute of Southern Italy "Franco Scalabrino", 98165 Messina, Italy
| | - Pietro Cavaliere
- Orthopaedic Institute of Southern Italy "Franco Scalabrino", 98165 Messina, Italy
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Perrot S, Trouvin AP, Bouhassira D. Three dimensions of pain in osteoarthritis: development and validation of the Osteoarthritis Symptom Inventory Scale. Pain 2023; 164:1566-1577. [PMID: 36602324 PMCID: PMC10281021 DOI: 10.1097/j.pain.0000000000002856] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2022] [Revised: 11/16/2022] [Accepted: 12/09/2022] [Indexed: 01/06/2023]
Abstract
ABSTRACT We describe here the development and validation of the Osteoarthritis Symptom Inventory Scale (OASIS), a new self-administered questionnaire specifically designed to evaluate the various osteoarthritis (OA) pain symptoms with different dimensions related to OA pain mechanisms. The initial development phase and qualitative study generated a list of 17 descriptors reflecting OA pain and other associated symptoms, leading to the first version of the questionnaire (OASIS17). Each item was quantified on a 0 to 10 Numerical Scale. Validation was performed using 123 consecutive patients with OA pain recruited at 28 centers in France, mainly general practitioner offices. Validation involved (1) determining the questionnaire's factorial structure through exploratory and confirmatory analyses, (2) analyzing convergent and divergent validities (ie, construct validity), (3) assessing each item's test-retest reliability, and (4) evaluating OASIS ability to detect treatment effects (ie, sensitivity to change). The final OASIS version includes 9 items discriminating and quantifying 3 distinct, clinically relevant OA pain dimensions sensitive to treatment. OASIS9 psychometric properties suggest that it could improve the characterization of OA pain profiles for 3 clinically relevant domains: localized, neuropathic-like, and deep pain. The OASIS9 questionnaire could be used to phenotype OA pain patients and identify responders to various therapeutic interventions as a function of OA pain dimensions.
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Affiliation(s)
- Serge Perrot
- Centre d'Evaluation et de Traitement de la Douleur, Hôpital Cochin, Université Paris Cité, INSERM U987, Paris, France
- Inserm U987, UVSQ-Paris-Saclay University, Ambroise Pare hospital, 92100 Boulogne-Billancourt, France
| | - Anne-Priscille Trouvin
- Centre d'Evaluation et de Traitement de la Douleur, Hôpital Cochin, Université Paris Cité, INSERM U987, Paris, France
- Inserm U987, UVSQ-Paris-Saclay University, Ambroise Pare hospital, 92100 Boulogne-Billancourt, France
| | - Didier Bouhassira
- Inserm U987, UVSQ-Paris-Saclay University, Ambroise Pare hospital, 92100 Boulogne-Billancourt, France
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Andronic O, Germann C, Jud L, Zingg PO. Factors influencing patient-reported outcomes following periacetabular osteotomy and open osteochondroplasty in the setting of borderline hip dysplasia. Bone Joint J 2023; 105-B:735-742. [PMID: 37391200 DOI: 10.1302/0301-620x.105b7.bjj-2022-1058.r2] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 07/02/2023]
Abstract
Aims This study reports mid-term outcomes after periacetabular osteotomy (PAO) exclusively in a borderline hip dysplasia (BHD) population to provide a contrast to published outcomes for arthroscopic surgery of the hip in BHD. Methods We identified 42 hips in 40 patients treated between January 2009 and January 2016 with BHD defined as a lateral centre-edge angle (LCEA) of ≥ 18° but < 25°. A minimum five-year follow-up was available. Patient-reported outcomes (PROMs) including Tegner score, subjective hip value (SHV), modified Harris Hip Score (mHHS), and Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) were assessed. The following morphological parameters were evaluated: LCEA, acetabular index (AI), α angle, Tönnis staging, acetabular retroversion, femoral version, femoroepiphyseal acetabular roof index (FEAR), iliocapsularis to rectus femoris ratio (IC/RF), and labral and ligamentum teres (LT) pathology. Results The mean follow-up was 96 months (67 to 139). The SHV, mHHS, WOMAC, and Tegner scores significantly improved (p < 0.001) at last follow-up. According to SHV and mHHS, there were three hips (7%) with poor results (SHV < 70), three (7%) with a fair score (70 to 79), eight (19%) with good results (80 to 89), and 28 (67%) who scored excellent (> 90) at the last follow-up. There were 11 subsequent operations: nine implant removals due to local irritation, one resection of postoperative heterotopic ossification, and one hip arthroscopy for intra-articular adhesions. No hips were converted to total hip arthroplasty at last follow-up. The presence of preoperative labral lesions or LT lesions did not influence any PROMs at last follow-up. From the three hips that had poor PROMs, two have developed severe osteoarthritis (> Tönnis II), presumably due to surgical overcorrection (postoperative AI < -10°). Conclusion PAO is reliable in treating BHD with favourable mid-term outcomes. Concomitant LT and labral lesions did not negatively influence outcomes in our cohort. Technical accuracy with avoidance of overcorrection is essential in achieving successful outcomes.
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Affiliation(s)
- Octavian Andronic
- Department of Orthopaedics, Balgrist University Hospital, University of Zürich, Zürich, Switzerland
| | - Christoph Germann
- Department of Radiology, Balgrist University Hospital, University of Zürich, Zürich, Switzerland
| | - Lukas Jud
- Department of Orthopaedics, Balgrist University Hospital, University of Zürich, Zürich, Switzerland
| | - Patrick O Zingg
- Department of Orthopaedics, Balgrist University Hospital, University of Zürich, Zürich, Switzerland
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Kirschner J, Michel S, Becker R, Stiebitz O, Hommel H, Schulz R, Daszkiewicz M, Królikowska A, Prill R. Determination of Relationships between Symmetry-Based, Performance-Based, and Functional Outcome Measures in Patients Undergoing Total Hip Arthroplasty. J Pers Med 2023; 13:1046. [PMID: 37511659 PMCID: PMC10381123 DOI: 10.3390/jpm13071046] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2023] [Revised: 06/06/2023] [Accepted: 06/23/2023] [Indexed: 07/30/2023] Open
Abstract
Due to the high heterogeneity in outcome measures after total hip arthroplasty (THA), the prospective observational study investigated the relationships between symmetry-based (SBMs), performance-based (PBMs), and functional outcome measures in THA patients to determine necessary or redundant categories of tests. The study material consisted of 24 patients with end-stage hip osteoarthritis scheduled for THA. The patients were examined one day before surgery and consecutively on the 4th day, 9th day, and 10th week postoperatively using the SBMs (weight-bearing chair-rising test, measurements of the maximal isometric torque of the quadriceps muscle); the PBMs (10-m walk, timed up-and-go, and stair-climbing tests); and the functional outcome measure (Harris Hip Score). The results obtained in a given category of tests at different time points were compared, and the correlations between the tests were determined. The reliability of the outcome measures was determined. The results of tests in the studied categories statistically significantly (p < 0.05) improved at the 10th week postoperatively compared to preoperative results. No strong correlations were revealed between the three studied types of outcome measures in THA patients. Therefore, none of them can be considered redundant. It also means that the relevance of symmetry for a core measurement set to describe the domain function in THA patients must be further clarified.
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Affiliation(s)
- Jana Kirschner
- Department of Therapy Sciences, Brandenburg University of Technology Cottbus-Senftenberg, 03046 Cottbus, Germany
| | - Sven Michel
- Department of Therapy Sciences, Brandenburg University of Technology Cottbus-Senftenberg, 03046 Cottbus, Germany
| | - Roland Becker
- Center of Orthopaedics and Traumatology, University Hospital Brandenburg a.d.H., Brandenburg Medical School Theodor Fontane, 14770 Brandenburg an der Havel, Germany
- Faculty of Health Sciences Brandenburg, Brandenburg Medical School Theodor Fontane, 14770 Brandenburg an der Havel, Germany
| | - Olaf Stiebitz
- Department of Therapy Sciences, Brandenburg University of Technology Cottbus-Senftenberg, 03046 Cottbus, Germany
| | - Hagen Hommel
- Department of Therapy Sciences, Brandenburg University of Technology Cottbus-Senftenberg, 03046 Cottbus, Germany
- District Hospital Märkisch Oderland GmbH, 16269 Wriezen, Germany
| | - Robert Schulz
- BIH QUEST Center for Responsible Research, Berlin Institute of Health at Charité, Universitätsmedizin Berlin, 10178 Berlin, Germany
| | | | - Aleksandra Królikowska
- Ergonomics and Biomedical Monitoring Laboratory, Department of Physiotherapy, Faculty of Health Sciences, Wroclaw Medical University, 50367 Wroclaw, Poland
| | - Robert Prill
- Center of Orthopaedics and Traumatology, University Hospital Brandenburg a.d.H., Brandenburg Medical School Theodor Fontane, 14770 Brandenburg an der Havel, Germany
- Faculty of Health Sciences Brandenburg, Brandenburg Medical School Theodor Fontane, 14770 Brandenburg an der Havel, Germany
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Lila AM, Alekseeva LI, Baranov AA, Taskina EA, Kashevarova NG, Lapkina NA, Trofimov EA. Chondroitin sulfate and glucosamine combination in patients with knee and hip osteoarthritis: A long-term observational study in Russia. World J Orthop 2023; 14:443-457. [PMID: 37377986 PMCID: PMC10292059 DOI: 10.5312/wjo.v14.i6.443] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/06/2023] [Revised: 04/19/2023] [Accepted: 05/12/2023] [Indexed: 06/19/2023] Open
Abstract
BACKGROUND Oral treatment of glucosamine (GA) combined with chondroitin sulfate (CS) was reportedly effective for pain relief and function improvement in osteoarthritis patients with moderate to severe knee pain in clinical trials. While the effectiveness of GA and CS on both clinical and radiological findings has been demonstrated, only a few high-quality trials exist. Therefore, controversy regarding their effectiveness in real-world clinical practice remains.
AIM To investigate the impact of GA + CS on clinical outcomes of patients with knee and hip osteoarthritis in routine clinical practice.
METHODS A multicenter prospective observational cohort study included 1102 patients of both genders with knee or hip osteoarthritis (Kellgren & Lawrence grades I-III) in 51 clinical centers in the Russian Federation from November 20, 2017, to March 20, 2020, who had started to receive oral capsules of glucosamine hydrochloride 500 mg and CS 400 mg according to the approved patient information leaflet starting from 3 capsules daily for 3 wk, followed by a reduced dosage of 2 capsules daily before study inclusion (minimal recommended treatment duration is 3-6 mo). Changes in subscale scores [Pain, Symptoms, Function, and Quality of Life (QOL)] of the Knee Injury and Osteoarthritis Outcome Score (KOOS)/Hip Disability and Osteoarthritis Outcome Score (HOOS) questionnaires during the observational period (up to 54-64 wk with a total of 4 visits). Patients’ treatment satisfaction, data on the combined oral use of glucosamine hydrochloride and CS, concomitant use of non-steroidal anti-inflammatory drugs (NSAIDs), and adverse events (AEs) were also evaluated.
RESULTS A total of 1102 patients with knee and hip osteoarthritis were included in the study. The mean patient age was 60.4 years, most patients were women (87.8%), and their average body mass index was 29.49 kg/m2. All subscale scores (Pain, Symptoms, Function, and QOL) of the KOOS and HOOS demonstrated clinically and statistically significant improvements. In patients with knee osteoarthritis, the mean score increases from baseline to the end of Week 64 were 22.87, 20.78, 16.60, and 24.87 on Pain, Symptoms, Physical Function (KOOS-PS), and QOL subscales (P < 0.001 for all), respectively. In patients with hip osteoarthritis, the mean score increases were 22.81, 19.93, 18.77, and 22.71 on Pain, Symptoms, Physical Function (HOOS-PS), and QOL subscales (P < 0.001 for all), respectively. The number of patients using any NSAIDs decreased from 43.1% to 13.5% (P < 0.001) at the end of the observation period. Treatment-related AEs occurred in 2.8% of the patients and mainly included gastrointestinal disorders [25 AEs in 24 (2.2%) patients]. Most patients (78.1%) were satisfied with the treatment.
CONCLUSION Long-term oral GA + CS was associated with decreased pain, reduced concomitant NSAID therapy, improved joint function and QOL in patients with knee and hip osteoarthritis in routine clinical practice.
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Affiliation(s)
- Alexander M Lila
- Director, Research Institute of Rheumatology Named after VA Nasonova, Moscow 115522, Moscow, Russia
| | - Lyudmila I Alekseeva
- Bone and Joints Metabolic Diseases Laboratory, Research Institute of Rheumatology Named after VA Nasonova, Moscow 115522, Moscow, Russia
| | - Andrey A Baranov
- Department of Therapy, Clinical Laboratory Diagnostics and Medical Biochemistry, Yaroslavl State Medical University, Yaroslavl 150000, Yaroslavl, Russia
| | - Elena A Taskina
- Bone and Joints Metabolic Diseases Laboratory, Research Institute of Rheumatology Named after VA Nasonova, Moscow 115522, Moscow, Russia
| | - Natalya G Kashevarova
- Bone and Joints Metabolic Diseases Laboratory, Research Institute of Rheumatology Named after VA Nasonova, Moscow 115522, Moscow, Russia
| | - Natalia A Lapkina
- Department of Therapy, Clinical Laboratory Diagnostics and Medical Biochemistry, Yaroslavl State Medical University, Yaroslavl 150000, Yaroslavl, Russia
| | - Evgeny A Trofimov
- Department of Therapy and Rheumatology, North-Western State Medical University named after I.I. Mechnikov, St. Petersburg 191015, St. Petersburg, Russia
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Zhang K, Miao X, Jiang L, Cui S, Liu Z, Wang Z. Postoperative analgesic efficacy and safety of imrecoxib versus celecoxib in hip osteoarthritis patients undergoing total hip arthroplasty: a multi-center, randomized, controlled, non-inferiority study. Inflammopharmacology 2023:10.1007/s10787-023-01260-7. [PMID: 37306938 DOI: 10.1007/s10787-023-01260-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2023] [Accepted: 05/26/2023] [Indexed: 06/13/2023]
Abstract
BACKGROUND Imrecoxib, a novel cyclooxygenase-2 inhibitor, possesses a certain postoperative analgesic effect for several orthopedic surgeries. This multi-center, randomized, controlled, non-inferiority study intended to investigate the postoperative analgesic efficacy and safety profile of imrecoxib (versus celecoxib) in hip osteoarthritis patients undergoing total hip arthroplasty (THA). METHODS 156 hip osteoarthritis patients planned for THA were randomized into imrecoxib (N = 78) and celecoxib (N = 78) groups. Patients were orally administrated with imrecoxib or celecoxib 200 mg at 2 h (h) after THA, 200 mg every 12 h to day (D)3, and 200 mg every 24 h to D7; additionally, each patient received patient-controlled analgesia (PCA) for 2 days. RESULTS Resting pain visual analogue scale (VAS) score at 6 h, 12 h, D1, D2, D3, and D7 post THA was not varied between imrecoxib and celecoxib groups (all P > 0.050), neither was moving pain VAS score (all P > 0.050). Importantly, the upper of 95% confidence interval of pain VAS score margin between imrecoxib and celecoxib groups was within the non-inferiority threshold (Δ = 1.0), indicating the fact that non-inferiority was established. The additional and total consumption of PCA was not varied between imrecoxib and celecoxib groups (both P > 0.050). Also, no difference was seen in Harris hip score, European Quality of Life 5-Dimensions (EQ-5D) total and VAS scores at month (M)1, M3 between the two groups (all P > 0.050). Besides, the incidences of all adverse events were not different between imrecoxib and celecoxib groups (all P > 0.050). CONCLUSION Imrecoxib is non-inferior to celecoxib for postoperative analgesia in hip osteoarthritis patients undergoing THA.
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Affiliation(s)
- Kai Zhang
- Department of Orthopedics, Handan Central Hospital, No. 59 Congtai North Road, Handan, 056000, China
| | - Xiaoyan Miao
- Department of General Surgery, Affiliated Hospital of Hebei Engineering University, Handan, 056002, China
| | - Liqiang Jiang
- Department of Orthopedics, Handan Central Hospital, No. 59 Congtai North Road, Handan, 056000, China
| | - Shubei Cui
- Department of Orthopedics, Handan Central Hospital, No. 59 Congtai North Road, Handan, 056000, China
| | - Zhenwu Liu
- Department of Orthopedics, Handan Central Hospital, No. 59 Congtai North Road, Handan, 056000, China
| | - Zhiyun Wang
- Department of Orthopedics, Handan Central Hospital, No. 59 Congtai North Road, Handan, 056000, China.
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Lin C, Liang Z, Liu J, Sun W. A machine learning-based prediction model pre-operatively for functional recovery after 1-year of hip fracture surgery in older people. Front Surg 2023; 10:1160085. [PMID: 37351328 PMCID: PMC10282650 DOI: 10.3389/fsurg.2023.1160085] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2023] [Accepted: 05/22/2023] [Indexed: 06/24/2023] Open
Abstract
Background Machine learning (ML) has been widely utilized for constructing high-performance prediction models. This study aimed to develop a preoperative machine learning-based prediction model to identify functional recovery one year after hip fracture surgery. Methods We collected data from 176 elderly hip fracture patients admitted to the Department of Orthopaedics and Oncology at Shenzhen Second People's Hospital between May 2019 and December 2019, who met the inclusion criteria. Patient's functional recovery was monitored for one year after surgery. We selected 26 factors, comprising 12 preoperative indicators, 8 surgical indicators, and 6 postoperative indicators. Eventually, 77 patients were included based on the exclusion criteria. Random allocation divided them into the training set (70%) and test set (30%) for internal validation. The Lasso method was employed to screen prognostic variables. We conducted comparisons among various common machine learning classifiers to determine the best prediction model. Prediction performance was evaluated using the area under the receiver operating characteristic curve (ROC), calibration curve, and decision curve analysis. To identify the importance of the predictor variables, we performed the recursive feature elimination (RFE) algorithm based on Shapley Additive Explanations (SHAP) values. Results The AUCs for the testing dataset were as follows: logistic regression (Logit) model = 0.934, k-nearest neighbors (KNN) model = 0.930, support vector machine (SVM) model = 0.910, Gaussian naive Bayes (GNB) model = 0.926, decision tree (DT) model = 0.730, random forest (RF) model = 0.957, and Extreme Gradient Boosting (XGB) model = 0.902. Among the seven ML-based models tested, the RF model demonstrated the best prediction performance, incorporating four features: postoperative rehabilitation compliance, marital status, age-adjusted Charlson comorbidity score (aCCI), and clinical frailty scale (CFS). Conclusion We developed a prediction model for the functional recovery following hip fracture surgery in elderly patients after one year, based on the Random Forest (RF) algorithm. This model exhibited superior prediction performance (ROC) compared to other models. The software application is available for use. External validation in a larger patient cohort or diverse hospital settings is necessary to assess the clinical utility of this tool.
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Affiliation(s)
- Chun Lin
- Department of Orthopedics, Shenzhen Second People’s Hospital, the First Affiliated Hospital of Shenzhen University Health Science Center, Shenzhen, China
- Department of General Medicine and Geriatrics, Shenzhen Qianhai Shekou Free Trade Zone Hospital, Shenzhen, China
| | - Zhen Liang
- Department of Geriatrics, Shenzhen People’s Hospital, Shenzhen, China
| | - Jianfeng Liu
- Department of Cardiology, the Second Medical Center and National Clinical Research Center for Geriatric Diseases, Chinese People’s Liberation Army General Hospital, Beijing, China
| | - Wei Sun
- Department of Orthopedics, Shenzhen Second People’s Hospital, the First Affiliated Hospital of Shenzhen University Health Science Center, Shenzhen, China
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Tariq MA, Ahmed B, Shaikh S, Amin H, Ali SU. Efficacy of Ibuprofen after Total Hip Arthroplasty to Prevent Heterotopic Ossification: Systematic Review and Meta-Analysis. Rev Bras Ortop 2023; 58:378-387. [PMID: 37396093 PMCID: PMC10310429 DOI: 10.1055/s-0042-1748947] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2021] [Accepted: 03/14/2022] [Indexed: 10/17/2022] Open
Abstract
The objective of this study was to conduct a systematic review and meta-analysis of relevant randomized control trials (RCTs) to determine the role of ibuprofen, as well as the optimum dose and duration of therapy, in preventing the incidence of heterotopic ossification (HO) after primary total hip arthroplasty (THA). A literature search was performed using the PubMed/MEDLINE and Cochrane Library databases for RCTs that compared the use of ibuprofen versus placebo as prophylaxis for HO in patients after THA. The main outcomes for this study were overall occurrence of HO, occurrence according to the Brooker classification, and gastrointestinal complications. A total of 27 potential articles were identified from the database. Eventually, four trials with 1,153 patients were included in the final analysis. When compared with placebo, the use of ibuprofen is associated with a reduction in the incidence of HO at the 3- and 12-month follow-up appointments, as well as the incidence of Brooker II and III HO ( p < 0.05). However, there was no significant difference between the ibuprofen and placebo groups in terms of treatment discontinuation due to gastrointestinal complications or the incidence of Brooker I and IV HO ( p > 0.05). The existing data indicates that ibuprofen is safe and efficacious in reducing the total incidence of HO along with Brooker II and III HO at follow-up. However, due to the small number of studies, the conclusions are limited; therefore, more high-quality clinical trials are required to develop guidelines for optimal dose and duration of therapy.
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Affiliation(s)
- Muhammad Ali Tariq
- Departamento de Cirurgia Ortopédica, Dow International Medical College, Karachi, Paquistão
| | - Bilal Ahmed
- Departamento de Cirurgia Ortopédica, Dow International Medical College, Karachi, Paquistão
| | - Shehryar Shaikh
- Departamento de Cirurgia Ortopédica, Dow International Medical College, Karachi, Paquistão
| | - Hamza Amin
- Departamento de Cirurgia Ortopédica, Dr. Ruth K. M. Pfau Civil Hospital, Karachi, Paquistão
| | - Syed Uzair Ali
- Departamento de Cirurgia Ortopédica, Dow International Medical College, Karachi, Paquistão
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Cai Q, Fu K, Jia W, Li X, He H, Yao Z, Chen X, Dong Y, Wang Q, Kang B, Qian B, Chen S, Zhang C. In-hospital waiting time to surgery and functional outcomes in geriatric hip fractures: a directed acyclic graph-based preplanned analysis from a prospective multicenter cohort study. Int J Surg 2023; 109:1612-1619. [PMID: 37039039 PMCID: PMC10389213 DOI: 10.1097/js9.0000000000000385] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2022] [Accepted: 03/27/2023] [Indexed: 04/12/2023]
Abstract
BACKGROUND The early recovery of hip function after hip fracture surgery values more attention, especially for patients with delayed surgery of longer than 48 h. We aim to evaluate the associations of in-hospital surgical waiting time with the functional outcomes [Harris Hip Score (HHS), Parker Mobility Score (PMS), and EuroQol 5 dimensions VAS (visual analogue scale) score (EQ-5D VAS)] in elderly patients who sustained hip fractures. MATERIALS AND METHODS Data on sociodemographic and clinical factors were prospectively collected using a multicenter hip fracture registry system. Participants in the cohort underwent a 12-month follow-up investigation. After adjusting potential confounders identified by the directed acyclic graphs, the associations between surgical waiting time longer than 48 h and functional outcomes were estimated by log-binomial regression and multivariable linear regression models with generalized estimating equations. RESULTS Of 863 survival participants with available functional data at 12 months after surgery, an increased risk was obtained from receiving surgery after 48 h and the poor functional outcomes (HHS<80: relative risk (RR)=1.56, 95% CI: 1.00-2.51; PMS<7: RR=1.49, 95% CI: 1.13-2.01; EQ-5D VAS<80: RR=1.97, 95% CI: 1.57-2.47). In-hospital waiting time greater than 48 h were time-invariantly associated with lower PMS during recovery (-0.44 units 95% CI: -0.70 to -0.18). In addition, delayed surgery was time-varying associated with HHS and EQ-5D VAS. CONCLUSIONS The associations between in-hospital waiting time and postoperative functional score suggest that delayed surgery can lead to poor functional outcomes, especially in patients waiting longer than 72 h from injury. Delayed surgery mainly impacted hip function and mobility recovery with a slower speed in early recovery of the first 3 months. More attention should be paid to mechanisms behind the associations between delayed surgery on general healthy status.
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Affiliation(s)
- Qianying Cai
- Department of Orthopedic Surgery, Shanghai Institute of Microsurgery on Extremities
| | - Kai Fu
- Department of Orthopedic Surgery, Shanghai Sixth People’s Hospital Affiliated to Shanghai Jiao Tong University School of Medicine
| | - Weitao Jia
- Department of Orthopedic Surgery, Shanghai Sixth People’s Hospital Affiliated to Shanghai Jiao Tong University School of Medicine
| | - Xiaolin Li
- Department of Orthopedic Surgery, Shanghai Sixth People’s Hospital Affiliated to Shanghai Jiao Tong University School of Medicine
| | - Haiyan He
- Department of Orthopedic Surgery, Shanghai Institute of Microsurgery on Extremities
| | - Zhenjun Yao
- Department of Orthopedic Surgery, Zhongshan Hospital, Fudan University
| | - Xiaodong Chen
- Department of Orthopedic Surgery, Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine
| | - Yuqi Dong
- Department of Orthopedics Trauma, Department of Orthopedics, Renji Hospital, School of Medicine
| | - Qiugen Wang
- Department of Trauma and Orthopedics, Shanghai General Hospital, Shanghai Jiao Tong University
| | - Bin Kang
- Department of Bone and Joint Surgery, Peking University Shenzhen Hospital, Shenzhen, People’s Republic of China
| | - Biyun Qian
- Hongqiao International Institute of Medicine, Shanghai Tong Ren Hospital and Clinical Research Institute, Shanghai Jiao Tong University School of Medicine
- Shanghai Clinical Research Promotion and Development Center, Shanghai Shen Kang Hospital Development Center, Shanghai
| | - Shengbao Chen
- Department of Orthopedic Surgery, Shanghai Institute of Microsurgery on Extremities
| | - Changqing Zhang
- Department of Orthopedic Surgery, Shanghai Sixth People’s Hospital Affiliated to Shanghai Jiao Tong University School of Medicine
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Pinheiro JS, Carlos FR, Caseiro-Filho LC, Ferraz Picado CH, Garcia FL, de Oliveira Guirro EC, de Jesus Guirro RR. Segmental bioelectrical impedance analysis can detect differences between the affected and non-affected limbs in individuals with hip osteoarthritis. BMC Musculoskelet Disord 2023; 24:420. [PMID: 37231384 DOI: 10.1186/s12891-023-06541-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/13/2023] [Accepted: 05/17/2023] [Indexed: 05/27/2023] Open
Abstract
OBJECTIVE To analyze the bioelectrical impedance parameters of the lower limbs of individuals with hip osteoarthritis and healthy individuals. DESIGN Cross-sectional study. SETTING The study was carried out at the Hip Surgery Outpatient Clinic. PARTICIPANTS The volunteers had to be between 45 and 70 years of age, of both sexes, with a clinical and radiological diagnosis of hip osteoarthritis for at least three years, unilateral involvement, or a significant complaint in one hip. METHODS This was a cross-sectional study. Fifty-four individuals were recruited for the study, 31 individuals with hip osteoarthritis (OA group) and 29 healthy individuals for the control group (C group). Demographic and anthropometric data were collected and then the Numerical Pain Rating Scale, WOMAC, Harris Hip Score, and bioimpedance assessment were applied. MAIN OUTCOME MEASURE(S) Electrical bioimpedance parameters. Phase angle (PhA), impedance, reactance, and muscle mass. RESULTS There was a significant difference in phase angle (PhA), impedance, and muscle mass at 50 kHz frequency on the side affected by OA when compared to the contralateral side. In the OA group, there was a significant decrease in phase angle (PhA) -0.54 (-0.85 to -0.23) and muscle mass - 0.29 (-0.40 to -0,19), as well as an increase in impedance at the 50 kHz frequency on the side affected by OA when compared to contralateral side 21.71 (13.69 to 29.74). In the C group, there was no difference between the dominant and non-dominant sides (P > 0.05). CONCLUSION The segmental electrical bioimpedance equipment can detect differences between limbs affected and unaffected by hip osteoarthritis.
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Affiliation(s)
- Jocassia Silva Pinheiro
- Laboratory of Physiotherapeutic Resources, Postgraduate Program in Rehabilitation and Functional Performance, Department of Health Sciences, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, SP, Brazil.
| | - Filipe Ramos Carlos
- Laboratory of Physiotherapeutic Resources, Postgraduate Program in Rehabilitation and Functional Performance, Department of Health Sciences, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, SP, Brazil
| | - Luis Carlos Caseiro-Filho
- Laboratory of Physiotherapeutic Resources, Postgraduate Program in Rehabilitation and Functional Performance, Department of Health Sciences, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, SP, Brazil
| | - Celso Hermínio Ferraz Picado
- Department of Orthopedics and Anesthesiology, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, SP, Brazil
| | - Flávio Luís Garcia
- Department of Orthopedics and Anesthesiology, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, SP, Brazil
| | - Elaine Caldeira de Oliveira Guirro
- Laboratory of Physiotherapeutic Resources, Postgraduate Program in Rehabilitation and Functional Performance, Department of Health Sciences, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, SP, Brazil
| | - Rinaldo Roberto de Jesus Guirro
- Laboratory of Physiotherapeutic Resources, Postgraduate Program in Rehabilitation and Functional Performance, Department of Health Sciences, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, SP, Brazil
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Wang L, Zhang N, Fang L, Cui Z, Niu H, Lv F, Hu D, Wu D. Effect of hip CPM on gross motor function and development of the hip joint: a single-center randomized controlled study on spastic cerebral palsy children with hip dysplasia. Front Pediatr 2023; 11:1090919. [PMID: 37228431 PMCID: PMC10203473 DOI: 10.3389/fped.2023.1090919] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/30/2023] [Accepted: 04/17/2023] [Indexed: 05/27/2023] Open
Abstract
Objective To investigate the effectiveness of hip continuous passive motion (hCPM) on hip development at skeletal maturity and gross motor function for spastic cerebral palsy children with hip dysplasia. Methods Prospective case-control research of hCPM with goal-directed training versus merely goal-directed training. On the basis of goal-directed training, the hCPM group used the hip joint CPM instrument (the external fixator was connected to the power device to make the hip joint carry out continuous passive movement) for 40-60 min, twice a day, and five times a week, and received continuous training for 8 weeks simultaneously. The control group received only goal-directed training for 8 weeks. Functional outcomes pertaining to the affected hip joints were assessed via gross motor function measure (GMFM), migration percentage (MP), acetabular index (AI), and Harris hip functional score (HHS) at the time of enrollment and the end of the intervention. Results The case-control research included 65 participants (mean age = 46.20 months, SD = 17.09 months; Gross Motor Function Grading System level: III = 41, IV = 24) who were randomly selected to either the hCPM (n = 45) or the control group (n = 20). No differences were found in baseline (acquisition phase) GMFM, MP, AI, or HHS (t = -1.720, P = 0.090; t* = 1.836, P* = 0.071; t# = -1.517, P# = 0.139; t* = -1.310, P* = 0.195; t# = -1.084, P# = 0.097; t = -1.041, P = 0.301). At the 8-week follow-up, GMFM, MP, AI, and HHS significantly improved over baseline in the hCPM group (hCPM group: t = 18.59, 20.172*, 40.291#, 16.820*, 32.900#, 28.081; P < 0.001). Between-group differences at 8-week follow-up times points favored the hCPM group for GMFM (t = -2.637, P = 0.011), MP (t* = 2.615, P* = 0.014; t# = 3.000, P# = 0.006), AI (t* = 2.055, P* = 0.044; t# = 2.223, P# = 0.030), HHS (t = -4.685, P < 0.001) (*: left side; #: right side). Conclusion Spastic cerebral palsy children with hip dysplasia achieved meaningful functional improvement after 8 weeks of goal-directed training with hCPM therapy.
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Affiliation(s)
- Lulu Wang
- Pediatric Neurological Rehabilitation Center, Pediatric Department, The First Affiliated Hospital of Anhui Medical University, Hefei, China
| | - Nuochen Zhang
- Pediatric Neurological Rehabilitation Center, Pediatric Department, The First Affiliated Hospital of Anhui Medical University, Hefei, China
| | - Liwei Fang
- Pediatric Neurological Rehabilitation Center, Pediatric Department, The First Affiliated Hospital of Anhui Medical University, Hefei, China
| | - Zhenzhen Cui
- Pediatric Neurological Rehabilitation Center, Pediatric Department, The First Affiliated Hospital of Anhui Medical University, Hefei, China
| | - Huihui Niu
- Pediatric Neurological Rehabilitation Center, Pediatric Department, The First Affiliated Hospital of Anhui Medical University, Hefei, China
| | - Fuli Lv
- Pediatric Neurological Rehabilitation Center, Pediatric Department, The First Affiliated Hospital of Anhui Medical University, Hefei, China
| | - Dayong Hu
- Department of Pediatrics, Anhui Hefei Southeast Surgical Hospital
| | - De Wu
- Pediatric Neurological Rehabilitation Center, Pediatric Department, The First Affiliated Hospital of Anhui Medical University, Hefei, China
- Department of Pediatrics, Anhui Hefei Southeast Surgical Hospital
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Badi HA, Tanzer M, Nooh A, Hall B, Hart A. A Short Course of Celecoxib Prevents Heterotopic Ossification Following Cementless Total Hip Arthroplasty. Life (Basel) 2023; 13:life13040944. [PMID: 37109473 PMCID: PMC10142707 DOI: 10.3390/life13040944] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2023] [Revised: 03/19/2023] [Accepted: 03/31/2023] [Indexed: 04/07/2023] Open
Abstract
Heterotopic ossification (HO) is a common complication after total hip arthroplasty (THA) and can result in pain and loss of motion of the hip. This is the first study in the literature to determine if a short course of Celecoxib is effective in the prevention of HO in patients undergoing cementless THA. In this retrospective study of prospectively collected data, consecutive patients undergoing a primary cementless THA were reviewed at a 2-year follow-up. The Control group consisted of 104 hips that did not receive Celecoxib (Control group), while the 208 hips in the Celecoxib group received 100 mg twice daily for 10 days. Radiographs, patient-recorded outcome measures and range of motion (ROM) were evaluated. Overall, there was a significantly decreased incidence of HO in the Celecoxib group (18.7%) than in the Control group (31.7%) (p = 0.01). The odds that a patient developed HO using Celecoxib were 0.4965 times the odds that a patient developed HO without treatment. Clinically, the Celecoxib group demonstrated significantly greater improvement in their mean WOMAC stiffness (0.35 vs. 0.17, p = 0.02) and physical function scores (3.26 vs. 1.83, p = 0.03) compared to those in the Control group, but there was no difference in the ROM between the two groups. This study is the first to demonstrate that the lowest dose of Celecoxib for a short course of only 10 days is a simple and effective prophylactic treatment option that can significantly reduce the incidence of HO following cementless THA.
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Affiliation(s)
- Hamid Al Badi
- Jo Miller Orthopaedic Research Laboratory, Division of Orthopaedic Surgery, McGill University, Montreal, QC H3G 1A4, Canada
| | - Michael Tanzer
- Jo Miller Orthopaedic Research Laboratory, Division of Orthopaedic Surgery, McGill University, Montreal, QC H3G 1A4, Canada
| | - Anas Nooh
- Jo Miller Orthopaedic Research Laboratory, Division of Orthopaedic Surgery, McGill University, Montreal, QC H3G 1A4, Canada
| | - Brandon Hall
- Jo Miller Orthopaedic Research Laboratory, Division of Orthopaedic Surgery, McGill University, Montreal, QC H3G 1A4, Canada
| | - Adam Hart
- Jo Miller Orthopaedic Research Laboratory, Division of Orthopaedic Surgery, McGill University, Montreal, QC H3G 1A4, Canada
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Korytkin AA, El Moudni YM, Novikova YS, Kovaldov KA, Morozova EA. A prospective randomised comparison of earlier function after total hip arthroplasty with a mini posterior approach or supercapsular percutaneously-assisted total hip approach: a gait analysis study. Hip Int 2023; 33:169-177. [PMID: 34030517 DOI: 10.1177/11207000211018440] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
BACKGROUND The supercapsular percutaneously-assisted total hip (SuperPATH) approach is a muscle sparing surgical technique for total hip arthroplasty (THA). The literature reports good clinical and functional results of the SuperPATH technique in the short term. We aimed to compare early outcomes and gait analysis of THA using the mini posterior approach (MPA) and supercapsular percutaneously-assisted total hip (SuperPATH) approach. METHODS 44 patients who underwent THA, were randomly allocated to either MPA or SuperPATH. The data were then collected prospectively (preoperatively and postoperatively at 6 weeks). Plain anteroposterior radiographs of the pelvis and instrumental gait analysis were obtained. The visual analogue scale (VAS), Harris Hip Score (HHS) and Hip disability and Osteoarthritis Outcome Scores (HOOS) were used to assess functional and clinical outcomes. RESULTS No significant difference was found in patients' surgical outcomes. Patients in the SuperPATH group had less pain according to the VAS score at follow-up than the MPA group (p < 0.01). There was also a significant improvement in HHS and HOOS scores for all patients (p < 0.001) with the SuperPATH group showing superior changes. The comparison of mean differences in gait velocity between preoperative and 6 weeks postoperative result, revealed improvement in the SuperPATH group over the MPA group (p = 0.06). Limping was more persistent in the MPA group. Kinematic parameters demonstrated improved hip joint excursion slightly higher in the MPA group. There was no significant improvement in kinetic and kinematic parameters at different walking moments for all patients at 6 weeks compared to preoperative gait patterns. CONCLUSIONS SuperPATH and MPA both show excellent results. This study reveals that the SuperPATH technique was associated with lower postoperative pain levels, and higher physical function and quality of life. Improved functional outcomes allowed earlier postoperative rehabilitation and faster recovery. Specific improvement in gait patterns were identified with nonsignificant differences between the 2 approaches at 6 weeks follow-up.
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Affiliation(s)
- Andrey A Korytkin
- Department of Research Organisation, Novosibirsk Research Institute of Traumatology and Orthopaedics, Novosibirsk, Russian Federation
| | - Younes M El Moudni
- Department of Trauma and Orthopaedic Surgery, University Hospital Ibn Rochd, Casablanca, Morocco
| | - Yana S Novikova
- Department of Research Organisation, Novosibirsk Research Institute of Traumatology and Orthopaedics, Novosibirsk, Russian Federation
| | - Kirill A Kovaldov
- Department of Adult Orthopaedics, University Clinic of Privolzhsky Research Medical University, Nizhny Novgorod, Russian Federation
| | - Ekaterina A Morozova
- Department of Adult Orthopaedics, University Clinic of Privolzhsky Research Medical University, Nizhny Novgorod, Russian Federation
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