Primary hip arthroplasty for the treatment of alkaptonuric hip arthritis: 3- to 24-year follow-ups

Total Hip Arthroplasty in Ochronotic Arthropathy: A Case Report

Introduction

Total hip arthroplasty (THA) is a common procedure used to treat various hip conditions. However, patients with ochronotic arthropathy, a rare genetic disorder characterized by the abnormal accumulation of homogentisic acid, are at a higher risk of post-surgical dislocation and instability due to poor bone quality and joint degeneration.

Case Report

This case study features a 52-year-old male patient diagnosed with ochronotic arthropathy who underwent bilateral THA with the use of a dual mobility cup (DMC). Ochronotic arthropathy had caused significant joint degeneration and stiffness, leading to considerable functional impairment.

Conclusion

The application of a DMC in THA for patients with ochronotic arthropathy has shown promising outcomes. The DMC offers increased range of motion and improved stability, effectively reducing the risk of post-surgical dislocation and implant failure. This case study highlights the potential of DMC as a viable solution for addressing the challenges posed by poor bone quality in patients with ochronotic arthropathy undergoing THA.

Return to work following primary total hip arthroplasty: a systematic review and meta-analysis

BACKGROUND

Total hip arthroplasty (THA) is increasingly common in younger patients, who are more likely to be working preoperatively. There is a need for an updated review of the literature regarding the rate and time to return to work (RTW), which is important when counseling patients, and also from an economic standpoint.

METHODS

A systematic review and meta-analysis of the literature was performed on January 20, 2022, and studies reporting the rate and/or time to RTW after THA were included. Two authors independently selected relevant papers. RTW was extracted and analyzed using fixed-effects or random-effects models where appropriate.

RESULTS

A total of 48 studies were included in the final analysis. We found that 70.7% of patients were working after primary THA. Among patients who were working before surgery, this rate increases to 87.9%, while 28.1% of patients who were not working preoperatively started working after surgery. Younger patients were more likely to RTW, while patients with a physically demanding job were less likely to RTW. Minimally invasive techniques were reported to yield a higher rate of RTW and an earlier time to RTW.

CONCLUSION

We found that the majority of patients return to work after THA, and some patients are able to start working after surgery. Compared to previous reviews, patients seem to have a higher rate and earlier RTW. The overall trend of the literature suggests that patients are returning to work earlier and at a higher rate compared to previous reviews.