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1.
Zingg PO Schallberger A Rüdiger HA Poutawera V Dora C 《Archives of orthopaedic and trauma surgery》2012,132(3):299-303
Introduction
The risk that hip preserving surgery may negatively influence the performance and outcome of subsequent total hip replacement (THR) remains a concern. The aim of this study was to identify any negative impact of previous hip arthroscopy on THR. 相似文献2.
Neuerburg C Impellizzeri F Goldhahn J Frey P Naal FD von Knoch M Leunig M von Knoch F 《Archives of orthopaedic and trauma surgery》2012,132(4):527-533
Background
Second generation metal-on-metal total hip replacements (THR) were introduced in the late 1980s and various studies reported conflicting data on their outcome. 相似文献3.
Alma B Pedersen Frank Mehnert Soren Overgaard Soren P Johnsen 《BMC musculoskeletal disorders》2009,10(1):167-12
Background
Allogeneic red blood cell transfusion is frequently used in total hip replacement surgery (THR). However, data on the prognosis of transfused patients are sparse. In this study we compared the risk of complications following THR in transfused and non-transfused patients. 相似文献4.
Background
Heterotopic ossification (HO) is a well-known complication after total hip and knee arthroplasty. But limited studies have focused on prevalence of HO following cervical total disc arthroplasty (CTDA) and the published data show controversial results. 相似文献5.
Clément M. L. Werner Stefan M. Zimmermann Carola C. Würgler-Hauri Joseph M. Lane Guido A. Wanner Hans-Peter Simmen 《HSS journal》2013,9(2):166-170
Background
Heterotopic ossification (HO) is a common complication following orthopedic and trauma surgery, which may have substantial negative effects on the postoperative outcome. Angiogenesis appears to play a critical role in heterotopic ossification. One of the involved signaling molecules is platelet-derived growth factor (PDGF) which may be inhibited by imatinib.Questions/Purposes
Our goal was to prevent HO by pharmacologically interfering with the molecular signaling pathways involved in the developmental process. We hypothesized that by administering a proven inhibitor of PDGF expression, heterotopic bone formation may be prevented.Methods
The effect of imatinib on HO formation was studied in a murine model which reliably produces islets of HO within the soft tissue following Achilles tenotomy. The control group underwent Achilles tenotomy only. The imatinib group received imatinib mesylate. After trial completion, the limbs were harvested and scanned by micro-CT. Heterotopic bone volume was then identified and quantified.Results
The mean volume of heterotopic bone formed in the control group was 0.976mm3 compared to 0.221 mm3 in the imatinib group. The volume of HO in the treatment group was reduced by 85% compared to the control group.Conclusions
The administration of imatinib was associated with a significantly reduced volume of HO. This may be due to the inhibitory effect of imatinib on the PDGF signaling pathway during development of HO.Clinical Relevance
The successful reduction of HO formation following imatinib administration has led to further insight concerning the pathogenesis of HO which in the future may lead to new clinical approaches towards the prevention of HO.Electronic supplementary material
The online version of this article (doi:10.1007/s11420-013-9335-y) contains supplementary material, which is available to authorized users. 相似文献6.
Moritz M. Innmann Michael W. Maier Marcus R. Streit George Grammatopoulos Thomas Bruckner Tobias Gotterbarm Christian Merle 《The Journal of arthroplasty》2018,33(1):156-161
Background
There is a lack of prospective studies investigating the additive effect of both acetabular and femoral reconstruction parameters on the functional outcome following total hip arthroplasty (THA).Methods
The aim of this prospective cohort study was to determine the combined influence of hip geometry reconstruction and component positioning on the clinical outcome following primary THA for unilateral osteoarthritis. We prospectively assessed the clinical outcome and radiographic parameters for hip geometry reconstruction, component position, and orientation using validated measurements for the operated hip compared to the contralateral native hip in a consecutive series of 113 patients with primary unilateral cementless THA. The correlation of reconstruction parameters was investigated using a multivariate polynomial regression model for the dependent variable ΔHHS (difference between the Harris hip scores preoperatively and 2.0-4.8 years postoperatively). Target zones for hip reconstruction and component positioning were investigated for an association with superior clinical outcome.Results
The regression model demonstrated a significant correlation for the ΔHHS and both hip offset (HO) reconstruction and leg length difference. Patients with accurate to slightly increased HO reconstruction combined with balanced leg length demonstrated a significantly higher ΔHHS than patients outside this zone (HO: 5 ± 5 and LLD: 0 ±5 mm, P = .029). This finding could be confirmed for 2 enlarged zones (zone 1: HO, 7.5 ± 7.5 and LLD, 2.5 ± 7.5 mm, P = .028; zone 2: HO, 7.5 ± 7.5 and LLD, 7.5 ± 7.5 mm, P = .007).Conclusion
HO and leg length reconstruction demonstrated an additive effect on clinical outcome and surgeons should aim for high accuracy in the reconstruction of both factors. 相似文献7.
Background
Heterotopic ossification (HO) is the formation of mature, lamellar bone within soft tissues other than the periosteum. There are three recognized etiologies of HO: traumatic, neurogenic, and genetic. Presently, there are no definitively documented causal factors of HO. The following factors are presumed to place a patient at higher risk: 60 years of age or older, male, previous HO, hypertrophic osteoarthritis, ankylosing spondylitis, diffuse idiopathic skeletal hyperostosis, prior hip surgery, and surgical risk factors. 相似文献8.
Purpose
The authors tried to assess the treatment outcomes depending on the extent of resection in axial chordomas and compare the outcome of two adjunctive therapies (external beam radiation therapy vs. stereotactic radiosurgery) following incomplete tumour resection in terms of local tumour control. 相似文献9.
Nicolai Kjærgaard Jonas B. Kjærsgaard Christian L. Petersen Michael U. Jensen Mogens B. Laursen 《Journal of orthopaedics and traumatology》2017,18(4):401-406
Background
This is a prospective cohort study to define the thresholds to distinguish patients with a satisfactory or unsatisfactory outcome after total hip replacement (THR) based on patient-reported outcome measures (PROMs) including the Oxford Hip Score (OHS), and using patient satisfaction and patient-perceived function as global transition items. The thresholds are intended to be used as a tool in the process of determining which patients are in need of postoperative outpatient evaluation.Methods
One hundred and three THR patients who had completed a preoperative questionnaire containing the OHS questionnaire were invited to complete the same questionnaire and supplementary questions at a mean of 6 (4–9) months after surgery. Correlations between outcome measures and anchors were calculated using Pearson’s correlation coefficient. Thresholds were established by receiver operating characteristic (ROC) analysis, using multiple anchors.Results
Significant correlations were found between outcome measures and anchors. Thresholds were determined for outcome measures coupled with satisfaction, patient-perceived function and a combination thereof using a cut-off of 50 and 70.Conclusions
We have established a set of thresholds for Oxford scores that may help determine which THR patients are in need of postoperative evaluation. These thresholds can be implemented in clinical practice.Level of evidence
Level 3.10.
Devendra Mahadevan Christopher Challand Jonathan Keenan 《Journal of orthopaedics and traumatology》2010,11(3):159-165
Background
Revision total hip replacement (THR) is associated with increased blood loss and extended hospitalization. 相似文献11.
Shi BZ Meng XF Yang JX Hao XW Cui T Lu ZF Zhang HR Zhou JC Liu JF 《Acta neurochirurgica》2012,154(6):1081-1086
Background
Studies have demonstrated that brain oedema formation following spontaneous intracerebral haemorrhage is associated with substances derived from blood clots or blood components. However, these studies did not completely reveal the role of blood components in brain oedema formation following traumatic intracerebral haemorrhage (TICH). Here, we explore the role of erythrocytes in brain oedema development by studying the effect of erythrocytes on brain water content (BWC) and expression of haem oxygenase-1 (HO-1) in rats with TICH. 相似文献12.
Arthur Grzesiak Kamiar Aminian Estelle Lécureux Florence Jobin Brigitte M. Jolles 《International orthopaedics》2014,38(4):717-724
Purpose
The aim of this study was to determine outcomes of total hip replacement (THR) with the Lemania cemented femoral stem.Methods
A total of 78 THR patients were followed and compared to 17 “fit”, healthy, elderly and 72 “frail” elderly subjects without THR, using clinical outcome measures and a portable, in-field gait analysis device at five and ten years follow-up.Results
Forty-one patients (53 %), mean age 83.4 years, available at ten years follow-up, reported very good to excellent satisfaction. Mean Harris Hip and Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) scores were 81.2 and 10.5 points, respectively, with excellent radiological preservation of proximal femur bone stock. Spatial and temporal gait parameters were close to the fit group and better than the frail group.Conclusions
Lemania THR demonstrated very good, stable clinical and radiological results at ten years in an older patient group, comparable to other cemented systems for primary THR. Gait analysis confirmed good walking performance in a real-life environment. 相似文献13.
Ernst Sendtner Katja Borowiak Tibor Schuster Michael Woerner Joachim Grifka Tobias Renkawitz 《Archives of orthopaedic and trauma surgery》2011,131(5):597-602
Background and purpose
There is still conflicting evidence about the true benefit of minimally invasive (MI) techniques in total hip replacement (THR). The aim of this prospective study was to evaluate the safeness of a MI approach during the learning curve of a single surgeon. Second, clinical and radiographic results among the MI THR group were compared with the results using a standard transgluteal (Bauer) approach. 相似文献14.
Introduction
The aim of the present study was to define the medium-term outcomes following total hip replacement (THR) for hip fracture.Methods
We prospectively followed up 92 patients who underwent THR for a displaced hip fracture over a 3-year period between 2007 and 2010. These patients were followed up at 5 years using the Oxford Hip Score, Short-Form 12 (SF-12) questionnaire and satisfaction questionnaire. These outcomes were compared to the short-term outcomes previously reported at 2 years to determine any significant differences.Results
Mean follow-up was at 5.4 years with a mean age at follow-up of 76.5 years. Seventy-four patients (80%) responded. Patients reported excellent functional outcomes and satisfaction (mean Oxford Hip Score 40.3; SF-12 Physical Health Composite Score 44.0; SF-12 Mental Health Composite Score 46.2; mean satisfaction 90%). The rates of dislocation (2%), deep infection (2%) and revision (3%) were comparable to those quoted for elective THR. When compared with 2-year follow-up, there were no statistically significant adverse changes in outcome parameters.Conclusions
Medium-term outcomes for THR after hip fracture in fit older patients are excellent, and these results demonstrate that the early proven benefits of this surgery are sustained into the midterm.15.
Malte Ohlmeier Eduardo M. Suero Mirko Aach Renate Meindl Thomas A. Schildhauer Mustafa Citak 《The spine journal》2017,17(10):1519-1522
Background Context
Heterotopic ossification (HO) is a known complication especially in people with traumatic spinal cord injury (SCI). Although some risk factors have already been described, the pathophysiology of HO is still unknown. The pelvis is the most common region for HO occurrence. However, the prevalence of HO by muscle groups about the hip is not well described.Purpose
To analyze the prevalence of early HO in muscle groups about the hip in 267 patients with SCI.Patient Sample
267 patients with traumatic SCI and pelvic HO.Methods
Between January 2001 and December 2014, 267 patients with SCI were treated in our university hospital and were included in the study. Patients were routinely screened for HO using ultrasound. The diagnosis of HO was validated using magnetic resonance imaging (MRI) or computed tomography (CT). The primary outcome measure was the prevalence of HO by muscle groups around the hip. The following muscle groups around the hip were defined: (1) gluteal group, (2) adductor group, (3) iliopsoas group, and (4) deep muscle group. Additionally, the prevalence of concomitant trochanteric bursitis was recorded in all cases.Results
The gluteal group showed the highest HO prevalence with 55.8%, followed by the deep muscle group with 31.1%. Concomitant trochanteric bursitis was found in 62 patients (23.2%). No association between pelvic trauma and HO development was observed (n=16, 11%).Conclusions
The most common muscular location for the occurrence of HO about the hip was the gluteal muscle group. Considering that no laboratory parameters are currently available for screening for HO, highly sensitive ultrasound screening examinations should be routinely performed, with particular attention paid to the gluteal muscles. Additionally, routine range of motion examination for extension and external rotation of the hip joint is warranted. 相似文献16.
Objectives
The purpose of this study is to investigate the incidence of heterotopic ossification (HO) in the Bryan cervical arthroplasty group and to identify associations between preoperative factors and the development of HO. 相似文献17.
Hyun-Jin Park Chong-Suh Lee Sung-Soo Chung Se-Jun Park Wan-Seok Kim Jin-Sung Park Kyung-Joon Lee Chan-Ha Hwang 《The spine journal》2018,18(5):762-768
Background
The long-term results of heterotopic ossification (HO) following lumbar total disc replacement (TDR) and the corresponding clinical and radiological outcomes are unclear.Purpose
This study aimed to report the long-term results of HO following lumbar TDR and to analyze the clinical and radiological outcomes.Study Design/Setting
A retrospective case review was performed for the consecutive patients who underwent lumbar TDR.Patient Sample
The study included 48 patients (60 segments) who underwent lumbar TDR.Outcome Measures
The time and location of HO development, segmental range of motion (ROM) of index level, the visual analog scale (VAS), and the Oswestry Disability Index (ODI) were analyzed.Methods
Forty-eight patients (60 segments) were divided into HO and non-HO groups, and radiographs were used to measure the time and location of HO development. We compared segmental ROM between two groups using flexion-extension radiographs. Clinical outcomes were assessed using the VAS and the ODI. Furthermore, the segmental ROM, VAS, and ODI scores of each HO class were compared with those of the non-HO group.Results
The mean follow-up duration was 104.4 months. Heterotopic ossification was detected in 30 of 60 segments following lumbar TDR, and HO progression was noted in six segments. The mean segmental ROM was significantly lower in the HO group than in the non-HO group. The mean VAS and ODI scores were not significantly different between the two groups. Segmental ROM was significantly lower in the class III and IV of the HO group than in the non-HO group. The VAS and ODI scores were not significantly different among the different classes.Conclusions
We found that the incidence of HO is the highest within 12 months after lumbar TDR, and the incidence might increase 5 years after surgery. Furthermore, HO progressed over time. Segmental ROM was decreased in the HO groups; however, the limitation in motion might have little clinical influence. 相似文献18.
Purpose
To identify the factors that may affect outcome in C-ADR and provide the pooled results of postoperative success rate of implanted segment range of motion (ROM), incidence of heterotopic ossification (HO), incidence of radiographic adjacent segment degeneration (r-ASD)/adjacent segment disease (ASD), and surgery rate for ASD.Methods
We systematically searched in PubMed, Embase, Cochrane library and Web of knowledge from 2001 to May 2015. Two independent reviewers screened the primary records. Eleven questions regarding the effect of patient selection issues and radiographic parameters issues on outcome were posed previously. Studies addressing the framed questions were included for analysis.Results
Twenty-two studies were included for the final analysis. Results showed that number of surgical level (single versus double-level) had no effect on primary clinical outcome and radiographic outcome, surgical level had no effect on clinical and radiographic outcome, and smoking habits had negative effect on clinical outcome. No evidence for the effect of patient’s age and pathology category (radiculopathy or myelopathy) on outcome was found. The overall success rate of ROM was 79.4 %. ROM of the implanted segment and cervical sagittal alignment had no effects on clinical outcome. The pooled incidences of grade 1–4 HO and grade 3–4 HO were 27.7 and 7.8 %, respectively. The pooled incidence of r-ASD and surgery rate for ASD were 42.4 and 3.8 %, respectively.Conclusions
The available evidence showed that most of the pre-selected factors had no effect on outcome after C-ADR, and the ROM success rate, incidence of HO and r-ASD/ASD, and surgery rate for ASD are acceptable. There is a lack of evidence from RCTs for some factors.19.
Veera Venkata Satyanarayana Eethakota Vinod Vaishnav Linda Johnston Rami Abboud Weijie Wang 《The surgeon》2018,16(6):339-349
Background and purpose
Currently it is not clear whether age is a factor affecting revisions in total hip replacement (THR) and hip resurfacing (HR). This study aimed to investigate which of THR or HR has a higher risk in terms of revision and complication within similar age groups.Methods
A systemic review was performed for published literature research databases and local data and compared the two procedures under the condition that both groups of patients were age matched. Meta-analysis techniques were used to analyse revision and complication rates. Twenty-seven literature studies were included along with local audit data. In total, 2520 HR procedures were compared with age-matched 2526 of THR procedures.Main findings
It was found that revision risk of HR is significantly higher than THR (risk ratio 1.65, 95% CI 1.28–2.31, p < 0.0001), highlighting that HR has a slightly higher chance of reoperation when compared to THR within the similar age group population. In terms of complications, HR was found to have an advantage over THR (risk ratio 0.84, 95% CI 0.73–0.96, p < 0.01).Conclusion
THR had a lower revision risk but a slightly higher complication risk than HR under the condition that the two surgical procedures were applied to similar age groups of patients. In other words, age has not played an important role in revision and complication. Survivorship cannot be measured as follow-up periods were different in the studies used. 相似文献20.
Xin-Bao Wu Ming-Hui Yang Shi-Wen Zhu Qi-Yong Cao Hong-Hua Wu Man-Yi Wang Derly O. Cuellar III Cyril Mauffrey 《Injury》2014