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Cup Positioning In Total Hip Arthroplasty / Th. Scheerlinck in Acta Orthopaedica Belgica, Vol 80/3 (Septembre 2014)
[article]
Titre : Cup Positioning In Total Hip Arthroplasty Type de document : texte imprimé Auteurs : Th. Scheerlinck, Auteur Année de publication : 2014 Article en page(s) : p.336-347 Langues : Anglais (eng) Mots-clés : hip arthroplasty cup orientation acetabular component biomechanics Résumé : The “optimal” positioning of the cup in total hip arthroplasty can improve hip function and reduce wear, impingement and dislocation. The cup position is described as the spatial relation between the hip rotation centre and the pelvis and, as the cup orientation around the rotation centre. The first parameter affects hip balance and, if not managed properly, might result in poor function and leg length discrepancy. The second parameter is often “silent”, unless impingement or dislocation occurs. However, inappropriate cup orientation can accelerate wear and cause early failure. As such, it is mandatory to get both right, taking into account multiple parameters : the stem position, the approach, the bearing surface, the cup coverage and the pelvic orientation during loading. In most cases a “standard” cup position is adequate. However, specific anatomic features might require an individualized approach. This paper aims at reviewing the parameters that impact on the optimal cup position. This should allow for more judicious choices in those particular cases. Permalink : ./index.php?lvl=notice_display&id=34648
in Acta Orthopaedica Belgica > Vol 80/3 (Septembre 2014) . - p.336-347[article] Cup Positioning In Total Hip Arthroplasty [texte imprimé] / Th. Scheerlinck, Auteur . - 2014 . - p.336-347.
Langues : Anglais (eng)
in Acta Orthopaedica Belgica > Vol 80/3 (Septembre 2014) . - p.336-347
Mots-clés : hip arthroplasty cup orientation acetabular component biomechanics Résumé : The “optimal” positioning of the cup in total hip arthroplasty can improve hip function and reduce wear, impingement and dislocation. The cup position is described as the spatial relation between the hip rotation centre and the pelvis and, as the cup orientation around the rotation centre. The first parameter affects hip balance and, if not managed properly, might result in poor function and leg length discrepancy. The second parameter is often “silent”, unless impingement or dislocation occurs. However, inappropriate cup orientation can accelerate wear and cause early failure. As such, it is mandatory to get both right, taking into account multiple parameters : the stem position, the approach, the bearing surface, the cup coverage and the pelvic orientation during loading. In most cases a “standard” cup position is adequate. However, specific anatomic features might require an individualized approach. This paper aims at reviewing the parameters that impact on the optimal cup position. This should allow for more judicious choices in those particular cases. Permalink : ./index.php?lvl=notice_display&id=34648 Exemplaires (1)
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Exclu du prêtDual mobility versus unipolar total hip arthroplasty for neck of femur fractures : a single centre study / Zain Sadozai in Acta Orthopaedica Belgica, Vol.87/1 (Mars 2021)
[article]
Titre : Dual mobility versus unipolar total hip arthroplasty for neck of femur fractures : a single centre study Type de document : texte imprimé Auteurs : Zain Sadozai ; Richard Limb ; Syed Awais Bokhari ; Aaron Ng ; Manjit Bhamra Année de publication : 2021 Article en page(s) : p. 35-39 Note générale : https://doi.org/10.52628/87.1.05 Langues : Anglais (eng) Mots-clés : Dual mobility fracture femur dislocation comparison hip arthroplasty Résumé : Current national guidelines (NICE) recommends that all medically fit, independently-mobile patients without cognitive impairment receive a total hip arTHAoplasty(THA) for displaced intracapsular neck of femur (NOF) fractures. Dislocation is a concern(2-10%). Dual mobility cups have been suggested to address this complication. Our study sets out to compare dislocation rates between dual mobility cups versus unipolar cups.
We performed a retrospective single centre multiple surgeon study of all THAs performed for NOFs between January 2012 and May 2018. A total of 322 total hip replacements (127 dual mobility and 195 unipolar ; Age range of patients, 29 to 91, mean 70 years) were identified for analysis using a database. Data was obtained from electronic patient records and radiographs.
12 patients sustained a dislocation of their THA out of our 322 patients. Of these, 10 dislocations occurred in the unipolar group (5.13%). From the dual mobility cups, 2 had dislocations(1.57%), both with a 28mm head. Both of these dislocations were in alcohol dependent patients with increased susceptibility to falls. Statistical analysis of our data was performed using chi-squared test (p value = 0.0723)
In ‘Getting It Right First Time’ (GIRFT), the authors recommend that all patients that sustain a NOF fracture meeting the criteria of a THA to be offered a dual mobility acetabular cup to reduce the risk of dislocation. The cost of the dual mobility acetabular cup is offset from the cost of overall revision surgery. Limitations of our study are its retrospective nature and selection bias.Permalink : ./index.php?lvl=notice_display&id=96574
in Acta Orthopaedica Belgica > Vol.87/1 (Mars 2021) . - p. 35-39[article] Dual mobility versus unipolar total hip arthroplasty for neck of femur fractures : a single centre study [texte imprimé] / Zain Sadozai ; Richard Limb ; Syed Awais Bokhari ; Aaron Ng ; Manjit Bhamra . - 2021 . - p. 35-39.
https://doi.org/10.52628/87.1.05
Langues : Anglais (eng)
in Acta Orthopaedica Belgica > Vol.87/1 (Mars 2021) . - p. 35-39
Mots-clés : Dual mobility fracture femur dislocation comparison hip arthroplasty Résumé : Current national guidelines (NICE) recommends that all medically fit, independently-mobile patients without cognitive impairment receive a total hip arTHAoplasty(THA) for displaced intracapsular neck of femur (NOF) fractures. Dislocation is a concern(2-10%). Dual mobility cups have been suggested to address this complication. Our study sets out to compare dislocation rates between dual mobility cups versus unipolar cups.
We performed a retrospective single centre multiple surgeon study of all THAs performed for NOFs between January 2012 and May 2018. A total of 322 total hip replacements (127 dual mobility and 195 unipolar ; Age range of patients, 29 to 91, mean 70 years) were identified for analysis using a database. Data was obtained from electronic patient records and radiographs.
12 patients sustained a dislocation of their THA out of our 322 patients. Of these, 10 dislocations occurred in the unipolar group (5.13%). From the dual mobility cups, 2 had dislocations(1.57%), both with a 28mm head. Both of these dislocations were in alcohol dependent patients with increased susceptibility to falls. Statistical analysis of our data was performed using chi-squared test (p value = 0.0723)
In ‘Getting It Right First Time’ (GIRFT), the authors recommend that all patients that sustain a NOF fracture meeting the criteria of a THA to be offered a dual mobility acetabular cup to reduce the risk of dislocation. The cost of the dual mobility acetabular cup is offset from the cost of overall revision surgery. Limitations of our study are its retrospective nature and selection bias.Permalink : ./index.php?lvl=notice_display&id=96574 Exemplaires (1)
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Exclu du prêtLow blood transfusion rate after implementation of tranexamic acid for fast- track hip- and knee arthroplasty. An observational study of 5205 patients / Yoeri Bemelmans in Acta Orthopaedica Belgica, Vol.87/1 (Mars 2021)
[article]
Titre : Low blood transfusion rate after implementation of tranexamic acid for fast- track hip- and knee arthroplasty. An observational study of 5205 patients Type de document : texte imprimé Auteurs : Yoeri Bemelmans ; Emil Van Haaren ; Bert Boonen ; Roel Hendrickx ; Martijn Schotanus Année de publication : 2021 Article en page(s) : p. 9-16 Note générale : https://doi.org/10.52628/87.1.02 Langues : Anglais (eng) Mots-clés : Tranexamic acid fast-track surgery knee arthroplasty hip arthroplasty unicompartmental knee arthroplasty Résumé : The purpose of this study was to retrospectively evaluate the efficacy of a tranexamic acid (TXA) perioperative protocol for primary hip- and knee arthroplasty, in terms of allogenic blood transfusion rates. A retrospective cohort study was conducted and included all primary hip and knee arthroplasty procedures in the period of 2014-2019. Patients who underwent surgery due to trauma or revision were excluded. A total amount of 5205 patients were eligible for inclusion. Two equal and weight depending doses of TXA were given, preoperative as an oral dose and intravenously at wound closure. The primary outcome was blood transfusion rate. Further analysis on patient characteristics (e.g. age, gender), blood loss, perioperative haemoglobin (Hb) levels and complication/readmission rate was performed.
A total of 49 (0.9%) patients received perioperative allogenic blood transfusions. Mean age, distribution of gender, body-mass index, American Society of Anaesthesiologists score, duration of surgery, type of arthroplasty, estimated blood loss, perioperative Hb levels and length of stay were statistically significant different between transfused and not-transfused patients. The incidence of thromboembolic adverse events (e.g. deep vein thrombosis/lung embolism) was 0.5%. Low blood transfusion rate was found after implementation of a standardized perioperative TXA protocol for primary hip and knee arthroplasty.Permalink : ./index.php?lvl=notice_display&id=96571
in Acta Orthopaedica Belgica > Vol.87/1 (Mars 2021) . - p. 9-16[article] Low blood transfusion rate after implementation of tranexamic acid for fast- track hip- and knee arthroplasty. An observational study of 5205 patients [texte imprimé] / Yoeri Bemelmans ; Emil Van Haaren ; Bert Boonen ; Roel Hendrickx ; Martijn Schotanus . - 2021 . - p. 9-16.
https://doi.org/10.52628/87.1.02
Langues : Anglais (eng)
in Acta Orthopaedica Belgica > Vol.87/1 (Mars 2021) . - p. 9-16
Mots-clés : Tranexamic acid fast-track surgery knee arthroplasty hip arthroplasty unicompartmental knee arthroplasty Résumé : The purpose of this study was to retrospectively evaluate the efficacy of a tranexamic acid (TXA) perioperative protocol for primary hip- and knee arthroplasty, in terms of allogenic blood transfusion rates. A retrospective cohort study was conducted and included all primary hip and knee arthroplasty procedures in the period of 2014-2019. Patients who underwent surgery due to trauma or revision were excluded. A total amount of 5205 patients were eligible for inclusion. Two equal and weight depending doses of TXA were given, preoperative as an oral dose and intravenously at wound closure. The primary outcome was blood transfusion rate. Further analysis on patient characteristics (e.g. age, gender), blood loss, perioperative haemoglobin (Hb) levels and complication/readmission rate was performed.
A total of 49 (0.9%) patients received perioperative allogenic blood transfusions. Mean age, distribution of gender, body-mass index, American Society of Anaesthesiologists score, duration of surgery, type of arthroplasty, estimated blood loss, perioperative Hb levels and length of stay were statistically significant different between transfused and not-transfused patients. The incidence of thromboembolic adverse events (e.g. deep vein thrombosis/lung embolism) was 0.5%. Low blood transfusion rate was found after implementation of a standardized perioperative TXA protocol for primary hip and knee arthroplasty.Permalink : ./index.php?lvl=notice_display&id=96571 Exemplaires (1)
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Exclu du prêtRisk analysis of restrictive factors for fast-track hip arthroplasty - a retrospective study of 1138 patients / Florian Radetzki in Acta Orthopaedica Belgica, Vol. 87/4 (Décembre 2021)
[article]
Titre : Risk analysis of restrictive factors for fast-track hip arthroplasty - a retrospective study of 1138 patients Type de document : texte imprimé Auteurs : Florian Radetzki ; Tina Körber ; David Wohlrab Année de publication : 2021 Article en page(s) : p. 601-606 Note générale : https://doi.org/10.52628/87.4.04 Langues : Anglais (eng) Mots-clés : fast track program hip arthroplasty restrictive factors Résumé : Fast track programs have been introduced to reduce perioperative complication rates and to quickly reintegrate the patient into everyday life. The aim of this retrospective case-control study was to identify patient characteristics and patient-independent factors that influence fast track programs in hip arthroplasty. A total of 1138 patients were examined. A hospital stay of more than seven days was used to define the case group. In addition to the causes for the longer hospitalisation, age, sex, BMI, chronic nicotine and alcohol abuse, ASA score, surgical duration, anaemia and blood transfusion as well as concomitant diseases were assessed. The statistical analysis included two-sample t-test, chi-square test and logistic regression analyses. An 95% confidence interval was calculated (p<0.05). 16.9% of patients could not leave the hospital on the seventh day. The main causes were delayed wound healing (69.4%), increased CRP (43.0%>100 mg/l), and internal complications (19.7%). At a mean of 69.2 ± 10.7 years, the age of the case group was significantly higher than that of the control group, which had a mean of 63.3 ± 10.3 years (p<0.001). Cardiac comorbidities (p<0.001), BMI (p=0.023), and alcohol consumption (p<0.001) increased the risk for longer hospitalisation. Significant patient-independent factors were duration of the surgery (p<0.001) and transfusion (p<0.001). Successful application of fast-track hip arthroplasty is possible for every patient. However, longer hospi- talisation and delayed discharge must be taken into account for patients with advanced age, cardiac comorbidities, alcohol consumption, and high BMI. Permalink : ./index.php?lvl=notice_display&id=102009
in Acta Orthopaedica Belgica > Vol. 87/4 (Décembre 2021) . - p. 601-606[article] Risk analysis of restrictive factors for fast-track hip arthroplasty - a retrospective study of 1138 patients [texte imprimé] / Florian Radetzki ; Tina Körber ; David Wohlrab . - 2021 . - p. 601-606.
https://doi.org/10.52628/87.4.04
Langues : Anglais (eng)
in Acta Orthopaedica Belgica > Vol. 87/4 (Décembre 2021) . - p. 601-606
Mots-clés : fast track program hip arthroplasty restrictive factors Résumé : Fast track programs have been introduced to reduce perioperative complication rates and to quickly reintegrate the patient into everyday life. The aim of this retrospective case-control study was to identify patient characteristics and patient-independent factors that influence fast track programs in hip arthroplasty. A total of 1138 patients were examined. A hospital stay of more than seven days was used to define the case group. In addition to the causes for the longer hospitalisation, age, sex, BMI, chronic nicotine and alcohol abuse, ASA score, surgical duration, anaemia and blood transfusion as well as concomitant diseases were assessed. The statistical analysis included two-sample t-test, chi-square test and logistic regression analyses. An 95% confidence interval was calculated (p<0.05). 16.9% of patients could not leave the hospital on the seventh day. The main causes were delayed wound healing (69.4%), increased CRP (43.0%>100 mg/l), and internal complications (19.7%). At a mean of 69.2 ± 10.7 years, the age of the case group was significantly higher than that of the control group, which had a mean of 63.3 ± 10.3 years (p<0.001). Cardiac comorbidities (p<0.001), BMI (p=0.023), and alcohol consumption (p<0.001) increased the risk for longer hospitalisation. Significant patient-independent factors were duration of the surgery (p<0.001) and transfusion (p<0.001). Successful application of fast-track hip arthroplasty is possible for every patient. However, longer hospi- talisation and delayed discharge must be taken into account for patients with advanced age, cardiac comorbidities, alcohol consumption, and high BMI. Permalink : ./index.php?lvl=notice_display&id=102009 Réservation
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DisponibleOnly limited correlations between patient-reported outcomes and objectively monitored physical activity 10-years after THA / Jetse Jelsma in Acta Orthopaedica Belgica, Vol. 87/4 (Décembre 2021)
[article]
Titre : Only limited correlations between patient-reported outcomes and objectively monitored physical activity 10-years after THA Type de document : texte imprimé Auteurs : Jetse Jelsma, Auteur ; Sander Van Kuijk ; Ivo Buil Année de publication : 2021 Article en page(s) : p. 593-599 Note générale : https://doi.org/10.52628/87.4.03 Langues : Anglais (eng) Mots-clés : hip arthroplasty patient reported outcomes (PROMs) physical activity physical activity monitoring wearables Résumé : In orthopaedics, patient reported outcomes (PROMs) are designed to quantify changes in pain and to assess physical function, most often after joint arthroplasty. However, PROMs have some disadvantages, most important is their subjective nature. The aim was to investigate how patient-self-reported-outcomes of general health, disease-specific outcome and physical function, joint-awareness and self-perceived activity- levels are correlated with objectively-measured physical-activity (PA) parameters derived from wearable activity-monitors (AM) in subjects with a hip-arthroplasty. A prospective cohort study was conducted in a group of 32 patients, with a mean follow-up of 10 years after total hip arthroplasty. To assess different domains, the SF-36 (general health), HOOS-PS (pain/functional outcome), FJS-12 (joint awareness) and SQUASH (physical activity) were chosen. Activity-monitoring was performed using a 3-axis accelerometer, gyroscope and magnetometer. No significant correlations between PA-parameters and the FJS-12 and SQUASH were found. The HOOS- PS was significant correlated with BMI, the daily time walking and total-time active and the amount of daily steps. The physical functioning-subscale of the SF-36 was significant negative correlated with BMI and time sitting, but significant positive correlated with time walking, total-time active and the amount of daily steps. Considering the value of PA for maintaining general health, the value of using sensor-based AMs to assess efficacy of treatments in this health related dimension or use it as a tool for patient education, awareness and communication, seems very high. Permalink : ./index.php?lvl=notice_display&id=102008
in Acta Orthopaedica Belgica > Vol. 87/4 (Décembre 2021) . - p. 593-599[article] Only limited correlations between patient-reported outcomes and objectively monitored physical activity 10-years after THA [texte imprimé] / Jetse Jelsma, Auteur ; Sander Van Kuijk ; Ivo Buil . - 2021 . - p. 593-599.
https://doi.org/10.52628/87.4.03
Langues : Anglais (eng)
in Acta Orthopaedica Belgica > Vol. 87/4 (Décembre 2021) . - p. 593-599
Mots-clés : hip arthroplasty patient reported outcomes (PROMs) physical activity physical activity monitoring wearables Résumé : In orthopaedics, patient reported outcomes (PROMs) are designed to quantify changes in pain and to assess physical function, most often after joint arthroplasty. However, PROMs have some disadvantages, most important is their subjective nature. The aim was to investigate how patient-self-reported-outcomes of general health, disease-specific outcome and physical function, joint-awareness and self-perceived activity- levels are correlated with objectively-measured physical-activity (PA) parameters derived from wearable activity-monitors (AM) in subjects with a hip-arthroplasty. A prospective cohort study was conducted in a group of 32 patients, with a mean follow-up of 10 years after total hip arthroplasty. To assess different domains, the SF-36 (general health), HOOS-PS (pain/functional outcome), FJS-12 (joint awareness) and SQUASH (physical activity) were chosen. Activity-monitoring was performed using a 3-axis accelerometer, gyroscope and magnetometer. No significant correlations between PA-parameters and the FJS-12 and SQUASH were found. The HOOS- PS was significant correlated with BMI, the daily time walking and total-time active and the amount of daily steps. The physical functioning-subscale of the SF-36 was significant negative correlated with BMI and time sitting, but significant positive correlated with time walking, total-time active and the amount of daily steps. Considering the value of PA for maintaining general health, the value of using sensor-based AMs to assess efficacy of treatments in this health related dimension or use it as a tool for patient education, awareness and communication, seems very high. Permalink : ./index.php?lvl=notice_display&id=102008 Réservation
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