• Title/Summary/Keyword: Total hip arthroplasty

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Pseudotumor and Subsequent Implant Loosening as a Complication of Revision Total Hip Arthroplasty with Ceramic-on-Metal Bearing: A Case Report

  • Naik, Lokesh Gudda;Shon, Won Yong;Clarke, I.C.;Moon, Jun-Gyu;Mukund, Piyush;Kim, Sang-Min
    • Hip & pelvis
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    • v.30 no.4
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    • pp.276-281
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    • 2018
  • Pseudotumors are not uncommon complications after total hip arthroplasty (THA) and may occur due to differences in bearing surfaces of the head and the liner ranging from soft to hard articulation. The most common causes of pseudotumors are foreign-body reaction, hypersensitivity and wear debris. The spectrum of pseudotumor presentation following THA varies greatly-from completely asymptomatic to clear implant failure. We report a case of pseudo-tumor formation with acetabular cup aseptic loosening after revision ceramic-on-metal hip arthroplasty. The patient described herein underwent pseudotumor excision and re-revision complex arthroplasty using a trabecular metal shell and buttress with ceramic-on-polyethylene THA. Surgeons should be aware of the possibility of a pseudotumor when dealing with revisions to help prevent rapid progression of cup loosening and implant failure, and should intervene early to avoid complex arthroplasty procedures.

Effects of Supportive Nursing Care Program on Hip Function, Anxiety and Uncertainty for Patients with Total Hip Arthroplasty (인공 고관절 수술 환자에서 지지간호중재가 고관절 기능, 불안 및 불확실성에 미치는 효과)

  • Kim, Sun Hwa;Lee, Hye Jin
    • Journal of Korean Clinical Nursing Research
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    • v.19 no.3
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    • pp.419-431
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    • 2013
  • Purpose: This study was to evaluate the effect of supportive nursing care program for patients with total hip arthroplasty. Methods: Forty-two patients with total hip arthroplasty were enrolled in this study from September, 20, 2011 to January, 3, 2012. The participants were assigned to one of two groups: Twenty-six subjects in the experimental group were provided with supportive nursing care program which comprised of 6 nurse visits pre and post operation and 4 follow-up phone calls after discharge. Another 26 subjects received conventional nursing care program as a control group. Hip function, anxiety, and uncertainty were evaluated before the intervention, and 5 weeks after completion of the intervention. The analysis included descriptive statistics, Chi-square test, and t-test by SPSS 18.0. Results: Hip function was significantly increased in the experimental group (t=-3.31, p<.002). Anxiety and uncertainty group was significantly lower in the experimental group (t=7.12, p<.001 and t=4.66, p<.001). Conclusion: The results of this study indicate that the supportive care intervention for patients receiving total hip arthroplasty could be utilized as a nursing intervention to improve hip function and to reduce anxiety and uncertainty of patients receiving total hip arthroplasty.

Total Hip Arthroplasty in the Severely Narrowed Femoral Canal by a Fibular Strut Using Knee Arthroscopic Tools: A Case Report and Technical Note

  • Vikram Indrajit Shah;Javahir A Pachore;Sachin Upadhyay;Pichai Suryanarayan
    • Hip & pelvis
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    • v.34 no.3
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    • pp.172-176
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    • 2022
  • A 58-year-old-male patient presented with worsening pain and restricted movements of his right hip after undergoing multiple procedures for treatment of an inter-trochanteric fracture. Secondary arthrosis and an incorporated intramedullary fibular cortical bone graft which caused severe narrowing of the medullary canal were observed by imaging. Total hip arthroplasty (THA) using knee arthroscopic tools was performed for preparation of the severely narrowed femoral canal. A satisfactory clinical outcome was achieved and stable components were observed on radiographs at the 11-year follow-up. The technique described here may be considered when attempting to perform a conversion THA for preparation of a severely narrowed femoral canal using a fibular strut in order to minimize morbidity and prevent structural destabilization.

A Study on the Usefulness of Total Hip Replacement Arthroplasty Using Fluoroscopy (투시하에 시행한 고관절 확대계측 촬영술의 유용성에 관한 분석)

  • Lee, H.J.;Son, S.Y.;Um, J.Y.;Chin, J.H.;Kim, K.C.
    • Journal of radiological science and technology
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    • v.22 no.1
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    • pp.21-26
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    • 1999
  • To make a comparative analysis for clinical application of total hip replacement arthroplasty(THRA) using fluoroscopy, we have performed total hip replacement arthroplasty making 30 patients an object with general radiography and fluoroscopy respectively. The results are as follows : 1) Reexamination rate was 80% of patients and mean 3.9 sheets in the general radiography, where as it was 46.7% and 0.37 sheets in the fluoroscopy(p<0.01) 2) Add examination was 2 cases in the general radiography, but fluoroscopy was no add examination. 3) The total film sheet used was mean 10.16 in the general radiography and 6.73 in the fluoroscopy. 4) In the cause of reexmination and add examination, inaccurate position of patient accounted for 72.6% in the general radiography and poor exposure condition accounted for 45.5% in the fluoroscopy. Total hip replacement arthroplasty using the fluoroscopy decreased reexamination and add examination rate, for these reasons, this method was effective abatement of pain, exposured radiation dose, and examination time and so on.

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Recent updates for biomaterials used in total hip arthroplasty

  • Hu, Chang Yong;Yoon, Taek-Rim
    • Biomaterials Research
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    • v.22 no.4
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    • pp.259-270
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    • 2018
  • Background: Total hip arthroplasty (THA) is probably one of the most successful surgical interventions performed in medicine. Through the revolution of hip arthroplasty by principles of low friction arthroplasty was introduced by Sir John Charnley in 1960s. Thereafter, new bearing materials, fixation methods, and new designs has been improved. The main concern regarding failure of THA has been the biological response to particulate polyethylene debris generated by conventional metal on polyethylene bearing surfaces leading to osteolysis and aseptic loosening of the prosthesis. To resolve these problems, the materials of the modern THA were developed since then. Methods: A literature search strategy was conducted using various search terms in PUBMED. The highest quality articles that met the inclusion criteria and best answered the topics of focus of this review were selected. Key search terms included 'total hip arthroplasty', 'biomaterials', 'stainless steel', 'cobalt-chromium', 'titanium', 'polyethylene', and 'ceramic'. Results: The initial search retrieved 6921 articles. Thirty-two articles were selected and used in the review. Conclusion: This article introduces biomaterials used in THA and discusses various bearing materials in currentclinical use in THA as well as the newer biomaterials which may even further decrease wear and improve THA survivorship.

The Wear Rate and Survivorship in Total Hip Arthroplasty Using a Third-generation Ceramic Head on a Conventional Polyethylene Liner: A Minimum of 15-year Follow-up

  • Bum-Jin Shim;Sung-Jin Park;Chan Ho Park
    • Hip & pelvis
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    • v.34 no.2
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    • pp.115-121
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    • 2022
  • Purpose: The purpose of this study was to evaluate the wear and survival rates of third-generation ceramic heads on a conventional ultra-high molecular weight polyethylene liner. Materials and Methods: A total of 160 hips (147 patients with a mean age of 55.9 years) who underwent total hip arthroplasty using the third-generation ceramic head on a conventional polyethylene liner from March 1998 to August 2003 were reviewed retrospectively. Evaluation of the wear rate for 56 hips (49 patients) followed-up for at least 15 years was performed using the PolyWare program version 8 (Draftware Developers, USA). The Kaplan-Meier survivorship was also evaluated. Results: Linear wear and volumetric wear rates were 0.11±0.47 mm/year and 32.75±24.50 mm3/year, respectively. Nine revisions were performed during the follow-up period because of cup or stem loosening. The Kaplan-Meier survival rate, using cup revision or total revision total hip arthroplasty (THA) as the endpoint of analysis, was 93.7% at 15 years and 73.6% at 20 years. Conclusion: Because all revisions were performed between 15 and 20 years in our study, surgeons should pay greater attention to patients who underwent THA with ceramic-on-polyethylene bearing from 15 years postoperatively. Contemporary alumina ceramic on highly cross-linked polyethylene could certainly be a good alternative bearing couple providing better longevity.

Periprosthetic Fracture around a Cemented Stem in Total Hip Arthroplasty

  • Jun-Young Heu;Ju-Yeong Kim;Se-Won Lee
    • Hip & pelvis
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    • v.34 no.3
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    • pp.140-149
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    • 2022
  • The increase in the number of primary total hip arthroplasties that will be performed over the next several decades will lead to an increase in the incidence of periprosthetic fractures around the femoral stem. A search of targeted articles was conducted using on-line databases of PubMed (National Library of Medicine) and articles were obtained from January 2008 to November 2021. Reliable prediction of treatment can be achieved using the Vancouver classification; internal fixation is indicated in fractures involving a stable implant and revision arthroplasty is indicated in those with unstable prostheses. To the best of our knowledge, relatively fewer studies regarding periprosthetic proximal femur fractures of cemented stems have been reported. The focus of this review is on the risk factors and strategies for treatment of these fractures for periprosthetic femoral fractures around a cemented hip arthroplasty.

A Review on the trends of acupuncture and moxibustion treatment for Hip arthroplasty (고관절 치환술에 침구치료를 적용한 국내외 연구에 대한 동향 분석)

  • Oh, Eun-Mi;Lee, Eun-Jung
    • The Journal of Churna Manual Medicine for Spine and Nerves
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    • v.14 no.1
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    • pp.77-91
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    • 2019
  • Objectives : The purpose of this study was to investigate the effects of using acupuncture and moxibustion for the treatment of hip arthroplasty. Methods : We searched a total of six Korean and international databases (OASIS, KISS, RISS, Pubmed, Cochrane library, and CNKI) up to March 2019, and included randomized controlled trials which investigated the treatment effects of acupuncture and moxibustion in patients with hip arthroplasty. Results : In total, 29 studies were selected and included in the analysis. These studies conducted interventions, with the most frequently conducted methods being electroacupuncture (24.1%) and auricular acupuncture (20.7%). The most frequently used acupoints were the Ashi-, Lower four-, and Lower five points. VAS (48.9%) and Harris scores (22.2%) were commonly used to evaluate treatment effects. In total, 27 studies (93.1%) reported favorable treatment effects following acupuncture and moxibustion treatment, compared to the control group. Conclusions : These results may suggest that acupuncture and moxibustion have favorable effect on Hip arthroplasty.

Factors Influencing Physical Activity after Discharge from Hospital for Total Hip Arthroplasty Patients

  • Ju Young Kim;Mi Yang Jeon
    • Physical Therapy Rehabilitation Science
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    • v.11 no.4
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    • pp.535-545
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    • 2022
  • Objective: This study was conducted to identify predictive factors of physical activity in total hip arthroplasty patients, and to provide basic data for the developing physical activity promotion program for total hip arthroplasty patients. Design: Descriptive correlational research. Methods: Data were collected from August 2017 to May 2018. Surveys were distributed to 60 patients in a G university hospital located at J city, Gyeongsangnam-do. Data were analyzed by frequency, mean, standard deviation, t-test, ANOVA, Pearson's correlation coefficient, multiple regression analysis using SPSS 24 Win program. Results: The variables affecting the 4-week physical activity after discharge were age (β=.07), residence after discharge (β=-.22), cerebrovascular disease (β=-.13), mental and behavioural disease (β=-.11), taking antibiotic (β=-.26), walking ability (β=.41), nutritional status (β=.25), depression (β=.05). The eight variables accounted for 39.4% in the 4-week physical activity (F=4.49 p=.001). The variables affecting the 8-week physical activity after discharge were age (β=.06), waking ability (β=.34), nutritional status (β=.20), exercise self-efficacy (β=.05), depression (β=-.05). The six variables accounted for 28.0% in the 8-week physical activity (F=4.58, p<.001). Conclusions: The walking ability in discharge important to improve the physical activity, there is a need to develop an program to improve walking ability before discharge, in total hip arthroplasty. There is a need to develop a physical activity program to consistently participate in a community.

Effect of Real Patient Controlled Analgesia (PCA) Education with Practice on Postoperative Pain, Consumption of Analgesics, and Anxiety for Elderly Patients with Total Hip Arthroplasty (실물 통증자가조절기 교육 프로그램이 노인 고관절수술 환자의 통증, 진통제 사용량 및 불안에 미치는 효과)

  • Ryu, Su Hyang;Jo, Hyun Sook
    • Journal of Korean Clinical Nursing Research
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    • v.22 no.2
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    • pp.152-160
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    • 2016
  • Purpose: The purpose of this study was to evaluate the effects of real PCA education with practice on postoperative pain, consumption of analgesics, and anxiety for elderly patients with total hip arthroplasty. Methods: This study utilized a non-equivalent control group pretest-posttest design. The participants were 52 elderly patients (${\geq}65$) with total hip arthroplasty at the G. hospital in Seoul. The participants were recruited from December 3, 2014 to April 30, 2015. Twenty six of them were assigned to the experimental group and the other to the control group. Preoperative real PCA education with practice was performed individually with the experimental group by the author. Results: There were statistically significant differences in 24 and 48 hour postoperative pain (t=-2.59, p=.012; t=-3.80, p<.001 respectively), and in consumption of analgesics at 24 and 48 hours after operation between the two groups (t=-3.61, p<.001; t=-4.19, p<.001 respectively). However, no significant difference in anxiety (t=-1.03, p=.308) at 48 hour after operation. Conclusion: This study has confirmed that the individualized real PCA education with practice contributes to relieve postoperative pain and reduce analgesic uses of the elderly with total hip arthroplasty. Thus, it is highly recommended that this education program could be applied in clinical settings as a nursing intervention in reducing postoperative pain for the elderly with total hip arthroplasty.