• Title/Summary/Keyword: Total hip arthroplasty

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Comparison of Short Curved Stems and Standard-length Single Wedged Stems for Cementless Total Hip Arthroplasty

  • Chan Young Lee;Sheng-Yu Jin;Ji Hoon Choi;Taek-Rim Yoon;Kyung-Soon Park
    • Hip & pelvis
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    • v.36 no.2
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    • pp.120-128
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    • 2024
  • Purpose: The purpose of this study was to compare the clinical and radiographic outcomes with use of short-curved stems versus standard-length single wedged stems over a minimum follow-up period of five years. Materials and Methods: A retrospective study of primary total hip arthroplasties performed using the Fitmore® stem (127 hips, 122 patients) and the M/L taper® stem (195 hips, 187 patients) between October 2012 and June 2014 was conducted. The clinical and radiographic outcomes were obtained for evaluation over a minimum follow-up period of five years. Results: In both the Fitmore® and M/L taper® groups, the mean Harris hip score improved from 52.4 and 48.9 preoperatively to 93.3 and 94.5 at the final follow-up, respectively (P=0.980). The mean Western Ontario and McMaster Universities Osteoarthritis Index scores also improved from 73.3 and 76.8 preoperatively to 22.9 and 25.6 at the final follow-up, respectively (P=0.465). Fifteen hips (Fitmore®: 14 hips; M/L taper®: one hip, P<0.001) developed intraoperative cracks and were treated simultaneously with cerclage wiring. Radiography showed a radiolucent line in 24 hips in the Fitmore® group and 12 hips in the M/L taper® group (P=0.125). Cortical hypertrophy was detected in 29 hips (Fitmore® group: 28 hips; M/L taper® group: one hip, P<0.001). Conclusion: Similarly favorable clinical and radiographic outcomes were achieved with use of both short-curved stems and standard-length single wedged stems. However, higher cortical hypertrophy and a higher rate of femoral crack were observed with use of Fitmore® stems.

Effect of a PNF Intervention Strategy with the ICF Tool Applied to a Patient with Bilateral Total Hip Replacement Walking a Crosswalk (양측 엉덩관절 전치환술 환자의 횡단보도 걷기 개선을 위해 ICF Tool을 적용한 PNF 중재전략: 사례보고 )

  • Jin-cheol Kim;Jae-heon Lim
    • Journal of the Korean Society of Physical Medicine
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    • v.19 no.1
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    • pp.95-105
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    • 2024
  • PURPOSE: This study aimed to utilize the International Classification of Functioning, Disability, and Health (ICF) tool to identify a problem list and explore intervention effects using proprioceptive neuromuscular facilitation (PNF) for improving the crosswalk performance of patients who have undergone a bilateral hip arthroplasty. METHODS: The subject of this study was a 43-year-old male who had undergone a bilateral hip arthroplasty. To address the subject's functional status, a clinical decision-making process was carried out in the order of examination, evaluation, diagnosis, prognosis, intervention, and outcome. Patient information during the examination was collected using the ICF core set. The evaluation involved listing the items of each problem using the ICF assessment sheet and identifying the interaction between activity limitations and the impairment level. The diagnosis explicitly described the causal relationships derived from the evaluation using ICF terminology. The prognosis presented activity goals, body function, and structured goals in terms of the activity and participation levels that needed to be achieved for an individual's functional status. The intervention approached problems through the four components of the PNF philosophy, namely basic principles and procedures, techniques, and patterns, in an indirect-direct-task sequence. Results were compared before and after the intervention using the ICF evaluation display. RESULTS: The results of the study showed that the primary activity limitation, which was the walking time across the crosswalk, showed improvement, and the trunk's counter rotation and the weight-bearing capacity of both the lower limbs, which were impairment level indicators, were enhanced. CONCLUSION: This study suggests that PNF intervention strategies will serve as a positive approach for improving crosswalk walking in patients with bilateral hip arthroplasty.

Relationship between Oxidation and Wear of Ultra-High Molecular Weight Polyethylene for Total Joint Arthroplasty

  • Lee, Kwon-Yong
    • KSTLE International Journal
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    • v.2 no.1
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    • pp.55-58
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    • 2001
  • The most widely-used orthopaedic grade polymer bearing liner material, ultrahigh molecular weight polyethylene (UHMWPE), for the total joint arthroplasty degrades after gamma-irradiation sterilization through the progressive oxidation in a shelf and in vivo. Oxidative degradation makes UHMWPE brittle and leads to decrease in mechanical properties. In this study the relationship between post-gamma-irradiation aging time and wear of UHMWPE was investigated. Six retrieved polyethylene hip liners implanted for 3-16 years and then stored in air for 1.5-6.5 years until tests were used. Two types of pin-on-disk wear testing were conducted by the uni-directional repeat pass rotating and by the linear reciprocating stainless steel disks against stationary polyethylene pins under 4Mpa at 1Hz with bovine serum lubrication in ambient environment. Wear of retrieved polyethylene hip liners does not have direct correlation with in vivo or total aging time. Linear reciprocal sliding motion generated more remarkable wear than uni-directional repeat pass sliding motion. It indicates that kinematic motion affects very crucially on the wear of aged UHMWPE having brittle white band region.

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Postoperative Irradiation for Prevention of Heterotopic Bone Formation after Total Hip Replacement Arthroplasty (고관절전치환 성형술 후 관절주위 골형성 예방을 위한 수술 후 방사선 요법)

  • Park Woo Yoon;Kim Il Han;Ha Sung Whan;Park Charn Il
    • Radiation Oncology Journal
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    • v.4 no.1
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    • pp.75-80
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    • 1986
  • Heterotopic bone formation is a complication which occurs in 0.6 to $61.7\%$ of patients after total hip replacement arthroplasty. We reviewed 4 patients (8 hips) who received postoperative irradiation on their hi ps for prevention of heterotopic bone formation in the Department of Therapeutic of Therapeutic Radiology, Seoul National University versify Hospital from January 1981 through August 1985. Radiation therapy was started 6 to 10 days postoperatively with the dosage of 2,000 cGy given in 10 fractions. As a result, 7 hips had Grade 0 and 1 hip had Grade 1 heterotopic ossification according to modified Blocker system. Our result and review of the literatures strongly support that the postoperative radiotherapy is effective for prevention of heterotopic bone formation in high risk group.

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Effects of Structured Exercise Program on Hip Pain, Physical Function and Quality of Life in Patients with Total Hip Arthroplasty (구조화된 운동 프로그램이 인공고관절 전치환술 환자의 고관절 통증, 신체기능 및 삶의 질에 미치는 효과)

  • Kwon, Eunhee;Lee, Haejung;Lee, Sunghwa
    • Journal of muscle and joint health
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    • v.25 no.2
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    • pp.122-134
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    • 2018
  • Purpose: The purpose of this study was to develop a 12-week structured exercise program (12-week-SEP) and evaluate its effects on pain, physical function and quality of life in patients with total hip arthroplasty (THA). Methods: A nonequivalent control group non-synchronized design was utilized to examine the effects of the 12-week-SEP on patients' outcomes after THA. A total of 46 adult patients (experimental group=25, control group=21) who had THA were recruited for the study. The 12-week-SEP consisted of education, exercise (muscle strengthening and progressive walking), and feedback. Data were analyzed by SPSS/WIN 21.0 using the $x^2$ test and repeated measures ANOVA. Results: The mean age of the participants was 60.9 years and 25 men (54.5%) and 21 women (45.7%) were included in the study. There were significant intervention effects on pain reduction and increased physical function but no effects on quality of life. Conclusion: The 12-week-SEP provided pain relief and enhanced physical function in patients underwent THA. Clinical application of the 12-week-SEP can improve postoperative nursing practices for patients with THA. Future research with larger sample is of necessity to obtain greater generalizability of the empirical evidences of the 12-week-SEP.

Decision-Making and Principle of Management in Periprosthetic Femoral Fracture after Total Hip Arthroplasty (고관절 치환술 후 삽입물의 안정성 판단과 대퇴 삽입물 주위 골절의 치료 원칙)

  • Kim, Beom-Soo;Lee, Kyung-Jae;Min, Byung-Woo
    • Journal of the Korean Orthopaedic Association
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    • v.56 no.3
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    • pp.200-207
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    • 2021
  • Periprosthetic femoral fractures remain as one of the most challenging complications following total hip arthroplasty. A thorough clinical and radiographic evaluation, precise classification, and understanding of modern management principles are essential to obtain optimal results for these fractures. The Vancouver classification system is a simple, effective, and reproducible method for the planning treatments of these injuries. The fractures associated with a stable femoral stem can be treated effectively with osteosynthesis, but periprosthetic femoral fractures associated with a loose stem require revision arthroplasty. This paper describes the principle of the treatment of patients with periprosthetic femoral fractures and how to assess the stability of the femoral stem.

Effect of Preoperative Warming on Prevention of Hypothermia during Surgery in Patients with Total Hip Replacement Arthroplasty under Spinal Anesthesia (척추마취하 고관절 전치환술 환자의 수술 전 가온이 수술 중 저체온 예방에 미치는 효과)

  • Lee, Min Ji;Jeong, Jeong Hee
    • Journal of Korean Clinical Nursing Research
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    • v.26 no.3
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    • pp.365-373
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    • 2020
  • Purpose: The purpose of this study was to evaluate the effect of preoperative warming to prevent hypothermia in surgery for patients undergoing total hip replacement arthroplasty under spinal anesthesia. Methods: A randomized experimental study was conducted. Data were collected at an S University hospital in Gyeonggido from December 3, 2019 to March 31, 2020. A random allocation program was used to randomize participants into intervention and control groups. A total of 90 participants were assigned to the study: 30 people were randomized to a pre-warming group using Bair Hugger forced-air warming blankets(Model 505) 30 minutes before surgery, 30 to a pre-warming group 15 minutes before surgery, or 30 to a control group. The findings from 88 participants were analyzed. For data analysis, χ2 test and ANOVA were used utilizing the SPSS 21.0 program. Results: The pre-warming group 30 minutes before surgery had significantly higher body temperature than the control group, from 30 minutes after inducing anesthesia to the end of anesthesia. Body temperature over anesthesia time showed significant differences among the three groups, but there were no statistically significant differences in interactions between time and groups. Conclusion: Warming patients' body for 30 minutes before surgery was effective in maintaining normal body temperature while preventing intraoperative hypothermia.

Mid-term Results of Total Hip Arthroplasty for Posttraumatic Osteoarthritis after Acetabular Fracture

  • Sharath K. Ramanath;Tejas Tribhuvan;Uday Chandran;Rahul Hemant Shah;Ajay Kaushik;Sandesh Patil
    • Hip & pelvis
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    • v.36 no.1
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    • pp.37-46
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    • 2024
  • Purpose: The prognosis of total hip replacement (THR) after open reduction and internal fixation (ORIF) versus THR following non-operative treatment of acetabular fractures is unclear. Few studies have been conducted in this regard. Therefore, the purpose of the current study was to perform an assessment and compare the functional outcomes for study subjects in the ORIF and non-ORIF groups during the follow-up period compared to baseline. Materials and Methods: This longitudinal comparative study, which included 40 patients who underwent THR for either posttraumatic arthritis after fixation of an acetabular fracture or arthritis following conservative management of a fracture, was conducted for 60 months. Twenty-four patients had undergone ORIF, and 16 patients had undergone nonoperative/conservative management for acetabular fractures. Following THR, the patients were followed up for monitoring of functional outcomes for the Harris hip score (HHS) and comparison between the ORIF and non-ORIF groups was performed. Results: The HHS showed significant improvement in both ORIF and non-ORIF groups. At the end of the mean follow-up period, no significant variation in scores was observed between the groups, i.e., ORIF group (91.61±6.64) compared to non-ORIF group (85.74±11.56). A significantly higher number of re-interventions were required for medial wall fractures and combined fractures compared to posterior fractures (P <0.05). Conclusion: THR resulted in improved functional outcome during follow-up in both the groups; however, the ORIF group was observed to have better functional outcome. Re-intervention was not required for any of the posterior fractures at the end of the mean follow-up period.