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Management of osteoporotic acetabular fractures
Published in Peter V. Giannoudis, Thomas A. Einhorn, Surgical and Medical Treatment of Osteoporosis, 2020
Peter V. Giannoudis, Panagiotis Douras
Overall, the aim of treatment is to reduce anatomically the affected hip joint and to achieve a stable fixation allowing early mobilization with a timely recovery of function and level of preinjury mobility. Surgical reconstruction, however, may not be possible due to the degree of comminution, articular impaction, and bone quality, thus pointing to the option of a total hip arthroplasty (THA). Selection of which one of these two surgical options may be more appropriate for the patient can be difficult. However, careful assessment of all of the facets discussed and detailed discussion with the patient would help in reaching the most sensible, “safe,” long-lasting option for the patient.
Hip reconstruction osteotomy by Ilizarov method as a salvage option for abnormal hip joints
Published in K. Mohan Iyer, Hip Preservation Techniques, 2019
Masood Umer, Yasir Mohib, Talal Aqeel Qadri, Haroon Rashid
Chronic hip instability with pain and limp is a challenging orthopedic clinical situation to handle. The problem is further complicated in younger individuals. The gold-standard treatment, which restores joint mechanics most optimally, is a total hip replacement,1,2 yet a hip arthroplasty in the younger population presents with issues such as earlier need for revision arthroplasty and higher chances of dislocation due to their active lifestyle.3 Another viable option, especially in males, is hip arthrodesis, yet it comes with concerns of decreased range of motion, limp, and early degeneration in the spine, knee, and contralateral hip.4,5
Total Hip in a Day: Setup and Early Experiences in Outpatient Hip Surgery
Published in K. Mohan Iyer, Hip Joint in Adults: Advances and Developments, 2018
Total joint replacement of the hip is one of the most frequently performed surgeries in the orthopaedics, with approximately 230,000 primary operations in 2010 in Germany [1] and more than 310,000 in the United States [1, 2]. In our clinic, the authors operate on approximately 300 patients with elective total hip arthroplasty (THA) per year. In the recent years, we have adapted the rapid recovery track for our total joint replacement patients [3,4]. This means that patients who receive a knee or hip replacement will be discharged after a maximum of three to four days of the surgery.
The effect of transferring weekend physical therapy services from the acute to sub-acute setting in patients following hip and knee arthroplasty: a quasi-experimental study
Published in Physiotherapy Theory and Practice, 2022
Romi Haas, Kelly-Ann Bowles, Lisa O’Brien, Terry Haines
This study was conducted at a 520-bed public tertiary hospital situated in Melbourne, Australia and included consenting patients who underwent elective lower limb joint arthroplasty and were hospitalized in the designated study wards between February 3, 2014 and February 28, 2015. Surgery procedures considered for inclusion were total hip arthroplasty, total knee arthroplasty and revision total hip or knee arthroplasty. The study wards included two orthopedic specific acute wards and one sub-acute ward where patients may be admitted following their acute stay for rehabilitation depending on clinical need. This sub-acute ward accepted orthopedic admissions from acute wards locally including those not involved in the trial and from other hospitals. Exclusion criteria were patients less than 18 years old, patients undergoing joint arthroplasty immediately following trauma (e.g. fracture) and patients with moderate cognitive impairment assessed as less than or equal to 5/10 on the Short Portable Mental Status Questionnaire (Pfeiffer, 1975). Participants were also excluded if they were admitted to an off-site ward for rehabilitation or exposed to both interventions during their hospital admission (i.e. admission dates included both July and August 2014).
Impact of the COVID-19 pandemic on emergency and elective hip surgeries in Norway
Published in Acta Orthopaedica, 2021
Karin Magnusson, Jon Helgeland, Mari Grøsland, Kjetil Telle
Because of COVID-19, Norway implemented early one of the strictest lockdown policies of all countries. The lockdown measures are believed to have limited the spread of the virus in this country dramatically, but on the other hand, may have had several unknown negative side effects on the planned and acute care for vulnerable groups. As an example, people with osteoporotic fractures and osteoarthritis are often elderly and fragile, with a high need for care to prevent long-term disability and death. The conditions are often managed by the most commonly performed surgical joint procedure worldwide: total hip arthroplasty (Learmonth et al. 2007). Whereas acute hip fracture surgeries should be performed within 24 hours according to national guidelines (NOF 2018), surgeries due to hip osteoarthritis are typically planned weeks or months in advance (Zhang et al. 2008).
Effectiveness of ankle fusion in patients with hemophilia, advanced ankle degeneration, and unbearable pain for whom nonsurgical and surgical treatments have been ineffective
Published in Expert Review of Hematology, 2021
E. Carlos Rodriguez-Merchan, Carlos A. Encinas-Ullan, Primitivo Gomez-Cardero
There is major controversy in the literature regarding the decision between ankle fusion and total ankle arthroplasty. Although more durable ankle arthroplasties are under development, their survival is still short compared with hip and knee arthroplasties. Regarding total ankle arthroplasty, Undén et al found the following overall prosthetic survival rates: 85% at 5 years, 74% at 10 years, 63% at 15 years, and 58% at 20 years. For early prosthetic designs, the 5-year and 10-year implant survival rates were 81% and 69%, respectively, whereas the corresponding rates for current designs are 88% and 84%. Current prosthetic designs have better survival [32]. For total knee arthroplasty, Kim et al reported that the survival rate at 25 years was 98% [33]. For total hip arthroplasty in patients 30 years of age or younger, Mohaddes et al found that the 10-year and 15-year implant survival was 90% and 78%, respectively. The corresponding figures for patients older than 30 years were 94% and 89% [34]. The long-term survival (20–25 years) of total ankle arthroplasty is not yet known because prosthetic ankle designs developed much later that hip and knee designs.