Hip

You are looking at 11 - 20 of 119 items

Thorsten Gehrke Department of Orthopaedic Surgery, Helios ENDO-Klinik, Hamburg, Germany

Search for other papers by Thorsten Gehrke in
Google Scholar
PubMed
Close
,
Mustafa Citak Department of Orthopaedic Surgery, Helios ENDO-Klinik, Hamburg, Germany

Search for other papers by Mustafa Citak in
Google Scholar
PubMed
Close
, and
Mustafa Akkaya Department of Orthopaedic Surgery, Helios ENDO-Klinik, Hamburg, Germany

Search for other papers by Mustafa Akkaya in
Google Scholar
PubMed
Close

  • Acetabular revision arthroplasty, a demanding field of reconstructive hip surgery, calls for innovative strategies to deal with challenging bone defects and implant failure seen in revision cases.

  • Conventional implant solutions might fall short of adequately addressing severe bone loss and ensuring stable fixation, highlighting the necessity of customized strategies.

  • Personalized megaimplants, distinguished by their tailor-made design and large-scale construction, present a viable option to overcome these challenges.

  • The present article provides an elaborate analysis of custom-made megaimplants in acetabular revision arthroplasty, shedding light on the underlying principles, design complexities, manufacturing methods, applications in the clinical setting, and outcome assessment.

  • The aim of this review is to present a comprehensive insight into personalized megaimplants and their contribution to the advancement of orthopedic surgery.

Open access
Tarik Ait-Si-Selmi Centre Orthopédique Santy, Hôpital Privé Jean Mermoz, Ramsay Santé, 55 Avenue Jean Mermoz, Lyon, France
Artro Institute, 8, rue du Pont de Thé, Annecy Le Vieux, France

Search for other papers by Tarik Ait-Si-Selmi in
Google Scholar
PubMed
Close
,
Jean-Pierre Vidalain Artro Institute, 8, rue du Pont de Thé, Annecy Le Vieux, France

Search for other papers by Jean-Pierre Vidalain in
Google Scholar
PubMed
Close
,
Sonia Ramos-Pascual ReSurg SA, Rue Saint Jean 22, Nyon, Switzerland

Search for other papers by Sonia Ramos-Pascual in
Google Scholar
PubMed
Close
,
Thomas Kuratle ReSurg SA, Rue Saint Jean 22, Nyon, Switzerland

Search for other papers by Thomas Kuratle in
Google Scholar
PubMed
Close
,
Mo Saffarini ReSurg SA, Rue Saint Jean 22, Nyon, Switzerland

Search for other papers by Mo Saffarini in
Google Scholar
PubMed
Close
,
Edouard Dejour ReSurg SA, Rue Saint Jean 22, Nyon, Switzerland

Search for other papers by Edouard Dejour in
Google Scholar
PubMed
Close
, and
Michel P Bonnin Centre Orthopédique Santy, Hôpital Privé Jean Mermoz, Ramsay Santé, 55 Avenue Jean Mermoz, Lyon, France
Artro Institute, 8, rue du Pont de Thé, Annecy Le Vieux, France

Search for other papers by Michel P Bonnin in
Google Scholar
PubMed
Close

Purpose

  • to systematically review comparative studies reporting revision rates, clinical outcomes, or radiographic outcomes of total hip arthroplasty (THA) using collared versus collarless conventional-length uncemented hydroxyapatite (HA)-coated stems.

Methods

  • In adherence with PRISMA guidelines, a literature search was performed on Medline, Embase, and Scopus. Comparative clinical studies were eligible if they reported outcomes of collared versus collarless uncemented HA-coated stems for primary THA. Two reviewers screened titles, abstracts, and full-texts to determine eligibility; then performed data extraction; and assessed the quality of studies according to Joanna Briggs Institute (JBI) checklist.

Results

  • The search returned 972 records, 486 were duplicates, and 479 were excluded after title/abstract/full-text screening. Three further studies were included from the references of eligible studies and from discussions with subject matter experts, resulting in 11 included studies. The JBI checklist indicated six studies scored ≥7 points and four studies ≥4 points. Pooled data revealed collared stems had significantly lower revision rates (OR = 0.45; 95% CI = 0.31–0.64) and subsidence (MD = −1 mm; 95% CI = −1.6–-0.3), but no significant difference in intraoperative complication rates (OR = 0.94; 95% CI = 0.67–1.32) in the short term to mid-term. Unpooled data indicated that collared stems provide equivalent survival, equivalent or better outcomes, and equivalent or lower complication rates.

Conclusion

  • In comparative studies, collared stems have lower revision rates than collarless stems, as well as equivalent or better clinical and radiographic outcomes. Differences could be due to a protective effect that the collar offers against subsidence, particularly in undersized or misaligned stems. Further studies are warranted to confirm long-term results and better understand differences between registry data and clinical studies.

Open access
Mattia Loppini Department of Biomedical Sciences, Humanitas University, Via Rita Levi Montalcini 4, Pieve Emanuele, Milan, Italy
IRCCS Humanitas Research Hospital, Via Manzoni 56, Rozzano, Milan, Italy
Fondazione Livio Sciutto Onlus, Campus Savona - Università degli Studi di Genova, Via Magliotto 2, Savona, Italy

Search for other papers by Mattia Loppini in
Google Scholar
PubMed
Close
,
Francesco Manlio Gambaro Department of Biomedical Sciences, Humanitas University, Via Rita Levi Montalcini 4, Pieve Emanuele, Milan, Italy
IRCCS Humanitas Research Hospital, Via Manzoni 56, Rozzano, Milan, Italy

Search for other papers by Francesco Manlio Gambaro in
Google Scholar
PubMed
Close
,
Marco di Maio Università degli Studi di Trieste, Piazzale Europa 1, Trieste, Italy

Search for other papers by Marco di Maio in
Google Scholar
PubMed
Close
, and
Guido Grappiolo IRCCS Humanitas Research Hospital, Via Manzoni 56, Rozzano, Milan, Italy
Fondazione Livio Sciutto Onlus, Campus Savona - Università degli Studi di Genova, Via Magliotto 2, Savona, Italy

Search for other papers by Guido Grappiolo in
Google Scholar
PubMed
Close

  • The number of primary total hip arthroplasties (THAs) and revisions is expected to steadily grow in the future. The femoral revision surgery can be technically demanding whether severe bone defects need to be addressed.

  • The femoral revision aims to obtain a proper primary stability of the stem with a more proximal fixation as possible. Several authors previously proposed classification systems to describe the morphology of the bony femoral defect and to drive accordingly the surgeon in the revision procedure.

  • The previous classifications mainly considered cortical and medullary bone at the level of the defect of poor quality by definition. Therefore, the surgical strategies aimed to achieve a distal fixation bypassing the defect or to fill the defect with bone impaction grafting or structured bone grafts up to the replacement of the proximal femur with megaprosthesis.

  • The consensus on a comprehensive and reliable classification system and management algorithm is still lacking. A new classification system should be developed taking into account the bone quality. The rationale of a new classification is that ‘functional’ residual bone stock could be present at the level of the defect. Therefore, it can be used to achieve a primary (mechanical) and secondary (biological) stability of the implants with a femoral fixation more proximal as possible.

Open access
Yun Yang Department of Orthopaedics, The Third People’s Hospital of Chengdu, Sichuan, PR China

Search for other papers by Yun Yang in
Google Scholar
PubMed
Close
,
Yin-xiao Peng Department of Orthopaedics, The Third People’s Hospital of Chengdu, Sichuan, PR China

Search for other papers by Yin-xiao Peng in
Google Scholar
PubMed
Close
, and
Bin Yu Department of Orthopaedics, The Third People’s Hospital of Chengdu, Sichuan, PR China

Search for other papers by Bin Yu in
Google Scholar
PubMed
Close

Aim

  • The aim of this study was to provide a comprehensive overview of floating hip injury and attempt to provide a management algorithm.

Methods

  • PubMed was searched using the terms ‘Floating hip’ or ‘acetabular fracture’ and ‘Ipsilateral femoral fracture’ or ‘pelvic fracture’ and ‘Ipsilateral femoral fracture’. One author performed a preliminary review of the abstracts and references of the retrieved articles.

Results

  • The mean injury severe score reported was higher than 20. Chest and abdominal injuries, as well as fractures at other sites, were the most common associated injuries. Despite the high disability rate, surgery remained the preferred option for managing these injuries. The surgical timing varied from a few hours to several days and was subjected to the principles of damage control orthopedics. Although, in most cases, fixation of femoral fractures took precedence over pelvic or acetabular fractures, there was still a need to consider the impact of damage control orthopedics, associated injuries, and surgeon's considerations and preferences. Posttraumatic arthritis, neurological deficits, heterotopic ossification, femoral head necrosis, femoral nonunion, and limb inequality were common complications of the floating hip injury.

Conclusions

  • The severity of such injuries often exceeds that of an isolated injury and often requires specialized multidisciplinary treatment. In the management of these complex cases, the complexity and severity of the injury should be fully assessed, and an appropriate surgical plan should be developed to perform definitive surgery as early as possible, with attention to prevention of complications during the perioperative period.

Open access
Guido Grappiolo IRCCS Humanitas Research Hospital, Rozzano, Milan, Italy
Fondazione Livio Sciutto Onlus, Campus Savona - Università degli Studi di Genova, Via

Search for other papers by Guido Grappiolo in
Google Scholar
PubMed
Close
,
Edoardo Guazzoni IRCCS Humanitas Research Hospital, Rozzano, Milan, Italy
Department of Orthopaedics and Traumatology, IRCCS Fondazione Policlinico San Matteo, University of Pavia, Pavia, Italy

Search for other papers by Edoardo Guazzoni in
Google Scholar
PubMed
Close
,
Francesco Manlio Gambaro Fondazione Livio Sciutto Onlus, Campus Savona - Università degli Studi di Genova, Via
Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Milan, Italy

Search for other papers by Francesco Manlio Gambaro in
Google Scholar
PubMed
Close
, and
Mattia Loppini IRCCS Humanitas Research Hospital, Rozzano, Milan, Italy
Fondazione Livio Sciutto Onlus, Campus Savona - Università degli Studi di Genova, Via
Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Milan, Italy

Search for other papers by Mattia Loppini in
Google Scholar
PubMed
Close
Open access
Hanna Wellauer Department of Orthopaedics, HFR Fribourg - Cantonal Hospital, Fribourg, Switzerland

Search for other papers by Hanna Wellauer in
Google Scholar
PubMed
Close
,
Roman Heuberger RMS Foundation, Bettlach, Switzerland

Search for other papers by Roman Heuberger in
Google Scholar
PubMed
Close
,
Emanuel Gautier Department of Orthopaedics, HFR Fribourg - Cantonal Hospital, Fribourg, Switzerland

Search for other papers by Emanuel Gautier in
Google Scholar
PubMed
Close
,
Moritz Tannast Department of Orthopaedics, HFR Fribourg - Cantonal Hospital, Fribourg, Switzerland

Search for other papers by Moritz Tannast in
Google Scholar
PubMed
Close
,
Hubert Steinke Institute for the History of Medicine, University of Bern, Bern, Switzerland

Search for other papers by Hubert Steinke in
Google Scholar
PubMed
Close
, and
Peter Wahl Division of Orthopaedics and Trauma Surgery, Cantonal Hospital Winterthur, Winterthur, Switzerland

Search for other papers by Peter Wahl in
Google Scholar
PubMed
Close
Open access
Free access
Pablo Castillón Department of Trauma and Orthopaedic Surgery, Hospital, Universitari Mútua Terrassa, Terrassa, Barcelona, Spain
Universidad Autònoma de Barcelona (UAB), Bellaterra, Barcelona, Spain

Search for other papers by Pablo Castillón in
Google Scholar
PubMed
Close
,
Josep Maria Muñoz Vives Department of Trauma and Orthopaedic Surgery, Hospital Althaia Manresa. Manresa, Barcelona, Spain
Department of Trauma and Orthopaedic Surgery, Hospital Nostra Senyora de Meritxell, Andorra

Search for other papers by Josep Maria Muñoz Vives in
Google Scholar
PubMed
Close
,
Héctor José Aguado Department of Trauma and Orthopaedic Surgery, Hospital Clínico Universitario de Valladolid. Valladolid, Spain
Universidad de Valladolid, Valladolid, Spain

Search for other papers by Héctor José Aguado in
Google Scholar
PubMed
Close
,
Arantxa Capel Agundez Department of Trauma and Orthopaedic Surgery, Hospital Universitario 12 de Octubre, Madrid, Spain

Search for other papers by Arantxa Capel Agundez in
Google Scholar
PubMed
Close
,
Alina Ortega-Briones Department of Trauma and Orthopaedic Surgery, Hospital Clínico Universitario de Valladolid. Valladolid, Spain

Search for other papers by Alina Ortega-Briones in
Google Scholar
PubMed
Close
,
Jorge Hassan Núñez Department of Trauma and Orthopaedic Surgery, Hospital, Universitari Mútua Terrassa, Terrassa, Barcelona, Spain
Universidad Autònoma de Barcelona (UAB), Bellaterra, Barcelona, Spain

Search for other papers by Jorge Hassan Núñez in
Google Scholar
PubMed
Close
, and
the PISCO Investigators †
Search for other papers by the PISCO Investigators † in
Google Scholar
PubMed
Close
the PISCO Investigators

  • A peri-implant femoral fracture (PIFF) is defined as a femoral fracture in the presence of a pre-existing non-prosthetic implant. Classification systems, treatment guidelines and fixation strategies exist for peri-prosthetic fractures, but there is no standard of care regarding PIFFs.

  • The aim of the Peri-Implant Spanish Consensus (aka PISCO) investigators is to reach an agreement regarding current practices for management of PIFFs and to propose four main principles to assess surgical treatment and prevention of these fractures.

  • This consensus review was conducted according to the Delphi method. Twenty-two expert orthopaedic trauma surgeons performed the consensus and the definitive statements were approved unanimously.

  • Biological fixation principles must be utilized in the surgical treatment of peri-implant femur fractures, which include closed or minimally invasive reduction techniques. The osteosynthesis must protect the entire bone.

  • Gaps between two implants should be avoided. If implant overlap is not possible to achieve, then spanning inter-implant fixation systems must be used, especially in osteoporotic bone.

  • Previous implants should be retained during surgical treatment of peri-implant femur fractures. Only those implants that would interfere with current fixation goals should be removed.

  • If the previous implant is in the femoral neck region, then femoral neck protection must be maintained when treating the peri-implant fracture, even if the neck fracture has already healed.

Open access
Joseph J Ruzbarsky Steadman Philippon Research Institute, Vail, Colorado, USA
Steadman Clinic and United States Coalition for the Prevention of Illness and Injury in Sport, Vail, Colorado, USA

Search for other papers by Joseph J Ruzbarsky in
Google Scholar
PubMed
Close
,
Rui W Soares Department of Orthopaedic Surgery, Cleveland Clinic, Cleveland, Ohio, USA

Search for other papers by Rui W Soares in
Google Scholar
PubMed
Close
,
Spencer M Comfort Steadman Philippon Research Institute, Vail, Colorado, USA

Search for other papers by Spencer M Comfort in
Google Scholar
PubMed
Close
,
Justin W Arner Department of Orthopaedic Surgery, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA

Search for other papers by Justin W Arner in
Google Scholar
PubMed
Close
, and
Marc J Philippon Steadman Philippon Research Institute, Vail, Colorado, USA
Steadman Clinic and United States Coalition for the Prevention of Illness and Injury in Sport, Vail, Colorado, USA

Search for other papers by Marc J Philippon in
Google Scholar
PubMed
Close

  • With the growing number of primary arthroscopies performed, patients requiring revision hip arthroscopies for various issues is high including postoperative adhesion formation, a source of pain, mechanical symptoms, range of motion limitation, stiffness, and microinstability.

  • Adhesions are a consequence of biological pathways that have been stimulated by injury or surgical interventions leading to an increased healing response.

  • Preventative efforts have included surgical adjuncts during/after primary hip arthroscopy, biologic augmentation, and postoperative rehabilitation.

  • Treatment options for adhesion formation includes surgical lysis of adhesions with or without placement of biologic membranes aimed at inhibiting adhesion reformation as well as systemic medications to further reduce the risk.

  • Postoperative rehabilitation exercises have also been demonstrated to prevent adhesions as a result of hip arthroscopy. Ongoing clinical trials are further investigating pathways and prevention of adhesion formation.

Open access
Vasileios F Pegios Academic Orthopaedic Department, Aristotle University Medical School, General Hospital Papageorgiou, Thessaloniki, Greece
Centre of Orthopaedic and Regenerative Medicine (CORE), Center for Interdisciplinary Research and Innovation (CIRI)-Aristotle University of Thessaloniki (AUTH), Balkan Center, Thessaloniki, Greece

Search for other papers by Vasileios F Pegios in
Google Scholar
PubMed
Close
,
Eustathios Kenanidis Academic Orthopaedic Department, Aristotle University Medical School, General Hospital Papageorgiou, Thessaloniki, Greece
Centre of Orthopaedic and Regenerative Medicine (CORE), Center for Interdisciplinary Research and Innovation (CIRI)-Aristotle University of Thessaloniki (AUTH), Balkan Center, Thessaloniki, Greece

Search for other papers by Eustathios Kenanidis in
Google Scholar
PubMed
Close
,
Stavros Tsotsolis Centre of Orthopaedic and Regenerative Medicine (CORE), Center for Interdisciplinary Research and Innovation (CIRI)-Aristotle University of Thessaloniki (AUTH), Balkan Center, Thessaloniki, Greece
Department of Trauma and Orthopaedics, Guy’s and St Thomas’ NHS Foundation Trust, London, UK

Search for other papers by Stavros Tsotsolis in
Google Scholar
PubMed
Close
,
Michael Potoupnis Academic Orthopaedic Department, Aristotle University Medical School, General Hospital Papageorgiou, Thessaloniki, Greece
Centre of Orthopaedic and Regenerative Medicine (CORE), Center for Interdisciplinary Research and Innovation (CIRI)-Aristotle University of Thessaloniki (AUTH), Balkan Center, Thessaloniki, Greece

Search for other papers by Michael Potoupnis in
Google Scholar
PubMed
Close
, and
Eleftherios Tsiridis Academic Orthopaedic Department, Aristotle University Medical School, General Hospital Papageorgiou, Thessaloniki, Greece
Centre of Orthopaedic and Regenerative Medicine (CORE), Center for Interdisciplinary Research and Innovation (CIRI)-Aristotle University of Thessaloniki (AUTH), Balkan Center, Thessaloniki, Greece

Search for other papers by Eleftherios Tsiridis in
Google Scholar
PubMed
Close

Purpose

  • The main indication of bisphosphonates (BPs) is osteoporosis treatment. However, there is growing interest in the peri- and postoperative use of BPs to mitigate total hip arthroplasty (THA) aseptic loosening (AL) risk. This systematic review aimed to evaluate the implant survival and the AL rate in patients with elective THA receiving BPs compared to those that do not receive BPs. Secondary outcomes included the comparison of revision rate, postoperative complications, and patients’ functional scores.

Methods

  • This systematic review was conducted under the PRISMA 2020 guidelines with a pre-registered PROSPERO protocol. Three engines and grey literature were searched up until May 2022. Randomized and nonrandomized controlled trials and comparative cohort studies assessing BP and control therapy impact on THA survival were included.

Results

  • Twelve studies embraced the inclusion criteria. A total of 99 678 patients and 99 696 THAs were included; 10 025 patients received BPs (BP group), and 89 129 made up the control group. The overall revision and AL rates were lower in the BP group (2.17% and 1.85%) than in the control group (4.06% and 3.2%). Periprosthetic fracture (PPF) cases were higher in the BP group (0.24%) than in the control group (0.04%); however, the majority of PPF cases were derived from a single study. Further complication risk was similar between groups. Most studies reported comparable functional scores between groups.

Conclusion

  • BP treatment after elective THA seems to reduce the overall revision and AL risk. Other complications’ risk and functional scores were similar between groups. Further high-quality studies are needed to validate the results due to the multifactorial AL pathogenesis.

Open access