Are Younger Patients Undergoing THA Appropriately Characterized as Active?

Keeney, James A.; Nunley, Ryan M.; Baca, Geneva; Clohisy, John C.

doi:10.1007/s11999-014-3952-8

Cited by 37 publications

(22 citation statements)

References 29 publications

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“…Следует учитывать, что возраст пациентов существенно отражается на сроках реэндопротезирования. Высокая степень жизненной активности, интенсивность физических нагрузок у пациентов подросткового возраста после тотального эндопротезирования тазобедренного сустава пропорциональны статико-динамическим нагрузкам и отражаются на показателях «выживаемости» эндопротезов [17][18][19][20][21]. В конечном счете оправдывается высказывание Jona Charnley: «На сегодняшний день не существует эндопротеза, который может быть установлен молодому пациенту на все время его жизни».…”

Section: Discussionunclassified

Long-term treatment results of congenital hip disease in adolescents

Абакарович¹,

Abakarov

Алиевич

2020

Pediatr Traum Orthop Reconstr Surg

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Backgrоund. An analysis of modern literature reveals that presently, there are no algorithms for determining the correct method of surgical treatment for adolescents with high congenital hip dislocation; few publications are devoted to the treatment of adolescents with this pathology. Children are treated by podiatrists until the age of 18 before transferring to adult specialists. There remain debatable issues of total hip replacement in adolescents because there are time limits for hip preservation. The search for improved treatment methods for adolescents with this pathology by preserving their own bone structures continues to be relevant. Aim. To evaluate the long-term results of the treatment of adolescents with complete congenital hip dislocation after intertrochanteric osteotomy using the authors technique. Materials and methods. From 19902006, in the Republican Orthopedic and Traumatological Center of the Republic of Dagestan and the clinic of the Department of Traumatology and Orthopedics of the Dagestan State Medical University, 37 patients with high congenital dislocation of the hip underwent 49 operations using the method developed by the authors. The surgeries were performed by a single orthopedist and were presented as an angulatory lengthening by transtrochantiс osteotomy of the femur by fixation with a fingered plate. All patients underwent clinical, radiographical, biomechanical, and statistical evaluation before and after surgery using the Harris and VAS scales. The results of the study were processed using the Student, Pearson, and Kolmogorov coefficients and confidence intervals. Results. Over a long-term treatment period of up to 10 years, the average Harris score increased from 44.2 (95% CI 38.747.9) to 80.5 (95% CI 77.185.3). After the 10-year follow-up period (1015 years after surgery), the scores gradually dropped to 72.4 (95% CI 70.178.3). Unsatisfactory treatment results were found in 13.5% of cases and were mainly associated with an unsuccessful choice of support point under the pelvis and the preservation of uncompensated shortening of the limb. The alignment of the created degree of angulation of the hip in terms of adolescent age groups was not established. Differences in treatment results (depending on the inter-operation time for the bilateral dislocation of the hip) were not established. At follow-up periods of 1015 years after surgery, total hip replacement was performed in 21 joints (56.7%). Conclusions. The proposed method of surgical treatment of congenital hip dislocation in adolescents improves the staticdynamic capabilities of the hip joint and remains effective over the following 15 years of life. The duration of inpatient treatment is reduced and does not interfere with subsequent total hip arthroplasty.

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Section: Discussionunclassified

Long-term treatment results of congenital hip disease in adolescents

Абакарович¹,

Abakarov

Алиевич

2020

Pediatr Traum Orthop Reconstr Surg

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“…населения, а в возрасте старше 85 лет этот показатель в среднем приближается к 1000, при этом в Швейцарии достигает почти 1300 операций на 100 тыс. населения 7 . Разница между мужчинами и женщинами также зна-чительно колеблется в зависимости от страны.…”

Section: Discussionunclassified

“…Разница между мужчинами и женщинами также зна-чительно колеблется в зависимости от страны. В частности, в Норвегии в 2008 г. женщин было прооперировано в 1,6 раза больше, а в Швейцарии в тот же период разницы по полу практически не было 7 . С другой стороны, в более молодом возрасте мужчины чаще, чем женщины, подвер-гаются тотальному эндопротезированию ТБС.…”

Section: Discussionunclassified

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Epidemiology of Primary Hip Arthroplasty: Report From Register of Vreden Russian Research Institute of Traumatology and Orthopedics

Шубняков

Тихилов

Николаев³

et al. 2017

Traumatology and Orthopedics of Russia

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The paper presents data analysis of the Hip Arthroplasty Register of Vreden Russian Research Institute of Traumatology and Orthopedics, namely information on 37373 primary THA performed at the Vreden Institute and at several other orthopedic centers and 1200 hip replacements at other hospitals of St. Petersburg.There were 1.5 times more women in the studied cohort than men. A significant predominance of women with dysplastic osteoarthritis (72.4%) and rheumatoid arthritis (82.1%) was reported. A male predominance was noted in patients with secondary osteoarthritis (53.1%), post-traumatic changes of hip (61.0%) and osteonecrosis of the femoral head (68.6 %). The mean age of patients was 58.0±12.9 years (95% CI from 57.9 to 58.1, median 59 years). Age data of the study revealed that patients were 10-12 years younger than reported in the national arthroplasty registers of other countries.Total hip arthroplasty was performed in the absolute majority of patients – 37295 cases (99,8%). Uncemented implants were used in 59.3% of cases, hybrid – in 29.6%, cemented – in 10.2%, reverse-hybrid – in 0.9% of all patients. The most common bearing used was metal on crosslink polyethylene, which was applied in 50.1% of all cases of arthroplasty. The type of fixation of the implant, and the use of different bearings varied in different age groups. The paper presents not only the absolute numbers of the data, but also demonstrated the dynamics of the changes in time starting from 2007.The present epidemiological study does not claim the absolute completeness of the presented data, but contains the analysis of the large number of cases, comparable with follow-ups of patients in some national registers of certain European countries. The authors analyzed about 10% of all cases of hip replacements performed on the territory of the Russian Federation in ten-year period.

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“…4,[6][7][8][9][10] Although patients after THR often overestimate their activity level, approximately 19% to 45% of people after THR, depending on what measurement tool and cutpoints used, engage in low levels of physical activity or are sedentary. 4,6,7,11,12 Improving activity levels after THR surgery is important both because of physical activity is critical for healthy aging, 13,14 and in order to fully meet the expectations of THR patients. Barriers to physical activity have been extensively investigated in general populations of older adults and in people with OA, but are not well understood in people with THRs.…”

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Hip abductor strength and fatigue are associated with activity levels more than 1 year after total hip replacement

Foucher

Cinnamon

Ryan

et al. 2017

Journal Orthopaedic Research

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Despite improvements in pain and function, people who undergo total hip arthroplasty (THR) may not always return to desired levels of physical activity (PA). The factors associated with low activity levels are not fully understood. Abductor weakness and fatigue have both been proposed as factors that limit activity in older adults or people with hip osteoarthritis, but have not been investigated after THR. We hypothesized that abductor weakness and fatigue are associated with lower activity levels in people who have undergone a THR and that fatigue mediates the association between abductor strength and activity. We evaluated 16 subjects (24 ± 10 months post-THR; age 56.8 ± 8.4 yrs; BMI 31 ± 7 kg/m ). Fatigue was assessed using the PROMIS fatigue short-form 7a. Peak isometric hip abductor torque was assessed using a dynamometer with subjects in a sidelying position. We assessed activity level using the UCLA activity score. We used Pearson correlations to explore the associations among the variables. Next we used a three-step linear regression procedure to test whether or not fatigue acted as a mediator between abductor torque and UCLA activity scores. Higher abductor torque was associated with less fatigue (R = 0.275; p = 0.037) and with higher UCLA scores (R = 0.488, p = 0.003). Higher fatigue was associated with lower UCLA scores (R = 0. 307, p = 0.017), however there was no evidence of mediation. This suggests that addressing both abductor strength and fatigue may increase physical activity. Statement of Clinical Significance: Fatigue and abductor weakness should be evaluated in sedentary THR patients presenting for long-term follow-up. © 2017 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 36:1519-1525, 2018.

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Are Younger Patients Undergoing THA Appropriately Characterized as Active?

Cited by 37 publications

References 29 publications

Long-term treatment results of congenital hip disease in adolescents

Long-term treatment results of congenital hip disease in adolescents

Epidemiology of Primary Hip Arthroplasty: Report From Register of Vreden Russian Research Institute of Traumatology and Orthopedics

Hip abductor strength and fatigue are associated with activity levels more than 1 year after total hip replacement

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