Implant Survival and Patient-Reported Outcomes after Total HIP Arthroplasty in Young Patients with Developmental Dysplasia of the HIP

Swarup, Ishaan; Marshall, Astrid C.; Lee, Yuo-yu; Figgie, Mark P.

doi:10.5301/hipint.5000354

Cited by 35 publications

(32 citation statements)

References 39 publications

(62 reference statements)

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“…This supports an upper age limit for patients undergoing PAO (Steppacher et al 2008, Matheney et al 2009, Hartig-Andreasen et al 2012, Albers et al 2013, Ziran et al 2018. Moreover, our survival rate (80%) surpasses the 15-year implant survival rate after THA which was reported to be 64% in young patients below 35 treated for symptomatic hip dysplasia (Swarup et al 2016). Among our patients, 0.4% experienced DVT and no pulmonary embolism was experienced within 1 month after PAO.…”

Section: Hoos Mediansupporting

confidence: 81%

14-year hip survivorship after periacetabular osteotomy: a follow-up study on 1,385 hips

et al. 2020

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Background and purpose — Few studies have evaluated the long- and mid-term outcomes after minimally invasive periacetabular osteotomy (PAO). We investigated: (1) the long-term hip survival rate after PAO; (2) the risk of complications and additional surgery after PAO; and (3) the hip function at different follow-up points. Patients and methods — We reviewed 1,385 hips (1,126 patients) who underwent PAO between January 2004 and December 2017. Through inquiry to the Danish National Patient Registry we identified conversions to total hip arthroplasty (THA) and complications after PAO. We evaluated the Hip disability and Osteoarthritis Outcome Score (HOOS) obtained preoperatively, and at 6 months, 2-, 5-, and 10-years’ follow-up. Results — 73 of the 1,385 hips were converted to THA. The overall Kaplan–Meier hip survival rate was 80% (95% CI 68–88) at 14 years with a mean follow-up of 5 years (0.03–14). 1.1% of the hips had a complication requiring surgical intervention. The most common additional surgery was removal of screws (13%) and 11% received a hip arthroscopy. At the 2-year follow-up, HOOS pain improved by a mean of 26 points (CI 24–28) and a HOOS pain score > 50 was observed in 86%. Interpretation — PAO preserved 4 of 5 hips at 14 years, with higher age leading to lower survivorship. The PAO technique was shown to be safe; 1.1% of patients had a complication that demanded surgical intervention. The majority of the patients with preserved hips have no or low pain. The operation is effective with a good clinical outcome.

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Section: Hoos Mediansupporting

confidence: 81%

14-year hip survivorship after periacetabular osteotomy: a follow-up study on 1,385 hips

et al. 2020

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“…Femoral reduction may be difficult and is associated with a high risk of neurologic injury because of the high dislocation and soft tissue contracture. Furthermore, higher complication rates were reported for THA for high hip dislocation; these complications included intraoperative fractures, recurrent infection, dislocation, osteolysis, mechanical loosening, and revisions.…”

Section: Introductionmentioning

confidence: 99%

Outcomes after Total Hip Arthroplasty Using a Cementless S‐ROM Modular Stem for Patients with High Hip Dislocation Secondary to Hip Pyogenic Arthritis

Yang

Wang

et al. 2019

Orthopaedic Surgery

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Objective To evaluate the midterm results of the cementless S‐ROM modular femoral stem used with subtrochanteric transverse shortening osteotomy for the treatment of high hip dislocation secondary to hip pyogenic arthritis. Methods We retrospectively reviewed the data of 49 patients (49 hips) with an average infection quiescent period of 37.4 years who underwent cementless total hip arthroplasty (THA) with simultaneous subtrochanteric transverse shortening osteotomy from July 2008 to June 2012. There were 23 men and 26 women with a mean age of 44.3 years at the time of surgery. The following clinical outcomes were evaluated: the Western Ontario and McMaster Universities Arthritis Index (WOMAC) score, Harris hip score (HSS), modified Merle d'Aubigne‐Postel hip (MAP) score, low back pain visual analog scale score, 12‐item short‐form health survey questionnaire score, limp, and Trendelenburg sign. Radiographic outcomes and complications were also evaluated. Results The mean follow‐up period was 8.7 years (range, 5.5–10 years). No infection recurrence was observed after THA. The average HSS significantly improved from 45.0 to 84.8. The WOMAC score improved from 70.1 ± 3.5 (range, 65–76) to 43.1 ± 13.4 (range, 21–67). The modified MAP score improved from 5.9 ± 1.9 (range, 3–9) to 14.3 ± 2.4 (range, 11–18). The low back pain visual analog scale score, 12‐item short‐form health survey questionnaire score, limp, and Trendelenburg sign also improved significantly. The average limb length discrepancy decreased from 39.6 mm (range, 30–55 mm) to 7.2 mm (range, 0–22 mm). Two patients had temporary sciatic nerve paralysis but recovered within 6 months without any functional defects; one had an intraoperative fracture fixed by cerclage wires. One hip required revision surgery because of femoral stem aseptic loosening. Conclusions The cementless S‐ROM modular femoral stem used with subtrochanteric transverse shortening osteotomy is safe and effective for high hip dislocation secondary to pyogenic arthritis and provides satisfactory midterm results. Significant improvements in clinical function were observed, as were high rates of stable fixation of the cementless implant, restoration of more normal limb lengths, and a low incidence of complications.

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“…A previous study reported by Lazarinis showed approximately a revision rate of 7.5% after 10 years for CTHA [11]. More recent studies have almost all focused on the application of UTHA and have shown exceptional results, with 5-year survival rates approaching 90-100% [6,12]. However, these first-rate results have not been verified in other studies, e.g., Swarup reported a 10-year survival rate of 87% for UTHA [8].…”

Section: Introductionmentioning

confidence: 95%

“…Although previous literature has reported implant survival and HHSs after primary CTHA or UTHA, they have either focused on complication rates or primary diagnoses [6,7]. Additionally, the reported results for implant survival and HHSs vary widely and are mainly attributable to differences in inclusion and exclusion criteria, sample sizes, and the length of follow-up [8,9].…”

Section: Introductionmentioning

confidence: 99%

Long-term survival of cemented versus uncemented total hip arthroplasty in the treatment of acute femoral neck fracture: A retrospective observational study with a mean 10-year follow-up

Han

Lin

et al. 2020

Preprint

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Background Despite the increased use of uncemented total hip arthroplasty (UTHA), there is little evidence of its superiority over cemented total hip arthroplasty (CTHA). The purpose of this retrospective study was to compare the long-term survivorship and Harris Hip Scores (HHSs) of CTHA versus UTHA in the treatment of acute femoral neck fractures (FNFs). Methods Data involving 224 hips (CTHA, n= 112; UTHA, n=112) that underwent primary surgery in our medical institutions during 2005-2017 were analysed retrospectively. The primary endpoint was the risk of all-cause revision. The difference in the risk of all-cause revision between groups was assessed by Kaplan-Meier survival analysis with a log-rank test and Cox regression analysis. Results The mean follow-up from surgery was 10 years (range, 3 - 13 years). Kaplan-Meier estimated that the 10-year implant survival was 98.1% (CI: 96.1–98.5) in the CTHA group and 96.2% (CI: 95.2–97.3) in the UTHA group (p = 0.030). The adjusted Cox regression analysis demonstrated a lower risk of revision in CTHA than in UTHA (hazard ratio [HR] = 1.4, 95% confidence interval [CI] = 1.1-2.6, p = 0.000). At the final follow-up, significant differences were detected in HHS (85.10[±12.21] for CTHA vs. 79.11[±13.19] for UTHA). Conclusion This retrospective analysis demonstrates that CTHA has superior survival to UTHA, with a significantly reduced revision risk and higher functional outcome scores. Further follow-up is necessary to verify whether the CTHA advantage persists over time.

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Implant Survival and Patient-Reported Outcomes after Total HIP Arthroplasty in Young Patients with Developmental Dysplasia of the HIP

Abstract: Young patients with DDH have good outcomes after surgery. Patient factors and implant characteristics should be considered when predicting implant survival and outcomes after THA in young patients with DDH.

Cited by 35 publications

References 39 publications

14-year hip survivorship after periacetabular osteotomy: a follow-up study on 1,385 hips

14-year hip survivorship after periacetabular osteotomy: a follow-up study on 1,385 hips

Outcomes after Total Hip Arthroplasty Using a Cementless S‐ROM Modular Stem for Patients with High Hip Dislocation Secondary to Hip Pyogenic Arthritis

Long-term survival of cemented versus uncemented total hip arthroplasty in the treatment of acute femoral neck fracture: A retrospective observational study with a mean 10-year follow-up

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