Improving planning and post-operative assessment for Total Hip Arthroplasty

Abstract

Total Hip Arthroplasty (THA) remains the gold standard of treatment for patients who suffer with a variety of hip-related pathological degeneration or trauma. These patients often exhibit significantly less post-operative pain and an increase in the range of motion of the joint, but there are still relatively common instances of debilitating periprosthetic complications that call into question the method for pre-surgical implant choice. Currently, there are two principal options for THA prostheses: cemented or non cemented. Utilizing the cemented procedure ensures a faster acquisition of adequate implant stability than with the non cemented procedure, but can eventually lead to an increased periprosthetic fracture risk. Non cemented prosthetic stems are more frequently revised within the first few years following THA due to periprosthetic fracture, but non cemented revision surgeries generally result in fewer complications than those of cemented implants. Surgeons typically rely on experience or simple patient metrics such as age and sex to prescribe which implant procedure is optimal, and while this may work for most patients, there is a clear need to analyze more rigoriously patient conditions that correlate to optimal post-THA outcomes. The results from the investigation reported herein indicate that an understanding of how the percent composition and quality of a patient's quadriceps muscle in both healthy and operated legs may be a better indicator for prosthetic choice. Additionally, these data emphasize that the traditional metrics of age and sex inadequately predict changes in quadriceps composition and quality and thereby have comparatively minor utility in determining the patient-appropriate prosthetic type.

Efficacy of Hip Strengthening on Pain Intensity, Disability, and Strength in Musculoskeletal Conditions of the Trunk and Lower Limbs: A Systematic Review with Meta-Analysis and Grade Recommendations

“…Three trials investigated the efficacy of hip strengthening compared with control (no intervention), and six trials investigated whether hip strengthening combined with other active interventions enhanced the effects of the other active interventions. The outcomes included NPRS [ 16 , 17 , 18 , 30 , 33 , 38 ], VAS [ 31 , 32 , 35 , 36 , 37 ], and measured pain intensity [ 32 ]. Self-reported disability was assessed by the Oswestry Disability Index (ODI) [ 33 , 34 , 35 , 36 , 38 ], the Lower Extremity Functional Scale (LEFS), the Anterior Knee Pain Scale (AKPS) [ 30 ], the Roland–Morris questionnaire [ 37 ], and the Western Ontario and McMaster Universities osteoarthritis index (WOMAC) [ 31 ].…”

“…In addition, we included trials investigating whether hip strengthening combined with other active interventions enhances the effects of the other active interventions. The outcomes of interest were neuromuscular function (e.g., muscle strength, power, and muscle activation of the gluteus muscle), pain intensity (evaluated by any numerical perception rating scale (NPRS) or visual analog scale (VAS)), and disability (evaluated by any valid instrument) [ 15 , 16 , 17 ].…”

3D false color computed tomography for diagnosis and follow-up of permanent denervated human muscles submitted to home-based Functional Electrical Stimulation

“…Additional analytical methods of muscle tissue volume and density may be found in other published clinical imaging articles, [74][75] in studies of aging 76 and are described in detail in other reviews and articles of the EJTM Special "News on clinical imaging of muscle tissue". [77][78][79][80][81] …”

Effect of Physiological Fluids Contamination on Selected Mechanical Properties of Acrylate Bone Cement

“…The scope of medical applications of cement materials primarily involves fixing endoprostheses in total knee arthroplasty (TKA) and total hip arthroplasty (THA). This medical substrate is, moreover, applied in reconstructive procedures, particularly in the presence of bone defects that require grafting, such as in the case of vertebroplasty and kyphoplasty [4,5,6,7,8,9,10]. Note that cement is not an adhesive material, and it does not form a permanent bond with the implant or the bone.…”