National trends and in hospital outcomes for total hip arthroplasty in avascular necrosis in the United States

Mayers, William F.; Schwartz, Brian; Schwartz, Aaron; Moretti, Vincent M.; Goldstein, Wayne M.; Shah, Rohan J.

doi:10.1007/s00264-015-3089-8

Cited by 16 publications

(7 citation statements)

References 24 publications

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“…Although the most common indication for hip arthroplasty is a diagnosis of osteoarthritis, approximately 5%-18% are performed in the setting of avascular necrosis (AVN) of the femoral head, whereas joint sparing procedures are becoming less common [1] , [2] , [3] . AVN can be idiopathic in nature or attributed to a number of potential etiologies, including alcohol abuse, steroid use, organ transplant, autoimmune disease, sickle cell disease, systemic lupus erythematosus, irradiation, and hematologic diseases (leukemia, lymphoma).…”

Section: Introductionmentioning

confidence: 99%

“…Considering the various etiologies of AVN, patients undergoing hip arthroplasty are often medically challenging despite being relatively young with reported mean ages of 37 to 45 years [1] , [5] , [6] , [7] . Most studies report on hip arthroplasty for all-cause AVN and have found increased rates of infection, myocardial infarction, mortality, blood transfusion, readmission, revision, and prolonged hospital stays [1] , [8] , [9] , [10] , [11] . However, few studies have evaluated the subset of patients with AVN secondary to excessive alcohol use.…”

Section: Introductionmentioning

confidence: 99%

“…However, few studies have evaluated the subset of patients with AVN secondary to excessive alcohol use. Alcohol abuse is one of the most common risk factors for atraumatic AVN in patients younger than 40 years of age, particularly males [1] , [12] . Yuan et al.…”

Section: Introductionmentioning

confidence: 99%

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Hip arthroplasty for osteonecrosis of the femoral head secondary to alcohol abuse

et al. 2019

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Although the challenges of hip arthroplasty for avascular necrosis (AVN) are known, limited data exist to describe patient demographics and outcomes in the setting of AVN attributed to alcoholism. We retrospectively identified 43 patients (62 hips) who underwent primary hip arthroplasty between 1999 and 2016 for a diagnosis of AVN of the femoral head with a concomitant diagnosis of alcohol abuse and minimum follow-up of 2 years (mean, 8.6 years). The mean age was 51 years, predominantly male (88%), with a high rate of comorbidities. History of cigarette smoking was prevalent (65%). Mean length of stay was 5.3 days, which is prolonged due to a high prevalence of acute postoperative alcohol withdrawal (14.5% of cases). There were 5 early (≤2 years) reoperations (8% of hips) for instability, periprosthetic acetabular fracture and component loosening, heterotopic ossification, superficial infection, and acute periprosthetic infection. There were no additional radiographic failures. The mean postoperative Hip dysfunction and Osteoarthritis Outcome Score for Joint Replacement was 97.8 ± 7.8, indicative of excellent outcomes at final follow-up of 2 to 18 years. Early risks associated with hip replacement surgery must be communicated to the predominantly young male subgroup of patients with AVN attributed to alcoholism, but these patients may achieve excellent mid- to long-term outcomes.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Hip arthroplasty for osteonecrosis of the femoral head secondary to alcohol abuse

et al. 2019

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“…Another meta -analysis consisting of 37 studies reached a similar conclusion, showing that OA was protective factor in predicting PJI after THA/TKA [18]. Besides, Mayers W et al searched the patients' profiles with primary THA in US fro m 2001-2010, and found that patient underwent THA fo r OA have lesser medical complications and lower incidence for myocardial infarction than those with AVN [34].…”

Section: Discussionmentioning

confidence: 88%

Patients' risk factors for periprosthetic joint infection in total hip arthroplasty: A systematic review and meta-analysis of 34 studies

Ren

Zhang

et al. 2020

Preprint

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BackgroundPeriprosthetic joint infection (PJI) is a catastrophic complication following total hip arthroplasty (THA). This meta-analysis aimed to identify the individual-related risk factors that predispose patients to PJI undergoing THA.MethodsWe performed extensive literature retrieval from related databases from inception to October 20, 2019. Patient-related risk factors were compared and grouped according to modifiable factors (BMI, smoke and alcohol abuse), non- modifiable factors (gender, age), and medical history characteristics, such as diabetes mellitus (DM), avascular necrosis (AVN) of femoral head, femoral neck fracture, rheumatoid arthritis (RA), cardiovascular disease (CVD), and osteoarthritis (OA) etc. Meta-analysis was performed using risk ratios with 95% corresponding intervals. Sensitivity analysis and publication bias were performed to assess the credibility of the results.ResultsOverall, 34 studies with 2,141,960 hips were included. By implementing cumulative meta-analysis, we found that higher BMI significantly increased the rate of PJI after THA. Meanwhile, medical characteristics comprising DM, AVN, femoral neck fracture, RA, CVD, chronic pulmonary disease and neurological disease, were also markedly associated with higher PJI risk. Conversely, dysplasia or dislocation, and OA were protective factors. Notably, female gender was protective for PJI only after longer follow-up. Besides, age, smoking, alcohol abuse, previous joint surgery, renal disease, hypertension, cancer and steroid use were not correlated with risk of PJI.ConclusionOur finding indicates that the main risk factors for PJI are high BMI, DM, AVN, femoral neck fracture, RA, CVD, chronic pulmonary disease, and neurological disease. Protective factors are female gender, dysplasia/ dislocation and OA.

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“…Men accounted for 51.9 % of the AVN group and 43.0 % of the OA group (p < 0.01). 6 Overweight and obesity are often associated with hyperlipidemia. This in turn is associated with elevated fasting and postprandial plasma insulin concentrations that can promote adipose synthesis and inhibit the decomposition of adipose tissue.…”

Section: Discussionmentioning

confidence: 99%

Relationship of Alcohol and Tobacco With Avn of Femoral Head in Adult Indian Population

Suman

Sharma

Acharya

et al. 2021

ijmsdr

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Background: Avascular necrosis (AVN) or osteonecrosis is the death of bone tissues due to decreased blood flow of femoral head, it is a major orthopaedic disease with many risk factors including the chronic alcohol and tobacco consumption. Aims and objectives: To study the relationship of alcohol and tobacco with AVN of femoral head in adult population. Materials and Methods: This study included 72 patients of AVN of femoral head (ONFH) who attending our hospital between Sept 2018 to Sept 2020. History of alcoholism and tobacco consumption, detailed information of the amount and duration of smoking and alcohol intake was recorded. Results: Majority of the AVN patients were working age groups males (72%) and 28% were females. Out of 72 patient 55% had history of alcohol consumption and 60% were smokers which indicates a positive correlation of cellular toxicity with AVN of femoral head. Conclusion: Present study conclude that the alcohol ingestion and tobacco smoking are the major cause of cellular toxicity and AVN of femoral heads. Keywords: alcohol drinking, femur head necrosis, smoking

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National trends and in hospital outcomes for total hip arthroplasty in avascular necrosis in the United States

Cited by 16 publications

References 24 publications

Hip arthroplasty for osteonecrosis of the femoral head secondary to alcohol abuse

Hip arthroplasty for osteonecrosis of the femoral head secondary to alcohol abuse

Patients' risk factors for periprosthetic joint infection in total hip arthroplasty: A systematic review and meta-analysis of 34 studies

Relationship of Alcohol and Tobacco With Avn of Femoral Head in Adult Indian Population

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