Posterior Approach to Optimise Patient-Reported Outcome from Revision Hip Arthroplasty

Blackburn, Julia; Lim, Diana; Harrowell, I.; Parry, Michael; Blom, Ashley W; Whitehouse, Michael R

doi:10.5301/hipint.5000442

Cited by 8 publications

(8 citation statements)

References 18 publications

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“…A surgical approach is a significant surgical choice both for primary [24, 25] and revision [26–28] procedures, and should be based on several factors, such as previous approach, soft tissue and bone condition, and surgeon experience.…”

Section: Resultsmentioning

confidence: 99%

How to prevent dislocation after revision total hip arthroplasty: a systematic review of the risk factors and a focus on treatment options

et al. 2018

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BackgroundDislocation represents the most common complication after revision total hip arthroplasty (rTHA). Understanding risk factors for dislocation has a great clinical relevance for every hip surgeon in order to consider all surgical options for effective planning. The aim of this systematic review was to answer two main questions—(1) what are the risk factors for instability after rTHA? and (2) what are the best preoperative assessments and surgical options to avoid dislocation after rTHA?Materials and methodsScientific databases were accessed to identify papers dealing with prevention and treatment of dislocation after rTHA. We performed a search using the keywords ‘revision hip arthroplasty’ and ‘dislocation’, ‘instability’, ‘outcome’, ‘failure’, ‘treatment’. After removal of duplicates and exclusion of works published in different languages, 33 articles were reviewed completely.ResultsRisk factors were analysed in order to establish the most relevant and evidence-based treatments available in the current literature.ConclusionsThe risk of dislocation after rTHA can be reduced using some precautions inferred from the literature. The use of a larger femoral and acetabular component, elevated rim liner and dual mobility implants can significantly reduce the risk of dislocation after rTHA. However, care must be taken regarding patient-related risk factors since these cannot be addressed and modified. Hence, a complete evaluation of risk factors should be performed for each patient and procedure before starting rTHA.

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Section: Resultsmentioning

confidence: 99%

How to prevent dislocation after revision total hip arthroplasty: a systematic review of the risk factors and a focus on treatment options

et al. 2018

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“…Hence, there is no perfect approach. Posterolateral has been regarded as a preferred approach by individual authors as both the posterior column of the acetabulum and the femoral shaft can be addressed through the same 10) .…”

Section: Introductionmentioning

confidence: 99%

Evaluation of Direct Anterior Approach for Revision Total Hip Arthroplasty: A Systematic Review

Singh¹,

Khurana

Gupta

2021

Hip & Pelvis

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The direct anterior approach (DAA) is an established approach for total hip arthroplasty (THA) but has been sparingly tried for revisions. The purpose of this study was to examine the available literature in order to consolidate information available on revision THA using the DAA. A PubMed, Embase, and Scopus search was performed using relevant keywords. Studies reporting on patients undergoing revision THA using DAA were included for analysis. In a review of the literature, nine studies matched the pre-decided inclusion criteria with 319 hip joints undergoing revision THA. Mean follow-up of all included studies was 34 months. The indications of revision after primary THA in decreasing order were aseptic loosening (53%), prosthetic joint infection (20.7%), peri-prosthetic fracture (16.9%), dislocation (7.2%), psoas impingement (1.9%), polyethylene wear (1.2%), pain (0.6%), and instability (0.3%). Of the 319 revisions evaluated, 107 underwent a stem revision, 142 underwent cup revision, 49 underwent a combined revision, and 21 underwent isolated liner/head change. A statistically significant improvement in functional score ( P <0.05) was observed for all studies reporting on functional outcomes. A low complication rate (51/319, 16.0%), which includes dislocation (12), infection (12), loosening of the acetabular shell (5), peri-prosthetic fractures (6), haematoma (4), and transient nerve palsy (6), was reported. Based on available level III-IV evidence, DAA appears to be a reliable alternative for revision of the failed hip arthroplasty with acceptable complication rates. Evidence of a higher quality is needed to further characterize its role in revision scenarios.

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“…There are few studies reporting the outcomes relative to the more common PL and MMH approaches in revision THA [ [13] , [14] , [15] , [16] ], and we were only able to locate one limited study reporting results using the ABMS approach for revision THA [ 17 ]. Shigemura et al.…”

Section: Discussionmentioning

confidence: 99%

“…grouped the surgical approach for primary THA with subsequent revision approaches to measure overall outcomes using the Western Ontario and McMaster Universities Arthritis Index and Oxford Hip Score scales [ 15 ]. They found that patients had better scores if they had a posterior approach for both their primary and revision THAs than when both primary and revision surgeries were performed in the lateral approach as well as a primary lateral approach and revision THA posterior approach [ 15 ]. In our study, there was no difference in outcome scores between approaches with respect to average change from baseline.…”

Section: Discussionmentioning

confidence: 99%

Outcomes of Revision Hip Arthroplasty Using the Supine Anterior-Based Muscle Sparing Approach

et al. 2022

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Posterior Approach to Optimise Patient-Reported Outcome from Revision Hip Arthroplasty

Cited by 8 publications

References 18 publications

How to prevent dislocation after revision total hip arthroplasty: a systematic review of the risk factors and a focus on treatment options

How to prevent dislocation after revision total hip arthroplasty: a systematic review of the risk factors and a focus on treatment options

Evaluation of Direct Anterior Approach for Revision Total Hip Arthroplasty: A Systematic Review

Outcomes of Revision Hip Arthroplasty Using the Supine Anterior-Based Muscle Sparing Approach

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