Soft tissue reinforcement with a Leeds-Keio artificial ligament in revision surgery for dislocated total hip arthroplasty

Aota, Shigeo; Kikuchi, Shinichi; Ohashi, Hironori; Kitano, Naoko; Hakozaki, Michiyuki; Konno, Satoshi

doi:10.5301/hipint.5000573

Cited by 6 publications

(5 citation statements)

References 38 publications

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“…On the other hand, in Group 2, the artificial ligament significantly impacted on the mechanics of reconstruction, giving 64% and 17% survival rates, at 120 months. The mechanical role of artificial ligaments in improving mechanics of the reconstruction is well known [ 6 , 32 , 33 ]. However, due to lower soft tissue excision, a limited resection probably has lower impact on hip stability.…”

Section: Discussionmentioning

confidence: 99%

Periacetabular Tumour Resection under Anterosuperior Iliac Spine Allows Better Alloprosthetic Reconstruction than Above: Bone Contact Matters

Bruschi

Cevolani

Spazzoli

et al. 2022

JCM

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Background: Periacetabular resections are more affected by late complications than other pelvic resections. Reconstruction using bone allograft is considered a suitable solution. However, it is still not clear how the bone-allograft contact surface impacts on mechanical and functional outcome. Materials and methods: This paper presents the results of a retrospective analysis of 33 patients with resection of the entire acetabulum and reconstruction with an allograft-prosthetic composite for the period 1999 to 2010. Patients were divided in two groups, based on type of resection. In Group 1. patients had resections under anterosuperior iliac spine allowing the highest bone-allograft surface contact in reconstruction, while in Group 2 patients had resections over it. Results: Mechanical survival of the implant and Musculoskeletal Tumor Society functional score were calculated. Impact of age and artificial ligament were investigated as well. Patients in Group 1 had 38% mechanical failure rate of the implant while patients in Group 2 had 88%. Average functional score was higher in Group 1 compared with patients in Group 2. An artificial ligament was shown to have non-significant impact on survival of the reconstruction in Group 1, while significantly improving survival of reconstruction in Group 2. Conclusion: Bone-allograft contact matters: resection under anterosuperior iliac spine allows better mechanical survival and offers better reconstruction functional scores.

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Section: Discussionmentioning

confidence: 99%

Periacetabular Tumour Resection under Anterosuperior Iliac Spine Allows Better Alloprosthetic Reconstruction than Above: Bone Contact Matters

Bruschi

Cevolani

Spazzoli

et al. 2022

JCM

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“…При ревизионном эндопротезировании усиленное ушивание тоже показывает эффективность: после ревизионного эндопротезирования задним доступом ре-ревизия по поводу вывихов делалась в 1,9% [93] и в 2,5% [94] случаев в группах усиленного ушивания и в 10% случаев в группах обычного ушивания [93,94]. Недавно S. Aota c соавторами предложили новую методику усиленного ушивания с использованием синтетической связки Leeds-Keio, которая, по их данным, позволила стабилизировать сустав в 82% случаев ревизий по поводу сложных случаев многократных вывихов [95]. В 1987 г. S.J.…”

Section: таблица 1 влияние офсета на вывихunclassified

“…При ревизии, конечно же, важны и имеют место уже описанные маневры по усиленному ушиванию при задних доступах [93,94], пластика синтетическими материалами [95], дистализация большого вертела [96]. Теоретически в некоторых редких случаях есть перспектива у артроскопической реконструкции капсулы [97].…”

Section: классификация хирургической тактикиunclassified

Dislocations after Hip Arthroplasty (Review)

Середа

Smetanin

2020

Traumatology and Orthopedics of Russia

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One of hip arthroplasty complications is dislocation of the endoprosthesis head. In the vast majority of cases, the cause of dislocation is multifactorial. That is why only a thorough analysis of the patient’s peculiarities, surgery and rehabilitation will help to avoid the relapse. This review analyzed the risk factors of dislocation and treatment tactics. Risk factors associated with the patient include: old age, male gender, obesity, concomitant diseases, low level of preoperative physical activity, low compliance and a some others. The problem of the biomechanical ratio in the segment “spine – pelvis – lower limb” deserves special attention. Besides, there are risk factors associated with the surgeon: access option; type, fixation and position of endoprosthesis components, experience and surgical technique of a orthopedic surgeon. The strategy of dislocations rate reduction is based on a detailed study of dislocation causes and their elimination, and adequate surgery planning. The treatment of a patient with dislocation should take into account the multifactorial etiology of the condition.

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“…Sufficient soft-tissue tension that is formed by the joint capsule, short external rotators, and gluteal muscles also is important in reducing dislocation rates following revision total hip arthroplasty 42 . Multiple studies have demonstrated reduced rates of dislocation with the addition of posterior soft-tissue repair in revision total hip arthroplasties 61 . Following revision total hip arthroplasties, 1.9% of hips that were revised through the posterior approach with soft-tissue repair dislocated compared with 10% of revised hips without soft-tissue repair 62 .…”

Section: Soft-tissue Tension and Repairmentioning

confidence: 99%

“…Following revision total hip arthroplasties, 1.9% of hips that were revised through the posterior approach with soft-tissue repair dislocated compared with 10% of revised hips without soft-tissue repair 62 . Aota et al detailed a novel soft-tissue reinforcement technique with a Leeds-Keio ligament during revision surgery, resulting in 82% of cases being resolved of their intractable dislocation 61 . Moreover, Dargel et al reported that softtissue tension can be increased without extending the leg by increasing the offset between the femoral stem and the rotation center of the hip joint 3 .…”

Section: Soft-tissue Tension and Repairmentioning

confidence: 99%

Etiology, Evaluation, and Management of Dislocation After Primary Total Hip Arthroplasty

Saiz¹,

Lum²,

Pereira³

2019

JBJS Rev

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The rate of dislocation after primary total hip arthroplasty has decreased, but given the high volume of total hip arthroplasty procedures that are performed, dislocation remains a common complication.» The etiology of dislocation after total hip arthroplasty is multifactorial and depends on the patient's characteristics as well as the orthopaedic surgeon's operative techniques and decisions regarding implants.» A detailed assessment of the patient, preoperative planning, a thorough understanding of the anatomy, proper surgical technique, and knowledge of the biomechanics of the implant decrease the likelihood of dislocations following total hip arthroplasty.» The advent of new techniques and procedures has further reduced the occurrence of dislocation following total hip arthroplasty. However, should dislocation occur, primary management or revision total hip arthroplasty techniques provide excellent results to salvage the mobility and function of the hip. With nearly 400,000 Americans undergoing total hip arthroplasty every year, total hip arthroplasty deserves the distinction of "operation of the century" 1,2 . Although the surgery drastically decreases pain, improves function, and increases quality of life, total hip arthroplasty is not without risk and failures. The most common reason for failure and indication for early revision is instability 3 . The rate of dislocation after primary total hip arthroplasty ranges from 0.2% to 10% and is as high as 28% with revision total hip arthroplasty, affecting thousands of patients per year 3-6 . Therefore, dislocation represents a major challenge to the orthopaedic surgeon and the health-care system. This article reviews patient risk factors, surgical techniques, implant design, and management strategies regarding total hip arthroplasty instability. Risk FactorsTiming Dislocation is the most common early complication of total hip arthroplasty following primary implantation, and most dislocations occur within 3 weeks of the index procedure 7 . Of note, the timing of a first dislocation is a risk factor for having a second dislocation. Brennan et al. demonstrated that patients with a first-time dislocation at 13 weeks had an increased risk of occurrence of a second dislocation when compared with those who had a first-time dislocation at 3 weeks 8 . Therefore, early dislocation may be an indicator of instability due to surgical technique, including inadequate soft-tissue tensioning or lack of repair of the surgical approach, or patient noncompliance since even well-positioned implants will dislocate under these circumstances. In contrast, late first-time dislocations Disclosure: The authors indicated that no external funding was received for any aspect of this work. The Disclosure of Potential Conflicts of Interest forms are provided with the online version of the article (http://links.lww.com/JBJSREV/A472).

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Soft tissue reinforcement with a Leeds-Keio artificial ligament in revision surgery for dislocated total hip arthroplasty

Cited by 6 publications

References 38 publications

Periacetabular Tumour Resection under Anterosuperior Iliac Spine Allows Better Alloprosthetic Reconstruction than Above: Bone Contact Matters

Periacetabular Tumour Resection under Anterosuperior Iliac Spine Allows Better Alloprosthetic Reconstruction than Above: Bone Contact Matters

Dislocations after Hip Arthroplasty (Review)

Etiology, Evaluation, and Management of Dislocation After Primary Total Hip Arthroplasty

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