Systematic Review of Total Hip Arthroplasty in Patients under 30 Years old

Gee, M.; Ajuied, Adil; Shah, Zameer; George, Marc; Bankes, Marcus

doi:10.5301/hipint.5000002

Cited by 17 publications

(13 citation statements)

References 35 publications

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“…Symptoms such as pain, swelling and deformity are observed in 19% to 50% of SpA patients, and 47% to 90% of SpA patients have bilateral involvement . In SpA patients, hip deformity may be associated with a longer disease course, younger age, serious spine function, rapid progression (measured by Bath Ankylosing Spondylitis Disease Activity Index [BASDAI]), and a higher disability rate . In SpA patients, hip joint involvement is an important cause of disability, and the overall annual prevalence of total hip arthroplasty is 0.17% to 5% .…”

Section: Introductionmentioning

confidence: 99%

Application and preliminary validation of the hip inflammation MRI scoring system (HIMRISS) in spondyloarthritis

et al. 2018

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Aims: Spondyloarthritis (SpA) is an inflammatory rheumatic disease and hip involvement often results in severe deformities and functional impairment. Magnetic resonance imaging (MRI) is a powerful imaging tool for detecting early hip lesions in SpA.The aims of this study are to apply the hip inflammation MRI scoring system (HIMRISS) in SpA patients and to evaluate its reproducibility and validity.Methods: Four readers new to HIMRISS (two radiologists and two rheumatologists) scored the MRI scans obtained from a total of 55 SpA patients with hip lesions in two separate exercises (33 patients in exercise 1 and 22 patients in exercise 2). After the training and review process for exercise 1, these well-trained readers with expertise in the HIMRISS method scored the scans obtained from 22 patients and evaluated the association between HIMRISS and clinical activity of SpA, including Ankylosing Spondylitis Disease Activity Score (ASDAS), laboratory features, Bath Ankylosing Spondylitis Disease Activity Index and Harris hip scores. Results: HIMRISS is a reliable MRI scoring method for bone merrow lesions (BML)and synovitis in SpA. After 2 training exercises, the reliability improved from 0.67 to 0.90. The reliability for detecting femoral BML, acetabular BML, and synovitis effusion was very good after the 2 exercises (overall intraclass correlation coefficient = 0.73, 0.84 and 0.88, respectively). The clinical correlations between HIMRISS and ASDAS were most significant, and the correlations were closer to summed bilateral HIMRISS scores than just the worse side. HIMRISS was found to be an excellent tool for the early diagnosis of inflammation before the occurrence of structural damage, which was not significantly reflected in the systemic diagnosis.Conclusion: HIMRISS offers a reliable MRI scoring method for hip joint in SpA, and it is beneficial for early detection and fast quantification in disease activity assessment. K E Y W O R D SDiagnosis, Hip, magnetic resonance imaging, spondyloarthritis | 229 ZHENG Et al.

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Section: Introductionmentioning

confidence: 99%

Application and preliminary validation of the hip inflammation MRI scoring system (HIMRISS) in spondyloarthritis

et al. 2018

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“…Uncemented implants provide long-term fixation of joint replacements, particularly when implanted in young and active patients. [1][2][3][4] Their advantages over traditional cemented implantations are bone preservation and long-term biological fixation 5,6 and their use is shown to be increasing in national joint registries. 7,8 However, there are similarly increasing numbers of revision procedures.…”

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confidence: 99%

Influence of trabecular bone quality and implantation direction on press‐fit mechanics

Damm

Morlock

Bishop

2016

Journal Orthopaedic Research

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Achieving primary stability of uncemented press-fit prostheses in patients with poor quality bone can involve axial implantation forces large enough to cause bone fracture. Radial implantation eliminates intraoperative impaction forces and could prevent this damage. Platens of two commercial implant surfaces ("Beaded" and "Flaked") were implanted onto trabecular bone specimens of varying quality in a press-fit simulator. Samples were implanted with varying interference, either axially (shear) or radially (normal). Push-in and pull-out forces were measured to assess stability. Microstructural changes in the bone were determined from μCT analysis. For force-defined implantation analysis, push-in and pull-out forces both increased proportionally with increasing radial force, independent of implantation direction, bone quality or implant surface. For position-defined implantation analysis, pull-out forces were generally found to increase with interference and to be greater for radial than axial implantation direction, and to be lower for poor quality bone. Bone density increased locally at the tested interface due to implantation, in particular for the Beaded surface under axial implantation. If a safe radial stress can be determined for cortical bone in a particular patient, the associated implantation force, and pull-out force which represents primary stability, can be directly derived, regardless of implantation direction, bone quality or implant surface. Radial implantation delivers primary stability that is no worse than that for axial implantation and may eliminate potentially damaging impaction forces. Development of implant designs based on this principal might improve implant fixation. © 2016 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 35:224-233, 2017.

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“…These papers reveal the evolution from using entirely cemented prostheses to more recent series of patients where uncemented prostheses were used. AS patients are on average a young group to require hip arthroplasty and there is now increasing evidence of prolonged survivorship in these groups when uncemented prostheses are used [ 50 ]. There are two series using metal resurfacing arthroplasties which have additionally been included in the review of outcomes (Table 1 ).…”

Section: Discussionmentioning

confidence: 99%

“…A recent systematic review of total hip arthroplasty in patients under 30 years old with a variety of causative pathologies for their severe hip disease (predominantly osteonecrosis, juvenile rheumatoid arthritis and developmental dysplasia) found substantial clinical improvements in patients’ function and pain. The revision rate across all papers was 19.86% for the acetabular components and 6.5% for the femoral side over a follow up period which ranged from 7.7-20 years [ 57 ]. This is comparable with the clinical outcome and revision rate for AS patients and also demonstrates a higher acetabular component failure rate than femoral component failure rate.…”

Section: Discussionmentioning

confidence: 99%

A Literature Review of Total Hip Arthroplasty in Patients with Ankylosing Spondylitis: Perioperative Considerations and Outcome

Putnis¹,

Wartemberg²,

Khan³

et al. 2015

TOORTHJ

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Ankylosing spondylitis is a spondyloarthropathy affecting the sacro-iliac joints with subsequent progression to the spine and the hip joints. The hip joints are affected by synovitis, enthesial inflammation, involvement of medullary bone, progressive degeneration and secondary osteoarthritis. Clinical presentation is usually in the form of pain and stiffness progressing to disabling fixed flexion contractures and in some instances, complete ankylosis. Hip arthroplasty should be considered for hip pain, postural and functional disability, or pain in adjacent joints due to hip stiffness. We conducted a literature review to determine peri-operative considerations and outcome in ankylosing spondylitis patients undergoing hip arthroplasty. In this review, we have discussed pre-operative surgical planning, thromboprophylaxis, anaesthetic considerations and heterotopic ossification. Outcomes of arthroplasty include range of movement, pain relief, survivorship and complications.

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Systematic Review of Total Hip Arthroplasty in Patients under 30 Years old

Cited by 17 publications

References 35 publications

Application and preliminary validation of the hip inflammation MRI scoring system (HIMRISS) in spondyloarthritis

Application and preliminary validation of the hip inflammation MRI scoring system (HIMRISS) in spondyloarthritis

Influence of trabecular bone quality and implantation direction on press‐fit mechanics

A Literature Review of Total Hip Arthroplasty in Patients with Ankylosing Spondylitis: Perioperative Considerations and Outcome

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