The Effect of Previous Hip Surgery on the Outcome of Hip Arthroplasty in Young Patients

Kargın, Deniz; Incesoy, Mustafa Alper; Onaç, Osman; Albayrak, Akif; Kaygusuz, Mehmet Akif; Bayhan, Avni İlhan

doi:10.1016/j.arth.2018.04.005

Cited by 9 publications

(10 citation statements)

References 17 publications

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“…TJA is a successful and common surgical treatment for patients with end-stage knee or hip diseases because it can significantly relieve pain and improve patients’ function and quality of life [11]. Although efforts have been made to reduce perioperative blood loss, significant early postoperative total blood loss of up to 1000–1500 mL including intraoperative bleeding and hidden blood loss remains a challenge [12].…”

Section: Discussionmentioning

confidence: 99%

Closed suction drainage following routine primary total joint arthroplasty is associated with a higher transfusion rate and longer postoperative length of stay: a retrospective cohort study

Xie

Lei

et al. 2019

J Orthop Surg Res

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Background In an enhanced recovery after surgery program, not placing a closed suction drain following routine primary total joint arthroplasty (TJA) is becoming more acceptable. However, the influence of drain use on transfusion rate and postoperative length of stay (PLOS) in TJA remains controversial. Therefore, we aimed to compare drain use with no drain in routine primary TJA to determine the differences in transfusion rate and PLOS. Methods We analyzed the data from 12,992 patients undergoing primary unilateral TJA: 6325 total knee arthroplasties (TKA) and 6667 total hip arthroplasties (THA). Patients were divided into two groups according to whether they received a drain postoperatively following TKA and THA. We extracted information for transfusion and PLOS from patients’ electronic health records and analyzed the data by logistic and linear regression analyses. Results The transfusion rate and PLOS were 15.07% and 7.75 ± 3.61 days, respectively, in the drain group and 6.72% and 6.54 ± 3.32 days, respectively, in the no-drain group following TKA. The transfusion rate and PLOS were 20.53% and 7.00 ± 3.35 days, respectively, in the drain group and 13.57% and 6.07 ± 3.06 days, respectively, in the no-drain group following THA. After adjusting for the following variables: age, gender, body mass index, orthopedic diagnoses, hypertension, type 2 diabetes, coronary heart disease, chronic obstructive pulmonary disease, preoperative hemoglobin, albumin, analgesic use, anesthesia, American Society of Anesthesiologists class, tranexamic acid use, intraoperative bleeding, operative time, and tourniquet use (for TKA), drain use correlated significantly with a higher transfusion rate (risk ratio = 2.812, 95% confidence interval (CI) 2.224–3.554, P < 0.001 for TKA and risk ratio = 1.872, 95% CI 1.588–2.207, P < 0.001 for THA) and a longer PLOS (partial regression coefficient ( B ) = 1.099, 95% CI 0.879–1.318, P < 0.001, standard regression coefficient ( B ′) = 0.139 for TKA; B = 0.973, 95% CI 0.695–1.051, P < 0.001, and B ′ = 0.115 for THA). Two groups showed no significant difference in wound complications. Conclusions Our findings indicated that drain use was associated with a higher transfusion rate and a longer PLOS in patients undergoing routine primary TJA. The routine use of postoperative drainage is not recommended in primary unilateral TJA.

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Section: Discussionmentioning

confidence: 99%

Closed suction drainage following routine primary total joint arthroplasty is associated with a higher transfusion rate and longer postoperative length of stay: a retrospective cohort study

Xie

Lei

et al. 2019

J Orthop Surg Res

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“…Total hip arthroplasty (THA) is 1 of the most successful orthopaedic procedures and the number of young and active patients with higher demands that receive a THA are increasing. [1][2][3][4][5][6] Despite favourable outcomes, some aspects of the procedure are still being improved upon, such as new materials to maximise longevity and intraoperative fluoroscopy assessment to enhance surgeon precision. [7][8][9][10][11][12][13] Nevertheless, controversy remains regarding the ideal approach.…”

Section: Introductionmentioning

confidence: 99%

“…Total hip arthroplasty (THA) is 1 of the most successful orthopaedic procedures and the number of young and active patients with higher demands that receive a THA are increasing. 1–6…”

Section: Introductionmentioning

confidence: 99%

Direct anterior approach versus posterior approach in primary total hip replacement: comparison of minimum 2-year outcomes

et al. 2019

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Introduction: The direct anterior approach (DAA) has gained popularity in recent years for total hip arthroplasty (THA). Several authors reported significantly better early outcomes when compared to the posterior approach (PA). Nevertheless, controversy exists regarding longer-term benefits of the DAA. Methods: Data was prospectively collected and retrospectively reviewed for primary THAs conducted between July 2008 and July 2016. Patients who underwent DAA and PA with minimum 2-year follow-up for Harris Hip Score (HHS), Forgotten Joint Score-12 (FJS-12), Veteran RAND 12 Mental (VR-12 Mental), Veteran RAND 12 Physical (VR-12 Physical), 12-Item Short Form Survey Mental (SF-12 Mental), 12-Item Short Form Survey Physical (SF-12 Physical), visual analogue scale, and patient satisfaction were included. Propensity score matching was performed on the DAA and PA cohorts (1:1) based on the following variables: age, sex, body mass index, and laterality. Results: 205 DAA hips were satisfactorily matched to 205 PA hips. The DAA group had higher scores at final follow-up for VR-12 Mental ( p = 0.0145), VR-12 Physical ( p = 0.0236), SF-12 Mental ( p = 0.0393), and SF-12 Physical ( p = 0.0391). The DAA and PA groups had comparable HHS ( p = 0.0737) and FJS-12 ( p = 0.2900). Conclusions: Although the DAA and PA groups had different follow-up periods, both the DAA and PA groups reported favourable outcomes at minimum 2-year follow-up. While both groups achieved comparable scores for the majority of PROs including VAS and patient satisfaction, the DAA group achieved superior quality of life outcomes when compared with a propensity score matched group of PA surgeries.

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“…TJA is a successful surgical treatment for end-stage knee or hip diseases due to that it can relieve pain, improve function, and elevate the quality of patients , life [1, 2]. With the advancement of the Enhanced Recovery After Surgery program, the number of patients undergoing TJA has significantly increased in recent years.…”

Section: Introductionmentioning

confidence: 99%

A nested case-control study on the risk factors of deep vein thrombosis for Chinese after total joint arthroplasty

Zhang

Xie

et al. 2019

J Orthop Surg Res

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Background Deep vein thrombosis (DVT) is one of the life-threatening complications of total joint arthroplasty (TJA) postoperatively, and its risk factors are still controversial. The aim of this study was to identify the risk factors of DVT after TJA. Study design and methods A nested case-control study based on a large dataset of 15,326 patients undergoing TJA was performed. Potential risk factors of DVT and demographic information were extracted from the electronic health record. Patients with DVT (73 patients) were treated as study group while non-DVT patients who were matched 1:4 according to the anticoagulant type, were considered as control group (292 patients). These variables of potential risk factors for DVT including age, sex, body mass index (BMI), American Society of Anesthesiologists class, comorbidity, preoperative hemoglobin (HB) level and analgesic use, surgical site (knee or hip) and type, the start time of drug anticoagulation, ambulation time, transfusion, and whether to use tranexamic acid (TXA), drain, human serum albumin, and measures of physical thromboprophylaxis after operation were collected and evaluated by survival analysis and presented as P value and odds ratio with 95% confidence interval. Results There were 15,326 patients underwent TJA and 73 (0.48%) patients had DVT among them, and the occurrence rates were 0.71% for the patients underwent total knee arthroplasty (TKA) while 0.24% for total hip arthroplasty. The risk factors associated with DVT included TKA (compared with THA), advanced age (> 70 years), drain use, and delayed ambulation (≥ 72 h) postoperatively. Conclusion The present results suggest that the occurrence rate of DVT on the patients underwent TJA was low (0.48%) relatively. And the risk factors associated with increased risk of DVT included TKA (compared with THA), advanced age, drain use, and delayed ambulation postoperatively. Individualized and more efficient risk stratification protocols of anticoagulation after TJA for Chinese may need to be developed in the future.

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The Effect of Previous Hip Surgery on the Outcome of Hip Arthroplasty in Young Patients

Cited by 9 publications

References 17 publications

Closed suction drainage following routine primary total joint arthroplasty is associated with a higher transfusion rate and longer postoperative length of stay: a retrospective cohort study

Closed suction drainage following routine primary total joint arthroplasty is associated with a higher transfusion rate and longer postoperative length of stay: a retrospective cohort study

Direct anterior approach versus posterior approach in primary total hip replacement: comparison of minimum 2-year outcomes

A nested case-control study on the risk factors of deep vein thrombosis for Chinese after total joint arthroplasty

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