Total Hip Arthroplasty in Patients with Down Syndrome

Kosashvili, Yona; Taylor, Drew W.; Backstein, David; Safir, Oleg; Gross, Allan E.; Lakstein, Dror

doi:10.3928/01477447-20100722-32

Cited by 12 publications

(5 citation statements)

References 5 publications

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“…In patients with early onset of neuromuscular abnormalites, including those with cerebral palsy, poliomyelitis and Down syndrome, the age of presentation for THA is considerably younger than that expected in general for patients with osteoarthritis. 2-6,31 The mean age was between 19 and 48 years (Table I).…”

Section: Resultsmentioning

confidence: 99%

Total hip arthroplasty in patients with neuromuscular imbalance

Konan

Duncan

2018

The Bone & Joint Journal

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Patients with neuromuscular imbalance who require total hip arthroplasty (THA) present particular technical problems due to altered anatomy, abnormal bone stock, muscular imbalance and problems of rehabilitation. In this systematic review, we studied articles dealing with THA in patients with neuromuscular imbalance, published before April 2017. We recorded the demographics of the patients and the type of neuromuscular pathology, the indication for surgery, surgical approach, concomitant soft-tissue releases, the type of implant and bearing, pain and functional outcome as well as complications and survival. Recent advances in THA technology allow for successful outcomes in these patients. Our review suggests excellent benefits for pain relief and good functional outcome might be expected with a modest risk of complication. Cite this article: 2018;100-B(1 Supple A):17-21.

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Section: Resultsmentioning

confidence: 99%

Total hip arthroplasty in patients with neuromuscular imbalance

Konan

Duncan

2018

The Bone & Joint Journal

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“…[16][17][18][19] COMPLICATIONS As with any surgical procedure, complications occur, and in many cases the complication rate is not significantly different from that which would be expected with other etiologies. Degenerative arthritis may occur secondary to hip instability with progressive subluxation or dislocation but may also occur secondary to the other hip pathologies associated with Trisomy 21, namely slipped capital femoral epiphysis and Perthes disease.…”

Section: Fixed Dislocationmentioning

confidence: 99%

Management of Hip Instability in Trisomy 21

Kelley

Wedge²

2013

Journal of Pediatric Orthopaedics

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The unstable hip in Trisomy 21 presents with a spectrum of hip instability with different problems at different ages. What links this multiphase problem, in many patients, is the final common pathway of untreated instability, that of a stiff, dislocated, and often-painful hip, leading to significant functional disability. Historically, the results of treating hip instability in Trisomy 21 were variable with a notable frequency of poor results. With an improved understanding of the Trisomy 21 hip in terms of its pathoanatomy and a more contemporary surgical approach to hip reconstruction, much improved results can be expected and indeed have recently been shown. The mainstay of treatment for the habitual dislocation group presenting before 8 years of age is the femoral varus derotation osteotomy. The older group presenting with painful subluxation often show signs of secondary acetabular dysplasia and thus are best treated with redirectional acetabular osteotomy with or without the use of femoral varus derotation osteotomy. The presence of radiographic features of degenerative arthritis in the fixed dislocation group precludes the use of joint-preserving techniques for hip reconstruction, and these patients can achieve excellent results with total joint arthroplasty. The natural history, historical results, assessment, treatment, and management of complications of hip instability in Trisomy 21 are addressed in this paper.

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“…A Finnish population-based study reported that 20% of patients with DS in an age group over 30 years had had at least one orthopaedic surgery during their life, including fractures and dislocations [16]. Several publications have reported positive results with pain-relief and improved function from hip surgery in people with DS [39,40]. Only a small number in this cohort had any reported orthopaedic surgery for joint implants which call for studies investigating potential needs for future improvements for this target group.…”

Section: Discussionmentioning

confidence: 90%

Health care utilisation among older people with Down syndrome compared to specific medical guidelines for health surveillance: a Swedish national register study

Ahlström

Axmon

Sandberg

et al. 2020

BMC Health Serv Res

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Background Specific medical guidelines for health surveillance exist for people with Down syndrome (DS) since 25 years but knowledge of adherence to the guidelines is lacking. The guidelines were developed to avoid unnecessary suffering from preventable conditions. The aims of the study were to investigate 1) planned health care visits in relation to the co-morbidities described in specific medical guidelines as a measure of adherence, 2) unplanned health care visits as a measure of potentially unmet health care needs and 3) gender differences in health care utilisation among older people with DS. Methods This register-based study includes people with DS (n = 472) from a Swedish national cohort of people with intellectual disability (n = 7936), aged 55 years or more, and with at least one support according to the disability law, in 2012. Data on inpatient and outpatient specialist health care utilisation were collected from the National Patient Register for 2002–2012. Results A total of 3854 inpatient and outpatient specialist health care visits were recorded during the 11 years, of which 54.6% (n = 2103) were planned, 44.0% (n = 1695) unplanned and 1.4% (n = 56) lacked information. More than half of the visits, 67.0% (n = 2582) were outpatient health care thus inpatient 33% (n = 1272). Most planned visits (29.4%, n = 618) were to an ophthalmology clinic, and most unplanned visits to an internal medicine clinic (36.6%, n = 621). The most common cause for planned visits was cataract, found at least once for 32.8% in this cohort, followed by arthrosis (8.9%), epilepsy (8.9%) and dementia (6.6%). Pneumonia, pain, fractures and epilepsy each accounted for at least one unplanned visit for approximately one-fourth of the population (27.1, 26.9, 26.3 and 19.7% respectively). Men and women had similar numbers of unplanned visits. However, women were more likely to have visits for epilepsy or fractures, and men more likely for pneumonia. Conclusions Increased awareness of existing specific medical guidelines for people with DS is vital for preventive measures. The relatively few planned health care visits according to the medical guidelines together with a high number of unplanned visits caused by conditions which potentially can be prevented suggest a need of improved adherence to medical guidelines.

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Total Hip Arthroplasty in Patients with Down Syndrome

Cited by 12 publications

References 5 publications

Total hip arthroplasty in patients with neuromuscular imbalance

Total hip arthroplasty in patients with neuromuscular imbalance

Management of Hip Instability in Trisomy 21

Health care utilisation among older people with Down syndrome compared to specific medical guidelines for health surveillance: a Swedish national register study

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