Hip Resurfacing at Surface HippyPosted on by Patricia Walter
The Bone & Joint Channel A video to accompany the article “Effects of physical activity on long-term survivorship after metal-on-metal hip resurfacing arthroplasty: is it safe to return to sports?” published in the October 2019 issue of the Bone & Joint Journal. Read the full article: https://online.boneandjoint.org.uk/do…
Infographic: Effects of physical activity on long-term survivorship after metal-on-metal hip resurfacing arthroplasty – is it safe to return to sports?
Patients undergoing HRA improved their preoperative gait pattern of a significant limp to a symmetrical gait at high speeds and on inclines, almost indistinguishable from normal controls. HRA with an approved device offers substantial functional gains, almost indistinguishable from healthy controls. Read Full Study Here: https://online.boneandjoint.org.uk/doi/full/10.1302/0301-620X.101B11.BJJ-2019-0383.R1 … Read the rest
Mortality after hip resurfacing versus total hip arthroplasty in young patients: a single surgeon experience. Brooks PJ1, Samuel LT1, Levin JM1, Sultan AA1, Khlopas A1, Brigati D1, Ng M1, Greenwald AS1, Mont MA2. Author information Department of Orthopaedic Surgery, Cleveland Clinic, Cleveland, OH, USA. & Department of Orthopaedic Surgery, Lenox Hill Hospital, New York, NY, USA.
Background:
The aims of this study were to investigate the following questions: (I) what are the mortality rates in patients age 55 years and younger who underwent a hip resurfacing arthroplasty (HRA) versus a standard total hip arthroplasty (THA)? (II) is the type of operation independently associated with mortality?
…Conclusions:
We have demonstrated that patients age 55 and younger who undergo HRA have a … Read the rest
Hip Resurfacing at Surface HippyPosted on by Patricia Walter
After reviewing thousands of case studies going back 25 years across six countries, researchers at the University of Bristol say they indicate that eight out of 10 total knee replacements (TKRs) and six out of 10 total hip replacements (THEs) will still be in place after 25 years.
Hip Resurfacing at Surface HippyPosted on by Patricia Walter
International surgeon series and registry data have demonstrated positive outcomes and long-term survival of the Birmingham Hip Resurfacing (BHR) implant. We report the 5 to 10-year results from a single center in the U.S.
…Conclusions: BHR demonstrated excellent survivorship and clinical outcomes at 5 to 10 years in selected patients. As compared with total hip arthroplasty, the use of the BHR may provide highly active patients with clinically important advantages in postoperative activity as well as a greater likelihood of remaining highly active. Continued follow-up is necessary to validate long-term BHR outcomes…
A Single Institution’s Experience
Marcus C. Ford, MD, Michael D. Hellman, MD, Gregory S. Kazarian, John C. Clohisy, MD, Ryan M. Nunley, MD, Robert L. Barrack, MD… Read the rest
October 2018 – Metal on metal hip resurfacing (MoM-HR) is an alternative to total hip arthroplasty in young and active patients. The purpose was to determine the survivorship of MoM-HR procedures performed in patients aged 45 years and younger assessing patient-reported outcome measures (PROMs) at minimum 5-year follow-up…
…All 217 patients equal to or younger than 45 years of age at the time of surgical intervention presenting to our center with MoM-HR between May 2002 and May 2011 were prospectively followed…
…he overall survivorship excluding septic failures was 94.6% and 93.8% at 5 and 10 years, respectively…
… The survivorship of HR in the younger than 45 age-group was similar to that of total hip arthroplasty, as well as HR in … Read the rest
Hip Resurfacing at Surface HippyPosted on by Patricia Walter
Published on Aug 7, 2018
James Pritchett MD discusses the preference his patients have for hip resurfacing compared to hip replacement. No metal on metal implants were included and the follow-up averaged 11 years and up to 26 years. A polyethylene acetabular component with a ceramic or ceramic coated femoral implant was used. 270 patients. This was a statistically valid independent, blinded, paired bilateral study. More than 85% of patients with a well functioning hip replacement preferred their hip resurfacing side because of better function, feel and performance. The risks and survivorship of hip resurfacing compared to hip replacement was also better in the hand of Dr. Pritchett with a long term failure rate of less than 3.5%. The patients average age was 48 and … Read the rest
June 1, 2018 – BARCELONA, Spain – Total surface replacement may still be a viable hip arthroplasty option in young, active patients based on how well it fared in a study when it was revised to total hip replacement vs. primary THR that was revised to THR, according to a presenter at the EFORT Annual Congress…
…“Our study shows, therefore, that there is less blood loss, there’s a shorter length of stay and better function in patients undergoing revision of resurfacing as opposed to revision of a standard stemmed prosthesis,” Kent said… Read the rest
All 217 patients equal to or less than 45 years of age at time of surgical intervention presenting to our centre with MoM-HR between May 2002 and May 2011…
…This study indicates that MoM-HR is a suitable option for young individuals…
…The survivorship of HR in the less than 45 age group was similar to that of total hip replacement, as well as HR in older patients. Given the proposed benefits of HR, this procedure may be viewed as a viable option in patients aged less than 45 years.… Read the rest
Hip Resurfacing at Surface HippyPosted on by Patricia Walter
Read Complete Article Here Written by Angie Stewart-March 15, 2018 – The population of patients receiving hip and knee replacements was younger in 2014 than in 2000, according to a study presented at the 2018 Annual Meeting of the American Academy of Orthopaedic Surgeons. A younger population could increase the likelihood of modern implants wearing out in the patients’ lifetimes… …1. The average age for primary total hip replacement decreased from 66.3 years to 64.9 years from 2000 to 2014… …7. Researchers predict primary total hip replacement will grow 171 percent and primary total knee replacement will grow by up to 189 percent by 2030, for a total of 635,000 and 1.28 million procedures, respectively.… Read the rest
Aspirin, Xarelto show no difference in preventing venous thromboembolism after TJA.
Among patients who received 5 days of rivaroxaban prophylaxis after total hip or total knee arthroplasty, extended prophylaxis with aspirin was not significantly different from rivaroxaban in the prevention of symptomatic venous thromboembolism.
After patients received once-daily oral Xarelto (rivaroxaban, Bayer Pharma) until postoperative day 5, Michael Dunbar, MD, FRCSC, PhD, and colleagues then randomly assigned 3,424 patients undergoing either THA or TKA to continue rivaroxaban or switch to aspirin for an additional 9 days after TKA or for 30 days after THA. The primary effectiveness outcome was symptomatic venous thromboembolism 90 days after randomization and the primary safety outcome was bleeding complications, including major or clinically relevant … Read the rest
Hip Resurfacing at Surface HippyPosted on by Patricia Walter
Washington D.C. [USA], Jan. 20 : A study has recently revealed that patients who live alone can be safely discharged and sent home from a hospital to recover from hip or knee replacement surgery.
The results question the belief that patients who live alone should routinely be sent to an inpatient rehabilitation facility after total joint replacement surgery before going home.
Researchers said, “Patients living alone had a safe and manageable recovery when discharged directly home after total joint Arthroplasty.”
Andrew N. Fleischman and colleagues from The Rothman Institute, Thomas Jefferson University, Philadelphia, conducted the study.
The team examined 769 patients who were discharged and sent home after one-sided total hip or knee replacement. Of these, 138 patients were living alone for the first two … Read the rest
The Medicines and Healthcare products Regulatory Agency (MHRA) UK has called for longer-term monitoring of all patients fitted with metal-on-metal hip implants, as a precautionary measure, in an update to its original guidance issued in 2012.
“MHRA, in colsultation with its independent Metal-on-Metal Expert Advisory Group (MoM EAG), has continued to monitor the performance of MoM hip joint articulations for the occurrence of soft tissue reaction associated with these devices. However, some patients will develop progressive soft tissue reactions to the wear debris associated with MoM articulations.”
Advice varies according to device, age and sex of patients. The BHR is device with a 10A ODEP rating. Those patients are recommended to have follow-ups and blood … Read the rest
Recent studies indicate that females demonstrate an increased risk of experiencing adverse local tissue reactions, aseptic loosening, and revision after primary metal-on-metal hip resurfacing arthroplasty compared with males; the underlying biological mechanisms responsible for sex discrepancies in implant failure remain unclear. In addition to anatomical and biomechanical sex differences, there may be inherent immunological disparities that predispose females to more aggressive adaptive immune reactivity to implant debris, i.e., metal sensitivity…
…The findings support the possibility that the higher rate of complications after TJA in women may have an “adaptive immunological basis.” But it is still unclear whether the sex-related difference in immune sensitization is related to intrinsic biologic factors, such as hormones, or to environmental factors, such as exposure to metals … Read the rest
…(The Study) involved 769 patients undergoing primary THR or TKR. Of these, 138 patients lived alone and 631 lived with other people. In both groups, patients age 75 and older were well represented. The patients who lived alone were more likely to stay an additional night in the hospital prior to discharge and utilize more home health services, especially older patients. Limited support without weekly visits was reported by 37.2 percent of patients living alone, although nearly 80 percent had a friend or … Read the rest
…We identified 63,158 patients who had undergone total hip replacement and 54,276 who had total knee replacement between Jan 1, 1991, and Aug 10, 2011, and followed up these patients to a maximum of 20 years…
…researchers analyzed data from the Clinical Practice Research Datalink on just over 63,000 patients who had undergone a total hip replacement and 54,000 that had total knee replacements. The surgeries took place between January 1, 1991 and August 10, 2011. Researchers followed the patients for a maximum of 20 years, to see how they made out with their prosthetic joints…
Results showed the following:
For total hip replacement, the 10-year implant survival rate was 95-96 percent, and the 20-year rate 85 percent.
…We present the short-term outcome of our first 77 hip resurfacings done as an outpatient procedure performed by two experienced surgeons. Young patients without major medical co-morbidities were selected…
…All patients were successfully discharged on the day of surgery from our physician-owned outpatient surgery center. There were no major complications noted in the first 6 weeks postoperative…
…This represents a cost savings for the insurance company of nearly $9,000 (26%) compared to the lowest cost and $39,000 (60%) compared to the highest cost hospital in our region…
