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Reducing the failure rate of hip resurfacing in dysplasia patients: a retrospective analysis of 363 cases.
- Source :
-
BMC Musculoskeletal Disorders . 6/7/2016, Vol. 17, p1-14. 14p. 1 Color Photograph, 2 Diagrams, 10 Charts, 2 Graphs. - Publication Year :
- 2016
-
Abstract
- <bold>Background: </bold>Arthritis secondary to developmental hip dysplasia often mandates implant surgery at a relatively young age. Hip resurfacing arthroplasty (HRA), compared with standard stemmed total hip arthroplasty (THA), affords a more active lifestyle including extreme-motion activities but stimulates concerns pertaining to implant failure.<bold>Methods: </bold>We addressed the primary modes of failure through a series of interventions, including a new guideline for achieving proper implant alignment through intraoperative x-rays. We then compared two sequential cohorts in a single-surgeon practice: patients with developmental dysplasia who underwent HRA before (Group 1; 121 hips in 105 patients) and after (Group 2; 242 hips in 210 patients) June 2008, at which time the four interventions were all in place.<bold>Results: </bold>Implants in Group 2 failed less frequently within two years (0.8 % vs. 6.6 %, p = 0.002) and were more likely to have projected seven-year Kaplan-Meier survivorship (99 % vs. 89 %, p < 0.0001 by log-rank test). Patients in Group 2 were more likely to have normal metal ion levels (77 % vs. 56 %, p = 0.0008) and optimum metal ion levels (99 % vs. 86 %, p = 0.0008). Patients in Group 2 also benefited from a 19-min decrease in mean operation time, a 45 % decrease in mean estimated blood loss, and a 0.9-day decrease in mean hospital stay (p < 0.0001 in each instance).<bold>Conclusions: </bold>We believe the interventions reported here, combined with sufficient surgeon experience and properly designed implants, afford patients with mild developmental dysplasia a more active lifestyle with favorable implant survival. [ABSTRACT FROM AUTHOR]
- Subjects :
- *TOTAL hip replacement
*ARTIFICIAL hip joints
*LIFESTYLES & health
*CONGENITAL hip dislocation
*KAPLAN-Meier estimator
*LOG-rank test
*PATIENTS
*HIP surgery
*ARTIFICIAL joints
*COMPARATIVE studies
*HIP joint
*HIP joint diseases
*IONS
*RANGE of motion of joints
*LONGITUDINAL method
*RESEARCH methodology
*INTRAOPERATIVE care
*MEDICAL cooperation
*MEDICAL protocols
*METALS
*OSTEOARTHRITIS
*PROSTHETICS
*COMPLICATIONS of prosthesis
*RADIOGRAPHY
*REOPERATION
*RESEARCH
*SURGICAL complications
*EVALUATION research
*LIFESTYLES
*RETROSPECTIVE studies
*DISEASE complications
*EQUIPMENT & supplies
Subjects
Details
- Language :
- English
- ISSN :
- 14712474
- Volume :
- 17
- Database :
- Academic Search Index
- Journal :
- BMC Musculoskeletal Disorders
- Publication Type :
- Academic Journal
- Accession number :
- 116021731
- Full Text :
- https://doi.org/10.1186/s12891-016-1095-7