MyMedR

Zoledronate for hip fractures: the road towards achieving consensus

Cheah MH, Ong T

Age Ageing, 2024 Apr 01;53(4).

PMID: 38557668 DOI: 10.1093/ageing/afae062

Matched MeSH terms: Hip Fractures*

Fulltext Commentary: Vascularized bone graft is an effective technique for extra-cortical bone bridging to combat cemented megaprosthesis loosening at the bone-implant junction

Singh VA

J Orthop Surg (Hong Kong), 2020 12 22;28(3):2309499020972483.

PMID: 33345709 DOI: 10.1177/2309499020972483

Matched MeSH terms: Hip Prosthesis*; Arthroplasty, Replacement, Hip*

Does intraoperative fluoroscopy improve acetabular component positioning and limb-length discrepancy during direct anterior total hip arthroplasty? A meta-analysis

Sun C, Lee WG, Ma Q, Zhang X, Zhao Z, Cai X

J Orthop Surg Res, 2023 Aug 08;18(1):586.

PMID: 37553600 DOI: 10.1186/s13018-023-04023-w

BACKGROUND: The positioning of implant components for total hip arthroplasty (THA) is essential for joint stability, polyethylene liner wear, and range of motion. One potential benefit of the direct anterior approach (DAA) for THA is the ability to use intraoperative fluoroscopy for acetabular cup positioning and limb-length evaluation. Previous studies comparing intraoperative fluoroscopy with no fluoroscopy during DAA have reported conflicting results. This meta-analysis aimed to evaluate whether intraoperative fluoroscopy improves component positioning compared to no fluoroscopy during direct anterior total hip arthroplasty.

METHODS: A systematic review following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines was conducted. We searched Web of Science, EMBASE, PubMed, Cochrane Controlled Trials Register, Cochrane Library, Highwire, CBM, CNKI, VIP, and Wanfang database in May 2023 to identify studies involving intraoperative fluoroscopy versus no fluoroscopy during direct anterior total hip arthroplasty. Finally, we identified 1262 hips assessed in seven studies.

RESULTS: There were no significant differences in terms of acetabular cup inclination angle (ACIA, P = 0.21), ACIA within safe zone rate (P = 0.97), acetabular cup anteversion angle (ACAA, P = 0.26); ACAA within safe zone rate (P = 0.07), combined safe zone rate (P = 0.33), and limb-length discrepancy (LLD, P = 0.21) between two groups.

CONCLUSION: Even though intraoperative fluoroscopy was not related to an improvement in cup location or LDD. With fewer experienced surgeons, the benefit of intraoperative fluoroscopy might become more evident. More adequately powered and well-designed long-term follow-up studies were required to determine whether the application of the intraoperative fluoroscopy for direct anterior total hip arthroplasty will have clinical benefits and improve the survival of prostheses.

Matched MeSH terms: Hip Joint/surgery; Hip Prosthesis*

Advancement in total hip implant: a comprehensive review of mechanics and performance parameters across diverse novelties

Soliman MM, Islam MT, Chowdhury MEH, Alqahtani A, Musharavati F, Alam T, et al.

J Mater Chem B, 2023 Nov 15;11(44):10507-10537.

PMID: 37873807 DOI: 10.1039/d3tb01469j

The UK's National Joint Registry (NJR) and the American Joint Replacement Registry (AJRR) of 2022 revealed that total hip replacement (THR) is the most common orthopaedic joint procedure. The NJR also noted that 10-20% of hip implants require revision within 1 to 10 years. Most of these revisions are a result of aseptic loosening, dislocation, implant wear, implant fracture, and joint incompatibility, which are all caused by implant geometry disparity. The primary purpose of this review article is to analyze and evaluate the mechanics and performance factors of advancement in hip implants with novel geometries. The existing hip implants can be categorized based on two parts: the hip stem and the joint of the implant. Insufficient stress distribution from implants to the femur can cause stress shielding, bone loss, excessive micromotion, and ultimately, implant aseptic loosening due to inflammation. Researchers are designing hip implants with a porous lattice and functionally graded material (FGM) stems, femur resurfacing, short-stem, and collared stems, all aimed at achieving uniform stress distribution and promoting adequate bone remodeling. Designing hip implants with a porous lattice FGM structure requires maintaining stiffness, strength, isotropy, and bone development potential. Mechanical stability is still an issue with hip implants, femur resurfacing, collared stems, and short stems. Hip implants are being developed with a variety of joint geometries to decrease wear, improve an angular range of motion, and strengthen mechanical stability at the joint interface. Dual mobility and reverse femoral head-liner hip implants reduce the hip joint's dislocation limits. In addition, researchers reveal that femoral headliner joints with unidirectional motion have a lower wear rate than traditional ball-and-socket joints. Based on research findings and gaps, a hypothesis is formulated by the authors proposing a hip implant with a collared stem and porous lattice FGM structure to address stress shielding and micromotion issues. A hypothesis is also formulated by the authors suggesting that the utilization of a spiral or gear-shaped thread with a matched contact point at the tapered joint of a hip implant could be a viable option for reducing wear and enhancing stability. The literature analysis underscores substantial research opportunities in developing a hip implant joint that addresses both dislocation and increased wear rates. Finally, this review explores potential solutions to existing obstacles in developing a better hip implant system.

Matched MeSH terms: Hip Joint/surgery; Hip Prosthesis*

Fulltext Infantile coxa vara

Dhillon KS

Med J Malaysia, 1986 Sep;41(3):273-7.

PMID: 3670146

Infantile or developmental coxa vara is a relatively infrequent localised dysplasia of unknown etiology which usually presents in the second or third year of life soon after the child begins walking. The clinical and radiological picture is usually characteristic especially when seen early. Early surgery leads to a satisfactory outcome. However, difficulty arises in diagnosis and treatment when patients present late, three cases diagnosed in adolescence at the University Hospital, Kuala Lumpur over the last 10 years are presented to increase awareness of this condition, which may be underdiagnosed, and the difficulties in diagnosis and treatment with late presentation are stressed.

Matched MeSH terms: Hip Dislocation/radiography*; Hip Dislocation/surgery; Hip Dislocation, Congenital/radiography*; Hip Dislocation, Congenital/surgery

Fulltext Bilateral traumatic hip dislocation in a child: a case report

Khoo, S,M.

Malays Orthop J, 2007;1(2):17-20.

MyJurnal

Traumatic hip dislocation in children is uncommon; when this condition is diagnosed in paediatric patients, it is most frequently seen as a unilateral posterior dislocation and is rarely associated with fracture. We report here a case involving a young girl who dislocated both hips in two separate incidents.

Matched MeSH terms: Hip; Hip Dislocation; Hip Joint

Fulltext Comment on: Developmental dysplasia of the hip: why are we still operating on them? A plea for institutional newborn clinical screening

Ibrahim S

Singapore Med J, 2019 06;60(6):322.

PMID: 31243463 DOI: 10.11622/smedj.2019060

Matched MeSH terms: Hip Dislocation, Congenital*; Hip Joint

Fulltext Minimally Invasive Total Hip Arthroplasty in a Patient with Hereditary Multiple Exostoses: A Case Report

Santoso A, Utomo P, Im CJ, Park KS, Yoon TR

Malays Orthop J, 2018 Nov;12(3):53-56.

PMID: 30555649 DOI: 10.5704/MOJ.1811.010

Hip geometry abnormalities found in patients with hereditary multiple exostoses (HME) could promote premature hip joint degeneration which needs treatment. We report the case of a 45-year old male with right hip arthrosis who underwent two-incision minimally invasive (MIS-2) total hip arthroplasty (THA), with satisfactory outcome. This technique could be an alternative approach for performing THA in patients with hereditary multiple exostoses.

Matched MeSH terms: Hip; Hip Joint; Osteoarthritis, Hip; Arthroplasty, Replacement, Hip

Fulltext Surface Acoustic Wave (SAW) Sensors for Hip Implant: A Numerical and Computational Feasibility Investigation Using Finite Element Methods

Hafizh M, Soliman MM, Qiblawey Y, Chowdhury MEH, Islam MT, Musharavati F, et al.

Biosensors (Basel), 2023 Jan 02;13(1).

PMID: 36671914 DOI: 10.3390/bios13010079

In this paper, a surface acoustic wave (SAW) sensor for hip implant geometry was proposed for the application of total hip replacement. A two-port SAW device was numerically investigated for implementation with an operating frequency of 872 MHz that can be used in more common radio frequency interrogator units. A finite element analysis of the device was developed for a lithium niobate (LiNBO3) substrate with a Rayleigh velocity of 3488 m/s on COMSOL Multiphysics. The Multiphysics loading and frequency results highlighted a good uniformity with numerical results. Afterwards, a hip implant geometry was developed. The SAW sensor was mounted at two locations on the implant corresponding to two regions along the shaft of the femur bone. Three discrete conditions were studied for the feasibility of the implant with upper- and lower-body loading. The loading simulations highlighted that the stresses experienced do not exceed the yield strengths. The voltage output results indicated that the SAW sensor can be implanted in the hip implant for hip implant-loosening detection applications.

Matched MeSH terms: Hip Prosthesis*; Arthroplasty, Replacement, Hip*

Fulltext Can posterior hip fracture-dislocation occur in indoor football (futsal)? A report of two cases

Yasin FN, Singh VA

BMJ Case Rep, 2009;2009.

PMID: 21686368 DOI: 10.1136/bcr.12.2008.1317

Hip fracture-dislocation is extremely rare in sports and is most frequently seen after road traffic accidents. This injury is associated with considerable long-term disability and rapidly progressive joint degeneration. This case report illustrates two cases of hip fracture dislocation that occurred while playing recreational indoor football (futsal). Futsal is a fast-emerging recreational sport in Malaysia and we are now beginning to see high-impact injuries rarely encountered in recreational sports. Therefore, futsal cannot be taken lightly and it is important to take adequate precautions to prevent serious injuries when participating in such sports.

Matched MeSH terms: Hip Dislocation; Hip Fractures

Fulltext Anatomical Alterations Following Resurfacing Hip Arthroplasty

Sivananthan, K., Drabu, K.J.

Malays Orthop J, 2009;3(1):42-45.

MyJurnal

The number of hip replacement procedures in the United States is expected to increase four-fold by 2030. Younger patients, those under 65 years old, are expected to account for 53% of hip replacements in 2030, compared to 44% in 2005. As midterm review results are becoming available worldwide now, the problem that perplexes surgeons is the alteration of limb length which has been an ancillary goal of Total Hip Replacements. The lack of modularity in neck lengths and offsets in resurfacing arthroplasty clearly limits the change in limb lengths achievable for the hip. The goal of this study is to scrutinize the various parameters that affect implant seating in resurfacing arthroplasty and to determine the alteration of limb length achievable during surgery.

Matched MeSH terms: Hip Prosthesis; Arthroplasty, Replacement, Hip

Fulltext Bilateral fracture of prostheses post-hip replacement

Surinder S, George P

Med J Malaysia, 2017 02;72(1):71-72.

PMID: 28255148 MyJurnal

Fracture of hip prostheses is a rare occurrence. A case of bilateral hip prostheses fracture is described here. The need to follow-up and remain vigilant post hip replacement is highlighted.

Matched MeSH terms: Hip Prosthesis; Arthroplasty, Replacement, Hip

A commentary update on NICE CG124. Hip fracture:management (2023)

Ong T, Vindlacheruvu M

Age Ageing, 2023 Jun 01;52(6).

PMID: 37389557 DOI: 10.1093/ageing/afad110

The National Institute for Health and Care Excellence released its second update on hip fracture management in early 2023. First published in 2011, the last update was in 2017. The scope of this recent update focussed on surgical implants for hip fracture. This included recommendation to offer total hip replacements instead of hemiarthroplasty for displaced intracapsular hip fractures, and a move away from Orthopaedic Device Evaluation Panel rated implants to a more standardised consistent choice. Other recommendations such as the importance of multidisciplinary orthogeriatric care, early surgery and prompt mobilisation remain. As the literature surrounding hip fracture management continue to grow, guidance such as this needs to continue updating itself to ensure patients with hip fracture receive the best possible care.

Matched MeSH terms: Arthroplasty, Replacement, Hip*

Early clinical and radiographic analysis of the Fitmore cup

Merican AM, Randle R

J Arthroplasty, 2006 Sep;21(6):846-51.

PMID: 16950037

The Fitmore titanium mesh cementless acetabular component in 115 hip arthroplasties was reviewed at an average of 33 months of follow-up. None were revised nor had infection. One hip dislocated 4 years postoperatively. Two femoral components were revised. The average Harris Hip Score at the last follow-up was 90 points. In the 96 sets of radiographs available, there was no loosening or new radiolucency. One hip had nonprogressive osteolysis adjacent to a screw. This press-fit cup has its polar region flattened and is rim loading. Noncontact (gaps) at the acetabular floor is expected and is not critical for fixation. In all but 6 hips, these gaps filled. In 5 hips, a minimal gap (

Matched MeSH terms: Hip Joint/radiography*; Hip Joint/surgery; Hip Prosthesis*; Arthroplasty, Replacement, Hip*

Fulltext In defence of Girdlestone excision arthroplasty: a comment on 'Unusual way of loosened total hip arthroplasty treatment with an Austin Moore endoprosthesis'

Sinha NK, Bhardwaj A, Poduval M, Rao BS

J Postgrad Med, 2014 Apr-Jun;60(2):222-3.

PMID: 24823541 DOI: 10.4103/0022-3859.132388

Matched MeSH terms: Hip Prosthesis*; Arthroplasty, Replacement, Hip*

Fabrication of low-cost, cementless femoral stem 316L stainless steel using investment casting technique

Baharuddin MY, Salleh ShH, Suhasril AA, Zulkifly AH, Lee MH, Omar MA, et al.

Artif Organs, 2014 Jul;38(7):603-8.

PMID: 24404766 DOI: 10.1111/aor.12222

Total hip arthroplasty is a flourishing orthopedic surgery, generating billions of dollars of revenue. The cost associated with the fabrication of implants has been increasing year by year, and this phenomenon has burdened the patient with extra charges. Consequently, this study will focus on designing an accurate implant via implementing the reverse engineering of three-dimensional morphological study based on a particular population. By using finite element analysis, this study will assist to predict the outcome and could become a useful tool for preclinical testing of newly designed implants. A prototype is then fabricated using 316L stainless steel by applying investment casting techniques that reduce manufacturing cost without jeopardizing implant quality. The finite element analysis showed that the maximum von Mises stress was 66.88 MPa proximally with a safety factor of 2.39 against endosteal fracture, and micromotion was 4.73 μm, which promotes osseointegration. This method offers a fabrication process of cementless femoral stems with lower cost, subsequently helping patients, particularly those from nondeveloped countries.

Matched MeSH terms: Hip Prosthesis/economics*; Arthroplasty, Replacement, Hip/economics

Reliability and sensitivity of radiographic measures of hip dysplasia in childhood Charcot-Marie-Tooth disease

Dwan LN, Gibbons P, Jamil K, Little D, Birke O, Menezes MP, et al.

Hip Int, 2023 Mar;33(2):323-331.

PMID: 34180253 DOI: 10.1177/11207000211027591

BACKGROUND: Hip dysplasia is a lack of femoral head coverage and disruption of hip and acetabular alignment and congruency, with severity ranging from mild subluxation in nascent at-risk hips to complete dislocation. Presentation of hip dysplasia in neuromuscular conditions can be sub-clinical or associated with a limp with or without hip pain, abductor and flexor weakness and reduced hip range of motion. Untreated hip dysplasia leads to early onset osteoarthritis requiring hip arthroplasty in early adulthood. Hip dysplasia occurs in 6-20% of children with Charcot-Marie-Tooth disease, however little is known about the reliability and sensitivity of detection on plain film pelvic radiographs.

METHODS: 14 common measures of hip dysplasia on anteroposterior pelvis radiographs were independently assessed by 2 orthopaedic specialists in 30 ambulant children with Charcot-Marie-Tooth disease. Hip health was also categorised based on clinical impression to assess the sensitivity of radiographic measures to identify hip dysplasia status.

RESULTS: 8 measures (acetabular index, head width, lateral centre-edge angle, lateral uncoverage, medial joint width, migration percentage, neck shaft angle, triradiate status) exhibited 'excellent' reliability between clinical evaluators. 5 of the 30 patients (17%) were identified as having nascent hip dysplasia. Reliable radiographic measures that significantly distinguished between nascent hip dysplasia and healthy hips were acetabular index, lateral centre edge angle, medial joint width and migration percentage.

CONCLUSIONS: We have identified a subset of reliable and sensitive radiographic hip measures in children with Charcot-Marie-Tooth disease to prioritise during hip screening to mitigate the deleterious effects of hip dysplasia, pain and disability in adulthood.

Matched MeSH terms: Hip Joint/surgery; Arthroplasty, Replacement, Hip*

Downsizing and minimising medialisation of the acetabular component: Novel technique to preserve bone in THA

Raj JJ, Thompson M, Whitehouse SL, Jaiprakash A, Varughese I, Crawford RW

Proc Inst Mech Eng H, 2023 Mar;237(3):368-374.

PMID: 36734414 DOI: 10.1177/09544119231152351

Standard practice for acetabular component placement in total hip arthroplasty (THA) is to medialise the acetabular component. Bone preservation techniques during primary THA are beneficial for possible future revisions. The goal of this study is to examine the effect of downsizing and minimising medialisation of the acetabular component on bone resection volume. The volume of bone resected during acetabular preparation for different sizes of components was calculated and the volume of bone preserved by downsizing the cup was determined. Minimising medialisation of the acetabular component by 1-3 mm from the true floor was calculated. Absolute values and percentage of bone volume preserved when acetabular components are downsized or less medialised is presented. Downsizing the acetabular component by one size (2 mm) preserves between 2.6 cm3 (size 40 vs 42) and 8.4 cm3 (size 72 vs 74) of bone volume and consistently reduces resected bone volume by at least 35% (range 35.2%-37.5%). Similarly, reducing medialisation of a 56 mm acetabular cup (as an example of a commonly implanted component) by 3 mm reduces bone loss by 5.9 cm3- 44% less bone volume resection. Downsizing and minimising medialisation of the cup in THA substantially preserves bone which may benefit future revision surgeries. Surgeons could consider implanting the smallest acceptable acetabular shell to preserve bone without compromising on head size.

Matched MeSH terms: Hip Prosthesis*; Arthroplasty, Replacement, Hip*

Oversized acetabular socket causing groin pain after total hip arthroplasty

Abbas AA, Kim YJ, Song EK, Yoon TR

J Arthroplasty, 2009 Oct;24(7):1144.e5-8.

PMID: 18848418 DOI: 10.1016/j.arth.2008.09.008

The causes of groin pain after total hip arthroplasty are numerous, and the condition itself is disabling. Therefore, it is imperative that the cause of the pain is identified and managed appropriately. We report a case where the patient had groin pain after total hip arthroplasty as a result of an oversized cementless acetabular component, which caused a breach in the anterior wall of the acetabulum. The anterior wall of the acetabulum was reconstructed with femoral head allograft, and the patient has been symptom free since.

Matched MeSH terms: Hip Joint/radiography; Hip Joint/surgery; Hip Prosthesis*; Arthroplasty, Replacement, Hip/adverse effects*; Arthroplasty, Replacement, Hip/instrumentation*

Fulltext New hips for old! Lessons from the Arabian Nights

Harwant S

Med J Malaysia, 2004 Dec;59 Suppl F:2.

PMID: 15941152

Matched MeSH terms: Arthroplasty, Replacement, Hip/instrumentation*

Displaying publications 1 - 20 of 244 in total