Level IV, therapeutic study. See the Guidelines for Authors for a complete description of levels of evidence.

Purpose To analyse the impact of prolonged mandatory lockdown due to COVID-19 on hip fracture epidemiology. Methods Retrospective case-control study of 160 hip fractures operated upon between December 2019 and May 2020. Based on the date of declaration of national lockdown, the cohort was separated into two groups: 'pre-COVID time' (PCT), including 86 patients, and 'COVID time' (CT), consisting of 74 patients. All CT patients tested negative for SARS-CoV-2. Patients were stratified based on demographic characteristics. Outcome measures were 30-day complications, readmissions and mortality. A logistic regression model was run to evaluate factors associated with mortality. Results Age, female/male ratio, body mass index and American Society of Anaesthesia score were similar between both groups (p > 0.05). CT patients had a higher percentage of Charlson ≥ 5 and Rockwood Frailty Index ≥ 5 scores (p < 0.05) as well as lower UCLA and Instrumental Activities of Daily Living scores (p < 0.05). This translated into a higher hemiarthroplasty/total hip arthroplasty ratio during CT (p = 0.04). Thromboembolic disease was higher during CT (p = 0.02). Readmissions (all negative for SARS-CoV-2) were similar between both groups (p = 0.34). Eight (10.8%) casualties were detected in the CT group, whereas no deaths were seen in the control group. Logistic regression showed that frailer (p = 0.006, OR 10.46, 95%CI 8.95-16.1), less active (p = 0.018, OR 2.45, 95%CI 1.45-2.72) and those with a thromboembolic event (p = 0.005, OR 30, 95%CI 11-42) had a higher risk of mortality.

We prospectively compared the utility and precision of preoperative templating performed in printed films (analogue) with that performed on digital radiographs (digital) in 69 patients undergoing primary total hip replacement. Five patients were excluded when misplacement of the marker resulted in a magnification error greater that 10%; in the remaining patients (64 hips), the cup size was within ± one size in 62 (97%) of the analogue and 52 (81%) of the digital (p=0.01) plans. The stem size was within ± one size in 63 (98%) of the analogue and 60 (94%) of the digital (p=0.39) plans. The distance from the proximal corner of the lesser trochanter to the center of the prosthetic head (LTCD) in the analogue differed by 5 mm or more from the digital plan in nine cases (14%). Analogue preoperative planning yielded more predictable results than digital planning, particularly in terms of acetabular component size and LTCD that dictates limb lengtheningshortening. The sources of error were not clearly explained by variations in magnification. Inconsistent positioning of the magnification marker may jeopardise the safe implementation of digital templating.Résumé Nous avons, de façon prospective, comparé l'utilité et la précision de la planification préopératoire réalisée sur des films radiologiques classiques ou sur des radiographies numérisées sur 69 patients devant bénéficier d'une prothèse totale de hanche. 5 patients ont été exclus car il existait une erreur de plus de 10% sur le coefficient d'agrandissement et sur les 64 hanches restantes, la taille prévue de la cupule correspondant dans 97% des cas (62 hanches) sur les films classiques et dans 81% des cas (52 hanches) sur les films numérisés. La taille de la pièce fémorale était celle prévue dans 98% des cas (63 hanches) sur les films classiques, dans 94% des cas (60 hanches) sur les films numérisés. La distance entre bord proximal du petit trochanter et la tête prothétique (LTCD) sur les films classiques, n'a pas montré de différence de plus de 5 millimètres. Cette distance était supérieure dans 9 cas (14%) sur les films numérisés. Une planification pré opératoire est beaucoup plus fiable sur les films classiques que sur les films numérisés, particulièrement en ce qui concerne la taille du composant acétabulaire et les problèmes d'inégalité de longueurs. Les sources d'erreur ne sont pas très clairement expliquées par les modifications du taux d'agrandissement, la planification sur des clichés numérisés peut être source d'erreur.

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Background The sensitivity and specificity to detect periprosthetic infection of the different methods have been questioned, and no single laboratory test accurately detects infection before revision arthroplasty. Questions/purposes We asked whether preoperative C-reactive protein (CRP) and interleukin-6 (IL-6) could lead to similar sensitivity, specificity, and predictive values as our previous results obtained with intraoperative frozen section (FS) in revision total hip arthroplasty (THA). Methods We prospectively followed 69 patients who had undergone revision THA for failure of a primary THA. The definitive diagnosis of an infection was determined on the basis of positive histopathologic evidence of infection or growth of bacteria on culture.