Reverse hybrid total hip arthroplasty

Jain, Sameer; Magra, M; Dube, B.; Veysi, V T; Whitwell, George; Aderinto, Joseph; Emerton, Mark; Stone, Martin; Pandit, Hemant

doi:10.1302/0301-620x.100b8.bjj-2017-1297.r1

Cited by 7 publications

(6 citation statements)

References 27 publications

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“…In such cases, the cemented arthroplasty advocates recommend a hybrid surgery that produces a better functional effect than the screw-cup system (cemented acetabulum, stem fixed with no cement) [12,13]. Similarly to the findings of other authors, our study confirms that BMI, gender, type of incision and cutaneous suture have no impact on the functional outcome and incidence of complications following the hip arthroplasty operation [14]. Moreover, we demonstrate that there is a high negative correlation between functional outcomes and age, which is not reflected in the literature [15].…”

Section: Discussionsupporting

confidence: 87%

Emergency Procedure Applied to Tackle the Lack of Sphericity after Cutting the Bone Bed for Cementless Hip Arthroplasty - The Acetabular Screw-Cup System Developed by Aesculap

Poszepczyński¹,

Pawłowicz²,

Krzysztof³

et al. 2021

J Clin Cases Rep

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BACKGROUND The study aimed to analyze the complications following cementless arthroplasty surgery where original sphericity was not obtained and screw-cap system was required. METHOD The study inclusion criteria were met by 39 patients aged 47 - 90 and the mean follow-up period was 54 months. Patients were operated in a lateral position, through the posterolateral or minimal posterior approach.To assess postoperative functionality, Harris Hip Score and Hoos questionnaire were applied. RESULTS According to the Harris Hip Score, 64.3% of the scores were very good and good and the mean score was 96 according to the Hoos questionnaire. The incision type, BMI and the type of cutaneous suture had no impact on the functional outcome, incidence of complications and a pain rate in the groin. Scar esthetics received highest scores from the patients operated through the minimal posterior approach and treated with a running intra-cutaneous suture. Yet a lateral position during the surgery made any intraoperative assessment of the limb length considerably more difficult. Consequently, 30% of the operated patients reported different limb lengths, which significantly (p = 0.036) lowered a functional outcome measured according to the HOOS and Harris Hip Score. The functional outcomes demonstrate a considerably negative correlation with age but not with gender although men are more vulnerable to the postoperative complications (p = 0.18). CONCLUSION Despite a relatively large number of complications following the surgery using a screw-cap system, 75% of the patients declared they would not mind another surgery using such system.

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Section: Discussionsupporting

confidence: 87%

Emergency Procedure Applied to Tackle the Lack of Sphericity after Cutting the Bone Bed for Cementless Hip Arthroplasty - The Acetabular Screw-Cup System Developed by Aesculap

Poszepczyński¹,

Pawłowicz²,

Krzysztof³

et al. 2021

J Clin Cases Rep

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“…One author provided additional unpublished data in the form of net survival estimates. 27 Reidy et al reported survival estimates, but no CIs. 13 Net survival estimates and corresponding CIs were thus extracted from three studies at 5 years and one study at 10 years.…”

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

“…Additional data provided by the author indicate that they found no evidence of a difference in implant survival according to surgeon grade (Trainee: 98.1%; 95% CI 95.9 to 99.1; Consultant: 96.7%; 95% CI 94.7 to 97.9). 27 Secondary outcome: crude revision rate (THR) Meta-analysis showed no strong evidence of an association between surgeon grade and the crude revision rate at 5 or 10 years. The RR of revision at 5 and 10 years was 0.88 (95% CI 0.46 to 1.70) and 0.68 (95% CI 0.37 to 1.26), respectively (figure 3).…”

Section: Hip Replacementmentioning

confidence: 99%

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Association between surgeon grade and implant survival following hip and knee replacement: a systematic review and meta-analysis

et al. 2021

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ObjectiveTo investigate the association between surgeon grade (trainee vs consultant) and implant survival following primary hip and knee replacement.DesignA systematic review and meta-analysis of observational studies.Data sourcesMEDLINE and Embase from inception to 6 October 2021.SettingUnits performing primary hip and/or knee replacements since 1990.ParticipantsAdult patients undergoing either a primary hip or knee replacement, predominantly for osteoarthritis.InterventionWhether the surgeon recorded as performing the procedure was a trainee or not.Primary and secondary outcome measuresThe primary outcome was net implant survival reported as a Kaplan-Meier survival estimate. The secondary outcome was crude revision rate. Both outcomes were reported according to surgeon grade.ResultsNine cohort studies capturing 4066 total hip replacements (THRs), 936 total knee replacements (TKRs) and 1357 unicompartmental knee replacements (UKRs) were included (5 THR studies, 2 TKR studies and 2 UKR studies). The pooled net implant survival estimates for THRs at 5 years were 97.9% (95% CI 96.6% to 99.2%) for trainees and 98.1% (95% CI 97.1% to 99.2%) for consultants. The relative risk of revision of THRs at 5 and 10 years was 0.88 (95% CI 0.46 to 1.70) and 0.68 (95% CI 0.37 to 1.26), respectively. For TKRs, the net implant survival estimates at 10 years were 96.2% (95% CI 94.0% to 98.4%) for trainees and 95.1% (95% CI 93.0% to 97.2%) for consultants. We report a narrative summary of UKR outcomes.ConclusionsThere is no strong evidence in the existing literature that trainee surgeons have worse outcomes compared with consultants, in terms of the net survival or crude revision rate of hip and knee replacements at 5–10 years follow-up. These findings are limited by the quality of the existing published data and are applicable to countries with established orthopaedic training programmes.PROSPERO registration numberCRD42019150494.

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“…The remaining published literature on this topic is limited to a small number of observational studies, none of which have reported a negative association between THAs performed by trainees and implant failure. [18][19][20][21] The relationship between surgical experience and the dislocation of THAs has been the focus of previous investigation. Individual cohort studies [22][23][24] and meta-analyses have drawn contradictory conclusions.…”

Section: Discussionmentioning

confidence: 99%

The association between surgeon grade and risk of revision following total hip arthroplasty

Fowler

Aquilina

Reed

et al. 2022

The Bone & Joint Journal

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Aims Total hip arthroplasties (THAs) are performed by surgeons at various stages in training with varying levels of supervision, but we do not know if this is safe practice with comparable outcomes to consultant-performed THA. Our aim was to examine the association between surgeon grade, the senior supervision of trainees, and the risk of revision following THA. Methods We performed an observational study using National Joint Registry (NJR) data. We included adult patients who underwent primary THA for osteoarthritis, recorded in the NJR between 2003 and 2016. Exposures were operating surgeon grade (consultant or trainee) and whether or not trainees were directly supervised by a scrubbed consultant. Outcomes were all-cause revision and the indication for revision up to ten years. We used methods of survival analysis, adjusted for patient, operation, and healthcare setting factors. Results We included 603,474 THAs, of which 58,137 (9.6%) procedures were performed by a trainee. There was no association between surgeon grade and all-cause revision up to ten years (crude hazard ratio (HR) 1.00 (95% confidence interval (CI) 0.94 to 1.07); p = 0.966), a finding which persisted with adjusted analysis. Fully adjusted analysis demonstrated an association between trainees operating without scrubbed consultant supervision and an increased risk of all-cause revision (HR 1.10 (95% CI 1.00 to 1.21); p = 0.045). There was an association between trainee-performed THA and revision for instability (HR 1.14 (95% CI 1.01 to 1.30); p = 0.039). However, this was not observed in adjusted models, or when trainees were supervised by a scrubbed consultant. Conclusion Within the current training system in England and Wales, appropriately supervised trainees achieve comparable THA survival to consultants. Trainees who are supervised by a scrubbed consultant achieve superior outcomes compared to trainees who are not supervised by a scrubbed consultant, particularly in terms of revision for instability. Cite this article: Bone Joint J 2022;104-B(3):341–351.

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Reverse hybrid total hip arthroplasty

Abstract: This is the largest reported study into reverse hybrid THA and it confirms successful outcomes, irrespective of age, gender, head size and surgeon grade. Cite this article: Bone Joint J 2018;100-B:1010-17.

Cited by 7 publications

References 27 publications

Emergency Procedure Applied to Tackle the Lack of Sphericity after Cutting the Bone Bed for Cementless Hip Arthroplasty - The Acetabular Screw-Cup System Developed by Aesculap

Emergency Procedure Applied to Tackle the Lack of Sphericity after Cutting the Bone Bed for Cementless Hip Arthroplasty - The Acetabular Screw-Cup System Developed by Aesculap

Association between surgeon grade and implant survival following hip and knee replacement: a systematic review and meta-analysis

The association between surgeon grade and risk of revision following total hip arthroplasty

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