Revision Surgery for Instability After Total Hip Arthroplasty: Does Timing Matter?

Heckmann, Nathanael; Yang, JaeWon; Ong, Kevin; Lau, Edmund; Fuller, Brian C.; Bohl, Daniel D.; Valle, Craig J. Della

doi:10.1016/j.arth.2020.12.035

Cited by 12 publications

(8 citation statements)

References 18 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…This study from Chicago (Illinois, USA) has clear clinical ramifications as the surgeon is left balancing between delaying surgery in an effort to decrease risk for infection, and proceeding with revision due to the need to stabilize the hip. 4 This is a large-scale study with 445,499 primary THAs identified from the USA Medicare database, with 9,298 patients (2.1%) requiring return to the operating theatre for revision due to instability. The study was set up to examine any associations between timing of revision surgery and the eventual outcome in terms of re-dislocation.…”

Section: Revision Surgery For Instability After Total Hip Arthroplast...mentioning

confidence: 99%

Hip & Pelvis

2022

Bone & Joint 360

View full text Add to dashboard Cite

Section: Revision Surgery For Instability After Total Hip Arthroplast...mentioning

confidence: 99%

Hip & Pelvis

2022

Bone & Joint 360

View full text Add to dashboard Cite

“…Instability, one of the main reasons for early revision, occurs in approximately 2% of cases in the first week after surgery [8]. Several studies have indicated an increased risk of infection associated with early revisions (i.e., in the year following index surgery) [9][10][11]. A recent study suggested that early aseptic THA revision was associated with an increased risk of subsequent periprosthetic joint infection (PJI) [9].…”

Section: Introductionmentioning

confidence: 99%

“…A recent study suggested that early aseptic THA revision was associated with an increased risk of subsequent periprosthetic joint infection (PJI) [9]. Heckmann et al demonstrated a relationship between the timing of revision and the risk of PJI; revisions performed within 3 months had significantly higher rates of PJI than revisions done after 12 months; the rate of PJI decreased from approximately 12.7% when the revision was performed at < 1 month to 10.6% at 2-3 months and 6.9% at > 12 months [10]. This could be due to early revisions causing a "second hit" during the physiological recovery from the index surgery.…”

Section: Introductionmentioning

confidence: 99%

Managing early complications in total hip arthroplasty: the safety of immediate revision

Descamps,

Teissier,

Graff

et al. 2023

J Orthop Traumatol

View full text Add to dashboard Cite

Purpose Immediate revision refers to a reoperation that involves resetting, draping, and exchanging the implant, after wound closure in total hip arthroplasty. The purpose of this study is to investigate the impact of immediate revision after total hip arthroplasty on subsequent infection and complication rates. Methods A total of 14,076 primary total hip arthroplasties performed between 2010 and 2020 were identified in our institutional database, of which 42 underwent immediate revision. Infection rates were determined 2 years after the index arthroplasty. The cause and type of revision, duration of primary and revision surgeries, National Nosocomial Infections Surveillance score, implant type, changes in implants, complications, and preoperative and intraoperative antibiotic prophylaxis were all determined. Results No infections were observed within 2 years after the index arthroplasty. Leg length discrepancy (88%, n = 37) and dislocation (7.1%, n = 3) were the main causes of immediate revision. In most cases of discrepancy, the limb was clinically and radiologically longer before the immediate revision. The mean operative time was 48 ± 14 min for the primary procedure and 23.6 ± 9 min for the revision. The time between the first incision and last skin closure ranged from 1 to 3 h. None of the patients were extubated between the two procedures. Two patients had a National Nosocomial Infections Surveillance score of 2, 13 had a score of 1, and 27 had a score of 0. Conclusion Immediate revision is safe for correcting clinical and radiological abnormalities, and may not be associated with increased complication or infection rates. Study design Retrospective cohort study; level of evidence, 3.

show abstract

“…The adaptive properties of bone tissue, depending on its external load, are a powerful means for the body to restore impaired functions of the bone system [3,5]. However, in diagnostic studies used today, these properties are taken into account subjectively.…”

Section: Introductionmentioning

confidence: 99%

Physical and Mathematical Modeling of the Distribution of Load Forces on the Feminal Component of an Endoprosthesis of the Hip Joint Under Real Conditions

Torchynskyi,

Nizalov,

Shmelyova

et al. 2023

Rep. of Morph.

View full text Add to dashboard Cite

Determination of the factors causing the development of aseptic instability of endoprosthesis components is one of the main tasks of modern traumatology and orthopedics. It is important from a scientific and medical point of view to carry out physical and mathematical modeling of the distribution of load forces and their moments on the femoral component of a hip endoprosthesis. The purpose of the study: to conduct a physical and mathematical modeling of the distribution of load forces on the femoral component of a hip endoprosthesis under real conditions of incomplete axially symmetrical contact of the femoral component of the endoprosthesis and the femur, when the surface of the lower end of the endoprosthesis is not in contact with the surface of the bone. In the work, mathematical modeling of the distribution of point load forces and their moments on the contact surface between the femoral endoprosthesis stem and the bone marrow canal of the femur in real conditions is carried out. For qualitative estimates of point distributions of the load force, based on the analysis of previous results, an estimated empirical formula was obtained for these distributions: g(λ,λ1)=Р(λ,λ1) / 140λ7/2, in which the pressure Р(λ,λ1) is taken in kilograms per square centimeter (kg/cm2), and the point force g(λ,λ1) is in kilograms (kg). It was determined that the best, from the point of view of minimizing the harmful mechanical impact of the prosthesis on the femur, is the situation when the length of the prosthesis stem is not less than half the length of the femur (λ≥0.5). In this case, the values of the point load forces do not exceed 0.1 kg, at least for the length of the area of real contact, which is not less than half the length of the prosthesis stem (λ1≥0.5λ). It has been proven that the use of a prosthesis stem that is less than a third of the length of the femur is not advisable. Since already at the length of the prosthesis stem, which is 30 % of the length of the femur (λ=0.3), point loads increase rapidly and can reach from 0.55 to 1.5 kg depending on the length of the contact area. Such point loads are undesirable for the femur in the area of contact with the prosthesis in terms of the integrity of the femur.

show abstract

Revision Surgery for Instability After Total Hip Arthroplasty: Does Timing Matter?

Cited by 12 publications

References 18 publications

Hip & Pelvis

Hip & Pelvis

Managing early complications in total hip arthroplasty: the safety of immediate revision

Physical and Mathematical Modeling of the Distribution of Load Forces on the Feminal Component of an Endoprosthesis of the Hip Joint Under Real Conditions

Contact Info

Product

Resources

About