Total hip arthroplasty in patients with Trisomy 21: Systematic review and exploratory patient level analysis

Sha, Shiv; Abdelsabour, Hany; Vijimohan, Suganth J.; Board, Tim; Alshryda, Sattar

doi:10.1016/j.surge.2018.04.008

Cited by 5 publications

(6 citation statements)

References 19 publications

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“…The prevalence of hip osteoarthritis and dysplasia in Down’s syndrome stands at 8%–28% for which total hip arthroplasty has been advised 5. However, the native hip morphology was normal in our patient (figure 1).…”

Section: Discussionmentioning

confidence: 61%

Management of neck of femur fracture in an adult with short stature and learning disability

2022

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Neck of femur fractures (NOFF) are one of the major health concerns, with their incidence and the cost of care rising each year. Though a plethora of literature remains available on NOFF and its management, we found very little evidence for management of NOFF in patients with short stature and learning disability. Because of this unique combination of conditions in our patient, we had to deviate from the standard practice in terms of the implant choice. The usage of cemented Asian C stem AMT with a 36 mm metallic head which is normally reserved for total hip replacements, helped us obtain the desired hip joint stability. This was supplemented by early involvement of the learning disability physiotherapy team and eventually the patient had a satisfactory outcome at 8 months of follow-up. This rare amalgamation of NOFF, short stature and learning disability deserves more attention which our case report hopes to achieve.

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Section: Discussionmentioning

confidence: 61%

Management of neck of femur fracture in an adult with short stature and learning disability

2022

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“…In a recent review of adults with DS who underwent THA the surgical revision rate was 7.5% after 5 years, twice that of controls (Sha et al 2019). The rate of perioperative, medical, and surgical complications in adults with DS is also higher compared to controls (Boylan et al 2016; Sha et al 2019).…”

Section: Discussionmentioning

confidence: 98%

“…In the general population, the majority of hip replacements occur in patients older than 65 years, and the need for surgical revision is between 10 and 15% in 10-20 years (Crawford and Murray 1997). In a recent review of adults with DS who underwent THA the surgical revision rate was 7.5% after 5 years, twice that of controls (Sha et al 2019). The rate of perioperative, medical, and surgical complications in adults with DS is also higher compared to controls (Boylan et al 2016;Sha et al 2019).…”

Section: Discussionmentioning

confidence: 99%

Co‐occurring medical conditions in adults with Down syndrome: A systematic review toward the development of health care guidelines. Part II

Capone

Chicoine

Bulova

et al. 2020

American J of Med Genetics Pt A

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Adults with Down syndrome (DS) represent a unique population who are in need of clinical guidelines to address their medical care. Many of these conditions are of public health importance with the potential to develop screening recommendations to improve clinical care for this population. Our workgroup previously identified and prioritized co-occurring medical conditions in adults with DS. In this study, we again performed detailed literature searches on an additional six medical conditions of clinical importance. A series of key questions (KQ) were formulated a priori to guide the literature search strategy. Our KQs focused on disease prevalence, severity, risk-factors, methodologies for screening/evaluation, impact on morbidity, and potential costs/benefits. The available evidence was extracted, evaluated and graded on quality. The number of participants and the design of clinical studies varied by condition and were often inadequate for answering most of the KQ. Based upon our review, we provide a summary of the findings on hip dysplasia, menopause, acquired cardiac valve disease, type 2 diabetes mellitus, hematologic disorders, and dysphagia. Minimal evidence demonstrates significant gaps in our clinical knowledge that compromises clinical decision-making and management of these medically complex individuals. The creation of evidence-based clinical guidance for this population will not be possible until these gaps are addressed.

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“…52 Conversely, authors of a systematic review that evaluated nine studies involving patients with DS who underwent total hip arthroplasty found that medical and surgical complications were three times higher in patients with DS than in their matched controls. 53 Specifically, patients with DS experienced higher rates of pneumonia, acute renal failure, urinary tract infection, wound hemorrhage, and wound infection. 53 Authors of a study comparing postoperative complications among children with and without DS who underwent abdominal and thoracic procedures found that patients with DS were more likely to experience postoperative complications (16.2% versus 10.8%, P < .001); however, after adjusting for other comorbidities, they concluded that the complication rates were the same.…”

Section: Infection Preventionmentioning

confidence: 99%

“…53 Specifically, patients with DS experienced higher rates of pneumonia, acute renal failure, urinary tract infection, wound hemorrhage, and wound infection. 53 Authors of a study comparing postoperative complications among children with and without DS who underwent abdominal and thoracic procedures found that patients with DS were more likely to experience postoperative complications (16.2% versus 10.8%, P < .001); however, after adjusting for other comorbidities, they concluded that the complication rates were the same. 22…”

Section: Infection Preventionmentioning

confidence: 99%

Down Syndrome: A Review of Key Perioperative Implications

Hines¹,

Simmons²

2022

AORN Journal

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Down syndrome (DS) is the most common chromosomal abnormality in humans that is compatible with life. This syndrome occurs when there is an extra copy of the 21st chromosome. Down syndrome is associated with numerous comorbidities that can pose challenges for the perioperative nurse caring for a patient with DS undergoing surgery. These challenges can affect the patient assessment, communication with the patient, and patient safety (eg, preventing complications). As the life expectancy of people with DS has increased, so too have the chances that perioperative nurses will care for a patient with this disorder. This article reviews the pathophysiology of DS, discusses common comorbidities that may directly affect perioperative care, and reviews an exemplar case study that demonstrates how personnel with knowledge of DS can positively influence surgical team decision making for these patients in the perioperative setting.

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Total hip arthroplasty in patients with Trisomy 21: Systematic review and exploratory patient level analysis

Cited by 5 publications

References 19 publications

Management of neck of femur fracture in an adult with short stature and learning disability

Management of neck of femur fracture in an adult with short stature and learning disability

Co‐occurring medical conditions in adults with Down syndrome: A systematic review toward the development of health care guidelines. Part II

Down Syndrome: A Review of Key Perioperative Implications

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