Total Hip Arthroplasty via direct anterior approach for osteonecrosis; comparison with primary hip osteoarthritis in a mid term follow up

Purpose This systematic review and meta-analysis aimed to compare the outcomes of THA in patients with osteonecrosis (ON) and those with osteoarthritis (OA). Methods Four databases were searched from inception till December 2022 for original studies that compared the outcomes of THA in ON and OA. The primary outcome was the revision rate; the secondary outcomes were dislocation and Harris hip score. This review was conducted in line with PRISMA guidelines, and the risk of bias was assessed using the Newcastle–Ottawa scale. Results A total of 14 observational studies with 2,111,102 hips were included, with a mean age of 50.83 ± 9.32 and 55.51 ± 8.95 for ON and OA groups, respectively. The average follow-up was 7.25 ± 4.6 years. There was a statistically significant difference in revision rate between ON and OA patients in favour of OA (OR: 1.576; 95%CI: 1.24–2.00; p-value: 0.0015). However, dislocation rate (OR: 1.5004; 95%CI: 0.92–2.43; p-value: 0.0916) and Haris hip score (HHS) (SMD: − 0.0486; 95%CI: − 0.35–0.25; p-value: 0.6987) were comparable across both groups. Further sub-analysis adjusting for registry data also showed similar results between both groups. Conclusion A higher revision rate, periprosthetic fracture and periprosthetic joint infection following total hip arthroplasty were associated with osteonecrosis of the femoral head compared with osteoarthritis. However, both groups had similar dislocation rates and functional outcome measures. This finding should be applied in context due to potential confounding factors, including patient’s age and activity level.

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The outcomes of total hip replacement in osteonecrosis versus osteoarthritis: a systematic review and meta-analysis

Salman

Hantouly

Khatkar

et al. 2023

International Orthopaedics (SICOT)

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Bilateral total hip arthroplasty in a case with fibrous dysplasia: a case report

Moharrami,

Mirghaderi,

Moazen-Jamshidi

et al. 2023

J Med Case Reports

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Background Fibrous dysplasia (FD) is a benign neoplasm with a broad spectrum of presentations. The treatment of FD in the hip region is controversial among orthopedic surgeons. Several treatment options exist, including curettage and grafting, valgus osteotomy, medial displacement osteotomy, and so on. Performing total hip arthroplasty (THA) on these patients and their subsequent outcome is still in infancy. Case presentation The patient is a 32-year-old white female with bilateral proximal femur FD who underwent bilateral THA with long stem implants. A year following surgery, she had no complications and had satisfactory radiological, pain, and functional outcomes. Conclusion A bilateral THA with a long stem prosthesis showed promising results when performed following appropriate curettage of the proximal bone in an FD case. A cementless long stem could have enabled better diaphyseal fixation distal to the lesion site.

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The relationship of hip fracture and thyroid disorders: a systematic review

SeyedAlinaghi,

Yarmohammadi,

Dashti

et al. 2023

Front. Endocrinol.

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IntroductionBone density regulation is considered one of the systems affected by thyroid hormones, leading to low bone density that can result in pathologic fractures, including hip fractures. This review aimed to update clinicians and researchers about the current data regarding the relationship between hip fractures and thyroid disorders.MethodsEnglish papers were thoroughly searched in four main online databases of Scopus, Web of Science, PubMed, and Embase. Data extraction was done following two steps of screening/selection using distinct inclusion/exclusion criteria. This study used the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) checklist and the Newcastle-Ottawa Scale (NOS) as bias assessment.ResultsIn total, 19 articles were included in the research. The risk of hip fractures in women with differentiated thyroid cancer (DTC) is higher than hip fractures caused by osteoporosis. Men with hyperthyroidism and subclinical hyperthyroidism are at higher risk for hip fracture. Also, a decrease in serum thyroid stimulating hormone (TSH) may be associated with an increased risk of hip fracture.ConclusionReaching a consensus conclusion regarding the association between subclinical thyroid dysfunction and hip fracture is not feasible due to the heterogenicity of evidence; however, there may be a higher risk of fracture in individuals with subclinical hyperthyroidism.

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Total Hip Arthroplasty via direct anterior approach for osteonecrosis; comparison with primary hip osteoarthritis in a mid term follow up

Cited by 3 publications

References 48 publications

The outcomes of total hip replacement in osteonecrosis versus osteoarthritis: a systematic review and meta-analysis

The outcomes of total hip replacement in osteonecrosis versus osteoarthritis: a systematic review and meta-analysis

Bilateral total hip arthroplasty in a case with fibrous dysplasia: a case report

The relationship of hip fracture and thyroid disorders: a systematic review

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