2 research outputs found
Outcomes Following Total Hip Arthroplasty for Hip Dysplasia in Older Adults. Are They Comparable to Those with Osteoarthritis?
Background: Total hip arthroplasty (THA) for the treatment of hip dysplasia, which disproportionately impacts the younger population, has been shown to be an effective intervention to restore functionality and improve quality of life. However, it is unclear whether these outcomes can be just as beneficial in treating hip dysplasia when it presents in older patients. Therefore, we sought to investigate and compare the pre-and postoperative outcomes of THA for hip dysplasia in older adults to those with end-stage osteoarthritis (OA).
Methods: A prospectively collected database from a single institution was queried from September 1st, 2016 to October 31st, 2021 to identify 323 unilateral THA patients age 50 years or older and separated into 2 groups given a primary diagnosis of hip dysplasia (n = 90 patients) or osteoarthritis (n = 233 patients). Preoperative and minimum 1-year postoperative outcomes were then compared using the Hip Outcome Score (HOS), Hip Disability and Osteoarthritis Outcome Score (HOOS), University of California-Los Angeles (UCLA) activity score, Pain Catastrophizing Score (PCS), and the Depression Anxiety Stress Scale (DASS).
Results: The outcomes between the groups showed no significant differences in their pre-and postoperative HOOS (P = 0.22 and P = 0.63 respectively), DASS Anxiety (P = 0.81 and P = 0.29 respectively), and the DASS Stress Score (P = 0.17 and P = 0.28 respectively). Patients with hip dysplasia reported significantly better preoperative (10.1 vs 12.9, P P = 0.01) DASS Depression Scores but scored significantly lower in the pre-operative HOS (35.4 vs 42.2, P P = 0.02), but no significant difference was seen postoperatively (4.6 vs 5.0, P = 0.11). The PCS noted no significant differences preoperatively (23.2 vs 21.0, P = 0.12). However, the hip dysplasia group has significantly better postoperative scores (6.6 vs 10.0, P = 0.02).
Conclusion: Our investigation demonstrates THA as an excellent surgical option for treating hip dysplasia when presenting in older adults and can yield comparable outcomes as those noted in THA performed for OA in older adults
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Osteochondral Lesions of the Distal Tibial Plafond: A Systematic Review of Lesion Locations and Treatment Outcomes.
BackgroundOsteochondral lesions of the tibial plafond (OLTPs) remain less common than osteochondral lesions of the talus (OLTs), but recognition of the condition has increased.PurposeTo systematically evaluate the literature on lesion locations and treatment outcomes of OLTPs, whether in isolation or in combination with OLTs.Study designSystematic review; Level of evidence, 4.MethodsA search was performed using the PubMed, Embase, and CINAHL databases for studies on lesion locations or with imaging or treatment outcomes of OLTPs. Case reports and reports based on expert opinion were excluded. Lesion locations as well as outcome measure results were aggregated. The Methodological Index for Non-randomized Studies score was used to assess methodological quality when applicable.ResultsIncluded in this review were 10 articles, all published in 2000 or later. Most studies were evidence level 4, and the mean Methodological Index for Non-randomized Studies score was 8.6 (range, 8-10). Overall, 174 confirmed OLTP cases were identified, and the mean patient age was 38.8 years. Of the 157 lesions with confirmed locations, the most common was central-medial (32/157; 20.4%). Of 6 studies on treatment outcomes, all but 1 evaluated bone marrow stimulation techniques. Microfracture of small lesions (<150 mm2) was the most common treatment utilized. Imaging and functional outcomes appeared favorable after treatment. The data did not support differences in outcomes between isolated OLTPs and OLTPs with coexisting OLTs.ConclusionOsteochondral lesions of the distal tibia most commonly occurred at the central-medial tibial plafond. Microfracture of small lesions was the most common treatment utilized, and clinical and magnetic resonance imaging results were favorable, although data were heterogeneous. Areas for future research include the following: the effect of patient factors and additional pathologies on outcomes; larger or deeper lesion treatment; more direct comparisons of outcomes between kissing or coexisting lesions and isolated lesions; and head-to-head comparison of treatments, such as microfracture, bone marrow-derived cell transplantation, and osteochondral autografts/allografts