Introduction of total knee arthroplasty in Lithuania: Results from the first 10 years

Background and purpose We have previously reported that the first 10 years of hip arthroplasty in Lithuania resulted in a higher cumulative revision rate than that observed in Sweden. We thus compared the corresponding results after introduaction of total knee replacement in Lithuania

Dual mobility cup reduces dislocation rate after arthroplasty for femoral neck fracture

<p>Abstract</p> <p>Background</p> <p>Hip dislocation after arthroplasty for femoral neck fractures remains a serious complication. The aim of our study was to investigate the dislocation rate in acute femoral neck fracture patients operated with a posterior approach with cemented conventional or dual articulation acetabular components.</p> <p>Methods</p> <p>We compared the dislocation rate in 56 consecutive patients operated with conventional (single mobility) cemented acetabular components to that in 42 consecutive patients operated with dual articulation acetabular components. All the patients were operated via posterior approach and were followed up to one year postoperatively.</p> <p>Results</p> <p>There were 8 dislocations in the 56 patients having conventional components as compared to no dislocations in those 42 having dual articulation components (p = 0.01). The groups were similar with respect to age and gender distribution.</p> <p>Conclusions</p> <p>We conclude that the use of a cemented dual articulation acetabular component significantly reduces the dislocation rates in femoral neck fracture patients operated via posterior approach.</p

Delayed hospitalization increases mortality in displaced femoral neck fracture patients

Background and purpose Reports regarding the relationship between delayed surgery and mortality in femoral neck fracture patients are contradictory. We could not find any study in the literature investigating delayed arrival to hospital and delayed surgery as separate factors affecting mortality in femoral neck fracture patients, which was the purpose of our study

Total hip replacement with second generation cementing technique and the monobloc ScanHip: a 10-year follow-up

In 230 consecutive patients 244 hips were operated with a 32-mm cemented prosthesis. The mean age at surgery was 77 (46-96) years. At the 10-year follow-up 89 patients (95 hips) were dead and 33 patients (35 hips) did not attend because of old age or medical problems. Thirteen hips had been revised for aseptic loosening, two for infection, one for recurrent dislocations, and one for fracture. Four hips were found to be loose and seven had suspected radiographic loosening zones but only minor clinical symptoms. No or little limp was experienced by 52% of patients and 62% reported no or little pain. Eighty-seven percent were satisfied with the early postoperative result and 77% were still content at the time of follow-up. On the 10-year radiographs wear of the cups was, on average, 2.2 mm in loose hips and 1.5 mm in intact hips (P=0.02). There was no correlation between dissatisfaction and loosening visible by X-ray at follow-up

Intracapsular pressure and pain in coxarthrosis

Intracapsular hip pressure was measured before surgery in 17 patients (18 hips) with coxarthrosis. The results were correlated to pain as registered on a visual analog scale. With the hip in extension, the pressure was 49.5 mmHg (SD, 40.2); in 45 degrees of flexion, it was 21.3 mmHg (SD, 14.6); in extension and inward rotation, it was 105.7 mmHg (SD, 76.0); and in extension and outward rotation, it was 40.8 mmHg (SD, 32.0). A small amount, 0.7 mL (SD, 1.14), of joint fluid was aspirated following pressure registration. Pressure correlated significantly to pain at night, when starting to walk, and on walking. It is suggested that the increase in intracapsular hip pressure is a cause of pain in coxarthrosis, with subsequent limitation of movement and joint contracture

The short rotators do not influence capsular compliance or pain in severe hip osteoarthritis. A randomised controlled trial.

Abstract: A randomised controlled trial was performed to investigate if the short rotators affected the compliance of the capsule in osteoarthritis (OA). 68 OA patients admitted for total hip arthroplasty (THA) were randomised to have their compliance estimated during surgery with either their short rotators intact or released. Radiographic severity of OA, range of motion and pain were assessed in the affected hip before surgery. There was no significant difference in the compliance of the capsule whether the short rotators were intact or released (p= 0.5). Furthermore, there was no significant correlation between pain and capsular compliance (p=0.4 and p=0.5). We found no significant effect of the short rotators on compliance of the hip joint capsule, and no significant correlation between pain and capsular compliance

Risk of mortality following hip fracture in Japan

Background. Excessive mortality and morbidity are serious problems after hip fracture in the elderly. Methods. Hip fractures in persons aged 50 years or older were prospectively registered in Japan in 2000. Questionnaires regarding both the first onset and the second 120-day period after hip fracture were obtained from 759 patients, 546 of whom were female and 213 male. Results. Their average age at the time of fracture was 80 years. Altogether, 68 people (9%) died within 120 days after fracture; and 25 patients died within 30 days. Those dying within 120 days and those alive after hip fracture were compared. By univariate analysis, risk factors were poor walking ability, need for a walking aid, low body mass index, history of falls, and lack of active exercise; however, none of these factors was identified as a risk factor by multivariate analysis. By multivariate analysis, the five risk factors associated with mortality were male sex, older age, high American Academy of Anesthesiology (ASA) grade, dementia, and residence in an institution. Conclusions. During the treatment and rehabilitation period special attention should be paid to patients with chronic diseases and reduced mental status

Fragility Fractures in Patients with Rheumatoid Arthritis and Osteoarthritis Compared with the General Population.

To determine the rate ratios of hip and distal radius fractures in patients with rheumatoid arthritis (RA), hip osteoarthritis (OA), and knee OA