5 research outputs found

    Wyniki czynno艣ciowe usprawniania chorych po aloplastykach ca艂kowitych stawu biodrowego endoprotezami kr贸tkotrzpieniowymi i przynasadowymi

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    Wst臋p: Aloplastyki ca艂kowite stawu biodrowego z pewno艣ci膮 zajmuj膮 ju偶 trwa艂e miejsce w praktyce operacyjnej choroby zwyrodnieniowej, a tak偶e uszkodze艅 urazowych szyjki ko艣ci udowej. Na przestrzeni ostatnich kilkunastu lat coraz wi臋ksz膮 uwag臋 skupiaj膮 na sobie tzw. endoprotezy przynasadowe i kr贸tkotrzpieniowe, kt贸re nios膮 ze sob膮 nowe wyzwania operacyjne i rehabilitacyjne. Celem pracy by艂a ocena wynik贸w czynno艣ciowych aloplastyki ca艂kowitej staw贸w biodrowych z wykorzystaniem endoprotez kr贸tkotrzpieniowych, przynasadowych oraz niecementowanych z trzpieniem standardowym. Projekt bada艅: Badanie retrospektywne. Materia艂 bada艅: Materia艂 bada艅 pochodzi z lat 1993-2014 i obejmuje 180 operowanych z powodu zwyrodnienia staw贸w biodrowych metod膮 aloplastyki ca艂kowitej, w tym 96 endoprotez膮 niecementowan膮 z trzpieniem standardowym typu ABG-1, co stanowi 53,4%, 62 endoprotez膮 przynasadow膮 typu Proxima, co daje 34,4%, 14 endoprotez膮 kr贸tkotrzpieniow膮 typu BTS, czyli 7,7% oraz 8 endoprotez膮 z kr贸tkim trzpieniem typu TL, co stanowi 4,4%. Metoda bada艅: Kilkukrotnie wykonywany test czynno艣ciowy Harrisa. Wyniki bada艅: Uzyskane wyniki czynno艣ciowe w poszczeg贸lnych grupach operowanych s膮 por贸wnywalne i zbie偶ne, bez wyra藕nych r贸偶nic. Wnioski: Analizowane aloplastyki ca艂kowite staw贸w biodrowych u wi臋kszo艣ci operowanych, zar贸wno w obserwacji wczesnej, jak i odleg艂ej, skutkuj膮 bardzo dobrymi i dobrymi wynikami czynno艣ciowymi oraz s膮 por贸wnywalne z wynikami aloplastyk ca艂kowitych endoprotezami z trzpieniem standardowym. Operowani analizowanymi metodami nie wymagaj膮 odmiennych programu rehabilitacji o odr臋bnej charakterystyce biomechanicznej i klinicznej.Introduction: Total hip arthroplasty already has a permanent place among surgical procedures dealing with osteoarthritis, as well as traumatic injuries of the femoral neck. In recent years, there has been an increased interest in metaphyseal-fitting and short-stem endoprostheses, which bring new challenges regarding operating technique and rehabilitation care. The aim of this study was to evaluate functional results of total hip arthroplasty using the following endoprostheses: short-stem, metaphyseal-fitting, and cementless with a standard stem. Research Project: Retrospective study. Materials and methods: The research material covers the period between 1993 and 2014 and includes 180 patients operated on due to hip osteoarthritis using total hip arthroplasty. In 96 patients (53.4%) cementless endoprosthesis with a standard ABG-1 stem was used, in 62 patients (34.4%) the Proxima metaphyseal prosthesis was implanted, in 14 patients (7.7%) the BTS short-stem endoprosthesis was used, and in 8 patients (4.4%) TL short-stem endoprosthesis was used. Each patient was evaluated several times using the Harris Hip Score. Results: Functional results obtained in individual groups of patients who underwent surgery are comparable and consistent, without pronounced differences. Conclusions: Functional results obtained in analysed total hip arthroplasties were excellent and good in the majority of patients, both in the early and late observation periods. They are comparable with results of total hip arthroplasties with standard stem endoprosthesis. Patients operated on using the described methods do not require a different rehabilitation programme with different biomechanical or clinical characteristics when compared to patients with standard stem endoprostheses

    Health-related quality-of-life and functional outcomes in short-stem versus standard-stem total hip arthroplasty : an 18-month follow-up cohort study

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    BACKGROUND: Osteoarthritis (OA) progressively produces symptoms and disability that may significantly reduce health-related quality of life (HRQoL). Total hip arthroplasty (THA) is an important treatment for symptomatic OA. An alternative to standard-stem THA for younger patients is short-stem THA. The aim of this study was to investigate potential HRQoL and functional outcome differences between these patient groups to provide additional data that will be clinically useful in the decision making between the types of prosthesis. MATERIAL/METHODS: In an 18-month follow-up longitudinal cohort study, we conducted Harris Hip Score (HHS) evaluations and SF-36 questionnaires in a study group and a control group undergoing short-stem and standard-stem THA preoperatively and during follow-up at 1, 3, 6, 12, and 18 months. Effect size was calculated to estimate the size of changes in scores during follow-up between chosen time intervals. RESULTS: A total of 168 patients were included in the study. The total HHS score was significantly increased postoperatively from 46.9 to 87.0 in the standard-stem group, and from 42.7 to 85.1 in the short-stem group. All SF-36 scores improved after THA in both groups. No HRQoL or functional differences were found in the use of either surgical option in the HHS or SF-36 score results (all p>0.05). CONCLUSIONS: As there were no differences in HRQoL in the two groups, we strongly recommend considering short-stem THA, especially in younger patients, due to the benefit of future revision options and a minimally invasive approach
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