Hip international : the journal of clinical and experimental research on hip pathology and therapy
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Pneumatic compression and cryotherapy have been successfully being employed in the management of acute tissue damage. The Game Ready System (GRS) combines cyclic compression and cryotherapy. No randomised controlled trial has been performed on the effects of combined cyclic compression and cryotherapy in total hip arthroplasty (THA). ⋯ One event of deep venous thrombosis occurred in the control group. Intermittent cryocompression therefore appears to reduce postoperative blood loss. A trend towards less analgesic use, shorter hospital stay, less wound discharge and less pain at 6 weeks postoperatively was also observed.
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Serum lactate has been shown to be an indicator of adverse clinical outcomes in patients admitted secondary to general trauma or sepsis. We retrospectively investigated whether admission serum venous lactate can predict in-hospital mortality in patients with hip fractures. ⋯ Patients with an elevated venous lactate following hip trauma should be identified as being at increased risk of death and may benefit from targeted medical therapy.
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Complications following surgical intervention for periprosthetic hip fractures are not uncommon. We report the clinical outcome following definitive surgical intervention for this indication at a single tertiary referral centre. All patients admitted between 2003 and 2009 undergoing such treatment were included. ⋯ There were no deaths in-hospital or at 30-days, with 10 fatalities (15%) at a mean 2-year follow-up. Lower rates of re-intervention and mortality were observed when surgery for acute periprosthetic hip fractures was performed at a tertiary centre. Revision hip arthroplasty with or without fracture fixation proved an effective and safe treatment of periprosthetic hip fractures in a high-risk patient population.
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Recent advances in chemotherapy and radiation therapy in the treatment of malignant bone tumours as well as the consistent increase of revision arthroplasties have been followed by an increased use of megaprostheses. These large foreign bodies make infection a common and feared complication. ⋯ Apart from the basic principles of septic revision arthroplasty, special patient and implant factors have to be considered in infected megaprosthesis, which we have summarised in our paper (e.g. life expectancy, implant design, spacers and external stabilisation). This article further analyses the current literature available for these cases and summarises outcome after treatment of periprosthetic infections.
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We present our experience of the articular surface replacement (ASR) hip and the implant recall process. One hundred and twenty-one ASR components were implanted (21 resurfacing hip arthroplasty (RHA) and 100 ASR/XL modular total hip replacements). At the time of the implant recall in August 2010 there were 111 surviving hips (92%) with a mean follow-up of 44 months. ⋯ Our current revision rate for ASR RHA is 19% (mean follow-up 62 months, range 29-80) and for the ASR/XL is 19% (mean follow-up 53 months, range 10-80). The 5-year cumulative survival rates with revision for any reason for the ASR/XL, was 80.8% (95% confidence interval 72.0 - 89.5). Given experience elsewhere we expect this rate may increase significantly with time.