Clinical orthopaedics and related research
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Clin. Orthop. Relat. Res. · Feb 2016
Comparative StudyCan Radiographs Predict the Use of Modular Stems in Developmental Dysplasia of the Hip?
Abnormal anatomy frequently results in the use of a modular stem in patients undergoing primary total hip arthroplasty (THA) for developmental dysplasia of the hip (DDH). However, because these stems are not always available in the operating room, it would be helpful if standard radiographic views could be analyzed in such a way that patients whose femoral anatomy might call for stem modularity could be anticipated before surgery. To our knowledge, no such parameters have been defined. ⋯ Preoperative radiographs anticipated the use of modular stems during THA for DDH in a practice where modular stems were chosen on the basis of a neck-shaft angle of greater than 25° measured at surgery. We found that this could be predicted on preoperative radiographs based on smaller lateral neck-shaft angles, steeper AP radiographic neck-shaft angles, and increased femoral anteversion calculated using these angles. Prospective studies are needed to better determine if these cutoff values adequately predict the use of modular stems.
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Clin. Orthop. Relat. Res. · Feb 2016
John Charnley Award: Preoperative Patient-reported Outcome Measures Predict Clinically Meaningful Improvement in Function After THA.
Despite the overall effectiveness of total hip arthroplasty (THA), a subset of patients remain dissatisfied with their results because of persistent pain or functional limitations. It is therefore important to develop predictive tools capable of identifying patients at risk for poor outcomes before surgery. ⋯ Level III, prognostic study.
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Clin. Orthop. Relat. Res. · Feb 2016
Can a Conical Implant Successfully Address Complex Anatomy in Primary THA? Radiographs and Hip Scores at Early Followup.
Total hip arthroplasty (THA) in patients with small or abnormal proximal femoral anatomy is challenging as a result of complex anatomic deformities in the hip. It is unclear which stem is the most appropriate for these patients. One possible implant design that may help meet this need is the modified Wagner Cone prosthesis, whose design consists of monoblock cone with splines; however, to our knowledge, no clinical results have been published using this implant. ⋯ Level IV, therapeutic study.
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Clin. Orthop. Relat. Res. · Feb 2016
Ceramic-on-ceramic THA Implants in Patients Younger Than 20 Years.
Poor survival of THA implants in very young patients has been attributed to use of cemented implants, wear of conventional polyethylene, and the presence of morphologic deformities in the proximal femur or in the acetabulum. Few studies have reported the long-term results of ceramic-on-ceramic implants in THAs in patients younger than 20 years. ⋯ Level IV, therapeutic study.