State of the Art in Hip Replacement Surgery

A special issue of Journal of Clinical Medicine (ISSN 2077-0383). This special issue belongs to the section "Orthopedics".

Deadline for manuscript submissions: 30 May 2024 | Viewed by 1275

Special Issue Editors


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Guest Editor
Department of Orthopedics, Jena University Hospital, Campus Eisenberg, Eisenberg, Germany
Interests: hip and knee arthroplasty; hip revision surgery; trauma

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Guest Editor
Center for Orthopaedics, Trauma Surgery and Rehabilitation Medicine, University Medicine Greifswald, Greifswald, Germany
Interests: hip and knee arthroplasty; hip dysplasia; periacetabular osteotomy

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Guest Editor
Division of Orthopaedics, Trauma and Plastic Surgery, University Hospital Leipzig, Leipzig, Germany
Interests: knee and hip arthroplasty; osteoporosis; bone diseases

Special Issue Information

Dear Colleagues,

As we all know, Learmonth, Young and Rorabeck once named total hip arthroplasty (THA) the “operation of the century”. Since their article was published in 2007, 16 years of innovations have emerged. There have been great advances in the follow-up treatment of patients, minimally invasive approaches, short-stem endoprosthetics, local pain concepts, the widespread use of tranexamic acid, and so much more.

With this Special Issue, we want to provide an update on the latest advances and prospects in hip arthroplasty techniques as one of the most frequently performed surgical procedures in orthopedic surgery worldwide.

Topics of interest for this Special Issue include, but are not limited to, the following: current concepts in modern hip arthroplasty, fast-track and out-patient hip replacement (pro and contra), minimally invasive approaches, short-stem hip arthroplasty, modern bearings and the consequences on wear and debris, navigation, robotics and augmented/mixed reality (past and future concepts), proven and new fixation techniques, custom-made implants, and primary and revision hip arthroplasty.

Dr. Steffen Brodt
Prof. Dr. Georgi Iwan Wassilew
Prof. Dr. Andreas J. Roth
Guest Editors

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Keywords

  • hip arthroplasty
  • hip endoprosthetics
  • minimally invasive approaches
  • fixation techniques
  • joint implants

Published Papers (2 papers)

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Research

11 pages, 3047 KiB  
Article
Elastic Compression Dressing after Total Hip Replacement Slightly Reduces Leg Swelling: A Randomized Controlled Trial
by Sebastian Rohe, Sabrina Böhle, Georg Matziolis, Frank Layher and Steffen Brodt
J. Clin. Med. 2024, 13(8), 2207; https://doi.org/10.3390/jcm13082207 - 11 Apr 2024
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Abstract
Background: Even minor adverse reactions after total hip replacement (THR), including lymphedema, postoperative leg swelling, and blood loss, compromise patient comfort in times of minimally invasive fast-track surgery. Compression dressings are commonly used in surgical practice to reduce swelling or blood loss. [...] Read more.
Background: Even minor adverse reactions after total hip replacement (THR), including lymphedema, postoperative leg swelling, and blood loss, compromise patient comfort in times of minimally invasive fast-track surgery. Compression dressings are commonly used in surgical practice to reduce swelling or blood loss. However, the use of spica hip compression dressings after primary THR is controversial, and prospective studies are lacking. Methods: We conducted a prospective, single-center, two-arm, randomized controlled trial (RCT) of patients undergoing THR for primary osteoarthritis. A total of 324 patients were enrolled; 18 patients were excluded, and 306 patients were finally analyzed. Leg swelling as primary endpoint was measured pre- and postoperatively with a rotating 3D infrared body scanner. Secondary endpoints were transfusion rate and blood loss, estimated by Nadler and Gross formulas. Results: Postoperative leg swelling was lower in the compression group (241 ± 234 mL vs. 307 ± 287 mL; p = 0.01), even after adjustment for surgery time and Body-Mass-Index (BMI) (p = 0.04). Estimated blood loss was also lower in the compression group on the first (428 ± 188 mL vs. 462 ± 178 mL; p = 0.05) and third (556 ± 247 mL vs. 607 ± 251 mL; p = 0.04) postoperative days and leveled off on the fifth postoperative day, but lost significance after adjustment for BMI and surgery time. Neither group received a transfusion. Conclusions: Compression dressing after THR in the context of minimally invasive surgery slightly reduces leg swelling, but has no effect on blood loss or blood transfusion rate. So, this method could not generally be recommended in primary hip replacement. Full article
(This article belongs to the Special Issue State of the Art in Hip Replacement Surgery)
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12 pages, 2714 KiB  
Article
Comparison of Cylindrical and Tapered Stem Designs for Femoral Revision Hip Arthroplasty
by José María Hernández-Mateo, Javier Orozco-Martínez, José Antonio Matas-Díaz, Francisco Javier Vaquero and Pablo Sanz-Ruiz
J. Clin. Med. 2024, 13(6), 1745; https://doi.org/10.3390/jcm13061745 - 18 Mar 2024
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Abstract
Background: Cylindrical fully-coated cobalt-chromium stems (CCS) have been widely used in femoral revisions. However, monoblock fluted conical tapered stems (FCTS) are growing in popularity. The present study seeks to determine whether there are any long-term differences between the two designs. Material and methods: [...] Read more.
Background: Cylindrical fully-coated cobalt-chromium stems (CCS) have been widely used in femoral revisions. However, monoblock fluted conical tapered stems (FCTS) are growing in popularity. The present study seeks to determine whether there are any long-term differences between the two designs. Material and methods: A retrospective study of 38 CCS versus 40 FCTS was carried out. Demographic data, clinical variables and radiographic parameters were recorded. Results: Demographic data were comparable. A greater proportion of septic revisions, periprosthetic fractures and previous osteosynthesis failures was observed with FCTS versus CCS (p = 0.012). A greater use of FCTS was recorded in cases with bone defects of type IIIA and higher (p = 0.025). There were no significant differences in terms of in-hospital complications (p = 0.815), postoperative surgical complications or need for reoperation (p = 0.156). The CCS group presented a higher percentage of clinical thigh pain at the end of follow-up (p = 0.006). Additionally, a greater presence of radiolucencies was observed with CCS, especially in proximal zones (1, 7, 10 and 14). More subsidence, tip cortical hypertrophy and stress shielding were recorded in the CCS group. The overall survival at 120 months was 84.2% in the CCS group and 85% in the FCTS group (p = 0.520). When analyzing isolated aseptic loosening as the cause of failure, the survival rate was 94.7% in the CCS group and 95% in the FCTS group (p = 0.506). Conclusions: Both FCTS and CCS with diaphyseal anchorage afford excellent long-term survival rates, with no differences between the two designs. However, a higher incidence of stress shielding, radiolucencies and thigh pain with CCS seems to favor the use of FCTS. Full article
(This article belongs to the Special Issue State of the Art in Hip Replacement Surgery)
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