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Medicina
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Techniques, Risks and Recovery of Hip Surgery
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Techniques, Risks and Recovery of Hip Surgery

A special issue of Medicina (ISSN 1648-9144). This special issue belongs to the section "Orthopedics".

Deadline for manuscript submissions: closed (31 October 2025) | Viewed by 2510

Special Issue Editors

Dr. Alberto D. Delgado-Martínez

E-Mail Website
Guest Editor
Department of Orthopedic Surgery, Hospital Universitario de Jaén, 23007 Jaén, Spain
Interests: hip surgery; hip fractures; hip replacement
Dr. Eduardo García-Rey

E-Mail Website
Guest Editor
Department of Orthopaedic Surgery and Traumatology, Hip Unit at Hospital Universitario La Paz, Autonomous University of Madrid, Madrid, Spain
Interests: arthroplasty hip; fracture hip and knee arthroplasty; hip arthroplasty; orthopedic biomechanics; orthopedics; biomechanics bone; metabolism bone biology
Special Issues, Collections and Topics in MDPI journals
Prof. Dr. Enrique Guerado

E-Mail Website
Guest Editor
Department of Orthopaedic Surgery and Traumatology, Hospital Universitario Costa del Sol, University of Malaga, Malaga, Spain
Interests: bone fracture; osteoporosis; hip arthroplasty; osteoarthritis bone biology; trauma surgery hip; knee arthroplasty

Special Issue Information

Dear Colleagues,
Background and history of this topic:

Hip surgery is a growing field of research. New techniques have recently been developed and they offer some advantages over old techniques.

Aim and scope of the Special Issue:

The scope of this Special Issue is to publish new research on surgical techniques related on hip surgery, mainly focused on early results, the risks associated with them, recovery, and long term results.

Cutting-edge research:

New techniques on hip fracture and non-unions, new surgical approaches to hip arthoplasty, new techniques on revision hip arthoplasty, and new approaches to indications for hip arthroscopy comprise topics of interest.

What kind of papers we are soliciting:
We are looking for articles based on new techniques in hip surgery, related to fractures, arthroplasty, or arthroscopy

Dr. Alberto D. Delgado-Martínez
Dr. Eduardo García-Rey
Prof. Dr. Enrique Guerado
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Medicina is an international peer-reviewed open access monthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2200 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • hip surgery
  • hip fracture
  • hip arthroplasty
  • hip arthroscopy
 

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Published Papers (4 papers)

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Research

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13 pages, 437 KB  
Article
Low-Dose Subarachnoid Anesthesia Combined with PENG and FLCN Blocks Reduces Hypotensive Episodes Without Compromising Anesthetic Depth and Duration in Hip Fracture Surgery: A Retrospective Observational Study
by Daniel Salgado-García, Agustín Díaz-Álvarez, José L. González-Rodríguez, María R. López-Iglesias, Eduardo Sánchez-López, Manuel J. Sánchez-Ledesma and María I. Martínez-Trufero
Medicina 2025, 61(10), 1808; https://doi.org/10.3390/medicina61101808 - 9 Oct 2025
Viewed by 438
Abstract
Background and Objectives: In the context of hip fracture surgeries, episodes of hypotension are common, and have been associated in various studies with increased complications and mortality. The latest clinical guidelines recommend close hemodynamic management. Our research team hypothesized that the use [...] Read more.
Background and Objectives: In the context of hip fracture surgeries, episodes of hypotension are common, and have been associated in various studies with increased complications and mortality. The latest clinical guidelines recommend close hemodynamic management. Our research team hypothesized that the use of peripheral nerve blocks in this surgery could help adjust the doses of subarachnoid anesthesia for these procedures, thereby limiting the hypotensive episodes, without compromising an adequate depth and duration of intraoperative anesthesia. Materials and Methods: A retrospective study of 184 elderly patients undergoing hip fracture surgery is proposed. In total, 76 patients were operated under subarachnoid anesthesia using 9.5 mg of hyperbaric bupivacaine 0.5% and 10 mcg of fentanyl (Group S), while 108 received a reduced dose of 5 mg hyperbaric bupivacaine 0.5% and 10 mcg of fentanyl, supplemented by preoperative PENG and FLCN blocks (Group B). The main outcome of this study is to compare the number and duration of hypotensive episodes, and its secondary outcome is to compare the use of vasoactive drugs between the groups. Results: The number of hypotensive episodes and their duration were lower in Group B: −12.94 min (−8.57 to −18.03, p = 0.000). The consumption of vasoactive drugs did not reach statistical significance. None of the patients in Group B required supplementary intraoperative anesthesia. Conclusions: Reducing the dose in subarachnoid anesthesia is associated with better hemodynamic control in hip fracture surgeries, and PENG + NFCL blocks are proposed as an appropriate adjunct to ensure adequate anesthetic depth and duration despite a substantial subarachnoid anesthesia dose adjustment. Full article
(This article belongs to the Special Issue Techniques, Risks and Recovery of Hip Surgery)
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12 pages, 1169 KB  
Article
Does Total Hip Arthroplasty Influence Pelvic Version? A Retrospective Case Control Study Using the Sacro-Femoro-Pubic Angle in Osteoarthritis and Fracture Patients
by Giuseppe Geraci, Alberto Corrado Di Martino, Enrico Masi, Alessandro Panciera, Chiara Di Censo and Cesare Faldini
Medicina 2025, 61(8), 1414; https://doi.org/10.3390/medicina61081414 - 5 Aug 2025
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Abstract
Background and Objectives: Spinopelvic alignment may affect the outcomes of total hip arthroplasty (THA), with pelvic version influencing the risk of mechanical complications occurring after surgery. On the other hand, THA surgery itself may contribute to the modification of pelvis version. The [...] Read more.
Background and Objectives: Spinopelvic alignment may affect the outcomes of total hip arthroplasty (THA), with pelvic version influencing the risk of mechanical complications occurring after surgery. On the other hand, THA surgery itself may contribute to the modification of pelvis version. The sacro-femoro-pubic (SFP) angle is measured on anteroposterior (AP) radiographs of the pelvis in a supine position, and is used to estimate pelvic tilt (PT), representative of pelvic version, which requires lateral views of the sacrum for its calculation; however, these X rays are not routinely performed in the preoperative setting of hip surgery. This study aims to analyze how THA determines changes in the pelvic version of operated patients; the SFP angle will be used to assess pelvic version on standard AP radiographs. Materials and Methods: This retrospective study included 182 consecutive patients undergoing THA for unilateral primary degenerative hip osteoarthritis (HOA-study group, n = 104) or femoral neck fracture (FNF-control group, n = 78) at the author’s institution. The SFP angle was measured on AP pelvic radiographs of the non-replaced hip preoperatively, postoperatively, and at the last follow-up. PT values were derived from SFP angles. Pre- and postoperative PT and its variations ΔPT were assessed. Study groups were compared in terms of native and postoperative variations of pelvic version. Results: The average absolute value of ΔPT was 2.99° ± 3.07° in the HOA group and 3.57° ± 2.92° in FNF group. There was no significant overall difference in preoperative or postoperative PT values between groups. In both groups, THA surgery led to a certain improvement, still not significant, in pelvic orientation, with FNF patients presenting a greater tendency toward retroversion. No significant differences in complication rates were found comparing patients with different pelvic orientations. Conclusions: THA can lead to a “normalization” of pelvic version in a certain number of patients with preoperative anteversion or retroversion. Although statistically non-significant, this observation may have clinical implications for spinopelvic balance and could support prioritizing THA in patients with concurrent spinal disease. Further research is needed to confirm these findings and to evaluate the long-term impact of THA on spinopelvic alignment. Full article
(This article belongs to the Special Issue Techniques, Risks and Recovery of Hip Surgery)
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12 pages, 919 KB  
Article
Use of Bone Bank Grafts in Revision Total Hip Arthroplasty: Patient Characteristics at a Referral Center
by Thiago de Carvalho Gontijo, Luiz Octávio Pereira Xavier, Lucas Carneiro Morais, Gustavo Waldolato Silva, Janaíne Cunha Polese, Raquel Bandeira da Silva and Amanda Aparecida Oliveira Leopoldino
Medicina 2025, 61(7), 1246; https://doi.org/10.3390/medicina61071246 - 10 Jul 2025
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Abstract
Background and Objectives: To characterize the epidemiological profile of patients undergoing revision total hip arthroplasty (THA) using bone allografts from a tissue bank, and to identify clinical and surgical factors associated with the selection of graft type in cases of severe periprosthetic [...] Read more.
Background and Objectives: To characterize the epidemiological profile of patients undergoing revision total hip arthroplasty (THA) using bone allografts from a tissue bank, and to identify clinical and surgical factors associated with the selection of graft type in cases of severe periprosthetic bone loss. Materials and Methods: This observational, cross-sectional study involved a retrospective review of medical records from a specialized referral center, including revision THA procedures performed between 2013 and 2019. Data were collected on 36 variables covering demographic details (age, sex), surgical history of both hips, comorbidities, medication use, perioperative complications, hospitalization, surgical technique, and characteristics of the bone grafts used. Patients were grouped based on the type of allograft received—structured or morselized (impacted)—and comparative analyses were performed. Results: A total of 67 revision THA cases were evaluated, with a mean patient age of 63.2 years. Nearly half (47.8%) had no prior hip revision. The average number of previous procedures per patient was 1.73, and the mean interval from primary THA to revision was 178.4 months. Morselized bone allografts were used in 66.7% of cases, and structured allografts in 33.3%. Patients receiving structured grafts had undergone a significantly higher number of prior surgeries (p = 0.01) and had a longer duration since the initial THA (p = 0.04). Conclusions: These findings suggest that younger patients undergoing primary total hip arthroplasty may be at increased risk for complex revision procedures involving structured grafts later in life, underscoring the need for long-term monitoring and tailored surgical planning in this population. Full article
(This article belongs to the Special Issue Techniques, Risks and Recovery of Hip Surgery)
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Other

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12 pages, 2038 KB  
Systematic Review
Thromboembolic Risk After Total Hip Replacement Versus Hemiarthroplasty in Femoral Neck Fracture Patients: A Systematic Review and Meta-Analysis
by Ibrahim A. Hakami, Mohammed A. Altammar, Shafi A. Alaklabi, Meshari M. Alotaibi, Saleh N. Almunyif, Mohammed I. Alshuwaier, Sultan T. Alobaysi, Sultan S. Aldalbahi, Abdullah H. Alotaibi, Mohammed M. Alotaibi, Omar S. Alobaysi, Moath T. Aladhyani and Mohammad A. Jareebi
Medicina 2025, 61(11), 1929; https://doi.org/10.3390/medicina61111929 - 28 Oct 2025
Viewed by 178
Abstract
Background and Objectives: Femoral neck fractures are common among elderly patients and are typically managed surgically to restore mobility and reduce complications. Total Hip Replacement (THR) and Hemiarthroplasty (HA) are standard interventions. While both procedures are widely used, the comparative risks of [...] Read more.
Background and Objectives: Femoral neck fractures are common among elderly patients and are typically managed surgically to restore mobility and reduce complications. Total Hip Replacement (THR) and Hemiarthroplasty (HA) are standard interventions. While both procedures are widely used, the comparative risks of thromboembolic complications remain unclear. This study aimed to systematically compare the risk of Venous Thromboembolism (VTE), including Deep Vein Thrombosis (DVT), Pulmonary Embolism (PE), and Arterial Thromboembolic events in patients undergoing THR versus hemiarthroplasty for femoral neck fractures. Materials and Methods: A comprehensive literature search was conducted in PubMed, Web of Science, Google Scholar, and OVID-Medline for studies published between 2000 and 2024. Eligible studies included patients aged ≥50 years with femoral neck fractures treated with THR or Hemiarthroplasty and reported thromboembolic outcomes. Risk of bias was assessed using the Newcastle–Ottawa Scale and the RoB 2 tools. Meta-analysis was performed using RevMan software (Version 5.4). Results: Twelve studies were included in the systematic review, and ten in the meta-analysis, encompassing over 160,000 patients. THR was associated with a significantly increased risk of DVT (RR = 1.53; 95% CI: 1.40–1.68, p = 0.00001) and combined VTE (RR = 1.48; 95% CI: 1.36–1.61, p = 0.00001) compared to HA. No significant difference was observed in PE risk. Interestingly, THR was linked to a lower risk of Arterial Thromboembolic events, such as Ischemic Stroke. Conclusions: Compared with Hemiarthroplasty, THR increases the risk of VTE, including DVT, with no increased risk of PE. Surgical decisions should be guided by individual patients’ risk factors for thrombotic and cardiovascular events. Full article
(This article belongs to the Special Issue Techniques, Risks and Recovery of Hip Surgery)
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