17 research outputs found
The young osteoarthritic hip: clinical outcome of total hip arthroplasty and a cost-effectiveness analysis
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129685.pdf (Publisher’s version ) (Open Access)Radboud Universiteit Nijmegen, 26 september 2014Promotor : Veth, R.P.H. Co-promotores : Schreurs, B.W., Gardeniers, J.W.M
[Choice of hip prosthesis in patients younger than 50 years]
No full textThere is no agreement about the most ideal type of hip prosthesis to be used in patients younger than 50 years. The most commonly used hip prostheses in patients younger than 50 years are uncemented or resurfacing prostheses and to a lesser extent cemented prostheses. A good result of a hip prosthesis can be defined as follows: 10 years after surgery more than 90% of the prostheses should be still in situ during endpoint revision for any reason. No trials are available comparing cemented, uncemented or resurfacing hip prostheses. Studies are available of cemented hip prostheses in patients younger than 50 years that prove that more than 90% of the hips are still in situ after 50 years. There are no studies available of uncemented or resurfacing hip prostheses in younger patients that prove that after to years of follow-up 90% or more of the prostheses are still in situ. The Scandinavian hip registers show that the highest rate of prostheses still in situ after 10 years is achieved by cemented hip prostheses
[Choice of hip prosthesis in patients younger than 50 years]
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52843.pdf (Publisher’s version ) (Closed access)There is no agreement about the most ideal type of hip prosthesis to be used in patients younger than 50 years. The most commonly used hip prostheses in patients younger than 50 years are uncemented or resurfacing prostheses and to a lesser extent cemented prostheses. A good result of a hip prosthesis can be defined as follows: 10 years after surgery more than 90% of the prostheses should be still in situ during endpoint revision for any reason. No trials are available comparing cemented, uncemented or resurfacing hip prostheses. Studies are available of cemented hip prostheses in patients younger than 50 years that prove that more than 90% of the hips are still in situ after 50 years. There are no studies available of uncemented or resurfacing hip prostheses in younger patients that prove that after to years of follow-up 90% or more of the prostheses are still in situ. The Scandinavian hip registers show that the highest rate of prostheses still in situ after 10 years is achieved by cemented hip prostheses
[Favourable long-term results from cemented total hip arthroplasty combined with acetabular bone impaction grafting in patients under the age of 50]
No full textOBJECTIVE: Determination of long-term results of hip replacements in patients who, at the time of operation, were under the age of 50. Procedures whereby an existing acetabulum defect was filled with bone chips that were impacted into a strong layer, after which a cemented total hip prosthesis was implanted. DESIGN: Descriptive. METHOD: Prospectively collected data from patients who were under the age of 50, and had undergone a hip replacement operation at our hospital between 1 July 1979 and 31 December 1987 were analysed. Data were collected up to 31 December 2002. The main outcome was time to revision. Survival was calculated by the Kaplan-Meier method. RESULTS: The study group consisted of 25 patients, 17 women and 8 men with 29 prosthetic hips. The average age at operation was 37.6 years (range: 20-49). Follow-up time was 15-23 years (median: 18.7 years). 1 patient (1 hip) was lost to follow-up. 3 patients (4 hips) died within 15 years after the operation; none of them had undergone revision. 4 revisions had been performed: I septic loosening (14 years p.o.) and 3 aseptic loosenings (6, 15, 20 years p.o.). The cumulative survival with the end-point 'revision for any reason' was 96% (95% CI: 88-100) at to years and 88% (95% CI: 74-100) at 20 years; after exclusion of the septic loosening the survival at 20 years was 92% (95% CI: 80-100). CONCLUSION: Hip replacement including a reconstruction technique for an acetabulum defect in patients under the age of 50 was regarded as successful if after 10 years, at least 90% of the prostheses were still in situ
Acetabular reconstruction with impaction bone-grafting and a cemented cup in patients younger than fifty years old: a concise follow-up, at twenty to twenty-eight years, of a previous report
No full textItem does not contain fulltextIn a previous report, we presented our results of forty-two acetabular reconstructions, performed with use of impaction bone-grafting and a cemented polyethylene cup, in thirty-seven patients who were younger than fifty years and had a minimum of fifteen years of follow-up. The present update study shows the results after twenty to twenty-eight years. Eight additional cups had to be revised--four because of aseptic loosening, three because of wear, and one during a revision of the stem. Three additional cups were considered loose on radiographs. Survivorship of the acetabular reconstructions, with an end point of revision for any reason, was 73% after twenty years and 52% after twenty-five years. With revision for aseptic loosening as the end point, survival was 85% after twenty years and 77% after twenty-five years; for signs of loosening on radiographs, survival was 71% at twenty years and 62% at twenty-five years. In conclusion, our previous results have declined but the technique of using impacted morselized bone graft and a cemented cup is useful for the purpose of restoring bone stock in young patients whose acetabular defects require primary or revision total hip arthroplasty
[Favourable long-term results from cemented total hip arthroplasty combined with acetabular bone impaction grafting in patients under the age of 50]
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53064.pdf (Publisher’s version ) (Closed access)OBJECTIVE: Determination of long-term results of hip replacements in patients who, at the time of operation, were under the age of 50. Procedures whereby an existing acetabulum defect was filled with bone chips that were impacted into a strong layer, after which a cemented total hip prosthesis was implanted. DESIGN: Descriptive. METHOD: Prospectively collected data from patients who were under the age of 50, and had undergone a hip replacement operation at our hospital between 1 July 1979 and 31 December 1987 were analysed. Data were collected up to 31 December 2002. The main outcome was time to revision. Survival was calculated by the Kaplan-Meier method. RESULTS: The study group consisted of 25 patients, 17 women and 8 men with 29 prosthetic hips. The average age at operation was 37.6 years (range: 20-49). Follow-up time was 15-23 years (median: 18.7 years). 1 patient (1 hip) was lost to follow-up. 3 patients (4 hips) died within 15 years after the operation; none of them had undergone revision. 4 revisions had been performed: I septic loosening (14 years p.o.) and 3 aseptic loosenings (6, 15, 20 years p.o.). The cumulative survival with the end-point 'revision for any reason' was 96% (95% CI: 88-100) at to years and 88% (95% CI: 74-100) at 20 years; after exclusion of the septic loosening the survival at 20 years was 92% (95% CI: 80-100). CONCLUSION: Hip replacement including a reconstruction technique for an acetabulum defect in patients under the age of 50 was regarded as successful if after 10 years, at least 90% of the prostheses were still in situ
Preparing for an orthopedic consultation using an eHealth tool: a randomized controlled trial in patients with hip and knee osteoarthritis
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219390.pdf (Publisher’s version ) (Open Access
Acetabular reconstruction with impaction bone-grafting and a cemented cup in patients younger than fifty years old.
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57643.pdf (Publisher’s version ) (Open Access)BACKGROUND: Acetabular bone deficiency can present a challenge during total hip arthroplasty, especially in young patients. The purpose of the present study was to evaluate the long-term clinical and radiographic outcomes of primary and revision acetabular reconstruction with use of an impaction bone-grafting technique and a cemented polyethylene cup in young patients who had preexisting acetabular bone deficiency. METHODS: Forty-two consecutive acetabular reconstructions were performed in thirty-seven patients who were younger than fifty years old (average, 37.2 years old). The impaction bone-grafting technique was used for twenty-three primary and nineteen revision acetabular reconstructions. Twenty-eight patients (thirty-one hips) were available for review after a minimum duration of follow-up of fifteen years. Clinical and radiographic results were assessed, and survivorship analysis was performed with the Kaplan-Meier method. RESULTS: Eight hips were revised at a mean of twelve years (range, three to twenty-one years) after a primary reconstruction (four hips) or revision reconstruction (four hips). The revision was performed because of aseptic loosening of the acetabular component in four hips and because of culture-proven septic loosening in two. Two additional cups (both in hips that had had a revision reconstruction) were revised, during revision of the femoral stem, because of wear (one hip) or because of persistent intraoperative instability (one hip). Twenty-eight hips (in twenty-five patients) had retention of the acetabular component for a minimum of fifteen years. The mean Harris hip score for that group was 89 points. Twenty-six of these twenty-eight hips had no or slight pain. Kaplan-Meier analysis revealed a twenty-year survival rate of 80% (95% confidence interval, 67% to 94%) with acetabular revision for any reason as the end point and of 91% (95% confidence interval, 80% to 100%) with acetabular revision because of aseptic loosening as the end point. CONCLUSIONS: Acetabular reconstruction with use of impaction bone-grafting and a cemented polyethylene cup is a reliable and durable technique that is associated with good long-term results in young patients with acetabular bone-stock defects
Posterolateral corner reconstruction in combined injuries of the knee: Improved stability with Larson's fibular sling reconstruction and comparison with LaPrade anatomical reconstruction
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220956.pdf (Publisher’s version ) (Closed access)BACKGROUND: The goal of this prospective cohort study was to present the clinical results of a two-year follow-up of a Larson's posterolateral corner reconstruction (fibular sling) in patients with symptomatic instability of the knee. These data were compared with data of an anatomical reconstruction of the posterolateral corner as described by LaPrade et al. (combined tibial tunnel and fibular sling) [1]. METHODS: Eleven patients underwent a Larson's posterolateral corner reconstruction. Cruciate ligament ruptures were reconstructed if present. Multiple subjective knee outcome scores (VAS satisfaction score, Tegner, Lysholm, Noyes score, and IKDC subjective knee score) were obtained pre-operatively and two years after surgery. Laxity of the joint was measured using bilateral varus stress radiographs. RESULTS: All patients had concomitant ACL or PCL surgery. VAS satisfaction, the Tegner, Noyes and the IKDC subjective knee score all improved significantly. Median varus laxity of the injured knee on varus stress radiographs improved significantly from 6.2° (3.1-10.1) to 3.9° (1.1-5.7), p = .0076. Post-operative varus laxity did not return to the level of the uninjured knee: 2.7° (1-5.7), p = .028. In comparison with our data on the reconstruction technique according to LaPrade, no statistically significant differences in clinical outcome were observed. CONCLUSION: Reconstruction of the posterolateral corner in combined injuries of the knee using a Larson fibular sling technique results in improved varus stability but not to the level of the uninjured knee. Functional knee scores improved significantly. We found no differences in functional and radiological outcome between the Larson's fibular sling reconstruction and LaPrade anatomical reconstruction. LEVEL OF EVIDENCE: IV
Anatomical superficial medial collateral ligament reconstruction with posteromedial capsule reefing successfully restores valgus knee laxity
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220008.pdf (Publisher’s version ) (Closed access
