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Hip Joint Replacement (hip + joint_replacement)
Selected AbstractsINCIDENCE AND OUTCOMES OF KNEE AND HIP JOINT REPLACEMENT IN VETERANS AND CIVILIANSANZ JOURNAL OF SURGERY, Issue 5 2006Vanessa Wells Background: This article describes the incidence of total knee and hip replacement, and compares post-surgery health status outcomes in veterans and civilians. Methods: The numbers of male veterans and civilians who had a knee and/or a hip replacement in South Australia (1994,2002) were obtained. Standardized morbidity ratios, and odds ratios for age group by veteran/civilian interactions, were calculated. Presurgery and 1-year post-surgery Medical Outcomes Short Form (36) Health Survey, Knee Society and Harris hip scores were completed. Independent samples t -tests were used to compare presurgery scores. ancova models were used to determine any differences between veterans and civilians post-surgery. Results: For veterans, standardized morbidity ratios were 0.987 and 0.715 for knee and hip replacements, respectively (P < 0.0001). Veterans' odds ratios for knee and hip replacements were significantly lower in the 65- to 74-year age group (P < 0.001), similar in the 75- to 84-year and above 85-year age groups for hip replacement, but significantly higher in the above 85-year age group for knee replacement (P < 0.001). Presurgery, veterans reported significantly lower scores (P < 0.003) for knee function. After knee replacement, veterans reported significantly lower Medical Outcomes Short Form (36) Health Survey scores for bodily pain, physical functioning, role , physical, role , emotional, social functioning and physical component summary (P < 0.033). Significantly lower physical functioning, role , physical and physical component summary scores (P < 0.02) were reported by veterans post-surgery for hip replacement. Conclusion: Veterans are delaying joint replacement. Presurgical knee function is worse in veterans. Post-surgery, the veterans are worse off in a number of health status outcomes. [source] Amyloidosis: a rheumatological perspective on diagnosis, further investigation and treatmentINTERNATIONAL JOURNAL OF RHEUMATIC DISEASES, Issue 1 2008S. K. L. LAM Abstract In this Grand Round, we present a 58-year-old man with a presumptive diagnosis of rheumatoid arthritis (RA) who was being managed by a plastic surgery unit for a dorsal swelling of his right hand. While awaiting surgery for this lesion, he sustained a pathological fracture of his left neck of femur. This necessitated a total hip joint replacement and pathology revealed amyloidosis. Excision of the hand swelling also revealed amyloidosis as the cause. We discuss the ways in which amyloidosis can mimic musculoskeletal disease as well as the importance and some potential pitfalls of further investigation and management once the diagnosis of amyloidosis has been made. [source] Bilateral Femoral Head Osteonecrosis After Septic Shock and Multiorgan Failure,JOURNAL OF BONE AND MINERAL RESEARCH, Issue 3 2004Mark J Bolland Abstract A case of bilateral femoral head osteonecrosis after septic shock is presented. We suggest that the osteonecrosis was caused by ischemic insults to the proximal femora. The association between septic shock and osteonecrosis has not been previously reported. Introduction: Osteonecrosis is an uncommon disorder characterized by the in situ death of bone. A diverse range of conditions has been associated with osteonecrosis. We present a case of bilateral femoral head osteonecrosis that occurred after an episode of septic shock. Materials and Methods: A 66-year-old woman presented with a left-sided renal stone and a urinary tract infection. Her condition rapidly progressed to a life-threatening illness with septic shock complicated by multiorgan failure, which necessitated prolonged intensive care and inotropic support. She made a full recovery but 3 months later developed bilateral osteonecrosis of the femoral heads requiring bilateral total hip joint replacement. Results and Conclusions: We propose that the osteonecrosis was caused by ischemic insults to the femoral heads as a result of the widespread systemic ischemia that occurred during her initial illness. To our knowledge, septic shock has not been previously described as a cause of osteonecrosis. Clinicians should be aware of this association, particularly in patients presenting with bone pain after episodes of sepsis. [source] Cross-linked N-telopeptide of type I collagen (NTx) in urine as a predictor of periprosthetic osteolysisJOURNAL OF ORTHOPAEDIC RESEARCH, Issue 7 2006Thord von Schewelov Abstract Periprosthetic osteolysis is often nonsymptomatic and hard to visualize by conventional radiography. Cross-linked N-telopeptide of type I collagen (NTx), a marker of osteoclast mediated bone resorption, has been suggested to evaluate local particulate-induced osteolysis in patients operated on with a total hip prosthesis. Urine specimens were sampled after hip joint replacement in 160 patients. NTx was analyzed by a commercially available ELISA kit. Osteolysis was identified in the acetabulum and confirmed at operation. Using analysis of covariance to correct for differences in age, gender, and time after operation, NTx (mean SD) was 36,±,12 BCE/nM creatinine in patients with osteolysis (n,=,33) and 27,±,13 BCE/nM creatinine in patients without osteolysis (n,=,127) (p,=,0.003). Eighteen hips of 38 (47%), demonstrating an annual wear of more than 0.2 mm and an NTx value above 29 BCE/nM creatinine, had been revised due to osteolysis. The osteolysis prevalence in this group was increased 10 times (CI 4-23, p,<,0.05). Indeed, NTx release and annual wear were both associated with increased prevalence of osteolysis, however, independently of each other. NTx seems a feasible marker of periprosthetic osteolysis. A preoperative baseline NTx level is likely needed for its use as a predictor of periprosthetic osteolysis in individual cases. © 2006 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 24:1342,1348, 2006 [source] Patterns of the circumflex femoral arteries revisitedCLINICAL ANATOMY, Issue 2 2007M.T. Vazquez Abstract Knowledge of variations of the circumflex femoral arteries is important when undertaking clinical procedures within the femoral region and in hip joint replacement. Since the 19th century, many different patterns have been proposed to classify their origins. This work studied a statistically reliable sample, the lower limbs of 221 embalmed human cadavers (equal right,left and approximately equal sex distributions), and reviewed the previous literature to propose a unified and simple classification that will be useful to clinicians. Statistical comparisons were made using the ,2 test. The medial and lateral circumflex femoral arteries have been classified into three different patterns based on the levels of their origin. Distribution related to sex and side was also studied. Pattern I: Both arteries arose from the deep femoral artery (346 cases, 78.8%). This pattern was more frequent in females, P = 0.01. There was no significant difference between sides. Type Ia, medial circumflex femoral artery origin was proximal to the lateral circumflex femoral artery origin (53.2%); Type Ib, lateral circumflex femoral artery origin was proximal to medial circumflex femoral artery origin (23.4%); Type Ic, both arteries arose from a common trunk (23.4%). Pattern II: One of the arteries arose from the femoral artery and the other from the deep femoral artery (90 cases, 20.5%). Type IIa, the medial circumflex femoral artery arose from the femoral artery (77.8%) and Type IIb, the lateral circumflex femoral artery arose from the femoral artery (22.2%). There were no significant differences between sexes or sides. Pattern III: Both arteries arose from the femoral artery (2 cases, 0.5%). In every disposition there was a significantly higher prevalence of unilateral rather than bilateral occurrence. In one dissection the medial circumflex femoral artery was absent. Awareness of these variations could avoid unexpected injuries. Clin. Anat. 20:180,185, 2007. © 2006 Wiley-Liss, Inc. [source] | |||||||||||||