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primary total hip arthroplasty on Complex hips Conditions in a Low-Resource Setting

Open Journal of Orthopedics 2024年第7期14卷 325-333页

作者： Souleymane Ouédraogo Malick Diallo Sékou Sidibé Massadiami Soulama Adama Sidibé Ousmane Ouermi Patrick W. H. Dakouré Orthopedics and Traumatology Department University Hospital Sour SANOU Bobo-Dioulasso Burkina Faso Superior Institute of Medical Sciences University Nazi BONI Bobo-Dioulasso Burkina Faso

Introduction: total hip arthroplasty of complex morphology is a challenge for the orthopaedic surgeon. Careful analysis of the hip’s anatomy helps to unravel the difficulties and anticipate the procedures to be performed and the implants to be planned. The aim was to identify the types of hip that make first-line THR difficult, specify the technical procedures to be used on these sites, and assess the functional results of the series. Material and Methods: This was a retrospective study that concerned patients operated on for total hip arthroplasty between January 2015 and December 2022 at the medical center “La Grâce” in Bobo-Dioulasso, Burkina Faso. Patients with coxarthrosis (on hip dysplasia, acetabular protrusio, acetabular malunion or neurological hip) and those with ankylosis of the hip, osteonecrosis secondary to neglected dislocation of the hip or hemoglobinopathy were included. Results: A total of 31 total hip replacements were performed in 30 patients. The mean age of patients at the surgery time was 36.2 years with extremes of 17 and 61 years. The male-to-female sex ratio was 1. The main indications for THA were the dysplasic hip osteoarthritis (11 cases) and the neglected hip dislocations (7 cases). In situ femoral neck osteotomy before hip dislocation was performed in seven cases. The acetabulum reconstruction techniques varied from the structural iliac bone graft (n = 3) and cancellous bone graft (n = 4) to the Kerboull plate (n = 1). After 45 months of mean follow-up, all hips were evaluated. The mean PMA score increased from 7.1 [4 - 8] before the surgery to 13.2 [13 - 17]. Conclusion: The large spectrum of challenges in complex hip management requires effective preoperative planning. Preoperative planning minimizes complications and ensures a better outcome.

关键词： primary total hip arthroplasty hip Dysplasia Complex hip

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Highly cross-linked versus conventional polyethylene inserts in total hip arthroplasty,a five-year Roentgen stereophotogrammetric analysis randomised controlled trial

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World Journal of Orthopedics 2020年第10期11卷 442-452页

作者： Justin van Loon Daniël Hoornenborg Inger Sierevelt Kim TM Opdam Gino MMJ Kerkhoffs Daniël Haverkamp Department of Orthopaedic Surgery Xpert Orthopedie Amsterdam/Specialized Center of Orthopedic Research and EducationAmsterdam 1101EANetherlands Department of Orthopaedic Surgery Amsterdam University Medical CentresLocation Academic Medical CenterAmsterdam 1105AZNetherlands

BACKGROUND Polyethylene(PE)particles produced by wear of the acetabular insert are thought to cause osteolysis and thereby aseptic loosening of the implant in total hip arthroplasty(THA).As highly cross-linked polyethylene(HXLPE)is presumed to give lower wear rates,in vivo studies are needed to confirm *** To compare the wear of REXPOL,a HXPLE,with conventional PE within the first five years after implantation using Roentgen stereophotogrammetric analysis(RSA).METHODS Patients were randomised to receive either a HXLPE(REXPOL)or a conventional PE insert during primary *** images were obtained directly postoperative and after 6 wk,12 wk,6 mo,12 mo,24 mo and five *** outcomes were assessed using the hip Injury and Osteoarthritis Outcome Score and Harris hip Score at baseline and five years after *** The HXLPE(REXPOL)showed less wear in the latero-medial *** wear rates of conventional PE were seen in the latero-medial and center-proximal direction and in volume and corrected volume,whereas the REXPOL did not show these outcomes over *** from baseline in functional outcome did not significantly *** total 3D wear is less in THAs inserted with a REXPOL inlay than a conventional PE inlay after five *** study confirms,for the first,that the REXPOL HXLPE inlay is preferred to standard PE.

关键词： Highly cross-linked polyethylene primary total hip arthroplasty Polyethylene wear Roentgen stereophotogrammetric analysis

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