Bulletin of the NYU hospital for joint diseases
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Bull NYU Hosp Jt Dis · Jan 2009
Comparative StudyA comparison of total hip resurfacing and total hip arthroplasty - patients and outcomes.
A comparison of pertinent preoperative and postoperative data relative to total hip resurfacing versus total hip arthroplasty (THA) would assist in evaluating current perceptions in outcome. We compared 50 consecutive metal-metal resurfacing replacements in 50 patients with 44 consecutive conventional total hip arthroplasties in 35 patients, who were implanted during the same time period, by the same surgeon, and followed prospectively for 2 to 4 years. The patients undergoing hip resurfacing were 62% male, 9 years younger, and 3.2 inches taller, with a lower mean body mass index and American Society of Anesthesiologists (ASA) grade than patients undergoing total hip arthroplasty. ⋯ There were no differences in postoperative range of motion or dislocation (one each). The preoperative characteristics and general health status of the average patient undergoing resurfacing are more favorable than that of the average patient undergoing conventional total hip arthroplasty. Caution should be applied in attributing differences in outcomes directly to the arthroplasty technology.
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Bull NYU Hosp Jt Dis · Jan 2009
ReviewResurfacing versus conventional total hip arthroplasty - review of comparative clinical and basic science studies.
Although standard total hip arthroplasties have a long and successful history as the standard of care for advanced, symptomatic osteoarthritis, there is increasing patient demand and surgeon interest in femoral bone conserving resurfacing alternatives. The purpose of this study was to assess the state of the research that directly compares the outcomes of conventional total hip arthroplasty procedures with the current generation of metal-on-metal resurfacing hip arthroplasties. ⋯ While there is still much debate and room for additional research on this topic, multiple midterm clinical results suggest that resurfacing hip arthroplasty represents a safe, effective alternative to conventional total hip arthroplasty, especially for younger, active patients.
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Bull NYU Hosp Jt Dis · Jan 2009
ReviewCan RAPID3, an index without formal joint counts or laboratory tests, serve to guide rheumatologists in tight control of rheumatoid arthritis in usual clinical care?
Tight control of rheumatoid arthritis (RA) may be guided by RAPID3 (routine assessment of patient index data), an index without formal joint counts or laboratory tests, which can be scored on a multidimensional health assessment questionnaire (MDHAQ) in 5 seconds, compared to 42 seconds to score a standard HAQ, 90 seconds to perform a 28-joint count, 114 seconds to score a disease activity score 28 (DAS28), and 106 seconds to score a clinical disease activity index (CDAI). RAPID3 scores are correlated significantly with DAS28 and CDAI (rho > 0.65, p < 0.001), and distinguish active from control treatment similarly to DAS28 and CDAI in clinical trials of methotrexate, lefunomide, adalimumab, abatacept, certolizumab, and infiximab. RAPID3 scores can be used to classify patient disease activity status as high (> 12), moderate (6.1-12), low (3.1-6), and remission (
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Bull NYU Hosp Jt Dis · Jan 2009
The early results of metal-on-metal hip resurfacing - a prospective study at a minimum two-year follow-up.
Hip resurfacing has recently been offered as an attractive alternative to conventional total hip arthroplasty. This report evaluated the short-term functional outcome and longevity of a newer generation resurfacing device and includes the results of 228 consecutive hip resurfacing in 209 patients at a minimum of two-year follow-up. All resurfacing were performed by a single surgeon using a posterior approach. ⋯ The overall survival at 4.6 years was 96.9%. The survival of resurfacing in this study was comparable to that of other published studies of hip resurfacing. Surface hip arthroplasty appears to be an effective alternative to conventional total hip arthroplasty in patients suffering from osteoarthritis.
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Bull NYU Hosp Jt Dis · Jan 2009
Comparative StudyResurfacing matched to standard total hip arthroplasty by preoperative activity levels - a comparison of postoperative outcomes.
Some studies have suggested that resurfacing patients are generally more active postoperatively than their conventional total hip arthroplasty (THA)counterparts, but controversy remains over whether this is a reflection of preferential use of resurfacing for younger and higher-activity patients. We hypothesized that, when controlling for preoperative activity levels, in addition to relevant clinical and demographic factors, resurfacing provides similar results to conventional hip arthroplasty. ⋯ The results of this study suggest that patients treated with hip resurfacing arthroplasty have a significantly higher postoperative activity level, as compared to those treated with conventional THA, when controlled for preoperative factors.