Hip international : the journal of clinical and experimental research on hip pathology and therapy
-
Multicenter Study
The proportion of perioperative mortalities attributed to cemented implantation in hip fracture patients treated by hemiarthroplasty.
Bone cement for fixation of prostheses, comorbidity and age have been previously shown to be associated with increased relative risk of mortality within the first day of surgery. However, the proportion of mortalities associated to each of these exposures is not adequately expressed by relative risk estimates. ⋯ The estimated AFs on perioperative mortality in hip fracture patients treated by hemiarthroplasty showed that about half of the mortalities within the first day of surgery could be associated with the use of bone cement.
-
Many techniques have been described for closed reduction of posterior hip dislocations, but most require forceful and sustained traction, assistants to stabilise the pelvis and awkward positioning of the surgeon and/or the patient. We describe a new technique of closed reduction that does not need traction-countertraction or special positioning and can be safely and effectively performed by one surgeon. Fifteen patients, mean age 36.4 years, were subjected to reduction. ⋯ One hip could not be reduced due to incarceration of a posterior wall fragment and was managed by open reduction and internal fixation. Our new technique has proved to be a reliable, safe and effective alternative for closed reduction of posterior hip dislocations. It can be carried out by one surgeon, does not need traction and can be especially beneficial in polytrauma patients and also in those patients who have pelvic fractures and ipsilateral lower limb injuries.
-
Elevated cobalt and chromium ion concentrations have been associated with the use of metal-on-metal bearings in hip arthroplasty. The use of a differential hardness bearing may reduce metal particle release. The aim of our study was to compare circulating cobalt (Co) and chromium (Cr) ion levels between patients treated with a standard all 'as-cast' heat treated bearing and a differential hardness bearing. ⋯ Compared with conventional heat-treated CoCr bearings, differential hardness metal-on metal bearings do not confirm in vivo the hopes of a substantial reduction in circulating metal ions concentrations suggested by in vitro wear studies.