Hip international : the journal of clinical and experimental research on hip pathology and therapy
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Review Meta Analysis
A systematic review and meta-analysis of the use of antifibrinolytic agents in total hip arthroplasty.
Antifibrinolytic agents such as tranexamic acid (TXA), epsilon aminocaproic acid (EACA), and aprotinin are widely used to reduce bleeding and the need for transfusion in cardiac, orthopaedic, and hepatic surgery. We aimed to assess the efficacy and safety of antifibrinolytic agents in total hip arthroplasty (THA). ⋯ Our meta-analysis demonstrated that antifibrinolytic agents significantly reduce blood loss and blood transfusion requirements while not increasing the risk of DVT in patients undergoing total hip arthroplasty.
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Large-head metal-on-metal (MoM) total hip arthroplasties were introduced because of their purported advantages. Inflammatory pseudotumours occasionally occur after MoM hip arthroplasty and often lead to revision. The purpose of this study was to assess the outcome of revision of large-head MoM total hip arthroplasties after an extensive screening protocol for all MoM articulations with a minimum 2 year follow-up. ⋯ We found 6 residual masses on routine postoperative CT scans. The indication for revision of this cohort is inevitable but the clinical outcome 2 years after revision for pseudotumour is disappointing. Revising a MoM hip arthroplasty to a conventional cemented polyethylene or dual-mobility cup with bone impaction grafting and a 28 mm head can adequately treat the high ion levels and probably the disease of ARMD.
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Piriformis syndrome involves the irritation of the piriformis muscle due to various reasons that are primarily related to anatomical variation or sciatic nerve compression due to contraction caused by overuse. In this study, we aimed to define an injection method that is easy to apply, safe, simple and repeatable. ⋯ Our findings lead to the conclusion that fluoroscopy-guided percutaneous local anaesthetic and corticosteroid injection is a simple and effective piriformis syndrome treatment that can feasibly be effectively performed by orthopaedic surgeons.
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Comparative Study
Lesion of gluteal nerves and muscles in total hip arthroplasty through 3 surgical approaches. An electromyographically controlled study.
Three surgical approaches in total hip arthroplasty (THA) were compared concerning: 1) clinical and radiological results; 2) innervation of the tensor fasciae latae and gluteal muscles; 3) clinical outcome of the nerve lesions; 4) sensitivity of the EMG analysis. ⋯ Despite some disadvantages associated with the anterolateral approach, the transgluteal and posterior approaches are often connected with a partial lesion of the gluteus medius and maximus muscles. In all approaches, clinical sequelae are not significant in primary THA.
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The Harris Hip Score (HHS) is one of the most widely used health related quality of life (HRQOL) measures for the assessment of hip pathology: in spite of this, a validation study, and an official Italian version have not been provided yet. The aim of this study was to create an Italian valid and reliable version of the HHS. ⋯ Statistical and clinical analysis showed that HHS is highly valid and reliable in this new Italian version.