Hip international : the journal of clinical and experimental research on hip pathology and therapy
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Performance-based outcome measures are becoming increasingly important in health care. The 2-minute walk test (2MWT) and the Timed Up and Go test (TUG) are frequently used in clinical trials as performance-based tests in many diseases including osteoarthritis. The purposes of this study were: (1) to determine test-retest reliability of data for the 2MWT and the TUG; (2) to determine minimal detectable change (MDC) scores for the TUG and 2MWT in patients with total hip arthroplasty (THA). ⋯ Clinicians and researchers can be confident that greater changes than 1.62 seconds for TUG and 17.56 m for the 2MWT over time represent a real clinical change in rehabilitation process in patients with THA. Both the 2MWT and TUG may assist in early identification of patients who may need additional rehabilitation to reduce the potential for poor outcomes after THA. Therefore, both of these tests can be used in a clinical setting with a small measurement error.
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Meta Analysis
Outcomes of total hip arthroplasty using dual-mobility cups for femoral neck fractures: a systematic review and meta-analysis.
Femoral neck fractures (FNFs), with up to 15% mortality, are prominent orthopaedic emergencies. After treating FNFs, dislocation is another challenge increasing morbidity, mortality and treatment costs substantially. The emerging dual-mobility cup (DMC) may decrease dislocation rates following total hip arthroplasty (THA) for FNFs. We performed a systematic review of literature reporting dislocation and mortality rates with DMC-THA for the treatment of FNFs. ⋯ The mean dislocation and mortality rates in DMC-THA are lower than previously reported rates for THA with single cup and comparable to unipolar and bipolar hemiarthroplasty. Further research involving randomised control trials to assess differences in outcomes, longevity and cost-effectiveness needs to be conducted to make recommendations for the use of DMC in treating FNFs.
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A new regional anaesthetic technique, coined the pericapsular nerve group (PENG) block, targets the anterior hip capsule by blocking the articular branches of the femoral nerve and accessory obturator nerve. In this study, we evaluated: (1) patient outcomes; (2) postoperative pain scores; and (3) postoperative opioid consumption in total hip arthroplasty (THA) patients who received a PENG block in comparison to a control group. ⋯ Our findings suggest that the PENG block has the potential of impacting THA recovery pathways and contributing to cost savings. Thus, its use further supports the transition to the outpatient setting and drives us towards achieving value-driven healthcare.
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Long-term use of bisphosphonates (BPs) has been associated with a specific type of tensile side femoral stress fracture known as Atypical Femoral Fracture (AFF). Theoretically periprosthetic femoral fractures (PFF) should be excluded from the diagnosis of AFF. However, emerging evidence correlates prolonged BPs use with the occurrence of a type of PFF with an atypical pattern (atypical PFF, APFF). The aim of the present study is to report 3 cases of APFF treated at a single centre. ⋯ Despite occurring around a hip stem like PFF, APFF had peculiar clinical and radiographic features, making them more similar to AFF. Therefore, the orthopaedic surgeon should also consider the natural history and healing problems associated with AFF prior in order to choose the most appropriate management for APFF.
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The aim of the study was to evaluate the mortality and the outcomes of femoral revision in periprosthetic femoral fractures (PFF) using a titanium modular fluted tapered stem. ⋯ Femoral revision with a modular fluted tapered stem in patients with periprosthetic fractures results in good clinical and radiological outcomes. However, mortality remains high and, despite the modularity design, dislocation is the most frequent complication.