Clinical evaluation of total hip arthroplasty for osteoarthropathy secondary to septic hip arthritis.

To investigate the clinical efficacy and prognosis of total hip arthroplasty (THA) in patients with osteoarthropathy secondary to septic hip arthritis. A total of 100 patients with osteoarthropathy secondary to septic hip arthritis who underwent surgery in our hospital from December 2010 to December 2021 were selected. Operative data were summarized. Moreover, preoperative and postoperative differences in Harris score, Western Ontario and McMaster Universities Osteoarthritis Index score, Visual Analogue Scale score, hip mobility were compared. Due to hospital transfer, the epidemic of COVID-2019 and other reasons, 10 patients were lost to follow-up and finally 90 patients were recorded. According to the results, the mean operation time (OT) was 1.78 ± 0.32 (hour), the mean intraoperative blood loss (BL) was 586.62 ± 31.66 (mL), the mean red blood cell (RBC) transfusion was 3.84 ± 0.75 (U), and 2 cases were positive, and 88 cases were negative for Trendelenburg sign. Postoperatively, the unequal length of the lower limbs and the Visual Analogue Scale score were significantly lower than that of the preoperative, while the Western Ontario and McMaster Universities Osteoarthritis Index score, Harris score, and hip joint range of motion were significantly higher than those of the preoperative (P < .05). At the last follow-up, all the incisions healed with no deep infections, 1 case suffered from transient sciatic nerve palsy, 2 cases had intermuscular venous thrombosis, and 2 cases who occurred hip dislocation recovered after treatment. THA surgery for osteoarthropathy secondary to septic hip arthritis has a good effect, relieving the patient's pain effectively, improving prognosis and joint mobility. For osteoarthropathy secondary to septic hip arthritis, THA may be meaningful in terms of prognosis.

UK poSt Arthroplasty Follow-up rEcommendations (UK SAFE): what does analysis of linked, routinely collected national data sets tell us about mid-late term revision risk after hip replacement? Retrospective cohort study.

OBJECTIVE: To identify patients at risk of mid-late term revision of hip replacement to inform targeted follow-up. DESIGN: Analysis of linked national data sets from primary and secondary care (Clinical Practice Research Datalink (CPRD-GOLD); National Joint Registry (NJR); English Hospital Episode Statistics (HES); Patient-Reported Outcome Measures (PROMs)). PARTICIPANTS: Primary elective total hip replacement (THR) aged≥18. EVENT OF INTEREST: Revision surgery≥5 years (mid-late term) after primary THR. STATISTICAL METHODS: Cox regression modelling to ascertain risk factors of mid-late term revision. HR and 95% CI assessed association of sociodemographic factors, comorbidities, medication, surgical variables and PROMs with mid-late term revision. RESULTS: NJR-HES-PROMs data were available from 2008 to 2011 on 142 275 THR; mean age 70.0 years and 61.9% female. CPRD GOLD-HES data covered 1995-2011 on 17 047 THR; mean age 68.4 years, 61.8% female. Patients had minimum 5 years postprimary surgery to end 2016. In NJR-HES-PROMS data, there were 3582 (2.5%) revisions, median time-to-revision after primary surgery 1.9 years (range 0.01-8.7), with 598 (0.4%) mid-late term revisions; in CPRD GOLD, 982 (5.8%) revisions, median time-to-revision 5.3 years (range 0-20), with 520 (3.1%) mid-late term revisions.Reduced risk of mid-late term revision was associated with older age at primary surgery (HR: 0.96; 95% CI: 0.95 to 0.96); better 6-month postoperative pain/function scores (HR: 0.35; 95% CI: 0.27 to 0.46); use of ceramic-on-ceramic (HR: 0.73; 95% CI: 0.56 to 0.95) or ceramic-on-polyethylene (HR: 0.76; 95% CI: 0.58 to 1.00) bearing surfaces.Increased risk of mid-late term revision was associated with the use of antidepressants (HR: 1.32; 95% CI: 1.09 to 1.59), glucocorticoid injections (HR: 1.33; 95% CI: 1.06 to 1.67) and femoral head size≥44 mm (HR: 2.56; 95% CI: 1.09 to 6.02)No association of gender, obesity or Index of Multiple Deprivation was observed. CONCLUSION: The risk of mid-late term THR is associated with age at primary surgery, 6-month postoperative pain and function and implant factors. Further work is needed to explore the associations with prescription medications observed in our data.

Orthopedics and 3D technology in Turkey: A preliminary report.

OBJECTIVES: In this study, we present the use of case specific three-dimensional (3D) printed plastic models and custom-made acetabular implants in orthopedic surgery. MATERIALS AND METHODS: Between March 2018 and September 2020, surgeries were simulated using plastic models manufactured by 3D printers on the two patients with pilon fractures. Also, custom-made acetabular implants were used on two patients with an acetabular bone defect for the revision of total hip arthroplasty (THA). RESULTS: More comfortable surgeries were experienced in pilon fractures using preoperative plastic models. Similarly, during the follow-up period, the patients that applied custom-made acetabular implants showed a fixed and well-positioning in radiographic examination. These patients did not experience any surgical complications and achieved an excellent recovery. CONCLUSION: Preoperative surgical simulation with 3D printed models can increase the comfort of fracture surgeries. Also, custom-made 3D printed acetabular implants can perform an important task in patients treated with revision THA surgery due to severe acetabular defects.