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1.
Sci Rep ; 10(1): 21233, 2020 12 04.
Article in English | MEDLINE | ID: mdl-33277508

ABSTRACT

"Fast-track" protocols has improved surgical care with a reduction in length of hospital stay (LOS) in total hip (THA) and knee arthroplasty (TKA). However, the effects of continuous refinement of perioperative care lack detailed assessment. We studied time-related changes in LOS and morbidity after THA and TKA within a collaboration with continuous scientific refinement of perioperative care. Prospective multicentre consecutive cohort study between 2010 and 2017 from nine high-volume orthopaedic centres with established fast-track THA and TKA protocols. Prospective collection of comorbidities and complete 90-day follow-up from the Danish National Patient Registry and medical records. Of 36,935 procedures median age was 69 [62 to 75] years and 58% women. LOS declined from three [two to three] days in 2010 to one [one to two] day in 2017. LOS > 4 days due to "medical" or "surgical" complications, and "with no recorded morbidity" declined from 4.4 to 2.7%, 1.5 to 0.6%, and 3.8 to 1.3%, respectively. 90-days readmission rate declined from 8.6 to 7.7%. Our multicentre study in a socialized healthcare setting was associated with a continuous reduction in LOS and morbidity after THA and TKA.


Subject(s)
Arthroplasty, Replacement, Hip/adverse effects , Arthroplasty, Replacement, Knee/adverse effects , Aged , Arthroplasty, Replacement, Hip/history , Arthroplasty, Replacement, Hip/mortality , Arthroplasty, Replacement, Knee/history , Arthroplasty, Replacement, Knee/mortality , Cohort Studies , Female , History, 21st Century , Humans , Length of Stay/statistics & numerical data , Male , Middle Aged , Morbidity , Observational Studies as Topic , Patient Readmission/statistics & numerical data , Postoperative Complications/etiology , Prospective Studies
3.
Unfallchirurg ; 120(5): 367-370, 2017 May.
Article in German | MEDLINE | ID: mdl-28144690

ABSTRACT

The aim of implantation of cementless hip prostheses is vital ingrowth of bone into the structured metal surface of the implant. Since the 1960s several implants with surfaces made of cobalt-based alloys have been produced for this purpose. In the 1980s a novel hip endoprosthesis with a spongiosa-metal surface was introduced. The three-dimensional ingrowth of bone tissue into the structured surface of the implant could be demonstrated both histologically and using scanning electron microscopy (SEM). These implants made of cobalt-based alloys can also be used in endo-exo prostheses. Titanium implants with a microstructured surface have also been used and very good osseintegration of the surface was also demonstrated by histomorphology. The optimization of the surface and design of the prostheses plays an increasingly more important role in the field of revision endoprostheses.


Subject(s)
Arthroplasty, Replacement, Hip/history , Hip Joint/surgery , Hip Prosthesis/history , Joint Diseases/history , Osseointegration , Prosthesis Design/history , History, 20th Century , History, 21st Century , Humans , Internationality
4.
Int Orthop ; 41(3): 611-618, 2017 Mar.
Article in English | MEDLINE | ID: mdl-27990600

ABSTRACT

INTRODUCTION: Since 1962, the low friction arthroplasty developed by Sir John Charnley has given us very good long terms results at more than 40 years follow up, but dislocation remains a major complication. The dislocation rate is a permanent risk during the life of the patient and the prosthesis, defined by J. Caton and D. Berry in 2004 as a cumulative risk. History and concept development: The concept of dual mobility was thought up by G. Bousquet, A. Rambert and J. Rieu in the 1970s (1974-1979). The first one in 1979 was called NOVAE and combined two articulations: one large and one smaller by a recruitement phenomenon increasing the jumps distance and so decreasing dislocation forces. In 2003, D. Noyer published the first paper about the «third articulation¼: a true metal/PE bearing. Since 1996, twenty years after the first patent, many dual mobility cups have been developed with various fixation ways and various designs. CONCLUSION: Today with the same principles there are many differences for the «third generation¼ with excellent results at more than ten years FU with less than 1% to 2% dislocation rate in primary, revision, recurrent THA dislocation and THA after femoral neck fractures.


Subject(s)
Arthroplasty, Replacement, Hip/history , Hip Dislocation/history , Hip Prosthesis/adverse effects , Arthroplasty, Replacement, Hip/adverse effects , Arthroplasty, Replacement, Hip/methods , Hip Dislocation/etiology , Hip Dislocation/surgery , History, 20th Century , History, 21st Century , Humans , Prosthesis Design , Prosthesis Failure
6.
Arch Orthop Trauma Surg ; 136(7): 1007-14, 2016 Jul.
Article in English | MEDLINE | ID: mdl-27139185

ABSTRACT

After the low friction arthroplasty by John Charnley was no longer confined to specialized hospitals but commonplace in the general orthopedic practice, the issue remained how to most optimally reach the hip. The names of the authors of these approaches remain in a lot of cases connected to the approach. By evaluating the original articles in which the approaches are described we ascertain the original description and technique. By various sources we obtained the (short) biography of the people whose name is connected to the approach. Our research covers the biographies of colleagues Smith-Petersen, Watson-Jones, Hardinge, Charnley, Moore and Ludloff. The eponymous approaches are shown and described after the short biography on each individual. This study shows that without the work of our colleagues we cannot proceed in our profession. An understanding and knowledge of the people who dedicated themselves to developing the orthopedic surgery to the high standard it has today is the least honour we should give them.


Subject(s)
Arthroplasty, Replacement, Hip/history , Hip Joint/surgery , Orthopedic Procedures/history , Arthroplasty, Replacement, Hip/methods , Eponyms , History, 19th Century , History, 20th Century , Humans , Male , Orthopedics
10.
Int Orthop ; 38(3): 655-61, 2014 Mar.
Article in English | MEDLINE | ID: mdl-24170131

ABSTRACT

In 1939, Frederick R. Thompson of New York and Austin T. Moore of South Carolina separately developed replacements for the entire ball of the hip. These were used to treat hip fractures and also certain arthritis cases. This type of hemiarthroplasty addressed the problem of the arthritic femoral head only. The diseased acetabulum (hip socket) was not replaced. This prosthesis consisted of a metal stem that was placed into the marrow cavity of the femur, connected in one piece with a metal ball fitted into the hip socket. Bohlman and Austin T. Moore (1939) collaborated for the fabrication and implantation of a custom made 12-inch-long vitallium (metal alloy invented by Venable) femoral head prosthesis for a patient with a recurrent giant cell tumour. This prosthesis functioned well and later on influenced the development of long stem femoral head prostheses.


Subject(s)
Arthroplasty, Replacement, Hip/history , Hip Prosthesis/history , Arthroplasty, Replacement, Hip/instrumentation , Arthroplasty, Replacement, Hip/methods , History, 19th Century , History, 20th Century , United States
11.
Int Orthop ; 38(1): 193-8, 2014 Jan.
Article in English | MEDLINE | ID: mdl-24173675

ABSTRACT

Dr. Marius N. Smith-Petersen, in Boston, MA, USA, introduced the mould arthroplasty (1923). He used a reactive synovial-like membrane that he found had developed around a piece of glass he had removed from a workman's back, which had been imbedded there for a year. The original design was a ball-shaped, hollow hemisphere of glass that could fit over the femoral head of the hip joint. The objective was to stimulate cartilage regeneration on both sides of the moulded glass joint. Smith-Peterson intended to remove the glass after the cartilage had been restored. Glass provided a new, smooth surface for movement, and although proving biocompatible, it could not withstand the stresses of walking and quickly failed. Smith-Petersen succeeded in his endeavour by using Vitallium alloy.


Subject(s)
Arthroplasty, Replacement, Hip/history , History, 20th Century , United States
12.
Tidsskr Nor Laegeforen ; 133(23-24): 2513-8, 2013 Dec 10.
Article in English, Norwegian | MEDLINE | ID: mdl-24326506

ABSTRACT

Modern arthroplasty is undoubtedly the greatest contribution that orthopaedic surgery has ever made to medical science. The honour for the good results achieved with total hip replacement surgery goes chiefly to the Briton John Charnley (1911-1982). However, the Norwegian Tor Aas Christiansen (1917-1981) has also earned a place in this history. He wanted to improve the operative treatment of dislocated, medial fractures of the femoral neck, and in the 1960s he constructed a hemiprosthesis. Later, he also made a total prosthesis for the hip joint. Over time, the prostheses proved to be less than successful. Nevertheless, approximately 6,500 Christiansen prostheses were fitted in Norway before a prospective Charnley vs. Christiansen study at the Coastal Hospital in Hagavik finally put an end to his prostheses in 1983. Indirectly, the study led to the establishment of a national register of hip prostheses, now the National Arthroplasty Register, at Haukeland University Hospital. Based on our personal cooperation with Christiansen, as well as original drawings and correspondence from the Polaris factory in Sandnes, we will tell the story of Christiansen's hemi- and total prostheses. These are a key element in the history of hip arthroplasty in Norway.


Subject(s)
Arthroplasty, Replacement, Hip/history , Femoral Neck Fractures/surgery , Hip Prosthesis/history , Arthroplasty, Replacement, Hip/instrumentation , Femoral Neck Fractures/history , History, 20th Century , Humans , Norway , Registries
13.
Int Orthop ; 37(11): 2313-8, 2013 Nov.
Article in English | MEDLINE | ID: mdl-23881060

ABSTRACT

Over the last two centuries, treatment of hip pathology has evolved from joint excision and osteotomies to modern total hip arthroplasty (THA), which is considered one of the most successful surgical interventions ever developed. We here review the history of hip procedures that preceded Themistocles Glück. This evaluation reminds us of the ephemeral nature of human industriousness and how medical research and procedures are not isolated developments but correlate to the social, economical, and cultural framework of their time.


Subject(s)
Arthroplasty, Replacement, Hip/history , France , History, 18th Century , History, 19th Century , History, 20th Century , Romania , United States
15.
Acta Chir Iugosl ; 60(1): 9-13, 2013.
Article in Serbian | MEDLINE | ID: mdl-24669557

ABSTRACT

November 2012 marked the 50th anniversary of the first implantation of a successful and long-lived hip endoprosthesis, which was performed by Prof Sir John Charnley in the "Centre for Hip Surgery" at a small country place in the north-west England. John Charnley (1911-1982) finished medical school at the Victoria University of Manchester in 1935, and than started training in orthopaedics at the Manchester Royal Infirmary, and completed it after the Second World War, in which he served as a volunteer. After that he continued working in the same hospital, and, apart from that he worked as a lecturer at the University of Manchester, and from 1949 as a visiting surgeon in the Wrightington Hospital. In 1958 Charnley decided to put his efforts into the development of hip replacement research and surgery, and initiated the foundation of the "Centre for Hip Surgery" with Biomechanical laboratory in the Wrightington Hospital in 1960, where the intesive basic and clinical research started, and becuase of that Charnley in 1962 left Manchester and moved with a full time practice at the Wrightington Hospital. That period of research time was not easy, there were many "trial and tribulations", but, owing to the tenacity and inventive mind of Charnley, in 1962 a new prosthesis consisting of a cemented metal stem with a 22 mm head articulating with a cemented polyethilene acetabular component, and with a low frictional torque was designed. The first such prosthesis, which later produced excellent long-term results, was implanted on November 22nd, 1962, and today, when we look back over a distance of fifty years, we can conclude that that day could be considered as a beginning of a modem aloarthroplastic surgery, and certainly as one of the greatest orthopaedic advance in the whole of the 20th century; and all that was initiated and promoted by Prof. Sir John Charnley.


Subject(s)
Arthroplasty, Replacement, Hip/history , Hip Prosthesis/history , England , History, 20th Century
16.
Med Glas (Zenica) ; 9(1): 136-42, 2012 Feb.
Article in English | MEDLINE | ID: mdl-22634928

ABSTRACT

Since the 1960s total hip arthroplasty (THA) has represented one of the greatest accomplishments in orthopedic surgery. It improves the functionality, working ability and quality of life of patients with non-functional hip joint due to various reasons. This article reviews general and regional history of THA, current knowledge and concepts regarding the long-term outcomes of the procedure and emphasizes the need for establishing national (and international) THA registries as an essential way of gathering data critical for decision making in daily practice as well as in defining national healthcare policies in respect to arthroplasty procedures.


Subject(s)
Arthroplasty, Replacement, Hip/history , Hip Prosthesis/history , History, 20th Century , History, 21st Century , Humans , Prosthesis Failure , Survival Analysis
17.
Rev Med Suisse ; 8(367): 2429-32, 2012 Dec 19.
Article in French | MEDLINE | ID: mdl-23346746

ABSTRACT

Total hip replacement has seen a tremendous development and has become one of the most successful surgical interventions in orthopaedics. While during the first decades of development of total hip arthroplasty the fixation of the implant into the bone was the main concern, the focus has shifted towards surgical technique and soft tissue handling. In order to avoid permanent soft tissue damage, muscular dysfunction and concerns in regards to cosmetics, minimal invasive and anatomic approaches have been developed. We here provide a short overview on various methods of total hip replacements and we describe our technique through a minimal invasive direct anterior approach. While muscle and nerve damage is minimal, this technique allows for a rapid rehabilitation and is associated with an excellent functional outcome and a minimal risk for dislocation.


Subject(s)
Arthroplasty, Replacement, Hip/methods , Minimally Invasive Surgical Procedures/methods , Arthroplasty, Replacement, Hip/economics , Arthroplasty, Replacement, Hip/history , Arthroplasty, Replacement, Hip/trends , Cost-Benefit Analysis , Femur Head/surgery , Hip Joint/surgery , History, 20th Century , History, 21st Century , Humans , Minimally Invasive Surgical Procedures/economics , Patient Satisfaction , Postoperative Complications/diagnosis , Postoperative Complications/epidemiology , Postoperative Complications/prevention & control
19.
Public Adm ; 89(3): 956-74, 2011.
Article in English | MEDLINE | ID: mdl-22165152

ABSTRACT

In terms of clinical procedures (to take the example used in this article, hip operations), both public and private organizations provide highly professionalized services. For this service type, our knowledge about ownership differences is sparse. To begin to fill this gap, we investigate how the ownership of hip clinics affects professional behaviour, treatment quality and patient satisfaction. The comparison of private and public hip clinics is based on data from the Danish Hip Arthroplasty Register and the Danish Central Patient Register combined with 20 semi-structured interviews. We find that private clinics employ stronger individual financial incentives and try harder to increase the income/costs ratio than do public clinics. Private clinics optimize non-clinical factors such as waiting time much more than public clinics and have fewer complication-prone patients than public clinics. However, the clinical procedures are very similar in the two types of clinics. Private clinics do not achieve better clinical results, but patient satisfaction is nevertheless higher with private clinics. The implication is that ownership matters for highly professionalized services, but professionalism neutralizes some ­ but not all ­ ownership differences.


Subject(s)
Ambulatory Care Facilities , Arthroplasty, Replacement, Hip , Delivery of Health Care , Health Care Costs , Health Services , Socioeconomic Factors , Ambulatory Care Facilities/economics , Ambulatory Care Facilities/history , Arthroplasty, Replacement, Hip/economics , Arthroplasty, Replacement, Hip/history , Delivery of Health Care/economics , Delivery of Health Care/ethnology , Delivery of Health Care/history , Delivery of Health Care/legislation & jurisprudence , Denmark/ethnology , Health Care Costs/history , Health Services/economics , Health Services/history , Health Services/legislation & jurisprudence , History, 20th Century , History, 21st Century , Professional Role/history , Professional Role/psychology , Socioeconomic Factors/history , Specialties, Surgical/economics , Specialties, Surgical/education , Specialties, Surgical/history
20.
Ned Tijdschr Geneeskd ; 155(38): A3564, 2011.
Article in Dutch | MEDLINE | ID: mdl-21939571

ABSTRACT

Sir John Charnley (1911-1982), pioneer of the total hip prosthesis, saved countless elderly people from immobility. During the Second World War he assisted Dudley Buxton, orthopaedic surgeon to the British armed forces in the Middle East, in developing new instruments and splints. After the war he first studied healing of bone fractures and the role of compression, and then completely dedicated himself to arthroplasty of the hip. Through countless experiments he found the optimal diameter for the head of the stainless steel prosthesis as well as the optimal polymer for the socket; he also advocated tight cementing of the shaft into the femur. Sir John Charnley received the Lasker Award in 1974 and was knighted in 1977.


Subject(s)
Arthroplasty, Replacement, Hip/history , Hip Prosthesis/history , History, 20th Century , Humans , United Kingdom
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