Reducing the failure rate of hip resurfacing in dysplasia patients
Arthritis secondary to developmental hip dysplasia often mandates implant surgery at a relatively young age. Hip resurfacing arthroplasty (HRA), compared with standard stemmed total hip arthroplasty (THA), affords a more active lifestyle including extreme-motion activities but stimulates concerns pertaining to implant failure.
We addressed the primary modes of failure through a series of interventions, including a new guideline for achieving proper implant alignment through intraoperative x-rays. We then compared two sequential cohorts in a single-surgeon practice: patients with developmental dysplasia who underwent HRA before (Group 1; 121 hips in 105 patients) and after (Group 2; 242 hips in 210 patients) June 2008, at which time the four interventions were all in place.
Fig. 1. Kaplan-Meier survivorship curves for pre-2008 (Group 1) and post-2008 (Group 2) resurfacing procedures on dysplasia patients. Revision of any component was used as endpoint. Plus signs represent censored deaths unrelated to the patient’s hip surgery. (*statistically significant)
Implants in Group 2 failed less frequently within two years (0.8% vs. 6.6%, p = 0.002) and were more likely to have projected seven-year Kaplan-Meier survivorship (99% vs. 89%, p < 0.0001 by log-rank test). Patients in Group 2 were more likely to have normal metal ion levels (77% vs. 56%, p = 0.0008) and optimum metal ion levels (99% vs. 86%, p = 0.0008). Patients in Group 2 also benefited from a 19-minute decrease in mean operation time, a 45% decrease in mean estimated blood loss, and a 0.9-day decrease in mean hospital stay (p < 0.0001 in each instance).
We believe the interventions reported here, combined with sufficient surgeon experience and properly designed implants, afford patients with mild developmental dysplasia a more active lifestyle with favorable implant survival.
Dani Gaillard
Midlands Orthopaedics & Neurosurgery, Columbia, SC, USA
Publication
Reducing the failure rate of hip resurfacing in dysplasia patients: a retrospective analysis of 363 cases.
Gaillard MD, Gross TP
BMC Musculoskelet Disord. 2016 Jun 7
Related Articles:
 | Improving assessment of arthritis models to better… Rheumatoid Arthritis (RA) is a common inflammatory disease that is characterized by swelling and tenderness of multiple joints. The resulting pain and joint stiffness cause disability for patients and treatment… |
 | Looking inside the heart: how multiple chronic… The aim of this study was to understand how having several ongoing health problems—what we refer to as multimorbidity—impacts the heart in people with cardiovascular disease, especially those undergoing heart… |
 | Unlocking new treatments for bone diseases: using… Despite appearances, bones are a constantly changing organ in the body. Cells that produce new bone (named osteoblasts) and cells that break down bone (named osteoclasts) work in harmony to… |
 | Does UV-B radiation modify gene expression? Frequently the harsh environmental conditions, such as, high temperatures, low freezing conditions, high levels of PAR and UV-B sun radiation induce remarkable adaptive reactions in plants. These responses suggest that… |
 | UCLA researchers pioneer AI-based tissue staining to… Los Angeles, CA – September 10, 2024 – Researchers at the University of California, Los Angeles (UCLA) have pioneered a groundbreaking approach in the imaging and detection of amyloid deposits… |
 | Mortality risk among cocaine users after and before… This study targeted residents in northern Italy who turned to a public treatment centre for primary cocaine use between 1982 and 2016. Its aims were to estimate mortality risk, and… |
Leave a Reply
You must be logged in to post a comment.