The Experts below are selected from a list of 101358 Experts worldwide ranked by ideXlab platform
Jos J. A. M. Raay - One of the best experts on this subject based on the ideXlab platform.
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No clinical difference between large metal-on-metal total Hip Arthroplasty and 28-mm-head total Hip Arthroplasty?
International Orthopaedics, 2011Co-Authors: Wierd P. Zijlstra, Inge Akker-scheek, Jos J. A. M. RaayAbstract:Purpose We aimed to test the claim of greater range of motion (ROM) with large femoral head metal-on-metal total Hip Arthroplasty. Methods We compared 28-mm metal-on-polyethylene (MP) total Hip Arthroplasty with large femoral head metal-on-metal (MM) total Hip Arthroplasty in a randomised clinical trial. ROM one year postoperatively was determined in 50 patients. Mean head sizes were 28 mm (MP) and 48 mm (MM). Results After one year, the large head MM group showed greater improvement in internal rotation (14 degrees) than the 28 mm group (seven degrees).There were no significant differences in the absolute values of postoperative internal rotation, external rotation, flexion, extension, abduction and abduction. Conclusions Absolute postoperative range of motion did not differ between the two groups. The improvement in internal rotation was greater after large femoral head metal-on-metal total Hip Arthroplasty. It is however questionable whether this difference is clinically relevant.
Kevin J Bozic - One of the best experts on this subject based on the ideXlab platform.
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the epidemiology of revision total Hip Arthroplasty in the united states
Journal of Bone and Joint Surgery American Volume, 2009Co-Authors: Kevin J Bozic, Thomas P. Vail, Steven M Kurtz, Daniel J BerryAbstract:Background: Understanding the causes of failure and the types of revision total Hip Arthroplasty performed is essential for guiding research, implant design, clinical decision-making, and health-care policy. The purpose of the present study was to evaluate the mechanisms of failure and the types of revision total Hip Arthroplasty procedures performed in the United States with use of newly implemented ICD-9-CM (International Classification of Diseases, Ninth Revision, Clinical Modification) diagnosis and procedure codes related specifically to revision total Hip Arthroplasty in a large, nationally representative population. Methods: The Healthcare Cost and Utilization Project Nationwide Inpatient Sample database was used to analyze clinical, demographic, and economic data from 51,345 revision total Hip Arthroplasty procedures performed between October 1, 2005, and December 31, 2006. The prevalence of revision procedures was calculated for population subgroups in the United States that were stratified according to age, sex, diagnosis, census region, primary payer class, and type of hospital. The cause of failure, the average length of stay, and total charges were also determined for each type of revision Arthroplasty procedure. Results: The most common type of revision total Hip Arthroplasty procedure performed was all-component revision (41.1%), and the most common causes of revision were instability/dislocation (22.5%), mechanical loosening (19.7%), and infection (14.8%). Revision total Hip Arthroplasty procedures were most commonly performed in large, urban, nonteaching hospitals for Medicare patients seventy-five to eighty-four years of age. The average length of hospital stay for all types of revision arthroplasties was 6.2 days, and the average total charges were $54,553. However, the average length of stay, average charges, and procedure frequencies varied considerably according to census region, hospital type, and type of revision total Hip Arthroplasty procedure performed. Conclusions: Hip instability and mechanical loosening are the most common indications for revision total Hip Arthroplasty in the United States. As further experience is gained with the new diagnosis and procedure codes specifically related to revision total Hip Arthroplasty, this information will be valuable in directing future research, implant design, and clinical decision-making. Level of Evidence: Prognostic Level II. See Instructions to Authors for a complete description of levels of evidence.
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the impact of infection after total Hip Arthroplasty on hospital and surgeon resource utilization
Journal of Bone and Joint Surgery American Volume, 2005Co-Authors: Kevin J Bozic, Michael D RiesAbstract:Background: Deep infection following total Hip Arthroplasty is a devastating complication for the patient and a costly one for patients, surgeons, hospitals, and payers. The purpose of this study was to compare revision total Hip Arthroplasty for infection, revision total Hip Arthroplasty for aseptic loosening, and primary total Hip Arthroplasty with respect to their impact on hospital and surgeon resource utilization and referral patterns to a tertiary-care hospital. Methods: Clinical, demographic, and economic data were obtained for twenty-five consecutive patients with an infection after a total Hip replacement who underwent a two-stage revision Arthroplasty (Group 1) performed by one of two surgeons, between March 2001 and December 2002, at a single institution. Similar data were collected during the same time-period for a cohort of twenty-five consecutive patients who underwent revision of both components because of aseptic loosening (Group 2) and twenty-five consecutive patients who underwent a primary Hip Arthroplasty (Group 3). Quantitative and categorical variables were compared among the groups. Referral patterns were examined by reviewing the primary diagnosis for all patients referred to our institution for a revision total Hip Arthroplasty during a five-year period. Results: Revision procedures for infection were associated with longer operative time, more blood loss, and a higher number of complications compared with revisions for aseptic loosening or primary total Hip Arthroplasty (p < 0.02 for all). Revisions for infection were also associated with a higher total number of hospitalizations, total number of days in the hospital, total number of operations, total hospital costs, total outpatient visits, and total outpatient charges during the twelve-month period following the index procedure (p < 0.001 for all). The incidence of referrals to our institution for a diagnosis of infection following total Hip Arthroplasty increased significantly over a five-year period (Spearman rank correlation, 1.0; p = 0.0083), while referral rates for revision for causes other than infection remained relatively constant (Spearman rank correlation, 0.500; p = 0.3910). Conclusions: The treatment of patients with an infection after a total Hip Arthroplasty is associated with significantly greater hospital and physician resource utilization compared with the treatment of patients who have a revision because of aseptic loosening or who have a primary total Hip Arthroplasty. We believe that the lack of incremental reimbursement associated with these procedures results in strong financial disincentives for physicians and hospitals to provide treatment for patients with an infection after a total Hip Arthroplasty.
Wierd P. Zijlstra - One of the best experts on this subject based on the ideXlab platform.
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No clinical difference between large metal-on-metal total Hip Arthroplasty and 28-mm-head total Hip Arthroplasty?
International Orthopaedics, 2011Co-Authors: Wierd P. Zijlstra, Inge Akker-scheek, Jos J. A. M. RaayAbstract:Purpose We aimed to test the claim of greater range of motion (ROM) with large femoral head metal-on-metal total Hip Arthroplasty. Methods We compared 28-mm metal-on-polyethylene (MP) total Hip Arthroplasty with large femoral head metal-on-metal (MM) total Hip Arthroplasty in a randomised clinical trial. ROM one year postoperatively was determined in 50 patients. Mean head sizes were 28 mm (MP) and 48 mm (MM). Results After one year, the large head MM group showed greater improvement in internal rotation (14 degrees) than the 28 mm group (seven degrees).There were no significant differences in the absolute values of postoperative internal rotation, external rotation, flexion, extension, abduction and abduction. Conclusions Absolute postoperative range of motion did not differ between the two groups. The improvement in internal rotation was greater after large femoral head metal-on-metal total Hip Arthroplasty. It is however questionable whether this difference is clinically relevant.
Richard N. Villar - One of the best experts on this subject based on the ideXlab platform.
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EARLY OUTCOMES OF A SHORT-STEM Hip Arthroplasty COMPARED WITH A CONVENTIONAL TOTAL Hip Arthroplasty
Journal of Bone and Joint Surgery-british Volume, 2020Co-Authors: Sachin Daivajna, Luciano Agnello, Ali Ahsan Bajwa, Richard N. VillarAbstract:Introduction Short-stem Hip Arthroplasty is gaining popularity as a method of treating Hip arthritis in biologically younger patients. The potential benefit of using a short-stem is preservation of bone in the proximal femur for a future revision. We have compared the early clinical and radiological results of a short-stem Hip Arthroplasty versus a conventional total Hip Arthroplasty (THA) using a standard length femoral prosthesis with particular focus on functional outcome. Methods We evaluated a prospectively collected data on consecutive series of 249 patients, who underwent uncemented total Hip Arthroplasty at our institution. They were distributed into 2 groups: Group I, 125 patients received an uncemented short femoral stem (Mini Hip Arthroplasty (MHA), Corin, Cirencester) and Group II, 124 patients received a conventional uncemented femoral stem (Accolade, Stryker, Michigan) with mean follow up of 3.2 years (2–4). The characteristics of the two groups have been presented in Table I. Evaluation was based on plain radiographs performed at 6 months, 1 year and 2 years postoperatively, while their clinical status was assessed using the modified Harris Hip score (mHHS) preoperatively and postoperatively at 6 weeks, 6 months, 1-year, 2-years and annually thereafter. Results The outcome measures and complications in the two groups are presented in Table II. The mHHS was split into their two components (pain and function) to evaluate any differences between the groups. The postoperative results for pain were similar in both groups (p > 0.05), but the functional element of mHHS was significantly better (p Conclusion Our study suggests that the results of short-stem Hip Arthroplasty are comparable to conventional uncemented THA in the short-term. The functional outcome scores appear to be better in the short-stem group compared to the conventional group, but the difference is not clinically relevant. Short-stem Hip Arthroplasty can be an optimal choice for use in younger patients with good bone quality, who are expected to require revision in the future.
Thomas P. Vail - One of the best experts on this subject based on the ideXlab platform.
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Approaches in primary total Hip Arthroplasty.
Journal of Bone and Joint Surgery American Volume, 2009Co-Authors: Thomas P. Vail, E. Marc Mariani, Michael H. Bourne, Richard A. Berger, R. Michael MeneghiniAbstract:• Learn the basic strategy and concepts required for successful execution of a primary total Hip Arthroplasty with use of commonly employed minimally invasive approaches • Learn the evidence supporting and questioning the minimally invasive philosophy • Learn the indications for using the minimally invasive total Hip Arthroplasty techniques.
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the epidemiology of revision total Hip Arthroplasty in the united states
Journal of Bone and Joint Surgery American Volume, 2009Co-Authors: Kevin J Bozic, Thomas P. Vail, Steven M Kurtz, Daniel J BerryAbstract:Background: Understanding the causes of failure and the types of revision total Hip Arthroplasty performed is essential for guiding research, implant design, clinical decision-making, and health-care policy. The purpose of the present study was to evaluate the mechanisms of failure and the types of revision total Hip Arthroplasty procedures performed in the United States with use of newly implemented ICD-9-CM (International Classification of Diseases, Ninth Revision, Clinical Modification) diagnosis and procedure codes related specifically to revision total Hip Arthroplasty in a large, nationally representative population. Methods: The Healthcare Cost and Utilization Project Nationwide Inpatient Sample database was used to analyze clinical, demographic, and economic data from 51,345 revision total Hip Arthroplasty procedures performed between October 1, 2005, and December 31, 2006. The prevalence of revision procedures was calculated for population subgroups in the United States that were stratified according to age, sex, diagnosis, census region, primary payer class, and type of hospital. The cause of failure, the average length of stay, and total charges were also determined for each type of revision Arthroplasty procedure. Results: The most common type of revision total Hip Arthroplasty procedure performed was all-component revision (41.1%), and the most common causes of revision were instability/dislocation (22.5%), mechanical loosening (19.7%), and infection (14.8%). Revision total Hip Arthroplasty procedures were most commonly performed in large, urban, nonteaching hospitals for Medicare patients seventy-five to eighty-four years of age. The average length of hospital stay for all types of revision arthroplasties was 6.2 days, and the average total charges were $54,553. However, the average length of stay, average charges, and procedure frequencies varied considerably according to census region, hospital type, and type of revision total Hip Arthroplasty procedure performed. Conclusions: Hip instability and mechanical loosening are the most common indications for revision total Hip Arthroplasty in the United States. As further experience is gained with the new diagnosis and procedure codes specifically related to revision total Hip Arthroplasty, this information will be valuable in directing future research, implant design, and clinical decision-making. Level of Evidence: Prognostic Level II. See Instructions to Authors for a complete description of levels of evidence.
