Harris Hip Function Score Research Articles

A comparison of navigational and traditional dynamic hip screw fixations for intertrochanteric fractures in elderly patients

Objective To compare the navigational and traditional dynamic hip screw （DHS） fixations in the treatment of intertrochanteric fractures in elderly patients. Methods A retrospective study was conducted to analyze the elderly patients with intertrochanterie fracture who had been treated in our department from April 2005 to April 2007 and whose clinical data were complete. Enrolled in the present study were 25 cases that had received navigational DHS fixation and 31 cases who had received traditional DHS fixation. In navigational group, there were 10 males and 15 females, with an average age of 82. 1 years. They were 14 cases of Evans type Ⅰ and 11 Evans type Ⅱ. In traditional group, there were 12 males and 19 females, with an average age of 82.8 years. They were 16 cases of Evans type Ⅰand 15 Evans type Ⅱ. The 2 groups were compared in incision length, operation time, bleeding volume, X-ray exposure time, bed-ridden time, medical and implant complications, and one-year functional recovery. Results In navigational group, 23 patients were followed for 11 to 20 （average, 14） months and 2 were lost. In traditional group, 30 patients were followed up for 14 to 23 （average, 18） months and 1 died from cardiovascular disease within 1 year. Compared with traditional group, navigational group had a smaller incision, less blood loss, shorter bed-ridden time and less X-ray exposure time, a higher rate of fracture healing at 3 months, with statistically significant differences （ P 〈 0.05）. The Harris hip function scores at postoperative 1 year were of no significant difference between the 2 groups （ P 〉 0. 05） . In navigational group there were 3 medical and 1 implant complications. In traditional group there were 9 medical and 5 implant complications. There was no significant difference between the 2 groups （ P 〉 0.05）. Conclusion In the treatment of intertrochanterie fractures for the elderly patients, the navigational DHS fixation is superior to traditional DHS fixation due to its advantages of smaller incision, less blood loss, shorter bed-ridden time, faster fracture healing and better functional recovery. Key words: Hip fracture; Dynamic hip screw; Surgery, computer-assisted; Aged

The influence of pre-operative factors on the length of in-patient stay following primary total hip replacement for osteoarthritis

We analysed which pre-operative factors could be used to predict the length of in-patient stay following unilateral primary total hip replacement undertaken for osteoarthritis. Data were collected prospectively from 2302 patients undergoing primary total hip replacement over a nine-year period. The relationships between the various pre-operative factors and length of stay were studied separately using either Student's t-test or Pearson's correlation, and then subjected to multiple linear regression analysis. The mean length of stay was 8.1 days (median 7; 3 to 58). After adjusting for the effects of other pre-operative factors, younger age, male gender, higher combined Harris hip function and activity score, higher general health perception dimension of the Short-Form 36 score, and non-steroidal anti-inflammatory drug use were all found to be significantly associated with a reduced length of stay.

Progressive subsidence of a tapered, proximally coated femoral stem in total hip arthroplasty

The purpose of this study was to determine if subsidence of a tapered, proximally porous- and hydroxyapatite-coated femoral implant with immediate postoperative weight-bearing differed between men and women. Modified Harris Hip Pain and Function Scores were collected preoperatively, and six weeks and one year postoperatively. Femoral subsidence was determined at six weeks and one year after surgery. Men demonstrated significantly increased Harris Hip Function Scores at six weeks, with slightly inferior Harris Hip Pain Scores at one year. Regardless of sex, subsidence was greater at one year than at six weeks; however, men subsided significantly more at one year than women (1.7 +/- 2.0 mm vs 1.0 +/- 1.4 mm, p = 0.03). While it appears that this stem provided excellent early fixation in women, it is unclear if the increased subsidence in men was more related to patient-related factors of age, weight and activity level or with specific implant characteristics.

Metal-on-Metal Hip Resurfacing Compares Favorably with THA at 2 Years Followup

Metal-on-metal total hip resurfacing is a bone-conserving reconstructive option for patients with advanced articular damage. While intended to address several problems with conventional THA, the safety and efficacy is not well established. We therefore retrospectively compared the outcomes of 52 patients (57 hips) with resurfacing arthroplasty to 84 patients (93 hips) with cementless primary THAs. The patients had a minimum 2-year followup (mean 3 years). The patients with resurfacing arthroplasty had a mean age of 47 years (range, 22-64) while those with cementless primary THA had a mean age of 57 years (range, 17-92). After controlling for age, gender, and preoperative differences, the total Harris Hip Scores (HHS), function scores, and pain scores were similar between the two groups. However, the resurfacing group had higher activity scores (14 versus 13, p < 0.001) and range of motion (ROM) scores (5.0 versus 4.8, p < 0.001). The complication rates (5.3% for resurfacing versus 14.0% for THA) and reoperation rates (3.5% for resurfacing versus 4.3% for THA) were similar. The total hip arthroplasty and metal-on-metal resurfacing groups both showed improvement in HHS, pain, activity, and ROM and had similar early complication and reoperation rates.

A Clinical, Radiographic, and Cost Comparison of Cerclage Techniques: Wires vs Cables

The cerclage technique is used to secure femoral fractures, allografts, and plates. It is not clear whether wires or cables are better suited for this technique. A retrospective radiographic review of the 6460 total hip arthroplasties done between 1986 and 2003 was performed. Wires/cables were used in 249 hips. It was found that one cable was broken (0.92%) compared with 11 wires (1.72%) ( P < .5373). It was found that there was no statistical difference in Harris hip function or pain scores between patients with wires and those with cables or between those with broken wires/cables and those without broken wires/cables. The Luque wires, which cost $29.79 each, performed equally to the cables, which cost $275.40 each, suggesting that wiring may be the preferred cerclage technique.