Hip Replacement Patients Research Articles

Incidence of symptomatic venous thromboembolism in 2372 knee and hip replacement patients after discharge: data from a thromboprophylaxis registry in Montreal, Canada.

BackgroundLow-molecular-weight heparin (LMWH) is a recommended anticoagulant for thromboprophylaxis after major orthopedic surgery. Dabigatran etexilate is an oral anticoagulant recognized as noninferior to LMWH. We aimed to assess the incidence of symptomatic venous thromboembolic events (VTEs) after discharge in patients who underwent joint replacement, using a hospital registry.Patients and methodsPatients who underwent total knee and hip arthroplasty between September 2011 and March 2015 were selected. Subcutaneous enoxaparin (30 mg twice daily) was given during hospitalization. At discharge, patients received either enoxaparin 30 mg twice daily/40 mg once daily or dabigatran 220 mg/150 mg once daily. Patients were seen or called at 2, 6, and 12 weeks after surgery. Outcomes were the number of VTEs, including deep venous thrombosis, pulmonary embolism, and the number of major/minor bleeding events after discharge.ResultsAfter discharge, 1468 patients were prescribed enoxaparin and 904 dabigatran (1396 total knee arthroplasty and 976 total hip arthroplasty patients). Mean age was 66±10 years, and 60% were female. The cumulative incidence of VTEs during the 12-week follow-up was 0.7%. One patient sustained a VTE during the switch window. Seven patients sustained a pulmonary embolism (0.3%). There was no statistical difference between the total knee arthroplasty and total hip arthroplasty groups. The incidence of major and minor bleeding events during follow-up was 0.3% and 30.3%, respectively. These events had a higher incidence in the dabigatran group compared to the enoxaparin group after discharge (p<0.05), but not between knee and hip replacement groups for major bleeding events.ConclusionA pharmaceutical prophylaxis protocol using LMWH and dabigatran during the post-discharge period resulted in low incidences of VTE and equivalence between treatments. However, the increased number of major and minor bleeding events in patients taking dabigatran is of concern regarding the safety and needs to be evaluated using analyses adjusted for risk factors.

Factors affecting the length of stay after total hip replacement; a retrospective analysis

Background: Total hip replacement is one of the most commonly performed surgical procedures. Healthcare budgets are finite. Much of the cost of total hip arthroplasty comprises the length of stay in hospital. Advancing care in joint replacement requires identification and correction of the factors affecting LOS. Materials & Methods: A retrospective case series of 299 patients of elective primary total hip replacement, performed between 04/2015 to 03/2016 in a District General Hospital to determine patient and implant related factors. Results: We looked at 299 patients. There was a clear correlation between ASA PS score and length of stay. With ASA PS Score one, LOS is three days, to ASA PS 3 = LOS five days. Effect of BMI on LOS is only significant in people with Grade III Obesity with average LOS is more than five days. Effect of age is only significant in patients above 80 years old. Patient with age range of 32 to 79 had an average LOS Four days but patient in the age group of above 80 years had an average LOS of Six days. Gender has an association with LOS in males four days and females have average LOS five days. Type of Implant shows an effect on LOS with shortest LOS four days in Uncemented Implants. Conclusions: Our study showed that LOS after THR is multi factorial. Health system resources are limited, understanding of these variables is important for more effective use of resource, safe practice and high patient satisfaction in delivery of Orthopaedic care.

The validity and reliability of the modified forgotten joint score

We aim to validate the “Modified Forgotten Joint Score” (MFJS) as a new patient-reported outcome measure (PROM) in hip and knee arthroplasty, against the UK’s gold standard Oxford Hip and Knee Scores (OHS/OKS).The original Forgotten Joint Score (FJS) (12 items) was created to assess post-arthroplasty joint awareness. We modified the FJS to 10-items to improve its reliability.Postal questionnaires were sent out to 400 total hip or knee replacement (THR/TKR) patients who were 1–2 years’ post-op, along with the OHS/OKS. Data, collected from the 212 returned questionnaires (53% response rate), was analysed in relation to construct and content validity. A sub-cohort of 77 patients took part in a test-retest repeatability study, to assess reliability of the MFJS.The MFJS proved to have an increased discriminatory power in high-performing patients in comparison to the OHS and OKS. 30.8% of TKR patients (n = 131) scored highly (87.5% or more) in the OKS compared to just 7.69% in the MFJS TKR patients. The MFJS proved to have increased test-retest repeatability, based upon its intra-class correlation coefficient of 0.968 compared to the Oxford’s 0.845, p < 0.001.The MFJS is a more relevant tool, compared to the FJS, with greater discrimination in the assessment of well performing hip and knee arthroplasties in comparison to the OHS/OKS.

The impact of an underlying inflammatory disease on the cardiovascular risk of hip or knee replacement patients

The impact of an underlying inflammatory disease on the cardiovascular risk of hip or knee replacement patients

Agreement between retrospectively and contemporaneously collected patient-reported outcome measures (PROMs) in hip and knee replacement patients

PurposeTo investigate the relationship between retrospectively and contemporaneously collected patient-reported outcome measures (PROMs) and the influence on this relationship of patients’ age and socio-economic status and the length of time.MethodsPatients undergoing hip or knee replacement in four hospitals who had completed a pre-operative questionnaire were invited to recall their pre-operative health status shortly after surgery. The questionnaires included a disease-specific (Oxford Hip Score; Oxford Knee Score) and generic (EQ-5D-3L) PROM. Consistency and absolute agreement between contemporary and retrospective reports were investigated using intraclass correlations (ICCs). Differences were visualised using Bland–Altman plots. Linear regression analysis explored whether retrospective can predict contemporary PROMs.ResultsPatients’ recalled health statuses were similar to their contemporaneous reports, with no significant systematic bias. Absolute agreement for disease-specific PROMs was very strong (ICC 0.82) and stronger than for the generic PROM (ICC 0.60, 0.62). Agreement was consistently strong across the range of severity of a patient’s condition, age and socio-economic status. Patients’ age and socio-economic status had no significant influence on size of difference and direction of recall, although reliability of recall was slightly worse among the over-75s versus under-60s for hips (Oxford Hip Score ICC 0.88 vs. 0.78). Mean retrospective PROMs for groups or populations of patients can reliably predict what mean contemporary reports of PROMs would have been.ConclusionRetrospective PROMs can be used to obtain a baseline assessment of health status when contemporary collection is not feasible or cost effective. Research is needed to determine the feasibility of retrospective PROMs in emergency admissions.

Hospital Readmission in Total Hip Replacement Patients in 2009 and 2014

ObjectiveTo document changes in 30-day hospital readmission rates and causes for returning to the hospital for care in THR patients. DesignRetrospective cross-sectional descriptive design. SettingCommunity-based acute care hospitals. ParticipantsTotal sample size (N=142,022) included THR patients (identified as ICD-9-CM procedure code 81.51) in 2009 (n=31,232) and (n=32,863) in 2014. InterventionsNot applicable. Main Outcome Measures30-Day hospital readmission. ResultsThe overall readmission rate decreased by 1.3% from 2009 to 2014. The decrease in readmission rates varied by groups, with lesser improvements seen in THR patients who were younger, with private insurance, and residing in lower-income and rural communities. Device complications were the leading cause of readmission in THR patients, increasing from 19.8% in 2009 to 23.9% in 2014. ConclusionsThere has been little decrease in hospital 30-day readmission rates for US community hospitals between 2009 and 2014. Findings from this brief report indicate patient groups at greater risk for 30-day hospital readmission as well as leading causes for readmission in THR patients which can inform the development of tailored interventions for reduction.

Hip replacement in patients younger than 65 years: Results of the CLS prosthesis:

We present the results of a retrospective review of 65 CLS uncemented total hip replacements in 47 patients all of whom were less than 65 years of age at the time of surgery. The mean follow-up was 6.5 years and only one case was lost to follow-up. The clinical results were good. The mean (95% confidence interval) Merle d'Aubigne Postel score for pain (max. 6) was 5.42 ± 1.13 (5.13 – 5.71) and for mobility (max. 6) 5.55 ± 0.71 (5.37 – 5.73). The mean score for patient satisfaction (max. 5) was 4.89 ± 0.46 (4.77 – 5.00). The mean total score was therefore 15.97 ± 1.70 (95% confidence interval 15.54 - 16.40) from a maximum of 17 points. There were three revisions over the study period giving a mean (95% confidence interval) survivorship of 96.5% (91.9% - 100%) at five years. We present the results of a radiological review, which show that the surviving implants show evidence of osseointegration. This was achieved despite the lack of a porous or hydroxyapatite coating.

Cemented total hip replacement in patients under 55 years

Background and purpose — About 86,000 total hip replacements (THR) have been registered in patients under 55 years in the National Joint Registry of England and Wales (NJR). The use of uncemented implants has increased, despite their outcomes not having been proven to be significantly better than cemented implants in this registry. We determined the implant survivorship and functional outcomes of cemented THR in patients under 55 years at a minimum follow-up of 22 years.Patients and methods — 104 hips in 100 patients were included in this prospective study. Functional outcome was assessed using the Harris Hip Score and radiographs were assessed for implant failure and “at risk” of failure. Kaplan–Meier survivorship analysis was performed.Results — 89% of hips showed good to excellent results at final follow-up with a mean Harris Hip Score of 88 at a mean follow-up of 25 years. Revision was performed in 3/104 hips. 14 acetabular components and 4 femoral components were “at risk” of failure. The survivorship at minimum 22 years with revision for any reason as the end-point was 97% (95% CI 95–98).Interpretation — Cemented hip replacements perform well in young patients with good long-term functional and radiographic outcomes.

Study of clinical and functional outcome of total hip replacement in avascular necrosis of femoral head

Avascular necrosis (AVN) of the femoral head is one of the common causes of painful hip in a young adult. Since young age is associated with high functional demand AVN may have a devastating effect on the quality of life. The natural course of this disease is one of relentless progression with eventual collapse of the femoral head followed by secondary osteoarthritic changes in the hip. The management depends upon many factors including severity and location of necrotic lesion, patient factors and probability of collapse. Total hip replacement (THR) is needed in cases of collapse of femoral head, severe pain, osteoarthritis or destruction of hip joint. However there has been debate over whether THR is a viable option for AVN considering unique pathophysiology of AVN. Moreover the factors like functional outcome after surgery implant longevity and need for revision surgeries must be considered while doing total hip arthroplasty. In this context we conducted this prospective observational study to find out the clinical and functional outcomes of THR in patients with of AVN. Aims and Objectives: To study the clinical and functional outcome of total hip replacement in avascular necrosis of femoral head. Material and methods: Patients admitted to department of orthopedics in a tertiary care hospital in a metropolitan city with diagnosis of AVN were included in the study after taking into consideration a pre-defined inclusion and exclusion criteria for the study. Sample size of 30 was considered following statistical formula and admission registry of our hospital. Patients were recruited to the study after approval from institutional ethical committee and informed consent of patients. A detailed history was taken and thorough clinical examination was done in all patients. All patients were assessed with Harris hip score and points were allocated for each components of the score, which formed base line statistics for our study. Further patients were followed up at 6 weeks, 12 weeks and 24 weeks. Patients who could not turn up to the hospital were contacted over telephone and outcome was assessed through set of questionnaire based on Harris hip score. Result: The study consisted of 30 patients diagnosed to be having avascular necrosis of head of femur. Out of these 30 patients 23 were males and 7 patients were females with a M: F ratio of 1: 0.30. The most common age group affected was 21-40 years (43.33%) followed by 41-60 years (33.33%) and 61-80 years (23.33%). Majority of the patients with AVN had a body mass index between 25 to 29.99 (36.67%). Co-morbidities like diabetes or hypertension were seen in 11 (36.67%) patients. 9 (30%) patients were having history of either alcohol consumption or smoking. 13 patients had some predisposing factor for AVN in the form of either alcohol consumption, steroid therapy, history of trauma or pregnancy and rest of the patients were found to be having idiopathic AVN. The most common presenting complaints in the studied cases were found to be pain and difficulty in walking (90%) and most of the patients (43.33%) had symptoms for more than 1 year. Majority of the patients had right hip joint involvement (56.67%) followed by left (36.67%) and only in 2 patients (6.67%) there was bilateral involvement of hip joint. Out of the study cases 28 (93.33%) patient had cemented total hip arthroplasty while non-cemented total hip arthroplasty was seen in only 2 (6.67%) patients. There was a statistically significant difference in preoperative and postoperative total Harris hip score, pain score, range of motion, gait and daily activities like climbing stairs and distance walked. Finally in this study 28 (93.33%) patients had excellent results while 2 (6.67%) had good functional outcome after total hip replacement for avascular necrosis of femoral head. Conclusion: There was significant improvement in clinical and functional outcome after Total Hip Replacement in patients with avascular necrosis of femoral head and we recommend Total hip replacement as surgical modality of treatment for Ficat and Arlet stage 3 and 4 of avascular necrosis of femoral head.

A review of wearable motion tracking systems used in rehabilitation following hip and knee replacement.

Clinical teams are under increasing pressure to facilitate early hospital discharge for total hip replacement and total knee replacement patients following surgery. A wide variety of wearable devices are being marketed to assist with rehabilitation following surgery. A review of wearable devices was undertaken to assess the evidence supporting their efficacy in assisting rehabilitation following total hip replacement and total knee replacement. A search was conducted using the electronic databases including Medline, CINAHL, Cochrane, PsycARTICLES, and PubMed of studies from January 2000 to October 2017. Five studies met the eligibility criteria, and all used an accelerometer and a gyroscope for their technology. A review of the studies found very little evidence to support the efficacy of the technology, although they show that the use of the technology is feasible. Future work should establish which wearable technology is most valuable to patients, which ones improve patient outcomes, and the most economical model for deploying the technology.

Midterm follow-up study of metal on metal total hip replacement

Background: Metallosis and pseudotumors are long discussed complications with metal on metal bearing total hip replacement which has increased the rate of revision total hip replacements in these patients. Aims and Objective: To evaluate the levels of metal ion (Cobalt and Chromium), factors affecting theses metal ion levels and incidence of pseudotumors in metal on metal total hip replacement patients. Materials And Methods: Prospective descriptive study done on 25 patients who had metal on metal bearing surface replacement and total hip replacement with a mean post-op period of 6 years. Serum metal ion levels (Cobalt and Chromium), MARS-MRI (Metal Artifact Reduction Sequence) and acetabular cup inclination angle on X-rays and functional score were recorded in theses patients on two follow-up visits with mean follow-up period of 1 year. Result: Mean cobalt was 1.64 and mean chromium was 3.06. 28% of the study population showed asymptomatic pseudotumors but were less than 5cm. Mean cup inclination angle was 41.8* on X-rays which did not have any influence on serum metal ions and functional score. Gender (Male / Female) and type of arthroplasty (Articular surface replacement / Total hip replacement) has no affect on serum metal ions. Functional scores of these metal on metal patients comparable to metal on polyethylene bearing patients. Revison total hip replacement done in one metal on metal THR patient who had a dislocated cup in his second follow-up. Conclusion: Metal on metal hip arthroplasty patients were functionally doing well like the regular metal on polyethylene patients. Chromium values were significant and higher than cobalt. Incidence of asymptomatic pseudotumors was 28%.

Results of surgical treatment of intertrochanteric and trochanteric fractures in eldery patients

Intertrochateric and trochanteric include 52 % out of all femo­ral fractures. More than 91 % of these fractures occur in peo­ple 65 years of age and older. Despite the variety of implants, the number of unsatisfactory treatment outcomes remains high. The fatal outcome due to these fractures is 12–19 % and in­creases with age.Objective: to evaluate the long-term results of metalloesteosynthesis and hip replacement in an improved method in elderly people with intertrochateric and trochanteric lfemoral fractures.Methods: 156 patients aged 61 to 94 years were examined. Joint replacement was performed in 51 patients (study group), metalloesteosynthesis with PFN, DHS, angular and LCP-plates — 105 (control). The Harris score was used to analyze long-term functional results.Results: satisfactory functional results of the treatment were obtained after the PFN and DHS — (75.13 ± 10.14) and (72.83 ± 17.36) respectively. When using angular and LCP plates, treatment was unsatis­factory — (55.71 ± 19.28) and (67.67 ± 19.73) points, respec­tively. In the group of total cement endoprosthesis, the results were evaluated as excellent — (93.0 ± 4.33) points; subtotal bipolar — good (86.53 ± 9.7) points; subtotal monopolar — satisfactory (78.23 ± 7.92) points. The total score of excellent and good results in patients in the study group was 76.47 %, the control group — 35.48 %, the poor — 5.88 % and 64.58 % respectively.Conclusion: hip joint replacement in patients over 61 years of age with intertrochateric and trochanteric fractures of the femur gives the best long-term functional results com­pared to the metalloesteosynthesis.

CUSTOM TRIFLANGE ACETABULAR COMPONENTS IN REVISION HIP REPLACEMENT (EXPERIENCE REVIEW)

Extensive defects of acetabulum especially accompanied by pelvis discontinuity at the level of acetabulum pose a serious challenge in revision hip replacement and create additional complexity in fixing the acetabular component. One of the perspective options to solve the above issue is the use of custom triflange acetabular components (CTAC) designed based on preoperative computer tomography given the specifics of bone defects of the patient. Purpose of the study — to evaluate the outcomes of CTAC use in revision hip replacement.Materials and methods. The authors analyzed treatment outcomes of 12 patients after revision hip replacement using additive techniques of computer simulation and 3D printing CTAC. Follow up period after the surgery averaged 7±3 months (from one to ten months). 7 out of 12 patients had acetabular defects of Paprosky 3B type, 4 patients had defects of Paprosky 3A and in one patient — of Paprosky 2C.Results. Two out of twelve patients had prosthesis dislocations that required revision hip surgery, one of those patients underwent open reduction of dislocation with wound debridement, another patient underwent replacement of articulating couple of acetabular component. Total scores under Harris Hip Score and paint VAS score prior to treatment was 28±7 and 7±1 points respectively, postoperative scores were 76±9 and 3±1 respectively.Conclusion. The application of additive techniques for revision hip replacement in patients with extensive acetabular and pelvic defects allows to make a precise preoperative planning, to restore joint rotation center, to reconstruct bone defects and to securely fix triflange acetabular component that altogether significantly improve treatment outcomes and patients satisfaction with the surgery.

Gait Analysis of Leg Length Discrepancy—Differentiated Hip Replacement Patients With Developmental Dysplasia: A Midterm Follow-Up

BackgroundFew studies investigate gait characteristics and symmetry of developmental dysplasia of the hip patients (Crowe II and III) after total hip arthroplasty (THA) whose leg length discrepancy (LLD) is within 20 mm. Our study aimed to explore whether gait analysis parameters in these patients can return to the level of unaffected people and how bodies compensate for the discrepancy. MethodA total of 45 patients who underwent cementless THA and 20 healthy controls were involved in this study prospectively. Group 1 includes patients whose LLD is <10 mm and group 2 includes patients whose LLD is 10-20 mm. Gait analysis was performed during 5-year midterm postoperative follow-up. ResultThe parameters, particularly the range of motion (ROM) in the hip, in both experimental groups (1 and 2) were significantly lower than healthy control group. For the nonoperated side, group 1 displayed significantly reduced ROM in the hip and knee compared with the age-matched controls. This was not observed in group 2. Greater bilateral symmetry can be seen in group 1 compared with group 2. ConclusionDespite LLD being limited to within 20 mm, THA patients in both groups showed a less efficient gait than that of healthy controls on 5-year midterm follow-up. The increased ROM in the nonoperated hip may act as a compensatory mechanism. LLD of 10 mm may be a cutoff value to assess whether compensation occurs in the contralateral limb. Reconstruction of equal limb length is recommended when surgeons perform THA for dysplastic hips.

Does mobilising total hip and knee replacement patients on the same day as surgery affect their length of stay?

Does mobilising total hip and knee replacement patients on the same day as surgery affect their length of stay?

Postoperative Myocardial Injury and Inflammation Is Not Blunted by a Trial of Atorvastatin in Orthopedic Surgery Patients.

Orthopedic patients are at risk for adverse postoperative cardiovascular outcomes. This pilot randomized controlled trial (RCT) of atorvastatin vs. placebo in orthopedic surgery patients was performed in order to assess: (1) the prevalence of perioperative myocardial injury; (2) the effect of atorvastatin on perioperative inflammation; and (3) the feasibility of performing a large RCT of statin therapy in orthopedic patients. Hip fracture (hip Fx) and total hip and knee replacement (THR and TKR) patients were randomized 1:1 to atorvastatin 40mg daily vs. placebo, starting preoperatively and continuing until postoperative day (POD) 45. High-sensitivity cardiac troponin I (hs-cTnI), high-sensitivity C-reactive protein (hs-CRP), and interleukin-6 (IL-6) were measured preoperatively and on POD 2. Patients were monitored for adverse events until POD 90. Five hundred fifty-six patients were screened, 22 were recruited (4 hip Fx, 11 THR, 7 TKR), and 2 withdrew. Most (80%) had detectable hs-cTnI (>1.1pg/mL) preoperatively. Twenty percent had a perioperative rise in hs-cTnI (≥10pg/mL), which was not blunted by atorvastatin. Hs-CRP rose in 19/20 patients, and IL-6 rose in all patients. However, atorvastatin did not blunt the rise in these inflammatory biomarkers. On POD 2, IL-6 and hs-cTnI levels correlated (ρ=0.59, p=0.02). Recruitment was limited by the high prevalence of statin use in the screened population and a high prevalence of exclusions among hip fracture patients. Perioperative myocardial injury and inflammation are common in orthopedic patients and do not appear to be reduced in those randomized to atorvastatin. NCT02197065.

Pathomorphology of the femoral head lesion and some clinical and morphological dependences in patients with dysplastic coxarthrosis

Quantitative morphological changes in the tissues of the proximal epimetaphysis of the femur with dysplastic coxarthrosis may differ from those observed in the hip joint in other diseases.Objective: based on the study of the pathohistological characteristics of the femoral head tissue and some frequency differences between them, establish correlation dependencies between clinical and morphological parameters in dysplastic coxarthrosis patients.Methods: we studied femoral head tissue in 22 patients. Clinical parameters were taken into account — the age of patients, the duration of the disease, the intensity of the pain syndrome according to the visual analogue scale. Based on the detected pathohistological changes in the tissues of the femoral head, several morphological gradation indices were taken into account, which diversify the degree of severity of dystrophic-destructive changes.Results: in the complex of pathomorphological changes in femoral head, the most significant are: deformation of the articular surface, degeneration and destruction of articular cartilage, bone-cartilaginous growths, pathology of subchondral spongiosis tissue. They occur with different frequencies and in some cases are combined at different degrees of severity. Between the individual clinical manifestations and morphological indices of the condition of the femoral head tissues, correlation dependencies are established, which should be taken into account when predicting the degree of hip joint lesion in dysplastic coxarthrosis.Conclusions: the revealed morphological features and clinical and morphological dependencies are important for planning the fixation of the femoral component of the endoprosthesis in the case of hip replacement in patients with dysplastic coxarthrosis of different time of presentation, the type of displacement of femoral head by Crowe and the degree of disruption of joint function.

Functional outcomes and survival-ship of total hip replacement in patients with Ankylosing Spondylitis: A systematic review

BackgroundAim of this systematic review was to study the current literature regarding total hip replacement (THR) in patients suffering from ankylosing spondylitis to answer following questions: (1) Is there functional improvement in these patients after THR (2) Is there a higher risk of hetrotopic bone formation or loss of range of motion in long term follow up, and (3) What are the survival rates of THR in AS? MethodsLiterature search was carried out in electronic databases PubMed, EMBASE, Google Scholar and Cochrane Library. Search was done using a pre-designed search strategy. Data on functional outcomes, survival-ship and hetero-topic ossification was collected. ResultsBased on inclusion criteria 13 studies were included in the systematic review. Total of 917 arthroplasties were carried out in 585 patients. Swignificant improvement in hip function was seen in all studies. Failure defined as the need for revision THR was seen in 90 hips (11.9%). Clinically significant (class III or IV) heterotopic ossification was seen in only 40 (4.5%) patients and only 6 cases of reankylosis or reduced range of motion were reported. ConclusionThe outcomes and survival-ship of total hip replacement in patients with ankylosing spondylitis are as good as those done for other indications. Heterotopic ossification and re-ankylosis after THR is not a common phenomenon and routine prophylaxis are not recommended. But there is lack of high quality controlled studies comparing outcomes in patients undergoing total hip replacement for ankylosing spondylitis and osteoarthritis.

The use of polycarbonate-urethane as an acetabular shell bearing surface: a 5-year prospective study.

To evaluate the clinical performance of a polycarbonate-urethane liner as a bearing material inside a cobalt-chrome acetabular shell. Between December 2007 and July 2011, this material combination was used in 27 total hip replacement patients, most of whom had an indication of osteoarthritis. This report focuses on the first 5-year results of the clinical use of this material combination in the TriboFit® Hip System. Mean Harris Hip Score showed significant improvement from 40 to 86 after 5 years, similar to studies in the literature. No adverse events - revisions or complications - or disadvantages that have been reported for other total hip materials were observed over the 5-year period. The radiographs showed no signs of wear, migration or loosening of the implants. These early results indicate this new material combination offers promise as a safe and effective alternative bearing material for use in total hip systems. Further clinical trials are necessary to reconfirm these findings.

Information about sexual activity after hip replacement: A literature review

Sexual activity is an important aspect of quality of life and contributes to healing and recovery. Adequate information may minimize post-operative risks and improve wellbeing. The aim of this literature review was to identify and review articles regarding the information on sexual activity after hip replacement provided to or obtained by patients and partners prior to their hip replacement surgery. The literature search was performed in the following databases: CINAHL, PubMed/Medline, MEDLINE (via Ebscoost) and Scopus. The results underline the importance of providing hip replacement patients and partners with relevant information, to reduce their concerns and improve their satisfaction and quality of life. Such information could promote person-centered care for patient and partner, and increase long-term cost-effectiveness for the healthcare organization. Information to patients and partners on post-hip-replacement sexual limitations has not been closely studied. Further research is needed to help healthcare providers promote patients’ and partners’ sexual health and quality of life and improve wellbeing.