Cemented or cementless THA in patients over 80 years with fracture neck of femur: a prospective comparative trial Early complications of anterior supine intermuscular total hip arthroplasty. A systematic review of psychological interventions in total hip and knee arthroplasty Early experience with dual mobility acetabular systems featuring highly cross-linked polyethylene liners for primary hip arthroplasty in patients under fifty five years of age: an international multi-centre preliminary study Robot‐assisted total hip arthroplasty: Clinical outcomes and complication rate Robot-assisted primary cementless total hip arthroplasty with a short femoral stem: a prospective randomized short-term outcome study. Robot-assisted primary cementless total hip arthroplasty with a short femoral stem: a prospective randomized short-term outcome study Internal fixation versus hemiarthroplasty versus total hip arthroplasty for displaced subcapital fractures of femur--13 year results of a prospective randomised study.
Background Total hip arthroplasty is associated with a better long term outcome and lesser reoperation rates in the elderly but the risk of complications are beleived to be higher in very elderly patients . The study aims to compare the short-term results of cemented and cementless total hip arthroplasty ( THA ) in active patients > 80 years of age with femoral neck fractures . Methods Sixty-two consecutive patients underwent THA during the study period  ( cemented—31 and cementless—31 ) . The mean age was 84 years ( 81–94 years ) . Patients in both groups were comparable in their preoperative variables . Functional and radiological assessment s were carried out using vali date d outcome measures . Complications were recorded . Results Fifty-one patients were available for final analysis after accounting for deaths and cases lost in follow-up . Of the 51 patients , 25 ( 49 % ) regained their pre-injury mobility status and 36 ( 70 % ) were community ambulant . Cementless THA was associated with significantly less surgical time , blood loss , transfusion rates and hospital stay . The overall mortality rates , complications , functional and radiological results were similar in both groups though the number of deaths in the perioperative period was significantly high in patients undergoing cemented THA . ConclusionS atisfactory improvement in function with low reoperation rates can be achieved irrespective of the technique used . Complication rates are higher when compared to younger patients undergoing the procedure . Risks and benefits should be carefully assessed and explained before subjecting these patients to THA Anterior supine intermuscular total hip arthroplasty ( THA ) performed on a fracture table has been increasingly used for primary THA . Accurate cup placement , low incidence of dislocation , shorter hospital stay , and faster return of function are potential benefits of the technique . However , a high complication rate , particularly during a surgeon 's learning curve , has been reported . A retrospective analysis of 61 consecutive anterior supine intermuscular primary THAs with at least 6-month follow-up was performed . All procedures were performed using the anterior supine intermuscular approach with cementless implants under fluoroscopic guidance on a fracture table . Prospect ively collected data were retrospectively review ed to evaluate the early complication rate and radiographic accuracy of implant placement . Five ( 8.2 % ) intraoperative complications were observed : including 3 trochanteric fractures and 2 calcar fractures , 4 of which required cable fixation during the index procedure . One nondisplaced trochanteric fracture was treated conservatively . One patient sustained an injury of the lateral femoral cutaneous nerve . Postoperative complications included 1 anterior dislocation , 1 infected superficial hematoma , 1 stem subsidence , and 1 loose stem , with the latter 2 presenting as increasing thigh pain postoperatively and requiring stem revision . The overall complication rate was 16.4 % ( 10/61 ) . Overall , 3 patients ( 4 hips ; 6.5 % ) required reoperation . No femoral or sciatic nerve injuries occurred , and no patient was diagnosed with venous thromboembolism . All intraoperative fractures occurred during the first 32 cases , and none during the last 29 cases . A potentially high incidence of complications with the anterior supine intermuscular THA exists during a surgeon 's learning curve in an academic setting Background The current practice in elective orthopaedics does not routinely include psychological interventions despite evidence that psychological factors such as personality , anxiety , depression and negative thinking styles can influence outcomes and recovery from surgery . The objective of this paper was to review the effectiveness of psychological interventions used in conjunction with total hip ( THA ) and knee arthroplasty ( TKA ) , in improving patient reported joint outcomes . Methods An extensive literature search was conducted according to Preferred Reporting Items for Systematic review s and Meta-Analyses guidelines . Search terms included psychology , interventions , and orthopaedics . Articles were included if they were r and omised controlled trials ( RCTs ) of psychological interventions involving active patient participation measured with patient reported joint outcomes in patients undergoing hip or knee arthroplasty . Results A total of 19,489 titles were screened . Seven studies met the inclusion criteria and were included . Five of seven studies did not show improvements in patient reported outcomes after surgery . Specifically , psycho-education alone was not effective at improving patient reported joint outcomes in two out of two studies . Conclusion The current literature does not support routine psychological interventions for TKA and THA . However , it should be noted that the literature for psychological interventions in conjunction with TKA and THA is still in its infancy . This gap in the literature is surprising , considering the importance of the role of psychological factors in recovery . Further RCTs with long term follow ups , multidisciplinary involvement , and more comprehensive and focused interventions that go beyond educating patients are needed . Future studies should account for the dem and effect , include measures of psychological variables to determine whether psychological interventions are more beneficial for some patients compared to others , and compare the different modes of delivery and timing of interventions to determine the optimal nature and duration of psychological interventions for TKA and THA Purpose To evaluate early performance of contemporary dual mobility acetabular systems with second generation annealed highly cross-linked polyethylene for primary hip arthroplasty of patients under 55 years of age . Methods A prospect i ve observational five years study across five centers in Europe and the USA of 321 patients with a mean age of 48.1 years was performed . Patients were assessed for  causes of revision , hip instability , intra-prosthetic dissociation , Harris hip score and radiological signs of osteolysis .  Results There were no dislocations and no intra-prosthetic dissociations . Kaplan Meier analysis demonstrated 97.51 % survivorship for all cause revision and 99.68 % survivorship for acetabular component revision at five years . Mean Harris hip score was 93.6 . Two acetabular shells were revised for neck-rim implant impingement without dislocation and ten femoral stems were revised for causes unrelated to dual mobility implants . Conclusion Contemporary highly cross-linked polyethylene dual mobility systems demonstrate excellent early clinical , radiological , and survivorship results in a cohort of patients that dem and high performance from their implants . It is envisaged that DM and second generation annealed HXLPE may reduce THA instability and wear , the two most common causes of THA revision in hip arthroplasty BACKGROUND The purpose of this study was to report minimum 2-year outcomes and complications for robotic-arm-assisted total hip arthroplasty ( THA )  . METHODS Data were prospect ively collected and retrospectively review ed between June 2011 and April 2014 . Inclusion criteria were primary robotic-arm-assisted THAs treating idiopathic osteoarthritis with ≥ 2-year follow-up .  Demographics , operating time , complications , 2-year outcome scores and satisfaction , and subsequent surgeries were recorded . RESULTS There were 181 cases eligible for inclusion , of which 162 ( 89.5 % ) had minimum 2-year follow-up . At the latest follow-up , the mean visual analogue scale was 0.7 , satisfaction was 9.3 , Harris hip score was 91.1 and forgotten joint score was 83.1 . Six ( 3.7 % ) intraoperative complications and six ( 3.7 % ) postoperative complications were reported . No leg length discrepancies ( LLDs ) or dislocations were reported . CONCLUSIONS Robotic-arm-assisted THA demonstrates favourable short-term outcomes and does not result in a higher complication rate compared to non-robotic THA as reported by the literature BACKGROUND Recently , two topical issues in total hip arthroplasty ( THA ) have been robot-assisted surgery and use of a short stem . The purpose of this study was to evaluate the effects of robotic milling on the accuracy of short femoral stem positioning and on the short-term clinical outcome in THA using a prospect i ve , r and omized design . METHODS We r and omized 54 patients into two groups , either robotic milling group or manual rasping group .  The patients were assessed clinical ly and radiographically at 8 weeks , 5 months , 12 months , and 24 months . RESULTS Robotic milling group had a significantly longer operation time , requiring on average 8.9 min for registration and 11.2 min for milling . On the other h and , robotic milling group showed superior results in terms of stem alignment and leg length e quality . Two intraoperative femoral fractures occurred only in manual rasping group . Harris hip scores and WOMAC scores at 24 months postoperatively were similar in both groups . No complications including stem loosening , infection , nerve palsy , or dislocation were encountered in either group during the follow-up period . CONCLUSIONS The present study suggested that robot-assisted short stem THA could increase the accuracy of stem alignment , improve leg length e quality , and help reduce the risk of intraoperative femoral fracture as compared with manual rasping . However , the clinical outcome scores did not differ between the two groups at the time of short-term follow-up . Long-term follow-up is needed to determine whether there will be a long-term clinical relevance of robot-assisted implantation of short femoral stems in THA Abstract Background : Recently , two topical issues in total hip arthroplasty ( THA ) have been robot-assisted surgery and use of a short stem . The purpose of this study was to evaluate the effects of robotic milling on the accuracy of short femoral stem positioning and on the short-term clinical outcome in THA using a prospect i ve , r and omized design . Methods : We r and omized 54 patients into two groups , either robotic milling group or manual rasping group .  The patients were assessed clinical ly and radiographically at 8 weeks , 5 months , 12 months , and 24 months . Results : Robotic milling group had a significantly longer operation time , requiring on average 8.9 min for registration and 11.2 min for milling . On the other h and , robotic milling group showed superior results in terms of stem alignment and leg length e quality . Two intraoperative femoral fractures occurred only in manual rasping group . Harris hip scores and WOMAC scores at 24 months postoperatively were similar in both groups . No complications including stem loosening , infection , nerve palsy , or dislocation were encountered in either group during the follow-up period . Conclusions : The present study suggested that robot-assisted short stem THA could increase the accuracy of stem alignment , improve leg length e quality , and help reduce the risk of intraoperative femoral fracture as compared with manual rasping . However , the clinical outcome scores did not differ between the two groups at the time of short-term follow-up . Long-term follow-up is needed to determine whether there will be a long-term clinical relevance of robot-assisted implantation of short femoral stems in THA In this prospect i ve r and omised trial we compare the mortality , morbidity and functional results of patients following each of the three principal methods of treatment for displaced subcapital fractures of the femur . Two hundred and ninety patients over the age of 65 years were included and r and omly allocated to undergo closed reduction and internal fixation with a sliding compression screw plate or uncemented Austin Moore hemiarthroplasty or cemented Howse II total hip arthroplasty ( THA ) .  Nineteen patients were subsequently excluded . The 13 year results show that there was no statistical difference in the mortality between the three groups ( 81 , 85 and 91 % respectively ) . Internal fixation and hemiarthroplasty groups fared poorly with a revision rate of 33 and 24 % , respectively , compared with 6.75 % in the THA group . The dislocation rate was 13 % following hemiarthroplasty and 20 % following THA .  Average Harris hip scores were 62 , 55 and 80 , respectively , for the internal fixation , hemiarthroplasty and THA groups . In the long term , both internal fixation and hemiarthroplasty result ed in a poor outcome with respect to pain and mobility . Despite high early complications , THA result ed in least pain and most mobility both in the short and long-term and was encouraging with a revision rate of only 6.25 % . THA should be seriously considered in physiologically active patients with a displaced subcapital fracture of the femur
Conclusion Total hip arthroplasty in patients younger than 55 years provides reliable outcomes at up to 10 years .
Background Total hip arthroplasty ( THA ) is increasingly performed in younger patients despite the lack of comprehensive assessment of long-term outcomes .
We systematic ally review ed the contemporary literature to assess the 1 ) indications , 2 ) implant selection and long-term survivorship , 3 ) complication and reoperation rates and 4 ) radiographic and functional outcomes of primary THA in patients younger than 55 years .