American Hip Institute

News Updates

Understanding hip instability helps orthopedists perform revision THA
Source: Healio

When it comes to recurrent dislocation of the hip after total hip arthroplasty, surgeons will find it helpful to identify the primary cause of the patient’s instability and correct the problem at the time of revision surgery.

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Vitamin B6 linked to increased risk of hip fracture
Source: Medical Xpress 

Vitamin B6, but not vitamin B12, is associated with increased risk of hip fracture during extended follow-up, according to a study published online June 2 in the Journal of Bone and Mineral Research.

Maria Garcia Lopez, M.D., from the University Hospital in Oslo, Norway, and colleagues conducted a secondary analysis of combined data from two large randomized controlled trials to examine the effect of an intervention with B-vitamins on the risk of hip fracture. The intervention consisted of a daily capsule of folic acid plus vitamin B12 and vitamin B6, folic acid plus vitamin B12, folic acid plus vitamin B6, or placebo.

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Recreational running benefits hip and knee joint health
Source: Medical Xpress 

Recreational runners are less likely to experience knee and hip osteoarthritis compared to sedentary individuals and competitive runners, according to a new study published in the June issue of the Journal of Orthopaedic & Sports Physical Therapy (JOSPT).

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Childhood obesity a major link to hip diseases
Source: Science Daily 

A strong link between childhood obesity and hip diseases in childhood has been revealed by a new research study.

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Arthroscopic Treatment of Hip Pain in Adolescent Patients With Borderline Dysplasia of the Hip: Minimum 2-Year Follow-Up
Source: Arthroscopy: The Journal of Arthroscopic and Related Surgery 

This study shows favorable 2-year outcomes in adolescent patients with borderline dysplasia undergoing labral treatment and capsular plication. Outcomes in the borderline dysplastic patients were as good as those of a control group. Although adolescents with borderline dysplasia have traditionally been a challenging group of patients to treat, these results suggest that an arthroscopic approach that addresses both labral pathology and instability may be beneficial.

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Outcomes of Hip Arthroscopy in Competitive Athletes
Source: Arthroscopy: The Journal of Arthroscopic and Related Surgery 

Patient-reported outcomes and VAS in athletes significantly improved at a minimum of 2 years after capsular plication as a part of hip arthroscopy addressing varying pathologies. In addition, most patients returned to sports at similar or higher competitive levels. These results suggest that capsular plication is a favorable treatment option in athletes with ligamentous laxity and/or borderline dysplasia.

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AAOS releases new clinical practice guideline for osteoarthritis of the hip
Source: Medical Xpress

The American Academy of Orthopaedic Surgeons (AAOS) recently released a new clinical practice guideline (CPG) on the treatment of osteoarthritis of the hip that strongly recommends the use of pre-surgical treatments to ease pain and improve mobility, including corticosteroid injections, physical therapy and non-narcotic medications.

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Parental hip fracture predicts fracture risk in adult offspring
Source: Healio

Adults are at higher risk for major osteoporotic fracture if one of their parents experienced a hip fracture, particularly if that fracture occurred at a younger age, according to recent study findings.

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Same-Day Hip Surgery?
Source: Ivanhoe

Three-hundred thirty-two thousand Americans have hip replacement every year. For most, the surgery requires a hospital stay, and weeks of rehabilitation.  Now, a different approach to surgery is getting patients back on their feet and out of the hospital faster than ever before.

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Better patient-reported outcome scores seen for primary vs revision hip arthroscopy
Source: Healio

Patients who underwent primary hip arthroscopy experienced greater improvement in patient-reported outcome scores at 2-year follow-up compared with patients who underwent revision arthroscopy, according to results presented at the Arthroscopy Association of North America Annual Meeting.

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Farmers are not just the backbone of a nation, they may have stronger hips too
Source: Science Daily

Researchers find that male Swedish farmers have a significantly lower risk of hip fracture, possibly due to their high levels of physical activity

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Shorter hospital stay for hip fracture associated with increased odds of survival
Source: Medical Xpress

The longer a hip fracture patient stays in a hospital, the more likely that patient will die within 30 days of leaving, according to a study led by Stephen Kates, M.D., chair of the Department of Orthopaedic Surgery at the Virginia Commonwealth University School of Medicine.

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Corin receives FDA approval for hip stem system
Source: Healio

Corin announced it has received FDA 510(k) approval for an additional range of stem options for its MetaFix hip stem system.

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Study indicates factors and costs correlated with readmission after THA
Source: Healio

Severity of illness, route of readmission and patient insurance effect the hospital costs overall for readmission within 90 after total hip arthroplasty, according to study results.

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Clinical and Functional Outcomes of the Birmingham Hip Resurfacing System
Source: Healio

This study reported the outcomes of patients treated with the Birmingham Hip Resurfacing System (Smith & Nephew, Memphis, Tennessee) to identify the prevalence of complications and failures. A retrospective review of 202 patients (206 hips) was performed.

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After hip-replacement surgery, medication use decreases
Source: Medical Xpress

A new study, published November 15, in the journal Pain provides information on the trajectories of prescription drug use before and after hip-replacement surgery—total hip arthroplasty (THA), one of the most common types of joint replacement surgery. Hip- replacement surgery is commonly followed by long-term reductions in the use of prescription drugs for pain and insomnia.

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Hip osteoarthritis may not appear on X-ray
Source: Medical Xpress

In the majority of cases, hip x-rays are not reliable for diagnosing hip osteoarthritis (OA), and can delay the treatment of this debilitating disease.

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Osteonecrosis risk may reduce more after ORIF vs CRIF for femoral neck fractures
Source: Healio

Patients who underwent open reduction and internal fixation compared with closed reduction and internal fixation for treatment of pediatric femoral neck fractures had a higher fracture reduction quality and reported fewer complications, including osteonecrosis, according to results of this study.

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THA seen as a possibility for patients with neuromuscular disorders
Source: Healio

ORLANDO, Fla. — Although primary total hip arthroplasty was rarely performed in patients with neuromuscular disorders due to concerns about loosening, dislocation and uncertain functional benefit, a surgeon here said the operation is now an option for these patients.

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Patient and provider interventions yield modest improvements in osteoarthritis outcomes
Source: Medical News Today

A low-intensity combined patient and doctor intervention may help to improve physical function and physical activity for patients with knee or hip osteoarthritis. The research is published in Annals of Internal Medicine.

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More complications, longer length of stay found after revision hip arthroplasty
Source: Healio

Patients who underwent revision hip arthroplasty experienced more perioperative complications and required more operative time, more blood transfusions and a longer hospital stay compared with patients who underwent revision knee arthroplasty, according to results.

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Satisfactory results seen in revision THA with acetabular reinforcement, HA granules, autograft
Source: Healio

Using acetabular revision for loosening as an endpoint, investigators of this study found more than 90% acetabular component survival at 10 years among patients who underwent revision total hip arthroplasty for acetabular bone deficiency using a Kerboull-type acetabular reinforcement device to support hydroxyapatite granules and structural autograft.

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High complication rates seen in obese adolescents after Bernese PAO
Source: Healio

Despite radiographic correction of acetabular dysplasia in obese adolescents after Bernese periacetabular osteotomy, complication rates were high, according to these study results.

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Ask Well: Running After Hip Replacement
Source: The New York Times

Is it healthy for older people who have hip replacements to take up running or jogging?

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Similar clinical outcomes found with THA, hip resurfacing arthroplasty
Source: Healio

Although patients who underwent total hip arthroplasty experienced greater leg length discrepancy and less accurate restoration of offset compared with patients who underwent hip resurfacing arthroplasty, investigators of this retrospective study found no difference in clinical outcomes between the procedures.

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Cup orientation angle change during THA may cause malpositioning
Source: Healio

Recently published data indicated significant changes in the orientation of the equatorially-expanded cup inserted during total hip arthroplasty may cause malpositioning.

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Hip internal rotation during skating deceleration likely cause of higher FAI rate in ice hockey goaltenders
Source: Healio

According to recently published data, hip internal rotation during skating deceleration is likely the cause of femoroacetabular impingement being more common in ice hockey goaltenders than other athletes.

Researchers evaluated skating, butterfly save and recovery movements on the ice from 14 professional and collegiate goaltenders.

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Heavier patients require less blood transfusions in hip, knee replacement surgery
Source: Medical Xpress

Blood transfusion rates in hip and knee replacement surgery were dramatically lower in overweight or obese patients than patients of normal weight, according to a study at Henry Ford Hospital in Detroit.

Researchers also found no correlation between the heavier patients and post-surgical complications such as blood clots and heart attacks.

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A Different Perspective on Metal-on-Metal Implants for THA
Source: ICJR

Henri Migaud, MD, told attendees at the recent World Arthroplasty Congress that abandoning all metal-on-metal implants for total hip arthroplasty without considering which ones could be safely used is a mistake. The right implant with the right patient can still produce a good outcome.

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Patient-specific predictive model offers more accurate preoperative templating in hip arthroplasty
Source: Healio

A prediction model presented better estimates of the actual size of implants used in total hip arthroplasty and, in the long term, may help reduce the cost of health care by minimizing implant inventory costs, according to study results.

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Low complication rates, excellent clinical outcomes observed with anterior approach THA
Source: Healio

Recently published findings demonstrated low rates of perioperative complications and excellent clinical outcomes were observed in patients who underwent simultaneous bilateral anterior approach total hip arthroplasty.

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Better methods to measure, image anatomy will advance science of joint replacement
Source: Healio

More than 1 million joint replacement surgeries will be performed in the United States in 2015, with the most common procedures being related to knee replacement. Despite a percentage of patients who are not satisfied with their outcomes, improved understanding of 3-D anatomy and the surrounding soft tissues has led to significant changes in the surgical techniques used to preserve and protect the normal anatomy while replacing deformed and arthritic joints.

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Make no bones about it: The female athlete triad can lead to problems with bone health
Source: Medical Xpress

Participation in sports by women and girls has increased from 310,000 individuals in 1971 to 3.37 million in 2010. At the same time, sports-related injuries among female athletes have skyrocketed. 

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Panel discusses epidemic of youth sports injuries, role of prevention programs
Source: Healio

At Orthopedics Today Hawaii 2015, we convened a special Banyan Tree session to talk about injuries in youth athletes. This is a real problem that all orthopedic surgeons see on a regular basis — one that, I think, is still under-recognized. 

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3D Imaging and Templating May Improve Glenoid Positoning in Anatomic TSA
Source: International Congress for Joint Reconstruction

In this prospective, randomized, controlled study, Ianotti et al compared glenoid implant positioning in 3 patient cohorts: 25 patients who underwent anatomic total shoulder arthroplasty (TSA) with 3D CT imaging and templating 

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Splint-based treatment may yield high restoration rate for ACL
Source: Healio

LYON, France — A splint-based conservative treatment yielded the same high rate of anatomical and functional restoration of the ACL as seen in a smaller, previously reported study, according to results presented at the International Society for Arthroscopy, Knee Surgery and Orthopaedic Sports Medicine Biennial Congress, here. 

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Use of Topical Tranexamic Acid in Primary THA
Source: ICJR

Which total hip arthroplasty patients benefit most from TXA administration? A study from Brown University looked at gender, age, BMI, preoperative hemoglobin, and surgical approach to find out.

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Common hip issue in teens misdiagnosed as pulled muscle
Source: Science Daily

An athlete felt pain in his groin after a collision at the plate with an opposing player. He thought he had pulled a muscle, but it turns out he was suffering from a common condition seen in teens and young adults known as hip impingement.

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Study shows substantial benefits in obese patients after hip arthroscopy
Source: Healio

Although obese patients undergoing hip arthroscopy started with lower absolute scores preoperatively and ended with lower overall absolute postoperative scores, they showed substantial benefit from surgery, demonstrating a degree of improvement similar to non-obese patients, according to study results.

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Hip protector saves you when you slip
Source: Science Daily

Are you well used to wearing studded shoes in winter? If so, you’re probably ready for yet another step towards tackling the eternally icy winter streets: a hip protector.

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Thigh Pain After Total Hip Replacement: A Pathophysiological Review and a Comprehensive Classification
Source: Healio

Total hip replacement (THR) is a successful procedure that provides excellent pain relief and considerable improvement of function. The postoperative satisfaction rate is estimated to be as high as 90%.

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Study: Hip replacement an excellent option to relieve pain in juvenile arthritis patients
Source: Medical News Today

Implant lasts at least 10 years in 85 percent of patients

Hip replacement is often performed in patients with juvenile arthritis when their joints have been severely damaged by the disease. A study at Hospital for Special Surgery (HSS) finds that the procedure is an excellent option to alleviate pain and improve function in juvenile arthritis patients under age 35 when conservative treatments fail to provide relief.

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Pain injections for hip arthroscopy patients may not predict surgical outcomes
Source: Medical News Today

How best to treat and recover from complicated hip injuries is a growing field in orthopaedic medicine. While diagnostic hip injections are commonly performed for patients with labral tear to confirm the pain etiology, research presented at the American Orthopaedic Society for Sports Medicine’s (AOSSM) Specialty Day suggests that pain relief from this diagnostic injection may not predict better outcomes following arthroscopic hip surgery.

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Middle-age hip replacements nearly double from 2002-2011
Source: Medical News Today

The number of total hip replacements (THRs) nearly doubled among middle-aged patients between 2002-2011, primarily due to the expansion of the middle-aged population in the U.S., according to a new study presented at the 2015 Annual Meeting of the American Academy of Orthopaedic Surgeons (AAOS).

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Making hip surgery safer
Source: Medical News Today

Experts have issued new guidelines for certain surgeries that are performed in patients with hip fractures. The surgeries, called cemented hemiarthroplasty, involve the use of bone cement during hip reconstruction.

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An Anterior-based Muscle-sparing Approach to THA
Source: International Congress for Joint Reconstruction

A 66-year-old female who has acetabular protrusio and end-stage osteoarthritis of the right hip undergoes total hip arthroplasty through the ABMSparing approach. According to the authors, this approach avoids the complications of wound healing that can occur with an approach that crosses the hip flexion crease, as well as avoids cutting muscle.

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What Is the Future of Mobile-bearing Acetabular Components?
Source: International Congress for Joint Reconstruction

Mobile-bearing acetabular components are a relatively new design option for total hip arthroplasty. The goal of these components, say the manufacturers, is to allow a better fit with the patient’s anatomy, provide greater mobility, and create a stable hip that’s less prone to dislocation.

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Getting the perfect fit for artificial hips
Source: Medical News Today

When a patient receives a new hip, it is usually adjusted only approximately to leg length. Greater accuracy requires a more precise measuring process as well as adjustable implants. Now, a new type of measurement method coupled with a modular implant should allow orthopedic surgeons to precisely calibrate leg length after the operation so it matches its original length.

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Ceramic-on-ceramic bearing surfaces may increase risk of squeaking, total implant fracture in THA
Source: Healio

A meta-analysis of randomized, controlled trials found ceramic-on-ceramic bearing surfaces in total hip arthroplasty increased the risk of squeaking and total implant fracture significantly compared with ceramic-on-polyethylene bearing surfaces; however, no significant differences were observed between bearing surfaces with regard to revision, osteolysis and radiolucent lines, loosening, dislocation or deep infection, according to study results.

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Hip Function and Predictors of Subjective Outcomes in Individuals With a History of Low Back Pain
Source: Healio

Increased fatigability of the trunk and hip extensors has been reported in individuals with a history of low back pain. However, muscle function of the hip abductors as a result of exercise is currently unknown. The purpose of this study was to assess muscle function during a side-lying hip abduction exercise between 12 individuals with and 12 individuals without a history of low back pain.

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High hip survival rate seen after hip arthroscopy in patients with dysplastic hips
Source: Healio

Seventy percent of patients with hip dysplasia who underwent hip arthroscopy did not require total hip arthroplasty at 5 years and demonstrated improved outcome scores, quality of life and patient satisfaction, according to data presented at the American Academy of Orthopaedic Surgeons Annual Meeting.

“In the difficult patient population of those with dysplastic hips, arthroscopy has had a controversial role,” said Marc J. Philippon, MD,managing partner of the Steadman Clinic and co-chair and board member of the Steadman Philippon Research Institute. “There is not much evidence to support treatment by arthroscopy in this group. But, a correlation has been shown between hip dysplasia and early-onset osteoarthritis, tears of the labrum and joint failure in the young patient.”

Philippon and his colleagues evaluated data from a prospective data registry to determine survivorship, defined as not requiring total hip replacement, at 3 years to 8 years after hip arthroscopy in patients with dysplastic hips. A single surgeon performed all consecutive hip arthroscopies in the data registry from 2005 to 2011.

Inclusion criteria were primary hip arthroscopy for labral pathology and femoroacetabular impingement with no previous total hip replacement or resurfacing and a center edge angle of 20° or less. Patients were excluded if they were professional athletes or had hip fracture, hips with bone grafting, bone plugs, hemicap implant performed during arthroscopy, underlying hip disease such as Legg-Calve-Perthes, pigmented villonodular synovitis, synovial chondromatosis or labral reconstruction during arthroscopy.

Researchers identified 11 hips that met the inclusion criteria. Patients were an average age of 39 years and the study included six women and five men. Their average centeredge angle was 16°, and their average alpha angle was 69°. All hips had a labral repair, 10 had a femoral neck osteoplasty, and five had a minimal acetabular rim trimming.

Three patients required total hip arthroplasty: a 50-year-old patient at 12 months after the index hip arthroscopy, a 42-year-old patient at 15 months and a 58-year-old patient at 25 months. Two of these patients had a joint space of less than 2 mm.

For those patients who did not require total hip replacement, preoperative modified Harris hip scores improved from 55 points to 74 points postoperatively. The postoperative SF-12 physical component score was 53.2 points and the mean SF-12 mental component score was 53 points. Patients rated their satisfaction at a median of nine out of 10.

“Patients requiring total hip replacement were older and two of the three had limited joint space,” Philippon said during his presentation. “Hip arthroscopy was successful in the younger dysplastic adult with adequate joint space. Patients improved in function and symptoms. They had good general physical and mental health, and high patient satisfaction was reported. We use hip arthroscopy as a first stage in treatment, often to assess the cartilage and the status of the labrum, and we coordinate further treatment in the patient when indicated.” – by Tina DiMarcantonio

References:Philippon MJ. Paper #411. Presented at: American Academy of Orthopaedic Surgeons Annual Meeting; March 11-15, 2014; New Orleans.

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Revision preservation with hip arthroscopy successful after failed primary procedure
Source: Healio

After failed primary hip preservation surgery, revision with hip arthroscopy achieved moderately successful outcomes on the basis of multiple patient-reported outcome scores, according to study results.

All patients who underwent revision hip preservation with arthroscopy from April 2008 to December 2010, including patients who had previous open surgery and underwent revision with arthroscopy, were included. The researchers obtained patient-reported outcome (PRO) scores preoperatively and at 3-month, 1-year, 2-year and 3-year follow-up time points. Using a multiple regression analysis, the researchers looked for positive and negative predictive factors for improvement in PROs after revision hip arthroscopy.

Overall, 47 hips in 43 patients had completed 2 years’ follow-up or needed total hip arthroplasty. Sixty-six percent of the hips had either unaddressed or incompletely treated femoroacetabular impingement.

At a mean 29 months after revision, the researchers found a significant improvement in all PRO scores, as well as improvement in VAS scores. The Non-Arthritic Hip Score showed improvements of at least 10 points in 65% of hips and of at least 20 points in 44% of hips. According to study results, four hips in three patients required conversion to total hip arthroplasty.

The researchers found previous open surgery, pincer impingement, cam impingement, symptomatic heterotopic ossification and segmental labral defects treated with labral reconstruction to be positive predictive factors for PRO improvement.

Disclosures: Jackson, Domb, Stake, Lindner and El-Bitar received support from the American Hip Institute. Domb also received support from MAKO Surgical and Arthrex.

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Primary hip arthroscopy showed favorable outcomes for torn acetabular labrum
Source: Healio

Primary arthroscopy of the torn acetabular labrum had favorable outcomes and evidence of good healing, according to study results.

Researchers assessed patients undergoing hip arthroscopy with the modified Harris Hip Score; 37 patients underwent primary repair of a torn acetabular labrum and had reached 2 years’ follow-up over a 4-year period. The researchers also evaluated the ratio of labral refixations after pincer femoroacetabular impingement correction to primary repairs for perspective on the frequency of this procedure.

Modified Harris Hip Score showed a mean improvement of 18.9 points, with 92% of hips showing improvement, including good and excellent results. Articular damage was seen in 21 hips, ligamentum teres in 14 hips, cam femoroacetabular impingement in 11 hips, borderline dysplasia in three hips, dysplasia in two hips and iliopsoas in two hips.

At a mean 10 months postoperatively, four patients underwent repeat arthroscopy, and the labral repair site was fully healed in each of these cases. Overall, the researchers did not observe any complications.

Disclosures: Byrd received support from Smith & Nephew, A3 Surgical and Springer Medical Publishing. Jones also received support from Smith & Nephew.

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Speaker: Hip arthroscopy has a role in the management of FAI in adolescents
Source: Healio

Hip arthroscopy can be used in the management of adolescents with symptomatic femoroacetabular impingement, according to data presented at the American Orthopaedic Society for Sports Medicine Annual Meeting, here.

“This study reports favorable outcomes of arthroscopic management of [femoroacetabular impingement] FAI in adolescents with results at least comparable to an adult population. Concomitant procedures and revision surgery are both more common among adolescents and there is certainly a propensity for athletes in both groups,” J.W. Thomas Byrd, MD, said.
Byrd and colleagues at the Nashville Sports Medicine Center prospectively assessed 122 consecutive hips among 108 adolescent patients who had arthroscopic surgery for symptomatic FAI. The adolescent group was 55% female with an average age of 16 years. The matched control group was 122 patients with an average of 36 years and was 58% male. Minimum follow-up was 1 year with an average follow-up of 30 months. Overall, 96% of the adolescents participated in athletics compared with 61% of the adults in the control group.

The average improvement in the modified Harris Hip Score was 23 points for the adolescent group and 21 points for the adult group. For the adolescent group, FAI correction was performed for 36 cam and 17 pincer lesions and for 69 combined lesions. There were 111 labral tears that required 85 refixations and 26 debridements. There were 101 acetabular chondral lesions with four microfractures. There were three femoral chondral lesions. The researchers removed seven loose bodies and debrided 19 lesions of the ligamentum teres. Concomitant extraarticular procedures included 13 iliopsoas tendon releases and two iliotibial band tendinoplasties.

Among the adult cohort, the researchers performed FAI correction for 53 cam and 5 pincer lesions and for 64 combined lesions. There were 103 labral tears that required 52 refixations and 50 debridements. There were 112 acetabular chondral lesions with 20 microfractures and 17 femoral chondral lesions. The researchers removed 17 loose bodies and debrided 21 lesions of the ligamentum teres in the adult group. Concomitant extraarticular procedures included four iliopsoas tendon releases and one abductor repair.

Four adolescents needed repeat arthroscopic surgery and one patient underwent a periacetabular osteotomy. One adult patient had repeat arthroscopic surgery. – by Kristine Houck, MA, ELS

Reference:Byrd JWT. Paper #32.Presented at: American Orthopaedic Society for Sports Medicine Annual Meeting; July 10-13, 2014; Seattle.

Disclosure: Byrd is a consultant to and receives research support from Smith & Nephew Endoscopy and is a consultant to and has stock in A3 Surgical.

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Smith & Nephew DYONICS(TM) PLAN brings first-of-its-kind, individualized surgical planning to hip arthroscopy
Source:
The Wall Street Journal

Smith & Nephew (NYSE:SNN;LSE:SN), the global medical technology business, will launch its DYONICS PLAN Hip Impingement Planning System at this week’s American Academy of Orthopaedic Surgeons (AAOS) annual meeting in New Orleans. Unlike standard imaging tools, DYONICS PLAN is a revolutionary 3D software system that allows surgeons to visualize, assess and generate a comprehensive surgical report for each patient’s unique Femoroacetabular impingement (FAI) surgery before that patient ever enters the operating room.

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Genetics may explain high-functioning senior athletes with hip abnormalities
Source:
Science Daily

Genetics may explain why some senior athletes are high functioning despite having one or both hip abnormalities typically associated with early onset osteoarthritis: developmental dislocation of the hip (dysplasia), a loose hip joint; or femoroacetabular impingement (FAI), a condition in which the hip bones are abnormally shaped.

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Osteoarthritis Patients Will Benefit from Exercise That Strengthens Bones
Source:
ScienceDaily

The postmenopausal women who may be at risk of osteoporosis (bone loss), as well as at risk of osteoarthritis, can safely carry out progressive high-impact training to maintain bone health and physical function. This was found out in a study conducted in the Department of Sport and Health Sciences at the University of Jyväskylä, Finland. The study examined the effects of high-impact exercise on bones, cartilages, the symptoms of osteoarthritis and the physical performance of postmenopausal women with mild knee osteoarthritis. The study was conducted in cooperation with the Central Finland Central Hospital and the Department of Medical Technology, the Institute of Biomedicine at the University of Oulu, Finland.

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Multidisciplinary treatment can help with pain after TKA or THA
Source:
Healio

Multidisciplinary pain treatment has been shown in a recent study to one way to aid patients following total knee arthroplasty and total hip arthroplasty procedures.

In the study, investigators found that multidisciplinary pain treatment (MPT) “has beneficial short-term and mid-term effects on subjective pain intensity, physical capability and depression levels in patients with persistent pain after joint arthroplasty,” lead author Christian Merle, MD, MSc, and colleagues, wrote.

Merle and colleagues conducted a retrospective study that followed 40 patients (mean age 62 years) with persistent unexplained pain following total knee arthroplasty (TKA) or total hip arthroplasty (THA) that previous treatments were unable to rectify.  The procedures were performed between April 2007 and April 2010.

The evaluations, which were done before MPT, after 3 weeks of MPT and at 32 months mean follow-up, focused on the patients’ pain intensity, physical capability and psychological status, according to the study.

All the scores used showed a significant improvement at the completion of MPT over the baseline pain scores. At 32 months’ follow-up, pain intensity, physical capability and depression levels deteriorated slightly, but were significantly better than at baseline.

The results showed 79% of the 34 patients available for final follow-up reported a reduction in pain on the Numeric Rating Scale of 0.5 to 5.0 points. All patients reported pre-MPT NSAID use, 41% of patients continued to use NSAIDs and15% of them reported using opioids after 32 months.

Because MPT helps to alleviate unexplained pain following TKA and THA, Merle and colleagues noted in the study it may help patients avoid exploratory revision surgery.

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Rose Needs Surgery on Torn Right Meniscus
Source:
Chicago Tribune

Derrick Rose had so looked forward to the warm embrace that awaited him on Sunday.

With friends and family looking on from where he makes his offseason home, Rose was scheduled to play the Clippers in a matinee at the Staples Center. That’s mere miles from where he spent so many grueling hours rehabilitating his torn left anterior cruciate ligament over many of the previous 19 months.

Instead, Rose was headed back to Chicago on Sunday, facing more surgery early this week and uncertainty after an MRI exam confirmed a medial meniscus tear to his right knee. The Bulls said Rose will be sidelined indefinitely.

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Socially Isolated Patients With Arthritis Have More Pain After THR
Source:
Healio

SAN DIEGO – Socially isolated patients with osteoarthritis are nearly three times more likely to experience serious ongoing pain after total hip replacement than patients with good social ties, according to researchers from Hospital for Special Surgery.

“Previous studies have shown that social isolation is a risk factor for poor health outcomes,” Lisa A. Mandl, MD, MPH, from Hospital for Special Surgery, stated. “Studies show that people who don’t have good social ties are at increased risk of suffering a heart attack or stroke, and even dying, compared to those who enjoy the social support of family, friends and the community.”

In the study, social isolation was defined based on whether the patients were married, were members of any community or religious groups or had fewer than six friends or relatives. Mandl and colleagues noted that, although the 132 rheumatoid arthritis (RA) patients and 392 osteoarthritis (OA) patients had similar demographics and proportions of socially isolated patients, the OA patients had a statistically significant association with postoperative decreased WOMAC scores and social isolation, according to the abstract.

Severe social isolation in OA patients was also significantly associated with WOMAC scores less than 60 points and 2.9 times postoperative pain than control patients, but it was not associated with poor postoperative function.

Patients with OA who underwent a total hip replacement had worse pain outcomes than patients with RA. In RA patients, severe social isolation was significantly associated with poor postoperative function, but not postoperative pain.

“We believe further prospective studies should be done to determine whether interventions to evaluate and improve patients’ social ties before surgery could lead to a better pain outcome after hip replacement,” Mandl said. “It could be a way to improve outcomes without medication or other costly interventions. I see no downside to helping patients get the social support they may need to improve their quality of life.”

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Healthier Hearts After Joint Surgery
Source:
DailyRx

For patients with arthritis, joint replacement surgery could mean more than relief from pain and stiffness. It might protect against heart disease too.

These researchers found that joint surgery significantly reduced arthritis patients’ risk of heart problems like heart attack and stroke.

The authors of the study suggested that the surgery may have allowed patients to become more physically active, thus protecting them from heart disease.

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J&J to pay $2.5B to settle hip-replacement lawsuits
Source:
Modern Healthcare

Johnson & Johnson will pay about $2.5 billion to settle thousands of lawsuits filed by patients who already underwent surgery to replace the company’s faulty metal-on-metal hip implants, which failed at higher rates than traditional hip implants and were eventually recalled.

About 8,000 patients who had revision surgery before Aug. 31 are part of the settlement, the New Brunswick, N.J.-based healthcare company said. More patients who received Johnson & Johnson’s metal-on-metal hip implants are expected to undergo revision surgeries in the future.

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Mistake-Proof Hip Replacements With Robotic Arm
Source:
NewsChannel5

200,000 people will have a hip replacement surgery this year. Even more will have one or two knees replaced. Until now, getting the right fit was just an educated guessing game for surgeons. Now, there’s a new way to get new hips and knees that fit just right.

It’s been a painful trek for Chuck Murray. Last year he started feeling pain in his hip that just seemed to get worse and worse.

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Robot technology aids in hip, knee replacements
Source:
Tonawanda News

For Lewiston resident Betty Rienzo, the ability to be up and about on her feet was pretty important to her.

Up until last November, the now-70-year-old, worked as a certified medical assistant for a podiatrist, which, like for many in the medical industry, involved lots of walking around and long hours on her feet.

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Knee and hip replacements easier thanks to medical advancements
Source:
Miami Herald

Imagine hanging cabinets using educated guesswork.

The potential result: a wobbly kitchen.

And yet, just a few years ago, before the arrival of robotic-assisted surgery, three-dimensional imaging and custom-fit implants, this was the challenge surgeons faced when performing knee and hip replacements. Perfect alignment of implants could be hit and miss. Patients endured longer recovery times because muscles were cut.
Rehabilitation was beset by limitations and requirements, which made knee and hip replacement a less-than-thrilling prospect for the hundreds of thousands of people who suffer from arthritis or joint injuries.

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Robot Assisted Hip Surgery Improves Procedure
Source
: Fox 4 News

Nearly 300,000 hip replacement surgeries are performed in the U.S. every year, and some of those patients have to head back into the operating room due to complications. But now, robotic 3D technology is making the process more reliable.

This high-tech procedure was recently approved for use in the U.S. It uses a robotic arm to help surgeons get a more accurate alignment of the replacement hip every time.

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Photo Galleries: Robotic Hip Replacements
Source:
Naplesnews

Dr. Jon Dounchis, left, sews up the final stitches alongside his physician assistant Rick Yarosh after performing a hip replacement surgery on MalazSourial on Tuesday. During the surgery Dr. Dounchis used a new robotic system, made by MAKO Surgical, that allows him to resurface the hip socket and then place a shell fitting so when the hip joint is put in, there is reduced likelihood of dislodging. Dounchis has been part of a study group for MAKO. The system also uses a CAT scan of the diseased hip so there is precise fit of the implant. According to MAKO project leader RenenBassik, the robotic system makes the surgery more accurate as well as make it repeatable.

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Knee And Hip Replacement Goes Robotic
Source:
NHPR

It’s been two weeks since Bonnie Parker had her hip replaced.

She is 50, petite, a tattoo artist. So she’s no stranger to pain, but says the past few years have been really tough.

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MAKO Surgical Corp. Showcases Pioneering MAKOplasty(R) Treatment Options

for Total Hip Replacement and Partial Knee Resurfacing Surgeries at AAOS 2013

Annual Meeting
Source:GlobeNewswire

MAKOplasty THA is the company’s latest application for its RIO® Robotic Arm Interactive Orthopedic System, which will be highlighted by the company during the meeting. The RIO system overcomes limitations of conventional arthroplasty surgeries by providing auditory, visual and tactile guidance that, when integrated with the touch and feel of the surgeon’s skilled hand, provides consistently reproducible precision in total hip and partial knee surgeries. MAKO’s robotic arm assisted THA may result in a reduction in complications associated with conventional hip replacement surgery.

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Stryker to Buy Mako for $1.65 Billion for Robotic Surgery
Source:
Bloomberg

Stryker Corp. (SYK), the second-largest seller of orthopedic devices, agreed to buy Mako Surgical Corp. (MAKO) for $1.65 billion to add technology for robot-assisted surgery.

Investors in Mako will receive $30 a share from Kalamazoo, Michigan-based Stryker, the companies said today in a statement. The offer carries an 86 percent premium over Fort Lauderdale, Florida-based Mako’s closing price yesterday.

Mako, founded in 2004, pioneered the use of robotic-assisted surgery in orthopedics. It sells the Rio Robotic Arm, which enables surgeons to precisely and consistently cut through bone. The incisions are designed for the company’s Restoris implants, including partial knee resurfacing in people with early or mid-stage osteoarthritis. Mako recently added an application for total hip replacements.

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Stryker Buys Mako at Hefty Premium – Analyst Blog
Source:
NASDAQ

Stryker Corporation( SYK ), the leading medical device provider in the global orthopedics market, must have big dreams about the small and not-so-old robotic assisted surgery developer MAKO Surgical Corp. ( MAKO ); otherwise it would not have agreed to acquire the latter at a handsome premium of 85.5% to its closing price of $16.17 on Sep 24.

Stryker inked a deal to acquire MAKO for $30 per share, putting the deal’s value at about $1.65 billion. The deal also includes the issuance of 3.953 million shares related to a previously planned acquisition by MAKO.

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Stryker to Acquire Mako Surgical for About $1.65 Billion
Source:
The Wall Street Journal

Stryker Corp. SYK -0.09% agreed to acquire Mako Surgical Corp. MAKO +0.10% and its robotic-surgery platform for roughly $1.65 billion, a move aimed at distinguishing Stryker’s line of replacement knees and hips for its increasingly cost-conscious hospital customers.

Mako shareholders will receive $30 a share, an 86% premium to the stock’s Tuesday closing price. The Fort Lauderdale, Fla., company is expected to issue an additional four million shares in connection with the deal.

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Periprosthetic tissue metal content predicts tissue response in patients with metal-on-metal hips
Source:
Healio

Researchers found an association between periprosthetic metal content and hypersensitivity in patients with failed metal-on-metal total hip components, according to results of this study.

“In conclusion, tissue responses to metal wear debris are complex, and metal hypersensitivity (in the form of a type-IV delayed hypersensitivity reaction) may cause accelerated aseptic loosening of endoprostheses,” the researchers wrote in the study. “High metal content in the periprosthetic tissue appeared to favor a lymphocyte-dominated tissue response, whereas a macrophage-dominated response was observed at low metal concentrations.”

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Bisphosphonates Could Offer Effective Pain Relief in Osteoarthritis
Source:
Science Daily

St George’s, University of London research has found that a drug normally given to osteoporosis sufferers could provide effective pain relief to patients with knee and hip osteoarthritis.

“We found that, generally, bisphosphonates are ineffective at managing pain associated with osteoarthritis. But zoledronate and alendronate, which are specific forms of bisphosphonates, do show the potential for effective pain management specifically in patients with knee and hip osteoarthritis.

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New techniques shorten recovery time in hip, knee replacements
Source:
nwitimes.com

It wasn’t too long ago that patients who underwent a hip replacement or knee surgery spent nearly a week in the hospital and months in rehab. Today, more patients find themselves at home just days after surgery and back at work within weeks.

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Researchers find lower than reported incidence of joint infection in HIV population after TJA
Source:
Healio

Researchers found a lower than reported incidence of joint infection after total joint arthroplasty in patients with HIV.
“While there may be a slight increase, current findings do not support prior findings of a large increase in infection rate in the HIV population,” Brian M. Capogna, MD, and colleagues wrote in the study

Capogna and colleagues compared 69 patients with HIV to 138 matched control patients, all of whom were undergoing total joint arthroplasty (TJA), according to the abstract. The reasons for surgery differed between the HIV group and the control group: patients with HIV most commonly required total knee arthroplasty (TKA) due to osteoarthritis and total hip arthroplasty (THA) for avascular necrosis. Patients in the control group most commonly required TKA or THA for osteoarthritis.

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Higher risk of complications found for TJA patients with atrial fibrillation
Source:
Healio

Patients with preoperative atrial fibrillation who underwent aseptic primary or revision total joint arthroplasty had higher rates of transfusion, periprosthetic joint infection and longer hospital stays compared to patients without the condition, according to the results of this study.

“A diagnosis of atrial fibrillation … significantly increased the odds of total joint arthroplasty complication and the need for hospital readmission,” Vinay K. Aggarwal, BA, and colleagues from The Rothman Institute of Orthopedics at Thomas Jefferson University Hospital, wrote in their abstract.

In their retrospective review, the investigators compared 161 patients with atrial fibrillation and 161 matched controls who underwent total joint arthroplasty at their center from March 2007 to August 2011.

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Dedicated OR for joint arthroplasty decreases operating time
Source:
Healio

In a dedicated operating room for joint arthroplasty, researchers found an improved time of 19 minutes per procedure compared to a traditional operating room, according to this study.

“The dedicated [operating room] OR system significantly decreased operative time, anesthesia controlled time, and turnover time for [total knee arthroplasty] TKA and [total hip arthroplasty] THA procedures, without increasing complication rates,” Wael K. Barsoum, MD, and colleagues wrote in the study. “Further studies are required to determine what benefits are made possible by these time savings, but may include improvements in employee satisfaction and retention, cost savings to the hospital, and/or opportunity to increase surgical volume.”

Barsoum and colleagues analyzed the effectiveness of six ORs with dedicated staff for THA and TKA procedures compared to performing total joint arthroplasty procedures in ORs using a traditional staffing model. In the dedicated OR, the team performed primary 529 THA and TKA surgeries while the traditional OR performed 475 surgeries.

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DJO Global Hip Brace

http://www.americanhipinstitute.org/wp-content/themes/americanhip/images/djo-global-hip-brace.jpg” alt=”DJO Global Hip Brace” width=”161″ height=”200″ border=”0″>

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Preventing Cell Death In Osteoarthritis
Source:
Medical News Today

UK scientists have found a naturally occurring molecule in the body which may have important consequences for treating osteoarthritis.

Osteoarthritis, a painful condition associated with a loss of joint mobility particularly in the knees, hips, hands and vertebrae, is caused by the destruction and loss of cartilage within these joints and is on the rise as people live longer.

Specialised cells called chondrocytes are responsible for producing and maintaining healthy cartilage but in osteoarthritis the number of active cells is reduced.

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The Kind of Arthritis Matters in Surgery
Source:
dailyRx

Rheumatoid arthritis total hip replacement patients have worse outcomes than osteoarthritis patients
Arthritis is painful, no matter the cause. If hip surgery is needed, though, patients with one kind of arthritis could benefit longer down the line compared to patients with the other kind of arthritis.

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Evidence of capsular defect following hip arthroscopy
Source:
MDLinx

The purpose of this study is to identify the incidence of capsular defects in patients undergoing revision hip arthroscopy. The findings of this study demonstrate post–surgical radiographic and anatomical evidence of capsular defects in a select group of patients following hip arthroscopy.

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Arthroscopic Removal of Proximal Femoral Locking Screws: A Novel Application of Hip Arthroscopy
Source:
Healio

The authors describe a novel application of hip arthroscopy. Symptomatic proximal locking screws can readily be removed via an arthroscope. Not only can the proximal screw be removed with much less morbidity than in previously described procedures, but the abductor mechanisms can also be evaluated for injury sustained during the index procedure. Furthermore, scarred or inflamed trochanteric bursal tissue may be resected during this arthroscopic approach.

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Oak Brook surgeon eases woman’s pain from terrorist bombing
Source:
Hinsdale.Suntimes

A Hinsdale Orthopaedics surgeon has donated his skills to help a mother recover from a terrorist bombing that killed her child and injured her and her husband in Israel.

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To see Hip Arthroscopy in the news, please follow the links below.

Patients physically more active than ever before and after hip implantations
Source:
PR-inside.com

The proportion of patients physically active before and after a hip implantation increased in the last decade by 14%, Swiss researchers reported at the EFORT Congress in Istanbul. The sustainable success of hip replacements was confirmed in a recent long-term study which nevertheless cautioned against excessive physical activity.

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Patients rave about anterior hip replacement, but it’s not right for all
Source:
Tampa Bay Times

Ann Elias knew something was wrong when her much-loved tennis games produced more pain than pleasure. X-rays showed the source of her discomfort — enough damage to her hip joint to warrant hip replacement surgery. But the 71-year-old put it off for more than two years after friends shared frightening stories about the long, painful recovery from hip surgery done in the conventional way, through an incision made on the back side of the body.

For instance, with the anterior approach there is less danger of the new ball joint popping out of its socket in the six weeks or so after surgery. “Medicare estimates that 2 to 3 percent of all (hip replacement) patients nationally have dislocation” with the standard surgery, Cooper said. “With anterior, it’s 0.2 percent.”

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No Time to Hesitate Before Hip Surgery
Source:
dailyRx

Older adults who take a bad fall or blow to the hip might need to act quickly. If the hip’s fractured, there’s no time to delay.

A study recently presented at a conference found that delaying surgery to treat a fractured hip more than two days increased the odds of dying by about 10 percent.

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Smoking is bad to the bone
Source:
Daily Rx

The body is designed to heal after breaking a bone. But it may not be designed to heal a broken bone while processing cigarette smoke and nicotine.

A recent study looked at the differences between smokers and non-smokers when healing from a broken bone. Results showed that smokers took several extra weeks to heal from a fracture.

Smokers also had higher odds of the fracture not healing properly.

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Cartilage damage helps detect osteoarthritis?
Source:
ivanhoe.com

Osteoarthritis is the most common joint disorder and affects about one-third of older adults.  New research suggests that cartilage damage from exercise may aid in early detection of osteoarthritis.

“We discovered that GAG-depleted tissue is most vulnerable to high rates of loading and not just the magnitude of the load.  This finding suggests that people with early degradation of cartilage, even before such changes would be felt as pain, should be careful of dynamic activities such as running or jumping,” Grodzinsky was quoted as saying.

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A new approach to hip surgery
Source:
The New York Times Health

Larry Kufel had always been an active man, tall and rangy, who worked out regularly and picked up basketball games at the gym. But age was taking a toll on his joints, and it had become clear that he needed a hip replacement.

The procedure that Mr. Kufel received is called anterior hip replacement. The surgeon makes the incision at the front of the hip instead of through the buttocks or the side of the hip. This approach permits the doctor to reach the hip socket without cutting through major muscle groups. Proponents claim that the procedure results in less pain and fewer complications for patients than standard hip replacement.

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Hip surgery flip! Direct Anterior Hip Replacement
Source:
ivanhoe.com

The numbers are sky-rocketing. There were more than 300 thousand total hip replacements in 2010, that’s up 135 thousand compared to just ten years earlier. As more and more people need help to relieve the pain, there’s an option that’s becoming popular with patients and surgeons.

“It’s a less invasive approach,” Stefan Kreuzer, MD, associate professor at Memorial Hermann Hospital, told Ivanhoe.

He went through the front of her leg to get to her hip, instead of the more traditional technique of going through the back.

The doctor says the normal post-operative restrictions on hip movements do not apply to patients who undergo direct anterior hip replacement. He tells us it great for most people in need of a hip replacement, including highly active patients. The doctor is currently training surgeons from around the world on the technique.

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New technique revolutionizing hip-replacement surgery
Source:
palmbeachpost.com

“It’s a ‘micro-invasive’ technique,” says Grandic.
And it offers myriad advantages over other techniques.

“All muscles, tendons, ligaments and soft tissue are spared, and the hip socket is never twisted into unnatural positions during surgery,” Grandic explains.

Thus, he says, patients experience little or no post-operative discomfort; are able to walk immediately, with no restrictions; and are usually discharged from the hospital within 24 to 48 hours.

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Quit smoking and enjoy that new hip
Source
: Daily Rx

Total hip replacement and smoking cigarettes just don’t mix. That’s because smoking can cramp the healing process. Even quitting just before surgery is better than not quitting at all.

Researchers recently studied a group of patients who had undergone total hip replacement surgery.

Patients who were current smokers had higher rates of infection, pain and loosened hip joints, which had to be corrected with a second surgery, compared to non-smokers.

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New surgery makes hip replacement easier
Source:
charlotteobserver.com

The surgery is extensive. It involves removing the joint – the damaged bone and cartilage – and replacing it with prosthetic parts made of metal, plastic or ceramics. Typically, surgeons enter the joint from the rear, which requires cutting through muscle and cartilage. But a relatively new procedure enables surgeons to enter from the front and only stretch the muscles aside, avoiding the cutting and minimizing pain and recovery time. Those who use this anterior technique say the benefits are substantial.

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The fate of new hips in women
Source:
DailyRx.com

Hip joint replacements can help patients regain normal mobility. But just like any surgery, risks are involved in hip replacement. And women may have a higher risk than men when it comes to failure of the new hip.

Women were slightly more likely than men to have a failed hip replacement within three years of surgery, according to a new study.

The findings highlighted the risks and precautions patients should consider before deciding to get a new hip.

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Toss the vitamin D and calcium?
Source:
DailyRx.com

Preventing the risk of fractures as you grow older is important. Previously, vitamin D and calcium supplements were thought to help reduce that risk – but recommendations have changed.

The Task Force actually recommends against vitamin D in daily doses of 400 IU or less and calcium in daily doses of 1000 mg or less because it can increase the risk of kidney stones. At those doses, supplements do not prevent fractures in younger men and women.

However, the Task Force continues to recommend vitamin D supplements to prevent falls in adults 65 and older who are at higher risk for falls.

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More intense activity results in greater polyethylene wear for THA patients
Source:
Healio

More intense activity, rather than amount of activity, has been linked with greater in-vivo polyethylene wear in highly crosslinked polyethylene implants, according to a results of a study from the Orthopaedic Research Society Annual Meeting.

“Based on this information, patients can be better instructed on what protects their joint form wear and what activities can be performed without affecting longevity,” Senden said. “Given our results, patients can protect the longevity of their implants without being less active.”

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What’s it like: To get hip replacement surgery
Source
: Newsok.com

Joint degeneration from age, wear or disease can drive a doctor’s decision to replace your hip joint. Learn what the surgery and recovery is like.

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Lady Gaga’s Hip Labral Tear
Source:
Ginger Garner

Lady Gaga’s tour operators, Live Nation, announced February 14, 2013 that she would be cancelling the remainder of her tour due to a hip injury. You may not know one single song that Lady Gaga sings (I don’t), so why, you are thinking, should I be interested in this news?

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Lady Gaga thanks her fans after surgery on her hip
Source:
BBC

The singer had to cancel the last part of her Born This Way Ball world tour after suffering from synovitis, an inflammation of the joints.

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Minimally Invasive Hip Replacement Means Faster Recovery
Source:
Birmingham MedicalNews

The vast majority of surgeons use the posterior approach for hip replacement, entering at the butt and cutting through the large gluteus maximus muscle, then detaching the deep muscles, as well as the small muscles controlling hip rotation, to reach the hip joint. Its major surgery, with muscle cut from the bone and an extensive recovery period, but it’s been the preferred method, in large part, because the hip joint is well exposed.

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Surgery to Preserve Hips in Young Patients on Rise
Source:
medicine.utah.edu

Young patients with hip pain have traditionally found themselves caught halfway between hurting and hip replacement. Unless the damage is obvious and dire, no one’s wild about replacing the joint, because artificial joints wear out over time and, eventually, younger patients will require a return trip to the operating room for yet another set of hips.

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Computer-Assisted Robotic Hip Replacement Surgery
Source:
bonesmart.org

In computer-assisted robotic surgery, a robot acts as an extension of the surgeon’s eyes and hands in a minimally invasive surgery to replace an arthritic hip. The robotics help surgeons operate more effectively through a smaller incision.

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Bursitis: A Source of Hip Pain
Source:
EverydayHealth

Your body limits friction between bones and tendons with fluid-filled sacs called bursae. Swelling and irritation of one or more of these sacs is called bursitis. You can get bursitis in any of your major joints such as knees, shoulders, and hips.

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New hip replacement approach offers multiple benefits
Source:
Daily Republic

It’s no fun walking around with an ailing hip; anyone with severe arthritis knows that kind of pain all too well. For years, orthopaedic surgeons have been performing total hip replacements when less invasive options don’t provide the desired results.

The bottom line for those who have hip pain that significantly interferes with their quality of life is that there’s no need to suffer. If non-operative treatments don’t provide the long term relief, hip replacement or resurfacing may be the answer.

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BMD better preserved with resurfacing arthroplasty than THA
Source:
Healio

Pressfit resurfacing hip arthroplasty was found to better preserve periacetabular bone mineral density (BMD) than conventional total hip arthroplasty (THA) in this randomized controlled trial that included 71 patients.

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