PURPOSE: To evaluate the clinical and radiographic outcomes of the revision total hip arthroplasty using the acetabular reinforcement ring. MATERIALS AND METHODS: Thirty-six acetabular revisions were performed in 36 patients with use of the reinforcement ring and structural or morselized allograft, between 1997 and 2005, in thirty-six patients. According to the AAOS classification, thirty-four cases of acetabular defects were Ttype III, and two were Ttype IV. Mean follow-up period after surgery was 7.2 years. RESULTS: The mean Harris hip score was 92.3, which was significantly increased compared with the preoperative score. (p<0.001). There were five failures: a case of aseptic loosening of Muller ring, two cases of infection (5.4%) and two cases of hip dislocation (5.4%). Graft incorporation and bone remodeling occurred successfully in all hips, but in the case of aseptic loosening in which the ring fixation had been inadequate at the time of surgery. The success rate was 91.7% with a mean follow-up of 7.2 years, if the cases of revision or loosening of the component were classified into failure cases. CONCLUSION: Patients treated with acetabular revision with three kinds of reinforcement ring had reconstitution of periacetabular bone stock as well as good clinical and radiographic results. For the good results, the secure implant fixation during the surgery should be confirmed and we should completely understand the characters of the each kinds of reinforcement rings.
Acetabulum ; Arthroplasty ; Bone Remodeling ; Follow-Up Studies ; Hip ; Hip Dislocation ; Humans ; Reinforcement (Psychology) ; Transplantation, Homologous ; Transplants

PURPOSE: This study evaluated the results of acetabular medial wall osteotomy to reconstruct the acetabulum in dysplastic hip during total hip arthroplasty. MATERIALS AND METHODS: We clinically and radiologically evaluated 30 hips of 30 patients with secondary hip osteoarthritis caused by congenital hip dislocation or acetabular dysplasia who underwent total hip arthroplasty (THA) between March 1999 and October 2002. The average age of subjects was 46.5 years(17 to 73 years), and the mean follow-up period was 5 years(5.3 to 8.7 years). In 26 cases, a cementless hemispherical acetabular cup was inserted in the true acetabulum; in 4 cases a reinforced ring was inserted. Only 2 hips needed structural bone grafting. RESULTS: The average Harris hip score improved from 56.3 points preoperatively to 93.2 points at the last follow up. Radiographic analysis revealed no aseptic loosening or radiolucent line, and showed stable bony fixation at the true acetabulum. The mean thickness of the medial acetabular wall postoperative was 20.5 mm(10 to 36 mm). Bone union of the medial wall was observed at a mean of four months postoperatively. CONCLUSION: Acetabular medial wall osteotomy can maintain the integrity of the acetabular medial wall while achieving enhanced acetabular coverage and more normal hip biomechanics.
Acetabulum ; Arthroplasty ; Biomechanics ; Bone Transplantation ; Displacement (Psychology) ; Follow-Up Studies ; Hip ; Hip Dislocation, Congenital ; Humans ; Osteoarthritis, Hip ; Osteotomy

Fractures of the femoral neck in elderly patients can be treated by internal fixation, hemiarthroplasty, or total hip arthroplasty (THA), and the treatment modality used should be determined on the basis of considerations of the degree of fracture displacement, age, functional demands, and the risk factors for surgery and anesthesia. We studied 85 active elderly patients who underwent minimally invasive two-incision THA or conventional bipolar hemiarthroplasty (BHA) within 2 weeks of injury for the treatment of acute displaced femoral neck fractures. Patients were followed up for a minimum of 24 months. The average operation times were 70 minutes in the THA group and 46 minutes in the BHA group (p=0.002), and average blood losses during the perioperative period were 921 cc and 892 cc, respectively (p=0.562). In the THA group, the average postoperative Harris hip score was 88.3 and the average Western Ontario and McMaster University score was 28.8, whereas in the BHA group the corresponding scores were 80.4 (p=0.006) and 32.5 (p=0.012), respectively. There were 2 cases of hip dislocation in the THA group, and 2 cases in the BHA group underwent conversion to THA. Our short-term follow-up results were better for minimally invasive two-incision THA than for conventional BHA for the treatment of acute displaced femoral neck fractures in active elderly patients.
Aged ; Anesthesia ; Arthroplasty ; Butylated Hydroxyanisole ; Displacement (Psychology) ; Femoral Neck Fractures ; Femur Neck ; Follow-Up Studies ; Hemiarthroplasty ; Hip ; Hip Dislocation ; Humans ; Ontario ; Perioperative Period ; Risk Factors ; Tacrine

BACKGROUND: Concerns of patients on sexual activity after total hip arthroplasty have not been well studied in Asian patients. This study aimed to determine the following: (1) what are the concerns of patients related to sexual activity after total hip arthroplasty? (2) what are the changes in sexual activity after total hip replacement in Korean patients? METHODS: Details of sexual activity and concerns were obtained using a questionnaire designed specifically for the study. The questionnaire was administered to 64 patients in a face-to-face interview at an outpatient clinic. RESULTS: Preoperatively, 53.1% of patients experienced difficulties, primarily due to hip pathology and limitations of motion. The median time to the resumption of sexual activity was 3 months postoperatively, and most patients had no increase in the frequency of sexual activity after the total hip replacement. In 39.1% of patients were seen having difficulties with leg positioning following total hip replacement, and they were likely to change coital positions. The most common concern regarding sexual activity of patients was the fear of dislocation. Furthermore, patients with a higher stress level had lower satisfaction rates. Most patients were unable to obtain information on sexual activity following the total hip arthroplasty, and they did not consult with a physician due to the private nature of the topic. CONCLUSIONS: Dislocation was the most common concern of patients during sexual activity following a total hip arthroplasty, and a higher stress level was found to be associated with a lower satisfaction rate. Because most patients were unprepared to consult a physician, the provision of appropriate information before a consultation might be beneficial.
Adult ; Aged ; Arthroplasty, Replacement, Hip/adverse effects/*methods/*psychology ; Female ; Hip Dislocation/psychology ; Humans ; Male ; Middle Aged ; Patient Satisfaction ; Preoperative Period ; Questionnaires ; Republic of Korea ; Retrospective Studies ; Sexual Behavior/*psychology ; Young Adult