Comparison of clinical characteristics and 10-year survival rates of revision hip arthroplasties among revision time groups.

INTRODUCTION: No significant regression has been reported in revision total hip arthroplasty (THA) rates despite substantial progress in implant technologies and surgical techniques. It is critical to investigate how patient demographics, THA indications, surgical techniques, types of implants, and other factors influence the frequency of early and late revision surgery. The main purpose of the present study was to evaluate the clinical characteristics and 10-year survival rates of revision hip arthroplasties among revision time groups. MATERIAL AND METHODS: The clinical data of 396 patients who underwent revision hip arthroplasty between 2005 and 2011 were evaluated in this multi-centre study. Patients were assigned to one of four revision time groups based on the interval between the index hip arthroplasty and the revision surgery (< 2, 2-5, 5-10, and > 10 years). RESULTS: There were significant differences among revision time groups in terms of aetiology for primary hip arthroplasty, indications for revision hip arthroplasty, and types of revision procedures. Patients with hip dysplasia more frequently received revision hip arthroplasty within 2 years in contrast to those with osteoarthritis. Revision hip arthroplasties due to periprosthetic infection and instability were conducted earlier compared to aseptic loosening. The overall 10-year survival rate of revision hip arthroplasty was 83.2%, and it was highest for the very early revisions (< 2 years). CONCLUSIONS: According to our results, early revision hip arthroplasty was found to be mostly dependent on surgery-related factors rather than demographic factors. On the other hand, we observed that survival rates of very early revision hip arthroplasties are higher than late revision hip arthroplasties.

The critical shoulder angle, the acromial index, the glenoid version angle and the acromial angulation are associated with rotator cuff tears.

PURPOSE: To compare the critical shoulder angle (CSA), acromion index (AI), acromion angulation (AA) and glenoid version angle (GVA) between patients with full-thickness rotator cuff tears (RCTs) and patients with intact rotator cuffs. METHODS: Between 2014 and 2018, the CSA, AI, AA and GVA were measured in consecutively included patients aged > 40 years who underwent shoulder arthroscopy for full-thickness RCTs. A total of 437 patients with RCTs and a mean age of 51.2 years (± 5.8) were included, 35.7% of whom were male. In the control group, there were n = 433 patients (36.3% male) with an intact rotator cuff, and the mean age was 50.7 years (± 5.3). RESULTS: The mean AI for the RCT group was 0.7 ± 0.1, which was significantly higher than the mean AI for the control group (0.6 ± 0.1, p < 0.001). The mean CSA for the RCT group was 33.6° ± 3.9°, which was significantly higher than the mean CSA for the control group (31.5° ± 4°, p < 0.001). The mean AA for the RCT group was 13.9° ± 9°, which was significantly higher than the mean AA for the control group (12.4 ± 8.6, p = 0.012). The mean GVA for the RCT group was - 3.5° ± 4.6° and significantly retroverted compared with the mean GVA for the control group (- 2.2° ± 4.6°, p < 0.001). The cutoff values determined by the ROC curve analyses were as follows: 0.6 for AI, 31.4° for CSA, 9.6° for AA and - 2.6° for GVA. CONCLUSION: The CSA, AI, GVA and AA values measured by MRI were determined to be significantly related to full-thickness rotator cuff ruptures. The AI, CSA, AA and GVA may be considered risk factors for degenerative rotator cuff tears. Assessing the CSA, AI, GVA and AA can be helpful for diagnostic evaluation of patients with full-thickness RCTs. LEVEL OF EVIDENCE: III.

The Incidence and Interrelationship of Concomitant Anomalies in Congenital Scoliosis.

AIM: To report the incidence and interrelationship of concomitant anomalies in congenital scoliosis (CS) patients. MATERIAL AND METHODS: Whole-spine computed tomography and magnetic resonance imaging (MRI) examination, echocardiography, and renal ultrasonography (USG) evaluations of 231 patients with CS were reviewed. Additionally, intraspinal pathologies and structural cardiac and renal anomalies were recorded. RESULTS: The incidence of intraspinal pathology was 53.7%. Echocardiography was performed in 140 of 231 patients, and congenital heart disease was detected in 38 patients. Renal USG was performed in 133 of 231 patients, and a renal disease was detected in 37 patients. In 133 patients, spinal MRI, echocardiography, and renal USG were performed. In 22 of 67 (32.8%) patients with an intraspinal anomaly, an additional cardiac anomaly was detected. In 27 of 67 (40.3%) patients with an intraspinal anomaly, an additional renal anomaly was detected. In 47.3% of patients with a cardiac anomaly, an additional renal anomaly was detected. In 15 of 133 patients (11.2%) intraspinal, cardiac, and renal anomalies were identified. CONCLUSION: Surgeons should evaluate additional anomalies in CS if patients report having a congenital anomaly. Because cardiac and renal anomalies increase intra- and postoperative complication risks, a careful and comprehensive preoperative evaluation is needed.