Revision of ASR hip arthroplasty: analysis of two hundred and ninety six recalled patients at seven years.

PURPOSE: The aim of this study is to present an algorithm for the evaluation of both symptomatic and asymptomatic patients. METHODS: From November 2004 to May 2010, there were performed 296 operations: 245 total hip arthroplasty and 51 resurfacing arthroplasty with the ASR DePuy system. In April 2010, there was the first Medical Device Alert regarding all MoM hip replacements in the UK and in August 2010, DePuy recall started worldwide. In March 2012, we started our recall. All patients were invited to undergo clinical investigation, X-ray evaluations, and blood chrome and cobalt level determination. For a short period of time, there were performed second level exams and subsequently, we carried out MARS MRI hip study to all symptomatic patients and there was evidence of ALVAL lesions. RESULTS: To the patients with ALVAL lesions were proposed surgical hip revision while the others frequent follow-up controls. One hundred patients underwent hip surgical revision. CONCLUSIONS: We recommend constant MoM THA patients monitoring and early revision if necessary.

Total hip arthroplasty after hip fracture or osteoarthritis: are there differences in characteristics and outcomes in the early rehabilitative stage?

BACKGROUND: Despite some practitioner perception of an inferior outcome in patients with total hip arthroplasty (THA) following hip fracture (HF) vs. osteoarthritis (OA), few studies have analyzed this issue. PURPOSE: This cohort study compares characteristics and short-term outcomes in patients with THA following HF and OA during the rehabilitative postsurgical period. METHODS: Records of all consecutive patients admitted in a rehabilitation department of a city hospital for THA, following HF or OA, were reviewed. Outcome measures were the Barthel Index, passive range of motion (PROM) for hip flexion and abduction, and length of hospitalization in the rehabilitation department. Participants were assessed at admission to department and at discharge. RESULTS: Five hundred seven patients were included (353 in the OA group). The HF group had a longer length of rehabilitation hospital stay and more comorbidity, whereas the OA group had higher functional performances at admission. Both groups improved in all clinical outcome measures with less improvement in PROM abduction scores in the OA group. CONCLUSIONS: Patients undergoing traumatic and elective surgery have distinctive clinical characteristics. Results support the idea that OA patient can have a reduced PROM when compared with HF patients.