Dataset Information

Staged Bilateral Total Hip Arthroplasty in a 17-Year-Old With Type VI Mucopolysaccharidosis.

ABSTRACT: Mucopolysaccharidosis encompasses multiple lysosomal storage disorders that are relevant to the orthopedic surgeon as they lead to disruption in bone and cartilage development. These patients may present with early-onset joint pain, including end-stage hip arthritis warranting total hip replacement. The altered hip anatomy in this disorder is of specific importance to the arthroplasty surgeon as it presents challenges when reconstructing the proximal femur and acetabulum and informs implant choice. We present a 17-year-old patient with end-stage bilateral hip arthritis who underwent staged bilateral total hip arthroplasty. We discuss technical considerations in surgical technique and the consequences of acetabular and femoral deformity on implant selection.

SUBMITTER: Robin JX

PROVIDER: S-EPMC9729915 | biostudies-literature | 2023 Feb

REPOSITORIES: biostudies-literature

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Staged Bilateral Total Hip Arthroplasty in a 17-Year-Old With Type VI Mucopolysaccharidosis.

Robin Joseph X JX Brash Andrew I AI Schwarzkopf Ran R

Arthroplasty today 20221206

Mucopolysaccharidosis encompasses multiple lysosomal storage disorders that are relevant to the orthopedic surgeon as they lead to disruption in bone and cartilage development. These patients may present with early-onset joint pain, including end-stage hip arthritis warranting total hip replacement. The altered hip anatomy in this disorder is of specific importance to the arthroplasty surgeon as it presents challenges when reconstructing the proximal femur and acetabulum and informs implant choi ...[more]

PMID: 36507284

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Project description:BackgroundTotal joint arthroplasty (TJA), including total knee arthroplasty (TKA) and total hip arthroplasty (THA), is required for many patients. This study aimed to evaluate the medical costs, length of stay (LOS), blood transfusion and in-hospital complications in patients undergoing simultaneous and staged TJA.MethodsAll patients who underwent primary bilateral TJA from 2013 to 2018 in our institute were included. The propensity score matching analysis was performed between simultaneous and staged TJA patients. The difference in medical costs, LOS, blood transfusion and in-hospital complications was compared between simultaneous and staged groups.ResultsExcept for materials fees and general therapy fees, medical costs (bed fees, general therapy fees, nursing care fees, check-up and laboratory test fees, surgical fees and drug fees) were significantly lower in the simultaneous TKA, THA and TJA group. The total average medical costs in simultaneous and staged TKA groups were $15 385 and $16 729 (p<0.001), respectively; THA groups were $14 503 and $16 142 (p=0.016), respectively; TJA groups were $15 389 and $16 830 (p<0.001), respectively. The highest and lowest costs were materials fees and nursing care fees. No significant differences were found for five common comorbidities and postoperative complications between the two subgroups. The simultaneous groups had a shorter LOS and the differences from the staged group for TKA, THA and the TJA group were 8, 6 and 8 days, respectively. The incidence of blood transfusion is higher for simultaneous groups and the difference from the staged group for TKA, THA and TJA is 32.69%, 18% and 29.3%, respectively.ConclusionsOur results indicate that simultaneous TKA and THA with a shorter LOS would cost fewer (costs incurred during hospitalisation) than staged TKA and THA. Complication rates were not affected by the choice for staged or simultaneous arthroplasty, but the incidence of blood transfusion was higher in the simultaneous groups.

Project description:BackgroundTotal hip arthroplasty (THA) relieves pain and restores function in patients with severe rheumatoid arthritis and osteoarthritis. Over the past few decades, several authors have attempted to assess the efficacy and safety of simultaneous bilateral THA compared with staged bilateral THA. The purpose of this meta-analysis is to compare the mortalities and complications between simultaneous bilateral THA and staged bilateral THA.MethodsA literature search to identify eligible studies was undertaken to identify all relevant articles published until August 2018. We included studies that compared simultaneous bilateral THA and staged bilateral THA and their effects on mortality and complications. The outcomes included mortality, the occurrence of deep venous thrombosis (DVT), the occurrence of pulmonary embolism (PE), respiratory complications, cardiovascular complications, digestive system complications and the occurrence of dislocation. Stata 12.0 was used for the meta-analysis.ResultsNineteen studies involving 59,257 patients were identified; among them, 16,758 patients were selected for treatment with simultaneous bilateral THA, and 42,499 patients were chosen for the purpose of staged bilateral THA. The meta-analysis results demonstrated that there was no significant difference between simultaneous bilateral THA and staged bilateral THA in terms of mortality (risk ratio [RR] = 1.15, 95% CI = 0.76, 1.74; P = .520). Compared with staged bilateral THA, simultaneous bilateral THA was associated with a reduction in the occurrence of DVT, PE and respiratory complications (P < .05). There were no significant differences in the cardiovascular complications, digestive system complications or the occurrence of dislocation and infection (P = .057).ConclusionsWe observed that the prevalence of DVT, PE and respiratory complications was considerably lower with the use of simultaneous bilateral THA than with the use of staged bilateral THA. Thus, simultaneous bilateral THA is a considerably safer procedure than staged bilateral THA in selected THA patients.

Dataset Information

Staged Bilateral Total Hip Arthroplasty in a 17-Year-Old With Type VI Mucopolysaccharidosis.

Publications

Staged Bilateral Total Hip Arthroplasty in a 17-Year-Old With Type VI Mucopolysaccharidosis.

Similar Datasets

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