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Bone & Joint Open
Vol. 4, Issue 5 | Pages 385 - 392
24 May 2023
Radiostereometric analysis and clinical outcomes of a novel reverse total hip system at two years
Turgeon TR Hedden DR Bohm ER Burnell CD
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Aims

Instability is a common cause of failure after total hip arthroplasty. A novel reverse total hip has been developed, with a femoral cup and acetabular ball, creating enhanced mechanical stability. The purpose of this study was to assess the implant fixation using radiostereometric analysis (RSA), and the clinical safety and efficacy of this novel design.

Methods

Patients with end-stage osteoarthritis were enrolled in a prospective cohort at a single centre. The cohort consisted of 11 females and 11 males with mean age of 70.6 years (SD 3.5) and BMI of 31.0 kg/m2 (SD 5.7). Implant fixation was evaluated using RSA as well as Western Ontario and McMaster Universities Osteoarthritis Index, Harris Hip Score, Oxford Hip Score, Hip disability and Osteoarthritis Outcome Score, 38-item Short Form survey, and EuroQol five-dimension health questionnaire scores at two-year follow-up. At least one acetabular screw was used in all cases. RSA markers were inserted into the innominate bone and proximal femur with imaging at six weeks (baseline) and six, 12, and 24 months. Independent-samples t-tests were used to compare to published thresholds.

Orthopaedic Proceedings
Vol. 93-B, Issue SUPP_IV | Pages 588 - 588
1 Nov 2011
169 – FUNCTIONAL OUTCOME OF REVISION TOTAL KNEE REPLACEMENT – IS IT AS POOR AS WE THINK IT IS?
Turgeon TR Bohm ER Petrak MJ Sinaisky M
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Purpose: While it is generally accepted that the results of revision total knee replacement (TKR) are inferior to those of primary TKR, there is little published information documenting this. The purpose of this study is to compare patient-reported functional outcomes following primary and revision total knee arthroplasty patients using standardized, validated outcome metrics.

Method: Using data from an academic arthroplasty database, we undertook a review of health related quality of life (SF-12) and disease specific measures (WOMAC) of patients undergoing either primary or revision TKR. The sample included 39 patients who had undergone revision TKR for reasons other than infection, and 39 patients who had undergone primary TKR matched by gender, age, modified Charnley classification, and number of years of follow-up. Student’s t-test was used to compare both groups. Average length of follow up was 2 years.

Results: The mean age was 65 years. Sixty percent (67%) of the patients were female.

Despite being matched by age, gender and modified Charnley classification, there were significant differences in post-operative functional scores. The revision TKR group’s mean WOMAC score was 73 (SD 17), compared to the primary group’s mean score of 84 (SD 14), p=0.002. Similarly, the revision group’s mean SF-12 PCS score was 35 (SD 8) compared to the primary group’s superior score of 44 (SD 10), p< 0.0001. There was no differences detected in post-operative SF-12 mental component scores; 49 (SD 12) for the revision group compared to 53 (SD 10) for the primary group, p=0.11.

Conclusion: This study confirms the general clinical impression that the functional results of revision TKR are inferior to primary TKR, as measured by both the WOMAC and SF-12 tools.