Total Joint Replacement or Try Stem Cells First
What is the prognosis of revision total hip arthroplasty in patients 55 years and younger?
Adelani MA1, Crook K, Barrack RL, Maloney WJ, Clohisy JC.
- 1Department of Orthopaedic Surgery, Washington University School of Medicine, 660 South Euclid Avenue, Campus Box 8233, St Louis, MO, 63110, USA, [email protected].
Revision THAs are expected to increase; however, few studies have characterized the prognosis of revision THAs in younger patients.
We performed a case-control study to evaluate intermediate-term survivorship, complications, and hip and activity scores after revision THAs in patients 55 years and younger, compared these outcomes with the results of primary THAs in a matched patient population, and evaluated risk factors for failed revisions.
At mean followup of 6.7 years, 71 revision THAs (69%) survived, compared with 102 (99%) primary THAs
At intermediate-term followup, young patients undergoing revision THAs had markedly higher failure and complication rates and more modest clinical improvements compared with patients in a matched cohort who had primary THAs.
CORR Insights®: What is the prognosis of revision total hip arthroplasty in patients 55 years and younger? [Clin Orthop Relat Res. 2014]
Do activity levels increase after total hip and knee arthroplasty?
Harding P1, Holland AE, Delany C, Hinman RS.
- 1Department of Physiotherapy, The Alfred, Melbourne, VIC, Australia.
People with osteoarthritis (OA) often are physically inactive. Surgical treatment including total hip arthroplasty or total knee arthroplasty can substantially improve pain, physical function, and quality of life. However, their impact on physical activity levels is less clear.
We used accelerometers to measure levels of physical activity pre- and (6 months) post arthroplasty and to examine the proportion of people meeting the American Physical Activity Guidelines.
There was no change in objectively measured physical activity after arthroplasty. The majority of participants were sedentary, both before and after arthroplasty, and did not meet the American Physical Activity Guidelines recommended to promote health. This was despite significant improvements in self-reported measures of pain, function, quality of life, and physical activity after arthroplasty.
Despite patient-reported improvements in pain, function, and physical activity after arthroplasty, objectively measured improvements in physical activity may not occur.
In my Blog this week, I wanted to share some recent scientific publications pertaining to joint replacement, with emphasis on the limitations of hip replacement. Next week, I will update you with a Blog reviewing the Application of Stem Cells to Orthopedic Conditions. I am in the unique position of having performed joint replacements over a professional lifetime and now practice Cellular Orthopedics in an attempt to postpone or avoid a joint replacement. Patient , you decide about a joint replacement or trying stem cells first.
Tags: Hip Arthritis, Revision Total Hip Replacement, Stem Cells for the Hip, Total Hip Replacement