Controversy has prevailed for many years relating to the safety of one-stage and two-stage total hip arthroplasty (THA) for bilateral disease. We performed a meta-analysis of 1460 studies of which 5 prospective studies met our inclusion criteria. A total of 579 patients had two-stage procedures and 334 had one-stage surgery. The studies showed a low heterogeneity (I2 =0%) allowing pooling of da...

INTRODUCTION Historically, cemented total hip arthroplasty (THA) femoral stems inserted in varus have yielded poor clinical results. Few studies to date have addressed the question of the effects of varus alignment on cementless stems. We conducted a retrospective review of 125 uncemented THA femoral stems implanted by a single surgeon from 1994 to 1999. METHODS We conducted a retrospective r...

Anticoagulant medications help to reduce the risk of thromboembolic events after total hip arthroplasty and total knee arthroplasty. Traditionally, this has been accomplished with medications, such as low-molecular-weight heparin and warfarin. However, these traditional anticoagulants possess a variety of shortcomings that leave much room for improvement. A new class of oral anticoagulants is n...

Between 2001 and 2011, 1168 revision hip arthroplasties were reviewed for "early" failures within 5 years of the primary total hip arthroplasty (THA). 24.1% underwent revision within 5 years of index THA. Aseptic loosening, infection, instability, metallosis, and fracture were common modes of failure. In our previous report from 1986 to 2000, 33% were "early" revisions, with instability and ase...

INTRODUCTION Girdlestone hip arthroplasty, though described as a salvage procedure for infected hip joints, can also be considered for failed Hemiarthroplasty procedures. The functional results of such Girdlestone hip may not be satisfactory. They may require total hip replacement to improve the quality of life, which are technically challenging. Here we are reporting such a case ina 60 year ol...

OBJECTIVE To investigate the percentage of ideal patients who would be eligible for hip-resurfacing surgery at a reference service for hip arthroplasty. METHODS Out of all the cases of hip arthroplasty operated at Hospital do Servidor Público Estadual de São Paulo (HSPE) between January 2009 and December 2010, we assessed a total of 592 procedures that would fit the criteria for indication fo...

INTRODUCTION Metal-on-metal hip resurfacing has provided an alternative to standard total hip arthroplasty in younger, more active patients. However, detractors argue that many of the benefits of resurfacing can be obtained with the use of larger femoral heads. The purported advantages of the resurfacing procedure include preservation of femoral bone stock, increased range of motion, decreased ...

Robert Judet first performed hip arthroplasty via the anterior approach (AA) in 1947 on an orthopaedic table. Our center has a near 20-year experience on more than 3500 patients operated by AA hip arthroplasty. While primary AA total hip arthroplasty techniques have been discussed in the literature, revision AA total hip arthroplasty techniques are relatively new. The current article in the Jou...

Improved pain management techniques and accelerated rehabilitation programs are revolutionizing our patients' postoperative experience after total hip and knee arthroplasty. The process involves regional anesthesia with multimodal pain control using local periarticular injections in combination with enhanced patient education and accelerated rehabilitation provided by a dedicated team of surgeo...

BACKGROUND There is controversy regarding the most appropriate strategy to prevent venous thromboembolism following total joint arthroplasty. Our objective was to estimate the lifetime costs, quality-adjusted life-years (QALYs), and costs per QALY gained using low-molecular-weight heparin compared with low-dose aspirin for two weeks after total knee or total hip arthroplasty in patients with no...