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      Bilateral Greater Trochanteric Avulsion Fractures after Bilateral Simultaneous Total Hip Arthroplasty

      case-report
      , , ,
      Case Reports in Orthopedics
      Hindawi

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          Abstract

          We report a case of bilateral spontaneous greater trochanteric fracture after bilateral simultaneous total hip arthroplasty (THA) performed via the posterolateral approach during the early postoperative phase. A 75-year-old woman underwent bilateral simultaneous THA (BS-THA) for severe osteoarthritis with developmental dysplasia of the hip; she also presented a limited range of adduction. BS-THA was successful without any intraoperative complications. Rehabilitation with full weight-bearing exercises was initiated the day after the surgery. On the 14th postoperative day, she experienced a spontaneous left greater trochanteric fracture during a walking exercise without any trauma. Osteosynthesis was performed for the fracture on the 18th postoperative day. On the 20th postoperative day, a right spontaneous greater trochanteric avulsion fracture occurred during a transfer exercise without any trauma; this was treated on the 27th postoperative day. In the 18th postoperative month, although the right fragment showed slight upper migration, the patient had no complaints of coxalgia and both hip joints showed an excellent range of motion.

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          Is the Anterior Approach Safe? Early Complication Rate Associated With 5090 Consecutive Primary Total Hip Arthroplasty Procedures Performed Using the Anterior Approach

          Few publications have raised concern with the safety of the anterior approach (AA) to total hip arthroplasty (THA). The purpose of this study is to report the early complications with AA THA in a combined, multicenter patient population from three different institutions.
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            The safety and efficacy of bilateral simultaneous total hip replacement: an analysis of 2063 cases.

            Comparison of the safety and efficacy of bilateral simultaneous total hip replacement (THR) and that of staged bilateral THR and unilateral THR was conducted using DerSimonian-Laird heterogeneity meta-analysis. A review of the English-language literature identified 23 citations eligible for inclusion. A total of 2063 bilateral simultaneous THR patients were identified. Meta-analysis of homogeneous data revealed no statistically significant differences in the rates of thromboembolic events (p = 0.268 and p = 0.365) and dislocation (p = 0.877) when comparing staged or unilateral with bilateral simultaneous THR procedures. A systematic analysis of heterogeneous data demonstrated that the mean length of hospital stay was shorter after bilateral simultaneous THR. Higher blood transfusion requirements were expected following bilateral simultaneous THR than staged or unilateral THR, and surgical time was not different between groups. This procedure was also found to be economically and functionally efficacious when performed by experienced surgeons in specialist centres.
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              Simultaneous bilateral versus unilateral total hip arthroplasty an outcomes analysis.

              This study compared the morbidity, mortality, and outcomes of 900 simultaneous bilateral total hip arthroplasties in 450 patients and 450 unilateral total hip arthroplasties. Pulmonary complications were significantly higher in the simultaneous bilateral group (1.6% vs 0.7%; P < .0312). Fourteen (3.1%) patients in the simultaneous bilateral group and 18 (4%) patients in the unilateral group died within the first postoperative year. Patients with mortality in the first postoperative year were significantly older (69.8 vs 62.3 years; P < .0012). Long-term patient survival, the prosthetic survival, and functional outcomes were not significantly different between groups. Simultaneous bilateral total hip arthroplasty has advantages where both hips are symptomatic and has less risk in younger patients with understanding of the increased risk of pulmonary complications.
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                Author and article information

                Contributors
                Journal
                Case Rep Orthop
                Case Rep Orthop
                CRIOR
                Case Reports in Orthopedics
                Hindawi
                2090-6749
                2090-6757
                2018
                29 April 2018
                : 2018
                : 6596135
                Affiliations
                Department of Orthopaedic Surgery, Oita University, Oita, Japan
                Author notes

                Academic Editor: Elke R. Ahlmann

                Author information
                http://orcid.org/0000-0002-4041-1870
                Article
                10.1155/2018/6596135
                5949174
                163c9fe5-e114-48ca-9881-94edca59fb00
                Copyright © 2018 Hiroaki Tagomori et al.

                This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                : 14 February 2018
                : 15 March 2018
                Categories
                Case Report

                Orthopedics
                Orthopedics

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