Effective treatment of hip replacement: A Synthesis of Findings from 23 Studies

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Original Abstract of the Article

Major Research Findings

Hip replacement surgery is a common procedure for patients with severe hip pain and disability, often caused by conditions such as osteoarthritis. Research indicates that hip replacement surgery can provide numerous benefits, including pain relief, improved walking ability, and an enhanced quality of life. 16 , 9 , 3

However, as with any surgery, there are potential risks associated with hip replacement. These risks can include infection, blood clots, and dislocation. 6 , 23 . To minimize these risks, thorough pre-operative assessments and careful post-operative management are crucial. 20 , 7

Hip replacement surgery encompasses various types, such as total hip replacement and hemiarthroplasty. The suitability of each type depends on the specific condition and the patient’s overall health. 10 , 22 . It is essential to consult with a physician pre-operatively to discuss available options and choose the most appropriate procedure. 15

In addition, patients with underlying bone conditions such as osteoporosis may require additional considerations. Pre-operative bone density measurements and osteoporosis treatment may be necessary. 21 , 12 . Post-operative rehabilitation is also essential for optimal recovery. 19 , 14

Treatment Summary

Treatment options for hip replacement surgery include total hip replacement and hemiarthroplasty, each appropriate for different conditions and patient characteristics. 10 , 22 . Patients with osteoporosis may need pre-operative bone density assessments and treatment. 21 , 12 . To reduce dislocation risk, constrained acetabular components (CACs) and dual mobility implants (DMIs) may be utilized. 23

Benefits and Risks

Benefits Summary

Hip replacement surgery offers several benefits, including pain relief, improved walking ability, and an enhanced quality of life. 16 , 9 , 3

Risks Summary

Potential risks associated with hip replacement surgery include infection, blood clots, and dislocation. 6 , 23

Comparison Across Studies

Similarities Across Studies

Many studies consistently demonstrate the effectiveness of hip replacement surgery in reducing pain, improving walking ability, and enhancing quality of life. 16 , 9 , 3

Differences Across Studies

Variations exist among studies regarding surgical techniques, post-operative outcomes, and the types of implants used. 10 , 22 . Additionally, the age, health conditions, and lifestyle of study participants can influence the findings. 15

Consistency and Contradictions in Findings

While numerous studies support the effectiveness of hip replacement surgery in pain relief, improved walking ability, and quality of life, there is variability in the risks and post-operative outcomes reported across different studies. 6 , 23 . Therefore, tailoring treatment approaches to individual patient needs is paramount. 20 , 7

Practical Application Considerations

Hip replacement surgery offers the potential for pain relief, improved walking ability, and enhanced quality of life. However, individual outcomes can vary. 6 , 23 . Prior to surgery, consulting with a physician to discuss individual needs and choose the appropriate treatment is essential. 20 , 7

Limitations of Current Research

Research on hip replacement surgery remains incomplete. 15 . Specifically, further research is needed to understand long-term outcomes and the impact of various factors on surgical results. 9

Future Research Directions

Research is needed to investigate long-term outcomes of hip replacement surgery and the influence of various factors on surgical results. 9 . Additionally, research focusing on post-operative rehabilitation and lifestyle factors in relation to recovery outcomes is crucial. 19 , 14

Conclusion

Hip replacement surgery offers the potential for pain relief, improved walking ability, and enhanced quality of life. 16 , 9 , 3 . However, individual outcomes can vary. 6 , 23 . It is essential to consult with a physician prior to surgery to discuss individual needs and choose the appropriate treatment. 20 , 7 . Active participation in post-operative rehabilitation is also crucial for optimal recovery. 19 , 14

Treatment List

Total hip replacement, hemiarthroplasty, constrained acetabular components (CACs), dual mobility implants (DMIs)

Literature analysis of 23 papers
Positive Content
20
Neutral Content
2
Negative Content
1
Article Type
11
7
12
8
23
1.

Treatment of femoral neck fractures with total hip replacement versus cemented and noncemented hemiarthroplasty.

Author: DorrL D, GlousmanR, HoyA L, VanisR, ChandlerR

Femoral neck fracture treatment
Dislocation

A study of 89 patients with displaced femoral neck fractures found that cemented total hip replacement and cemented hemiarthroplasty resulted in similar outcomes, with better outcomes for younger patients. Non-cemented hemiarthroplasty resulted in increased pain and decreased ambulation.

Clinical TrialA clinical trial is a planned study conducted on humans to evaluate the efficacy and safety of pharmaceuticals, medical devices, and treatment methods. It aims to explore the possibilities of new treatments and improve the health of patients.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.

Language : English

2.

The effectiveness of metal on metal hip resurfacing: a systematic review of the available evidence published before 2002.

Author: WynessLaura, ValeLuke, McCormackKirsty, GrantAdrian, BrazzelliMiriam

Hip disease treatment

Traditional hip replacement surgery might have a higher risk of failure over time, especially for younger people. Metal-on-metal hip resurfacing, which preserves bone, is becoming more popular as an alternative for patients not suitable for traditional replacement. This study compares the effectiveness of metal-on-metal hip resurfacing to other hip treatments available in the UK.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.
Systematic ReviewA review that systematically collects, evaluates, and integrates relevant research to answer a specific research question.

Language : English

3.

Comparison of internal fixation with total hip replacement for displaced femoral neck fractures. Randomized, controlled trial performed at four years.

Author: BlomfeldtRichard, TörnkvistHans, PonzerSari, SöderqvistAnita, TidermarkJan

Femoral neck fracture treatment

This study examines the long-term (4 years) outcomes of two treatments for a broken hip (displaced femoral neck fracture) in older, healthy patients: 1) hip replacement and 2) internal fixation (using screws or plates to hold the bone together). The study builds on previous research that showed hip replacement was more effective than internal fixation at 2 years after surgery. The aim of this study is to evaluate if this benefit is maintained at 4 years.

Clinical TrialA clinical trial is a planned study conducted on humans to evaluate the efficacy and safety of pharmaceuticals, medical devices, and treatment methods. It aims to explore the possibilities of new treatments and improve the health of patients.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.

Language : English

4.

Arthroplasties (with and without bone cement) for proximal femoral fractures in adults.

Author: ParkerM J, GurusamyK

Improved hip fracture treatment
Hip fracture

Different types of hip replacements are used to surgically treat hip fractures. The main differences are in the design of the implant's stem, whether it is cemented in place, whether it has a second joint, and whether a partial or total hip replacement is used.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Meta-AnalysisA statistical technique that integrates the results of multiple studies to draw more general conclusions about a particular issue.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.
Systematic ReviewA review that systematically collects, evaluates, and integrates relevant research to answer a specific research question.

Language : English

5.

A randomised study comparing resection of acetabular bone at resurfacing and total hip replacement.

Author: VendittoliP-A, LavigneM, GirardJ, RoyA G

Hip replacement treatment

This study compared the amount of bone removed during two hip replacement surgeries: total hip replacement and hip resurfacing. The study found that while hip resurfacing preserves more bone on the femur (thigh bone) side, using a specific design of implant and careful surgical technique, the amount of bone removed from the hip socket (acetabulum) was similar for both procedures.

Comparative StudyResearch that compares multiple groups/interventions to determine differences/similarities in outcomes/characteristics.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.

Language : English

6.

Operative and non-operative treatment options for dislocation of the hip following total hip arthroplasty.

Author: KhanR J K, Carey SmithR L, AlakesonR, FickD P, WoodD

Recurrent dislocation

This systematic review aimed to determine the best methods of treatment of recurrent dislocation following total hip replacement. However, no randomized or quasi-randomized trials comparing operative and non-operative treatments for recurrent dislocation following total hip replacement were identified. The authors encourage researchers to perform RCTs comparing different treatment options.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.
Systematic ReviewA review that systematically collects, evaluates, and integrates relevant research to answer a specific research question.

Language : English

7.

Early discharge and home intervention reduces unit costs after total hip replacement: results of a cost analysis in a randomized study.

Author: SigurdssonEyjolfur, SiggeirsdottirKristin, JonssonHalldor, GudnasonVilmundur, MatthiassonThorolfur, JonssonBrynjolfur Y

Cost reduction
Hospital stay reduction
Rehabilitation effectiveness

This study compared two pathways of postoperative treatment for total hip replacement (THR), with one group receiving preoperative and postoperative education programs and home visits from an outpatient team.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Multicenter StudyResearch conducted in collaboration with multiple research institutions. It aims to collect a wide range of data and obtain more generalizable results.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.

Language : English

9.

Long-term follow-up of replacement compared with internal fixation for displaced femoral neck fractures: results at ten years in a randomised study of 450 patients.

Author: LeonardssonO, SernboI, CarlssonA, AkessonK, RogmarkC

Femoral neck fracture treatment

This study compared the outcomes of internal fixation versus replacement for displaced fractures of the femoral neck in patients over 70 years of age.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Multicenter StudyResearch conducted in collaboration with multiple research institutions. It aims to collect a wide range of data and obtain more generalizable results.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.

Language : English

10.

Arthroplasties (with and without bone cement) for proximal femoral fractures in adults.

Author: ParkerMartyn J, GurusamyKurinchi Selvan, AzegamiShin

Hip fracture treatment

Different types of hip replacements are used to surgically treat hip fractures. The main differences are in the design of the implant's stem, whether it is cemented in place, whether it has a second joint, and whether a partial or total hip replacement is used.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Meta-AnalysisA statistical technique that integrates the results of multiple studies to draw more general conclusions about a particular issue.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.
Systematic ReviewA review that systematically collects, evaluates, and integrates relevant research to answer a specific research question.

Language : English

11.

What is the evidence base to guide surgical treatment of infected hip prostheses? systematic review of longitudinal studies in unselected patients.

Author: BeswickAndrew D, ElversKaren T, SmithAlison J, Gooberman-HillRachael, LoveringAndrew, BlomAshley W

Treatment of prosthetic joint infection

Infection after hip replacement is uncommon but serious. Two main surgical approaches are used, often based on surgeon preference. This study highlights the need for evidence to compare the effectiveness of single-stage and two-stage revision surgeries in preventing reinfection after hip replacement infection.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Meta-AnalysisA statistical technique that integrates the results of multiple studies to draw more general conclusions about a particular issue.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.
Systematic ReviewA review that systematically collects, evaluates, and integrates relevant research to answer a specific research question.

Language : English

12.

Salmon calcitonin (Miacalcic ns 200 IU) in prevention of bone loss after hip replacement.

Author: ArnalaI O

Hip prosthesis loosening prevention

Calcitonin was found to have a positive effect on periprosthetic bone after total hip arthroplasty, potentially preventing loosening of the prosthesis and improving clinical outcomes.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.

Language : English

13.

Acute total hip replacement for acetabular fractures: a systematic review of the literature.

Author: De BellisUmberto Giovanni, LegnaniClaudio, CaloriGiorgio Maria

Clinical improvement
Walking ability improvement
Loosening
Revision surgery

Immediate total hip replacement (THR) can be successful in appropriately selected elderly patients or patients with extensive osteoporosis, combined acetabular and femoral neck fractures or pathological fractures.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.
Systematic ReviewA review that systematically collects, evaluates, and integrates relevant research to answer a specific research question.

Language : English

14.

Exercise therapy may postpone total hip replacement surgery in patients with hip osteoarthritis: a long-term follow-up of a randomised trial.

Author: SvegeIda, NordslettenLars, FernandesLinda, RisbergMay Arna

Improved function
Reduced THR need
No pain/stiffness benefit

Exercise therapy, in addition to patient education, reduced the need for THR by 44% in patients with hip OA.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.

Language : English

15.

Internal fixation compared with total hip replacement for displaced femoral neck fractures: a minimum fifteen-year follow-up study of a previously reported randomized trial.

Author: JohanssonTorsten

Improved long-term outcomes

Total hip replacement is superior to internal fixation in the treatment of a displaced femoral neck fracture.

Comparative StudyResearch that compares multiple groups/interventions to determine differences/similarities in outcomes/characteristics.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.

Language : English

16.

Total hip replacement for the treatment of end stage arthritis of the hip: a systematic review and meta-analysis.

Author: TsertsvadzeAlexander, GroveAmy, FreemanKaroline, CourtRachel, JohnsonSamantha, ConnockMartin, ClarkeAileen, SutcliffePaul

THR treatment

Advances in total hip replacement (THR) implants have led to a wide range of options. This review examines the effectiveness of different types of THR implants used for severe hip arthritis, aiming to determine the best choices for patients.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Meta-AnalysisA statistical technique that integrates the results of multiple studies to draw more general conclusions about a particular issue.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.
Systematic ReviewA review that systematically collects, evaluates, and integrates relevant research to answer a specific research question.

Language : English

17.

Total hip replacement and surface replacement for the treatment of pain and disability resulting from end-stage arthritis of the hip (review of technology appraisal guidance 2 and 44): systematic review and economic evaluation.

Author: ClarkeAileen, Pulikottil-JacobRuth, GroveAmy, FreemanKaroline, MistryHema, TsertsvadzeAlexander, ConnockMartin, CourtRachel, KandalaNgianga-Bakwin, CostaMatthew, SuriGaurav, MetcalfeDavid, CrowtherMichael, MorrowSarah, JohnsonSamantha, SutcliffePaul

Improved hip function
Lower revision rates
Reduced hip pain
Higher cost
Lower QALYs

Total hip replacement (THR) was more cost-effective than resurfacing arthroplasty (RS) for end-stage arthritis of the hip. THR was cheaper and more effective, with lower revision rates.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.
Systematic ReviewA review that systematically collects, evaluates, and integrates relevant research to answer a specific research question.

Language : English

19.

Sports Therapy Interventions Following Total Hip Replacement.

Author: BeckHeidrun, BeyerFranziska, GeringFranziska, GüntherKlaus-Peter, LütznerCornelia, WaltherAchim, StiehlerMaik

Improved THR outcomes

Sport rehabilitation after total hip replacement (THR) may improve muscle strength around the hip joint, cardiopulmonary endurance performance, and stance stability.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.

Language : English

20.

What are patients' preferences for revision surgery after periprosthetic joint infection? A discrete choice experiment.

Author: CarrollFran E, Gooberman-HillRachael, StrangeSimon, BlomAshley W, MooreAndrew J

This study assesses patients' preferences for aspects of revision surgery for periprosthetic hip infection, highlighting the importance of understanding patient preferences for shared decision-making.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Multicenter StudyResearch conducted in collaboration with multiple research institutions. It aims to collect a wide range of data and obtain more generalizable results.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.

Language : English

21.

Bisphosphonates Can Maintain Periprosthetic Bone Mass Density after Total Hip Replacement, with Controversy in Region of Interest 5.

Author: HaoDongsheng, WangJunjie, ZuoLiyun

Improved BMD
Reduced bone turnover
Adverse effects
Reduced compliance

A meta-analysis of nine randomized controlled trials (359 patients) found that bisphosphonates (BPs) effectively maintain overall periprosthetic bone mineral density (BMD) after total hip replacement (THR) but BMD in a specific region of interest remains controversial. BPs are generally safe but compliance may be relatively low.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Meta-AnalysisA statistical technique that integrates the results of multiple studies to draw more general conclusions about a particular issue.
Systematic ReviewA review that systematically collects, evaluates, and integrates relevant research to answer a specific research question.

Language : English

22.

Hemiarthroplasty compared to total hip arthroplasty for the treatment of femoral neck fractures: a systematic review and meta-analysis.

Author: LiXinbo, LuoJianning

Reduced blood loss
Shorter surgery time
Increased complications
Increased hospital stay

Hemi-arthroplasty (HA) resulted in less blood loss and shorter surgery time compared to total hip arthroplasty (THA) for femoral neck fractures. THA was associated with a shorter hospital stay and lower rates of pneumonia and renal failure.

Comparative StudyResearch that compares multiple groups/interventions to determine differences/similarities in outcomes/characteristics.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Meta-AnalysisA statistical technique that integrates the results of multiple studies to draw more general conclusions about a particular issue.
Systematic ReviewA review that systematically collects, evaluates, and integrates relevant research to answer a specific research question.

Language : English

23.

The Incidence and Temporal Trends of Dislocation After the Use of Constrained Acetabular Components and Dual Mobility Implants in Primary Total Hip Replacements: A Systematic Review and Meta-Analysis of Longitudinal Observational Studies.

Author: DonovanRichard L, JohnsonHarvey, FernandoSherwin, Foxall-SmithMichael, WhitehouseMichael R, BlomAshley W, KunutsorSetor K

Improved stability
Reduced dislocation risk

This meta-analysis examined the use of constrained acetabular components (CACs) and dual mobility implants (DMIs) in total hip replacement (THR) surgery. The results suggest that CACs and DMIs may be effective in preventing hip dislocation in patients at high risk for this complication.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Meta-AnalysisA statistical technique that integrates the results of multiple studies to draw more general conclusions about a particular issue.
Systematic ReviewA review that systematically collects, evaluates, and integrates relevant research to answer a specific research question.

Language : English

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