Blood loss in primary total hip arthroplasty with a short versus conventional cementless stem: a retrospective cohort study
Introduction To evaluate the impact of short cementless stem on several clinical and radiographic outcomes, with particular focus on blood loss, in comparison with conventional cementless stem in total hip arthroplasty (THA). Materials and methods Patients undergoing THA with GTS short stem or CLS c...
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| Veröffentlicht in: | Archives of orthopaedic and trauma surgery 2020-10, Vol.140 (10), p.1551-1558 |
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| creator | Loppini, Mattia Della Rocca, Antonello Ferrentino, Davide Pizzi, Costanza Grappiolo, Guido |
| description | Introduction
To evaluate the impact of short cementless stem on several clinical and radiographic outcomes, with particular focus on blood loss, in comparison with conventional cementless stem in total hip arthroplasty (THA).
Materials and methods
Patients undergoing THA with GTS short stem or CLS conventional stem were included. Clinical data were retrospectively collected including preoperative and postoperative day 1 value for haemoglobin (HB); rate of postoperative blood transfusions; intraoperative bone infractions; stem alignment; 5-year follow-up Harris Hip Score (HHS) and rate of stem revision at 5 years of follow-up of the short and conventional cementless stem.
Results
GTS and CLS stem group included 374 and 321 patients, respectively. The mean difference between the preoperative and postoperative day 1 HB value was 3.98 g/dL (SD 1.12) and 3.67 g/dL (SD 1.19) in the GTS and CLS group, respectively, which correspond to a crude effect (β) of 0.32 (95% CI 0.15; 0.49) and adjusted effect of 0.11 (95% CI − 0.08; 0.3). GTS group reported a significantly higher number of patients with excellent results in terms of HHS (
p
= 0.001). The rate of intraoperative bone infractions was 1.6% and 0.3% in the GTS and CLS group, respectively (
p
= 0.013). At radiographic assessment, the rate of varus position of the stem was 14% in the GTS group and 6% in the CLS group (
p
|
| doi_str_mv | 10.1007/s00402-020-03561-w |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_2430093240</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2430093240</sourcerecordid><originalsourceid>FETCH-LOGICAL-c391t-a8d5023c7b3d6472e87563a7af8da35c56051364d56a7be481ea6d48d3839683</originalsourceid><addsrcrecordid>eNp9kMtu2zAQRYkiReOm_YEuCi67UTt8iKKzS4K8gADdZE_Q4rhWIIkqh7Jh5OfDxk6XWXEAnnsxcxj7JuCnAGh-EYAGWYGEClRtRLX7wBZCK12ppTAnbAFLZSoLtThln4meAIS0S_jETpVstGpALtjzZR9j4H0k4t3Ip9QNPu15jtn3fNNN3Ke8SXHqPeU933V5wz2nTUyZbzHRTLyN4xbH3MWxJFocytxjaaOMw3mBE-YUacI2d1ss9GuW8hz2X9jHte8Jvx7fM_Z4c_14dVc9_L69v7p4qNpyR668DTVI1TYrFYxuJNqmNso3fm2DV3Vbm3KhMjrUxjcr1FagN0HboKxaGqvO2I9D7ZTi3xkpu6GjFvvejxhnclIrKKakhoLKA9qWlSnh2h2FOAHun3N3cO6Kc_fq3O1K6Puxf14NGP5H3iQXQB0AKl_jH0zuKc6p6KL3al8AvTOPYg</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2430093240</pqid></control><display><type>article</type><title>Blood loss in primary total hip arthroplasty with a short versus conventional cementless stem: a retrospective cohort study</title><source>MEDLINE</source><source>SpringerLink Journals - AutoHoldings</source><creator>Loppini, Mattia ; Della Rocca, Antonello ; Ferrentino, Davide ; Pizzi, Costanza ; Grappiolo, Guido</creator><creatorcontrib>Loppini, Mattia ; Della Rocca, Antonello ; Ferrentino, Davide ; Pizzi, Costanza ; Grappiolo, Guido</creatorcontrib><description>Introduction
To evaluate the impact of short cementless stem on several clinical and radiographic outcomes, with particular focus on blood loss, in comparison with conventional cementless stem in total hip arthroplasty (THA).
Materials and methods
Patients undergoing THA with GTS short stem or CLS conventional stem were included. Clinical data were retrospectively collected including preoperative and postoperative day 1 value for haemoglobin (HB); rate of postoperative blood transfusions; intraoperative bone infractions; stem alignment; 5-year follow-up Harris Hip Score (HHS) and rate of stem revision at 5 years of follow-up of the short and conventional cementless stem.
Results
GTS and CLS stem group included 374 and 321 patients, respectively. The mean difference between the preoperative and postoperative day 1 HB value was 3.98 g/dL (SD 1.12) and 3.67 g/dL (SD 1.19) in the GTS and CLS group, respectively, which correspond to a crude effect (β) of 0.32 (95% CI 0.15; 0.49) and adjusted effect of 0.11 (95% CI − 0.08; 0.3). GTS group reported a significantly higher number of patients with excellent results in terms of HHS (
p
= 0.001). The rate of intraoperative bone infractions was 1.6% and 0.3% in the GTS and CLS group, respectively (
p
= 0.013). At radiographic assessment, the rate of varus position of the stem was 14% in the GTS group and 6% in the CLS group (
p
< 0.0001). The rate of stem revision at 5 years of follow-up was 0.8% and 0.4% in the GTS and CLS group, respectively (
p
= 0.63).
Conclusions
GTS short stem was not associated with a clinically significant lower blood loss in the immediately postoperative period. Unadjusted exploratory analyses show that GTS stem provides the same results of CLS stem in terms of HHS and rate of stem revision at 5 years of follow-up.</description><identifier>ISSN: 0936-8051</identifier><identifier>EISSN: 1434-3916</identifier><identifier>DOI: 10.1007/s00402-020-03561-w</identifier><identifier>PMID: 32743702</identifier><language>eng</language><publisher>Berlin/Heidelberg: Springer Berlin Heidelberg</publisher><subject>Arthroplasty, Replacement, Hip - adverse effects ; Arthroplasty, Replacement, Hip - instrumentation ; Arthroplasty, Replacement, Hip - statistics & numerical data ; Blood Loss, Surgical - statistics & numerical data ; Hip Arthroplasty ; Hip Joint - surgery ; Hip Prosthesis - adverse effects ; Humans ; Medicine ; Medicine & Public Health ; Orthopedics ; Prosthesis Design ; Retrospective Studies</subject><ispartof>Archives of orthopaedic and trauma surgery, 2020-10, Vol.140 (10), p.1551-1558</ispartof><rights>Springer-Verlag GmbH Germany, part of Springer Nature 2020</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c391t-a8d5023c7b3d6472e87563a7af8da35c56051364d56a7be481ea6d48d3839683</citedby><cites>FETCH-LOGICAL-c391t-a8d5023c7b3d6472e87563a7af8da35c56051364d56a7be481ea6d48d3839683</cites><orcidid>0000-0001-8569-0669</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s00402-020-03561-w$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s00402-020-03561-w$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>314,780,784,27924,27925,41488,42557,51319</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/32743702$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Loppini, Mattia</creatorcontrib><creatorcontrib>Della Rocca, Antonello</creatorcontrib><creatorcontrib>Ferrentino, Davide</creatorcontrib><creatorcontrib>Pizzi, Costanza</creatorcontrib><creatorcontrib>Grappiolo, Guido</creatorcontrib><title>Blood loss in primary total hip arthroplasty with a short versus conventional cementless stem: a retrospective cohort study</title><title>Archives of orthopaedic and trauma surgery</title><addtitle>Arch Orthop Trauma Surg</addtitle><addtitle>Arch Orthop Trauma Surg</addtitle><description>Introduction
To evaluate the impact of short cementless stem on several clinical and radiographic outcomes, with particular focus on blood loss, in comparison with conventional cementless stem in total hip arthroplasty (THA).
Materials and methods
Patients undergoing THA with GTS short stem or CLS conventional stem were included. Clinical data were retrospectively collected including preoperative and postoperative day 1 value for haemoglobin (HB); rate of postoperative blood transfusions; intraoperative bone infractions; stem alignment; 5-year follow-up Harris Hip Score (HHS) and rate of stem revision at 5 years of follow-up of the short and conventional cementless stem.
Results
GTS and CLS stem group included 374 and 321 patients, respectively. The mean difference between the preoperative and postoperative day 1 HB value was 3.98 g/dL (SD 1.12) and 3.67 g/dL (SD 1.19) in the GTS and CLS group, respectively, which correspond to a crude effect (β) of 0.32 (95% CI 0.15; 0.49) and adjusted effect of 0.11 (95% CI − 0.08; 0.3). GTS group reported a significantly higher number of patients with excellent results in terms of HHS (
p
= 0.001). The rate of intraoperative bone infractions was 1.6% and 0.3% in the GTS and CLS group, respectively (
p
= 0.013). At radiographic assessment, the rate of varus position of the stem was 14% in the GTS group and 6% in the CLS group (
p
< 0.0001). The rate of stem revision at 5 years of follow-up was 0.8% and 0.4% in the GTS and CLS group, respectively (
p
= 0.63).
Conclusions
GTS short stem was not associated with a clinically significant lower blood loss in the immediately postoperative period. Unadjusted exploratory analyses show that GTS stem provides the same results of CLS stem in terms of HHS and rate of stem revision at 5 years of follow-up.</description><subject>Arthroplasty, Replacement, Hip - adverse effects</subject><subject>Arthroplasty, Replacement, Hip - instrumentation</subject><subject>Arthroplasty, Replacement, Hip - statistics & numerical data</subject><subject>Blood Loss, Surgical - statistics & numerical data</subject><subject>Hip Arthroplasty</subject><subject>Hip Joint - surgery</subject><subject>Hip Prosthesis - adverse effects</subject><subject>Humans</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Orthopedics</subject><subject>Prosthesis Design</subject><subject>Retrospective Studies</subject><issn>0936-8051</issn><issn>1434-3916</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2020</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9kMtu2zAQRYkiReOm_YEuCi67UTt8iKKzS4K8gADdZE_Q4rhWIIkqh7Jh5OfDxk6XWXEAnnsxcxj7JuCnAGh-EYAGWYGEClRtRLX7wBZCK12ppTAnbAFLZSoLtThln4meAIS0S_jETpVstGpALtjzZR9j4H0k4t3Ip9QNPu15jtn3fNNN3Ke8SXHqPeU933V5wz2nTUyZbzHRTLyN4xbH3MWxJFocytxjaaOMw3mBE-YUacI2d1ss9GuW8hz2X9jHte8Jvx7fM_Z4c_14dVc9_L69v7p4qNpyR668DTVI1TYrFYxuJNqmNso3fm2DV3Vbm3KhMjrUxjcr1FagN0HboKxaGqvO2I9D7ZTi3xkpu6GjFvvejxhnclIrKKakhoLKA9qWlSnh2h2FOAHun3N3cO6Kc_fq3O1K6Puxf14NGP5H3iQXQB0AKl_jH0zuKc6p6KL3al8AvTOPYg</recordid><startdate>20201001</startdate><enddate>20201001</enddate><creator>Loppini, Mattia</creator><creator>Della Rocca, Antonello</creator><creator>Ferrentino, Davide</creator><creator>Pizzi, Costanza</creator><creator>Grappiolo, Guido</creator><general>Springer Berlin Heidelberg</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0001-8569-0669</orcidid></search><sort><creationdate>20201001</creationdate><title>Blood loss in primary total hip arthroplasty with a short versus conventional cementless stem: a retrospective cohort study</title><author>Loppini, Mattia ; Della Rocca, Antonello ; Ferrentino, Davide ; Pizzi, Costanza ; Grappiolo, Guido</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c391t-a8d5023c7b3d6472e87563a7af8da35c56051364d56a7be481ea6d48d3839683</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2020</creationdate><topic>Arthroplasty, Replacement, Hip - adverse effects</topic><topic>Arthroplasty, Replacement, Hip - instrumentation</topic><topic>Arthroplasty, Replacement, Hip - statistics & numerical data</topic><topic>Blood Loss, Surgical - statistics & numerical data</topic><topic>Hip Arthroplasty</topic><topic>Hip Joint - surgery</topic><topic>Hip Prosthesis - adverse effects</topic><topic>Humans</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Orthopedics</topic><topic>Prosthesis Design</topic><topic>Retrospective Studies</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Loppini, Mattia</creatorcontrib><creatorcontrib>Della Rocca, Antonello</creatorcontrib><creatorcontrib>Ferrentino, Davide</creatorcontrib><creatorcontrib>Pizzi, Costanza</creatorcontrib><creatorcontrib>Grappiolo, Guido</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Archives of orthopaedic and trauma surgery</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Loppini, Mattia</au><au>Della Rocca, Antonello</au><au>Ferrentino, Davide</au><au>Pizzi, Costanza</au><au>Grappiolo, Guido</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Blood loss in primary total hip arthroplasty with a short versus conventional cementless stem: a retrospective cohort study</atitle><jtitle>Archives of orthopaedic and trauma surgery</jtitle><stitle>Arch Orthop Trauma Surg</stitle><addtitle>Arch Orthop Trauma Surg</addtitle><date>2020-10-01</date><risdate>2020</risdate><volume>140</volume><issue>10</issue><spage>1551</spage><epage>1558</epage><pages>1551-1558</pages><issn>0936-8051</issn><eissn>1434-3916</eissn><abstract>Introduction
To evaluate the impact of short cementless stem on several clinical and radiographic outcomes, with particular focus on blood loss, in comparison with conventional cementless stem in total hip arthroplasty (THA).
Materials and methods
Patients undergoing THA with GTS short stem or CLS conventional stem were included. Clinical data were retrospectively collected including preoperative and postoperative day 1 value for haemoglobin (HB); rate of postoperative blood transfusions; intraoperative bone infractions; stem alignment; 5-year follow-up Harris Hip Score (HHS) and rate of stem revision at 5 years of follow-up of the short and conventional cementless stem.
Results
GTS and CLS stem group included 374 and 321 patients, respectively. The mean difference between the preoperative and postoperative day 1 HB value was 3.98 g/dL (SD 1.12) and 3.67 g/dL (SD 1.19) in the GTS and CLS group, respectively, which correspond to a crude effect (β) of 0.32 (95% CI 0.15; 0.49) and adjusted effect of 0.11 (95% CI − 0.08; 0.3). GTS group reported a significantly higher number of patients with excellent results in terms of HHS (
p
= 0.001). The rate of intraoperative bone infractions was 1.6% and 0.3% in the GTS and CLS group, respectively (
p
= 0.013). At radiographic assessment, the rate of varus position of the stem was 14% in the GTS group and 6% in the CLS group (
p
< 0.0001). The rate of stem revision at 5 years of follow-up was 0.8% and 0.4% in the GTS and CLS group, respectively (
p
= 0.63).
Conclusions
GTS short stem was not associated with a clinically significant lower blood loss in the immediately postoperative period. Unadjusted exploratory analyses show that GTS stem provides the same results of CLS stem in terms of HHS and rate of stem revision at 5 years of follow-up.</abstract><cop>Berlin/Heidelberg</cop><pub>Springer Berlin Heidelberg</pub><pmid>32743702</pmid><doi>10.1007/s00402-020-03561-w</doi><tpages>8</tpages><orcidid>https://orcid.org/0000-0001-8569-0669</orcidid><oa>free_for_read</oa></addata></record> |
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| source | MEDLINE; SpringerLink Journals - AutoHoldings |
| subjects | Arthroplasty, Replacement, Hip - adverse effects Arthroplasty, Replacement, Hip - instrumentation Arthroplasty, Replacement, Hip - statistics & numerical data Blood Loss, Surgical - statistics & numerical data Hip Arthroplasty Hip Joint - surgery Hip Prosthesis - adverse effects Humans Medicine Medicine & Public Health Orthopedics Prosthesis Design Retrospective Studies |
| title | Blood loss in primary total hip arthroplasty with a short versus conventional cementless stem: a retrospective cohort study |
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