[Show abstract][Hide abstract] ABSTRACT: Total Joint Arthroplasty (TJA) is a relatively safe orthopaedic procedure. However, complications do occur, and some may necessitate admission to the intensive care unit (ICU). Our purpose was to determine risk factors associated with admittance to ICU following TJA. We evaluated 22,343 primary and revision total hip and knee arthroplasties from 1999 to 2008. 130 patients were admitted to the ICU. Cases were matched 1:2 for date of surgery, surgeon and type of surgery. The causes for admission to ICU were recorded. Independent risk factors for ICU admission were: smoking; cemented arthroplasty; general anesthesia; allogenic transfusion; higher C-reactive protein; lower hemoglobin; higher body mass index; and older age. Proper identification and management of these “at-risk” patients may decrease the incidence of ICU admittance after TJA.
Full-text · Article · Nov 2011 · The Journal of arthroplasty
[Show abstract][Hide abstract] ABSTRACT: We performed a retrospective examination of the anteroposterior pelvic CT scout views of 419 randomly selected patients between April 2004 and August 2009 in order to determine the prevalence of cam-type femoroacetabular deformity in the asymptomatic population. The CT scans had all been undertaken for conditions unrelated to disorders of the hip. The frequency of cam-type femoroacetabular deformity was assessed by measuring the α-angle of each hip on the anteroposterior images. The α-angles were classified according to the Copenhagen Osteoarthritis Study. Among 215 male hips (108 patients) the mean α-angle was 59.12° (37.75° to 103.50°). Of these, a total of 30 hips (13.95%) were defined as pathological, 32 (14.88%) as borderline and 153 (71.16%) as normal. Among 540 female hips (272 patients) the mean α-angle was 45.47° (34.75° to 87.00°), with 30 hips (5.56%) defined as pathological, 33 (6.11%) as borderline and 477 (88.33%) as normal. It appears that the cam-type femoroacetabular deformity is not rare among the asymptomatic population. These anatomical abnormalities, as determined by an increased α-angle, appear to be twice as frequent in men as in women. Although an association between osteoarthritis and femoroacetabular impingement is believed to exist, a long-term epidemiological study is needed to determine the natural history of these anatomical abnormalities.
Full-text · Article · Oct 2011 · The Bone & Joint Journal