Research Roundup: Cementless Hip Implants Not Impacted by Aseptic Loosening

The following is a roundup of three recently published medical studies that provide new insights into orthopedic procedures and patient outcomes:

Diabetes Complications Could Lead to Surgical Site Infection
The Journal of Bone and Joint Surgery

Diabetes complications were significantly associated with higher rates of site infection following foot and ankle surgery, according to a recent study.

Researchers evaluated 2,060 consecutive surgical cases. Patients were categorized as nondiabetic patients without neuropathy (Group 1) or with neuropathy (Group 2), or as patients with diabetes who had no complications (Group 3) or at least one complication of diabetes (Group 4).

The observed rate of surgical site infection was 3.1 percent. Group 4 was 7.25 times more likely to incur surgical site infection compared with Group 1 and 3.72 times more likely than Group 3. Group 2 was 4.72 times more likely to incur surgical site infection as opposed to Group 1, though Group 2 did not have a significantly higher likelihood of surgical site infection than Group 3, according to the researchers.The frequency of surgical site infection in Group 3 was not significantly different from Group 1.

“Multivariable logistic regression analysis demonstrated that peripheral neuropathy and a hemoglobin A1c of ≥ 8 percent were independently associated with surgical site infection,” the researchers wrote.


Ankle Fractures Most Common Fractures in Foot, Ankle Region
The Journal of Foot and Ankle Surgery

Ankle fractures were found to be the most common fractures in the foot and ankle region, whereas midfoot fractures were the least common, according to a recent study.

Researchers analyzed the frequency and proportion of 280,933 fractures of the foot and ankle using National Trauma Bank data from 2007 to 2011. Fractures were classified as ankle, rearfoot, midfoot and forefoot. The researchers also analyzed the proportions of open fractures within each fracture location and broader anatomic category.

Ankle fractures (56 percent) were most common type of fracture seen at major U.S. trauma hospitals. The prevalence of rearfoot and forefoot fractures were similar at approximately 17 percent, and midfoot fractures were least common. Approximately 20 percent of all foot and ankle fractures were open fractures, according to the researchers.

“We did this study because we wanted to provide a reference for those dealing with foot and ankle fractures,” said Naohiro Shibuya, D.P.M., M.S., F.A.C.F.A.S., an associate professor in the department of surgery at Texas A&M University Health Science Center. “Our findings showed that the prevalence of ankle fractures exceeds all of the foot fractures combined in the major trauma centers. Though clinically and surgically it may not change treatment plans, the information is important for health services and setting up prevention programs.”


Aseptic Loosening not a Concern for Patients With Cementless Hip Implants
The Journal of Arthroplasty

Cementless hip implants were not adversely affected by aseptic loosening over the long term and produced good clinical outcomes, according to study findings.

Researchers retrospectively reviewed 33 hips in 27 consecutive patients with a confirmed diagnosis of Paget’s disease who underwent primary hip arthroplasty. Patients’ mean age was 75 years. Follow-up occurred at six weeks and again at one, three, five, 10, 15 and 20 years.

Patients were mobilized early and allowed full weight bearing in all cases except when an osteotomy was performed. The researchers evaluated modified Harris hip score (HHS), assessment of thigh or groin pain, pain grade in each area, range of motion, leg length discrepancy and limp presence.

After excluding patients who were lost to follow-up, died, or required revision, 11 patients (14 hips) were available for clinical and radiographic follow-up at the minimum 10-year mark. Mean HHS improved from 56 to 83 at final follow-up, with 73 percent achieving good or excellent results. No cases of dislocation or sepsis were observed.