Publications by authors named "Thomas Alastair Denova"

2 Publications

  • Page 1 of 1

A Comparative Cohort Study With a 20-Year Age Gap: Hip Resurfacing in Patients Aged ≤35 Years and Patients Aged ≥55 Years.

Arthroplast Today 2021 Feb 24;7:22-28. Epub 2020 Dec 24.

Department of Orthopedic Surgery, Adult Reconstruction & Joint Replacement Division, Hospital for Special Surgery, New York, NY, USA.

Background: This single-center retrospective cohort study aimed to evaluate and compare implant survival and patient-reported outcome measures in 2 distinct age groups separated by 20 years who underwent hip resurfacing arthroplasty (HRA).

Methods: Between 2005 and 2014, 2042 HRAs were performed by a single-surgeon, and 75 and 377 hips from patients aged ≤35 years and ≥55 years, respectively, were included in this study. Implant survival was determined for all available hips. Clinical features and patient-reported outcome measures were collected.

Results: Seven hips were revised, 4 for aseptic loosening of one or both components, one for infection, one for accelerated wear and metallosis, and one for femoral neck fracture. There was no difference in all-cause 10-year revision, with 97.1% (95% confidence interval 80.9 to 99.6) and 99.6% (95% confidence interval: 97 to 99.9) survivorship in younger and older patients, respectively ( = .246). Preoperatively, younger patients were less active than older patients on the Lower Extremity Activity Scale (LEAS) or University of California, Los Angeles, activity scale, but at follow-up, younger patients outpaced older ones.

Conclusion: Original to our study was the isolation and comparison of 2 distinct age groups. With excellent results in disparate age groups, HRA can be applied to a broad patient demographic and is suitable for those patients who want to achieve a high activity level as defined by Lower Extremity Activity Scale or University of California, Los Angeles, scores.
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http://dx.doi.org/10.1016/j.artd.2020.11.006DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7818604PMC
February 2021

Total hip arthroplasty utilizing an uncemented, flat, tapered stem with a reduced distal profile.

Arthroplast Today 2019 Dec 19;5(4):503-508. Epub 2019 Sep 19.

Adult Reconstruction & Joint Replacement Division, Department of Orthopedic Surgery, Hospital for Special Surgery, New York, NY, USA.

Background: The aim of this study was to report the midterm results of an uncemented, flat, and tapered femoral stem with a reduced distal profile.

Methods: 219 total hip arthroplasties were performed using this stem between March 2007 and October 2012. Survival, radiographs, and modified Harris Hip Scores were analyzed.

Results: Twenty-two (11.1%) patients died from comorbidities but retained their hips; 18 (9.1%) patients were lost to follow-up. Of the remaining 179 hips, all stems remained in situ at a median follow-up of 8.4 (7.0-9.3) years. There was 97.5% (95% CI: 95.1-99.9) survival for all-cause revision with 4 hips revised for instability. Early stem subsidence was identified in 2 patients within 3 months postoperative measured at 4 mm in patient 1 and 3 mm in patient 2. Long-term radiographic follow-up showed 2 hips with incomplete radiolucencies but no evidence of stress shielding, osteolysis, or subsidence among examined hips (n = 93). Spot welding and cortical hypertrophy were present in 58 (62.4%) and 50 (53.8%) hips, respectively. Femoral component position did not change from early postoperative imaging relative to long-term follow-up at ≥5 years ( = .097). Median modified Harris Hip Scores improved from 58.3 (49.5-64.9) points preoperative to 95.7 (88.0-100) points at follow-up ( < .0001).

Conclusions: The reduced distal profile stem studied showed no stem revisions at long-term follow-up with an all-cause survivorship of 97.5% at a median follow-up of 8.4 (7.0-9.3) years. The stem showed good bone integration and stability at midterm follow-up in most patients reviewed.
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http://dx.doi.org/10.1016/j.artd.2019.08.009DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6920712PMC
December 2019
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