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Biomedical subjects

D Engela

Publications and source records attributed to D Engela.

3 recordsLinked to original sources

A study of the factors in hip replacement dislocation. Part 2.

Dislocation is a dramatic and distressing common complication following total hip replacement. The first article describing this study, published last week, considered some of the factors thought to predispose to dislocation. The authors emphasised the multifactorial nature of hip replacement dislocation and in this second article they examine the factors relating to acetabular position and orientation, and femoral component placement.

Causality↗

A study of the factors in hip replacement dislocation. Part 1.

This is the first of two articles which describe a clinical and radiographic review of the reasons for dislocation in patients who have received customised total hip replacements. The researchers compared the alignment of 19 arthroplasties which had dislocated with 347 which had not. A number of factors were considered including pre- and post-operative factors, femoral component placement, component head size, and acetabular position and orientation. It was found the the femoral head size had the greatest influence on dislocation. However, the researchers point out that dislocation on these patients is a multifactoral problem and that prevention, through effective pre-operative and post-operative patient education in relation to care of the hip and mobilising, should be encouraged. They also advocate a multidisciplinary approach to improve patient outcomes. The second article will appear next week.

Adult↗

Total hip replacement: a study of customized prostheses.

The majority of widely used hip prostheses offer a limited range of offset sizes, including 35, 37, 40, 44 and 45mm. These sizes are provided to match the mean population offset which has been reported as 43.0mm (Noble et al 1988). The variability of proximal femoral geometry in terms of offset is consistent with the theory that the geometry of the femur is determined by a large number of genetic and environmental factors (Ericksen 1979). This paper suggests that the range in offset sizes offered by off-the-shelf hip protheses is not sufficient to match the extremes of anatomical offset variability of the Northern Ireland sample studied and that a custom stem that matches more accurately key femoral dimensions such as offset, may be more desirable.

Clinical Nursing Research↗