Patient Cohort Essay

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Patient Cohort From January 2001 to December 2014, a single surgeon (TPG) performed 3777 consecutive metal-on-metal HRA procedures, of which, 27% were women. Choosing December 2014 as our date range cut-off point ensured a minimum of 2 years of follow-up results for both study groups. Group 1 consisted of 357 cases in 309 females performed before 2008, prior to the establishment of the newly developed surgical interventions. Group 2 comprises 654 resurfacings in 556 females. Group 2 females were significantly older, at a mean of 54 years compared to 50 years (p30% uncovered, and in all patients who have had an acetabular complication on the opposite hip, or who have a DEXA scan T-score 30. We have also demonstrated that a slowed weight bearing protocol and alendronate can prevent EFF [26]. Over time we evolved to develop a comprehensive protocol which establishes three groups based on proven risk factors: Group A, femoral neck T-score >0 and BMI 30; and Group C, Femoral neck T-score< -1.5. Group A patients progress to WBAT. They typically use crutches for 2 weeks, and a cane for another 2 weeks. Group B patients also progress to WBAT but are prescribed alendronate for 6 months. Patients from …show more content…

Metal ion levels are an excellent indicator for potential wear failure [35–37]. We converted serum and plasma test results to whole blood ion level values using Smolder’s method [35,38]. We then used whole blood values for all comparisons. Based on previous research, we defined five categories of ion levels for both unilateral and bilateral patients [31,35,38,39]: normal, optimal, acceptable, problematic, and potentially toxic. These reference values are presented in the legend of Table

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