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Total Hip Arthroplasty in Patients with Spasticity

A Critical Analysis Review

Statz, Joseph M., MD1; Sierra, Rafael J., MD1; Trousdale, Robert T., MD1; Milbrandt, Todd A., MD1

doi: 10.2106/JBJS.RVW.18.00115
Review Articles with Critical Analysis Component
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  • » Patients with neuromuscular spasticity about the hip with concomitant painful hip arthritis can be effectively treated with total hip arthroplasty, with excellent clinical outcomes and durable implant survivorship.
  • » Certain subsets of patients in this population are at increased risk of dislocation, component loosening, and heterotopic ossification and are also prone to postoperative medical complications.
  • » Strategies that may mitigate the risk of dislocation include using large femoral heads or dual-mobility articulations with cautious use of constrained liners, careful repairing of soft-tissue structures at the conclusion of the surgical procedure, and performing concomitant adductor and flexor tenotomies. In addition, the other common complications can be reduced by coordinating perioperative care with neurological and medical specialists and administering perioperative heterotopic ossification prophylaxis, most commonly in the form of nonsteroidal anti-inflammatory medications, if tolerated.

1Department of Orthopedic Surgery, Mayo Clinic, Rochester, Minnesota

E-mail address for J.M. Statz: statz.joseph@mayo.edu

E-mail address for R.J. Sierra: sierra.rafael@mayo.edu

E-mail address for R.T. Trousdale: trousdale.robert@mayo.edu

E-mail address for T.A. Milbrandt: milbrandt.todd@mayo.edu

Investigation performed at the Department of Orthopedic Surgery, Mayo Clinic, Rochester, Minnesota

Disclosure: There was no source of external funding for this study. On the Disclosure of Potential Conflicts of Interest forms, which are provided with the online version of the article, one or more of the authors checked “yes” to indicate that the author had a relevant financial relationship in the biomedical arena outside the submitted work (http://links.lww.com/JBJSREV/A449).

Copyright © 2019 by The Journal of Bone and Joint Surgery, Incorporated
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