P Broos, I Fourneau, (Department of Traumatology, University Hospital Gasthuisberg, Belgium)
Host factors that affect outcome of total hip arthroplasty.
The Lancet 2000; 29 April, 355: 1479.
Rapid polyethylene wear was found to be an important contributor to aseptic fixation failure.
The two most important host factors contributing to the survival failure of the hip implant are poor bone quality (atrophic, osteoarthritis) and poor structure of the hip.
Pekka Kannus, Jari Parkkari, et al.
Prevention of hip fracture in elderly people with use of a hip protector
New Engl Jr Med. Vol.343, Nov. 23, 2000, pg.1506-1512
Hip fractures are common in frail elderly adults. The authors of this study have investigated the effect of an anatomically designed external hip protector on the risk of these fractures. The hip protector is a convex shield, with its deepest portion designed to fit over the greater trochanter and is shaped to cover the proximal femur. It is anatomically designed to shunt the energy of an impact away from the greater trochanter. Two protectors, which are padded, are worn with use of a specially designed stretchy undergarment containing a pocket on each side for placement of a protector.
Authors randomly assigned 1801 ambulatory frail adults either to a group that wore a hip protector or to a control group. During follow-up 13 subjects in the hip protector group had a hip fracture, as compared with 67 subjects in the control group. It is concluded that the risk of hip fracture can be reduced in frail elderly adults by the use of an anatomically designed external hip protector.
Hip protectors a breakthrough in fracture prevention.
The rate of noncompliance was high in the hip protector group. Nonetheless, the rate of hip fracture in the hip-protector group was 54 percent lower than that in the control group. The author also calculated the rate of fractures among subjects in the hip-protector group according to whether they were wearing or not wearing hip protectors when they fell. The rate of hip fracture per fall was 84 percent lower when the hip protector were being worn.