Browsing by Author "Khanin Iamthanaporn"

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    Radiographic manifestation of hip dislocation after total hip arthroplasty
    (2014-01-01) Varah Yuenyongviwat; Khanin Iamthanaporn; Thossart Harnroongroj; Prince of Songkla University; Mahidol University
    Objective: The authors hypothesized that a patient who has posterior hip dislocation after total hip replacement does not have the same clinical manifestations of malposition as with a natural hip. The present study aimed to study clinical manifestation of hip dislocation after total hip arthroplasty. Material and Method: Thirty-five cases of posterior dislocation after total hip replacement were retrospectively studied by medical records and radiographic evaluation. The study included leg position after hip dislocation, leg length, and leg abduction/adduction angles. Results: External rotation of the patient's leg was found in 13 cases (37.1%), neutral position in six cases (17.2%), and internal rotation in 16 cases (45.7%). Measurements of the femoral shaft-vertical axis angle found adduction in 17 cases (average 17.4 degrees, range 1-25 degrees), abduction in 15 cases (average 6 degrees, range 1-15 degrees), and 0 degrees in three cases. Average leg shortening was 3.55 cm (range 0.6-13.5 cm). Conclusion: The present study shows that patients with hip dislocation after hip replacement can manifest many signs of limb deformity in rotation (internal, external, and neutral) and abduction/adduction positions.
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    Reasons for revision of failed hemiarthroplasty: Are there any differences between unipolar and bipolar?
    (2018-08-01) Khanin Iamthanaporn; Keerati Chareancholvanich; Chaturong Pornrattanamaneewong; Faculty of Medicine, Prince of Songkia University; Faculty of Medicine, Siriraj Hospital, Mahidol University
    © 2018, Springer-Verlag France SAS, part of Springer Nature. Background: Hemiarthroplasty (HA) is an effective procedure for treatment of femoral neck fracture. However, it is debatable whether unipolar or bipolar HA is the most suitable implant. Objective: The purpose of this study was to compare the causes of failure and longevity in both types of HA. Materials and methods: We retrospectively reviewed 133 cases that underwent revision surgery of HA between 2002 and 2012. The causes of revision surgery were identified and stratified into early (≤ 5 years) failure and late (> 5 years) failure. Survival analyses were performed for each implant type. Results: The common causes for revision were aseptic loosening (49.6%), infection (22.6%) and acetabular erosion (15.0%). Unipolar and bipolar HA were not different in causes for revision, but the unipolar group had a statistically significantly higher number of acetabular erosion events compared with the bipolar group (p = 0.002). In the early period, 24 unipolar HA (52.9%) and 28 bipolar HA (34.1%) failed. There were no statistically significant differences in the numbers of revised HA in each period between the two groups (p = 0.138). The median survival times in the unipolar and bipolar groups were 84.0 ± 24.5 and 120.0 ± 5.5 months, respectively. However, the survival times of both implants were not statistically significantly different. Conclusions: Aseptic loosening was the most common reason for revision surgery after hemiarthroplasty surgery in early and late failures. Unipolar and bipolar hemiarthroplasty were not different in terms of causes of failure and survivorship except bipolar hemiarthroplasty had many fewer acetabular erosion events.
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    Revision primary total hip replacement: Causes and risk factors
    (2015-01-01) Khanin Iamthanaporn; Keerati Chareancholvanich; Chaturong Pornrattanamaneewong; Prince of Songkla University; Mahidol University
    © 2015, Medical Association of Thailand. All rights reserved. Objective: To determine 1) causes of failure of primary total hip replacement (THR) in Thai patients and 2) whether patient characteristics, underlying diagnosis, and type of primary THR were associated with the causes of revision THR. Material and Method: The authors retrospectively reviewed all revision THRs in one referral hospital in Thailand between 2002 and 2012. All medical records and radiographic studies were used to identify the causes of primary THR failure. Randomly selected primary THRs performed in the same period were used to compare with revision THRs to determine the risk factors for revision. Results: This study included 219 THRs. After 5 years (late failure) from index surgery, 138 primary THRs (63.0%) were revised. Late failures were aseptic loosening (75.4%) followed by periprosthetic fracture (8.0%), and polyethylene wear (5.8%). The major reasons for revision surgery within 5 years (early failure) were periprosthetic joint infection (29.6%), aseptic loosening (28.4%), and instability (22.2%). Age <45 at index surgery had the lowest risk for revision with a hazards ratio of 0.695 (95% CI 0.492-0.981). Hybrid fixation was found to be a risk factor for revision THR with a hazards ratio of 1.652 (95% CI 1.166-2.341). Conclusion: Most THRs failed after 5 years. Periprosthetic joint infection was the most common cause of failure in the early period. Aseptic loosening was a major cause of failure in the late period and overall in both periods. Hybrid fixation is an independent risk factor for revision surgery after primary THR. Younger patients at the time of primary THR were associated with a reduced risk for failure.