Title :

Is pre-operative block-test with lidocaine injection efficient in predicting the functional result of revision total hip arthroplasty?

Author(s) :

Wolf, Maxime [Auteur]
Université de Lille
Faure, Philippe-Alexandre [Auteur]
Centre Hospitalier Régional Universitaire [CHU Lille] [CHRU Lille]
Dartus, Julien [Auteur]
Centre Hospitalier Régional Universitaire [CHU Lille] [CHRU Lille]
Amouyel, Thomas [Auteur]
Centre Hospitalier Régional Universitaire [CHU Lille] [CHRU Lille]
Behal, Helene [Auteur]
Centre Hospitalier Régional Universitaire [CHU Lille] [CHRU Lille]
Girard, Julien [Auteur]
Unité de Recherche Pluridisciplinaire Sport, Santé, Société (URePSSS) - ULR 7369
Migaud, Henri [Auteur]
Centre Hospitalier Régional Universitaire [CHU Lille] [CHRU Lille]
Martinot, Pierre [Auteur]
Université de Lille

Journal title :

Orthopaedics & Traumatology: Surgery & Research

Abbreviated title :

Orthop Traumatol Surg Res

Pages :

104075

Publisher :

Elsevier

Publication date :

2024-12-01

ISSN :

1877-0568

HAL domain(s) :

Sciences du Vivant [q-bio]

English abstract : [en]

Background While performing a hip joint aspiration for culture, a lidocaine diagnostic injection called block test can be performed during the investigation of painful total hip arthroplasties (THA). This test was formerly ...
Show more >Background While performing a hip joint aspiration for culture, a lidocaine diagnostic injection called block test can be performed during the investigation of painful total hip arthroplasties (THA). This test was formerly applied to limited series in pre-operative and without assessing the predictive value on the results of THA revision. Therefore we investigated a consecutive series of THA revisions who underwent pre-operative aspiration-block test to determine if patients with pre-operative positive block test (disappearance of symptoms) have a better clinical improvement after revision. Hypothesis The positive pre-operative block test has a positive predictive value greater than 80% in predicting the favourable result of THA revisions. Materials and methods We reviewed 152 patients who had a hip aspiration associated with a block test before their THA revision. The patients were evaluated according to the Oxford hip score (OHS). The primary outcome was considered positive if the patient presented an improvement in the OHS greater than the Minimal Clinically Important Difference (MCID; 9 points) and/or if the postoperative OHS was higher than the Patient Acceptable Symptom State (PASS, defined as 39/48). Results Block tests were positive for 61.2% (93/152) of patients. The median improvement in the OHS was 23.0 [IQR 16.0; 30.0] if the block test was positive versus 16.0 [IQR 4.0; 17.0] if negative (p = 0.002). The primary outcome after revision was strongly associated with block test positivity (p < 0.0001). The positive block test had a 67.7% sensitivity, 73.3% specificity, 91.4% Positive Predictive Value and 37.3% Negative Predictive Value for significant improvement after revision surgery. Conclusion Hip joint aspiration for culture with concomitant block test seems to be an interesting tool in predicting outcomes of revision surgery for painful THA.Show less >

Language :

Anglais

Audience :

Internationale

Popular science :

Non

Administrative institution(s) :

Université de Lille
Univ. Artois
Univ. Littoral Côte d’Opale

Collections :

• Unité de Recherche Pluridisciplinaire Sport, Santé, Société (URePSSS) - ULR 7369

Submission date :

2024-12-02T22:02:24Z
2024-12-11T09:56:54Z