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Revision total hip arthroplasty

Matti Seppänen, Mikko Karvonen, Petri Virolainen, Ville Remes, Pekka Pulkkinen, Antti Eskelinen, Antti Liukas, Keijo T Mäkelä
Background and purpose - In a previous registry report, short-term implant survival of hip resurfacing arthroplasty (HRA) in Finland was found to be comparable to that of total hip arthroplasty (THA). Since then, it has become evident that adverse reactions to metal debris (ARMDs) may also be associated with HRA, not only with large-diameter head metal-on-metal THA. The aim of the study was to assess medium- to long-term survivorship of HRA based on the Finnish Arthroplasty Register (FAR). Patients and methods - 5,068 HRAs performed during the period 2001-2013 in Finland were included...
October 19, 2016: Acta Orthopaedica
Carmela E Corallo, Louise Grannell, Huyen Tran
A 62-year-old man was admitted to hospital for elective revision of a left total hip arthroplasty. His history was significant for human immunodeficiency virus (HIV) infection for which he was taking the following antiretroviral agents (ARVs): etravirine, ritonavir, darunavir, raltegravir and tenofovir/emtricitabine. Rivaroxaban 10 mg daily was commenced on the second postoperative day for venous thromboembolism (VTE) prophylaxis. Approximately 24 h later, the patient developed hypotension and anaemia, accompanied by thigh swelling due to bleeding at the surgical site...
December 2015: Drug Saf Case Rep
Daniel S Hill, Kuntal Patel, Deepak Herlekar
BACKGROUND: Highly cross-linked polyethylene in total hip arthroplasty (THA) has been shown to decrease wear rate compared with a conventional polyethylene liner. However, it has also been reported that the manufacturing processes can cause early failure of the implant. CASE: We describe early catastrophic failure at <4 years following primary THA surgery of a PINNACLE MARATHON® polyethylene acetabular liner resulting from a malaligned PINNACLE DUOFIX HA® acetabular shell with resultant point loading...
October 13, 2016: Hip International: the Journal of Clinical and Experimental Research on Hip Pathology and Therapy
Kathryn Gill, Sarah L Whitehouse, Matthew J W Hubble, Matthew J Wilson
BACKGROUND: Dislocation following primary total hip arthroplasty (THA) is a complication with an incidence of 2%-5%. This study examines the clinical and radiological outcome of a constrained acetabular implant used in primary THA in high-risk patients to prevent dislocation. METHODS: 54 patients with 55 constrained implants for primary THA were reviewed clinically and radiologically. Oxford, Harris Hip and Charlson scores were recorded. RESULTS: 54 patients, with an average age of 83...
October 8, 2016: Hip International: the Journal of Clinical and Experimental Research on Hip Pathology and Therapy
Tatsuya Sueyoshi, John B Meding, Kenneth E Davis, Wesley G Lackey, Robert A Malinzak, Merrill A Ritter
INTRODUCTION: With the rising number of total hip arthroplasties (THAs) each year, it is increasingly important for surgeons to have evidence-based information on which to determine how often patients should be examined postoperatively. The purpose of this research was to determine whether it is possible to identify - based on Harris Hip Score (HHS) - early signs or predictors of THA failure so that methods of postoperative follow-up can be scheduled in advance of the time frame indicated by those predictors of failure...
October 10, 2016: Hip International: the Journal of Clinical and Experimental Research on Hip Pathology and Therapy
Cody C Wyles, Benjamin A McArthur, Eric R Wagner, Matthew T Houdek, Jose H Jimenez-Almonte, Robert T Trousdale
Trunnionosis and taper corrosion have recently emerged as problems in total hip arthroplasty (THA). No longer restricted to metal-on-metal bearings, these phenomena now affect an increasing number of metal-on-polyethylene THAs and are exacerbated by modularity. Resulting increases in metal toxicity and patient morbidity, and the added costs of toxicity surveillance and revision surgery, will place a substantial economic burden on many health systems. Although they are more expensive than cobalt-chrome heads, ceramic femoral heads make metal toxicity a nonissue...
September 2016: American Journal of Orthopedics
Lloyd Roffe, Anthony J FitzPatrick, Geoffrey W Rodgers, Tim B F Woodfield, Gary J Hooper
: Squeaking in ceramic-on-ceramic total hip arthroplasty was investigated with an acoustic monitoring device to distinguish between squeaking emanating from the Trunnion Morse Taper connection versus the articular surface. Eighty-two patients with implant problems scheduled for revision were selected and acoustic emissions with simple movements monitored. Five of these patients with ceramic-on-ceramic implants underwent surgery and their retrieved implant components were analysed in vitro...
October 13, 2016: Journal of Orthopaedic Research: Official Publication of the Orthopaedic Research Society
Antoine Dangin, Sandrine Boulat, Frédéric Farizon, Rémi Philippot
INTRODUCTION: Total hip arthroplasty (THA) is a common surgery presenting well-known failures that may require surgical revision. To reduce the risk of hip dislocation after revision THA, we hypothesize the interest of the use of a new generation dual mobility cup by evaluating its survival and complication rates. MATERIALS AND METHODS: We analyzed the survival and the failures rate of 91 patients who underwent revision THAs with a specific dual mobility cup Novae® E TH (SERF, Décines-Charpieu, France)...
October 6, 2016: Surgical Technology International
B Fink, R Lass
Background: Total hip arthroplasty (THA) is one of the most common and successful surgical procedures in orthopedic surgery and clinical success can be characterized by the revision rate and improvement of function, as well as the patient's satisfaction and pain. Despite the clinical success of primary THA with 10-year survival rates as high as 96 % (Swedish Hip Arthroplasty Register, 2011), the prevalence of groin pain after conventional total hip replacement ranges from 0.4 to 18.3 % and activity-limiting thigh pain is still an existing problem linked to the femoral component of uncemented hip replacement in up to 1...
October 2016: Zeitschrift Für Orthopädie und Unfallchirurgie
M C Koper, N M C Mathijssen, F Witt, M M Morlock, S B W Vehmeijer
BACKGROUND: Metal-on-Metal (MoM) total hip arthroplasties (THA) are associated with pseudotumor formation and high revision rates. This prospective study analysed the clinical and wear analyses of 9 large Metal-on-Metal (MoM) total hip arthroplasties (THA) to understand the underlying mechanisms of failure. The MoM bearings were revised for multiple reasons; the main reason was pseudotumor formation. MATERIALS AND METHODS: From 2006 till 2010 the Reinier de Graaf Hospital implanted 160 large head M2a-Magnum™ (Biomet Inc...
2016: PloS One
Friedrich Boettner, Gabriele Koehler, Alexander Wegner, Tom Schmidt-Braekling, Georg Gosheger, Christian Goetze
OBJECTIVE: The current study investigates the diagnostic accuracy of the criteria described for frozen sections and whether modern leukocyte specific staining techniques including leukocyte peroxidase and Naphtol-AS-D-chloroacetate-esterase will improve the accuracy of the intra-operative histology. METHOD: 77 patients undergoing revision total hip and knee arthroplasty were included in this retrospective study. Patients were grouped into septic and aseptic based on intraoperative cultures...
2016: Open Orthopaedics Journal
Chelsea N Koch, Laura Serrano Mateo, Stephen Kayiaros, Kevin A Cassidy, Seth A Jerabek, Alejandro Gonzalez Della Valle
BACKGROUND: Femoral stem fracture following total hip arthroplasty is an uncommon event that requires immediate revision surgery. QUESTIONS/PURPOSES: We report on four patients who experienced stem fractures of one design and a review of the US Food and Drug Administration adverse event reports on this design. METHODS: Fracture surfaces of four EMPERION™ (Smith & Nephew, Memphis, TN) femoral stems were analyzed under optical and scanning electron microscopy...
October 2016: HSS Journal: the Musculoskeletal Journal of Hospital for Special Surgery
Lane Koenig, Qian Zhang, Matthew S Austin, Berna Demiralp, Thomas K Fehring, Chaoling Feng, Richard C Mather, Jennifer T Nguyen, Asha Saavoss, Bryan D Springer, Adolph J Yates
BACKGROUND: Demand for total hip arthroplasty (THA) is high and expected to continue to grow during the next decade. Although much of this growth includes working-aged patients, cost-effectiveness studies on THA have not fully incorporated the productivity effects from surgery. QUESTIONS/PURPOSES: We asked: (1) What is the expected effect of THA on patients' employment and earnings? (2) How does accounting for these effects influence the cost-effectiveness of THA relative to nonsurgical treatment? METHODS: Taking a societal perspective, we used a Markov model to assess the overall cost-effectiveness of THA compared with nonsurgical treatment...
October 3, 2016: Clinical Orthopaedics and related Research
J Palan, M C Smith, P Gregg, S Mellon, A Kulkarni, K Tucker, A W Blom, D W Murray, H Pandit
AIMS: Periprosthetic fracture (PF) after primary total hip arthroplasty (THA) is an uncommon but potentially devastating complication. This study aims to investigate the influence of cemented stem designs on the risk of needing a revision for a PF. PATIENTS AND METHODS: We analysed data on 257 202 primary THAs with cemented stems and 390 linked first revisions for PF recorded in the National Joint Registry (NJR) of England, Wales and Northern Ireland to determine if a cemented femoral stem brand was associated with the risk of having revision for a PF after primary THA...
October 2016: Bone & Joint Journal
Ross A Miller, Jae Y Ro, Mary R Schwartz
Hip arthroplasty is commonly performed on patients with debilitating hip disease to relieve symptoms and improve quality of life. Generally, long-term success rates are excellent. However, a subset of patients requires revision due to prosthesis failure. A wide array of microscopic findings can be seen in surrounding tissues and many of the findings are etiologically nonspecific. The aim of this review is to discuss the etiologies and accompanying adverse tissue reactions seen with prosthesis failure, including the findings seen in aseptic lymphocyte-dominated vasculitis-associated lesion...
August 18, 2016: Annals of Diagnostic Pathology
Viktor Janz, Georgi I Wassilew, Carsten F Perka, Benjamin Bartek
BACKGROUND: It is currently unclear if an isolated exchange of the mobile components, in cases of periprosthetic joint infection (PJI), leads to a complete eradication of all bacteria or if residual bacteria remain attached to the retained components? OBJECTIVE: The purpose of this study was to investigate if bacteria only adhere to certain components or materials, or if they are ubiquitously distributed throughout the joint. METHODS: Twenty hundred and eighty four patients undergoing revision total hip or total knee arthroplasty surgery were included in this retrospective cohort study...
September 23, 2016: Technology and Health Care: Official Journal of the European Society for Engineering and Medicine
Dia Eldean Giebaly, Haider Twaij, Mazin Ibrahim, Fares S Haddad
INTRODUCTION: Total hip replacement is a successful procedure with long survival records compared to other joint arthroplasties. Cemented implants have been available for many years, however the complications associated with loosening and, ultimately, failure over time has led to the development of cementless stems and implants.The ideal prosthesis should recreate a biomechanically normal hip joint, allow pain-free function and last the patient's life span without requiring revision. Optimal results with uncemented femoral stems rely on obtaining initial stability, osseointegration, biological fixation, and uniform stress transfer to the proximal bone...
September 29, 2016: Hip International: the Journal of Clinical and Experimental Research on Hip Pathology and Therapy
S Singh, S Reddy, Raj Shrivastva
This study compared the National Joint Registry for England, Wales, Northern Ireland and the Isle of Man (NJR) data for total hip replacements (THRs) and total knee replacements (TKRs) from Hospital A [with laminar airflow (LAF)] and Hospital B (without LAF). These hospitals were originally managed by two different trusts that subsequently merged. Consequently, the theatres in Hospital A have always had LAF and those in Hospital B had only conventional ventilation systems. As this merger happened before the establishment of the NJR, it puts us in a unique position, enabling direct comparison of the revision rates for infected hip and knee replacements between the two hospitals that follow similar infection protocols...
September 29, 2016: European Journal of Orthopaedic Surgery & Traumatology: Orthopédie Traumatologie
Kenichi Oe, Hirokazu Iida, Kohei Tsuda, Tomohisa Nakamura, Naofumi Okamoto, Yusuke Ueda
BACKGROUND: The purpose of this study was to identify the long-term durability of the Kerboull-type reinforcement device (KT plate) in acetabular reconstruction for massive bone defects, assessing the remodeling of structural bone grafts. METHODS: This study retrospectively evaluated 106 hips that underwent acetabular reconstruction using a KT plate between November 2000 and December 2010. Thirty-eight primary total hip arthoplasties (THAs) and 68 revised THAs were performed, and the mean duration of clinical follow-up was 8 years (5-14 years)...
August 24, 2016: Journal of Arthroplasty
Ahmed El-Bakoury, Hazem Hosny, Mark Williams, Jonathan Keenan, Rathan Yarlagadda
BACKGROUND: Periprosthetic fracture following total hip arthroplasty is a significant problem faced by hip surgeons, and its management in elderly patients remains a considerable challenge. METHODS: We retrospectively reviewed 28 Vancouver B2 and B3 periprosthetic femoral fractures (PFF) treated with revision of the femoral stems by distally locked, hydroxyapatite-coated uncemented stems (Cannulok). Patients were aged 75 years or older at the time of surgery. RESULTS: The mean follow-up was 44...
August 12, 2016: Journal of Arthroplasty
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