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Modular hip arthroplasty

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https://www.readbyqxmd.com/read/28634092/alarmingly-high-rate-of-implant-fractures-in-one-modular-femoral-stem-design-a-comparison-of-two-implants
#1
Ritesh R Shah, Jeffrey M Goldstein, Nancy E Cipparrone, Alexander C Gordon, Matthew L Jimenez, Wayne M Goldstein
BACKGROUND: Reports of implant fracture at the modular junction have been seen in modular neck designs, stem-sleeve modular femoral stems, and diaphyseal engaging bi-body modular stems. To date, however, there has never been a direct comparison between 2 different implant designs from the same modular family. The purpose of this study is to compare the rate of implant failure of 2 such stem-sleeve modular femoral stem designs, the S-ROM and Emperion, to further identify factors which increase the risk of this mode of failure...
May 22, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28625686/the-influence-of-contamination-and-cleaning-on-the-strength-of-modular-head-taper-fixation-in-total-hip-arthroplasty
#2
Annika Krull, Michael M Morlock, Nicholas E Bishop
BACKGROUND: Intraoperative interface contamination of modular head-stem taper junctions of hip implants can lead to poor fixation strength, causing fretting and crevice corrosion or even stem taper fracture. Careful cleaning before assembly should help to reduce these problems. The purpose of this study was to determine the effect of cleaning (with and without drying) contaminated taper interfaces on the taper fixation strength. METHODS: Metal or ceramic heads were impacted onto titanium alloy stem tapers with cleaned or contaminated (fat or saline solution) interfaces...
May 13, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28623650/the-incidence-of-dissociated-liners-in-4-751-consecutive-total-hip-arthroplasties-using-pinnacle-polyethylene-acetabular-liners
#3
Richard J Napier, Owen Diamond, Chris K J O'Neill, Seamus O'Brien, David E Beverland
INTRODUCTION: Acetabular liner dissociation is a complication exclusive to modular designs. We present a single surgeon series of 8 polyethylene liner dissociations with the Pinnacle Acetabular System (DePuy Orthopaedics) from over 4,750 cases. We also present a review of the literature and data from the UK National Joint Registry (NJR) on dissociation in total hip arthroplasty (THA). METHODS: The Pinnacle Acetabular System has been used exclusively by the senior author since April 2003, and to date 5,882 have been implanted (837 ceramic liners, 4,751 polyethylene liners (1,606 Enduron/3,145 Marathon) and 294 metal liners)...
June 14, 2017: Hip International: the Journal of Clinical and Experimental Research on Hip Pathology and Therapy
https://www.readbyqxmd.com/read/28615939/effect-of-carbon-ion-implantation-on-the-tribology-of-metal-on-metal-bearings-for-artificial-joints
#4
Hironobu Koseki, Masato Tomita, Akihiko Yonekura, Takashi Higuchi, Sinya Sunagawa, Koumei Baba, Makoto Osaki
Metal-on-metal (MoM) bearings have become popular due to a major advantage over metal-on-polymer bearings for total hip arthroplasty in that the larger femoral head and hydrodynamic lubrication of the former reduce the rate of wear. However, concerns remain regarding adverse reactions to metal debris including metallosis caused by metal wear generated at the taper-head interface and another modular junction. Our group has hypothesized that carbon ion implantation (CII) may improve metal wear properties. The purpose of this study was to investigate the wear properties and friction coefficients of CII surfaces with an aim to ultimately apply these surfaces to MoM bearings in artificial joints...
2017: International Journal of Nanomedicine
https://www.readbyqxmd.com/read/28602532/what-is-the-difference-between-modular-and-nonmodular-tapered-fluted-titanium-stems-in-revision-total-hip-arthroplasty
#5
Yong Huang, Yixin Zhou, Hongyi Shao, Jianming Gu, Hao Tang, Qiheng Tang
BACKGROUND: Both modular and nonmodular tapered fluted titanium stems are used in revision total hip arthroplasty (THA), with follow-up showing good results for both stems. We aimed to determine whether there were any differences in clinical outcomes, survivorship, or frequency of complications. METHODS: A retrospective review of 160 consecutive THAs (153 patients) revised with a tapered fluted modular titanium stem from 2002 to 2014 and 129 consecutive THAs (128 patients) revised with a tapered fluted nonmodular titanium stem between 2008 and 2014 was conducted...
May 18, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28598491/modularity-in-total-hip-arthroplasty-benefits-risks-mechanisms-diagnosis-and-management
#6
Ben M Vierra, Sarah R Blumenthal, Derek F Amanatullah
Modular implants are currently widely used in total hip arthroplasty because they give surgeons versatility during the operation, allow for easier revision surgery, and can be adjusted to better fit the anatomy of the specific patient. However, modular implants, specifically those that have metal-on-metal junctions, are susceptible to crevice and fretting corrosion. This can ultimately cause implant failure, inflammation, and adverse local tissue reaction, among other possible side effects. Surgeons should be aware of the possibility of implant corrosion and should follow a set of recommended guidelines to systematically diagnose and treat patients with corroded implants...
June 9, 2017: Orthopedics
https://www.readbyqxmd.com/read/28566395/the-use-of-femoral-stems-with-exchangeable-necks-in-primary-total-hip-arthroplasty-increases-the-rate-of-revision
#7
S E Graves, R de Steiger, D Davidson, W Donnelly, S Rainbird, M F Lorimer, K S Cashman, R J Vial
AIMS: Femoral stems with exchangeable (modular) necks were introduced to offer surgeons an increased choice when determining the version, offset and length of the femoral neck during total hip arthroplasty (THA). It was hoped that this would improve outcomes and reduce complications, particularly dislocation. In 2010, the Australian Orthopaedic Association National Joint Replacement Registry (AOANJRR) first reported an increased rate of revision after primary THA using femoral stems with an exchangeable neck...
June 2017: Bone & Joint Journal
https://www.readbyqxmd.com/read/28552447/same-same-but-different-12-14-stem-and-head-tapers-in-total-hip-arthroplasty
#8
Ulrike Mueller, Steffen Braun, Stefan Schroeder, Robert Sonntag, J Philippe Kretzer
BACKGROUND: Taper corrosion has been identified to be a major concern in total hip arthroplasty during the past years. So far, the mechanisms that lead to taper corrosion in modular taper junctions are not fully understood. However, it has been shown that corrosion is also influenced by the geometry and topography of the taper, and these parameters vary among the implant manufacturers. The purpose of this study was to investigate the variations of common stem and head tapers regarding design and surface characteristics...
April 27, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28509828/modular-fluted-tapered-stems-in-aseptic-revision-total-hip-arthroplasty
#9
Matthew P Abdel, Umberto Cottino, Dirk R Larson, Arlen D Hanssen, David G Lewallen, Daniel J Berry
BACKGROUND: Modular fluted tapered stems have become the most commonly employed category of femoral component in revision hip arthroplasty in North America as a result of favorable early results and simplicity of use. Despite wide adoption, the majority of published data are limited to relatively small series with modest follow-up. The goal of the current study was to determine the success rate and factors associated with success, failure, and complications of the use of modular fluted tapered stems in aseptic revision total hip arthroplasties (THAs) in a large patient cohort...
May 17, 2017: Journal of Bone and Joint Surgery. American Volume
https://www.readbyqxmd.com/read/28508765/a-comparison-of-outcomes-of-treatment-with-resection-prosthesis-of-the-hip-in-revision-and-oncological-surgery
#10
Paweł Kamiński, Jakub Szmyd, Jarosław Ambroży, Jerzy Mirosław Jaworski, Bogusław Frańczuk
INTRODUCTION: The introduction of resection prostheses paved the way for the development of limb-sparing surgery in patients with primary or metastatic bone tumours. After some time, the developing possibilities of treatment of extensive bone defects allowed for the use of resection prostheses as an emergency procedure in patients undergoing revision surgery due to hip implant loosening. The aim of this paper is to compare treatment outcomes in patients receiving the Modular Universal Tumour and Revision System (MUTARS) resection prosthesis during arthroplasty performed for different indications: treatment of a tumour metastasis and revision surgery in cases of implant loosening...
April 12, 2017: Ortopedia, Traumatologia, Rehabilitacja
https://www.readbyqxmd.com/read/28485507/the-effect-of-impact-assembly-on-the-interface-deformation-and-fretting-corrosion-of-modular-hip-tapers-an-in-vitro-study
#11
Anna Panagiotidou, Timothy Cobb, Jay Meswania, John Skinner, Alister Hart, Fares Haddad, Gordon Blunn
Wear and corrosion at the modular head-neck junction has been recognised to be a potential clinical concern, with multiple reports on adverse local tissue reactions and subsequent early failure of metal-on-metal hip replacements. Furthermore, reports on head-neck taper corrosion are also being described with conventional metal-on-polyethylene bearings. Manufacturing tolerances, surgical technique, non-axial alignment, material combination, high frictional torque and high bending moment have all been implicated in the failure process...
May 9, 2017: Journal of Orthopaedic Research: Official Publication of the Orthopaedic Research Society
https://www.readbyqxmd.com/read/28483210/metal-on-metal-compared-with-metal-on-polyethylene-the-effect-on-trunnion-corrosion-in-total-hip-arthroplasty
#12
Brent A Lanting, Matthew G Teeter, James L Howard, Steven J MacDonald, Douglas W Van Citters
BACKGROUND: Trunnion tribocorrosion in total hip arthroplasties is concerning, but retrieval studies often are subjective or lack comparison groups. Quantitative comparisons of clinically relevant implants are required. The purpose of this investigation was to evaluate material loss in metal-on-metal (MoM) and metal-on-polyethylene (MoP) total hip articulations while controlling for trunnion design and head size. METHODS: The 166 retrieved femoral heads from 2 manufacturers were analyzed...
March 29, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28479057/a-single-center-experience-with-a-titanium-modular-neck-total-hip-arthroplasty
#13
Wade T Gofton, Emmanuel M Illical, Robert J Feibel, Paul R Kim, Paul E Beaulé
BACKGROUND: Added modular junction has been associated with implant-related failures. We report our experience with a titanium-titanium modular neck-stem interface to assess complications, possible clinical factors influencing use of neck modularity, and whether modularity reduced the incidence of dislocation. METHODS: A total of 809 total hip arthroplasties completed between 2005 and 2012 from a prospectively collected database were reviewed. The mean follow-up interval was 5...
March 20, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28457759/modular-neck-vs-nonmodular-femoral-stems-in-total-hip-arthroplasty-clinical-outcome-metal-ion-levels-and-radiologic-findings
#14
Rasmus T Mikkelsen, Marianne Fløjstrup, Christian Lund, Per Kjærsgaard-Andersen, Thomas Skjødt, Claus Varnum
BACKGROUND: Modular neck femoral stem (MNFS) for total hip arthroplasty (THA) was introduced to optimize the outcome, but created concerns about pain, elevated blood metal ion levels, and adverse reaction to metal debris such as pseudotumors (PTs), related to corrosion between femoral neck and stem. We compared these outcomes in patients with MNFS or nonmodular femoral stem (NFS) THA. METHODS: Thirty-three patients with unilateral MNFS THA were compared with 30 patients with unilateral NFS THA...
April 7, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28455470/functional-outcome-of-debridement-antibiotics-and-implant-retention-in-periprosthetic-joint-infection-involving-the-hip-a-case-control-study
#15
G Grammatopoulos, M-E Bolduc, B L Atkins, B J L Kendrick, P McLardy-Smith, D W Murray, R Gundle, A H Taylor
AIMS: Advocates of debridement, antibiotics and implant retention (DAIR) in hip periprosthetic joint infection (PJI) argue that a procedure not disturbing a sound prosthesis-bone interface is likely to lead to better survival and functional outcome compared with revision. This case-control study aims were to compare outcome of DAIRs for infected primary total hip arthroplasty (THA) with outcomes following primary THA and two-stage revision of infected primary THAs. PATIENTS AND METHODS: We retrospectively reviewed all DAIRs, performed for confirmed infected primary hip arthropasty (n = 82) at out institution, between 1997 and 2013...
May 2017: Bone & Joint Journal
https://www.readbyqxmd.com/read/28416253/mechanical-stability-of-the-taper-connection-of-large-metal-femoral-heads-with-adapter-sleeves-in-total-hip-arthroplasty-analyzed-using-explicit-finite-element-simulations
#16
Danny Vogel, Adrian Falkenberg, Sarah Bierbaum, Christian Schulze, Rainer Bader, Daniel Kluess
BACKGROUND: Large diameter heads (LDHs) of metal-on-metal bearings in total hip arthroplasty provide increased range of motion and reduced dislocation rates. However, major concerns grew over high wear rates from the modular connection between femoral stem and head, especially in combination with adapter sleeves. METHODS: A computational study on the taper connection stability of LDH (50 mm) with adapter sleeves of different lengths (S, M, L, and XL) compared with a standard femoral head (32 mm) without adapter sleeves was conducted using explicit finite element analyses...
March 22, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28413142/outcomes-of-modular-dual-mobility-acetabular-components-in-revision-total-hip-arthroplasty
#17
E Grant Sutter, Taylor R McClellan, David E Attarian, Michael P Bolognesi, Paul F Lachiewicz, Samuel S Wellman
BACKGROUND: There is a high rate of dislocation after revision total hip arthroplasty. This study evaluated the outcomes of 1 modular dual mobility component in revision total hip arthroplasty in patients at high risk of dislocation. METHODS: We reviewed 64 revisions performed in 27 (42%) patients for recurrent dislocation, 16 (25%) for adverse local tissue reaction, 11 (17%) for reimplantation infection, and 10 (16%) for aseptic loosening, malposition, or fracture...
March 23, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28410835/modified-extended-trochanteric-osteotomy-for-the-treatment-of-vancouver-b2-b3-periprosthetic-fractures-of-the-femur
#18
Andreas Ladurner, Pia Zurmühle, Vilijam Zdravkovic, Karl Grob
BACKGROUND: Femoral component revision is the treatment of choice for Vancouver type B2/B3 periprosthetic femur fractures (PFFs). The purpose of this study was to report the clinical outcome of revision total hip arthroplasty with the use of a modified extended trochanteric osteotomy (ETO) in PFF treatment. METHODS: A total of 43 cases between 2000 and 2014 were analyzed. Clinical and radiographic evaluation was performed with a mean follow-up of 40 months. Patient survival after revision surgery, complications, radiographic outcomes, and quality of life and hip function were assessed...
March 8, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28395391/dual-mobility-acetabular-cups-in-primary-total-hip-arthroplasty-in-patients-at-high-risk-for-dislocation
#19
Steven F Harwin, Jaydev B Mistry, Morad Chughtai, Anton Khlopas, Chukwuweike Gwam, Jared M Newman, Carlos A Higuera, Peter M Bonutti, Arthur L Malkani, Frank R Kolisek, Ronald E Delanois, Michael A Mont
INTRODUCTION: Postoperative dislocation occurs in approximately 2% of primary total hip arthroplasties (THAs). Risk factors associated with dislocation include: age of 70 years or older, body mass index (BMI) of 30 kg/m2 or greater, alcohol abuse, and neuro-degenerative diseases such as multiple sclerosis or Parkinson's disease. As a result, dual-mobility articulations, which have been typically used for revision procedures, have become an increasingly popular option for these "at risk" primary THAs...
April 11, 2017: Surgical Technology International
https://www.readbyqxmd.com/read/28395388/results-of-a-modular-femoral-revision-system-before-and-after-taper-roller-hardening-in-total-hip-arthroplasty
#20
Dean J Marshall, Keith R Berend, Michael J Morris, Joanne B Adams, Adolph V Lombardi
INTRODUCTION: Modular component options can aid in addressing complex femoral reconstructions in total hip arthroplasty (THA) by allowing for customization of version control and proximal to distal sizing. However, component breakage at the modular junction has occurred, particularly in the presence of poor bone stock. A taper roller hardening (RH) process was developed to strengthen the modular junction to reduce breakage. The purpose of this study is to review THA patients before and after taper roller hardening to compare stem survival and frequency of breakage...
April 11, 2017: Surgical Technology International
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