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Modular hip arthroplasty

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https://www.readbyqxmd.com/read/28087160/mri-retrieval-analysis-and-histologic-evaluation-of-adverse-local-tissue-reaction-in-metal-on-polyethylene-total-hip-arthroplasty
#1
Scott R Nodzo, Christina I Esposito, Hollis G Potter, Chitranjan S Ranawat, Timothy M Wright, Douglas E Padgett
BACKGROUND: The severity and location of adverse local tissue reaction (ALTR) seen in metal-on-polyethylene total hip arthroplasty (THA) is not well described. METHODS: We retrospectively reviewed the records of patients who underwent a revision THA using our biomechanics database. We included all patients who underwent revision surgery for the diagnosis of ALTR with THA implants that had modularity solely at the head-neck junction and excluded patients with implant modularity at sites other than the head-neck junction...
December 8, 2016: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28064103/why-do-some-titanium-alloy-total-hip-arthroplasty-modular-necks-fail
#2
Samo K Fokter, Andrej Moličnik, Rajko Kavalar, Primož Pelicon, Rebeka Rudolf, Nenad Gubeljak
BACKGROUND: Increased modularity in total hip arthroplasty (THA) through extra junction between the neck and the femoral stem is gaining popularity among orthopaedic community. However, the advantage of the additional junction is shadowed by an increased risk of mechanical failure. The aim of this study was to describe the exact mechanism of fracture of the modular femoral neck in an uncemented stem. METHODS: Clinical, metallurgical, and mechanical analysis including finite-element modelling and elemental-sensitive tissue analysis with the micro-PIXE method was performed on two patients treated with fully modular primary THA made from Titanium alloy of the same oval taper-cone design...
December 27, 2016: Journal of the Mechanical Behavior of Biomedical Materials
https://www.readbyqxmd.com/read/28063775/assessment-of-head-displacement-and-disassembly-force-with-increasing-assembly-load-at-the-head-trunnion-junction-of-a-total-hip-arthroplasty-prosthesis
#3
Darryl N Ramoutar, Emilie A Crosnier, Faiz Shivji, Anthony W Miles, Harinderjit S Gill
BACKGROUND: Most femoral components used now for total hip arthroplasty are modular, requiring a strong connection at assembly. The aim of this study was to assess the effect of assembly force on the strength of head-trunnion interface and to measure the initial displacement of the head on the trunnion with different assembly forces. METHODS: Three assembly load levels were assessed (A: 2 kN, B: 4 kN, C: 6 kN) with 4 implants in each group. The stems were mounted in a custom rig and the respective assembly loads were applied to the head at a constant rate of 0...
December 14, 2016: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28057394/metal-ion-levels-in-young-active-patients-receiving-a-modular-dual-mobility-total-hip-arthroplasty
#4
Denis Nam, Rondek Salih, Katherine M Brown, Ryan M Nunley, Robert L Barrack
BACKGROUND: Dual mobility total hip arthroplasty (THA) components improve stability, yet use of a modular cobalt alloy acetabular liner may be associated with metal ion release. This study's purpose was to measure blood metal ion levels in young, active patients receiving a dual mobility THA prosthesis. METHODS: This is a prospective study of young, active patients undergoing primary THA. Twenty-six patients received a 22-mm cobalt alloy (n = 10) or a 28-mm ceramic (n = 16) femoral head, a modular cobalt chrome acetabular liner, with a highly cross-linked polyethylene insert (dual mobility)...
December 21, 2016: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28043037/stem-taper-mismatch-has-a-critical-effect-on-ceramic-head-fracture-risk-in-modular-hip-arthroplasty
#5
Julian Gührs, Mandy Körner, Maren Bechstedt, Annika Krull, Michael M Morlock
BACKGROUND: Modular total hip prostheses with ceramic heads are well established in orthopedic surgery and widely used. With the variety of different manufacturers and available designs, components are at risk for mismatch. Several case studies show the potentially devastating effects of mismatch. METHODS: The aim of this study was to investigate the outcome of one arbitrary component mismatch with commercially available components that appear to provide a stable fixation during assembly...
December 16, 2016: Clinical Biomechanics
https://www.readbyqxmd.com/read/28042114/dislocation-following-total-hip-arthroplasty-using-dual-mobility-acetabular-components-a-systematic-review
#6
I De Martino, R D'Apolito, V G Soranoglou, L A Poultsides, P K Sculco, T P Sculco
AIMS: The aim of this systematic review was to report the rate of dislocation following the use of dual mobility (DM) acetabular components in primary and revision total hip arthroplasty (THA). MATERIALS AND METHODS: A systematic review of the literature according to the Preferred Reporting Items for Systematic Reviews and Meta-analyses guidelines was performed. A comprehensive search of Pubmed/Medline, Cochrane Library and Embase (Scopus) was conducted for English articles between January 1974 and March 2016 using various combinations of the keywords "dual mobility", "dual-mobility", "tripolar", "double-mobility", "double mobility", "hip", "cup", "socket"...
January 2017: Bone & Joint Journal
https://www.readbyqxmd.com/read/28009708/trunnion-corrosion-in-metal-on-polyethylene-total-hip-arthroplasty-a-case-series
#7
Sivashanmugam Raju, Karthikeyan Chinnakkannu, Mohan K Puttaswamy, Matthew J Phillips
INTRODUCTION: Modular total hip arthroplasty implants can help the operating surgeon reproduce the optimum limb length and offset; however, the modularity can lead to fretting and corrosion with associated metal-related problems. Although metal-on-metal bearings are often reported to have problems, recent case reports suggest that the problems can occur with any articulation, usually as a result of problems at the head/neck junction. METHODS: We retrospectively reviewed three cases of a specific implant combination with nontraumatic trunnion failure, with two cases presenting as acute complete dissociation of the femoral head from the neck...
December 22, 2016: Journal of the American Academy of Orthopaedic Surgeons
https://www.readbyqxmd.com/read/28007372/wear-rates-of-larger-diameter-cross-linked-polyethylene-at-5-to-13-years-does-liner-thickness-or-component-position-matter
#8
Jonathan G Haw, Andrew K Battenberg, Der-Chen T Huang, Thomas P Schmalzried
BACKGROUND: Cross-linked polyethylene (XLPE) has demonstrated significantly reduced wear and osteolysis into the second decade for total hip arthroplasty. There is a relative paucity of data with ≥36-mm bearings. Issues include potential effects of reduced liner thickness and component position on wear, osteolysis, and mechanical failure of the bearing. METHODS: Radiographs of 48 primary total hip arthroplasties with ≥36-mm modular XLPE bearings were analyzed at a minimum 5 years postoperative on serial radiographs using a validated, edge-detection-based algorithm...
November 23, 2016: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28002921/restoring-the-femoral-offset-prevent-early-migration-of-the-stem-in-total-hip-arthroplasty-an-ebra-fca-study
#9
G Vicenti, G Solarino, A Spinarelli, M Carrozzo, G Picca, R Maddalena, F Rifino, B Moretti
The use of modular stems is still debated and controversial. Some authors have highlighted a number of disadvantages of modular prostheses including high costs, the tendency to fracture, the fretting and corrosion and the increased production of debris. Other authors have emphasized several advantages to adapt the prosthesis to the morphometric differences of patients, to allow better accuracy in restoring the anatomy and biomechanics of hip joint. The advantages of the modular devices appear to be more evident in patients with developmental dysplasia of the hip (DDH)...
October 2016: Journal of Biological Regulators and Homeostatic Agents
https://www.readbyqxmd.com/read/27999925/total-hip-arthroplasty-instability-in-italy
#10
REVIEW
Francesco Falez, Matteo Papalia, Fabio Favetti, Gabriele Panegrossi, Filippo Casella, Gianluca Mazzotta
Hip dislocation is a major and common complication of total hip arthroplasty (THA), which appears with an incidence between 0.3% and 10% in primary total hip arthroplasties and up to 28% in revision THA. The hip dislocations can be classified into three groups: early, intermediate and late. Approximately two-thirds of cases can be treated successfully with a non-operative approach. The rest require further surgical intervention. The prerequisite to developing an appropriate treatment strategy is a thorough evaluation to identify the causes of the dislocation...
December 20, 2016: International Orthopaedics
https://www.readbyqxmd.com/read/27923597/long-term-results-of-cementless-total-hip-arthroplasty-with-subtrochanteric-shortening-osteotomy-in-crowe-type-iv-developmental-dysplasia
#11
Duan Wang, Ling-Li Li, Hao-Yang Wang, Fu-Xing Pei, Zong-Ke Zhou
BACKGROUND: When surgeons reconstruct hips with a high dislocation related to severe developmental dysplasia of the hip (DDH) in total hip arthroplasty (THA), archiving long-term stable implant fixation and improving patient function and satisfaction remain challenging. The purpose of this study was to evaluate the 10-year outcomes of transverse subtrochanteric shortening osteotomy in cementless, modular THA in Crowe type IV-Hartofilakidis type III DDH. METHODS: We reviewed 62 patients (76 hips) who underwent cementless THA with transverse subtrochanteric shortening osteotomy from 2002-2010...
November 15, 2016: Journal of Arthroplasty
https://www.readbyqxmd.com/read/27923596/revision-hip-arthroplasty-using-a-modular-cementless-femoral-stem-intermediate-term-follow-up
#12
Sureshan Sivananthan, Chin-Tat Lim, Rapeepat Narkbunnam, Alex Sox-Harris, James I Huddleston, Stuart B Goodman
BACKGROUND: Modular femoral stem provides flexibility in femoral reconstruction, ensuring improved "fit and fill". However, there are risks of junction failure and corrosion, as well as cost concerns in the use of modular femoral stems. METHODS: We reviewed prospectively-gathered clinical and radiographic data on revision total hip arthroplasties (THAs) performed from 2001-2007 using modular, cementless femoral component performed by the 2 senior authors. Patients with a minimum follow-up of 7 years were included in this study...
November 2, 2016: Journal of Arthroplasty
https://www.readbyqxmd.com/read/27900304/clinical-outcome-of-design-modifications-to-the-cls-spotorno-stem-in-total-hip-replacement
#13
Angelo Graceffa, Pier Francesco Indelli, Leonardo Latella, Paolo Poli, Alexander Fulco, Massimiliano Marcucci
PURPOSE: historically, the original CLS Spotorno Stem has demonstrated excellent survival. The design of this stem was recently modified, resulting in the introduction of a shorter, modular version (CLS Brevius). The purpose of the current study was to evaluate the functional, radiological and survivorship outcomes of the cementless CLS Brevius Stem in a multi-surgeon, single center, consecutive series study at two years post-surgery. METHODS: the Authors performed 170 total hip arthroplasties in 155 patients using the shorter, triple-taper stem design (CLS Brevius)...
July 2016: Joints
https://www.readbyqxmd.com/read/27888094/nano-analyses-of-wear-particles-from-metal-on-metal-and-non-metal-on-metal-dual-modular-neck-hip-arthroplasty
#14
Zhidao Xia, Benjamin F Ricciardi, Zhao Liu, Christopher von Ruhland, Mike Ward, Alex Lord, Louise Hughes, Steven R Goldring, Edward Purdue, David Murray, Giorgio Perino
Increased failure rates due to metallic wear particle-associated adverse local tissue reactions (ALTR) is a significant clinical problem in resurfacing and total hip arthroplasty. Retrieved periprosthetic tissue of 53 cases with corrosion/conventional metallic wear particles from 285 revision operations for ALTR was selected for nano-analyses. Three major classes of hip implants associated with ALTR, metal-on-metal hip resurfacing arthroplasty (MoM HRA) and large head total hip replacement (MoM LHTHA) and non-metal-on-metal dual modular neck total hip replacement (Non-MoM DMNTHA) were included...
November 22, 2016: Nanomedicine: Nanotechnology, Biology, and Medicine
https://www.readbyqxmd.com/read/27869634/goals-and-challenges-of-identifying-asymptomatic-pseudotumors-in-patients-treated-with-total-hip-arthroplasty-commentary-on-an-article-by-young-min-kwon-md-phd-et-al-asymptomatic-pseudotumors-in-patients-with-taper-corrosion-of-a-dual-taper-modular-femoral
#15
https://www.readbyqxmd.com/read/27869625/asymptomatic-pseudotumors-in-patients-with-taper-corrosion-of-a-dual-taper-modular-femoral-stem-mars-mri-and-metal-ion-study
#16
Young-Min Kwon, Sariah Khormaee, Ming Han Lincoln Liow, Tsung-Yuan Tsai, Andrew A Freiberg, Harry E Rubash
BACKGROUND: Modularity in total hip arthroplasty facilitates intraoperative restoration of patient anatomy. Although dual-taper modular total hip arthroplasty offers potential advantages for optimizing the hip center of rotation, it has been associated with modular taper corrosion. This corrosion has led to adverse local tissue reactions (pseudotumors) at the neck-stem junction and elevated metal-ion levels. However, the occurrence of taper-corrosion-related pseudotumors in patients who remain asymptomatic following total hip arthroplasty with a dual-taper modular femoral stem remains largely unknown...
October 19, 2016: Journal of Bone and Joint Surgery. American Volume
https://www.readbyqxmd.com/read/27836578/will-new-metal-heads-restore-mechanical-integrity-of-corroded-trunnions
#17
Aditya Derasari, Jonathan E Gold, Sabir Ismaily, Philip C Noble, Stephen J Incavo
BACKGROUND: Metal wear and corrosion from modular junctions in total hip arthroplasty can lead to further unwanted surgery. Trunnion tribocorrosion is recognized as an important contributor to failure. This study was performed to determine if new metal heads restore mechanical integrity of the original modular junction after impaction on corroded trunnions, and assess which variables affect stability of the new interface created at revision total hip arthroplasty. METHODS: Twenty-two trunnions, cobalt-chromium (CoCr) and titanium alloy (TiAIV), (CoCr, n = 12; TiAIV, n = 10) and new metal heads were used, 10 trunnions in pristine condition and 12 with corrosion damage...
October 11, 2016: Journal of Arthroplasty
https://www.readbyqxmd.com/read/27803221/five-year-outcome-of-proximal-femoral-endoprosthetic-arthroplasty-for-non-tumour-indications
#18
G Grammatopoulos, A Alvand, H Martin, D Whitwell, A Taylor, C L M H Gibbons
OBJECTIVES: A possible solution for the management of proximal femoral bone loss is a modular femoral endoprosthesis (EPR). Although the outcome of EPRs in tumour surgery has been well described, the outcome of their use in revision hip surgery has received less attention. The aim of this study was to describe the outcome of using EPR for non-neoplastic indications. METHODS: A retrospective review of 79 patients who underwent 80 EPRs for non-neoplastic indications was performed, including the rates of complication and survival and the mean Oxford Hip Scores (OHS), at a mean of five years post-operatively...
November 2016: Bone & Joint Journal
https://www.readbyqxmd.com/read/27791244/3rd-generation-alumina-on-alumina-in-modular-hip-prosthesis-13-to-18-years-follow-up-results
#19
Aldo Toni, Federico Giardina, Giovanni Guerra, Alessandra Sudanese, Maurizio Montalti, Susanna Stea, Barbara Bordini
INTRODUCTION: Ceramic-on-ceramic (CoC) couplings are alternative bearings surfaces that have been reported to reduce osteolysis, wear debris and aseptic loosening compared to the use of polyethylene. Early experiences with ceramics had poor results, but they have led to many improvements in the manufacture and design of subsequent implants. METHODS: We analysed medical files of 300 CoC total hip arthroplasty (THA) with a modular neck performed during period 1995-2000 by a single surgeon for a minimum follow-up of 13 years, evaluating clinical and radiological outcome...
October 24, 2016: Hip International: the Journal of Clinical and Experimental Research on Hip Pathology and Therapy
https://www.readbyqxmd.com/read/27789206/modular-stem-fracture-at-stem-sleeve-junction-after-primary-total-hip-arthroplasty
#20
Junya Yoshitani, Takuya Nakamura, Yoshinobu Maruhashi, Takeshi Sasagawa, Kenichi Ueshima, Kiyonobu Funaki
No abstract text is available yet for this article.
October 25, 2016: Journal of Orthopaedic Science: Official Journal of the Japanese Orthopaedic Association
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