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Modular hip arthroplasty

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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
#1
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
#2
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
#3
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
#4
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
#5
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
https://www.readbyqxmd.com/read/28393600/shell-design-and-reaming-technique-affect-deformation-in-mobile-bearing-total-hip-arthroplasty-acetabular-components
#6
Scott R Small, John B Meding, Jordan W Oja, Katherine S Lakstins, Danielle J Gehron, Renee D Rogge, Christine A Buckley
Press-fit acetabular components are susceptible to rim deformation. The inherent variability within acetabular reaming techniques may generate increased press-fit and, subsequently, additional component deformation. The purpose of this study was to analyze the insertion and deformation characteristics of acetabular components designed for dual-mobility systems based on component design, size, and reaming technique. Shell deformation was quantified in a validated worst-case scenario foam pinch model. Thin-walled, one-piece, and modular dual-mobility shells of varying size were implanted in under- and over-reamed cavities with insertion force measured and shell deformation assessed using digital image correlation...
April 1, 2017: Proceedings of the Institution of Mechanical Engineers. Part H, Journal of Engineering in Medicine
https://www.readbyqxmd.com/read/28385931/total-hip-arthroplasty-using-a-monobloc-cementless-femoral-stem-for-patients-with-childhood-perthes-disease
#7
K H Lee, W-L Jo, Y C Ha, Y K Lee, S B Goodman, K H Koo
AIMS: Modular or custom-made femoral components have been preferred for total hip arthroplasty (THA) in patients with a history of Perthes' disease because of the distortion in the anatomy of the proximal femur. However, it has not been established whether a monobloc cementless stem will fit the distorted proximal femur or whether the results of the procedure are satisfactory in this group of patients. PATIENTS AND METHODS: We reviewed 68 consecutive patients who had undergone THA for childhood Perthes' disease between June 2003 and December 2008...
April 2017: Bone & Joint Journal
https://www.readbyqxmd.com/read/28385469/the-impact-of-subsidence-on-straight-and-curved-modular-cementless-revision-stems-in-hip-revision-surgery
#8
A Fraile Suari, S Gil González, D Pérez Prieto, A León García, C Mestre Cortadellas, M Tey Pons, F Marqués López
Subsidence is one of the potential complications in femoral stem revision total hip arthroplasty surgery, and can affect stability and osseointegration. A retrospective study was conducted on the outcomes at one year and 5 years (specifically subsidence and clinical relevance) of 40 consecutive femoral total hip arthroplasty revisions, comparing two modular cementless revision stems, Straight vs. Curved, with 20 patients in each group. No mechanical failure was observed, and there was an improvement in functional outcomes...
April 3, 2017: Revista Española de Cirugía Ortopédica y Traumatología
https://www.readbyqxmd.com/read/28385345/outcome-following-debridement-antibiotics-and-implant-retention-in-hip-periprosthetic-joint-infection-an-18-year-experience
#9
George Grammatopoulos, Benjamin Kendrick, Martin McNally, Nicholas A Athanasou, Bridget Atkins, Peter McLardy-Smith, Adrian Taylor, Roger Gundle
BACKGROUND: Debridement-antibiotics-and-implant-retention (DAIR) may be considered a suitable surgical option in periprosthetic joint infections (PJIs) with soundly fixed prostheses, despite chronicity. This study aims to define the long-term outcome following DAIR in hip PJI. METHODS: We reviewed all hip DAIRs performed between 1997 and 2013 (n = 122) to define long-term outcome and identify factors influencing it. Data recorded included patient demographics, medical history, type of DAIR performed (+/- exchange of modular components), and organisms identified...
March 6, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28363889/hip-revision-arthroplasty-for-failed-osteosynthesis-in-periprosthetic-vancouver-type-b1-fractures-using-a-cementless-modular-tapered-revision-stem
#10
B Fink, D Oremek
AIMS: To evaluate the hypothesis that failed osteosynthesis of periprosthetic Vancouver type B1 fractures can be treated successfully with stem revision using a transfemoral approach and a cementless, modular, tapered revision stem with reproducible rates of fracture healing, stability of the revision stem, and clinically good results. PATIENTS AND METHODS: A total of 14 patients (11 women, three men) with a mean age of 72.4 years (65 to 90) undergoing revision hip arthroplasty after failed osteosynthesis of periprosthetic fractures of Vancouver type B1 were treated using a transfemoral approach to remove the well-fixed stem before insertion of a modular, fluted titanium stem which obtained distal fixation...
April 2017: Bone & Joint Journal
https://www.readbyqxmd.com/read/28343828/the-morscher-press-fit-acetabular-component-an-independent-long-term-review-at-18-22-years
#11
REVIEW
David P Gwynne-Jones, Heath W R Lash, Andrew W James, Ella E Iosua, John A Matheson
BACKGROUND: There are relatively few 20-year results of uncemented acetabular components, and most of these are modular designs. This study reports the 20-year results of a monoblock press-fit acetabular component. METHODS: A total of 122 total hip arthroplasties (111 patients) using the Morscher cup were reviewed at a mean of 19.7 years. The average age at implantation was 57.3 years (range, 36-74 years), and 81 (66%) were men. RESULTS: Twenty-two patients (25 hips) had died...
March 2, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28343824/assessment-of-corrosion-fretting-and-material-loss-of-retrieved-modular-total-knee-arthroplasties
#12
Audrey J Martin, Kirsten A Seagers, Douglas W Van Citters
BACKGROUND: Modular junctions in total hip arthroplasties have been associated with fretting, corrosion, and debris release. The purpose of this study is to analyze damage severity in total knee arthroplasties of a single design by qualitative visual assessment and quantitative material loss measurements to evaluate implant performance and patient impact via material loss. METHODS: Twenty-two modular knee retrievals of the same manufacturer were identified from an institutional review board-approved database...
February 28, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28341314/fretting-and-corrosion-at-the-backside-of-modular-cobalt-chromium-acetabular-inserts-a-retrieval-analysis
#13
T David Tarity, Chelsea N Koch, Jayme C Burket, Timothy M Wright, Geoffrey H Westrich
BACKGROUND: Adverse local tissue reaction formation has been suggested to occur with the Modular Dual Mobility (MDM) acetabular design. Few reports in the literature have evaluated fretting and corrosion damage between the acetabular shell and modular metal inserts in this modular system. We evaluated a series of 18 retrieved cobalt chromium MDM inserts for evidence of fretting and corrosion. METHODS: We assessed the backsides of 18 MDM components for evidence of fretting and corrosion in polar and taper regions based on previously established methods...
March 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28326418/combining-a-hip-arthroplasty-stem-with-trochanteric-reattachment-bolt-and-a-polyaxial-locking-plate-in-the-treatment-of-a-periprosthetic-fracture-below-a-well-integrated-implant
#14
Urban Hedlundh, Lars Karlsson
Distally anchored uncemented modular tapered porous stems are often the preferred treatment in total hip arthroplasty revisions and failed subtrochanteric fractures. These conditions mainly affect elderly osteoporotic patients, with an increased risk of later fractures below the well-fixated implant. Treatment in secondary fractures with long looking plates is the recommended treatment, where stability is a key to fracture healing. We report a complicated case in which this was achieved by an innovative technique combing the trochanteric attachment bolt of the stem system and a locking plate with polyaxial screws...
December 2016: Arthroplasty Today
https://www.readbyqxmd.com/read/28323248/accuracy-and-reproducibility-of-preoperative-three-dimensional-planning-for-total-hip-arthroplasty-using-biplanar-low-dose-radiographs-a-pilot-study
#15
Didier Mainard, Olivier Barbier, Yohann Knafo, Rémi Belleville, Laurence Mainard-Simard, Jean-Baptiste Gross
BACKGROUND: In total hip arthroplasty (THA), the acetabular cup and femoral stem must be correctly sized and positioned to avoid intraoperative and postoperative complications, achieve good functional outcomes and ensure long-term survival. Current two-dimensional (2D) techniques do not provide sufficient accuracy, while low-dose biplanar X-rays (EOS) had not been assessed in this indication. Therefore we performed a case-control study to: 1) evaluate the prediction of stem and cup size for a new 3D planning technique (stereoradiographic imaging plus 3D modeling) in comparison to 2D templating on film radiographs and 2) evaluate the accuracy and reproducibility of this 3D technique for preoperative THA planning...
March 16, 2017: Orthopaedics & Traumatology, Surgery & Research: OTSR
https://www.readbyqxmd.com/read/28291145/isolated-head-and-liner-exchange-in-revision-hip-arthroplasty
#16
David William Walmsley, James P Waddell, Emil H Schemitsch
As the number of primary total hip arthroplasties increases, so does the burden of revision procedures. The decision to revise well-fixed components in the setting of polyethylene wear and osteolysis is controversial. Modular head and liner exchange offers the advantages of reduced invasiveness, faster recovery, and bone preservation. These advantages come at the expense of higher rates of revision surgery for instability. Using the native locking mechanism for securing the new liner is preferred; however, cementing a liner into a well-fixed acetabular component is a practical alternative...
April 2017: Journal of the American Academy of Orthopaedic Surgeons
https://www.readbyqxmd.com/read/28214460/managing-acetabular-defects-in-total-hip-arthroplasty
#17
REVIEW
Brian Park, Frank Liporace, Scott Marwin
With the aging population and rising incidence of primary total joint arthroplasty has come the increasing incidence of revision total hip arthroplasties. One challenge in revision total hip arthroplasty is dealing with acetabular defects. The orthopaedic surgeon who chooses to take on these challenges requires a proper method for the evaluation of these defects as well as an evidence-based treatment algorithm. Initial assessment requires appropriate use and interpretation of imaging modalities such as x-rays and computed tomography...
January 2017: Bulletin of the Hospital for Joint Diseases
https://www.readbyqxmd.com/read/28204856/ultrasound-findings-in-asymptomatic-patients-with-modular-metal-on-metal-total-hip-arthroplasty
#18
Nicholas B Frisch, Nolan M Wessell, Kevin Taliaferro, Marnix Van Holsbeeck, Craig D Silverton
OBJECTIVE: The use of metal-on-metal and modular total hip arthroplasty is associated with potentially serious local and systemic complications. The primary aim of this study was to identify the prevalence of a pseudotumor in asymptomatic patients with a particular metal-on-metal hip prosthesis after a minimum follow-up of 5 years using ultrasound evaluation. A secondary purpose was to identify associations between the presence of pseudotumor and serum metal ion levels following implantation...
February 15, 2017: Skeletal Radiology
https://www.readbyqxmd.com/read/28190644/what-are-normal-metal-ion-levels-after-total-hip-arthroplasty-a%C3%A2-serologic-analysis-of-four-bearing-surfaces
#19
Brian T Barlow, Philippe A Ortiz, John W Boles, Yuo-Yu Lee, Douglas E Padgett, Geoffrey H Westrich
BACKGROUND: The recent experiences with adverse local tissue reactions have highlighted the need to establish what are normal serum levels of cobalt (Co), chromium (Cr), and titanium (Ti) after hip arthroplasty. METHODS: Serum Co, Cr, and Ti levels were measured in 80 nonconsecutive patients with well-functioning unilateral total hip arthroplasty and compared among 4 bearing surfaces: ceramic-on-ceramic (CoC); ceramic-on-polyethylene (CoP); metal-on-polyethylene (MoP), and dual mobility (DM)...
May 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28167873/corrosion-of-the-head-stem-taper-junction-are-we-on-the-verge-of-an-epidemic-review-article
#20
REVIEW
Michael Morlock, Dennis Bünte, Julian Gührs, Nicholas Bishop
BACKGROUND: The modular head taper junction has contributed to the success of total hip arthroplasty (THA) greatly. Taper corrosion and wear problems reported for large and extra-large metal-on-metal bearings as well as for bi-modular THA stems have cast doubt on the benefit of the taper interface. Presently, corrosion problems are being reported for nearly all kinds of artificial hip joints incorporating metal heads, questioning taper connections in general. QUESTIONS/PURPOSES: This study aimed to review the mechanical and electrochemical relationships that may lead to taper corrosion, which have been reported more commonly in recent literature, and to also review the contribution of patient characteristics and surgical techniques involved in taper assembly that may contribute to the problem...
February 2017: HSS Journal: the Musculoskeletal Journal of Hospital for Special Surgery
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