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Modular hip arthroplasty

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https://www.readbyqxmd.com/read/28214460/managing-acetabular-defects-in-total-hip-arthroplasty
#1
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
#2
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
#3
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)...
December 3, 2016: 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
#4
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
https://www.readbyqxmd.com/read/28167872/characterization-of-femoral-head-taper-corrosion-features-using-a-22-year-retrieval-database
#5
Jacob Cartner, Patrick Aldinger, Chenxi Li, David Collins
BACKGROUND: Modularity in total hip arthroplasty has been used for decades with great success, but new findings regarding corrosion artifacts have caused a resurgence in tapered junction research. Mechanically assisted crevice corrosion (MACC) is thought to be the mechanism by which corrosive attack occurs. Myriad multi-factorial variables are known to influence the susceptibility of a modular taper junction to MACC. Some of these variables are design and manufacture related and others can be controlled by the surgeon...
February 2017: HSS Journal: the Musculoskeletal Journal of Hospital for Special Surgery
https://www.readbyqxmd.com/read/28159679/is-there-a-role-for-femoral-offset-restoration-during-total-hip-arthroplasty-a-systematic-review
#6
REVIEW
Marcello De Fine, Matteo Romagnoli, Angelo Toscano, Alice Bondi, Matteo Nanni, Stefano Zaffagnini
BACKGROUND: Benefits of femoral offset restoration during total hip arthroplasty should be the reduction of bearing surfaces wear, implant loosening and dislocation rates. Modular neck stems ensure offset customization, but fretting corrosion and catastrophic failures are well documented complications. Since clinical evidences are needed to substantiate the effectiveness of femoral offset restoration and promote modular neck choice, we systematically reviewed the literature to ascertain whether femoral offsetitself has a proven clinical influence: 1) on bearing surfaces wear, 2) implant loosening, 3) and dislocation rates...
January 31, 2017: Orthopaedics & Traumatology, Surgery & Research: OTSR
https://www.readbyqxmd.com/read/28155838/periprosthetic-metastatic-lesion-in-stem-region-after-tha-case-study
#7
Janusz Płomiński, Artur Pepłoński, Mateusz Jeśkiewicz
The paper describes a periprosthetic metastatic lesion in the stem region which developed 4 years after cementless total hip arthroplasty in a 64-year-old female patient. The patient underwent primary THA due to osteoarthritis in 2010. In June 2014, she presented with increasing hip pain. Diagnostic imaging revealed a periprosthetic osteolytic lesion in the stem region. The patient was referred to the Orthopaedic Department for further evaluation with a suspicion of pyogenic osteomyelitis. An open surgical biopsy was performed...
November 30, 2016: Ortopedia, Traumatologia, Rehabilitacja
https://www.readbyqxmd.com/read/28130016/cortical-strut-allograft-support-of-modular-femoral-junctions-during-revision-total-hip-arthroplasty
#8
Chin Tat Lim, Derek F Amanatullah, James I Huddleston, Katherine L Hwang, William J Maloney, Stuart B Goodman
BACKGROUND: There is risk of junction failure when using modular femoral stems for revision total hip arthroplasty (THA), especially with loss of bone stock in the proximal femur. Using a cortical strut allograft may provide additional support of a modular femoral construct in revision THA. METHODS: We reviewed prospectively gathered clinical and radiographic data for 28 revision THAs performed from 2004 to 2014 using cementless modular femoral components with cortical strut allograft applied to supplement proximal femoral bone loss: 5 (18%) were fluted taper designs and 23 (82%) were porous cylindrical designs All the patients had a Paprosky grade IIIA or greater femoral defect...
December 21, 2016: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28087160/mri-retrieval-analysis-and-histologic-evaluation-of-adverse-local-tissue-reaction-in-metal-on-polyethylene-total-hip-arthroplasty
#9
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
#10
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
#11
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
#12
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
#13
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
#14
REVIEW
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
#15
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...
February 2017: 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
#16
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
#17
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
#18
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
#19
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
#20
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
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