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Modular hip arthroplasty

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https://www.readbyqxmd.com/read/28509828/modular-fluted-tapered-stems-in-aseptic-revision-total-hip-arthroplasty
#1
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
#2
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
#3
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
#4
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
#5
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
#6
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
#7
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
#8
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
#9
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
#10
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
#11
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
#12
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
#13
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
#14
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
#15
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
#16
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
#17
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
#18
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
#19
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
#20
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
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