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Modular hip arthroplasty

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https://www.readbyqxmd.com/read/29756511/surface-integrity-of-polyethylene-liners-following-trunnionosis-of-a-dual-modular-neck-total-hip-implant
#1
Ben Gi Spiegelberg, Brent A Lanting, James L Howard, Matthew G Teeter, Douglas Dr Naudie
BACKGROUND: There has been a trend in the evolution of total hip arthroplasty towards increased modularity; with this increase in modularity come some potentially harmful consequences. Modularity at the neck shaft junction has been linked to corrosion, adverse reaction to metal debris and pseudotumour formation. AIM: The aim of this retrieval study is to assess whether the surface integrity of the polyethylene (PE) liner is affected by metal wear debris in a single implant design series of THA revised for trunnionosis...
May 1, 2018: Hip International: the Journal of Clinical and Experimental Research on Hip Pathology and Therapy
https://www.readbyqxmd.com/read/29756492/cementless-total-hip-arthroplasty-in-young-patients-under-the-age-of-30-a-minimum-10-year-follow-up
#2
Eun Ho Shin, Kyoung Ho Moon
PURPOSE: The purpose of this study was to evaluate the clinical and radiologic outcomes of young patients (under the age of 30) who received a total hip arthroplasty (THA) and in whom patients had been followed for more than 10 years. MATERIALS AND METHODS: This retrospective study was conducted for 51 hips (44 patients) that had undergone THA. The mean age for the index operation was 25.71 years, and the mean follow-up period was 13.7 years. Clinical outcomes were evaluated by Harris hip score (HHS), activity level, and complications...
May 1, 2018: Hip International: the Journal of Clinical and Experimental Research on Hip Pathology and Therapy
https://www.readbyqxmd.com/read/29748069/sensitivity-and-specificity-of-metal-ion-level-in-predicting-adverse-local-tissue-reactions-due-to-head-neck-taper-corrosion-in-primary-metal-on-polyethylene-total-hip-arthroplasty
#3
Young-Min Kwon, John MacAuliffe, Paul G Arauz, Yun Peng
BACKGROUND: There is increasing concern regarding the occurrence of adverse local tissue reactions (ALTRs) in metal-on-polyethylene (MoP) total hip arthroplasty (THA) patients due to mechanically assisted crevice corrosion at the head-neck modular taper junction. The utility of metal ion levels in evaluating MoP patients with head-neck taper has not been fully characterized. This study aimed to investigate the sensitivity and specificity of serum metal ions as a predictor of ALTR in MoP THA patients...
April 16, 2018: Journal of Arthroplasty
https://www.readbyqxmd.com/read/29716387/outcomes-of-vancouver-b2-and-b3-periprosthetic-femoral-fractures-after-total-hip-arthroplasty-in-elderly-patients
#4
Jesús Moreta, Iker Uriarte, Amaia Ormaza, Javier Mosquera, Kattalin Iza, Urko Aguirre, María José Legarreta, José Luis Martínez-De Los Mozos
INTRODUCTION: The objective was to evaluate clinical and radiological outcomes of Vancouver B2 and B3 periprosthetic femoral fractures in patients older than 65 years treated at our institution from 2000 to 2014. We compared the most common methods of fixation: a modular tapered rectangular titanium stem versus a monoblock tapered stem. METHODS: A retrospective review was performed with a minimum follow-up time of 2 years. Patient mobility in the period prior to the fracture and after fracture healing and functional results was assessed according to the Harris Hip Score...
April 1, 2018: Hip International: the Journal of Clinical and Experimental Research on Hip Pathology and Therapy
https://www.readbyqxmd.com/read/29705684/what-factors-drive-taper-corrosion
#5
Robin Pourzal, Hannah J Lundberg, Deborah J Hall, Joshua J Jacobs
Adverse local tissue reactions to corrosion products can lead to total hip arthroplasty failure. Although this problem has been well known for more than 25 years, it has seemingly increased in frequency over the recent years. The occurrence of corrosion is multifactorial-depending on implant, patient, and surgeon factors. As of now, there is no "one-size-fits-all" solution to prevent corrosion in total hip arthroplasty devices. Thus, it is imperative to fully understand the exact mechanisms of modular junction corrosion to prevent premature implant failure...
March 30, 2018: Journal of Arthroplasty
https://www.readbyqxmd.com/read/29698302/is-there-a-cardiotoxicity-associated-with-metallic-head-hip-prostheses-a-cohort-study-in-the-french-national-health-insurance-databases
#6
Marion Lassalle, Sandrine Colas, Annie Rudnichi, Mahmoud Zureik, Rosemary Dray-Spira
BACKGROUND: There are four distinguishable types of THA devices in wide use, as defined by the femoral and acetabular bearing surfaces: metal-on-polyethylene (MoP), ceramic-on-polyethylene (CoP), metal-on-metal (MoM), and ceramic-on-ceramic (CoC). Metallic head THAs (MoP and MoM) can potentially induce cardiac toxicity because cobalt species, generated at the head-neck trunnion, and in the case of MoM devices, at the articular surface as well, can be absorbed systemically. However, studies have provided inconsistent results...
April 23, 2018: Clinical Orthopaedics and related Research
https://www.readbyqxmd.com/read/29682286/maximizing-the-fixation-strength-of-modular-components-by-impaction-without-tissue-damage
#7
A Krull, M M Morlock, N E Bishop
Objectives: Taper junctions between modular hip arthroplasty femoral heads and stems fail by wear or corrosion which can be caused by relative motion at their interface. Increasing the assembly force can reduce relative motion and corrosion but may also damage surrounding tissues. The purpose of this study was to determine the effects of increasing the impaction energy and the stiffness of the impactor tool on the stability of the taper junction and on the forces transmitted through the patient's surrounding tissues...
February 2018: Bone & Joint Research
https://www.readbyqxmd.com/read/29673377/total-hip-arthroplasty-to-treat-acetabular-protrusions-secondary-to-rheumatoid-arthritis
#8
Ping Zhen, Xusheng Li, Shenghu Zhou, Hao Lu, Hui Chen, Jun Liu
BACKGROUND: The treatment of acetabular protrusions during total hip arthroplasty of patients with rheumatoid arthritis is difficult. A lack of bone stock, deficient medial cup support, and medialization of the joint center in those with protrusio acetabuli must be addressed during acetabular reconstruction. The purpose of this study was to assess the short-term clinical results of total hip arthroplasty in patients with severe acetabular protrusions secondary to rheumatoid arthritis...
April 19, 2018: Journal of Orthopaedic Surgery and Research
https://www.readbyqxmd.com/read/29656966/corrigendum-to-modular-neck-vs-nonmodular-femoral-stems-in-total-hip-arthroplasty-clinical-outcome-metal-ion-levels-and-radiologic-findings-journal-of-arthroplasty-32-2017-2774-2778
#9
Rasmus T Mikkelsen, Marianne Fløjstrup, Nicolai Klem, Raymond Andre Tellefsen, Christian Lund, Per Kjærsgaard-Andersen, Thomas Skjødt, Claus Varnum
No abstract text is available yet for this article.
April 12, 2018: Journal of Arthroplasty
https://www.readbyqxmd.com/read/29628686/treatment-options-for-chronic-pelvic-discontinuity
#10
REVIEW
Mark D Hasenauer, Wayne G Paprosky, Neil P Sheth
Chronic pelvic discontinuity is a distinct and unique challenge seen during revision total hip arthroplasty (THA) in which the superior ilium is separated from the inferior ischiopubic segment through the acetabulum, rendering the anterior and posterior columns discontinuous. The operative management of acetabular bone loss in revision THA is one of the most difficult challenges today. Common treatment options include cage reconstruction with bulk acetabular allograft, custom triflange acetabular component, a cup-cage construct, jumbo acetabular cup with porous metal augments, or acetabular distraction with a porous tantalum shell with or without modular porous augments...
January 2018: Journal of Clinical Orthopaedics and Trauma
https://www.readbyqxmd.com/read/29599032/femoral-bone-restoration-patterns-in-revision-total-hip-arthroplasty-using-distally-fixed-modular-tapered-titanium-stems-and-an-extended-trochanteric-osteotomy-approach
#11
Andreas Ladurner, Vilijam Zdravkovic, Karl Grob
BACKGROUND: Mechanical failure of modular revision stems is a serious complication in revision total hip arthroplasty. The lack of adequate osseous support to the proximal component, especially in cases of an extended trochanteric osteotomy approach, is considered a risk factor for stem failure. In this study, we analyze proximal bone regeneration patterns in patients undergoing revision total hip arthroplasty for aseptic stem loosening through an extended trochanteric osteotomy approach using an uncemented dual modular stem...
February 26, 2018: Journal of Arthroplasty
https://www.readbyqxmd.com/read/29564374/early-fracture-of-the-modular-neck-of-a-modulus-femoral-stem
#12
Katsufumi Uchiyama, Takeaki Yamamoto, Mitsutoshi Moriya, Kensuke Fukushima, Yojiro Minegishi, Naonobu Takahira, Masashi Takaso
We present the case of a 46-year-old woman who underwent revision surgery approximately 4 years after total hip arthroplasty because of a fracture of the modular neck of a MODULUS femoral stem. The fractured surfaces of the retrieved implant were inspected using optical and scanning electron microscopy. Three-dimensional finite element analysis was also performed to identify the stresses that might have caused the failure. We concluded that active, obese patients who are implanted with a high-offset, small-sized modular component could experience stress-induced fractures of the modular neck, with proper fixation and osseointegration of the distal stem, especially if residual bone or tissue is present on the inner surface of the neck that could contribute to micromovement and decreased proximal fixation...
June 2017: Arthroplasty Today
https://www.readbyqxmd.com/read/29560387/tapered-modular-fluted-titanium-stems-for-femoral-fixation-in-revision-total-knee-arthroplasty
#13
Jeffrey B Stambough, J Bohannon Mason, Aldo M Riesgo, Thomas K Fehring
Consensus regarding femoral stem fixation options in revision total knee arthroplasty remains controversial. Tapered, modular, fluted titanium (TMFT) stems have an excellent track record in total hip arthroplasty for their ability to provide axial and rotational stability in situations of compromised host bone. We present 3 successfully treated cases in which the Food & Drug Administration granted permission to use custom TMFT stems in situations of failed femoral fixation in multiple revised knees. These stems hold promise to achieve stable fixation in revision total knee arthroplasty where host metadiaphyseal bone is deficient...
March 2018: Arthroplasty Today
https://www.readbyqxmd.com/read/29529660/can-dislocation-of-a-constrained-liner-be-salvaged-with-dual-mobility-constructs-in-revision-tha
#14
Brian P Chalmers, Graham D Pallante, Michael J Taunton, Rafael J Sierra, Robert T Trousdale
BACKGROUND: Revision THA to treat recurrent instability can itself be complicated by recurrent instability, and when this occurs, this problem is difficult to treat. Some patients' THAs will continue to dislocate despite use of a constrained liner. One option in this difficult-to-treat group is conversion to a dual-mobility (DM) construct, but there are few data on this approach. QUESTIONS/PURPOSES: (1) What were the Harris hip scores in a small group of patients whose constrained liners were converted to DM constructs to treat recurrent dislocation? (2) What were the redislocation, rerevision, and DM construct retention rates in these patients? METHODS: We conducted a retrospective analysis of a longitudinally maintained institutional database maintained by individuals other than the treating surgeons to identify patients undergoing conversion of constrained liners to DM constructs in revision THA from 2011 to 2014...
February 2018: Clinical Orthopaedics and related Research
https://www.readbyqxmd.com/read/29511786/-anatomical-total-shoulder-replacement-in-glenohumeral-osteoarthritis-indications-current-implants-and-clinical-results
#15
REVIEW
O Lorbach
IMPLANT DESIGNS: Within the last 50 years, implants for shoulder replacement have developed rapidly. Monobloc-stems in few sizes were changed to modular implant systems that allow for an individual adaption of the stem, as well as adaption of the humeral head component according to the specific anatomic situation of the patient. Moreover, stemless und short stem implants are available, which may highly simplify primary implantation, especially in posttraumatic cases as well as in revision cases with a need for removal or change of the implants...
May 2018: Der Orthopäde
https://www.readbyqxmd.com/read/29502964/diagnosis-taper-corrosion-when-is-it-the-taper-and-when-is-it-something-else
#16
Craig J Della Valle, Tyler E Calkins, Joshua J Jacobs
There has been an increasing use of modularity at the head-neck junction in total hip arthroplasty to more closely mimic the native anatomy, allowing for optimal leg length and stability. Corrosion at this junction in metal-on-polyethylene bearings can lead to an adverse local tissue reaction (ALTR). This increasingly prevalent condition should be considered in the differential diagnosis of hip pain and difficulty ambulating. A recent symposium by the American Academy of Hip and Knee Surgeons described the diagnosis, etiology, management, and prevention of taper corrosion...
March 1, 2018: Journal of Arthroplasty
https://www.readbyqxmd.com/read/29500091/cementless-total-hip-arthroplasty-in-crowe-iii-and-iv-dysplasia-high-hip-center-and-modular-necks
#17
Maurizio Montalti, Francesco Castagnini, Federico Giardina, Enrico Tassinari, Federico Biondi, Aldo Toni
BACKGROUND: Total hip arthroplasty (THA) in severe developmental dysplasia of the hip (DDH) is a challenging procedure. The most used techniques involve anatomic cup positioning, augmentation femoral osteotomy. However, anatomic cup positioning is not always feasible in severe DDH and osteotomy nonunion may ensue. The purpose of the study was to assess the survivorship, the hip score results, the radiological parameters (fixation, loosening, component position) of a large cohort of patients with Crowe III and IV DDH, treated with high hip center and modular necks THAs...
February 2, 2018: Journal of Arthroplasty
https://www.readbyqxmd.com/read/29500088/dual-mobility-constructs-in-revision-total-hip-arthroplasties
#18
Matthew P Abdel
Dislocation after revision total hip arthroplasty (THA) continues to be one of the most common and concerning complications after the procedure. As with every hip arthroplasty, it is essential to optimize component positioning, minimize impingement, and maintain the integrity of the abductor complex during the revision THAs. However, in several revision circumstances, additional strategies are required to mitigate the risk of dislocation, particularly those being revised for instability or those with cognitive or neuromuscular disorders...
May 2018: Journal of Arthroplasty
https://www.readbyqxmd.com/read/29468265/the-tridimensional-geometry-of-the-proximal-femur-should-determine-the-design-of-cementless-femoral-stem-in-total-hip-arthroplasty
#19
Julien Wegrzyn, Jean-Paul Roux, Charlotte Loriau, Nicolas Bonin, Vincent Pibarot
PURPOSE: Using a cementless femoral stem in total hip arthroplasty (THA), optimal filling of the proximal femoral metaphyseal volume (PFMV) and restoration of the extramedullary proximal femoral (PF) parameters (i.e., femoral offset (FO), neck length (FNL), and head height (FHH)) constitute key goals for optimal hip biomechanics, functional outcome, and THA survivorship. However, almost 30% of mismatch between the PF anatomy and implant geometry of the most widely implanted non-modular cementless femoral stem has been demonstrated in a computed tomography scan (CT scan) study...
February 22, 2018: International Orthopaedics
https://www.readbyqxmd.com/read/29428321/cement-augmentation-in-the-proximal-femur-to-prevent-stem-subsidence-in-revision-hip-arthroplasty-with-paprosky-type-ii-iiia-defects
#20
Shang-Wen Tsai, Cheng-Fong Chen, Po-Kuei Wu, Chao-Ming Chen, Wei-Ming Chen
BACKGROUND: Subsidence remains a common complication after revision hip arthroplasty which may lead to prolonged weight-bearing restrictions, leg-length discrepancies or considerable loss of function. We evaluated the effectiveness of cement augmentation in the proximal femoral metaphysis during a revision of femoral components to prevent post-operative stem subsidence. METHODS: Forty patients were enrolled. Follow-up averaged 67.7 months (range: 24-149). Twenty-seven patients had a Paprosky type II defect and 13 had a type IIIa defect...
February 7, 2018: Journal of the Chinese Medical Association: JCMA
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