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Modular hip arthroplasty

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https://www.readbyqxmd.com/read/28710154/outcomes-following-revision-surgery-performed-for-adverse-reactions-to-metal-debris-in-non-metal-on-metal-hip-arthroplasty-patients-analysis-of-185-revisions-from-the-national-joint-registry-for-england-and-wales
#1
G S Matharu, A Judge, D W Murray, H G Pandit
OBJECTIVES: Few studies have assessed outcomes following non-metal-on-metal hip arthroplasty (non-MoMHA) revision surgery performed for adverse reactions to metal debris (ARMD). We assessed outcomes following non-MoMHA revision surgery performed for ARMD, and identified predictors of re-revision. METHODS: We performed a retrospective observational study using data from the National Joint Registry for England and Wales. All non-MoMHAs undergoing revision surgery for ARMD between 2008 and 2014 were included (185 hips in 185 patients)...
July 2017: Bone & Joint Research
https://www.readbyqxmd.com/read/28702784/cementless-modular-distally-fixed-stem-in-hip-revision-arthroplasty-a-single-center-study-of-132-consecutive-hips
#2
Ali Hashem, Ammar Al-Azzawi, Hasan Riyadh, Sebastian Mukka, Arkan Sayed-Noor
PURPOSE: The use of cementless, modular, distally fixed stem in hip revision arthroplasty has increased during the last decades. We aimed to analyze the early and late postoperative complications, re-operation rate, and survival rate of the MP stem operated at our county hospital with relatively limited caseload. METHODS: In this retrospective study, we included 132 hips operated with MP stem between January 2007-2014. An independent observer reviewed patients' medical records in July 2015 (18-102 months postoperatively, median 52...
July 12, 2017: European Journal of Orthopaedic Surgery & Traumatology: Orthopédie Traumatologie
https://www.readbyqxmd.com/read/28695179/inflammatory-pseudotumor-after-ceramic-on-ceramic-total-hip-arthroplasty
#3
Joshua Campbell, Sean Rajaee, Earl Brien, Guy D Paiement
We present a unique case of a symptomatic adverse local tissue reaction in a patient with a ceramic-on-ceramic total hip bearing surface. To our knowledge, this pathological finding has not yet been described in a ceramic-on-ceramic articulation without a cobalt-chromium alloy trunnion or modular neck component as a source of metal wear. We conclude that despite its mechanical mostly benign wear characteristics, ceramic wear debris is not entirely inert and may lead to the development of adverse local tissue reaction...
June 2017: Arthroplasty Today
https://www.readbyqxmd.com/read/28674737/systematic-review-of-the-outcome-of-total-hip-arthroplasty-in-patients-with-sequelae-of-legg-calv%C3%A3-perthes-disease
#4
Sammy A Hanna, Khaled M Sarraf, Manoj Ramachandran, Pramod Achan
BACKGROUND: Total hip arthroplasty (THA) in patients with sequelae of Legg-Calvé-Perthes disease (LCP) is technically demanding because of the disease related deformities occuring in the proximal femur and/or the multiplanar deformities secondary to corrective osteotomies in childhood. Little is known about the long-term outcome of the procedure in this challenging group of patients. METHODS: We carried out a systematic review of the literature to determine the functional outcome, complications and revision rate of THA in patients with sequelae of LCP disease...
August 2017: Archives of Orthopaedic and Trauma Surgery
https://www.readbyqxmd.com/read/28647286/the-taper-corrosion-pattern-observed-for-one-bi-modular-stem-design-is-related-to-geometry-determined-taper-mechanics
#5
Dennis Buente, Michael Bryant, Michael Ward, Anne Neville, Michael Morlock, Gerd Huber
Bi-modular primary hip stems exhibit high revision rates owing to corrosion at the stem-neck taper, and are associated with local adverse tissue reactions. The aim of this study was to relate the wear patterns observed for one bi-modular design to its design-specific stem-neck taper geometry. Wear patterns and initial geometry of the taper junctions were determined for 27 retrieved bi-modular primary hip arthroplasty stems (Rejuvenate, Stryker Orthopaedics) using a tactile coordinate-measuring device. Regions of high-gradient wear patterns were additionally analyzed via optical and electron microscopy...
June 21, 2017: Medical Engineering & Physics
https://www.readbyqxmd.com/read/28634092/alarmingly-high-rate-of-implant-fractures-in-one-modular-femoral-stem-design-a-comparison-of-two-implants
#6
Ritesh R Shah, Jeffrey M Goldstein, Nancy E Cipparrone, Alexander C Gordon, Matthew L Jimenez, Wayne M Goldstein
BACKGROUND: Reports of implant fracture at the modular junction have been seen in modular neck designs, stem-sleeve modular femoral stems, and diaphyseal engaging bi-body modular stems. To date, however, there has never been a direct comparison between 2 different implant designs from the same modular family. The purpose of this study is to compare the rate of implant failure of 2 such stem-sleeve modular femoral stem designs, the S-ROM and Emperion, to further identify factors which increase the risk of this mode of failure...
May 22, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28625686/the-influence-of-contamination-and-cleaning-on-the-strength-of-modular-head-taper-fixation-in-total-hip-arthroplasty
#7
Annika Krull, Michael M Morlock, Nicholas E Bishop
BACKGROUND: Intraoperative interface contamination of modular head-stem taper junctions of hip implants can lead to poor fixation strength, causing fretting and crevice corrosion or even stem taper fracture. Careful cleaning before assembly should help to reduce these problems. The purpose of this study was to determine the effect of cleaning (with and without drying) contaminated taper interfaces on the taper fixation strength. METHODS: Metal or ceramic heads were impacted onto titanium alloy stem tapers with cleaned or contaminated (fat or saline solution) interfaces...
May 13, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28623650/the-incidence-of-dissociated-liners-in-4-751-consecutive-total-hip-arthroplasties-using-pinnacle-polyethylene-acetabular-liners
#8
Richard J Napier, Owen Diamond, Chris K J O'Neill, Seamus O'Brien, David E Beverland
INTRODUCTION: Acetabular liner dissociation is a complication exclusive to modular designs. We present a single surgeon series of 8 polyethylene liner dissociations with the Pinnacle Acetabular System (DePuy Orthopaedics) from over 4,750 cases. We also present a review of the literature and data from the UK National Joint Registry (NJR) on dissociation in total hip arthroplasty (THA). METHODS: The Pinnacle Acetabular System has been used exclusively by the senior author since April 2003, and to date 5,882 have been implanted (837 ceramic liners, 4,751 polyethylene liners (1,606 Enduron/3,145 Marathon) and 294 metal liners)...
June 14, 2017: Hip International: the Journal of Clinical and Experimental Research on Hip Pathology and Therapy
https://www.readbyqxmd.com/read/28615939/effect-of-carbon-ion-implantation-on-the-tribology-of-metal-on-metal-bearings-for-artificial-joints
#9
Hironobu Koseki, Masato Tomita, Akihiko Yonekura, Takashi Higuchi, Sinya Sunagawa, Koumei Baba, Makoto Osaki
Metal-on-metal (MoM) bearings have become popular due to a major advantage over metal-on-polymer bearings for total hip arthroplasty in that the larger femoral head and hydrodynamic lubrication of the former reduce the rate of wear. However, concerns remain regarding adverse reactions to metal debris including metallosis caused by metal wear generated at the taper-head interface and another modular junction. Our group has hypothesized that carbon ion implantation (CII) may improve metal wear properties. The purpose of this study was to investigate the wear properties and friction coefficients of CII surfaces with an aim to ultimately apply these surfaces to MoM bearings in artificial joints...
2017: International Journal of Nanomedicine
https://www.readbyqxmd.com/read/28602532/what-is-the-difference-between-modular-and-nonmodular-tapered-fluted-titanium-stems-in-revision-total-hip-arthroplasty
#10
Yong Huang, Yixin Zhou, Hongyi Shao, Jianming Gu, Hao Tang, Qiheng Tang
BACKGROUND: Both modular and nonmodular tapered fluted titanium stems are used in revision total hip arthroplasty (THA), with follow-up showing good results for both stems. We aimed to determine whether there were any differences in clinical outcomes, survivorship, or frequency of complications. METHODS: A retrospective review of 160 consecutive THAs (153 patients) revised with a tapered fluted modular titanium stem from 2002 to 2014 and 129 consecutive THAs (128 patients) revised with a tapered fluted nonmodular titanium stem between 2008 and 2014 was conducted...
May 18, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28598491/modularity-in-total-hip-arthroplasty-benefits-risks-mechanisms-diagnosis-and-management
#11
Ben M Vierra, Sarah R Blumenthal, Derek F Amanatullah
Modular implants are currently widely used in total hip arthroplasty because they give surgeons versatility during the operation, allow for easier revision surgery, and can be adjusted to better fit the anatomy of the specific patient. However, modular implants, specifically those that have metal-on-metal junctions, are susceptible to crevice and fretting corrosion. This can ultimately cause implant failure, inflammation, and adverse local tissue reaction, among other possible side effects. Surgeons should be aware of the possibility of implant corrosion and should follow a set of recommended guidelines to systematically diagnose and treat patients with corroded implants...
June 9, 2017: Orthopedics
https://www.readbyqxmd.com/read/28566395/the-use-of-femoral-stems-with-exchangeable-necks-in-primary-total-hip-arthroplasty-increases-the-rate-of-revision
#12
S E Graves, R de Steiger, D Davidson, W Donnelly, S Rainbird, M F Lorimer, K S Cashman, R J Vial
AIMS: Femoral stems with exchangeable (modular) necks were introduced to offer surgeons an increased choice when determining the version, offset and length of the femoral neck during total hip arthroplasty (THA). It was hoped that this would improve outcomes and reduce complications, particularly dislocation. In 2010, the Australian Orthopaedic Association National Joint Replacement Registry (AOANJRR) first reported an increased rate of revision after primary THA using femoral stems with an exchangeable neck...
June 2017: Bone & Joint Journal
https://www.readbyqxmd.com/read/28552447/same-same-but-different-12-14-stem-and-head-tapers-in-total-hip-arthroplasty
#13
Ulrike Mueller, Steffen Braun, Stefan Schroeder, Robert Sonntag, J Philippe Kretzer
BACKGROUND: Taper corrosion has been identified to be a major concern in total hip arthroplasty during the past years. So far, the mechanisms that lead to taper corrosion in modular taper junctions are not fully understood. However, it has been shown that corrosion is also influenced by the geometry and topography of the taper, and these parameters vary among the implant manufacturers. The purpose of this study was to investigate the variations of common stem and head tapers regarding design and surface characteristics...
April 27, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28509828/modular-fluted-tapered-stems-in-aseptic-revision-total-hip-arthroplasty
#14
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
#15
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
#16
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
#17
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
#18
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
#19
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
#20
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
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