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Hip revision

Michael Ryan, Thomas Youm, Jonathan Vigdorchik
Hip arthroscopy as we know it today developed over the last 15 to 20 years, yet its true beginning is far more dated. Initially developed as a means of removing loose bodies or as a means of lavage, hip arthroscopy was not utilized to treat femoroacetabular impingement (FAI) until much later. Its usefulness as a means of treating FAI did not arise until hip impingement was understood to be causal in the development of degenerative changes of the labrum and articular surfaces. As our understanding of FAI grew, the tools for treating it developed in tandem...
March 2018: Bulletin of the Hospital for Joint Diseases
Zhi-Sen Gao, Yong-Gang Zhou, Yin-Qiao Du, Shang Piao, Jing-Yang Sun, Ya-Wen Peng, Wen-Ming Wu
OBJECTIVE: To investigate the risk factors for the failure in treating periprosthetic infection of coagulase-negative staphylococci by two-stage revision. METHODS: From January 2005 to June 2015, 57 patients with periprosthetic hip and knee joint infection of coagulase-negative staphylococcus by two-stage revision were retrospectively reviewed with an average age of (61.3±11.9) years old. According to the drug resistance of methicillin, the patients were divided into methicillin sensitive group(MSCoN) and methicillin resistance(MRCoN) group, 25 cases in MSCoN group(9 knees and 16 hips) included 12 males and 13 females, 32 cases in MRCoN group(11 knees and 21 hips) included 14 males and 18 females...
February 25, 2018: Zhongguo Gu Shang, China Journal of Orthopaedics and Traumatology
Jing-Yang Sun, Yong-Gang Zhou, Yin-Qiao Du, Shang Piao, Sen Wang, Zhi-Sen Gao, Wen-Ming Wu, Hai-Yang Ma
OBJECTIVE: To observe the clinical effect of ceramic on ceramic total hip arthroplasty(THA)in Crowe IV developmental dysplasia of the hip(DDH). METHODS: From April 2008 to December 2015, 137 hips of 111 Crowe IV DDH patients received THA using Forte or Delta ceramic on ceramic by one senior surgeon, which consists of 85 unilateral hips and 26 bilateral hips. The average age of the patients was(38.88±10.83) years old ranging from 18 to 68 years old. The mean follow-up was(41...
February 25, 2018: Zhongguo Gu Shang, China Journal of Orthopaedics and Traumatology
Karsten D Ottink, Marjan Wouthuyzen-Bakker, Greetje A Kampinga, Paul C Jutte, Joris J Ploegmakers
BACKGROUND: Diagnosing a chronic prosthetic joint infection (PJI) can be challenging. We hypothesized that obtaining preoperative tissue samples for culture in hip arthroplasty will increase the likelihood of diagnosing an infection before revision surgery. The aim of this cohort study was to determine the diagnostic accuracy of 2 tissue acquiring biopsy strategies to diagnose a PJI. METHODS: Patients with a painful hip arthroplasty, in which a chronic PJI was suspected, were included...
February 5, 2018: Journal of Arthroplasty
Adolph V Lombardi, Antonio G Manocchio, Keith R Berend, Michael J Morris, Joanne B Adams
INTRODUCTION: Short stem femoral components in primary total hip arthroplasty (THA) have increased in popularity since the advent of minimally invasive surgical techniques. The concept of a short stem is particularly compatible with tapered designs where the goal is to offload forces proximally in the femur. The purpose of this retrospective review was to review our early experience with a short, tapered titanium femoral component with updated design features. MATERIALS AND METHODS: Beginning in November 2011 through February 2012, 92 consented patients (93 hips), at a single center, were treated with primary cementless THA using a short stem, tapered femoral component (Taperloc® Complete Microplasty; Zimmer Biomet, Warsaw, Indiana) and were available for review with a minimum two-year follow-up...
March 12, 2018: Surgical Technology International
Kevin L Garvin, Ryan E Miller, Todd M Gilbert, Anthony M White, Elizabeth R Lyden
BACKGROUND: Two-stage reimplantation has consistently yielded high rates of success for patients with chronic prosthetic joint infection, although results more than 5 years after reimplantation are not commonly reported. Numerous factors may contribute to the risk of reinfection, although these factors-as well as the at-risk period after reimplantation-are not well characterized. QUESTIONS/PURPOSES: (1) What is the risk of reinfection after reimplantation for prosthetic joint infection at a minimum of 5 years? (2) Is the bacteriology of the index infection associated with late reinfection? (3) Is the presence of bacteria at the time of reimplantation associated with late reinfection? METHODS: Between 1995 and 2010, we performed 97 two-stage revisions in 93 patients for prosthetic joint infection of the hip or knee, and all are included in this retrospective study...
February 2018: Clinical Orthopaedics and related Research
Paul F Lachiewicz, Jane Anne O'Dell
BACKGROUND: The best method for acetabular revisions in patients with severe bone loss remains controversial; typical approaches include jumbo cups, cages, cup-cages, and custom components. Tantalum (TM) components have good results at midterm followup, but the longer term survival and complications are not available. We previously reported on a series of such reconstructions; here we provide additional followup on that group along with a larger study cohort. QUESTIONS/PURPOSES: (1) What is the survival at a minimum followup of 5 years of these components implanted in difficult revisions and what is the mechanism of failure? (2) What is the most common complication of these reconstructions, and what hip scores did these patients achieve? METHODS: Between 2001 and 2010, one surgeon performed 150 acetabular revisions, of which 74 (49%) were done using TM components...
February 2018: Clinical Orthopaedics and related Research
William S Murphy, Ho Hyun Yun, Brett Hayden, Jens H Kowal, Stephen B Murphy
BACKGROUND: Cup malposition is a common cause of impingement, limitation of ROM, acceleration of bearing wear, liner fracture, and instability in THA. Previous studies of the safe zone based on plain radiographs have limitations inherent to measuring angles from two-dimensional projections. The current study uses CT to measure component position in stable and unstable hips to assess the presence of a safe zone for cup position in THA. QUESTIONS/PURPOSES: (1) Does acetabular component orientation, when measured on CT, differ in stable components and those revised for recurrent instability? (2) Do CT data support historic safe zone definitions for component orientation in THA? METHODS: We identified 34 hips that had undergone revision of the acetabulum for recurrent instability that also had a CT scan of the pelvis between August 2003 and February 2017...
February 2018: Clinical Orthopaedics and related Research
James A Keeney
No abstract text is available yet for this article.
February 2018: Clinical Orthopaedics and related Research
Anton Khlopas, Morad Chughtai, Randa K Elmallah, David Hip-Flores, Arthur L Malkani, Steven F Harwin, Michael A Mont, Michael D Ries
BACKGROUND: Bone loss in patients undergoing revision THA poses a considerable challenge for orthopaedic surgeons. Often, to achieve better fixation in remaining bone, larger diameter acetabular components and reaming superiorly may be necessary. However, this is likely to raise the hip center of rotation, which may lead to altered biomechanics, specifically, insufficiency of the abductor muscles, altered gait, and increased risk of dislocation from impingement. More recently, a newer acetabular shell has been designed to more closely replicate the native hip center of rotation in these circumstances while maintaining adequate fixation...
February 2018: Clinical Orthopaedics and related Research
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
Robert H Hopper, Henry Ho, Supatra Sritulanondha, Ann C Williams, Charles A Engh
BACKGROUND: Crosslinked polyethylene (XLPE) liners used for primary THA have demonstrated lower wear rates than noncrosslinked, conventional polyethylene (CPE) liners through the first decade of clinical service. However, little high-quality evidence is currently available regarding the second decade performance of these implants and it remains uncertain whether the onset of osteolysis has simply been delayed or if the wear associated with XLPE liners will remain low enough that osteolysis will not occur...
February 2018: Clinical Orthopaedics and related Research
Sang-Hyun Park, Zhen Lu, Robert S Hastings, Patricia A Campbell, Edward Ebramzadeh
BACKGROUND: In 2010, a widely used metal-on-metal hip implant design was voluntarily recalled by the manufacturer because of higher than anticipated failure rates at 5 years. Although there was a large published range of revision rates, numerous studies had reported a higher risk of revision for excessive wear and associated adverse tissue reactions when compared with other metal-on-metal total hips. The reasons for this were suggested by some to be related to cup design features. QUESTIONS/PURPOSES: From retrievals of ASR metal-on-metal implants and tissue samples obtained at revision surgery, we asked the following questions: (1) What were the common and uncommon surface features? (2) What were the common and uncommon linear and volumetric wear characteristics? (3) Were there common taper corrosion characteristics? (4) What aseptic lymphocytic vasculitis-associated lesion (ALVAL) features were present in the tissues? METHODS: Five hundred fifty-five ASRs, including 23 resurfacings, were studied at one academic research center...
February 2018: Clinical Orthopaedics and related Research
Kodali Siva R K Prasad
No abstract text is available yet for this article.
February 2018: Clinical Orthopaedics and related Research
Gulraj S Matharu, Andrew Judge, David W Murray, Hemant G Pandit
BACKGROUND: Metal-on-metal hip replacement (MoMHR) revision surgery for adverse reactions to metal debris (ARMD) has been associated with an increased risk of early complications and reoperation and inferior patient-reported outcome scores compared with non-ARMD revisions. As a result, early revision specifically for ARMD with adoption of a lower surgical threshold has been widely recommended with the goal of improving the subsequent prognosis after ARMD revisions. However, no large cohorts have compared the risk of complications and reoperation after MoMHR revision surgery for ARMD (an unanticipated revision indication) with those after non-ARMD revisions (which represent conventional modes of arthroplasty revision)...
February 2018: Clinical Orthopaedics and related Research
Brett K J Kilb, Andrew P Kurmis, Michael Parry, Karen Sherwood, Paul Keown, Bassam A Masri, Clive P Duncan, Donald S Garbuz
BACKGROUND: Once touted as the future of hip arthroplasty, metal-on-metal (MoM) bearing surfaces have fallen sharply from favor with the emergence of a strong body of evidence demonstrating unacceptably high premature implant failure rates. The previously unpredictable development of adverse local tissue reactions (ALTRs) has been a substantive contributor to this. Although the underlying pathophysiology of these so-called "pseudotumors" is now well understood, the fundamental predisposing patient risk factors have remained elusive...
February 2018: Clinical Orthopaedics and related Research
John D Gilbert, Roger W Byard
Sotos syndrome is a rare congenital syndrome caused by deletions or mutations in the NSD1 gene (chromosome 5q35) which results in overgrowth. A wide range of manifestations may result in unexpected and/or early death, including congenital cardiac malformations and tumours, epilepsy, intra-tumoural haemorrhage or embolism and bleeding diatheses. A case of lethal pulmonary fat embolism complicating revision of a left total hip replacement following spontaneous fracture is reported in a 39-year-old man with Sotos syndrome...
January 1, 2018: Medicine, Science, and the Law
Murat Oto, İlker Abdullah Sarıkaya, Ozan Ali Erdal, Ali Şeker
OBJECTIVES: This study aims to review the efficacy of femoral varus derotation osteotomy (VDRO) and Dega transiliac osteotomy in the treatment of hip subluxation and dislocation of cerebral palsy (CP) patients. PATIENTS AND METHODS: This retrospective study included 25 hips of 22 CP patients (9 males, 13 females; mean age 8.7 years; range 4 to 18 years) who were operated due to hip subluxation and dislocation between July 2010 and December 2015. The mean follow-up period was 36...
April 2018: Eklem Hastalıkları Ve Cerrahisi, Joint Diseases & related Surgery
Stephen A Jones
BACKGROUND: Dislocation remains one of the most common complications after total hip arthroplasty. Constrained acetabular liners were developed to address the problem of recurrent instability. They have been in clinical use since the mid 1980s and function by capturing the femoral head. METHOD: The aim of this review is to highlight the mechanism of action, development, and advances in constrained liner design, together with an emphasis on the modes of failure and the authors' opinion on the current indications for the use of these implants...
March 7, 2018: Journal of Arthroplasty
Victoire Bouveau, Thomas-Xavier Haen, Joel Poupon, Christophe Nich
BACKGROUND: Function after revision total hip arthroplasty (THA) in failed metal-on-metal (MoM) hip resurfacing arthroplasty (HRA) is variable, but post-operative complication rates are reportedly high. We hypothesized HRA conversion to THA using the direct anterior approach (DAA) would be associated with optimal outcome. METHODS: Seventeen MoM-HRAs in 15 patients (seven males, eight females) were revised through the DAA. The mean age was 45 years (28-59 yrs)...
March 8, 2018: International Orthopaedics
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