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Stem selection in THA

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https://www.readbyqxmd.com/read/29896456/treatment-of-periprosthetic-femoral-fractures-following-hip-arthroplasty
#1
Joong-Myung Lee, Tae-Sup Kim, Tae-Ho Kim
Purpose: This study was performed to assess potential improvements in clinical outcomes when applying recent advanced hip arthroplasty surgical techniques and understand the potential relationship between bone mineral density (BMD) and surgical outcomes. Materials and Methods: Among 37 cases of periprosthetic femoral fractures after hip arthroplasty treated between March 2014 and September 2016, all included a follow-up of at least one year and were included in this study...
June 2018: Hip & Pelvis
https://www.readbyqxmd.com/read/29858615/periprosthetic-bone-mineral-density-around-uncemented-titanium-stems-in-the-second-and-third-decade-after-total-hip-arthroplasty-a-dxa-study-after-12-17-and-21-years
#2
David S Peitgen, Moritz M Innmann, Christian Merle, Tobias Gotterbarm, Babak Moradi, Marcus R Streit
Implant failure and periprosthetic fractures because of periprosthetic bone loss are a major concern in total hip arthroplasty (THA). Hardly any clinical data exist on the long-term evolution of bone mineral density (BMD) around uncemented femoral implants. The question to address is whether relevant bone loss continues into third decade around well-fixed uncemented femoral implants. BMD around stable uncemented straight titanium femoral implants was assessed in a longitudinal cohort study. We included 142 hips of 128 patients and measured the development of the periprosthetic BMD using dual-energy X-ray absorptiometry...
June 1, 2018: Calcified Tissue International
https://www.readbyqxmd.com/read/29808731/discrepancy-and-contradiction-regarding-fixation-of-hip-stems-with-or-without-cement-survey-among-765-hip-arthroplasty-specialists
#3
Tim A E J Boymans, Ide C Heyligers, Bernd Grimm
INTRODUCTION: The growing use of cementless stems is associated with an increase in implant-related complications. This global survey study investigates which parameters orthopaedic surgeons currently consider for either cemented or cementless stem fixation in primary total hip arthroplasty (THA). METHODS: A survey regarding current practice patterns was distributed among hip arthroplasty specialists. Key questions concerned: (i) frequency of using cemented/cementless stems; (ii) frequency of using parameters which influence a choice between both; (iii) usage of specific cut-off values for parameters...
May 1, 2018: Hip International: the Journal of Clinical and Experimental Research on Hip Pathology and Therapy
https://www.readbyqxmd.com/read/29736726/high-incidence-of-intraoperative-calcar-fractures-with-the-cementless-cls-spotorno-stem
#4
Carla Timmer, Davey M J M Gerhardt, Enrico de Visser, Marinus de Kleuver, Job L C van Susante
INTRODUCTION: This study reports on the incidence of intraoperative calcar fractures with the cementless Spotorno (CLS) stem, and the potential role of a learning curve and implant positioning is investigated. METHODS: After introduction of the CLS stem, 800 consecutive cementless total hip arthroplasties (THA) were analyzed. The incidence of calcar fracture in the first 400 THA was compared with the second 400 THA, in order to study a potential learning curve effect...
May 7, 2018: European Journal of Orthopaedic Surgery & Traumatology: Orthopédie Traumatologie
https://www.readbyqxmd.com/read/29683803/is-cemented-or-cementless-femoral-stem-fixation-more-durable-in-patients-older-than-75-years-of-age-a-comparison-of-the-best-performing-stems
#5
Michael Tanzer, Stephen E Graves, Andrea Peng, Andrew J Shimmin
BACKGROUND: There is ongoing debate concerning the best method of femoral fixation in older patients receiving primary THA. Clinical studies have shown high survivorship for cemented and cementless femoral stems. Arthroplasty registry studies, however, have universally shown that cementless stems are associated with a higher rate of revision in this patient population. It is unclear if the difference in revision rate is a reflection of the range of implants being used for these procedures rather than the mode of fixation...
July 2018: Clinical Orthopaedics and related Research
https://www.readbyqxmd.com/read/29564292/short-term-outcomes-of-ceramic-coated-metal-on-metal-large-head-in-total-hip-replacement-arthroplasty
#6
Weon-Yoo Kim, Myung-Sup Ko, Se-Won Lee, Kwang-Sub Kim
Purpose: This study characterizes the short-term outcomes of ceramic coated metal-on-metal (MoM) large head total hip arthroplasty (THA) in prospectively selected patients aged 70 to 75 years. Materials and Methods: Eighteen patients (18 hips) between the ages of 70 and 75-years old with THA using ceramic-coated MoM large heads between June 2014 and December 2014 were evaluated. We prospectively selected patients younger than 70 years for bipolar hemiarthroplasty and older than 75 years for conventional THA...
March 2018: Hip & Pelvis
https://www.readbyqxmd.com/read/29481346/do-stem-design-and-surgical-approach-influence-early-aseptic-loosening-in-cementless-tha
#7
Loes Janssen, Karolina A P Wijnands, Dennis Janssen, Michiel W H E Janssen, Jan W Morrenhof
BACKGROUND: Some studies have revealed an increased risk of early aseptic loosening of cementless stems in THA when inserted through an anterior or anterolateral approach compared with a posterior approach, whereas approach does not appear to be a risk factor in others. Stem design, whether "anatomic" (that is, stems with a curved lateral profile or an obtuse angle at the proximal-lateral portion of the stem) or "shoulder" (that is, straight with a proximal shoulder), may also be associated with a differential risk of aseptic loosening in cementless THA depending on the surgical approach used, but if so, this risk is not well characterized...
June 2018: Clinical Orthopaedics and related Research
https://www.readbyqxmd.com/read/29480891/high-revision-rate-for-large-head-metal-on-metal-tha-at-a-mean-of-7-1-years-a-registry-study
#8
Matti Seppänen, Inari Laaksonen, Pekka Pulkkinen, Antti Eskelinen, Ari-Pekka Puhto, Jukka Kettunen, Jarkko Leskinen, Mikko Manninen, Keijo Mäkelä
BACKGROUND: Large-diameter head metal-on-metal (MoM) THA has largely been abandoned as a result of higher than anticipated revision rates. However, the majority of these implants are still in situ. Although earlier reports from the Finnish Arthroplasty Register noted similar short-term survivorship between large-diameter head MoM THA and conventional cemented THA, longer term survivorship of this population is unclear. Although reported revision rates for this implant group have been high, the majority of these implants have not been revised and followup is important to improve long-term management...
June 2018: Clinical Orthopaedics and related Research
https://www.readbyqxmd.com/read/28927561/interobserver-and-intraobserver-reliability-of-three-dimensional-preoperative-planning-software-in-total-hip-arthroplasty
#9
Yasushi Wako, Junichi Nakamura, Michiaki Miura, Yuya Kawarai, Masahiko Sugano, Kento Nawata
BACKGROUND: The purpose of this study is to clarify interobserver and intraobserver reliabilities of the three-dimensional (3D) templating of total hip arthroplasty (THA). METHODS: We selected preoperative computed tomography from 60 hips in 46 patients (14 men and 32 women) who underwent primary THA. To evaluate interobserver and intraobserver reliability, 6 orthopedic surgeons performed 3D templating twice over a 4-week interval. We investigated intraclass correlation coefficients (ICCs) and percent agreement of component size and alignment, comparing morphological differences in the hip...
February 2018: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28784121/bone-preserving-level-of-osteotomy-in-short-stem-total-hip-arthroplasty-does-not-influence-stress-shielding-dimensions-a-comparing-finite-elements-analysis
#10
COMPARATIVE STUDY
Rene Burchard, Sabrina Braas, Christian Soost, Jan Adriaan Graw, Jan Schmitt
BACKGROUND: The main objective of every new development in total hip arthroplasty (THA) is the longest possible survival of the implant. Periprosthetic stress shielding is a scientifically proven phenomenon which leads to inadvertent bone loss. So far, many studies have analysed whether implanting different hip stem prostheses result in significant preservation of bone stock. The aim of this preclinical study was to investigate design-depended differences of the stress shielding effect after implantation of a selection of short-stem THA-prostheses that are currently available...
August 7, 2017: BMC Musculoskeletal Disorders
https://www.readbyqxmd.com/read/28583059/mid-term-results-of-the-sl-plus-femoral-prosthesis-the-influence-of-femoral-bone-type
#11
Iori Takigami, Yoshiki Ito, Kazu Matsumoto, Nobuo Terabayashi, Takaki Miyagawa, Haruhiko Akiyama
BACKGROUND: Cementless fixation of the femoral stem has been shown to be durable and predictable in total hip arthroplasty (THA), primarily as a result ofrecent improvements in prosthesis geometry and porous surface. Although patients with osteoporotic bone have been considered poor candidates for the use of a cementless femoral component, some recent studies have indicated satisfactory results. However, the indications and selection criteria of cementless stems based on the morphology of the femoral canal have not been established...
April 2017: Bulletin of the Hospital for Joint Diseases
https://www.readbyqxmd.com/read/28406232/peptidoglycan-o-acetylation-increases-in-response-to-vancomycin-treatment-in-vancomycin-resistant-enterococcus-faecalis
#12
James D Chang, Erin E Foster, Ashley G Wallace, Sung Joon Kim
Vancomycin resistance is conferred upon vancomycin-resistant enterococci (VRE) through the replacement of peptidoglycan (PG) stem terminal d-Ala-d-Ala with d-Ala-d-Lac. The d-Ala-d-Lac incorporation can affect both the fitness and virulence of VRE. Here we comprehensively investigate the changes to PG composition in vancomycin-resistant Enterococcus faecalis following the growth in presence of vancomycin using liquid chromatography-mass spectrometry. Using high-resolution mass spectrometry, 104 unique muropeptides fragments were identified and the relative abundance of each fragment was accurately quantified by integrating the ion current of a selected ion using extracted-ion chromatogram...
April 13, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28353049/single-stage-acetabular-revision-during-two-stage-tha-revision-for-infection-is-effective-in-selected-patients
#13
Bernd Fink, Michael Schlumberger, Damian Oremek
BACKGROUND: The treatment of periprosthetic infections of hip arthroplasties typically involves use of either a single- or two-stage (with implantation of a temporary spacer) revision surgery. In patients with severe acetabular bone deficiencies, either already present or after component removal, spacers cannot be safely implanted. In such hips where it is impossible to use spacers and yet a two-stage revision of the prosthetic stem is recommended, we have combined a two-stage revision of the stem with a single revision of the cup...
August 2017: Clinical Orthopaedics and related Research
https://www.readbyqxmd.com/read/28337731/arthroplasty-registries-around-the-world-valuable-sources-of-hip-implant-revision-risk-data
#14
REVIEW
Richard E Hughes, Aditi Batra, Brian R Hallstrom
PURPOSE OF REVIEW: National and regional arthroplasty registries have proliferated since the Swedish Knee Arthroplasty Register was started in 1975. Registry reports typically present implant-specific estimates of revision risk and patient- and technique-related factors that can inform clinical decision-making about implants and techniques. However, annual registry reports are long and it is difficult for clinicians to extract comparable revision risk data. Since implants may appear in multiple registry reports, it is even more difficult to gather relevant data for clinical decision-making about implant selection...
June 2017: Current Reviews in Musculoskeletal Medicine
https://www.readbyqxmd.com/read/28224575/radiological-study-of-tha-after-mini-incision-technique
#15
R Hart, V Stipcak, M Janecek, P Visna
Mini-incision procedures reduce perioperative blood loss, postoperative pain, time of the postoperative recovery, length of the surgical scar, and hospitalisation time. Implant malposition and poor stability are potential risks for compromising long-term results. Between September 2000 and February 2002 (18 months), 120 cemented primary total hip arthroplasties for primary osteoarthritis were performed at the authors institutions. In 60 of these cases selected at random, a posterolateral mini-incision up to 10 cm was used...
April 2005: Hip International: the Journal of Clinical and Experimental Research on Hip Pathology and Therapy
https://www.readbyqxmd.com/read/28124357/arthroplasty-in-high-grade-congenital-hip-dislocation-personal-experience-and-review-of-the-literature
#16
F Randelli, P Randelli, O Visentin, M Monteleone, G Brianza, G Randelli
Total hip arthroplasty (THA) in congenital high grade hip dislocation often represents a problematic issue. Reviewing their selected cases and literature data, authors focus on some key points for this demanding surgery. Most important steps are acetabular positioning and surgical approach (exposure and release). We used two different cups, the Zweymuller and the Wagner cup, with good primary stability. A Conus stem (Wagner) or an Alloclassic stem (in less displastic femoral shape) were used. We always performed this surgery as a one step procedure...
April 2002: Hip International: the Journal of Clinical and Experimental Research on Hip Pathology and Therapy
https://www.readbyqxmd.com/read/27783837/comparison-of-complications-following-revision-of-metal-on-metal-versus-metal-on-polyethylene-total-hip-arthroplasty
#17
COMPARATIVE STUDY
Shoji Nishio, Shigeo Fukunishi, Shinichi Yoshiya, David C Sing, Erik N Hansen, Thomas P Vail
The aim of this study was to examine the clinical characteristics of patients who required revision and the rate of early complications after revision for metal-on-metal total hip arthroplasty (MOM THA) and metal-on-polyethylene total hip arthroplasty (MOP THA). Matched cohorts were selected by retrospective review from a single-center database of revision THAs for failed MOM and MOP THAs from 2010 to 2014. A total of 140 hips in 140 patients comprised the study population; 39 revisions were performed for failed MOM THAs (MOM group), and 101 revisions were performed for failed MOP THAs (MOP group)...
January 1, 2017: Orthopedics
https://www.readbyqxmd.com/read/27672012/nonmodular-tapered-fluted-titanium-stems-osseointegrate-reliably-at-short-term-in-revision-thas
#18
Nemandra A Sandiford, Donald S Garbuz, Bassam A Masri, Clive P Duncan
BACKGROUND: The ideal femoral component for revision THA is undecided. Cylindrical nonmodular stems have been associated with stress shielding, whereas junctional fractures have been reported with tapered fluted modular titanium stems. We have used a tapered fluted nonmodular titanium femoral component (Wagner Self-locking [SL] femoral stem) to mitigate this risk. This component has been used extensively in Europe by its designer surgeons, but to our knowledge, it has not been studied in North America...
January 2017: Clinical Orthopaedics and related Research
https://www.readbyqxmd.com/read/27650276/retention-of-the-well-fixed-implant-in-the-single-stage-exchange-for-chronic-infected-total-hip-arthroplasty-an-average-of-five%C3%A2-years-of-follow-up
#19
Baochao Ji, Boyong Xu, Wentao Guo, Aili Rehei, Wenbo Mu, Desheng Yang, Li Cao
PURPOSE: Removal of an infected prosthesis was considered the gold standard for eradication of infection. However, removal of well-fixed components can result in structural bone damage and compromised reconstruction. In these situations we questioned whether the infection after the total hip arthroplasty could be treated effectively and retain the well-fixed implant in a single-stage exchange. METHODS: A retrospective analysis which included 31 patients with chronic infected THA who underwent major partial single-stage revision, including routinely exchanged femoral head and liner components, aggressive soft tissue debridement, removal of the femoral stem or acetabular cup and retention of the well-fixed component, thorough exposed component brushing, and adequate surgical soaking...
May 2017: International Orthopaedics
https://www.readbyqxmd.com/read/27583104/total-hip-arthroplasty-around-the-inception-of-the-interface-bioactive-bone-cement-technique
#20
REVIEW
Hiroyuki Oonishi, Hirotsugu Ohashi, Ikuo Kawahara
BACKGROUND: To augment cement-bone fixation, Dr. Hironobu Oonishi attempted additional physicochemical bonding through interposition of osteoconductive crystal hydroxyapatite (HA) granules at the cement-bone interface in 1982. He first used the interface bioactive bone cement (IBBC) technique in 12 selected patients (12 hips) in 1982 (first stage) and followed them for 2 years. In 1985, the technique was applied in 25 total hip arthroplasty (THA) patients (second stage) and the effects were investigated by comparing the side with the IBBC technique and the other side without the IBBC technique...
September 2016: Clinics in Orthopedic Surgery
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