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Cup loosening

L Busanelli, F Castagnini, B Bordini, S Stea, P P Calderoni, A Toni
BACKGROUND: Reconstructions in case of acetabular bone loss in hip revision arthroplasty are challenging. A few techniques have been proposed, with inconstant outcomes. Biological reconstructions using bone allografts may address the acetabular bone loss and restore the hip anatomy. Aim of this work was the description of the surgical technique and the evaluation of the outcomes using a regional arthroplasty register. MATERIALS AND METHODS: Minor or massive bone allografting was performed in hip revision arthroplasties in a tertiary center...
October 16, 2018: Musculoskeletal Surgery
George Grammatopoulos, Wade Gofton, Zaid Jibri, Matthew Coyle, Johanna Dobransky, Cheryl Kreviazuk, Paul R Kim, Paul E Beaulé
BACKGROUND: Many patients undergo both THA and spinal arthrodesis, and those patients may not fare as well as those who undergo one procedure but not the other. The mechanisms of how spinal arthrodesis affects patient function after THA remain unclear. QUESTIONS/PURPOSES: The aims of our study were to (1) determine how patient-reported outcome measures (PROMs), including the Oxford hip score as well as dislocations and complications compare after THA between patients with and without spinal arthrodesis; (2) characterize sagittal pelvic changes in these patients that occur when moving between different functional positions and test for differences between patients with and without spinal arthrodesis; and (3) assess whether differences in sagittal pelvic dynamics are associated with PROMs, complications, and dislocations after THA...
May 30, 2018: Clinical Orthopaedics and related Research
Laura Marie-Hardy, Padhraig O'Laughlin, Michel Bonnin, Tarik Ait Si Selmi
INTRODUCTION: Dual mobility cups have become the implant of choice for older patients with a high risk of dislocation. However, to our knowledge, no study has explored the possibility of metal ion production with these implants that incorporate a polyethylene-on-metal bearing. This led us to conduct a prospective study to determine whether use of a dual mobility cup is accompanied by increased levels of nickel and chromium in the blood. HYPOTHESIS: Use of a dual mobility cup is accompanied by an increase of nickel and chromium levels in the blood...
October 5, 2018: Orthopaedics & Traumatology, Surgery & Research: OTSR
I Závodský, R Pavličný, M Holinka
PURPOSE OF THE STUDY Trapeziometacarpal osteoarthritis affects primarily postmenopausal middle-aged and older women. Total joint replacement is one of the surgical treatment options for symptomatic advanced degenerative changes of the carpometacarpal joint. This study aims to evaluate the short-term functional and radiological results of the Ivory ® prosthesis with the minimum followup period of three years after the surgery. MATERIAL AND METHODS Presented are the results of 48 total trapeziometacarpal joint replacements in the group of 40 patients composed of 36 women and 4 men...
2018: Acta Chirurgiae Orthopaedicae et Traumatologiae Cechoslovaca
Viktor Lindgren, Vincent P Galea, Audrey Nebergall, Meridith E Greene, Ola Rolfson, Henrik Malchau
BACKGROUND: New materials in cementless total hip arthroplasty are continuously introduced into clinical practice. The objective of this study was to compare the radiographic and clinical performances of acetabular shells made with porous titanium coating (PTC) and plasma-sprayed titanium (PS). METHODS: Data from a prospective multicenter study monitoring PTC and PS shells were analyzed. Three hundred and eighty patients (191 with PTC and 189 with PS) with postoperative (within 10 months after the operation) and 5-year radiographs were available for assessment of radiographic outcomes and patient-reported outcome measures (PROMs)...
October 3, 2018: Journal of Bone and Joint Surgery. American Volume
Georg Bergmann, Alwina Bender, Jörn Dymke, Georg N Duda, Philipp Damm
BACKGROUND: High friction moments in hip implants contribute to the aseptic loosening of cementless cups, of which there are approximately 100,000 cases per year; sustained joint loading may cause such high moments. The most "critical" physical activities associated with sustained joint loading were identified in this study. METHODS: Friction moments in the cup were telemetrically measured about 33,000 times in the endoprostheses of 9 subjects during >1,400 different activities...
October 3, 2018: Journal of Bone and Joint Surgery. American Volume
Yoshitoshi Higuchi, Taisuke Seki, Yasuhiko Takegami, Daigo Komatsu, Daigo Morita, Naoki Ishiguro
BACKGROUND: To avoid wear-induced osteolysis, ceramic-on-ceramic (CoC) and metal-on-metal (MoM) bearings have been developed. At present, there are no direct material related clinical comparisons between cementless total hip arthroplasty with CoC and MoM at more than 5-year follow-up. The bearing that is more likely to prevent osteolysis is still controversial. Therefore, we performed a retrospective case control study evaluating CoC and MoM cementless THAs in order to: - compare the longevity and complications for CoC and MoM THAs at 5-10 years postoperatively; - compare the incidence of osteolysis between both type THAs; - evaluate pseudotumors in MoM THAs...
September 27, 2018: Orthopaedics & Traumatology, Surgery & Research: OTSR
V Kubinec
PURPOSE OF THE STUDY Aseptic loosening of endoprosthetic components is the most frequent reason for total hip arthroplasty revision. This paper aimed to verify the influence of the type of hip-component fixation of total hip replacement in correlation with the age of patients on aseptic loosening of components during mid-term survival. MATERIAL AND METHODS The retrospective, monocentric study statistically evaluated the data of 67 cases of implanted total hip replacements in 66 patients with the loosening of at least one of the components requiring a revision of the total number of 1,488 primary total hip replacements implanted during the 1995 to 2006 period at a single department...
2018: Acta Chirurgiae Orthopaedicae et Traumatologiae Cechoslovaca
Anne Jacobsen, Frank Seehaus, Yutong Hong, Han Cao, Alexander Schuh, Raimund Forst, Stefan Sesselmann
BACKGROUND: Non-cemented acetabular cup components demonstrated different clinical performance depending on their surface texture or bearing couple. However, clinical osseointegration needs to be proved for each total joint arthroplasty (TJA) design. Aim of this study was to detect the in vivo migration pattern of a non-cemented cup design, using model-based roentgen stereophotogrammetric analysis with elementary geometrical shape models (EGS-RSA) to calculate early cup migration. METHODS: Interchangeable applicability of the model-based EGS-RSA method next to gold standard marker-based RSA method was assessed by clinical radiographs...
September 18, 2018: BMC Musculoskeletal Disorders
Danny Vogel, Christian Schulze, Henry Dempwolf, Daniel Kluess, Rainer Bader
After total hip arthroplasty, stress-shielding is a potential risk factor for aseptic loosening of acetabular cups made of metals. This might be avoided by the use of acetabular cups made of implant materials with lower stiffness. The purpose of this numerical study was to determine whether a modular acetabular cup with a shell made of poly-ether-ether-ketone or poly-ether-ether-ketone reinforced with carbon fibers might be an alternative to conventional metallic shells. Therefore, the press-fit implantation of modular cups with shells made of different materials (Ti6Al4V, poly-ether-ether-ketone, and poly-ether-ether-ketone reinforced with carbon fibers) and varying liner materials (ceramics and ultra-high-molecular-weight polyethylene) into an artificial bone cavity was simulated using finite element analysis...
October 2018: Proceedings of the Institution of Mechanical Engineers. Part H, Journal of Engineering in Medicine
Francesco Castagnini, Barbara Bordini, Susanna Stea, Pierina Paola Calderoni, Claudio Masetti, Luca Busanelli
PURPOSE: Highly porous cups were developed to improve osseointegration and reduce the rate of aseptic loosening. Highly porous titanium cups could mix the reliability of titanium metal with an enhanced porosity, improving the bony ingrowth. The aim of this report was to assess the survival rates and reasons for revision of a highly porous titanium cup, Fixa Ti-Por (Adler Ortho, Milan, Italy), fabricated using an additive manufacturing. METHODS: The Registry of Prosthetic Orthopedic Implants (RIPO), the Emilia-Romagna region arthroplasty registry, was enquired about cementless cups, implanted since July 2007...
August 23, 2018: International Orthopaedics
Henri Migaud, Harold Common, Julien Girard, Denis Huten, Sophie Putman
Bone defects during acetabular revision of total hip arthroplasty raise a problem of primary fixation and of durable reconstruction. Bone graft with direct cemented fixation or in a reinforcement cage was long considered to be the gold standard; however, failures were reported after 10 years' follow-up, especially in segmental defect of the roof or pelvic discontinuity. In such cases, metallic materials were proposed, to ensure primary fixation by a roughness effect with added screws, and especially to avoid failure due to bone resorption in the medium term...
August 20, 2018: Orthopaedics & Traumatology, Surgery & Research: OTSR
Dietmar Dammerer, David Putzer, Bernhard Glodny, Johannes Petersen, Ferdi Arrich, Martin Krismer, Rainer Biedermann
PURPOSE: Occult intra-operative periprosthetic acetabular fracture is a seldom-reported complication of primary total hip arthroplasty (THA). It may potentially be associated with cup instability and implant loosening. The present study aimed to investigate clinical consequences of this complication. METHODS: Between 2003 and 2012, a total of 3390 cementless total hip arthroplasties (THA) were performed at our institution. Their medical histories were retrospectively reviewed to identify all patients who received a thin-layer computer tomography (CT) scan of the pelvis including the acetabulum within the first 30 post-operative days...
August 10, 2018: International Orthopaedics
Kyung-Soon Park, Chee-Ken Chan, Dong-Hyun Lee, Taek-Rim Yoon
Background: Conversion from failed bipolar hemiarthroplasty (HA) to total hip arthroplasty (THA) presents a great challenge to orthopedic surgeons for bipolar head removal and cup placement with or without change of femoral stem. Conversion THA after failed bipolar arthroplasty is known to offer both symptomatic and functional improvement. This study evaluates the midterm functional outcome and complications, especially dislocation associated with femoral head diameter, after conversion THA...
July 2018: Indian Journal of Orthopaedics
Shinji Yoshioka, Shunji Nakano, Yutaka Kinoshita, Masaru Nakamura, Tomohiro Goto, Daisuke Hamada, Koichi Sairyo
BACKGROUND: The use of 3-dimensional highly porous acetabular cups is increasing. Their structure and mechanical properties mimic those of natural bone; therefore, they should promote stronger biological fixation. In our experience with total hip arthroplasty, radiolucent lines are observed when a 3-dimensional highly porous cup (Stryker Tritanium) is used. We compared the clinical and radiographic results between a Tritanium cup and a conventional cup (Stryker Trident HA) over a short time period...
July 25, 2018: Journal of Orthopaedic Science: Official Journal of the Japanese Orthopaedic Association
Christopher G Lenz, Patrick O Zingg, Claudio Dora
BACKGROUND: During total hip replacement (THR), subchondral acetabular bone cysts are either left alone or treated by filling with autologous bone graft. We hypothesized that subchondral cysts would consolidate spontaneously over time without compromising the midterm survival of the implant. METHODS: We retrospectively screened the anteroposterior hip radiographs of 731 consecutive patients who underwent primary THR between January 2006 and April 2009. Patients were included in the current study if they had acetabular subchondral bone cysts visible radiographically that had been left alone during THR...
July 26, 2018: Hip International: the Journal of Clinical and Experimental Research on Hip Pathology and Therapy
Jakub Zeman, Matúš Ranuša, Martin Vrbka, Jiří Gallo, Ivan Křupka, Martin Hartl
Ultra-high molecular polyethylene (UHMWPE) is one of the most used materials of the acetabular liners in total tip arthroplasty (THA). Polyethylene has good tribological properties and biocompatibility. However, the lifetime of polyethylene implants is limited by wear related complications. Polyethylene material released into the periprosthetic environment induces osteolysis that can be followed by implant loosening. Wear of cup is influenced mainly by orientation of the cup in pelvis, by initial geometry before the material degradation and by tribological parameters...
November 2018: Journal of the Mechanical Behavior of Biomedical Materials
N Shahemi, S Liza, A A Abbas, A M Merican
A revision of a metal-on-ultra high molecular weight (UHMWPE) bearing couple for total hip replacement was performed due to aseptic loosening after 23 years in-vivo. It is a major long-term failure identified from wear generation. This study includes performing failure analysis of retrieved polyethylene acetabular cup from Zimmer Trilogy® Acetabular system. The UHMWPE acetabular cup was retrieved from a 61 years old male patient with ability to walk but limited leg movement when he presented to hospital in early 2016 with complaint left thigh pain...
November 2018: Journal of the Mechanical Behavior of Biomedical Materials
Roman Cebrian-Gomez, Alejandro Lizaur-Utrilla, Emilio Sebastia-Forcada, Fernando A Lopez-Prats
We compared 84 patients with the Ivory trapeziometacarpal prosthesis versus 62 with ligament reconstruction and tendon interposition arthroplasty performed for osteoarthritis. There were 134 women and 12 men with a mean age of 60 years. Prospective clinical assessment was made using the Quick Disability of the Arm, Shoulder and Hand (DASH) questionnaire, visual analogue scale for pain, range of motion, and grip and pinch strength. The mean follow-up was 4 years (range 2-5). Prosthetic replacement provided significantly better thumb abduction, adduction, pinch strength, QuickDASH, pain relief, satisfaction and a faster return to daily activities and previous work...
January 1, 2018: Journal of Hand Surgery, European Volume
Tatsuya Tamaki, Taishi Ninomiya, Kurato Jonishi, Yoko Miura, Kazuhiro Oinuma, Hideaki Shiratsuchi
BACKGROUND: The direct anterior approach has gained popularity in total hip arthroplasty (THA) over the past decade. However, there are few reports that describe the use of this approach for cases of complex revision. The purpose of this study was to report the surgical procedure and early clinical results of acetabular revision in the presence of bone defects using a Kerboull-type reinforcement device through the direct anterior approach. METHODS: Eleven patients who had undergone acetabular reconstruction using a Kerboull-type reinforcement device for aseptic or septic loosening bone defects were enrolled...
May 2018: Journal of Orthopaedic Surgery
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