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Cup loosening

Lokesh Gudda Naik, Won Yong Shon, I C Clarke, Jun-Gyu Moon, Piyush Mukund, Sang-Min Kim
Pseudotumors are not uncommon complications after total hip arthroplasty (THA) and may occur due to differences in bearing surfaces of the head and the liner ranging from soft to hard articulation. The most common causes of pseudotumors are foreign-body reaction, hypersensitivity and wear debris. The spectrum of pseudotumor presentation following THA varies greatly-from completely asymptomatic to clear implant failure. We report a case of pseudo-tumor formation with acetabular cup aseptic loosening after revision ceramic-on-metal hip arthroplasty...
December 2018: Hip & Pelvis
Yingyong Suksathien, Jithayut Sueajui
PURPOSE: To evaluate the clinical and radiographic mid-term results of short-stem total hip arthroplasty (THA) in patients with osteonecrosis of the femoral head (ONFH). METHODS: We reviewed 83 cases that underwent Metha stem between November 2010 and November 2012. The appearance of bone trabeculae development and radiolucent line were reviewed and HHS was recorded at 6 months postoperatively then yearly to evaluate the clinical results. RESULTS: The mean age of patients was 43...
December 11, 2018: Hip International: the Journal of Clinical and Experimental Research on Hip Pathology and Therapy
Steven F Harwin, Nipun Sodhi, Joseph Ehiorobo, Anton Khlopas, Assem A Sultan, Michael Mont
BACKGROUND: Instability can account for over 20% of all revision total hip arthroplasties (THAs). Although a number of surgical techniques have been developed to limit the number of dislocations, prevention still remains a challenge. More recently, dual mobility (DM) cups have been developed to potentially target this problem. Although this implant design has been shown to have a number of potential advantages in the revision setting, there is limited data in the literature on the use of modular dual mobility (MDM) implants for primary THAs...
November 30, 2018: Surgical Technology International
Chahine C Assi, Hanane B Barakat, Jacques G Caton, Elie N Najjar, Camille T Samaha, Kaissar F Yammine
BACKGROUND: The dual mobility cups (DMCs) were shown to reduce dislocation rate following total hip arthroplasty for any etiology, including femoral neck fractures. No reported studies evaluating DMC results for femoral neck fracture in a Middle Eastern population were found in the literature. METHODS: This study aims to look for mortality rate, clinical, and functional outcomes in a population having specific rituals involving extreme hip positions as part of their daily activities...
November 1, 2018: Journal of Arthroplasty
Shaoqi Tian, Karan Goswami, Jorge Manrique, Kier Blevins, Ibrahim Azboy, William J Hozack
BACKGROUND: Our experience with direct anterior approach total hip arthroplasty (THA) suggests that it can be performed successfully with a morphometrically optimized metaphyseal-diaphyseal engaging femoral stem (NOT a short stem), a regular operating room table (NOT a special custom table), and WITHOUT intraoperative fluoroscopy. We report our minimum 2-year results. METHODS: A retrospective review of a single-surgeon series of primary direct anterior approach THAs was performed...
October 26, 2018: Journal of Arthroplasty
P Jordá-Gómez, I Escribá-Urios, J Castro-Gil, J Aracil Silvestre
INTRODUCTION: Acetabular fractures in elderly patients present a therapeutic challenge, since their osteosynthesis may be hindered by comminution and poor bone quality. In certain cases, a good solution is acute total hip arthroplasty (THA) by direct anterior approach with or without minimal associated osteosynthesis. The objective of this study was to establish the indications and evaluate the clinical/functional, radiological results and complications, in the short and medium term, of acute THA using an anterior approach after acetabular fractures...
November 11, 2018: Revista Española de Cirugía Ortopédica y Traumatología
C Hipfl, V Janz, J Löchel, C Perka, G I Wassilew
AIMS: Severe acetabular bone loss and pelvic discontinuity (PD) present particular challenges in revision total hip arthroplasty. To deal with such complex situations, cup-cage reconstruction has emerged as an option for treating this situation. We aimed to examine our success in using this technique for these anatomical problems. PATIENTS AND METHODS: We undertook a retrospective, single-centre series of 35 hips in 34 patients (seven male, 27 female) treated with a cup-cage construct using a trabecular metal shell in conjunction with a titanium cage, for severe acetabular bone loss between 2011 and 2015...
November 2018: Bone & Joint Journal
Steffen Braun, Robert Sonntag, Stefan Schroeder, Ulrike Mueller, Sebastian Jaeger, Jan Philippe Kretzer
INTRODUCTION: Besides head-insert articulation in hip joint replacements, micro-motions between the backside of assembled polyethylene acetabular liners and the metal cup may cause additional wear. Pelvic osteolysis frequently occurs in the region of screw holes, and cup loosening hints to clinically relevant amounts of polyethylene backside wear. It has yet to be confirmed whether backside wear particles differ in size and morphology compared to articulating wear. Previous methods have been limited to subjective assessment of backside surface damages without consideration of wear debris...
November 5, 2018: Acta Biomaterialia
Chih-Hsiang Chang, Chih-Chien Hu, Chun-Chieh Chen, John Mahajan, Yuhan Chang, Hsin-Nung Shih, Young-Min Kwon
There are several surgical options for addressing Paprosky type III acetabular defects during revision total hip arthroplasty. In physiologically young and active patients, using structural bone graft to restore bone defects and provide adequate initial support for the revision acetabular component is one such option. This study reports the mid-term results of using a structural allograft accompanied by a trabecular metal-coated hemispherical cup for Paprosky type III defects. A retrospective analysis was performed of the data collected for 20 consecutive hips in 20 patients (mean age, 56...
November 1, 2018: Orthopedics
Edouard Dessyn, Xavier Flecher, Sebastien Parratte, Matthieu Ollivier, Jean-Noël Argenson
AIM: The purpose of this study is to report the 20-year follow-up of a continuous series of 232 total hip arthroplasties (THAs) performed in patients aged less than 50 at the index surgery. PATIENTS AND METHODS: This is a retrospective monocentric study which reports the clinical, radiographical and survival results of 232 THAs performed with a custom cementless femoral stem in 212 patients evaluated at follow-up ranging from 14 to 27 years. RESULTS: At the time of follow-up, the mean Harris Hip Score was 94...
October 23, 2018: Hip International: the Journal of Clinical and Experimental Research on Hip Pathology and Therapy
C D Novoa-Parra, J M Pelayo-de Tomás, S Gómez-Aparicio, R E López-Trabucco, M Morales-Suárez-Varela, J L Rodrigo-Pérez
OBJECTIVE: To evaluate the clinical results and survival of primary hip prosthesis with ceramic delta bearings (C-C) with a minimum follow-up of 5years. MATERIAL AND METHOD: A total of 205 primary hip arthroplasties performed between 2008 and 2012 were studied. The clinical results, pre-surgical and at 5years of follow-up were evaluated using the Harris Hip Score (HHS), the Short Form-36 (SF-36), the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), and the visual analogue scale (VAS)...
October 19, 2018: Revista Española de Cirugía Ortopédica y Traumatología
Thomas Neri, Remi Philippot, Antonio Klasan, Sven Putnis, Murilo Leie, Bertrand Boyer, Frederic Farizon
The dual mobility cup (DMC) concept was proposed by Professor Gilles Bousquet in 1974. Its' aims were to prevent postoperative dislocation, restore the physiological range of motion of the hip, and reduce the stresses at the interface. Since it was created, this design has been modified multiple times to reduce the complication rate, improve implant survival, and expand the indications. Areas covered: The objective of this review is to discuss the advantages and disadvantages of this implant based on its 40-year history and also to propose a range of indications based on published results...
October 22, 2018: Expert Review of Medical Devices
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...
December 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...
December 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
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