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Cup loosening

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...
July 12, 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...
July 11, 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
Jun-Dong Chang, In-Sung Kim, Sameer Ajit Mansukhani, Vishwas Sharma, Sang-Soo Lee, Je-Hyun Yoo
PURPOSE: The purpose of this study is to evaluate the clinical and radiologic outcomes after revision total hip arthroplasty (THA) using fourth-generation ceramic-on-ceramic (CoC) bearing surfaces. METHODS: A total of 52 revision THAs (28 men and 19 women) using the fourth-generation CoC bearing surfaces were retrospectively evaluated. Both acetabular cup and femoral stem were revised in all cases. The mean follow-up period was 7.3 years (range, 4.0-9.9 years). The clinical results with Harris hip score (HHS), Western Ontario McMaster Osteoarthritis Index (WOMAC), and radiologic outcomes were evaluated...
May 2018: Journal of Orthopaedic Surgery
I Aguado-Maestro, E Cebrián Rodríguez, E Paredes Herrero, F Brunie Vegas, M Oñate Miranda, N Fernández García, M García Alonso
OBJECTIVES: We present the results of the prospective follow up of a sample of large head metal-metal total hip arthroplasty obtained after the safety alert regarding a higher incidence of revision of these implants. MATERIAL AND METHODS: All patients implanted with the Recap-M2a-Magnum cup between 2008 and 2011 were included. They were prospectively reviewed recording Harris Hip Score, clinical symptoms of chromium or cobalt intoxication. Serum levels of these ions were requested as well as X-Rays and ultrasonography...
June 11, 2018: Revista Española de Cirugía Ortopédica y Traumatología
William J Long, Samir Nayyar, Kevin K Chen, David Novikov, Roy I Davidovitch, Jonathan M Vigdorchik
Ultraporous acetabular components were developed to improve osseointegration and fit for increased longevity and better outcomes after total hip arthroplasty. There is a paucity of literature detailing this acetabular component's clinical performance, with even less detailing those with screw fixation. We identify 5 patients at our institution who underwent revision total hip arthroplasty for early aseptic acetabular cup loosening of an ultraporous acetabular component known as the Tritanium primary cup with secondary screw fixation...
June 2018: Arthroplasty Today
Joong-Myung Lee, Tae-Ho Kim
The rate of acetabular cup revision arthroplasty is gradually rising along with an increased risk of osteolysis and prosthesis loosening over time and an increase in life expectancy. The goals of revision total hip arthroplasty are: i) implant stability through reconstruction of large bone defects, ii) restoration of range of motion and biomechanics of the hip joint, and iii) normalization of uneven limb lengths. In acetabular cup revision arthroplasty, stable fixation of acetabular components is difficult in the presence of severe bone loss (e...
June 2018: Hip & Pelvis
Mahdi Motififard, Ali Andalib, Seyed Jalil Hamidi, Sajad Badiei
Background: The purpose of this study is to report outcomes of total hip arthroplasty (THA) in patients under the age of 35 years regarding pain and joint function. Materials and Methods: This preliminary analytic-descriptive study was performed in prospective consecutive series of forty-three patients younger than 35 years old who had undergone unilateral THA during a 36-month period. As the primary outcome, the severity of pain using visual analog scale (VAS) of 1-10, and as the secondary outcomes, joint range of motion (ROM) and the Harris Hip Score (HHS) were assessed in the preoperative visit, 1, 6, and 18 months after operation for each patient...
2018: Advanced Biomedical Research
Faizan Iqbal, Asmat Ullah, Sajid Younus, Akram Aliuddin, Osama Bin Zia, Naveed Khan
PURPOSE: To assess the functional outcome of acute primary total hip replacement in the management of complex acetabular fractures. MATERIALS AND METHODS: This prospective observational study was conducted in orthopedic department of Liaquat National Hospital and Medical College, Karachi. The study was approved by the Ethics review committee of hospital (0190-2016). Patients who encountered between January 2010 to January 2016 were entered. Fifty-four patients with acetabular fractures with certain indications (marginal impaction or significant comminution (> 3 fragments) of the articular surface of the acetabulum, full-thickness articular injury to the femoral head, an associated femur neck fracture, or preexisting symptomatic osteoarthritis) were treated with primary total hip replacement...
May 29, 2018: European Journal of Orthopaedic Surgery & Traumatology: Orthopédie Traumatologie
Vincent P Galea, Inari Laaksonen, Gabrielle S Donahue, Kiyokazu Fukui, Ayumi Kaneuji, Henrik Malchau, Charles Bragdon
BACKGROUND: The primary aim of this study was to determine the clinical outcomes at 13-year follow-up of patients diagnosed with developmental dysplasia of the hip and subsequently treated with total hip arthroplasty (THA). The secondary aim was to investigate the effect of hip center location on clinical outcomes and polyethylene wear. METHODS: We reviewed data from a consecutive series of 104 patients (123 hips) from a single center. Patients were treated with THA with the high hip center (HHC) technique using cementless acetabular shells and highly cross-linked liners...
April 30, 2018: Journal of Arthroplasty
Vahit E Ozden, Goksel Dikmen, Burak Beksac, Remzi Tozun
INTRODUCTION: The purpose of this study was to summarise the performance of dual-mobility cup systems for revision total hip arthroplasty in patients with abductor-trochanteric complex deficiency. METHODS: We prospectively followed 17 patients (20 hips) with a mean age of 64.5 years (range 33-89 years) who underwent acetabular reconstruction with dual-mobility cups for aseptic loosening in 12 hips, infection treatment as second or single stage in 6 hips, and instability in 2 hips...
May 1, 2018: Hip International: the Journal of Clinical and Experimental Research on Hip Pathology and Therapy
Alexander Jahnke, Stefan Schroeder, Carlos A Fonseca Ulloa, Gafar A Ahmed, Bernd A Ishaque, Markus Rickert
Aseptic loosening is the main reason for revision of total hip arthroplasty, and relative micromotions between cementless acetabular cups and bone play an important role regarding their comparatively high loosening rate. Therefore, the aim of the present study was to analyze the influence of resulting frictional torques on the primary stability of press-fit acetabular cups subjected to two different bearing partners. A cementless press-fit cup was implanted in bone-like foam. Primary stability of the cup was analyzed by determining spatial total, translational, and rotational interface micromotions by means of an eddy current sensor measuring system...
May 10, 2018: Journal of Orthopaedic Research: Official Publication of the Orthopaedic Research Society
Loïc Laurendon, Rémi Philippot, Thomas Neri, Bertrand Boyer, Frédéric Farizon
INTRODUCTION: The original cementless Sunfit® dual mobility cup (SERF, Décines, France) exhibited limited osseointegration due to its hydroxyapatite and alumina coating. We hypothesized that replacement of the alumina with plasma-sprayed titanium + hydroxyapatite and improvement of the external geometry (Sunfit TH®) would not increase the risk of aseptic loosening. The primary goal of this study was to determine the survivorship and clinical and radiological outcomes among patients with the Sunfit TH® implant...
June 1, 2018: Surgical Technology International
Hazem A H Hosny, Ahmed El-Bakoury, Sreebala C M Srinivasan, Rathan Yarlagadda, Jonathan Keenan
BACKGROUND: The use of highly porous acetabular components has shown to produce good results in revision acetabular surgery. Their surface characteristics enhance initial fixation and bone ingrowth which are prerequisites for adequate osseointegration. The purpose of this study is to analyze the mid-term to long-term survival, clinical and radiological outcomes using the Tritanium cup (Stryker, Mahwah, NJ) in revision hip surgery. METHODS: This is a retrospective review of all patients who underwent acetabular revision surgery using "Tritanium revision cup" between April 2007 and November 2010 at our institution...
August 2018: Journal of Arthroplasty
Ping Zhen, Xusheng Li, Shenghu Zhou, Hao Lu, Hui Chen, Jun Liu
BACKGROUND: The treatment of acetabular protrusions during total hip arthroplasty of patients with rheumatoid arthritis is difficult. A lack of bone stock, deficient medial cup support, and medialization of the joint center in those with protrusio acetabuli must be addressed during acetabular reconstruction. The purpose of this study was to assess the short-term clinical results of total hip arthroplasty in patients with severe acetabular protrusions secondary to rheumatoid arthritis...
April 19, 2018: Journal of Orthopaedic Surgery and Research
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