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https://www.readbyqxmd.com/read/28790470/management-guidelines-for-metal-on-metal-hip-resurfacing-arthroplasty-a-strategy-on-followup
#1
Naoki Nakano, Andrea Volpin, Jonathan Bartlett, Vikas Khanduja
Despite the initial promise of metal-on-metal (MoM) implants as the ideal bearing surface for hip replacements and resurfacings, high short term failure rates due to an adverse reaction to metal debris (ARMD) have led to a dramatic reduction in the number of MoM implants used in the modern era. With over one million patients worldwide having undergone hip operations utilizing a MoM bearing surface, the long term outcomes for such patients remains unknown, and there is much debate as to the most effective management of these patients...
July 2017: Indian Journal of Orthopaedics
https://www.readbyqxmd.com/read/28781016/blood-metal-ion-levels-have-limited-utility-in-the-surveillance-of-asymptomatic-large-head-metal-on-metal-total-hip-arthroplasties
#2
Manish Kiran, Deepak Shivarathre, Viju K Peter
BACKGROUND: Blood cobalt (Co) and chromium (Cr) ion levels have been used as surveillance tools for adverse reaction to metal debris (ARMD) in metal-on-metal (MoM) articulations with varying thresholds in different countries. The aim of our study is to present the serial 12-year blood Co and Cr levels in a cohort of MoM total hip arthroplasties (THAs) with femoral head size ≥36 mm and analyze their utility in asymptomatic patients at current thresholds. METHODS: A total of 256 patients with unilateral MoM THA with femoral head size ≥36 mm were included in this study with data collected prospectively...
July 20, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28754580/microstructure-and-surface-damage-in-retrieved-metal-on-metal-hip%C3%A2-arthroplasties
#3
Mariano Fernández-Fairen, Miquel Punset, Antonio Murcia-Asensio, Francisco Ferrero-Manzanal, José Sueiro, Javier Gil
BACKGROUND: Besides promising results of metal-on-metal (MOM) hip arthroplasty (HA), frequent failures have been reported even in the short term. Many host, surgical, design, metallurgical, and processing factors have been evoked in the base of these events. We have tried to characterize and to evaluate metallurgical and processing features present in this type of implants. METHODS: The acetabular and femoral components of 20 MOM HAs collected from a multicenter retrieval program were examined...
July 8, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28750857/interventions-for-improving-hip-resurfacing-outcomes-in-women-a-high-volume-retrospective-study
#4
Emily B Gaillard, Melissa D Gaillard, Thomas P Gross
BACKGROUND: Women seeking surgical intervention for their hip disorders will often find total hip arthroplasty (THA) presented as their only option. THA, when compared with hip resurfacing arthroplasty, removes substantially more bone-stock, limits range-of-motion, exhibits increased dislocation risk, and presents greater overall 10-year mortality rate. Despite these risks, most surgeons continue to select against women for hip resurfacing because registries notoriously report inferior survivorship when compared with men and THA...
June 9, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28723917/evidence-base-and-practice-variation-in-acute-care-processes-for-knee-and-hip-arthroplasty-surgeries
#5
Marcel Mayer, Justine Naylor, Ian Harris, Helen Badge, Sam Adie, Kathryn Mills, Joseph Descallar
BACKGROUND: Lack of evidence contributes to unnecessary variation in treatment costs and outcomes. This study aimed to identify from interventions historically used for total knee or hip arthroplasty (TKA, THA): i) if routine use is supported by high-level evidence; ii) whether surgeon use aligns with the evidence. METHODS: Part 1: Systematic search of electronic library databases for systematic reviews and practice guidelines concerning seven acute-care interventions...
2017: PloS One
https://www.readbyqxmd.com/read/28715928/lack-of-evidence-the-anti-stepwise-introduction-of-metal-on-metal-hip-replacements
#6
Aleksi Reito, Lari Lehtovirta, Olli Lainiala, Keijo Mäkelä, Antti Eskelinen
Background and purpose - Orthopedics and especially joint replacement surgery have had more than their fair share of unsuccessful innovations that have violated widely endorsed principles for the introduction of new surgical innovations. We aimed to investigate (1) the trends in the use of the Birmingham Hip Resurfacing (BHR), the ASR hip resurfacing (ASR HRA) and the ASR XL total hip replacement (ASR XL THR) system with very different market approval processes and (2) whether their use was corroborated by clinical trials published in the peer-reviewed literature...
October 2017: Acta Orthopaedica
https://www.readbyqxmd.com/read/28711342/birmingham-hip-resurfacing-vs-total-hip-arthroplasty-a-matched-pair-comparison-of-clinical-outcomes
#7
Victor R Ortiz-Declet, David A Iacobelli, Leslie C Yuen, Itay Perets, Austin W Chen, Benjamin G Domb
BACKGROUND: Birmingham hip resurfacing (BHR) has proven to be a good alternative for younger patients with osteoarthritis. Some have asserted that BHR may yield outcomes which are superior to total hip arthroplasty (THA), and that some studies which failed to show a difference were plagued by ceiling effects and lack of sensitivity of outcome measures. The purpose of this study is to compare outcomes of BHR and THA using the "Forgotten Joint" Score-12 (FJS), a more sensitive score with lesser vulnerability to the ceiling effect...
June 23, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28663390/risk-factors-for-wear-related-failures-after-hip-resurfacing-in-patients-with-a-low-contact-patch-to-rim-distance
#8
H C Amstutz, M J Le Duff, S K Bhaurla
AIMS: A contact patch to rim (CPR) distance of < 10 mm has been associated with edge-loading and excessive wear. However, not all arthroplasties with a low CPR distance show problems with wear. Therefore, CPR distance may not be the only variable affecting the post-operative metal ion concentrations. PATIENTS AND METHODS: We used multiple logistic regression to determine what variables differed between the patients who had high and low cobalt (CoS) and chromium (CrS) serum ion concentrations within a cohort of patients with low (< 10 mm) CPR distances...
July 2017: Bone & Joint Journal
https://www.readbyqxmd.com/read/28660477/correlation-of-serum-metal-ion-levels-with-pathological-changes-of-armd-in-failed-metal-on-metal-hip-resurfacing-arthroplasties
#9
George Grammatopoulos, Mitsuru Munemoto, Athanasios Pollalis, Nicholas A Athanasou
BACKGROUND: Metal-on-metal-hip-resurfacing arthroplasties (MoMHRAs) have been associated with an increased failure rates due to an adverse-response-to-metal-debris (ARMD) associated with a spectrum of pathological features. Serum levels of cobalt (Co) and chromium (Cr) are used to assess MoMHRAs, with regard to ARMD, but it is not certain whether ion levels correlate with pathological changes in periprosthetic tissues. METHODS: Serum Co and Cr levels were correlated with histological findings in 38 revised MoMHRAs (29 pseudotumour cases and 9 non-pseudotumour cases revised for pain)...
August 2017: Archives of Orthopaedic and Trauma Surgery
https://www.readbyqxmd.com/read/28660436/adventure-sports-and-sexual-freedom-hip-replacement-the-tripolar-hip
#10
James W Pritchett
Certain athletic activities and lifestyles require a completely stable and very mobile hip. Total hip replacement with a natural femoral head size and two mobile-bearing surfaces (i.e., a "tripolar" prosthesis) is the most stable prosthesis. Elegant design and wear-resistant bearing surfaces are the keys to long-term implant survivorship. The hypothesis is that a ceramic-coated tripolar prosthesis using highly cross-linked polyethylene can provide full function and complete stability with low wear. This study sought to determine: (1) patient-reported outcomes, (2) functional outcomes, (3) implant survivorship and complications, and (4) postoperative sexual limitations...
June 28, 2017: European Journal of Orthopaedic Surgery & Traumatology: Orthopédie Traumatologie
https://www.readbyqxmd.com/read/28642661/customized-guide-for-femoral-component-positioning-in-hip-resurfacing-arthroplasty
#11
Chaturong Pornrattanamaneewong, Rapeepat Narkbunnam, Keerati Chareancholvanich
OBJECTIVE: To prove the accuracy of a customized guide developed according to our method. METHODS: This customized guide was developed from a three-dimensional model of proximal femur reconstructed using computed tomography data. Based on the new technique, the position of the guide pin insertion was selected and adjusted using the reference of the anatomical femoral neck axis. The customized guide consists of a hemispheric covering designed to fit the posterior part of the femoral neck...
March 2017: Acta Ortopedica Brasileira
https://www.readbyqxmd.com/read/28641972/equal-primary-fixation-of-resurfacing-stem-but-inferior-cup-fixation%C3%A2-with-anterolateral-vs-posterior-surgical-approach-a-2-year-blinded-randomized-radiostereometric-and-dual-energy-x-ray-absorptiometry-study-of-metal-on-metal-hip-resurfacing-arthroplasty
#12
Mette H Hjorth, Nina D Lorenzen, Kjeld Søballe, Stig S Jakobsen, Maiken Stilling
BACKGROUND: The anterolateral (AntLat) surgical approach may spare the blood supply to the femoral head and improve the accuracy of cup positioning in metal-on-metal hip resurfacing arthroplasty. Thereby, potentially lessen complications such as avascular head necrosis, femoral neck narrowing and fracture, improve implant fixation, and lessen periprosthetic bone mineral density (BMD) loss. METHODS: Between November 2008 and January 2012, a randomized clinical trial was performed at Aarhus University Hospital...
May 25, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28602531/outcomes-of-hip-arthroplasty-after-failed-hip-arthroscopy-a-case-control-study
#13
Simon J M Parker, George Grammatopoulos, Owain L I Davies, Karen Lynch, Tom C B Pollard, Antonio J Andrade
BACKGROUND: Hip arthroscopy is increasingly being used in joint preservation surgery with clear benefits in the treatment of prearthritic conditions. A number of patients, however, will still go on to require subsequent hip arthroplasty, and at present, little evidence exists determining the impact that prior hip arthroscopy may have on the outcomes of a subsequent arthroplasty. METHODS: Using prospectively collated data, we identified 35 patients who had a hip arthroplasty (22 total hip arthroplasties and 13 hip resurfacing arthroplasties) after prior ipsilateral hip arthroscopy (cases)...
May 18, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28578684/metal-on-metal-hip-resurfacing-in-patients-younger-than-50%C3%A2-years-a-retrospective-analysis-1285-cases-12-year-survivorship
#14
Melissa D Gaillard, Thomas P Gross
BACKGROUND: The Nordic registry reports patients under 50 years old with total hip replacements realize only 83% 10-year implant survivorship. These results do not meet the 95% 10-year survivorship guideline posed by the UK's National Institute for Health and Care Excellence (NICE) in 2014. METHODS: The purpose of this study is threefold: First, we evaluate if metal-on-metal hip resurfacing arthroplasty meets these high standards in younger patients. Next, we compare outcomes between age groups to determine if younger patients are at higher risk for revision or complication...
June 2, 2017: Journal of Orthopaedic Surgery and Research
https://www.readbyqxmd.com/read/28552834/high-impact-sport-after-hip-resurfacing-the-ironman-triathlon
#15
J Girard, A Lons, T Pommepuy, R Isida, K Benad, S Putman
BACKGROUND: Returning to high-impact sport is an increasingly frequent functional demand following hip replacement. The literature, however, is sparse on the subject and nonexistent regarding triathlon. We therefore conducted a retrospective study of hip resurfacing in triathlon players, to determine: (1) whether it is possible to return to this kind of sport; (2) if so, whether it is possible to return to the same level; and (3) how a resurfaced hip behaves under these conditions. HYPOTHESIS: Hip resurfacing allows return to competition level in long-distance triathlon...
May 25, 2017: Orthopaedics & Traumatology, Surgery & Research: OTSR
https://www.readbyqxmd.com/read/28497453/trends-in-total-hip-arthroplasty-in-young-patients-results-from-a-regional-register
#16
Amit Kumar, Benjamin V Bloch, Colin Esler
INTRODUCTION: In the United Kingdom, over 83,000 primary total hip arthroplasties (THAs) were performed last year, of which 20% are in patients under the age of 60 years. These patients generally have a longer life expectancy and a higher activity level than an older cohort, which may potentially translate to higher revision rates. METHODS: We reviewed our Trent regional arthroplasty register to assess current surgical practice in younger patients undergoing total hip arthroplasty...
May 10, 2017: Hip International: the Journal of Clinical and Experimental Research on Hip Pathology and Therapy
https://www.readbyqxmd.com/read/28461912/sequelae-of-large-head-metal-on-metal-hip-arthroplasties-current-status-and-future-prospects
#17
REVIEW
Christiaan P van Lingen, Luigi M Zagra, Harmen B Ettema, Cees C Verheyen
Large-head metal-on-metal (MoM) bearings were re-popularised in the late 1990s with the introduction of modern hip resurfacing (HR), followed closely by large metal head total hip arthroplasty (THA). A worldwide increase in the use of MoM hip arthroplasty subsequently saw a sharp decline, due to serious complications.MoM was rapidly adopted in the early 2000s until medical device alerts were issued by government regulatory agencies and national and international organisations, leading to post-marketing surveillance and discontinuation of these implants...
October 2016: EFORT open reviews
https://www.readbyqxmd.com/read/28456333/how-symmetric-are-metal-on-metal-hip-resurfacing-patients-during-gait-insights-for-the-rehabilitation
#18
Renan A Resende, Renata N Kirkwood, John F Rudan, Kevin J Deluzio
Metal-on-metal hip resurfacing patients demonstrate hip biomechanics closer to normal in comparison to total hip arthroplasty during gait. However, it is not clear how symmetric is the gait of hip resurfacing patients. Biomechanical data of 12 unilateral metal-on-metal hip resurfacing participants were collected during gait at a mean time of 45months (SD 24) after surgery. Ankle, knee, hip, pelvis and trunk kinematics and kinetics of both sides were measured with a motion and force-capture system. Principal component analysis and mean hypothesis' tests were used to compare the operated and healthy sides...
April 19, 2017: Journal of Biomechanics
https://www.readbyqxmd.com/read/28452042/what-should-i-expect-from-my-recalled-adept-hip-resurfacing
#19
Matteo Cadossi, Silvio Terrando, Andrea Sambri, Giuseppe Tedesco, Antonio Mazzotti, Barbara Bordini, Dalila De Pasquale, Cesare Faldini
"My Hip Resurfacing (HR) has been recalled. What will happen to me?" This is the question of every patient who underwent an implant recall, a highly stressful event for both patients and physicians. Triggered by a 11.64% failure rate at 7 years, a recall process started for Adept HR with head diameter less than 48 mm. We report our experience in the recall process of 40 patients with the above-mentioned components. One patient underwent revision surgery due to an adverse reaction to metal debris at 5-year follow-up...
April 27, 2017: Musculoskeletal Surgery
https://www.readbyqxmd.com/read/28436371/pigmented-villonodular-synovitis-various-manifestations-inconsistent-terminology-and-treatment-cases-study
#20
Paweł Kokoszka, Waldemar Woźniak, Łukasz Łapaj, Jacek Kruczyński
Pigmented villonodular synovitis (PVNS) as well as tenosynovial giant cell tumor (TGCT) are both diagnosed and described in two forms, namely a localized and diffuse type. They form a diverse group of proliferative lesions in articular synovium and tendon sheaths. The inconsistent terminology impedes communication between patients, orthopedic surgeons, radiologists and pathologists, leading to misunderstandings and delaying treatment. In this paper, we present three cases of PVNS/TGCT (involving the fourth toe extensor tendon sheath, hip joint after resurfacing and flexor hallucis longus tendon sheath) together with suggestions regarding the unification of the terminology as well as diagnosis and treatment...
January 26, 2017: Ortopedia, Traumatologia, Rehabilitacja
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