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Revision hip replacement

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https://www.readbyqxmd.com/read/29663665/investigation-of-nano-sized-debris-released-from-cocrmo-secondary-interfaces-in-total-hip-replacements-digestion-of-the-flakes
#1
Alina M Crainic, Mauro Callisti, Martin R Palmer, Richard B Cook
The in vivo release of wear debris and corrosion products from the metallic interfaces of total hip replacements is associated with a wide spectrum of adverse body reactions and systemic manifestations. The origin of debris and the electrochemical conditions at the sites of material loss both play a role in determining the physicochemical characteristics of the particles, and thus influence their in vivo reactivity. Debris retrieved from revised CoCrMo tapers and cement-stem interfaces consists of heterogeneous flakes that comprise mechanically mixed metal particles, corrosion products and organic material...
April 16, 2018: Journal of Biomedical Materials Research. Part B, Applied Biomaterials
https://www.readbyqxmd.com/read/29657453/periprosthetic-hip-fractures-a-review-of-the-economic-burden-based-on-length-of-stay
#2
Rebecca F Lyons, Robert P Piggott, William Curtin, Colin G Murphy
Introduction: With the increasing rates of total hip replacements being performed worldwide, there is an increasing incidence of periprosthetic fractures. As our patients' demographics change to include older patients with multiple medical co-morbidities, there is a concurrent increase in morbidity and mortality rates. This leads to longer hospital stays and increasing hospital costs. In the current economic climate, the cost of treating periprosthetic fractures must be addressed and appropriate resource and funding allocation for future provision of services should be planned...
March 2018: Journal of Orthopaedics
https://www.readbyqxmd.com/read/29652237/failure-of-facet-replacement-system-with-metal-on-metal-bearing-surface-and-subsequent-discovery-of-cobalt-allergy-report-of-2-cases
#3
Matthew L Goodwin, William Ryan Spiker, Darrel S Brodke, Brandon D Lawrence
The aim of this study was to report on 2 patients in whom metal-on-metal (MOM) facet replacements failed, with subsequent positive findings on allergy testing. Motion-preserving devices have been used with limited success when instrumentation is indicated in the mobile spine. MOM-bearing surfaces in orthopedics were developed to increase implant longevity, yet have been associated with numerous adverse outcomes, including local tissue reactions, pseudotumors, metallosis, and the need for revision surgery. Five patients with spinal stenosis and low-grade spondylolisthesis were randomized to undergo facet replacement surgery with the ACADIA facet replacement system at the authors' institution...
April 13, 2018: Journal of Neurosurgery. Spine
https://www.readbyqxmd.com/read/29651610/periprosthetic-femoral-fracture-as-cause-of-early-revision-after-short-stem-hip-arthroplasty-a-multicentric-analysis
#4
Sang-Min Kim, Seung-Beom Han, Kee Hyung Rhyu, Jeong Joon Yoo, Kwang-Jun Oh, Je Hyun Yoo, Kyung-Jae Lee, Seung-Jae Lim
BACKGROUND: The objective of this study was to analyze the prevalence and causes of early re-operation after hip replacement surgery using short bone-preserving stems in a large multicentre series. Specifically, we evaluated the clinical features of periprosthetic fractures occurring around short stems. METHODS: A total of 897 patients (1089 hips) who underwent primary total hip arthroplasty or bipolar hemiarthroplasty from January 2011 to February 2015 using short bone-preserving femoral stems were recruited...
April 12, 2018: International Orthopaedics
https://www.readbyqxmd.com/read/29643154/associations-between-preoperative-oxford-hip-and-knee-scores-and-costs-and-quality-of-life-of-patients-undergoing-primary-total-joint-replacement-in-the-nhs-england-an-observational-study
#5
Peter Eibich, Helen A Dakin, Andrew James Price, David Beard, Nigel K Arden, Alastair M Gray
OBJECTIVES: To assess how costs and quality of life (measured by EuroQoL-5 Dimensions (EQ-5D)) before and after total hip replacement (THR) and total knee replacement (TKR) vary with age, gender and preoperative Oxford hip score (OHS) and Oxford knee score (OKS). DESIGN: Regression analyses using prospectively collected data from clinical trials, cohort studies and administrative data bases. SETTING: UK secondary care. PARTICIPANTS: Men and women undergoing primary THR or TKR...
April 10, 2018: BMJ Open
https://www.readbyqxmd.com/read/29628676/metal-hypersensitivity-in-total-hip-and-knee-arthroplasty-current-concepts
#6
REVIEW
Samuel Akil, Jared M Newman, Neil V Shah, Natasha Ahmed, Ajit J Deshmukh, Aditya V Maheshwari
Metal hypersensitivity (MHS) is a rare complication of total joint arthroplasty that has been linked to prosthetic device failure when other potential causes have been ruled out. The purpose of this review was to conduct an analysis of existing literature in order to get a better understanding of the pathophysiology, presentation, diagnosis, and management of MHS. It has been described as a type IV hypersensitivity reaction to the metals comprising prosthetic implants, often nickel and cobalt-chromium. Patients suffering from this condition have reported periprosthetic joint pain and swelling as well as cutaneous, eczematous dermatitis...
January 2018: Journal of Clinical Orthopaedics and Trauma
https://www.readbyqxmd.com/read/29605150/inferomedial-hip-center-decreases-failure-rates-in-cementless-total-hip-arthroplasty-for-crowe-ii-and-iii-hip-dysplasia
#7
Chad D Watts, John R Martin, Keith A Fehring, William L Griffin
BACKGROUND: We sought to evaluate the outcomes of cementless acetabular components used in patients with Crowe II and III dysplasia, and to compare outcomes between cups placed within vs outside of an "anatomic" zone. Our specific aims were to (1) plot hip centers in these patients at our institution to characterize "anatomic" vs "nonanatomic" positions, (2) evaluate the association between hip center and radiographic loosening, (3) determine whether hip center was associated with acetabular component revision, and (4) compare patient-reported outcome scores between groups...
February 17, 2018: Journal of Arthroplasty
https://www.readbyqxmd.com/read/29598886/mapping-existing-hip-and-knee-replacement-registries-in-europe
#8
REVIEW
A Lübbeke, A J Silman, C Barea, D Prieto-Alhambra, A J Carr
The general shortage of evidence regarding benefits and harms of medical devices has been highlighted following the serious safety concerns with metal-on-metal hip replacements and silicone breast implants and was again pointed out in a recent survey of European Health Technology Assessment institutions. In this context the new European medical device regulation will enforce post-marketing surveillance of existing and new implants. The usefulness of registry data as a source of information for medical device real-world clinical performance and safety has been demonstrated...
March 17, 2018: Health Policy
https://www.readbyqxmd.com/read/29574978/canine-total-hip-replacement-using-a-cementless-threaded-cup-and-stem-a-review-of-55-cases
#9
H R Denny, M Linnell, T W Maddox, E J Comerford
OBJECTIVES: To determine the long-term results and complications associated with the Helica® cementless hip endoprosthesis system. MATERIALS AND METHODS: Retrospective study of 55 consecutive Helica total hip replacements performed between January 2010 and February 2015. RESULTS: A total of 55 total hip replacements were performed in 50 dogs; 45 dogs had unilateral hip replacements, and five had staged bilateral replacements. A total of 23 first-generation short femoral stems were implanted in 22 dogs, of which nine cases (39%) experienced complications and 19 (86%) recovered satisfactorily when revisions were included; 31 second-generation femoral stems were implanted in 28 dogs, of which 10 cases (32%) experienced complications, and 26 (93%) made satisfactory recoveries, including revisions...
March 25, 2018: Journal of Small Animal Practice
https://www.readbyqxmd.com/read/29572368/complication-of-intraprosthetic-dislocation-of-dual-mobility-hip-implant-following-closed-reduction
#10
Navin Mukundu Nagesh, Nimesh Patel, Jonathan Howell
Total hip replacement is a successful operation for the management of hip pain but there are potential complications, of which dislocation is one of the most common. The management of recurrent dislocation is a challenging problem that requires a multimodal approach and the use of dual-mobility implants is one option. We present a patient who was previously revised with a dual-mobility implant for recurrent dislocation, who had a complication after closed reduction of a subsequent intraprosthetic dislocation...
March 22, 2018: BMJ Case Reports
https://www.readbyqxmd.com/read/29572365/a-rare-presentation-of-haematuria-hip-prosthesis-in-the-bladder
#11
Yih Chyn Phan, Nnaemeka Eli, Praveen Pillai, Jonathan O'Dair
An 80-year-old woman presented to our department with visible haematuria and stage II acute kidney injury (AKI). She had stage IIB cervical cancer, for which she received chemotherapy and external beam radiotherapy in 2003. Four years later, she had a left dynamic hip screw for an extracapsular neck of femur fracture following a fall. In 2010, she underwent a right total hip replacement owing to osteoarthritis, and it was subsequently revised in 2012 owing to a right acetabular component failure. In this admission, her AKI improved with intravenous fluid administration and her haematuria settled following catheterisation with a three-way catheter and bladder irrigation with saline...
March 22, 2018: BMJ Case Reports
https://www.readbyqxmd.com/read/29560397/biarticular-total-femur-spacer-for-massive-femoral-bone-loss-the-mobile-solution-for-a-big-problem
#12
Pablo Sanz-Ruiz, Jose Antonio Calvo-Haro, Manuel Villanueva-Martinez, Jose Antonio Matas-Diez, Javier Vaquero-Martín
Bone cement spacers loaded with antibiotic are the gold standard in septic revision. However, the management of massive bone defects constitutes a surgical challenge, requiring the use of different nails, expensive long stems, or cement-coated tumor prostheses for preparing the spacer. In most cases, the knee joint must be sacrificed. We describe a novel technique for preparing a biarticular total femur spacer with the help of a trochanteric nail coated with antibiotic loaded cement, allowing mobility of the hip and knee joints and assisted partial loading until second step surgery...
March 2018: Arthroplasty Today
https://www.readbyqxmd.com/read/29548618/outpatient-focused-joint-arthroplasty-is-the-future-the-midwest-center-for-joint-replacement-experience
#13
Michael E Berend, Wesley G Lackey, Joshua L Carter
BACKGROUND: Perhaps, the most significant developments in joint arthroplasty in the past decade have been in the area of multimodal perioperative management reducing pain, nausea, and length of stay leading to outpatient arthroplasty. METHODS: Over a 2-year period, we performed 1230 arthroplasty cases including partial knee, total hip, total knee, and selected revision cases. RESULTS: Patient satisfaction ranged from 98% to 100% great/good...
February 9, 2018: Journal of Arthroplasty
https://www.readbyqxmd.com/read/29529664/the-safe-zone-range-for-cup-anteversion-is-narrower-than-for-inclination-in-tha
#14
William S Murphy, Ho Hyun Yun, Brett Hayden, Jens H Kowal, Stephen B Murphy
BACKGROUND: Cup malposition is a common cause of impingement, limitation of ROM, acceleration of bearing wear, liner fracture, and instability in THA. Previous studies of the safe zone based on plain radiographs have limitations inherent to measuring angles from two-dimensional projections. The current study uses CT to measure component position in stable and unstable hips to assess the presence of a safe zone for cup position in THA. QUESTIONS/PURPOSES: (1) Does acetabular component orientation, when measured on CT, differ in stable components and those revised for recurrent instability? (2) Do CT data support historic safe zone definitions for component orientation in THA? METHODS: We identified 34 hips that had undergone revision of the acetabulum for recurrent instability that also had a CT scan of the pelvis between August 2003 and February 2017...
February 2018: Clinical Orthopaedics and related Research
https://www.readbyqxmd.com/read/29529655/five-hundred-fifty-five-retrieved-metal-on-metal-hip-replacements-of-a-single-design-show-a-wide-range-of-wear-surface-features-and-histopathologic-reactions
#15
Sang-Hyun Park, Zhen Lu, Robert S Hastings, Patricia A Campbell, Edward Ebramzadeh
BACKGROUND: In 2010, a widely used metal-on-metal hip implant design was voluntarily recalled by the manufacturer because of higher than anticipated failure rates at 5 years. Although there was a large published range of revision rates, numerous studies had reported a higher risk of revision for excessive wear and associated adverse tissue reactions when compared with other metal-on-metal total hips. The reasons for this were suggested by some to be related to cup design features. QUESTIONS/PURPOSES: From retrievals of ASR metal-on-metal implants and tissue samples obtained at revision surgery, we asked the following questions: (1) What were the common and uncommon surface features? (2) What were the common and uncommon linear and volumetric wear characteristics? (3) Were there common taper corrosion characteristics? (4) What aseptic lymphocytic vasculitis-associated lesion (ALVAL) features were present in the tissues? METHODS: Five hundred fifty-five ASRs, including 23 resurfacings, were studied at one academic research center...
February 2018: Clinical Orthopaedics and related Research
https://www.readbyqxmd.com/read/29529653/outcomes-after-metal-on-metal-hip-revision-surgery-depend-on-the-reason-for-failure-a-propensity-score-matched-study
#16
Gulraj S Matharu, Andrew Judge, David W Murray, Hemant G Pandit
BACKGROUND: Metal-on-metal hip replacement (MoMHR) revision surgery for adverse reactions to metal debris (ARMD) has been associated with an increased risk of early complications and reoperation and inferior patient-reported outcome scores compared with non-ARMD revisions. As a result, early revision specifically for ARMD with adoption of a lower surgical threshold has been widely recommended with the goal of improving the subsequent prognosis after ARMD revisions. However, no large cohorts have compared the risk of complications and reoperation after MoMHR revision surgery for ARMD (an unanticipated revision indication) with those after non-ARMD revisions (which represent conventional modes of arthroplasty revision)...
February 2018: Clinical Orthopaedics and related Research
https://www.readbyqxmd.com/read/29528771/lethal-fat-embolism-complicating-sotos-syndrome
#17
John D Gilbert, Roger W Byard
Sotos syndrome is a rare congenital syndrome caused by deletions or mutations in the NSD1 gene (chromosome 5q35) which results in overgrowth. A wide range of manifestations may result in unexpected and/or early death, including congenital cardiac malformations and tumours, epilepsy, intra-tumoural haemorrhage or embolism and bleeding diatheses. A case of lethal pulmonary fat embolism complicating revision of a left total hip replacement following spontaneous fracture is reported in a 39-year-old man with Sotos syndrome...
January 1, 2018: Medicine, Science, and the Law
https://www.readbyqxmd.com/read/29511786/-anatomical-total-shoulder-replacement-in-glenohumeral-osteoarthritis-indications-current-implants-and-clinical-results
#18
REVIEW
O Lorbach
IMPLANT DESIGNS: Within the last 50 years, implants for shoulder replacement have developed rapidly. Monobloc-stems in few sizes were changed to modular implant systems that allow for an individual adaption of the stem, as well as adaption of the humeral head component according to the specific anatomic situation of the patient. Moreover, stemless und short stem implants are available, which may highly simplify primary implantation, especially in posttraumatic cases as well as in revision cases with a need for removal or change of the implants...
March 6, 2018: Der Orthopäde
https://www.readbyqxmd.com/read/29511363/application-of-a-causal-discovery-algorithm-to-the-analysis-of-arthroplasty-registry-data
#19
REVIEW
Camden Cheek, Huiyong Zheng, Brian R Hallstrom, Richard E Hughes
Improving the quality of care for hip arthroplasty (replacement) patients requires the systematic evaluation of clinical performance of implants and the identification of "outlier" devices that have an especially high risk of reoperation ("revision"). Postmarket surveillance of arthroplasty implants, which rests on the analysis of large patient registries, has been effective in identifying outlier implants such as the ASR metal-on-metal hip resurfacing device that was recalled. Although identifying an implant as an outlier implies a causal relationship between the implant and revision risk, traditional signal detection methods use classical biostatistical methods...
2018: Biomedical Engineering and Computational Biology
https://www.readbyqxmd.com/read/29498932/force-plates-may-be-used-for-dynamic-analyses-of-endoprostheses-explantation-procedures
#20
Hendrik Kohlhof, Sebastian Köhring, Dieter Christian Wirtz, Hartmut Witte
The number of hip and knee arthroplasty replacement surgeries is increasing steadily. In combination with demographic aging and the number of periprosthetic complications, this development has lead to the phenomenon where the need for revision surgery is rising. The problem is, that, while implantation procedures of hip arthroplasties are more or less standardized, explantation is a non-standardized task for experienced specialists, due to the unpredictability of the adequate loosening method. The surgeon often only gets to decide on which tools and methods may be applied to detach the prosthesis, only after getting access to the operation site...
March 2, 2018: Biomedizinische Technik. Biomedical Engineering
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