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C Huxley, J Achten, M L Costa, F Griffiths, X L Griffin
OBJECTIVES: The annual incidence of hip fracture is 620 000 in the European Union. The cost of this clinical problem has been estimated at 1.75 million disability-adjusted life years lost, equating to 1.4% of the total healthcare burden in established market economies. Recent guidance from The National Institute for Health and Clinical Excellence (NICE) states that research into the clinical and cost effectiveness of total hip arthroplasty (THA) as a treatment for hip fracture is a priority...
October 2016: Bone & Joint Research
Philippe Hernigou, Jean Charles Auregan, Damien Potage, François Roubineau, Charles Henri Flouzat Lachaniette, Arnaud Dubory
PURPOSE: Revision total hip arthroplasty (THA) is associated with increased rates of dislocation in obese patients. It is not known whether dual-mobility implants decrease dislocation in these patients with obesity. METHODS: We retrospectively reviewed two groups of revision THAs to compare the dislocation rate between 32 obese patients (BMI >30 kg/m(2)) with standard cups, and 35 obese patients (BMI >30 kg/m(2)) with dual-mobility cups. All patients received the same implants except for diameter head (32-mm head with standard cups and 28-mm head with dual mobility) and had the same cemented stem that was not changed at revision...
October 20, 2016: International Orthopaedics
Antoine Dangin, Sandrine Boulat, Frédéric Farizon, Rémi Philippot
INTRODUCTION: Total hip arthroplasty (THA) is a common surgery presenting well-known failures that may require surgical revision. To reduce the risk of hip dislocation after revision THA, we hypothesize the interest of the use of a new generation dual mobility cup by evaluating its survival and complication rates. MATERIALS AND METHODS: We analyzed the survival and the failures rate of 91 patients who underwent revision THAs with a specific dual mobility cup Novae® E TH (SERF, Décines-Charpieu, France)...
October 6, 2016: Surgical Technology International
C Morin, C Ursu, C Delecourt
INTRODUCTION: The everyday life of a non-ambulatory adolescent or young adult with cerebral palsy can be severely impaired by a painful or stiff hip. The usual surgical solutions such as proximal femoral resection (PFR) are not entirely satisfactory for pain relief, and are mutilating. HYPOTHESIS: A retrospective study assessed the impact of total hip replacement (THR) on such impairment, on the hypothesis that it is more effective than PFR in relieving pain, without aggravating disability...
September 30, 2016: Orthopaedics & Traumatology, Surgery & Research: OTSR
Pierre Martz, Abderrahmane Bourredjem, Davy Laroche, Marc Arcens, Ludovic Labattut, Christine Binquet, Jean-Francis Maillefert, Emmanuel Baulot, Paul Ornetti
PURPOSE: We assumed that the combination of dual-mobility total hip arthroplasty (THA) using the minimally-invasive Röttinger anterolateral approach could guarantee hip stability with faster functional recovery. We objectively analyzed functional improvement after dual-mobility THA by quantitative gait analysis. METHODS: We compared the results achieved following two different surgical approaches: Röttinger's versus Moore's approach (posterolateral approach). We included 70 patients in an open prospective single-centre study: 38 by Rottinger's approach (age = 67yo) and 32 by Moores's approach (age = 68yo)...
July 6, 2016: International Orthopaedics
Yasuhiro Homma, Tomonori Baba, Hideo Kobayashi, Asuka Desroches, Hironori Ochi, Yu Ozaki, Mikio Matsumoto, Takahito Yuasa, Kazuo Kaneko
PURPOSE: No previous reports have described the benefits and risks associated with the dual mobility cup (DMC) in primary THA via direct anterior approach (DAA). The aim of this study was to compare the safety and rate of early postoperative complication of the DAA with the DMC for THA with those of the DAA with a single standard cup, and to investigate the influence of the learning curve of the use of DMC on intra- and perioperative outcomes. METHODS: We retrospectively investigated 60 hips treated in the single-DAA group and 60 hips treated in the dual-DAA group...
August 2016: European Journal of Orthopaedic Surgery & Traumatology: Orthopédie Traumatologie
Bradford S Waddell, Ivan De Martino, Thomas Sculco, Peter Sculco
BACKGROUND: Total hip arthroplasty is a successful operation for the treatment of hip pain. One of the common complications of hip arthroplasty is dislocation. While reduction of standard prosthetic dislocations is highly successful, new prostheses add the potential for new complications. CASE REPORT: We present the case of a patient who experienced intraprosthetic dislocation of an anatomic dual-mobility total hip prosthesis after a closed hip reduction and include the prereduction and postreduction radiographic findings...
2016: Ochsner Journal
Jason Samona, Brian Flanagan, Norman Walter
The use of bipolar components in hip surgery was introduced more than 40 years ago with the rationale of a dual-mobility hip implant. This design used a small femoral head that would decrease the rate of wear because of the smaller surface area but would still provide implant stability because of the larger outer shell that articulated with the acetabulum, decreasing dislocation rates. In April 2011, the E1 Active Articulation Hip System (Biomet, Warsaw, Indiana) was introduced to the orthopedic market. It is considered to be part of the next generation of bipolar designs, with similar designs available from competing companies, such as Stryker (Mahwah, New Jersey)...
September 1, 2016: Orthopedics
A A Sassoon, R L Barrack
The use of large-diameter metal-on-metal (MoM) components in total hip arthroplasty (THA) is associated with an increased risk of early failure due to adverse local tissue reaction to metal debris (ARMD) in response to the release of metal ions from the bearing couple and/or head-neck taper corrosion. The aim of this paper was to present a review of the incidence and natural history of ARMD and the forms of treatment, with a focus on the need for and extent of resection or debulking of the pseudotumour. An illustrative case report is presented of a patient with an intra-pelvic pseudotumour associated with a large diameter MoM THA, which was treated successfully with revision of the bearing surface to a dual mobility couple and retention of the well-fixed acetabular and femoral components...
June 2016: Bone & Joint Journal
William G Hamilton
No abstract text is available yet for this article.
October 2016: Clinical Orthopaedics and related Research
Miguel E Cabanela
No abstract text is available yet for this article.
October 2016: Clinical Orthopaedics and related Research
Mo Saffarini, Thomas Gregory, Eric Vandenbussche
BACKGROUND: This study aimed to measure femoral head penetration before occurrence of real wear, and to quantify the portions attributable respectively to clearance and plastic deformations in various acetabular designs. METHODS: We analyzed CT scans from 15 patients at 'day five' after total hip arthroplasty (THA). All patients received Exafit(®) femoral stems and 28 mm heads: 5 patients had cemented Durasul(®) all-PE cups, 5 patients had un-cemented Allofit(®) metal-backed cups, and 5 patients had un-cemented Stafit(®) dual-mobility cups...
April 2016: Annals of Translational Medicine
Grégoire Thürig, Jürgen Wilfried Schmitt, Ksenija Slankamenac, Clément M L Werner
BACKGROUND: The femoral neck fracture is one of the most common fractures in the elderly. A variety of methods and approaches are used to treat it. Total hip arthroplasty is a preferred approach in independent, mobile, elderly patients, given its more favorable long-term outcome. Our hypothesis is that the direct anterior approach in geriatric trauma patients has a lower dislocation-rate with the advantage of early recovery due to a muscle sparing approach and therefore early possible full weight-bearing...
2016: Patient Safety in Surgery
Morad Chughtai, Jaydev B Mistry, Aloise M Diedrich, Julio J Jauregui, Randa K Elmallah, Peter M Bonutti, Steven F Harwin, Arthur L Malkani, Frank R Kolisek, Michael A Mont
No abstract text is available yet for this article.
May 6, 2016: Clinical Orthopaedics and related Research
Philippe Hernigou, Matthieu Trousselier, François Roubineau, Charlie Bouthors, Charles Henri Flouzat Lachaniette
BACKGROUND: Obesity is associated with an increased risk of dislocation after total hip arthroplasty (THA). However, in patients with obesity, it is not known whether the risk is only in the early postoperative period or whether it persists several years after surgery, and whether having bariatric surgery before undergoing THA and/or receiving a specific device (such as a dual-mobility or constrained acetabular liner) is more effective in terms of decreasing the risk of dislocation. QUESTION/PURPOSES: (1) What is the cumulative risk of dislocation in patients with obesity after THA in the absence of a dual-mobility or constrained liner, and is this related to component positioning? (2) Does bariatric surgery before undergoing THA decrease dislocation risk in patients with obesity? (3) Are dual-mobility and constrained liners efficient in preventing dislocation in patients with obesity? METHODS: At our university-based practice, all surgeons adhered to the following treatment approaches: Before 2000 no dual-mobility implants or constrained liners were used for primary THAs...
October 2016: Clinical Orthopaedics and related Research
Morad Chughtai, Jaydev B Mistry, Aloise M Diedrich, Julio J Jauregui, Randa K Elmallah, Peter M Bonutti, Steven F Harwin, Arthur L Malkani, Frank R Kolisek, Michael A Mont
BACKGROUND: Dislocation complicates 1% to 5% of primary total hip arthroplasties (THAs). As a result, some surgeons consider dual-mobility articulations, which are usually used in the revision setting to decrease the likelihood of dislocation, as an option for primary THA. However, few studies have evaluated their use in this setting. QUESTIONS/PURPOSES: (1) What is the cup survivorship when the dual-mobility articulation is used in the setting of primary THA? (2) What are the clinical outcomes with this approach? (3) What are the radiographic outcomes? (4) What are the complications of dual-mobility articulations in primary THA? METHODS: Between 2011 and 2013, the five participating surgeons performed 495 cementless primary THAs...
October 2016: Clinical Orthopaedics and related Research
Darren R Plummer, Jonathan M Christy, Scott M Sporer, Wayne G Paprosky, Craig J Della Valle
BACKGROUND: The purpose of this study was to evaluate the performance of dual-mobility articulations in patients at high risk for dislocation after revision total hip arthroplasty. METHODS: We reviewed the results of 36 consecutive revision total hip arthroplasties performed on patients considered high risk for instability. Indications for inclusion included abductor insufficiency, recurrent instability, failure of constrained liner, or inadequate intraoperative stability when trialing...
September 2016: Journal of Arthroplasty
Peter K Sculco, Matthew S Austin, Carlos J Lavernia, Aaron G Rosenberg, Rafael J Sierra
Restoration of equal leg lengths and dynamic hip stability are essential elements of a successful total hip arthroplasty. A careful clinical examination, a preoperative plan, and appropriate intraoperative techniques are necessary to achieve these goals. Preoperative identification of patients at risk for residual leg length discrepancy allows surgeons to adjust the surgical approach and/or the type of implant and provide better preoperative patient education. The use of larger femoral heads, high-offset stem options, and enhanced soft-tissue repairs have improved impingement-free range of motion as well as dynamic hip stability and have contributed to an overall reduction in dislocation...
2016: Instructional Course Lectures
Michaël P A Bus, Andrzej Szafranski, Simen Sellevold, Tomasz Goryn, Paul C Jutte, Jos A M Bramer, M Fiocco, Arne Streitbürger, Daniel Kotrych, Michiel A J van de Sande, P D Sander Dijkstra
BACKGROUND: Reconstruction of periacetabular defects after pelvic tumor resection ranks among the most challenging procedures in orthopaedic oncology, and reconstructive techniques are generally associated with dissatisfying mechanical and nonmechanical complication rates. In an attempt to reduce the risk of dislocation, aseptic loosening, and infection, we introduced the LUMiC(®) prosthesis (implantcast, Buxtehude, Germany) in 2008. The LUMiC(®) prosthesis is a modular device, built of a separate stem (hydroxyapatite-coated uncemented or cemented) and acetabular cup...
March 28, 2016: Clinical Orthopaedics and related Research
Bertrand Vedrine, Pierre Guillaumot, Jean-Luc Chancrin
An eight-year-old male English Setter was referred for management of a dislocation of a cemented dual mobility canine total hip prosthesis that occurred four months after the initial surgery. Revision surgery showed that the dislocation was associated with fracture of the ultra-high molecular weight polyethylene liner. The dislocation was successfully reduced after replacing the liner. A dual mobility acetabular component is composed of a mobile polyethylene liner inside a metallic cemented cup. Chronic wear of the components of a canine dual mobility total hip replacement has not been described previously...
May 18, 2016: Veterinary and Comparative Orthopaedics and Traumatology: V.C.O.T
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