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Revision hip arthroplasty

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https://www.readbyqxmd.com/read/29166684/-implantation-of-a-modular-distal-femoral-replacement-with-compressive-osseointegration-as-a-salvage-procedure-in-a-complex-femoral-posttraumatic-setting
#1
Anna Janine Schreiner, Peter Marten de Zwart, Christian Arnscheidt, Ulrich Stöckle, Björn Gunnar Ochs
Background Large bone defects and losses play a crucial role in both tumour surgery and in complex primary and revision total knee replacement. The established options of cemented or uncemented long intramedullary stems are limited by large bone defects and are at risk from relatively high exposure to aseptic loosening. There is no general valid agreement on implant fixation of the distal femur. A further option is the cementless fixation method with compressive osseointegration, based on the so-called Wolff law of bone remodelling...
November 22, 2017: Zeitschrift Für Orthopädie und Unfallchirurgie
https://www.readbyqxmd.com/read/29161115/hip-arthroscopic-surgery-for-femoroacetabular-impingement-with-capsular-management-factors-associated-with-achieving-clinically-significant-outcomes
#2
Gregory L Cvetanovich, Alexander E Weber, Benjamin D Kuhns, Jennifer Alter, Joshua D Harris, Richard C Mather, Shane J Nho
BACKGROUND: There has been increasing interest in defining clinically meaningful outcomes in patient reported outcomes following orthopaedic surgery. Little is known about the factors associated with clinically meaningful outcomes after hip arthroscopy for femoroacetabular impingement. STUDY DESIGN: Case-control study; Level of evidence, 3. PURPOSE: To report on a large, prospectively collected consecutive series of patients who underwent comprehensive arthroscopic treatment of femoroacetabular impingement (FAI) and capsular management with greater than 2-year follow-up...
November 1, 2017: American Journal of Sports Medicine
https://www.readbyqxmd.com/read/29160130/the-effect-of-bearing-type-on-the-outcome-of-total-hip-arthroplasty
#3
Rinne M Peters, Liza N Van Steenbergen, Martin Stevens, Paul C Rijk, Sjoerd K Bulstra, Wierd P Zijlstra
Background and purpose - Alternative bearing surfaces such as ceramics and highly crosslinked polyethylene (HXLPE) were developed in order to further improve implant performance of total hip arthroplasties (THAs). Whether these alternative bearing surfaces result in increased longevity is subject to debate. Patients and methods - Using the Dutch Arthroplasty Register (LROI), we identified all patients with a primary, non-metal-on-metal THA implanted in the Netherlands in the period 2007-2016 (n = 209,912). Cumulative incidence of revision was calculated to determine differences in survivorship of THAs according to bearing type: metal-on-polyethylene (MoPE), metal-on-HXLPE (MoHXLPE), ceramic-on-polyethylene (CoPE), ceramic-on-HXLPE (CoHXLPE), ceramic-on-ceramic (CoC), and oxidized-zirconium-on-(HXL)polyethylene (Ox(HXL)PE)...
November 21, 2017: Acta Orthopaedica
https://www.readbyqxmd.com/read/29153632/a-2-to-16-year-clinical-follow-up-of-revision-total-hip-arthroplasty-using-a-new-acetabular-implant-combined-with-impacted-bone-allografts-and-a-cemented-cup
#4
Hampus Stigbrand, Oscar Gustafsson, Gösta Ullmark
BACKGROUND: Treatment of acetabular bone loss with impaction bone grafting (IBG) at revision total hip arthroplasty is highly dependent on mechanical stability and graft compression for clinical success. Here, we describe a new technique to further compress and stabilize the acetabular graft bed with a thin, perforated titanium shell. METHODS: We retrospectively analyzed 170 cases of acetabular revision arthroplasty 7 years (standard deviation 2.8) after IBG combined with a graft-compressing titanium shell implant...
October 10, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/29152495/midterm-outcomes-of-titanium-modular-femoral-necks-in-total-hip-arthroplasty
#5
Thurial Collet, Jean-Pierre Atanasiu, Jean-Baptiste de Cussac, Kamal Oufroukhi, Hugo Bothorel, Mo Saffarini, François Badatcheff
Background: Modular femoral necks present surgical and biomechanical advantages in total hip arthroplasty (THA), but their benefits remain controversial due to risks of corrosion and fracture at the additional junction. This study aimed to report 10-year survival and clinical outcomes of a titanium femoral stem with a titanium modular neck in consecutive series. Methods: The authors reviewed the records of 97 patients (99 THAs) using uncemented modular stem and ceramic-on-ceramic acetabular components...
October 2017: Annals of Translational Medicine
https://www.readbyqxmd.com/read/29151013/decreasing-the-incidence-of-surgical-site-infections-following-joint-replacement-surgery
#6
Lorraine Hutzler, Jarrett Williams
OBJECTIVE: Despite the generalized use of prophylactic antibiotics in orthopaedic surgery, Surgical Site Infections (SSIs) are still a major source of morbidity, mortality, and hospital cost. This is due in part to the increasing prevalence of antibiotic resistant organisms. METHODS: A review of local epidemiology, the importance of an antibiotic stewardship program, patient optimization, and risk stratification options to reduce SSIs. RESULTS: The proportion of revisions due to infection is projected to rise rapidly over the next 25 years...
December 2017: Bulletin of the Hospital for Joint Diseases
https://www.readbyqxmd.com/read/29145010/the-use-of-hardened-bone-cement-as-an-impaction-grafting-extender-for-revision-hip-arthroplasty
#7
Mark Ruddy, David P FitzPatrick, Kenneth T Stanton
Impaction bone grafting is a method of restoring bone stock to patients who have suffered significant bone loss due to revision total hip surgery. The procedure requires morsellised cancellous bone (MCB) to be impacted into the site of bone loss in order to stabilise the prosthesis with the aim of long term resorption and reintegration of the impacted bone graft. Due to financial cost and the potential to transmit disease, the use of supplementary material, known as an extender, is frequently used to increase the graft material volume...
November 13, 2017: Journal of the Mechanical Behavior of Biomedical Materials
https://www.readbyqxmd.com/read/29137901/impact-of-femoral-stem-design-on-failure-after-anterior-approach-total-hip-arthroplasty
#8
Krishna R Cidambi, Steven L Barnett, Paige R Mallette, Jay J Patel, Nader A Nassif, Robert S Gorab
BACKGROUND: An increased rate of complications related to femoral component failure has been described with less invasive total hip arthroplasty (THA). This study evaluated the incidence of femoral complications associated with the direct anterior approach for THA. METHODS: Retrospective review was performed of the initial 1120 consecutive patients who underwent direct anterior THA by 2 surgeons. RESULTS: A total of 899 patients (80.3%) had a 2-year follow-up (range, 2-8 years)...
November 11, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/29136258/ultra-short-versus-conventional-uncemented-stems-for-hip-replacement-in-octogenarians
#9
Young-Hoo Kim, Jang-Won Park, Jun-Shik Kim
The aim of this study was to determine how an ultra-short anatomic uncemented stem vs a diaphyseal filling five-eighths porous coated uncemented femoral stem (conventional stem) affects the survival of primary total hip arthroplasties in octogenarians. The current study consisted of 52 patients (55 hips) in the ultra-short stem group (mean age, 85.5±5.3 years) and 61 patients (72 hips) in the diaphyseal (conventional) stem group (mean age, 84.1±4.8 years). The predominant diagnosis was osteoarthritis, followed by osteonecrosis of the femoral head, in both groups...
November 11, 2017: Orthopedics
https://www.readbyqxmd.com/read/29135673/myocardial-cobalt-levels-are-elevated-in-the-setting-of-total-hip-arthroplasty
#10
Cody C Wyles, T Carson Wright, Melanie C Bois, Md Shahrier Amin, Ahmed Fayyaz, Sarah M Jenkins, Saranya P Wyles, Patrick L Day, David L Murray, Robert T Trousdale, Nandan S Anavekar, William D Edwards, Joseph J Maleszewski
BACKGROUND: Arthroplasty implants commonly contain elemental metal that may undergo wear-related release. Recently, cases of hip implant-associated myocardial injury have been reported. However, we are not aware of any previous study that has systematically measured myocardial metal levels or examined the relationship with total hip arthroplasty (THA). METHODS: Archives of our institution were queried for autopsies of individuals who had undergone THA between 1990 and 2013...
November 15, 2017: Journal of Bone and Joint Surgery. American Volume
https://www.readbyqxmd.com/read/29135667/nationwide-analysis-of-femoral-neck-fractures-in-elderly-patients-a-receding-tide
#11
Derek G Ju, Sean S Rajaee, James Mirocha, Carol A Lin, Charles N Moon
BACKGROUND: Geriatric femoral neck fractures are associated with substantial morbidity and medical cost. We evaluated the incidence and management trends of femoral neck fractures in recent years in the U.S. METHODS: Patient data from 2003 through 2013 were obtained from the Nationwide Inpatient Sample database. Femoral neck fractures in patients ≥65 years old were identified and grouped using the International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) procedure codes for internal fixation, hemiarthroplasty, or total hip arthroplasty (THA)...
November 15, 2017: Journal of Bone and Joint Surgery. American Volume
https://www.readbyqxmd.com/read/29135666/total-hip-arthroplasty-with-use-of-the-cementless-zweym%C3%A3-ller-alloclassic-system-a-concise-follow-up-at-a-minimum-of-25-years-of-a-previous-report
#12
Ana Cruz-Pardos, Eduardo García-Rey, Eduardo García-Cimbrelo
We previously reported the 10 to 13-year follow-up results for 104 total hip replacements with the Zweymüller Alloclassic stem and a threaded cup in 94 patients. The present study is a clinical and radiographic outcome update after a minimum follow-up of 25 years. Four patients (4 hips) were lost and 46 patients (50 hips) died, leaving 44 patients (50 hips) available for follow-up. Since our previous report, 7 cups and 2 stems were revised. At 20 years, the probability of survival of any component was 84.1% (95% confidence interval [CI], 73...
November 15, 2017: Journal of Bone and Joint Surgery. American Volume
https://www.readbyqxmd.com/read/29132552/intravenous-drug-abuse-is-a-risk-factor-in-the-failure-of-two-stage-treatment-for-infected-total-hip-arthroplasty
#13
Yu-Jie Su, Sung-Yen Lin, Hsuan-Ti Huang, Je-Ken Chang, Chung-Hwan Chen
Reinfection after two-stage revision hip arthroplasty (RHA) is still a complex issue. Only few studies revealed the factors affecting the success rate in the treatment of periprosthetic hip infection (PHI), especially risk factors. A retrospective study was conducted using records of 30 patients underwent two-stage RHA for infected total hip arthroplasty (THA). Treatment was defined as successful if a patient did not need any reoperation or invasive procedure such as image-guided drainage during the two years after reimplantation...
December 2017: Kaohsiung Journal of Medical Sciences
https://www.readbyqxmd.com/read/29119371/risk-of-revision-and-dislocation-in-single-dual-mobility-and-large-femoral-head-total-hip-arthroplasty-systematic-review-and-network-meta-analysis
#14
Kwanchai Pituckanotai, Alisara Arirachakaran, Harit Tuchinda, Chinundorn Putananon, Nitiphol Nualsalee, Kittipong Setrkraising, Jatupon Kongtharvonskul
Postoperative dislocation is a challenging complication after total hip arthroplasty (THA) that affects patient outcome worldwide. Instability is one of the main complications with rates exceeding 20% in some series. Currently, alternative acetabular components are available with dual mobility (DMTHA) bearing surfaces and larger femoral head size that may reduce the risk of dislocation, yet provide the functional benefit of standard single mobility (STHA) bearing surface THA. However, whether STHA, big femoral head (BTHA) and DMTHA should be used is still controversial...
November 8, 2017: European Journal of Orthopaedic Surgery & Traumatology: Orthopédie Traumatologie
https://www.readbyqxmd.com/read/29116392/anchoring-and-resulting-primary-stability-of-a-kinked-compared-to-a-straight-uncemented-femoral-stem
#15
Markus Heinecke, Fabian Rathje, Frank Layher, Georg Matziolis
INTRODUCTION: The number of revision hip arthroplasties being performed is growing and implantation of a cementless stem has become established as the gold standard. For producing a primary stability, the press-fit procedure is the method of choice, but also can be achieved by multiple-point impactions. Specific femoral stems should follow the anatomical shape and provide a more extensive anchorage. The objective of this study was to evaluate the type, localization of the impaction and resulting primary stability of two different femoral revision stem designs (kinked vs...
November 7, 2017: Archives of Orthopaedic and Trauma Surgery
https://www.readbyqxmd.com/read/29116325/age-and-early-revision-after-primary-total-hip-arthroplasty-for-osteoarthritis
#16
Zachary Meyer, Geneva Baca, Richard Rames, Robert Barrack, John Clohisy, Denis Nam
Prior reports have noted an increased risk of early revision among younger patients undergoing total hip arthroplasty (THA) but have been confounded by the inclusion of various diagnoses. The purpose of this study was to assess the revision rate and the time to revision for patients undergoing THA for osteoarthritis based on age. Patients with a diagnosis of osteoarthritis who underwent both primary and revision THA at the same institution were identified. The time between primary and revision surgery and the indication for revision were collected...
November 1, 2017: Orthopedics
https://www.readbyqxmd.com/read/29114642/two-stage-treatment-of-a-large-pelvic-cystic-pseudotumor-in-a-metal-on-metal-total-hip-arthroplasty
#17
Umberto Cottino, Federico Dettoni, Salvatore Risitano, Antonio Marmotti, Roberto Rossi
The authors report a case of a huge cystic pseudotumor, surrounding a failed metal-on-metal total hip arthroplasty (THA). The cyst surrounded the hip anteriorly, occupied part of the anterior portion of the thigh, and extended to the anterolateral aspect of the abdomen. The case was treated by a two-stage procedure. The first stage consisted of a percutaneous drainage of the fluid content of the cyst (∼1,200 mL). This procedure reduced the risk of tearing the cyst capsule spreading the liquid in the tissues surrounding the THA, and in the abdomen...
June 2017: Joints
https://www.readbyqxmd.com/read/29113756/fretting-and-corrosion-damage-in-retrieved-metal-on-polyethylene-modular-total-hip-arthroplasty-systems-what-is-the-importance-of-femoral-head-size
#18
Matthew P Siljander, Erin A Baker, Kevin C Baker, Meagan R Salisbury, Clayton C Thor, James J Verner
BACKGROUND: Fretting and corrosion at the modular femoral head-femoral neck (taper) interface have been reported in retrieved total hip arthroplasty (THA) prostheses. This study investigated associations among implant design, radiographic factors, and patient factors with corrosion and fretting at the taper interface in retrieved metal-on-polyethylene modular THA prostheses. METHODS: Ninety-two retrieved primary metal-on-polyethylene THA implants were evaluated and graded for fretting, corrosion, and damage at the taper interface, including the femoral stem trunnion and femoral head...
October 16, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/29113670/primary-arthroplasty-in-healed-osteoarticular-allograft-in-patients-with-history-of-primary-femoral-bone-tumors
#19
Bianca M Verbeek, Courtney L Kaiser, Nuno Rui Paulino Pereira, Francis J Hornicek, Kevin A Raskin, Joseph H Schwab, Santiago A LozanoCalderón
BACKGROUND: Roughly 25-35% of patients who are treated with osteoarticular allograft for primary bone sarcomas or aggressive benign bone tumors require surgery in the long-term due to degenerative changes of the articular surface of the allograft. There are three established methods of reconstruction for this complication; a total hip arthroplasty (THA) or total knee arthroplasty (TKA) in the retained osteoarticular allograft, a proximal or distal endoprosthesis after removal of the allograft, and an allograft-prosthesis composite (APC)...
December 2017: Surgical Oncology
https://www.readbyqxmd.com/read/29111845/pre-clinical-evaluation-of-the-mechanical-properties-of-a-low-stiffness-cement-injectable-hip-stem
#20
Ibrahim Eldesouky, Ola Harrysson, Denis J Marcellin-Little, Harvey West, Hassan El-Hofy
In total hip arthroplasty (THA), the femoral stem can be fixed with or without bone cement. Cementless stem fixation is recommended for young and active patients as it eliminates the risk of loss of fixation at the bone-cement and cement-implant interfaces. Cementless fixation, however, suffers from a relatively high early revision rate. In the current research, a novel low-stiffness hip stem was designed, fabricated and tested. The stem design provided the option to inject biodegradable bone cement that could enhance initial stem stability...
November 7, 2017: Journal of Medical Engineering & Technology
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