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https://www.readbyqxmd.com/read/29321813/novel-concept-of-a-modular-hip-implant-could-contribute-to-less-implant-failure-in-tha-a-hypothesis
#1
Ronny Grunert, Stefan Schleifenbaum, Robert Möbius, Michael Kopper, Christian Rotsch, Welf-Guntram Drossel, Niels Hammer, Torsten Prietzel
Background: The modularity in total hip arthroplasty (THA) allows orthopaedic surgeons for an exact reconstruction of hip biomechanical parameters especially in revision and tumor arthroplasty. Modular structured femoral stems using taper junctions showed increased implant breakage in the recent past. Presentation of the hypothesis: We hypothesize that a novel modular stem-neck-interface leads to less implant breakage compared to conventional femoral stems. Testing of the hypothesis: For this purpose, a novel modular femoral stem for THA was to design and manufacture...
2018: Patient Safety in Surgery
https://www.readbyqxmd.com/read/29260384/predictive-factors-for-metal-ion-levels-in-metal-on-metal-total-hip-arthroplasty
#2
Maximilian F Kasparek, Lisa Renner, Martin Faschingbauer, Wenzel Waldstein, Michael Weber, Friedrich Boettner
INTRODUCTION: Although metal-on-metal (MoM) total hip arthroplasty (THA) and hip resurfacings (HR) have similar bearing surfaces and comparable wear rates, metal ion levels and risk of failure are higher for MoM-THA. The mechanism behind the increased metal ion levels in large head MoM-THA is not completely understood. The current study aims to identify predictive factors for increased metal ion levels in unilateral and bilateral large head MoM-THA. MATERIALS AND METHODS: 99 Birmingham modular MoM-THA in 87 patients with metal ion levels at least 36 months after index procedure were analyzed...
December 19, 2017: Archives of Orthopaedic and Trauma Surgery
https://www.readbyqxmd.com/read/29152495/midterm-outcomes-of-titanium-modular-femoral-necks-in-total-hip-arthroplasty
#3
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/29113756/fretting-and-corrosion-damage-in-retrieved-metal-on-polyethylene-modular-total-hip-arthroplasty-systems-what-is-the-importance-of-femoral-head-size
#4
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/29098102/compression-of-the-femoral-vessels-by-a-pseudotumor-after-metal-on-metal-total-hip-arthroplasty
#5
Yasuaki Tamaki, Tomohiro Goto, Takahiko Tsutsui, Tomoya Takasago, Keizo Wada, Koichi Sairyo
Here we present a case of pseudotumor following total hip arthroplasty (THA) that resulted in a circulatory disturbance caused by compression of the femoral vasculature. A 63-year-old man presented with pain, swelling, and redness of the left leg 5 years after primary metal-on-metal THA using the AML-Plus stem, Pinnacle® acetabular cup, and 36 mm diameter Ultamet™ metal head system (DePuy Orthopaedics, Warsaw, IN). Enhanced computed tomography and magnetic resonance imaging revealed a large cystic lesion extending from the left hip anteriorly to the intrapelvic region and compressing the left femoral vessels...
2017: Case Reports in Orthopedics
https://www.readbyqxmd.com/read/29048694/effect-of-sleeved-ceramic-femoral-heads-on-titanium-ion-release
#6
Anthony Deny, Janie Barry, Jonathan R B Hutt, Martin Lavigne, Vincent Massé, Pascal-André Vendittoli
INTRODUCTION: Metal ion release from wear and corrosion at the femoral head-stem taper junction can evoke local adverse reactions to metal debris (ARMD). In a specific large-diameter head (LDH) total hip arthroplasty (THA) system, ceramic femoral heads of 44 to 48 mm are available with a titanium (Ti) adaptor sleeve, while heads of 36- to 40-mm come without sleeves. The hypothesis of this study is that the Ti adaptor sleeve with LDH ceramic-on-ceramic (CoC) bearings will not cause wear or corrosion at the taper junction and, thus, will not generate high whole blood Ti ion levels...
October 16, 2017: Hip International: the Journal of Clinical and Experimental Research on Hip Pathology and Therapy
https://www.readbyqxmd.com/read/29033155/does-the-additional-articulation-in-retrieved-bipolar-hemiarthroplasty-implants-decrease-trunnionosis-compared-to-total-hip-arthroplasty
#7
Christopher Del Balso, Matthew G Teeter, Sok C Tan, Brent A Lanting, James L Howard
BACKGROUND: Trunnionosis at the modular head-neck taper interface in metal-on-polyethylene total hip arthroplasty (MoP THA) has been shown to occur, and represents a potential mode of MoP THA failure. The purpose of the present investigation is to elucidate differences in fretting and corrosion at the head-neck taper interface of prostheses retrieved from bipolar hemiarthroplasty (BH) and MoP THA. METHODS: A retrieval analysis of BH and MoP THA prostheses featuring a single taper design from a single manufacturer and in vivo for a minimum 2 years was performed...
August 31, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28983216/ceramic-bearings-with-titanium-adapter-sleeves-implanted-during-revision-hip-arthroplasty-show-minimal-fretting-or-corrosion-a-retrieval-analysis
#8
Chelsea N Koch, Mark Figgie, Mark P Figgie, Marcella E Elpers, Timothy M Wright, Douglas E Padgett
BACKGROUND: The BIOLOX® option system, consisting of a BIOLOX® delta ceramic femoral head with a titanium alloy adapter sleeve, is being increasingly utilized in revision hip arthroplasty. The sleeve protects the ceramic head from fracture and improper motion about the stem trunnion when a damaged trunnion is encountered at revision surgery. Corrosion and fretting due to metal-metal contact at the taper region of hip prosthesis create the potential of causing periprosthetic osteolysis and adverse local tissue reactions...
October 2017: HSS Journal: the Musculoskeletal Journal of Hospital for Special Surgery
https://www.readbyqxmd.com/read/28884275/alloy-microstructure-dictates-corrosion-modes-in-tha-modular-junctions
#9
COMPARATIVE STUDY
Robin Pourzal, Deborah J Hall, Jonas Ehrich, Stephanie M McCarthy, Mathew T Mathew, Joshua J Jacobs, Robert M Urban
BACKGROUND: Adverse local tissue reactions (ALTRs) triggered by corrosion products from modular taper junctions are a known cause of premature THA failure. CoCrMo devices are of particular concern because cobalt ions and chromium-orthophosphates were shown to be linked to ALTRs, even in metal-on-polyethylene THAs. The most common categories of CoCrMo alloy are cast and wrought alloy, which exhibit fundamental microstructural differences in terms of grain size and hard phases. The impact of implant alloy microstructure on the occurring modes of corrosion and subsequent metal ion release is not well understood...
December 2017: Clinical Orthopaedics and related Research
https://www.readbyqxmd.com/read/28878517/comparison-of-metal-ion-levels-in-patients-with-hip-resurfacing-versus-total-hip-arthroplasty
#10
Craig W Forsthoefel, Nicholas M Brown, Mark L Barba
Mechanical wear at the articular surface and corrosive processes at modular junctions, such as the trunnion, are responsible for metal ions production. We retrospectively reviewed 64 patients who underwent THA with a metal on metal bearing surface and 34 patients with hip Resurfacing. Metal ion measurements, six-week post-op radiographs, and functional scores were included in the analysis. Cobalt ion levels were significantly elevated in THA patients, 2.95 μg/L as compared to resurfacing patients, (2.95 versus 1...
December 2017: Journal of Orthopaedics
https://www.readbyqxmd.com/read/28566326/retrieval-analysis-of-metal-and-ceramic-femoral-heads-on-a-single-cocr-stem-design
#11
A Di Laura, H Hothi, J Henckel, I Swiatkowska, M H L Liow, Y-M Kwon, J A Skinner, A J Hart
OBJECTIVES: The use of ceramic femoral heads in total hip arthroplasty (THA) has increased due to their proven low bearing wear characteristics. Ceramic femoral heads are also thought to reduce wear and corrosion at the head-stem junction with titanium (Ti) stems when compared with metal heads. We sought to evaluate taper damage of ceramic compared with metal heads when paired with cobalt chromium (CoCr) alloy stems in a single stem design. METHODS: This retrieval study involved 48 total hip arthroplasties (THAs) with CoCr V40 trunnions paired with either CoCr (n = 21) or ceramic (n = 27) heads...
May 2017: Bone & Joint Research
https://www.readbyqxmd.com/read/28511949/serum-metal-levels-for-diagnosis-of-adverse-local-tissue-reactions%C3%A2-secondary-to-corrosion-in-metal-on-polyethylene-total%C3%A2-hip%C3%A2-arthroplasty
#12
Yale A Fillingham, Craig J Della Valle, Daniel D Bohl, Mick P Kelly, Deborah J Hall, Robin Pourzal, Joshua J Jacobs
BACKGROUND: Recently, corrosion at the head-neck junction in metal-on-polyethylene bearing surface total hip arthroplasty (THA) has been recognized as a cause of adverse local tissue reactions (ALTRs). Serum metal levels have been advocated as a tool for the diagnosis of ALTR; however, no prior studies have specifically examined their utility. The purpose of this study was to determine the optimal cutoff values for serum cobalt and chromium levels in diagnosing ALTR after metal-on-polyethylene bearing surface THA...
April 20, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28479059/comparison-of-pre-revision-magnetic-resonance-imaging-and-operative-findings-in-mechanically-assisted-crevice-corrosion-in-symptomatic-metal-on-polyethylene-total-hip-arthroplasties
#13
Pavel P Morozov, Munib Sana, Brian J McGrory, Steven W Farraher, Tod G Abrahams
BACKGROUND: Failed total hip arthroplasty (THA) caused by mechanically assisted crevice corrosion (MACC) has serious consequences-notably, adverse local tissue reactions. Metal artifact reduction sequence (MARS) magnetic resonance imaging (MRI) has been used to evaluate failed THA for other reasons but has not been assessed for the analysis of cases of MACC in the setting of metal-on-polyethylene arthroplasties. METHODS: We examined the correlation between preoperative MARS MRI and surgical findings in a cohort of 20 consecutive patients undergoing revision THA for symptomatic MACC without other associated orthopedic diagnoses...
March 18, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28457759/modular-neck-vs-nonmodular-femoral-stems-in-total-hip-arthroplasty-clinical-outcome-metal-ion-levels-and-radiologic-findings
#14
Rasmus T Mikkelsen, Marianne Fløjstrup, Christian Lund, Per Kjærsgaard-Andersen, Thomas Skjødt, Claus Varnum
BACKGROUND: Modular neck femoral stem (MNFS) for total hip arthroplasty (THA) was introduced to optimize the outcome, but created concerns about pain, elevated blood metal ion levels, and adverse reaction to metal debris such as pseudotumors (PTs), related to corrosion between femoral neck and stem. We compared these outcomes in patients with MNFS or nonmodular femoral stem (NFS) THA. METHODS: Thirty-three patients with unilateral MNFS THA were compared with 30 patients with unilateral NFS THA...
September 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28392135/ten-year-cross-sectional-study-of-mechanically-assisted-crevice-corrosion-in-1352-consecutive-patients-with-metal-on-polyethylene-total-hip-arthroplasty
#15
Daniel K Hussey, Brian J McGrory
BACKGROUND: Mechanically assisted crevice corrosion (MACC) in metal-on-polyethylene total hip arthroplasty (THA) is of concern, but its prevalence, etiology, and natural history are incompletely understood. METHODS: From January 2003 to December 2012, 1352 consecutive THA surgeries using a titanium stem, cobalt-chromium alloy femoral head, and highly cross-linked polyethylene liner from a single manufacturer were performed. Patients were followed at 1-year and 5-year intervals for surveillance, but also seen earlier if they had symptoms...
August 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28167873/corrosion-of-the-head-stem-taper-junction-are-we-on-the-verge-of-an-epidemic-review-article
#16
REVIEW
Michael Morlock, Dennis Bünte, Julian Gührs, Nicholas Bishop
BACKGROUND: The modular head taper junction has contributed to the success of total hip arthroplasty (THA) greatly. Taper corrosion and wear problems reported for large and extra-large metal-on-metal bearings as well as for bi-modular THA stems have cast doubt on the benefit of the taper interface. Presently, corrosion problems are being reported for nearly all kinds of artificial hip joints incorporating metal heads, questioning taper connections in general. QUESTIONS/PURPOSES: This study aimed to review the mechanical and electrochemical relationships that may lead to taper corrosion, which have been reported more commonly in recent literature, and to also review the contribution of patient characteristics and surgical techniques involved in taper assembly that may contribute to the problem...
February 2017: HSS Journal: the Musculoskeletal Journal of Hospital for Special Surgery
https://www.readbyqxmd.com/read/28087160/mri-retrieval-analysis-and-histologic-evaluation-of-adverse-local-tissue-reaction-in-metal-on-polyethylene-total-hip-arthroplasty
#17
Scott R Nodzo, Christina I Esposito, Hollis G Potter, Chitranjan S Ranawat, Timothy M Wright, Douglas E Padgett
BACKGROUND: The severity and location of adverse local tissue reaction (ALTR) seen in metal-on-polyethylene total hip arthroplasty (THA) is not well described. METHODS: We retrospectively reviewed the records of patients who underwent a revision THA using our biomechanics database. We included all patients who underwent revision surgery for the diagnosis of ALTR with THA implants that had modularity solely at the head-neck junction and excluded patients with implant modularity at sites other than the head-neck junction...
May 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28065626/choosing-a-femoral-head-a-survey-study-of-academic-adult-reconstructive-surgeons
#18
Sumon Nandi, Matthew S Austin
BACKGROUND: Our aim was to examine how academic adult reconstructive surgeons have interpreted evidence on femoral head material in total hip arthroplasty (THA). METHODS: A 16-question survey to evaluate attitudes toward ceramic and cobalt-chrome head use was emailed to 274 faculty at 42 US adult reconstruction fellowship programs. RESULTS: With 116 respondents, the response rate was 42.2%. Faculty use ceramic heads 72.9% of the time. The most common reason why respondents do not use ceramic heads is cost (44...
May 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28064103/why-do-some-titanium-alloy-total-hip-arthroplasty-modular-necks-fail
#19
Samo K Fokter, Andrej Moličnik, Rajko Kavalar, Primož Pelicon, Rebeka Rudolf, Nenad Gubeljak
BACKGROUND: Increased modularity in total hip arthroplasty (THA) through extra junction between the neck and the femoral stem is gaining popularity among orthopaedic community. However, the advantage of the additional junction is shadowed by an increased risk of mechanical failure. The aim of this study was to describe the exact mechanism of fracture of the modular femoral neck in an uncemented stem. METHODS: Clinical, metallurgical, and mechanical analysis including finite-element modelling and elemental-sensitive tissue analysis with the micro-PIXE method was performed on two patients treated with fully modular primary THA made from Titanium alloy of the same oval taper-cone design...
December 27, 2016: Journal of the Mechanical Behavior of Biomedical Materials
https://www.readbyqxmd.com/read/28041772/elevated-intra-articular-cobalt-and-chromium-levels-in-mechanically-assisted-crevice-corrosion-in-metal-on-polyethylene-total-hip-arthroplasty
#20
Brian J McGrory, Abigail M Payson, Johanna A MacKenzie
BACKGROUND: Failed total hip arthroplasty (THA) caused by mechanically assisted crevice corrosion (MACC) has serious consequences such as adverse local tissue reaction (ALTR). Serum cobalt (Co) and chromium (Cr) ion levels have been used to diagnose taper corrosion, but have not been shown to be an accurate measure of the severity of MACC or associated ALTRs. Additionally, elevated serum ions are not specific in patients with multiple artificial joints. METHODS: We examined the relationship between serum and intra-articular (IA) Co and Cr levels in a cohort of 20 patients undergoing revision THA, 16 who had symptomatic MACC...
May 2017: Journal of Arthroplasty
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