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Femoral stem design

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https://www.readbyqxmd.com/read/29756511/surface-integrity-of-polyethylene-liners-following-trunnionosis-of-a-dual-modular-neck-total-hip-implant
#1
Ben Gi Spiegelberg, Brent A Lanting, James L Howard, Matthew G Teeter, Douglas Dr Naudie
BACKGROUND: There has been a trend in the evolution of total hip arthroplasty towards increased modularity; with this increase in modularity come some potentially harmful consequences. Modularity at the neck shaft junction has been linked to corrosion, adverse reaction to metal debris and pseudotumour formation. AIM: The aim of this retrieval study is to assess whether the surface integrity of the polyethylene (PE) liner is affected by metal wear debris in a single implant design series of THA revised for trunnionosis...
May 1, 2018: Hip International: the Journal of Clinical and Experimental Research on Hip Pathology and Therapy
https://www.readbyqxmd.com/read/29738596/relatively-high-complication-and-revision-rates-of-the-mayo-%C3%A2-metaphysical-conservative-femoral-stem-in-young-patients
#2
Tal Frenkel Rutenberg, Yaniv Warshevski, Aviram Gold, Nadav Shasha, Nimrod Snir, Ofir Chechik, Oleg Dolkart, Dynai Eilig, Amir Herman, Ehud Rath, Moti Kramer, Michael Drexler
The Mayo metaphysical conservative femoral stem (Zimmer, Warsaw, Indiana) is a wedge-shaped implant designed to transfer loads proximally, reduce femoral destruction, and enable the preservation of bone stock in the proximal femur. Thus, it is a potentially preferred prosthesis for active, non-elderly patients who may require additional future surgeries. This retrospective case study analyzed the outcomes of consecutive patients who underwent total hip replacements with this stem between May 2001 and February 2013...
May 8, 2018: Orthopedics
https://www.readbyqxmd.com/read/29726298/an-evaluation-of-proximal-femur-bone-density-in-young-active-patients-undergoing-total-hip-arthroplasty-at-one-year-postoperatively
#3
Denis Nam, Rondek Salih, Robert L Barrack, Ryan M Nunley
BACKGROUND: Prior investigations have shown a decrease in periprosthetic bone mineral density (BMD) of the calcar following total hip arthroplasty (THA). The purpose of this investigation was to study proximal femur BMD in a cohort of young, active patients following THA at 1 year postoperatively using a recently introduced stem design. METHODS: This was a prospective, IRB-approved investigation of patients with an age <65 years, BMI <35 kg/m2 , and presymptomatic UCLA score of >6 undergoing a primary THA for a diagnosis of osteoarthritis...
May 1, 2018: Hip International: the Journal of Clinical and Experimental Research on Hip Pathology and Therapy
https://www.readbyqxmd.com/read/29682992/higher-periprosthetic-fracture-rate-associated-with-use-of-modern-uncemented-stems-compared-to-cemented-stems-in-femoral-neck-fractures
#4
Jin Soo A Song, Daryl Dillman, Dave Wilson, Michael Dunbar, Glen Richardson
INTRODUCTION: Hemiarthroplasty is the preferred treatment for displaced femoral neck fractures in elderly patients. Recently, short tapered-wedge cementless stems have increasingly been used in this population. However, historic data has consistently shown higher rates of periprosthetic fracture with uncemented stems in hip fracture patients. This study aims to evaluate the rate of periprosthetic fracture requiring re-operation and all-cause mortality between cemented and uncemented femoral stem designs including more recent short tapered-wedge cementless stems in hip fracture patients...
April 1, 2018: Hip International: the Journal of Clinical and Experimental Research on Hip Pathology and Therapy
https://www.readbyqxmd.com/read/29682286/maximizing-the-fixation-strength-of-modular-components-by-impaction-without-tissue-damage
#5
A Krull, M M Morlock, N E Bishop
Objectives: Taper junctions between modular hip arthroplasty femoral heads and stems fail by wear or corrosion which can be caused by relative motion at their interface. Increasing the assembly force can reduce relative motion and corrosion but may also damage surrounding tissues. The purpose of this study was to determine the effects of increasing the impaction energy and the stiffness of the impactor tool on the stability of the taper junction and on the forces transmitted through the patient's surrounding tissues...
February 2018: Bone & Joint Research
https://www.readbyqxmd.com/read/29663105/cemented-versus-uncemented-hemiarthroplasty-of-the-hip-in-patients-with-a-femoral-neck-fracture-a-comparison-of-two-modern-stem-design-implants
#6
M R M Frenken, M G M Schotanus, E H van Haaren, R Hendrickx
PURPOSE: We wished to compare the outcome of two types of cemented and uncemented modern stem design implants after hemiarthroplasty, with both an Orthopaedic Data Evaluation Panel rating of 10A. METHODS: This retrospective study compares data obtained from two centres, with a total study population of 655 (n = 393 cemented, n = 262 uncemented). Patients were matched at baseline for gender, age, surgery side, American Society of Anesthesiologists score, body mass index and pre-operative haemoglobin level...
April 16, 2018: European Journal of Orthopaedic Surgery & Traumatology: Orthopédie Traumatologie
https://www.readbyqxmd.com/read/29661229/can-arthroplasty-stem-influence-outcome-casino-a-randomized-controlled-equivalence-trial-of-125-mm-versus-150-mm-exeter-v40-stems-in-total-hip-arthroplasty
#7
David F Hamilton, Nicholas E Ohly, Paul Gaston
BACKGROUND: The use of shorter length femoral stems during total hip arthroplasty has been suggested to accommodate wider patient femoral geometry and offer maximal bone preservation. However, cemented short-stem designs may increase the risk of varus stem malalignment and influence patient outcomes. METHODS/DESIGN: CASINO is a multi-centre randomised equivalence trial that will recruit 220 patients undergoing total hip arthroplasty for osteoarthritis at two NHS hospitals in Scotland...
April 16, 2018: Trials
https://www.readbyqxmd.com/read/29657845/long-term-bone-remodelling-around-legendary-cementless-femoral-stems
#8
Charles Rivière, Guido Grappiolo, Charles A Engh, Jean-Pierre Vidalain, Antonia-F Chen, Nicolas Boehler, Jihad Matta, Pascal-André Vendittoli
Bone remodelling around a stem is an unavoidable long-term physiological process highly related to implant design. For some predisposed patients, it can lead to periprosthetic bone loss secondary to severe stress-shielding, which is thought to be detrimental by contributing to late loosening, late periprosthetic fracture, and thus rendering revision surgery more complicated.However, these concerns remain theoretical, since late loosening has yet to be documented among bone ingrowth cementless stems demonstrating periprosthetic bone loss associated with stress-shielding...
February 2018: EFORT Open Reviews
https://www.readbyqxmd.com/read/29657466/a-long-term-comparative-study-between-two-different-designs-of-cemented-stems-distal-cylindrical-versus-distal-taper
#9
Yuki Okutani, Koji Goto, Tomotoshi Kawata, Yaichiro Okuzu, Kazutaka So, Yutaka Kuroda, Shuichi Matsuda
Introduction: The aim of this study was to calculate the wear rate of highly cross-linked polyethylene (HXLPE) and investigate long-term clinical and radiographic outcomes related to two femoral stem designs, the distal-cylindrical (DC) and distal-taper (DT) stems. Materials and methods: Outcomes for the DC and DT stems were evaluated in 110 patients, who underwent total hip arthroplasty using an HXLPE socket, over a 5-year follow-up period. There were 56 hips (53 patients) in the DC group and 60 hips (57 patients) in the DT group...
March 2018: Journal of Orthopaedics
https://www.readbyqxmd.com/read/29644322/conservative-treatment-of-periprosthetic-femur-fractures-around-metaphyseal-short-stems-a-feasible-option
#10
K Toth, H Gality, K Gion, K Sisak
Periprosthetic femoral fractures are rare but significant events following total hip replacement. Metaphyseal short stems have recently been popularized as a bone preserving alternative to conventional uncemented total hip replacement. We present two periprosthetic femur fractures which occurred around two different metaphyseal uncemented stem designs. Successful conservative treatment was possible in both cases achieving bony union and excellent clinical results.
June 2017: Trauma Case Reports
https://www.readbyqxmd.com/read/29608134/hip-stem-fatigue-the-implications-of-increasing-patient-mass
#11
Ashley P Westerman, Andrew R Moor, Martin H Stone, Todd D Stewart
General trends of increasing body mass index have been observed in many western countries along with an increasing demand for joint replacement. Standards have been developed for testing the fatigue properties of femoral stems; however, the loads that these apply are based on a historic patient weight and may not be valid in the current patient population. Several fatigue tests were conducted using distally fixed titanium alloy stems positioned according to the ISO standard but with a cyclic load based on a current 75th percentile patient sample...
May 2018: Proceedings of the Institution of Mechanical Engineers. Part H, Journal of Engineering in Medicine
https://www.readbyqxmd.com/read/29599034/clinical-outcomes-and-bearing-specific-complications-following-fourth-generation-alumina-ceramic-on-ceramic-total-hip-arthroplasty-a-single-surgeon-series-of-749-hips-at-a-minimum-of-5-year-follow-up
#12
Seung-Jae Lim, Hyung-Gon Ryu, Hyeon-Jun Eun, Chan-Woo Park, Kyeu-Back Kwon, Youn-Soo Park
BACKGROUND: The purpose of this study is to evaluate the minimum 5-year outcomes and bearing-specific complications in a single surgeon series of fourth-generation alumina ceramic-on-ceramic total hip arthroplasties (THAs). METHODS: We retrospectively analyzed 667 patients (749 hips) who underwent primary THAs by a single surgeon using fourth-generation alumina ceramic bearings. There were 315 men and 352 women with a mean age of 54.2 years. The surgeon used cementless prostheses with an identical design and BIOLOX Delta ceramics in all hips, using a 36-mm head in 472 hips (63%) and a 32-mm head in 227...
February 17, 2018: Journal of Arthroplasty
https://www.readbyqxmd.com/read/29587147/load-transfer-and-periprosthetic-fractures-after-total-hip-arthoplasty-comparison-of-periprosthetic-fractures-of-femora-implanted-with-cementless-distal-load-or-proximal-load-femoral-components-and-measurement-of-the-femoral-strain-at-the-time-of-implantation
#13
E Schwarz, G Reinisch, A Brandauer, S Aharinejad, W Scharf, K Trieb
BACKGROUND: Little is known about the causes and mechanisms underlying periprosthetic fractures around femoral components particularly in relation to the stem design. In an in vitro study 20 pairs of fresh cadaveric femora were loaded to fracture axially and transversally. FINDINGS: When proximal femoral strain was measured at the time of impaction of cementless stems the load transfer was determined by the underlying anatomy rather than by the shape of the stem, so that the so-called "load transfer" properties - proximal or distal - ascribed to stem designs are a myth...
March 21, 2018: Clinical Biomechanics
https://www.readbyqxmd.com/read/29570762/the-proximal-and-distal-femoral-canal-geometry-influences-cementless-stem-anchorage-and-revision-hip-and-knee-implant-stability
#14
Markus Heinecke, Fabian Rathje, Frank Layher, Georg Matziolis
Although cementless revision arthroplasty of the hip has become the gold standard, revision arthroplasty of the distal femur is controversial. This study evaluated the anchoring principles of different femoral revision stem designs in extended bone defect situations, taking into account the anatomical conditions of the proximal and distal femur, and the resulting primary stability. Cementless press-fit stems of 4 different designs were implanted in synthetic femurs. The specimens were analyzed by computed tomography and were tested considering axial/torsional stiffness and migration resistance...
March 23, 2018: Orthopedics
https://www.readbyqxmd.com/read/29529704/early-experience-with-a-short-tapered-titanium-porous-plasma-sprayed-stem-with-updated-design
#15
Adolph V Lombardi, Antonio G Manocchio, Keith R Berend, Michael J Morris, Joanne B Adams
INTRODUCTION: Short stem femoral components in primary total hip arthroplasty (THA) have increased in popularity since the advent of minimally invasive surgical techniques. The concept of a short stem is particularly compatible with tapered designs where the goal is to offload forces proximally in the femur. The purpose of this retrospective review was to review our early experience with a short, tapered titanium femoral component with updated design features. MATERIALS AND METHODS: Beginning in November 2011 through February 2012, 92 consented patients (93 hips), at a single center, were treated with primary cementless THA using a short stem, tapered femoral component (Taperloc® Complete Microplasty; Zimmer Biomet, Warsaw, Indiana) and were available for review with a minimum two-year follow-up...
March 12, 2018: Surgical Technology International
https://www.readbyqxmd.com/read/29529656/otto-aufranc-award-crosslinking-reduces-tha-wear-osteolysis-and-revision-rates-at-15-year-followup-compared-with-noncrosslinked-polyethylene
#16
Robert H Hopper, Henry Ho, Supatra Sritulanondha, Ann C Williams, Charles A Engh
BACKGROUND: Crosslinked polyethylene (XLPE) liners used for primary THA have demonstrated lower wear rates than noncrosslinked, conventional polyethylene (CPE) liners through the first decade of clinical service. However, little high-quality evidence is currently available regarding the second decade performance of these implants and it remains uncertain whether the onset of osteolysis has simply been delayed or if the wear associated with XLPE liners will remain low enough that osteolysis will not occur...
February 2018: Clinical Orthopaedics and related Research
https://www.readbyqxmd.com/read/29481346/do-stem-design-and-surgical-approach-influence-early-aseptic-loosening-in-cementless-tha
#17
Loes Janssen, Karolina A P Wijnands, Dennis Janssen, Michiel W H E Janssen, Jan W Morrenhof
BACKGROUND: Some studies have revealed an increased risk of early aseptic loosening of cementless stems in THA when inserted through an anterior or anterolateral approach compared with a posterior approach, whereas approach does not appear to be a risk factor in others. Stem design, whether "anatomic" (that is, stems with a curved lateral profile or an obtuse angle at the proximal-lateral portion of the stem) or "shoulder" (that is, straight with a proximal shoulder), may also be associated with a differential risk of aseptic loosening in cementless THA depending on the surgical approach used, but if so, this risk is not well characterized...
February 23, 2018: Clinical Orthopaedics and related Research
https://www.readbyqxmd.com/read/29474948/assessment-of-a-press-fit-proximal-femoral-modular-reconstruction-implant-pfmr-%C3%A2-at-14-5-years-a-48-case-series-with-a-disturbing-rate-of-implant-fracture
#18
Q Dumoulin, S Sabau, T Goetzmann, A Jacquot, F Sirveaux, D Mole, O Roche
INTRODUCTION: The PFMR® proximal femoral modular reconstruction implant (Protek, Sulzer Orthopedics, Switzerland) is a straight modular stem in sanded titanium with press-fit anchorage, intended to achieve spontaneous bone reconstruction following Wagner's principle. The aim of the present study was to analyze long-term clinical and radiological outcome. MATERIAL AND METHOD: A single-center retrospective study included 48 PFMR stems implanted in 47 patients between 1998 and 2002...
May 2018: Orthopaedics & Traumatology, Surgery & Research: OTSR
https://www.readbyqxmd.com/read/29468265/the-tridimensional-geometry-of-the-proximal-femur-should-determine-the-design-of-cementless-femoral-stem-in-total-hip-arthroplasty
#19
Julien Wegrzyn, Jean-Paul Roux, Charlotte Loriau, Nicolas Bonin, Vincent Pibarot
PURPOSE: Using a cementless femoral stem in total hip arthroplasty (THA), optimal filling of the proximal femoral metaphyseal volume (PFMV) and restoration of the extramedullary proximal femoral (PF) parameters (i.e., femoral offset (FO), neck length (FNL), and head height (FHH)) constitute key goals for optimal hip biomechanics, functional outcome, and THA survivorship. However, almost 30% of mismatch between the PF anatomy and implant geometry of the most widely implanted non-modular cementless femoral stem has been demonstrated in a computed tomography scan (CT scan) study...
February 22, 2018: International Orthopaedics
https://www.readbyqxmd.com/read/29381984/periprosthetic-bone-remodeling-of-short-cementless-femoral-stems-in-primary-total-hip-arthroplasty-a-systematic-review-and-meta-analysis-of-randomized-controlled-trials
#20
REVIEW
Shuang G Yan, Di Li, Shuai Yin, Xingyi Hua, Jian Tang, Florian Schmidutz
BACKGROUND: Short-stem total hip arthroplasty (SHA) has been increasingly used in the treatment of hip arthroplasty. However, it is unclear whether there is a superiority of SHA in periprosthetic bone remodeling over standard stem total hip arthroplasty (THA). This meta-analysis of randomized-controlled trials (RCTs) compared the periprosthetic bone remodeling after SHA and THA. METHODS: PubMed and Embase were screened for relevant publications up to May 2017. RCTs that compared periprosthetic bone remodeling with bone mineral density (BMD) changes between SHA and THA were included...
November 2017: Medicine (Baltimore)
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