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Femoral stem design

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https://www.readbyqxmd.com/read/28064103/why-do-some-titanium-alloy-total-hip-arthroplasty-modular-necks-fail
#1
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/28050701/comparing-return-to-sport-activities-after-short-metaphyseal-femoral-arthroplasty-with-resurfacing-and-big-femoral-head-arthroplasties
#2
Panagiotis K Karampinas, Eustratios G Papadelis, John A Vlamis, Hlias Basiliadis, Spiros G Pneumaticos
OBJECTIVES: Young patients feel that maintaining sport activities after total hip arthroplasty constitutes an important part of their quality of life. The majority of hip surgeons allow patients to return to low-impact activities, but significant caution is advised to taking part in high-impact activities. The purpose of this study is to compare and evaluate the post-operative return to daily living habits and sport activities following short-metaphyseal hip and high functional total hip arthroplasties (resurfacing and big femoral head arthroplasties)...
January 3, 2017: European Journal of Orthopaedic Surgery & Traumatology: Orthopédie Traumatologie
https://www.readbyqxmd.com/read/28043711/total-hip-arthroplasty-with-a-fully-hydroxyapatite-coated-stem-a-cohort-study-during-23-28-years
#3
Olav Reikerås
BACKGROUND: Long-term results of a hydroxyapatite (HA)-coated stem are sparse. We have followed a cohort of patients operated with a grit-blasted titanium stem designed for press-fit insertion and entirely plasma-sprayed with HA up to 28 years. METHODS: In the years 1988-1993, we performed 323 primary total hip arthroplasties in 276 patients (189 women). Their mean age was 48 (15-79) years. During the following years, 83 patients with 88 hips have died, and 18 patients did not attend the follow-up examination, but had no major symptoms according to telephone interviews and control examination...
December 18, 2016: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28042119/periprosthetic-femoral-fractures-and-trying-to-avoid-them-what-is-the-contribution-of-femoral-component-design-to-the-increased-risk-of-periprosthetic-femoral-fracture
#4
A V Carli, J J Negus, F S Haddad
AIMS: Periprosthetic femoral fractures (PFF) following total hip arthroplasty (THA) are devastating complications that are associated with functional limitations and increased overall mortality. Although cementless implants have been associated with an increased risk of PFF, the precise contribution of implant geometry and design on the risk of both intra-operative and post-operative PFF remains poorly investigated. A systematic review was performed to aggregate all of the PFF literature with specific attention to the femoral implant used...
January 2017: Bone & Joint Journal
https://www.readbyqxmd.com/read/28042113/not-all-cementless-femoral-stems-are-created-equal-but-the-results-may-be-comparable
#5
S W Carlson, S S Liu, J J Callaghan
AIMS: The aim of this study was to compare the survivorship and radiographic outcomes at ten-year follow-up of three prospective consecutive series of patients each of which received a different design of cementless femoral components for total hip arthroplasty (THA). PATIENTS AND METHODS: In Cohort 1, 91 consecutive patients (100 hips) underwent THA with a cementless porous-coated anatomic femoral stem (PCA) between October 1983 and January 1986. In Cohort 2, 86 consecutive patients (100 hips) underwent THA with an extensively porous-coated cementless femoral stem (Prodigy) between June 1994 and October 1997...
January 2017: Bone & Joint Journal
https://www.readbyqxmd.com/read/28031499/mid-term-outcome-of-total-hip-arthroplasty-using-a-short-stem
#6
Rajesh Malhotra, Vijay Kumar
PURPOSE: To review the outcome of total hip arthroplasty (THA) using a short femoral stem in 33 hips. METHODS: Records of 33 hips in 20 men and 10 women aged 25 to 40 (mean, 30) years who underwent cementless THA using a short femoral stem by a single senior surgeon were reviewed. The diagnosis included avascular necrosis (n=9), ankylosing spondylitis (n=12), rheumatoid arthritis (n=7), posttraumatic arthritis (n=4), and Hurler syndrome (n=1). Clinical outcome was assessed using the Harris Hip Score...
December 2016: Journal of Orthopaedic Surgery
https://www.readbyqxmd.com/read/27900304/clinical-outcome-of-design-modifications-to-the-cls-spotorno-stem-in-total-hip-replacement
#7
Angelo Graceffa, Pier Francesco Indelli, Leonardo Latella, Paolo Poli, Alexander Fulco, Massimiliano Marcucci
PURPOSE: historically, the original CLS Spotorno Stem has demonstrated excellent survival. The design of this stem was recently modified, resulting in the introduction of a shorter, modular version (CLS Brevius). The purpose of the current study was to evaluate the functional, radiological and survivorship outcomes of the cementless CLS Brevius Stem in a multi-surgeon, single center, consecutive series study at two years post-surgery. METHODS: the Authors performed 170 total hip arthroplasties in 155 patients using the shorter, triple-taper stem design (CLS Brevius)...
July 2016: Joints
https://www.readbyqxmd.com/read/27886361/comparison-of-anatomic-vs-straight-femoral-stem-design-in-total-hip-replacement-femoral-canal-fill-in-vivo
#8
Friso A de Boer, Elhadi Sariali
INTRODUCTION: The femoral canal fill between an anatomic and a straight prosthesis design in cementless total hip arthroplasty (THA) was compared. We hypothesised that the anatomic SPS stem has higher proximal fill and lesser distal fill than the straight stem. MATERIAL AND METHODS: The femoral canal fill was measured on 3 months routine postoperative x-rays at 5 levels of the stem in 50 consecutive patients, aged 35-83 years, who underwent 56 THA procedures by a single surgeon in this hospital...
November 22, 2016: Hip International: the Journal of Clinical and Experimental Research on Hip Pathology and Therapy
https://www.readbyqxmd.com/read/27862950/region-specific-effects-of-oestradiol-on-adipose-derived-stem-cell-differentiation-in-post-menopausal-women
#9
Kimberly A Cox-York, Christopher B Erickson, Rocio I Pereira, Daniel H Bessesen, Rachael E Van Pelt
The goal of this study was to determine the effect of acute transdermal 17β-oestradiol (E2 ) on the adipogenic potential of subcutaneous adipose-derived stem cells (ASC) in post-menopausal women. Post-menopausal women (n = 11; mean age 57 ± 4.5 years) were treated for 2 weeks, in a randomized, cross-over design, with transdermal E2 (0.15 mg) or placebo patches. Biopsies of abdominal (AB) and femoral (FEM) subcutaneous adipose tissue (SAT) were obtained after each treatment and mature adipocytes were analysed for cell size and ASC for their capacity for proliferation (growth rate), differentiation (triglyceride accumulation) and susceptibility to tumour necrosis factor alpha-induced apoptosis...
November 15, 2016: Journal of Cellular and Molecular Medicine
https://www.readbyqxmd.com/read/27846875/the-design-of-a-randomised-controlled-trial-to-evaluate-the-cost-effectiveness-of-the-posterolateral-versus-the-direct-anterior-approach-for-tha-polada-trial
#10
K Rykov, I H F Reininga, B A S Knobben, M S Sietsma, B L E F Ten Have
BACKGROUND: Total hip arthroplasty (THA) is one of the most successful orthopaedic procedures. Because of the increasing number of THAs, a growing demand for faster recovery and a greater emphasis on cost-effectiveness, minimally invasive THAs have been introduced in the last decades. The direct anterior approach is a minimally invasive, tissue-sparing approach in which intermuscular planes are used. Theoretically, this approach should result in a faster recovery of physical functioning and higher health-related quality of life...
November 15, 2016: BMC Musculoskeletal Disorders
https://www.readbyqxmd.com/read/27803218/the-exeter-universal-cemented-femoral-stem-at-20-to-25-years-a-report-of-382-hips
#11
T G Petheram, S L Whitehouse, H A Kazi, M J W Hubble, A J Timperley, M J Wilson, J R Howell
AIMS: We present a minimum 20-year follow-up study of 382 cemented Exeter Universal total hip arthroplasties (350 patients) operated on at a mean age of 66.3 years (17 to 94). PATIENTS AND METHODS: All patients received the same design of femoral component, regardless of the original diagnosis. Previous surgery had been undertaken for 33 hips (8.6%). During the study period 218 patients with 236 hips (62%) died, 42 hips (11%) were revised and 110 hips (29%) in 96 patients were available for review...
November 2016: Bone & Joint Journal
https://www.readbyqxmd.com/read/27793497/cementless-tapered-wedge-femoral-stems-decrease-subsidence-in-obese-patients-compared-to-traditional-fit-and-fill-stems
#12
Tanner W Grant, Luke R Lovro, David J Licini, Lucian C Warth, Mary Ziemba-Davis, Robert M Meneghini
BACKGROUND: Femoral component stability and resistance to subsidence is critical for osseointegration and clinical success in cementless total hip arthroplasty. The purpose of this study was to radiographically evaluate the anatomic fit and subsidence of 2 different proximally tapered, porous-coated modern cementless femoral component designs. METHODS: A retrospective cohort study of 126 consecutive cementless total hip arthroplasties was performed. Traditional fit-and-fill stems were implanted in the first 61 hips with the remaining 65 receiving morphometric tapered wedge stems...
September 28, 2016: Journal of Arthroplasty
https://www.readbyqxmd.com/read/27768219/head-neck-taper-corrosion-following-total-hip-arthroplasty-with-stryker-meridian-stem
#13
Sonika Patel, Carl T Talmo, Sumon Nandi
BACKGROUND: Taper corrosion at the modular junctions of total hip arthroplasty (THA) femoral stems are known to cause locally destructive adverse local tissue reaction (ALTR). However, the implants at risk remain to be fully elucidated. CASE REVIEW: We report the case of a 76-year-old woman with hip pain, abductor weakness, and sciatic nerve symptoms 2 years following metal-on-polyethylene THA. Serum cobalt levels were elevated, while chromium levels were normal...
November 10, 2016: Hip International: the Journal of Clinical and Experimental Research on Hip Pathology and Therapy
https://www.readbyqxmd.com/read/27703419/spontaneous-fractures-of-a-modern-modular-uncemented-femoral-stem
#14
Chelsea N Koch, Laura Serrano Mateo, Stephen Kayiaros, Kevin A Cassidy, Seth A Jerabek, Alejandro Gonzalez Della Valle
BACKGROUND: Femoral stem fracture following total hip arthroplasty is an uncommon event that requires immediate revision surgery. QUESTIONS/PURPOSES: We report on four patients who experienced stem fractures of one design and a review of the US Food and Drug Administration adverse event reports on this design. METHODS: Fracture surfaces of four EMPERION™ (Smith & Nephew, Memphis, TN) femoral stems were analyzed under optical and scanning electron microscopy...
October 2016: HSS Journal: the Musculoskeletal Journal of Hospital for Special Surgery
https://www.readbyqxmd.com/read/27694588/the-influence-of-cemented-femoral-stem-choice-on-the-incidence-of-revision-for-periprosthetic-fracture-after-primary-total-hip-arthroplasty-an-analysis-of-national-joint-registry-data
#15
J Palan, M C Smith, P Gregg, S Mellon, A Kulkarni, K Tucker, A W Blom, D W Murray, H Pandit
AIMS: Periprosthetic fracture (PF) after primary total hip arthroplasty (THA) is an uncommon but potentially devastating complication. This study aims to investigate the influence of cemented stem designs on the risk of needing a revision for a PF. PATIENTS AND METHODS: We analysed data on 257 202 primary THAs with cemented stems and 390 linked first revisions for PF recorded in the National Joint Registry (NJR) of England, Wales and Northern Ireland to determine if a cemented femoral stem brand was associated with the risk of having revision for a PF after primary THA...
October 2016: Bone & Joint Journal
https://www.readbyqxmd.com/read/27689504/cementless-hip-implants-an-expanding-choice
#16
Dia Eldean Giebaly, Haider Twaij, Mazin Ibrahim, Fares S Haddad
INTRODUCTION: Total hip replacement is a successful procedure with long survival records compared to other joint arthroplasties. Cemented implants have been available for many years, however the complications associated with loosening and, ultimately, failure over time has led to the development of cementless stems and implants.The ideal prosthesis should recreate a biomechanically normal hip joint, allow pain-free function and last the patient's life span without requiring revision. Optimal results with uncemented femoral stems rely on obtaining initial stability, osseointegration, biological fixation, and uniform stress transfer to the proximal bone...
September 29, 2016: Hip International: the Journal of Clinical and Experimental Research on Hip Pathology and Therapy
https://www.readbyqxmd.com/read/27672012/nonmodular-tapered-fluted-titanium-stems-osseointegrate-reliably-at-short-term-in-revision-thas
#17
Nemandra A Sandiford, Donald S Garbuz, Bassam A Masri, Clive P Duncan
BACKGROUND: The ideal femoral component for revision THA is undecided. Cylindrical nonmodular stems have been associated with stress shielding, whereas junctional fractures have been reported with tapered fluted modular titanium stems. We have used a tapered fluted nonmodular titanium femoral component (Wagner Self-locking [SL] femoral stem) to mitigate this risk. This component has been used extensively in Europe by its designer surgeons, but to our knowledge, it has not been studied in North America...
January 2017: Clinical Orthopaedics and related Research
https://www.readbyqxmd.com/read/27664796/fully-porous-3d-printed-titanium-femoral-stem-to-reduce-stress-shielding-following-total-hip-arthroplasty
#18
Sajad Arabnejad, Burnett Johnston, Michael Tanzer, Damiano Pasini
Current hip replacement femoral implants are made of fully solid materials which all have stiffness considerably higher than that of bone. This mechanical mismatch can cause significant bone resorption secondary to stress shielding, which can lead to serious complications such as peri-prosthetic fracture during or after revision surgery. In this work, a high strength fully porous material with tunable mechanical properties is introduced for use in hip replacement design. The implant macro geometry is based off of a short stem taper-wedge implant compatible with minimally invasive hip replacement surgery...
September 24, 2016: Journal of Orthopaedic Research: Official Publication of the Orthopaedic Research Society
https://www.readbyqxmd.com/read/27646510/high-serum-ion-levels-in-conserve-plus-big-femoral-head-cemented-total-hip-arthroplasty
#19
Jan F A Somers, Catherine Van Der Straeten, Luc De Coninck
AIM: We report the short-term clinical, radiographic and ion level data of the Conserve Plus metal-on-metal (MoM) big femoral head (BFH) total hip arthroplasty (THA), used with a cemented cobalt-chrome (Co-Cr) Profemur Xm stem and a titanium (Ti) modular neck. RESULTS: In a consecutive series of 40 hips, survivorship at 3 years was 92.5% with revision for any reason. Average Harris Hip Score was 91.3. There were no implant loosenings. No osteolysis was observed...
September 29, 2016: Hip International: the Journal of Clinical and Experimental Research on Hip Pathology and Therapy
https://www.readbyqxmd.com/read/27642748/finite-element-analysis-of-cementless-femoral-stems-based-on-mid-and-long-term-radiological-evaluation
#20
Kanehiro Matsuyama, Yasuhiro Ishidou, Yong-Ming Guo, Hironori Kakoi, Takao Setoguchi, Satoshi Nagano, Ichiro Kawamura, Shingo Maeda, Setsuro Komiya
BACKGROUND: Femoral bone remodeling in response to stress shielding induces periprosthetic bone loss. Computerized finite element analysis (FEA) is employed to demonstrate differences in initial stress distribution. However, FEA is often performed without considering the precise sites at which the stem was fixed. We determined whether FEA reflects mid-term radiological examination exactly as predicted following long-term stress shielding. METHODS: Femur-stem fixation sites were evaluated radiologically according to the location of spot welds in two anatomical cementless stem designs...
2016: BMC Musculoskeletal Disorders
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