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Femoral stem design

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https://www.readbyqxmd.com/read/28300706/tapered-stems-one-third-proximally-coated-have-higher-complication-rates-than-cylindrical-two-third-coated-stems-in-patients-with-high-hip-dislocation-undergoing-total-hip-arthroplasty-with-step-cut-shortening-osteotomy
#1
Vahit Emre Ozden, Goksel Dikmen, Burak Beksac, Ismail Remzi Tozun
BACKGROUND: The results of cementless stems in total hip arthroplasty (THA) done because of congenital dislocation with step-cut osteotomy is not well known, particularly the influence of the design and the role of extent of porous coating. Therefore we performed a retrospective study to evaluate the mid to long-term results THA performed with a single type acetabular component and different geometry and fixation type stems with ceramic bearings in the setting of step-cut subtrochanteric osteotomy in high hip dislocated (HHD) patients...
March 11, 2017: Orthopaedics & Traumatology, Surgery & Research: OTSR
https://www.readbyqxmd.com/read/28283706/three-dimensional-analysis-of-the-proximal-anterior-femoral-flare-and-torsion-anatomic-bases-for-metaphyseally-fixed-short-stems-design
#2
Elhadi Sariali, Yohan Knaffo
PURPOSE: The use of femoral stems with a short metaphyseal fixation may lead to fractures or subsidence. Such failures may be related to a mismatch between the torsions or the sagittal flares of the stem and the femur. The goal of our study was to perform a 3D analysis of the proximal metaphyseal femur anatomy with a special focus on the anterior proximal flare and torsion. Such data may help to detect the outlier patients for whom a short metaphyseal fixation should be avoided. METHODS: A prospective study included 80 consecutive patients who underwent a primary cementless THA with a 3D CT-scan based pre-operative planning...
March 10, 2017: International Orthopaedics
https://www.readbyqxmd.com/read/28271719/micromotion-induced-peri-prosthetic-fluid-flow-around-a-cementless-femoral-stem
#3
Valérie Malfroy Camine, Alexandre Terrier, Dominique P Pioletti
Micromotion-induced interstitial fluid flow at the bone-implant interface has been proposed to play an important role in aseptic loosening of cementless implants. High fluid velocities are thought to promote aseptic loosening through activation of osteoclasts, shear stress induced control of mesenchymal stem cells differentiation, or transport of molecules. In this study, our objectives were to characterize and quantify micromotion-induced fluid flow around a cementless femoral stem using finite element modeling...
March 8, 2017: Computer Methods in Biomechanics and Biomedical Engineering
https://www.readbyqxmd.com/read/28262457/trochantoplasty-for-total-hip-arthroplasty-in-patients-with-coxa-vara-deformity
#4
Jun-Il Yoo, Javad Parvizi, Ji-Ung Song, Yong-Chan Ha, Young-Kyun Lee, Kyung-Hoi Koo
BACKGROUND: In total hip arthroplasty (THA) of hips with coxa vara, the femoral stems might be inserted in a varus alignment. To avoid varus insertion, we designed a technique, which we termed "trochantoplasty." In this procedure, the medial half of the greater trochanter was removed during THA. METHODS: We evaluated 30 patients (31 hips) who had coxa vara deformity and underwent THA using trochantoplasty at the mean follow-up of 5 years (range, 3-9 years). RESULTS: All stems were inserted in the neutral position...
February 14, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28249969/assessment-of-the-equivalence-of-a-generic-to-a-branded-femoral-stem
#5
H Hothi, J Henckel, P Shearing, T Holme, A Cerquiglini, A Di Laura, A Atrey, J Skinner, A Hart
AIMS: The aim of this study was to compare the design of the generic OptiStem XTR femoral stem with the established Exeter femoral stem. MATERIALS AND METHODS: We obtained five boxed, as manufactured, implants of both designs at random (ten in total). Two examiners were blinded to the implant design and independently measured the mass, volume, trunnion surface topography, trunnion roughness, trunnion cone angle, Caput-Collum-Diaphyseal (CCD) angle, femoral offset, stem length, neck length, and the width and roughness of the polished stem shaft using peer-reviewed methods...
March 2017: Bone & Joint Journal
https://www.readbyqxmd.com/read/28194710/exchangeable-femoral-neck-dual-modular-tha-prostheses-have-poorer-survivorship-than-other-designs-a-nationwide-cohort-of-324-108-patients
#6
Sandrine Colas, Assia Allalou, Antoine Poichotte, Philippe Piriou, Rosemary Dray-Spira, Mahmoud Zureik
BACKGROUND: Exchangeable neck stems, defined as those with a dual taper (that is, a modular junction between the femoral head and the femoral neck and an additional junction between the neck and the stem body), were introduced in THA to improve restoration of joint biomechanics (restoring anteversion, offset, and limb length) and reduce the risk of dislocation. However exchangeable necks have been reported to result in adverse effects such as stem fractures and acute local tissue reaction...
February 13, 2017: Clinical Orthopaedics and related Research
https://www.readbyqxmd.com/read/28176355/strain-shielding-inspired-re-design-of-proximal-femoral-stems-for-total-hip-arthroplasty
#7
Myriam Cilla, Sara Checa, Georg N Duda
A large number of hip prosthesis with different designs have been developed. However, the influence of hip implant design changes on the strains induced in the bone remains unclear. The purpose of this study is to better understand the mechanics of short stem total hip arthroplasty. Specifically, it investigates whether strain shielding can be avoided by changing implant shape and/or material properties. It is hypothesized that the re-design of existing implant designs can result in further reduction of strain shielding and thus keep bone loss minimal following total hip replacement...
February 8, 2017: Journal of Orthopaedic Research: Official Publication of the Orthopaedic Research Society
https://www.readbyqxmd.com/read/28167872/characterization-of-femoral-head-taper-corrosion-features-using-a-22-year-retrieval-database
#8
Jacob Cartner, Patrick Aldinger, Chenxi Li, David Collins
BACKGROUND: Modularity in total hip arthroplasty has been used for decades with great success, but new findings regarding corrosion artifacts have caused a resurgence in tapered junction research. Mechanically assisted crevice corrosion (MACC) is thought to be the mechanism by which corrosive attack occurs. Myriad multi-factorial variables are known to influence the susceptibility of a modular taper junction to MACC. Some of these variables are design and manufacture related and others can be controlled by the surgeon...
February 2017: HSS Journal: the Musculoskeletal Journal of Hospital for Special Surgery
https://www.readbyqxmd.com/read/28165591/stable-migration-pattern-of-an-ultra-short-anatomical-uncemented-hip-stem-a-prospective-study-with-2-years-radiostereometric-analysis-follow-up
#9
Ahmed Nageeb Mahmoud, Uldis Kesteris, Gunnar Flivik
INTRODUCTION: Shorter, anatomically shaped and proximally loading stems have been developed to achieve better stress distribution and be more bone preserving. The purpose of this prospective study was to evaluate the migration pattern of the Proxima™ ultra-short uncemented stem using radiostereometric analysis (RSA), and to review the literature regarding the migration of short stemmed hip arthroplasty. METHODS: 25 patients (28 hips) with hip osteoarthritis received a Proxima stem during total hip arthroplasty (THA)...
February 4, 2017: Hip International: the Journal of Clinical and Experimental Research on Hip Pathology and Therapy
https://www.readbyqxmd.com/read/28159679/is-there-a-role-for-femoral-offset-restoration-during-total-hip-arthroplasty-a-systematic-review
#10
REVIEW
Marcello De Fine, Matteo Romagnoli, Angelo Toscano, Alice Bondi, Matteo Nanni, Stefano Zaffagnini
BACKGROUND: Benefits of femoral offset restoration during total hip arthroplasty should be the reduction of bearing surfaces wear, implant loosening and dislocation rates. Modular neck stems ensure offset customization, but fretting corrosion and catastrophic failures are well documented complications. Since clinical evidences are needed to substantiate the effectiveness of femoral offset restoration and promote modular neck choice, we systematically reviewed the literature to ascertain whether femoral offsetitself has a proven clinical influence: 1) on bearing surfaces wear, 2) implant loosening, 3) and dislocation rates...
January 31, 2017: Orthopaedics & Traumatology, Surgery & Research: OTSR
https://www.readbyqxmd.com/read/28130016/cortical-strut-allograft-support-of-modular-femoral-junctions-during-revision-total-hip-arthroplasty
#11
Chin Tat Lim, Derek F Amanatullah, James I Huddleston, Katherine L Hwang, William J Maloney, Stuart B Goodman
BACKGROUND: There is risk of junction failure when using modular femoral stems for revision total hip arthroplasty (THA), especially with loss of bone stock in the proximal femur. Using a cortical strut allograft may provide additional support of a modular femoral construct in revision THA. METHODS: We reviewed prospectively gathered clinical and radiographic data for 28 revision THAs performed from 2004 to 2014 using cementless modular femoral components with cortical strut allograft applied to supplement proximal femoral bone loss: 5 (18%) were fluted taper designs and 23 (82%) were porous cylindrical designs All the patients had a Paprosky grade IIIA or greater femoral defect...
December 21, 2016: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28116264/failure-of-polyethelene-insert-locking-mechanism-after-a-posterior-stabilised-total-knee-arthroplasty-a-case-report
#12
Gurava Reddy Ay, Soundar Rajan D, Chiranjeevi T, Karthik C, Krishna Kiran E
INTRODUCTION: Disengagement of polyethylene insert used in total knee arthroplasty is a rare but serious complication. Still rarer is disengagement because of failure of tibial insert locking mechanism. We report a previously unpublished complication of polyethylene insert locking mechanism failure in a 10-months-old posterior stabilized total knee arthroplasty in a 70-year-old woman with osteoarthritis for whom Attune (Depuy) knee implant was used. CASE PRESENTATION: A 70-year-old female underwent (Attune, Depuy) primary bilateral posterior stabilised total knee arthroplasty in a private hospital...
July 2016: Journal of Orthopaedic Case Reports
https://www.readbyqxmd.com/read/28110243/a-biomechanical-testing-system-to-determine-micromotion-between-hip-implant-and-femur-accounting-for-deformation-of-the-hip-implant-assessment-of-the-influence-of-rigid-body-assumptions-on-micromotions-measurements
#13
Steven Leuridan, Quentin Goossens, Jorg Roosen, Leonard Pastrav, Kathleen Denis, Michiel Mulier, Wim Desmet, Jos Vander Sloten
BACKGROUND: Accurate pre-clinical evaluation of the initial stability of new cementless hip stems using in vitro micromotion measurements is an important step in the design process to assess the new stem's potential. Several measuring systems, linear variable displacement transducer-based and other, require assuming bone or implant to be rigid to obtain micromotion values or to calculate derived quantities such as relative implant tilting. METHODS: An alternative linear variable displacement transducer-based measuring system not requiring a rigid body assumption was developed in this study...
January 16, 2017: Clinical Biomechanics
https://www.readbyqxmd.com/read/28110182/a-large-taper-mismatch-is-one-of-the-key-factors-behind-high-wear-rates-and-failure-at-the-taper-junction-of-total-hip-replacements-a-finite-element-wear-analysis
#14
Ariyan Ashkanfar, David J Langton, Thomas J Joyce
Total hip replacement (THR) is one of the most successful orthopaedic surgeries; however, failures can occur due to adverse reactions to wear debris. Recently, a large number of failures linked to the release of metal particles from the taper junction between femoral head and femoral stem have been reported. One possible reason for this may be design variations such as taper mismatches associated with the taper and trunnion angles. Could a large taper mismatch lead to inappropriate contact mechanics and increase relative micromotion and thus wear? In this study, 3D finite element (FE) models of a commercial THR from a perfectly matched interface to large taper mismatches and a wear algorithm were used to investigate the extent of wear that could occur at this junction and identify the optimum tolerances in order to reduce the wear...
January 12, 2017: Journal of the Mechanical Behavior of Biomedical Materials
https://www.readbyqxmd.com/read/28108172/the-accuracy-of-digital-templating-for-primary-total-hip-arthroplasty-is-there-a-difference-between-direct-anterior-and-posterior-approaches
#15
Shai S Shemesh, Jonathan Robinson, Aakash Keswani, Michael J Bronson, Calin S Moucha, Darwin Chen
BACKGROUND: The direct anterior approach (DAA) has gained recent popularity for total hip arthroplasty (THA), as it provides immediate feedback on cup position and limb length using fluoroscopy. The purpose of this study is to evaluate any differences in the accuracy of digital templating for preoperative planning of THA, performed with 2 different surgical approaches: DAA using a radiolucent table with intraoperative fluoroscopy and the posterior approach (PA). METHODS: One hundred thirty-one consecutive patients (148 hips) underwent a THA by a single surgeon, using the same cup and stem designs...
December 27, 2016: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28064103/why-do-some-titanium-alloy-total-hip-arthroplasty-modular-necks-fail
#16
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
#17
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
#18
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
#19
REVIEW
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
#20
COMPARATIVE STUDY
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
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