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Femoral stem design

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https://www.readbyqxmd.com/read/29137901/impact-of-femoral-stem-design-on-failure-after-anterior-approach-total-hip-arthroplasty
#1
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/29126601/an-international-cross-sectional-survey-of-the-management-of-vancouver-type-b1-periprosthetic-femoral-fractures-around-total-hip-arthroplasties
#2
Brent D Bates, David W Walmsley, Milena R Vicente, Paul R Kuzyk, Aaron Nauth, James P Waddell, Michael D McKee, Emil H Schemitsch
INTRODUCTION: The incidence of periprosthetic femoral fractures around total hip arthroplasties is increasing. Fractures around a stable implant stem (Vancouver type B1) are among the most common of these fractures. Various fixation strategies for Vancouver type B1 periprosthetic fractures have been reported in the literature; however, little high-level evidence exists. This study was designed to determine the current management strategies and opinions among orthopaedic surgeons treating Vancouver type B1 periprosthetic femoral fractures, and to evaluate the need for a large prospective randomized controlled trial for the management of these injuries...
October 26, 2017: Injury
https://www.readbyqxmd.com/read/29116392/anchoring-and-resulting-primary-stability-of-a-kinked-compared-to-a-straight-uncemented-femoral-stem
#3
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/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/29111845/pre-clinical-evaluation-of-the-mechanical-properties-of-a-low-stiffness-cement-injectable-hip-stem
#5
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
https://www.readbyqxmd.com/read/29107490/cementless-tapered-wedge-stem-length-affects-the-risk-of-periprosthetic-femoral-fractures-in-direct-anterior-total-hip-arthroplasty
#6
Tatsuya Tamaki, Kurato Jonishi, Yoko Miura, Kazuhiro Oinuma, Hideaki Shiratsuchi
BACKGROUND: Although the popularity of the direct anterior approach for total hip arthroplasty has increased, the femoral procedure in this approach is considered technically challenging, and one of the most frequent complications reported was periprosthetic femoral fractures. The present study aimed to identify factors for predicting the risk of periprosthetic femoral fractures after using stems with a cementless tapered-wedge design through the direct anterior approach. METHODS: We retrospectively assessed the medical records of 686 patients (851 hips) who underwent primary total hip arthroplasty using a single stem with a cementless tapered-wedge design having a short or standard length option...
October 6, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/29100185/numerical-evaluation-of-bone-remodelling-and-adaptation-considering-different-hip-prosthesis-designs
#7
Ievgen Levadnyi, Jan Awrejcewicz, José Eduardo Gubaua, Jucélio Tomás Pereira
BACKGROUND: The change in mechanical properties of femoral cortical bone tissue surrounding the stem of the hip endoprosthesis is one of the causes of implant instability. We present an analysis used to determine the best conditions for long-term functioning of the bone-implant system, which will lead to improvement of treatment results. METHODS: In the present paper, a finite element method coupled with a bone remodelling model is used to evaluate how different three-dimensional prosthesis models influence distribution of the density of bone tissue...
October 18, 2017: Clinical Biomechanics
https://www.readbyqxmd.com/read/29098919/current-methods-of-preventing-aseptic-loosening-and-improving-osseointegration-of-titanium-implants-in-cementless-total-hip-arthroplasty-a-review
#8
Dragos Apostu, Ondine Lucaciu, Cristian Berce, Dan Lucaciu, Dan Cosma
Hip osteoarthritis is the most common joint disorder, and is represented by a degenerative process, resulting in pain and functional impairment. If conservative treatment for hip osteoarthritis fails, the only remaining option is hip arthroplasty. Despite good survival of implants, loosening of components is the most common complication. This leads to revision surgeries, which are technically demanding, expensive, and result in a low satisfaction rate. Uncemented hip replacements require proper osseointegration for increased survival...
January 1, 2017: Journal of International Medical Research
https://www.readbyqxmd.com/read/29082427/cementless-modular-neck-stems-are-they-a-safe-option-in-primary-total-hip-arthroplasty
#9
José M Pelayo-de-Tomás, José L Rodrigo-Pérez, Carlos D Novoa-Parra, Alejandro Lizaur-Utrilla, María Morales-Suárez-Varela, José Antonio Blas-Dobón
PURPOSE: The objective was to assess aseptic complications and functional outcome using a primary total hip arthroplasty with modular neck. METHODS: Prospective cohort of 317 consecutive patients. The mean age was 61.1 (range, 41-84) years. The H-Max-M model (Lima, Italy) system was used in all patients. The functional assessment was made by the Harris Hip Score, Short Form-36 (SF-36), Western Ontario and McMaster Universities Osteoarthritis Index and visual analogue scale for pain...
October 29, 2017: European Journal of Orthopaedic Surgery & Traumatology: Orthopédie Traumatologie
https://www.readbyqxmd.com/read/29069636/development-and-in-vitro-validation-of-a-simplified-numerical-model-for-the-design-of-a-biomimetic-femoral-stem
#10
Bruno Jetté, Vladimir Brailovski, Charles Simoneau, Mathieu Dumas, Patrick Terriault
BACKGROUND: Dense and stiff metallic femoral stems implanted into femurs for total hip arthroplasties produce a stress shielding effect since they modify the original load sharing path in the bony structure. Consequently, in the long term, the strain adaptive nature of bones leads to bone resorption, implant loosening, and the need for arthroplasty revision. The design of new cementless femoral stems integrating open porous structures can reduce the global stiffness of the stems, allowing them a better match with that of bones and provide their firm fixation via bone ingrowth, and, thus reduce the risk of implantation failure...
October 16, 2017: Journal of the Mechanical Behavior of Biomedical Materials
https://www.readbyqxmd.com/read/29033155/does-the-additional-articulation-in-retrieved-bipolar-hemiarthroplasty-implants-decrease-trunnionosis-compared-to-total-hip-arthroplasty
#11
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/29027190/midterm-results-of-revision-total-hip-arthroplasty-with-an-uncemented-modular-femoral-component
#12
Bertram Rieger, Thomas Ilchmann, Lilianna Bolliger, Karl K Stoffel, Lukas Zwicky, Martin Clauss
INTRODUCTION: During revision total hip arthroplasty (THA), the surgeon commonly faces deficient proximal femoral bone. In this situation, distal fixation of the prosthesis is required. The aim of the current retrospective study is to assess the clinical and radiographic midterm outcome of revision total hip arthroplasty using a modular uncemented, tapered, grit-blasted, distal straight stem system. METHODS: This retrospective study included 70 femoral revisions that were performed in 67 patients using the device of interest...
October 12, 2017: Hip International: the Journal of Clinical and Experimental Research on Hip Pathology and Therapy
https://www.readbyqxmd.com/read/29027189/evidence-based-recommendations-for-reducing-head-neck-taper-connection-fretting-corrosion-in-hip-replacement-prostheses
#13
Christian M Wight, Brent Lanting, Emil H Schemitsch
INTRODUCTION: This systematic review seeks to summarise the published studies investigating prosthetic design, manufacture and surgical technique's effect on fretting corrosion at the head-neck taper connection, and provide clinical recommendations to reduce its occurrence. METHODS: PubMed, MEDLINE and EMBASE electronic databases were searched using the terms taper, trunnion, cone and head-neck junction. Articles investigating prosthetic design, manufacture and surgical technique's effect on fretting corrosion were retrieved, reviewed and graded according to OCEBM levels of evidence and grades of recommendation...
October 9, 2017: Hip International: the Journal of Clinical and Experimental Research on Hip Pathology and Therapy
https://www.readbyqxmd.com/read/28988365/global-radiological-score-for-femoral-cementless-revision-stem
#14
François Canovas, Sophie Putman, Julien Girard, Olivier Roche, François Bonnomet, Pierre Le Béguec
PURPOSE: The purpose of this study was to evaluate the outcomes of total hip arthroplasty (THA) revision with cementless stems using a numeric global radiological score (GRxS) that summarizes two previously validated scores: secondary bone stock (SBS) and osseointegration-secondary stability (O-SS). METHOD: One hundred fifty cases of THA were evaluated at a mean follow-up of 6.5 ± 3.7 years. The GRxS combines the SBS, which evaluated cortical bone thickness, bone density and bone defects in each Gruen zone and the O-SS, which evaluated the location and extent of a single radiolucent line...
October 7, 2017: International Orthopaedics
https://www.readbyqxmd.com/read/28975538/proximal-femoral-anatomy-and-collared-stems-in-hip-arthroplasty-is-a-single-collar-size-sufficient
#15
Nicolas Bonin, Jean-Emmanuel Gedouin, Vincent Pibarot, Jacques Bejui-Hughues, Hugo Bothorel, Mo Saffarini, Cécile Batailler
BACKGROUND: Even if the benefits of collars are unclear, they remain widely used, in several femoral stem designs. This study aimed to determine whether collar size should be proportional to hip dimensions and morphology. The hypothesis was that the collar should be larger for greater stem sizes and for varus femoral necks. METHODS: Computed Tomography scans of 204 healthy hips were digitally analysed and manually templated to determine principle dimensions, appropriate stem size and model, as well as cortical distance at the femoral calcar (ideal collar size)...
October 3, 2017: Journal of Experimental Orthopaedics
https://www.readbyqxmd.com/read/28956171/the-baba-classification-focused-on-implant-designs-is-useful-in-setting-the-therapeutic-strategy-for-interprosthetic-femoral-fracture
#16
Tomonori Baba, Kazuo Kaneko, Yasuhiro Homma, Hironori Ochi, Yu Ozaki, Taiji Watari, Mikio Matsumoto
PURPOSE: The purpose of this study was to investigate the clinical outcomes of femoral fracture with implants on the proximal and distal sides to verify whether actual fracture morphologies follow the fracture types of Baba classification focusing on implant designs useful for periprosthetic femoral fracture. METHODS: Prosthesis was present in 85 with periprosthetic femoral fractures. Excluding 73 patients with fracture around the femoral stem or fracture of the TKA femoral component alone, 12 patients with 14 legs with both implants were investigated...
September 27, 2017: European Journal of Orthopaedic Surgery & Traumatology: Orthopédie Traumatologie
https://www.readbyqxmd.com/read/28940776/influence-of-collars-on-the-primary-stability-of-cementless-femoral-stems-a-finite-element-study-using-a-diverse-patient-cohort
#17
Rami M A Al-Dirini, Daniel Huff, Ju Zhang, Thor Besier, John G Clement, Mark Taylor
For cementless femoral stems, there is debate as to whether a collar enhances primary stability and load transfer compared to collarless designs. Finite Element (FE) analysis has the potential to compare stem designs within the same cohort, allowing for subtle performance differences to be identified, if present. Subject-specific FE models of intact and implanted femora were run for a diverse cohort (21 males, 20 females; BMI 16.4-41.2 kg/m(2) , age 50-80 yrs). Collared and collarless versions of Corail(®) (DePuy Synthes, Warsaw, IN) were sized and positioned using an automated algorithm that aligns the femoral/stem axes, preserves the head-center location, and maximizes metaphyseal fit...
September 21, 2017: Journal of Orthopaedic Research: Official Publication of the Orthopaedic Research Society
https://www.readbyqxmd.com/read/28939969/tibial-shaft-anatomy-differs-between-caucasians-and-east-asian-individuals
#18
Hongyi Shao, Chilung Chen, Daniel Scholl, Ahmad Faizan, Antonia F Chen
PURPOSE: The orientation and distance from the shaft of the femur and tibia to the articular surface centre is important for performing total knee arthroplasty (TKA) with cementless stems. It is important to understand anatomic differences between races to match the tibial and femoral shaft axis to the knee articular surface. Thus, the purpose of this study was to compare knee morphology between Caucasian and East Asian individuals to determine the optimal placement of tibial and femoral stems...
September 22, 2017: Knee Surgery, Sports Traumatology, Arthroscopy: Official Journal of the ESSKA
https://www.readbyqxmd.com/read/28915961/short-stem-total-hip-arthroplasty-potential-explanations-for-persistent-post-surgical-thigh-pain
#19
Isabel A C Baert, Enrique Lluch, Francis Van Glabbeek, Rudy Nuyts, Salim Rufai, Joanna Tuynman, Filip Struyf, Mira Meeus
Short stem uncemented femoral implants were developed with the aim of preserving proximal bone stock for future revisions, improving biomechanical reconstruction, aiding insertion through smaller incisions and potentially decreasing or limiting the incidence of thigh pain. Despite all the advantages of short stem designs, it remains unclear whether they are able to limit post-surgical thigh pain. In patients with short stem hip arthroplasty and persistent thigh pain, it is of the utmost importance to understand the potential etiologies of this chronic pain for selecting the appropriate treatment strategy...
September 2017: Medical Hypotheses
https://www.readbyqxmd.com/read/28901195/feedforward-coordinate-control-of-a-robotic-cell-injection-catheter
#20
Weyland Cheng, Peter K Law
Remote and robotically actuated catheters are the stepping-stones toward autonomous catheters, where complex intravascular procedures may be performed with minimal intervention from a physician. This article proposes a concept for the positional, feedforward control of a robotically actuated cell injection catheter used for the injection of myogenic or undifferentiated stem cells into the myocardial infarct boundary zones of the left ventricle. The prototype for the catheter system was built upon a needle-based catheter with a single degree of deflection, a 3-D printed handle combined with actuators, and the Arduino microcontroller platform...
August 2017: Cell Transplantation
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