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Hip resurfacing

Matti Seppänen, Mikko Karvonen, Petri Virolainen, Ville Remes, Pekka Pulkkinen, Antti Eskelinen, Antti Liukas, Keijo T Mäkelä
Background and purpose - In a previous registry report, short-term implant survival of hip resurfacing arthroplasty (HRA) in Finland was found to be comparable to that of total hip arthroplasty (THA). Since then, it has become evident that adverse reactions to metal debris (ARMDs) may also be associated with HRA, not only with large-diameter head metal-on-metal THA. The aim of the study was to assess medium- to long-term survivorship of HRA based on the Finnish Arthroplasty Register (FAR). Patients and methods - 5,068 HRAs performed during the period 2001-2013 in Finland were included...
October 19, 2016: Acta Orthopaedica
Matthieu Durand-Hill, Johann Henckel, Matthew Burwell, John Skinner, Alister Hart
We describe the case of a 53-year-old man who underwent a left metal-on-metal hip resurfacing in 2015. Component size mismatch (CSM) was suspected because of the patient's immediate post-operative mechanical symptoms and high metal ion levels. Surgical notes indicated the appropriate combinations of implants were used. However, we detected a mismatch using computed tomography. Revision was performed and subsequent measurements of explanted components confirmed the mismatch. To our knowledge, this case is the first report of a CT method being used in a patient to pre-operatively identify CSM...
September 22, 2016: Skeletal Radiology
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 3, 2016: Hip International: the Journal of Clinical and Experimental Research on Hip Pathology and Therapy
Gulraj S Matharu, Andrew Judge, David W Murray, Hemant G Pandit
BACKGROUND: Most metal-on-metal hip resurfacing (MoMHR) designs have experienced high short-term failure rates because of pseudotumors. The impact of this complication into the second decade after the procedure is unknown. We investigated (1) the prevalence of, and risk factors for, all-cause and pseudotumor-related revision at up to 15 years following MoMHR and (2) whether risk factors were sex-specific. METHODS: This single-center prospective cohort study included 1,429 MoMHRs (1216 patients; 40% female) implanted between 1999 and 2009...
September 7, 2016: Journal of Bone and Joint Surgery. American Volume
Ryan J O'Leary, Melissa D Gaillard, Thomas P Gross
BACKGROUND: The optimal surgical treatment for osteonecrosis of the femoral head has yet to be elucidated. To evaluate the role of femoral fixation techniques in hip resurfacing, we present a comparison of the results for 2 consecutive groups: group 1 (75 hips) received hybrid hip resurfacing implants with a cemented femoral component; group 2 (103 hips) received uncemented femoral components. Both groups received uncemented acetabular components. METHODS: We retrospectively analyzed our clinical database to compare failures, reoperations, complications, clinical results, metal ion test results, and X-ray measurements...
August 9, 2016: Journal of Arthroplasty
Benjamin G Domb, Chengcheng Gui, Mark R Hutchinson, Shane J Nho, Michael A Terry, Parth Lodhia
BACKGROUND: With the rapid increase in hip preservation procedures, revision hip arthroscopic surgery and conversion to total hip arthroplasty (THA) or hip resurfacing (HR) after primary hip arthroscopic surgery have become a large focus in the recent literature. PURPOSE: The primary purpose was to perform a survival analysis in a large mixed cohort of patients undergoing hip arthroscopic surgery at a high-volume tertiary referral center for hip preservation with a minimum 2-year follow-up...
October 2016: American Journal of Sports Medicine
Jason J Howard
Due to problems with wear particle generation and subsequent loosening using conventional metal-on-polyethylene total hip replacements, there has been a shift toward alternative bearing systems, including metal-on-metal (MoM), for younger, more active patients with degenerative joint disease. Based on positive results from early short-term clinical studies, MoM hip replacements were readily adopted by orthopedic surgeons with thousands being implanted worldwide over the past decade. Unacceptably high revision rates reported by two national joint registries called into question the rigorousness of the regulatory approval process for these implants, particularly with respect to premarket data requirements to prove safety, effectiveness, and the appropriateness of the regulatory pathway chosen...
2016: Medical Devices: Evidence and Research
Inari Laaksonen, Gabrielle S Donahue, Rami Madanat, Keijo T Makela, Henrik Malchau
BACKGROUND: The aim of this review was to synthesize the main findings of clinical studies that have evaluated outcomes of the articular surface replacement (ASR) Hip System. METHODS: We performed a systematic literature search to identify all articles published between January 2008 and June 2015 that included ASR hip resurfacing arthroplasty (ASR HRA) or ASR total hip arthroplasty (ASR XL THA) outcomes according to the PRISMA statement. RESULTS: A total of 56 studies were assessed...
July 6, 2016: Journal of Arthroplasty
Simo S A Miettinen, Tatu J Mäkinen, Inari Laaksonen, Keijo Mäkelä, Heini Huhtala, Jukka Kettunen, Ville Remes
PURPOSE: Early aseptic loosening of cementless monoblock acetabular components is a rare complication of total hip arthroplasty (THA) and hip resurfacing arthroplasty (HRA). The purpose of this study was to evaluate the incidence and risk factors for early aseptic loosening of the cementless monoblock acetabular components. METHODS: This retrospective analysis consisted of 4,043 cementless hip devices (3,209 THAs and 834 HRAs). We identified 41 patients with early aseptic loosening of the acetabular component...
August 10, 2016: International Orthopaedics
Jan Fritz, Benjamin Fritz, Gaurav K Thawait, Esther Raithel, Wesley D Gilson, Mathias Nittka, Michael A Mont
OBJECTIVE: Compressed sensing (CS) acceleration has been theorized for slice encoding for metal artifact correction (SEMAC), but has not been shown to be feasible. Therefore, we tested the hypothesis that CS-SEMAC is feasible for MRI of metal-on-metal hip resurfacing implants. MATERIALS AND METHODS: Following prospective institutional review board approval, 22 subjects with metal-on-metal hip resurfacing implants underwent 1.5 T MRI. We compared CS-SEMAC prototype, high-bandwidth TSE, and SEMAC sequences with acquisition times of 4-5, 4-5 and 10-12 min, respectively...
October 2016: Skeletal Radiology
Sameer R Oak, Gregory J Strnad, Colin O'Rourke, Carlos A Higuera, Kurt P Spindler, Peter J Brooks
BACKGROUND: Birmingham hip resurfacing (BHR) is the only Food and Drug Administration approved resurfacing option currently available in the United States. While adequate BHR outcomes are established, there is a paucity of US-based literature demonstrating factors critical to improve patient reported outcomes (PROs). This study answers: (1) What is the implant survivorship in a large US cohort? (2) Which preoperative factors result in higher PRO scores over 5 years postoperatively? METHODS: A retrospective 541 hip single-surgeon cohort with mean of 6...
July 6, 2016: Journal of Arthroplasty
Kaushik Mukherjee, Sanjay Gupta
The importance of clinical studies notwithstanding, the failure assessment of implant-bone structure has alternatively been carried out using finite element analysis. However, the accuracy of the finite element predicted results is dependent on the applied loading and boundary conditions. Nevertheless, most finite element-based evaluations on acetabular component used a few selective load cases instead of the eight load cases representing the entire gait cycle. These in silico evaluations often suffer from limitations regarding the use of simplified musculoskeletal loading regimes...
October 2016: Proceedings of the Institution of Mechanical Engineers. Part H, Journal of Engineering in Medicine
Daniel K Hussey, Rami Madanat, Gabrielle S Donahue, Ola Rolfson, Orhun K Muratoglu, Henrik Malchau
Background and purpose - Blood metal ion levels can be an indicator for detecting implant failure in metal-on-metal (MoM) hip arthroplasties. Little is known about the effect of bilateral MoM implants on metal ion levels and patient-reported outcomes. We compared unilateral patients and bilateral patients with either an ASR hip resurfacing (HR) or an ASR XL total hip replacement (THR) and investigated whether cobalt or chromium was associated with a broad spectrum of patient outcomes. Patients and methods - From a registry of 1,328 patients enrolled in a multicenter prospective follow-up of the ASR Hip System, which was recalled in 2010, we analyzed data from 659 patients (311 HR, 348 THR) who met our inclusion criteria...
October 2016: Acta Orthopaedica
Stephen M Mann, Manuela Kunz, Randy E Ellis, John F Rudan
BACKGROUND: Metal ion levels are used as a surrogate marker for wear in hip resurfacing arthroplasties. Improper component position, particularly on the acetabular side, plays an important role in problems with the bearing surfaces, such as edge loading, impingement on the acetabular component rim, lack of fluid-film lubrication, and acetabular component deformation. There are little data regarding femoral component position and its possible implications on wear and failure rates. The purpose of this investigation was to determine both femoral and acetabular component positions in our cohort of mechanically stable hip resurfacing arthroplasties and to determine if these were related to metal ion levels...
June 23, 2016: Journal of Arthroplasty
Wael A Rahman, Tomás Amenábar, Bandar M Hetaimish, Oleg A Safir, Paul R Kuzyk, Allan E Gross
BACKGROUND: This is a retrospective review of the functional outcomes and complications of revision total hip arthroplasty (THA) of failed metal-on-metal (MoM) hip arthroplasty. METHODS: A total of 20 revision THAs were performed in 19 patients. Of them, 2 cases were failed hip resurfacing, and 18 cases were failed (MoM) THA. The mean age at revision (THA) was 59.35 years (standard deviation [SD] 9.83). RESULTS: The mean follow-up was 45 months (SD 13...
May 6, 2016: Journal of Arthroplasty
R P Sidaginamale, T J Joyce, J G Bowsher, J K Lord, P J Avery, S Natu, A V F Nargol, D J Langton
AIMS: We wished to investigate the influence of metal debris exposure on the subsequent immune response and resulting soft-tissue injury following metal-on-metal (MoM) hip arthroplasty. Some reports have suggested that debris generated from the head-neck taper junction is more destructive than equivalent doses from metal bearing surfaces. PATIENTS AND METHODS: We investigated the influence of the source and volume of metal debris on chromium (Cr) and cobalt (Co) concentrations in corresponding blood and hip synovial fluid samples and the observed agglomerated particle sizes in excised tissues using multiple regression analysis of prospectively collected data...
July 2016: Bone & Joint Journal
H C Amstutz, M J Le Duff
AIMS: Hip resurfacing arthroplasty (HRA) is an alternative to conventional total hip arthroplasty for patients with osteonecrosis (ON) of the femoral head. Our aim was to report the long-term outcome of HRA, which is not currently known. PATIENTS AND METHODS: Long-term survivorship, clinical scores and radiographic results for 82 patients (99 hips) treated with HRA for ON over a period of 18 years were reviewed retrospectively. The mean age of the 67 men and 15 women at the time of surgery was 40...
July 2016: Bone & Joint Journal
B G Pijls, J M T A Meessen, J W Schoones, M Fiocco, H J L van der Heide, A Sedrakyan, R G H H Nelissen
IMPORTANCE: There are concerns about increased mortality in patients with metal-on-metal bearings in total hip arthroplasty (THA). OBJECTIVE: To determine the mortality and the morbidity in patients with metal-on-metal articulations (MOM THA) compared to patients with non-metal-on-metal articulations (non-MOM THA) after primary total hip arthroplasty. DATA SOURCES: Search of PubMed, MEDLINE, EMBASE, Web of Science, Cochrane, CINAHL, AcademicSearchPremier, ScienceDirect, Wiley and clinical trial registers through March 2015, augmented by a hand search of references from the included articles...
2016: PloS One
Yinxian Yu, Chengqing Yi, Jinzhong Ma, Qiugen Wang
OBJECTIVE: To evaluate the clinical and radiographic outcomes of hip resurfacing arthroplasty (HRA) for treating osteonecrosis of the femoral head (ONFH) in young and middle-aged patients. METHODS: Between January 2008 and April 2009, 34 patients with ONFH underwent HRA. There were 19 males and 15 females with an average age of 54 years (range, 33-59 years). Of 34 cases, 16 left hips and 18 right hips were involved, including 9 cases of alcohol-induced ONFH, 8 cases of steroid-induced ONFH, 7 cases of traumatic ONFH, and 10 cases of unexplained ONFH...
February 2016: Chinese Journal of Reparative and Reconstructive Surgery
Scott W Cheatham, Monique Mokha, Matt Lee
CONTEXT: Hip-resurfacing arthroplasty (HRA) has become a popular procedure in the treatment of hip-joint arthritis in individuals under the age of 65 y. Although the body of literature examining operative procedures has grown, there is a lack of consistent reporting of the effectiveness of an HRA postoperative rehabilitation program. To date, no systematic reviews have evaluated the available evidence on postoperative rehabilitation programs. OBJECTIVE: To evaluate the available evidence on postoperative rehabilitation programs after HRA...
May 2016: Journal of Sport Rehabilitation
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