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Stem version THA

Francesco Castagnini, Giordano Valente, Gianluigi Crimi, Fulvia Taddei, Barbara Bordini, Susanna Stea, Aldo Toni
BACKGROUND: In ceramic-on-ceramic (CoC) total hip arthroplasty (THA), component positioning demonstrated to influence the bearing damage: however the connection between angles and clinical outcomes at long-term follow-ups is currently lacking. Aims of this study were: the computer tomography (CT) assessment of component positioning in CoC THAs; the correlation analysis between positioning and ceramic damage; the identification of safe zones. METHODS: 91 consecutive post-operative CT scans including two types of CoC implants, with a mean follow-up of 12 ± 4...
January 3, 2019: Journal of Orthopaedic Science: Official Journal of the Japanese Orthopaedic Association
Manish Noticewala, Taylor S Murtaugh, Jonathan Danoff, Gregory J Cunn, Roshan P Shah, Jeffrey Geller
Background: Displaced femoral neck fractures (DFNF) in the elderly can be treated with hemiarthroplasty or total hip arthroplasty (THA). One concern with utilizing THA in this setting is post-operative dislocation. The purposes of this study were to determine the incidence of hip dislocation following THA for DFNF and to identify risk factors for dislocation. Methods: The charts of 66 posterior-approach THA cases performed for DFNF with mean post-operative follow-up of 4...
October 2018: Journal of Clinical Orthopaedics and Trauma
Maria C Inacio, Michelle Lorimer, David C Davidson, Richard N De Steiger, Peter L Lewis, Stephen E Graves
BACKGROUND: Despite wide adoption of hydroxyapatite (HA)-coated femoral stems in THA, no studies have found differences in the risk of revision surgery with its use or investigated the interaction of different prosthesis designs with stem coating. QUESTIONS/PURPOSES: The purpose of this study was to evaluate the risk of revision in THAs with HA-coated stems compared with non-HA-coated. To achieve this purpose, we asked: (1) What is the difference in risk of revision of THAs with HA-coated femoral stems compared with non-HA-coated using an aggregate analysis? (2) What is the difference in risk of revision of THAs with HA-coated femoral stems compared with non-HA-coated for five prosthesis types that used the same femoral and acetabular component combination but where the femoral stem had both a HA and non-HA coating option? METHODS: The Australian Orthopaedic Association National Joint Replacement Registry analyzed cementless primary THA registered between September 1, 1999, and December 31, 2014...
December 2018: Clinical Orthopaedics and related Research
S R Nodzo, C-C Chang, K M Carroll, B T Barlow, S A Banks, D E Padgett, D J Mayman, S A Jerabek
AIMS: The aim of this study was to evaluate the accuracy of implant placement when using robotic assistance during total hip arthroplasty (THA). PATIENTS AND METHODS: A total of 20 patients underwent a planned THA using preoperative CT scans and robotic-assisted software. There were nine men and 11 women (n = 20 hips) with a mean age of 60.8 years (sd 6.0). Pelvic and femoral bone models were constructed by segmenting both preoperative and postoperative CT scan images...
October 2018: Bone & Joint Journal
Tomonori Shigemura, Yohei Yamamoto, Yasuaki Murata, Takashi Sato, Ryuto Tsuchiya, Norichika Mizuki, Yasunori Toki, Yuichi Wada
BACKGROUND: Several studies have reported regarding total hip arthroplasty (THA) for osteonecrosis of the femoral head after failed transtrochanteric rotational osteotomy (TRO). However, to our knowledge, no formal systematic review and meta-analysis have been published yet summarizing the clinical results of a THA after failed TRO. Therefore, we conducted a systematic review and meta-analysis of the THA outcomes after failed TRO. We focussed on the issue whether a previous TRO affects the results of subsequent THA, including operative time, operative blood loss, radiological parameters, postoperative complications, and clinical outcomes...
December 2018: Orthopaedics & Traumatology, Surgery & Research: OTSR
Francesco Pisanu, Carlo Doria, Matteo Andreozzi, Marco Bartoli, Laura Saderi, Giovanni Sotgiu, Paolo Tranquilli Leali
PURPOSE: To summarize the biological effects of metal debris from hip arthroplasties which characterize a polymorphic clinical spectrum of local and remote manifestation. METHODS: Retrospective study. Patient, implant, and surgical characteristics were collected, including implant survival, clinical manifestations, cause of arthroplasty revision or implant failure, and peri- and intra-operative complications. The primary endpoint was implant survivorship. Hip revision arthroplasty was decided considering clinical signs and symptoms, abnormal imaging (XR, MR, TC, echotomography, scintigraphy), and blood metal ion level...
September 29, 2018: International Orthopaedics
Takaaki Shishido, Toshiyuki Tateiwa, Yasuhito Takahashi, Toshinori Masaoka, Tsunehito Ishida, Kengo Yamamoto
We investigated the effects of varus-valgus alignment on the long-term outcomes after cementless total hip arthroplasty (THA) using a porous coated version of Bi-Metric® femoral stems. The Kaplan-Meier survival analysis was performed in 71 hips. The survival rate with femoral revision for aseptic loosening as the end point was 100% at 17 years. Nevertheless, the initial stem alignment was more valgus in patients with the Engh grade III-IV stress shielding than patients with the Engh grade I-II. Our results suggest that valgus misalignment of cementless Bi-Metric stem might be a potential risk factor for the progression of stress shielding...
March 2018: Journal of Orthopaedics
Ichiro Nakahara, Takayuki Kyo, Yasuo Kuroda, Hidenobu Miki
A computed tomography (CT)-based navigation system is one of the support tools to place implant with appropriate alignment and position in total hip arthroplasty (THA). To determine whether the higher performance of the navigation would further improve the accuracy of implant placement in the clinical setting, we retrospectively compared the navigation accuracy of two different versions of a navigation system. The newer version of the navigation system had an upgraded optical sensor with superior positional accuracy...
September 2018: Journal of Artificial Organs: the Official Journal of the Japanese Society for Artificial Organs
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...
October 2018: International Orthopaedics
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)
Shinya Hayashi, Shingo Hashimoto, Tomoyuki Matsumoto, Koji Takayama, Kotaro Nishida, Kazunari Ishida, Ryosuke Kuroda
The short tapered-wedge stem is popular worldwide because it potentially preserves more bone stock during total hip arthroplasty (THA). However, stem version mismatch may affect physiological stress distribution. In this study, we analyzed the correlations between periprosthetic bone mineral density (BMD) changes and anteversion mismatch in patients who underwent THA using a short tapered-wedge stem. The study included 44 patients (44 joints) who underwent THA with a Tri-Lock stem. At baseline and at 6 and 24 months postoperatively, the BMDs in the seven Gruen zones were evaluated using dual-energy X-ray absorptiometry...
September 2017: Journal of Orthopaedic Surgery
Jakob van Oldenrijk, Vanessa A B Scholtes, Loes W A H van Beers, Carel H Geerdink, Bob B A M Niers, Wouter Runne, Mohit Bhandari, Rudolf W Poolman
OBJECTIVES: Primary aim was to compare the functional results at 3 months and 2 years between short and conventional cementless stem total hip arthroplasty (THA). Secondary aim was to determine the feasibility of a double-blind implant-related trial. DESIGN: A prospective blinded randomised controlled multicentre trial in patients with osteoarthritis of the hip. All patients, research assistants, clinical assessors, investigators and data analysts were blinded to the type of prosthesis...
October 16, 2017: BMJ Open
S Brodt, E Eigendorff, G Matziolis
There is a great deal of data available, in part contradictory, on the best fixation technique to use for total hip arthroplasty (THA) in hip osteoarthritis. Both the cementless and the cemented versions offer excellent long-term outcomes - if the respective technique is applied correctly. However, as far as we know, no recommendation has been made regarding cemented vs. cementless THA in primary myelofibrosis. The case described here concerns a very active 76-year-old patient with primary myelofibrosis. This is a rare hematological disease...
2017: Acta Chirurgiae Orthopaedicae et Traumatologiae Cechoslovaca
S E Graves, R de Steiger, D Davidson, W Donnelly, S Rainbird, M F Lorimer, K S Cashman, R J Vial
AIMS: Femoral stems with exchangeable (modular) necks were introduced to offer surgeons an increased choice when determining the version, offset and length of the femoral neck during total hip arthroplasty (THA). It was hoped that this would improve outcomes and reduce complications, particularly dislocation. In 2010, the Australian Orthopaedic Association National Joint Replacement Registry (AOANJRR) first reported an increased rate of revision after primary THA using femoral stems with an exchangeable neck...
June 2017: Bone & Joint Journal
Ping Zhen, Jun Liu, Hao Lu, Hui Chen, Xusheng Li, Shenghu Zhou
BACKGROUND: Developmental hip dysplasia (DDH) may lead to severe acetabular and femoral abnormalities that can render total hip arthroplasty (THA) challenging, especially in DDH patients with a small physique. Most conventional cemented or cementless femoral components are often difficult to implant in the narrow femoral canal and require slight version correction during surgery. The aim of this study was to present the mid-term results of THA in the treatment of DDH patients with a small physique using a cementless Wagner cone prosthesis (Zimmer®, US)...
May 15, 2017: BMC Musculoskeletal Disorders
Dean J Marshall, Keith R Berend, Michael J Morris, Joanne B Adams, Adolph V Lombardi
INTRODUCTION: Modular component options can aid in addressing complex femoral reconstructions in total hip arthroplasty (THA) by allowing for customization of version control and proximal to distal sizing. However, component breakage at the modular junction has occurred, particularly in the presence of poor bone stock. A taper roller hardening (RH) process was developed to strengthen the modular junction to reduce breakage. The purpose of this study is to review THA patients before and after taper roller hardening to compare stem survival and frequency of breakage...
July 25, 2017: Surgical Technology International
Derek F Amanatullah, Graham D Pallante, Lorena V Floccari, George I Vasileiadis, Robert T Trousdale
The cement-in-cement technique is useful in the setting of revision total hip arthroplasty (THA), especially to gain acetabular exposure, change a damaged or loose femoral component, or change the version, offset, or length of a fixed femoral component. The goal of this retrospective study was to assess the clinical and radiographic characteristics of revision THA using the cement-in- cement technique. Between 1971 and 2013, a total of 63 revision THAs used an Omnifit (Osteonics, Mahwah, New Jersey) or Exeter (Howmedica, Mahwah, New Jersey) stem and the cement-in-cement technique at the senior author's institution...
March 1, 2017: Orthopedics
José Joaquín Mira, Irene Carrillo, Cesar Fernandez, Maria Asuncion Vicente, Mercedes Guilabert
BACKGROUND: Adverse events are a reality in clinical practice. Reducing the prevalence of preventable adverse events by stemming their causes requires health managers' engagement. OBJECTIVE: The objective of our study was to develop an app for mobile phones and tablets that would provide managers with an overview of their responsibilities in matters of patient safety and would help them manage interventions that are expected to be carried out throughout the year...
December 8, 2016: JMIR MHealth and UHealth
Michael Worlicek, Markus Weber, Benjamin Craiovan, Michael Wörner, Florian Völlner, Hans R Springorum, Joachim Grifka, Tobias Renkawitz
BACKROUND: Improper femoral and acetabular component positioning can be associated with instability, impingement, component wear and finally patient dissatisfaction in total hip arthroplasty (THA). The concept of "femur first"/"combined anteversion", incorporates various aspects of performing a functional optimization of the prosthetic stem and cup position of the stem relative to the cup intraoperatively. In the present study we asked two questions: (1) Do native femoral anteversion and anteversion of the implant correlate? (2) Do anteversion of the final broach and implant anteversion correlate? METHODS: In a secondary analysis of a prospective controlled trial, a subgroup of 55 patients, who underwent computer-assisted, cementless THA with a straight, tapered stem through an anterolateral, minimally invasive (MIS) approach in a lateral decubitus position were examined retrospectivly...
September 20, 2016: BMC Musculoskeletal Disorders
Wolf Siepen, Lukas Zwicky, Karl Kilian Stoffel, Thomas Ilchmann, Martin Clauss
BACKGROUND: Cemented stems show good long-term results and the survival of new implants can be predicted by their early subsidence. With EBRA-FCA (Femoral Component Analysis using Einzel-Bild-Röntgen-Analyse) early subsidence as an early indicator for later aseptic loosening can be analysed. For the cemented TwinSys stem mid- and long-term data is only avalible from the New Zeeland Arthroplasty register, thus close monitoring of this implant system is still mandatory. METHODS: We conducted a 2 year follow up of 100 consecutive hybrid THA (Total hip arthroplasty) of a series of 285 primary THA operated between Jan 2009 und Oct 2010...
September 17, 2016: BMC Musculoskeletal Disorders
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