Stochastic Simulation of Modular Connections in Total Hip Replacement

2013 ◽  
Author(s):  
Finn E. Donaldson ◽  
James C. Coburn
Keyword(s):  
Adverse Reaction ◽  
Total Hip Arthroplasty ◽  
Stochastic Simulation ◽  
Total Hip Replacement ◽  
Hip Arthroplasty ◽  
Hip Replacement ◽  
Fretting Wear ◽  
Chemical Corrosion ◽  
Total Hip ◽  
Early Revision

Several modern Total Hip Arthroplasty (THA) implants have been associated with increased release of metallic debris through combined mechanical fretting wear and chemical corrosion. These particles can lead to painful Adverse Reaction to Metallic Debris, often requiring early revision [1]. While much research has focused on improving the performance of bearing surfaces, the key parameters driving release of metallic debris at modular junctions remains unclear.

A Proximal Referencing System for the Charnley Low Friction Arthroplasty

2002 ◽  
Vol 12 (3) ◽  
pp. 303-307
Author(s):  
M.D.A. Fletcher ◽  
J.C.J. Webb ◽  
T. Maung
Keyword(s):  
Soft Tissue ◽  
Total Hip Arthroplasty ◽  
Total Hip Replacement ◽  
Hip Arthroplasty ◽  
Surgical Approach ◽  
Hip Replacement ◽  
Recurrent Dislocation ◽  
Soft Tissue Balance ◽  
Low Friction ◽  
Total Hip

Dislocation is a serious complication of total hip arthroplasty occurring in up to 9% of cases. Recurrent dislocation accounts for 4% of revisions in the Swedish Hip Arthroplasty Study. Soft tissue balancing is one of the factors, independent of the surgical approach used, that is involved in producing a stable total hip replacement. We describe a proximal referencing system for use with the Charnley low friction arthrosplasty (LFA), which optimises this factor. The dislocation rate, using this method, is 0.3% (in 333 cases performed by a single surgeon over a 5 year period). This system should prove valuable to orthopaedic surgeons in training, ensuring they achieve correct soft tissue balance in total hip arthroplasty.

scholarly journals Surgical management of avascular necrosis of femoral head in young adults treated with uncemented total hip replacement

2021 ◽  
Vol 7 (6) ◽  
pp. 1166
Author(s):  
Vijaya Bhaskar Reddy ◽  
N. Brahma Chary ◽  
Kacham Nikitha
Keyword(s):  
Femoral Head ◽  
Total Hip Arthroplasty ◽  
Avascular Necrosis ◽  
Total Hip Replacement ◽  
Hip Arthroplasty ◽  
Hip Replacement ◽  
Daily Activities ◽  
Harris Hip Score ◽  
Total Hip ◽  
Uncemented Total Hip Replacement

<p class="abstract"><strong>Background: </strong>Normal hip joint is subjected to many stresses during daily activities performed by an individual. Since it is one of the major weight bearing joints of the body, its normal function is necessary for daily activities. Avascular necrosis (AVN) of the femoral head is one of the common causes of painful hip in a young adult. Core decompression, fibular sturt graft can be considered in early stages, total hip arthroplasty in later stages of AVN of femoral head.</p><p class="abstract"><strong>Methods:</strong> This is a retrospective study of 30 patients following uncemented total hip replacement, who were operated between August 2017 and March 2020 at MNR medical college and hospital, Sangareddy. They were followed up for a minimum period of 1 year and evaluated using Harris hip scoring system. Harris hip score is designed specifically for measuring functional outcomes in hip arthroplasty.</p><p class="abstract"><strong>Results: </strong>There was a significant improvement in function as measured with the Harris hip score. The overall preoperative Harris hip score was 43, which remarkably improved to 89 postoperatively. The results observed, showed that all patients had good to excellent results, (Harris hip score ≥0) thus showing a good degree of pain relief, improvement in function and range of motion.</p><p class="abstract"><strong>Conclusions: </strong>Although the use of total hip arthroplasty in young patients will more likely necessitate future revision surgery, the consistent relief of pain and good functional results have made this procedure an attractive treatment choice for the debilitating arthritis resulting from osteonecrosis of the femoral head.  </p>

scholarly journals Anterior Subluxation after Total Hip Replacement Confirmed by Radiographs: Report of Two Cases

2011 ◽  
Vol 2011 ◽  
pp. 1-4
Author(s):  
Conor P. McGrory ◽  
Brian J. McGrory
Keyword(s):  
Femoral Head ◽  
Total Hip Arthroplasty ◽  
Total Hip Replacement ◽  
Hip Arthroplasty ◽  
Hip Replacement ◽  
Rare Complication ◽  
Unusual Complication ◽  
Total Hip ◽  
Anterior Subluxation

Demonstrable anterior subluxation of the femoral head after a total hip arthroplasty is a rare complication and is usually transient. Both a case of recurrent subluxation and a case of chronic subluxation are described in this paper, each one presenting with unexpected femoral head eccentricity in the acetabulum on radiograph. We show how this unusual complication can be successfully identified and treated.

scholarly journals Limb-Sparing Using Total Hip Arthroplasty in a Dog with Femoral Head Osteosarcoma

2017 ◽  
Vol 45 ◽  
pp. 6
Author(s):  
Fernando Yoiti Kitamura Kawamoto ◽  
Aflailton Zeponi ◽  
Wanderley Severo Dos Santos Júnior ◽  
Luís Guilherme De Faria ◽  
Guilherme Galhardo Franco ◽  
...  
Keyword(s):  
Femoral Head ◽  
Local Recurrence ◽  
Total Hip Arthroplasty ◽  
Head And Neck ◽  
Total Hip Replacement ◽  
Hip Arthroplasty ◽  
Proximal Femur ◽  
Hip Replacement ◽  
Appendicular Skeleton ◽  
Total Hip

Background: Osteosarcoma (OSA) is the most common primary bone tumor of the appendicular skeleton of dogs. It mainly affects the metaphyseal region of long bones in large and giant breed dogs.The markedly aggressive and metastatic character of the disease leads to an invariably poor to unfavorable prognosis.Although amputation is commonly performed, different surgical techniques may be used to preserve the limb. The most common methods of limb preserving surgeries involve the use of endoprosthesis and allogeneic or autologous grafts. This report describes the successful use of total hip replacement to treat a 3-year-old male dog, with OSA in the femoral head and neck.Case: This report describes the successful use of total hip replacement to treat a 3-year-old male dog, with OSA in the femoral head and neck. The OSA stage IA located in the femoral head and neck was resected and treated through the limb-sparing. The bone defect and joint function was reconstructed with total hip arthroplasty technique using a cementless hip prosthesis. The result of the histopathological analysis of the excised bone tissue showed a minimally productive osteoblastic osteosarcoma. To date, the patient shows satisfactory movement rate and motion range, with no pain to palpation and without lameness in that limb. The radiographic follow-up after 24 months showed no local recurrence, metastasis pulmonary or complications related to the implant. Total hip arthroplasty resulted in safe recovery of orthopedic signs associated with osteosarcoma of the femoral head and neck, effectively acting as a limb preserving surgery after 32 months.Discussion: The limb-sparing procedure is an option to control local tumors that has become more popular among owners that do not accept the amputation of the limb. Similarly, it is a good alternative when another condition may interfere with the other limbs or may require amputation of another limb. The size and the potential for weight gain of the dog in this study could compromise its ambulation later, and it was a factor in the decision for the limb-sparing surgery. The allografts can be used to reconstruct the proximal femur, but they were not considered a viable option for this patient because of the reported complications, including graft fracture, non-union with the host bone and collapse of subchondral bone. The hip region does not allow the realization of arthrodesis because this joint is highly mobile, so the use of prosthetics as described is ideal for the preservation of joint biomechanics. Furthermore, the implant provides rapid postoperative recovery and immediate stability. Mean survival times were not significantly different between the limb-sparing and amputation techniques without adequate chemotherapy. In this case, despite the recommendation, the patient was monitored continuously without the association of adjuvant treatments according to the owner’s choice. The complications related with the use of cortical allograft, endoprosthesis, and pasteurized autograft include infection (31-60%), local recurrence (15-28%) or implant failure (11-40%). The implant luxation is the most common non-traumatic acute complication in the short term after limb-sparing surgery of proximal femur in humans and total hip replacement in dogs. To date, no complications have been observed after the procedure was performed. In conclusion, preservation of limbs in cases of osteosarcoma is favorable depending on the degree of involvement, but it requires specific techniques according to the location, to improve the quality of life and animal survival. In this case, the total hip arthroplasty for initial osteosarcoma in the femoral head and neck got an unexpected result, especially given the nature of osteosarcoma, limitations of wide excision with this approach and lack of adjuvant therapy.

scholarly journals Total hip arthroplasty in children who have undergone arthroplasty with demineralized bone-cartilage allocups

2017 ◽  
Vol 5 (1) ◽  
pp. 13-20 ◽  
Author(s):  
Vladimir E. Baskov ◽  
Valentin A. Neverov ◽  
Pavel I. Bortulev ◽  
Andrey I. Krasnov ◽  
Dmitry B. Barsukov ◽  
...  
Keyword(s):  
Total Hip Arthroplasty ◽  
Total Hip Replacement ◽  
Acetabular Component ◽  
Hip Joint ◽  
Hip Arthroplasty ◽  
Hip Replacement ◽  
Pelvic Bone ◽  
Total Hip ◽  
Medical Histories ◽  
Demineralized Bone

Introduction. Treating children with degenerative dystrophic diseases of the hip joint has become one of the most acute problems in contemporary orthopedics. Until recently, we performed arthroplasty by demineralized bone-cartilage allocups (DBCA) in the Clinic of the Hip Joint Pathology of the Turner Scientific and Research Institute for Children’s Orthopedics for patients showing clinical and radiological signs of irreversible destruction of the hip joint; we carried out this procedure to preserve the function of the lower limb. However, over the last 8 years, we have changed our protocol for children older than 12 years of age and have replaced DBCA with total hip replacement. In a number of cases, total hip replacement was performed after a previous intervention involving arthroplasty with DBCA. Objective. To determine the technical peculiarities of total hip replacement after a previous intervention involving arthroplasty with DBCA. Material and methods. We analyzed the results of treatment involving various types of hip pathology in 13 children (100%) aged between 15 and 16 years [8 girls (61.5%) and 5 boys (38.5%)]. The medical histories of all 13 children (100%) showed repeated operations on the hip joint, ultimately resulting in arthroplasty with DBCA. All 13 children (100%) underwent a total hip replacement. Upon hip replacement, all 13 patients (100%) showed a pronounced thinning and hardening of the edges and the bottom of the acetabulum, which created some difficulties in the process of acetabular component implantation. The transformation of DBCA was not evident in any of the 13 cases (100%). Results. During the observation period of 3–5 years following total hip arthroplasty, all 13 cases (100%) showed recovery in the range of motion and absence of pain. An important criterion for evaluating the quality of care was the complete social and domestic adaptation of all 13 children (100%) during the period from 6 to 9 months following total hip replacement surgery. Conclusions. The main feature of the implementation of total hip replacement, following a previous intervention involving arthroplasty with DBCA, was a pronounced deficit of the pelvic bone in the joint component. This significantly complicated the subsequent implantation of the acetabular prosthesis component, and in some cases required the use of a cemented acetabular component. Our experience suggests that patients under 11 years of age who show clinical and radiological signs of coxarthrosis can be treated with arthroplasty with DBCA in order to save the lost function of the hip joint and maintain the function of the periarticular muscles.

Metal Allergy and other Adverse Reactions in Patients with Total Hip Replacement

2015 ◽  
Vol 1114 ◽  
pp. 283-287 ◽  
Author(s):  
Marius Niculescu ◽  
Dan Laptoiu ◽  
Florin Miculescu ◽  
Iulian Vasile Antoniac
Keyword(s):  
Total Hip Arthroplasty ◽  
Total Hip Replacement ◽  
Hip Arthroplasty ◽  
Hip Replacement ◽  
Hip Prosthesis ◽  
Metal Corrosion ◽  
Metal Allergy ◽  
Total Hip Prosthesis ◽  
Total Hip ◽  
Tissue Reactions

Total hip prosthese are widely used in total hip arthroplasty, offering many benefit to patients with different articular diseases like osteoarthritis or after different accidents. Many total hip prosthesis are now available to the orthopaedic surgeons to replace the hip articulation, with different design and with components made by different type of biomaterials: metallic (cobalt-chrome and titanium alloys, zirconium-niobium alloy named oxinium), ceramic (alumina, zirconia), polymers (ultra high weight molecular polyethylene-UHMWPE). Even total hip arthroplasty has a high success rate, implant loosening may occur, with different symptoms that could be attributed to metal allergy. Because the stem components of the total hip prosthesis are made by metallic biomaterials, many papers describe the adverse effects related to the release of metal ions (like cytotoxicity, carcinogenicity and metal allergy). There are different types of metal corrosion: intergranular, pitting, crevice, fatigue, stress, fretting, and galvanic. On the other hand, in many cases (like metal-on-metal prosthesis) appear corrosion and wear between two metallic components. This processes are favourable for the aparition of hypersensitivity-related tissue reactions. Especially some metallic ions (nickel, cobalt, and chromium) presents in stainless steels and cobalt-chromium alloys are most known to be released from prostheses components and give metal allergy. Of course, during the time was developped some solutions in order to improve the performance of the hip prostheses components made by metallic components like coating with thin layers using different biomaterials like porous titanium or hydroxiapatite. The aims of this review article were to explore mainly the relationship between corrosion products and implant-related hypersensitivity, the importance of surface treatment for metallic components, try define the effect of metal ion concentrations, and differentiate between allergy and infection in total hip replacement. The long-term performance of the coated components will be also analyzed and synthetic described based on clinical results. Also, some relevant aspects from our clinical experience and retrieved prosthesis analysis using stereomicroscopy and scanning electron microscopy will be shown in order to support the conclusions.

Hallmarks in the History and Development of Total Hip Arthroplasty

2020 ◽  
pp. 155335062094720
Author(s):  
Konstantinos Markatos ◽  
Olga D. Savvidou ◽  
Aggeliki Foteinou ◽  
Styliani Kosmadaki ◽  
Ioannis Trikoupis ◽  
...  
Keyword(s):  
Total Hip Arthroplasty ◽  
20Th Century ◽  
Total Hip Replacement ◽  
Hip Arthroplasty ◽  
Orthopedic Surgery ◽  
Hip Replacement ◽  
Hip Surgery ◽  
Operative Techniques ◽  
Total Hip

Total hip replacement remains one of the most successful and popular operative techniques in orthopedic surgery. Over several decades, several patients have been benefited by this mechanical and surgical achievement. It is an innovation that stands among the most significant surgical and technological achievements of the 20th century. The purpose of this review was to summarize the main landmarks on the evolution of hip surgery and the resulting modern total hip arthroplasty technique.

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