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Perez Alamino L, Garabano G, Rodriguez JA, Cullari M, Del Sel H, Pesciallo CA. Effectiveness of two-stage revision with commercial polymethylmethacrylate articulated hip spacer: similar outcomes against monomicrobial and polymicrobial hip periprosthetic joint infections. J Bone Jt Infect 2023. [DOI: 10.5194/jbji-8-51-2023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/08/2023] Open
Abstract
Abstract. Background: orthopaedic surgeons still struggle against a devastating complication – periprosthetic joint infection (PJI). A two-stage revision is
considered the gold standard for chronic PJI for several authors, with
success rates over 90 %. This strategy implies the remotion of the
prosthesis and the implantation of an antibiotic-impregnated cement spacer
in the joint. The primary objective of this study was to assess the
effectiveness of a two-stage revision approach using a commercial
prefabricated antibiotic-impregnated cement hip spacer for the treatment of
hip PJI regarding monomicrobial and polymicrobial infections. Secondly, to
assess risk factors for failure of two-stage revision. Material and methods:
we conducted a retrospective study on patients that underwent revision of
total hip arthroplasty (THA) between January 2002 and January 20218. We included adult patients with a diagnosis of chronic hip PJI that underwent two-stage revision using a
prefabricated gentamicin-impregnated cement of polymethylmethacrylate (PMMA)
hip spacer. We assessed whether it was monomicrobial or polymicrobial infections and comorbidities. Treatment success was defined when eradication of the
infection was observed and no further procedures or mortality were
registered after the second stage. Persistence or recurrence of infection
was considered a failure of treatment. Results: the final series consisted
of 84 patients treated with the same hip spacer: 60 (71.4 %) monomicrobial
and 24 (28.6 %) polymicrobial joint infections with an overall follow-up
of 59.0 (36.0–84.0) months. The overall success rate was 90.5 %. Eight
(9.5 %) patients failed. Smoking and BMI greater than 30 m kg−2 were
identified independent risk factors for failure in multivariate analysis.
Conclusion: our study suggests that prefabricated gentamicin-impregnated
PMMA spacer is an effective tool for the treatment of PJI, achieving similar
outcomes whether it is monomicrobial or polymicrobial infections. Randomized prospective studies are needed to obtain more reliable conclusions.
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Xu J, Oni T, Shen D, Chai Y, Walter WK, Walter WL. Long-Term Results of Alumina Ceramic-On-Ceramic Bearings in Cementless Total Hip Arthroplasty: A 20-Year Minimum Follow-Up. J Arthroplasty 2022; 37:549-553. [PMID: 34843912 DOI: 10.1016/j.arth.2021.11.028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/02/2021] [Revised: 11/10/2021] [Accepted: 11/22/2021] [Indexed: 02/02/2023] Open
Abstract
BACKGROUND Alumina ceramic-on-ceramic bearings are used in total hip arthroplasty (THA) because of their wear-resistant and inert properties. In this study, we assessed the clinical and radiographic outcomes of patients undergoing primary cementless ceramic-on-ceramic THA at a minimum follow-up of 20 years. METHODS A series of 301 consecutive primary THAs in 283 patients were assessed. Clinically, patients were assessed with the modified Harris Hip Score (HHS) and pain questionnaires. Anteroposterior radiographs of the pelvis and lateral radiographs of the hip were used to radiologically assess the implant. Patients were classified as lost to follow-up if they could not be contacted on multiple occasions or did not wish to participate further in this study. RESULTS At twenty years after operation, 60 patients had died of a cause unrelated to surgery, 16 had experienced complications requiring reoperation, and 100 hips had both clinical assessments and radiographs at a minimum of 20 years of follow-up. The average HHS improved from 56.1 (range: 17-89) before THA to 92.5 (range: 63-100) at the latest follow-up. The classification of the HHS was good or excellent in 96.4% of patients. Only 1.8% of patients still had moderate residual pain at the thigh or groin. Radiographically, all patients demonstrated bony ingrowth but no clinical symptoms of loosening. The overall survival rate of the implants was 94.2% at 20 years with revision for any reason as the end point. CONCLUSION Long-Term follow-up in our series showed excellent implant survival, excellent functional outcomes, and minimal late complications. There was no significant radiographic evidence of failure at a minimum of 20 years after THA. LEVEL OF EVIDENCE Therapeutic Level IV.
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Affiliation(s)
- Joshua Xu
- Department of Orthopaedics and Traumatic Surgery, Royal North Shore Hospital, Sydney, Australia; Institute of Bone and Joint Research, Kolling Institute, The University of Sydney, Sydney, Australia
| | - Tofunmi Oni
- Department of Orthopaedics and Traumatic Surgery, Royal North Shore Hospital, Sydney, Australia
| | - David Shen
- Department of Orthopaedics and Traumatic Surgery, Royal North Shore Hospital, Sydney, Australia
| | - Yuan Chai
- Institute of Bone and Joint Research, Kolling Institute, The University of Sydney, Sydney, Australia
| | - William K Walter
- Department of Orthopaedic Surgery, Mater Hospital, Sydney, Australia
| | - William L Walter
- Department of Orthopaedics and Traumatic Surgery, Royal North Shore Hospital, Sydney, Australia; Institute of Bone and Joint Research, Kolling Institute, The University of Sydney, Sydney, Australia
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Chung KY, Cheung KW, Fan CH, Poon WC, Chiu KH, Ho KKW. Long-Term Outcome on the Mal-Seating of Ceramic-on-Ceramic Articulation in Total Hip Arthroplasty. J Arthroplasty 2021; 36:2100-2104. [PMID: 33573813 DOI: 10.1016/j.arth.2021.01.024] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/05/2020] [Revised: 01/04/2021] [Accepted: 01/11/2021] [Indexed: 02/02/2023] Open
Abstract
BACKGROUND Total hip arthroplasty with ceramic-on-ceramic articulation aims to decrease wear, osteolysis, and aseptic loosening. A metal-backed ceramic liner was developed to reduce the risk of liner fracture. However, a significant number of cases of mal-seating of the metal-backed ceramic liner were observed in the 2000s, and there were concerns about their outcome. This review aims to investigate the long-term performance of the mal-seated ceramic liner. METHODS From July 2003 to March 2007, 35 ceramic-on-ceramic total hip arthroplasties were performed with the Trident acetabular system. Clinical assessment, radiological analysis, and outcome assessment were performed. The prevalence of liner mal-seating and its long-term outcomes were investigated. RESULTS There was liner mal-seating in 8 hips (22.9%). One liner was exchanged in the early postoperative period. No revision surgery was required for the remaining 7 hips at a mean follow-up of 14 years. All patients were free of hip pain with a mean Harris Hip Score of 94.7 at the most recent follow-up. No adverse event was observed. CONCLUSION The long-term outcomes of the mal-seated liner were favorable. However, surgeons should exercise meticulous surgical technique to achieve a properly aligned liner within the acetabular shell to minimize this potentially correctable error.
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Affiliation(s)
| | | | - Chi-Ho Fan
- Department of Orthopaedics and Traumatology, Alice Ho Miu Ling Nethersole Hospital, Tai Po, Hong Kong
| | - Wai-Chin Poon
- Department of Orthopaedics and Traumatology, The Chinese University of Hong Kong, Shatin, Hong Kong
| | - Kwok-Hing Chiu
- Department of Orthopaedics and Traumatology, Prince of Wales Hospital, Shatin, Hong Kong
| | - Kevin Ki-Wai Ho
- Department of Orthopaedics and Traumatology, The Chinese University of Hong Kong, Shatin, Hong Kong
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Primary total hip arthroplasty with a fully porous-coated uncemented stem: up to twenty-eight years. Retrospective cohort study. EUROPEAN JOURNAL OF ORTHOPAEDIC SURGERY AND TRAUMATOLOGY 2021; 32:91-97. [PMID: 33738602 DOI: 10.1007/s00590-021-02940-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/22/2020] [Accepted: 03/12/2021] [Indexed: 10/21/2022]
Abstract
PURPOSE The use of cementless prosthesis has increased in the last 30 years with the aim of improving the long-term results of total hip arthroplasties in young and active patients. Encouraging results have recently been reported for cementless titanium and cobalt chromium stems. However, there are few studies with long-term follow-up, and the majority have analysed several models of uncemented stems due to their modifications over the years. Therefore, the aim was to assess the long-term survival rate of the Mittelmeier Mark III or Autophor 900-S stem. METHODS A retrospective cohort study of both gender patients under 70 years old with at least one implanted Mittelmeier Mark III uncemented stem was performed. Survival rate was defined as the proportion of stems that did not need a surgical revision from any cause. Clinical status was evaluated using the Merle d'Aubigne scale modified by Matta (excellent/good/fair/poor). RESULTS Between 1990 and 1999, 73 stems were implanted. The mean (SD) age at surgical time was 49.3 (9.9) years, and the median (range) of follow-up was 22 (1-28) years. The overall survival rate was 93% (68/73, 95%CI: 85-97%). The stem revisions were due to stem breakage (n = 2), to aseptic loosening (n = 2) and to septic loosening (n = 1). Clinical results were: excellent 84%, good 15% and fair 1.5%. CONCLUSIONS The Mittelmeier Mark III stem had an excellent survival rate with a stable long-term fixation and excellent clinical outcomes.
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Buddhdev PK, Vanhegan IS, Khan T, Hashemi-Nejad A. Early to medium-term outcomes of uncemented ceramic-bearing total hip arthroplasty in teenagers for paediatric hip conditions. Bone Joint J 2020; 102-B:1491-1496. [PMID: 33135445 DOI: 10.1302/0301-620x.102b11.bjj-2020-0668.r1] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
AIMS Despite advances in the treatment of paediatric hip disease, adolescent and young adult patients can develop early onset end-stage osteoarthritis. The aims of this study were to address the indications and medium-term outcomes for total hip arthroplasty (THA) with ceramic bearings for teenage patients. METHODS Surgery was performed by a single surgeon working in the paediatric orthopaedic unit of a tertiary referral hospital. Databases were interrogated from 2003 to 2017 for all teenage patients undergoing THA with a minimum 2.3 year follow-up. Data capture included patient demographics, the underlying hip pathology, number of previous surgeries, and THA prostheses used. Institutional ethical approval was granted to contact patients for prospective clinical outcomes and obtain up-to-date radiographs. In total, 60 primary hips were implanted in 51 patients (35 female, 16 male) with nine bilateral cases. The mean age was 16.7 years (12 to 19) and mean follow-up was 9.3 years (2.3 to 16.8). RESULTS The most common indication for teenage hip arthroplasty was avascular necrosis secondary to slipped upper femoral epiphysis (31%; n = 16). Overall, 64% of patients (n = 33) had undergone multiple previous operations. The survival at follow-up was 97%; two patients required revision for aseptic loosening (one femoral stem, one acetabular component). Both patients had fused hips noted at the time of arthroplasty. A further two patients had radiolucent lines but were asymptomatic. At latest follow-up the mean Oxford Hip Score was 44 (31 to 48) and a Visual Analogue Scale measurement of 1.5, indicating satisfactory function. CONCLUSION Operating on this cohort can be complicated by multiple previous surgeries and distorted anatomy, which in some cases require custom-made prostheses. We have demonstrated a good outcome with low revision rate in this complex group of patients. Cite this article: Bone Joint J 2020;102-B(11):1491-1496.
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Affiliation(s)
- Pranai K Buddhdev
- Catterall Unit, Royal National Orthopaedic Hospital, Brockley Hill, Stanmore, UK
| | - Ivor S Vanhegan
- Catterall Unit, Royal National Orthopaedic Hospital, Brockley Hill, Stanmore, UK
| | - Tahir Khan
- Catterall Unit, Royal National Orthopaedic Hospital, Brockley Hill, Stanmore, UK
| | - Aresh Hashemi-Nejad
- Catterall Unit, Royal National Orthopaedic Hospital, Brockley Hill, Stanmore, UK
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Abstract
Metal-on-highly cross-linked polyethylene is considered the preferred bearing surface for conventional total hip arthroplasty because of its safety profile and excellent results in the first 10 to 15 years of use. However, with younger patient age, activity expectations increase, and the life expectancy of patients with total hip arthroplasty also has increased, so interest remains in other bearing couples. These other options include the use of various ceramic composites for the femoral head on highly cross-linked polyethylene, the so-called second-generation antioxidant polyethylenes, and ceramic acetabular liners. Several of these bearing couples have shown excellent wear rates in vitro, and short-term clinical studies have demonstrated favorable wear and safety results. It is uncertain whether any of these bearing couples should be adopted at present. Understanding the unique properties and possible complications of these bearing couples is critical for appropriate implant selection.
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Patient satisfaction after total hip arthroplasty in an Egyptian population as an example of a developing country. CURRENT ORTHOPAEDIC PRACTICE 2016. [DOI: 10.1097/bco.0000000000000436] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Ferreira A, Aslanian T, Dalin T, Picaud J. Ceramic bearings with bilayer coating in cementless total hip arthroplasty. A safe solution. A retrospective study of one hundred and twenty six cases with more than ten years’ follow-up. INTERNATIONAL ORTHOPAEDICS 2016; 41:893-899. [DOI: 10.1007/s00264-016-3271-7] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/21/2016] [Accepted: 08/01/2016] [Indexed: 10/21/2022]
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Dilogo IH, Chandra W. Short-term outcome of ceramic-on-ceramic total hip replacement in young adult patients. MEDICAL JOURNAL OF INDONESIA 2015. [DOI: 10.13181/mji.v24i3.1184] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022] Open
Abstract
Background: Ceramic-on-ceramic (CoC) total hip replacement (THR) was developed to minimize debris and osteolytic reaction. The major concern is its brittleness. The aim of this study was to evaluate the short-term outcome of CoC THR in young adult patients. Methods: 11 patients, 13 THR procedures, were followed up until six months after surgery in Cipto Mangunkusumo Hospital. Evaluation included Harris hip score (HHS), visual analog scale (VAS), patients’ complaint, short form-36 (SF-36), and acetabular and femoral component angles. Data were analyzed using Wilcoxon signed rank test, paired t-test, and Spearman test. Results: The average age of the patients was 33.6 years old and 55% of them were female. Systemic lupus erythematosus was the main causative disease for THR. The VAS average decreased before surgery and after six months of surgery (5 to 1). Pre- and post-operative HHS and SF-36 increased significantly by (25 to 92) and (21 to 54) respectively. Squeaking sound was reported by two patients. No correlation was found between acetabular and femoral component and squeaking incidence.Conclusion: CoC THR showed excellent short term outcome for young adult patients. With proper indications, CoC THR ensures excellent clinical outcomes and promising survivorship.
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High failure rate of a new pressfit cup in mid-term follow-up. INTERNATIONAL ORTHOPAEDICS 2015; 39:1813-7. [DOI: 10.1007/s00264-015-2872-x] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/17/2015] [Accepted: 04/21/2015] [Indexed: 10/23/2022]
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Kmieć K, Dorman T, Andrzej G, Synder M, Kozłowski P, Sibiński M. Early results of revision acetabular cup using antiprotrusio reconstruction rings and allografts. Indian J Orthop 2015; 49:317-22. [PMID: 26015632 PMCID: PMC4443414 DOI: 10.4103/0019-5413.156205] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
BACKGROUND Hip arthroplasty is one of the most frequently performed orthopedic procedures with high scores of success while its most common complication is aseptic loosening of the acetabular component, which may result from host bone loss or even from pelvis discontinuity. The purpose of the study was to evaluate results in patients after revision acetabular arthroplasty with reconstruction rings and allografts. MATERIALS AND METHODS Retrospective data was collected from 69 revisions of acetabular components, performed in a group of 69 treated patients (the mean age 65.1 years). Before surgery, the patients had bone defects of type IIb (n = 5), IIc (n = 20), IIIa (n = 27) or IIIb (n = 17), according to Paprosky et al. RESULTS The mean followup period of the patients was 7.2 years (range 3-19 years). A Kaplan-Meier analysis showed that a 3- and 10 year survival rate was 92.8% and 84.8% respectively, using further revision for any reason of the acetabular device as an end point. Eight patients revealed implant related complications. Four patients presented with ring loosening, one with a loose acetabular polyethylene cup, two hips demonstrated recurrent dislocations and one patient was with deep infection. Regarding the remaining 61 patients without re-revision surgery, the mean Harris hip score improved from 30.5 to 73.8 points. CONCLUSION A modified, antiprotrusion cage provides an acceptable survival rate and radiological results, but complications could still be expected. It seems that the observed massive bone loss with pelvic discontinuity and an insufficient fixation of the cage to the ischium may result in implant loosening. Stable fixation of the ischial ring flange with screws is an essential condition to expect a good outcome.
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Affiliation(s)
- Krzysztof Kmieć
- Department of Orthopedics, Clinic of Orthopedics and Pediatric Orthopedics, Medical University of Lodz, Lodz, Poland
| | - Tomasz Dorman
- Department of Orthopedics, Clinic of Orthopedics and Pediatric Orthopedics, Medical University of Lodz, Lodz, Poland
| | - Grzegorzewski Andrzej
- Department of Orthopedics, Clinic of Orthopedics and Pediatric Orthopedics, Medical University of Lodz, Lodz, Poland
| | - Marek Synder
- Department of Orthopedics, Clinic of Orthopedics and Pediatric Orthopedics, Medical University of Lodz, Lodz, Poland
| | - Piotr Kozłowski
- Department of Orthopedics, Clinic of Orthopedics and Pediatric Orthopedics, Medical University of Lodz, Lodz, Poland
| | - Marcin Sibiński
- Department of Orthopedics, Clinic of Orthopedics and Pediatric Orthopedics, Medical University of Lodz, Lodz, Poland,Address for correspondence: Dr. Marcin Sibiński, ul. Drewnowska 75, 95-083 Łódź, Poland. E-mail:
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Mihalko WM, Wimmer MA, Pacione CA, Laurent MP, Murphy RF, Rider C. How have alternative bearings and modularity affected revision rates in total hip arthroplasty? Clin Orthop Relat Res 2014; 472:3747-58. [PMID: 25070918 PMCID: PMC4397767 DOI: 10.1007/s11999-014-3816-2] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
BACKGROUND Total hip arthroplasty (THA) continues to be one of the most successful surgical procedures in the medical field. However, over the last two decades, the use of modularity and alternative bearings in THA has become routine. Given the known problems associated with hard-on-hard bearing couples, including taper failures with more modular stem designs, local and systemic effects from metal-on-metal bearings, and fractures with ceramic-on-ceramic bearings, it is not known whether in aggregate the survivorship of these implants is better or worse than the metal-on-polyethylene bearings that they sought to replace. QUESTIONS/PURPOSES Have alternative bearings (metal-on-metal and ceramic-on-ceramic) and implant modularity decreased revision rates of primary THAs? METHODS In this systematic review of MEDLINE and EMBASE, we used several Boolean search strings for each topic and surveyed national registry data from English-speaking countries. Clinical research (Level IV or higher) with ≥ 5 years of followup was included; retrieval studies and case reports were excluded. We included registry data at ≥ 7 years followup. A total of 32 studies (and five registry reports) on metal-on-metal, 19 studies (and five registry reports) on ceramic-on-ceramic, and 20 studies (and one registry report) on modular stem designs met inclusion criteria and were evaluated in detail. Insufficient data were available on metal-on-ceramic and ceramic-on-metal implants, and monoblock acetabular designs were evaluated in another recent systematic review so these were not evaluated here. RESULTS There was no evidence in the literature that alternative bearings (either metal-on-metal or ceramic-on-ceramic) in THA have decreased revision rates. Registry data, however, showed that large head metal-on-metal implants have lower 7- to 10-year survivorship than do standard bearings. In THA, modular exchangeable femoral neck implants had a lower 10-year survival rate in both literature reviews and in registry data compared with combined registry primary THA implant survivorship. CONCLUSIONS Despite improvements in implant technology, there is no evidence that alternative bearings or modularity have resulted in decreased THA revision rates after 5 years. In fact, both large head metal-on-metal THA and added modularity may well lower survivorship and should only be used in select cases in which the mission cannot be achieved without it. Based on this experience, followup and/or postmarket surveillance studies should have a duration of at least 5 years before introducing new alternative bearings or modularity on a widespread scale.
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Affiliation(s)
- William M Mihalko
- Campbell Clinic Department of Orthopaedic Surgery and Biomedical Engineering, University of Tennessee, 956 Court Avenue, Suite E226, Memphis, TN, 38163, USA,
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Sun ZH, Liu YJ, Li H. Femoral stress and strain changes post-hip, -knee and -ipsilateral hip/knee arthroplasties: a finite element analysis. Orthop Surg 2014; 6:137-44. [PMID: 24890296 DOI: 10.1111/os.12105] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/28/2013] [Accepted: 02/19/2014] [Indexed: 12/22/2022] Open
Abstract
OBJECTIVE To identify the optimal ratio of free femur for minimizing the risks of periprosthetic fracture. METHODS Three dimensional models of the femur with hip and knee stem elongation were constructed. With the distal femoral condylar surface fixed in a three dimensional model, the femoral head loading was performed according to the methods described by Huiskes and van Rietbergen in the models of hip replacement, knee replacement with or without hip stem or knee stem elongation. The maximum principal stress (MPS) and maximum principal elastic strain (MPES) of the femur were recorded and their relationships to the free femur ratio were analyzed using Pearson's correlation analysis. RESULTS There were no obvious changes in MPS and MPES with hip stem elongation from 100 to 180 mm. In ipsilateral hip and knee replacement, the MPS and MPES had a tendency to decrease with knee and hip stem elongation. The MPS and MPES were mainly located in the anterior medial side of the middle to distal femur post-hip replacement and distalized with stem elongation. When the knee stem had been elongated more than 120 mm, the stress and strain concentrated strongly in the middle of the femoral shaft. There was a positive correlation between MPS and MPES to the free femur ratio (P < 0.01); however, no optimal ratio of free femur that would minimize the risks of periprosthetic fracture was identified. CONCLUSION Positive correlations were found between implant free femur and stress and strain changes in total knee arthroplasty, total hip arthroplasty and ipsilateral hip and knee replacement.
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Affiliation(s)
- Zhen-hui Sun
- Center for Joint Diseases, Tianjin People's Hospital, Tianjin, China
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Tozun IR, Ozden VE, Dikmen G, Beksac B. Mid-term result of ceramic bearings in total hip arthroplasty. INTERNATIONAL ORTHOPAEDICS 2014; 38:2027-31. [DOI: 10.1007/s00264-014-2387-x] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/13/2014] [Accepted: 05/14/2014] [Indexed: 11/29/2022]
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Ni SH, Guo L, Jiang TL, Zhao J, Zhao YG. Press-fit cementless acetabular fixation with and without screws. INTERNATIONAL ORTHOPAEDICS 2013; 38:7-12. [PMID: 23982638 DOI: 10.1007/s00264-013-2075-2] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/22/2013] [Accepted: 08/06/2013] [Indexed: 12/21/2022]
Abstract
PURPOSE Cementless acetabular fixation for total hip arthroplasty (THA) is widely used. The question of using screws for a better primary and secondary acetabular fixation has been discussed in the literature in recent years. The aim of this meta-analysis was to compare fixation of acetabular cups with and without screws in total hip arthroplasty. METHODS Electronic databases Embase, PubMed and Cochrane Library were used to search for randomised controlled trials reported through May 2013 of cementless acetabular fixation for THA with and without screws. Two independent reviewers assessed the trials for eligibility and quality. All related data matching our standards were abstracted for meta-analysis by RevMan 5.0. Evaluation criteria included revisions, migration and osteolysis. RESULTS A total of 1,130 THAs enrolled into five trials were included in this meta-analysis. All studies compared fixation of acetabular cups with and without screws, and our pooled data showed no statistical significance between the two surgical methods in revision, migration and osteolysis. CONCLUSION There is no significant difference between cementless acetabular fixation for THA with and without screws in revisions, migration or osteolysis.
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Affiliation(s)
- Sheng-Hui Ni
- Department of Orthopedic Surgery, First Affiliated Hospital, China Medical University, Shenyang, Liaoning, 110001, People's Republic of China
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