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Segawa Y, Jinno T, Matsubara M, Matsuyama Y, Fujiwara T, Okawa A. A cross-sectional study evaluating patients' preferences for Salter innominate osteotomy. J Orthop Sci 2023; 28:1298-1302. [PMID: 36272927 DOI: 10.1016/j.jos.2022.09.007] [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: 04/16/2022] [Revised: 07/27/2022] [Accepted: 09/13/2022] [Indexed: 11/05/2022]
Abstract
BACKGROUND Residual acetabular dysplasia in children after reduction of hip dislocation is often treated using Salter innominate osteotomy to prevent future osteoarthritis. Preventive surgery for asymptomatic patients, which could result in overtreatment, should be carefully applied with consideration of patients' opinions. In this study, we aimed to describe opinions on Salter innominate osteotomy as preventive surgery for children among adult patients who had undergone periacetabular osteotomy for hip pain due to hip dysplasia. METHODS A mail-in questionnaire survey was conducted with 77 patients who underwent periacetabular osteotomy. Participants responded whether they would recommend Salter innominate osteotomy as preventive surgery for children and the reason for their opinion. We also performed a patient-based evaluation using the Japanese Orthopaedic Association Hip-Disease Evaluation Questionnaire and assessed clinical outcome measures with the Japanese Orthopedic Association score. Their recommendations and reasons were evaluated, and associations between their opinions and demographic and clinical characteristics were analyzed. RESULTS Forty-three patients (56%) responded to the questionnaire. Of these, 10 (23%) patients recommended undergoing Salter innominate osteotomy, 28 (65%) patients did not, and 5 (12%) patients responded they were undecided. No significant association was observed between their opinions and demographic/clinical characteristics evaluated in the survey. The most frequent reason for why they do not recommend Salter innominate osteotomy was related to uncertainty about future hip pain. CONCLUSIONS In total, 65% of the study participants did not recommend Salter innominate osteotomy for children with risk of dysplasia in the future. Participants' preferences regarding preventive surgery were not influenced by demographic and clinical characteristics.
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Affiliation(s)
- Yuko Segawa
- Department of Orthopaedic Surgery, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo, 113-8519, Japan.
| | - Tetsuya Jinno
- Department of Orthopaedic Surgery, Dokkyo Medical University Saitama Medical Center, 2-1-50 Minamikoshigaya, Koshigaya, Saitama, 343-8555, Japan
| | - Masaaki Matsubara
- Division of Orthopaedic Surgery, Nissan Tamagawa Hospital, 4-8-1 Seta, Setagaya-ku, Tokyo, 158-0095, Japan
| | - Yusuke Matsuyama
- Department of Global Health Promotion, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo, 113-8519, Japan
| | - Takeo Fujiwara
- Department of Global Health Promotion, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo, 113-8519, Japan
| | - Atsushi Okawa
- Department of Orthopaedic Surgery, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo, 113-8519, Japan
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Sneha KR, Sailaja GS. Intrinsically radiopaque biomaterial assortments: a short review on the physical principles, X-ray imageability, and state-of-the-art developments. J Mater Chem B 2021; 9:8569-8593. [PMID: 34585717 DOI: 10.1039/d1tb01513c] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
X-ray attenuation ability, otherwise known as radiopacity of a material, could be indisputably tagged as the central and decisive parameter that produces contrast in an X-ray image. Radiopaque biomaterials are vital in the healthcare sector that helps clinicians to track them unambiguously during pre and post interventional radiological procedures. Medical imaging is one of the most powerful resources in the diagnostic sector that aids improved treatment outcomes for patients. Intrinsically radiopaque biomaterials enable themselves for visual targeting/positioning as well as to monitor their fate and further provide the radiologists with critical insights about the surgical site. Moreover, the emergence of advanced real-time imaging modalities is a boon to the contemporary healthcare systems that allow to perform minimally invasive surgical procedures and thereby reduce the healthcare costs and minimize patient trauma. X-ray based imaging is one such technologically upgraded diagnostic tool with many variants like digital X-ray, computed tomography, digital subtraction angiography, and fluoroscopy. In light of these facts, this review is aimed to briefly consolidate the physical principles of X-ray attenuation by a radiopaque material, measurement of radiopacity, classification of radiopaque biomaterials, and their recent advanced applications.
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Affiliation(s)
- K R Sneha
- Department of Polymer Science and Rubber Technology, Cochin University of Science and Technology, Kochi - 682022, India.
| | - G S Sailaja
- Department of Polymer Science and Rubber Technology, Cochin University of Science and Technology, Kochi - 682022, India. .,Interuniversity Centre for Nanomaterials and Devices, CUSAT, Kochi - 682022, India.,Centre for Advanced Materials, CUSAT, Kochi - 682022, India
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Uemura K, Hamada H, Ando W, Takao M, Sugano N. Minimum 10 years clinical results of an anatomical short stem with a proximal hydroxyapatite coating. Mod Rheumatol 2021; 31:1066-1072. [PMID: 33428474 DOI: 10.1080/14397595.2020.1868129] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
OBJECTIVES The CentPillar stem (Stryker Orthopaedics), an anatomical short stem, was designed to match the proximal femoral canal shape in both patients with normal hips and those with developmental dysplasia of the hip (DDH). The long-term outcomes of the CentPillar stem was examined herein. METHODS In total, 222 hips that underwent total hip arthroplasty using the CentPillar stem were analyzed. DDH was the main reason for surgery (79.3%). Implant survivorship was assessed using Kaplan-Meier analysis. For radiographic evaluation, stress shielding was assessed using the Engh classification. For functional evaluation, patients' ability to perform deep hip bending activities (sit on the floor, squat, and sit straight) was assessed. RESULTS During a median follow-up of 13.1 years, 2 stem revisions were performed (aseptic loosening and late hematogenous periprosthetic infection), and the overall cumulative implant survival rate was 99.0% at 15 years. In the radiographic evaluation, grade >3 stress shielding was found in only one hip. More than 80% of the patients were able to perform each of the three deep hip bending activities. CONCLUSIONS Good fixation at the proximal part of the femur was obtained, and the implant survival rate of the CentPillar stem was excellent during a long-term follow-up.
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Affiliation(s)
- Keisuke Uemura
- Department of Orthopaedic Medical Engineering, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Hidetoshi Hamada
- Department of Orthopaedic Surgery, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Wataru Ando
- Department of Orthopaedic Medical Engineering, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Masaki Takao
- Department of Orthopaedic Surgery, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Nobuhiko Sugano
- Department of Orthopaedic Medical Engineering, Osaka University Graduate School of Medicine, Osaka, Japan
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Chatterjee S, Roy S, Majumder S, RoyChowdhury A. Biomechanical Analysis to Probe Role of Bone Condition and Subject Weight in Stiffness Customization of Femoral Stem for Improved Periprosthetic Biomechanical Response. J Biomech Eng 2020; 142:1082899. [PMID: 32320044 DOI: 10.1115/1.4046973] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2019] [Indexed: 11/08/2022]
Abstract
Stress shielding due to difference in stiffness of bone and implant material is one among the foremost causes of loosening and failure of load-bearing implants. Thus far, femoral geometry has been given priority for the customization of total hip joint replacement (THR) implant design. This study, for the first time, demonstrates the key role of bone condition and subject-weight on the customization of stiffness and design of the femoral stem. In particular, internal hollowness was incorporated to reduce the implant stiffness and such designed structure has been customized based on subject parameters, including bone condition and bodyweight. The primary aim was to tailor these parameters to achieve close to natural strain distribution at periprosthetic bone and to reduce interfacial bone loss over time. The maintenance of interfacial bone density over time has been studied here through analysis of bone remodeling (BR). For normal bodyweight, the highest hollowness exhibited clinically relevant biomechanical response, for all bone conditions. However, for heavier subjects, consideration of bone quality was found to be essential as higher hollowness induced bone failure in weaker bones and implant failure in stronger bones. Moreover, for stronger bone, thinner medial wall was found to reduce bone resorption over time on the proximo-lateral zone of stress shielding, while lateral thinning was found advantageous for weaker bones. The findings of this study are likely to facilitate designing of femoral stems for achieving better physiological outcomes and enhancement of the quality of life of patients undergoing THR surgery.
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Affiliation(s)
- Subhomoy Chatterjee
- Department of Aerospace Engineering and Applied Mechanics, Indian Institute of Engineering Science and Technology, Howrah, West Bengal 711103, India; Materials Research Centre, Indian Institute of Science, Bangalore, Karnataka 560012, India
| | - Sandipan Roy
- Department of Aerospace Engineering and Applied Mechanics, Indian Institute of Engineering Science and Technology, Howrah, West Bengal 711103, India; Department of Mechanical Engineering, SRM Institute of Science & Technology, Kattankulathur, Kancheepuram, Chennai, Tamil Nadu 603203, India
| | - Santanu Majumder
- Department of Aerospace Engineering and Applied Mechanics, Indian Institute of Engineering Science and Technology, Shibpur, Howrah, West Bengal 711103, India
| | - Amit RoyChowdhury
- Department of Aerospace Engineering and Applied Mechanics, Indian Institute of Engineering Science and Technology, Shibpur, Howrah, West Bengal 711103, India
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Vajapey SP, Morris J, Li D, Greco NG, Li M, Spitzer AI. Outcome Reporting Patterns in Total Hip Arthroplasty. JBJS Rev 2020; 8:e0197. [DOI: 10.2106/jbjs.rvw.19.00197] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
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Hu H, Liu Z, Liu B, Ding X, Liu S, Wu T, Ma W, Han Y. Comparison of Clinical Outcomes, Radiological Outcomes and Bone Remodeling Outcomes Between Proximal Coated Single-Wedge New Stem and Full Coated Dual-Wedge Classic Stem in 1-Stage Bilateral Total Hip Arthroplasty. Med Sci Monit 2020; 26:e921847. [PMID: 32001666 PMCID: PMC7006600 DOI: 10.12659/msm.921847] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
Background This retrospective study investigated the clinical outcomes, radiological outcomes, and bone remodeling patterns associated with a Medial/Lateral Taper (M/L Taper) stem and Link Classic Uncemented (LCU) stem in 1-stage bilateral total hip arthroplasty (THA). Material/Methods The results of 52 patients who underwent 1-stage bilateral THA with a M/L Taper stem on one side and an LCU stem on the other between January 2012 and February 2015 were retrospectively compared. Patients were clinically assessed by the Harris hip score (HHS), visual analogue score (VAS) and incidence of complications. Radiological indicators were measured. Periprosthetic bone remodeling was assessed via bone mineral density (BMD) measurements. Results The mean follow-up time was 5.2 years. At each follow-up, there was no difference in the HHS and VAS between the 2 groups. The neck-shaft angle, offset, vertical height of the rotational center and limb lengthening were lower in the M/L Taper group than in the LCU group (P<0.001). The Engh total score was lower in the LCU group (P=0.039). Significantly higher (P<0.001) BMDs were observed in the M/L Taper group in Gruen zones 1, 2, and 6. significantly lower (P<0.001) BMDs were observed in the M/L Taper group in Gruen zones 3 and 5. Conclusions Due to the increased postoperative neck-shaft angle, the full coated dual-wedge classic stem was prone to cause lower limb lengthening. The proximal coated single-wedge new stem patients were more likely to have an insufficient postoperative neck length. The new stem achieved load transfer and proximal fixation, leading to better proximal femoral bone preservation is more in line with human biomechanical characteristics.
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Affiliation(s)
- Hongpeng Hu
- Department of Osteonecrosis and Hip Surgery, The Third Hospital of Hebei Medical University, Shijiazhuang, Hebei, China (mainland)
| | - Zeming Liu
- Department of Osteonecrosis and Hip Surgery, The Third Hospital of Hebei Medical University, Shijiazhuang, Hebei, China (mainland)
| | - Bo Liu
- Department of Osteonecrosis and Hip Surgery, The Third Hospital of Hebei Medical University, Shijiazhuang, Hebei, China (mainland)
| | - Xuzhuang Ding
- Department of Osteonecrosis and Hip Surgery, The Third Hospital of Hebei Medical University, Shijiazhuang, Hebei, China (mainland)
| | - Sikai Liu
- Department of Osteonecrosis and Hip Surgery, The Third Hospital of Hebei Medical University, Shijiazhuang, Hebei, China (mainland)
| | - Tao Wu
- Department of Osteonecrosis and Hip Surgery, The Third Hospital of Hebei Medical University, Shijiazhuang, Hebei, China (mainland)
| | - Wenhui Ma
- Department of Osteonecrosis and Hip Surgery, The Third Hospital of Hebei Medical University, Shijiazhuang, Hebei, China (mainland)
| | - Yongtai Han
- Department of Osteonecrosis and Hip Surgery, The Third Hospital of Hebei Medical University, Shijiazhuang, Hebei, China (mainland)
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Civantos A, Martínez-Campos E, Ramos V, Elvira C, Gallardo A, Abarrategi A. Titanium Coatings and Surface Modifications: Toward Clinically Useful Bioactive Implants. ACS Biomater Sci Eng 2017; 3:1245-1261. [DOI: 10.1021/acsbiomaterials.6b00604] [Citation(s) in RCA: 182] [Impact Index Per Article: 26.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Affiliation(s)
- Ana Civantos
- Tissue
Engineering Group, Institute of Biofunctional Studies, Associated
Unit to the Institute of Polymer Science and Technology (CSIC), Pharmacy
Faculty, Complutense University of Madrid (UCM), Paseo Juan XXIII 1, 28040 Madrid, Spain
- Polymer
Functionalization Group, Institute of Polymer Science and Technology, ICTP-CSIC, Juan de la Cierva, 3, 28006 Madrid, Spain
| | - Enrique Martínez-Campos
- Tissue
Engineering Group, Institute of Biofunctional Studies, Associated
Unit to the Institute of Polymer Science and Technology (CSIC), Pharmacy
Faculty, Complutense University of Madrid (UCM), Paseo Juan XXIII 1, 28040 Madrid, Spain
- Polymer
Functionalization Group, Institute of Polymer Science and Technology, ICTP-CSIC, Juan de la Cierva, 3, 28006 Madrid, Spain
| | - Viviana Ramos
- Tissue
Engineering Group, Institute of Biofunctional Studies, Associated
Unit to the Institute of Polymer Science and Technology (CSIC), Pharmacy
Faculty, Complutense University of Madrid (UCM), Paseo Juan XXIII 1, 28040 Madrid, Spain
- Noricum S.L., San Sebastián
de los Reyes, Av. Fuente Nueva, 14, 28703 Madrid, Spain
| | - Carlos Elvira
- Polymer
Functionalization Group, Institute of Polymer Science and Technology, ICTP-CSIC, Juan de la Cierva, 3, 28006 Madrid, Spain
| | - Alberto Gallardo
- Polymer
Functionalization Group, Institute of Polymer Science and Technology, ICTP-CSIC, Juan de la Cierva, 3, 28006 Madrid, Spain
| | - Ander Abarrategi
- Haematopoietic
Stem Cell Laboratory, The Francis Crick Institute, 1 Midland
Road, NW1 1AT London, U.K
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Koyano G, Jinno T, Koga D, Yamauchi Y, Muneta T, Okawa A. Comparison of Bone Remodeling Between an Anatomic Short Stem and a Straight Stem in 1-Stage Bilateral Total Hip Arthroplasty. J Arthroplasty 2017; 32:594-600. [PMID: 27554784 DOI: 10.1016/j.arth.2016.07.016] [Citation(s) in RCA: 30] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/29/2015] [Revised: 07/03/2016] [Accepted: 07/08/2016] [Indexed: 02/08/2023] Open
Abstract
BACKGROUND Femurs of dysplastic hips exhibit specific abnormalities, and use of modular or specially designed components is recommended. An anatomic short stem was previously designed specifically for dysplastic hips using 3-dimensional data acquired from dysplastic patients. To investigate effects of stem geometry on bone remodeling, we undertook a prospective, randomized study of patients who had undergone 1-stage bilateral total hip arthroplasty (THA) with the anatomic short stem on one side and a conventional straight stem on the other. METHODS The study included 36 patients who underwent the above THA procedure. We assessed bone mineral density as well as the presence of cancellous condensation or bony atrophy due to stress shielding based on the analysis of Gruen's zones and newly defined equal-interval zones, at an average follow-up period of 9.2 years. RESULTS All stems were bone ingrown stable. Cancellous condensation was observed more proximally, and areas of bone atrophy were narrower on the anatomic short stem side than on the straight stem side. Bone mineral density values reflected results of cancellous condensation and stress shielding and were higher in more proximal zones on the anatomic short stem side than on the straight stem side. CONCLUSION Although radiographic results indicated good midterm outcomes of THA with both stems, the loading pattern differed. The anatomic short stem achieved its design purpose in terms of proximal fixation and load transfer and led to better preservation of the proximal femur.
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Affiliation(s)
- Gaku Koyano
- Department of Orthopaedic Surgery, Medical Hospital of Tokyo Medical and Dental University, Tokyo, Japan
| | - Tetsuya Jinno
- Department of Orthopaedic Surgery, Medical Hospital of Tokyo Medical and Dental University, Tokyo, Japan
| | - Daisuke Koga
- Department of Orthopaedic Surgery, Medical Hospital of Tokyo Medical and Dental University, Tokyo, Japan
| | - Yuki Yamauchi
- Department of Orthopaedic Surgery, Medical Hospital of Tokyo Medical and Dental University, Tokyo, Japan
| | - Takeshi Muneta
- Department of Orthopaedic Surgery, Medical Hospital of Tokyo Medical and Dental University, Tokyo, Japan
| | - Atsushi Okawa
- Department of Orthopaedic Surgery, Medical Hospital of Tokyo Medical and Dental University, Tokyo, Japan
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Inaba Y, Kobayashi N, Oba M, Ike H, Kubota S, Saito T. Difference in Postoperative Periprosthetic Bone Mineral Density Changes Between 3 Major Designs of Uncemented Stems: A 3-Year Follow-Up Study. J Arthroplasty 2016; 31:1836-41. [PMID: 26952205 DOI: 10.1016/j.arth.2016.02.009] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/13/2015] [Revised: 01/19/2016] [Accepted: 02/02/2016] [Indexed: 02/01/2023] Open
Abstract
BACKGROUND Although few studies have examined the direct effect of stress shielding on clinical outcomes, periprosthetic bone loss due to stress shielding is still an issue of concern, especially when physicians perform uncemented total hip arthroplasty (THA) in younger patients. Differences in femoral stem design may affect the degree of postoperative stress shielding. Therefore, the characteristics of the behavior for stress shielding of each type of femoral stem should be determined. This study compares differences in bone mineral density (BMD) change in the femur after primary THA between 3 major types of uncemented stems. METHODS Among a total of 89 hips, 26 hips received THA with a fit-and-fill type stem (VerSys Fiber Metal MidCoat; Zimmer, Inc, Warsaw, IN), 32 hips received a tapered rectangular Zweymüller-type stem (SL-Plus; Smith & Nephew Inc, Memphis, TN), and 31 received a tapered wedge-type stem (Accolade TMZF; Stryker Orthopaedics, Mahwah, NJ). BMD measurements were performed with a HOLOGIC Discovery device (Hologic Inc, Waltham, MA). RESULTS BMD in the medial-proximal femur was maintained for 3 years after THA in the group with the tapered wedge-type stem. BMD in the lateral-proximal femur was maintained for 3 years after THA in the group with the Zweymüller-type stem. There were no significant differences in the Harris Hip Score among the 3 stem groups preoperatively and 1, 2, and 3 years after surgery. CONCLUSION There are clear differences in postoperative BMD loss of the proximal femur among these 3 commonly used uncemented stems.
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Affiliation(s)
- Yutaka Inaba
- Department of Orthopaedic Surgery, Yokohama City University, Yokohama, Japan
| | - Naomi Kobayashi
- Department of Orthopaedic Surgery, Yokohama City University, Yokohama, Japan
| | - Masatoshi Oba
- Department of Orthopaedic Surgery, Yokohama City University, Yokohama, Japan
| | - Hiroyuki Ike
- Department of Orthopaedic Surgery, Yokohama City University, Yokohama, Japan
| | - So Kubota
- Department of Orthopaedic Surgery, Yokohama City University, Yokohama, Japan
| | - Tomoyuki Saito
- Department of Orthopaedic Surgery, Yokohama City University, Yokohama, Japan
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