Influence of acetabular cup thickness on seating and primary stability in total hip arthroplasty

AbstractThe aim of this study was to assess a large, single-surgeon dataset of uncemented total hip arthroplasties that had been templated using software. This assessment compared preoperative templated predictions with what was implanted with regard to (1) femoral prosthesis size and (2) acetabular cup size. The operation notes for two types of uncemented total hip arthroplasty performed by a single surgeon between January 9, 2008, and March 21, 2019, were assessed. The data were refined so that only those that were fully templated on a correctly calibrated pelvic radiograph were included. This provided a total of 153 cases. The predicted software template was compared with actual implanted component sizes. With regard to the femoral stems, the templating software was exactly correct in 45.75% of cases and was accurate to within one size in 87.59% of cases. With regard to the acetabular component, the templating software was exactly correct in 52.94% of cases and was accurate to within one size (2 mm) in 86.94% of cases. Templating software offers an accurate prediction of the size of uncemented femoral and acetabular components. In addition, the benefits of templating include cognitive rehearsal, insight into potentially challenging aspects of surgery, and highlighting intraoperative issues where there is a large intraoperative deviation from what is templated. This study demonstrates the congruence and reproducibility of templating software when compared with other smaller studies performed in the literature.

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Endoscopic tenotomy for iliopsoas tendinopathy following total hip arthroplasty can relieve pain regardless acetabular cup overhang or anteversion

Arthroscopy The Journal of Arthroscopic and Related Surgery ◽

10.1016/j.arthro.2021.03.043 ◽

2021 ◽

Author(s):

Maria-Roxana Viamont-Guerra ◽

Sonia Ramos-Pascual ◽

Mo Saffarini ◽

Nicolas Bonin

Keyword(s):

Total Hip Arthroplasty ◽

Hip Arthroplasty ◽

Acetabular Cup ◽

Total Hip ◽

Relieve Pain

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Revision Total Hip Arthroplasty of an Acetabular Cup with Acetabular Bone Defects

The Journal of the Korean Hip Society ◽

10.5371/jkhs.2011.23.4.237 ◽

2011 ◽

Vol 23 (4) ◽

pp. 237 ◽

Cited By ~ 4

Author(s):

Kyu Tae Hwang ◽

Young Ho Kim

Keyword(s):

Total Hip Arthroplasty ◽

Hip Arthroplasty ◽

Bone Defects ◽

Revision Total Hip Arthroplasty ◽

Acetabular Cup ◽

Acetabular Bone ◽

Total Hip ◽

Acetabular Bone Defects

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Compression of the Femoral Vessels by a Pseudotumor after Metal-on-Metal Total Hip Arthroplasty

Case Reports in Orthopedics ◽

10.1155/2017/2594902 ◽

2017 ◽

Vol 2017 ◽

pp. 1-5

Author(s):

Yasuaki Tamaki ◽

Tomohiro Goto ◽

Takahiko Tsutsui ◽

Tomoya Takasago ◽

Keizo Wada ◽

...

Keyword(s):

Total Hip Arthroplasty ◽

Hip Arthroplasty ◽

Vascular Compression ◽

Acetabular Cup ◽

Primary Metal ◽

Total Hip ◽

Circulatory Disturbance ◽

Metal Head ◽

Metal On Metal ◽

Femoral Vessels

Here we present a case of pseudotumor following total hip arthroplasty (THA) that resulted in a circulatory disturbance caused by compression of the femoral vasculature. A 63-year-old man presented with pain, swelling, and redness of the left leg 5 years after primary metal-on-metal THA using the AML-Plus stem, Pinnacle® acetabular cup, and 36 mm diameter Ultamet™ metal head system (DePuy Orthopaedics, Warsaw, IN). Enhanced computed tomography and magnetic resonance imaging revealed a large cystic lesion extending from the left hip anteriorly to the intrapelvic region and compressing the left femoral vessels. Percutaneous puncture of the lesion yielded a dark red aspirate and the patient was diagnosed to have a pseudotumor causing compression of the femoral vessels. We performed revision surgery to replace the metal head and metal liner with a smaller ceramic head and polyethylene liner without removal of the stem. Corrosion of the head-neck junction was identified intraoperatively with no obvious wear on the bearing surfaces. The left leg swelling and redness improved immediately postoperatively. A large pseudotumor should be kept in mind as a cause of vascular compression with unilateral leg edema in a patient who has undergone metal-on-metal THA.

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Failure Mode of Polyethylene Liner in Total Hip Arthroplasty with Harris-Galante II Acetabular Cup

The Journal of the Korean Orthopaedic Association ◽

10.4055/jkoa.2004.39.7.766 ◽

2004 ◽

Vol 39 (7) ◽

pp. 766

Author(s):

Byung Woo Min ◽

Ki Cheol Bae ◽

Kyung Jae Lee ◽

Sung Won Sohn ◽

Chul Hyung Kang

Keyword(s):

Total Hip Arthroplasty ◽

Failure Mode ◽

Hip Arthroplasty ◽

Polyethylene Liner ◽

Acetabular Cup ◽

Total Hip

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To cement or not to cement acetabular cups in total hip arthroplasty: a systematic review and re-evaluation

SICOT-J ◽

10.1051/sicotj/2019032 ◽

2019 ◽

Vol 5 ◽

pp. 35

Author(s):

Frank Van Praet ◽

Michiel Mulier

Keyword(s):

Total Hip Arthroplasty ◽

Hip Arthroplasty ◽

English Literature ◽

Cost Effective ◽

Acetabular Cup ◽

Qualitative Synthesis ◽

Osteoarthritis Of The Hip ◽

Total Hip ◽

Primary Osteoarthritis ◽

Cemented Stem

Introduction: Total Hip Arthroplasty (THA) in the treatment of primary osteoarthritis of the hip has evolved to a very safe and cost-effective intervention with revision rates below 5% after 10 years. To this day, however, controversy remains on whether or not to cement the acetabular cup. Methods: A comprehensive PubMed search of the English literature for studies published between 2007 and 2018 was performed. Studies comparing the clinical (revision rate, functionality), radiological (wear) or economic (cost) differences between cemented (cemented stem with cemented cup) and hybrid (cemented stem with uncemented cup) prostheses for primary osteoarthritis of the hip were identified as eligible. Results: A total of 1032 studies were identified whereof twelve were included for qualitative synthesis. All studies concerning the risk of revision were based on registry data, covering a total of 365,693 cups. Cemented prostheses had a similar or lower risk of revision compared to hybrid prostheses in every study, but performed slightly worse on functionality and quality of life. While cemented prostheses were the cheapest option, hybrids were the most cost-effective. Discussion: The widespread preference for cementless fixation of the acetabulum cannot be explained by a superior survival of cementless or hybrid models. Irrespective of age, cemented fixation of the acetabulum remains the gold standard to which other techniques should be compared.

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The Wagner SL-Revision Stem for Aseptic Loosening: Clinical and Radiological Results 5 to 7 Years after Femoral Revision

Hip International ◽

10.1177/112070000301300206 ◽

2003 ◽

Vol 13 (2) ◽

pp. 94-100

Author(s):

M.J.F. Diks ◽

M. Spruit ◽

J.J. Reimering ◽

F. Den Boer ◽

P.G. Anderson

Keyword(s):

Total Hip Arthroplasty ◽

Bone Loss ◽

Aseptic Loosening ◽

Hip Arthroplasty ◽

Primary Stability ◽

Harris Hip Score ◽

Radiological Evaluation ◽

Total Hip ◽

Revision Stem

Aseptic loosening in total hip arthroplasty can lead to proximal femoral periprosthetic bone loss. The non-cemented Wagner revision stem achieves primary fixation in the diaphysis. The purpose of this study is to evaluate the results after medium- to long-term follow-up of the Wagner prosthesis for revision of the femoral component for aseptic loosening in total hip arthroplasty with proximal femoral bone loss. We performed 53 femoral revisions for aseptic loosening with the non-cemented Wagner revision stem. Clinical assessment included a modified Harris Hip Score and a radiological evaluation. The mean follow-up was 65 months. The Harris Hip Score improved significantly (42.9 to 72.3). Radiological evaluation revealed 24.5% subsidence (>5 mm) in our population. Nine re-revisions were done, eight in the first post-operative year. The re-revisions were performed for progressive subsidence (five), recurrent dislocations (one), subsidence with low-grade infection (one), false route (one), and aseptic loosening after 75 months (one). The cumulative survival rate of the Wagner stem after 12 months was 85% and 76% after 75 months. A relatively high re-revision rate was observed during the first post-operative year. Analysis of these failures has shown that subsidence may be the result of insufficient primary stability. Adequate pre-operative planning and intra-operative radiological assistance is necessary for perfect primary stability and fixation of the Wagner stem. The re-revision incidence after the first 12 months is 0.45 per 100 implants per year. The prosthesis has good survival potential after proper introduction.

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