Durability of Implant Fixation After Less-Invasive Total Hip Arthroplasty

In this review, we discuss the evidence for patients returning to sport after hip arthroplasty. This includes the choices regarding level of sporting activity and revision or complications, the type of implant, fixation and techniques of implantation, and how these choices relate to health economics. It is apparent that despite its success over six decades, hip arthroplasty has now evolved to accommodate and support ever-increasing patient demands and may therefore face new challenges. Cite this article: Bone Joint J 2020;102-B(6):661–663.

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Cemented versus uncemented hip implant fixation

Bone and Joint Research ◽

10.1302/2046-3758.812.bjr-2019-0337 ◽

2019 ◽

Vol 8 (12) ◽

pp. 604-607 ◽

Cited By ~ 4

Author(s):

Sujith Konan ◽

Matthew P. Abdel ◽

Fares S. Haddad

Keyword(s):

Cost Effectiveness ◽

Total Hip Arthroplasty ◽

Femoral Component ◽

Hip Arthroplasty ◽

Chronological Age ◽

Implant Fixation ◽

Hip Implant ◽

Total Hip ◽

Cementless Total Hip Arthroplasty ◽

The Uk

There is continued debate as to whether cemented or cementless implants should be utilized in particular cases based upon chronological age. This debate has been rekindled in the UK and other countries by directives mandating certain forms of acetabular and femoral component fixation based exclusively on the chronological age of the patient. This editorial focuses on the literature-based arguments to support the use of cementless total hip arthroplasty (THA), while addressing potential concerns surrounding safety and cost-effectiveness. Cite this article: Bone Joint Res. 2019;8(12):604–607.

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Predicting Cementless Stem Fixation in Total Hip Arthroplasty Using Radiodensity Mapping

10.29007/dv5n ◽

2020 ◽

Author(s):

Teja Cherukuri ◽

Chameka Madurawe ◽

Jim Pierrepont ◽

Jonathan Bare ◽

Stephen McMahon ◽

...

Keyword(s):

Bone Density ◽

Total Hip Arthroplasty ◽

Hip Arthroplasty ◽

Femoral Stem ◽

X Rays ◽

Implant Fixation ◽

X Ray ◽

Total Hip ◽

Stem Subsidence

Femoral component loosening due to poor fixation is a common failure mode in cementless total hip arthroplasty (THA). We sought to develop a technique to predicted femoral stem fixation using pre-operative CT.Forty-nine patients requiring THA received pre-operative CTs as part of Corin OPSTM 3D dynamic planning. All patients received a taper wedged blade stem (TriFitTM TS, Corin UK) implanted through a posterior approach. Post-operatively, patients received an immediate CT and AP x-ray and a 1-year follow-up x-ray. The distance between the most superior point of the greater trochanter and the shoulder of the stem was measured and scaled using the known cup diameter on both the immediate and 1- year follow-up x-rays. The difference was recorded as stem subsidence. Subsidence greater than 4mm was deemed clinically relevant. The precise placement of the stem determined by registering the known 3D implant geometry to the post-op CT was virtually implanted back into the pre-operative OPSTM planning software. A colour map of the bone density at the stem/bone interface using the Hounsfield Units (HU) of each CT pixel was generated. Blue represents low density bone transitioning through to green and then red.Mean stem subsidence was 1.8mm (0 to 11.1mm). Five patients had clinically relevant subsidence. Significant areas of blue and green around the proximal portion of the stem was observed in high subsidence stems when compared to the stems with minimal subsidence.Using the HU of the CT scan as an indicator for bone density, we were able to predict poor implant fixation and subsequent subsidence in a taper wedge stem.

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Clinical, functional and instrumental results of total hip arthroplasty in primary osteoarthritis

Medical alphabet ◽

10.33667/2078-5631-2019-2-37(412)-34-39 ◽

2020 ◽

Vol 2 (37) ◽

pp. 34-39

Author(s):

D. V. Volchenko ◽

A. Yu. Terskov ◽

I. F. Akhtyamov ◽

Yu. D. Udalov ◽

O. A. Sozonov ◽

...

Keyword(s):

Total Hip Arthroplasty ◽

Hip Arthroplasty ◽

Friction Pair ◽

Early Period ◽

Harris Hip Score ◽

Implant Fixation ◽

Total Hip ◽

Primary Osteoarthritis ◽

Group I ◽

Group Ii

A comparative analysis of the clinical, functional and radiological results of total hip arthroplasty (THA) in pts with primary osteoarthritis (PA) was carried out. The aim was to improve the results of THA in pts with degenerative diseases of the hip joint based on the choice of the optimal type of components fixation. The study included 125 patients (68 women, 57 men) with primary coxarthritis who underwent 125 operations of unilateral THA. All pts were divided into two groups depending on the type of components fixation. Group I (N = 63; average age 69.8 ± 3.1; from 34 to 75 years) included pts with cementless fixation (DePuy, Zimmer, titanium cups, titanium stems such as Corail and Zweymuller), in group II (N = 62; average age 67.2 ± 2.7; from 44 to 87 years) — with cement fixation (Zimmer, Smith & Nephew — low-profile Muller cup, Muller stem). Metal-polyethylene friction pair and head size 32 mm were used in all cases. Evaluation of the results was carried out on 2, 6 months, 1, 5, 10 years after the operation and included: functional state assessment (Harris Hip Score), radiographs analysis, as well as the frequency of complications and revision interventions. There were no significant differences in the incidence of deep periprosthetic infection, thromboembolic complications, hematomas, paraarticular ossifications, aseptic loosening, dislocations and revision interventions. There was faster positive dynamics in the early period (up to 6 months) when using cemented THA. Subsequently all the indicators were comparable in both groups. Osteolysis at the border of implant fixation was recorded in two cases in group I and in 11 cases in group II (p < 0,05). In group I, eight periprosthetic intraoperative fractures of the proximal hip were recorded; in group II, this complication was obtained in one pt (p < 0.05). Stress-shielding syndrome was detected in six pts from group I. This complication was not detected in group II (p < 0.05). Thus, both methods are comparable in results and can be equally applicable for the surgical treatment of patients with primary osteoarthritis, which can significantly expand the possibilities of specialized medical care and effective rehabilitation of this category of patients.

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No consensus on cementless fixation currently being the most cost‐effective mode of implant fixation in younger total hip arthroplasty patients

International Journal of Clinical Practice ◽

10.1111/ijcp.14587 ◽

2021 ◽

Vol 75 (9) ◽

Author(s):

Hidde D. Veldman ◽

Robin T. A. L. Bot ◽

Ide C. Heyligers ◽

Tim A. E. J. Boymans ◽

Mickaël Hiligsmann

Keyword(s):

Total Hip Arthroplasty ◽

Hip Arthroplasty ◽

Cost Effective ◽

Cementless Fixation ◽

Implant Fixation ◽

Total Hip

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Comparison of postoperative effectiveness of less invasive short external rotator sparing approach versus standard posterior approach for total hip arthroplasty

10.21203/rs.3.rs-68784/v2 ◽

2020 ◽

Author(s):

Tianbao Wang ◽

Yongwei Zhou ◽

Xiaofei Li ◽

Siqi Gao ◽

Qining Yang

Keyword(s):

Postoperative Pain ◽

Total Hip Arthroplasty ◽

Blood Loss ◽

Hip Arthroplasty ◽

Posterior Approach ◽

Short External Rotator ◽

Total Hip ◽

Less Invasive ◽

External Rotator ◽

Standard Posterior Approach

Abstract Background: Most of the studies assessing the corrective posterior total hip arthroplasty (THA) mainly focused on the mini-incision approach. Studies exploring the short external rotator sparing approach are rare. Therefore, this study aimed to compare the effectiveness of standard posterior approach and short external rotator sparing approach.Methods: This prospective observational study included 126 patients who underwent THAin 06/2017-06/2018. Patients were assigned to standard (standard posterior approach) and corrective (short external rotator sparing approach) groups based on the surgical method. Surgical data were recorded postoperatively. Postoperative hip joint recovery was assessed using the times to ambulation and independent stair use, and Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) score, Harris score, and Oxford hip score (OHS) at 2 and 8 postoperative weeks. The visual analog scale (VAS) was used for postoperative pain assessment.Results: Postoperative changes of creatine kinase (CK), myoglobin, CRP, and prosthesis position were similar in both groups (P > 0.05). However, intraoperative blood loss (P < 0.001) and postoperative 6-hour drainage volume (P = 0.03), hospital stay, blood transfusion rate, and times to ambulation and independent stair use were significantly reduced in the corrective group. Postoperatively, Oxford and WOMAC scores significantly decreased in both groups. After surgery, the VAS score was more overtly decreased in the corrective group compared with the standard group.Conclusions: This study concluded that the less invasive short external rotator sparing approach for THA caused less damage, reducing perioperative blood loss, shortening functional recovery time, maintaining prosthesis stability, and improving postoperative pain.

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