A Distal Fluted, Proximal Modular Femoral Prosthesis in Revision Hip Arthroplasty

2010 ◽  
Vol 25 (6) ◽  
pp. 932-938 ◽  
Author(s):  
Myung-Sik Park ◽  
Ju-Hong Lee ◽  
Jong-Hyuk Park ◽  
Dong-Hun Ham ◽  
Yang-Keun Rhee
2014 ◽  
Vol 6 (1) ◽  
Author(s):  
Ali Ghoz ◽  
Matthew L. Broadhead ◽  
John Morley ◽  
Shawn Tavares ◽  
David McDonald

With an increasing number of primary hip replacements being performed every year, the burden of revision hip arthroplasty, for septic and aseptic loosening, recurrent dislocation or periprosthetic fracture, is also increasing. In recent years, different approaches to revising the femoral prosthesis have emerged; including both cemented and cementless techniques. With a stable cement mantle and good bone quality, or through the use of impaction bone grafting when bone stock is lacking, it is possible to re-cement a femoral prosthesis. Alternatively, a cementless modular femoral prosthesis may be used, providing the surgeon with further options for restoring leg length, hip offset, anteversion and stability. Studies evaluating the use of modular cementless prostheses have so far been limited to mid-term studies, with results comparable to primary hip arthroplasty. There are some concerns, however, regarding tribological complications such as stem fracture, corrosion, and failure, and long-term studies are required to further evaluate these concerns. This review outlines the current evidence for the use of both cemented and cementless modular femoral prostheses in the setting of revision hip arthroplasty. Results of prospective and retrospective studies will be outlined, along with results obtained from national joint registries.


2002 ◽  
Vol 17 (1) ◽  
pp. 108-110 ◽  
Author(s):  
Heikki M[auml ]enp[auml ][auml ] ◽  
Kari Laiho ◽  
Markku Kauppi ◽  
Kalevi Kaarela ◽  
Hannu Kautiainen ◽  
...  

2009 ◽  
Vol 468 (2) ◽  
pp. 491-496 ◽  
Author(s):  
Corey J. Richards ◽  
Clive P. Duncan ◽  
Bassam A. Masri ◽  
Donald S. Garbuz

2021 ◽  
Vol 11 ◽  
pp. 88-101
Author(s):  
Alex Upfill-Brown ◽  
Peter P. Hsiue ◽  
Troy Sekimura ◽  
Jay N. Patel ◽  
Micah Adamson ◽  
...  

2000 ◽  
Vol 120 (7-8) ◽  
pp. 386-389 ◽  
Author(s):  
G. B. Flugsrud ◽  
Stein Øvre ◽  
Bjarne Grøgaard ◽  
Lars Nordsletten

Orthopedics ◽  
1999 ◽  
Vol 22 (3) ◽  
pp. 313-318 ◽  
Author(s):  
Henry D Clarke ◽  
Timothy A Damron ◽  
Robert T Trousdale ◽  
Franklin H Sim ◽  
Dirk R Larson

2021 ◽  
Vol 103-B (6) ◽  
pp. 1070-1077
Author(s):  
Christian Hipfl ◽  
Wiebke Mooij ◽  
Carsten Perka ◽  
Sebastian Hardt ◽  
Georgi I. Wassilew

Aims The purpose of this study was to evaluate unexpected positive cultures in total hip arthroplasty (THA) revisions for presumed aseptic loosening, to assess the prevalence of low-grade infection using two definition criteria, and to analyze its impact on implant survival after revision. Methods A total of 274 THA revisions performed for presumed aseptic loosening from 2012 to 2016 were reviewed. In addition to obtaining intraoperative tissue cultures from all patients, synovial and sonication fluid samples of the removed implant were obtained in 215 cases (79%) and 101 cases (37%), respectively. Histopathological analysis was performed in 250 cases (91%). Patients were classified as having low-grade infections according to institutional criteria and Musculoskeletal Infection Society (MSIS) International Consensus Meeting (ICM) 2013 criteria. Low-grade infections according to institutional criteria were treated with targeted antibiotics for six weeks postoperatively. Implant failure was defined as the need for re-revision resulting from periprosthetic joint infection (PJI) and aseptic reasons. The mean follow-up was 68 months (26 to 95). Results Unexpected positive intraoperative samples were found in 77 revisions (28%). Low-grade infection was diagnosed in 36 cases (13%) using institutional criteria and in nine cases (3%) using MSIS ICM 2013 criteria. In all, 41 patients (15%) had single specimen growth of a low-virulent pathogen and were deemed contaminated. Coagulase-negative Staphylococcus and anaerobes were the most commonly isolated bacteria. Implant failure for PJI was higher in revisions with presumed contaminants (5/41, 12%) compared to those with low-grade infections (2/36, 6%) and those with negative samples (5/197, 3%) (p = 0.021). The rate of all-cause re-revision was similar in patients diagnosed with low-grade infections (5/36, 14%) and those with presumed contaminants (6/41, 15%) and negative samples (21/197, 11%) (p = 0.699). Conclusion Our findings suggest that the presumption of culture contamination in aseptic revision hip arthroplasty may increase the detection of PJI. In this cohort, the presence of low-grade infection did not increase the risk of re-revision. Further studies are needed to assess the relevance of single specimen growth and the benefits of specific postoperative antibiotic regimens. Cite this article: Bone Joint J 2021;103-B(6):1070–1077.


Sign in / Sign up

Export Citation Format

Share Document