Plasma Prekallikrein Activity in Patients with Total Hip Arthroplasty

1987 ◽  
Vol 58 (04) ◽  
pp. 1040-1042
Author(s):  
J J M L Hoffmann ◽  
J H J P M Kortmann
Keyword(s):  
Total Hip Arthroplasty ◽  
Hip Arthroplasty ◽  
Hip Prosthesis ◽  
Contact System ◽  
Factor Xii ◽  
Total Hip ◽  
Activity Factor ◽  
Patient Groups ◽  
Kallikrein Activity

SummaryThe behaviour of the contact system was studied in 40 patients with total hip arthroplasty, by measuring plasma prekallikrein, spontaneous kallikrein activity and factor XII. In the literature it had been shown that patients with complications from this operation had decreased prekallikrein and increased kallikrein activity (M. Nakahara. Acta orthop scand 1982; 53: 591-6). In the present study, comprising patients with and without pain and proven loosening of the hip prosthesis, these findings could only partially be confirmed. Patients with a loosened prosthesis had significantly lower prekallikrein (mean 0.78 ± 0.28 U/ml; p <0.01) than patients without problems, but no detectable kallikrein activity in plasma. Patients with pain but no loosening had normal prekallikrein (1.04 ±0 0.26 U/ml) and also no demonstrable kallikrein activity. Factor XII was normal in all patient groups. It is concluded that decreased prekallikrein is limited to patients with a loosened hip prosthesis, with or without pain.

Treatment of Femoral Fractures Associated with Stem Loosening following Total Hip Arthroplasty

1998 ◽  
Vol 8 (3) ◽  
pp. 138-144 ◽  
Author(s):  
B. Erdemli ◽  
I. Gurkan ◽  
B. Guzel ◽  
I. Cetin
Keyword(s):  
Total Hip Arthroplasty ◽  
Hip Arthroplasty ◽  
Hip Prosthesis ◽  
Femoral Fractures ◽  
Early Mobilization ◽  
Revision Operation ◽  
Hip Revision ◽  
Total Hip ◽  
Primary Hip Arthroplasty ◽  
Fractures Of The Femur

We report the results of Kent hip revision arthroplasties performed in 5 patients with fractures of the femur associated with femoral loosening following total hip arthroplasty. The fractures occurred at an average of 40.4 months following the primary hip arthroplasty. The system of Merle D'Aubigné and Postel, as modified by Charnley, was used for the clinical evaluation. One to four years (mean, 2.6 years) after the revision operation, the clinical and radiographic results were satisfactory. With the help of the transfixion screws the Kent Hip prosthesis provides stable fixation and facilitates early mobilization, with its attendant advantages.

scholarly journals Impact of stem design and cementation on postoperative femoral antetorsion in 227 patients with total hip arthroplasty (THA)

2020 ◽  
Vol 49 (12) ◽  
pp. 2001-2009
Author(s):  
Tim Fischer ◽  
Christoph Stern ◽  
Benjamin Fritz ◽  
Patrick O. Zingg ◽  
Christian W. A. Pfirrmann ◽  
...  
Keyword(s):  
Retrospective Study ◽  
Total Hip Arthroplasty ◽  
Hip Arthroplasty ◽  
Hip Prosthesis ◽  
Femoral Stem ◽  
Stem Design ◽  
Femoral Antetorsion ◽  
Total Hip ◽  
Posterior Condylar ◽  
Lower Variability

Abstract Objective In total hip arthroplasty (THA), surgeons attempt to achieve a physiological antetorsion. However, postoperative antetorsion of the femoral stem is known to show large variabilities. The purpose of this study was to assess whether postoperative antetorsion is influenced by stem design or cementation. Materials and methods This retrospective study included 227 patients with a hip prosthesis with five different stem designs (S1: short curved, S2 and S3: standard straight, S4: standard straight collared, S5: cemented straight), who had metal suppressed 1.5T-MRI of the hip between February 2015 and October 2019. Measurement of femoral antetorsion was done independently by two fellowship-trained radiologists on axial images by measuring the angle between the long axis of the femoral neck and the posterior condylar tangent of the knee. Measured angles in the different groups were compared using the t test for independent samples. Results The cementless collared stem S4 showed the highest antetorsion with 18.1° (± 10.5°; range –10°–45°), which was significantly higher than the antetorsion of the collarless S3 with 13.3° (± 8.4°; − 4°–29°) and the cemented S5 with 12.7° (± 7.7°; − 3°–27°) with p = 0.012 and p = 0.007, respectively. S1 and S2 showed an antetorsion of 14.8° (± 10.0°; 1°–37°) and 14.1° (± 12.2°; − 20°–41°). The torsional variability of the cementless stems (S1–4) was significantly higher compared with that of the cemented S5 with a combined standard deviation of 10.5° and 7.7° (p = 0.019). Conclusion Prosthesis design impacts the postoperative femoral antetorsion, with the cementless collared stem showing the highest antetorsion. Cemented stems demonstrated significantly lower variability, suggesting the lowest rate of inadvertent malrotation.

Total Hip Arthroplasty with the Porous-Coated Anatomic Hip Prosthesis

2006 ◽  
Vol 21 (3) ◽  
pp. 338-343 ◽  
Author(s):  
Bryan S. Little ◽  
Richard L. Wixson ◽  
S. David Stulberg
Keyword(s):  
Total Hip Arthroplasty ◽  
Hip Arthroplasty ◽  
Hip Prosthesis ◽  
Total Hip

scholarly journals Total Hip Arthroplasty – over 100 years of operative history

2011 ◽  
Vol 3 (2) ◽  
pp. 16 ◽  
Author(s):  
Stephen Richard Knight ◽  
Randeep Aujla ◽  
Satya Prasad Biswas
Keyword(s):  
Total Hip Arthroplasty ◽  
Hip Arthroplasty ◽  
Total Hip ◽  
Prosthetic Materials ◽  
Patient Groups ◽  
Selection Of

<p>Total hip arthroplasty (THA) has completely revolutionised the nature in which the arthritic hip is treated, and is considered to be one of the most successful orthopaedic interventions of its generation (1). With over 100 years of operative history, this review examines the progression of the operation from its origins, together with highlighting the materials and techniques that have contributed to its development. Knowledge of its history contributes to a greater understanding of THA, such as the reasons behind selection of prosthetic materials in certain patient groups, while demonstrating the importance of critically analyzing research to continually determine best operative practice. Finally, we describe current areas of research being undertaken to further advance techniques and improve outcomes.</p>

scholarly journals The Utility of Digital Linear Tomosynthesis Imaging of Total Hip Joint Arthroplasty with Suspicion of Loosening: A Prospective Study in 40 Patients

2013 ◽  
Vol 2013 ◽  
pp. 1-6 ◽  
Author(s):  
Jan H. Göthlin ◽  
Mats Geijer
Keyword(s):  
Total Hip Arthroplasty ◽  
Prospective Study ◽  
Hip Joint ◽  
Hip Arthroplasty ◽  
Clinical Utility ◽  
Hip Prosthesis ◽  
Joint Arthroplasty ◽  
Acetabular Cup ◽  
Total Hip ◽  
A Prospective Study

Aim. The clinical utility of digital linear tomosynthesis in musculoskeletal applications has been validated in only a few reports. Technical performance and utility in hip prosthesis imaging have been discussed in technical reports, but no clinical evaluation has been reported. The purpose of the current study was to assess the added clinical utility of digital linear tomosynthesis compared to radiography in loosening of total hip joint arthroplasty.Materials and Methods. In a prospective study, radiography and digital tomosynthesis were performed in 40 consecutive patients with total hip arthroplasty referred for suspect prosthesis loosening. Tomosynthesis images were compared to anterior-posterior (AP) and cross-table lateral radiographs regarding demarcation and extent of demineralization and osteolysis. Further noted were skeletal fractures, cement fractures, fragmentation, and artifacts interfering with the diagnosis.Results. Tomosynthesis was superior to radiography with sharper delineation of demineralization and osteolysis in the AP projection. A limitation was the inability to generate lateral tomosynthesis images, with inferior assessment of the area anterior and posterior to the acetabular cup compared to cross-table radiographs. Artifacts interfering with diagnosis were found in one hip.Conclusion. Tomosynthesis improved evaluation of total hip arthroplasty in the AP projection but was limited by the lack of lateral projections.

scholarly journals Subgroup Analysis of Topical Tranexamic Acid in Primary Total Hip Arthroplasty

2015 ◽  
Vol 5 (1) ◽  
Author(s):  
Walter Anazonwu ◽  
John Tuttle ◽  
Lee Rubin
Keyword(s):  
Total Hip Arthroplasty ◽  
Tranexamic Acid ◽  
Hip Arthroplasty ◽  
Blood Product Transfusion ◽  
Specific Patient ◽  
Total Hip ◽  
Patient Groups ◽  
Topical Tranexamic Acid ◽  
Consistent Response ◽  
Primary Total Hip Arthroplasty

Tranexamic acid (TXA) is an antifibrinolytic agent that can effectively be utilized for the reduction of blood loss when administered via intravenous or intraarticular injection following total joint arthroplasty. Despite data published to date, it remains unclear as to which specific patient groups undergoing primary total hip arthroplasty (THA) would benefit most regarding transfusion reduction from TXA administration. Using a retrospective cohort study model involving 123 THA patients who received topical TXA compared against 111 THA controls who did not receive TXA, we assessed data within the following subgroups: age, gender, BMI, preoperative hemoglobin, and surgical approach. Critical analysis of these subgroups revealed that the most reliable and consistent response to TXA was found in patients who were female and over 65 years old. Continued study of TXA administration in THA is essential to help reduce blood losses, minimize blood product transfusion, and improve outcomes following THA.

scholarly journals Enzymes and cytokines disease in total hip arthroplasty: promoters of immune loosening

2018 ◽  
Vol 66 (3) ◽  
pp. 477-484
Author(s):  
Victorino Pacheco-Martelo ◽  
Sebastián Roldán-Vasco
Keyword(s):  
Total Hip Arthroplasty ◽  
Aseptic Loosening ◽  
Hip Arthroplasty ◽  
Hip Prosthesis ◽  
Prosthesis Loosening ◽  
Total Hip ◽  
Hip Prosthesis Loosening ◽  
Arthroplasty Failure

Introducción. Una de las causas más importantes de falla de la prótesis de cadera lo constituye el fenómeno de aflojamiento, el cual se relaciona con la liberación de enzimas mediada por citocinas y produce la lisis del hueso que soporta el implante.Objetivo. Describir los mecanismos de interacción biológica de las moléculas promotoras del aflojamiento de la prótesis total de cadera que con mayor frecuencia están presentes en el proceso.Materiales y métodos. Se realizó una búsqueda de artículos originales y casos clínicos en las bases de datos PubMed y Scopus, sin límite de fecha de publicación, utilizando los términos MeSH “hip prosthesis loosening”, “aseptic loosening”, “cytokines” y “hip arthroplasty failure”. La extracción de datos se hizo mediante la lectura de 250 estudios, de los cuales se seleccionaron 66 para fines de redacción.Resultados. Los autores describen las moléculas más representativas implicadas en el aflojamiento de la prótesis de cadera, además se presentan las interacciones entre ellas.Conclusiones. Enzimas y citocinas han sido ampliamente estudiadas por cuatro décadas, aunque sus mecanismos de interacción son poco conocidos. Los autores proponen un mecanismo de interacción, proceso que podría denominarse “enfermedad de las enzimas y citocinas” o “aflojamiento inmunológico”.

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