Short-Term Follow-Up of the PROSTALAC Implant for Primary Total Hip Arthroplasty in Patients with an Infected Native/Total Hip

Author(s):  
Jean Chia ◽  
Alfred Roy ◽  
Emma Jackman ◽  
Mark Inglis ◽  
Christopher Wilson

AbstractInfection after a total hip replacement (THR) is a significant complication for patients and is costly for health services. The two-stage Prosthesis with Antibiotic Loaded Acrylic (PROSTALAC) procedure has been the gold standard treatment for managing THR infections. The aim of this study is to evaluate using a one-stage PROSTALAC procedure as an alternative for patients who would otherwise not be able to undergo THR surgery due to a previous hip infection.We evaluated nine cases where the PROSTALAC implant was used in the native hip. The reasons for surgery, clinical results, and complications were reviewed. An Australian Orthopaedic Association National Joint Replacement Registry data report verified that no patients were revised outside of our local center.All patients reported symptomatic relief and satisfactory function, one patient had a peri-prosthetic fracture after experiencing a fall, and one patient underwent surgery for loosening of the joint. No cases were revised to another implant or had further infection. Minimum follow-up was 2 years.Our results suggest that this implant is useful in patients with osteoarthritis of the hip with a history of previous infection or chronic infection of the native hip.

2020 ◽  
pp. 112070002096964
Author(s):  
Kirill Gromov ◽  
Nanna H Sillesen ◽  
Thomas Kallemose ◽  
Henrik Husted ◽  
Henrik Malchau ◽  
...  

Background: Introduction of new implants should be monitored closely to capture any signs of compromising patient safety. Vitamin E infused highly-crosslinked polyethylene liners (VEPE) offer the potential for reduced wear. Highwall liners have been hypothesised to result in increased wear and potential liner fractures. The aim of this study was to determine the 3–7-year follow-up of highwall VEPE for primary total hip arthroplasty (THA), focusing on liner-related complications. Methods: We included 1221 consecutive THA operations from July 2010 to May 2014 with minimum follow-up of 3 (3.1–6.8) years Data collected included demographics, implant data, complications, reoperations, and deaths. Data were cross-referenced with the Danish Hip Arthroplasty Registry in order to ensure validity and completeness. Acetabular shell position was measured using Martell Hip Analysis Suite in a subgroup of 931 THAs. Results: Cumulative stem revision and shell revision at 3-year follow-up was 3.4% and 0.4% respectively. There were no revisions due to liner failure. Reason for revision included 11 dislocations, 15 soft-tissue revisions for infection, 44 stem revisions of which 34 were periprosthetic fractures and 13 shell revisions of which 6 were combined shell and stem revisions. Conclusion: Early follow-up of VEPE liners for primary THA have not shown any revisions associated with liner failure. Continued monitoring of new materials are necessary to capture any signs of compromised patient safety.


2020 ◽  
Author(s):  
Nicolas Bonin ◽  
Gilles Estour ◽  
Jean-Emmanuel Gedouin ◽  
Olivier Guyen ◽  
Frederic Christopher Daoud

Abstract Background: This study estimated the short-term clinical safety and efficacy of hemispherical with flattened pole cobalt-chromium metal-back with porous outer hydroxyapatite coating dual-mobility acetabular cup (HFPC-DM-HA) in primary total hip arthroplasty.Methods: Single-center retrospective observational cohort study of consecutive patients undergoing total hip arthroplasty with a HFPC-DM-HA 2 years prior to study start. Prospective 2-year follow-up with letter and phone questionnaires.Results: Sampling frame: 361 patients including 59 patients (16.3%) in the cohort. 6 patients (10%) lost to follow-up. Median age 77.5 years (range: 67 ; 92), 32% female, median BMI 25.2 kg.m-2 (18.4 to 56.8). Clinical indications: Primary THA in all patients, resulting from primary osteoarthritis in 80% of them. Median follow-up 3.0 years (2.7 to 4.1). Primary endpoint: 2-year implant survival rate: 97% [87, 99]. Prosthetic dislocation: 0%. Secondary endpoint: Modified HHS (pain & functional subscore) improved from baseline 39.7 [34.6, 44.7] to 75.8 [72.1, 79.6] at 1-year and to 86.7 [83.7, 89.7] at 2-year follow-up (p<0.0001).Conclusions: The authors deemed the short-term outcomes of this acetabular cup in primary total hip arthroplasty to be satisfactory.Study registration: clinicaltrials.gov NCT04209374.


2017 ◽  
Vol 01 (04) ◽  
pp. 200-204 ◽  
Author(s):  
Roby Abraham ◽  
Joseph Scollan ◽  
Patrick Mixa ◽  
Denis Cherkalin ◽  
Jeffrey Varghese ◽  
...  

AbstractGunshot wound (GSW) injuries around the hip joint can lead to debilitating post-traumatic arthritis, requiring a technically demanding primary total hip arthroplasty (THA). These surgeries are often complicated by bullet debris, extensive scaring, prior operations, and altered local anatomy. Although most literature focuses on acute management of GSW around the hip, a few reports detail the mid-term outcomes of GSW patients with primary THA for post-traumatic arthritis. The purpose of this study was to assess the outcomes and complications associated with THA in nine patients with secondary arthritis due to prior GSW injuries. At a mean follow-up of 35 months (range 12–60 months), significant improvement was shown in hip function, activity, and pain levels, and was similar to the outcomes of 18 patients who underwent primary THA for degenerative joint disease. While technically demanding, THA seems to reduce pain and improve function safely and effectively for patients with GSW-induced hip arthritis.


2021 ◽  
Author(s):  
Ugur Unsal ◽  
Huri Sabur ◽  
Mehmet Soyler

Abstract Purpose: To describe a novel surgical technique for iridodialysis repair using iris retractor segments and report its clinical results.Methods: 53 eyes of 53 patients who underwent surgery for iridodialysis repair were enrolled in this retrospective study. Data recorded from patient files consisted of age, sex, history of trauma, surgical indications and type of surgery, preoperative and postoperative corrected distance visual acuity (CDVA), intraocular pressure (IOP), complications, and follow-up time. The novel, minimally invasive surgical technique was explicitly described in detail.Results: Mean follow-up time was 34.4 (range 12-84) months. The subjects were 29 (54.7%) men and 26 (45.3%) women, and the mean age was 56.6±14.0 years. Iridodialysis repair performed using one segment in 37 (69.8%) eyes, two segments in 15 (28.3%) eyes, and three segments in 1 (1.9%) eye. Pupilloplasty was performed in 17 eyes due to wide pupil diameter. The iridodialysis repair was combined with lens removal in 48 eyes, and anterior vitrectomy was performed in 10 eyes. CDVA significantly improved after surgery (p<0.001). Post-traumatic IOP rise was the most common complication, and six patients needed medical therapy for glaucoma control.Conclusion: Iridodialysis repair using iris retractor segment is a minimally invasive technique and found to be safe and effective, providing less surgical manipulation and surgical time than other techniques.


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