scholarly journals 1244 The TAL Suction Retractor: A Simple Technique for Visualising the Transverse Acetabular Ligament (TAL) During Total Hip Replacement (THR) Surgery

2021 ◽  
Vol 108 (Supplement_6) ◽  
Author(s):  
B Murphy ◽  
R Pollock ◽  
S Ramchurn ◽  
C Hurson
Keyword(s):  
Hip Replacement ◽  
Simple Technique ◽  
Suction Catheter ◽  
Acetabular Cup ◽  
Total Hip ◽  
Replacement Surgery ◽  
Total Hip Replacements ◽  
Surgical Tool ◽  
Hip Replacements ◽  
Transverse Acetabular Ligament

Abstract Introduction The transverse acetabular ligament (TAL) is an anatomical landmark that is of particular use during primary total hip replacements (THR). Visualisation is important to aid the orientation of the acetabular cup and it is a structure that can be identified in virtually every primary hip replacement surgery. We introduce a simple technique to facilitate this. Method A thoracic suction catheter is taped to the distal end of a blunt Hohmann’s retractor with two steristrips wrapping around the catheter and retractor leaving approximately 1-1.5cm of retractor exposed. Our preference is for a thoracic suction catheter with side holes and a proximal end which allows direct connection with the tip of the Yankauer suction. The blunt Hohmann’s retractor is used as the inferior acetabular retractor in the usual way, placed inferior to the transverse acetabular ligament, resting on the posterior ischial surface. The catheter suction tip should lie just under the TAL, in the most dependant point of the wound. Results The TAL suction catheter can be used continuously or intermittently to facilitate visualisation of the TAL during reaming, trialling, and acetabular cup placement. The TAL suction retractor provides suction in the most dependant point of the surgical wound, preventing unnecessary movement and facilitates a clutter-free surgical field leading to more streamlined and efficient surgery with potential reduced operative times. Conclusions The transverse acetabular ligament (TAL) suction retractor is a simple improvised surgical tool that makes it easier to visualise the TAL during acetabular preparation in total hip replacements.

Failure of an Uncemented Press-Fit Acetabular Cup in Primary Total Hip Arthroplasty

2002 ◽  
Vol 12 (4) ◽  
pp. 371-377 ◽  
Author(s):  
N. Rama Mohan ◽  
P. Grigoris ◽  
D.L. Hamblen
Keyword(s):  
Femoral Stem ◽  
Acetabular Cup ◽  
Total Hip ◽  
Press Fit ◽  
Total Hip Replacements ◽  
Locking Mechanism ◽  
Hip Replacements ◽  
The Mean ◽  
Open Position ◽  
Primary Total Hip Arthroplasty

We reviewed fifteen primary total hip replacements performed using the uncemented, non-porous coated press-fit AcSys Shearer Cup. A modular titanium straight femoral stem with a 32mm head was used in all cases. The mean age of the group containing five males and 10 females was 66 years. Eight cups have been revised for aseptic loosening at a mean of seven years and the remaining four cups are radiologically loose. At revision surgery none of the cups showed any evidence of bony ingrowth. Our 10-year results with this cup indicate an unacceptably high failure rate of 80%. Absence of bony ingrowth and the lack of a secure locking mechanism between the polyethylene liner and the metal shell are the most important causes of failure. The use of a 32mm diameter head and implantation of the cup in an open position contributed to this failure. Even though this cup is no longer manufactured, our experience suggests that all non-porous coated cups should be closely followed up.

THREE-DIMENSIONAL MORPHOMETRY OF NATIVE ACETABULUM IN RELATION TO DESIGN AND IMPLANTATION OF CANINE TOTAL HIP REPLACEMENTS

2012 ◽  
Vol 24 (06) ◽  
pp. 549-555 ◽  
Author(s):  
Ching-Ho Wu ◽  
Cheng-Chung Lin ◽  
Tung-Wu Lu ◽  
Lih-Seng Yeh
Keyword(s):  
Total Hip Replacement ◽  
Hip Replacement ◽  
Quantitative Data ◽  
Three Dimensional ◽  
Morphological Parameters ◽  
3D Ct ◽  
Total Hip ◽  
Acetabular Orientation ◽  
Total Hip Replacements ◽  
Hip Replacements

Total hip replacement (THR) has been one of the main choices in treating dysplasia and other disabling conditions of the coxofemoral joint of large-breed dogs. Quantitative data of the three-dimensional (3D) morphology of the native normal acetabulum will be helpful for better design and implantation of prosthetic components. However, 3D orientation and morphological parameters of the native acetabulum in large-breed dogs are rarely reported. The purposes of the study were to measure the values of the 3D morphological parameters of the native acetabulum in Labrador Retriever dogs, namely acetabular orientation in relation to the pelvis, as well as the radius, angle between ventral and dorsal rims, and the distance from the center to the dorsal rim of the acetabulum using a 3D CT-derived model. The data will be useful for developing a more accurate guideline for improving current THR designs and for more accurate placement of the acetabulum component during THR surgery.

scholarly journals 1528 Pseudotumour from Corrosive Material of Total Hip Replacement: A Rare Complication with an Unusual Presentation

2021 ◽  
Vol 108 (Supplement_6) ◽  
Author(s):  
M Ahmed ◽  
S Radha
Keyword(s):  
Hip Replacement ◽  
Metal Ion ◽  
Galvanic Corrosion ◽  
Rare Complication ◽  
Iliac Fossa ◽  
Cystic Mass ◽  
Rare Presentation ◽  
Total Hip ◽  
Total Hip Replacements ◽  
Hip Replacements

Abstract Total hip replacements have been performed in the UK since the 1960s, with over 280000 primary hip replacements being conducted between January 2017 – December 2019. The formation of pseudotumours is an uncommon and an unusual long-term complication of total hip replacements. Formed by galvanic corrosion of the metal prosthesis, patients can display an array of symptoms. We herein report a rare presentation of unilateral leg oedema in an elderly female, mimicking deep vein thrombosis. Despite normal metal ion levels, radiological investigations revealed an irregular cystic mass extending into the iliac fossa compressing the neurovascular bundle in the groin. The patient underwent complex revision hip surgery with dual mobility hip replacement and an Exeter stem with excision of the pseudotumour. This case highlights the importance of appropriate workup for these patients and the involvement of a multidisciplinary team.

An Experimental Study of Metallic Transfer on Ceramic Femoral Heads

2009 ◽  
Author(s):  
Douglas M. Doud ◽  
Preston R. Beck ◽  
Donald R. Petersen ◽  
Jack E. Lemons ◽  
Alan W. Eberhardt
Keyword(s):  
Experimental Study ◽  
Femoral Head ◽  
Life Expectancy ◽  
Metal Transfer ◽  
Acetabular Cup ◽  
Total Hip ◽  
Total Hip Replacements ◽  
Femoral Heads ◽  
Hip Replacements ◽  
Postoperative Dislocation

Postoperative dislocation of total hip replacements has been documented to occur at a rate of approximately 2.4–3.9% [1–3]. Such events may result in the transfer of titanium from the acetabular cup to the femoral head, both during the dislocation and surgical reduction of the dislocated joint [3,4]. If the head is reduced with this transfer present, the joint life expectancy, which depends on articulating surfaces remaining smooth, is reduced [4]. Although the presence of metal transfer on retrieved femoral heads after dislocation is documented, no previous studies have attempted to quantify the forces or contact stresses at which metal transfer occurs.

scholarly journals Finite element analysis of polyethylene wear in total hip replacement: A literature review

2019 ◽  
Vol 233 (11) ◽  
pp. 1067-1088 ◽  
Author(s):  
Lin Wang ◽  
Graham Isaac ◽  
Ruth Wilcox ◽  
Alison Jones ◽  
Jonathan Thompson
Keyword(s):  
Finite Element ◽  
Literature Review ◽  
Hip Replacement ◽  
Material Selection ◽  
Polyethylene Wear ◽  
Element Analysis ◽  
Total Hip ◽  
Total Hip Replacements ◽  
Hip Replacements ◽  
Modelling Techniques

Evaluation and prediction of wear play a key role in product design and material selection of total hip replacements, because wear debris is one of the main causes of loosening and failure. Multifactorial clinical or laboratory studies are high cost and require unfeasible timeframes for implant development. Simulation using finite element methods is an efficient and inexpensive alternative to predict wear and pre-screen various parameters. This article presents a comprehensive literature review of the state-of-the-art finite element modelling techniques that have been applied to evaluate wear in polyethylene hip replacement components. A number of knowledge gaps are identified including the need to develop appropriate wear coefficients and the analysis of daily living activities.

Thromboprophylaxis and Total Hip Replacement: A Cost-Efficacy Study Comparing Duplex Screening of Asymptomatic Venous Thrombosis versus Prolonged Prophylaxis with Low-Molecular-Weight Heparins

2002 ◽  
Vol 17 (3-4) ◽  
pp. 93-97
Author(s):  
M. T. Barrellier
Keyword(s):  
Molecular Weight ◽  
Direct Cost ◽  
Hip Replacement ◽  
Prophylactic Treatment ◽  
Low Molecular Weight ◽  
Low Molecular Weight Heparins ◽  
Total Hip ◽  
Total Hip Replacements ◽  
Annual Budget ◽  
Hip Replacements

Background: Despite use of the anti-thrombotic prophylaxis, clinical thrombo-embolic events and fatal pulmonary embolism are still observed after total hip replacement. To reduce these complications, two strategies have been adopted: to prolong the use of low-molecular-weight heparins (LMWH) to 35 days or to screen patients systematically before discharge, using duplex ultrasonography, following the short-course prophylactic treatment. Objective: To assess, based on published literature, the relative costs and benefits of these two strategies for prophylaxis following total hip arthroplasty. Method: The author identified relevant papers in this field from his own resources and from medical literature databases. Synthesis: Prolonging LMWH treatment to a total of 35 days represents a direct cost in France of approximately £340 per patient, or for 100000 total hip replacements per year, an annual budget of £34 000000. If this strategy attained maximum efficacy, it would avoid 150 fatal pulmonary embolisms. The direct cost would therefore be at least £227000 per life saved. A systematic single duplex ultrasound examination before discharge from hospital would cost £76 per patient, or for 100 000 arthroplasties a total annual budget in France of £7 600000. If this approach achieved maximum efficacy, preventing the 150 fatal pulmonary embolisms corresponding to 100000 total hip replacements, the minimum direct cost would be £50 300 per life saved. Conclusion: Duplex screening may be more effective and lest costly than prolongation of prophylactic treatment using LMWH. This deduction needs to be confirmed by complex cost-benefit studies using clinical end-points.

scholarly journals Anaesthesia for Hip Replacement in Ankylosing Spondylitis

1986 ◽  
Vol 79 (8) ◽  
pp. 457-459 ◽  
Author(s):  
F W Wittmann ◽  
P A Ring
Keyword(s):  
Ankylosing Spondylitis ◽  
Hip Replacement ◽  
Indirect Laryngoscopy ◽  
Emergency Intubation ◽  
Total Hip ◽  
Preoperative Visit ◽  
Total Hip Replacements ◽  
Hip Replacements

Thirteen total hip replacements in 8 patients with ankylosing spondylitis are reviewed. Complications of the disease which can lead to anaesthetic difficulties are discussed, and the importance of a preoperative visit and the value of indirect laryngoscopy emphasized. As intubation problems may occur, especially in undiagnosed cases, equipment for emergency intubation should always be readily available. The results fully justify the operation.

scholarly journals The hidden costs of metal-on-metal hip resurfacing: the financial and logistical implications of a change in hospital follow-up policy

2013 ◽  
Vol 95 (3) ◽  
pp. 88-91
Author(s):  
J Lloyd ◽  
I Starks ◽  
T Wainwright ◽  
R Middleton
Keyword(s):  
Hip Replacement ◽  
Hip Resurfacing ◽  
Surface Wear ◽  
Bearing Surface ◽  
Total Hip ◽  
Total Hip Replacements ◽  
Large Head ◽  
Metal On Metal ◽  
Hip Replacements

Metal-on-metal (MoM) hip resurfacings (HRs) and large head total hip replacements (LHTHRs) were perceived by many as a surgical revolution, with clear advantages over the traditional metal-on-polyethylene total hip replacement (THR). This is especially the case for younger, active individuals in whom conventional THR has been associated with higher rates of aseptic loosening. In addition to less bearing surface wear, frequently cited advantages for HR include the preservation of femoral bone stock, lower dislocation rates, and superior function and activity scores.

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