P039 Evolutionary course of Juvenile Idiopathic Arthritis

Rheumatology ◽  
2021 ◽  
Vol 60 (Supplement_5) ◽  
Author(s):  
F Mechid ◽  
N Bahaz ◽  
A Remilaoui ◽  
F H Zehraoui ◽  
R Benaziez ◽  
...  
Keyword(s):  
Juvenile Idiopathic Arthritis ◽  
Hip Replacement ◽  
Antinuclear Antibodies ◽  
Hip Prosthesis ◽  
Age Of Onset ◽  
Pulmonary Involvement ◽  
Total Hip Prosthesis ◽  
Total Hip ◽  
The Mean ◽  
International League

Abstract Background Juvenile idiopathic arthritis (JIA) is a heterogeneous group of rare conditions that begin before the age of 16. Seven categories have been defined by the International League of Associations for Rheumatology (ILAR) classification. The aim of our work is to describe the demographic, clinical, and radiological characteristics and therapeutic of patients with JIA. Materials and methods A retrospective, descriptive study of patients followed for AIJ in the rheumatology department of Mohamed LamineDebaghine during a period of 15 years (2005–2020). Patients were included if satisfied ILAR criteria. Results Ten patients with JIA were included, 5 of whom were females. The mean age of onset was 9.20 ± 3.15 (range: 5–14 years). The subtypes were as follows: 4 patients had RF-negative polyarthritis, one case had RF-positive polyarthritis, one with systemic arthritis form, 2 cases of oligoarthritis, 1 case of psoriatic arthritis, and enthesitis-related arthritis. Three children have coxitis. ACPA was positive in one case and antinuclear antibodies were negative. Eight patients have developed osteoarticular destruction. Pulmonary involvement was noted in a patient who had RF-positive polyarthritis. Corticosteroid therapy was prescribed in 9 patients, 5 of whom developed complications related to steroids, including growth retardation, which was observed in 3 cases. Nine JIA patients received methotrexate. The use of etanercept and IL-1 inhibitors were required in 7 and 1 cases, respectively. Corticosteroid infiltrations were performed in 9 patients. Total hip replacement was indicated in 3 patients. Conclusion Through our study, we note a predominance of the polyarticular form. Osteoarticular destruction seems to be frequent, particularly in the hip. The use of biotherapy and the total hip prosthesis proved the severity of juvenile idiopathic arthritis in our patients.

Metal Allergy and other Adverse Reactions in Patients with Total Hip Replacement

2015 ◽  
Vol 1114 ◽  
pp. 283-287 ◽  
Author(s):  
Marius Niculescu ◽  
Dan Laptoiu ◽  
Florin Miculescu ◽  
Iulian Vasile Antoniac
Keyword(s):  
Total Hip Arthroplasty ◽  
Total Hip Replacement ◽  
Hip Arthroplasty ◽  
Hip Replacement ◽  
Hip Prosthesis ◽  
Metal Corrosion ◽  
Metal Allergy ◽  
Total Hip Prosthesis ◽  
Total Hip ◽  
Tissue Reactions

Total hip prosthese are widely used in total hip arthroplasty, offering many benefit to patients with different articular diseases like osteoarthritis or after different accidents. Many total hip prosthesis are now available to the orthopaedic surgeons to replace the hip articulation, with different design and with components made by different type of biomaterials: metallic (cobalt-chrome and titanium alloys, zirconium-niobium alloy named oxinium), ceramic (alumina, zirconia), polymers (ultra high weight molecular polyethylene-UHMWPE). Even total hip arthroplasty has a high success rate, implant loosening may occur, with different symptoms that could be attributed to metal allergy. Because the stem components of the total hip prosthesis are made by metallic biomaterials, many papers describe the adverse effects related to the release of metal ions (like cytotoxicity, carcinogenicity and metal allergy). There are different types of metal corrosion: intergranular, pitting, crevice, fatigue, stress, fretting, and galvanic. On the other hand, in many cases (like metal-on-metal prosthesis) appear corrosion and wear between two metallic components. This processes are favourable for the aparition of hypersensitivity-related tissue reactions. Especially some metallic ions (nickel, cobalt, and chromium) presents in stainless steels and cobalt-chromium alloys are most known to be released from prostheses components and give metal allergy. Of course, during the time was developped some solutions in order to improve the performance of the hip prostheses components made by metallic components like coating with thin layers using different biomaterials like porous titanium or hydroxiapatite. The aims of this review article were to explore mainly the relationship between corrosion products and implant-related hypersensitivity, the importance of surface treatment for metallic components, try define the effect of metal ion concentrations, and differentiate between allergy and infection in total hip replacement. The long-term performance of the coated components will be also analyzed and synthetic described based on clinical results. Also, some relevant aspects from our clinical experience and retrieved prosthesis analysis using stereomicroscopy and scanning electron microscopy will be shown in order to support the conclusions.

scholarly journals Mechanical Behavior of Bone Cement under Dynamic Loading

2017 ◽  
Vol 61 (3) ◽  
pp. 204
Author(s):  
Mohammed Elnedhir Belgherras ◽  
Boualem Serier ◽  
Ali Benouis ◽  
Lalia Hachemi
Keyword(s):  
Bone Cement ◽  
Hip Replacement ◽  
Hip Prosthesis ◽  
Three Dimensional ◽  
Dynamic Loads ◽  
The Finite Element Method ◽  
Three Dimensional Model ◽  
Total Hip Prosthesis ◽  
Total Hip ◽  
Climbing Stairs

In orthopedic surgery and particularly in total hip arthroplasty, The fixation of the implant is generally made by the surgical cement, constituted essentially by polymer (PMMA), It is necessary to know the strengths applied to the prosthetic articulation during the current activities exercised by the patient in their life, to know the distribution of the constraints in the system (bone - cement - implant).This study aims to analyze numerically using the finite element method, the effect of activities (dynamic loads) of the patient on the level and distribution of stresses generated in the components of total hip prosthesis. Five activities, the most frequently performed by the patient such as normal walking, the up and down stairs, sitting and up from chair, were selected for this study. For this purpose, a three-dimensional model of the total hip prosthesis has been developed. The results obtained from this model show that the total hip replacement components and especially the bone cement are more highly stressed during the process of climbing stairs. These excessively high loads can lead to damage of the cement and thus the loosening of the prosthesis.

The canine cemented modular total hip prosthesis

1995 ◽  
Vol 31 (2) ◽  
pp. 109-124 ◽  
Author(s):  
ML Olmstead
Keyword(s):  
Veterinary Medicine ◽  
Hip Replacement ◽  
Hip Prosthesis ◽  
Clinical Results ◽  
Total Hip Prosthesis ◽  
Total Hip ◽  
Modular Prosthesis ◽  
Technical Advances ◽  
A Prospective Study ◽  
Better Than

Total hip replacement (THR) is well established as a treatment modality for dogs with noninfectious, nonneoplastic, disabling conditions of the coxofemoral joint. Since the mid 1970s, a fixed-head prosthesis has been used in this procedure. A modular prosthesis, which is based on many of the technical advances found in human prostheses, now is available for use in veterinary medicine. The prosthesis, surgical instrumentation, surgical technique, and clinical results have been evaluated in a prospective study conducted at The Ohio State University's College of Veterinary Medicine. The modular prosthesis provides results equal to or better than the fixed-head prosthesis.

Paper 9: Problems of Acetabular Fixation in Total Hip Replacement

1966 ◽  
Vol 181 (10) ◽  
pp. 112-120
Author(s):  
J. N. Wilson
Keyword(s):  
Surgical Treatment ◽  
Hip Replacement ◽  
Present Method ◽  
Hip Prosthesis ◽  
Screw Fixation ◽  
Total Hip Prosthesis ◽  
Total Hip ◽  
Press Fit ◽  
Pin Fixation ◽  
Acetabular Fixation

The need for complete joint replacement in the surgical treatment of osteo-arthritis of the hip is becoming more apparent following the unpredictable results of other forms of arthroplasty where only one or other side of the joint is replaced. The introduction of total hip prosthesis poses the problem of fixation of the acetabular component. Charnley's contribution in using acrylic cement to grout in the stem of the femoral component has largely solved the fixation on this side of the joint. It is not so easy to apply the same principle to the acetabular part of the prosthesis. No fixation, long-screw fixation, and straight-pin fixation have not proved satisfactory. It remains to be seen whether the present method used by McKee and Charnley, of a press fit into cement, will prove the test of time. In the early stages of development of the Stanmore hip joint various forms of acetabular fixation were considered. It was finally decided that an adequate hold could only be obtained by three-point fixation, using diverging nails inserted into the three primary bony components of the acetabulum. This principle has been maintained in the later models, but by using cement for grouting the nails, it has been possible to simplify the prosthesis and discard some of the complicated instruments required for the insertion. A brief description of the surgical technique will be given.

Estimation of Wear in Total Hip Replacement Using a Ten Station Hip Simulator

1996 ◽  
Vol 210 (3) ◽  
pp. 187-190 ◽  
Author(s):  
K Brummitt ◽  
C S Hardaker
Keyword(s):  
Hip Replacement ◽  
Hip Prosthesis ◽  
Coordinate Measuring Machine ◽  
Hip Joints ◽  
Total Hip Prosthesis ◽  
Total Hip ◽  
Hip Simulator ◽  
Study Support ◽  
Measuring Machine ◽  
Good Agreement

The results of hip simulator tests on a total of 16 total hip joints, all of them 22.25 mm Charnley designs, are presented. Wear at up to 6.75 million cycles was assessed by using a coordinate measuring machine. The results gave good agreement with clinical estimates of wear rate on the same design of joint replacement from a number of sources. Good agreement was also obtained when comparison was made with the published results from more sophisticated simulators. The major source of variation in the results was found to occur in the first million cycles where creep predominates. The results of this study support the use of this type of simplified simulator for estimating wear in a total hip prosthesis. The capability to test a significant number of joints simultaneously may make this mechanism preferable to more complex machines in many cases.

Position, Orientation and Component Interaction in Dislocation of the Total Hip Prosthesis

1988 ◽  
Vol 29 (4) ◽  
pp. 441-444 ◽  
Author(s):  
K. Herrlin ◽  
G. Selvik ◽  
H. Pettersson ◽  
P. Kesek ◽  
R. Önnerfält ◽  
...  
Keyword(s):  
Hip Replacement ◽  
Clinical Relevance ◽  
Hip Prosthesis ◽  
Reference Group ◽  
Femoral Anteversion ◽  
Leverage Effect ◽  
Component Position ◽  
Total Hip Prosthesis ◽  
Total Hip ◽  
Femoral Flexion

The position, orientation in space and interaction of prosthetic components was determined in 15 patients with known episodes of dislocation after total hip replacement. The same calculations were performed in a reference group of 44 patients without dislocation. In the group with dislocations, there was a significantly decreased femoral anteversion, and a decreased femoral flexion permitted by the prosthetic components. There were no further significant differences of clinical relevance between the groups concerning all other examined parameters of component position, orientation and interaction. It is concluded that the decreased range of flexion, caused by impingement of the prosthetic components with ensuing leverage effect is one cause of dislocation.

Intrapelvic Extraction of a Total Hip Prosthesis

1992 ◽  
Vol &NA; (282) ◽  
pp. 154???157 ◽  
Author(s):  
RICHARD P. EVANS ◽  
J. PHILLIP NELSON
Keyword(s):  
Hip Prosthesis ◽  
Total Hip Prosthesis ◽  
Total Hip
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