TOTAL HIP REPLACEMENT COMBINED WITH BONE GRAFTING FOR ACETABULAR DYSPLASIA CAUSING SEVERE OSTEOARTHRITIS OF THE HIP JOINT

Background: Ceramics are inorganic nonmetallic materials and are used as bioinert components in joint replacement surgeries. Ceramics are known to be low allergenic. We experienced a ceramic-induced psoriasis. Objective: We report a first case of possible ceramic-induced psoriasis caused by a ceramic insert. Methods: A 55-year-old female received an implanted ceramic-on-ceramic total hip replacement for osteoarthritis of the right hip joint. Following surgery, she developed psoriatic lesions, which continued for 10 years. We suspected that psoriasis was caused by a ceramic insert and removed it surgically. Results: When the ceramic insert was replaced with a polyethylene-on-metal hip joint, the psoriatic lesions completely disappeared. Conclusion: The pathogenesis of psoriasis is still an enigma, although deregulation of nuclear factor κB signaling and resulting abnormal cytokine secretion are speculated to be involved. Ceramics may affect these signaling events and cause the onset of psoriasis. Renseignements de base: Les céramiques sont des matériaux non métalliques inorganiques et sont utilisées comme composants bio-inertes dans les arthroplasties. Les céramiques sont reconnues pour être peu allergisantes. Nous avons observé un psoriasis provoqué par la céramique. Objectif: Nous exposons un premier cas possible de psoriasis provoqué par la céramique causé par un implant en céramique. Méthodes: Une femme de 55 ans a reçu une prothèse céramique-sur-céramique implantée lors d'une arthroplastie totale de la hanche pour traiter l'arthrose de l'articulation de la hanche droite. Après la chirurgie, elle a développé des lésions psoriasiques dont la manifestation s'est poursuivie pendant 10 ans. Nous avons soupçonné que le psoriasis était causé par l'implant en céramique, et nous l'avons enlevé chirurgicalement. Résultats: Une fois l'implant en céramique remplacé par une prothèse articulaire en polyéthylène-sur-métal, les lésions psoriasiques ont disparu complètement. Conclusion: La pathogenèse du psoriasis demeure une énigme, bien qu'on suppose que la dérégulation de la voie de signalisation NF-κB et que la sécrétion anormale de cytokines résultante soient impliquées. Les céramiques peuvent affecter ces événements de signalisation et provoquer l'apparition du psoriasis.

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Hip joint anatomy virtual and stereolithographic reconstruction for preoperative planning of total hip replacement

International Congress Series ◽

10.1016/j.ics.2005.03.055 ◽

2005 ◽

Vol 1281 ◽

pp. 708-712 ◽

Cited By ~ 7

Author(s):

E. De Momi ◽

E. Pavan ◽

B. Motyl ◽

C. Bandera ◽

C. Frigo

Keyword(s):

Total Hip Replacement ◽

Hip Joint ◽

Hip Replacement ◽

Preoperative Planning ◽

Total Hip

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Localised bone grafting of acetabular cysts during total hip replacement

Annals of The Royal College of Surgeons of England ◽

10.1308/rcsann.2012.535 ◽

2012 ◽

Vol 94 (7) ◽

pp. 535-535

Author(s):

A Mumith ◽

P Ward

Keyword(s):

Total Hip Replacement ◽

Bone Grafting ◽

Hip Replacement ◽

Total Hip

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Acoustic Vibration and Mechanical In Vivo Analysis of the Hip Joint After a Total Hip Arthroplasty

ASME 2007 Summer Bioengineering Conference ◽

10.1115/sbc2007-175137 ◽

2007 ◽

Author(s):

D. A. Glaser ◽

R. D. Komistek ◽

H. E. Cates ◽

M. Mahfouz

Keyword(s):

Femoral Head ◽

Total Hip Replacement ◽

Hip Joint ◽

Hip Replacement ◽

Acoustic Vibration ◽

Valuable Insight ◽

Acetabular Cup ◽

Total Hip ◽

Resonance Frequencies

The major complications following total hip replacement (THA) are implant loosening, dislocation, instability, fracture and infection. It is hypothesized that vibration, in the range of the resonance frequencies, may cause pain, bone degeneration and fracture. A further understanding of the physical response resulting from impact during femoral head sliding may lead to valuable insight pertaining to THA failure. Therefore, the first objective of this present study was to determine if frequencies propagating through the hip joint near resonant frequencies may lead to wear or loosening of the components. Recently, studies found that femoral head sliding, often referred to as hip separation, between the acetabulum cup and the femoral head does occur, which may also play a role in complications observed with THA today, but a the effects of hip separation and the causes of its occurrence has not been studied as jet. Therefore, the second objective of this study was to determine if a sound sensor, externally attached, could be used to correlate impact loading sounds from femoral head sliding in the acetabular cup. Additional objective of this study was to develop a mathematical model that better simulates the in vivo loading conditions of total hip replacement patients using in vivo fluoroscopic and ground reaction data as input.

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Osteonecrosis of the Femoral Head (Part 2)

Hip International ◽

10.1177/112070009800800304 ◽

1998 ◽

Vol 8 (3) ◽

pp. 145-153

Author(s):

M.E. Steinberg

Keyword(s):

Total Hip Replacement ◽

Bone Grafting ◽

Hip Replacement ◽

Clinical Success ◽

Bone Matrix ◽

Core Decompression ◽

Head Part ◽

Total Hip ◽

Early Results ◽

First Choice

Although there is no completely effective treatment for osteonecrosis (ON), core decompression is one of the more popular methods used to promote healing and retard progression. However, there has been considerable controversy about its safety and effectiveness. Published reports have indicated clinical success which has varied from 40 to 90 percent. We performed core decompression with supplementary cancellous bone grafting on 406 hips with ON. There were five complications in the entire series, including two hip fractures resulting from falls. Of 297 hips with a two to fourteen year follow-up, total hip replacement was required in only 36 percent of treated hips as compared to 77 percent of non-operated controls. The outcome was correlated with both the stage and the size of the necrotic lesion. Only 22 percent of the hips with small lesions required total hip replacement as compared to 39 percent with intermediate or large lesions. There was no correlation between outcome and the amount of pain present prior to surgery. Various modifications of core decompression have also been used to treat ON. These have included the use of supplementary grafts of various types, electrical stimulation, decalcified bone matrix, and bone morphogenic protein. Early results in limited series have been encouraging, but some of those techniques remain experimental. At the present time we feel that core decompression, with or without bone grafting, is a simple, safe, and established technique which is our first choice for the treatment of patients with earlier stages of ON. The role of vascularized fibular grafts is promising and the place of other new techniques is currently being evaluated.

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