Midterm Outcome of the Plasma Cup in Total Hip Arthroplasty

2002 ◽  
Vol 12 (2) ◽  
pp. 119-125 ◽  
Author(s):  
A. Gordon ◽  
J.M. Wilkinson ◽  
I. Stockley
Keyword(s):  
Polyethylene Wear ◽  
Harris Hip Score ◽  
Osteolytic Lesions ◽  
Secondary Osteoarthritis ◽  
Total Hip ◽  
Midterm Outcome ◽  
Kaplan Meier ◽  
Age At Surgery ◽  
High Incidence ◽  
Hip Arthroplasties

One hundred and twenty eight primary total hip arthroplasties (THA) in 104 patients were reviewed to assess mid-term survivorship and clinical outcome of the ‘Plasma’ cup. Outcome was evaluated clinically, radiographically, and by self-administered questionnaires. Patient mean age at surgery was 51 years, and 52 THAs (41%) were performed for secondary arthritis. Prior to surgery the median Merle D'Aubigne score was 8. At 59 (standard deviation 18) months this score had improved to 17, and the median Harris hip score was 85. The mean annual polyethylene wear rate was 0.14mm/year. There were no instances of aseptic loosening but 2 cups had small, focal osteolytic lesions at the site of screw holes. Three cups were revised, two for recurrent dislocations, and one for infection. Cup survivorship at 5 years was 97% (Kaplan-Meier).This data suggests that the Plasma cup performs well in the mid-term and may be used safely in a young population with a high incidence of secondary osteoarthritis.

Mid-term Results of Hydroxyapatite-Coated Threaded Cup Implanted without Supplementary Supporting Screws

2009 ◽  
Vol 19 (2) ◽  
pp. 102-108 ◽  
Author(s):  
Stergios J. Trapotsis ◽  
George E. Petsatodis ◽  
Petros D. Antonarakos ◽  
Panagiotis K. Givissis ◽  
Anastasios G. Christodoulou ◽  
...  
Keyword(s):  
Second Generation ◽  
Bone Ingrowth ◽  
Harris Hip Score ◽  
Radiographic Examination ◽  
Acetabular Cup ◽  
Osteolytic Lesions ◽  
The Stability ◽  
Hip Arthroplasties ◽  
Mid Term Results

We retrospectively reviewed the clinical, radiographic, and survivorship outcomes in a series of 180 patients that underwent 204 primary Total Hip Arthroplasties with the use of a second generation threaded hydroxyapatite-coated acetabular cup that was implanted without any supplementary supporting screws. At an average follow-up period of 10.2 (range: 8–14) years, one hundred and seventy-four patients (198 cups) were available for assessment. All patients underwent detailed physical and radiographic examination; their functional status was evaluated according to the Harris Hip Score (HHS). Following their digitization, all radiographs were further reviewed in order to determine the existence of any migration of the acetabular cup. Osteolytic lesions, radiolucent lines or zones of increased bone density were also recorded and classified according to the system of DeLee & Charnley. The modified Engh's criteria were used in order to evaluate the stability of the prosthesis. The patients' mean HHS at their latest follow-up visit (97.24 points) was statistically significantly better than the preoperative mean score of 40.31 points (p<0.001). Radiographic analysis showed “stable with bone ingrowth” fixation (modified Engh's criteria) of all implants with no significant migration of the cup (mean cranial migration: 0.597 mm, mean horizontal migration: 0.607 mm, mean observed difference of the cup's inclination angle: 0.26 degrees). No areas of significant osteolysis were found. The cumulative survival rate of the implants was 97.05%. Our results suggest that second generation hydroxyapatite-coated threaded acetabular cups can be successfully implanted (and achieve excellent results) without the use of any supplementary supporting screws.

scholarly journals Primary total hip arthroplasty using an uncemented Wagner SL stem in elderly patients with Dorr type C femoral bone

2019 ◽  
Vol 14 (1) ◽  
Author(s):  
Ping Zhen ◽  
Jun Liu ◽  
Xusheng Li ◽  
Hao Lu ◽  
Shenghu Zhou
Keyword(s):  
Lateral View ◽  
Harris Hip Score ◽  
Radiographic Evaluation ◽  
Femoral Bone ◽  
Stem Design ◽  
Total Hip ◽  
Tapered Stem ◽  
Type C ◽  
Hip Arthroplasties

Abstract Background The purpose of this study was to review retrospectively the primary total hip arthroplasties operated upon with the cementless Wagner Self-Locking stem in patients with type C femoral bone. Methods Twenty-eight total hip arthroplasties were performed in 25 patients aged ≥ 60 years using a cementless Wagner Self-Locking femoral component between 2006 and 2011. According to Dorr’s criteria, all 28 femora were classified as type C bone. All patients were treated with THA using a cementless Wagner cone prosthesis. Clinical and radiologic evaluations were performed on all patients. Results Mean follow-up period was 125 ± 10.5 months (range 96 to 156 months). Average Harris hip score pre-operatively was 46 ± 9 (range 39 to 62) and at the last follow-up was 90 ± 9 (range 83 to 98). The stem to canal fill is calculated as percentages on the operative side at three distinct levels: just below the lesser trochanter, at midstem, and 1 cm above the tip of the component on anteroposterior radiograph. The mean proximal stem-to-canal fill percentages were 97% ± 2.1%, 95% ± 3.5%, and 88% ± 2.6%, respectively (anteroposterior view) and 92% ± 2.2%, 86% ± 1.9%, and 83% ± 2.5%, respectively (lateral view). Radiographic evaluation demonstrated good osteointegration of the implants in the follow-up. Conclusions Based on the long-straight cylindrical tapered stem design, the cementless Wagner SL stem can achieve reliable stability by close apposition of the stem and wide stovepipe femoral canal from metaphysis to diaphysis in type C bone.

scholarly journals The Reconstruction Accuracy of the Hip Center of Rotation After Cementless Total Hip Arthroplasty for Failed Treatment of Acetabular Fractures. Does It Matter?

2021 ◽  
Author(s):  
Liang Zhang ◽  
Mingxue Chen ◽  
Zhuyi Ma ◽  
Tao Bian ◽  
Shaoliang Li ◽  
...  
Keyword(s):  
Harris Hip Score ◽  
Acetabular Fractures ◽  
X Rays ◽  
Reconstruction Accuracy ◽  
Center Of Rotation ◽  
Total Hip ◽  
Radiographic Outcomes ◽  
Negative Effect ◽  
Hip Arthroplasties

Abstract Background To assess the impaction of reconstruction accuracy of hip center of rotation (COR) on midterm clinical and radiographic results of cementless reconstruction of total hip arthroplasties (THAs) for patients after failed treatment of acetabular fractures. Methods One hundred and four patients (107 hips) who underwent THAs after failed treatment of acetabular fractures were retrospectively evaluated and cementless cups and stems were implanted in all hips. Clinical outcomes were assessed using the Harris hip score (HHS) and Western Ontario and McMaster Universities Arthritis Index (WOMAC) scoring system. Radiographic results were analyzed by serial perioperative x-rays. Results At the latest follow-up examination, the median HHS increased from 52 (42-65) before surgery to 93 (90-97) (p < 0.001) and the median WOMAC decreased from 52 (36-65) before surgery to 5.8 (1.5-8) (p < 0.001). Compared with normal contralateral hip, 79 cups migrated superiorly (0.2-33.6mm) and 22 cups migrated inferiorly (0.2-16.1mm). The distance of superior migration of reconstructed COR was correlated with positive Trendelenburg sign at the latest follow-up examination (r=0.504; p < 0.001). The percentage of postoperative Trendelenburg sign was significantly higher in superior migration subgroup than that in subgroup with anatomical restoration of COR (P=0.015). Conclusions Cementless THAs in patients after failed treatment for acetabular fractures achieved predictable clinical and radiographic outcomes. A superiorly migrated hip COR appeared to exert a negative effect on abductor muscle function.

scholarly journals 32-mm ceramic-on-ceramic total hip arthroplasty versus 28-mm ceramic bearings: 5- to 15-year follow-up study

2018 ◽  
Vol 29 (1) ◽  
pp. 65-71 ◽  
Author(s):  
Yoshitoshi Higuchi ◽  
Taisuke Seki ◽  
Yukiharu Hasegawa ◽  
Yasuhiko Takegami ◽  
Daigo Morita ◽  
...  
Keyword(s):  
Total Hip Arthroplasty ◽  
Hip Arthroplasty ◽  
Harris Hip Score ◽  
Total Hip ◽  
Kaplan Meier ◽  
Significant Difference ◽  
Average Patient ◽  
The Mean ◽  
Ceramic On Ceramic

Introduction: This study aimed to compare the clinical and radiographic results of 28-mm ceramic-on-ceramic (CoC) total hip arthroplasty (THA) to those of 32-mm CoC during a 5- to 15-year follow-up period. Methods: 107 joints (95 women and 6 men) underwent 28-mm CoC, and 60 (49 women and 7 men) underwent 32-mm CoC. The average patient age at the time of surgery was 56.1 and 55.7 years in the 28-mm and 32-mm CoC groups, respectively. Clinical and radiologic measurements of all patients were analysed. Results: The mean preoperative Harris hip score (HHS) was similar in the 2 groups (28-mm, 58.9; and 32-mm, 58.5). However, at final follow-up, the mean HHS of the 32-mm CoC (91.8) was significantly better than that of the 28-mm CoC (88.2) ( p = 0.003), as were the ranges of motion (ROM) for flexion (98.3 ± 13.5° vs. 87.3 ± 19.3°, p < 0.001) and abduction (27.8 ± 14.9° vs. 22.1 ± 19.3°, p = 0.007). The mean wear rate was 0.0044 mm/year for the 28-mm CoC and 0.0044 mm/year for the 32-mm CoC. No ceramic fractures were found in the 2 groups. One joint in the 28-mm CoC (0.9%) required revision owing to progressive osteolysis. Kaplan-Meier survival at 10 years, with implant loosening or revision THA as the endpoint, was 98.3% for 28-mm CoC and 100% for 32-mm CoC ( p = 0.465). Conclusion: There was no significant difference in ceramic-related complications between the 2 groups. Our study demonstrated that the 32-mm and 28-mm CoC are safe and are associated with good clinical outcomes.

scholarly journals Long-Term results of total Hip Arthroplasty performed using a cementless expansive Acetabular Cup and Spotorno Femoral Stem

2020 ◽  
Vol 37 (1) ◽  
Author(s):  
Engin Çarkçı ◽  
Ayse Esin Polat ◽  
Yusuf Öztürkmen ◽  
Tolga Tüzüner
Keyword(s):  
Total Hip Arthroplasty ◽  
Hip Arthroplasty ◽  
Survival Rates ◽  
Femoral Stem ◽  
Long Term Results ◽  
Harris Hip Score ◽  
Acetabular Cup ◽  
Total Hip ◽  
Kaplan Meier

Objective: In this study we aimed to investigate the long-term clinical and radiological results, revision rates and causes, and the rate of implant survival in total hip arthroplasty performed using CLS® expansion cup and Spotorno® cementless femoral stem. Methods: Clinical results of total hip arthroplasty performed on 131 hips of 114 patients in Istanbul Training and Research Hospital between 1993 and 2003 were retrospectively evaluated according to the Harris Hip Score. Revision rates were determined and implant survival rates were identified using the Kaplan-Meier estimator. Results: Of the patients, 39 were males and 75 were females. The average age of the patients at surgery was 48.7±11.3 years. Patients were followed up for a mean period of 13.9±2.4 years. The mean Harris Hip Score was 34.35±6.09 preoperatively and 88.20±7.11 at the final follow-up (p<0.001). The Kaplan-Meier survivorship estimate for the cup at 13.9 years, taking revision for any reason as the end point was 95.6% (95% CI), while the 15th and 17th year survival rates were 90% and 85%, respectively. Conclusion: In total hip arthroplasty using a cementless expansive acetabular cup, a 95.6% survival rate is achieved after an average of 14 years, whereas the rate decreases to 85% after 17 years. Even if the incidence of cup breakage is reduced with proper implantation, particle disease and periacetabular osteolysis remains a problem for the long-term survival. doi: https://doi.org/10.12669/pjms.37.1.3089 How to cite this:Carkci E, Polat AE, Ozturkmen Y, Tuzuner T. Long-Term results of total Hip Arthroplasty performed using a cementless expansive Acetabular Cup and Spotorno Femoral Stem. Pak J Med Sci. 2021;37(1):52-58. doi: https://doi.org/10.12669/pjms.37.1.3089 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

scholarly journals Catastrophic Failure and Metallosis of the Acetabular Component in Total Hip Arthroplasty

2021 ◽  
Author(s):  
FIRAT OZAN ◽  
Murat Kahraman ◽  
Ali Baktır ◽  
Kürşat Gençer
Keyword(s):  
Revision Arthroplasty ◽  
Femoral Stem ◽  
Harris Hip Score ◽  
Catastrophic Failure ◽  
Total Hip ◽  
Catastrophic Failures ◽  
Revision Tha ◽  
The Mean ◽  
Hip Arthroplasties

Abstract Background: To evaluate the clinical features and results of the revision total hip arthroplasties (THA) in patients with catastrophic failures and metallosis. Methods: Fifteen hips of 14 patients with catastrophic failure and metallosis in hip arthroplasties were evaluated. They were followed for at least 4.2 years after the revision THA. Clinical evaluation was performed using Harris hip score. Osteolysis, loosening or presence of metallosis was evaluated with standard radiographs. Metallosis was evaluated intraoperatively according to the metallosis severity classification. Results: The mean time from failure until revision surgery was 9.4 years. It was observed that in the primary THA, metal-on-ceramic (MoC), ceramic-on-ceramic (CoC) and metal-on-conventional polyethylene (MoCPE) bearings were used in 1, 3 and 11 hips, respectively. Grade III metallosis was observed in all patients during revision surgeries. The mean Harris hip score increased from 55 points before revision THA to 75 points at the final follow-up. In revision arthroplasty, MoCPE and CoC bearings were used in 13 and 2 hips, respectively. The femoral stem was replaced in 5 hips. All acetabular cups, except that of one hip, were revised. Conclusions: Revisions of THAs with catastrophic failures and metallosis are quite challenging. Routine follow-up of arthroplasty patients is beneficial to examine for osteolysis, loosening, and asymmetric wear.

Long-Term Results of Total Hip Arthroplasty with the Cementless Spotorno (CLS) System

2017 ◽  
Vol 27 (5) ◽  
pp. 465-471 ◽  
Author(s):  
Christiaan Smeekes ◽  
Pieter B. de Witte ◽  
Bas F. Ongkiehong ◽  
Bart C.H. van der Wal ◽  
Alexander F.W. Barnaart
Keyword(s):  
Total Hip Arthroplasty ◽  
Hip Arthroplasty ◽  
Repeated Measures ◽  
Long Term Results ◽  
Factors Associated ◽  
Total Hip ◽  
Kaplan Meier ◽  
Age At Surgery

Background This study presents the long-term results of the Cementless Spotorno (CLS) total hip arthroplasty system and an analysis of factors associated with clinical and radiographic outcome. Methods We studied a series of 120 consecutive CLS arthroplasties in a young patient group (mean age at surgery: 55.9 ± 5.9 years). The Merle d'Aubigné-Postel score, polyethylene (PE) wear, and radiographic status were recorded during follow-up. Survival analyses, repeated-measures analysis of variance, and a nested case-control study were used for statistical evaluation. Results After a mean follow-up of 14.6 years (range 0.1-24.2 years, including revisions and lost to follow-up), 24 revisions had been performed, 16 of which for aseptic cup loosening. Kaplan-Meier survival analysis showed a 24-year survival of 72.8% (95% CI, 63.0%-82.6%) with revision for any reason as endpoint, and 80.1% (95% CI, 70.9%-89.3%) for revision for aseptic cup loosening. Mean final Merle d'Aubigné-Postel score was 16.1 points (range 7-18). Mean PE wear at final follow-up was 2.3 mm (range 0.6-6.8 mm). A higher rate of PE wear was associated with better clinical scores but also with revision for cup loosening. Factors associated with more PE wear were: younger age at surgery; 32 - mm head; longer follow-up; and steeper inclination angle. Conclusions Beyond 10 years, the CLS stem is reliable, but the high revision rate for aseptic cup loosening is concerning, specifically with better performing (cementless) alternatives available.

scholarly journals Eleven Year Results of Total Hip Arthroplasty in Patients with Secondary Osteoarthritis Due to Slipped Capital Femoral Epiphysis

2013 ◽  
Vol 7 (1) ◽  
pp. 158-162 ◽  
Author(s):  
Benjamin Schoof ◽  
Mustafa Citak ◽  
Padhraig F O’Loughlin ◽  
Daniel Kendoff ◽  
Carl Haasper ◽  
...  
Keyword(s):  
Total Hip Arthroplasty ◽  
Health Survey ◽  
Hip Arthroplasty ◽  
Short Form ◽  
Slipped Capital Femoral Epiphysis ◽  
Harris Hip Score ◽  
Secondary Osteoarthritis ◽  
Total Hip ◽  
Patient Cohort

Background: Total hip arthroplasty (THA) in patients with a history of Slipped Capital Femoral Epiphysis (SCFE), is typically indicated to address the consequent deformity of the proximal femur and/or acetabulum. It can be a challenging procedure for the orthopaedic surgeon. Previous studies have focused on prevention of osteoarthritis post-SCFE. However, there is a paucity of data on the outcomes of total hip arthroplasty in patients with osteoarthritis secondary to SCFE. This study was performed to assess the mid-term results of total hip arthroplasty in this patient cohort. Materials and Methods: All patients with secondary osteoarthritis due to slipped capital femoral epiphysis, treated with total hip arthroplasty between 1987 and 2005, were included in this retrospective study (n=30). Thirty patients (17 male, 13 female) met the inclusion criteria with one patient lost to follow-up and one unrelated death one year before follow up examination, thereby leaving 28 patients (32 hips) eligible for the study with a mean follow-up time period of 11.2 years. The Harris Hip Score (HHS) and MOS 36 short form health survey (SF36) were determined preoperatively and at most recent follow-up for all patients. Complications were also noted for all cases. Results: The mean Harris Hip Score increased significantly from 47 (32-59; SD=8.3) to 92.3 (65-100; SD=8.2) (p<0.0001). The SF-36 health survey showed an improvement of quality-of-life in all sub-scales. Overall, revision surgery was required in six cases (19 %). Aseptic loosening, leading to implant removal, was noted in five cases. A single-stage revision to address infection was performed in one case. The cumulative survival rate at latest follow-up was 81 %. No other complications were encountered during the study. Conclusions: Despite a higher failure rate, compared to total hip arthroplasty in the treatment of primary osteoarthritis, total hip arthroplasty can be considered a feasible option for patients with secondary osteoarthritis of the hip due to slipped capital femoral epiphysis. The current study demonstrates good outcomes in patients treated with a cementless column-preserving prosthesis, which is of particular relevance for this young patient cohort. However, further clinical prospective randomized studies are warranted to provide more definitive evidence.

Clinical Predictors for Possible Failure after Total Hip Arthroplasty

2016 ◽  
Vol 26 (6) ◽  
pp. 531-536 ◽  
Author(s):  
Tatsuya Sueyoshi ◽  
John B. Meding ◽  
Kenneth E. Davis ◽  
Wesley G. Lackey ◽  
Robert A. Malinzak ◽  
...  
Keyword(s):  
Significant Risk ◽  
Time Frame ◽  
Harris Hip Score ◽  
Time To Failure ◽  
Clinical Predictors ◽  
Total Hip ◽  
Primary Thas ◽  
Kaplan Meier ◽  
Early Predictor

Introduction With the rising number of total hip arthroplasties (THAs) each year, it is increasingly important for surgeons to have evidence-based information on which to determine how often patients should be examined postoperatively. The purpose of this research was to determine whether it is possible to identify – based on Harris Hip Score (HHS) – early signs or predictors of THA failure so that methods of postoperative follow-up can be scheduled in advance of the time frame indicated by those predictors of failure. Methods The HHS of 9,949 primary THAs performed from 1973 to 2012 was reviewed retrospectively to identify the clinical predictors of failure. 1,131 hips were completely lost to follow-up, leaving 8,331 primary THAs in 6,979 patients. Time to failure was recorded with Kaplan-Meier analysis performed with aseptic loosening or revision of any component as the endpoint. Results Regression analysis revealed that a pain score of 30 or less at any time of follow-up (p<0.0001) was a significant risk and strongly indicative of later failing. A low distance walked score of 5 or less at 6 months (p = 0.0087) and 1 year (p = 0.0167) served as an early predictor of future failure. A lower stairs score of 2 or less was also an early predictor at 1 year (p = 0.0343) and at 3 years (p = 0.0245). A lower limp score of 8 or less was a mid-term predictor at 3 (p = 0.0001), 5 (p = 0.0002), 7 (p = 0.0191) and 10 (0.0028) years postoperative follow-up. Conclusions Pain, walk, stairs and limp scores are predictive of THA failure. Surgeons with patients who present with these indicators should optimise postoperative follow-ups to alert their patients.

Hip resurfacing with a highly cross-linked polyethylene acetabular liner and a titanium nitride-coated femoral component

2018 ◽  
Vol 28 (4) ◽  
pp. 422-428 ◽  
Author(s):  
James W Pritchett
Keyword(s):  
Titanium Nitride ◽  
Femoral Component ◽  
Acetabular Component ◽  
Polyethylene Wear ◽  
Hip Resurfacing ◽  
Harris Hip Score ◽  
Kaplan Meier ◽  
Joint Biomechanics ◽  
Cementless Femoral Component ◽  
The Mean

Aims: This study evaluated a specific hip resurfacing system to determine the: (1) function and complications, (2) implant survivorship, (3) acetabular bone conservation and joint biomechanics and (4) osteolysis and polyethylene wear. Methods: I performed 234 resurfacing procedures (192 patients) using a two-piece titanium acetabular component with a 4 mm highly cross-linked polyethylene liner and a cementless titanium nitride-coated titanium femoral component. Function was assessed with Harris Hip, WOMAC, SF-12, and UCLA scores. Radiography and CT scans were used to evaluate bone retention, component position, joint biomechanics, and osteolysis. Retrieved polyethylene liners were analyzed for wear. Results: Median follow-up was 8 years and patients averaged 48 years of age at surgery. The mean Harris Hip Score was 96 and all scores improved significantly. Kaplan-Meier survivorship was 97%. The mean medial acetabular thickness was 9 mm postoperatively versus 14 mm preoperatively ( p = 0.019). Femoral bone conservation (head:neck ratio) was 1.36 postoperatively versus 1.42 preoperatively ( p = 0.02). There was no polyethylene wear through or osteolysis. Eight polyethylene retrievals had a mean wear of 0.05 mm/yr. Conclusions: Resurfacing with a highly cross-linked polyethylene acetabular component and a titanium nitride-coated titanium cementless femoral component is a reliable and bone-conserving procedure at mid-term.

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