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.

Two Stage one Component Revision in Infected Total hip Replacements - two Case reports and Literature Review

2009 ◽  
Vol 19 (3) ◽  
pp. 292-298 ◽  
Author(s):  
Radwane Faroug ◽  
Yousaf Shah ◽  
Michael J. H. Mccarthy ◽  
Maher Halawa
Keyword(s):  
Case Reports ◽  
Femoral Stem ◽  
Acetabular Cup ◽  
Two Stage ◽  
Total Hip ◽  
Total Hip Replacements ◽  
First Case ◽  
Hip Replacements ◽  
Component Revision

We present two cases of infected primary total hip replacements (THR) where only one of the two components exhibited loosening. Both were revised using a two stage, one component revision technique, replacing the loose component only. In the first case the acetabular component was revised leaving the original femoral stem in situ. In the second case, the femoral component was revised, leaving the original acetabular cup undisturbed. Both patients remained infection free at three and half and three years follow up respectively.

scholarly journals Early radiological and functional outcomes for a cementless press-fit design modular femoral stem revision system

2018 ◽  
Vol 29 (1) ◽  
pp. 35-40 ◽  
Author(s):  
Douglas S Hancock ◽  
Paul K Sharplin ◽  
Peter D Larsen ◽  
Fredrick TS Phillips
Keyword(s):  
Functional Outcomes ◽  
Femoral Stem ◽  
X Rays ◽  
Press Fit ◽  
Total Hip Replacements ◽  
Hip Replacements ◽  
Revision Hip Surgery ◽  
The Mean ◽  
Low Levels

Aim: To assess early radiological and functional outcomes of revision hip surgery with a cementless press-fit design femoral stem. Patients and methods: A retrospective review of 48 consecutive revision total hip replacements using the RECLAIM revision hip system, between October 2012 and August 2015. Radiographic assessment was undertaken with serial anteroposterior (AP) X-rays of the pelvis. Risk factors for subsidence were evaluated. Prospective clinical follow up was performed on 21 patients to assess functional outcomes. Results: Mean stem subsidence was 1.1 mm (95% confidence interval[CI]: 0.63–1.57). Median follow up of 12 months. An inverse relationship was observed between level of subsidence and femoral stem diameter r = −0.45, p = 0.001. Subsidence at the time of follow-up assessment was correlated with initial subsidence (correlation coefficient rho 0.69, p = 0.001). The mean Merle d’Aubigne score at the latest follow up was 14.2 (range 8–17). The mean OHS was 34.1 (range 15–48). Conclusion: Early radiological and functional outcomes for the RECLAIM revision system showed very low levels of subsidence and good functional outcomes. There was an association with smaller diameter femoral stems and greater levels of subsidence.

Double-Modular Hip Device Design Susceptible to Stress Corrosion Failure

2009 ◽  
Author(s):  
Sara A. Atwood ◽  
Eli W. Patten ◽  
Kevin J. Bozic ◽  
Lisa A. Pruitt ◽  
Michael D. Ries
Keyword(s):  
Femoral Head ◽  
Femoral Anteversion ◽  
Metal Alloy ◽  
Leg Length ◽  
Acetabular Cup ◽  
Corrosion Failure ◽  
Total Hip ◽  
Press Fit ◽  
Free Mobility ◽  
Hip Replacements

Total hip replacements restore pain-free mobility to approximately 200,000 patients in the U.S. each year [1]. A typical hip system comprises a metal alloy stem, a femoral head (ceramic or metal alloy), and a polyethylene acetabular cup fit into a metal alloy backing. A modular press-fit Morse taper is commonly used to attach the femoral head to the stem. There are also more recent designs that incorporate a second interface at the neck-stem junction (Figure 1). Increased modularity in total hip replacement design allows the surgeon to intraoperatively preserve patient anatomy such as leg length and femoral anteversion and better balance the surrounding soft tissue for optimal biomechanics. However, modularity also increases the number of mechanical junctions and interfaces in the device which may lead to complications such as corrosion, wear, and fracture.

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.

Early Micromotion of a Tapered Femoral Stem in Cementless Total Hip Replacements (THR) in Young Patients

2009 ◽  
Vol 24 (2) ◽  
pp. e77 ◽  
Author(s):  
David Ayers ◽  
Peyton Hays ◽  
Mark Eskander ◽  
Daniel Osuch ◽  
Henrik Malchau ◽  
...  
Keyword(s):  
Young Patients ◽  
Femoral Stem ◽  
Total Hip ◽  
Total Hip Replacements ◽  
Hip Replacements

scholarly journals The Difference of Acetabular Cup Orientation Between Two Surgical Sides After Primary Total Hip Arthroplasty by Right-handed Surgeons

2021 ◽  
Author(s):  
Ao Xiong ◽  
su liu ◽  
Guoqing Li ◽  
Jian Weng ◽  
Deli Wang ◽  
...  
Keyword(s):  
Total Hip Arthroplasty ◽  
Hip Arthroplasty ◽  
Safe Zone ◽  
Dominant Hand ◽  
Acetabular Cup ◽  
Total Hip ◽  
Left And Right ◽  
The Mean ◽  
The Right ◽  
Primary Total Hip Arthroplasty

Abstract Background: We performed the retrospective cohort study to compare the acetabular cup orientation, including anteversion angle (AA) and inclination angle (IA), of dominant hand side and non-dominant hand side after primary total hip arthroplasty (THA) by right-handed orthopedic surgeons. Methods: Between January 2018 and December 2018, 290 patients who aged below 60 years and underwent primary THA were retrospective screened. Patients who had hemiarthroplasty, previous hip surgery, ankylosing spondylitis, developmental dysplasia of hip (DDH, Crowe type-Ⅲ and type-Ⅳ), severe comorbidity, missing information, inferior quality radiographs were excluded. According to the surgery side, all patients were divided into left group and right group. Postoperative plain radiographs were analyzed to compare the AA and IA between left and right side. Univariate and stepwise multivariable linear regression to control included confounding factors. Stratified analysis was performed to identify whether the operation approach can affect the result, including anterolateral (ALA) and posterolateral approach (PLA). Results: The mean AA was 17.7° (range 6.0° to 30.0°) and 21.0° (range 9.5° to 35.0°) for the left and right side respectively. The mean difference was 3.28° (95% CI: 1.92 – 4.64; P<0.001). The mean IA was 41.1° (range 24.0° to 59.0°) and 40.1° (range 20.5° to 56.0°) for the left and right side respectively (P=0.314). 113 patients' AA within the “safe zone” in the left (93.4 %), while the right was 93 patients (82.3 %) (P=0.009). 95 patients' IA within the “safe zone” in the left (78.5 %), while the right was 97 patients (85.8 %) (P=0.144). The IA of ALA group was smaller than PLA group in both sides. The mean difference was 3.98° (95% CI: 1.22 - 6.74; P=0.005). Conclusions: We concluded that AA in left side may be more accurate than right side after primary THA by right-handed surgeons. The IA was no difference between the two sides, while it was smaller in ALA than in PLA. The results are still needed to be verified in future.

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