Hip Resurfacing using the Trochanteric Flip Osteotomy

2009 ◽  
Vol 19 (2) ◽  
pp. 131-135 ◽  
Author(s):  
Vijay V. Killampalli ◽  
Andrew Hayes ◽  
Nick Parsons ◽  
Mathew L. Costa ◽  
Udai Prakash
Keyword(s):  
Femoral Head ◽  
Clinical Results ◽  
Hip Resurfacing ◽  
Component Failure ◽  
Ucla Activity Score ◽  
Resurfacing Arthroplasty ◽  
Early Results ◽  
Oxford Hip Score ◽  
Trochanteric Flip Osteotomy

We report the early results and complications of resurfacing arthroplasty using the ‘Trochanteric Flip Osteotomy’ approach to the hip. There are no published clinical results of this approach used for resurfacing arthroplasty. One hundred consecutive patients were assessed prospectively for a minimum follow-up of 2 years (range 2 - 5 years). The Oxford Hip Score fell from a median of 30 pre-operatively to 5 at two years. Similar improvement was found in the UCLA Activity Score. There were no cases of component failure or fractures. However, nine patients had minor complications related to the osteotomy. Resurfacing Arthroplasty of the hip may be successfully performed through a trochanteric flip osteotomy. This surgical approach may avoid some of the complications associated with avascular necrosis of the femoral head.

scholarly journals Subchondral insufficiency fractures of the femoral head: systematic review of diagnosis, treatment and outcomes

2019 ◽  
Vol 7 (1) ◽  
pp. 85-94
Author(s):  
Michael A Gaudiani ◽  
Linsen T Samuel ◽  
Bilal Mahmood ◽  
Assem A Sultan ◽  
Atul F Kamath
Keyword(s):  
Systematic Review ◽  
Femoral Head ◽  
Treatment Options ◽  
Delayed Diagnosis ◽  
Operative Management ◽  
Hip Resurfacing ◽  
Insufficiency Fractures ◽  
Early Results ◽  
Meta Analyses

Abstract Subchondral insufficiency fractures of the femoral head (SIFFH) are a cause of femoral head collapse leading to degenerative hip disease. SIFFH is often mistaken for osteonecrosis given similar clinical and radiographic features. These similarities often lead to missed or delayed diagnosis which can often delay or change management. The purpose of this article is to systematically review the spectrum of demographics, diagnostic and treatment options, including hip preservation in young patient populations. A systematic review was conducted according to the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) guidelines. All related peer-reviewed publications from January 1999 to January 2019 were reviewed using the following databases: Medline, EMBASE, Scopus and Web of Science. The systematic review identified 54 articles, encompassing 482 patients (504 hips) diagnosed with SIFFH. One hundred and seventy-six (35%) males and 306 (63%) females were included, with a mean age of 53.6 ± 17.5 years and mean body mass index of 23.4 ± 4.0 kg/m2. Mean follow-up was 23.4 ± 15.9 months. Treatment decisions were 256 (55%) non-operative, 157 (34%) total hip arthroplasty (THA), 24 (5%) transtrochanteric anterior rotational osteotomy, 9 (2%) hip arthroscopy, 7 (2%) hip resurfacing, 3 (1%) bone grafting, 3 (1%) hemiarthroplasty and 1 (1%) tantalum rod insertion. Overall, 35% of SIFFH hips were converted to THA at latest follow-up. A majority of SIFFH patients had symptom resolution with non-operative management. Failure most often resulted in THA. In younger patients, hip preservation techniques have shown promising early results and should be considered as an alternative.

Comparative repeatability of guide-pin axis positioning in computer-assisted and manual femoral head resurfacing arthroplasty

2007 ◽  
Vol 221 (7) ◽  
pp. 713-724 ◽  
Author(s):  
A Hodgson ◽  
N Helmy ◽  
B A Masri ◽  
N V Greidanus ◽  
K B Inkpen ◽  
...  
Keyword(s):  
Femoral Head ◽  
Computer Assisted Surgery ◽  
Hip Resurfacing ◽  
Computer Assisted ◽  
Comparable Amount ◽  
Hip Resurfacing Arthroplasty ◽  
Resurfacing Arthroplasty ◽  
Surgeon Experience ◽  
Position And Orientation ◽  
Version Measurement

The orientation of the femoral component in hip resurfacing arthroplasty affects the likelihood of loosening and fracture. Computer-assisted surgery has been shown to improve significantly the surgeon's ability to achieve a desired position and orientation; nevertheless, both bias and variability in positioning remain and can potentially be improved. The authors recently developed a computer-assisted surgical (CAS) technique to guide the placement of the pin used in femoral head resurfacing arthroplasty and showed that it produced significantly less variation than a typical manual technique in varus/valgus placement relative to a pre-operatively determined surgical plan while taking a comparable amount of time. In the present study, the repeatability of both the CAS and manual techniques is evaluated in order to estimate the relative contributions to overall variability of surgical technique (CAS versus manual), surgeon experience (novice versus experienced), and other sources of variability (e.g. across specimens and across surgeons). This will enable further improvements in the accuracy of CAS techniques. Three residents/fellows new to femoral head resurfacing and three experienced hip arthroplasty surgeons performed 20-30 repetitions of each of the CAS and manual techniques on at least one of four cadaveric femur specimens. The CAS system had markedly better repeatability (1.2°) in varus/valgus placement relative to the manual technique (2.8°), slightly worse repeatability in version (4.4° versus 3.2°), markedly better repeatability in mid-neck placement (0.7 mm versus 2.5 mm), no significant dependence on surgeon skill level (in contrast to the manual technique), and took significantly less time (50 s versus 123 s). Proposed improvements to the version measurement process showed potential for reducing the standard deviation by almost two thirds. This study supports the use of CAS for femoral head resurfacing as it is quicker than the manual technique, independent of surgeon experience, and demonstrates improved repeatability.

scholarly journals RETROSPECTIVE EVALUATION OF SUCCESS OF IMPLANT SUPPORTED PROSTHESIS: EARLY RESULTS

2020 ◽  
Vol 7 (12) ◽  
pp. 189-198
Author(s):  
Zeynep Başağaoğlu Demirekin ◽  
Yavuz Findik ◽  
S. Süha Turkaslan ◽  
Timuçin Baykul ◽  
Merve Erken
Keyword(s):  
Treatment Options ◽  
Clinical Results ◽  
Long Term Results ◽  
Retrospective Evaluation ◽  
Early Results ◽  
Single Crown ◽  
Long Term Follow Up ◽  
Implant Therapy

Introduction: The interpretation of clinical results of dental implant supported prosthesis treatment is very crucial to be able to make a comparison between different implant systems and treatment options and furthermore to benefit the experiences of the other clinicians. However, the clinical outcomes of these studies should be reported in an objective way and be independent from the system used and also be prepared in accordance with certain criteria and standards that have been accepted scientifically world-wide for being reliable and describing long-term results. Aim: Three-hundred and eighty-two consecutive NTA implants were performed on ninety-nine patients. The implants used in 2016 and the constructed restorations were retrospectively analyzed. In addition, the effect of the experience of clinician was evaluated related with the success of the implant therapy. Materials and Method: This retrospective study was conducted in the Department of Prosthodontics Süleyman Demirel University. Three-hundred and eighty-two consecutive NTA implants were performed on ninety-nine patients. The implants used in 2016 and the constructed restorations were retrospectively analyzed. Results: The implants were followed for at least 2 years. In total, 239 implants were inserted. It was found in 143 mandibles. Prosthetic restorations were determined to be partial prosthetics (219), single crown (81) and overdenture prosthetics (64). During the evaluation period, 6 implants failed before prosthetic treatment, ten decementations, six retentive screw loosening and five porcelain chipping were detected. Discussion and Conclusions: The early results of our study are consistent with the results of other studies. However, long-term follow-up is required for more accurate assessments.

Marker-based or model-based RSA for evaluation of hip resurfacing arthroplasty? A clinical validation and 5-year follow-up

2013 ◽  
Vol 133 (11) ◽  
pp. 1613-1621 ◽  
Author(s):  
Nina Dyrberg Lorenzen ◽  
Maiken Stilling ◽  
Stig Storgaard Jakobsen ◽  
Klas Gustafson ◽  
Kjeld Søballe ◽  
...  
Keyword(s):  
Hip Resurfacing ◽  
Clinical Validation ◽  
Hip Resurfacing Arthroplasty ◽  
Resurfacing Arthroplasty ◽  
Model Based

Hip resurfacing arthroplasty and total hip arthroplasty in the same patient: which do they prefer?

2019 ◽  
pp. 112070001988292 ◽  
Author(s):  
Tyler E Calkins ◽  
Linda I Suleiman ◽  
Chris Culvern ◽  
Sulaiman Alazzawi ◽  
Gregory S Kazarian ◽  
...  
Keyword(s):  
Total Hip Arthroplasty ◽  
Hip Arthroplasty ◽  
Hip Resurfacing ◽  
Contralateral Side ◽  
Harris Hip Score ◽  
Hip Resurfacing Arthroplasty ◽  
Total Hip ◽  
Resurfacing Arthroplasty ◽  
Patient Reported

Introduction: Hip resurfacing arthroplasty (HRA) is an alternative to conventional total hip arthroplasty (THA) with potential advantages of preserving femoral bone stock and the ability to participate in higher impact activities. This study compares outcomes, satisfaction and preference in patients who underwent HRA in 1 hip and THA on the contralateral side. Methods: 62 Patients with an HRA in 1 hip and a contralateral THA were retrospectively identified at 3 centres, consisting of 38 males and 24 females with 53 patients (85.5%) undergoing HRA first. A survey regarding satisfaction and preference for each procedure and outcome scores were obtained. Results: Patients were younger (51.5 vs. 56.6 years, p = 0.002) and had longer follow-up on the HRA hip (11.0 vs. 6.0 years, p < 0.001). HRA was associated with larger increase in Harris Hip Score from preoperative to final follow-up (35.8 vs. 30.6, p = 0.035). 18 Patients (29.0%) preferred HRA, 19 (30.6%) preferred THA and 25 (40.3%) had no preference ( p = 0.844). When asked what they would choose if they could only have 1 surgery again, 41 (66.1%, p < 0.001) picked HRA. Overall satisfaction ( p = 0.504), willingness to live with their HRA versus THA for the rest of their life ( p = 0.295) and recommendation to others ( p = 0.097) were similar. Conclusions: Although HRA is associated with risks related to metal-on-metal bearings, it showed greater increase in patient-reported outcomes and a small subjective preference amongst patients who have undergone both conventional and resurfacing arthroplasty.

Clinical and Radiographic outcomes of the Birmingham Hip Resurfacing Arthroplasty at a Minimum follow-up of 10 Years: Results from an Independent Centre

2017 ◽  
Vol 27 (2) ◽  
pp. 134-139 ◽  
Author(s):  
Antonio Moroni ◽  
Maria Teresa Miscione ◽  
Riccardo Orsini ◽  
Giovanni Micera ◽  
Salvatore Mosca ◽  
...  
Keyword(s):  
Survival Rate ◽  
Los Angeles ◽  
Weight Bearing ◽  
Hip Resurfacing ◽  
Harris Hip Score ◽  
Heterotopic Bone ◽  
Ucla Activity Score ◽  
Radiographic Outcomes ◽  
Active Patients

Background Metal-on-metal hip resurfacing (MoMHR) has been proposed as an effective surgical treatment for young and active patients with symptomatic hip disease. Recently, good clinical and radiographic outcomes have been reported by the designer surgeons at a 15.3 years follow-up; however, results at long follow-up by non-designer surgeons are less satisfactory. The aim of the study was to investigate if MoMHR can produce satisfactory clinical and radiographic results and if survival rate can be high even if the procedure is performed by non-designer surgeons. Methods All patients were assessed about implant survival. All patients completed an Oxford Hip Score (OHS), Harris Hip Score (HHS) and a University of California Los Angeles (UCLA) activity score preoperatively, at 1 year and at last available follow-up; at this time, a standard anteroposterior weight-bearing radiograph was performed. Results The survival rate with revision for any reason is 96%, similar to those obtained by designer surgeons. All the clinical scores improved over time: according to the OHS the survivors are asymptomatic and according to the UCLA maintain a high level of function. 6 remodellings of the femoral neck and 2 heterotopic bone formations were seen, but they were asymptomatic. Conclusions As designer surgeons have already shown, MoMHR can provide in active patients a durable treatment for hip arthritis, with low risk of revision and good results at 10 years follow-up, even if the procedure is performed by non-designer surgeons.

scholarly journals Outcomes after the conversion of metal-on-metal hip resurfacing arthroplasty to ceramic-on-ceramic total hip arthroplasty: A retrospective observational study with a mean 10-year follow-up

2020 ◽  
Author(s):  
Weiguang Yu ◽  
Mao Shuai ◽  
Jinluan Lin ◽  
Baomin Chen ◽  
Mingdong Zhao ◽  
...  
Keyword(s):  
Total Hip Arthroplasty ◽  
Hip Arthroplasty ◽  
Metal Ion ◽  
Hip Resurfacing ◽  
Hip Resurfacing Arthroplasty ◽  
Resurfacing Arthroplasty ◽  
Metal On Metal ◽  
The Mean ◽  
Ceramic On Ceramic

Abstract Background The purpose of this retrospective study was to assess clinical outcomes following failed metal-on-metal hip resurfacing arthroplasty (MoM-HRA) revised using ceramic-on-ceramic total hip arthroplasty (CoC-THA) via the direct anterior approach (DAA).Methods Data involving 112 patients (112 hips) with failed primary MoM-HRA that was revised using CoC-THA via the DAA during 2006 - 2018 were retrospectively analysed. The mean age was 54.6 years (45–63 years). Frequent surgical indications for conversion were aseptic loosening and femoral neck fracture. The primary endpoint was the Postel-Merle d’Aubigne functional score (PMA). Secondary endpoints were the major orthopaedic complication rate and serum metal ion levels (chromium and cobalt).Results The mean follow-up time was 10 years (range, 4 - 13 years). The mean PMA improved from 9 (4-14) to 16 (13-18) (p = 0.001). Six patients had undergone a re-revision intervention. Fourteen incidents of aseptic loosening and four periprosthetic fractures were observed. A consistent decline in mean serum metal ion levels was detected [chromium decreased from 36.6 μg/L (12.5-76.5 μg/L) prior to conversion to 2.6 μg/L (0.1-13.5 μg/L) at final follow-up (p = 0.001), cobalt decreased from 37.5 μg/L (6.7-93.2 μg/L) to 2.2 μg/L (1.2-18.4 μg/L) (p =0.003)].Conclusion Failed primary MoM-HRA converted to CoC-THA using the DAA yielded acceptable clinical outcomes.

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