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.

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.

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 1244 The TAL Suction Retractor: A Simple Technique for Visualising the Transverse Acetabular Ligament (TAL) During Total Hip Replacement (THR) Surgery

2021 ◽  
Vol 108 (Supplement_6) ◽  
Author(s):  
B Murphy ◽  
R Pollock ◽  
S Ramchurn ◽  
C Hurson
Keyword(s):  
Hip Replacement ◽  
Simple Technique ◽  
Suction Catheter ◽  
Acetabular Cup ◽  
Total Hip ◽  
Replacement Surgery ◽  
Total Hip Replacements ◽  
Surgical Tool ◽  
Hip Replacements ◽  
Transverse Acetabular Ligament

Abstract Introduction The transverse acetabular ligament (TAL) is an anatomical landmark that is of particular use during primary total hip replacements (THR). Visualisation is important to aid the orientation of the acetabular cup and it is a structure that can be identified in virtually every primary hip replacement surgery. We introduce a simple technique to facilitate this. Method A thoracic suction catheter is taped to the distal end of a blunt Hohmann’s retractor with two steristrips wrapping around the catheter and retractor leaving approximately 1-1.5cm of retractor exposed. Our preference is for a thoracic suction catheter with side holes and a proximal end which allows direct connection with the tip of the Yankauer suction. The blunt Hohmann’s retractor is used as the inferior acetabular retractor in the usual way, placed inferior to the transverse acetabular ligament, resting on the posterior ischial surface. The catheter suction tip should lie just under the TAL, in the most dependant point of the wound. Results The TAL suction catheter can be used continuously or intermittently to facilitate visualisation of the TAL during reaming, trialling, and acetabular cup placement. The TAL suction retractor provides suction in the most dependant point of the surgical wound, preventing unnecessary movement and facilitates a clutter-free surgical field leading to more streamlined and efficient surgery with potential reduced operative times. Conclusions The transverse acetabular ligament (TAL) suction retractor is a simple improvised surgical tool that makes it easier to visualise the TAL during acetabular preparation in total hip replacements.

Correlation between Radiologic and Clinical Findings in Charnley Total Hip Replacement

1987 ◽  
Vol 28 (5) ◽  
pp. 607-613 ◽  
Author(s):  
B. Wejkner ◽  
M. Wiege
Keyword(s):  
Sagittal Plane ◽  
Femoral Stem ◽  
Clinical Findings ◽  
Total Hip ◽  
Radiologic Findings ◽  
Total Hip Replacements ◽  
Hip Replacements ◽  
The Relationship ◽  
Acetabular Components

The main purpose of this study was to evaluate the relationship between the radiologic findings in clinically successful Charnley total hip replacements (THR) at an average of five years postoperatively (‘5-year follow-up’) and the clinical result 10 to 14 years after operation (‘10-year follow-up’). The study included 150 arthroplasties graded as clinically successful at the 5-year follow-up despite radiologic loosening of the femoral component in 41 per cent and of the acetabular component in 7 per cent. The incidence of clinical failure between the two follow-ups was 7 per cent (10 hips). Only 2 per cent (3/125) of THRs with intact components or a loose stem with migration not exceeding 4 mm became failures. Clinical failures resulted in 28 per cent (7/25) of THRs with more extensive loosening of the stem or with a loose socket. At the 10-year follow-up 47 per cent of the femoral and 13 per cent of the acetabular components were loose. Progression of loosening of the femoral stem occurred in 63 per cent and of the socket in 73 per cent between the two follow-ups. The incidence of loosening of the stem showed a significant correlation both with the extent of cementation distal to the tip and with the orientation of the prosthesis in the sagittal plane.

scholarly journals An MRI-Based Patient-Specific Computational Framework for the Calculation of Range of Motion of Total Hip Replacements

2021 ◽  
Vol 11 (6) ◽  
pp. 2852
Author(s):  
Maeruan Kebbach ◽  
Christian Schulze ◽  
Christian Meyenburg ◽  
Daniel Kluess ◽  
Mevluet Sungu ◽  
...  
Keyword(s):  
Range Of Motion ◽  
Internal Rotation ◽  
Computer Aided Design ◽  
External Rotation ◽  
Patient Specific ◽  
Computational Framework ◽  
Total Hip ◽  
Total Hip Replacements ◽  
Significant Difference ◽  
Hip Replacements

The calculation of range of motion (ROM) is a key factor during preoperative planning of total hip replacements (THR), to reduce the risk of impingement and dislocation of the artificial hip joint. To support the preoperative assessment of THR, a magnetic resonance imaging (MRI)-based computational framework was generated; this enabled the estimation of patient-specific ROM and type of impingement (bone-to-bone, implant-to-bone, and implant-to-implant) postoperatively, using a three-dimensional computer-aided design (CAD) to visualize typical clinical joint movements. Hence, patient-specific CAD models from 19 patients were generated from MRI scans and a conventional total hip system (Bicontact® hip stem and Plasmacup® SC acetabular cup with a ceramic-on-ceramic bearing) was implanted virtually. As a verification of the framework, the ROM was compared between preoperatively planned and the postoperatively reconstructed situations; this was derived based on postoperative radiographs (n = 6 patients) during different clinically relevant movements. The data analysis revealed there was no significant difference between preoperatively planned and postoperatively reconstructed ROM (∆ROM) of maximum flexion (∆ROM = 0°, p = 0.854) and internal rotation (∆ROM = 1.8°, p = 0.917). Contrarily, minor differences were observed for the ROM during maximum external rotation (∆ROM = 9°, p = 0.046). Impingement, of all three types, was in good agreement with the preoperatively planned and postoperatively reconstructed scenarios during all movements. The calculated ROM reached physiological levels during flexion and internal rotation movement; however, it exceeded physiological levels during external rotation. Patients, where implant-to-implant impingement was detected, reached higher ROMs than patients with bone-to-bone impingement. The proposed framework provides the capability to predict postoperative ROM of THRs.

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