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.

Wear Failure Analysis of UHMWPE Acetabular Cups in THR

2019 ◽  
Vol 957 ◽  
pp. 417-426
Author(s):  
Corneliu Nicolae Druga ◽  
Ileana Constanta Rosca ◽  
Radu Necula
Keyword(s):  
Femoral Component ◽  
Total Hip Replacement ◽  
Acetabular Component ◽  
Hip Replacement ◽  
Hip Prosthesis ◽  
Polyethylene Wear ◽  
Femoral Shaft ◽  
Hip Resurfacing ◽  
Total Hip ◽  
Joint Prostheses

The UHMWPE acetabular cups are the most popular joints for joint prostheses after Charnley introduced UHMWPE for the acetabular component in 1962. It has been demonstrated that polyethylene wear remains the main source of particles in the THR and therefore requires particular attention. The paper presents a series of theoretical and practical aspects regarding the wear of acetabular cups (made of UHMWPE) from the total hip prosthesis component. At the same time, the other tribological phenomena that occur in these MoP (metal on polyethylene) combinations are treated, such as lubrication and friction. Total Hip Replacement & Hip Resurfacing A hip replacement involves replacing the hip joint with a mechanical bearing system which is comprised of a femoral component and an acetabular component. During a hip replacement the acetabulum is reamed and the acetabular component is fitted into the cavity and the femoral component can either be placed over a reamed femoral head, in a procedure referred to as hip resurfacing, or positioned inside the femoral shaft during a total hip replacement [1]. Fig. 1. Total Hip Replacement (a) and Hip Resurfacing Replacement (b) [2].

Medial Placement of a Cementless Acetabular Component in a Modern Alumina-on-Alumina THA

2007 ◽  
Vol 330-332 ◽  
pp. 1243-1246
Author(s):  
Jeong Joon Yoo ◽  
Hee Joong Kim ◽  
Young Min Kim ◽  
Kang Sup Yoon ◽  
Kyung Hoi Koo ◽  
...  
Keyword(s):  
Acetabular Component ◽  
Polyethylene Wear ◽  
Clinical Results ◽  
Harris Hip Score ◽  
Bearing Surface ◽  
The Mean ◽  
Acetabular Components ◽  
Cementless Acetabular Component ◽  
Acetabular Wall

Medial placement of a cementless acetabular component into or beyond the medial wall of a shallow, dysplastic acetabulum is a technique to enhance its coverage during difficult total hip arthroplasty (THA). Dysplastic hips almost always need small size of acetabular component, so an accelerated polyethylene wear can occur when a conventional bearing surface is used. Modern alumina-on-alumina couplings can be an alternative for these patients. We evaluated the clinical results of 43 medially placed cementless acetabular components (PLASMACUP®SC) incorporating a modern alumina bearing surface (BIOLOX® forte). Acetabular components were inserted medially beyond the ilioischial line and, therefore, beyond the level of the cortical bone of the cotyloid notch, and followed up for more than 5 years (range, 60 – 93 months). In 14 hips, the medial acetabular wall was perforated purposefully and the medial aspect of the cup was placed beyond both the ilioischial and the iliopubic line on radiographs. The mean Harris hip score improved from 55.3 points preoperatively to 94.5 points postoperatively. Postoperatively, the hip center migrated 12.1 mm medially and 1.5 mm inferiorly. The average amount of cup protrusion beyond the ilioischial and the iliopubic line was 3.1 mm and 1.9 mm, respectively. The average superolateral coverage of the cup was 98.5 percent. During follow-up, no osteolysis or loosening of acetabular components was observed and no revision was required. Medial placement of a cementless acetabular component into or beyond the medial acetabular wall offers predictable clinical results and durable fixation in modern alumina-on-alumina THA.

scholarly journals Revision Arthroplasty Through the Direct Anterior Approach Using an Asymmetric Acetabular Component

2020 ◽  
Vol 9 (9) ◽  
pp. 3031
Author(s):  
Peter Michael Prodinger ◽  
Igor Lazic ◽  
Konstantin Horas ◽  
Rainer Burgkart ◽  
Rüdiger von Eisenhart-Rothe ◽  
...  
Keyword(s):  
Acetabular Component ◽  
Anterior Approach ◽  
Survival Rates ◽  
Revision Arthroplasty ◽  
Direct Anterior Approach ◽  
Harris Hip Score ◽  
Kaplan Meier ◽  
The Mean ◽  
Component Revision ◽  
Extramedullary Fixation

Despite increasing numbers of primary hip arthroplasties performed through the direct anterior approach (DAA), there is a lack of literature on DAA revision arthroplasty. The present study was performed in order to evaluate outcomes and revision rates after revision through the DAA using an asymmetric acetabular component with optional intra- and extramedullary fixation. In a retrospective cohort study, we analyzed prospectively collected data of 57 patients (61 hips, 43 female, 18 male) who underwent aseptic acetabular component revision through the DAA with the abovementioned implant system between January 2015 and December 2017. The mean follow-up was 40 months (12–56). Survival rates were estimated using the Kaplan–Meier method. All complications were documented and functional outcomes were assessed pre- and postoperatively. Kaplan–Meier analysis revealed an estimated five-year implant survival of 97% (confidence interval CI 87–99%). The estimated five-year survival with revision for any cause was 93% (CI 83–98%). The overall revision rate was 6.6% (n = 4). Two patients had to undergo revision due to periprosthetic infection (3.3%). In one patient, the acetabular component was revised due to aseptic loosening four months postoperatively. Another patient suffered from postoperative iliopsoas impingement and was treated successfully by arthroscopic iliopsoas tenotomy. Two (3.3%) of the revised hips dislocated postoperatively. The mean Harris Hip Score improved from 35 (2–66) preoperatively to 86 (38–100) postoperatively (p < 0.001). The hip joint’s anatomical center of rotation was restored at a high degree of accuracy. Our findings demonstrate that acetabular revision arthroplasty through the DAA using an asymmetric acetabular component with optional intra- and extramedullary fixation is safe and practicable, resulting in good radiographic and clinical midterm results.

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.

Revision of Failed Cemented Total Hip Arthroplasty Using the Charnley Technique and Implants

1997 ◽  
Vol 7 (1) ◽  
pp. 17-27 ◽  
Author(s):  
G. CH. Babis ◽  
TH. Pantazopoulos ◽  
TH. Ioannidis ◽  
G. Hartofilakidis
Keyword(s):  
Total Hip Arthroplasty ◽  
Femoral Component ◽  
Acetabular Component ◽  
Bone Stock ◽  
Total Hip ◽  
The Mean ◽  
Hip Arthroplasties ◽  
Cemented Total Hip Arthroplasty

The authors present the results of 57 revisions in 54 patients performed for aseptic loosening of cemented total hip arthroplasties. The Charnley technique and implants were used in all cases. The mean follow-up was 8 years and 6 months with a minimum of 5 years. The failure rate for the femoral component was 15% and for the acetabular component it was 19.1%. The cumulative success rate at 8 years was 81.7% for the femoral component and 83.4% for the acetabular component. The Charnley technique and implants were found efficient for revision of cemented total hip arthroplasties in the long term, but there are limitations to their use in the presence of severely compromised bone stock.

scholarly journals Midterm Survivorship of an Uncemented Hydroxyapatite-Coated Titanium Femoral Component and Clinically Meaningful Outcomes in Patients Older Than 75 Years

2021 ◽  
Vol 10 (5) ◽  
pp. 1019
Author(s):  
Alexander Zimmerer ◽  
Luis Navas ◽  
Stefan Kinkel ◽  
Stefan Weiss ◽  
Matthias Hauschild ◽  
...  
Keyword(s):  
Survival Rate ◽  
Femoral Component ◽  
Survival Rates ◽  
Femoral Stem ◽  
Harris Hip Score ◽  
Rank Test ◽  
Kaplan Meier ◽  
Clinically Meaningful Outcomes ◽  
Modified Harris Hip Score

Purpose: It remains controversial whether cementless femoral components are safe in elderly patients. The aim of this study was (1) to determine the stem survival rate in patients >75 years of age who were treated with an uncemented femoral component and (2) to report clinically significant results on a mid-term follow-up. Methods: 107 total hip arthroplasties (THA) were retrospectively evaluated in 97 patients over 75 years of age (mean age 78 years, range 75–87) treated with an uncemented femoral stem. The minimum follow-up was five years (mean 6.4 years, range 5–8). Stem survival rates, clinically meaningful outcomes, and incidence of complications were evaluated. Results: Kaplan-Meier survival analysis, with the endpoint revision for any reason, showed a 6.4-year survival rate of 98% (95% CI, 95–99%; 63 hips at risk). The survival rates were comparable for male and female patients (log-rank test, p = 0.58). The modified Harris Hip Score (mHHS) improved from 42.2 (12 to 85) points to 81.1 (22 to 97) points (p < 0.0001). Mid-term minimal clinically important difference (MCID), substantial clinical benefit (SCB), and patient acceptable symptomatic state (PASS) were 25, 84, and 70, respectively. Conclusion: An uncemented stem is a viable option in patients over 75 years with good clinical outcomes and survivorship. Periprosthetic fractures were not a relevant failure mechanism with the stem used.

The 20-year results of the first 400 Conserve Plus hip resurfacing arthroplasties

2021 ◽  
Vol 103-B (7 Supple B) ◽  
pp. 25-32 ◽  
Author(s):  
Harlan C. Amstutz ◽  
Michel Jean Le Duff
Keyword(s):  
Los Angeles ◽  
Short Form ◽  
Young Patients ◽  
Hip Resurfacing ◽  
Developmental Dysplasia ◽  
Small Component ◽  
Component Size ◽  
Kaplan Meier ◽  
The Mean ◽  
Tissue Reactions

Aims Adverse local tissue reactions associated with abnormal wear considerably slowed down the general use of metal-on-metal (MoM) hip resurfacing arthroplasty (HRA), now limited to a few specialized centres. In this study, we provide the clinical results of 400 consecutive MoM HRAs implanted more than 20 years ago in one such centre. Methods A total of 355 patients (400 hips) were treated with Conserve Plus HRA between November 1996 and November 2000. There were 96 female (27%) and 259 male patients (73%). Their mean age was 48.2 years (SD 10.9). The University of California, Los Angeles (UCLA) hip scores and 12-item Short Form Survey (SF-12) quality of life scores were reported. Survivorship was assessed using Kaplan-Meier analyses. Results The mean follow-up was 16.5 years (0.1 to 24.0), including 34 patients (37 hips) who died. The mean UCLA hip scores were 9.3 (2 to 10), 9.1 (3 to 10), 9.0 (3 to 10), and 6.9 (2 to 10) for pain, walking, function, and activity, respectively. The mean SF-12 scores were 48.4 (16.0 to 62.1) for the physical component and 48.5 (10.5 to 66.5) for the mental component, and did not differ from those of the general population of the USA. A total of 60 hips in 55 patients were revised. Using revision for any indication as the endpoint, the Kaplan-Meier survivorship was 83.5% at 20 years. A diagnosis of developmental dysplasia (hazard ratio (HR) 2.199 (95% confidence interval (CI) 1.140 to 4.239); p = 0.019) and a low BMI (HR 0.931 (95% CI 0.873 to 0.994); p = 0.032) were risk factors for revision. Female sex was a risk factor only because of hip dysplasia and small component size. There were no cases of metal sensitivity associated with revision surgery. Radiological analysis showed persistent fixation in all but one hip. Conclusion The 83.5% 20-year survivorship of this initial series surpasses that of total hip arthroplasties in use 20 years ago in these young patients, suggesting satisfactory lifelong durability of the device for almost all of the remaining patients. Cite this article: Bone Joint J 2021;103-B(7 Supple B):25–32.

scholarly journals The Survival of Well-Fixed Cementless Femoral Component After Isolated Acetabular Component Revision

2020 ◽  
Vol 54 (6) ◽  
pp. 885-891
Author(s):  
Mehmet Ekinci ◽  
Yucel Bilgin ◽  
Yasin Sayar ◽  
Omer Naci Ergin ◽  
Ahmet Salduz ◽  
...  
Keyword(s):  
Femoral Component ◽  
Acetabular Component ◽  
Cementless Femoral Component ◽  
Component Revision

scholarly journals Revision hip arthroplasty using a porous tantalum acetabular component

2020 ◽  
pp. 112070002091329
Author(s):  
Hannu JA Miettinen ◽  
Simo SA Miettinen ◽  
Jukka S Kettunen ◽  
Jussi Jalkanen ◽  
Heikki Kröger
Keyword(s):  
Survival Analysis ◽  
Acetabular Component ◽  
Hip Arthroplasty ◽  
Revision Surgery ◽  
University Hospital ◽  
Revision Hip Arthroplasty ◽  
Cumulative Proportion ◽  
Kaplan Meier ◽  
The Mean

Introduction: Reconstruction of acetabulum in case of bone defects can be challenging. The aim of this retrospective study was to investigate the 10-year survival of trabecular tantalum metal (TM) acetabulum component in revision hip arthroplasty operations and to evaluate complications. Methods: A total of 100 consecutive acetabulum revision hip arthroplasties (100 patients) were operated on between May 2004 and October 2006 at Kuopio University Hospital. The mean follow-up time was 9.4 years and the median was 11.5 years (SD 4.118; range 0.1–13.4 years). Kaplan-Meier survival analysis was performed to study the survival of patients to re-revision surgery. Intra- and postoperative complications and reasons for re-revision were evaluated. Results: The Kaplan-Meier analysis showed a cumulative proportion of revision hip survivorship of 66% at 13.4 years (SE 0.403, 95% CI, 10.886–12.466) based on the need for further re-revision surgery for any major reason. The Kaplan-Meier survival analysis of time to re-revision surgery due acetabular component loosening showed a cumulative proportion of survivorship of 98.9% at 13.4 years (SE 0.136; 95% CI, 12.998–13.529). There were a total of 41/100 complications and the most common complication was dislocation (24/100). Re-revision for any major reason was performed on 18/100 of the revision arthroplasties. The mean time to re-revision was 4.9 years (SD 5.247; range 0.1–13.2 years). Discussion: The trabecular TM acetabular component gives excellent outcomes regarding stability and fixation to the acetabulum in acetabulum revision hip arthroplasty at a minimum of ten years of follow-up. However, acetabular component malposition and the small head size (28 mm) are risk factors for dislocation.

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