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.

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.

Hip replacement in patients younger than 65 years: Results of the CLS prosthesis

2003 ◽  
Vol 13 (3) ◽  
pp. 133-141 ◽  
Author(s):  
G.S. Radcliffe ◽  
J.I. Wilson ◽  
R.U. Ashford ◽  
P.G. De Boer
Keyword(s):  
Patient Satisfaction ◽  
Confidence Interval ◽  
Hip Replacement ◽  
Clinical Results ◽  
Total Hip Replacements ◽  
Hip Replacements ◽  
Show Evidence ◽  
The Mean ◽  
Lost To Follow Up

We present the results of a retrospective review of 65 CLS uncemented total hip replacements in 47 patients all of whom were less than 65 years of age at the time of surgery. The mean follow-up was 6.5 years and only one case was lost to follow-up. The clinical results were good. The mean (95% confidence interval) Merle d'Aubigne Postel score for pain (max. 6) was 5.42 ± 1.13 (5.13 – 5.71) and for mobility (max. 6) 5.55 ± 0.71 (5.37 – 5.73). The mean score for patient satisfaction (max. 5) was 4.89 ± 0.46 (4.77 – 5.00). The mean total score was therefore 15.97 ± 1.70 (95% confidence interval 15.54 - 16.40) from a maximum of 17 points. There were three revisions over the study period giving a mean (95% confidence interval) survivorship of 96.5% (91.9% - 100%) at five years. We present the results of a radiological review, which show that the surviving implants show evidence of osseointegration. This was achieved despite the lack of a porous or hydroxyapatite coating.

scholarly journals The Corail Stem as a Reverse Hybrid – Survivorship and X-Ray Analysis at 10 Years

2017 ◽  
Vol 27 (4) ◽  
pp. 354-360 ◽  
Author(s):  
Helge Wangen ◽  
Lars Nordsletten ◽  
Jens G. Boldt ◽  
Anne M. Fenstad ◽  
David E. Beverland
Keyword(s):  
Clinical Outcome ◽  
Femoral Stem ◽  
Successful Outcome ◽  
Harris Hip Score ◽  
Heterotopic Bone ◽  
Heterotopic Bone Formation ◽  
X Rays ◽  
The Mean ◽  
Cemented Cup

Background The use of a cemented cup together with an uncemented stem in total hip arthroplasty (THA) has become popular in Norway and Sweden during the last decade. The results of this prosthetic concept, reverse hybrid THA have been sparsely described. We report our experience of reverse hybrid THA, using the Elite plus polyethylene cemented cup together with the Corail fully hydroxyapatite-coated uncemented stem and a 28-mm alumina ceramic head. Patients and methods 132 consecutive reverse hybrid hip arthroplasties were performed from January 2000 to December 2003 in 126 patients with a mean age of 54.3 years (28-65). All patients were routinely reviewed at 3 months, 1, 5, 7 and 10 years postoperatively. At each follow-up patients were seen either by a consultant orthopaedic surgeon or a senior trainee. Anteroposterior pelvic and lateral x-rays of the hip were taken at each visit. To estimate the survival of the THAs we used the Kaplan-Meier method with 95% confidence interval (CI). Logistic regression analysis was performed to determine which factors affected the presence of radiolucency around the femoral stem. Results The mean follow-up was 11.1 years (9.0-14.2). 1 patient was lost to follow-up, and 7 patients were deceased at the time of 10-year follow up. At 10 years 7 patients have had further surgery. 5 for infection, 1 periprosthetic femoral fracture and 1 heterotopic bone formation. All stems were classified as well fixed. 2 cups were defined as loose at 10 years. 1 patient is scheduled for revision the other refused revision. The clinical outcome and radiological findings were assessed in 123 hips. The mean Harris Hip Score was 94 (35-100) at 10 years and the mean WOMAC score was 89 (30.2-100). Conclusions We report good results with respect to clinical outcome and survival of the reverse hybrid concept in patients younger than 65. A successful outcome depends on meticulous preoperative planning, use of modern cementing techniques in the acetabulum and experience in implanting an uncemented stem.

scholarly journals Midterm results of the cylindrical fully porous-coated uncemented femoral stem in revision patients with Paprosky I–IIIA femoral defects

2018 ◽  
Vol 26 (2) ◽  
pp. 230949901878390 ◽  
Author(s):  
Salduz Ahmet ◽  
Kılıçoğlu Önder İsmet ◽  
Ekinci Mehmet ◽  
Yıldız Eren ◽  
Tözün Remzi ◽  
...  
Keyword(s):  
Aseptic Loosening ◽  
Femoral Stem ◽  
Assistive Device ◽  
Harris Hip Score ◽  
X Rays ◽  
Functional Scores ◽  
Femoral Stems ◽  
The Mean ◽  
Uncemented Femoral Stem

Introduction: The aim of this study was to analyze the survival of the Echelon® femoral stems in revision hip surgeries in patients with Paprosky I–IIIA femoral defects. Patients and methods: Sixty-six patients (70 hips) who underwent revision hip surgery with at least 3 years of follow-up data were included in the study between 2000 and 2013. The mean patient age was 64.5 (32–83) years, and the mean follow-up period was 93 (45–206) months. The reasons for revision were aseptic loosening in 55 (78.6%) patients, periprosthetic joint infection in 9 (12.9%) patients, periprosthetic fracture in 4 (5.7%) patients, and stem fracture in 2 (2.9%) patients. The preoperative and postoperative follow-up X-rays and functional scores were evaluated. Results: Five patients died in an average of 70 (45–86) months after surgery due to non-related diseases. We encountered sciatic nerve palsy in two patients and early hip dislocation in two patients, whereas 54 patients were able to walk without any assistive device. The remaining 12 patients required an assistive device to walk. The mean Harris hip score significantly increased from 34 (7–63) preoperatively to 72 (43–96) postoperatively. Aseptic loosening was observed in one patient. The survival of the porous-coated anatomical uncemented femoral stem was 98.4% over 10 years. Conclusion: This study showed that good clinical outcomes and survival can be obtained when using porous-coated anatomical uncemented femoral stems.

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.

Analysis of human acellular nerve allograft combined with contralateral C7 nerve root transfer for restoration of shoulder abduction and elbow flexion in brachial plexus injury: a mean 4-year follow-up

2020 ◽  
Vol 132 (6) ◽  
pp. 1914-1924 ◽  
Author(s):  
Liang Li ◽  
Jiantao Yang ◽  
Bengang Qin ◽  
Honggang Wang ◽  
Yi Yang ◽  
...  
Keyword(s):  
Brachial Plexus ◽  
Nerve Root ◽  
Functional Outcomes ◽  
Elbow Flexion ◽  
Shoulder Abduction ◽  
Allograft Reconstruction ◽  
Acellular Nerve Allograft ◽  
The Mean ◽  
Monofilament Test

OBJECTIVEHuman acellular nerve allograft applications have increased in clinical practice, but no studies have quantified their influence on reconstruction outcomes for high-level, greater, and mixed nerves, especially the brachial plexus. The authors investigated the functional outcomes of human acellular nerve allograft reconstruction for nerve gaps in patients with brachial plexus injury (BPI) undergoing contralateral C7 (CC7) nerve root transfer to innervate the upper trunk, and they determined the independent predictors of recovery in shoulder abduction and elbow flexion.METHODSForty-five patients with partial or total BPI were eligible for this retrospective study after CC7 nerve root transfer to the upper trunk using human acellular nerve allografts. Deltoid and biceps muscle strength, degree of shoulder abduction and elbow flexion, Semmes-Weinstein monofilament test, and static two-point discrimination (S2PD) were examined according to the modified British Medical Research Council (mBMRC) scoring system, and disabilities of the arm, shoulder, and hand (DASH) were scored to establish the function of the affected upper limb. Meaningful recovery was defined as grades of M3–M5 or S3–S4 based on the scoring system. Subgroup analysis and univariate and multivariate logistic regression analyses were conducted to identify predictors of human acellular nerve allograft reconstruction.RESULTSThe mean follow-up duration and the mean human acellular nerve allograft length were 48.1 ± 10.1 months and 30.9 ± 5.9 mm, respectively. Deltoid and biceps muscle strength was grade M4 or M3 in 71.1% and 60.0% of patients. Patients in the following groups achieved a higher rate of meaningful recovery in deltoid and biceps strength, as well as lower DASH scores (p < 0.01): age < 20 years and age 20–29 years; allograft lengths ≤ 30 mm; and patients in whom the interval between injury and surgery was < 90 days. The meaningful sensory recovery rate was approximately 70% in the Semmes-Weinstein monofilament test and S2PD. According to univariate and multivariate logistic regression analyses, age, interval between injury and surgery, and allograft length significantly influenced functional outcomes.CONCLUSIONSHuman acellular nerve allografts offered safe reconstruction for 20- to 50-mm nerve gaps in procedures for CC7 nerve root transfer to repair the upper trunk after BPI. The group in which allograft lengths were ≤ 30 mm achieved better functional outcome than others, and the recommended length of allograft in this procedure was less than 30 mm. Age, interval between injury and surgery, and allograft length were independent predictors of functional outcomes after human acellular nerve allograft reconstruction.

Long-term outcomes of lumbar microdiscectomy in the pediatric population: a large single-institution case series

2019 ◽  
Vol 24 (5) ◽  
pp. 549-557
Author(s):  
Malia McAvoy ◽  
Heather J. McCrea ◽  
Vamsidhar Chavakula ◽  
Hoon Choi ◽  
Wenya Linda Bi ◽  
...  
Keyword(s):  
Conservative Management ◽  
Functional Outcomes ◽  
Pediatric Patients ◽  
Clinical Presentation ◽  
Case Series ◽  
Csf Leak ◽  
Single Institution ◽  
The Mean

OBJECTIVEFew studies describe long-term functional outcomes of pediatric patients who have undergone lumbar microdiscectomy (LMD) because of the rarity of pediatric disc herniation and the short follow-up periods. The authors analyzed risk factors, clinical presentation, complications, and functional outcomes of a single-institution series of LMD patients over a 19-year period.METHODSA retrospective case series was conducted of pediatric LMD patients at a large pediatric academic hospital from 1998 to 2017. The authors examined premorbid risk factors, clinical presentation, physical examination findings, type and duration of conservative management, indications for surgical intervention, complications, and postoperative outcomes.RESULTSOver the 19-year study period, 199 patients underwent LMD at the authors’ institution. The mean age at presentation was 16.0 years (range 12–18 years), and 55.8% were female. Of these patients, 70.9% participated in competitive sports, and among those who did not play sports, 65.0% had a body mass index greater than 25 kg/m2. Prior to surgery, conservative management had failed in 98.0% of the patients. Only 3 patients (1.5%) presented with cauda equina syndrome requiring emergent microdiscectomy. Complications included 4 cases of postoperative CSF leak (2.0%), 1 case of a noted intraoperative CSF leak, and 3 cases of wound infection (1.5%). At the first postoperative follow-up appointment, minimal or no pain was reported by 93.3% of patients. The mean time to return to sports was 9.8 weeks. During a mean follow-up duration of 8.2 years, 72.9% of patients did not present again after routine postoperative appointments. The total risk of reoperation was a rate of 7.5% (3.5% of patients underwent reoperation for the same level; 4.5% underwent adjacent-level decompression, and one patient [0.5%] ultimately underwent a fusion).CONCLUSIONSMicrodiscectomy is a safe and effective treatment for long-term relief of pain and return to daily activities among pediatric patients with symptomatic lumbar disc disease in whom conservative management has failed.

scholarly journals Results of minimal invasive coracoclavicular fixation by double button lift-up system in Neer type II distal clavicle fractures

2017 ◽  
Vol 25 (1) ◽  
pp. 230949901668472 ◽  
Author(s):  
Süleyman Semih Dedeoğlu ◽  
Yunus İmren ◽  
Haluk Çabuk ◽  
Murat Çakar ◽  
Samet Murat Arslan ◽  
...  
Keyword(s):  
Functional Outcomes ◽  
Clavicle Fracture ◽  
Rehabilitation Program ◽  
Minimal Invasive ◽  
X Rays ◽  
Distal Clavicle ◽  
Distal Clavicle Fracture ◽  
Shoulder Scores ◽  
Coracoclavicular Fixation

Aim: We aimed to evaluate clinical and functional outcomes of indirect fracture reduction performed by coracoclavicular fixation with minimal invasive double button lift-up system in Neer type IIa unstable fractures of distal clavicle. Material and methods: 22 patients with Neer type 2 distal clavicle fracture were enrolled in that prospective study. All patients underwent indirect reduction and osteosynthesis performed by coracoclavicular fixation with minimal invasive double button lift-up system. Postoperative follow-up was carried out clinically and radiologically with plain X-rays and utilization of Constant and American Shoulder and Elbow Surgeons Standardized Shoulder Assessment (ASES) shoulder scores. Mean follow-up time was 15 months. A standard sling was applied for 2 weeks, postoperatively. Rehabilitation program was started on postoperative day 1. Results: Mean age was 39 (range: 21–60), 18 of the patients were male. Right dominant extremity was affected in 14 patients. Mean duration of the surgical intervention was 40 min (range: 30–55 min). Mean union time was found to be 14 weeks (range: 7–21 weeks). Mean postoperative ASES and Constant scores were 79.9 (66.9–88.3) and 82.2 (71–100), respectively. The duration of return to normal daily activities were found to be 4.5 months. Any loss of reduction, AC joint arthrosis, and clavicular shortening were not detected in X-rays. Conclusion: This study has demonstrated that indirect osteosynthesis performed by coracoclavicular fixation with double button lift-up system in the treatment of unstable Neer type IIa fractures of the distal clavicle had successful clinical, radiological, and functional outcomes.

Ten-Year Follow-up Study of Charnley and Charnley-Mueller Total Hip Replacements.

1992 ◽  
Vol 41 (2) ◽  
pp. 604-607
Author(s):  
Kiyotaka Okuyama ◽  
Kenichiro Shibata ◽  
Masahiro Kina ◽  
Shinji Tomari ◽  
Shinichi Motomatsu ◽  
...  
Keyword(s):  
Total Hip ◽  
Follow Up Study ◽  
Total Hip Replacements ◽  
Hip Replacements

scholarly journals Preliminary Results in Anatomic All-inside Anterior Cruciate Ligament Reconstruction

2016 ◽  
Vol 1 (s2) ◽  
pp. 23-26
Author(s):  
Octav Russu ◽  
Tiberiu Bățagă ◽  
Andrei-Marian Feier ◽  
Radu Prejbeanu ◽  
Radu Fleaca ◽  
...  
Keyword(s):  
Anterior Cruciate Ligament ◽  
Acl Reconstruction ◽  
Cruciate Ligament ◽  
Knee Laxity ◽  
Clinical Results ◽  
Lysholm Score ◽  
X Rays ◽  
The Mean ◽  
Anterior Cruciate

Abstract Introduction: Anterior cruciate ligament (ACL) rupture is one of the most common lesions in knee traumatology; therefore the number of ACL reconstructions is increasing worldwide. Usually, an anteromedial (AM) accessory portal is required in anatomical positioning of the femoral tunnel, which is not absolutely necessary in this technique. Aim: Assessment of all-inside ACL reconstruction preliminary clinical results with adjustable loops and buttons on both femoral and tibial surfaces. Method: Our prospective study included 28 subjects (19 male, 9 female) with chronic ACL ruptures. The mean age of the study population was 27.72 ± 8.23 years. In all cases ACL reconstruction was carried out with the use of quadrupled semitendinosus auto-grafts with adjustable loops and buttons on the femoral and tibial surfaces and anatomic placement of both tunnels, using an outside-in technique, with flipcutters (Arthrex®). Clinical and radiological evaluations were carried out before surgery and at 3 and 6 months postoperatively, with the Lysholm scoring system, the Tegner activity scale and anterior-posterior and latero-lateral X-rays. Anterior knee laxity was measured in 25° of flexion using a portable arthrometer (RolimeterTM, Aircast®) and maximum manual force. Results: During the final follow-up, the Lysholm score was good and excellent in 27 cases, with a mean Lysholm score of 95.55 ± 4.63; all results were classified as good. The mean preoperative Tegner activity score was 3.46 ± 1.71 (range: 1-7), and the post-operative mean score was 5.75 ± 2.24 (range: 2-10). We found no graft ruptures. Preoperative knee laxity measurements showed a mean displacement of 11.5 ± 3.1 mm and side-to-side differences of 5.6 ± 3.5 mm, while the postoperative measurements at the last follow-up were 6.3 ± 1.54 mm and 2.65 ± 1.86 mm, respectively. Conclusion: Short-term clinical outcomes of all-inside ACL restoration with anatomic placement femoral and tibial tunnels seem to recommend this surgical option, with good subjective and objective results. Additional research will have to prove the long-term success.

Sign in / Sign up

Export Citation Format

Share Document