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 ◽  
...  

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.

2006 ◽  
Vol 309-311 ◽  
pp. 1357-1362
Author(s):  
Masahiro Hasegawa ◽  
Akihiro Sudo ◽  
Atsumasa Uchida

In ceramic-on-ceramic total hip arthroplasty (THA), modular acetabular component with a sandwich insertion was developed and evaluated mid-term clinical results. 35 hips had undergone cementless ceramic-on-ceramic THA with sandwich cup (Kyocera, Kyoto, Japan). The mean duration of follow-up was 5 years. 6 hips had undergone component revisions. The reasons for revision included infection in 1 hip, dislocation with loosening in 2 hips, alumina liner fractures in 2 hips, and cup dissociation in 1 hip. All femoral and acetabular components showed no loosening in the unrevised hips at the time of the last follow-up. None of the 29 unrevised hips had osteolysis.


2019 ◽  
Vol 27 (3) ◽  
pp. 230949901987311 ◽  
Author(s):  
Ozhan Pazarci ◽  
Seyran Kilinc ◽  
Yalkin Camurcu ◽  
Okay Bulut

Background: Gunshot injury of the hip joint was reported to constitute 2–17% of all extremity firearm injuries. However, there are few studies in the literature related to gunshot injuries of the hip joint. The aim of the current study was to present the results of 10 cases treated with arthroplasty following a gunshot injury to the hip joint together with the recommended treatment algorithm. Methods: Patients with a previous medical history of hip joint region gunshot injury who underwent total hip arthroplasty were retrospectively evaluated. Those with incomplete medical records or who were lost to follow-up were excluded. Patients were classified according to the severity of the previous gunshot injury to the hip joint region. Harris hip score (HHS) and Short Form-12 quality of life score were the main outcome measurements. Postoperative complications encountered during follow-up were recorded. Results: The mean age of the patients at the time of surgery was 29.9 years. The mean preoperative HHS was 25.2 points and it was 65.8 at the final follow-up. Patients with bullet fragments in the hip joint, classified as group 1, had better HHS, whereas those with contaminated hip joint with intestinal flora, classified as group 3, had worst HHS. Conclusion: Hip arthroplasty after hip joint gunshot injury is a good treatment choice in young patients to reduce pain and regain functions. However, very high infection rates can be seen in patients with accompanying intestinal injury.


2018 ◽  
Vol 26 (2) ◽  
pp. 230949901878391 ◽  
Author(s):  
Jun-Dong Chang ◽  
In-Sung Kim ◽  
Sameer Ajit Mansukhani ◽  
Vishwas Sharma ◽  
Sang-Soo Lee ◽  
...  

Purpose: The purpose of this study is to evaluate the clinical and radiologic outcomes after revision total hip arthroplasty (THA) using fourth-generation ceramic-on-ceramic (CoC) bearing surfaces. Methods: A total of 52 revision THAs (28 men and 19 women) using the fourth-generation CoC bearing surfaces were retrospectively evaluated. Both acetabular cup and femoral stem were revised in all cases. The mean follow-up period was 7.3 years (range, 4.0–9.9 years). The clinical results with Harris hip score (HHS), Western Ontario McMaster Osteoarthritis Index (WOMAC), and radiologic outcomes were evaluated. Results: At the final follow-up examination, the average HHS was 90.4 (range, 67–100). The average WOMAC pain and physical function score were 2.8 (range, 0–12) and 16.4 (range, 0–42), respectively. Complications were observed in 10 hips (19.2%). However, there were no bearing surface-related complications, and no cases of dislocation and squeaking. Retroacetabular pelvic osteolysis without cup loosening was observed in one hip at the final follow-up. However, no hip showed radiographic signs of cup loosening, vertical or horizontal acetabular cup migrations, and changes of inclinations during the follow-up period. Conclusion: Our data showed that clinical and radiologic outcomes after revision THA using fourth-generation CoC bearing were favorable. Hence, revision THA with the use of CoC bearing surfaces can be preferentially considered. Further studies with long-term follow-up data are warranted.


2003 ◽  
Vol 46 (3) ◽  
pp. 113-115 ◽  
Author(s):  
Karel Karpaš ◽  
Pavel Šponer

The aim of this study is to present our experience with two-stage reimplantation in the management of the infected hip arthroplasty. Between January 1993 and December 2001 the replacement of the total hip arthroplasty in two stages was performed in 18 patients. There were 7 male and 11 female patients and the average age was 62 years. The mean follow-up after revision was 3.5 years. The mean postoperative Harris Hip Score averaged 78 (50–96) points. None of 18 patients had a recurrence of the infection. Two-stage reconstruction of the infected hip is preferred to one-stage exchange arthroplasty at our department because of higher rate of eradication of the infection.


10.29007/455b ◽  
2018 ◽  
Author(s):  
Itay Perets ◽  
John Walsh ◽  
Brian Mu ◽  
Yosif Mansor ◽  
Leslie Yuen ◽  
...  

Recent advances have made robotic assistance a viable option in total hip arthroplasty (THA). However, the clinical outcomes of this procedure relative to THA without robotic assistance have yet to be reported. This study presents short-term outcomes of robotically assisted THA compared to a pair-matched control group of patients that underwent THA without robotic assistance.Data were prospectively collected on all THAs performed from July 2011 to January 2015. Patients were included if they underwent primary THA treating idiopathic osteoarthritis and were eligible for minimum two-year follow-up. Outcomes were measured using Harris Hip Score (HHS), the Forgotten Joint Score (FJS-12), pain on a visual analog scale (VAS), and satisfaction from 0-10. Patients that underwent THA with robotic assistance were matched 1:1 with THA patients without robotic assistance for age, sex, BMI, and approach.There were 85 patients in each study group. There were no significant differences in the demographic factors matched for. Both HHS and FJS-12 were significantly higher in the robotic assistance group at minimum two-year follow-up. VAS was lower in the robotic assistance group, but this was not statistically significant (p = 0.12). There was a not a significant difference in patient satisfaction. There was no significant difference in the rate of postoperative complications or subsequent revisions between groups.Robotically assisted THA is safe and may lead to superior short-term outcomes compared to THA without robotic assistance.


2020 ◽  
Vol 62 (1) ◽  
Author(s):  
Đắc Việt Mai ◽  
Thu Thủy Nguyễn

This study aimed to report the outcome of total hip arthroplasty (THA) with an extensive hydroxyapatite (HA) coating for the fixation of a tapered femoral stem (Corail) in patients aged 60 or younger than sixty years with stage IV, V và VI osteonecrosis of femoral head. Subject and method: Descriptive prospective research of ninety osteonecrotic hips in ninety patients were available for clinical and radiographic analyses at minimum follow-up of 5 years. Results and Conclusion: The mean Harris hip score improved from 43.74 ± 9,25points preoperatively to 96.67 ± 3.82points at final follow-up. Seventy-four (100%) hips demonstrated stable bone ingrowth. No hips showed acetabular or femoral osteolysis radiolucency and loosening, or required revision for aseptic loosening. We believe that cementless THA with a Corail stem is a promising procedure for patients with osteonecrosis of the femoral head.


2020 ◽  
Vol 8 (5_suppl5) ◽  
pp. 2325967120S0007
Author(s):  
Gandhi Nathan Solayar

Introduction: Complex and revision Total Hip Arthroplasty (THA) is a challenging prospect in patients with acetabular bone deficiencies. Augmentation using allograft and trabecular metal (TM) are among some of the options in these situations. This study report the outcomes of 14 cases of complex and revision THA using acetabular augments performed in our institution between 2015 and 2018 Materials and Methods: In this retrospective study, data included demographic features, indication for THA, type of augments and clinical outcomes using the Harris hip score were collected for the to determine early results following THA. Results: The mean cohort age was 51.3 years. Gender distribution was equal with 7 male and female patients each. 7 THAs were augmented with allograft and 7 cases with TM augments. The average duration of follow-up was 16.9 months. Most patients (11 of 14) required complex primary THA following prior traumatic hip dislocations and its subsequent complications. The mean post-operative Harris hip score for functionality was 80.84 in our cohort at final follow-up (from an average of 33.8 pre-operatively). At present, there have been no reports of wound complications, infections or dislocations in this early cohort. Discussions: Complex/revision THA using allografts for acetabular augmentation have been used for decades with good and replicable results as shown in our series. TM is relatively new but current literatures show encouraging results. Both options have resulted in good outcomes in our cohort and further long term studies would be necessary before TM augments were to replace the need for allograft. Conclusions: Both allografts and TM acetabular augments showed good early results post-operatively in our cohort. With the improved flexibility of component selection and the lower risk of allograft infection, TM augments is currently our choice of acetabular augmentation and the early results are promising.


2019 ◽  
Vol 47 (4) ◽  
pp. 1544-1554 ◽  
Author(s):  
Qian Xu ◽  
Jiajie Lai ◽  
Fan Zhang ◽  
Yangkai Xu ◽  
Fugui Zhu ◽  
...  

Objectives This study was performed to compare the long-term clinical and radiological outcomes of conversion total hip arthroplasty (CTHA) following prior failed InterTan nail (IT) fixation or dynamic hip screw (DHS) fixation in Asian patients with osteoporotic intertrochanteric hip fractures (IHFs) and to clarify which implant tends to be more favourable for CTHA. Methods Records of consecutive Asian patients with osteoporosis who underwent conversion of failed primary unilateral IT or DHS fixation to THA from 2010 to 2013 were extracted from the comprehensive database of the China Pacific Insurance Company Ltd. All consecutive procedures were managed by high-volume surgeons. The primary endpoint was the clinical outcome. The secondary endpoint was the radiological outcome. Results In total, 447 Asian patients with osteoporotic IHFs (DHS, n = 223; IT, n = 224) were assessed during a median follow-up of 46 months (range, 39–53 months). The two groups showed a significant difference in the Harris hip score at final follow-up and in the orthopaedic complication rate (DHS, 20.2%; IT, 9.8%). Conclusion Conversion to THA following prior failed DHS fixation tends to be associated with poorer clinical and radiological outcomes in Asian patients with osteoporotic IHFs than that following prior failed IT fixation.


2019 ◽  
Vol 47 (4) ◽  
pp. 1610-1619 ◽  
Author(s):  
Chen Yang ◽  
Xiulan Han ◽  
Jie Wang ◽  
Zheng Yuan ◽  
Tao Wang ◽  
...  

Objective To compare medium-term clinical and radiological outcomes of primary unilateral uncemented (UN) or cemented (CE) femoral component total hip arthroplasty (THA) in elderly patients with osteoporosis. Methods Consecutive patients with osteoporosis who underwent primary unilateral UN or CE THAs at our institution from 2006 to 2013 were retrospectively reviewed. All consecutive procedures were managed by high-volume surgeons, using UN or CE THA approaches. Follow-up assessments occurred at 1, 3, 6, 9, and 12 months postoperatively, and yearly thereafter. Patient-related functional outcomes were assessed using the Harris Hip Score (HHS). Primary and secondary endpoints were early revision (<5 years) and functional outcome. Results In total, 496 primary unilateral THAs (CE, n = 184; UN, n = 182) were assessed with a median follow-up period of 75 months (range, 65–86 months). From 3 months after surgery to the final follow-up, HHS was consistently superior in the CE group. Respective prosthetic loosening rates in the UN and CE groups were 26.4% and 16.8% at a minimum of 5 years. There was a significant difference in rate of early revision (7.6% CE vs. 14.8% UN). Conclusion Compared with UN THA, CE THA exhibits a superior outcome in elderly patients with primary osteoporosis.


Arthroplasty ◽  
2019 ◽  
Vol 1 (1) ◽  
Author(s):  
Seung-Jae Lim ◽  
Ingwon Yeo ◽  
Chan-Woo Park ◽  
Kyung-Jae Lee ◽  
Byung-Woo Min ◽  
...  

Abstract Purpose Highly cross-linked polyethylene has been introduced to decrease osteolysis secondary to polyethylene wear debris generation. However, few long-term data on revision total hip arthroplasty (THA) using highly cross-linked polyethylene liners are available. The objective of this study was to determine long-term outcomes of a highly cross-linked polyethylene liner in revision THA. Materials & methods We evaluated 63 revision THAs performed in 63 patients using a highly cross-linked polyethylene liner between April 2000 and February 2005. Of these, nine died and four were lost to follow-up. Thus, the final study cohort consisted of 50 patients (50 hips), including 26 males and 24 females with a mean age of 53 years (range, 27–75 years). Mean follow-up was 11 years (range, 10–14 years). Results The mean Harris hip score improved from 44 points preoperatively to 85 points at the final follow-up. No radiographic evidence of osteolysis was found in any hip. The mean rate of polyethylene liner wear was 0.029 mm/year (range, 0.003 to 0.098 mm/year). A total of 5 hips (10%) required re-revision arthroplasty, including one cup loosening, one recurrent dislocation, and three deep infections. Kaplan-Meier survivorship with an end point of re-revision for any reason was 91.1% and for aseptic cup loosening was 97.9% at 11 years. Conclusion At a minimum of 10 years, the highly cross-linked polyethylene liners showed excellent clinical performance and implant survivorship, and were not associated with osteolysis in our patients with revision THAs.


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