Stand up! Are normal weight-bearing forces sufficient for a 12/14 Morse taper locking in total hip arthroplasty?

2020 ◽  
pp. 112070002096700
Author(s):  
Suleman Qurashi ◽  
Matthew H Pelletier ◽  
Tian Wang ◽  
Nicholas Bramich ◽  
Jason Chinnappa ◽  
...  
Keyword(s):  
Surface Roughness ◽  
Total Hip Arthroplasty ◽  
Hip Arthroplasty ◽  
Weight Bearing ◽  
Normal Weight ◽  
Total Hip ◽  
Ceramic Femoral Head ◽  
Head Surface ◽  
Cyclical Loading

Background: The aim of this study was to investigate total hip arthroplasty (THA) Morse taper pull-off strengths after impaction prior to cyclical loading compared to cyclical loading alone. The practical relevance of the experiment is to provide a perspective on what may be clinically satisfactory taper assembly given the spectrum of head tapping patterns used by surgeons, as well as compare traditional impaction performed in standard THA with alternate methods of taper engagement such as ‘ in situ assembly’ used in micro-invasive techniques. Methods: 36 taper constructs utilising a combination of cobalt-chrome alloy and ceramic-titanium alloy junctions were investigated in vitro in wet and dry conditions with cyclical loading of the constructs. Taper disengagement strengths with and without impaction were compared. Secondary investigation of the surface roughness of the heads and tapers was also assessed. Results: An impaction to a wet taper resulted in a greater pull off force compared to a dry taper with a CoCr head and taper combination. Impacting the head and dryness of the taper did not affect pull off forces of a ceramic femoral head on titanium taper. Pulling a head off a taper significantly alters the head surface roughness. Conclusion: Impaction of a taper does not provide any benefit over cyclical loading of a taper assembly alone for pull-off strength.

Comparison of Polyethylene Wear between Highly Crosslinked and Annealed UHMWPE and Conventional UHMWPE against Ceramic Heads in Total Hip Arthroplasty

2012 ◽  
Vol 529-530 ◽  
pp. 279-284 ◽  
Author(s):  
Taishi Sato ◽  
Yasuharu Nakashima ◽  
Mio Akiyama ◽  
Takuaki Yamamoto ◽  
Taro Mawatari ◽  
...  
Keyword(s):  
Femoral Head ◽  
Total Hip Arthroplasty ◽  
Hip Arthroplasty ◽  
Polyethylene Wear ◽  
Wear Rates ◽  
Head Penetration ◽  
Total Hip ◽  
Patient Demographics ◽  
Ceramic Femoral Head ◽  
Implantation Period

The purpose of this study was to examine the effects of ceramic femoral head material on the wear of annealed, crosslinked ultra-high molecular weight polyethylene (UHMWPE) (XLPE) in total hip arthroplasty compared to non-crosslinked conventional UHMWPE (CPE). XLPE was fabricated by crosslinking with 60 kGy irradiation and annealing. Femoral heads made from zirconia and alumina ceramics, and cobalt-chrome (CoCr) of 22 mm or 26 mm diameter were used. In this study, the femoral head penetration into the cup was measured digitally on radiographs of 70 hips with XLPE and 50 hips with CPE. The average follow-up periods were 6.1 and 12.7 years, respectively. The steady wear rate of XLPE was significantly lower than those of CPE (0.002 versus 0.08 mm/year, respectively). Zirconia displayed increased wear rates compared to alumina in CPE; however, there was no difference among head materials in XLPE (0.0028, 0.011 and 0.009 mm/year for zirconia, alumina and CoCr, respectively). Neither head size or implantation period impacted XLPE wear. In contrast to CPE, XLPE displayed low wear rates surpassing the effects of varying femoral head material, size, implantation period and patient demographics.

Early Osteolysis Following Total Hip Arthroplasty with Use of a Hylamer Liner in Combination with a Modular Ceramic Femoral Head. A Case Report*

1999 ◽  
Vol 81 (10) ◽  
pp. 1446-9 ◽  
Author(s):  
BRADLEY K. VAUGHN ◽  
THOMAS B. DAMERON ◽  
THOMAS W. BAUER ◽  
YUICHI MOCHIDA ◽  
TOSHIHIRO AKISUE ◽  
...  
Keyword(s):  
Case Report ◽  
Femoral Head ◽  
Total Hip Arthroplasty ◽  
Hip Arthroplasty ◽  
Total Hip ◽  
Ceramic Femoral Head

In-Vitro Investigation of a Noninvasive Referencing Technology for Computer-Assisted Total Hip Arthroplasty

Orthopedics ◽  
2010 ◽  
Author(s):  
Tobias Renkawitz ◽  
Sabine Gneiting ◽  
Jens Schaumburger ◽  
Michael Woerner ◽  
Hans-Robert Springorum ◽  
...  
Keyword(s):  
Total Hip Arthroplasty ◽  
Hip Arthroplasty ◽  
Computer Assisted ◽  
Total Hip ◽  
In Vitro Investigation

scholarly journals Acetabular Fractures in the Elderly

2015 ◽  
Vol 6 ◽  
pp. CMTIM.S12265 ◽  
Author(s):  
Joshua L. Gary
Keyword(s):  
Total Hip Arthroplasty ◽  
Hip Arthroplasty ◽  
Acetabular Fracture ◽  
Open Reduction ◽  
Weight Bearing ◽  
Revision Arthroplasty ◽  
Early Mobilization ◽  
Acetabular Fractures ◽  
Posttraumatic Arthritis ◽  
Total Hip

As the population ages, the incidence of osteoporotic fractures, including those of the pelvis and acetabulum, continues to rise. Treatment of the elder patients with an acetabular fracture is much more controversial than the treatment of younger patients with similar injuries, where prevention of posttraumatic arthritis and total hip replacement remains optimal to limit need for revision arthroplasty. Arthroplasty for fractures of the proximal femur is commonplace in an older population and is a mainstay of treatment to promote early mobilization and weight-bearing. However, even with acute total hip arthroplasty for a geriatric acetabular fracture, most surgeons do not permit immediate weight-bearing postoperatively. Therefore, controversy regarding optimal treatment of these challenging fractures persists. Four treatment options have emerged: nonoperative treatment with early mobilization, open reduction and internal fixation (ORIF), limited open reduction and percutaneous screw fixation, and acute total hip arthroplasty. The exact indications and benefits of each treatment remain unknown. This article serves as a review of these four treatments and the data existing to support them.

Outcome of an “Enhanced Recovery” Program in Contemporary Total Hip Arthroplasty in Germany

2019 ◽  
Vol 158 (02) ◽  
pp. 214-220
Author(s):  
Karl Philipp Kutzner ◽  
Alexander Meyer ◽  
Marie Bausch ◽  
Michael Schneider ◽  
Philipp Rehbein ◽  
...  
Keyword(s):  
Total Hip Arthroplasty ◽  
Hip Arthroplasty ◽  
Enhanced Recovery ◽  
Weight Bearing ◽  
Hemoglobin Concentration ◽  
Inpatient Rehabilitation ◽  
Clinical Results ◽  
Total Hip ◽  
Recovery Program ◽  
Inpatient Length Of Stay

Abstract Background An inpatient hospital stay of up to 10 days after total hip arthroplasty (THA) is still common in Germany, mostly followed by inpatient rehabilitation. Internationally already widespread concepts for enhanced recovery are increasingly gaining popularity in Germany. Objectives The presentation of content and results of a newly implemented enhanced recovery concept in THA. Materials and Methods In this single-center, prospective observational study of a consecutive patient collective of a single surgeon, between January 2016 and July 2016, 103 short-stem THA patients were enrolled and treated using a newly introduced enhanced recovery concept. After 6 weeks and 6 months clinical examination was performed regarding function, pain, satisfaction and possible complications. Results The goal of discharge on day 4 after operation was reached in 61.2% of the patients with a mean postoperative inpatient stay of 4.9 days. After 6 weeks and 6 months respectively, excellent clinical results were achieved with high patient satisfaction. The complication rate was found to be low. Mean hemoglobin concentration decreased by 2.1 g/dl. A fissure of the femur below the implant healed conservatively applying no weight bearing for a total of 6 weeks. A pulmonary embolism that occurred during rehabilitation was also successfully treated. After 6 months one case showed a bursitis trochanterica. Conclusions Inpatient length of stay can be reduced by enhanced recovery concepts without increasing the risks to patients. Thus, in Germany these concepts will be applied increasingly.

scholarly journals Cement Removal from the Femur Using the ROBODOC System in Revision Total Hip Arthroplasty

2013 ◽  
Vol 2013 ◽  
pp. 1-5 ◽  
Author(s):  
Mitsuyoshi Yamamura ◽  
Nobuo Nakamura ◽  
Hidenobu Miki ◽  
Takashi Nishii ◽  
Nobuhiko Sugano
Keyword(s):  
Total Hip Arthroplasty ◽  
Bone Cement ◽  
Hip Arthroplasty ◽  
Weight Bearing ◽  
Full Weight Bearing ◽  
Revision Total Hip Arthroplasty ◽  
Total Hip ◽  
Revision Tha ◽  
Cement Removal

Introduction. The perforation and fracture of the femur during the removal of bone cement in revision total hip arthroplasty (THA) are serious complications. The ROBODOC system has been designed to selectively remove bone cement from the femoral canal, but results have not been reported yet. The purpose of our study was to evaluate the clinical and radiographic results of revision THA using the ROBODOC system for cement removal.Materials and Methods. The subjects comprised 19 patients who underwent revision THA using the ROBODOC system. The minimum duration of follow-up was 76 months (median, 109 months; range, 76–150 months). The extent of remaining bone cement on postoperative radiography, timing of weight bearing, and the complications were evaluated.Results. The mean Merle d’Aubigne and Postel score increased from 10 points preoperatively to 14 points by final follow-up. Bone cement was completely removed in all cases. Full weight bearing was possible within 1 week after surgery in 9 of the 19 cases and within 2 months in all remaining cases. No instances of perforation or fracture of the femur were encountered.Conclusions. Bone cement could be safely removed using the ROBODOC system, and no serious complications occurred. Full weight bearing was achieved early in the postoperative course because of circumferential preservation of the femoral cortex.

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