scholarly journals Long-term clinical and radiological outcome in patients with severe Legg-Calvé-Perthes disease after Chiari pelvic osteotomy: a mean of 14 years follow-up

2021 ◽  
pp. 112070002098815
Author(s):  
Dammerer Dietmar ◽  
Braito Matthias ◽  
Peter Ferlic ◽  
Kaufmann Gerhard ◽  
Juana Kosiol ◽  
...  
Keyword(s):  
Total Hip Arthroplasty ◽  
Hip Joint ◽  
Hip Arthroplasty ◽  
Pelvic Osteotomy ◽  
Perthes Disease ◽  
Total Hip ◽  
Joint Incongruence ◽  
Chiari Pelvic Osteotomy

Introduction: The Chiari pelvic osteotomy (CPO) has been recommended as a salvage procedure to improve head coverage in case of hip joint incongruence in paediatric hip disease. In this study, we aimed to assess the long-term results of CPO for severe Legg-Calvé-Perthes disease (LCPD). Methods: A total of 39 patients who underwent a CPO at our department between 1995 and 2010 were prospectively followed both radiologically (Stulberg classification) and clinically (Harris Hip Score [HHS], conversion into total hip arthroplasty). In this study, we retrospectively reviewed the cases of 12 hips (12 patients, 3 girls, 8 left hips) treated by CPO for severe LCPD (Catterall grade 3 or 4) with hip joint incongruence. Mean follow-up was 14.0 (range 7.6–21.3) years. Results: Mean age at surgery was 10.2 (range 8.2–17.8) years. Additional femoral osteotomy was performed in 8 patients. A good radiological result (Stulberg I or II) was achieved in 2 patients, a fair result (Stulberg III) in 4 patients, and a poor outcome (Stulberg IV or V) in 6 patients. Mean postoperative HHS averaged 93 (range 65–100) points. An excellent functional outcome (HHS 90–100 points) was achieved in 9 patients. No patient underwent total hip arthroplasty during follow-up. Postoperative limb-length discrepancy was found in 3 patients. Conclusions: CPO for severe LCPD with hip joint incongruence resulted in good long-term clinical outcome in about ⅔ of our patients after a mean of 14 years. Our results suggest that CPO can still be considered as a salvage joint-conserving procedure in this selected group of younger patients.

scholarly journals Ten-year comparison of two different techniques for femoral bone cavity preparation—broaching versus compaction in patients with cementless total hip arthroplasty

2021 ◽  
Vol 2 (12) ◽  
pp. 1035-1042
Author(s):  
Maciej Okowinski ◽  
Mette Holm Hjorth ◽  
Sebastian Breddam Mosegaard ◽  
Jonathan Hugo Jürgens-Lahnstein ◽  
Stig Storgaard Jakobsen ◽  
...  
Keyword(s):  
Total Hip Arthroplasty ◽  
Clinical Outcomes ◽  
Hip Arthroplasty ◽  
Harris Hip Score ◽  
Femoral Bone ◽  
Total Hip ◽  
Stem Subsidence ◽  
Femur Fractures

Aims Femoral bone preparation using compaction technique has been shown to preserve bone and improve implant fixation in animal models. No long-term clinical outcomes are available. There are no significant long-term differences between compaction and broaching techniques for primary total hip arthroplasty (THA) in terms of migration, clinical, and radiological outcomes. Methods A total of 28 patients received one-stage bilateral primary THA with cementless femoral stems (56 hips). They were randomized to compaction on one femur and broaching on the contralateral femur. Overall, 13 patients were lost to the ten-year follow-up leaving 30 hips to be evaluated in terms of stem migration (using radiostereometry), radiological changes, Harris Hip Score, Oxford Hip Score, and complications. Results Over a mean follow-up period of 10.6 years, the mean stem subsidence was similar between groups, with a mean of -1.20 mm (95% confidence interval (CI) -2.28 to -0.12) in the broaching group and a mean of -0.73 mm (95% CI -1.65 to 0.20) in the compaction group (p = 0.07). The long-term migration patterns of all stems were similar. The clinical and radiological outcomes were similar between groups. There were two intraoperative fractures in the compaction group that were fixed with cable wire and healed without complications. No stems were revised. Conclusion Similar stem subsidence and radiological and clinical outcomes were identified after the use of compaction and broaching techniques of the femur at long-term follow-up. Only the compaction group had intraoperative periprosthetic femur fractures, but there were no long-term consequences of these. Cite this article: Bone Jt Open 2021;2(12):1035–1042.

3rd generation ceramic-on-ceramic cementless total hip arthroplasty: a minimum 10-year follow-up study

2018 ◽  
Vol 28 (2) ◽  
pp. 133-138 ◽  
Author(s):  
Yeong J. Lau ◽  
Shashank Sarmah ◽  
Johan D. Witt
Keyword(s):  
Total Hip Arthroplasty ◽  
Hip Arthroplasty ◽  
Senior Author ◽  
Long Term Results ◽  
Abduction Angle ◽  
Wear Properties ◽  
Total Hip ◽  
Ceramic On Ceramic

Introduction: 3rd generation ceramic bearings were introduced in total hip arthroplasty (THA) with the potential to have better mechanical strength and wear properties than their predecessors. At present, there are few studies looking at the long-term results of this latest generation of ceramic bearings. The purpose of our study was to investigate the long-term clinical and radiographic results of 3rd generation ceramic-on-ceramic THA and the incidence of ceramic specific complications such as squeaking and bearing surface fracture. Methods: The database of the senior author (J.D.W.) was reviewed. A total of 126 hip replacements performed in 108 patients (average age 39.6 years) with an average follow-up of 12.1 years (10-16 years) was identified. Clinical notes and plain radiographs were reviewed. To measure function, patients were contacted and an Oxford Hip Questionnaire was completed. Patients were also directly questioned about the presence of squeaking or any other sounds from the hip. Radiographs were evaluated for signs of wear, osteolysis, loosening and heterotopic ossification. The abduction angle of the acetabular component was measured. Results: The average Oxford Hip Score was 39.8 out of 48. Survivorship at 10 years was 94.6% (95% CI) with revision for any cause as the endpoint. There was 1 femoral head fracture, no osteolysis, no squeaking and no detectable wear. Conclusions: The good clinical and radiographic results for this series of patients are similar to other recent long-term studies looking at 3rd generation ceramic-on-ceramic THA. The results compare favourably with other bearing surfaces. The lack of osteolysis associated with this articulation is encouraging and may also make it a good choice for younger patients requiring total hip replacement.

Mid- to long-term outcomes of cementless modular, fluted, tapered stem for massive femoral bone loss in revision total hip arthroplasty

2020 ◽  
Author(s):  
Kai Zheng ◽  
Ning Li ◽  
Weicheng Zhang ◽  
Jun Zhou ◽  
Yaozeng Xu ◽  
...  
Keyword(s):  
Total Hip Arthroplasty ◽  
Bone Loss ◽  
Hip Arthroplasty ◽  
Long Term Results ◽  
Revision Total Hip Arthroplasty ◽  
Femoral Bone ◽  
Total Hip ◽  
Tapered Stem

Abstract Background: Revision total hip arthroplasty is frequently accompanied by bone loss. The purpose of this study is to evaluate mid- to long-term results of revision total hip arthroplasty for massive femoral bone loss using cementless modular, fluted, tapered stems.Methods: During the period of 2007 to 2015 at a single hospital, 34 hips (33 patients) underwent primary revision surgery with cementless modular, fluted, tapered stems due to massive bone loss, and patients with prosthetic joint infection (PJI) or tumours were excluded. The hips were revised with the LINK MP (Waldemar Link, Hamburg, Germany) prosthesis. Bone loss was categorized by the Paprosky classification for prosthesis loosening and Vancouver classification for peri-prosthetic fracture. All revision bearing surfaces were ceramic-on-ceramic (CoC). Clinical outcomes, radiographic outcomes and survivorship were evaluated.Results: The mean follow-up was 9.1±2.5 years (range, 5-13 years). The Harris hip score was 43.6±11.5 preoperatively and maintained at 86.5±6.6 at the time of latest follow-up (p<0. 05). The X-ray showed bone ingrowth fixation in 30 hips (88%), fibrous stable fixation in 3 hips (9%) and instability in 1 hip (3%). The average stem subsidence was 3.9±2.2 mm (range, 1 to 10 mm). The survivorship of prostheses with re-revision for any reason was 95% (95% CI, 12.0 to 13.0) at the 10-year follow-up. Three (9%) re-revisions were needed, including 1 for aseptic loosening, 1 for dislocation and 1 for infection.Conclusions: The mid- to long-term results of revision total hip arthroplasty with the cementless modular, fluted, tapered stem (LINK MP stem) are encouraging for massive femoral bone loss.

scholarly journals A Mid- to Long-Term Follow-Up Experience with a Specific Metal-on-Metal Total Hip Arthroplasty Design

Joints ◽  
2020 ◽  
Author(s):  
Christian Carulli ◽  
Giacomo Sani ◽  
Fabrizio Matassi ◽  
Roberto Civinini ◽  
Massimo Innocenti
Keyword(s):  
Total Hip Arthroplasty ◽  
Acetabular Component ◽  
Hip Arthroplasty ◽  
Harris Hip Score ◽  
Systemic Complications ◽  
Total Hip ◽  
Metal On Metal ◽  
Long Term Follow Up

Abstract Purrpose Metal-on-metal (MoM) total hip arthroplasty (THA) has been a subject of recent discussion and concern due to the early failures caused by local and systemic adverse reactions related to specific designs. The aim of this study is to analyze the outcomes and survival rates of a single brand of MoM implants implanted in a consecutive series of patients at a single institution. Methods Between 2007 and 2012, 116 (118 hips) patients were evaluated at a mean follow-up of 6.6 years after primary THA. The diagnosis leading to surgery was osteoarthritis (80 patients) and proximal femoral fracture (36 patients). A single design of THA was implanted. All patients were evaluated before surgery and postoperatively at 1, 3, 6, and 12 months by clinical scores and radiographic studies. The data analysis was made using Student's t-test. Results The minimum follow-up was of 4 years, with a mean follow-up of 6.6 years. Two aseptic loosenings of the acetabular component were recorded (one per group), which were not associated with local or systemic complications related to metal ion release. Both were revised by an isolated acetabular cup substitution with metal-on-polyethylene couplings. Nonprogressive radiolucency lines < 2 mm in zone 2 were observed in other six patients around the acetabular component without clinical manifestation (four in the arthritis group and two in the fracture group). Postoperative Harris Hip Score and SF-36 (36-Item Short Form Survey) score improved in both groups. Conclusion Despite several MoM implants showing early complications and failures, a specific MoM design may be associated with good clinical results at a mid- to long-term follow-up. Level of Evidence This is a therapeutic case series, Level 4 study.

Mid-To-Long Term follow-up of Transcend Metal-On-Metal versus Interseal Metal-On-Polyethylene Bearings in Total Hip Arthroplasty

2011 ◽  
Vol 21 (5) ◽  
pp. 571-576 ◽  
Author(s):  
James P. Yoon ◽  
Michel J. Le Duff ◽  
Karren M. Takamura ◽  
Stephen Hodge ◽  
Harlan C. Amstutz
Keyword(s):  
Total Hip Arthroplasty ◽  
Hip Arthroplasty ◽  
Total Hip ◽  
Metal On Metal ◽  
Long Term Follow Up
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