Assessment of Titanium Alloy on Polyethylene Bearing Surfaces in Retrieved Uncemented Total Hip Replacements

1994 ◽  
Vol 208 (2) ◽  
pp. 91-95 ◽  
Author(s):  
K J Drabu ◽  
R J Michaud ◽  
P J J McCullagh ◽  
K Brummitt ◽  
R A Smith
Keyword(s):  
Titanium Alloy ◽  
Hip Arthroplasty ◽  
Surface Finish ◽  
Revision Surgery ◽  
Articular Surface ◽  
Total Hip ◽  
Total Hip Replacements ◽  
Femoral Heads ◽  
Hip Replacements ◽  
Bone Particles

Changes to the bearing surfaces of eighteen uncemented total hip replacements retrieved at revision surgery were assessed by three-dimensional binocular microscopy, Rank Taylor Hobson talysurf measurements, scanning electron microscopy, and X-ray dispersive analysis. Abrasions on the non-articular surface of the polyethylene cups were present. Bone particles were found in tracks in the bearing surfaces of both the titanium femoral heads and the polyethylene cups and were responsible for wear of these surfaces. Although the wear of the femoral heads appeared substantial to naked eye examination, the surface finish of these surfaces remained within the British ISO standards for titanium alloy when assessed by the methods used above. This study concluded that direct contact between polyethylene and bone should be avoided in total hip arthroplasty and that ‘third body’ wear from bone particles occurred in these uncemented prostheses. Both components of this type of implant should be replaced at revision surgery and titanium should be avoided as a bearing surface in hip arthroplasty. Present methods of assessing the surface finish of titanium should be re-evaluated and more reliable ones considered.

scholarly journals Biotribology in Arthroplasty: Worn Surfaces Investigation on Ceramic Hip Femoral Heads Considering Wettability

2020 ◽  
Vol 10 (24) ◽  
pp. 8919
Author(s):  
Saverio Affatato ◽  
Alessandro Ruggiero
Keyword(s):  
Amplitude Distribution ◽  
Average Roughness ◽  
Surface Evolution ◽  
Total Hip ◽  
Total Hip Replacements ◽  
Roughness Profile ◽  
Femoral Heads ◽  
Hip Replacements ◽  
Worn Surfaces

Ceramic-on-ceramic bearings for total hip replacement are considered the best choice to avoid problems such as osteolysis and wear, mainly related to soft bearings. The aim of this work was to investigate in a comparative way different kinds of ceramic femoral heads for total hip replacements from a biotribological point of view, discussing the results obtained in terms of topographies, presence of metal transfer (MT) phenomena, and wettability on their worn surfaces in a tribological framework. Different ceramic femoral heads derived from in vitro wear tests, retrieved form patients, and brand new total hip replacements were investigated. The patients group had an average age of 60 years (ranging from 27 to 83). In most cases, the cause of failure was aseptic loosening of the acetabular component. Roughness analyses were performed to measure the tribological surface evolution of the material; an SEM and EDS investigation on the explanted heads proves and quantified MT, while the wettability was measured through a novel optical laboratory set-up with the aim to furnish useful data in the framework of synovial lubrication phenomena acting in the tribosystem. For the average roughness measurements on explanted specimens were considered three parameters (Ra = the average area between the roughness profile and its mean line; Rt = the vertical distance from the deepest valley to the highest peak of the roughness profile; and Rsk = it is the skewness and it is a measure of the asymmetry of the amplitude distribution function. In other words, the skewness indicates whether a surface is dominated by peaks or by valleys) and their values were: Ra 0.22 ± 0.12 μm, Rt 34.5 ± 13.5 μm and Rsk −0.01 ± 11.3; on the new specimens we measured Ra 0.01 ± 0.001 μm, Rt 0.12 ± 0.09 μm, and Rsk = 5.67 ± 8.7; for the in vitro specimens they were Ra 0.05 ± 0.12 μm, Rt 0.71 ± 1.4 μm and Rsk 7.73 ± 20.6. The wettability angle measurements showed hydrophilic surfaces for all femoral heads considered in this study with small differences between the three investigated categories, allowing to discuss their effects on the biobearings’ lubrication phenomena.

An Experimental Study of Metallic Transfer on Ceramic Femoral Heads

2009 ◽  
Author(s):  
Douglas M. Doud ◽  
Preston R. Beck ◽  
Donald R. Petersen ◽  
Jack E. Lemons ◽  
Alan W. Eberhardt
Keyword(s):  
Experimental Study ◽  
Femoral Head ◽  
Life Expectancy ◽  
Metal Transfer ◽  
Acetabular Cup ◽  
Total Hip ◽  
Total Hip Replacements ◽  
Femoral Heads ◽  
Hip Replacements ◽  
Postoperative Dislocation

Postoperative dislocation of total hip replacements has been documented to occur at a rate of approximately 2.4–3.9% [1–3]. Such events may result in the transfer of titanium from the acetabular cup to the femoral head, both during the dislocation and surgical reduction of the dislocated joint [3,4]. If the head is reduced with this transfer present, the joint life expectancy, which depends on articulating surfaces remaining smooth, is reduced [4]. Although the presence of metal transfer on retrieved femoral heads after dislocation is documented, no previous studies have attempted to quantify the forces or contact stresses at which metal transfer occurs.

Decreasing Incidence of Postoperative Ileus Following Total Hip Arthroplasty: A 17-Year Retrospective Review of 31,619 Total Hip Replacements at One Institution

2019 ◽  
Vol 03 (02) ◽  
pp. 089-092
Author(s):  
Bob Nguyen ◽  
Olivia J. Bono ◽  
James V. Bono
Keyword(s):  
Total Hip Arthroplasty ◽  
Hip Arthroplasty ◽  
Postoperative Ileus ◽  
Length Of Hospital Stay ◽  
Fiscal Year ◽  
Total Hip ◽  
Total Hip Replacements ◽  
Revision Tha ◽  
Hip Replacements ◽  
Preventable Complication

AbstractIleus following total hip arthroplasty (THA) is a clinically and financially significant postoperative complication that has not been extensively described in the orthopaedic joint literature. Ileus has been found to occur in 0.7 to 4.0% of patients after total joint arthroplasty and as high as 5.6% in patients after revision THA.1,2,3 In a 17-year period (2001 Fiscal Year through 2017 Fiscal Year) at one institution, the authors found an incidence of 0.674% (213/31619) following THA. In addition, the incidence of ileus following THA has drastically declined over this 17-year period, from 1.822% (19/1043) in 2001 to 0.099% (3/3036) in 2017. This decrease may be attributed to a reduction in narcotic use postoperatively, earlier ambulation following surgery, and reduction in length of hospital stay. Though postoperative ileus is not yet a preventable complication, recognition of risk factors may permit earlier intervention to ameliorate some of the morbidity associated with this condition.

Outcome of Revision Arthroplasty for Failed Metal-On-Metal Total Hip Replacements; is there a Relation with Metal Ions?

2017 ◽  
Vol 27 (3) ◽  
pp. 235-240 ◽  
Author(s):  
Hafiz J. Iqbal ◽  
Waheeb A.K. Al-Azzani ◽  
Esther Jackson-Taylor ◽  
Elizabeth Clatworthy ◽  
Alun John
Keyword(s):  
Metal Ions ◽  
Revision Surgery ◽  
Revision Arthroplasty ◽  
Poor Correlation ◽  
Metal Debris ◽  
Total Hip ◽  
Total Hip Replacements ◽  
Metal On Metal ◽  
Hip Replacements ◽  
Oxford Hip Score

Purpose We aimed to assess the early outcome following revision arthroplasty for failed metal-on-metal (MoM) total hip replacements (THR) due to adverse reaction to metal debris (ARMD). Methods We reviewed 106 consecutive revision arthroplasties. Case notes and radiological investigations were reviewed to assess the complications. Oxford Hip Score (OHS) and Euroqol (EQ-5D-3L) scores were used to assess the functional outcome and improvement of quality of life. Results At a mean follow-up of 20 months (12-48 months), the mean OHS was 28.7. Pain improved in 61% patients. A majority of patients were in level 2 for all the EQ-5D-3L dimensions. The overall complication rate was 16%. Survivorship free from further revision for any cause was 94.3% at 48 months. There was no correlation between pre-revision blood metal ions and the final outcome. Conclusions Revision surgery for failed MoM hip replacement due to ARMD is associated with a relatively higher rate of complications and risk of chronic pain. There is poor correlation between serum metal ions and development of ARMD and outcome following revision surgery.

scholarly journals Imageless navigation total hip arthroplasty – an evaluation of operative time

SICOT-J ◽  
2018 ◽  
Vol 4 ◽  
pp. 18 ◽  
Author(s):  
Epaminondas Markos Valsamis ◽  
David Ricketts ◽  
Adnan Hussain ◽  
Amir-Reza Jenabzadeh
Keyword(s):  
Total Hip Arthroplasty ◽  
Hip Arthroplasty ◽  
Operative Time ◽  
Statistical Tools ◽  
New Techniques ◽  
Total Hip ◽  
Total Hip Replacements ◽  
Imageless Navigation ◽  
Significant Difference ◽  
Hip Replacements

Introduction: Imageless navigation has been successfully integrated in knee arthroplasty but its effectiveness in total hip arthroplasty (THA) has been debated. It has consistently been shown that navigation adds significant time and cost to the operation. Further, the relative success of traditional hip replacements has impeded the adoption of new techniques. Methods: We compared the operative time between fifty total hip replacements with and without the use of imageless navigation by a single senior surgeon in a retrospective study. We employed standard statistical tools to compare the two methods. A correlation-based analysis was used to delimit the “learned” phase of imageless navigation to make comparisons meaningful. Results: Contrary to what has previously been reported, there was no significant difference between operative time in navigated, when compared to traditional operations (p = 0.498). Only fourteen operations were required to delimit the learning phase of this operation. Discussion: This is the first study that demonstrates no added operative time when using imageless navigation in THA, achieved with an improved workflow. The results also demonstrate a very reasonable learning curve.

Risk factors for mid-term revision surgery in patients with articular surface replacement total hip arthroplasty

2017 ◽  
Vol 28 (1) ◽  
pp. 44-49
Author(s):  
Gabrielle S. Donahue ◽  
Viktor Lindgren ◽  
Vincent P. Galea ◽  
Rami Madanat ◽  
Orhun K. Muratoglu ◽  
...  
Keyword(s):  
Total Hip Arthroplasty ◽  
Hip Arthroplasty ◽  
Revision Surgery ◽  
Metal Ion ◽  
Articular Surface ◽  
Cobalt Metal ◽  
Surface Replacement ◽  
Total Hip ◽  
Articular Surface Replacement ◽  
Patient Reported

Introduction: This study assessed the associations between gender and implant survival, as well as adverse local tissue reaction (ALTR), in patients with articular surface replacement (ASR) XL total hip arthroplasty (THA). Secondly, we sought to report the differences between genders in metal ion levels and patient reported outcome measures (PROMs) in these patients. Methods: 563 unilateral ASR XL THA patients were enrolled in a multicentre follow-up study at a mean of 6.4 years after index surgery. All patients had blood metal ion levels and PROMs obtained annually, and a valid anteroposterior pelvis radiograph. A sub-set of patients from a single centre had annual MRI performed and were analysed for the presence of moderate-to-severe ALTR. Results: 60 hips (11%) were revised during the study period. The only variables found to be associated with revision surgery in patients with unilateral THA were VAS pain (hazard ratio [HR], 1.35; p<0.001) and elevated cobalt metal ion levels (HR, 1.05; p<0.001). No variables assessed were found to be associated with prevalence of ALTR. Chromium concentrations were greater in female patients than males, while cobalt levels were similar between genders. Males reported higher HHS, EQ-5D and UCLA scores than females. Conclusions: Both males and females with metal-on-metal THA implants should be followed with equal vigilance as gender does not appear to be associated with poor outcomes, such as revision surgery and presence of ALTR.

Sign in / Sign up

Export Citation Format

Share Document