Trunnion corrosion in metal-on-polyethylene hip arthroplasty

Aims To report our experience with trunnion corrosion following metal-on-polyethylene total hip arthroplasty, in particular to report the spectrum of presentation and determine the mean time to presentation. Patients and Methods We report the presenting symptoms and signs, intraoperative findings, and early results and complications of operative treatment in nine patients with a mean age of 74 years (60 to 86). The onset of symptoms was at a mean of seven years (3 to 18) after index surgery. Results Patients presented with a variety of symptoms including pain, limp and rash. The preoperative mean serum cobalt level was 7.1 ppb (2.2 to 12.8) and mean serum chromium level was 2.2 ppb (0.5 to 5.2). Metal artifact reduction sequence (MARS) MRI showed fluid collection and possible pseudotumour formation in five hips, fluid collection in two hips, and synovitis/debris in one hip, with no MRI in one patient. Acetabular revision was performed in three patients, six patients underwent liner and head exchange only. The postoperative metal levels decreased in all patients: mean cobalt 0.5 ppb (0 to 1.8) and mean chromium 0.9 ppb (0 to 2.6) at a mean of five months (3 to 8) postoperatively. Seven patients had good pain relief and no complications at one year. There were two major complications requiring reoperation: acute infection at six weeks, for which the patient required two-stage reimplantation; and recurrent dislocation, for which the patient was revised to a dual mobility component. Conclusion Trunnion corrosion in metal-on-polyethylene THA has a range of presenting symptoms, and may present later than previously described. A high index of suspicion is warranted, and serum cobalt and chromium levels are recommended for diagnosis. Patients should be counselled about possible postoperative complications. Cite this article: Bone Joint J 2018;100-B:898–902.

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Short-term outcomes with the REDAPT monolithic, tapered, fluted, grit-blasted, forged titanium revision femoral stem

The Bone & Joint Journal ◽

10.1302/0301-620x.102b2.bjj-2019-0743.r1 ◽

2020 ◽

Vol 102-B (2) ◽

pp. 191-197 ◽

Cited By ~ 1

Author(s):

Jonathan A. Gabor ◽

Jorge A. Padilla ◽

James E. Feng ◽

Erik Schnaser ◽

William B. Lutes ◽

...

Keyword(s):

Regression Analysis ◽

Total Hip Arthroplasty ◽

Hip Arthroplasty ◽

Intraoperative Complications ◽

Femoral Stem ◽

Stem Length ◽

Total Hip ◽

Early Results ◽

One Year

Aims Although good clinical outcomes have been reported for monolithic tapered, fluted, titanium stems (TFTS), early results showed high rates of subsidence. Advances in stem design may mitigate these concerns. This study reports on the use of a current monolithic TFTS for a variety of indications. Methods A multi-institutional retrospective study of all consecutive total hip arthroplasty (THA) and revision total hip arthroplasty (rTHA) patients who received the monolithic TFTS was conducted. Surgery was performed by eight fellowship-trained arthroplasty surgeons at four institutions. A total of 157 hips in 153 patients at a mean follow-up of 11.6 months (SD7.8) were included. Mean patient age at the time of surgery was 67.4 years (SD 13.3) and mean body mass index (BMI) was 28.9 kg/m2 (SD 6.5). Outcomes included intraoperative complications, one-year all-cause re-revisions, and subsidence at postoperative time intervals (two weeks, six weeks, six months, nine months, and one year). Results There were eight intraoperative complications (4.9%), six of which were intraoperative fractures; none occurred during stem insertion. Six hips (3.7%) underwent re-revision within one year; only one procedure involved removal of the prosthesis due to infection. Mean total subsidence at latest follow-up was 1.64 mm (SD 2.47). Overall, 17 of 144 stems (11.8%) on which measurements could be performed had >5 mm of subsidence, and 3/144 (2.1%) had >10 mm of subsidence within one year. A univariate regression analysis found that additional subsidence after three months was minimal. A multivariate regression analysis found that subsidence was not significantly associated with periprosthetic fracture as an indication for surgery, the presence of an extended trochanteric osteotomy (ETO), Paprosky classification of femoral bone loss, stem length, or type of procedure performed (i.e. full revision vs conversion/primary). Conclusion Advances in implant design, improved trials, a range of stem lengths and diameters, and high offset options mitigate concerns of early subsidence and dislocation with monolithic TFTS, making them a valuable option for femoral revision. Cite this article: Bone Joint J 2020;102-B(2):191–197.

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Early results of a high friction surface coated uncemented socket in revision hip arthroplasty

Hip International ◽

10.1177/1120700019863002 ◽

2019 ◽

Vol 30 (6) ◽

pp. 739-744 ◽

Cited By ~ 1

Author(s):

Vinay Chacko ◽

Pranshu Agrawal ◽

Martyn L Porter ◽

Tim N Board

Keyword(s):

Aseptic Loosening ◽

Hip Arthroplasty ◽

Revision Arthroplasty ◽

Recurrent Dislocation ◽

Deep Infection ◽

Revision Hip Arthroplasty ◽

Radiolucent Lines ◽

Early Results ◽

And Migration

Background: Revision hip arthroplasty with high friction trabecular metal sockets has resulted in good medium-term results. Many manufacturers have therefore introduced higher friction coatings to their implants to meet a growing demand for similar implants. The Pinnacle Gription was introduced in 2007 as an evolution of the standard Pinnacle socket. This study aimed to assess the early results of this socket in a revision setting. Methods: Between August 2009 and December 2016, the Gription socket was used in 146 revision hip replacements. The mean age was 63 (19–88) years. Defects were classified as Paprosky Grade 2 in 71(2A [28], 2B [19], 2C [24]) and grade 3 in 20 (3A [18], 3B [2]). Bearing combinations were ceramic-on-ceramic in 23, metal-on-polyethylene in 71, ceramic-on-polyethylene in 52. Screws were used in 112 cases, impaction bone grafting in 34 and metal augments in 1 case. Radiographs were analysed for progressive radiolucent lines and migration. Results: Mean follow-up was 43.5 (range 25–62) months. There were 6 re-revisions (2 for deep infection, 2 for recurrent dislocation and 2 for aseptic loosening). None of the other cases had evidence of socket migration or progressive radiolucent lines. There were no intraoperative or postoperative periprosthetic fractures. The crude survivorship for all-cause failure was 95.8% and the survivorship for aseptic loosening was 98.6%. at 43.5 months follow-up. Conclusions: This is the largest reported series of Gription socket use in revision arthroplasty and demonstrates encouraging early results. We therefore advocate the continued cautious use of this implant.

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Early Results of Total Hip Arthroplasty in the Super-Obese Patients

Journal of Long-Term Effects of Medical Implants ◽

10.1615/jlongtermeffmedimplants.2013010098 ◽

2013 ◽

Vol 23 (4) ◽

pp. 309-313 ◽

Cited By ~ 6

Author(s):

Kimona Issa ◽

Hirschel Wohl ◽

Qais Naziri ◽

James D. McDermott ◽

Jeffery J. Cherian ◽

...

Keyword(s):

Total Hip Arthroplasty ◽

Hip Arthroplasty ◽

Obese Patients ◽

Super Obese ◽

Total Hip ◽

Early Results

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Dual mobility cups for recurrent dislocation of total hip arthroplasty

10.26226/morressier.579b42c3d462b80290b4cd25 ◽

2016 ◽

Author(s):

Afshin Taheriazam

Keyword(s):

Total Hip Arthroplasty ◽

Hip Arthroplasty ◽

Recurrent Dislocation ◽

Dual Mobility ◽

Total Hip ◽

Dual Mobility Cups

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Early Results of Cementless versus Hybrid Total Hip Arthroplasty in Patients with Posttraumatic Osteoarthritis

The Medical Journal of Cairo University ◽

10.21608/mjcu.2019.85222 ◽

2019 ◽

Vol 87 (12) ◽

pp. 4809-4814

Author(s):

AHMED ZAGHLOUL, M.Sc.; MAHMOUD S. KORKOR, M.D. ◽

WAIL L. ABDELNABY, M.D.; AKRAM HAMMAD, M.D.

Keyword(s):

Total Hip Arthroplasty ◽

Hip Arthroplasty ◽

Total Hip ◽

Posttraumatic Osteoarthritis ◽

Early Results

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Coronary endarterectomy in coronary artery disease: Factors affecting graft patency and survival

Asian Cardiovascular and Thoracic Annals ◽

10.1177/02184923211006851 ◽

2021 ◽

pp. 021849232110068

Author(s):

Simon CY Chow ◽

Jacky YK Ho ◽

Micky WT Kwok ◽

Takuya Fujikawa ◽

Kevin Lim ◽

...

Keyword(s):

Myocardial Infarction ◽

Graft Patency ◽

Complete Revascularization ◽

Coronary Endarterectomy ◽

Factors Affecting ◽

Early Results ◽

Cerebrovascular Events ◽

Obtuse Marginal ◽

One Year

Background Coronary endarterectomy aims to improve completeness of revascularization in patients with occluded coronary vessels. The benefits of coronary endarterectomy remain uncertain. The aim of this study was to evaluate short-term surgical outcomes and factors affecting graft patency post-coronary endarterectomy. Methods Between 2009 and 2019, 81 consecutive patients who had coronary endarterectomy done were evaluated for their perioperative and early results. A total of 36 patients with follow-up coronary studies were included in patency analysis. Mortality rates, major adverse cardiac and cerebrovascular events, and graft patency were outcomes of interest. Survival and risk factor analysis were performed with Kaplan–Meier and logistic regression analysis. Results The average age of the cohort was 61.9 ± 9.29 years. Complete revascularization rate was 95.4% post-coronary endarterectomy. The 30-day and 1-year mortality was 2.5 and 6.2%, respectively. One-year major adverse cardiac and cerebrovascular events rate was 11.1%. Periprocedural myocardial infarction rate was 7.4%. Three patients required repeat revascularization within a mean follow-up duration of 49.6 ± 36.5 months. Overall graft patency was 89.2% at 20.2 months and graft patency post-coronary endarterectomy was 85.4%. Arterial grafts showed 100% patency. Vein grafts to endarterectomized obtuse marginal branch had patency rates of 33.3%. Multiple endarterectomies were associated with worse one-year major adverse cardiac and cerebrovascular events (OR: 28.6 ± 1.16; P = 0.003). Conclusions Coronary endarterectomy facilitates completeness of revascularization and does not increase early mortality. Graft patency post-coronary endarterectomy on obtuse marginal artery was suboptimal. Judicious use of coronary endarterectomy should be practiced to balance the need of completeness of revascularization against the risk of myocardial infarction.

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The first commercial use of the Valiant Navion stent graft system for endovascular repair of a descending thoracic aortic aneurysm

Vascular ◽

10.1177/1708538120981127 ◽

2020 ◽

pp. 170853812098112

Author(s):

Cassra N Arbabi ◽

Navyash Gupta ◽

Ali Azizzadeh

Keyword(s):

Stent Graft ◽

Standard Of Care ◽

Aortic Aneurysms ◽

Descending Thoracic Aortic Aneurysm ◽

Thoracic Aortic Aneurysms ◽

Commercial Use ◽

Early Results ◽

Multiple Configuration ◽

One Year

Objectives Thoracic endovascular aortic repair (TEVAR) is the standard of care for descending thoracic aortic aneurysms (DTAA), and newer generation stent grafts have significant design improvements compared to earlier generation devices. Methods We report the first commercial use of the Medtronic Valiant Navion stent graft for treatment of an 85-year-old woman with a 5.8 cm DTAA and a highly tortuous thoracic aorta. Results A percutaneous TEVAR was performed using a two-piece combination of the Valiant Navion FreeFlo and CoveredSeal stent graft configurations for zones 2–5 coverage. The devices were successfully delievered through highly tortuous anatomy and deployed, excluding the entire length of the aneurysm with precise landing, excellent apposition and no evidence of endoleak. The patient tolerated the procedure well and has had no stent graft-related complications through one-year follow-up. Conclusions Design enhancements such as a lower profile delivery system, better conformability, and a shorter tapered tip are some of the improvements to this third-generation TEVAR device. Coupled with the multiple configuration options available, this gives physicians a better tool to treat thoracic aortic pathologies in patients with challenging anatomy. The early results are encouraging, and evaluation of long-term outcomes will continue.

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EARLY RESULTS FROM THE HIGH-RESOLUTION FLY's EYE

International Journal of Modern Physics A ◽

10.1142/s0217751x0100876x ◽

2001 ◽

Vol 16 (supp01c) ◽

pp. 1019-1021

Author(s):

JOHN BELZ

Keyword(s):

High Resolution ◽

Cosmic Ray ◽

Energy Spectra ◽

Fluorescence Technique ◽

Early Results ◽

One Year ◽

High Resolution Fly's Eye

The High-Resolution Fly's Eye cosmic ray observatory has been operating in monocular (stereo) mode for about three years (one year), during which time we have observed extensive airshowers with an integrated aperture of ~ 1500 km2-sr-yr (~ 400 km-sr-yr) at 5×1019 eV. We describe the HiRes experiment and the nitrogen fluorescence technique, and present data taken in both monocular and stereo modes including preliminary energy spectra.

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