scholarly journals The design of the acetabular component and size of the femoral head influence the risk of revision following 34 721 single-brand cemented hip replacements

2012 ◽  
Vol 94-B (12) ◽  
pp. 1611-1617 ◽  
Author(s):  
S. S. Jameson ◽  
P. N. Baker ◽  
J. Mason ◽  
P. J. Gregg ◽  
N. Brewster ◽  
...  
Keyword(s):  
Femoral Head ◽  
Acetabular Component ◽  
Hip Replacements

Radiolucent lines do not affect the longevity of highly cross-linked polyethylene cemented components in total hip arthroplasty

2021 ◽  
Vol 103-B (10) ◽  
pp. 1604-1610
Author(s):  
Yusuke Takaoka ◽  
Koji Goto ◽  
Jiro Tamura ◽  
Yaichiro Okuzu ◽  
Toshiyuki Kawai ◽  
...  
Keyword(s):  
Femoral Head ◽  
Total Hip Arthroplasty ◽  
Acetabular Component ◽  
Hip Arthroplasty ◽  
Long Term Outcome ◽  
Total Hip ◽  
Radiolucent Lines ◽  
Kaplan Meier ◽  
Acetabular Components

Aims We aimed to evaluate the long-term outcome of highly cross-linked polyethylene (HXLPE) cemented acetabular components and assess whether any radiolucent lines (RLLs) which arose were progressive. Methods We retrospectively reviewed 170 patients who underwent 187 total hip arthroplasties at two hospitals with a minimum follow-up of ten years. All interventions were performed using the same combination of HXLPE cemented acetabular components with femoral stems made of titanium alloy. Kaplan-Meier survival analysis was performed for the primary endpoint of acetabular component revision surgery for any reason and secondary endpoint of the appearance of RLLs. RLLs that had appeared once were observed over time. We statistically assessed potential relationships between RLLs and a number of factors, including the technique of femoral head autografting and the Japanese Orthopaedic Association score. Results The mean follow-up period was 13.0 years (10.0 to 16.3). Femoral head autografting was performed on 135 hips (72.2%). One acetabular component was retrieved because of deep infection. No revision was performed for the aseptic acetabular loosening. The Kaplan-Meier survival curve for the primary and secondary endpoints were 98.2% (95% confidence interval (CI) 88.6% to 99.8%) and 79.3% (95% CI 72.8% to 84.6%), respectively. RLLs were detected in 38 hips (21.2%), at a mean of 1.7 years (1 month to 6 years) postoperatively. None of the RLLs were progressive, and the presence of RLLs did not show a significant association with the survival and clinical score. RLLs were more frequently observed in hips without femoral head autografts than in those with autografts. Conclusion The use of HXLPE cemented acetabular components in total hip arthroplasty demonstrated excellent clinical outcomes after ten years, and no RLLs were progressive, and their presence did not affect the outcome. Femoral head autografting did not negatively impact the acetabular component survival or the appearance of RLLs. Cite this article: Bone Joint J 2021;103-B(10):1604–1610.

Does Robotic-Assisted Total Hip Arthroplasty Improve Accuracy of Cup Positioning?

2019 ◽  
Vol 03 (04) ◽  
pp. 176-180 ◽  
Author(s):  
Joshua A. Lawson ◽  
Andrew T. Garber ◽  
Jeffrey D. Stimac ◽  
Rama Ramakrishnan ◽  
Langan S. Smith ◽  
...  
Keyword(s):  
Total Hip Arthroplasty ◽  
Acetabular Component ◽  
Hip Arthroplasty ◽  
Consecutive Series ◽  
Goal Alignment ◽  
Robotic Assisted ◽  
Component Placement ◽  
Total Hip ◽  
Hip Replacements ◽  
Cup Positioning

AbstractAcetabular component malpositioning is a frequent cause of complications in total hip arthroplasty including instability, increased wear, osteolysis, impingement, and revision surgery. Recently, robotics and navigation have been introduced to improve cup positioning in total hip arthroplasty. The purpose of this study was to compare the accuracy of postoperative acetabular component positioning using MAKO robotic-assisted versus manual acetabular component placement. A consecutive series of 100 total hip replacements were performed in 100 patients. The first 50 were performed using manual techniques, while the second 50 were performed using MAKO-guided acetabular component placement. Postoperative anteroposterior pelvis radiographs were used to determine the postoperative anteversion and inclination of the cup relative to the goal of 15 and 45°, respectively. In the manual group, the average anteversion and inclination was 14.3 and 44.2°, respectively, with 28% within 5° and 82% within 10° of the goal alignment, respectively. In the robotic group, the average anteversion and inclination was 15.1 and 45.6°, respectively, with 54 and 88% within 5 and 10° of the goal alignment, respectively. This equated to a statistically significant improvement in the number of acetabular components placed within 5° of the target alignment with the use of robotic guidance (p = 0.0142). From the authors' study, they were able to demonstrate a significant improvement in acetabular component alignment with the use of robotic techniques. Additional studies are needed to demonstrate improvement in clinical outcomes as a result of improved accuracy and precision of acetabular component placement.

Double-Modular Hip Device Design Susceptible to Stress Corrosion Failure

2009 ◽  
Author(s):  
Sara A. Atwood ◽  
Eli W. Patten ◽  
Kevin J. Bozic ◽  
Lisa A. Pruitt ◽  
Michael D. Ries
Keyword(s):  
Femoral Head ◽  
Femoral Anteversion ◽  
Metal Alloy ◽  
Leg Length ◽  
Acetabular Cup ◽  
Corrosion Failure ◽  
Total Hip ◽  
Press Fit ◽  
Free Mobility ◽  
Hip Replacements

Total hip replacements restore pain-free mobility to approximately 200,000 patients in the U.S. each year [1]. A typical hip system comprises a metal alloy stem, a femoral head (ceramic or metal alloy), and a polyethylene acetabular cup fit into a metal alloy backing. A modular press-fit Morse taper is commonly used to attach the femoral head to the stem. There are also more recent designs that incorporate a second interface at the neck-stem junction (Figure 1). Increased modularity in total hip replacement design allows the surgeon to intraoperatively preserve patient anatomy such as leg length and femoral anteversion and better balance the surrounding soft tissue for optimal biomechanics. However, modularity also increases the number of mechanical junctions and interfaces in the device which may lead to complications such as corrosion, wear, and fracture.

scholarly journals Salvaging Unstable or Recurrent Dislocating Total Hip Arthroplasty with the Constrained Acetabular Component

2002 ◽  
Vol 10 (2) ◽  
pp. 165-169 ◽  
Author(s):  
DA Stanton ◽  
WJ Bruce ◽  
JA Goldberg ◽  
W Walsh
Keyword(s):  
Total Hip Arthroplasty ◽  
Acetabular Component ◽  
Hip Arthroplasty ◽  
Recurrent Dislocation ◽  
Total Hip ◽  
Hip Replacements ◽  
The Mean ◽  
Acetabular Components ◽  
Constrained Acetabular Component

Purpose. To review cases of implantation of constraining acetabular components for unstable or recurrent dislocating total hip arthroplasty at the Department of Orthopaedics, Concord Hospital, Sydney. Methods. A retrospective analysis was performed on prospectively collected data of 13 consecutively enrolled patients. Results. From 1989 to 2000, 13 constraining acetabular components were implanted into 13 patients as a revision procedure. The surgical approach for the implantation of the constrained liner was posterolateral in 11 cases; a modified Hardinge approach was applied in 2 cases. The mean clinical follow-up duration was 43 months (range, 14–121 months) and the mean age at the time of surgery was 73 years (range, 52–84 years). No patients were lost to follow-up. Indications for using the constrained acetabular component were recurrent dislocation in revision hip replacements (n=8), and intra-operative instability (n=5). There were no episodes of dislocation of the constrained arthroplasty. In 7 cases, the constrained component was implanted into a previously well-fixed shell. Conclusion. We recommend the judicious use of the constrained component in cases of hip instability during or after total hip arthroplasty when other methods are not successful.

scholarly journals Algorithm of selection of acetabular component of hip joint endoprothesis in patients with femoral head aseptic necrosis.

2015 ◽  
Vol 20 (1) ◽  
pp. 27-34
Author(s):  
A. Ye. Loskutov ◽  
A. Ye. Olejnik ◽  
A. V. Altanets ◽  
Ye. A. Kovbasa
Keyword(s):  
Femoral Head ◽  
Acetabular Component ◽  
Hip Joint ◽  
Aseptic Necrosis ◽  
Selection Of

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.

Radiographic Native Femoral Head Size Correlates with Acetabular Cup Size in Primary Total Hip Arthroplasty

2019 ◽  
Vol 03 (04) ◽  
pp. 197-202
Author(s):  
Daniel Pfeufer ◽  
Jeremy Gililland ◽  
Rane Ajinkya ◽  
Ian Duensing ◽  
Mike B. Anderson ◽  
...  
Keyword(s):  
Femoral Head ◽  
Total Hip Arthroplasty ◽  
Acetabular Component ◽  
Hip Arthroplasty ◽  
Head Size ◽  
Radiographic Measurement ◽  
Femoral Head Size ◽  
Acetabular Cup ◽  
Component Size ◽  
Primary Total Hip Arthroplasty

AbstractThere is very little literature on whether a simple radiographic measurement of native femoral head size correlates with implanted acetabular cup size. We hypothesized that there would be a high correlation between the radiographically measured native femoral head and implanted acetabular component size in primary total hip arthroplasty (THA). We conducted a retrospective study of 277 consecutive patients who underwent primary THA. Patients with prior contralateral THA or a history of congenital deformity were excluded (n = 95). We used the postoperative anteroposterior (AP) pelvic view to calibrate the image using known implanted femoral head component size. We then measured the diameter of the contralateral native femoral head under the assumption that femoral heads are generally symmetrical in patients. Two of the authors performed all measurements. To determine if native femoral head size was correlated with acetabular component size we used the Pearson correlation coefficient (r). There was a high correlation between contralateral native femoral head size and acetabular component size (r = 0.86, 95% confidence interval [CI]: 0.82–0.89). The median difference in radiographically measured native femoral head size and acetabular component size was 7 mm (interquartile range [IQR] = 5–8). Our data showed a high correlation between acetabular component size and radiographically measured contralateral native femoral head size, with the difference being 7 mm. In addition to verifying the actual femoral head size with calipers during surgery, this simple radiographic measurement, which could be done on the affected or contralateral hip, may help surgeons to plan better and improve preoperative templating in primary THA.

scholarly journals The in vivo location of edge-wear in hip arthroplasties

2021 ◽  
Vol 10 (10) ◽  
pp. 639-649
Author(s):  
Sean Bergiers ◽  
Harry Hothi ◽  
Johann Henckel ◽  
Anna Di Laura ◽  
Martín Belzunce ◽  
...  
Keyword(s):  
Acetabular Component ◽  
Computational Models ◽  
Wear Rates ◽  
Walking Gait ◽  
Hip Replacements ◽  
Edge Wear ◽  
Definition Of ◽  
Wear Maps ◽  
Hip Arthroplasties

Aims Acetabular edge-loading was a cause of increased wear rates in metal-on-metal hip arthroplasties, ultimately contributing to their failure. Although such wear patterns have been regularly reported in retrieval analyses, this study aimed to determine their in vivo location and investigate their relationship with acetabular component positioning. Methods 3D CT imaging was combined with a recently validated method of mapping bearing surface wear in retrieved hip implants. The asymmetrical stabilizing fins of Birmingham hip replacements (BHRs) allowed the co-registration of their acetabular wear maps and their computational models, segmented from CT scans. The in vivo location of edge-wear was measured within a standardized coordinate system, defined using the anterior pelvic plane. Results Edge-wear was found predominantly along the superior acetabular edge in all cases, while its median location was 8° (interquartile range (IQR) -59° to 25°) within the anterosuperior quadrant. The deepest point of these scars had a median location of 16° (IQR -58° to 26°), which was statistically comparable to their centres (p = 0.496). Edge-wear was in closer proximity to the superior apex of the cups with greater angles of acetabular inclination, while a greater degree of anteversion influenced a more anteriorly centred scar. Conclusion The anterosuperior location of edge-wear was comparable to the degradation patterns observed in acetabular cartilage, supporting previous findings that hip joint forces are directed anteriorly during a greater portion of walking gait. The further application of this novel method could improve the current definition of optimal and safe acetabular component positioning. Cite this article: Bone Joint Res 2021;10(10):639–649.

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