scholarly journals Filling Bone Defects after Hip Arthroplasty Revision Using Hydroxyapatite/?-tricalcium Phosphate: A Case Report with Long-term Result

2021 ◽  
Vol 11 (6) ◽  
Author(s):  
Sandris Petronis ◽  
Ruta Jakusonoka ◽  
Viktors Linovs ◽  
Andris Jumtins
Keyword(s):  
Case Report ◽  
Bone Defect ◽  
Hip Arthroplasty ◽  
Tricalcium Phosphate ◽  
Periprosthetic Fracture ◽  
Bone Defects ◽  
Femoral Bone ◽  
Left Femur ◽  
Arthroplasty Revision

Introduction: The increasing number of primary total hip replacements means that there is an increased need for hip arthroplasty revisions. The periprosthetic fractures which cause bone defects can occur during removal of the femoral component and healing of these fractures can be delayed. In femoral bone defects during revisions, there are no metal augments for filling these defects. Case Report: Fifty-nine-year-old female presented with infected loosening of the left hip non-cemented endoprosthesis 5 years after surgery. The patient underwent removal of endoprosthesis. In 2 months, re-implantation of non-cemented endoprosthesis was performed and biphasic calcium phosphate (BCP) ceramic granules with hydroxyapatite/?-tricalcium phosphate (HAp/?-TCP) were implanted in the femoral bone defects. Eleven months following the arthroplasty patient had periprosthetic fracture of the distal third of the left femur. The osteosynthesis was performed and BCP ceramic granules with HAp/?-TCP were used to fill the bone defect. Long-term follow-up showed very good functional outcome and bone defect healing. Conclusion: The BCP ceramic granules with HAp/?-TCP material adjusted to the bone defect anatomy, showed effective femoral bone defect and periprosthetic fracture healing in a patient with hip arthroplasty revision and periprosthetic fracture. Keywords: Bone defect, femoral, revision.

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.

scholarly journals An Early Periprosthetic Fracture of a Cementless Oxford Unicompartmental Knee Arthroplasty: Risk Factors and Mitigation Strategies

2021 ◽  
Vol 11 (4) ◽  
Author(s):  
Li Zong Xian ◽  
Andrew Tan Hwee Chye
Keyword(s):  
Case Report ◽  
Knee Arthroplasty ◽  
Periprosthetic Fracture ◽  
Perioperative Complications ◽  
Survival Rates ◽  
Mitigation Strategies ◽  
Term Survival ◽  
Revision Total Knee Replacement ◽  
Total Knee

Introduction: The cementless Oxford partial knee arthroplasty is associated with low perioperative complications and good long-term survival rates. However, perioperative fractures remain a serious morbidity for patients. Case Report: This case report describes an early post-operative tibial periprosthetic fracture through the keel slot, which we believe may be contributed by the deep implant keel design and the presence of a narrow metaphysis in the Asian knee. The patient subsequently underwent a revision total knee replacement and fixation of the periprosthetic fracture. Conclusion: This paper discusses the ways to identify patients at high risk of developing periprosthetic fractures and to minimize such occurrences, including adopting a modified tibial preparation, doing precise saw cuts, and considering a cemented tibial implant. Keywords: Cementless, Oxford, unicompartmental, periprosthetic, keel.

scholarly journals Prediction of Bone Damage Formation in Resurfacing Hip Arthroplasty

2019 ◽  
Vol 9 (1) ◽  
pp. 5879-5885
Keyword(s):  
Hip Arthroplasty ◽  
Hip Replacement ◽  
Femoral Bone ◽  
Cobalt Chromium ◽  
Element Analysis ◽  
Left Femur ◽  
Bone Model ◽  
Replacement Method ◽  
Physiological Loading ◽  
Resurfacing Hip Arthroplasty

Resurfacing Hip Arthroplasty (RHA) is a hip replacement method that is widely known nowadays. However, the complication on femoral bone fracture often happens in this hip replacement method which associated with the implant positioning. The objective of this study is to predict the damage formation on the bone which resulting from the RHA pin malposition. Finite element analysis was conducted in order to predict the damage formation on the bone model based on the computed tomography (CT) image of a patient. A 3D inhomogeneous bone model was developed from a 47 year old patient with an osteoarthritis disease located on the left femur. The material used for the RHA implant model is cobalt chromium and the implant is then being inserted into the femoral bone. Straight implant position with angle 130° was selected as a reference in the analysis while another three position of varus (> 130°) and valgus (<130°) were selected and known as the pin malposition. The simulation was conducted on each of the selected angles in order to predict the damage formation towards the bone model. The damage formation obtained was from the results of elements failure which occurred after applying the load. Physiological loading of a human which focusing on the normal walking condition was selected as the loading and boundary condition in this study. The femoral bone model experienced the highest damage formation when the implant located at the varus position while reduced significantly when the implant placed at the valgus position.

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.

Revision Hip Arthroplasty with an Extensively Porous-coated Stem - Excellent Long-term Results Also in Severe Femoral Bone Stock Loss

2013 ◽  
Vol 23 (4) ◽  
pp. 352-358 ◽  
Author(s):  
Per B. Thomsen ◽  
Niels J.F. Jensen ◽  
Jens Kampmann ◽  
Torben Bæk Hansen
Keyword(s):  
Hip Arthroplasty ◽  
Revision Hip Arthroplasty ◽  
Long Term Results ◽  
Bone Stock ◽  
Femoral Bone

scholarly journals Some aspects of the hip arthroplasty revision. Bone defect plasty with sponge allografts

2016 ◽  
pp. 29-35
Author(s):  
U.F. Mukhametov ◽  
◽  
F.F. Mukhametov ◽  
Ia.N. Suleimanov ◽  
R.Ia. Nagaev ◽  
...  
Keyword(s):  
Bone Defect ◽  
Hip Arthroplasty ◽  
Arthroplasty Revision

scholarly journals What Characteristics of the Acetabular Defect Influence the Choice of the Acetabular Component During Revision Hip Arthroplasty?

2020 ◽  
Vol 26 (2) ◽  
pp. 31-49
Author(s):  
R. M. Tikhilov ◽  
A. A. Dzhavadov ◽  
A. N. Kovalenko ◽  
A. O. Denisov ◽  
A. S. Demin ◽  
...  
Keyword(s):  
Hip Arthroplasty ◽  
Retrospective Cohort ◽  
Defect Formation ◽  
Bone Defects ◽  
Revision Hip Arthroplasty ◽  
Acetabular Defects ◽  
Type 3 ◽  
Revision Operations

The purposes of the retrospective cohort study were: 1) to determine the severity of defects in the acetabulum and the probable causes of their formation in patients who underwent revision hip arthroplasty (RHA), as well as an assessment of factors that exacerbate the severity of the defects; 2) identifying the proportion of severe defects in the overall structure of acetabular revisions and determining the effectiveness of using serial implants in comparison with individual constructions made by 3D printing; 3) the rationale for rational indications for the use of individual constructions.Materials and Methods. The structure and reasons for the formation of bone defects in the acetabulum were evaluated in 726 cases of revisions performed from 2004 to 2018. In addition, the results of revision operations in a group of patients with severe defects (type 3 according to Paprosky and pelvic discontinuity) were evaluated.Results. The most frequent cause of defect formation was iatrogenic (53.2%), and the share of severe defects was 39.5% (287 observations). A factor aggravating the severity of the defect is the lack of its limitation by the support bone. The results of RHA in patients with severe defects were assessed in 186 cases out of 287 (64.8%). In 73 (39.2%) cases, individual constructions were used, the average follow-up was 26 months. (from 12 to 50), and in 113 (60.8%) cases, serial implants were used, the average follow-up period was 62 months. (12 to 186). Individual constructions were more often implanted in patients with 3B acetabular defects (p<0.05) and its uncontained defects (p<0.001). The number of cases of aseptic loosening in the group of patients undergoing endoprosthetics using serial implants was greater than in the group of patients with individual constructions for the entire period (p<0.05) and in the early stages of observation (p<0.05).Conclusion. In case of RHA in patients with severe acetabular defects, individual implants, in comparison with serials, demonstrate better survival with an average follow-up of 26 months and due to design features, they can count on great long-term effectiveness. This study needs to be continued to increase follow-up.

Sign in / Sign up

Export Citation Format

Share Document