scholarly journals Enzymes and cytokines disease in total hip arthroplasty: promoters of immune loosening

2018 ◽  
Vol 66 (3) ◽  
pp. 477-484
Author(s):  
Victorino Pacheco-Martelo ◽  
Sebastián Roldán-Vasco
Keyword(s):  
Total Hip Arthroplasty ◽  
Aseptic Loosening ◽  
Hip Arthroplasty ◽  
Hip Prosthesis ◽  
Prosthesis Loosening ◽  
Total Hip ◽  
Hip Prosthesis Loosening ◽  
Arthroplasty Failure

Introducción. Una de las causas más importantes de falla de la prótesis de cadera lo constituye el fenómeno de aflojamiento, el cual se relaciona con la liberación de enzimas mediada por citocinas y produce la lisis del hueso que soporta el implante.Objetivo. Describir los mecanismos de interacción biológica de las moléculas promotoras del aflojamiento de la prótesis total de cadera que con mayor frecuencia están presentes en el proceso.Materiales y métodos. Se realizó una búsqueda de artículos originales y casos clínicos en las bases de datos PubMed y Scopus, sin límite de fecha de publicación, utilizando los términos MeSH “hip prosthesis loosening”, “aseptic loosening”, “cytokines” y “hip arthroplasty failure”. La extracción de datos se hizo mediante la lectura de 250 estudios, de los cuales se seleccionaron 66 para fines de redacción.Resultados. Los autores describen las moléculas más representativas implicadas en el aflojamiento de la prótesis de cadera, además se presentan las interacciones entre ellas.Conclusiones. Enzimas y citocinas han sido ampliamente estudiadas por cuatro décadas, aunque sus mecanismos de interacción son poco conocidos. Los autores proponen un mecanismo de interacción, proceso que podría denominarse “enfermedad de las enzimas y citocinas” o “aflojamiento inmunológico”.

scholarly journals Novel Stemless Hip Prosthesis Design and Finite Element Analysis to validate stemless Prosthesis for Reduction of Aseptic Loosening in Total Hip Arthroplasty

2020 ◽  
Author(s):  
Nishan Khadka ◽  
Mukesh Yadav ◽  
Adhish Ghimire
Keyword(s):  
Finite Element Analysis ◽  
Finite Element ◽  
Total Hip Arthroplasty ◽  
Aseptic Loosening ◽  
Hip Arthroplasty ◽  
Hip Prosthesis ◽  
Element Analysis ◽  
Total Hip ◽  
Conventional Models ◽  
Better Than

Total Hip Arthroplasty/ Replacement is a major corrective procedure involving replacement of femoral head and neck of the long bone connected to the pelvis. Conventional methods involved using long stemmed Titanium Alloy (Ti6Al4V) implants with a Cobalt-Chrome (Co-Cr) spherical caps. The invasiveness, large distributions of interfacial stresses induce stress shielding and bone resorption leading to loosening and painful remission surgeries specifically in the younger more active individuals. The need to improve upon the less invasive stemless models in warranted. This paper incorporates an improved novel design to a stemless hip prosthesis. Finite element analysis concluded average stresses of 9MPa, average strains of 0.0063 mm/mm, total deformation of 88mm all within comparable ranges and better than conventional long-stemmed models as prosthesis for an exaggerated point load of thrice the body weight of human (867N) taken redundantly. Fatigue life is better than conventional models crossing 1010 cycles for the extreme loading. The contact stresses also proved to be lesser and spread over a smaller area reducing the chances of aseptic loosening compared to conventional models.

Plasma Prekallikrein Activity in Patients with Total Hip Arthroplasty

1987 ◽  
Vol 58 (04) ◽  
pp. 1040-1042
Author(s):  
J J M L Hoffmann ◽  
J H J P M Kortmann
Keyword(s):  
Total Hip Arthroplasty ◽  
Hip Arthroplasty ◽  
Hip Prosthesis ◽  
Contact System ◽  
Factor Xii ◽  
Total Hip ◽  
Activity Factor ◽  
Patient Groups ◽  
Kallikrein Activity

SummaryThe behaviour of the contact system was studied in 40 patients with total hip arthroplasty, by measuring plasma prekallikrein, spontaneous kallikrein activity and factor XII. In the literature it had been shown that patients with complications from this operation had decreased prekallikrein and increased kallikrein activity (M. Nakahara. Acta orthop scand 1982; 53: 591-6). In the present study, comprising patients with and without pain and proven loosening of the hip prosthesis, these findings could only partially be confirmed. Patients with a loosened prosthesis had significantly lower prekallikrein (mean 0.78 ± 0.28 U/ml; p <0.01) than patients without problems, but no detectable kallikrein activity in plasma. Patients with pain but no loosening had normal prekallikrein (1.04 ±0 0.26 U/ml) and also no demonstrable kallikrein activity. Factor XII was normal in all patient groups. It is concluded that decreased prekallikrein is limited to patients with a loosened hip prosthesis, with or without pain.

scholarly journals Incidence of low-grade infection in aseptic loosening of total hip arthroplasty

2010 ◽  
Vol 81 (6) ◽  
pp. 667-673 ◽  
Author(s):  
Dirk Jan F Moojen ◽  
Gijs van Hellemondt ◽  
H Charles Vogely ◽  
Bart J Burger ◽  
Geert H I M Walenkamp ◽  
...  
Keyword(s):  
Total Hip Arthroplasty ◽  
Aseptic Loosening ◽  
Hip Arthroplasty ◽  
Low Grade ◽  
Total Hip

scholarly journals No Association of CALCA Polymorphisms and Aseptic Loosening after Primary Total Hip Arthroplasty

2018 ◽  
Vol 2018 ◽  
pp. 1-7 ◽  
Author(s):  
Tünay Aydin-Yüce ◽  
Gina Kurscheid ◽  
Hagen Sjard Bachmann ◽  
Thorsten Gehrke ◽  
Marcel Dudda ◽  
...  
Keyword(s):  
Total Hip Arthroplasty ◽  
Aseptic Loosening ◽  
Hip Arthroplasty ◽  
Fragment Length Polymorphism ◽  
Genotype Distribution ◽  
Chain Reaction ◽  
Total Hip ◽  
Polymerase Chain ◽  
European Group ◽  
Primary Total Hip Arthroplasty

Studies of aseptic loosening showed an influence of calcitonin andα-CGRP, both encoded from the calcitonin/α-CGRP (CALCA) gene by alternative splicing. The aim of this study was to detect a possible association of the CALCA polymorphisms P1(rs1553005), P2(rs35815751), P3(rs5240), and P4(rs2956) with the time to aseptic loosening after THA. 320 patients suffering from aseptic loosening after primary total hip arthroplasty were genotyped for CALCA-P1 polymorphism and 161 patients for CALCA-P2 and CALCA-P3 polymorphisms and 160 patients for CALCA-P4 polymorphism. CALCA genotypes were determined by polymerase chain reaction and restriction-fragment length polymorphism. The genotype distribution of CALCA-P1 was CC 10%, CT 43%, and 46% TT. CALCA-P2 showed a distribution of 90.7%II, 8.7% ID, and 0.6% DD. The CALCA-P3 genotype distribution was 97.5% TT and 2.5% TC. The CALCA-P4 genotype distribution was 48.1% AA, 40% AT, and 11.9% TT. Significant differences between the CALCA genotypes were not found concerning age at implantation and replantation, BMI, gender, and cementation technique. No associations of the time for aseptic loosening were found. In conclusion, we did not find a significant association of CALCA polymorphisms and the time to aseptic loosening after primary THA in a Western European group.

scholarly journals Promising results of revision total hip arthroplasty using a hexagonal, modular, tapered stem in cases of aseptic loosening

PLoS ONE ◽  
2020 ◽  
Vol 15 (6) ◽  
pp. e0233035
Author(s):  
Jan Schwarze ◽  
Christoph Theil ◽  
Georg Gosheger ◽  
Ralf Dieckmann ◽  
Burkhard Moellenbeck ◽  
...  
Keyword(s):  
Total Hip Arthroplasty ◽  
Aseptic Loosening ◽  
Hip Arthroplasty ◽  
Revision Total Hip Arthroplasty ◽  
Total Hip ◽  
Tapered Stem

Treatment of Femoral Fractures Associated with Stem Loosening following Total Hip Arthroplasty

1998 ◽  
Vol 8 (3) ◽  
pp. 138-144 ◽  
Author(s):  
B. Erdemli ◽  
I. Gurkan ◽  
B. Guzel ◽  
I. Cetin
Keyword(s):  
Total Hip Arthroplasty ◽  
Hip Arthroplasty ◽  
Hip Prosthesis ◽  
Femoral Fractures ◽  
Early Mobilization ◽  
Revision Operation ◽  
Hip Revision ◽  
Total Hip ◽  
Primary Hip Arthroplasty ◽  
Fractures Of The Femur

We report the results of Kent hip revision arthroplasties performed in 5 patients with fractures of the femur associated with femoral loosening following total hip arthroplasty. The fractures occurred at an average of 40.4 months following the primary hip arthroplasty. The system of Merle D'Aubigné and Postel, as modified by Charnley, was used for the clinical evaluation. One to four years (mean, 2.6 years) after the revision operation, the clinical and radiographic results were satisfactory. With the help of the transfixion screws the Kent Hip prosthesis provides stable fixation and facilitates early mobilization, with its attendant advantages.

The Wagner SL-Revision Stem for Aseptic Loosening: Clinical and Radiological Results 5 to 7 Years after Femoral Revision

2003 ◽  
Vol 13 (2) ◽  
pp. 94-100
Author(s):  
M.J.F. Diks ◽  
M. Spruit ◽  
J.J. Reimering ◽  
F. Den Boer ◽  
P.G. Anderson
Keyword(s):  
Total Hip Arthroplasty ◽  
Bone Loss ◽  
Aseptic Loosening ◽  
Hip Arthroplasty ◽  
Primary Stability ◽  
Harris Hip Score ◽  
Radiological Evaluation ◽  
Total Hip ◽  
Revision Stem

Aseptic loosening in total hip arthroplasty can lead to proximal femoral periprosthetic bone loss. The non-cemented Wagner revision stem achieves primary fixation in the diaphysis. The purpose of this study is to evaluate the results after medium- to long-term follow-up of the Wagner prosthesis for revision of the femoral component for aseptic loosening in total hip arthroplasty with proximal femoral bone loss. We performed 53 femoral revisions for aseptic loosening with the non-cemented Wagner revision stem. Clinical assessment included a modified Harris Hip Score and a radiological evaluation. The mean follow-up was 65 months. The Harris Hip Score improved significantly (42.9 to 72.3). Radiological evaluation revealed 24.5% subsidence (>5 mm) in our population. Nine re-revisions were done, eight in the first post-operative year. The re-revisions were performed for progressive subsidence (five), recurrent dislocations (one), subsidence with low-grade infection (one), false route (one), and aseptic loosening after 75 months (one). The cumulative survival rate of the Wagner stem after 12 months was 85% and 76% after 75 months. A relatively high re-revision rate was observed during the first post-operative year. Analysis of these failures has shown that subsidence may be the result of insufficient primary stability. Adequate pre-operative planning and intra-operative radiological assistance is necessary for perfect primary stability and fixation of the Wagner stem. The re-revision incidence after the first 12 months is 0.45 per 100 implants per year. The prosthesis has good survival potential after proper introduction.

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