Polyethylene Liner and Femoral Head Exchange in Total Hip Arthroplasty

2019 ◽  
Vol 101 (5) ◽  
pp. 421-428 ◽  
Author(s):  
Stephen M. Petis ◽  
Bernd Kubista ◽  
Robert U. Hartzler ◽  
Matthew P. Abdel ◽  
Daniel J. Berry
Keyword(s):  
Femoral Head ◽  
Total Hip Arthroplasty ◽  
Hip Arthroplasty ◽  
Polyethylene Liner ◽  
Total Hip

scholarly journals Metallosis after Exchange of the Femoral Head and Liner following Ceramic Acetabular Liner Dissociation in Total Hip Arthroplasty with a Modular Layered Acetabular Component

2016 ◽  
Vol 2016 ◽  
pp. 1-5
Author(s):  
Tomoya Takasago ◽  
Tomohiro Goto ◽  
Keizo Wada ◽  
Daisuke Hamada ◽  
Toshiyuki Iwame ◽  
...  
Keyword(s):  
Femoral Head ◽  
Total Hip Arthroplasty ◽  
Hip Arthroplasty ◽  
Polyethylene Liner ◽  
Metal Debris ◽  
Ceramic Fracture ◽  
Total Hip ◽  
Metal Implants ◽  
Revision Tha ◽  
Ceramic Liner

The type of bearing material that should be used in revision surgery after the failure of ceramic-on-ceramic total hip arthroplasty (THA) remains controversial. In the case of ceramic fracture, the residual ceramic particles can cause consequent metallosis when metal implants are used for revision THA. On the other hand, in the case of THA failure without ceramic fracture, revision THA with a metal femoral head provides satisfactory results. We report an unusual case of progressive osteolysis due to metallosis that developed after revision THA for ceramic liner dissociation without a liner fracture performed using a metal femoral head and polyethylene liner. The residual metal debris and abnormal pumping motion of the polyethylene liner due to the breakage of the locking system or the aspherical metal shell being abraded by the ceramic head seemed to be the cause of the progressive osteolysis.

scholarly journals Early Intraprosthetic Dislocation of Dual-Mobility Total Hip Arthroplasty Implant Following Attempted Closed Reduction: A Case Report

2014 ◽  
Vol 5 (2) ◽  
pp. 23-26 ◽  
Author(s):  
Joseph Schirmers, MD ◽  
Ryan Horazdovsky, MD ◽  
Scott Marston, MD
Keyword(s):  
Femoral Head ◽  
Total Hip Arthroplasty ◽  
Hip Arthroplasty ◽  
Late Complication ◽  
Polyethylene Liner ◽  
Consecutive Series ◽  
Original Design ◽  
Dual Mobility ◽  
Total Hip ◽  
Intraprosthetic Dislocation

Introduced in 1974 by Bousquet, the dual-mobility bearing for use in total hip arthroplasty (THA) confers increased jump distance and improved overall stability relative to conventional THA designs [1-3]. The dual-mobility bearing incorporates a relatively small (22-28mm) metal or ceramic femoral head press fit into a larger polyethylene liner which articulates with the acetabular component. Dissociation of the femoral head from the polyethylene liner (intraprosthetic dislocation) is a known late complication thought to be related to polyethylene liner wear and has been previously reported [2-7]. In a consecutive series of 384 primary THAs employing Bousquet’s original design, there were 14 intraprosthetic dislocations over 15 years (3.6%). The authors cited polyethylene wear as causative and mean time to intraprosthetic dislocation was 8.9 years [2].

scholarly journals Dual mobility total hip arthroplasty: should everyone get one?

2019 ◽  
Vol 4 (9) ◽  
pp. 541-547 ◽  
Author(s):  
William G. Blakeney ◽  
Jean-Alain Epinette ◽  
Pascal-André Vendittoli
Keyword(s):  
Femoral Head ◽  
Total Hip Arthroplasty ◽  
Patient Selection ◽  
Hip Arthroplasty ◽  
Revision Surgery ◽  
Polyethylene Liner ◽  
Fixed Bearing ◽  
Hip Instability ◽  
Dual Mobility ◽  
Total Hip

Hip instability following total hip arthroplasty (THA) remains a major challenge and is one of the main causes of revision surgery. Dual mobility (DM) implants have been introduced to try to overcome this problem. The DM design consists of a small femoral head captive and mobile within a polyethylene liner. Numerous studies have shown that DM implants reduce the rate of dislocation compared to fixed-bearing inserts. Early designs for DM implants had problems with wear and intra-prosthetic dislocations, so their use was restricted to limited indications. The results of the latest generation of DM prostheses demonstrate that these problems have been overcome. Given the results of these studies presented in this review, surgeons may now consider DM THA for a wider patient selection. Cite this article: EFORT Open Rev 2019;4:541-547. DOI: 10.1302/2058-5241.4.180045

Epidemiological Study of Femoral Head Osteonecrosis

2017 ◽  
Vol 68 (5) ◽  
pp. 974-976
Author(s):  
Alexandru Patrascu ◽  
Liliana Savin ◽  
Dan Mihailescu ◽  
Victor Grigorescu ◽  
carmen Grierosu ◽  
...  
Keyword(s):  
Risk Factors ◽  
Femoral Head ◽  
Total Hip Arthroplasty ◽  
Hip Arthroplasty ◽  
Young Patients ◽  
Head Group ◽  
Bipolar Hemiarthroplasty ◽  
Aseptic Necrosis ◽  
Total Hip ◽  
Femoral Head Osteonecrosis

In recent years, there has been an increase in the number of studies on the etiology of femoral head necrosis. We retrospectively reviewed all patients diagnosed with aseptic necrosis of the femoral in the period of 2010-2015. We recorded a total of 230 cases diagnosed with aseptic necrosis of the femoral head, group was composed of 65.7% men and 34.3% women, risk factors identified was 19.13% (post-traumatic), 13.91% (glucocorticoids), 26.52% (alcohol), 3.47% (another cause) and in 36 95% of the cases no risk factors were found. The results of the study based on the type of surgery performed on the basis of stages of disease progression, 8 patients (3.48%) benefited from osteotomy, 28 patients (12.17%) benefited of bipolar hemiarthroplasty prosthesis and 188 patients (81.74%) benefited of total hip arthroplasty. Osteonecrosis of the femoral head is characteristic to young patients between the age of 30-50 years old. Predisposing factors, alcohol and corticosteroid therapy remains an important cause of the disease. Total hip arthroplasty remains the best option for the patients with osteonecrosis of the femoral head.

scholarly journals A Novel Measurement Using Digital Radiography to Minimize Fluoroscopy in Total Hip Arthroplasty

2021 ◽  
Author(s):  
Andrew G. Yun ◽  
Marilena Qutami ◽  
Kory B. Dylan Pasko
Keyword(s):  
Femoral Head ◽  
Total Hip Arthroplasty ◽  
Radiation Exposure ◽  
Hip Arthroplasty ◽  
Fluoroscopy Time ◽  
Lesser Trochanter ◽  
Total Hip ◽  
Preoperative Templating ◽  
The Mean ◽  
Templating Technique

AbstractPreoperative templating for total hip arthroplasty (THA) is fraught with uncertainty. Specifically, the conventional measurement of the lesser trochanter to the center (LTC) of the femoral head used in preoperative planning is easily measured on a template but not measurable intraoperatively. The purpose of this study was to examine the utility of a novel measurement that is reproducible both on templating and in surgery as a more accurate and practical guide. We retrospectively reviewed 201 patients with a history of osteoarthritis who underwent primary THA. For preoperative templating, the distance from the top of the lesser trochanter to the equator (LeTE) of the femoral head was measured on a calibrated digital radiograph with a neutral pelvis. This measurement was used intraoperatively to guide the choice of the trial neck and head. As with any templating technique, the goal was to construct a stable, impingement-free THA with equivalent leg lengths and hip offset. In evaluating this novel templating technique, the primary outcomes measured were the number of trial reductions and the amount of fluoroscopic time, exposures, and radiation required to obtain a balanced THA reconstruction. Using the LeTE measurement, the mean number of trial reductions was 1.21, the mean number of intraoperative fluoroscopy images taken was 2.63, the mean dose of radiation exposure from fluoroscopy was 0.02 mGy, and the mean fluoroscopy time per procedure was 0.6 seconds. In hips templated with the conventional LTC prior to the LeTE, the mean fluoroscopy time was 0.9 seconds. There was a statistically significant difference in fluoroscopy time (p < 0.001). The LeTE is a reproducible measurement that transfers reliably from digital templating to surgery. This novel preoperative templating metric reduces the fluoroscopy time and consequent radiation exposure to the surgical team and may minimize the number of trial reductions.

scholarly journals Outcomes of total hip arthroplasty in patients with osteonecrosis of the femoral head—a current review

2015 ◽  
Vol 8 (3) ◽  
pp. 246-251 ◽  
Author(s):  
Todd P. Pierce ◽  
Randa K. Elmallah ◽  
Julio J. Jauregui ◽  
Daniel F. Verna ◽  
Michael A. Mont
Keyword(s):  
Femoral Head ◽  
Total Hip Arthroplasty ◽  
Hip Arthroplasty ◽  
Total Hip ◽  
Current Review ◽  
A Current

Comparison of Polyethylene Wear between Highly Crosslinked and Annealed UHMWPE and Conventional UHMWPE against Ceramic Heads in Total Hip Arthroplasty

2012 ◽  
Vol 529-530 ◽  
pp. 279-284 ◽  
Author(s):  
Taishi Sato ◽  
Yasuharu Nakashima ◽  
Mio Akiyama ◽  
Takuaki Yamamoto ◽  
Taro Mawatari ◽  
...  
Keyword(s):  
Femoral Head ◽  
Total Hip Arthroplasty ◽  
Hip Arthroplasty ◽  
Polyethylene Wear ◽  
Wear Rates ◽  
Head Penetration ◽  
Total Hip ◽  
Patient Demographics ◽  
Ceramic Femoral Head ◽  
Implantation Period

The purpose of this study was to examine the effects of ceramic femoral head material on the wear of annealed, crosslinked ultra-high molecular weight polyethylene (UHMWPE) (XLPE) in total hip arthroplasty compared to non-crosslinked conventional UHMWPE (CPE). XLPE was fabricated by crosslinking with 60 kGy irradiation and annealing. Femoral heads made from zirconia and alumina ceramics, and cobalt-chrome (CoCr) of 22 mm or 26 mm diameter were used. In this study, the femoral head penetration into the cup was measured digitally on radiographs of 70 hips with XLPE and 50 hips with CPE. The average follow-up periods were 6.1 and 12.7 years, respectively. The steady wear rate of XLPE was significantly lower than those of CPE (0.002 versus 0.08 mm/year, respectively). Zirconia displayed increased wear rates compared to alumina in CPE; however, there was no difference among head materials in XLPE (0.0028, 0.011 and 0.009 mm/year for zirconia, alumina and CoCr, respectively). Neither head size or implantation period impacted XLPE wear. In contrast to CPE, XLPE displayed low wear rates surpassing the effects of varying femoral head material, size, implantation period and patient demographics.

Sign in / Sign up

Export Citation Format

Share Document