Modular stem in total hip arthroplasty for patients with trochanter valgus deformity: surgical technique and case series

Abstract Background: Trochanter valgus deformity (TVD) is a rare condition of total hip arthroplasty (THA). The femoral osteotomy might be required to correct the deformity to implant the femoral stem in severe TVD. In this study, we described one unpublished technique of reverse sleeve of S-ROM to get through the complex situation. This study aimed to summarize and evaluate its technical challenges, safety and effectiveness. Methods : From January 2006 to December 2014, the patients whose sleeves were implanted towards the great trochanter rather than sitting on the calcar, to solve the TVD in THA were enrolled. Their demographics, perioperative and postoperative information were recorded. To explore its indication, we measured and analyzed the ratio of greater trochanter/lesser trochanter (G/L ratio) and trochanter valgus angle (TVA). Results : Twelve patients (1 male and 11 female, average age 42.30±10.23) who had the complete clinical data were analyzed. The survivorship of femoral prosthesis were 100% with mean follow-up of 6 years. No other complications were found, except for two patients with intraoperative fracture of femur. The Harris hip score (HHS) increased from preoperative 34.31±14.43 to postoperative 84.12±11.33. All patients’ G/L ratio were larger than 1.50. Conclusions: The reverse sleeve of S-ROM was a reliable method for the patients with severe trochanter valgus deformity, which brought satisfying clinical outcomes in mid-term follow-up.

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Modular stem in total hip arthroplasty for patients with trochanter valgus deformity: surgical technique and case series

10.21203/rs.2.15961/v4 ◽

2020 ◽

Author(s):

Xiangpeng Kong ◽

Wei Chai ◽

Minzhi Yang ◽

Alvin Ong ◽

Jiying Chen ◽

...

Keyword(s):

Total Hip Arthroplasty ◽

Hip Arthroplasty ◽

Great Trochanter ◽

Case Series ◽

Femoral Stem ◽

Valgus Deformity ◽

Harris Hip Score ◽

Complex Situation ◽

Total Hip ◽

Modular Stem

Abstract Background: Trochanter valgus deformity (TVD) is a rare condition of total hip arthroplasty (THA). Femoral osteotomy could be required in correcting the deformity to implant femoral stem in severe TVD. In this study, we described one unpublished technique of reverse sleeve of S-ROM to get through the complex situation. This study aimed to summarize and evaluate its technical challenges, safety and effectiveness.Methods: From January 2006 to December 2014, we enrolled patients whose sleeves were implanted towards the great trochanter in THA with TVD. Their demographics, perioperative and postoperative information were recorded. To explore its indication, we measured and analyzed the ratio of greater trochanter/lesser trochanter (G/L ratio) and trochanter valgus angle (TVA).Results: Twelve patients (1 male and 11 female, average age 42.30±10.23) had mean follow-up of 6 years. Among them, only two patients had intraoperative femoral fracture. The survivorship of femoral prosthesis was 100%. The Harris hip score (HHS) increased from preoperative 34.31±14.43 to postoperative 84.12±11.33. All patients’ G/L ratio were larger than 1.50.Conclusions: The reverse sleeve of S-ROM was a reliable method for the patients with severe TVD, which brought satisfying clinical outcomes in mid-term follow-up.Keywords: cementless modular stem; reverse sleeve; total hip arthroplasty; trochanter valgus deformity.

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Modular stem in total hip arthroplasty for patients with trochanter valgus deformity: surgical technique and case series

10.21203/rs.2.15961/v2 ◽

2019 ◽

Author(s):

Xiangpeng Kong ◽

Wei Chai ◽

Minzhi Yang ◽

Alvin Ong ◽

Jiying Chen ◽

...

Keyword(s):

Total Hip Arthroplasty ◽

Hip Arthroplasty ◽

Great Trochanter ◽

Case Series ◽

Femoral Stem ◽

Valgus Deformity ◽

Harris Hip Score ◽

Total Hip ◽

Modular Stem

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The reverse sleeve in total hip arthroplasty for patients with trochanter valgus deformity: surgical technique and case series

10.21203/rs.2.15961/v1 ◽

2019 ◽

Author(s):

Xiangpeng Kong ◽

Wei Chai ◽

Minzhi Yang ◽

Alvin Ong ◽

Jiying Chen ◽

...

Keyword(s):

Surgical Technique ◽

Total Hip Arthroplasty ◽

Hip Arthroplasty ◽

Case Series ◽

Femoral Stem ◽

Valgus Deformity ◽

Harris Hip Score ◽

Complex Situation ◽

Total Hip

Abstract Background: Ttrochanter valgus deformity (TVD) is a rare condition of total hip arthroplasty (THA). The femoral osteotomy might be required to correct the deformity to implant the femoral stem in severe TVD. In this study, we described one unpublished technique of reverse sleeve of S-ROM to get through the complex situation. The aim of this study was to summarize the technical challenges of this special sleeve-implanting method and evaluate its effectiveness and safety. Methods: From January 2006 to December 2014, the patients who had the reverse sleeve to solve the TVD in THA were enrolled. Their demographics, perioperative and postoperative information were recorded. To explore its indication, we measured and analyzed the ratio of greater trochanter/lesser trochanter (G/L ratio) and trochanter valgus angle (TVA). Results: Twelve patients (1 male and 11 female, average age 42.30±10.23) who had the complete clinical data were analyzed. The survivorship of femoral prosthesis were 100% with mean follow-up of 6 years. No other complications were found, except for two patients with intraoperative fracture of femur. The Harris hip score (HHS) increased from preoperative 34.31±14.43 to postoperative 84.12±11.33. All patients’ G/L ratio were larger than1.50. Conclusions: The reverse sleeve of S-ROM was a simple and reliable method for patients with severe TVD, which brought satisfying clinical outcomes in mid-term follow-up. When G/L ratio is larger than 1.50, surgeons should consider this special surgical technique. Keywords: cementless modular stem; reverse sleeve; total hip arthroplasty; trochanter valgus deformity.

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Excellent Clinical and Radiographic Outcomes with Direct Superior Total Hip Arthroplasty with a Minimum of Two-Year Follow Up

Surgical Technology Online ◽

10.52198/21.sti.38.os1336 ◽

2021 ◽

Author(s):

Moritz Sharabianlou ◽

Prerna Arora ◽

Derek Amanatullah

Keyword(s):

Total Hip Arthroplasty ◽

Functional Recovery ◽

Hip Arthroplasty ◽

Case Series ◽

Harris Hip Score ◽

Timed Up And Go ◽

Total Hip ◽

Radiologic Evaluation ◽

Superior Approach

This study aims to establish the midterm safety and performance for the direct superior approach to minimally invasive surgery total hip arthroplasty (MIS-THA). We used a unicentric, single-surgeon, retrospective, consecutive case series analysis of the first 40 patients who received primary unilateral direct superior MIS-THA. Special attention was given to functional recovery by measuring Harris Hip Score (HHS) and timed-up-and-go (TUG) with a mean follow up of 2.2 ± 0.4 years. A radiologic evaluation was performed. HHS and TUG improved significantly at three months and one year (p < 0.001). All components were placed within the Lewinnek safe zone with no change position or signs of loosening at two years. With a minimum of two years of follow up, the direct superior approach appears to be safe without any obvious or consistent postoperative complications—clinically or radiographically—with excellent functional recovery. Additionally, our subgroup analysis supported no late learning curve effect.

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Midterm outcomes of total hip arthroplasty with a modular Birmingham head

Hip International ◽

10.1177/1120700019877389 ◽

2019 ◽

pp. 112070001987738 ◽

Cited By ~ 1

Author(s):

Duncan W Cushnie ◽

Brent A Lanting ◽

Richard McCalden ◽

Douglas DR Naudie ◽

James L Howard

Keyword(s):

Soft Tissue ◽

Total Hip Arthroplasty ◽

Hip Arthroplasty ◽

Femoral Stem ◽

Tissue Reaction ◽

Harris Hip Score ◽

Total Hip ◽

Tissue Reactions ◽

Clinical Records

Introduction: Birmingham Hip Resurfacing (BHR) implants may be combined with a conventional femoral stem to create a modular metal-on-metal total hip arthroplasty (BHR MoM THA). There is little outcome data regarding this construct. This study examines midterm outcomes of BHR MoM THA compared to oxidised zirconium total hip arthroplasty (THA). Methods: A retrospective institutional review identified all patients receiving BHR MoM THA between April 2005 and February 2011 and a matched control cohort of zirconium THA patients. Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), Harris Hip Score (HHS), and SF-12 Health status scores were obtained. Revisions and complications were collected from clinical records. Radiographs were assessed for evidence of component malposition, loosening, osteolysis, or heterotopic ossification. Results: 63 modular BHR MoM THA were identified in 61 patients (36 with BHR cups, 27 with R3 cups) and 63 zirconium THA in 58 matched controls. Mean follow-up was 58 months. 14 BHR MoM THA hips (22.2%) were revised (4 infections, 1 dislocation, 9 soft tissue reactions) compared to 3 (4.8%) zirconium THA (all infections). At latest follow-up, 18.4% of surviving BHR MoM THA hips were painful compared to 0.5% of zirconium THA controls ( p < 0.001). WOMAC, HHS, and SF-12 did not differ significantly between surviving members of the 2 groups. Discussion: BHR MoM THA demonstrated a high revision rate, largely for adverse local soft tissue reaction and pain. Among those not revised, many reported some residual pain despite similar quality of life measures to those who received zirconium THA.

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EVALUATION OF THE RESULTS OF CEMENTLESS TOTAL HIP ARTHROPLASTY IN PATIENTS WITH STAGES IV, V AND VI OSTEONECROSIS OF THE FEMORAL HEAD

Tạp chí Y học Cộng đồng ◽

10.52163/jcm.v62i1.6 ◽

2020 ◽

Vol 62 (1) ◽

Author(s):

Đắc Việt Mai ◽

Thu Thủy Nguyễn

Keyword(s):

Femoral Head ◽

Total Hip Arthroplasty ◽

Hip Arthroplasty ◽

Bone Ingrowth ◽

Femoral Stem ◽

Stage Iv ◽

Harris Hip Score ◽

Total Hip ◽

The Mean

This study aimed to report the outcome of total hip arthroplasty (THA) with an extensive hydroxyapatite (HA) coating for the fixation of a tapered femoral stem (Corail) in patients aged 60 or younger than sixty years with stage IV, V và VI osteonecrosis of femoral head. Subject and method: Descriptive prospective research of ninety osteonecrotic hips in ninety patients were available for clinical and radiographic analyses at minimum follow-up of 5 years. Results and Conclusion: The mean Harris hip score improved from 43.74 ± 9,25points preoperatively to 96.67 ± 3.82points at final follow-up. Seventy-four (100%) hips demonstrated stable bone ingrowth. No hips showed acetabular or femoral osteolysis radiolucency and loosening, or required revision for aseptic loosening. We believe that cementless THA with a Corail stem is a promising procedure for patients with osteonecrosis of the femoral head.

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Total Hip Arthroplasty in Octogenarians: A Local Retrospective Case Series

Acta Medica Philippina ◽

10.47895/amp.v52i6.271 ◽

2018 ◽

Vol 52 (6) ◽

Author(s):

Peter B. Bernardo ◽

Clint P. Guitarte

Keyword(s):

Total Hip Arthroplasty ◽

Femoral Neck ◽

Hip Arthroplasty ◽

Case Series ◽

Femoral Stem ◽

Femoral Neck Fractures ◽

Retrospective Case ◽

Total Hip ◽

Retrospective Case Series

With improving healthcare, the number of Filipino octogenarians is increasing. Projected population of octogenarians as reported by the Philippine National Statistics Office will increase by 28% to 3,227,253 by year 2040 (from 2015: 912,817). This is a multicenter retrospective case series involving 24 patients (1 patient with surgery on 2 hips), with an average age at the time of surgery of 82 years old (range: 80-88 years old) who underwent total hip arthroplasty during the period 2007-2016. Indications for total hip arthroplasty included 12 cases of degenerative osteoarthritis, 8 cases of displaced femoral neck fractures, 4 cases of untreated femoral neck fractures, and 1 case of subtrochanteric fracture with hip arthritis. Of the 24 patients, 21 were females and 3 were males. Of the 25 hips, 19 were treated with cemented total hip, 5 with hybrid implants, and 1 with calcar replacing cemented femoral stem. Average follow-up was 36 months (range: 6-87 months). All patients were able to ambulate and return to premorbid function. There were no intraoperative or postoperative complications encountered. Revision rate was zero percent as of last follow-up. Clinical/functional results were assessed using the Harris Hip Scoring system. The results of this study affirm that primary total hip arthroplasty is a viable treatment option for active octogenarians with end-stage arthritis and hip fractures.

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Cementless total hip arthroplasty after failed internal fixation of acetabular fractures: A single center experience of 25 consecutive patients

Journal of Orthopaedic Surgery ◽

10.1177/2309499020910666 ◽

2020 ◽

Vol 28 (2) ◽

pp. 230949902091066

Author(s):

Min Uk Do ◽

Won Chul Shin ◽

Nam Hoon Moon ◽

Suk-Woong Kang ◽

Kuen Tak Suh

Keyword(s):

Total Hip Arthroplasty ◽

Internal Fixation ◽

Hip Arthroplasty ◽

Femoral Stem ◽

Harris Hip Score ◽

Acetabular Fractures ◽

Walking Ability ◽

Total Hip ◽

The Mean

Purpose: Total hip arthroplasty (THA) is an available surgical option for failed acetabular fracture, previously managed by open reduction and internal fixation. This study aimed to report the postoperative outcomes of cementless THA in patients with this condition. Materials and Methods: Between November 2000 and September 2016, 25 consecutive cementless THAs for failed internal fixation after acetabular fractures with a minimum follow-up of 2 years were analyzed. The mean age at the time of surgery was 58 years (36–85 years), and the time elapsed between fracture and THA was 70 months (7–213 months). Clinical and radiologic evaluations were performed on all patients. Results: Clinically, the mean Harris hip score at the last follow-up was 88 points. Walking ability recovered to pre-injury status in 92% patients, and activities of daily living recovered in 96% patients. Radiographically, none of the acetabular cups showed evidence of migration and loosening during the mean follow-up of 50 months. All cases showed stable femoral stem fixation at the last follow-up. Dislocation occurred in three cases (12%). Conclusion: Outcomes of cementless THA after failed internal fixation for acetabular fractures were satisfactory. However, a relatively high incidence of postoperative dislocation is still a concern.

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Systematic review of primary total hip arthroplasty using titanium-titanium modular-neck prostheses: the true risk of revision

Hip International ◽

10.1177/1120700020916870 ◽

2020 ◽

pp. 112070002091687 ◽

Cited By ~ 1

Author(s):

Johnathan R Lex ◽

Matthew D Welch ◽

Abbas See ◽

Thomas C Edwards ◽

Nikolaos A Stavropoulos ◽

...

Keyword(s):

Systematic Review ◽

Total Hip Arthroplasty ◽

Hip Arthroplasty ◽

Revision Rate ◽

Case Series ◽

Harris Hip Score ◽

Modular Neck ◽

Total Hip ◽

Primary Total Hip Arthroplasty

Aims: Modular-neck femoral implants are used to enable more variability in femoral neck version, offset and length. It has been reported that these implants carry a higher rate of revision. The aim of this review was to assess the overall and cause-specific revision rate of titanium-titanium alloy modular-neck implants in primary total hip arthroplasty (THA). Methods: A systematic review was conducted following PRISMA guidelines and utilising multiple databases. All results were screened for eligibility. Studies published from 2000 onwards, using a current-generation, titanium-titanium, modular-neck implant were included. Overall and cause-specific revision rates were analysed, comparing to fixed-neck prostheses where applicable. Results: 920 studies were screened. After applying exclusion criteria, 23 were assessed in full and 14 included. These consisted of 12 case series and 2 joint registry analyses. 21,841 patients underwent a modular-neck implant with a weighted mean follow-up of 5.7 years, mean age of 62.4 years, and average body mass index (BMI) of 28.4kg/m2. The overall revision rate was 3.95% and 2.98% for modular and fixed-neck prostheses, respectively. For studies with >5 years follow-up the mean revision rate was 3.08%. There was no difference in cause-specific revision rates by implant design. Mean improvement in Harris Hip Score was 41.9. Conclusions: At medium-term, revision rates for titanium-titanium primary modular-neck THA are acceptable. These prostheses are a sensible management option in patients with considerable anatomical hip deformity not amenable to correction with standard fixed-neck implants. Patients of male gender, high BMI and requiring prostheses with a larger neck, offset or head are at higher risk of implant failure.

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Conversion total hip arthroplasty with a proximally modular, distal fixation reconstruction prosthesis following cephalomedullar nail failure

Hip International ◽

10.1177/1120700020937952 ◽

2020 ◽

Vol 30 (1_suppl) ◽

pp. 26-33 ◽

Cited By ~ 1

Author(s):

Daniel Godoy-Monzon ◽

Fernando Diaz Dilernia ◽

Francisco Piccaluga ◽

Alberto Cid Casteulani ◽

Luis Turus ◽

...

Keyword(s):

Total Hip Arthroplasty ◽

Hip Arthroplasty ◽

Clinical Success ◽

Femoral Stem ◽

Harris Hip Score ◽

Secondary Outcome ◽

Consecutive Series ◽

Leg Length ◽

Total Hip

Background: The goals of intertrochanteric hip fracture (IHF) treatment are stable fixation, early mobilisation and function restoration. If the attempt to reduce, stabilise and fracture healing utilising a femoral cephalomedullar nail (CMN) fails, options for subsequent attempts are limited. Purpose: Evaluate the clinical and radiographic outcomes of conversion total hip arthroplasty (THA) using a modular stem following a CMN failure. Materials and methods: We retrospectively reviewed a consecutive series of patients with an IHF between 2012 and 2014 to identify CMN patients that went on to the subsequent failure and conversion to THA utilising a modular femoral stem (MFS). In all cases, MP Reconstruction Prosthesis (Waldemar Link, Hamburg, Germany) was implanted. Primary clinical outcomes were assessed using Harris Hip Score (HSS) before conversion procedure, 3 months, 6 months and recent office visit post-conversion THA thereafter. The secondary outcome was to analyse intra and postoperative complications. Serial radiographs at each follow-up interval were assessed for clinical success or to confirm adverse events. Results: 28 patients were included in the study; 17 were females. The average age was 72.7 years (SD ± 10.5); the average time from the index procedure to conversion THA was 12.6 months (SD ± 3.5). At baseline, average HHS was 42.1 (SD ± 3.6), improved to 80.7 (SD ± 5.1) at 3 months, 86.0 (SD ± 3.9) at 6-months which levelled off to 86.1 (SD ± 4.0) at final follow-up. There were 4 (14%) post-conversion complications: 2 dislocations, 1 superficial wound infection, 1 patient with symptomatic abductor deficiency. All 4 cases were conservatively treated successfully, the implants were retained, and the patients progressed without further issue. Conclusions: MFSs allow to successfully treat failed CMN and adverse variations in femoral anatomy with a device that will permit simultaneous correction of leg length, offset and version to relieve pain, restore function and create a durable prosthetic to host composite.

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