scholarly journals Femoral Stem Displacement in a Patient Suffering Recurrent Dislocations After Hip Hemiarthroplasty: Case Report

2011 ◽  
Vol 5 (1) ◽  
pp. 400-402 ◽  
Author(s):  
Panagiotis Tsagozis ◽  
Magnus Henriksson ◽  
Ioannis Ioannidis
Keyword(s):  
Hip Arthroplasty ◽  
Closed Reduction ◽  
Rare Event ◽  
Femoral Stem ◽  
Operative Management ◽  
Cement Mantle ◽  
Illustrative Case ◽  
Complex Issue ◽  
Hip Hemiarthroplasty ◽  
Proximal Migration

Displacement of the femoral component during attempt to closed reduction of a dislocated hip arthroplasty is an exceptionally rare, catastrophic event, which renders operative management obligatory. We report the proximal migration of a femoral stem during attempt to closed reduction in a patient with recurrent postoperative dislocations after hip hemiarthroplasty, and describe successful management by conversion to a standard total hip arthroplasty, retaining the same stem in the existing cement mantle. This illustrative case is reported not only as an extremely rare event, but also to highlight and discuss pitfalls and efficient measures in the management of this complex issue.

Displacement of Femoral Stem during Closed Reduction of Total Hip Arthroplasty

1997 ◽  
Vol 7 (3) ◽  
pp. 125-127
Author(s):  
J. Cordes ◽  
K. Sperling ◽  
M. Kramhøft
Keyword(s):  
Total Hip Arthroplasty ◽  
Hip Arthroplasty ◽  
Closed Reduction ◽  
Femoral Stem ◽  
Stem Design ◽  
Total Hip ◽  
Straight Stem ◽  
Image Intensification

In the literature, only one case of displacement of a cemented femoral stem from its cement bed during closed reduction of a dislocation has been reported. In that case, it was suggested that the stem design may in part be the explanation for the displacement. Another case with a cemented Müller straight stem is now presented, emphasizing the use of image intensification if reduction proves difficult.

scholarly journals Fixation of the Cemented Stem: Clinical Relevance of the Porosity and Thickness of the Cement Mantle

2009 ◽  
Vol 3 (1) ◽  
pp. 8-13 ◽  
Author(s):  
Philippe Hernigou ◽  
Gildasio Daltro ◽  
Charles Henri Flouzat Lachaniette ◽  
Xavier Roussignol ◽  
Martin Mukisi Mukasa ◽  
...  
Keyword(s):  
Hip Arthroplasty ◽  
Review Paper ◽  
Mechanical Stability ◽  
Femoral Stem ◽  
Clinical Results ◽  
Cement Mantle ◽  
Frictional Torque ◽  
Stem Design ◽  
Cement Interface ◽  
Cemented Stem

The aim of this review paper is to define the fixation of the cemented stem. Polymethyl methacrylate, otherwise known as “bone cement”, has been used in the fixation of hip implants since the early 1960s. Sir John Charnley, the pioneer of modern hip replacement, incorporated the use of cement in the development of low frictional torque hip arthroplasty. In this paper, the concepts of femoral stem design and fixation, clinical results, and advances in understanding of the optimal use of cement are reviewed. The purpose of this paper is to help understanding and discussions on the thickness and the porosity of the cement mantle in total hip arthroplasty. Cement does not act as an adhesive, as sometimes thought, but relies on an interlocking fit to provide mechanical stability at the cement–bone interface, while at the prosthesis– cement interface it achieves stability by optimizing the fit of the implant in the cement mantle, such as in a tapered femoral stem.

scholarly journals Dislocation of a Polished Femoral Stem following a Cemented Total Hip Arthroplasty: A Report of 2 Cases

2005 ◽  
Vol 13 (1) ◽  
pp. 73-75 ◽  
Author(s):  
VS Pai
Keyword(s):  
Total Hip Arthroplasty ◽  
Hip Arthroplasty ◽  
Open Reduction ◽  
Femoral Stem ◽  
Hip Dislocation ◽  
Total Hip ◽  
Proximal Migration ◽  
Cemented Total Hip Arthroplasty

We report 2 cases of hip dislocation after a total hip arthroplasty, which could not be successfully reduced by closed method. Post-manipulation radiographs revealed proximal migration of the prosthesis in both cases, which required open reduction. The pathogenesis and treatment of this hip dislocation is discussed.

Displacement of a Cemented Femoral Stem During Attempted Closed Reduction of a Dislocated Total Hip Arthroplasty

2010 ◽  
Vol 25 (4) ◽  
pp. 658.e11-658.e15 ◽  
Author(s):  
Rehan-Ul Haq ◽  
Kyung Soon Park ◽  
Hyun Kee Yang ◽  
Keun Bae Lee ◽  
Taek Rim Yoon
Keyword(s):  
Total Hip Arthroplasty ◽  
Hip Arthroplasty ◽  
Closed Reduction ◽  
Femoral Stem ◽  
Total Hip

scholarly journals Outcomes of Cement in Cement revision, in Revision Total Hip Arthroplasty

2019 ◽  
Vol 7 (23) ◽  
pp. 4059-4065
Author(s):  
Abhijeet Kumar ◽  
Martyn Porter ◽  
Nikhil Shah ◽  
Chakshu Gaba ◽  
Paul Siney
Keyword(s):  
Total Hip Arthroplasty ◽  
Femoral Component ◽  
Hip Arthroplasty ◽  
Operative Time ◽  
Femoral Stem ◽  
Cement Mantle ◽  
Consecutive Series ◽  
Revision Total Hip Arthroplasty ◽  
Total Hip ◽  
Average Operative Time

BACKGROUND: The cement-in-cement femoral revision technique involves removing a femoral component from a well-fixed femoral cement mantle and cementing a new stem into the original mantle. This technique, when carried out for the correct indications, is fast, relatively inexpensive and carries a reduced short-term risk for the patient compared with conventional way of removing well-fixed cement. AIM: To analyze the effectiveness of cement in cement revision of the femoral stem while performing a revision Total Hip Arthroplasty (THA). METHODS: We analyzed a consecutive series of 79 patients who underwent a cement in cement revision THA between June-2015 to June-2018. All the patients were retrospectively analysed for operative time, complications, clinical and radiological outcomes. RESULTS: Average age was 76 years (49-86). The mean follow-up was 16.2 months (12-45). The average operative time was 184.6 (90-290) minutes. Most common indication was cup loosening in 28 patients (42.4%), dislocation in 14 patients (21.2%) and stem loosening in 12 patients (18.2%) Nine patients (11%) had one or more complications. Pre-operatively, 10 patients (13%) had lucency at the cement bone interface. Recent review has shown that 8 of these patients’ radiographs have remained unchanged, and in 2 of them there is a slight progression of lucency. Common post op clinical complaintswere persistent pain and abductor weakness. Five (6.3%) patients required a re-revision. Most of the patients had a good or satisfactory outcome.No stems showed radiological loosening. CONCLUSION: The cement-in-cement technique for revision of the femoral component gave promising results and had the advantages of speed, less blood or bone stock loss, less risk of femoral perforation or fracture, decreased financial costs and reduced post op morbidity.

scholarly journals Value of 3D Preoperative Planning for Primary Total Hip Arthroplasty Based on Biplanar Weightbearing Radiographs

2019 ◽  
Vol 2019 ◽  
pp. 1-7 ◽  
Author(s):  
Y. Knafo ◽  
F. Houfani ◽  
B. Zaharia ◽  
F. Egrise ◽  
I. Clerc-Urmès ◽  
...  
Keyword(s):  
Total Hip Arthroplasty ◽  
Hip Arthroplasty ◽  
Preoperative Planning ◽  
Femoral Stem ◽  
Leg Length ◽  
Femoral Offset ◽  
Postoperative Result ◽  
Total Hip ◽  
Planning Software ◽  
Navigated Surgery

Two-dimensional (2D) planning on standard radiographs for total hip arthroplasty may not be sufficiently accurate to predict implant sizing or restore leg length and femoral offset, whereas 3D planning avoids magnification and projection errors. Furthermore, weightbearing measures are not available with computed tomography (CT) and leg length and offset are rarely checked postoperatively using any imaging modality. Navigation can usually achieve a surgical plan precisely, but the choice of that plan remains key, which is best guided by preoperative planning. The study objectives were therefore to (1) evaluate the accuracy of stem/cup size prediction using dedicated 3D planning software based on biplanar radiographic imaging under weightbearing and (2) compare the preplanned leg length and femoral offset with the postoperative result. This single-centre, single-surgeon prospective study consisted of a cohort of 33 patients operated on over 24 months. The routine clinical workflow consisted of preoperative biplanar weightbearing imaging, 3D surgical planning, navigated surgery to execute the plan, and postoperative biplanar imaging to verify the radiological outcomes in 3D weightbearing. 3D planning was performed with the dedicated hipEOS® planning software to determine stem and cup size and position, plus 3D anatomical and functional parameters, in particular variations in leg length and femoral offset. Component size planning accuracy was 94% (31/33) within one size for the femoral stem and 100% (33/33) within one size for the acetabular cup. There were no significant differences between planned versus implanted femoral stem size or planned versus measured changes in leg length or offset. Cup size did differ significantly, tending towards implanting one size larger when there was a difference. Biplanar radiographs plus hipEOS planning software showed good reliability for predicting implant size, leg length, and femoral offset and postoperatively provided a check on the navigated surgery. Compared to previous studies, the predictive results were better than 2D planning on conventional radiography and equal to 3D planning on CT images, with lower radiation dose, and in the weightbearing position.

scholarly journals Femoral Stem Cementation in Hip Arthroplasty: The Know-How of a “Lost” Art

2021 ◽  
Author(s):  
Ahmed K. Emara ◽  
Mitchell Ng ◽  
Viktor E. Krebs ◽  
Michael Bloomfield ◽  
Robert M. Molloy ◽  
...  
Keyword(s):  
Hip Arthroplasty ◽  
Femoral Stem ◽  
Know How

scholarly journals The impact of reducing the femoral stem length in total hip arthroplasty during gait

2021 ◽  
Author(s):  
Anatole Vilhelm Wiik ◽  
Adeel Aqil ◽  
Bilal Al-Obaidi ◽  
Mads Brevadt ◽  
Justin Peter Cobb
Keyword(s):  
Total Hip Arthroplasty ◽  
Gait Analysis ◽  
Hip Arthroplasty ◽  
Femoral Stem ◽  
Short Stem ◽  
Stem Length ◽  
Practical Consideration ◽  
Total Hip ◽  
Long Stem ◽  
The Impact

Abstract Aim The length of the femoral stem in total hip arthroplasty (THA) is a practical consideration to prevent gait impairment. The aim of this study was to determine if reducing the femoral stem length in THA would lead to impaired gait biomechanics. Methods Patients uniformly with the same brand implant of differing lengths (100 mm vs 140–166 mm) were taken retrospectively from a prospective trial introducing a new short stem. Twelve patients without any other disorder to alter gait besides contralateral differing length stem THA were tested at differing gradients and speed on a validated instrumented treadmill measuring ground reaction forces. An anthropometrically similar group of healthy controls were analysed to compare. Results With the same posterior surgical approach, the offset and length of both hips were reconstructed within 5 mm of each other with an identical mean head size of 36 mm. The short stem was the last procedure for all the hips with gait analysis occurring at a mean of 31 and 79 months postoperatively for the short and long stem THA, respectively. Gait analysis between limbs of both stem lengths demonstrated no statistical difference during any walking condition. In the 90 gait assessments with three loading variables, the short stem was the favoured side 51% of the time compared 49% for the long stem. Conclusion By testing a range of practical walking activities, no lower limb loading differences can be observed by reducing the femoral stem length. A shorter stem demonstrates equivalence in preference during gait when compared to a reputable conventional stem in total hip arthroplasty.

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