scholarly journals Periprosthetic osteolysis and its association with RANKL expression

2007 ◽  
pp. 455-462
Author(s):  
D Veigl ◽  
J Niederlová ◽  
O Kryštůfková
Keyword(s):  
Hip Replacement ◽  
Nuclear Factor Kappa B ◽  
Orthopedic Implants ◽  
Prosthetic Material ◽  
Wear Particles ◽  
Periprosthetic Osteolysis ◽  
Total Hip Replacements ◽  
Receptor Activator ◽  
Hip Replacements ◽  
Cemented Implants

Extensive osteolysis adjacent to orthopedic implants is often associated with wear particles of prosthetic material. The activation of the RANKL/RANK/OPG system is considered to be a likely cause of periprosthetic osteolysis leading to implant failure. The aim of this study was to examine the possible correlation between the clinical extent of osteolysis, the number of wear particles and expression of the osteoclastic mediator RANKL (receptor activator of nuclear factor kappa B ligand) in the tissues around aseptically loosened cemented and non-cemented total hip replacements. Periprosthetic tissues were harvested from 59 patients undergoing revision of hip replacement for aseptic loosening. We observed RANKL-positive cells in 23 of our 59 patients, their presence was noted predominantly in tissues with a loosened cemented endoprosthesis. We have found that RANKL is present only in tissues with a large amount of wear debris and predominantly in cases involving loosened cemented implants.

THREE-DIMENSIONAL MORPHOMETRY OF NATIVE ACETABULUM IN RELATION TO DESIGN AND IMPLANTATION OF CANINE TOTAL HIP REPLACEMENTS

2012 ◽  
Vol 24 (06) ◽  
pp. 549-555 ◽  
Author(s):  
Ching-Ho Wu ◽  
Cheng-Chung Lin ◽  
Tung-Wu Lu ◽  
Lih-Seng Yeh
Keyword(s):  
Total Hip Replacement ◽  
Hip Replacement ◽  
Quantitative Data ◽  
Three Dimensional ◽  
Morphological Parameters ◽  
3D Ct ◽  
Total Hip ◽  
Acetabular Orientation ◽  
Total Hip Replacements ◽  
Hip Replacements

Total hip replacement (THR) has been one of the main choices in treating dysplasia and other disabling conditions of the coxofemoral joint of large-breed dogs. Quantitative data of the three-dimensional (3D) morphology of the native normal acetabulum will be helpful for better design and implantation of prosthetic components. However, 3D orientation and morphological parameters of the native acetabulum in large-breed dogs are rarely reported. The purposes of the study were to measure the values of the 3D morphological parameters of the native acetabulum in Labrador Retriever dogs, namely acetabular orientation in relation to the pelvis, as well as the radius, angle between ventral and dorsal rims, and the distance from the center to the dorsal rim of the acetabulum using a 3D CT-derived model. The data will be useful for developing a more accurate guideline for improving current THR designs and for more accurate placement of the acetabulum component during THR surgery.

scholarly journals 1528 Pseudotumour from Corrosive Material of Total Hip Replacement: A Rare Complication with an Unusual Presentation

2021 ◽  
Vol 108 (Supplement_6) ◽  
Author(s):  
M Ahmed ◽  
S Radha
Keyword(s):  
Hip Replacement ◽  
Metal Ion ◽  
Galvanic Corrosion ◽  
Rare Complication ◽  
Iliac Fossa ◽  
Cystic Mass ◽  
Rare Presentation ◽  
Total Hip ◽  
Total Hip Replacements ◽  
Hip Replacements

Abstract Total hip replacements have been performed in the UK since the 1960s, with over 280000 primary hip replacements being conducted between January 2017 – December 2019. The formation of pseudotumours is an uncommon and an unusual long-term complication of total hip replacements. Formed by galvanic corrosion of the metal prosthesis, patients can display an array of symptoms. We herein report a rare presentation of unilateral leg oedema in an elderly female, mimicking deep vein thrombosis. Despite normal metal ion levels, radiological investigations revealed an irregular cystic mass extending into the iliac fossa compressing the neurovascular bundle in the groin. The patient underwent complex revision hip surgery with dual mobility hip replacement and an Exeter stem with excision of the pseudotumour. This case highlights the importance of appropriate workup for these patients and the involvement of a multidisciplinary team.

The Initial Stability of Femoral Impaction Grafting

1996 ◽  
Vol 6 (4) ◽  
pp. 166-172 ◽  
Author(s):  
E.J. Smith ◽  
J.B. Richardson ◽  
I.D. Learmonth ◽  
G.P. Evans ◽  
K. Nelson ◽  
...  
Keyword(s):  
Experimental Studies ◽  
Major Advance ◽  
Impaction Grafting ◽  
Total Hip Replacements ◽  
Initial Stability ◽  
Hip Replacements ◽  
Cause Of Failure ◽  
Cyclical Loading ◽  
Revision Hip Surgery ◽  
Cemented Implants

Aseptic loosening is the major cause of failure in primary total hip replacements. Loss of bone stock occurs in both cementless and cemented implants. Impaction of morsellised allograft represents a major advance in the restoration of bone loss at revision hip surgery. This study was designed to test the early stability of the femoral impaction construct. Polished double tapered stems were inserted into neomedullary canals within impacted allograft in fibreglass femora. Subsidence was measured during cyclical loading. Four methods of impaction grafting were tested: allograft alone; allograft and heparinised blood; allograft/cement/heparinised blood; allograft/cement/clotted blood. Uncemented impaction grafting failed at low loads and few cycles. The cemented technique supported higher loads. Heparinised blood reduced the strength of the composite. Initial stability was achieved with allograft, cement and clotted blood. There is need for caution in the early post-operative period due to the wide variation in initial stability of the allograft composite. The reliability of this technique has been increased by the use of specialised instruments. Experimental studies and clinical experience suggest that this approach to revision surgery is technique dependent.

scholarly journals Finite element analysis of polyethylene wear in total hip replacement: A literature review

2019 ◽  
Vol 233 (11) ◽  
pp. 1067-1088 ◽  
Author(s):  
Lin Wang ◽  
Graham Isaac ◽  
Ruth Wilcox ◽  
Alison Jones ◽  
Jonathan Thompson
Keyword(s):  
Finite Element ◽  
Literature Review ◽  
Hip Replacement ◽  
Material Selection ◽  
Polyethylene Wear ◽  
Element Analysis ◽  
Total Hip ◽  
Total Hip Replacements ◽  
Hip Replacements ◽  
Modelling Techniques

Evaluation and prediction of wear play a key role in product design and material selection of total hip replacements, because wear debris is one of the main causes of loosening and failure. Multifactorial clinical or laboratory studies are high cost and require unfeasible timeframes for implant development. Simulation using finite element methods is an efficient and inexpensive alternative to predict wear and pre-screen various parameters. This article presents a comprehensive literature review of the state-of-the-art finite element modelling techniques that have been applied to evaluate wear in polyethylene hip replacement components. A number of knowledge gaps are identified including the need to develop appropriate wear coefficients and the analysis of daily living activities.

Metal Versus Polyethylene Wear Particles in Total Hip Replacements

1996 ◽  
Vol 329 ◽  
pp. S206-S216 ◽  
Author(s):  
Peter F. Doorn ◽  
Patricia A. Campbell ◽  
Harlan C. Amstutz
Keyword(s):  
Polyethylene Wear ◽  
Wear Particles ◽  
Total Hip ◽  
Total Hip Replacements ◽  
Hip Replacements

Thromboprophylaxis and Total Hip Replacement: A Cost-Efficacy Study Comparing Duplex Screening of Asymptomatic Venous Thrombosis versus Prolonged Prophylaxis with Low-Molecular-Weight Heparins

2002 ◽  
Vol 17 (3-4) ◽  
pp. 93-97
Author(s):  
M. T. Barrellier
Keyword(s):  
Molecular Weight ◽  
Direct Cost ◽  
Hip Replacement ◽  
Prophylactic Treatment ◽  
Low Molecular Weight ◽  
Low Molecular Weight Heparins ◽  
Total Hip ◽  
Total Hip Replacements ◽  
Annual Budget ◽  
Hip Replacements

Background: Despite use of the anti-thrombotic prophylaxis, clinical thrombo-embolic events and fatal pulmonary embolism are still observed after total hip replacement. To reduce these complications, two strategies have been adopted: to prolong the use of low-molecular-weight heparins (LMWH) to 35 days or to screen patients systematically before discharge, using duplex ultrasonography, following the short-course prophylactic treatment. Objective: To assess, based on published literature, the relative costs and benefits of these two strategies for prophylaxis following total hip arthroplasty. Method: The author identified relevant papers in this field from his own resources and from medical literature databases. Synthesis: Prolonging LMWH treatment to a total of 35 days represents a direct cost in France of approximately £340 per patient, or for 100000 total hip replacements per year, an annual budget of £34 000000. If this strategy attained maximum efficacy, it would avoid 150 fatal pulmonary embolisms. The direct cost would therefore be at least £227000 per life saved. A systematic single duplex ultrasound examination before discharge from hospital would cost £76 per patient, or for 100 000 arthroplasties a total annual budget in France of £7 600000. If this approach achieved maximum efficacy, preventing the 150 fatal pulmonary embolisms corresponding to 100000 total hip replacements, the minimum direct cost would be £50 300 per life saved. Conclusion: Duplex screening may be more effective and lest costly than prolongation of prophylactic treatment using LMWH. This deduction needs to be confirmed by complex cost-benefit studies using clinical end-points.

scholarly journals Anaesthesia for Hip Replacement in Ankylosing Spondylitis

1986 ◽  
Vol 79 (8) ◽  
pp. 457-459 ◽  
Author(s):  
F W Wittmann ◽  
P A Ring
Keyword(s):  
Ankylosing Spondylitis ◽  
Hip Replacement ◽  
Indirect Laryngoscopy ◽  
Emergency Intubation ◽  
Total Hip ◽  
Preoperative Visit ◽  
Total Hip Replacements ◽  
Hip Replacements

Thirteen total hip replacements in 8 patients with ankylosing spondylitis are reviewed. Complications of the disease which can lead to anaesthetic difficulties are discussed, and the importance of a preoperative visit and the value of indirect laryngoscopy emphasized. As intubation problems may occur, especially in undiagnosed cases, equipment for emergency intubation should always be readily available. The results fully justify the operation.

Interaction Between Bone Cement Cracking and Non-Slip Implant Interfaces

2007 ◽  
Author(s):  
Pan Gi Park ◽  
Leszek J. Sudak
Keyword(s):  
Hip Replacement ◽  
Implant Fixation ◽  
National Hospital ◽  
National Hospital Discharge Survey ◽  
New Techniques ◽  
Knee Replacements ◽  
Hip Replacements ◽  
Total Knee ◽  
Cemented Implants ◽  
Better Than

According to National Hospital Discharge Survey 2003, approximately 217,000 and 402,000 patients in the U.S. underwent Total Hip Replacement (THR) and Total Knee Replacement (TKR) operations, respectively and $24.7 billion dollars were spent in hospitalization related to these replacement surgeries. In addition, there were 36,000 revision hip replacements and 33,000 revision knee replacements. To decrease the revision surgeries and increase the performance of the implants, many researchers have provided new techniques for better implant fixation and mechanisms of debonding around implants. With respect to fixation, performance of cemented prosthesis is reported to be better than those of cementless ones. Moreover, surgery with cemented implants has been among the most popular and widely performed.

Hip replacement in patients younger than 65 years: Results of the CLS prosthesis

2003 ◽  
Vol 13 (3) ◽  
pp. 133-141 ◽  
Author(s):  
G.S. Radcliffe ◽  
J.I. Wilson ◽  
R.U. Ashford ◽  
P.G. De Boer
Keyword(s):  
Patient Satisfaction ◽  
Confidence Interval ◽  
Hip Replacement ◽  
Clinical Results ◽  
Total Hip Replacements ◽  
Hip Replacements ◽  
Show Evidence ◽  
The Mean ◽  
Lost To Follow Up

We present the results of a retrospective review of 65 CLS uncemented total hip replacements in 47 patients all of whom were less than 65 years of age at the time of surgery. The mean follow-up was 6.5 years and only one case was lost to follow-up. The clinical results were good. The mean (95% confidence interval) Merle d'Aubigne Postel score for pain (max. 6) was 5.42 ± 1.13 (5.13 – 5.71) and for mobility (max. 6) 5.55 ± 0.71 (5.37 – 5.73). The mean score for patient satisfaction (max. 5) was 4.89 ± 0.46 (4.77 – 5.00). The mean total score was therefore 15.97 ± 1.70 (95% confidence interval 15.54 - 16.40) from a maximum of 17 points. There were three revisions over the study period giving a mean (95% confidence interval) survivorship of 96.5% (91.9% - 100%) at five years. We present the results of a radiological review, which show that the surviving implants show evidence of osseointegration. This was achieved despite the lack of a porous or hydroxyapatite coating.

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