scholarly journals New Technique for Custom-Made Spacers in Septic Two-Stage Revision of Total Hip Arthroplasties

Antibiotics ◽  
2021 ◽  
Vol 10 (9) ◽  
pp. 1073
Author(s):  
Moritz Mederake ◽  
Ulf Krister Hofmann ◽  
Bernd Fink
Keyword(s):  
Bone Cement ◽  
Senior Author ◽  
New Technique ◽  
Related Complication ◽  
Two Stage ◽  
Total Hip ◽  
Interim Phase ◽  
Joint Fracture ◽  
Custom Made ◽  
Hip Arthroplasties

The choice of spacer in the interim phase of two-stage revision hip arthroplasty is crucial. Conventional concepts like a Girdlestone situation, handformed or preformed bone cement spacers show complications like soft-tissue contractions, abrasion of bone cement particles, dislocation, breakage and a low level of mobility in the interim phase. To address these disadvantages, the senior author developed a new technique for custom-made spacers in septic two-stage revision of total hip arthroplasties using prosthetic implants with individualized antibiotic mixture in the cement applying a mechanical inferior cementation method. The aim of this study was to evaluate the results of these spacers with respect to their non-inferiority in terms of reinfection and survival-rate of the new implant and to describe the complications associated with this procedure. Our collective consisted of 130 patients with a median follow-up of nearly five years. With a reinfect-free rate of 92% and a spacer-related complication rate of 10% (8% articular dislocation, 1% periprosthetic joint fracture, 1% breakage), this procedure seems to be safe and superior regarding complications compared to conventional concepts. Further studies are necessary to show the clinical benefit of this procedure.

Two-Stage Cementless Revision Total Hip Arthroplasty for Infected Primary Hip Arthroplasties

2015 ◽  
Vol 30 (9) ◽  
pp. 1597-1601 ◽  
Author(s):  
Yalkin Camurcu ◽  
Hakan Sofu ◽  
Abdul Fettah Buyuk ◽  
Sarper Gursu ◽  
Mehmet Akif Kaygusuz ◽  
...  
Keyword(s):  
Total Hip Arthroplasty ◽  
Hip Arthroplasty ◽  
Revision Total Hip Arthroplasty ◽  
Two Stage ◽  
Total Hip ◽  
Hip Arthroplasties

Autopsy studies of the bone-cement interface in well-fixed cemented total hip arthroplasties

1993 ◽  
Vol 8 (2) ◽  
pp. 179-188 ◽  
Author(s):  
Thomas P. Schmalzried ◽  
William J. Maloney ◽  
Murali Jasty ◽  
Louis M. Kwong ◽  
William H. Harris
Keyword(s):  
Bone Cement ◽  
Cement Interface ◽  
Total Hip ◽  
Hip Arthroplasties

The Incidence of Dissociated Liners in 4,751 Consecutive Total Hip Arthroplasties Using Pinnacle Polyethylene Acetabular Liners

2017 ◽  
Vol 27 (6) ◽  
pp. 537-545 ◽  
Author(s):  
Richard J. Napier ◽  
Owen Diamond ◽  
Chris K.J. O'Neill ◽  
Seamus O'Brien ◽  
David E. Beverland
Keyword(s):  
Senior Author ◽  
Polyethylene Liner ◽  
National Joint Registry ◽  
Total Hip ◽  
Joint Registry ◽  
Locking Mechanism ◽  
Associated Risk Factors ◽  
The Uk ◽  
Hip Arthroplasties ◽  
Radiographic Investigation

Introduction Acetabular liner dissociation is a complication exclusive to modular designs. We present a single surgeon series of 8 polyethylene liner dissociations with the Pinnacle Acetabular System (DePuy Orthopaedics) from over 4,750 cases. We also present a review of the literature and data from the UK National Joint Registry (NJR) on dissociation in total hip arthroplasty (THA). Methods The Pinnacle Acetabular System has been used exclusively by the senior author since April 2003, and to date 5,882 have been implanted (837 ceramic liners, 4,751 polyethylene liners (1,606 Enduron/3,145 Marathon) and 294 metal liners). We reviewed all cases of liner dissociation from this cohort to determine an overall incidence with polyethylene liners, identify associated risk factors, and report the outcome following revision surgery. Results Our incidence of this complication is 8 out of 4,751 cases (0.17%). Review of these cases and the literature suggests that femoral neck impingement against the polyethylene liner and/or edge loading may produce fatigue failure of the locking mechanism and subsequent dissociation. Conclusions Ensuring correct liner seating/locking, minimising impingement, achieving appropriate component version and avoiding radiographic cup inclinations >50° should minimise the risk of liner dissociation. Any new noise or squeaking from a polyethylene liner should undergo radiographic investigation to exclude dissociation. We recommend managing late cases of liner dissociation with revision of the acetabular shell if the cup orientation could be improved or if there is any damage to the liner-locking groove, to reduce the risk of recurrence.

Comparison of complications associated with commercially available and custom-made articulating spacers in two-stage total hip arthroplasty revision

2013 ◽  
Vol 24 (4) ◽  
pp. 406-413 ◽  
Author(s):  
Fady Youssef Sabry ◽  
Caleb R. Szubski ◽  
John J. Stefancin ◽  
Alison K. Klika ◽  
Carlos A. Higuera ◽  
...  
Keyword(s):  
Total Hip Arthroplasty ◽  
Hip Arthroplasty ◽  
Two Stage ◽  
Total Hip ◽  
Custom Made ◽  
Arthroplasty Revision

The Microscopic Anatomy of the Bone-Cement Interface in Failed Total Hip Arthroplasties

1987 ◽  
Vol &NA; (218) ◽  
pp. 123???135 ◽  
Author(s):  
NORMAN A. JOHANSON ◽  
PETER G. BULLOUGH ◽  
PHILIP D. WILSON ◽  
EDUARDO A. SALVATI ◽  
CHITRANJAN S. RANAWAT
Keyword(s):  
Bone Cement ◽  
Microscopic Anatomy ◽  
Cement Interface ◽  
Total Hip ◽  
Hip Arthroplasties

Assessment of an Orthopaedic Templating Software Package for Uncemented Total Hip Arthroplasty

2020 ◽  
Vol 4 (04) ◽  
pp. 155-157
Author(s):  
Michael Newman ◽  
David Hartwright
Keyword(s):  
Total Hip Arthroplasty ◽  
Hip Arthroplasty ◽  
Acetabular Cup ◽  
Total Hip ◽  
Pelvic Radiograph ◽  
Uncemented Total Hip Arthroplasty ◽  
Femoral Stems ◽  
Hip Arthroplasties ◽  
Acetabular Components ◽  
Insight Into

AbstractThe aim of this study was to assess a large, single-surgeon dataset of uncemented total hip arthroplasties that had been templated using software. This assessment compared preoperative templated predictions with what was implanted with regard to (1) femoral prosthesis size and (2) acetabular cup size. The operation notes for two types of uncemented total hip arthroplasty performed by a single surgeon between January 9, 2008, and March 21, 2019, were assessed. The data were refined so that only those that were fully templated on a correctly calibrated pelvic radiograph were included. This provided a total of 153 cases. The predicted software template was compared with actual implanted component sizes. With regard to the femoral stems, the templating software was exactly correct in 45.75% of cases and was accurate to within one size in 87.59% of cases. With regard to the acetabular component, the templating software was exactly correct in 52.94% of cases and was accurate to within one size (2 mm) in 86.94% of cases. Templating software offers an accurate prediction of the size of uncemented femoral and acetabular components. In addition, the benefits of templating include cognitive rehearsal, insight into potentially challenging aspects of surgery, and highlighting intraoperative issues where there is a large intraoperative deviation from what is templated. This study demonstrates the congruence and reproducibility of templating software when compared with other smaller studies performed in the literature.

Clinical utility of accelerated MAVRIC-SL with robust-PCA compared to conventional MAVRIC-SL in evaluation of total hip arthroplasties

2021 ◽  
Author(s):  
Zoe Doyle ◽  
Daehyun Yoon ◽  
Philip K. Lee ◽  
Jarrett Rosenberg ◽  
Brian A. Hargreaves ◽  
...  
Keyword(s):  
Clinical Utility ◽  
Robust Pca ◽  
Total Hip ◽  
Hip Arthroplasties
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