Variability associated with assessing changes in position of a canine uncemented femoral stem prosthesis

2015 ◽  
Vol 28 (06) ◽  
pp. 409-416 ◽  
Author(s):  
H. M. Korani ◽  
D. J. Marcellin-Little ◽  
S. C. Roe
Keyword(s):  
Hip Replacement ◽  
Femoral Stem ◽  
Single Measurement ◽  
Greater Trochanter ◽  
Time Points ◽  
Horizontal Beam ◽  
Wide Range ◽  
Femoral Stems ◽  
Uncemented Total Hip Replacement ◽  
Uncemented Femoral Stem

SummaryObjective: Evaluate variability associated with assessing changes in the position of uncemented femoral stems.Methods: Stem level, canal fill, stem angle, and version angle were measured on craniocaudal horizontal beam (CCHB) and open leg lateral (OLL) radiographic projections of the femur of 20 dogs that had uncemented total hip replacement. Intraobserver and inter -observer repeatability were determined on immediate postoperative (PO) images. Differences in position were calculated between the first (3 months – R1) and second (6 months – R2) re-evaluation (R1-R2) time points, and between PO and R1.Results: The measurement process was very repeatable. For R1-R2, the stem appeared to subside 0.8 ± 1.4 mm for measurements based on the greater trochanter on the CCHB images, but there was a wide range (-3.9 to 2 mm; positive values indicate proximad movement). Measurements based on the inter-trochanteric crest on the OLL images had the same mean, and also a wide range (-4.4 to 2.1 mm; negative values indicate proximad movement). For PO-R1, the stem appeared to subside 1.8 ± 2.0 mm (CCHB, based on the greater trochanter, range -7.7 to 2.2 mm), 1.6 ± 1.5 mm (CCHB, based on the intertrochanteric crest, range -0.7 to 4.3 mm); and 2.1 ± 2.1 mm (OLL, based on the intertrochanteric crest, range -1.6 to 6.8 mm).Conclusion: The position of a stable stem can appear different on subsequent re-evaluations, but this may be due to variability associated with inconsistency of positioning of the patient and limb.Clinical significance: Documenting subsidence in individual patients should not rely on calculations based on a single measurement.

scholarly journals Midterm results of the cylindrical fully porous-coated uncemented femoral stem in revision patients with Paprosky I–IIIA femoral defects

2018 ◽  
Vol 26 (2) ◽  
pp. 230949901878390 ◽  
Author(s):  
Salduz Ahmet ◽  
Kılıçoğlu Önder İsmet ◽  
Ekinci Mehmet ◽  
Yıldız Eren ◽  
Tözün Remzi ◽  
...  
Keyword(s):  
Aseptic Loosening ◽  
Femoral Stem ◽  
Assistive Device ◽  
Harris Hip Score ◽  
X Rays ◽  
Functional Scores ◽  
Femoral Stems ◽  
The Mean ◽  
Uncemented Femoral Stem

Introduction: The aim of this study was to analyze the survival of the Echelon® femoral stems in revision hip surgeries in patients with Paprosky I–IIIA femoral defects. Patients and methods: Sixty-six patients (70 hips) who underwent revision hip surgery with at least 3 years of follow-up data were included in the study between 2000 and 2013. The mean patient age was 64.5 (32–83) years, and the mean follow-up period was 93 (45–206) months. The reasons for revision were aseptic loosening in 55 (78.6%) patients, periprosthetic joint infection in 9 (12.9%) patients, periprosthetic fracture in 4 (5.7%) patients, and stem fracture in 2 (2.9%) patients. The preoperative and postoperative follow-up X-rays and functional scores were evaluated. Results: Five patients died in an average of 70 (45–86) months after surgery due to non-related diseases. We encountered sciatic nerve palsy in two patients and early hip dislocation in two patients, whereas 54 patients were able to walk without any assistive device. The remaining 12 patients required an assistive device to walk. The mean Harris hip score significantly increased from 34 (7–63) preoperatively to 72 (43–96) postoperatively. Aseptic loosening was observed in one patient. The survival of the porous-coated anatomical uncemented femoral stem was 98.4% over 10 years. Conclusion: This study showed that good clinical outcomes and survival can be obtained when using porous-coated anatomical uncemented femoral stems.

scholarly journals Removal of an osteointegrated broken uncemented femoral stem after hip arthroplasty—technical note

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Peter Wahl ◽  
Theo Solinger ◽  
Michel Schläppi ◽  
Emanuel Gautier
Keyword(s):  
Fatigue Failure ◽  
Hip Arthroplasty ◽  
Femoral Stem ◽  
Bone Defects ◽  
Technical Note ◽  
Revision Hip Arthroplasty ◽  
Standard Approach ◽  
Transfemoral Approach ◽  
Femoral Stems ◽  
Uncemented Femoral Stem

AbstractBroken stems are particularly challenging in revision hip arthroplasty, as no standard extraction instruments fit anymore. Well-integrated uncemented stem remnants can be particularly arduous to remove. Stem fatigue failure is not rare with modular stems. Since these are particularly useful in revision hip arthroplasty, increasing numbers of broken stems are to be expected. Usually applied techniques using cortical fenestration distally to the tip of the stem or using an extended transfemoral approach cause supplementary bone defects impairing reconstruction. We present a relatively simple and reproducible revision technique, using a limited standard approach and only regular orthopedic instruments, to extract the remnants of broken uncemented femoral stems in hip arthroplasty. This technique was applied successfully and without complications in 6 cases, permitting eventually the reimplantation of even shorter stems.

scholarly journals Adherence to Ketogenic and Mediterranean Study Diets in a Crossover Trial: The Keto–Med Randomized Trial

Nutrients ◽  
2021 ◽  
Vol 13 (3) ◽  
pp. 967
Author(s):  
Matthew J. Landry ◽  
Anthony Crimarco ◽  
Dalia Perelman ◽  
Lindsay R. Durand ◽  
Christina Petlura ◽  
...  
Keyword(s):  
Randomized Trial ◽  
Randomized Clinical Trials ◽  
Secondary Analysis ◽  
Critical Factor ◽  
Detailed Examination ◽  
Diet Patterns ◽  
Time Points ◽  
Study Results ◽  
Wide Range ◽  
Diet Pattern

Adherence is a critical factor to consider when interpreting study results from randomized clinical trials (RCTs) comparing one diet to another, but it is frequently not reported by researchers. The purpose of this secondary analysis of the Keto–Med randomized trial was to provide a detailed examination and comparison of the adherence to the two study diets (Well Formulated Ketogenic Diet (WFKD) and Mediterranean Plus (Med-Plus)) under the two conditions: all food being provided (delivered) and all food being obtained by individual participants (self-provided). Diet was assessed at six time points including baseline (x1), week 4 of each phase when participants were receiving food deliveries (x2), week 12 of each phase when participants were preparing and providing food on their own (x2), and 12 weeks after participants completed both diet phases and were free to choose their own diet pattern (x1). The adherence scores for WFKD and Med-Plus were developed specifically for this study. Average adherence to the two diet patterns was very similar during both on-study time points of the intervention. Throughout the study, a wide range of adherence was observed among participants—for both diet types and during both the delivery phase and self-provided phase. Insight from this assessment of adherence may aid other researchers when answering the important question of how to improve behavioral adherence during dietary trials. This study is registered at clinicaltrials.gov NCT03810378.

scholarly journals Differences in subsidence rate between alternative designs of a commonly used uncemented femoral stem

2016 ◽  
Vol 13 (4) ◽  
pp. 322-326 ◽  
Author(s):  
Munnan Al-Najjim ◽  
Usman Khattak ◽  
Juluis Sim ◽  
Iain Chambers
Keyword(s):  
Femoral Stem ◽  
Subsidence Rate ◽  
Alternative Designs ◽  
Uncemented Femoral Stem

Composition and morphology of wear debris in failed uncemented total hip replacement

1994 ◽  
Vol 76-B (1) ◽  
pp. 60-67 ◽  
Author(s):  
AS Shanbhag ◽  
JJ Jacobs ◽  
TT Glant ◽  
JL Gilbert ◽  
J Black ◽  
...  
Keyword(s):  
Total Hip Replacement ◽  
Hip Replacement ◽  
Wear Debris ◽  
Total Hip ◽  
Uncemented Total Hip Replacement

scholarly journals The Distribution and Severity of Corrosion Damage at Eight Distinct Zones of Metallic Femoral Stem Implants

Metals ◽  
2018 ◽  
Vol 8 (10) ◽  
pp. 840 ◽  
Author(s):  
Roohollah Milimonfared ◽  
Reza Oskouei ◽  
Mark Taylor ◽  
Lucian Solomon
Keyword(s):  
Spatial Distribution ◽  
Hip Replacement ◽  
Logistic Regression Model ◽  
Statistical Significance ◽  
Femoral Stem ◽  
Corrosion Damage ◽  
Distal Region ◽  
Proximal Region ◽  
Visual Scoring ◽  
Ordinal Logistic Regression Model

Metallic taper junctions of modular total hip replacement implants are analysed for corrosion damage using visual scoring based on different granularity levels that span from analysing the taper holistically to dividing the taper into several distinct zones. This study aims to objectively explore the spatial distribution and the severity of corrosion damage onto the surface of metallic stem tapers. An ordinal logistic regression model was developed to find the odds of receiving a higher score at eight distinct zones of 137 retrieved stem tapers. A method to find the order of damage severity across the eight zones is introduced based on an overall test of statistical significance. The findings show that corrosion at the stem tapers occurred more commonly in the distal region in comparison with the proximal region. Also, the medial distal zone was found to possess the most severe corrosion damage among all the studied eight zones.

Variation in femoral anteversion in patients requiring total hip replacement

2019 ◽  
Vol 30 (3) ◽  
pp. 281-287
Author(s):  
Jim W Pierrepont ◽  
Ed Marel ◽  
Jonathan V Baré ◽  
Leonard R Walter ◽  
Catherine Z Stambouzou ◽  
...  
Keyword(s):  
Total Hip Replacement ◽  
Hip Replacement ◽  
Femoral Stem ◽  
Femoral Anteversion ◽  
Patient Specific ◽  
3 Dimensional ◽  
Total Hip ◽  
Age Related ◽  
Gender And Age ◽  
Implant Alignment

Background: Optimal implant alignment is important for total hip replacement (THR) longevity. Femoral stem anteversion is influenced by the native femoral anteversion. Knowing a patient’s femoral morphology is therefore important when planning optimal THR alignment. We investigated variation in femoral anteversion across a patient population requiring THR. Methods: Preoperatively, native femoral neck anteversion was measured from 3-dimensional CT reconstructions in 1215 patients. Results: The median femoral anteversion was 14.4° (−27.1–54.5°, IQR 7.4–20.9°). There were significant gender differences (males 12.7°, females 16.0°; p < 0.0001). Femoral anteversion in males decreased significantly with increasing age. 14% of patients had extreme anteversion (<0° or >30°). Conclusions: This is the largest series investigating native femoral anteversion in a THR population. Patient variation was large and was similar to published findings of a non-THR population. Gender and age-related differences were observed. Native femoral anteversion is patient-specific and should be considered when planning THR.

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