New Evidence Supporting Joint Preservation Procedures of the Hip A confocal microscopy study of the femoral head

2019 ◽  
Vol 70 (10) ◽  
pp. 3561-3563
Keyword(s):  
Femoral Head ◽  
Total Hip Arthroplasty ◽  
Confocal Microscopy ◽  
Hip Arthroplasty ◽  
Articular Surface ◽  
Young Patients ◽  
Microscopy Study ◽  
Total Hip ◽  
Orthopedic Surgeons ◽  
Total Arthroplasty

Surgical indication of joint preserving alternative procedures, remain extremely rare worldwide in comparison to total hip arthroplasty. The aim of our study was to map the femoral head in regard to quality of the articular surface using confocal microscopy, and to bring more arguments that would encourage orthopedic surgeons to take into consideration procedures that preserve the femoral head and joint in young patients, as opposed to direct total arthroplasty of the hip. Furthermore we believe that new procedures could be described in order to reach these two main goals: sparing the femoral head and, of course, better function of the hip. Our results show that while the superior pole of the femoral head presents completely deteriorated cartilage and contact surface, other areas of the femoral head present relatively good quality cartilage, whereas the inferior pole of the femoral head which is non-weightbearing has unaltered surface anatomy. In conclusion, we do encourage for further research in the direction of femoral head sparing procedures of the hip, in order to improve function and delay total hip arthroplasty in carefully selected patients. Keywords: confocal microscopy, femoral head, orthopedic surgeons, arthroplasty

scholarly journals New Evidence Supporting Joint Preservation Procedures of the Hip A confocal microscopy study of the femoral head

2019 ◽  
Vol 70 (10) ◽  
pp. 3561-3563
Author(s):  
Adrian Emil Lazarescu ◽  
Dan Grigore Cojocaru ◽  
Mihaela Boanca ◽  
Bogdan Gheorghe Hogea ◽  
Bogdan Corneliu Andor ◽  
...  
Keyword(s):  
Femoral Head ◽  
Total Hip Arthroplasty ◽  
Confocal Microscopy ◽  
Hip Arthroplasty ◽  
Articular Surface ◽  
Young Patients ◽  
Microscopy Study ◽  
Total Hip ◽  
Surface Anatomy ◽  
Total Arthroplasty

Surgical indication of joint preserving alternative procedures, remain extremely rare worldwide in comparison to total hip arthroplasty. The aim of our study was to map the femoral head in regard to quality of the articular surface using confocal microscopy, and to bring more arguments that would encourage orthopedic surgeons to take into consideration procedures that preserve the femoral head and joint in young patients, as opposed to direct total arthroplasty of the hip. Furthermore we believe that new procedures could be described in order to reach these two main goals: sparing the femoral head and, of course, better function of the hip. Our results show that while the superior pole of the femoral head presents completely deteriorated cartilage and contact surface, other areas of the femoral head present relatively good quality cartilage, whereas the inferior pole of the femoral head which is non-weightbearing has unaltered surface anatomy. In conclusion, we do encourage for further research in the direction of femoral head sparing procedures of the hip, in order to improve function and delay total hip arthroplasty in carefully selected patients.

Epidemiological Study of Femoral Head Osteonecrosis

2017 ◽  
Vol 68 (5) ◽  
pp. 974-976
Author(s):  
Alexandru Patrascu ◽  
Liliana Savin ◽  
Dan Mihailescu ◽  
Victor Grigorescu ◽  
carmen Grierosu ◽  
...  
Keyword(s):  
Risk Factors ◽  
Femoral Head ◽  
Total Hip Arthroplasty ◽  
Hip Arthroplasty ◽  
Young Patients ◽  
Head Group ◽  
Bipolar Hemiarthroplasty ◽  
Aseptic Necrosis ◽  
Total Hip ◽  
Femoral Head Osteonecrosis

In recent years, there has been an increase in the number of studies on the etiology of femoral head necrosis. We retrospectively reviewed all patients diagnosed with aseptic necrosis of the femoral in the period of 2010-2015. We recorded a total of 230 cases diagnosed with aseptic necrosis of the femoral head, group was composed of 65.7% men and 34.3% women, risk factors identified was 19.13% (post-traumatic), 13.91% (glucocorticoids), 26.52% (alcohol), 3.47% (another cause) and in 36 95% of the cases no risk factors were found. The results of the study based on the type of surgery performed on the basis of stages of disease progression, 8 patients (3.48%) benefited from osteotomy, 28 patients (12.17%) benefited of bipolar hemiarthroplasty prosthesis and 188 patients (81.74%) benefited of total hip arthroplasty. Osteonecrosis of the femoral head is characteristic to young patients between the age of 30-50 years old. Predisposing factors, alcohol and corticosteroid therapy remains an important cause of the disease. Total hip arthroplasty remains the best option for the patients with osteonecrosis of the femoral head.

Bipolar versus Total Hip Arthroplasty in the Treatment of Avascular Necrosis of the Femoral Head in Young Patients

2002 ◽  
Vol 12 (2) ◽  
pp. 142-149 ◽  
Author(s):  
T. Scheerlinck ◽  
M. Dezillie ◽  
A. Monsaert ◽  
P. Opdecam
Keyword(s):  
Femoral Head ◽  
Total Hip Arthroplasty ◽  
Avascular Necrosis ◽  
Hip Arthroplasty ◽  
Groin Pain ◽  
Functional Result ◽  
Young Patients ◽  
Total Hip ◽  
Lost To Follow Up

The authors evaluate medium-term results of bipolar and total hip arthroplasty as a treatment for avascular necrosis of the femoral head. Between 1990 and 2000, 57 hips (45 patients) were treated with a bipolar (BHA: 37 hips) or total hip arthroplasty (THA: 20 hips) depending on the radiographic and macroscopic aspect of the acetabulum. At surgery, all patients were under 65 years of age (average: 45.09 years). All had the same cementless hydroxylapatite coated femoral stem inserted through an anterolateral approach. The BHA were followed during a mean of 4.49 years. One BHA was lost to follow-up. Seven out of 36 hips (19.44%) were considered failures: three due to a poor functional result (Harris Hip Score (HHS) <70) and four which needed conversion to THA for groin pain. Two hips were revised for periprosthetic fracture. Twenty BHA (55.56%) had a good or excellent result (HHS 80). The THA were followed for a mean of 4.32 years. One THA was lost to follow-up. Four out of 19 hips (21.05%) were considered as failures. Three due to a poor functional result (HHS<70) and one which needed cup revision for recurrent dislocation. Fifteen THA (78.95%) had a good or excellent functional result (HHS80). BHA as a treatment of avascular necrosis of the femoral head in young patients preserves bone stock for later revisions and can lead to excellent results. But the outcome seems less predictable than after THA. Groin pain associated to BHA can be treated successfully with conversion to THA if necessary.

Total hip arthroplasty with dual mobility cup in osteonecrosis of the femoral head in young patients: over ten years of follow-up

2016 ◽  
Vol 41 (3) ◽  
pp. 605-610 ◽  
Author(s):  
Pierre Martz ◽  
Alexandre Maczynski ◽  
Sebastien Elsair ◽  
Ludovic Labattut ◽  
Brice Viard ◽  
...  
Keyword(s):  
Femoral Head ◽  
Total Hip Arthroplasty ◽  
Hip Arthroplasty ◽  
Young Patients ◽  
Dual Mobility Cup ◽  
Dual Mobility ◽  
Total Hip

Common Factors Associated with Osteonecrosis of the Femoral Head in Young Patients Requiring Total Hip Arthroplasty

2015 ◽  
Vol 25 (3) ◽  
pp. 232-236 ◽  
Author(s):  
Ishaan Swarup ◽  
Yuo-yu Lee ◽  
Peter Movilla ◽  
Mark P. Figgie
Keyword(s):  
Femoral Head ◽  
Total Hip Arthroplasty ◽  
Hip Arthroplasty ◽  
Young Patients ◽  
Common Factors ◽  
Factors Associated ◽  
Total Hip

scholarly journals Femoral Head and Liner Exchange in Patients with Atraumatic Dislocation. Results of a Retrospective Study with 6 Years Follow-Up

Medicina ◽  
2021 ◽  
Vol 57 (11) ◽  
pp. 1188
Author(s):  
Maximilian G. Hanslmeier ◽  
Michael W. Maier ◽  
Manuel Feisst ◽  
Nicholas A. Beckmann
Keyword(s):  
Femoral Head ◽  
Total Hip Arthroplasty ◽  
Hip Arthroplasty ◽  
Polyethylene Wear ◽  
Revision Arthroplasty ◽  
Revision Total Hip Arthroplasty ◽  
Total Hip ◽  
Total Arthroplasty ◽  
Primary Total Hip Arthroplasty

Background and Objectives: Femoral head and liner exchange is an established treatment for polyethylene wear but has had a more limited role in the treatment of other conditions including dislocation, because of concerns about an increased postoperative dislocation rate. Some authors have considered dislocation associated with polyethylene wear to be a contraindication for this procedure. Materials and Methods: Our retrospective review evaluated the outcome of head and liner exchange in a small consecutively operated heterogeneous cohort of 20 patients who presented with dislocation unrelated to trauma, component malposition or component loosening. Of this group, 12 had prior primary total hip arthroplasty, and 8 had prior revision total hip arthroplasty, and included 4 patients with prior revision for dislocation. Mean follow-up was 6 ± 3.5 years (range 1–145 months). Results: Kaplan–Meier analysis revealed a revision-free implant survival from any cause of 80% (confidence interval 95%:64.3–99.6%) at 5 years after head and liner exchange (index surgery). At final follow-up, 83.3% of patients (n = 10) with prior primary total hip arthroplasty and 62.5% of patients (n = 5) with prior revision total hip arthroplasty, had not required subsequent revision for any cause. None (0%) of the primary total hip arthroplasty group and 3 (38%) of the revision arthroplasty group had required revision for further dislocation. Of the eight revision arthroplasty patients, four had a prior revision for dislocation and three of these four patients required further revision for dislocation after index surgery. The fourth patient had no dislocation after index surgery. One additional patient who had prior revision surgery for femoral component fracture suffered dislocation after index surgery, but was successfully treated with closed reduction. Conclusions: In our study population, femoral head and liner exchange was an effective treatment option for patients with prior primary total hip arthroplasty and also for a highly select group of revision total arthroplasty patients with no prior history of dislocation. Femoral head and liner exchange does not appear to be a viable treatment option for patients who have had revision total arthroplasty after prior dislocations.

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