Hydroxyapatite Ceramic Hip Survey Alumina on Alumina Bearings

2005 ◽  
Vol 284-286 ◽  
pp. 1065-1068
Author(s):  
James M. Buchanan
Keyword(s):  
Hip Arthroplasty ◽  
Operative Technique ◽  
Implant Failure ◽  
Consecutive Series ◽  
Hydroxyapatite Ceramic ◽  
Ceramic Implant

To reduce osteolysis and loosening, alumina bearings in hip arthroplasty have been used in Sunderland since 1991. This consecutive series demonstrates the results which have been most rewarding. However, ceramic implant fractures have been encountered but these probably represent less than meticulous operative technique. The results are published and the complications discussed together with advice to reduce the incidence of implant failure.

Nineteen Years Review of Hydroxyapatite Ceramic Coated Hip Implants: A Clinical and Histological Evaluation

2007 ◽  
Vol 361-363 ◽  
pp. 1315-1318 ◽  
Author(s):  
James M. Buchanan ◽  
Sally Goodfellow
Keyword(s):  
Hip Arthroplasty ◽  
Hip Prosthesis ◽  
Histological Evaluation ◽  
Consecutive Series ◽  
Hydroxyapatite Ceramic ◽  
Bioactive Materials ◽  
Total Period ◽  
Cemented Arthroplasty ◽  
Wear Products ◽  
Cementing Techniques

The goal of hip arthroplasty is to restore the patient to an active and pain free life for ever. Unfortunately, prosthetic implants fail because of loosening, wear or infection. This study sets out to ascertain whether or not Hydroxyapatite hip arthroplasty (HA) will produce long-lasting function of at least ten years in unselected patients of all ages and all diagnoses. Cemented implants used in hip arthroplasty often loosen after ten or more years of use. This is partly mechanical but also associated with debris disease arising from plastic wear products. Cementing techniques have been improved and the Swedish Hip Register [1] demonstrates that the revision rates have been reduced with improved cementing techniques. Revision surgery after cemented arthroplasty is difficult and may be complicated by fracture of the host bone Bioactive materials are being used to secure joint implants [2,3] and this paper presents the results of a consecutive series of hip arthroplasties carried out over a total period of over 19 years using the Furlong Hydroxyapatite Ceramic Coated hip prosthesis.[4, 5]

16 Year Review of Hydroxyapatite Ceramic Coated Hip Implants - A Clinical and Histological Evaluation

2005 ◽  
Vol 284-286 ◽  
pp. 1049-1052 ◽  
Author(s):  
James M. Buchanan
Keyword(s):  
Hip Arthroplasty ◽  
Histological Evaluation ◽  
Harris Hip Score ◽  
Consecutive Series ◽  
Hydroxyapatite Ceramic ◽  
Bioactive Materials ◽  
Total Period ◽  
Pain Scores ◽  
Hip Arthroplasties ◽  
Cementing Techniques

Traditionally implants for hip arthroplasty are secured with bone cement. Problems have been encountered with cement fixation with loosening and osteolysis attributed to the reaction to particulate cement material and also polyethylene debris from wear. Cementing techniques have been improved and the Swedish Hip Register [1] demonstrates that the revision rates have been reduced with improved cementing techniques. However, uncemented hip arthroplasty is now having a revival. In particular, bioactive materials are being used and this paper presents the results of a consecutive series of hip arthroplasties carried out over a total period of just 16 years. All the patients are included, including primary and revision hip arthroplasty. Patients are assessed using the Harris Hip Score [2]. 13% of the hips scored less than 80 on the Harris Hip Score but only 9.4% scored poor pain scores. These represent the results of poor hip arthroplasty, of which an even smaller percentage are related to failed HA hip arthroplasty.

scholarly journals Are the First and Second Hip in Staged Bilateral Total Hip Arthroplasty Equal? A Hospital Adverse Event and Perioperative Risk Comparison

2021 ◽  
Author(s):  
Jesus M. Villa ◽  
Tejbir S. Pannu ◽  
Carlos A. Higuera ◽  
Juan C. Suarez ◽  
Preetesh D. Patel ◽  
...  
Keyword(s):  
Total Hip Arthroplasty ◽  
Adverse Events ◽  
Hip Arthroplasty ◽  
Retrospective Chart Review ◽  
Consecutive Series ◽  
Level Of Evidence ◽  
Exact Test ◽  
Total Hip ◽  
Discharge Disposition ◽  
The Mean

AbstractHospital adverse events remain a significant issue; even “minor events” may lead to increased costs. However, to the best of our knowledge, no previous investigation has compared perioperative events between the first and second hip in staged bilateral total hip arthroplasty (THA). In the current study, we perform such a comparison. A retrospective chart review was performed on a consecutive series of 172 patients (344 hips) who underwent staged bilateral THAs performed by two surgeons at a single institution (2010–2016). Based on chronological order of the staged arthroplasties, two groups were set apart: first-staged THA and second-staged THA. Baseline-demographics, length of stay (LOS), discharge disposition, hospital adverse events, and hospital transfusions were compared between groups. Statistical analyses were performed using independent t-tests, Fisher's exact test, and/or Pearson's chi-squared test. The mean time between staged surgeries was 465 days. There were no significant differences in baseline demographics between first-staged THA and second-staged THA groups (patients were their own controls). The mean LOS was significantly longer in the first-staged THA group than in the second (2.2 vs. 1.8 days; p < 0.001). Discharge (proportion) to a facility other than home was noticeably higher in the first-staged THA group, although not statistically significant (11.0 vs. 7.6%; p = 0.354). The rate of hospital adverse events in the first-staged THA group was almost twice that of the second (37.2 vs. 20.3%; p = 0.001). There were no significant differences in transfusion rates. However, these were consistently better in the second-staged THA group. When compared with the first THA, our findings suggest overall shorter LOS and fewer hospital adverse events following the second. Level of Evidence Level III.

Unexpected low-grade infections in revision hip arthroplasty for aseptic loosening

2021 ◽  
Vol 103-B (6) ◽  
pp. 1070-1077
Author(s):  
Christian Hipfl ◽  
Wiebke Mooij ◽  
Carsten Perka ◽  
Sebastian Hardt ◽  
Georgi I. Wassilew
Keyword(s):  
Aseptic Loosening ◽  
Hip Arthroplasty ◽  
Joint Infection ◽  
Implant Failure ◽  
Revision Hip Arthroplasty ◽  
Coagulase Negative Staphylococcus ◽  
Histopathological Analysis ◽  
Low Grade ◽  
Single Specimen ◽  
Musculoskeletal Infection

Aims The purpose of this study was to evaluate unexpected positive cultures in total hip arthroplasty (THA) revisions for presumed aseptic loosening, to assess the prevalence of low-grade infection using two definition criteria, and to analyze its impact on implant survival after revision. Methods A total of 274 THA revisions performed for presumed aseptic loosening from 2012 to 2016 were reviewed. In addition to obtaining intraoperative tissue cultures from all patients, synovial and sonication fluid samples of the removed implant were obtained in 215 cases (79%) and 101 cases (37%), respectively. Histopathological analysis was performed in 250 cases (91%). Patients were classified as having low-grade infections according to institutional criteria and Musculoskeletal Infection Society (MSIS) International Consensus Meeting (ICM) 2013 criteria. Low-grade infections according to institutional criteria were treated with targeted antibiotics for six weeks postoperatively. Implant failure was defined as the need for re-revision resulting from periprosthetic joint infection (PJI) and aseptic reasons. The mean follow-up was 68 months (26 to 95). Results Unexpected positive intraoperative samples were found in 77 revisions (28%). Low-grade infection was diagnosed in 36 cases (13%) using institutional criteria and in nine cases (3%) using MSIS ICM 2013 criteria. In all, 41 patients (15%) had single specimen growth of a low-virulent pathogen and were deemed contaminated. Coagulase-negative Staphylococcus and anaerobes were the most commonly isolated bacteria. Implant failure for PJI was higher in revisions with presumed contaminants (5/41, 12%) compared to those with low-grade infections (2/36, 6%) and those with negative samples (5/197, 3%) (p = 0.021). The rate of all-cause re-revision was similar in patients diagnosed with low-grade infections (5/36, 14%) and those with presumed contaminants (6/41, 15%) and negative samples (21/197, 11%) (p = 0.699). Conclusion Our findings suggest that the presumption of culture contamination in aseptic revision hip arthroplasty may increase the detection of PJI. In this cohort, the presence of low-grade infection did not increase the risk of re-revision. Further studies are needed to assess the relevance of single specimen growth and the benefits of specific postoperative antibiotic regimens. Cite this article: Bone Joint J 2021;103-B(6):1070–1077.

scholarly journals Lower Dislocation Rate Following Total Hip Arthroplasty via Direct Anterior Approach than via Posterior Approach: Five-Year-Average Follow-Up Results

2015 ◽  
Vol 9 (1) ◽  
pp. 157-162 ◽  
Author(s):  
Sachiyuki Tsukada ◽  
Motohiro Wakui
Keyword(s):  
Total Hip Arthroplasty ◽  
Hip Arthroplasty ◽  
Anterior Approach ◽  
Posterior Approach ◽  
Direct Anterior Approach ◽  
Dislocation Rate ◽  
Rank Test ◽  
Consecutive Series ◽  
Total Hip

Objective: The aim of the study was to compare the dislocation rate between total hip arthroplasty (THA) via direct anterior approach (DAA) and via posterior approach (PA). Methods: We compared a consecutive series of 139 THAs via DAA with 177 THAs via PA. All study patients received ceramic-on-ceramic bearing surfaces and similar uncemented prostheses. Dislocation-free survival after THA was estimated using the Kaplan–Meier survival method and compared between groups using the log-rank test. Results: In the DAA group, none of 139 hips experienced dislocations in five-year-average follow-up. In the PA group, seven hips experienced dislocations among 177 hips (4 %). The dislocation was significantly less in the DAA group compared to the PA group (p = 0.033). Conclusion: The dislocation rate of THA via DAA was significantly less than that of THA via PA.

Our Experience with Hydroxyapatite Ceramic Coated Furlong Mod. Hip Prosthesis

1992 ◽  
Vol 2 (2) ◽  
pp. 63-67
Author(s):  
A. Surace ◽  
G. Mineo ◽  
C. Micale
Keyword(s):  
Hip Arthroplasty ◽  
Hip Prosthesis ◽  
Hydroxyapatite Ceramic

The Authors present the results of their two years experience in hip arthroplasty with a hydroxyapatite coated Furlong mod. prosthesis. The deducible considerations taken from these results represent a logic evolution of a new philosophical conceptuality on every suggested usage for hip arthroplasty

Does Robotic-Assisted Total Hip Arthroplasty Improve Accuracy of Cup Positioning?

2019 ◽  
Vol 03 (04) ◽  
pp. 176-180 ◽  
Author(s):  
Joshua A. Lawson ◽  
Andrew T. Garber ◽  
Jeffrey D. Stimac ◽  
Rama Ramakrishnan ◽  
Langan S. Smith ◽  
...  
Keyword(s):  
Total Hip Arthroplasty ◽  
Acetabular Component ◽  
Hip Arthroplasty ◽  
Consecutive Series ◽  
Goal Alignment ◽  
Robotic Assisted ◽  
Component Placement ◽  
Total Hip ◽  
Hip Replacements ◽  
Cup Positioning

AbstractAcetabular component malpositioning is a frequent cause of complications in total hip arthroplasty including instability, increased wear, osteolysis, impingement, and revision surgery. Recently, robotics and navigation have been introduced to improve cup positioning in total hip arthroplasty. The purpose of this study was to compare the accuracy of postoperative acetabular component positioning using MAKO robotic-assisted versus manual acetabular component placement. A consecutive series of 100 total hip replacements were performed in 100 patients. The first 50 were performed using manual techniques, while the second 50 were performed using MAKO-guided acetabular component placement. Postoperative anteroposterior pelvis radiographs were used to determine the postoperative anteversion and inclination of the cup relative to the goal of 15 and 45°, respectively. In the manual group, the average anteversion and inclination was 14.3 and 44.2°, respectively, with 28% within 5° and 82% within 10° of the goal alignment, respectively. In the robotic group, the average anteversion and inclination was 15.1 and 45.6°, respectively, with 54 and 88% within 5 and 10° of the goal alignment, respectively. This equated to a statistically significant improvement in the number of acetabular components placed within 5° of the target alignment with the use of robotic guidance (p = 0.0142). From the authors' study, they were able to demonstrate a significant improvement in acetabular component alignment with the use of robotic techniques. Additional studies are needed to demonstrate improvement in clinical outcomes as a result of improved accuracy and precision of acetabular component placement.

Safety of Ceramic Components

2006 ◽  
Vol 309-311 ◽  
pp. 1321-1324 ◽  
Author(s):  
Patricie Merkert ◽  
Christoph Krause ◽  
Meinhard Kuntz ◽  
Martin Dietrich
Keyword(s):  
Failure Rate ◽  
Implant Failure ◽  
Limited Mobility ◽  
The Past ◽  
Surgeon Training ◽  
Increased Risk ◽  
Ceramic Components ◽  
Total Failure ◽  
Implant System ◽  
Ceramic Implant

A statistical analysis of ceramic implant failure is presented. It is shown that the majority of failures occure within the first 12 months after implantation. From this characteristic distribution the prediction of the total failure rate is possible even for the latest years of production. There have been considerable improvements of the reliability in the past 5 years. Furthermore, there is evidence that the failure rate strongly depends on ball head diameter. For the largest ceramic ball head of 36mm diameter up to now no failure has been reported. From these results it is concluded that ceramic implant failure is in general released by individual circumstances. In particular, the probability of failure may be strongly increased in the case of limited mobility and an increased risk of impingement. In the case of a well developed specific surgeon training and right choice of the ceramic implant system the ceramic components provide an extremely reliable and safe solution for the patient.

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