Durability of Zirconia-Based Ceramics and Composites for Total Hip Replacement

2007 ◽  
Vol 361-363 ◽  
pp. 791-794 ◽  
Author(s):  
Laurent Gremillard ◽  
Jérôme Chevalier
Keyword(s):  
Total Hip Replacement ◽  
Hip Replacement ◽  
High Hardness ◽  
Clinical Results ◽  
Degradation Mechanisms ◽  
Acetabular Cup ◽  
Total Hip ◽  
Specific Degradation ◽  
Metal Polymer

Ceramics have been increasingly used in orthopaedics during the last 30 years. Their biological inertness, high hardness and good mechanical strength make them excellent candidates for components such as femoral heads and acetabular cup in Total Hip Replacement prostheses. Currently used bio-inert ceramics – alumina and zirconia – give good clinical results, especially compared to metal – polymer couplings. However, they are subjected to severe biological, tribological and mechanical solicitations during more than fifteen years for the most successful prostheses. They answer these solicitations by presenting specific degradation mechanisms. We will thus examine the phenomena that can account for the long-term behaviour of zirconia components (heads and cups) in THR prostheses.

Short stems in total hip replacement: evidence on primary stability according to the stem type

2018 ◽  
Vol 29 (2) ◽  
pp. 118-127 ◽  
Author(s):  
Georgios I Drosos ◽  
Panagiotis Touzopoulos
Keyword(s):  
Total Hip Replacement ◽  
Clinical Studies ◽  
Hip Replacement ◽  
Primary Stability ◽  
Clinical Results ◽  
Migration Patterns ◽  
Total Hip ◽  
Short Stems ◽  
Stem Migration

Background: As the prevalence of total hip replacement is increasing in younger patients, less invasive implants (short stems) are becoming more favourable. However, despite the advantages of these stems, clinical results with a follow-up of more than 10 years are limited to a very few stem designs. There has been an increase in publications recently – mechanical and clinical studies – concerning the primary stability of short stems. Primary stem stability is an important factor as it reflects final stem stabilisation and is related to the clinical results of the prosthesis. Method: We conducted a systematic review of the literature to retrieve evidence concerning primary implant stability in short stems – as expressed by implant micromotion and stem subsidence – according to our previously proposed short-stem classification. Results: Mechanical in vitro studies on stem micromotion are very few and limited to type 2 “partial collum” short stems. The results are comparable to those of stems with a known long-term excellent clinical course. Clinical results concerning stem migration patterns are also limited to some of the commercially available short stems. Although comparative studies are very few, the results for most of the short stems are similar to those of standard stems. Conclusion: There are promising results concerning biomechanical studies of the initial micromotion of short stems, as well as clinical results of stem migration patterns. Long-term clinical studies are needed in order to confirm these findings. The existing literature concerns very few of the many commercially available implants.

scholarly journals Total Hip Replacement: Exchange of a Loose Perforated Press-Fit Cup with a Porous-Coated Press-Fit Cup in a Dog

VCOT Open ◽  
2020 ◽  
Vol 03 (02) ◽  
pp. e129-e133
Author(s):  
Stephanie M.M. Colthurst ◽  
James O. Simcock ◽  
Ricky G. Cashmore
Keyword(s):  
Total Hip Replacement ◽  
Hip Replacement ◽  
Internal Diameter ◽  
Acetabular Cup ◽  
Total Hip ◽  
Press Fit ◽  
Long Term Follow Up ◽  
Excellent Functional Outcome ◽  
Head Neck

Abstract Objective The aim of this study was to report the successful revision of a loose perforated press-fit cup by exchange with a porous-coated press-fit cup while maintaining the original locking stem and head–neck unit. Methods Cup revision was performed in a dog with a loose acetabular cup that had undergone total hip replacement with a perforated press-fit cup and locking stem 29 months previously. The original locking stem was well integrated. A single session cup exchange was performed by implantation of a 28-mm porous-coated press-fit cup with 16 mm internal diameter to allow the original locking stem and head–neck unit to be preserved. Results Revision total hip arthroplasty by cup exchange resulted in excellent functional outcome with long-term follow-up 18 months postoperatively. There were no intraoperative or postoperative complications. Conclusion A loose perforated press-fit cup was successfully revised with a porous press-fit cup while allowing preservation of the initial locking stem and head–neck unit.

Is the RM- Uncemented Coated Acetabular Cup a Reliable Component in Total Hip Replacement?

1993 ◽  
Vol 3 (3-4) ◽  
pp. 75-83
Author(s):  
A. Avai ◽  
M. Bombelli
Keyword(s):  
Total Hip Replacement ◽  
Hip Replacement ◽  
Clinical Results ◽  
Acetabular Cup ◽  
Proper Position ◽  
Total Hip ◽  
Bone Reaction

From August 1987 to the Ist of March 1993 1,477 RM.-isoelastic, uncemented cup components (257 HA, 1,220 Titanium coated) were inserted for T.H.R., matched with the RM- isoelastic and isotitan stem components. At a 4 year mean follow-up (7-1 years) 1,302 cups were clinically and radiographically assessed; 6.2% of cups could not be controlled, because at follow-up time the patients had died; 5.6% could not be traced. All the cups were fixed with 3.2 mm peripheral screws (mean number of screws: 6). The cups more than 60 mm in diameter were fixed with 2 additional cancellous (6.5 mm) screws. The Charnley score is: - 9 - (97.5%) - 8- (2.43%); 1 cup was removed because of infection (0.07%); 3 cups were revised because of malposition and reinserted in proper position. The results with a similar number of RM.-uncoated cups, fixed with only one or two screws from 1979 to 1985, at a mean 4 year follow-up were: 7% revision and 9% impending loosening. Even bone reaction at the bone-cup interface signifies no osteolisis, neither around the cup nor around the screws. The satisfactory clinical results suggest to proceed with the use of this cup

Long Term Results of Cementless Total Hip Replacement for Reversal of hip Ankylosis

2009 ◽  
Vol 19 (2) ◽  
pp. 120-127 ◽  
Author(s):  
Samuel S. Rajaratnam ◽  
Shaun A. Sexton ◽  
Tim S. Waters ◽  
William L. Walter ◽  
Bernard A. Zicat ◽  
...  
Keyword(s):  
Total Hip Replacement ◽  
Hip Replacement ◽  
Long Term Results ◽  
Harris Hip Score ◽  
Acetabular Cup ◽  
Total Hip ◽  
And Function ◽  
Lost To Follow Up ◽  
Cementless Total Hip Replacement

Fifteen patients (16 hips) with an ankylosed hip joint for a mean of 36 years (3.5 to 65), had their hips converted to a cementless Total Hip Replacement (THR). They were followed-up for a median of 10.75 years (5.0 to 19) with none lost to follow-up. All patients showed improved mobility and function post-operatively. The Harris Hip Score improved from 70 (SEM 3.4) to 83 post-operatively (SEM 4.4), which was statistically significant (p < 0.05). There was one acetabular cup revision at 5 years post implantation for aseptic loosening. All other femoral and acetabular components remained clinically and radiographically well fixed. We conclude that a previously ankylosed hip can be effectively converted to a cementless total hip replacement with good long term results.

Strain Gauge and Photoelastic Evaluation of the Load Transfer in the Pelvis in Total Hip Replacement: The Effect of the Position of the Axis of Rotation

1989 ◽  
Vol 203 (2) ◽  
pp. 103-107 ◽  
Author(s):  
A W Miles ◽  
P B McNamee
Keyword(s):  
Total Hip Replacement ◽  
Acetabular Component ◽  
Strain Gauge ◽  
Hip Replacement ◽  
Load Transfer ◽  
Acetabular Cup ◽  
Total Hip ◽  
Axis Of Rotation ◽  
Strain Gauge Measurements

Aseptic loosening of the acetabular component is the principal long-term complication in total hip replacement. Radiographic evidence suggests a higher incidence of loosening with medialization of the axis of rotation of the acetabular cup. A simplified two-dimensional photoelastic investigation of the load transfer in the pelvis demonstrates that the stress distribution is substantially changed when this axis of rotation is medialized. Strain gauge measurements on three dry hemi-pelvic bones confirm this effect. It is postulated that the redistribution of load resulting from medialization may result in inadequate skeletal support for the acetabular component predisposing to loosening.

Long-term results of harris total hip replacement

1986 ◽  
Vol 1 (4) ◽  
pp. 229-236 ◽  
Author(s):  
Paul F. Lachiewicz ◽  
Byron D. Rosenstein
Keyword(s):  
Total Hip Replacement ◽  
Hip Replacement ◽  
Long Term Results ◽  
Total Hip

Relationship between clinical results of total hip replacement and postoperative activities including weeding and snow shovelling

2017 ◽  
Vol 28 (2) ◽  
pp. 145-147
Author(s):  
Hiroaki Kijima ◽  
Shin Yamada ◽  
Natsuo Konishi ◽  
Hitoshi Kubota ◽  
Hiroshi Tazawa ◽  
...  
Keyword(s):  
Total Hip Replacement ◽  
Hip Replacement ◽  
Japanese Orthopaedic Association ◽  
Clinical Results ◽  
Average Period ◽  
Work Activities ◽  
Total Hip ◽  
Hip Disease ◽  
High Level ◽  
Better Than

Introduction: Weeding or snow shovelling is indispensable for life in farm villages of northern countries. Clarifying the relationships between the degrees of these activities after total hip replacement (THR) and the clinical results of THR may enable us to predict the results of THR for high-level activity patients. The relationships between work activities after THR and the results were investigated. Methods: The subjects were 95 post-THR patients, who consulted 6 hospitals in August 2012. First, the Japanese Orthopaedic Association Hip-Disease Evaluation Questionnaire (JHEQ) and a questionnaire on postoperative activity were administered. Then, the Japanese Orthopaedic Association hip score (JOA score) was evaluated. Results: The subjects’ average age was 68 years. The average period after surgery was 4 years and 5 months. Weeding and snow shovelling were performed after THR in 44.2% and 40.0% of cases, respectively. The rate of farming after surgery (25.6%) was greater than that of swimming (21.1%). Both the JOA score and JHEQ were higher in those who played sports after THR than in those who did not (p = 0.003, p = 0.0046). The JOA score of those who performed work activities after THR was higher than that of those who did not (p = 0.0295). Conclusions: Nearly half of patients performed weeding or snow shovelling after THR, and about 1/4 of the patients engaged in farming after THR. The clinical results in cases doing sports and work activities after THR were better than those of cases not doing such activities. Therefore, these activities may be positively recommended.

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