Wear of XLPE Liner against Zirconium Heads in Cementless Total Hip Arthroplasty for Patients under 40 Years of Age

2017 ◽  
Vol 27 (6) ◽  
pp. 532-536 ◽  
Author(s):  
Motoki Sonohata ◽  
Masaru Kitajima ◽  
Shunsuke Kawano ◽  
Masaaki Mawatari
Keyword(s):  
Total Hip Arthroplasty ◽  
Hip Arthroplasty ◽  
Polyethylene Wear ◽  
Japanese Orthopaedic Association ◽  
Young Patients ◽  
Stress Shielding ◽  
Developmental Dysplasia ◽  
Total Hip ◽  
The Mean

Introduction Total hip arthroplasty (THA) in the young is challenging. The purpose of this study was to retrospectively determine the clinical, radiographic, and polyethylene wear rate of relatively young patients. Methods We evaluated the outcome of consecutive patients receiving primary THA who were under 40 years of age with a minimum 10-year follow-up. Indications for THA in these patients were osteoarthritis due to developmental dysplasia of the hip joint (9 hips), osteonecrosis of the femoral head (7 hips), juvenile idiopathic arthritis (2 hips), and osteoarthritis due to Perthes disease (1 hip). All THA were performed with a cross-linked ultra-high-molecular-weight polyethylene (XLPE) liner against zirconium heads with cementless implants. Results The average Japanese Orthopaedic Association hip score significantly improved from 42 to 93 points at the latest follow-up. The mean steady wear was 0.015 mm/year (maximum 0.033 mm/year), and the mean creep wear was 0.111 mm (maximum 0.4 mm). Osteolysis was observed around 1 acetabular component and 2 stems. 1 femoral component had subsidence over 5 mm. All of the femoral components achieved fixation with an optimal interface with spot welds at the latest follow-up. Stress shielding was observed in all hips. Conclusions THA using an XLPE liner against zirconium heads appeared to have improved THA longevity. However, the imaging findings in some cases were suggestive of wear debris. A rigorous continual follow-up is required for relatively young patients undergoing THA.

scholarly journals Future of total hip arthroplasty with the Metha short stem in modern surgeries

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Marek Drobniewski ◽  
Marek Synder ◽  
Marek Aleksander Synder ◽  
Magdalena Krasińska ◽  
Lukasz Olewnik ◽  
...  
Keyword(s):  
Total Hip Arthroplasty ◽  
Hip Arthroplasty ◽  
Young Patients ◽  
Functional Results ◽  
Total Hip ◽  
Good Outcome ◽  
The Mean ◽  
Poor Outcomes ◽  
Uncemented Total Hip Replacement

AbstractThe aim of the study was to analyse the results of uncemented total hip replacement, using the Metha (metaphyseal) stem. A total of 158 patients (70 females and 88 males) were qualified to the study and submitted to total hip arthroplasty (183 procedures altogether), using the Metha stem. The mean age of the patients on the day of surgery was 51.7 years (the range from 17 to 69 years). The mean follow up period was 9.2 years (the range from 5 to 13.5 years). Preoperative assessments gave poor scores, according to the Merle d’Aubigne and Postel classification, modified by Charnley. The average improvement after surgery, according to the used scale, was 6.9 points. A very good outcome was recorded in 154 cases (84.2%), a good outcome was achieved in 20 cases (10.9%) and a poor outcome was confirmed in 9 cases, while no satisfactory case was observed. Poor outcomes were associated with implant loosening. Extraskeletal ossification was noted in 10 cases (5.5%). According to the Kaplan–Meier estimator, the 10-year survival was 93.2% and 97.3% for the whole implant and the stem alone, respectively. 1. Our follow-up period of more than 9 years on the average, indicates that Metha stems produce excellent clinical and functional results in operated young patients with advanced degenerative changes of the hip joint. 2. Assuming a proper qualification for the procedure, the absence of complications and a correct surgical technique, which is slightly more difficult, when compared to standard stem implantation, the risk of aseptic loosening is fairly negligible.

Total Hip Arthroplasty in Patients 21 Years and Younger Using Highly Cross-Linked Polyethylene: Excellent Survivorship at Five Years

2018 ◽  
Vol 02 (02) ◽  
pp. 092-096
Author(s):  
Muyibat Adelani ◽  
Frank Bohnenkamp ◽  
Gail Pashos ◽  
John Clohisy ◽  
Adam Sassoon
Keyword(s):  
Los Angeles ◽  
Total Hip Arthroplasty ◽  
Hip Arthroplasty ◽  
Polyethylene Wear ◽  
Short Form ◽  
Young Patients ◽  
Wear Rates ◽  
Total Hip ◽  
Radiographic Outcomes

AbstractThe survivorship of contemporary total hip arthroplasty has improved substantially as a result of the success of highly cross-linked polyethylene. Nevertheless, there is limited information on its performance in extremely young patients. The purpose of this study is to evaluate the (1) clinical and radiographic outcomes, (2) polyethylene wear rates, and (3) mid-term survivorship of total hip arthroplasty in patients 21 years or younger using highly cross-linked polyethylene. After Institutional Review Board approval, the authors identified 45 patients aged 21 years or younger (56 hips) who underwent primary total hip arthroplasty with highly cross-linked polyethylene at their institution by the senior author between 2000 and 2009. Patients were followed for a minimum of 2 years, or until revision. At a mean follow-up of 57 months, modified Harris Hip Scores, Western Ontario McMaster Universities Arthritis Index scores, Short Form-12 physical function scores, and University of California, Los Angeles activity scores improved significantly in all patients. There was no radiographic evidence of osteolysis in any patient. The mean linear polyethylene wear rate was 0.02 mm per year. Survivorship was 98% with one revision for acetabular loosening at 71 months. Total hip arthroplasty in patients 21 years or younger with highly cross-linked polyethylene had excellent clinical and radiographic outcomes at mid-term follow-up. Longer-term data are needed in this patient population to confirm continued survivorship in the extremely young. The level of evidence used for this study was level III.

scholarly journals Treatment of Crowe IV developmental dysplasia of the hip with cementless total hip arthroplasty and shortening subtrochanteric osteotomy

2019 ◽  
Vol 47 (7) ◽  
pp. 3223-3233 ◽  
Author(s):  
Tang Liu ◽  
Sisi Wang ◽  
Guoliang Huang ◽  
Wanchun Wang
Keyword(s):  
Total Hip Arthroplasty ◽  
Hip Arthroplasty ◽  
Developmental Dysplasia ◽  
Harris Hip Score ◽  
Acetabular Cup ◽  
Total Hip ◽  
Cementless Total Hip Arthroplasty ◽  
The Mean ◽  
Dysplasia Of The Hip

Objective This study was performed to document the clinical and radiographic results of consecutive patients with Crowe IV developmental dysplasia of the hip (DDH) treated by cementless total hip arthroplasty (THA) using an S-ROM femoral component with shortening derotational subtrochanteric osteotomy. Methods Twenty-three hips of 21 patients with Crowe IV DDH were treated by cementless THA combined with shortening derotational subtrochanteric osteotomy from January 2005 to January 2011. The mean preoperative modified Harris hip score (mHHS) and University of California, Los Angeles (UCLA) activity score were 40.7 and 4.2, respectively. Results The mean follow-up was 105 months. The mean mHHS and UCLA score improved to 87.0 and 9.1, respectively, at the latest follow-up. Nine of the 23 hips had a negative Trendelenburg sign. One of the 23 hips was outside the Lewinnek acetabular cup inclination safe range, and 3 of the 23 hips were outside the Lewinnek acetabular cup anteversion safe range. The probability of prosthesis survival was 100% at 5 years and 91.3% at 10 years. Conclusion Patients with Crowe IV DDH can be treated by cementless THA combined with shortening derotational subtrochanteric osteotomy. This method can greatly improve hip joint function and relieve pain without significant complications.

scholarly journals Downsizing in total hip arthroplasty. A short stem as a revision implant

2021 ◽  
Author(s):  
Marcel Coutandin ◽  
Yama Afghanyar ◽  
Philipp Rehbein ◽  
Jens Dargel ◽  
Philipp Drees ◽  
...  
Keyword(s):  
Total Hip Arthroplasty ◽  
Aseptic Loosening ◽  
Hip Arthroplasty ◽  
Case Series ◽  
Stress Shielding ◽  
Short Stem ◽  
Total Hip ◽  
The Mean ◽  
Short Stems

Abstract Background Short stems have constantly gained popularity in primary total hip arthroplasty (THA) over the last decade. Although cementless short stems are not primarily designed to be used as revision implants, there may be certain indications for which downsizing the femoral component in failed conventional THA is potentially advantageous. Methods In this single center retrospective case series, six patients who underwent revision using a calcar-guided short stem after failed THA are presented. The mean follow-up was 3.32 years (SD 0.63 years). The health status was evaluated by the EQ-5D-5L score. Patient reported outcome measurements (PROM) were recorded using the Harris hip score (HHS) and The Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC). Pain and satisfaction were assessed using a visual analogue scale (VAS). Radiographic analysis was performed by evaluating osteolysis, stress shielding, alignment and signs of aseptic loosening. Complications were documented. Results At last follow-up the mean EQ-5D-5L index was 0.851 (SD 0.098). Clinical outcome was excellent (HHS ≥ 90) in 4 patients and moderate (HHS 71 and 79) in 2 patients. The mean WOMAC score was 9.20% (SD 12.61%). Pain and satisfaction on VAS were 1.00 (SD 1.15) and 9.17 (SD 0.37), respectively. No major complications occurred. To date, no further revision surgery was needed. Radiologically, no signs of subsidence, aseptic loosening, stress shielding and fractures were obvious. Conclusion The present case series indicates that in failed conventional THA downsizing may be considered a treatment option, using short stem THA in selected cases.

Cementless total hip arthroplasty in young patients under the age of 30: a minimum 10-year follow-up

2018 ◽  
Vol 28 (5) ◽  
pp. 507-513 ◽  
Author(s):  
Eun Ho Shin ◽  
Kyoung Ho Moon
Keyword(s):  
Total Hip Arthroplasty ◽  
Hip Arthroplasty ◽  
Young Patients ◽  
Revision Arthroplasty ◽  
Activity Level ◽  
Head Size ◽  
Harris Hip Score ◽  
Total Hip ◽  
The Mean

Purpose: The purpose of this study was to evaluate the clinical and radiologic outcomes of young patients (under the age of 30) who received a total hip arthroplasty (THA) and in whom patients had been followed for more than 10 years. Materials and methods: This retrospective study was conducted for 51 hips (44 patients) that had undergone THA. The mean age for the index operation was 25.71 years, and the mean follow-up period was 13.7 years. Clinical outcomes were evaluated by Harris hip score (HHS), activity level, and complications. Radiographic evaluations were assessed according to osteolysis, loosening, and polyethylene wear. Results: The average HHS improved from 67.47 pre-operatively to 97.42 at the final follow-up ( p < 0.001). The activity level changed from 1.92 pre-operatively to 1.33 at the final follow-up ( p < 0.001). Ten cases had undergone revision arthroplasty within the follow-up period, and the overall survival rate was 80.4% at the final follow-up with revision for any reason as the end point. Polyethylene liners were used in all revision cases ( p = 0.003). Patients with modular stem had a higher failure rate than patients with a fully porous coated stem ( p < 0.001). Furthermore, a small diameter head size was associated with a higher risk of revision surgery ( p = 0.003). Complications such as dislocations were found in three hips. Conclusion: Cementless THA yields encouraging clinical and radiological results in young and active patients under the age of 30. However, the bearing surface, type of stem, and head size influenced component durability and revision rate.

Cementless total hip arthroplasty with delta-on-delta ceramic bearing in patients younger than 30 years

2019 ◽  
pp. 112070001988959
Author(s):  
Young-Kyun Lee ◽  
Ki-Choul Kim ◽  
Byung-Ho Yoon ◽  
Tae-Young Kim ◽  
Yong-Chan Ha ◽  
...  
Keyword(s):  
Total Hip Arthroplasty ◽  
Hip Arthroplasty ◽  
Young Patients ◽  
Harris Hip Score ◽  
Registration System ◽  
Ceramic Fracture ◽  
Total Hip ◽  
Ceramic Bearing ◽  
The Mean

Background: Despite improvements in the mechanical properties of alumina ceramics, the outcome of total hip arthroplasty (THA) with contemporary ceramic bearings in young patients remains a matter of concern. We evaluated the results of cementless THA with the use of the delta ceramic bearing, and determined the prevalence of osteolysis, squeaking, and ceramic fracture in patients aged < 30 years at mid-term. Methods: From March 2008 to January 2012, 76 consecutive patients (91 hips), younger than 30 years, underwent cementless THA with Delta ceramic bearings. In each follow-up, the clinical evaluation including noise and radiological evaluations were recorded. Results: Among them, 72 patients (86 THAs) were followed-up for a minimum of 5 years (mean 70.8; 60−95.9 months). There were 44 men (47 hips) and 28 women (39 hips). The mean age at the time of the index arthroplasty was 25.9 (16−30) years and the mean preoperative Harris Hip Score (HHS) was 59.4 (23−79) points. HHS improved to 96.3 (64−100) points at the final follow-up evaluation. 8 hips (9.3%) exhibited grinding or squeaking. No hip had aseptic loosening and no hip was revised. No osteolysis was detected around any acetabular or femoral components. Conclusions: Our results suggest that cementless THA with the use of Delta ceramic bearing provides satisfactory results without osteolysis or ceramic fracture in patients aged <30 years at a mid-term follow-up. Clinical Trials.gov Protocol Registration System (trial no. NCT01838096).

scholarly journals Augmented Rehabilitation Program for Young Patients Following Total Hip Arthroplasty

2021 ◽  
Author(s):  
Ahmed Negm ◽  
Milad Yavarai ◽  
Gian Jhangri ◽  
Robert Haennel ◽  
Allyson Jones
Keyword(s):  
Physical Activity ◽  
Total Hip Arthroplasty ◽  
Hip Arthroplasty ◽  
Intervention Group ◽  
Young Patients ◽  
Rehabilitation Program ◽  
Control Group ◽  
Total Hip ◽  
The Impact

Abstract BackgroundThe increase rate seen in Total Hip Arthroplasty (THA) for younger patients has implications for future rehabilitation demands for primary and revision THA surgery. This study aims to determine the impact of a 6-week post-operative rehabilitation program designed for THA patients ≤ 60 years on physical activity (PA) and function compared to age- and a sex-matched control group received usual postoperative care at 12-week post-THA. MethodsIn this quasi-experimental study, a cohort of THA candidates was recruited during their 6-week postoperative visit to their surgeons. The out-patient rehabilitation program consisted of 12 structured exercise classes (2 hrs/class) over 6 weeks. Physical activity was assessed using Sense Wear Pro ArmbandTM [SWA]. Participants completed the Hip Osteoarthritis Outcome Score (HOOS), and THA satisfaction questionnaire before and immediately after the intervention. ResultsThe intervention group took significantly more steps/day at the follow-up compared to baseline. The intervention group had a higher mean change in the number of weekly PA bouts than the control group. Within the intervention groups, all HOOS subscales were significantly higher at the follow-up compared to baseline. ConclusionThe augmented rehabilitation program may have immediate effects on pain relief and symptom reduction for patients (≤60 years) following THA.

scholarly journals 5-Year Clinical and Radiographic Results of the Direct Anterior Approach for Total Hip Arthroplasty Using a Collared Cementless Femoral Short-Stem Prosthesis

2022 ◽  
Vol 11 (2) ◽  
pp. 346
Author(s):  
Ali Darwich ◽  
Kim Pankert ◽  
Andreas Ottersbach ◽  
Marcel Betsch ◽  
Sascha Gravius ◽  
...  
Keyword(s):  
Total Hip Arthroplasty ◽  
Clinical Outcome ◽  
Hip Arthroplasty ◽  
Anterior Approach ◽  
Hip Osteoarthritis ◽  
Direct Anterior Approach ◽  
Short Stem ◽  
Total Hip ◽  
The Mean

The aim of this study was to investigate the radiological and clinical outcome of the direct anterior approach (DAA) in total hip arthroplasty (THA) using a collared cementless femoral short-stem. This retrospective study included 124 patients with 135 THAs operated from 2014 to 2016 using a collared cementless triple tapered hydroxyapatite-coated femoral short-stem (AMIStem H Collared®, Medacta International, Castel San Pietro, Switzerland) implanted with a DAA. Follow-up was performed at three months, 12 months, and five years. Clinical outcome was assessed using the hip osteoarthritis outcome score (HOOS) and radiological analysis was done using conventional radiographs, which included evaluation of the femur morphology based on Dorr classification, of radiolucencies based on the Gruen zone classification and of stem subsidence. The mean age was 67.7 ± 11.3 years and the mean body mass index (BMI) was 27.4 ± 4.4 kg/m2. The stem survival rate at five years was 99.1% with one revision due to recurrent dislocations. Mean HOOS score improved from 40.9 ± 18.3 preoperatively to 81.5 ± 19.7 at three months, 89.3 ± 10.9 at 12 months, and 89.0 ± 14.0 at five years (all with p < 0.001). No significant correlations were found between age, femoral bone morphology, BMI and HOOS, and the appearance of relevant radiolucencies.

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