Comparative Analysis of Two Cementless Stems in Total Hip Arthroplasties in Patients with Osteonecrosis of Femoral Head - Summit® Stem and Bencox® Stem -

Background: Osteonecrosis of femoral head (ONFH) is characterised by cell death in the subchondral bone caused by abnormalities of blood flow to the femoral head. About 5% to 13% of arthroplasties are performed yearly for ONFH in United States. Ficat and Arlet classification is the commonest system used for grading of ONFH. Advanced stages 3 and 4 are best managed with total hip arthroplasty (THA). THA restores hip range of movement and allows early ambulation in ONFH.Methods: After seeking approval from local institutional ethical committee 25 patients with stage 3 and stage 4 ONFH (Ficat and Arlet) were admitted from OPD of SKIMS MC and Hospital Bemina, Srinagar. The study was conducted from February 2018 to February 2020 in department of Orthopaedics SKIMS MC and Hospital Bemina, Srinagar. 25 patients with mean age of 50.64 years comprising of 13 females and 12 males with unilateral osteonecrosis of femoral head with collapsed head underwent uncemented total hip arthroplasty and were followed up to a minimum of 1 year post-operatively.Results: Outcome was evaluated by comparing pre-operative and post-operative Harris hip scores. The average Harris hip scores improved from 65.87 in the pre-operative group to 96.54 at 1-year follow-up post-operatively. Marked improvement was noted in pain scores. No revisions were performed during the study. One patient developed superficial surgical site infection which healed with supervised dressings and oral antibiotics.Conclusions: Uncemented THA has excellent short-term outcomes in advanced stages of ONFH. It provides mobile hip joint and pain free ambulation shortly after surgery.

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Third-Generation Ceramic-On-Ceramic Total Hip Arthroplasty in Patients Younger Than 30 Years with Osteonecrosis of Femoral Head

The Journal of Arthroplasty ◽

10.1016/j.arth.2011.07.004 ◽

2012 ◽

Vol 27 (7) ◽

pp. 1337-1343 ◽

Cited By ~ 31

Author(s):

Jae-Wook Byun ◽

Taek-Rim Yoon ◽

Kyung-Soon Park ◽

Jong-Keun Seon

Keyword(s):

Femoral Head ◽

Total Hip Arthroplasty ◽

Hip Arthroplasty ◽

Third Generation ◽

Osteonecrosis Of Femoral Head ◽

Total Hip ◽

Ceramic On Ceramic

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Femoral head size is a risk factor for total hip luxationA study of 42,987 primary hip arthroplasties from the Norwegian Arthroplasty Register

Acta Orthopaedica Scandinavica ◽

10.1080/00016470310017893 ◽

2003 ◽

Vol 74 (5) ◽

pp. 514-524 ◽

Cited By ~ 125

Author(s):

Sven Byström ◽

Birgitte Espehaug ◽

Ove Furnes ◽

Leif Havelin

Keyword(s):

Risk Factor ◽

Femoral Head ◽

Head Size ◽

Femoral Head Size ◽

Arthroplasty Register ◽

Total Hip ◽

Hip Arthroplasties ◽

Norwegian Arthroplasty Register

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Septic Arthritis of the Hip Joint in Cervical Cancer Patients after Radiotherapy: Three Case Reports

Journal of Orthopaedic Surgery ◽

10.1177/230949900100900209 ◽

2001 ◽

Vol 9 (2) ◽

pp. 41-45 ◽

Cited By ~ 8

Author(s):

Shu-Hua Yang ◽

Rong-Sen Yang ◽

Chin-Lin Tsai

Keyword(s):

Cervical Cancer ◽

Femoral Head ◽

Septic Arthritis ◽

Cancer Patients ◽

Hip Joint ◽

Defense Mechanisms ◽

Case Reports ◽

Causative Organism ◽

Total Hip ◽

Hip Arthroplasties

Cervical cancer patients may experience hip problems related to the cancer itself or therapeutic management for the cancer. Septic arthritis should be one of the possibilities but there have been no reports on this. Here we present three patients who developed hip problems more than two years after radiotherapy with or without a radical operation. One patient was managed as septic arthritis because of significant inflammatory signs around the affected hip joint even though the causative organism was not confirmed. Succeeding total hip arthroplasty functioned well and had no recurrence of infection. The hip problems of the other two patients were diagnosed as radiation osteonecrosis of the femoral head initially. However, Bacteroides fragilis infection was found several months after total hip arthroplasties. Radiotherapy to the pelvis may damage the hip joint and compromise host-defense mechanisms of the pelvic region. Both factors may increase the possibility of infection of hip joints. Further clinical evidence is needed to understand whether subacute or chronic anaerobic infection could also be one of the causes leading to progressive destruction of the femoral head.

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Late Nontraumatic Dissociation of the Femoral Head and Trunnion in a Total Hip Arthroplasty

Case Reports in Orthopedics ◽

10.1155/2015/738671 ◽

2015 ◽

Vol 2015 ◽

pp. 1-5 ◽

Cited By ~ 2

Author(s):

Simon J. M. Parker ◽

Wasim Khan ◽

Simon Mellor

Keyword(s):

Femoral Head ◽

Total Hip Arthroplasty ◽

Hip Arthroplasty ◽

Soft Tissues ◽

Total Hip ◽

Mild Wear ◽

Long Term Follow Up ◽

Utmost Care ◽

Articulating Surface ◽

Hip Arthroplasties

Background. Modular total hip arthroplasties are increasingly popular because customisation allows optimal restoration of patient biomechanics. However, the introduction of component interfaces provides greater opportunities for failure. We present a case of late nontraumatic dissociation of the head-neck interface, more than 10 years after insertion.Case Description. A 58-year-old woman had a left metal-on-metal total hip arthroplasty in 2002 for hip dysplasia. Following an uneventful 10-year period, she presented to hospital in severe pain after standing from a seated position, and radiographs demonstrated complete dissociation of the modular femoral head from the stem, with the femoral head remaining in its cup. There was no prior trauma or infection. Mild wear and metallosis were present on the articulating surface between the femoral head and trunnion. Soft tissues were unaffected.Discussion and Conclusions. This is the latest occurrence reported to date for nontraumatic component failure in such an implant by more than 7 years. The majority of cases occur in the context of dislocation and attempted closed reduction. We analyse and discuss possible mechanisms for failure, aiming to raise awareness of this potential complication and encouraging utmost care in component handling and insertion, as well as the long term follow-up of such patients.

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