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Heijnens LJM, Schotanus MGM, VAN Haaren EH. Excellent survival of two anatomically adapted hydroxyapatite coated cementless Total Hip Arthroplasties. A mean follow-up of 11.3 years. Acta Orthop Belg 2024; 90:35-40. [PMID: 38669646 DOI: 10.52628/90.1.11314] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/28/2024]
Abstract
There are many different types of cementless anatomically adapted Total Hip Arthroplasties (THAs) on the market, the Anatomic Benoist Gerard (ABG) I and II are such types of cementless THAs. In this retrospective single-centre study we evaluated the overall survival with revision for any reason and aseptic loosening as endpoint at more than 11 years follow-up. Between 2000 and 2004, 244 cementless THAs were performed in 230 patients in a primary care hospital. At a mean of 11.3 years follow-up (range 9.8 - 12.8 years) clinical examination, plain radiography and Patient Reported Outcome Measures (PROMs) were obtained and analysed. The PROMs consisted of the Oxford Hip Score (OHS) and the Western Ontario and McMaster University Index (WOMAC). At a mean of 11.3 years follow-up 32 patients (13.1%) had died of unrelated causes. Of the remaining cohort all 198 patients (212 THAs) have been reached for evaluation. There were no patients considered as lost to follow-up. At a mean of 11.3 years 11 patients (11 THAs) have had a revision of either the femoral implant or acetabular component resulting in an overall survival of 95.5%. There was no statistically significant difference (p=0.564) in survival between the ABG I and II THAs. Radiographic there were no changes between the ABG I and II last follow up. The ABG II performed statistically significant better in PROMs. We concluded that both anatomically adapted hydroxyapatite coated cementless THAs show excellent survival at more than 11 years follow-up.
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Li M, Zeng Y, Nie Y, Liao K, Pei F, Yang J, Xie H, Shen B. A high risk of postoperative periprosthetic femoral fracture in Dorr type C femurs: a retrospective cohort study with 10-year follow-up data and a preliminary monochromatic image analysis. Int J Surg 2024; 110:296-305. [PMID: 37830949 PMCID: PMC10793812 DOI: 10.1097/js9.0000000000000810] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2023] [Accepted: 09/18/2023] [Indexed: 10/14/2023]
Abstract
BACKGROUND The authors applied Anatomique Benoist Girard II (ABG II) stems for total hip arthroplasty in some Dorr type C femurs as early attempts. Here, the authors compared the long-term follow-up results between ABG II stems and the 'well-performing' Corail stems and their monochromatic images. METHODS Among 3214 primary total hip arthroplasty records, 43 short ABG II stems and 67 standard-length Corail stems implanted in Dorr type C femurs were eligible and enrolled in this retrospective cohort study, with a mean follow-up of 10.3 years. Revision rates, Harris hip scores, and radiologic signs were compared. Spectral CT scans from a representative sample were obtained, and monochromatic images were reconstructed. A quantitative method was developed to measure the volume of the gap around stems. Patient-specific finite element analysis was conducted to investigate the strains. RESULTS The revision rate of ABG II stems was significantly higher than that of Corail stems (21 vs. 3%, P <0.05). In the monochromatic images, fewer spot-weld signs (2.2 vs. 3.4, P <0.05) and wider gaps around stems (1.64 cm 3 vs. 0.13 cm 3 , P <0.05) were observed on average in the ABG II group. The mean maximum principal strains of the proximal femurs in the ABG II group were close to the yield strains and significantly larger than those in the Corail group (0.0052 vs. 0.0011, P <0.05). CONCLUSIONS There was a high risk of postoperative periprosthetic femoral fracture for ABG II stems in Dorr type C femurs. Monochromatic images provided some insight into the failure mechanism. LEVEL OF EVIDENCE III.
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Affiliation(s)
- Mingyang Li
- Department of Orthopedic Surgery and Orthopedic Research Institute, West China Hospital
| | - Yi Zeng
- Department of Orthopedic Surgery and Orthopedic Research Institute, West China Hospital
| | - Yong Nie
- Department of Orthopedic Surgery and Orthopedic Research Institute, West China Hospital
| | - Kai Liao
- Department of Radiology, West China Hospital, West China Medical School, Sichuan University, Chengdu, Sichuan Province, People’s Republic of China
| | - Fuxing Pei
- Department of Orthopedic Surgery and Orthopedic Research Institute, West China Hospital
| | - Jing Yang
- Department of Orthopedic Surgery and Orthopedic Research Institute, West China Hospital
| | - Huiqi Xie
- Department of Orthopedic Surgery and Orthopedic Research Institute, West China Hospital
| | - Bin Shen
- Department of Orthopedic Surgery and Orthopedic Research Institute, West China Hospital
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Kropivšek L, Antolič V, Mavčič B. Surgeon-Stratified Periprosthetic Fracture Risk in a Single-Hospital Cohort of 1531 Uncemented ABG-II Femoral Stems at Primary Total Hip Arthroplasty. Indian J Orthop 2023; 57:1850-1857. [PMID: 37881273 PMCID: PMC10593654 DOI: 10.1007/s43465-023-00996-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/05/2023] [Accepted: 09/04/2023] [Indexed: 10/27/2023]
Abstract
Purpose Late periprosthetic fracture risk with uncemented ABG-II femoral stems at primary total hip arthroplasty (THA) has been reported before, but single-hospital surgeon-stratified reports of this implant have never been published. We asked whether periprosthetic fracture rates of ABG-II femoral stems implanted at a single tertiary hospital depended on patients' age, gender and the operating surgeon. Methods The study included 1531 consecutive primary ABG-II femoral stems implanted at a single tertiary hospital between January 1, 2012 and December 31, 2018. The Kaplan-Meier and Cox regression analyses were performed after 3.6-10.6 years of follow-up. Results In the cohort, we recorded 8 intraoperative, 22 early postoperative (within 90 days of implantation) and 26 late periprosthetic fractures (over 90 days postoperatively). The revision rate of ABG-II femoral stems was 5.1/100 component-years for early and 0.3/100 component-years for late periprosthetic fractures. The Kaplan-Meier cumulative probability of periprosthetic fracture was 2.1% at one, 2.3% at 2, 3.2% at 5, and 6.5% at 10 years after the implantation. Higher patient's age at operation was an independent risk factor of subsequent periprosthetic fracture (hazard ratio 1.07, 95% confidence interval 1.03-1.10; p < 0.01), regardless of the operating surgeon. Most of the fractured femora were Dorr type C (stovepipe). Conclusion The study presents the largest published ABG-II femoral stem cohort from a single hospital so far with 9291 component-years of observation. Periprosthetic fracture risk of ABG-II increased with patients' age, had no variability between different surgeons, and was considerably higher from other uncemented femoral stems used at the same hospital. Level of Evidence III.
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Affiliation(s)
- Luka Kropivšek
- Chair of Orthopaedics, Faculty of Medicine, University of Ljubljana, Zaloška 9, 1000 Ljubljana, Slovenia
| | - Vane Antolič
- Department of Orthopaedic Surgery, University Medical Centre Ljubljana, Zaloška 9, 1000 Ljubljana, Slovenia
| | - Blaž Mavčič
- Department of Orthopaedic Surgery, University Medical Centre Ljubljana, Zaloška 9, 1000 Ljubljana, Slovenia
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Coulomb R, Mansour J, Essig J, Asencio G, Kouyoumdjian P. Clinical results at 10 years of minimum follow-up with the ABG 2 hip arthroplasty, matched with ceramic-on-ceramic bearings. SICOT J 2022; 8:32. [PMID: 35969123 PMCID: PMC9377216 DOI: 10.1051/sicotj/2022032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/15/2022] [Accepted: 06/27/2022] [Indexed: 11/18/2022] Open
Abstract
Introduction: The current study aimed as a primary goal is to assess the results of a ceramic-on-ceramic (CoC) bearing hip system matched with ABG (Anatomic Benoist Girard) 2 components in terms of survivorship. Secondary objectives addressed specifically ceramic-related complications as well as specific patterns at the bone-implant interface. Material and methods: This is a retrospective bicentric continuous series involving 147 patients (95 males vs. 52 females) who underwent ABG 2 arthroplasties with CoC bearings. One hundred and twenty-five hips were closely followed-up at a mean period of 11.3 years. Results and discussion: With a mean follow-up of 11.3 years, nine cases (5.7%) underwent revision surgery, four caused by acetabular aseptic loosening, three by deep infections, one ceramic head fracture, and one femoro-acetabular impingement. The global survivorship was 92.2% at 12.7 years. The Harris Hip Score (HHS) mean scores increased post-operatively from 50.1 up to 96.1 points (p < 0.001). All stems featured patterns of radiological osseous integration onto the hydroxyapatite (HA)-coated zones. No radiological wear or osteolysis of ceramic bearings was demonstrated however, five patients reported hip squeaking using this bearing. This study demonstrated excellent results at mid-term follow-up in patients younger than 70 years of age using cementless ABG 2 components coupled with CoC bearings with no increase in complication rate.
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Affiliation(s)
- Remy Coulomb
- University Hospital of Nîmes, Rue du Pr. Robert Debré, 30029 Nimes cedex 9, France
| | - Jad Mansour
- University Hospital of Nîmes, Rue du Pr. Robert Debré, 30029 Nimes cedex 9, France
| | - Jérome Essig
- Clinique Médipole-Garonne, 45, rue Gironis, 31036 Toulouse cedex 1, France
| | - Gérard Asencio
- University Hospital of Nîmes, Rue du Pr. Robert Debré, 30029 Nimes cedex 9, France
| | - Pascal Kouyoumdjian
- University Hospital of Nîmes, Rue du Pr. Robert Debré, 30029 Nimes cedex 9, France - Laboratory of Mechanics and Civil Engineering (LMGC), CNRS-UM1, 860 Rue de St-Priest, 34090 Montpellier, France - Université Montpellier 1, 2 Rue de l'École de Médecine, 34090 Montpellier, France
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Mulford JS, Mathew R, Penn D, Cuthbert AR, De Steiger R. Periprosthetic fracture as a late mode of failure of the Anatomique Benoist Girard II femoral prosthesis. ANZ J Surg 2022; 92:1165-1170. [PMID: 35191171 PMCID: PMC9306843 DOI: 10.1111/ans.17547] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2021] [Revised: 01/26/2022] [Accepted: 01/31/2022] [Indexed: 11/30/2022]
Abstract
Aim The Anatomique Benoist Girard (ABG) II femoral implant was a commonly used stem for primary total hip replacement (THR) at our institution (Launceston, Tasmania Australia). We identified peri‐prosthetic fracture as the main cause of late failure. Methods The late periprosthetic fracture rate for ABG II implants was reviewed with national statistics, using Australian Orthopaedic Association National Joint Replacement Registry (AOANJRR) data. National revision rates for periprosthetic fracture were used to compare ABG II with all other cementless femoral stems. Result ABG II stems accounted for 1% (2719 implants) of all femoral stem implants in Australia during the 12‐year review period, compared to 23% (587 implants) in Launceston Hospitals. Although the Launceston cumulative percent revision rate for the ABG II stem was lower than the National rate at all time points, the reasons for revision were similar. The most common reason for revision of ABG II was fracture (56.8%), followed by loosening (15.3%). This differs from the reasons for revision in other cementless prostheses (loosening 23.9%, fracture 20.8%, dislocation 18.7%). Cumulative percent revision rates from late periprosthetic fracture, were higher for the ABG II stem than other cementless femoral prostheses. Conclusion This review of the AOANJRR has confirmed a local and national higher revision rate of the ABG II stem due to late periprosthetic fracture compared with other cementless stems. Stem design must be considered to reduce the risk of late periprosthetic fracture.
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Affiliation(s)
- Jonathan S Mulford
- Orthopaedic Department, Department of Surgery, Launceston General Hospital, Launceston, Tasmania, Australia.,Launceston Clinical School, School of Health Sciences, University of Tasmania, Hobart, Tasmania, Australia
| | - Ronnie Mathew
- Orthopaedic Department, Department of Surgery, Launceston General Hospital, Launceston, Tasmania, Australia
| | - David Penn
- Orthopaedic Department, Department of Surgery, Launceston General Hospital, Launceston, Tasmania, Australia
| | - Alana R Cuthbert
- Australian Orthopaedic Association National Joint Replacement Registry, Adelaide, South Australia, Australia
| | - Richard De Steiger
- Australian Orthopaedic Association National Joint Replacement Registry, Adelaide, South Australia, Australia.,Department of Surgery, Epworth Healthcare, University of Melbourne, Melbourne, Victoria, Australia
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Heijnens LJ, Schotanus MG, Verburg AD, van Haaren EH. Disappointing long-term outcome of THA with carbon-fiber-reinforced poly-ether-ether-ketone (CFR-PEEK) as acetabular insert liner: a prospective study with a mean follow-up of 14.3 years. Hip Int 2021; 31:735-742. [PMID: 32340489 DOI: 10.1177/1120700020918157] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
INTRODUCTION Insert liner wear of the acetabular component is one of the predictive values for survival of total hip arthroplasties (THAs). This prospective single-centre study was designed to evaluate the follow-up of carbon-fiber-reinforced poly-ether-ether-ketone (CFR-PEEK) insert liner used as bearing in cementless THAs. METHODS 29 healthy patients with an indication for cementless THA were selected for a CFR-PEEK insert liner and followed over time. All patients received a cementless THA with a CFR-PEEK insert liner used as bearing. At different follow-up moments patients were routinely examined and were analysed using the Oxford Hip Score (OHS), the modified Merle d'Aubigne-Postel (MAP) score, and radiologically. At the follow up moments the plain radiographics where assessed for loosening, cyst formations and wear of the CFR-PEEK liners. RESULTS At a mean of 14.3 years follow-up 4 revisions of the acetabular component were performed, resulting in a survival rate of 86.5% (CI 95%, 72.4-96.6). A statistically significant difference in OHS and MAP scores between pre- and postoperative follow-up moments was observed. The acetabular components of the remaining patients showed no radiological abnormalities at 14.3 years follow-up. The overall CFR-PEEK wear was low, with a mean of 0.81 (0.2-1.4) mm wear at 14.3 years follow-up. CONCLUSIONS In this series we found an aseptic loosening with unclear reasons in 4 well-positioned acetabular components, hence we do not recommend routine use of CFR-PEEK insert liners as bearing in cementless THAs. All the remaining THAs and acetabular components were in situ without abnormalities at 14.3 years follow-up.
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Affiliation(s)
- Luc Jm Heijnens
- Department of Orthopaedic Surgery, Zuyderland Medical Centre Sittard, The Netherlands
| | - Martijn Gm Schotanus
- Department of Orthopaedic Surgery, Zuyderland Medical Centre Sittard, The Netherlands
| | - Aart D Verburg
- Department of Orthopaedic Surgery, Zuyderland Medical Centre Sittard, The Netherlands
| | - Emil H van Haaren
- Department of Orthopaedic Surgery, Zuyderland Medical Centre Sittard, The Netherlands
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Uemura K, Hamada H, Ando W, Takao M, Sugano N. Minimum 10 years clinical results of an anatomical short stem with a proximal hydroxyapatite coating. Mod Rheumatol 2021; 31:1066-1072. [PMID: 33428474 DOI: 10.1080/14397595.2020.1868129] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
OBJECTIVES The CentPillar stem (Stryker Orthopaedics), an anatomical short stem, was designed to match the proximal femoral canal shape in both patients with normal hips and those with developmental dysplasia of the hip (DDH). The long-term outcomes of the CentPillar stem was examined herein. METHODS In total, 222 hips that underwent total hip arthroplasty using the CentPillar stem were analyzed. DDH was the main reason for surgery (79.3%). Implant survivorship was assessed using Kaplan-Meier analysis. For radiographic evaluation, stress shielding was assessed using the Engh classification. For functional evaluation, patients' ability to perform deep hip bending activities (sit on the floor, squat, and sit straight) was assessed. RESULTS During a median follow-up of 13.1 years, 2 stem revisions were performed (aseptic loosening and late hematogenous periprosthetic infection), and the overall cumulative implant survival rate was 99.0% at 15 years. In the radiographic evaluation, grade >3 stress shielding was found in only one hip. More than 80% of the patients were able to perform each of the three deep hip bending activities. CONCLUSIONS Good fixation at the proximal part of the femur was obtained, and the implant survival rate of the CentPillar stem was excellent during a long-term follow-up.
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Affiliation(s)
- Keisuke Uemura
- Department of Orthopaedic Medical Engineering, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Hidetoshi Hamada
- Department of Orthopaedic Surgery, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Wataru Ando
- Department of Orthopaedic Medical Engineering, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Masaki Takao
- Department of Orthopaedic Surgery, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Nobuhiko Sugano
- Department of Orthopaedic Medical Engineering, Osaka University Graduate School of Medicine, Osaka, Japan
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Brunello G, Elsayed H, Biasetto L. Bioactive Glass and Silicate-Based Ceramic Coatings on Metallic Implants: Open Challenge or Outdated Topic? MATERIALS (BASEL, SWITZERLAND) 2019; 12:E2929. [PMID: 31510062 PMCID: PMC6766230 DOI: 10.3390/ma12182929] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/16/2019] [Revised: 09/05/2019] [Accepted: 09/07/2019] [Indexed: 12/19/2022]
Abstract
The overall success and long-term life of the medical implants are decisively based on the convenient osseointegration at the hosting tissue-implant interface. Therefore, various surface modifications and different coating approaches have been utilized to the implants to enhance the bone formation and speed up the interaction with the surrounding hosting tissues, thereby enabling the successful fixation of implants. In this review, we will briefly present the main metallic implants and discuss their biocompatibility and osseointegration ability depending on their chemical and mechanical properties. In addition, as the main goal of this review, we explore the main properties of bioactive glasses and silica-based ceramics that are used as coating materials for both orthopedic and dental implants. The current review provides an overview of these bioactive coatings, with a particular emphasis on deposition methods, coating adhesion to the substrates and apatite formation ability tested by immersion in Simulated Body Fluid (SBF). In vitro and in vivo performances in terms of biocompatibility, biodegradability and improved osseointegration are examined as well.
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Affiliation(s)
- Giulia Brunello
- Department of Management and Engineering, University of Padova, Stradella San Nicola 3, 36100 Vicenza, Italy.
- Department of Neurosciences, Section of Dentistry, University of Padova, Via Giustiniani 2, 35128 Padova, Italy.
| | - Hamada Elsayed
- Department of Industrial Engineering, University of Padova, Via F. Marzolo 9, 35131 Padova, Italy.
- Ceramics Department, National Research Centre, El-Bohous Street, Cairo 12622, Egypt.
| | - Lisa Biasetto
- Department of Management and Engineering, University of Padova, Stradella San Nicola 3, 36100 Vicenza, Italy.
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Aro E, Alm JJ, Moritz N, Mattila K, Aro HT. Good stability of a cementless, anatomically designed femoral stem in aging women: a 9-year RSA study of 32 patients. Acta Orthop 2018; 89:490-495. [PMID: 29987941 PMCID: PMC6202764 DOI: 10.1080/17453674.2018.1490985] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/08/2023] Open
Abstract
Background and purpose - We previously reported a transient, bone mineral density (BMD)-dependent early migration of anatomically designed hydroxyapatite-coated femoral stems with ceramic-ceramic bearing surfaces (ABG-II) in aging osteoarthritic women undergoing cementless total hip arthroplasty. To evaluate the clinical significance of the finding, we performed a follow-up study for repeated radiostereometric analysis (RSA) 9 years after surgery. Patients and methods - Of the 53 female patients examined at 2 years post-surgery in the original study, 32 were able to undergo repeated RSA of femoral stem migration at a median of 9 years (7.8-9.3) after surgery. Standard hip radiographs were obtained, and the subjects completed the Harris Hip Score and Western Ontario and McMaster Universities Osteoarthritis Index outcome questionnaires. Results - Paired comparisons revealed no statistically significant migration of the femoral stems between 2 and 9 years post-surgery. 1 patient exhibited minor but progressive RSA stem migration. All radiographs exhibited uniform stem osseointegration. No stem was revised for mechanical loosening. The clinical outcome scores were similar between 2 and 9 years post-surgery. Interpretation - Despite the BMD-related early migration observed during the first 3 postoperative months, the anatomically designed femoral stems in aging women are osseointegrated, as evaluated by RSA and radiographs, and exhibit good clinical function at 9 years.
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Affiliation(s)
- Erik Aro
- Department of Orthopaedic Surgery and Traumatology, Turku University Hospital and University of Turku, Turku;
| | - Jessica J Alm
- Department of Orthopaedic Surgery and Traumatology, Turku University Hospital and University of Turku, Turku;
| | - Niko Moritz
- Department of Orthopaedic Surgery and Traumatology, Turku University Hospital and University of Turku, Turku;
| | - Kimmo Mattila
- Department of Diagnostic Imaging, Turku University Hospital, Turku, Finland
| | - Hannu T Aro
- Department of Orthopaedic Surgery and Traumatology, Turku University Hospital and University of Turku, Turku; ,Correspondence:
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Elmallah RK, Cherian JJ, Meneghini RM, Hozack WJ, Westrich GH, Mont MA. How to Approach a Recalled Dual Modular Hip Implant: An Update. J Arthroplasty 2016; 31:2646-2652. [PMID: 27542855 DOI: 10.1016/j.arth.2016.06.059] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/17/2016] [Revised: 05/08/2016] [Accepted: 06/27/2016] [Indexed: 02/01/2023] Open
Abstract
BACKGROUND The aim of this study was to provide an update on the "Modular taper junction corrosion and failure: how to approach a recalled total hip arthroplasty implant" (Pivec et al JOA 2014) publication. METHODS We performed a comprehensive review of the literature in English, with search terms referencing to the diagnosis, management, and outcomes of patients who underwent total hip arthroplasty with a recalled dual modular hip implant. RESULTS Based on this review and the new guidelines by the American Academy of Orthopedic Surgeons and the Hip Society, we propose an updated algorithm for the diagnosis and management of patients with these recalled implants. CONCLUSION When encountering patients with these prostheses, it is imperative to take a step-by-step approach to evaluate whether patients are having potential complications. We hope that this has further clarified the appropriate steps that need to be carried out when confronted with these recalled devices.
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Affiliation(s)
- Randa K Elmallah
- Center for Joint Preservation and Replacement, Rubin Institute for Advanced Orthopedics, Sinai Hospital of Baltimore, Baltimore, Maryland
| | - Jeffrey J Cherian
- Department of Orthopaedic Surgery, Philadelphia College of Osteopathic Medicine, Philadelphia, Pennsylvania
| | - Robert M Meneghini
- Department of Orthopaedic Surgery, Indiana University School of Medicine, Indianapolis, Indiana
| | - William J Hozack
- Department of Orthopedic surgery, Rothman Institute, Thomas Jefferson University, Philadelphia, Pennsylvania
| | - Geoffrey H Westrich
- Department of Orthopaedic Surgery, Adult Reconstruction and Joint Replacement Service, Hospital for Special Surgery, New York, New York
| | - Michael A Mont
- Center for Joint Preservation and Replacement, Rubin Institute for Advanced Orthopedics, Sinai Hospital of Baltimore, Baltimore, Maryland
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Faizan A, Gerges JJ, Asencio G, Essig J, Munini E, Hozack WJ. Changes in Femoral Version During Implantation of Anatomic Stems: Implications on Stem Design. J Arthroplasty 2016; 31:512-6. [PMID: 26481406 DOI: 10.1016/j.arth.2015.09.008] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/03/2015] [Revised: 08/21/2015] [Accepted: 09/08/2015] [Indexed: 02/01/2023] Open
Abstract
BACKGROUND Component positioning in total hip arthroplasty (THA) is among the primary indicators for longevity and success. Acetabular component positioning has been discussed in literature at length; however, femoral component positioning is also important as it contributes to combined anteversion. METHODS In this study, we examined the changes in femoral anteversion after the implantation of anatomic stem ABG II. A cadaveric study, a computed tomography-based computer modeling study, and a clinical study using a navigation system were conducted to document these changes. RESULTS These studies demonstrated that the anatomic stem ABG II increased the postimplantation femoral version by approximately 7°. The postimplantation versions followed a bimodal distribution. The computed tomography and navigation data also highlighted that the patient population may roughly be divided into 2 groups: the first group that needs anteverted stem and the second group that needs little or no anteversion in the stem to recreate the desired version and offset. CONCLUSION Based upon our data, we propose a new anatomic stem design that is offered in 2 version angles of 0° and 7° to help create the desired version and offset.
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Affiliation(s)
| | | | | | | | | | - William J Hozack
- Department of Orthopedic Surgery, Rothman Institute and Thomas Jefferson University, Philadelphia, Pennsylvania
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12
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Heijnens LJM, Schotanus MGM, Kort NP, Verburg AD, van Haaren EH. Results of Cemented Anatomically Adapted Total Hip Arthroplasty: A Follow-Up Longer Than 10 years. J Arthroplasty 2016; 31:194-8. [PMID: 26404845 DOI: 10.1016/j.arth.2015.08.023] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/16/2015] [Revised: 07/22/2015] [Accepted: 08/27/2015] [Indexed: 02/01/2023] Open
Abstract
This retrospective single-center study evaluated the >10-year follow-up (FU) and survival of 2 anatomically adapted cemented total hip arthroplasties (THAs) in a series of 308 patients (323 THAs) with a mean age of 76.2 years at operation. At a mean of 11 years of FU, patient-reported outcome measures, clinical examination, and plain radiography were analyzed. In 6 THAs, the femoral and/or acetabular component was revised. Reasons for revision were aseptic loosening and infection. At >10 years of FU, there was an overall survival for both THAs of 98.1%. Radiographic radiolucent lines were seen in 15 THAs affecting Gruen zone 4 and Delee and Charnley zone II. We conclude that both anatomically adapted cemented THAs have an excellent survival at 11 years of FU.
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Affiliation(s)
- Luc J M Heijnens
- Department of Orthopaedic Surgery, Zuyderland Medical Centre, Sittard-Geleen, the Netherlands
| | - Martijn G M Schotanus
- Department of Orthopaedic Surgery, Zuyderland Medical Centre, Sittard-Geleen, the Netherlands
| | - Nanne P Kort
- Department of Orthopaedic Surgery, Zuyderland Medical Centre, Sittard-Geleen, the Netherlands
| | - Aart D Verburg
- Department of Orthopaedic Surgery, Zuyderland Medical Centre, Sittard-Geleen, the Netherlands
| | - Emil H van Haaren
- Department of Orthopaedic Surgery, Zuyderland Medical Centre, Sittard-Geleen, the Netherlands
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Cementless hydroxyapatite coated hip prostheses. BIOMED RESEARCH INTERNATIONAL 2015; 2015:386461. [PMID: 25802848 PMCID: PMC4352755 DOI: 10.1155/2015/386461] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/28/2014] [Revised: 12/16/2014] [Accepted: 12/30/2014] [Indexed: 12/13/2022]
Abstract
More than twenty years ago, hydroxyapatite (HA), calcium phosphate ceramics, was introduced as a coating for cementless hip prostheses. The choice of this ceramic is due to its composition being similar to organic apatite bone crystals. This ceramic is biocompatible, bioactive, and osteoconductive. These qualities facilitate the primary stability and osseointegration of implants. Our surgical experience includes the implantation of more than 4,000 cementless hydroxyapatite coated hip prostheses since 1990. The models implanted are coated with HA in the acetabulum and in the metaphyseal area of the stem. The results corresponding to survival and stability of implants were very satisfactory in the long-term. From our experience, HA-coated hip implants are a reliable alternative which can achieve long term survival, provided that certain requirements are met: good design selection, sound choice of bearing surfaces based on patient life expectancy, meticulous surgical technique, and indications based on adequate bone quality.
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Does hydroxyapatite coating have no advantage over porous coating in primary total hip arthroplasty? A meta-analysis. J Orthop Surg Res 2015; 10:21. [PMID: 25626520 PMCID: PMC4314743 DOI: 10.1186/s13018-015-0161-4] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/07/2014] [Accepted: 01/08/2015] [Indexed: 11/18/2022] Open
Abstract
There are some arguments between the use of hydroxyapatite and porous coating. Some studies have shown that there is no difference between these two coatings in total hip arthroplasty (THA), while several other studies have shown that hydroxyapatite has advantages over the porous one. We have collected the studies in Pubmed, MEDLINE, EMBASE, and the Cochrane library from the earliest possible years to present, with the search strategy of “(HA OR hydroxyapatite) AND ((total hip arthroplasty) OR (total hip replacement)) AND (RCT* OR randomiz* OR control* OR compar* OR trial*)”. The randomized controlled trials and comparative observation trials that evaluated the clinical and radiographic effects between hydroxyapatite coating and porous coating were included. Our main outcome measurements were Harris hip score (HHS) and survival, while the secondary outcome measurements were osteolysis, radiolucent lines, and polyethylene wear. Twelve RCTs and 9 comparative observation trials were included. Hydroxyapatite coating could improve the HHS (p < 0.01), reduce the incidence of thigh pain (p = 0.01), and reduce the incidence of femoral osteolysis (p = 0.01), but hydroxyapatite coating had no advantages on survival (p = 0.32), polyethylene wear (p = 0.08), and radiolucent lines (p = 0.78). Hydroxyapatite coating has shown to have an advantage over porous coating. The HHS and survival was duration-dependent—if given the sufficient duration of follow-up, hydroxyapatite coating would be better than porous coating for the survival. The properties of hydroxyapatite and the implant design had influence on thigh pain incidence, femoral osteolysis, and polyethylene wear. Thickness of 50 to 80 μm and purity larger than 90% increased the thigh pain incidence. Anatomic design had less polyethylene wear.
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Study of the polycarbonate-urethane/metal contact in different positions during gait cycle. BIOMED RESEARCH INTERNATIONAL 2014; 2014:548968. [PMID: 25247180 PMCID: PMC4163484 DOI: 10.1155/2014/548968] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/27/2014] [Accepted: 07/25/2014] [Indexed: 12/12/2022]
Abstract
Nowadays, a growing number of young and more active patients receive hip replacement. More strenuous activities in such patients involve higher friction and wear rates, with friction on the bearing surface being crucial to ensure arthroplasty survival in the long term. Over the last years, the polycarbonate-urethane has offered a feasible alternative to conventional bearings. A finite element model of a healthy hip joint was developed and adjusted to three gait phases (heel strike, mid-stance, and toe-off), serving as a benchmark for the assessment of the results of joint replacement model. Three equivalent models were made with the polycarbonate-urethane Tribofit system implanted, one for each of the three gait phases, after reproducing a virtual surgery over the respective healthy models. Standard body-weight loads were considered: 230% body-weight toe-off, 275% body-weight mid-stance, and 350% body-weight heel strike. Contact pressures were obtained for the different models. When comparing the results corresponding to the healthy model to polycarbonate-urethane joint, contact areas are similar and so contact pressures are within a narrower value range. In conclusion, polycarbonate-urethane characteristics are similar to those of the joint cartilage. So, it is a favorable alternative to traditional bearing surfaces in total hip arthroplasty, especially in young patients.
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