Aims. It is important to analyze objectively the hammering sound in cup press-fit technique in total hip arthroplasty (THA) in order to better understand the change of the sound during impaction. We hypothesized that a specific characteristic would present in a hammering sound with successful fixation. We designed the study to quantitatively investigate the acoustic characteristics during
Aims. It is important to analyze objectively the hammering sound in cup press-fit technique in total hip arthroplasty (THA) in order to better understand the change of the sound during impaction. We hypothesized that a specific characteristic would present in a hammering sound with successful fixation. We designed the study to quantitatively investigate the acoustic characteristics during
Purpose.
Introduction. In most cases of revision acetabular total hip arthoplasty (THA), some degree of bone loss will be accompanied. If the bone loss is massive, the management of bone defect is more challenging problem. We consider that using
Introduction: Stable cup anchorage in dysplastic hips is a key problem of THA. The pupose of this study was to evaluate the usefulness of a
Introduction. Bulk bone grafting is commonly used in total hip arthroplasty (THA) for developmental dysplasia. However, it is a technically demanding surgery with several critical issues, including graft resorption, graft collapse, and cup loosening. The purpose of this study is to describe our new bone grafting technique and review the radiographic and clinical results. Patients and Methods. We retrospectively reviewed 105 hips in 89 patients who had undergone covered bone grafting (CBG) in total hip arthroplasty for developmental dysplasia. We excluded patients who had any previous surgeries or underwent THA with a femoral shortening osteotomy. According to the Crowe classification, 6 hips were classified as group I, 39 as group II, 40 as group III, and 20 as group IV. Follow-up was at a mean of 4.1 (1 ∼ 6.9) years. The surgery was performed using the direct anterior approach. The acetabulum was reamed as close to the original acetabulum as possible. The pressfit
Purpose: There is no report concerning about long-term comparison result of high placed
Introduction. Bulk bone grafting of the cup is commonly used in total hip arthroplasty (THA) for developmental dysplasia. However, it carries a risk of the graft collapse in the mid-term or long-term results. The purpose of this study is to describe our new bulk bone grafting technique and review the radiographic and clinical results. Patients and Methods. We retrospectively reviewed 85 hips in 74 patients who had undergone bulk bone grafting in total hip arthroplasty for developmental dysplasia between 2008 and 2013. We excluded patients who had any previous surgeries or performed THA with the femoral shortening osteotomy. According to the Crowe classification, 4 hips were classified as Type 1, 28 as Type 2, 35 as Type 3, and 18 as Type 4. Follow-up was at a mean of 4.0 years (1 to 6.1). The surgery was performed using the direct anterior approach on a standard surgical table. The acetabulum was reamed for as close to the original acetabulum as possible. The pressfit
In total hip arthroplasty (THA),
The concept of stainless steel dual mobility cups in total hip arthroplasty has demonstrated very low long-term instability rates and a 98% survival rate after 12 years. We systematically implanted titanium alloy acetabular cups during a one year period. The purpose of our retrospective study was to report the 18-year clinical outcome data in a homogeneous and continuous series of 103 primary total hip replacements after implantation of a
The aim of this paper is to present a new solution in treating osteoarthritis after congenital dysplasia. In the First Orthopaedic Clinic in Prague, we have obtained, by using oval-shaped cups, excellent results in the treatment of acetabular deficiency occurring in THA loosening. These positive results have also encouraged us to use the implants in THA for secondary coxarthrosis. In severe acetabular defects, an endoprothesis is very difficult to implant. A whole range of methods has been described for fixing the acetabular component. We prefer not to use cemented implants with middle-aged patients. Methods using bulk bone grafts are being scaled down. Cup implantation to the neoacetabulum is disadvantageous because forces inherent to the hip joint are considerably higher in the superior lateral position. Cotyloplasty and controlled fracture impair the medial wall with the enhanced risk of implant protrusion to the pelvis. The implementation of an oval cup eliminates the above-mentioned disadvantages. During the period of 1994 to 1998, we applied the LOR cup in treating secondary coxarthrosis eight times in six women (mean age: 54 years). 83% had already been operated for congenital hip dislocation. The stage of the dysplasia was classified as Crowe II in two hip joints, Crowe III in four, and Crowe IV in two. An average of four screws were used for a 52x64 cup. Mean follow-up was 4.8 years. The mean Harris hip score at follow-up was 92 points. There were no infections, luxations, implant migrations, or screw failures. The radiograph evaluations revealed just one case of a translucent line 1 mm wide in the b,c zone. Osteointegration was perfect with the other implants. Using the oval-shaped cup does not usually require implementation of bulk bone grafts. Implant shape and the option of implementing an eccentric inlay enables preservation of the rotational centre, which is advantageous in terms of biomechanics. Implantation of the cup is easy and fast. Because of the good results, we suggest introducing the oval-shaped cup as a standard method of THA primo-implantation with patients who have acetabular dysplasia. The LOR cup was designed as a revision implant, but a disadvantage is the insufficient size scale and the 32 insert. For widespread application, it is therefore necessary to design a smaller size 28 inlay cup. We are currently developing our own acetabular component with a more suitable size scale and a plasma-sprayed hydroxyapatite ceramic coating.
The mid- or long-term results of acetabular revision total hip arthroplasty (THA) in Korea are rare. The purpose of this study is to report the mid-term radiographic results (> 5 years) of acetabular revision THA with porous-coated cementless Trilogy® cup (Zimmer, Warsaw, IN, USA). Between 1999 and 2010, 77 patients (79 hips) had underwent acetabular revision THA with Trilogy® cup. Eight patients (8 hips) were excluded due to death before 5-year follow-up, and 22 patients (23 hips) were excluded due to less than 5-year follow-up or follow-up loss. Forty-seven patients (48 hips) were included in our study. The mean age was 57.9 years (range, 36 to 76 years) and the mean follow-up was 9.8 years (range 5.0 to 16.2 years). The causes of revision were aseptic loosening in 40 hips, and septic loosening in 8 hips, respectively. Both acetabular and femoral revisions were performed in 14 hips and isolated acetabular revision was done in 34 hips. Preoperetive acetabular bone defect according to Paprosky classification was; 1 in type I, 6 in IIA, 11 in IIB, 9 in IIC, 15 in IIIA, and 6 in IIIB.Introduction
Materials and Methods
Introduction:
In acetabular revision press-fit cups usually are used in smaller defects and contact to the host bone should be more than 50 %. Due to the thin wall thickness and the surface design the
The initial diagnosis was primary coxarthrosis in 63, rheumatoid arthritis in 10, congenital dislocation of the hip in 5 and necrosis of the femoral hed in 3. In all cases the cementless Alloclassic stem was used, as bearing material metasul was implanted in 73 and ceramic-polyethylene in 8 cases.
The preoperative Harris hip score was 53,13 pts (23–73), the postoperative score after 10 years 96,5 (78–100). Radiographic evaluation after 10 years showed no lucencies in 78 of 81 jpints. 3 hips had a lucent line of 1mm in zone III. We detected no signs of osteolysis, loosening or migration. No reoperations for any reason exept 2 septic cases have been performed yet.
First generation uncemented modular cups reproduciblyfixed to bone but they were associated with unacceptable rates of pelvicosteolysis and mechanical failure. Consequently, second generation cups weredeveloped with shells having a limited number of holes or no holes, and improved conformity and locking mechanisms with the liner. The purpose of this study is to report the clinical and radiographic results of a second generation acetabular component for primary total hip arthroplasty. 297 patients who underwent 335 consecutive primary total hip arthroplasties by a single surgeon with the Trilogy modular acetabular component were followed clinically with the Hospital for Special Surgery Hip Scoring System and radiographs, for 4 to 7 years. All cups were implanted with a press-fit technique. This second generation acetabular cup design achieved predictable fixation and was associated with a low prevalence of revision for loosening and low prevalence of osteolysis at an intermediate follow up.
Aims. Manual impaction, with a mallet and introducer, remains the standard method of installing
In primary total hip arthroplasty (THA) for patients with Crowe II or higher classes developmental dysplasia of the hip (DDH) or rapidly destructive coxopathy (RDC), the placement of the cup can be challenging due to superior and lateral acetabular bone defects. Traditionally, bone grafts from resected femoral heads were used to fill these defects, but bulk graft poses a risk of collapse, especially in DDH with hypoplastic femoral heads or in RDC where good quality bone is scarce. Recently, porous metal augments have shown promising outcomes in revision surgeries, yet reports on their efficacy in primary THA are limited. This study retrospectively evaluated 27 patients (30 hips) who underwent primary THA using
Objectives. Total hip replacement is increasingly being conducted in younger and more active patients, so surgeons often use bearing surfaces with improved wear characteristics, such as ceramic on ceramic. The primary objective of this study was to determine if survivorship for a BIOLOX® delta ceramic on delta ceramic couple used with the PROCOTYL® L acetabular cup is significantly different from all other