Registry data from around the world demonstrates instability following primary THA is a leading indication for revision. However, the burden of THA dislocation is poorly documented and is not routinely recorded or reported at a national level. Our aim was to determine the rate of dislocation following primary THA in contemporary practice and in doing so determining the burden of THA dislocation to the NHS in Wales. We considered all Welsh residents who underwent primary THA from 2011–2016. Via clinical coding linkage using Patient Episode Database for Wales (PEDW), the equivalent of HES data in England, we were able determine re-admission for dislocation, revision THA following dislocation and all cause revision at 1 to 5 years follow-up.Introduction
Method
Concerns regarding UHMWPE wear particle induced osteolysis in total hip replacement (THR, [1]) have led to alternative materials to be sought. Carbon-fibre reinforced poly-ether-ether-ketone (CFR-PEEK) has shown reduced wear in hip and knee configurations compared with conventional polyethylene [2-4]. The aim of this study was to investigate the wear performance of a ceramic-on-CFR PEEK THR through a simulator study. Five 36mm diameter Biolox Delta heads were paired with extruded CFR-PEEK cups and tested in a hip wear simulator (Simulator Solutions, UK) for 10 million cycles (Mc). Tests were performed in a Prosim hip simulator, which applied a twin peak loading cycle, with a peak load of 3kN. Flexion-extension of −15 to +30 degrees was applied to the head and internal-external rotation of +/− 10 degrees was applied to the cup, components were mounted anatomically. The lubricant was 25% (v/v) calf serum supplemented with 0.03% (w/v) sodium azide. Wear was assessed gravimetrically at several intervals adjusted for moisture uptake using loaded and unloaded soak controls.Introduction
Methodology