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Orthopaedic Proceedings
Vol. 94-B, Issue SUPP_XXIII | Pages 60 - 60
1 May 2012
Raman R Dickson D Angus P Ridge J Johnson G Graham A
Full Access

We aim to report the clinical and radiological outcome of consecutive primary hip arthroplasties using the JRI-Furlong HAC coated femoral and acetabular components.

We reviewed 586 consecutive cementless primary THA in 542 patients with a minimum 12-18 year follow-up, performed at one institution between 1986 and 1994. Twenty-eight (32 THA) were lost to follow-up. Clinical outcome was measured using Harris, Charnley and Oxford scores. Quality of life using EuroQol

EQ-5D. Radiographs were systematically analysed.

The mean age was 75.2 years. Dislocation occurred in 12 patients (three recurrent). Re operations were performed in 11 patients (1.9%). Four acetabular and one stem revisions were performed for aseptic loosening. Other re-operations were for infection (two), periprosthetic fractures (two), cup malposition (one), revision of worn liner (two). The mean Harris and Oxford scores were 89 (79–96) and 18.4 (12–32) respectively. The Charnley score was 5.7 for pain, 5.3 for movement and 5.4 for mobility. Acetabular radiolucencies were present in 54 hips (9.7%).

The mean linear polythene wear was 0.06 mm/year. Stable stem by bony ingrowth was identified in all hips excluding one femoral revision case. Mean stem subsidence was 2.2mm (0.30–3.4mm). Radiolucencies were present around 37 (6.6%) stems. EQ- 5D description scores and health thermometer scores were 0.81 (0.71–0.89) and 86 (64–95). With an end point of definite or probable loosening, survival at 12 years was 96.1% for acetabular and 98.3% for femoral components. Overall survival at 12 years with removal or repeat revision of either component for any reason as the end point was 97.2%.

The results of this study support the continued use of a fully coated prosthesis and documents the durability of the HAC coated components. In our clinical experience, the Furlong prosthesis revealed encouraging radiographic stability over a long-term period.


Orthopaedic Proceedings
Vol. 94-B, Issue SUPP_XXIII | Pages 224 - 224
1 May 2012
Raman R Dickson D Sharma H Angus P Shaw C Johnson G Graham A
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We report the clinical and radiological outcome of consecutive primary hip arthroplasties using the JRI-Furlong Hydroxyapatite ceramic (HAC) coated acetabular components.

We reviewed 412 consecutive cementless primary THA using fully coated acetabular shell in 392 patients—with a minimum 12 to 18 year follow-up—performed at two institutions between 1986 and 1994. Twenty (22 THA) were lost prior to 12-year follow-up, leaving 372 patients (390 THA) available for study. Fully HAC coated stems were used in all patients. The clinical outcome was measured using Harris, Charnley and Oxford hip scores and the quality of life using EuroQol EQ-5D. Radiographs were systematically analysed for implant position, loosening, migration, osteolysis. Polythene wear was digitally measured. The radiographic stability of the acetabular component was determined by Enghs criteria.

The mean age was 74.4 years. The mean Harris and Oxford scores were 87 (78– 97) and 19.1 (12–33) respectively. The Charnley score was 5.6 (5-6) for pain, 5.2 (4–6) for movement and 5.3 (4–6) for mobility. Migration of acetabular component was seen in four hips. Acetabular radiolucencies were present in 54 hips (9.7%). The mean linear polythene wear was 0.06mm/year. Mean inclination was 48.4° (38–65).

Radiolucencies were present around 37 (6.6%) stems. Dislocation occurred in 10 patients (three recurrent). Re-operations were performed in nine patients (1.9%). Four acetabular revisions were performed for aseptic loosening. Other re-operations were for infection (three), periprosthetic fractures (one), cup malposition (one) and revision of worn liner (three). Mean EQ-5D description scores and health thermometer scores were 0.81 (0.71–0.89) and 86 (64–95). With an end point of definite or probable loosening, the probability of survival at 12 years was 97.1% for acetabular component. Overall survival at 12 years with removal or repeat revision of either component for any reason as the end point was 96.2%.

The results of this study support the continued use of a fully coated prosthesis and documents the durability of the HAC coated components. In our clinical experience, the Furlong prosthesis revealed encouraging radiographic stability over a long-term period.


Orthopaedic Proceedings
Vol. 94-B, Issue SUPP_IV | Pages 80 - 80
1 Mar 2012
Raman R Eswaramoorthy V Dickson D Madhu T Angus P
Full Access

Introduction

We aim to report the clinical and radiological outcome of consecutive primary hip arthroplasties using the JRI-Furlong HAC coated femoral and acetabular components.

Methods

We reviewed 586 consecutive cementless primary THA in 542 patients, with a minimum 12-year follow-up to 18 years, performed at one institution between 1986 and 1994. Twenty eight (32 THA) were lost to follow-up. Clinical outcome was measured using Harris, Charnley and Oxford scores. Quality of life using EuroQol EQ-5D. Radiographs were systematically analysed.


Orthopaedic Proceedings
Vol. 93-B, Issue SUPP_III | Pages 281 - 282
1 Jul 2011
Thompson GH Dickson D Poe-Kochert C Son-Hing JP Armstrong DG
Full Access

Purpose: Determine if one or two pairs of pedicle screws were superior to multiple laminar hooks for the distal foundation segmental in spinal instrumentation (SSI) in the surgical correction of AIS.

Method: We analyzed 108 consecutive patients identi-fied from our Pediatric Orthopaedic Spine Database (1992–2005) that underwent a posterior spinal fusion (PSF) and segmental spine instrumentation (SSI). There were 3 patient groups: Group 1, one pair of pedicle screws for the distal foundation (n=12); Group 2, two or more pairs of pedicle screws (n=44) and Group 3, multiple hooks only (n=52). The mean age at surgery was 13.5 years, 14.1 years, and 13.0 years, respectively. The major curve was measured perioperatively and at one month, 6 months, 12 months, and 24 months postoperatively and the mean percentage of correction, as well as loss of correction determined. We also analyzed the length of surgery (hours), length of hospitalization and complications.

Results: The mean preoperative major curve was 52.5 degrees in Group 1, 52. degrees in Group 2, and 48.8 degrees in Group 3. The mean percent postoperative correction (POC%) at 1 month was 67.2, 65.2, and 63.4 % in the 3 groups, respectively (p=0.531). The mean percent post-operative correction (POC%) at 24 month was 55.6% for Group 1, 56.6% for Group 2 and 51.5% for Group 3 (p=0.478). The mean percent loss of correction (LOC%) at 24 months was 3.1%, 2.25%, and 2.9% respectively(p=0.648). One-way ANOVA demonstrated no significant differences in patient age, number of levels fused, length of surgery, or length of hospital stay. There were no implant related complications.

Conclusion: Hybrid constructs with one or more pairs of pedicle screws and all-hook constructs for distal foundations in SSI provided similar major curve correction, percentage postoperative correction, and are associated with a minimal loss of correction postoperatively. There was no significant difference between length of surgery, hospital stay or complications.


Orthopaedic Proceedings
Vol. 91-B, Issue SUPP_I | Pages 2 - 2
1 Mar 2009
Raman R Eswaramoorthy V Dickson D Angus P
Full Access

Aim: To report the clinical and radiological outcome of consecutive primary hip arthroplasties using the JRI-Furlong Hydroxyapatite ceramic (HAC) coated femoral and acetabular components

Methods: We reviewed 586 consecutive cementless primary THA using HAC coated components in 542 patients, with a minimum 12-year follow-up to 18 years, performed at one institution between 1986 and 1994. Twenty eight (32 THA) were lost prior to 12-year follow-up, leaving 514 patients (554 THA) available for study. Threaded cups were used in 64% and press-fit cups with screws in the rest. Fully HAC coated stems were used in all patients. The clinical outcome was measured using Harris, Charnley and Oxford hip scores. Anterior thigh pain was quantified on a visual analogue scale (VAS) and quality of life using EuroQol EQ-5D. Radiographs were systematically analysed for implant position, loosening, migration, osteolysis and stress shielding. Polythene wear was digitally measured. The radiographic stability of the femoral component was determined by Enghs criteria

Results: The mean age was 75.2 yrs. Dislocation occurred in 12 patients (3 recurrent). Re operations were performed in 11 patients (1.9%). Four acetabular and one stem revisions were performed for aseptic loosening. Other re-operations were for infection (2), periprosthetic fractures (2), cup malposition (1), revision of worn liner (2). The mean Harris and Oxford scores were 89 (79–96) and 18.4 (12–32) respectively. The Charnley score was 5.7 (5–6) for pain, 5.3 (4–6) for movement and 5.4 (4–6) for mobility. Migration of acetabular component was seen in 4 hips. Acetabular radiolucencies were present in 54 hips (9.7%). The mean linear polythene wear was 0.06mm/year. Stable stem by bony ingrowth was identified in all hips excluding one femoral revision case. Mean stem subsidence was 2.2mm (0.30–3.4mm). Radiolucencies were present around 37 (6.6%) stems. Mean EQ- 5D description scores and health thermometer scores were 0.81 (0.71–0.89) and 86 (64–95). With an end point of definite or probable loosening, the probability of survival at 12 years was 96.1% for acetabular and 98.3% for femoral components. Overall survival at 12 years with removal or repeat revision of either component for any reason as the end point was 97.2%.

Conclusion: The results of this study support the continued use of a fully coated prosthesis and documents the durability of the HAC coated components. In our clinical experience, the Furlong prosthesis revealed encouraging radiographic stability over a long term period.