Background. Published simulator studies for metal/UHMWPE bearings couples showed that increasing the femoral head diameter by 1 mm increases wear by approximately 10% due to increased contact area. Therefore, there are concerns about increased wear with
Aims. Instability remains a challenging problem in both primary and
revision total hip arthroplasty (THA).
Aims. Prior studies have identified that malseating of a modular
Dislocation and instability remain leading cause of failure following THA. We present a single-surgeon 10-year experience with use of
Dislocation is still one of the more common reasons for revision of THR.Registry and large institutional data has demonstrated the effectiveness of
Aims.
Background.
In metal-on-metal (MoM) hip replacements or resurfacings, mechanical induced corrosion can lead to a local inflammatory response, pseudo tumours and elevated serum metal ions, requiring revision surgery. The size and diametral clearance of Anatomic (ADM) and Modular (MDM)
Dislocation remains among the most common complications of, and reasons for, revision of both primary and revision total hip arthroplasties in the United States. We have advocated identifying the primary cause of instability to plan appropriate treatment (Wera, Della Valle, et al., JOA 2012). Once implant position, leg length, and offset have been optimised and sources of impingement have been removed, the surgeon can opt for a large femoral head, a
Introduction. Enhanced stability using
Introduction. Patients undergoing primary total hip arthroplasty (THA) with prior lumbar spine fusion (LSF) are at high risk for instability with reported incidence of dislocation as high as 8.3%. The use of
Treatment of recurrent dislocation: approximately: 1/3 of failures (probably higher in the absence of a clear curable cause). In the US: most popular treatment option: constrained liners with high redislocation and loosening rates in most reports. Several interfaces leading to various modes of failures. In Europe:
Introduction. Dual-mobility bearings increase the stable range of motion of total hip arthroplasty (THA) but are limited by the mechanical effects of a large diameter metal on polyethylene bearing which may cause high rates of wear from the surfaces of the polyethylene bearing and the head-stem taper. Improved polyethylene (PE) has reduced concern over bearing wear but the effects on the taper junction are unknown. We aimed to better understand the effect of
Aims.
Modular
In primary total hip replacements there are numerous options available for providing hip stability in difficult situations (i.e. Down's syndrome, Parkinson's disease). However, in the revision situation in general and in revision for recurrent dislocation specifically, it is important to have all options available including
Constrained liners are a tantalizing solution to both prevent and treat instability, as they markedly increase the force needed for a dislocation to occur. They have, however, several important negatives that the surgeon must consider before entertaining their use including: Increased stresses at the implant bone interface which can increase the risk of loosening or cause catastrophic failure in the early post-operative period; Decreased range of motion with a greater risk of impingement; and Usually require an open reduction if they dislocate or otherwise fail. Given the limitations of constrained liners, we have looked to
Background:.
In primary total hip replacements there are numerous options available for providing hip stability in difficult situations i.e. Down's syndrome, Parkinson's disease. However, in the revision situation, in general, and in revision for recurrent dislocation situations specifically, it is important to have all options available including
Introduction. Reoperations to manage unstable total hip arthroplasty are reported with a high failure rate. The
National Institute of Clinical Excellence (NICE) recommended total hip replacement (THR) surgery for fit patients with fracture neck of femur (NOF) in 2011. Our hospital implemented hip fracture program to follow these recommendations the same year. However, the increased incidence of further procedures compared with those undergoing the THR for osteoarthritis alone has led to concern regarding dislocation and other complications when using THR treatment for fracture NOF particularly with the posterior approach. We introduced
Aims. Dislocation is the most common indication for further surgery following total hip arthroplasty (THA) when undertaken in patients with a femoral neck fracture. This study aimed to assess the complication rates of THA with
Although the incidence of total hip dislocation has decreased, it still remains a major problem particularly if recurrent. The actual incidence is around 1–2% but it has been documented as the leading cause for hip revision in the United States. In patients with recurrent hip dislocation, technical issues of leg length inequality, incorrect offset, and poor implant position should be addressed surgically and the abnormality corrected. In patients with recurrent hip dislocation, the articulation is preferably converted to a more stable articulation, with constrained sockets and
Dislocation is a particular problem after total hip replacement in femoral neck fractures and elderly, especially female, patients. The increased rate of dislocation in this population is probably due to significant ligamentous laxity in these patients and poor coordination and proprioception. Another population of patients with increased propensity for dislocation is the revision hip replacement patient. Current dislocation rates in these patients can approach 10% with conventional implant systems. The
Aims. This combined clinical and in vitro study aimed to determine the incidence of liner malseating in modular
Instability continues to be a troublesome complication after THA and has been reported to be the main indication for revision in the United States, accounting for 22.5% of revisions. Risk factors associated with dislocation include: age of 75 years or older, body mass index (BMI) of 30 kg/m2 or greater, alcohol abuse, and neuro-degenerative diseases such as multiple sclerosis or Parkinson's disease. Dual-mobility articulations have become an increasingly popular option for these “at risk” primary THAs. Few studies have assessed their use in this complex patient population. The purpose of this study was to assess dislocation rate, radiographic outcomes and complications of the dual-mobility articulation in the setting of primary THA for patients at high risk for dislocation at a minimum follow up of 2 years. We retrospectively reviewed 151
Aims. Modular
Although the incidence of total hip dislocation has decreased, it still remains a major problem particularly if recurrent. The actual incidence is around 1–2% but it has been documented as the leading cause for hip revision in the United States. In patients with recurrent hip dislocation, technical issues of leg length inequality, incorrect offset, and poor implant position should be addressed surgically and the abnormality corrected. In patients with recurrent hip dislocation, the articulation is preferably converted to a more stable articulation, with constrained sockets and
Background. Instability and dislocation are some of the most important postoperative complications and potential causes of failure that dual mobility total hip arthroplasty (THA) systems continue to address. Studies have shown that increasing the relative head size provides patients implanted with smaller and larger cups increased stability, greater ROM and a lesser incidence of impingement, without compromising clinical results. The purpose of the current study was to review clinical outcomes in three groups of primary THA patients receiving a
Introduction. The rapidly expanding aging population in the UK are living longer than ever before, which is reflected by the rising number of relatively fit and healthy people that sustain fracture NOF (neck of femur). According to current NICE (National institute for health clinical excellence) guidelines a large proportion of fracture NOF patients meet the requirements to have a total hip arthroplasty (THA) for this injury. Dislocation rate of THA can be as high as 20% for patients with fracture NOF, which is a disastrous complication in these vulnerable patients. Numerous techniques have been adopted to minimise the risk of dislocation. The use of
Dislocation remains one of the most common complications after total hip arthroplasty. Precise cup position appears to be a main factor as significant variations occur for frontal and sagittal acetabular tilt and anteversion according to sitting or standing positions. An innovative
Studies have indicated that the shallow Ultra High Molecular Weight Polyethylene (UHMWPE) acetabular socket or the socket with no head center inset can significantly increase the risk of hip joint dislocation. A previous study suggested the rim loading model in UHMWPE socket and metal femoral head can generate an intrinsic dislocating force component pushing head out of socket. Recently there has been renewed interest in
The main causes of total hip arthroplasty (THA) revisions are loosening and instability. Use of a
Introduction. Cementless acetabular fixation in total hip replacement (THA) is reliable and has been the fixation method of choice in the United States for decades. While revision for failure of osseointegration or early loosening is relatively rare, recurrent dislocation remains a leading cause of early revision. Novel acetabular implants and those offered by smaller companies often lack constrained or
Introduction. The published results of the use of a
Background. Revision surgery for failed metal-on-metal (MOM) total hip arthroplasty (THA) or hip resurfacing (HR) has been a challenge. Previous studies have reported high failure and complication rates, including dislocation, infection, aseptic loosening and lower patient satisfaction. Options for revision depend on the integrity and stability of the femoral and acetabular components. When both components fail, full revision is required; however, when the acetabular component remains well fixed and oriented, only the isolated femoral component revision can be performed.
Introduction. Postoperative dislocation remains a vexing problem for patients and surgeons following total hip arthroplasty (THA). It is the commonest reason for revision THA in the US.
Aims. Dislocation remains a significant complication after total hip arthroplasty (THA), being the third leading indication for revision. We present a series of acetabular revision using a
Introduction. The