Aims.
We describe the results of Copeland
Surface hip replacement (SHR) is generally used
in younger, active patients as an alternative conventional total
hip replacement in part because of the ability to preserve femoral
bone. This major benefit of
Fractures of the proximal humerus can lead to malalignment of the humeral head, necrosis and post-traumatic osteoarthritis. In such cases
There has been a renewed interest in
Purpose:
Introduction: Shoulder
Cementless
Introduction: Glenohumeral arthritis with a massive rotator cuff tear is a devastating condition that seriously compromises the comfort and function of the shoulder. Cuff tear arthropathy presents a unique surgical challenge and many arthroplasty options were used for its treatment. The purpose of this study was to evaluate the clinical and radiological results of Copeland cementless
Avascular necrosis (AVN) of the humeral head is an extremely disabling condition (Gerber et al, JSES 1998. 7(6):586–90). The results of stemmed arthroplasty for this condition are good, with Hattrup and Cofield reporting 79% subjective improvement at nine years (JSES 2000;9:177–82). This study reports the outcomes of
The Copeland Shoulder Arthroplasty is a cementless, pegged humeral head
Introduction: There is an increasing interest in
The Articular
Introduction: Rheumatoid arthritis often leads to severe destruction of the glenohumeral joint including synovitis and inflammation induced alterations of the rotator cuff. Cup arthroplasty, or
Copeland
The classic Hill-Sachs lesion is a compression or impression fracture of the humeral head in occurrence with anterior glenohumeral instability. The true incidence is unknown but clearly increases with recurrent instability episodes. Recent peer-reviewed literature has highlighted the importance of addressing “significant” humeral and glenoid bone defects in the management of glenohumeral instability. Quantification of the “significance” of a Hill-Sachs lesion with regard to location, size, and depth in relation to the glenoid has helped guide indications for surgical management. Options for managing Hill-Sachs lesions include both humeral-sided techniques (soft tissue, bone, and/or prosthetic techniques) and also glenoid-sided techniques (bone transfers to increase glenoid width). The majority of significant acute or chronic Hill-Sachs lesions can be effectively managed without prosthetic replacement. Is a prosthetic
Introduction:
Aims. Our first aim was to determine whether there are significant
changes in the level of metal ions in the blood at mid-term follow-up,
in patients with an Articular
Biologic resurfacing of the glenoid combined with
Total hip arthroplasty (THA) is among the most successful interventions in all of medicine and has recently been termed “The Operation of the Century”. Charnley originally stated that “Objectives must be reasonable. Neither surgeons nor engineers will ever make an artificial hip joint that will last 30 years and at some time in this period enable the patient to play football.” and he defined an appropriate patient as generally being over 65 years of age. Hip rating scales developed during this time were consistent with this approach and only required relief of pain and return to normal activities of daily living to achieve a perfect score. Since this time, however, hip arthroplasty has been applied to high numbers of younger, more active individuals and patient expectations have increased. One recent study showed that in spite of a good hip score, only 43% of patients had all of their expectations completely fulfilled following THA. The current generation metal-metal hip
Total hip arthroplasty is among the most successful interventions in all of medicine and has recently been termed “The Operation of the Century”. Charnley originally stated that “Objectives must be reasonable. Neither surgeons nor engineers will ever make an artificial hip joint that will last 30 years and at some time in this period enable the patient to play football.” and he defined appropriate patient as generally being over 65 years of age. Hip rating scales developed during this time were consistent with this approach and only required relief of pain and return to normal activities of daily living to achieve a perfect score. Since this time, however, hip arthroplasty has been applied to high numbers of younger, more active individuals and patient expectations have increased. One recent study showed that in spite of a good hip score, only 43% of patients had all of their expectations completely fulfilled following THA. The current generation metal-metal hip
Purpose: The presence of metal ions in the blood of patients with a metal-on-metal (MM) bearing points to the importance of understanding the long-term effects of these ions. Metal ions have the potential to induce the production of reactive oxygen species (ROS), making them prime suspects for inducing molecular damage in circulating cells. The aim of this study was to analyze the levels of oxidative stress markers in the plasma of patients with hip
We present the early clinical and radiological results of Articular
Introduction: Metal-metal (MM)
Hill-Sachs and reverse Hill-Sachs lesions come in different shapes and sizes, and their effect on “glenoid track” can vary. Small Hill-Sachs lesions that do not engage can be successfully treated with a Bankart repair alone done arthroscopically or open. Moderate, engaging, Hill-Sachs lesions can be treated either with the addition of remplissage to an arthroscopic Bankart or by adding the triple blocking effect of the Bristow-Latarjet procedure.
We evaluated the concentrations of chromium and cobalt ions in blood after metal-on-metal
Metal-metal
Hip resurfacing is widely recognised as a bone conserving procedure with respect to proximal femoral resection. However, it has been argued that this is not the case for the acetabulum due to the thickness of the acetabular component and the large diameter bearing surfaces. We have investigated whether the Birmingham Hip is a bone conserving procedure with respect to the acetabular bone stock. Data was obtained from 257 consecutive Midland Medical Technology (MMT)
The aim of this study was to assess the medium-term results of the Copeland cementless
The Hill-Sachs lesion is a bony defect of the humeral head that occurs in association with anterior instability of the glenohumeral joint. Hill-Sachs lesions are common, with an incidence approaching nearly 100% in the setting of recurrent anterior glenohumeral instability. However, the indications for surgical management are very limited, with less than 10% of anterior instability patients considered for treatment of the Hill-Sachs lesion. Of utmost importance is addressing bone loss on the anterior-inferior glenoid, which is highly successful at preventing recurrence of instability even with humeral bone loss. In the rare situation where the Hill-Sachs lesion may continue to engage the glenoid, surgical management is indicated. Surgical strategies are variable, including debridement, arthroscopic remplissage, allograft transplantation,
It has been proposed that a major advantage of
Purpose: The purpose of the study was to evaluate the clinical and radiological results of Copeland cementless
Introduction. Studies of metal-on-metal (MoM) hip resurfacing arthroplasty (HRA) have reported high complication and failure rates due to elevated metal ion levels. These rates were shown to be especially high for the Articular
Considerable controversy remains in the literature as to whether hemiarthroplasty or total shoulder arthroplasty (TSA) is the better treatment option for patients with shoulder arthritis. Several cohort studies have compared the outcomes of stemmed hemiarthroplasty with those of stemmed TSA and had inconsistent conclusions as to which procedure is best. However, these studies suggest that stemmed TSA provided better functional outcome. 340 CSRA cases were performed between 1987–2003, 218 Hemiarthroplasty – Humeral Surface Arthroplasty (HSA) and 122 TSA. There was very little difference in the functional outcome and pain in patients with and without a glenoid implant early, as well as, later after surgery. Mean post-operative Constant score for TSA was 85.0% (59.8 points) and for HSA patients 86.8% (62.3 points) with no statistically significant differences (t-test, p=0.4821). A highly significant difference between the overall proportions of revised cases was observed, with (21/122) 17.2% and (6/218) 2.8% of TSA and HSA cases revised, respectively (p<
0.0001). Further, HSA prostheses survive significantly longer than TSA prostheses. The difference between the survival curves was highly significant, both in the earlier post-operative period (Wilcoxon’s test, p=0.0053) as well as the later on (Log-rank test, p=0.0028). Long-term survival of total joint replacement is related to polyethylene wear debris, and therefore its use should be avoided if possible. The difference between our series and those with stemmed prostheses may be due to the fact that with
Cementless
The Hill-Sachs lesion is a bony defect of the humeral head that occurs in association with anterior instability of the glenohumeral joint. Hill-Sachs lesions are common, with an incidence approaching nearly 100% in the setting of recurrent anterior glenohumeral instability. However, the indications for surgical management are very limited, with less than 10% of anterior instability patients considered for treatment of the Hill-Sachs lesion. Of utmost importance is addressing bone loss on the anterior-inferior glenoid, which is highly successful at preventing recurrence of instability even with humeral bone loss. In the rare situation where the Hill-Sachs lesion may continue to engage the glenoid, surgical management is indicated. Surgical strategies are variable, including debridement, arthroscopic remplissage, allograft transplantation,
Aim: To compare the strain pattern in intact and resurfaced femurs with and without abductor force using validated third generation composite femurs and rosette strain gauges. Methods: Rosette strain gauges were applied to an intact and a resurfaced third generation composite femur at three sites; narrowest part of the lateral surface of the neck, narrowest part of the medial surface of the neck and medial surface at the level of lesser trochanter. The femurs were loaded with axial loads of 600N, 800N and 1000N sequentially. The tests were repeated thrice for each femur. Maximum and minimum principal strains were calculated. Further tests were carried out in which an abductor load was included in the model. Testing was done at 600N and repeated thrice for each femur. The principal strains were calculated and compared with the principal strains without the abductor load. Results: The maximum principal strains in the resurfaced femur were approximately 50% higher in the lateral surface of the neck and about 30% higher in the lesser trochanteric region when loaded without including an abductor force. Inclusion of the abductor force decreased the strain particularly at the lateral surface of the neck by approximately 45% in the intact femur and approximately 25% in the implanted femur. Even with the inclusion of the abductor load, the strain in the resurfaced femur remained more than 50% higher at the lateral surface of the neck and 20% higher in the lesser trochanteric region. Conclusion: Our study suggests that proximal femoral stress protection will not occur following
Purpose: Precise biomechanical reconstruction of the hip joint by a hip arthroplasty is essential for the success of this procedure. With the increasing use of
Total hip arthroplasty is among the most successful interventions in all of medicine and has recently been termed “The Operation of the Century”. Charnley originally stated that “Objectives must be reasonable. Neither surgeons nor engineers will ever make an artificial hip joint that will last 30 years and at some time in this period enable the patient to play football.” and he defined the appropriate patient as generally being over 65 years of age. Hip rating scales developed during this time were consistent with this approach and only required relief of pain and return to normal activities of daily living to achieve a perfect score. Since this time, however, hip arthroplasty has been applied to high numbers of younger, more active individuals and patient expectations have increased. One recent study showed that in spite of a good hip score, only 43% of patients had all of their expectations completely fulfilled following THA. The current generation of metal-metal hip
Fifteen patients with rheumatoid arthritis had 19 elbow arthroplasties with the Wadsworth type of
We evaluated the results of Cementless
Heterotopic ossification (HO) occurs commonly after total hip arthroplasty (THA). Its severe form can result in impaired range of motion with reduced functional outcome. The rate and severity of HO after hip
During the past fifty years metal hip implants have been used in orthopaedics. While these implants are considered biologically inert, several studies indicated that prosthetic implants could release metal ions following wear. The aim of this study was to evaluate serum and urine concentrations of metal ions in patients treated with hybrid
Introduction: Heterotopic ossification (HO) occurs commonly after total hip arthroplasty (THA). Its severe form can result in impaired range of motion with reduced functional outcome. The rate and severity of HO after hip
The aim of this studdy was to examine the effect of cementless
INTRODUCTION: Improved factors influencing component wear with regards to bearing surfaces, metallurgy, tribology, and manufacturing technology allowed reintroduction of metal-on-metal (MOM) articulation in total hip arthroplasty (THA) and
Introduction. A metal ion study was undertaken in patients who had received an articular
Introduction. While fixation on the acetabular side in resurfacing implants has been uncemented, the femoral component is usually cemented. The most common causes for early revision in hip resurfacing are femoral head and or neck fractures and aseptic loosening of the femoral component. Later failures appear to be more related to adverse soft-tissue reactions due to metal wear. Little is known about the effect of cementing techniques on the clinical outcome in hip resurfacing, since retrieval analysis of failed hip resurfacing show large variations. Two cementing techniques have dominated. The indirect low viscosity (LV) technique as for the Birmingham Hip resurfacing (BHR) system and the direct high viscosity (HV) technique as for the Articular