To evaluate the effect of hydroxyapatite coating, two same shape cementless stems were compared in this randomized control trial study. Between May 2003 and February 2010, 88 patients had a primary cementless total hip arthroplasty with two different types of cementless stems. Forty-three patients had Proarc stems (P group) (Kyocera Medical, Osaka, Japan), and Forty-five patients had Proarc HA stems (HA group) (Kyocera Medical, Osaka, Japan) which was coated with thin (20 micrometer) hydroxyapatite on Proarc rough porous coating. Gender distribution, average age at surgery, average weight and average follow-up period were same in the two groups. The average follow-up period was 8.5 years (range, 5 to 13 years). The average age at the time of surgery was 63 years. Porous acetabular shells and highly crosslinked polyethylene liners made by Kyocera Medical corporation were implanted into all hips. Stems were implanted with a modified Hardinge surgical approach without trochanteric osteotomy. Harris Hip Score was used for clinical evaluation. Post-op radiographs of these patients were evaluated. Fisher's exact probability test was used for statistical analysis. P values of less than 0.05 were considered to be significant.Introduction
Methods
Deformity after femoral osteotomy varies between patients. Some researchers reported good results when using cemented stems for the hips after femoral osteotomy, but there are many disadvantages that obstruct ideal fixation using cemented stems. Therefore, we developed cementless custom-made stems and inserted those using a computed tomography (CT) –based navigation system Eighteen dysplastic hips of 15 patients after intertrochanteric osteotomy were investigated in the present study. Individual computed tomography data were used to manufacture cementless custom-made femoral stems out of Ti-6Al-4V. The proximal 1/3 of each stem was coated using porous coating covered with hydroxyapatite coating. The stems were inserted using a CT-based fluoro navigation system for accuracy of insertion. The average patient age at time of surgery was 66 years, and the average follow-up period was 3.5 years.Introduction
Methods
Hemophilia arthropathy often occurs in the ankle, knee and elbow. In contrast, hemophilic arthropathy in the hip is rare. We report short-term results of total hip arthroplasty (THA) in patients with hemophilia. Four primary THAs performed in four hemophilic patients from 2007 to 2015 were reviewed retrospectively. Two patients underwent cementless THA, and two patients had cemented THA. All patients had hemophilia A, and clotting factor replacement was performed perioperatively. Blood loss, surgery duration, complications, pre- and post-operative range of motion, and the pre- and post-operative Japanese Orthopedic Association (JOA) score were assessed.Introduction
Method
We recommended an early discharge if rheumatoid patients who had undergone arthroplasty could easily walk around a flat barrier-free corridor as we had a financial motive to increase the circulation rate of patients. Unfortunately, after this discharge, two of our patients fell down in their home, one breaking her leg. So we began to ask our patients to use medical pole walking, which they learned during rehabilitation, after being discharged. There were two male and six female rheumatoid arthritis patients, with an average of 64. We required them to train in medical pole walking five times a week, 20 minutes a day for about 4–6 weeks until they were discharged. We checked for mobility, physical strength and flexibility. After one year of medical pole walking, two patients can play golf and one patient can visit many famous places in Japan with her sister without the assistance of a cane. At the point of 1 year after arthroplasty their time of with medical pole walking and T cane walking or free walking was improved about 5 seconds compared to the point 4 weeks after surgery. Chair stand test after 1 year medical pole walking exercise was much improved than after 4 weeks after arthroplasty.
To utilize existing cancellous bone for initial stability, custom-made stems were implanted without reaming and rasping. This study reviewed the results of this non-reaming technique. One hundred and fifty-three hips (138 patients) were followed-up for an average of 12 years (range, 8 to 18). Average age at the surgery was 59 (range, 19 to 78). Seventy percent of the etiologies were dysplastic hips including 17 hips after femoral osteotomy. The Ti-6Al-4V stems were designed using CT data and directly inserted into the femora without reaming and rasping. The stems were coated with hydroxyapatite on the porous coating at proximal 1/3. Harris hip score was used for clinical evaluation.Introduction
Methods
