Total hip arthroplasty (THA) is one of the most successful surgical procedures; several bearing technologies have been used, however none of these is optimal. Metal on polycarbonate-urethane (PCU) is a new bearing technology with several potential advantages: PCU is a hydrophilic soft pliable implant quite similar in elasticity to human cartilage, offers biostability, high resistance to hydrolysis, oxidation, and calcification, no biodegradation, low wear rate and high corrosion resistance and can be coupled with large metal heads (Tribofit Hip System, THS). The aim of this prospective study was to report the survivorship and the clinical and radiographic outcomes and the metal ions dosage of a group of patients operated with metal on PCU arthroplasty featuring large metal diameter heads, at 5 years from surgery. 68 consecutive patients treated with the THS were included. The patients have been contacted by phone call and invited to return to our centre for clinical (Oxford Hip Score, OHS, and Harris Hip Score, HHS), radiographic exam and metal ion levels evaluation. All the patients were operated with uncemented stems.Objectives
Study Design & Methods
The aim of this study is to analysis the ability of these patients, treated with MOMHR, to resume sport activities by gait analysis and clinical evaluations. Metal on metal hip resurfacing (MOMHR) is indicated to treat symptomatic hip osteoarthritis in young active patients. These patients require a high level of function and desire to resume sport activities after surgery. 30 consecutive male patients playing high impact sports with unilateral hip osteoarthritis and normal contralateral hip were included in the study, they were treated with MOMHR by the same surgeon. No patients were lost to follow. The mean age at operation was 39.1 years (range 31 to 46). Primary diagnosis was osteoarthritis. OHS, HHS, UCLA activity score were completed at pre-operative time, six months and one year after surgery. Functionally, gait analysis was performed in all patients 6 months and one year after surgery. A stereophotogrammetric system (Smart-DX, BTS, Milano, Italy, 10 cameras, 250Hz) and two platforms (9286BA Kistler Instrumente AG, Switzerland) were used. Cluster of 4 markers were attached on the skin of each bone segment, a number of anatomical landmarks were calibrated and segment anatomical frames defined, markers were positioned by the same operator. Walking, running and squat jump were analyzed and strength and range of movement of the hips and knees were calculated.Background
Study Design & Methods
The aim of this study was to analyze the results of our series of female patients treated with <48 mm MOMHR devices at a minimum follow-up of 5 years, to understand which is the most important aspects affecting the results and to define if the metal ions dosage has to be indicated as a routinely follow-up. This is a retrospective clinical study; the cohort included 198 consecutive MOMHR implanted in 181 female patients (17 bilateral procedures). All operations were performed between 2002 and 2011. All operations were performed by the senior surgeon. Indications to MOMHR included primary or secondary osteoarthritis (OA), rheumatoid arthritis and avascular necrosis. Contraindications included poor proximal femoral bone stock (T-score<−2.5sd in BMD of the femoral neck) or severely distorted hip anatomy. All patients were advised to underwent clinical and radiological review with the operating surgeon at 5 weeks, 3, 6 and 12 months postoperatively and then every subsequent 2 years.182 patients answered to our phone calls; 4 patients died (one of them was operated bilaterally) for causes not related to the study, and in 11 cases the phone number was expired. The minimum follow-up was 5.0 years (mean 7.5, maximum 13.2, sd 0.11).Introduction
Methods
High grade hallux rigidus is a forefoot deformity characterized by a limitation of dorsiflexion of the first toe associated with pain, and severe damage of the first metatarsophalangeal joint. Most authors recommended resection arthroplasty or arthrodesis of the first metatarsophalangeal joint. The aim of this study was to present the results of our series of 42 consecutive cases of severe hallux rigidus treated by resection of the first metatarsal head and implant of a poly D-L lactic (PDLLA) bioreabsorbable spacer to promote the interposition of fibrous tissue to preserve the range of motion of the joint. Forty-two feet in 27 patients affected by high grade hallux rigidus were included in the study. Surgical treatment consisted of resection of the first metatarsal head and positioning of a poly D-L lactic acid (PDLLA) bioreabsorbable implant. Post-operative care consisted in gauze bandage of the forefoot, and immediate weight-bearing with talus shoes for 3 weeks. All patients were clinically and radiographically evaluated preoperatively and checked at a mean 6 (5–7) year follow-up.Objective
Material and methods
Combined metatarso-phalangeal and inter-phalangeal deformity represents about 1% of hallux valgus deformity, and its treatment remains a debated topic, because a single osteotomy does not entirely correct the deformity and double osteotomies are needed. The aim of this study is to review the results of 50 consecutive combined metatarso-phalangeal and inter-phalangeal hallux valgus treated by Akin proximal phalangeal osteotomy and SERI minimally invasive distal metatarsal osteotomy. Fifty feet in 27 patients, aged between 18 and 75 years (mean 42 years) affected by symptomatic hallux valgus without arthritis were included. Two 1-cm medial incisions were performed at the metatarsal neck and at proximal phalanx. Then SERI osteotomy was performed to correct metatarso-phalangeal deformity and Akin osteotomy was performed to correct interphalangeal deformity. Both osteotomies were fixed with a single K-wire. A gauze bandage of the forefoot was applied and immediate weight-bearing on hindfoot was allowed. K-wire was removed after 4 weeks. All patients were checked at a mean 4 year follow-up.Objective
Material and Methods
