Potential implant and technique related factors to improve patellofemoral (PF) kinematics in total knee arthroplasty (TKA) are design of trochlear geometry and patella, restoration of posterior offset, patellar tilt and avoid overstuffing. The primary aim of this prospective, matched pair study was to assess the radiographic features of PF kinematics with an anatomic patella. Between July 2012 and May 2013, 49 consecutive posterior stabilized cemented Attune TKAs (Depuy Synthes Warsaw Indiana) were matched to the 49 PFC Sigma (Depuy) based on age, gender, and body mass index (BMI). All surgeries were performed via medial parapatellar approach with patellar resurfacing. Radiographic analysis was performed prospectively with minimum 1-year follow-up and included overall limb alignment, anterior offset, posterior offset, joint line, patellar thickness, patellar tilt and patellar displacement by two independent observers.Introduction
Material and Methods
Total hip arthroplasty (THR) with non-cemented or hybrid fixation remains one of the most successful procedures performed today. The aim of this study was to assess the safety and efficacy of a hydroxyapatite (HA) coated, hemispherical cup. Between 2003 and 2007, 223 THAs (210 patients) with peripheral self-locking (PSL) cup and highly cross-linked polyethylene (Crossfire, Stryker, Mahwah, NJ) with minimum 5 years clinical and radiographic follow-up (5–9 years) were analyzed. The mean age was 62.5 years ± 10.8 (range, 32.7 – 86.3) at the time of surgery and the predominant preoperative diagnoses was osteoarthritis (97.8%). 72% were solid cups without screw augmentation and 28% were multi-hole with screw. Clinical analysis included Hospital for Special Surgery (HSS) hip scores at latest follow-up. Detail radiographic analysis was carried out on anteroposterior and false profile views for evidence of osseointegration in all Charnley's zones. Osseointegration was assessed based on presence of Stress Induced Reactive Cancellous Bone (SIRCaB) with trabecular bone hypertrophy 5–15mm extending from the cup, and absence of radiolucency or demarcation. EBRA software was used to assess cup positioning.Introduction
Material and Methods
Highly cross-linked polyethylene (HCLPE) was introduced to reduce wear and osteolysis in total hip arthroplasty (THA). There is no reported data regarding wear rates and clinical performance of Crossfire HCLPE (Stryker, Mahwah, New Jersey) in young and active patients. The purpose of this prospective study is to assess minimum 10-year wear rates and survivorship of Crossfire in young and active patients. Between January 2001 to December 2003, 52 consecutive THAs (43 patients; 26 males and 17 females), 55 years and younger, with an average University of California Los Angeles activity (UCLA) score of 7.3 ± 1.5 (5 – 10) at the time of surgery were prospectively followed. The mean age of patients was 47.4 ± 7.8 years old (range 24 to 55 years). Indication for surgery included osteoarthritis in all cases. All operations were performed by the senior surgeon via a posterolateral approach. All components were non-cemented SecurFit femoral stem, 28 mm Cobalt-Chromium (Co-Cr) femoral head, and Trident PSL cup with Crossfire HCLPE acetabular liner (Stryker, Mahwah, New Jersey). At minimum 10-years follow-up (mean 11.5 ± 0.94 years), wear rates were assessed using the Roman software. Hospital for Special Surgery (HSS) scores and survivorship data were analyzed.Background
Material and Methods