Isolated acetabular liner exchange with a highly crosslinked polyethylene (HXLPE) component is an option to address polyethylene wear and osteolysis following total hip arthroplasty (THA) in the presence of a well-fixed acetabular shell. The liner can be fixed either with the original locking mechanism or by being cemented within the acetabular component. Whether the method used for fixation of the HXLPE liner has any bearing on the long-term outcomes is still unclear. Data were retrieved for all patients who underwent isolated acetabular component liner exchange surgery with a HXLPE component in our institute between August 2000 and January 2015. Patients were classified according to the fixation method used (original locking mechanism (n = 36) or cemented (n = 50)). Survival and revision rates were compared. A total of 86 revisions were performed and the mean duration of follow-up was 13 years.Aims
Methods
The aim of this study was to evaluate the survival of a collarless, straight, hydroxyapatite-coated femoral stem in total hip arthroplasty (THA) at a minimum follow-up of 20 years. We reviewed the results of 165 THAs using the Omnifit HA system in 138 patients, performed between August 1993 and December 1999. The mean age of the patients at the time of surgery was 46 years (20 to 77). Avascular necrosis was the most common indication for THA, followed by ankylosing spondylitis and primary osteoarthritis. The mean follow-up was 22 years (20 to 31). At 20 and 25 years, 113 THAs in 91 patients and 63 THAs in 55 patients were available for review, respectively, while others died or were lost to follow-up. Kaplan-Meier analysis was performed to evaluate the survival of the stem. Radiographs were reviewed regularly, and the stability of the stem was evaluated using the Engh classification.Aims
Methods
We investigated whether strontium-enriched calcium
phosphate cement (Sr-CPC)-treated soft-tissue tendon graft results
in accelerated healing within the bone tunnel in reconstruction
of the anterior cruciate ligament (ACL). A total of 30 single-bundle
ACL reconstructions using tendo Achillis allograft were performed
in 15 rabbits. The graft on the tested limb was treated with Sr-CPC,
whereas that on the contralateral limb was untreated and served
as a control. At timepoints three, six, nine, 12 and 24 weeks after
surgery, three animals were killed for histological examination.
At six weeks, the graft–bone interface in the control group was
filled in with fibrovascular tissue. However, the gap in the Sr-CPC
group had already been completely filled in with new bone, and there
was evidence of the early formation of Sharpey fibres. At 24 weeks,
remodelling into a normal ACL–bone-like insertion was found in the
Sr-CPC group. Coating of Sr-CPC on soft tissue tendon allograft
leads to accelerated graft healing within the bone tunnel in a rabbit
model of ACL reconstruction using Achilles tendon allograft. Cite this article:
Arthrodesis of the hip has been employed since the late 19th century. Late complications can arise decades after fusion in patients who were previously asymptomatic. We describe two patients who developed pain in the hip many years after a successful fusion. There was no infection or loosening of the implants. After careful investigation, including oblique radiographs and diagnostic injections of local anaesthetic, the pain was found to be caused by protrusion of the implant. Subsequent removal of the device resulted in complete resolution of the symptoms.
We have investigated the errors in the identification of the transepicondylar axis and the anteroposterior axis between a minimally-invasive and a conventional approach in four fresh-frozen cadaver knees. The errors in aligning the femoral prosthesis were compared with the reference transepicondylar axis as established by CT. The error in the identification of the transepicondylar axis was significantly higher in the minimal approach (4.5° of internal rotation,