The primary outcome was investigating differences in wear, as measured by femoral head penetration, between cross-linked vitamin E-diffused polyethylene (vE-PE) and cross-linked polyethylene (XLPE) acetabular component liners and between 32 and 36 mm head sizes at the ten-year follow-up. Secondary outcomes included acetabular component migration and patient-reported outcome measures (PROMs) such as the EuroQol five-dimension questionnaire, 36-Item Short-Form Health Survey, Harris Hip Score, and University of California, Los Angeles Activity Scale (UCLA). A single-blinded, multi-arm, 2 × 2 factorial randomized controlled trial was undertaken. Patients were recruited between May 2009 and April 2011. Radiostereometric analyses (RSAs) were performed from baseline to ten years. Of the 220 eligible patients, 116 underwent randomization, and 82 remained at the ten-year follow-up. Eligible patients were randomized into one of four interventions: vE-PE acetabular liner with either 32 or 36 mm femoral head, and XLPE acetabular liner with either 32 or 36 mm femoral head. Parameters were otherwise identical except for acetabular liner material and femoral head size.Aims
Methods
The aim of this study was to determine whether there is a difference
in the rate of wear between acetabular components positioned within
and outside the ‘safe zones’ of anteversion and inclination angle. We reviewed 100 hips in 94 patients who had undergone primary
total hip arthroplasty (THA) at least ten years previously. Patients
all had the same type of acetabular component with a bearing couple
which consisted of a 28 mm cobalt-chromium head on a highly crosslinked
polyethylene (HXLPE) liner. A supine radiostereometric analysis
(RSA) examination was carried out which acquired anteroposterior
(AP) and lateral paired images. Acetabular component anteversion
and inclination angles were measured as well as total femoral head
penetration, which was divided by the length of implantation to
determine the rate of polyethylene wear.Aims
Patients and Methods
We report a multicentre prospective consecutive
study assessing the long-term outcome of the proximally hydroxyapatite
(HA)-coated ABG II monobloc femoral component in a series of 1148
hips in 1053 patients with a mean age at surgery of 64.77 years
(22 to 80) at a mean follow-up of 10.84 years (10 to 15.25). At
latest follow-up, the mean total Harris hip score was 94.7 points
( Cite this article:
Total hip replacement (THR) is a very common
procedure undertaken in up to 285 000 Americans each year. Patient
satisfaction with THR is very high, with improvements in general
health, quality of life, and function while at the same time very
cost effective. Although the majority of patients have a high degree
of satisfaction with their THR, 27% experience some discomfort,
and up to 6% experience severe chronic pain. Although it can be
difficult to diagnose the cause of the pain in these patients, this
clinical issue should be approached systematically and thoroughly.
A detailed history and clinical examination can often provide the
correct diagnosis and guide the appropriate selection of investigations, which
will then serve to confirm the clinical diagnosis made. Cite this article:
This conversation represents an attempt by several
arthroplasty surgeons to critique several abstracts presented over
the last year as well as to use them as a jumping off point for trying
to figure out where they fit in into our current understanding of
multiple issues in modern hip and knee arthroplasty.
Digital templating in hip replacement is commonly performed with radiological markers to determine the magnification. The latter can also be determined by measuring the distance from the x-ray focal spot to the object and the distance from the x-ray focal spot to the radiological cassette or image receptor. We used post-operative radiographs of total hip replacements and hemiarthroplasties from 22 patients to calculate the magnification using both methods. The accuracy of each method was ascertained by measuring the size of the head of the implant projected on to the radiographs and comparing the result with the known size recorded in the medical records. The accuracy was found to be similar with a mean absolute measurement error of 2.6% ( We conclude that the distance measuring method is as accurate as the radiological marker method, but may avoid some of the disadvantages such as misplacement of the marker or placement outside the radiological field. It may also be more acceptable to the patient and radiographer.
