Aims. To clarify the mid-term results of transposition osteotomy of the acetabulum (TOA), a type of spherical periacetabular osteotomy, combined with structural
Cartilage defects of the hip cause significant
pain and may lead to arthritic changes that necessitate hip replacement.
We propose the use of fresh osteochondral
Aims. The management of acetabular defects at the time of revision hip arthroplasty surgery is a challenge. This study presents the results of a long-term follow-up study of the use of irradiated
Femoral revision after cemented total hip replacement
(THR) might include technical difficulties, following essential cement
removal, which might lead to further loss of bone and consequently
inadequate fixation of the subsequent revision stem. . Femoral impaction
Revision arthroplasty after infection can often be complicated by both extensive bone loss and a relatively high rate of re-infection. Using
We retrospectively reviewed 40 hips in 36 patients who had undergone acetabular reconstruction using a titanium Kerboull-type acetabular reinforcement device with bone
Aims. The aim of this study was to report the medium-term outcomes of impaction bone
Iontophoresis is a novel technique which may be used to facilitate the movement of antibiotics into the substance of bone using an electrical potential applied externally. We have examined the rate of early infection in
Bone
A common situation presenting to the orthopaedic
surgeon today is a worn acetabular liner with substantial acetabular
and pelvic osteolysis. The surgeon has many options for dealing
with osteolytic defects. These include
We retrospectively reviewed 44 consecutive patients
(50 hips) who underwent acetabular re-revision after a failed previous
revision that had been performed using structural or morcellised
allograft bone, with a cage or ring for uncontained defects. Of
the 50 previous revisions, 41 cages and nine rings were used with
allografts for 14 minor-column and 36 major-column defects. We routinely
assessed the size of the acetabular bone defect at the time of revision
and re-revision surgery. This allowed us to assess whether host
bone stock was restored. We also assessed the outcome of re-revision
surgery in these circumstances by means of radiological characteristics,
rates of failure and modes of failure. We subsequently investigated
the factors that may affect the potential for the restoration of bone
stock and the durability of the re-revision reconstruction using
multivariate analysis. At the time of re-revision, there were ten host acetabula with
no significant defects, 14 with contained defects, nine with minor-column,
seven with major-column defects and ten with pelvic discontinuity.
When bone defects at re-revision were compared with those at the
previous revision, there was restoration of bone stock in 31 hips, deterioration
of bone stock in nine and remained unchanged in ten. This was a
significant improvement (p <
0.001). Morselised allografting
at the index revision was not associated with the restoration of
bone stock. . In 17 hips (34%), re-revision was possible using a simple acetabular
component without
There are few medium- and long-term data on the outcome of the use of proximal femoral structural
This study reports the clinical outcome of reconstruction
of deficient abductor muscles following revision total hip arthroplasty
(THA), using a fresh–frozen
Previously, radiostereometric analysis following hip revision performed using impacted morsellised
The use of
We report the long-term results of revision total
hip replacement using femoral impaction
A two-stage procedure was carried out on 57 patients with confirmed infection in a hip replacement.
Between 1990 and 2000, 123 hips in 110 patients were reconstructed for aseptic loosening using impaction bone grafting with frozen, irradiated, morsellised femoral heads and cemented acetabular components. This series was reported previously at a mean follow-up of five years. We have extended this follow-up and now describe the outcome of 86 hips in 74 patients at a mean of ten years. There have been 19 revisions, comprising nine for infection, seven for aseptic loosening and three for dislocation. In surviving acetabular reconstructions, union of the graft had occurred in 64 of 67 hips (95.5%). Survival analysis for all indications at ten years was 83.3% (95% confidence interval (CI) 68 to 89) and 71.3% (95% CI 58 to 84) at 15 years. Acetabular reconstruction using irradiated
We report 11 patients having revision of total hip arthroplasty using massive structural
Infection of a total hip replacement (THR) requires component removal and thorough local debridement. Usually, long-term antibiotic treatment in conjunction with a two-stage revision is required. This may take several months. One-stage revision using antibiotic-loaded cement has not gained widespread use, although the clinical and economic advantages are obvious.