The outcome of
We describe a patient with a painful sciatic neuropathy after
The aims of this study were to determine the
functional impact and financial burden of isolated and recurrent dislocation
after
We report two cases of surface deterioration of a zirconia ceramic femoral head associated with phase transformation after
Hip resurfacing is being performed more frequently in the United Kingdom. The possible benefits include more accurate restoration of leg length, femoral offset and femoral anteversion than occurs after
Three-dimensional surface models of the normal hemipelvis derived from volumetric CT data on 42 patients were used to determine the radius, depth and orientation of the native acetabulum. A sphere fitted to the lunate surface and a plane matched to the acetabular rim were used to calculate the radius, depth and anatomical orientation of the acetabulum. For the 22 females the mean acetabular abduction, anteversion, radius and normalised depth were 57.1° (50.7° to 66.8°), 24.1° (14.0° to 33.3°), 25 mm (21.7 to 30.3) and 0.79 mm (0.56 to 1.04), respectively. The same parameters for the 20 males were 55.5° (47.7° to 65.9°), 19.3° (8.5° to 32.3°), 26.7 mm (24.5 to 28.7) and 0.85 mm (0.65 to 0.99), respectively. The orientation of the native acetabulum did not match the safe zone for acetabular component placement described by Lewinnek. During
The aim of this study was to evaluate fretting and corrosion in retrieved oxidized zirconium (OxZr; OXINIUM, Smith & Nephew, Memphis, Tennessee) femoral heads and compare the results with those from a matched cohort of cobalt-chromium (CoCr) femoral heads. A total of 28 OxZr femoral heads were retrieved during revision total hip arthroplasty (THA) and matched to 28 retrieved CoCr heads according to patient demographics. The mean age at index was 56 years (46 to 83) in the OxZr group and 70 years (46 to 92) in the CoCr group. Fretting and corrosion scores of the female taper of the heads were measured according to the modified Goldberg scoring method.Aims
Patients and Methods
There are few medium- and long-term data on the outcome of the use of proximal femoral structural allografts in revision hip arthroplasty. This is a study of a consecutive series of 40 proximal femoral allografts performed for failed
The design of the Charnley
We have investigated the contaminating bacteria in primary hip arthroplasty and their sensitivity to the prophylactic antibiotics currently in use. Impressions (627) of the gloved hands of the surgical team in 50
Malposition of the acetabular component is a risk factor for post-operative dislocation after
Aims. The aim of this study was to assess the reproducibility and validity
of cross table radiographs for measuring the anteversion of the
acetabular component after
Bilateral venography was performed between 12 and 15 days after
Post-mortem retrieval of canine, cemented femoral components was analysed to assess the performance of these implants in the dog as a model for human
Aims. The primary aim of this study was to analyse the position of
the acetabular and femoral components in total hip arthroplasty
undertaken using an anterior surgical approach. . Patients and Methods. In a prospective, single centre study, we used the EOS imaging
system to analyse the position of components following THA performed
via the anterior approach in 102 patients (103 hips) with a mean
age of 64.7 years (. sd. 12.6). Images were taken with patients
in the standing position, allowing measurement of both anatomical
and functional anteversion of the acetabular component. . Results. The mean inclination of the acetabular component was 39° (standard
deviation (. sd). 6), the mean anatomical anteversion was
30° (. sd. 10), and the mean functional anteversion was 31°
(. sd. 8) five days after surgery. The mean anteversion of
the femoral component was 20° (. sd. 11). Anatomical and functional
anteversion of the acetabular component differed by >
10° in 23
(22%) cases. Pelvic tilt was the only pre-operative predictive factor
of this difference. Conclusion. Our study showed that anteversion of the acetabular component
following THA using the anterior approach was greater than the recommended
target value, and that substantial differences were observed in
some patients when measured using two different measurement planes.
If these results are confirmed by further studies, and considering
that the anterior approach is intended to limit the incidence of
dislocation, a new correlation study for each reference plane (anatomical
and functional) will be necessary to define a ‘safe zone’ for use
with the anterior approach. Take home message: EOS imaging system is helpful in the pre-operative
and post-operative radiological analysis of
Thresholds for operative eligibility based on body mass index (BMI) alone may restrict patient access to the benefits of arthroplasty. The purpose of this study was to evaluate the relationship between BMI and improvements in patient-reported outcome measures (PROMs), and to determine how many patients would have been denied improvements in PROMs if BMI cut-offs were to be implemented. A prospective cohort of 3,449 primary total hip arthroplasties (THAs) performed between 2015 and 2018 were analyzed. The following one-year PROMs were evaluated: hip injury and osteoarthritis outcome score (HOOS) pain, HOOS Physical Function Shortform (PS), University of California, Los Angeles (UCLA) activity, Veterans Rand-12 Physical Component Score (VR-12 PCS), and VR-12 Mental Component Score (VR-12 MCS). Positive predictive values for failure to improve and the number of patients denied surgery in order to avoid a failed improvement were calculated for each PROM at different BMI cut-offs.Aims
Methods
This study compared component wear rates and pre-revision blood metal ions levels in two groups of failed metal-on-metal hip arthroplasties: hip resurfacing and modular
We present a case of early retrieval of an Oxinium femoral head and corresponding polyethylene liner where there was significant surface damage to the head and polyethylene. The implants were retrieved at the time of revision surgery to correct leg-length discrepancy just 48 hours after the primary hip replacement. Appropriate analysis of the retrieved femoral head demonstrated loss of the Oxinium layer with exposure of the underlying substrate and transfer of titanium from the acetabular shell at the time of a reduction of the index
We present a case of delayed presentation of a subdural haematoma causing cauda equina syndrome which occurred 96 hours after a spinal anaesthetic had been administered for an elective