The practice of removing a well-fixed cementless
femoral component is associated with high morbidity. Ceramic bearing
couples are low wearing and their use minimises the risk of subsequent
further revision due to the production of wear debris. A total of
165 revision hip replacements were performed, in which a polyethylene-lined acetabular
component was revised to a new
Aims. The aim of this study is to evaluate whether
Aims. In metal-on-metal (MoM) hip arthroplasties and resurfacings, mechanically induced corrosion can lead to elevated serum metal ions, a local inflammatory response, and formation of pseudotumours, ultimately requiring revision. The size and diametral clearance of anatomical (ADM) and modular (MDM) dual-mobility polyethylene bearings match those of Birmingham hip MoM components. If the
Aims. The aim of the study was to investigate whether the primary stability of press-fit
Aims. Dislocation remains a leading cause of failure following revision total hip arthroplasty (THA). While dual-mobility (DM) bearings have been shown to mitigate this risk, options are limited when retaining or implanting an uncemented shell without modular DM options. In these circumstances, a monoblock DM cup, designed for cementing, can be cemented into an uncemented
Aims. Large
Aims.
We analysed the results of different strategies in the revision of primary uncemented
Aims. Pelvic discontinuity is a rare but increasingly common complication of total hip arthroplasty (THA). This single-centre study evaluated the performance of custom-made triflange
Aims. After failed acetabular fractures, total hip arthroplasty (THA) is a challenging procedure and considered the gold standard treatment. The complexity of the procedure depends on the fracture pattern and the initial fracture management. This study’s primary aim was to evaluate patient-reported outcome measures (PROMs) for patients who underwent delayed uncemented
Aims. To investigate the extent of bone development around the scaffold of custom triflange
Orientation of the native
Aims. The aim of this study was to assess the clinical and radiological results of patients who were revised using a custom-made triflange
Aims. Registry studies on modified
Aims. To determine if primary cemented
Aims. Navigation devices are designed to improve a surgeon’s accuracy in positioning the
Aims. Modular dual mobility (MDM)
Aims. The main advantage of 3D-printed, off-the-shelf
Aims. Periprosthetic fracture and implant loosening are two of the major reasons for revision surgery of cementless implants. Optimal implant fixation with minimal bone damage is challenging in this procedure. This pilot study investigates whether vibratory implant insertion is gentler compared to consecutive single blows for
Pelvic discontinuity with associated bone loss is a complex challenge in acetabular revision surgery. Reconstruction using ilio-ischial cages combined with trabecular metal
We present an update of the clinical and radiological results of 62 consecutive
Aims. Uncemented metal
Ensuring the accuracy of the intra-operative orientation of the
Aims. The objective of this study was to compare the two-year migration and clinical outcomes of a new cementless hydroxyapatite (HA)-coated titanium
Aims. Various surgical techniques have been described for total hip arthroplasty (THA) in patients with Crowe type III dislocated hips, who have a large
Aims. Cross-table lateral (CTL) radiographs are commonly used to measure
We evaluated the use of a stemmed
Aims. The lateral centre-edge angle (LCEA) is a plain radiological measure of superolateral cover of the femoral head. This study aims to establish the correlation between 2D radiological and 3D CT measurements of
Aims. Custom triflange
Aims. The effect of pelvic tilt (PT) and sagittal balance in hips with pincer-type femoroacetabular impingement (FAI) with
Aims. The aim of the study was to compare two methods of calculating pelvic incidence (PI) and pelvic tilt (PT), either by using the femoral heads or
Aims. The aim of this study was to determine if uncemented
Aims. The main aims were to identify risk factors predictive of a radiolucent line (RLL) around the
Aims. Appropriate
Between 1986 and 1990, we carried out 55 rotational
We present the results of 62 consecutive acetabular
revisions using impaction bone grafting and a cemented polyethylene
acetabular component in 58 patients (13 men and 45 women) after
a mean follow-up of 27 years (25 to 30). All patients were prospectively
followed. The mean age at revision was 59.2 years (23 to 82). . We performed Kaplan–Meier (KM) analysis and also a Competing
Risk (CR) analysis because with long-term follow-up, the presence
of a competing event (i.e. death) prevents the occurrence of the
endpoint of re-revision. . A total of 48 patients (52 hips) had died or had been re-revised
at final review in March 2011. None of the deaths were related to
the surgery. The mean Harris hip score of the ten surviving hips
in ten patients was 76 points (45 to 99). The KM survivorship at 25 years for the endpoint ‘re-revision
for any reason’ was 58.0% (95% confidence interval (CI) 38 to 73)
and for ‘re-revision for aseptic loosening’ 72.1% (95% CI 51 to
85). With the CR analysis we calculated the KM analysis overestimates
the failure rate with respectively 74% and 93% for these endpoints.
The current study shows that
Aims. The aims of this study were to determine the change in pelvic sagittal alignment before, during, and after total hip arthroplasty (THA) undertaken with the patient in the lateral decubitus position, and to determine the impact of these changes on
Aims. Rotational
We have reviewed 54 patients who had undergone 61 total hip replacements using bulk femoral autografts to augment a congenitally dysplastic acetabulum. There were 52 women and two men with a mean age of 42.4 years (29 to 76) at the time of the index operation. A variety of different prostheses was used: 28 (45.9%) were cemented and 33 (54.1%) uncemented. The graft technique remained unchanged throughout the series. Follow-up was at a mean of 8.3 years (3 to 20). The Hospital for Special Surgery hip score improved from a mean of 10.7 (4 to 18) pre-operatively to a mean of 35 (28 to 38) at follow-up. The position of the
Aims. In elderly patients with osteoarthritis and protrusio who require arthroplasty, dislocation of the hip is difficult due to migration of the femoral head. Traditionally, neck osteotomy is performed in situ, so this is not always achieved. Therefore, the purpose of this study is to describe a partial resection of the posterior wall in severe protrusio. Methods. This is a descriptive observational study, which describes the surgical technique of the partial resection of the posterior wall during hip arthroplasty in patients with severe
Aims. This single-centre observational study aimed to describe the results of extensive bone impaction grafting of the whole
Aims. The aim of this study was to determine whether there is a difference
in the rate of wear between
Aims. To compare long-term survival of all-cemented and hybrid total hip arthroplasty (THA) using the Exeter Universal stem. Methods. Details of 1,086 THAs performed between 1999 and 2005 using the Exeter stem and either a cemented (632) or uncemented
Aims. The aim of the current study was to assess the reliability of the Ottawa classification for symptomatic
Aims. Some patients presenting with hip pain and instability and underlying
Aims. We previously reported the long-term results of the cementless Duraloc-Profile total hip arthroplasty (THA) system in a 12- to 15-year follow-up study. In this paper, we provide an update on the clinical and radiological results of a previously reported cohort of patients at 23 to 26 years´ follow-up. Patients and Methods. Of the 99 original patients (111 hips), 73 patients (82 hips) with a mean age of 56.8 years (21 to 70) were available for clinical and radiological study at a minimum follow-up of 23 years. There were 40 female patients (44 hips) and 33 male patients (38 hips). Results. All
Aims. We analyzed the
The
Aims. To compare the in vivo long-term fixation achieved by two
Aims. The use of trabecular metal (TM) shells supported by augments has provided good mid-term results after revision total hip arthroplasty (THA) in patients with a bony defect of the acetabulum. The aim of this study was to assess the long-term implant survivorship and radiological and clinical outcomes after
Aims. Severe
Objectives. In order to address
Aims. Rotational
Aims. In the 1990s, a bioactive bone cement (BABC) containing apatite-wollastonite glass-ceramic (AW-GC) powder and bisphenol-a-glycidyl methacrylate resin was developed at our hospital. In 1996, we used BABC to fix the
Aims. The aim of this study was to compare the incidence of aseptic
loosening after the use of a cemented
Aims. A borderline dysplastic hip can behave as either stable or unstable and this makes surgical decision making challenging. While an unstable hip may be best treated by
Aims. Dislocation remains a significant complication after total hip arthroplasty (THA), being the third leading indication for revision. We present a series of
Aims. Reconstruction of the acetabulum after failed total hip arthroplasty
(THA) can be a surgical challenge in the presence of severe bone
loss. We report the long-term survival of a porous tantalum revision
acetabular component, its radiological appearance and quality of
life outcomes. Patients and Methods. We reviewed the results of 46 patients who had undergone revision
of a failed
The ‘jumbo’
Aims. Custom flange
Aims. This study aims to: determine the difference in pelvic position that occurs between surgery and radiographic, supine, postoperative assessment; examine how the difference in pelvic position influences subsequent component orientation; and establish whether differences in pelvic position, and thereafter component orientation, exist between total hip arthroplasties (THAs) performed in the supine versus the lateral decubitus positions. Patients and Methods. The intra- and postoperative anteroposterior pelvic radiographs of 321 THAs were included; 167 were performed with the patient supine using the anterior approach and 154 were performed with the patient in the lateral decubitus using the posterior approach. The inclination and anteversion of the
Aims. Long-term clinical outcomes for ceramic-on-ceramic (CoC) bearings
are encouraging. However, there is a risk of squeaking. Guidelines
for the orientation of the
Aims. Accurate placement of the
Aims. The stability of cementless
Aims. The aim of this study was to report the long-term results of rotational
Ideal placement of the
Aims. What represents clinically significant
Patients with
Aims. The purpose of this retrospective study was to evaluate the minimum
five-year outcome of revision total hip arthroplasty (THA) using
the Kerboull
The Norwegian Arthroplasty Register has shown that several designs of uncemented femoral stems give good or excellent survivorship. The overall findings for uncemented total hip replacement however, have been disappointing because of poor results with the use of metal-backed
Aims. Accurate placement of the
Damage to and repair of the
Aims. The hypothesis of this study was that thigh circumference, distinct from body mass index (BMI), may be associated with the positioning of components when undertaking total hip arthroplasty (THA) using the direct anterior approach (DAA), and that an increased circumference might increase the technical difficulty. Patients and Methods. We performed a retrospective review of prospectively collected data involving 155 consecutive THAs among 148 patients undertaken using the DAA at an academic medical centre by a single fellowship-trained surgeon. Preoperatively, thigh circumference was measured at 10 cm, 20 cm, and 30 cm distal to the anterior superior iliac spine, in quartiles. Two blinded reviewers assessed the inclination and anteversion of the
An uncemented hemispherical
Orientation of the
Aims. Several radiological methods of measuring anteversion of the
Aims. The aim of this study was to examine the results of the acetabular
distraction technique in achieving implantation of a stable construct,
obtaining biological fixation, and producing healing of chronic
pelvic discontinuity at revision total hip arthroplasty. Patients and Methods. We identified 32 patients treated between 2006 and 2013 who underwent
acetabular revision for a chronic pelvic discontinuity using acetabular
distraction, and who were radiographically evaluated at a mean of
62 months (25 to 160). Of these patients, 28 (87.5%) were female.
The mean age at the time of revision was 67 years (44 to 86). The patients
represented a continuous series drawn from two institutions that
adhered to an identical operative technique. Results. Of the 32 patients, one patient required a revision for aseptic
loosening, two patients had evidence of radiographic loosening but
were not revised, and three patients had migration of the acetabular
component into a more stable configuration. Radiographically, 22
(69%) of the cohort demonstrated healing of the discontinuity. The
Kaplan–Meier construct survivorship was 83.3% when using revision
for aseptic
Deficiencies of
The technique of femoral cement-in-cement revision
is well established, but there are no previous series reporting its
use on the
The purpose of this study was to compare the
amount of
Aims. It is important to consider sagittal pelvic rotation when introducing
the
Pseudotumours are a rare complication of hip resurfacing. They are thought to be a response to metal debris which may be caused by edge loading due to poor orientation of the
We report the outcome of the flangeless, cemented all-polyethylene Exeter
Aims. The aim of this systematic review was to report the rate of dislocation
following the use of dual mobility (DM)
Aims. This study aimed to determine the diagnostic performance of radiographic
criteria to detect aseptic
Aims. The purpose of this study was to evaluate whether an innovative
templating technique could predict the need for
Excessive
Aims. This study sought to establish the prevalence of the cross over
sign (COS) and posterior wall sign (PWS) in relation to the anterior
pelvic plane (APP) in an asymptomatic population through reliable
and accurate 3D-CT based assessment. Materials and Methods. Data from pelvic CT scans of 100 asymptomatic subjects (200 hips)
undertaken for conditions unrelated to disorders of the hip were
available for analysis in this study. A previously established 3D
analysis method was applied to assess the prevalence of the COS
and PWS in relation to the APP. Results. Of the 200 included hips, 24% (48) presented a positive COS and
5.5% (11) presented a positive PWS. A combination of COS and PWS
was observed in 1% (two) of all hips (1%). . Conclusion. The high incidence of
Aims.
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
A variety of radiological methods of measuring
version of the
Orthopaedic surgeons have accepted various radiological
signs to be representative of
We treated 34 patients with recurrent dislocation of the hip with a constrained
In a prospective randomised clinical study
The increasing need for total hip replacement
(THR) in an ageing population will inevitably generate a larger number
of revision procedures. The difficulties encountered in dealing
with the bone deficient acetabulum are amongst the greatest challenges
in hip surgery. The failed
Cementless
Aims. It may not be possible to undertake revision total hip arthroplasty
(THA) in the presence of massive loss of
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 total hip arthroplasty (THA) and to compare
it with measurements using CT scans. Patients and Methods. A total of 29 patients who underwent THA between June 2010 and
January 2016 were included. There were 17 men and 12 women. Their
mean age was 43 years (26 to 65). Seven patients underwent a bilateral
procedure. Thus, 36 THAs were included in the study. Lateral radiographs
and CT scans were obtained post-operatively and radiographs repeated
three weeks later. The anteversion of the
Aims . The highly cross-linked polyethylene Exeter RimFit flanged cemented
acetabular component was introduced in the United Kingdom in 2010.
This study aimed to examine the rates of emergence of radiolucent
lines observed when the Rimfit