{"title":"A new method of trochanteric fixation after osteotomy in revision total hip arthroplasty with a calcar replacement femoral component.","authors":"R. Emerson, W. Head, L. Higgins","doi":"10.1054/ARTH.2001.28717","DOIUrl":"https://doi.org/10.1054/ARTH.2001.28717","url":null,"abstract":"Two series of cementless revision hip arthroplasties, using a transtrochanteric approach and an identical calcar replacement femoral prosthesis, were compared to ascertain the rate of trochanteric union and device problems. The failed implants removed at the time of revision were short-stemmed cemented or cementless designs in comparable patient populations. Eighteen patients had a traditional wiring fixation with a 72% union rate, and 111 patients had a bolt-and-plate fixation device, when it became available, that transfixed the trochanter to the lateral side of the femur through the proximal femoral component. The rate of union here was 94%. Of 111 bolt-and-plate devices, 13 (11.7%) were radiographically loose, although asymptomatic with a united osteotomy. Two bolts of the first-generation design broke, with 1 needing removal. Two bolt-and-plate devices disassembled, with 1 needing removal.","PeriodicalId":280050,"journal":{"name":"The Journal of arthroplasty","volume":"55 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2001-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"126686708","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Biochemical analyses of human macrophages activated by polyethylene particles retrieved from interface membranes after failed total hip arthroplasty.","authors":"J. Chiba, W. Maloney, K. Inoue, H. Rubash","doi":"10.1054/ARTH.2001.29138","DOIUrl":"https://doi.org/10.1054/ARTH.2001.29138","url":null,"abstract":"Human monocyte/macrophages (M/M) were exposed to retrieved ultra-high molecular weight polyethylene (UHMWPE) particles isolated after enzymatic digestion of revision total hip arthroplasty interface membrane tissue samples. The cellular response of human M/M to UHMWPE was compared with the response of these cells to latex particles and culture medium alone. We incubated macrophages in good contact with polyethylene particles using an inverted culture system. Chamber slides on which macrophages were attached were filled with polyethylene particle suspension and sealed with plastic sheets. After the slides were inverted, the incubation was completed. Retrieved UHMWPE particulate debris stimulated human M/M to secrete interleukin (IL)-1beta, IL-6, and tumor necrosis factor (TNF)-alpha. Human M/M exposed to retrieved UHMWPE particles secreted significantly more IL-1beta, IL-6, and TNF-alpha compared with M/M exposed to latex particles (P<.05).","PeriodicalId":280050,"journal":{"name":"The Journal of arthroplasty","volume":"39 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2001-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"116838528","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Triple taper polished cemented stem in total hip arthroplasty: rationale for the design, surgical technique, and 7 years of clinical experience.","authors":"B. Wroblewski, P. Siney, P. Fleming","doi":"10.1054/ARTH.2001.28374","DOIUrl":"https://doi.org/10.1054/ARTH.2001.28374","url":null,"abstract":"Successful long-term clinical results with the Charnley low-friction torque arthroplasty have identified proximal femoral strain shielding as a long-term problem to be addressed. The problem has arisen because of the load transfer by a distally supported stem that is no longer subject to fracture. To overcome this problem and improve proximal load transfer to the femur, a continuous triple-tapered stem--the C stem--was designed. This article describes the first 500 primary hip arthroplasties at a mean follow-up of 3 years, 5 months (range, 1-7 years). There have been no revisions for aseptic stem loosening, and no stem is considered to be at risk for loosening. In 20% of cases, there was subjective radiologic improvement of the bone-cement interface.","PeriodicalId":280050,"journal":{"name":"The Journal of arthroplasty","volume":"53 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2001-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"127034817","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
G. Li, S. Zayontz, E. Most, E. Otterberg, K. Sabbag, H. Rubash
{"title":"Cruciate-retaining and cruciate-substituting total knee arthroplasty: an in vitro comparison of the kinematics under muscle loads.","authors":"G. Li, S. Zayontz, E. Most, E. Otterberg, K. Sabbag, H. Rubash","doi":"10.1054/ARTH.2001.28367","DOIUrl":"https://doi.org/10.1054/ARTH.2001.28367","url":null,"abstract":"The kinematics of posterior cruciate ligament (PCL)-retaining (PCR) and PCL-substituting (PS) total knee arthroplasty (TKA) were compared directly in a robotic, in vitro study, and the forces in the PCL and cam-spine mechanism were measured from 0 degrees to 120 degrees of flexion. The forces in the PCL after PCR TKA and in cam-spine contact after PS TKA increased only at a flexion of > or =90 degrees. Posterior translation of the lateral femoral condyle was significantly greater than translation of the medial femoral condyle in the intact knees, consistent with femoral rollback and internal tibial rotation. The PCR and PS TKAs partially restored these kinematics when the knee flexed >60 degrees (ie, when the forces increased in the PCL and cam-spine mechanism), whereas the PCL-deficient TKA failed to do so. The results reflect the importance of the PCL and cam-spine mechanism after PCL retention and substitution in TKA and confirm the necessity for either one, if knee kinematics are to be restored even partially.","PeriodicalId":280050,"journal":{"name":"The Journal of arthroplasty","volume":"144 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2001-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"119736319","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Stem design and dislocation after revision total hip arthroplasty: clinical results and computer modeling.","authors":"R. Barrack, R. Butler, D. R. Laster, P. Andrews","doi":"10.1054/ARTH.2001.28359","DOIUrl":"https://doi.org/10.1054/ARTH.2001.28359","url":null,"abstract":"The effect of the size and shape of the neck and the taper of the femoral stem on dislocation rate after revision total hip arthroplasty was examined. Design I had a large (14/16), long taper with a circular neck cross-section; a fixed 42-mm offset; and a neck that was anteverted relative to the stem. Design II was characterized by a smaller (12/14), shorter taper; a trapezoidal neck cross-section; a progressive (40-50 mm) offset; and no neck anteversion relative to the stem. The stems were digitized and placed through a range of motion using virtual reality software, and the cross-sectional area of the neck, length of the taper, and total arc of motion before impingement between the neck and liner were compared. The dislocation rate at a minimum of 2 years' follow-up was 15.4% (8 of 52) for design I compared with 4.3% (2 of 46) for design II. This finding was consistent with the results of computer modeling, which showed that design I had a cross-sectional area that was 32% greater and a total arc of motion that was 76% less compared with design II. The results suggest that neck and taper design may be an important factor in dislocation after revision total hip arthroplasty.","PeriodicalId":280050,"journal":{"name":"The Journal of arthroplasty","volume":"24 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2001-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"114191409","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
M. Nogler, M. Krismer, P. Waldenberger, F. Rachbauer, C. Bach
{"title":"Multiple previous surgeries, infection, and preoperative radiation: a cause for arterial rupture in closed reduction?","authors":"M. Nogler, M. Krismer, P. Waldenberger, F. Rachbauer, C. Bach","doi":"10.1054/ARTH.2001.27254","DOIUrl":"https://doi.org/10.1054/ARTH.2001.27254","url":null,"abstract":"We report a patient who underwent revision hip arthroplasty with preoperative radiation after a septic loosening of the primary hip prosthesis. Subsequently the patient presented with a dislocation of the hip. During the closed reduction with general anesthesia, a rupture of the arteria profunda femoris occurred. The patient was treated by angiographic obliteration of the arteria profunda femoris followed by an open reduction and augmentation of the acetabular component.","PeriodicalId":280050,"journal":{"name":"The Journal of arthroplasty","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2001-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"124401530","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
A. Lombardi, T. Mallory, M. Alexiades, J. Cuckler, P. Faris, K. Jaffe, E. Keating, C. Nelson, C. Ranawat, J. Williams, R. Wixson, J. Hartman, S. Capps, C. Kefauver
{"title":"Short-term results of the M2a-taper metal-on-metal articulation.","authors":"A. Lombardi, T. Mallory, M. Alexiades, J. Cuckler, P. Faris, K. Jaffe, E. Keating, C. Nelson, C. Ranawat, J. Williams, R. Wixson, J. Hartman, S. Capps, C. Kefauver","doi":"10.1054/ARTH.2001.29307","DOIUrl":"https://doi.org/10.1054/ARTH.2001.29307","url":null,"abstract":"A polyethylene-free, metal-on-metal acetabular system (M2a-taper [Biomet, Inc., Warsaw, IN]) was designed in an effort to improve total hip arthroplasty (THA) longevity. Minimum 2-year follow-up results involving 72 polyethylene liner THAs and 78 metal liner THAs from a multicenter, randomized, controlled, investigational device exemption study are reported. Mean Harris hip scores of 95.54 (polyethylene liner group) and 95.23 (metal liner group) were reported at mean follow-up intervals of 3.29 and 3.23 years. Radiographic evaluation revealed no evidence of early failure. No acetabular components have been revised or are pending revision. No statistically significant differences in the data were calculated between liner types except for the immediate postoperative (P=.0415) and minimum 2-year follow-up (P=.0341) angles of inclination. The M2a-taper metal-on-metal articulation may represent a viable alternative for THA in younger, higher demand patients.","PeriodicalId":280050,"journal":{"name":"The Journal of arthroplasty","volume":"121 3 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2001-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"124520134","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Per Morberg, Carina B. Johansson, Astor Reigstad, M. Røkkum
{"title":"Vital staining of bone in stable, retrieved femoral surface replacement prostheses: a microscopic study of undecalcified ground sections.","authors":"Per Morberg, Carina B. Johansson, Astor Reigstad, M. Røkkum","doi":"10.1054/ARTH.2001.27255","DOIUrl":"https://doi.org/10.1054/ARTH.2001.27255","url":null,"abstract":"We used vital staining with tetracycline to detect viability of bone at the bone-cement interface in 11 stable ICLH femoral surface replacement prostheses that were retrieved at revision surgery for acetabular loosening. The resected femoral heads were processed for undecalcified ground sections with the prostheses in situ. All sections showed direct bone-to-cement contacts. Bone in direct contact with or close to the cement sometimes showed an abnormal staining, indicating that the bone was not fully mineralized. Areas with fluorescence were observed within all femoral heads but never in direct bone-to-cement contact. From this study, we conclude that the mechanical stability of these cemented femoral surface replacement prostheses depends mainly on the original bone present at the time of primary operation.","PeriodicalId":280050,"journal":{"name":"The Journal of arthroplasty","volume":"20 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2001-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"125132405","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
J. Boldt, Punit Dilawari, Sanjeev Agarwal, K. Drabu
{"title":"Revision total hip arthroplasty using impaction bone grafting with cemented nonpolished stems and charnley cups.","authors":"J. Boldt, Punit Dilawari, Sanjeev Agarwal, K. Drabu","doi":"10.1054/ARTH.2001.25559","DOIUrl":"https://doi.org/10.1054/ARTH.2001.25559","url":null,"abstract":"This article reports the results of 181 cemented revision total hip arthroplasties in which impacted morcellized allograft and cement was used for reconstitution of acetabular and femoral bone deficiencies. There were 173 acetabular and 79 femoral reconstructions. The mean follow-up was 4.0 years. The overall survival rate was 97.2%. Evidence of revascularization of the impacted allograft was shown in 29 of 30 (97%) randomly selected bone scintigraphies. Radiographic evidence of allograft incorporation was observed in 128 of 173 (74%) acetabula and 48 of 73 (61%) femora. Stem subsidence occurred in all types of femoral bone deficiencies and was not time dependent (P =.17). The acetabular components showed significant migration with increased bone deficiency (P =.0003). Impaction bone grafting has shown promising results in revision total hip arthroplasty but is not recommended in type 3 acetabular defects.","PeriodicalId":280050,"journal":{"name":"The Journal of arthroplasty","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2001-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"125163555","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
H. Sakoda, A. Voice, H. McEwen, G. Isaac, C. Hardaker, B. Wroblewski, J. Fisher
{"title":"A comparison of the wear and physical properties of silane cross-linked polyethylene and ultra-high molecular weight polyethylene.","authors":"H. Sakoda, A. Voice, H. McEwen, G. Isaac, C. Hardaker, B. Wroblewski, J. Fisher","doi":"10.1054/ARTH.2001.27234","DOIUrl":"https://doi.org/10.1054/ARTH.2001.27234","url":null,"abstract":"Cross-linked polyethylenes are being introduced widely in acetabular cups in hip prostheses as a strategy to reduce the incidence of wear debris-induced osteolysis. It will be many years before substantial clinical data can be collected on the wear of these new materials. Silane cross-linked polyethylene (XLPE) was introduced into clinical practice in a limited series of acetabular cups in 1986 articulating against 22.225-mm alumina ceramic femoral heads and showed reduced wear rates compared with conventionally sterilized (gamma irradiation in air) ultra-high molecular weight polyethylene (UHMWPE). We compared the wear of XLPE manufactured in 1986 with the wear of UHMWPE manufactured in 1986 in nonirradiated and irradiated forms. In the nonirradiated forms, the wear of XLPE was 3 times less than UHWMPE when articulating against smooth counterfaces. The nonirradiated materials did not show signs of oxidation. In the irradiated forms, only UHMWPE showed high levels of oxidation, and this caused a substantial increase in wear. Antioxidants added to XLPE during processing gave resistance to oxidative degradation. When sliding against scratched counterfaces, the wear of UHMWPE increased by a factor of 2 to 3 times. Against the same scratched counterfaces, the wear of XLPE increased dramatically by 30 to 200 times. This difference may be attributed to the reduction in toughness of XLPE. Clinically, XLPE has been articulated against damage-resistant ceramic heads, and this probably has been an important factor in contributing to reduced wear. New cross-linked polyethylenes differ considerably from XLPE. This study indicates that it is prudent to examine the wear of new polyethylenes under a range of conditions that may occur in vivo.","PeriodicalId":280050,"journal":{"name":"The Journal of arthroplasty","volume":"72 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2001-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"116935465","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}