Search results for "Hip Prosthesis"

CD3+ lymphocytosis in the peri-implant membrane of 222 loosened joint endoprostheses depends on the tribological pairing.

2017

Background and purpose — The most frequent cause of arthroplasty failure is aseptic loosening—often induced by particles. Abrasion material triggers inflammatory reactions with lymphocytic infiltration and the formation of synovial-like interface membranes (SLIM) in the bone–implant interface. We analyzed CD3 quantities in SLIM depending on articulating materials and possible influences of proven material allergies on CD3 quantities. Patients and methods — 222 SLIM probes were obtained from revision surgeries of loosened hip and knee arthroplasties. SLIM cases were categorized according to the SLIM-consensus classification and to the particle algorithm. The CD3 quantities were analyzed immu…

Metastatic instability at the proximal end of the femur

1994

A retrospective study was performed of the surgical treatment of metastatic lesions of the proximal femur in 50 patients. In 25 consecutive cases a megaprosthesis was implanted; compound plate osteosynthesis was performed in another 25 consecutive patients. Indications for surgical treatment were pathological fractures or, for prophylactic treatment, lesions of the femoral cortex exceeding 2.5 cm in diameter or affecting half the diameter of the bone or more. In all patients capable of walking preoperatively mobility was regained. Immediate full weight-bearing stability was obtained in all patients. Group analysis showed that the functional rating of the hip joint was unchanged, i.e., good …

Quantitative computed tomography-assisted osteodensitometry of the pelvis after press-fit cup fixation: a prospective ten-year follow-up.

2011

Background: As a follow-up of a previously reported three-year study, we analyzed the periprosthetic acetabular cortical and cancellous bone density changes at ten years after implantation of a press-fit cup. Methods: Prospective clinical, radiographic, and quantitative computed tomography examinations were performed within ten days and at mean periods of one, three, and ten years after total hip arthroplasty with a press-fit cup, a femoral stem with a tapered design, and alumina-alumina pairing. Periacetabular cortical and cancellous bone density (mg CaHA/mL) in the cranial, ventral, and dorsal regions about the cup were measured for twenty-four hips in vivo. Results: All acetabular cups s…

Incidence of heterotopic ossification in minimally invasive short-stem THA using the modified anterolateral approach.

2017

Introduction Heterotopic ossification (HO) is known to be a common complication after total hip arthroplasty (THA). The minimal invasive (MIS) modified anterolateral approach has become popular in combination with a short stem. We analysed the incidence of HO following short-stem THA using this approach in combination with a postoperative administration of nonsteroidal anti-inflammatory drugs (NSAIDs). Materials and methods 216 short stems were implanted in 162 patients. NSAIDs were administered for 2 weeks after surgery in 154 patients (95.1%). Standardised pre- and postoperative radiographic imaging was done at 2-year follow-up. HO was analysed according to the Brooker classification. Inf…

Mid- to Long-Term Outcome of Cementless Total Hip Arthroplasty in Younger Patients

2010

Purpose. To assess mid- to long-term outcomes of cementless primary total hip arthroplasty (THA) in younger patients. Methods. Records of 28 women and 34 men (75 hips) aged 18 to 55 (mean, 38) years who underwent primary THA using a hydroxyapatite-coated stem and a threaded cup and had been followed up for a mean of 10 (6–15) years were reviewed. 13 of the patients had bilateral THAs. Clinical and radiographic outcomes were evaluated. Results. After a minimum follow-up of 7 (range, 7–14) years, 12 (16%) of the hips were revised, of which 8 (11%) were for the cup. The causes for revision were late deep infections (n=2), aseptic loosening of the cup (n=4), and polyethylene wear (n=6). No stem…

The internal calcar septum and its contact with the virtual stem in THR: a computer tomographic evaluation.

2003

The internal calcar septum is a ridge of cortical bone protruding from the inner cortical wall of the proximal femur into the medullary canal. It extends from the lesser trochanter into the femoral neck and narrows the femoral cavity in its dorsal third. This region is essential for THR stability, but the degree of contact between the septum and standard THR implants has never been studied. We obtained CT scans of 50 arthrotic hip joints from patients requiring THR. Virtual stems (50 straight/wedge-shaped and 50 anatomic stems) were placed in CT images of the femora using a PC-based preoperative planning unit. The dimensions of the septum, degree and location of contact between the septum a…

Prosthetic joint infection caused by Mycobacterium avium complex.

2019

Reduced-dose computed tomography is the most accurate method to measure ceramic hip resurfacing cup version

2020

Background: A precise assessment of cup version after hip resurfacing is generally requested, especially in clinical trials or in case of complications. Aims: To identify which diagnostic imaging modality, between AP pelvis X-rays, the AP Pelvis CT Scout image and reduced-dose axial CT scan, is the most precise to assess cup version of an all-ceramic hip resurfacing implant in a first-in-human clinical trial. Methods: We retrospectively assessed the cup version of the first 20 patients who underwent an experimental all-ceramic hip resurfacing on AP pelvis X-rays (0.8 mSv of radiation), AP pelvis CT scout images (0.016 mSv) and axial CT slices performed using a reduced dose protocol (0.3 mSv…

Pharmacokinetics of methylmethacrylate monomer during total hip replacement in man.

1988

The concentration of methylmethacrylate monomer (MMA) in the blood stream after implantation of the components of 15 total hip prostheses using bone cement was determined in the pulmonary artery, the radial artery, and the superior vena cava after cement application, and correlated with the observed drop in blood pressure and the increase in the pulmonary arterial pressure. In all samples MMA was found. The values ranged from 0.02 micrograms/ml to 59 micrograms/ml. The mean maximum value after implantation of the stem was measured to be 7.8 micrograms/ml in the pulmonary artery, 4.6 micrograms/ml in the radial artery, and 1.75 micrograms/ml in the superior vena cava. After implantation of t…

Ultrasound-Guided Periprosthetic Biopsy in Failed Total Hip Arthroplasty: A Novel Approach to Test Infection in Patients With Dry Joints

2021

Background: To diagnose periprosthetic joint infection (PJI) preoperatively, ultrasound-guided joint aspiration (US-JA) may not be performed when effusion is minimal or absent. We aimed to report and investigate the diagnostic performance of ultrasound-guided periprosthetic biopsy (US-PB) of synovial tissue to obtain joint samples in patients without fluid around the implants. Methods: One-hundred nine patients (55 men; mean age: 68 ± 13 years) with failed total hip arthroplasty (THA) who underwent revision surgery performed preoperative US-JA or US-PB to rule out PJI. Results: Sixty-nine of 109 patients had joint effusion and underwent US-JA, while the remaining 40 with dry joint re…