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101.
Influence of varying stem and metaphyseal sleeve size on the primary stability of cementless revision tibial trays used to reconstruct AORI IIA defects. A simulation study 下载免费PDF全文
Maged Awadalla Rami M. A. Al‐Dirini Dermot O'Rourke Lucian B. Solomon Mark Heldreth Mark Taylor 《Journal of orthopaedic research》2018,36(7):1876-1886
102.
Olivier Freddy Hitz Xavier Flecher Sébastien Parratte Matthieu Ollivier Jean-Noël Argenson 《The Journal of arthroplasty》2018,33(7):2197-2202
Background
Options for total hip arthroplasty (THA) in high dislocated hips include subtrochanteric osteotomy (STO), high hip center positioning, and 2-stage surgery with progressive lowering using an external fixator before THA. We described the long-term results of 1-stage THA performed without STO, using a cementless customized stem associated if necessary with sequential tenotomies and/or greater trochanteric osteotomy.Methods
Ninety-eight consecutive THA without STO were performed using this technique. Of those 98 hips, 26 hips with high dislocation (12 class III and 14 class IV according to the Crowe classification) were evaluated at an average follow-up of 16 (10-22) years.Results
At the time of last follow-up, the mean Harris Hip Score was 86 points (37-100). The mean leg-length discrepancy was 7 ± 5 mm (0-17). Two transient (7.7%) nerve palsies (1 sciatic and 1 femoral) were notified. A revision was required for 6 hips (23.1%). Kaplan-Meier survivorship analysis at 15 years regarding aseptic loosening of the femoral component was 87.5% (95% confidence interval, 76.5-99.1). During the same period, acetabular implant survivorship free from revision for aseptic loosening was 96.1% (95% confidence interval, 92.7-99.9).Conclusion
The combination of intramedullary fit and extramedullary adaptation for offset and anteversion provided by the custom stem can avoid additional procedures associated to THA in high developmental dysplasia of the hip. The clinical function and long-term survival reported in this series is encouraging for THA performed in case of high hip dislocation. 相似文献103.
Assem A. Sultan Anton Khlopas Nipun Sodhi Mark L. Denzine Prem N. Ramkumar Steven F. Harwin Michael A. Mont 《The Journal of arthroplasty》2018,33(3):761-765
Background
Lack of consensus exists on the use of cementless total knee arthroplasty (TKA) in patients with knee osteonecrosis. Therefore, this study was conducted to evaluate (1) implant survivorship; (2) clinical outcomes and complications; and (3) radiographic outcomes of primary cementless TKA in knee osteonecrosis.Methods
This study included 46 patients (49 knees) who had knee osteonecrosis and underwent primary cementless TKA and had a mean follow-up of 44 months (range 36-96). Kaplan-Meier analysis was used to evaluate implant survivorship. Follow-up was performed post-operatively at 6 weeks, 3 months, and annually thereafter. Clinical outcomes including the Knee Society Scores (KSS) for pain and function, changes in range-of-motion, complications, and radiographic outcomes were analyzed.Results
Aseptic implant survivorship was 97.9% (95% confidence interval 1.01-0.93) and all-cause implant survivorship was 95.9% (95% confidence interval 1.01-0.9), with 1 septic and 1 aseptic failures. The mean KSS for pain was 93 points (range 85-100) and the mean KSS for function was 84 points (range 70-90). Additionally, 1 patient had superficial wound necrosis and was treated with local wound care with no further sequela. Otherwise, no evidence of loosening, subsidence, or progressive radiolucencies were noted on radiological evaluation.Conclusion
Excellent implant survivorship, clinical, and radiographic outcomes of primary cementless TKA in the setting of knee osteonecrosis was demonstrated. Although further long-term study is needed to validate survivorship, new generation cementless TKA implants provide promising results in this subset of patients. 相似文献104.
Steven F. Harwin Jay M. Levin Anton Khlopas Prem N. Ramkumar Nicolas S. Piuzzi Martin Roche Michael A. Mont 《The Journal of arthroplasty》2018,33(5):1399-1403
Background
The purpose of this study is to evaluate (1) implant survivorship; (2) patient outcomes; (3) complications; and to (4) perform a radiographic analysis of cementless posteriorly stabilized total knee arthroplasty (TKA) patients at a minimum of 7-year follow-up.Methods
Our original cohort was composed of 114 consecutive cementless posteriorly stabilized total knee arthroplasties (110 patients) performed by a single surgeon between 2008 and 2010. Since our original report, 4 (1 bilateral) patients died and 2 were lost to follow-up. Therefore, there were 104 patients who had 107 knees available for final follow-up. The final cohort included 43 men and 61 women, who had a mean age of 69 years (range 47-87) and were followed from 7 to 9 years (mean 8 years). Patient outcomes and complications were obtained from electronic medical records. Radiographic assessment was done using the Knee Society Radiographic Evaluation System.Results
The all-cause survivorship was 98% (95% confidence interval 1.01-0.96). Since the original report, there has been 1 post-traumatic loosening of the tibial baseplate, and 1 revision for instability. There were no femoral revisions or patella revisions. The mean Knee Society pain score was 93 points (range 80-100) and the function score was 78 points (range 68-95). Excluding revisions, there was no evidence of progressive loosening of any implant components.Conclusion
Based on these 7-year minimum follow-ups, femoral, tibial, and patellar cementless hydroxylapatite-coated beaded implants perform well at up to 9 years postoperatively and offer surgeons and patients a cementless option that may provide long-lasting biological fixation. 相似文献105.
Patrick J. MurrayKatherine L. Hwang MS Susanna N. ImrieJames I. Huddleston III MD Stuart B. Goodman 《The Journal of arthroplasty》2014
The outcome of 25 primary THAs in patients with hip dysplasia using the AML Bantam femoral stem (DePuy) is reported. Age at operation averaged 43 ± 10 years. Twenty-two of 25 stems were cementless. All cementless acetabular components had conventional or cross-linked polyethylene and screws. Follow-up averaged 11 ± 5 years (range 4–18). Four cementless stems were revised after 3, 4, 8, and 9 years; 2/3 cemented stems were revised at 8 and 18 years. Femoral revisions demonstrated extensive conventional polyethylene wear, periprosthetic osteolysis and loosening. Five entire cups were revised for wear and loosening; four liners were replaced. Harris Hip Scores for patients with retained stems went from 43 ± 12 to 85 ± 13. High revision rates with the proximally porous coated Bantam stem are due to loss of fixation, often associated with polyethylene wear and osteolysis. 相似文献
106.
To evaluate the effects of micro-arc oxidation (MAO) coating on the outcomes of a grit-blasted tapered-wedge stem in total hip arthroplasty (THA), we performed a retrospective review of 141 THAs using MAO coated stem for a minimum of 5 years and compared them to 219 THAs using the same geometry stem without MAO coating. Harris hip score improved from 43.7 points preoperatively to 93.9 points postoperatively. No hips were revised for aseptic loosening. Complications included one squeaking hip, one iliopsoas tendonitis, and one deep vein thrombosis. Postoperative Harris hip scores, WOMAC scores, UCLA activity scores, stem stabilities, and complication rates did not differ between the groups. After medium-term follow-up, our findings did not support the use of MAO coating on grit-blasted tapered-wedge stem to improve clinical outcomes. 相似文献
107.
Bun-Jung Kang Yong-Chan Ha Sun-Chul Hwang Young-Kyun Lee Kyung-Hoi Koo 《The Journal of arthroplasty》2014
Seventy-nine patients (94 hips), who underwent cementless alumina-on-alumina total hip arthroplasty (THA) with the use of a 36-mm delta ceramic liner-on-alumina ceramic femoral head, were followed for an average of 6.5 years (range, 5–7.7 years). All acetabular and femoral components were bone-ingrown and neither pelvic nor femoral osteolysis was identified until the latest follow-up. The survivorship with revision surgery as an endpoint was 97.9% (95% confidence interval = 100%–95%). Ceramic related complications such as fracture and squeaking did not occur in any patient. The mid-term results of cementless THA with this type of ceramic articulation are encouraging. 相似文献
108.
We prospectively analyzed 83 patients who underwent ceramic-on-ceramic THA using preassembled (n = 22) or modular acetabular components (n = 61) between June 2010 and June 2012. There were no significant differences in mean postoperative radiographic outcomes, functional outcomes, or complications between the two groups. Both groups showed satisfactory performance at the 2 year follow up. Only the gender of the patients was significantly different between the two groups. Half of the women had smaller acetabular diameters accommodating a cup size of only 48-50-mm. Although a preassembled cup with a 36-mm ceramic liner is proven to be safe in the short term, future research should focus on evaluating the long-term risks. 相似文献
109.
Arjuna M. Imbuldeniya Stephen M. TaiTariq Aboelmagd William L. WalterWilliam K. Walter MBBS FRACS FAORthA Bernard A. Zicat MD FRACS FAOrthA 《The Journal of arthroplasty》2014
We present a long-term follow-up report of 33 cementless total hip arthroplasties in 27 patients who have an established diagnosis of Paget’s disease. The medium term results of this series were reported in 2007 (Lusty et al. Journal of Arthroplasty. 2007;22:692). Fourteen cases were available for follow-up at an average of 12.3 years (range 10–17). Harris Hip scores improved from 56/100 preoperatively (16–98/100) to 83/100 post operatively (72–90/100). All surviving components were radiographically ingrown. Based on these findings, cementless total hip arthroplasty has a good long-term outcome in Paget’s disease. 相似文献
110.
《Clinical toxicology (Philadelphia, Pa.)》2013,51(7):550-556
AbstractIntroduction. Vanadium (V) is a minor constituent of the Titanium–Aluminum–Vanadium (TiAlV) alloy currently used in cementless hip prostheses. Present study aimed at verifying the correlation of vanadium levels among different matrices and assessing reference levels of the ion in a population of patients wearing a well-functioning hip prosthesis. Methods. Vanadium was measured using Inductive Coupled Plasma Mass Spectrometry (ICP-MS) in whole blood, serum and urine of 129 patients implanted with a TiAlV-alloy hip prosthesis. Results. The values in the serum were above the upper limit of the reference values in 42% of patients (29% in urine and 13% in whole blood). A good correlation among matrices was observed (p < 0.001). The cohort of patients (N = 32) complaining of pain or in which a loosening or damage to the prosthesis was assessed showed a significantly higher excretion of vanadium in urine as compared with the remaining asymptomatic patients (p = 0.001). The 95th percentile distribution of vanadium in the cohort of patients with a well-functioning prosthesis was 0.3 μg/L in whole blood, 0.5 μg/L in serum and 2.8 μg/L in urine, higher that in the unexposed population, especially for urine. Conclusions. The presence of a prosthesis, even though well-functioning, may cause a possible release of vanadium into the blood and a significant urinary excretion. The reference values of vanadium of the asymptomatic patients with titanium alloy hip prostheses supplied information regarding the background exposure level of the ions and their lower and upper limits. 相似文献