Analysis of the Fixation Quality of Total Hip Replacements Using a Vibrational Technique

Volume 2 ◽  
2004 ◽  
Author(s):  
Siegfried V. N. Jaecques ◽  
Cezar Pastrav ◽  
Georges Van der Perre
Keyword(s):  
Hip Replacement ◽  
Mode Shapes ◽  
Vibration Modes ◽  
Total Hip ◽  
Total Hip Replacements ◽  
Element Simulation ◽  
Hip Replacements ◽  
System 2 ◽  
Operative Assessment

Vibration analysis can be used as a more sensitive alternative to conventional techniques for the detection of loosening of total hip replacement (THR) components. The vibration modes of the human femur and of selected THR prosthetic stems were studied by experimental modal analysis using a CADA-X system and by finite element simulation using MARC/Mentat software. Two hypotheses were formulated: (1) the differences between the vibrational behavior of an intact femur and of the system formed by a femur and an implanted prosthesis will increase with increasing complexity of the mode shapes of the system; (2) when a prosthesis is implanted in a femur, the vibration modes of the prosthesis will be more affected by this interaction than the modes of the femur. After confirming these hypotheses, a method for per-operative assessment of the fixation quality of a THR stem was derived, based on the frequency shifts of the vibration modes of the system.

Total hip replacement: modes of failure

2011 ◽  
Author(s):  
Rob Pollock
Keyword(s):  
Aseptic Loosening ◽  
Success Rates ◽  
Total Hip ◽  
Reactive Protein ◽  
Modes Of Failure ◽  
Total Hip Replacements ◽  
Hip Replacements ◽  
Simple Fixation

♦ Total hip replacements (THRs) may fail in various ways. They may become infected, they may be subject to aseptic loosening, they may dislocate, or a periprosthetic fracture may occur. The patient with a failed THR must be thoroughly assessed before treatment is contemplated♦ Infection may be acute or chronic. Assessment involves clinical assessment, plain radiographs, blood tests (C-reactive protein and erythrocyte sedimentation rate), hip aspiration, and, sometimes, nuclear medicine. The acutely infected hip may be treated with one-stage revision. This involves thorough lavage, debridement, and exchange of all modular components as well as long-term antibiotic therapy. The gold standard of treatment for a chronically infected THR is a two-stage revision. Success rates of 80–90% can be expected♦ Aseptic loosening typically occurs at the cement bone interface in hips where a metal-on-polyethylene bearing couple has been used. Bone resorption takes place as a result of an inflammatory response to small wear particles. After infection has been excluded the treatment of choice is a single-stage revision♦ Dislocation may be the result of patient factors, implant factors, or poor surgical technique. It is imperative for the clinician to minimize the risk by selecting patients carefully, using the correct combination of implants and performing surgery accurately♦ The management of periprosthetic fractures depends on how well the implants are fixed and quality of bone stock. Treatment ranges from simple fixation of the fracture through to revision augmented with strut allograft.

THREE-DIMENSIONAL MORPHOMETRY OF NATIVE ACETABULUM IN RELATION TO DESIGN AND IMPLANTATION OF CANINE TOTAL HIP REPLACEMENTS

2012 ◽  
Vol 24 (06) ◽  
pp. 549-555 ◽  
Author(s):  
Ching-Ho Wu ◽  
Cheng-Chung Lin ◽  
Tung-Wu Lu ◽  
Lih-Seng Yeh
Keyword(s):  
Total Hip Replacement ◽  
Hip Replacement ◽  
Quantitative Data ◽  
Three Dimensional ◽  
Morphological Parameters ◽  
3D Ct ◽  
Total Hip ◽  
Acetabular Orientation ◽  
Total Hip Replacements ◽  
Hip Replacements

Total hip replacement (THR) has been one of the main choices in treating dysplasia and other disabling conditions of the coxofemoral joint of large-breed dogs. Quantitative data of the three-dimensional (3D) morphology of the native normal acetabulum will be helpful for better design and implantation of prosthetic components. However, 3D orientation and morphological parameters of the native acetabulum in large-breed dogs are rarely reported. The purposes of the study were to measure the values of the 3D morphological parameters of the native acetabulum in Labrador Retriever dogs, namely acetabular orientation in relation to the pelvis, as well as the radius, angle between ventral and dorsal rims, and the distance from the center to the dorsal rim of the acetabulum using a 3D CT-derived model. The data will be useful for developing a more accurate guideline for improving current THR designs and for more accurate placement of the acetabulum component during THR surgery.

scholarly journals 1528 Pseudotumour from Corrosive Material of Total Hip Replacement: A Rare Complication with an Unusual Presentation

2021 ◽  
Vol 108 (Supplement_6) ◽  
Author(s):  
M Ahmed ◽  
S Radha
Keyword(s):  
Hip Replacement ◽  
Metal Ion ◽  
Galvanic Corrosion ◽  
Rare Complication ◽  
Iliac Fossa ◽  
Cystic Mass ◽  
Rare Presentation ◽  
Total Hip ◽  
Total Hip Replacements ◽  
Hip Replacements

Abstract Total hip replacements have been performed in the UK since the 1960s, with over 280000 primary hip replacements being conducted between January 2017 – December 2019. The formation of pseudotumours is an uncommon and an unusual long-term complication of total hip replacements. Formed by galvanic corrosion of the metal prosthesis, patients can display an array of symptoms. We herein report a rare presentation of unilateral leg oedema in an elderly female, mimicking deep vein thrombosis. Despite normal metal ion levels, radiological investigations revealed an irregular cystic mass extending into the iliac fossa compressing the neurovascular bundle in the groin. The patient underwent complex revision hip surgery with dual mobility hip replacement and an Exeter stem with excision of the pseudotumour. This case highlights the importance of appropriate workup for these patients and the involvement of a multidisciplinary team.

scholarly journals Finite element analysis of polyethylene wear in total hip replacement: A literature review

2019 ◽  
Vol 233 (11) ◽  
pp. 1067-1088 ◽  
Author(s):  
Lin Wang ◽  
Graham Isaac ◽  
Ruth Wilcox ◽  
Alison Jones ◽  
Jonathan Thompson
Keyword(s):  
Finite Element ◽  
Literature Review ◽  
Hip Replacement ◽  
Material Selection ◽  
Polyethylene Wear ◽  
Element Analysis ◽  
Total Hip ◽  
Total Hip Replacements ◽  
Hip Replacements ◽  
Modelling Techniques

Evaluation and prediction of wear play a key role in product design and material selection of total hip replacements, because wear debris is one of the main causes of loosening and failure. Multifactorial clinical or laboratory studies are high cost and require unfeasible timeframes for implant development. Simulation using finite element methods is an efficient and inexpensive alternative to predict wear and pre-screen various parameters. This article presents a comprehensive literature review of the state-of-the-art finite element modelling techniques that have been applied to evaluate wear in polyethylene hip replacement components. A number of knowledge gaps are identified including the need to develop appropriate wear coefficients and the analysis of daily living activities.

Thromboprophylaxis and Total Hip Replacement: A Cost-Efficacy Study Comparing Duplex Screening of Asymptomatic Venous Thrombosis versus Prolonged Prophylaxis with Low-Molecular-Weight Heparins

2002 ◽  
Vol 17 (3-4) ◽  
pp. 93-97
Author(s):  
M. T. Barrellier
Keyword(s):  
Molecular Weight ◽  
Direct Cost ◽  
Hip Replacement ◽  
Prophylactic Treatment ◽  
Low Molecular Weight ◽  
Low Molecular Weight Heparins ◽  
Total Hip ◽  
Total Hip Replacements ◽  
Annual Budget ◽  
Hip Replacements

Background: Despite use of the anti-thrombotic prophylaxis, clinical thrombo-embolic events and fatal pulmonary embolism are still observed after total hip replacement. To reduce these complications, two strategies have been adopted: to prolong the use of low-molecular-weight heparins (LMWH) to 35 days or to screen patients systematically before discharge, using duplex ultrasonography, following the short-course prophylactic treatment. Objective: To assess, based on published literature, the relative costs and benefits of these two strategies for prophylaxis following total hip arthroplasty. Method: The author identified relevant papers in this field from his own resources and from medical literature databases. Synthesis: Prolonging LMWH treatment to a total of 35 days represents a direct cost in France of approximately £340 per patient, or for 100000 total hip replacements per year, an annual budget of £34 000000. If this strategy attained maximum efficacy, it would avoid 150 fatal pulmonary embolisms. The direct cost would therefore be at least £227000 per life saved. A systematic single duplex ultrasound examination before discharge from hospital would cost £76 per patient, or for 100 000 arthroplasties a total annual budget in France of £7 600000. If this approach achieved maximum efficacy, preventing the 150 fatal pulmonary embolisms corresponding to 100000 total hip replacements, the minimum direct cost would be £50 300 per life saved. Conclusion: Duplex screening may be more effective and lest costly than prolongation of prophylactic treatment using LMWH. This deduction needs to be confirmed by complex cost-benefit studies using clinical end-points.

scholarly journals Anaesthesia for Hip Replacement in Ankylosing Spondylitis

1986 ◽  
Vol 79 (8) ◽  
pp. 457-459 ◽  
Author(s):  
F W Wittmann ◽  
P A Ring
Keyword(s):  
Ankylosing Spondylitis ◽  
Hip Replacement ◽  
Indirect Laryngoscopy ◽  
Emergency Intubation ◽  
Total Hip ◽  
Preoperative Visit ◽  
Total Hip Replacements ◽  
Hip Replacements

Thirteen total hip replacements in 8 patients with ankylosing spondylitis are reviewed. Complications of the disease which can lead to anaesthetic difficulties are discussed, and the importance of a preoperative visit and the value of indirect laryngoscopy emphasized. As intubation problems may occur, especially in undiagnosed cases, equipment for emergency intubation should always be readily available. The results fully justify the operation.

Patients with Rheumatoid Arthritis Are More Likely to Have Pain and Poor Function After Total Hip Replacements than Patients with Osteoarthritis

2014 ◽  
Vol 41 (9) ◽  
pp. 1774-1780 ◽  
Author(s):  
Susan M. Goodman ◽  
Danielle N. Ramsden-Stein ◽  
Wei-Ti Huang ◽  
Rebecca Zhu ◽  
Mark P. Figgie ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Womac Pain ◽  
Postoperative Function ◽  
Total Hip ◽  
Disease Modifying Therapy ◽  
Total Hip Replacements ◽  
Hip Replacements ◽  
Disease Modifying ◽  
And Function

Objective.Total hip replacement (THR) outcomes have been worse for patients with rheumatoid arthritis (RA) compared with those who have osteoarthritis (OA). Whether this remains true in contemporary patients with RA with a high use of disease-modifying and biologic therapy is unknown. The purpose of our study is to assess pain, function, and quality of life 2 years after primary THR, comparing patients with RA and patients with OA.Methods.Baseline and 2-year data were compared between validated patients with RA and patients with OA who were enrolled in a single-center THR registry between May 1, 2007, and February 25, 2011.Results.There were 5666 eligible primary THR identified, of which 193 were for RA. RA THR had worse baseline Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) pain (44.8 vs 53.2, p < 0.001) and function (38.7 vs 49.9, p < 0.001) compared with OA. These differences remained after surgery: pain (88.4 vs 94.0, p < 0.001) and function (82.9 vs 91.8, p < 0.001). Patients with RA were as likely to have a significant improvement as patients with OA (Δ WOMAC > 10) in pain (94% vs 96%, p = 0.35) and function (95% vs 94%, p = 0.69), but were 4 times as likely to have worse function (WOMAC ≤ 60; 19% vs 4%, p < 0.001) and pain (12% vs 3%, p < 0.001). In multivariate logistic regression controlling for multiple potential confounders, RA increased the odds of poor postoperative function (OR 4.32, 95% CI 1.57–11.9), and in patients without a previous primary THR, worse postoperative pain (OR 3.17, 95% CI 1.06–9.53).Conclusion.Contemporary patients with RA have significant improvements in pain and function after THR, but higher proportions have worse 2-year pain and function. In addition, RA is an independent predictor of 2-year pain and poor function after THR, despite high use of disease-modifying therapy.

scholarly journals The hidden costs of metal-on-metal hip resurfacing: the financial and logistical implications of a change in hospital follow-up policy

2013 ◽  
Vol 95 (3) ◽  
pp. 88-91
Author(s):  
J Lloyd ◽  
I Starks ◽  
T Wainwright ◽  
R Middleton
Keyword(s):  
Hip Replacement ◽  
Hip Resurfacing ◽  
Surface Wear ◽  
Bearing Surface ◽  
Total Hip ◽  
Total Hip Replacements ◽  
Large Head ◽  
Metal On Metal ◽  
Hip Replacements

Metal-on-metal (MoM) hip resurfacings (HRs) and large head total hip replacements (LHTHRs) were perceived by many as a surgical revolution, with clear advantages over the traditional metal-on-polyethylene total hip replacement (THR). This is especially the case for younger, active individuals in whom conventional THR has been associated with higher rates of aseptic loosening. In addition to less bearing surface wear, frequently cited advantages for HR include the preservation of femoral bone stock, lower dislocation rates, and superior function and activity scores.

The Incidence of Fracture in Total Hip Replacement Femoral Components

1978 ◽  
Vol 7 (2) ◽  
pp. 107-110 ◽  
Author(s):  
H. S. Dobbs
Keyword(s):  
Femoral Component ◽  
Total Hip Replacement ◽  
Hip Replacement ◽  
Fracture Rate ◽  
Total Hip ◽  
Total Hip Replacements ◽  
Orthopaedic Hospital ◽  
Hip Replacements ◽  
Cobalt Chrome

The paper reports on the incidence of fracture of the femoral component of total hip replacements in patients at the Royal National Orthopaedic Hospital over the period 1963-1976. The average incidence of fracture was approximately 0.2 per cent per year for air melt air cast cobalt chrome components. For vacuum melt vacuum cast components there were no fractures, but because of the small number of insertions with a long follow-up period, this result could have been fortuitous. There was a suggestion that the fracture rate increased with time, but even 0.2 per cent is considered too high.

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