scholarly journals A Case of a C-Stem Fracture at the Head-Neck Junction and a Review of the Literature

2012 ◽  
Vol 2012 ◽  
pp. 1-4 ◽  
Author(s):  
David Morley ◽  
Ian Starks ◽  
Justin Lim
Keyword(s):  
Fatigue Failure ◽  
Review Of The Literature ◽  
First Case ◽  
Metal On Metal ◽  
Femoral Heads ◽  
Stem Fracture ◽  
Active Patients ◽  
Large Femoral Heads ◽  
Head Neck ◽  
Neck Junction

We report the first case of a fracture of the standard C-stem in combination with a large metal-on-metal articulation. This occurred at the head-neck junction. Analysis of the fractured stem showed evidence of fatigue failure with possible corrosion. The use of large femoral heads with neck adaptors and narrow tapers should be used with caution, especially in heavy, active patients.

Femoral head material loss at the head-neck junction in total hip arthroplasty: the effect of head size, stem material and stem offset

2018 ◽  
Vol 29 (6) ◽  
pp. 647-651 ◽  
Author(s):  
Giuseppe Valente ◽  
Brent Lanting ◽  
Steven MacDonald ◽  
Matthew G Teeter ◽  
Douglas Van Citters ◽  
...  
Keyword(s):  
Femoral Head ◽  
Total Hip Arthroplasty ◽  
Hip Arthroplasty ◽  
Head Size ◽  
Material Loss ◽  
Total Hip ◽  
Femoral Heads ◽  
Measuring Machine ◽  
Head Neck ◽  
Neck Junction

Introduction:Material loss at the head-neck junction in total hip arthroplasty may cause adverse clinical symptoms and implant failure. The purpose of this study was to quantitatively examine the effects of head size, stem material and stem offset on material loss of the head-neck taper interface of a single trunnion design in retrieval implants of metal on polyethylene bearing surfaces.Methods:A retrieval study was performed to identify all 28-mm and 32-mm femoral heads from a single implant/taper design implanted for >2 years. This included n = 56 of the 28-mm heads and n = 23 of the 32-mm heads. The 28-mm femoral heads were matched to 32-mm femoral heads based on time in vivo and head length. A coordinate measuring machine was used to determine maximum linear corrosion depth (MLD). Differences in MLD for head diameter, stem material, and stem offset were determined.Results:There were no differences between groups for age, gender, BMI, or implantation time. There was no difference in MLD between 28 mm and 32 mm matched paired head diameters ( p = 0.59). There was also no difference in MLD between titanium or cobalt-chromium stems ( p = 0.79), and regular or high-offset stems ( p = 0.95).Conclusion:There is no statistical difference in femoral head MLD at the head-neck junction in THA between 28-mm and 32-mm matched paired femoral heads, similar or mixed alloy coupled femoral head stem constructs, and regular or high offset stems.

Evidence Based Recommendations for Reducing Head-Neck Taper Connection Fretting Corrosion in Hip Replacement Prostheses

2017 ◽  
Vol 27 (6) ◽  
pp. 523-531 ◽  
Author(s):  
Christian M. Wight ◽  
Brent Lanting ◽  
Emil H. Schemitsch
Keyword(s):  
Flexural Rigidity ◽  
Prosthetic Design ◽  
Fretting Corrosion ◽  
Strict Adherence ◽  
Hip Prostheses ◽  
Relative Contribution ◽  
Metal On Metal ◽  
Femoral Heads ◽  
Connection Design ◽  
Head Neck

Introduction This systematic review seeks to summarise the published studies investigating prosthetic design, manufacture and surgical technique's effect on fretting corrosion at the head-neck taper connection, and provide clinical recommendations to reduce its occurrence. Methods PubMed, MEDLINE and EMBASE electronic databases were searched using the terms taper, trunnion, cone and head-neck junction. Articles investigating prosthetic design, manufacture and surgical technique's effect on fretting corrosion were retrieved, reviewed and graded according to OCEBM levels of evidence and grades of recommendation. Results The initial search yielded 1,224 unique articles, and 91 were included in the analysis. Conclusions There is fair evidence to recommend against the use of high offset femoral heads, larger diameter femoral heads, and to pay particular consideration to fretting corrosion's progression with time and risk with heavier or more active patients. Particular to metal-on-metal hip prostheses, there is fair evidence to recommend positioning the acetabular component to minimise edge loading. Particular to metal-on-polyethylene hip prostheses, there is fair evidence to recommend the use of ceramic femoral heads, against use of cast cobalt alloy femoral heads, and against use of low flexural rigidity femoral stems. Evidence related to taper connection design is largely conflicting or inconclusive. Head-neck taper connection fretting corrosion is a multifactorial problem. Strict adherence to the guidelines presented herein does not eliminate the risk. Prosthesis selection is critical, and well-controlled studies to identify each design parameter's relative contribution to head-neck taper connection fretting corrosion are required.

scholarly journals Have large femoral heads reduced prosthetic impingement in total hip arthroplasty?

2018 ◽  
Vol 29 (1) ◽  
pp. 83-88 ◽  
Author(s):  
Bradford S Waddell ◽  
Chelsea Koch ◽  
Myra Trivellas ◽  
Jayme C Burket ◽  
Timothy Wright ◽  
...  
Keyword(s):  
Total Hip Arthroplasty ◽  
Hip Arthroplasty ◽  
Revision Arthroplasty ◽  
Head Size ◽  
Total Hip ◽  
Potential Source ◽  
Femoral Heads ◽  
Large Femoral Heads ◽  
Head Neck ◽  
Prosthetic Impingement

Background: Prosthetic impingement is implicated in dislocation after total hip arthroplasty (THA). While use of larger diameter femoral heads reduces the incidence of dislocation, the effect of larger heads upon impingement rate is unknown. We assessed retrieved THA components for evidence of impingement to determine if large femoral heads reduced the rate of impingement in primary THA and what factors might influence impingement. Methods: Liners from 97 primary THAs retrieved at revision arthroplasty were scored for evidence of impingement, defined as wear or deformation on the rim of the component. Component inclination and version were measured from anteroposterior and cross-table lateral radiographs. Results: Independent of revision diagnosis, 77% of liners demonstrated evidence of impingement. Impingement was less prevalent and less severe as head size increased. Severe impingement was observed in 50% of the liners with 28-mm heads, 15% of liners with 32-mm heads, and 21% of liners with 36-mm heads. Regardless of head size, 76% of liners revised for instability demonstrated impingement. Decreased head-neck ratio, use of an elevated liner, increased length of implantation, and increased version were associated with increased severity of impingement. Discussion: We showed that larger head sizes are associated with decreased incidence of impingement on retrieved acetabular liners when compared to smaller head sizes. Larger heads have reduced but not eliminated impingement, which remains a potential source of instability.

scholarly journals Osteoid Osteoma of the Atlas in a Boy: Clinical and Imaging Features–A Case Report and Review of the Literature

2020 ◽  
Author(s):  
Adelaide Valluzzi ◽  
Salvatore Donatiello ◽  
Graziana Gallo ◽  
Monica Cellini ◽  
Antonino Maiorana ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Osteoid Osteoma ◽  
Soft Tissues ◽  
Tissue Reaction ◽  
Imaging Features ◽  
Review Of The Literature ◽  
Resonance Imaging ◽  
Radiological Findings ◽  
First Case ◽  
Upper Cervical

AbstractOsteoid osteoma is a benign osteoblastic tumor, quite uncommon in the spine. We report a case of an osteoid osteoma involving the atlas in a 6-year-old boy, who presented with suboccipital pain and torticollis. Initial radiological findings were ambiguous as magnetic resonance imaging showed mainly edema of upper cervical soft tissues. The subsequent computed tomography depicted a lesion of left lamina of C1. As conservative treatment failed, the lesion was surgically resected and the patient became pain free. To our knowledge, this is the first case of osteoid osteoma involving the atlas associated with abnormal soft tissue reaction reported in literature.

Osteoblastoma of the clavicle at the site of a previous fracture—first case report and review of the literature

2019 ◽  
Vol 48 (10) ◽  
pp. 1623-1628
Author(s):  
Adriana C. Moreira ◽  
David I. Suster ◽  
Sterling Ellis Eide ◽  
Daniel I. Rosenthal ◽  
Connie Y. Chang
Keyword(s):  
Case Report ◽  
Review Of The Literature ◽  
Previous Fracture ◽  
First Case

scholarly journals B.05 Hemi-laryngopharyngeal spasm (HELPS) syndrome: The discovery, cure, and characterization of a new neurological condition

2017 ◽  
Vol 44 (S2) ◽  
pp. S11-S11
Author(s):  
C Honey ◽  
M Morrison
Keyword(s):  
Surgical Care ◽  
Review Of The Literature ◽  
The Past ◽  
First Case ◽  
Patient Reported ◽  
Operative Outcome ◽  
Small Cohort ◽  
The Common ◽  
Similar Motor

Background: We published the world’s first case of hemi-laryngpharyngeal spasm (HELPS) syndrome cured by microvascular decompression (MVD) of the Xth cranial nerve in 2016. We now present a small cohort of patients (n=3) successfully treated with surgery in order to better delineate the common characteristics of this syndrome, diagnostic tests of choice, nuances of their surgical care and outcomes of their treatment. Methods: The history and physical examination of three patients with HELPS syndrome are presented. Pre-operative laryngoscopy, neuroimaging, response to botox and intra-operative videos are detailed. Post-operative outcome and complications are presented. Results: Each patient reported similar motor (choking) and sensory (coughing) features in their history. Episodic choking relentlessly progressed over the years until it occurred while sleeping and with frightening severity prompting tracheostomy in one patient and intubation in another. A “tickling” sensation deep in the throat triggered episodic coughing that worsened over the years until it occurred while sleeping and with frightening severity (syncope and incontinence). Conclusions: A review of the literature suggests that patients with similar symptoms, often called episodic laryngospasm in the past, have been treated with psychotherapy or antacids. With the recognition that a clearly defined subset of these patients have HELPS syndrome, we can offer them the potential of a neurosurgical cure.

scholarly journals Hemophagocytic Lymphohistiocytosis Complicating Erythroleukemia in a Child with Monosomy 7: A Case Report and Review of the Literature

2013 ◽  
Vol 2013 ◽  
pp. 1-3
Author(s):  
Samin Alavi ◽  
Maryam Ebadi ◽  
Alireza Jenabzadeh ◽  
M. T. Arzanian ◽  
Sh. Shamsian
Keyword(s):  
Bone Marrow ◽  
Case Report ◽  
Hemophagocytic Lymphohistiocytosis ◽  
Chromosomal Abnormalities ◽  
Bone Marrow Aspiration ◽  
Review Of The Literature ◽  
Monosomy 7 ◽  
Persistent Fever ◽  
First Case ◽  
Erythroid Precursors

Herein, the first case of childhood erythrophagocytosis following chemotherapy for erythroleukemia in a child with monosomy 7 is reported. A 5-year-old boy presented with anemia, thrombocytopenia, and hepatosplenomegaly in whom erythroleukemia was diagnosed. Prolonged pancytopenia accompanied by persistent fever and huge splenomegaly and hepatomegaly became evident after 2 courses of chemotherapy. On bone marrow aspiration, macrophages phagocytosing erythroid precursors were observed and the diagnosis of HLH was established; additionally, monosomy 7 was detected on bone marrow cytogenetic examination. In conclusion, monosomy 7 can lead to erythrophagocytosis associated with erythroid leukemia and should be considered among the chromosomal abnormalities contributing to the association.

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