scholarly journals The effect of the hip joint endoprosthesis length after a total hip arthroplasty: A biomechanical study

2019 ◽  
Vol 26 (1) ◽  
pp. 61-66 ◽  
Author(s):  
Andreas-Foivos Smyris ◽  
Vassiliki T. Potsika ◽  
Ioannis-Ilias K. Farmakis ◽  
Nikolaos Tachos ◽  
Dimitrios I. Fotiadis ◽  
...  
Keyword(s):  
Total Hip Arthroplasty ◽  
Hip Arthroplasty ◽  
Cost Effective ◽  
Normal Weight ◽  
Biomechanical Study ◽  
Stem Length ◽  
Fourth Generation ◽  
Stem Size ◽  
Total Hip ◽  
Hip Joint Endoprosthesis

Background/purpose: Total hip arthroplasty is a safe, cost-effective surgical intervention which restores mobility and alleviates pain from most kinds of hip arthritis. The proposed biomechanical study evaluates the effect of the stem size on the mechanical environment of the hip and its association with aseptic loosening. Methods: Medium left, fourth-generation, composite femoral models were used, and different prosthesis dimensions were examined. Fourteen strain gages were placed at specific positions on the femur. Load cycles were programmed to simulate single-leg stance of gait of a normal-weight subject. Results: Microstrains in the anterior and posterior region of the femur shaft were found to decrease with increasing the stem length, while no specific tendency was observed in the regions of the great and lesser trochanteric as well as in the medial and lateral femur. Conclusion: This study indicates that shorter implants are subjected to higher strains distally to the pertrochanteric area.

scholarly journals The impact of reducing the femoral stem length in total hip arthroplasty during gait

2021 ◽  
Author(s):  
Anatole Vilhelm Wiik ◽  
Adeel Aqil ◽  
Bilal Al-Obaidi ◽  
Mads Brevadt ◽  
Justin Peter Cobb
Keyword(s):  
Total Hip Arthroplasty ◽  
Gait Analysis ◽  
Hip Arthroplasty ◽  
Femoral Stem ◽  
Short Stem ◽  
Stem Length ◽  
Practical Consideration ◽  
Total Hip ◽  
Long Stem ◽  
The Impact

Abstract Aim The length of the femoral stem in total hip arthroplasty (THA) is a practical consideration to prevent gait impairment. The aim of this study was to determine if reducing the femoral stem length in THA would lead to impaired gait biomechanics. Methods Patients uniformly with the same brand implant of differing lengths (100 mm vs 140–166 mm) were taken retrospectively from a prospective trial introducing a new short stem. Twelve patients without any other disorder to alter gait besides contralateral differing length stem THA were tested at differing gradients and speed on a validated instrumented treadmill measuring ground reaction forces. An anthropometrically similar group of healthy controls were analysed to compare. Results With the same posterior surgical approach, the offset and length of both hips were reconstructed within 5 mm of each other with an identical mean head size of 36 mm. The short stem was the last procedure for all the hips with gait analysis occurring at a mean of 31 and 79 months postoperatively for the short and long stem THA, respectively. Gait analysis between limbs of both stem lengths demonstrated no statistical difference during any walking condition. In the 90 gait assessments with three loading variables, the short stem was the favoured side 51% of the time compared 49% for the long stem. Conclusion By testing a range of practical walking activities, no lower limb loading differences can be observed by reducing the femoral stem length. A shorter stem demonstrates equivalence in preference during gait when compared to a reputable conventional stem in total hip arthroplasty.

scholarly journals Identification of Critical Genes and lncRNAs in Osteolysis after Total Hip Arthroplasty and Osteoarthritis by RNA Sequencing

2021 ◽  
Vol 2021 ◽  
pp. 1-13
Author(s):  
Guang Yang ◽  
Kai Tang ◽  
Li Qiao ◽  
Yixin Li ◽  
Shui Sun
Keyword(s):  
Total Hip Arthroplasty ◽  
Effective Treatment ◽  
Rna Sequencing ◽  
Hip Arthroplasty ◽  
Specific Interaction ◽  
Cost Effective ◽  
Common Complication ◽  
Total Hip ◽  
Cost Effective Treatment ◽  
Coexpression Networks

Total hip arthroplasty (THA) is a cost-effective treatment for osteoarthritis (OA), and osteolysis is a common complication of THA. This study was aimed at exploring the relevant molecular biomarkers for osteolysis after THA. We performed RNA sequence to identify and characterize expressed mRNAs and lncRNAs in OA and osteolysis. Differentially expressed mRNAs (DEmRNAs) and lncRNAs (DElncRNAs) in OA and osteolysis were acquired, as well as shared DEmRNAs/DElncRNAs in OA and osteolysis and osteolysis-specific DEmRNAs/DElncRNAs. Then, shared and osteolysis-specific DElncRNA-DEmRNA coexpression networks were constructed to further investigate the function of DElncRNAs and DEmRNAs in OA and osteolysis. In total, 343 DEmRNAs and 25 DElncRNAs in OA, 908 DEmRNAs and 107 DElncRNAs in osteolysis, and 406 DEmRNAs and 46 DElncRNAs between OA and osteolysis were acquired. A total of 136 shared DEmRNAs and 9 shared DElncRNAs in OA and osteolysis and 736 osteolysis-specific DEmRNAs and 103 osteolysis-specific DElncRNAs were acquired. Then, 128 shared DElncRNA-DEmRNA coexpression pairs and 522 osteolysis-specific DElncRNA-DEmRNA coexpression pairs were identified. The present study highlighted the roles of four interaction pairs, including two shared lncRNA-mRNA interaction pairs in OA and osteolysis (AC111000.4 and AC016831.6), which may function in the immune process of OA and osteolysis by regulating CD8A and CD8B, respectively, and two osteolysis-specific interaction pairs (AC090607.4-FOXO3 and TAL1-ABALON), which may play an important role in osteoclastogenesis.

scholarly journals Retrograde Cement Extrusion into Femoral Nutrient Vessels Following Uncomplicated Total Hip Arthroplasty

2017 ◽  
Vol 16 (1) ◽  
Author(s):  
Lim Chia Hua ◽  
V.A. Jacob ◽  
N. Premchandran
Keyword(s):  
Total Hip Arthroplasty ◽  
Hip Arthroplasty ◽  
Femoral Artery ◽  
Femoral Stem ◽  
Deep Femoral Artery ◽  
Neck Of Femur ◽  
Term Survival ◽  
Stem Size ◽  
Total Hip ◽  
Femoral Cortex

The present concepts in Total Hip Arthroplasty advocate mechanical cement interlock with trabecular bone utilising the third-generation cementing technique. However, the force generated can easily reach peak pressure of 122 kPa to 1500 kPa, leading to extrusion of cement through nutrient foramina into femoral cortex into nutrient vessels, henceforth the retrograde arteriovenogram. A 76 years old lady who premorbid ADLindependent had a fall and sustained a closed right neck of femur fracture. She underwent cemented right total hip arthroplasty. Acetabulum cup of 47mm and femoral stem size 1 was utilized. Femoral canal was prepared and medullary cavity plug inserted before retrograde cement was introduced using the cementing gun. Intraoperative no complications were noted. This case has been followed up to a year with no adverse effect. The post-operative radiograph demonstrated a linear radio-opacity communicating with the posterior aspect of the femoral shaft which continues proximally and medially for approximately 10cm. Its uniformity in shape and position corresponds to the vascular supply of proximal femur. In Farouk et al cadaveric study, nutrient vessel arises in 166 ± 10 mm from the greater trochanter and is a branch of the second perforating artery from the deep femoral artery. Knight et al infer that retrograde cement extrusion occurs in female patients with small stature and small endosteal canal. Cement extrusion unlikely will influence the long haul survival of prosthesis as shown in the radiograph that cement is well pressurized to interlock with the endosteal bone. Moreover, because of extensive anastomoses of perforating branches of the deep femoral artery, segmental obliteration of nutrient artery alone is unlikely to lead to vascularity issues. Cement extrusion into the nutrient foramen is a vital differential in presence of posterior medial cement in the diaphysis of the femur following total hip replacement. This is to differentiate from extra osseous extrusions due to the iatrogenic breach of the femoral cortex suggesting periprosthetic fracture which affects the long term survival of prosthesis.

scholarly journals One-Stage Bilateral Total Hip Arthroplasty. Modern Representations and Our Experience

2020 ◽  
Vol 106 (3) ◽  
pp. 52-62
Author(s):  
O.M. Kosiakov ◽  
P.V. Bulych ◽  
K.O. Hrebennikov ◽  
A.V. Myloserdov ◽  
Ye. V. Tuz ◽  
...  
Keyword(s):  
Total Hip Arthroplasty ◽  
Hip Arthroplasty ◽  
Surgical Intervention ◽  
Joint Damage ◽  
Cost Effective ◽  
Modern Medicine ◽  
Postoperative Rehabilitation ◽  
Surgical Interventions ◽  
Total Hip ◽  
One Stage

Summary. Relevance. Total hip arthroplasty remains one of the most successful and cost-effective surgical interventions in modern medicine. This is proven by the ever-growing number of total arthroplasties worldwide, which reached 650,000 implantations in Europe only in 2018. In 2024, this number is expected to be 730,000 [1]. According to experts, from 15 to 25 percent of patients need a bilateral procedure [2, 8]. The experience of our Center allows us to recommend a successful one-stage replacement of both hip joints for patients with a number of medical and social comorbidities. Objective. The study is set out to highlight the possibilities of performing simultaneous bilateral arthroplasty of the hip joint in a group of patients with bilateral joint damage, as well as to substantiate the economic, medical and social benefits of this surgical intervention. Materials and Methods. We have analyzed the data from publications of our foreign colleagues. We also present our own observations – more than 100 cases over the past 11 years (2008-2019). Results. Based on data from foreign publications and our own observations, the undoubted advantages, features and limitations of this type of surgical intervention are shown. Complex cases of bilateral joint damage and the results of one-stage surgical treatment have been demonstrated. Conclusions. One-stage bilateral hip arthroplasty is the method of choice for symmetric lesions and should take its rightful place in the arsenal of modern orthopedics clinics. We continue to advocate simultaneous bilateral hip replacement for a selected group of healthy patients ≤65 years old. Thoughtful preoperative planning, surgical intervention lasting up to 90 minutes on each joint, careful postoperative monitoring, strictly controlled prevention of thromboembolic complications and active postoperative rehabilitation provide our patients with quick and safe functional recovery.

scholarly journals To cement or not to cement acetabular cups in total hip arthroplasty: a systematic review and re-evaluation

SICOT-J ◽  
2019 ◽  
Vol 5 ◽  
pp. 35
Author(s):  
Frank Van Praet ◽  
Michiel Mulier
Keyword(s):  
Total Hip Arthroplasty ◽  
Hip Arthroplasty ◽  
English Literature ◽  
Cost Effective ◽  
Acetabular Cup ◽  
Qualitative Synthesis ◽  
Osteoarthritis Of The Hip ◽  
Total Hip ◽  
Primary Osteoarthritis ◽  
Cemented Stem

Introduction: Total Hip Arthroplasty (THA) in the treatment of primary osteoarthritis of the hip has evolved to a very safe and cost-effective intervention with revision rates below 5% after 10 years. To this day, however, controversy remains on whether or not to cement the acetabular cup. Methods: A comprehensive PubMed search of the English literature for studies published between 2007 and 2018 was performed. Studies comparing the clinical (revision rate, functionality), radiological (wear) or economic (cost) differences between cemented (cemented stem with cemented cup) and hybrid (cemented stem with uncemented cup) prostheses for primary osteoarthritis of the hip were identified as eligible. Results: A total of 1032 studies were identified whereof twelve were included for qualitative synthesis. All studies concerning the risk of revision were based on registry data, covering a total of 365,693 cups. Cemented prostheses had a similar or lower risk of revision compared to hybrid prostheses in every study, but performed slightly worse on functionality and quality of life. While cemented prostheses were the cheapest option, hybrids were the most cost-effective. Discussion: The widespread preference for cementless fixation of the acetabulum cannot be explained by a superior survival of cementless or hybrid models. Irrespective of age, cemented fixation of the acetabulum remains the gold standard to which other techniques should be compared.

A novel locking screw hip stem to achieve immediate stability in total hip arthroplasty: A biomechanical study

Injury ◽  
2015 ◽  
Vol 46 ◽  
pp. S83-S87 ◽  
Author(s):  
Stephan Grechenig ◽  
Boyko Gueorguiev ◽  
Arne Berner ◽  
Peter Heiss ◽  
Michael Müller ◽  
...  
Keyword(s):  
Total Hip Arthroplasty ◽  
Hip Arthroplasty ◽  
Biomechanical Study ◽  
Total Hip ◽  
Locking Screw

scholarly journals Subcuticular sutures versus staples for skin closure after primary hip arthroplasty

2021 ◽  
Vol 87 (1) ◽  
pp. 55-64
Author(s):  
Hany Elbardesy ◽  
Rehan Gul ◽  
Shane Guerin
Keyword(s):  
Total Hip Arthroplasty ◽  
Systematic Reviews ◽  
Hip Arthroplasty ◽  
Meta Analysis ◽  
Random Effect ◽  
Cost Effective ◽  
Skin Closure ◽  
Patient’S Satisfaction ◽  
Total Hip ◽  
Significant Difference

High-quality and cost-effective health care are highly recommended especially in joint replacement surgeries, particularly in total hip arthroplasty. Therefore, it is indispensable for orthopaedic surgeons to spot the potential areas of quality improvement. Evaluating the efficacy of the different ways of skin closure is an unacknowledged topic. We performed this study following both the Preferred Reporting Items for Systematic Reviews and Meta- analyses Statement (PRISMA) and the Cochrane Handbook for systematic reviews and meta-analysis. Articles were from any country, written in any language. We included all randomised control trials and retrospective cohort studies undergoing primary total hip arthroplasty who either received staples or subcuticular sutures for skin closure. The primary outcome was the incidence of wound infection. Secondary outcomes included length of stay (LOS), time to skin closure, total cost, and patient’s satisfaction. We included five studies in our cumulative meta- analysis. We conducted them using Review Manager V.5.0. We computed the risk ratio as a measure of the treatment effect, taking into account heterogeneity. We used Random-effect models. Primary skin closure with subcuticular sutures had insignificant marginal advantages for wound infections, LOS, and wound oozing. On the contrary, staples were more cost- effective and had less time for closure with higher patient’s satisfaction. Except for closure time and patient satisfaction , no significant difference between the two groups. The use of staples after THA may have several slight clinical advantages over the subcuticular sutures. However, owing to the complexities associated with wound closure, future clinical and laboratory studies assessing their complication outlines must be examined before an optimum technique can be determined.

scholarly journals Femoral stem size mismatch in women undergoing total hip arthroplasty

2018 ◽  
Vol 15 (2) ◽  
pp. 293-296 ◽  
Author(s):  
John M. Dundon ◽  
Dvorah Leah Felberbaum ◽  
William J. Long
Keyword(s):  
Total Hip Arthroplasty ◽  
Hip Arthroplasty ◽  
Femoral Stem ◽  
Size Mismatch ◽  
Stem Size ◽  
Total Hip

scholarly journals Value of preoperative three-dimensional planning software (AI-HIP) in primary total hip arthroplasty: a retrospective study

2021 ◽  
Vol 49 (11) ◽  
pp. 030006052110588
Author(s):  
Xuzhuang Ding ◽  
Bingshi Zhang ◽  
Wenao Li ◽  
Jia Huo ◽  
Sikai Liu ◽  
...  
Keyword(s):  
Retrospective Study ◽  
Total Hip Arthroplasty ◽  
Hip Arthroplasty ◽  
Preoperative Planning ◽  
Intraclass Correlation ◽  
Three Dimensional ◽  
Femoral Stem ◽  
Stem Size ◽  
Total Hip ◽  
Primary Total Hip Arthroplasty

Objective We performed a retrospective study to compare the accuracy of preoperative planning using three-dimensional AI-HIP software and traditional two-dimensional manual templating to predict the size and position of prostheses. The purpose of this study was to evaluate the accuracy of AI-HIP in preoperative planning for primary total hip arthroplasty. Methods In total, 316 hips treated from April 2019 to June 2020 were retrospectively reviewed. A typical preoperative planning process for patients was implemented to compare the accuracy of the two preoperative planning methods with respect to prosthetic size and position. Intraclass correlation coefficients (ICCs) were used to evaluate the homogeneity between the actual prosthetic size and position and the preoperative planning method. Results When AI-HIP software and manual templating were used for preoperative planning, the stem agreement was 87.7% and 58.9%, respectively, and the cup agreement was 94.0% and 65.2%, respectively. The results showed that when AI-HIP software was used, an extremely high level of consistency (ICC > 0.95) was achieved for the femoral stem size, cup size, and femoral osteotomy level (ICC = 0.972, 0.962, and 0.961, respectively). Conclusion AI-HIP software showed excellent reliability for predicting the component size and implant position in primary total hip arthroplasty.

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