Results of a Stemmed Bone Ingrowth HIP Resurfacing Arthroplasty in the Canine

1985 ◽  
Vol 55 ◽  
Author(s):  
W. C. Kim ◽  
H. Rechl ◽  
H. C. Amstutz ◽  
K. Hermens ◽  
P. F. O'Carroll ◽  
...  
Keyword(s):  
Femoral Head ◽  
Femoral Neck ◽  
Bone Ingrowth ◽  
Stress Shielding ◽  
Load Sharing ◽  
Hip Resurfacing ◽  
Hip Resurfacing Arthroplasty ◽  
Resurfacing Arthroplasty ◽  
Compressive Stresses ◽  
Acetabular Components

ABSTRACTA stemmed bone ingrowth hip resurfacing arthroplasty designed for use with bone deficient femoral heads raises concerns of stress shielding and is investigated in this study. Ten CoCr bone ingrowth hip resurfacing devices were implanted in five adult canines. Design consisted of a 6mm deep cylindrical cavity with porous beaded surface of 150um pore size and Imm nominal depth. A 3mm diameter smooth CoCr stem was eccentrically fixed to the component for additional fixation with threaded nut at the lateral cortex. Femoral head was reamed for interference fit with hole for the stem placed superiorly. Acrylic fixed polyethylene cups were used for acetabular components. Animals were followed with serial radiographs to sacrifice at 73 to 267 days. After sacrifice microradiographs of ground sections and histologic specimens were evaluated for bone ingrowth, remodeling, and femoral neck attenuation. All specimens showed well ingrown bone at the porous layer. Bone remodeling showed preservation of proximal femoral neck cancellous trabecular pattern and medial cortical support. Resorption of bone at the implant rim and femoral neck thinning were, however, present. Two specimens had neck thinning of 10% or less, four of 10 to 25%, three of 25 to 50%, and one greater than 50%. There was no correlation with time to sacrifice for parameters evaluated. Results indicate preservation of the compressive stresses through the femoral head. Resorption of bone at the rim and femoral neck attenuation, however, indicates load sharing between the implant and bone. Though a lower modulus material such as titanium would decrease load sharing, the geometrical design insures the presence of stress distribution anomalies.

scholarly journals Design of Custom-made Navigational Template of Femoral Head and Pilot Research in Total Hip Resurfacing Arthroplasty

2020 ◽  
Author(s):  
Jinlong LIANG ◽  
Yonghui Zhao ◽  
Xinjian Gao ◽  
Xuewei Fang ◽  
Yongqing Xu ◽  
...  
Keyword(s):  
Femoral Head ◽  
Femoral Neck ◽  
Hip Resurfacing ◽  
Kirschner Wires ◽  
Hip Resurfacing Arthroplasty ◽  
Prosthesis Implantation ◽  
Total Hip ◽  
Resurfacing Arthroplasty ◽  
Valgus Angle ◽  
Custom Made

Abstract Background To develop a novel custom-made navigational template for accurate prosthesis implantation in total hip resurfacing arthroplasty (THRA) by computer-aided technology. Methods The template was produced based on data preoperatively acquired with computed tomography (CT) scan. The position of the drill guide was chosen as the anatomical axis of the femoral neck which was defined by the ligature between the center of the femoral head and another point on the centerline of proximal femoral neck. And the final direction of the drill guide was confirmed by a small valgus angle. The surface of the template was constructed as the inverse of the femoral neck surface. Then each template was formed from acrylate resin by using rapid prototyping (RP) technique. Finally, the template was tested in 18 cadavers scheduled for THRA and postoperative medical imaging was used to evaluate the accuracy and validity of the template. Results The template had a near-prefect fit with the femoral neck surface. There were no guide failures. Postoperative evaluation revealed that the Kirschner wires pass through the center of the femoral head, have a relative valgus angle to the central axis of the femoral neck and have no obvious varus-valgus angles or anterior/posterior inclination angles. So, the Kirschner wires achieved the expected implant requirement. Conclusion This study shows a novel way of guiding the prosthesis implantation accurately in THRA. The template is an excellent medium for preoperative planning and intraoperative technique, and embodies the development tendency of Computer Assisted Surgery.

Comparative repeatability of guide-pin axis positioning in computer-assisted and manual femoral head resurfacing arthroplasty

2007 ◽  
Vol 221 (7) ◽  
pp. 713-724 ◽  
Author(s):  
A Hodgson ◽  
N Helmy ◽  
B A Masri ◽  
N V Greidanus ◽  
K B Inkpen ◽  
...  
Keyword(s):  
Femoral Head ◽  
Computer Assisted Surgery ◽  
Hip Resurfacing ◽  
Computer Assisted ◽  
Comparable Amount ◽  
Hip Resurfacing Arthroplasty ◽  
Resurfacing Arthroplasty ◽  
Surgeon Experience ◽  
Position And Orientation ◽  
Version Measurement

The orientation of the femoral component in hip resurfacing arthroplasty affects the likelihood of loosening and fracture. Computer-assisted surgery has been shown to improve significantly the surgeon's ability to achieve a desired position and orientation; nevertheless, both bias and variability in positioning remain and can potentially be improved. The authors recently developed a computer-assisted surgical (CAS) technique to guide the placement of the pin used in femoral head resurfacing arthroplasty and showed that it produced significantly less variation than a typical manual technique in varus/valgus placement relative to a pre-operatively determined surgical plan while taking a comparable amount of time. In the present study, the repeatability of both the CAS and manual techniques is evaluated in order to estimate the relative contributions to overall variability of surgical technique (CAS versus manual), surgeon experience (novice versus experienced), and other sources of variability (e.g. across specimens and across surgeons). This will enable further improvements in the accuracy of CAS techniques. Three residents/fellows new to femoral head resurfacing and three experienced hip arthroplasty surgeons performed 20-30 repetitions of each of the CAS and manual techniques on at least one of four cadaveric femur specimens. The CAS system had markedly better repeatability (1.2°) in varus/valgus placement relative to the manual technique (2.8°), slightly worse repeatability in version (4.4° versus 3.2°), markedly better repeatability in mid-neck placement (0.7 mm versus 2.5 mm), no significant dependence on surgeon skill level (in contrast to the manual technique), and took significantly less time (50 s versus 123 s). Proposed improvements to the version measurement process showed potential for reducing the standard deviation by almost two thirds. This study supports the use of CAS for femoral head resurfacing as it is quicker than the manual technique, independent of surgeon experience, and demonstrates improved repeatability.

scholarly journals CUSTOMIZED GUIDE FOR FEMORAL COMPONENT POSITIONING IN HIP RESURFACING ARTHROPLASTY

2017 ◽  
Vol 25 (2) ◽  
pp. 103-106
Author(s):  
Chaturong Pornrattanamaneewong ◽  
Rapeepat Narkbunnam ◽  
Keerati Chareancholvanich
Keyword(s):  
Femoral Neck ◽  
Three Dimensional ◽  
Posterior Part ◽  
Image Intensifier ◽  
Hip Resurfacing ◽  
Three Dimensional Model ◽  
Level Of Evidence ◽  
Hip Resurfacing Arthroplasty ◽  
Femoral Neck Axis ◽  
Resurfacing Arthroplasty

ABSTRACT Objective: To prove the accuracy of a customized guide developed according to our method. Methods: This customized guide was developed from a three-dimensional model of proximal femur reconstructed using computed tomography data. Based on the new technique, the position of the guide pin insertion was selected and adjusted using the reference of the anatomical femoral neck axis. The customized guide consists of a hemispheric covering designed to fit the posterior part of the femoral neck. The performance of the customized guide was tested in eight patients scheduled for total hip arthroplasty. The stability of the customized guide was assessed by orthopedic surgeons. An intraoperative image intensifier was used to assess the accuracy. Results: The customized guide was stabilized with full contact and was fixed in place in all patients. The mean angular deviations in relation to the what was planned in anteroposterior and lateral hip radiographs were 0.5º ± 1.8º in valgus and 1.0º ± 2.4º in retroversion, respectively. Conclusion: From this pilot test, the authors suggest that the proposed technique could be applied as a customized guide to the positioning device for hip resurfacing arthroplasty with acceptable accuracy and user-friendly interface. Level of Evidence IV, Cases Series.

Femoral Neck Fracture After Birmingham Hip Resurfacing Arthroplasty

2013 ◽  
Vol 28 (1) ◽  
pp. 147-153 ◽  
Author(s):  
Gulraj S. Matharu ◽  
Callum W. McBryde ◽  
Matthew P. Revell ◽  
Paul B. Pynsent
Keyword(s):  
Femoral Neck ◽  
Femoral Neck Fracture ◽  
Hip Resurfacing ◽  
Hip Resurfacing Arthroplasty ◽  
Resurfacing Arthroplasty ◽  
Birmingham Hip Resurfacing ◽  
Neck Fracture

Hip Resurfacing Arthroplasty in Patients with Varus Deformity of the Femoral Neck-Shaft Angle

2011 ◽  
Vol 21 (2) ◽  
pp. 225-230 ◽  
Author(s):  
Graeme S. Carlile ◽  
Christopher P. Wakeling ◽  
Nichola Fuller ◽  
Darren Fern ◽  
Mark R. Norton
Keyword(s):  
Femoral Neck ◽  
Varus Deformity ◽  
Hip Resurfacing ◽  
Hip Resurfacing Arthroplasty ◽  
Neck Shaft Angle ◽  
Resurfacing Arthroplasty ◽  
Shaft Angle
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