Investigation of Modular Taper Material and Design Factors That Affect Mechanically Assisted Crevice Corrosion at the Femoral Head-Stem Junctions in Total Hip Arthroplasties

2021 ◽  
Author(s):  
Sevi Berna Kocagoz
Keyword(s):  
Femoral Head ◽  
Crevice Corrosion ◽  
Total Hip ◽  
Hip Arthroplasties ◽  
Design Factors

scholarly journals Septic Arthritis of the Hip Joint in Cervical Cancer Patients after Radiotherapy: Three Case Reports

2001 ◽  
Vol 9 (2) ◽  
pp. 41-45 ◽  
Author(s):  
Shu-Hua Yang ◽  
Rong-Sen Yang ◽  
Chin-Lin Tsai
Keyword(s):  
Cervical Cancer ◽  
Femoral Head ◽  
Septic Arthritis ◽  
Cancer Patients ◽  
Hip Joint ◽  
Defense Mechanisms ◽  
Case Reports ◽  
Causative Organism ◽  
Total Hip ◽  
Hip Arthroplasties

Cervical cancer patients may experience hip problems related to the cancer itself or therapeutic management for the cancer. Septic arthritis should be one of the possibilities but there have been no reports on this. Here we present three patients who developed hip problems more than two years after radiotherapy with or without a radical operation. One patient was managed as septic arthritis because of significant inflammatory signs around the affected hip joint even though the causative organism was not confirmed. Succeeding total hip arthroplasty functioned well and had no recurrence of infection. The hip problems of the other two patients were diagnosed as radiation osteonecrosis of the femoral head initially. However, Bacteroides fragilis infection was found several months after total hip arthroplasties. Radiotherapy to the pelvis may damage the hip joint and compromise host-defense mechanisms of the pelvic region. Both factors may increase the possibility of infection of hip joints. Further clinical evidence is needed to understand whether subacute or chronic anaerobic infection could also be one of the causes leading to progressive destruction of the femoral head.

scholarly journals Late Nontraumatic Dissociation of the Femoral Head and Trunnion in a Total Hip Arthroplasty

2015 ◽  
Vol 2015 ◽  
pp. 1-5 ◽  
Author(s):  
Simon J. M. Parker ◽  
Wasim Khan ◽  
Simon Mellor
Keyword(s):  
Femoral Head ◽  
Total Hip Arthroplasty ◽  
Hip Arthroplasty ◽  
Soft Tissues ◽  
Total Hip ◽  
Mild Wear ◽  
Long Term Follow Up ◽  
Utmost Care ◽  
Articulating Surface ◽  
Hip Arthroplasties

Background. Modular total hip arthroplasties are increasingly popular because customisation allows optimal restoration of patient biomechanics. However, the introduction of component interfaces provides greater opportunities for failure. We present a case of late nontraumatic dissociation of the head-neck interface, more than 10 years after insertion.Case Description. A 58-year-old woman had a left metal-on-metal total hip arthroplasty in 2002 for hip dysplasia. Following an uneventful 10-year period, she presented to hospital in severe pain after standing from a seated position, and radiographs demonstrated complete dissociation of the modular femoral head from the stem, with the femoral head remaining in its cup. There was no prior trauma or infection. Mild wear and metallosis were present on the articulating surface between the femoral head and trunnion. Soft tissues were unaffected.Discussion and Conclusions. This is the latest occurrence reported to date for nontraumatic component failure in such an implant by more than 7 years. The majority of cases occur in the context of dislocation and attempted closed reduction. We analyse and discuss possible mechanisms for failure, aiming to raise awareness of this potential complication and encouraging utmost care in component handling and insertion, as well as the long term follow-up of such patients.

Treatment of Osteonecrosis: Treatment by Femoral Osteotomy

1998 ◽  
Vol 8 (3) ◽  
pp. 154-158 ◽  
Author(s):  
F. Menschik ◽  
K.D. Schatz ◽  
R. Kotz
Keyword(s):  
Femoral Head ◽  
Survival Curve ◽  
Weight Bearing ◽  
Harris Hip Score ◽  
Term Outcome ◽  
Long Term Outcome ◽  
Total Hip ◽  
Special Cases ◽  
Hip Arthroplasties

The purpose of the use of an osteotomy for the treatment of osteonecrosis (ON) of the femoral head is to move the necrotic segment away from the major load-transmitting area of the acetabulum and to redistribute the weight-bearing forces to articular cartilage that is supported by healthy bone. The most common osteotomies are the varus, valgus, flexion, rotational (Sugioka), and combined osteotomies. Their long term outcome, reported in the literature, is quite controversial. We found a decreasing frequency of flexion osteotomies between 1986 and 1996 performed at our department. In 1977 we started with the Sugioka osteotomy in special cases of femoral head ON (necrotic angle in the AP-view about 90 degree) resulting in a total of 51 cases. Forty-one of them have been analyzed regarding complications, reoperations and Harris Hip Scores. Seventeen of 41 patients developed complications and underwent reoperation. Nevertheless the results according to the Harris Hip Score were satisfactoy (excellent and good in 24 patients fair in 10 and poor only in 7 cases). Independently from the size of the necrosis total hip arthroplasties have been performed in 8 cases. The survival curve of 41 Sugioka osteotomies shows a 50% decrease at 6 years. Due to this fact and the regression in the number of osteotomies of the femur in cases of ON of the hip joint we find in our material that the importance of osteotomies has dramatically decreased in contrast to the excellent results of total hip arthroplasty.

scholarly journals A 6 to 10 Years Follow-Up Study Comparing Two-incision Total Hip Arthroplasties in Patients with Osteonecrosis of the Femoral Head or Hip Dysplasia

2017 ◽  
Vol 01 (01) ◽  
pp. 033-037
Author(s):  
Hou Chen ◽  
Meng-Lin Lu ◽  
Feng-Chih Kou ◽  
I-Der Lu ◽  
Po-Chun Lin ◽  
...  
Keyword(s):  
Femoral Head ◽  
Hip Dysplasia ◽  
Total Hip ◽  
Follow Up Study ◽  
Hip Arthroplasties

Ten years on: increased metal ion levels in a cohort of patients who underwent uncemented metal-on-polyethylene total hip arthroplasty

2020 ◽  
Vol 102-B (7) ◽  
pp. 832-837
Author(s):  
Caroline Dover ◽  
Jan Herman Kuiper ◽  
Peter Craig ◽  
Phillip Shaylor
Keyword(s):  
Femoral Head ◽  
Total Hip Arthroplasty ◽  
Hip Arthroplasty ◽  
Metal Ion ◽  
Revision Arthroplasty ◽  
Total Hip ◽  
Uncemented Total Hip Arthroplasty ◽  
Oxford Hip Score ◽  
Hip Arthroplasties ◽  
Over Time

Aims We have previously demonstrated raised cobalt and chromium levels in patients with larger diameter femoral heads, following metal-on-polyethylene uncemented total hip arthroplasty. Further data have been collected, to see whether these associations have altered with time and to determine the long-term implications for these patients and our practice. Methods Patients from our previous study who underwent Trident-Accolade primary total hip arthroplasties using a metal-on-polyethylene bearing in 2009 were reviewed. Patients were invited to have their cobalt and chromium levels retested, and were provided an Oxford Hip Score. Serum ion levels were then compared between groups (28 mm, 36 mm, and 40 mm heads) and over time. Results Metal ion levels were repeated in 33 patients. When comparing the results of serum metal ion levels over time, regardless of head size, there was a significant increase in both cobalt and chromium levels (p < 0.001). Two patients with larger head sizes had undergone revision arthroplasty with evidence of trunnion damage at surgery. Two patients within the 40 mm subgroup had metal ion levels above the MHRA (Medicines and Healthcare Products Regulatory Agency) threshold for detailed investigation. The increase in cobalt and chromium, when comparing the 36 mm and 40 mm groups with those of the 28 mm group, was not significant (36 mm vs 28 mm; p = 0.092/p = 0.191; 40 mm vs 28 mm; p = 0.200/p = 0.091, respectively). There was no difference, between femoral head sizes, when comparing outcome as measured by the Oxford Hip Score. Conclusion This study shows an increase in cobalt and chromium levels over time for all modular femoral head sizes in patients with metal-on-polyethylene bearings, with two patients demonstrating ion levels above the MHRA threshold for failure, and a further two patients requiring revision surgery. These results may have clinical implications regarding longer term follow-up of patients and future implant choice, particularly among younger patients. Cite this article: Bone Joint J 2020;102-B(7):832–837.

Epidemiological Study of Femoral Head Osteonecrosis

2017 ◽  
Vol 68 (5) ◽  
pp. 974-976
Author(s):  
Alexandru Patrascu ◽  
Liliana Savin ◽  
Dan Mihailescu ◽  
Victor Grigorescu ◽  
carmen Grierosu ◽  
...  
Keyword(s):  
Risk Factors ◽  
Femoral Head ◽  
Total Hip Arthroplasty ◽  
Hip Arthroplasty ◽  
Young Patients ◽  
Head Group ◽  
Bipolar Hemiarthroplasty ◽  
Aseptic Necrosis ◽  
Total Hip ◽  
Femoral Head Osteonecrosis

In recent years, there has been an increase in the number of studies on the etiology of femoral head necrosis. We retrospectively reviewed all patients diagnosed with aseptic necrosis of the femoral in the period of 2010-2015. We recorded a total of 230 cases diagnosed with aseptic necrosis of the femoral head, group was composed of 65.7% men and 34.3% women, risk factors identified was 19.13% (post-traumatic), 13.91% (glucocorticoids), 26.52% (alcohol), 3.47% (another cause) and in 36 95% of the cases no risk factors were found. The results of the study based on the type of surgery performed on the basis of stages of disease progression, 8 patients (3.48%) benefited from osteotomy, 28 patients (12.17%) benefited of bipolar hemiarthroplasty prosthesis and 188 patients (81.74%) benefited of total hip arthroplasty. Osteonecrosis of the femoral head is characteristic to young patients between the age of 30-50 years old. Predisposing factors, alcohol and corticosteroid therapy remains an important cause of the disease. Total hip arthroplasty remains the best option for the patients with osteonecrosis of the femoral head.

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