scholarly journals Dynamic trial fitting of the cup in press-fit total hip arthroplasty, a feasibility study

2021 ◽  
Vol 87 (2) ◽  
pp. 327-331
Author(s):  
Daniël Hoornenborg ◽  
Justin Van Loon ◽  
Sheryl De Waard ◽  
Inger N. Sierevelt ◽  
Kim T.M. Opdam ◽  
...  
Keyword(s):  
Clinical Practice ◽  
Total Hip Arthroplasty ◽  
Feasibility Study ◽  
Hip Arthroplasty ◽  
Screw Fixation ◽  
The Real ◽  
Revision Thas ◽  
Total Hip ◽  
Press Fit ◽  
Potential Association

Trial fitting of the cup during total hip arthroplasty (THA) is done by trial cups, which do not resemble the real press-fit obtained by the definitive implant. Our goal is to judge feasibility of the X-pander® in clinical practice ; a device developed to mimic the real press-fit obtained by the definitive cup, to ensure satisfactory press-fit. In this feasibility study 45 experienced orthopaedic surgeons from 7 European countries filled in a structured survey after 78 primary THA and 31 revision surgeries, using the X-pander instead of traditional trial cups. Primary outcomes were decision change concerning cup size or further reaming and increased confidence regarding cup insertion and size. Additionally, potential association between the primary outcomes and procedure (primary or revi- sion), bone quality and experience of the surgeon were evaluated. In 33.3% of the primary and 32.2% of the revision cases the X-pander measurement changed the deci- sion and further reaming or change of cup size was decided. In 61.5% and 58.1% of respectively the primary and revision THAs the X-pander was judged to give fairly to much more reliable information than traditional trial cups. The X-pander could lead to less additional screw fixation, as stated in 37.2% of the primary and 25.8% of the revision cases and to better cup insertion in respectively 50.0% and 51.6%. This study validates that the X-pander may be a suitable option for accurate sizing and assessment of the reamed acetabulum and could replace traditional trial cups in THA.

scholarly journals Surgical anatomy of the pelvic vasculature, with particular reference to acetabular screw fixation in cementless total hip arthroplasty in Asian population

2017 ◽  
Vol 25 (1) ◽  
pp. 230949901668552 ◽  
Author(s):  
Hironori Ohashi ◽  
Shinichi Kikuchi ◽  
Shigeo Aota ◽  
Michiyuki Hakozaki ◽  
Shinichi Konno
Keyword(s):  
Total Hip Arthroplasty ◽  
Acetabular Component ◽  
Vascular Injury ◽  
Hip Arthroplasty ◽  
Screw Fixation ◽  
Kirschner Wire ◽  
Safety Zone ◽  
Total Hip ◽  
Cementless Total Hip Arthroplasty ◽  
Posterior Area

Purpose: Pelvic vascular injury is a serious complication associated with acetabular component setting with screw fixation in cementless total hip arthroplasty (THA). In this study, we investigated the safety zone for acetabular component setting with screw fixation in cementless THA as a means to prevent pelvic vascular injury. Methods: Thirty left hip joints of Japanese cadavers (11 males and 19 females) were analyzed. We used a hemispherical measuring cup with 52 guide holes designed to allow vertical insertion of a Kirschner wire. After the measuring cup was placed on the acetabulum, the Kirschner wire was inserted from each guide hole to examine the anatomical relationship between the acetabulum and the pelvic vessels. We calculated the frequency of pelvic vessel punctures and measured the distance from the acetabular surface to the pelvic vessels at each guide hole. Results: Our findings revealed that pelvic vessels do not exist in certain parts of the posterior area of the acetabulum. Furthermore, in this area, intrapelvic vessels are either lacking or located at a distance ≥31 mm from the surface of the acetabulum. Conclusion: The posterior area of the acetabulum, excluding its central portion, appeared to be the safety zone for acetabular screw fixation in Japanese cadavers.

scholarly journals Freedom Constrained Liner for the Treatment and Prevention of Dislocation in Total Hip Arthroplasty

2016 ◽  
Vol 106 (2) ◽  
pp. 165-172 ◽  
Author(s):  
M. Karvonen ◽  
H. Karvonen ◽  
M. Seppänen ◽  
A. Liukas ◽  
M. Koivisto ◽  
...  
Keyword(s):  
Risk Factors ◽  
Total Hip Arthroplasty ◽  
Failure Rate ◽  
Hip Arthroplasty ◽  
Mechanical Failure ◽  
University Hospital ◽  
Revision Thas ◽  
Total Hip ◽  
Locking Mechanism ◽  
Constrained Liner

Background and Purpose: Dislocation is one of the most common complications following total hip arthroplasty. The aim of our study was to assess failure rate of the Biomet Freedom constrained liner (Biomet, Warsaw, IN, USA) either in revision surgery for recurrent dislocation, or as a preventive method in high dislocation risk patients. Patients and Methods: We assessed retrospectively 105 consecutive surgical procedures in 103 patients where a Freedom constrained liner or cup was used in Turku University Hospital over a 7-year period from 2007 to 2014. The mechanical failure rate of the device was assessed based on medical records. The average age of the patients was 73.4 years. The number of male patients was 53 (51%). Mean follow-up time was 2.5 years. The association between failure of the device and potential risk factors—age, gender, indication, and approach—was analyzed with logistic regression. Results were expressed by odd ratios and 95% confidence intervals. Results: The mechanical failure rate of the Freedom device was 6 out of 105 (5.7%). None of the 11 preventive primary THAs against dislocation failed, 4 out of 52 (7.7%) preventive revision THAs against dislocation failed, and 2 out of 42 (4.8%) of the treated dislocation cases failed. Four out of six failures were dislocations due to impingement and failure of the locking mechanism. Two liners failed because of loosening. The risk factors assessed were not associated with failure of the device. Interpretation: We found out that the mechanical failure rate of a Freedom constrained device was low. These results encourage us to continue using the device.

scholarly journals Effect of screw fixation on acetabular component alignment change in total hip arthroplasty

2014 ◽  
Vol 38 (6) ◽  
pp. 1155-1158 ◽  
Author(s):  
Takaaki Fujishiro ◽  
Shinya Hayashi ◽  
Noriyuki Kanzaki ◽  
Shingo Hashimoto ◽  
Nao Shibanuma ◽  
...  
Keyword(s):  
Total Hip Arthroplasty ◽  
Acetabular Component ◽  
Hip Arthroplasty ◽  
Screw Fixation ◽  
Component Alignment ◽  
Total Hip

scholarly journals Migration pattern of cementless press fit cups in the presence of stabilizing screws in total hip arthroplasty

2011 ◽  
Vol 16 (3) ◽  
pp. 127 ◽  
Author(s):  
C Zilkens ◽  
S Djalali ◽  
B Bittersohl ◽  
T Kälicke ◽  
CN Kraft ◽  
...  
Keyword(s):  
Total Hip Arthroplasty ◽  
Hip Arthroplasty ◽  
Migration Pattern ◽  
Total Hip ◽  
Press Fit

scholarly journals Structural and Morselized Allografting Combined with a Cementless Cup for Acetabular Defects in Revision Total Hip Arthroplasty: A 4- to 14-Year Follow-Up

2018 ◽  
Vol 2018 ◽  
pp. 1-7 ◽  
Author(s):  
Hou-Tsung Chen ◽  
Cheng-Ta Wu ◽  
Tsan-Wen Huang ◽  
Hsin-Nung Shih ◽  
Jun-Wen Wang ◽  
...  
Keyword(s):  
Total Hip Arthroplasty ◽  
Hip Arthroplasty ◽  
Type Ii ◽  
Revision Total Hip Arthroplasty ◽  
Total Hip ◽  
Press Fit ◽  
Cementless Cup ◽  
Revision Tha ◽  
Acetabular Defects

Using morselized and structural allograft to restore bone stock for massive acetabular bone defect in revision total hip arthroplasty (THA) is an appealing procedure. However, concerns about inability to achieve long-term stability following allograft resorption remained. From 2003 to 2012, 59 hips in 58 patients undergoing revision THA for Paprosky type II or III acetabular defects were retrospectively reviewed. The acetabular defects were managed with deep-frozen morselized and structural allografts, and a press-fit cementless cup along with supplementary screws. Clinical outcomes and radiographic results were analyzed with a mean follow-up of 8.7 years. The clinical successful rate was 100% for hips with Paprosky type II defect, 95.2% for IIIA defect, and 92.8% for IIIB defect. Three hips with type III defect failed at 4, 7, and 9 years, respectively. Harris Hip Score improved significantly from 60.1 preoperatively to 91.3 at the latest follow-up. All hips with good clinical results showed trabecular bridging in the allograft-host bone interface. Deep-frozen structural and morselized allograft in combination with a press-fit cementless cup represented a viable option to reconstruct acetabular defects in revision THA.

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