AIM: Dysplastic coxarthritis usually occurs earlier than primary coxarthritis. As a rule dysplastic coxarthritis mostly affects young and active individuals. Bilateral coxarthritis may lead to severe impairment requiring surgical replacement of both hip joints, as the patients are frequently dissatisfied with the substitution of one joint alone. METHOD: In a retrospective study, 15 patients with bilateral hip dysplasia who had received total endoprostheses in both hip joints in a one-stage procedure (group A) were compared to 15 patients with bilateral dysplasia who had been operated on bilaterally in two stages (group B). Group B was subdivided into B1 (first side) and B2 (second side). All dysplasias were classified according to Hartofilakidis and Crowe. RESULTS: On the first postoperative day, group A experienced a mean drop of 33.9% in haemoglobin values, group B1 a mean drop of 25.1% and group B2 a mean drop of 26.3%. Patients of groups A/B1/B2 received on average 1.7/1.1/1.3 units of autologous blood and 1.2/0.1/0.3 units of foreign blood, respectively. Both groups experienced an improvement in their quality of life due to marked improvements in their Harris Hip Score and UCLA Score. Group A had no higher rate of complications. CONCLUSION: Although the single-stage procedure involved greater effort in terms of physiotherapy, patients preferred bilateral implantation of total hip endoprosthesis in a single surgical session because they needed to undergo the process of operation, mobilisation and rehabilitation only once.

Adult↗

PubMedDate not supplied

[Cement-free Zweymüller hip system. Results of a 5-year follow-up study].

85 patients with 96 cementless pressfit hip implants were followed over a period of at least 5 years postoperatively. Average Harris score was 87.5 points. One socket had to be exchanged because of aseptic loosening. Additionally, 5 implants developed radiolucent lines, only one of them totally around the socket. In no case an exchange of the stem was necessary; one stem initially sank by 4 mm axially but was stable at the last follow-up investigation. Only one patient personally is dissatisfied with the outcome of the operation. In no case, implant specific complications such as breakage of the implant, breakage or crack of the stem, or shattering of the pelvic girdle by acetabular-screwing could be observed.

Adult↗

PubMedDate not supplied

[5- to 10-year results of an acetabulum with ceramic pegs for cement-free bone implantation. Material and analysis of design].

The authors report on the follow-up results of a hemispherical acetabular cup with small pegs, which is designed for cementless implantation in human beings. At an average time of 89 months after implantation, these results reveal a high percentage of 60% loosenings and seam formations of more than 2 mm which could constitute the basis for subsequent loosening. An analysis of these failures attributes the cause to material-engineering as well as design problems associated with the bone pathology. A ceramic cup of this shape is apparently unsuitable for osteointegration. It would appear that the design favours tilting movements and, due to its high E-module, it is unable to compensate for the relative movements of the pelvis.

Acetabulum↗

PubMedDate not supplied

[Analysis and results following replacement surgery of loose, cemented hip endoprostheses].

Between 1971 and May 1981 2380 Total Hip Replacements were performed at the Orthopedic Clinic of the University of Vienna. In 145 patients (6,1%) a revision arthroplasty had to be done, because of loosening of the prostheses. 10 of these patients had to be reoperated once more because of a second failure. All together 76% of the patients were either very or almost content with the result of the operation. Considering only patients with one revision arthroplasty we saw 87% good and very good results. The average hip movement was 93 degrees in flexion, 20 degrees in abduction and 24 degrees in adduction. They had a fairly good walking capacity and have not been reduced in their daily work. The revision arthroplasty of a loosened total hip replacement can be advised to the patients, even though the second operation is larger and of higher risk to the patients than the first one.

Adult↗

PubMedDate not supplied

[Periarticular ossifications following implantation of cement-free total hip endoprostheses of the Zweymüller-Endler type].

Ectopic ossifications after 158 cementless implanted Total hip endoprostheses Type Zweymüller-Endler have been examined postoperatively within 12 months at the earliest. The rate of ossification was 39.9%. This range is higher than the mean range of cemented hip endoprostheses reported in the literature. The higher range of ossification is found in low grade ossification grade CA I. Severe ossification of grade CA III occurred only in a low percentage. The influence of various factors (as prophylaxis for thrombosis approach, duration of operation, sex, age, other diseases, complications) on the frequency of occurrence is examined. There was no significant result concerning these parameters. The main causes for ectopic ossification seem therefore to be dispositional and constitutional factors. Male patients under the age of fifty show ectopic ossification in the highest degree.

Adult↗