PubMed Health⌕ Search

SEARCH · PubMed Health

Results for “Hip Prosthesis”

Explore indexed PubMed citations for clinical trials, systematic reviews and public health research. Read source abstracts and follow each citation to its original PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 217 records · Page 12Linked to original sources
PubMedDate not supplied

An infected hip prosthesis in a dog diagnosed with a 99mTc-ciprofloxacin (infecton) scan.

This case report describes the use of the 99mTc-labeled radiopharmaceutical ciprofloxacin (Infecton) in a case of hip prosthesis loosening in a dog. Serial planar radiographs were not conclusive, and culture of the synovial fluid was negative. Antibiotic treatment did not result in improvement of the lameness. Scintigraphy was performed with 99-Tc-Infecton, a tracer claimed to be specific for infection. Antibiotic treatment was interrupted 6 weeks prior to the examination. Planar and tomographic images at 3 h and at 24 h postinjection showed increased activity along the acetabulum and the proximal femoral bone surrounding the femoral prosthesis, indicating focal infection. Bacteriology performed after removal of the implant revealed Pseudomonas aeruginosa.

Animals↗
PubMedDate not supplied

[Six to ten year results of use of the alloclassic hip prosthesis--a multicentre survival analysis].

AIM: This prospective study describes This retrospective multicenter study was undertaken to calculate mid- and long-term survival rates of the cementless Zweymüller/Alloclassic total hip prosthesis. MATERIAL AND METHODS: The rectangular titanium stem and threaded cup have been in use since 1986. The ball head is made of alumina ceramic, the inlay of UHMW polyethylene. Five hospitals in Austria, France and Germany cooperated in the follow-up of 848 patients operated between October 1986 and September 1990 (mean age 62.2 years, 62% women, 38% men, mean patient weight 73.8 kg, body mass index 26.8). 468 patients were followed clinically, 320 patients interviewed on the phone, 29 sent a letter. No information was available concerning the remaining 31 patients. Probabilities of implant survival were estimated with the Kaplan-Meier method. RESULTS: 98 patients (11.5%) had died at a median follow-up time of 81.1 months. The probability of survival at 81.1 months was 98.6% looking at stem and cup. There was no significant association of survival of the prosthesis and patient weight, gender or body mass index. CONCLUSION: Our results are in accordance with previously published data of smaller series using the Zweymüller/Alloclassic( total hip. The survival rate of this cementless rectangular titanium prosthesis for the reported follow-up time compares favorably with contemporary cemented hip prostheses.

Adult↗
PubMed1992

[Coma during a hip prosthesis under spinal anesthesia. Apropos of a case].

A case is reported of a postoperative coma in a ASA I 79 years old patient undergoing a spinal anaesthesia for hip prosthesis. The complication occurred three hours after the subarachnoidal puncture and 90 minutes after the completion of surgery. A complete recovery was observed in the following 48 hrs with the help of symptomatic treatments. Possible aetiologies and mechanisms of such accidents are discussed. However no definite cause could be ascertained in the case reported above, which is to add to similar ones observed during spinal anaesthesia in healthy patients. Anyhow, close surveillance is always mandatory.

Aged↗
PubMed1978

[The fixation of madreporic total hip prosthesis; an experimental study (author's transl)].

The author has designed a new type of total hip prosthesis described as "madreporic" because its surface is rough and resembles some kinds of coral. This type of implant, which does not require cement, was tested on dogs. The bone-prosthesis junction was assessed using light and electron microscopy. Radio-spectrography and micro-radiography showed that osteogenesis occurred in the roughened surface of the implant leading to an early, strong and long-standing fixation. The prosthesis was inserted in two hundred patients. Five were removed after septic complications and one after premature death. The fixation with new bone to the surface of the metal was confirmed.

Alloys↗
PubMed1996

[Labeled leukocyte scintigraphy and total hip prosthesis].

During the last few years, labelled leukocyte scintigraphy has become a decisive tool in the diagnosis of bone infections. However, this test may sometimes be deceptive as far as hip prostheses are concerned. The authors have carried out a retrospective study of 62 labelled leucocyte scintigraphies performed for suspected infection of a hip prosthesis. The comparison of the results with the different clinical, biological and radiological factors and the follow up of the patients allows determination of the sensitivity and specificity of this test which are 41% and 100% respectively. The results reported in the literature and the indications for this examination are discussed.

Adult↗
PubMed2006

[The cemented Müller straight stem total hip prosthesis with polyethylene cup and 28 mm head: ten-year results].

PURPOSE OF THE STUDY: The purpose of this study was to evaluate the 10-year results of the cemented Müller straight stem total hip prosthesis with polyethylene cup and 28 mm head. MATERIAL AND METHOD: From May 1988 to May 1990, 187 cemented prostheses (second-generation technique) were implanted via a transgluteal approach for degenerative hip disease. A Protasul 10 straight stem with a 28 mm modular head and a gamma ray sterilized polyethylene cup was used in all cases. At ten years, the follow-up of the 187 implants was: 60 implants in deceased patients, 24 implants in patients contacted by telephone (all with implants in place), 90 implants in 82 patients seen for review. The series thus included 40 women and 42 men, mean age 65 years. The clinical outcome was assessed with the Postel Merle d'Aubigné (PMA) score. Radiographic assessment noted lucent lines, granulomas, implant migration, polyethylene wear, and ossifications. Survival curves were established with the actuarial method. RESULTS: Among the 187 implants, two patients required revision: one for sepsis and the other for posttraumatic dislocation. Among the 82 patients reviewed at 10 year, the PMA score was 16.8 (92% good and very good results). Radiographically, assessment of the acetabular component demonstrated three probable and one certain loosening, four cases of polyethylene wear greater than 2 mm. At the femoral level, osteolysis was noted in zones 1, 3, and 7 and rarified bone in zone 7 in four patients. Linear penetration of the stem into the cup was 0.09 mm/yr, corresponding to a volumetric wear of 55, 35 mm3/year. Brooker grade 3 ossification was observed in 27% of men and 14% of women. DISCUSSION: The clinical results were comparable to other series of cemented prostheses. At ten years, acetabular loosening was more frequent with active radiolucent lines present from the fifth year. It would thus appear that better results could be achieved by optimizing the bearing. Furthermore, there was no parallelism between the clinical and anatomic observations, cup loosening and femoral osteolysis were well tolerated. The prevention of ossification appears to be an important point, particularly in men.

Aged↗
PubMed2003

[Tripolar arthroplasty for recurrent total hip prosthesis dislocation].

PURPOSE OF THE STUDY: The purpose of this study was to assess the results of revision surgery for recurrent total hip prosthesis dislocation using a tripolar prosthesis composed of a conventional stem with a mobile head of an intermediary prosthesis measuring more than 40 mm and a modified cup. This technique was used in two centers in Rouen France and Los Angeles USA. MATERIAL AND METHODS: Twenty-one hips in 21 patients were operated on. The mobile heads measured 40 to 47 mm. Mean patient age was 70 years (range 29-92). The indication for the tripolar prosthesis was reserved for extremely unstable hips in patients with major risk factors for recurrent dislocation. These 21 patients had experienced 95 dislocations. The acetabular cup was custom-made for the large-diameter heads. A cemented polyethylene cup was used in 14 cases and a press-fit metal-backed around a polyethylene insert in 7. The polyethylene thickness varied from 6.5 to 16 mm for the cemented cups and 4 to 5 mm for the press-fit cups. Fourteen femoral stems were left in place as were two press-fit cups where only the inserts were changed. Mean follow-up was 5.4 years (range 3-11.8). RESULTS: There has been no recurrent dislocation for 20 hips. One patient experienced a dislocation one week after surgery which required a second revision procedure to reposition the acetabular implant. Final outcome was good at 7.6 years for this hip. One patient who had not had any recurrent dislocation died 4 years after the revision surgery due to a cause unrelated to the prosthesis. Two patients were lost to follow-up at 3.7 and 6 years, both were pain free and had no radiological anomalies. Infection occurred in one patient undergoing chemotherapy for a myeloma; the head and neck had to be resected. For the 20 other patients, functional outcome, assessed with the UCLA score, showed improvement in pain (5.8 preoperatively, 9.2 at last follow-up), walking (4.8 and 8 respectively), function (4 and 6 respectively), and daily activities (3.3 and 5.2 respectively). A revision procedure was necessary for one patient during the 4(th) year because of a fracture of the polyethylene insert on a metal-back cup; the insert alone was changed. Excepting the patient with infection, there were no cases of certain or probable loosening during the follow-up. DISCUSSION: The tripolar prosthesis with a mobile cup and a large-diameter head appears to be a reliable solution for these severely unstable hips. The procedure can often be limited to the acetabular component, reducing morbidity. The thickness of the polyethylene cup is a limitation which may affect long-term survival. Search for a highly wear-resistant couple continues.

Adult↗
PubMed2004

Seven to 10 years followup of an anatomic hip prosthesis: an international study.

Hypothetically, hydroxyapatite-coated anatomic-shaped femoral stems and hemispheric acetabular cups should improve biologic fixation of the implant and strength transmission to the bone, improving unsatisfactory results of the first cementless hip prosthesis focused on the stress-shielding phenomenon at the femur and failure of the threaded acetabular cups. A consecutive series of 312 patients who had primary Anatomique Benoist Giraud hip prostheses unilaterally implanted were followed up. We analyzed the clinical and radiographic results and report the outcomes 7-10 years after implantation. Two hundred thirty-two patients were assessed at 7-10 years. The survival rate for the implant was 96.8%; 77.2% of patients had no pain, 72.4% maintained total mobility, and 62.9% were able to walk without restrictions. However, radiologic assessment shows that problems improved but did not disappear. More than 55% of femurs had signs of proximal stress-shielding develop. More important, substantial polyethylene wear was observed in at least 62% of the acetabular inserts at 7-10 years followup.

Adult↗
PubMed1999

The Charnley versus the Spectron hip prosthesis: radiographic evaluation of a randomized, prospective study of 2 different hip implants.

A total of 410 hips were randomized to treatment with either a Charnley (206 hips) or a Spectron (204 hips) total hip arthroplasty. The patients were operated on by a standardized procedure using a contemporary cementing technique and were followed after 1, 3, 5 to 6, and 10 years. The postoperative radiographs showed a significantly increased rate of malalignment and consequently low grade of cement mantle quality of the Charnley stem compared to the Spectron. No differences concerning cement mantle quality or positioning were found between the Charnley ogee cup and the metal-backed Spectron. Evaluation of the follow-up radiographs revealed 10 loose Charnley stems and 1 loose Spectron stem and 4 loose Charnley ogee cups and 23 loose Spectron metal-backed cups. The differences of revision rate for the femoral and acetabular components of the 2 prostheses were significant (P = .03, Charnley femoral component more frequent; P = .03, Spectron acetabular component more frequent). The radiographic evaluation strengthened this disparity. Poor wear characteristics of the metal-backed Spectron cup are perhaps the main reason for the highly significant difference in mechanical failure rate between the 2 cups. We therefore propose that metal-backing of cemented cups should be avoided, at least when combined with larger femoral heads. The difficulty in positioning the Charnley stem with an adequate cement mantle, especially in the absence of trochanteric osteotomy, might explain the inferior Charnley stem longevity in this study.

Aged↗
PubMed1982

Cementless isoelastic RM total hip prosthesis.

Some surgeons are beginning to doubt the reliability of bone cement in joint replacements. In 1967 Robert Mathys conceived the idea of an isoelastic prosthesis made of plastic, which would anchor into the bone without cement. He developed the idea by extensive tests in animals and, in 1973, the first human RM cementless hip prosthesis was inserted by E Morscher. In this paper the concept of the cementless isoelastic prosthesis is developed by Robery Mathys, and Professor Bombelli records his experience with the prosthesis between 1977 and 1981.

Aged↗
PubMed1992

Severe metallosis due to abnormal abrasion of the femoral head in a dual bearing hip prosthesis. A case report.

The authors report on a patient with a case of severe metallosis due to an abnormal abrasion of the femoral head. A primary arthroplasty was performed using a dual bearing hip prosthesis with acetabular bone grafting by ceramic screws. At the time of the revision surgery the synovia was black, and an analysis using a scanning electron microscope and scanning electron microscope-electron probe micro-analyzer revealed numerous small particles of small alumina ceramic on the inner surface of the bearing insert of high-density polyethylene. These particles, which came from the broken ceramic screws due to proximal migration of the prosthesis, scraped the femoral head away. A line and area analysis of the black synovia revealed that the synovia contained metal particles of a cobalt-chromium alloy as well as a cobalt ion. The patient's serum showed elevated concentrations of cobalt, chromium, and molybdenum that dramatically reduced 2 months after the revision surgery.

Adult↗
PubMed1996

Revision of a failed cemented total hip prosthesis with insertion of an acetabular component without cement and a femoral component with cement. A five to eight-year follow-up study.

Sixty-one consecutive so-called hybrid revision total hip arthroplasties were performed in fifty-five patients by one surgeon, from 1986 through 1988, for mechanical failure of a cemented total hip prosthesis. In all of the patients, the acetabular and femoral components were revised to a porous-coated Harris-Galante acetabular component inserted without cement and an Iowa femoral component inserted with cement. Contemporary cementing techniques were used, but structural bone graft was not. The over-all prevalence of repeat revision for aseptic loosening was 0 per cent for the acetabular components and 3 per cent (two hips) for the femoral components. In addition, 2 per cent (one) of the acetabular components and 5 per cent (three) of the femoral components demonstrated radiographic evidence of loosening. In the forty-three patients (forty-nine hips) who were alive at an average of seventy-four months (range, sixty to ninety-five months) after the revision, none of the acetabular components and 2 per cent (one) of the femoral components were revised again for aseptic loosening. An additional 2 per cent (one) of the acetabular components and 6 per cent (three) of the femoral components were radiographically loose. Ninety-eight per cent (forty-one) of the forty-two living patients (98 per cent [forty-seven] of the forty-eight hips) who had a clinical examination at least five years after the revision had increased function; 90 per cent (thirty-eight) of these patients (forty-four [92 per cent] of the hips) were satisfied with the result. The group that had a hybrid revision was compared with a group of seventy patients (seventy-four hips) who had had a revision total hip arthroplasty with use of contemporary cementing techniques for both components. These revisions had been performed by the same surgeon, before he performed the hybrid revisions, and the prevalence of repeat revision of the acetabular component was 7 per cent (five hips) and that of the femoral component was 4 per cent (three hips). In addition, 16 per cent (twelve) of the acetabular components and 3 per cent (two) of the femoral components were radiographically loose. The comparison group was not a consecutive series, as only the patients who had had radiographs made five to eight years after the revision were evaluated. In the fifty-two such patients (fifty-six hips) who were alive at five years after the revision with cement (average duration of radiographic follow-up, seventy-seven months; range, sixty to ninety-nine months), 9 per cent (five) of the acetabular components and 5 per cent (three) of the femoral components were revised again for aseptic loosening. An additional 21 per cent (twelve) of the acetabular components and 4 per cent (two) of the femoral components were radiographically loose. The results of the present study demonstrated a significant improvement (p = 0.0001) in the survival of the acetabular component of so-called hybrid revision total hip arthroplasties compared with that of revision total hip arthroplasties with cement performed by the same surgeon and followed for a comparable period.

Acetabulum↗
PubMed1992

Interface corrosion of a modular head total hip prosthesis.

Wear and corrosion products released from metallic prosthetic joints can stimulate adverse reactions in the surrounding tissues that may eventually require revision of the prostheses. The authors report here a case of a modular total hip prosthesis removed after 35 months that showed evidence of corrosion and fretting at the Morse taper interface between the titanium alloy femoral stem and the cobalt-chromium ball.

Aged↗
PubMed2001

Cathepsin K in aseptic hip prosthesis loosening: expression in osteoclasts without polyethylene wear particles.

OBJECTIVE: To investigate the expression of the bone matrix degrading cysteine proteinase cathepsin K and to determine the colocalization of cathepsin K with polyethylene (PE) particles in tissue specimens of patients with aseptic hip prosthesis loosening (AHPL). METHODS: The expression of cathepsin K was studied by immunohistochemistry in tissue specimens of 9 patients with aseptically loosened acetabular components of failed cementless total hip replacements. The expression of cathepsin K was compared to that of the macrophage marker CD68 by serial section analysis. Double labeling of the expression of cathepsin K or CD68 by immunohistochemistry and of PE particles by modified Oil Red staining method was performed. RESULTS: Cathepsin K could be predominantly detected in osteoclasts attached to the bone tissue, while only a few (CD68+) mononuclear and multinucleated foreign body giant cells (MGC) were positive for this enzyme. By double labeling with Oil Red staining we found the majority of CD68 positive cells of the periprosthetic tissue that were colocalized with PE particles. However, cathepsin K-expressing osteoclasts could not be stained with Oil Red. CONCLUSION: The present data suggest that in AHPL neither mononuclear cells nor MGC but rather osteoclasts are mainly involved in cathepsin K mediated bone matrix destruction. Using double labeling of immunohistochemistry and Oil Red staining we observed that the cathepsin K-expressing osteoclasts did not include PE particles.

Acetabulum↗
PubMed2001

Molecular identification of a Dietzia maris hip prosthesis infection isolate.

Dietzia maris, an environmental actinomycete, has been implicated only once in human disease. We herein report the first D. maris isolate from a bone biopsy specimen in a patient hospitalized for a total hip prosthesis replacement. Cell wall fatty acid analysis and 16S ribosomal DNA gene sequencing were utilized to achieve its definite identification. This case report illustrates the usefulness of such methods for the accurate identification of actinomycetes.

Actinomycetales↗
PubMed1993

The porous-coated anatomic total hip prosthesis, inserted without cement. Results after five to seven years in a prospective study.

The results of 100 primary arthroplasties with a porous-coated anatomic total hip prosthesis that were performed consecutively in ninety-one patients were followed prospectively for five to seven years after the operation or until death. Clinical Harris hip ratings and anteroposterior and lateral radiographs were made preoperatively, several times in the first postoperative year, and at annual intervals thereafter. Average sequential hip ratings were maintained between 92 and 93 points during the follow-up interval. Pain in the thigh, which did not limit function, was recorded at the yearly examinations from the first to the fifth year. After one year, 18 per cent of the thighs were painful, and in succeeding years, 19 per cent, 23 per cent, 26 per cent, and 15 per cent were painful. Radiographs demonstrated that the fixation of the femoral component was by ingrowth of bone in 94 per cent of the hips, by stable fibrous fixation in 1 per cent, and by unstable fibrous fixation in 5 per cent, according to the criteria of Engh et al. By five years, 6 per cent of the acetabular components had migrated, and 5 per cent of the femoral components had subsided. Two acetabular components had been revised, and one revision of a femoral component was pending. The evaluated device was an early-generation prosthesis that was designed for insertion without the use of cement. Further study is necessary to determine the long-term durability of the prosthesis-bone interface.

Adult↗
PubMed2005

Influence of cement viscosity and cement mantle thickness on migration of the Exeter total hip prosthesis.

The effect of bone cement viscosity and cement mantle thickness on the migration of the Exeter total hip prosthesis was studied in a prospective, randomized, double-blind clinical Roentgen Stereophotogrammetric Analysis study. Forty-one cemented total hip arthroplasty in 39 patients were included and randomized into a low/medium Simplex P cement group and a high-viscosity Simplex AF cement group. At time of stem introduction, 5 minutes after mixing, the Simplex AF was more viscous than Simplex P. No statistical difference existed between the 2 cement groups, for neither translation nor rotation migration data. Subsidence of the stem at 2-year follow-up was 1.1 +/- 0.56 mm for Simplex AF cement and 1.5 +/- 1.00 mm for Simplex P cement. The mean rotation of the acetabular components about the sagittal axis was 1.7 degrees +/- 3.8 degrees in the Simplex AF group and 0.7 degrees +/- 2.1 degrees for the Simplex P group. No effect of cement mantle thickness on migration of neither the acetabular cups nor the femoral stems was found. Although there were no differences in migration data for the cups and the stems, 2 acetabular cups in the Simplex AF group (almost 10%) were revised because of mechanical loosening. Because of these findings, we suggest caution before using this new high-viscosity bone cement for fixation of acetabular components.

Acetabulum↗