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At least 307 records · Page 17Linked to original sources
PubMedDate not supplied

[Long-term influence of the spongiosa metal surface prosthesis on the periprosthetic bone. A radiological and osteodensitometric analysis of implantation of the S& G (ESKA) hip prosthesis].

INTRODUCTION: The anatomically shaped, cementless total hip replacement (THR) (S and G, ESKA Lübeck) has a fully porous coating for secondary osseointegration. The aim of the present study was to analyse the long-term effect of the prosthesis on periprosthetic bone remodelling. METHODS: 137 THR in 117 patients were analysed clinically and radiographically 12.8 years (10-14.9 years) postoperatively. The average age at the last follow-up was 71.8 years (range: 34-87 years). Osteodensitometric DEXA measurements of the periprosthetic bone in comparison to the contralateral non-operated femora were performed. RESULTS: Cumulative survival rates of all implanted THR (n = 231) at 14.9 years were 86.2 % (+/-5.3 %) for the fully porous coated stem and 90.1 % (+/- 8 %) for the cup. Five stem fractures (3.6 %) at the middle part were recorded. The Harris hip score of the non-revised THR at the last follow-up averaged 88.3 (34-100) points. Bony atrophy in the proximal periprosthetic femora in Gruen zones I (16.8 %) and VII (34.6 %) confirmed a proximal stress-shielding. Osteodensitometric analyses demonstrated in comparison to the contralateral femora (BMD 1.3 g/cm (2)) a significantly reduced bone density at the calcar femoris (BMD 0.9 g/cm (2)) (p < 0.001). CONCLUSION: The original goal of a physiological load transfer has not been realised with this fully porous, cementless THR. The anatomic S & G stem will mainly be osseointegrated by distal load transfer.

Absorptiometry, Photon↗
PubMed1990

Wear and loosening of the hip prosthesis. A roentgen stereophotogrammetric 3-year study of 14 cases.

Fourteen patients were followed by roentgen stereophotogrammetry for 3 years after hip arthroplasty. In 11 of the 14 acetabular components, definite wear was identified. The mean wear rate was 0.13 mm per year. There was no correlation between the wear and loosening of either the acetabular or the femoral component. Our findings indicate that products of wear do not initiate prosthetic loosening.

Follow-Up Studies↗
PubMedDate not supplied

[Polyethylene content and cell size of foreign body giant cells in aseptic hip prosthesis loosening--a histomorphometric study].

INTRODUCTION: In aseptic loosening of cementless hip arthroplasty polyethylene particles are phagocytized by macrophages and foreign-body giant cells. This initiates an osteolytic cascade. In this study, the authors investigated if there are correlations between the size of foreign-body giant cells and the polyethylene loading and number of intracellular particles as determined by light microscopy. MATERIAL AND METHOD: Histological specimens were processed from tissues retrieved during revision surgery of 7 cases of cementless hip arthroplasty which had become aseptically loose. The specimens were analyzed by histolomorphology and histomorphometry. The cell size, polyethylene loading and intracellular particle number of 111 foreign-body giant cells were determined. A regression analysis was performed to investigate if there was a correlation between these variables. RESULTS: The mean cell size was 1417 +/- 487 micron 2, the mean polyethylene loading was 49 +/- 42 micron 2 and the mean intracellular particle number was 10.4 +/- 5.4. The cell size correlated with both the intracellular particle number (r = 0.25) and the polyethylene loading (r = 0.39). CONCLUSIONS: In the cellular reaction to polyethylene particles in aseptic loosening of cementless total hip arthroplasty, the size of foreign-body giant cells correlates with intracellular polyethylene loading and intracellular polyethylene particle number as determined by light microscopy. The presence of large foreign body giant cells might be associated with a high particle load of the tissue and a high osteolytic activity.

Aged↗
PubMed1979

[Total hip prosthesis and sport (author's transl)].

The artificial replacement of the hip joint has become a routine operation the assessment of load resistance of the total hip prothesis (THP), on the other hand, is very variable. If at all possible, a THP should only be implanted in elderly people usually with the object of obtaining painless and improved walking ability. Occasionally, however, the question of the possibility of sports activities arises. But for this there are no practical pointers for better orientation. Therefore 120 operated patients under the age of 60 were questioned in detail on their sports activities and followed up. Then an attempt was made to classify the types of sport. Swimming, cycling, gymnastics, walking and rowing seemed suitable.

Adult↗
PubMed1995

Clinical outcome and survival of Link RS total hip prosthesis.

We report the clinical outcome and survival of 100 total hip arthroplasties with Link RS cementless hip prostheses after a mean of 63 months (51 to 93). The average preoperative Merle d'Aubigné hip score was 9.4 points and the average score at the latest follow-up was 15.3 points. Thirteen prostheses have been revised and seven await revision. Survivorship analysis based on intention to revise showed only 68% survival at seven years (95% CI 53% to 81%). The survivals of femoral and acetabular components verified to be loose at surgery were 78% and 89% respectively at seven years. A number of other patients have pain and it seems likely that there will be substantial reduction in these survival figures in the future.

Adult↗
PubMed1996

[Use of ultrasound for the removal of cement in hip prosthesis reoperations].

PURPOSE OF THE STUDY: One of the challenges facing the surgeon during revision procedures is the harduous task of complete acrylic cement removal while leaving the surrounding cortical bone intact. A set of ultra sonic driven instruments has been evaluated revisions of total hip and total knee prosthesis. The principle is to convert standard electrical energy into mechanical energy via an ultrasonic transducer. MATERIAL: 10 revisions of cemented hip prosthesis and one of a total knee prosthesis (Guepar Howmedica) have been performed with success easily and safely. RESULTS: The ultra-sonically driven tools used have reduced the incidence of perforation (1 cases), with no need to cut cortical windows to remove the distal plug, and have also reduced the time for cement removal and the intra-operative blood loss. CONCLUSION: The author thinks that this technique provides a great facility in revision surgery. A larger study will be done soon.

Bone Cements↗
PubMed2004

[Phantom sensations and peripheral induced neglect following implantation of total hip prosthesis].

OBJECTIVES: O. Sacks describes in his book "A leg to stand on" the inability to move his leg for along period after rupture of the tendon of m. quadriceps. He refers the history of similar cases, especially of a woman with a hip fracture. He discusses this as a result of disruption of proprioception (peripheral induced neglect). The aim of this investigation is to answer the question how frequently this symptom may be found in patients with hip fracture and/or arthrosis perioperativly after implantation of a total prosthesis. METHODS: we examined 106 patients aged 70.35 +/- 10.01 years (36-male 67.54 +/- 9.74 years and 69 female 71.9 +/- 9.9 years) who underwent an implantation of a hip prosthesis - antero-lateral access Watson-Jones - (right side n = 61, left n = 44) because of arthrosis (n = 81) or a hip fracture (n = 18) on postoperative day 1./2. and 10. - 14. Besides exact neurologic examination, we particularly asked for changed perception of the operated leg. RESULTS: by neurological examination we found only rarely signs of peripheral nerve lesion as a complication of implantation of hip prosthesis (1 femoral nerve lesion, 1 ischiadicus nerve lesion). 14 patients reported a changed perception at the first examination: 5 patients felt their operated leg shorter or longer, 4 patients described their leg changed in a strange manner (like a block of wood or lead), 2 patients felt their leg changed, but could not tell how. At follow-up examination there was no patient with a changed perception of the operated leg. CONCLUSIONS: at first examination only a small number of patients report a changed perception of the operated leg. Early mobilization of the operated leg may be the cause of quick normalization of perception. The peripherally induced neglect, described by O. Sacks, was possibly caused by decrease of cortical representation because of immobilization, but not by disrupted proprioception.

Aged↗