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[Treatment of femur head necrosis using a total hip prosthesis following kidney transplantation].

From 1972 to 1978 we implanted 30 total hip prostheses in 20 patients with kidney transplant and femoral head necrosis. All were patients who still had immune suppressing drug therapy. To reduce the infection risk the patients had a special preoperative treatment -- single room -- always the same surgeon, short operative procedure in the greenhouse of 45 minutes on an average and only 4 blood infusions. Thereby, we had no complications peroperative and none were observed during the following checks extending from 4 months to 6 years. Hence, we believe that the implantation of total hip prostheses in high risk patients with kidney transplants and femoral head necrosis is recommendable.

Adolescent↗
PubMed2001

The uncemented fully textured Lord hip prosthesis: a 10- to 15-year followup study.

One hundred fourteen total hip arthroplasties in 110 patients performed between 1979 and 1983 using the Lord femoral component were analyzed. Nine femoral revisions were performed within 13 years after surgery (two because of infection). Excluding infections there was a 94% 13-year survival according to a Kaplan-Meier analysis. Subsidence was seen in five hips (five patients), but only one needed revision surgery. Seventy-six hips (73 patients) had a radiographic followup of 10 years or more and were analyzed in detail. Changes in cortical thickness, density, and formation of spotwelds continued beyond 5 years after surgery, meaning the remodeling of periprosthetic bone continued beyond that time. Osteolysis on the femoral side was seen in seven hips, always in the proximal part of the femur, apparently as a continuation of the joint space. No remote focal osteolysis was seen. Elderly patients, women, and patients with a pedestal were overrepresented among individuals with many spotwelds. For the clinical outcome the Merle d'Aubigne and Postel score as modified by Charnley was used. Among 69 hips (66 patients) with a mean followup of 153 months 96% (66 hips) had a pain score equal to or greater than 4 and 74% (51 hips) had a score of 5 or 6. The Lord femoral component gave surprisingly good clinical long term results despite the bone remodeling (stress shielding), which in some cases was pronounced. The most obvious disadvantage with this design appears to be the difficulties associated with its removal when indicated.

Adult↗
PubMed1988

The isoelastic hip prosthesis followed for 5 years.

In 1981 and 1982, 58 patients (61 hips) received an isoelastic noncemented femoral component and a bipolar cup for nontraumatic hip disease. Three patients were lost to follow-up and 8 died, leaving 47 patients (51 hips) for review after a minimum of 5 years. There were seven failures--two infections, four technical errors, and one migration of an acetabular component. Of the remaining 44 hips, 42 scored good or better at review.

Adult↗
PubMed1981

The postero-lateral approach for total hip prosthesis.

The surgical technique of the postero-lateral approach for total hip prostheses is described. The advantages over the transtrochanteric approach are a smaller blood loss, a shorter operating time and a shorter period of hospitalization. There are no differences in the clinical and radiographic results. The transtrochanteric approach facilitates better biomechanical "reconstruction" of the hip in cases in which the anatomy is abnormal, and is therefore justified in selected cases.

Acetabulum↗
PubMed1987

Long-term results and survivorship of the McKee-Farrar total hip prosthesis.

Five hundred and eleven McKee-Farrar prostheses implanted at the Orthopedic Hospital of the Invalid Foundation (Helsinki, Finland) between 1967 and 1973 were analyzed for long-term survivorship, clinical results, and the risk factors leading to aseptic loosening of the prosthesis. Reoperation was necessary for aseptic loosening of 91 prostheses and for septic loosening of 19 prosthesis. Ten-year survivorship was 76% and the annual failure rate 2.3%. The failure rate correlated with time. Acetabular cup loosening occurred 1.2 times more often than stem loosening. The retained prostheses remained clinically stable with respect to pain and mobility, but some deterioration was observed in walking ability. In addition to the follow-up period, prosthetic design, right-sided prosthesis, and lengthening of the operated leg proved to be significant factors for aseptic loosening in multiple stepwise regression analysis. After exclusion of the unmeasured leg length inequalities, the lengthening of the operated leg proved to be the most important factor explaining aseptic loosening of the prosthesis. Surgeon's inexperience, operation time, post-traumatic coxarthrosis, and previous operations were correlated to aseptic loosening of the prosthesis.

Adult↗
PubMed1980

Aseptic loosening of the Monk hip prosthesis.

In a preliminary report concerning 104 Monk arthroplasties satisfactory results were found within an observation time of 1.6 years (Hansen & Rechnagel 1977). However an early tendency for aseptic loosening was recorded. At a follow-up of the same patients after 5 years it was found that 17 patients, with their primary prostheses in place, had died. Of the remaining 86 prostheses not less than 50% had been removed because of loosening causing symptoms. Furthermore at re-examination of 39 patients with 43 of the primary prostheses still in situ radiological and clinical evidence of progressive aseptic loosening was present. The aetiology of the loosening is discussed and it is suggested that wear of the polyethylene cap plays an important role. It is concluded that the "soft top" Monk prosthesis cannot be recommended for replacement arthroplasty of the hip.

Follow-Up Studies↗