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At least 343 records · Page 19Linked to original sources
PubMed1993

A clinical, radiological and biomechanical study of the TARA hip prosthesis.

We reviewed 60 patients with 72 TARA (total articular replacement arthroplasty) resurfacing hip prostheses. To analyse the behaviour of the femoral component a radiographic study was done and a two-dimensional finite element model was constructed. The stem of the femoral component plays a role in the load transfer mechanism. Stress shielding is seen in the proximal femur but depends on the interface conditions. When only the dome of the cup is assumed to be bonded to the bone, the stresses in the head increase dramatically and there is no more stress shielding. Five years after implantation radiographic signs of loosening of the femoral component were seen in 6.8% of the implants placed without notching in the femoral neck and in 28.6% of the components with notching (significant difference, P = 0.0005). Signs of loosening of the acetabular component were seen in 37.7% 5 years postoperatively. The cumulative survival rates of the femoral and acetabular components were 89.7% and 85.6% respectively 5 years after implantation. The overall clinical results are represented by an integration of the clinical results (Harris Hip Score System), the radiographic results and the survival analysis. This gave a success rate of only 72% 5 years after implantation.

Adult↗
PubMed2003

A rare cause of irreducible dislocation of a total hip prosthesis.

This report describes a patient with an anterior dislocation of the total hip arthroplasty, which was irreducible using described techniques of closed reduction. It required an open reduction using a direct lateral approach with the release of the rectus femoris.

Aged↗
PubMed2005

Long-term results of the cementless porous-coated anatomic total hip prosthesis.

Between January 1984 and January 1986, 131 porous-coated anatomic total hip replacements were performed in 119 consecutive patients. Of these, 100 patients (110 hips) who were alive at a minimum of 18 years after replacement were included in the study. The mean age of the patients at surgery was 48.4 years and that of surviving patients at the latest follow-up was 67.8 years. The mean duration of the clinical and radiological follow-up was 19.4 years (18 to 20). The mean Harris hip score initially improved from 55 points before to 95 points at two years after operation, but subsequently decreased to 91 points after six years, 87 points after 11.2 years, and 85 points after 19.4 years. At the final follow-up, 23 hips (18%) of the entire cohort and 21% of survivors had undergone revision because of loosening or osteolysis of the acetabular component and eight hips (6%) of the entire cohort and 7% of survivors for loosening or osteolysis of the femoral component. Only four femoral components (4%) were revised for isolated aseptic loosening without osteolysis and two (2%) for recurrent dislocation. On the basis of these long-term results, the porous-coated anatomic femoral component survived for a minimum of 18 years after operation while the acetabular component was less durable. The findings identify the principles of uncemented joint replacement which can be applied to current practice.

Acetabulum↗
PubMed1997

Long-term results and survivorship of Protasul 10 straight stem Müller femoral hip prosthesis.

In a retrospective study 88 consecutively cemented Protasul 10 straight stem total hip prostheses, implanted during a two year period, were investigated. After a nine to ten year period 8 hips had been revised. In the clinically and radiologically checked group, the patients' opinion was in 82% very good or good, in 9% moderate and in 9% bad. The X-Ray findings showed in 20% an initial or advanced loosening of the stem and/or the cup. The survivorship after a nine to ten year period is 89%.

Aged↗
PubMed1995

Fixation and effect on bone strain pattern of a stemless hip prosthesis.

Given the relatively short survival time of total hip replacement in young patients, a different concept of femoral implant was designed and evaluated biomechanically prior to clinical application. The femoral component has no intramedullary stem and fits into an angular resection of the femoral neck. A trans-trochanteric screw provides immediate strong fixation. A comparative biomechanical study with cadaver femora and a dynamic hip simulator was performed. The study had three objectives. (1) The strains generated under loading in the intact proximal femur were compared to those generated in the presence of the experimental implant and a classic cemented implant. (2) The short-term stability of the experimental prosthesis under loading conditions encountered during fast walking was evaluated. (3) Most importantly, the implant design was improved in the light of the experimental observations prior to any clinical trial. Indeed, the prototype underwent several important modifications in the course of the study. With the modified design, later used in a clinical trial, it was demonstrated that if accurate fit and position of the prosthesis were provided, fixation remained sound for over one million loading cycles with peak loads of three times the body weight. The measured interface micromotion was compatible with direct bone apposition and ingrowth. No statistical difference was found between the strain measurements obtained before and after implantation of the experimental prosthesis whereas significant stress shielding was observed with a stemmed, cemented prosthesis.

Biomechanical Phenomena↗
PubMed1978

Technetium 99Tcm pyrophosphate scanning in the assessment of the painful hip prosthesis.

Technetium 99Tcm pyrophosphate bone scans were done on 35 patients who complained of persistent hip following total hip replacement. The scans of six patients were normal and the symptoms of these patients either resolved (three) or greatly improved (three) without further treatment. Twenty-nine patients had abnormal scans. Seventeen of these were due to infection or loosening of the prosthesis. Paget's disease of bone, protrusion of the prosthesis and heterotopic ossification also caused scan abnormalities. These causes could not be distinguished from one another on the scan. A radiograph of the hip is essential for interpreting the scan correctly. Scanning of the painful hip prosthesis helps to detect patients in whom serious complications are present or are likely to develop.

Aged↗
PubMed1998

[Possibilities of follow-up imaging after implantation of a carbon fiber-reinforced hip prosthesis].

INTRODUCTION: There are many problems in the radiological diagnosis of aseptic loosening in total hip arthroplasty. Computed tomography (CT) and magnetic resonance tomography (MRT) are not usable for metallic implants (stainless steel, cobalt alloy, titanium alloy). MATERIAL AND METHODS: From April 1993 to December 1993 15 CFRP non-cemented hip prostheses have been implanted. In a prospective clinical study plane radiographs, CT and MRT have been analysed. RESULTS: Three stems were revised (1 femoral fracture, 1 severe thigh pain, 1 aseptic loosening). CFRP are not visible in plane radiographs. There was a complete (two-third of the cases) or nearly complete (one-third of the cases) small sclerotic interface between the prosthesis and the bone, these were apparent in CT and MRT in stable implant cases and did not have any clinical correlations. DISCUSSION: The small sclerotic interface is quite different in comparison to so called "Reactive Lines". In one case of aseptic loosening there was an interposition of soft tissue between prosthesis and bone in MRT and CT. CFRP inaugurates new diagnostic possibilities in aseptic loosening of hip prosthesis and in tumour surgery too.

Aged↗