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PubMed1992

[Value of false profile of the pelvis in the monitoring of total hip prosthesis].

The authors used a retrospective series of cases of total hip replacement with a follow-up of between 6 and 12 years, including 10 undergoing reoperation for slipping of the prosthesis, to define the value of the false lateral view of the pelvis in the monitoring of such patients. This view provides earlier detection than AP views of wearing of polyethylene which manifests itself by penetration of the femoral head into the acetabular implant. This penetration, which can be measured radiologically, is better visualised in the false lateral view of the pelvis for simple reasons of radiological incidences. The false lateral view of the pelvis has another use in the monitoring of total hip replacements. It enables visualisation of the posterior part of the acetabulum which is generally the site of first appearance of the earliest signs of slipping in the form of a thin line.

Acetabulum↗
PubMed2001

[Hooked roof cup in revision of difficult loose hip prosthesis cups. Results after a minimum of 10 years].

The long-term results of acetabular revision after total hip arthroplasty (THA) with the use of a reinforcement ring with hook were evaluated. The study included 57 cases of surgery dating back 10 years or more. Of a total of 54 patients (57 operated hips), 18 patients (19 hips) died during the 10-year period and 2 patients (2 hips) were completely lost to follow-up. At the time of the revision surgery, the mean age of the remaining 34 patients (36 hips) was 62.5 years (range: 47-80). A THA revision was done in 25 cases and an acetabular revision only in 11 cases. The most common acetabular defect was a combined segmental and cavitary defect (n = 19), and in three cases there was pelvic discontinuity. Autologous or homologous cancellous bone grafts were used to fill acetabular cavities in 17 hip joints. Structured bone grafts, predominantly homologous bone, were used in ten cases for acetabular reconstruction. At a mean follow-up of 11.4 years (range: 10-14.5) three hip joints (8%) had undergone further revision. The revisions were done for aseptic loosening of the acetabular component in two cases and a septic loosening of both components in one case. Three further cases (8%) revealed signs of acetabular loosening. Two of these three patients were symptomatic but refused further revision surgery. In the 33 unrevised hip joints, a good or excellent clinical result with a d'Aubingé score of more than 14 points was found in 30 cases (92%). Osseous acetabular reconstruction with the use of a reinforcement ring leads to favorable results compared to other techniques. In the authors' opinion, this technique is preferable to those using oversized cups without osseous reconstruction of the acetabulum.

Acetabulum↗
PubMed1994

Isokinetic force-velocity curves in patients following implantation of an individual total hip prosthesis.

There are only a few studies which could support conclusions concerning the strength of the muscles surrounding the hip joint and especially concerning the strength relationships following implantation of endoprostheses. The aim of this study was to examine the post-operative course of strength deficits in this musculature compared to clinical parameters. Fifty-eight patients between 30 and 67 years of age, in whom individual total hip prostheses were implanted, were clinically examined prior, 9 weeks and 6 months after surgery. Moreover, the maximum isometric strengths of abductors, flexors, and rotator muscles as well as maximum isokinetic strengths of the extensors and flexor musculature at 60 degrees/s and 120 degrees/s were measured. The flexor and extensor musculature already showed a clear increase in maximum strength after 9 weeks and 6 months. By contrast, the isometric strengths of the rotators increased only slightly, the abductor strength decreased after 9 weeks to below the preoperative baseline level and attained this level again only after 6 months. The clinical parameters Trendelenburg sign, limping, and walking capacity were clearly improved after 6 months, but no correlation to the abductor strength could be demonstrated. It is concluded that limp-free gait can be attained even without maximum strength increase in the abductors, which are important for fluid gait, at least for short distances. The importance of regular training of the rotator and abductor musculature in coxarthrosis is emphasized to delay limitation of movement and decreased strength in the sense of a capsule pattern.

Adult↗
PubMed1996

Hip abductor muscle activity in persons with a hip prosthesis while carrying loads in one hand.

BACKGROUND AND PURPOSE: Carrying loads in one hand may result in the hip abductor (HA) muscles needing to generate large forces. For a person with a prosthetic hip, these forces may contribute to loosening of the implant. In this study, surface electromyography (EMG) was used to estimate the relative demands placed on the HA muscles as persons with a prosthetic hip carried loads in one hand. SUBJECTS: Twenty-five active subjects (9 female, 16 male) with a prosthetic hip participated. Subjects were aged 40 to 86 years (mean = 63.7, SD = 10.7). METHODS: Surface EMG data from the HA muscles (primarily the gluteus medius) were analyzed during mid-stance as subjects carried loads weighing 5%, 10%, and 15% of their body weight. Loads were carried in the hand opposite the side of the prosthetic hip (contralaterally held loads) or in the hand on the same side as the prosthetic hip (ipsilaterally held loads). RESULTS: Results showed that the contralaterally held loads produced greater HA muscle EMG activity levels than no-load walking. The ipsilaterally held loads produced lower HA muscle EMG activity levels than no-load walking. CONCLUSION AND DISCUSSION: These EMG data, in addition to calculations using a simple biomechanical model, suggest that persons should use caution or avoid carrying loads in the hand on the side contralateral to their prosthetic hip.

Adult↗
PubMed2001

[A new ISO/FDIS 14242-1 compatible hip prosthesis simulator: E-SIM].

The continuing development of new, highly sophisticated materials for the articulating surfaces of total hip endoprostheses involves the need for testing, not only of biocompatibility and dynamic loadability, but also of tribological properties (friction, wear, lubrication). For decades, the wear resistance of these materials has been tested in wear simulators. In consequence of the currently often widely differing test methods, the technical committee (TC 150) of the ISO (International Organization for Standardization) has been concerned to develop an International Standard (ISO/FDIS 14242 1 and 2: Implants for Surgery--wear of total hip joint prostheses--on the basis of kinetic and kinematic data from gait analysis. This new standard will be the basis for ensuring the comparability of scientific data obtained from tribological testing of total hip endoprothesis. The new hip simulator, E-SIM, presented in this paper, complies with the currently published FDIS (Final Draft International Standard), and enables testing in accordance with these specifications.

Equipment Failure Analysis↗
PubMed1990

[Long-term scintigraphic follow-up study of the hip prosthesis].

The authors emphasize the importance of the bone scan in long-term follow-ups of total hip arthroplasty and describe some technical details of the examination. The changes revealed in the bone scan are confirmed by the operative report. Even though the number of patients in the study was relatively small, the fact that the bone scan taken of patients with cementless total hip replacements revealed no pathological changes is considered significant.

Bone Cements↗
PubMed1984

[X-ray features of the long-term follow-up (l0-12 years) of the Charnley hip prosthesis fixed with acrylic cement].

A long term follow-up (10 divided by 12 years) of Charnley total hip arthroplasties fixed with radiopaque acrylic cement is reported. Clinical results and X-rays features have been correlated and discussed with reference to the bone reaction and to the diagnostic possibilities of standard radiographs. A radiographic diagnosis of loosening preceding relevant clinical symptom may allow revision arthroplasty before anatomical situation becomes too deteriorated.

Acrylates↗
PubMed1992

Cemented versus uncemented femoral components in the ring hip prosthesis.

A prospective, randomised and independently assessed trial of the Ring UPM total hip replacement showed that the quality of the early result was better if the femoral prosthesis was cemented than if it was not. More patients with cemented prostheses were painfree at four months (58% cemented:42% uncemented) and at one year (63% cemented:50% uncemented), but at two years pain relief was equal in both groups. At two years significantly more patients with cemented prostheses could walk without support (96% cemented:62% uncemented, p = 0.01 to 0.05). There is a need for more similar trials to compare the results of contemporary designs of cemented and uncemented total hip prostheses.

Activities of Daily Living↗