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 55 records · Page 3Linked to original sources
PubMed1976

Arthrography in total hip prosthesis complications.

Previous reports have stressed the value of hip arthrography primarily in determining the presence of loosening of the total hip prosthesis. Although loosening is a common complication and frequently associated with infection, other complications producing a painful hip prosthesis exist and are demonstrable by arthrography. Since the etiologies of these are as diversely different as the treatment, the hip arthrogram is advocated as an integral part of the diagnostic approach to the patient with a painful hip prosthesis in order to assess the specific complication and determine the therapeutic approach.

Aged↗
PubMedDate not supplied

[Loosening of total hip prosthesis].

The problem of total hip prosthesis is an immediate and long-term stability. An insufficient bone anchorage of the prosthesis produces a tissue reaction around the implant that causes a loosening. The hight incidence of loosening of cemented total prosthesis has spurred the research into uncemented implants. The experience at the Busto Arsizio Hip Center (Director Prof. R. Bombelli) with more than 2,800 R.M. uncemented isoelastic total hip prostheses was favorable and the study with the cooperation of Pathology Department (Director Prof. P. Lampertico) of the 82 loosening hips has shown: 1) the importance of the elasticity for a stress transmission to the surrounding bone; 2) the pursuit of the most suitable stem calibre and length; 3) the necessity of a stable primary mechanical fixation, waiting for a biological reaction.

Cementation↗
PubMed1986

[Determination of methylmethacrylate in expired gases after hip prosthesis cementing].

Total hip replacement using methylmethacrylate can induce early intraoperative hypoxaemia caused, according to some authors, by alveolar gas dilution by acrylic monomer vapour. In order to test this hypothesis, expired monomer was measured in ten patients undergoing total hip replacement carried out under narconeuroleptanalgesia. Methylmethacrylate was collected by adsorption on activated charcoal and measured by gas chromatography. The quality of expired monomer was 25 +/- 10 micrograms after cotyloid sealing. It is of 264 +/- 396 micrograms after femoral sealing; the most important excretion took place in the first three minutes, and its total duration may exceed 18 min. A simple calculation showed quite convincingly that the volume of expired monomer vapour was not sufficient to explain the hypoxaemia: impaired arterial oxygenation associated with the use of methylmethacrylate is not due to a dilution technique.

Aged↗
PubMed1986

[Aseptic loosening of a total hip prosthesis].

Detachment of a total hip prosthesis, whether or not it is cemented, presents as an abnormal mobility between the implant and the bone. Mechanical pain, which may be continuous from the time of the operation or which may appear after a variable pain free period, is the usual presenting symptom. Clinical examination may induce the pain by forced rotation, by a shaking maneuver or by traction-impaction of the lower limb. The most suggestive signs of detachment of the prosthesis are the inability to extend the limb and the instability of weight-bearing on one foot. At this stage, the findings of radiological and laboratory investigations are able to characterise the type of detachment and its septic or aseptic nature. Two clinical situations can be defined on the basis of this survey: the diagnosis of detachment is obvious due to rupture or fracture of the prosthesis, of the cement or of the bone, by displacement of the prosthetic elements or by the destruction of the bone in contact with the prosthetic elements; the diagnosis may be suspected and can be confirmed by careful comparative analysis with the initial films or by further investigations: dynamic tests, scintigraphy, arthrography under traction and possibly coxonar. There are a number of causes of detachment: poor positioning, incorrect conception or design of the prosthesis, poor bony support and host reaction to the implant.(ABSTRACT TRUNCATED AT 250 WORDS)

Hip Fractures↗
PubMed1991

Planning of radiotherapy for patients with hip prosthesis.

The effects of a hip prosthesis on the dose distribution when treating pelvic cancer have been evaluated. A prosthesis of titanium alloy in a water phantom was used as a model. Photon radiation beams with energies of 6, 20, and 50 MV and with a focus phantom distance of 100 cm were directed against the prosthesis. The dose profiles at different depths were measured with the RFA-7 system. The sphere of the prosthesis was inhomogeneous. The dose in a beam behind the prosthesis was reduced with the order of 10-40% and the largest distortion was behind the shaft. Using an opposed four-field technique with the same weight on all the fields, the dose reduction was as large as 7-12% in a string across the target behind the end of the shaft. With 50% weight on the lateral fields, the dose reduction was 4-8% of the average dose. Such an uneven dose distribution may decrease the curability, and a treatment technique not including the prosthesis should be preferred. Finally, a local increase of the dose close to the prosthesis seems to be of limited practical concern even at the highest energies.

Hip Prosthesis↗
PubMed1998

A lump in the groin: an unusual presentation of loose hip prosthesis.

We describe the loose hip prosthesis presenting as a mass in the groin, with a collection of titanium and polyethylene debris within the ileopsoas bursa. Titanium tissue staining has been noted, at the time of revision of titanium prostheses, but frank ileopsoas bursitis presenting as a groin mass, after hip replacement has not previously been described.

Bursitis↗
PubMed1990

Unsatisfactory results with a ceramic total hip prosthesis.

We reviewed the results of forty-two total hip replacements that had been done with the self-locking Autophor ceramic total hip prosthesis in thirty-four patients. The patients ranged in age from twenty-five to sixty-seven years (average, forty-eight years). The diagnoses were avascular necrosis (eight patients), degenerative arthritis (nineteen patients), ankylosing spondylitis (one patient), post-traumatic arthritis (two patients), and rheumatoid arthritis (four patients). Seven procedures were revisions: five, of a loose cemented total hip prosthesis and two, of a loose noncemented endoprosthesis. No revision was done for infection. The length of follow-up ranged from twenty-seven to sixty-six months (average, fifty-one months). The patients were evaluated by physical examination, serial radiographs, and questionnaires. The hips were rated with the modified Harris hip score. At the time of follow-up, eleven of the twenty-seven patients who had had a primary hip replacement complained of at least moderate pain that limited activities; however, only three patients had to have a revision. The femoral components had a notable tendency to subside more than five millimeters, and in fifteen hips there was radiographic evidence of progressive loosening. Our experience with the self-locking Autophor ceramic total hip prosthesis has been disappointing. We no longer use it.

Adult↗
PubMed2004

Fifty-one-year survival of a Judet polymethylmethacrylate hip prosthesis.

Revision arthroplasty of a Judet polymethylmethacrylate (PMMA) hip hemiprosthesis was performed 51 years after implantation. This makes it the first implant to have survived for longer than 50 years. No signs of aggressive osteolysis were found on histologic analysis, which confirms good tissue tolerance for PMMA. Judet's hip prosthesis did not follow the concept of low-friction arthroplasty; nevertheless, it represents an important step in the development of the hip prosthesis currently used.

Aged↗
PubMed2006

[Old and new materials in the hip prosthesis].

Since the second half of the XX century a steady evolution of hip prosthesis design is taking place. Implant shape, fixation systems and materials are constantly evolving. The paper presents the materials combinations most commonly used in hip prosthesis (metal-metal, metal-polyethylene and ceramic). All the above mentioned materials have been in used for over 25 years, and thanks to minor modification and better quality are widely used all over the world. The authors basing on biochemical studies, clinical observations and personal experience present problems related to materials used in hip prosthesis.

Arthroplasty, Replacement, Hip↗
PubMed2000

Expression of the CD69 activation antigen on lymphocytes of patients with hip prosthesis.

The aim of the study was to evaluate the sensitization to metals in patients with Co-Cr hip prosthesis. Peripheral blood mononuclear cells (PBMC) were collected from 14 healthy donors and three groups of patients: 10 candidates for primary total joint replacements, 11 patients with well-fixed implant and 13 patients with aseptic loosening of the hip prosthesis. PBMCs were cultured with the metal ions employed for implant manufacturing and the expression of CD69 activation antigen on CD3/T lymphocytes was detected by flow cytometry. Chromium extract increased significantly the expression of CD3/CD69 phenotype in patients with loosening of hip prosthesis. The chromium-induced 'activation index' was higher in patients with loosening of hip prosthesis than in healthy donors and in pre-implant patients. The cobalt-stimulated PBMC of patients with either well-fixed or loosened prosthesis had an 'activation index' significantly higher than healthy donors. The activation index values were used to graduate the PBMC-response as 'normal' (> or = 0.9 and < 2), 'low' (< 0.9) and 'high' (> or = 2): an high-activation index was observed only in chromium-exposed PBMC of patients with prosthesis. Our data show that chromium released from orthopedic implants could be responsible for the lymphocyte sensitization and flow cytometry is an easy and reliable method for monitoring the hypersensitivity state in patients with metal prostheses. Activated lymphocytes in the peri-implant tissue are likely to elicit a localized immune response and contribute to maintain the inflammatory process evolving in the implant failure.

Aged↗
PubMed1991

[Total hip prosthesis after high femoral osteotomy].

This study reviews a series of 75 total hip prosthesis (THP) after high femoral osteotomy operated on between 1968 and 1986. The mean delay between osteotomy and THP was 14 years. 53 prosthesis were available for long term follow-up with a mean follow up of 7 years. It was included in the category of total hip prosthesis operations considered as difficult. The lateral view is indispensable to plan the operation. Valgus intertrochanteric osteotomies and moderate internal translations posed no problems. Trochanteric osteotomy did not have to be systematic; it's inconveniences were not neglectible. It was reserved for isolated varizations for it modifies the axis of entry of the stem. The reamer was used in cases of narrowing of the femoral canal; notably after significant medializations. Derotation osteotomy was the last resort when it was impossible to position the stem secondary to a subtrochanteric osteotomy or significant angulation in the sagittal plane. An intertrochanteric osteotomy, when correctly realised, posed few problems during placement of a total hip prosthesis and licits a continued use in young subjects. Results of THP after intertrochanteric osteotomy compared well with primary THP, with 77.5 per cent good results and 15 per cent loosening. In addition to problems posed by etiologies (congenital dislocations), subtrochanteric osteotomies rendered cementing extremely difficult, even impossible. At long term, only 14.5 per cent of the results were good and the loosening rate was 45 per cent. Fortunately subtrochanteric osteotomies are practically abandoned.

Adolescent↗
PubMed2004

[CT evaluation of total HIP prosthesis infection].

PURPOSE: To evaluate the ability of CT imaging to detect infectious lesions in total hip prosthesis. PATIENTS AND METHODS: CT was performed in 17 cases of suspected total hip prosthesis infection. Images were reviewed to evaluate for the presence of soft tissue abscess, hip joint effusion or fistula and peri-prosthetic lucency or erosion at bone window setting. The feasibility of CT imaging is assessed with regards to metallic artifacts. RESULTS: Infection was confirmed in 10 hips. A soft tissue abscess was present in 8 of these cases, in association to a joint effusion, presumably septic, in 7 cases. A fistula was identified in 8 cases. A peri-prosthetic lucency was present in 10 cases, 7 of which with infection, and erosions were noted in 4 patients, 2 of which with infection. Metallic artifacts reduced image quality but did not prevent detection of soft tissue abscesses. CONCLUSION: CT is useful for detection of soft tissue abscesses in patients with infected hip prosthesis. CT is useful for surgical planning or follow-up of patients treated conservatively.

Aged↗
PubMed1994

[Hip prosthesis infection: diagnostic approach and treatment of 27 cases].

BACKGROUND: Preoperative diagnosis of hip prosthesis infection (HPI) is difficult. There is no therapeutic option which is completely effective and without risk. The aim of this study was to evaluate a diagnostic approach and therapeutic strategy in a group of patients with HPI. PATIENTS AND METHODS: A retrospective study of 27 episodes of HPI diagnosed by anatomopathologic and/or microbiologic examination of surgical samples was performed. RESULTS: Twenty-three patients with 27 episodes of HPI out of a total of 24 hip prosthesis (HP) were treated. The infection was early in 15 episodes. The etiologic agents were plasmocoagulase negative staphylococcus (NSP) in 11 cases, P. aeruginosa in 8, S. aureus in 5, Enterococcus sp. in 2 and miscellaneous in the remaining cases. In 2 cases the infection was polymycrobial. Following a mean follow period of 22.6 +/- 15.2 months, 13 out of the 14 patients in whom the prosthesis was withdrawn were cured (in 4 a second prosthesis was implanted), one out of 6 in those in whom the prosthesis remained in situ following debridement, and 2 out of 3 episodes in whom reimplantation was performed over time. The withdrawal of the prosthesis was significantly greater than debridement in the treatment of early infection (p < 0.001). The total mean length of postoperative antibiotherapy was 48.2 +/- 17 days. No differences were observed in the oral versus parenteral treatment (p = 0.22), and nor was prognosis worse in those treated for less than 42 days. CONCLUSIONS: The authors' experience suggests that attempts to save a hip prosthesis in early infection usually fail. In addition to prosthesis withdrawal or implantation of another prosthesis, six weeks of postoperative antibiotic therapy, which may be oral route, appear to be sufficient.

Aged↗
PubMed1991

False-positive radionuclide arthroscintigraphy with a porous-coated total hip prosthesis.

The evaluation of a painful hip prosthesis for suspected loosening frequently requires a multi-modality approach. Radionuclide arthroscintigraphy is a valuable adjunct to contrast arthrography, demonstrating greater sensitivity than contrast arthrography in detecting loosening of the femoral component of the prosthesis. Despite its reliability in the evaluation of cemented hip prostheses, the value of arthroscintigraphy in patients with uncemented or porous-coated prostheses is undetermined. The case of a false-positive radionuclide arthroscintigram in a patient with an uncemented prosthesis is reported. The literature is briefly examined, and the potential implications regarding interpretation of arthroscintigraphy in patients with porous-coated prostheses are discussed.

False Positive Reactions↗
PubMed1988

Results of histological grading on 100 cases of hip prosthesis failure.

One hundred cases of hip prosthesis failure were classified on the basis of the different types of tissue reaction occurring around alloplastic material. The results revealed infectious phlogosis in 32% of the cases, phlogosis due to wear in 42%, phlogosis due to allergy in 1% and mixed phlogosis in 25%. The distribution of the type and degree of intensity of the phlogosis, in relation to the duration of the implant, is also highlighted. This new grading technique yields reproducible results.

Biocompatible Materials↗
PubMed2003

Endovascular repair of external iliac artery occlusion after hip prosthesis migration.

PURPOSE: To report emergent endovascular intervention to restore lower extremity arterial patency after migration of a hip prosthesis caused thrombosis of the external iliac artery (EIA). CASE REPORT: Nine months following left hip revision arthroplasty, a 66-year-old woman presented to the Emergency Department with the complaints of an acutely painful left lower extremity for over 6 hours. Imaging showed the metallic acetabular portion of the hip prosthesis in the iliac fossa, with severe external compression of the EIA. After thrombolysis to remove clot from the EIA, an 8x60-mm self-expanding Smart stent was deployed in the left EIA from a contralateral access. The procedure was successful, and the patient was discharged. An infected wound from a compartment fasciotomy delayed revision of the hip prosthesis. Nine weeks after stenting, the patient returned with a cold, pulseless left limb; a femorofemoral bypass was constructed to restore perfusion. CONCLUSIONS: While stent placement restored flow for 9 weeks after the initial ischemic event, the recurrent thrombosis could have been prevented by earlier revision of the migrated prosthesis.

Aged↗