IntroductionRevision acetabulum arthroplasty is one of the common procedures, which has been on the rise recently. Many implants are available in the market with variable results. Aseptic loosening is the most common indication for revision acetabulum arthroplasty. Birmingham dysplasia cup has been used occasionally in these complex procedures. We know ...

The relation between acetabular dysplasia and osteoarthritis of the hip was examined in a series of 1516 pelvic radiographs taken for non-skeletal indications. Osteoarthritis was assessed by measuring joint space, and dysplasia by the centre-edge angle and acetabular depth. In contrast with previous studies of ...

The purpose of the present study was to evaluate the 6- to 11-year follow-up results of hemispherical porous-coated cups implanted into dysplastic hips using press-fit technique without screws focusing on the amount of host bone coverage. There were 87 patients who underwent 98 primary total hip arthroplasties. Bony coverage was measured as the angle between the vertical line ...

... congenital acetabular retroversion, developmental dysplasia of ... as well as any abnormality resulting in ... 5) The chondral abnormalities resulting from ...

), slipped epiphysis, bursitis, developmental dysplasia of the hip and femoro-acetabular impingement

Knowledge of the acetabular rim and surface can be invaluable for hip surgery planning and dysplasia evaluation. The acetabular rim can also be used as a landmark for registration purposes. At the present time acetabular features are mostly extracted manually at great cost of time and human labor. Using a recent ...

The centre of rotation of the hip can be displaced in hip dysplasia and revision arthroplasty. This study examined the effect of artificial femoral head load after acetabular component displacement in total hip arthroplasty. Sixteen total hip arthroplasty models of human cadaver specimens were reconstructed, and under different ...

The centre of rotation of the hip can be displaced in hip dysplasia and revision arthroplasty. This study examined the effect of artificial femoral head load after acetabular component displacement in total hip arthroplasty. Sixteen total hip arthroplasty models of human cadaver specimens were reconstructed, and under different ...

Acetabular bone loss hampers implantation of a total hip arthroplasty in patients with developmental dysplasia of the hip. The bone impaction grafting technique in combination with a cemented total hip can restore the bone stock in these patients, but do these reconstructions yield satisfying long-term results? We used this technique in 28 hips (22 ...

Founded in Barcelona in 1985, the Spanish Hip Society (SECCA) now has over 200 members and organizes annual meetings. Papers read in the SECCA meeting are published in Hip International, since our society is affiliated with this journal. The late Sixties and early Seventies coincided with the beginning and development of total hip replacement. At present, over 30,000 hip prostheses are implanted ...

In primary and revision total hip arthroplasty (THA), the acetabular component continues to pose greater challenges than the femoral component. Numerous factors lead to polyethylene wear, which subsequently affects primary THA survival. Progressive polyethylene wear is associated with the occurrence of osteolysis, especially overlying the acetabulum, which can lead to ...

The study uses idealized two-dimensional finite element models to examine the behaviour of the acetabular construct following revision hip arthroplasty, carried out using the Slooff-Ling impaction grafting technique. The behaviour of bone graft was considered in detail, with non-linear elasticity and non-associated plasticity being adopted. Load was applied to the ...

BackgroundContact pressure of UHMWPE acetabular cup has been shown to correlate with wear in total hip replacement (THR). The aim of the present study was to test the hypotheses that the cup geometry, abduction angle, thickness and clearance can modify the stresses in cemented polyethylene cups.MethodsAcetabular ...

There are no clear explanations for the spectrum of hip dysplasia nor for the observation that in normal and dysplastic hips, final development may be unpredictable with or without treatment. Immunohistochemical and histological studies of a three month old child's acetabulae were performed. Multiple inclusions were found in the lateral ring epiphysis and in the three flanges ...

BackgroundSevere acetabular deficiencies in cases of developmental dysplasia of the hip (DDH) often require complex reconstructive procedures in total hip arthroplasty (THA). The use of autologous femoral head grafts for acetabular reconstruction has been described, but few data is available about clinical results, the rates of ...

Developmental dysplasia of the hip (DDH) is a spectrum of disease starting in childhood and in many cases persisting into adulthood. The spectrum ranges from acetabular dysplasia, through hip subluxation to dislocation. The aim of this research was to determine the prevalence and pathoanatomy of acetabular ...

Developmental dysplasia of the hip (DDH) is a spectrum of disease starting in childhood and in many cases persisting into adulthood. The spectrum ranges from acetabular dysplasia, through hip subluxation to dislocation. The aim of this research was to determine the prevalence and pathoanatomy of acetabular ...

BackgroundWe performed a retrospective study to evaluate the results of acetabular circumferential medial wall osteotomy, a procedure designed to provide secure fixation of a cementless hemispherical acetabular cup for the sequelae of septic arthritis of the hip.MethodsWe assessed 38 total hip arthroplasties (THAs) with circumferential ...

INTRODUCTION: Irreducible developmental dysplasia of the hip (DDH) in newborns is a rare entity. The different obstacles preventing reduction have been described in the literature. HYPOTHESIS: A clinical form of DDH with hypertrophy of the cartilage of the acetabular roof (acetabular bulge) can be reliably identified on ultrasound and ...

INTRODUCTION: Revision surgery in patients showing polyethylene wear and acetabular osteolysis without visible acetabular cup loosening involves the difficult decision of whether to revise only the liner or both the cup and the liner. The purpose of this study is to compare the outcomes of complete ...

Background: Treatment of hip dysplasia has focused on corrective osteotomy surgery, while hip arthroscopy remains controversial. Improved understanding of intra-articular disease patterns associated with hip dysplasia will help delineate the role of arthroscopy as an adjunct to osteotomy surgery for dysplastic hips. Purpose: The authors set out to describe ...

The relatively high incidence of labral tears among patients presenting with hip pain suggests that the acetabular labrum is often subjected to injurious loading in vivo. However, it is unclear whether the labrum participates in load transfer across the joint during activities of daily living. This study examined the role of the acetabular labrum in load ...

A major concern during revision hip arthroplasty is acetabular bone loss and bleeding during the extraction of well-fixed cementless acetabular cup, because no interface exists between the host bone and the cup. Forceful removal of such component using curved gouges and osteotomes often leads to extended bone loss ...

Appropriate anatomic concepts for surgery to treat femoroacetabular impingement require a precise appreciation of the native acetabular anatomy. We therefore determined (1) the spatial acetabular rim profile, (2) the topography of the articular lunate surface, and (3) the 3-D relationships of the acetabular opening plane comparing 66 ...

Ensuring the stability of a cemented PROSTALAC cup (Depuy, Warsaw, Ind) in the presence of severe superior acetabular segmental deficiency is critical to the success of the first-stage surgery. We present an illustrative case and the surgical technique required to achieve this. PMID:21752577

Five fresh cadaver pelves were cleaned of soft tissue and instrumented with strain gauges. The acetabula were reamed, and a cementless cup, oversized at the periphery, was inserted. The applied force and cup acceleration were measured during insertion and used to calculate an effective mass of the cup, insertion device, and pelvis ...

Abstract. We reviewed a series of 17 hip arthroplasties in 16 patients performed when the patients were 30 years old or younger who presented to us for consideration of revision. The mean age was 23.1years (14 to 30) at the initial arthroplasty. At the time of the original procedure there were 4 sequelae of septic arthritis, 7 old traumatic hip injures, 3 cases of developmental ...

We reviewed a series of 17 hip arthroplasties in 16 patients performed when the patients were 30 years old or younger who presented to us for consideration of revision. The mean age was 23.1 years (14 to 30) at the initial arthroplasty. At the time of the original procedure there were 4 sequelae of septic arthritis, 7 old traumatic hip injures, 3 cases of developmental ...

It is well accepted that youth and high activity levels are among the factors that increase the risk of mechanical failure of total hip prostheses. However, there are few reports of long-term results in very young patients. In this study, we evaluated the results of total 49 hip replacements (THRs) using an uncemented total hip prosthesis in 44 patients (28 females) who were 30 years or younger ...

It is well accepted that youth and high activity levels are among the factors that increase the risk of mechanical failure of total hip prostheses. However, there are few reports of long-term results in very young patients. In this study, we evaluated the results of total 49 hip replacements (THRs) using an uncemented total hip prosthesis in 44 patients (28 females) who were 30�years or younger ...

Monoblock trabecular metal cups are made of a novel porous material intended to enhance ingrowth and improve fixation. We prospectively followed 223 consecutive patients with 245 trabecular metal acetabular cups implanted during primary total hip arthroplasties to determine the overall survivorship of the implant, and any association ...

The purpose of this study was to compare acetabular component positioning using an imageless system to a matched control group using conventional techniques. Thirty procedures were performed using navigation. A multislice computed tomographic scan was used to assess cup position. There was no significant difference between mean inclination (P = .11) and ...

Abstract. It is unknown how often femoro-acetabular impingement (FAI) and hip dysplasia co-exist and which is more important in the development of intra-articular lesions such as labral tears. This study identified the prevalence of dysplasia on standard radiographs in a group of 76 consecutive patients with symptomatic FAI. The ...

The purpose of this paper was to evaluate the results of acetabular revisions with the use of an oblong revision cup that is designed with its longitudinal diameter elongated relative to its transverse diameter. Between 1996 and 2001, 62 hips in 60 patients underwent an acetabular revision with the insertion of a LOR ...

BackgroundThe aim of this study was to answer the following two questions: 1) Do the radiological parameters of dysplasia have significant correlations between themselves or with the parameters of the proximal femoral deformity and vice versa? 2) Do the physical parameters have a significant correlation with the radiological parameters of hip dysplasia and ...

Contact mechanics analysis for a typical McKee-Farrar metal-on-metal hip implant was carried out in this study. The finite element method was used to predict the contact area and the contact pressure distribution at the bearing surfaces. The study investigated the effects of the cement and underlying bone, the geometrical parameters such as the radial clearance between the ...

Fifty-three patients (54 hips) treated with cemented total hip reconstruction with the aid of an acetabular mesh made of Vitallium (Howmedica Inc., Rutherford, New Jersey), a cobalt-chrome molybdenum alloy, to reinforce the medial cement for deficient bone stock in the central acetabular region, were evaluated at an average follow-up period of 6.8 years ...

A radiographic study of a singular type of threaded cup, revised due to aseptic loosening, was performed with Einzel-Bild-Roentgen-Analyse (EBRA) to detect eventual risk factors and patterns of loosening. Fifty-three cups of 50 patients were revised. Forty-two cups could be measured with EBRA. No cup had obvious ...

The impact of femoral head surface roughness on wear of gamma-irradiation sterilized (3 MRad in nitrogen, crosslinked) and nonsterilized (not crosslinked) UHMWPE acetabular cups has been evaluated. Gravimetric wear testing was performed in a hip joint simulator for 2 x 10(6) cycles. CoCrMo heads were used with different surface roughness (R(a) = 15 nm and ...

The purpose of the study was to investigate the contact stresses in 3 different acetabular cup rim designs (new, worn, chamfer) during edge loading, after microseparation of ceramic on ceramic hip prostheses. A 3-dimensional finite element analysis was conducted for a 28-mm diameter alumina ceramic bearing with a radial clearance of 40 ?m using a normal ...

The Ganz periacetabular osteotomy (PAO) is currently the most popular hip-sparing procedure in adults with acetabular dysplasia. If this procedure fails and a total hip arthroplasty is necessary, spatial reorientation of the acetabulum alters the conditions of implanting the acetabular component of the prosthesis. In our study, we ...

The study of acetabular morphology has shown that there are geographic differences in the morphology and prevalence of acetabular dysplasia among different ethnic groups. However, few data exist on the shape of the acetabulum in various populations around the world. In this study, we examined samples of pelvic radiographs from Egyptian ...

Exostoses or osteochondromas are the most common benign bone tumors in children. The proximal femur is affected in approximately 30% of individuals and may lead to growth disturbances, acetabular dysplasia, and possible subluxation. Intraarticular lesions may also occur but are rarer. We present 2 cases of intraarticular exostoses that were successfully ...

The major failure mode of cemented or noncemented acetabular fixation is osteolysis produced by biologic reaction to polyethylene and metallic debris. A monoblock acetabular noncemented component offers advantages in reducing the failure mechanism of acetabular cups. First, there is no extra-articular back surface ...

Followed by successful demonstration of high interfacial tensile strength in a new design of cemented all-polyethylene acetabular cup, interfacial shear strength was investigated in this study, with the use of canine-size prototypes of polymethylmethacrylate (PMMA) precoated UHMWPE acetabular cups. In addition to ...

We reviewed 81 consecutive ABG I primary total hip replacements implanted in 72 patients between January 1993 and December 1998. The mean follow-up was 8.2 (range 7-12) years. There was significant polyethylene wear and osteolysis associated with the acetabular cup . The cumulative survival of the cup with revision being the end point ...

Cementless acetabular components are routinely used in revision hip surgery. Nevertheless, few investigators have assessed their retention and efficacy over the long term. This occurs mainly in cases which originate from moderate to severe bone losses (cavitary and or segmental) requiring the use of morselized and or bulk bone graft. Our objective in the present study is to ...

This paper explores the effect of under-reaming on micromotion at the cup/bone interface of a press-fit acetabular cup. A cadaver experiment was performed on 11 acetabuli implanted with a cementless acetabular cup. The loading profile simulated hip impingement at the extremes of motion and ...

A finite element model has been developed to predict in vivo micro motion between a modular acetabular cup and liner after cement less total hip arthroplasty. The purpose of this study is to experimentally validate the model. Six LVDT sensors were used to monitor the micromotion of the liner when subjected to loading conditions ranging from 250 N to 5000 ...

The theoretical advantage of using thinner acetabular components in hip resurfacing has not yet been clinically verified. Our purpose was to test the hypothesis of bone conservation and assess the effects of using a thinner acetabular component on hip biomechanics and clinical outcome. We compared the bone conservation, biomechanical results, and ...

The authors propose a simple and practical method to measure radiologically the angle of ante- or retroversion of the acetabular cup using a goniometer. It only necessitates an anteroposterior radiograph centered on the femoral head and another one centered on the public symphysis. Special x ray equipment, compass, conversion table, mathematical formulas, ...

Orthopaedic surgeons must currently choose from several types of ultra high molecular weight polyethylene acetabular cups that differ in their material properties and in the methods used for their sterilization. Information on the wear resistance of these different cups may help in the selection process. This study included two ...

Reconstructive acetabular osteotomy is a well established and effective procedure in the treatment of acetabular dysplasia. However, the dysplasia is frequently accompanied by intra-articular pathology such as labral tears. We intended to determine whether a concomitant hip arthroscopy with ...

Hip resurfacing is femoral bone preserving, but there is controversy regarding the amount of bone removed at the acetabular side. We therefore compared the implanted acetabular cup sizes in primary THAs between two resurfacing devices and a conventional press-fit cup using a series of 2134 THAs ...

AbstractTotal hip arthroplasty (THA) in young patients has a high loosening rate, due in part to acetabular deformities that may compromise bone fixation and polyethylene wear. We therefore asked whether wear or osteolysis and loosening differ in patients under 40�years of age with alumina-on-alumina THA compared to those who are older. We prospectively followed 56 patients ...

The pathological anatomy in neglected developmental dysplasia of the hip often demands some sort of reconstructive surgery to augment the acetabular bone stock during total hip arthroplasty. We have reviewed 11 hips in 10 patients with osteoarthritis secondary to developmental hip dysplasia who underwent cemented total hip arthroplasty ...

We report the results of 24 acetabular reconstructions in which cemented polyethylene cups and tamped corticocancellous allografts were used for severe acetabular bone deficiency. Eleven hips had type-II (cavitary) bone deficiency and 13 had type-III (combined) defects. At a mean follow-up of 5.8 years, two components had migrated more ...

Neutral pelvic positioning during recording of anteroposterior pelvic radiographs has been recommended for precise interpretation of acetabular deformities. Because the effect of pelvic positioning is controversial in the literature, we asked whether the weightbearing position would alter radiographic interpretations. We obtained sets of supine and weightbearing ...

In view of the controversy about bulk autografts to provide support for the acetabular cup in reconstruction of the dysplastic hip, a series of 15 dysplastic hips were investigated as follows: Femoral head autograft shelf reconstruction and cemented acetabular components were evaluated at an average follow-up period of 99 months after ...

The use of large metal on metal bearings has led to a reduction in the risk of dislocation post hip arthroplasty. Because of this, and also because of the technical difficulties associated with resurfacing surgery in particular, it could be argued that a less meticulous approach to acetabular cup placement has developed in comparison with conventional ...

BackgroundIt has been indicated that, in the long term, the rate of wear and the degree of osteolysis observed with uncemented acetabular components are greater than those associated with cemented cups, but most studies which compare the wear characteristics of cementless with cemented cups have used historical controls. We report a ...

This article summarises a clinical and radiographical analysis of 30 acetabular revisions in patients younger than 55�years old, performed with impaction bone grafting and cemented cups. Preoperative Merle D�Aubigne and Postel functional score was an average 7 points. At a mean follow-up of 86.5�months (range 34�228) functional score averaged 16.3 ...

BackgroundLoosening of acetabular components often leads to bony defects. Management of extensive acetabular bone loss in hip revision arthroplasty can be a tremendous challenge.Questions/purposesWe asked whether a reconstruction with impacted bone grafts will provide a durable and pain-free function in extensive acetabular defects. We ...

ABSTRACT: BACKGROUND: Correct placement of the acetabular cup is a crucial step in total hip replacement to achieve a satisfactory result and remains a challenge with free hand techniques. Imageless navigation may provide a viable alternative to freehand technique and improve placement significantly. The purpose of this project was to assess and validate ...

BackgroundCorrect placement of the acetabular cup is a crucial step in total hip replacement to achieve a satisfactory result and remains a challenge with free-hand techniques. Imageless navigation may provide a viable alternative to free-hand technique and improve placement significantly. The purpose of this project was to assess and validate ...

Massive acetabular bone loss (more than 50% of the acetabular area) can result in insufficient native bone for stable fixation and long-term bone ingrowth of conventional porous cups. The development of trabecular metal cages with osteoconductive properties may allow a more biological and versatile approach that will help restore bone ...

We report a case of a 46-year-old male patient who sustained a fracture of the Burch�Schneider anti-protrusio cage (APC) that was implanted 13 years before. The fracture occurred in the transitional area to the proximal flange and was caused by direct and recurrent contact between the prosthetic metal head and the acetabular device. Late failure was related to increased wear ...

Alumina ceramic-on-ceramic total hip arthroplasty (THA) has been widely used due to its advantages such as low wear, scratch resistance, wettable surface and relatively low biological reactivity of the wear particles. Nevertheless, this material in THA still persists to be one of the major concerns about the risk of fracture, due to its brittleness. Many authors have reported a fracture of the ...

A subject-specific three-dimensional finite element (FE) pelvic bone model has been developed and applied to the study of bone-cement interfacial response in cemented acetabular replacements. The pelvic bone model was developed from CT scan images of a cadaveric pelvis and validated against the experiment data obtained from the same specimen at a simulated single-legged ...

BACKGROUND: The recent interest in hip resurfacing arthroplasty is motivated by its potential advantages over THA. One advantage of hip resurfacing arthroplasty is that it conserves bone on the femoral side; however, it is unclear whether it does so on the acetabular side. QUESTIONS/PURPOSES: We determined whether the amount of acetabular reaming and ...

Implantation of a cementless press-fit acetabular cup during hip arthroplasty alters stress transfer to the periacetabular bone, resulting in stress shielding of cancellous bone and enhanced load transfer to cortical bone. Theoretically, the thicker, stiffer and larger acetabular cup of a hip resurfacing may ...

Ultra-high molecular weight polyethylene acetabular cups backed by Ti-6Al-4V acetabular shells were articulated against Co-Cr-Mo alloy, ion-implanted Co-Cr-Mo alloy, and zirconia ceramic femoral heads in a hip joint simulator. Three tests of three million walking cycles each were run with five different head-cup ...

BackgroundHydroxyapatite (HA) is the main inorganic component of bone, and HA coating is widely used on acetabular cups in hip arthroplasty. It has been suggested that this surface finish improves cup survival.MethodsAll patients registered in the Swedish Hip Arthroplasty Register between 1992 and 2007 with an uncemented ...

We evaluated the fate of bulk femoral head autograft in cementless total hip arthroplasty (THA) for developmental hip dysplasia. Of 87 hips (80 patients) studied, 37 hips (32 patients) were available for follow-up at a mean of 18.5 years (range, 15-24 years) postoperatively. The mean age of these 32 patients at the index procedure was 53.8 years (range, 40-65 years). The ...

Acetabular labral tears have been the focus of much attention in recent years. With the increased use of hip arthroscopy and magnetic resonance arthrography, the infrequent labral tear has proved to be more prevalent than previously thought. The majority of labral tears occur due to an underlying anatomic abnormality. Anatomic abnormalities that can lead to labral tears ...

Five patients presented with fiber metal mesh shedding of a Harris Galante II acetabular cup detected between 11 and 15 years after implantation. All patients presented with hip pain and 4 demonstrated gross acetabular loosening and fiber metal separation on preoperative radiographs. The remaining patient underwent revision surgery ...

The success of metal bearings is dependent on several parameters. The effects of in vivo forces on the deformation of monoblock acetabular components have yet to be determined. The purpose of our study was to assess the amount of deformation with press-fit fixation of 1-piece metal acetabular components. Four manufacturers provided 1-piece metal ...

We applied a Raman confocal spectroscopic technique to quantitatively assess the structural features of two kinds of acetabular cups made of ultra-high molecular weight polyethylene. We wanted to know whether polyethylene cups belonging to different generations, and thus manufactured by different procedures, possess different molecular ...

The anatomic femoral component and Harris-Galante porous II (HGPII) cup were developed to provide more reliable bone ingrowth. We performed 20 cementless total hip arthroplasties (THAs) with anatomic stem/HGPII cup with 22-mm head in 14 consecutive patients, and evaluated the clinical and radiological results for a mean follow-up of 12.8�years. The ...

Five different porous-coated acetabular prosthetic configurations underwent in vitro testing to assess mechanical stability in embalmed cadaver hemipelves: Harris Galante II cup with three cancellous screws, Biomet Universal cup, Whiteside cup with peripheral pegs, Whiteside cup with two ...

Acetabular osteolysis associated with socket loosening is one of the main long-term complications of total hip arthroplasty. In case of major bone loss, where <50% host bone coverage can be obtained with a porous-coated cementless cup, it is generally agreed that a metal ring or cage in association with a cemented component and allograft bone should be ...

Two methods were developed and evaluated for cross-linking the bearing surface of a polyethylene acetabular cup to a limited depth, in order to improve its resistance to wear without degrading the mechanical properties of the bulk of the component. In the first method, low-energy electron beams were used to cross-link only the bearing surface of the ...

BackgroundCotyloplasty is a technique that involves making a perforation of the medial wall of a shallow acetabulum and then inserting an acetabular cup with the medial aspect of its dome beyond the Kohler line. The purpose of this study was to evaluate the results of cementless total hip arthroplasty (THA) using cotyloplasty with focusing on the amount of ...

Taguchi technique is a powerful method of solving engineering problems in order to improve the performance of a process and to enhance the productivity. The methodology for the design of the experiment is proposed in order to find the best parameters for better experimental results with less number of experiments as possible. In this study, Taguchi technique was applied to optimize the compression ...

A custom-made hip is essential for the initial stability and longevity which correspond to an optimal stress distribution, since a standard hip cannot always satisfy every patient's need. In order to find out the designing principles of a custom-made hip, a patient's personal features on which the design was based were acquired. In this study, an integrated finite element model of the hip ...

Eighty-six polyethylene liners and 56 metallic shells of acetabular components were evaluated by visual and stereomicroscopic examination for impingement, backside polyethylene wear, creep, and fretting at the screw-metallic shell interface using a subjective scoring system. Medical records and radiological data were available in 65 and 46 patients, respectively. Impingement ...

Aluminia-on-aluminia hip prosthesis with titanium alloy stem was used in 255 cases, for 143 patients with cemented acetabular cup and 112 with an uncemented screw cup. The average age of the patients was 62 years. Of the patients, 35 were treated bilaterally. The indication for surgery was osteoarthritis in 186 cases, fractures and ...

In approximately 25% of patients with hereditary multiple exostosis, there is an abnormal osteochondral formation localized in the femoral proximal metaphysis. This formation often causes a mechanically progressive insufficiency of the acetabular cavity, a true developmental hip dysplasia, that together with a coxa valga deformity, which is also present, ...

Between March 1990 and May 1991 we performed 85 primary total hip replacements in 74 patients using the Landos Atoll hydroxyapatite (HA)-coated cup and the Corail HA-coated stem. The patients were followed up for a mean of ten years. Of the 85 cups, 26 (31%) have already been revised and a further six are radiologically unstable and awaiting revision. Two ...

The first case of metaphyseal chondrodysplasia with marked cupping of the metaphyses and cone epiphyses combined with complete alopecia was described in 1966 by Bellini. A second identical case was found in another Italian patient. Both show extremely early epiphyseal fusion. This is probably a new form of metaphyseal chondrodysplasia.

Osteoarthritis; Post-Traumatic Arthritis; Collagen Disorders; Avascular Necrosis; Congenital Hip Dysplasia; Slipped Capital Femoral Epiphysis

Primary total hip arthroplasty (THA) in patients with osteoarthrosis secondary to developmental hip dysplasia is often complex due to anterolateral acetabular bone deficiency. The use of femoral head (shelf) autograft during the index arthroplasty provides nonimmunogenic, osteoconductive support with the potential for enhanced bone stock should revision ...

Total joint replacements (TJRs) have a limited lifetime, but the introduction of components that exhibit good lubricating properties with low friction and low wear could extend the life of TJRs. A novel acetabular cup design using polyurethane (PU) as a compliant layer (to mimic the natural joint) has been developed. This study describes a series of ...

Impaction grafting is controversial in the presence of segmental and cavitary acetabular defects and requires the use of supplemental devices to close segmental defects. This approach, however, would allow treating combined deficiencies that could not be managed with impacted cancellous bone alone. We raised the following two questions: (1) What is the survival rate in ...

OBJECTIVES:Our primary aim was to compare the long?term survivorship rates and the rates of successful osseointegration between two different types of uncemented acetabular components.INTRODUCTION:Two types of alloys have primarily been used for the manufacture of the uncemented acetabular components: titanium?based and cobalt?based alloys. A ...

A basic understanding of the surgical approach, technique, and potential complications in addition to the types of hardware used is essential in interpreting postoperative imaging of the hip. This article reviews the various surgical approaches to the hip and hardware components in total hip arthroplasty and hip preservation surgery and the potential complications that may arise. The various ...

The use of a lateral femoral head autograft with total hip arthroplasty is an effective method to treat moderate to severe acetabular dysplasia with an excellent chance of satisfactory results. The operation was performed on 42 hips in 37 patients over a 12-year period. The average follow-up period was 5.7 years, with none shorter than two years. A ...

Metal press-fit cups and shells are widely used in hip resurfacing and total hip replacement procedures. These acetabular components are inserted into a reamed acetabula cavity by either impacting their inner polar surface (shells) or outer rim (cups). Two-dimensional explicit dynamics axisymmetric finite element models were developed ...

Squeaking in total hip arthroplasty (THA) has been observed only in hard-on-hard bearings, such as ceramic-on-ceramic or metal-on-metal. We report the case of a patient with a squeaking THA who had undergone multiple femoral head revisions combined with a composite ceramic cup (polyurethane, ceramic). Squeaking started 6 years postoperatively and ...

BackgroundMorquio syndrome is an autosomal recessive lysosomal storage disorder, a mucopolysaccharidosis (PMS), characterized by abnormal metabolism of glycosaminoglycans. Major treatable concerns in patients with MPS type IV involve C1 to C2 instability, genu valgum, and hip subluxation. All patients demonstrate characteristic acetabular dysplasia and ...

Using computed tomography-assisted (CT) osteodensitometry, we studied the bone changes that occurred in 12 patients at 2 weeks and again at 1 year after total hip arthroplasty with insertion of a press-fit acetabular cup and an uncemented femoral tapered stem. There was a greater decrease in full bone density (BD) lateral to the femoral stem when compared ...

Joint simulators are important tools in wear studies of prosthetic joint materials. The type of motion in a joint simulator is crucial with respect to the wear produced. It is widely accepted that only multidirectional motion yields realistic wear for polyethylene acetabular cups. Multidirectionality, however, is a wide concept. The type of ...

In the 1970s, high failure rates of cemented acetabular components, especially in young patients, in the middle- and long-term prompted a search for alternatives. The Mecring was one of the most popular first generation uncemented, threaded cups widely used in the 1980s for arthroplasty of the hip. First generation threaded cups ...

Factors that influence the outcome of acetabular replacement are design materials, means of fixation, operative technique, and patient-related parameters (e.g., etiology of osteoarthrosis). Whereas improved cementing techniques have produced a marked reduction in the rate of femoral component loosening, the incidence of acetabular loosening has been only ...

BACKGROUND: The recommended range of anteversion of the components in total hip arthroplasty (THA) is between 10 and 30�, but the intraoperative estimation of these versions may be inadequate. HYPOTHESIS: The components anteversion in primary cementless THA using straight stem and hemispherical cup is not significantly different from the native anteversion of the hip joint. ...

The total penetration of femoral heads into acetabular cups is achieved by a combination of long-term wear and early non-recoverable deformation or creep. The former is important in determining the total rate of production of polyethylene wear debris, recently implicated in the development of osteolysis and loosening, while the latter contributes to the ...

Recent in vitro work has shown that sealing the acetabular notch with bone graft in bovine acetabulum samples results in improved cement penetration in the acetabular bone during total hip arthroplasty. Successful sealing of the notch may be identified on postoperative films by a lack of cement extrusion. This study aimed to assess the clinical ...

Quantifying soft-tissue tension around the hip joint during total hip arthroplasty remains difficult. In this study, a three-dimensional computer-aided design model was developed to clarify how component position in total hip arthroplasty contributes to the primary cause of posterior dislocation in cases of flexion, adduction and internal rotation. To better understand the influences of ...

Porous surfaces are intended to enhance osteointegration of cementless implants. Tantalum has been introduced in an effort to enhance osseointegration potential of uncemented components. We therefore compared the clinical outcome of acetabular components with two different porous surfaces. We retrospectively reviewed 283 patients (295 hips) who underwent cementless revision ...

The implantation of an endoprosthetic socket into the acetabulum alters the mechanical stresses in the periacetabular region in a significant manner compared with the natural hip joint. In this way, a remodelling process is initiated. Primary stability to achieve osseointegration and a loading of the acetabulum owing to the biomechanical interaction between cup and bone that ...

Femoroacetabular impingement (FAI) can be associated with labral ossification, acetabular rim fractures, and os acetabuli. Typically, these fragments can be completely excised as part of a femoroacetabular impingement correction procedure. In rare instances, however, larger, weight-bearing fragments contribute to pincer-type impingement, but complete removal might create ...

After total hip replacement (THR) impingement of the implant components causes shear stresses at the acetabular implant-bone interface. In the current study the finite element method (FEM) was applied to analyse the shear stresses at a fully bonded implant-bone interface assuming total ingrowth of the cup. The FE model of a press-fit ...

A new uncemented acetabular component, the Cambridge cup, has been designed to mimic the anatomy and physiology of subchondral bone in order to minimise stress shielding and enhance long-term component stability. Cambridge cups were implanted in a cohort of 50 women who presented with displaced sub-capital fracture of the femoral neck. ...

The aim of the study was to analyze early results of total uncemented hip replacement with use of small diameter acetabular components. In the group of 13 patients (15 hips) with severe dysplastic coxarthrosis mean age at surgery was 43.6 years. There were 8 right and 7 left hips operated. For clinical assessment Merle d'Aubign� and Postel classification modified by Charnley ...

Intrapelvic acetabular cup migration is a rare but serious complication, which can occur after cup loosening following total hip arthroplasty. To make safe intrapelvic implant removal, several principles must be respected: identification of potential risks with a thorough preoperative workup, preoperative planing of a surgical strategy ...

High-porosity "cancellous metal" coatings have been introduced to increase the fixation and biologic incorporation of acetabular cups. The strength of initial fixation provided by a cancellous metal cups vs conventional alternatives in the deficient revision acetabulum was investigated. Cancellous, plasma-sprayed, and beaded ...

Small-diameter cemented Metasul� cups have been previously identified to be at high risk of early loosening. We asked whether this particular mode of failure was associated with a specific histological feature. Periprosthetic tissues were obtained at the time of revision of two aseptically loose cemented Metasul� cups. Each tissue sample was processed ...

BackgroundSubchondral insufficiency fracture of the femoral head occurs mainly in elderly patients with osteoporosis. Spontaneous resolution is observed after nonoperative treatment in some patients whereas other show progressive joint destruction requiring THA. Several studies report the occurrence of subchondral insufficiency fracture of the femoral head in dysplastic hips.Questions/purposesWe ...

The Rim Cutter (Stryker Orthopedics, Mahwah, New Jersey) is a tool designed to cut a ledge inside the rim of the acetabulum, onto which a precisely trimmed, cemented, flanged cup can be fitted. The aim was to investigate the effect of the Rim Cutter on the intra-acetabular cement mantle pressure and the depth of cement penetration during ...

INTRODUCTIONExtensive bone loss associated with revision hip surgery is a significant orthopaedic challenge. Acetabular reconstruction with the use of impaction bone grafting and a cemented polyethylene cup is a reliable and durable technique in revision situations with cavitatory acetabular bone defects. Some use cancellous graft ...

IntroductionMany kind of hydroxyapatite-coated cups were used, with favorable results in short term studies; it was supposed that its use could improve osteointegration of the cup, enhancing thus stability and survivorship. The purpose of this study is to analyze the long term behavior of the hemispheric HA coated, Dual Radius Osteonics ...

Uncemented, threaded acetabular components with smooth surface treatment were widely used in continental Europe in the 1970s and 1980s for primary total hip arthroplasty (THA). Previously published studies showed high failure rates in the mid-term. In a consecutive series of 116 patients, 127 threaded cups with smooth surface treatment (Weill ...

A review of current clinically applied biomaterials for the femoral heads and acetabular cups of total hip prostheses (UHMWPE, CoCrMo alloys, alumina and zirkonium) in terms of their resistance to wear is presented. Further developments in metallic and ceramic materials over the last few years have now left UHMWPE as the weakest link in the prosthesis ...

Resurfacing systems use press-fit, monoblock, cobalt chrome alloy acetabular sockets because of the material's ability to withstand stresses while accommodating a large femoral head. Despite the widespread use of these types of sockets for both hip resurfacing and total hip replacement, there is a paucity of literature assessing the outcomes of these cups ...

There are six different definitions of acetabular position based on observed inclination and anteversion made in either the (1) anterior pelvic plane or (2) coronal planes and based on whether each of the observations made in one of these two planes is (1) anatomic, (2) operative, or (3) radiographic. Anteroposterior pelvic tilt is the angle between the anterior pelvic plane ...

The complications, management, and outcome of a consecutive series of 61 ilioischial reconstruction rings performed by 1 surgeon over a 15-year period are reported. Structural corticocancellous allografts were used in 48 cases. Twenty-seven cases had no complications, 9 had medical complications, and 5 had complications related to femoral revision. Other complications included 4 sciatic and 2 ...

The versatility of modular total hip arthroplasties have rapidly extended their applications. However, these new interfaces can lead to complications that were not observed with monolithic components. These problems have been noted with modular femoral and acetabular components and have been associated with the generation of particulate debris. This article reviews the ...

The main design features of metal-on-metal (MOM) hip resurfacing prostheses in promoting elastohydrodynamic lubrication were investigated in the present study, including the femoral head diameter, the clearance, and the cup wall thickness. Simplified conceptual models were developed, based on equivalent uniform wall thicknesses for both the cup and the ...

Total hip arthroplasty (THA) still carries a higher failure rate in patients with avascular necrosis of the femoral head (AVN) than in a similar patient population with THA for other reasons. This is particularly true for the acetabular component. One of the major factors accounting for this is the compromised acetabular bone quality with structural ...

Five patients with cerebral palsy, hip dysplasia, pelvic obliquity, and scoliosis were evaluated retrospectively using three dimensional computed tomography (3DCT) scans of the proximal femur, pelvis, and lumbar spine to qualitatively evaluate their individual deformities by measuring a number of anatomical landmarks. Three dimensional reconstructions of the data were ...

Although the use of ultrasound in the diagnosis and early treatment of developmental dysplasia of the hip (DDH) has reduced the number of patients diagnosed late and decreased the number of operative procedures, surgical treatment is still needed in some patients. Late cases continue to occur as a result of missing the screening examination, being normal at initial screening ...

The prevalence of rotation of the pelvis along its length axis was noted, as was the number of rotations towards the right or left hand side of the dog, on 7,012 conventional hip extended radiographs, which were sent for official screening. 29.8% of the radiographs showed a rotation the pelvis. The rotation was statistically more frequent towards the left hand side of the dog. The number of ...

We present 3 patients followed at our institution for developmental hip dysplasia for an average of 20 years. Each patient underwent a Pemberton pelvic osteotomy for developmental hip dysplasia and remained symptom-free during childhood. All 3, however, returned as young adults at an average 12 years from surgery with delayed onset of ipsilateral hip pain ...

Cementless acetabular components gained popularity because of the increased rate of loosening associated with cemented cups after intermediate and long-term follow-up. There are few long-term follow-up studies of cementless acetabular components. This study aims to evaluate the clinical and radiological long-term results of the ...

BackgroundDue to wide variations in acetabular structure of individuals with hip dysplasia, the measurement of the acetabular orientation may not be sufficient to predict the joint loading and pressure distribution across the joint. Addition of mechanical analysis to preoperative planning, therefore, has the potential to improve the ...

BackgroundThere are multiple revision implant systems currently available for socket revision in revision total hip arthroplasty. Up until now, not all of these systems have been followed up with regards to their long-term use as a revision implantation.For the first time, this study presents the hemispherical porous-coated socket Plasmacup SC, produced by Aesculap, Tuttlingen, Germany, and the ...

While favorable tribological properties and allowance for larger femoral head sizes have made metal-on-metal (MoM) bearings an increasingly popular choice for total hip arthroplasty, concerns have mounted regarding adverse reactions to metal wear debris and ions. MoM cups differ from conventional polyethylene cups in terms of edge profile design and ...

A technique for primary uncemented total hip arthroplasty in the presence of a superolateral acetabular deficiency is described. The resected femoral head is used as an autograft. Matching reamers are used to ream the pseudoacetabulum and femoral head. Lag screw fixation is then performed and reaming of the graft and host bone simultaneously allows placement of an uncemented ...

At 10 years, we reported survivorship of the Omnifit hydroxyapatite-coated femoral stem and the Omnifit-PSL porous-coated dual-radius acetabular shell (Stryker, Mahwah, NJ) with polyethylene liners sterilized by gamma radiation in air. Our 15-year follow-up examines survivorship and functional outcomes of this system. Ninety-two patients (98 hips) were identified from our ...

Bone stock deficiency presents the major challenge in acetabular reconstruction during revision hip arthroplasty. The preoperative assessment of acetabular bone stock before revision surgery is critical because the amount and location of pelvic osteolysis can determine the type and success of revision surgery. Traditionally, plain radiographs with AP and ...

The study investigates the short-term behaviour of the acetabular construct following revision hip arthroplasty, carried out using the Slooff-Ling impaction grafting technique; using 3D finite element analyses. An elasto-plastic material model is used to describe the constitutive behaviour of morsellised cortico-cancellous bone (MCB) graft, since it has been shown that MCB ...