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 ...

... wear rate of prosthesis contact surfaces is greatly accelerated if loose fragments of bone cement become detached and act as an abrasive in the ...

... Panel meeting; Dr. Mayor reported that his laboratory has not received any CoMplete � Acetabular Hip System components for retrieval analysis. ...

Patients Receiving Primary Hip Arthroplasty Using the Continuum Metal on Polyethylene Acetabular System

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 ...

PURPOSE: The purpose of this study was to investigate the mid-term results of 32 acetabular reconstructions performed using a Kerboull-type acetabular reinforcement device and bone graft between June 1997 and January 2009. METHODS: The mean age of the patients at the time of surgery was 71.4 years (range 55-85). Patients were followed-up for a mean of 7.5 ...

Objective: In order to achieve accurate implantation of the acetabular prosthesis in total hip arthroplasty (THA), we designed individual templates based on a three-dimensional (3D) model generated from computed tomography (CT) scans. Methods: Individual templates were designed for 12 patients who underwent THA. A physical template was designed to conform ...

PURPOSE: At present, the indications for femoral derotational osteotomy remain controversial due to the inconsistent findings in femoral neck anteversion in developmental dysplasia of the hip (DDH). Moreover, combined anteversion is not assessed in unilateral DDH using three dimensional-CT. Therefore, the purposes of our study were to observe whether the femoral neck ...

- oral and acetabular implants and their respective receiving bones. Such systems lack the predictive is to model the bone/implant system and subse- quently study numerically the mechanical effects and the discretization of the area between the external bone boundary and the boundary of the implant. NUMERICAL RESULTS

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 patients with symptomatic ...

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

We report two Australian patients with possible cobalt toxicity related to metal-on-metal total hip replacements. Both patients were treated for osteoarthritis with a DePuy ASR (articular surface replacement) XL Acetabular Hip System prosthesis, which contains cobalt and chromium, and which has recently been ...

A simple hip dislocation is one without fracture of the proximal femur or acetabulum. Complex fracture-dislocations involve the acetabulum, femoral head, or femoral neck. The incidence of posttraumatic arthritis is much lower in simple dislocations than in fracture-dislocations. The most common mechanism of injury is a high-energy motor vehicle accident, which is usually ...

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 ...

We assessed 90 total hip arthroplasties (THAs) performed with the Metasul metal-on-metal hip system (Zimmer, Warsaw, Indiana); the patients were monitored for >10 years. The average Harris Hip Score of the patients was 40.5 points preoperatively and 85.8 points at final follow-up. No adverse reactions to the ...

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 ...

We report 3 cases of a bifid posterior acetabular labrum in a hip joint, diagnosed arthroscopically in patients with other symptomatic hip pathology. One of the patients underwent investigation with magnetic resonance arthrography, which was suggestive of a posterior labral tear, whereas the bifid posterior labrum was found ...

We report the updated results at a minimum of fifteen years after eighty-four consecutive total hip arthroplasties performed in sixty-seven female patients with high dislocation of the hip. Sixty-four arthroplasties were performed in forty-nine patients, between 1976 and 1994, with Charnley low-friction acetabular and femoral ...

In patients with dysplastic hips the acetabular angles and femoral anteversion were determined in a CT investigation. Comparative investigations of femoral anteversion were made by ultrasonography and biomedical radiography. The investigations are describ...

The treatment and prognosis of labral tears of the hip depend primarily on whether there is concomitant injury of the adjacent acetabular articular cartilage. We asked whether a delamination cyst on the preoperative plain radiographs correlated with delamination of the acetabular articular cartilage at the time of ...

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 ...

Hip resurfacing is gaining popularity as an acceptable treatment option for young active patients with hip osteoarthritis. The Buechel-Pappas hip resurfacing system has a titanium alloy femoral and acetabular component with a polyethylene liner. The titanium nitride coating of the femoral ...

The goal of this study was to determine the prevalence of associated acetabular cartilage lesions and labral tears in patients with cam-type femoro-acetabular impingement (FAI). We evaluated acetabular cartilage lesions and labral tears found during hip arthroscopy in 52 patients with radiological signs of cam-type ...

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 ...

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) ...

The human hip is subjected to several hundred million loading cycles during a lifetime. Hip instability and femoro-acetabular impingement cause damage to the rim of the acetabulum. The acetabular rim is a highly specialized structure known as the labro-acetabular complex. A unidirectional flow ...

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 ...

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. ...

A case of a large recurrent hydatid cyst involving the right ilium and right hip treated with excision of the cyst, Total hip replacement and revision of the acetabular component with a Tripolar articulation for cyst recurrence and acetabular component loosening is presented along with a review of the relevant ...

Displaced acetabular fractures should be treated surgically. Over the past decade, surgical approaches to the acetabulum and the surgical technique for repair of common fracture patterns have advanced. Excellent outcomes after repair of these injuries can be achieved. The aim of this study was to assess the medium-term results of reconstruction of ...

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 ...

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 ...

Osteonecrosis (ON) of the femoral head continues to be a devastating disorder for young patients. We evaluated the F-18 fluoride positron emission tomography (PET) imaging modality for use in detection of the bone involved in ON of the hip. We retrospectively reviewed the records of 60 consecutive patients diagnosed with ON and interviewed all by phone. Eleven patients (17 ...

Osteonecrosis (ON) of the femoral head continues to be a devastating disorder for young patients. We evaluated the F-18 fluoride positron emission tomography (PET) imaging modality for use in detection of the bone involved in ON of the hip. We retrospectively reviewed the records of 60 consecutive patients diagnosed with ON and interviewed all by phone. Eleven patients (17 ...

As hip arthroscopy becomes a more common procedure, more complications may occur. We present a case of abdominal compartment syndrome resulting from fluid extravasation in a 42-year-old man who underwent routine hip arthroscopy for femoral acetabular impi...

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 ...

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 ...

We report a rare case of vesico-acetabular fistula due to an improperly treated pelvic fracture with urinary stone formation in the joint cavity. This complication was related to an unrecognized mechanism of bladder wall entrapment in the acetabular floor defect during weight bearing. This situation led to several mistreatment decisions in our case and ...

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 ...

The authors reviewed the indications, technique, and results of cementing an acetabular liner into a well-fixed cementless acetabular shell. Indications for this procedure include a worn acetabular liner in a well-fixed cementless acetabular shell as well as an unstable total hip construct ...

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 ...

This is a prospective review of 135�HA-coated ABG I total hip arthroplasty (THA) systems with a mean clinical and radiographic follow-up of 8.5�years. The 5-year survival rate was 85%, but 22% of the patients were dissatisfied. Revision THA was already indicated in 28% of the patients, with 26% indicated for cup loosening. PE wear was detected by x-ray ...

Wear of the polyethylene in total joint prostheses has been a source of morbidity and early device failure, which has been extensively reported in the last 20 years. Although research continues to attempt to reduce the wear of polyethylene joint-bearing surfaces by modifications in polymer processing, there is a renewed interest in the use of metal-on-metal bearing couples for ...

Surgical simulations are particularly appropriate for the large volume and expense of joint replacement procedures in orthopaedics. A generation surgical simulator has developed to model implantation procedure for cementless acetabular and compo- nents in total hip replacement surgery. simulator is based upon finite clement analysis and predicts early ...

Over the past few years, arthroscopy of the hip joint is becoming more common as a technique in both the diagnosis and treatment of hip pain. A frequent cause of hip and groin pain is a tear of the acetabular labrum. Patients with labral tears complain of pain in the groin region and pain with clicking in the ...

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 ...

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

Orientation of the native acetabular plane as defined by the transverse acetabular ligament (TAL) and the posterior labrum was measured intra-operatively using computer-assisted navigation in 39 hips. In order to assess the influence of alignment on impingement, the range of movement was calculated for that defined by the TAL and the ...

The computed tomographic (CT) and conventional radiographic appearances of the acetabulum are correlated for assessment of acetabular fractures according to the Judet and Letournel classification system, a system widely used by orthopedic surgeons performing fracture reduction and external fixation of the acetabulum. A desiccated ...

There have been considerable recent advances in the understanding and management of femoroacetabular impingement and associated labral and chondral pathology. We have developed a classification system for acetabular chondral lesions. In our system, we use the six acetabular zones previously described by ...

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 ...

IntroductionUrinary system fistula to the hip joint is a rare complication. We report a case of delayed posterior urethral fistula to the hip joint following penetrating gunshot wound injury.Case presentationA 37-year-old Iranian Balochi male was shot with a firearm in the superior part of his right pelvis. He underwent primary closure ...

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 ...

A retrospective review of 25 patients who underwent 28 acetabular revisions with the Burch-Schnieder antiprotrusio cage (Protek, Berne, Switzerland) and cancellous allograft bone was performed. Follow-up periods averaged 33 months. Patients had averaged 2.1 prior operations per hip. Twenty-two hips had American Academy of Orthopaedic ...

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 ...

Computed tomography usually can provide accurate documentation of the adequacy of a reduction in congenital dislocation of the hip. It should supplement other radiographic examinations when the status of a reduction is in question because the patient is wearing a plaster cast. The computed tomography scan provides a clear image of the reduction in the transverse plane, so that ...

BackgroundOsteoarthritis of the hip is successfully treated by total hip arthroplasty with metal-on-polyethylene articulation. Polyethylene wear debris can however lead to osteolysis, aseptic loosening and failure of the implant. Large head metal-on-metal total hip arthroplasty may overcome polyethylene wear induced prosthetic failure, ...

Total hip joint arthroplasty is commonly used in cases of osteoarthritis and rheumatoid arthritis. A hip joint prosthesis consists of a cup and a stem. The relative pose (position and orientation) of the prosthesis, when the patient is standing naturally, is planned pre-operatively; however, there is no guarantee that the pre-operatively planned pose will ...

Reinforcement cages are widely used for the treatment of large acetabular bone defects. We report the case of a loosened Burch-Schneider reinforcement ring causing a recurrent macrohaematuria due to a perforation of the urinary bladder. After performing several diagnostic procedures, the patient underwent interdisciplinary revision surgery. Due to the severe destruction of the ...

Fourteen patients were followed by roentgen stereophotogrammetry for 3 years after hip arthroplasty. In 11 of the 14 acetabular components, definite wear was identified. The mean wear rate was 0.13 mm per year. There was no correlation between the wear and loosening of either the acetabular or the femoral component. Our findings ...

Migration of total hip arthroplasty components is generally associated with a medial acetabular wall defect and may cause various intrapelvic complications. This is often a result of the destructive bone loss that takes place with infection. To our knowledge, this is the first report that presents complete intrapelvic migration of a femoral stem of total ...

...Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES ORTHOPEDIC...prostheses that have an acetabular component made of alloys, such as cobalt-chromium-molybdenum. This generic type of device is...

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 ...

The purpose of this study was to evaluate the outcome of trabecular metal (TM) acetabular components used in revision hip arthroplasty with major bone deficiency. We retrospectively reviewed the records of 46 patients undergoing revision hip arthroplasty with severe acetabular bone loss. Clinical outcomes were ...

We report the outcome of revision hip arthroplasty for patients with acetabular bone loss in whom the femoral head retrieved from arthritic contralateral hip during the same anesthesia was used as autograft for acetabular reconstruction. Thirty-two hips in 16 patients with a mean age of 63.8 ...

The Exeter� Universal hip (Stryker Inc., Newbury, UK) has reported survival rates of 91.74% at 12�years in all patients with reoperation as an endpoint. However, its performance in younger patients has not been fully established. We reviewed survivorship and the clinical and radiographic outcomes of this hip system implanted in 107 ...

BackgroundAseptic loosening of cemented hip prostheses is recognized as a long-term problem, and especially in males and younger patients. Much energy has been focused on developing new prostheses that are designed for cementless fixation. We evaluated the performance of and periprosthetic bone response to a tapered, titanium, hydroxyapatite (HA)-coated femoral ...

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 ...

A polyethylene-free, metal-on-metal acetabular system (M2a-taper [Biomet, Inc., Warsaw, IN]) was designed in an effort to improve total hip arthroplasty (THA) longevity. Minimum 2-year follow-up results involving 72 polyethylene liner THAs and 78 metal liner THAs from a multicenter, randomized, controlled, investigational device ...

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 proximal femoral ...

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 ...

The optimal fixation of the acetabular component in primary total hip arthroplasty remains controversial. Long-term follow-up studies show that significant loosening rates occur with cemented acetabular components and that these problems persist despite attempts to improve cementing technique. Cementless acetabular ...

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 ...

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 ...

The use of modular components in total hip arthroplasty has increased in popularity. The advantages of modularity in hip arthroplasty include improved visualization during acetabular revision and restoration of proper hip biomechanics. Disadvantages include disassociation of components, failure at modular ...

Abnormal or excessive force on the anterior hip joint may cause anterior hip pain, subtle hip instability and a tear of the acetabular labrum. We propose that both the pattern of muscle force and hip joint position can affect the magnitude of anterior joint force and thus possibly lead to ...

The aim of this study was to analyze the clinical outcome and incidence of hip arthritis in elderly patients with acetabular fractures. Because of poor bone quality in the elderly, even a low-energy trauma may lead to an acetabular fracture. An anatomical reconstruction of the acetabulum is necessary to achieve sufficient stability ...

The course of development of acetabulae after the reduction of congenitally dislocated hips was investigated to identify factors that might predict the need for acetabuloplasty. One hundred five congenitally dislocated hips in 83 children were followed roentgenographically for an average of eight years after reduction. While the percentage of children ...

We reviewed 77 patients with an acetabular fracture, treated operatively through a non-extensile approach after an average time of 45 months. The ilioinguinal approach was chosen in 41, the Kocher-Langenbeck approach in 36 patients. Following the Letournel classification, the most frequent lesions were posterior wall (26%), two-column (22.1%) and anterior column (14.3%) ...

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 adults. ...

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 ...

Numerous parameters control the long-term performance of a total hip joint arthroplasty. The articulating motions between the femoral and the acetabular components produce wear debris in a hip implant. Surface roughness, clearance, coefficient of friction and sliding distance are found to be contributing parameters that affect wear ...

In order to determine the magnitude of temperature increases in resurfaced hips, temperature sensors were placed percutaneously in both hip joints of 12 volunteer patients who had 1 or both joints resurfaced. Temperature recordings were made with patients at rest (baseline) and after patients walked for 20 and 60 minutes. The hip ...

Periprosthetic bone changes following hip arthroplasty are yet to be completely described. The material consisted of imagistic records (X-ray films, CT and MRI scans) and of acetabular bone tissue sampled from 14 cases with femoral head prosthesis and revision of the prosthesis fixed and decalcified in Duboscq-Brazil solution and stained with Hematoxylin ...

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 ...

We report a rare case of vesico-acetabular fistula due to an improperly treated pelvic fracture with urinary stone formation in the joint cavity. This complication was related to an unrecognized mechanism of bladder wall entrapment in the acetabular floor defect during weight bearing. This situation led to several mistreatment decisions in our case and ...

The treatment of labral pathologic condition of the hip has become a topic of increasing interest. In patients undergoing hip arthroscopy, tears of the acetabular labrum are the most commonly found pathologic condition and most common cause of mechanical symptoms. Although a labral tear may occur with a single traumatic event, often ...

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 treated by surgical ...

Impingement of the iliopsoas muscle after total hip arthroplasty is a potential cause of postoperative groin pain. In addition, hematoma within the iliopsoas sheath has been documented as a cause of groin pain in patients on long-term anticoagulation. We present the case of a patient on long-term anticoagulation presenting after total hip arthroplasty with ...

Bioengineering reasons for increased wear and failure of metal-on-metal (MoM) bearings in hip prostheses have been described. Low wear occurs in MoM hips when the centre of the femoral head is concentric with the centre of the acetabular component and the implants are correctly positioned. Translational or rotational malpositioning of ...

We have reviewed, at a mean follow-up of 63.7 months, 36 total hip replacements performed with bulk acetabular autograft. Before surgery all the hips had acetabular insufficiency. Improvement of acetabular coverage was achieved in all cases with the patient's femoral head screwed to the ilium. ...

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 ...

We reviewed 123 second-generation uncemented total hip replacements performed on 115 patients by a single surgeon between 1993 and 1994. The acetabular component used in all cases was a fully porous-coated threaded hemispheric titanium shell (T-Tap ST) with a calcium ion stearate-free, isostatically compression-moulded polyethylene liner. The titanium ...

A retrospective study of 50 surgically confirmed painful hip arthroplasties was performed to identify the roentgenographic findings that are most important in the detection of component loosening or infection. Plain film radiographs and subtraction arthrograms were reviewed in all cases, and specific features revealed by these two radiographic modalities indicative of ...

A retrospective study of 50 surgically confirmed painful hip arthroplasties was performed to identify the roentgenographic findings that are most important in the detection of component loosening or infection. Plain film radiographs and subtraction arthrograms were reviewed in all cases, and specific features revealed by these two radiographic modalities indicative of ...

Metal-on-metal total hip replacement has been targeted at younger patients with anticipated long-term survival, but the effect of the production of metal ions is a concern because of their possible toxicity to cells. We have reviewed the results of the use of the Ultima hybrid metal-on-metal total hip replacement, with a cemented polished tapered femoral ...

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 polyethylene wear. ...

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 peri-acetabular ...

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 is a mid-term report at 10 years' mean follow-up of a study of a precoated femoral component used in primary hybrid total hip arthroplasty (THA). Of an original cohort of 98 hips undergoing THA performed by one surgeon, 75 hips in 65 patients (mean age, 67 years) were prospectively followed up for 7 to 12 years (mean, 10 years). ...

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 ...

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 ...

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 ...

Pathology of the acetabular labrum plays an increasing role in the treatment of hip pain. Hip arthroscopy has proven its clinical value as a useful procedure for successful treatment of labral tears. Until today, only a few studies have investigated the influence of articular cartilage defects on the clinical outcome of partial ...

PURPOSE. To evaluate long-term outcomes of total hip arthroplasty (THA) using the Perfecta cementless system. METHODS. 73 men and 76 women aged 65 to 88 (mean, 71) years underwent 168 THAs using the Perfecta cementless system and were followed up for a mean of 13 (10 to 15) years. 19 patients had bilateral THA. The diagnoses were ...

The survival of acetabular components depends on several factors: wear, osteolysis and septic or aseptic loosening. Osteolysis seems to be the main cause for concern in cementless arthroplasties. Acetabular osteolysis results from particle debris and segmental unloading of acetabular bone by rigid sockets. We investigated a cementless ...

MR imaging of the hip is one of the most common musculoskeletal MR imaging studies performed today to assess for occult fractures, acetabular labral tears, hyaline cartilage loss, and musculotendinous injuries. Several developmental variations are seen in the hip, which can be mistaken for disease or potentially even contribute to the ...

We report a case of synovial hemangioma of the hip causing joint destruction severe enough to warrant arthroplasty in a 32-year-old man who presented with a 2-year history of hip pain and worsening limp. Plain radiographs demonstrated advanced degenerative changes of the hip articular surface. Magnetic resonance imaging revealed ...

Ultra-high molecular weight polyethylene acetabular cups of 5 different total hip systems (M�ller, Mallory-Head, Lubinus, P.C.A. and Charnley-Elite) were worn on a new 5-station hip joint simulator. The cups articulated against modular metallic (stainless steel in M�ller and Charnley-Elite, ion-implanted ...

Background: Recent biomechanical reports have described the function of the acetabular labrum and iliofemoral ligament in providing hip stability, but the relative stability provided by each structure has not been well described. Hypothesis: Both the iliofemoral ligament and acetabular labrum are important for hip ...

...Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES ORTHOPEDIC...femoral and an acetabular component, both made of alloys, such as cobalt-chromium-molybdenum. The femoral component is...

...Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES ORTHOPEDIC...femoral and an acetabular component, both made of alloys, such as cobalt-chromium-molybdenum. This generic type of device is...

We present an update of the clinical and radiological results of 62 consecutive acetabular revisions using impacted morsellised cancellous bone grafts and a cemented acetabular component in 58 patients, at a mean follow-up of 22.2 years (20 to 25). The Kaplan-Meier survivorship for the acetabular component with revision for any reason ...

We aimed to investigate the transfer of metal to both ceramic (alumina) and metal (cobalt-chrome) heads that were scraped by a titanium alloy surface under different load conditions. The ceramic and metal heads for total hip arthroplasties were scraped by an acetabular metal shell under various loads using a creep tester. Microstructural changes in the ...

The main concern of patients with longer life expectancies and of patients who are younger and more active is the longevity of their total hip arthroplasty. We retrospectively reviewed 83 cementless total hip arthroplasties in 73 patients implanted with metal-on-metal articulation. All patients were younger than 50�years old (average age, 41�years) at ...

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 ...

The acetabular depression fracture is defined as a rotated, impacted, osteocartilaginous fragment of the posteromedial acetabulum that occurs in conjunction with a posterior fracture dislocation of the hip. Displacement of this fracture fragment creates incongruity of the posterior acetabular articular surface and the potential for ...

Peritendinitis calcarea and os acetabuli have long been confused during interpretations of hip-joint radiographs. Such confusion is reflected in the medical literature. The present study differentiated these two entities according to their interval radiog...

Acetabular labral tears are usually seen in individuals in whom the hip is exposed to elevated axial and torsional forces. In our experience we have encountered a series of female patients in whom symptom onset was during pregnancy or obstetric labour. We reviewed our patient database to identify all patients who had undergone hip ...

A total of 133 cementless primary total hip arthroplasties using the Zweymuller-Alloclassic grit-blasted titanium tapered stem were performed in 3 institutions. The patient cohort was divided into 2 subgroups, nonselected and selected, on the basis of excellent bone stock and age (<65 years old at surgery). Acetabular components were all cementless, and ...

An effective lubrication can significantly reduce wear of metal-on-metal artificial hip joints. The improvement of the lubrication can be achieved through the optimisation of the bearing geometry in terms of a small clearance and/or the structural support such as a polyethylene backing underneath a metallic bearing in a sandwich acetabular cup form. The ...

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 ...

This study reports minimum 5-year results of 95 hips implanted with a Pinnacle (DePuy, Warsaw, Ind) modular metal-on-metal acetabular prosthesis. Clinical scores such as the Harris Hip and Western Ontario and McMaster Universities Arthritis Index revealed excellent clinical outcomes at mean 6-year follow-up. With the use of ...

The aim of the research was to investigate the cemented bone-implant interface behavior (cement layer degradation and bone-cement interface debonding) with emphasis on imaging techniques suitable to detect the early defects in the cement layer. To simulate in vivo conditions a human pelvic bone was implanted with polyurethane acetabular cup using commercial acrylic bone ...

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 ...

Morphological variations in hip joint anatomy are a possible mechanism for femoroacetabular impingement (FAI) which leads to hip osteoarthritis. Significant geometric variations of the acetabular rim exist between patients including variations in depths of the postereosuperior depression (PSD) and psoas valley (PV). Computed ...

Anterior femoroacetabular impingement results from abnormal abutment of the anterolateral femoral head-neck junction with the anterior acetabular-labral complex resulting in pain and progressive hip dysfunction. This under-recognized problem could be the manifestation of acetabular or proximal femoral deformity, and when left untreated ...

In 15 documented cases, subluxation or dislocation of the hip was discovered months or years after previous multiple normal physical examinations. The examiners were unique in that six were professors specializing in childrens' orthopedics, four were board-certified orthopedists, and five were pediatricians. An increased acetabular index, subluxation, and ...

2D- and 3D-based innovative methods for surgical planning and simulation systems in orthopedic surgery have emerged enabling the interactive or semi-automatic identification of the clinical landmarks (CL) on the patient individual virtual bone anatomy. They enable the determination of the optimal implant sizes and positioning according to the computed CL, the visualization of ...

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 ...

Physical findings demarking pathologic somatovisceral reflex activity and fascial strain patterns may lead the osteopathic physician to diagnoses that are masked within the initial presentation of a patient. The authors present a case report that demonstrates the use of osteopathic principles in the diagnosis of a chronic acetabular fracture and acetabular ...

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 ...

PURPOSE: Acetabular orientation is important to consider in hip joint pathology and treatment. This study aims to describe the functional orientation of the acetabulum as a representative measure of force transmitted through the hip joint generated from bone density mapping and compare it to landmark-based anatomical orientation ...

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 ...

Finite element analysis was used to examine the initial stability after hip resurfacing and the effect of the procedure on the contact mechanics at the articulating surfaces. Models were created with the components positioned anatomically and loaded physiologically through major muscle forces. Total micromovement of less than 10 mum was predicted for the press-fit ...

Total hip arthroplasty has become a successful way of treating the painful and destroyed hip joint in the patient with rheumatoid arthritis (RA). Two hundred twenty (135 cemented and 85 noncemented) total hip arthroplasties were performed in 180 patients with rheumatoid arthritis. The average age was 48.61 years and the average ...

Slipped capital femoral epiphysis is usually treated with in situ fixation to prevent progression of deformity. However, slipped capital femoral epiphysis always is associated with structural risk factors for hip dysfunction in addition to the risk of slip progression. Femoro-acetabular impingement causes some mechanical abnormality in every ...

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 ...

Based on low incidence and lack of personal experience only few evidence based studies exist on several questions in pelvic and acetabular surgery. As part of an international consensus pelvic and acetabular course personal preferences and experience of an distinguished faculty and senior participants were discussed and we summarize in the paper the ...

Understanding of the etiology and pathology of hip instability has increased in recent years as new information has emerged regarding the disease processes of the hip. Hip instability, heretofore considered uncommon in clinical practice, is increasingly recognized as a pathologic entity. Instability may be classified as traumatic or ...

This article presents a case of a 10-year-old boy with a right acetabular fracture secondary to a direct blow to the pelvis and back. He sustained a right hip dislocation and transverse with posterior wall acetabular fracture with a nonconcentric hip joint after reduction. The fracture was treated with right labral ...

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 ...

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 ...

Polyetheretherketone (PEEK) is one of the up-to-date organic polymer thermoplastics with applications in orthopaedics and trauma medicine. This study presents a detailed analysis of its tests and applications in clinical medicine. A wide range of PEEK modifications and composites are commercially available, e.g., PEEK-Classix, PEEK-Optima, Endolign and Motis. They differ in their physical ...

Soft bearing materials that aim to reproduce the tribological function of the natural joint are gaining popularity as an alternative concept to conventional hard bearing materials in the hip and knee. However, it has not been proven so far that an elastic cushion bearing can be sufficiently durable as a long term (?20 years) articulating joint prosthesis. The use of new ...

Conventional radiography is the primary imaging modality to evaluate the condition of hip resurfacing implants and the preferred method of assessing implant stability over time. Radiographs assess the angle of inclination of the femoral and acetabular components, implant stability, and femoral neck narrowing. Ultrasonography detects solid or soft tissue ...

Hip arthroscopy has gained popularity in recent years as an alternative to open treatment for several conditions including bursitis, acetabular labral tears, synovitis, arthritis, extraction of loose bodies, and femoroacetabular impingement. Complications during hip arthroscopy are rare in the current literature, but reports include ...

The motions of counterface articulation against the bearing surface of the acetabular liner strongly influence polyethylene wear debris production in contemporary total hip arthroplasty. However, the available body of relevant articular force and motion information is largely confined to resultant load excursions measured relative to instrumented femoral ...

The motions of counterface articulation against the bearing surface of the acetabular liner strongly influence polyethylene wear debris production in contemporary total hip arthroplasty. However, the available body of relevant articular force and motion information is largely confined to resultant load excursions measured relative to instrumented femoral ...

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 ...

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 nonunions of the ...

Although there is a great deal in the literature about the clinical accuracy of computed tomography (CT)-based navigation systems for acetabular cup orientation and leg length discrepancy in total hip arthroplasty, there is little analysis of femoral stem orientation. Thirty total hip arthroplasties in which ...

The goal of this study was to evaluate the long-term survivorship of primary cementless total hip arthroplasty (THA) using Harris-Galante porous I acetabular and Harris-Galante porous femoral components. From July 1985 to December 1991, we performed primary cementless THA on 76 hips (70 patients). Twenty-nine patients (31 ...

Dislocation is one of the most common complications of total hip arthroplasty. The use of constrained liners is an option for the management of chronic hip instability, typically used after other methods have failed. The purposes of this study were to evaluate the overall clinical outcomes and failure rates of a tripolar constrained liner design, to assess ...

Abstract. The incidence of iatrogenic peripheral nerve injury during hip arthroplasty procedures has been reported to be between 0.6 and 1.3 percent. The relative risk of nerve palsy is higher in certain groups of patients such as women, patients with developmental dysplasia of the hip, and those who have undergone revision arthroplasty. In this study, the ...

Bilateral total hip arthroplasty during one anesthetic procedure can be beneficial in properly selected patients. For patients who have a failed hip arthroplasty requiring revision and a contralateral arthritic hip requiring primary arthroplasty, bilateral surgery permits the resected femoral head from the primary procedure to be used ...

The developmental dysplasia of the hip (DDH) is a congenital malformation affecting the proximal femurs and acetabulum that are subluxatable, dislocatable, and dislocated. Early diagnosis and treatment is important because failure to diagnose and improper treatment can result in significant morbidity. In this paper, we designed and implemented a computer aided ...

The occurrence of pseudotumours (soft tissue masses relating to the hip joint) following metal-on-metal hip resurfacing arthroplasty (MoMHRA) has been associated with high serum metal ion levels and consequently higher than normal bearing wear. We investigated the relationship between serum metal ion levels and contact stress on the ...

This article describes a rare case of primary synovial chondromatosis of the hip associated with classical femoroacetabular impingement. A 38-year-old man presented with left hip pain of 3 years' duration and range of motion (ROM) limitations. Flexion abduction external rotation and impingement tests were positive and preoperative Harris ...

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 and compromises ...

The past decade has seen unprecedented growth in the number of hip arthroscopies. Acetabular labral tears are the leading indication for arthroscopy of this joint. However, labral anatomy and function, as well as the effects of labral tears and surgical outcomes, have only recently been studied. Labral tears may cause pain and microinstability of the ...

Posterior wall acetabular fractures are rare in the pediatric patient but require proper management to prevent significant complications. Plain radiographs and computed tomography scans are standard diagnostic imaging used with clinical examination of hip stability to determine if the injury requires open reduction and internal fixation. Two cases are ...

We evaluated the relationship and the difference between measurements of version angles (VAs) of the acetabular components in total hip arthroplasty taken using 2 different methods. One VA was measured on an anteroposterior radiograph of the hip joint (VAP) and the other on a cross-table lateral radiograph (VCL) in 97 ...