Revision hip arthroplasty

Part 2 book "Advances in small animal total joint replacement" includes content: Clinical application of total hip replacement, revision strategies for total hip replacement, biomechanical considerations in total knee replacement, clinical application of total knee replacement, biomechanical considerations in total elbow development, clinical application of total elbow replacement in dogs, emerging arthroplasties, custom total joint arthroplasty.

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The metal-on-metal large-diameter-head (MoM-LDH) hip replacements increased in popularity during the start of the twenty-first century. Subsequently reports raised concerns regarding adverse reactions due to elevated chromium (Cr) and cobalt (Co) concentrations as well as high rates of other complications and revisions.

10p vimackenziebezos 30-11-2021 6 1   Download

Aseptic loosening is the most frequent indication for revision of total hip arthroplasty. Revision arthroplasty of acetabular component is a challenge for every surgeon because they have to simultaneously deal with the reconstruction of bone defects, adequate implant geometry and stable fixation.

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The “cup-in-cup” technique allows for revision of failed total hip arthroplasty (THA) when the cement‑ less cup is well fixed. Furthermore, it can be used for liner wear or mechanical failure where liner replacement may be impossible or impractical. Recently, the “cup-in-cup” technique in combination with dual mobility cups (DMC) has drawn increased attention.

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Two-stage revision arthroplasty is today regarded as the gold standard treatment method for deep prosthetic joint infection. The aim of the present study was to evaluate clinical and functional outcomes with the Modular Universal Tumor And Revision System (MUTARS) RS stem in patients undergoing two-stage revisions.

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Monoblock taper fluted stems have been reliably used to treat proximal femoral periprosthetic fractures (PFF) and femoral aseptic loosening (AL). Although proximal femoral remodeling has been observed around the Wagner Self-Locking (SL) stem, the exact characteristics of this process are yet to be established.

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The increasing incidence of prosthesis revision surgery in the Western world has led to an increased focus on the capacity for stem removal. We previously reported on a femoral stem implanted in goats with an approximate 15% reduction in retention force by drilling longitudinally orientated grooves on the side of the stem.

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Periprosthetic femoral fractures are becoming increasingly common and are a major complication of total hip arthroplasty and hemiarthroplasty. The treatment of periprosthetic femoral fracture after femoral revision using a long stem is more complex and challenging.

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Heterotopic ossification (HO) is a complication after tissue trauma, fracture and surgery (i.e. total hip arthroplasty). Prophylaxis is the most effective therapy. If HO formations become symptomatic and limit patients’ quality of life, revision surgery is indicated and is usually combined with a perioperative oral prophylaxis (NSAIDs) and/or irradiation.

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The number of septic total hip arthroplasty (THA) revisions is increasing continuously, placing a growing financial burden on hospitals. Orthopedic departments performing septic THA revisions have no basis for decision making regarding resource allocation as the costs of this procedure for the departments are unknown.

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Pain is an indication for total hip arthroplasty (THA) and it should be resolved post-surgery. Because patients’ pain is typically treated pharmacologically we tested whether opioid use can be used as a surrogate for patient-reported pain and as an indicator for early surgical failure.

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Some aspects of validity are missing for the Harris Hip Score (HHS). Our objective was to examine the clinically meaningful change thresholds, responsiveness and the predictive ability of the HHS questionnaire.

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Cementless fixation of total hip arthroplasties (THAs) is often favored in young, high-demanding patients due to the conservation of valuable bone-stock and easier revision if loosening has occurred. Long-term outcome data of the spongy metal structured implant used in the present study in patients younger than 65 years are still lacking.

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Dislocation following total hip arthroplasty has to date not been resolved satisfactorily. Previous work has shown that using a less-invasive adaption of Bauer’s lateral transgluteal approach with capsular repair significantly reduces dislocation rates in primary total hip arthroplasty.

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Approximately 88,000 primary hip replacements are performed in England and Wales each year. Around 1% go on to develop deep prosthetic joint infection. Between one-stage and two-stage revision arthroplasty best treatment options remain unclear.

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The optimal surgical option for patients requiring bilateral hip replacement remains controversial. The purpose of this study was to compare surgical accuracy; functional outcome and health-related quality of life; and prosthetic-related complications and revision surgery of a simultaneous bilateral total hip arthroplasty (THA) with those of a staged bilateral THA with an interval between procedures

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In young patients with osteonecrosis of the femoral head (ONFH), short-stem total hip arthroplasty (THA) could allow a potential advantage in preserving metaphyseal bone-stock, when revision surgery might become necessary.

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In the context of an increase number of primary and revision total hip and total knee arthroplasty performed yearly, an increased risk of complication is expected. Prosthetic joint infection (PJI) remains the most common and feared arthroplasty complication. Ralstonia pickettii is a Gram-negative bacterium, that has also been identified in biofilms.

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The present study aimed to identify the risk factors associated with revision total hip arthroplasty (THA) failure using a Kerboull-type (KT) plate. The midterm outcomes of revision THA indicate that type of bone graft and bone defect size may affect radiographic survival rate when using a KT plate.

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The number of hip and knee arthroplasties completed is expected to double over the next decade. In public hospitals, regular post-arthroplasty orthopaedic review has commonly occurred for the duration of a patient’s life, which requires substantial outpatient resources.

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