OWL: OCOSH Classification/Orthopaedic Procedures/Arthroplasty/Replacement Arthroplasty/Hip Replacement Arthroplasty

Harris Hip Score

Alex Chelenkov — 2006-03-10 00:46:00 GMT

Site to calculate the Harris Hip Score

Orthopaedic Scores

Kurer — 2006-11-09 00:46:00 GMT

Goldmine of orthopaedic scores and scoring systems. 10 surgeon based and 20 patient based scoring systems for all regions of the musculoskeletal system. Includes: Harris Hip Score, Knee Society Score, Oxford Knee Score, WOMAC, Cincinatti Knee Score, Tegner Lysholm, American Foot & Ankle Score AFAS, UCLA Shoulder Rating Scale, Mayo Elbow Score, DASH (Disabilities of Arm Shoulder & Hand) and several more.

1997 First experience with omnifit hip prosthesis with hydroxyapatite

Carfagni et al — 2007-07-29 00:46:00 GMT

First experience with omnifit hip prosthesis with hydroxyapatite: minimum two years follow-up
A.Carfagni, R .Giacomi, C.F.De Biase Internet Journal of Orthopedic Surgery and related Subjects Issue 1 1997 C.F.De Biase Department of Orthopaedic and Traumatology San Carlo di Nancy Roma
The purpose of this study is to evaluate the results obtained by our group fare capo at the European A.G.O.R.A. group (Apatite Group of Orthopaedic Research on Arthroplasties). Supported by computerised system for data processing we have examined 171 cases with two years minimum follow up and maximum 5 years.

AAOS 1999 Symposium J Low Wear Bearings for Total Hip Replacements

Amstutz — 2002-02-04 00:46:00 GMT

Archive Copy: - 1999 Annual Meeting Scientific Program. Low Wear Bearings for Total Hip Replacements
Moderator H. Amstutz

Acetabluar Component Loosening

CRWheeless — 2006-04-19 00:46:00 GMT

Wheeless Textbook of Orthopaedics (THR) - Loosening of Uncemented Acetabular Components: (press fit acetabular components) - normal bone ingrowth: - generally for bone ingrowth to occur, the component must lie with 50 micrometers of the acetabulum, inorder for host bone ingrowht to occur; - as noted by RD Bloebaum et al 1997, bone ingrowth into component averages only 12%, eventhough 84% of the cup surface was in contact w/ periprosthetic bone; - bone ingrowth was found to be uniform in all zones, most likely due to the uniform distribution of stresses from the metal backing; - radiographic signs of loosening: (see radiographic techniques for eval of acetabulum) - radiolucent lines that initially appeared after two years - progression of radiolucent lines after two years - radiolucent lines in all three zones - radiolucent lines 2 mm or wider in any zone - migration - loosening is present w/ more than 2 mm of migration (either horizontal or vertical); - continuous radiolucent line; - note that peripheral radiolucent lines which are non-continuous are commonly found in press fit acetabular components and are often not progressive; - of note, postoperative gaps are net necessarily associated with subsequent presence of radiolucent lines, progressive radiolucent lines, or socket-loosening;

Acetabular wear in Total Hip Arthroplasty eMedicine Orthopedics

Bezwada & Nazarian — 2008-03-19 00:46:00 GMT

Bezwada & Nazarian 2004
Since the introduction of the low-friction total hip arthroplasty (THA) by Sir John Charnley, wear has been a primary issue in hip arthroplasty. Charnley's original choice for bearing surfaces was a stainless steel head on polytetrafluoroethylene (PTFE). This choice was complicated by a wear rate of 7-10 mm within a 3-year period. This led him to search for other bearing materials, namely high molecular weight polyethylene. Although wear remains a problematic issue in THA, its consequences, namely osteolysis and prosthetic loosening, loom as larger issues.
Synonyms and related keywords: low-friction total hip arthroplasty, THA, acetabular wear debris, fatigue, interfacial wear, backside wear, linear penetration, hip reconstruction, hip prosthesis, hip implant, hip replacement, osteolysis, prosthetic loosening

Anatomy and Biomechanics of the Hip Relevant to Arthroplasty

Not Available — 2008-03-11 00:46:00 GMT

Even though an enormous volume of literature concerns the anatomy and biomechanics of the hip, little of it is specifically organized from the perspective of total hip arthroplasty. Also, since an analysis of the finer elements of these factors has formed a significant part of the development of the porous coated anatomic (PCA) hip system, those aspects that we believe to be particularly important are reviewed in some detail.
Although a three-dimensional perspective is of critical importance in developing any kind of total hip system, we must recognize that much of the information that we gather in every day practice is two dimensional, namely, x-rays of the hip. The axial view provided by computed axial tomography (CAT) scanning is beginning to become a part of the common knowledge, but the information that it imparts has not yet had much impact on prosthetic design. The detailed cross-sectional anatomy presented in this chapter provides the informational background for the design of the PCA hip. It is our hope that this section will be particularly well studied.
The section on anatomy presents only the soft tissues that are encountered at hip arthroplasty from the perspective of the surgeon. However, since the direct lateral approach, which we are using, may be unfamiliar to many, these anatomical details will also be helpful for a better understanding of the surgical exposure.

Ankylosing Spondylitis of the hip Wheeless

C.R.Wheeless — 2002-02-04 00:46:00 GMT

hip joint:
- is affected in upto 50 % of patients with AS, and when it occurs it is often bilateral;
- protrusio and hip flexion contractures are common;
- heterotopic ossification may follow THR;
- total hip replacement:
- hetertopic ossification;
- occurs in 20-40 % of hip replacements and is more common w/ trochanteric osteotomy;
- to avoid heterotopic ossification consider insertion of a cemented acetabular component followed by 750 rads around the component;
Wheeless' Textbook of Orthopaedics

Anterolateral Approach to the Hip Wheeless

CRWheeless — 2002-02-04 00:46:00 GMT

Discussion: - major problems with the Watson Jones technique are dealing w/ gluteus medius & minimus, which lie over anteior capsule and must be damaged or cut to obtain adequate exposure; - original Charnely technique used anterolateral approach w/ pt supine, osteotomy of greater troch, & ant dislocation of hip; - this approach is used less commonly now as result of problems related to reattachement of the greater trochanter;
Wheeless' Textbook of Orthopaedics

Assessment of the primary rotational stability of uncemented hip stems using an analytical model - comparison with finite element analyses

Zeman et al — 2008-09-27 00:46:00 GMT

Sufficient primary stability is a prerequisite for the clinical success of cementless implants. Therefore, it is important to have an estimation of the primary stability that can be achieved with new stem designs in a pre-clinical trial. Fast assessment of the primary stability is also useful in the preoperative planning of total hip replacements, and to an even larger extent in intraoperatively custom-made prosthesis systems, which result in a wide variety of stem geometries.
Maria E Zeman , Nicolas Sauwen , Luc Labey , Michiel Mulier , Georges Van der Perre and Siegfried VN Jaecques Journal of Orthopaedic Surgery and Research 2008, 3:44 Full text available

Biocompatibility a biomechanical and biological concept in total hip replacement

I.D.Learmonth — 2008-09-09 00:46:00 GMT

The insertion of any implant or prosthesis into bone usually changes the biomechanical environment and, thus, alters the stresses and strains applied to the bone. Both bone overload and excessive stress protection can result in bone resorption. The material and geometry of any implant should be designed to avoid excessive flexural mismatch. Incompatibility of materials may result in interface and mechanical failure, with the consequent generation of particulate debris, subsequent osteolysis and implant failure. Particulate debris can be generated from articulating surfaces and from any other modular or fixation interface. Larger particles are associated with a foreign body giant cell reaction. Polyethylene particles in the size range of 0.5 to 10�m excite a cytochemical reaction that culminates in osteolysis. The precise pathogenesis of osteolysis has not been characterised, but it is probable that different pathogenetic mechanisms are involved in the different radiological types of osteolysis. A large number of very small metallic particles are released from metal-on-metal couples. These may cause mutagenic damage (chromatid breaks, chromosome translocations, aneuploidy, etc.). In defining implant biocompatibility it is essential to consider the biological response both to an altered mechanical environment and to the liberation of particulate debris.
Surg J R Coll Surg Edinb Irel., 1 February 2003, 1-8

Cement Removal using Ultrasonic Tools in Revision THA

Cesare — 2008-03-11 00:46:00 GMT

Paul E. Di Cesare, MD Co-Director, Arthritis Service Director, Cartilage & Bone Research Center Hospital for Joint Diseases Orthopaedic Institute New York
Removal of well-fixed or loose, cemented (polymethylmethacrylate) total hip components presents many challenges to the orthopaedic surgeon. In cases of loose components with extensive bone-cement radiolucencies, extraction may not be too difficult because a well-defined soft tissue plane that has been biologically placed facilitates removal of hard cement from hard bone. In cases where well-fixed cemented components and cement need to be removed - due to infection, catastrophic polyethelene wear, revision implant mismatch, malposition with chronic dislocations, and distal cement plugs and mantles the surgeon, how ever, may face difficult challenges that may lead to increased operative time, blood loss, bone perforation, or fracture. Additionally, in cases with cemented porous implants or implants with pre-coating to bond the stem to the cement, removal of the components again may not be easy. In these situations, it is often difficult to determine the plane between hard bone and hard cement which predisposes to operative difficulties.

Cementless Total Hip Arthroplasty

Berger et al — 2002-04-19 00:46:00 GMT

THA for post-traumatic arthritis versus non-traumatic arthritis Surgical approach for prior ORIF treatment versus prior closed treatment Surgical technique for both primary and revision cases Cementless versus cemented arthroplasty Clinical and radiographic postoperative evaluations Component survivorship analysis Review of complications

Clinical Trials Hip Replacement

Not Available — 2008-03-19 00:46:00 GMT

There are currently no trials listed

Comment on Hip arthroplasty for salvage of failed treatment of intertrochanteric hip fractures.

Callahan — 2006-12-17 00:46:00 GMT

Commentary & Perspective on "Hip Arthroplasty for Salvage of Failed Treatment of Intertrochanteric Hip Fractures" by George J. Haidukewych, MD, and Daniel J. Berry, MD by John J. Callaghan, MD*, Department of Orthopaedic Surgery, University of Iowa Hospitals and Clinics, Iowa City, IA In summary, this article is helpful to the surgeon performing hip arthroplasty in patients with previous intertrochanteric femoral fractures and to the patients and families of the patients considering this operation. For the patient disabled by the failure of internal fixation of an intertrochanteric femoral fracture, hip arthroplasty can provide durable fixation and pain relief (although the surgeon should explain to the patients that they may have some residual pain in the greater trochanter). Addressing the patients� preoperative and postoperative medical problems are paramount, as long operative times and large amounts of blood loss are not uncommon with this procedure. Trochanteric osteotomy may be required to provide adequate exposure, and hardware should probably be removed after dislocating the hip to prevent fractures of the femoral shaft. The surgeon should compensate for proximal bone loss with a calcar-replacement implant and bypass any screw-holes in the femoral shaft with use of a long-stem prosthesis. If acetabular cartilage is preserved, a bipolar replacement may aid hip stability. If a total hip arthroplasty is chosen, and hip stability is problematic, a constrained implant can be used (because of low patient demands), especially if the abductor musculature is compromised. Postoperative prophylaxis against thromboembolism should be utilized. If these principles, outlined by Haidukewych and Berry, are followed, satisfying results of salvage hip arthroplasty in patients who have had failed treatment of an intertrochanteric fracture can be obtained.