Follow-up Of Total Hip Arthroplasty Research Articles

Long-term follow-up of total hip arthroplasty using polyethylene-ceramic composite (sandwich) liner.

Ceramic-on-ceramic bearings have been widely used since their introduction in the 1970s. First-generation ceramics have very high fracture (breakage) rates. To overcome this, in the 1990s, modular cotyloid insert designs were developed, consisting of a ceramic and polyethylene composite (sandwich-type) liner; however, high implant fracture rates were observed in the medium term. We aimed to estimate the cumulative incidences of revision surgery (implant failure) and implant failure due to fractures, survival rates (time-to-revision surgery and time-to-fracture), and the long-term clinical and radiological outcomes in our series. This was an observational, longitudinal, ambispective, single-centre study based on patients who underwent primary total hip arthroplasty (THA) using a sandwich-type liner (Cerasul), only available in our tertiary hospital between January 1999 and December 2002. Cumulative incidences were estimated and the 95% confidence interval (95% CI) was calculated. The Kaplan-Meier method was used to assess the time-to-revision surgery and time-to-fracture. 54 patients (49 men) were included, accounting for 59 sandwich-type linear implants. The mean (range) age was 47.4 (22-57) years. The primary THA indications were osteoarthritis (28 patients), osteonecrosis (14), childhood pathology sequelae (11), and inflammatory arthritis (6). The cumulative incidence of revision surgery by implants was 8.5% (5/59, 95% CI, 3.5-19.2%), 9.3% by patients (5/54, 95% CI, 4.0-19.9%), and 5.1% by implant fractures (3/59, 95%CI, 1.7-13.9%). The median (Interquartile Range, IQR) time-to-revision surgery was 158 (72.5-161) months, and the time to fracture was 182 (138-215) months. All primary THAs had good clinical and long-term survival outcomes. All implants had signs of solid fixation. After a 20-year follow-up period, the polyethylene-ceramic sandwich-type liner showed a long survival rate and low cumulative incidence of implant fracture; however, implant fractures remain the main complication. Orthopaedic surgeons should be aware that some patients still have this type of prosthesis and must be capable of responding quickly if a fracture occurs.

Minimum 10-Year Follow-Up of Total Hip Arthroplasty With a Collarless Triple-Tapered Polished Cemented Stem With Line-to-Line Implantation Using a Direct Anterior Approach

BackgroundThe Trilliance stem (B. Braun-Aesculap, Tuttlingen, Germany), a novel collarless triple-tapered polished stem, was introduced in 2009. The aim of this study is to evaluate the long-term clinical and radiological results of the Trilliance stem with line-to-line implantation in primary total hip arthroplasty using a direct anterior approach. MethodsA consecutive retrospective series of 130 patients (151 hips) who underwent total hip arthroplasty between February 2009 and August 2011 were evaluated for a minimum of 10 years. Of these, 87.4% had a diagnosis of secondary osteoarthritis based on developmental hip dysplasia. Clinical and radiological results, complications were evaluated and survival analysis was performed. ResultsThe mean follow-up was 10.7 years (range, 10.0-12.1). Thirteen hips (13 patients, 6.8%) were lost to follow-up. Adequate cementation (Barrack grade A) was achieved in 136 hips (93.8%) 1 week post-operatively. Nearly all (144 hips, 99.3%) had been inserted within the range of 3°. No significant differences were identified between high- (≥30 procedures/year) and low- (<30 procedures/year) volume surgeons. The Kaplan–Meier survival analysis with revision of the femoral component for aseptic loosening, revision of the femoral component for any reason and revision of either component for any reason as the end points, cumulative survivorship was 100.0%, 97.6% (95% confidence interval (CI) 95.4-100.0) and 96.5% (95% CI 93.8-99.3) at 10 years, respectively. ConclusionThe Trilliance stem with line-to-line implantation using a direct anterior approach has an excellent clinical and radiological outcome at a minimum of 10 years’ follow-up. Level of EvidenceLevel IV, Retrospective cohort study.

Результаты клинического применения ацетабулярных компонентов с поверхностью из пористого тантала в эндопротезах при дефектах стенок вертлужной впадины и остеопорозе

В статье представлены ближайшие результаты эндопротезирования тазобедренного сустава в условиях остеопороза и дефектов стенок вертлужной впадины у 26 пациентов с использованием ацетабулярного компонента press-fit-фиксации с танталовым покрытием. Положительные результаты лечения в средние сроки наблюдения 2,6 (от 1 до 3,5) года после операции были получены в 100 % случаев.

Effectiveness, Patient Satisfaction, and Cost Reduction of Virtual Joint Replacement Clinic Follow-Up of Hip and Knee Arthroplasty

BackgroundTotal hip and knee arthroplasties are increasingly performed operations, and routine follow-up places huge demands on orthopedic services. This study investigates the effectiveness, patients’ satisfaction, and cost reduction of Virtual Joint Replacement Clinic (VJRC) follow-up of total hip arthroplasty and total knee arthroplasty patients in a university hospital. VJRC is especially valuable when in-person appointments are not advised or feasible such as during the COVID-19 pandemic. MethodsA total of 1749 patients who were invited for VJRC follow-up for knee or hip arthroplasty from January 2017 to December 2018 were included in this retrospective study. Patients were referred to VJRC after their 6-week postoperative review. Routine VJRC postoperative review was undertaken at 1 and 7 years and then 3-yearly thereafter. We evaluated the VJRC patient response rate, acceptability, and outcome. Patient satisfaction was measured in a subgroup of patients using a satisfaction survey. VJRC costs were calculated compared to face-to-face follow-up. ResultsThe VJRC had a 92.05% overall response rate. Only 7.22% required further in-person appointments with only 3% being reviewed by an orthopedic consultant. VJRC resulted in an estimated saving of £42,644 per year at our institution. The patients’ satisfaction survey showed that 89.29% of the patients were either satisfied or very satisfied with VJRC follow-up. ConclusionVJRC follow-up for hip and knee arthroplasty patients is an effective alternative to in-person clinic assessment which is accepted by patients, has high patient satisfaction, and can reduce the cost to both health services and patients.

Systematic review of the clinical effectiveness for long-term follow-up of total hip arthroplasty.

Objectives: Total hip arthroplasty (THA) is highly successful but national registries indicate that average age has lowered and that younger patients are at higher risk of revision. Long-term follow-up of THA was historically recommended to identify aseptically failing THA, minimising the risks associated with extensive changes, but follow-up services are now in decline. A systematic review was conducted to search for evidence of the clinical or cost-effectiveness of hip arthroplasty surveillance.Methods: The study was registered with PROSPERO International Prospective Register of Systematic Reviews and conducted according to PRISMA guidelines; databases included MEDLINE and Embase, and all studies were quality assessed. Original studies (2005 to 2017) reporting follow-up of adults with THA in situ >5 years were included. Researchers extracted quantitative and qualitative data from each study.Results: For eligibility, 4,137 studies were screened: 114 studies were included in the final analysis, representing 22 countries worldwide. Data extracted included study endpoint, patient detail, loss to follow-up, revisions, scores and radiographic analysis. Six themes were derived from inductive content analysis of text: support for long-term follow-up, subgroups requiring follow-up, effect of materials/techniques on THA survival, effect of design, indicators for revision, review process. Main findings—follow-up was specifically recommended to monitor change (eg asymptomatic loosening), when outcomes of joint construct are unknown, and for specific patient subgroups. Outcome scores alone are not enough, and radiographic review should be included.Conclusion: There were no studies directly evaluating the clinical effectiveness of the long-term follow-up of THA but expert opinions from a range of international authors advocated its use for defined subgroups to provide patient-centred care. In the absence of higher level evidence, these opinions, in conjunction with emerging outputs from the national joint registries, should be used to inform services for long-term follow-up of THA.

Guidelines for the follow-up of total hip arthroplasty: do they need to be revised?.

The aim of this retrospective audit was to determine the route of referral or presentation of patients requiring revision following primary total hip arthroplasty (THA). A total of 4802 patients were implanted with an Orthopaedic Data Evaluation Panel (ODEP) 10A* cementless implant (Corail/Pinnacle) between 2005 and 2015; 80 patients with a mean age of 67.8 years (sd 10.8) underwent a subsequent revision. The primary outcome measure was route of referral for revision. Of the 80 revisions, 31 (38.8%) took place within the first year and 69 (86.3%) took place within six years. Only two of the 80 patients were picked up at a routine review clinic, one for infection and the other for liner dissociation. A total of 36 revised patients (45.0%) were reviewed following self-referral. Of the remaining 44 revised patients (55.0%), 15 (18.8%) were General Practitioner referrals, 13 (16.3%) were other hospital referrals, six (7.5%) were inpatients, six (7.5%) were Emergency Department referrals, and two (2.5%) were readmitted from their homes. No revisions were carried out on asymptomatic patients. Our experience suggests that if there is a robust system in place for self-referral, patients with an ODEP 10A* hip implant can, if asymptomatic, be safely discharged at the time of their first postoperative review. Cite this article: Bone Joint J 2019;101-B:536-539.

The Results of Long-term Follow-up of Total Hip Arthroplasty Using Hydroxyapatite-coated Cups.

PurposeThe aim of this study was to report the long-term outcome and the failure mechanism of cementless total hip arthroplasty (THA) using hydroxyapatite (HA)-coated acetabular cup.Materials and MethodsFrom January 1992 to May 1994, a total of 123 consecutive cementless primary THAs were performed using a HA-coated acetabular cup with metal-on-polyethylene articulation. We retrospectively evaluated 66 hips available for follow-up at a mean 18.3 years (range, 10.4-23.6 years). The survival analysis was performed by the Kaplan-Meier method. We defined end point as any failure that required a reoperation of acetabular component.ResultsThirty-nine of 66 hips (59.1%) were defined as a failure for progressive acetabular osteolysis or aseptic loosening of the cup. Acetabular osteolysis was observed in 47 hips (71.2%) and 33 hips (50.0%) were revised because of cup loosening. The Kaplan-Meier method showed the survival rate of the acetabular cup to be 46.3% at 15 years and 34.8% at 20 years for any failure that required a reoperation of acetabular component.ConclusionThe long-term survival rate of THA using HA-coated acetabular cup was unsatisfactory, and it was attributed to vulnerable property of HA coating and progressive osteolysis.

Stability of Uncemented Cups — Long-Term Effect of Screws, Pegs and HA Coating: A 14-Year RSA Follow-Up of Total Hip Arthroplasty

Screws, pegs and hydroxyapatite-coating are used to enhance the primary stability of uncemented cups. We present a 14-year follow-up of 48 hips randomized to four groups: press-fit only, press-fit plus screws, press-fit plus pegs and hydroxyapatite-coated cups. Radiostereometric migration measurements showed equally good stability regardless cup augmentation. The mean wear rate was high, 0.21mm/year, with no differences between the groups. Seven hips had radiographical osteolysis but only in hips with augmented cups. Cups without screw-holes compared with cups with screw-holes resulted in better clinical outcome at the 14-year follow-up. Thus, augmentation of uncemented cups with screws, pegs, or hydroxyapatite did not appear to improve the long-term stability compared with press-fit only.

Should primary care physicians perform routine long-term follow-up of total hip arthroplasty patients?

BackgroundIt has been suggested by some that follow-up of primary total hip arthroplasty (THA) patients should be performed by primary care physicians (general practitioners or GP’s in the UK), rather than by orthopaedic specialists. Such follow-up would, most likely, include radiographic follow-up based on review of radiographic reports. AimTo look at the quality of the radiographic reports to determine their usefulness as a method of radiographic follow-up of THAs. MethodsPre-revision radiographs of 50 patients were interpreted by a senior orthopaedic registrar, supervised by a consultant with a revision THA practice. This acted as the control against which the findings stated on the radiologist’s report of the same radiograph were compared. Signs of failure were categorised into loosening, bone lysis and polyethylene wear. ResultsComparison to previous radiographs was performed by radiologists in only 42% of cases. Fixation type (cemented/uncemented) was stated in the radiologists report in only 2 cases (4%) and was correct in one. Acetabular component loosening was missed by radiologists in 24% of cases and femoral component loosening in 55%. Radiologists missed osteolysis on the acetabular side in 67% of cases and on the femoral side in 57%. Radiologists failed to report polyethylene wear in 93% of cases. DiscussionThe radiographs reviewed contained definite evidence of failure, being pre-revision radiographs. Vital information, essential in prompting specialist review, was lacking in the radiologists' report and primary care physicians using these reports for radiographic follow-up would have been falsely reassured that all was well with the prosthesis in a significant number of cases. We feel that proposals for primary care based follow-up of THAs that depend on review of radiological reports as a surrogate for specialist review of the radiographs themselves are not safe.

Results of Total Hip Arthroplasty Differ in Subtypes of High Dislocation

In a previous study, we described two subtypes of high dislocation of the hip depending on the presence (C1) or absence (C2) of a false acetabulum, yet we have already presented the concise followup of total hip arthroplasty (THA) in these patients as a group at a minimum of 15 years. In this retrospective study, we investigated differences in the results of THA in the C1 and C2 subtypes of high dislocation such as (1) survivorship of the reconstructions; (2) Merle d'Aubigné-Postel clinical scores; (3) leg lengthening and femoral shortening; and (4) site of reattachment and union rate of the greater trochanter. We included 49 hips of the C1 subtype and 30 hips of the C2 subtype operated on from 1976 to 1994. We evaluated survivorship (using reoperation for any reason as the end point) and performed chart and radiographic reviews. The 15-year survival was 84% (± 10% [95% CI]) for the C1 subtype and 60% (± 17% [95% CI]) for the C2 subtype (p = 0.001). Cox regression analysis, after adjustment for confounding factors, showed also statistically significantly worse survivorship in the C2 subtype (p = 0.021) and, after adjustment for possible predictive factors, found a statistically significant relationship of high dislocation subtype (p = 0.018) and trochanteric union (p = 0.005) with survival of THAs. Pain, function, and mobility scores improved from preoperative to last followup in C1 and C2 groups but they did not differ between C1 and C2 hips. C2 hips were lengthened more (p < 0.001) despite greater amounts of femoral shortening (p = 0.006). Site of reattachment and the risk of greater trochanter nonunion were not different between the groups. We found important differences in fundamental parameters after THA in the high-dislocation subtypes, including the risk of revision, which was higher in patients whose hips did not have a false acetabulum. These findings indicate that while reporting THA results in patients with high dislocation, mixing results of the two subtypes may lead to statistical bias.

Long-Term Follow-Up Results of a Second-Generation Cementless Femoral Prosthesis with a Collar and Straight Distal Fixation Channels

PurposeWe evaluated the results of more than 10 years of follow-up of total hip arthroplasty using a second-generation cementless femoral prosthesis with a collar and straight distal fixation channels.Materials and MethodsOne hundred five patients (129 hips) who underwent surgery between 1991 and 1996 for primary total hip arthroplasty using cementless straight distal fluted femoral stems were followed for more than 10 years. Ninety-four hips in 80 patients were available for clinical and radiologic analysis. The mean age at the time of surgery was 47 years, and the mean duration of follow-up was 14.3 years.ResultsThe mean Harris hip scores had improved from 58 points to 88 points at the time of the 10-year follow-up. Activity-related thigh pain was reported in nine hips (10%). At the last follow-up, 93 stems (99%) were biologically stable and one stem (1%) was revised because of loosening. No hip had distal diaphyseal osteolysis. Proximal femoral stress-shielding was reported in 86 hips (91%). We found no significant relationship between collar-calcar contact and thigh pain, stem fixation status, or stress-shielding. The cumulative survival of the femoral stem was 99% (95% confidence interval, 98-100%) after 10 years.ConclusionThe long-term results of total hip arthroplasty using a second-generation cementless femoral prosthesis with a collar and straight distal fixation channels were satisfactory; however, the high rate of proximal stress-shielding and the minimal effect of the collar indicate the need for some changes in the stem design.

Pelvis and total hip arthroplasty acetabular component orientations in sitting and standing positions: Measurements reproductibility with EOS imaging system versus conventional radiographies

The literature has recently underlined the interest of pelvic and acetabular component orientation measurements in the standing and sitting position. Radiographic follow-up of total hip arthroplasty (THA) is based on standard AP and lateral X-rays. The use of EOS™ 2D imaging system reduces patient's radiation exposure compared to conventional X-rays. However, using this system, the validity and reproducibility of angular measurements, have not been studied yet for the measurement of pelvic and acetabular parameters in patients with THA. The EOS™ 2D imaging system offers similar advantages to conventional X-rays in the measurement of pelvic and acetabular orientation parameters which are commonly used. Five angular parameters characterizing pelvic tilt and acetabular cup orientation were determined using the same digital measurement Imagika™ software based on two series of standard X-rays and EOS™ 2D images acquired in both standing and sitting positions. Radiographs from 50 patients with unilateral THA were measured three times by two observers. Intra- and interobserver reproducibility using each method was independently studied then paired comparison was performed. The ICC and Spearman rank correlation coefficient demonstrated an excellent EOS/conventional X-ray correlation. According to the parameters, the mean difference between these two imaging modalities ranged from 0.30° to 3.43° (P<0.05). The intra- and interobserver variability ranged from ± 2.97° to ± 6.46° using the EOS™ imaging system and from ± 4.26° to ± 10.22° using conventional X-rays (P<0.05). The EOS™ 2D imaging system may replace conventional X-rays in the assessment and monitoring of pelvic and acetabular cup orientation in THA. Level III. Prospective diagnostic study.

Long-term Followup of Total Hip Arthroplasty in Patients with Cerebral Palsy

Patients with cerebral palsy (CP) are at risk for hip arthrosis secondary to the loss of joint congruity. We asked whether THA relieved pain, improved function, and provided durable improvements. We retrospectively identified 56 patients (59 hips) with CP who had THAs for painful hips. Chart review determined the preoperative, postoperative, and current functional levels. All patients or caregivers completed a questionnaire, including a modified Gross Motor Function Classification System mobility scale and qualitative reports of pain and satisfaction. Pain levels were measured on a visual analog scale at three times: preoperative, postoperative, and current. The average age of the patients at the time of surgery was 30.6 years. Minimum followup was 2 years (average, 9.7 years; range, 2-28 years). Pain relief was obtained in all patients. All patients returned to preoperative function (59) and 52 patients returned to prepain functional status (88%). Seven patients underwent acetabular component revisions, and two patients had a femoral stem component revision. The 2-year implant survival was 95%, and 10-year survivorship was 85%. THA can provide durable relief and improved function in patients with CP with severe coxarthrosis. Level IV, therapeutic study. See the Guidelines for Authors for a complete description of levels of evidence.

Clinical Results of the Wear Performance of Cross-Linked Polyethylene in Total Hip Arthroplasty: Prospective Randomized Trial

To investigate the clinical results of cross-linked polyethylene (CLPE) and to compare the CLPE wear against zirconia and stainless steel heads, we studied the radiographic wear after a minimum 3-year follow-up in total hip arthroplasty (THA). Ninety-four hips were randomly implanted with a 22.225-mm head cemented THA—the group of non-CLPE against zirconia and CLPE against 2 different zirconias and stainless steel. The linear wear rate was significantly lower in the group of CLPE against zirconia (0.067, 0.059 mm/y) and against stainless steel (0.068 mm/y) compared with non-CLPE against zirconia (0.170 mm/y). In the short-term results, the wear performance of CLPE against zirconia was superior to that of non-CLPE; however, it did not show a better wear rate than CLPE against stainless steel. Furthermore, long-term investigations will be necessary for understanding CLPE wear in vivo.

Effect of augmented cup fixation on stability, wear, and osteolysis: A 5-year follow-up of total hip arthroplasty with RSA

To evaluate different modes of cementless fixation of hemispherical cups, we operated on 87 hips in 81 patients using 4 different means of cup fixation. The hips were randomly assigned to fixation with press-fit technique only (PF), or with augmentation with screws (S), pegs (P), or hydroxyapatite (HA) coating. The patients were evaluated with radiostereometric analysis (RSA) for cup migration and wear, conventional radiography for osteolysis, and Harris Hip Score for clinical outcome over 5 years. The fixation of the cups did not differ between the groups, but HA showed a tendency to decrease proximal migration. HA-coated cups displayed the best interface with hardly any signs of radiolucent lines, indicating a superior sealing effect of the HA coating. Cups with screws or pegs had more radiolucent lines and osteolytic lesions than the other groups. Radiolucent lines were correlated to higher proximal migration, young age, and female gender ( r 2=.2). The wear rate of the ethylene oxide-sterilized polyethylene liner was high (0.2 mm/y) but did not differ between the groups. Two cups with a perioperative fracture of the acetabular rim showed large initial migration but stabilized thereafter.

Effect of augmented cup fixation on stability, wear, and osteolysis*1A 5-year follow-up of total hip arthroplasty with RSA

To evaluate different modes of cementless fixation of hemispherical cups, we operated on 87 hips in 81 patients using 4 different means of cup fixation. The hips were randomly assigned to fixation with press-fit technique only (PF), or with augmentation with screws (S), pegs (P), or hydroxyapatite (HA) coating. The patients were evaluated with radiostereometric analysis (RSA) for cup migration and wear, conventional radiography for osteolysis, and Harris Hip Score for clinical outcome over 5 years. The fixation of the cups did not differ between the groups, but HA showed a tendency to decrease proximal migration. HA-coated cups displayed the best interface with hardly any signs of radiolucent lines, indicating a superior sealing effect of the HA coating. Cups with screws or pegs had more radiolucent lines and osteolytic lesions than the other groups. Radiolucent lines were correlated to higher proximal migration, young age, and female gender (r2=.2). The wear rate of the ethylene oxide-sterilized polyethylene liner was high (0.2 mm/y) but did not differ between the groups. Two cups with a perioperative fracture of the acetabular rim showed large initial migration but stabilized thereafter.

Low-friction arthroplasty of the hip using alumina ceramic and cross-linked polyethylene

The Journal of Bone and Joint Surgery. British volumeVol. 81-B, No. 1 HipFree AccessLow-friction arthroplasty of the hip using alumina ceramic and cross-linked polyethyleneA TEN-YEAR FOLLOW-UP REPORTB. M. Wroblewski, P. D. Siney, P. A. FlemingB. M. WroblewskiConsultant Orthopaedic Surgeon, Professor of Orthopaedic BiomechanicsSearch for more papers by this author, P. D. SineyResearch FellowSearch for more papers by this author, P. A. FlemingResearch AssistantSearch for more papers by this authorPublished Online:1 Jan 1999https://doi.org/10.1302/0301-620X.81B1.0810054AboutSectionsPDF/EPUB ToolsAdd to FavouritesDownload CitationsTrack CitationsPermissions ShareShare onFacebookTwitterLinked InRedditEmail AbstractWe report the results of our continued review of 14 hip arthroplasties using alumina ceramic femoral heads with cross-linked polyethylene cups.There have been no complications and a very low rate of penetration. This was 0.02 mm per year after an initial ‘bedding-in’ period of two years. There has been no change in the mean rate between our earlier study at six years and the current results at 10 to 11 years.The use of these bearing surfaces appears to reduce the potential amount of polyethylene debris and may provide the next logical stage in the development of the Charnley low-friction arthroplasty.FiguresReferencesRelatedDetailsCited byMidterm Results of a Contemporary, Porous-Coated Acetabular System in Patients Undergoing Primary Total Hip Replacement for Degenerative Hip Disease: A Prospective, Multicenter StudyThe Journal of Arthroplasty, Vol. 35, No. 7Influence of hip joint simulator design and mechanics on the wear and creep of metal-on-polyethylene bearings9 May 2016 | Proceedings of the Institution of Mechanical Engineers, Part H: Journal of Engineering in Medicine, Vol. 230, No. 5A randomised controlled trial comparing highly cross-linked and contemporary annealed polyethylene after a minimal eight-year follow-up in total hip arthroplasty using cemented acetabular componentsJ. Langlois, F. Atlan, C. Scemama, J. P. Courpied, M. Hamadouche1 November 2015 | The Bone & Joint Journal, Vol. 97-B, No. 11Long-Term Performance of Ceramic and Metal Femoral Heads on Conventional Polyethylene in Young and Active PatientsJournal of Bone and Joint Surgery, Vol. 95, No. 13Raman characterisation of conventional and cross-linked polyethylene in acetabular cups run on a hip joint simulator11 February 2011 | Journal of Raman Spectroscopy, Vol. 42, No. 6Highly Cross-Linked Polyethylenes28 May 2011Impaction bone grafting in revision hip surgery: past, present and future15 January 2010 | Cell and Tissue Banking, Vol. 11, No. 1Long-term in-vitro wear performance of an innovative thermo-compressed cross-linked polyethyleneTribology International, Vol. 43, No. 1-2Charnley low-frictional torque arthroplastyFOLLOW-UP FOR 30 TO 40 YEARSB. M. Wroblewski, P. D. Siney, P. A. Fleming1 April 2009 | The Journal of Bone and Joint Surgery. British volume, Vol. 91-B, No. 4Bone ingrowth into porous silicon nitrideJournal of Biomedical Materials Research Part A, Vol. 9999AComparison of wear of ultra-high molecular weight polyethylene acetabular cups against surface-engineered femoral heads30 October 2008 | Proceedings of the Institution of Mechanical Engineers, Part H: Journal of Engineering in Medicine, Vol. 222, No. 7Total Joint ReplacementArthroplasty Options for the Young PatientClinical Orthopaedics and Related Research, Vol. 441, No. &amp;NA;Low-friction arthroplasty of the hip using alumina ceramic and cross-linked polyethyleneA 17-YEAR FOLLOW-UP REPORTB. M. Wroblewski, P. D. Siney, P. A. Fleming1 September 2005 | The Journal of Bone and Joint Surgery. British volume, Vol. 87-B, No. 9Ceramics in Total Hip ReplacementClinical Orthopaedics & Related Research, Vol. 430A Review of Current Cross-linked Polyethylenes Used in Total Joint ArthroplastyClinical Orthopaedics & Related Research, Vol. 430Conquest of a Worldwide Human DiseaseClinical Orthopaedics and Related Research, Vol. 429Highly Cross-linked, Electron-Beam-Irradiated, Melted PolyethyleneClinical Orthopaedics and Related Research, Vol. 429Wear and Structural Fatigue Simulation of Crosslinked Ultra-High Molecular Weight Polyethylene for Hip and Knee Bearing ApplicationsJournal of ASTM International, Vol. 1, No. 1Highly Cross-Linked Polyethylene in Cemented THAClinical Orthopaedics & Related Research, Vol. 417Effect of Radiation, Heat, and Aging on In Vitro Wear Resistance of PolyethyleneClinical Orthopaedics & Related Research, Vol. 417Ultrastructural Analysis of Retrieved Ceramic Ball Heads24 January 2018 | HIP International, Vol. 13, No. 4Alternative bearing surfaces: Crosslinked polyethylene24 January 2018 | HIP International, Vol. 13, No. 3Alternative Bearing Surfaces: Crosslinked Polyethylenes for Total Hip Replacement. A Review24 January 2018 | HIP International, Vol. 13, No. 3Analysis of Survivorship After Total Hip Arthroplasty Using a Ceramic HeadClinical Orthopaedics and Related Research, Vol. 391The influence of phospholipid concentration in protein-containing lubricants on the wear of ultra-high molecular weight polyethylene in artificial hip joints5 August 2016 | Proceedings of the Institution of Mechanical Engineers, Part H: Journal of Engineering in Medicine, Vol. 215, No. 2Long-Term Outcome after Charnley Low Frictional Torque Arthroplasty Vol. 81-B, No. 1 Metrics History Published online 1 January 1999 Published in print 1 January 1999 InformationCopyright © 1999, The British Editorial Society of Bone and Joint Surgery: All rights reservedPDF download

Dual X-ray absorptiometry for the evaluation of bone density from the proximal femur after total hip arthroplasty: Analysis protocols and reproducibility

Dual X-ray absorptiometry (DXA) instruments are now able to evaluate bone mineral density (BMD) of bone surrounding metal implants. The assessment of BMD around prosthetic components could provide additional information for the follow-up of total hip arthroplasty (THA). In this study, we evaluated the potential application of DXA in the field of THA. BMD was measured in the proximal femur of both THA and THA-free sides in 14 postmenopausal women 6-18 months after THA. The explored segment was divided into seven zones as proposed by Gruen et al. [18]. The precision error of BMD measurements ranged from 1.8 to 6.8% on the THA side and from 1.1 to 2% to the THA-free side. The reduction of BMD of the THA versus the THA-free side was significant in all seven zones (P < 0.01, t-test for paired data). These results showed significant differences in BMD around femoral components of THA with respect to contralateral healthy side, and demonstrate the sensitivity of DXA for detecting these changes.