Clinical Orthopaedics and Related Research ®

A Publication of The Association of Bone and Joint Surgeons ®

Symposium: 2015 International Hip Society Proceedings 13 articles

Articles

The Role of Highly Selective Implant Retention in the Infected Hip Arthroplasty

Moataz El-Husseiny MB BCh, MRCS, Dip Sport M, MD (Res), Fares S. Haddad BSc, MCh(Orth), FRCS(Orth), MD (Res), FFSEM

There is debate around how to treat patients with periprosthetic joint infection of the hip. When there is an ingrown component on one side of the arthroplasty and a loose component on the other, treatment is typically revision of the entire construct. There is an argument to retain an ingrown implant in instances in which removal would result in severe bone damage. However, little has been reported on the likelihood of success with this approach.

Does Surface Topography Play a Role in Taper Damage in Head-neck Modular Junctions?

Robin Pourzal PhD, Deborah J. Hall BS, Nguyen Q. Ha BA, Robert M. Urban, Brett R. Levine MD, Joshua J. Jacobs MD, Hannah J. Lundberg PhD

There are increasing reports of total hip arthroplasty failure subsequent to modular taper junction corrosion. The surfaces of tapers are machined to have circumferential machining marks, resulting in a surface topography of alternating peaks and valleys on the scale of micrometers. It is unclear if the geometry of this machined surface topography influences the degree of fretting and corrosion damage present on modular taper junctions or if there are differences between modular taper junction material couples.

Cementless Total Hip Arthroplasty With Metasul Bearings Provides Good Results in Active Young Patients: A Concise Followup

Christian P. Delaunay MD, Sophie Putman MD, Benjamin Puliéro MD, Matthieu Bégin MD, Henri Migaud MD, François Bonnomet MD

A primary concern of younger, more active patients who have undergone total hip arthroplasty (THA) is the longevity of the implant. Cementless fixation and hard-on-hard bearings are recognized as options to enhance THA durability. Earlier, we published a series of 83 cementless primary THAs using 28-mm metal-on-metal (MoM) bearings in patients aged 50 years or younger; here we provide concise followup on that same group after an additional 8-year survey period.

Hips With Protrusio Acetabuli Are at Increased Risk for Failure After Femoroacetabular Impingement Surgery: A 10-year Followup

Markus S. Hanke MD, Simon D. Steppacher MD, Corinne A. Zurmühle MD, Klaus A. Siebenrock MD, Moritz Tannast MD

Protrusio acetabuli is a rare anatomic pattern of the hip in which the femoral head protrudes into the true pelvis. The increased depth of the hip and the excessive size of the lunate surface typically lead to severe pincer-type femoroacetabular impingement (FAI); however, to our knowledge, there are no published mid- or long-term studies on results of circumferential acetabular rim trimming through a surgical hip dislocation for patients with this condition.

Do the Reasons for Ceramic-on-ceramic Revisions Differ From Other Bearings in Total Hip Arthroplasty?

Henri Migaud MD, Sophie Putman MD, Grégory Kern MD, Ronald Isida MD, Julien Girard MD, PhD, Nassima Ramdane PhD, Christian P. Delaunay MD, Moussa Hamadouche MD, PhD

Despite widespread use of ceramic-on-ceramic (CoC) in total hip arthroplasty (THA) during the past 10 years, little is known about why revisions are performed in hips with this bearing or the time elapsed before revision.

Periprosthetic Joint Infection in Hip Arthroplasty: Is There an Association Between Infection and Bearing Surface Type?

Rocco P. Pitto MD, PhD, Laurent Sedel MD

Preliminary studies have raised the question of whether certain prosthetic biomaterials used in total hip arthroplasty (THA) bearings are associated with increased risk of periprosthetic joint infection (PJI). For example, some observational data suggest the risk of PJI is higher with metal-on-metal bearings. However, it is not known whether other bearings—including ceramic bearings or metal-on-polyethylene bearings—may be associated with a higher or lower risk of PJI.

Early Subsidence Predicts Failure of a Cemented Femoral Stem With Minor Design Changes

Per-Erik Johanson MD, Martin Antonsson MStat MScCSE, Bita Shareghi BSc, Johan Kärrholm MD, PhD

Radiostereometry (RSA) measurements of early micromotion can predict later failure in hip and knee prostheses. In hip implants, RSA has been particularly helpful in the evaluation of composite-beam stem designs. The Spectron EF Primary stem (Smith & Nephew, London, UK) has shown inferior performance compared with its predecessors in both clinical studies and registry reports. Early RSA studies have shown somewhat greater subsidence for the Spectron EF Primary stem compared with the earlier Spectron EF, but still within boundaries considered to be safe.

No Benefit After THA Performed With Computer-assisted Cup Placement: 10-year Results of a Randomized Controlled Study

Sebastien Parratte MD, PhD, Matthieu Ollivier MD, Alexandre Lunebourg MD, Xavier Flecher MD, PhD, Jean-Noel A. Argenson MD, PhD

Computer-assisted surgery (CAS) for cup placement has been developed to improve the functional results and to reduce the dislocation rate and wear after total hip arthroplasty (THA). Previously published studies demonstrated radiographic benefits of CAS in terms of implant position, but whether these improvements result in clinically important differences that patients might perceive remains largely unknown.

Dual-mobility or Constrained Liners Are More Effective Than Preoperative Bariatric Surgery in Prevention of THA Dislocation

Philippe Hernigou MD, Matthieu Trousselier MD, François Roubineau MD, Charlie Bouthors MD, Charles Henri Flouzat Lachaniette MD

Obesity is associated with an increased risk of dislocation after total hip arthroplasty (THA). However, in patients with obesity, it is not known whether the risk is only in the early postoperative period or whether it persists several years after surgery, and whether having bariatric surgery before undergoing THA and/or receiving a specific device (such as a dual-mobility or constrained acetabular liner) is more effective in terms of decreasing the risk of dislocation.

Rotational Acetabular Osteotomy for Pre- and Early Osteoarthritis Secondary to Dysplasia Provides Durable Results at 20 Years

Yuji Yasunaga MD, Mitsuo Ochi MD, Takuma Yamasaki MD, Takeshi Shoji MD, Sotaro Izumi MD

Hip dysplasia is a common cause of secondary osteoarthritis (OA). Periacetabular osteotomy or rotational acetabular osteotomy has been used as joint-preserving procedures. However, only a few reports of long-term results with these operations have been reported.

Low Frequency of Early Complications With Dual-mobility Acetabular Cups in Cementless Primary THA

Morad Chughtai MD, Jaydev B. Mistry MD, Aloise M. Diedrich BS, Julio J. Jauregui MD, Randa K. Elmallah MD, Peter M. Bonutti MD, Steven F. Harwin MD, Arthur L. Malkani MD, Frank R. Kolisek MD, Michael A. Mont MD

Dislocation complicates 1% to 5% of primary total hip arthroplasties (THAs). As a result, some surgeons consider dual-mobility articulations, which are usually used in the revision setting to decrease the likelihood of dislocation, as an option for primary THA. However, few studies have evaluated their use in this setting.

Complications Are Not Increased With Acetabular Revision of Metal-on-metal Total Hip Arthroplasty

Colin T. Penrose BS, Thorsten M. Seyler MD, PhD, Samuel S. Wellman MD, Michael P. Bolognesi MD, Paul F. Lachiewicz MD

Isolated revision of the acetabular component in the setting of total hip arthroplasty has an increased risk of dislocation. With local soft tissue destruction frequently associated with failed metal-on-metal (MoM) bearings, it is presumed that acetabular revision of these hips will have even greater risk of complications. However, no study directly compares the complications of MoM with metal-on-polyethylene (MoP) acetabular revisions.

Hard-on-Hard Bearings Are Associated With Increased Noise Generation in Young Patients Undergoing Hip Arthroplasty

Denis Nam MD, MSc, Toby Barrack BA, Staci R. Johnson MEd, Ryan M. Nunley MD, Robert L. Barrack MD

Patient-perceived noise from prostheses after total hip arthroplasty (THA) does occur, yet questions remain including the overall frequency of this finding, demographic and prosthesis-related factors, and the association of noise generation with patient-reported outcomes.