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At least 19 recordsLinked to original sources

A cementless system of total hip prosthesis. Experimental studies on total hip prosthesis in dogs.

It is essential that the prosthetic material should not be harmful to the human body, it should be strictly fitted to the body and it should have sufficient durability. To investigate those conditions of an artificial joints as mentioned above, it is important to have experimental studies using a model of the artificial joint in animals instead of a simulator. The authors have developed their own total hip prosthesis for a dog since 1970. These prostheses were fixed to the bone without bone cement. These dogs were killed periodically from 8 weeks to 3 years after surgery of total hip replacement. Not only were pathohistological studies on the joint capsule and bony tissue of the femur surrounding the prosthesis performed, but also scanning electron microscopic examination on capsule and the surface of the prosthetic head were performed. The results were excellent. Ther was no loosening or wear when the new type of acetabular socket with large spikes was used. On the other hand, in the case of the old type socket with its smooth surface and smaller spikes, loosening of the socket and prosthetic stem occurred within one year after surgery.

Animals↗

[Quality assurance in hip prosthesis surgery. New type hip prostheses, review of a 3-year material].

This article deals with the short-term results of prosthetic replacement of the hip joint. The investigation was carried out three years after the introduction of a new hip prosthesis - the ITH (" International Total Hip") prosthesis. Our results were analysed retrospectively, the primary goal being quality assessment of the results of our hip surgery. We found that the results of hip prosthetic surgery with the ITH-prosthesis were satisfying, although the frequency of complications was rather high: 185 implantations of the ITH-prosthesis gave 13 cases of deep venous thrombosis; one case of deep infection and subsequent revision surgery; four cases of dislocation of the prosthesis, of which two cases have been subsequently revised; one case of perforation of the femur with later revision; and one case of permanent paralysis of the femoral nerve. The overall rate of revisions was 2.7%. The overall survival of the prosthesis according to Kaplan Meier was 97% after three years.

Adult↗

The direct fixation system of total hip prosthesis. Research of the possibilities of fixing total hip prosthesis directly to bone.

There are two methods for the fixation of prostheses to bone; one is a method using bone cement and another is the direct fixation of the prostheses to bone. Four types of animal experiments were performed to compare the two methods of fixation. A small pyramid shaped test piece was used to compare the fixation capacity of the socket spike. Also, a special test piece was used to study the time of bone formation, to check the fixation capacity of bone bar formation occurring in the hole in the based part of the prosthetic component. furthermore, models of prosthetic stem and socket were made and attached to the femur and ilium of dog to perform fixation tests and fatigue tests. As a result, any of the tests proved that the direct fixation method without the usage of bone cement was superior to the fixation method using bone cement.

Acetabulum↗

Biomechanical comparison of newly designed stemless prosthesis and conventional hip prosthesis--an experimental study.

Local bone loss after implantation of traditional stem-type prostheses remains an unsolved problem during the long-term application of total hip replacement. The stress shielding effect and osteolysis were thought to be the two main factors that result in local bone loss after prosthesis implantation. A newly designed stemless cervico-trochanteric (C-T) prosthesis was thus developed to reduce stress shielding and osteolysis caused by the implantation of conventional stem-type prosthesis. Eight synthetic femora were implanted with C-T and porous coated anatomic (PCA) prostheses. Under 2,000-Newton load, the surface strains of proximal femora were compared between the intact, PCA press-fit femora and the C-T implanted femora with three different fixation modes: two-screw fixation, three-screw fixation, and three-screw combined with cement fixation. The results revealed that stress shielding in the C-T implanted femora was significantly eliminated compared to that of the PCA implanted femora (p<0.01). No statistical difference in strain magnitude was found for the C-T implanted femora among the three different fixation modes (p>0.1). The C-T implanted femur has more physiological strain distribution. Moreover, from the C-T prosthetic characteristic design, the localized osteolysis would be also reduced due to the overall coverage of neck-trochanteric area. The newly designed C-T prosthesis may be a useful alternative to the traditional stem-type prosthesis in the future.

Arthroplasty↗

A false-positive indium-111 labeled leukocyte scintigram in a patient with a painful hip prosthesis.

A Tronzo hip prosthesis is designed to elicit an inflammatory reaction in order to promote prosthesis stability. A three-phased bone scan and Ga-67 imaging in conjunction with physical examination and laboratory findings failed to demonstrate evidence for osteomyelitis in a patient with a painful hip prosthesis, in whom images obtained with In-111-labeled leukocytes were positive. This observation demonstrated that the interpretation of the latter technique in demonstrating inflammation can cause a false impression of an infectious process.

Diagnosis, Differential↗

[Dislocation-dissociation of a bipolar hip prosthesis].

The incidence of hip prosthesis dislocation ranges from 0.4% to 15% depending on the series (1, 6). In classical dislocations of hip prosthesis, the prosthetic femoral head escapes from the natural acetabular cavity or prosthetic acetabulum in case of total hip arthroplasty. In the case presented here, a bipolar hip prosthesis dislocation occurred between the small head of the prosthesis and the polyethylene. A total hip prosthesis restored good function. Only a few cases of this type have been described in the literature. The different causes are discussed.

Hip Dislocation↗

[Clinical evaluation of the hip joint after implantation of cementless Mittelmeier type and Parhofer-Mönch type hip prosthesis].

Total hip replacement is the most common procedure in the treatment of severe degenerative changes in the hip joint. The authors present clinical evaluation of 129 patients (151 hips) who underwent total hip replacement using either the Mittelmeier type or the Parhofer-Mönch type hip prothesis. The age of the patients ranged at the time of the operation between 17 and 74 years (average 44.9). The follow-up ranged from 24 to 143 months (average 61.2 months). The P-M prothesis was implanted in 53 hips, the P-M "Plasmapore" prothesis in 42 patients, Mittelmeier Autophor 900 prothesis in 49 patients and the Mittelmeier Autophor 900S prothesis in 7 patients. Clinical evaluation was performed according to the d'Aubigne-Postel method with the Charnley modification. The results were graded as very good in 17 cases, good in 64 cases, satisfactory in 53 cases and poor in 17 cases. Very good and good results were mainly observed after implantation of the P-M type prothesis and P-M "Plasmapore" type prothesis. Worse results were observed in patients, who at the time of the operation were aged 45 years or less and who had congenital hip dysplasia. P-M type prothesis gives better clinical results in the treatment of degenerative changes of the hip joint.

Adolescent↗

The canine cemented modular total hip prosthesis.

Total hip replacement (THR) is well established as a treatment modality for dogs with noninfectious, nonneoplastic, disabling conditions of the coxofemoral joint. Since the mid 1970s, a fixed-head prosthesis has been used in this procedure. A modular prosthesis, which is based on many of the technical advances found in human prostheses, now is available for use in veterinary medicine. The prosthesis, surgical instrumentation, surgical technique, and clinical results have been evaluated in a prospective study conducted at The Ohio State University's College of Veterinary Medicine. The modular prosthesis provides results equal to or better than the fixed-head prosthesis.

Animals↗

Primary total hip arthroplasty with the AML total hip prosthesis.

Primary total hip arthroplasty using an uncemented AML total hip prosthesis (trispiked cup and a 4/5 porous coated stem) was performed in 50 patients (52 hips). The average age of the patients at the time of surgery was 47.6 years (range, 19-68 years), and the diagnosis was osteonecrosis of the femoral head in 18 hips, osteoarthritis in 16, fracture of the femoral neck in 14, osteoarthrosis secondary to childhood pyogenic arthritis in two, childhood tuberculous arthritis in one, and traumatic arthritis in one. The average followup was 11.3 years (range, 11-12 years). The average preoperative Harris Hip Score was 59 points, which improved to 90 points. Twenty-five (48%) hips had excellent results, 14 (27%) had good results, three (6%) had fair results, and 10 (19%) had poor results. The overall rate of revision was 15% (eight hips). The rate of revision of the femoral component was 2% (one hip), and the rate of revision of the acetabular component was 15% (eight hips). Twenty (38%) hips had acetabular and femoral osteolysis. Nine (17%) hips had femoral osteolysis only. Thirty-four (65%) hips had an average of 3.3 mm (range, 2-12 mm) of wear in the polyethylene liner. The average wear rate was 0.29 mm (range, 0.17 to 1.04 mm) per year.

Adult↗

In vivo isocenter dose in two hip prosthesis patients.

Hip prostheses may cause irradiation dose inhomogeneities in conventional four-field target volumes to the pelvis. Two patients, with bilateral and unilateral prostheses, were subjected to thermoluminescent dosimetry measurements in the prostatic urethra during 24 MV photon portal exposures. The results suggested a 13% decrease in absorbed dose only for conventional four-field beam geometry with bilateral prostheses, as compared to oblique four-field beam geometry or unilateral prosthesis. This supports the suggestion that beam technique modifications may be warranted for patients with hip prostheses.

Alloys↗

The resolution of protrusio acetabuli treated with Ring's hip prosthesis.

Seven hips with protrusio acetabuli which showed complete or partial resolution of the protrusion after replacement with Ring's prosthesis are reported. It is suggested that this prosthesis offers a simple and effective method of treating painful protrusion into the pelvis; it allows healing of the medial wall of the acetabulum while avoiding many of the hazards of other methods of treatment.

Acetabulum↗