Howse II cemented titanium metal-backed acetabular cups Poor 10-year results in 107 hips (original) (raw)
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BMC musculoskeletal disorders, 2015
Aim of this prospective study was to evaluate mid-term clinical and radiographic outcomes in total hip arthroplasty using an acetabular cup made of an innovative biomaterial, Trabecular Titanium™, whose highly porous structure and mechanical properties have been designed to mimic those of the natural bone, thus promoting a more physiological load transfer and a more durable fixation. Between September 2007 and November 2009, 134 total hip replacements and eight revisions were carried out using DELTA-TT primary cups (Lima Corporate, Villanova di San Daniele del Friuli, Italy) in 133 consecutive patients. Mean age was 57.5 ± 14.7 SD (18-92) years. Diagnosis was primarily hip osteoarthritis in 85 (63 %) cases, developmental dysplasia of the hip (DDH) in 24 (18 %) and hip avascular necrosis (AVN) in 10 (7 %). All the revision procedures were due to aseptic loosening of the original implant. Approval of the Institutional Review Board of the IRCCS Policlinico San Matteo in Pavia was obtai...
Clinical experiences with a titanium alloy total hip prosthesis: a posterior approach
PubMed, 1979
Using a titanium alloy femoral prosthesis (STH Zimmer) and an ultra high molecular weight polyethylene acetabular cup with a posterior surgical approach to the hip joint, 237 consecutive total hip arthroplasties in 215 patients were performed between December 1975 and May 1977. The preliminary results and early postoperative complications suggest that this system can be considered an alternative to total hip arthroplasty using other materials and surgical approaches.
The Journal of Bone and Joint Surgery
We evaluated 377 patients (428 hips) who had been managed, by a total of fourteen surgeons at twelve clinical sites in the United States and Europe, with a porous-coated press-fit acetabular cup, a hydroxyapatite-coated threaded screw-in cup, or one of two similar designs of hydroxyapatite-coated press-fit cups between April 1987 and November 1992. The same type of hydroxyapatite-coated femoral stem was inserted without cement in all patients. After a minimum duration of follow-up of five years (mean, 7.9 years; range, 5.3 to 9.1 years), one (1 per cent) of the 131 hydroxyapatite-coated threaded cups, two (2 per cent) of the 109 porous-coated press-fit cups, and twenty-one (11 per cent) of the 188 hydroxyapatite-coated press-fit cups had been revised because of aseptic loosening. A common radiographic sign of impending failure of the hydroxyapatite-coated press-fit cups was radiolucency at the interface between the implant and the subchondral bone beneath it. This radiolucency usual...
MOJ Orthopedics & Rheumatology, 2017
Introduction: Total hip replacement (THR) following acetabular fracture has a special difficulty regarding the longer duration of operative procedure and the presence of hardware used in fixation of acetabular fracture. Patients and method: Fourteen patients were included in this prospective study that gave a history of acetabular fracture and were surgically treated with THR using porous-coated metal cups. The mean age was 52 years. The mean interval between initial acetabular fracture and THR operation was 6 months. The minimum follow up was 24 months. Results: The mean Harris hip score improved from 34 preoperatively to 83 postoperatively. No registered cases of dislocation during the follow up period. Two cases showed Brooker type I dystrophic calcification postoperatively. No case showed progressive radiolucent lines in the radiological follow up. Porous-coated metal cups gave encouraging clinical and radiological results after a minimum of 24 months follow up. Conclusion: Longer terms follow up is recommended in order to be able to judge the durability of porous-coated metal cups in the treatment of post acetabular fracture THR.
Interactive Surgery, 2007
The second generation of metal-on-metal prostheses appeared at the end of the 1980’s as a serious alternative to metal on polyethylene bearing couples. Short-term clinical results were promising; however certain questions remain concerning clinical, radiological and biological aspects. Release of chromium and cobalt from the bearing couple is one of these aspects. The aim of this study is to analyse the results of a series of 97 cemented total hip prostheses comprising a titanium femoral stem and the Metasul® metal-metal bearing couple. Mean follow-up was nine years (7–12 years). Complications were marked by 12 revisions, out of which two were for recurrent early dislocations, eight for clinical and radiological failure, and two for worrying radiological alterations. During these revisions, we observed a serious infiltration of metal debris four times, leading to an alternative strategy using an alumina-alumina bearing couple. Three more revisions are planned for rapidly evolving radiological alterations. Thirty implants showed radiological signs of preoccupying deterioration on the acetabular side. Eight segmentary femoral osteolysis have been observed. Twelve patients suffer from recurrent subluxation. Concerning the global evolution of metal serum levels, cobalt remains stable after five years. The values are three to four times above those of a non-exposed subject, but largely below toxic ratios. The evolution of serum chromium levels is similar to cobalt. Implantation of two prostheses in one same patient leads to significant increase in serum metal ratios. This series raises questions concerning the reliability of the metal-on-metal bearing couple. Osteolysis is an unsolved problem. Today, cemented fixation is debatable although this series doesn’t allow this parameter to be held directly responsible. Nothing points to any shortcomings concerning the taper fixation or the metallurgy of the femoral stem. The study of the serum metal levels seems a good indicator of the impingement situations and the functioning of the bearing couple.
Five-year follow-up with a ceramic sandwich cup in total hip replacement
Archives of orthopaedic and trauma surgery, 2002
The results of the first 56 consecutive total hip replacements using a new cementless, sandwich (alumina-polyethylene-titanium) acetabular component are reported. From March 1994 to March 1995 we operated on 39 female and 17 male patients; their mean age was 62.8 years (range 32-85 years). The Harris Hip Score was used for clinical evaluation. X-rays were examined according to the DeLee and Charnley method. At an average follow up of 62.4 months, 51 patients had complete clinical and radiographic data. For them, we recorded a good clinical result (average HHS 90.6), and we could detect no acetabular radiolucencies on X-rays. At the 5-year follow-up the results of this ceramic acetabular cup are quite encouraging. As a matter of fact, although the clinical results are very similar to those reported by other authors with conventional ceramic-polyethylene coupling prosthesis, the absence of periacetabular radiolucency and socket migration could mean less debris formation, less acetabul...
Orthopaedics & traumatology, surgery & research : OTSR, 2014
Although Charnley-Kerboull metal-on-polyethylene 22.2mm cemented total hip arthroplasty (THA) is considered to be the gold standard in France, results with this prosthesis are conflicting, in particular in relation to Scandinavian registers. The goal of this retrospective study was to confirm the validity of this prosthesis at a minimum of 10years follow-up. Survival of this type of THA would fulfill NICE conditions (survival at 10 years of at least 90%). One hundred and five primary THA were performed in 93 patients (30 men and 63 women) mean age 72.6 years old (60-86) between January 1998 and March 2001. After a mean follow-up of 10.6 years (10-13 years), 21 patients (23 THA) were lost to follow-up and 32 (35 THA) had died leaving 40 patients (47 THA) for clinical analysis (Merle d'Aubigné and Oxford scores) and X-ray assessment. Survival was calculated with revision for any cause and radiological loosening with or without revision as end-points. The mean Oxford score at the f...
Polyethylene wear in cemented metal-backed acetabular cups
The Bone & Joint Journal
We examined radiographic polyethylene wear in 233 cemented total hip arthroplasties (201 patients) with either a metal-backed or a non-metal-backed acetabular cup. All patients had identical cemented one-piece titanium femoral stems with a femoral head diameter of 28 mm. The mean linear wear rate was 0.11 mm/yr in metal-backed sockets and 0.08 mm/yr in non-metal-backed sockets (p = 0.0002). The mean volumetric wear rate was 66.2 mm3/yr in the metal-backed sockets and 48.2 mm3/yr in the polyethylene sockets (p = 0.0002). The addition of metal backing to a cemented acetabular cup therefore resulted in a 37% increase in mean polyethylene wear rates which may partially explain the higher failure rate of cemented metal-backed cups. Linear regression analysis also implicated increased follow-up time (log), gross acetabular migration, metal backing and male gender in increasing polyethylene wear. We advocate the use of an all-polyethylene cup in cemented total hip arthroplasty. The increas...