Improving the Accuracy of Acetabular Component Orientation: Avoiding Malpositioning

Moskal, Joseph T.; Capps, Susan G.; Scanelli, John

doi:10.2106/jbjs.l.00685

Cited by 10 publications

(10 citation statements)

References 32 publications

(29 reference statements)

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“…Malpositioning of metal‐on‐metal HR can be catastrophic. Edge loading especially, in addition to rim impingement and acetabular component deformation, can result in bearing failure, metallosis and pseudotumours 1,2,4 . This study confirms that functional positioning in HR results in improved precision and accuracy in achieving functional acetabular ideal zones.…”

Section: Discussionsupporting

confidence: 70%

“…Malpositioning of the acetabular component in total hip arthroplasty (THA) can lead to instability, impingement and edge loading, 1,2 when the head‐cup contact patch extends over the cup rim 3 . In hip resurfacing (HR), partly because of a large femoral component diameter, these prostheses have a low dislocation rate, potentially allowing suboptimal positioning of the acetabular component 4 .…”

Section: Introductionmentioning

confidence: 99%

“…In hip resurfacing (HR), partly because of a large femoral component diameter, these prostheses have a low dislocation rate, potentially allowing suboptimal positioning of the acetabular component 4 . Malpositioning of metal‐on‐metal bearings results in edge loading and can lead to bearing failure and increased wear, and highly destructive reactions from metal debris 1,2,4 …”

Section: Introductionmentioning

confidence: 99%

“…4 Malpositioning of metal-on-metal bearings results in edge loading and can lead to bearing failure and increased wear, and highly destructive reactions from metal debris. 1,2,4 Metal-on-metal HR is predominantly used for osteoarthritis in younger males. 4 Australian Orthopaedic Association National Joint Replacement Registry indicates a mean age of 53 and 79.7% performed in men.…”

Section: Introductionmentioning

confidence: 99%

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Functional navigation in hip resurfacing

Waters

D’Alessandro

Yates

2020

ANZ Journal of Surgery

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Malpositioning of metal‐on‐metal hip resurfacing can have catastrophic outcomes. Edge loading especially, in addition to rim impingement and deformation of the acetabular component, can result in bearing failure and metallosis and pseudotumours from cobalt and chromium metal debris. This study has confirmed that the use of functional positioning in hip resurfacing results in improved precision and accuracy in achieving functional acetabular ideal zones. Overall the use of functional navigation in hip resurfacing has achieved both improved clinical outcomes and decreased complication rates leading to revision or failure.

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Section: Discussionsupporting

confidence: 70%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Functional navigation in hip resurfacing

Waters

D’Alessandro

Yates

2020

ANZ Journal of Surgery

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“…The first, the Registro dell'implantologia Protesica Ortopedica (Register of the Orthopaedic Prosthetic Implants), known as the RIPO Report from the Emilia-Romagna region of Italy, reports the rates of revision for THA from 2000 to 2013; the rate of revision for cementless THA was higher than for cemented THA for aseptic loosening of the femoral stem, recurrent dislocation/subluxation, and periprosthetic fracture (Table 2) [37]. The difference in revision rates for recurrent dislocation and/or subluxation was very small (cementless: 16.8% vs cemented: 16.0%); dislocation of THA is somewhat dependent on surgical accuracy and may be less influenced by fixation [40]. The second, from the National Joint Registry of England, Wales and Northern Ireland, found similar results; revision for aseptic loosening, dislocation, and periprosthetic fracture was higher for cementless THA (Table 3); again, the smallest difference was for revision due to dislocation [38].…”

Section: Resultsmentioning

confidence: 99%

Still no single gold standard for using cementless femoral stems routinely in total hip arthroplasty

Moskal

Capps²,

Scanelli³

2016

Arthroplasty Today

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BackgroundThere is now a clear trend with increased usage of cementless femoral stems for all ages and most patients. As the number of total hip arthroplasties (THAs) performed annually continues to increase with expanding indications for THA and demands for improved quality of life, so will the prevalence of THA in the elderly and aging populations. This is worrisome as the risk of complications with cementless femoral stems increases in elderly patients and those with poor bone quality. The purpose of this study is to analyze the available data from comparative studies to determine whether cementless femoral stems are overused and whether cemented stems warrant increased consideration.MethodsUsing Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, searches were performed to find original studies comparing cementless and cemented femoral stems; large population registry studies and reports were also included.ResultsThis systematic review documents that older patients with cementless fixation increase the risk of revision, there is no clear fixation advantage in midaged patients, and younger patients fare better with cementless fixation. Complications after THA create burdens on the health care system and on patients.ConclusionsUsing evidence-based data should be better guidance in selecting the most reliable implants for THA. Although cementless femoral fixation for THA has evolved to the “new standard,” it has not been proven to be the “gold standard” for all patients.

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