A Comparison of Two Implant Systems in Restoration of Hip Geometry in Arthroplasty

Archibeck, Michael J.; Cummins, Tamara; Carothers, Joshua T.; Junick, Daniel W.; White, Richard E.

doi:10.1007/s11999-010-1678-9

Cited by 58 publications

(29 citation statements)

References 13 publications

(13 reference statements)

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“…Following the successful introduction of modular heads, femoral stems with an additional modular junction between the neck and body of the stem soon became available. These so-called dualtaper stems allow for increased options for hip-center restoration by allowing for adjustments in offset, length, and version, which can be made independent of femoral stem fixation [1][2][3] . Most major device manufacturers offer stem designs with a modular neck option.…”

mentioning

confidence: 99%

Adverse Local Tissue Reaction Arising from Corrosion at the Femoral Neck-Body Junction in a Dual-Taper Stem with a Cobalt-Chromium Modular Neck

Cooper

Urban

Wixson

et al. 2013

The Journal of Bone and Joint Surgery-American Volume

342

246

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mentioning

confidence: 99%

Adverse Local Tissue Reaction Arising from Corrosion at the Femoral Neck-Body Junction in a Dual-Taper Stem with a Cobalt-Chromium Modular Neck

Cooper

Urban

Wixson

et al. 2013

The Journal of Bone and Joint Surgery-American Volume

342

246

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“…Na ta način je omogočena natančna prilagoditev odmika in usmeritev vratu stegnenice. Med spoloma obstajajo pomembne anatomske razlike glede premera, dolžine vratu in kota med vratom ter diafizo (CCD kot) stegnenice (1,2). Neustrezna restavracija biomehanike kolka pri vstavitvi totalne endoproteze lahko vodi v šepa-nje in hitrejšo obrabo umetnega sklepa.…”

Section: Uvodunclassified

Inovacijska past: izmenljivi vrat totalne kolčne endoproteze

Fokter¹,

Levašič

Kovač

2017

SlovMedJour

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IzvlečekIzhodišča: Inovacije so ključnega pomena za uspešnost ortopedske kirurgije. Žal lahko včasih že majhne spremembe v sicer ustaljenih kirurških postopkih in preizkušenih oblikah vsadkov vodijo v katastrofo. Zdi se, da nas razsežnost zlomov izmenljivih vratov (24 od okoli 4.000 vgrajenih) pri popolnoma modularni artroplastiki kolka, priljubljeni v naši deželi v zadnjih 20 letih, preizkuša v takšnih nesrečnih posledicah. Namen prispevka je analizirati obseg in vzroke problema ter predlagati možne rešitve.Metode: Zaradi težav z modelom kolčne endoproteze z izmenljivim vratom Profemur Z (ali zgodnejših različic z enako izvedbo samozapornega konusa), izdelane iz titanove zlitine (Ti6Al4V), smo iskali zapise o tem v ustrezni strokovni literaturi. Za natančno ovrednotenje uspešnosti tega tipa debla endoproteze smo pregledali registre artroplastike. Pozornost smo namenili tudi proučevanju mehanizmov zlomov modularnega vratu navedenega kolčnega vsadka.Rezultati: Posamezna poročila o katastrofalnih zlomih izmenljivih vratov kolčnih endoprotez Profemur Z so bila objavljena od leta 2010 dalje. Prvi slovenski primer je bil opisan v letu 2012. Dve večji skupini bolnikov z zlomi izmenljivih vratov sta bili objavljeni v letu 2016. Pogostejšo pojavnost revizijskih operacij zaradi zlomov obravnavanega pripomočka za rekonstrukcijo kolka je leta 2013 zaznal Avstralski register artroplastike. Javna agencija za zdravila in medicinske pripomočke (JAZMP) je prvi dve poročili o zapletu z izmenljivim vratom Profemur Z iz tujine prejela v letu 2010, prvo slovensko poročilo v letu 2012, skupno pa so do decembra 2016 prejeli 7 poročil iz slovenskih bolnišnic. Odgovornost za nesprejemljivo visoko pojavnost zlomov pripomočka pripisujemo koroziji na stiku izmenljivega vratu z deblom endoproteze, ki je posledica kombinacije dveh enakih ali različnih materialov, podvrženih nenehni obrabi ob prisotnosti telesne tekočine.Zaključki: Odgovornost za izdelavo in trženje izključno varnih izdelkov je na strani proizvajalcev, zdravniki pa moramo biti posebej pozorni na morebitne neželene učinke uvedenih novosti. JAZMP je ustrezno ukrepala šele po prejetju obvestila o odpoklicu medicinskega pripomočka -izmenljivega vratu dolge izvedbe iz kobalt-kromove zlitine s strani proizvajalca v letu 2015, saj zaradi neporočanja o vigilančnih zapletih v Republiki Sloveniji ni bila v celoti seznanjena z razsežnostjo zapleta. Nacionalni register artroplastike bi ortopedsko skupnost najverjetneje lahko prej opozoril na slabe rezultate obravnavane vprašljive inovacije. Vse deležnike zato s člankom pozivamo, da čimprej omogočijo vzpostavitev takšnega registra v dobrobit naših bolnikov. AbstractBackground: Innovations play the key role in the success of orthopaedic surgery. However, even minor modifications in the established concepts and proven designs may result in disasters. The endemic of modular femoral neck fracture (24 cases of about 4000 implanted) in fully modular total hip arthroplasty, popular in our country for the last 20 years, seems to challenge us wit...

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“…The attraction of this degree of modularity to the operating surgeon is clear. Armed with these options, alterations to the offset, version and length of the final implanted device can be achieved independent of the femoral stem fixation, thus restoring the hip centre [5] .…”

Section: Introductionmentioning

confidence: 99%

Trunnionosis: A pain in the neck

Pastides

Dodd²,

Sarraf³

et al. 2013

WJO

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Metal-on-metal (MoM) hip replacements have proven to be a modern day orthopaedic failure. The early enthusiasm and promise of a hard, durable bearing was quickly quashed following the unanticipated wear rates. The release of metal ions into the blood stream has been shown to lead to surrounding soft tissue complications and early failure. The devastating destruction caused has led to a large number of revision procedures and implant extractions. The resulting research into this field has led to a new area of interest; that of the wear at the trunnion of the prosthesis. It had been previously thought that the metal debris was generated solely from the weight bearing articulation, however with the evolution of modularity to aid surgical options, wear at the trunnion is becoming more apparent. The phenomenon of "trunnionosis" is a rapidly developing area of interest that may contribute to the overall effect of metallosis in MoM replacements but may also lead to the release of metal ions in non MoM hip designs. The aim of this paper is to introduce, explain and summarise the evidence so far in the field of trunnionosis. The evidence for this phenomenon, the type of debris particles generated and a contrast between MoM, non MoM and resurfacing procedures are also presented.

show abstract

A Comparison of Two Implant Systems in Restoration of Hip Geometry in Arthroplasty

Abstract: Level II, prognostic study. See Guidelines for Authors for a complete description of levels of evidence.

Cited by 58 publications

References 13 publications

Adverse Local Tissue Reaction Arising from Corrosion at the Femoral Neck-Body Junction in a Dual-Taper Stem with a Cobalt-Chromium Modular Neck

Adverse Local Tissue Reaction Arising from Corrosion at the Femoral Neck-Body Junction in a Dual-Taper Stem with a Cobalt-Chromium Modular Neck

Inovacijska past: izmenljivi vrat totalne kolčne endoproteze

Trunnionosis: A pain in the neck

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