Curved-stem Hip Resurfacing

Pritchett, James W.

doi:10.1007/s11999-008-0165-z

Cited by 22 publications

(5 citation statements)

References 31 publications

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“…It is possible, however, for a patient to prefer a prosthesis that ultimately does not perform as well as another. In my prior study, all of 27 patients who had an HRA on 1 side and a conventional THA on the other preferred the HRA 15 . Several—but not all—comparison studies have shown HRA to have advantages over THA 3 - 8 .…”

Section: Discussionmentioning

confidence: 95%

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Hip Replacement or Hip Resurfacing with a Highly Cross-Linked Polyethylene Acetabular Bearing

Pritchett

2020

JBJS Open Access

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Background: Most surgeons strongly prefer total hip arthroplasty (THA) over hip resurfacing arthroplasty (HRA). However, it is unknown whether patients prefer the results of 1 procedure over the other. The purpose of this study was to answer 3 questions: (1) Do patients with an HRA on 1 side and a THA on the other notice a difference? (2) Do patients have a preference? (3) What are the reasons for their preference? Methods: Between 1998 and 2012, 332 patients underwent staged bilateral hip arthroplasties with cementless THA on 1 side and HRA on the other, with a highly cross-linked polyethylene acetabular component used for both. Patient preferences, Harris hip scores, and Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) scores were recorded by blinded examiners. Patients provided reasons for their preference in semi-structured interviews using both quantitative and qualitative measures. Results: The mean follow-up was 11 years (range, 7 to 21 years). Of 324 patients with complete data, 279 (86%) preferred the HRA, 19 (6%) preferred the THA, and 26 (8%) had no preference. The most common reasons for preference for the HRA were better balance (n = 143), felt more normal (n = 141), better activity participation/more reliable hip during sports (n = 139), and stronger on stairs (n = 129). A fair or poor outcome was reported by the patient after 4 HRAs and 7 THAs. The remainder of the patients reported improved function and satisfactory pain relief and range of motion for both hips. Conclusions: In conclusion, most patients in this study preferred the side on which the HRA had been done. Since essentially all current hip prostheses perform well, a paired bilateral study may be the optimal way to determine patient preferences and values of HRA compared with THA. Level of Evidence: Therapeutic Level III. See Instructions for Authors for a complete description of levels of evidence.

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Section: Discussionmentioning

confidence: 95%

“…There are reasons beyond femoral bone conservation for surgeons to consider HRA. There is less stress-shielding of the proximal part of the femur with HRA, since the endosteal medullary surface of the femur is loaded more physiologically 15 , 16 . Complications such as infection and instability can be more difficult to treat after THA 16 .…”

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confidence: 99%

Hip Replacement or Hip Resurfacing with a Highly Cross-Linked Polyethylene Acetabular Bearing

Pritchett

2020

JBJS Open Access

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“…Femoral neck fracture is a rare complication after hip resurfacing, occurring at reported rates of 0% to 7%. Femoral components placed in 5° valgus have a factor of 6.1 reduction in the relative risk of an adverse outcome [ 18 , 19 ]. These findings emphasize that sufficient and careful preoperative planning is essential to improve the outcomes and longevity of surface arthroplasty.…”

Section: Discussionmentioning

confidence: 99%

Mid-Term Results of Metal-on-Metal Hip Resurfacing for Treatment of Osteoarthritis Secondary to Developmental Dysplasia of the Hip: A Minimum of 8-Years of Follow-Up

Jiang

Zhao

et al. 2014

Med Sci Monit

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BackgroundMetal-on-metal resurfacing arthroplasty is an attractive alternative to conventional total hip arthroplasty in patients with osteoarthritis secondary to developmental dysplasia of the hip (DDH). The purpose of this study was to assess the mid-term clinical outcome and mid-term survivorship of Metal-on-metal resurfacing arthroplasty in patients suffering from osteoarthritis secondary to DDH.Material/MethodsBetween May 2003 and Dec. 2005, 15 operations using ASR™ and 19 using Corin were performed in 29 patients to treat advanced osteoarthritis secondary to DDHs. There were 6 males (20.7%) and 23 females (79.3%), with an average age of 47.2 years (range, 36–64 years). Clinical and radiographic results were observed. All patients were followed up at the 1st, 2nd, 3rd, 6th, and 12th months after surgery and annually thereafter.ResultsThe overall survival was 88.2% at a minimum follow-up of 8 years, but the survival was 91.2% after excluding the infections as the cause of component loosening and failure. The mean Harris hip score improved from 48.27±3.13 (range, 14–71) to 89.63±3.42 (range, 65–100) at latest follow-up. The flexion was from 75.14±8.05° to 107.21±9.34. Only 4 failed because of deep infection, femoral neck fracture, and aseptic loosening.ConclusionsMetal-on-metal resurfacing arthroplasty showed perfect results at a minimum of 8-years of follow-up in our study, and may be a reasonable option for osteoarthritis secondary to developmental dysplasia of the hip (DDH).

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“…The acetabular and bipolar polyethylene are from 3.23–3.68 mm in minimum thickness. The acetabular shells are 2 mm thick and the coating for cementless fixation adds another 1 mm ( 13 , 21 , 22 ). The polyethylene bearings are GUR 1020 cross-linked at 7.5 Mrad.…”

Section: Methodsmentioning

confidence: 99%

Wear and performance of a tripolar total hip replacement

Pritchett¹

2022

Ann Joint

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Background An unconstrained tripolar hip replacement matches a large capacity two-piece metal/polyethylene acetabular component with a bipolar prosthesis. This combination of accepted technology is different than the relatively new dual mobility prosthesis. The goal is to protect against dislocation and allow close to a normal range of motion (ROM). So far there has not been enough information about wear and performance of tripolar hip replacement to support its wide use. Methods Twenty-four tripolar prostheses were retrieved from 23 patients after a mean of 14 years (range, 5–21 years). All implants had been placed in high-demand patients who participated in adventure sports, had occupations where a dislocation would be dangerous, or in patients undergoing revision. The tripolar prosthesis has three important design features: (I) the acetabular component uses highly cross-linked polyethylene with an internal diameter of 41–54 mm, (II) the bipolar is titanium nitride-coated, and (III) the bipolar prosthesis has positive eccentricity. The retrievals were evaluated for wear, performance, and mechanical function. Results The total volumetric wear was 24 mm 3 /yr. compared to 54 mm 3 /yr. For a dual mobility prosthesis and 38 mm 3 /yr. for a 40 mm conventional hip replacement. The jump distance was 16 mm compared to 12 mm for a 36 mm hip replacement. There was no osteolysis. The combined flexion/extension was 145 compared to 119 for a conventional prosthesis. The mean UCLA score was 7.9. Radiographs showed continued shared movement between the inner and outer articulations. The prosthetic bipolar separation force was 2,180 N. High-demand activities generate approximately 340 N. Conclusions The wear of this tripolar hip prosthesis is low below the osteolytic threshold. The increased ROM and increased jump distance provide the most stable unconstrained hip replacement available. The wear and mechanical performance seen in this study suggest a lifetime of use is possible in even the highest demand patients. The absence of intraprosthetic dislocation, metal wear reaction, and limited acetabular stress shielding make this a safer technology compared to a dual mobility prosthesis.

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Curved-stem Hip Resurfacing

Cited by 22 publications

References 31 publications

Hip Replacement or Hip Resurfacing with a Highly Cross-Linked Polyethylene Acetabular Bearing

Hip Replacement or Hip Resurfacing with a Highly Cross-Linked Polyethylene Acetabular Bearing

Mid-Term Results of Metal-on-Metal Hip Resurfacing for Treatment of Osteoarthritis Secondary to Developmental Dysplasia of the Hip: A Minimum of 8-Years of Follow-Up

Wear and performance of a tripolar total hip replacement

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