Endoprostheses for osteonecrosis of the femoral head

Grecula, Michael J.; Grigoris, P.; Schmalzried, Thomas P.; Dorey, Fred; Campbell, Patricia A.; Amstutz, Harlan C.

doi:10.1007/bf00181858

Cited by 29 publications

(4 citation statements)

References 35 publications

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“…There a few randomized controlled trials in advanced osteonecrosis. One by Grecula et al [120] in 1995 compared the outcomes of patients aged under 50 treated with either standard cemented arthroplasty, limited femoral resurfacing, or total hip resurfacing. When followed up at 96 months, results were found to be 80%, 70%, and 15%, respectively.…”

Section: Discussionmentioning

confidence: 99%

SAS Weekly Rounds: Avascular Necrosis

Hamilton¹,

Goodman

Figgie

2009

HSS Journal®

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Osteonecrosis of the femoral head is a condition that affects upwards of 10,000 individuals in the USA each year. The peak incidence is in the fourth decade of life, and overall, there is a male preponderance. The condition accounts for up to 12% of total hip arthroplasties performed in developed countries. The etiology can be traumatic or non-traumatic, with 90% of atraumatic cases attributed to corticosteroid therapy or excess alcohol consumption. Osteonecrosis of the femoral head reflects the final common pathway of a range of insults to the blood supply and ultimately results in femoral head collapse, acetabular involvement, and secondary osteoarthritis. Currently, conservative treatment options, which aim to correct pathophysiologic features allowing revascularization and new bone formation, appear to be able to delay but not halt the progression of this condition. As a consequence of femoral head osteonecrosis, many individuals undergo surgical treatments including: core decompression, osteotomy, non-vascularized bone matrix grafting, free vascularized fibular grafts, limited femoral resurfacing, total hip resurfacing, and total hip arthroplasty.

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Section: Discussionmentioning

confidence: 99%

SAS Weekly Rounds: Avascular Necrosis

Hamilton¹,

Goodman

Figgie

2009

HSS Journal®

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“…The experience of hemi-resurfacing arthroplasty for avascular necrosis of the femoral head, using a articulating surfaces also played a role in the early failure of cementless resurfacing systems. However, cemented cup articulating against the relatively intact acetabulum, has shed more light on the role as the implications of wear-debris-induced osteolysis were not fully appreciated at the time, failure was of polyethylene wear debris in the failure of hip resurfacing [31,32]. In the absence of polyethylene attributed to other factors including avascular necrosis of the femoral head and acetabular compo-wear debris, no cup loosening was observed and the hips that failed clinically required revision for groin nent loosening due to high frictional torque.…”

Section: Figmentioning

confidence: 99%

Hip resurfacing arthroplasty: The evolution of contemporary designs

Grigoris

Roberts

Panousis

et al. 2006

Proc Inst Mech Eng H

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Metal-on-metal hip resurfacing is considered by many as the most significant recent development in hip arthroplasty. It preserves proximal femoral bone stock, optimizes stress transfer to the proximal femur, and offers inherent stability and optimal range of movement. The early results of hip resurfacing in the 1970s and 1980s were poor and the procedure was largely abandoned by the mid-1980s. The expectation that these prostheses would be easy to revise was not often fulfilled. The large diameter of the articulation combined with thin polyethylene cups or liners resulted in accelerated wear and the production of large volumes of biologically active particulate debris, leading to bone loss and implant loosening. Failure has been attributed to other factors, mainly avascular necrosis of the femoral head. However, this concern has not been confirmed by retrieval studies. The failure of early hip resurfacings was essentially a consequence of the use of inappropriate materials, poor implant design, inadequate instrumentation, and crude surgical technique. It was not an inherent problem with the procedure itself. The renaissance of metal-on-metal articulations for total hip arthroplasty enabled the introduction of new hip resurfacings and most of the major implant manufacturers have already introduced such systems. Early results are encouraging and complications commonly seen in the 1970s and 1980s, such as early implant loosening and femoral neck fracture, now appear to be rare. Whilst early results should be regarded with caution, modern metal-on-metal hip resurfacing potentially offers the ultimate bone preservation and restoration of function in appropriately selected young patients.

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“…According to the U.S. Centers for Disease Control, there are approximately 360,000 hemiarthroplasty operations performed each year in the US (CDC/NCHS, 2013). Common indications for hemiarthroplasty include acute bone fracture or failed internal fixation, such as proximal femoral fractures of the hip (Giliberty, 1983), and proximal humeral fractures of the shoulder (Connor and D’Alessandro, 1995; Loew et al, 2006); osteonecrosis of the femoral or humeral head (Barnes et al, 1991; Baumgarten et al, 2004; Grecula et al, 1995); and low activity expectations (Cuckler and Tamarapalli, 1994). In all cases, hemiarthroplasty is indicated only if the non-resurfaced native articular layer shows no significant signs of disease, including osteoarthritis, rheumatoid arthritis, or Paget’s disease (Rodriguez-Merchan, 2002).…”

Section: Introductionmentioning

confidence: 99%

Wear and damage of articular cartilage with friction against orthopedic implant materials

Oungoulian

Durney

Jones

et al. 2015

Journal of Biomechanics

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The objective of this study was to measure the wear response of immature bovine articular cartilage tested against glass or alloys used in hemiarthroplasties. Two cobalt chromium alloys and a stainless steel alloy were selected for these investigations. The surface roughness of one of the cobalt chromium alloys was also varied within the range considered acceptable by regulatory agencies. Cartilage disks were tested in a configuration that promoted loss of interstitial fluid pressurization to accelerate conditions believed to occur in hemiarthroplasties. Results showed that considerably more damage occurred in cartilage samples tested against stainless steel (10 nm roughness) and low carbon cobalt chromium alloy (27 nm roughness) compared to glass (10 nm) and smoother low or high carbon cobalt chromium (10 nm). The two materials producing the greatest damage also exhibited higher equilibrium friction coefficients. Cartilage damage occurred primarily in the form of delamination at the interface between the superficial tangential zone and the transitional middle zone, with much less evidence of abrasive wear at the articular surface. These results suggest that cartilage damage from frictional loading occurs as a result of subsurface fatigue failure leading to the delamination. Surface chemistry and surface roughness of implant materials can have a significant influence on tissue damage, even when using materials and roughness values that satisfy regulatory requirements.

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Endoprostheses for osteonecrosis of the femoral head

Cited by 29 publications

References 35 publications

SAS Weekly Rounds: Avascular Necrosis

SAS Weekly Rounds: Avascular Necrosis

Hip resurfacing arthroplasty: The evolution of contemporary designs

Wear and damage of articular cartilage with friction against orthopedic implant materials

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