Mid-Term Survival of Total Hip Arthroplasty in Patients Younger Than 55-year-old

Lombardi, Adolph V.; Byrd, Zackary O.; Berend, Keith R.; Morris, Michael J.; Adams, Joanne B.; Crawford, David A.

doi:10.1016/j.arth.2022.02.092

Cited by 5 publications

(2 citation statements)

References 34 publications

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“…Konopitski et al’s meta-analysis and systematic review highlight how advances in surgical techniques and implant technology, such as the shift from metal on ultra-high molecular weight polyethylene (UHMWPE) to modern THA using ceramic on highly cross-linked polyethylene (HXLPE), have improved implant longevity [ 34 ]. Specifically, younger patients fitted with modern vitamin E-stabilized HXLPE liners show no increased revision rates at mid-term follow-up [ 35 ]. Additionally, Vendittoli et al’s long-term prospective study underscores the benefits of CoC bearings in an active, younger patient demographic, where wear-related reactions pose significant concerns [ 36 ].…”

Section: Discussionmentioning

confidence: 99%

Extreme Serum Titanium Concentration Induced by Acetabular Cup Failure: Unveiling a Unique Scenario of Titanium Alloy Debris Accumulation

Fokter,

Ledinek,

Kljaić Dujić

et al. 2024

Bioengineering

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The majority of contemporary total hip arthroplasty (THA) implants are constructed from Ti alloys, which are generally believed to generate fewer adverse local tissue reactions (ALTRs) compared to CoCr alloys. This study presents a case of unusual primary THA failure where a substantial release of Ti alloy debris was observed. A 52-year-old active male underwent THA after post-traumatic aseptic necrosis of the femoral head in 2006. Seventeen years after the procedure, the patient presented with groin pain and a restricted range of motion. X-rays revealed the protrusion of the alumina ceramic head through the Ti6Al4V acetabular cup. Trace element analysis indicated significantly elevated levels of serum Ti, Al, and V. CT and MRI confirmed Ti alloy cup failure and a severe ALTR. During revision surgery, it was found that the worn-out ceramic head was in direct contact with the acetabular cup, having protruded through a central hole it had created over time. No acetabular liner was found. Histological analysis of his tissue samples showed wear-induced synovitis with areas of multinucleated foreign body giant cells and the accumulation of numerous metal particles but no acute inflammatory response. Six months after the revision THA, the patient has experienced favourable outcomes. This case provides an instructive illustration for studying the consequences of the substantial release of Ti alloy debris from orthopedic implants.

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Section: Discussionmentioning

confidence: 99%

Extreme Serum Titanium Concentration Induced by Acetabular Cup Failure: Unveiling a Unique Scenario of Titanium Alloy Debris Accumulation

Fokter,

Ledinek,

Kljaić Dujić

et al. 2024

Bioengineering

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show abstract

“…The majority of patients with a score of 8 have a poor prognosis, ultimately leading to collapse. Once collapse occurs, due to the limited lifespan of the prosthesis, the patient's age should be considered when choosing therapy method [ 30 , 31 ]. The previous research has found that THA with ultra-short uncemented stem or ceramic-on-ceramic bearing provides successful survival and functional outcomes in young patients, while for skeletally immature patients, individualized surgical treatment should be chosen according to the patient's own situation [ 32 – 34 ].…”

Section: Discussionmentioning

confidence: 99%

Analysis of the natural collapse course of non-traumatic osteonecrosis of the femoral head based on the matrix model

Zhao,

Wang,

Hao

et al. 2024

J Orthop Surg Res

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Background There are many predictions about the progression of natural collapse course of osteonecrosis of the femoral head. Here, we aimed to combine the three classical prediction methods to explore the progression of the natural collapse course. Methods This retrospective study included 127 patients admitted to our hospital from October 2016 to October 2017, in whom the femoral head had not collapsed. Logistic regression analysis was performed to determine the collapse risk factors, and Kaplan–Meier survival curves were used for femoral head survival analysis. The collapse rate of the femoral head was recorded within 5 years based on the matrix model. The specificity of the matrix model was analyzed using the receiver operating characteristic curve. Results A total of 127 patients with a total of 202 hips were included in this study, and 98 hips collapsed during the follow-up period. Multivariate logistics regression analysis showed that the predictive ability of the matrix model was stronger than Association Research Circulation Osseous staging, Japanese Investigation Committee classification, and area (P < 0.05). Kaplan–Meier survival curve showed that the median survival time of femoral head in patients was 3 years. The result of the receiver operating characteristic curve analysis showed that the area under the curve (AUC) of the matrix model had better predictive value (AUC = 0.771, log-rank test: P < 0.001). Conclusion We creatively combined the three classical prediction methods for evaluating the progression of the natural collapse course based on the matrix model and found that the higher the score of the matrix model, the higher the femoral head collapse rate. Specifically, the matrix model has a potential value in predicting femoral head collapse and guiding treatment selection.

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Risk factors for residual pelvic obliquity one year after total hip arthroplasty

Ozawa,

Osawa,

Takegami

et al. 2024

Eur J Orthop Surg Traumatol

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Purpose It is not uncommon for patients with hip disorders to present with pelvic obliquity (PO), and residual PO after total hip arthroplasty (THA) may not only affect hip joint function but also cause adjacent intervertebral joint disorders. This study aimed to investigate the postoperative PO impact on clinical outcomes and risk factors by comparing patients who had PO after THA to those who did not. Methods A single-center, retrospective cohort study was conducted. A total of 103 patients who underwent THA were included in this study from 2018 to 2020. Demographics, functional outcomes, and spinopelvic parameters were compared between post-THA PO of less than 2° (NT group, 55 patients) and PO of 2° or more (O group, 48 patients). Multivariate analysis was performed using factors with significant differences in univariate analysis. Results Postoperative Harris Hip Score Activity was significantly lower in the T group than in the NT group (p = 0.031). Preoperative PO was smaller in the NT group than in the T group (p = 0.001). Preoperative lumbar bending range (LBR) was significantly more flexible in the NT group than in the T group. In the logistic regression analysis, Age (odds ratio 0.957, 95% CI 0.923–0.993, p = 0.020), preoperative PO (odds ratio 1.490, 95% CI 1.100–2.020, p = 0.001), and LBR (odds ratio 0.848, 95% CI 0.756–0.951, p = 0.005) were found to be significant factors. Conclusion Younger age and large preoperative PO, and poor lumbar spine mobility were identified as risk factors for residual postoperative PO.

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Mid-Term Survival of Total Hip Arthroplasty in Patients Younger Than 55-year-old

Cited by 5 publications

References 34 publications

Extreme Serum Titanium Concentration Induced by Acetabular Cup Failure: Unveiling a Unique Scenario of Titanium Alloy Debris Accumulation

Extreme Serum Titanium Concentration Induced by Acetabular Cup Failure: Unveiling a Unique Scenario of Titanium Alloy Debris Accumulation

Analysis of the natural collapse course of non-traumatic osteonecrosis of the femoral head based on the matrix model

Risk factors for residual pelvic obliquity one year after total hip arthroplasty

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