New Bearing Surfaces in Total Hip Replacement

Schwartsmann, Carlos Roberto; Boschin, Leonardo Carbonera; Gonçalves, Ramiro Zilles; Yépez, Anthony Kerbes; Spinelli, Leandro de Freitas

doi:10.1016/s2255-4971(15)30079-3

Cited by 9 publications

(7 citation statements)

References 34 publications

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“… 4 , 5 , 6 The main problem related to wear is the generation of debris, which can incite a highly inflammatory biological response that can lead to subsequent localized periprosthetic bone loss, and consequently, re-surgery is required. 7 Particularly for ultra-high molecular weight polyethylene (UHMWPE) cup liners, high wear occurs mostly in the superior-lateral portion of the liner, 8 and the consequent debris generation into the body becomes a main factor to limiting the life of the implant. 1 …”

Section: Introductionmentioning

confidence: 99%

Importance of preclinical evaluation of wear in hip implant designs using simulator machines

Trommer

Maru

2017

Revista Brasileira de Ortopedia (English Edition)

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Total hip arthroplasty (THA) is a surgical procedure that involves the replacement of the damaged joint of the hip by an artificial device. Despite the recognized clinical success of hip implants, wear of the articulating surfaces remains as one of the critical issues influencing performance. Common material combinations used in hip designs comprise metal-on-polymer (MoP), ceramic-on-polymer (CoP), metal-on-metal (MoM), and ceramic-on-ceramic (CoC). However, when the design of the hip implant is concerned besides the materials used, several parameters can influence its wear performance. In this scenario, where the safety and efficacy for the patient are the main issues, it is fundamental to evaluate and predict the wear rate of the hip implant design before its use in THA. This is one of the issues that should be taken into account in the preclinical evaluation step of the product, in which simulated laboratory tests are necessary. However, it is fundamental that the applied motions and loads can reproduce the wear mechanisms physiologically observed in the patient. To replicate the in vivo angular displacements and loadings, special machines known as joint simulators are employed. This article focuses on the main characteristics related to the wear simulation of hip implants using mechanical simulators, giving information to surgeons, researchers, regulatory bodies, etc., about the importance of preclinical wear evaluation. A critical analysis is performed on the differences in the principles of operation of simulators and their effects on the final results, and about future trends in wear simulation.

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Section: Introductionmentioning

confidence: 99%

Importance of preclinical evaluation of wear in hip implant designs using simulator machines

Trommer

Maru

2017

Revista Brasileira de Ortopedia (English Edition)

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“…The increased life expectancy has elevated the number of procedures 1, 2, 3. In the United States, more than 168,000 THAs and 30,000 implant substitutions are performed per year.…”

Section: Introductionmentioning

confidence: 99%

Total hip arthroplasty complications in patients with or without controlled diabetes mellitus during hospitalization

Falcão

Dias

Wolfovitch

et al. 2016

Revista Brasileira de Ortopedia (English Edition)

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IntroductionTotal hip arthroplasty (THA) is a procedure that aims to restore the function of the hip joint. Diabetes mellitus (DM) is one of the most prevalent comorbidities among patients undergoing THA. DM involves various immunological and metabolic aspects, which lead to limitations and surgical complications.ObjectiveTo evaluate the association between THA complications and controlled DM during hospitalization period.MethodsCross-sectional research through the analysis of retrospective records of a private hospital in Salvador, Bahia. The chi-squared and Fisher's exact tests were used in SAS statistical program.ResultsMost patients were elderly females. The most prevalent comorbidities in the sample were hypertension and diabetes. The most frequent underlying pathology in the sample was coxarthrosis; among patients with DM, it was femoral neck fracture. The most common complications were changes in the hemolymphopoietic system, among which anemia was the most frequent complication. Cardiovascular, nervous, and blood glucose complications were positively associated with controlled DM. In turn, hemolymphopoietic, genitourinary, digestive, electrolyte, and infectious complications were not associated with DM. Having DM was a protective factor for thermal complications. There was no statistically significant difference between patients that had or did not have DM in each complication group studied.ConclusionPatients with controlled DM did not present more complications than those without DM during hospitalization in the post THA.

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“…These collective findings suggest that in the pediatric patient, special consideration should be given to both the mode of implant fixation and the type of bearing surfaces. With respect to bearing surfaces, ceramics have the lowest documented wear rate of any commercially available bearing surfaces and may be particularly beneficial in the active pediatric patient, a notion that has also been demonstrated in the literature [12,43]. Depending on institutional availability, ceramic-onceramic or ceramic-on-highly-crosslinked UHMWPE may be the preferred bearing surfaces to ensure implant longevity and minimize the long-term risk of osteolysis [40].…”

Section: Discussionmentioning

confidence: 97%

Total Hip Arthroplasty for the Sequelae of Femoral Neck Fractures in the Pediatric Patient

et al. 2020

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Although rare, total hip arthroplasty (THA) may be indicated in pediatric patients with degenerative changes of the hip joint after previous trauma. To illustrate management principles in this patient population, this study describes the case of a 15-year-old female who sustained bilateral femoral neck fractures after a generalized tonic-clonic seizure, an atypical, low-energy mechanism for this injury. These fractures were not diagnosed until 14 weeks after the seizure episode, at which point they had progressed to nonunion on the left side, malunion on the right side, and degenerative hip joint changes were developing bilaterally. Bilateral THA was ultimately performed, and the patient had favorable outcomes at 1 year postoperatively. In determining the optimal management strategy for such patients, a multidisciplinary approach should be used, with input from the patient's family, pediatrician, pediatric endocrinologist, pediatric orthopaedic surgeon, and adult reconstruction surgeon. From a surgical standpoint, this report highlights the importance of selecting the appropriate bearing surfaces, broaching technique, mode of implant fixation, and implant features when performing THA in the active pediatric patient.

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New Bearing Surfaces in Total Hip Replacement

Cited by 9 publications

References 34 publications

Importance of preclinical evaluation of wear in hip implant designs using simulator machines

Importance of preclinical evaluation of wear in hip implant designs using simulator machines

Total hip arthroplasty complications in patients with or without controlled diabetes mellitus during hospitalization

Total Hip Arthroplasty for the Sequelae of Femoral Neck Fractures in the Pediatric Patient

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