One-Stage Hip Revision Arthroplasty Using Megaprosthesis in Severe Bone Loss of The Proximal Femur Due to Radiological Diffuse Osteomyelitis

Abstract

Managing substantial proximal and/or distal femoral bone defects is one of the biggest challenges in chronic hip periprosthetic joint infection. Most authors use two-stage arthroplasty with a temporary antibiotic-loaded cement spacer for the management of these patients. In this study, we show our experience with one-stage exchange arthroplasty in managing severe bone defects due to radiological-extensive proximal femoral osteomyelitis. Two patients were included in the study. They showed radiological-extensive proximal femoral osteomyelitis, and they were treated with one-stage exchange arthroplasty using megaprosthesis. Diffuse osteomyelitis was confirmed in both cases; in one case, the histology was compatible with osteomyelitis, and the other case had a positive culture identified in a bone sample. At a minimum of a four-year follow-up, the patients did not reveal any clinical, radiological or laboratory signs of infection. In conclusion, one-stage exchange arthroplasty and megaprosthesis is an option for the treatment of chronic hip periprosthetic joint infection associated with radiological-diffuse proximal femoral osteomyelitis.

In Silico Contact Pressure of Metal-on-Metal Total Hip Implant with Different Materials Subjected to Gait Loading

“…Unfortunately, the wear particles of the polyethylene material in their articulation with the hard material can result in a reduced life span of the artificial hip joint [4][5][6]. The wear particles of polyethylene range in size between sub-micrometers to micrometers and can absorb into human bone resulting in mechanical loosening and fixation loss of implant components [7]. Ultimately, reoperation is required to correct the condition with a new hip joint prosthesis.…”

Minimizing Risk of Failure from Ceramic-on-Ceramic Total Hip Prosthesis by Selecting Ceramic Materials Based on Tresca Stress

“…The present study has worked to improve implant performance in ceramic materials selection. In addition, several efforts can be made to improve implant performance, including the evaluation of ceramic-on-ceramic couplings geometry [42], adding dimples on the contact surface [43], surface finish [44], and coating/surfacing applications [45]. Surgical procedures from orthopedic doctors also affect the resistance of the total hip prosthesis after primary surgery [46].…”