Total Hip Arthroplasty in the Very Young Patient

Polkowski, Gregory G.; Callaghan, John J.; Mont, Michael A.; Clohisy, John C.

doi:10.5435/jaaos-20-08-487

Cited by 88 publications

(71 citation statements)

References 34 publications

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“…Revision surgery to address such failure involves increased risks, complications, and costs. Given that the average life expectancy of many patients undergoing total hip arthroplasty (THA) exceeds 25 years, ongoing stress shielding is clinically important and the demand for implants which maximize the load-bearing capabilities of the bone is high [16, 17]. …”

Section: Introductionmentioning

confidence: 99%

Minimizing Stress Shielding and Cement Damage in Cemented Femoral Component of a Hip Prosthesis through Computational Design Optimization

Moussa

Fischer

Yadav

et al. 2017

Advances in Orthopedics

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The average life expectancy of many people undergoing total hip replacement (THR) exceeds twenty-five years and the demand for implants that increase the load-bearing capability of the bone without affecting the short- or long-term stability of the prosthesis is high. Mechanical failure owing to cement damage and stress shielding of the bone are the main factors affecting the long-term survival of cemented hip prostheses and implant design must realistically adjust to balance between these two conflicting effects. In the following analysis we introduce a novel methodology to achieve this objective, the numerical technique combines automatic and realistic modeling of the implant and embedding medium, and finite element analysis to assess the levels of stress shielding and cement damage and, finally, global optimization, using orthogonal arrays and probabilistic restarts, were used. Applications to implants, fabricated using a homogeneous material and a functionally graded material, were presented.

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Section: Introductionmentioning

confidence: 99%

Minimizing Stress Shielding and Cement Damage in Cemented Femoral Component of a Hip Prosthesis through Computational Design Optimization

Moussa

Fischer

Yadav

et al. 2017

Advances in Orthopedics

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“…Young patients present a unique dilemma for bearing survivorship in that they not only live longer, but commonly pursue more physically demanding activities that place significantly more stresses across the articulation surfaces [12, 42]. Currently, few reports in the literature focus on long-term results of HXLPLE in younger cohorts [3], which is an important issue to clarify due to recent problems with hip resurfacing, metal-on-metal, and primary modular implants.…”

Section: Introductionmentioning

confidence: 99%

Long-Term Results of Total Hip Arthroplasty with 28-Millimeter Cobalt-Chromium Femoral Heads on Highly Cross-Linked Polyethylene in Patients 50Years and Less

Stambough

Pashos

Bohnenkamp

et al. 2016

The Journal of Arthroplasty

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Highly cross-linked polyethylene (HXLPE) is the most commonly used bearing surface in total hip arthroplasty (THA) because of its superior wear properties, but long-term results in young patients are limited. We report on the clinical outcome, radiographic wear patterns and survivorship of 72 patients ≤50 years old who had a 28-millimeter cobalt-chromium femoral head on HXLPE acetabular liner. Mean and median true linear wear rates at average ten-year follow-up were 0.0104 and 0.016 mm per year +/− 0.07 mm. Mean and median two-dimensional volumetric wear rates were 12.79 mm3 and 5.834 mm3 per year +/− 26.1mm3 as determined by Martell analysis. As a result of the minimal wear profile, there was no evidence of radiographic osteolysis and no wear-related revisions.

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“…2,3 Although hip replacement is an effective approach to relieve pain and improve hip function in the short term, its long-term performance remains unsatisfactory. 4,5 Furthermore, non-traumatic ONFH typically occurs in young adults and involves both hips. On the other hand, not all ONFH will progress to femoral head collapse.…”

Section: Advances In Knowledgementioning

confidence: 99%

Osteonecrosis of the femoral head: using CT, MRI and gross specimen to characterize the location, shape and size of the lesion

Hu¹,

Huang²,

Wei³

et al. 2015

BJR

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of the femoral head: using CT, MRI and gross specimen to characterize the location, shape and size of the lesion. Br J Radiol 2015;88:20140508. FULL PAPER Osteonecrosis of the femoral head: using CT, MRI and gross specimen to characterize the location, shape and size of the lesion The results were compared with findings from coronal sectional gross specimens. Two radiologists independently measured the volume of necrotic lesions from CT and MR images using computer software, and the results were averaged. The volume of specimens' necrotic lesion was measured using the water displacement method.Results: There was a high degree of consistency between CT, MRI and the coronal sectional gross specimen on the location, shape and spatial structure of lesions.Differences of the lesion volume measured from CT and MR images were not statistically significant between two radiologists. The necrotic lesion volumes measured from CT and MR images and gross specimens were 22.07 6 5. Osteonecrosis of the femoral head (ONFH) is a common disease of the hip joint. If untreated, 80% of patients with ONFH will suffer the collapse of femoral head articular surface in a few years of disease progression.1 Once the femoral head collapses, osteoarthritis becomes inevitable and function of the hip joint will be seriously affected, which eventually will lead to artificial joint replacement. 2,3Although hip replacement is an effective approach to relieve pain and improve hip function in the short term, its long-term performance remains unsatisfactory.4,5 Furthermore, non-traumatic ONFH typically occurs in young adults and involves both hips. On the other hand, not all ONFH will progress to femoral head collapse.6 Therefore, being able to accurately predict the risk of femoral head collapse according to the disease severity and to take appropriate therapeutic measures are critical to preserve the hip joint and improve the prognosis of ONFH. 7 Studies have shown that the size and location of necrotic lesions are major factors associated with femoral head collapse.6-9 Although various approaches have been reported to illustrate the lesion location and size, all were based on MRI and/or radiographs.6-11 As a main imaging modality for diagnosis of ONFH, CT can clearly display ONFH that is in Association Research Circulation Osseous (ARCO) stage II or above. Multislice CT can achieve isotropic resolution. Volume data acquired from axial scans can be used to reconstruct in any direction to observe lesions. But so far, there has been no study that reports the feasibility and accuracy of using CT to measure the size of ONFH lesions. We hypothesized that CT and MRI could achieve highly consistent results in illustrating the size, shape and location of ONFH lesions in ARCO stage II and above, and both methods can be used to assess the risk of necrotic femoral head collapse.The objectives of this study are (1) to investigate the accuracy of using CT to capture the size, location, shape and spatial structural relationship of the necrotic lesion by com...

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Total Hip Arthroplasty in the Very Young Patient

Cited by 88 publications

References 34 publications

Minimizing Stress Shielding and Cement Damage in Cemented Femoral Component of a Hip Prosthesis through Computational Design Optimization

Minimizing Stress Shielding and Cement Damage in Cemented Femoral Component of a Hip Prosthesis through Computational Design Optimization

Long-Term Results of Total Hip Arthroplasty with 28-Millimeter Cobalt-Chromium Femoral Heads on Highly Cross-Linked Polyethylene in Patients 50Years and Less

Osteonecrosis of the femoral head: using CT, MRI and gross specimen to characterize the location, shape and size of the lesion

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