Uncemented Total Hip Replacement

Abstract

Summary: During the last 20 years almost 3000 uncemented total hip replacements have been used in the treatment of osteoarthritis and rheumatoid arthritis. The development of an axially located prosthesis is outlined, and the causes of failure indicated. Uncemented prostheses have the advantage of a relatively low mortality and morbidity and the rate of infection in particular is low. Interface pain, with or without frank prosthetic loosening, is the commonest cause of failure, but revisional surgery is relatively easy, and usually successful. Loss of function without significant pain may occur after many years from distal migration of the femoral component. The development of an uncemented metal-onplastic joint has produced better short-term results than the metal-on-metal articulation, probably because of its lower frictional coefficient and the use of a wider range of pelvic and femoral components.

New joints for the Millennium: Wear control in total replacement hip joints

“…head, since McKee wrote that the Vitallium components However, clinical experience was to show that some were 'lapped-in'. metal-on-metal implants survived for long periods, in In due course the need for a small but nite clearance excess of 20 years, with very little wear [42,[71][72][73][74][75][76][77][78]. The between the components was recognized, mainly to limit early promise of these mid-century metal-on-metal total equatorial binding and excessive friction.…”

“…9 McKee-Farrar metal-on-metal total replacement hip joint 4 Overall clinical penetration rates in total hip replacefriction torques. In the early 1970s Ring [73] reported ments [42] on the performance of 591 total hip replacements implanted between 1 and 8 years previously. clearance was introduced.…”

Tribology and corrosion in hip joint replacements: materials and engineering

“…other forms of metal-on-metal total hip replacements were developed in the 1950s and 1960s, notably the Ring (1968Ring ( , 1971) with its integral cup and long pelvic screw, the sivash (1969), with its constrained head, the Müller, with three intriguing plastic pads within the bearing region of the acetabular cups to minimise friction (see semlitsch and willert, 1997) and the stanmore (see Duff-Barclay et al, 1966), with its horseshoe-shaped bearing area in the acetabular cup.…”

Διερεύνηση σηπτικών φλεγμονών επί εδάφους ολικής αρθροπλαστικής ισχίου με ραδιοεπισημασμένα μονοκλωνικά αντισώματα (LeukoScan)

“…Ο Ring ήδη από το 1964 είχε εισάγει την έννοια "μέταλλο σε μέταλλο", χωρίς τη χρήση οστικού τσιμέντου [29] . Δυστυχώς όμως παρατηρήθηκε πως και στις ολικές αρθροπλαστικές χωρίς τσιμέντο υπήρχαν τα ίδια προβλήματα χαλάρωσης των στελεχών όπως και κατά τη χρήση του τσιμέντου, γεγονός που οδήγησε στο συμπέρασμα πως δεν μπορεί να ευθύνεται αποκλειστικά το τελευταίο για την επιπλοκή αυτή.…”

“…κοντά σε μία περιοχή έλκους. Οι περιπροθετικοί ιστοί των περιπτώσεων άσηπτης χαλάρωσης που αναδεικνύουν μια 2+ πολυμορφοπυρηνική διήθηση, συνήθως παρουσιάζουν αντίδραση τύπου μακροφάγων ή γιγαντοκυττάρων, σε προϊόντα φθοράς της αρθροπλαστικής (Εικόνες29,30,31).…”