OBJECTIVES: Alzheimer's disease (AD) impairs cognitive functions, subsequently decreasing activity of daily living (ADL), and is frequently accompanied by lower limb fracture including hip fracture in the elderly. However, there have been few studies on what kinds of physical functions are affected or what degrees of dysfunction are produced by ...

PURPOSE: In anterior cruciate ligament reconstruction with looped soft-tissue grafts, an interference screw is frequently used for tibial fixation. This study compared three alternatives thought to improve the initial mechanical properties of direct bioabsorbable interference screw fixation: suturing the graft to close the loop, adding a supplementary staple, or increasing ...

Recent studies have reported the presence of acetylcholine (ACh) receptor subtypes in bone tissue, and demonstrated that inhibition of the ACh receptors has negative effects on bone mass and fracture healing capacity. However little is known about the potential clinical effects that an increased ACh signaling might have on bone. ...

Objectives: To evaluate strategies for increasing the axial stiffness of a hybrid external bone fixator. Materials and methods: Type Ia hybrid fixators, consisting of a uniplanar linear component connected to a circular ring were tested in displacement controlled loading in axial compression. The basic hybrid construct was modified to explore ...

Two-stage revision arthroplasty using articulating spacers for the treatment of infected total knee arthroplasty (TKA) is a successful management technique. Our purpose was to report our results using preformed, commercially available articulating spacers made of gentamicin-impregnated cement. Thirty-three patients with infected primary or revision TKAs were treated with these spacers ...

OBJECTIVE: To use finite element analysis to study the stability of different fixation methods used to repair Vancouver type B1 periprosthetic fractures occurring after total hip arthroplasty (THA). METHODS: An artificial femur was used as the basis for the solid model; U2 series femoral stem (United Orthopedic Corporation, Hsinchu, Taiwan) ...

OBJECTIVE: This study evaluated the contribution of Aptus EndoStaples (Aptus Endosystems, Sunnyvale, Calif) in the proximal fixation of eight endografts used in the endovascular repair of abdominal aortic aneurysms (EVAR). METHODS: Nine human cadaveric aortas were exposed, left in situ, and transected to serve as fixation zones. The Zenith (Cook, ...

OBJECTIVE: To evaluate gene transfer in an equine metacarpal IV (MCIV) ostectomy model using adenoviral vectors encoding the human bone morphogenetic protein-2 and protein-7 gene (Ad-BMP-2/-7). STUDY DESIGN: Experimental ANIMALS: Healthy adult horses (n = 15). METHODS: A plate stabilized, critical size 1.5 cm ostectomy was created in left and ...

The neurovascular anatomy of the carpus and hand is complex. Therefore, precise exposures are required to avoid iatrogenic injury. In general, dorsal exposures are more forgiving than volar exposures because major neurovascular structures lie on the volar aspect of the hand and fingers; however, volar, ulnar, and radial approaches to ...

The systematic of device development for support in the period after surgery and for consolidation of fractures of lower limb, manufactured in aluminium alloy and PVC, integrated with quick fixes, cleanliness simplified, retractable, and adaptable to wide range of biotope. Has as value-added a possibility of transforming an axillary crutch ...

Evidence suggests a growing incidence of revision total hip arthroplasty (THA) including a subset with large acetabular defects. Revision THA for severe acetabular bone loss is associated with a relatively high rate of mechanical failure. We questioned whether cementing a cage to the reconstructed acetabular defect and pelvis would improve ...

Highly crosslinked UHMWPE is associated with increased wear resistance in hip simulator and clinical studies. Laboratory and case studies, however, have described rim fracture in crosslinked acetabular liners. Controversy exists, therefore, on the relative merits of crosslinked liners over conventional liners in terms of wear performance versus resistance to fatigue ...

Optimal techniques for acetabular revision in the setting of major pelvic osteolysis have not been established. Bilobed components, structural grafts, and reinforcement cages have demonstrated 10-24% midterm failure rates. While cementless hemispherical components have been utilized to treat large acetabular defects, most reports have not focused specifically on patients with ...

Infection is uncommon after THA performed for failed acetabular fracture repair, despite a high reported incidence of culture-positive fixation implants. The use of frozen section analysis at the time of THA after acetabular fracture fixation surgery is unknown. We asked whether frozen section analysis predicted occult infection after THA performed ...

Liner exchange and bone grafting are commonly performed for wear and osteolysis around well-fixed modular acetabular components that otherwise would require structural allografting and revision THA. However, liner exchange in the face of substantial lysis around TKA has been performed rarely with reports of failure rates of up to 25% ...

Young patients with degenerative cartilage disease of the hip remain a challenge for the orthopaedic surgeon. Different treatment options are available of which uncemented hips are the most popular owing to long-term concerns about cemented implants. As an alternative, we have used a cemented hip design in combination with bone ...

The theoretical advantage of using thinner acetabular components in hip resurfacing has not yet been clinically verified. Our purpose was to test the hypothesis of bone conservation and assess the effects of using a thinner acetabular component on hip biomechanics and clinical outcome. We compared the bone conservation, biomechanical results, ...

Impaction bone grafting has been used for acetabular reconstruction in revision surgery. However, most series do not establish differences in survival in revisions with differing severity of bone loss. We therefore determined (1) the survival rate for rerevision associated with varying degrees of bone loss; (2) the frequency with which ...

Wear of polyethylene acetabular cups in patients of total hip arthroplasty is routinely deduced from the penetration of the femoral head into the acetabular liner as observed in the radiographs. However, the linear penetration thus measured represents the cumulative contribution of two components, one due to wear, and the other ...

Acetabular osteolysis associated with socket loosening is one of the main long-term complications of total hip arthroplasty. In case of major bone loss, where <50% host bone coverage can be obtained with a porous-coated cementless cup, it is generally agreed that a metal ring or cage in association with a ...

The acetabular labrum plays an important role in hip joint stability and protection of the articular cartilage of the hip. Despite this, few investigators have evaluated its microscopic vasculature and, to our knowledge, none has assessed its macroscopic blood supply. The purposes of this study were to identify the origin ...

For the proper diagnosis or treatment of hip joint disorders caused by anatomical abnormalities, the normal hip joint morphology must be studied to understand its influence on the maximum range of motion (ROM) until bony impingement by focusing on gender differences. Acetabular and femoral morphologies were analyzed from 3D CT ...

Loosening of acetabular components often leads to bony defects. Management of extensive acetabular bone loss in hip revision arthroplasty can be a tremendous challenge. We asked whether a reconstruction with impacted bone grafts will provide a durable and pain-free function in extensive acetabular defects. We specifically determined the (1) survival ...

To identify factors predicting poor radiographic and functional outcome and delayed total hip arthroplasty in operatively managed acetabular fractures in patients 55 years of age and older. Retrospective chart and radiographic review of a prospectively maintained database. Tertiary care hospital. Ninety-three with a mean age of 67 years met all ...

We report the outcome of the flangeless, cemented all-polyethylene Exeter acetabular component at a mean of 14.6 years (10 to 17) after operation. Of the 263 hips in 243 patients, 122 prostheses are still in situ; 112 patients (119 hips) have died, 18 hips have been revised, and three patients ...

Our purpose was to examine survivorship of the native hip joint in patients ages 60 and over who underwent percutaneous reduction and fixation of acetabular fractures. A retrospective review at a University Level I Trauma Center was performed. Our institutional trauma database was reviewed. Patients aged 60 or older treated ...

A limited number of reports have detailed the cause of fracture of a highly cross-linked polyethylene liner. Typically, the fractures have occurred in a region of thin and/or unsupported polyethylene, in association with superiorly directed edge loading conditions secondary to an excessively inclinated acetabular component. This case report details an ...

Acetabular both-column fractures are challenging articular injuries. They usually require operative treatment. We report on fundamental elements of pathoanatomy and radiology that are reviewed as far as they may influence treatment planning and surgical intervention. Surgical strategy, choice of the most suitable approach, reduction manoeuvres and fixation techniques are presented, ...

Retrieval studies of total hip replacements with highly cross-linked ultra-high-molecular-weight polyethylene liners have shown much less surface damage than with conventional ultra-high-molecular-weight polyethylene liners. A recent revision hip replacement for recurrent dislocation undertaken after only five months revealed a highly cross-linked polyethylene liner with a large area of visible delamination. ...

The slotted acetabular augmentation procedure can never achieve a concentric and congruous reduction of the femoral head. The aim of this study was to review the results of the slotted acetabular augmentation procedure performed at the time of open reduction for developmental dysplasia of the hip in older children. Twenty-two ...

In total hip arthroplasty (THA), excessive retroversion is associated with posterior instability, anterior impingement, and resultant groin pain. Excessive anteversion can lead to anterior instability and posterior impingement. The transverse acetabular ligament straddles the inferior limit of the bony acetabulum. It is a strong load-bearing structure and, in the normal ...

Periacetabular osteolysis is the greatest challenge for longevity of total hip arthroplasty. The generation of wear debris from the bearing surface is inevitably going to cause bone loss around the implants. The challenges for the arthroplasty surgeon in managing this problem are: detection, knowing when to intervene surgically, and choosing ...

Component malposition in hip resurfacing can cause early failure through the 2 main failure modes: femoral neck fracture and wear-related failures. The femoral component should be aligned in slight valgus with no notching of the superior femoral neck. Varus placement and notching are strongly correlated with early femoral neck fracture. ...

The combination of acetabular bone loss and hip instability is challenging. Sixteen patients underwent revision total hip arthroplasty using constrained acetabular liners cemented into cages. The average follow-up was 28 months (range, 24-60 months). Clinical evaluation was obtained using the Harris hip score along with radiographic data. At latest follow-up, ...

The long-term results of grafting with hydroxyapatite granules for acetabular deficiency in revision total hip replacement are not well known. We have evaluated the results of revision using a modular cup with hydroxyapatite grafting for Paprosky type 2 and 3 acetabular defects at a minimum of ten years' follow-up. We ...

Acetabular fractures are generally treated with open reduction and internal fixation, with the goals of anatomic reduction and preservation of the native hip joint. Modern techniques of internal fixation have resulted in good to excellent outcomes in the vast majority of patients when anatomic reduction can be obtained. Total hip ...

The majority of acetabular defects can be reconstructed with a hemispherical acetabular component alone. However, severe bone loss encountered at the time of revision acetabular surgery can result in compromised initial fixation leading to component micromotion, failure of bone ingrowth, and mechanical failure. Porous acetabular augments offer a potential solution ...

In this single-surgeon series, both resurfaced hips in 1 woman and a total hip arthroplasty in another were revised for symptomatic pseudotumor (3 of 588 hips; 0.51% overall incidence; 2.2% in women). All 3 hips had 50-mm acetabular components. There was no difference in mean lateral opening angle (mean 38.7° ...

Although vascular injuries associated with primary and revision total hip arthroplasty are infrequent, these complications can have devastating effects that can lead to morbidity and even mortality. No previous reports have described embolic distal limb ischemia secondary to a failed and migrated acetabular implant in discontinuity with the pelvis. We ...

BACKGROUND: Wear of the ultra-high molecular weight polyethylene articular surface has been recognized as a major factor threatening the long-term success of total hip arthroplasty. Manual techniques that have been used to measure femoral head penetration into the polyethylene have been plagued with poor reproducibility and limited accuracy. Using a ...

Cotyloplasty is a technique that involves making a perforation of the medial wall of a shallow acetabulum and then inserting an acetabular cup with the medial aspect of its dome beyond the Kohler line. The purpose of this study was to evaluate the results of cementless total hip arthroplasty (THA) ...

BACKGROUND AND PURPOSE: The appearance of acetabular version differs between the supine and weight bearing positions in developmental dysplasia of the hip. Weight bearing radiographic evaluation has been recommended to ensure the best coherence between symptoms, functional appearance, and hip deformities. Previous prevalence estimates of acetabular retroversion in dysplastic hips ...

We assessed 90 total hip arthroplasties (THAs) performed with the Metasul metal-on-metal hip system (Zimmer, Warsaw, Indiana); the patients were monitored for >10 years. The average Harris Hip Score of the patients was 40.5 points preoperatively and 85.8 points at final follow-up. No adverse reactions to the metal debris were ...

Abstract There is a growing need for specific revision implants to meet the increasing occurrence of failed total hip arthroplasties displaying massive deficiencies in acetabular bone stock. The developed acetabular revision cup presented in this study is aimed at individual patient solutions using a multi-axial and angular stable fixation peg ...

To study the influences of head/neck ratio and femoral antetorsion on the safe-zone of operative acetabular orientations, which meets the criteria for desired range of motion (ROM) for activities of daily living in total hip arthroplasty (THA). A three-dimensional generic, parametric and kinematic simulation module of THA was developed to ...

The results of isolated acetabular revision performed in 35 patients (36 hips) were monitored from 3 to 10 years. All femoral components were well fixed and not removed or revised during index surgery. All revision acetabular implants were cementless, using a porous-coated hemispheric cup with or without bone graft. There were ...

Increasingly, acetabular retroversion is recognized in patients undergoing hip arthroplasty. Although prosthetic component positioning is not determined solely by native acetabular anatomy, acetabular retroversion presents a dilemma for component positioning if the surgeon implants the device in the anatomic position. We asked (1) whether there is a difference in ROM ...

A 4-U hybrid total hip arthroplasty (THA) system was specifically designed for patients with developmental dysplasia of the hip (DDH). Straight stem with an appropriate offset and various size variations are advantages. We followed 128 hips in 124 patients, 13 men and 111 women, for a mean of 6.5 years (range, ...

We identified 128 revision total hip arthroplasties from 1993 to 2005 involving a well-fixed Harris-Galante Porous (HGP)-I or HGP-II acetabular component with minimum 2-year post-revision follow-up. Three treatment cohorts were identified. Of the hips that underwent modular liner exchange at revision, 14 hips (25%) required re-revision of the acetabular component, ...

The purpose of the present study was to evaluate the 6- to 11-year follow-up results of hemispherical porous-coated cups implanted into dysplastic hips using press-fit technique without screws focusing on the amount of host bone coverage. There were 87 patients who underwent 98 primary total hip arthroplasties. Bony coverage was ...