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Query: UNIPROT:P50502 (Hip)
 7,003 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

A retrospective review of 81 sequential primary total hip arthroplasties using a cementless, high-offset femoral stem was performed. Follow-up was 24 to 60 months. The average age at the time of surgery was 54 years. The femoral bone types were: 36% Dorr A, 51% Dorr B, and 13% Dorr C. The mean postoperative Harris Hip Score was 95. The mean postoperative Oxford score was 17. Eighty-five percent had no clinical leg-length difference. All stems were radiographically stable. The stem features of hydroxyapatite coating on a rough circumferential titanium arc-deposit proximal surface in conjunction with distal flutes seem to provide immediate stability, making this implant clinically versatile. Potential benefits of increased offset include improved joint stability and avoidance of leg lengthening.
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PMID:Efforts to improve cementless femoral stems in THR: 2- to 5-year follow-up of a high-offset femoral stem with distal stem modification (Secur-Fit Plus). 1471 53

This investigation is an ongoing clinical and radiographic analysis of a titanium tapered-wedge femoral component with a proximal plasma-spray porous coating. Integral femoral stems (Biomet, Warsaw, IN) were implanted in 200 hips in 186 patients. Nineteen patients died before 10-year follow-up, and 50 patients were lost to follow-up. The mean follow-up of the remaining 129 hips was 11.6 years. Harris Hip Scores improved from 58 to 93. Thigh pain was 2.3%. Radiographic analysis revealed adaptive distal remodeling in zones 2, 3, 5, 6, and 13, with no evidence of osteolysis below the level of the calcar and the greater trochanteric region. Only 2 femoral stems were revised: 1 with suspected fibrous fixation at 7 years postoperatively and another with a broken trunion at 10 years postoperatively. A tapered titanium femoral stem with circumferential plasma-spray porous coating provides excellent long-term fixation, durable clinical outcome, and protects against osteolysis below the level of the calcar and greater trochanter.
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PMID:Cementless titanium tapered-wedge femoral stem: 10- to 15-year follow-up. 1528 73

A unique, straight-stemmed, proximally porous-coated, modular hip arthroplasty system, coated with thin-film (5- to 9-microm), titanium-nitride ceramic, was used clinically in 130 hip arthroplasties in 117 patients who were followed over a 2- to 12-year interval (mean, 6.45 years). Harris Hip Scores demonstrated 82.3% excellent, 15.4% good, 2.3% fair, and 0% poor results. Thigh pain that limited activities of daily living was seen in 0.8% (1 of 130) hips. Kaplan-Meier survival estimates using an endpoint of revision of any component for any reason demonstrated an overall survival of 95.5% during the 12-year interval. Cementless fixation survivorship of the acetabular and femoral components was 98.5% during the 12-year interval.
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PMID:Two- to 12-year evaluation of cementless Buechel-Pappas total hip arthroplasty. 1558 38

Sixteen proximally cemented, collared, and distally splined, Bridge Hip femoral stems with a matte proximal surface and smooth distal surface were retrieved because of loosening. Electron microscopy, with correlated elemental analysis, identified titanium particulate embedded in the internal surface of the cement mantle. Data supported the observations that loosening of the femoral stems was related to proximal debonding at the cement-implant interface, loosening at the proximal cement-bone interface, and inherent rotational instability. Cement-implant interface debonding resulted in the proximally matte femoral stem surface abrading with the opposing cement mantle, resulting in particulate and osteolysis in some cases. Careful consideration of implant design and clinically relevant biomechanical testing protocols should be considered before the clinical introduction of future proximally cemented femoral stems.
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PMID:Analysis of 16 retrieved proximally cemented femoral stems. 1662 61

The main problem facing the longevity of total joint replacements is wear particle-induced osteolysis, particularly around the acetabular component. Ovine Total Hip Replacement surgery was performed with roughened femoral heads in order to enhance wear debris generation in vivo. The resistance to aseptic loosening of acetabular components with different surface coatings was investigated. Implants remained in vivo for 1 year. Sheep were randomly assigned to one of six experimental groups where the acetabular cup was fixed utilising an: (a) cemented polyethylene acetabular cup, (b) metal backed grit blasted surface, (c) metal backed plasma sprayed titanium porous coating, (d) metal backed sintered beaded coating, (e) Hydroxyapatite (HA)-coated grit blasted surface (f) and HA-coated porous components. Ground Reaction Force (GRF) was used to asses the functional performance of the implants and data was collected pre-operatively and at 12, 24, 36 and 52 weeks post op. Wear debris generated was analysed and radiographs taken prior to preparation of thin sections. Fibrous tissue (FT) thickness and bone contact at 1 mm intervals along the acetabular bone-implant interface was calculated. GRF data demonstrated significant differences between experimental groups. In all groups there was an increase in the function of the hip after surgery and up to 24 weeks but thereafter the function of the group with the grit blasted surface reduced whereas the function of the other groups did not significantly change. Average wear particles generated were <1 microm in size. The cemented group demonstrated a significantly thicker average FT layer (2.69 mm) when compared with all other groups (p<0.05 in all cases) except the grit blasted group (1.56 mm). HA porous coated cups demonstrated significantly least fibrous tissue adjacent to its interface when compared with all other groups (cemented p<0.05, grit blasted p=0.029, porous p<0.05, sintered beads p<0.05 and HA grit blasted p<0.05). Significantly increased bone contact to HA-coated porous cups (73.33%) when compared with all groups was identified except HA-coated grit blasted cups where no significant difference was demonstrated. Radiographic signs of loosening were visible in all groups except the HA-coated porous group. Results demonstrated that HA porous coated acetabular components significantly enhanced bone ingrowth in the presence of wear particles, preventing their migration and reducing osteolysis. Non-HA-coated porous and sintered beaded components provided a more effective seal against the ingress of wear debris when compared with cemented cups.
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PMID:Role of hydroxyapatite coating in resisting wear particle migration and osteolysis around acetabular components. 1566 43

The Capital Hip implant was a Charnley-based system which included a flanged and a roundback stem, both of which were available in stainless steel and titanium. The system was withdrawn from the market because of its inferior performance. However, all four of the designs did not produce poor rates of survival. Using a simulated-based, finite-element analysis, we have analysed the Capital Hip system. Our aim was to investigate whether our simulation was able to detect differences which could account for the varying survival between the Capital Hip designs, thereby further validating the simulation. We created finite-element models of reconstructions with the flanged and roundback Capital Hips. A loading history was applied representing normal walking and stair-climbing, while we monitored the formation of fatigue cracks in the cement. Corresponding to the clinical findings, our simulation was able to detect the negative effects of the titanium material and the flanged design in the Capital Hip system. Although improvements could be made by including the effect of the roughness of the surface of the stem, our study increased the value of the model as a predictive tool for determining failure of an implant.
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PMID:Finite-element analysis of failure of the Capital Hip designs. 1626 Jun 81

Hip arthroplasty is performed nowadays according to the needs of the patients irrespective of their age. Tapered rectangular stems for cementless fixation are chosen in most cases in central Europe. They provide primary stability by press-fit implantation into a precisely rasped osseous bed and secondary stability by bone ingrowth into the highly biocompatible titanium alloy with a microrough surface. The 10-year survival of such devices is 92%. Typical radiographic patterns include cortical atrophy and radiolucent lines in Gruen zones 1 and 7. They are due to stress shielding with these distally fixed implants. The number one reason for revision is polyethylene wear and subsequent osteolysis. Metal-on-metal and ceramic-on-ceramic bearings show less wear but osteolysis continues to be a problem.
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PMID:[Results of cementless hip arthroplasty]. 1655 11

This study was designed to investigate bone remodelling around the cup in cementless THA. Previous studies indicate an advantage of better sealing of the bone-prosthesis interface by HA/TCP coating of implants, inhibiting polyethylene-induced osteolysis. One hundred patients gave informed consent to participate in a controlled randomized study between porous coated Trilogy versus Trilogy Calcicoat (HA/TCP coated). The cup was inserted in press-fit fixation. The femoral component was a cementless porous coated titanium alloy stem (Bi-Metric), with a modular 28-mm CrCo head. The Harris Hip Score (HHS) and bone mineral density (BMD) determined by DEXA scanning were used to study the effect. Measurements revealed no difference between the two groups after 3 years either in the clinical outcome or in terms of periprosthetic bone density. Patients with a body mass index above normal regained more bone mineral than patients with normal weight. This finding supports the assumption that load is beneficial to bone remodelling.
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PMID:Bone remodelling around HA-coated acetabular cups : a DEXA study with a 3-year follow-up in a randomised trial. 1676 Nov 53

The Fitmore titanium mesh cementless acetabular component in 115 hip arthroplasties was reviewed at an average of 33 months of follow-up. None were revised nor had infection. One hip dislocated 4 years postoperatively. Two femoral components were revised. The average Harris Hip Score at the last follow-up was 90 points. In the 96 sets of radiographs available, there was no loosening or new radiolucency. One hip had nonprogressive osteolysis adjacent to a screw. This press-fit cup has its polar region flattened and is rim loading. Noncontact (gaps) at the acetabular floor is expected and is not critical for fixation. In all but 6 hips, these gaps filled. In 5 hips, a minimal gap (<or=0.5 mm) remained in part of the equatorial region. The Fitmore cup osseointegrates successfully.
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PMID:Early clinical and radiographic analysis of the Fitmore cup. 1695 37

Many techniques have been advanced to achieve reliable femoral stem fixation in revision total hip arthroplasty. In a cross-sectional study, we compared quality of life in 220 patients with two femoral stem designs: a modular tapered and fluted titanium stem design and a cylindrical extensively coated chrome-cobalt stem with single modularity (head size and neck length alone). We matched cohorts based on age decade and gender. The minimum followup was 1 year with a median of 2 years. Subjective outcome assessment and patient satisfaction were measured using the WOMAC Osteoarthritis Index, the Oxford Hip Score, the SF-12, and the Arthroplasty Satisfaction Scale. At followup, all quality of life measures favored the tapered titanium stem. WOMAC pain, function, and overall scores all were higher in this group. The Oxford Hip Score and the Satisfaction score reflected a greater difference in outcome between the two stem designs. We presume reduced stiffness of the titanium stem, coupled with the intraoperative modularity, resulted in the improved patient outcomes observed in this study.
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PMID:Improved outcome in femoral revision arthroplasty with tapered fluted modular titanium stems. 1731 93


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