The aim of this work was to assess the preliminary anatomical and functional results of patients to establish prospects. Materials and method: We report here the preliminary results of a retrospective mono-centric, ho...The aim of this work was to assess the preliminary anatomical and functional results of patients to establish prospects. Materials and method: We report here the preliminary results of a retrospective mono-centric, homogeneous and continuous series, of 21 non-cemented total hip implants, implanted from January 2011 to December 2014. The mean follow-up time was 24 months. The patients were evaluated by Harris’s hip at the last follow-up. Results: The mean age of the intervention was 30 years. In our series, we observed a male predominance (60% of cases). Clinically, the Harris score varied significantly from 52.6 ± 11.4 pre-operatively to 85.1 ± 5.1 during the last follow-up visit. Among the items in the score, pain was the parameter that showed the greatest improvement. Thigh pain was observed in only one patient operated on the two sides. At the level of radiology, the femoral implant showed great stability. Bone resorption was suspected in 14 cases (66.66%), and confirmed in 4 cases (19.04%) with excellent bone remodeling, illustrated by the Engh and Massin scores. A loosening and a prosthetic dislocation was observed in a patient (4.76%). Any heterotopic ossification was observed. Conclusion: Our study confirmed good clinical and radiological results of the non-cemented hip prosthesis series in young patients. The rates of aseptic loosening, acetabular edges or osteolysis are low and stable over time.展开更多
BACKGROUND Total hip replacement has become one of the most successful orthopaedic procedures.The length of the femoral stem constitutes one of the most important geometrical and mechanical features of the prosthesis....BACKGROUND Total hip replacement has become one of the most successful orthopaedic procedures.The length of the femoral stem constitutes one of the most important geometrical and mechanical features of the prosthesis.Several different implants are currently available but data are limited concerning the clinical results for some of these implants.AIM To report the short-term clinical and radiological results of a novel squared section,tapered design–with four conicity-short stem in total hip replacement.METHODS This is a retrospective study of a prospectively collected data using of MINIMA?short stem in 61 consecutive patients with at least 1 year follow-up.The collected data included patients’demographics,type of arthritis,bone morphology,perioperative data,clinical results using Harris Hip Score,EuroQol(EQ-5D),pain score and satisfaction rate,complications and radiological results.RESULTS Total 61 patients were included in our study with a mean age of 56 years of age(range 25-73 years).The majority of them(68.6%)were women,thirty seven patients(56.9%)were less than 60 years of age and almost half of patients(45.1%)suffered from secondary osteoarthritis(hip dysplasia,osteonecrosis,etc.).The mean time of follow-up examination was 33.4 mo(2.8 years)with a range of 12-57 months(1-4.8 years).In 35 patients(56.9%)the follow-up examination was more than 3 years.No major complications such as revision,periprosthetic fracture,dislocation or infection were presented.Re-admission 90 d postoperatively or laterwas deemed unnecessary for any reason regarding the operation.Respectively,the mean pain score,mean Harris hip score,and mean EQ-5D were improved from 6.3,58.7 and 77.3 preoperatively to 0.1,95.1,and 79.8 postoperatively.The Satisfaction rate at the final follow-up was 9.9(SD 0.3,range 8.0-10.0).All stems were classified as stable bone ingrowth and no radiolucent lineswere revealed in any of the modified Gruens’zone at the postoperative Xrays.Stem subsidence was within acceptable limits and the incidence of distal cortical hypertrophy was relatively low.CONCLUSION The clinical and radiological results concerning the MINIMA?short stem are excellent according to this first report of this specific design of the short femoral stems.Because of the small number of cases and short-term follow-up of this study,a longer follow up time and more patients’enrollment is required.展开更多
Trauma, osteoarthritis and rheumatoid arthritis can destroy the articulating cartilage in small and large joints, especially in the metacarpo [tarso] phalangeal (MCP/MTP) and phalangeal-phalangeal (PIP) joints. Single...Trauma, osteoarthritis and rheumatoid arthritis can destroy the articulating cartilage in small and large joints, especially in the metacarpo [tarso] phalangeal (MCP/MTP) and phalangeal-phalangeal (PIP) joints. Single piece finger prosthetic designs can reduce pain and correct aesthetic issues, with problems on contemporary designs including decreased stability, lack of fixation and loss of functionality. The examined implants are representative models of currently available total joint replacement (TJR) designs for MCP replacement, such as the Swanson one piece implant. These implants have been shown clinically to have a high failure rate (up to 90%), but the cause of failure is unknown. Compressive studies using a 50 N force and medial-lateral loads of 50 N perpendicular to the longitudinal axis of the arms of the implant were individually applied. Due to material failings, lower values had to be used in some cases. Maximum stress values were found for flexion loading;the Swanson approximation had a peak stress of 8.71 GPa at the interface of the joint arm and the flexion center, Neuflex had 0.188 GPa peak stress at the fixation center of the arm, and in the center of the joint, and the Avanta design had a 5.20 GPa peak stress at the flexion center. The location and concentration of stresses on the models correspond to literature searches for clinical data, showing that the main failure mechanism for these implants is due to primary flexion-extension natural movement of the joint.展开更多
文摘The aim of this work was to assess the preliminary anatomical and functional results of patients to establish prospects. Materials and method: We report here the preliminary results of a retrospective mono-centric, homogeneous and continuous series, of 21 non-cemented total hip implants, implanted from January 2011 to December 2014. The mean follow-up time was 24 months. The patients were evaluated by Harris’s hip at the last follow-up. Results: The mean age of the intervention was 30 years. In our series, we observed a male predominance (60% of cases). Clinically, the Harris score varied significantly from 52.6 ± 11.4 pre-operatively to 85.1 ± 5.1 during the last follow-up visit. Among the items in the score, pain was the parameter that showed the greatest improvement. Thigh pain was observed in only one patient operated on the two sides. At the level of radiology, the femoral implant showed great stability. Bone resorption was suspected in 14 cases (66.66%), and confirmed in 4 cases (19.04%) with excellent bone remodeling, illustrated by the Engh and Massin scores. A loosening and a prosthetic dislocation was observed in a patient (4.76%). Any heterotopic ossification was observed. Conclusion: Our study confirmed good clinical and radiological results of the non-cemented hip prosthesis series in young patients. The rates of aseptic loosening, acetabular edges or osteolysis are low and stable over time.
文摘BACKGROUND Total hip replacement has become one of the most successful orthopaedic procedures.The length of the femoral stem constitutes one of the most important geometrical and mechanical features of the prosthesis.Several different implants are currently available but data are limited concerning the clinical results for some of these implants.AIM To report the short-term clinical and radiological results of a novel squared section,tapered design–with four conicity-short stem in total hip replacement.METHODS This is a retrospective study of a prospectively collected data using of MINIMA?short stem in 61 consecutive patients with at least 1 year follow-up.The collected data included patients’demographics,type of arthritis,bone morphology,perioperative data,clinical results using Harris Hip Score,EuroQol(EQ-5D),pain score and satisfaction rate,complications and radiological results.RESULTS Total 61 patients were included in our study with a mean age of 56 years of age(range 25-73 years).The majority of them(68.6%)were women,thirty seven patients(56.9%)were less than 60 years of age and almost half of patients(45.1%)suffered from secondary osteoarthritis(hip dysplasia,osteonecrosis,etc.).The mean time of follow-up examination was 33.4 mo(2.8 years)with a range of 12-57 months(1-4.8 years).In 35 patients(56.9%)the follow-up examination was more than 3 years.No major complications such as revision,periprosthetic fracture,dislocation or infection were presented.Re-admission 90 d postoperatively or laterwas deemed unnecessary for any reason regarding the operation.Respectively,the mean pain score,mean Harris hip score,and mean EQ-5D were improved from 6.3,58.7 and 77.3 preoperatively to 0.1,95.1,and 79.8 postoperatively.The Satisfaction rate at the final follow-up was 9.9(SD 0.3,range 8.0-10.0).All stems were classified as stable bone ingrowth and no radiolucent lineswere revealed in any of the modified Gruens’zone at the postoperative Xrays.Stem subsidence was within acceptable limits and the incidence of distal cortical hypertrophy was relatively low.CONCLUSION The clinical and radiological results concerning the MINIMA?short stem are excellent according to this first report of this specific design of the short femoral stems.Because of the small number of cases and short-term follow-up of this study,a longer follow up time and more patients’enrollment is required.
文摘Trauma, osteoarthritis and rheumatoid arthritis can destroy the articulating cartilage in small and large joints, especially in the metacarpo [tarso] phalangeal (MCP/MTP) and phalangeal-phalangeal (PIP) joints. Single piece finger prosthetic designs can reduce pain and correct aesthetic issues, with problems on contemporary designs including decreased stability, lack of fixation and loss of functionality. The examined implants are representative models of currently available total joint replacement (TJR) designs for MCP replacement, such as the Swanson one piece implant. These implants have been shown clinically to have a high failure rate (up to 90%), but the cause of failure is unknown. Compressive studies using a 50 N force and medial-lateral loads of 50 N perpendicular to the longitudinal axis of the arms of the implant were individually applied. Due to material failings, lower values had to be used in some cases. Maximum stress values were found for flexion loading;the Swanson approximation had a peak stress of 8.71 GPa at the interface of the joint arm and the flexion center, Neuflex had 0.188 GPa peak stress at the fixation center of the arm, and in the center of the joint, and the Avanta design had a 5.20 GPa peak stress at the flexion center. The location and concentration of stresses on the models correspond to literature searches for clinical data, showing that the main failure mechanism for these implants is due to primary flexion-extension natural movement of the joint.