Anatomical large femoral heads: early complications and mid term results

Journal Title: Orthopaedics, Traumatology and Prosthetics - Year 2016, Vol 602, Issue 1

Abstract

Purpose: mechanical complications such as malrestoration of hip anatomy still impede surgical results and patient satisfaction after THA. Anatomical femoral «mega-heads» are a novel approach which enables a surgeon to use a large diameter metal on metal implant to restore hip anatomy. Ability to place femoral head eccentrically on the femoral taper results in possible anteversion, retroversion, offset and lengthening. Our hypothesis is that use of this device will result in more accurate anatomical restoration and clinical results. Methods: 64 anatomical mega-head arthroplasties were evaluated. Preoperative planning was done in order to determine the desired position of the head, restore the anatomy and avoid leg lengthening. Patients were observed at an average of 50-months for both subjective and objective outcomes. Radiograph analysis assessed anatomical restoration. Results: 51 of the 64 hips were available for follow up. In 35 the head was placed eccentrically. In 20 the positioning was inferior, 6 — posterior, 3 — anterior, 1 — superior, and 4 inferior and posterior. Harris Hip and SF-36 scores improved significantly (P < 0.001). Mean radiographic limb and offset discrepancy were 0.1 and 0.01mm respectively. Six patients (11.7 %) underwent revision surgery; elevated metal ion levels and pseudotumor (3), acetabular component loosening (2), and unexplained hip pain (1). Conclusions: The novel anatomical femoral mega-head allows versatility in restoration of normal hip anatomy. Mid-term follow-up showed a higher than anticipated rate of complications for this cup design and reduced longevity of the implant. Novel ways need to be explored to allow such versatility in restoring hip anatomy.

Authors and Affiliations

Alon Grundshtein, Ofir Chechik, Ran Schwarzkopf, Ely Steinberg, Oleg Dolkart, Shmuel Dekel, Nimrod Snir

Keywords

Related Articles

THE EFFECTIVENESS OF THE DIFFERENT SCHEMES OF COMPLEX CONSERVATIVE TREATMENT OF ANIMALS WITH INDUCED KNEE ARTHRITIS

The effectiveness of conservative treatment in patients with knee joint arthritis can be enhanced through the use of the linked pharmacological and physical factors. The possibility of comprehensive use of low-intensity...

Morphological peculiarities of bone healing in the place of experimental cortical defect of long bone of rats in the conditions of naturalhydroxyapatite implantation

The goal: to investigate bone-healing process after implantation of osteoplastic material Cerabone® in compact bone defect. Methods: experiment was performed on 24 white rats (male). Hole-like defect (2.5 mm diameter) w...

The morphological changes in the spinal motor segments of the lumbar spine after rigid spinal stabilization with implants.

Rigid implants for spinal fusion are widely used in the clinical practice. However, there are only a few studies that have examined at the tissue level reorganization of structures of the spinal unit in a fusion. Object...

The results of conservative treatment and short transpedicular fixation at burst fractures of thoracic and lumbar spine

Multifragmentary (burst) fracture can happen in case of spine trauma under the influence of high-energy axial compression with penetration of bone fragments into spine canal and paravertebral tissues. Objective: to anal...

The results of clinical application of the spring-loaded fixator in osteosynthesis of the medial fractures of femoral neck

The share of femoral neck fractures in the structure of injuries enlarges every year due to increasing number of elderly people. Known techniques of osteosynthesis do not provide satisfactory results of treatment in the...

Download PDF file
  • EP ID EP202203
  • DOI 10.15674/0030-59872016115-22
  • Views 266
  • Downloads 0

How To Cite

Alon Grundshtein, Ofir Chechik, Ran Schwarzkopf, Ely Steinberg, Oleg Dolkart, Shmuel Dekel, Nimrod Snir (2016). Anatomical large femoral heads: early complications and mid term results. Orthopaedics, Traumatology and Prosthetics, 602(1), 15-22. https://europub.co.uk/articles/-A-202203