PurposeThe purpose of this study was to evaluate the clinical and radiological results of total hip arthroplasty using a proximal modular femoral stem in patients who had secondary coxarthrosis associated with a dysplastic hip.Materials and MethodsForty-two patients (45 hips) with secondary coxarthrosis were evaluated after undergoing primary total hip arthroplasty using an S-ROM proximal modular femoral stem. The average follow-up was 80 months (range: 60 to 96 months). Clinical and radiological assessments were performed based on the Harris hip score and the radiological changes around the prosthesis.ResultsThe average Harris hip score improved from 52.2 points to 88.5 points. All femoral stems showed stable fixation; there were 37 cases by bony ingrowth and 8 cases by stable fibrous ingrowth. Neither osteolysis nor progressive radiolucent lines around the femoral stem were found at the last follow-up. Forty-one hips (91.9%) revealed excellent or good clinical results at the most recent follow-up.ConclusionFor advanced secondary coxarthrosis, total hip arthroplasty with the use of the proximal modular femoral stem yielded good mid-term results with respect to the clinical and radiological criteria.

Lipoma arborescens (LA) is a rare benign lesion of unknown etiology. It is characterized histologically by villous proliferation of the synovial membrane and diffuse replacement of the subsynovial tissue by mature fat cells. This condition affects the knee joint most commonly. Cases involving other locations including glenohumeral joint,[1] hip,[2] elbow,[3] hand[4] and ankle[5] have been rarely described. Involvement of the subdeltoid bursa has also been reported, but to date no case has described LA with osseous/chondroid differentiation of this bursa. Another significant finding in our case was the coexistence of LA with intermuscular lipoma, SLAP lesion and labral cyst.

Conventional gamma sterilization could induce substantial oxidative degradation during subsequent storage of the PE component in air and during their use in vivo. This oxidative degradation may induce high wear rates, delamination and/or gross fracture of the affected PE component. An improved understanding of the effects of cross-linking and oxidation on ultra high molecular weight polyethylene (UHMWPE) has lead to the common use of oxygen-protected packing during radiation sterilization and shelf storage. More recently, methods to deliberately highly cross link UHMWPE while reducing the material's potential to oxidize have been develop in the form of highly cross linked UHMWPE. We reviewed the manufacturing, sterilization, cross linking methods and clinical results of the new polyethylene.

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