Bipolar Prosthetic Replacement for the Treatment of Avascular Necrosis of the Femoral Head

Takaoka, Kunio; Nishina, Tetsuhiko; Ohzono, Kenji; Saito, Masanobu; Matsui, Minoru; Sugano, Nobuhiko; Saito, Susumu; Kadowaki, Tohru; Ono, Katsuhiko

doi:10.1097/00003086-199204000-00014

Cited by 35 publications

(19 citation statements)

References 0 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Historically, it has always produced suboptimal results (Table 8) and does not circumvent the need for resection of the femoral neck and violation of the femoral canal which may complicate future revisions. The use of a thin polyethylene cup can also lead to extensive wear and subsequent osteolysis, particularly in active patients [130][131][132]. As a result, bipolar hemiarthroplasty should largely be avoided as a treatment for osteonecrosis, particularly in young patients.…”

Section: Discussionmentioning

confidence: 99%

SAS Weekly Rounds: Avascular Necrosis

Hamilton¹,

Goodman

Figgie

2009

HSS Journal®: The Musculoskeletal Journal of Hospital for Speci

View full text Add to dashboard Cite

Osteonecrosis of the femoral head is a condition that affects upwards of 10,000 individuals in the USA each year. The peak incidence is in the fourth decade of life, and overall, there is a male preponderance. The condition accounts for up to 12% of total hip arthroplasties performed in developed countries. The etiology can be traumatic or non-traumatic, with 90% of atraumatic cases attributed to corticosteroid therapy or excess alcohol consumption. Osteonecrosis of the femoral head reflects the final common pathway of a range of insults to the blood supply and ultimately results in femoral head collapse, acetabular involvement, and secondary osteoarthritis. Currently, conservative treatment options, which aim to correct pathophysiologic features allowing revascularization and new bone formation, appear to be able to delay but not halt the progression of this condition. As a consequence of femoral head osteonecrosis, many individuals undergo surgical treatments including: core decompression, osteotomy, non-vascularized bone matrix grafting, free vascularized fibular grafts, limited femoral resurfacing, total hip resurfacing, and total hip arthroplasty.

show abstract

Section: Discussionmentioning

confidence: 99%

SAS Weekly Rounds: Avascular Necrosis

Hamilton¹,

Goodman

Figgie

2009

HSS Journal®: The Musculoskeletal Journal of Hospital for Speci

View full text Add to dashboard Cite

show abstract

“…The cartilage space was still present in most cases (64%), but both the articular cartilage and good subchondral bone prevent wear. [21][22][23][24][25] We are satisfied with the design of the prosthetic stem; the one failure was in bone treated by radiotherapy. Stress shielding represented only a minor problem as after a mean follow-up of 12.25 years no failure can be related to this.…”

Section: Discussionmentioning

confidence: 89%

Modular prosthetic replacement of the proximal femur after resection of a bone tumour

Donati

Zavatta

Gozzi

et al. 2001

The Journal of Bone and Joint Surgery. British volume

View full text Add to dashboard Cite

We describe 25 patients who were treated for a tumour of the proximal femur by resection and replacement with an uncemented, bipolar, modular prosthesis. When followed up after more than ten years four prostheses (16%) had required revision. Two joints showed wear and another necrosis of the acetabulum. One patient with loosening of the stem had been treated by radiotherapy to the femur. Articular cartilage seemed to be a reliable barrier to acetabular wear. Very few signs of the formation of particulate debris were observed. The most obvious feature in the bone-stem relationship was stress shielding, seen as osteoporosis of the proximal part of the femur around the stem in 68%. Functional activity was satisfactory in 68% of the patients. A better system of reattachment of the soft tissues is needed to avoid pain and a persistent limp.

show abstract

“…Thus, it is controversial whether hemiarthroplasty or THA should be the preferred treatment for patients with ON. Although hemiarthroplasty has been associated with groin pain [4,21,26,27,44] and head migration [4,21,44], the treatment would be beneficial in young patients if acetabular wear could be substantially reduced. LTI pyrolytic carbon hemiarthroplasty showed substantially less wear than titanium or cobalt chromium-molybdenum alloys in a canine model [8].…”

Section: Discussionmentioning

confidence: 99%

“…Reports indicate hemiprosthetic failure is likely the result of accelerated acetabular erosion resulting in groin pain postoperatively [5,10,21]. However, disadvantages of hemiarthroplasty include incidence of groin pain (range, 12%-42%) [4,21,26,27,44] and head migration (range, 8%-23%) [4,21,44], whereas THA in younger patients is associated with early failure owing to bearing wear and osteolysis [12,35]. Hemiarthroplasty in younger patients has the potential advantage of eliminating bearing surface wear [1-5, 21, 30, 39] and is easily revisable [10]; however, the reported success rates have ranged from 64% to Each author certifies that he or she has no commercial associations (eg, consultancies, stock ownership, equity interest, patent/licensing arrangements, etc) that might pose a conflict of interest in connection with the submitted article.…”

Section: Introductionmentioning

confidence: 99%

Pyrolytic Carbon Endoprosthetic Replacement for Osteonecrosis and Femoral Fracture of the Hip: A Pilot Study

Bernasek

Stahl

Pupello

2009

Clinical Orthopaedics &Amp; Related Research

View full text Add to dashboard Cite

Hemiarthroplasty in young patients has the potential for eliminating bearing wear, but has the disadvantage of cartilage wear. Low-temperature isotropic (LTI) pyrolytic carbon reportedly reduces cartilage wear in canine hemiarthroplasties. We therefore initiated a study in humans when it was released for human use. However, we observed failures in some patients. We therefore document and report the high failure rate observed in a subset of patients treated with an LTI pyrolytic carbon femoral head for osteonecrosis. We conducted a prospective pilot study of 17 patients treated with a titanium stem and an LTI pyrolytic carbon femoral head bearing surface for unipolar hemiarthroplasty for either femoral neck fracture (10

show abstract

Bipolar Prosthetic Replacement for the Treatment of Avascular Necrosis of the Femoral Head

Cited by 35 publications

References 0 publications

SAS Weekly Rounds: Avascular Necrosis

SAS Weekly Rounds: Avascular Necrosis

Modular prosthetic replacement of the proximal femur after resection of a bone tumour

Pyrolytic Carbon Endoprosthetic Replacement for Osteonecrosis and Femoral Fracture of the Hip: A Pilot Study

Contact Info

Product

Resources

About