Revision Total Hip Arthroplasty with Retained Acetabular Component

Adelani, Muyibat A.; Mall, Nathan A.; Nyazee, Humaa A.; Clohisy, John C.; Barrack, Robert L.; Nunley, Ryan M.

doi:10.2106/jbjs.l.01177

Cited by 30 publications

(30 citation statements)

References 30 publications

(57 reference statements)

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“…Periprosthetic osteolysis caused aseptic prosthetic loosening has been considered as the main factor for failure in joint replacement surgery. The limited surgical treatment choices for periprosthetic osteolysis such as complete or partial revision with bone grafting of joint replacement are far from being satisfactory because of recurrence of osteolysis (Adelani et al, 2014). The development of orthopedic material, such as highly cross-linked polyethylene (stabilized with vitamin E or not) for acetabular lining, has an uncertain effect with regard to controlling osteolysis in comparison to ultra-high-molecular-weight polyethylene (Endo et al, 2002;Boyer et al, 2018).…”

Section: Discussionmentioning

confidence: 99%

Tussilagone Inhibits Osteoclastogenesis and Periprosthetic Osteolysis by Suppressing the NF-κB and P38 MAPK Signaling Pathways

Yin

Chen

et al. 2020

Front. Pharmacol.

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Background: Aseptic prosthetic loosening is one of the main factors causing poor prognosis of limb function after joint replacement and requires troublesome revisional surgery. It is featured by wear particle-induced periprosthetic osteolysis mediated by excessive osteoclasts activated in inflammatory cell context. Some natural compounds show antiosteoclast traits with high cost-efficiency and few side effects. Tussilagone (TUS), which is the main functional extract from Tussilago farfara generally used for relieving cough, asthma, and eliminating phlegm in traditional medicine has been proven to appease several RAW264.7-mediated inflammatory diseases via suppressing osteoclast-related signaling cascades. However, whether and how TUS can improve aseptic prosthetic loosening via modulating osteoclast-mediated bone resorption still needs to be answered. Methods:We established a murine calvarial osteolysis model to detect the preventative effect of TUS on osteolysis in vivo. Micro-CT scanning and histomorphometric analysis were used to determine the variation of bone resorption and osteoclastogenesis. The antiosteoclast-differentiation and anti-bone-resorption bioactivities of TUS in vitro were investigated using bone slice resorption pit evaluation, and interference caused by cytotoxicity of TUS was excluded according to the CCK-8 assay results. Quantitative polymerase chain reaction (qPCR) analysis was applied to prove the decreased expression of osteoclast-specific genes after TUS treatment. The inhibitory effect of TUS on NF-kB and p38 MAPK signaling pathways was testified by Western blot and NF-kB-linked luciferase reporter gene assay.Results: TUS better protected bones against osteolysis in murine calvarial osteolysis model with reduced osteoclasts than those in the control group. In vitro studies also showed that TUS exerted antiosteoclastogenesis and anti-bone-resorption effects in both bone marrow macrophages (BMMs) and RAW264.7 cells, as evidenced by the decline of Frontiers in Pharmacology | www.frontiersin.org osteoclast-specific genes according to qPCR. Western blotting revealed that TUS treatment inhibited IkBa degradation and p38 phosphorylation. Conclusions:Collectively, our studies proved for the first time that TUS inhibits osteoclastogenesis by suppressing the NF-kB and p38 MAPK signaling pathways, therefore serving as a potential natural compound to treat periprosthetic osteolysisinduced aseptic prosthetic loosening.

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Section: Discussionmentioning

confidence: 99%

Tussilagone Inhibits Osteoclastogenesis and Periprosthetic Osteolysis by Suppressing the NF-κB and P38 MAPK Signaling Pathways

Yin

Chen

et al. 2020

Front. Pharmacol.

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“…The risk of failure in patients who received a CUHMWPE liner at the time of the primary THA was 14.8 times higher than in patients who received an HCLPE liner because of high wear[24]. Although, fractures of HCLPE were also reported [25–27].…”

Section: Discussionmentioning

confidence: 99%

“…To address the polyethylene wear associated with osteolysis, isolated liner exchange is a common surgical intervention when the acetabular component remains well fixed [1, 24]. The results showed no locking mechanism failure, no acetabular loosening, and no osteolysis.…”

Section: Discussionmentioning

confidence: 99%

Comparison of Polyethylene Wear before and after Hip Revision with Liner Exchange Fixed with the Original Locking Mechanism

Tang

et al. 2016

PLoS ONE

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ObjectiveTo compare the wear of conventional ultra-high molecular weight polyethylene (CUHMWPE) and highly cross-linked polyethylene (HCLPE) in hip revision with liner exchange fixed with original locking mechanism using analysis of history medical data.MethodsFrom Jan. 1, 2000, to Dec. 31, 2007, 26 patients (with 29 involved hips) underwent liner exchange revision fixed with the original locking mechanism due to wear of CUHMWPE and/or osteolysis. The mean age was 53 ± 9 years at the time of the primary total hip arthroplasty (THA) and 64 ± 9 years at the revision. The exchanged liners (Marathon, Depuy) were made of HCLPE. Annual X-rays were used to measure linear wear and osteolysis. The annual linear penetration was measured using PolyWare® software (Draftware Inc.). Annual Harris Hip Scores(HSS) were recorded.ResultsThe mean follow-up time between the primary and revision THAs was 11 ± 2 years and 8 ± 2 years after revision. The mean Harris Hip Score(HHS) before primary THA, 1 year after primary THA, before revision and 1 year after revision was 43±5, 85±5, 71±6, 83±7 individually. The mean penetration of the CUHMWPE and HCLPE liners occurring in the first year were 0.44 ± 0.28 mm and 0.38 ± 0.14 mm, respectively (p = 0.211). The mean annual linear penetration of CUHMWPE and HCLPE from the second year onward were 0.29±0.09 mm and 0.08 ± 0.03 mm respectively (p <0.01). All THAs with CUHMWPE showed osteolysis on acetabular and/or femoral side before revision. No HCLPE liner showed osteolysis at the last follow-up. Conclusion: The CUHMWPE liner had a significantly higher wear rate than did the HCLPE liner. The HCLPE liner showed a satisfactory liner penetration rate after revision with isolated liner exchange fixed with the original locking mechanism.

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“…The selected of surgical strategy according to the status of bone matrix defects requires, in extreme cases, the manu facture of a tailor-made implant [15]. Garcia and Adelai stress that a good late outcome is predominantly owed to the restoration of physiolo gical joint biomechanics [16,17]. However, taking into account the economics of the procedures, the suggestion to per form additional diagnostic testing in primary uncom pli cated hip arthrosis, as expressed by Kawasaki and Kirkpatrick, may be ex aggerated [18,19].…”

Section: Discussionmentioning

confidence: 99%

“…Se lek tyw ne do bra nie me tod ope racyj nych w za le żno ści od ubyt ków zrę bu kost ne go, w skraj nych przy pad kach wy ma ga wy ko na nia implan tu na wy miar [15]. García i Ade la ni pod kre śla ją, że do bry wy nik od le gły w du żej mie rze za le ży od odtwo rze nia pra wi dło wej bio me cha ni ki sta wu [16,17]. Uwzględ nia jąc jed nak eko no mi kę pro ce dur, au to rzy uwa żają za prze sa dę roz sze rza nie dia gno sty ki pro pono wa ną przez Ka wa sa ki czy Kirk pa trick w pier wotnych nie po wi kła nych ar tro zach bio dra [18,19].…”

Section: Dys Ku Sjaunclassified

Surgical Strategy in Intra-pelvic Cup Migration During Total Hip Arthroplasty. A Case Study

Pozowski¹,

Kowal²,

Kuciel−Lewandowska³

et al. 2016

Ortop Traumatol Rehabil

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STRESZCZENIEPrzed sta wiono przy pa dek 63-let niej pa cjent ki skie ro wa nej do na sze go ośrod ka z po wo du wcze snych po wikłań po ope ra cyj nych bę dą cych wy ni kiem błę du śród o pe ra cyj ne go. Pod czas przy go to wy wa nia ło ży ska dla panew ki en do pro te zy wy ła ma no jej dno, wy twa rza jąc roz le gły uby tek seg men tal ny o śred ni cy uży wa ne go fre zu. Pró ba sta bi li za cji pa new ki en do pro te zy za po mo cą ce men tu kost ne go bez od two rze nia ubyt ku oka za ła się niesku tecz na, a sa mo roz wią za nie bu dzi ło zdzi wie nie. Pod czas osa dza nia pa new ki en do pro te zy na ce men cie kostnym, znacz na je go część zo sta ła we pchnię ta w głąb, po za ob rys pa new ki kost nej. Stop nio wa wcze sna mi gracja pa new ki en do pro te zy wraz z ce men tem, wo bec niepod ję cia szyb kiej in ter wen cji ope ra cyj nej, do pro wa dziła do ich prze miesz cze nia w głąb ja my brzusz nej. Wy nik ba da nia ob ra zo we go wy ko na ne go po 3 mie sią cach od ope ra cji za de cy do wał o przy ję ciu dwu eta po we go po stę po wa nia ope ra cyj ne go. W pierw szym z do stę pu poza otrzew no we go usu nię to ce ment i pa new kę. W dru gim, po 3 ty go dniach, wy ko na no re alo pla sty kę czę ści panew ko wej en do pro te zy z re kon struk cją dna pa new ki.Słowa kluczowe: staw biodrowy, panewka, endoprotezoplastyka, protruzja SUMMARYWe report the case of a 63-year-old female patient referred to our department due to an early postoperative complication resulting from intraoperative fault. During the preparation of a bone socket for the acetabular cup, the acetabular fossa was broken, forming an extensive segmental defect of the diameter of the reamer used. An attempt to stabilize the acetabular prosthesis using bone cement without repairing the bone defect was ineffective and inappropriate. During the deposition of the acetabular prosthesis on the cement, much of the cement was pushed beyond the outline of the bony acetabulum. Progressive early migration of the acetabular cup together with the cement due to the non-implementation of rapid intervention led to their displacement into the abdominal cavity. On analysing a radiograph performed 3 months after the operation, we decided to adopt a two-stage surgical strategy. In the first stage, the acetabular prosthesis with the cement was removed from a retroperitoneal approach. Three weeks later a revision arthroplasty of the acetabular component was carried out with reconstruction of the acetabular floor. Key words: hip, acetabulum, total hip arthroplasty, protrusionO O r r t t o o p p e e d d i i a a Traumatologia Rehabilitacja © MEDSPORTPRESS, 2016; 3(6); Vol. 18, 289-294 DOI: 10.5604/15093492.1212998 WSTĘPBłę dy śród o pe ra cyj ne mo gą zda rzyć się ka żde mu ope ru ją ce mu. Za rów no chi rur gom z mniej szym, jak i z więk szym do świad cze niem. Tym dru gim przy trafić się mo gą ra czej w przy pad kach o du żej ska li trudno ści. O pro ble mach ope ra cyj nych i kom pli ka cjach w ar tro pla sty kach bio dra pier wot nych (THA) i re wizyj nych ...

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Revision Total Hip Arthroplasty with Retained Acetabular Component

Abstract: Adelani, Muyibat A.; Mall, Nathan A.; Nyazee, Humaa; Clohisy, John C.; Barrack, Robert L.; and Nunley, Ryan M., ,"Revision total hip arthroplasty with retained acetabular component

Cited by 30 publications

References 30 publications

Tussilagone Inhibits Osteoclastogenesis and Periprosthetic Osteolysis by Suppressing the NF-κB and P38 MAPK Signaling Pathways

Tussilagone Inhibits Osteoclastogenesis and Periprosthetic Osteolysis by Suppressing the NF-κB and P38 MAPK Signaling Pathways

Comparison of Polyethylene Wear before and after Hip Revision with Liner Exchange Fixed with the Original Locking Mechanism

Surgical Strategy in Intra-pelvic Cup Migration During Total Hip Arthroplasty. A Case Study

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