Total hip arthroplasty: a still evolving technique

Gália, Carlos Roberto; Diesel, Cristiano Valter; Guimarães, Marcelo Reuwsaat; Ribeiro, Tiango Aguiar

doi:10.1016/j.rboe.2016.09.011

Cited by 16 publications

(14 citation statements)

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“…Bone cements (calcium phosphate and poly(methyl methacrylate)) have been used for years, to stabilize bone and implants, and also as antibiotics carriers [65][66][67]. Antibiotics loaded into bone cements could be easily replaced by AMPs, representing a possible straightforward strategy to step into the market [48][49][50][51].…”

Section: Bone Cements/beadsmentioning

confidence: 99%

Antimicrobial Peptides in the Battle against Orthopedic Implant-Related Infections: A Review

et al. 2021

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Prevention of orthopedic implant-related infections is a major medical challenge, particularly due to the involvement of biofilm-encased and multidrug-resistant bacteria. Current therapies, based on antibiotic administration, have proven to be insufficient, and infection prevalence may rise due to the dissemination of antibiotic resistance. Antimicrobial peptides (AMPs) have attracted attention as promising substitutes of conventional antibiotics, owing to their broad-spectrum of activity, high efficacy at very low concentrations, and, importantly, low propensity for inducing resistance. The aim of this review is to offer an updated perspective of the development of AMPs-based preventive strategies for orthopedic and dental implant-related infections. In this regard, two major research strategies are herein addressed, namely (i) AMP-releasing systems from titanium-modified surfaces and from bone cements or beads; and (ii) AMP immobilization strategies used to graft AMPs onto titanium or other model surfaces with potential translation as coatings. In overview, releasing strategies have evolved to guarantee higher loadings, prolonged and targeted delivery periods upon infection. In addition, avant-garde self-assembling strategies or polymer brushes allowed higher immobilized peptide surface densities, overcoming bioavailability issues. Future research efforts should focus on the regulatory demands for pre-clinical and clinical validation towards clinical translation.

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Section: Bone Cements/beadsmentioning

confidence: 99%

Antimicrobial Peptides in the Battle against Orthopedic Implant-Related Infections: A Review

et al. 2021

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“…Symptomatic osteoarthritis secondary to developmental dysplasia of the hip (DDH) is a common indication for total hip arthroplasty (THA) ( Cooperman et al, 1983 ; Harris, 1986 ; Hartofilakidis et al, 1996 ). Surgical reconstructions of appropriate component alignments, anatomic acetabular rotation center, and equal leg length are essential requirements in THA that guarantee good clinical results ( Galia et al, 2017 ). However, a broad range of pathomorphological changes from both the acetabulum and femoral sides exist in DDH patients, including bony acetabular defect, a high-riding or even dislocated femoral head, and excessively anteverted femur.…”

Section: Introductionmentioning

confidence: 99%

Postoperative Hip Center Position Associated With the Range of Internal Rotation and Extension During Gait in Hip Dysplasia Patients After Total Hip Arthroplasty

Zou

Sun

et al. 2022

Front. Bioeng. Biotechnol.

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Background: Total hip arthroplasty (THA) for hip dysplasia patients is sometimes complex and compromises pathomorphological changes in these patients. However, it remains unclear whether it is preoperative deformities or postoperative structures or anatomic changes during THA that have the most remarkable correlation with the hip dynamic function during gait. The purpose of this study was to investigate this relationship and propose insights into the surgical reconstruction strategy in patients with developmental dysplasia of the hip.Methods: A total of 21 unilateral hip dysplasia patients received computed tomography scans for the creation of 3D hip models before surgery and at the last follow-up. Acetabular and femoral orientations, hip center positions, and femoral length were measured before and after THA. Hip kinematics of the operated side during gait was quantified using a dual fluoroscopic imaging technique. Pearson correlation and multiple linear regression were performed to evaluate the relationship between hip maximum range of motion in six directions and demographics characters and above hip anatomic parameters before and after THA and their changes in surgery.Results: Pearson correlation analysis found significant correlations with the gait range of motion mainly in postoperative structures, including postoperative hip center positions and acetabulum and combined anteversion. Further multiple linear regression indicated that a laterally placed hip center was significantly correlated with an increased internal rotation (R2 = 0.25, p = 0.021), which together with increased postoperative acetabulum anteversion explained 45% of external rotation decreasing (p = 0.004). A proximally placed hip center was correlated with more extension (R2 = 0.30, p = 0.010). No significant demographic characters or preoperative deformities or surgical changes were included into other multiple regression models.Conclusion: Strong correlations between postoperative structures, especially hip center positions and gait range of motion in unilateral hip dysplasia patients after THA were found. It indicated that postoperative prosthesis structures, particularly hip center positions had significant impact on the hip gait motion range and should be treated with particular caution in surgery.

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“…The stem comes in 12 sizes [1][2][3][4][5][6][7][8][9][10][11]14 and a 12 to 14 mm cone. The stem sizes are offered in two offset types: standard and lateral.…”

Section: Surgerymentioning

confidence: 99%

The Accuracy and Ability of Preoperative Templating to Restore Femoral Offset in Calcar-Guided Short-Stem Total Hip Prosthesis through Direct Anterior Approach

Favier¹,

Beek²,

Tengrootenhuysen³

2021

The Journal of Hip Surgery

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The aim of this study was to assess the applicability and ability of preoperative templating to restore femoral offset and hip length with a calcar-guided short-stem implant design in total hip arthroplasty through the direct anterior approach. Preoperative measurements were performed of femoral offset, hip length, and stem size and compared with the perioperative placed prosthesis in 100 patients undergoing primary total hip replacement through direct anterior approach. Additionally, the pre- and postoperative femoral offset and hip length were compared to evaluate the ability to restore the offset and hip length with this kind of femoral short stem. With an acceptance of 1 size difference pre- and postoperatively, a 94% accuracy of predicting the size of the calcar-guided short stem was achieved with templating. Femoral offset was within means of 5 mm in 82.2% of the patients. Postoperative hip length was within 6 mm in 90% of the patients compared with the preoperative length.The use of preoperative templating for total hip arthroplasty with calcar-guided short-stem implants was proven to be a useful tool to predict the definite implanted size of the femoral prosthesis. Our results show that this new stem design does not significantly differ from previous reported outcomes with other stem designs and is competent to restore the femoral offset and hip length within clinical acceptable range. Level of evidence Level 3 retrospective case study.

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Total hip arthroplasty: a still evolving technique

Cited by 16 publications

References 50 publications

Antimicrobial Peptides in the Battle against Orthopedic Implant-Related Infections: A Review

Antimicrobial Peptides in the Battle against Orthopedic Implant-Related Infections: A Review

Postoperative Hip Center Position Associated With the Range of Internal Rotation and Extension During Gait in Hip Dysplasia Patients After Total Hip Arthroplasty

The Accuracy and Ability of Preoperative Templating to Restore Femoral Offset in Calcar-Guided Short-Stem Total Hip Prosthesis through Direct Anterior Approach

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