Are Hooded, Crosslinked Polyethylene Liners Associated with a Reduced Risk of Revision After THA?

Background: Hooded acetabular liners and head sizes ≥ 32 mm have both shown to have a beneficial effect on the revision rate for dislocation in THA. Experience with noncrosslinked polyethylene (nonXLPE) raised concerns regarding the risk of impingement damage, loosening, and osteolysis with hooded liners; however, the evidence for this in crosslinked polyethylene (XLPE) is inconclusive. The interaction between different femoral head sizes and hooded liners is not well understood, and it is unclear whether hooded XLPE liners have a beneficial effect on overall long-term survivorship.

Outcome following total knee replacement in patients with a previous patellectomy.

Although patellectomy is a rarely performed surgical procedure, patients may still progress to develop osteoarthritis of the tibiofemoral compartments leading to total knee replacement surgery. Due to the mechanical disadvantage of a previous patellectomy, it has previously been suggested that a prosthesis with more constraint should be used, however, there are conflicting reports in the literature. We aimed to assess the effects of stability following total knee replacement in patellectomised knee with revision as a primary endpoint.

Staged venous thromboemolic events prophylaxis with low-molecular-weight heparin followed by aspirin is safe and effective after arthroplasty.

Background: The rate of fatal pulmonary embolism (PE) following hip and knee arthroplasty has remained unchanged despite the use of low-molecular-weight heparin (LMWH) and oral antithrombotic agents. Concerns regarding bleeding and wound complications resulted in the introduction of a staged chemoprophylaxis protocol at our institution in 2002. We hypothesized that staged chemoprophylaxis using LMWH in hospital followed by aspirin after discharge was safe and effective for the prevention of venous thromboembolic events (VTE).

Sciatic Nerve Palsy following Total Hip Replacement via Direct Anterior Approach after Recommencement of Warfarin for Prophylaxis in Atrial Fibrillation.

The occurrence of sciatic nerve palsy following posterior and anterolateral approaches to the hip has been well documented and is about 1-2%. To our knowledge, however, there are no reports of sciatic nerve palsy occurring secondary to the anterior approach to the hip for arthroplasty. We describe a case of sciatic nerve palsy secondary to haematoma formation following total hip replacement through the anterior approach.

Extended trochanteric osteotomy followed by cemented impaction allografting in revision hip arthroplasty.

The aim of this study is to present the medium- to long-term results of all cases of femoral impaction allografting revision at our institution that required an extended trochanteric osteotomy (ETO) at the time of surgery. Eighteen patients with a mean age of 60 years were evaluated. Indication for revision was aseptic loosening in all cases.

Posterior longitudinal split osteotomy for femoral component extraction in revision total hip arthroplasty.

We present a technique of single posterior longitudinal split osteotomy. This technique allows the expansion of the proximal femur and easier extraction of uncemented femoral components. Since 1998 we have performed this osteotomy in 12 revision total hip arthroplasties in 11 patients who had either stable fibrous ingrowth or a small amount of bony ingrowth.