Assessing Taper Geometry, Head Size, Head Material, and Their Interactions in Taper Fretting Corrosion of Retrieved Total Hip Arthroplasty Implants.

Background: Decreased fretting and corrosion damage at the taper interface of retrieved ceramic-on-polyethylene total hip arthroplasty (THA) implants has been consistently reported; however, resultant fretting corrosion as a function of femoral head size and taper geometry has not been definitively explained.

Methods: Eight cohorts were defined from 157 retrieved THA implants based on femoral head composition (n = 95, zirconia-toughened alumina, ZTA vs n = 62, cobalt-chromium alloy, CoCr), head size (n = 56, 32mm vs n = 101, 36mm), and taper geometry (n = 84, 12/14 vs n = 73, V40). THA implants were evaluated and graded for taper fretting and corrosion.

Analysis of Retrieved Unicompartmental Knee Implants and Tissue: Third-Body Wear as a Potential Contributor to Progression of Arthritis to Adjacent Compartments.

Unicompartmental knee arthroplasty (UKA) for the treatment of single-compartment osteoarthritis has been associated with polyethylene wear and progression of osteoarthritis into adjacent compartments, leading to revision. In this study, damage and clinical failure modes of retrieved UKA implants were investigated and protein expression profiles between articular cartilage adjacent to UKA and primary osteoarthritic cartilage were compared. Fifty retrieved UKA implants were analyzed for various damage.

Intraoperative Psoas Compartment Block vs Preoperative Fascia Iliaca Block for Pain Control After Direct Anterior Total Hip Arthroplasty: A Randomized Controlled Trial.

Background: Modern joint arthroplasty protocols place an emphasis on minimizing patient-reported postoperative pain while minimizing opioid consumption. The use of multimodal pain management protocols has been reported to improve patient outcomes and satisfaction after total hip arthroplasty.

Methods: In a prospective, single-surgeon trial, 50 patients undergoing primary direct anterior approach total hip arthroplasty were randomized to receive a preoperative fascia iliaca compartment block (FICB) or an intraoperative surgeon-delivered psoas compartment block (PCB).

Psoas Compartment Block vs Periarticular Local Anesthetic Infiltration for Pain Management After Anterior Total Hip Arthroplasty: A Prospective, Randomized Study.

Background: The psoas compartment block (PCB) or periarticular soft-tissue local anesthetic injection are forms of regional anesthesia often used as one of the components in multimodal anesthesia applied during total hip arthroplasty (THA). The most efficacious form of regional anesthesia for THA has yet to be determined.

Methods: In a single-surgeon, prospective, clinical trial, patients undergoing THA via direct anterior approach were randomized to receive an intraoperative periarticular local anesthetic infiltration (periarticular injection) or a PCB.

Fretting and Corrosion Damage in Retrieved Metal-on-Polyethylene Modular Total Hip Arthroplasty Systems: What Is the Importance of Femoral Head Size?

Background: Fretting and corrosion at the modular femoral head-femoral neck (taper) interface have been reported in retrieved total hip arthroplasty (THA) prostheses. This study investigated associations among implant design, radiographic factors, and patient factors with corrosion and fretting at the taper interface in retrieved metal-on-polyethylene modular THA prostheses.

Methods: Ninety-two retrieved primary metal-on-polyethylene THA implants were evaluated and graded for fretting, corrosion, and damage at the taper interface, including the femoral stem trunnion and femoral head.

Increasing Liner Anteversion Decreases the Interfacial Strength of Polyethylene Liners Cemented Into Titanium-Alloy Acetabular Shells.

Background: Acetabular component positioning during revision total hip arthroplasty can be suboptimal. Cementation of an acetabular liner into a well-fixed acetabular shell can allow surgeons to correct component version and inclination without the need for extensive revision surgery and progressive pelvic bone loss. However, to date, it is unknown what degree of version can be corrected without sacrificing fixation strength of the construct.

Clinical performance of a highly cross-linked polyethylene at two years in total hip arthroplasty: a randomized prospective trial.

We report the 2-year results for a prospective randomized trial comparing highly cross-linked with standard polyethylene in total hip replacements. In our study, 46 hips were available for radiographic analysis at 2- and 3-year follow-up. Femoral bearings were 28-mm cobalt chrome with the polyethylene insert randomly selected at the time of implantation to be highly cross-linked polyethylene (Crossfire; Stryker Howmedica Osteonics, Allendale, NJ) or standard polyethylene (N(2)/Vac, Stryker Howmedica Osteonics).