Use of an alumina ceramic-on-alumina ceramic bearing surface in THA in a 13 year old with JIA--a single case study.

Total hip arthroplasty (THA) has been shown to be highly effective in ameliorating pain and increasing function in adults with end stage arthritis of the hip. Early studies of cemented THA in children with advanced hip disease reported poor results, but, more recently, results of cementless THA show greatly improved outcomes. More recently, concerns related to THA in children have focused on wear of the bearing surfaces, which may result in periprosthetic bone loss and eventual loosening of the prosthetic components.

Fractures and amputations in children and adolescents requiring hospitalization after farm equipment injuries.

Background: The majority of farm-related injuries in children are caused by farm machinery. The aim of this study is to report the incidence of children requiring hospitalization for orthopaedic trauma after injury secondary to farm equipment accidents.

Methods: Data for this study were culled from the Kids' Inpatient Database for the years 2000, 2003, and 2006 using the E-code for injuries caused by agricultural machinery to identify the study group.

Trochanteric excision following persistent nonunion of the greater trochanter.

Trochanteric nonunion associated with total hip arthroplasty (THA) may result from 1 of 3 situations: 1) isolated fracture of the greater trochanter; 2) complication of trochanteric osteotomy; or 3) fracture secondary to cystic formation or osteolysis from wear debris post-THA. Isolated fracture of the greater trochanter can occur during primary or revision THA or as a result of trauma in the post-THA patient. It is estimated that approximately 5% of intraoperative femoral fractures involve just the greater trochanter.

Ceramic-on-ceramic total hip arthroplasty: update.

This prospective, randomized, multicenter study of alumina ceramic-on-alumina ceramic bearing couples includes 452 patients (475 hips). Their average age was 53 years with approximately two thirds men and 82% with osteoarthritis. At an average 8-year follow-up, clinical results were excellent and cortical erosions significantly less than in the conventional polyethylene-on-metal bearing group.

Late remodeling around a proximally HA-coated tapered titanium femoral component.

Unlabelled: Most bone remodeling is thought to occur within the first few years after THA. Loss of bone density later may be associated with stress shielding or normal bone loss of aging. We evaluated remodeling changes over time with a proximally hydroxyapatite-coated tapered titanium stem.

Emergency department visits secondary to amusement ride injuries in children.

Background: Amusement rides are located not only in large amusement parks but also at local fairs and carnivals, in shopping malls, and at schools, and are even rented for private use. Millions of children in the United States participate in amusement rides annually. The amusement park industry has a vested interest in the safety of its equipment, and indeed, reports of severe injury or death are rare compared to the huge number of rides per year.

Long-term outcome of surface replacement with comparison to an age- and time-matched primary total hip arthroplasty cohort.

Surface replacement (SR) was introduced as a bone-conserving alternative to total hip arthroplasty (THA) 3 decades ago, then was abandoned due to polyethylene wear, stress shielding, and loosening. Improved bearing surfaces have renewed interest in SR. This study examined long-term SR outcome compared to an age- and time-matched THA cohort.

Primary osteoarthritis of the elbow: lack of radiographic evidence for morphologic predisposition, results of operative debridement at intermediate follow-up, and basis for a new radiographic classification system.

This study evaluated whether or not a morphologic predisposition exists to the development of primary osteoarthritis and establishes a classification tool to predict outcome in surgical treatment of elbow osteoarthritis. Detailed radiographic morphologic analysis of the ulnotrochlear and radio-capitellar joints in 90 normal and 24 osteoarthritic elbows showed few differences. Based upon commonly demonstrated radiographic features of degenerative changes, joint space narrowing, and marginal osteophytes, a classification system for rating the severity of primary osteoarthritis of the elbow was developed and applied retrospectively classified the preoperative radiographs of 18 patients (21 elbows) who had undergone elbow debridement and capsular release through a lateral collateral ligament preserving approach.

Orthopaedic injuries in children with nonaccidental trauma: demographics and incidence from the 2000 kids' inpatient database.

The purpose of this study was to examine the demographic and injury characteristics of children hospitalized with nonaccidental trauma as a causative factor using a large national database. Of the nearly 2.5 million cases in the database, 1794 (0.

Impaction grafting for femoral component revision using a non-polished bead-blasted chrome cobalt stem-average 8 1/2-year follow-up.

Impaction grafting for femoral component revision in patients with significant bone loss has been reported using a tapered polished femoral component that is meant to subside. This study reports our results of femoral component revision using impaction grafting with a bead-blasted chrome cobalt stem designed not to subside. Forty-eight femoral component revisions using impaction grafting were retrospectively reviewed with a minimum 6 1/2-year follow-up.

Hydroxyapatite-coated femoral components: 15-year minimum followup.

Hydroxyapatite-coated femoral components were introduced to enhance fixation, but concerns were raised about whether the coating would be maintained over time. We therefore determined the long-term clinical and radiographic results of a proximally hydroxyapatite-coated femoral component and compared the mechanical failure rate to other fixation methods at similar lengths of followup. The study group, culled from a large, multicenter prospective study population, consisted of 146 patients (166 hips) with followup of 15 to 18 years.

Epidemiology and mechanisms of femur fractures in children.

The most common pediatric orthopaedic injury requiring hospitalization is a femur fracture. This study aimed to identify the epidemiology and mechanisms of injury so that these injuries might be reduced through specifically targeted safety measures. Data for this study were culled from the 2000 Kids' Inpatient Database representing over 2.

Orthopaedic implants in children: survey results regarding routine removal by the pediatric and nonpediatric specialists.

The role of orthopaedic implant removal in children is controversial. Some children later require adult reconstruction; implant removal may be difficult or may adversely affect the outcome. The purpose of this study is to compare the opinions of the pediatric and nonpediatric specialists regarding routine implant removal in children.

Arc-deposited hydroxyapatite-coated cups: results at four to seven years.

Unlabelled: A second-generation arc-deposited hydroxyapatite-coated acetabular component was developed after detailed analysis of a failed first-generation grit-blasted hydroxyapatite-coated cup. In our prospective multicenter study we aimed to compare clinical results and survivorship of the newly designed cup to the previous cup and to a similarly designed porous-coated cup during the same time period. The effect of bearing surface-alumina-on-alumina to polyethylene-on-metal-was analyzed.

Does smoking affect implant survivorship in total hip arthroplasty? A preliminary retrospective case series.

This retrospective study aimed to explore the effects of smoking on hip implant survivorship. The study included 147 patients (165 hips) from 1985 to 1991 who underwent total hip arthroplasty (THA) with a particular uncemented cup, and either a cemented or uncemented femoral component of the same design. Thirty-one patients (34 hips, 21 percent of study group) smoked at the time of surgery.

Alternative bearing surfaces: alumina ceramic bearings for total hip arthroplasty.

Osteolysis resulting from polyethylene wear debris is one of the most common causes of implant failure in young, active individuals who undergo total hip arthroplasty. Reducing wear may help extend the life of the implant in these patients. Contemporary alumina ceramic/alumina ceramic bearing articulations are harder, scratch resistant, and more hydrophilic than other bearing couples, resulting in reduced wear and reduction of particle load to the surrounding tissue.

Septic arthritis of the ankle due to Salmonella enteritidis: a case report.

Salmonella septic arthritis in healthy individuals is a rare phenomenon in the United States. This case report chronicles the clinical course of a 41-year-old male farmworker who presented with a 3-week history of fever, chills, night sweats with pain, and swelling and redness of his left ankle. He had an open fracture of the ankle 2 years earlier that healed and was asymptomatic despite prior radiographic evidence of avascular necrosis of the talar dome.

Clinical outcome and incidence of pregnancy after bipolar and total hip arthroplasty in young women.

Female patients under 45 years of age (average, 32.5; range, 14-44) at the time of primary bipolar or total hip arthroplasty (THA) were surveyed an average 10.5 years (range, 1.

Elective primary total hip arthroplasty in octogenarians.

Background: Total hip arthroplasty (THA) has resulted in decreased pain and increased function in people with end-stage hip arthritis for several decades. In elderly people, THA has been used most often following femoral neck fracture. However, with life spans increasing and people remaining healthy and active well into their eighties, arthroplasty surgeons are now performing primary THA as an elective procedure in octogenarians.

Primary hybrid total hip arthroplasty with a roughened femoral stem: integrity of the stem-cement interface.

One hundred and two consecutive cemented femoral stems were evaluated in 92 patients at an average 9-year follow-up and a minimum 5-year follow-up (range, 5-14 years). The stem used was cobalt chromium with a collar, normalization steps, and a roughened surface (Ra 40); the stem was inserted using contemporary cementing techniques. This series demonstrated a femoral component aseptic loosening rate of 2.

Ten-year results with hydroxyapatite-coated total hip femoral components in patients less than fifty years old. A concise follow-up of a previous report.

We report the results of total hip arthroplasty with use of a proximally hydroxyapatite-coated femoral component after a minimum follow-up of ten years in a group of patients who were less than fifty years old at the time of the primary procedure. In the five years since the original publication of our study, two additional stems have undergone revision. Thus, a total of six stems have been revised.

Hydroxyapatite coated stems in younger and older patients with hip arthritis.

A primary aim of research in total hip arthroplasty is to extend longevity through improved fixation and decreased wear and osteolysis. Age range of patients receiving hip implants is ever increasing as technology improves and average life span increases. The current report focuses on minimum 10-year results of a proximally hydroxyapatite-coated stem in patients with degenerative joint disease, comparing those 45 years and older (n = 229 hips) with younger patients (n = 41 hips).

Factors related to false- versus true-positive neuromonitoring changes in adolescent idiopathic scoliosis surgery.

Study Design: A retrospective study of 134 adolescent patients who underwent surgical correction of idiopathic scoliosis between June 1992 and August 1998 was conducted.

Objective: To examine factors related to changes in somatosensory-evoked potentials with or without neurogenic motor-evoked potentials.

Summary Of Background Data: Studies document and demonstrate threshold criteria for changes in neuromonitoring that predict changes in spinal cord function.

Evaluation of the forearm in untreated adult subjects with multiple hereditary osteochondromatosis.

Background: Limb-length discrepancy or angular deformities as a result of altered bone growth may lead to a decreased range of motion and impaired function as well as premature osteoarthritis in patients with multiple hereditary osteochondromatosis. The purpose of this study was to describe the function of the forearm in untreated patients in order to facilitate comparison with studies of the results of treatment of this condition.

Methods: The medical records of fifty-one pediatric patients were identified and served as the basis for identifying a cohort of adult relatives with the disorder.