Do large heads enhance stability and restore native anatomy in primary total hip arthroplasty?

Background: Dislocation remains a serious complication in hip arthroplasty. Resurfacing proponents tout anatomic femoral head restoration as an advantage over total hip arthroplasty. However, advances in bearings have expanded prosthetic head options from traditional sizes of 22, 26, 28, and 32 mm to diameters as large as 60 mm.

Perivascular lymphocytic infiltration is not limited to metal-on-metal bearings.

Background: Perivascular lymphocytic infiltration (PVLI) suggests an adaptive immune response. Metal hypersensitivity after THA is presumed associated with idiopathic pain and aseptic loosening, but its incidence and relationship to metallic wear leading to revision are unclear as are its presence and relevance in non-metal-on-metal arthroplasty.

Questions/purposes: We compared (1) incidence and severity of PVLI in failed hip metal-on-metal (MoM) to non-MoM implants and TKA; (2) PVLI in MoM and non-MoM hip arthroplasty based on reason for revision; and (3) PVLI grade to diffuse lymphocytic infiltration (DLI) and tissue reaction to metal particles.

Perioperative complications of simultaneous versus staged unicompartmental knee arthroplasty.

Background: The complication risk of staged versus simultaneous total knee arthroplasty continues to be debated in the literature. Previous reports suggest unicompartmental knee arthroplasty provides a more rapid functional recovery than total knee arthroplasty. However, little data exist on whether simultaneous unicompartmental knee arthroplasty can be performed without increasing the perioperative risk compared with staged unicompartmental knee arthroplasty.

The dislocator, early and late: the role of large heads.

Dislocation after total hip arthroplasty (THA) is a potentially devastating complication that can be difficult to manage. Many patient and mechanical factors have been associated with an increased risk of dislocation. Conservative treatments such as abduction bracing have not proven effective at treating this difficult problem.

Survivorship of 2000 tapered titanium porous plasma-sprayed femoral components.

Unlabelled: Tapered titanium porous plasma-sprayed components have performed well in primary THA. To confirm the literature at longer followup we retrospectively reviewed all 1639 patients who underwent 2000 THAs in which a specific porous femoral component was used. One hundred fourteen patients (134 hips) were lost to followup leaving a cohort of 1525 patients (1866 THAs).