The interface between periacetabular osteotomy, hip arthroscopy and total hip arthroplasty in the young adult hip.

Hip pain is highly prevalent in both the younger and the elderly population. In older patients, pain arising from osteoarthritis (OA) is most frequent, whereas in younger patients, non-degenerative diseases are more often the cause of pain. The pain may be caused by hip dysplasia and femoroacetabular impingement (FAI).

Comparing osteonecrosis clinical phenotype, timing, and risk factors in children and young adults treated for acute lymphoblastic leukemia.

Background: Treatment-related osteonecrosis (ON) is a serious complication of treatment of acute lymphoblastic leukemia (ALL).

Procedure: This study included 1,489 patients with ALL, aged 1-45 years, treated according to the Nordic Society of Paediatric Haematology and Oncology ALL2008 protocol, using alternate-week dexamethasone during delayed intensification, with prospective registration of symptomatic ON. We aimed at comparing risk factors, timing, and clinical characteristics of ON in children and young adults.

Femoral revision with impaction allografting and an uncemented femoral component.

A technique for uncemented revision of the femoral component which combines impaction allografting and the use of a long-stemmed proximally coated titanium prostheses (Bimetric, Biomet Inc.) is described. The results after a mean follow-up of 112 months are reported.

Good performance of a titanium femoral component in cementless hip arthroplasty in younger patients: 97 arthroplasties followed for 5-11 years.

We performed 97 uncemented primary total hip arthroplasties in 80 patients having an average age of 50 years. The femoral implant was a titanium stem with a proximal circumferential plasma spray-coating. Three different acetabular components were used: a threaded and partly porous-coated design in 70% of the cases.

Long-term results after cemented revision of the femoral component in total hip arthroplasty.

The need for revision total hip arthroplasty has been increasing. The early results have been poor, and different revision techniques have been introduced. We report our results of 84 consecutive cemented first-time revisions of femoral components performed from 1981 through 1988 using a long-stem revision component.

[Non-cemented acetabular cup in hip arthroplasty. Prosthesis survival and clinical results after 1-8 years].

This is a retrospective clinical evaluation of 1028 primary hip arthroplasties performed with the non-cemented Harris-Galante I acetabulaer cup. Hospital records regarding all hips operated from July 1985 through March 1992 were evaluated after a median of 48 (12-93) months. Furthermore, questionnaires were sent out to all patients still alive in order to establish the actual function of the hips.

Evaluation of 100 Müller curved-stem and 276 Müller long-stem total hip arthroplasties after 10 to 15 years of follow-up.

This study evaluates 376 total hip arthroplasties performed between 1978 and 1983 using 276 Müller long-stem and 100 Müller curved-stem prostheses. Demographic and clinical data were obtained from patient records. All patients still alive who did not undergo revision arthroplasty were sent a detailed questionnaire.

[Femoral head necrosis treated with total hip alloplasty].

One hundred and three patients with non-traumatic osteonecrosis of the femoral head had 144 primary total hip replacements performed. Average age was 47 (22-73) years. In 85 cases a cemented prosthesis, and in 45 cases an uncemented prosthesis was used, while 14 cases had a cemented femoral stem and an uncemented cup.

Risk factors for recurrent aseptic loosening of the femoral component after cemented revision.

A series of 160 consecutive cemented first revisions, performed from 1977 through 1988 for aseptic loosening of a primary cemented femoral component, were studied using survivorship methods with the purpose of identifying risk factors for recurrent loosening of the femoral component. Risk of recurrent loosening depended on the length of the revision stem, with a significantly increased risk of loosening if the tip of the primary stem was overbridged by the revision stem with less than one width of the femoral shaft. Risk of recurrent loosening was also related to the extension of a cement mantle, exceeding more than 2 mm, around the revision stem measured on postrevision anteroposterior radiographs.

[Unsatisfactory results after repeated revision of hip alloplasties].

Sixty one cemented second revision total hip arthroplasties and 18 cemented third revision total hip arthroplasties were studied with emphasis on cause of failure, complications, risk of further revision, and clinical and radiographic outcome of surviving, not further revised patients. Aseptic loosening was the major reason for both second and third revisions followed by recurrent dislocations. Twenty one second revisions failed again.

Late disassembly of modular acetabular components. A report of two cases.

We report two cases of late disassembly of modular acetabular components, 4 and 5 years after implantation. One was revised immediately after the disassembly and one after 4 months, the latter demonstrating excessive wear of metal and polyethylene. Radiographs showing eccentric displacement of the femoral head in the cup associated with a dark, curved shadow representing the displaced polyethylene insert identify this type of implant failure.

Unsatisfactory results after repeated revision of hip arthroplasty. 61 cases followed for 5 (1-10) years.

61 cemented second revision total hip arthroplasties and 18 cemented third revision total hip arthroplasties were studied with emphasis on causes of failure, complications, risk of further revision, and clinical and radiographic results of surviving, not further revised patients. Aseptic loosening was the major reason for both second and third revisions followed by recurrent dislocations. Of 61 second revisions, 21 failed again.

Survivorship analysis of failure pattern after revision total hip arthroplasty.

Failure, defined as established indication for or performed re-revision of one or both components, was analyzed using survivorship methods in 306 revision total hip arthroplasties. The longevity of revision total hip arthroplasties was inferior to that of previously reported primary total hip arthroplasties. The overall survival curve was two-phased, with a late failure period associated with aseptic loosening of one or both components and an early failure period associated with causes of failure other than loosening.

Clinical results after revision and primary total hip arthroplasty.

Results after 184 primary and 227 revision total hip arthroplasties were compared with an emphasis on rates of failure leading to reoperation and intra- and postoperative complications and on the clinical outcome of the nonrevised arthroplasties in the two series. The failure rate was 7% (11 of 156) in the primary series, versus 27% (54 of 195) in the revision series. The rate of complications was substantially higher after revision, due to 16% (36 of 227) intraoperative fractures of the femoral shaft and 6% (14 of 227) postoperative dislocations.

Arthroplasty for congenital hip dislocation. Techniques for acetabular reconstruction.

We investigated a series of 63 arthroplasties for chronically dislocated hips or severe dysplasia with at least two thirds of the femoral head uncovered. Direct cementation into the neoacetabulum at the pelvic wing was followed by 6/20 revision arthroplasties and 3/20 impending failures. Cups supported by cortical bone grafts were revised in 8/16 and found loose in 2/12 arthroplasties.

Traumatic amputation of the upper limb: the use of body-powered prostheses and employment consequences.

Forty three patients with unilateral traumatic amputations were reviewed as to the use of prostheses and employment consequences of the amputation. Seventeen of 19 below-elbow amputees, and 12 of 24 above-elbow amputees used their prostheses. Non-users compared to users of prostheses were characterized by: 1) Higher level of amputation 2) Non-dominant arm amputation and 3) Younger age at the time of amputation.

Acute spontaneous streptococcal myositis. Case report.

Streptococcal myositis of the acute spontaneous type is extremely rare. To the best of our knowledge, this report describes the first case in which a patient has survived, and reviews the differential diagnosis. The treatment is primarily surgical.

Failures with the Judet noncemented total hip.

Primary failures with 36 noncemented Judet total hip arthroplasties are reported. Steep-cup inclination in 7 cases resulted in two dislocations, two migrations, one skew insertion, and two painful hips. Moreover, two migrations were encountered in patients with rheumatoid arthritis.