Is Preoperative Identification of the Infecting Organism Essential Before Single-Stage Revision Hip Arthroplasty for Periprosthetic Infection?

Background: It is commonly stated that identification of the infecting organism is a prerequisite to single-stage revision arthroplasty of the hip for deep infection. We have performed single-stage revision in a series of patients where the organism was not identified preoperatively. The aim of this study is to investigate whether the rate of infection eradication following single-stage revision was affected by preoperative knowledge of the infecting organism.

Survivorship and Radiological Analysis of a Monoblock, Hydroxyapatite-Coated Titanium Stem in Revision Hip Arthroplasty.

Background: We evaluated the survivorship, incidence of complications, radiological subsidence, proximal stress shielding, and patient-reported outcomes of a conservative, monoblock, hydroxyapatite-coated femoral stem.

Methods: This retrospective cohort study reports on 254 revision hip arthroplasties between January 2006 and June 2016. The mean age of patients was 71 years.

Outcomes of Cement in Cement Revision, in Revision Total Hip Arthroplasty.

Background: The cement-in-cement femoral revision technique involves removing a femoral component from a well-fixed femoral cement mantle and cementing a new stem into the original mantle. This technique, when carried out for the correct indications, is fast, relatively inexpensive and carries a reduced short-term risk for the patient compared with conventional way of removing well-fixed cement.

Aim: To analyze the effectiveness of cement in cement revision of the femoral stem while performing a revision Total Hip Arthroplasty (THA).

A 28-year clinical and radiological follow-up of alumina ceramic-on-crosslinked polyethylene total hip arthroplasty: a follow-up report and analysis of the oxidation of a shelf-aged acetabular component.

Aims: Our aim in this study was to describe a continuing review of 11 total hip arthroplasties using 22.225 mm Alumina ceramic femoral heads on a Charnley flanged femoral component, articulating against a silane crosslinked polyethylene.

Patients And Methods: Nine patients (11 THAs) were reviewed at a mean of 27.

Acetabular revision with bone grafting and cementation for aseptic loosening after primary Charnley low-friction hip arthroplasty with structural bulk autografts.

Purpose: To review the outcome of acetabular revision with bone grafting and cementation for aseptic loosening after primary Charnley low-friction hip arthroplasty with structural bulk autografts in 15 patients.

Methods: Records were reviewed for 3 men and 12 women aged 31 to 72 (mean, 53) years who underwent acetabular revision with bone grafting and cementation for aseptic loosening at a mean of 12.4 (range, 6.

Fate of the unrevised cemented stem following cup only revision: 227 hips at an average of 6 years follow-up.

Background: After primary total hip replacement, aseptic loosening of the acetabular cup is more common than loosening of the femoral stem. Removal of a well-fixed stem adds to operative time, blood loss, risk of bone loss and fracture. There is limited evidence that isolated cup revision can be a safe option in revision hip arthroplasty.

Microseparation, fluid pressure and flow in failures of metal-on-metal hip resurfacing arthroplasties.

Objectives: Metal-on-metal (MoM) hip resurfacing was introduced into clinical practice because it was perceived to be a better alternative to conventional total hip replacement for young and active patients. However, an increasing number of reports of complications have arisen focusing on design and orientation of the components, the generation of metallic wear particles and serum levels of metallic ions. The procedure introduced a combination of two elements: large-dimension components and hard abrasive particles of metal wear.

The C-stem in clinical practice: fifteen-year follow-up of a triple tapered polished cemented stem.

The triple tapered polished cemented stem, C-Stem, introduced in 1993 was based on the original Charnley concept of the "flat back" polished stem. We present our continuing experience with the C-Stem in 621 consecutive primary arthroplasties implanted into 575 patients between 1993 and 1997. Four hundred and eighteen arthroplasties had a clinical and radiological follow-up past 10 years with a mean follow-up of 13 years (10-15).

Charnley low-friction arthroplasty in teenage patients: the ultimate challenge.

Increasing follow-up identifies the outcome in younger patients who have undergone total hip replacement (THR) and reveals the true potential for survival of the prosthesis. We identified 28 patients (39 THRs) who had undergone cemented Charnley low friction arthroplasty between 1969 and 2001. Their mean age at operation was 17.

The principle of low frictional torque in the Charnley total hip replacement.

The design of the Charnley total hip replacement follows the principle of low frictional torque. It is based on the largest possible difference between the radius of the femoral head and that of the outer aspect of the acetabular component. The aim is to protect the bone-cement interface by movement taking place at the smaller radius, the articulation.

Charnley low-frictional torque arthroplasty: follow-up for 30 to 40 years.

Of the 11 054 Charnley low-frictional torque arthroplasties carried out at our hospital between 1962 and 1977, 110 (94 patients) had a minimum follow-up of 30 years with a mean of 32.3 years (30.0 to 40.

Effect of reduced diameter neck stem on incidence of radiographic cup loosening and revisions in Charnley low-frictional torque arthroplasty.

Previous studies of the Charnley low-frictional torque arthroplasty have established an exponential correlation between the depth of cup penetration and the incidence of ultrahigh molecular weight polyethylene cemented cup migration. Impingement of the neck of the stem on the rim of the cup was considered to be the cause. We compared the incidence of radiographic loosening and revision of the cup in 2 groups of patients: those with 12.

Increasing patients' body mass. Are the criteria for testing stemmed femoral components in total hip arthroplasty still valid?

The increasing incidence of obesity in the population is a topic of current interest. This trend is reflected in patients undergoing primary Charnley hip replacement. Over a 21 year period from January 1986 to October 2006, during which 6910 primary operations were performed, the body mass of patients increased at a mean rate of 0.

Charnley low-friction arthroplasty: survival patterns to 38 years.

We studied survival to 38 years after Charnley low-friction arthroplasty of the hip. We used revision as an end-point, while adopting a policy of regular follow-up and early revision for radiological changes alone if indicated. Between November 1962 and June 2005, 22,066 primary low-friction arthroplasties (17,409 patients) had been performed at Wrightington Hospital by more than 330 surgeons.

Charnley low-frictional torque arthroplasty in young rheumatoid and juvenile rheumatoid arthritis: 292 hips followed for an average of 15 years.

Introduction: In the early 1960s, Charnley was cautious with his patient selection for total hip replacement. As follow-up increased and confidence in the operation grew, younger patients were selected. We present our results of the Charnley LFA in young patients with rheumatoid and juvenile rheumatoid arthritis with a followup of up to 36 years.

The Charnley hip replacement -- 43 years of clinical success.

The Charnley low-frictional torque arthroplasty of the hip with 22.225 mm diameter head and thick ultra high molecular weigh polyethylene cup, both components grouted with cold curing acrylic cement, has reached 43 years of clinical success. Follow-up past 30 years is now available.

The angle-bore acetabular component and dislocation after revision of a failed total hip replacement.

We reviewed 1039 revision total hip replacements where an angle-bore acetabular component was used. After a mean follow-up of nine years (0 to 20.6), the incidence of revision for dislocation was 2.

Charnley low-frictional torque arthroplasty for avascular necrosis of the femoral head.

Forty-nine patients (mean age, 37 years; 20-50 years) had had 69 Charnley low-frictional arthroplasties for avascular necrosis of the femoral head. Their mean follow-up was 13.4 years (2-25 years).

Low-friction arthroplasty of the hip using alumina ceramic and cross-linked polyethylene. A 17-year follow-up report.

We report the results of our continued review of 11 total hip arthroplasties using 22.225 mm alumina ceramic femoral heads on a Charnley flanged stem, articulating with chemically cross-linked polyethylene. There was an initial bedding-in of up to 0.

Wear of the cup in the Charnley LFA in the young patient.

Since wear and loosening of the ultra-high-molecular-weight polyethylene cup are factors which limit the life of an arthroplasty we have attempted to identify factors associated with either low wear (0.02 mm/year or less) or high wear (0.2 mm/year or more).

Wear of ultra-high-molecular-weight polyethylene cup articulating with 22.225 mm zirconia diameter head in cemented total hip arthroplasty.

A number of studies have highlighted the increasing incidence of aseptic cup loosening with increasing depth of cup penetration by the metal head. We present our experience with a 22.225 mm diameter zirconia head on a 9-10 taper articulating with an ultra-high-molecular-weight polyethylene (UHMWPE) cup in cemented total hip arthroplasties.

Determination of the trabecular bone direction from digitised radiographs.

There is increasing evidence for monitoring the bone trabecular structure to explain, in part, the mechanical properties of bone. Despite the emergence of Computed Tomography, a radiograph is the standard format as it is cheap and used for assessing implant performance. Furthermore, various image-processing techniques developed to assess the trabecular structure from radiographs have regained interest owing to improvements in imaging equipment.

Wear of enhanced ultra-high molecular-weight polyethylene (Hylamer) in combination with a 22.225 mm diameter zirconia femoral head.

We have prospectively studied the wear of enhanced ultra-high molecular-weight polyethylene (Hylamer) in combination with a zirconia femoral head of 22.225 mm diameter on a cemented, triple-tapered, collarless, polished stem, the C Stem. The 71 patients who underwent total hip arthroplasty had a mean follow-up of six years (3 to 8).