Introduction: Aseptic loosening is the main long-term complication and indicates total hip replacement failure. There are many and often intricate causes for aseptic loosening. Incorrect placement of the implants is the most incriminated factor. Other patient and implant related factors may also predispose to loosening but to various degrees.
Methods: We conducted a retrospective study of 64 cases with aseptic loosening of total hip prosthesis to individuate patient, implant type and surgical technique related factors leading to aseptic loosening and to provide recommendations to minimize this risk.
Results: This was an analytic retrospective study of 64 cases with aseptic loosening. The classification is that used by the French Society of Orthopedic Surgery and Traumatology. The average age of the patients at the time of the first arthroplasty was 40 years, 62 years at the time of loosening. Charnley stem was implanted in 55 cases, Muller stem in 9 cases. Acetabular component was well positioned in 69% of cases with an average inclination of 47.8 °. The stems were canal-filling in 86% of cases with Grade A cementation in 60% of cases. The mean time for loosening onset was 12 years. 72% of the prostheses had a survival longer than 10 years. Statistical analysis of the results identified risk factors leading to loosening, such as: age, body mass index, level of activity, cup inclination, femoral offset and cementation quality.
Conclusion: A significant reduction in aseptic loosening of total hip prostheses may only be achieved by a more rigorous selection of patients, a greater security in the technical act and a better choice of the implant to be placed.
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http://dx.doi.org/10.11604/pamj.2016.24.260.8164 | DOI Listing |
Background: The cementation technique is crucial for achieving adequate fixation and optimal survivorship in total knee arthroplasty (TKA). The thickness of the cement at the tibial bone-implant surface may be related to aseptic tibial loosening. However, to date, no studies have demonstrated a direct association between cement thickness and rates of aseptic tibial loosening.
View Article and Find Full Text PDFArch Orthop Trauma Surg
December 2024
Department of General Orthopaedics, Auguste-Viktoria-Clinic Bad Oeynhausen, University Hospital of RUB-Bochum, Am Kokturkanal, 32545, Bad Oeynhausen, Germany.
Introduction: Total lower limb arthroplasties are standard orthopedic surgeries that are steadily increasing in modern civilization. In proportion, the number of revision arthroplasties and the corresponding financial burden for healthcare systems will increase. The present clinical investigation analyzed morbidities after aseptic revision knee arthroplasty.
View Article and Find Full Text PDFArch Orthop Trauma Surg
December 2024
Department of Orthopedic Surgery, Kobe University Graduate School of Medicine, 7-5-1, Kusunoki-cho, Chuo-ku, Kobe, Hyogo, 650-0017, Japan.
Introduction: Thigh pain, aseptic loosening, and failure after total hip arthroplasty has been reported. Therefore, this study examines the impact of femoral stem alignment on periprosthetic bone mineral density (BMD) in THA using the Avenir Complete cementless stem, focusing on the role of precise stem alignment in maintaining proximal femoral BMD.
Materials And Methods: Consecutive patients who received the Avenir Complete stem via mini anterolateral approach in the supine position between March 2019 and March 2022 were included.
Mol Med
December 2024
Department of Orthopedics, Nanjing Jinling Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing, China.
Background: Periprosthetic osteolysis and subsequent aseptic loosening are the leading causes of failure following total joint arthroplasty. Osteogenic impairment induced by wear particles is regarded as a crucial contributing factor in the development of osteolysis, with endoplasmic reticulum (ER) stress identified as a key underlying mechanism. Therefore, identifying potential therapeutic targets and agents that can regulate ER stress adaption in osteoblasts is necessary for arresting aseptic loosening.
View Article and Find Full Text PDFJ Arthroplasty
December 2024
Department of Orthopaedic Surgery, University of Utah, Salt Lake City, UT, United States.
Introduction: Aseptic total knee arthroplasty (TKA) complications can be challenging to diagnose. Many studies have defined periprosthetic joint infection (PJI) using synovial aspirations, but few studies have described aspiration characteristics in aseptic TKA problems. The aim of this study was to determine the synovial fluid characteristics of patients who had TKA failure caused by two common aseptic diagnoses: aseptic loosening and instability.
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