ABSTRACT
Increasing use of joint replacement for various conditions has led to a new group of fractures- the periprosthetic fractures. Periprosthetic fractures are considered which are associated with an orthopaedic implant. Worldwide incidence of Periprosthetic fractures is increasing due to increased number of primary joint arthroplasties and other revision surgeries. Periprosthetic femoral fracture can be classified as intraoperative & post-operative. The intraoperative periprosthetic fractures usually occur during the insertion of the femoral stem, often preceded by an area of increased cortical thickness. The management of these fractures are complex and usually needs application of basic principles to fit an individual situation rather than having a fixed set of rules. Standard treatment protocol includes use of locking plate with encirclage wires. In this study, we provide a case of periprosthetic femur fracture pain. A 75-year-old woman presented to us with pain in her right hip and thigh. The patient was a homemaker who had cemented total hip replacement surgery due to a femoral neck fracture 27 days back. After the primary replacement surgery, the patient appeared to be doing well and adhering to the hip precautions. While getting out of bed, she tripped and fell carelessly in the morning & complained of severe pain in her right hip. After assessment of all her medical conditions and physical examination, she was advised for revision surgery. An open reduction and internal fixation of the fracture with revision of the femoral component was planned. Risks, benefits, and alternatives were discussed at length with her and her family. The patient and her family agreed to the operative plan.
ABSTRACT
Presentamos el caso de una paciente de 89 años de edad que sufrió paro cardiorrespiratorio durante la realización de hemiartroplastía de cadera cementada que precisó resucitación cardiopulmonar. Esta complicación ocurrió inmediatamente después de usar el sistema de lavado mediante dióxido de carbono CarboJet®, y se atribuyó a embolismo gaseoso, tras descartar otras entidades. Se discuten los posibles factores que pueden contribuir a esta complicación quirúrgica.
Case report of an 89 year-old patient who had cardiorespiratory arrest during cemented hip hemiarthroplasty and required cardiopulmonary resuscitation. This complication occurred immediately after using the carbon dioxide-based lavage system known as CarboJet® and was attributed to gas embolism once other entities were ruled out. The possible factors that may contribute to this surgical complication are discussed.
Subject(s)
Aged, 80 and over , Female , Humans , Embolism, Air/etiology , Hemiarthroplasty , Intraoperative Complications/etiology , Therapeutic Irrigation/adverse effectsABSTRACT
Objective To propose some detailed methods for diagnosis of fractured stem failure in clinic by studying the mechanical mechanism of fractured stem failure and the specific causes of fracture occurrence after the total hip arthroplasty (THA). Methods The correlations between fracture stem failure and production, clinical situation and patients were analyzed by 2D and 3D finite element analysis (FEA) method to study the biomechanical mechanism of fracture processes. Results The reasoning route for fractured stem failure analysis after THA was proposed, and mechanical analysis and validation on fractured stem failure were conducted by FEA methods successfully. Conclusions Fracture should not occur on the artificial stem, for those that gone through the strength design and experimental test; statistical analysis on fractured stem failure showed that the occurrence of such fractured stem is a kind of little probability random event, which could be induced by a variety of non-normal factors, such as fluctuations in product quality, technical errors in clinic, patient accidents and so on. Strict controls on these factors can reduce the fractured stem occurrence; the reasoning route for fractured stem failure can help to discover the reasons of failure occurrence; the mechanical mechanism of specific fracture stem occurrence can be detected by 2D and 3D FEA methods.
ABSTRACT
PURPOSE: The purpose of this study was to evaluate the clinical and radiological results of total hip arthroplasty using a proximal modular femoral stem in patients who had secondary coxarthrosis associated with a dysplastic hip. MATERIALS AND METHODS: Forty-two patients (45 hips) with secondary coxarthrosis were evaluated after undergoing primary total hip arthroplasty using an S-ROM proximal modular femoral stem. The average follow-up was 80 months (range: 60 to 96 months). Clinical and radiological assessments were performed based on the Harris hip score and the radiological changes around the prosthesis. RESULTS: The average Harris hip score improved from 52.2 points to 88.5 points. All femoral stems showed stable fixation; there were 37 cases by bony ingrowth and 8 cases by stable fibrous ingrowth. Neither osteolysis nor progressive radiolucent lines around the femoral stem were found at the last follow-up. Forty-one hips (91.9%) revealed excellent or good clinical results at the most recent follow-up. CONCLUSION: For advanced secondary coxarthrosis, total hip arthroplasty with the use of the proximal modular femoral stem yielded good mid-term results with respect to the clinical and radiological criteria.
Subject(s)
Adult , Aged , Female , Humans , Male , Middle Aged , Arthroplasty, Replacement, Hip/adverse effects , Femur/pathology , Hip Dislocation, Congenital/complications , Hip Prosthesis , Joint Deformities, Acquired/complications , Osteoarthritis, Hip/etiology , Postoperative Complications/pathologyABSTRACT
0.05),but the integrated arthoplasty group had significant differences from the other two groups(P
ABSTRACT
The conversion of the fused hip to THA may be used for patients with painful pseudoarthrosis, and malposition of the arthrodesed hip. It may also be used for patients with disabling pain in the ipsilateral knee, contralateral hip or lower back. Nineteen fused hips have been converted to total hip arthroplasty from January 1985 to December 1993. They were followed up for an average of 6 years. The causes of the fused hip were post-traumatic osteoarthritis (8 cases), tuberculous arthritis (6 cases), ankylosing spondylitis (3 cases) and rheumatoid arthritis (2 cases). The results of THA were satisfactory in all cases. The average Harris hip score after THA was improved from 56 to 84.1. The results of THA were best in patients with tuberculous arthritis and poorest in patients with ankylosing spondylitis. The average range of motion after THA is as follows: flexion 82 degree, abduction 28 degree, adduction 16 degree, external rotation 27 degree and internal rotation 13 degree. The average leg length discrepancy improved from 3 cm to 1.5 cm. The conversion of the fused hip to THA improves the patient s quality of life, so it is a useful treatment for the fused hip.