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2.
J Bone Joint Surg Am ; 86(11): 2419-23, 2004 Nov.
Article in English | MEDLINE | ID: mdl-15523012

ABSTRACT

We previously reported the results at a mean of five years following the use of a tripolar constrained acetabular component to treat recurrently dislocating total hip prostheses. In this study, we report the results after longer follow-up, with emphasis on the prevalence of implant loosening, osteolysis, and later recurrent instability. Fifty-five patients treated with a total of fifty-six constrained acetabular components because of recurrent dislocations of a total hip prosthesis (average, six dislocations; range, two to twenty dislocations) were followed for an average of 10.2 years (range, 7.0 to 13.2 years) or until death. Four (7%) of the fifty-six hips had a subsequent dislocation or failure of the device. Three femoral components (5%) and two acetabular components (4%) were revised because of aseptic loosening. One hip was revised because of osteolysis. We concluded that this constrained acetabular component provides durable protection against additional dislocations without substantial deleterious effects on component fixation. We use this device to treat recurrent dislocation when other modalities are unlikely to be effective.


Subject(s)
Arthroplasty, Replacement, Hip/adverse effects , Hip Dislocation/etiology , Hip Prosthesis/adverse effects , Acetabulum , Adult , Aged , Aged, 80 and over , Follow-Up Studies , Hip Dislocation/diagnostic imaging , Hip Joint/diagnostic imaging , Humans , Middle Aged , Prosthesis Design , Prosthesis Failure , Radiography , Recurrence , Reoperation , Survival Analysis
3.
J Arthroplasty ; 18(7 Suppl 1): 131-7, 2003 Oct.
Article in English | MEDLINE | ID: mdl-14560423

ABSTRACT

The short-term efficacy of using constrained acetabular components for hip instability in the total hip arthroplasty construct has been documented. However, long-term concerns including late dislocation, loosening of components, and osteolysis have not been addressed. The authors evaluated, at an average 10.3-year follow-up, 101 tripolar constrained components (Stryker Howmedica Osteonics) used in the total hip arthroplasty construct. At final follow-up, 6 hips had dislocated or had failure of the constrained component, 5 of which were revised. In addition, 4 hips were revised for aseptic loosening of the acetabular component, 4 hips were revised for aseptic femoral loosening, and 1 hip was revised for acetabular osteolysis. Considering the complexity of the cases, this component has provided durable fixation and hip stability at this intermediate-term follow-up.


Subject(s)
Arthroplasty, Replacement, Hip , Hip Prosthesis , Joint Instability/surgery , Acetabulum , Adult , Aged , Female , Follow-Up Studies , Humans , Male , Prosthesis Failure , Reoperation
4.
J Arthroplasty ; 17(8): 1070-3, 2002 Dec.
Article in English | MEDLINE | ID: mdl-12478522

ABSTRACT

Skin necrosis associated with warfarin anticoagulation is a rare but serious complication. Few cases of warfarin-induced skin necrosis are found in the orthopaedic literature. We report a fatal case of warfarin-induced skin necrosis after total hip arthroplasty.


Subject(s)
Anticoagulants/adverse effects , Arthroplasty, Replacement, Hip , Skin/pathology , Warfarin/adverse effects , Aged , Fatal Outcome , Female , Humans , Necrosis , Postoperative Complications
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