RESUMO
There is no consensus on the bearing of choice in revision for ceramic fracture after total hip arthroplasty (THA). The aim of this study was to evaluate the outcomes using ceramic-on-polyethylene (CoP) articulation in revision for ceramic breakage. Twelve patients who underwent revision hip surgery between 2002 and 2013 were followed-up. Appropriate surgical technique, including accurate synoviectomy, was used. The cup and the head were changed in four patients and only the liner and the head were replaced in the remaining eight patients. At the final follow-up there were no cases of re-revision due to tribological reasons, and only one case of polyethylene (PE) wear and osteolysis was scheduled for a new revision because of clear cup malposition. Complications were four cases of dislocation, one case of loosening and one case of infection. Revision of fractured ceramic is a challenging situation with a high risk of early complications. Using CoP liners with accurate synoviectomy and correction of misalignment can be considered a valuable bearing option at medium-term follow-up.
Assuntos
Artroplastia de Quadril/efeitos adversos , Fraturas Ósseas/cirurgia , Prótese de Quadril/efeitos adversos , Falha de Prótese , Reoperação , Adulto , Idoso , Materiais Biocompatíveis , Cerâmica , Feminino , Seguimentos , Fraturas Ósseas/diagnóstico por imagem , Humanos , Itália , Masculino , Pessoa de Meia-Idade , Polietileno , Estudos Retrospectivos , Resultado do TratamentoRESUMO
Residual acetabular dysplasia leads to hip arthritis as a consequence of insufficient femoral head coverage which causes abnormal pressure on the joint cartilage. Spherical periacetabular osteotomy, described by H. Wagner, improves the acetabular coverage of the head. This surgical technique has been performed by the senior author, in Galeazzi Orthopaedic Institute of Milan, Italy since 1979. The purpose of this study is to evaluate the clinical and radiographic results of 14 patients affected by acetabular dysplasia and operated before 1985 by the same surgeon with this technique. The analysis of long term results (follow-up longer than 20 years) has shown that it is possible to achieve good clinical outcomes and to delay the need for total hip arthroplasty if a precise surgical technique is employed and if the correct indications are followed. Obese patients or hips with X-ray signs of osteoarthritis show the worst results in our experience. Our attitude is nowadays: full indication of spherical periacetabular osteotomy in dysplasia of the adolescent, indication in young adult patients only when some symptom is present, very rare indication in arthritis and only in very mild cases in young patients.
RESUMO
See PDF. Unfortunately the following two abstracts were left out from the section dedicated to the abstracts of the Italian Hip Society, which were published in Hip International 2003; 13: 239-266. We reprint them underneath with apologies to the authors.
