Serial radiographs are the mainstay in the longitudinal assessment of hip implants. The prosthesis, periprosthetic bone, and juxta-articular soft tissues are inspected for fracture, periosteal reaction, stress shielding, calcar resorption, osteolysis, bony remodeling, metallic debris, and heterotopic ossification. Comparison radiographs best confirm implant migration, subsidence, and aseptic lo...

BACKGROUND AND PURPOSE Metal-on-metal hip implants have been widely used, especially in the USA, Australia, England and Wales, and Finland. We assessed risk of death and updated data on the risk of cancer related to metal-on-metal hip replacements. PATIENTS AND METHODS A cohort of 10,728 metal-on-metal hip replacement patients and a reference cohort of 18,235 conventional total hip replacemen...

BACKGROUND Stress shielding of the proximal femur has been observed in a number of conventional cementless implants used in total hip arthroplasty. Short femoral-neck implants are claiming less interference with the biomechanics of the proximal femur. The goal of this study was to investigate the changes of bone-mineral density in the proximal femur and the clinical outcome after implantation o...

Improving the quality of care for hip arthroplasty (replacement) patients requires the systematic evaluation of clinical performance of implants and the identification of "outlier" devices that have an especially high risk of reoperation ("revision"). Postmarket surveillance of arthroplasty implants, which rests on the analysis of large patient registries, has been effective in identifying outl...

This paper reviews the current knowledge relating to the management of adult patients with congenital hip disease. Orthopaedic surgeons who treat these patients with a total hip replacement should be familiar with the arguments concerning its terminology, be able to recognise the different anatomical abnormalities and to undertake thorough pre-operative planning in order to replace the hip usin...

Postoperative infections are a major concern in patients that receive implants. These infections generally occur in areas with poor blood flow and pathogens do not always respond to antibiotic treatment. With the latest developments in nanotechnology, the incorporation of antibiotics into prosthetic implants may soon become a standard procedure. The success will, however, depend on the ability ...

The removal of solidly fixed implants during revision hip and knee arthroplasty is a technically challenging procedure with the potential for a large amount of bone loss during component removal. This bone loss may compromise the subsequent reconstruction. Careful preoperative planning is essential before undertaking removal of solidly fixed implants. The surgeon should determine the type and s...

Approximately half of the over 120,000 total hip replacement operations performed annually in the United States use cementless implants. The standard method for preparing the femoral cavity for such implants uses a mallet-driven hand-held broach whose shape matches that of (he desired implant. In-vitro experiments have supported the possibility (ha( a more accurate (and, we expect, more efficac...

The primary stability of cementless total hip endoprosthesis is of vital importance for proximate, long-term osteointegration. The extent of micromotions between implant and acetabulum is an indicator of primary stability. Based on this hypothesis, different cementless hip joint endoprosthesis were studied with regard to their micromotions. The primary stability of nine different cementless thr...

The success rate of orthopaedic implants is strongly dependent on the initial fixation, but the objective intra-operative assessment of primary stability of cementless implants is still a challenge and, moreover, excessive press-fitting of the implant can cause intraoperative fractures. In a series of in vitro and in vivo experiments the change in the frequency response function (FRF) of the hi...