This article describes a case of severe metallosis in a 67-year-old woman who initially underwent primary total hip arthroplasty with a ceramic-on-ceramic articular bearing. This was subsequently revised to a metal-on-polyethylene articulation due to ceramic liner fracture. She presented with severe hip pain and a pelvic mass. Infective workup was negative. Perforation of the cobalt-chrome femo...

BACKGROUND Hydroxyapatite (HA) is the main inorganic component of bone, and HA coating is widely used on acetabular cups in hip arthroplasty. It has been suggested that this surface finish improves cup survival. METHODS All patients registered in the Swedish Hip Arthroplasty Register between 1992 and 2007 with an uncemented acetabular implant that was available either with or without HA coati...

We followed prospectively 69 patients with 78 proximal femoral allografts performed for revision of total hip arthroplasty for an average of 36 months (range 29 to 68). Large fragment proximal femoral allografts and cortical strut allografts were successful in 85%. Grafts smaller than 3 cm in length (calcar grafts) were clinically successful in 81%, but 50% underwent significant radiographic re...

We reviewed the results of 25 consecutive patients who underwent revision of a hip resurfacing prosthesis to a total hip replacement. Revisions were performed for recurrent pain and effusion, infection and proximal femoral fractures. Both components were revised in 20 cases.There were 12 male and 13 female patients with average time to revision of 34.4 and 26.4 months respectively. The mean fol...

Purpose: The goal of this study was to investigate whether our institution adhered to current guidelines for the use of prophylactic antibiotics in hip and knee arthroplasty. Type of Study: Retrospective case series. Methods: Data on the administration of prophylactic antibiotics for 798 consecutive total hip arthroplasty, total knee arthroplasty, and hip hemiarthroplasty procedures were record...

Fistula formation between bowel and total hip arthroplasty or revision arthroplasty hardware is rare. We present a case of a 78-year-old woman with protrusio of left hip arthroplasty and acetabular reconstruction hardware that caused direct perforation of the sigmoid colon and fistula formation between the sigmoid colon and the left hip joint. The patient underwent several joint debridements, s...

BACKGROUND AND PURPOSE An increasing number of patients have several joint replacement procedures during their lifetime. We investigated the use and suitability of multi-state model techniques in providing a more comprehensive analysis and description of complex arthroplasty histories held in arthroplasty registries than are allowed for with traditional survival methods. PATIENTS AND METHODS ...

Issue 1: Arthroplasty vs ORIF • Non-displaced or minimally displaced fractures-standard treatment is closed reduction and internal fixation in all ages. o Hudson, CORR, 1998. At 8 year f/u  Nondisplaced treated with ORIF-no difference in revision rate compared to arthroplasty  Displaced treated with ORIF – higher 8 year cumulative revision rate in older patients compared to arthroplasty o How...

EDUCATIONAL OBJECTIVES As a result of reading this article, physicians should be able to: 1. Identify the available types of reconstruction for failed total hip arthroplasty. 2. Summarize the preoperative workup of patients with failed total hip arthroplasty and massive proximal femoral bone loss. 3. Assess the surgical technique of proximal femoral replacement for failed total hip arthroplasty...

Revision rates of total hip arthroplasty have decreased after introducing total hip arthroplasty (THA) using ceramic component, since ceramic components could reduce components wear and osteolysis. The fracture of a ceramic component is a rare but potentially serious event. Thus, ceramic on polyethylene articulation is gradually spotlighted to reduce ceramic component fracture. There are a few ...