Radiologic Assessment of Total Hip Arthroplasty: Loosening
|
|
- Rosemary Barton
- 8 years ago
- Views:
Transcription
1 March 2004 Radiologic Assessment of Total Hip Arthroplasty: Loosening Grant Garrigues, Harvard Medical School
2 Anatomy Liner Acetabular Component Calcar Stem Femoral Component 2
3 Patient JQ 67 year-old man Left THA 10 years ago Hip/thigh pain What do you see? Position Lucencies Density 3 PACS, MGH
4 Implant loosening >500,000 THA and TKA each year in US 10% are revisions of failed implants Overall, very successful Aging population, obesity, more THA, younger patients vs. Improved surgical technique, implant design, and pharmacotherapy Bauer TW et al. Skeletal Rad,
5 Total Hip Complications Short-term Deep Venous Thrombosis (fatal PE, 0.3%) Nerve Palsies (1.7%) Vascular Complications (0.25%) Fracture/Perforations Dislocation (2-2.5%) Leg-length Discrepancy Long-term Namba RS et al. Current Ortho, Loosening (10%) Infection (1-5%) Heterotopic Ossification (significant, 8%) 5
6 Radiologic Assessment Assessment of long-term complications Loosening is the most significant Plain films: great bone/metal visualization Radiographic features Peri-implant lucency > 2mm Describe using Gruen Zones (following slide) Stress views / Interval change in position 6 Keogh CF et al. AJR 2003.
7 Gruen Zones 7
8 Other Modalities Arthrography Effective joint space visualized Aspirate and Biopsy CT and MRI Metal artifact US and Nuclear medicine Select applications Keogh CF et al. AJR Keogh CF et al. AJR White Griffiths LM HJ et et al. al. Radiology Clin
9 Ddx of Radiographic Loosening Peri-implant bone loss Aseptic loosening Infection Stress Shielding / Adaptive remodeling Aging / Osteoporosis Mechanical Failure Catastrophic Interfacial Bauer TW et al. Skeletal Rad, Tiggles S et al. AJR,
10 Aseptic Loosening Most common cause of TJR failure Wear debris Most generated at the articulating surface Submicron UHMWPE, HA, TiAlV, CoCr particles Spread throughout the effective joint space Phagocytosed by macrophages Induces bone resorption (osteolysis) Formation of fibrous, granulomatous tissue Willert and Semlitsch JBMR Shanbhag, et al. JOR
11 Aseptic Loosening Macrophages phagocytose wear debris, leading to two processes. Interfacial Membrane FBGC with wear debris Bone Resorption Osteoclast in Howship s lacuna Courtesy of Arun Shanbhag, MD 11
12 Head displacement: Millions of submicron polyethylene particles created with each step 12 Courtesy of Ferris Hall, MD
13 Aseptic Loosening Wear debris is the prevailing theory Hydrodynamic pressure may also contribute to aseptic loosening Early loosening from periprosthetic bone loss Trauma, chemicals, and thermal damage Joint pressures >700 mmhg Pumping action of loosened implants May cause aseptic loosening without particles Similar to mechansim of subchondral cysts in OA Aspenberg P et al. Acta Ortho Mjoberg B et al. Ortho
14 Aseptic Loosening Sequellae Painful loosening Revision arthroplasty Pathologic fractures Osteolysis leading to pathologic avulsion fracture Berry DJ J Arthro PACS, MGH
15 Septic Loosening Less common today Laminar flow OR UV lights Prophylactic Antibiotics Foreign body nidus Pathogens adhere to biomaterials S. epidermidis produces glycocalyx 15
16 Septic Loosening Radiographs mimic aseptic loosening Dx often with arthrogram and clinical correlation Peri-implant bone loss Sinus tracts Joint fluid aspiration: (culture, gram stain, etc.) Synovial biopsy Nuclear Med Tc-99m nonspecific In-111 leukocytes preferred Keogh CF et al. AJR, Griffiths HJ et al. Rad Clin, Arthrogram: sinus tracts and abcesses Keogh CF et al. AJR,
17 Septic Loosening Sequellae Painful implant loosening Revision arthroplasty Sterilize site before reimplantation Antibiotic impregnated cement spacers Sepsis, osteomyelitis, sinus tracts 17 Bauer TW et al. Skeletal Rad, 1999.
18 Stress Shielding Loading transferred from bone to stiffer prosthesis Proximal Stress Distal Stress Finite Element Analysis Interference Stress Interference + Load Stress 18 Friedman RJ et al. JBJS, Abaqus,
19 Stress Shielding Stress transferred through stem Metal is stiffer than bone Bypasses proximal periprosthetic bone Resorption of bone around proximal femoral shaft (Wolff s Law) More common in uncemented Increased risk of pathologic fracture Jacobs JJ et al. Ortho Clin Friedman RJ et al. JBJS, Keogh CF et al. AJR 2003.
20 Mechanical Failure Catastrophic failure is rare Fractured stem Shattered Zirconia ceramic heads Interface failure most common Cement fatigue fracture Debonding of cement-implant interface Porous coating fracture 20
21 Mechanical Failure Fractured Stem Keogh CF et al. AJR
22 Cement Fracture Debonding: implantcement interface is disrupted Courtesy of Ferris Hall, MD Subsidence: implant slides into medullary canal Cortical Reaction 22 Courtesy of Ferris Hall, MD
23 Porous Coating Fatigue Porous coatings, fiber-metal mesh, and other surfaces allow bone in-growth to cementless implants Multiple loose beads PACS, BIDMC Cross-section through fiber-metal mesh shows bone in-growth 23 PACS, BIDMC
24 Summary: JQ Aseptic Loosening of uncemented femoral component 67 year-old man Left THA Hip/thigh pain Volumetric wear Varus shift Subsidence Osteolytic Lesions Cortical Reaction Stress Fracture 24 PACS, MGH
25 Other THA Complications We have discussed loosening, the most common complication of THA, in detail. Bonus cases of other radiographically assessable complications follow 25
26 This is a powerful reminder of the possibility of fat emboli forced through bridging veins by manipulation in the meduallary canal. Cement Venogram: cement forced into vein before hardening Courtesy of Ferris Hall, MD Alastair et al. Brief report: fulminating fat embolism syndrome caused by paradoxical embolism through a patent foramen ovale, NEJM, 1993; 329(13):
27 Heterotopic ossification: This patient had a h/o spondylitis but any joint procedure has a small chance of this complication Courtesy of Ferris Hall, MD 27
28 References Aspenberg P, van der Vis H. Fluid pressure may cause periprosthetic osteolysis. Acta Orthop Scand, 1998; 69(1):1-4. Bauer TW, Schils J. The pathology of total joint arthroplasty. Skeletal Rad, 1999; 28: Berry DJ. Periprosthetic fractures associated with osteolysis. J Arthrop, 2003; 18(3, supl.): Friedman RJ, et al. Current concepts in orthopaedic biomaterials and implant fixation. JBJS, 1993; 75A(7): Griffiths HJ, et al. Total hip replacement and other orthopedic hip procedures in Rad Clinics of N America: Imaging of Orthopedic Hardware, 1995; 33(2): Jacobs JJ, Sumner DR, Galante JO. Mechanisms of bone loss associated with total hip replacement. Ortho Clin of N Amer; 1993; 24(4): Keogh CF, et al. Imaging of the painful hip arthroplasty. AJR, 2003; 180: Mjoberg B. The theory of early loosening of hip prostheses. Orthopedics, 1997; 20(12): Namba RS, et al. Adult reconstructive surgery in Current Diagnosis and Treatment in Orthopaedics, 3rd ed, Skinner HB ed.mcgraw-hill, Shanbhag A, et al. J Ortho R, 1994 Tigges S, et al. Complications of hip arthroplasty causing periprosthetic radiolucency on plain radiographs. AJR, 1994; 162: White LM, et al. Complications of total hip arthroplasty: MR imaging. Radiology, 2000; 215(1): Willert and Semlitsch. JBMR,
29 Acknowledgements Special Thanks to: Ferris Hall, MD Arun Shanbhag, PhD Harry Rubash, MD Pamela Lepkowski Larry Barbaras 29
Metal-on-Metal Hip Systems
Meeting of the Orthopaedic and Rehabilitation Devices Advisory Panel June 27-28, 2012 Metal-on-Metal Hip Systems Center for Devices and Radiological Health U.S. Food and Drug Administration Meeting of
More informationBONE PRESERVATION STEM
TRI-LOCK BONE PRESERVATION STEM Featuring GRIPTION Technology SURGICAL TECHNIQUE IMPLANT GEOMETRY Extending the TRI-LOCK Stem heritage The original TRI-LOCK Stem was introduced in 1981. This implant was
More informationFrom Department of Orthopaedics, Conquest Hospital, The Ridge, East Sussex. n N.A. Sandiford, FRCS (Tr/Orth), MFSEM, Specialist. Registrar.
Acta Orthop. Belg., 2014, 80, 372-379 ORIGINAL STUDY Primary total hip arthroplasty with hydroxyapatite coated titanium femoral stems. Does design philosophy influence long term outcome? : results of a
More informationSingle Stage Revision Joint Replacement for Infection
Single Stage Revision Joint Replacement for Infection Infection adds a large number of difficulties to fixing a joint replacement that has gone wrong. Some patients are not suitable for single stage surgery,
More informationY O U R S U R G E O N S. choice of. implants F O R Y O U R S U R G E R Y
Y O U R S U R G E O N S choice of implants F O R Y O U R S U R G E R Y Y O U R S U R G E O N S choice of implants F O R Y O U R S U R G E R Y Your Surgeon Has Chosen the C 2 a-taper Acetabular System The
More informationApproach to Lower Extremity Osteomyelitis. A radiologic tour of a patient encounter
Approach to Lower Extremity Osteomyelitis A radiologic tour of a patient encounter David Guo,, HMS III Gillian Lieberman, MD BIDMC, October 2009 Our learning goals Review lower extremity anatomy Discuss
More informationHip joint replacement surgery has been the most common
Radiographic Imaging of Hip Replacement Hardware Catherine C. Roberts, MD,* and Felix S. Chew, MD, MBA Hip joint replacement surgery has been the most common type of elective and semi-elective orthopedic
More informationImagine being an orthopedic surgeon and knowing that your patient s
http://www.surgicalproductsmag.com/product-releases/2009/05/safer-methods-internal-bone-fixation Advances in Internal Bone Fixation Sharps safety for orthopedic surgeons by Ron Stoker Imagine being an
More informationIntroduction to the Bertram Hip Spacer
Introduction to the Bertram Hip Spacer Approximately 200,000 hip replacement surgeries are done every year in United States. Fortunately the incidence of infection is routinely 0.5 percent-1 percent. However
More informationMetallurgical analysis of five failed cast cobalt-chromium-molybdenum alloy hip prostheses
Veterans Administration Journal of Rehabilitation Research and Development Vol. 23 No. 4 Pages 27-36 Metallurgical analysis of five failed cast cobalt-chromium-molybdenum alloy hip prostheses STEPHEN D.
More informationWhy an Exactech Hip is Right for You
Why an Exactech Hip is Right for You Why do I need a total hip replacement? Which surgical approach is best for me? How long will it last? Which implant is right for me? Founded in 1985 by an orthopaedic
More informationTechnology Assessment
Technology Assessment Horizon Scan on Hip Replacement Surgery Technology Assessment Program Agency for Healthcare Research and Quality 540 Gaither Road Rockville, Maryland 20850 December 22, 2006 Horizon
More informationModular Dual Mobility Acetabular Components: An Important Extension of a Proven Approach to Hip Instability
Modular Dual Mobility Acetabular Components: An Important Extension of a Proven Approach to Hip Instability Robert Wetzel, MD, Lalit Puri, MD, S. David Stulberg, MD Disclosure In accordance with ACCME
More informationClinically Proven Fiber Metal Material. Power to choose advanced bearing technologies to match patient demands
Trilogy IT Acetabular System Design Rationale 1 For orthopedic surgeons treating a wide range of patients, the Trilogy IT Acetabular System provides a clinically proven1-5 Fiber Metal Material and the
More informationComputer Aided Engineering (CAE) Techniques Applied To Hip Implant
International Journal Of Computational Engineering Research (ijceronline.com) Vol. 3 Issue. 3 Computer Aided Engineering (CAE) Techniques Applied To Hip Implant 1, M. S. Abo_Elkhair, 2, M. E. Abo-Elnor,
More informationUnderstanding the biological outcomes and responses to orthopaedic surgical implants.
Understanding the biological outcomes and responses to orthopaedic surgical implants. Dr Catherine Bladen, University of Leeds,UK A report for the Winston Churchill Memorial Trust, 2012 1 Acknowledgements:
More informationTaperloc Complete Hip System
Taperloc Complete Hip System One Surgeon. One Patient. Over 1 million times per year, Biomet helps one surgeon provide personalized care to one patient. The science and art of medical care is to provide
More informationAnswers to commonly asked questions from patients with metal-on-metal hip replacements / resurfacings. Contents
Answers to commonly asked questions from patients with metal-on-metal hip replacements / resurfacings John Skinner 1 and Alister Hart 2, Consultant Orthopaedic Surgeons and Directors of the London Implant
More informationTotal Hip Joint Replacement. A Patient s Guide
Total Hip Joint Replacement A Patient s Guide Don t Let Hip Pain Slow You Down What is a Hip Joint? Your joints are involved in almost every activity you do. Simple movements such as walking, bending,
More informationfrequently asked questions Knee and Hip Joint Replacement Technology
frequently asked questions Knee and Hip Joint Replacement Technology frequently asked questions Knee and Hip Joint Replacement Technology Recently, you may have seen advertisements from legal companies
More informationThe Right Choice. Exeter. total hip system
The Right Choice Exeter total hip system Exeter The Right Choice Anatomic Reconstruction Offset The objectives of total hip replacement are to: relieve pain increase mobility and function Achieving a correct
More informationZimmer Longevity Highly Cross-linked Polyethylene
Zimmer Longevity Highly Cross-linked Polyethylene Clinical Value Dossier April 9, 2012 TOC Clinical Value Dossier for Zimmer Longevity Highly Cross-linked Polyethylene 1 Executive Summary 7 2 Burden of
More informationFungal Infection in Total Joint Arthroplasty. Dr.Wismer Dr.Al-Sahan
Fungal Infection in Total Joint Arthroplasty Dr.Wismer Dr.Al-Sahan Delayed Reimplantation Arthroplasty for Candidal Prosthetic Joint Infection: A Report of 4 Cases and Review of the Literature David M.
More informationClinical Testing for Metal-on-Metal Prosthetic Wear and Tear
Clinical Testing for Metal-on-Metal Prosthetic Wear and Tear Frederick G. Strathmann, PhD, DABCC (CC, TC) February 8 th, 2013 Disclosures None Objectives Compare heavy metal analysis in synovial fluid
More informationJoint Revision Surgery - When Do I Need It?
Page 1 of 7 Joint Revision Surgery - When Do I Need It? Joint replacement surgery is undoubtedly one of the greatest medical advances of our time. Hip and knee replacements have been performed in millions
More informationTOTAL HIP REPLACEMENT FOR A LIFETIME: THE CEMENTLESS METAL ON METAL RECONSTRUCTION
Richard A. Sweet, M.D. Louisville Orthopaedic Clinic Louisville, KY TOTAL HIP REPLACEMENT FOR A LIFETIME: THE CEMENTLESS METAL ON METAL RECONSTRUCTION INTRODUCTION Total hip replacement surgery (THR) has
More informationfemoral component. RESULTS AT A MINIMUM FOLLOW-UP OF 20 YEARS
N. Sandiford, C. Doctor, S. S. Rajaratnam, S. Ahmed, D. J. East, K. Miles, A. Butler-Manuel, J. A. N. Shepperd From Conquest Hospital, St Leonards on Sea, United Kingdom N. Sandiford, MRCS, MSc(SEM), SpR
More informationTotal hip replacement
Patient Information to be retained by patient What is a total hip replacement? In a total hip replacement both the ball (femoral or thigh bone) side of the hip joint and the socket (acetabular or pelvic
More informationCOMPARISON OF DIFFERENT DIAGNOSTIC MODALITIES IN EVALUATION OF INFECTION OF TOTAL HIP ARTHROPLASTY. Summary
J Biomed Clin Res Volume 2 Number 1, 2009 Original Article COMPARISON OF DIFFERENT DIAGNOSTIC MODALITIES IN EVALUATION OF INFECTION OF TOTAL HIP ARTHROPLASTY Plamen S. Kinov, 1 Teodor Z. Petrov, 1 Dilyana
More informationHip Replacement Surgery Understanding the Risks
Hip Replacement Surgery Understanding the Risks Understanding the Risks of Hip Replacement Surgery Introduction This booklet is designed to help your doctor talk to you about the most common risks you
More informationMusculoskeletal Trauma of the Wrist
September 2000 Musculoskeletal Trauma of the Wrist Murat Akalin, Harvard Medical School, Year- IV Gillian Lieberman, MD The Wrist Most common site of injury in entire skeleton Distal radius and ulna fractures
More informationCustom Design of Knee Joint Prosthesis By Using Computerized Tomography (CT) Images and 3D Modelling
Custom Design of Knee Joint Prosthesis By Using Computerized Tomography (CT) Images and 3D Modelling Qasem Alyazji Near East University, Department of Biomedical Engineering Nicosia, North Cyprus, Turkey
More informationVERILAST Technology for Hip Replacement Implants
VERILAST Technology for Hip Replacement Implants Surgeon Name Clinic Name Clinic Address Clinic i Address Phone Number Web Address Total Hip Replacement What Is VERILAST Hip Technology? OXINIUM Oxidized
More informationRunning head: PSEUDOTUMORS IN ASSOCIATION WITH HIP PROSTHESES 1 PSEUDOTUMORS IN ASSOCIATION WITH HIP PROSTHESES: A LITERTURE REVIEW WITH CASE STUDIES
Running head: PSEUDOTUMORS IN ASSOCIATION WITH HIP PROSTHESES 1 PSEUDOTUMORS IN ASSOCIATION WITH HIP PROSTHESES: A LITERTURE REVIEW WITH CASE STUDIES November 13, 2013 PSEUDOTUMORS IN ASSOCIATION WITH
More informationFEMORAL NECK FRACTURE FOLLOWING TOTAL KNEE REPLACEMENT
1 FEMORAL NECK FRACTURE FOLLOWING TOTAL KNEE REPLACEMENT László Sólyom ( ), András Vajda & József Lakatos Orthopaedic Department, Semmelweis University, Medical Faculty, Budapest, Hungary Correspondence:
More informationRadiologic Diagnosis of Spinal Metastases
September 2002 Radiologic Diagnosis of Spinal Metastases Natalie J. M. Dailey, Harvard Medical Student Year III Our Patient s Presenting Story 70 year old male Presents to the hospital for laparascopic
More informationon-metal Hips: Device Mechanics and Failure Modes
1 Metal-on on-metal Hips: Device Mechanics and Failure Modes Steven M. Kurtz, Ph.D., and Richard Underwood, Ph.D. Exponent, Inc., and Drexel University NIH R01 AR47904 2 Contracts: DePuy Orthopaedics,
More informationBIRMINGHAM HIP Resurfacing (BHR ) System PATIENT INFORMATION
BIRMINGHAM HIP Resurfacing (BHR ) System PATIENT INFORMATION Table of Contents 1.0 What is the BHR Device? 2.0 What is the Purpose of the BHR Device? 3.0 When Should the BHR Device Not Be Used? (Contraindications)
More informationDisclosures. Outline 2/24/2014. No Financial Disclosures. New Insights in Osteoarthrtis. Advances in Total Joint Replacement.
Disclosures February 25, 2014 No Financial Disclosures Erik Hansen MD Assistant Professor Department of Orthopaedic Surgery University of California, San Francisco Outline New Insights in Osteoarthrtis
More informationPMA P050016 Cormet 2000 Hip Resurfacing System
PMA P050016 Cormet 2000 Hip Resurfacing System ORTHOPEDIC AND REHABILITATION DEVICES PANEL Gaithersburg, Maryland February 22, 2007 PMA P050016 1 Agenda Introduction Device Description & Preclinical Testing
More informationPUBLISHED VERSION PERMISSIONS. This document has been archived with permission from the editor of the Medical Journal of Australia, 26 April 2007.
PUBLISHED VERSION Graves, Stephen Ellis; Davidson, David Charles; Ingerson, Lisa; Ryan, Philip; Griffith, Elizabeth Catherine; McDermott, Brian Francis John; Pratt, Nicole Leanne The Australian Orthopaedic
More informationKaiser Permanente. National Total Joint Replacement Registry. Liz Paxton Director of Surgical Outcomes & Analysis
Kaiser Permanente National Total Joint Replacement Registry Liz Paxton Director of Surgical Outcomes & Analysis Overview Background Total Joint Replacement (TJR) Importance of establishing a TJR post-market
More informationYour Practice Online
P R E S E N T S Your Practice Online Disclaimer This information is an educational resource only and should not be used to make a decision on Revision Hip Replacement or arthritis management. All decisions
More informationTotal Hip Replacement
Please contactmethroughthegoldcoasthospitaswityouhaveanyproblemsafteryoursurgery. Dr. Benjamin Hewitt Orthopaedic Surgeon Total Hip Replacement The hip joint is a ball and socket joint that connects the
More informationPrognosis of Total Hip Replacement
2 Prognosis of Total Hip Replacement Update and Validation of Results from the Swedish National Hip Arthroplasty Registry 1979-1998. HENRIK MALCHAU PETER HERBERTS PETER SÖDERMAN ANDERS ODÉN DEPARTMENT
More informationAnalysis of Functional and Radiological Outcome of Total Hip Replacements in Rheumatoid and Osteoarthritis Patients *
Open Journal of Rheumatology and Autoimmune Diseases, 2013, 3, 246-250 Published Online November 2013 (http://www.scirp.org/journal/ojra) http://dx.doi.org/10.4236/ojra.2013.34038 Hip Replacements in Rheumatoid
More informationHip Resurfacing 2011 ORIGINAL ARTICLE. James W. Pritchett MD. Introduction. Abstract
1 ORIGINAL ARTICLE Hip Resurfacing 2011 James W. Pritchett MD Abstract In 1938 Marion Smith-Peterson placed a cobalt chromium cup on a reshaped femoral head to perform the first hip resurfacing. 15 Also,
More informationRobotic-Arm Assisted Surgery
Mako TM Robotic-Arm Assisted Surgery for Total Hip Replacement A Patient s Guide Causes of Your Hip Pain Your joints are involved in almost every activity you do. Movements such as walking, bending and
More informationClinical performance of endoprosthetic and total hip replacement systems
Veterans Administration Journal of Rehabilitation Research and Development Vol. 24 No. 3 Pages 49 56 Clinical performance of endoprosthetic and total hip replacement systems P. M. SANDBORN, B.S. ; S. D.
More informationPatient Labeling Information System Description
Patient Labeling Information System Description The Trident Ceramic Acetabular System is an artificial hip replacement device that features a new, state-of-the-art ceramic-on-ceramic bearing couple. The
More informationGraphic courtesy of DePuy Orthopaedics, Inc. HealthEast Joint Replacement Registry: 20 Year Report
Graphic courtesy of DePuy Orthopaedics, Inc. HealthEast Joint Replacement Registry: 20 Year Report HealthEast Joint Replacement Registry: 20 Year Report Foreword HealthEast Care System began the first
More informationThe Journal of Arthroplasty
The Journal of Arthroplasty 29 (2014) 219 224 Contents lists available at ScienceDirect The Journal of Arthroplasty journal homepage: www.arthroplastyjournal.org One-Component Revision of Failed Hip Resurfacing
More informationTitle: Revision Rates of Metal Hip Replacement Devices. Date: September 19, 2007. Context and policy issues: a. Total hip replacement
Title: Revision Rates of Metal Hip Replacement Devices Date: September 19, 2007 Context and policy issues: a. Total hip replacement Total hip replacement (THR) is a common orthopedic procedure which involves
More informationAn Alternative Conservative Approach to Hip Reconstruction
Joint Implant Surgery & Research Foundation Chagrin Falls, Ohio, USA An Alternative Conservative Approach to Hip Reconstruction Craig S. Waller, MD* and Timothy McTighe, Dr. H.S. (hc)** Acknow ledgement:
More informationProstalac Hip System. Surgical Technique
Prostalac Hip System Surgical Technique Prostalac Hip System The Prostalac Hip System is engineered to provide a functional short-term total hip replacement for those patients who need a two-stage procedure
More informationHow To Make An Implant From A Metal That Is Like Bone
Trabecular Metal Technology The Best Thing Next to Bone Trabecular Metal Technology The Best Thing Next to Bone When you need a hip, knee, shoulder or spine implant, you want assurance that your implant
More informationNATIONAL INSTITUTE FOR HEALTH AND CARE EXCELLENCE
NATIONAL INSTITUTE FOR HEALTH AND CARE EXCELLENCE Overview Total hip replacement and resurfacing arthroplasty for treating pain or disability resulting from end stage arthritis of the hip (review of technology
More informationOsteoarthritis and Joint Replacement. Jonathan Clabeaux, M.D. Total Joint Replacement Surgery Virginia Mason Medical Center Seattle, Washington
Osteoarthritis and Joint Replacement Jonathan Clabeaux, M.D. Total Joint Replacement Surgery Virginia Mason Medical Center Seattle, Washington Disclosure Surgeon proctor for Medacta International All patients
More informationAcetabular Wedge Augment System
Orthopaedics Acetabular Wedge Augment System Stryker Hips. Implant with confidence. Restoration Acetabular Wedge Augment System Restoration Acetabular Wedge Augments, united with Tritanium, Trident, MDM
More informationHUNTER TENDON IMPLANTS 127846-6
HUNTER TENDON IMPLANTS 127846-6 The following languages are included in this packet: English (en) Deutsch (de) Nederlands (nl) Français (fr) Español (es) Italiano (it) Português (pt) - Chinese (sch) Türkçe
More informationRandal S. Ford. ATTORNEY AT LAW (205) 752-4440 attorney@randalsford.com. DePuy ASR Hip Implant Recall Fact Sheet
DePuy ASR Hip Implant Recall Fact Sheet Recalled Devices: ASR XL Acetabular System on the market since 2004, and sold worldwide. Dates of Implant: July 2003 to 2010 ASR Hip Resurfacing System on the market
More informationAnterior Hip Replacement
Disclaimer This movie is an educational resource only and should not be used to manage Orthopaedic health. All decisions about the management of hip replacement and arthritis management must be made in
More informationMetal on Metal Hips. Total Hip Replacement. Total Hip Replacement
Metal on metal hips: Questions Metal on Metal Hips Jim Sullivan Why were metal on metal hips popular? Are all metal on metal hips the same? What are the problems with the ASR hip? What are the issues with
More informationResearch Letter Biomimetic Composite-Metal Hip Resurfacing Implant
Research Letters in Materials Science Volume 2008, Article ID 368985, 4 pages doi:10.1155/2008/368985 Research Letter Biomimetic Composite-Metal Hip Resurfacing Implant Habiba Bougherara and Martin N.
More informationAmerican College of Radiology ACR Appropriateness Criteria
American College of Radiology ACR Appropriateness Criteria Date of origin: 1998 Last review date: 2015 Clinical Condition: Variant 1: Imaging After Total Hip Arthroplasty Follow-up of the asymptomatic
More informationABGII Cement Free Total Hip Replacement System
Cement Free Total Hip Replacement System Efficacy Innovation Cement Free Hip System The ABG Cement Free Hip System is one of the foremost ranges of cementless total hip replacement prosthesis. Used extensively
More informationImaging of Total Knee Arthroplasty
Imaging of Total Knee Arthroplasty Kevin R. Math, M.D., 1,2 Syed Furqan Zaidi, M.D., 1,2 Catherine Petchprapa, M.D., 1,2 and Steven F. Harwin, M.D., F.A.C.S. 3,4 ABSTRACT Painful total knee arthroplasty
More informationNATIONAL INSTITUTE FOR HEALTH AND CLINICAL EXCELLENCE. Health Technology Appraisal
NATIONAL INSTITUTE FOR HEALTH AND CLINICAL EXCELLENCE Health Technology Appraisal Total hip replacement and resurfacing arthroplasty for the treatment of pain or disability resulting from end stage arthritis
More informationCHARACTERSTIC RADIOGRAPHIC APPEARANCE
OSTEOLYTIC LESIONS APPROACH AGE Metastatic Neuroblastoma in infant and young child. Metastases and multiple myeloma in middle aged and elderly. Ewing s sarcoma and simple bone cyst in children and teens.
More informationFailure Mechanisms and Closed Reduction of a Constrained Tripolar Acetabular Liner
The Journal of Arthroplasty Vol. 24 No. 2 2009 Case Report Failure Mechanisms and Closed Reduction of a Constrained Tripolar Acetabular Liner William J. Robertson, MD, Christopher J. Mattern, MD/MBA, John
More informationSt. Charles Hospital Orthopedic Specialists Invent and Refine Surgical Techniques
St. Charles Hospital Orthopedic Specialists Invent and Refine Surgical Techniques By: Jennifer Webster Tuesday, October 01, 2013 It s one thing to practice advanced surgery. But St. Charles Hospital takes
More informationUnderstanding Total Hip Replacement
Understanding Total Hip Replacement Brian J. White MD Orthopaedic Specialist in Disorders of the Hip Assistant Team Physician Denver Nuggets Western Orthopaedics Denver, Colorado Introduction This is designed
More informationImaging of Hip Arthroplasty
Imaging of Hip Arthroplasty Theodore T. Miller, M.D. 1 ABSTRACT Radiography is the mainstay of the imaging evaluation of the prosthetic hip, but arthrography, aspiration, scintigraphy, sonography, computed
More informationSlipped Capital Femoral Epiphysis, Emergency? Scott Ferry, MD Rockford Orthopedic Associates November 10 th, 2012
Slipped Capital Femoral Epiphysis, Emergency? Scott Ferry, MD Rockford Orthopedic Associates November 10 th, 2012 AAOS-POSNA 2011 Course AAOS/POSNA Five Pediatric Orthopaedic Problems that Should Get You
More informationUlnar sided Wrist Pain
Ulnar sided Wrist Pain 1 Susan Cross, 1 Anshul Rastogi, 2 Brian Cohen, 1 Rosy Jalan 1 Dept of Radiology, Barts Health NHS Trust, London, UK 2 London Orthopaedic Centre Contact: susan.cross@bartshealth.nhs.uk
More informationA Diagnostic Chest XRay: Multiple Myeloma
Daniela Marinho Tridente, VI FCMSCSP October 2013 A Diagnostic Chest XRay: Multiple Myeloma Daniela Marinho Tridente, VI FCMSCSP Our Learning Agenda Introduction of our patient His imaging data and findings
More informationInformation for Our Patients Regarding Metal-on-Metal (MoM) Hip Replacements
Information for Our Patients Regarding Metal-on-Metal (MoM) Hip Replacements The American Association of Hip and Knee Surgeons, The Hip Society and the American Academy of Orthopaedic Surgeons Concerns
More informationYour Practice Online
P R E S E N T S Your Practice Online Disclaimer This information is an educational resource only and should not be used to make a decision on Knee replacement or arthritis management. All decisions about
More informationARTHROSCOPIC HIP SURGERY
ARTHROSCOPIC HIP SURGERY Hip Arthroscopy is a relatively simple procedure whereby common disorders of the hip can be diagnosed and treated using keyhole surgery. Some conditions, which previously were
More informationM 2 a-magnum. Design Rationale. Large Metal Articulation. Knees Hips Extremities Cement and Accessories PMI. Technology
M 2 a-magnum Large Metal Articulation Design Rationale Knees Hips Extremities Cement and Accessories PMI Technology M 2 a-magnum Large Metal Articulation History of Metal-on-Metal Early metal-on-metal
More informationX-Plain Hip Replacement Surgery - Preventing Post Op Complications Reference Summary
X-Plain Hip Replacement Surgery - Preventing Post Op Complications Reference Summary Introduction Severe arthritis in the hip can lead to severe pain and inability to walk. To relieve the pain and improve
More informationMetal-On-Metal Hip Resurfacing for Young Active Adults with Degenerative Hip Disease
Metal-On-Metal Hip Resurfacing for Young Active Adults with Degenerative Hip Disease November 1, 2006 Life is Movement TABLE OF CONTENTS The Alberta Bone & Joint Health Institute.. 2 Request. 2 Distribution
More informationTOTAL HIP REPLACEMENT: MODERN SURGERY FOR SEVERE ARTHRITIS OF THE HIP
TOTAL HIP REPLACEMENT: MODERN SURGERY FOR SEVERE ARTHRITIS OF THE HIP John T. Dearborn, M.D. and Alexander P. Sah, M.D. The Center for Joint Replacement Please read this pamphlet before you see me so that
More informationImplant materials. Learning outcomes. Implant materials in trauma. How to use this handout? Functions of implants. Types of materials
Implant materials How to use this handout? The left column is the information as given during the lecture. The column at the right gives you space to make personal notes. Learning outcomes At the end of
More informationCommonly Missed Fractures in the Emergency Department
Commonly Missed Fractures in the Emergency Department Taylor Sittler MS IV - UMASS Images courtesy of Jim Wu, MD, Sanjay Shetty, MD and Mary Hochman, MD Diagnostic Errors in the ED Taylor Sittler, MS IV
More informationHip Resurfacing (Re-Review)
20, 2012 Health Technology Assessment Hip Resurfacing (Re-Review) Final Evidence Report October 14, 2013 Health Technology Assessment Program (HTA) Washington State Health Care Authority PO Box 42712 Olympia,
More informationTechnology Breakthrough in Spinal Implants (Technical Insights)
Technology Breakthrough in Spinal Implants (Technical Insights) Biomaterial innovations is a growth factor for spinal implant market June 2014 Table of Contents Section Page Number Executive Summary 4
More informationEvaluation of Total Hip Arthroplasty Research in the US and Europe. Marcy J Simmons A THESIS. submitted to. Oregon State University
Simmons 1 Evaluation of Total Hip Arthroplasty Research in the US and Europe by Marcy J Simmons A THESIS submitted to Oregon State University in partial fulfillment of the requirements for the degree of
More informationZimmer Trabecular Metal Dental Implant
Zimmer Trabecular Metal Dental Implant TRABECULAR METAL MATERIAL: Designed to Enhance Secondary Stability Through Bone Ingrowth. Artistic Rendering osseoincorporation TRABECULAR METAL MATERIAL Designed
More informationRADIOGRAPHIC EVALUATION
Jeff Husband MD Objectives Evaluate, diagnose and manage common wrist injuries due to high energy trauma in athletes Appropriately use radiographs, CT scans and MRI Know when to refer patients for additional
More information! # %# & # ( # # )# # +# ) #,+# ( # ( #!./0 12 % + + # 3 4%. 2 // 4 / 5((6 /07347137 8 0 10/ 010 4 /09 3 % 1030
! # %# & # ( # # )# # +# ) #,+# ( # ( #!./0 12 % + + # 3 4%. 2 // 4 / 5((6 /07347137 8 0 10/ 010 4 /09 3 % 1030 : Litigation after hip and knee replacement in the National Health Service A. B. McWilliams,
More informationZimmer M/L Taper Hip Prosthesis with Kinectiv Technology
Zimmer M/L Taper Hip Prosthesis with Kinectiv Technology Hips designed to fit the unique anatomies of men and women Independent control for a natural fit Simple, practical solutions for optimal restoration
More informationSimultaneous or Staged? A Comparison of Bilateral Uncemented Total Knee Arthroplasty.
Simultaneous or Staged? A Comparison of Bilateral Uncemented Total Knee Arthroplasty. JRM Hutchinson, MBBS, FRCS (Orth & Tr) Research Fellow EN Parish, MHSc Research Assistant MJ Cross, OAM, MBBS, MD,
More informationNCB Periprosthetic Femur Plate System. Surgical Technique
NCB Periprosthetic Femur Plate System Surgical Technique NCB Periprosthetic Femur System Surgical Technique 3 Table of Contents Introduction 4 System Features and Benefits 9 Indications and Contraindications
More informationINCIDENCE OF REASONS FOR REVISION HIP SURGERY: PRELIMINARY STUDY
Rev. Med. Chir. Soc. Med. Nat., Iaşi 2015 vol. 119, no. 3 SURGERY ORIGINAL PAPERS INCIDENCE OF REASONS FOR REVISION HIP SURGERY: PRELIMINARY STUDY D. Mihăilescu 1*, P. Botez 1,2, Liliana Savin 1, Carmen
More informationMN Community Measurement Total Knee Replacement Impact and Recommendation Document June 2010
MN Community Measurement Total Knee Replacement Impact and Recommendation Document June 2010 Degree of Impact Relevance to Consumers, Employers and Payers Annually there are over 500,000 total knee replacement
More informationPeri-prosthetic Joint Infection
Therapeutics, Pharmacology and Clinical Toxicology Vol XV, Number 4, December 2011 Pages 293-299 Copyright reserved 2011 ORIGINAL PAPERS Peri-prosthetic Joint Infection - A Diagnostic and Treatment Hospital
More informationModel Coverage Determination: Total Joint Arthroplasty
Model Coverage Determination: Total Joint Arthroplasty LCD ID Number LCD Title Major Joint Replacement (Hip and Knee) Indications and Limitations of Coverage and/or Medical Necessity Joint replacement
More informationThe information contained in this document is intended for healthcare professionals only.
The information contained in this document is intended for healthcare professionals only. Dall-Miles Cabling System Dall-Miles Recon and Trauma Cable System Trochanteric Reattachment Using the Trochanteric
More information(English) NEXUS SPINE SPACER SYSTEM
(English) NEXUS SPINE SPACER SYSTEM INDICATIONS FOR USE NEXUS Spine Spacer System, a GEO Structure is indicated for use in the thoraco-lumbar spine (i.e., T1 to L5) to replace a diseased vertebral body
More information