Volume 91(Supplement 6):121-128 Sex Differences in Hip Morphology: Is Stem Modularity Effective for Total Hip Replacement? by Francesco Traina, Manuela.

Slides:

Advertisements

Similar presentations

The Swedish Total Hip Replacement Register by Henrik Malchau, Peter Herberts, Thomas Eisler, Göran Garellick, and Peter Söderman J Bone Joint Surg Am Volume.

Advertisements

Long-Term Survival of Cemented Distal Femoral Endoprostheses with a Hydroxyapatite-Coated Collar by Melanie Jean Coathup, Vineet Batta, Robin C. Pollock,

Is There a Safe Area for the Axillary Nerve in the Deltoid Muscle? by Ozgur Cetik, Murad Uslu, Halil Ibrahim Acar, Ayhan Comert, Ibrahim Tekdemir, and.

Balancing the Flexion Gap: Relationship Between Tibial Slope and Posterior Cruciate Ligament Release and Correlation with Range of Motion by Adolph V.

Cemented Versus Cementless Total Hip Replacements in Patients Fifty-five Years of Age or Older with Rheumatoid Arthritis by Keijo T. Mäkelä, Antti Eskelinen,

Subtrochanteric Valgus Osteotomy for Chronically Dislocated, Painful Spastic Hips by Kathleen A. Hogan, Matthew Blake, and Richard H. Gross J Bone Joint.

Evaluation of the Gluteus Medius Muscle After a Pelvic Support Osteotomy to Treat Congenital Dislocation of the Hip by Muharrem Inan, Alpay Alkan, Ahmet.

Distal Radial Fractures in Older Men by Carl M. Harper, Shannon K. Fitzpatrick, David Zurakowski, and Tamara D. Rozental J Bone Joint Surg Am Volume 96(21):

Early Clinical and Radiographic Outcomes of Intramedullary-Fixation Total Ankle Arthroplasty by Andrew R. Hsu, and Steven L. Haddad J Bone Joint Surg Am.

Morbid Obesity: A Significant Risk Factor for Failure of Two-Stage Revision Total Hip Arthroplasty for Infection by Matthew T. Houdek, Eric R. Wagner,

Atypical Fractures of the Femur: Evaluation and Treatment by Travis Blood, R.J. Feller, Eric Cohen, Christopher T. Born, and Roman Hayda JBJS Reviews Volume.

Intermediate-Term Follow-up After Ankle Distraction for Treatment of End-Stage Osteoarthritis by Mai P. Nguyen, Douglas R. Pedersen, Yubo Gao, Charles.

Effects of Regional Versus General Anesthesia on Outcomes After Total Hip Arthroplasty by Mohammad A. Helwani, Michael S. Avidan, Arbi Ben Abdallah, Dagmar.

Complex Total Hip Replacement in a Patient with Epidermolytic Hyperkeratosis by Thomas L. Bernasek, and Elizabeth A. Rommel J Bone Joint Surg Am Volume.

The Influence of Head Size and Sex on the Outcome of Birmingham Hip Resurfacing by Callum W. McBryde, Kanthan Theivendran, Andrew M.C. Thomas, Ronan B.C.

Detection of Orthopaedic Implants in Vivo by Enhanced- Sensitivity, Walk-Through Metal Detectors by Miguel A. Ramirez, Edward K. Rodriguez, David Zurakowski,

Early Corrosion-Related Failure of the Rejuvenate Modular Total Hip Replacement by Morteza Meftah, Amgad M. Haleem, Matthew B. Burn, Kevin M. Smith, and.

Osteoporosis Disease Management: What Every Orthopaedic Surgeon Should Know by Richard M. Dell, Denise Greene, David Anderson, and Kathy Williams J Bone.

Factors Affecting Aseptic Failure of Fixation after Primary Charnley Total Hip Arthroplasty. Multivariate Survival Analysis* by SENEKI KOBAYASHI, KUNIO.

Achieving Stability and Lower-Limb Length in Total Hip Arthroplasty by Keith R. Berend, Scott M. Sporer, Rafael J. Sierra, Andrew H. Glassman, and Michael.

Evaluation of Patients with Pain Following Total Hip Replacement by Patrick J. Duffy, Bassam A. Masri, Donald S. Garbuz, and Clive P. Duncan J Bone Joint.

Total Knee Arthroplasty with Retention of Both Cruciate Ligaments. A Nine to Eleven-Year Follow-up Study* by J.-M. CLOUTIER, P. SABOURET, and A. DEGHRAR.

Allogeneic Cancellous Bone Graft and a Burch-Schneider Ring for Acetabular Reconstruction in Revision Hip Arthroplasty by E. Winter, M. Piert, R. Volkmann,

A Prospective Study of 80,000 Total Joint and 5000 Anterior Cruciate Ligament Reconstruction Procedures in a Community-Based Registry in the United States.

Modes of Failure of Custom Expandable Repiphysis Prostheses by Aditya V. Maheshwari, Patrick F. Bergin, and Robert M. Henshaw J Bone Joint Surg Am Volume.

Range of Motion of Standard and High-Flexion Posterior Stabilized Total Knee Prostheses by Young-Hoo Kim, Keun-Soo Sohn, and Jun-Shik Kim J Bone Joint.

Comparative Effectiveness of Ceramic-on-Ceramic Implants in Stemmed Hip Replacement by Art Sedrakyan, Stephen Graves, Barbara Bordini, Miquel Pons, Leif.

Dislocation of Rotating Hinge Total Knee Prostheses by William G. Ward, David Haight, Paul Ritchie, Stan Gordon, and Jeffrey J. Eckardt J Bone Joint Surg.

Effect of Flexibility of the Femoral Stem on Bone- Remodeling and Fixation of the Stem in a Canine Total Hip Arthroplasty Model without Cement* by E. J.

Instructional Course Lectures, The American Academy of Orthopaedic Surgeons - Fixation with a Modular Stem in Revision Total Hip Arthroplasty*† by JAMES.

Can the Need for Future Surgery for Acute Traumatic Anterior Shoulder Dislocation Be Predicted? by Raymond A. Sachs, Mary Lou Stone, Elizabeth Paxton,

Enhanced Early Outcomes with the Anterior Supine Intermuscular Approach in Primary Total Hip Arthroplasty by Keith R. Berend, Adolph V. Lombardi, Brian.

A Comparison of the Effects of Alendronate and Alfacalcidol on Bone Mineral Density Around the Femoral Implant and in the Lumbar Spine After Total Hip.

Maintenance of Proximal Cortical Bone with Use of a Less Stiff Femoral Component in Hemiarthroplasty of the Hip without Cement. An Investigation in a Canine.

The Prosthesis-Bone Interface Adjacent to Tibial Components Inserted without Cement. Clinical and Radiographic Follow-up at Nine to Twelve Years* by CRAIG.

Lengthening in Congenital Femoral Deficiency by Sheena R. Black, Michael S. Kwon, Alexander M. Cherkashin, Mikhail L. Samchukov, John G. Birch, and Chan-Hee.

Risk of Injury to the Superior Gluteal Nerve When Using a Proximal Incision for Insertion of a Piriformis-Entry Reamed Femoral Intramedullary Nail by Jason.

Preoperative Planning for Revision Total Hip Arthroplasty by Robert L. Barrack, and R. Stephen J. Burnett J Bone Joint Surg Am Volume 87(12):

Osteoporosis Disease Management: The Role of the Orthopaedic Surgeon by Richard Dell, Denise Greene, Steven R. Schelkun, and Kathy Williams J Bone Joint.

Impaction Bone-Grafting before Insertion of a Femoral Stem with Cement in Revision Total Hip Arthroplasty. A Minimum Two-Year Follow-up Study* by JOHN.

Alumina-on-Alumina Total Hip Arthroplasty by Young-Kyun Lee, Yong-Chan Ha, Jeong Joon Yoo, Kyung-Hoi Koo, Kang Sup Yoon, and Hee Joong Kim J Bone Joint.

The Risk of Cancer Following Total Hip or Knee Arthroplasty by Ravi Tharani, Frederick J. Dorey, and Thomas P. Schmalzried J Bone Joint Surg Am Volume.

Surgical Treatment of Femoroacetabular Impingement: Evaluation of the Effect of the Size of the Resection by Rodrigo M. Mardones, Carlos Gonzalez, Qingshan.

The Trends in Treatment of Femoral Neck Fractures in the Medicare Population from 1991 to 2008 by Benjamin J. Miller, Xin Lu, and Peter Cram J Bone Joint.

Arthroscopic Management of Labral Tears in the Hip by Michael K. Shindle, James E. Voos, Shane J. Nho, Benton E. Heyworth, and Bryan T. Kelly J Bone Joint.

Total Hip Replacement for the Dislocated Hip by Greg Jaroszynski, Ian Woodgate, Khaled Saleh, and Allan Gross J Bone Joint Surg Am Volume 83(2):

Vascularized Compared with Nonvascularized Fibular Grafting for the Treatment of Osteonecrosis of the Femoral Head by Anton Y. Plakseychuk, Shin-Yoon Kim,

Soft-Tissue Balancing of the Hip by Mark N. Charles, Robert B. Bourne, J. Roderick Davey, A. Seth Greenwald, Bernard F. Morrey, and Cecil H. Rorabeck J.

Ilizarov Hip Reconstruction for the Late Sequelae of Infantile Hip Infection by S. Robert Rozbruch, Dror Paley, Anil Bhave, and John E. Herzenberg J Bone.

A Comparison of Two Approaches for the Closed Treatment of Low-Energy Tibial Fractures in Children by Mauricio Silva, Michael J. Eagan, Melissa A. Wong,

Risk Factors for Infection After Knee Arthroplasty by Esa Jämsen, Heini Huhtala, Timo Puolakka, and Teemu Moilanen J Bone Joint Surg Am Volume 91(1):38-47.

Mechanism of Anterior Impingement Damage in Total Knee Arthroplasty by Scott A. Banks, Melinda K. Harman, and W. Andrew Hodge J Bone Joint Surg Am Volume.

Comparison of Ten-Year Survivorship of Hip Prostheses with Use of Conventional Polyethylene, Metal-on-Metal, or Ceramic-on-Ceramic Bearings by Ingrid Milošev,

Surveillance of Patients with Metal-on-Metal Hip Resurfacing and Total Hip Prostheses by A.J. Hart, S.A. Sabah, B. Sampson, J.A. Skinner, J.J. Powell,

Total Hip Arthroplasty with Insertion of the Acetabular Component without Cement in Hips with Total Congenital Dislocation or Marked Congenital Dysplasia*

Metal-Carbon Fiber Composite Femoral Stems in Hip Replacements by D.B. Bennett, J.C. Hill, J. Dennison, S. O’Brien, J.L. Mantel, G.H. Isaac, and D.E. Beverland.

Wait-and-See Policy as a First-Line Management for Extra- Abdominal Desmoid Tumors by Sylvain Briand, Olivier Barbier, David Biau, Axelle Bertrand-Vasseur,

Salter Innominate Osteotomy for the Treatment of Developmental Dysplasia of the Hip in Children by Paul Böhm, and Annemarie Brzuske J Bone Joint Surg Am.

Percutaneously Assisted Total Hip Arthroplasty (PATH): A Preliminary Report by Brad L. Penenberg, W. Seth Bolling, and Michelle Riley J Bone Joint Surg.

Ultrasound Measurements of Torsions in the Tibia and Femur by David Hudson, Todd Royer, and James Richards J Bone Joint Surg Am Volume 88(1): January.

Periacetabular Osteotomy: the Bernese Experience by Klaus A Siebenrock, Michael Leunig, and Reinhold Ganz J Bone Joint Surg Am Volume 83(3): March.

Surgical Correction of Residual Hip Dysplasia in Two Pediatric Age-Groups by François D. Lalonde, Steven L. Frick, and Dennis R. Wenger J Bone Joint Surg.

An Association Between Functional Second Metatarsal Length and Midfoot Arthrosis by James S. Davitt, Nancy Kadel, Bruce J. Sangeorzan, Sigvard T. Hansen,

Femoral Revision with the Wagner SL Revision Stem by Paul Böhm, and Oliver Bischel J Bone Joint Surg Am Volume 83(7): July 1, 2001 ©2001 by The.

Impingement with Total Hip Replacement

Familial Bilateral Osteochondritis Dissecans of the Femoral Head by Mark C. Lee, Derek M. Kelly, Daniel J. Sucato, and John A. Herring J Bone Joint Surg.

Mid-Term Results of Third-Generation Alumina-on-Alumina Ceramic Bearings in Cementless Total Hip Arthroplasty by Eric Yeung, Paul Thornton Bott, Rishi.

Three-Dimensional Mechanics, Kinematics, and Morphology of the Knee Viewed in Virtual Reality by Donald G. Eckhoff, Joel M. Bach, Victor M. Spitzer, Karl.

Eccentric Rotational Acetabular Osteotomy for Acetabular Dysplasia and Osteoarthritis by Yukiharu Hasegawa, Toshiki Iwase, Shinji Kitamura, Masashi Kawasaki,

by D. TÖNNIS, and A. HEINECKE

Presentation transcript:

Volume 91(Supplement 6):121-128 Sex Differences in Hip Morphology: Is Stem Modularity Effective for Total Hip Replacement? by Francesco Traina, Manuela De Clerico, Federico Biondi, Federico Pilla, Enrico Tassinari, and Aldo Toni J Bone Joint Surg Am Volume 91(Supplement 6):121-128 November 1, 2009 ©2009 by The Journal of Bone and Joint Surgery, Inc.

Anatomic differences in hip morphology between men and women. Anatomic differences in hip morphology between men and women. CCD = cervicodiaphyseal. Francesco Traina et al. J Bone Joint Surg Am 2009;91:121-128 ©2009 by The Journal of Bone and Joint Surgery, Inc.

Femoral offset (FO), which is the perpendicular distance from the center of rotation of the hip to the long axis of the femur. Femoral offset (FO), which is the perpendicular distance from the center of rotation of the hip to the long axis of the femur. Francesco Traina et al. J Bone Joint Surg Am 2009;91:121-128 ©2009 by The Journal of Bone and Joint Surgery, Inc.

Schematic diagram showing hip mechanics. Schematic diagram showing hip mechanics. The body weight lever arm (B) is the distance from the center of the femoral head to a vertical line through the symphysis pubis. The abductor lever arm (A) is the perpendicular distance from the center of the femoral head to a line drawn from the anterior superior iliac spine and tangential to the greater trochanter. Since B is greater than A, the abductor force required to balance the body in an upright position should be larger than the body weight. Francesco Traina et al. J Bone Joint Surg Am 2009;91:121-128 ©2009 by The Journal of Bone and Joint Surgery, Inc.

Diagram showing how, with monoblock stems, femoral offset (yellow arrows) is proportionally dependent on stem size while this is not true with modular neck stems. Diagram showing how, with monoblock stems, femoral offset (yellow arrows) is proportionally dependent on stem size while this is not true with modular neck stems. Francesco Traina et al. J Bone Joint Surg Am 2009;91:121-128 ©2009 by The Journal of Bone and Joint Surgery, Inc.

Radiographs showing hip shapes that are difficult to restore with use of monoblock stems: large shaft, short neck, low offset (a); thin shaft, long neck, high offset (b); large shaft, short neck, high offset (c); and thin shaft, long neck, low offset (d). Radiographs showing hip shapes that are difficult to restore with use of monoblock stems: large shaft, short neck, low offset (a); thin shaft, long neck, high offset (b); large shaft, short neck, high offset (c); and thin shaft, long neck, low offset (d). Francesco Traina et al. J Bone Joint Surg Am 2009;91:121-128 ©2009 by The Journal of Bone and Joint Surgery, Inc.

Six different neck models were available: straight, varus-valgus (8°), anteverted-retroverted (8° and 15°), and the combination of 6° of varus and 4.5° of retroversion for the left and the right side. Six different neck models were available: straight, varus-valgus (8°), anteverted-retroverted (8° and 15°), and the combination of 6° of varus and 4.5° of retroversion for the left and the right side. Francesco Traina et al. J Bone Joint Surg Am 2009;91:121-128 ©2009 by The Journal of Bone and Joint Surgery, Inc.

Diagram showing how implant offset (X) and neck length (Y) were calculated in each patient. Francesco Traina et al. J Bone Joint Surg Am 2009;91:121-128 ©2009 by The Journal of Bone and Joint Surgery, Inc.

Estimated Kaplan-Meier survival curve with 95% confidence intervals at eleven years for the 2131 modular neck prostheses. Estimated Kaplan-Meier survival curve with 95% confidence intervals at eleven years for the 2131 modular neck prostheses. Francesco Traina et al. J Bone Joint Surg Am 2009;91:121-128 ©2009 by The Journal of Bone and Joint Surgery, Inc.

Comparison of estimated Kaplan-Meier survival curves at eleven years between 1080 prostheses implanted in women and 1051 prostheses implanted in men (p = 0.07). Comparison of estimated Kaplan-Meier survival curves at eleven years between 1080 prostheses implanted in women and 1051 prostheses implanted in men (p = 0.07). Francesco Traina et al. J Bone Joint Surg Am 2009;91:121-128 ©2009 by The Journal of Bone and Joint Surgery, Inc.

Distribution of modular neck lengths in men and women. Francesco Traina et al. J Bone Joint Surg Am 2009;91:121-128 ©2009 by The Journal of Bone and Joint Surgery, Inc.

An anteverted-retroverted (AR) neck was used more frequently in women than in men. Francesco Traina et al. J Bone Joint Surg Am 2009;91:121-128 ©2009 by The Journal of Bone and Joint Surgery, Inc.

Offset distribution correlated with stem size distribution in both women and men. Offset distribution correlated with stem size distribution in both women and men. Offset in women was lower than that in men independent of stem size. Francesco Traina et al. J Bone Joint Surg Am 2009;91:121-128 ©2009 by The Journal of Bone and Joint Surgery, Inc.

Distribution of stem sizes in women and men. Distribution of stem sizes in women and men. The implant used in this series is available in eight different sizes. Smaller stems were predominantly used in women. Francesco Traina et al. J Bone Joint Surg Am 2009;91:121-128 ©2009 by The Journal of Bone and Joint Surgery, Inc.

A patient with a small femoral canal and a long femoral neck. A patient with a small femoral canal and a long femoral neck. Prosthetic modularity allowed restoration of proper anatomy, with avoidance of limb-length discrepancy and restoration of femoral offset. Francesco Traina et al. J Bone Joint Surg Am 2009;91:121-128 ©2009 by The Journal of Bone and Joint Surgery, Inc.

A patient with a large femoral canal and a short femoral neck, anatomy typical of older women. A patient with a large femoral canal and a short femoral neck, anatomy typical of older women. In this case, a short neck of the femoral component allowed the surgeon to restore offset and lower-limb length independent of the large stem size required to fill the femoral canal and achieve good primary stability. Francesco Traina et al. J Bone Joint Surg Am 2009;91:121-128 ©2009 by The Journal of Bone and Joint Surgery, Inc.

a: A patient with a thin femoral shaft, a large femoral offset, and a short neck. a: A patient with a thin femoral shaft, a large femoral offset, and a short neck. A monoblock prosthesis was used to achieve equal lower-limb lengths, and the offset was reduced. b: A patient with a large femoral shaft, a large offset, and a short neck. A modular neck prosthesis allowed the surgeon to restore hip offset, equalizing the lower-limb lengths. c: A patient with a thin femoral shaft, a long neck, and a low offset. A modular neck prosthesis allowed the surgeon to restore the hip anatomy. Francesco Traina et al. J Bone Joint Surg Am 2009;91:121-128 ©2009 by The Journal of Bone and Joint Surgery, Inc.

Diagram showing how a retroverted neck helps to reduce the risk of implant impingement and dislocation in hip adduction-external rotation. Diagram showing how a retroverted neck helps to reduce the risk of implant impingement and dislocation in hip adduction-external rotation. Francesco Traina et al. J Bone Joint Surg Am 2009;91:121-128 ©2009 by The Journal of Bone and Joint Surgery, Inc.

A woman with a short straight modular neck, reducing lower-limb length and decreasing hip offset. A woman with a short straight modular neck, reducing lower-limb length and decreasing hip offset. After dislocation (center), revision surgery was performed. A long retroverted neck was implanted in order to equalize the limb lengths, restore femoral offset, and avoid impingement in adduction and external rotation. Francesco Traina et al. J Bone Joint Surg Am 2009;91:121-128 ©2009 by The Journal of Bone and Joint Surgery, Inc.

The relative risk of failure of modular implants in men and women. The relative risk of failure of modular implants in men and women. Analysis of the demographic characteristics of the two populations under investigation in this study showed a lower risk of neck failure in women than in men. This lower risk of failure in women is due to an average lower implant offset (a), smaller stem size (b), and lower body weight (c). High offset, large stems, and high body weight increase the risk of modular neck failure. Francesco Traina et al. J Bone Joint Surg Am 2009;91:121-128 ©2009 by The Journal of Bone and Joint Surgery, Inc.