Forum for Science, Industry and Business

Sponsored by:     3M 
Search our Site:

 

Cementless Cup Device Developed for Total Hip Replacements Shows Durability after More than Twenty Years

04.02.2009
Durability shown even with patients who had a previously failed hip replacement

When a first hip replacement fails, patients may be concerned that their options for a durable hip replacement are limited and that the prognosis is poor. However, a research study to be published in the February issue of the Journal of Bone and Joint Surgery suggests that this may not be the case.

Researchers from Rush University Medical Center examined their results using one of the first cementless metal cup designs and found that fixation of the implant to bone is extremely durable even twenty years after repeat or “revision” hip replacement. The implant utilized, the Harris-Galante-1 acetabular metal shell, which is designed to allow a patient’s bone to grow into the implant, remained fixed in place in 95 percent of hip revision cases at a minimum follow-up of 20 years.

The implant and its bone in-growth surface were originally developed in conjunction with Dr. Jorge Galante, an orthopedic surgeon at Rush University Medical Center and one of the present study’s investigators. The cup’s porous surface allows bone and tissue to grow into the device to keep the hip implant in place. Earlier generation implants relied on the use of bone cement to secure the implant to the patient’s pelvis and were associated with a higher rate of failure, particularly when used in patients who had previously had a hip implant that had failed.

“The study’s results indicate that even the first generation of this device has excellent clinical results and durability,” said Dr. Craig Della Valle, orthopedic surgeon at Rush and study investigator. “Even after 20 years, there is low rate of failure in terms of fixation.”

Researchers previously reported the results of the use of the Harris-Galante-1 cementless acetabular shell for total hip revision procedures in 138 hips at a minimum of three, seven, and fifteen years postoperatively. The current report presents the long-term outcomes of this group at a follow-up of 20 years.

Of the original cohort of 138 hips, researchers were able to follow 73 patients who were still living (77 hips) for 20 years or more. Of the 77 hips, 37 had both clinical and radiographic evaluation, 20 had a clinical evaluation via telephone questionnaire and 21 underwent a repeat revision of the acetabular metal shell.

Twenty of the 21 cementless cups were found to be well fixed at the time of repeat revision and only one had become loose. During the entire study period, four cups were identified radiographically as being loose. For the entire cohort of 138 hips, the 20-year survivorship of the acetabular component was 95 percent.

While the long-term fixation of the device performed very well, the study did find an increased rate of repeat surgery for wear-related complications compared to the 15-year report. Ten patients, or 18 percent, had a complication related to wear of the bearing surface as opposed to 3 percent at 15 years.

“Although we have seen more complications related to wear as we have continued to follow these patients, our studies have taught us valuable lessons regarding failure mechanisms and how to avoid them,” said Della Valle.

Despite the increasing prevalence of wear-related problems, the main modes of failure were infection and recurrent dislocations. The study authors recommend the use of larger diameter femoral heads and more wear-resistant bearings to decrease the risks of these complications.

“We can continue to make vast improvements in the quality of bearing and stability in the next generation of devices used in total hip replacements with the information we have gathered from this study,” said Galante. “More and more patients are living longer and we must continue to further develop sustainable devices that will give patients a better quality of life.”

Rush University Medical Center’s orthopedics program ranks tenth in the nation, according to U.S. News & World Report. Physicians from Rush serve as the team physicians for the Chicago Bulls and the Chicago White Sox. For more information on orthopedics at Rush, visit http://www.rush.edu/rumc/page-R11726.html or call (888) 352-RUSH.

Rush University Medical Center is an academic medical center that encompasses the more than 600 staffed-bed hospital (including Rush Children’s Hospital), the Johnston R. Bowman Health Center and Rush University. Rush University, with more than 1,730 students, is home to one of the first medical schools in the Midwest, and one of the nation’s top-ranked nursing colleges. Rush University also offers graduate programs in allied health and the basic sciences. Rush is noted for bringing together clinical care and research to address major health problems, including arthritis and orthopedic disorders, cancer, heart disease, mental illness, neurological disorders and diseases associated with aging.

Deborah Song | EurekAlert!
Further information:
http://www.rush.edu

More articles from Health and Medicine:

nachricht Team discovers how bacteria exploit a chink in the body's armor
20.01.2017 | University of Illinois at Urbana-Champaign

nachricht Rabies viruses reveal wiring in transparent brains
19.01.2017 | Rheinische Friedrich-Wilhelms-Universität Bonn

All articles from Health and Medicine >>>

The most recent press releases about innovation >>>

Die letzten 5 Focus-News des innovations-reports im Überblick:

Im Focus: Traffic jam in empty space

New success for Konstanz physicists in studying the quantum vacuum

An important step towards a completely new experimental access to quantum physics has been made at University of Konstanz. The team of scientists headed by...

Im Focus: How gut bacteria can make us ill

HZI researchers decipher infection mechanisms of Yersinia and immune responses of the host

Yersiniae cause severe intestinal infections. Studies using Yersinia pseudotuberculosis as a model organism aim to elucidate the infection mechanisms of these...

Im Focus: Interfacial Superconductivity: Magnetic and superconducting order revealed simultaneously

Researchers from the University of Hamburg in Germany, in collaboration with colleagues from the University of Aarhus in Denmark, have synthesized a new superconducting material by growing a few layers of an antiferromagnetic transition-metal chalcogenide on a bismuth-based topological insulator, both being non-superconducting materials.

While superconductivity and magnetism are generally believed to be mutually exclusive, surprisingly, in this new material, superconducting correlations...

Im Focus: Studying fundamental particles in materials

Laser-driving of semimetals allows creating novel quasiparticle states within condensed matter systems and switching between different states on ultrafast time scales

Studying properties of fundamental particles in condensed matter systems is a promising approach to quantum field theory. Quasiparticles offer the opportunity...

Im Focus: Designing Architecture with Solar Building Envelopes

Among the general public, solar thermal energy is currently associated with dark blue, rectangular collectors on building roofs. Technologies are needed for aesthetically high quality architecture which offer the architect more room for manoeuvre when it comes to low- and plus-energy buildings. With the “ArKol” project, researchers at Fraunhofer ISE together with partners are currently developing two façade collectors for solar thermal energy generation, which permit a high degree of design flexibility: a strip collector for opaque façade sections and a solar thermal blind for transparent sections. The current state of the two developments will be presented at the BAU 2017 trade fair.

As part of the “ArKol – development of architecturally highly integrated façade collectors with heat pipes” project, Fraunhofer ISE together with its partners...

All Focus news of the innovation-report >>>

Anzeige

Anzeige

Event News

Sustainable Water use in Agriculture in Eastern Europe and Central Asia

19.01.2017 | Event News

12V, 48V, high-voltage – trends in E/E automotive architecture

10.01.2017 | Event News

2nd Conference on Non-Textual Information on 10 and 11 May 2017 in Hannover

09.01.2017 | Event News

 
Latest News

Helmholtz International Fellow Award for Sarah Amalia Teichmann

20.01.2017 | Awards Funding

An innovative high-performance material: biofibers made from green lacewing silk

20.01.2017 | Materials Sciences

Ion treatments for cardiac arrhythmia — Non-invasive alternative to catheter-based surgery

20.01.2017 | Life Sciences

VideoLinks
B2B-VideoLinks
More VideoLinks >>>