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Minimally Invasive Two-Incision Total Hip Replacement using large Diameter Ceramic-on-Ceramic Articulation

  • Taek-Rim Yoon
  • C.-I. Hur
  • S. Diwanji
  • D.-S. Lee
Conference paper
Part of the Ceramics in Orthopaedics book series (CIO)

Abstract

Background

Our experience with the minimally invasive (MI) two-incision technique over the last 4 years has shown that total hip arthroplasty (THA) can be performed safely and effectively in properly selected patients. Total hips with larger-diameter femoral heads are more resistant to dislocation. The purpose of the present study was to evaluate the short-term results of a minimally invasive two-incision THA Using Large Diameter Ceramic-on-Ceramic Articulation.

Patients and Methods

A consecutive series of 50 patients who underwent unilateral MI two-inicision THA from June 2006 to October 2006 were studied. There were 35 men and 15 women with a mean age at arthroplasty of 44.9 years (range, 23 to 73 years). There were 36 left and 14 right hip arthroplasties performed. Indications for THA were avascular necrosis of the femoral head in 29 cases, osteoarthritis in 12 cases, rheumatoid arthritis in 3 cases, femur neck fracture in 2 cases, dysplastic hips in 2 cases and ankylosing arthritis in 1 case. A modified two-incision approach was used for all procedures in lateral position. In-hospital data were collected retrospectively, and the initial postoperative radiographs were analyzed. Twenty-eight patients received 36 mm diameter femoral heads, while 22 patients received 32 mm diameter heads.

Results

All patients could mobilize in the following days after surgery. There was no case of intraoperative complications such as intraoperative fracture, nerve palsy, or vascular injury. Postoperatively there was no dislocation or deep vein thrombosis. All femoral stems were inserted neutral or within 5 degree valgus. In all patients, leg length discrepancy was within 5mm difference. The average ROM of hips at last follow-up was significantly improved compared with the preoperative values.

Conclusion

Short-term results of a minimally invasive two-incision THA using large diameter ceramic-on-ceramic articulation were excellent.

Keywords

Femoral Head Acetabular Component Gluteus Medius Femoral Head Size Large Femoral Head 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

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References

  1. 1.
    Barrack RL, Butler RA, Laster DR, Andrews P (2001) Stem design and dislocation after revision total hip arthroplasty: Clinical results and computer modeling. J Arthroplasty 16:8–12.PubMedCrossRefGoogle Scholar
  2. 2.
    Berry DJ, Von Knoch, Schleck CD, Harmsen WS (2004) The cumulative long-term risk of dislocation after primary Charnley total hip arthroplasty. J Bone Joint Surg Am 86:9–14.PubMedGoogle Scholar
  3. 3.
    Boehler M, Knahr K, Salzer M et al (1994) Long term results of uncemented alumina acetabular implants. J Bone Joint Surg Br 76:53–59.PubMedGoogle Scholar
  4. 4.
    Boettcher WG (1992) Total hip arthroplasties in the elderly: morbidity, mortality, and cost effectiveness. Clin Orthop Relat Res 274:30–34.PubMedGoogle Scholar
  5. 5.
    Boutin P (1972) Arthroplastie Totale de Hanche par Prothese en Alumine Frittee Rev Chir Orthop 58:229–246.Google Scholar
  6. 6.
    Boutin P, Blanquaert D (1981) Le Frottement Al/Al en Chirurgie de la Hanche-1205 Arthroplasties Totales. Rev Chir Orthop 67:279–287.PubMedGoogle Scholar
  7. 7.
    Burroughs BR, Hallstrom B, Golladay GJ, Hoeffel D, Harris WH (2005) Range of motion and stability in total hip arthroplasty with 28-, 32-, 38-, and 44-mm femoral head sizes: an in vitro study. J Arthroplasty 20:11–19.PubMedCrossRefGoogle Scholar
  8. 8.
    Bystrom S, Espehaug B, Furnes O, Havelin LI (2003) Femoral head size is a risk factor for total hip luxation.: a study of 42,987 primary hip arthroplasties from the Norwegian Arthroplasty Register. Acta Orthop Scand 74:514–524.PubMedCrossRefGoogle Scholar
  9. 9.
    Capello WN, D’Antonio JA, Feinberg JR, Manley MT (2005) Alternative bearing surfaces: alumina ceramic bearings for total hip arthroplasty. Instr Course Lect 54:171–176.PubMedGoogle Scholar
  10. 10.
    Crowninshield RD, Maloney WJ, Wentz DH, Humphrey SM, Blanchard CR (2004) Biomechanics of large femoral heads: what they do and don’t do. Clin Orthop Relat Res 429:102–107.PubMedCrossRefGoogle Scholar
  11. 11.
    D’Antonio J, Capello W, Manley M, naughton M, Sutton K (2005) Alumina ceramic bearings for total hip arthroplasty: five-year results of a prospective randomized study. Clin Orthop Relat Res 436:164–171.PubMedCrossRefGoogle Scholar
  12. 12.
    De Wal H, Su E, DiCesare PE (2003) Instability following total hip arthroplasty. Am J Orthop 32:377–382.Google Scholar
  13. 13.
    Duwelius PJ, Berger RA (2005) Minimally invasive total hip arthroplasty: the two-incision approach. Curr Opin Orthop 16:5–9.CrossRefGoogle Scholar
  14. 14.
    Eftekhar NS (1993) Dislocation and instability. In: Eftekhar NS(eds) Total Hip Arthroplasty. Mosby, St. Louis CV, pp 1505–1553.Google Scholar
  15. 15.
    Hannouche D, Hamadouche M, Nizard R, Bizot P, Meunier A, Sedel L (2005) Ceramics in total hip replacement. Clin Orthop Relat Res 430:62–71.PubMedCrossRefGoogle Scholar
  16. 16.
    Hannouche D, Nich C, Bizot P, Meunier A, Nizard R, Sedel L (2003) Fractures of ceramic bearings: history and present status. Clin Orthop Relat Res 417:19–26.PubMedGoogle Scholar
  17. 17.
    Hasegawa M, Sudo A, Uchida A (2006) Alumina ceramic-on-ceramic total hip replacement with a layered acetabular component. J Bone Joint Surg Br 88:877–882.PubMedCrossRefGoogle Scholar
  18. 18.
    Ha YC, Kim SY, Kim HJ, Yoo JJ, Koo KH (2007) Ceramic Liner Fracture after Cementless Alumina-on-Alumina Total Hip Arthroplasty. Clin Orthop Relat Res 458:106–110.PubMedGoogle Scholar
  19. 19.
    Katz JN, Losina E, Barrett J, Phillips CB, Mahomed NN, Lew RA, Guadagnoli E, Harris WH, Poss R, Baron JA (2001) Association between hospital and surgeon procedure volume and outcomes of total hip replacement in the United States Medicare Population. J Bone Joint Surg Am 83:1622–1629.PubMedCrossRefGoogle Scholar
  20. 20.
    Lachiewicz PF, Soileau ES (2002) Stability of total hip arthroplasty in patients 75 years or older. Clin Orthop Relat Res 405:65–69.PubMedCrossRefGoogle Scholar
  21. 21.
    Lee PC, Shih CH, Chen WJ, Tu YK, Tai CL (1999) Early polyethylene wear and osteolysis in cementless total hip arthroplasty: the influence of femoral head size and polyethylene thickness. J Arthroplasty. 14:976–981.PubMedCrossRefGoogle Scholar
  22. 22.
    Lewinnek GE, Lewis JL, Tarr R, Compere CL, Zimmerman JR (1978) Dislocations after total hip-replacement arthroplasties. J Bone Joint Surg Am 60:217–220.PubMedGoogle Scholar
  23. 23.
    Mahoney CR, Pellicci PM (2003) Complications in primary total hip arthroplasty. Avoidance and management of dislocations. Instr Course Lect 52:247–255.PubMedGoogle Scholar
  24. 24.
    Masonis JL, Bourne RB (2002) Surgical approach, abductor function, and total hip arthroplasty dislocation. Clin Orthop Relat Res 405:46–53.PubMedCrossRefGoogle Scholar
  25. 25.
    Morrey BF (1992) Instability after total hip arthroplasty. Orthop Clin North America 23:237–248.Google Scholar
  26. 26.
    Muratoglu OK, Bragdon CR, O’Connor D, Perinchief RS, Estok DM 2nd, Jasty M, Harris WH (2001) Larger diameter femoral heads used in conjunction with a highly cross-linked ultra-high molecular weight polyethylene: a new concept. J Arthroplasty 16(suppl 1):24–30.PubMedCrossRefGoogle Scholar
  27. 27.
    Phillips CB, Barrett JA, Losina E, Mahomed NN, Lingard EA, Guadagnoli E, Baron JA, Harris WH, Poss R, Katz JN (2003) Incidence rates of dislocation, pulmonary embolism, and deep infection during the first six months after elective total hip replacement. J Bone Joint Surg Am. 85:20–26.PubMedCrossRefGoogle Scholar
  28. 28.
    Robbins GM, Masri BA, Garbuz DS, Greidanus N, Duncan CP (2001) Treatment of hip instability. Orthop Clin North Am 32:593–610.PubMedCrossRefGoogle Scholar
  29. 29.
    Turner RS (1994) Postoperative total hip prosthetic femoral head dislocations: Incidence, etiologic factors, and management. Clin Orthop 301:196–204.PubMedGoogle Scholar
  30. 30.
    Von Knoch M, Berry DJ, Harmsen WS, Morrey BF (2002) Late dislocation after total hip arthroplasty. J Bone Joint Surg Am 84:1949–1953.Google Scholar
  31. 31.
    Weisse B, Zahner M, Weber W, Rieger W (2003) Improvement of the reliability of ceramic hip joint implants. J Biomech 36:1633–1639.PubMedCrossRefGoogle Scholar

Copyright information

© Steinkopff Verlag 2007

Authors and Affiliations

  • Taek-Rim Yoon
    • 1
  • C.-I. Hur
  • S. Diwanji
  • D.-S. Lee
  1. 1.Center for Joint DiseaseChonnam National University Hwasun HospitalJeonnamKorea

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