Hip international : the journal of clinical and experimental research on hip pathology and therapy
-
Review Case Reports
Trochanteroplasty to treat sequelae of septic arthritis of the hip in infancy. Case series and review of the literature.
The authors report a series of 11 patients treated surgically by trochanteroplasty for septic arthritis of the hip at our institution from 1974 to 2010. Trochanteroplasty was indicated due to the absence of a valid alternative, and because it does not rule out the option of total hip arthroplasty at a later stage.
-
Given the recent reports of high failure rates, an improved understanding of the mechanism of failure of large diameter metal-on-metal hip arthroplasties is essential. We present clinical data and tribological analysis of a consecutive series of 74 failed large diameter metal-on-metal hips, comparing the Durom (Zimmer) with the Birmingham hip resurfacing (BHR) (Smith and Nephew). We retrospectively analysed pre-, intra-, and post-operative clinical data and measured the linear wear and component form of the explanted components using a roundness measuring machine. ⋯ Comparison of roundness measurement revealed that the Durom hip was significantly lower wearing than the BHR (p<0.05) but the Durom femoral components were subject to significantly greater form errors (p<0.001), the pole of the head being flattened by up to 31 microns. Although the Durom hip is low wearing, reduced sphericity of the femoral component may have resulted in equatorial bearing, leading to an increased frictional torque at the cup-bone interface, preventing bone in-growth, and culminating in acetabular loosening. This supports recent clinical findings of high revision rates as a result of acetabular loosening for the Durom metal-on-metal hip system.