Biomechanical, morphological, and histological analysis of early failures in hip resurfacing arthroplasty

The present revival of hip resurfacing arthroplasty may be related to an increase in early failures owing to the challenging technique of the procedure. Fifty-five retrieved implants were analysed with respect to wear, cement mantle and cement penetration, fracture and head morphology, as well as standard histology. Femoral neck fractures occurred in median after 102 days. The time to failure was shorter for older women. Major deviations from the suggested cement mantle thickness and cement penetration were found. Indications for high trauma during implantation leading to early failure due to weakening of the femoral neck were also observed. Some failures had signs of pseudarthrosis beneath the implant. Four different fracture patterns with different mean survival times were identified. Observed wear was minor with the exception of that due to alignment mistakes (rim loading). The cups were not damaged by the failures. Histological results indicate that avascular necrosis is not necessarily connected with this kind of endoprosthetic surgery. Most of the failures analysed can probably be attributed to the 'learning curve' effect, which is an unsatisfactory situation.

Subjects

Aged

Arthroplasty, Hip Replacement

Biomechanical Phenomena

Equipment Failure Analysis

Female

Femoral Fractures

Femur Head

Femur Head Necrosis

Hip Prosthesis

Humans

Male

Middle Aged

Surface Properties

Treatment Outcome

Prosthesis Failure

DDC Class

610: Medizin

Lizenz

http://rightsstatements.org/vocab/InC/1.0/

Name

095441105x69015.pdf

Size

434.75 KB

Format

Adobe PDF

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Biomechanical, morphological, and histological analysis of early failures in hip resurfacing arthroplasty