Modular femoral components have been developed to aid in recreating native femoral version, limb length, and offset in total hip arthroplasty. Use of modular implants results in cost savings, as well. Inventory can be reduced while allowing intraoperative flexibility and options. With modular implants, the femoral prosthesis can be built in situ, which is helpful in minimizing incision length a...

Stress shielding is a well-known failure factor in hip implants. This work proposes a design concept for hip implants, using a combination of metallic stem with a polymer coating (polyether ether ketone (PEEK)). The proposed design concept is simulated using titanium alloy stems and PEEK coatings with thicknesses varying from 100 to 400 μm. The Finite Element analysis of the cancellous bone sur...

Extensive osteolysis adjacent to orthopedic implants is often associated with wear particles of prosthetic material. The activation of the RANKL/RANK/OPG system is considered to be a likely cause of periprosthetic osteolysis leading to implant failure. The aim of this study was to examine the possible correlation between the clinical extent of osteolysis, the number of wear particles and expres...

OBJECTIVES The objective of this study was to assess all evidence comparing the Thompson monoblock hemiarthroplasty with modular unipolar implants for patients requiring hemiarthroplasty of the hip with respect to mortality and complications. METHODS A literature search was performed to identify all relevant literature. The population consisted of patients undergoing hemiarthroplasty of the h...

Dear Editor, Antibiotic-impregnated bone cement has been used routinely in total hip and knee replacements as it has been shown to reduce the incidence of deep wound infection.1-7 The antibiotics used include nephrotoxic gentamicin as well as tobramycin and polymyxin, besides other less nephrotoxic such as cefuroxime. The risk of nephrotoxicity from the use of the former has been deemed to be l...

OBJECTIVE To determine the evidence of effectiveness and safety for introduction of five recent and ostensibly high value implantable devices in major joint replacement to illustrate the need for change and inform guidance on evidence based introduction of new implants into healthcare. DESIGN Systematic review of clinical trials, comparative observational studies, and registries for comparati...

OBJECTIVES To establish a laboratory model of implant cutout, which can evaluate the effect of implant design on cutout resistance in a clinically realistic "worst case" scenario. SETTING Orthopaedic biomechanics laboratory. DESIGN Implant cutout was simulated in an unstable pertrochanteric fracture model, which accounted for dynamic loading, osteoporotic bone, and a defined implant offset....

Background The USA devotes roughly $200 billion (6%) of annual national health expenditures to medical devices. A substantial proportion of this spending occurs during orthopedic (eg, hip and knee) arthroplasties - two high-volume hospital procedures. The implants used in these procedures are commonly known as physician preference items (PPIs), reflecting the physician's choice of implant and v...

Conservative hip implants preserve healthy bone for revision surgeries and improve physiological loading; however, they have little supporting biomechanical data with respect to their 3D orientation during implantation. This study endeavored to determine the optimal 3D orientation of a straight short stem hip implant within the proximal femur that would yield a stress distribution most similar ...