79 research outputs found
Perspectives on metaphyseal conservative stems
Total hip replacement is showing, during the last decades, a progressive evolution toward principles of reduced bone and soft tissue aggression. These principles have become the basis of a new philosophy, tissue sparing surgery. Regarding hip implants, new conservative components have been proposed and developed as an alternative to conventional stems. Technical and biomechanical characteristics of metaphyseal bone-stock-preserving stems are analyzed on the basis of the available literature and our personal experience. Mayo, Nanos and Metha stems represent, under certain aspects, a design evolution starting from shared concepts: reduced femoral violation, non-anatomic geometry, proximal calcar loading and lateral alignment. However, consistent differences are level of neck preservation, cross-sectional geometry and surface finishing. The Mayo component is the most time-tested component and, in our hands, it showed an excellent survivorship at the mid-term follow-up, with an extremely reduced incidence of aseptic loosening (partially reduced by the association with last generation acetabular couplings). For 160 implants followed for a mean of 4.7 years, survivorship was 97.5% with 4 failed implants: one fracture with unstable stem, 1 septic loosening and 2 aseptic mobilizations. DEXA analysis, performed on 15 cases, showed a good calcar loading and stimulation, but there was significant lateral load transfer to R3–R4 zones, giving to the distal part of the stem a function not simply limited to alignment. Metaphyseal conservative stems demonstrated a wide applicability with an essential surgical technique. Moreover, they offer the options of a “conservative revision” with a conventional primary component in case of failure and a “conservative revision” for failed resurfacing implants
Computer-Assisted Navigation Increases Precision of Component Placement in Total Knee Arthroplasty
Correction of Moderate to Severe Hallux Valgus Deformity by a Modified Chevron Shaft Osteotomy
Surgical Treatment of Mild Hallux Valgus Deformity: The State of Practice Among Academic Foot and Ankle Surgeons
Clinical Diagnostic Accuracy and Magnetic Resonance Imaging of Patients Referred by Physical Therapists, Orthopaedic Surgeons, and Nonorthopaedic Providers
The Appropriate Use of Patellofemoral Arthroplasty: An Analysis of Reported Indications, Contraindications, and Failures
Treatment of Infected Total Knee Arthroplasty Using an Articulating Spacer: 2- to 12-Year Experience
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