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consequently increases the prosthetic survival time. 26 Secondary affecting biomechanical factors The theory of early loosening further postulates that, if loosening has been initiated, the progression of loosening is affected by biomechanical
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Conventional techniques for hip and knee arthroplasty have led to good long-term clinical outcomes, but complications remain despite better surgical precision and improvements in implant design and quality.
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Technological improvements and a better understanding of joint kinematics have facilitated the progression to ‘personalized’ implant positioning (kinematic alignment) for total hip (THA) and knee (TKA) arthroplasty, the true value of which remains to be determined.
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By achieving a true knee resurfacing, the kinematic alignment (KA) technique for TKA aims at aligning the components with the physiological kinematic axes of the knee and restoring the constitutional tibio-femoral joint line frontal and axial orientation and soft-tissue laxity.
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The KA technique for THA aims at restoring the native ‘combined femoro-acetabular anteversion’ and the hip’s centre of rotation, and occasionally adjusting the cup position and design based on the assessment of the individual spine-hip relation.
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The key element for optimal prosthetic joint kinematics (hip or knee) is to reproduce the femoral anatomy.
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The transverse acetabular ligament (TAL) is the reference landmark to adjust the cup position.
Cite this article: EFORT Open Rev 2018;3:98-105. DOI: 10.1302/2058-5241.3.170022
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% vs 17%, respectively). Excellent survivorship occurs for patients with Ficat I disease. Mazieres et al (1997) 22 CD 20/20 Ficat II 2 After a mean of 24 months, 50% of the hips showed signs of radiographic progression. 1/8 hips
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replacements. Early diagnosis is therefore critical as it affects essentially the young and middle-aged population and because a progression of the disease to a collapse of the femoral head is seen in up to 80% of patients if left untreated. 6 In addition
Life and Health Sciences Research Institute (ICVS), School of Medicine, University of Minho, Portugal
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Life and Health Sciences Research Institute (ICVS), School of Medicine, University of Minho, Portugal
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posterior wall intersects the centre of the femoral head. 42 Its presence reveals an anomalous acetabular version even in the absence of cross-over sign which is associated with an early progression to osteoarthrosis ( Fig. 2d ). 3 , 42
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collapse, with 25 of 45 (55.6%) hips requiring THA. 29 A prospective, randomized controlled study by Gangji et al demonstrated a significantly improved time to collapse, progression of disease, and decreased hip pain and joint symptoms when comparing
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stump and fixed with anterograde Kirschner wires. 63 Of the hips, 93% presented with no progression of osteoarthritis, good clinical scores and no subsequent total hip arthroplasty (THA) at 10-year follow-up 64 following a modified Dunn
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progression to complete fracture and in reducing hospital stay. 45 It also seems that fractures heal faster when treated surgically. 46 Progression to complete fracture and pain refractory to non-surgical treatment reduce the success rate of non
Academic Unit of Bone Metabolism, University of Sheffield Medical School, Sheffield, UK
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Centre of Orthopaedic and Regenerative Medicine (CORE), Center for Interdisciplinary Research and Innovation (CIRI), Aristotle University of Thessaloniki, Thessaloniki, Greece
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Centre of Orthopaedic and Regenerative Medicine (CORE), Center for Interdisciplinary Research and Innovation (CIRI), Aristotle University of Thessaloniki, Thessaloniki, Greece
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. Our findings suggest that PD patients did not experience increased mortality in the immediate postoperative period compared to controls; however, long-term follow-up data showed a higher mortality risk, likely attributed to the disease progression
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concentration at the junction of the thinner bone trabeculae in the necrotic area and the thicker bone trabeculae in the repaired area, eventually leading to the formation of a sclerotic zone ( 18 ). With the progression of the disease, the trabecular bone
