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Prosthesis fixation: Femoral stem fixation can be either cemented or non-cemented (biological) fixation. Attached to the femoral component is the neck and head which in most prostheses can be altered in size to create a stable joint. They can be described by length, taper, and presence of a collar. įemoral component or stem: this refers to the prosthesis which is implanted into the femur. MoM is also contraindicated in pregnant women, patients with renal disease, and patients at risk of metal hypersensitivity.
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However, the potential for pseudotumor development as well as metallosis-based reactions (type-IV delayed hypersensitivity reactions) has resulted in a decline in the use of MoM. MoM has lower linear-wear rates and decreased volume of particles generated. Metal-on-metal (MoM): Although falling out of favor, MoM has historically demonstrated better wear properties from its MoP counterpart.Ceramic-on-ceramic (CoC): CoC has the best wear properties of all THA bearing surfaces.Ceramic-on-polyethylene (CoP): becoming an increasingly popular option.Metal-on-polyethylene (MoP): MoP has the longest track record of all bearing surfaces at the lowest cost.These will give different appearance on radiograph depending on the configuration. The femoral head and the acetabular liner can be used in different combinations. THA prosthetic designs have been evolving since their inception.Ĭontemporary THA techniques have evolved into press-fit femoral and acetabular components.īearing surfaces are the surfaces which articulate in the prosthetic joint. Hip prosthesis (titanium), with a ceramic head and polyethylene acetabular cup This will guide the need for further investigations if needed. This would be the first and, in a lot of cases, only radiological investigations requested, as a lot of the diagnoses in need of a hip replacement can be diagnosed or confirmed by this. An orthopaedic surgeon will guide the diagnosis and management process. A comprehensive differential diagnosis should also be made for patients complaining of hip pain, as it can often be referred from the spine or pelvis and have no connection to the hip joint itself.Pain, loss of range of motion and functional impairments are mostly considered. The diagnosis of patients requiring total hip replacement surgery is mostly symptom-based. Severe cases of vascular dysfunction ĭiagnostic Procedures.extra-articularticular) active, ongoing infection or bacteremia THA is contraindicated in the following clinical scenarios:
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Congenital hip dislocations and dysplasia Ĭontraindications for Surgery.Hardware failure after internal fixation of hip fractures.Rheumatoid arthritis including juvenile rheumatoid arthritis.
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Hip ON, on average, presents in the younger patient population (35 to 50 years of age) and accounts for approximately 10% of annual THAs. Some common indications include: In addition, hip (osteonecrosis) ON, congenital hip disorders including hip dysplasia, and inflammatory arthritic conditions are not uncommon reasons for performing THA. The most common indication for THA includes end-stage, symptomatic hip OA.
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