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Changes in the Appendicular Skeleton with Age01:09

Changes in the Appendicular Skeleton with Age

The upper and lower limb initially develops as a small bulge called a limb bud, which appears on the lateral side of the early embryo. The upper limb bud appears near the end of the fourth week of development, with the lower limb bud appearing shortly after.
Initially, the limb buds consist of a core of mesenchyme covered by a layer of ectoderm. The ectoderm at the end of the limb bud thickens to form a narrow crest called the apical ectodermal ridge. This ridge stimulates the underlying...

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Second-generation modular acetabular components provide fixation at 10 to 16 years.

Paul F Lachiewicz1, Elizabeth S Soileau

  • 1Chapel Hill Orthopedics Surgery and Sports Medicine, 101 Conner Drive, Suite 200, Chapel Hill, NC 27514, USA. paul.lachiewicz@gmail.com

Clinical Orthopaedics and Related Research
|June 22, 2011
PubMed
Summary

The second-generation acetabular component shows no loosening or dissociation and a low rate of pelvic osteolysis. Liner exchange is feasible without cement, supporting its continued use in total hip arthroplasty.

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Area of Science:

  • Orthopedic Surgery
  • Biomaterials Engineering
  • Arthroplasty Research

Background:

  • First-generation modular acetabular components had high rates of wear, pelvic osteolysis, and liner dissociation.
  • Second-generation components aimed to mitigate these issues, but their efficacy required further evaluation.

Purpose of the Study:

  • To assess the risk of revision surgery for loosening, wear, or liner dissociation with second-generation acetabular components.
  • To evaluate the rate of pelvic osteolysis associated with these components.
  • To determine the feasibility of liner exchange without bone cement.

Main Methods:

  • Retrospective review of prospectively collected data from 118 total hip arthroplasties (THAs) using second-generation modular titanium acetabular components.
  • Minimum 10-year follow-up (mean 12 years) with assessment of component fixation, wear, osteolysis, and functional outcomes (Harris hip score).

Main Results:

  • All acetabular components remained well-fixed without revision or removal; no liner dissociation occurred.
  • Pelvic osteolysis was observed in 7% of hips. Three reoperations for dislocation and three for loose femoral components were noted.
  • Two liners were exchanged for wear-related issues at 11 and 14 years, demonstrating practical liner exchange without cement.

Conclusions:

  • The second-generation modular titanium acetabular component demonstrated excellent long-term fixation, no liner dissociation, and a low rate of pelvic osteolysis.
  • Liner exchange is a practical option without bone cement, supporting the continued use of this component with advanced polyethylene liners.