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Related Concept Videos

Bones of the Lower Limb: Femur and Patella01:16

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The femur is the body's longest and strongest bone spanning the thigh region. Its head articulates with the acetabulum of the hip bone to form the hip joint. A minor indentation on the medial side of the femoral head, called the fovea capitis, serves as the site of attachment for the ligament of the head of the femur. This weak ligament spans the femur and acetabulum and supports the hip joint. The narrowed region below the head is the neck of the femur. The inclination angle between the...
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The knee joint is the most complicated joint in the body. It consists of three articulations– two tibiofemoral and one patellofemoral. As is characteristic of synovial joints, the knee joint has a thin articular capsule that partially surrounds this joint cavity. Additionally, several ligaments, muscles, and cartilaginous structures support the movement of the knee.
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The tibia is the main weight-bearing bone of the lower leg. It is larger than the fibula with which it is paired. The tibia is also the second longest bone in the body and is located right below the skin. The proximal end of the tibia forms the medial and the lateral condyle, which articulates with the condyles of the femur to form the knee joint. Between the articulating surfaces is the irregular elevated area known as the intercondylar eminence that serves as the inferior attachment point for...
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Individualized Stem-positioning in Calcar-guided Short-stem Total Hip Arthroplasty
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High Risk of Failure With Bimodular Femoral Components in THA.

Aidin Eslam Pour1, Robert Borden2, Takayuki Murayama2

  • 1Department of Orthopaedic Surgery, University of Michigan, 2912 Taubman Center, 1500 E. Medical Center Drive, SPC 5328, Ann Arbor, MI, 48103, USA. aeslampo@med.umich.edu.

Clinical Orthopaedics and Related Research
|September 2, 2015
PubMed
Summary
This summary is machine-generated.

Bimodular femoral neck implants showed an 85% survivorship but had significant failure modes like loosening and neck fractures. Factors such as larger head size and BMI increased fracture risk, leading to a recommendation against their use.

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Area of Science:

  • Orthopedic surgery
  • Biomedical engineering
  • Materials science

Background:

  • Bimodular femoral neck implants offer surgical advantages in total hip arthroplasty (THA).
  • However, failures including neck fractures and adverse tissue reactions to metal debris have been reported.
  • This study assesses the outcomes of PROFEMUR® bimodular implants in THA.

Purpose of the Study:

  • To determine the survivorship of PROFEMUR® bimodular femoral neck stems.
  • To identify the modes of failure for this specific bimodular implant.
  • To identify risk factors associated with the major failure modes.

Main Methods:

  • Retrospective analysis of 277 primary THAs (2003-2009) using PROFEMUR® Z and E bimodular stems.
  • Inclusion of all bearing combinations (metal-on-metal, metal-on-polyethylene, ceramic-on-ceramic).
  • Kaplan-Meier survivorship analysis and logistic regression for risk factor identification.

Main Results:

  • Overall stem survivorship was 85% at a mean follow-up of 50 months for both PROFEMUR® E and Z stems.
  • Most common failures included loosening (9% for PROFEMUR® E) and neck fracture (6% for PROFEMUR® Z).
  • Femoral stem loosening was associated with PROFEMUR® E, while larger head size, BMI, and total offset were linked to neck fracture.

Conclusions:

  • Bimodular neck junction failures may be influenced by long neck lengths, greater offset, and larger head diameters.
  • The PROFEMUR® E implant demonstrated a high rate of periprosthetic loosening.
  • The study advises against the use of bimodular femoral neck implants based on observed failure rates and risk factors.