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Are component positioning and prosthesis size associated with hip resurfacing failure?

dc.contributor.author Marker, David R
dc.contributor.author Zywiel, Michael G
dc.contributor.author Johnson, Aaron J
dc.contributor.author Seyler, Thorsten M
dc.contributor.author Mont, Michael A
dc.coverage.spatial England
dc.date.accessioned 2015-08-12T18:12:13Z
dc.date.accessioned 2015-08-18T15:51:34Z
dc.date.issued 2010-10-02
dc.identifier http://www.ncbi.nlm.nih.gov/pubmed/20920316
dc.identifier 1471-2474-11-227
dc.identifier.uri https://hdl.handle.net/10161/10410
dc.description.abstract BACKGROUND: Recent studies suggest that there is a learning curve for metal-on-metal hip resurfacing. The purpose of this study was to assess whether implant positioning changed with surgeon experience and whether positioning and component sizing were associated with implant longevity. METHODS: We evaluated the first 361 consecutive hip resurfacings performed by a single surgeon, which had a mean follow-up of 59 months (range, 28 to 87 months). Pre and post-operative radiographs were assessed to determine the inclination of the acetabular component, as well as the sagittal and coronal femoral stem-neck angles. Changes in the precision of component placement were determined by assessing changes in the standard deviation of each measurement using variance ratio and linear regression analysis. Additionally, the cup and stem-shaft angles as well as component sizes were compared between the 31 hips that failed over the follow-up period and the surviving components to assess for any differences that might have been associated with an increased risk for failure. RESULTS: Surgeon experience was correlated with improved precision of the antero-posterior and lateral positioning of the femoral component. However, femoral and acetabular radiographic implant positioning angles were not different between the surviving hips and failures. The failures had smaller mean femoral component diameters as compared to the non-failure group (44 versus 47 millimeters). CONCLUSIONS: These results suggest that there may be differences in implant positioning in early versus late learning curve procedures, but that in the absence of recognized risk factors such as intra-operative notching of the femoral neck and cup inclination in excess of 50 degrees, component positioning does not appear to be associated with failure. Nevertheless, surgeons should exercise caution in operating patients with small femoral necks, especially when they are early in the learning curve.
dc.language eng
dc.publisher Springer Science and Business Media LLC
dc.relation.ispartof BMC Musculoskelet Disord
dc.relation.isversionof 10.1186/1471-2474-11-227
dc.relation.replaces http://hdl.handle.net/10161/10375
dc.relation.replaces 10161/10375
dc.subject Adolescent
dc.subject Adult
dc.subject Aged
dc.subject Arthroplasty, Replacement, Hip
dc.subject Equipment Failure Analysis
dc.subject Female
dc.subject Hip Prosthesis
dc.subject Humans
dc.subject Male
dc.subject Middle Aged
dc.subject Prosthesis Failure
dc.subject Retrospective Studies
dc.subject Young Adult
dc.title Are component positioning and prosthesis size associated with hip resurfacing failure?
dc.type Journal article
duke.contributor.id Seyler, Thorsten M|0655963
pubs.author-url http://www.ncbi.nlm.nih.gov/pubmed/20920316
pubs.begin-page 227
pubs.organisational-group Clinical Science Departments
pubs.organisational-group Duke
pubs.organisational-group Orthopaedics
pubs.organisational-group School of Medicine
pubs.publication-status Published online
pubs.volume 11
dc.identifier.eissn 1471-2474
duke.contributor.orcid Seyler, Thorsten M|0000-0003-1157-132X


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