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Title: Survival analysis of total hip arthroplasty according to the type of articulation

Abstract:

Introduction: According to literature, 70% of late failures of joint arthroplasty is related to wear of the articulation and accompanying osteolysis leading to prosthesis loosening. The goal of the study is to assess the impact of-type of articulation on survival of prosthesis-type of articulation and its wear on clinical outcome of THA-wear of articulation on loosening of prosthesis-type of articulation on survival of prosthesis depending on fixation of prosthesisMaterial and methods: After applying the inclusion and exclusion criteria in order to unify the material, a group of 293 patients was selected The material was divided into 3 groups according to the type of articulation used. Group I PE-M (UHMWPE-Co-Cr-Mo) – 153 patients, group II PE-C (UHMWPE-Biolox forte) – 67, group III M-M articulation (Metasul) – 73. Analysis of the material was based on clinical and radiological examinations. The clinical assessment was based on the HHS and the radiological assessment on X-ray imaging taken with digital techniques in standardized anteroposterior (AP). Results: The analyzed material showed statistically significant differences in the wear of specific types of articulation in the long-term 10- year follow-up as well as their impact on the survival of prosthesis. The influence of wear of the articulation on loosening was also demonstrated. In the M-M articulation no wear and loosening were observed. In the analyzed material, statistically significant difference in the 10-year survival of THA was dependent on the type of articulation. The influence of wear of the articulation on clinical outcome (HHS) was evident. The best HHS results were noted in the M-M articulation, and the worst in PE- M articulation. Statistically significant influence on linear wear proved to be younger age of patients at time of surgery for the PE-M articulation. During the study, a correlation between younger age of the patients at the time of surgery and a better clinical outcome (HHS) after 10 years was only observed in the M-M articulation. Conclusion: Among the many factors affecting the survival of implants, the type of articulation seem to be the most important. The highest percentage of survival of implants has been demonstrated in the M-M articulation, whereas the worst in PE- M. Loosening of prosthesis was dependent on the degree of wear of the articulation and occurred the earliest in PE-M articulation. The clinical evaluation (HHS) is useful, and deterioration of outcome may indirectly confirm the above phenomenon. The articulation in which polyethylene is a component, the material of the femoral prosthetic head plays an essential role. Metal head is responsible for greater polyethylene wear comparison with a ceramic head. The PE-M articulation significantly reduces the survival of uncemented prostheses.

Place of publishing:

Kraków

Level of degree:

2 - studia doktoranckie

Degree discipline:

ortopedia

Degree grantor:

Uniwersytet Jagielloński. Collegium Medicum. Wydział Lekarski.

Promoter:

Daniel Zarzycki

Date issued:

2013

Format:

application/pdf

Identifier:

oai:dl.cm-uj.krakow.pl:3898

Call number:

ZB-120636

ControlNumberVIRTUA:

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Language:

pol

Access rights:

tylko w bibliotece

Location of original object:

Biblioteka Medyczna Uniwersytetu Jagiellońskiego- Collegium Medicum

Object collections:

Last modified:

Jun 26, 2019

In our library since:

May 22, 2014

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27

Number of object content views in PDF format

23

All available object's versions:

http://dl.cm-uj.krakow.pl:8080/publication/3898

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ZB-120636 Jun 26, 2019
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