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Instructional Course Lectures, The American Academy of Orthopaedic Surgeons - Fixation with a Modular Stem in Revision Total Hip Arthroplasty*† by JAMES.

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Presentation on theme: "Instructional Course Lectures, The American Academy of Orthopaedic Surgeons - Fixation with a Modular Stem in Revision Total Hip Arthroplasty*† by JAMES."— Presentation transcript:

1 Instructional Course Lectures, The American Academy of Orthopaedic Surgeons - Fixation with a Modular Stem in Revision Total Hip Arthroplasty*† by JAMES V. BONO, JOSEPH C. MCCARTHY, JO-ANN LEE, ROBERT J. CARANGELO, and RODERICK H. TURNER J Bone Joint Surg Am Volume 81(9):1326-36 September 1, 1999 ©1999 by The Journal of Bone and Joint Surgery, Inc.

2 Radiographs of a sixty-six-year-old man who was managed with a resection arthroplasty of the left hip (Fig. 1-A) after an infection developed at the site of a total hip replacement. JAMES V. BONO et al. J Bone Joint Surg Am 1999;81:1326- 36 ©1999 by The Journal of Bone and Joint Surgery, Inc.

3 Radiographs of a sixty-six-year-old man who was managed with a resection arthroplasty of the left hip (Fig. 1-A) after an infection developed at the site of a total hip replacement. JAMES V. BONO et al. J Bone Joint Surg Am 1999;81:1326- 36 ©1999 by The Journal of Bone and Joint Surgery, Inc.

4 Radiographs of a sixty-six-year-old man who was managed with a resection arthroplasty of the left hip (Fig. 1-A) after an infection developed at the site of a total hip replacement. JAMES V. BONO et al. J Bone Joint Surg Am 1999;81:1326- 36 ©1999 by The Journal of Bone and Joint Surgery, Inc.

5 Radiographs of a woman who had pain at the site of a bipolar hemiarthroplasty with cement (Fig. 2-A). JAMES V. BONO et al. J Bone Joint Surg Am 1999;81:1326- 36 ©1999 by The Journal of Bone and Joint Surgery, Inc.

6 Radiographs of a woman who had pain at the site of a bipolar hemiarthroplasty with cement (Fig. 2-A). JAMES V. BONO et al. J Bone Joint Surg Am 1999;81:1326- 36 ©1999 by The Journal of Bone and Joint Surgery, Inc.

7 Radiographs of a woman who had pain at the site of a bipolar hemiarthroplasty with cement (Fig. 2-A). JAMES V. BONO et al. J Bone Joint Surg Am 1999;81:1326- 36 ©1999 by The Journal of Bone and Joint Surgery, Inc.

8 Fig. 3 Photograph showing some of the various combinations that are available with the S-ROM modular total hip system (DePuy [Johnson and Johnson], Warsaw, Indiana). JAMES V. BONO et al. J Bone Joint Surg Am 1999;81:1326- 36 ©1999 by The Journal of Bone and Joint Surgery, Inc.

9 Radiographs of a man who had femoral osteolysis and loosening at the site of a total hip arthroplasty (Fig. 4-A) and was managed with revision to an S-ROM femoral component (Fig. 4- B) when he was seventy years old, fifteen years after the primary procedure. JAMES V. BONO et al. J Bone Joint Surg Am 1999;81:1326- 36 ©1999 by The Journal of Bone and Joint Surgery, Inc.

10 Radiographs of a man who had femoral osteolysis and loosening at the site of a total hip arthroplasty (Fig. 4-A) and was managed with revision to an S-ROM femoral component (Fig. 4- B) when he was seventy years old, fifteen years after the primary procedure. JAMES V. BONO et al. J Bone Joint Surg Am 1999;81:1326- 36 ©1999 by The Journal of Bone and Joint Surgery, Inc.

11 Radiographs of a man who had femoral osteolysis and loosening at the site of a total hip arthroplasty (Fig. 4-A) and was managed with revision to an S-ROM femoral component (Fig. 4- B) when he was seventy years old, fifteen years after the primary procedure. JAMES V. BONO et al. J Bone Joint Surg Am 1999;81:1326- 36 ©1999 by The Journal of Bone and Joint Surgery, Inc.

12 Radiographs of a sixty-seven-year-old woman, made six years after a primary total hip arthroplasty, showing a stem with ingrowth of bone and cortical density extending to the tip of the proximal sleeve (magnified inside box of Fig. 5-B). JAMES V. BONO et al. J Bone Joint Surg Am 1999;81:1326- 36 ©1999 by The Journal of Bone and Joint Surgery, Inc.

13 Radiographs of a sixty-seven-year-old woman, made six years after a primary total hip arthroplasty, showing a stem with ingrowth of bone and cortical density extending to the tip of the proximal sleeve (magnified inside box of Fig. 5-B). JAMES V. BONO et al. J Bone Joint Surg Am 1999;81:1326- 36 ©1999 by The Journal of Bone and Joint Surgery, Inc.

14 Radiographs of a sixty-eight-year-old man, made four years after a femoral revision arthroplasty, showing subsidence of the stem (Fig. 6-A). JAMES V. BONO et al. J Bone Joint Surg Am 1999;81:1326- 36 ©1999 by The Journal of Bone and Joint Surgery, Inc.

15 Radiographs of a sixty-eight-year-old man, made four years after a femoral revision arthroplasty, showing subsidence of the stem (Fig. 6-A). JAMES V. BONO et al. J Bone Joint Surg Am 1999;81:1326- 36 ©1999 by The Journal of Bone and Joint Surgery, Inc.

16 Figs. 7-A, 7-B, and 7-C: Radiographs of a sixty-four-year-old man, made six years after a revision total hip arthroplasty. JAMES V. BONO et al. J Bone Joint Surg Am 1999;81:1326- 36 ©1999 by The Journal of Bone and Joint Surgery, Inc.

17 Fig. 7-B: Radiograph showing endosteal hypertrophy (arrows). JAMES V. BONO et al. J Bone Joint Surg Am 1999;81:1326- 36 ©1999 by The Journal of Bone and Joint Surgery, Inc.

18 Fig. 7-C Radiograph showing cortical hypertrophy (arrows) in response to proximal loading of the bone. JAMES V. BONO et al. J Bone Joint Surg Am 1999;81:1326- 36 ©1999 by The Journal of Bone and Joint Surgery, Inc.

19 Fig. 8 Radiograph of a sixty-three-year-old man, made six years after a femoral revision arthroplasty, showing reactive endosteal bone (arrows) surrounding the tip of a well fixed femoral stem. JAMES V. BONO et al. J Bone Joint Surg Am 1999;81:1326- 36 ©1999 by The Journal of Bone and Joint Surgery, Inc.


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