| 1. |
- Kesteris, Uldis, et al.
(author)
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Polyethylene wear and synovitis in total hip arthroplasty: a sonographic study of 48 hips
- 1999
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In: Journal of Arthroplasty. - 0883-5403. ; 14:2, s. 138-143
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Journal article (peer-reviewed)abstract
- Forty-six patients (48 hips), operated on with cemented total hip arthroplasty (THA) because of arthrosis, were examined radiographically and sonographically at 10-year follow-up. Polyethylene wear of acetabular cups was measured on conventional non-weight-bearing pelvic radiographs, and the volume of polyethylene debris was calculated. Radiographic signs of loosening were identified. The capsular distance (ie, thickness of the synovium or synovial contents) was measured sonographically. We found a significant correlation between increased volumetric wear and increased capsular distance. Hips with radiographically loose acetabular components had significantly greater volumetric wear and capsular distance than those without signs of acetabular loosening. This relationship was not observed in hips with radiographically loose femoral components. In cemented THA, the volume of polyethylene wear debris and the thickness of the synovium and the synovial contents are related. In the event of radiographic loosening of the acetabular component, they are both increased.
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| 2. |
- Robertsson, Otto, et al.
(author)
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Intracapsular pressure and loosening of hip prostheses. Preoperative measurements in 18 hips
- 1997
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In: Acta Orthopaedica Scandinavica. - : Medical Journals Sweden AB. - 0001-6470. ; 68:3, s. 231-234
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Journal article (peer-reviewed)abstract
- We measured the intracapsular pressure preoperatively in 18 hips (17 patients) before revision of a total hip arthroplasty because of aseptic loosening. Distension of the joint capsule was measured with sonography in 13 cases. In extension, the mean intracapsular pressure was 26 (0-60) mmHg, in extension and inward rotation it was 159 (24-280) mmHg, in extension and outward rotation it was 30 (3-67) mmHg and in 45 degrees of flexion it was 12 (0-28) mmHg. A mean of 6 (0.5-20) mL of joint fluid was aspirated after the pressure measurements. Sonography showed increased joint fluid/synovial edema and/or increased capsular thickness, as compared to 34 unrevised, radiographically not loose prosthetic hips, and that the capsular distension correlated to intracapsular pressure during extension and inward rotation. We conclude that the intracapsular pressure usually is elevated in a hip joint with loose prosthetic components, that the intracapsular pressure varies with the position of the hip and that capsular distension reflects increased intracapsular pressure. The increased and often very high pressure, varying during gait, may pump debris away from the joint along the interfaces and even by itself cause osteolysis and loosening.
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| 3. |
- Robertsson, Otto, et al.
(author)
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Intracapsular pressure and pain in coxarthrosis
- 1995
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In: Journal of Arthroplasty. - 0883-5403. ; 10:5, s. 632-635
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Journal article (peer-reviewed)abstract
- Intracapsular hip pressure was measured before surgery in 17 patients (18 hips) with coxarthrosis. The results were correlated to pain as registered on a visual analog scale. With the hip in extension, the pressure was 49.5 mmHg (SD, 40.2); in 45 degrees of flexion, it was 21.3 mmHg (SD, 14.6); in extension and inward rotation, it was 105.7 mmHg (SD, 76.0); and in extension and outward rotation, it was 40.8 mmHg (SD, 32.0). A small amount, 0.7 mL (SD, 1.14), of joint fluid was aspirated following pressure registration. Pressure correlated significantly to pain at night, when starting to walk, and on walking. It is suggested that the increase in intracapsular hip pressure is a cause of pain in coxarthrosis, with subsequent limitation of movement and joint contracture.
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