-
GLÜCK
-
Interpositional arthroplasty
Carnochan wood bloks between joint surfaces (1840) Verneuil Auguste soft tissue interposition arthroplasty in 1860 (FIRST) Ollier Leopold (1885) adipose tissue Chlumsky Vitaslav (1896) wide varity of interposition materials (muscle, celluloid, silver plates, rubber struts, magnesium, zinc glass, pyres, decalcified bones and wax. Fascia lata =1893 : Murphy and Lexer skin, Foedre et W.S. Bear 1918: pig bladders submucosa Robert Jones gold foil : cover the femoral heads -
John benjamin murphy
noticed the osteophytes : REMOVAL
Better pain and movement
but degenartive process continued Beginning of the 20th -
Pierre Delbet
used rubber prosthesis for replacing the femoral head -
Marius Smith-Petersen
Mold arthroplasty out of glass : smooth surface
==> shattered décrit en 1923, implanté en 1932 (H3) Puis autre matériaux: celluloïde, bakelite, Pyrex 1937: Vitaalium -
Ernest W. Hey Groves
used Ivory -
Philip Wiles
First THA using stainless steel components fitted to the bone with bolts and screws, but with unsatisfacotry results (H3) -
E.J Haboush and K. McKee
1940' with dental acrylic cement for fixation.
McKee,Farrar and Ring further de eloped metal on metal prostheses with different designs -
Robert et Jean Judet
acrylic prosthesis mais usure +++ -
Frederick Roeck Thompson
Vitallium based prostheses which featured a flared collar below the head and a vertically intramedullary stem. -
Harold R. Bohlman and Austin Moore
implant made of Vitallium with a fenestrated stem which allowed bony ingrowth -
George McKee
modfiied Thompson stem ( a cemented hemiarthroplasty used for neck of femur fracutre treatment) wit h a new one-piece cobalt-chrome socket as the new acetabulum
= FIRST METAL ON METAL PROSTHESIS
unpopular biy mid 1970s local effects of metal particles durng revison surgery for prosthetic failure. -
George McKee
Used a thompson femoral stem and for the acetabular side a combination of cobalt-chrome as a single piece, used until Charnley (H3) -
Different combinations 1
Peter Ring: cementless MoM arthroplastyin the 60's (McKee = cemented) -
Ring
pioneer of the uncemented total hip in the 60's
used screws on the aetabuar component and a valgus placement of the implant in order to achieve fixatio.
The porous coated stem was developed in order to allow bony ingrowth and successful integration of the implant -
John Charnley
= Father of the modern THA"Low Friction Arhtroplasty" designed in the early 1960s, identical to the prostheses used today: 3 parts
Low friction< => small femoral head = reduction of wearmetal femoral stem
polyetyhlene acetabular component
acrylic bone ccement -
Charnley BIS
H3: 3 distinct ideas:
1) idea of low friction torque arthroplasty
2) Use of acrylic cement to fix components
3) introduction of high-density polyethylene as bearing material
BEFORE: mimic native joint anatomy
Charnley: reduced to 22mm (femoral head) --> greater range of motion = steel ball rolling on a polytetrafluoroethylene (PTFE/Teflon) acetabular cup
(Muller later: -> 32mm) .
But Teflon = bof (aseptic loosening/ osteolysis) => UHMWPE
+ refining use of PMMA bone cement techniques -
70's = decade of innovation in stem technology
Exeter, Stanmore, Lord and Muler straight stem taper-sip stem Exeter v/s composite-beam (Stanmor) stem
Taper-sip better -
Different combinations 2
Boutin (fr) ceramic on ceramic CoC bearing
-> 1977: modular ceramic bearing -
Uncemented ftw
in the 70's : the uncemented bearings were increasingly popular (Cement disease) -
CoC ftw
CoC gained popularity in the 80's -
UltraHigh Crossedlinked polyethylene (UHXLPE)
UHXLPE
led to BIOLOX(R) Forte in 1995
and to BIOLOX(R) Delta in 2003 (limitent la propagation des fissures) cf "la céramique composite Biolox Delta limite-t-elle le risque de rupture"? -
latest technologies:
development of VitE enriched poly in 2010 -
Future
intertwined with the development of technology and artificail intelligence.
Cemented hip arthroplasty is more likely to be limited to revision IN the last years, hip arthroplasty became less invasive, with better materials, more resistant to wear and more biocompatible and the prevention of complications and perioperative management is greatly improving together with advances in pain control, anesthesia an rehabilitation.