N Lokikere

Wrightington Hospital

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A Saraogi

Wrightington Hospital

PR Kay

Wrightington Hospital

Martyn Porter

Wrightington Hospital

Henry Wynn-Jones

Wrightington Hospital

Nikhil Shah

Wrightington Hospital

Hiroki Nagai

Tohoku University

K.V. Syam

Imperial College London

Ulhas Sonar

Tameside Hospital

A.K. Gambhir

Wrightington Hospital

N. Shah

Wrightington Hospital

Cooperative Institutions

Wrightington Hospital

Wrightington, Wigan and Leigh NHS Foundation Trust

Royal Albert Edward Infirmary

University of Manchester

Norfolk and Norwich University Hospital

Robert Jones and Agnes Hunt Orthopaedic Hospital

University of Liverpool

The University of Tokyo

Royal Lancaster Infirmary

University Hospitals of Morecambe Bay NHS Foundation Trust

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FEMORAL IMPACTION BONE GRAFTING IN REVISION HIP ARTHROPLASTY: FIVE- TO 19-YEAR FOLLOW-UP

Orthopaedic Proceedings (2018)

A Saraogi N Lokikere P Siney H. Nagai B Purbach

The choice of stem length in total hip revision with impaction bone grafting of femur is essentially based upon the grade of cavitation of femur and surgeon's preference. The standard length stem has been often critiqued for the apprehension of peri-prosthetic fracture. Our study highlights the importance of proximal bone stock rather than distal cavitation in determining the length of femoral stem.168 total hip revisions of 162 patients with impaction bone grafting and cemented standard C-stem (done with standardized technique) between 1995 and 2008 at a tertiary referral centre were included. Revisions for infection and segmental bone defects were excluded. Serial radiographs were retrospectively analysed by two people independently, using Endoklinik classification, Gruen zones and more and outcomes were analysed.Mean follow-up of the 168 revision hips was 10.5 years (range 5 – 19.1 years). 14 patients (8.3%) were re-revised, reasons being, persistent deep infection (1.8%), repeated dislocations (1.2%),...

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ALPHA-DEFENSIN (SYNOVASURE) TEST IN PROSTHETIC HIP AND KNEE INFECTION: AN UPDATE ON RELEVANCE IN CURRENT PRACTICE

Orthopaedic Proceedings (2018)

Aashish Saraogi N Lokikere Robert H. Iii Lafferty Hisashi Nagai G. Pavlou

Prosthetic joint infection continues to remain a diagnostic challenge for unhappy primary arthroplasty of hip and knees. There is increasing dependence upon alpha-defensin test to make key decision...

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RESULTS OF ASIAN C-STEM IN FEMORA WITH ABNORMAL ANATOMY

Orthopaedic Proceedings (2018)

N Lokikere C Jakaraddi Henry Wynn-Jones N. Shah

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RESULTS OF ASIAN C-STEM IN FEMORA WITH ABNORMAL ANATOMY

Journal of Bone and Joint Surgery-british Volume (2016)

N Lokikere C Jakaraddi Henry Wynn-Jones Nikhil Shah

Primary total hip replacement (THR) in patients with abnormal/altered proximal femoral anatomy/narrow canals presents a technical challenge. There are only limited standard prosthetic stems available to deal with narrow canals or abnormal morphology. Many prefer to use expensive custom implants which often have a lag time to manufacture and do not always have long term published outcomes. We present results of the Asian C-stem (which is a standard implant available on the shelf) used in patients predominantly of Caucasian origin with abnormal proximal femoral anatomy. We retrospectively reviewed clinic-radiological results of 131 patients (131 stems) who underwent primary THR using Asian C-stem at Wrightington Hospital till their latest follow up. Revision for any reason was considered as primary end point. Mean age at surgery was 50.8 years (16 – 80). The 2 commonest indications were primary osteoarthritis (66 patients) and hip dysplasia (54 patients). Mean follow up was 43.5 months with a minimum follow up of 12 months and maximum follow up of 97 months. There were 2 recurrent dislocations and 1 hip subluxed twice. One dislocation needed revision surgery. 1 patient underwent acetabular revision for loosening. There was no stem failure, obvious loosening or loss of fixation in any patients in our series with regards to the Asian C-stem. There were no infections and intra-operative perforations or fractures. C-stem Asian is a reliable implant for patients undergoing THR with abnormal proximal femoral anatomy or narrow canals. Long term follow up is essential.

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IS PROXIMAL FEMORAL REPLACEMENT A PRACTICAL SOLUTION FOR PROFOUND BONE LOSS

Orthopaedic Proceedings (2018)

K.V. Syam William Wilson-Theaker N Lokikere A Saraogi A.K. Gambhir

With increasing burden of revision hip arthroplasty, one of the major challenge is the management of bone loss associated with previous multiple surgeries. Proximal femoral replacement (PFR) has al...

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IMPACTION BONE GRAFTING OF FEMUR IN REVISION HIP ARTHROPLASTY: A FIVE- TO 19-YEAR FOLLOW-UP STUDY. DOES LENGTH OF THE STEM MATTER?

Orthopaedic Proceedings (2018)

A Saraogi N Lokikere Paul D. Siney Hiroki Nagai B Purbach

Introduction: Revision hip arthroplasty for aseptic loosening of femoral component is successfully treated with impaction bone grafting technique. Owing to easier technique and shorter operative ti...

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Hip Arthroplasty

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