PhD ceremony Mr. B.H. Bosker: Pitfalls in traditional and innovative hip replacement surgery
|We 18-12-2013 at 16:15
|Academiegebouw, Broerstraat 5, Groningen
PhD ceremony: Mr. B.H. Bosker
Dissertation: Pitfalls in traditional and innovative hip replacement surgery
Promotor(s): prof. S.K. Bulstra
Faculty: Medical Sciences
Instability, increased wear, and reduced motion range are important complications of total hip arthroplasty (THA) and associated with cup malpositioning. Despite modern alternatives like computer navigation, most cups are still implanted by using a freehand technique. Because cup malposition is associated with shortened survival and dislocation, the accuracy of this freehand technique is questioned.
The first part of this thesis describes a prospective cohort study on the accuracy of freehand cup positioning in THA. Factors contributing to the inaccuracy were further investigated. Dislocation of the prosthesis resulting from cup malposition is a serious complication. Revisional surgery is frequently indicated to treat recurrent dislocations. The results of a less invasive procedure by using an augmentation ring are discussed in a retrospective cohort study.
The second part of the thesis discusses the problems associated to metal-on-metal total hip arthroplasties. We found a much higher incidence of pseudotumors than as earlier described in the literature. Risk factors for pseudotumor formation and revision were investigated. The specific design and corrosion of the prosthesis might play an important role in the high incidence of pseudotumors, and might lead to early failure and fracture of the implant.