Issue: Issue 2 2012
April 24, 2012
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Tribology Day symposium to address large diameter heads and new implant designs

A major Tribology Day session at the 13th EFORT 2012 Congress will review indications for large diameter heads and cover the optimal implants for patients.

Issue: Issue 2 2012
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A session scheduled for this year’s Tribology Day at the 13th EFORT Congress 2012 in Berlin will focus on the role large diameter heads play in hip arthroplasty, advantages of conforming vs. non-conforming bearings and indications for metal-on-metal large heads, according to meeting organizers.

Perspective from Karl Knahr, MD

Paolo Tranqulli Leali, MD, of the University of Sassari in Italy, and Christina Doyle, PhD, of Exeter, England, co-organized the 1.5-hour session scheduled to take place Friday, May 25 at 9:15 in the Istanbul auditorium. Tranquilli Leali told Orthopaedics Today Europe the symposium will be dedicated to the problems of articulation and will make the case for using large diameter heads, but will also address new technology, such as ultra-highly crosslinked polyethylene and ceramic articulations. 

Paolo Tranqulli Leali
Paolo Tranqulli Leali

“The main take-home message is large is good. A larger head gives the patient a more physiological range of motion and very good proprioception,” Tranqulli Leali said. “From the point of view of the surgeon, there is an almost impossible dislocation of the joint because the larger the head, the lower the risk of dislocation.”

Controversy of metal articulations

Tranquilli Leali noted that a large diameter head with a low dislocation rate is most favorable for elderly patients, where a reoperation can sometimes be fatal. Additionally, he said he will present on the clinical aspects of large metal-on-metal heads during the symposium, a topic which has drawn controversy because of the material’s adverse effects in some patients due to wear or incorrect implant placement.

“It is known from the Australian register [that] the main problem in metal-metal joints is the ‘human factor,’ so an incorrect positioning of the implant can increase the wear at very dangerous levels,” Tranquilli Leali said.

Update on polyethylene, ceramic

Among others scheduled to participate in the session is John Fisher, PhD, director of the University of Leeds Institute for Medical and Biological Engineering, in the United Kingdom, where a ceramic-on-metal hip implant was developed. He is scheduled to discuss non-conforming bearings.

Other planned symposium participants include Robert Streicher, PhD, of Zurich, who is expected speak about conforming bearings, and Eduardo Garcia-Rey, MD, PhD, of Madrid. Garcia-Rey is scheduled to present information on the clinical aspects of new polyethylene material, according to the preliminary program.

“In this presentation, he will present some future propositions for new kinds and new categories of implants and preliminary work on new materials and new components in arthroplasty surgery in [the] hip and knee,” Tranquilli Leali said. – by Jeff Craven

Reference:
  • Tranquilli Leali P, Doyle C. Large diameter heads: Risk/benefit? Scheduled to be presented May 25, 9:15-10:45, at the 13th EFORT Congress 2012. May 23-25. Berlin.
For more information:
  • Prof. Paolo Tranquilli Leali, MD, can be reached at the Department of Orthopaedics, University of Sassari, 21 University Square, 07100 Sassari, Italy; +39 079 228 036; email: tranquilli@uniss.it.
  • Disclosure: Tranquilli Leali has no relevant financial disclosures.