Displaying all 18 publications

  1. Md Razak Daud, Wan Nor Shela Ezwane Wan Jusoh, Syahrullail Samion
    This study investigates metal removal rate (MRR) of the biomaterial by using discharge machine Neuar CNC A50 Electrical Discharge Machine Die Sinking (EDM DS). The purpose of this study is to compare machining curvature cup for material SKD 11 and stainless steel with shape curvature cup acetabular. The result showed that electrode wear is higher when high current is applied. For each applied current 0.5A and 3.0A could result electrode wear of 0.236 mm, 0.246 mm and 0.269 mm respectively. Mean time of complete discharged for each pit with 0.3mm depth with supply 0. 5A is 6.51 minutes; 1. 5A is 3.54 minutes and 3A is 1.52 minutes. The biggest mean parameter of the pit is 0.356 mm, with 3A of current is applied. From this study, it can be concluded that low current set may give lower electrode copper wear. The experiment will help a researcher to discharge biomaterial types of metal with small size of copper electrode use of EDM DS Neuar for discharge multi hole or micro pit.
    Matched MeSH terms: Acetabulum
  2. Chai AL, Sivanantham M
    Med J Malaysia, 1990 Jun;45(2):159-68.
    PMID: 2152021
    A retrospective review of patients with congenital dislocation of the hip (CDH) seen in the Institute of Orthopaedics, Kuala Lumpur General Hospital from 1975 to 1988 is presented. There was a female predominance of 17 to five. The average follow-up was 43 months and the average age at final assessment was 63 months. The results were assessed clinically and radiographically using Severin criteria. Eighty eight percent of the hips had excellent or good clinical results at final review compared with 40% of the hips which had excellent or good radiological grading (Severin I and II). Initial acetabular angle before treatment and types of treatment appeared to have a correlation with the final result. The incidence of avascular necrosis was 16%.
    Matched MeSH terms: Acetabulum/radiography
  3. Shahemi N, Liza S, Abbas AA, Merican AM
    J Mech Behav Biomed Mater, 2018 11;87:1-9.
    PMID: 30031358 DOI: 10.1016/j.jmbbm.2018.07.017
    A revision of a metal-on-ultra high molecular weight (UHMWPE) bearing couple for total hip replacement was performed due to aseptic loosening after 23 years in-vivo. It is a major long-term failure identified from wear generation. This study includes performing failure analysis of retrieved polyethylene acetabular cup from Zimmer Trilogy® Acetabular system. The UHMWPE acetabular cup was retrieved from a 61 years old male patient with ability to walk but limited leg movement when he presented to hospital in early 2016 with complaint left thigh pain. It was 23 years after his primary total hip replacement procedure. Surface roughness and morphology condition were measured using 3D laser microscope and Scanning Electron Microscope (SEM) to evaluate and characterize the wear features on polyethylene acetabular cup surface. ATR-Fourier Transform Infra-Red (ATR-FTIR), differential scanning calorimetry (DSC) and gel permeation chromatography (GPC) were used to characterize the chemical composition of carbon-oxygen bonding, crystallinity percentage and molecular weight of the polymer liner that might changes the mechanical properties of polyethylene. Nano indentation is to measure hardness and elasticity modulus where the ratio of hardness to elastic modulus value can be reflected as the degradation of mechanical properties. A prominent difference of thickness between two regions resulted from acentric loading concentration was observed and wear rate were measured. The linear wear rate for thin side and thick side were 0.33 mm/year and 0.05 mm/year respectively. Molecular weight reduction of 57.5% and relatively low ratio of hardness to elastic modulus (3.59 × 10-3) were the indicator of major mechanical properties degradation happened on UHMWPE acetabular cup. This major degradation was contributed by oxidation and polishing wear feature accompanied with delamination, craters, ripple and cracks were the indication of extensive usage of UHMWPE from the suggested life span of acetabular cup application.
    Matched MeSH terms: Acetabulum*
  4. Faisham, W.I., Muslim, D.A.J., Bhavaraju, V.M.K., Nawaz, A.H., Zulmi, W.
    Malays Orthop J, 2009;3(1):36-41.
    Extensive peri-acetabular osteolysis caused by malignant disease process is a major surgical challenge as conventional hip arthroplasty is not adequate. We describe a modified use of the Harrington procedure for acetabular insufficiency secondary to metastatic disease in twelve patients. The procedures include application of multiple threaded pins to bridge the acetabular columns, anti-protrusio cage and cemented acetabular cup. Eleven patients were able to walk pain free and achieved a mean Musculoskeletal Tumour Society Functional Score of 80 (range, 68 to 86).
    Matched MeSH terms: Acetabulum
  5. Aytekin K, Esenyel CZ
    Malays Orthop J, 2018 Mar;12(1):45-47.
    PMID: 29725513 DOI: 10.5704/MOJ.1803.010
    Hip arthroplasty is an extremely satisfying treatment method for coxarthrosis which is in increasing use throughout the world. However, loosening of the prosthesis is a significant complication and to overcome this, ceramic liners are increasingly being selected. If the survival of ceramic surfaces is prolonged, there is a risk of fracture of the ceramic materials. New ceramic materials developed to overcome this problem are more resistant. The case presented here is of a patient in whom liner fracture developed following ceramic-ceramic hip arthroplasty. The ceramic femoral head was observed to have protruded into the defect created in the acetabular component. Acetabular revision was applied to the patient.
    Matched MeSH terms: Acetabulum
  6. Mohd Syafiq Mohd Suri, Nor Liyana Safura Hashim, Ardiyansyah Syahrom, Mohd Juzaila Abd. Latif, Muhamad Noor Harun
    Introduction: The lubricant thickness in clearance between bearing surfaces for metallic hip implants are currently incapable of accommodating the motion experienced (high load and low entraining motion) in hip walking cycle. Thus, micro-dimpled surfaces were introduced onto surfaces of metallic acetabular cups to improve lubricant thick- ness. Micro-dimpled surface is a method of advanced surface improvement to increase the lubricant thickness in various tribological applications, such as hip implants. However, the application of micro-dimpled surfaces in hip implants has not yet been explored adequately. Therefore, this study aims to identify the influence of micro-dimpled depth on lubricant thickness elastohydrodynamically for metallic hip implants using Fluid-Structure Interaction (FSI) approach. Methods: Fluid-Structure Interaction (FSI) approach is an alternative method for analysing characteristics of lubrication in hip implant. Dimples of radius 0.25 mm and various depths of 5μm, 45μm and 100μm were applied on the cup surfaces. The vertical load in z-direction and rotation velocity around y-axes representing the average load and flexion-extension (FE) velocity of hip joint in normal walking were applied on Elastohydrodynamic lubri- cation (EHL) model. Results: The metallic hip implants with micro-dimpled surfaces provided enhanced lubricant thickness, namely by 6%, compared to non-dimpled surfaces. Furthermore, it was suggested that the shallow depth of micro-dimpled surfaces contributed to the enhancement of lubricant thickness. Conclusion: Micro-dimpled sur- faces application was effective to improve tribological performances, especially in increasing lubricant thickness for metallic hip implants.
    Matched MeSH terms: Acetabulum
  7. Park KS, Chan CK, Lee GW, Ahn HW, Yoon TR
    Injury, 2017 Feb;48(2):388-393.
    PMID: 27914663 DOI: 10.1016/j.injury.2016.11.029
    INTRODUCTION: Anatomical reduction of displaced acetabular fracture is not without its' limitations and complications. This study is conducted to assess clinical and radiological outcomes as well as complications of treating displaced acetabular fractures with emphasis on anatomical reduction in weight-bearing area, mainly the posterior column, and imperfect reduction of the anterior column is acceptable. However, stability of both columns is mandatory.

    METHODS: It was a retrospective study carried out in a Level 1 arthroplasty and trauma centre. 23 patients (17 males, 6 females) with average age of 50.1 years (range, 36-68 years) with displaced acetabular fracture treated with combined incisions and plate-cable systems were included. There were 3 elementary and 18 associated fractures according to Letournel classification. Average follow-up was 23.5 months (range, 12-38.7 months). Mean operation time was 160min (range: 75-320min). Functional scores were evaluated using Harris Hip Score (HHS) whilst reduction was assessed by Matta criteria. Any displacement of reduction, osteoarthritis, heterotopic ossification, and other complications was recorded.

    RESULT: 65.2% (15/23) of the patients obtained excellent HHS and 21.7% (5/23) had good HHS. There were 12 anatomical, 6 imperfect, and 5 poor reductions. No displacement was recorded in final follow-up. Complications documented: three lateral femoral cutaneous nerve injuries, two conversions to total hip arthroplasty, three Brooker stage 1 heterotrophic ossification, one pulmonary embolism and one screw irritation. No incidence of wound breakdown, infection and radiological osteoarthritis was reported.

    CONCLUSIONS: Imperfect reduction of the anterior column provided clinical outcomes that are as good as total anatomical reduction. This approach minimizes soft tissue damage and reduces perioperative morbidities.

    Matched MeSH terms: Acetabulum/injuries; Acetabulum/surgery*
  8. Goh, K.L., Zamzuri, Z., Mohd Ariff, S., Mohamed Azril, M.A.
    Introduction: Application of dynamic hip screw (DHS) implant for the treatment of unstable intertrochanteric fractures continues to raise concern related to risk of lag screw cut-out with or without subsequent damage to the acetabulum. Measurement of tip-apex distances (TAD) has been recommended to guide the optimal placement of lag screw and to predict subsequent risk of screw cut-out. In this study, the value of TAD was evaluated to verify its usefulness.
    Methods: This is a retrospective study of 33 consecutive patients with intertrochanteric fracture treated with DHS. Demographic data of the patients were traced from their case notes. Post-operative radiographs were reviewed by focusing on measurement of TAD on anteroposterior and lateral radiographs. Radiographs at one year follow-up were reviewed to depict any fixation-related failure or complication.
    Results: Fifty two percent of patients did not achieved the recommended TAD of ≤ 25mm. The mean post-operative TAD was 25.9mm and elderly patients were likely to achieve TAD of ≤ 25mm. The overall complication rate of 6% was attributed to screw cut-out in two cases. The unstable left-sided fracture was identified to be a potential risk for screw cut-out or migration.
    Conclusion: TAD is a valuable measurement to guide optimal placement of lag screw during DHS fixation of intertrochanteric fracture.
    KEYWORDS: Intertrochanteric fracture, dynamic hip screw, tip-apex distance, screw cut-out
    Matched MeSH terms: Acetabulum
  9. Abbas, A.A., Merican, A.M., Mohamad, J.A.
    Malays Orthop J, 2007;1(1):5-7.
    We report the outcome of 32 patients who underwent total hip replacement (THR) augmented with morsellized fresh frozen femoral head allografts and acetabular reconstruction cages. Nine patients underwent primary THR and 23 patients underwent revision THR. Follow-up ranged from two to 9 years. Two most common indications for the procedures as reported in literature were rheumatoid arthritis and aseptic loosening of the hip. All but one patient achieved good outcome with radiographs showing full incorporation of bone grafts and no evidence of loosening of the implants. Morsellized bone grafting used with acetabular reinforcement devices is valuable for addressing severe acetabular deficiencies.
    Matched MeSH terms: Acetabulum
  10. Wazir,N.N., Ravindran, T., Mukundala, V.V., Choon, S.K.
    Malays Orthop J, 2007;1(2):21-23.
    In 1977, a female patient, aged 31y, presented with histiocytosis X in the right pelvis and was treated with radiotherapy. She presented again in 1999 at the age of 53y with a similar problem at the same location this time also involving the acetabulum. The affected right hip was treated with cemented total hip replacement. Two years postoperatively, the patient was pain free with no evidence of local recurrence or loosening of implant, thus demonstrating that total hip replacement is a viable treatment option for histiocytosis involving the hip.
    Matched MeSH terms: Acetabulum
  11. Park KS, Seon JK, Lee KB, Kim SK, Chan CK, Yoon TR
    J Arthroplasty, 2017 02;32(2):503-509.
    PMID: 27546473 DOI: 10.1016/j.arth.2016.07.010
    BACKGROUND: This study aims at determining the average long-term result of revision total hip arthroplasty (THA) using the acetabular reinforcement ring with a hook (ARRH) and bone grafting in severe acetabular bony defect. Expected 15-year survival of ARRH in revision THA is included in the study.

    METHODS: Retrospective review of 48 patients (48 hips) with follow-up duration of average 11.4 years (range, 6.1-21.4 years) was conducted. At each follow-up, Harris hip score was used to assess functional outcome, and radiographic acetabular component osteolysis was measured by DeLee and Charnley classification. Bone defects were assessed preoperatively and intraoperatively using American academy of orthopedic surgeons and Paprosky classification. The common modes of ARRH failures were evaluated. Bone consolidation, presence of heterotopic ossification, and complications such as infection and dislocation were recorded.

    RESULTS: The bone defects were varied and included cavitary, segmental, and combined defects without any pelvic discontinuity. Mean Harris hip score improved from 52.6 points preoperatively to 82.0 points postoperatively. Nine acetabular revisions and 3 stem revisions (2 concurrent with acetabular revisions and 1 isolated stem revision) were performed. There were 5 infected cases and 1 patient with recurrent dislocation. The 11.4-year survival of revision THA with ARRH was 71% as the end point for acetabular revision surgery for any reason. The expected 15-year survival of revision THA with ARRH was 60%. The most common failure mode of ARRH was superomedial migration followed by lateral migration.

    CONCLUSION: ARRH combined with bone grafting produces relatively good average long-term clinical results.

    Matched MeSH terms: Acetabulum/surgery*
  12. Song MH, Kamisan N, Lim C, Shin CH, Yoo WJ, Song HR, et al.
    J Pediatr Orthop, 2021 Mar 01;41(3):e285-e290.
    PMID: 33534367 DOI: 10.1097/BPO.0000000000001739
    BACKGROUND: Osteogenesis imperfecta (OI) can develop a protrusio acetabuli deformity. However, the authors observed a pseudo-protrusio-type acetabular deformity (PPAD) on 3-dimensional computed tomography (3D-CT). Hence, we systematically reviewed 3D-CT and pelvis radiographs of OI patients and report the incidence and patterns of acetabular deformity in OI patients and the associated radiographic signs.

    METHODS: The study included 590 hips of 295 OI patients, who were older than 5 years, and did not have a pelvic fracture. The incidence of a deformed acetabulum (center-edge angle >40 degrees) and its correlation with disease severity were investigated. In 40 hips for which 3D-CT was available, 3-dimensional morphology of the acetabular deformity was analyzed to delineate PPAD. On plain radiographs, PPAD-related signs were determined, focusing on the contour of ilioischial line, iliopectineal line, acetabular line, and their relationship. These radiographic signs were also evaluated in the remaining hips with deformed acetabula that did not have 3D-CT.

    RESULTS: One hundred twenty-three hips of 590 hips (21%) showed deformed acetabula. The incidence of deformed acetabula was significantly associated with disease severity (P<0.001). Three-dimensional analysis showed that 10 hips had protrusio acetabuli, whereas 17 had PPAD, which showed that the hemipelvis was crumpled, the acetabular roof was rotated upwardly and medially, and the hip center migrated superiorly, uncovering the anterior femoral head. Among the PPAD-related signs, superomedial bulging of the iliopectineal line was the most predictive radiographic sign (73% sensitivity and 100% specificity). This sign was also observed in almost one third of deformed acetabula of those investigated only with plain radiographs.

    CONCLUSIONS: This study showed that acetabular deformity is common in OI patients and is associated with disease severity. A substantial number of hips showed PPAD, which may not cause femoroacetabular impingement but result in anterior uncovering of the hip joint. Superomedial bulging of the iliopectineal line suggests this pattern of acetabular deformity.

    LEVEL OF EVIDENCE: Lever IV-prognostic studies.

    Matched MeSH terms: Acetabulum/abnormalities*
  13. Ariff M, Zulmi W, Faisham W, Nor Azman M, Nawaz A
    Malays Orthop J, 2013 Mar;7(1):56-62.
    PMID: 25722809 MyJurnal DOI: 10.5704/MOJ.1303.018
    We reviewed the surgical treatment and outcomes of 13 patients with pelvic osteosarcoma treated in our centre in the past decade. The study sample included 9 males and 4 females with a mean age of 28.1 years. Four patients had ileal lesions, five had acetabulum lesions, one had a ischiopubis lesion, and three had involvement of the whole hemipelvis. Seven patients presented with distant metastases at diagnosis. Limb salvage was performed in 6 patients and amputation in 7. In 60% of cases in the limb salvage surgery group, we attempted wide resection with positive microscopic margin compared to only 16.7% in the amputation group. Local recurrence was higher in the limb salvage group. Overall survival was 18 months for mean follow up of 14.8 months. Median survival was 19 months in the limb salvage group compared to 9 months in amputation group. The outcome of surgical treatment of pelvic osteosarcoma remains poor despite advancements in musculoskeletal oncology treatment.
    Matched MeSH terms: Acetabulum
  14. Omar M, Abdul Rahman AA, Mohd Hussein AM, Mustafa N
    Family Physician, 2005;13(3):15-15.
    Osteopoikilosis is a rare bone dysplasia which is inherited as an autosomal dominant trait with a prevalence of less than 0.1 per million.1 It is characterised by dense ovoid or circular spots in cancellous bone which may appear at birth or during skeletal growth. It is usually found in the metaphyseal and epiphyseal regions of long bones, the carpals and tarsals, the end of large turbular bones and around the acetabula. It is clinically asymptomatic and occasionally associated with hereditary multiple exostosis and dermatofibrosis lenticularis disseminata. It is not associated with spontaneous fractures and treatment is unnecessary. However a case of osteosarcoma developing in a man with osteopoikilosis has been reported. The first case of osteopoikilosis was reported in Malaysia four years ago in a 25 years old lady who is also of Indian descent. It would be interesting to know if these two patients are related. Since the bone lesions could easily be mistaken for metastatic disease, it is important that family physicians be aware of the benign nature of this condition.
    Matched MeSH terms: Acetabulum
  15. Park KS, Chan CK, Lee DH, Yoon TR
    Indian J Orthop, 2018 8 7;52(4):369-373.
    PMID: 30078894 DOI: 10.4103/ortho.IJOrtho_494_16
    Background: Conversion from failed bipolar hemiarthroplasty (HA) to total hip arthroplasty (THA) presents a great challenge to orthopedic surgeons for bipolar head removal and cup placement with or without change of femoral stem. Conversion THA after failed bipolar arthroplasty is known to offer both symptomatic and functional improvement. This study evaluates the midterm functional outcome and complications, especially dislocation associated with femoral head diameter, after conversion THA.

    Materials and Methods: Forty eight hips with the conversion of bipolar HA to THA were followed up for an average 6.2 years (range 2.0-11.5 years). Twenty one hips had conversion surgery to THA using metal-on-metal articulation (28 or 32 mm head). Nine hips used ceramic-on-ceramic (28-40 mm) and eighteen hips used large head metal-on-metal bearing (>40 mm). Outcome was evaluated using Harris Hip Score (HHS) and Western Ontario McMaster Universities Osteoarthritis Index (WOMAC) score. The radiographs were analyzed for evidence of osteolysis and/or loosening. The complications were evaluated, especially dislocation with different femoral head diameter.

    Results: Average HHS significantly improved from 42 preoperatively to 86 postoperatively and the average WOMAC score also significantly improved from 47 to 22 postoperatively. Radiological evaluation showed all the femoral components were stable. There was one acetabular component loosening, which required revision 9 years after conversion to THA. One dislocation and one recurrent dislocation were recorded in isolated acetabular revision hip; whereas one dislocation, one recurrent dislocation, and one trochanteric nonunion occurred in the hips with revision of both components. All dislocations occurred in hips with a femoral head size of 28 mm (P = 0.052). The cup and femoral head interval length was the most significant factor contributing to dislocation (P = 0.013).

    Conclusions: Conversion THA after failed bipolar HA offers a reliable pain relief and functional improvement. To prevent dislocation, it is highly recommended to use a larger diameter femoral head, especially where the cup size is big.

    Matched MeSH terms: Acetabulum
  16. Razak KAA, Ghani KHA, Musa AA
    Injury, 2021 Jan;52(1):90-94.
    PMID: 33168201 DOI: 10.1016/j.injury.2020.11.004
    BACKGROUND: Acetabular fractures in childhood are rare and the literature is scarce to describe a standard protocol in surgical management of these injuries. As the patient is still growing, it warrants a detailed assessment with a sound surgical plan if operative intervention is deemed necessary to prevent late complications. Throughout literature, most fixation rely on using pins, screws, plates or combination of the three which require large surgical exposure and risk of secondary physeal injury, hence we come up with a method of using the Titanium Elastic Nail System (TENS) to overcome this issue. We describe a novel technique in managing acetabular fractures in this group of patients using the TENS.

    METHOD: An 8 year old girl with a diagnosis of right anterior column posterior hemitransverse acetabular fracture was fixed with 3 TENS for supra-acetabular, anterior column and posterior column fragments. Surgery was performed in a minimally invasive manner. No drilling was performed during the surgery and implant insertion is done manually.

    RESULTS: Advantages of this procedure include minimally invasive surgery with smaller wounds, minimal intraoperative bleeding and theoretically reduces the risk of premature fusion of the triradiate cartilage. Patient is allowed early rehabilitation with this method.

    CONCLUSION: This novel method provides an alternative to traditional usage of wires, pins, plates and screws as is described in most literature. However, it requires the surgeon to appreciate that the safe corridors for the implant are much narrower than adults. We recommend this technique for fractures that are deemed suitable for intramedullary fixation and further research in the future will be needed.

    Matched MeSH terms: Acetabulum
  17. Abbas AA, Kim YJ, Song EK, Yoon TR
    J Arthroplasty, 2009 Oct;24(7):1144.e5-8.
    PMID: 18848418 DOI: 10.1016/j.arth.2008.09.008
    The causes of groin pain after total hip arthroplasty are numerous, and the condition itself is disabling. Therefore, it is imperative that the cause of the pain is identified and managed appropriately. We report a case where the patient had groin pain after total hip arthroplasty as a result of an oversized cementless acetabular component, which caused a breach in the anterior wall of the acetabulum. The anterior wall of the acetabulum was reconstructed with femoral head allograft, and the patient has been symptom free since.
    Matched MeSH terms: Acetabulum*
  18. Merican AM, Randle R
    J Arthroplasty, 2006 Sep;21(6):846-51.
    PMID: 16950037
    The Fitmore titanium mesh cementless acetabular component in 115 hip arthroplasties was reviewed at an average of 33 months of follow-up. None were revised nor had infection. One hip dislocated 4 years postoperatively. Two femoral components were revised. The average Harris Hip Score at the last follow-up was 90 points. In the 96 sets of radiographs available, there was no loosening or new radiolucency. One hip had nonprogressive osteolysis adjacent to a screw. This press-fit cup has its polar region flattened and is rim loading. Noncontact (gaps) at the acetabular floor is expected and is not critical for fixation. In all but 6 hips, these gaps filled. In 5 hips, a minimal gap (
    Matched MeSH terms: Acetabulum
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