Craig G. Mohler, MD
Hip & Knee Arthritis, Mechanisms of Failure of Total Joint Replacements, Total Hip & Knee Replacements Specialist
24 years of experience
Video profile
Accepting new patients
Cal Young
Slocum Center for Orthopedics & Sports Medicine
55 Coburg Rd
Eugene, OR 97401
(541) 485-8111
Locations and availability (1)

Education ?

Medical School Score Rankings
University of Missouri at Columbia (1986)
  • Currently 3 of 4 apples
Top 50%
Residency
University Of Iowa Hospital & Clinic (1991) *
Fellowship
Rush Presbyterian-St. Luke's Center (1992) *
* This information was reported to Vitals by the doctor or doctor's office.

Awards & Distinctions ?

Associations
American Society for Dermatologic Surgery
American Association of Hip and Knee Surgeons
American Board of Orthopaedic Surgery

Affiliations ?

Dr. Mohler is affiliated with 2 hospitals.

Hospital Affilations

Score

Rankings

  • Sacred Heart Medical Center
    Orthopaedic Surgery
    1255 Hilyard St, Eugene, OR 97401
    • Currently 4 of 4 crosses
    Top 25%
  • McKenzie - Willamette Medical Center
    Orthopaedic Surgery
    1460 G St, Springfield, OR 97477
    • Currently 4 of 4 crosses
    Top 25%
  • Publications & Research

    Dr. Mohler has contributed to 7 publications.
    Title A Prospective Randomized Trial of Cemented Femoral Components with Polished Versus Grit-blasted Surface Finish and Identical Stem Geometry.
    Date December 2003
    Journal The Journal of Arthroplasty
    Excerpt

    This randomized, prospective study compared 2 cemented hip stems that differed only in the surface finish, which was polished or grit blasted. A total of 226 hybrid total hips were evaluated at an average of 4.8 years postoperatively. No stem in either group was loose or revised for aseptic loosening. There was one case of significant distal lysis in the grit-blasted group. There was no statistical difference between polished and grit-blasted stems in incidence of lysis or bone-cement radiolucency. Harris Hip score, Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), and SF-36 analysis showed no difference between groups. In conclusion, when adequate cement mantles are achieved around the femoral component, little difference in construct durability between polished and grit-blasted surface finish components can be detected at 4.8-year follow-up for this stem design.

    Title Comparison of Clinical Outcomes in Total Hip Arthroplasty Using Rough and Polished Cemented Stems with Essentially the Same Geometry.
    Date June 2002
    Journal The Journal of Bone and Joint Surgery. American Volume
    Excerpt

    BACKGROUND: Aseptic loosening of the cemented stem is the most common cause of revision of total hip arthroplasties. The loosening is often associated with substantial lysis of the surrounding bone. The surface finish of femoral components is suspected as a contributing factor to this bone lysis. The purpose of this study was to compare the results associated with a rough surface and those associated with a polished surface in a consecutive series of cemented stems with essentially the same geometry. METHODS: The study included 244 consecutive total hip arthroplasties with a cemented femoral component performed by one surgeon. There was no difference in patient selection criteria or surgical techniques between the group treated with a polished stem and that treated with a grit-blasted stem. All arthroplasties were hybrid, with an uncemented acetabular component. Generally, patients were over the age of sixty years (mean age, 70.6 years). The stems inserted in the initial 122 hips had a grit-blasted surface with a roughness of 2.1 microm. The stem surface in the second 122 hips was polished (roughness, 0.1 microm). The results of clinical and radiographic assessments performed immediately after surgery were compared with those performed at the most recent visit. The average duration of clinical follow-up for the patients treated with the grit-blasted and polished stems was 5.98 years and 5.32 years, respectively. RESULTS: Four hips treated with the grit-blasted stem had aseptic loosening with substantial surrounding lysis and required revision. An additional two hips in this group had radiographic evidence of substantial lysis and were judged to have an impending need for revision. In contrast, no hip treated with the polished stem required revision, and only one had minimal lysis. This difference regarding failures and impending failures was significant (p = 0.05). The clinical results were comparable, with an Iowa hip rating of 98 points at the time of follow-up in both groups. CONCLUSIONS: There was a significant difference between grit-blasted and polished stems with respect to the prevalence of revisions and impending revisions, all of which were identified in a relatively short follow-up period. The results in this series favor the use of a polished stem when cement is employed for fixation of the femoral component.

    Title Loosening Rates and Bone Lysis with Rough Finished and Polished Stems.
    Date February 1999
    Journal Clinical Orthopaedics and Related Research
    Excerpt

    In the senior author's 27-year experience in cementing femoral components, stems with smooth and rough surfaces were implanted. Prospective data have been kept on all patients allowing extensive long term followup. The polished Charnley stem was implanted in 168 hips from 1971 to 1975. To date, only four (2.4%) stems have required revision for aseptic loosening and four others for fracture. None showed significant bone lysis. The experience with the T-28 and TR-28 allows comparison of stems of similar geometry, but with different surface finishes. From 1972 to 1977, 209 polished T-28 stems were inserted and to date 18 (14 for fracture and four for loosening, 1.9%) have required revision. None had associated bone lysis. From 1977 to 1982, 227 second generation TR-28 matte surface finish stems (Ra 30) were implanted. Five required revision, three (2.2%) with major bone lysis. Radiographic review revealed minimal lysis in four (1.9%) polished T-28 stems and in 11 (4.9%) TR-28 stems, three of which showed major bone destruction. From 1980 to 1993, 1061 Iowa stems were implanted. In 1986 proximal precoat was added, which required additional roughening of the surface. In 1995 a 1.5% early loosening rate was reported with significant bone lysis, complicating revision. By 1998 34 (3.2%) stems have required revision, all associated with significant bone loss. Revision of one of 12 original Iowa (Ra 30) and 12 of 22 (Ra 80) grit blasted stems was needed before 5 years postoperatively. These early failures prompted the author to return to a polished stem with a geometry almost identical to the Charnley stem.

    Title Early Loosening of the Femoral Component at the Cement-prosthesis Interface After Total Hip Replacement.
    Date October 1995
    Journal The Journal of Bone and Joint Surgery. American Volume
    Excerpt

    Between 1980 and 1990, 1941 total hip replacements were performed with use of the Iowa femoral component fixed with cement. Twenty-seven of these patients (twenty-nine hips) had early loosening of the femoral component two to ten years (average, five years) after the operation. The average age of these patients at the time of the operation was fifty-nine years (range, forty-one to seventy-seven years). The acetabular cup had been inserted without cement in seventeen hips, and the cup had been inserted with cement in twelve. The femoral stems had a matte finish; twenty had been precoated with polymethylmethacrylate and nine had not been precoated. The pattern of loosening of the femoral stem was unique: in each hip, the loosening was initially reflected by debonding (a superolateral lucency between the cement and the prosthesis in zone 1 of Gruen et al.), and this was followed by progressive loosening at the cement-prosthesis interface with maintenance of the bone-cement interface. In twenty hips, the debonding was followed by extensive osteolysis. Twenty patients (twenty-one hips) had a revision, and one was considering a revision at the time of writing. The average time from the onset of the symptoms to the revision for the nineteen hips for which this information was available was nine months. We believe that both the geometry (a cylindrical shape distal to the proximal cobra shape) and the surface finish of the Iowa femoral component were responsible for the pattern of progressive loosening.(ABSTRACT TRUNCATED AT 250 WORDS)

    Title Total Hip Replacement with Insertion of an Acetabular Component Without Cement and a Femoral Component with Cement. Four to Seven-year Results.
    Date February 1995
    Journal The Journal of Bone and Joint Surgery. American Volume
    Excerpt

    One hundred and fifty-three so-called hybrid total hip replacements were performed in 142 patients from 1985 to 1987 at Rush-Presbyterian-St. Luke's Medical Center. A hemispherical porous-coated acetabular component was inserted without cement and was fixed with screws, and a femoral stem was inserted with the use of so-called third-generation cementing techniques. The average age of the patients at the time of the operation was sixty-seven years (range, thirty-nine to eighty-five years). The average preoperative Harris hip score was 46 points (range, 9 to 73 points). One hundred and eleven patients (120 hips) were available for clinical review; 100 of these patients (109 hips) had a complete set of radiographs available. The average Harris hip score was 86 points (range, 29 to 100 points) at the time of follow-up (average duration, sixty-two months; range, forty-eight to eighty-five months). There was progressive migration of one cup (1 per cent); another cup migrated one centimeter in the first two years after the operation, with no additional migration evident after that time. The remaining acetabular components were stable. Two femoral components (2 per cent) were determined to be definitely loose. The remaining femoral components were stable. This population of patients had a good result after so-called hybrid total hip replacement with insertion of a porous-coated acetabular component without cement and a femoral component with cement for the reconstruction of a painful hip.

    Title Osteosarcoma of the Hand: a Case Report and Review of the Literature.
    Date July 1994
    Journal The Journal of Hand Surgery
    Title The Effect of Total Knee Replacement on the Knee Varus Angle and Moment During Walking and Stair Ascent.
    Date
    Journal Clinical Biomechanics (bristol, Avon)
    Excerpt

    BACKGROUND: This study examined the effect of total knee replacement surgery on the frontal plane knee varus angle and moment. Secondarily, the relationships between knee varus angle and moment to a clinical outcome measure were assessed. METHODS: Twenty-one patients with total knee replacement and 21 controls performed level walking and stair ascent at two testing periods, pre- and 6-months post-surgery. The dependent variables included frontal plane knee angle and moment, and Western Ontario and McMaster Universities Osteoarthritis Index scores. FINDINGS: During level walking the mean knee varus moment of the patient group was significantly greater than controls at pre-surgery but was restored to control level post-operatively. During stair ascent the patient group produced a significantly smaller knee varus moment post-surgically. The mean frontal knee valgus angle of total knee replacement patients increased significantly from pre- to post-surgery during level walking. The Western Ontario and McMaster Universities Osteoarthritis Index score was not significantly correlated to the knee variables. However, the knee angle and moment were significantly correlated during level walking pre- and post-operatively and stair ascent post-operatively. INTERPRETATION: The decreased frontal plane knee moment in total knee replacement patients during level walking appeared to be affected by surgical realignment of the tibio-femoral joint, as the frontal knee angle and varus moment were strongly correlated. The subjective Western Ontario and McMaster Universities Osteoarthritis Index and the objective gait measures appeared to capture different dimensions of knee osteoarthritis.


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