Thirty patients with isolated patellofemoral complications after total knee arthroplasty were compared 20 well functioning replacements without complications. The epicondylar axis and tibial tubercle used as references on computed tomography scans to measure quantitatively rotational alignment of the femoral components. group had excessive combined (tibial plus femoral) internal component rotation. This rotation was directly proportional severity complication. Small amounts (1°-4°)...

Background: The importance of particles generated by wear and corrosion joint replacement prostheses has been understood primarily in the context local effects particle-induced periprosthetic osteolysis aseptic loosening. We studied dissemination patients with total hip knee to determine prevalence histopathological response prosthetic debris liver, spleen, abdominal para-aortic lymph nodes. Methods: Postmortem specimens from twenty-nine biopsy two living a failed were analyzed. Specimens...

Abstract One hundred forty‐eight retrieved modular hip prostheses of both mixed (Ti‐6Al‐4V/CoCr) and similar (CoCr/CoCr) metal combinations were examined positive evidence corrosive attack was found in the conical taper region between head stem. Significant corrosion observed with 16% necks 35% heads (for mixed‐metal cases), 14% 23% similar‐metal cases) showing moderate to severe attack. There a significant correlation percentage duration implantation for cases, indicating that this...

Background: Corrosion at the modular head-neck junction of femoral component in total hip arthroplasty has been identified as a potential concern, although symptomatic adverse local tissue reactions secondary to corrosion have rarely described. Methods: We retrospectively reviewed records ten patients with metal-on-polyethylene prosthesis, from three different manufacturers, who underwent revision surgery for junction. Results: All presented pain or swelling around hip, and two recurrent...

There is an increasing recognition that, in the long term, total joint replacement may be associated with adverse local and remote tissue responses that are mediated by degradation products of prosthetic materials. Particular interest has centered on metal-degradation replacements because known toxicities metal elements make up alloys used implants. We measured concentrations titanium, aluminum, cobalt, chromium serum concentration urine seventy-five patients during a three-year prospective,...

Directed cell adhesion remains an important goal of implant and tissue engineering technology. In this study, surface energy roughness were investigated to ascertain which these properties show more overall influence on biomaterial-cell colonization. Jet impingement was used quantify cellular strength. Cellular proliferation extracellular matrix secretion characterize colonization 3T3MC fibroblasts on: HS25 (a cobalt based alloy, ASTM F75), 316L stainless steel, Ti-6Al4V titanium alloy),...

A multicenter retrieval analysis of 231 modular hip implants was done to investigate the effects material combination, metallurgic condition, flexural rigidity, head and neck moment arm, length, implantation time on corrosion fretting taper surfaces. Scores for were assigned medial, lateral, anterior, posterior quadrants necks, proximal distal regions heads. Neck scores found be significantly higher mixed alloy versus similar couples. Moderate severe observed in 28% heads couples 42%...

Background: There is a renewed interest in unicompartmental knee arthroplasty. The present report describes the minimum ten-year results associated with arthroplasty design that current use. Methods: Sixty-two consecutive arthroplasties were performed cemented modular Miller-Galante implants fifty-one patients studied prospectively both clinically and radiographically. All had isolated disease without patellofemoral symptoms. No patient was lost to follow-up. Thirteen (thirteen knees) died...

Particulate wear-debris are detected in histiocytes/macrophages of granulomatous tissues adjacent to loose joint prostheses. Such cell-particle interactions have been simulated vitro by challenging macrophages with particles dosed according weight percent, volume and number particles. Each these dosage methods has inherent shortcomings due varying size density different compositions. In this study we challenged P388D1 titania polystyrene (< 2 microns), based on the ratio surface area cells....

Interfacial membranes collected at revision from 11 failed uncemented Ti-alloy total hip replacements were examined. Particles in the characterised by electron microscopy, microchemical spectroscopy and particle size analysis. Most polyethylene had a mean of 0.53 micron +/- 0.3. They similar to particles seen base resin used manufacture acetabular implants. Relatively few titanium seen. Fragments bone, stainless steel silicate found small amounts. too be light microscopy. Electron microscopy...

To assess the potential recovery rate of a minimally invasive total hip replacement technique with minimal soft tissue disruption, an accelerated rehabilitation protocol was implemented weightbearing as tolerated on day surgery. One hundred consecutive patients were enrolled in this prospective study. Ninety-seven (97%) met all inpatient physical therapy goals required for discharge to home surgery; 100% achieved these within 23 hours Outpatient initiated 9% immediately, 62% by 1 week, and 2...

Background: Femoral stems with dual-taper modularity were introduced to allow additional options for hip-center restoration independent of femoral fixation in total hip arthroplasty. Despite the increasing availability and use these stems, concerns exist about potential complications arising from modular neck-body junction. Methods: This was a multicenter retrospective case series twelve hips (eleven patients) adverse local tissue reactions secondary corrosion at The cohort included eight...

This guideline supersedes a prior one from 2007 on similar topic. The work group evaluated the available literature concerning various aspects of patient screening, risk factor assessment, and prophylactic treatment against venous thromboembolic disease (VTED), as well use postoperative mobilization, neuraxial agents, vena cava filters. recommended further assessment patients who have had previous thromboembolism but not for other potential factors. Patients should be assessed known bleeding...

From the Rubin Institute for Advanced Orthopedics and Center Joint Preservation Replacement, Sinai Hospital of Baltimore, MD (Dr. Mont) Department Orthopaedic Surgery, Rush University Medical Center, Chicago, IL Jacobs). Dr. Mont or an immediate family member has received royalties from Stryker; serves as a paid consultant to Johnson & Johnson, Active Systems, Salient Surgical, Stryker, TissueGene; research institutional support National Institutes Health (NIAMS NICHD), TissueGene, Wright...

Migration of solid corrosion products from the modular head-neck junction fifteen total hip replacements to periprosthetic tissues was studied. The devices and were recovered at time a revision procedure or autopsy after mean sixty-four months (range, eight ninety-seven months). prostheses had cobalt-chromium-alloy head coupled with titanium-alloy stem. product identified by electron microprobe analysis Fourier transform infrared spectroscopy as chromium orthophosphate hydrate-rich material....

There has been a resurgence of interest in the use metal on bearings total hip arthroplasty. Although bearing couples would eliminate or substantially reduce particulate polyethylene generation (depending presence absence implant system), there is concern about potential for increased and ionic comparison with bearings. These metallic degradation products may be transported away from site distributed systemically. Chromium concentrations serum urine cobalt were measured subjects chromium...

A prospective study was done of the intermediate-term clinical and radiographic results 121 total hip arthroplasties in which a Harris-Galante porous titanium-fiber-coated prosthesis inserted without cement 110 patients. The average age at time operation forty-nine years (range, twenty to seventy years). duration follow-up sixty-seven months fifty-five seventy-nine months). preoperative Harris score 55 points, postoperative 93 points. One acetabular component revised due recurrent...

Abstract Particulate wear debris from bone cement or prosthetic components can stimulate macrophages to cause resorption in a dose-dependent manner. This activity of particulate-stimulated is associated with increased levels both prostaglandin E2 (PGE2) and interleukin-1 (IL-1). In this study we compared the effect particulate size, concentration, composition on secretion IL-1 PGE2 by peritoneal bone-resorbing conditioned medium (CM) harvested particulate-challenged macrophages. Particulates...