Intramedullary Cement Fixation: A Comparison of the Fixation of Custom-Made Prostheses with the Fixation of Standard Joint Replacements

1990 ◽  
pp. 151-163 ◽  
Author(s):  
G. W. Blunn ◽  
M. E. Wait
Keyword(s):  
Joint Replacements ◽  
Custom Made ◽  
Custom Made Prostheses

scholarly journals On the Analysis of the Contact Conditions in Temporomandibular Joint Prostheses

2018 ◽  
Vol 2018 ◽  
pp. 1-10 ◽  
Author(s):  
B. Gonzalez-Perez-Somarriba ◽  
G. Centeno ◽  
C. Vallellano ◽  
L. M. Gonzalez-Perez
Keyword(s):  
Temporomandibular Joint ◽  
Failure Process ◽  
Anatomical Reconstruction ◽  
Factors Affecting ◽  
Joint Replacements ◽  
Custom Made ◽  
Final Failure ◽  
Stress States ◽  
Custom Made Prostheses ◽  
Joint Prostheses

Temporomandibular joint replacement (TMJR) is a complex surgical procedure in which the artificial joints available must assure the anatomical reconstruction and guarantee a good range of the natural temporomandibular joint (TMJ) movements. With this aim, different types of TMJ prostheses, including the stock prosthetic system and custom-made prostheses, are being currently implanted. Although temporomandibular joint replacements (TMJRs) are expected to accomplish their function during a number of years, they might actually fail and need to be replaced. This paper analyzes different design factors affecting the contact stress distributions within the TMJ prosthesis interface, which are consequently involved in their deterioration and final failure of the prosthetic device. With this purpose, a numerical model based on finite elements has been carried out in order to evaluate the stress states attained in different prosthesis configurations corresponding to general types of TMJ prostheses. On the other hand, the actual degradation of resected implants has been evaluated via optical microscopy. The linkage between the numerical simulations performed and experimental evidence allowed the authors to establish the different wear and damage mechanisms involved in the failure of stock TMJ prostheses. Indeed, the results obtained show that the contact stresses at the interface between the mandible and the glenoid fossa components play a key role in the failure process of the TMJR devices.

Limb-salvage reconstruction following resection of pelvic bone sarcomas involving the acetabulum

2021 ◽  
Vol 103-B (4) ◽  
pp. 795-803
Author(s):  
Tomohiro Fujiwara ◽  
Manuel Ricardo Medellin Rincon ◽  
Andrea Sambri ◽  
Yusuke Tsuda ◽  
Rhys Clark ◽  
...  
Keyword(s):  
Limb Salvage ◽  
Major Complication ◽  
Ice Cream ◽  
Pelvic Bone ◽  
Limb Salvage Surgery ◽  
Consecutive Series ◽  
Major Complications ◽  
Custom Made ◽  
The Mean ◽  
Custom Made Prostheses

Aims Limb salvage for pelvic sarcomas involving the acetabulum is a major surgical challenge. There remains no consensus about what is the optimum type of reconstruction after resection of the tumour. The aim of this study was to evaluate the surgical outcomes in these patients according to the methods of periacetabular reconstruction. Methods The study involved a consecutive series of 122 patients with a periacetabular bone sarcoma who underwent limb-salvage surgery involving a custom-made prosthesis in 65 (53%), an ice-cream cone prosthesis in 21 (17%), an extracorporeal irradiated autograft in 18 (15%), and nonskeletal reconstruction in 18 (15%). Results The rates of major complications necessitating further surgery were 62%, 24%, 56%, and 17% for custom-made prostheses, ice-cream cone prostheses, irradiated autografts and nonskeletal reconstructions, respectively (p = 0.001). The ten-year cumulative incidence of failure of the reconstruction was 19%, 9%, 33%, and 0%, respectively. The major cause of failure was deep infection (11%), followed by local recurrence (6%). The mean functional Musculoskeletal Tumour Society (MSTS) scores were 59%, 74%, 64%, and 72%, respectively. The scores were significantly lower in patients with major complications than in those without complications (mean 52% (SD 20%) vs 74% (SD 19%); p < 0.001). For periacetabular resections involving the ilium, the mean score was the highest with custom-made prostheses (82% (SD 10%)) in patients without any major complication; however, nonskeletal reconstruction resulted in the highest mean scores (78% (SD 12%)) in patients who had major complications. For periacetabular resections not involving the ilium, significantly higher mean scores were obtained with ice-cream cone prostheses (79% (SD 17%); p = 0.031). Conclusion Functional outcome following periacetabular reconstruction is closely associated with the occurrence of complications requiring further surgery. For tumours treated with periacetabular and iliac resection, skeletal reconstruction may result in the best outcomes in the absence of complications, whereas nonskeletal reconstruction is a reasonable option if the risk of complications is high. For tumours requiring periacetabular resection without the ilium, reconstruction using an ice-cream cone prosthesis supported by antibiotic-laden cement is a reliable option. Cite this article: Bone Joint J 2021;103-B(4):795–803.

Early to medium-term outcomes of uncemented ceramic-bearing total hip arthroplasty in teenagers for paediatric hip conditions

2020 ◽  
Vol 102-B (11) ◽  
pp. 1491-1496
Author(s):  
Pranai K. Buddhdev ◽  
Ivor S. Vanhegan ◽  
Tahir Khan ◽  
Aresh Hashemi-Nejad
Keyword(s):  
Total Hip Arthroplasty ◽  
Hip Arthroplasty ◽  
Femoral Stem ◽  
Adolescent And Young Adult ◽  
Medium Term ◽  
Total Hip ◽  
Custom Made ◽  
The Mean ◽  
Custom Made Prostheses

Aims Despite advances in the treatment of paediatric hip disease, adolescent and young adult patients can develop early onset end-stage osteoarthritis. The aims of this study were to address the indications and medium-term outcomes for total hip arthroplasty (THA) with ceramic bearings for teenage patients. Methods Surgery was performed by a single surgeon working in the paediatric orthopaedic unit of a tertiary referral hospital. Databases were interrogated from 2003 to 2017 for all teenage patients undergoing THA with a minimum 2.3 year follow-up. Data capture included patient demographics, the underlying hip pathology, number of previous surgeries, and THA prostheses used. Institutional ethical approval was granted to contact patients for prospective clinical outcomes and obtain up-to-date radiographs. In total, 60 primary hips were implanted in 51 patients (35 female, 16 male) with nine bilateral cases. The mean age was 16.7 years (12 to 19) and mean follow-up was 9.3 years (2.3 to 16.8). Results The most common indication for teenage hip arthroplasty was avascular necrosis secondary to slipped upper femoral epiphysis (31%; n = 16). Overall, 64% of patients (n = 33) had undergone multiple previous operations. The survival at follow-up was 97%; two patients required revision for aseptic loosening (one femoral stem, one acetabular component). Both patients had fused hips noted at the time of arthroplasty. A further two patients had radiolucent lines but were asymptomatic. At latest follow-up the mean Oxford Hip Score was 44 (31 to 48) and a Visual Analogue Scale measurement of 1.5, indicating satisfactory function. Conclusion Operating on this cohort can be complicated by multiple previous surgeries and distorted anatomy, which in some cases require custom-made prostheses. We have demonstrated a good outcome with low revision rate in this complex group of patients. Cite this article: Bone Joint J 2020;102-B(11):1491–1496.

scholarly journals Hand-Modelled Composite Prostheses after Resection of Peri-Acetabular Bone Malignancies

Sarcoma ◽  
2003 ◽  
Vol 7 (1) ◽  
pp. 19-27
Author(s):  
G. Delepine ◽  
F. Delepine ◽  
T. Sokolov ◽  
N. Delepine
Keyword(s):  
Hip Prosthesis ◽  
Staging System ◽  
Deep Infection ◽  
Extensive Resection ◽  
Reconstructive Procedures ◽  
Acetabular Bone ◽  
Titanium Screws ◽  
Custom Made ◽  
Custom Made Prostheses

Purpose: To improve function after pelvic resection involving the acetabulum, using an anatomic composite implant built with screws and cement.Material and method: Since 1990, 66 patients with peri-acetabular bone malignancies have been treated by extensive resection followed by hand-modelled innominate prosthesis with partially constrained total hip prosthesis. The hand-modelled innominate prosthesis was made of a titanium cup, a set of long titanium screws and two or three packs of gentamycine-loaded cement.Results: Many postoperative complications were observed: deep infection (14%), hip prosthesis dislocation (25%) and local recurrence (15%). Sixteen patients (25%) had to be reoperated. Nevertheless, at last follow-up, 62 patients still had composite prosthesis. The mean functional result, rated according to a modified Enneking's staging system, was 80% with unlimited walking without support, average hip flexion 100°, length discrepancy less than 1 cm.Discussion: These results were similar to those described in the literature for custom-made innominate prostheses and much better than those of alternative reconstructive procedures. Hand-modelled composite prostheses are cheaper, easier, more adaptable and enables better anchorage than custom-made prostheses. Such a procedure can be used even after total iliac wing resection.Conclusion: The advantages of such a procedure plead for its extensive use after acetabular resection. But long-term follow-up is necessary to validate indications.

Distal femoral arthroplasty using custom-made prostheses

1993 ◽  
Vol 8 (3) ◽  
pp. 259-268 ◽  
Author(s):  
Paul S. Unwin ◽  
Justin P. Cobb ◽  
Peter S. Walker
Keyword(s):  
Custom Made ◽  
Custom Made Prostheses

Analysis of principles inspiring design of three-dimensional-printed custom-made prostheses in two referral centres

2020 ◽  
Vol 44 (5) ◽  
pp. 829-837 ◽  
Author(s):  
Andrea Angelini ◽  
Daniel Kotrych ◽  
Giulia Trovarelli ◽  
Andrzej Szafrański ◽  
Andrzej Bohatyrewicz ◽  
...  
Keyword(s):  
Three Dimensional ◽  
Custom Made ◽  
Custom Made Prostheses

scholarly journals Reconstruction of the hip after resection of periacetabular oncological lesions

2018 ◽  
Vol 100-B (1_Supple_A) ◽  
pp. 22-30 ◽  
Author(s):  
T. S. Brown ◽  
C. G. Salib ◽  
P. S. Rose ◽  
F. H. Sim ◽  
D. G. Lewallen ◽  
...  
Keyword(s):  
English Language ◽  
Mortality Data ◽  
Porous Tantalum ◽  
Radiographic Outcomes ◽  
Implant Survivorship ◽  
Custom Made ◽  
Alive With Disease ◽  
Saddle Prosthesis ◽  
Custom Made Prostheses

AimsReconstruction of the acetabulum after resection of a periacetabular malignancy is technically challenging and many different techniques have been used with varying success. Our aim was to prepare a systematic review of the literature dealing with these techniques in order to clarify the management, the rate of complications and the outcomes.Patients and MethodsA search of PubMed and MEDLINE was conducted for English language articles published between January 1990 and February 2017 with combinations of key search terms to identify studies dealing with periacetabular resection with reconstruction in patients with a malignancy. Studies in English that reported radiographic or clinical outcomes were included. Data collected from each study included: the number and type of reconstructions, the pathological diagnosis of the lesions, the mean age and follow-up, gender distribution, implant survivorship, complications, functional outcome, and mortality. The results from individual studies were combined for the general analysis, and then grouped according to the type of reconstruction.ResultsA total of 57 studies met the inclusion criteria and included 1700 patients. Most lesions were metastatic (41%), followed by chondrosarcoma (29%), osteosarcoma (10%), Ewing’s sarcoma (7%), and multiple myeloma (2%). The techniques of reconstruction were divided into seven types for analysis: those involving a Harrington reconstruction, a saddle prosthesis, an allograft and allograft prosthesis composite, a pasteurised autograft, a porous tantalum implant, a custom-made prosthesis and a modular hemipelvic reconstruction. The rate of complications was 50%, with infection (14%) and instability (8%) being the most common. Mortality data were available for 1427 patients (84%); 50% had died of disease progression, 23% were alive with disease, and 27% had no evidence of disease at a mean follow-up of 3.4 years (0 to 34).ConclusionBoth the rate of complications and mortality are high following resection of oncological periacetabular lesions and reconstruction. Many types of reconstruction have been used with unique challenges and complications for each technique. Newer prostheses, including custom-made prostheses and porous tantalum implants and augments, have shown promising early functional and radiographic outcomes. Cite this article: Bone Joint J 2018;100-B(1 Supple A):22–30.

Custom made prostheses for TMJ replacecement due to trauma during oral intubation

2013 ◽  
Vol 42 (10) ◽  
pp. 1365
Author(s):  
J. Mareque-Bueno ◽  
M. Fernandez-Barriales ◽  
M. Morey-Mas ◽  
F. Hernendez-Alfaro
Keyword(s):  
Oral Intubation ◽  
Custom Made ◽  
Custom Made Prostheses
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