Interaction Between Bone Cement Cracking and Non-Slip Implant Interfaces

2007 ◽  
Author(s):  
Pan Gi Park ◽  
Leszek J. Sudak
Keyword(s):  
Hip Replacement ◽  
Implant Fixation ◽  
National Hospital ◽  
National Hospital Discharge Survey ◽  
New Techniques ◽  
Knee Replacements ◽  
Hip Replacements ◽  
Total Knee ◽  
Cemented Implants ◽  
Better Than

According to National Hospital Discharge Survey 2003, approximately 217,000 and 402,000 patients in the U.S. underwent Total Hip Replacement (THR) and Total Knee Replacement (TKR) operations, respectively and $24.7 billion dollars were spent in hospitalization related to these replacement surgeries. In addition, there were 36,000 revision hip replacements and 33,000 revision knee replacements. To decrease the revision surgeries and increase the performance of the implants, many researchers have provided new techniques for better implant fixation and mechanisms of debonding around implants. With respect to fixation, performance of cemented prosthesis is reported to be better than those of cementless ones. Moreover, surgery with cemented implants has been among the most popular and widely performed.

VP13 Relation Between Magnetic Resonance Imaging Use And Hip Or Knee Replacements In The Organisation For Economic Co-operation And Development

2017 ◽  
Vol 33 (S1) ◽  
pp. 151-152
Author(s):  
Robert Emprechtinger
Keyword(s):  
Hip Replacement ◽  
The Other ◽  
Resonance Imaging ◽  
Inappropriate Use ◽  
Total Knee Replacements ◽  
Knee Replacements ◽  
Hip Replacements ◽  
Total Knee ◽  
The Relationship ◽  
Primary Hip Replacement

INTRODUCTION:A high degree of geographic variation in the use of medical interventions is usually considered as a sign for inappropriate use. However, the plain geographic variation has the disadvantage that the variation might also be appropriate due to differences in the regions. Hence, we conducted a more comprehensive analysis on Magnetic Resonance Imaging (MRI) use and the relationship to hip or knee replacements. We evaluated whether there is evidence that guideline recommendations regarding hip replacements and total knee replacements are being followed. Additionally, we tried to assess whether the use of MRI is related to subsequent interventions.METHODS:We extracted recommendations of the American College of Radiology (ACR) on the use of MRI relevant to hip replacements and total knee replacements. Subsequently, we created three hypotheses on MRI for hip or total knee replacements on what to expect from the data when these recommendations are being followed.For each hypothesis we calculated a multiple linear regression to analyze Organisation for Economic Co-operation and Development (OECD) data. This was necessary to control for other important variables that might have had an influence on the number of interventions despite the MRI use (for example, healthcare spending, or Computed Tomography (CT) use).RESULTS:The initial results on (primary) hip replacement and secondary hip replacement were heavily influenced by outliers. After the exclusion of the outliers (Turkey and Belgium), (primary) hip replacements were related to MRI use but not secondary hip replacements. The results on MRI and (primary) hip replacement suggest that the relationship between MRI and hip replacement in Turkey is lower than in the other OECD nations.Regarding knee replacements, we detected a relationship between the MRI use and total knee replacement. An increase of 10 MRI examinations per 1,000 population would, according to our model, result in 9.8 additional total knee replacements per 100,000 population.CONCLUSIONS:The relationship of MRI and (primary) hip replacement hints to inappropriate use of MRI in Turkey since the data shows a substantial deviation in the relationship compared to the other OECD nations. Apart from this, we found no evidence for inappropriate use of MRI in connection with hip replacements.However, our results suggest that MRI is inappropriately used in relation to total knee replacements. This might contribute to potentially unnecessary total knee replacements.

The Wear of UHMWPE in Total Knee Replacements: Experimental and Finite Element Analysis of Contact Behaviour

2001 ◽  
Author(s):  
Dorothy M. Murphy ◽  
Alan Kavanagh ◽  
Tim M. McGloughlin
Keyword(s):  
Molecular Weight ◽  
Finite Element Analysis ◽  
Element Analysis ◽  
Total Knee Replacements ◽  
Total Hip Replacements ◽  
Contact Behaviour ◽  
Knee Replacements ◽  
Hip Replacements ◽  
Total Knee ◽  
Ultra High Molecular Weight

Abstract Upon examination of failed total knee replacements, it has been concluded that it is the performance of the ultra high molecular weight polyethylene (UHMWPE) tibial component that governs the useful lifespan of such a joint. Severe wear of UHMWPE is associated more with tibial components of the knee than with the acetabular cups of total hip replacements. This is due to a notable lack of congruity between the articulating surfaces which leads to the presence of significant localised stresses in the femoro-tibial interface.

scholarly journals Design and Analysis of Porous Functionally Graded Femoral Prostheses with Improved Stress Shielding

Designs ◽  
2020 ◽  
Vol 4 (2) ◽  
pp. 12 ◽  
Author(s):  
Morassa Jafari Chashmi ◽  
Alireza Fathi ◽  
Masoud Shirzad ◽  
Ramazan-Ali Jafari-Talookolaei ◽  
Mahdi Bodaghi ◽  
...  
Keyword(s):  
Aseptic Loosening ◽  
Hip Replacement ◽  
State Of The Art ◽  
Research Work ◽  
Stress Shielding ◽  
Functionally Graded ◽  
Graded Materials ◽  
Hip Replacements ◽  
3D Finite Element Method ◽  
Better Than

One of the most important problems of total hip replacement is aseptic loosening of the femoral component, which is related to the changes of the stress distribution pattern after implantation of the prosthesis. Stress shielding of the femur is recognized as a primary factor in aseptic loosening of hip replacements. Utilizing different materials is one of the ordinary solutions for that problem, but using functionally graded materials (FGMs) could be better than the conventional solutions. This research work aims at investigating different porous FGM implants and a real femoral bone by a 3D finite element method. The results show that a neutral functionally graded prosthesis cannot extraordinarily make changes in the stress pattern of bone and prosthesis, but an increasing functionally graded prosthesis leads a lower level of stress in the prosthesis, and a decreasing functionally graded prosthesis can properly reduce the stress shielding among these three architectures. Due to the absence of similar results in the specialized literature, this paper is likely to fill a gap in the state-of-the-art bio-implants, and provide pertinent results that are instrumental in the design of porous femoral prostheses under normal walking loading conditions.

Polyethylene Wear Debris Produced in a Knee Simulator Model: Effect of Crosslinking and Counterface Material

2007 ◽  
Author(s):  
Paul A. Williams ◽  
Cindy M. Brown ◽  
Riichro Tsukamoto ◽  
Takashi Nakamura ◽  
Ian C. Clarke
Keyword(s):  
Wear Debris ◽  
Polyethylene Wear ◽  
Total Hip ◽  
Total Knee Replacements ◽  
Knee Simulator ◽  
Total Hip Replacements ◽  
Gravimetric Measurements ◽  
Knee Replacements ◽  
Hip Replacements ◽  
Total Knee

Polyethylene (PE) debris has been examined in total hip replacements from clinical retrievals and laboratory simulator studies, but little is known about PE debris from total knee replacements. In this study we investigated the effects of crosslinking PE and the counterface material. Mildly and highly crosslinked PE were studied in combination with CoCr and Zirconia femoral components. Wear was determined by gravimetric measurements and the wear debris was isolated and morphologically characterized. Although the zirconia counterface with 7 Mrad PE did not exhibit measurable wear, wear debris was found. This indicated that wear occurred below the limits of the gravimetric approach. This study showed that the amount of crosslinking of PE and the counterface material were important factors in the wear of PE in a knee simulator model.

scholarly journals Periprosthetic osteolysis and its association with RANKL expression

2007 ◽  
pp. 455-462
Author(s):  
D Veigl ◽  
J Niederlová ◽  
O Kryštůfková
Keyword(s):  
Hip Replacement ◽  
Nuclear Factor Kappa B ◽  
Orthopedic Implants ◽  
Prosthetic Material ◽  
Wear Particles ◽  
Periprosthetic Osteolysis ◽  
Total Hip Replacements ◽  
Receptor Activator ◽  
Hip Replacements ◽  
Cemented Implants

Extensive osteolysis adjacent to orthopedic implants is often associated with wear particles of prosthetic material. The activation of the RANKL/RANK/OPG system is considered to be a likely cause of periprosthetic osteolysis leading to implant failure. The aim of this study was to examine the possible correlation between the clinical extent of osteolysis, the number of wear particles and expression of the osteoclastic mediator RANKL (receptor activator of nuclear factor kappa B ligand) in the tissues around aseptically loosened cemented and non-cemented total hip replacements. Periprosthetic tissues were harvested from 59 patients undergoing revision of hip replacement for aseptic loosening. We observed RANKL-positive cells in 23 of our 59 patients, their presence was noted predominantly in tissues with a loosened cemented endoprosthesis. We have found that RANKL is present only in tissues with a large amount of wear debris and predominantly in cases involving loosened cemented implants.

scholarly journals The Diagnostic Accuracy of Radionuclide Arthrography for Prosthetic Loosening in Hip and Knee Arthroplasty

2013 ◽  
Vol 2013 ◽  
pp. 1-4 ◽  
Author(s):  
Timothy H. French ◽  
Nicholas Russell ◽  
Anand Pillai
Keyword(s):  
Knee Arthroplasty ◽  
Predictive Value ◽  
Diagnostic Tools ◽  
Total Knee Replacements ◽  
Knee Replacements ◽  
Hip Replacements ◽  
Hip And Knee Arthroplasty ◽  
Prosthetic Loosening ◽  
Total Knee ◽  
Mean Time

Purpose of Study. Diagnosis of prosthetic loosening in hip and knee arthroplasty remains a challenge. Although there are a number of diagnostic tools, no single test or combination is 100% sensitive or specific. There has been a recent interest in the use of radionuclide arthrography (RNA) for detection of prosthetic loosening.Methods. A retrospective review of 45 consecutive RNA scans from 2005 to 2010 was conducted. RNA findings were compared with intraoperative findings at revision and/or serial radiographic examinations to confirm loosening. A component was considered loose if sequential radiographs demonstrated macromotion, gross subsidence, or progressive radiolucency.Results. There were 26 females and 17 males, with mean age at RNA of 71 years (range of 53–89 years) and mean time from index surgery, 6.4 years (range of 0.5–23 years). There were 23 total knee replacements (TKR) (19 primary and 4 revision) and 20 total hip replacements (THR) (11 primary and 9 revision). 15 patients underwent revision surgery following RNA. Strict inclusion criteria allowed 27 patients for further analysis. Sixteen RNA scans were suggestive of loosening, of which 14 were confirmed loose. Eleven scans were suggestive of a stable prosthesis, of which 10 were confirmed well fixed. RNA had a sensitivity of 93%, specificity of 83%, positive predictive value of 88%, and negative predictive value of 91%.Conclusion. Radionuclide arthrography should be considered a useful adjunct in the diagnosis of prosthetic loosening in the challenging patient.

A Partial Weight Bearing Reminder Device for Rehabilitation After Lower Extremity Surgery

2011 ◽  
Author(s):  
Elsbeth Adams ◽  
Travis Kiser ◽  
Rochelle LaPorte ◽  
Tracy Roux ◽  
Eric Stanistreet ◽  
...  
Keyword(s):  
Hip Replacement ◽  
Cruciate Ligament ◽  
Weight Bearing ◽  
The United States ◽  
Full Weight Bearing ◽  
Cell Transplant ◽  
Partial Weight Bearing ◽  
Hip Replacements ◽  
Total Knee ◽  
Partial Weight

Annually, in the United States there are roughly 352,000 incidents of hip fractures [1], 300,000 total hip replacements, and 270,000 total knee replacements, most of which are in adults over age 50 [2]. During rehabilitation, patients who have undergone total knee or hip replacement, cartilage cell transplant, cruciate ligament replacement, meniscus debridement, or complex fracture repairs may be instructed to restrict weight bearing. Partial weight bearing (PWB) includes everything from toe-touch to strict PWB (10–50% of the patients’ body weight), to full weight bearing as tolerated [3]. The restrictions following a hip replacement with a cement-less implant typically require a 6-week PWB regimen [4].

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