Type 3 finger length pattern is associated with total knee replacements due to osteoarthritis but not with hip replacements or hand osteoarthritis in the elderly: The AGES-Reykjavik study

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.

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

ASME/STLE 2007 International Joint Tribology Conference, Parts A and B ◽

10.1115/ijtc2007-44422 ◽

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.

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Shapes and dimensional characteristics of polyethylene wear particles generatedin vivo by total knee replacements compared to total hip replacements

Journal of Biomedical Materials Research ◽

10.1002/(sici)1097-4636(199723)38:3<203::aid-jbm4>3.0.co;2-t ◽

1997 ◽

Vol 38 (3) ◽

pp. 203-210 ◽

Cited By ~ 75

Author(s):

Thomas P. Schmalzried ◽

Pat Campbell ◽

Alexandra K. Schmitt ◽

Ian C. Brown ◽

Harlan C. Amstutz

Keyword(s):

Polyethylene Wear ◽

Wear Particles ◽

Total Hip ◽

Total Knee Replacements ◽

Total Hip Replacements ◽

Knee Replacements ◽

Hip Replacements ◽

Total Knee

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

International Journal of Technology Assessment in Health Care ◽

10.1017/s0266462317003075 ◽

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.

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

BioMed Research International ◽

10.1155/2013/693436 ◽

2013 ◽

Vol 2013 ◽

pp. 1-4 ◽

Cited By ~ 5

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.

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How Noisy are Total Knee and Hip Replacements?

Journal of Perioperative Practice ◽

10.1177/175045891702701204 ◽

2017 ◽

Vol 27 (12) ◽

pp. 292-295 ◽

Cited By ~ 2

Author(s):

JP Simpson ◽

AJ Hamer

Keyword(s):

Noise Levels ◽

Total Knee Replacements ◽

Total Hip Replacements ◽

Knee Replacements ◽

Hip Replacements ◽

Theatre Staff ◽

Total Knee ◽

Oscillating Saw ◽

Loss Of Hearing ◽

Short Time

Orthopaedic theatre can be noisy. Fifty percent of orthopaedic theatre staff have features of noise-induced hearing loss (NIHL). In this study, decibel (dB) levels were recorded in 17 total knee replacements (TKRs) and 11 total hip replacements (THRs). Noise levels reached 105.6dB(A) using a hammer and 97.9dB(A) with an oscillating saw. Exposure to levels above 90dB (which occurred in every case) even for short time periods is proven to cause irreversible loss of hearing. Tools used in orthopaedic theatre produce impulse noises that can cause NIHL. Further investigation is required.

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The size and shape of particulate polyethylene wear debris in total joint replacements

Proceedings of the Institution of Mechanical Engineers Part H Journal of Engineering in Medicine ◽

10.1243/0954411971534638 ◽

1997 ◽

Vol 211 (1) ◽

pp. 11-15 ◽

Cited By ~ 90

Author(s):

A Kobayashi ◽

W Bonfield ◽

Y Kadoya ◽

T Yamac ◽

M A R Freeman ◽

...

Keyword(s):

High Performance ◽

Polyethylene Wear ◽

Exact Nature ◽

Joint Replacements ◽

Total Joint Replacements ◽

Total Knee Replacements ◽

Knee Replacements ◽

Hip Replacements ◽

Total Knee

Osteolysis induced by wear particles has been recognized as one of the major causes of long-term failure in total joint replacements. However, little is currently known about the exact nature of particles, as the particles are too small to be characterized by light microscopy. In this study, ultra-high molecular weight polyethylene (UHMWPE) particles retrieved from ten cases (six cemented and four uncemented) for Freeman type conforming tibiofemoral total knee replacements (TKRs), three Charnley total hip replacements (THRs) and five Imperial College/London Hospital double cup surface hip replacements for aseptic loosening were extracted using a high-performance method with ultracentrifugation and characterized by scanning electron microscopy. The equivalent circle diameter (ECD) of all 18 cases ranged from 0.40 to 1.15 μm (Mean ± SE = 0.70 ± 0.05 μm, median = 0.67 μm). The aspect ratio was 1.50 to 2.04 (Mean ± SE = 1.75 ± 0.04, median = 1.73), and roundness was 1.24 to 2.34 (Mean ± SE = 1.61 ± 0.07, median = 1.65). The numbers of particles were 5.2 × 108 to 9.17 × 1010/g tissue (Mean ± SE = 1.42 × 1010 ± 5.41 × 109/g tissue, median = 7.04 × 109). The number of polyethylene (PE) particles/g tissue in TKRs was significantly larger than that in THRs (1.04 × 1010/g tissue and 2.16 × 109/g tissue respectively, median. p = 0.03, Mann-Whitney U test). Unstable fixation of the tibial PE component might account for the accumulation of a large number of PE particles in the interface tissue.

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