Configuration and Management of a Femoral Heads Bone Bank in a Specialised Tertiary Orthopaedic Hospital in Bucharest

2020 ◽  
Vol 71 (4) ◽  
pp. 472-479
Author(s):  
Ioan Cristian Stoica ◽  
Ana-Maria Munteanu ◽  
Alexandru Luchian ◽  
Constantin Nicolae ◽  
Stefan Mogos
Keyword(s):  
Femoral Head ◽  
Hepatitis B ◽  
Positive Result ◽  
Bacterial Culture ◽  
Significant Proportion ◽  
Bone Bank ◽  
Screening Process ◽  
Orthopaedic Hospital ◽  
Femoral Heads ◽  
Staphylococcus Spp

The purpose of the current paper is to describe the functioning protocol of a femoral heads bone bank in a specialised tertiary orthopaedic hospital in Bucharest and the results of its activity between January 2011 and December 2016. Since the initiation of the femoral head bone bank in 2011, we selected and tested 761 donors of femoral heads. Out of them, we implanted 435 grafts to a total of 242 recipient patients. We performed a thorough donor screening process, which resulted in a significant proportion of femoral head allografts discarded, mainly due to a positive hepatitis B or/and C viruses test or a positive result of the bacterial culture from the bone graft (in 3% of the grafts); the offending micro-organism was a Methicillin-Sensible Staphylococcus spp. Our bone bank may serve as a framework for developing similar structures by other hospitals in our country or elsewhere.

Holding Power of Orthopaedic Screws in Bovine Femoral Heads

1993 ◽  
Vol 06 (03) ◽  
pp. 160-162 ◽  
Author(s):  
M. J. Ulm ◽  
D. G. Wilson
Keyword(s):  
Femoral Head ◽  
Cannulated Screws ◽  
Cancellous Screw ◽  
Holding Power ◽  
Cortical Screw ◽  
Femoral Heads ◽  
Cancellous Screws ◽  
Physeal Fractures

SummaryFemoral capital physeal fractures have been successfully repaired using 7.0 mm cannulated screws. The holding power of 7.0 mm cannulated screws was compared to the holding power of 5.5 mm cortical screws and 6.5 mm cancellous screws using paired bovine femoral heads. The 7.0 mm cannulated screw’s holding power was superior to the 6.5 mm cancellous screw and similar to that of the 5.5 mm cortical screw.When placed in the bovine femoral head, 7.0 mm cannulated screws have holding power greater than 6.5 mm cancellous screws and similar to 5.5 mm cortical screws.

A comparison of 2 cementing techniques in hip resurfacing using human femoral heads

2021 ◽  
pp. 112070002199706
Author(s):  
Sarah J Shiels ◽  
Martin Williams ◽  
Gordon C Bannister ◽  
Richard P Baker
Keyword(s):  
Femoral Head ◽  
Femoral Component ◽  
Bubble Formation ◽  
Young Male ◽  
Cement Mantle ◽  
Hip Resurfacing ◽  
Air Bubble ◽  
Low Viscosity ◽  
Femoral Heads ◽  
Group 2

Introduction: Hip resurfacing remains a valid option in young male patients. The creation of the optimum cement mantle aids fixation of the femoral component. If the cement mantle is too thick the prosthesis can remain proud leading to early failure or if it penetrates too far into the femoral head, it may cause osteonecrosis. Method: 18 of 96 femoral heads collected from patients undergoing total hip arthroplasty were matched for their surface porosity. They were randomly allocated into 2 different cementing groups. Group 1 had the traditional bolus of cement technique, while group 2 had a modified cementing technique (swirl) where the inside of the femoral component was lined with an even layer of low viscosity cement. Results: The traditional bolus technique had significantly greater cement mantle thickness in 3 of 4 zones of penetration ( p = 0.002), greater and larger air bubble formation (6 of 9 in bolus technique vs. 1 in 9 in swirl technique, p = 0.05) and more incomplete cement mantles compared with the swirl technique. There was no relationship to femoral head porosity. Conclusion: The swirl technique should be used to cement the femoral component in hip resurfacing. Long-term clinical studies would conform if this translates into increased survivorship of the femoral component.

scholarly journals Microvascular Density of Rapidly Destructive Arthropathy of the Hip Joint

2005 ◽  
Vol 13 (1) ◽  
pp. 40-45 ◽  
Author(s):  
T Yamakawa ◽  
A Sudo ◽  
M Tanaka ◽  
A Uchida
Keyword(s):  
Femoral Head ◽  
Hip Joint ◽  
Joint Destruction ◽  
Bone Destruction ◽  
Microvascular Density ◽  
Blood Capillaries ◽  
Secondary Osteoarthritis ◽  
Femoral Heads ◽  
Formalin Fixed Paraffin Embedded ◽  
Destructive Arthropathy

Purpose. To assess the vascularity of the femoral head and determine how it is related to the destruction of the arthritic hip joint. The process of destructive arthropathy in arthritic hip joints is variable. Some patients with osteoarthritis of the hip have rapidly progressive destructive changes resulting in the disappearance of the femoral head. Method. Six femoral heads from patients diagnosed with rapidly destructive arthropathy and 6 femoral heads from patients with secondary osteoarthritis caused by acetabular dysplasia were analysed to reveal the association between blood capillaries and osteoclasts. The von Willebrand Factor immunostaining and counterstaining with Mayer's haematoxylin were used to label the microvessels and osteoclasts in formalin-fixed, paraffin-embedded specimens of femoral heads. The numbers of immunostained microvessels and osteoclasts in selected regions were counted. Result. The microvascular density of the bone surfaces of rapidly progressive arthritic hips was hypervascular. Osteoclasts were also found in increased numbers on the bone surfaces of rapidly progressive arthritic hips. The higher microvascular density coincided with extensive bone destruction and with the increased osteoclast count. Conclusion. These findings suggested that hypervascularity of the granulation in the femoral head may be associated with bone and joint destruction.

Femoral head material loss at the head-neck junction in total hip arthroplasty: the effect of head size, stem material and stem offset

2018 ◽  
Vol 29 (6) ◽  
pp. 647-651 ◽  
Author(s):  
Giuseppe Valente ◽  
Brent Lanting ◽  
Steven MacDonald ◽  
Matthew G Teeter ◽  
Douglas Van Citters ◽  
...  
Keyword(s):  
Femoral Head ◽  
Total Hip Arthroplasty ◽  
Hip Arthroplasty ◽  
Head Size ◽  
Material Loss ◽  
Total Hip ◽  
Femoral Heads ◽  
Measuring Machine ◽  
Head Neck ◽  
Neck Junction

Introduction:Material loss at the head-neck junction in total hip arthroplasty may cause adverse clinical symptoms and implant failure. The purpose of this study was to quantitatively examine the effects of head size, stem material and stem offset on material loss of the head-neck taper interface of a single trunnion design in retrieval implants of metal on polyethylene bearing surfaces.Methods:A retrieval study was performed to identify all 28-mm and 32-mm femoral heads from a single implant/taper design implanted for >2 years. This included n = 56 of the 28-mm heads and n = 23 of the 32-mm heads. The 28-mm femoral heads were matched to 32-mm femoral heads based on time in vivo and head length. A coordinate measuring machine was used to determine maximum linear corrosion depth (MLD). Differences in MLD for head diameter, stem material, and stem offset were determined.Results:There were no differences between groups for age, gender, BMI, or implantation time. There was no difference in MLD between 28 mm and 32 mm matched paired head diameters ( p = 0.59). There was also no difference in MLD between titanium or cobalt-chromium stems ( p = 0.79), and regular or high-offset stems ( p = 0.95).Conclusion:There is no statistical difference in femoral head MLD at the head-neck junction in THA between 28-mm and 32-mm matched paired femoral heads, similar or mixed alloy coupled femoral head stem constructs, and regular or high offset stems.

scholarly journals Hepatic Histologic Changes in Patients with Chronic Hepatitis B Virus Infection with High DNA Level and Normal or Minimally Elevated Alanine Aminotransferase

2016 ◽  
Vol 10 (1) ◽  
pp. 3-8
Author(s):  
ASM Salimullah ◽  
ASMA Raihan ◽  
MM Shahin Ul Islam ◽  
Mohammad Asadur Rahman ◽  
Dewan Saifuddin Ahmed ◽  
...  
Keyword(s):  
Chronic Hepatitis ◽  
Hepatitis B Virus ◽  
Hepatitis B ◽  
Chronic Hepatitis B ◽  
Significant Proportion ◽  
Histological Changes ◽  
Asymptomatic Patients ◽  
Chronic Hepatitis B Virus ◽  
B Virus ◽  
Normal Alt

Hepatitis B Virus (HBV) infection can causes spectrum of diseases ranging from clinically asymptomatic state to the development of cirrhosis and hepatocellular carcinoma (HCC). There is ongoing debate in the management of asymptomatic patients with chronic hepatitis B virus (CHBV) infection with high DNA and normal ALT level. It has been recently shown that a significant proportion of patients with CHBV infection with high DNA and normal ALT level have significant histological abnormality. So this study was aimed to see the histological changes in patients with CHBV infection with high DNA and ALT level <2 times of upper limit of normal (ULN). Total 64 patients were included in this cross sectional study. Mean age was 29 years, 55 (85.9%) patients were men. Forty patients (62.5%) were HBeAg positive. Thirty seven (57.8%) patients had normal ALT levels and 27 patients (42.2%) had ALT levels 1-2 x ULN. Out of 64 patients 46.8% had significant histological abnormalities. Among them 31.2% had significant fibrosis and 26.5% had significant necroinflammatory changes. Among 37 patients with normal ALT levels 35% had significant histological abnormalities. But among 27 patients with ALT levels of 1-2 x ULN, 63% had significant histological abnormalities. In this series significant histological abnormalities were found in 40% of HBeAg+ve cases and 58.3% of HBeAg-ve cases. But this difference was not statistically significant. It was also found that patients with significant histological abnormalities were significantly older and had a lower median HBV DNA level, lower mean platelet count, lower mean prothrombin activity ratio and lower mean albumin level than patients with nonsignificant histological changes. In logistic regression analysis it was found that serum ALT levels and age at which patients entered the study were independently associated with the risk for significant histological abnormalities.Faridpur Med. Coll. J. Jan 2015;10(1): 3-8

Contribution to the Diagnosis of Idiopathic Femoral Head Necrosis by Scintigraphy with 99mTc-MDP Assessed Quantitatively by Computer

1983 ◽  
Vol 22 (05) ◽  
pp. 232-236 ◽  
Author(s):  
J. Pardo-Montaner ◽  
O. Caballero-Carpena
Keyword(s):  
Femoral Head ◽  
Gamma Camera ◽  
Lumbar Vertebra ◽  
Subjective Assessment ◽  
The Other ◽  
Femoral Head Necrosis ◽  
Control Group ◽  
Histopathological Analysis ◽  
Femoral Heads ◽  
Abnormal Uptake

The authors have studied by quantification the bone uptake of 99mTc-MDP in femoral head necrosis in order to evaluate in an objective manner conventional scintigraphy, and thus to increase the sensitiveness and efficacy of an exploration for an early diagnosis of these patients. Twenty cases of femoral necrosis have been studied, diagnosed in all cases by histopathological analysis; in twelve of them the process was unilateral and in the other eight bilateral. All explorations were carried out with 99mTc-MDP, a gamma camera and a PDP 11/40 computer for the quantitative study with the obtention of indices relating the activity between the femoral heads and, of these, to a normal vertebra. Quantification in the control group showed that the uptake of the nuclide was similar in both femoral heads and is lower than this in the vertebra. In all cases of unilateral necrosis the abnormal deviations of the indices relating the pathological head to the contralateral head and the lumbar vertebra were significant. In bilateral femoral head necrosis, an increase has been observed in all indices, although only the index relating the contralateral femoral head suspect of a lesion to vertebral activity was statistically significant. The proposed method for quantifying can be carried out easily and is very useful for diagnosing femoral necrosis since it improves the results of a subjective assessment of the scintigraphic image and can earlier detect the abnormal uptake of the lesion.

scholarly journals Dynamic deformation of the femoral head occurs on weightbearing in Legg-Calves-Perthes disease

2020 ◽  
Vol 1 (7) ◽  
pp. 364-369 ◽  
Author(s):  
Alexander Aarvold ◽  
Ryan Lohre ◽  
Harpreet Chhina ◽  
Kishore Mulpuri ◽  
Anthony Cooper
Keyword(s):  
Femoral Head ◽  
Late Stage ◽  
Early Stage ◽  
Intraclass Correlation ◽  
Correlation Coefficients ◽  
Perthes Disease ◽  
Upright Mri ◽  
Lateral Extrusion ◽  
Femoral Heads ◽  
Head Height

Aims Though the pathogenesis of Legg-Calve-Perthes disease (LCPD) is unknown, repetitive microtrauma resulting in deformity has been postulated. The purpose of this study is to trial a novel upright MRI scanner, to determine whether any deformation occurs in femoral heads affected by LCPD with weightbearing. Methods Children affected by LCPD were recruited for analysis. Children received both standing weightbearing and supine scans in the MROpen upright MRI scanner, for coronal T1 GFE sequences, both hips in field of view. Parameters of femoral head height, width, and lateral extrusion of affected and unaffected hips were assessed by two independent raters, repeated at a one month interval. Inter- and intraclass correlation coefficients were determined. Standing and supine measurements were compared for each femoral head. Results Following rigorous protocol development in healthy age-matched volunteers, successful scanning was performed in 11 LCPD-affected hips in nine children, with seven unaffected hips therefore available for comparison. Five hips were in early stage (1 and 2) and six were in late stage (3 and 4). The mean age was 5.3 years. All hips in early-stage LCPD demonstrated dynamic deformity on weightbearing. Femoral head height decreased (mean 1.2 mm, 12.4% decrease), width increased (mean 2.5 mm, 7.2% increase), and lateral extrusion increased (median 2.5 mm, 23% increase) on standing weightbearing MRI compared to supine scans. Negligible deformation was observed in contra-lateral unaffected hips, with less deformation observed in late-stage hips. Inter- and intraclass reliability for all measured parameters was good to excellent. Conclusion This pilot study has described an effective novel research investigation for children with LCPD. Femoral heads in early-stage LCPD demonstrated dynamic deformity on weightbearing not previously seen, while unaffected hips did not. Expansion of this protocol will allow further translational study into the effects of loading hips with LCPD. Cite this article: Bone Joint Open 2020;1-7:364–369.

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