Fluid load support and contact mechanics of hemiarthroplasty in the natural hip joint.

Science.gov (United States)

Pawaskar, Sainath Shrikant; Ingham, Eileen; Fisher, John; Jin, Zhongmin

2011-01-01

The articular cartilage covering the ends of the bones of diarthrodial synovial joints is thought to have evolved so that the loads are transferred under different and complex conditions, with a very high degree of efficiency and without compromising the structural integrity of the tissue for the life of an individual. These loading conditions stem from different activities such as walking, and standing. The integrity of cartilage may however become compromised due to congenital disease, arthritis or trauma. Hemiarthroplasty is a potentially conservative treatment when only the femoral cartilage is affected as in case of femoral neck fractures. In hemiarthroplasty, a metallic femoral prosthesis is used to articulate against the natural acetabular cartilage. It has also been hypothesized that biphasic lubrication is the predominant mechanism protecting the cartilage through a very high fluid load support which lowers friction. This may be altered due to hemiarthroplasty and have a direct effect on the frictional shear stresses and potentially cartilage degradation and wear. This study modelled nine activities of daily living and investigated the contact mechanics of a hip joint with a hemiarthroplasty, focussing particularly on the role of the fluid phase. It was shown that in most of the activities studied the peak contact stresses and peak fluid pressures were in the superior dome or lateral roof of the acetabulum. Total fluid load support was very high (~90%) in most of the activities which would shield the solid phase from being subjected to very high contact stresses. This was dependent not only on the load magnitude but also the direction and hence on the location of the contact area with respect to the cartilage coverage. Lower fluid load support was found when the contact area was nearer the edges where the fluid drained easily. Copyright © 2010 IPEM. Published by Elsevier Ltd. All rights reserved.

21 CFR 888.3390 - Hip joint femoral (hemi-hip) metal/polymer cemented or uncemented prosthesis.

Science.gov (United States)

2010-04-01

... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Hip joint femoral (hemi-hip) metal/polymer... § 888.3390 Hip joint femoral (hemi-hip) metal/polymer cemented or uncemented prosthesis. (a) Identification. A hip joint femoral (hemi-hip) metal/polymer cemented or uncemented prosthesis is a two-part...

21 CFR 888.3380 - Hip joint femoral (hemi-hip) trunnion-bearing metal/polyacetal cemented prosthesis.

Science.gov (United States)

2010-04-01

... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Hip joint femoral (hemi-hip) trunnion-bearing... Devices § 888.3380 Hip joint femoral (hemi-hip) trunnion-bearing metal/polyacetal cemented prosthesis. (a) Identification. A hip joint femoral (hemi-hip) trunnion-bearing metal/polyacetal cemented prosthesis is a two...

Hip joint replacement

Science.gov (United States)

Hip arthroplasty; Total hip replacement; Hip hemiarthroplasty; Arthritis - hip replacement; Osteoarthritis - hip replacement ... Your hip joint is made up of 2 major parts. One or both parts may be replaced during surgery: ...

Primary cemented total hip arthroplasty: 10 years follow-up

Directory of Open Access Journals (Sweden)

Nath Rajendra

2010-01-01

Full Text Available Background: Primary cemented total hip arthroplasty is a procedure for non-traumatic and traumatic affections of the hip. Long term follow-up is required to assess the longevity of the implant and establish the procedure. Indo-Asian literature on long term result of total hip arthroplasty is sparse. We present a 10-year follow-up of our patients of primary cemented total hip arthroplasty. Materials and Methods: We operated 31 hips in 30 patients with primary cemented total hip arthroplasty. We followed the cases for a minimum period of 10 years with a mean follow-up period of 12.7 years. The mean age of the patients was 60.7 years (range 37-82 yrs male to female ratio was 2:1. The clinical diagnoses included - avascular necrosis of femoral head (n=15, sero positive rheumatoid arthritis (n=5, seronegative spondylo-arthropathy (n=4, neglected femoral neck fractures (n=3, healed tubercular arthritis (n=2 and post traumatic osteoarthritis of hip (n=2. The prostheses used were cemented Charnley′s total hip (n=12 and cemented modular prosthesis (n=19. The results were assessed according to Harris hip score and radiographs taken at yearly intervals. Results: The mean follow-up is 12.7 yrs (range 11-16 yrs Results in all operated patients showed marked improvement in Harris hip score from preoperative mean 29.2 to 79.9 at 10 years or more followup. However, the non-inflammatory group showed more sustained long term improvement as compared to the inflammatory group, as revealed by the Harris hip score. Mean blood loss was 450ml (±3.7 ml, mean transfusion rate was 1.2 units (±.3. The complications were hypotension (n=7, shortening> 1.5 cm (n=9, superficial infection (n=2 and malposition of prosthesis (n=1. Conclusion: The needs of Indian Asian patients, vary from what is discussed in literature. The pain tolerance is greater than western population and financial constraints are high. Thus revision surgery among Indian-Asian patients is less compared

Resurfacing hemiarthroplasty compared to stemmed hemiarthroplasty for glenohumeral osteoarthritis

DEFF Research Database (Denmark)

Rasmussen, Jeppe V; Olsen, Bo S; Sorensen, Anne Kathrine

2015-01-01

PURPOSE: The aim of this study was to conduct a randomised, clinical trial comparing stemmed hemiarthroplasty and resurfacing hemiarthroplasty in the treatment of glenohumeral osteoarthritis. METHODS: A total of 40 shoulders (35 patients) were randomised to stemmed hemiarthroplasty or resurfacing...... hemiarthroplasty and evaluated three and 12 months postoperatively using the Constant-Murley score (CMS) and Western Ontario Osteoarthritis of the Shoulder (WOOS) index. RESULTS: There were no statistically significant differences in age, gender or pre-operative scores except for WOOS at baseline. Two patients...

STUDY OF FUNCTIONAL RESULTS OF CEMENTED TOTAL HIP REPLACEMENT BY MOORE’S APPROACH

Directory of Open Access Journals (Sweden)

Arunim

2016-02-01

Full Text Available INTRODUCTION The total hip replacement (THR has probably become the surgical procedure of choice for vide variety of hip joint disabling diseases. The prosthesis used for THR is often grouped into cemented, cement-less and hybrid ones. There has been increasing trends in use of cement-less components citing more number of complications namely loosening, increased infection rate etc. however with additional cost factors as well. We conducted this study to ascertain whether in a developing country like ours should we really switch over to un-cemented hip replacements dreading such complications or can we still use cemented prosthesis with equally good if not better results. METHODS A study of functional results of cemented total hip replacement was done in patients with varied age groups ranging from 40 years to 75 years with the average age being 54.8 years. 20 patients with 21 diseased hips were treated with cemented total hip replacement by Moore’s posterior approach at NSCB Subharti medical college, Meerut, UP from December 2010 to December 2013 and reviewed thereafter with an average follow-up period of 4.2 years. Average surgical time required was one and half hour. Patients were asked to come for follow up on 1st month, 3rd month and 6th month and then every 6 months and were assessed as per modified Harris Hip Score. RESULTS All the patients were evaluated according to the Modified Harris Hip Scoring system. The results showed 14(67% hips with excellent results, 4(19% with good results, and 3(14% hips with fair results. No poor outcome was noted in this study. 2 cases of dislocation (10% were noted one on the 5th post-operative day and the other occurred after the patient was discharged from the institution. CONCLUSIONS The management of diseased and destroyed hips with chronic pain with cemented total hip replacement is effective and gives stable, mobile and painless hip joint to the patient. Functional results are excellent and

21 CFR 888.3350 - Hip joint metal/polymer semi-constrained cemented prosthesis.

Science.gov (United States)

2010-04-01

... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Hip joint metal/polymer semi-constrained cemented... HUMAN SERVICES (CONTINUED) MEDICAL DEVICES ORTHOPEDIC DEVICES Prosthetic Devices § 888.3350 Hip joint metal/polymer semi-constrained cemented prosthesis. (a) Identification. A hip joint metal/polymer semi...

21 CFR 888.3300 - Hip joint metal constrained cemented or uncemented prosthesis.

Science.gov (United States)

2010-04-01

... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Hip joint metal constrained cemented or uncemented... HUMAN SERVICES (CONTINUED) MEDICAL DEVICES ORTHOPEDIC DEVICES Prosthetic Devices § 888.3300 Hip joint metal constrained cemented or uncemented prosthesis. (a) Identification. A hip joint metal constrained...

21 CFR 888.3310 - Hip joint metal/polymer constrained cemented or uncemented prosthesis.

Science.gov (United States)

2010-04-01

... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Hip joint metal/polymer constrained cemented or... Hip joint metal/polymer constrained cemented or uncemented prosthesis. (a) Identification. A hip joint... replace a hip joint. The device prevents dislocation in more than one anatomic plane and has components...

The Use of a Supra-Acetabular Antibiotic-Loaded Cement Shelf to Improve Hip Stability in First-Stage Infected Total Hip Arthroplasty.

Science.gov (United States)

Drexler, Michael; Kuzyk, Paul R T; Koo, Kevin; Gross, Allan E; Kosashvili, Yona; Reischl, Nickola; Rutenberg, Tal Frenkel; Safir, Oleg

2016-11-01

Antibiotic-loaded cement spacers in first-stage revision total hip arthroplasty (THA) for managing infection are associated with high dislocation and fracture rates. The aim of this study was to report the use of an antibiotic-loaded cemented supra-acetabular roof augmentation to reinforce hip stability after cement spacer insertion for first-stage total hip revision in the treatment of infected THA. We retrospectively reviewed a consecutive series of 50 THAs involving 47 patients with an infected hip requiring staged revisions of THA. We documented dislocation, reinfection, and time for revision and outcome. There were no cases of hip dislocation, cement fractures, or any other technical complications associated with the use of the roof augmentation lip. Thirteen cases (26%) had a cemented spacer for longer than 120 days. Seven (14%) cases had recurrent infection after staged revision THA. The antibiotic-loaded cemented supra-acetabular roof augment improved femoral head spacer coverage for patients requiring a staged revision THA for infection. Copyright © 2016 Elsevier Inc. All rights reserved.

Changes in collagen metabolites in serum after cemented hip and knee arthroplasty

DEFF Research Database (Denmark)

Joerring, S; Jensen, L T

1993-01-01

Markers of types I and III collagen turnover were measured in serial blood samples collected preoperatively and 60 days after surgery in 13 patients undergoing cemented total hip arthroplasty and 11 patients undergoing cemented total knee arthroplasty. The markers were the carboxyterminal extension....... We suggest that the changes in serum PICP and serum PIIINP reflect collagen formation in healing soft connective tissue 60 days after cemented hip or knee arthroplasty....

A computerized pre-clinical test for cemented hip prostheses based on finite element techniques

NARCIS (Netherlands)

Stolk, Jan

2003-01-01

Despite the success of cemented total hip replacement (THR), high failure rates are occasionally reported for cemented hip implants that are introduced on the orthopaedic market. Rigorous pre-clinical testing of hip implants could prevent these disasters, by detecting unsafe implant designs at a

The effect of cup outer sizes on the contact mechanics and cement fixation of cemented total hip replacements.

Science.gov (United States)

Hua, Xijin; Li, Junyan; Wang, Ling; Wilcox, Ruth; Fisher, John; Jin, Zhongmin

2015-10-01

One important loosening mechanism of the cemented total hip arthroplasty is the mechanical overload at the bone-cement interface and consequent failure of the cement fixation. Clinical studies have revealed that the outer diameter of the acetabular component is a key factor in influencing aseptic loosening of the hip arthroplasty. The aim of the present study was to investigate the influence of the cup outer diameter on the contact mechanics and cement fixation of a cemented total hip replacement (THR) with different wear penetration depths and under different cup inclination angles using finite element (FE) method. A three-dimensional FE model was developed based on a typical Charnley hip prosthesis. Two acetabular cup designs with outer diameters of 40 and 43 mm were modelled and the effect of cup outer diameter, penetration depth and cup inclination angle on the contact mechanics and cement fixation stresses in the cemented THR were studied. The results showed that for all penetration depths and cup inclination angles considered, the contact mechanics in terms of peak von Mises stress in the acetabular cup and peak contact pressure at the bearing surface for the two cup designs were similar (within 5%). However, the peak von Mises stress, the peak maximum principal stress and peak shear stress in the cement mantle at the bone-cement interface for the 43 mm diameter cup design were predicted to be lower compared to those for the 40 mm diameter cup design. The differences were predicted to be 15-19%, 15-22% and 18-20% respectively for different cup penetration depths and inclination angles, which compares to the clinical difference of aseptic loosening incidence of about 20% between the two cup designs. Copyright © 2015 IPEM. Published by Elsevier Ltd. All rights reserved.

Failure analysis of the cement mantle in total hip arthroplasty with an efficient probabilistic method.

Science.gov (United States)

Kaymaz, Irfan; Bayrak, Ozgu; Karsan, Orhan; Celik, Ayhan; Alsaran, Akgun

2014-04-01

Accurate prediction of long-term behaviour of cemented hip implants is very important not only for patient comfort but also for elimination of any revision operation due to failure of implants. Therefore, a more realistic computer model was generated and then used for both deterministic and probabilistic analyses of the hip implant in this study. The deterministic failure analysis was carried out for the most common failure states of the cement mantle. On the other hand, most of the design parameters of the cemented hip are inherently uncertain quantities. Therefore, the probabilistic failure analysis was also carried out considering the fatigue failure of the cement mantle since it is the most critical failure state. However, the probabilistic analysis generally requires large amount of time; thus, a response surface method proposed in this study was used to reduce the computation time for the analysis of the cemented hip implant. The results demonstrate that using an efficient probabilistic approach can significantly reduce the computation time for the failure probability of the cement from several hours to minutes. The results also show that even the deterministic failure analyses do not indicate any failure of the cement mantle with high safety factors, the probabilistic analysis predicts the failure probability of the cement mantle as 8%, which must be considered during the evaluation of the success of the cemented hip implants.

Failure rate of cemented and uncemented total hip replacements

DEFF Research Database (Denmark)

Makela, K. T.; Matilainen, M.; Pulkkinen, P.

2014-01-01

). Participants 347 899 total hip replacements performed during 1995-2011. Main outcome measures Probability of implant survival (Kaplan-Meier analysis) along with implant survival with revision for any reason as endpoint (Cox multiple regression) adjusted for age, sex, and diagnosis in age groups 55-64, 65......Objective To assess the failure rate of cemented, uncemented, hybrid, and reverse hybrid total hip replacements in patients aged 55 years or older. Design Register study. Setting Nordic Arthroplasty Register Association database (combined data from Sweden, Norway, Denmark, and Finland......-74, and 75 years or older. Results The proportion of total hip replacements using uncemented implants increased rapidly towards the end of the study period. The 10 year survival of cemented implants in patients aged 65 to 74 and 75 or older (93.8%, 95% confidence interval 93.6% to 94.0% and 95.9%, 95...

Can finite element models detect clinically inferior cemented hip implants?

NARCIS (Netherlands)

Stolk, J.; Maher, S.A.; Verdonschot, N.J.J.; Prendergast, P.J.; Huiskes, R.

2003-01-01

Rigorous preclinical testing of cemented hip prostheses against the damage accumulation failure scenario will reduce the incidence of aseptic loosening. For that purpose, a finite element simulation is proposed that predicts damage accumulation in the cement mantle and prosthetic migration. If the

Novel cemented cup-holding technique while performing total hip arthroplasty with navigation system

OpenAIRE

Hirokazu Takai, MD; Tomoki Takahashi, MD, PhD

2017-01-01

Recently, navigation systems have been more widely utilized in total hip arthroplasty. However, almost all of these systems have been developed for cementless cups. In the case of cemented total hip arthroplasty using a navigation system, a special-ordered cemented holder is needed. We propose a novel cemented cup-holding technique for navigation systems using readily available articles. We combine a cementless cup holder with an inverted cementless trial cup. The resulting apparatus is used ...

Novel cemented cup-holding technique while performing total hip arthroplasty with navigation system.

Science.gov (United States)

Takai, Hirokazu; Takahashi, Tomoki

2017-09-01

Recently, navigation systems have been more widely utilized in total hip arthroplasty. However, almost all of these systems have been developed for cementless cups. In the case of cemented total hip arthroplasty using a navigation system, a special-ordered cemented holder is needed. We propose a novel cemented cup-holding technique for navigation systems using readily available articles. We combine a cementless cup holder with an inverted cementless trial cup. The resulting apparatus is used as a cemented cup holder. The upside-down cup-holding technique is useful and permits cemented cup users to utilize a navigation system for placement of the acetabular component.

Novel cemented cup-holding technique while performing total hip arthroplasty with navigation system

Directory of Open Access Journals (Sweden)

Hirokazu Takai, MD

2017-09-01

Full Text Available Recently, navigation systems have been more widely utilized in total hip arthroplasty. However, almost all of these systems have been developed for cementless cups. In the case of cemented total hip arthroplasty using a navigation system, a special-ordered cemented holder is needed. We propose a novel cemented cup-holding technique for navigation systems using readily available articles. We combine a cementless cup holder with an inverted cementless trial cup. The resulting apparatus is used as a cemented cup holder. The upside-down cup-holding technique is useful and permits cemented cup users to utilize a navigation system for placement of the acetabular component.

EFFECTS OF DEXAMETHASONE AND PHENIRAMINE MALEATE ON HEMODYNAMIC AND RESPIRATORY PARAMETERS AFTER CEMENTATION IN CEMENTED PARTIAL HIP PROSTHESIS.

Science.gov (United States)

Yektaş, Abdulkadir; Gümüş, Funda; Totoz, Tolga; Gül, Nurten; Erkalp, Kerem; Alagöl, Ayşin

2015-02-01

To prevent hemodynamic and respiratory changes that are likely to occur during cementation in partial hip prosthesis by prophylactic use of pheniramine maleate and dexamethasone. The study included 40 patients aged between 60 and 85 years with an American Society ofAnesthesiologists (ASA) grade of II-III who underwent partial hip prosthesis. Just after spinal anesthesia, 4 mL normal saline was pushed in patients in Group S, whereas 45.5 mg pheniramine maleate and 8 mg dexamethasone mixture was pushed intravenously in a total volume of 4 mL in patients in Group PD. Amounts of atropine and adrenaline administered after cementation were significantly higher in Group S than in Group PD (P pheniramine maleate and dexamethasone in partial hip prosthesis led to an increase in SpO2 value and a decrease in the utilization of adrenaline and atropine after cementation.

The effect of endoskeleton on antibiotic impregnated cement spacer for treating deep hip infection

Directory of Open Access Journals (Sweden)

Hsu Wei-Hsiu

2011-01-01

Full Text Available Abstract Backgrounds A two-stage revision arthroplasty was suggested optimal treatment for deep infections in hip joint. The effect of endoskeleton of cement spacers on the interim function and infection control remains unclear. Methods From Jan. 2004 to Dec. 2007, we collected a prospective cohort of consecutive 34 patients who treated with two-stage revision total hip arthroplasty for deep infection of hip joint. In group 1, fifteen patients were treated by a novel design augmented with hip compression screw while nineteen patients were treated by traditional design in group 2. Results No fracture of cement spacer occurred in group 1 while 6 cases developed spacer failure in group 2. (p Conclusions Patients being treated for deep infection of hip joint using cement spacer augmented with stronger endoskeleton have lower pain levels and better joint function between stages.

21 CFR 888.3340 - Hip joint metal/composite semi-constrained cemented prosthesis.

Science.gov (United States)

2010-04-01

... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Hip joint metal/composite semi-constrained... Hip joint metal/composite semi-constrained cemented prosthesis. (a) Identification. A hip joint metal... hip joint. The device limits translation and rotation in one or more planes via the geometry of its...

21 CFR 888.3320 - Hip joint metal/metal semi-constrained, with a cemented acetabular component, prosthesis.

Science.gov (United States)

2010-04-01

... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Hip joint metal/metal semi-constrained, with a... Devices § 888.3320 Hip joint metal/metal semi-constrained, with a cemented acetabular component, prosthesis. (a) Identification. A hip joint metal/metal semi-constrained, with a cemented acetabular...

Debridement, antibiotics, irrigation, and retention (DAIR) of the prosthesis after hip hemiarthroplasty infections. Does it work?

Science.gov (United States)

Kazimoglu, Cemal; Yalcin, Nadir; Onvural, Burak; Akcay, Serkan; Agus, Haluk

2015-08-01

Debridement, antibiotic, and implant retention (DAIR) is an attractive treatment modality after hip hemiarthroplasty (HA) infections. Data about the success of the procedure after acute onset infections is lacking. The aim of this study was to analyze the clinical outcome and associated risk factors. A multicenter, retrospective cohort study was designed, including 39 patients with acute onset prosthetic infection who had undergone debridement and irrigation with prosthesis retention. The primary outcome measure was infection eradication without prosthesis removal. We also analyzed how the success rate was influenced by the length of the interval between implantation of the prosthesis and the beginning of the treatment. The overall success rate was 41%. Sedimentation rate over 60 mm/h and the longer duration (2 weeks) after prosthesis implantation were found as factors negatively influencing the success rate. Our results indicated limited success to DAIR- treated patients with infected HA. The high failure rate of DAIR treatment after 2 weeks from the implantation should be taken into consideration.

Impact of implant size on cement filling in hip resurfacing arthroplasty.

Science.gov (United States)

de Haan, Roel; Buls, Nico; Scheerlinck, Thierry

2014-01-01

Larger proportions of cement within femoral resurfacing implants might result in thermal bone necrosis. We postulate that smaller components are filled with proportionally more cement, causing an elevated failure rate. A total of 19 femoral heads were fitted with polymeric replicas of ReCap (Biomet) resurfacing components fixed with low-viscosity cement. Two specimens were used for each even size between 40 and 56 mm and one for size 58 mm. All specimens were imaged with computed tomography, and the cement thickness and bone density were analyzed. The average cement mantle thickness was 2.63 mm and was not correlated with the implant size. However, specimen with low bone density had thicker cement mantles regardless of size. The average filling index was 36.65% and was correlated to both implant size and bone density. Smaller implants and specimens with lower bone density contained proportionally more cement than larger implants. According to a linear regression model, bone density but not implant size influenced cement thickness. However, both implant size and bone density had a significant impact on the filling index. Large proportions of cement within the resurfacing head have the potential to generate thermal bone necrosis and implant failure. When considering hip resurfacing in patients with a small femoral head and/or osteoporotic bone, extra care should be taken to avoid thermal bone necrosis, and alternative cementing techniques or even cementless implants should be considered. This study should help delimiting the indications for hip resurfacing and to choose an optimal cementing technique taking implant size into account.

Imaging of hip arthroplasty

Energy Technology Data Exchange (ETDEWEB)

Miller, Theodore T., E-mail: millertt@hss.edu [Department of Radiology and Imaging, Hospital for Special Surgery, 535 E. 70th Street, New York, NY 10021 (United States)

2012-12-15

The imaging evaluation of the prosthetic hip begins with radiography, but arthrography, aspiration, scintigraphy, sonography, CT and MR imaging all have roles in the evaluation of the painful prosthesis. This article will review the appearance of normal hip arthroplasty including hemiarthroplasty, total arthroplasty, and hip resurfacing, as well as the appearances of potential complications such as aseptic loosening and osteolysis, dislocation, infection, periprosthetic fracture, hardware failure, and soft tissue abnormalities.

Total Hip Arthroplasty Using a Polished Tapered Cemented Stem in Hereditary Multiple Exostosis

Science.gov (United States)

Kanda, Akio; Kaneko, Kazuo; Obayashi, Osamu; Mogami, Atsuhiko

2016-01-01

A 61-year-old Japanese man underwent right total hip arthroplasty for hereditary multiple exostosis. At first presentation, he had suffered from coxalgia for a long time. On radiographic images, there was a gigantic femoral head, increased shaft angle, and large diameter of the femoral neck. He had also developed coxarthrosis and severe pain of the hip joint. The transformation of the proximal femur bone causes difficulty in setting a cementless total hip prosthesis. Therefore, total hip arthroplasty using a cemented polished tapered stem was performed via a direct lateral approach. Using a cemented polished tapered stem allowed us to deal with the femoral bone transformation and bone substance defectiveness due to exostosis and also minimized the invasiveness of the operation. PMID:27127668

Probabilistic analysis of the influence of the bonding degree of the stem-cement interface in the performance of cemented hip prostheses.

Science.gov (United States)

Pérez, M A; Grasa, J; García-Aznar, J M; Bea, J A; Doblaré, M

2006-01-01

The long-term behavior of the stem-cement interface is one of the most frequent topics of discussion in the design of cemented total hip replacements, especially with regards to the process of damage accumulation in the cement layer. This effect is analyzed here comparing two different situations of the interface: completely bonded and debonded with friction. This comparative analysis is performed using a probabilistic computational approach that considers the variability and uncertainty of determinant factors that directly compromise the damage accumulation in the cement mantle. This stochastic technique is based on the combination of probabilistic finite elements (PFEM) and a cumulative damage approach known as B-model. Three random variables were considered: muscle and joint contact forces at the hip (both for walking and stair climbing), cement damage and fatigue properties of the cement. The results predicted that the regions with higher failure probability in the bulk cement are completely different depending on the stem-cement interface characteristics. In a bonded interface, critical sites appeared at the distal and medial parts of the cement, while for debonded interfaces, the critical regions were found distally and proximally. In bonded interfaces, the failure probability was higher than in debonded ones. The same conclusion may be established for stair climbing in comparison with walking activity.

Stair climbing is more detrimental to the cement in hip replacement than walking

NARCIS (Netherlands)

Stolk, J.; Verdonschot, N.J.J.; Huiskes, H.W.J.

2002-01-01

Stair climbing may be detrimental to cemented total hip arthroplasties, because it subjects the reconstruction to high torsional loads. The current study investigated how stair climbing contributes to damage accumulation in the cement around a femoral stem compared with walking, taking into account

Does femoral offset recover and affect the functional outcome of patients with displaced femoral neck fracture following hemiarthroplasty?

Science.gov (United States)

Ji, Hyung-Min; Won, Seok-Hyung; Han, Jun; Won, Ye-Yeon

2017-06-01

Restoring preoperative horizontal femoral offset (FO) promised good functional outcome in patients receiving total hip arthroplasty. However, relatively little was known regarding the clinical relevance of restoring the offset in patients with bipolar hemiarthroplasty to treat displaced femoral neck fracture. Therefore, the objective of this study was to evaluate postoperative FO accurately and verify its relation with functional outcome. One hundred elderly patients who received bipolar hemiarthroplasty to treat displaced femoral neck fracture were identified. Preoperative CT scanning of contralateral hip joint and reconstruction of images led to rotation-free FO. By referencing postoperative implant specification and comparing to measured values in Picture Archive and Communication System, rotation-free postoperative FO and the amount of change were acquired. Postoperative Harris Hip Score (HHS) and Modified Barthel Index (MBI) were evaluated to measure functional outcome at 12-month after the surgery. Patients with significant FO change were identified. Multiple regression analysis was conducted to determine if the FO change might independently affect the outcome regardless of confounding factors. The mean preoperative offset was 37.4±2.5 increased by 12.7±9.6% after the surgery. Only 25.0% of postoperative offset after hemiarthroplasty was changed within ±5% of preoperative offset. A total of 45.0% of postoperative offset changed within ±10% while 77.0% of postoperative offset changed within ±20%. 23% of patients whose FO changed more than 20% showed significantly worse outcome score than the patients whose FO change remained within ±20% of initial value. Mean MBI and HHS were negatively correlated with FO change. After adjusting for confounding factors, significant correlation remained between modification of FO and MBI, but not between FO change and HHS (B=4.576; β=0.235; 95% confidence interval of B: 0.534 to 8.135). FO was not properly restored in 23

The effect of cement on hip stem fixation: a biomechanical study.

Science.gov (United States)

Çelik, Talip; Mutlu, İbrahim; Özkan, Arif; Kişioğlu, Yasin

2017-06-01

This study presents the numerical analysis of stem fixation in hip surgery using with/without cement methods since the use of cement is still controversial based on the clinical studies in the literature. Many different factors such as stress shielding, aseptic loosening, material properties of the stem, surgeon experiences etc. play an important role in the failure of the stem fixations. The stem fixation methods, cemented and uncemented, were evaluated in terms of mechanical failure aspects using computerized finite element method. For the modeling processes, three dimensional (3D) femur model was generated from computerized tomography (CT) images taken from a patient using the MIMICS Software. The design of the stem was also generated as 3D CAD model using the design parameters taken from the manufacturer catalogue. These 3D CAD models were generated and combined with/without cement considering the surgical procedure using SolidWorks program and then imported into ANSYS Workbench Software. Two different material properties, CoCrMo and Ti6Al4V, for the stem model and Poly Methyl Methacrylate (PMMA) for the cement were assigned. The material properties of the femur were described according to a density calculated from the CT images. Body weight and muscle forces were applied on the femur and the distal femur was fixed for the boundary conditions. The calculations of the stress distributions of the models including cement and relative movements of the contacts examined to evaluate the effects of the cement and different stem material usage on the failure of stem fixation. According to the results, the use of cement for the stem fixation reduces the stress shielding but increases the aseptic loosening depending on the cement crack formations. Additionally, using the stiffer material for the stem reduces the cement stress but increases the stress shielding. Based on the results obtained in the study, even when taking the disadvantages into account, the cement usage

21 CFR 888.3410 - Hip joint metal/polymer or ceramic/polymer semiconstrained resurfacing cemented prosthesis.

Science.gov (United States)

2010-04-01

... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Hip joint metal/polymer or ceramic/polymer... Devices § 888.3410 Hip joint metal/polymer or ceramic/polymer semiconstrained resurfacing cemented prosthesis. (a) Identification. A hip joint metal/polymer or ceramic/polymer semi-constrained resurfacing...

Wiring Techniques for the Fixation of Trochanteric Fragments during Bipolar Hemiarthroplasty for Femoral Intertrochanteric Fracture: Clinical Study and Technical Note.

Science.gov (United States)

Lee, Joong-Myung; Cho, Yongsuk; Kim, Junhyun; Kim, Dong-Won

2017-03-01

Femoral intertrochanteric fractures are common in the elderly. Appropriate surgical fixation of trochanteric fracture fragments can restore normal anatomical structure and ambulation, and can aid in the recovery of biomechanical function of the hip. We evaluated clinical outcomes of bipolar hemiarthroplasty using a wiring technique for trochanteric fracture fragment fixation. From September 2006 to February 2015, a total of 260 cases underwent simultaneous bipolar hemiarthroplasty and wire fixation. A total of 65 patients (69 hips) with an average age of 78 years and more than one year of follow-up was included in the study. Using pre-, postoperative and follow-up radiograms, we evaluated wire fixation failure and also assessed changes in walking ability. Loosening or osteolysis around the stem was not observed; however, we did observe bone growth around the stem (54 cases), cortical hypertrophy (6 cases), a wide range of sclerotic lines but no stem subsidence (1 case), wire breakage (9 cases), and fracture fragment migration with no significant functional deficiency (2 cases). Our study showed that additional wiring for trochanteric fracture fragment fixation following bipolar hemiarthroplasty can help restore normal anatomy. The added stability results in faster rehabilitation, and good clinical and radiographic outcomes. We recommend this procedure in this type of fracture.

Comparison of outcomes following uncemented hemiarthroplasty and dynamic hip screw in the treatment of displaced subcapital hip fractures in patients aged greater than 70 years.

LENUS (Irish Health Repository)

El-Abed, Kaldoun

2012-02-03

As health care costs increase, evaluating treatment methods in femoral neck fractures to determine the most effective treatment paradigm will become increasingly important. The current study compared two methods of treatment in similar cohorts of displaced femoral neck fractures. One hundred and twenty two patients were randomly assigned to two groups: In Group A, 62 patients were treated with a hemiarthroplasty. In group B, 60 patients were treated with dynamic screw fixation. Patients were evaluated at a minimum 3 year follow-up. Using the Matta functional hip score, 42% of group A and 70% of group B had good to excellent results. This difference was significant (p = 0.004). A significant agreement between physician assessment using the Matta score, and patient perception of outcome using the SF-36 scale was demonstrated (r = 0.64). No statistical difference between groups for revision surgery existed. Both physician based and patient based outcome scores favour retention and internal fixation of the femoral head in this cohort of patients at a short-term follow-up.

Cemented total hip replacement cable debris and acetabular construct durability.

Science.gov (United States)

Altenburg, Aaron J; Callaghan, John J; Yehyawi, Tameem M; Pedersen, Douglas R; Liu, Steve S; Leinen, Jessica A; Dahl, Kevin A; Goetz, Devon D; Brown, Thomas D; Johnston, Richard C

2009-07-01

Third-body wear can adversely affect the outcome of total hip arthroplasty by causing increased polyethylene wear, osteolysis, and component loosening. We hypothesized that there would be greater generation and migration of metal debris to the bearing surfaces in hips in which cobalt-chromium cables were used to reattach the osteotomized greater trochanter when compared with hips in which stainless steel wires were used. Between June 1981 and December 1983, 196 consecutive total hip arthroplasties were performed with use of an Iowa stem and a titanium-backed cemented acetabular component, with cobalt-chromium cable trochanteric reattachment. After nineteen to twenty years of follow-up, the patients were evaluated with regard to the depth of head penetration into the polyethylene (as a surrogate for wear), osteolysis, loosening, and the need for revision. The results were compared with those for a series of 304 total hip arthroplasties that were performed by the same surgeon from January 1984 to December 1985 with use of the same components and the same surgical technique, but with stainless steel wire trochanteric reattachment. The two groups had a comparable nineteen to twenty-year follow-up. All living patients (fifty-nine hips in the cable group and ninety-two hips in the wire group) had minimum ten-year follow-up radiographs. The polyethylene wear rate was 0.101 mm/yr for the cable group and 0.082 mm/yr for the wire group (p = 0.039). For the living patients, the rate of revision of the acetabular component because of aseptic loosening was 37.3% (twenty-two hips) for the cable group and 20.7% (nineteen hips) for the wire group (p = 0.025). The rate of acetabular osteolysis was 44% (twenty-six hips) for the cable group and 26% (twenty-four hips) for the wire group (p = 0.022). Kaplan-Meier analysis with revision of the acetabular component because of aseptic loosening as the end point demonstrated survival rates of 73.7% +/- 9% and 83% +/- 7% for the cable and

Influence of bone density on the cement fixation of femoral hip resurfacing components.

Science.gov (United States)

Bitsch, Rudi G; Jäger, Sebastian; Lürssen, Marcus; Loidolt, Travis; Schmalzried, Thomas P; Clarius, Michael

2010-08-01

In clinical outcome studies, small component sizes, female gender, femoral shape, focal bone defects, bad bone quality, and biomechanics have been associated with failures of resurfacing arthroplasties. We used a well-established experimental setup and human bone specimens to analyze the effects of bone density on cement fixation of femoral hip resurfacing components. Thirty-one fresh frozen femora were prepared for resurfacing using the original instruments. ASR resurfacing prostheses were implanted after dual-energy X-ray densitometer scans. Real-time measurements of pressure and temperature during implantation, analyses of cement penetration, and measurements of micro motions under torque application were performed. The associations of bone density and measurement data were examined calculating regression lines and multiple correlation coefficients; acceptability was tested with ANOVA. We found significant relations between bone density and micro motion, cement penetration, cement mantle thickness, cement pressure, and interface temperature. Mean bone density of the femora was 0.82 +/- 0.13 g/cm(2), t-score was -0.7 +/- 1.0, and mean micro motion between bone and femoral resurfacing component was 17.5 +/- 9.1 microm/Nm. The regression line between bone density and micro motion was equal to -56.7 x bone density + 63.8, R = 0.815 (p density scans are most helpful for patient selection in hip resurfacing, and a better bone quality leads to higher initial component stability. A sophisticated cementing technique is recommended to avoid vigorous impaction and incomplete seating, since increasing bone density also results in higher cement pressures, lower cement penetration, lower interface temperatures, and thicker cement mantles. Copyright 2010 Orthopaedic Research Society. Published by Wiley Periodicals, Inc.

Outcomes of osteoporotic trochanteric fractures treated with cement-augmented dynamic hip screw

Science.gov (United States)

Gupta, Rakesh Kumar; Gupta, Vinay; Gupta, Navdeep

2012-01-01

Background: Dynamic hip screw (DHS) has been the standard treatment for stable trochanteric fracture patterns, but complications of lag screw cut out from a superior aspect, due to inadequate bone anchorage, occur frequently in elderly osteoporotic patients. Polymethylmethacrylate (PMMA) has been used as an augmentation tool to facilitate fixation stability in cadaveric femora for biomechanical studies and in pathological fractures. However, there are very few reports on the utilization of PMMA cement to prevent these complications in fresh intertrochanteric fractures. A prospective study was conducted to evaluate the outcome and efficacy of PMMA augmented DHS in elderly osteoporotic patients with intertrochanteric fractures. Materials and Methods: The study included 64 patients (AO type31-A2.1 in eight, A2.2 in 29, A2.3 in 17 patients, and 31-A3.1 in five, A3.2 in three, and A3.3 in two patients) with an average age of 72 years (60 – 94 years) of which 60 were available for final followup. PMMA augmentation of DHS was performed in all cases by injecting PMMA cement into the femoral head with a custommade gun designed by the authors. The clinical outcome was rated as per the Salvati and Wilson scoring system at the time of final followup of one year. Results were graded as excellent (score > 31), good (score 24 – 31), fair (score 16 – 23), and poor (score < 16). Results: Fracture united in all patients and the average time to union was 13.8 weeks (range 12 – 16 weeks). At an average followup of 18 months (range 12 – 24 months), no incidence of varus collapse or superior screw cut out was observed in any of the patients in spite of weightbearing ambulation from the early postoperative period. There was no incidence of avascular necrosis (AVN) or cement penetration into the joint in our series. Most of the patients were able to regain their prefracture mobility status with a mean hip pain score of 8.6. Conclusion: Cement augmentation of DHS appears to be an

Outcomes of osteoporotic trochanteric fractures treated with cement-augmented dynamic hip screw

Directory of Open Access Journals (Sweden)

Rakesh Kumar Gupta

2012-01-01

Full Text Available Background: Dynamic hip screw (DHS has been the standard treatment for stable trochanteric fracture patterns, but complications of lag screw cut out from a superior aspect, due to inadequate bone anchorage, occur frequently in elderly osteoporotic patients. Polymethylmethacrylate (PMMA has been used as an augmentation tool to facilitate fixation stability in cadaveric femora for biomechanical studies and in pathological fractures. However, there are very few reports on the utilization of PMMA cement to prevent these complications in fresh intertrochanteric fractures. A prospective study was conducted to evaluate the outcome and efficacy of PMMA augmented DHS in elderly osteoporotic patients with intertrochanteric fractures. Materials and Methods: The study included 64 patients (AO type31-A2.1 in eight, A2.2 in 29, A2.3 in 17 patients, and 31-A3.1 in five, A3.2 in three, and A3.3 in two patients with an average age of 72 years (60 − 94 years of which 60 were available for final followup. PMMA augmentation of DHS was performed in all cases by injecting PMMA cement into the femoral head with a custommade gun designed by the authors. The clinical outcome was rated as per the Salvati and Wilson scoring system at the time of final followup of one year. Results were graded as excellent (score > 31, good (score 24 − 31, fair (score 16 − 23, and poor (score < 16. Results: Fracture united in all patients and the average time to union was 13.8 weeks (range 12 − 16 weeks. At an average followup of 18 months (range 12 − 24 months, no incidence of varus collapse or superior screw cut out was observed in any of the patients in spite of weightbearing ambulation from the early postoperative period. There was no incidence of avascular necrosis (AVN or cement penetration into the joint in our series. Most of the patients were able to regain their prefracture mobility status with a mean hip pain score of 8.6. Conclusion: Cement augmentation of DHS appears

Percutaneous bone cement refixation of aseptically loose hip prostheses: the effect of interface tissue removal on injected cement volumes

Energy Technology Data Exchange (ETDEWEB)

Malan, Daniel F. [Leiden University Medical Center, Department of Orthopaedics, Leiden (Netherlands); Delft University of Technology, Department of Intelligent Systems, Delft (Netherlands); Valstar, Edward R. [Leiden University Medical Center, Department of Orthopaedics, Leiden (Netherlands); Delft University of Technology, Department of Biomechanical Engineering, Delft (Netherlands); Nelissen, Rob G.H.H. [Leiden University Medical Center, Department of Orthopaedics, Leiden (Netherlands)

2014-11-15

To quantify whether injected cement volumes differed between two groups of patients who underwent experimental minimally invasive percutaneous cement injection procedures to stabilize aseptically loose hip prostheses. One patient group was preoperatively treated using gene-directed enzyme prodrug therapy to remove fibrous interface tissue, while the other group received no preoperative treatment. It was hypothesized that cement penetration may have been inhibited by the presence of fibrous interface tissue in periprosthetic lesions. We analyzed 17 patients (14 female, 3 male, ages 72-91, ASA categories 2-4) who were treated at our institution. Osteolytic lesions and injected cement were manually delineated using 3D CT image segmentation, and the deposition of injected cement was quantified. Patients who underwent preoperative gene-directed enzyme therapy to remove fibrous tissue exhibited larger injected cement volumes than those who did not. The observed median increase in injected cement volume was 6.8 ml. Higher cement leakage volumes were also observed for this group. We conclude that prior removal of periprosthetic fibrous interface tissue may enable better cement flow and penetration. This might lead to better refixation of aseptically loosened prostheses. (orig.)

Perioperative mortality in hip fracture patients treated with cemented and uncemented hemiprosthesis: a register study of 11,210 patients.

Science.gov (United States)

Talsnes, Ove; Vinje, Tarjei; Gjertsen, Jan Erik; Dahl, Ola E; Engesæter, Lars B; Baste, Valborg; Pripp, Are Hugo; Reikerås, Olav

2013-06-01

Adverse events associated with the use of bone cement for fixation of prostheses is a known complication. Due to inconclusive results in studies of hip fracture patients treated with cemented and uncemented hemiprostheses, this study was initiated. Our study is based on data reported to the Norwegian Hip Fracture Register on 11,210 cervical hip fractures treated with hemiprostheses (8,674 cemented and 2,536 uncemented). Significantly increased mortality within the first day of surgery was found in the cemented group (relative risk 2.9, 95 % confidence interval 1.6-5.1, p=0.001). The finding was robust giving the same results after adjusting for independent risk factors such as age, sex, cognitive impairment and comorbidity [American Society of Anesthesiologists (ASA) score]. For the first post-operative day the number needed to harm was 116 (one death for every 116 cemented prosthesis). However, in the most comorbid group (ASA worse than 3), the number needed to harm was only 33. We found increased mortality for the cemented hemiprosthesis the first post-operative day compared to uncemented procedures. This increased risk is closely related to patient comorbidity estimated by the patient's ASA score.

Particulate metallic debris in cemented total hip arthroplasty.

Science.gov (United States)

Salvati, E A; Betts, F; Doty, S B

1993-08-01

Several studies conducted by the authors in the last six years demonstrate that the generation of metallic debris is more severe with titanium alloy than with cobalt-chrome alloy femoral components in cemented total hip arthroplasty (THA). The debris is generated from the articulating surface, particularly if entrapped acrylic debris produces three-body wear, and from the stem surface when the component loosens and abrades against fragmented cement. In selected cases in which the titanium metallic debris is copious, premature failure and severe progressive bone loss occurs. Electron microscopy demonstrates that the particles of metallic debris can be extremely small (a few hundredths of 1 micron). They are phagocytized by the macrophages and transported to the phagolysosomes. In this highly corrosive environment, the very high surface area of the particles may release toxic concentrations of the constituents of the alloy intracellularly, probably leading to progressive cell degeneration and death, with subsequent release of intracellular enzymes and ingested metallic debris. This cycle most likely repeats itself, leading to tissue necrosis. The results presented do not support the use of titanium alloy femoral components for cemented THA, particularly for the articulating surface.

Implant survival of the most common cemented total hip devices from the Nordic Arthroplasty Register Association database

DEFF Research Database (Denmark)

Junnila, Mika; Laaksonen, Inari; Eskelinen, Antti

2016-01-01

Background and purpose - According to previous Nordic Arthroplasty Register Association (NARA) data, the 10-year implant survival of cemented total hip arthroplasties (THAs) is 94% in patients aged 65-74 and 96% in patients aged 75 or more. Here we report a brand-level comparison of cemented THA...

Calcar femorale grafting in the hemiarthroplasty of the hip for unstable inter trochanteric fractures.

Science.gov (United States)

Thakkar, Chandrashekar J; Thakkar, Savyasachi; Kathalgere, Rajshekhar T; Kumar, Malhar N

2015-01-01

The sliding screw-plate devices and cephalo-medullary nail devices have performed well in stable inter-trochanteric fractures in patients with reasonably good quality of bone. However, their suboptimal performance in comminuted fractures in the presence of osteoporotic bone has prompted many surgeons to consider bipolar hemiarthroplasty as the primary modality of management of comminuted inter-trochanteric fractures in elderly patients. However, long term stability of the hemiarthroplasty implant also may be compromised due to the presence of postero-medial bone loss at the area of the calcar. We have presented a simple and effective technique of calcar grafting by harvesting cortical bone strut from the neck of the fractured femur. A total of 34 patients with inter-trochanteric fractures of the femur were treated with calcar grafting. The mean age was 79.2 years. The graft was harvested from the calcar region of the head and neck fragment of the femur and wedged between the medial femoral cortex and medial edge of the prosthesis. The mean followup period was 54.5 months. In 32 of 34 (94%) patients in our series, the calcar graft healed well without dislodgement. There was graft resorption in two patients associated with subsidence of the implant and loosening. Calcar grafting using this technique provides stability to the implant in the presence of comminution and incorporates well in the majority of patients. Donor site morbidity of graft harvesting is also avoided.

Pre-clinical evaluation of the mechanical properties of a low-stiffness cement-injectable hip stem.

Science.gov (United States)

Eldesouky, Ibrahim; Harrysson, Ola; Marcellin-Little, Denis J; West, Harvey; El-Hofy, Hassan

2017-11-01

In total hip arthroplasty (THA), the femoral stem can be fixed with or without bone cement. Cementless stem fixation is recommended for young and active patients as it eliminates the risk of loss of fixation at the bone-cement and cement-implant interfaces. Cementless fixation, however, suffers from a relatively high early revision rate. In the current research, a novel low-stiffness hip stem was designed, fabricated and tested. The stem design provided the option to inject biodegradable bone cement that could enhance initial stem stability. The stem was made of Ti6Al4V alloy. The proximal portion of the stem was porous, with cubic cells. The stem was fabricated using electron beam melting (EBM) technology and tested in compression and bending. Finite-element analysis was used to evaluate stem performance under a dynamic load representing a stair descending cycle and compare it to the performance of a solid stem with similar geometry. The von Mises stresses and maximum principal strains generated within the bone increased after porous stem insertion compared to solid stem insertion. The low-modulus stem tested in this study has acceptable mechanical properties and generates strain patterns in bone that appear compatible with clinical use.

Posterior Hip Dislocation with Ipsilateral Femoral Neck Fracture ...

African Journals Online (AJOL)

He was managed by bipolar hemiarthroplasty as opposed to total hip athroplasty due to financial constrains. This case highlights the challenge of ... of the knee revealed a communited fracture of the pa- tella at the inferior pole (Fig. 2 2). ... Our case was managed by prosthetic replacement of the proximal femur. This was ...

Cement-in-cement acetabular revision with a constrained tripolar component.

Science.gov (United States)

Leonidou, Andreas; Pagkalos, Joseph; Luscombe, Jonathan

2012-02-17

Dislocation of a total hip replacement (THR) is common following total hip arthroplasty (THA). When nonoperative management fails to maintain reduction, revision surgery is considered. The use of constrained acetabular liners has been extensively described. Complete removal of the old cement mantle during revision THA can be challenging and is associated with significant complications. Cement-in-cement revision is an established technique. However, the available clinical and experimental studies focus on femoral stem revision. The purpose of this study was to present a case of cement-in-cement acetabular revision with a constrained component for recurrent dislocations and to investigate the current best evidence for this technique. This article describes the case of a 74-year-old woman who underwent revision of a Charnley THR for recurrent low-energy dislocations. A tripolar constrained acetabular component was cemented over the primary cement mantle following removal of the original liner by reaming, roughening the surface, and thoroughly irrigating and drying the primary cement. Clinical and radiological results were good, with the Oxford Hip Score improving from 11 preoperatively to 24 at 6 months postoperatively. The good short-term results of this case and the current clinical and biomechanical data encourage the use of the cement-in-cement technique for acetabular revision. Careful irrigation, drying, and roughening of the primary surface are necessary. Copyright 2012, SLACK Incorporated.

Static coefficient of friction between stainless steel and PMMA used in cemented hip and knee implants.

Science.gov (United States)

Nuño, N; Groppetti, R; Senin, N

2006-11-01

Design of cemented hip and knee implants, oriented to improve the longevity of artificial joints, is largely based on numerical models. The static coefficient of friction between the implant and the bone cement is necessary to characterize the interface conditions in these models and must be accurately provided. The measurement of this coefficient using a repeatable and reproducible methodology for materials used in total hip arthroplasty is missing from the literature. A micro-topographic surface analysis characterized the surfaces of the specimens used in the experiments. The coefficient of friction between stainless steel and bone cement in dry and wet conditions using bovine serum was determined using a prototype computerized sliding friction tester. The effects of surface roughness (polished versus matt) and of contact pressure on the coefficient of friction have also been investigated. The serum influences little the coefficient of friction for the matt steel surface, where the mechanical interactions due to higher roughness are still the most relevant factor. However, for polished steel surfaces, the restraining effect of proteins plays a very relevant role in increasing the coefficient of friction. When the coefficient of friction is used in finite element analysis, it is used for the debonded stem-cement situation. It can thus be assumed that serum will propagate between the stem and the cement mantle. The authors believe that the use of a static coefficient of friction of 0.3-0.4, measured in the present study, is appropriate in finite element models.

The long-term in vivo behavior of polymethyl methacrylate bone cement in total hip arthroplasty.

Science.gov (United States)

Oonishi, Hiroyuki; Akiyama, Haruhiko; Takemoto, Mitsuru; Kawai, Toshiyuki; Yamamoto, Koji; Yamamuro, Takao; Oonishi, Hironobu; Nakamura, Takashi

2011-10-01

The long-term success of cemented total hip arthroplasty (THA) has been well established. Improved outcomes, both radiographically and clinically, have resulted mainly from advances in stem design and improvements in operating techniques. However, there is concern about the durability of bone cement in vivo. We evaluated the physical and chemical properties of CMW1 bone cements retrieved from patients undergoing revision THA. CMW1 cements were retrieved from 14 patients who underwent acetabular revision because of aseptic loosening. The time in vivo before revision was 7-30 years. The bending properties of the retrieved bone cement were assessed using the three-point bending method. The molecular weight and chemical structure were analyzed by gel permeation chromatography and Fourier-transform infrared spectroscopy. The porosity of the bone cements was evaluated by 3-D microcomputer tomography. The bending strength decreased with increasing time in vivo and depended on the density of the bone cement, which we assume to be determined by the porosity. There was no correlation between molecular weight and time in vivo. The infrared spectra were similar in the retrieved cements and in the control CMW1 cements. Our results indicate that polymer chain scission and significant hydrolysis do not occur in CMW1 cement after implantation in vivo, even in the long term. CMW1 cement was stable through long-term implantation and functional loading.

Cement augmentation in the proximal femur to prevent stem subsidence in revision hip arthroplasty with Paprosky type II/IIIa defects

Directory of Open Access Journals (Sweden)

Shang-Wen Tsai

2018-06-01

Full Text Available Background: Subsidence remains a common complication after revision hip arthroplasty which may lead to prolonged weight-bearing restrictions, leg-length discrepancies or considerable loss of function. We evaluated the effectiveness of cement augmentation in the proximal femoral metaphysis during a revision of femoral components to prevent post-operative stem subsidence. Methods: Forty patients were enrolled. Follow-up averaged 67.7 months (range: 24–149. Twenty-seven patients had a Paprosky type II defect and 13 had a type IIIa defect. All revision hip arthroplasty used a cementless, cylindrical, non-modular cobalt–chromium stem. The defect in the metaphysis was filled with antibiotic-loaded bone cement. Thirteen patients who had undergone stem revision only was allowed to walk immediately without weight-bearing restrictions. Twenty-seven patients who had undergone revision total hip arthroplasty was allowed partial weight-bearing within 6 weeks after surgery in the consideration of acetabular reconstruction. Results: Three patients (7.5% had post-surgery stem subsidences of three mm, five mm, and 10 mm, respectively, at three, one, and 14 months. There were no acute surgical site infections. There were three femoral stem failures: two delayed infections and one periprosthetic Vancouver B2 fracture. Both five- and 10-year survivorships of the femoral implant were 90.1%. Conclusion: An adequate length of the scratch-fit segment and diaphyseal ingrowth remain of paramount importance when revising femoral components. To fill metaphyseal bone defects with antibiotic-loaded bone cement may be an alternative method in dealing with proximal femoral bone loss during a femoral revision. Keywords: Bone defect, Cement augmentation, Femur, Revision hip arthroplasty, Subsidence

Does cement mantle thickness really matter?

OpenAIRE

Caruana, J.

2008-01-01

The thickness of the cement mantle around the femoral component of total hip replacements is a contributing factor to aseptic loosening and revision. Nevertheless, various designs of stems and surgical tooling lead to cement mantles of differing thicknesses. This thesis is concerned with variability in cement thickness around the Stanmore Hip, due to surgical approach, broach size and stem orientation, and its effects on stress and cracking in the cement. The extent to which cement mantle thi...

[Stress analysis on the acetabular side of bipolar hemiarthroplasty by the two-dimensional finite element method incorporating the boundary friction layer].

Science.gov (United States)

Ichihashi, K; Imura, S; Oomori, H; Gesso, H

1994-11-01

We compared the biomechanical characteristics of bipolar and unipolar hemiarthroplasty on the proximal migration of the outer head by determining the von Mises stress distribution and acetabular (outer head) displacement with clinical assessment of hemiarthroplasty in 75 patients. This analysis used the two-dimensional finite element method, which incorporated boundary friction layers on both the inner and outer bearings of the prosthesis. Acetabular reaming increased stress within the pelvic bone and migration of the outer head. A combination of the acetabular reaming and bone transplantation increased the stress within the pelvic bone and grafted bone, and caused outer head migration. These findings were supported by clinical results. Although the bipolar endoprosthesis was biomechanically superior to the unipolar endoprosthesis, migration of the outer head still occurred. The bipolar endoprosthesis appeared to be indicated in cases of a femoral neck fracture or of avascular necrosis in the femoral head, but its use in cases of osteoarthritis in the hip required caution.

[Non-cemented self-locking total arthroplasty of the hip. Clinical and radiological results after three years].

Science.gov (United States)

Desjardins, A L; Roy, A; Duchesne, R; Béliveau, P; Fallaha, M; Bornais, S

1993-01-01

We reviewed 47 patients who had fifty-one (51) primary, cementless biofit total hip arthroplasties (THA) implanted at Maisonneuve-Rosemont Hospital between 1986 and 1990. An independent observer rated the patients on the Harris Hip Score (HHS) by questionnaire, physical examination and radiological assessment. The average follow-up was 40 months. Twenty-two percent (22%) of the femoral components had been revised because of incapacitating pain, limping or a HHS inferior to 60. A little more than 20% of the unrevised prostheses had a mediocre result (HHS inferior to 70). There was no correlation between results and radiological signs of instability. The femoral component of the hip arthroplasty has a poor clinical performance which compares unfavourably with cemented prostheses.

Incidence of perioperative complications in total hip and knee arthroplasty in patients with Parkinson disease.

Science.gov (United States)

Sharma, Tankamani; Hönle, Wolfgang; Handschu, René; Adler, Werner; Goyal, Tarun; Schuh, Alexander

2018-06-01

The aim of this study is to evaluate the difference in perioperative complication rate in total hip, bipolar hemiarthroplasties and total knee arthroplasty in patients with Parkinson disease in trauma and elective surgery in our Musculoskeletal Center during a period of 10 years. Between 2006 and 2016, 45 bipolar hemiarthroplasties in trauma surgery, 15 total knee and 19 total hip arthroplasties in patients with Parkinson's disease were performed. We divided the patients in two groups. Group I included trauma cases (45) and group II elective surgery cases (34). Complications were documented and divided into local minor and major complications and general minor and major complications. Fisher's exact test was used for statistical evaluation. In both groups, there was one local major complication (p > 0.05): In group I, there was one case of loosening of a K-wire which was removed operatively. In group II, there was one severe intraarticular bleeding requiring puncture of the hematoma. In group I, there were 38 general complications; in group II, there were 17 general complications. There was no statistical difference in complication rate (p > 0.05). Total hip arthroplasty, bipolar hemiarthroplasties and knee arthroplasty in patients with Parkinson disease is possible in elective and trauma surgery. Complication rate is higher in comparison with patients not suffering from Parkinson disease, but there is no difference in complication rate in elective and trauma surgery. Nevertheless, early perioperative neurological consultation in patients with Parkinson disease is recommended to minimize complications and improve early outcomes after arthroplasty.

Effects of Prosthesis Stem Tapers on Stress Distribution of Cemented Hip Arthroplasty

International Nuclear Information System (INIS)

Abdullah, Abdul Halim; Nor, Mohd Asri Mohd; Saman, Alias Mohd; Tamin, Mohd Nasir; Kadir, Mohammed Rafiq Abdul

2010-01-01

Aseptic loosening effects are critical issues in encouraging long term stability of cemented hip arthroplasty. Stress shielding is believed to be an important factor that contributes to the aseptic loosening problems. The numerous changes in the prosthesis stem design are intended to minimize the stress shielding and aseptic loosening problems and to improve the long term performance of the implants. In this study, the stress distribution in cemented hip arthroplasty is established using finite element method. The taper of the prosthesis is designed to be 3 deg. at anterior/posterior, 3 deg. at medial/lateral and 10 deg. from wide lateral to narrow medial. Major muscle loads and contact forces are simulated for walking (toe-off phase) and stair climbing load cases. Effects of prosthesis stem tapers on the resulting stress distribution are investigated. Results show that compressive stress dominates in the medial plane while tensile stress in the lateral plane of the femur. The corresponding stress levels of intact femur for walking and stair-climbing load cases are 22 and 29 MPa, respectively. The magnitude of Tresca stress for the THA femur in stair-climbing load case remains higher in the region of 85 MPa while the walking load case induces around 40 MPa. The stress range in the straight and single taper stem prosthesis is lower than 260 MPa, while localized Tresca stress is in the order of the yield strength of Ti-6Al-4V alloy for double and triple taper stem design.

Lower reoperation rate for cemented hemiarthroplasty than for uncemented hemiarthroplasty and internal fixation following femoral neck fracture

DEFF Research Database (Denmark)

Viberg, Bjarke; Overgaard, Søren; Lauritsen, Jens

2013-01-01

a reoperation rate (RR) of 5% and was used as reference in the Cox regression analysis, which showed significantly higher hazard ratios (HRs) for IF (HR = 3.8, 95% CI: 1.9-7.5; RR = 18%), uncemented HA (HR = 2.2, CI: 1.1-4.5; RR = 11%) and uncemented hydroxyapatite-coated HA (HR = 3.6, CI: 1.8-7.4; RR = 16...... treated with either internal fixation (IF), cemented HA, or uncemented HA (with or without hydroxyapatite coating), after 12-19 years of follow-up. Methods 4 hospitals with clearly defined guidelines for the treatment of 75+ year-old patients with a displaced femoral neck fracture were included. Cohort 1...... an uncemented hydroxyapatite-coated Furlong HA. Data were retrieved from patient files, from the region-based patient administrative system, and from the National Registry of Patients at the end of 2010. We performed survival analysis with adjustment for comorbidity, age, and sex. Results Cemented HA had...

The mechanical effect of the existing cement mantle on the in-cement femoral revision.

LENUS (Irish Health Repository)

Keeling, Parnell

2012-08-01

Cement-in-cement revision hip arthroplasty is an increasingly popular technique to replace a loose femoral stem which retains much of the original cement mantle. However, some concern exists regarding the retention of the existing fatigued and aged cement in such cement-in-cement revisions. This study investigates whether leaving an existing fatigued and aged cement mantle degrades the mechanical performance of a cement-in-cement revision construct.

Revision of cemented hip arthroplasty using a hydroxyapatite-ceramic-coated femoral component.

Science.gov (United States)

Raman, R; Kamath, R P; Parikh, A; Angus, P D

2005-08-01

We report the clinical and radiological outcome of 86 revisions of cemented hip arthroplasties using JRI-Furlong hydroxyapatite-ceramic-coated acetabular and femoral components. The acetabular component was revised in 62 hips and the femoral component in all hips. The mean follow-up was 12.6 years and no patient was lost to follow-up. The mean age of the patients was 71.2 years. The mean Harris hip and Oxford scores were 82 (59 to 96) and 23.4 (14 to 40), respectively. The mean Charnley modification of the Merle d'Aubigné and Postel score was 5 (3 to 6) for pain, 4.9 (3 to 6) for movement and 4.4 (3 to 6) for mobility. Migration of the acetabular component was seen in two hips and the mean acetabular inclination was 42.6 degrees. The mean linear polyethylene wear was 0.05 mm/year. The mean subsidence of the femoral component was 1.9 mm and stress shielding was seen in 23 (28%) with bony ingrowth in 76 (94%). Heterotopic ossification was seen in 12 hips (15%). There were three re-revisions, two for deep sepsis and one for recurrent dislocation and there were no re-revisions for aseptic loosening. The mean EuroQol EQ-5D description scores and health thermometer scores were 0.69 (0.51 to 0.89) and 79 (54 to 95), respectively. With an end-point of definite or probable loosening, the probability of survival at 12 years was 93.9% and 95.6% for the acetabular and femoral components, respectively. Overall survival at 12 years, with removal or further revision of either component for any reason as the end-point, was 92.3%. Our study supports the continued use of this arthroplasty and documents the durability of hydroxyapatite-ceramic-coated components.

Stability Loss of the Cemented Stem of Hip Prosthesis due to Fretting Corrosion Fatigue

Directory of Open Access Journals (Sweden)

L. Capitanu

2017-12-01

Full Text Available Aim of this project was to study the fretting behaviour of the cemented femoral stem fixation of a total hip prosthesis, trying to capture the loss of contact between the femoral stem and polymetylmethacrilate cement fixation. To have a landmark, studies were performed compared with cementless fixation, where no fretting phenomenon occurs, on real prostheses, under biological 3D loading conditions. A fatigue test device, installed on a servo-hydraulic triaxial dynamic testing machine was used. It allowed monitoring the flexion-extension, abduction-adduction, inner-outer rotation movements, and the variation of the torsional torque, depending on normal loading. The test ends when the sample does not fail after 2000000 cycles, or when it has reached a predetermined number of cycles. Test fluid medium used was NaCl mixed with distilled water, a favourable environment for appearance of fretting corrosion. After the failure of stem fixation at 2450000 cycles, the mantle of bone cement remaining adherent on femoral stem was removed. Microscopic inspection of the femoral stem and of the inner part of the polymetylmethacrilate mantle demonstrated the existence of corrosion of the femoral stem surface beneath the cement mantle, and Fe2O3 deposits on the femoral stem surface and on the inner part of the mantle.

Migration and head penetration of Vitamin-E diffused cemented polyethylene cup compared to standard cemented cup in total hip arthroplasty: study protocol for a randomised, double-blind, controlled trial (E1 HIP).

Science.gov (United States)

Sköldenberg, Olof; Rysinska, Agata; Chammout, Ghazi; Salemyr, Mats; Muren, Olle; Bodén, Henrik; Eisler, Thomas

2016-07-07

In vitro, Vitamin-E-diffused, highly cross-linked polyethylene (PE) has been shown to have superior wear resistance and improved mechanical properties when compared to those of standard highly cross-linked PE liners used in total hip arthroplasty (THA). The aim of the study is to evaluate the safety of a new cemented acetabular cup with Vitamin-E-doped PE regarding migration, head penetration and clinical results. In this single-centre, double-blinded, randomised controlled trial, we will include 50 patients with primary hip osteoarthritis scheduled for THA and randomise them in a 1:1 ratio to a cemented cup with either argon gas-sterilised PE (control group) or Vitamin-E-diffused PE (vitamin-e group). All patients and the assessor of the primary outcome will be blinded and the same uncemented stem will be used for all participants. The primary end point will be proximal migration of the cup at 2 years after surgery measured with radiostereometry. Secondary end points include proximal migration at other follow-ups, total migration, femoral head penetration, clinical outcome scores and hip-related complications. Patients will be followed up at 3 months and at 1, 2, 5 and 10 years postoperatively. Results will be analysed using 95% CIs for the effect size. A regression model will also be used to adjust for stratification factors. The ethical committee at Karolinska Institutet has approved the study. The first results from the study will be disseminated to the medical community via presentations and publications in relevant medical journals when the last patient included has been followed up for 2 years. NCT02254980. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

Polyurethane as a potential knee hemiarthroplasty biomaterial: an in-vitro simulation of its tribological performance.

Science.gov (United States)

Luo, Y; McCann, L; Ingham, E; Jin, Z-M; Ge, S; Fisher, J

2010-01-01

Hemiarthroplasty is an attractive alternative to total joint replacement for the young active patient, when only one side of the synovial joint is damaged. In the development of a hemiarthroplasty prosthesis, a comprehensive understanding of the tribology of both the natural joint and the hemireplaced joint is necessary. The objectives of this study were to investigate the tribological response of polyurethane (PU) as a potential hemiarthroplasty material. Bovine medial compartmental knees were tested in a Prosim pendulum friction simulator, which applied physiologically relevant loading and motion. The healthy medial compartment was investigated as a negative control; a stainless steel hemiarthroplasty was investigated as a positive control; and three PU hemiarthroplasty plates of different moduli (1.4 MPa, 6.5 MPa, and 22 MPa) were also investigated. Using the lower-modulus PU caused reduced levels of contact stress and friction shear stress, which resulted in reduced levels of opposing cartilage wear. The two PU bearings with the lowest moduli demonstrated a similar tribological performance to the negative control. The higher-modulus PU (22 MPa) did demonstrate higher levels of friction shear stress, and wear resulted on the opposing cartilage, although not as severe as the wear from the stainless steel group. This study supports the use of compliant PU designs in future tribological experiments and hemiarthroplasty design applications.

Primary total hip replacement for displaced subcapital fractures of the femur.

Science.gov (United States)

Taine, W H; Armour, P C

1985-03-01

The management of displaced subcapital fracture of the hip is still controversial because of the high incidence of complications after internal fixation or hemiarthroplasty. To avoid some of these complications we have used primary total hip replacement for independently mobile patients over 65 years of age. A total of 163 cases, operated on over four years, have been reviewed. There were relatively more dislocations after operation for fracture than after total replacement for arthritis, and these were associated with a posterior approach to the hip. Only seven revision operations have been required. Of 57 patients who were interviewed an average of 42 months after replacement, 62% had excellent or good results as assessed by the Harris hip score. All the others had major systemic disease which affected their assessment. This inadequacy of current systems of hip assessment is discussed. It is concluded that total hip replacement is the best management for a selected group of patients with this injury, and that further prospective studies are indicated.

Outcome of an uncemented hydroxyapatite coated hemiarthroplasty for displaced femoral neck fractures

DEFF Research Database (Denmark)

Eschen, Jacob; Kring, Søren; Brix, Michael

2012-01-01

discouraged their use. There is limited evidence for the use of modern uncemented femoral stems in the treatment of DFNF, and we wished to investigate the clinical and radiographic performance of an uncemented hydroxyapatite coated hemiarthroplasty at 2-year follow-up. Patients and methods: We included 97...... consecutive patients who had an uncemented, hydroxyapatite coated hemiarthroplasty (Corail, Depuy) inserted during a 1-year period. Due to unwillingness or cognitive impairment (n = 6) and death before follow-up (n = 44), a total of 47 patients (39 females) with a mean age of 81 years were available. Results......-up. Conclusion: The results suggest that an uncemented hydroxyapatite coated hemiarthroplasty can be used to treat displaced intracupsular femoral neck fractures with good clinical and radiographic outcomes at short term follow-up....

OUTCOME OF UNCEMENTED UNIPOLAR HEMIARTHROPLASTY IN FRACTURE NECK OF FEMUR, IN GERIATRIC PATIENTS IN RELATION TO BONE QUALITY

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Mehraj Din

2015-09-01

Full Text Available BACKGROUND: Osteoporosis plays an important role in pathogenesis of fracture neck of femur in mobile elderly. Hemiarthroplasty is most common mode of management of femoral neck fractures in elderly in developing world. We report the outcome of uncemented hemiarthropl asty in elderly patients with a femoral neck fracture in relation to bone quality of patient as estimated by Dual energy x ray absorptiometry (DEXA scan. MATERIALS AND METHODS: 75 uncemented hemiarthroplasties for femoral neck fractures were performed in elderly patients more than 70 years of age between August 2008 and April 2012. The clinical, radiological results and bone mineral density of 65 hips in 65 patients who could be followed up were analyzed. For all cases Austin Moore prosthesis was implanted . RESULTS: The mean age of the patients was 79.96±7.21 years ( 7 1 to 96 years. 44 patients were women and 21 were men. Average duration of follow - up was 18.59±11.53 months ( R ange 4 to 44 months. The mean Harris Hip Score in patients with osteopenia was 80 .29±13.29 and in patients with osteoporosis it was 79.96 ± 11.67 at the time of the last follow - up. There was no significant difference in mean Harris hi p score in osteoporotic and non - osteoporotic patient’s p value 0.923. Out of 65 patients whose results were assessed in our study 48 patients (73.8% had osteoporosis and 17 patients (26.1% had Osteopenia. None of the patients in our study had a normal bone density. The mean T Score as measured on DEXA scan was - 3.74±1.57. CONCLUSION: Uncemented hemiarthro plasty for elderly patients more than 70 years of age with a femoral neck fracture showed satisfactory short - term results with no relationship to the bone quality

Persistently High Hip Circumference after Bariatric Surgery Is a Major Hurdle to Successful Hip Replacement

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Menachem M. Meller

2014-01-01

Full Text Available The prevalence of class III obesity (BMI≥40 kg/m2 in black women is 18%. As class III obesity leads to hip joint deterioration, black women frequently present for orthopedic care. Weight loss associated with bariatric surgery should lead to enhanced success of hip replacements. However, we present a case of a black woman who underwent Roux-en-Y gastric bypass with the expectation that weight loss would make her a better surgical candidate for hip replacement. Her gastric bypass was successful as her BMI declined from 52.0 kg/m2 to 33.7 kg/m2. However, her hip circumference after weight loss remained persistently high. Therefore, at surgery the soft tissue tunnel geometry presented major challenges. Tunnel depth and immobility of the soft tissue interfered with retractor placement, tissue reflection, and surgical access to the acetabulum. Therefore a traditional cup placement could not be achieved. Instead, a hemiarthroplasty was performed. After surgery her pain and reliance on external support decreased. But her functional independence never improved. This case demonstrates that a lower BMI after bariatric surgery may improve the metabolic profile and decrease anesthesia risk, but the success of total hip arthroplasties remains problematic if fat mass in the operative field (i.e., high hip circumference remains high.

CLINICAL STUDY OF MANAGEMENT OF INTRACAPSULAR FRACTURE NECK OF THE FEMUR IN ELDERLY WITH BIPOLAR HEMIARTHROPLASTY

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Pavan Kumar

2015-03-01

Full Text Available Hemiarthroplasty is a common treatment for fracture neck of femur in elderly patients. Unipolar hemiarthroplasty has shown good results, though there is high incidence of erosion, protrusion and needs revision in future. The concept of dual bearing surfaces results in sharing of motion at the two surfaces and hence reduction of net wears at either surface, thus reducing erosion at the acetabular - joint interface. From our relatively short term prospective non - randomized study, we conclude that bipolar hemiarthroplasty gives good results

Cemented versus uncemented fixation in total hip replacement: a systematic review and meta-analysis of randomized controlled trials

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Ali Abdulkarim

2013-03-01

Full Text Available The optimal method of fixation for primary total hip replacements (THR, particularly fixation with or without the use of cement is still controversial. In a systematic review and metaanalysis of all randomized controlled trials comparing cemented versus uncemented THRS available in the published literature, we found that there is no significant difference between cemented and uncemented THRs in terms of implant survival as measured by the revision rate. Better short-term clinical outcome, particularly an improved pain score can be obtained with cemented fixation. However, the results are unclear for the long-term clinical and functional outcome between the two groups. No difference was evident in the mortality and the post operative complication rate. On the other hand, the radiographic findings were variable and do not seem to correlate with clinical findings as differences in the surgical technique and prosthesis design might be associated with the incidence of osteolysis. We concluded in our review that cemented THR is similar if not superior to uncemented THR, and provides better short term clinical outcomes. Further research, improved methodology and longer follow up are necessary to better define specific subgroups of patients in whom the relative benefits of cemented and uncemented implant fixation can be clearly demonstrated.

Cemented versus uncemented fixation in total hip replacement: a systematic review and meta-analysis of randomized controlled trials.

LENUS (Irish Health Repository)

Abdulkarim, Ali

2013-02-22

The optimal method of fixation for primary total hip replacements (THR), particularly fixation with or without the use of cement is still controversial. In a systematic review and metaanalysis of all randomized controlled trials comparing cemented versus uncemented THRS available in the published literature, we found that there is no significant difference between cemented and uncemented THRs in terms of implant survival as measured by the revision rate. Better short-term clinical outcome, particularly an improved pain score can be obtained with cemented fixation. However, the results are unclear for the long-term clinical and functional outcome between the two groups. No difference was evident in the mortality and the post operative complication rate. On the other hand, the radiographic findings were variable and do not seem to correlate with clinical findings as differences in the surgical technique and prosthesis design might be associated with the incidence of osteolysis. We concluded in our review that cemented THR is similar if not superior to uncemented THR, and provides better short term clinical outcomes. Further research, improved methodology and longer follow up are necessary to better define specific subgroups of patients in whom the relative benefits of cemented and uncemented implant fixation can be clearly demonstrated.

Clinical and radiological evaluation of hybrid hip replacement in various disorders of hip

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Dhaon B

2005-01-01

Full Text Available Background: High rates of loosening of cemented implants led to change in technique of fixation of the implant. Methods: Fifty-nine hips were operated in 42 patients with non-cemented acetabular and cemented femoral components between January 1999 and July 2003. The average age of the patient was 45.2 years in our study. Preoperative diagnosis was avascular necrosis (28, ankylosing spondylitis (18, fracture neck femur (9, rheumatoid arthritis (2 and osteoarthritis (2. Results: At an average follow up of 3.6 years (range 1.2-5.8 years excellent to good results were obtained 92% according to Harris hip criteria. No radiological loosening was noted in any femoral or acetabular component on follow up. One poor result was seen in a case of bilateral ankylosing spondylitis operated on one side. Conclusion: Hybrid THA provides a viable and highly acceptable method of treatment of diseases of hip in young patients.

[Poldi-Čech cemented femoral stem in total hip arthroplasty after 25 years].

Science.gov (United States)

Rozkydal, Z; Janíček, P

2010-08-01

The aim of the study was to evaluate the results of Poldi-Čech femoral stem implantation in primary total hip arthroplasty after 25 years. A group of 65 patients (90 hips) with Poldi-Čech total hip arthroplasty carried out between 1974 and 1984 was evaluated at the end of 2009. The mean follow-up of all patients was 28 years (25 to 35). There were seven men and 58 women. The mean age at the time of implantation was 43 years (26 to 60) and at the latest follow-up it was 72 years. In all patients the cemented UHMW PE acetabular component (RCH 1000) was used together with AKV Ultra 2 Poldi steel femoral stems (1st, 2nd and 3rd generations). The stem was a monoblock with a 32-mm head. The evaluation of the results was based on the Harris hip score and X ray with an A-P view of the pelvis and the affected hip. Statistical analysis was made using the life-table method. At the latest follow up the mean Harris score was 69.7 points (40 to 88). There were 69 hips with an original Poldi-Čech femoral component still in situ, 64 of them were stable and five with radiological evidence of aseptic loosening. Five patients had undergone Girdlestone resection arthroplasty for septic loosening. Thirteen patients (16 hips) had femoral stem revision. The cumulative proportion of clinical survivorship of the Poldi-Čech femoral stem, with revision for any reason as the endpoint, .was 0.93 at 6 years, 0.84 at 12 years, and 0.77 at 18, 24 and 30 years after the index surgery. Radiographic findings revealed 64 hips with stable stems, five hips with ;aseptic loosening (probable, 0 possible, 2, definite, 3). Six- teen hips were after revision surgery for aseptic loosening of the stem and five hips were after Girdlestone resection arthroplasty for septic failure. The cumulative proportion of radiological survivorship of the Poldi-Čech femoral stem with any reason as the endpoint was 0.92 at 6 years, 0.78 at 12 years, 0.72 at 18 years, 0.69 at 24 years and 0.69 at 30 years. The Poldi

10-year results of a new low-monomer cement: follow-up of a randomized RSA study.

Science.gov (United States)

Söderlund, Per; Dahl, Jon; Röhrl, Stephan; Nivbrant, Bo; Nilsson, Kjell G

2012-12-01

The properties and performance of a new low-monomer cement were examined in this prospective randomized, controlled RSA study. 5-year data have already been published, showing no statistically significant differences compared to controls. In the present paper we present the 10-year results. 44 patients were originally randomized to receive total hip replacement with a Lubinus SPII titanium-aluminum-vanadium stem cemented either with the new Cemex Rx bone cement or with control bone cement, Palacos R. Patients were examined using RSA, Harris hip score, and conventional radiographs. At 10 years, 33 hips could be evaluated clinically and 30 hips could be evaluated with RSA (16 Cemex and 14 Palacos). 9 patients had died and 4 patients were too old or infirm to be investigated. Except for 1 hip that was revised for infection after less than 5 years, no further hips were revised before the 10-year follow-up. There were no statistically significant clinical differences between the groups. The Cemex cement had magnitudes of migration similar to or sometimes lower than those of Palacos cement. In both groups, most hips showed extensive radiolucent lines, probably due to the use of titanium alloy stems. At 10 years, the Cemex bone cement tested performed just as well as the control (Palacos bone cement).

Experimental and numerical study of cemented bone-implant interface behaviour

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P. Zlamal

2011-01-01

Full Text Available Although the total hip replacement (THR is a long-proven method of surgical treatment of diseases and disorders of the human hip, the surgery brings some risk of long-term instability of the joint. The aim of the research was to investigate the cemented bone-implant interface behavior. The main problems (cement layer degradation and bone-cement interface debonding during physiological loading conditions have been investigated using a custom hip simulator. The experimental setup was designed to allow cyclic loading of the sample of pelvic bone with implanted cemented acetabular component. The hip contact force of required direction and magnitude was applied to the implant using a spherical femoral component head. The most unfavorable activity (downstairs walking was simulated. The process of damage accumulation in the fixation was monitored by repeated scanning using high resolution micro Computed Tomography (µCT. Use of micro-focus source and large high-resolution flat panel detector allows investigation of structural changes and crack propagation both in the cement layer and the trabecular bone.

Femoral hip prosthesis design for Thais using multi-objective shape optimization

International Nuclear Information System (INIS)

Virulsri, Chanyaphan; Tangpornprasert, Pairat; Romtrairat, Parineak

2015-01-01

Highlights: • A multi-objective shape optimization was proposed to design hip prosthesis for Thais. • The prosthesis design was optimized in terms of safety of both cement and prosthesis. • The objective functions used the Soderberg fatigue strength formulations. • Safety factors of the cement and prosthesis are 1.200 and 1.109 respectively. • The newly designed prosthesis also fits well with chosen small-sized Thai femurs. - Abstract: The long-term success of Total Hip Arthroplasty (THA) depends largely on how well the prosthetic components fit the bones. The majority of cemented femoral hip prosthesis failures are due to aseptic loosening, which is possibly caused by cracking of the cement mantle. The strength of cement components is a function of cement mantles having adequate thickness. Since the size and shape of cemented femoral hip prostheses used in Thailand are based on designs for a Caucasian population, they do not properly conform to most Thai patients’ physical requirements. For these reasons, prostheses designed specifically for Thai patients must consider the longevity and functionality of both cement and prosthesis. The objective of this study was to discover a new design for femoral hip prostheses which is not only optimal and safe in terms of both cement and prosthesis, but also fits the selected Thai femur. This study used a small-sized Thai femoral model as a reference model for a new design. Biocompatible stainless steel 316L (SS316L) and polymethylmethacrylate (PMMA) were selected as raw materials for the prosthesis and bone cement respectively. A multi-objective shape optimization program, which is an interface between optimization C program named NSGA-II and a finite element program named ANSYS, was used to optimize longevity of femoral hip prostheses by varying shape parameters at assigned cross-sections of the selected geometry. Maximum walking loads of sixty-kilograms were applied to a finite element model for stress and

Contact mechanics of reverse engineered distal humeral hemiarthroplasty implants.

Science.gov (United States)

Willing, Ryan; King, Graham J W; Johnson, James A

2015-11-26

Erosion of articular cartilage is a concern following distal humeral hemiarthroplasty, because native cartilage surfaces are placed in contact with stiff metallic implant components, which causes decreases in contact area and increases in contact stresses. Recently, reverse engineered implants have been proposed which are intended to promote more natural contact mechanics by reproducing the native bone or cartilage shape. In this study, finite element modeling is used in order to calculate changes in cartilage contact areas and stresses following distal humeral hemiarthroplasty with commercially available and reverse engineered implant designs. At the ulna, decreases in contact area were -34±3% (p=0.002), -27±1% (pengineered and cartilage reverse engineered designs, respectively. Peak contact stresses increased by 461±57% (p=0.008), 387±127% (p=0.229) and 165±16% (p=0.003). At the radius, decreases in contact area were -21±3% (p=0.013), -13±2% (p0.999), 241±32% (p=0.010) and 61±10% (p=0.021). Between the three different implant designs, the cartilage reverse engineered design yielded the largest contact areas and lowest contact stresses, but was still unable to reproduce the contact mechanics of the native joint. These findings align with a growing body of evidence indicating that although reverse engineered hemiarthroplasty implants can provide small improvements in contact mechanics when compared with commercially available designs, further optimization of shape and material properties is required in order reproduce native joint contact mechanics. Copyright © 2015 Elsevier Ltd. All rights reserved.

Operative Trends in the Treatment of Hip Fractures and the Role of Arthroplasty

Science.gov (United States)

Grau, Luis; Summers, Spencer; Rosas, Samuel; Ong, Alvin; Hernandez, Victor Hugo

2018-01-01

Introduction: There is a projected exponential increase in the number of hip fractures in the United States. Trends in patient demographics and the role of total hip arthroplasty (THA) and its associated outcomes following hip fractures surgery have not been well studied. Methods: Patients with proximal femur fractures between 1990 and 2007 were identified in the National Hospital Discharge Survey database. Demographics, comorbidities, perioperative complications, and discharge status for patients undergoing THA, hemiarthroplasty, or internal fixation were examined. Multivariable regression was performed to determine independent risk factors for perioperative complications. Results: Between 1990 and 2007, there was a statistically significant increase in patient age, adverse events, medical comorbidities, surgical complications, medical complications, and nonroutine discharge across all surgical treatment modalities. In the same time period, the utilization of THA for all fracture types decreased significantly. Discussion: Total hip arthroplasty was found to be an independent risk factor for perioperative complications. Orthopedic surgeons should be aware that the hip fracture population continues to get older, with more medical comorbidities and are at higher risk for perioperative complications. Conclusion: Total hip arthroplasty is associated with a higher rate of perioperative complications in the hip fracture population. PMID:29619275

The initial instability of cemented and non-cemented femoral stems fixated with a bone grafting technique

NARCIS (Netherlands)

Schreurs, B.W.; Huiskes, H.W.J.; Slooff, T.J.J.H.

1994-01-01

To reconstruct intramedullary bone stock in revision surgery of failed total hip arthroplasties, a method was developed using impacted trabecular bone grafts. In an in vitro model with femora of the goat, the initial stabilities of both cemented and non-cemented hydroxylapatite-coated stems in this

Late Prosthetic Shoulder Hemiarthroplasty after Failed Management of Complex Proximal Humeral Fractures

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A. Panagopoulos

2013-01-01

Full Text Available Background. The purpose of this study was to report our experience with shoulder hemiarthroplasty in the context of old trauma. Methods. 33 patients with failed treatment for a complex proximal humeral fracture underwent prosthetic hemiarthroplasty. There were 15 men and 18 women with a mean age of 58.1 years. The average period from initial treatment was 14.9 months. Sequelae included 11 malunions, 4 nonunions, 15 cases with avascular necrosis (AVN and 3 neglected posterior locked dislocations. Follow up investigation included radiological assessment and clinical evaluation using the Constant score and a visual analogue pain scale. Results. After a mean follow up of 82.5 months the median Constant score was 75.7 points, improved by 60% in comparison to preoperative values. Greater tuberosity displacement, large cuff tears and severe malunion were the factors most affected outcome. No cases of stem loosening or severe migration were noted. 60% of the patients were able to do activities up to shoulder level compared with 24% before reconstruction. Conclusions. Late shoulder hemiarthroplasty is technically difficult and the results are inferior to those reported for acute humeral head replacement, nonetheless remains a satisfactory reconstructive option when primary treatment fails.

Outcome, revision rate and indication for revision following resurfacing hemiarthroplasty for osteoarthritis of the shoulder

DEFF Research Database (Denmark)

Rasmussen, J V; Polk, A; Sorensen, A K

2014-01-01

In this study, we evaluated patient-reported outcomes, the rate of revision and the indications for revision following resurfacing hemiarthroplasty of the shoulder in patients with osteoarthritis. All patients with osteoarthritis who underwent primary resurfacing hemiarthroplasty and reported...... to the Danish Shoulder Arthroplasty Registry (DSR), between January 2006 and December 2010 were included. There were 772 patients (837 arthroplasties) in the study. The Western Ontario Osteoarthritis of the Shoulder (WOOS) index was used to evaluate patient-reported outcome 12 months (10 to 14) post......-operatively. The rates of revision were calculated from the revisions reported to the DSR up to December 2011 and by checking deaths with the Danish National Register of Persons. A complete questionnaire was returned by 688 patients (82.2%). The mean WOOS was 67 (0 to 100). A total of 63 hemiarthroplasties (7...

Reverse hybrid total hip arthroplasty

DEFF Research Database (Denmark)

Wangen, Helge; Havelin, Leif I.; Fenstad, Anne M

2017-01-01

Background and purpose - The use of a cemented cup together with an uncemented stem in total hip arthroplasty (THA) has become popular in Norway and Sweden during the last decade. The results of this prosthetic concept, reverse hybrid THA, have been sparsely described. The Nordic Arthroplasty....... Patients and methods - From the NARA, we extracted data on reverse hybrid THAs from January 1, 2000 until December 31, 2013. 38,415 such hips were studied and compared with cemented THAs. The Kaplan-Meier method and Cox regression analyses were used to estimate the prosthesis survival and the relative risk...

Comparison of radiographic and radionuclide hip arthrography in determination of femoral component loosening of hip arthroplasties

International Nuclear Information System (INIS)

Capello, W.N.; Uri, B.G.; Wellman, H.N.; Robb, J.A.; Stiver, P.L.

1985-01-01

Radiographic examination of a patient experiencing pain following total hip arthroplasty is an important step in the systematic approach to evaluating component loosening, even though the information yielded is often equivocal and nondiagnostic in assessing component loosening. The radiographic criteria for loosening are especially difficult to assess following revision surgery, for radiolucent lines frequently exist at the bone-cement interface immediately following implantation. The advent of noncemented hip prostheses poses another problem: the routinely noted disruption of bone-cement of prosthesis-cement interfaces is not present with uncemented prostheses. As the criteria for loosening of the noncemented prostheses are still evolving, plain radiographic examination is frequently nondiagnostic. Femoral component loosening is difficult to detect with standard contrast arthrography because the bone, metal, surrounding radiopaque cement and contrast agents have similar or identical radiographic appearances. In contrast arthrography, if the prosthesis is loose the injected agent opacifies the radiolucent zone encircling the prosthesis or cement mangle. Because of the similarity in the appearances of these agents and the surrounding structures on x-ray films, interpretation is difficult. The inclusion of subtraction techniques in routine contrast arthrography has improved its accuracy; however, these techniques require special equipment and demand precise patient positioning. The purpose of this study is to introduce a new form of hip arthrography using a radionuclide agent in place of the contrast agent. A comparison of the results using these two techniques is presented

[Total hip arthroplasty in post-dysplastic hip arthritis. Can type and position of the acetabular component influence longevity of the prosthesis?].

Science.gov (United States)

Fousek, J; Indráková, P

2007-02-01

The aim of the study was a retrospective evaluation of our patients with post-dysplastic hips treated by cemented or non-cemented total hip arthroplasty (THA) in order to ascertain which type and position of the acetabular component was most effective. In the years 1999-2002, 111 THA procedures were performed in 93 patients, 76 women and 17 men, with post-dysplastic hip arthritis. The average age of the patients at the time of implantation was 52.6 years. On the basis of pre-operative radiographic findings, the patients' conditions were evaluated using the Hartofilakidis classification into three disease categories: dysplasia, low dislocation and high dislocation, and the patients were placed in two groups. Group 1 included 78 patients, and group 2 comprised 26 patients. None of our patients was classified as having high dislocation. Thirty-nine of these patients had previously undergone surgery for dysplastic hips. A total of 104 THAs were evaluated, because radiographic data was incomplete in seven cases. In addition to X-ray findings, the prosthesis type (cemented, hybrid, non-cemented), post-operative complications and signs of loosening were included in the evaluation. Clinical outcomes were assessed by the Harris score. The follow-up terminating on 31st December 2005 was 67 months on the average. In group 1 patients, the average Harris score increased from 38.6 to 80.3 points and in group 2 patients from 35.5 to 84.9 points, mostly with excellent and good results. In 72.1 % of the hips, a press-fit acetabular component was implanted. In 55.8 % of the cases, the acetabular component was implanted off the anatomical center of rotation, into the high hip center, with the range from 9 to 20 mm and an average of 15 mm. The average limb lengthening was 2.5 cm, ranging from 1.0 to 3.5 cm. Our results show that it is more effective to use non-cemented THA for post-dysplastic hips. The implantation of a noncemented acetabular component into the high center provides

Analysis of rehabilitation activities within skilled nursing and inpatient rehabilitation facilities after hip replacement for acute hip fracture.

Science.gov (United States)

Munin, Michael C; Putman, Koen; Hsieh, Ching-Hui; Smout, Randall J; Tian, Wenqiang; DeJong, Gerben; Horn, Susan D

2010-07-01

To characterize rehabilitation services in two types of postacute facilities in patients who underwent hip replacement following a hip fracture. Multisite prospective observational cohort from 6 freestanding skilled nursing facilities and 11 inpatient rehabilitation facilities. Patients (n = 218) with hip fracture who had either hemiarthroplasty or total hip arthroplasty followed by rehabilitation at skilled nursing facilities or inpatient rehabilitation facilities were enrolled. Using a point-of-care methodology, we recorded data from actual physical therapy and occupational therapy sessions completed including functional outcomes during the postacute admission. Onset time from surgical repair to rehabilitation admission was not significantly different between sites. Average skilled nursing facilities length of stay was 24.7 +/- 13.6 days, whereas inpatient rehabilitation facilities was 13.0 +/- 5.7 days (P inpatient rehabilitation facilities. For weekdays only, these data changed to 1.6 in skilled nursing facilities and 2.6 hrs per patient in inpatient rehabilitation facilities (P inpatient rehabilitation facilities accrued more time for gait training and exercise in physical therapy, which was found to be 48% and 40% greater, respectively, through day 8. In occupational therapy, patients of inpatient rehabilitation facilities had more time allocated to lower body dressing and transfers. Significant differences in rehabilitation activities were observed, and intensity was notably different within the first 8 therapy days even though baseline demographics and medical complexity were comparable across facility types. Our data suggest that after more complex hip replacement surgery, hip fracture patients can tolerate more intensive therapy earlier within the rehabilitation program.

One-stage revision of infected hip arthroplasty: outcome of 39 consecutive hips.

Science.gov (United States)

Ilchmann, Thomas; Zimmerli, Werner; Ochsner, Peter Emil; Kessler, Bernhard; Zwicky, Lukas; Graber, Peter; Clauss, Martin

2016-05-01

There are various options for treating periprosthetic joint infection (PJI). Two-stage exchange has traditionally been the gold standard. However, if the appropriate surgical intervention is chosen according to a rational algorithm, the outcome is similar when using all types of interventions. In an observational cohort study, the outcome of patients with PJI after hip replacement treated with one-stage revision was analysed. All patients fulfilling all criteria for one-stage exchange according to the Infectious Diseases Society of America (IDSA) guidelines and six without preoperative identification of a microorganism were included. Implant removal, debridement and cemented or uncemented reimplantations were performed in a single intervention. If a cemented device was implanted, commercially available gentamicin cement was used in all cases. Antibiotic treatment was administered intravenously for at least 2 weeks, followed by oral therapy for a total duration of 3 months. Patients had standardised clinical and radiological follow-up visits. Between 1996 and 2011, 38 patients (39 hips) were treated with a one-stage procedure and followed for at least 2 years. Coagulase-negative staphylococci were the most frequent pathogens, and polymicrobial infection was observed in five cases. In 25 hips, an uncemented revision stem was implanted, and 37 hips received an acetabular reinforcement ring. The mean follow-up was 6.6 (2.0-15.1) years. No patient had persistent, recurrent or new infection. There were four stem revisions for aseptic loosening. The mean Harris Hip Score was 81 points (26-99) at the final follow-up. Excellent cure rate and function seen in our study suggest that one-stage exchange is a safe procedure, even without local antibiotic treatment, provided that the patient has no sinus tract or severe soft tissue damage, no major bone grafting is required and the microorganism is susceptible to orally administered agents with high bioavailability.

Reduced survival for uncemented compared to cemented total hip arthroplasty after operatively treated acetabular fractures.

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Clarke-Jenssen, John; Westberg, Marianne; Røise, Olav; Storeggen, Stein Arne Øvre; Bere, Tone; Silberg, Ingunn; Madsen, Jan Erik

2017-11-01

Post traumatic arthritis and avascular necrosis of the femoral head are common complications after operatively treated acetabular fractures. This may cause severe disabilities for the patient, necessitating a total hip arthroplasty. Even though an arthroplasty may provide good symptomatic relief, the long-term results are more uncertain and no consensus exists according to preferred prosthetic designs. With this cohort study, we aimed to investigate the medium to long term arthroplasty survival and clinical results of total hip arthroplasty after operatively treated acetabular fractures. We included 52 patients treated with a secondary total hip arthroplasty at a median of 2.4 (0.1-14.1) years after an operatively treated acetabular fracture. The median age was 54 (11-82) years. Cemented arthroplasty was used for 33 patients, 10 patients had an uncemented arthroplasty and 9 patients received a hybrid arthroplasty. Average follow up was 8.0 (SD 5.0) years. Ten-year revision free arthroplasty survival was 79%. Uncemented arthroplasties had a significantly worse 10-year survival of 57%. Arthroplasties performed at a centre without a pelvic fracture service also had a significantly worse 10-years survival of 51%. Cox regression showed similar results with an 8-fold increase in risk of revision for both uncemented arthroplasties and operations performed at a non-pelvic trauma centre. Total hip arthroplasty secondary to an operatively treated acetabular fracture provides good symptomatic relief. These patients are, however, complex cases and are probably best treated at specialist centres with both pelvic trauma surgeons and arthroplasty surgeons proficient in complex revisions present. Copyright © 2017 Elsevier Ltd. All rights reserved.

Sports- and Work-Related Outcomes After Shoulder Hemiarthroplasty.

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Garcia, Grant H; Mahony, Gregory T; Fabricant, Peter D; Wu, Hao-Hua; Dines, David M; Warren, Russell F; Craig, Edward V; Gulotta, Lawrence V

2016-02-01

With an active aging population, more patients expect to return to previous activities and work after surgery. To determine the rate and timing to return of sports and employment after shoulder hemiarthroplasty. Case series; Level of evidence, 4. This was a retrospective review of consecutive patients who underwent shoulder hemiarthroplasty from 2007 to 2013. Follow-up consisted of a patient-reported questionnaire regarding physical fitness, sporting activities, and work status. From 105 patients screened, 79 were available for follow-up. The average follow-up time was 63.1 months, and the average age at follow-up was 69 years. Scores on the visual analog scale for pain improved from 6.2 to 2.1 (P sports preoperatively, and 67.2% of these restarted at least 1 of their previous sports postoperatively. The average time to return to full sports was 6.5 months for those who returned. Direct rates of return were as follows: fitness sports (69%), swimming (65%), running (64%), cycling (63%), and doubles tennis (57%). Younger age was associated with highest demand level achieved (P = .023). Forty-nine patients worked preoperatively, with 69.4% returning to previous employment after surgery; the average time to return to work was 1.4 months. In comparative analysis, patients who did not return to work had a higher mean body mass index (32 ± 7 vs 27 ± 5 kg/m(2); P sports at an average of 6.5 months postoperatively. Patients older than 65 years experienced similar improvements in ASES scores compared with patients younger than 65 years, although absolute scores were lower on average. Those who returned to higher demand sports were younger on average. Of patients working preoperatively, 69.4% returned to their previous employment at an average of 1.4 months. Patients who did not return to employment had significantly higher body mass index on average. These findings will help surgeons manage expectations of shoulder hemiarthroplasty candidates preoperatively. © 2015 The

Reasons for revision of failed hemiarthroplasty: Are there any differences between unipolar and bipolar?

Science.gov (United States)

Iamthanaporn, Khanin; Chareancholvanich, Keerati; Pornrattanamaneewong, Chaturong

2018-03-16

Hemiarthroplasty (HA) is an effective procedure for treatment of femoral neck fracture. However, it is debatable whether unipolar or bipolar HA is the most suitable implant. The purpose of this study was to compare the causes of failure and longevity in both types of HA. We retrospectively reviewed 133 cases that underwent revision surgery of HA between 2002 and 2012. The causes of revision surgery were identified and stratified into early (≤ 5 years) failure and late (> 5 years) failure. Survival analyses were performed for each implant type. The common causes for revision were aseptic loosening (49.6%), infection (22.6%) and acetabular erosion (15.0%). Unipolar and bipolar HA were not different in causes for revision, but the unipolar group had a statistically significantly higher number of acetabular erosion events compared with the bipolar group (p = 0.002). In the early period, 24 unipolar HA (52.9%) and 28 bipolar HA (34.1%) failed. There were no statistically significant differences in the numbers of revised HA in each period between the two groups (p = 0.138). The median survival times in the unipolar and bipolar groups were 84.0 ± 24.5 and 120.0 ± 5.5 months, respectively. However, the survival times of both implants were not statistically significantly different. Aseptic loosening was the most common reason for revision surgery after hemiarthroplasty surgery in early and late failures. Unipolar and bipolar hemiarthroplasty were not different in terms of causes of failure and survivorship except bipolar hemiarthroplasty had many fewer acetabular erosion events.

High risk of early periprosthetic fractures after primary hip arthroplasty in elderly patients using a cemented, tapered, polished stem

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Brodén, Cyrus; Mukka, Sebastian; Muren, Olle; Eisler, Thomas; Boden, Henrik; Stark, André; Sköldenberg, Olof

2015-01-01

Background and purpose Postoperative periprosthetic femoral fracture (PPF) after hip arthroplasty is associated with considerable morbidity and mortality. We assessed the incidence and characteristics of periprosthetic fractures in a consecutive cohort of elderly patients treated with a cemented, collarless, polished and tapered femoral stem (CPT). Patients and methods In this single-center prospective cohort study, we included 1,403 hips in 1,357 patients (mean age 82 (range 52–102) years, 72% women) with primary osteoarthritis (OA) or a femoral neck fracture (FNF) as indication for surgery (367 hips and 1,036 hips, respectively). 64% of patients were ASA class 3 or 4. Hip-related complications and need for repeat surgery were assessed at a mean follow-up time of 4 (1–7) years. A Cox regression analysis was used to evaluate risk factors associated with PPF. Results 47 hips (3.3%) sustained a periprosthetic fracture at median 7 (2–79) months postoperatively; 41 were comminute Vancouver B2 or complex C-type fractures. The fracture rate was 3.8% for FNF patients and 2.2% for OA patients (hazard ratio (HR) = 4; 95% CI: 1.3–12). Patients > 80 years of age also had a higher risk of fracture (HR = 2; 95% CI: 1.1–4.5). Interpretation We found a high incidence of early PPF associated with the CPT stem in this old and frail patient group. A possible explanation may be that the polished tapered stem acts as a wedge, splitting the femur after a direct hip contusion. Our results should be confirmed in larger, registry-based studies, but we advise caution when using this stem for this particular patient group. PMID:25280133

Structural degradation of acrylic bone cements due to in vivo and simulated aging.

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Hughes, Kerry F; Ries, Michael D; Pruitt, Lisa A

2003-05-01

Acrylic bone cement is the primary load-bearing material used for the attachment of orthopedic devices to adjoining bone. Degradation of acrylic-based cements in vivo results in a loss of structural integrity of the bone-cement-prosthesis interface and limits the longevity of cemented orthopedic implants. The purpose of this study is to investigate the effect of in vivo aging on the structure of the acrylic bone cement and to develop an in vitro artificial aging protocol that mimics the observed degradation. Three sets of retrievals are examined in this study: Palacos brand cement retrieved from hip replacements, and Simplex brand cement retrieved from both hip and knee replacement surgeries. In vitro aging is performed using oxidative and acidic environments on three acrylic-based cements: Palacos, Simplex, and CORE. Gel permeation chromatography (GPC) and Fourier transform infrared spectroscopy (FTIR) are used to examine the evolution of molecular weight and chemical species within the acrylic cements due to both in vivo and simulated aging. GPC analysis indicates that molecular weight is degraded in the hip retrievals but not in the knee retrievals. Artificial aging in an oxidative environment best reproduces this degradation mechanism. FTIR analysis indicates that there exists a chemical evolution within the cement due to in vivo and in vitro aging. These findings are consistent with scission-based degradation schemes in the cement. Based on the results of this study, a pathway for structural degradation of acrylic bone cement is proposed. The findings from this investigation have broad applicability to acrylic-based cements and may provide guidance for the development of new bone cements that resist degradation in the body. Copyright 2003 Wiley Periodicals, Inc.

Medial calcar of proximal humeral fracture as landmark in restoration of humeral length in case of hemiarthroplasty

Czech Academy of Sciences Publication Activity Database

Hromádka, R.; Kuběna, Aleš Antonín; Šmíd, Martin; Popelka, S.

2014-01-01

Roč. 35, č. 5 (2014), s. 473-479 ISSN 0930-1038 Institutional support: RVO:67985556 Keywords : Fracture of proximal humerus * Calcar of humeral fracture * Reconstruction of proximal humerus * Reconstruction of humeral length * Shoulder arthroplasty * Shoulder hemiarthroplasty Subject RIV: FJ - Surgery incl. Transplants Impact factor: 1.047, year: 2014 http://library.utia.cas.cz/separaty/2013/E/smid-medial calcar of proximal humeral fracture as landmark in restoration of humeral length in case of hemiarthroplasty.pdf

Fixation of Trochanteric Fragments in Cementless Bipolar Hemiarthroplasty of Unstable Intertrochanteric Fracture: Cerclage Wiring.

Science.gov (United States)

Lee, Young-Kyun; Park, Chan Ho; Koo, Kyung-Hoi

2017-12-01

Bipolar hemiarthroplasty (HA) is an option for the treatment of unstable intertrochanteric fracture in elderly patients. There is a raising concern regarding cable-grip related complications for the fixation of trochanteric fragments. Therefore, the aim of this study was to evaluate outcome of cementless HA with fixation for the trochanteric fragments using monofilament wires in unstable intertrochanteric fracture. We reviewed 92 cementless bipolar HAs using a grit-blasted long stem design for unstable intertrochanteric fractures in 91 elderly patients with a mean age of 81.7 years. During the arthroplasty, trochanteric fracture fragments were fixed using 1 or 2 vertical wires and transverse wires. We evaluated the clinical outcomes such as abductor power, ambulatory ability and wire-related complications, and radiologic outcomes including the union of the trochanteric fragment and subsidence of stem. Sixty-two patients were followed for a minimum of 2 years (mean, 59 months) postoperatively. The mean abductor power and Koval category was 4.1 (range, 3 to 5) and 4.6 (range, 1 to 6). The wire was broken in 3 hips (4.8%) and the nonunion of the greater trochanter occurred in 1 hips (1.6%). Two stems subsided by 3 mm and 8 mm, respectively, during postoperative 6 weeks, after which the subsidence was not progressive. Cerclage wiring of the trochanter using monofilament wire leads to acceptable outcome in cementless HA for senile patients with unstable intertrochanteric fracture. Cerclage wiring using a monofilament wire is recommended for the fixation of trochanteric fragments.

Modular femoral component for conversion of previous hip surgery in total hip arthroplasty.

Science.gov (United States)

Goldstein, Wayne M; Branson, Jill J

2005-09-01

The conversion of previous hip surgery to total hip arthroplasty creates a durable construct that is anatomically accurate. Most femoral components with either cemented or cementless design have a fixed tapered proximal shape. The proximal femoral anatomy is changed due to previous hip surgery for fixation of an intertrochanteric hip fracture, proximal femoral osteotomy, or a fibular allograft for avascular necrosis. The modular S-ROM (DePuy Orthopaedics Inc., Warsaw, Ind) hip stem accommodates these issues and independently prepares the proximal and distal portion of the femur. In preparation and implantation, the S-ROM hip stem creates less hoop stresses on potentially fragile stress risers from screws and thin bone. The S-ROM hip stem also prepares a previously distorted anatomy by milling through cortical bone that can occlude the femoral medullar canals and recreate proper femoral anteversion and reduces the risk of intraoperative or postoperative periprosthetic fracture due to the flexible titanium-slotted stem. The S-ROM femoral stem is recommended for challenging total hip reconstructions.

Treatment of first metatarsophalangeal joint arthritis using hemiarthroplasty with a synthetic cartilage implant or arthrodesis: A comparison of operative and recovery time.

Science.gov (United States)

Glazebrook, Mark; Younger, Alastair S E; Daniels, Timothy R; Singh, Dishan; Blundell, Chris; de Vries, Gwyneth; Le, Ian L D; Nielsen, Dominic; Pedersen, M Elizabeth; Sakellariou, Anthony; Solan, Matthew; Wansbrough, Guy; Baumhauer, Judith F

2017-05-29

First metatarsophalangeal joint (MTPJ1) hemiarthroplasty using a novel synthetic cartilage implant was as effective and safe as MTPJ1 arthrodesis in a randomized clinical trial. We retrospectively evaluated operative time and recovery period for implant hemiarthroplasty (n=152) and MTPJ1 arthrodesis (n=50). Perioperative data were assessed for operative and anaesthesia times. Recovery and return to function were prospectively assessed with the Foot and Ankle Ability Measure (FAAM) Sports and Activities of Daily Living (ADL) subscales and SF-36 Physical Functioning (PF) subscore. Mean operative time for hemiarthroplasty was 35±12.3min and 58±21.5min for arthrodesis (pSport, FAAM ADL, and SF-36 PF subscores versus arthrodesis patients. MTPJ1 hemiarthroplasty with a synthetic cartilage implant took less operative time and resulted in faster recovery than arthrodesis. III, Retrospective case control study. Copyright © 2017 European Foot and Ankle Society. Published by Elsevier Ltd. All rights reserved.

Hip arthroplasty in failed intertrochanteric fractures in elderly

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Javahir A Pachore

2013-01-01

Full Text Available Background: Failed intertrochanteric fractures in elderly patients are surgical challenge with limited options. Hip arthroplasty is a good salvage procedure even though it involves technical issues such as implant removal, bone loss, poor bone quality, trochanteric nonunion and difficulty of surgical exposure. Materials and Methods: 30 patients of failed intertrochanteric fractures where hip arthroplasty was done between May 2008 and December 2011 were included in study. 13 were males and 17 were females with average age of 67.3 years. There were 2 cemented bipolar arthroplasties, 19 uncemented bipolar, 4 cemented total hip arthroplasty and 5 uncemented total hip arthroplasties. 16 patients had a trochanteric nonunion, which was treated by tension band principles. Total hip was considered where there was acetabular damage due to the penetration of implant. Results: The average followup was 20 months (range 6-48 months. Patients were followed up from 6 to 48 months with average followup of 20 months. None of the patients were lost to followup. There was no dislocation. All patients were ambulatory at the final followup. Conclusion: A predictable functional outcome can be achieved by hip arthroplasty in elderly patients with failed intertrochanteric fractures. Though technically demanding, properly performed hip arthroplasty can be a good salvage option for this patient group.

The Direct Anterior Approach Does Not Increase Return to Function Following Hemiarthroplasty for Femoral Neck Fracture.

Science.gov (United States)

Carlson, Victor R; Ong, Alvin C; Orozco, Fabio R; Lutz, Rex W; Duque, Andres F; Post, Zachary D

2017-11-01

The purpose of this study was to evaluate functional outcomes for hemiarthroplasty using a direct anterior approach or a direct lateral approach for femoral neck fracture. This retrospective review used data collected from a single institution between 2006 and 2016. Eighty-five and 75 consecutive patients who underwent hemiarthroplasty via a direct anterior approach and a direct lateral approach, respectively, met inclusion criteria. All patients with femoral neck fractures were treated by 1 of 2 fellowship-trained orthopedic surgeons using the direct anterior approach or the direct lateral approach to hemiarthroplasty. Disposition, ambulation, and other perioperative surgical outcomes were compared between the cohorts. Compared with the direct lateral cohort, the direct anterior cohort had a shorter mean operative time (2.4 minutes, P<.01), a shorter mean length of hospital stay (2.7 days, P<.01), and a smaller mean decrease in hemoglobin postoperatively (0.7 g/dL, P<.01). No significant difference was observed between the cohorts for postoperative disposition, the number of feet ambulated on the second postoperative day, or the prevalence of ambulatory decline at 4- to 6-week and 4- to 6-month follow-up visits. Compared with the direct lateral approach, the direct anterior approach may benefit patients by small, but statistically significant, improvements in blood loss, surgical time, and length of hospital stay after hemiarthroplasty. However, the direct anterior approach does not appear to decrease the likelihood of transfer to a skilled nursing facility postoperatively or accelerate return to preoperative function. [Orthopedics. 2017; 40(6):e1055-e1061.]. Copyright 2017, SLACK Incorporated.

The mechanical effect of the existing cement mantle on the in-cement femoral revision.

Science.gov (United States)

Keeling, Parnell; Lennon, Alexander B; Kenny, Patrick J; O'Reilly, Peter; Prendergast, Patrick J

2012-08-01

Cement-in-cement revision hip arthroplasty is an increasingly popular technique to replace a loose femoral stem which retains much of the original cement mantle. However, some concern exists regarding the retention of the existing fatigued and aged cement in such cement-in-cement revisions. This study investigates whether leaving an existing fatigued and aged cement mantle degrades the mechanical performance of a cement-in-cement revision construct. Primary cement mantles were formed by cementing a polished stem into sections of tubular steel. If in the test group, the mantle underwent conditioning in saline to simulate ageing and was subject to a fatigue of 1 million cycles. If in the control group no such conditioning or fatigue was carried out. The cement-in-cement procedure was then undertaken. Both groups underwent a fatigue of 1 million cycles subsequent to the revision procedure. Application of a Mann-Whitney test on the recorded subsidence (means: 0.51, 0.46, n=10+10, P=0.496) and inducible displacement (means: 0.38, 0.36, P=0.96) revealed that there was no statistical difference between the groups. This study represents further biomechanical investigation of the mechanical behaviour of cement-in-cement revision constructs. Results suggest that pre-revision fatigue and ageing of the cement may not be deleterious to the mechanical performance of the revision construct. Thus, this study provides biomechanical evidence to back-up recent successes with this useful revision technique. Copyright © 2012 Elsevier Ltd. All rights reserved.

Acetabular QCT in Total Hip Arthroplasty - a reliability study using porcine hips

DEFF Research Database (Denmark)

Mussmann, Bo Redder; Overgaard, Soren; Torfing, Trine

and reliability of bone mineral density measurements (BMD) in close proximity of the acetabular cup using SECT and DECT images and 3D segmentation software. Materials and methods 22 acetabular cups (12 cemented, 10 un-cemented) were inserted in porcine hip specimens ex vivo. A femoral stem was attached to each...... difference between the double measurements in SECT was 8 mg/cm3 (p=0.64) and 2 mg/cm3 in DECT (p=0.6). In the cemented concept the differences were 33 mg/cm3 (p=0.054) and 11 mg/cm3 (p=0.014), respectively. ICC was >0.90 regardless of scan mode and cup type. In both cup types the Bland-Altman limits...... of agreement were wider in SECT (uncemented: -95 to 111; cemented: -86 to 153) compared with DECT (uncemented: -28 to 23; cemented: -21 to 44). Conclusion There were no statistically significant reliability differences between SECT and DECT, but results suggest that the agreement of DECT is better than...

Early outcomes of pyrolytic carbon hemiarthroplasty for the treatment of trapezial-metacarpal arthritis

NARCIS (Netherlands)

Martinez de Aragon, J. S.; Moran, Steven L.; Rizzo, Marco; Reggin, Kirsten B.; Beckenbaugh, Robert D.

2009-01-01

PURPOSE: Pyrolytic carbon implants have been successfully used in the treatment of osteoarthritis of the metacarpophalangeal and proximal interphalangeal joints. Recently, pyrolytic carbon hemiarthroplasties have been proposed for the treatment of osteoarthritis of the trapezial-metacarpal (TM)

Neglected simultaneous bilateral femoral neck fractures secondary to narcotic drug abuse treated by bilateral one-staged hemiarthroplasty: a case report

Directory of Open Access Journals (Sweden)

Vahedi Ehsan

2010-06-01

Full Text Available Abstract Simultaneous bilateral femoral neck fractures are extremely rare and associated with various conditions. Up to now Most cases had correlations with major trauma, repetitive minor trauma, seizure, parathyroid or renal dysfunction, anti-epileptic medications, seizure, etc. A 28-year-old addict man referred to us with a 10-year history of narcotic drug abuse and history of 8 months bilateral groin pain. He admitted with displaced bilateral femoral neck fracture. Because of long duration of this condition and osteonecrosis revealed on bone scan, one-staged bilateral hip hemiarthroplasty was done. A good function was noted after surgery to 4-month follow up. Up to now, have not be founded in the literature that a case of bilateral femoral neck fracture associated with narcotic drug abuse. Because of negative effects of opium or smoking on bone tissues, a simple bone pain should aware us about the risk of stress or fatigue fracture.

Good Outcome Following Copeland Hemiarthroplasty for Acromegalic Arthropathy

Directory of Open Access Journals (Sweden)

S. E. Johnson-Lynn

2011-01-01

Full Text Available We report the unusual case of a patient with acromegalic arthropathy who presented with severe shoulder arthrosis with marked osteophytosis. This patient is currently pain-free and has good shoulder function 4 years following a Copeland shoulder hemiarthroplasty. Acromegaly is a rare condition of growth hormone oversecretion, but arthropathy is a common feature of the natural history of the disease. This is the first published case report of the outcome of shoulder arthroplasty in a patient with acromegalic arthropathy and demonstrated that a good result can be obtained in this patient.

Satisfactory Results of the Exeter Revision Femoral Stem Used for Primary Total Hip Arthroplasty.

Science.gov (United States)

Desy, Nicholas M; Johnson, Joshua D; Sierra, Rafael J

2017-02-01

The Exeter cemented femoral stem has demonstrated excellent clinical and radiographic outcomes as well as long-term survivorship free from aseptic loosening. A shorter revision stem (125 mm) with a 44 offset became available for the purpose of cement-in-cement revision situations. In certain cases, this shorter revision stem may be used for various primary total hip arthroplasties (THAs) where the standard length stem would require distally reaming the femoral canal. We sought to report on the early to midterm results of this specific stem when used for primary THA regarding (1) clinical and radiographic outcomes, (2) complications, and (3) survivorship. Twenty-nine patients (33 hips) underwent a hybrid THA using the smaller revision Exeter cemented femoral stem. Twenty-five patients (28 hips) had at least 2 years of follow-up and were assessed for clinical and radiographic outcomes. All 33 hips were included in the analysis of complications and survivorship. The Kaplan-Meier survivorship was performed using revision for all causes and for aseptic loosening as the end points. The average clinical follow-up was 4 years (range, 2-7). Harris Hip Scores improved from a mean preoperative value of 56 (range, 23-96) to 90 (range, 51-100) at the latest follow-up. All patients demonstrated superior cement mantles with no signs of loosening. One patient suffered a B2 periprosthetic fracture and 1 patient experienced 2 episodes of instability. The 5-year Kaplan-Meier survivorship was 96.7% for all causes of revision and was 100% using aseptic loosening as the end point. The shorter Exeter revision cemented femoral stem has favorable early to midterm clinical and radiographic outcomes when used for primary THA with a low complication rate and is a viable option in patients with narrow femoral canals where uncemented stem fixation is not desired. Copyright © 2016 Elsevier Inc. All rights reserved.

Cervical hip fractures do not occur in arthrotic joints. A clinicoradiographic study of 256 patients.

Science.gov (United States)

Dretakis, E K; Steriopoulos, K A; Kontakis, G M; Giaourakis, G; Economakis, G; Dretakis, K E

1998-08-01

We studied endogenic factors for the occurrence of cervical hip fractures in 256 patients. 230 underwent hemiarthroplasty, and 26 were treated with internal fixation or without surgery. The condition of the fractured hip and of the ipsilateral knee, as well as the mobility of the patient before the fracture, were studied in all 256 patients. The removed femoral heads were examined, photographed and radiographs were taken with sensitive film. The acetabulum and the femoral head were macroscopically normal in all 230 cases and there was no radiographic evidence of arthrosis. 64% of the patients were fully mobile before the fracture, 34% were mobile with the aid of a cane and 2% were dependent. In 88%, the ipsilateral knee was normal both clinically and radiographically, and in 12%, there was moderate arthrosis. When comparing the mobility before the fracture and the condition of the ipsilateral hip and knee in 100 patients having a cervical fracture with 100 patients having a trochanteric fracture matched for age and sex, we found that a normal hip joint was sine qua non while a normal ipsilateral knee and a fully mobile individual were important additional conditions for the occurrence of a cervical hip fracture, instead of a trochanteric one, after a fall in an elderly person.

"Tripolar" hip arthroplasty for failed hip resurfacing: nineteen years follow-up.

Science.gov (United States)

Scheerlinck, T; Casteleyn, P P

2001-10-01

The authors describe the case of a 37-year-old patient who sustained a subcapital femoral neck fracture six months after ICLH double-cup hip resurfacing. As the polyethylene acetabular resurfacing component was undamaged and well fixed, a standard femoral stem with a bipolar head was inserted. The outer diameter of the bipolar head was chosen to fit the resurfacing socket. The "tripolar" hip arthroplasty has functioned well for 19 years and was revised for aseptic cup loosening. The cemented femoral stem was still well fixed and was not revised. Although the "tripolar" hip has functioned well in our case, we believe it is not indicated for metal on metal bearings. In this case the use of an appropriate modular head with a correct head-socket clearance is preferred.

Mechanical behaviour of a new acryclic radiopaque iodine-containing bone cement

NARCIS (Netherlands)

Hooy-Corstjens, van C.S.J.; Govaert, L.E.; Spoelstra, A.B.; Bulstra, S.K.; Wetzels, G.M.R.; Koole, L.H.

2004-01-01

In total hip replacement, fixation of a prosthesis is in most cases obtained by the application of methacrylic bone cements. Most of the commercially available bone cements contain barium sulphate or zirconium dioxide as radiopacifier. As is shown in the literature, the presence of these inorganic

Fixation method does not affect restoration of rotation center in hip replacements: A single-site retrospective study

Directory of Open Access Journals (Sweden)

Wegner Alexander

2012-06-01

Full Text Available Abstract Background Aseptic loosening is one of the greatest problems in hip replacement surgery. The rotation center of the hip is believed to influence the longevity of fixation. The aim of this study was to compare the influence of cemented and cementless cup fixation techniques on the position of the center of rotation because cemented cup fixation requires the removal of more bone for solid fixation than the cementless technique. Methods We retrospectively compared pre- and post-operative positions of the hip rotation center in 25 and 68 patients who underwent artificial hip replacements in our department in 2007 using cemented or cementless cup fixation, respectively, with digital radiographic image analysis. Results The mean horizontal and vertical distances between the rotation center and the acetabular teardrop were compared in radiographic images taken pre- and post-operatively. The mean horizontal difference was −2.63 mm (range: -11.00 mm to 10.46 mm, standard deviation 4.23 mm for patients who underwent cementless fixation, and −2.84 mm (range: -10.87 to 5.30 mm, standard deviation 4.59 mm for patients who underwent cemented fixation. The mean vertical difference was 0.60 mm (range: -20.15 mm to 10.00 mm, standard deviation 3.93 mm and 0.41 mm (range: -9.26 mm to 6.54 mm, standard deviation 3.58 mm for the cementless and cemented fixation groups, respectively. The two fixation techniques had no significant difference on the position of the hip rotation center in the 93 patients in this study. Conclusions The hip rotation center was similarly restored using either the cemented or cementless fixation techniques in this patient cohort, indicating that the fixation technique itself does not interfere with the position of the center of rotation. To completely answer this question further studies with more patients are needed.

Application of individually performed acrylic cement spacers containing 5% of antibiotic in two-stage revision of hip and knee prosthesis due to infection.

Science.gov (United States)

Babiak, Ireneusz

2012-07-03

Deep infection of a joint endoprosthesis constitutes a threat to the stability of the implant and joint function. It requires a comprehensive and interdisciplinary approach, involving the joint revision and removal of the bacterial biofilm from all tissues, the endoprosthesis must be often removed and bone stock infection treated. The paper presents the author's experience with the use of acrylic cement spacers, custom-made during the surgery and containing low dose of an antibiotic supplemented with 5% of a selected, targeted antibiotic for the infection of hip and knee endoprostheses. 33 two-stage revisions of knee and hip joints with the use of a spacer were performed. They involved 24 knee joints and 9 hip joints. The infections were mostly caused by staphylococci MRSA (18) and MSSA (8), and in some cases Enterococci (4), Salmonella (1), Pseudomonas (1) and Acinetobacter (1). The infection was successfully treated in 31 out of 33 cases (93.93%), including 8 patients with the hip infection and 23 patients with the knee infection. The endoprosthesis was reimplanted in 30 cases: for 7 hips and 23 knees, in 3 remaining cases the endoprosthesis was not reimplanted. Mechanical complications due to the spacer occurred in 4 cases: 3 dislocations and 1 fracture (hip spacer). The patients with hip spacers were ambulatory with a partial weight bearing of the operated extremity and those with knee spacers were also ambulatory with a partial weight bearing, but the extremity was initially protected by an orthosis. The spacer enables to maintain a limb function, and making it by hand allows the addition of the specific bacteria targeted antibiotic thus increasing the likelihood of the effective antibacterial treatment.

A biodegradable gentamicin-hydroxyapatite-coating for infection prophylaxis in cementless hip prostheses

NARCIS (Netherlands)

Neut, D.; Dijkstra, R. J. B.; Thompson, J. I.; Kavanagh, C.; van der Mei, H. C.; Busscher, H. J.

2015-01-01

A degradable, poly (lactic-co-glycolic acid) (PLGA), gentamicin-loaded prophylactic coating for hydroxyapatite (HA)-coated cementless hip prostheses is developed with similar antibacterial efficacy as offered by gentamicin-loaded cements for fixing traditional, cemented prostheses in bone. We

[Revision hip arthroplasty by Waldemar Link custom-made total hip prosthesis].

Science.gov (United States)

Medenica, Ivica; Luković, Milan; Radoicić, Dragan

2010-02-01

The number of patients undergoing hip arthroplasty revision is constantly growing. Especially, complex problem is extensive loss of bone stock and pelvic discontinuity that requires reconstruction. The paper presented a 50-year old patient, who ten years ago underwent a total cement artrhroplasty of the left hip. A year after the primary operation the patient had difficulties in walking without crutches. Problems intensified in the last five years, the patient had severe pain, totally limited movement in the left hip and could not walk at all. Radiographically, we found loose femoral component, massive loss of bone stock of proximal femur, acetabular protrusion and a consequent pelvic discontinuity. Clinically, a completely disfunctional left hip joint was registered (Harris hip score--7.1). We performed total rearthroplasty by a custom-made Waldemar Link total hip prosthesis with acetabular antiprotrusio cage and compensation of bone defects with a graft from the bone bank. A year after the operation, we found clinically an extreme improvement in Harris hip score--87.8. Radiographically, we found stability of implanted components, a complete graft integration and bone bridging across the site of pelvic discontinuity. Pelvic discontinuity and massive loss of proximal femoral bone stock is a challenging and complex entity. Conventional prostheses cannot provide an adequate fixation and stability of the hip. Application of custom-made prosthesis (measured specificaly for a patient) and additional alografting bone defects is a good method in revision surgery after unsuccessful hip arthroplasty with extensive bone defects.

Revision of failed hemiarthroplasty for painful glenoid arthrosis to anatomic total shoulder arthroplasty.

Science.gov (United States)

Sheth, Mihir M; Sholder, Daniel; Abboud, Joseph; Lazarus, Mark D; Ramsey, Matthew L; Williams, Gerald R; Namdari, Surena

2018-05-10

The impending burden of revision shoulder arthroplasty has increased interest in outcomes of revision procedures. Painful glenoid arthrosis following hemiarthroplasty is a common cause of reoperation, and conversion to anatomic total shoulder arthroplasty is one option. We identified patients who underwent revision of painful hemiarthroplasty to total shoulder arthroplasty over a 15-year period in a single tertiary-care health system. Presurgical and operative data were analyzed for 28 patients who met the inclusion and exclusion criteria. Patients were contacted at a minimum of 2 years' follow-up after revision surgery for functional outcome scores, reoperations, and implant survival. The 2- and 5-year implant survival rates were 93% and 86%, respectively. Functional outcomes were obtained from 21 patients with surviving implants. The mean American Shoulder and Elbow Surgeons score, visual analog scale score for pain, and Single Assessment Numerical Evaluation score were 78 ± 20, 2.3 ± 2.6, and 71 ± 24, respectively. The mean Short Form 12 mental and physical scores were 49 ± 10 and 43 ± 9, respectively. Of the patients, 17 (81%) were either satisfied or very satisfied with their outcome. Complications were seen in 10 patients (36%), and 6 patients (21%) required reoperation. Anatomic total shoulder arthroplasty following hemiarthroplasty can achieve successful outcomes and implant survival rates. Given our poor understanding of reverse shoulder arthroplasty longevity, this procedure should remain an option for patients with glenoid arthrosis and an intact rotator cuff. Copyright © 2018 Journal of Shoulder and Elbow Surgery Board of Trustees. Published by Elsevier Inc. All rights reserved.

In vivo performance of a reduced-modulus bone cement

Science.gov (United States)

Forehand, Brett Ramsey

Total joint replacement has become one of the most common procedures in the area of orthopedics and is often the solution in patients with diseased or injured hip joints. Component loosening is a significant problem and is primarily caused by bone resorption at the bone-cement interface in cemented implants. It is our hypothesis that localized shear stresses are responsible for the resorption. It was previously shown analytically that local stresses at the interface could be reduced by using a cement of lower modulus. A new reduced modulus cement, polybutyl methylmethacrylate (PBMMA), was developed to test the hypothesis. PBMMA was formulated to exist as polybutyl methacrylate filler in a polymethyl methacrylate matrix. The success of PBMMA cement is based largely on the fact that the polybutyl component of the cement will be in the rubbery state at body temperature. In vitro characterization of the cement was undertaken previously and demonstrated a modulus of approximately one-eighth that of conventional bone cement, polymethyl methacrylate (PMMA) and increased fracture toughness. The purpose of this experiment was to perform an in vivo comparison of the two cements. A sheep model was selected. Total hip arthroplasty was performed on 50 ewes using either PBMMA or PMMA. Radiographs were taken at 6 month intervals. At one year, the contralateral femur of each sheep was implanted so that each animal served as its own control, and the animals were sacrificed. The stiffness of the bone-cement interface of the femoral component within the femur was assessed by applying a torque to the femoral component and demonstrated a significant difference in loosening between the cements when the specimens were tested in external rotation (p sheep had a greater amount of loosening for each subject, 59% versus 4% for standard PMMA. A radiographic analysis demonstrated more signs of loosening in the PMMA series of subjects. A brief histological examination showed similar bony

Outcome of Revision Shoulder Arthroplasty After Resurfacing Hemiarthroplasty in Patients with Glenohumeral Osteoarthritis

DEFF Research Database (Denmark)

Rasmussen, Jeppe V; Olsen, Bo S; Al-Hamdani, Ali

2016-01-01

hemiarthroplasty was 62 points (interquartile range, 40 to 88 points). Of the 80 cases that had follow-up, 33 (41%) had an unacceptable outcome, defined as a WOOS of ≤50 points. Of the 107 cases that required a revision surgical procedure, 11 arthroplasties (10%) required a further revision surgical procedure...

survival of primary cemented total hip arthroplasties in east africa

African Journals Online (AJOL)

2017-09-11

Sep 11, 2017 ... In addition, patients who had not returned for follow-up in the last 12 months were contacted by phone and/or mail. A wide variety of cemented and non- cemented implants were used. End points of the implant were revision or removal for any reason. Survival was analysed by the use of Kaplan Meir tables.

Revision hip arthroplasty by Waldemar Link custom-made total hip prosthesis

Directory of Open Access Journals (Sweden)

Medenica Ivica

2010-01-01

Full Text Available Background. The number of patients undergoing hip arthroplasty revision is constantly growing. Especially, complex problem is extensive loss of bone stock and pelvic discontinuity that requires reconstruction. Case report. The paper presented a 50-year old patient, who ten years ago underwent a total cement artrhroplasty of the left hip. A year after the primary operation the patient had difficulties in walking without crutches. Problems intensified in the last five years, the patient had severe pain, totally limited movement in the left hip and could not walk at all. Radiographically, we found loose femoral component, massive loss of bone stock of proximal femur, acetabular protrusion and a consequent pelvic discontinuity. Clinically, a completely disfunctional left hip joint was registered (Harris hip score - 7.1. We performed total rearthroplasty by a custom- made Waldemar Link total hip prosthesis with acetabular antiprotrusio cage and compensation of bone defects with a graft from the bone bank. A year after the operation, we found clinically an extreme improvement in Harris hip score - 87.8. Radiographically, we found stability of implanted components, a complete graft integration and bone bridging across the site of pelvic discontinuity. Conclusion. Pelvic discontinuity and massive loss of proximal femoral bone stock is a challenging and complex entity. Conventional prostheses cannot provide an adequate fixation and stability of the hip. Application of custom-made prosthesis (measured specifically for a patient and additional alografting bone defects is a good method in revision surgery after unsuccessful hip arthroplasty with extensive bone defects.

Differences in Femoral Head Penetration Between Highly Cross-Linked Polyethylene Cemented Sockets and Uncemented Liners.

Science.gov (United States)

Morita, Daigo; Seki, Taisuke; Higuchi, Yoshitoshi; Takegami, Yasuhiko; Ishiguro, Naoki

2017-12-01

This study aimed at investigating differences in femoral head penetration between highly cross-linked polyethylene (HXLPE) cemented sockets and uncemented liners during 5 years postoperatively. Ninety-six patients (106 hips) with a mean age of 64.4 (range, 35-83) years underwent total hip arthroplasty using a HXLPE cemented socket or liner and were respectively divided into cemented (35 patients [37 hips]) and uncemented (61 patients [69 hips]) groups. Femoral head penetrations were evaluated on both anteroposterior (AP)-view and Lauenstein-view radiographs, and mean polyethylene (PE) wear rates were calculated based on femoral head penetration from 2 to 5 years. Multivariate analyses were performed to assess risk factors for PE wear. At 5 years postoperatively, the cemented and uncemented groups exhibited proximal direction femoral head penetrations of 0.103 mm and 0.124 mm (P = .226) and anterior direction penetrations of 0.090 mm and 0.151 mm (P = .002), respectively. The corresponding mean PE wear rates were 0.004 mm/y and 0.009 mm/y in the AP-view (P = .286) and 0.005 mm/y and 0.012 mm/y in the Lauenstein-view (P = .168), respectively. Left-side operation and high activity were independent risk factors for PE wear on AP-view. When HXLPE was used, all mean PE wear rates were very low and those of cemented sockets and uncemented liners were very similar. PE particle theory suggests that the occurrence of osteolysis and related aseptic loosening might consequently decrease. Copyright © 2017 Elsevier Inc. All rights reserved.

Three-dimensional shape optimization of a cemented hip stem and experimental validations.

Science.gov (United States)

Higa, Masaru; Tanino, Hiromasa; Nishimura, Ikuya; Mitamura, Yoshinori; Matsuno, Takeo; Ito, Hiroshi

2015-03-01

This study proposes novel optimized stem geometry with low stress values in the cement using a finite element (FE) analysis combined with an optimization procedure and experimental measurements of cement stress in vitro. We first optimized an existing stem geometry using a three-dimensional FE analysis combined with a shape optimization technique. One of the most important factors in the cemented stem design is to reduce stress in the cement. Hence, in the optimization study, we minimized the largest tensile principal stress in the cement mantle under a physiological loading condition by changing the stem geometry. As the next step, the optimized stem and the existing stem were manufactured to validate the usefulness of the numerical models and the results of the optimization in vitro. In the experimental study, strain gauges were embedded in the cement mantle to measure the strain in the cement mantle adjacent to the stems. The overall trend of the experimental study was in good agreement with the results of the numerical study, and we were able to reduce the largest stress by more than 50% in both shape optimization and strain gauge measurements. Thus, we could validate the usefulness of the numerical models and the results of the optimization using the experimental models. The optimization employed in this study is a useful approach for developing new stem designs.

Aseptic loosening of the femoral implant after cemented total hip arthroplasty in dogs: 11 cases in 10 dogs (1991-1995)

International Nuclear Information System (INIS)

Edwards, M.R.; Egger, E.L.; Schwarz, P.D.

1997-01-01

Objective-To determine clinical signs, radiographic findings, results of surgical management, and potential causes of aseptic loosening of the femoral implant (ALFI) in dogs that have undergone cemented total hip arthroplasty (THA). Design-Retrospective study. Animals-11 cases of ALFI in 10 dogs. Procedure-Medical records of all dogs undergoing THA revision surgery were reviewed. Only dogs with ALFI were included. The prosthesis and cement were removed by creating a longitudinal osteotomy of the cranial femoral cortex. Postoperative radiographs of all dogs that underwent THA during the study period were reviewed. Results-The most common clinical sign was intermittent, subtle. or non-weight-bearing lameness. On radiographs obtained after THA, contact of the distal stem tip with cortical endosteum was evident in all dogs. Radiographic changes at the time of diagnosis of ALFI included asymmetric periosteal reaction along the femoral diaphysis, radiolucent lines between the prosthesis and cement, altered implant position, and femoral fracture. Surgical revision yielded good or excellent results in 9 cases. In 1 dog. the implant became infected; in another, aseptic loosening recurred. Aseptic loosening was significantly more common in dogs in which there was contact between the distal stem tip and cortical endosteum than in dogs in which there was no contact. Clinical Implications-ALFI is an uncommon, but important, complication of THA, and radiography is warranted in dogs with clinical signs of ALFI. Initial centering of the prosthetic stem within the femoral shaft may reduce the incidence of ALFI

Association Between Patient Factors and Outcome of Synthetic Cartilage Implant Hemiarthroplasty vs First Metatarsophalangeal Joint Arthrodesis in Advanced Hallux Rigidus.

Science.gov (United States)

Goldberg, Andy; Singh, Dishan; Glazebrook, Mark; Blundell, Chris M; De Vries, Gwyneth; Le, Ian L D; Nielsen, Dominic; Pedersen, M Elizabeth; Sakellariou, Anthony; Solan, Matthew; Younger, Alastair S E; Daniels, Timothy R; Baumhauer, Judith F

2017-11-01

We evaluated data from a clinical trial of first metatarsophalangeal joint (MTPJ1) implant hemiarthroplasty and arthrodesis to determine the association between patient factors and clinical outcomes. Patients ≥18 years with hallux rigidus grade 2, 3, or 4 were treated with synthetic cartilage implant MTPJ1 hemiarthroplasty or arthrodesis. Pain visual analog scale (VAS), Foot and Ankle Ability Measure (FAAM) sports and activities of daily living (ADL) scores, and Short Form-36 Physical Function (SF-36 PF) subscore were obtained preoperatively, and at 2, 6, 12, 24, 52, and 104 weeks postoperatively. Final outcome data, great toe active dorsiflexion motion, secondary procedures, radiographs, and safety parameters were evaluated for 129 implant hemiarthroplasties and 47 arthrodeses. The composite primary endpoint criteria for clinical success included VAS pain reduction ≥30%, maintenance/improvement in function, no radiographic complications, and no secondary surgical intervention at 24 months. Predictor variables included hallux rigidus grade; gender; age; body mass index (BMI); symptom duration; prior MTPJ1 surgery; preoperative hallux valgus angle, range of motion (ROM), and pain. Two-sided Fisher exact test was used ( P .05) when stratified by hallux rigidus grade, gender, age, BMI, symptom duration, prior MTPJ1 surgery status, and preoperative VAS pain, hallux valgus, and ROM. Synthetic cartilage implant hemiarthroplasty was appropriate for patients with grade 2, 3, or 4 hallux rigidus. Its results in those with associated mild hallux valgus (≤20 degrees) or substantial preoperative stiffness were equivalent to MTPJ1 fusion, irrespective of gender, age, BMI, hallux rigidus grade, preoperative pain or symptom duration. Level II, randomized clinical trial.

Total hip reconstruction in acetabular dysplasia.

NARCIS (Netherlands)

Schller, H.M.; Dalstra, M.; Huiskes, R.; Marti, R.K.

1993-01-01

In acetabular dysplasia, fixation of the acetabular component of a cemented total hip prosthesis may be insecure and superolateral bone grafts are often used to augment the acetabular roof. We used finite element analysis to study the mechanical importance of the lateral acetabular roof and found

[Technology of cementless hip endoprosthetics].

Science.gov (United States)

Ungethüm, M; Blömer, W

1987-06-01

The success achieved with non-cemented hip arthroplasty depends mainly on the stability of the fixation, the quality of the stabilizing bone being just as important as favourable biomechanical conditions. The results of the intensive research and development with respect to the particular features of a non-cemented hip endoprosthesis can be divided into the following basic categories: Biomechanical aspects with special reference to bone related to the design of the prosthesis; material characteristics, such as fatigue strength, tribology, corrosion resistance, and biocompatibility; and development of new materials and coatings to permit direct bonding of implant and bone. With regard to the stem of hip prostheses, the different design parameters of various types are examined to determine their typical design characteristics, such as bearing surface of the collar, geometry of cross section, anatomically adapted shaping, and surface of the implant forming the contact with the bone. The latter can be divided into macroprofiles and macro- and micro-porous coated surfaces. On the other hand, the methods of cementless fixation of acetabular cups can be primarily divided into conical and spherical screw fixation and pegged fixation with additional macroprofiles of porous surfaces. In a separate study of the biomechanical aspects of screwed sockets, the special importance of socket shape and thread geometry are presented with reference to primary stability and long-term fixation of prostheses.

Life Estimation of Hip Joint Prosthesis

Science.gov (United States)

Desai, C.; Hirani, H.; Chawla, A.

2015-07-01

Hip joint is one of the largest weight-bearing structures in the human body. In the event of a failure of the natural hip joint, it is replaced with an artificial hip joint, known as hip joint prosthesis. The design of hip joint prosthesis must be such so as to resist fatigue failure of hip joint stem as well as bone cement, and minimize wear caused by sliding present between its head and socket. In the present paper an attempt is made to consider both fatigue and wear effects simultaneously in estimating functional-life of the hip joint prosthesis. The finite element modeling of hip joint prosthesis using HyperMesh™ (version 9) has been reported. The static analysis (load due to the dead weight of the body) and dynamic analysis (load due to walking cycle) have been described. Fatigue life is estimated by using the S-N curve of individual materials. To account for progressive wear of hip joint prosthesis, Archard's wear law, modifications in socket geometry and dynamic analysis have been used in a sequential manner. Using such sequential programming reduction in peak stress has been observed with increase in wear. Finally life is estimated on the basis of socket wear.

Fixation method does not affect restoration of rotation center in hip replacements: A single-site retrospective study

OpenAIRE

Wegner, Alexander; Kauther, Max Daniel; Landgraeber, Stefan; von Knoch, Marius

2012-01-01

Abstract Background Aseptic loosening is one of the greatest problems in hip replacement surgery. The rotation center of the hip is believed to influence the longevity of fixation. The aim of this study was to compare the influence of cemented and cementless cup fixation techniques on the position of the center of rotation because cemented cup fixation requires the removal of more bone for solid fixation than the cementless technique. Methods We retrospectively compared pre- and post-operativ...

Articulating spacers used in two-stage revision of infected hip and knee prostheses abrade with time.

Science.gov (United States)

Fink, Bernd; Rechtenbach, Annett; Büchner, Hubert; Vogt, Sebastian; Hahn, Michael

2011-04-01

Articulating spacers used in two-stage revision surgery of infected prostheses have the potential to abrade and subsequently induce third-body wear of the new prosthesis. We asked whether particulate material abraded from spacers could be detected in the synovial membrane 6 weeks after implantation when the spacers were removed for the second stage of the revision. Sixteen hip spacers (cemented prosthesis stem articulating with a cement cup) and four knee spacers (customized mobile cement spacers) were explanted 6 weeks after implantation and the synovial membranes were removed at the same time. The membranes were examined by xray fluorescence spectroscopy, xray diffraction for the presence of abraded particles originating from the spacer material, and analyzed in a semiquantitative manner by inductively coupled plasma mass spectrometry. Histologic analyses also were performed. We found zirconium dioxide in substantial amounts in all samples, and in the specimens of the hip synovial lining, we detected particles that originated from the metal heads of the spacers. Histologically, zirconium oxide particles were seen in the synovial membrane of every spacer and bone cement particles in one knee and two hip spacers. The observations suggest cement spacers do abrade within 6 weeks. Given the presence of abrasion debris, we recommend total synovectomy and extensive lavage during the second-stage reimplantation surgery to minimize the number of abraded particles and any retained bacteria.

Radiological evaluation of failed total hip replacement

International Nuclear Information System (INIS)

Raspa, V.; Aldrovandi, S.; Pompei, G.

1988-01-01

The retrospective study of 50 operated cases of cemented total hip replacement and a review of the literature enabled the authors to define the radiological features of the above-mentioned condition. These features include one or more of the following signs: calcar reabsorption, lacunar erosions, modified relatioships between the prosthesis components, sepsis and loosening, periarticular calcifications dislocation and fracture of prosthesis components. Careful evaluation of these radiological features is extremely important for both an early diagnosis of failed total hip replacement and the choice of an adequate surgical treatment

Femoral component loosening after hip resurfacing arthroplasty

International Nuclear Information System (INIS)

Zustin, Jozef; Sauter, Guido; Hahn, Michael; Morlock, Michael M.; Ruether, Wolfgang; Amling, Michael

2010-01-01

Before the re-introduction of the current generation of total hip resurfacing arthroplasty, component loosening and osteolysis were of great concern to the orthopaedic community. Early, mid- and long-term clinical results are encouraging, but component loosening still exists. Macroscopic, contact radiographic and histopathological analyses after undecalcified preparation of bone tissue specimens were performed. To investigate the frequency and morphological patterns of the loosening of the femoral component, we analysed a series of 190 retrieved femoral remnants that were revised for aseptic failures. Thirty-five (18.4%) hips were revised for clinical and/or radiographic loosening of the femoral component. Pseudoarthrosis (n = 17; median in situ time: 16 weeks, interquartile range [IQR]: 9 to 34), collapsed osteonecrosis (n = 5; median in situ time: 79 weeks, IQR: 63 to 97), cement-socket debonding (n = 3; median in situ time: 89 weeks, IQR: 54 to 97) and at later follow-up bone-cement loosening (n = 10; median in situ time: 175 weeks; IQR 112 to 198; p =0.005) were distinct patterns of the femoral remnant-implant loosening. Fibrocartilaginous metaplasia of interface bone trabeculae (n = 38; median in situ time: 61 weeks, IQR: 32 to 138) was strongly associated with femoral component loosening (p = 0.009). Both the trabecular hyperosteoidosis (n = 32; median in situ time: 71 weeks, IQR 50 to 129) and excessive intraosseous lymphocyte infiltration (n = 12; median in situ time: 75 weeks, IQR 51 to 98) at the bone-cement interface correlated strongly with fibrocartilaginous metaplasia (p = 0.001 and p = 0.016 respectively) and all three lesions were associated with the female gender (p = 0.021, p = 0.009, and p = 0.051). Femoral component loosening at early follow-up was mostly caused by pathological changes of the femoral remnant bone tissue: pseudoarthrosis and collapsed osteonecrosis. Fibrocartilaginous metaplasia was frequently observed in hips with femoral

Artroplastia parcial no tratamento das fraturas do colo do fêmur Hemiarthroplasty in the treatment of fractures of the femoral neck

Directory of Open Access Journals (Sweden)

Nelson Keiske Ono

2010-01-01

Full Text Available OBJETIVO: Realizar avaliação epidemiológica e clínica dos pacientes com fratura desviada do colo femoral, que foram submetidos ao tratamento cirúrgico, com artroplastia parcial do quadril cimentada. MÉTODOS: Foram avaliados, de forma retrospectiva, todos os pacientes com fratura desviada do colo do fêmur (Garden III e IV submetidos à artroplastia parcial do quadril com prótese unipolar (Thompson, cimentada pela via de acesso posterolateral do quadril, no período de junho de 2005 a setembro de 2008. RESULTADOS: Foram avaliados, inicialmente, 70 pacientes. A média de idade foi de 83,1 anos. Houve predomínio de pacientes do sexo feminino (84,3%. Houve acompanhamento ambulatorial de 36 pacientes, cujo tempo de seguimento variou de 10 a 48 meses (média de 26,5 meses. Houve perda de seguimento de 15 pacientes. Dezenove pacientes foram a óbito, com uma taxa de mortalidade no primeiro ano de 25,4%. Os pacientes classificados como ASA III apresentaram taxa de 25,7%, enquanto os pacientes ASA II, uma taxa de 12,1%. Dois pacientes apresentaram trombose venosa profunda sintomática; um paciente, infecção do sítio operatório; e nenhum paciente apresentou luxação do quadril. A maioria dos pacientes evoluiu sem dor. Doze pacientes (33%, durante a evolução, apresentaram piora na capacidade de deambulação. CONCLUSÃO: Nenhum caso de luxação do quadril foi observado. Os pacientes classificados como ASA III apresentaram um índice de mortalidade mais elevado, em relação aos pacientes ASA I e II. Houve uma piora da capacidade de deambular em 33% dos pacientes. Não foi necessária revisão de nenhum paciente por soltura ou dor. Trinta pacientes não apresentavam dor (83,3%, quatro apresentavam dor moderada (11,1% e dois apresentavam dor intensa (5,5%.OBJETIVE: To epidemiologically and clinically evaluate patients with displaced femoral neck fractures that had surgical treatment with cemented hemiarthroplasty. METHODS: We evaluated

Hemi replacement arthroplasty for unstable inter-trochanteric fractures of femur.

Science.gov (United States)

Singh, Sudhir; Shrivastava, Chetan; Kumar, Sanjiv

2014-10-01

Unstable inter-trochanteric fracture in the geriatric population is a common injury and is associated with poor bone quality, excessive collapse, loss of fixation, and cut-out of the lag screw, are the common problems of attempts to fix these fractures. Present study is an attempt to evaluate the functional outcome of primary cemented bipolar hemiarthroplasty in unstable inter-trochanteric fractures in elderly patients. This prospective study included 25 cases with unstable inter-trochanteric fracture of femur between 60 -75 y of age in whom primary Cemented Bipolar hemi - arthroplasty was performed. The patients were followed up at six week, three month, six month and one year postoperatively and assessed using Harris Hip Score (HHS), Lower Extremity Functional Scale (LEFS), Visual analogue scale (VAS) for evaluation of outcome. The mean HHS score was 78.86+8.13 by the end of one year. Similarly mean LEFS score was 34.36+7.01 by the end of one year, whereas the mean pain score on VAS Scale by the year end was 1.04+1.02. The changes in HHS, LEFS and VAS up to six months periods are much greater which starts showing a stable trend thereafter. Fair to good scores were observed in all the patients. We compared our results with those reported by other authors and our study gave quite comparable results. We also used lower extremity function status score (LEFS) for assessment of functional ability. The purpose of its use was that while Harris Hip Score (HHS) provides information on a multitude of factors, LEFS is more patient oriented and provides the correct information about the level of activities a patient can resume post-operatively and can be offered as a self assessment tool. No significant complication except for grade I pressure sores in four patients were seen in postoperative period but they all resolved with proper nursing care by six week follow up. No patient required revision surgery. The authors believe that primary cemented bipolar hemiarthroplasty for

Are digital images good enough? A comparative study of conventional film-screen vs digital radiographs on printed images of total hip replacement

International Nuclear Information System (INIS)

Eklund, K.; Jonsson, K.; Lindblom, G.; Lundin, B.; Sanfridsson, J.; Sloth, M.; Sivberg, B.

2004-01-01

The aim of this study was to evaluate the inter- and intra-observer variability and to find differences in diagnostic safety between digital and analog technique in diagnostic zones around hip prostheses. In 80 patients who had had a total hip replacement (THR) for more than 2 years, a conventional image and a digital image were taken. Gruen's model of seven distinct regions of interest was used for evaluations. Five experienced radiologists observed the seven regions and noted in a protocol the following distances: stem-cement; cement-bone; and stem-bone. All images were printed on hard copies and were read twice. Weighted kappa, κ w , analyses were used. The two most frequently loosening regions, stem-cement region 1 and cement-bone region 7, were closely analyzed. In region 1 the five observers had an agreement of 86.75-97.92% between analog and digital images in stem-cement, which is a varied κ w 0.29-0.71. For cement-bone region 7 an agreement of 87.21-90.45% was found, which is a varied κ w of 0.48-0.58. All the kappa values differ significantly from nil. The result shows that digital technique is as good as analog radiographs for diagnosing possible loosening of hip prostheses. (orig.)

Dual mobility cups for preventing early hip arthroplasty dislocation in patients at risk: experience in a county hospital

Directory of Open Access Journals (Sweden)

Sebastian S. Mukka

2013-06-01

Full Text Available Dislocation remains a major concern after hip arthroplasty. We asked whether dual mobility cups (DMC would improve early hip stability in patients with high risk of dislocation. We followed 34 patients (21 females, 13 males treated between 2009 and 2012 with cemented DMC for hip revisions caused recurrent hip prosthetic dislocation or as a primary procedure in patients with high risk of instability. Functional outcome and quality of life were evaluated using Harris Hip Score and EQ-5D respectively. We found that the cemented DMC gave stability in 94%. Seven patients (20% were re-operated due to infection. One patient sustained a periprosthetic fracture. At follow-up (6 to 36 months, mean 18, the mean Harris hip score was 67 (standard deviation: 14 and mean EQ-5D was 0.76 (standard deviation: 0.12. We concluded that treating patients with high risk of dislocation with DMC can give good stability. However, complications such as postoperative infection can be frequent and should be managed carefully.

A Cost-Effectiveness Analysis of Reverse Total Shoulder Arthroplasty versus Hemiarthroplasty for the Management of Complex Proximal Humeral Fractures in the Elderly.

Science.gov (United States)

Osterhoff, Georg; O'Hara, Nathan N; D'Cruz, Jennifer; Sprague, Sheila A; Bansback, Nick; Evaniew, Nathan; Slobogean, Gerard P

2017-03-01

There is ongoing debate regarding the optimal surgical treatment of complex proximal humeral fractures in elderly patients. To evaluate the cost-effectiveness of reverse total shoulder arthroplasty (RTSA) compared with hemiarthroplasty (HA) in the management of complex proximal humeral fractures, using a cost-utility analysis. On the basis of data from published literature, a cost-utility analysis was conducted using decision tree and Markov modeling. A single-payer perspective, with a willingness-to-pay (WTP) threshold of Can$50,000 (Canadian dollars), and a lifetime time horizon were used. The incremental cost-effectiveness ratio (ICER) was used as the study's primary outcome measure. In comparison with HA, the incremental cost per quality-adjusted life-year gained for RTSA was Can$13,679. One-way sensitivity analysis revealed the model to be sensitive to the RTSA implant cost and the RTSA procedural cost. The ICER of Can$13,679 is well below the WTP threshold of Can$50,000, and probabilistic sensitivity analysis demonstrated that 92.6% of model simulations favored RTSA. Our economic analysis found that RTSA for the treatment of complex proximal humeral fractures in the elderly is the preferred economic strategy when compared with HA. The ICER of RTSA is well below standard WTP thresholds, and its estimate of cost-effectiveness is similar to other highly successful orthopedic strategies such as total hip arthroplasty for the treatment of hip arthritis. Copyright © 2017 International Society for Pharmacoeconomics and Outcomes Research (ISPOR). Published by Elsevier Inc. All rights reserved.

[Effect of bone cement application on the incidence of deep vein thrombosis in major joint arthroplasties].

Science.gov (United States)

Aslan, Ahmet; Ağar, Emre; Aydoğan, Nevres Hürriyet; Atay, Tolga; Baydar, Metin Lütfi; Kırdemir, Vecihi; Ozden, Ahmet

2011-12-01

In this study, we have investigated whether the application of bone cement has an effect on the frequency of deep vein thrombosis (DVT) in major joint arthroplasties (MJA). A total of 95 MJA cases meeting the inclusion criteria of this study between January 2004 and January 2005 were divided into cemented and cementless groups. For prophylaxis, all patients were given low molecular weight heparin (LMWH). The patients were scanned for DVT preoperatively and on the postoperative 12(th) day by color Doppler ultrasonography. In hip arthroplasties, in knee arthroplasties and in general, DVT was seen more frequently in cemented group, however, there was no statistically significant difference between groups in the frequency of DVT (p=0.549, p=0.749 and p=0.462, respectively). Also, there was no significant difference between the results of the different LMWH groups (p=0.616). The results of this study shows that bone cement application in MJAs such as hip or knee arthroplasties has no significant effect on the frequency of DVT.

Micromechanical modeling of the cement-bone interface: the effect of friction, morphology and material properties on the micromechanical response

OpenAIRE

Janssen, Dennis; Mann, Kenneth A.; Verdonschot, Nico

2008-01-01

In order to gain insight into the micro-mechanical behavior of the cement-bone interface, the effect of parametric variations of frictional, morphological and material properties on the mechanical response of the cement-bone interface were analyzed using a finite element approach. Finite element models of a cement-bone interface specimen were created from micro-computed tomography data of a physical specimen that was sectioned from an in vitro cemented total hip arthroplasty. In five models t...

Age-related hip fractures in men: clinical spectrum and short-term outcomes.

Science.gov (United States)

Poór, G; Atkinson, E J; Lewallen, D G; O'Fallon, W M; Melton, L J

1995-01-01

Clinical spectrum, treatment and short-term outcomes were assessed among the 131 Rochester, Minnesota, men who contracted an initial hip fracture due to moderate trauma during 1978-89. Three-fourths of falls leading to hip fracture occurred indoors with little seasonality, and 91% of fractures were in men 65 years of age or older. The ratio of cervical to intertrochanteric femur fractures was 1.4:1, and there was a tendency toward more neurological conditions among the patients with cervical fractures. Hemiarthroplasty and total hip replacement were mostly performed for cervical fractures, while internal fixation was preferred for intertrochanteric fractures. In-hospital mortality was 11.5%, and the 30-day case fatality rate was 16.0%. Age and postoperative deterioration of mental status significantly increased the risk of early death, the latter even after adjustment in a multivariate model, while comorbidity had a suggestive but not statistically significant influence on mortality. More than half the men were discharged to nursing homes, and 79% of the patients who survived at 1 year resided in nursing homes or intermediate care facilities or were attended by home care. Only 41% of survivors recovered their prefracture level of functioning and nearly 60% of patients limped and required a cane or walker. After implementation of the prospective payment system in 1984, the length of hospital stay was reduced, but there was no change in early mortality rates, in the duration of physical therapy following fracture or in attendance at nursing homes. The results of this population-based study demonstrate the strong impact of hip fractures on short-term outcomes in men.

Are digital images good enough? A comparative study of conventional film-screen vs digital radiographs on printed images of total hip replacement

Energy Technology Data Exchange (ETDEWEB)

Eklund, K.; Jonsson, K.; Lindblom, G.; Lundin, B.; Sanfridsson, J.; Sloth, M. [Department of Radiology, Center for Medical Imaging and Physiology, Lund University Hospital, 22185, Lund (Sweden); Sivberg, B. [Department of Nursing, Faculty of Medicine, Lund University, P.O. Box 157, 22100, Lund (Sweden)

2004-05-01

The aim of this study was to evaluate the inter- and intra-observer variability and to find differences in diagnostic safety between digital and analog technique in diagnostic zones around hip prostheses. In 80 patients who had had a total hip replacement (THR) for more than 2 years, a conventional image and a digital image were taken. Gruen's model of seven distinct regions of interest was used for evaluations. Five experienced radiologists observed the seven regions and noted in a protocol the following distances: stem-cement; cement-bone; and stem-bone. All images were printed on hard copies and were read twice. Weighted kappa, {kappa}{sub w}, analyses were used. The two most frequently loosening regions, stem-cement region 1 and cement-bone region 7, were closely analyzed. In region 1 the five observers had an agreement of 86.75-97.92% between analog and digital images in stem-cement, which is a varied {kappa}{sub w} 0.29-0.71. For cement-bone region 7 an agreement of 87.21-90.45% was found, which is a varied {kappa}{sub w} of 0.48-0.58. All the kappa values differ significantly from nil. The result shows that digital technique is as good as analog radiographs for diagnosing possible loosening of hip prostheses. (orig.)

Patient-oriented functional results of total femoral endoprosthetic reconstruction following oncologic resection.

Science.gov (United States)

Jones, Kevin B; Griffin, Anthony M; Chandrasekar, Coonoor R; Biau, David; Babinet, Antoine; Deheshi, Benjamin; Bell, Robert S; Grimer, Robert J; Wunder, Jay S; Ferguson, Peter C

2011-11-01

Functional outcomes following oncologic total femoral endoprosthetic reconstruction (TFR) are lacking. We compared patient-oriented functional results of TFRs to proximal femur and distal femur reconstructions (PFR and DFR). We also compared function and complications with regard to knee and hip componentry. Fifty-four TFR patients were identified from three institutional prospective databases. Forty-one had fixed- and 13 had rotating-hinge knees, 37 hemiarthroplasty and 17 total hip arthroplasty componentry. Toronto Extremity Salvage Scores (TESS) for n = 27 were compared between groups and to cohorts of PFR (n = 31) and DFR (n = 85) patients using the Mann-Whitney U-test. Follow-up averaged 4 years. Mechanical complications included five hip dislocations and one femoral malrotation. Four dislocations were in fixed-hinge implants, all in those lacking abductor reattachment. TESS averaged 69.3 ± 17.8, statistically decreased from DFR (P = 0.002) and PFR patients (P = 0.036). No significant differences were detected between patients in the fixed-hinge (n = 18) and rotating-hinge (n = 9) groups (P = 0.944), or total hip (n = 8) and hemiarthroplasty (n = 19) groups (P = 0.633). TFR is reserved for extreme cases of limb salvage, portending a poor prognosis overall. Function reflects additive impairments from PFR and DFR. TFR outcomes differ little with rotating- or fixed-hinge, total hip or hemiarthroplasty implants. Copyright © 2011 Wiley Periodicals, Inc.

A Review of Periprosthetic Femoral Fractures Associated With Total Hip Arthroplasty

Science.gov (United States)

Marsland, Daniel; Mears, Simon C.

2012-01-01

Periprosthetic fractures of the femur in association with total hip arthroplasty are increasingly common and often difficult to treat. Patients with periprosthetic fractures are typically elderly and frail and have osteoporosis. No clear consensus exists regarding the optimal management strategy because there is limited high-quality research. The Vancouver classification facilitates treatment decisions. In the presence of a stable prosthesis (type-B1 and -C fractures), most authors recommend surgical stabilization of the fracture with plates, strut grafts, or a combination thereof. In up to 20% of apparent Vancouver type-B1 fractures, the femoral stem is loose, which may explain the high failure rates associated with open reduction and internal fixation. Some authors recommend routine opening and dislocation of the hip to perform an intraoperative stem stability test to rule out a loose component. Advances in plating techniques and technology are improving the outcomes for these fractures. For fractures around a loose femoral prosthesis (types B2 and 3), revision using an extensively porous-coated uncemented long stem, with or without additional fracture fixation, appears to offer the most reliable outcome. Cement-in-cement revision using a long-stem prosthesis is feasible in elderly patients with a well-fixed cement mantle. It is essential to treat the osteoporosis to help fracture healing and to prevent further fractures. We provide an overview of the causes, classification, and management of periprosthetic femoral fractures around a total hip arthroplasty based on the current best available evidence. PMID:23569704

THE INFLUENCE OF THE SURGICAL APPROACH CONCERNING DISLOCATION IN TOTAL HIP ARTHROPLASTY.

Science.gov (United States)

Vicente, José Ricardo Negreiros; Pires, André Fernandes; Lee, Bruno Takasaki; Leonhardt, Marcos Camargo; Ejnisman, Leandro; Croci, Alberto Tesconi

2009-01-01

Our primary aim was to evaluate the occurrence of dislocation of non-cemented total hip arthroplasty, when using the posterior and the direct lateral approaches. We performed a comparative retrospective study with 232 patients submitted to non-cemented total hip arthroplasty, due to the diagnosis of primary or secondary osteoarthritis. The posterior approach was used in 105 patients while direct lateral approach was used in 127 patients. There was only one prosthesis model and the same rehabilitation program and post-operative care was used for all patients. We checked the occurrence of dislocation, the acetabular positioning and also the size of the components. There was only one case of dislocation, treated with closed reduction successfully. This was a 47 year-old female, submitted to direct lateral approach. The mean follow-up time for both groups was 23.7 months, ranging from six to 42 months. The authors conclude that the prevalence of total hip arthroplasty dislocation is similar for both approaches, and educational measures besides the use of a higher femoral offset seem to reduce the risk of this complication.

Total hip reconstruction in acetabular dysplasia : a finite element study

NARCIS (Netherlands)

Schüller, H.M.; Dalstra, M.; Huiskes, H.W.J.; Marti, R.K.

1993-01-01

In acetabular dysplasia, fixation of the acetabular component of a cemented total hip prosthesis may be insecure and superolateral bone grafts are often used to augment the acetabular roof. We used finite element analysis to study the mechanical importance of the lateral acetabular roof and found

High proximal migration in cemented acetabular revisions operated with bone impaction grafting; 47 revision cups followed with RSA for 17 years.

Science.gov (United States)

Mohaddes, Maziar; Herberts, Peter; Malchau, Henrik; Johanson, Per-Erik; Kärrholm, Johan

2017-05-12

Bone impaction grafting is a biologically and mechanically appealing option in acetabular revision surgery, allowing restitution of the bone stock and restoration of the biomechanics. We analysed differences in proximal migration of the revision acetabular components when bone impaction grafting is used together with a cemented or an uncemented cup. 43 patients (47 hips), revised due to acetabular loosening and judged to have less than 50% host bone-implant contact were included. The hips were randomised to either an uncemented (n = 20) or a cemented (n = 27) revision cup. Radiostereometry and radiography was performed postoperatively, at 3 and 6 months, 1, 2, 3, 5, 7, 10 and 13 and 17 years postoperatively. Clinical follow-up was performed at 1, 2 and 5 years postoperatively and thereafter at the same interval as in the radiographic follow-up. There were no differences in the base line demographic data between the 2 groups. At the last follow-up (17 years) 14 hips (10 cemented, 4 uncemented) had been re-revised due to loosening. 3 additional cups (1 uncemented and 2 cemented) were radiographically loose. There was a higher early proximal migration in the cemented cups. Cups operated on with cement showed a higher early migration measured with RSA and also a higher number of late revisions. The reason for this is not known, but factors such as inclusion of cases with severe bone defects, use of smaller bone chips and issues related to the impaction technique might have had various degrees of influence.

Normal microscopic architecture of acetabular labrum of hip joint: a qualitative original study with clinical aspects.

Science.gov (United States)

Kapetanakis, Stylianos; Gkantsinikoudis, Nikolaos; Dermon, Antonios; Kommata, Vassiliki; Papathanasiou, Jannis; Soukakos, Panagiotis; Dermon, Caterina

2017-01-01

Normal histologic architecture of acetabular labrum, regarding presence of Free Nerve Endings (FNEs) and Nerve End Organs (NEOs) has been four times described. Nevertheless, elderly cadaveric specimens and individuals were recruited, leading to considerably high unreliability probability due to microscopic degenerative alterations. Aim of this paper is to analyze distribution pattern of FNEs and NEOs in acetabular labra of healthy middle-aged individuals, configuring thus more reliably acetabular labrum microscopic profile. Six patients with middle age 52 ± 2.5 years were enrolled in this study. Injury of acetabular labrum and normal hip radiograph were present in all cases. Patients were all subjected to successful hip hemi-arthroplasty and derived acetabular labra were subsequently histologically processed and observed under a compound microscope. FNEs and NEOs were detected in all specimens. All types of NEOs were identified, including Paccini, Golgi-Mazzoni, Ruffini and Krause corpuscles. FNEs and NEOs were both in ventral part and in chondral side of labrum predominantly detected. FNEs and NEOs presence was greater in ventral side of labrum, being thus in partial agreement with previous studies results. Further study is required, in order to elucidate the exact acetabular labrum normal microscopic anatomy. IV.

Pinning down loosened prostheses : imaging and planning of percutaneous hip refixation

NARCIS (Netherlands)

Malan, Daniel Francois

2015-01-01

This thesis examines how computer software can be used to analyse medical images of an aseptically loosening hip prosthesis, and subsequently to plan and guide a minimally invasive cement injection procedure to stabilize the prosthesis. We addressed the detection and measurement of periprosthetic

Successful staged hip replacement in septic hip osteoarthritis in osteopetrosis: a case report

Directory of Open Access Journals (Sweden)

Manzi Giovanni

2012-04-01

Full Text Available Abstract Background Osteopetrosis is a rare, inherited, bone disorder, characterized by osteosclerosis, obliteration of the medullary cavity and calcified cartilage. The autosomal dominant form is compatible with a normal life span, although fractures often result from minimal trauma, due to the pathologic nature of bone. Osteomyelitis is common in patients with osteopetrosis because of a reduced resistance to infection, attributed to the lack of marrow vascularity and impairment of white cell function. Only one case of osteomyelitis of the proximal third of the femur has been previously reported, treated with several repeated debridements and finally with femoral head resection. Here we present for the first time a case of a staged implant of a cementless total hip prosthesis for the treatment of a septic hip in femoral neck nonunion in osteopetrosis. Case presentation A 36-years-old woman, affected by autosomal dominant osteopetrosis was referred to our department because of a septic hip arthritis associated with femoral neck septic non-union, with draining fistulas. The infection occurred early after a plate osteosynthesis for a closed perthrocanteric fracture of the femur and persisted in spite of osteosynthesis removal, surgical debridement and external fixation. In our hospital the patient underwent accurate debridement, femoral head and greater trochanter resection, preparation of the diaphyseal intramedullary canal and implant of an antibiotic-loaded cement spacer. The spacer was exchanged after one month, due to infection recurrence and four months later, a cementless total hip arthroplasty was implanted, with no clinical and laboratory signs of infection recurrence at two years follow-up. Conclusions In case of hip septic arthritis and proximal femur septic non-union, femoral head resection may not be the only option available and staged total hip arthroplasty can be considered.

Radionuclide arthrogram with SPECT/CT for the evaluation of mechanical loosening of hip and knee prostheses

International Nuclear Information System (INIS)

Chew, C.G.; Lewis, P.; Middleton, F.; Wijngaard, R. van den; Deshaies, A.

2010-01-01

The Objective of this study was to evaluate the value of single photon emission computed tomography (SPECT)/CT in radionuclide arthrogram (RNA) for the assessment of mechanical loosening of hip and knee prostheses. A retrospective audit of 117 RNA SPECT/CTs evaluated by a single reader- 40 hips, (1 hemiarthroplasty) and 77 knees (12 unicompartmental). The detection of any radiotracer within the bone/prosthetic interface was deemed positive for loosening. The operative assessment of 29 hip and 44 knee prosthetic joints was known and used as the gold standard. A subsequent blinded reassessment of the planar images was performed and compared with the SPECT/CT results for 26 of the 29 hip and 42 of the 44 knee prostheses. The respective SPECT/CT versus planar results were as follows: hips- acetabular cup: sensitivity: 73 versus 0%; specificity: 71 versus 100%; positive predictive value: 62% versus indeterminate; negative predictive value: 80% versus 72% (p=0.0044). Hips- femoral component: sensitivity: 78 versus 63%; specificity: 90 versus 94%; positive predictive value: 78 versus 83%; negative predictive value: 90 versus 85% (p=0.2482). Knees- femoral component: sensitivity: 75 versus 17%; specificity 63 versus 97%; positive predictive value: 43 versus 67%; negative predictive value: 87 versus 74% (p=0.0001). Knees- tibial component: sensitivity: 86 versus 63%; specificity: 86 versus 76%; positive predictive value: 55 versus 38%; negative predictive value: 97 versus 90% (p=0.6831). For evaluation of mechanical loosening of the hip prosthesis SPECT/CT was significantly better than planar scanning for the acetabular cup, but not for the femoral stem. For evaluation of the knee prosthesis, a significant improvement was noted using SPECT/CT for the femoral component, and although superior results were also noted for the tibial component, statistical significance was not reached. Taking into account the limitations of this retrospective audit, the value of using RNA SPECT

The design of the acetabular component and size of the femoral head influence the risk of revision following 34 721 single-brand cemented hip replacements: a retrospective cohort study of medium-term data from a National Joint Registry.

Science.gov (United States)

Jameson, S S; Baker, P N; Mason, J; Gregg, P J; Brewster, N; Deehan, D J; Reed, M R

2012-12-01

Despite excellent results, the use of cemented total hip replacement (THR) is declining. This retrospective cohort study records survival time to revision following primary cemented THR using the most common combination of components that accounted for almost a quarter of all cemented THRs, exploring risk factors independently associated with failure. All patients with osteoarthritis who had an Exeter V40/Contemporary THR (Stryker) implanted before 31 December 2010 and recorded in the National Joint Registry for England and Wales were included in the analysis. Cox's proportional hazard models were used to analyse the extent to which risk of revision was related to patient, surgeon and implant covariates, with a significance threshold of p brand of cement/presence of antibiotic, femoral head material (stainless steel/alumina) and stem taper size/offset. However, the risk of revision for dislocation was significantly higher with a 'plus' offset head (HR 2.05, p = 0.003) and a hooded acetabular component (HR 2.34, p designs of acetabular component and sizes of femoral head after adjustment for a range of covariates.

Radiological evaluation of painful total hip replacement

International Nuclear Information System (INIS)

Tehranzadeh, J.; Schneider, R.; Freiberger, R.H.

1981-01-01

Ninety-four cases of clinically failed, cemented, total hip prostheses requiring surgery were reviewed to determine the accuracy of preoperative plain radiography, culture of aspirated fluid, arthrography, and bone scanning. When radiopaque cement had been used to embed the prosthesis, plain radiography was highly accurate in detecting a loose femoral component, less so in detecting a loose acetabular component. Culture of aspirated fluid was accurate in diagnosing infection. A positive arthrogram identified loosening with good accuracy; however, a negative arthrogram did not reliably exclude loosening. 99 mTc bone scans frequently differentiated loosening from loosening with infection. The suggested sequence of diagnostic tests is plain radiography followed by bone scanning. If the bone scan shows diffuse augmented uptake, culture of aspirated fluid followed by arthrography is indicated

Irrigation and Debridement with Component Retention for Acute Infection After Hip Arthroplasty: Improved Results with Contemporary Management.

Science.gov (United States)

Bryan, Andrew J; Abdel, Matthew P; Sanders, Thomas L; Fitzgerald, Steven F; Hanssen, Arlen D; Berry, Daniel J

2017-12-06

There are conflicting data on the results of irrigation and debridement with component retention in patients with acute periprosthetic hip infections. The goals of this study were to examine contemporary results of irrigation and debridement with component retention for acute infection after primary hip arthroplasty and to identify host, organism, antibiotic, or implant factors that predict success or failure. Ninety hips (57 total hip arthroplasties and 33 hemiarthroplasties) were diagnosed with acute periprosthetic hip infection (using strict criteria) and were treated with irrigation and debridement and component retention between 2000 and 2012. The mean follow-up was 6 years. Patients were stratified on the basis of McPherson criteria. Hips were managed with irrigation and debridement and retention of well-fixed implants with modular head and liner exchange (70%) or irrigation and debridement alone (30%). Seventy-seven percent of patients were treated with chronic antibiotic suppression. Failure was defined as failure to eradicate infection, characterized by a wound fistula, drainage, intolerable pain, or infection recurrence caused by the same organism strain; subsequent removal of any component for infection; unplanned second wound debridement for ongoing deep infection; and/or occurrence of periprosthetic joint infection-related mortality. Treatment failure occurred in 17% (15 of 90 hips), with component removal secondary to recurrent infection in 10% (9 of 90 hips). Treatment failure occurred in 15% (10 of 66 hips) after early postoperative infection and 21% (5 of 24 hips) after acute hematogenous infection (p = 0.7). Patients with McPherson host grade A had a treatment failure rate of 8%, compared with 16% (p = 0.04) in host grade B and 44% in host grade C (p = 0.006). Most treatment failures (12 of 15 failures) occurred within the initial 6 weeks of treatment; failures subsequent to 6 weeks occurred in 3% of those treated with chronic antibiotic

Takotsubo cardiomyopathy in an 81-year-old woman after injection of bone cement during hemiarthroplasty: An orthogeriatric case report

Directory of Open Access Journals (Sweden)

Paolo Mazzola

2016-01-01

Conclusion: Despite the good prognosis associated with early recognition, Takotsubo represents a life-threatening adverse event. Considering its possible pathogenesis, a “gentle care” approach and the optimization of pain control must be pursued in elderly subjects with hip fracture, aiming at reducing the stress of the hospitalization and related procedures.

Unusual way of loosened total hip arthroplasty treatment with an Austin Moore endoprosthesis

OpenAIRE

M Erceg; K Becic

2014-01-01

A 65-year-old female patient with aseptic loosening of total cemented hip endoprosthesis and pathologic fracture of the femur at the level of the stem of endoprosthesis was presented. As no appropriate endoprosthesis was available due to the war in Croatia and war priority, the problem was managed by femur osteosynthesis and implantation of a partial Austin Moore hip endoprosthesis. The endoprosthesis is still functioning well (for 20 years).To the best of the author′s knowledge, nobody has e...

Simulation of the mechanical behavior of a HIP implant. Implant fixed to bone by cementation under arbitrary load

Science.gov (United States)

Oldani, C. R.; Dominguez, A. A.

2007-11-01

In a previous work a finite elements model was constructed to simulate a fatigue assay according to the norm IRAM 9422-3. Three materials were studied, two of them are the most used in this type of implant (Stainless steel 3161 and alloy T16A14V) and the third was a new developed titanium alloy (Ti35Nb7Zr5Ta). Static loads were applied to the model according to the highest requirements of the norm and the stress - strain distribution were determined. In this study a simplified analysis of the material's fatigue was done according to the previous work. The best behavior of the titanium alloys vs. the stainless steel was evident. With the objective of studying the behavior of both: the implant and the femur bone, new finite elements models were realized, in which the presence of the bone was considered. Inside the bone, the femoral component of the implant was placed in a similar way of a cemented prosthesis in a total hip arthroplasty. The advantage of the titanium implant related to the stainless steel one, was very clear.

Simulation of the mechanical behavior of a HIP implant. Implant fixed to bone by cementation under arbitrary load

Energy Technology Data Exchange (ETDEWEB)

Oldani, C R [Materials Department - FCEFyN - Universidad Nacional de Cordoba, Av.Velez Sarsfield 1611 (5016) Cordoba (Argentina); Dominguez, A A [INTI Cordoba, Av. Velez Sarsfield 1561 (5016) Cordoba (Argentina)

2007-11-15

In a previous work a finite elements model was constructed to simulate a fatigue assay according to the norm IRAM 9422-3. Three materials were studied, two of them are the most used in this type of implant (Stainless steel 3161 and alloy T16A14V) and the third was a new developed titanium alloy (Ti35Nb7Zr5Ta). Static loads were applied to the model according to the highest requirements of the norm and the stress - strain distribution were determined. In this study a simplified analysis of the material's fatigue was done according to the previous work. The best behavior of the titanium alloys vs. the stainless steel was evident. With the objective of studying the behavior of both: the implant and the femur bone, new finite elements models were realized, in which the presence of the bone was considered. Inside the bone, the femoral component of the implant was placed in a similar way of a cemented prosthesis in a total hip arthroplasty. The advantage of the titanium implant related to the stainless steel one, was very clear.

Experimental and numerical study of cemented bone-implant interface behaviour

Czech Academy of Sciences Publication Activity Database

Kytýř, Daniel; Doktor, Tomáš; Jiroušek, Ondřej; Zlámal, Petr; Pokorný, D.

2011-01-01

Roč. 15, č. 15 (2011), s. 5-13 ISSN 1971-8993 R&D Projects: GA ČR(CZ) GAP105/10/2305 Institutional research plan: CEZ:AV0Z20710524 Keywords : bone-cement interface * computed tomography * hip simulator * crack detection Subject RIV: FI - Traumatology, Orthopedics http://www.gruppofrattura.it/index.php?option=com_content&task=view&id=90&Itemid=284

Periprosthetic femoral fracture within two years after total hip replacement:

DEFF Research Database (Denmark)

Thien, T. M.; Chatziagorou, G.; Garellick, G.

2014-01-01

BACKGROUND: We used the Nordic Arthroplasty Register Association database to evaluate whether age, sex, preoperative diagnosis, fixation, and implant design influence the risk of revision arthroplasty due to periprosthetic fracture within two years from operation of a primary total hip replacement....... METHODS: Included in the study were 325,730 cemented femoral stems and 111,899 uncemented femoral stems inserted from 1995 to 2009. Seven frequently used stems (two cemented stems [Exeter and Lubinus SP II] and five uncemented stems [Bi-Metric, Corail, CLS Spotorno, ABG I, and ABG II]) were specifically...... studied. RESULTS: The incidence of revision at two years was low: 0.47% for uncemented stems and 0.07% for cemented stems. Uncemented stems were much more likely to have this complication (relative risk, 8.72 [95% confidence interval, 7.37 to 10.32]; p

Femoral component revision with use of impaction bone-grafting and a cemented polished stem.

NARCIS (Netherlands)

Schreurs, B.W.; Arts, J.J.C.; Verdonschot, N.J.J.; Buma, P.; Slooff, T.J.J.H.; Gardeniers, J.W.M.

2005-01-01

BACKGROUND: The purpose of this study was to evaluate the clinical and radiographic outcomes of revision of the femoral component of a hip arthroplasty with use of an impaction bone-grafting technique and a cemented polished stem. METHODS: Thirty-three consecutive femoral reconstructions that were

Dynamic void behavior in polymerizing polymethyl methacrylate cement.

Science.gov (United States)

Muller, Scott D; McCaskie, Andrew W

2006-02-01

Cement mantle voids remain controversial with respect to survival of total hip arthroplasty. Void evolution is poorly understood, and attempts at void manipulation can only be empirical. We induced voids in a cement model simulating the constraints of the proximal femur. Intravoid pressure and temperature were recorded throughout polymerization, and the initial and final void volumes were measured. Temperature-dependent peak intravoid pressures and void volume increases were observed. After solidification, subatmospheric intravoid pressures were observed. The magnitude of these observations could not be explained by the ideal gas law. Partial pressures of the void gas at peak pressures demonstrated a dominant effect of gaseous monomer, thereby suggesting that void growth is a pressure-driven phenomenon resulting from temperature-dependent evaporation of monomer into existing trapped air voids.

Periprosthetic fungal infection of a hip caused by Trichosporon inkin

Directory of Open Access Journals (Sweden)

Federico José Burgo, MD

2018-03-01

Full Text Available An immunocompromised patient with a history of multiple hip implant revisions extended courses of empiric antibiotic treatment, and a retained metallic rod in the femoral medullary canal was transferred for diagnostic studies and treatment. A high suspicion of fungal infection and utilization of extended and specific fungal cultures were the diagnostic keys for infection with Trichosporon inkin. The treatment consisted in a debridement surgery with the use of a functional spacer with cement supplemented with voriconazole and vancomycin plus a 6-month systemic treatment with voriconazole. After 2 years of follow-up, the patient is free of symptoms. Keywords: Hip arthroplasty, Periprosthetic fungal infection, Trichosporon inkin

Normal microscopic architecture of acetabular labrum of hip joint: a qualitative original study with clinical aspects

Science.gov (United States)

Kapetanakis, Stylianos; Gkantsinikoudis, Nikolaos; Dermon, Antonios; Kommata, Vassiliki; Papathanasiou, Jannis; Soukakos, Panagiotis; Dermon, Caterina

2017-01-01

Summary Background Normal histologic architecture of acetabular labrum, regarding presence of Free Nerve Endings (FNEs) and Nerve End Organs (NEOs) has been four times described. Nevertheless, elderly cadaveric specimens and individuals were recruited, leading to considerably high unreliability probability due to microscopic degenerative alterations. Aim of this paper is to analyze distribution pattern of FNEs and NEOs in acetabular labra of healthy middle-aged individuals, configuring thus more reliably acetabular labrum microscopic profile. Materials and methods Six patients with middle age 52 ± 2.5 years were enrolled in this study. Injury of acetabular labrum and normal hip radiograph were present in all cases. Patients were all subjected to successful hip hemi-arthroplasty and derived acetabular labra were subsequently histologically processed and observed under a compound microscope. Results FNEs and NEOs were detected in all specimens. All types of NEOs were identified, including Paccini, Golgi-Mazzoni, Ruffini and Krause corpuscles. FNEs and NEOs were both in ventral part and in chondral side of labrum predominantly detected. Conclusion FNEs and NEOs presence was greater in ventral side of labrum, being thus in partial agreement with previous studies results. Further study is required, in order to elucidate the exact acetabular labrum normal microscopic anatomy. Level of evidence IV. PMID:29264339

[Significance of bone mineral density and modern cementing technique for in vitro cement penetration in total shoulder arthroplasty].

Science.gov (United States)

Pape, G; Raiss, P; Kleinschmidt, K; Schuld, C; Mohr, G; Loew, M; Rickert, M

2010-12-01

Loosening of the glenoid component is one of the major causes of failure in total shoulder arthroplasty. Possible risk factors for loosening of cemented components include an eccentric loading, poor bone quality, inadequate cementing technique and insufficient cement penetration. The application of a modern cementing technique has become an established procedure in total hip arthroplasty. The goal of modern cementing techniques in general is to improve the cement-penetration into the cancellous bone. Modern cementing techniques include the cement vacuum-mixing technique, retrograde filling of the cement under pressurisation and the use of a pulsatile lavage system. The main purpose of this study was to analyse cement penetration into the glenoid bone by using modern cement techniques and to investigate the relationship between the bone mineral density (BMD) and the cement penetration. Furthermore we measured the temperature at the glenoid surface before and after jet-lavage of different patients during total shoulder arthroplasty. It is known that the surrounding temperature of the bone has an effect on the polymerisation of the cement. Data from this experiment provide the temperature setting for the in-vitro study. The glenoid surface temperature was measured in 10 patients with a hand-held non-contact temperature measurement device. The bone mineral density was measured by DEXA. Eight paired cadaver scapulae were allocated (n = 16). Each pair comprised two scapulae from one donor (matched-pair design). Two different glenoid components were used, one with pegs and the other with a keel. The glenoids for the in-vitro study were prepared with the bone compaction technique by the same surgeon in all cases. Pulsatile lavage was used to clean the glenoid of blood and bone fragments. Low viscosity bone cement was applied retrogradely into the glenoid by using a syringe. A constant pressure was applied with a modified force sensor impactor. Micro-computed tomography

Unusual way of loosened total hip arthroplasty treatment with an Austin Moore endoprosthesis.

Science.gov (United States)

Erceg, M; Becic, K

2014-01-01

A 65-year-old female patient with aseptic loosening of total cemented hip endoprosthesis and pathologic fracture of the femur at the level of the stem of endoprosthesis was presented. As no appropriate endoprosthesis was available due to the war in Croatia and war priority, the problem was managed by femur osteosynthesis and implantation of a partial Austin Moore hip endoprosthesis. The endoprosthesis is still functioning well (for 20 years).To the best of the author's knowledge, nobody has ever treated problem like this using this alternative, an unconventional method, with an Austin Moore endoprosthesis.

Revision total hip arthoplasty: factors associated with re-revision surgery.

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Khatod, Monti; Cafri, Guy; Inacio, Maria C S; Schepps, Alan L; Paxton, Elizabeth W; Bini, Stefano A

2015-03-04

The survivorship of implants after revision total hip arthroplasty and risk factors associated with re-revision are not well defined. We evaluated the re-revision rate with use of the institutional total joint replacement registry. The purpose of this study was to determine patient, implant, and surgeon factors associated with re-revision total hip arthroplasty. A retrospective cohort study was conducted. The total joint replacement registry was used to identify patients who had undergone revision total hip arthroplasty for aseptic reasons from April 1, 2001, to December 31, 2010. The end point of interest was re-revision total hip arthroplasty. Risk factors evaluated for re-revision total hip arthroplasty included: patient risk factors (age, sex, body mass index, race, and general health status), implant risk factors (fixation type, bearing surface, femoral head size, and component replacement), and surgeon risk factors (volume and experience). A multivariable Cox proportional hazards model was used. Six hundred and twenty-nine revision total hip arthroplasties with sixty-three (10%) re-revisions were evaluated. The mean cohort age (and standard deviation) was 57.0 ± 12.4 years, the mean body mass index (and standard deviation) was 29.5 ± 6.1 kg/m(2), and most of the patients were women (64.5%) and white (81.9%) and had an American Society of Anesthesiologists score of associated with the risk of re-revision. For every ten-year increase in patient age, the hazard ratio for re-revision decreases by a factor of 0.72 (95% confidence interval, 0.58 to 0.90). For every five revision surgical procedures performed by a surgeon, the risk of revision decreases by a factor of 0.93 (95% confidence interval, 0.86 to 0.99). At the time of revision, a new or retained cemented femoral implant or all-cemented hip implant increases the risk of revision by a factor of 3.19 (95% confidence interval, 1.22 to 8.38) relative to a retained or new uncemented hip implant. A ceramic on a

Can Arthroplasty Stem INfluence Outcome? (CASINO): a randomized controlled equivalence trial of 125 mm versus 150 mm Exeter V40 stems in total hip arthroplasty.

Science.gov (United States)

Hamilton, David F; Ohly, Nicholas E; Gaston, Paul

2018-04-16

The use of shorter length femoral stems during total hip arthroplasty has been suggested to accommodate wider patient femoral geometry and offer maximal bone preservation. However, cemented short-stem designs may increase the risk of varus stem malalignment and influence patient outcomes. CASINO is a multi-centre randomised equivalence trial that will recruit 220 patients undergoing total hip arthroplasty for osteoarthritis at two NHS hospitals in Scotland. Patients will be aged 45-80, undergoing unilateral primary hip arthroplasty, with no plan for contralateral procedure within the study timeframe, and able to comply with the protocol. Participants will be randomised to receive either a short (125 mm) or a standard (150 mm) Exeter V40 stem. The Contemporary acetabular component will be used in all cases. All implants will be cemented. Patient pain, function and satisfaction will be assessed using change from baseline measurement in Oxford Hip Score, Forgotten Joint Score, EQ-5D, pain numerical rating scores, and patient satisfaction questionnaire at baseline and at 1 and 2 years following surgery. Radiographic assessment will evaluate stem position and will be appraised by independent reviewers. Patients will be blind to implant allocation. Stem length may be associated with outcome; however, we can find no randomised trial in which researchers investigated the effect of stem length on patient outcome following cemented total hip arthroplasty. The aim of this trial is to determine if the use of short cemented stems offers equivalent patient outcomes to those achieved following surgery with standard length stems. International Standard Randomised Controlled Trial Number, ISRCTN13154542 , Registered on 30 June 2017.

Total Hip Arthroplasty in an Inveterate Femoral Neck Fracture in a Patient with Congenital Insensitivity to Pain with Anhidrosis.

Science.gov (United States)

Dagnino, Augusto; Ursino, Nicola; Ripamonti, Carlo A M; Fiorentini, Carlo E; Scelsi, Michele; D'Ambrosi, Riccardo; Portinaro, Nicola M

2017-12-01

Congenital insensitivity to pain with anhidrosis (CIPA) is an extremely rare disorder characterized by autonomic and sensory nerves malfunction with insensitivity to both deep and superficial painful stimuli, inability to sweat and produce tears, and mild to moderate mental retardation with self-mutilating behavior. Related consequences of inveterate musculoskeletal injuries represent a major issue for these patients, since pain cannot act as a protection mechanism. For the same reason, the patients are at risk during postoperative rehabilitation, which should be taken into account when selecting an orthopaedic implant. To our knowledge, only one case of total hip arthroplasty has been reported in the literature to date. A 21-year-old Caucasian male patient affected with CIPA arrived at our attention complaining about a functional limitation of the left hip. No history of trauma was reported. The X-rays showed an inveterate femoral neck fracture with a severe necrosis and resorption of the femoral head. We decided to perform a total hip arthroplasty with a cemented stem and a cemented dual mobility cup. The postoperative course and rehabilitation were satisfactory, with excellent clinical results, measured with the Harris Hip Score at 1 year.

Gene therapy and cement injection for the treatment of hip prosthesis loosening in elderly patients

NARCIS (Netherlands)

Poorter, Jolanda de

2010-01-01

Approximately one million total hip replacement operations are performed worldwide annually, mostly for osteoarthritis and rheumatoid arthritis. A major complication in total hip arthroplasties is loosening of the prosthesis leading to pain and walking difficulties and a higher risk for dislocations

Hip resurfacing arthroplasty: current status and future perspectives

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K Corten

2011-03-01

Full Text Available Hip resurfacing arthroplasty (HRA is a concept of hip replacement that allows treating young active patients with a femoral bone preserving procedure. The proposed advantages of resuming an active lifestyle with increased frequency and duration of sports activities have been shown to be realistic. The 30-year cost-effectiveness in young male patients has been shown to be higher in resurfacing compared to conventional total hip replacement (THA. However, prognosticators of an inferior outcome have also been identified. The most important patient related factors are secondary osteoarthritis as the indication for surgery such as post-childhood hip disorders or AVN, female gender, smaller component sizes and older age (>65 years for males and >55 years for females. In addition, surgical technique (approach and cementing technique and component design are also important determinant factors for the risk of failure. Moreover, concerns have surfaced with respect to high metal ion concentrations and metal ion hypersensitivities. In addition, the presumed ease of revising HRA has not reflected in improved or equal survivorship in comparison to a primary THA. This highlights the importance of identifying patient-, surgery-, and implant-related prognosticators for success or failure of HRA. Rather than vilifying the concept of hip resurfacing, detailed in depth analysis should be used to specify indications and improve implant design and surgical techniques.

Preliminary results of a randomized trial comparing 400 cGy vs 700 cGy as an adjuvant to prevent heterotopic ossification after total hip arthroplasty

International Nuclear Information System (INIS)

Nguyen, Cam; Gupta-Burt, Shalina; Silverton, Craig; Cummings, Marilyn; Galante, Jorge O.

1997-01-01

Purpose/Objective: We report our preliminary results of a randomized trial comparing one single dose of 400 cGy versus 700 cGy given postoperatively in an attempt to prevent heterotopic ossification after total hip arthroplasty. Materials and Methods: From 09/1993 and 05/1996, over 800 total hip replacements were performed at our hospital. From this group of patients, 120 hips in 114 high-risk patients (14%) were enrolled in a randomized trial to determine if 400 cGy (Group A) is as efficacious as 700 cGy (Group B) in preventing heterotopic ossification. In Group A, there were 42 males (46 hips) and 12 females (12 hips) with a mean age of 60 (range 41-79); with 18 primary cementless femoral components (33%), 30 primary cemented stems (55%) and 10 revisions. In Group B, there were 30 males (32 hips) and 30 females (31 hips) with a median age of 59 (range 41-85); with 12 primary cementless femoral components (20%), 44 primary cemented stems (73%) and 6 revisions. All acetabular components were of the cementless type. Patients were randomized to receive either 400 cGy or 700 cGy in one fraction. Radiotherapy is given within 48 hours post-operatively using paired anterior and posterior fields, with blocking of the cementless acetabular component and the femoral component. Results: All 114 patients were available for a minimum follow-up of 6 months (range 6-30 months). None of the arthroplasties has failed at the latest follow-up. There were no radiation therapy complications noted. Statistical analysis revealed no difference in the distribution of patients in either group according to age, sex, primary or revision arthroplasty, cemented or cementless femoral component fixation, preoperative heterotopic ossification risk, or surgical approach. Of the 58 hips in Group A, heterotopic ossification was graded as Grade 0 in 24 hips, Grade I in 10 hips, Grade II in 18 hips, Grade III in 6 hips, with no cases of Grade IV. Of the 63 hips in Group B, heterotopic ossification was

CEMENT SLURRIES FOR GEOTHERMAL WELLS CEMENTING

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Nediljka Gaurina-Međimurec

1994-12-01

Full Text Available During a well cementing special place belongs to the cement slurry design. To ensure the best quality of cementing, a thorough understanding of well parameters is essential, as well as behaviour of cement slurry (especially at high temperatures and application of proven cementing techniques. Many cement jobs fail because of bad job planning. Well cementing without regarding what should be accomplished, can lead to well problems (channels in the cement, unwanted water, gas or fluid production, pipe corrosion and expensive well repairs. Cementing temperature conditions are important because bot-tomhole circulating temperatures affect slurry thickening time, arheology, set time and compressive strength development. Knowing the actual temperature which cement encounters during placement allows the selection of proper cementing materials for a specific application. Slurry design is affected by well depth, bottom hole circulating temperature and static temperature, type or drilling fluid, slurry density, pumping time, quality of mix water, fluid loss control, flow regime, settling and free water, quality of cement, dry or liquid additives, strength development, and quality of the lab cement testing and equipment. Most Portland cements and Class J cement have shown suitable performances in geot-hermal wells. Cement system designs for geothermal wells differ from those for conventional high temperature oil and gas wells in the exclusive use of silica flour instead of silica sand, and the avoidance of fly ash as an extender. In this paper, Portland cement behaviour at high temperatures is described. Cement slurry and set cement properties are also described. Published in literature, the composition of cement slurries which were tested in geothermal conditions and which obtained required compressive strength and water permeability are listed. As a case of our practice geothermal wells Velika Ciglena-1 and Velika Ciglena-la are described.

Quality of life and functionality after non-cemented total hiparthroplasty

International Nuclear Information System (INIS)

Shah, Z.A.; Arif, U.; Aslam, M.N.; Bilal, A.; Khan, M.N.B.

2013-01-01

Objectives: To evaluate the functional outcome of non-cemented total hip arthroplasty in terms of pain relief, functional capacity, range of motion and absence of deformity using Harris hip score. Study Design: Descriptive study. Place and Duration of Study: From January 2012 to December 2012, at Nawaz Sharif Social Security Teaching Hospital, Lahore (University College Medicine and Dentistry). Subject and Methods: Thirty patients meeting the inclusion criteria were admitted through orthopedics outpatient department of Nawaz Sharif social security hospital Lahore. Pre operative Harris scoring was done and was compared with the post operative score to find the improvement. Results: Mean age of patients was 52.53 +- 18.21 years, and 17 were males and 13 females. Average pre operative Harris Hip score was 23.77 +- 9.50 and post-operative score 87.90 +- 10.42. Conclusion: It was concluded that THR is a safe surgical procedure with promising results in relieving pain, improving movements and upgrading the quality of life. (author)

Femoral component revision with use of impaction bone-grafting and a cemented polished stem. Surgical technique.

NARCIS (Netherlands)

Schreurs, B.W.; Arts, J.J.C.; Verdonschot, N.J.J.; Buma, P.; Slooff, T.J.J.H.; Gardeniers, J.W.M.

2006-01-01

BACKGROUND: The purpose of this study was to evaluate the clinical and radiographic outcomes of revision of the femoral component of a hip arthroplasty with use of an impaction bone-grafting technique and a cemented polished stem. METHODS: Thirty-three consecutive femoral reconstructions that were

Arthroscopic treatment of secondary rotator cuff damage after shoulder hemiarthroplasty (case report

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S. Y. Dokolin

2015-01-01

Full Text Available Anatomical shoulder arthroplasty is an effective treatment for patients with primary deforming arthritis, rheumatoid arthritis and aseptic necrosis of the humeral head. However this kind of surgery is associated with high risk of complications, and within five-year follow-up the incidence of complications increases. The authors described a clinical case illustrating one of these complications - secondary rotator cuff damage after shoulder hemiarthroplasty. The tear was verified using radiological methods and arthroscopy. They performed arthroscopic rotator cuff repair using suture anchors in order to alleviate pain and preserve shoulder functions. If there are no signs of endoprosthetic instability and coracoacromial ligament is preserved, arthroscopic treatment of such damages extends the time of limb function preserving the endoprosthesis. Patients should not raise their arms above the horizontal level.

Unusual way of loosened total hip arthroplasty treatment with an Austin Moore endoprosthesis

Directory of Open Access Journals (Sweden)

M Erceg

2014-01-01

Full Text Available A 65-year-old female patient with aseptic loosening of total cemented hip endoprosthesis and pathologic fracture of the femur at the level of the stem of endoprosthesis was presented. As no appropriate endoprosthesis was available due to the war in Croatia and war priority, the problem was managed by femur osteosynthesis and implantation of a partial Austin Moore hip endoprosthesis. The endoprosthesis is still functioning well (for 20 years.To the best of the author′s knowledge, nobody has ever treated problem like this using this alternative, an unconventional method, with an Austin Moore endoprosthesis.

Anchorage strategies in geriatric hip fracture management

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Knobe Matthias

2016-12-01

Full Text Available There is an enormous humanitarian and socioeconomic need to improve the quality and effectiveness of care for patients with hip fracture. To reduce mechanical complications in the osteosynthesis of proximal femoral fractures, improved fixation techniques have been developed including blade or screw-anchor devices, locked minimally invasive or cement augmentation strategies. However, despite numerous innovations and advances regarding implant design and surgical techniques, systemic and mechanical complication rates remain high. Treatment success depends on secure implant fixation in often-osteoporotic bone as well as on patient-specific factors (fracture stability, bone quality, comorbidity, and gender and surgeon-related factors (experience, correct reduction, and optimal screw placement in the head/neck fragment. For fracture fixation, the anchorage of the lag screw within the femoral head plays a crucial role depending on the implant’s design. Meta-analyses and randomized controlled studies demonstrate that there is a strong trend towards arthroplasty treating geriatric femoral neck fractures. However, for young adults as well as older patients with less compromised bone quality, or in undisplaced fractures, head-preserving therapy is preferred as it is less invasive and associated with good functional results. This review summarizes the evidence for the internal fixation of femoral neck fractures and trochanteric femoral fractures in elderly patients. In addition, biomechanical considerations regarding implant anchorage in the femoral head including rotation, migration, and femoral neck shortening are made. Finally, cement augmentation strategies for hip fracture implants are evaluated critically.

Positive effect of removal of subchondral bone plate for cemented acetabular component fixation in total hip arthroplasty: a randomised RSA study with ten-year follow-up.

Science.gov (United States)

Flivik, G; Kristiansson, I; Ryd, L

2015-01-01

We hypothesised that the removal of the subchondral bone plate (SCBP) for cemented acetabular component fixation in total hip arthroplasty (THA) offers advantages over retention by improving the cement-bone interface, without jeopardising implant stability. We have previously published two-year follow-up data of a randomised controlled trial (RCT), in which 50 patients with primary osteoarthritis were randomised to either retention or removal of the SCBP. The mean age of the retention group (n = 25, 13 males) was 70.0 years (sd 6.8). The mean age in the removal group (n = 25, 16 males) was 70.3 years (sd 7.9). Now we have followed up the patients at six (retention group, n = 21; removal group, n = 20) and ten years (retention group: n = 17, removal group: n = 18), administering clinical outcome questionnaires and radiostereometric analysis (RSA), and determining the presence of radiolucent lines (RLLs) on conventional radiographs. RSA demonstrated similar translation and rotation patterns up to six years. Between six and ten years, proximal acetabular component migration and changes of inclination were larger in the retention group, although the mean differences did not reach statistical significance. Differences in migration were driven by two patients in the SCBP retention group with extensive migration versus none in the SCBP removal group. The significant difference (p < 0.001) in the development of radiolucent lines in the retention group, previously observed at two years, increased even further during the course of follow-up (p < 0.001). While recognising SCBP removal is a more demanding technique, we conclude that, wherever possible, the SCBP should be removed to improve the cement-bone interface in order to maximise acetabular component stability and longevity. ©2015 The British Editorial Society of Bone & Joint Surgery.

Early failure mechanisms of constrained tripolar acetabular sockets used in revision total hip arthroplasty.

Science.gov (United States)

Cooke, Christopher C; Hozack, William; Lavernia, Carlos; Sharkey, Peter; Shastri, Shani; Rothman, Richard H

2003-10-01

Fifty-eight patients received an Osteonics constrained acetabular implant for recurrent instability (46), girdlestone reimplant (8), correction of leg lengthening (3), and periprosthetic fracture (1). The constrained liner was inserted into a cementless shell (49), cemented into a pre-existing cementless shell (6), cemented into a cage (2), and cemented directly into the acetabular bone (1). Eight patients (13.8%) required reoperation for failure of the constrained implant. Type I failure (bone-prosthesis interface) occurred in 3 cases. Two cementless shells became loose, and in 1 patient, the constrained liner was cemented into an acetabular cage, which then failed by pivoting laterally about the superior fixation screws. Type II failure (liner locking mechanism) occurred in 2 cases. Type III failure (femoral head locking mechanism) occurred in 3 patients. Seven of the 8 failures occurred in patients with recurrent instability. Constrained liners are an effective method for treatment during revision total hip arthroplasty but should be used in select cases only.

Financial aspects of arthroplasty options for intra-capsular neck of femur fractures: a cost analysis study to review the financial impacts of implementing NICE guidelines in the NHS organisations.

Science.gov (United States)

Horriat, S; Hamilton, P D; Sott, A H

2015-02-01

To review the financial aspects of implementing the latest NICE guideline for neck of femur fracture (CG124), which recommends offering Total Hip Replacement (THR) as an alternative to hemiarthroplasty (HA) for patients, who are independently mobile before injury, not cognitively impaired and well enough to tolerate the operation. Between April 2011 and April 2013 data collected from our Hip Fracture database (NHFD) showed that by following the latest NICE guideline (CG124), out of 840 patients, 176 patients (21%) should be considered for THR rather than HA. Individual procedure costs were calculated by considering cost of implants and consumables (extracted from providers' published catalogues) added to the cost of running operating theatre for each operation. We then used the national tariff for each procedure using relevant HRG codes to calculate the total cost and the income to the Trust. Our data indicated that by implementing the latest NICE guideline (CG124), 37.1% of patients with intra-capsular fracture neck of femur (IC-NOF fracture) would be eligible for THR rather than HA. Although performing cemented THR was the more expensive procedure, our calculation shows that despite increased cost of performing the operation, Trusts can increase their net income by £300-600 (depending on their market force factor) per patient using correct HRG coding and National Tariff. Utilising 2012-13 National Tariff, performing a cemented THR instead of a HA for patients with IC-NOF fracture, as recommended by the latest NICE guideline (CG124) can increase the Trust's revenue per patient in a predictable way. This practice not only results in potentially better patient outcomes but also can increase financial reward and potential for reinvestment in all hip fracture units in the UK. Copyright © 2014 Elsevier Ltd. All rights reserved.

Effect of the sterilization process on physical and mechanical properties of the bonacryl bone cement

International Nuclear Information System (INIS)

Morejon, L.; Delgado, J.A.; Aguero, L.; Rapado, M.; Ginebra, M.P.; Gil, F.J.; Mendizabal, E.

2008-01-01

The use of bone cements of poly(methyl methacrylate) (PMMA) to fix artificial prosthesis to the human body is a habitual method in orthopedic surgery. The hip and the knee joints have a very complex biomechanics and support high loads, for these reasons, acrylic bone cements have to comply with international standards in order to secure the biofuncionality and durability of the implant. In this work we report the effect of sterilization by ethylene oxide or gamma radiation on the BONACRYL Cuban cement. We determined how sterilization methods affect the molecular weight of the polymer as well as its quasi-static mechanical properties. The results demonstrated that the gamma radiation modifies the molecular weight of the PMMA although the compression and bending strength were not affected by the sterilization process applied. (authors)

The acetabulum: A prospective study of three-phase bone and indium white blood cell scintigraphy following porous-coated hip arthroplasty

International Nuclear Information System (INIS)

Oswald, S.G.; Van Nostrand, D.; Savory, C.G.; Anderson, J.H.; Callaghan, J.J.

1990-01-01

Although few studies address the use of three-phase bone scanning (TPBS) and indium-111-labeled white blood cell scintigraphy ( 111 In-WBC) in hip arthroplasty utilizing a porous-coated prosthesis, the literature suggests that scintigraphic patterns in the uncomplicated patient may differ from that seen with the cemented prosthesis. In an attempt to determine the scintigraphic natural history, 25 uncomplicated porous-coated hip arthroplasties in 21 patients were prospectively studied with serial TPBS and 111I n-WBC at approximately 7 days, and 3, 6, 12, 18, and 24 mo postoperatively. This report deals with findings related to the acetabulum. All 25 prostheses (144 of 144 scans) demonstrated increased uptake on the bone-phase images. Although this activity decreased with time, 76% had persistent uptake at 24 mo. Twenty-three of 25 prostheses (126 of 140 scans) showed increased uptake on 111 In-WBC scintigraphy, invariably decreasing with time, but with 37% having significant uptake at 24 mo. Scintigraphic patterns in the uncomplicated porous-coated hip arthroplasty patient appear to differ from patterns described in cemented prostheses

Traumatic subchondral fracture of the femoral head in a healed trochanteric fracture.

Science.gov (United States)

Lee, Sang Yang; Niikura, Takahiro; Iwakura, Takashi; Kurosaka, Masahiro

2014-07-11

An 82-year-old woman sustained a trochanteric fracture of the left femur after a fall. Fracture fixation was performed using proximal femoral nail antirotation (PFNA) II, and she was able to walk with a T-cane after 3 months. Eleven months following the operation, the patient presented with left hip pain after a fall. Radiographs showed a subchondral collapse of the femoral head located above the blade tip. The authors removed the PFNA-II and subsequently performed cemented bipolar hemiarthroplasty. Histological evaluation of the femoral head showed osteoporosis with no evidence of osteonecrosis. Repair tissue, granulation tissue and callus formation were seen at the collapsed subchondral area. Based on these findings, a traumatic subchondral fracture of the femoral head in a healed trochanteric fracture was diagnosed. A traumatic subchondral fracture of the femoral head may need to be considered as a possible diagnosis after internal fixation of the trochanteric fracture. 2014 BMJ Publishing Group Ltd.

Single- and dual energy QCT around acetabular cups in total hip arthroplasty using 3-dimensional segmentation

DEFF Research Database (Denmark)

Mussmann, Bo Redder; Andersen, Poul Erik; Torfing, Trine

of segmentation software and to compare bone mineral density (BMD) measurements in single- and dual energy CT (SECT and DECT) Materials and Methods: 24 male patients with total hip arthroplasty (12 cemented and 12 uncemented) were scanned and rescanned using SECT and virtual monochromatic DECT images. 3D- ROIs......Background: Bone density measurements around hip implants are challenged by artifacts and the complex anatomy of the acetabulum. We developed 3D segmentation software and used dual energy CT to reduce artifacts. Purpose / Aim of Study: To test the between-scan agreement and reliability...... the cemented cup the mean BMD for SECT was 523 mg/ccm with a between-scan difference of 14 mg/ccm, p=0.25 and 186 mg/ccm in DECT with a difference of 6 mg/ccm, p=0.15. ICC was >0.95 with more narrow limits of agreement in DECT compared with SECT. Computed tomography dose index (CTDI) was 25% higher with DECT...

Chronic asymptomatic dislocation of a total hip replacement: a case report

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Lidder Surjit

2009-08-01

Full Text Available Abstract Introduction Dislocation of a prosthetic hip is the second most common complication after thromboembolic disease in patients undergoing total hip arthroplasty, with an incidence reported as 0.5 to 20%. Although the period of greatest risk for dislocation has been reported to be within the first few months after surgery, late dislocation occurs more commonly then previously thought. Case presentation A 60-year-old man underwent a right Exeter cemented total hip replacement and was subsequently discharged after appropriate follow-up. He next presented 8 years later complaining of pain in the left groin. An anterioposterior radiograph of the pelvis revealed degenerative changes in the left hip and a dislocated right total hip replacement. The dislocated femoral component had formed a neoacetabulum within the ilium, in which it was freely articulating. He remained pain-free on this side, had 5 cm of true leg length shortening with a good range of movement and was very pleased with his hip replacement. He was later placed on the waiting list for a left total hip replacement. Conclusion This case illustrates that a dislocated total hip replacement may occasionally not cause symptoms that cause significant discomfort or reduction in range of movement. The prosthetic femoral head can form a neoacetabulum allowing a full range of pain-free movement. Furthermore it emphasises that with an increased trend to earlier hospital discharge and shorter follow-up, potential complications may be missed. We urge a low index of suspicion for potential complications and suggest that regular review with radiographic follow-up should be made.

Functional outcome, revision rates and mortality after primary total hip replacement--a national comparison of nine prosthesis brands in England.

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Mark Pennington

Full Text Available The number of prosthesis brands used for hip replacement has increased rapidly, but there is little evidence on their effectiveness. We compared patient-reported outcomes, revision rates, and mortality for the three most frequently used brands within each prosthesis type: cemented (Exeter V40 Contemporary, Exeter V40 Duration and Exeter V40 Elite Plus Ogee, cementless (Corail Pinnacle, Accolade Trident, and Taperloc Exceed, and hybrid (Exeter V40 Trilogy, Exeter V40 Trilogy, and CPT Trilogy.We used three national databases of patients who had hip replacements between 2008 and 2011 in the English NHS to compare functional outcome (Oxford Hip Score (OHS ranging from 0 (worst to 48 (best in 43,524 patients at six months. We analysed revisions and mortality in 187,201 patients. We used multiple regression to adjust for pre-operative differences. Prosthesis type had an impact on post-operative OHS and revision rates (both p<0.001. Patients with hybrid prostheses had the best functional outcome (mean OHS 39.4, 95%CI 39.1 to 39.7 and those with cemented prostheses the worst (37.7, 37.3 to 38.1. Patients with cemented prostheses had the lowest reported 5-year revision rates (1.3%, 1.2% to 1.4% and those with cementless prostheses the highest (2.2%, 2.1% to 2.4%. Differences in mortality according to prosthesis type were small and not significant (p = 0.06. Functional outcome varied according to brand among cemented (p = 0.05, with Exeter V40 Duration having the best and cementless prostheses (p = 0.01, with Corail Pinnacle having the best. Revision rates varied according to brand among hybrids (p = 0.05, with Exeter V40 Trident having the lowest.Functional outcomes were better with cementless cups and revision rates were lower with cemented stems, which underlies the good overall performance of hybrids. The hybrid Exeter V40 Trident seemed to produce the best overall results. This brand should be considered as a benchmark in randomised trials.

Release of Gentamicin and Vancomycin from Preformed Spacers in Infected Total Hip Arthroplasties: Measurement of Concentrations and Inhibitory Activity in Patients’ Drainage Fluids and Serum

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Dario Regis

2013-01-01

Full Text Available Gentamicin (G and vancomycin (V concentrations in drainage fluids obtained from patients during the first 24 hours after implantation of antibiotic-loaded polymethylmethacrylate (PMMA spacers in two-stage revision of infected total hip arthroplasty were studied. The inhibitory activity of drainage fluids against different multiresistant clinical isolates was investigated as well. Seven hips were treated by implantation of industrial G-loaded spacers. Vancomycin was added by manually mixing with PMMA bone cement. Serum and drainage fluid samples were collected 1, 4, and 24 hours after spacer implantation. Antibiotics concentrations and drains bactericidal titer of combination were determined against multiresistant staphylococcal strains. The release of G and V from PMMA cement at the site of infection was prompt and effective. Serum levels were below the limit of detection. The local release kinetics of G and V from PMMA cement was similar, exerting a pronounced, combined inhibitory effect in the implant site. The inhibitory activity of drainage fluids showed substantial intersubject variability related to antibiotic concentrations and differed according to the pathogens tested. Gentamicin and vancomycin were released from temporary hip spacers at bactericidal concentrations, and their use in combination exerted strong inhibition against methicillin-resistant S. aureus and Coagulase Negative Staphylococci strains.

Mechanical aspects of degree of cement bonding and implant wedge effect.

Science.gov (United States)

Yoon, Yong-San; Oxland, Thomas R; Hodgson, Antony J; Duncan, Clive P; Masri, Bassam A; Choi, Donok

2008-11-01

The degree of bonding between the femoral stem and cement in total hip replacement remains controversial. Our objective was to determine the wedge effect by debonding and stem taper angle on the structural behavior of axisymmetric stem-cement-bone cylinder models. Stainless steel tapered plugs with a rough (i.e. bonded) or smooth (i.e. debonded) surface finish were used to emulate the femoral stem. Three different stem taper angles (5 degrees , 7.5 degrees , 10 degrees ) were used for the debonded constructs. Non-tapered and tapered (7.5 degrees ) aluminum cylindrical shells were used to emulate the diaphyseal and metaphyseal segments of the femur. The cement-aluminum cylinder interface was designed to have a shear strength that simulated bone-cement interfaces ( approximately 8MPa). The test involved applying axial compression at a rate of 0.02mm/s until failure. Six specimens were tested for each combination of the variables. Finite element analysis was used to enhance the understanding of the wedge effect. The debonded stems sustained about twice as much load as the bonded stem, regardless of taper angle. The metaphyseal model carried 35-50% greater loads than the diaphyseal models and the stem taper produced significant differences. Based on the finite element analysis, failure was most probably by shear at the cement-bone interface. Our results in this simplified model suggest that smooth (i.e. debonded) stems have greater failure loads and will incur less slippage or shear failure at the cement-bone interface than rough (i.e. bonded) stems.

Support for total hip replacement surgery: Structures modeling, Gait Data Analysis and Report system

Directory of Open Access Journals (Sweden)

Gianluca Mario Izzo

2012-03-01

Full Text Available For the treatment of advanced damages of hip joints, Total Hip Arthroplasty is well proven. Due to the different mechanical properties of the prosthesis material and the bone tissue, a partial unloading of the periprosthetic bone occurs. The bone cement causes reduction in bone density as a result of removal of normal stress from the bone, leading to weakening of the bone in that area and the fracture risk increases. Bone loss is identified as one of the main reasons for loosening of the stem. Otherwise, thanks to the press-fit of the non-cemented stem achieved by surgery, the bone layers immediately adjacent to the stem are preloaded, thus encouraged growing, and the bone getting stronger. The non-cemented stem would be the better choice for every patient, but the question remains if the femur can handle the press- fitting surgery. This studies aim to develop a monitoring techniques based on Gait analysis and bone density changes to assess patient recovery after Total Hip Arthroplasty. Furthermore, to validate computational processes based on 3D modeling and Finite Element Methods for optimizing decision making in the operation process and selecting the suited surgical procedure. A vision could be minimizing risk of periprosthetic fracture during and after surgery. Patients: The sample presents 11 patients receiving cemented implant and 13 for the uncemented. Patients are grouped by type of implant. Three checkpoints were considered: before, after operation and one year later. CT scans, gaitrite and kinepro measurements have been realized. Main outcome measures: Fracture risk probability is higher in bone with low bone mineral density; therefore bones are more fragile in elderly people. BMD is indeed one parameter considered among all the observations. Periprosthetic fracture of the femur is a rare but complex complication of THA, and requires demanding surgery. As such, they result in considerable morbidity and dysfunction. Thus, tests of

[Tripolar arthroplasty for recurrent total hip prosthesis dislocation].

Science.gov (United States)

Beaulé, P-E; Roussignol, X; Schmalzried, T-P; Udomkiat, P; Amstutz, H-C; Dujardin, F-H

2003-05-01

The purpose of this study was to assess the results of revision surgery for recurrent total hip prosthesis dislocation using a tripolar prosthesis composed of a conventional stem with a mobile head of an intermediary prosthesis measuring more than 40 mm and a modified cup. This technique was used in two centers in Rouen France and Los Angeles USA. Twenty-one hips in 21 patients were operated on. The mobile heads measured 40 to 47 mm. Mean patient age was 70 years (range 29-92). The indication for the tripolar prosthesis was reserved for extremely unstable hips in patients with major risk factors for recurrent dislocation. These 21 patients had experienced 95 dislocations. The acetabular cup was custom-made for the large-diameter heads. A cemented polyethylene cup was used in 14 cases and a press-fit metal-backed around a polyethylene insert in 7. The polyethylene thickness varied from 6.5 to 16 mm for the cemented cups and 4 to 5 mm for the press-fit cups. Fourteen femoral stems were left in place as were two press-fit cups where only the inserts were changed. Mean follow-up was 5.4 years (range 3-11.8). There has been no recurrent dislocation for 20 hips. One patient experienced a dislocation one week after surgery which required a second revision procedure to reposition the acetabular implant. Final outcome was good at 7.6 years for this hip. One patient who had not had any recurrent dislocation died 4 years after the revision surgery due to a cause unrelated to the prosthesis. Two patients were lost to follow-up at 3.7 and 6 years, both were pain free and had no radiological anomalies. Infection occurred in one patient undergoing chemotherapy for a myeloma; the head and neck had to be resected. For the 20 other patients, functional outcome, assessed with the UCLA score, showed improvement in pain (5.8 preoperatively, 9.2 at last follow-up), walking (4.8 and 8 respectively), function (4 and 6 respectively), and daily activities (3.3 and 5.2 respectively). A

The economics of using prophylactic antibiotic-loaded bone cement in total knee replacement.

Science.gov (United States)

Gutowski, C J; Zmistowski, B M; Clyde, C T; Parvizi, J

2014-01-01

The rate of peri-prosthetic infection following total joint replacement continues to rise, and attempts to curb this trend have included the use of antibiotic-loaded bone cement at the time of primary surgery. We have investigated the clinical- and cost-effectiveness of the use of antibiotic-loaded cement for primary total knee replacement (TKR) by comparing the rate of infection in 3048 TKRs performed without loaded cement over a three-year period versus the incidence of infection after 4830 TKRs performed with tobramycin-loaded cement over a later period of time of a similar duration. In order to adjust for confounding factors, the rate of infection in 3347 and 4702 uncemented total hip replacements (THR) performed during the same time periods, respectively, was also examined. There were no significant differences in the characteristics of the patients in the different cohorts. The absolute rate of infection increased when antibiotic-loaded cement was used in TKR. However, this rate of increase was less than the rate of increase in infection following uncemented THR during the same period. If the rise in the rate of infection observed in THR were extrapolated to the TKR cohort, 18 additional cases of infection would have been expected to occur in the cohort receiving antibiotic-loaded cement, compared with the number observed. Depending on the type of antibiotic-loaded cement that is used, its cost in all primary TKRs ranges between USD $2112.72 and USD $112 606.67 per case of infection that is prevented.

Implant Optimisation for Primary Hip Replacement in Patients over 60 Years with Osteoarthritis: A Cohort Study of Clinical Outcomes and Implant Costs Using Data from England and Wales.

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Simon S Jameson

Full Text Available Hip replacement is one of the most commonly performed surgical procedures worldwide; hundreds of implant configurations provide options for femoral head size, joint surface material and fixation method with dramatically varying costs. Robust comparative evidence to inform the choice of implant is needed. This retrospective cohort study uses linked national databases from England and Wales to determine the optimal type of replacement for patients over 60 years undergoing hip replacement for osteoarthritis.Implants included were the commonest brand from each of the four types of replacement (cemented, cementless, hybrid and resurfacing; the reference prosthesis was the cemented hip procedure. Patient reported outcome scores (PROMs, costs and risk of repeat (revision surgery were examined. Multivariable analyses included analysis of covariance to assess improvement in PROMs (Oxford hip score, OHS, and EQ5D index (9159 linked episodes and competing risks modelling of implant survival (79,775 procedures. Cost of implants and ancillary equipment were obtained from National Health Service procurement data.EQ5D score improvements (at 6 months were similar for all hip replacement types. In females, revision risk was significantly higher in cementless hip prostheses (hazard ratio, HR = 2.22, p<0.001, when compared to the reference hip. Although improvement in OHS was statistically higher (22.1 versus 20.5, p<0.001 for cementless implants, this small difference is unlikely to be clinically important. In males, revision risk was significantly higher in cementless (HR = 1.95, p = 0.003 and resurfacing implants, HR = 3.46, p<0.001, with no differences in OHS. Material costs were lowest with the reference implant (cemented, range £1103 to £1524 and highest with cementless implants (£1928 to £4285. Limitations include the design of the study, which is intrinsically vulnerable to omitted variables, a paucity of long-term implant survival data (reflecting the

Postoperative hemoglobin level in patients with femoral neck fracture.

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Nagra, Navraj S; Van Popta, Dmitri; Whiteside, Sigrid; Holt, Edward M

2016-01-01

The aim of this study was to analyze the changes of hemoglobin levels in patients undergoing fixation for femoral neck fracture. Peroperative hemoglobin levels of patients who underwent either dynamic hip screw (DHS) fixation (n=74; mean age: 80 years) or hip hemiarthroplasty (n=104; mean age: 84 years) for femoral neck fracture was monitored. There was a statistically and clinically significant mean drop of 31.1 g/L between the preoperative (D0) and postoperative Day 5 Hb levels (pmeasurement, DHS patients had lower hemoglobin values over hemiarthroplasty patients (p=0.046). The decrease in hemoglobin in the first 24-hour postoperative period (D0 to Day 1) is an underestimation of the ultimate lowest value in hemoglobin found at Day 2. Relying on the Day 1 hemoglobin level could be detrimental to patient care. We propose a method of predicting patients likely to be transfused and recommend a protocol for patients undergoing femoral neck fracture surgery to standardize postoperative hemoglobin monitoring.

Reconstruction of the Shallow Acetabulum With a Combination of Autologous Bulk and Impaction Bone Grafting Fixed by Cement.

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Maruyama, Masaaki; Wakabayashi, Shinji; Ota, Hiroshi; Tensho, Keiji

2017-02-01

Acetabular bone deficiency, especially proximal and lateral deficiency, is a difficult technical problem during primary total hip arthroplasty (THA) in developmental dysplasia of the hip (DDH). We report a new reconstruction method using a medial-reduced cemented socket and additional bulk bone in conjunction with impaction morselized bone grafting (additional bulk bone grafting method). In a population of patients with acetabular dysplasia undergoing THA using a medial-reduced cemented socket and additional bulk bone with impacted morselized bone grafting, we evaluated (1) the radiographic appearance of bone graft; (2) the proportion of cups that developed loosening and subsequent revision; and (3) clinical results (outcome scores and complications). Forty percent of 330 THAs for DDH performed at one center between 1999 and 2009 were defined as shallow dysplastic hips. The additional bulk bone grafting method was performed on 102 THAs with shallow acetabulum (31% for DDH) at one center between 1999 and 2009. We used this approach and technique for shallow acetabuli when a cup protruded from the lateral acetabular edge in preoperative templating. The other 132 dysplastic hips without bone grafting had THA performed at the same periods and served as a control. Acetabuli were defined as shallow when the depth was less than or equal to one-fifth of the pelvic height (cranial-caudal length on radiograph). The additional bulk bone grafting technique was as follows: the resected femoral head was sectioned at 1 to 2 cm thickness, and a suitable size of the bulk bone graft was placed on the lateral iliac cortex and fixed by poly-L-lactate absorbable screws. Autologous impaction morselized bone grafting, with or without hydroxyapatite granules, was performed along with the implantation of a medial-reduced cemented socket. We defined an "incorporated" graft as remodeling and trabeculation including rounding off of the protruding edge of a graft beyond the socket

Choice of implant combinations in total hip replacement: systematic review and network meta-analysis.

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López-López, José A; Humphriss, Rachel L; Beswick, Andrew D; Thom, Howard H Z; Hunt, Linda P; Burston, Amanda; Fawsitt, Christopher G; Hollingworth, William; Higgins, Julian P T; Welton, Nicky J; Blom, Ashley W; Marques, Elsa M R

2017-11-02

Objective  To compare the survival of different implant combinations for primary total hip replacement (THR). Design  Systematic review and network meta-analysis. Data sources  Medline, Embase, The Cochrane Library, ClinicalTrials.gov, WHO International Clinical Trials Registry Platform, and the EU Clinical Trials Register. Review methods  Published randomised controlled trials comparing different implant combinations. Implant combinations were defined by bearing surface materials (metal-on-polyethylene, ceramic-on-polyethylene, ceramic-on-ceramic, or metal-on-metal), head size (large ≥36 mm or small meta-analysis for revision. There was no evidence that the risk of revision surgery was reduced by other implant combinations compared with the reference implant combination. Although estimates are imprecise, metal-on-metal, small head, cemented implants (hazard ratio 4.4, 95% credible interval 1.6 to 16.6) and resurfacing (12.1, 2.1 to 120.3) increase the risk of revision at 0-2 years after primary THR compared with the reference implant combination. Similar results were observed for the 2-10 years period. 31 studies (2888 patients) were included in the analysis of Harris hip score. No implant combination had a better score than the reference implant combination. Conclusions  Newer implant combinations were not found to be better than the reference implant combination (metal-on-polyethylene (not highly cross linked), small head, cemented) in terms of risk of revision surgery or Harris hip score. Metal-on-metal, small head, cemented implants and resurfacing increased the risk of revision surgery compared with the reference implant combination. The results were consistent with observational evidence and were replicated in sensitivity analysis but were limited by poor reporting across studies. Systematic review registration  PROSPERO CRD42015019435. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence

A modified PMMA cement (Sub-cement) for accelerated fatigue testing of cemented implant constructs using cadaveric bone.

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Race, Amos; Miller, Mark A; Mann, Kenneth A

2008-10-20

Pre-clinical screening of cemented implant systems could be improved by modeling the longer-term response of the implant/cement/bone construct to cyclic loading. We formulated bone cement with degraded fatigue fracture properties (Sub-cement) such that long-term fatigue could be simulated in short-term cadaver tests. Sub-cement was made by adding a chain-transfer agent to standard polymethylmethacrylate (PMMA) cement. This reduced the molecular weight of the inter-bead matrix without changing reaction-rate or handling characteristics. Static mechanical properties were approximately equivalent to normal cement. Over a physiologically reasonable range of stress-intensity factor, fatigue crack propagation rates for Sub-cement were higher by a factor of 25+/-19. When tested in a simplified 2 1/2-D physical model of a stem-cement-bone system, crack growth from the stem was accelerated by a factor of 100. Sub-cement accelerated both crack initiation and growth rate. Sub-cement is now being evaluated in full stem/cement/femur models.

The influence of early radiolucent lines appearing on femoral head penetration into HXLPE cemented sockets.

Science.gov (United States)

Morita, Daigo; Seki, Taisuke; Higuchi, Yoshitoshi; Takegami, Yasuhiko; Amano, Takafumi; Ishiguro, Naoki

2018-04-01

This study investigates differences in femoral head penetration between highly cross-linked polyethylene (HXLPE) cemented sockets both with and without radiolucent lines (RLLs) in the early postoperative phase and at 5 years follow-up. There were 35 patients (37 hips), mean age of 66.8 years, who underwent total hip arthroplasty (THA) using highly HXLPE cemented sockets. They were divided into 2 groups based on postoperative the early appearance of RLLs. Femoral head penetrations on both anteroposterior- and Lauenstein-view radiographs were evaluated, and the mean polyethylene (PE) wear rate was calculated based on femoral head penetrations between 2 and 5 years. Femoral head penetrations in the proximal direction were 0.075 mm and 0.150 mm in the RLL and non-RLL groups at 1 year postoperatively ( p = 0.019). At 5 years measured penetration was 0.107 mm and 0.125 mm in the RLL and non-RLL groups, respectively ( p = 0.320). The mean PE wear rates in anteroposterior-view were 0.008 mm/year and 0.003 mm/year in the RLL and non-RLL groups ( p = 0.390) and those in Lauenstein-view were 0.010 mm/year and 0.005 mm/year, respectively ( p = 0.239). In the RLL group, the PE bedding-in was less compared with those in the non-RLL group. Additionally, the mean PE wear rate in the RLL group tended to be higher than that in the non-RLL group. The distribution of stress loading through the cement may differ according to whether early RLLs appear.

Patients with Black Hip and Black Knee Due to Ochronotic Arthropathy: Case Report and Review of Literature

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Mehmet Ali Acar

2013-11-01

Full Text Available Ochronotic arthropathy is a manifestation of longstanding alkaptonuria. With increasing age, an accumulation of pigment deposits of homogentisic acid in the joint cartilage results in ochronotic osteoarthritis. We present a case of a 62-year-old female who underwent staged left uncemented total hip and right cemented total knee arthroplasty for osteoarthritis secondary to ochronosis.

Micro-mechanical modeling of the cement-bone interface: the effect of friction, morphology and material properties on the micromechanical response.

Science.gov (United States)

Janssen, Dennis; Mann, Kenneth A; Verdonschot, Nico

2008-11-14

In order to gain insight into the micro-mechanical behavior of the cement-bone interface, the effect of parametric variations of frictional, morphological and material properties on the mechanical response of the cement-bone interface were analyzed using a finite element approach. Finite element models of a cement-bone interface specimen were created from micro-computed tomography data of a physical specimen that was sectioned from an in vitro cemented total hip arthroplasty. In five models the friction coefficient was varied (mu=0.0; 0.3; 0.7; 1.0 and 3.0), while in one model an ideally bonded interface was assumed. In two models cement interface gaps and an optimal cement penetration were simulated. Finally, the effect of bone cement stiffness variations was simulated (2.0 and 2.5 GPa, relative to the default 3.0 GPa). All models were loaded for a cycle of fully reversible tension-compression. From the simulated stress-displacement curves the interface deformation, stiffness and hysteresis were calculated. The results indicate that in the current model the mechanical properties of the cement-bone interface were caused by frictional phenomena at the shape-closed interlock rather than by adhesive properties of the cement. Our findings furthermore show that in our model maximizing cement penetration improved the micromechanical response of the cement-bone interface stiffness, while interface gaps had a detrimental effect. Relative to the frictional and morphological variations, variations in the cement stiffness had only a modest effect on the micro-mechanical behavior of the cement-bone interface. The current study provides information that may help to better understand the load-transfer mechanisms taking place at the cement-bone interface.

Postoperative hemoglobin level in patients with femoral neck fracture

OpenAIRE

Nagra, Navraj; van Popta, Dmitri; Whiteside, Sigrid; Holt, Edward

2018-01-01

Objective: The aim of this study was to analyze the changes of hemoglobin levels in patients undergoing fixation for femoral neck fracture.Methods: Peroperative hemoglobin levels of patients who underwent either dynamic hip screw (DHS) fixation (n=74; mean age: 80 years) or hip hemiarthroplasty (n=104; mean age: 84 years) for femoral neck fracture was monitored.Results: There was a statistically and clinically significant mean drop of 31.1 g/L between the preoperative (D0) and postoperative D...

An analysis of postoperative hemoglobin levels in patients with a fractured neck of femur

OpenAIRE

Navraj S. Nagra; Dmitri van Popta; Sigrid Whiteside; Edward M. Holt

2016-01-01

Objectives: The aim of this study was to analyze the changes in hemoglobin level and to determine a suitable timeline for post-operative hemoglobin monitoring in patients undergoing fixation of femoral neck fracture. Patients and methods: Patients who underwent either dynamic hip screw (DHS) fixation (n = 74, mean age: 80 years) or hip hemiarthroplasty (n = 104, mean age: 84 years) for femoral neck fracture were included into the study. The hemoglobin level of the patients was monitored pe...

Hip dysplasia and congenital hip dislocation

Energy Technology Data Exchange (ETDEWEB)

Lingg, G.; Nebel, G.; von Torklus, D.

1981-11-01

In human genetics and orthopedics quite different answers have been given to the question of hereditary transmission and frequency of hip dysplasia in families of children with congenital hip dislocation. We therefore have made roentgenometric measurements of 110 parents of children with congenital hip dislocation. In 25% we found abnormal flat acetabulae, whereas 12% had pathologic deep hips. This may propose a new concept of morphology of congenital hip dysplasia.

Performance of Cement Containing Laterite as Supplementary Cementing Material

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Abbas Bukhari, Z. S.

2013-03-01

Full Text Available The utilization of different industrial waste, by-products or other materials such as ground granulated blast furnace slag, silica fume, fly ash, limestone, and kiln dust, etc. as supplemen- tary cementing materials has received considerable attention in recent years. A study has been conducted to look into the performance of laterite as Supplementary Cementing Materials (SCM. The study focuses on compressive strength performance of blended cement containing different percentage of laterite. The cement is replaced accordingly with percentage of 2 %, 5 %, 7 % and 10 % by weight. In addition, the effect of use of three chemically different laterites have been studied on physical performance of cement as in setting time, Le-Chatlier expansion, loss on ignition, insoluble residue, free lime and specifically compressive strength of cement cubes tested at the age of 3, 7, and 28 days. The results show that the strength of cement blended with laterite as SCM is enhanced. Key words: Portland cement, supplementary cementing materials (SCM, laterite, compressive strength KUI – 6/2013 Received January 4, 2012 Accepted February 11, 2013

The influence of orientation and practical size on the interface fracture of a bone-nano composite cement

International Nuclear Information System (INIS)

Ilik, Igor; Khandaker, Morshed

2010-01-01

Clinical follow-up studies in cemented total hip arthroplasties found that femoral prosthesis loosening is caused by the fracture of the bone-cement interfaces. The research objectives were to determine whether orientation of the bone has any influence on the interface fracture strength, and to determine whether inclusion of micro/nano sizes MgO particles on Cobalt HV bone cement has any influence on the interface fracture strength. Flexural tests were conducted on five groups of specimens to find Young Modulus and bending strength: (1) longitudinal bone, (2) transverse bone, (3) pure cement particles, (4) cement with 36 im and 27 nm MgO particles, and (5) cement with 27nm MgO particles. Also, fracture tests were conducted on six groups of bone-cement specimen to find interface fracture toughness: (1) longitudinal bone-cement without MgO particles, (2) transverse bone-cement without MgO particles, (3) longitudinal bone-cement with 36 im MgO particles, (4) transverse bone-cement with 36 im MgO particles, (5) , longitudinal bone-cement with 27 nm MgO particles, and (6) transverse bone-cement with 27 nm MgO particles. Transverse bone specimen was 14% stiffer than longitudinal specimen, while bending strength and fracture toughness of longitudinal specimen was 29% and 2.6 times lower than the transverse specimen, respectively. Reduction of Young's modulus (7.3%), bending strength (27%) and fracture toughness (16%) was observed by the inclusion of microsize MgO particles, and a reduction of the Young's Modulus (19%), bending strength (21%),and fracture toughness (19%) for nanosize MgO particles. The interface toughness of the transverse bone infused with 27nm MgO was about 6 times higher than transverse bone infused with 36 im particles of MgO. Preliminary studies show that orientation of the bone has significant influence on the interface fracture. MgO particles size have a significant effect on the strength of the bone - cement interface.(Author)

Indications of 99mTc-MDP scintigraphy bone scan in the evaluation of painful hip arthroplasties

International Nuclear Information System (INIS)

Eder, V.; Baulieu, F.; Secchi, V.; Gautier, B.; Pottier, J.M.; Rosset, P.

2000-01-01

The purpose of this study was to determine the indication of bone scintigraphy in hip prosthesis complications. Thirty-six patients and 38 hip prosthesis have had a 99 Tc-MDP scintigraphy in our laboratory between 1995 and 1997. It concerns 32 cemented total prosthesis, 3 intermediate prosthesis and 3 non-cemented total prosthesis. For 14 prosthesis, complication (loosening or infection) was confirmed by surgical operation in 12 cases (4 isolated acetabular complications, 2 isolated femoral loosening, 3 global loosening and 3 infections) or by concordant data from different examinations in 2 cases (global loosening) where intervention was unrealizable. About other patients, absence of complication was confirmed by a favourable evolution lasting at least 12 months. A cetabular and femoral complications were detected by scintigraphy respectively with a sensitivity of 100 % and 90 %, a specificity of 85 % and 78 %, a PPV of 75 % and 60 % and NPV of 100 % and 96 %. High negative predictive value allows to eliminate a prosthesis complication in the case of a normal scintigraphy and to override decision when the clinic and the radiography are doubtful. Scintigraphy may recognize other bone fixation abnormalities which may be responsible of clinical symptomatology. (authors)

HPLC/DAD Intercomparison on Phytoplankton Pigments (HIP-1, HIP-2, HIP-3 and HIP-4)

OpenAIRE

CANUTI Elisabetta; RAS Josephine; GRUNG Merete; ROTTGERS Rudiger; COSTA GOELA Priscilla; ARTUSO Florinda; CATALDI Dario

2016-01-01

From 2009 to 2015, in the context of the MERIS (Medium Resolution Imaging Spectrometer) validation activities, the JRC Marine Optical Laboratory organised four HPLC Intercomparison exercises for Phytoplankton Pigment measurements (HIP-1, HIP-2, HIP-3 and HIP-4), involving seven European accredited and reference laboratories. The objectives of these intercomparison exercises were: creating a reference community at European level for phytoplankton pigment analysis capable of supporting satel...

Studies on coagulation, fibrinolysis, kallikrein-kinin and complement activation in systemic and pulmonary circulation during hip arthroplasty with acrylic cement.

Science.gov (United States)

Dahl, O E; Molnar, I; Vinje, A; Rø, J S; Kierulf, P; Andersen, A B; Dalaker, K; Prydz, H

1988-06-15

This study was designed to evaluate the contribution of the plasma cascade systems to the cardiopulmonary complications, occasionally leading to sudden death during hip arthroplasty using acrylic cement. The intraoperative pattern following uneventful surgery was therefore investigated in 8 patients with osteoarthrosis with frequent sampling from the radial and pulmonary arteries. The following general findings emerged: A gradual consumption of coagulation factors (platelets, fibrinogen, factor VII, antithrombin III), fibrinolytic components (plasminogen, alpha-2-antiplasmin), kallikrein-kinin factors (prekallikrein, kallikrein inhibitor) and complement factors (C3c, C4) was observed. Some intrapulmonary proteolytic inhibition was noticed as evidenced by lower arterial than mixed venous blood levels of alpha-2-antiplasmin and kallikrein inhibitor. Insignificant changes occurred for factor VII-phospholipid complex. A rapid, massive and transient increase in fibrinopeptide A (FPA) values in the radial artery, as opposed to the moderate increase in the pulmonary artery, was found immediately after reaming and broaching of bone. This probably reflected intrapulmonary fibrinogen to fibrin conversion, reaching a maximum 15-20 minutes before the femoral implantation. As estimated from the FPA arterial peak values and the fall in fibrinogen concentrations, approximately 5-10% of the circulating fibrinogen molecules were devoided of FPA during this intraoperative phase. The marked a-v difference in FPA level supports earlier findings of intrapulmonary fibrin formation and deposition. This process, however preceded the critical period of cardiorespiratory collapse (CRC) by at least 15 minutes, and may thus predispose to this complication.

A quantitative assessment of facial protection systems in elective hip arthroplasty.

Science.gov (United States)

Hirpara, Kieran Michael; O'Halloran, Emily; O'Sullivan, Michael

2011-06-01

We aimed to assess the risk to surgeons of blood splatter during total hip arthroplasty. Hoods from personal protection systems used in 34 consecutive total hip replacements were collected and the area of blood splatter was measured and compared to goggles and visors. Thirty one primary THA's (13 cemented, 4 hybrid, 14 uncemented) and 3 revisions (1 hybrid, 2 uncemented) were collected. Splashes were detected on all of the masks with a mean of 034% cover. Splatter was greatest for the operating surgeon, followed by the first assistant, though the difference was not statistically significant. Operating personnel were at greater risk of contamination during uncemented arthroplasty (p blood cover was outside the area protected by goggles and visors respectively. There was a significant difference between the Personal Protection Systems (PPS) and goggles (p = 0.0231; 95% CI) as well as between the PPS and visors (p = 0.0293; 95% CI).

Cermet cements.

Science.gov (United States)

McLean, J W

1990-01-01

Cermet ionomer cements are sintered metal/glass powders, which can be made to react with poly(acids). These new cements are significantly more resistant to abrasion than regular glass ionomer cements and are widely accepted as core build-up materials and lining cements. They can strengthen teeth and provide the clinician with an opportunity to treat early dental caries.

Gait analysis, bone and muscle density assessment for patients undergoing total hip arthroplasty

Directory of Open Access Journals (Sweden)

Benedikt Magnússon

2012-12-01

Full Text Available Total hip arthroplasty (THA is performed with or without the use of bone cement. Facing the lack of reliable clinical guidelines on decision making whether a patient should receive THA with or without bone cement, a joint clinical and engineering approach is proposed here with the objective to assess patient recovery developing monitoring techniques based on gait analysis, measurements of bone mineral density and structural and functional changes of quadriceps muscles. A clinical trial was conducted with 36 volunteer patients that were undergoing THA surgery for the first time: 18 receiving cemented implant and 18 receiving non-cemented implant. The patients are scanned with Computer Tomographic (CT modality prior-, immediately- and 12 months post-surgery. The CT data are further processed to segment muscles and bones for calculating bone mineral density (BMD. Quadriceps muscle density Hounsfield (HU based value is calculated from the segmented file on healthy and operated leg before and after THA surgery. Furthermore clinical assessment is performed using gait analysis technologies such as a sensing carpet, wireless electrodes and video. Patients undergo these measurements prior-, 6 weeks post - and 52 weeks post-surgery. The preliminary results indicate computational tools and methods that are able to quantitatively analyze patient’s condition pre and post-surgery: The spatial parameters such as step length and stride length increase 6 weeks post op in the patient group receiving cemented implant while the angle in the toe in/out parameter decrease in both patient groups.

Trochanteric fragility fractures : Treatment using the cement-augmented proximal femoral nail antirotation.

Science.gov (United States)

Neuerburg, C; Mehaffey, S; Gosch, M; Böcker, W; Blauth, M; Kammerlander, C

2016-06-01

Use of standardized cement augmentation of the proximal femur nail antirotation (PFNA) for the treatment of trochanteric fragility fractures, which are associated with high morbidity and mortality, to achieve safer conditions for immediate full weight-bearing and mobilization, thus, improving preservation of function and independency of orthogeriatric patients. Trochanteric fragility fractures (type 31-A1-3). Ipsilateral arthritis of the hip, leakage of contrast agent into the hip joint, femoral neck fractures. Reduction of the fracture on a fracture table if possible, or minimally invasive open reduction of the proximal femur, i. e., using collinear forceps if necessary. Positioning of guidewires for adjustment of the PFNA and the spiral blade, respectively. Exclusion of leakage of contrast agent and subsequent injection of TRAUMACEM™ V(+) into the femoral head-neck fragment via a trauma needle kit introduced into the spiral blade. Dynamic or static locking of the PFNA at the diaphyseal level. Immediate mobilization of the patients with full weight-bearing and secondary prevention, such as osteoporosis management is necessary to avoid further fractures in the treatment of these patients. A total of 110 patients older than 65 years underwent the procedure. Of the 72 patients available for follow-up (average age 85.3 years), all fractures healed after an average of 15.3 months. No complications related with cement augmentation were observed. Approximately 60 % of patients achieved the mobility level prior to trauma.

COMPARISON OF DEXMEDETOMIDINE, BUPRENORPHINE AND FENTANYL AS AN ADJUVANT TO BUPIVACAINE DURING SPINAL ANAESTHESIA FOR HEMIARTHROPLASTY

Directory of Open Access Journals (Sweden)

Pradeep R

2016-10-01

Full Text Available BACKGROUND Opioids such as fentanyl or buprenorphine are being added as adjuvant to local anaesthetic for spinal anaesthesia. Dexmedetomidine, a new α2 agonist is being tried as an adjuvant in the recent times. MATERIALS AND METHODS The patients were randomised into three Groups (n=30 each by closed envelope technique. Patients in Group 1 received 10 µg fentanyl with 15 mg of 0.5% hyperbaric bupivacaine, Group 2 received 15 mg of 0.5% hyperbaric bupivacaine supplemented with 30 µg of buprenorphine and Group 3 received 15 mg of 0.5% hyperbaric bupivacaine plus 5 µg dexmedetomidine intrathecally. The time to reach maximum sensory and motor level, the regression time of the same, any adverse effects were recorded. Data were analysed using chi-square test or Fisher’s exact test for categorical data and analysis of variance for continuous data. A value of P<0.05 was accepted as statistically significant. Settings and Design- The study was conducted in a prospective, randomised and double-blind manner. It included ninety American Society of Anaesthesiologists class I and II patients undergoing hemiarthroplasty under spinal anaesthesia. RESULTS In this study, the patients in dexmedetomidine group showed significantly longer duration of motor block (240±20 mins. and sensory blockade (180±22.2 mins. compared to other groups, which is statistically significant (P=0.0001 and P=0.006, respectively. The time to first request of analgesic postoperatively was also longer (260±30.2 in dexmedetomidine group when compared with other groups (P=0.0001. Haemodynamic parameters were stable and there were no complications in any group. CONCLUSIONS We concluded that intrathecal dexmedetomidine (5 µg with bupivacaine provides significantly longer duration of sensory and motor blockade and longer duration for first request of analgesia in the recovery than intrathecal buprenorphine (30 µg or fentanyl (10 µg with bupivacaine for spinal anaesthesia for

Hip Resurfacing: An Alternative to Conventional Hip Replacement?

Science.gov (United States)

... Is hip resurfacing a good alternative to hip replacement? Answers from Mark Spangehl, M.D. Hip resurfacing has lost favor with many surgeons ... women with poor bone quality. Unlike traditional hip replacement, hip resurfacing doesn't completely replace the "ball" ...

ULTRA-LIGHTWEIGHT CEMENT

International Nuclear Information System (INIS)

Fred Sabins

2001-01-01

The objective of this project is to develop an improved ultra-lightweight cement using ultralight hollow glass spheres (ULHS). Work reported herein addresses Task 1: Assess Ultra-Lightweight Cementing Problems and Task 3: Test Ultra-Lightweight Cements. Results reported this quarter include a review and summary of Halliburton Energy Services (HES) and BJ Services historical performance data for lightweight cement applications. These data are analyzed and compared to ULHS cement and foamed cement performances. Similar data is expected from Schlumberger, and an analysis of this data will be completed in the following phases of the project. Quality control testing of materials used to formulate ULHS cements in the laboratory was completed to establish baseline material performance standards. A testing protocol was developed employing standard procedures as well as procedures tailored to evaluate ULHS and foamed cement. This protocol is presented and discussed. Results of further testing of ULHS cements are presented along with an analysis to establish cement performance design criteria to be used during the remainder of the project. Finally, a list of relevant literature on lightweight cement performance is compiled for review during the next quarter

Cement-latex grouting mortar for cementing boreholes

Energy Technology Data Exchange (ETDEWEB)

Kateev, I S; Golyshkina, L A; Gorbunova, I V; Kurochkin, B M; Vakula, Ya V

1980-01-01

The need for the development of cement-latex grouting mortar for the purpose of separating strata when reinforcing boreholes at deposits in the Tatar Associated SSR is evaluated. Results of studies of the physical and mechanical properties of cement-latex grouting mortar systems (mortar plus brick) are presented. Formulas for preparing cement-latex grouting mortor are evaluated and results of industrial tests of such mortars shown.

Study on Cr(VI) Leaching from Cement and Cement Composites

Science.gov (United States)

Palascakova, Lenka; Kanuchova, Maria

2018-01-01

This paper reports an experimental study on hexavalent chromium leaching from cement samples and cement composites containing silica fume and zeolite additions that were subjected to various leaching agents. The water-soluble Cr(VI) concentrations in cements ranged from 0.2 to 3.2 mg/kg and represented only 1.8% of the total chromium content. The presence of chromium compounds with both chromium oxidation states of III and VI was detected in the cement samples by X-ray photoelectron spectroscopy (XPS). Leaching tests were performed in a Britton-Robinson buffer to simulate natural conditions and showed increased dissolution of Cr(VI) up to 6 mg/kg. The highest amount of leached hexavalent chromium was detected after leaching in HCl. The findings revealed that the leaching of chromium from cements was higher by 55–80% than that from the cement composites. A minimum concentration was observed for all cement samples when studying the relationship between the soluble Cr(VI) and the cement storage time. PMID:29690550

COMPARISON OF UNIPOLAR (MOORE’S PROSTHESIS AND BIPOLAR HEMIARTHROPLASTY IN FRACTURE NECK OF FEMUR IN THE ELDERLY- A SHORT-TERM PROSPECTIVE STUDY

Directory of Open Access Journals (Sweden)

Mahendra Bendale

2016-11-01

Full Text Available BACKGROUND Femoral neck fractures are common in postmenopausal elderly females as a result of osteoporosis due to trivial trauma or in the young due to high energy trauma. The goal of the surgeon is to return the patient to his/her prefracture functional status. Femoral neck fracture could be impacted and undisplaced or displaced. Femoral neck fractures are also considered “fractures of necessity”, best treated surgically irrespective of displacement. Surgery permits early patient mobilisation and minimises the complications of prolonged recumbence. The bipolar prosthesis has advantage over the unipolar in having two bearings for the movements to occur. This study intends to compare the functional outcome of unipolar Moore’s hemi-replacement and fixed bipolar replacement in elderly patients with fracture neck of femur. In this scenario, the null hypothesis would be that there is no significant difference in the results between the patients treated with Moore’s prosthesis and those treated with bipolar prosthesis. The aim of the study is to compare the results of unipolar and bipolar hemi-arthroplasty for fracture neck of femur in the elderly patients. MATERIALS AND METHODS 30 elderly postmenopausal women with fracture neck femur were included in the study. They were divided into 2 groups and were operated upon by using unipolar and bipolar implants respectively after thorough investigation. The functional outcome was assessed using the Harris Hip Score (HHS. RESULTS Femoral neck fractures belonged to 53.3% with type III fracture and 46.7 had type IV fractures. Fifteen patients had replacement with Austin Moore prosthesis and fifteen patients with bipolar prosthesis. The average HHS at 6 weeks for unipolar and bipolar groups was 65.2 and 66.0, respectively. The average HHS at 12 months for unipolar and bipolar group was 81.0 and 83.6, respectively. 19 (65.5% patients had good HHS at the end of one year. Corrected chi-square value is 2

A quantitative assessment of facial protection systems in elective hip arthroplasty.

LENUS (Irish Health Repository)

Hirpara, Kieran Michael

2011-06-01

We aimed to assess the risk to surgeons of blood splatter during total hip arthroplasty. Hoods from personal protection systems used in 34 consecutive total hip replacements were collected and the area of blood splatter was measured and compared to goggles and visors. Thirty one primary THA\\'s (13 cemented, 4 hybrid, 14 uncemented) and 3 revisions (1 hybrid, 2 uncemented) were collected. Splashes were detected on all of the masks with a mean of 034% cover. Splatter was greatest for the operating surgeon, followed by the first assistant, though the difference was not statistically significant. Operating personnel were at greater risk of contamination during uncemented arthroplasty (p < 0.0001; 95% CI). On average 50.60% and 45.40% of blood cover was outside the area protected by goggles and visors respectively. There was a significant difference between the Personal Protection Systems (PPS) and goggles (p = 0.0231; 95% CI) as well as between the PPS and visors (p = 0.0293; 95% CI).

ULTRA-LIGHTWEIGHT CEMENT

International Nuclear Information System (INIS)

Fred Sabins

2001-01-01

The objective of this project is to develop an improved ultra-lightweight cement using ultra-lightweight hollow glass spheres (ULHS). Work reported herein addresses Task 1: Assess Ultra-Lightweight Cementing Issues, Task 2: Review Russian Ultra-Lightweight Cement Literature, Task 3: Test Ultra-Lightweight Cements, and Task 8: Develop Field ULHS Cement Blending and Mixing Techniques. Results reported this quarter include: preliminary findings from a literature review focusing on problems associated with ultra-lightweight cements; summary of pertinent information from Russian ultra-lightweight cement literature review; laboratory tests comparing ULHS slurries to foamed slurries and sodium silicate slurries for two different applications; and initial laboratory studies with ULHS in preparation for a field job

Periprosthetic hip fractures: A review of the economic burden based on length of stay.

Science.gov (United States)

Lyons, Rebecca F; Piggott, Robert P; Curtin, William; Murphy, Colin G

2018-03-01

With the increasing rates of total hip replacements being performed worldwide, there is an increasing incidence of periprosthetic fractures. As our patients' demographics change to include older patients with multiple medical co-morbidities, there is a concurrent increase in morbidity and mortality rates. This leads to longer hospital stays and increasing hospital costs. In the current economic climate, the cost of treating periprosthetic fractures must be addressed and appropriate resource and funding allocation for future provision of services should be planned. All periprosthetic hip fractures that were admitted to a single trauma unit over a three-year period were reviewed. Independent chart review, haematological and radiological review was undertaken. All patients with a periprosthetic fracture associated with a total hip arthroplasty or hemiarthroplasty were included. Follow up data including complications were collated. Data from the hospital inpatient database and finance department was utilized for cost analysis. All statistical analysis was preformed using Minitab version 17. 48 patients were identified who met the inclusion criteria for review. The majority of participants were female with a mean age of 73.5 years. The mean time to fracture was 4.5 years (9 months-18.5 years). Periprosthetic fracture was associated with total hip arthroplasty in 24 cases and a Vancouver B2 classification was most common at n = 20. The majority of patients had revision arthroplasty, with a mean length of stay of 24 days for the whole cohort (9-42). Vancouver B3 fractures had the longest inpatient stay at a mean of 26 days. The mean cost of for a full revision of stem with additional plate and cable fixation was over €27000 compared to €14,600 for ORIF and cable fixation based on length of hospital stay. The prolonged length of stay associated with Vancouver B2 and B3 fractures leads to increased costs to the healthcare service. Accurately calculating

Cement Formation

DEFF Research Database (Denmark)

Telschow, Samira; Jappe Frandsen, Flemming; Theisen, Kirsten

2012-01-01

Cement production has been subject to several technological changes, each of which requires detailed knowledge about the high multiplicity of processes, especially the high temperature process involved in the rotary kiln. This article gives an introduction to the topic of cement, including...... an overview of cement production, selected cement properties, and clinker phase relations. An extended summary of laboratory-scale investigations on clinkerization reactions, the most important reactions in cement production, is provided. Clinker formations by solid state reactions, solid−liquid and liquid......−liquid reactions are discussed, as are the influences of particles sizes on clinker phase formation. Furthermore, a mechanism for clinker phase formation in an industrial rotary kiln reactor is outlined....

Hip, Hip, Soret!

Science.gov (United States)

Müller-Plathe, Florian

Many years ago, Ludwig did detect the behaviour now called the Soret effect. Sodium sulphate in eighteen-fifty-six did not obediently follow Fick's first law. But if he cooled down one side the salt went left, the water to the right. He was surprised in every way. Hip, hip, Soret!

A Twofold Comparison between Dual Cure Resin Modified Cement and Glass Ionomer Cement for Orthodontic Band Cementation.

Science.gov (United States)

Attar, Hanaa El; Elhiny, Omnia; Salem, Ghada; Abdelrahman, Ahmed; Attia, Mazen

2016-12-15

To test the solubility of dual cure resin modified resin cement in a food simulating solution and the shear bond strength compared to conventional Glass ionomer cement. The materials tested were self-adhesive dual cure resin modified cement and Glass Ionomer (GIC). Twenty Teflon moulds were divided into two groups of tens. The first group was injected and packed with the modified resin cement, the second group was packed with GIC. To test the solubility, each mould was weighed before and after being placed in an analytical reagent for 30 days. The solubility was measured as the difference between the initial and final drying mass. To measure the Shear bond strength, 20 freshly extracted wisdom teeth were equally divided into two groups and embedded in self-cure acrylic resin. Four mm sections of stainless steel bands were cemented to the exposed buccal surfaces of teeth under a constant load of 500 g. Shear bond strength was measured using a computer controlled materials testing machine and the load required to deband the samples was recorded in Newtons. GIC showed significantly higher mean weight loss and an insignificant lower Shear bond strength, compared to dual cure resin Cement. It was found that dual cure resin modified cement was less soluble than glass ionomer cement and of comparable bond strength rendering it more useful clinically for orthodontic band cementation.

Cementless Hip Arthroplasty in Southern Iran, Midterm Outcome and Comparison of Two Designs

Directory of Open Access Journals (Sweden)

Gholam Hossein Shahcheraghi

2015-09-01

Full Text Available Background: Cementless hip prosthesis was designed to provide biologic fixation, without the use of cement. The second generation components have shown more reliable bone ingrowths and survival rates. We are reporting a midterm result of two designs of cementless prosthesis in a unique culture with different social habits and expectations. Methods: 52 primary cementless total hip arthroplasty in 42 patients with the mean age of 48.8 years were retrospectively studied. Two groups of prosthesis had been implanted: Harris-Galante II (HGII in 15 and Versys-Trilogy (V-T in 37 hips, both from Zimmer company. The patients were assessed clinically, radiographically and with Harris hip score, SF36, WOMAC, and MACTAR questionnaires, with 65 months (26-136 mean follow-up. Results: All the V-T prostheses had survived well. Eight of HG II were revised by the last follow-up in 19-102 months. All had undergone acetabular revision and 2 combined with femoral revision. Broken tines of HGII cups were seen in 4 radiographs. The 65 months overall survival was 96.2% for femoral and 84.6% for acetabular components. 90% had good or excellent Harris hip scores. The functional scores were poorer in the HG II group. Pain relief and improved walking were the two main patients’ expectations fulfilled in 97.6% and 92.8%, respectively. Conclusions: The outcome of cementless total hip arthroplasty (THA is satisfactory and comparable with the literature based on the results of function and survival of this small comparative group. The use of HGII acetabular component should be abandoned.

Evaluation of the amount of excess cement around the margins of cement-retained dental implant restorations: the effect of the cement application method.

Science.gov (United States)

Chee, Winston W L; Duncan, Jesse; Afshar, Manijeh; Moshaverinia, Alireza

2013-04-01

Complete removal of excess cement from subgingival margins after cementation of implant-supported restorations has been shown to be unpredictable. Remaining cement has been shown to be associated with periimplant inflammation and bleeding. The purpose of this study was to investigate and compare the amount of excess cement after cementation with 4 different methods of cement application for cement-retained implant-supported restorations. Ten implant replicas/abutments (3i) were embedded in acrylic resin blocks. Forty complete veneer crowns (CVCs) were fabricated by waxing onto the corresponding plastic waxing sleeves. The wax patterns were cast and the crowns were cemented to the implant replicas with either an interim (Temp Bond) or a definitive luting agent (FujiCEM). Four methods of cement application were used for cementation: Group IM-Cement applied on the internal marginal area of the crown only; Group AH-Cement applied on the apical half of the axial walls of the crown; Group AA-Cement applied to all axial walls of the interior surface of the crown, excluding the occlusal surface; and Group PI-Crown filled with cement then seated on a putty index formed to the internal configuration of the restoration (cementation device) (n=10). Cement on the external surfaces was removed before seating the restoration. Cement layers were applied on each crown, after which the crown was seated under constant load (80 N) for 10 minutes. The excess cement from each specimen was collected and measured. One operator performed all the procedures. Results for the groups were compared, with 1 and 2-way ANOVA and the Tukey multiple range test (α=.05). No significant difference in the amount of excess/used cement was observed between the 2 different types of cements (P=.1). Group PI showed the least amount of excess cement in comparison to other test groups (P=.031). No significant difference was found in the amount of excess cement among groups MI, AH, and AA. Group AA showed the

76 FR 76760 - Gray Portland Cement and Cement Clinker From Japan

Science.gov (United States)

2011-12-08

... and Cement Clinker From Japan Determination On the basis of the record \\1\\ developed in the subject... duty order on gray Portland cement and cement clinker from Japan would be likely to lead to... and Cement Clinker from Japan: Investigation No. 731- TA-461 (Third Review). By order of the...

Method and ranking of DSA of the hip in detecting loosening of endoprostheses

International Nuclear Information System (INIS)

Fink, B.K.; Fink, U.; Hansen, M.; Kirsch, C.M.; Pfahler, M.

1991-01-01

Digital subtraction arthrography (DSAr) of the operated hip is presented and compared to nuclide bone scan and plain radiograph. Surgical proof was obtained in 47 patients. In the evaluation DSAr proved to be superior to nuclide bone scan and plain radiograph. DSAr had the best predictive value in the diagnosis of loosening of a prosthesis. In contrast to conventional arthrography there is a better differentiation between the contrast medium, the prosthesis, the acryle cement and the bone by using DSAr. In addition DSAr presents the advantage of postprocessing, especially pixelshift. (orig.) [de

Cementing a wellbore using cementing material encapsulated in a shell

Energy Technology Data Exchange (ETDEWEB)

Aines, Roger D.; Bourcier, William L.; Duoss, Eric B.; Spadaccini, Christopher M.; Cowan, Kenneth Michael

2016-08-16

A system for cementing a wellbore penetrating an earth formation into which a pipe extends. A cement material is positioned in the space between the wellbore and the pipe by circulated capsules containing the cement material through the pipe into the space between the wellbore and the pipe. The capsules contain the cementing material encapsulated in a shell. The capsules are added to a fluid and the fluid with capsules is circulated through the pipe into the space between the wellbore and the pipe. The shell is breached once the capsules contain the cementing material are in position in the space between the wellbore and the pipe.

Cementing a wellbore using cementing material encapsulated in a shell

Energy Technology Data Exchange (ETDEWEB)

Aines, Roger D.; Bourcier, William L.; Duoss, Eric B.; Floyd, III, William C.; Spadaccini, Christopher M.; Vericella, John J.; Cowan, Kenneth Michael

2017-03-14

A system for cementing a wellbore penetrating an earth formation into which a pipe extends. A cement material is positioned in the space between the wellbore and the pipe by circulated capsules containing the cement material through the pipe into the space between the wellbore and the pipe. The capsules contain the cementing material encapsulated in a shell. The capsules are added to a fluid and the fluid with capsules is circulated through the pipe into the space between the wellbore and the pipe. The shell is breached once the capsules contain the cementing material are in position in the space between the wellbore and the pipe.

Two-stage revision surgery with preformed spacers and cementless implants for septic hip arthritis: a prospective, non-randomized cohort study

Directory of Open Access Journals (Sweden)

Logoluso Nicola

2011-05-01

Full Text Available Abstract Background Outcome data on two-stage revision surgery for deep infection after septic hip arthritis are limited and inconsistent. This study presents the medium-term results of a new, standardized two-stage arthroplasty with preformed hip spacers and cementless implants in a consecutive series of adult patients with septic arthritis of the hip treated according to a same protocol. Methods Nineteen patients (20 hips were enrolled in this prospective, non-randomized cohort study between 2000 and 2008. The first stage comprised femoral head resection, debridement, and insertion of a preformed, commercially available, antibiotic-loaded cement hip spacer. After eradication of infection, a cementless total hip arthroplasty was implanted in the second stage. Patients were assessed for infection recurrence, pain (visual analog scale [VAS] and hip joint function (Harris Hip score. Results The mean time between first diagnosis of infection and revision surgery was 5.8 ± 9.0 months; the average duration of follow up was 56.6 (range, 24 - 104 months; all 20 hips were successfully converted to prosthesis an average 22 ± 5.1 weeks after spacer implantation. Reinfection after total hip joint replacement occurred in 1 patient. The mean VAS pain score improved from 48 (range, 35 - 84 pre-operatively to 18 (range, 0 - 38 prior to spacer removal and to 8 (range, 0 - 15 at the last follow-up assessment after prosthesis implantation. The average Harris Hip score improved from 27.5 before surgery to 61.8 between the two stages to 92.3 at the final follow-up assessment. Conclusions Satisfactory outcomes can be obtained with two-stage revision hip arthroplasty using preformed spacers and cementless implants for prosthetic hip joint infections of various etiologies.

Natural cement as the precursor of Portland cement: Methodology for its identification

International Nuclear Information System (INIS)

Varas, M.J.; Alvarez de Buergo, M.; Fort, R.

2005-01-01

When cements appeared in the 19th century, they took the place of traditional binding materials (lime, gypsum, and hydraulic lime) which had been used until that time. Early cements can be divided into two groups, natural and artificial (Portland) cements. Natural cements were introduced first, but their widespread usage was short-lived as they were quickly replaced by artificial cements (Portland), still the most important and predominant today. The main differences between natural and artificial cements arise during the manufacturing process. The final properties of the cements are greatly influenced by differences in the raw materials and burning temperatures employed. The aim of this paper is to assess the efficiency of traditional analytical techniques (petrographic microscopy, X-ray diffraction (XRD), scanning electron microscopy (SEM), and Fourier transform infrared spectroscopy (FTIR)) used to differentiate natural and artificial cements

Cement technique for reducing post-operative bursitis after trochanteric fixation.

Science.gov (United States)

Derman, Peter B; Horneff, John G; Kamath, Atul F; Garino, Jonathan

2013-02-01

Post-operative trochanteric bursitis is a known complication secondary to the surgical approach in total hip arthroplasty. This phenomenon may be partially attributable to repetitive microtrauma generated when soft tissues rub against implanted hardware. Significant rates of post-operative trochanteric bursitis have been observed following procedures in which a trochanteric fixation device, such as a bolt-washer mechanism or a cable-grip/claw system, is used to secure the trochanteric fragment after trochanteric osteotomy. We present a simple technique for use with a bolt-washer system or grip plate in which trochanteric components are covered in bone wax followed by a layer of cement to decrease friction and to diminish the risk of post-operative bursitis.

Feasibility of producing nano cement in a traditional cement factory in Iraq

Directory of Open Access Journals (Sweden)

Sada Abdalkhaliq Hasan Alyasri

2017-12-01

Full Text Available This study investigates the economic feasibility of producing nano cement through the establishment of a production line within an existing cement factory. Creating a nano cement production line within the Alkufa Cement factory in Iraq is selected as a case study. Evaluation measures including internal rate of return (IRR, net present value (NPV and breakeven point (BEP are used to evaluate the possible gain that can be achieved from this option. The results demonstrated a positive NPV. The IRR is found to be 26.8% and BEP is reached within 3 years after the establishment of the line. This indicates that producing nano cement in the existing cement factory is economically feasible and can be more advantageous than the ordinary cement.

Use of a constrained tripolar acetabular liner to treat intraoperative instability and postoperative dislocation after total hip arthroplasty: a review of our experience.

Science.gov (United States)

Callaghan, John J; O'Rourke, Michael R; Goetz, Devon D; Lewallen, David G; Johnston, Richard C; Capello, William N

2004-12-01

Constrained acetabular components have been used to treat certain cases of intraoperative instability and postoperative dislocation after total hip arthroplasty. We report our experience with a tripolar constrained component used in these situations since 1988. The outcomes of the cases where this component was used were analyzed for component failure, component loosening, and osteolysis. At average 10-year followup, for cases treated for intraoperative instability (2 cases) or postoperative dislocation (4 cases), the component failure rate was 6% (6 of 101 hips in 5 patients). For cases where the constrained liner was cemented into a fixed cementless acetabular shell, the failure rate was 7% (2 of 31 hips in 2 patients) at 3.9-year average followup. Use of a constrained liner was not associated with an increased osteolysis or aseptic loosening rate. This tripolar constrained acetabular liner provided total hip arthroplasty construct stability in most cases in which it was used for intraoperative instability or postoperative dislocation.

[Early results of proximal femoral fractures treated with FENIX modular hemiarthroplasty].

Science.gov (United States)

Görski, Radosław; Górecki, Andrzej; Olszewski, Paweł; Biedrzycki, Jerzy; Skowronek, Paweł

2010-01-01

The article discusses preliminary clinical results in patients with proximal femoral fractures treated with hemiarthroplasty using a FENIX implant. The study group comprised 41 subjects aged 69 to 97 (median age 82.3 year). The follow-up study provided data on 26 subjects (63.4%), among which 15 attended the check-up, 5 subjects refused to visit at the Department and 6 subjects were reported as deceased. Median follow-up period amounted to 6.8 month (1 to 22 months). General hospitalization-related complications occurred in 8 patients (19.5%). During hospitalization no deaths occurred, in the deceased group 3 patients died within 12 months after surgery, while another 3 died after the twelve-month postoperative period (median of 13.3%). According to Merle d'Aubigne-Postel score favorable long-term results were observed in 9 patients (59.9%), 13 patients regained the level of motor function similar to the functional ability prior to fracture. The need to postpone the surgery due to general health status and impaired pre-operative motor function are significant negative prognostic factors. The results obtained were compared with previous efficacy studies on femoral fracture treatment using an Austin-Moore implant. Functional ability and self-reliance was higher in the FENIX group. FENIX arthroplasty effectively helps patients regain self-reliance and motor function thanks to its modular characteristics and anatmoical construction.

Sustainable Development of the Cement Industry and Blended Cements to Meet Ecological Challenges

Directory of Open Access Journals (Sweden)

Konstantin Sobolev

2003-01-01

Full Text Available The world production of cement has greatly increased in the past 10 years. This trend is the most significant factor affecting technological development and the updating of manufacturing facilities in the cement industry. Existing technology for the production of cement clinker is ecologically damaging; it consumes much energy and natural resources and also emits pollutants. A new approach to the production of blended or high-volume mineral additive (HVMA cement helps to improve its ecological compatibility. HVMA cement technology is based on the intergrinding of portland cement clinker, gypsum, mineral additives, and a special complex admixture. This new method increases the compressive strength of ordinary cement, improves durability of the cement-based materials, and - at the same time - uses inexpensive natural mineral additives or industrial by-products. This improvement leads to a reduction of energy consumption per unit of the cement produced. Higher strength, better durability, reduction of pollution at the clinker production stage, and decrease of landfill area occupied by industrial by-products, all provide ecological advantages for HVMA cement.

Cement for Oil Well Cementing Operations in Ghana

African Journals Online (AJOL)

Michael

For Portland cement to qualify as oil well cement, the chemical and physical properties must meet ..... Reservoir Engineering, Stanford University,. Stanford, California, pp. ... Construction”, PhD Thesis, Kwame Nkrumah. University of Science ...

Low force cementation.

Science.gov (United States)

Wilson, P R

1996-07-01

The marginal adaptation of full coverage restorations is adversely affected by the introduction of luting agents of various minimum film thicknesses during the cementation process. The increase in the marginal opening may have long-term detrimental effects on the health of both pulpal and periodontal tissues. The purpose of this study was to determine the effects of varying seating forces (2.5, 12.5, 25 N), venting, and cement types on post-cementation marginal elevation in cast crowns. A standardized cement space of 40 microns was provided between a machined gold crown and a stainless steel die. An occlusal vent was placed that could be opened or closed. The post-cementation crown elevation was measured, following the use of two commercially available capsulated dental cements (Phosphacap, and Ketac-cem Applicap). The results indicate that only the combination of Ketac-Cem Applicap and crown venting produced post-cementation crown elevation of less than 20 microns when 12.5 N seating force was used. Higher forces (25 N) and venting were required for comparable seating when using Phosphacap (19 microns). The amount of force required to allow maximum seating of cast crowns appears to be cement specific, and is reduced by effective venting procedures.

Custom-made lateral femoral hemiarthroplasty for traumatic bone loss: A case report.

Science.gov (United States)

Stuyts, Bart; Peersman, Geert; Thienpont, Emmanuel; Van den Eeden, Elke; Van der Bracht, Hans

2015-10-01

We report the case of a 32-year-old male patient involved in a road traffic accident in which he sustained a grade II open supra- and intercondylar fracture of the left distal femur with substantial bone loss of the lateral femoral condyle and trochlea (AO classification type 33 C3). Normal knee function was no longer possible, as the patella was trapped within the bony defect. Existing reconstructive options such as unicondylar osteoarticular allograft, arthrodesis, and arthroplasty were considered. However, as all these techniques present significant disadvantages, particularly in young and active patients, a custom-made lateral hemiarthroplasty was designed and implanted as an alternative treatment. Follow-up at 24 months revealed an excellent, pain-free level of function and radiographs showed no signs of implant loosening or migration. This technique offers the most anatomical means of reconstruction with maximal preservation of the bone stock, thereby better facilitating any revisions that may be necessary in the future. This is an experimental technique reserved for rare indications, and currently has no long-term follow-up results associated with its use. Additional research is therefore needed before widespread adoption of this technique can take place. Copyright © 2015 Elsevier B.V. All rights reserved.

HIP JOINT AND HIP ENDOPROSTHESIS BIOMECHANICS

OpenAIRE

Jakub Gryka

2017-01-01

This article contains a description of the basic issues related to anatomy, loading of hip joint and its endoprosthesis research methods. The methods of testing and simulating hip joint loads, factors that influence the selection of parameters during the design of prostheses, typical solutions to engineering problems related to this topic are presented. The article concludes with short summary of the finite element method for the design of hip replacements.

Synthesis of Portland cement and calcium sulfoaluminate-belite cement for sustainable development and performance

Science.gov (United States)

Chen, Irvin Allen

Portland cement concrete, the most widely used manufactured material in the world, is made primarily from water, mineral aggregates, and portland cement. The production of portland cement is energy intensive, accounting for 2% of primary energy consumption and 5% of industrial energy consumption globally. Moreover, portland cement manufacturing contributes significantly to greenhouse gases and accounts for 5% of the global CO2 emissions resulting from human activity. The primary objective of this research was to explore methods of reducing the environmental impact of cement production while maintaining or improving current performance standards. Two approaches were taken, (1) incorporation of waste materials in portland cement synthesis, and (2) optimization of an alternative environmental friendly binder, calcium sulfoaluminate-belite cement. These approaches can lead to less energy consumption, less emission of CO2, and more reuse of industrial waste materials for cement manufacturing. In the portland cement part of the research, portland cement clinkers conforming to the compositional specifications in ASTM C 150 for Type I cement were successfully synthesized from reagent-grade chemicals with 0% to 40% fly ash and 0% to 60% slag incorporation (with 10% intervals), 72.5% limestone with 27.5% fly ash, and 65% limestone with 35% slag. The synthesized portland cements had similar early-age hydration behavior to commercial portland cement. However, waste materials significantly affected cement phase formation. The C3S--C2S ratio decreased with increasing amounts of waste materials incorporated. These differences could have implications on proportioning of raw materials for cement production when using waste materials. In the calcium sulfoaluminate-belite cement part of the research, three calcium sulfoaluminate-belite cement clinkers with a range of phase compositions were successfully synthesized from reagent-grade chemicals. The synthesized calcium sulfoaluminate

Ultrafine portland cement performance

Directory of Open Access Journals (Sweden)

C. Argiz

2018-04-01

Full Text Available By mixing several binder materials and additions with different degrees of fineness, the packing density of the final product may be improved. In this work, ultrafine cement and silica fume mixes were studied to optimize the properties of cement-based materials. This research was performed in mortars made of two types of cement (ultrafine Portland cement and common Portland cement and two types of silica fume with different particle-size distributions. Two Portland cement replacement ratios of 4% and 10% of silica fume were selected and added by means of a mechanical blending method. The results revealed that the effect of the finer silica fume mixed with the coarse cement enhances the mechanical properties and pore structure refinement at a later age. This improvement is somewhat lower in the case of ultrafine cement with silica fume.

21 CFR 888.3353 - Hip joint metal/ceramic/polymer semi-constrained cemented or nonporous uncemented prosthesis.

Science.gov (United States)

2010-04-01

... linkage across-the-joint. The two-part femoral component consists of a femoral stem made of alloys to be... ceramic (aluminium oxide, A1203) head of the femoral component. The acetabular component is made of ultra... nonporous metal alloys, and used with or without bone cement. (b) Classification. Class II. [54 FR 48239...

Optimization of hip joint replacement location to decrease maximum von Mi ses Stress

International Nuclear Information System (INIS)

Pourjamali, H.; Najarian, S.; Katoozian, H. R.

2001-01-01

Hip replacement is used for inoperable femur head injuries and femur fractures where internal fixation can not be used. This operation is one of the most common orthopedic operations that many research have been done about it. Among these we can mention implant and cement materials and composites optimization and also implant shape optimization. This study was designed to optimize artificial hip joint position (placement) to decrease maximal von mi sees stress. First, a model of femur and implant were made and then a computer program was written with the ability to change the position of implant through an acceptable range in the femur. In each of these positions, the program simulated femur and implant according to finite element method and made, applied forces were weight and muscle traction. Our findings show that a small deviation of the implant from femur bone center causes a considerable decrease in von mi sees stress that consequently results in longer maintenance of the implant

Hip Fracture

Science.gov (United States)

... hip fractures in people of all ages. In older adults, a hip fracture is most often a result of a fall from a standing height. In people with very weak bones, a hip fracture can occur simply by standing on the leg and twisting. Risk factors The rate of hip fractures increases substantially with ...

Radioactive waste cementation

International Nuclear Information System (INIS)

Soriano B, A.

1996-01-01

This research was carried out to develop the most adequate technique to immobilize low and medium-activity radioactive waste. different brands of national cement were used, portland and pozzolanic cement. Prismatic and cylindrical test tubes were prepared with different water/cement (W/C) relationship. Additives such a as clay and bentonite were added in some other cases. Later, the properties of these test tubes were evaluated. Properties such as: mechanical resistance, immersion resistance, lixiviation and porosity resistance. Cement with the highest mechanical resistance values, 62,29 MPa was pozzolanic cement for a W/C relationship of 0,35. It must be mentioned that the other types of cements reached a mechanical resistance over 10 MPa, a value indicated by the international standards for transportation and storage of low and medium-activity radioactive waste at a superficial level. However, in the case of immersion resistance, Sol cement (portland type I) with a W/C relationship of 0,35 reached a compression resistance over 61,92 MPa; as in the previous cases, the other cements reached a mechanical resistance > 10 MPa. Regarding porosity, working with W/C relationships = 0,35 0,40 and 0,45, without additives and with additives, the percentage of porosity found for all cements is lower than 40% percentage indicated by international standards. With regard to the lixiviation test, pozzolanic cement best retained Cesium-137 and Cobalt-60, and increased its advantages when bentonite was added, obtaining a lixiviation rate of 2,02 x E-6 cm/day. Sol cement also improved its properties when bentonite was added and obtained a lixiviation rate of 2,84 x E-6 cm/day for Cesium-137. However, Cobalt-60 is almost completely retained with the 3 types of cement with or without additives, reaching the limits indicated by the international standards for the lixiviation rate of beta-gamma emitter < 5,00E-4 cm/day. Characterizing the final product involves the knowledge of its

Matched cohort study of topical tranexamic acid in cementless primary total hip replacement.

Science.gov (United States)

Sanz-Reig, Javier; Mas Martinez, Jesus; Verdu Román, Carmen; Morales Santias, Manuel; Martínez Gimenez, Enrique; Bustamante Suarez de Puga, David

2018-03-29

Tranexamic acid has been shown to be effective in reducing blood loss after total hip replacement. The purpose of this study was to prospectively assess the effectiveness of topical TXA use to reduce blood loss after primary total hip replacement and to compare these outcomes with those of a matched control group from a similar cohort that did not have received tranexamic acid. This is a prospective matched control study to assess the effect of a 2 g topical tranexamic acid in 50 mL physiological saline solution in total hip replacement. Primary outcomes were hemoglobin and hematocrit drop, and total blood loss. Secondary outcomes were transfusion rates, length of hospital stay, deep vein thrombosis, and pulmonary embolism events. We could match 100 patients to a control group. There were no statistical significantly differences between the two groups. The hemoglobin and hematocrit postoperative values were significantly higher in topical tranexamic acid group than in control group (P tranexamic acid group and 1163 in control group with significant differences (P = 0.001), which meant 34% reduction in total blood loss. Length of stay was lower in topical tranexamic acid group. The risk of deep vein thrombosis and pulmonary events did not increase. A single dose of 2 g tranexamic acid in 50 mL physiological saline solution topical administration was effective and safe in reducing bleeding in patients undergoing unilateral primary non-cemented total hip replacement compared to a matched control group.

Parameters of Alumina Cement and Portland Cement with Addition of Chalcedonite Meal

Science.gov (United States)

Kotwa, Anna

2017-10-01

Aluminous cement is a quick binder with special properties. It is used primarily to make non-standard monolithic components exposed to high temperatures, + 1300°C. It is also a component of adhesives and mortars. It has a very short setting time. It is characterized by rapid increase in mechanical strength and resistance to aggressive sulphates. It can be used in reinforced concrete structures. Laying of concrete, construction mortar made of alumina cement can be carried out even at temperatures of -10°C. This article discusses a comparison of the parameters of hardened mortar made of alumina cement GÓRKAL 40 and Portland cement CEM I 42.5R. The mortars contain an addition of chalcedonite meal with pozzolanic properties, with particle size of less than 0.063μm. The meal was added in amounts of 5% and 20% of cement weight. Chalcedonite meal used in the laboratory research is waste material, resulting from chalcedonite aggregate mining. It has the same properties as the rock from which it originates. We have compared the parameters of hardened mortar i.e. compressive strength, water absorption and capillarity. The addition of 20% chalcedonite meal to mortars made from aluminous cement will decrease durability by 6.1% relative to aluminous cement mortar without addition of meal. Considering the results obtained during the absorbency tests, it can be stated that the addition of chalcedonite meal reduces weight gains in mortars made with cement CEM I 42.5 R and alumina cement. Use of alumina cement without addition of meal in mortars causes an increase of mass by 248% compared to Portland cement mortars without additions, in the absorption tests. The addition of chalcedonite meal did not cause increased weight gain in the capillary action tests. For the alumina cement mortars, a lesser weight gains of 24.7% was reported, compared to the Portland cement mortar after 28 days of maturing.

TOTAL HIP ARTHROPLASTY IN CHILDREN WHO HAVE UNDERGONE ARTHROPLASTY WITH DEMINERALIZED BONE-CARTILAGE ALLOCUPS

Directory of Open Access Journals (Sweden)

Vladimir E. Baskov

2017-03-01

hip replacement surgery. Conclusions. The main feature of the implementation of total hip replacement, following a previous intervention involving arthroplasty with DBCA, was a pronounced deficit of the pelvic bone in the joint component. This significantly complicated the subsequent implantation of the acetabular prosthesis component, and in some cases required the use of a cemented acetabular component. Our experience suggests that patients under 11 years of age who show clinical and radiological signs of coxarthrosis can be treated with arthroplasty with DBCA in order to save the lost function of the hip joint and maintain the function of the periarticular muscles.

Total hip arthroplasty in children who have undergone arthroplasty with demineralized bone-cartilage allocups

Directory of Open Access Journals (Sweden)

Vladimir E. Baskov

2017-03-01

hip replacement surgery. Conclusions. The main feature of the implementation of total hip replacement, following a previous intervention involving arthroplasty with DBCA, was a pronounced deficit of the pelvic bone in the joint component. This significantly complicated the subsequent implantation of the acetabular prosthesis component, and in some cases required the use of a cemented acetabular component. Our experience suggests that patients under 11 years of age who show clinical and radiological signs of coxarthrosis can be treated with arthroplasty with DBCA in order to save the lost function of the hip joint and maintain the function of the periarticular muscles.

Spine–hip relations in patients with hip osteoarthritis

Science.gov (United States)

Rivière, Charles; Lazic, Stefan; Dagneaux, Louis; Van Der Straeten, Catherine; Cobb, Justin; Muirhead-Allwood, Sarah

2018-01-01

Patients with hip osteoarthritis often have an abnormal spine-hip relation (SHR), meaning the presence of a clinically deleterious spine-hip and/or hip-spine syndrome. Definition of the individual SHR is ideally done using the EOS® imaging system or, if not available, with conventional lumbopelvic lateral radiographs. By pre-operatively screening patients with abnormal SHR, it is possible to refine total hip replacement (THR) surgical planning, which may improve outcomes. An important component of the concept of kinematically aligned total hip arthroplasty (KA THA) consists of defining the optimal acetabular cup design and orientation based on the assessment of an individual’s SHR, and use of the transverse acetabular ligament to adjust the cup positioning. The Bordeaux classification might advance the understanding of SHR and hopefully help improve THR outcomes. Cite this article: EFORT Open Rev 2018;3:39-44. DOI: 10.1302/2058-5241.3.170020 PMID:29657844

Use of Incineration Solid Waste Bottom Ash as Cement Mixture in Cement Production

Science.gov (United States)

Jun, N. H.; Abdullah, M. M. A. B.; Jin, T. S.; Kadir, A. A.; Tugui, C. A.; Sandu, A. V.

2017-06-01

Incineration solid waste bottom ash was use to examine the suitability as a substitution in cement production. This study enveloped an innovative technology option for designing new equivalent cement that contains incineration solid waste bottom ash. The compressive strength of the samples was determined at 7, 14, 28 and 90 days. The result was compared to control cement with cement mixture containing incineration waste bottom ash where the result proved that bottom ash cement mixture able achieve its equivalent performance compared to control cement which meeting the requirement of the standards according to EN 196-1. The pozzolanic activity index of bottom ash cement mixture reached 0.92 at 28 days and 0.95 at 90 and this values can be concluded as a pozzolanic material with positive pozzolanic activity. Calcium hydroxide in Portland cement decreasing with the increasing replacement of bottom ash where the reaction occur between Ca(OH)2 and active SiO2.

Detecting Poor Cement Bonding and Zonal Isolation Problems Using Magnetic Cement Slurries

KAUST Repository

Nair, Sriramya D.; Patzek, Tadeusz; van Oort, Eric

2017-01-01

There has been growing interest in the use of magnetorheological fluids to improve displacement efficiency of fluids (drilling fluids, spacer fluids, cement slurries) in the eccentric casing annuli. When magnetic particles are mixed with the cement slurry for improved displacement, they provide an excellent opportunity for sensing the presence and quality of cement in the annulus. This work focuses on using sophisticated 3D computational electromagnetics to simulate the use of a magnetic cement slurry for well cement monitoring. The main goal is to develop a new tool, which is capable of locating magnetic cement slurry that is placed behind a stainless steel casing. An electromagnetic coil was used to generate a magnetic field inside the borehole. It was found that when a current was passed through the electric coils, magnetic field lines passed through the stainless steel casing, the cement annulus and the rock formation. Three sensors were placed inside the cased borehole and the magnetic field strength variations were observed at these locations. Various factors that have a significant influence on zonal isolation were considered. These include, effect of debonding between casing and cement annulus, effect of changing annuli thickness, influence of a fracture in the rock formation, effect of changing magnetic permeability of cement and finally influence of annuli eccentricity. Based on the results shown in the paper along with the next generation of supersensitive magnetic sensors that are being developed, the magnetic approach appears to be a viable alternative for evaluating the quality of the cement annulus to ensure good zonal isolation.

Detecting Poor Cement Bonding and Zonal Isolation Problems Using Magnetic Cement Slurries

KAUST Repository

Nair, Sriramya D.

2017-10-02

There has been growing interest in the use of magnetorheological fluids to improve displacement efficiency of fluids (drilling fluids, spacer fluids, cement slurries) in the eccentric casing annuli. When magnetic particles are mixed with the cement slurry for improved displacement, they provide an excellent opportunity for sensing the presence and quality of cement in the annulus. This work focuses on using sophisticated 3D computational electromagnetics to simulate the use of a magnetic cement slurry for well cement monitoring. The main goal is to develop a new tool, which is capable of locating magnetic cement slurry that is placed behind a stainless steel casing. An electromagnetic coil was used to generate a magnetic field inside the borehole. It was found that when a current was passed through the electric coils, magnetic field lines passed through the stainless steel casing, the cement annulus and the rock formation. Three sensors were placed inside the cased borehole and the magnetic field strength variations were observed at these locations. Various factors that have a significant influence on zonal isolation were considered. These include, effect of debonding between casing and cement annulus, effect of changing annuli thickness, influence of a fracture in the rock formation, effect of changing magnetic permeability of cement and finally influence of annuli eccentricity. Based on the results shown in the paper along with the next generation of supersensitive magnetic sensors that are being developed, the magnetic approach appears to be a viable alternative for evaluating the quality of the cement annulus to ensure good zonal isolation.

21 CFR 888.3400 - Hip joint femoral (hemi-hip) metallic resurfacing prosthesis.

Science.gov (United States)

2010-04-01

... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Hip joint femoral (hemi-hip) metallic resurfacing... HUMAN SERVICES (CONTINUED) MEDICAL DEVICES ORTHOPEDIC DEVICES Prosthetic Devices § 888.3400 Hip joint femoral (hemi-hip) metallic resurfacing prosthesis. (a) Identification. A hip joint femoral (hemi-hip...

The cement recycling of the earthquake disaster debris by Hachinohe Cement Co., Ltd

International Nuclear Information System (INIS)

Kataoka, Masayuki

2015-01-01

A tremendous quantity of earthquake disaster debris and tsunami sediment was resulted by the Great East Japan Earthquake on March 11, 2011. Hachinohe Cement Co., Ltd., a Sumitomo Osaka Cement subsidiary, was the first cement industry company to receive and process such waste materials outside of their usual prefecture area, while the company is performing their treatment and recycling services locally in Hachinohe City and Aomori Prefecture. This report provides an explanation about the recycling mechanism of waste materials and by-products in cement manufacturing process, and introduces an example of actual achievements for the disaster debris treatment by utilizing the cement recycling technologies at the Hachinohe Cement Plant. (author)

Effect of Cement Type on Autogenous Deformation of Cement-Based Materials

DEFF Research Database (Denmark)

Pietro, Lura; Ye, Guang; van Breugel, Klaas

2004-01-01

In this paper, measurements of non-evaporable water content, chemical shrinkage, autogenous deformation, internal relative humidity (RH), pore solution composition, and early-age elastic modulus are presented and discussed. All experiments were performed on Portland cement and blast-furnace slag...... (BFS) cement pastes. Self-desiccation shrinkage of the BFS cement paste was modeled based on the RH measurements, following the capillary-tension approach. The main findings of this study are: 1) self-desiccation shrinkage can be related to self-desiccation both for Portland and for BFS cement pastes......, taking into account the influence of the dissolved salts in the pore solution, 2) the BFS cement paste studied shows pronounced self-desiccation and self-desiccation shrinkage, mainly caused by its very fine pore structure....

Foamed cement for squeeze cementing low-pressure, highly permeable reservoirs

International Nuclear Information System (INIS)

Chmllowski, W.; Kondratoff, L.B.

1992-01-01

Four different cement squeezing techniques have been used on wells producing from the Keg River formation in the Rainbow Lake area of Alberta, Canada. This paper evaluates 151 cement squeeze treatments performed at 96 wellsites and compares the use of foam cement vs. conventional squeeze treatments and techniques. Discussion includes key aspects, such as candidate selection, slurry design, treatment design, economic evaluation, and operational considerations

Trans trochanteric approach with coronal osteotomy of the great trochanter: A new technique for extra-capsular trochanteric fracture patients treated by total hip arthroplasty (THA) in elderly.

Science.gov (United States)

Steffann, Francois; Prudhon, Jean-Louis; Puch, Jean-Marc; Ferreira, André; Descamps, Loys; Verdier, Régis; Caton, Jacques

2015-06-05

Several surgical approaches could be used in hip arthroplasty or trauma surgery: anterior, anterolateral, lateral, posterior (with or without trochanterotomy), using or not an orthopedic reduction table. Subtrochanteric and extra-capsular trochanteric fractures (ECTF) are usually treated by internal fixation with mandatory restrictions on weight bearing. Specific complications have been widely described. Mechanical failures are particularly high in unstable fractures. Hip fractures are a major public health issue with a mortality rate of 12%-23% at 1 year. An alternative option is to treat ECTF by total hip arthroplasty (THA) to prevent decubitus complications, to help rapid recovery, and to permit immediate weight bearing as well as quick rehabilitation. However, specific risks of THA have to be considered such as dislocation or cardiovascular failure. The classical approach (anterior or posterior) requires the opening of the joint and capsule, weakening hip stability and the repair of the great trochanter is sometimes hazardous. For 15 years, we have been treating unstable ECTF by THA with cementless stem, dual mobility cup (DMC), greater trochanter (GT) reattachment, and a new surgical approach preserving capsule, going through the fracture and avoiding joint dislocation. Bombaci first described a similar approach in 2008; our trans fractural digastric approach (medial gluteus and lateral vastus) is different. A coronal GT osteotomy is performed when there is no coronal fracture line. It allows easy access to the femoral neck and acetabulum. The THA is implanted without femoral internal rotation to avoid extra bone fragment displacement. With pre-operative planning, cup implantation is easy and stem positioning is adjusted referring to the top of the GT after trial reduction and preoperative planning. The longitudinal osteotomy and trochanteric fracture are repaired with wires and the digastric incision is closed. This variant of Bombaci approach could be use

Revision hip preservation surgery with hip arthroscopy: clinical outcomes.

Science.gov (United States)

Domb, Benjamin G; Stake, Christine E; Lindner, Dror; El-Bitar, Youseff; Jackson, Timothy J

2014-05-01

To analyze and report the clinical outcomes of a cohort of patients who underwent revision hip preservation with arthroscopy and determine predictors of positive and negative outcomes. During the study period from April 2008 to December 2010, all patients who underwent revision hip preservation with arthroscopy were included. This included patients who had previous open surgery and underwent revision with arthroscopy. Patient-reported outcome (PRO) scores were obtained preoperatively and at 3-month, 1-year, 2-year, and 3-year follow-up time points. Any revision surgeries and conversions to total hip arthroplasty were noted. A multiple regression analysis was performed to look for positive and negative predictive factors for improvement in PROs after revision hip arthroscopy. Forty-seven hips in 43 patients had completed 2 years' follow-up or needed total hip arthroplasty. The mean length of follow-up was 29 months (range, 24 to 47 months). Of the hips, 31 (66%) had either unaddressed or incompletely treated femoroacetabular impingement. There was a significant improvement in all PRO scores at a mean of 29 months after revision (P arthroscopy can achieve moderately successful outcomes and remains a viable treatment strategy after failed primary hip preservation surgery. Preoperative predictors of success after revision hip arthroscopy include segmental labral defects, unaddressed or incompletely addressed femoroacetabular impingement, heterotopic ossification, and previous open surgery. Level IV, therapeutic case series. Copyright © 2014 Arthroscopy Association of North America. Published by Elsevier Inc. All rights reserved.

The influence of cement type and temperature on chloride binding in cement paste

DEFF Research Database (Denmark)

Jensen, Ole Mejlhede; Korzen, Migge Sofie Hoffmann; Skibsted, Jørgen

1998-01-01

This paper describes effects of cement type and temperature on chloride binding in cement paste, which is an important subject in relation to life-time modelling of reinforced concrete structures. The influence of cement type on chloride binding is investigated by substituting cement with pure...... cement clinker. Both theoretical considerations and experimental data for chloride binding in cement pastes are presented. A physico-chemically based model to describe the influence of temperature on physical binding of chloride is presented. Solid-state 27Al and 29Si magic-angle spinning (MAS) nuclear...... magnetic resonance (NMR) spectroscopy has been used for quantification of the anhydrous and hydrated aluminate and silicate phases in the chloride exposed cement pastes. The 27Al isotropic chemical shift and nuclear quadrupole coupling is reported for a synthetic sample of Friedel's salt, Ca2Al(OH)6Cl×2H2O....

Characterization and chemical activity of Portland cement and two experimental cements with potential for use in dentistry.

Science.gov (United States)

Camilleri, J

2008-09-01

To evaluate the chemical activity of Portland cement and two other cement types with similar chemical composition to mineral trioxide aggregate with the aim of developing these cements for further applications in dentistry. The chemical composition of the three cement types namely Portland cement, calcium sulpho-aluminate cement and calcium fluoro-aluminate cement was evaluated by elemental analysis using energy dispersive analysis with X-ray under the scanning electron microscope and by X-ray diffraction analysis (XRD) to determine the phases. The constituents of the hydration reaction by-products were evaluated by XRD analysis of the set cements at 1, 7, 28 and 56 days and by analysis of the leachate by ion chromatography. The pH of both cements and leachate was determined at different time intervals. Cements admixed with micro-silica were also tested to determine the effect of micro-silica on the reaction by-products. All three cement types were composed of tricalcium silicate as the main constituent phase. The hydration reaction of Portland cement produced calcium hydroxide. However, this was not present in the other cements tested at all ages. Admixed micro-silica had little or no effect on the cements with regard to reaction by-products. The pH of all cements tested was alkaline. Both the experimental calcium sulpho-aluminate cement and calcium fluoro-aluminate cement had different hydration reactions to that of Portland cement even though calcium silicate was the major constituent element of both cement types. No calcium hydroxide was produced as a by-product to cement hydration. Micro-silica addition to the cement had no effect on the hydration reaction.

Design of Fit-for-Purpose Cement to Restore Cement-Caprock Seal Integrity

Science.gov (United States)

Provost, R.

2015-12-01

This project aims to study critical research needs in the area of rock-cement interfaces, with a special focus on crosscutting applications in the Wellbore Integrity Pillar of the SubTER initiative. This study will focus on design and test fit-for-purpose cement formulations. The goals of this project are as follows: 1) perform preliminary study of dispersing nanomaterial admixtures in Ordinary Portland Cement (OPC) mixes, 2) characterize the cement-rock interface, and 3) identify potential high-performance cement additives that can improve sorption behavior, chemical durability, bond strength, and interfacial fracture toughness, as appropriate to specific subsurface operational needs. The work presented here focuses on a study of cement-shale interfaces to better understand failure mechanisms, with particular attention to measuring bond strength at the cement-shale interface. Both experimental testing and computational modeling were conducted to determine the mechanical behavior at the interface representing the interaction of cement and shale of a typical wellbore environment. Cohesive zone elements are used in the finite element method to computationally simulate the interface of the cement and rock materials with varying properties. Understanding the bond strength and mechanical performance of the cement-formation interface is critical to wellbore applications such as sequestration, oil and gas production and exploration and nuclear waste disposal. Improved shear bond strength is an indication of the capability of the interface to ensure zonal isolation and prevent zonal communication, two crucial goals in preserving wellbore integrity. Understanding shear bond strength development and interface mechanics will provide an idea as to how the cement-formation interface can be altered under environmental changes (temperature, pressure, chemical degradation, etc.) so that the previously described objectives can be achieved. Sandia National Laboratories is a multi

Total Hip Arthroplasty Loosening Due to Mycobacterium Tuberculosis: A Case Report and Review of the Literature

Directory of Open Access Journals (Sweden)

Anis Tebourbi

2017-04-01

Full Text Available Context: Prosthetic joint infection due to Mycobacterium tuberculosis with no previous history of pulmonary or extra pulmonary tuberculosis is an extremely rare complication. Aims To report the case of a patient with tuberculous mycobacterial prosthetic hip infection, 14 years after surgery for post traumatic osteoarthritis, with no previous history of tuberculosis. Methods A 46-year-old male presented an acetabular loosening of a cemented total hip arthroplasty with subnormal biologic parameters. A one stage revision surgery was planned. Intraoperative findings suggested mycobacterial tuberculous infection with presence of periacetabular yellowish rice-shaped granules. Results A one-stage prosthesis exchange was performed; Culture on Löwenstein-Jensen medium grew MTB days after inoculation and histological examination confirmed tuberculous infection. Patient was treated by antituberculous agents for 12 months with optimal clinical and biological response and no prosthetic loosening signs at eighteen months follow up. Conclusions Total hip arthroplasty loosening due to mycobacterium tuberculosis is a rare entity, which should be evoked even when no inflammatory signs are shown. Discovery of yellowish rice-shaped granules is an indicator to investigate for tuberculosis. Management of prosthetic joint infection due to M.tuberculosis must involve both medical and surgical approach.

Hip instability: a review of hip dysplasia and other contributing factors

Science.gov (United States)

Kraeutler, Matthew J.; Garabekyan, Tigran; Pascual-Garrido, Cecilia; Mei-Dan, Omer

2016-01-01

Summary Background Hip instability has classically been associated with developmental dysplasia of the hip (DDH) in newborns and children. However, numerous factors may contribute to hip instability in children, adolescents, and adults. Purpose This review aims to concisely present the literature on hip instability in patients of all ages in order to guide health care professionals in the appropriate diagnosis and treatment of the various disorders which may contribute to an unstable hip. Methods We reviewed the literature on the diagnosis and surgical management of hip dysplasia and other causes of hip instability. Conclusions Multiple intra- and extra-articular variables may contribute to hip instability, including acetabular bony coverage, femoral torsion, femoroacetabular impingement, and soft tissue laxity. Physical examination and advanced imaging studies are essential to accurately diagnose the pathology contributing to a patient’s unstable hip. Conservative management, including activity modification and physical therapy, may be used as a first-line treatment in patients with intra-articular hip pathology. Patients who continue to experience symptoms of pain or instability should proceed with arthroscopic or open surgical treatment aimed at correcting the underlying pathology. Level of evidence V. PMID:28066739

Effects of cement particle size distribution on performance properties of Portland cement-based materials

Energy Technology Data Exchange (ETDEWEB)

Bentz, D.P.; Garboczi, E.J.; Haecker, C.J.; Jensen, O.M.

1999-10-01

The original size, spatial distribution, and composition of Portland cement particles have a large influence on hydration kinetics, microstructure development, and ultimate properties of cement-based materials. In this paper, the effects of cement particle size distribution on a variety of performance properties are explored via computer simulation and a few experimental studies. Properties examined include setting time, heat release, capillary porosity percolation, diffusivity, chemical shrinkage, autogenous shrinkage, internal relative humidity evolution, and interfacial transition zone microstructure. The effects of flocculation and dispersion of the cement particles in the starting microstructures on resultant properties are also briefly evaluated. The computer simulations are conducted using two cement particle size distributions that bound those commonly in use today and three different water-to-cement ratios: 0.5, 0.3, and 0.246. For lower water-to-cement ratio systems, the use of coarser cements may offer equivalent or superior performance, as well as reducing production costs for the manufacturer.

Low pH Cements

International Nuclear Information System (INIS)

Savage, David; Benbow, Steven

2007-05-01

The development of low-pH cements for use in geological repositories for radioactive waste stems from concerns over the potential for deleterious effects upon the host rock and other EBS materials (notably bentonite) under the hyperalkaline conditions (pH > 12) of cement pore fluids. Low pH cement (also known as low heat cement) was developed by the cement industry for use where large masses of cement (e.g. dams) could cause problems regarding heat generated during curing. In low pH cements, the amount of cement is reduced by substitution of materials such as fly ash, blast furnace slag, silica fume, and/or non-pozzolanic silica flour. SKB and Posiva have ruled out the use of blast furnace slag and fly-ash and are focusing on silica fume as a blending agent. Currently, no preferred composition has been identified by these agencies. SKB and Posiva have defined a pH limit ≤ 11 for cement grout leachates. To attain this pH, blending agents must comprise at least 50 wt % of dry materials. Because low pH cement has little, or no free portlandite, the cement consists predominantly of calcium silicate hydrate (CSH) gel with a Ca/Si ratio ≤ 0.8. Although there are potential implications for the performance of the spent fuel and cladding due to the presence of hyperalkaline fluids from cement, the principal focus for safety assessment lies with the behaviour of bentonite. There are a number of potential constraints on the interaction of hyperalkaline cement pore fluids with bentonite, including mass balance, thermodynamic issues, mass transport, and kinetics, but none of these is likely to be limiting if conventional OPC cements are employed in repository construction. Nevertheless: Low-pH cements may supply approximately 50 % less hydroxyl ions than conventional OPC for a given volume of cement, but mass balance constraints are complicated by the uncertainty concerning the type of secondary minerals produced during cement-bentonite interaction. The change of aqueous

Low pH Cements

Energy Technology Data Exchange (ETDEWEB)

Savage, David; Benbow, Steven [Quintessa Ltd., Henley-on-Thames (United Kingdom)

2007-05-15

The development of low-pH cements for use in geological repositories for radioactive waste stems from concerns over the potential for deleterious effects upon the host rock and other EBS materials (notably bentonite) under the hyperalkaline conditions (pH > 12) of cement pore fluids. Low pH cement (also known as low heat cement) was developed by the cement industry for use where large masses of cement (e.g. dams) could cause problems regarding heat generated during curing. In low pH cements, the amount of cement is reduced by substitution of materials such as fly ash, blast furnace slag, silica fume, and/or non-pozzolanic silica flour. SKB and Posiva have ruled out the use of blast furnace slag and fly-ash and are focusing on silica fume as a blending agent. Currently, no preferred composition has been identified by these agencies. SKB and Posiva have defined a pH limit {<=} 11 for cement grout leachates. To attain this pH, blending agents must comprise at least 50 wt % of dry materials. Because low pH cement has little, or no free portlandite, the cement consists predominantly of calcium silicate hydrate (CSH) gel with a Ca/Si ratio {<=} 0.8. Although there are potential implications for the performance of the spent fuel and cladding due to the presence of hyperalkaline fluids from cement, the principal focus for safety assessment lies with the behaviour of bentonite. There are a number of potential constraints on the interaction of hyperalkaline cement pore fluids with bentonite, including mass balance, thermodynamic issues, mass transport, and kinetics, but none of these is likely to be limiting if conventional OPC cements are employed in repository construction. Nevertheless: Low-pH cements may supply approximately 50 % less hydroxyl ions than conventional OPC for a given volume of cement, but mass balance constraints are complicated by the uncertainty concerning the type of secondary minerals produced during cement-bentonite interaction. The change of aqueous

Seating load parameters impact on dental ceramic reinforcement conferred by cementation with resin-cements.

LENUS (Irish Health Repository)

Addison, Owen

2010-09-01

Cementation of all-ceramic restorations with resin-cements has been demonstrated to reduce the incidence of fracture in service. The aim was to investigate the influence of loading force and loading duration applied during cementation on the reinforcement conferred by a resin-cement on a leucite reinforced glass-ceramic.

Longevity of metal-ceramic crowns cemented with self-adhesive resin cement: a prospective clinical study

Science.gov (United States)

Brondani, Lucas Pradebon; Pereira-Cenci, Tatiana; Wandsher, Vinicius Felipe; Pereira, Gabriel Kalil; Valandro, Luis Felipe; Bergoli, César Dalmolin

2017-04-10

Resin cements are often used for single crown cementation due to their physical properties. Self-adhesive resin cements gained widespread due to their simplified technique compared to regular resin cement. However, there is lacking clinical evidence about the long-term behavior of this material. The aim of this prospective clinical trial was to assess the survival rates of metal-ceramic crowns cemented with self-adhesive resin cement up to six years. One hundred and twenty-nine subjects received 152 metal-ceramic crowns. The cementation procedures were standardized and performed by previously trained operators. The crowns were assessed as to primary outcome (debonding) and FDI criteria. Statistical analysis was performed using Kaplan-Meier statistics and descriptive analysis. Three failures occurred (debonding), resulting in a 97.6% survival rate. FDI criteria assessment resulted in scores 1 and 2 (acceptable clinical evaluation) for all surviving crowns. The use of self-adhesive resin cement is a feasible alternative for metal-ceramic crowns cementation, achieving high and adequate survival rates.

Hip Hemiarthroplasty for Femoral Neck Fractures Using the Modified ...

African Journals Online (AJOL)

Journal of Surgical Technique and Case Report | Jan-Jun 2010 | Vol-2 | Issue-1. 8 ... anteriorly and posteriorly, to expose the gluteus minimus.[5]. The extent of exposure ... infection in our setting, where impervious and adhesive sterile drapes ...

Development of a 3-D x-ray micro-tomography system and its application to trabecular bone/cement interface

International Nuclear Information System (INIS)

Chi, Yong Ki; Cho, Gyuseong

2004-01-01

In recent years, the interface analysis of micro-structure based objects is an important research in osteoporosis, vascular imaging since a 3-D X-ray micro-tomography system was developed. However, the micro-tomographic image shows the white-out appearance in case of imaging of similar density objects with low energy X-ray. Therefore these images must be analyzed about the interface between microstructure based objects for its application to biomechanical study. Many published studies suggested approximately assumed model of interface and predicted mechanical failure by means of Finite Element Method (FEM) but these FEM analysis has not used for modeling the real structure and interface between objects such as roughness, voids and pores of objects. We developed micro-tomography system and suggest the application of micro-tomographic image for predicting mechanical failure at the interface. The micro-tomography system consists of a 5 μm micro-focus X-ray tube, a CMOS-based image sensor and a rotating sample holder controlled by a precision motor. CMOS image sensor has 62x62 mm 2 sensing area and uses optical lenses system for increasing resolution. The sample which was manufactured by implanting cement in a pig hip bone was used and its fracture is considered to be an important cause of loosening of hip joint replacement in orthopedic implants. A Feldkamp's cone-beam reconstruction algorithm on the equispatial detector case was used for bone/cement 3D volume data and the analysis of a trabecular bone/cement interface containing white-out appearance was performed by using multiple criterion segmentation of region and volume. Finally, the segmented data can be used for fracture prediction of FEM by determining node of hexahedron meshing. In this paper, we present development of a 3-D cone beam micro-tomographic system with CMOS image sensor and its application to a complex structure of a trabecular bone and implanted cement for predicting the failure mechanism of

Determining the water-cement ratio, cement content, water content and degree of hydration of hardened cement paste: Method development and validation on paste samples

International Nuclear Information System (INIS)

Wong, H.S.; Buenfeld, N.R.

2009-01-01

We propose a new method to estimate the initial cement content, water content and free water/cement ratio (w/c) of hardened cement-based materials made with Portland cements that have unknown mixture proportions and degree of hydration. This method first quantifies the composition of the hardened cement paste, i.e. the volumetric fractions of capillary pores, hydration products and unreacted cement, using high-resolution field emission scanning electron microscopy (FE-SEM) in the backscattered electron (BSE) mode and image analysis. From the obtained data and the volumetric increase of solids during cement hydration, we compute the initial free water content and cement content, hence the free w/c ratio. The same method can also be used to calculate the degree of hydration. The proposed method has the advantage that it is quantitative and does not require comparison with calibration graphs or reference samples made with the same materials and cured to the same degree of hydration as the tested sample. This paper reports the development, assumptions and limitations of the proposed method, and preliminary results from Portland cement pastes with a range of w/c ratios (0.25-0.50) and curing ages (3-90 days). We also discuss the extension of the technique to mortars and concretes, and samples made with blended cements.

The Utility of Digital Linear Tomosynthesis Imaging of Total Hip Joint Arthroplasty with Suspicion of Loosening: A Prospective Study in 40 Patients

Science.gov (United States)

Göthlin, Jan H.

2013-01-01

Aim. The clinical utility of digital linear tomosynthesis in musculoskeletal applications has been validated in only a few reports. Technical performance and utility in hip prosthesis imaging have been discussed in technical reports, but no clinical evaluation has been reported. The purpose of the current study was to assess the added clinical utility of digital linear tomosynthesis compared to radiography in loosening of total hip joint arthroplasty. Materials and Methods. In a prospective study, radiography and digital tomosynthesis were performed in 40 consecutive patients with total hip arthroplasty referred for suspect prosthesis loosening. Tomosynthesis images were compared to anterior-posterior (AP) and cross-table lateral radiographs regarding demarcation and extent of demineralization and osteolysis. Further noted were skeletal fractures, cement fractures, fragmentation, and artifacts interfering with the diagnosis. Results. Tomosynthesis was superior to radiography with sharper delineation of demineralization and osteolysis in the AP projection. A limitation was the inability to generate lateral tomosynthesis images, with inferior assessment of the area anterior and posterior to the acetabular cup compared to cross-table radiographs. Artifacts interfering with diagnosis were found in one hip. Conclusion. Tomosynthesis improved evaluation of total hip arthroplasty in the AP projection but was limited by the lack of lateral projections. PMID:24078921

The Utility of Digital Linear Tomosynthesis Imaging of Total Hip Joint Arthroplasty with Suspicion of Loosening: A Prospective Study in 40 Patients

Directory of Open Access Journals (Sweden)

Jan H. Göthlin

2013-01-01

Full Text Available Aim. The clinical utility of digital linear tomosynthesis in musculoskeletal applications has been validated in only a few reports. Technical performance and utility in hip prosthesis imaging have been discussed in technical reports, but no clinical evaluation has been reported. The purpose of the current study was to assess the added clinical utility of digital linear tomosynthesis compared to radiography in loosening of total hip joint arthroplasty. Materials and Methods. In a prospective study, radiography and digital tomosynthesis were performed in 40 consecutive patients with total hip arthroplasty referred for suspect prosthesis loosening. Tomosynthesis images were compared to anterior-posterior (AP and cross-table lateral radiographs regarding demarcation and extent of demineralization and osteolysis. Further noted were skeletal fractures, cement fractures, fragmentation, and artifacts interfering with the diagnosis. Results. Tomosynthesis was superior to radiography with sharper delineation of demineralization and osteolysis in the AP projection. A limitation was the inability to generate lateral tomosynthesis images, with inferior assessment of the area anterior and posterior to the acetabular cup compared to cross-table radiographs. Artifacts interfering with diagnosis were found in one hip. Conclusion. Tomosynthesis improved evaluation of total hip arthroplasty in the AP projection but was limited by the lack of lateral projections.

Stability of reinforced cemented backfills

International Nuclear Information System (INIS)

Mitchell, R.J.; Stone, D.M.

1987-01-01

Mining with backfill has been the subject of several international meetings in recent years and a considerable research effort is being applied to improve both mining economics and ore recovery by using backfill for ground support. Classified mill tailings sands are the most commonly used backfill material but these fine sands must be stabilized before full ore pillar recovery can be achieved. Normal portland cement is generally used for stabilization but the high cost of cement prohibits high cement usage. This paper considers the use of reinforcements in cemented fill to reduce the cement usage. It is concluded that strong cemented layers at typical spacings of about 3 meters in a low cement content bulk fill can reinforce the fill and reduce the overall cement usage. Fibre reinforcements introduced into strong layers or into bulk fills are also known to be effective in reducing cement usage. Some development work is needed to produce the ideal type of anchored fibre in order to realize economic gains from fibre-reinforced fills

Microscale Investigation of Arsenic Distribution and Species in Cement Product from Cement Kiln Coprocessing Wastes

Directory of Open Access Journals (Sweden)

Yufei Yang

2013-01-01

Full Text Available To improve the understanding of the immobilization mechanism and the leaching risk of Arsenic (As in the cement product from coprocessing wastes using cement kiln, distribution and species of As in cement product were determined by microscale investigation methods, including electron probe microanalysis (EPMA and X-ray absorption spectroscopy. In this study, sodium arsenate crystals (Na3AsO412H2O were mixed with cement production raw materials and calcined to produce cement clinker. Then, clinker was mixed water to prepare cement paste. EPMA results showed that As was generally distributed throughout the cement paste. As content in calcium silicate hydrates gel (C-S-H was in low level, but higher than that in other cement mineral phases. This means that most of As is expected to form some compounds that disperse on the surfaces of cement mineral phases. Linear combination fitting (LCF of the X-ray absorption near edge structure spectra revealed that As in the cement paste was predominantly As(V and mainly existed as Mg3(AsO42, Ca3(AsO42, and Na2HAsO4.

Evaluation of cement thixotropy for the cement of oil wells in areas ...

African Journals Online (AJOL)

... economical for cementing job operations in wells with loss zones. The results also show that the effect of LHF is positive, since in addition to his contribution to long term performances, especially the durability of hardened concrete, it improves the thixotropy of cement made of plaster. Keywords: cementing; lost circulation; ...

Hip Hip Hurrah! Hip size inversely related to heart disease and total mortality

DEFF Research Database (Denmark)

Heitmann, B L; Lissner, L

2011-01-01

During the past decade a series of published reports have examined the value of studying the relation between hip circumferences and cardiovascular end points. Specifically, in a series of recent studies the independent effects of hip circumference have been studied after adjustment for general o...... for women than men, but is evident in both genders. In this 'viewpoint', we wish to draw attention to the emerging body of evidence and to encourage researchers to continue collecting measures of lower body size in their surveys....... obesity and/or waist circumference. These studies have been remarkable in terms of their consistency, and in the unexpected finding of an adverse effect of small hip size, after statistically correcting for differences in general and abdominal size. The hazard related to a small hip size may be stronger...

The differences between soil grouting with cement slurry and cement-water glass slurry

Science.gov (United States)

Zhu, Mingting; Sui, Haitong; Yang, Honglu

2018-01-01

Cement slurry and cement-water glass slurry are the most widely applied for soil grouting reinforcement project. The viscosity change of cement slurry is negligible during grouting period and presumed to be time-independent while the viscosity of cement-water glass slurry increases with time quickly and is presumed to be time-dependent. Due to the significantly rheology differences between them, the grouting quality and the increasing characteristics of grouting parameters may be different, such as grouting pressure, grouting surrounding rock pressure, i.e., the change of surrounding rock pressure deduced by grouting pressure. Those are main factors for grouting design. In this paper, a large-scale 3D grouting simulation device was developed to simulate the surrounding curtain grouting for a tunnel. Two series of surrounding curtain grouting experiments under different geo-stress of 100 kPa, 150 kPa and 200 kPa were performed. The overload test on tunnel was performed to evaluate grouting effect of all surrounding curtain grouting experiments. In the present results, before 240 seconds, the grouting pressure increases slowly for both slurries; after 240 seconds the increase rate of grouting pressure for cement-water glass slurry increases quickly while that for cement slurry remains roughly constant. The increasing trend of grouting pressure for cement-water glass is similar to its viscosity. The setting time of cement-water glass slurry obtained from laboratory test is less than that in practical grouting where grout slurry solidifies in soil. The grouting effect of cement-water glass slurry is better than that of cement slurry and the grouting quality decreases with initial pressure.

Unilateral hip osteoarthritis: can we predict the outcome of the other hip?

International Nuclear Information System (INIS)

Vossinakis, I.C.; Georgiades, G.; Hartofilakidis, G.; Kafidas, D.

2008-01-01

The objective of this study was to define, in unilateral hip osteoarthritis (OA), factors predicting the outcome of the other hip. We examined the anteroposterior radiographs of the pelvis of 95 white patients with unilateral idiopathic (56 patients) or secondary to congenital hip diseases (39 patients) OA. The other hip was free from symptoms (pain or limping) at the initial examination and without radiographic evidence of OA; it was what we call a ''normal'' hip. Two parameters were evaluated: (1) the type of osteoarthritis of the involved hip and (2) the range of four radiographic indices of the contralateral hip: the sourcil inclination (weight-bearing surface), the acetabular angle, the Wiberg's center-edge angle, and the neck-shaft angle. Follow-up radiographs for the hips that remained OA-free were available for 10 to 35 years and for those that developed OA, at the time of initial symptoms, range 2 to 31 years. Logistic regression analysis showed that the presence of idiopathic OA in one hip had a statistically significant effect on the development of OA on the other hip (p<0.001). Minor deviations of radiographic indices of the contralateral hip is not a predictive factor for its outcome. When the radiographic indices are examined together with the pathology of the involved hip, only WBS was shown to have a significant effect to the development of OA and its type (p < 0.001). The following conclusions can be drawn from this study: 1. Patient with idiopathic OA of one hip is at increased risk of developing OA in the other hip. 2. The outcome of the other hip cannot be predicted only on the basis of the evaluation of its radiographic indices. 3. Among the different indices, WBS seems to have a strong influence toward the development of OA. (orig.)

Heat of hydration measurements on cemented radioactive wastes. Part 1: cement-water pastes

International Nuclear Information System (INIS)

Lee, D.J.

1983-12-01

This report describes the hydration of cement pastes in terms of chemical and kinetic models. A calorimetric technique was used to measure the heat of hydration to develop these models. The effects of temperature, water/cement ratio and cement replacements, ground granulated blast furnace slag (BFS) and pulverised fuel ash (PFA) on the hydration of ordinary Portland cement (OPC) is reported. The incorporation of BFS or PFA has a marked effect on the hydration reaction. The effect of temperature is also important but changing the water/cement ratio has little effect. Results from cement pastes containing only water and cement yield total heats of reaction of 400, 200 and 100 kJ/kg for OPC, BFS and PFA respectively. Using the results from the models which have been developed, the effect of major salts present in radioactive waste streams can be assessed. Values of the total heat of reaction, the time to complete 50 percent reaction, and the energy of activation, can be compared for different waste systems. (U.K.)

An analysis of postoperative hemoglobin levels in patients with a fractured neck of femur.

Science.gov (United States)

Nagra, Navraj S; van Popta, Dmitri; Whiteside, Sigrid; Holt, Edward M

2016-10-01

The aim of this study was to analyze the changes in hemoglobin level and to determine a suitable timeline for post-operative hemoglobin monitoring in patients undergoing fixation of femoral neck fracture. Patients who underwent either dynamic hip screw (DHS) fixation (n = 74, mean age: 80 years) or hip hemiarthroplasty (n = 104, mean age: 84 years) for femoral neck fracture were included into the study. The hemoglobin level of the patients was monitored perioperatively. Analysis found a statistically and clinically significant mean drop in hemoglobin of 31.1 g/L over time from pre-operatively (D0) to day-5 post-operatively (p hemoglobin values over hemiarthroplasty patients (p = 0.046). The decrease in hemoglobin in the first 24-h post-operative period (D0 to day-1) is an underestimation of the ultimate lowest value in hemoglobin found at day-2. Relying on the day-1 hemoglobin could be detrimental to patient care. We propose a method of predicting patients likely to be transfused, and recommend a protocol for patients undergoing femoral neck fracture surgery to standardize postoperative hemoglobin monitoring. Level IV Prognostic study. Copyright © 2016 Turkish Association of Orthopaedics and Traumatology. Production and hosting by Elsevier B.V. All rights reserved.

Účinek rázové vlny na kostní cement a její potenciální využití v ortopedii

Czech Academy of Sciences Publication Activity Database

Zeman, J.; Hach, J.; Dibdiak, L.; Šunka, Pavel; Lukeš, Petr; Hoffer, Petr; Sedláček, R.; Kociová, K.; Beneš, J.

2012-01-01

Roč. 6, č. 3 (2012), s. 100-102 ISSN 1802-1727 R&D Projects: GA ČR GA202/09/1151 Institutional research plan: CEZ:AV0Z20430508 Keywords : focused shock waves * hip joint replacement * reoperation * bone cement Subject RIV: BL - Plasma and Gas Discharge Physics http://www.medvik.cz/kramerius/PShowPageDoc.do?id=131562&it=&picp=13059&idpi=372711

Sulfur polymer cement concrete

International Nuclear Information System (INIS)

Weber, H.H.; McBee, W.C.

1990-01-01

Sulfur-based composite materials formulated using sulfur polymer cement (SPC) and mineral aggregates are described and compared with conventional portland cement based materials. Materials characteristics presented include mechanical strength, chemical resistance, impact resistance, moisture permeation, and linear shrinkage during placement and curing. Examples of preparation and placement of sulfur polymer cement concrete (SC) are described using commercial scale equipment. SC applications presented are focused into hostile chemical environments where severe portland cement concrete (PCC) failure has occurred

Sustainable Development of the Cement Industry and Blended Cements to Meet Ecological Challenges

OpenAIRE

Sobolev, Konstantin

2003-01-01

The world production of cement has greatly increased in the past 10 years. This trend is the most significant factor affecting technological development and the updating of manufacturing facilities in the cement industry. Existing technology for the production of cement clinker is ecologically damaging; it consumes much energy and natural resources and also emits pollutants. A new approach to the production of blended or high-volume mineral additive (HVMA) cement helps to improve its ecologi...

Longevity of metal-ceramic crowns cemented with self-adhesive resin cement: a prospective clinical study

Directory of Open Access Journals (Sweden)

Lucas Pradebon BRONDANI

2017-04-01

Full Text Available Abstract Resin cements are often used for single crown cementation due to their physical properties. Self-adhesive resin cements gained widespread due to their simplified technique compared to regular resin cement. However, there is lacking clinical evidence about the long-term behavior of this material. The aim of this prospective clinical trial was to assess the survival rates of metal-ceramic crowns cemented with self-adhesive resin cement up to six years. One hundred and twenty-nine subjects received 152 metal-ceramic crowns. The cementation procedures were standardized and performed by previously trained operators. The crowns were assessed as to primary outcome (debonding and FDI criteria. Statistical analysis was performed using Kaplan-Meier statistics and descriptive analysis. Three failures occurred (debonding, resulting in a 97.6% survival rate. FDI criteria assessment resulted in scores 1 and 2 (acceptable clinical evaluation for all surviving crowns. The use of self-adhesive resin cement is a feasible alternative for metal-ceramic crowns cementation, achieving high and adequate survival rates.

Reliability and Validity of the Hip Stability Isometric Test (HipSIT): A New Method to Assess Hip Posterolateral Muscle Strength.

Science.gov (United States)

Almeida, Gabriel Peixoto Leão; das Neves Rodrigues, Helena Larissa; de Freitas, Bruno Wesley; de Paula Lima, Pedro Olavo

2017-12-01

Study Design Cross-sectional study. Background The Hip Stability Isometric Test (HipSIT) evaluates the strength of the hip posterolateral stabilizers in a position that favors greater activation of the gluteus maximus and gluteus medius and lower activation of the tensor fascia lata. Objectives To check the validity and reliability of the HipSIT and to evaluate the HipSIT in women with patellofemoral pain (PFP). Methods The HipSIT was evaluated with a handheld dynamometer. During testing, the participants were sidelying, with their legs positioned at 45° of hip flexion and 90° of knee flexion. Participants were instructed to raise the knee of the upper leg while keeping the upper and lower heels in contact. To establish reliability and validity, 49 women were tested with the HipSIT by 2 different evaluators on day 1, and then again 7 days later. The strength of the hip extensors, abductors, and external rotators was also evaluated. Twenty women with unilateral PFP were also evaluated. Results The HipSIT has excellent intrarater and interrater reliability. The standard error of measurement was 0.01 kgf/kg, and the minimal detectable change was 0.036 kgf/kg. The HipSIT showed good validity in isolated hip abduction, external rotation, and extension (Pstrength deficits in women with PFP. J Orthop Sports Phys Ther 2017;47(12):906-913. Epub 9 Oct 2017. doi:10.2519/jospt.2017.7274.

Experimental Study on Artificial Cemented Sand Prepared with Ordinary Portland Cement with Different Contents

Directory of Open Access Journals (Sweden)

Dongliang Li

2015-07-01

Full Text Available Artificial cemented sand test samples were prepared by using ordinary Portland cement (OPC as the cementing agent. Through uniaxial compression tests and consolidated drained triaxial compression tests, the stress-strain curves of the artificial cemented sand with different cementing agent contents (0.01, 0.03, 0.05 and 0.08 under various confining pressures (0.00 MPa, 0.25 MPa, 0.50 MPa and 1.00 MPa were obtained. Based on the test results, the effect of the cementing agent content (Cv on the physical and mechanical properties of the artificial cemented sand were analyzed and the Mohr-Coulomb strength theory was modified by using Cv. The research reveals that when Cv is high (e.g., Cv = 0.03, 0.05 or 0.08, the stress-strain curves of the samples indicate a strain softening behavior; under the same confining pressure, as Cv increases, both the peak strength and residual strength of the samples show a significant increase. When Cv is low (e.g., Cv = 0.01, the stress-strain curves of the samples indicate strain hardening behavior. From the test data, a function of Cv (the cementing agent content with c′ (the cohesion force of the sample and Δϕ′ (the increment of the angle of shearing resistance is obtained. Furthermore, through modification of the Mohr-Coulomb strength theory, the effect of cementing agent content on the strength of the cemented sand is demonstrated.

Experimental Study on Artificial Cemented Sand Prepared with Ordinary Portland Cement with Different Contents.

Science.gov (United States)

Li, Dongliang; Liu, Xinrong; Liu, Xianshan

2015-07-02

Artificial cemented sand test samples were prepared by using ordinary Portland cement (OPC) as the cementing agent. Through uniaxial compression tests and consolidated drained triaxial compression tests, the stress-strain curves of the artificial cemented sand with different cementing agent contents (0.01, 0.03, 0.05 and 0.08) under various confining pressures (0.00 MPa, 0.25 MPa, 0.50 MPa and 1.00 MPa) were obtained. Based on the test results, the effect of the cementing agent content ( C v ) on the physical and mechanical properties of the artificial cemented sand were analyzed and the Mohr-Coulomb strength theory was modified by using C v . The research reveals that when C v is high (e.g., C v = 0.03, 0.05 or 0.08), the stress-strain curves of the samples indicate a strain softening behavior; under the same confining pressure, as C v increases, both the peak strength and residual strength of the samples show a significant increase. When C v is low (e.g., C v = 0.01), the stress-strain curves of the samples indicate strain hardening behavior. From the test data, a function of C v (the cementing agent content) with c ' (the cohesion force of the sample) and Δϕ' (the increment of the angle of shearing resistance) is obtained. Furthermore, through modification of the Mohr-Coulomb strength theory, the effect of cementing agent content on the strength of the cemented sand is demonstrated.

Hip fractures. Epidemiology, risk factors, falls, energy absorption, hip protectors, and prevention

DEFF Research Database (Denmark)

Lauritzen, J B

1997-01-01

have a high risk of hip fracture (annual rate of 5-6%), and the incidence of falls is about 1,500 falls/1,000 persons/year. Most hip fractures are a result of a direct trauma against the hip. The incidence of falls on the hip among nursing home residents is about 290 falls/1,000 persons/year and about......%, corresponding to 9 out of 247 residents saved from sustaining a hip fracture. The review points to the essentials of the development of hip fracture, which constitutes; risk of fall, type of fall, type of impact, energy absorption, and lastly bone strength, which is the ultimate and last permissive factor......The present review summarizes the pathogenic mechanisms leading to hip fracture based on epidemiological, experimental, and controlled studies. The estimated lifetime risk of hip fracture is about 14% in postmenopausal women and 6% in men. The incidence of hip fractures increases exponentially...

Influence of Cements Containing Calcareous Fly Ash as a Main Component Properties of Fresh Cement Mixtures

Science.gov (United States)

Gołaszewski, Jacek; Kostrzanowska-Siedlarz, Aleksandra; Ponikiewski, Tomasz; Miera, Patrycja

2017-10-01

The main goal of presented research was to examine usability of cements containing calcareous fly ash (W) from technological point of view. In the paper the results of tests concerning the influence of CEM II and CEM IV cements containing fly ash (W) on rheological properties, air content, setting times and plastic shrinkage of mortars are presented and discussed. Moreover, compatibility of plasticizers with cements containing fly ash (W) was also studied. Additionally, setting time and hydration heat of cements containing calcareous fly ash (W) were determined. In a broader aspect, the research contributes to promulgation of the possibility of using calcareous fly ash (W) in cement and concrete technology, what greatly benefits the environment protection (utilization of waste fly ash). Calcareous fly ash can be used successfully as the main component of cement. Cements produced by blending with processed fly ash or cements produced by interginding are characterized by acceptable technological properties. In respect to CEM I cements, cements containing calcareous fly ash worsen workability, decrease air content, delay setting time of mixtures. Cements with calcareous fly ash show good compatibility with plasticizers.

Theoretical prediction and experimental determination of the effect of mold characteristics on temperature and monomer conversion fraction profiles during polymerization of a PMMA-based bone cement.

Science.gov (United States)

Vallo, Claudia I

2002-01-01

The present work is concerned with applications of a kinetic model for free-radical polymerization of a polymethylmethacrylate-based bone cement. Autocatalytic behavior at the first part of the reaction as well as a diffusion control phenomenon near vitrification are described by the model. Comparison of theoretical computations with experimental measurements for the temperature evolution during batch casting demonstrated the capacity of the proposed model to represent the kinetic behavior of the polymerization reaction. Temperature evolution and monomer conversion were simulated for the cure of the cement in molds made of different materials. The maximum monomer conversion fraction was markedly influenced by the physical properties of the mold material. The unreacted monomer acts as a plasticizer that influences the mechanical behavior of the cement. Hence, the same cement formulation cured in molds of different materials may result in different mechanical response because of the differences in the amounts of residual monomer. Standardization of the mold type to prepare specimens for the mechanical characterization of bone cements is recommended. Theoretical prediction of temperature evolution during hip replacement indicated that for cement thickness lower than 6 mm the peak temperature at the bone-cement interface was below the limit stated for thermal injury (50 degrees C for more than 1 min). The use of thin cement layers is recommended to diminish the risk of thermal injury; however, it is accompanied by an increase in the amount of unreacted monomer present in the cured material. Copyright 2002 Wiley Periodicals, Inc. J Biomed Mater Res (Appl Biomater) 63: 627-642, 2002

Development of high-performance blended cements

Science.gov (United States)

Wu, Zichao

2000-10-01

This thesis presents the development of high-performance blended cements from industrial by-products. To overcome the low-early strength of blended cements, several chemicals were studied as the activators for cement hydration. Sodium sulfate was discovered as the best activator. The blending proportions were optimized by Taguchi experimental design. The optimized blended cements containing up to 80% fly ash performed better than Type I cement in strength development and durability. Maintaining a constant cement content, concrete produced from the optimized blended cements had equal or higher strength and higher durability than that produced from Type I cement alone. The key for the activation mechanism was the reaction between added SO4 2- and Ca2+ dissolved from cement hydration products.

Cements in Radioactive Waste Disposal

International Nuclear Information System (INIS)

Glasser, F.P.

2013-01-01

The use of cement and concrete to immobilise radioactive waste is complicated by the wide- ranging nature of inorganic cementing agents available as well as the range of service environments in which cement is used and the different functions expected of cement. For example, Portland cement based concretes are widely used as structural materials for construction of vaults and tunnels. These constructions may experience a long pre-closure performance lifetime during which they are required to protect against collapse and ingress of water: strength and impermeability are key desirable characteristics. On the other hand, cement and concrete may be used to form backfills, ranging in permeability. Permeable formulations allow gas readily to escape, while impermeable barriers retard radionuclide transport and reduce access of ground water to the waste. A key feature of cements is that, while fresh, they pass through a fluid phase and can be formed into any shape desired or used to infiltrate other materials thereby enclosing them into a sealed matrix. Thereafter, setting and hardening is automatic and irreversible. Where concrete is used to form structural elements, it is also natural to use cement in other applications as it minimises potential for materials incompatibility. Thus cement- mainly Portland cement- has been widely used as an encapsulant for storage, transport and as a radiation shield for active wastes. Also, to form and stabilise structures such as vaults and silos. Relative to other potential matrices, cement also has a chemical immobilisation potential, reacting with and binding with many radionuclides. The chemical potential of cements is essentially sacrificial, thus limiting their performance lifetime. However performance may also be required in the civil engineering sense, where strength is important, so many factors, including a geochemical description of service conditions, may require to be assessed in order to predict performance lifetime. The

Cements in Radioactive Waste Disposal

Energy Technology Data Exchange (ETDEWEB)

Glasser, F. P. [University of Aberdeen, Scotland (United Kingdom)

2013-09-15

The use of cement and concrete to immobilise radioactive waste is complicated by the wide- ranging nature of inorganic cementing agents available as well as the range of service environments in which cement is used and the different functions expected of cement. For example, Portland cement based concretes are widely used as structural materials for construction of vaults and tunnels. These constructions may experience a long pre-closure performance lifetime during which they are required to protect against collapse and ingress of water: strength and impermeability are key desirable characteristics. On the other hand, cement and concrete may be used to form backfills, ranging in permeability. Permeable formulations allow gas readily to escape, while impermeable barriers retard radionuclide transport and reduce access of ground water to the waste. A key feature of cements is that, while fresh, they pass through a fluid phase and can be formed into any shape desired or used to infiltrate other materials thereby enclosing them into a sealed matrix. Thereafter, setting and hardening is automatic and irreversible. Where concrete is used to form structural elements, it is also natural to use cement in other applications as it minimises potential for materials incompatibility. Thus cement- mainly Portland cement- has been widely used as an encapsulant for storage, transport and as a radiation shield for active wastes. Also, to form and stabilise structures such as vaults and silos. Relative to other potential matrices, cement also has a chemical immobilisation potential, reacting with and binding with many radionuclides. The chemical potential of cements is essentially sacrificial, thus limiting their performance lifetime. However performance may also be required in the civil engineering sense, where strength is important, so many factors, including a geochemical description of service conditions, may require to be assessed in order to predict performance lifetime. The

Dental Cements for Luting and Bonding Restorations: Self-Adhesive Resin Cements.

Science.gov (United States)

Manso, Adriana P; Carvalho, Ricardo M

2017-10-01

Self-adhesive resin cements combine easy application of conventional luting materials with improved mechanical properties and bonding capability of resin cements. The presence of functional acidic monomers, dual cure setting mechanism, and fillers capable of neutralizing the initial low pH of the cement are essential elements of the material and should be understood when selecting the ideal luting material for each clinical situation. This article addresses the most relevant aspects of self-adhesive resin cements and their potential impact on clinical performance. Although few clinical studies are available to establish solid clinical evidence, the information presented provides clinical guidance in the dynamic environment of material development. Copyright © 2017 Elsevier Inc. All rights reserved.

Three-phase bone scan and indium white blood cell scintigraphy following porous coated hip arthroplasty: A prospective study of the prosthetic tip

International Nuclear Information System (INIS)

Oswald, S.G.; Van Nostrand, D.; Savory, C.G.; Callaghan, J.J.

1989-01-01

Although few reports address the use of three-phase bone scanning (TPBS) and 111 In-labeled white blood cell (In-WBC) scintigraphy in hip arthroplasty utilizing a porous coated prosthesis, the literature suggests that scintigraphic patterns in the uncomplicated patient may differ from that seen in the cemented prosthesis. In an attempt to determine the scintigraphic natural history, 25 uncomplicated porous coated hip arthroplasties in 21 patients were prospectively studied with serial TPBS and In-WBC at approximately 7 days, and at 3, 6, 12, 18, and 24 mo postoperatively. This report deals with findings related to the prosthetic tip. Only one of 136 flow studies were abnormal and only two of 136 blood-pool images demonstrated focally increased activity. All 25 prostheses (120 of 143 scans) demonstrated increased uptake on the bone phase images. The area about the tip was divided into three segments; increased uptake at 24 mo was noted in the medial, distal, and lateral segments in 16%, 72%, and 56% of prostheses, respectively. Twenty of 25 prostheses (82 of 142 scans) showed uptake on In-WBC scintigraphy, being noted in 48% of prostheses at 24 mo. We conclude that scintigraphic patterns in the uncomplicated patient with a porous coated prosthesis appear to differ from patterns described in cemented prostheses

The effect of sand/cement ratio on radon exhalation from cement specimens containing 226Ra

International Nuclear Information System (INIS)

Takriti, S.; Shweikani, R.; Ali, A. F.; Rajaa, G.

2002-09-01

Portland cement was mixed with different kind of sand (calcite and silica) in different ratio to produce radioactive specimens with radium chloride. The release of radon from these samples was studied. The results showed that radon release from the calcite-cement samples increased with the increases of the sand mixed ratio until fixed value (about 20%) then decreased to less than its release from the beginning, and the release changed with the sand size also. Radon release from silica-cement samples had the same observations of calcite-cement samples. It was found that calcite-cement reduced the radon exhalation quantity rather than the silica-cement samples. The decreases of the radon exhalation from the cement-sand may be due to the creation of free spaces in the samples, which gave the possibility to radon to decay into these free spaces rather than radon exhalation. The daughters of the radon decay 214 Bi and 214 Pb reported by gamma measurements of the cement-sand samples. (author)

Cement for oil well developed from ordinary cement: characterization physical, chemical and mineralogical

International Nuclear Information System (INIS)

Oliveira, D.N.S.; Neves, G. de A.; Chaves, A.C.; Mendonca, A.M.G.D.; Lima, M.S. de; Bezerra, U.T.

2012-01-01

This work aims to characterize a new type of cement produced from the mixture of ordinary Portland cement, which can be used as an option in the cementing of oil wells. To enable this work we used the method of lineal programming for the new cement composition, then conducted tests to characterize through particle size analysis by laser diffraction, chemical analysis by EDX, TGA, X-ray diffraction, time grip, resistance to compression. The overall result showed that the new cement had made low-C3A, takes more time to the CPP, thermal stability up to 500 ° C, the kinetics of hydration and low levels of major components consistent with the specifications of ABNT. (author)

Fate of bulk auto grafts in uncemented total hip arthroplasty: Evaluation by bone scintigraphy

International Nuclear Information System (INIS)

Simsek, A.; Cila, E.; Sener, E.; Senkoylu, A.; Sipahioglu, S.; Atasever, T.; Akdemir, Ozgur

2006-01-01

Objective was to review short term results of uncemented cup implantation and the fate of bulk femoral head autografts in patients with acetabular bone deficiency due to dysplasia of the hip. We used bone scintigraphy to assess the viability of the grafts. We treated 19 hip joints of 17 patients with osteoarthritis due to developmental dysplasia of the hip with uncemented total hip arthroplasty between 1997-2003 in the Department of Orthopedics and Traumatology, Gazi University, Ankara, Turkey. The average age was 49.1 (31-72 years), and the average follow up period was 36 months. We used femoral head autografts to reconstruct superolateral segmental deficiencies of the acetabuli. We evaluated the patients clinically and radiologically to assess acetabular loosening, and we used three-phase bone scintigraphy to evaluate the viability of the autograft.There was no acetabular component revision throughout the follow up period. There was no radiological evidence of graft resorption or graft displacement in any of the patients. In bone scintigraphy, we observed hyperemia in the blood pool phase, and the osteoblastic activity of the bone graft was at the level of the neighboring iliac bone. The application of a non-cemented acetabular component with femoral autograft in superolateral acetabulum deficiency increases the stability of the implant and increases the bone stock. It is not easy to evaluate the viability of the graft by the use of radiological methods. Bone scintigraphy gives sufficient information about the viability of the graft as a non-invasive method. (author)

Rare Chronic Gastric Volvulus Associated with Left Atrial and Mediastinal Compression

OpenAIRE

Shriki, Jabi E.; Nguyen, Khanh; Rozo, Juan Carlos; Reul, George J.; Mortazavi, Ali

2002-01-01

We report a case of chronic gastric volvulus associated with left atrial compression in a 75-year-old woman who presented with chest pain, shortness of breath, and hypotension after elective hemiarthroplasty of the left hip. The patient's medical history included a paraesophageal hernia and gastric volvulus diagnosed in 1997 but left untreated. The present diagnosis of gastric volvulus was made on the basis of a chest radiograph and subsequent computed tomography. Echocardiography showed the ...

Sonography for hip joint effusion in adults with hip pain

NARCIS (Netherlands)

S.M. Bierma-Zeinstra (Sita); A.M. Bohnen (Arthur); J.A.N. Verhaar (Jan); A. Prins (Ad); J.S. Lameris; A.Z. Ginai (Abida)

2000-01-01

textabstractOBJECTIVE: To study the prevalence of ultrasonic hip joint effusion and its relation with clinical, radiological and laboratory (ESR) findings in adults with hip pain. METHODS: Patients (n = 224) aged 50 years or older with hip pain, referred by the general

Hip Implant Systems

Science.gov (United States)

... Implants and Prosthetics Metal-on-Metal Hip Implants Hip Implants Share Tweet Linkedin Pin it More sharing options Linkedin Pin it Email Print Hip implants are medical devices intended to restore mobility ...

Evaluation of stainless steel crowns cemented with glass-ionomer and resin-modified glass-ionomer luting cements.

Science.gov (United States)

Yilmaz, Yucel; Simsek, Sera; Dalmis, Anya; Gurbuz, Taskin; Kocogullari, M Elcin

2006-04-01

To evaluate in vitro and in vivo conditions of stainless steel crowns (SSC) cemented using one luting glass-ionomer cement (Aqua Meron) and one luting resin-modified glass-ionomer cement (Vitremer). In the in vitro part of this study, retentive properties of SSCs cemented using Aqua Meron and Vitremer on extracted primary first molars were tested. In addition, two specimens of each group were used to evaluate the tooth hard tissue-cement, within the cement itself, cement-SSC, and tooth hard tissue-cement-SSC under scanning electron microscope (SEM). In the in vivo part of this study, 152 SSCs were placed on the first or second primary molars of 86 children, and cemented using either Aqua Meron or Vitremer. The crowns were examined for retention. In addition, the clinical views of the crowns were recorded with an intraoral camera. No significant difference was found between the mean retentive forces of Aqua Meron and Vitremer (P> 0.05). SSCs cemented with Aqua Meron and Vitremer had an average lifespan of 26.44 and 24.07 months respectively. Only one (0.66%) of 152 SSCs was lost from the Aqua Meron group during post-cementation periods. Nineteen of the 152 SSCs (12.5%) had dents or perforations.

Gluteal tendinopathy and hip osteoarthritis: Different pathologies, different hip biomechanics.

Science.gov (United States)

Allison, Kim; Hall, Michelle; Hodges, Paul W; Wrigley, Tim V; Vicenzino, Bill; Pua, Yong-Hao; Metcalf, Ben; Grimaldi, Alison; Bennell, Kim L

2018-03-01

Gluteal tendinopathy (GT) and hip osteoarthritis (OA) are the most common causes of hip pain and associated disability in older adults. Pain and altered walking biomechanics are common to both conditions. This study aimed to compare three-dimensional walking biomechanics between individuals with unilateral, symptomatic GT and HOA. Sixty individuals with symptomatic unilateral GT confirmed by magnetic-resonance-imaging and 73 individuals with symptomatic unilateral HOA (Kellgren-Lawrence Grade ≥ 2) underwent three-dimensional gait analysis. Maximum and minimum values of the external sagittal hip moment, the first peak, second peak and mid-stance minimum of the hip adduction moment (HAM), sagittal plane hip excursion and hip joint angles, pelvic obliquity and trunk lean, at the three HAM time points during stance phase of walking were compared between groups. Compared to individuals with HOA, those with GT exhibited a greater hip peak extension moment (P < 0.001) and greater HAM throughout the stance phase of walking (P = 0.01-P < 0.001), greater hip adduction (P < 0.001) and internal rotation (P < 0.01-P < 0.001) angles and lower hip flexion angles and excursion (P = 0.02 - P < 0.001). Individuals with HOA exhibited a greater forward trunk lean (P ≤ 0.001) throughout stance, and greater ipsilateral trunk lean in the frontal plane (P < 0.001) than those with GT. Despite presence of pain in both conditions, hip kinematics and kinetics differ between individuals with symptomatic unilateral GT and those with symptomatic unilateral HOA. These condition-specific impairments may be targets for optimization of management of HOA and GT. Copyright © 2018 Elsevier B.V. All rights reserved.

Hip Strength Testing of Soccer Players With Long-Standing Hip and Groin Pain

DEFF Research Database (Denmark)

Rafn, Bolette S; Tang, Lars; Nielsen, Peter Martin

2016-01-01

OBJECTIVE: To investigate whether self-reported pain during hip strength testing correlates to a large degree with hip muscle strength in soccer players with long-standing unilateral hip and groin pain. DESIGN: Cross-sectional study. SETTING: Clinical assessments at Sports Orthopaedic Research...... Center-Copenhagen (SORC-C), Arthroscopic Centre Amager, Copenhagen University Hospital, Denmark. PARTICIPANTS: Twenty-four male soccer players with unilateral long-standing hip and groin pain. INTERVENTIONS: The soccer players performed 5 reliable hip muscle strength tests (isometric hip flexion...... strength (Spearman rho = -0.44, P = 0.016). CONCLUSIONS: Self-reported pain during testing does not seem to correlate with the majority of hip muscle strength tests used in soccer players with long-standing hip and groin pain....

Sonography for hip joint effusion in adults with hip pain

NARCIS (Netherlands)

Bierma-Zeinstra, S. M.; Bohnen, A. M.; Verhaar, J. A.; Prins, A.; Ginai-Karamat, A. Z.; Laméris, J. S.

2000-01-01

To study the prevalence of ultrasonic hip joint effusion and its relation with clinical, radiological and laboratory (ESR) findings in adults with hip pain. Patients (n = 224) aged 50 years or older with hip pain, referred by the general practitioner for radiological investigation, underwent a

Study on properties and testing methods of thermo-responsive cementing system for well cementing in heavy oil thermal recovery

Science.gov (United States)

Li, Lianjiang

2017-08-01

In this paper, thermo-responsive cement slurry system were being developed, the properties of conventional cement slurry, compressive strength high temperature of cement sheath, mechanical properties of cement sheath and thermal properties of cement sheath were being tested. Results were being used and simulated by Well-Life Software, Thermo-responsive cement slurry system can meet the requirements of heavy oil thermal recovery production. Mechanical and thermal properties of thermo-responsive cement sheath were being tested. Tensile fracture energy of the thermo-responsive cement sheath is larger than conventional cement. The heat absorption capacity of conventional cement sheath is larger than that of thermo-responsive cement sheath, this means more heat is needed for the unit mass once increasing 1.0 °C, which also indicates that thermo-responsive cement own good heat insulating and preservation effects. The heat conductivity coefficient and thermal expansion coefficient of thermo-responsive cement is less than and conventional cement, this means that thermo-responsive cement have good heat preservation and insulation effects with good thermal expansion stabilities.

Effect of temporary cements on the microtensile bond strength of self-etching and self-adhesive resin cement.

Science.gov (United States)

Carvalho, Edilausson Moreno; Carvalho, Ceci Nunes; Loguercio, Alessandro Dourado; Lima, Darlon Martins; Bauer, José

2014-11-01

The aim of this study was to evaluate the microtensile bond strength (µTBS) of self-etching and self-adhesive resin cement systems to dentin affected by the presence of remnants of either eugenol-containing or eugenol-free temporary cements. Thirty extracted teeth were obtained and a flat dentin surface was exposed on each tooth. Acrylic blocks were fabricated and cemented either with one of two temporary cements, one zinc oxide eugenol (ZOE) and one eugenol free (ZOE-free), or without cement (control). After cementation, specimens were stored in water at 37°C for 1 week. The restorations and remnants of temporary cements were removed and dentin surfaces were cleaned with pumice. Resin composite blocks were cemented to the bonded dentin surfaces with one of two resin cements, either self-etching (Panavia F 2.0) or self-adhesive (RelyX U-100). After 24 h, the specimens were sectioned to obtain beams for submission to µTBS. The fracture mode was evaluated under a stereoscopic loupe and a scanning electron microscope (SEM). Data from µTBS were submitted to two-way repeated-measure ANOVA and the Tukey test (alpha = 0.05). The cross-product interaction was statistically significant (p cements reduced the bond strength to Panavia self-etching resin cements only (p cements did not interfere in the bond strength to dentin of self-adhesive resin cements.

An Experimental Study of Portland Cement and Superfine Cement Slurry Grouting in Loose Sand and Sandy Soil

Directory of Open Access Journals (Sweden)

Weijing Yao

2018-04-01

Full Text Available Grouting technology is widely applied in the fields of geotechnical engineering in infrastructure. Loose sand and sandy soil are common poor soils in tunnel and foundation treatments. It is necessary to use superfine cement slurry grouting in the micro-cracks of soil. The different effectiveness of Portland cement slurry and superfine cement slurry in sandy soil by the laboratory grouting experiment method were presented in this paper. The grouting situations of superfine cement slurry injected into sand and sandy soil were explored. The investigated parameters were the dry density, wet density, moisture content, internal friction angle, and cohesion force. The results show that the consolidation effect of superfine cement is better than that of Portland cement due to the small size of superfine cement particles. The superfine cement can diffuse into the sand by infiltration, extrusion, and splitting. When the water–cement ratio of superfine cement slurry is less than 2:1 grouting into loose sand, the dry and wet density decrease with the increase in the water–cement ratio, while the moisture content and cohesive force gradually increase. When the water–cement ratio of superfine cement slurry is 1:1 grouting into loose sand and sandy soil, the dry density, wet density, and cohesive force of loose sand are larger than those of sandy soil. The results of the experiment may be relevant for engineering applications.

Asphalt cement poisoning

Science.gov (United States)

... petroleum material that hardens when it cools. Asphalt cement poisoning occurs when someone swallows asphalt. If hot ... found in: Road paving materials Roofing materials Tile cements Asphalt may also be used for other purposes.

Hydroxyapatite does not improve the outcome of a bipolar hemiarthroplasty.

NARCIS (Netherlands)

Meijerink, H.J.; Gardeniers, J.W.M.; Buma, P.; Lemmens, J.A.M.; Schreurs, B.W.

2004-01-01

In a one-surgeon study the clinical and radiographic results of 30 cementless bipolar hip prostheses in 24 patients younger than 55 years were evaluated. Eleven noncoated prostheses (Noncoated Group) and 19 hydroxyapatite-coated prostheses (Hydroxyapatite Group) were compared after a mean followup

Sustainable Blended Cements-Influences of Packing Density on Cement Paste Chemical Efficiency.

Science.gov (United States)

Knop, Yaniv; Peled, Alva

2018-04-18

This paper addresses the development of blended cements with reduced clinker amount by partial replacement of the clinker with more environmentally-friendly material (e.g., limestone powders). This development can lead to more sustainable cements with reduced greenhouse gas emission and energy consumption during their production. The reduced clicker content was based on improved particle packing density and surface area of the cement powder by using three different limestone particle diameters: smaller (7 µm, 3 µm) or larger (70 µm, 53 µm) than the clinker particles, or having a similar size (23 µm). The effects of the different limestone particle sizes on the chemical reactivity of the blended cement were studied by X-ray diffraction (XRD), thermogravimetry and differential thermogravimetry (TG/DTG), loss on ignition (LOI), isothermal calorimetry, and the water demand for reaching normal consistency. It was found that by blending the original cement with limestone, the hydration process and the reactivity of the limestone itself were increased by the increased surface area of the limestone particles. However, the carbonation reaction was decreased with the increased packing density of the blended cement with limestone, having various sizes.

Crown and bridge cements: clinical applications.

Science.gov (United States)

Bunek, Sabiha S; Powers, John M

2012-12-01

Cement selection can be confusing because factors such as substrate, the type of restoration, and patient needs must be considered. Some substrates require additional treatment before cementation. This article describes the most commonly used traditional crown and bridge cements (GI and RMGI) used for metal and metal-ceramic restorations, and resin cements used for all-ceramic restorations. Advantages, disadvantages, indications, and contraindications of cements have been reviewed. Recommended uses of cements for metal, ceramic, and laboratory composite restorations have been presented. General guidelines for surface treatment ot silica- and zirconia-based restorations when using resin cements have been discussed.

Hip Replacement Surgery

Science.gov (United States)

... Outreach Initiative Breadcrumb Home Health Topics English Español Hip Replacement Surgery Basics In-Depth Download Download EPUB ... PDF What is it? Points To Remember About Hip Replacement Surgery Hip replacement surgery removes damaged or ...

Push-out bond strengths of different dental cements used to cement glass fiber posts.

Science.gov (United States)

Pereira, Jefferson Ricardo; Lins do Valle, Accácio; Ghizoni, Janaina Salomon; Lorenzoni, Fábio César; Ramos, Marcelo Barbosa; Barbosa, Marcelo Ramos; Dos Reis Só, Marcus Vinícius

2013-08-01

Since the introduction of glass fiber posts, irreversible vertical root fractures have become a rare occurrence; however, adhesive failure has become the primary failure mode. The purpose of this study was to evaluate the push-out bond strength of glass fiber posts cemented with different luting agents on 3 segments of the root. Eighty human maxillary canines with similar root lengths were randomly divided into 8 groups (n=10) according to the cement assessed (Rely X luting, Luting and Lining, Ketac Cem, Rely X ARC, Biscem, Duo-link, Rely X U100, and Variolink II). After standardized post space preparation, the root dentin was pretreated for dual-polymerizing resin cements and untreated for the other cements. The mixed luting cement paste was inserted into post spaces with a spiral file and applied to the post surface that was seated into the canal. After 7 days, the teeth were sectioned perpendicular to their long axis into 1-mm-thick sections. The push-out test was performed at a speed of 0.5 mm/min until extrusion of the post occurred. The results were evaluated by 2-way ANOVA and the all pairwise multiple comparison procedures (Tukey test) (α=.05). ANOVA showed that the type of interaction between cement and root location significantly influenced the push-out strength (Pcements and glass ionomer cements showed significantly higher values compared to dual-polymerizing resin cements. In all root segments, dual-polymerizing resin cements provided significantly lower bond strength. Significant differences among root segments were found only for Duo-link cement. Copyright © 2013 The Editorial Council of the Journal of Prosthetic Dentistry. Published by Mosby, Inc. All rights reserved.

Mineral resource of the month: hydraulic cement

Science.gov (United States)

van Oss, Hendrik G.

2012-01-01

Hydraulic cements are the binders in concrete and most mortars and stuccos. Concrete, particularly the reinforced variety, is the most versatile of all construction materials, and most of the hydraulic cement produced worldwide is portland cement or similar cements that have portland cement as a basis, such as blended cements and masonry cements. Cement typically makes up less than 15 percent of the concrete mix; most of the rest is aggregates. Not counting the weight of reinforcing media, 1 ton of cement will typically yield about 8 tons of concrete.

Hydration of fly ash cement and microstructure of fly ash cement pastes

Energy Technology Data Exchange (ETDEWEB)

Shiyuan, H.

1981-01-01

The strength development and hydration of fly ash cement and the influence of addition of gypsum on those were studied at normal and elevated temperatures. It was found that an addition of a proper amount of gypsum to fly ash cement could accelerate the pozzolanic reaction between CH and fly ash, and as a result, increase the strength of fly ash cement pastes after 28 days.

Analysis of Chemical Composition of Portland Cement in Ghana: A Key to Understand the Behavior of Cement

OpenAIRE

Bediako, Mark; Amankwah, Eric Opoku

2015-01-01

The performance of Portland cement in concrete or mortar formation is very well influenced by chemical compositions among other factors. Many engineers usually have little information on the chemical compositions of cement in making decisions for the choice of commercially available Portland cement in Ghana. This work analyzed five different brands of Portland cement in Ghana, namely, Ghacem ordinary Portland cement (OPC) and Portland limestone cement (PLC), CSIR-BRRI Pozzomix, Dangote OPC, a...

Influence of temporary cement contamination on the surface free energy and dentine bond strength of self-adhesive cements.

Science.gov (United States)

Takimoto, Masayuki; Ishii, Ryo; Iino, Masayoshi; Shimizu, Yusuke; Tsujimoto, Akimasa; Takamizawa, Toshiki; Ando, Susumu; Miyazaki, Masashi

2012-02-01

The surface free energy and dentine bond strength of self-adhesive cements were examined after the removal of temporary cements. The labial dentine surfaces of bovine mandibular incisors were wet ground with #600-grit SiC paper. Acrylic resin blocks were luted to the prepared dentine surfaces using HY Bond Temporary Cement Hard (HY), IP Temp Cement (IP), Fuji TEMP (FT) or Freegenol Temporary Cement (TC), and stored for 1 week. After removal of the temporary cements with an ultrasonic tip, the contact angle values of five specimens per test group were determined for the three test liquids, and the surface-energy parameters of the dentine surfaces were calculated. The dentine bond strengths of the self-adhesive cements were measured after removal of the temporary cements in a shear mode at a crosshead speed of 1.0mm/min. The data were subjected to one-way analysis of variance (ANOVA) followed by Tukey's HSD test. For all surfaces, the value of the estimated surface tension component γ(S)(d) (dispersion) was relatively constant at 41.7-43.3 mJm(-2). After removal of the temporary cements, the value of the γ(S)(h) (hydrogen-bonding) component decreased, particularly with FT and TC. The dentine bond strength of the self-adhesive cements was significantly higher for those without temporary cement contamination (8.2-10.6 MPa) than for those with temporary cement contamination (4.3-7.1 MPa). The γ(S) values decreased due to the decrease of γ(S)(h) values for the temporary cement-contaminated dentine. Contamination with temporary cements led to lower dentine bond strength. The presence of temporary cement interferes with the bonding performance of self-adhesive cements to dentine. Care should be taken in the methods of removal of temporary cement when using self-adhesive cements. Copyright © 2011 Elsevier Ltd. All rights reserved.

Colorectal cancer and non-malignant respiratory disease in asbestos cement and cement workers

International Nuclear Information System (INIS)

Jacobsson, K.

1993-09-01

Radiologically visible parenchymal changes (small opacities >= 1/0;ILO 1980 classification) were present in 20% of a sample of workers (N=174), employed for 20 years (median) in an asbestos cement plant. Exposure-response relationships were found, after controlling for age and smoking habits. In a sample of asbestos cement workers with symptoms and signs suggestive of pulmonary disease (N=33), increased lung density measured by x-ray computed tomography, and reduced static lung volumes and lung compliance was found. In a cohort of asbestos cement workers (N=1.929) with an estimated median exposure of 1.2 fibres/ml, the mortality from non-malignant respiratory disease was increased in comparison to a regional reference cohort (N=1.233). A two-to three-fold increase of non-malignant respiratory mortality was noted among workers employed for more than a decade in the asbestos cement plant, compared to cement workers (N=1.526), who in their turn did not experience and increased risk compared to the general population. In the cohorts of asbestos cement and cement workers, there was a tow-to three-fold increased incidence of cancer in the right part of the colon, compared to the general population as well as to external reference cohorts of other industrial workers (N=3.965) and fishermen (N=8.092). A causal relation with the exposure to mineral dust and fibres was supported by the findings of higher risk estimated in subgroups with high cumulated asbestos doses or longer duration of cement work. The incidence of cancer in the left part of the colon was not increased. Morbidity data, but not mortality data, disclosed the subsite-specific risk pattern. Both asbestos cement workers and cement workers has an increased incidence of rectal cancer, compared with the general population, and with the fishermen. The risk was, however, of the same magnitude among the other industrial workers. 181 refs

Hip arthroscopy

Directory of Open Access Journals (Sweden)

Henrique Antônio Berwanger de Amorim Cabrita

2015-06-01

Full Text Available Hip arthroscopy is a safe method for treating a variety of pathological conditions that were unknown until a decade ago. Femoroacetabular impingement is the commonest of these pathological conditions and the one with the best results when treated early on. The instruments and surgical technique for hip arthroscopy continue to evolve. New indications for hip arthroscopy has been studied as the ligamentum teres injuries, capsular repair in instabilities, dissection of the sciatic nerve and repair of gluteal muscles tears (injuries to the hip rotator cuff, although still with debatable reproducibility. The complication rate is low, and ever-better results with fewer complications should be expected with the progression of the learning curve.

Compressive Strength and Physical Properties Behavior of Cement Mortars with addition of Cement Klin Dust

OpenAIRE

Auday A Mehatlaf

2017-01-01

Cement Klin Dust (CKD) was the waste of almost cement industry factories, so that in this paper utilization of CKD as filler in cement and/or concrete was the main objective. CKD from the Karbala cement factory had been used and analysis to know the chemical composition of the oxides was done. In this paper cement mortars with different weight percentages of CKD (0,5,10,20,30,40) had been prepared. Physical properties such as density and porosity were done in different age curing (3, 7, 28) d...

Low revision rate after total hip arthroplasty in patients with pediatric hip diseases

DEFF Research Database (Denmark)

Engesæter, Lars B; Engesæter, Ingvild Ø; Fenstad, Anne Marie

2012-01-01

Background The results of primary total hip arthroplasties (THAs) after pediatric hip diseases such as developmental dysplasia of the hip (DDH), slipped capital femoral epiphysis (SCFE), or Perthes' disease have been reported to be inferior to the results after primary osteoarthritis of the hip (OA.......9%) were operated due to pediatric hip diseases (3.1% for Denmark, 8.8% for Norway, and 1.9% for Sweden) and 288,435 THAs (77.8%) were operated due to OA. Unadjusted 10-year Kaplan-Meier survival of THAs after pediatric hip diseases (94.7% survival) was inferior to that after OA (96.6% survival......). Consequently, an increased risk of revision for hips with a previous pediatric hip disease was seen (risk ratio (RR) 1.4, 95% CI: 1.3-1.5). However, after adjustment for differences in sex and age of the patients, and in fixation of the prostheses, no difference in survival was found (93.6% after pediatric hip...

Chromium content in human skin after in vitro application of ordinary cement and ferrous-sulphate-reduced cement

DEFF Research Database (Denmark)

Fullerton, A; Gammelgaard, Bente; Avnstorp, C

1993-01-01

The amount of chromium found in human skin after in vitro application of cement suspensions on full-thickness human skin in diffusion cells was investigated. Cement suspensions made from ordinary Portland cement or Portland cement with the chromate reduced with added ferrous sulphate were used....... The cement suspensions were either applied on the skin surface under occlusion for 48 h or applied repeatedly every 24 h for 96 h. No statistically significant difference in chromium content of skin layers between skin exposed to ordinary Portland cement, skin exposed to cement with added ferrous sulphate...... and unexposed skin was observed, despite a more permeable skin barrier at the alkaline pH of the cement suspensions, i.e., pH 12.5. Increased chromium levels in epidermis and dermis were seen when ordinary Portland cement was applied as a suspension with added sodium sulphate (20%) on the skin surface for 96 h...

Hydration kinetics of cement composites with varying water-cement ratio using terahertz spectroscopy

Science.gov (United States)

Ray, Shaumik; Dash, Jyotirmayee; Devi, Nirmala; Sasmal, Saptarshi; Pesala, Bala

2015-03-01

Cement is mixed with water in an optimum ratio to form concrete with desirable mechanical strength and durability. The ability to track the consumption of major cement constituents, viz., Tri- and Dicalcium Silicates (C3S, C2S) reacting with water along with the formation of key hydration products, viz., Calcium-Silicate-Hydrate (C-S-H) which gives the overall strength to the concrete and Calcium Hydroxide (Ca(OH)2), a hydration product which reduces the strength and durability, using an efficient technique is highly desirable. Optimizing the amount of water to be mixed with cement is one of the main parameters which determine the strength of concrete. In this work, THz spectroscopy has been employed to track the variation in hydration kinetics for concrete samples with different water-cement ratios, viz., 0.3, 0.4, 0.5 and 0.6. Results show that for the sample with water-cement ratio of 0.3, significant amount of the C3S and C2S remain unreacted even after the initial hydration period of 28 days while for the cement with water-cement ratio of 0.6, most of the constituents get consumed during this stage. Analysis of the formation of Ca(OH)2 has been done which shows that the concrete sample with water-cement ratio of 0.6 produces the highest amount of Ca(OH)2 due to higher consumption of C3S/C2S in presence of excess water which is not desirable. Samples with water-cement ratio of 0.4 and 0.5 show more controlled reaction during the hydration which can imply formation of an optimized level of desired hydration products resulting in a more mechanically strong and durable concrete.

Polymer-cement interactions towards improved wellbore cement fracture sealants

Science.gov (United States)

Beckingham, B. S.; Iloejesi, C.; Minkler, M. J.; Schindler, A. K.; Beckingham, L. E.

2017-12-01

Carbon capture, utilization, and storage (CCUS) in deep geologic formations is a promising means of reducing point source emissions of CO2. In these systems, CO2 is captured at the source and then injected to be utilized (eg. in enhanced oil recovery or as a working fluid in enhanced geothermal energy plants) or stored in geologic formations such as depleted oil and gas reservoirs or saline aquifers. While CCUS in subsurface systems could aid in reducing atmospheric CO2 emissions, the potential for CO2 leakage from these systems to overlying formations remains a major limitation and poses a significant risk to the security of injected CO2. Thus, improved materials for both initial wellbore isolation and repairing leakage pathways that develop over time are sought. One approach for the repair of cement fractures in wellbore (and other) systems is the injection of polymer materials into the fracture with a subsequent environmentally dependent (temperature, pressure, pH, etc.) densification or solidification. Here, we aim to investigate novel polymer materials for use to repair leaking wellbores in the context of CCUS. We synthesize and fully characterize a series of novel polymer materials and utilize a suite of analysis techniques to examine polymer-cement interactions at a range of conditions (namely temperature, pressure and pH). Initial findings will be leveraged to design novel polymer materials for further evaluation in polymer-cement composite cores, cement fracture healing, and the aging behavior of healed cements.

Absorption Characteristics of Cement Combination Concrete Containing Portland Cement, fly ash, and Metakaolin

Directory of Open Access Journals (Sweden)

Folagbade S.O.

2016-03-01

Full Text Available The resistance to water penetration of cement combination concretes containing Portland cement (PC, fly ash (FA, and metakaolin (MK have been investigated at different water/cement (w/c ratios, 28-day strengths, and depths of water penetration using their material costs and embodied carbon-dioxide (eCO2 contents. Results revealed that, at equal w/c ratio, eCO2 content reduced with increasing content of FA and MK. MK contributed to the 28-day strengths more than FA. Compared with PC, FA reduced cost and increased the depth of water penetration, MK increased cost and reduced the depth of water penetration, and their ternary combinations become beneficial. At equal strengths and levels of resistance to water penetration, most of the cement combination concretes are more environmentally compatible and costlier than PC concrete. Only MK binary cement concretes with 10%MK content or more and ternary cement concretes at a total replacement level of 55% with 10%MK content or more have higher resistance to water penetration than PC concrete.

ULTRA-LIGHTWEIGHT CEMENT

Energy Technology Data Exchange (ETDEWEB)

Fred Sabins

2001-10-23

The objective of this project is to develop an improved ultra-lightweight cement using ultra-lightweight hollow glass spheres (ULHS). Work reported herein addresses tasks performed in the fourth quarter as well as the other three quarters of the past year. The subjects that were covered in previous reports and that are also discussed in this report include: Analysis of field laboratory data of active cement applications from three oil-well service companies; Preliminary findings from a literature review focusing on problems associated with ultra-lightweight cements; Summary of pertinent information from Russian ultra-lightweight cement literature review; and Comparison of compressive strengths of ULHS systems using ultrasonic and crush methods Results reported from the fourth quarter include laboratory testing of ULHS systems along with other lightweight cement systems--foamed and sodium silicate slurries. These comparison studies were completed for two different densities (10.0 and 11.5 lb/gal) and three different field application scenarios. Additional testing included the mechanical properties of ULHS systems and other lightweight systems. Studies were also performed to examine the effect that circulation by centrifugal pump during mixing has on breakage of ULHS.

Primary total hip replacement versus hip resurfacing - hospital considerations.

Science.gov (United States)

Ward, William G; Carter, Christina J; Barone, Marisa; Jinnah, Riyaz

2011-01-01

Multiple factors regarding surgical procedures and patient selection affect hospital staffing needs as well as hospital revenues. In order to better understand the potential impact on hospitals that hip arthroplasty device selection (standard total hip arthroplasty vs. resurfacing) creates, a review of all primary hip arthroplasties performed at one institution was designed to identify factors that impacted hospital staffing needs and revenue generation. All primary hip arthroplasties undertaken over three fiscal years (2008 to 2010) were reviewed, utilizing only hospital business office data and medical records data that had been previously extracted prior for billing purposes. Analysis confirmed differing demographics for two hip arthroplasty populations, with the resurfacing patients (compared to the conventional total hip arthroplasty population) consisting of younger patients (mean age, 50 vs. 61 years), who were more often male (75% vs. 45%), were more likely to have osteoarthritis as their primary diagnosis (83 vs. 67%) and were more often covered by managed care or commercial insurance (83 vs. 34%). They also had shorter hospital stays (mean length of stay, 2.3 vs. 4.1 days) and consequently provided a more favorable financial revenue stream to the hospital on a per patient basis. Several trends appeared during the study periods. There was a steady increase in all procedures in all groups except for the resurfacings, which decreased 26% in males and 53% in females between 2009 and 2010. Differences were observed in the demographics of patients presenting for resurfacing, compared to those presenting for conventional total hip arthroplasty. In addition to the revenue stream considerations, institutions undertaking a resurfacing program must commit the resources and planning in order to rehabilitate these patients more expeditiously than is usually required with conventional hip arthroplasty patients.

Is it cement to be? Downhole cement that uses zeolite additive may offer lightweight alternative

Energy Technology Data Exchange (ETDEWEB)

Mahoney, J.

2001-05-01

C2C Zeolite Corporation produces zeolites from a large deposit near Cache Creek, British Columbia, and processes them for use as an additive in downhole cement well casings. Early research indicates that zeolites can significantly improve the way downhole cement is made in the oil industry. Zeolites are made up mostly of silicates of aluminum and calcium. They have a great ability to absorb water, resulting in a lighter and more fluid cement than is currently available. C2C claims that zeolites will reduce cement weight, column pressure and operator costs. The cost benefits of using lighter cement downhole includes easier moving, processing and handling of the mix. Initial research suggests that zeolites might prove to be viable alternatives to other cement lighteners such as silica fumes or flyash. Zeolite-based cement also performed reasonably well in freeze-thaw tests and showed good adhesion and no evidence of shrinkage in downhole tests. 3 figs.

Prediction of hydroxyl concentrations in cement pore water using a numerical cement hydration model

NARCIS (Netherlands)

Eijk, van R.J.; Brouwers, H.J.H.

2000-01-01

In this paper, a 3D numerical cement hydration model is used for predicting alkali and hydroxyl concentrations in cement pore water. First, this numerical model is calibrated for Dutch cement employing both chemical shrinkage and calorimetric experiments. Secondly, the strength development of some

Development of low radio-activated cement. Characteristics of cement and clinker that decreased liquid phase content

International Nuclear Information System (INIS)

Ichitsubo, Koki

2008-01-01

Low radio-activated cement was developed by decreasing the parent elements of radionuclides in the materials. The characteristics of products, decreasing method of Na, Eu and Co in cement, design, tests, evaluation, and analysis of low radio-activated cement clinker are reported. In order to decrease the content of Na, Eu and Co, the raw materials have to include natural materials such as limestone and silica stone. The production method is the same as white cement. The low radio-activated cement produced by rotary kiln showed 4.9% C 3 A, 1.1% C 4 AF, 26.9% C 3 S and 61.0% C 2 S, which values were standardized by the Japanese Industrial Standards (JIS) of low temperature Portland cement. Another product that decreased a little more liquid phase content showed 4.0% C 3 A, 1.0% C 4 AF, 32.3% C 3 S and 56.5% C 2 S, which was standardized by JIS of sulfate resisting Portland cement. In the case of decommissioning reactor constructed by the low radio-activated cement, the whole amount of waste cement will be no more than the clearance level. (S.Y.)

The effects of cement-based and cement-ash-based mortar slabs on indoor air quality

DEFF Research Database (Denmark)

Krejcirikova, Barbora; Kolarik, Jakub; Wargocki, Pawel

2018-01-01

The effects of emissions from cement-based and cement-ash-based mortar slabs were studied. In the latter, 30% of the cement content had been replaced by sewage sludge ash. They were tested singly and together with either carpet or linoleum. The air exhausted from the chambers was assessed by means...... of odour intensity and chemical characterization of emissions. Odour intensity increased with the increased exposed area of the slabs. It did not differ significantly between cement-based or cement-ash-based mortar and neither did the chemical composition of the exhaust air. A significant sink effect...

Hip biomechanics during stair ascent and descent in people with and without hip osteoarthritis.

Science.gov (United States)

Hall, Michelle; Wrigley, Tim V; Kean, Crystal O; Metcalf, Ben R; Bennell, Kim L

2017-07-01

Hip osteoarthritis (OA) is often associated with pain and impaired function. Understanding biomechanical alterations in patients with hip OA during challenging activities such as stair use is important to inform treatments. The aim of this study was to determine whether kinematics and kinetics during stair ambulation differed between people with hip OA and healthy controls. Fifteen participants with symptomatic and radiographic hip OA and 15 asymptomatic healthy controls underwent 3-D motion analysis during stair ascent and descent. Trunk, pelvis, and hip kinematics as well as hip kinetics were evaluated. Analyses were performed unadjusted and adjusted for speed and leg length. In both the unadjusted and adjusted analyses, participants with hip OA ascended stairs with less hip range of motion in all three planes and a lower peak external rotation moment compared to controls. In the unadjusted analysis, hip OA participants descended stairs with greater ipsilateral trunk lean, less sagittal plane range of motion, lower peak extension moment, lower peak external rotation moment, and greater hip adduction moment impulse compared to controls. In the adjusted results, peak internal rotation moment and hip adduction moment impulse were greater in hip OA participants compared to controls. Findings show that individuals with hip OA display limited range of hip joint movement, particularly during stair ascent, and overall indicate the use of strategies (e.g., trunk lean; lower peak external rotation moment; higher adduction moment impulse) that implicate altered hip abductor function. Future research is required to further understand the implications of these findings on hip OA. © 2017 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 35:1505-1514, 2017. © 2017 Orthopaedic Research Society. Published by Wiley Periodicals, Inc.

Influence of carbonation on the acid neutralization capacity of cements and cement-solidified/stabilized electroplating sludge.

Science.gov (United States)

Chen, Quanyuan; Zhang, Lina; Ke, Yujuan; Hills, Colin; Kang, Yanming

2009-02-01

Portland cement (PC) and blended cements containing pulverized fuel ash (PFA) or granulated blast-furnace slag (GGBS) were used to solidify/stabilize an electroplating sludge in this work. The acid neutralization capacity (ANC) of the hydrated pastes increased in the order of PC > PC/GGBS > PC/PFA. The GGBS or PFA replacement (80 wt%) reduced the ANC of the hydrated pastes by 30-50%. The ANC of the blended cement-solidified electroplating sludge (cement/sludge 1:2) was 20-30% higher than that of the hydrated blended cement pastes. Upon carbonation, there was little difference in the ANC of the three cement pastes, but the presence of electroplating sludge (cement/sludge 1:2) increased the ANC by 20%. Blended cements were more effective binders for immobilization of Ni, Cr and Cu, compared with PC, whereas Zn was encapsulated more effectively in the latter. Accelerated carbonation improved the immobilization of Cr, Cu and Zn, but not Ni. The geochemical code PHREEQC, with the edited database from EQ3/6 and HATCHES, was used to calculate the saturation index and solubility of likely heavy metal precipitates in cement-based solidification/stabilization systems. The release of heavy metals could be related to the disruption of cement matrices and the remarkable variation of solubility of heavy metal precipitates at different pH values.

Health hazards of cement dust

International Nuclear Information System (INIS)

Meo, Sultan A.

2004-01-01

ven in the 21st century, millions of people are working daily in a dusty environment. They are exposed to different types of health hazards such as fume, gases and dust, which are risk factors in developing occupational disease. Cement industry is involved in the development of structure of this advanced and modern world but generates dust during its production. Cement dust causes lung function impairment, chronic obstructive lung disease, restrictive lung disease, pneumoconiosis and carcinoma of the lungs, stomach and colon. Other studies have shown that cement dust may enter into the systemic circulation and thereby reach the essentially all the organs of body and affects the different tissues including heart, liver, spleen, bone, muscles and hairs and ultimately affecting their micro-structure and physiological performance. Most of the studies have been previously attempted to evaluate the effects of cement dust exposure on the basis of spirometry or radiology, or both. However, collective effort describing the general effects of cement dust on different organ and systems in humans or animals, or both has not been published. Therefore, the aim of this review is to gather the potential toxic effects of cement dust and to minimize the health risks in cement mill workers by providing them with information regarding the hazards of cement dust. (author)

Using dehydrated cement paste as new type of cement additive

NARCIS (Netherlands)

Yu, R.; Shui, Z.H.; Dong, J

2013-01-01

This paper presents an experimental study, including evaluation and modification, on using dehydrated cement paste (DCP) as a new type of cement additive. After a series of processes, normal DCP (N-DCP) was produced as before and a modified form of DCP (M-DCP) was produced as well. The cementitious

Athletic Hip Injuries.

Science.gov (United States)

Lynch, T Sean; Bedi, Asheesh; Larson, Christopher M

2017-04-01

Historically, athletic hip injuries have garnered little attention; however, these injuries account for approximately 6% of all sports injuries and their prevalence is increasing. At times, the diagnosis and management of hip injuries can be challenging and elusive for the team physician. Hip injuries are seen in high-level athletes who participate in cutting and pivoting sports that require rapid acceleration and deceleration. Described previously as the "sports hip triad," these injuries consist of adductor strains, osteitis pubis, athletic pubalgia, or core muscle injury, often with underlying range-of-motion limitations secondary to femoroacetabular impingement. These disorders can happen in isolation but frequently occur in combination. To add to the diagnostic challenge, numerous intra-articular disorders and extra-articular soft-tissue restraints about the hip can serve as pain generators, in addition to referred pain from the lumbar spine, bowel, bladder, and reproductive organs. Athletic hip conditions can be debilitating and often require a timely diagnosis to provide appropriate intervention.

Barium aluminate cement: its application

International Nuclear Information System (INIS)

Drozdz, M.; Wolek, W.

1975-01-01

The technology of manufacturing barium aluminate cement from barium sulfate and alumina, using a rotary kiln for firing the clinker is described. The method of granulation of the homogenized charge was used. Conditions of using the ''to mud'' method in industry were indicated. The physical and chemical properties of barium aluminate cement are determined and the quality of several batches of cement prepared on a semi-industrial scale and their suitability for making highly refractory concretes are tested. The optimal composition of the concretes is determined as a function of the mixing water and barium aluminate cement contents. Several experimental batches of concretes were used in the linings of furnaces in the steel industry. The suitability of these cements for use in fields other than steelmaking is examined. It is established that calcium aluminate cement has certain limited applications [fr

Hip dysplasia: a significant risk factor for the development of hip osteoarthritis. A cross-sectional survey

DEFF Research Database (Denmark)

Jacobsen, Steffen; Sonne-Holm, Stig

2005-01-01

joint space width (JSW) /=60 yr of age. Of factors entered into logistic regression analyses, only age (P LT 0.001 for right hips and P LT 0.001 for left hips) and hip dysplasia (P LT 0.001 for right hips and P = 0.004 for left hips) were significantly associated with hip OA prevalence in women. In men......, only hip dysplasia was associated with hip OA prevalence, P LT 0.001 in right hips and P = 0.001 in left hips. CONCLUSIONS: Of the individual risk factors investigated in this study, only age and hip dysplasia were associated with the development of hip osteoarthritis.......OBJECTIVES: The aim of this cross-sectional survey of 2232 women and 1336 men (age range 20-91 yr) was to investigate individual risk factors for hip joint osteoarthritis (OA). METHODS: Standardized, weight-bearing pelvic radiographs were evaluated. Radiological hip joint OA was defined as minimum...

Comparative evaluation of marginal leakage of provisional crowns cemented with different temporary luting cements: In vitro study.

Science.gov (United States)

Arora, Sheen Juneja; Arora, Aman; Upadhyaya, Viram; Jain, Shilpi

2016-01-01

As, the longevity of provisional restorations is related to, a perfect adaptation and a strong, long-term union between restoration and teeth structures, therefore, evaluation of marginal leakage of provisional restorative materials luted with cements using the standardized procedures is essential. To compare the marginal leakage of the provisional crowns fabricated from Autopolymerizing acrylic resin crowns and bisphenol A-glycidyl dimethacrylate (BIS-GMA) resin crowns. To compare the marginal leakage of the provisional crowns fabricated from autopolymerizing acrylic resin crowns and BIS-GMA resin crowns cemented with different temporary luting cements. To compare the marginal leakage of the provisional crowns fabricated from autopolymerizing acrylic resin (SC-10) crowns cemented with different temporary luting cements. To compare the marginal leakage of the provisional crowns fabricated from BIS-GMA resin crowns (Protemp 4) cemented with different temporary luting cements. Freshly extracted 60 maxillary premolars of approximately similar dimensions were mounted in dental plaster. Tooth reduction with shoulder margin was planned to use a customized handpiece-holding jig. Provisional crowns were prepared using the wax pattern fabricated from computer aided designing/computer aided manufacturing milling machine following the tooth preparation. Sixty provisional crowns were made, thirty each of SC-10 and Protemp 4 and were then cemented with three different luting cements. Specimens were thermocycled, submerged in a 2% methylene blue solution, then sectioned and observed under a stereomicroscope for the evaluation of marginal microleakage. A five-level scale was used to score dye penetration in the tooth/cement interface and the results of this study was analyzed using the Chi-square test, Mann-Whitney U-test, Kruskal-Wallis H-test and the results were statistically significant P provisional crowns cemented with three different luting cements along the axial walls of

Analysis of hip perfusion at early and reversible stages of aseptic hip necrosis

International Nuclear Information System (INIS)

Predic, P.; Dodig, D.; Karner, I.

2002-01-01

Aim: A proper early diagnosis of aseptic hip necrosis is very important for further therapy.Since there has always been a question of the amount of perfusion in hips at different stages of aseptic hip necrosis we tried to impartially examine the perfusion in hips at early and reversible stages of aseptic hip necrosis. Material and Methods:Study included 143 patients with aseptic hip necrosis.The 550-740 MBq of Tc-99m-DPD were on bolus injected.All patients were subjected to 3-phase scintigraphy of hips and quantitative calculation of relative perfusion in the artery phase (3T) at early and repeated at reversible stages of aseptic hip necrosis. Results: At the early stage of aseptic hip necrosis the obtained 3T was decreased from 0.94-0.69 (3T=0.80).Scintigrams showed a moderate increase or diffuse accumulation. At the reversible stages we obtained 3T decreased from 0.92-0.71 (3T=0.79) thus evidencing hypoperfusion.Scintigrams showed an diffuse increased accumulation. Conclusion: With the aseptic hip necrosis quantitative analysis of perfusion in the artery phase-3T indicates that the perfusion is decreased at all stages of the process which however shows a significantly falling trend with the progress of the disease

Simplified cementation of lithium disilicate crowns: Retention with various adhesive resin cement combinations.

Science.gov (United States)

Johnson, Glen H; Lepe, Xavier; Patterson, Amanda; Schäfer, Oliver

2017-09-27

A composite resin cement and matching self-etch adhesive was developed to simplify the dependable retention of lithium disilicate crowns. The efficacy of this new system is unknown. The purpose of this in vitro study was to determine whether lithium disilicate crowns cemented with a new composite resin and adhesive system and 2 other popular systems provide clinically acceptable crown retention after long-term aging with monthly thermocycling. Extracted human molars were prepared with a flat occlusal surface, 20-degree convergence, and 4 mm axial length. The axio-occlusal line angle was slightly rounded. The preparation surface area was determined by optical scanning and the analysis of the standard tessellation language (STL) files. The specimens were distributed into 3 cement groups (n=12) to obtain equal mean surface areas. Lithium disilicate crowns (IPS e.max Press) were fabricated for each preparation, etched with 9.5% hydrofluoric acid for 15 seconds, and cleaned. Cement systems were RelyX Ultimate with Scotch Bond Universal (3M Dental Products); Monobond S, Multilink Automix with Multilink Primer A and B (Ivoclar Vivadent AG); and NX3 Nexus with OptiBond XTR (Kerr Corp). Each adhesive provided self-etching of the dentin. Before cementation, the prepared specimens were stored in 35°C water. A force of 196 N was used to cement the crowns, and the specimens were polymerized in a 35°C oven at 100% humidity. After 24 hours of storage at 100% humidity, the cemented crowns were thermocycled (5°C to 55°C) for 5000 cycles each month for 6 months. The crowns were removed axially at 0.5 mm/min. The removal force was recorded and the dislodgement stress calculated using the preparation surface area. The type of cement failure was recorded, and the data were analyzed by 1-way ANOVA and the chi-square test (α=.05) after the equality of variances had been assessed with the Levene test. The Levene test was nonsignificant (P=.936). The ANOVA revealed the mean removal

Analysis of CCRL proficiency cements 151 and 152 using the Virtual Cement and Concrete Testing Laboratory

International Nuclear Information System (INIS)

Bullard, Jeffrey W.; Stutzman, Paul E.

2006-01-01

To test the ability of the Virtual Cement and Concrete Testing Laboratory (VCCTL) software to predict cement hydration properties, characterization of mineralogy and phase distribution is necessary. Compositional and textural characteristics of Cement and Concrete Reference Laboratory (CCRL) cements 151 and 152 were determined via scanning electron microscopy (SEM) analysis followed by computer modeling of hydration properties. The general procedure to evaluate a cement is as follows: (1) two-dimensional SEM backscattered electron and X-ray microanalysis images of the cement are obtained, along with a measured particle size distribution (PSD); (2) based on analysis of these images and the measured PSD, three-dimensional microstructures of various water-to-cement ratios are created and hydrated using VCCTL, and (3) the model predictions for degree of hydration under saturated conditions, heat of hydration (ASTM C186), setting time (ASTM C191), and strength development of mortar cubes (ASTM C109) are compared to experimental measurements either performed at NIST or at the participating CCRL proficiency sample evaluation laboratories. For both cements, generally good agreement is observed between the model predictions and the experimental data

The Role of Hip Arthroscopy in Investigating and Managing the Painful Hip Resurfacing Arthroplasty.

Science.gov (United States)

Mei-Dan, Omer; Pascual-Garrido, Cecilia; Moreira, Brett; McConkey, Mark O; Young, David A

2016-03-01

To determine the safety and efficacy of hip arthroscopy performed in the peripheral compartment as a diagnostic and therapeutic treatment option for patients with hip pain after hip resurfacing surgery. Indications for hip arthroscopy after hip resurfacing included patients with a symptomatic hip-resurfaced arthroplasties who did not respond to nonoperative treatment. Patients who underwent a hip arthroscopy after a painful hip resurfacing were included with a minimum of 1 year follow-up. Subgroup analysis was performed according to whether an established diagnosis was made before arthroscopic intervention or not. Subjective measures were based on Western Ontario and McMaster Universities Arthritis Index (WOMAC) scores, and results were calculated and analyzed. We included 68 patients (26 male [38%] and 42 female [62%]) who underwent subsequent hip arthroscopy from a population of 978 consecutive hip-resurfaced arthroplasties performed between 1999 and 2010. The average age was 58 (range, 37 to 78 years). The mean follow-up after hip arthroscopy was 3.4 years (range, 12 months to 5.8 years). Patients who had an established diagnosis (n = 41) before hip arthroscopy showed statistical improvement in their WOMAC scores (7 to 2, P arthroscopy showed statistical worsening of the WOMAC (15 to 21, P = .002). Ten (37%) of these 27 patients without a diagnosis failed and needed to be converted to a THR. A significant correlation was found between the collections found on ultrasound (psoas bursa and/or in the hip joint) and the need for synovectomy (P = .01). The overall revision rate to THR after hip resurfacing in our group of patients was 1.3% (n = 13). Female patients were more likely to require postresurfacing hip arthroscopy with 42 (60%) female to only 26 (40%) male patients undergoing this procedure. In our study population, 70% (14/21, P arthroscopy. Hip arthroscopy is a safe surgical treatment option for those patients with a painful hip resurfacing

Comparative study on strength properties of cement mortar by partial replacement of cement with ceramic powder and silica fume

Science.gov (United States)

Himabindu, Ch.; Geethasri, Ch.; Hari, N.

2018-05-01

Cement mortar is a mixture of cement and sand. Usage of high amount of cement increases the consumption of natural resources and electric power. To overcome this problem we need to replace cement with some other material. Cement is replaced with many other materials like ceramic powder, silica fume, fly ash, granulated blast furnace slag, metakaolin etc.. In this research cement is replaced with ceramic powder and silica fume. Different combinations of ceramic powder and silica fume in cement were replaced. Cement mortar cubes of 1:3 grade were prepared. These cubes were cured under normal water for 7 days, 14days and 28 days. Compressive strength test was conducted for all mixes of cement mortar cubes.

Advanced cementation concepts

International Nuclear Information System (INIS)

Howard, C.G.

1989-10-01

The purpose of this programme of work was to investigate whether improvements could be made to existing formulations for cement suitable for the immobilization of intermediate level radioactive waste. Two additives were selected, microsilica and limestone flour. Improvements to the cement were only slight. (author)

Petroleum Sludge as gypsum replacement in cement plants: Its Impact on Cement Strength

Science.gov (United States)

Benlamoudi, Ali; Kadir, Aeslina Abdul; Khodja, Mohamed

2017-08-01

Due to high cost of cement manufacturing and the huge amount of resources exhaustion, companies are trying to incorporate alternative raw materials or by-products into cement production so as to produce alternative sustainable cement. Petroleum sludge is a dangerous waste that poses serious imparts on soil and groundwater. Given that this sludge contains a high percentage of anhydrite (CaSO4), which is the main component of gypsum (CaSO4.2H2O), it may play the same gypsum role in strength development. In this research, a total replacement of gypsum (100%) has been substituted by petroleum sludge in cement production and has led to an increase of 28.8% in UCS values after 28 curing days. Nevertheless, the burning of this waste has emitted a considerable amount of carbon monoxide (CO) gas that needs to be carefully considered prior to use petroleum sludge within cement plants.

Influence of Cement Particle-Size Distribution on Early Age Autogenous Strains and Stresses in Cement-Based Materials

DEFF Research Database (Denmark)

Bentz, Dale P.; Jensen, Ole Mejlhede; Hansen, Kurt Kielsgaard

2001-01-01

The influence of cement particle-size distribution on autogenous strains and stresses in cement pastes of identical water-to-cement ratios is examined for cement powders of four different finenesses. Experimental measurements include chemical shrinkage, to quantify degree of hydration; internal r...

Hip pain

Science.gov (United States)

... from a chair, walking, climbing stairs, and driving Hamstring strain Iliotibial band syndrome Hip flexor strain Hip ... and cool down afterward. Stretch your quadriceps and hamstrings. Avoid running straight down hills. Walk down instead. ...

Hip supporting device

DEFF Research Database (Denmark)

2011-01-01

The present invention relates to a device for limiting movements in one or more anatomical joints, such as a device for limiting movement in the human hip joint after hip replacement surgery. This is provided by a device for limiting movement in the human hip joint, said device comprising: at least...

Cements in radioactive waste management. Characterization requirements of cement products for acceptance and quality assurance purposes

International Nuclear Information System (INIS)

Rahman, A.A.; Glasser, F.P.

1987-01-01

Cementitious materials are used as immobilizing matrices for low (LLW) and medium-level wastes (MLW) and are also components of the construction materials in the secondary barriers and the repositories. This report has concerned itself with a critical assessment of the quality assurance aspects of the immobilization and disposal of MLW and LLW cemented wastes. This report has collated the existing knowledge of the use and potential of cementitious materials in radioactive waste immobilization and highlighted the physico-chemical parameters. Subject areas include an assessment of immobilization objectives and cement as a durable material, waste stream and matrix characterization, quality assurance concepts, nature of cement-based systems, chemistry and modelling of cement hydration, role and effect of blending agents, radwaste-cement interaction, assessment of durability, degradative and radiolytic processes in cements and the behaviour of cement-based matrices and their near-field interactions with the environment and the repository conditions

Cementation of liquid radioactive waste

International Nuclear Information System (INIS)

Efremenkov, V.

2004-01-01

The cementation methods for immobilisation of radioactive wastes are discussed in terms of methodology, chemistry and properties of the different types of cements as well as the worldwide experience in this field. Two facilities for cementation - DEWA and MOWA - are described in details

Achievement of 900kgf/cm[sup 2] super workable high strength concrete with belite portland cement. (elevator building of cement silo in Chichibu cement). Part 1. ; Development of cement for super workable high strength concrete. Ko belite kei cement de 900kgf/cm[sup 2] wo tassei (Chichibu cement cement sairo no elevaor to). 1. ; Koryudo kokyodo concrete yo no cement no kaihatsu

Energy Technology Data Exchange (ETDEWEB)

Tanaka, M.; Fukaya, Y.; Nawa, T. (Chichibu Cement Co. Ltd., Tokyo (Japan))

1993-08-01

This paper describes the features of high belite Portland cement which can make the super workable high strength concrete, and the properties of concrete using this. The super workable concrete is required an excellent segregation resistance property as well as high flow property. Since the high belite Portland cement contains a small amount of C[sub 3]S in the clinker, the amounts of C[sub 3]A and C[sub 4]AF can be reduced without hindering the calcination of clinker. Additionally, since it contains a large amount of C[sub 2]S with low heat of hydration, an increase in the temperature of members can be suppressed. 'Chichibu High Flow Cement' having characteristics of this high belite Portland cement was developed for the super workable high strength concrete. The concrete using the High Flow Cement exhibited the maximum flow value of 70cm. It also exhibited the strength of 1,075 kgf/cm[sup 2] at the age of 91 days, and 1,100 kgf/cm[sup 2] at the age of 14 days under insulating. 4 refs., 8 figs., 2 tabs.

Cementation process study

International Nuclear Information System (INIS)

Park, H.H.; Han, K.W.; Ahn, S.J.; Choi, K.S.; Lee, M.W.; Ryu, Y.K.

1985-01-01

In the cementation process study, in 1984, design of the waste treatment simulator was finished for the first step. We can experience not only the operation of solidification system but the design and construction of comming large scale plant through the design of cementation process. (Author)

Use of antibiotic-loaded cement in total knee arthroplasty.

Science.gov (United States)

Hinarejos, Pedro; Guirro, Pau; Puig-Verdie, Lluis; Torres-Claramunt, Raul; Leal-Blanquet, Joan; Sanchez-Soler, Juan; Monllau, Joan Carles

2015-12-18

Bone cement has the capacity to release antibiotic molecules if any antibiotic is included in it, and these elution properties are improved as cement porosity is increased. In vitro studies have shown high local antibiotic concentration for many hours or few days after its use. Antibiotic loaded bone cement (ALBC) is helpful when treating an infection in total knee arthroplasty (TKA) revision surgery. The purpose of this paper was to review the evidence for the routine use of ALBC in TKA in the literature, its pros and cons. Many authors have recommended the use of ALBC also in primary TKA for infection prophylaxis, but the evidence based on data from National Registries, randomized clinical trials and meta-analysis suggest a protective effect of ALBC against infection when used in hips, but not (or only mild) in knees. A possible explanation to this finding is that the duration and quantity of locally elevated antibiotic levels after surgery are smaller in TKA, due to the smaller amount of cement used for fixation in TKA-only a layer in the bone surface. There are some concerns about the routine use of ALBC in primary TKA as prophylaxis against infection: Firstly, there is a risk of hypersensivity or toxicity even when the chance is highly improbable. Secondly, there is a reduction in the mechanical properties of the cement, but this can be probably neglected if the antibiotic is used in low doses, not more than 1 g per 40 g cement package. Another significant concern is the increased economic cost, which could be overlooked if there were enough savings in treating fewer prosthetic infections. Finally, there is also a risk of selection of antibiotic-resistant strains of bacteria and this could be the main concern. If used, the choice of the antibiotic mixed in ALBC should consider microbiological aspects (broad antimicrobial spectrum and low rate of resistant bacteria), physical and chemical aspects (thermal stability, high water solubility), pharmacological

Don't forget the hip! Hip arthritis masquerading as knee pain

Directory of Open Access Journals (Sweden)

Florian F. Dibra, MD

2018-03-01

Full Text Available Background: Hip osteoarthritis typically manifests with groin or thigh pain. Other atypical pain patterns, including knee pain, have been described. Except for 2 case reports, there is no literature on this subject. Methods: From our institutional database, between 2011 and 2016, we identified 21 patients who were referred for treatment of knee pain but ultimately diagnosed with hip pathology as the cause of their pain. This group was evaluated for duration of symptoms prior to diagnosis, previous interventions, presence of walking aids, and symptom resolution after treatment of the hip pathology. Results: Fifteen of the 21 patients were referred from musculoskeletal providers (12 from orthopaedic surgeons. Prior to diagnosis of the hip etiology, 16 patients were reduced to major assistive devices including wheelchairs. Twelve of 21 patients had undergone surgical knee interventions, including total knee arthroplasty, with minimal to no relief of their pain. Seventeen of 21 referred patients underwent total hip arthroplasty at our institution. Fourteen patients had complete resolution of knee pain after total hip arthroplasty. Conclusions: Although knee pain referred from hip disease may be considered a basic and common knowledge, it continues to be an overlooked phenomenon. Most of the cases were misdiagnosed by musculoskeletal providers including orthopaedic surgeons and this highlights the need for continued education and awareness of this clinical scenario. Keywords: Hip pain, Knee pain, Referred pain, Delay in diagnosis, Unnecessary surgery

Compressive Strength and Physical Properties Behavior of Cement Mortars with addition of Cement Klin Dust

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Auday A Mehatlaf

2017-12-01

Full Text Available Cement Klin Dust (CKD was the waste of almost cement industry factories, so that in this paper utilization of CKD as filler in cement and/or concrete was the main objective. CKD from the Karbala cement factory had been used and analysis to know the chemical composition of the oxides was done. In this paper cement mortars with different weight percentages of CKD (0,5,10,20,30,40 had been prepared. Physical properties such as density and porosity were done in different age curing (3, 7, 28 day. In addition, mechanical properties included the coefficient of thermal conductivity and compressive strength had also observed with different age (3,7, and 28 for all prepared specimens. From the obtained the experimental results and their discussion, it was clear that the addition (20% of CKD had the good results in cement mortars.  

Exercise therapy may postpone total hip replacement surgery in patients with hip osteoarthritis

DEFF Research Database (Denmark)

Svege, Ida; Nordsletten, Lars; Fernandes, Linda

2015-01-01

Exercise treatment is recommended for all patients with hip osteoarthritis (OA), but its effect on the long-term need for total hip replacement (THR) is unknown.......Exercise treatment is recommended for all patients with hip osteoarthritis (OA), but its effect on the long-term need for total hip replacement (THR) is unknown....

Cement Mason's Curriculum. Instructional Units.

Science.gov (United States)

Hendirx, Laborn J.; Patton, Bob

To assist cement mason instructors in providing comprehensive instruction to their students, this curriculum guide treats both the skills and information necessary for cement masons in commercial and industrial construction. Ten sections are included, as follow: related information, covering orientation, safety, the history of cement, and applying…

21 CFR 888.4200 - Cement dispenser.

Science.gov (United States)

2010-04-01

... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Cement dispenser. 888.4200 Section 888.4200 Food... DEVICES ORTHOPEDIC DEVICES Surgical Devices § 888.4200 Cement dispenser. (a) Identification. A cement dispenser is a nonpowered syringe-like device intended for use in placing bone cement (§ 888.3027) into...

[Efficacy analysis on hip replacement for hip-joint diseases with Parkinson disease].

Science.gov (United States)

Sun, Qi-Cai; Ru, Xuan-Liang; Xia, Yan-Fei; Liu, Xiao-Li; Song, Bai-Shan; Qiao, Song; Yan, Shi-Gui; Wang, Xiang-Hua

2017-12-25

To explore clinical efficacy of hip replacement for hip-joint diseases with Parkinson disease. From December 2011 to December 2016, 18 patients with hip-joint diseases with Parkinson disease treated by hip replacement, including 8 males and 10 females aged from 59 to 87 years old with an average of 71 years old. Among them, 3 cases were developmental dysplasia of hip, 3 cases were femoral head necrosis and 12 cases were femoral neck fracture. All patients manifested with obvious pain and limitation of stepping ability. Postoperative complications were observed and Harris score were used to compare hip joint function after operation. The incision were healed well, and pain were alleviated or disappeared, and hip joint function were improved. Eighteen patients were followed up from 1 to 3 years with an average of 2.3 years. At the latest follow up, 14 cases recovered freedom-walk, 2 cases could walk with walking stick, 1 case could walk with walking aid and 1 case was died. Among 18 patients, 2 cases were occurred dislocation, and 1 case were died for cardiac disease at 3 months after operation. Four patients were occurred slight pain. There were significant differences in Harris scores among preoperative (41.7±1.4), 6 months after operation(80.1±5.4) and the final follow-up (83.4±2.1), and 10 cases got excellent result, 4 good, 1 fair and 2 poor. Application of hip replacement for hip-joint diseases with Parkinson disease is a safe and effective clinical therapy, and has advantages of less complications and rapid recovery of hip joint function.

Development of cement material using inorganic additives

International Nuclear Information System (INIS)

Toyohara, Masumitsu; Satou, Tatsuaki; Wada, Mikio; Ishii, Tomoharu; Matsuo, Kazuaki.

1997-01-01

Inorganic admixtures to enhance the fluidity of cement material was developed. These admixtures turned into easy to immobilize the miscellaneous radioactive waste using cement material. It was found that the ζ potential of cement particles was directly proportional to the content of the inorganic admixtures in cement paste and the particles of cement were dispersed at the high ζ potential. The condensed sodium phosphate, which was the main component of the inorganic admixtures, retarded the dissolution of Ca 2+ ion from the cement, and generated the colloids by incorporating dissolved Ca 2+ ion. The cement material containing the inorganic admixtures was found to have the same mechanical strength and adsorption potential of radionuclides in comparison to normal cement materials. It was confirmed that the cement material containing the inorganic admixture was effectively filled gaps of miscellaneous radioactive waste. (author)

HIPs at Ten

Science.gov (United States)

Kuh, George; O'Donnell, Ken; Schneider, Carol Geary

2017-01-01

2017 is the anniversary of the introduction of what are now commonly known as high-impact practices (HIPs). Many of the specific activities pursued under the HIPs acronym have been around in some form for decades, such as study abroad, internships, and student-faculty research. It was about ten years ago that, after conferring HIPs at Ten with…

Cement Types, Composition, Uses and Advantages of Nanocement, Environmental Impact on Cement Production, and Possible Solutions

Directory of Open Access Journals (Sweden)

S. P. Dunuweera

2018-01-01

Full Text Available We first discuss cement production and special nomenclature used by cement industrialists in expressing the composition of their cement products. We reveal different types of cement products, their compositions, properties, and typical uses. Wherever possible, we tend to give reasons as to why a particular cement type is more suitable for a given purpose than other types. Cement manufacturing processes are associated with emissions of large quantities of greenhouse gases and environmental pollutants. We give below quantitative and qualitative analyses of environmental impact of cement manufacturing. Controlling pollution is a mandatory legal and social requirement pertinent to any industry. As cement industry is one of the biggest CO2 emitters, it is appropriate to discuss different ways and means of CO2 capture, which will be done next. Finally, we give an account of production of nanocement and advantages associated with nanocement. Nanofillers such as nanotitania, nanosilica, and nanoalumina can be produced in large industrial scale via top-down approach of reducing size of naturally available bulk raw materials to those in the nanorange of 1 nm–100 nm. We mention the preparation of nanotitania and nanosilica from Sri Lankan mineral sands and quartz deposits, respectively, for the use as additives in cement products to improve performance and reduce the amount and cost of cement production and consequent environmental impacts. As of now, mineral sands and other treasures of minerals are exported without much value addition. Simple chemical modifications or physical treatments would add enormous value to these natural materials. Sri Lanka is gifted with highly pure quartz and graphite from which silica and graphite nanoparticles, respectively, can be prepared by simple size reduction processes. These can be used as additives in cements. Separation of constituents of mineral sands is already an ongoing process.

Review of fixation techniques for the four-part fractured proximal humerus in hemiarthroplasty

Directory of Open Access Journals (Sweden)

Lorenzetti Silvio

2011-07-01

Full Text Available Abstract Introduction The clinical outcome of hemiarthroplasty for proximal humeral fractures is not satisfactory. Secondary fragment dislocation may prevent bone integration; the primary stability by a fixation technique is therefore needed to accomplish tuberosity healing. Present technical comparison of surgical fixation techniques reveals the state-of-the-art approach and highlights promising techniques for enhanced stability. Method A classification of available fixation techniques for three- and four part fractures was done. The placement of sutures and cables was described on the basis of anatomical landmarks such as the rotator cuff tendon insertions, the bicipital groove and the surgical neck. Groups with similar properties were categorized. Results Materials used for fragment fixation include heavy braided sutures and/or metallic cables, which are passed through drilling holes in the bone fragments. The classification resulted in four distinct groups: A: both tuberosities and shaft are fixed together by one suture, B: single tuberosities are independently connected to the shaft and among each other, C: metallic cables are used in addition to the sutures and D: the fragments are connected by short stitches, close to the fragment borderlines. Conclusions A plurality of techniques for the reconstruction of a fractured proximal humerus is found. The categorisation into similar strategies provides a broad overview of present techniques and supports a further development of optimized techniques. Prospective studies are necessary to correlate the technique with the clinical outcome.

Effects of the super plasticizers and the water/cement ratio on the mini-slump of Portland cement pastes

International Nuclear Information System (INIS)

Meirelles, J.R.; Morelli, A.C.; Baldo, J.B.

1998-01-01

The rheology of Portland cement concrete is dominated by the cement paste rheology. In general the rheological behavior of cement pastes is evaluated by means of the mini-slump test. In the present paper it was investigated the effect of the water/cement ratio was as of two types of superplasticizers (melamine and naftalen based) on the mini-slump of pastes of common cement pastes. (author)

Influence of Temporary Cements on the Bond Strength of Self-Adhesive Cement to the Metal Coronal Substrate.

Science.gov (United States)

Peixoto, Raniel Fernandes; De Aguiar, Caio Rocha; Jacob, Eduardo Santana; Macedo, Ana Paula; De Mattos, Maria da Gloria Chiarello; Antunes, Rossana Pereira de Almeida

2015-01-01

This research evaluated the influence of temporary cements (eugenol-containing [EC] or eugenol-free [EF]) on the tensile strength of Ni-Cr copings fixed with self-adhesive resin cement to the metal coronal substrate. Thirty-six temporary crowns were divided into 4 groups (n=9) according to the temporary cements: Provy, Dentsply (eugenol-containing), Temp Cem, Vigodent (eugenol-containing), RelyX Temp NE, 3M ESPE (eugenol-free) and Temp Bond NE, Kerr Corp (eugenol-free). After 24 h of temporary cementation, tensile strength tests were performed in a universal testing machine at a crosshead speed of 0.5 mm/min and 1 kN (100 kgf) load cell. Afterwards, the cast metal cores were cleaned by scraping with curettes and air jet. Thirty-six Ni-Cr copings were cemented to the cast metal cores with self-adhesive resin cement (RelyX U200, 3M ESPE). Tensile strength tests were performed again. In the temporary cementation, Temp Bond NE (12.91 ± 2.54) and Temp Cem (12.22 ± 2.96) presented the highest values of tensile strength and were statistically similar to each other (p>0.05). Statistically significant difference (pcementation of Ni-Cr copings with self-adhesive resin cement. In addition, Temp Cem (120.68 ± 48.27) and RelyX Temp NE (103.04 ± 26.09) showed intermediate tensile strength values. In conclusion, the Provy eugenol-containing temporary cement was associated with the highest bond strength among the resin cements when Ni-Cr copings were cemented to cast metal cores. However, the eugenol cannot be considered a determining factor in increased bond strength, since the other tested cements (1 eugenol-containing and 2 eugenol-free) were similar.

Invariant hip moment pattern while walking with a robotic hip exoskeleton.

Science.gov (United States)

Lewis, Cara L; Ferris, Daniel P

2011-03-15

Robotic lower limb exoskeletons hold significant potential for gait assistance and rehabilitation; however, we have a limited understanding of how people adapt to walking with robotic devices. The purpose of this study was to test the hypothesis that people reduce net muscle moments about their joints when robotic assistance is provided. This reduction in muscle moment results in a total joint moment (muscle plus exoskeleton) that is the same as the moment without the robotic assistance despite potential differences in joint angles. To test this hypothesis, eight healthy subjects trained with the robotic hip exoskeleton while walking on a force-measuring treadmill. The exoskeleton provided hip flexion assistance from approximately 33% to 53% of the gait cycle. We calculated the root mean squared difference (RMSD) between the average of data from the last 15 min of the powered condition and the unpowered condition. After completing three 30-min training sessions, the hip exoskeleton provided 27% of the total peak hip flexion moment during gait. Despite this substantial contribution from the exoskeleton, subjects walked with a total hip moment pattern (muscle plus exoskeleton) that was almost identical and more similar to the unpowered condition than the hip angle pattern (hip moment RMSD 0.027, angle RMSD 0.134, p<0.001). The angle and moment RMSD were not different for the knee and ankle joints. These findings support the concept that people adopt walking patterns with similar joint moment patterns despite differences in hip joint angles for a given walking speed. Copyright © 2011 Elsevier Ltd. All rights reserved.

Rietveld analysis, powder diffraction and cement

International Nuclear Information System (INIS)

Peterson, V.

2002-01-01

Full text: Phase quantification of cement is essential in its industrial use, however many methods are inaccurate and/or time consuming. Powder diffraction is one of the more accurate techniques used for quantitative phase analysis of cement. There has been an increase in the use of Rietveld refinement and powder diffraction for the analysis and phase quantification of cement and its components in recent years. The complex nature of cement components, existence of solid solutions, polymorphic variation of phases and overlapping phase peaks in diffraction patterns makes phase quantification of cements by powder diffraction difficult. The main phase in cement is alite, a solid solution of tricalcium silicate. Tricalcium silicate has been found to exist in seven modifications in three crystal systems, including triclinic, monoclinic, and rhombohedral structures. Hence, phase quantification of cements using Rietveld methods usually involves the simultaneous modelling of several tricalcium silicate structures to fit the complex alite phase. An industry ordinary Portland cement, industry and standard clinker, and a synthetic tricalcium silicate were characterised using neutron, laboratory x-ray and synchrotron powder diffraction. Diffraction patterns were analysed using full-profile Rietveld refinement. This enabled comparison of x-ray, neutron and synchrotron data for phase quantification of the cement and examination of the tricalcium silicate. Excellent Rietveld fits were achieved, however the results showed that the quantitative phase analysis results differed for some phases in the same clinker sample between various data sources. This presentation will give a short introduction about cement components including polymorphism, followed by the presentation of some problems in phase quantification of cements and the role of Rietveld refinement in solving these problems. Copyright (2002) Australian X-ray Analytical Association Inc

76 FR 50252 - Gray Portland Cement and Cement Clinker From Japan; Scheduling of an Expedited Five-Year Review...

Science.gov (United States)

2011-08-12

... INTERNATIONAL TRADE COMMISSION [Investigation No. 731-TA-461 (Third Review)] Gray Portland Cement and Cement Clinker From Japan; Scheduling of an Expedited Five-Year Review Concerning the Antidumping Duty Order on Gray Portland Cement and Cement Clinker From Japan AGENCY: United States International...

Clinical Evaluation of Fused/Ankylosed Hip with Severe Flexion Deformity after Conversion to Total Hip Arthroplasty

Directory of Open Access Journals (Sweden)

Saroj Kumar Suwal

2016-06-01

Conclusions: THA is an effective treatment for ankylosed hip with severe flexion deformity although complications are noted more than routine hip arthroplasties. Keywords: ankylosed hip; fused hip; severe flexion deformity; total hip arthroplasty. | PubMed

Hip morphology predicts posterior hip impingement in a cadaveric model.

Science.gov (United States)

Morris, William Z; Fowers, Cody A; Weinberg, Douglas S; Millis, Michael B; Tu, Leigh-Anne; Liu, Raymond W

2018-05-01

Posterior hip impingement is a recently-identified cause of hip pain. The purpose of this study is to characterise posterior femoroacetabular and ischiofemoral impingement and identify its predisposing morphologic traits. Two hundred and six cadaveric hips were randomly selected and taken through controlled motion in two pure axes associated with posterior hip impingement: external rotation (through the mechanical axis) and adduction (coronal plane). The range of motion and location of impingement was noted for each specimen. Morphologic traits including femoral/acetabular version, and true neck-shaft angle (TNSA) were also measured. External rotation impingement occurred between the femoral neck and acetabulum in 83.0% of hips, and between the lesser trochanter and ischial tuberosity in 17.0%. Adduction impingement occurred between the lesser trochanter and ischial tuberosity in 78.6% of hips, and between the femoral neck and acetabulum in 21.4%. Multiple regression revealed that increased femoral/acetabular version predicted earlier external rotation and adduction impingement. Unstandardised betas ranging from -0.39 to -0.64 reflect that each degree of increased femoral/acetabular version individually accounts for a loss of external rotation or adduction of approximately half a degree before impingement ( p < 0.001 for each). Increased TNSA was associated with earlier adduction impingement only (unstandardised beta -0.35, p = 0.005). Relative femoral/acetabular anteversion was associated with earlier posterior hip impingement. Coxa valga was associated with earlier adduction impingement, but protective against external rotation impingement. These findings highlight the importance of monitoring correction during femoral/acetabular osteotomies, as overcorrection of retroversion may predispose to earlier posterior impingement.

Influence of hip dysplasia on the development of osteoarthritis of the hip

NARCIS (Netherlands)

A.M. Lievense (Annet); S.M. Bierma-Zeinstra (Sita); A.P. Verhagen (Arianne); J.A.N. Verhaar (Jan); B.W. Koes (Bart)

2004-01-01

textabstractBackground: It has been suggested that in some patients with primary hip osteoarthritis (OA), the disease occurs as a consequence of acetabular dysplasia or hip dysplasia (HD). Objective: To carry out a systematic review to investigate the association between acetabular dysplasia and hip

A Study on the Manufacturing Properties of Crack Self-Healing Capsules Using Cement Powder for Addition to Cement Composites

OpenAIRE

Choi, Yun-Wang; Oh, Sung-Rok; Choi, Byung-Keol

2017-01-01

We fabricated crack self-healing capsules using cement powder for mixing into cement composites and evaluated the properties of the capsule manufacturing process in this study. The manufacture of the self-healing capsules is divided into core production processing of granulating cement in powder form and a coating process for creating a wall on the surfaces of the granulated cement particles. The produced capsules contain unhardened cement and can be mixed directly with the cement composite m...

Cement replacement materials. Properties, durability, sustainability

International Nuclear Information System (INIS)

Ramezanianpour, Ali Akbar

2014-01-01

The aim of this book is to present the latest findings in the properties and application of Supplementary Cementing Materials and blended cements currently used in the world in concrete. Sustainability is an important issue all over the world. Carbon dioxide emission has been a serious problem in the world due to the greenhouse effect. Today many countries agreed to reduce the emission of CO2. Many phases of cement and concrete technology can affect sustainability. Cement and concrete industry is responsible for the production of 7% carbon dioxide of the total world CO2 emission. The use of supplementary cementing materials (SCM), design of concrete mixtures with optimum content of cement and enhancement of concrete durability are the main issues towards sustainability in concrete industry.

Characterization of monolith block of spent resin cementation

International Nuclear Information System (INIS)

Prayitno; Endro-Kismolo; Isman MT

1996-01-01

Spent resin immobilization process with cement was done to prevent release of radionuclide in the ultimate storage or disposal. The varied Composition of water/cement ratio in the cementation process were 0.3; 0.4; 0.5 and the various weight of resin waste are 25 g, 37.5 g and 50 gram. The compressive strength of the various water/cement ratio without spent resin was bigger than 0.3. This investigation proved that the compressive strength of Tiga Roda cement was bigger than those of Gresik cement or Nusantara cement. The compressive of the cement block of were the spent resin cementation was influenced by the water/cement ratio and the total spent resin addition. The best condition reached at the water/cement ratio of 0.3 and 25 gram spent resin, was compressive strength of 17.86 N/mm 2 . Leaching rate of the various weight composition of spent resin cementation for 91 days were between 10 -2 - 10 -4 gram.cm -2 .day -1

A Study on the Manufacturing Properties of Crack Self-Healing Capsules Using Cement Powder for Addition to Cement Composites

Directory of Open Access Journals (Sweden)

Yun-Wang Choi

2017-01-01

Full Text Available We fabricated crack self-healing capsules using cement powder for mixing into cement composites and evaluated the properties of the capsule manufacturing process in this study. The manufacture of the self-healing capsules is divided into core production processing of granulating cement in powder form and a coating process for creating a wall on the surfaces of the granulated cement particles. The produced capsules contain unhardened cement and can be mixed directly with the cement composite materials because they are protected from moisture by the wall material. Therefore, the untreated cement is present in the form of a capsule within the cement composite, and hydration can be induced by moisture penetrating the crack surface in the event of cracking. In the process of granulating the cement, it is important to obtain a suitable consistency through the kneading agent and to maintain the moisture barrier performance of the wall material. We can utilize the results of this study as a basis for advanced self-healing capsule technology for cement composites.

Effect of modified cementation technique on marginal fit and apical spread of excess cement for implant restorations: An in vitro study

Directory of Open Access Journals (Sweden)

Brijesh Patel

2016-01-01

Full Text Available Aim: To investigate and compare the vertical marginal discrepancy and spread of excess cement after cementation with modified cementation technique and conventional technique. Materials and Methods: Ten implant analogs with prefabricated standard abutments of similar dimensions were mounted individually in self-cure acrylic blocks subcrestally. Forty ideal metal coping specimens were prepared by conventional lost wax technique. Measurement of the marginal discrepancy at the implant-crown interface was done using a stereomicroscope before cementation. Abutment replicas (ARs were prepared for twenty specimens using cast copings and pattern resin. All forty copings were cemented according to the following cementation techniques and cement types, with ten specimens in each group. (1 Group 1: Half filling (HF cementation technique using provisional cement. (2 Group 2: HF cementation technique using permanent cement. (3 Group 3: AR technique using provisional cement. (4 Group 4: AR technique using permanent cement. Specimens were subjected to measurement of marginal discrepancy and spread of excess cement using stereomicroscope after cementation procedure. Data were analyzed using paired t-test and unpaired t-test. Results: AR technique showed significantly less marginal discrepancy (P = 0.000 and apical spread of excess cement (P = 0.002 than conventional HF technique. Provisional cement showed significantly more marginal discrepancy (HF-P = 0.000 and AR-P = 0.001 and less apical spread of excess cement (HF-P = 0.023 and AR-P = 0.002 and among both technique. Statistical Analysis: Unpaired t-test. Conclusion: An alternative technique of using AR is effective technique to prevent peri-implant diseases.

A cement based syntactic foam

International Nuclear Information System (INIS)

Li Guoqiang; Muthyala, Venkata D.

2008-01-01

In this study, a cement based syntactic foam core was proposed and experimentally investigated for composite sandwich structures. This was a multi-phase composite material with microballoon dispersed in a rubber latex toughened cement paste matrix. A trace amount of microfiber was also incorporated to increase the number of mechanisms for energy absorption and a small amount of nanoclay was added to improve the crystal structure of the hydrates. Three groups of cement based syntactic foams with varying cement content were investigated. A fourth group of specimens containing pure cement paste were also prepared as control. Each group contained 24 beam specimens. The total number of beam specimens was 96. The dimension of each beam was 30.5 cm x 5.1 cm x 1.5 cm. Twelve foam specimens from each group were wrapped with plain woven 7715 style glass fabric reinforced epoxy to prepare sandwich beams. Twelve cubic foam specimens, three from each group, with a side length of 5.1 cm, were also prepared. Three types of testing, low velocity impact test and four-point bending test on the beam specimens and compression test on the cubic specimens, were conducted to evaluate the impact energy dissipation, stress-strain behavior, and residual strength. Scanning electron microscope (SEM) was also used to examine the energy dissipation mechanisms in the micro-length scale. It was found that the cement based syntactic foam has a higher capacity for dissipating impact energy with an insignificant reduction in strength as compared to the control cement paste core. When compared to a polymer based foam core having similar compositions, it was found that the cement based foam has a comparable energy dissipation capacity. The developed cement based syntactic foam would be a viable alternative for core materials in impact-tolerant composite sandwich structures

Comparison of acetabular reamings during hip resurfacing versus uncemented total hip arthroplasty.

LENUS (Irish Health Repository)

Brennan, S A

2009-04-01

PURPOSE: To compare the quantity of bone removed from the acetabulum during resurfacing hip arthroplasty versus uncemented total hip arthroplasty (THA). METHODS: 62 consecutive patients with osteoarthritis of the hip were prospectively studied. 24 men and 7 women aged 40 to 86 (mean, 59) years underwent Birmingham hip resurfacing. 13 men and 18 women aged 34 to 88 (mean, 61) years underwent uncemented THA using the trident acetabular cup. Obese elderly women at risk of femoral neck fracture and patients with large subchondral pseudocysts or a history of avascular necrosis of the femoral head were assigned to uncemented THA. Acetabular reamings were collected; marginal osteophytes were not included. The reamings were dehydrated, defatted, and weighed. RESULTS: The mean weight of acetabular reamings was not significantly different between patients undergoing hip resurfacing and uncemented THA (p=0.57). CONCLUSION: In hip resurfacing, the use of an appropriately small femoral component avoids oversizing the acetabular component and removal of excessive bone stock.

Radioactivity of bone cement

International Nuclear Information System (INIS)

Scherer, M.A.; Winkler, R.; Ascherl, R.; Lenz, E.

1993-01-01

A total of 14 samples of different types of bone cement from five different manufacturers were examined for their radioactivity. Each of the investigated bone cements showed a low radioactivity level, i.e. between [de

Production of portland cement using Moroccan oil shale and comparative study between conventional cement plant and cement plant using oil shale

International Nuclear Information System (INIS)

Doumbouya, M.; Kacemi, K.E.; Kitane, S.

2012-01-01

Like the use of coal ash from power plants as an addition to cement, oil shale are used for cement production on an industrial scale in Estonia, China, USA and Germany. Oil shale can be utilized in manufacturing the cement. In addition to the utilization of these by-products after combustion, it can also reduce the required temperature for the clinkering reactions during the production of Portland clinker. We performed a study on the Moroccan oil shale to maximize the use of oil shale ash in the manufacturing of Portland cement. We found that Moroccan oil shale ash can be used up to 30% with 70% Portland clinker without altering its principle properties. The corresponding temperature required to generate the required liquid for the clinkering reactions as well as the essential ingredients for clinker was found to be around 850 to 1000 deg. C. The operating temperatures for this optimized blend ratio were found to 1000 deg. C. The resulting Portland clinker from this ratio will need further testing in accordance with international standards for Portland cement to examine properties like strength and setting time. (author)

Reducing cement's CO2 footprint

Science.gov (United States)

van Oss, Hendrik G.

2011-01-01

The manufacturing process for Portland cement causes high levels of greenhouse gas emissions. However, environmental impacts can be reduced by using more energy-efficient kilns and replacing fossil energy with alternative fuels. Although carbon capture and new cements with less CO2 emission are still in the experimental phase, all these innovations can help develop a cleaner cement industry.

Through BHA (Bottom Hole Assembly) cementing with proprietary cementing technology

Energy Technology Data Exchange (ETDEWEB)

Fanguy, Charles ' Joey' ; Mueller, Dan T. [BJ Services Company, Houston, TX (United States); Garrett, J.C. [Palm Energy Partners, LLC, Metairie, LA (United States)

2004-07-01

There are many problems that can arise when drilling into sub-normally pressured or naturally fractured zones. Lost circulation is one problem that is commonly encountered while drilling oil and gas wells. Lost circulation can lead to increased costs associated with drilling due to rig time, spreadsheet costs, and expensive mud system losses. Cement is one of the most effective treatment options, although it is not normally considered the first option because most operators are forced to trip out of the wellbore and utilize a squeeze packer. This is not always a viable option because of potential well control issues associated with the hydrostatic pressure reduction due to the losses of the whole mud. One treatment option that is commonly overlooked is pumping cement slurries through the bottom hole assembly and drill bit. This is generally not attempted for a variety of reasons. These reasons include: I Concern about 'squeezing off' of the cement in the bit II Lack of potential quality control associated with mixing 'on the fly' III Lack of the ability to test the actual mixed slurry samples The use of a pre-mixed, storable cement slurry has eliminated the concerns associated with pumping cement slurries through mud motors, MWD tools, BHA's, and drill bits. This advanced cement technology has been successfully utilized while reducing the risks associated with these lost circulation treatments. In addition, this technology has eliminated the costs associated with using a squeeze packer and the rig time required for several trips out of the wellbore. The paper will describe the premixed slurry properties and QA/QC procedures that are required for successful through the bit operations. This paper will also provide case histories of successful through the bit operation, as well as background information leading to the treatments. The case histories include successful through the bit remediation of severe lost circulation zones and as well the

Hip dislocations after 2,734 elective unilateral fast-track total hip arthroplasties

DEFF Research Database (Denmark)

Jørgensen, Christoffer Calov; Kjærsgaard-Andersen, Per; Kehlet, Henrik

2014-01-01

STUDY DESIGN: Retrospective review of prospectively collected data. OBJECTIVE: To investigate the incidence of hip dislocation 90 days after total hip arthroplasty in relation to time after surgery, mechanism of dislocation and predisposing factors. METHODS: Prospective data on preoperative patient.......31-3.40)] but not hospital stay of hip...

Cementation of the solid radioactive waste with polymer-cement solutions using the method of impregnation

International Nuclear Information System (INIS)

Gorbunova, O.

2015-01-01

Cementation of solid radioactive waste (SRW), i.e. inclusion of solid radioactive waste into cement matrix without cavities - is one of the main technological processes used for conditioning low and intermediate level radioactive waste. At FSUE 'Radon' the industrialized method of impregnation has been developed and since 2003 has been using for cementation of solid radioactive waste. The technology is that the polymer-cement solution, having high penetrating properties, is supplied under pressure through a tube to the bottom of the container in which solid radioactive waste has preliminarily been placed. The polymer-cement solution is evenly moving upwards through the channels between the particles of solid radioactive waste, fills the voids in the bulk volume of the waste and hardens, forming a cement compound, the amount of which is equal to the original volume. The aim of the investigation was a selection of a cement solution suitable for SRW impregnation (including fine particles) without solution depletion and bottom layers stuffing. It has been chosen a polymer: PHMG (polyhexamethylene-guanidine), which is a stabilizing and water-retaining component of the cement solution. The experiments confirm that the polymer increases the permeability of the cement solution by a 2-2.5 factor, the viscosity by a 1.2 factor, the stability of the consistency by a 1.5-1.7 factor, and extends the operating range of the W/C ratio to 0.5-1.1. So it is possible to penetrate a volume of SRW bigger by a 1.5-2.0 factor. It has been proved, that PHMG polymer increases strength and frost-resistance of the final compounds by a 1.8-2.7 factor, and contributes to fast strength development at the beginning of hardening and it decreases Cs-137 leashing rate by a 1.5-2 factor

Comparison of modified sulfur cement and hydraulic cement for encapsulation of radioactive and mixed wastes

International Nuclear Information System (INIS)

Kalb, P.D.; Heiser, J.H. III; Colombo, P.

1990-01-01

The majority of solidification/stabilization systems for low-level radioactive waste (LLW) and mixed waste, both in the commercial sector and at Department of Energy (DOE) facilities, utilize hydraulic cement (such as portland cement) to encapsulate waste materials and yield a monolithic solid waste form for disposal. Because hydraulic cement requires a chemical hydration reaction for setting and hardening, it is subject to potential interactions between elements in the waste and binder that can retard or prevent solidification. A new and innovative process utilizing modified sulfur cement developed by the US Bureau of Mines has been applied at Brookhaven National Laboratory (BNL) for the encapsulation of many of these problem wastes. Modified sulfur cement is a thermoplastic material, and as such, it can be heated above its melting point, combined with dry waste products to form a homogeneous mixture, and cooled to form a monolithic solid product. Under sponsorship of the DOE, research and development efforts at BNL have successfully applied the modified sulfur cement process for treatment of a range of LLWs including sodium sulfate salts, boric acid salts, and incinerator bottom ash and for mixed waste contaminated incinerator fly ash. Process development studies were conducted to determine optimal waste loadings for each waste type. Property evaluation studies were conducted to test waste form behavior under disposal conditions by applying relevant performance testing criteria established by the Nuclear Regulatory Commission (for LLW) and the Environmental Protection Agency (for hazardous wastes). Based on both processing and performance considerations, significantly greater waste loadings were achieved using modified sulfur cement when compared with hydraulic cement. Technology demonstration of the modified sulfur cement encapsulation system using production-scale equipment is scheduled for FY 1991

Hip ultrasound

Energy Technology Data Exchange (ETDEWEB)

Martinoli, Carlo, E-mail: carlo.martinoli@libero.it [Radiologia, DISC, Università di Genova, Largo Rosanna Benzi 8, I-16132 Genoa (Italy); Garello, Isabella; Marchetti, Alessandra; Palmieri, Federigo; Altafini, Luisa [Radiologia, DISC, Università di Genova, Largo Rosanna Benzi 8, I-16132 Genoa (Italy); Valle, Maura [Radiologia, Gaslini Children Hospital, Genova (Italy); Tagliafico, Alberto [Radiologia, National Institute for Cancer Research, Genoa (Italy)

2012-12-15

In newborns, US has an established role in the detection and management of developmental dysplasia of the hip. Later in childhood, when the limping child is a major diagnostic dilemma, US is extremely helpful in the identification of the varied disease processes underlying this condition, as transient synovitis, septic arthritis, Perthes disease and slipped femoral capital epiphysis. In adolescent practicing sporting activities, US is an excellent means to identify apophyseal injures about the pelvic ring, especially when avulsions are undisplaced and difficult-to-see radiographically. Later on, in the adulthood, US is an effective modality to diagnose tendon and muscle injuries about the hip and pelvis, identify effusion or synovitis within the hip joint or its adjacent bursae and guide the treatment of these findings. The aim of this article is to provide a comprehensive review of the most common pathologic conditions about the hip, in which the contribution of US is relevant for the diagnostic work-up.

Hip Injuries and Disorders

Science.gov (United States)

Your hip is the joint where your femur (thigh bone) meets your pelvis (hip bone). There are two main parts: a ball ... fits in a socket in the pelvis. Your hip is known as a ball-and-socket joint. ...

The Timing of Hip Arthroscopy After Intra-articular Hip Injection Affects Postoperative Infection Risk.

Science.gov (United States)

Wang, Dean; Camp, Christopher L; Ranawat, Anil S; Coleman, Struan H; Kelly, Bryan T; Werner, Brian C

2017-11-01

To evaluate the association of preoperative intra-articular hip injection with surgical site infection after hip arthroscopy. A large administrative database was used to identify all patients undergoing hip arthroscopy from 2007 to 2015 within a single private insurer and from 2005 to 2012 within Medicare in the United States. Those that received an ipsilateral preoperative intra-articular hip injection were identified. The patients were then divided into the following groups based on the interval between preoperative injection and ipsilateral hip arthroscopy: (1) 12 months) of preoperative hip injection. Patients developing a surgical site infection within 6 months following hip arthroscopy were identified using International Classification of Diseases, Ninth Revision, and Current Procedural Terminology codes associated with infection. Groups were compared using a multivariate logistic regression analysis to control for age, gender, body mass index, smoking status, alcohol usage, and multiple medical comorbidities including diabetes mellitus, hemodialysis use, inflammatory arthritis, and peripheral vascular disease. In total, 19% of privately insured and 6% of Medicare patients received a hip injection within 12 months of hip arthroscopy. The overall infection rate in privately insured and Medicare patients was 1.19% and 1.10%, respectively. Preoperative hip injection within 3 months of surgery was associated with a significantly higher risk of postoperative infection versus controls (2.16%, odds ratio [OR] 6.1, P arthroscopy increased when preoperative intra-articular hip injections were given within 3 months of surgery. Level III, retrospective comparative study. Copyright © 2017 Arthroscopy Association of North America. Published by Elsevier Inc. All rights reserved.

Rationale for one stage exchange of infected hip replacement using uncemented implants and antibiotic impregnated bone graft.

Science.gov (United States)

Winkler, Heinz

2009-09-04

Infection of a total hip replacement (THR) is considered a devastating complication, necessitating its complete removal and thorough debridement of the site. It is undoubted that one stage exchange, if successful, would provide the best benefit both for the patient and the society. Still the fear of re-infection dominates the surgeons decisions and in the majority of cases directs them to multiple stage protocols. However, there is no scientifically based argument for that practice. Successful eradication of infection with two stage procedures is reported to average 80% to 98%. On the other hand a literature review of Jackson and Schmalzried (CORR 2000) summarizing the results of 1,299 infected hip replacements treated with direct exchange (almost exclusively using antibiotic loaded cement), reports of 1,077 (83%) having been successful. The comparable results suggest, that the major factor for a successful outcome with traditional approaches may be found in the quality of surgical debridement and dead space management. Failures in all protocols seem to be caused by small fragments of bacterial colonies remaining after debridement, whereas neither systemic antibiotics nor antibiotic loaded bone cement (PMMA) have been able to improve the situation significantly. Reasons for failure may be found in the limited sensitivity of traditional bacterial culturing and reduced antibiotic susceptibility of involved pathogens, especially considering biofilm formation. Whenever a new prosthesis is implanted into a previously infected site the surgeon must be aware of increased risk of failure, both in single or two stage revisions. Eventual removal therefore should be easy with low risk of additional damage to the bony substance. On the other hand it should also have potential of a good long term result in case of success. Cemented revisions generally show inferior long term results compared to uncemented techniques; the addition of antibiotics to cement reduces its

A comparative evaluation of compressive strength of Portland cement with zinc oxide eugenol and Polymer-reinforced cement: an in vitro analysis.

Science.gov (United States)

Prakasam, S; Bharadwaj, Prakasam; Loganathan, S C; Prasanth, B Krishna

2014-01-01

The purpose of this study is to evaluate the ultimate compressive strength of 50% and 25% Portland cement mixed with Polymer-reinforced zinc oxide eugenol and zinc oxide eugenol cement after 1 hour, 24 hours, and 7 days. One hundred and eighty samples were selected. The samples were made cylindrical of size 6 × 8 mm and were divided into six groups as follows with each group consisting of 10 samples. Group 1: Polymer-reinforced zinc oxide eugenol with 50% Portland cement (PMZNPC 50%) Group 2: Polymer-reinforced zinc oxide eugenol with 25% Portland cement (PMZNPC 25%) Group 3: Polymer-reinforced zinc oxide eugenol with 0% Portland cement (PMZNPC 0%) Group 4: Zinc oxide eugenol with 50% Portland cement (ZNPC 50%) Group 5: Zinc oxide eugenol with 25% Portland cement (ZNPC 25%) Group 6: Zinc oxide eugenol with 0% Portland cement (ZNPC 0%) These samples were further subdivided based on time interval and were tested at 1 hour, 24 hours and at 7 th day. After each period of time all the specimens were tested by vertical CVR loaded frame with capacity of 5 tones/0473-10kan National Physical laboratory, New Delhi and the results were statistically analyzed using ANOVA and Scheffe test. Polymer-reinforced cement with 50% Portland cement, Zinc oxide with 50% Portland cement, Polymer-reinforced cement with 25% Portland cement and Zinc oxide with 25% Portland cement exhibited higher compressive strength when compared to Zinc oxide with 0% Portland cement and Polymer-reinforced cement with 0% Portland cement, at different periods of time. The difference between these two groups were statistically significant (P Portland cement in Zinc oxide eugenol and Polymer-modified zinc oxide cement can be used as core build up material and permanent filling material. It is concluded that 50% and 25% Portland cement in zinc oxide eugenol and polymer-modified zinc oxide eugenol results in higher compressive strength and hence can be used as permanent filling material and core built

Transient osteoporosis of the hip

International Nuclear Information System (INIS)

McWalter, Patricia; Hassan Ahmed

2007-01-01

Transient osteoporosis of the hip is an uncommon cause of hip pain, mostly affecting healthy middle-aged men and also women in the third trimester of pregnancy. We present a case of transient osteoporosis of the hip in a 33-year-old non-pregnant female patient. This case highlights the importance of considering a diagnosis of transient osteoporosis of the hip in patients who present with hip pain. (author)

Hip arthroscopy: prevalence of intra-articular pathologic findings after traumatic injury of the hip.

Science.gov (United States)

Khanna, Vickas; Harris, Adam; Farrokhyar, Forough; Choudur, Hema N; Wong, Ivan H

2014-03-01

The purpose of this study was to document and compare the incidence of intra-articular hip pathologic findings identified using arthroscopy versus conventional imaging in patients with acute trauma to the hip. This was a blinded prospective case series study designed to review the incidence of intra-articular pathologic disorders in patients with post-traumatic injury between the ages of 18 and 65 years who were referred to a single surgeon. Injuries included hip dislocation, proximal femur fracture, pelvic ring fracture, acetabular fracture, penetrating injury (gunshot wound), and soft tissue injury. Preoperative radiographs, computed tomographic (CT) scans, or magnetic resonance imaging/magnetic resonance angiography (MRI/MRA) scans (or a combination of these) were obtained. Findings were documented and compared with intraoperative findings. A total of 29 post-traumatic hips were enrolled in this study. Hip arthroscopy identified 17 of 29 hips (59%) as having loose bodies, 11 of 29 (38%) hips as having an intra-articular step deformity, 14 of 29 (49%) hips as having an osteochondral lesion, and 27 of 29 (93%) hips as having a labral tear. Plain radiographs and CT scans yielded low sensitivity when compared with arthroscopy for the identification of loose bodies and step deformities. MRI/MRA comparison with arthroscopic findings suggest that MRI/MRA is an accurate tool for identification of labral tears, because 91% of tears seen on arthroscopy were also identified by MRI/MRA. In 4 hips, however, MRI/MRA failed to identify osteochondral lesions that were subsequently identified by arthroscopy. Traumatic injuries of the hip result in substantial intra-articular pathologic findings, including loose bodies, labral tears, step deformities, and osteochondral lesions. The arthroscope is a powerful tool in identifying these injuries. Plain radiographs and CT scans appear to underestimate the true incidence of loose bodies and step deformities within the joint when

TREATMENT OF HIP DYSPLASIA

OpenAIRE

Iulian ICLEANU; Mariana CORDUN

2015-01-01

In this thesis, our purpose is to show that using physiotherapy on patients with hip dysplasia from the very beginning, in the first months of life, helps treating them faster. Common literature proposes to use physiotherapy on patients with hip dysplasia either after their recovery or in the terminal phase of recovery, claiming that any earlier intervention will prolong the hip recovery. The effects of hip dysplasia reflect over the whole musculoskeletal system, while it hinders the knees (g...

Portland cement hydration and early setting of cement stone intended for efficient paving materials

Science.gov (United States)

Grishina, A.

2017-10-01

Due to the growth of load on automotive roads, modern transportation engineering is in need of efficient paving materials. Runways and most advanced highways require Portland cement concretes. This makes important the studies directed to improvement of binders for such concretes. In the present work some peculiarities of the process of Portland cement hydration and early setting of cement stone with barium hydrosilicate sol were examined. It was found that the admixture of said sol leads to a shift in the induction period to later times without significant change in its duration. The admixture of a modifier with nanoscale barium hydrosilicates increases the degree of hydration of the cement clinker minerals and changes the phase composition of the hydration products; in particular, the content of portlandite and tricalcium silicate decreases, while the amount of ettringite increases. Changes in the hydration processes of Portland cement and early setting of cement stone that are caused by the nanoscale barium hydrosilicates, allow to forecast positive technological effects both at the stage of manufacturing and at the stage of operation. In particular, the formwork age can be reduced, turnover of molds can be increased, formation of secondary ettringite and corrosion of the first type can be eliminated.

Facial skeletal augmentation using hydroxyapatite cement.

Science.gov (United States)

Shindo, M L; Costantino, P D; Friedman, C D; Chow, L C

1993-02-01

This study investigates the use of a new calcium phosphate cement, which sets to solid, microporous hydroxyapatite, for facial bone augmentation. In six dogs, the supraorbital ridges were augmented bilaterally with this hydroxyapatite cement. On one side, the hydroxyapatite cement was placed directly onto the bone within a subperiosteal pocket. On the opposite side, the cement was contained within a collagen membrane tubule and then inserted into a subperiosteal pocket. The use of collagen tubules facilitated easy, precise placement of the cement. All implants maintained their original augmented height throughout the duration of the study. They were well tolerated without extrusion or migration, and there was no significant sustained inflammatory response. Histologic studies, performed at 3, 6, and 9 months revealed that when the cement was placed directly onto bone, progressive replacement of the implant by bone (osseointegration of the hydroxyapatite with the underlying bone) without a loss of volume was observed. In contrast, when the cement-collagen tubule combination was inserted, primarily a fibrous union was noted. Despite such fibrous union, the hydroxyapatite-collagen implant solidly bonded to the underlying bone, and no implant resorption was observed. Hydroxyapatite cement can be used successfully for the experimental augmentation of the craniofacial skeleton and may be applicable for such uses in humans.

Cement/slag chemistry studies

International Nuclear Information System (INIS)

Glasser, F.P.; Macphee, D.; Atkins, M.; Beckley, N.; Carson, S.O.; Wilding, C.R.; McHugh, G.

1988-01-01

The performance of cement-based matrices intended for radwaste immobilization is assessed. The long-term performance of the matrix is characterized by thermodynamic evaluation of experimental data. The results are presented in a general form, amenable to a range of specific formulations. The interaction of specific radwaste components with cements has been studied, using Iodine as an example. It occurs as both I - and IO 3 - species, but these differ sharply in sorption characteristics. The effect of ionizing radiation of the pH and E h of cement matrices is reported. (author)

The cement solidification systems at LANL

International Nuclear Information System (INIS)

Veazey, G.W.

1990-01-01

There are two major cement solidification systems at Los Alamos National Laboratory. Both are focused primarily around treating waste from the evaporator at TA-55, the Plutonium Processing Facility. The evaporator receives the liquid waste stream from TA-55's nitric acid-based, aqueous-processing operations and concentrates the majority of the radionuclides in the evaporator bottoms solution. This is sent to the TA-55 cementation system. The evaporator distillate is sent to the TA-50 facility, where the radionuclides are precipitated and then cemented. Both systems treat TRU-level waste, and so are operated according to the criteria for WIPP-destined waste, but they differ in both cement type and mixing method. The TA-55 systems uses Envirostone, a gypsum-based cement and in-drum prop mixing; the TA-50 systems uses Portland cement and drum tumbling for mixing

Chemistry of cements for nuclear applications

International Nuclear Information System (INIS)

Barrett, P.; Glasser, F.P.

1992-01-01

In recent times the nuclear industry has thrown up challenges which cannot be met by the application of conventional civil and materials engineering knowledge. The contributions in this volume investigate all aspects of cement performance. The scope of the papers demonstrates the current balance of activities which have as their objective the elucidation of kinetics and immobilization, determining material interactions and of assessing future performance. The papers reflect the varied goals of the sponsors who include national governments, the Commission of the European Communities and the nuclear industries. In six parts attention is paid to the durability of cement and concrete in repository environment; interactions between cement, waste components and ground water; properties and performance of cement materials; leach behavior and mechanisms, diffusional properties of cement and concrete, including porosity-permeability relationships; and thermodynamics of cementitious systems and modelling of cement performance

Structural differences between hip endoprostheses, and implications on a hip kinetics

Directory of Open Access Journals (Sweden)

Mirza Biščević

2005-11-01

Full Text Available We compared kinetic characteristic of unipolar, bipolar and total hip endoprostheses, implanted after dislocated femoral neck fracture. Ninety patients were divided into three groups (30 patients in each group; a group with unipolar partial hip endoprosthesis (UPEP, a group with bipolar partial hip endoprosthesis (BPEP and a group with total hip endoprosthesis (TEP. The patients from different groups were paired by parameters which could influence the long term functional result: follow up period, comorbidities, functional capabilities before injury, etc. After the average follow up 3.8 +/- 1.9 years, a measuring of range of hip motions (ROM was conducted. The largest mean amplitudes in flexion (104 degrees, extension (13 degrees, abduction (35 degrees and external rotation (38 degrees was achieved BPEP, the largest adduction (14 degrees was achieved UPEP, and internal rotation (34 degrees TEP. Differences in ROMs are partially related to the clinical parameters such as: level of the hip pain, gait pattern, age and rehabilitation period (P < 0.05. Measuring of ROMs is the most reliable part of the clinical exam and it does not depend on subjectivity of patient, as opposed to other clinical parameters (level of pain, walking distance, aids usage, etc. The results obtained are favorable for the bipolar hip endoprosthesis, and they can be related to the biomechanical differences between the three types of hip endoprostheses. Kinetic advantages of the BPEP as compared to the UPEP, can be explained by the BPEP's structure: two-level mobility and a thinner neck which delays impingement in the late motion phase. In comparison to the TEP, clinical advantages of the BPEP can be attributed to less extensive surgery and scarring.

Characterization of cement-stabilized Cd wastes

International Nuclear Information System (INIS)

Maria Diez, J.; Madrid, J.; Macias, A.

1996-01-01

Portland cement affords both physical and chemical immobilization of cadmium. The immobilization has been studied analyzing the pore fluid of cement samples and characterizing the solid pastes by X-ray diffraction. The influence of cadmium on the cement hydration and on its mechanical properties has been also studied by isothermal conduction calorimetry and by the measure of strength and setting development. Finally, the effect of cement carbonation on the immobilization of cadmium has been analyzed

Pre-cementation of deep shaft

Science.gov (United States)