WorldWideScience

Sample records for cemented metal-on-metal hip

  1. No Superiority of Cemented Metal-on-Metal vs Metal-on-Polyethylene THA at 5-Year Follow-up

    NARCIS (Netherlands)

    Zijlstra, Wierd P.; Cheung, John; Sietsma, Maurits S.; van Raay, Jos J. A. M.; Deutman, Robert

    2009-01-01

    A randomized controlled trial was performed to compare the cemented Stanmore metal-on-metal (Biomet, Warsaw, Indiana) total hip arthroplasty (THA; 102 hips) to the cemented Stanmore metal-on-polyethylene (Biomet) THA (98 hips). The primary outcome was clinical performance. Radiological performance,

  2. Management of failed metal-on-metal total hip arthroplasty

    OpenAIRE

    Griffin, Justin W.; D’Apuzzo, Michele; Browne, James A.

    2012-01-01

    The theoretical advantages of metal-on-metal (MOM) bearing couples in total hip arthroplasty (THA) have been recently balanced by concerns regarding adverse local and systemic effects. Higher than anticipated early revision rates have been reported by several joint registries. Failed MOM hips present with a spectrum of symptoms and findings and traditional methods of failure must be considered in addition to the failure modes that appear to be unique to the MOM bearing couple. Metal hypersens...

  3. The future role of metal-on-metal hip resurfacing.

    OpenAIRE

    Matharu, GS; Pandit, HG; Murray, DW; Treacy, RB

    2015-01-01

    PURPOSE: The purpose of this review was to assess the ten to 15-year outcomes of metal-on-metal hip resurfacing (MoM HR) when performed at designing and independent centres, and make recommendations for the future use of MoM HR. METHODS: Studies reporting ten to 15-year outcomes for modern MoM HR devices from both designing and independent centres were reviewed. Outcomes from these studies were assessed to allow the formulation of recommendations for the future use of MoM HR. RESULTS: Two MoM...

  4. Metal-on-metal hip resurfacings. A radiological perspective

    Energy Technology Data Exchange (ETDEWEB)

    Chen, Zhongbo [University of Oxford, Medical School, Oxford (United Kingdom); Pandit, Hemant; Taylor, Adrian; Gill, Harinderjit; Murray, David [University of Oxford, Nuffield Department of Orthopaedic Surgery, Oxford (United Kingdom); Ostlere, Simon [Nuffield Orthopaedic Centre, Department of Radiology, Oxford (United Kingdom)

    2011-03-15

    It is important to be aware of the various complications related to resurfacing arthroplasty of the hip (RSA) and the spectrum of findings that may be encountered on imaging. The bone conserving metal-on-metal (MOM) hip resurfacing has become increasingly popular over the last ten years, especially in young and active patients. Initial reports have been encouraging, but long-term outcome is still unknown. Early post operative complications are rare and have been well documented in the literature. Medium and long term complications are less well understood. A rare but important problem seen at this stage is the appearance of a cystic or solid periarticular reactive mass, which occurs predominately in women and usually affects both hips when seen in patients with bilateral RSAs. The following imaging findings are illustrated and their significance discussed; Uncomplicated hip resurfacing arthroplasty, radiolucency around the femoral peg, femoral neck fracture, loosening and infection, suboptimal component position, femoral notching, dislocation, heterotopic ossification, femoral neck thinning and reactive masses. The radiologist should be aware of the normal radiographic appearances and the variety of complications that may occur following RSA and should recommend ultrasound or MRI in patients with an unexplained symptomatic hip and normal radiographs. (orig.)

  5. Mortality rates at 10 years after metal-on-metal hip resurfacing compared with total hip replacement in England: retrospective cohort analysis of hospital episode statistics

    OpenAIRE

    Kendal, Adrian R.; Prieto-Alhambra, Daniel; Arden, Nigel K; Carr, Andrew; Judge, Andrew

    2013-01-01

    Objectives To compare 10 year mortality rates among patients undergoing metal-on-metal hip resurfacing and total hip replacement in England. Design Retrospective cohort study. Setting English hospital episode statistics database linked to mortality records from the Office for National Statistics. Population All adults who underwent primary elective hip replacement for osteoarthritis from April 1999 to March 2012. The exposure of interest was prosthesis type: cemented total hip replacement, un...

  6. High Re-Operation Rates Using Conserve Metal-On-Metal Total Hip Articulations

    DEFF Research Database (Denmark)

    Mogensen, S L; Jakobsen, Thomas; Christoffersen, Hardy;

    2016-01-01

    INTRODUCTION: Metal-on-metal hip articulations have been intensely debated after reports of adverse reactions and high failure rates. The aim of this study was to retrospectively evaluate the implant of a metal-on.metal total hip articulation (MOM THA) from a single manufacture in a two...

  7. Inflammatory pseudotumor causing deep vein thrombosis after metal-on-metal hip resurfacing arthroplasty.

    LENUS (Irish Health Repository)

    Memon, Adeel Rasool

    2013-01-01

    Metal-on-metal hip resurfacings have recently been associated with a variety of complications resulting from adverse reaction to metal debris. We report a case of extensive soft tissue necrosis associated with a huge pelvic mass causing extensive deep vein thrombosis of the lower limb secondary to mechanical compression of the iliac vein. This is a rare and unusual cause of deep vein thrombosis after metal-on-metal hip resurfacing arthroplasty.

  8. The effect of the metal-on-metal hip controversy on internet search activity.

    LENUS (Irish Health Repository)

    Phelan, Nigel

    2014-01-04

    The recall of the articular surface replacement (ASR) hip prosthesis in 2010 represents one of the most controversial areas in orthopaedic surgery in recent years. The aim of this study was to compare the impact of the metal-on-metal hip controversy on Internet search activity in four different regions and determine whether the number of related news reports affected Internet search activity. The Google Trends, Keywords and News applications were used to record the number of news articles and Internet search activity for the terms "hip recall", "metal-on-metal hip" and "ASR hip" from October 2009 to October 2012 in the USA, the UK, Australia and Ireland. There was a large increase in search activity following the official recall in August 2010 in all countries. There was significantly greater search activity after the recall in Ireland compared with the UK for the search term "hip recall" (P = 0.004). For the term "metal-on-metal hip", the UK had significantly more search activity (P = 0.0009). There was a positive correlation between the number of news stories in UK and Ireland with Internet search activity but not in the USA or Australia. Differences between countries affected by the same recall highlight the complex effects of the media on public awareness. The data demonstrates a window of opportunity prior to the official recall for the development of an awareness campaign to provide patients with accurate information.

  9. MRI of early symptomatic metal-on-metal total hip arthroplasty: a retrospective review of radiological findings in 20 hips

    Energy Technology Data Exchange (ETDEWEB)

    Toms, A.P. [Department of Radiology, Norfolk and Norwich University Hospital, Norwich, Norfolk (United Kingdom)], E-mail: andoni.toms@nnuh.nhs.uk; Marshall, T.J.; Cahir, J. [Department of Radiology, Norfolk and Norwich University Hospital, Norwich, Norfolk (United Kingdom); Darrah, C.; Nolan, J. [Department of Orthopaedics, Norfolk and Norwich University Hospital, Norwich, Norfolk (United Kingdom); Donell, S.T. [Institute of Health, University of East Anglia, Norwich, Norfolk (United Kingdom); Barker, T. [Department of Pathology, Norfolk and Norwich University Hospital, Norwich, Norfolk (United Kingdom); Tucker, J.K. [Department of Orthopaedics, Norfolk and Norwich University Hospital, Norwich, Norfolk (United Kingdom)

    2008-01-15

    Aim: To perform a retrospective review of all the conventional radiographic and magnetic resonance imaging (MRI) studies performed in patients with early postoperative pain following cobalt-chrome metal-on-metal total hip arthroplasty. Methods: A retrospective review of the radiology, surgical findings and histology in nineteen patients who had undergone a total of 20 hip arthroplasties using a cobalt-chromium on cobalt-chromium alloy prosthesis was undertaken. Results: Measures of implant placement on the immediate postoperative radiographs were all within the normal ranges (n = 20). Where more than one postoperative radiograph was available statistical analysis revealed no evidence of progressive change before the MRI examination (14). The median postoperative time to MRI was 35 months (range 11-63 months). Abnormalities were demonstrated using MRI in all symptomatic hips (n = 20). These comprised: periprosthetic fluid collections (20), which were isointense to muscle on T1-weighted images in 19 cases and hyperintense on T2-weighted images in 18 cases, periprosthetic bone marrow oedema (n = 6), muscle oedema (n = 4), avulsion of the gluteus minimus and medius tendons (n = 5), atrophy of piriformis (n = 15) and obturator internus (n = 17), and fracture of the medial calcar (n = 1). Operative findings in patients who had undergone revision surgery (n = 15) included: fluid-filled cavities (n = 11), soft tissue necrosis (n = 8), gluteal tendon avulsion (n = 5), proximal femoral diaphyseal necrosis (n = 4), and pitting and corrosion of the femoral stems (n = 8), which were, in all cases, firmly fixed to the cement mantle. Histology revealed viable tissue in six hips with necrosis (n = 12) and fibrin deposition (n = 15) being the predominate findings. Other findings included a perivascular lymphocytic infiltrate (n = 5), features of active inflammation (n = 4), and metallosis (n = 1). Conclusion: A significant number of patients with metal-on-metal hip replacements

  10. Short-term results with the Zweymueller-SL metal-on-metal total hip arthroplasty.

    Science.gov (United States)

    Korovessis, Panagiotis; Petsinis, Georgios; Repanti, Maria; Papazisis, Zisis; Iliopoulos, Panagiotis; Soucacos, Panagiotis N

    2002-01-01

    In a prospective study we followed 266 consecutive patients who received 350 Zweymueller-SL uncemented total hip replacements with metal-on-metal articulation for osteoarthritis. Mean follow-up was 52 (range 37-92) months. Patient age at the time of surgery was 55±9 (25-70) years. Pre-operative Harris score of 45±19 was increased post-operatively to 96±4. Pre-operative invalidity was significantly improved post-operatively (Pmetalosis (Mirra grades 1 and 2) was shown in all revised hips. The reasons for early loosening were unrelated to the metal-on-metal bearing but rather were the result of either low-grade deep infection or inadequate surgical technique. Survival rate for Zweymueller screw socket and stem 7.6 years after implantation was 99.4% and 96.8% respectively. There was no evidence that metal-on-metal articulation gives rise to new problems or complications. PMID:24570158

  11. Lubrication and friction prediction in metal-on-metal hip implants.

    Science.gov (United States)

    Wang, F C; Brockett, C; Williams, S; Udofia, I; Fisher, J; Jin, Z M

    2008-03-01

    A general methodology of mixed lubrication analysis and friction prediction for a conforming spherical bearing in hip implants was developed, with particular reference to a typical metal-on-metal hip replacement. Experimental measurement of frictional torque for a similar implant was carried out to validate the theoretical prediction. A ball-in-socket configuration was adopted to represent the articulation between the femoral head and the acetabular cup under cyclic operating conditions of representative load and motion. The mixed lubrication model presented in this study was first applied to identify the contact characteristics on the bearing surfaces, consisting of both fluid-film and boundary lubricated regions. The boundary lubricated contact was assumed to occur when the predicted fluid film thickness was less than a typical boundary protein layer absorbed on the bearing surfaces. Subsequently, the friction was predicted from the fluid-film lubricated region with viscous shearing due to both Couette and Poiseuille flows and the boundary protein layer contact region with a constant coefficient of friction. The predicted frictional torque of the typical metal-on-metal hip joint implant was compared with the experimental measurement conducted in a functional hip simulator and a reasonably good agreement was found. The mixed lubrication regime was found to be dominant for the conditions considered. Although the percentage of the boundary lubricated region was quite small, the corresponding contribution to friction was quite large and the resultant friction factor was quite high.

  12. Edge loading in metal-on-metal hips: low clearance is a new risk factor

    Science.gov (United States)

    Zografos, Angelos; Sayles, Ritchie S; Hart, Alister; Cann, Philippa

    2012-01-01

    The revision rate of large head metal-on-metal and resurfacing hips are significantly higher than conventional total hip replacements. The revision of these components has been linked to high wear caused by edge loading; which occurs when the head–cup contact patch extends over the cup rim. There are two current explanations for this; first, there is loss of entrainment of synovial fluid resulting in breakdown of the lubricating film and second, edge loading results in a large local increase in contact pressure and consequent film thickness reduction at the cup rim, which causes an increase in wear. This paper develops a method to calculate the distance between the joint reaction force vector and the cup rim – the contact patch centre to rim (CPCR) distance. However, the critical distance for the risk of edge loading is the distance from the contact patch edge to rim (CPER) distance. An analysis of explanted hip components, divided into edge worn and non-edge-worn components showed that there was no statistical difference in CPCR values, but the CPER value was significantly lower for edge worn hips. Low clearance hips, which have a more conformal contact, have a larger diameter contact patch and thus are more at risk of edge loading for similarly positioned hips. PMID:22558836

  13. Management of metal-on-metal hip implant patients: Who, when and how to revise?

    Science.gov (United States)

    Berber, Reshid; Skinner, John A; Hart, Alister J

    2016-05-18

    The debate on how best to manage patients with metal-on-metal (MOM) hip implants continues. With over 1 million patients affected worldwide, the impact is far reaching. The majority of the aggressive failures of MOM hip implants have been dealt with by revision hip surgery, leaving patients with a much more indolent pattern of failure of devices that have been in situ for more than 10 years. The longer-term outcome for such patients remains unknown, and much debate exists on how best to manage these patients. Regulatory guidance is available but remains open to interpretation due to the lack of current evidence and long-term studies. Metal ion thresholds for concern have been suggested at 7 ppb for hip resurfacing arthroplasty and below this level for large diameter total hip arthroplasties. Soft tissue changes including pseudotumours and muscle atrophy have been shown to progress, but this is not consistent. New advanced imaging techniques are helping to diagnose complications with metal hips and the reasons for failure, however these are not widely available. This has led to some centres to tackle difficult cases through multidisciplinary collaboration, for both surgical management decisions and also follow-up decisions. We summarise current evidence and consider who is at risk, when revision should be undertaken and how patients should be managed. PMID:27190754

  14. Perfusion MRI in hips with metal-on-metal and metal-on-polyethylene total hip arthroplasty

    OpenAIRE

    Anwander, H; Cron, G. O.; Rakhra, K.; Beaule, P. E.

    2016-01-01

    Objectives Hips with metal-on-metal total hip arthroplasty (MoM THA) have a high rate of adverse local tissue reactions (ALTR), often associated with hypersensitivity reactions. Dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) measures tissue perfusion with the parameter Ktrans (volume transfer constant of contrast agent). Our purpose was 1) to evaluate the feasibility of DCE-MRI in patients with THA and 2) to compare DCE-MRI in patients with MoM bearings with metal-on-polyethyl...

  15. Corrosion on the acetabular liner taper from retrieved modular metal-on-metal total hip replacements.

    Science.gov (United States)

    Gascoyne, Trevor C; Dyrkacz, Richard M; Turgeon, Thomas R; Burnell, Colin D; Wyss, Urs P; Brandt, Jan-M

    2014-10-01

    Eight retrieved metal-on-metal total hip replacements displayed corrosion damage along the cobalt-chromium alloy liner taper junction with the Ti alloy acetabular shell. Scanning electron microscopy indicated the primary mechanism of corrosion to be grain boundary and associated crevice corrosion, which was likely accelerated through mechanical micromotion and galvanic corrosion resulting from dissimilar alloys. Coordinate measurements revealed up to 4.3mm(3) of the cobalt-chromium alloy taper surface was removed due to corrosion, which is comparable to previous reports of corrosion damage on head-neck tapers. The acetabular liner-shell taper appears to be an additional source of metal corrosion products in modular total hip replacements. Patients with these prostheses should be closely monitored for signs of adverse reaction towards corrosion by-products.

  16. Balancing innovation and medical device regulation: the case of modern metal-on-metal hip replacements

    Directory of Open Access Journals (Sweden)

    Howard JJ

    2016-08-01

    Full Text Available Jason J Howard1,2 1Division of Orthopedic Surgery, Department of Surgery, Sidra Medical and Research Center, 2Department of Orthopedic Surgery, Weill Cornell Medical College, Doha, Qatar Abstract: Due to problems with wear particle generation and subsequent loosening using conventional metal-on-polyethylene total hip replacements, there has been a shift toward alternative bearing systems, including metal-on-metal (MoM, for younger, more active patients with degenerative joint disease. Based on positive results from early short-term clinical studies, MoM hip replacements were readily adopted by orthopedic surgeons with thousands being implanted worldwide over the past decade. Unacceptably high revision rates reported by two national joint registries called into question the rigorousness of the regulatory approval process for these implants, particularly with respect to premarket data requirements to prove safety, effectiveness, and the appropriateness of the regulatory pathway chosen. The purpose of this review was to investigate the balance between facilitating the introduction of new medical technologies and the need to ensure safety and effectiveness through comprehensive regulatory assessment. The case of MoM hip replacement devices was used to frame the investigation and subsequent discussions. The regulatory approval processes and post-market surveillance requirements associated with three common MoM hip replacements (two resurfacings: the Birmingham and articular surface replacement and the articular surface replacement XL total hip replacement were investigated. With respect to modern MoM hip replacement devices, the balance between facilitating the introduction of these new medical technologies and the need to ensure safety and effectiveness through comprehensive regulatory assessment was not achieved. The lessons learned from these experiences have application beyond joint replacements to the introduction of new medical technologies in

  17. Surface engineering: a low wearing solution for metal-on-metal hip surface replacements.

    Science.gov (United States)

    Leslie, Ian J; Williams, Sophie; Brown, Chris; Anderson, James; Isaac, Graham; Hatto, Peter; Ingham, Eileen; Fisher, John

    2009-08-01

    Increased patient blood and serum levels of Co and Cr and dissemination of metal wear particles throughout organs and tissues are the primary concerns with metal-on-metal surface replacements. Surface engineering, providing a ceramic bearing surface on a metal substrate, could provide a solution. This study investigated thick (>10 microm) arc evaporation plasma vapor deposition chromium nitride (CrN) coated surface replacements in terms of wear, ion levels, and wear particles in a 10 million cycle hip simulator study, compared to a contemporary metal-on-metal surface replacement. The ion levels were measured by inductively coupled plasma mass spectroscopy. The wear particles were imaged by field emission gun scanning electron microscopy. The CrN-coated bearings had 80% lower wear than the MoM controls. The Cr and Co ion levels in the lubricant of the CrN bearings were 73 and 98% lower than in the MoM controls. The wear particles produced were in the nanometer size range and round to oval in morphology. The CrN coating could provide a reduction in the wear and ion release of MoM surface replacements, thereby reducing the perceived risks to the patient associated with these prostheses. PMID:19195030

  18. Chromium and cobalt ion concentrations in blood and serum following various types of metal-on-metal hip arthroplasties

    DEFF Research Database (Denmark)

    Jantzen, Christopher; Jørgensen, Henrik L; Duus, Benn R;

    2013-01-01

    Widely different metal ion concentrations in blood and serum have been reported with metal-on-metal (MoM) implants. We reviewed the literature on blood and serum ion concentrations of chromium (Cr) and cobalt (Co) following various MoM hip arthroplasties.......Widely different metal ion concentrations in blood and serum have been reported with metal-on-metal (MoM) implants. We reviewed the literature on blood and serum ion concentrations of chromium (Cr) and cobalt (Co) following various MoM hip arthroplasties....

  19. Balancing innovation and medical device regulation: the case of modern metal-on-metal hip replacements

    Science.gov (United States)

    Howard, Jason J

    2016-01-01

    Due to problems with wear particle generation and subsequent loosening using conventional metal-on-polyethylene total hip replacements, there has been a shift toward alternative bearing systems, including metal-on-metal (MoM), for younger, more active patients with degenerative joint disease. Based on positive results from early short-term clinical studies, MoM hip replacements were readily adopted by orthopedic surgeons with thousands being implanted worldwide over the past decade. Unacceptably high revision rates reported by two national joint registries called into question the rigorousness of the regulatory approval process for these implants, particularly with respect to premarket data requirements to prove safety, effectiveness, and the appropriateness of the regulatory pathway chosen. The purpose of this review was to investigate the balance between facilitating the introduction of new medical technologies and the need to ensure safety and effectiveness through comprehensive regulatory assessment. The case of MoM hip replacement devices was used to frame the investigation and subsequent discussions. The regulatory approval processes and post-market surveillance requirements associated with three common MoM hip replacements (two resurfacings: the Birmingham and articular surface replacement and the articular surface replacement XL total hip replacement) were investigated. With respect to modern MoM hip replacement devices, the balance between facilitating the introduction of these new medical technologies and the need to ensure safety and effectiveness through comprehensive regulatory assessment was not achieved. The lessons learned from these experiences have application beyond joint replacements to the introduction of new medical technologies in general, particularly for those who have a significant potential for harm. In this regard, a series of recommendations have been developed to contribute to the evolution of the medical device regulatory process.

  20. Large head metal-on-metal cementless total hip arthroplasty versus 28mm metal-on-polyethylene cementless total hip arthroplasty : design of a randomized controlled trial

    NARCIS (Netherlands)

    Zijlstra, Wierd P.; Bos, Nanne; van Raaij, Jos J. A. M.

    2008-01-01

    Background: Osteoarthritis of the hip is successfully treated by total hip arthroplasty with metal-on-polyethylene articulation. Polyethylene wear debris can however lead to osteolysis, aseptic loosening and failure of the implant. Large head metal-on-metal total hip arthroplasty may overcome polyet

  1. Metal-on-metal bearings in total hip arthroplasties : Influence of cobalt chromium ions on bacterial growth and biofilm formation

    NARCIS (Netherlands)

    Hosman, Anton H.; van der Mei, Henny C.; Bulstra, Sjoerd K.; Busscher, Henk J.; Neut, Danielle

    2009-01-01

    Metal-on-metal (MOM) bearings involving cobalt-chromium (Co-Cr) alloys in total hip arthroplasties are becoming more and more popular due to their low wear. Consequences of corrosion products of Co-Cr alloys are for the most part unclear, and the influence of cobalt and chromium ions on biofilm form

  2. The Inflammatory Phenotype in Failed Metal-On-Metal Hip Arthroplasty Correlates with Blood Metal Concentrations.

    Directory of Open Access Journals (Sweden)

    Erja-Leena Paukkeri

    Full Text Available Hip arthroplasty is the standard treatment of a painful hip destruction. The use of modern metal-on-metal (MOM bearing surfaces gained popularity in total hip arthroplasties during the last decade. Recently, worrisome failures due to adverse reaction to metal debris (ARMD, including pseudotumor response, have been widely reported. However, the pathogenesis of this reaction remains poorly understood. The aim of the present study was to investigate the ARMD response by flow cytometry approach.Sixteen patients with a failed Articular Surface Replacement (ASR hip prosthesis were included in the study. Samples of pseudotumor tissues collected during revision surgery were degraded by enzyme digestion and cells were typed by flow cytometry. Whole blood chromium and cobalt concentrations were analyzed with mass spectrometry before revision surgery.Flow cytometry analysis showed that the peri-implant pseudotumor tissue expressed two principal phenotypes, namely macrophage-dominated and T-lymphocyte-dominated response; the average portions being 54% (macrophages and 25% (T-lymphocytes in macrophage-dominated inflammation and 20% (macrophages and 54% (T-lymphocytes in T-lymphocyte-dominated response. The percentages of B-lymphocytes and granulocytes were lower in both phenotypes. Interestingly, the levels of blood chromium and cobalt were significantly higher in patients with macrophage-dominated response.The results suggest that the adverse tissue reactions induced by MOM wear particles contain heterogeneous pathogeneses and that the metal levels are an important factor in the determination of the inflammatory phenotype. The present results support the hypothesis that higher metal levels cause cytotoxicity and tissue injury and macrophages are recruited to clear the necrotic debris. On the other hand, the adverse response developed in association with lower metal levels is T-lymphocyte-dominated and is likely to reflect hypersensitivity reaction.

  3. The Inflammatory Phenotype in Failed Metal-On-Metal Hip Arthroplasty Correlates with Blood Metal Concentrations

    Science.gov (United States)

    Paukkeri, Erja-Leena; Korhonen, Riku; Hämäläinen, Mari; Pesu, Marko; Eskelinen, Antti; Moilanen, Teemu; Moilanen, Eeva

    2016-01-01

    Introduction Hip arthroplasty is the standard treatment of a painful hip destruction. The use of modern metal-on-metal (MOM) bearing surfaces gained popularity in total hip arthroplasties during the last decade. Recently, worrisome failures due to adverse reaction to metal debris (ARMD), including pseudotumor response, have been widely reported. However, the pathogenesis of this reaction remains poorly understood. The aim of the present study was to investigate the ARMD response by flow cytometry approach. Methods Sixteen patients with a failed Articular Surface Replacement (ASR) hip prosthesis were included in the study. Samples of pseudotumor tissues collected during revision surgery were degraded by enzyme digestion and cells were typed by flow cytometry. Whole blood chromium and cobalt concentrations were analyzed with mass spectrometry before revision surgery. Results Flow cytometry analysis showed that the peri-implant pseudotumor tissue expressed two principal phenotypes, namely macrophage-dominated and T-lymphocyte-dominated response; the average portions being 54% (macrophages) and 25% (T-lymphocytes) in macrophage-dominated inflammation and 20% (macrophages) and 54% (T-lymphocytes) in T-lymphocyte-dominated response. The percentages of B-lymphocytes and granulocytes were lower in both phenotypes. Interestingly, the levels of blood chromium and cobalt were significantly higher in patients with macrophage-dominated response. Conclusions The results suggest that the adverse tissue reactions induced by MOM wear particles contain heterogeneous pathogeneses and that the metal levels are an important factor in the determination of the inflammatory phenotype. The present results support the hypothesis that higher metal levels cause cytotoxicity and tissue injury and macrophages are recruited to clear the necrotic debris. On the other hand, the adverse response developed in association with lower metal levels is T-lymphocyte-dominated and is likely to reflect

  4. Poor survivorship and frequent complications at a median of 10 years after metal-on-metal hip resurfacing revision

    OpenAIRE

    Matharu, GS; Pandit, HG; Murray, DW

    2016-01-01

    Background: High short-term failure rates have been reported for several metal-on-metal hip resurfacing (MoMHR) designs. Early observations suggested that MoMHRs revised to total hip arthroplasties (THAs) for pseudotumor had more major complications and inferior patient-reported outcomes compared with other revision indications. However, little is known about implant survivorship and patient-reported outcomes at more than 5 years after MoMHR revision.Questions/purposes: (1) What are the impla...

  5. The effectiveness of metal on metal hip resurfacing: a systematic review of the available evidence published before 2002

    OpenAIRE

    McCormack Kirsty; Vale Luke; Wyness Laura; Grant Adrian; Brazzelli Miriam

    2004-01-01

    Abstract Background Conventional total hip replacement (THR) may be felt to carry too high a risk of failure over a patient's lifetime, especially in young people. There is increasing interest in metal on metal hip resurfacing arthroplasty (MoM) as this offers a bone-conserving option for treating those patients who are not considered eligible for THR. We aim to evaluate the effectiveness of MoM for treatment of hip disease, and compare it with alternative treatments for hip disease offered w...

  6. Microfocus study of metal distribution and speciation in tissue extracted from revised metal on metal hip implants

    Energy Technology Data Exchange (ETDEWEB)

    Hart, Alister J [Department of Orthopaedic Surgery, Imperial College and Imperial College Healthcare NHS Trust, Charing Cross Hospital Campus, Fulham Palace Rd, London W6 8RF (United Kingdom); Sandison, Ann [Department of Histopathology, Imperial College and Imperial College Healthcare NHS Trust, Charing Cross Hospital Campus, Fulham Palace Rd, London W6 8RF (United Kingdom); Quinn, Paul; Mosselmans, J Frederick W [Science Division, Diamond Light Source, Harwell Science and Innovation Campus, Didcot, Oxon, OX11 0DE (United Kingdom); Sampson, Barry [Department of Clinical Biochemistry, Imperial College and Imperial College Healthcare NHS Trust, Charing Cross Hospital Campus, Fulham Palace Rd, London W6 8RF (United Kingdom); Atkinson, Kirk D [8 Nuclear Department Defence Academy College of Management and Technology HMS Sultan Military Road Gosport PO12 3BY (United Kingdom); Skinner, John A [Department of Orthopaedics, Royal National Orthopaedic Hospital, HA7 4LP (United Kingdom); Goode, Angela [Dept of Materials, Imperial College London, SW7 2AZ (United Kingdom); Powell, Jonathan J, E-mail: Paul.Quinn@diamond.ac.u [Medical Research Council Human Nutrition Research Centre, Cambridge CB1 9NL (United Kingdom)

    2009-11-15

    Unexplained tissue inflammation in metal-on-metal hip replacements is suspected to be caused by implant-derived nanoparticles. The aim of this study was to investigate the nature of the metal particles in tissue surrounding metal-on-metal (MOM) hips that has been extracted during revision. Mapping of tissue surrounding the failed MOM hips was performed using microfocus X-ray Fluorescence (XRF). This revealed mainly Cr which was localized to the cellular regions. There was co-localisation of Co, were present, to areas of high Cr abundance. XANES of the tissue and appropriate standards revealed that the most common species were Cr(III) and Co(II). EXAFS analysis of the tissue and various metal standards revealed that the most abundant implant-related species was Cr(III) phosphate. Different tissue preparation methods, including frozen sectioning, were examined but were found not to affect the distribution or speciation of the metals in the tissue.

  7. Midterm results of 36 mm metal-on-metal total hip arthroplasty

    Directory of Open Access Journals (Sweden)

    Hawar Akrawi

    2016-01-01

    Full Text Available Background: Despite the many perceived benefits of metal-on-metal (MoM articulation in total hip arthroplasty (THA, there have been growing concerns about metallosis and adverse reaction to metal debris (ARMD. Analysis of size 36 mm MoM articulation THAs is presented. These patients were evaluated for patient characteristics, relationship between blood metal ions levels and the inclination as well as the version of acetabular component, cumulative survival probability at final followup and functional outcome at final followup. Materials and Methods: 288, size 36 mm MoM THAs implanted in 269 patients at our institution from 2004 to 2010 were included in this retrospective study. These patients were assessed clinically for hip symptoms, perioperative complications and causes of revision arthroplasty were analysed. Biochemically, blood cobalt and chromium metal ions level were recorded and measurements of acetabular inclination and version were examined. Radiological evaluation utilizing Metal Artefact Reduction Sequence (MARS MRI was undertaken and implant cumulative survivorship was evaluated. Results: The mean followup was 5 years (range 2–7 years, mean age was 73 years and the mean Oxford hip score was 36.9 (range 5–48. Revision arthroplasty was executed in 20 (7.4% patients, of which 15 patients underwent single-stage revision THA. The causes of revision arthroplasty were: ARMD changes in 6 (2.2% patients, infection in 5 (1.9% patients and aseptic loosening in 5 (1.9% patients. Three (1.1% patients had their hips revised for instability, 1 (0.3% for raised blood metal ions levels. The implant cumulative survival rate, with revision for any reason, was 68.9% at 7 years. Conclusions: Although medium-sized MoM THA with a 36 mm head has a marginally better survivorship at midterm followup, compared to larger size head MoM articulating THA, our findings nonetheless are still worryingly poor in comparison to what has been quoted in the

  8. Do the Potential Benefits of Metal-on-Metal Hip Resurfacing Justify the Increased Cost and Risk of Complications?

    OpenAIRE

    Bozic, Kevin J.; Pui, Christine M.; Ludeman, Matthew J.; Vail, Thomas P.; Silverstein, Marc D.

    2010-01-01

    Background Metal-on-metal hip resurfacing arthroplasty (MoM HRA) may offer potential advantages over total hip arthroplasty (THA) for certain patients with advanced osteoarthritis of the hip. However, the cost effectiveness of MoM HRA compared with THA is unclear. Questions/purposes The purpose of this study was to compare the clinical effectiveness and cost-effectiveness of MoM HRA to THA. Methods A Markov decision model was constructed to compare the quality-adjusted life-years (QALYs) and ...

  9. Perfusion MRI in hips with metal-on-metal and metal-on-polyethylene total hip arthroplasty

    Science.gov (United States)

    Anwander, H.; Cron, G. O.; Rakhra, K.

    2016-01-01

    Objectives Hips with metal-on-metal total hip arthroplasty (MoM THA) have a high rate of adverse local tissue reactions (ALTR), often associated with hypersensitivity reactions. Dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) measures tissue perfusion with the parameter Ktrans (volume transfer constant of contrast agent). Our purpose was 1) to evaluate the feasibility of DCE-MRI in patients with THA and 2) to compare DCE-MRI in patients with MoM bearings with metal-on-polyethylene (MoP) bearings, hypothesising that the perfusion index Ktrans in hips with MoM THA is higher than in hips with MoP THA. Methods In this pilot study, 16 patients with primary THA were recruited (eight MoM, eight MoP). DCE-MRI of the hip was performed at 1.5 Tesla (T). For each patient, Ktrans was computed voxel-by-voxel in all tissue lateral to the bladder. The mean Ktrans for all voxels was then calculated. These values were compared with respect to implant type and gender, and further correlated with clinical parameters. Results There was no significant difference between the two bearing types with both genders combined. However, dividing patients by THA bearing and gender, women with MoM bearings had the highest Ktrans values, exceeding those of women with MoP bearings (0.067 min−1 versus 0.053 min−1; p-value stud. Bone Joint Res 2016;5:73–79. DOI: 10.1302/2046-3758.53.2000572. PMID:26935768

  10. Large head metal-on-metal cementless total hip arthroplasty versus 28mm metal-on-polyethylene cementless total hip arthroplasty: design of a randomized controlled trial

    Directory of Open Access Journals (Sweden)

    van Raaij Jos JAM

    2008-10-01

    Full Text Available Abstract Background Osteoarthritis of the hip is successfully treated by total hip arthroplasty with metal-on-polyethylene articulation. Polyethylene wear debris can however lead to osteolysis, aseptic loosening and failure of the implant. Large head metal-on-metal total hip arthroplasty may overcome polyethylene wear induced prosthetic failure, but can increase systemic cobalt and chromium ion concentrations. The objective of this study is to compare two cementless total hip arthroplasties: a conventional 28 mm metal-on-polyethylene articulation and a large head metal-on-metal articulation. We hypothesize that the latter arthroplasties show less bone density loss and higher serum metal ion concentrations. We expect equal functional scores, greater range of motion, fewer dislocations, fewer periprosthetic radiolucencies and increased prosthetic survival with the metal-on-metal articulation. Methods A randomized controlled trial will be conducted. Patients to be included suffer from non-inflammatory degenerative joint disease of the hip, are aged between 18 and 80 and are admitted for primary cementless unilateral total hip arthroplasty. Patients in the metal-on-metal group will receive a cementless titanium alloy acetabular component with a cobalt-chromium liner and a cobalt-chromium femoral head varying from 38 to 60 mm. Patients in the metal-on-polyethylene group will receive a cementless titanium alloy acetabular component with a polyethylene liner and a 28 mm cobalt-chromium femoral head. We will assess acetabular bone mineral density by dual energy x-ray absorptiometry (DEXA, serum ion concentrations of cobalt, chromium and titanium, self reported functional status (Oxford hip score, physician reported functional status and range of motion (Harris hip score, number of dislocations and prosthetic survival. Measurements will take place preoperatively, perioperatively, and postoperatively (6 weeks, 1 year, 5 years and 10 years. Discussion

  11. A comparison of leg length and femoral offset discrepancies in hip resurfacing, large head metal-on- metal and conventional total hip replacement: a case series

    Directory of Open Access Journals (Sweden)

    Herman Katie A

    2011-12-01

    Full Text Available Abstract Background A discrepancy in leg length and femoral offset restoration is the leading cause of patient dissatisfaction in hip replacement surgery and has profound implications on patient quality of life. The aim of this study is to compare biomechanical hip reconstruction in hip resurfacing, large-diameter femoral head hip arthroplasty and conventional total hip replacement. Method Sixty patient's post-operative radiographs were reviewed; 20 patients had a hip resurfacing (HR, 20 patients had a Large Head Metal-on-metal (LHM hip replacement and 20 patients had a conventional small head Total Hip Replacement (THR. The leg length and femoral offset of the operated and unoperated hips were measured and compared. Results Hip resurfacing accurately restored hip biomechanics with no statistical difference in leg length (P = 0.07 or femoral offset (P = 0.95 between the operated and non-operative hips. Overall HR was superior for reducing femoral offset discrepancies where it had the smallest bilateral difference (-0.2%, P = 0.9. The traditional total hip replacement was least effective at restoring the hip anatomy. Conclusion The use of a larger-diameter femoral head in hip resurfacing does not fully account for the superior biomechanical restoration, as LHM did not restore femoral offset as accurately. We conclude that restoration of normal hip biomechanics is best achieved with hip resurfacing.

  12. A MRI classification of periprosthetic soft tissue masses (pseudotumours) associated with metal-on-metal resurfacing hip arthroplasty

    Energy Technology Data Exchange (ETDEWEB)

    Hauptfleisch, Jennifer; Ostlere, Simon [Nuffield Orthopaedic Centre, Oxford University Hospitals NHS Trust, Department of Radiology, Oxford (United Kingdom); Pandit, Hemant; Grammatopoulos, George; Gill, Harinderjit S.; Murray, David W. [Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences (NDORMS), University of Oxford, Botnar Research Centre, Oxford (United Kingdom)

    2012-02-15

    Metal-on-metal hip resurfacing arthroplasty (MoMHRA) has become a popular option for young patients requiring hip replacement. A recognised complication is the formation of a symptomatic reactive periprosthetic soft tissue mass (pseudotumour). We present a radiological classification system for these reactive masses, dividing them into three groups: Type I are thin-walled cystic masses (cyst wall <3 mm), Type II are thick-walled cystic masses (cyst wall >3 mm, but less than the diameter of the cystic component) and Type III are predominantly solid masses. We reviewed all MRI performed over a 4-year period in patients with primary MoMHRA referred to our institution. In all cases the masses were assessed on MRI according to size, anatomical position, signal intensity and involvement of bone, muscle or neighbouring neurovascular bundles. Periprosthetic masses were seen in 33 hips in 17 female (7 bilateral) and 8 male patients (1 bilateral). The Type I lesions were the most common and more likely to be posterior to the hip joint. The Type III masses were significantly larger than the cystic lesions and were more likely to be located anterior to the hip joint. To date 22 patients have undergone revision surgery with conversions to total hip replacement. Severity of symptoms and revision rates were lowest in the Type I group and highest in the Type III group. Solid anterior pseudotumours were most likely to have the more severe symptoms and require revision surgery. (orig.)

  13. Massive failure of TiNbN coating in surface engineered metal-on-metal hip arthroplasty: Retrieval analysis.

    Science.gov (United States)

    Łapaj, Łukasz; Markuszewski, Jacek; Wendland, Justyna; Mróz, Adrian; Wierusz-Kozłowska, Małgorzata

    2016-07-01

    This article presents examination of a failed total hip replacement with surface engineered metal-on-metal (MoM) articulation. The implant was coated with a thin TiNbN film (Physical Vapor Deposition), and at retrieval 53 months after implantation the coating was abraded on weight-bearing part of the head and acetabular component. Scanning electron microscopy of bearing surfaces demonstrated multifocal crack formation, delamination of small film fragments, and formation of aggregates containing nanometer sized wear debris. We also observed coating damage in third body mechanism. Complex failure mechanism of TiNbN coating demonstrated in this study suggests insufficient bonding strength between the coating and substrate alloy and raise concerns regarding the use of such coatings in total hip arthroplasty with MoM bearing. © 2015 Wiley Periodicals, Inc. J Biomed Mater Res Part B: Appl Biomater, 104B: 1043-1049, 2016. PMID:25980456

  14. Changes in metal levels and chromosome aberrations in the peripheral blood of patients after metal-on-metal hip arthroplasty.

    Science.gov (United States)

    Ladon, Dariusz; Doherty, Ann; Newson, Roger; Turner, Justine; Bhamra, Manjit; Case, C Patrick

    2004-12-01

    A prospective study was performed to investigate changes in metal levels and chromosome aberrations in patients within 2 years of receiving metal-on-metal hip arthroplasties. There was a statistically significant increase of cobalt and chromium concentrations, with a small increase in molybdenum, in whole blood at 6, 12, and 24 months after surgery. There was also a statistically significant increase of both chromosome translocations and aneuploidy in peripheral blood lymphocytes at 6, 12, and 24 months after surgery. The changes were generally progressive with time, but the change in aneuploidy was much greater than in chromosome translocations. No statistically significant correlations were found in secondary analyses between chromosome translocation indices and cobalt or chromium concentration in whole blood. Although the clinical consequences of these changes, if any, are unknown, future epidemiological studies could usefully include direct comparisons of patients with implants of different composition.

  15. Surface Characterization of Retrieved Metal-on-Metal Total Hip Implants from Patients with Adverse Reaction to Metal Debris

    Directory of Open Access Journals (Sweden)

    Maria Burbano

    2014-03-01

    Full Text Available The use of metal-on-metal (MoM total hip implants has decreased recently due to reports of high failure rates and adverse local tissue reaction (ALTR. It has been hypothesized that wear metal debris released from CoCr bearing surfaces may provoke delayed hypersensitivity reactions. The goal of this study is to evaluate the microscopic bearing surface characteristics of implants revised due to evidence of ALTR. The bearing surface of each head and cup was analyzed using multiple microscopy techniques for characterization of the surface features. The presence of severe mechanical scratching was a common characteristic found in all of the implants evaluated. Mechanical factors seemed to be the prevalent failure mode related to the appearance of ALTR with this particular set of retrieved implants.

  16. [Bionic surface design in metal on metal bearings for total hip arthroplasty--optimization of tribological characteristics].

    Science.gov (United States)

    Böhling, U; Scholz, J; Thomas, W; Grundei, H

    2005-04-01

    Bionic systems are aiming to integrate natural observing into mechanical solutions. This has been realized in the design of metal on metal bearing in total hip resurface arthroplasty. The articular side of the femoral cup is covered with a dimple like surface. Under laboratory condition this so called "surf-metal-cup" achieved a reduction of the mechanical wear to almost a third part in comparison to a metal-cup with plane surface. This advantage, caused by the reduced friction-coefficient due to improved hydrodynamic lubrication could also be proved under laboratory conditions. The clinical introduction is expected to offer a significant extension of durability in this prosthetic system and needs to be proved in a long-term study.

  17. Acetabular bone density and metal ions after metal-on-metal versus metal-on-polyethylene total hip arthroplasty; short-term results

    NARCIS (Netherlands)

    Zijlstra, Wierd P.; van der Veen, Hugo C.; van den Akker-Scheek, Inge; Zee, Mark J. M.; Bulstra, Sjoerd K.; van Raay, Jos J. A. M.

    2014-01-01

    Information on periprosthetic acetabular bone density is lacking for metal-on-metal total hip arthroplasties. These bearings use cobalt-chromium instead of titanium acetabular components, which could lead to stress shielding and hence periprosthetic bone loss. Cobalt and chromium ions have detriment

  18. Comparison of different pseudotumor grading systems in a single cohort of metal-on-metal hip arthroplasty patients

    Energy Technology Data Exchange (ETDEWEB)

    Weegen, W. van der; Wullems, J.A.; Das, H.P. [St. Anna Hospital, Department of Orthopaedic Surgery, Geldrop (Netherlands); Brakel, K.; Horn, R.J. [St. Anna Hospital, Department of Radiology, Geldrop (Netherlands); Pilot, P. [Reinier de Graaf Gasthuis, Department of Orthopaedic Surgery, Delft (Netherlands); Nelissen, R.G. [Leids Universitair Medisch Centrum, Department of Orthopaedic Surgery, Leiden (Netherlands)

    2014-02-15

    Follow-up of pseudotumors observed with metal-artefact reducing sequence (MARS)-magnetic resonance imaging (MRI) following metal-on-metal total hip arthroplasty (MoMTHA) depends on how severe these pseudotumors are graded. Several pseudotumor grading systems for MARS-MRI have emerged but little is known of their validity. We studied the intra- and interobserver reliability of three different pseudotumor grading systems in a single cohort of MoMTHA. Two experienced musculoskeletal radiologists independently used three different pseudotumor grading systems for classifying MARS-MRI results of the same cohort of 42 MoMTHA patients (49 hips, mean follow-up 5.2 years). Intraobserver and interobserver reliability for each grading system was measured using Cohen's kappa (κ). Variance in pseudotumor severity grading between systems was analyzed. Intraobserver reliability on grading pseudotumor severity with the Anderson, Matthies, and Hauptfleisch grading system scored 0.47, 0.10, and 0.35 (observer 1), and 0.75, 0.38, and 0.42 (observer 2), respectively. Interobserver reliability scores for pseudotumor severity were 0.58, 0.23, and 0.34, respectively. Intraobserver reliability for grading pseudotumor severity on MARS-MRI ranged from poor to good, dependent on observer and grading system used. Interobserver reliability scored best with the Anderson system. A more succinct pseudotumor severity grading system is needed for clinical use. (orig.)

  19. The influence of clearance on friction, lubrication and squeaking in large diameter metal-on-metal hip replacements.

    Science.gov (United States)

    Brockett, Claire L; Harper, Phil; Williams, Sophie; Isaac, Graham H; Dwyer-Joyce, Rob S; Jin, Zhongmin; Fisher, John

    2008-04-01

    Large diameter metal-on-metal bearings (MOM) are becoming increasingly popular, addressing the needs of young and more active patients. Clinical data has shown excellent short-to-mid-term results, though incidences of transient squeaking have been noted between implantation and up to 2 years post-operative. Geometric design features, such as clearance, have been significant in influencing the performance of the bearings. Sets of MOM bearings with different clearances were investigated in this study using a hip friction simulator to examine the influence of clearance on friction, lubrication and squeaking. The friction factor was found to be highest in the largest clearance bearings under all test conditions. The incidence of squeaking was also highest in the large clearance bearings, with all bearings in this group squeaking throughout the study. A very low incidence of squeaking was observed in the other two clearance groups. The measured lubricating film was found to be lowest in the large clearance bearings. This study suggests that increasing the bearing clearance results in reduced lubricant film thickness, increased friction and an increased incidence of squeaking.

  20. Increased Mortality in Metal-on-Metal versus Non-Metal-on-Metal Primary Total Hip Arthroplasty at 10 Years and Longer Follow-Up: A Systematic Review and Meta-Analysis

    Science.gov (United States)

    Meessen, J. M. T. A.; Fiocco, M.; van der Heide, H. J. L.; Sedrakyan, A.; Nelissen, R. G. H. H.

    2016-01-01

    Importance There are concerns about increased mortality in patients with metal-on-metal bearings in total hip arthroplasty (THA). Objective To determine the mortality and the morbidity in patients with metal-on-metal articulations (MOM THA) compared to patients with non-metal-on-metal articulations (non-MOM THA) after primary total hip arthroplasty. Data Sources Search of PubMed, MEDLINE, EMBASE, Web of Science, Cochrane, CINAHL, AcademicSearchPremier, ScienceDirect, Wiley and clinical trial registers through March 2015, augmented by a hand search of references from the included articles. No language restrictions were applied. Study Selection Two reviewers screened and identified randomised controlled trials and observational studies of primary total hip arthroplasty comparing MOM THA with non-MOM THA. Data Extraction and Synthesis Two reviewers independently extracted study data and assessed risk of bias. Risk differences (RD) were calculated with random effect models. Meta-regression was used to explore modifying factors. Main Outcomes and Measures Difference in mortality and difference in morbidity expressed as revisions and medical complications between patients with MOM THA and non-MOM THA. Results Forty-seven studies were included, comprising 4,000 THA in randomised trials and over 500,000 THA in observational studies. For mortality, random effects analysis revealed a higher pooled RD of 0.7%, 95%, confidence interval (CI) [0.0%, 2.3%], I-square 42%; the heterogeneity was explained by differences in follow-up. When restricted to studies with long term follow-up (i.e. 10 years or more), the RD for mortality was 8.5%, 95%, CI [5.8%, 11.2%]; number needed to treat was 12. Further subgroup analyses and meta-regression random effects models revealed no evidence for other moderator variables (study level covariates, e.g. resurfacing vs. non-resurfacing MOM) than follow-up duration. The quality of the evidence presented in this meta-analysis was characterized as

  1. Increased Mortality in Metal-on-Metal versus Non-Metal-on-Metal Primary Total Hip Arthroplasty at 10 Years and Longer Follow-Up: A Systematic Review and Meta-Analysis.

    Directory of Open Access Journals (Sweden)

    B G Pijls

    Full Text Available There are concerns about increased mortality in patients with metal-on-metal bearings in total hip arthroplasty (THA.To determine the mortality and the morbidity in patients with metal-on-metal articulations (MOM THA compared to patients with non-metal-on-metal articulations (non-MOM THA after primary total hip arthroplasty.Search of PubMed, MEDLINE, EMBASE, Web of Science, Cochrane, CINAHL, AcademicSearchPremier, ScienceDirect, Wiley and clinical trial registers through March 2015, augmented by a hand search of references from the included articles. No language restrictions were applied.Two reviewers screened and identified randomised controlled trials and observational studies of primary total hip arthroplasty comparing MOM THA with non-MOM THA.Two reviewers independently extracted study data and assessed risk of bias. Risk differences (RD were calculated with random effect models. Meta-regression was used to explore modifying factors.Difference in mortality and difference in morbidity expressed as revisions and medical complications between patients with MOM THA and non-MOM THA.Forty-seven studies were included, comprising 4,000 THA in randomised trials and over 500,000 THA in observational studies. For mortality, random effects analysis revealed a higher pooled RD of 0.7%, 95%, confidence interval (CI [0.0%, 2.3%], I-square 42%; the heterogeneity was explained by differences in follow-up. When restricted to studies with long term follow-up (i.e. 10 years or more, the RD for mortality was 8.5%, 95%, CI [5.8%, 11.2%]; number needed to treat was 12. Further subgroup analyses and meta-regression random effects models revealed no evidence for other moderator variables (study level covariates, e.g. resurfacing vs. non-resurfacing MOM than follow-up duration. The quality of the evidence presented in this meta-analysis was characterized as moderate according to the CLEAR-NPT (for non-pharmacological trials and Cochrane risk of bias Table

  2. Usefulness of metal artifact reduction with WARP technique at 1.5 and 3T MRI in imaging metal-on-metal hip resurfacings

    Energy Technology Data Exchange (ETDEWEB)

    Lazik, Andrea; Lauenstein, Thomas C.; Theysohn, Jens M. [University Hospital Essen, Department of Diagnostic and Interventional Radiology and Neuroradiology, Essen (Germany); Landgraeber, Stefan; Schulte, Patrick [University Hospital Essen, Department of Orthopedics, Essen (Germany); Kraff, Oliver [University of Duisburg-Essen, Erwin L. Hahn Institute for Magnetic Resonance Imaging, Essen (Germany)

    2015-03-25

    To evaluate the usefulness of the metal artifact reduction technique ''WARP'' in the assessment of metal-on-metal hip resurfacings at 1.5 and 3T in the context of image quality and imaging speed. Nineteen patients (25 hip resurfacings) were randomized for 1.5 and 3T MRI, both including T1 and T2 turbo spin-echo as well as turbo inversion recovery magnitude sequences with and without view angle tilting and high bandwidth. Additional 3T sequences were acquired with a reduced number of averages and using the parallel acquisition technique for accelerating imaging speed. Artifact size (diameter, area), image quality (5-point scale) and delineation of anatomical structures were compared among the techniques, sequences and field strengths using the Wilcoxon sign-rank and paired t-test with Bonferroni correction. At both field strengths, WARP showed significant superiority over standard sequences regarding image quality, artifact size and delineation of anatomical structures. At 3T, artifacts were larger compared to 1.5T without affecting diagnostic quality, and scanning time could be reduced by up to 64 % without quality degradation. WARP proved useful in imaging metal-on-metal hip resurfacings at 1.5T as well as 3T with better image quality surrounding the implants. At 3T imaging could be considerably accelerated without losing diagnostic quality. (orig.)

  3. The influence of clearance on friction, lubrication and squeaking in large diameter metal-on-metal hip replacements

    OpenAIRE

    Brockett, CL; Harper, P; Williams, S.; Isaac, GH; Dwyer-Joyce, RS; Jin, Z; Fisher, J

    2008-01-01

    Large diameter metal-on-metal bearings (MOM) are becoming increasingly popular, addressing the needs of young and more active patients. Clinical data has shown excellent short-to-mid-term results, though incidences of transient squeaking have been noted between implantation and up to 2 years post-operative. Geometric design features, such as clearance, have been significant in influencing the performance of the bearings. Sets of MOM bearings with different clearances were investigated in this...

  4. Similar incidence of periprosthetic fluid collections after ceramic-on-polyethylene total hip arthroplasties and metal-on-metal resurfacing arthroplasties: results of a screening metal artefact reduction sequence-MRI study

    NARCIS (Netherlands)

    Bisseling, P.; Wit, B.W. de; Hol, A.M.; Gorp, M.J. van; Kampen, A. van; Susante, J.L. van

    2015-01-01

    Patients from a randomised trial on resurfacing hip arthroplasty (RHA) (n = 36, 19 males; median age 57 years, 24 to 65) comparing a conventional 28 mm metal-on-metal total hip arthroplasty (MoM THA) (n = 28, 17 males; median age 59 years, 37 to 65) and a matched control group of asymptomatic patien

  5. Asymptomatic prospective and retrospective cohorts with metal-on-metal hip arthroplasty indicate acquired lymphocyte reactivity varies with metal ion levels on a group basis.

    Science.gov (United States)

    Hallab, Nadim J; Caicedo, Marco; McAllister, Kyron; Skipor, Anastasia; Amstutz, Harlan; Jacobs, Joshua J

    2013-02-01

    Some tissues from metal-on-metal (MoM) hip arthroplasty revisions have shown evidence of adaptive-immune reactivity (i.e., excessive peri-implant lymphocyte infiltration/activation). We hypothesized that, prior to symptoms, some people with MoM hip arthroplasty will develop quantifiable metal-induced lymphocyte reactivity responses related to peripheral metal ion levels. We tested three cohorts (Group 1: n = 21 prospective longitudinal MoM hip arthroplasty; Group 2: n = 17 retrospective MoM hip arthroplasty; and Group 3: n = 20 controls without implants). We compared implant position, metal-ion release, and immuno-reactivity. MoM cohorts had elevated (p metal-reactivity (vs. 5% pre-op, metal-LTT, SI > 2), compared with 76% of Group 2, and 15% of Group 3 controls (patch testing was a poor diagnostic indicator with only 1/21 Group 1 positive). Higher cup-abduction angles (50° vs. 40°) in Group 1 were associated with higher serum Cr (p reactive versus non-reactive Group-1 participants (p metal-reactive versus non-reactive Group 1 participants. Our results showed that lymphocyte reactivity to metals can develop within the first 1-4 years after MoM arthroplasty in asymptomatic patients and lags increases in metal ion levels. This increased metal reactivity was more prevalent in those individuals with extreme cup angles and higher amounts of circulating metal.

  6. A safe zone for acetabular component position in metal-on-metal hip resurfacing arthroplasty: winner of the 2012 HAP PAUL award.

    Science.gov (United States)

    Liu, Fei; Gross, Thomas P

    2013-08-01

    A safe zone for acetabular component positioning in hip resurfacing (RAIL: Relative Acetabular Inclination Limit) was calculated based on implant size and acetabular inclination angle (AIA). For AIA below the RAIL, there were no adverse wear failures or dislocations, and only 1% of cases with ion levels above 10 μg/L. Other than high inclination angle and small bearing size, female gender was the only other factor that correlated with high ion levels in the multivariate analysis. Seven hundred sixty-one hip resurfacing cases are included in this study. The UCLA activity score, femoral shaft angle, body mass index, weight, American Society of Anesthesiologists score, combined range of motion, diagnosis, age, gender, implant brand, AIA, bearing size, and duration of implantation were analyzed to determine the potential risk factors for elevated metal ion levels. These findings apply to sub hemispheric metal-on-metal bearings with similar coverage arcs as the Biomet and Corin hip resurfacing brands. Additional problems may occur when these bearings are connected with trunions on stems for total hip arthroplasty. PMID:23540536

  7. Grading the severity of soft tissue changes associated with metal-on-metal hip replacements: reliability of an MR grading system

    Energy Technology Data Exchange (ETDEWEB)

    Anderson, Helen; Cahir, John G.; Goodwin, Richard W. [Norfolk and Norwich University Hospital, Department of Radiology, Norwich, Norfolk (United Kingdom); Toms, Andoni Paul [Norfolk and Norwich University Hospital, Department of Radiology, Norwich, Norfolk (United Kingdom); Norwich Radiology Academy, Norwich (United Kingdom); Wimhurst, James; Nolan, John F. [Norfolk and Norwich University Hospital, Department of Orthopaedics, Norwich, Norfolk (United Kingdom)

    2011-03-15

    Metal-on-metal (MoM) soft tissue reactions or aseptic lymphocytic vasculitis-associated lesions (ALVAL) are being recognised using metal artefact reduction (MAR) MR with increasing frequency following the advent of second generation metal-on-metal bearings, but there is no standardised technique for reporting of MR appearances in this disease. The aim of this study was to measure the reliability of a grading system designed for scoring the severity of MoM disease on MRI. MRI examinations of 73 hips in 59 patients were retrospectively selected and then anonymised, randomised and reviewed by three independent observers (musculoskeletal radiologists). Each MR examination was scored as either A: normal, B: infection, C1: mild MoM disease, C2: moderate MoM disease or C3: severe MoM disease according to pre-defined criteria. Kappa correlation statistics were used to compare the observations. There was substantial agreement among all three observers; the correlation coefficient between the two most experienced observers was {kappa} = 0.78 [95% confidence intervals (CI): 0.68-0.88] and when compared with the least experienced observer coefficients were {kappa} = 0.69 (95% CI: 0.57-0.80) and {kappa} = 0.66 (95% CI: 0.54-0.78). The strongest correlation occurred for grades A, C2 and C3. The weakest correlations occurred for grades B and C1. The grading system described in this study is reliable for evaluating ALVAL in MoM prostheses using MR but is limited in differentiating mild disease from infection. (orig.)

  8. Clinical outcome study and radiological findings of Zweymuller metal on metal total hip arthroplasty. a follow-up of 6 to 15 years.

    Science.gov (United States)

    Paleochorlidis, Ilias S; Badras, Leonidas S; Skretas, Efstathios F; Georgaklis, Vasilios A; Karachalios, Theofilos S; Malizos, Konstantinos N

    2009-01-01

    We report the clinical and radiological outcome of 99 Zweymuller metal on metal total hip arthroplasties in 84 patients followed up prospectively for a mean period of 9.5 (range, 6-15) years. There were 29 (34.5%) male and 55 (65.5%) female patients with a mean age of 62.85 years (range, 50-70 years) at the time of surgery. All patients had osteoarthritis. One acetabular component and one stem were revised due to aseptic loosening. One femoral stem was revised due to a periprosthetic fracture. HHS score improved from a preoperative mean of 62.56 points (SD 8.87) to a final postoperative follow-up mean of 93.48 (SD 7.7). Cumulative success rate for both implants at 13 years, with aseptic loosening as the end point, was 97.05%, while for both implants at 13 years, with revision for any reason as the end point, it was 91.17%. Satisfactory results were observed with the use of this prosthesis. PMID:20041375

  9. Influence of particulate and dissociated metal-on-metal hip endoprosthesis wear on mesenchymal stromal cells in vivo and in vitro.

    Science.gov (United States)

    Rakow, Anastasia; Schoon, Janosch; Dienelt, Anke; John, Thilo; Textor, Martin; Duda, Georg; Perka, Carsten; Schulze, Frank; Ode, Andrea

    2016-08-01

    In hip arthroplasty the implants' articulating surfaces can be made of a cobalt-chromium-molybdenum (CoCrMo) alloy. The use of these metal-on-metal (MoM) pairings can lead to the release of wear products such as metallic particles and dissociated metal species, raising concerns regarding their safety amongst orthopedic surgeons and the public. MoM-wear particles are reported to be heterogeneous in their physicochemical properties, are capable of inducing adverse effects on a cellular level and are thought to be involved in relevant clinical problems like aseptic osteolysis. Yet, it remains elusive how MoM-wear affects bone forming cells and their progenitors: bone marrow residing mesenchymal stromal cells (MSCs). This study introduces an assessment of the in vivo exposure to particulate and dissociated Co and Cr and evaluates the effects of MoM-wear on MSCs. The exposure to MoM-wear products in vivo and in vitro leads to a decrease in MSCs' osteogenic matrix mineralization and alkaline phosphatase activity on a cellular and systemic level. In conclusion, MoM-wear products are released in the periprosthetic region and elevate bone marrow Co and Cr concentrations towards levels that impair osteogenic differentiation of MSCs. Therefore, the ongoing use of CoCrMo alloys for articulating surfaces in joint replacement implants needs critical reconsideration. PMID:27179133

  10. In vivo response of heme-oxygenase-1 to metal ions released from metal-on-metal hip prostheses.

    Science.gov (United States)

    Beraudi, Alina; Bianconi, Eva; Catalani, Simona; Canaider, Silvia; De Pasquale, Dalila; Apostoli, Pietro; Bordini, Barbara; Stea, Susanna; Toni, Aldo; Facchin, Federica

    2016-07-01

    Metal ion release and accumulation is considered to be a factor responsible for the high failure rates of metal-on-metal (MoM) hip implants. Numerous studies have associated the presence of these ions, besides other factors, including a hypoxia‑like response and changes in pH due to metal corrosion leading to the induction of the oxidative stress response. The aim of the present study was to verify whether, in patients with a MoM hip prosthesis, mRNA and protein expression of HMOX‑1 was modulated by the presence of metal ions and whether patients without prostheses exhibit a different expression pattern of this enzyme. The study was conducted on 22 matched pairs of patients with and without prostheses, for a total of 44 samples. Ion dosage was determined using inductively coupled plasma mass spectrometry equipped with dynamic cell reaction. HMOX‑1 gene expression was quantified by reverse transcription-quantitative polymerase chain reaction and HMOX‑1 protein expression was analyzed using an enzyme-linked immunosorbent assay. The results demonstrated that although there were significant differences in the metallic ion concentrations amongst the two groups of patients, there was no correlation between circulating levels of cobalt (Co) and chromium (Cr), and HMOX‑1 gene and protein expression. Additionally, there was no significant difference in the protein expression levels of HMOX‑1 between the two groups. In conclusion, it was demonstrated that circulating Co and Cr ions released by articular prosthetics do not induce an increase in HMOX‑1 mRNA and protein expression at least 3.5 years after the implant insertion. The present study suggests that involvement of HMOX‑1 may be excluded from future studies and suggests that other antioxidant enzymes, including superoxide dismutase, glutathione peroxidase and reductase should be investigated. PMID:27176599

  11. Metal ion concentrations in body fluids after implantation of hip replacements with metal-on-metal bearing--systematic review of clinical and epidemiological studies.

    Directory of Open Access Journals (Sweden)

    Albrecht Hartmann

    Full Text Available INTRODUCTION: The use of metal-on-metal (MoM total hip arthroplasty (THA increased in the last decades. A release of metal products (i.e. particles, ions, metallo-organic compounds in these implants may cause local and/or systemic adverse reactions. Metal ion concentrations in body fluids are surrogate measures of metal exposure. OBJECTIVE: To systematically summarize and critically appraise published studies concerning metal ion concentrations after MoM THA. METHODS: Systematic review of clinical trials (RCTs and epidemiological studies with assessment of metal ion levels (cobalt, chromium, titanium, nickel, molybdenum in body fluids after implantation of metalliferous hip replacements. Systematic search in PubMed and Embase in January 2012 supplemented by hand search. Standardized abstraction of pre- and postoperative metal ion concentrations stratified by type of bearing (primary explanatory factor, patient characteristics as well as study quality characteristics (secondary explanatory factors. RESULTS: Overall, 104 studies (11 RCTs, 93 epidemiological studies totaling 9.957 patients with measurement of metal ions in body fluids were identified and analyzed. Consistently, median metal ion concentrations were persistently elevated after implantation of MoM-bearings in all investigated mediums (whole blood, serum, plasma, erythrocytes, urine irrespective of patient characteristics and study characteristics. In several studies very high serum cobalt concentrations above 50 µg/L were measured (detection limit typically 0.3 µg/L. Highest metal ion concentrations were observed after treatment with stemmed large-head MoM-implants and hip resurfacing arthroplasty. DISCUSSION: Due to the risk of local and systemic accumulation of metallic products after treatment with MoM-bearing, risk and benefits should be carefully balanced preoperatively. The authors support a proposed "time out" for stemmed large-head MoM-THA and recommend a restricted

  12. 21 CFR 888.3360 - Hip joint femoral (hemi-hip) metallic cemented or uncemented prosthesis.

    Science.gov (United States)

    2010-04-01

    ... uncemented prosthesis. 888.3360 Section 888.3360 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF... Hip joint femoral (hemi-hip) metallic cemented or uncemented prosthesis. (a) Identification. A hip joint femoral (hemi-hip) metallic cemented or uncemented prosthesis is a device intended to be...

  13. 21 CFR 888.3370 - Hip joint (hemi-hip) acetabular metal cemented prosthesis.

    Science.gov (United States)

    2010-04-01

    ... prosthesis. 888.3370 Section 888.3370 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND... (hemi-hip) acetabular metal cemented prosthesis. (a) Identification. A hip joint (hemi-hip) acetabular metal cemented prosthesis is a device intended to be implanted to replace a portion of the hip...

  14. 大直径金属-金属全髋关节置换的早期疗效%Short-term outcome of metal-on-metal total hip arthroplasty with large diameter head

    Institute of Scientific and Technical Information of China (English)

    袁东堂; 左文山; 刘开样; 戴志唐; 徐用亿

    2011-01-01

    BACKGROUND: Dislocation after total hip replacement is still one of the mam complications of traditional metal-on-polyethylenetotal hip replacement. Melal-on-metal lolai hip arthroplasty with large diameter head has a good stability, suitable for young andactive patients with higher requirement of movement.OBJECTIVE: To evaluate the short-term therapeutic effect of total hip arthroplasty with metal-on-metal bearings and largediameter head hip prosthesis.METHODS: A retrospective analysis was done in 48 patients (54 hips) with advanced stage hip disease treated by primary totalhip arthroplasty with metal-on-metal bearings and large diameter head hip prosthesis. The mean diameter of femoral headprosthesis was 44 mm (38 to 48 mm). The postoperative short-term effect was evaluated with Harris scores and X-ray plain.RESULTS AND CONCLUSION: Ail patients received the foliow-up of 18 to 36 months. The mean Harris hip score was 93.6 (91 to96) at the last follow-up. Trie mean range of hip motion was 232.6° (182° to 257°) at the last follow-up. There were no infection, nohip and thigh pain, no vessel and nerve complications, no dislocation. Posl-opretive X-ray plain revealed fine position of theprostheses without any loosening. Short-term results show that large diameter metal-on-metal total hip arthroplasty hasadvantages of lower wearing, large range of motion and few dislocations.%背景:髋关节置换后脱位仍然是传统的金属对聚乙烯全髋关节置换的主要并发症之一,大直径金属对金属的全髋关节置换后具有良好的稳定性,适合年轻、活动要求高的患者.目的:验证大直径金属-金属全髋关节置换治疗终末期髋关节疾病的早期疗效.方法:回顾性分析48例(54髋)初次大直径金属-金属全髋关节置换后的早期临床疗效.假体股骨头直径平均为44 mm(38-48 mm),采用Harris评分和X射线检查评估早期疗效.结果与结论:所有患者都获得18~36个月

  15. A Two Centre Study to Assess the Long-term Performance of the Pinnacle™ Cup With a Metal-on-Metal Bearing in Primary Total Hip Replacement

    Science.gov (United States)

    2014-04-29

    Rheumatoid Arthritis; Osteoarthritis; Post-traumatic Arthritis; Collagen Disorders; Avascular Necrosis; Traumatic Femoral Fractures; Nonunion of Femoral Fractures; Congenital Hip Dysplasia; Slipped Capital Femoral Epiphysis

  16. 21 CFR 888.3390 - Hip joint femoral (hemi-hip) metal/polymer cemented or uncemented prosthesis.

    Science.gov (United States)

    2010-04-01

    ... cemented or uncemented prosthesis. 888.3390 Section 888.3390 Food and Drugs FOOD AND DRUG ADMINISTRATION... § 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...

  17. 21 CFR 888.3380 - Hip joint femoral (hemi-hip) trunnion-bearing metal/polyacetal cemented prosthesis.

    Science.gov (United States)

    2010-04-01

    ... metal/polyacetal cemented prosthesis. 888.3380 Section 888.3380 Food and Drugs FOOD AND DRUG... 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...

  18. Clinical application of metal-on-metal hip joint prosthesis with large heads(ASRTM XL)%金属大头髋(ASRTM XL)的临床应用特点

    Institute of Scientific and Technical Information of China (English)

    徐又佳; 瞿玉兴; 王向利; 沈光思; 董启榕; 郑祖根

    2008-01-01

    目的 探讨金属大头髋(ASRTMXL)的临床应用特点.方法 对14例患者采用ASRTMXL金属大头髋进行全髋关节置换术(total hip arthroplasty,THA),其中强直性脊柱炎合并髋关节融合2髋,股骨头坏死3髋,继发性骨关节炎2髋,股骨颈骨折7髋.根据随访结果对金属大头髋的设计特点、临床特点进行分析.结果 本组患者术后1周开始扶拐行走,6周去拐行走,髋关节前屈、后伸、内旋、外旋、内收、外展显著改善,Harris评分术后平均90分(75~100分)、比术前平均30分(13~50分)显著提高.术后X线片示假体位置正确,外翻角、前倾角正常.无早期并发症发生.结论 金属大头髋早期随访效果好,假体设计具有磨损率低、活动范围大、脱位发生率低、臼杯变形小等特点.%Objective To explore clinical characteristic of metal-on-metal hip joint prosthesis with large heads(ASRTMXL).Methods Total hip arthroplasty(THA)with ASRTMXL was performed in 14 patients including two with ankylosing spondylitis combined with hip amalgamation,three with avascular necrosis,two with secondary osteoarthritis and seven with femoral neck fractures.Based on shortterm follow-up results,we analyzed its design characteristic and clinical properties.Results All patients walked with crotches one week after operation and began weight bearing without support six weeks later.An improvement was seen on the average range of motion of the hip including anteflexion,retroextension,internal rotation,external rotation,adduction and abduction.The mean Harris score was increased from precperative 30 points(13-50 points)to postoperative 90 points(75-100 points),with statistical difference.Postoperative X-ray showed right positions of the prostheses,normal abduction angle and anteversion angle,without complications cccurred.Condusion Short-term follow-up results show that metal-on-metal hip joint prosthesis with large heads has advantages of lower wearing,large range of

  19. Pseudotumour formation and subsequent resolution in metal-on-metal total hip arthroplasty following revision: Instructional review and an illustrative case report with revision using a dual mobility design.

    Science.gov (United States)

    Sassoon, A A; Barrack, R L

    2016-06-01

    The use of large-diameter metal-on-metal (MoM) components in total hip arthroplasty (THA) is associated with an increased risk of early failure due to adverse local tissue reaction to metal debris (ARMD) in response to the release of metal ions from the bearing couple and/or head-neck taper corrosion. The aim of this paper was to present a review of the incidence and natural history of ARMD and the forms of treatment, with a focus on the need for and extent of resection or debulking of the pseudotumour. An illustrative case report is presented of a patient with an intra-pelvic pseudotumour associated with a large diameter MoM THA, which was treated successfully with revision of the bearing surface to a dual mobility couple and retention of the well-fixed acetabular and femoral components. The pseudotumour was left in situ Resolution of the intra-pelvic mass and normalisation of metal ion levels was observed seven months post-operatively. Cite this article: Bone Joint J 2016;98-B:736-40. PMID:27235513

  20. A retrospective comparative study of mortality and causes of death among patients with metal-on-metal and metal-on-polyethylene total hip prostheses in primary osteoarthritis after a long-term follow-up

    Directory of Open Access Journals (Sweden)

    Paavolainen Pekka

    2010-04-01

    Full Text Available Abstract Background All patients with total hip arthroplasty (THA, especially those with metal-on-metal (MM THA, are exposed to metallic particles and ions, which may cause total or site-specific mortality. We analyzed the causes of total and site-specific mortality among a cohort of patients with MM and with metal-on-polyethylene (MP THA after a long follow-up time. Methods Standardized mortality ratios (SMR of total and site-specific causes of death were calculated for 579 patients with MM (McKee-Farrar and 1585 patients with MP (Brunswik, Lubinus THA for primary osteoarthritis. Results Mean follow-up time was 17.9 years for patients with MM and 16.7 years for patients with MP. Overall SMR was 0.95 for the MM cohort and 0.90 for the MP cohort, as compared to the normal population. Both cohorts showed significantly decreased mortality for the first decade postoperatively, equal mortality over the next 10 years, and significantly increased mortality after 20 years. Patients with MM THA had higher cancer mortality (SMR 1.01 than those with MP THA (SMR 0.66 during the first 20 years postoperatively, but not thereafter. Conclusion Both MM and MP prostheses are safe based on total and site-specific mortality of recipients during the first 20 postoperative years in comparison with the general population.

  1. Uneven damage on head and liner contact surfaces of a retrieved Co-Cr-based metal-on-metal hip joint bearing: An important reason for the high failure rate.

    Science.gov (United States)

    Koizumi, Yuichiro; Chen, Yan; Li, Yunping; Yamanaka, Kenta; Chiba, Akihiko; Tanaka, Shun-Ichiro; Hagiwara, Yoshihiro

    2016-05-01

    Detailed metallurgical investigations have been performed on a used Co-Cr-based metal-on-metal (MoM) hip joint bearing containing a type of liner that is commonly used in such joints. The damage on the metal-liner sliding surface was considerably more severe than that on the metal head counterpart, in terms of wear-scar density and width and microcrack frequency. Cross-sectional transmission electron microscopy revealed that a thick (>3 μm) nanocrystalline layer formed on the sliding surface of the head, whereas the liner had coarse carbides embedded in it and nanocrystals were formed in a very limited region no deeper than 1 μm. Comparative investigation of an unused head and a liner of identical type showed that although the chemical compositions of the liner and head were nearly identical, their microstructures were significantly different. Specifically, the grain size in the liner was larger than that in the head on average, and the grain boundaries of the liner were decorated with coarse carbides. Moreover, X-ray diffraction analysis revealed a large tensile residual stress only in the liner. These differences are possibly responsible for the wear damage on the liner being more serious than that on the head. PMID:26952456

  2. MR imaging with metal artifact-reducing sequences and gadolinium contrast agent in a case-control study of periprosthetic abnormalities in patients with metal-on-metal hip prostheses

    Energy Technology Data Exchange (ETDEWEB)

    Mueller, Gunilla M.; Mueller, Markus F.; Ekberg, Olle [Lund University, Skaane University Hospital, Department of Radiology, Malmoe (Sweden); Maansson, Sven [Lund University, Skaane University Hospital, Department of Medical Radiation Physics, Malmoe (Sweden); Schewelov, Thord von [Lund University, Skaane University Hospital, Department of Orthopedic Surgery, Malmoe (Sweden); Nittka, Mathias [Siemens AG, Healthcare Sector, Erlangen (Germany); Lundin, Bjoern [Lund University, Skaane University Hospital, Department of Radiology, Lund (Sweden)

    2014-08-15

    To apply and compare magnetic resonance imaging (MRI) metal artifact reducing sequences (MARS) including subtraction imaging after contrast application in patients with metal-on-metal (MoM) hip prostheses, investigate the prevalence and characteristics of periprosthetic abnormalities, as well as their relation with pain and risk factors. Fifty-two MoM prostheses (35 cases with pain and or risk factors, and 17 controls) in 47 patients were examined in a 1.5-T MR scanner using MARS: turbo spin echo (TSE) with high readout bandwidth with and without view angle tilting (VAT), TSE with VAT and slice encoding for metal artifact correction (SEMAC), short tau inversion recovery (STIR) with matched RF pulses, and post-contrast imaging. The relations of MRI findings to pain and risk factors were analyzed and in five revised hips findings from operation, histology, and MRI were compared. TSE VAT detected the highest number of osteolyses. Soft tissue mass, effusion, and capsular thickening were common, whereas osteolysis in acetabulum and femur were less frequent. Contrast enhancement occurred in bone, synovia, joint capsule, and the periphery of soft tissue mass. There was no significant relation between MRI findings and pain or risk factors. MARS and gadolinium subtraction imaging are useful for evaluation of complications to MoM prosthesis. TSE VAT had the highest sensitivity for osteolysis. Contrast enhancement might indicate activation of aseptic lymphocyte-dominated vasculitis-associated lesion (ALVAL). Pain, small head, or steep prosthesis inclination angle are not useful predictors of periprosthetic abnormalities, and wide indications for MR follow-up are warranted. (orig.)

  3. Hybrid metal-on-metal hip surface arthroplasty in 18 cases: 2 -year follow-up study%混合型金属对金属人工全髋表面置换术18例:2年随访

    Institute of Scientific and Technical Information of China (English)

    茹江英; 刘璠; 胡玉华; 胡传亮; 王长峰

    2008-01-01

    . Subsequently to install the femoral head prosthesis, femoral cup was laid on the ready caput femoris and impacted by the presser to make the metal cup paste close-up with sclerotin when the concocted bone cement was overlaid on the prefabricated caput femoris surface and internal surface of prosthesis. Further, short-term of femoral cup should be kept the conformity with axial ray of the femoral neck. ②Patients were allowed to make the function exercise such as initiative stretch and contract of quadriceps muscle of thigh, passive motion of the knee joint and initiative motion of the knee joint under the non-weight loading on bed. Then they were encouraged to walk with two walking sticks two weeks after operation, progressing to get out of the two walking sticks six weeks postoperatively. All affected extremities were fixated with T-shaped tabula shoes in the abduction position after operation. ③All patients were reviewed with taking the anteroposterior radiographs of pelvis, evaluation of the clinically curative effect on the procedure of metal-on-metal hip surface arthroplasty and biocompatibility between the prosthesis and the host one year and two years after operation. Moreover, Harris score was assessed for all affected hips preoperatively, one year and two years postoperatively.MAIN OUTCOME MEASURES: ①The clinically curative effect on metal on metal hip surface arthroplasty; ②Biocompatibility;③The Harris score for the affected hips; ④The pain status of hip after operation.RESULTS: Eighteen cases were all brought into the outcome analysis at last.①The curative effect on the metal-on-metal hip surface arthroplasty: The femoral component of one case had a varus deformation of 10°six weeks after operation, but such complications as component loosening and femoral neck fractures, etc. Did not occur during the coming follow-up. The locations of rest prosthesis were satisfactory. Substantial radiolucencies were found at the rim of acetabular component (1 and 2

  4. The behavior of the micro-mechanical cement-bone interface affects the cement failure in total hip replacement

    NARCIS (Netherlands)

    Waanders, D.; Janssen, D.; Mann, K.A.; Verdonschot, N.J.J.

    2011-01-01

    In the current study, the effects of different ways to implement the complex micro-mechanical behavior of the cement-bone interface on the fatigue failure of the cement mantle were investigated. In an FEA-model of a cemented hip reconstruction the cement-bone interface was modeled and numerically im

  5. CoCr wear particles generated from CoCr alloy metal-on-metal hip replacements, and cobalt ions stimulate apoptosis and expression of general toxicology-related genes in monocyte-like U937 cells

    International Nuclear Information System (INIS)

    Cobalt-chromium (CoCr) particles in the nanometre size range and their concomitant release of Co and Cr ions into the patients' circulation are produced by wear at the articulating surfaces of metal-on-metal (MoM) implants. This process is associated with inflammation, bone loss and implant loosening and led to the withdrawal from the market of the DePuy ASR™ MoM hip replacements in 2010. Ions released from CoCr particles derived from a resurfacing implant in vitro and their subsequent cellular up-take were measured by ICP-MS. Moreover, the ability of such metal debris and Co ions to induce both apoptosis was evaluated with both FACS and immunoblotting. qRT-PCR was used to assess the effects on the expression of lymphotoxin alpha (LTA), BCL2-associated athanogene (BAG1), nitric oxide synthase 2 inducible (NOS2), FBJ murine osteosarcoma viral oncogene homolog (FOS), growth arrest and DNA-damage-inducible alpha (GADD45A). ICP-MS showed that the wear debris released significant (p < 0.05) amounts of Co and Cr ions into the culture medium, and significant (p < 0.05) cellular uptake of both ions. There was also an increase (p < 0.05) in apoptosis after a 48 h exposure to wear debris. Analysis of qRT-PCR results found significant up-regulation (p < 0.05) particularly of NOS2 and BAG1 in Co pre-treated cells which were subsequently exposed to Co ions + debris. Metal debris was more effective as an inducer of apoptosis and gene expression when cells had been pre-treated with Co ions. This suggests that if a patient receives sequential bilateral CoCr implants, the second implant may be more likely to produce adverse effects than the first one. - Highlights: • Effects of CoCr nanoparticles and Co ions on U937 cells were investigated. • Ions released from wear debris play an important role in cellular response, • Toxicity of Co ions could be related to NO metabolic processes and apoptosis. • CoCr particles were a more effective inducer of apoptosis after cell

  6. CoCr wear particles generated from CoCr alloy metal-on-metal hip replacements, and cobalt ions stimulate apoptosis and expression of general toxicology-related genes in monocyte-like U937 cells

    Energy Technology Data Exchange (ETDEWEB)

    Posada, Olga M., E-mail: O.M.PosadaEstefan@leeds.ac.uk [Biomedical Engineering Department, University of Strathclyde, Wolfson Centre, Glasgow G4 0NW (United Kingdom); Gilmour, Denise [Pure and Applied Chemistry Department, University of Strathclyde, Thomas Graham Building, Glasgow G1 1XL (United Kingdom); Tate, Rothwelle J., E-mail: r.j.tate@strath.ac.uk [Strathclyde Institute for Pharmacy and Biomedical Sciences, University of Strathclyde, Glasgow G4 0RE (United Kingdom); Grant, M. Helen [Biomedical Engineering Department, University of Strathclyde, Wolfson Centre, Glasgow G4 0NW (United Kingdom)

    2014-11-15

    Cobalt-chromium (CoCr) particles in the nanometre size range and their concomitant release of Co and Cr ions into the patients' circulation are produced by wear at the articulating surfaces of metal-on-metal (MoM) implants. This process is associated with inflammation, bone loss and implant loosening and led to the withdrawal from the market of the DePuy ASR™ MoM hip replacements in 2010. Ions released from CoCr particles derived from a resurfacing implant in vitro and their subsequent cellular up-take were measured by ICP-MS. Moreover, the ability of such metal debris and Co ions to induce both apoptosis was evaluated with both FACS and immunoblotting. qRT-PCR was used to assess the effects on the expression of lymphotoxin alpha (LTA), BCL2-associated athanogene (BAG1), nitric oxide synthase 2 inducible (NOS2), FBJ murine osteosarcoma viral oncogene homolog (FOS), growth arrest and DNA-damage-inducible alpha (GADD45A). ICP-MS showed that the wear debris released significant (p < 0.05) amounts of Co and Cr ions into the culture medium, and significant (p < 0.05) cellular uptake of both ions. There was also an increase (p < 0.05) in apoptosis after a 48 h exposure to wear debris. Analysis of qRT-PCR results found significant up-regulation (p < 0.05) particularly of NOS2 and BAG1 in Co pre-treated cells which were subsequently exposed to Co ions + debris. Metal debris was more effective as an inducer of apoptosis and gene expression when cells had been pre-treated with Co ions. This suggests that if a patient receives sequential bilateral CoCr implants, the second implant may be more likely to produce adverse effects than the first one. - Highlights: • Effects of CoCr nanoparticles and Co ions on U937 cells were investigated. • Ions released from wear debris play an important role in cellular response, • Toxicity of Co ions could be related to NO metabolic processes and apoptosis. • CoCr particles were a more effective inducer of apoptosis after cell

  7. 21 CFR 888.3340 - Hip joint metal/composite semi-constrained cemented prosthesis.

    Science.gov (United States)

    2010-04-01

    ... cemented prosthesis. 888.3340 Section 888.3340 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF... Hip joint metal/composite semi-constrained cemented prosthesis. (a) Identification. A hip joint metal/composite semi-constrained cemented prosthesis is a two-part device intended to be implanted to replace...

  8. Cemented total hip prosthesis: Radiographic and scintigraphic evaluation

    International Nuclear Information System (INIS)

    Conventional radiographs, technetium-99m bone scans, and gallium-67 scans were reviewed in 44 patients who had undergone cemented total hip joint replacement and were imaged because of suspicion of prosthesis loosening or infection. A complete radiolucent line of 2 mm or wider along the bone-cement interface or metal-cement lucency on conventional radiographs was used as the criterion for prosthetic loosening with or without infection and proved to be 54% sensitive and 96% specific. Scintigraphic criteria for prosthetic loosening were increased focal uptake of the radiopharmaceutical for the femoral component and increased focal or diffuse uptake for the acetabular component. For bone scintigraphy, sensitivity was 73% and specificity was 96%. Combining the results of conventional radiographs and bone scans increased sensitivity to 84% and decreased specificity to 92% for the diagnosis of loosening, infection, or both. The study also showed that Ga-67 scintigraphy has a low sensitivity for the detection of infection

  9. Analysis of Femoral Components of Cemented Total Hip- Arthroplasty

    CERN Document Server

    Singh, Shantanu

    2014-01-01

    In cemented Total Hip Arthroplasty (THA), material chosen for femoral stem and cross section of stem itself, proved to be critical parameters for, stress distribution in the femoral components, interfacial stresses and micro movements. Titanium alloy (Ti6Al4V), when used as a material for femoral stem, recorded large displacement as compared to Chromium alloy (CoCrMo) stems. This large displacement in case of Ti6Al4V caused the stem to bend inside the cement mantle, thus destroying it. Thus, CoCrMo proved to be a better in cemented THA. Failure in THA may occur at cement-stem or cement-bone interface, thus interfacial stresses and micro movements were analysed in the present study. Comparison between trapezium and circular cross section showed that, femoral stem with trapezium cross section underwent lesser amount of sliding and debonding, at both interfaces, as compared to circular cross section. Moreover, trapezium cross section also generated lower peak stresses in femoral stem and cortical femur. The pres...

  10. Mechanical properties of femoral cortical bone following cemented hip replacement.

    Science.gov (United States)

    Ni, G X; Lu, W W; Chiu, P K Y; Wang, Y; Li, Z Y; Zhang, Y G; Xu, B; Deng, L F; Luk, K D K

    2007-11-01

    Femoral bone remodeling following total hip replacement is a big concern and has never been examined mechanically. In this study, six goats underwent unilateral cemented hip hemiarthroplasty with polymethyl methacrylate (PMMA) bone cement. Nine months later animals were sacrificed, and the femoral cortical bone slices at different levels were analysed using microhardness testing and microcomputed tomography (micro-CT) scanning. Implanted femurs were compared to contralateral nonimplanted femurs. Extensive bone remodeling was demonstrated at both the proximal and middle levels, but not at the distal level. Compared with the nonimplanted side, significant decreases were found in the implanted femur in cortical bone area, bone mineral density, and cortical bone hardness at the proximal level, as well as in bone mineral density and bone hardness at the middle level. However, no significant difference was observed in either variable for the distal level. In addition, similar proximal-to-distal gradient changes were revealed both in cortical bone microhardness and bone mineral density. From the mechanical point of view, the results of the present study suggested that stress shielding is an important mechanical factor associated with bone adaptation following total hip replacement. PMID:17506504

  11. Total hip arthroplasty in patients with avascular necrosis of the hip. Follow-up observations on cementless and cemented operations.

    Science.gov (United States)

    Katz, R L; Bourne, R B; Rorabeck, C H; McGee, H

    1992-08-01

    Thirty-one patients with avascular necrosis of the hip were treated by 34 total hip arthroplasties (THAs). All patients were observed prospectively with a minimum two-year follow-up evaluation (average, 46 months; range, 24-84 months). Twenty had cemented arthroplasties using contemporary cementing techniques. This included insertion of a medullary plug, cleansing of the canal with a medullary brush, pulsatile lavage irrigation, and insertion of the cement with a cement gun. In 14 hips, a cementless prosthesis was used. Patients were rated using a modified Harris hip score. Sequential postoperative roentgenograms were analyzed in each patient. The overall Harris hip score ratings were 88 in the cemented and 84 in the noncemented groups. Mechanical failure with loosening of the femoral component occurred in one patient who developed deep sepsis. Significant thigh pain occurred in four patients in the noncemented group. Previous studies in the literature have generally reported unfavorable results in patients with avascular necrosis of the hip treated with THA. Using cementless and cemented fixation with contemporary cementing techniques, improved results can be expected. A high incidence of thigh pain (29%) in the cementless group remains a problem. PMID:1499201

  12. Analysis of Femoral Components of Cemented Total Hip Arthroplasty

    Science.gov (United States)

    Singh, Shantanu; Harsha, A. P.

    2015-10-01

    There have been continuous on-going revisions in design of prosthesis in Total Hip Arthroplasty (THA) to improve the endurance of hip replacement. In the present work, Finite Element Analysis was performed on cemented THA with CoCrMo trapezoidal, CoCrMo circular, Ti6Al4V trapezoidal and Ti6Al4V circular stem. It was observed that cross section and material of femoral stem proved to be critical parameters for stress distribution in femoral components, distribution of interfacial stress and micro movements. In the first part of analysis, designs were investigated for micro movements and stress developed, for different stem materials. Later part of the analysis focused on investigations with respect to different stem cross sections. Femoral stem made of Titanium alloy (Ti6Al4V) resulted in larger debonding of stem at cement-stem interface and increased stress within the cement mantle in contrast to chromium alloy (CoCrMo) stem. Thus, CoCrMo proved to be a better choice for cemented THA. Comparison between CoCrMo femoral stem of trapezium and circular cross section showed that trapezoidal stem experiences lesser sliding and debonding at interfaces than circular cross section stem. Also, trapezium cross section generated lower peak stress in femoral stem and cortical femur. In present study, femur head with diameter of 36 mm was considered for the analysis in order to avoid dislocation of the stem. Also, metallic femur head was coupled with cross linked polyethylene liner as it experiences negligible wear compared to conventional polyethylene liner and unlike metallic liner it is non carcinogenic.

  13. 21 CFR 888.3310 - Hip joint metal/polymer constrained cemented or uncemented prosthesis.

    Science.gov (United States)

    2010-04-01

    ... uncemented prosthesis. 888.3310 Section 888.3310 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF... Hip joint metal/polymer constrained cemented or uncemented prosthesis. (a) Identification. A hip joint metal/polymer constrained cemented or uncemented prosthesis is a device intended to be implanted...

  14. 21 CFR 888.3350 - Hip joint metal/polymer semi-constrained cemented prosthesis.

    Science.gov (United States)

    2010-04-01

    ... prosthesis. 888.3350 Section 888.3350 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND... metal/polymer semi-constrained cemented prosthesis. (a) Identification. A hip joint metal/polymer semi-constrained cemented prosthesis is a device intended to be implanted to replace a hip joint. The device...

  15. 21 CFR 888.3300 - Hip joint metal constrained cemented or uncemented prosthesis.

    Science.gov (United States)

    2010-04-01

    ... prosthesis. 888.3300 Section 888.3300 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND... metal constrained cemented or uncemented prosthesis. (a) Identification. A hip joint metal constrained cemented or uncemented prosthesis is a device intended to be implanted to replace a hip joint. The...

  16. A Biomimetic Hip Joint Simulator and its Application in in vitro Study of the Integrity of Replacement Cemented Hip

    Institute of Scientific and Technical Information of China (English)

    Liu Chao-zong; S.M.Green; N.D.Watkins; A.W.McCaskie

    2005-01-01

    A biomimetic hip joint simulator that can be used to evaluate the outcome of the cemented total hip replacement has been designed, manufactured and evaluated. The simulator produces motion in the extension/flexion plane, with a socket to rotate internal/externally. At the same time a dynamic loading cycle is applied. A validation test was performed on a cemented femoral stem within a novel composite femur. The bone quality has a strong effect on the stem migration and on the integrity of the interfaces. The migration of the stem is a combination of 3-D translation and rotation of the stem. Under the same loading conditions, weak bone allows more stem migration than strong bone. There is a great decrease in the strength of the stem-cement interface after the dynamic test, and the weak bone composite exhibited a greater reduction in interfacial strength than the strong bone composite. The decrease of the interfacial strength indicates that the primary bonding between the stem and the cement mantle had deteriorated and the integrity of stem-cement interface was damaged.The study demonstrates the value of using a hip joint simulator to investigate stem migration and interface integrity within the cemented hip replacement, suggesting that method can be used for in vitro evaluation of the biomaterials used in the cemented hip replacements.

  17. The influence of cement mantle thickness and stem geometry on fatigue damage in two different cemented hip femoral prostheses.

    Science.gov (United States)

    Ramos, A; Simões, J A

    2009-11-13

    Experimental models can be used for pre-clinical testing of cemented and other type of hip replacements. Total hip replacement (THR) failure scenarios include, among others, cement damage accumulation and the assessment of accurate stress and strain magnitudes at the cement mantle interfaces (stem-cement and cement-bone) can be used to predict mechanical failure. The aseptic loosening scenario in cemented hip replacements is currently not fully understood, and methods of evaluating medical devices must be developed to improve clinical performance. Different results and conclusions concerning the cement micro-cracking mechanism have been reported. The aim of this study was to verify the in vitro behavior of two cemented femoral stems with respect to fatigue crack formation. Fatigue crack damage was assessed at the medial, lateral, anterior and posterior sides of the Lubinus SPII and Charnley stems. All stems were loaded and tested in stair climbing fatigue loading during one million cycles at 2 Hz. After the experiments each implanted synthetic femur was sectioned and analyzed. We observed more damage (cracks per area) for the Lubinus SPII stem, mainly on the proximal part of the cement mantle. The micro-cracking formation initiated in the stem-cement interface and grew towards the direction of cortical bone of the femur. Overall, the cement-bone interface seems to be crucial for the success of the hip replacement. The Charnley stem provoked more damage on the cement-bone interface. A failure index (maximum length of crack/maximum thickness of cement) considered was higher for the cement-stem interface of the Lubinus SPII stem. For a cement mantle thickness higher than 5 mm, cracking initiated at the cement-bone interface and depended on the opening canal process (reaming procedure and instrumentation). The analysis also showed that fatigue-induced damage on the cement mantle, increasing proximally, and depended on the axial position of the stem. The cement

  18. Hip-joint and abductor-muscle forces adequately represent in vivo loading of a cemented total hip reconstruction.

    NARCIS (Netherlands)

    Stolk, J.; Verdonschot, N.J.J.; Huiskes, R.

    2001-01-01

    Using finite element analyses, we investigated which muscle groups acting around the hip-joint most prominently affected the load distributions in cemented total hip reconstructions with a bonded and debonded femoral stem. The purpose was to determine which muscle groups should be included in pre-cl

  19. Palacos compared to Palamed bone cement in total hip replacement: a randomized controlled trial.

    Science.gov (United States)

    Meinardi, Joris E; Valstar, Edward R; Van Der Voort, Paul; Kaptein, Bart L; Fiocco, Marta; Nelissen, Rob G H H

    2016-10-01

    Background and purpose - Stability and survival of cemented total hip prostheses is dependent on a multitude of factors, including the type of cement that is used. Bone cements vary in viscosity, from low to medium and high. There have been few clinical RSA studies comparing the performance of low- and high-viscosity bone cements. We compared the migration behavior of the Stanmore hip stem cemented using novel low-viscosity Palamed bone cement with that of the same stem cemented with conventional high-viscosity Palacos bone cement. Patients and methods - We performed a randomized controlled study involving 39 patients (40 hips) undergoing primary total hip replacement for primary or secondary osteoarthritis. 22 patients (22 hips) were randomized to Palacos and 17 patients (18 hips) were randomized to Palamed. Migration was determined by RSA. Results - None of these 40 hips had been revised at the 10-year follow-up mark. To our knowledge, the patients who died before they reached the 10-year endpoint still had the implant in situ. No statistically significant or clinically significant differences were found between the 2 groups for mean translations, rotations, and maximum total-point motion (MTPM). Interpretation - We found similar migration of the Stanmore stem in the high-viscosity Palacos cement group and the low-viscosity Palamed cement group. We therefore expect that the risk of aseptic loosening with the new Palamed cement would be comparable to that with the conventional Palacos cement. The choice of which type of bone cement to use is therefore up to the surgeon's preference. PMID:27329869

  20. Revision total hip replacement with a cemented long femoral component: minimum 9-year follow-up results.

    OpenAIRE

    So, Kazutaka; Kuroda, Yutaka; Matsuda, Shuichi; Akiyama, Haruhiko

    2013-01-01

    [Background] Surgical revision after failed total hip replacement is a technically challenging procedure. The aim of this study was to analyze the long-term results of revision total hip replacement using a cemented long femoral component and identify factors that influence the results. [Methods] We retrospectively reviewed 34 hips in 33 patients who had undergone revision total hip replacement using a cemented long femoral component between 1994 and 2001. Hip function was evaluated according...

  1. A fluoroscopy-based planning and guidance software tool for minimally invasive hip refixation by cement injection

    NARCIS (Netherlands)

    Malan, D.F.; Van der Walt, S.J.; Raidou, R.G.; Van den Berg, B.; Stoel, B.C.; Botha, C.P.; Nelissen, R.G.H.H.; Valstar, E.R.

    2015-01-01

    Purpose In orthopaedics, minimally invasive injection of bone cement is an established technique. We present HipRFX, a software tool for planning and guiding a cement injection procedure for stabilizing a loosening hip prosthesis. HipRFX works by analysing a pre-operative CT and intraoperative C-arm

  2. Effects of metal-inlay thickness in polyethylene cups with metal-on-metal bearings.

    NARCIS (Netherlands)

    Verdonschot, N.J.J.; Vena, P.; Stolk, J.; Huiskes, R.

    2002-01-01

    A way to prevent polyethylene wear in total hip replacements is to use metal-on-metal bearings. The cup design of these bearings may be a metal inlay in a polyethylene cup. However, these metal inlays are relatively thin and may deform on loading. The purpose of the current study was to determine wh

  3. Cemented total hip arthroplasty with impacted morcellized bone-grafts to restore acetabular bone defects in congenital hip dysplasia.

    NARCIS (Netherlands)

    Bolder, S.B.T.; Melenhorst, J.; Gardeniers, J.W.M.; Slooff, T.J.J.H.; Veth, R.P.H.; Schreurs, B.W.

    2001-01-01

    We evaluated the results of 27 acetabular reconstructions in 21 patients with secondary osteoarthritis resulting from congenital dysplasia of the hip in which the acetabular bone defects were restored with impacted morcellized bone-grafts in combination with a cemented cup. At an average follow-up o

  4. 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.)

  5. 21 CFR 888.3320 - Hip joint metal/metal semi-constrained, with a cemented acetabular component, prosthesis.

    Science.gov (United States)

    2010-04-01

    ... cemented acetabular component, prosthesis. 888.3320 Section 888.3320 Food and Drugs FOOD AND DRUG..., prosthesis. (a) Identification. A hip joint metal/metal semi-constrained, with a cemented acetabular component, prosthesis is a two-part device intended to be implanted to replace a hip joint. The...

  6. 21 CFR 888.3353 - Hip joint metal/ceramic/polymer semi-constrained cemented or nonporous uncemented prosthesis.

    Science.gov (United States)

    2010-04-01

    ... cemented or nonporous uncemented prosthesis. 888.3353 Section 888.3353 Food and Drugs FOOD AND DRUG... prosthesis. (a) Identification. A hip joint metal/ceramic/polymer semi-constrained cemented or nonporous uncemented prosthesis is a device intended to be implanted to replace a hip joint. This device...

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

    Directory of Open Access Journals (Sweden)

    Akio Kanda

    2016-01-01

    Full Text Available 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.

  8. MRI does not detect acetabular osteolysis around metal-on-metal Birmingham THA

    OpenAIRE

    Waldstein, Wenzel; Schmidt-Braekling, Tom; Boettner, Friedrich

    2014-01-01

    Objective Osteolysis has not been recognized as a common failure mode of the Birmingham modular metal-on-metal (MoM) total hip arthroplasty (THA). The clinical value of metal artifact reduction sequence (MARS) magnetic resonance imaging (MRI) to assess the periprosthetic soft tissue is well documented; however, the appropriate image modalities to detect periacetabular osteolysis remain unclear. Case summary Eleven patients with periacetabular osteolysis within 3–6 years after uncemented Birmi...

  9. Femoral and obturator nerves palsy caused by pelvic cement extrusion after hip arthroplasty.

    Directory of Open Access Journals (Sweden)

    Pawel Zwolak

    2011-05-01

    Full Text Available Cement extrusion into the pelvis with subsequent palsy of the obturator and femoral nerves is a rare entity after hip replacement surgery. Cemented fixation of the acetabular cup has been considered as a safe and reliable standard procedure with very good long term results. We present a case of fifty year old female patient after hip arthroplasty procedure which suffered an obturator and femoral nerve palsy caused by extrusion of bone cement into the pelvis. Postoperative X-rays and CT-scan of the pelvis demonstrated a huge mass consisted of bone cement in close proximity of femoral and obturator nerves. The surgery charts reported shallow and weak bony substance in postero-superior aspect of the acetabulum. This weak bony acetabular substance may have caused extrusion of bone cement during press-fitting of the polyethylene cup into the acetabulum, and the following damage of the both nerves produced by polymerization of bone cement. The bone cement fragment has been surgically removed 3 weeks after arthroplasty. The female patient underwent intensive postoperative physical therapy and electro stimulation which resulted in full recovery of the patient to daily routine and almost normal electromyography results.

  10. Clinical application and therapeutic effectiveness of large diameter head metal-on-metal total hip replacement%金属对金属大直径股骨头全髋关节置换术的临床应用及近期疗效观察

    Institute of Scientific and Technical Information of China (English)

    刘二涛; 徐皓; 陈建梅; 姚晓东; 李金泉

    2013-01-01

    Objective To explore the short-term results of total hip replacement THR ) using large diameter heads( LDH )in metal-on-metal( MOM )articulation. Methods A consecutive series of 34 patients( 34 hips )who underwent THR using LDH in MOM articulation were studied. The results were e-valuated both clinically and radio graphically. Clinical outcomes were evaluated according to the Harris e-valuation score and the R0M( Range of motion ). Acetabular position, components migration and bone changes around the implant were measured radiographically. Results The average follow-up period of all 34 patients was 18. 7 months. There was no bright line around the prosthesis. No complications such as os-teolysis, prosthetic loosening, heterotopic ossification and prosthesis fracture occurred. The average Harris hip score at the last follow-up was significantly improved compared with the preoperative scores( 87. 82 points versus 35. 29 points ). The postoperative ROM of all patients improved remarkably. Conclusion The short-term results of LDH in MOM total hip replacement on hip osteoarthritis, aseptic femoral head necrosis, femur neck fracture and congenital hip hypoplasia are excellent. But the long-term results of THR using LDH in MOM articulation still need further investigation.%目的 总结金属对金属大直径股骨头全髋关节置换术(total hip replacement,THR)的近期疗效.方法 回顾性分析行金属对金属大直径股骨头THR患者34例34髋.临床评估以Harris评分及髋关节活动度为标准.影像学根据双髋关节正位片,观察髋臼、股骨假体的位置及周围骨质的改变.结果 34例患者平均随访18.7个月.术后均无假体周围透亮线产生,无骨溶解、假体松动、异位骨化及假体断裂等并发症.Harris评分由术前的20~48分,平均(35.29±8.59)分,提高至术后随访时的76~96分,平均(87.82±5.12)分.所有患者髋关节活动度术后显著提高.结论 采用金属对金属大直径股骨

  11. Complications Related to Metal-on-Metal Articulation in Trapeziometacarpal Joint Total Joint Arthroplasty

    DEFF Research Database (Denmark)

    Frølich, Christina; Hansen, Torben Bæk

    2015-01-01

    Adverse reactions to metal-on-metal (MoM) prostheses are well known from total hip joint resurfacing arthroplasty with elevated serum chrome or cobalt, pain and pseudo tumor formation. It may, however, also be seen after total joint replacement of the trapeziometacarpal joint using MoM articulation......, and we present two cases of failure of MoM prostheses due to elevated metal-serum levels in one case and pseudo tumor formation in another case. Furthermore, we suggest a diagnostic algorithm for joint pain after MoM trapeziometacarpal joint replacement based on published experiences from MoM hip...... prostheses and adverse reactions to metal....

  12. Infection or metal hypersensitivity? The diagnostic challenge of failure in metal-on-metal bearings.

    LENUS (Irish Health Repository)

    Galbraith, John G

    2011-04-01

    The use of second generation metal-on-metal hip articulations has gained favour in the past few years. A hypersensitivity reaction to the metal-on-metal bearing, although rare, is a reported complication and is a novel mode of failure of these implants. Differentiating failure secondary to infection from failure secondary to metal hypersensitivity represents a significant diagnostic challenge. A retrospective review of all cases of hip arthroplasty using metal-on-metal bearings over a 5-year period at a tertiary referral centre identified 3 cases of failure secondary to metal hypersensitivity. Clinical presentation, serological markers, radiological imaging and histological analysis of all cases identified were evaluated. Histological analysis of periprosthetic tissue in all 3 cases identified characteristic features such as perivascular lymphocytic aggregates and chronic inflammation consistent with aseptic lymphocytic vasculitis-associated lesions (ALVAL). This study highlights that failure secondary to metal hypersensitivity must be considered in patients presenting with the reappearance of persistent pain, marked joint effusion, and the development of early osteolysis in the absence of infection.

  13. Intraoperative monitoring for safety of total hip arthroplasty using third-generation cementing technique

    Institute of Scientific and Technical Information of China (English)

    LI Zi-jian; ZHANG Ke; YANG Hong; LIU Yan; L(U) Jing-qiao

    2009-01-01

    Background Controversies on the safety of the cement application between cemented and uncemented total hip arthroplasty (THA) have been existing for decades. The purpose of this study was to observe the changes in mean arterial pressure (MAP), heart rate (HR) and oxygen pressure (PaO2) during cemented THA, and to evaluate the intraoperative safety of using the third-generation cementing technique and investigate whether the intraoperative risk is higher in acute femoral neck fracture patients than non-traumatic patients. Methods Forty-two patients who underwent cemented THA between November 2005 and September 2007 were prospectively included in this study. The third-generation cementing technique as vacuum mixing and pulsatile lavage was used strictly. The MAP and HR were monitored and documented during each operation. Blood gas analysis was performed at exposure, cup implantation, stem implantation and wound closure. MAP, HR and PaO2 were compared between pre- and post-cement application. Comparisons of MAP, HR and PaO2 between patients with acute femoral neck fracture and non-traumatic patiens were performed as well. Results No intraoperative cardiopulmonary complication occurred in these cases. No obvious changes were observed in MAP, HR and PaO2 after cement application. There was no significant difference in MAP, HR and PaO2 between acute femoral fracture patients (18 patients) and non-traumatic patients (24 patients).Conclusions The results of this study suggested that the invasive blood pressure monitoring and blood gas analysis are essential for patients undergoing cemented THA, especially for patients with femoral neck fracture. The third-generation cementing technique is safe to use in THA.

  14. Ultrasound screening of periarticular soft tissue abnormality around metal-on-metal bearings.

    Science.gov (United States)

    Nishii, Takashi; Sakai, Takashi; Takao, Masaki; Yoshikawa, Hideki; Sugano, Nobuhiko

    2012-06-01

    Although metal hypersensitivity or pseudotumors are concerns for metal-on-metal (MoM) bearings, detailed pathologies of patterns, severity, and incidence of periprosthetic soft tissue lesions are incompletely understood. We examined the potential of ultrasound for screening of periarticular soft tissue lesions around MoM bearings. Ultrasound examinations were conducted in 88 hips (79 patients) with MoM hip resurfacings or MoM total hip arthroplasties with a large femoral head. Four qualitative ultrasound patterns were shown, including normal pattern in 69 hips, joint-expansion pattern in 11 hips, cystic pattern in 5 hips, and mass pattern in 3 hips. Hips with the latter 3 abnormal patterns showed significantly higher frequency of clinical symptoms, without significant differences of sex, duration of implantation, head sizes, and cup abduction/anteversion angles, compared with hips with normal pattern. Ultrasound examination provides sensitive screening of soft tissue reactions around MoM bearings and may be useful in monitoring progression and defining treatment for periarticular soft tissue abnormalities. PMID:22047978

  15. 21 CFR 888.3410 - Hip joint metal/polymer or ceramic/polymer semiconstrained resurfacing cemented prosthesis.

    Science.gov (United States)

    2010-04-01

    ... semiconstrained resurfacing cemented prosthesis. 888.3410 Section 888.3410 Food and Drugs FOOD AND DRUG... prosthesis. (a) Identification. A hip joint metal/polymer or ceramic/polymer semi-constrained resurfacing cemented prosthesis is a two-part device intended to be implanted to replace the articulating surfaces...

  16. Primary and revision total hip replacement without cement and with associated femoral osteotomy.

    Science.gov (United States)

    Holtgrewe, J L; Hungerford, D S

    1989-12-01

    Nine porous-coated total hip prostheses were implanted without cement in nine patients who had a major proximal femoral deformity. Six patients had revision and three, primary total hip replacement. In all nine patients, as well placed corrective osteotomy was needed to successfully perform the arthroplasty. The average time until union of the proximal femoral osteotomy was fifteen weeks for the patients who had a primary arthroplasty and twenty-seven weeks for the patients who had a revision arthroplasty. The average Harris hip-rating score was 94 points for the patients who had a primary arthroplasty and 84 points (range, 60 to 93 points) for those who had a revision arthroplasty. The length of follow-up averaged forty-seven months.

  17. 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

  18. Computer simulation on fatigue behavior of cemented hip prostheses: a physiological model.

    Science.gov (United States)

    Hung, Jui-Pin; Chen, Jian-Horng; Chiang, Hsiu-Lu; Wu, James Shih-Shyn

    2004-11-01

    This paper is concerned with the investigation on the fatigue failure of implant fixation by numerical approaches. A computer algorithm based on finite element analysis and continuum damage mechanics was proposed to quantify the fatigue damage rate of cement mantle under physiological conditions. In examining the interfacial debonding effect, the interface elements were introduced at cement-stem interfaces and calibrated with the increase of loading cycles. Current results reveal that the major sites for failure initiation are in the proximal anterior-medial regions and at the distal prosthesis tip, which clearly demonstrate the same failure scenario as observed in clinical studies. Such fatigue failures not only result in the corruption of cement-stem interfaces, but also greatly affect the cement stress distribution and the damage rate in subsequent loading cycles. Another significant result is that the predicted damage rate increases steadily with gait cycles. This trend in damage development is consistent with the findings obtained from fatigue tests available in literature. It is anticipated that presented methodology can serve as a pre-clinical validation of cemented hip prostheses.

  19. Complications Related to Metal-on-Metal Articulation in Trapeziometacarpal Joint Total Joint Arthroplasty

    OpenAIRE

    Christina Frølich; Torben Bæk Hansen

    2015-01-01

    Adverse reactions to metal-on-metal (MoM) prostheses are well known from total hip joint resurfacing arthroplasty with elevated serum chrome or cobalt, pain and pseudo tumor formation. It may, however, also be seen after total joint replacement of the trapeziometacarpal joint using MoM articulation, and we present two cases of failure of MoM prostheses due to elevated metal-serum levels in one case and pseudo tumor formation in another case. Furthermore, we suggest a diagnostic algorithm for ...

  20. Comparison of short-term efficacy of total hip arthroplasty using prosthesis with metal-on-metal versus metal-on-polyethylene bearing surfaces%金属对金属与金属对聚乙烯假体全髋关节置换术近期疗效比较研究

    Institute of Scientific and Technical Information of China (English)

    田家祥; 孙俊英; 陈夫圆; 杨少雷

    2013-01-01

    骨溶解等并发症。结论与MOP比较,采用大直径MOM行THA能够增加髋关节活动度,更为有效地恢复髋关节功能,术后可早期下床活动,临床效果明显。%Objective To compare short-term results of total hip arthroplasty (THA) using prosthesis with metal-on-metal (MOM) versus metal-on-polyethylene (MOP) bearing surfaces. Methods A total of 44 patients (44 hips) underwent THA from January 2009 to January 2010 in the First Affiliated Hospital of Soochow University. These patients were divided two group, those who underwent THA using large diameter MOM prosthesis (MOM group) and those who underwent THA using MOP prosthesis (MOP group). Intraoperative range of motion (ROM) of hip joint, times of postoperative ambulation, postoperative Harris scores, radiological results and complications in two groups were compared. Results Intraoperative ROM of hip joint in MOM group was larger than that in MOP group. All patients had been followed up, with the average time of 30 months (18-37 months) in MOM group, and 25 months (16-35 months) in MOP group. The time of postoperative ambulation in MOM and MOP group were (3 ± 1) d and (7 ± 2) d respectively, there had statistical difference between two groups (P <0.05). At preoperation, 1, 3, 6 and 12 months postoperatively, as well as the last follow-up, Harris score in MOM group was 37.8 ± 4.8, 85.6 ± 3.2, 89.4 ± 4.1, 94.5 ± 2.3, 94.7 ± 3.1, 93.8 ± 3.6 respectively, while 38.5 ± 5.5, 80.2 ± 4.4, 83.6 ± 2.9, 90.8 ± 2.7, 91.6 ± 3.6, 89.6 ± 6.3 in MOP group. There was statistically significant in postoperative Harris score between two groups (P <0.05). At 12 months after the surgery, total ROM of hip joint was (236 ± 9)° and (203 ± 10)° in MOM and MOP group, both were higher than preoperative (119 ± 14)° and (112 ± 15)° (P <0.05); and at 12 months postoperatively, that in MOM group was better than that in MOP group (P<0.05). Radiographic results showed that 22 femoral prosthesis

  1. Development and first validation of a simplified CT-based classification system of soft tissue changes in large-head metal-on-metal total hip replacement: intra- and interrater reliability and association with revision rates in a uniform cohort of 664 arthroplasties

    International Nuclear Information System (INIS)

    After implantation of a metal-on-metal total hip arthroplasty (MoM THA), a large incidence of pseudotumor formation has been described recently. Several centers have invited patients for follow-up in order to screen for pseudotumor formation. The spectrum of abnormalities found by CT in MoM THA patients can be unfamiliar to radiologists and orthopedic surgeons. Previously, a CT five-point grading scale has been published. In this paper, a simplification into a three-point classification system gives insight in the morphological distinction of abnormalities of the postoperative hip capsule in MoM implants in relation to the decision for revision. The reliability of this simplified classification regarding intra- and interrater reliability and its association with revision rate is investigated and discussed. All patients who underwent MoM THA in our hospital were invited for screening. Various clinical measures and CT scan were obtained in a cross-sectional fashion. A decision on revision surgery was made shortly after screening. CT scans were read in 582 patients, of which 82 patients were treated bilaterally. CT scans were independently single read by two board-certified radiologists and classified into categories I-V. In a second meeting, consensus was obtained. Categories were subsequently rubricated in class A (categories I and II), B (category III), and C (categories IV and V). Intra- and inter-radiologist agreement on MoM pathology was assessed by means of the weighted Cohen's kappa. Categorical data were presented as n (%), and tested by means of Fisher's exact test. Continuous data were presented as median (min-max) and tested by means of Mann-Whitney U test (two group comparison) or Kruskal-Wallis test (three group comparison). Logistic regression analysis was performed in order to study independence of CT class for association with revision surgery. Univariate statistically significant variables were entered in a multiple model. All statistical

  2. Development and first validation of a simplified CT-based classification system of soft tissue changes in large-head metal-on-metal total hip replacement: intra- and interrater reliability and association with revision rates in a uniform cohort of 664 arthroplasties

    Energy Technology Data Exchange (ETDEWEB)

    Boomsma, Martijn F.; Warringa, Niek [Isala Hospital, Department of Radiology, Zwolle (Netherlands); Edens, Mireille A. [Isala Hospital, Department of Innovation and Science, Zwolle (Netherlands); Lingen, Christiaan P. van; Ettema, Harmen B.; Verheyen, Cees C.P.M. [Isala Hospital, Department of Orthopaedics, Zwolle (Netherlands); Maas, Mario [AMC, Department of Radiology, Amsterdam (Netherlands)

    2015-08-15

    After implantation of a metal-on-metal total hip arthroplasty (MoM THA), a large incidence of pseudotumor formation has been described recently. Several centers have invited patients for follow-up in order to screen for pseudotumor formation. The spectrum of abnormalities found by CT in MoM THA patients can be unfamiliar to radiologists and orthopedic surgeons. Previously, a CT five-point grading scale has been published. In this paper, a simplification into a three-point classification system gives insight in the morphological distinction of abnormalities of the postoperative hip capsule in MoM implants in relation to the decision for revision. The reliability of this simplified classification regarding intra- and interrater reliability and its association with revision rate is investigated and discussed. All patients who underwent MoM THA in our hospital were invited for screening. Various clinical measures and CT scan were obtained in a cross-sectional fashion. A decision on revision surgery was made shortly after screening. CT scans were read in 582 patients, of which 82 patients were treated bilaterally. CT scans were independently single read by two board-certified radiologists and classified into categories I-V. In a second meeting, consensus was obtained. Categories were subsequently rubricated in class A (categories I and II), B (category III), and C (categories IV and V). Intra- and inter-radiologist agreement on MoM pathology was assessed by means of the weighted Cohen's kappa. Categorical data were presented as n (%), and tested by means of Fisher's exact test. Continuous data were presented as median (min-max) and tested by means of Mann-Whitney U test (two group comparison) or Kruskal-Wallis test (three group comparison). Logistic regression analysis was performed in order to study independence of CT class for association with revision surgery. Univariate statistically significant variables were entered in a multiple model. All statistical

  3. Two-stage revision total hip arthroplasty for periprosthetic infections using antibiotic-impregnated cement spacers of various types and materials.

    Science.gov (United States)

    Uchiyama, Katsufumi; Takahira, Naonobu; Fukushima, Kensuke; Moriya, Mitsutoshi; Yamamoto, Takeaki; Minegishi, Yojiro; Sakai, Rina; Itoman, Moritoshi; Takaso, Masashi

    2013-01-01

    Antibiotic-impregnated hip cement spacers of various types and materials have been used in the treatment of periprosthetic hip infections. We developed a handmade spacer by using polymethylmethacrylate (PMMA) and/or α -tricalcium phosphate ( α -TCP). In this study, we retrospectively reviewed the surgical outcomes in 36 consecutive patients treated with 2-stage revision total hip arthroplasty by using our antibiotic-impregnated hip cement spacers. We aimed to analyze the infection control and reinfection rates after revision surgery. Moreover, we analyzed the possible predictors of postoperative reinfection. After exclusion of 1 patient who died immediately after the first-stage surgery, infection was controlled in 33 of the 36 hips (success rate, 91.7%). Two of these 33 hips underwent resection arthroplasty. Of the 36 hips that had been treated with the antibiotic-cement spacer, 31 hips (86.1%) were eligible for the second-stage prosthesis re-implantation. The 31 protocol hip joints of patients followed up for >6 months (mean, 48.6 months). Ten of these 31 hips (32.3%) became reinfected. No possible predictor examined differed significantly between the reinfection-positive and reinfection-negative groups. However, spacers consisting of PMMA cement alone were associated with the highest risk of reinfection. Therefore, α -TCP-containing antibiotic-impregnated hip cement spacers might decrease the reinfection rate in patients undergoing re-implantation.

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

    International Nuclear Information System (INIS)

    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.

  5. Mechanical implications of interfacial defects between femoral hip implants and cement: a finite element analysis of interfacial gaps and interfacial porosity.

    NARCIS (Netherlands)

    Scheerlinck, T.; Broos, J.; Janssen, D.; Verdonschot, N.J.J.

    2008-01-01

    Two types of defect between femoral hip implants and cement have been identified. Interfacial porosity arises from cement shrinkage during curing and presents as pores randomly located along the stem. Interfacial gaps are much larger stem-cement separations caused by air introduced during stem inser

  6. Bond strength analysis of the bone cement- stem interface of hip arthroplasties

    Institute of Scientific and Technical Information of China (English)

    Lan-Feng Zhang; Shi-Rong Ge; Hong-Tao Liu; Kai-Jin Guo; Shu-Yang Han; Juan-Yan Qi

    2014-01-01

    Objective:To study and establish the preliminary linear and modified models for the interface shear mechanics performance between implant and bone cement and to explore its damage significance.Method:The loosening research between artificial hip joint prosthesis stem and bone cement interface performance can be evaluated by the push-in test.Based on the debonding performance test, the analytical expressions of the average load and displacement from the debonding failure and splitting failure process were deduced and determined.The correlations of the expressions of the average load-displacement and statistical experimental data were analyzed.Results:It demonstrated that the interface debonding failure mechanical model could be characterized as interface bond strength mechanical performance.Based on analysis of models and experimental data by the three statistical analysis methods, the results indicated the modified model could be better represented by the interfacial debonding strength properties. The bond stressτand relative slidings distribution along the embedment regional were coupling affected by both pressure arch effect and shear lag effect in bone cement.Two stress peaks of implant have been found at the distance from0.175La loading tip to0.325Lafree tip, which also verified the early loosening clinical reports for the proximal and latter region.As the bone cement arch effect, the bond stress peak tend to move to the free tip when the debonding failure would be changed into the splitting failure, which presents a preliminary study on the mechanism of early debonding failurefor the stem-cement interface.Conclusions:Functional models of the stem-bone cement interfacial debonding failure are developed to analyze the relevant mechanism.The different locational titanium alloy stress, and the interfacial bond stress and the relative slides are evaluated to acquire a guide of the different positions of interfacial damage.The coupling effect which is original from

  7. Effect of cementing technique and cement type on thermal necrosis in hip resurfacing arthroplasty - a numerical study

    NARCIS (Netherlands)

    Janssen, D.; Srinivasan, P.; Scheerlinck, T.; Verdonschot, N.J.J.

    2012-01-01

    Femoral fractures within resurfacing implants have been associated with bone necrosis, possibly resulting from heat generated by cement polymerization. The amount of heat generated depends on cement mantle volume and type of cement. Using finite element analysis, the effect of cement type and volume

  8. Size of metallic and polyethylene debris particles in failed cemented total hip replacements

    Science.gov (United States)

    Lee, J. M.; Salvati, E. A.; Betts, F.; DiCarlo, E. F.; Doty, S. B.; Bullough, P. G.

    1992-01-01

    Reports of differing failure rates of total hip prostheses made of various metals prompted us to measure the size of metallic and polyethylene particulate debris around failed cemented arthroplasties. We used an isolation method, in which metallic debris was extracted from the tissues, and a non-isolation method of routine preparation for light and electron microscopy. Specimens were taken from 30 cases in which the femoral component was of titanium alloy (10), cobalt-chrome alloy (10), or stainless steel (10). The mean size of metallic particles with the isolation method was 0.8 to 1.0 microns by 1.5 to 1.8 microns. The non-isolation method gave a significantly smaller mean size of 0.3 to 0.4 microns by 0.6 to 0.7 microns. For each technique the particle sizes of the three metals were similar. The mean size of polyethylene particles was 2 to 4 microns by 8 to 13 microns. They were larger in tissue retrieved from failed titanium-alloy implants than from cobalt-chrome and stainless-steel implants. Our results suggest that factors other than the size of the metal particles, such as the constituents of the alloy, and the amount and speed of generation of debris, may be more important in the failure of hip replacements.

  9. Biomechanical and histologic investigation of cemented total hip arthroplasties. A study of autopsy-retrieved femurs after in vivo cycling.

    Science.gov (United States)

    Maloney, W J; Jasty, M; Burke, D W; O'Connor, D O; Zalenski, E B; Bragdon, C; Harris, W H

    1989-12-01

    Eleven whole anatomic specimens of the femur were retrieved at autopsy from patients who previously had cemented total hip arthroplasty. Implant duration ranged from 0.5 to 210 months. Clinically and roentgenographically the implants were stable. A detailed biomechanical analysis evaluated bone strains and implant stability in both the single-limb stance and stair-climbing positions using a 100-pound spinal load. The stability offered by cement in these well-fixed prostheses was remarkable, with the maximum axial micromotion being 40 mu. This is a reflection of intimate osseointegration at the bone-cement interface with only rare intervening fibrous tissue. The strain gauge and photoelastic strain-coating studies revealed that marked stress shielding in the proximal medial femoral cortex persists long after a cemented femoral component is inserted. Even 17 years after surgery, the strain in the calcar region did not normalize. PMID:2582664

  10. [Favourable long-term results from cemented total hip arthroplasty combined with acetabular bone impaction grafting in patients under the age of 50

    NARCIS (Netherlands)

    Busch, V.J.; Gardeniers, J.W.M.; Slooff, T.J.J.H.; Veth, R.P.H.; Schreurs, B.W.

    2007-01-01

    OBJECTIVE: Determination of long-term results of hip replacements in patients who, at the time of operation, were under the age of 50. Procedures whereby an existing acetabulum defect was filled with bone chips that were impacted into a strong layer, after which a cemented total hip prosthesis was i

  11. 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.

  12. Pseudo-dynamic analysis of a cemented hip arthroplasty using a force method based on the Newmark algorithm.

    Science.gov (United States)

    Ramos, A; Talaia, P; Queirós de Melo, F J

    2016-01-01

    The main goal of this work was to develop an approached model to study dynamic behavior and prediction of the stress distribution in an in vitro Charnley cemented hip arthroplasty. An alternative version of the described pseudo-dynamic procedure is proposed by using the time integration Newmark algorithm. An internal restoring force vector is numerically calculated from the displacement, velocity, and acceleration vectors. A numerical model of hip replacement was developed to analyze the deformation of a dynamically stressed structure for all time steps. The experimental measurement of resulting internal forces generated in the structure (internal restoring force vector) is the second fundamental step of the pseudo-dynamic procedure. These data (as a feedback) are used by the time integration algorithm, which allows updating of the structure's shape for the next displacement, velocity, and acceleration vectors. In the field of Biomechanics, the potentialities of this method contribute to the determination of a dynamically equivalent in vitro stress field of a cemented hip prosthesis; implant fitted in patients with a normal mobility or practice sports. Consequences of the stress distribution in the implant zone that underwent cyclic fatigue loads were also discussed by using a finite element model. Application of this method in Biomechanics appears as a useful tool in the approximate stress field characterization of the peak stress state. Results show a peak value around two times the static situation, more for making possible the prediction of future damage and a programed clinical examination in patients using hip prosthesis. PMID:25483822

  13. Cemented bipolar hemiarthroplasty with a novel cerclage cable technique for unstable intertrochanteric hip fractures in senile patients

    Institute of Scientific and Technical Information of China (English)

    GU Gui-shan; WANG Gang; SUN Da-hui; QIN Da-ming; ZHANG Wei

    2008-01-01

    Objective: To observe the clinical result and assess clinical value of cemented bipolar hemiarthroplasty with a novel cerclage cable technique for treatment of unstable intertrochanteric hip fractures in senile patients.Methods: Forty-eight consecutive patients with unstable intertrochanteric fractures were treated in our hospital from March 2001 to March 2006 (Evans type Ⅲ in 11 cases, Evans type Ⅳ in 25 cases and Evans type Ⅴ in 22 cases). All the cases were evaluated by Zuckerman functional recovery score ( FRS ) and operative risk assessment software 1 (ORAS1), which were based on the patients' physical and laboratory examinations preoperatively. Seventeen cases (19 hips) were treated with cemented bipolar hemiarthroplasty. There were 5 male cases (5 hips) and 12 female cases (14 hips, including 2 patients who suffered from additional slight injuries and resulted in contralateral hip fracture and were treated with the same procedure 3 months after the first operation). The average age was 85 years (78-95 years). All the operations were carried out under general anesthesia, through Southern incision and lateral approach by the same orthopaedic surgeon. All prostheses consisted of Link SPⅡ femoral stem and bipolar femoral head. All patients were followed up for more than 30 days.Results: The operative risks of all the 17 cases (19 hips) were calculated by ORAS1 preoperatively. The average preoperative FRS was 81. 7 (80. 7- 82. 7). The average predictive value of operative morbidity was 10% (7 % -15 %). The average predictive value of mortality was 2.97% (2. 1%-3. 2%). The average operation time was 1.5 hours. The average blood transfusion was 400 ml. There were no operative or anesthetic complications and no deaths within 30 days after operation. Sitting up was permitted 3 to 4 days after operation, and partial weight bearing was permitted 5 to 7 days after operation. Patients were allowed to walk with a walker 10 days after operation. The average FRS was

  14. A STUDY OF PRIMARY CEMENTED BIPOLAR HEMIARTHROPLASTY OF HIP IN ELDERLY PATIENTS WITH OSTEOPOROTIC, UNSTABLE INTERTROCHANTERIC FRACTURE

    Directory of Open Access Journals (Sweden)

    Maheshwar

    2015-08-01

    Full Text Available BACKGROUND: Intertrochanteric fractures are a major cause of morbidity and mortality in geriatric population. Osteoporosis contributes significantly to the comminution and instability in such fractures. Internal fixations in unstable intertrochanteric fractures are a ssociated with high rates of implant failures and gross restriction of hip movements. This study was undertaken to evaluate the efficacy of cemented bipolar hemiart h roplasty in elderly patients with osteoporotic, unstable intertrochanteric fractures. PATIE NTS AND METHODS: 52 patients aged above 60 years with unstable, comminuted intertrochanteric fractures with Singh’s index < 4 were operated with primary cemented bipolar hemireplacement arthroplasty. All the patients were mobilized early with full weight b earing in the post - operative period as permitted. 50 patients were evaluated for the functional outcome with Harris Hip score. RESULTS: The average age of patients was 65 years with female predominance (64%. Left side (56% was commonly involved and the c ommonest mode of injury was due to a trivial fall at home. Hypertension (30% was the commonest co - morbid condition. Limb shortening was the commonest complication (8%. The mean ± S.D. of the Harris Hip score was 85.6 ± 10.59 with a range from 56 to 96. Resul ts were excellent in 62%, good in 22%, fair in 12% and poor in 4% of cases. CONCLUSION: Elderly osteoporotic patients with comminuted, unstable intertrochanteric fractures have an increased prevalence of unsatisfactory functional results with conventional internal fixation devices. Primary cemented bipolar hemiarthroplasty with anatomical reconstruction of the trochanters allows early mobilization, improved functional outcome with relatively low incidence of associated complications.

  15. 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

    2016-01-01

    Introduction 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. Methods and analysis 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 Results will be analysed using 95% CIs for the effect size. A regression model will also be used to adjust for stratification factors. Ethics and dissemination 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. Trial registration number NCT02254980. PMID:27388352

  16. 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

  17. Oxinium modular femoral heads do not reduce polyethylene wear in cemented total hip arthroplasty at five years: a randomised trial of 120 hips using radiostereometric analysis.

    Science.gov (United States)

    Jonsson, B A; Kadar, T; Havelin, L I; Haugan, K; Espehaug, B; Indrekvam, K; Furnes, O; Hallan, G

    2015-11-01

    We report the five-year outcome of a randomised controlled trial which used radiostereometric analysis (RSA) to assess the influence of surface oxidised zirconium (OxZr, Oxinium) on polyethylene wear in vivo. A total of 120 patients, 85 women and 35 men with a mean age of 70 years (59 to 80) who were scheduled for primary cemented total hip arthroplasty were randomly allocated to four study groups. Patients were blinded to their group assignment and received either a conventional polyethylene (CPE) or a highly cross-linked (HXL) acetabular component of identical design. On the femoral side patients received a 28 mm head made of either cobalt-chromium (CoCr) or OxZr. The proximal head penetration (wear) was measured with repeated RSA examinations over five years. Clinical outcome was measured using the Harris hip score. There was no difference in polyethylene wear between the two head materials when used with either of the two types of acetabular component (p = 0.3 to 0.6). When comparing the two types of polyethylene there was a significant difference in favour of HXLPE, regardless of the head material used (p < 0.001). In conclusion, we found no advantage of OxZr over CoCr in terms of polyethylene wear after five years of follow-up. Our findings do not support laboratory results which have shown a reduced rate of wear with OxZr. They do however add to the evidence on the better resistance to wear of HXLPE over CPE.

  18. Correction of error in two-dimensional wear measurements of cemented hip arthroplasties

    NARCIS (Netherlands)

    The, Bertram; Mol, Linda; Diercks, Ron L.; van Ooijen, Peter M. A.; Verdonschot, Nico

    2006-01-01

    The irregularity of individual wear patterns of total hip prostheses seen during patient followup may result partially from differences in radiographic projection of the components between radiographs. A method to adjust for this source of error would increase the value of individual wear curves. We

  19. In vitro assessment of Function Graded (FG artificial Hip joint stem in terms of bone/cement stresses: 3D Finite Element (FE study

    Directory of Open Access Journals (Sweden)

    Al-Jassir Fawzi F

    2013-01-01

    Full Text Available Abstract Background Stress shielding in the cemented hip prosthesis occurs due to the mismatching in the mechanical properties of metallic stem and bone. This mismatching in properties is considered as one of the main reasons for implant loosening. Therefore, a new stem material in orthopedic surgery is still required. In the present study, 3D finite element modeling is used for evaluating the artificial hip joint stem that is made of Function Graded (FG material in terms of joint stress distributions and stem length. Method 3D finite element models of different stems made of two types of FG materials and traditional stems made of Cobalt Chromium alloy (CoCrMo and Titanium alloy (Ti were developed using the ANSYS Code. The effects on the total artificial hip joint stresses (Shear stress and Von Mises stresses at bone cement, Von Mises stresses at bone and stem due to using the proposed FG materials stems were investigated. The effects on the total artificial hip joint system stresses due to using different stem lengths were investigated. Results Using FG stem (with low stiffness at stem distal end and high stiffness at its proximal end resulted in a significant reduction in shear stress at the bone cement/stem interface. Also, the Von Mises stresses at the bone cement and stem decrease significantly when using FG material instead of CoCrMo and Ti alloy. The stresses’ distribution along the bone cement length when using FG material was found to be more uniform along the whole bone cement compared with other stem materials. These more uniform stresses will help in the reduction of the artificial hip joint loosening rate and improve its short and long term performance. Conclusion FE results showed that using FG stem increases the resultant stresses at the femur bone (reduces stress shielding compared to metallic stem. The results showed that the stem length has significant effects on the resultant shear and Von Mises stresses at bone, stem and

  20. 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.

  1. 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.

  2. 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)

    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

  3. 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.

  4. Large diameter metal on metal total hip replacement for femoral neck fractures with neurological conditions A retrospective assessment

    Directory of Open Access Journals (Sweden)

    Jia Li

    2014-01-01

    Conclusion: We believe the use of L-MoM can diminish the rate of instability or dislocation, after operation. The L-MoM is an option for patients with Parkinson′s disease and poliomyelitis with femoral neck fracture.

  5. The Interchangeability of Plasma and Whole Blood Metal Ion Measurement in the Monitoring of Metal on Metal Hips

    Directory of Open Access Journals (Sweden)

    Ibrahim A. Malek

    2015-01-01

    Full Text Available One hundred and twenty six paired samples of plasma and whole blood were measured with inductively coupled plasma mass spectrometry technique for metal ions analysis to determine a relationship between them. There was a significant difference between the mean plasma and whole blood concentrations of both cobalt (Co and chromium (Cr (p<0.0001 for both Co and Cr. The mean ratio between plasma and whole blood Cr and Co was 1.56 (range: 0.39–3.85 and 1.54 (range: 0.64–18.26, respectively, but Bland and Altman analysis illustrated that this relationship was not universal throughout the range of concentrations. There was higher variability at high concentrations for both ions. We conclude that both these concentrations should not be used interchangeably and conversion factors are unreliable due to concentration dependent variability.

  6. Wear patterns of taper connections in retrieved large diameter metal-on-metal bearings.

    Science.gov (United States)

    Bishop, Nicholas; Witt, Florian; Pourzal, Robin; Fischer, Alfons; Rütschi, Marcel; Michel, Markus; Morlock, Michael

    2013-07-01

    Wear of the modular taper between head and shaft has been related to clinical failure resulting from adverse reactions to metallic debris. The problem has become pronounced in large metal-on-metal bearings, but the mechanism has not yet been fully understood. We analyzed retrieved components from five patients revised with various diagnoses. Two distinct wear patterns were observed for the head tapers. Three samples demonstrated "asymmetric" wear towards the inner end of the head taper. The other two showed "axisymmetric" radial wear (up to 65 µm) presenting the largest wear volumes (up to 20 mm(3)). Stem tapers demonstrated relatively little wear, and the fine thread on the stem taper surface was observed to be imprinted on the taper inside of the head. Our findings demonstrate that the cobalt-chrome head wears preferentially to the titanium stem taper. "asymmetric" wear suggests toggling due to the offset of the joint force vector from the taper. In contrast, samples with "axisymmetric" radial wear and a threaded imprint suggested that corrosion led to head subsidence onto the stem taper with gradual rotation. PMID:23440943

  7. Third-body Wear Damage Produced in CoCr Surfaces by Hydroxyapatite and Alumina Ceramic Debris: A 10-cycle Metal-on-Metal Simulator Study

    Directory of Open Access Journals (Sweden)

    Thomas Halim

    2015-12-01

    Full Text Available Ceramic particles are believed to be particularly abrasive due to their extreme hardness. Ceramic debris has been reported in retrieved total hip arthroplasty (THA due to chipping and fracture of alumina components or by flaking of hydroxyapatite from implant coatings. However there appears to be no abrasion ranking of such particle behavior. The hypotheses in this study were, i alumina particles would create large scratches in CoCr surfaces and ii hydroxyapatite would produce very mild scratching comparable to bone-cement particles. Hydroxyapatite beads came in two types of commercial powders while the flakes were scraped from retrieved femoral stems. Alumina beads came in two commercial powders and flakes were retrieved from a fractured ceramic head. Particle morphologies were determined by SEM and CoCr surface damage by interferometry and SEM. Six 38-mm MOM were mounted inverted in a hip simulator and run with ceramic particles inserted for a 10-second test. Surface-roughness ranking after 10-second abrasion test revealed that bone cement and hydroxyapatite produced least damage to CoCr surfaces while alumina produced the most. Alumina increased surface roughness 19-fold greater than either hydroxyapatite or bone-cement particles. The alumina debris produced numerous scratches typically 20-80 µm wide with some up to 140µm wide. Surprisingly the alumina beads and flakes were pulverized within the 10-second test interval and remained adherent to the CoCr surfaces. Additionally, the hydroxyapatite although also a ceramic had no more effect on CoCr than the bone-cement debris. Use of well-characterized and commercially available alumina and hydroxyapatite powders appeared advantageous for abrasion tests. These new data indicated that such ceramic powders have merit.

  8. Results of hip resurfacing for developmental dysplasia of the hip of Crowe type Ⅰ and Ⅱ

    Institute of Scientific and Technical Information of China (English)

    XU Wei-dong; LI Jia; ZHOU Zhen-hua; WU Yue-song; LI Ming

    2008-01-01

    Background Recently, the new generation of metal-on-metal total hip resurfacing arthroplasty is well known for preserving the proximal femoral bone stock, minimizing the risk of postoperative dislocation using large femoral heads, and expecting low wear of metal-on-metal articulation for longer prosthesis survival. It also has the advantage in biomechanical loading in the proximal femur. The osteoarthritis secondary to developmental dysplasia of the hip (DDH) has been the most common reason for total hip arthroplasty. Most of the patients are young and active, who require improved range of motion of the hip besides relief of the pain, even expect to resume the ability to run and jump after the joint arthroplasty, thus to be allowed an active lifestyle. The objective of the current study was to evaluate the early outcome of resurfacing arthroplasty for the mild DDH cases (Crowe type Ⅰ and Ⅱ).Methods Between September 2005 and May 2007, twenty-one consecutive patients (twenty-six hips) with the diagnosis of osteoarthritis secondary to DDH underwent metal-on-metal resurfacing arthroplasty. The average age at the time of surgery was 46.5 years (range, 37-59 years). Six patients (28.6%) were male and fifteen (71.4%) were female. Clinical and radiographic results were observed. The follow-up was performed at 6 weeks, 3, 6, 9 months and then yearly.Results All patients were followed for a mean of 18 months (9-29 months). During the follow-up period no complications, such as dislocation of hip joints, infection or femoral neck fracture occurred. The clinical outcomes, as rated with the Harris hip score, improved significantly compared with the preoperative ratings. The mean postoperative Harris hip score was 90.7, compared to 35.5 preoperatively. The radiographic analysis showed that all prostheses were fixed with no radiolucencies. All of the patients who had equal limb lengths preoperatively had equal lengths postoperatively. Of the nine patients with preoperative

  9. A Study to Assess the Long-term Performance of SmartSet® HV and SmartSet® GHV Bone Cements in Primary Total Hip Replacement

    Science.gov (United States)

    2016-08-12

    Rheumatoid Arthritis; Osteoarthritis; Post-traumatic Arthritis; Collagen Disorders; Avascular Necrosis; Traumatic Femoral Fractures; Nonunion of Femoral Fractures; Congenital Hip Dysplasia; Slipped Capital Femoral Epiphysis

  10. Risk of cancer following primary total hip replacement or primary resurfacing arthroplasty of the hip: a retrospective cohort study in Scotland

    OpenAIRE

    Brewster, D H; Stockton, D L; Reekie, A; Ashcroft, G. P.; Howie, C R; Porter, D E; Black, R. J.

    2013-01-01

    Background: Release and dispersion of particles arising from corrosion and wear of total hip arthroplasty (THA) components has raised concerns about a possible increased risk of cancer. Concerns have been heightened by a recent revival in the use of metal-on-metal (MoM) hip prostheses. Methods: From a linked database of hospital discharge, cancer registration, and mortality records, we selected a cohort of patients who underwent primary THA (1990–2009) or primary resurfacing arthroplasty (mai...

  11. 初次骨水泥型人工全髋关节置换术的中远期疗效分析%Mid-long term effect analysis of primary cemented total hip arthroplasty

    Institute of Scientific and Technical Information of China (English)

    温亮; 潘江; 曲铁兵; 林源; 王进军; 方超华

    2014-01-01

    目的:回顾性分析初次骨水泥型全髋关节置换术( THA)的中远期临床及影像学疗效、假体的生存率及其相关影响因素。方法对1991年7月至2006年6月间接受初次骨水泥型THA的患者187例(201髋)进行随访。观察并发症情况、影像学表现,并对Harris评分和骨密度结果值进行统计学分析,以假体翻修为随访终点,计算假体的生存率。结果共117例(126髋)获得完整随访,平均随访时间为13.5年。 Harris评分由术前的(32.8±22.5)分提高至末次随访时的(90.3±7.3)分,差异有统计学意义( t=-27.91, P<0.01)。假体周围界面有不同表现的患者的骨密度结果比较无统计学差异(F=0.289,P>0.05)。晚期感染1髋,脱位3髋,下肢深静脉血栓4髋,下肢不等长4髋,假体周围骨折2髋,异位骨化6髋,无菌性松动5髋。共有7髋接受髋关节翻修手术,平均翻修手术时间为初次置换术后11.3年,假体的生存率为94.4%。结论骨水泥型THA在治疗高龄骨质疏松患者髋关节疾病方面可以取得良好的临床效果,骨水泥假体的远期生存率令人满意。%Objective To evaluate the mid-long term clinical and radiographic effects of the primary cemented total hip arthroplasty ( THA).Methods One hundred and eighty-seven patients (201 hips) who had undergone primary cemented THA from July 1991 to June 2006 were followed up for their post-operative complications and imaging findings .Harris score and bone density value were used for statistical analysis .The survival rate of the implants was determined by using the revision of either prosthetic component for any reason as the end-point during the follow-up.Results One hundred and seventeen patients (126 hips) were followed up for 13.5 years averagely in the end .Harris score improved significantly from (32.8 ±22.5) points to (90.3 ±7.3) points (t =-27.91,P 0.05).There was late infection

  12. In vitro friction and lubrication of large bearing hip prostheses.

    Science.gov (United States)

    Flanagan, S; Jones, E; Birkinshaw, C

    2010-01-01

    New material combinations and designs of artificial hip implants are being introduced in an effort to improve proprioception and functional longevity. Larger joints in particular are being developed to improve joint stability, and it is thought that these larger implants will be more satisfactory for younger and more physically active patients. The study detailed here used a hip friction simulator to assess the friction and lubrication properties of large-diameter hip bearings of metal-on-metal and ceramic-on-reinforced-polymer couplings. Joints of different diameters were evaluated to determine what effect, if any, bearing diameter had on lubrication. In addition, the effects of lubricant type are considered, using carboxymethyl cellulose and bovine calf serum, and the physiological lubricant is shown to be considerably more effective at reducing friction. The frictional studies showed that the metal-on-metal joints worked under a mixed lubrication regime, producing similar friction factor values to each other. The addition of bovine calf serum (BCS) reduced the friction. The ceramic-on-reinforced-polymer samples were shown to operate with high friction factors and mixed lubrication. When tested with BCS, the larger-diameter bearings showed a decrease in friction compared with the smaller-size bearings, and the addition of BCS resulted in an increase in friction, unlike the metal-on-metal system. The study demonstrated that the component's diameter had little or no influence on the lubrication and friction of the large bearing combinations tested.

  13. The increase in cobalt release in metal-on-polyethylene hip bearings in tests with third body abrasives

    OpenAIRE

    de Villiers, Danielle; Traynor, Alison; Collins, Simon N; Shelton, Julia C

    2015-01-01

    Hypersensitivity reactions in patients receiving metal-on-metal hip replacements have been attributed to corrosion products as observed by elevated cobalt and chromium ions in the blood. Although the majority of cases are reported in metal-on-metal, incidences of these reactions have been reported in the metal-on-polyethylene patient population. To date, no in vitro study has considered cobalt release for this bearing combination. This study considered four 28 mm and seven 52 mm diameter meta...

  14. Epinephrine hydrochloride prevents bone cement implantation syndrome in cemented hip replacement%盐酸肾上腺素在骨水泥型髋关节置换术中预防骨水泥植入综合征发生的作用

    Institute of Scientific and Technical Information of China (English)

    齐向北; 张英泽; 潘进社; 马利杰; 王琳; 王建朝

    2010-01-01

    Objective To investigate the clinical application of epinephrine hydrochloride in the prevention of bone cement implantation syndrome in the cemented hip replacement. Methods The clinical data of 48 patients treated with cemented hip replacement from July 2008 to April 2009 were retrospectively analyzed. All the patients were divided into control group and intervention group. The bone marrow cavities of 24 patients in the control group were not pretreated with saline epinephrine hydrochloride before implantation of bone cement; the bone marrow cavities of 24 patients in the intervention group were pretreated with saline epinephrine hydrochloride before implantation of bone cement. Systolic blood pressure (SBP), diastolic blood pressure (DBP), the mean arterial pressure (MAP), heart rate (HR)and pulse oxygen saturation ( SPO2 ) were compared between the two groups before bone cement implantation and 1,2, 3, 4, 5, 6, 7, 8, 9, 10 minutes after bone cement implantation. The data were analyzed with variance analysis and Q test. Results (1) In the control group: the blood pressure was decreased in control group one minute after bone cement implantation and a significant decrease of the blood pressure was observed at 2-6 minutes after the implantation ( P < 0. 01 ). The blood pressure was increased seven minutes after the implantation, with the most significant increase of DBP ( P < 0.05 ).The blood pressure recovered to normal 10 minutes later. The SPO2 was decreased significantly ( P <0.05 ) but no significant change was observed in HR ( P > 0.05). (2) In the intervention group: the bone marrow cavity was pretreated with saline epinephrine hydrochloride before implantation of bone cement.ity. No significant difference was found in SBP, DBP, MAP, HR and SPO2 at different time points before and after bone cement implantation (P >0.05 ). Significant decrease of blood pressure and SPO2 was observed in control group and a significant hemodynamic change was detected

  15. Metal ion levels in large-diameter total hip and resurfacing hip arthroplasty-Preliminary results of a prospective five year study after two years of follow-up

    Directory of Open Access Journals (Sweden)

    Maurer-Ertl W

    2012-04-01

    Full Text Available Abstract Background Metal-on-metal hip resurfacing is an alternative to metal-on-metal total hip arthroplasty, especially for young and physically active patients. However, wear which might be detected by increased serum ion levels is a matter of concern. Methods The aims of this preliminary study were to determine the raise of metal ion levels at 2-years follow-up in a prospective setting and to evaluate differences between patients with either resurfacing or total hip arthroplasty. Furthermore we investigated if the inclination of the acetabular component and the arc of cover would influence these findings. Therefore, 36 patients were followed prospectively. Results The results showed increments for Co and Cr in both implant groups. Patients treated with large-diameter total hip arthroplasty showed fourfold and threefold, respectively, higher levels for Co and Cr compared to the resurfacing group (Co: p  Discussion In order to clarify the biologic effects of ion dissemination and to identify risks concerning long-term toxicity of metals, the exposure should be monitored carefully. Therefore, long-term studies have to be done to determine adverse effects of Co and Cr following metal-on-metal hip replacement.

  16. Cement Conundrum

    Institute of Scientific and Technical Information of China (English)

    2009-01-01

    China aims to streamline the crowded cement industry Policymakers are looking to build a concrete wall around the cement-making industry as they seek to solidify the fluid cement market and cut excessive production.

  17. Hip instability.

    Science.gov (United States)

    Smith, Matthew V; Sekiya, Jon K

    2010-06-01

    Hip instability is becoming a more commonly recognized source of pain and disability in patients. Traumatic causes of hip instability are often clear. Appropriate treatment includes immediate reduction, early surgery for acetabular rim fractures greater than 25% or incarcerated fragments in the joint, and close follow-up to monitor for avascular necrosis. Late surgical intervention may be necessary for residual symptomatic hip instability. Atraumatic causes of hip instability include repetitive external rotation with axial loading, generalized ligamentous laxity, and collagen disorders like Ehlers-Danlos. Symptoms caused by atraumatic hip instability often have an insidious onset. Patients may have a wide array of hip symptoms while demonstrating only subtle findings suggestive of capsular laxity. Traction views of the affected hip can be helpful in diagnosing hip instability. Open and arthroscopic techniques can be used to treat capsular laxity. We describe an arthroscopic anterior hip capsular plication using a suture technique. PMID:20473129

  18. 金属与金属相关节的人工髋关节的发展%Development of Metal-On-Metal Total Hip Replacement

    Institute of Scientific and Technical Information of China (English)

    周勇刚; 王岩; 何登伟; 刘芙进

    2001-01-01

    人工髋关节晚期失败的主要原因是高分子聚乙烯磨损颗粒引起的骨溶解导致假体松动.由于认识到了上述问题,同时由于20世纪80年代末第二代金属与金属相(MOM)假体的推出,使人们的兴趣又转移到了MOM假体上来.其磨损率明显降低,是普通人工关节的1/100.临床前实验及临床资料显示第二代MOM假体的磨损率非常低,令人满意.另外目前尚无材料可以证明MOM假体有钴或铬毒性和致癌性,但需要长期随访.通过人们不断对MOM假体的改进,MoM势必成为具有划时代意义的人工假体.

  19. Conus hip prosthesis.

    Science.gov (United States)

    Wagner, H; Wagner, M

    2001-01-01

    50 years ago, prosthetic replacement of the hip joint ushered in a new epoch in orthopaedics. Total hip replacement made it possible to remove a severely diseased, painful hip and restore normal function and a normal quality of life to the afflicted patient. The early results of total hip replacement are almost all spectacular and hip replacement has become the most successful type of orthopaedic surgery. These good results using an approach that was technically relatively simple resulted in a temptation to implant prosthetic hip joints with ever increasing frequency in ever younger patients. This led to the emergence of new problems, which were not so clearly recognised at the outset: it emerged that the stability of prosthetic hip joints was of limited duration. This had the following consequence: If a total hip prosthesis is implanted in an elderly person whose remaining life-expectancy is shorter than the longevity of the prosthesis, hip replacement is a life-long solution. We can therefore say that, for a patient who has only 10 to 15 years left to live, their hip problem is solved by total hip replacement. For young people, who still have a long life expectancy in front of them, it is different. They will experience failure of the artificial joint and require further surgery. The commonest and most important type of failure in total hip prostheses is aseptic loosening, which is associated with resorption of bone at the site of the prosthesis. The cause of this phenomenon has only gradually been recognised in the course of the years. Initially, the unanimous opinion was that the methacrylate cement, used to fix the components of the prosthesis in the bone, was the definitive cause of aseptic loosening because fissures and fractures of the cement were almost always found during surgical revision of loosened joints. There was talk of "cement disease" and great efforts were made to improve the quality of the cement and the cementing technique. Moreover, even

  20. Bone cement and bone grafting in nail path to strengthen dynamic hip screw fixation for senile osteoporotic intertrochanteric fracture%骨水泥、钉道植骨强化动力髋螺钉固定修复老年骨质疏松性股骨转子间骨折

    Institute of Scientific and Technical Information of China (English)

    林周胜; 孙鸿涛; 夏雄智; 江成; 黎飞猛

    2015-01-01

    背景:对于老年骨质疏松性髋部骨折的动力髋螺钉固定,如能避免使用过程中造成的骨量丢失,或是采用其他手段增加固定螺钉把持力,将改善动力髋螺钉固定的治疗效果。目的:对比研究3种固定方式修复老年骨质疏松性股骨转子间骨折的效果。方法:回顾性分析近5年来采用常规动力髋螺钉内固定、骨水泥强化后动力髋螺钉固定及主钉道压配植骨配合动力髋螺钉固定3种固定方式治疗老年骨质疏松性股骨转子间骨折患者的资料,分别设为对照组、骨水泥组和植骨组。结果与结论:经固定后2年随访,植骨组、骨水泥组和对照组Harris髋关节功能评分优良率分别为95%,80%,70%。植骨组骨折临床愈合时间明显缩短(P <0.05),出现螺钉固定失败情况与骨水泥组相当。对照组较其他2组相对更多出现退钉等内固定失败情况。结果表明,与其他常规动力髋螺钉内固定、骨水泥强化后动力髋螺钉固定方式相比较,主钉道压配植骨配合动力髋螺钉内固定的疗效及安全性更好。%BACKGROUND:In dynamic hip screw fixation for treating aged osteoporotic intertrochanteric fracture, avoiding the loss of bone mass, or by other means that can increase the fixed screw pulout strength, wil improve the therapeutic effect of dynamic hip screw fixation. OBJECTIVE: To compare the effects of three kinds of repair methods on aged osteoporotic intertrochanteric fracture. METHODS:Data of aged osteoporosis intertrochanteric fracture patients, who received conventional dynamic hip screw fixation, bone cement augmentation with dynamic hip screw fixation and bone grafting with dynamic hip screw fixation, were retrospectively analyzed. They were divided into control group, bone cement group and bone grafting group. RESULTS AND CONCLUSION:After two years of folow-up, the excelent and good rates of Harris hip function were 95%, 80% and 70% in

  1. Hip Ultrasound

    Science.gov (United States)

    ... Infant ultrasound can be used to check the hips for developmental dysplasia of the hip (DDH), which in infants can range from a shallow cup (bony acetabular dysplasia), to complete dislocation with the ball of the ...

  2. Hip Revision

    Medline Plus

    Full Text Available Hip Revision Featuring the ZMR® Hip System Tapered Distal Stem Zimmer, Inc. Winfield, Illinois September 3, 2009 Welcome to this OR Live webcast presentation, brought to you by Zimmer. ...

  3. Biomechanical evaluation of dynamic hip screw with bone cement augmentation in normal bone%骨水泥强化正常骨质DHS固定的生物力学研究

    Institute of Scientific and Technical Information of China (English)

    黎宁; 彭阿钦; 聂喜增; 李锋; 赵永涛; 毕靖博; 韩长伶

    2008-01-01

    背景:DHS是治疗股骨转子间骨折的标准内固定,对于伴有骨质疏松的骨折,容易发生拉力螺钉切割.国内外文献建议骨水泥强化DHS以达到坚强内固定,但是对于正常骨质,骨水泥强化是否有效还缺少报道.目的:选取正常骨密度的股骨转子间骨折标本,观察骨水泥强化对DHS固定的生物力学影响.设计、时间及地点:同一标本两侧对比观察实验,于2005-03/05在河北省骨科研究所生物力学实验室完成.材料:选取河北医科大学解剖教研室提供的成年男性防腐尸体双侧股骨上段标本.X射线证实无结核、畸形、肿瘤.方法:取成年男性防腐尸体双侧股骨上段标本24对48侧,制备A2型股骨转子间骨折模型.右侧标本行骨水泥强化DHS固定(在股骨头近端钉道用刮匙扩大.股骨头朝下,注入2mL低黏稠度骨水泥,拧入拉力螺钉,保持位置不变直至骨水泥凝固.置入套筒,拧紧尾钉适当加压,皮质骨螺钉固定钢板),为强化组;左侧行DHS常规固定,为对照组.两组标本进行弯曲强度试验及扭转强度试验.主要观察指标:两组标本的最大负荷及最大扭矩.结果:强化组最大负荷及最大扭矩与对照组比较,差异均无统计学意义[最大负荷分别为:(3852.1602±143.6031)N和(3702.9667±133.8601)N;最大扭矩分别为(15.5±2.6)N·m,(14.7±3.4)N·m, P>0.0⑤.结论:对于正常骨密度的股骨转子间骨折,骨水泥强化对DHS固定强度及骨折整体稳定性无显著的影响.%BACKGROUND: Dynamic hip screw (DHS) is a standard internal fixation for intertrochanteric fracture, whereas the patient combined with osteoporosis, cut-out incidence of lag screw is common. The articles in China and abroad indicate bone cement augmentation of DHS to achieve firm fixation. As for normal bone, no reports is published that whether bone cement augmentation is effective.OBJECTIVE: To investigate the biomechanics of DHS with bone cement augmentation for

  4. Curative effect and intervention measuers of bone cement type artificial hip joint for treatment fo femoral neck fracture%骨水泥型人工髋关节治疗股骨颈骨折的疗效

    Institute of Scientific and Technical Information of China (English)

    徐斌; 马锐; 陈建常; 滕勇; 马在松; 安伟; 张春浩

    2016-01-01

    Objective:To compare the efficacy of bone cement type artificial total hip and femoral head replacement for the treatment of femoral neck fracture , put forward specific nursing intervention measures .Methods:Retrospective analysis of 2008 January to 2012 Janu-ary, elderly patients undergoing cemented hip replacement in our hospital 83 cases of femoral neck fracture , the total hip arthroplasty in 52 cases (group A), 31 with femoral head replacement (group B), obtain the type of operation, postoperative drainage volume and other information, and follow-up analysis.R esults: In A group the operative time and the amount of bleeding during operation were higher than those of B group, there were statistically significant (P0.05).After March , June, 1 years, 3 years,Harris score of A group was significantly higher than that of B group , a statistically significant difference ( P<0.05) .Followed up for 3-5 years, an average of 41. years, 12 cases after 3 year lost;surgical site infection occurred in 1 patients, 2 cases after 3.5 years died of lung infection , 2 patient died of cardiovascular and cerebrovascular diseases , 3 patients died of other diseases;the last follow-up, 7 patients needed walker to walk .No prosthesis loosening and fracture during the follow -up period.Conclusion:By strengthening the perioperative intervention measures , increase the body's endurance , as far as possible the use of artificial hip replacement , in order to improve the quality of patients life .%目的:比较骨水泥型人工全髋关节与股骨头置换术治疗股骨颈骨折的疗效,提出具体护理干预措施。方法:回顾性分析2008年1月~2012年1月,我院83例股骨颈骨折行骨水泥型关节置换术的高龄患者为研究对象,其中行人工全髋关节置换术52例(A组),人工股骨头置换术31例(B组),获得如年龄、性别、手术类型、术后引流量等信息,并随访分析。结果: A组手术时间

  5. Formation of a pseudotumor in total hip arthroplasty using a tribological metal–polyethylene pair☆

    Science.gov (United States)

    Fagotti, Lorenzo; Vicente, José Ricardo Negreiros; Miyahara, Helder Souza; de Oliveira, Pedro Vitoriano; Bernabé, Antônio Carlos; Croci, Alberto Tesconi

    2015-01-01

    The aim here was to report a case of a young adult patient who evolved with tumor formation in the left thigh, 14 years after revision surgery on hip arthroplasty. Davies in 2005 made the first description of this disease in patients undergoing metal-on-metal hip arthroplasty. Over the last decade, however, pseudotumors around metal-on-polyethylene surfaces have become more prevalent. Our patient presented with increased volume of the left thigh 8 years after hip arthroplasty revision surgery. Two years before the arising of the tumor in the thigh, a nodule in the inguinal region was investigated to rule out a malignant neoplastic process, but the results were inconclusive. The main preoperative complaints were pain, functional limitation and marked reduction in the range of motion of the left hip. Plain radiographs showed loosening of acetabular and femoral, and a large mass between the muscle planes was revealed through magnetic resonance imaging of the left thigh. The surgical procedure consisted of resection of the lesion and removal of the components through lateral approach. In respect of total hip arthroplasty, pseudotumors are benign neoplasms in which the bearing surface consists of metal-on-metal, but they can also occur in different tribological pairs, as presented in this case. PMID:27218090

  6. Revision Total Hip Replacement: A Case Report

    Directory of Open Access Journals (Sweden)

    Md Hafizur Rahman

    2013-07-01

    Full Text Available Total hip replacement is a reconstructive procedure that has improved the management of those diseases of the hip joint that have responded poorly to conventional medical therapy. Conventional, primary total hip replacement is a durable operation in the majority of patients. A hip replacement is a mechanical device with parts that are assembled before and during the operation. But the possible complications of total hip arthroplasty, and its clinical performance over time, is a challenging occasion to the surgeons, and such a challenge we faced with our presenting patient. A 68 year old lady with history of cemented bipolar hemiarthroplasty done in a tertiary care hospital, due to fracture neck of the left femur having the history of diabetes, chronic kidney disease, heart disease, anaemia, and mental disorders presented with loosened prosthesis, thinning of medial proximal cortex of the femur which had broken within few months after surgery. She complained of painful walking at left hip joint. There was also evidence of chronic infective and degenerative arthritis of acetabular component of the affected hip joint. Cemented revision total hip replacement surgery was performed with expert multidisciplinary involvement. On 2nd postoperative day the patient was allowed to walk on operated limb with the aid of walker. On 12th postoperative day all the stitches were removed and wound was found healthy.

  7. Our Experience with Short Stem Hip Replacement Surgery

    Directory of Open Access Journals (Sweden)

    Sumeet Rastogi

    2016-07-01

    Full Text Available Context- A short anatomical metaphyseal femoral stem is a desirable hip implant for bone and soft tissue preserving hip replacing surgery in young arthritic patients. Physiological loading of the proximal femur prevents stress shielding and preserves bone stock of the femur in the long run. Thus it is an ideal hip implant suited for conservative hip surgeries in active young adults with arthritic hips. Materials and methods- 50 Proxima hip replacements were performed on 41 patients with a mean age of 45 over a 3-year period (between July 2006 and September 2009. Diagnosis of hip pathologies varied from osteoarthritis secondary to avascular necrosis, rheumatoid arthritis, post-tubercular arthritis to dysplastic hips. 9 of these patients had symptomatic bilateral hip involvement and underwent bilateral hip replacement in a single sitting. All patient had a Proxima metaphyseal stem implantation( DePuy, Warsaw with either a large diameter metal on metal or pinnacle articulation. Clinical and radiological evaluation was done at 3 months, 6 months, 1 year and then yearly thereafter. Statiscal analysis used- VAS and Harris hip score formed the basis of evaluation Results- These patients were followed up for a mean period of 49 months (Range 36-72 months. The average incision size was 14.38 cm (10-18 cm and blood loss was 269 ml (175-450 ml. There was no peri-operative mortality or serious morbidity in any patients. One patient had an intraoperative lateral cortex crack that required only delayed rehabilitation. Five of the 41 patients (12.1 % had complications with three recovering completely and one requiring revision of femoral stem for aseptic loosening. One patient was lost in follow-up. Harris hip score improved from 52 to 89.3 at last follow-up. Overall 95.1% (39/41 patients had an excellent outcome at last follow-up. Conclusion- We conclude that Proxima metaphyseal stem provided clinically and radiologically stable fixation through snug fit

  8. Comparison of friction and lubrication of different hip prostheses.

    Science.gov (United States)

    Scholes, S C; Unsworth, A

    2000-01-01

    It is well documented that an important cause of osteolysis and subsequent loosening of replacement hip joints is polyethylene wear debris. To avoid this, interest has been renewed in metal-on-metal and ceramic-on-ceramic prostheses. Various workers have assessed the lubrication modes of different joints by measuring the friction at the bearing surfaces, using different lubricants. Measurements of friction factors of a series of hip prostheses were undertaken using carboxymethyl cellulose (CMC) fluids, silicone fluids, synovial fluid and different concentrations of bovine serum as the lubricant. The experimental results were compared with theoretical predictions of film thicknesses and lubrication modes. A strong correlation was observed between experiment and theory when employing CMC fluids or silicone fluids as the lubricant. Mixed lubrication was found to occur in the metal-on-metal (CoCrMo/CoCrMo) joints with all lubricants at a viscosity within the physiological range. This was also the case for the metal-on-plastic (CoCrMo/ultra-high molecular weight polyethylene) joints. The ceramic-on-ceramic (Al2O3/Al2O3) joints, however, exhibited full fluid film lubrication with the synthetic lubricants but mixed lubrication with the biological lubricants. Employing a biological fluid as the lubricant affected the friction to varying degrees when compared with the synthetic lubricants. In the case of the ceramic-on-ceramic joints it acted to increase the friction factor tenfold; however, for the metal-on-metal joints, biological fluids gave slightly lower friction than the synthetic lubricants did. This suggests that, when measuring friction and wear of artificial joints, a standard lubricant should be used.

  9. Cementless isoelastic RM total hip prosthesis1

    OpenAIRE

    Bombelli, Renato; Mathys, Robert

    1982-01-01

    Some surgeons are beginning to doubt the reliability of bone cement in joint replacements. In 1967 Robert Mathys conceived the idea of an isoelastic prosthesis made of plastic, which would anchor into the bone without cement. He developed the idea by extensive tests in animals and, in 1973, the first human RM cementless hip prosthesis was inserted by E Morscher. In this paper the concept of the cementless isoelastic prosthesis is developed by Robery Mathys, and Professor Bombelli records his ...

  10. The importance of a thick cement mantle depends on stem geometry and stem-cement interfacial bonding.

    Science.gov (United States)

    Caruana, J; Janssen, D; Verdonschot, N; Blunn, G W

    2009-04-01

    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 different thicknesses. Opinion is divided on whether a thick mantle enhances implant longevity. This study investigates the effect of cement mantle thickness on accumulated damage in the cement, and how this is influenced by the presence or absence of a proximal collar and on whether the stem-cement interface remains bonded. Three-dimensional finite element simulations incorporating creep and non-linear damage accumulation were performed to investigate cracking in the cement mantles around Stanmore Hips under physiologically informed stair-climbing and gait loads. Cement mantle thickness, stem-cement interfacial bonding, and collar design were varied to assess the interactive effects of these parameters. In all cases, damage levels were three to six times higher when the stem-cement interface remained bonded. Cement mantle thickness had little effect on cement damage accumulation around debonded collared stems but was critical in both bonded and collarless cases, where a thicker mantle reduced cement cracking. Damage around a smooth debonded stem with a collar is thus much less sensitive to cement thickness than around bonded or collarless stems. PMID:19405437

  11. Tantalum as a buffer layer in diamond-like carbon coated artificial hip joints.

    Science.gov (United States)

    Kiuru, Mirjami; Alakoski, Esa; Tiainen, Veli-Matti; Lappalainen, Reijo; Anttila, Asko

    2003-07-15

    The acid resistance of tantalum coated and uncoated human hip joint prostheses was studied with commercial CrCoMo acetabular cups. The samples were exposed to 10% HCl solution and the quantities of dissolved Cr, Co, and Mo were measured with proton-induced X-ray emission (PIXE). The absolute quantities were obtained with the use of Cr and Se solution standards. Tantalum coatings (thicknesses 4-6 microm) were prepared in vacuum with magnetron sputtering. Tantalum coating decreased the corrosion rate by a factor of 10(6). As a spinoff from recent wear tests on artificial hip joints it was shown that tantalum has excellent mechanical properties as an intermediate layer of diamond-like carbon (DLC) coatings. When tantalum was tested together with DLC on three metal-on-metal hip joint pairs in a hip simulator, no observable defects occurred during 15 million walking cycles with a periodic 50-300-kg load (Paul curve). PMID:12808604

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

    Directory of Open Access Journals (Sweden)

    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.

  13. Comparison of postoperative curative effect and the possible survival rate of prosthesis following cemented and cementless total hip replacement%人工全髋关节置换骨水泥和无骨水泥假体术后疗效及假体可能的生存率比较

    Institute of Scientific and Technical Information of China (English)

    张勇; 杨彤涛; 周勇; 马保安

    2006-01-01

    ,假体都没有达到理想固定的效果.假体类型的选择并不影响假体的寿命,要根据患者的年龄及是否还要行翻修术来决定假体类型;骨溶解与患者年龄、性别、假体类型无关.%BACKGROUND: Patients who suffered total hip replacement are most concerned about the survivorship of prosthesis. OBJECTIVE: To evaluate the postoperative curative effect following ce mented and cementless THR with a retrospective method, so as to provide experience for prolonging the survivoship of prosthesis. DESIGN: Randomized and controlled observation. SETTING: General Center of Orthopaedic Department, General Institute of Bone Oncology, Tangdu Hospital, Fourth Military Medical University of Chinese PLA. PARTICIPANTS: We admitted 356 patients who underwent THR from Department of Orthopaedics, Tangdu Hospital, Fourth Military Medical U niversity of Chinese PLA between March 1993 and March 2004. Among them, 298 were contacted and 105 (108 hips) followed up. The patients participated in the review voluntarily. They were of either gender and had different types of prosthesis. Prosthesis made in China was adopted before 2000 and prosthesis made in American STRIKER company after 2000: Prosthesis made in China was made of home-made bone cement; Prosthesis bone cement (import) was provided by American STRIKER prosthesis company. Home-made bone cement and import have the same components. Barium was added in both bone cement . The whole operation was con ducted by the physicians who worked in the artificial joint department after examination. METHODS: According to informal discussion summary about total hip replacement of Chinese Journal of Surgery in 1982 and Evaluation Scale of Mayo Total Hip Replacement Curative Effect, we designed follow-up table by ourselves. Totally 105 (108 hips) patients were followed up, among them, 62 (63 hips) were in the cemented group, 43 (45 hips) in the ce mentless group. Pain, function and motion range of the patients and

  14. Hip ultrasound.

    Science.gov (United States)

    Martinoli, Carlo; Garello, Isabella; Marchetti, Alessandra; Palmieri, Federigo; Altafini, Luisa; Valle, Maura; Tagliafico, Alberto

    2012-12-01

    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. PMID:21571471

  15. 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.

  16. 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.

  17. Life Estimation of Hip Joint Prosthesis

    Science.gov (United States)

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

    2014-11-01

    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.

  18. Hip Revision

    Medline Plus

    Full Text Available ... the only downside is what we're doing right now -- sitting around waiting for the cement to ... of version in compared to where we are right now. Now in saying that, you don't ...

  19. CEMENT SLURRIES FOR GEOTHERMAL WELLS CEMENTING

    OpenAIRE

    Nediljka Gaurina-Međimurec; Davorin Matanović; Gracijan Krklec

    1994-01-01

    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...

  20. 可灌注骨水泥动力髋螺钉内固定修复骨质疏松股骨转子间骨折的优势%Advantages of cemented dynamic hip screw for osteoporotic intertrochanteric fracture

    Institute of Scientific and Technical Information of China (English)

    佘远时; 陈广祥; 陈广东; 王以进; 邹天明

    2014-01-01

    背景:动力髋螺钉内固定系统被认为是治疗股骨转子间骨折的经典方法,但髋螺钉切割股骨头后位置偏移是目前常见的力学失败,需要进行二次手术。目的:在传统动力髋螺钉内固定系统的基础上,对髋螺钉部分进行改良,设计可灌注骨水泥动力髋螺钉内固定系统,探讨其治疗骨质疏松股骨转子间骨折的可行性及生物力学性能。方法:取24具新鲜完整湿润的人骨质疏松髋部标本,测量骨密度,按标准制成AO31-A1型股骨转子间骨折模型,每份骨质疏松髋部标本,其中一侧置入可灌注骨水泥动力髋螺钉内固定系统作为实验组,另一侧置入传统动力髋螺钉内固定系统作为对照组,进行轴向压缩、扭转度及失效载荷生物力学测试,比较两者生物力学性能。结果与结论:实验组应力强度、轴向刚度、水平剪切刚度高于对照组(P<0.05);当扭角为3°时,实验组扭矩高于对照组(P <0.05);实验组失效载荷高于对照组(P <0.05)。表明可灌注骨水泥动力髋螺钉内固定系统治疗老年骨质疏松股骨转子间骨折,能有效增强髋螺钉的把持力,防止股骨头切割,其生物力学强度、刚度、抗疲劳性及稳定性均强于传统动力髋螺钉。%BACKGROUND:Dynamic hip screws have been considered as a classic method for intertrochanteric fracture. However, migration of the hip screw resulting in cut-out of the femoral head remains the most common mechanical failure, which requires secondary surgery. OBJECTIVE:On the basis of the traditional dynamic hip screw, we modified the lag screw, designed new internal fixation system as cemented dynamic hip screws to explore the feasibility and the biomechanical properties for the treatment of osteoporotic intertrochanteric fracture. METHODS:A total of 24 hip samples were harvested from fresh cadavers with osteoporosis. Bone density was measured. According to the

  1. 'Hip' pain.

    Science.gov (United States)

    Zacher, Josef; Gursche, Angelika

    2003-02-01

    'Hip' pain is usually located in the groin, upper thigh or buttock and is a common complaint. Slipped capital femoral epiphysis, avascular femoral head necrosis and apophyseal avulsion are the most common diagnoses in childhood and adolescents. Strains and fractures are common in sport-active adults. Osteoarthritis occurs in middle-aged and older adults. Trauma may result in femoral head fracture or typical muscle and tendon sprains and bursitis. Septic or inflammatory arthritis can occur at every age. Septic arthritis, fractures and acute epiphyseal slipping are real emergency cases. Congenital dysplasia of the hip joint may lead to labral tears and early osteoarthritis. The most important hip problems in children, adolescents, adult and older people are discussed; these problems originate from intra-articular disorders and the surrounding extra-articular soft tissues. Medical history, clinical examination and additional tests, including imaging, will be demonstrated. Principles of treatment are given for specific disorders. PMID:12659822

  2. Transplacental passage of metal ions in women with hip resurfacing: no teratogenic effects observed.

    Science.gov (United States)

    deSouza, Ruth-Mary; Wallace, David; Costa, Matthew L; Krikler, Stephen J

    2012-01-01

    Over recent years, hip resurfacing has been performed in young, active patients, including women in their child bearing years. Current work investigating the transplacental passage of metal ions (cobalt and chromium) suggests significant passage of ions across the placenta in mothers with metal on metal hip resurfacing. In vitro studies show that cobalt and chromium can create DNA and chromosome damage in human cells. The consequences of this ion transfer on the child during fetal development and thereafter have not been fully quantified. We report on 3 patients with metal on metal hip resurfacings who had the prosthesis in situ during pregnancy. Our data show that umbilical cord blood chromium levels are under a quarter of the maternal serum levels. Cord blood cobalt levels are approximately half that of maternal blood. All 3 children are healthy. Although there was transplacental passage of ions, there was no significant effect on the child in these cases. We did not show any teratogenic effect of metal ions on the child, and this is consistent with the reported literature. PMID:22383325

  3. 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......−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....

  4. Hip Revision

    Medline Plus

    Full Text Available ... re going to initially look at Scott's preoperative x-rays and just kind of describe the situation that ... up to that time. Here's Scott's initial preoperative x-ray, where we see a hybrid hip arthroplasty with ...

  5. Anterior Approach Total Hip Replacement

    Medline Plus

    Full Text Available ... have been anxiously waiting for some long-term data on the metal on metal here in the ... vitamin E doped polyethylene, and, you know, the data on this from the lab and the early ...

  6. Development and clinical trial of a novel bioactive bone cement

    Institute of Scientific and Technical Information of China (English)

    2008-01-01

    Strontium(Sr)and related compounds have become more attractive in the prevention and treatment of osteoporosis.Previously,we developed a novel bioactive bone cement which is mainly composed of strontium-containing hydroxyapatite(Sr-HA)filler and bisphenol A diglycidylether dimethacrylate(Bis-GMA)resin.This bone cement is superior to conventional polymethylmethacrylate (PMMA)bone cement in bioactivity,biocompatibility,and osseointegration.It also has shown sufficient mechanical strength properties for its use in percutaneous vertebroplasty(PVP)and total hip replacement(THR).In this paper,we review the in vitro,in vivo and clinical evidence for the effectiveness of this bioactive bone cement.

  7. 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.

  8. 人工全髋关节置换骨水泥和无骨水泥假体股骨近端广泛骨溶解的定量分析%Quantitative analysis of widespread osteolysis in the proximal end of cemented and cementless prostheses in total hip arthroplasty

    Institute of Scientific and Technical Information of China (English)

    张勇; 杨彤涛; 周勇; 马保安

    2006-01-01

    of osteolysis in proximal femur after total joint replacements (TJR) through the changing rules of bone density in proximal end of femur.DESIGN: Observation on patients before and after self-comparison.SETTING: Department of Orthopedics, Tangdu Hospital of Fourth Military Medical University of Chinese PLA.PARTICIPANTS: Twenty-eight hips in 26 patients received total hip replacements in the Department of Orthopedics, Tangdu Hospital of Fourth Military University from March 1994 to March 2004, including 16 hips in 14 male patients and 12 hips in 12 female patients, were selected. Types of prostheses: 17 hips in 16 patients with ameliorated Moore cemented prostheses were taken as cemented prosthesis group with a mean age of 57 years; 11 hips in 10 patients with microbores on the surface of implant were taken as cementless prosthesis group with a mean age of 55 years.Patients were diagnosed as traumatic arthritis before operation with the mean Harris score of 49 (20-77) points on hip. Age, gender and diagnosis after operation in patients of two groups were matched.METHODS: The gray degrees of X-ray in patients of two groups were measured with computer image analyzing, relative values were obtained,I.e. The average gray degrees of 1.0-2.0 cm2 area in femoral trochanter and iliac bone were measured with the same X-ray; Differences between them represented the relative value of bone density in greater trochanter of femur. Changing rules of bone density were quantitatively analyzed.MAIN OUTCOME MEASURES: Relative values of bone density in greater trochanter of femur of patients in two groups one week before and after operation, during the follow-up time were measured respectively.RESULTS: A total of 26 patients (28 hips) with the follow-up time of 9-126months were all involved in the analysis of results. Relative values of bone density were increased to different degree one week after operation. And rate of osteolysis was 100% with a mean value of 57.4 (9-118) in greater

  9. Simultaneous measurement of friction and wear in hip simulators.

    Science.gov (United States)

    Haider, Hani; Weisenburger, Joel N; Garvin, Kevin L

    2016-05-01

    We propose and have evaluated a method to measure hip friction during wear testing on a popular multi-station hip simulator. A 6-degree-of-freedom load cell underneath the specimen sensed forces and torques during implant wear testing of simulated walking. This included internal-external and adduction-abduction rotations which are often neglected during friction testing on pendulum-type machines. Robust mathematical analysis and data processing provided friction estimates in three simultaneous orthogonal rotations, over extended multi-million cycle wear tests. We tested various bearing couples including metal-on-plastic, ceramic-on-plastic, and metal-on-metal material couples. In one test series, new and intentionally scratched CoCrMo 40-mm-diameter femoral heads were tested against conventional ultrahigh-molecular-weight polyethylene, highly cross-linked, and highly cross-linked with vitamin E versions. The scratching significantly increased friction and doubled the wear of all groups. Before scratching, friction levels for the aforementioned plastic groups were 0.056 ± 0.0060, 0.062 ± 0.0080, and 0.070 ± 0.0045, respectively, but after scratching increased to 0.088 ± 0.018, 0.076 ± 0.0066, and 0.082 ± 0.0049, respectively, all statistically significant increases (p = 0.00059, 0.00005, 0.0115, respectively). In another test series of 44-mm femoral head diameter hips, metal-on-plastic hips with conventional ultrahigh-molecular-weight polyethylene showed the lowest friction at 0.045 ± 0.0085, followed by highly cross-linked with 0.046 ± 0.0035 (not significantly different). In a ceramic-on-plastic design with conventional ultrahigh-molecular-weight polyethylene, higher friction 0.079 ± 0.0070 was measured likely due to that ceramic surface being rougher than usual. Metal-on-metal hips were compared without and with a TiN coating, resulting in 0.049 ± 0.014 and 0.097 ± 0.020 friction factors, respectively

  10. Low-cycle fatigue of surgical cements

    Directory of Open Access Journals (Sweden)

    A. Balin

    2007-01-01

    Full Text Available Purpose: In case when surgical cement is used to fix endoprostheses of joints the fatigue character of mechanicalinterraction in the cement seems to be a significant importance. The paper suggests to adapt the research methodof low cycle fatigue for modelling the loads on surgical cements in an artificial hip joint. Surgical cements havealso been modified in order to improve their functional properties.Design/methodology/approach: Low cycle fatigue tests were conducted on samples made from Palamedcement without an addition and on samples modified with glassy carbon and titanium. The tests were conductedon a servohydraulic fatigue testing machine, MTS-810, with displacement control.Findings: Fatigue tests proved viscoelastic character of all the tested materials. During the fatigue tests, thephenomenon of stress cyclic relaxation was observed.Research limitations/implications: Modelling the loadings of cement in endoprostheses of joints with the lowcycle fatigue method takes into account all high value stresses, while cement is being used for endoprosthesesfor many years in the conditions of random stress and deformation courses. Therefore the obtained stress anddeformation values are bigger than those which would have been obtained in real conditions in the same time.Practical implications: The low cycle fatigue tests carried out showed how important is the factor of timefor the behavior of surgical cement in the conditions of changeable loadings. This fact is essential to assessits usability for endoprosthesoplasty of joints, specially of a hip joint. Post deformation return which is acharacteristic feature for material viscoelasticity enables its regeneration conditioning expected durability ofendoprosthesis of joints.Originality/value: Low cycle fatigue testing method for modelling of loads on surgical cement in artificial hipjoint enables to carry out the tests in a shorter period of time.

  11. Hip fracture - discharge

    Science.gov (United States)

    ... 2012:chap 55. Read More Broken bone Hip fracture surgery Hip pain Leg MRI scan Osteoporosis - overview Patient Instructions Getting your home ready - knee or hip surgery Osteomyelitis - discharge Update Date 11/ ...

  12. 硫酸钙骨水泥增强骨质疏松股骨粗隆间骨折内固定的有限元分析%Finite-Element Analysis of Injectable Calcium Sulfate Bone Cement Augmentation with Dynamic Hip Screw System for the Treatment of Osteoporotic Intertrochanteric Fractures

    Institute of Scientific and Technical Information of China (English)

    于晓巍; 王楠; 汤亭亭

    2009-01-01

    通过有限元分析,研究硫酸钙对稳定型骨质疏松股骨粗隆间骨折内固定增强的影响.建立骨质疏松股骨稳定型粗隆阅骨折有限元模型,模拟动力髋螺钉(DHS)固定及硫酸钙增强的DHS固定,分析硫酸钙对DHS固定的增强效果.有限元分析显示,硫酸钙增强后,股骨头部的松质骨最大应力减少了35%,提示螺钉切割出股骨头的可能性减小;而股骨骨折面最大应力从3.7 MPa减少到1.8 MPa,提示硫酸钙增强提高了DHS固定的稳定性.研究结果表明,硫酸钙骨水泥能有效增强骨质疏松性骨折内固定的稳定性,具有较好的临床应用前景.%The mechanical performance of the dynamic hip screw (DHS) system augmented with calcium sulfate bone cement (CSC) for the fixation of stable osteoporotic intertrochanteric fracture was evaluated by means of finite element analysis (FEA). Finite element model was used to simulate the stable osteoporotic intertrochanteric fracture with DHS fixation or DHS fixation plus CSC augmentation and the stress distribution was analyzed. With cement augmentation, 35% reduction of the maximum stress was found in the femur head, suggesting reduced possibility of screw cut-outs. Maximum stress at the fracture plane was also decreased from 3.7 MPa to 1.8 MPa, which indicates improved fixation after CSC augmentation. These results indicate that calcium sulfate cement is effective in augmenting fixation in osteoporotic bone. Calcium sulfate cement has potential application in the treatment of osteoporotic fractures.

  13. 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 descri

  14. Current status of noncemented hip implants.

    Science.gov (United States)

    Harris, W H

    1987-01-01

    Recently the operative techniques, instrumentation, design, and material properties of bony ingrowth total hip replacement have been greatly improved. I prefer a hemispherical acetabular component fixed with screws going through the metal shell. The titanium mesh allows microinterlock with new bone, and macrointerlock is obtained by adding bone graft into the unused screw holes. The femoral component, made of Tivanium with titanium mesh attached to it by a new process called diffusion bonding, retains superalloy fatigue strength characteristics. An intimate press fit is assured by the specific operative technique, and both the fiber mesh and the collar provide proximal stress transfer. The design affords a nondestructive method for removal if necessary. The short-term clinical results are promising; most patients function as well as with cemented total hip replacement. The incidence of thigh pain has been significantly reduced since prior reports of cementless total hip replacement; however, a few patients still have thigh pain. The results in revision surgery are also promising, but as in cemented total hip replacement, the functional capacity of revision cases is usually lower than primary cases. There is an increased capacity to correct complex and difficult acetabular problems with this acetabular component. Obviously, long-term data are needed to establish the behavior of these implants over the immediate and long term.

  15. Ultrasound: Infant Hip

    Science.gov (United States)

    ... ultrasound when they suspect a problem called developmental dysplasia of the hip (DDH) . DDH is a hip deformity that can ... THIS TOPIC X-Ray Exam: Leg Length Developmental Dysplasia of the Hip X-Ray Exam: Hip Contact Us Print Resources ...

  16. Fungal periprosthetic joint infection of the hip: a systematic review

    Directory of Open Access Journals (Sweden)

    Benjamin Schoof

    2015-03-01

    Full Text Available Periprosthetic joint infection (PJI is a severe complication of total joint arthroplasty with an incidence of approximately 1%. Due to the high risk of persisting infection, successful treatment of fungal PJI is challenging. The purpose of this study was to gain insight into the current management of fungal PJI of the hip and, by systematically reviewing the cases published so far, to further improve the medical treatment of this serious complication of total hip arthroplasty. Thus, we conducted a systematic review of the available literature concerning fungal PJI in total hip arthroplasty, including 45 cases of fungal PJI. At the moment a two-stage revision procedure is favorable and there is an ongoing discussion on the therapeutic effect of antifungal drug loaded cement spacers on fungal periprosthetic infections of the hip. Due to the fact that there is rare experience with it, there is urgent need to establish guidelines for the treatment of fungal infections of total hip arthroplasty.

  17. The contradictory effects of pores on fatigue cracking of bone cement.

    NARCIS (Netherlands)

    Janssen, D.; Aquarius, R.J.M.; Stolk, J.; Verdonschot, N.J.J.

    2005-01-01

    The beneficial effect of porosity reduction on the fatigue life of bone cement has been demonstrated in numerous experimental studies. Clinically, however, it seems that the beneficial effect of porosity reduction of cement around total hip replacement components can only be found in large follow-up

  18. In vivo implant fixation of carbon fiber-reinforced PEEK hip prostheses in an ovine model.

    Science.gov (United States)

    Nakahara, Ichiro; Takao, Masaki; Bandoh, Shunichi; Bertollo, Nicky; Walsh, William R; Sugano, Nobuhiko

    2013-03-01

    Carbon fiber-reinforced polyetheretherketone (CFR/PEEK) is theoretically suitable as a material for use in hip prostheses, offering excellent biocompatibility, mechanical properties, and the absence of metal ions. To evaluate in vivo fixation methods of CFR/PEEK hip prostheses in bone, we examined radiographic and histological results for cementless or cemented CFR/PEEK hip prostheses in an ovine model with implantation up to 52 weeks. CFR/PEEK cups and stems with rough-textured surfaces plus hydroxyapatite (HA) coatings for cementless fixation and CFR/PEEK cups and stems without HA coating for cement fixation were manufactured based on ovine computed tomography (CT) data. Unilateral total hip arthroplasty was performed using cementless or cemented CFR/PEEK hip prostheses. Five cementless cups and stems and six cemented cups and stems were evaluated. On the femoral side, all cementless stems demonstrated bony ongrowth fixation and all cemented stems demonstrated stable fixation without any gaps at both the bone-cement and cement-stem interfaces. All cementless cases and four of the six cemented cases showed minimal stress shielding. On the acetabular side, two of the five cementless cups demonstrated bony ongrowth fixation. Our results suggest that both cementless and cemented CFR/PEEK stems work well for fixation. Cup fixation may be difficult for both cementless and cemented types in this ovine model, but bone ongrowth fixation on the cup was first seen in two cementless cases. Cementless fixation can be achieved using HA-coated CFR/PEEK implants, even under load-bearing conditions.

  19. O uso de enxerto homólogo na revisão de artroplastias do quadril com cimentação do componente acetabular Use of homologous graft in hip arthroplasty reviews with acetabular component cementation

    Directory of Open Access Journals (Sweden)

    Fábio Stuchi Devito

    2006-01-01

    Full Text Available A artroplastia total do quadril representa um grande avanço no tratamento das enfermidades ortopédicas que acometem o quadril. A soltura asséptica desta prótese pode causar lesões e perdas ósseas, representando um grande desafio para a reconstrução cirúrgica destas artroplastias. Uma das alternativas para a reconstrução é o uso do enxerto ósseo de banco de ossos, podendo este ser usado em bloco ou na forma picada. Este estudo, baseado em uma revisão da literatura sobre enxertos ósseos, teve como objetivo uma análise quanto à reconstrução com enxertos em bloco e picado e sua integração. O enxerto picado mostrou melhores resultados quanto à integração quando se consegue estabilidade da reconstrução. Quando não conseguimos uma boa estabilidade, o enxerto em bloco associado aos anéis de reforço sobressai como a melhor opção.Hip total arthroplasty represents a breakthrough in the treatment of orthopaedic illnesses affecting the hip. The aseptic loosening of this prosthesis may cause injuries and bone losses, representing a great challenge for the surgical reconstruction of those arthroplasties. One alternative to reconstruction is the use of bone graft sourced by bone bases, which may be used as a block or in pieces. This study, based on a literature review addressing bone grafts, had as an objective to analyze reconstruction with grafts in blocks and in pieces and its union. The graft in pieces showed better results concerning union when reconstruction stability is achieved. When a good stability cannot be achieved, the graft in block combined with reinforcement rings is highlighted as the best option.

  20. Assessment of total hip arthroplasty as a predisposing factor for ischiofemoral impingement

    Energy Technology Data Exchange (ETDEWEB)

    Oliveira, Adriana L.; Azevedo, Debora C.; Eajazi, Alireza; Palmer, William E.; Bredella, Miriam A. [Massachusetts General Hospital and Harvard Medical School, Division of Musculoskeletal Imaging and Intervention, Boston, MA (United States); Kwon, Young-Min [Massachusetts General Hospital and Harvard Medical School, Department of Orthopedics, Boston, MA (United States); Torriani, Martin [Massachusetts General Hospital and Harvard Medical School, Division of Musculoskeletal Imaging and Intervention, Boston, MA (United States); Massachusetts General Hospital, Division of Musculoskeletal Imaging and Intervention Department of Radiology, Boston, MA (United States)

    2015-12-15

    To examine the effect of total hip arthroplasty (THA) on ischiofemoral (IF) and quadratus femoris (QF) spaces with the hypothesis that THA does not affect ischiofemoral relationships. The study was IRB approved and complied with HIPAA guidelines. We identified consecutive MR examinations (pelvis and/or hip) obtained at our institution in adults (≥18 years old) screened for THA-related complications. Native hips from the same individuals served as controls. We collected medical record data including age, gender, surgical history, and THA designs. Two radiologists independently measured the IF-RAD and IF-MRI (IF space on radiographs and MR imaging, respectively) and QF space (on MR imaging). Groups were compared using ANCOVA controlled for gender. The study group comprised 250 hips (132 subjects; 162 post-THA and 88 native hips). Subjects were aged 59 ± 10 years, with 66 males and 66 females. Comparison of IF-MRI and QF spaces between native and post-THA hips showed no differences (P > 0.12) and IF-RAD was higher in post-THA subjects (P = 0.01). No differences in the IF-MRI and QF spaces were present between native hips and different THA designs (P > 0.4). IF-RAD of metal-on-metal THA was higher than that of native hips (P = 0.01) and trended higher than ceramic-on-polyethylene THA (P = 0.08), with the remaining comparisons showing no significant differences (P > 0.4). Radiographic- and MRI-based measures in patients with standard THA do not show narrowing of IF and QF spaces. (orig.)

  1. Taper Hip Prosthesis

    Medline Plus

    Full Text Available ... the minimally invasive anterial lateral approach to the right hip in this gentleman. We're going to ... the anterior superior at the spine of the right hip. And at this point we'll begin. ...

  2. Hip fracture surgery

    Science.gov (United States)

    ... neck fracture repair; Trochanteric fracture repair; Hip pinning surgery; Osteoarthritis-hip ... You may receive general anesthesia before this surgery. This means ... spinal anesthesia. With this kind of anesthesia, medicine is ...

  3. Taper Hip Prosthesis

    Medline Plus

    Full Text Available ... OR Live" Webcast on the Kinectiv Total Hip System. At this time, let’s join Dr. Maltry in ... going to be installing the Zimmer Kinectiv Hip System today and we'll walk you through that. ...

  4. 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...

  5. BIOMECHANICAL EVALUATION OF DYNAMIC HIP SCREW WITH BONE CEMENT AUGMENTATION IN NORMAL BONE%骨水泥强化正常骨质动力髋螺钉固定的生物力学研究

    Institute of Scientific and Technical Information of China (English)

    黎宁; 彭阿钦; 柴仪; 曹晶; 刘勇; 郭锐; 韩长伶

    2007-01-01

    目的 选取正常骨密度的股骨转子间骨折标本,研究骨水泥强化对动力髋螺钉(dynamic hip screw,DHS)固定的生物力学影响.方法 取成年男性防腐尸体双侧股骨上段标本24对48侧,制备A2型股骨转子间骨折DHS固定模型.右侧标本行骨水泥强化DHS固定,为强化组;左侧行DHS常规固定,为对照组.两组标本进行弯曲强度实验及扭转强度实验.结果 强化组最大负荷及最大扭矩分别为3 852.160 2±143.603 1 N、15.5±2.6 Nm,对照组为3 702.966 7±133.860 1 N、14.7±3.4 Nm;两组比较生物力学差异均无统计学意义(P>0.05).结论 正常骨密度的股骨转子间骨折行骨水泥强化,对DHS固定强度及骨折整体稳定性无显著影响.

  6. HIP-HOP教室

    Institute of Scientific and Technical Information of China (English)

    2006-01-01

    从现在开始我们要为了Hip-hop而奋斗,使身边的人改变对Hip-hop文化的看法,让他们知道什么是真正的Hip-hop,更要让大家学会怎样用肢体去表达,Yo,在这里,永远不会出现半吊子的Hip-hop,因为我们都是来真的,Yo,来真的,因为我要将Hip-hop发扬到底,Yeah!

  7. Do normal hips dislocate?

    Science.gov (United States)

    Alshameeri, Zeiad; Rehm, Andreas

    2014-11-01

    There have been a small number of case reports describing late normal-hip dislocations in children who were later diagnosed with developmental dysplasia of the hip. Here, we contest the assumption that normal hips can dislocate. We argue that (as in our case) the ultrasound scans in all published case reports on late dislocated normal hips did not show results that were entirely normal and therefore, so far, there has been no convincing evidence of a dislocation of a normal hip. We also want to highlight the importance of meticulous ultrasound and clinical assessments of high-risk children by an experienced orthopaedic surgeon. PMID:25144883

  8. Hip arthroscopy in the setting of hip dysplasia

    OpenAIRE

    Yeung, M.; Kowalczuk, M.; Simunovic, N.; Ayeni, O. R.

    2016-01-01

    Objective Hip arthroscopy in the setting of hip dysplasia is controversial in the orthopaedic community, as the outcome literature has been variable and inconclusive. We hypothesise that outcomes of hip arthroscopy may be diminished in the setting of hip dysplasia, but outcomes may be acceptable in milder or borderline cases of hip dysplasia. Methods A systematic search was performed in duplicate for studies investigating the outcome of hip arthroscopy in the setting of hip dysplasia up to Ju...

  9. Criterio de predicción de la vida útil de la prótesis total de cadera en función de la falla del cemento en el componente femoral. // Life prediction criteria of hip prosthesis according to cement failure in femoral component.

    Directory of Open Access Journals (Sweden)

    G. García del pino

    2002-09-01

    Full Text Available En este trabajo se utiliza el Método de los Elementos Finitos para estudiar la combinación de diferentes parámetros, y suinfluencia en la vida útil de la prótesis total de cadera utilizando como criterio la falla del cemento que une estas prótesis alfémur, debido a que este tipo de falla es una de las fallas que mas provoca la perdida de la implantación. Los parámetrosestudiados aquí fueron el tipo de material del vástago de la prótesis dado por su modulo de elasticidad, la calidad del huesodada por la densidad y las cargas simulando diferentes actividades físicas y diferentes pesos del cuerpo.Los resultados obtenidos a través del Método de los Elementos Finitos, fueron procesados utilizando rutinas creadas enlenguaje C y técnicas de estadística, determinando las variables más influyentes y los valores más favorables para obteneruna transmisión apropiada de cargas, que garanticen una vida útil mayor.Palabras claves: biomecánica, ortopedia, elementos finitos, modulación__________________________________________________________________AbstractIn this paper the Finite Element Method is employ in order to study different parameters combination and their influence inthe duration of total hip prosthesis, taking as decision criteria the failure of cement that keep together femur and prosthesis,taking in account that this is the most common cause of implantation lost. The target parameters were: shank prosthesismaterial given by elasticity modulus, bone quality given by density, and finally, loads simulating different physicalactivities and body weight. The results were processed by means of statistical techniques and C language routines allowingto obtain the more influent variables to a proper load transmission and greater useful prosthesis life.Key words: Biomechanics, orthopaedic, finite elements, modulation

  10. Do Rerevision Rates Differ After First-time Revision of Primary THA With a Cemented and Cementless Femoral Component?

    DEFF Research Database (Denmark)

    Gromov, Kirill; Pedersen, Alma B; Overgaard, Søren;

    2015-01-01

    Worldwide use of cementless fixation for total hip arthroplasty (THA) is on the rise despite some evidence from the world's registries suggesting inferior survivorship compared with cemented techniques. The patterns of bone loss associated with failed cementless and cemented THAs may prejudice...

  11. Comparison of the Effect of Cemented Prosthesis and Biological Prosthesis in the Treatment of Patients with Development Dysplasia Hip%骨水泥型假体与生物型假体在髋关节发育不良患者中的疗效对比

    Institute of Scientific and Technical Information of China (English)

    阿卜杜瓦伊提·阿卜杜拉; 杜曼·吐鲁木汗; 史翀; 穆哈买提

    2014-01-01

    Objective To compare the effect of cemented prosthesis and biological prosthesis in the treatment of patients with development dysplasia hip (DDH).Methods 80 patients with DDH who would undergo total hip arthroplasty were randomly divided into research group (40 cases) and control group (40 cases). The total hip arthroplasty of research group was conducted with biological prosthesis while that of control group was conducted with cemented prosthesis. Then the safety and effectiveness of research group were compared with those of control group from the aspects of operation time, bleeding quantity, survival rate of prosthesis and Harris score.Results The average operation time of research group was (98.7±18.9) min while that of control group was (140.7±51.9) min. The average bleeding quantity of research group was (280.0±60) mL while that of control group was (360.0±100) mL. The survival rate of prosthesis of research group was 95% while that of control group was 82.5%. The Harris score calculated at the last follow-up of prosthesis of research group was (91.7±9.8) while that of control group was (82.9±11.3). There were signiifcant differences between research group and control group in operation time, bleeding quantity, survival rate of prosthesis and Harris score.Conclusion Total hip arthroplasty conducted with biological prosthesis which owns advantages such as high stability and ideal mid-term and long-term curative effect should be promoted in the treatment of patients with DDH.%目的:对比骨水泥型与生物型假体在髋关节发育不良患者中的疗效。方法将行全髋关节置换术的髋关节发育不良患者80例随机分为两组,研究组40例采用生物型假体进行置换术,对照组40例采用骨水泥型假体进行置换术。从手术时间、出血量、假体存活率、Harris评分等方面评价两组手术的安全性及疗效。结果研究组手术时间为(98.7±18.9)min,对照组为(140.7±51.9

  12. 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.

  13. 骨水泥填塞动力髋螺钉主钉孔:抗弯曲和抗扭转强度%Dynamic hip screw hole filled by bone cement: Anti-flexion and anti-torsion strength

    Institute of Scientific and Technical Information of China (English)

    郑海; 李神; 郭艳龙

    2010-01-01

    目的:评价髋关节后侧入路加骨水泥填塞后内侧支撑植骨治疗转子间骨折的临床效果.方法:应用计算机检索Science Direct数据库、Ei数据库1960-01/2009-10期间的相关文章,检索词为"bone cement,Intertrochanteric fracture",并限定文章语言种类为English.同时计算机检索中国期刊全文数据库、中国生物医学文献数据库等1994-01/2009-10期间的相关文章,检索词为"转子间骨折,髋内翻,髋关节后侧入路,主钉孔植入骨水泥",并限定文章语言种类为中文.此外还手工查阅相关专著数部.纳入有关股骨转子间骨折治疗方式研究,骨水泥治疗股骨转子间骨折的基础与临床实验.结果:股骨转子间骨折手术治疗方法都为外侧或前侧入路行动力髋钢板系统、动力髋螺钉、股骨近端髓内钉常规内固定.动力髋螺钉是治疗股骨转子间骨折的标准内固定,具有较强的抗旋转功能,符合生物力学要求.但螺钉松动、拔出和断裂等并发症发生率较高.采用骨水泥强化松质骨钉道后,骨水泥强化不仅增加螺钉把持力,有利于尾钉加压;同时也扩大了骨.钉接触界面,应力被分散传递至更大的钉-骨界面区域,明显提高动力髋螺钉固定的抗弯曲和抗扭转强度,整体提高骨折稳定性.骨水泥的强化机制在于通过充填于骨小梁闯隙与周围松质骨微观交锁,形成松质骨-骨水泥-螺钉的整体结构.结论:使用骨水泥填塞动力髋螺钉,可明显增强动力髋螺钉固定的抗弯曲和抗扭转强度,整体提高骨折稳定性.

  14. 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.

  15. Painful Hip Prosthesis: Definition

    OpenAIRE

    Ferrata, P.; Carta, S.; Fortina, M.; Scipio, D.; Riva, A.; Di Giacinto, S.

    2010-01-01

    Pain is the main reason inducing patients to undergo surgery and persistence of pain after the operation is a major concern, both for the patient and the surgeon. Up to 10% of patients report pain five years after hip arthroplasty. An analysis of the literature reveals numerous causes of pain localised to the replacement hip. In assessing a painful hip it is fundamental to arrive at a definite diagnosis before starting any treatment. Intrinsic causes can be identified, such as unrecognised as...

  16. Hip fracture - discharge

    Science.gov (United States)

    Inter-trochanteric fracture repair - discharge; Subtrochanteric fracture repair - discharge; Femoral neck fracture repair - discharge; Trochanteric fracture repair - discharge; Hip pinning surgery - discharge

  17. Meta-analysis of cemented versus uncemented fixation of femoral components in primary total hip arthroplasty%骨水泥与非骨水泥股骨柄在初次全髋关节置换术后疗效的Meta分析

    Institute of Scientific and Technical Information of China (English)

    周定; 臧谋圣; 胡勇; 张琪琪

    2014-01-01

    Objective To systematically evaluate all the randomized controlled trails ( RCTs ) comparing cemented versus uncemented fixation of the femoral components in primary total hip arthroplasty ( THA ) . Methods All the RCTs related to cemented versus uncemented fixation of the femoral components in the primary total hip arthroplasty were comprehensively searched on Pubmed, EMBASE, OVID, Hihgwire, SpringerLink, ScienceDirect, Cochrane library, China National Knowledge Infrastructure (CNKI) and Chinese BioMedical Literature Database ( CBM) from January 1990 to June 2013.Some related articles were hand-searched as well.The methodology quality of the articles was assessed according to the standards recommended by Cochrane Collaboration.Revman 5.2 was applied to the data analysis. Results Eleven RCTs involving 1 651 patients were included.The levels of the included RCTs were very high.The combined results indicated that without considering the patients′age and follow-up years, the revision rate of the femoral components was found no difference between the cemented group and the uncemented group [OR =3.20, 95%CI (0.72,14.22), P >0.05].The revision rate showed no statistical difference in the patients of 0 -5 years follow-up [OR=0.41, 95%CI (0.15,1.16), P>0.05], however the revision rate showed significant difference between the two groups after more than five years follow-up [OR=5.92, 95%CI (2.68,13.07), P0.05], the femoral stem loosening [OR=1.31,95%CI (0.27,6.30), P>0.05], the rate of femoral fracture[OR=0.91, 95%CI (0.3,2.7), P>0.05], the rate of infection [OR=2.46, 95%CI (0.7, 8.58), P>0.05], the rate of heterotopic ossification [OR=0.91, 95%CI (0.63,1.33), P>0.05]and the rate of dislocation [OR=3.11, 95%CI (0.6,16.10), P>0.05].Conclusion Both the cemented and uncemented stems are excellent for the fixation of femur components in the primary THA.Compared with the cemented fixation, the uncemented fixation may present a better long-time stability, but with an higher

  18. The concentric all-polyethylene Exeter acetabular component in primary total hip replacement.

    Science.gov (United States)

    Veitch, S W; Whitehouse, S L; Howell, J R; Hubble, M J W; Gie, G A; Timperley, A J

    2010-10-01

    We report the outcome of the flangeless, cemented all-polyethylene Exeter acetabular component at a mean of 14.6 years (10 to 17) after operation. Of the 263 hips in 243 patients, 122 prostheses are still in situ; 112 patients (119 hips) have died, 18 hips have been revised, and three patients (four hips) were lost to follow-up. Radiographs at the final review were available for 110 of the 122 surviving hips. There were acetabular radiolucent lines in 54 hips (49%). Two acetabular components had migrated but neither patient required revision. The Kaplan-Meier survivorship at 15 years with 61 hips at risk with revision for any cause as the endpoint was 89.9% (95% confidence interval (CI) 84.6 to 95.2) and for aseptic loosening of the acetabular component or lysis 91.7% (95% CI 86.6 to 96.8). In 210 hips with a diagnosis of primary osteoarthritis, survivorship with revision for any cause as the endpoint was 93.2% (95% CI 88.1 to 98.3), and for aseptic loosening of the acetabular component 95.0% (95% CI 90.3 to 99.7). The cemented all-polyethylene Exeter acetabular component has an excellent long-term survivorship.

  19. Obesity is a Major Risk Factor for Prosthetic Infection after Primary Hip Arthroplasty

    OpenAIRE

    Dowsey, Michelle M.; Choong, Peter F M

    2008-01-01

    The incidence of obesity and the number of hip arthroplasties being performed in Australia each year are increasing. Although uncommon, periprosthetic infection after surgery can have a devastating effect on patient outcomes. We therefore asked whether obesity correlated with periprosthetic infection after primary hip arthroplasty. We further asked whether variables such as patient comorbidities, operative time, blood transfusions, use of drains, and cementation practices correlated with peri...

  20. ULTRA-LIGHTWEIGHT CEMENT

    International Nuclear Information System (INIS)

    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

  1. Cement extractor device in revision prosthesis of the humerus.

    Science.gov (United States)

    Giannotti, Stefano; Bottai, Vanna; Dell'Osso, Giacomo; Bugelli, Giulia; Guido, Giulio

    2014-11-01

    In revision arthroplasty the surgeon is often faced with the problem of removal of residual cement in the medullary canal. Conventional manual cement removal by hand or power-driven instruments can be time-consuming, can require osteotomy, and can be associated with complications such as cortical perforation, fracture, or bone loss. Ultrasonic devices offer an alternative method of cement removal, but the potential for thermal injury exists, in particular for the humerus and the radial nerve. Considering these problems with the use of ultrasound, and whereas the old cement mantle may be left in place in the hip or knee but not in the shoulder, we tried this new mechanical cement extractor also in the humerus. We utilized this extractor in 5 cases, and we eliminated all residual resin in an accurate and complete way without bone loss and without iatrogenic fractures in all cases. We believe this system, which was designed for revisions of hip and knee surgery, is also suitable for the shoulder. PMID:25433154

  2. CONSERVATIVE TREATMENT OF HIP DYSPLASIA

    OpenAIRE

    Mikhail Mikhailovich Kamosko; Mahmoud Stanislavovich Poznovich

    2014-01-01

    Hip dysplasia in children is the subject of careful study by specialists both in our country and abroad. There are three basic variants of hip dysplasia: congenital acetabular dysplasia, congenital subluxation of the hip and congenital dislocation of the hip. However, treatment of congenital dislocation of the hip, which is the most severe form of hip dysplasia in children, currently remains one of the topical problems of children’s orthopedics, despite the significant achievements of modern ...

  3. Cardiovascular effects of acrylic bone cement in rabbits and cats.

    Science.gov (United States)

    Pelling, D; Butterworth, K R

    1973-06-16

    The cardiovascular responses to forcing acrylic bone cement, Plasticine, or soft paraffin wax into the medullary cavity of the femur have been studied in rabbits and cats. An acute fall in blood pressure, occurring within a few seconds of insertion, was demonstrated with each substance. In a few of the animals the blood pressure response had a second more protracted component and it is suggested that more than one mechanism is involved. The cardiovascular effects that have been observed in man when acrylic cement is used in prosthetic hip surgery also may be due to more than one mechanism. PMID:4714847

  4. Finite element analysis of a modified short hip endoprosthesis

    OpenAIRE

    Augustin Semenescu; Florentina Ioniță Radu; Ileana M. Mateș; Petre Bădică; Nicolae D. Batalu

    2016-01-01

    A finite element simulation of the mechanical static features for a modified short hip endoprosthesis was performed. The corkscrew-like femoral stem was modified introducing more turns of the thread. By such an approach it is expected that for some cases the mechanical fixation of the prosthesis to the bone will be improved or the use of the cement for bonding is not necessary. Our scenario was estimated for titanium and stainless steel, and both materials show good safety fact...

  5. TREATMENT OF HIP DYSPLASIA

    Directory of Open Access Journals (Sweden)

    Iulian ICLEANU

    2015-11-01

    Full Text Available 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 (genu valgum, the ankles (ankle valgus, calcaneal valgus and the spine (scoliosis especially at the lumbar level. The most spectacular are at the hip level, that is why we made an analytical evaluation only for this joint. To show the importance of physiotherapy for children with hip dysplasia we started from the hypothesis: untimely treatment for children with hip dysplasia has improved results in functional recovery and in obtaining a better stability, without the necessity of orthopedics or surgical interventions. The research methods used in this study are: the observation method, the bibliographic study method, the experimental method, the graphics method and the statistical mathematical method to process the data and to represent the results graphically. In the end, the results obtained are significantly different from the initial evaluations and we came to the conclusion that starting an untimely analytical kinetic treatment and globally personalizing it to every patient improves stability and biomechanical parameters for the hip.

  6. Hip joint injection

    Science.gov (United States)

    ... cause of the pain. For some, it can last weeks or months. Alternative Names Cortisone shot - hip; Hip injection; Intra-articular steroid ... writing by ADAM Health Solutions. About MedlinePlus Site Map FAQs Contact ... Institutes of Health Page last updated: 23 August 2016

  7. Hip Problems in Infants

    Science.gov (United States)

    ... problems that can lead to dislocation of the hip bones. This is also called dysplasia (say: "diss-play-see-uh"). This means that ... problems later in life? Source Screening for Developmental Dysplasia of the Hip by LM French, M.D., and FR Dietz, ...

  8. Femoral component loosening after hip resurfacing arthroplasty

    Energy Technology Data Exchange (ETDEWEB)

    Zustin, Jozef; Sauter, Guido [University Medical Centre Hamburg-Eppendorf, Institute of Pathology, Hamburg (Germany); Hahn, Michael [University Medical Centre Hamburg-Eppendorf, Center for Biomechanics and Skeletal Biology, Hamburg (Germany); Morlock, Michael M. [TUHH Hamburg University of Technology, Biomechanics Section, Hamburg (Germany); Ruether, Wolfgang [University Medical Centre Hamburg-Eppendorf, Department of Orthopaedics, Hamburg (Germany); Amling, Michael [University Medical Centre Hamburg-Eppendorf, Center for Biomechanics and Skeletal Biology, Hamburg (Germany); University Medical Centre Hamburg-Eppendorf, Department of Trauma, Hand and Reconstructive Surgery, Hamburg (Germany)

    2010-08-15

    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

  9. Formed HIP Can Processing

    Energy Technology Data Exchange (ETDEWEB)

    Clarke, Kester Diederik [Los Alamos National Lab. (LANL), Los Alamos, NM (United States)

    2015-07-27

    The intent of this report is to document a procedure used at LANL for HIP bonding aluminum cladding to U-10Mo fuel foils using a formed HIP can for the Domestic Reactor Conversion program in the NNSA Office of Material, Management and Minimization, and provide some details that may not have been published elsewhere. The HIP process is based on the procedures that have been used to develop the formed HIP can process, including the baseline process developed at Idaho National Laboratory (INL). The HIP bonding cladding process development is summarized in the listed references. Further iterations with Babcock & Wilcox (B&W) to refine the process to meet production and facility requirements is expected.

  10. Surface and Subsurface Analyses of Metal-on-Polyethylene Total Hip Replacement Retrievals.

    Science.gov (United States)

    Vuong, Vicky; Pettersson, Maria; Persson, Cecilia; Larsson, Sune; Grandfield, Kathryn; Engqvist, Håkan

    2016-05-01

    Metal-on-polyethylene (MoP) articulations are one of the most reliable implanted hip prostheses. Unfortunately, long-term failure remains an obstacle to the service life. There is a lack of higher resolution research investigating the metallic surface component of MoP hip implants. This study investigates the surface and subsurface features of metallic cobalt chromium molybdenum alloy (CoCrMo) femoral head components from failed MoP retrievals. Unused prostheses were used for comparison to differentiate between wear-induced defects and imperfections incurred during implant manufacturing. The predominant scratch morphology observed on the non-implanted references was shallow and linear, whereas the scratches on the retrievals consisted of largely nonlinear, irregular scratches of varying depth (up to 150 nm in retrievals and up to 60 nm in reference samples). Characteristic hard phases were observed on the surface and subsurface material of the cast samples. Across all samples, a 100-400 nm thick nanocrystalline layer was visible in the immediate subsurface microstructure. Although observation of the nanocrystalline layer has been reported in metal-on-metal articulations, its presence in MoP retrievals and unimplanted prostheses has not been extensively examined. The results suggest that manufacturing-induced surface and subsurface microstructural features are present in MoP hip prostheses prior to implantation and naturally, these imperfections may influence the in vivo wear processes after implantation. PMID:26399989

  11. Late Nontraumatic Dissociation of the Femoral Head and Trunnion in a Total Hip Arthroplasty

    Directory of Open Access Journals (Sweden)

    Simon J. M. Parker

    2015-01-01

    Full Text Available Background. Modular total hip arthroplasties are increasingly popular because customisation allows optimal restoration of patient biomechanics. However, the introduction of component interfaces provides greater opportunities for failure. We present a case of late nontraumatic dissociation of the head-neck interface, more than 10 years after insertion. Case Description. A 58-year-old woman had a left metal-on-metal total hip arthroplasty in 2002 for hip dysplasia. Following an uneventful 10-year period, she presented to hospital in severe pain after standing from a seated position, and radiographs demonstrated complete dissociation of the modular femoral head from the stem, with the femoral head remaining in its cup. There was no prior trauma or infection. Mild wear and metallosis were present on the articulating surface between the femoral head and trunnion. Soft tissues were unaffected. Discussion and Conclusions. This is the latest occurrence reported to date for nontraumatic component failure in such an implant by more than 7 years. The majority of cases occur in the context of dislocation and attempted closed reduction. We analyse and discuss possible mechanisms for failure, aiming to raise awareness of this potential complication and encouraging utmost care in component handling and insertion, as well as the long term follow-up of such patients.

  12. ULTRA-LIGHTWEIGHT CEMENT

    International Nuclear Information System (INIS)

    The objective of this project is to develop an improved ultra-lightweigh cement using ultralight hollow glass spheres (ULHS). Work reported herein addresses Task 1: Assess Ultra-Lightweight Cementing Problems, Task 2: Review Russian Ultra-Lightweight Cement Literature, and Task 3: Test Ultra-Lightweight Cements. Results reported this quarter include a review and summary surface pipe and intermediate casing cementing conditions historically encountered in the US and establishment of average design conditions for ULHS cements. Russian literature concerning development and use of ultra-lightweight cements employing either nitrogen or ULHS was reviewed, and a summary is presented. Quality control testing of materials used to formulate ULHS cements in the laboratory was conducted to establish baseline material performance standards. A testing protocol was developed employing standard procedures as well as procedures tailored to evaluate ULHS. This protocol is presented and discussed. finally, results of initial testing of ULHS cements is presented along with analysis to establish cement performance design criteria to be used during the remainder of the project

  13. The other hip in unilateral hip dysplasia

    DEFF Research Database (Denmark)

    Jacobsen, Steffen; Rømer, Lone; Søballe, Kjeld

    2006-01-01

    We reviewed transverse pelvic computed tomography scans of 197 consecutively referred adult patients with hip pain thought to be secondary to developmental dysplasia. A center-edge angle of 20 degrees or less was considered the upper normal value. Four groups were identified: 69 patients with app...

  14. Total hip arthroplasty

    Directory of Open Access Journals (Sweden)

    Slavković Nemanja

    2012-01-01

    Full Text Available Total hip arthroplasty is most common reconstructive hip procedure in adults. In this surgery we replace some parts of the upper femur and acetabulum with biocompatible materials. The main goal of this surgery is to eliminate pain and regain full extent of joint motion, maintaining hip stability. Surgical technique, biomaterials, design of the prosthesis and fixation techniques have evolved with time adjusting to each other. After total hip arthroplasty patients’ quality of life should be improved. There are many various postoperative complications. Some of them are fatal, and some are minor, which may become manifested years after surgery. Each next surgical procedure following previous hip surgery is associated with considerably lower chances to be successful. Therefore, in primary total hip arthroplasty, preoperative evaluation and preparation of patients are essential. Every orthopaedic surgeon needs to improve already adopted surgical skills applying them with precision and without compromise, with the main goal to achieve long-term durability of the selected implant. The number of total hip arthroplasties will also increase in future, and newer and higher quality materials will be used.

  15. Influence of the femoral head size on early postoperative gait restoration after total hip arthroplasty

    Institute of Scientific and Technical Information of China (English)

    ZHOU Yi-xin; GUO Sheng-jie; LIU Qing; TANG Jing; LI Yu-jun

    2009-01-01

    Background We investigated the effects of using large-diameter femoral heads in total hip prostheses on eady postoperative gait restoration in patients undergoing total hip arthroplasty (THA). Methods We collected data for 19 primary THAs using 28-mm metal-on-polyethylene heads (conventional group) and for 12 THAs (BHR group) using metal-on-metal femoral heads with an average size of 45 mm (range, 40-49 mm). All patients had unilateral femoral head avascular necrosis. All patients underwent Harris Hip Scores evaluation and gait analysis with the IDEEA device at the same 3 time points which were before surgery and then at 1 month and again at 3 months after surgery, and the parameters measured were walking speed, stride length (SL), single limb support (SLS), cycle duration (CD), and swing power (SP). Harris Hip Scores and gait analysis parameters for both groups were compared.Results Intraclass comparison indicated that Harris Hip Scores, speed scores, and gait parameter measures in both groups improved significantly with the passage of time; Interclass comparison showed no significance between Harris1m postop - Harrispreop and Harris3m postop- Harrispreop in both groups. The speed in the BHR group at 1 month and at 3 months after surgery was significantly higher than that of conventional group. At 1 month after surgery, each mean for SLnormal-SLaffected, (SLSnormal - SLSaffected)/CD, and SPnormal - SPaffocted in the BHR group was significantly lower than that for the conventional group. At 3 months after surgery, the differences between means for both groups for SLnormal - SLaffected.(SLSnormal- SLSaffected)/CD, and SPnormal - SPaffected were not significant, but the mean of SPnormal - SPaffected in the BHR group was significantly lower than that in the conventional group.Conclusions Our data suggest that large-diameter femoral heads in THA provide better early gait restoration than conventional-size femoral heads.

  16. Compatibility of the totally replaced hip. Reduction of wear by amorphous diamond coating.

    Science.gov (United States)

    Santavirta, Seppo

    2003-12-01

    Particulate wear debris in totally replaced hips causes adverse local host reactions. The extreme form of such a reaction, aggressive granulomatosis, was found to be a distinct condition and different from simple aseptic loosening. Reactive and adaptive tissues around the totally replaced hip were made of proliferation of local fibroblast like cells and activated macrophages. Methylmethacrylate and high-molecular-weight polyethylene were shown to be essentially immunologically inert implant materials, but in small particulate form functioned as cellular irritants initiating local biological reactions leading to loosening of the implants. Chromium-cobalt-molybdenum is the most popular metallic implant material; it is hard and tough, and the bearings of this metal are partially self-polishing. In total hip implants, prerequisites for longevity of the replaced hip are good biocompatibility of the materials and sufficient tribological properties of the bearings. The third key issue is that the bearing must minimize frictional shear at the prosthetic bone-implant interface to be compatible with long-term survival. Some of the approaches to meet these demands are alumina-on-alumina and metal-on-metal designs, as well as the use of highly crosslinked polyethylene for the acetabular component. In order to avoid the wear-based deleterious properties of the conventional total hip prosthesis materials or coatings, the present work included biological and tribological testing of amorphous diamond. Previous experiments had demonstrated that a high adhesion of tetrahedral amorphous carbon coatings to a substrate can be achieved by using mixing layers or interlayers. Amorphous diamond was found to be biologically inert, and simulator testing indicated excellent wear properties for conventional total hip prostheses, in which either the ball or both bearing surfaces were coated with hydrogen-free tetrahedral amorphous diamond films. Simulator testing with such total hip prostheses

  17. CONSERVATIVE TREATMENT OF HIP DYSPLASIA

    Directory of Open Access Journals (Sweden)

    Михаил Михайлович Камоско

    2014-12-01

    Full Text Available Hip dysplasia in children is the subject of careful study by specialists both in our country and abroad. There are three basic variants of hip dysplasia: congenital acetabular dysplasia, congenital subluxation of the hip and congenital dislocation of the hip. However, treatment of congenital dislocation of the hip, which is the most severe form of hip dysplasia in children, currently remains one of the topical problems of children’s orthopedics, despite the significant achievements of modern medicine. In spite of the large amount of research in this field, treatment principles of hip dysplasia are still under discussion.

  18. Complications in primary total hip arthroplasty: avoidance and management: wear.

    Science.gov (United States)

    Ries, Michael D

    2003-01-01

    Many factors, including polyethylene processing, sterilization method, counterface material, femoral head size, femoral offset, acetabular component position, implant design, and patient activity level, affect the rate of wear in total hip arthroplasty. For patients with life expectancy that exceeds the longevity of the conventional implant materials, an alternative bearing surface (highly cross-linked polyethylene, metal-on-metal, or ceramic-on-ceramic) may be considered. Although laboratory wear tests with these materials are very favorable, clinical outcomes have not been clearly established. When osteolysis does develop in response to particulate debris, the location and progression of the lesions may be quite variable. Asymptomatic stable lesions can be followed clinically and radiographically while symptomatic or enlarging lesions or those that may compromise the integrity of the periprosthetic bone stock require surgery. If acetabular component revision is necessary and an adequate rim of host bone is maintained to support a revision acetabular component, defects can be filled with particulate bone graft. Large segmental defects generally require structural allografts. If the acetabular shell is well fixed in good position and the osteolytic defects are accessible, treatment with curettage and bone grafting of the lesions with liner revision is appropriate to avoid use of a structural allograft. Proximal femoral defects around a well-fixed stem can be managed in a similar manner with curettage and bone grafting. Distal lesions associated with risk of periprosthetic femur fracture or implant loosening require stem revision. Osteoclastic resportion of bone in response to particulate debris can be impaired with use of some drugs such as alendronate. However, the safety and efficacy of alendronate in the clinical management of osteolysis associated with total hip arthroplasty has not been established. PMID:12690853

  19. Bone cement spacers and Link spacers for treatment of infection due to total hip arthroplasty:a comparative study%两种占位器治疗人工全髋关节置换术后感染的疗效比较

    Institute of Scientific and Technical Information of China (English)

    孙立; 田晓滨; 胡如印; 田家亮; 韩伟; 刘兆成

    2012-01-01

    目的 比较自制含万古霉素的骨水泥占位器和Link感染治疗型占位器的疗效,探讨人工髋关节置换术后慢性感染Ⅱ期翻修中占位器的选择.方法 26例人工髋关节置换术后感染患者,年龄32~82岁,平均69.5岁.彻底清创、取出假体后,14例置入含万古霉素的骨水泥占位器,12例采用Link感染治疗型占位器.术后静脉滴注抗生素2周后,改为口服抗生素6周;术后定期复查血白细胞、红细胞沉降率(ESR)和C-反应蛋白(CRP).Ⅱ期行人工髋关节翻修术.手术前、后以Harris髋关节评分标准评估临床治疗效果.结果 26例患者在彻底清创、取出假体、自制含万古霉素的骨水泥占位器或Link感染治疗型占位器置入后,伤口均Ⅰ期愈合.Ⅱ期翻修手术间隔时间平均5.2个月(3~11.5个月),翻修术后随访平均20.8个月(12~33个月),未出现感染复发征象.Harris髋关节评分Ⅰ期术前平均27.9分,Ⅱ期术前平均52.9分,最后随访时平均83.6分(P<0.05).含万古霉素骨水泥占位器患者Ⅱ期术前有1例断裂,Link感染治疗型占位器患者Ⅱ期术前无断裂.结论 (1)Ⅱ期翻修术具有感染清除率高、缓解疼痛、有效保留关节功能等优点,是治疗人工髋关节置换术后感染的有效方法;(2)使用自制含万古霉素的骨水泥占位器和Link感染治疗型占位器,均能有效感染控制和恢复部分患肢功能;(3)Link感染治疗型占位器术中操作简便,治疗间歇期患肢功能恢复较好,但置管易堵,不能长期缓释抗生素,费用较高,适用于体质较好、感染不严重、两次手术间隔期患肢功能要求较高的患者.%Objective To compare the efficacy of self-made bone cement spacers containing vancomycin(vancomycin spacer)and Link infection-treating spacers(Link type spacer)for chronic infection after total hip arthroplasty(HTA)and investigate the choice of spacers for the two-stage revision of infection.Methods The study

  20. Hip arthroscopy in the setting of hip dysplasia

    Science.gov (United States)

    Yeung, M.; Kowalczuk, M.; Simunovic, N.

    2016-01-01

    Objective Hip arthroscopy in the setting of hip dysplasia is controversial in the orthopaedic community, as the outcome literature has been variable and inconclusive. We hypothesise that outcomes of hip arthroscopy may be diminished in the setting of hip dysplasia, but outcomes may be acceptable in milder or borderline cases of hip dysplasia. Methods A systematic search was performed in duplicate for studies investigating the outcome of hip arthroscopy in the setting of hip dysplasia up to July 2015. Study parameters including sample size, definition of dysplasia, outcomes measures, and re-operation rates were obtained. Furthermore, the levels of evidence of studies were collected and quality assessment was performed. Results The systematic review identified 18 studies investigating hip arthroscopy in the setting of hip dysplasia, with 889 included patients. Criteria used by the studies to diagnose hip dysplasia and borderline hip dysplasia included centre edge angle in 72% of studies but the range of angles were quite variable. Although 89% of studies reported improved post-operative outcome scores in the setting of hip dysplasia, revision rates were considerable (14.1%), with 9.6% requiring conversion to total hip arthroplasty. Conclusion The available orthopaedic literature suggests that although improved outcomes are seen in hip arthroscopy in the setting of hip dysplasia, there is a high rate of re-operation and conversion to total hip arthroplasty. Furthermore, the criteria used to define hip dysplasia vary considerably among published studies. Cite this article: M. Yeung, M. Kowalczuk, N. Simunovic, O. R. Ayeni. Hip arthroscopy in the setting of hip dysplasia: A systematic review. Bone Joint Res 2016;5:225–231. DOI: 10.1302/2046-3758.56.2000533. PMID:27313136

  1. Hip joint replacement

    Science.gov (United States)

    ... may have problems with infection, loosening, or even dislocation of the new hip joint. Over time the artificial ... Professor, Chief, Sports Medicine and Shoulder Service, UCSF Department of Orthopaedic Surgery, San Francisco, ...

  2. Taper Hip Prosthesis

    Medline Plus

    Full Text Available ... L Taper Hip Prosthesis with Modular Neck Kinectiv® Technology March 12, 2009 7:00 PM EDT Welcome ... hopefully you will see the benefits and the advantages of the new Zimmer Kinectiv System. Thank you. ...

  3. HIP osteoarthritis and work.

    Science.gov (United States)

    Harris, E Clare; Coggon, David

    2015-06-01

    Epidemiological evidence points strongly to a hazard of hip osteoarthritis from heavy manual work. Harmful exposures may be reduced by the elimination or redesign of processes and the use of mechanical aids. Reducing obesity might help to protect workers whose need to perform heavy lifting cannot be eliminated. Particularly high relative risks have been reported in farmers, and hip osteoarthritis is a prescribed occupational disease in the UK for long-term employees in agriculture. Even where it is not attributable to employment, hip osteoarthritis impacts importantly on the capacity to work. Factors that may influence work participation include the severity of disease, the physical demands of the job, age and the size of the employer. Published research does not provide a strong guide to the timing of return to work following hip arthroplasty for osteoarthritis, and it is unclear whether patients should avoid heavy manual tasks in their future employment. PMID:26612242

  4. Hip flexor strain - aftercare

    Science.gov (United States)

    ... such as sprinting, kicking, and changing direction while running or moving, can stretch and tear the hip flexors. Runners, people who do martial arts, and football, soccer, and hockey players are more likely to have ...

  5. Revision rates after primary hip and knee replacement in England between 2003 and 2006.

    Directory of Open Access Journals (Sweden)

    Nokuthaba Sibanda

    2008-09-01

    Full Text Available BACKGROUND: Hip and knee replacement are some of the most frequently performed surgical procedures in the world. Resurfacing of the hip and unicondylar knee replacement are increasingly being used. There is relatively little evidence on their performance. To study performance of joint replacement in England, we investigated revision rates in the first 3 y after hip or knee replacement according to prosthesis type. METHODS AND FINDINGS: We linked records of the National Joint Registry for England and Wales and the Hospital Episode Statistics for patients with a primary hip or knee replacement in the National Health Service in England between April 2003 and September 2006. Hospital Episode Statistics records of succeeding admissions were used to identify revisions for any reason. 76,576 patients with a primary hip replacement and 80,697 with a primary knee replacement were included (51% of all primary hip and knee replacements done in the English National Health Service. In hip patients, 3-y revision rates were 0.9% (95% confidence interval [CI] 0.8%-1.1% with cemented, 2.0% (1.7%-2.3% with cementless, 1.5% (1.1%-2.0% CI with "hybrid" prostheses, and 2.6% (2.1%-3.1% with hip resurfacing (p < 0.0001. Revision rates after hip resurfacing were increased especially in women. In knee patients, 3-y revision rates were 1.4% (1.2%-1.5% CI with cemented, 1.5% (1.1%-2.1% CI with cementless, and 2.8% (1.8%-4.5% CI with unicondylar prostheses (p < 0.0001. Revision rates after knee replacement strongly decreased with age. INTERPRETATION: Overall, about one in 75 patients needed a revision of their prosthesis within 3 y. On the basis of our data, consideration should be given to using hip resurfacing only in male patients and unicondylar knee replacement only in elderly patients.

  6. HIP osteoarthritis and work

    OpenAIRE

    Harris, E C; Coggon, D.

    2015-01-01

    Epidemiological evidence points strongly to a hazard of hip osteoarthritis from heavy manual work. Harmful exposures may be reduced by the elimination or redesign of processes and the use of mechanical aids. Reducing obesity might help to protect workers whose need to perform heavy lifting cannot be eliminated. Particularly high relative risks have been reported in farmers, and hip osteoarthritis is a prescribed occupational disease in the UK for long-term employees in agriculture. Even where...

  7. Acoustic monitoring (RFM of total hip arthroplasty results of a cadaver study

    Directory of Open Access Journals (Sweden)

    Unger AC

    2009-06-01

    Full Text Available Abstract Introduction At present there are no reliable non-traumatic and non-invasive methods to analyse the healing process and loosening status after total hip replacement. Therefore early as well as late loosening of prosthesis and interface component problems are difficult to be found or diagnosed at any time. Methods In a cadaver study the potential application of Resonance Frequency Monitoring (RFM will be evaluated as a non-invasive and non-traumatic method to monitor loosening and interface problems in hip replacement. In a 65 year old female cadaver different stability scenarios for a total hip replacement (shaft, head/modular head and cup, ESKA, Luebeck, Germany are simulated in cemented and cement less prosthesis and then analysed with RFM. The types of stability vary from secure/press-fit to interface-shaft disruption. Results The RFM shows in cemented as well as cement less prosthesis significant intra-individual differences in the spectral measurements with a high dynamic (20 dB difference corresponding to the factor 100 (10000%, regarding the simulated status of stability in the prosthesis system. Conclusion The results of the study demonstrate RFM as a highly sensitive non-invasive and non-traumatic method to support the application of RFM as a hip prosthesis monitoring procedure. The data obtained shows the possibility to use RFM for osteointegration surveillance and early detection of interface problems, but will require further evaluation in clinical and experimental studies.

  8. Tympanoplasty with ionomeric cement

    DEFF Research Database (Denmark)

    Kjeldsen, A D; Grøntved, A M

    2000-01-01

    of > 10 dB, in 4 there was a slight improvement and in 2 a decline. The difference was not statistically significant. Hearing improvement using ionomeric cement in type II tympanoplasty was satisfactory. Reconstruction of the ossicular chain with ionomeric cement is recommended, as the procedure is easy...

  9. ULTRA-LIGHTWEIGHT CEMENT

    Energy Technology Data Exchange (ETDEWEB)

    Fred Sabins

    2002-01-23

    The objective of this project is to develop an improved ultra-lightweight cement using ultra-lightweight hollow glass spheres (ULHS). This report includes results from laboratory testing of ULHS systems along with other lightweight cement systems: foamed and sodium silicate slurries. Comparison studies of the three cement systems examined several properties: tensile strength, Young's modulus, water permeability, and shear bond. Testing was also done to determine the effect that temperature cycling has on the shear bond properties of the cement systems. In addition, analysis was carried out to examine alkali silica reactivity of slurries containing ULHS. Data is also presented from a study investigating the effects of mixing and pump circulation on breakage of ULHS. Information is also presented about the field application of ULHS in cementing a 7-in. intermediate casing in south Texas.

  10. Modified femoral pressuriser generates a longer lasting high pressure during cement pressurisation

    Directory of Open Access Journals (Sweden)

    Kjellson Fred

    2011-10-01

    Full Text Available Abstract Background The strength of the cement-bone interface in hip arthroplasty is strongly related to cement penetration into the bone. A modified femoral pressuriser has been investigated, designed for closer fitting into the femoral opening to generate higher and more constant cement pressure compared to a commercial (conventional design. Methods Femoral cementation was performed in 10 Sawbones® models, five using the modified pressuriser and five using a current commercial pressuriser as a control. Pressure during the cementation was recorded at the proximal and distal regions of the femoral implant. The peak pressure and the pressure-time curves were analysed by student's t-test and Two way ANOVA. Results The modified pressuriser showed significantly and substantially longer durations at higher cementation pressures and slightly, although not statistically, higher peak pressures compared to the conventional pressuriser. The modified pressuriser also produced more controlled cement leakage. Conclusion The modified pressuriser generates longer higher pressure durations in the femoral model. This design modification may enhance cement penetration into cancellous bone and could improve femoral cementation.

  11. Bipolar hip arthroplasty.

    Science.gov (United States)

    Chang, Qing; Liu, Shubing; Guan, Changyong; Yu, Fangyuan; Wu, Shenguang; Jiang, Changliang

    2011-12-01

    Our aim was to compare hip arthroplasty with internal screw fixation in the repair of intertrochanteric fractures in elderly patients with osteoporosis. Of 112 included patient, 70 (81.81 ± 4.88 years) received hip arthroplasty with a prosthesis specially designed for intertrochanteric fractures, and 42 (83.46 ± 5.11 years) underwent plate-screw fixation. The hip arthroplasty group had significantly longer operation time, intraoperative blood loss, and total volume of blood transfused but had shorter time to beginning weight-bearing (5.94 ± 2.76 vs 23.68 ± 22.01 days) and higher postoperative Harris hip score (91.37 ± 4.80 vs 86.14 ± 5.46). In the arthroplasty group, there were 2 dislocations; and in the plate-screw fixation group, there were 5 internal fixation failures. Hip arthroplasty is preferable to internal fixation in elderly patients (age >80 years) with osteoporosis. PMID:21530148

  12. A new design of cemented stem using functionally graded materials (FGM).

    Science.gov (United States)

    Hedia, H S; Aldousari, S M; Abdellatif, A K; Fouda, N

    2014-01-01

    One of the most frequent complications of total hip replacement (THR) is aseptic loosening of femoral component which is primarily due to changes of post-operative stress distribution pattern with respect to intact femur. Stress shielding of the femur is known to be a principal factor in aseptic loosening of hip replacements. Many designers show that a stiff stem shields the surrounding bone from mechanical loading causing stress shielding. Others show that reducing stem stiffness promotes higher proximal interface shear stress which increases the risk of proximal interface failure. Therefore, the task of this investigation is to solve these conflicting problems appeared in the cemented total hip replacement. The finite element method and optimization technique are used in order to find the optimal stem material which gives the optimal available stress distribution between the proximal medial femoral bone and the cement mantle interfaces. The stem is designed using the concept of functionally graded material (FGM) instead of using the conventional most common used stem material. The results showed that there are four feasible solutions from the optimization runs. The best of these designs is to use a cemented stem graded from titanium at the upper stem layer to collagen at the lower stem layer. This new cemented stem design completely eliminates the stress shielding problem at the proximal medial femoral region. The stress shielding using the cemented functionally graded stem is reduced by 98% compared to titanium stem. PMID:24840196

  13. ULTRA-LIGHTWEIGHT CEMENT

    Energy Technology Data Exchange (ETDEWEB)

    Fred Sabins

    2003-01-31

    The objective of this project is to develop an improved ultra-lightweight cement using ultra-lightweight hollow glass spheres (ULHS). This report discusses testing that was performed for analyzing the alkali-silica reactivity of ULHS in cement slurries. DOE joined the Materials Management Service (MMS)-sponsored joint industry project ''Long-Term Integrity of Deepwater Cement under Stress/Compaction Conditions.'' Results of the project contained in two progress reports are also presented in this report.

  14. POZZOLAN AND CEMENTS WITH POZZOLAN

    OpenAIRE

    Kaplan, Hasan; Hanifi BİNİCİ

    1995-01-01

    Cement, one of the basic material of construction engineering, has an important place in view of strength and cost of structures. Cement consumption is increasing parallel to development of building construction sector. For cement producers, minimal cost is desired by using new and economical material sources. On the other hand, the controllers and contractors need cheaper, safer and higher strength materials. From this respect cement industry tends to use cement with pozzolan. In Türkiye, ce...

  15. Metal-to-metal hip surface arthroplasty in 63 cases A follow-up assessment%金属对金属髋关节表面置换63例随访评价

    Institute of Scientific and Technical Information of China (English)

    徐卫东; 陈刚; 李甲; 徐凌; 梁志民

    2008-01-01

    involved in the follow-up. There were no cases of dislocation, deep venous embolism, deep infection or neurovascular complications that required further treatment. The mean Harris score was 38 points before operation and significantly increased to 90 points after operation. Two patients appeared a 2-mm crevice below acetabular prostheses, which disappeared 6 months after arthroplasty. Acetabular or femoral prostheses removal, or local osteolysis was detectable.CONCLUSION: Metal-on-metal hip surface arthroplasty has excellent early effects on young and active patients. The arthroplasty potentially offers the ultimate bone preservation and better restoration of hip articulation function in patients, without specific biocompatibility.%背景:随着制作假体T艺和于术技术的改进,髋关节表面置换后假体早期松动和股骨颈骨折等情况很少发生,能得到更佳的髋关节活动功能.目的:观察髋关节表面置换后材料与宿主的生物相容性及髋关节功能恢复情况.设计、时间及地点:回顾性病例分析,于2006-01/2007-08在解放军第二军医大学长海医院骨科进行.对象:52例髋关节疾病患者完成63侧髋关节表面置换,其中11例患者做了一期双侧置换.女25例,男27例,平均年龄47.6岁.方法:假体由Zimmer公司提供,髋关节以标准4mm厚非骨水泥型髋臼(金属臼杯厚3.7mm,外覆0.3mm等离子钛涂层)进行重建.髋臼杯是大直径、半圆形(165°),外覆等离子钛涂层用以非骨水泥固定.采用后外侧入路,髋臼假体均放置在髋关节解剖中心的位置,且覆盖髋臼假体面积超过90%以上.主要观察指标:①记录置换后脱位、感染等材料与宿主的生物相容性反应.②置换后1,3,6,12个月及其后每年一次采用Harris髋关节评分系统进行功能评估.③影像学资料按照DeLee和Charnley描述的区域,记录髋臼杯周围厚度>1mm的放射线可透区.结果:①所有患者均得到随访,没有发生脱位、没

  16. Hard-on-hard lubrication in the artificial hip under dynamic loading conditions.

    Directory of Open Access Journals (Sweden)

    Robert Sonntag

    Full Text Available The tribological performance of an artificial hip joint has a particularly strong influence on its success. The principle causes for failure are adverse short- and long-term reactions to wear debris and high frictional torque in the case of poor lubrication that may cause loosening of the implant. Therefore, using experimental and theoretical approaches models have been developed to evaluate lubrication under standardized conditions. A steady-state numerical model has been extended with dynamic experimental data for hard-on-hard bearings used in total hip replacements to verify the tribological relevance of the ISO 14242-1 gait cycle in comparison to experimental data from the Orthoload database and instrumented gait analysis for three additional loading conditions: normal walking, climbing stairs and descending stairs. Ceramic-on-ceramic bearing partners show superior lubrication potential compared to hard-on-hard bearings that work with at least one articulating metal component. Lubrication regimes during the investigated activities are shown to strongly depend on the kinematics and loading conditions. The outcome from the ISO gait is not fully confirmed by the normal walking data and more challenging conditions show evidence of inferior lubrication. These findings may help to explain the differences between the in vitro predictions using the ISO gait cycle and the clinical outcome of some hard-on-hard bearings, e.g., using metal-on-metal.

  17. Friction of total hip replacements with different bearings and loading conditions.

    Science.gov (United States)

    Brockett, Claire; Williams, Sophie; Jin, Zhongmin; Isaac, Graham; Fisher, John

    2007-05-01

    Metal-on-ultra-high molecular weight polyethylene (UHMWPE) total hip replacements have been the most popular and clinically successful implants to date. However, it is well documented that the wear debris from these prostheses contributes to osteolysis and ultimate failure of the prosthesis, hence alternative materials have been sought. A range of 28 mm diameter bearings were investigated using a hip friction simulator, including conventional material combinations such as metal-on-UHWMPE, ceramic-on-ceramic (CoC), and metal-on-metal (MoM), as well as novel ceramic-on-metal (CoM) pairings. Studies were performed under different swing-phase load and lubricant conditions. The friction factors were lowest in the ceramic bearings, with the CoC bearing having the lowest friction factor in all conditions. CoM bearings also had low friction factors compared with MoM, and the trends were similar to CoC bearings for all test conditions. Increasing swing phase load was shown to cause an increase in friction factor in all tests. Increased serum concentration resulted in increased friction factor in all material combinations, except MoM, where increased serum concentration produced a significant reduction in friction factor.

  18. Hip joint pathology

    DEFF Research Database (Denmark)

    Tijssen, M; van Cingel, R E H; de Visser, E;

    2016-01-01

    The purpose of this retrospective cohort study was to (a) describe the clinical presentation of femoroacetabular impingement (FAI) and hip labral pathology; (b) describe the accuracy of patient history and physical tests for FAI and labral pathology as confirmed by hip arthroscopy. Patients (18...... FABER test or a positive AIT and a positive FABER test were the shortest most sensitive combinations. The results of this study point out that in clinical practice absence of groin as main location of pain combined with a negative FABER test or the combination of a negative AIT and a negative FABER test...... are suggested to rule out the diagnosis of symptomatic FAI and/or labral pathology....

  19. X-Ray Exam: Hip

    Science.gov (United States)

    ... Tropical Delight: Melon Smoothie Pregnant? Your Baby's Growth X-Ray Exam: Hip KidsHealth > For Parents > X-Ray Exam: Hip Print A A A Text Size ... español Radiografía: cadera What It Is A hip X-ray is a safe and painless test that uses ...

  20. Hip Arthroscopy: A Brief History.

    Science.gov (United States)

    Kandil, Abdurrahman; Safran, Marc R

    2016-07-01

    Hip arthroscopy is a fast-growing and evolving field. Like knee and shoulder arthroscopy, hip arthroscopy began as a diagnostic procedure and then progressed to biopsy and resection of abnormalities. Subsequently, it has evolved to repair of various tissues and treatment of underlying causes. As the understanding of the hip joint and its associated pathophysiology grows, indications will continue to expand for this diagnostic and therapeutic modality. This article outlines the historic developments of hip arthroscopy, including advancements in instrumentation and techniques from the days of the first hip arthroscopies to the present day.

  1. Hip Arthroscopy: A Brief History.

    Science.gov (United States)

    Kandil, Abdurrahman; Safran, Marc R

    2016-07-01

    Hip arthroscopy is a fast-growing and evolving field. Like knee and shoulder arthroscopy, hip arthroscopy began as a diagnostic procedure and then progressed to biopsy and resection of abnormalities. Subsequently, it has evolved to repair of various tissues and treatment of underlying causes. As the understanding of the hip joint and its associated pathophysiology grows, indications will continue to expand for this diagnostic and therapeutic modality. This article outlines the historic developments of hip arthroscopy, including advancements in instrumentation and techniques from the days of the first hip arthroscopies to the present day. PMID:27343387

  2. The painful hip: new concepts

    Energy Technology Data Exchange (ETDEWEB)

    Blankenbaker, Donna G.; Tuite, Michael J. [University of Wisconsin Medical School, Department of Radiology, Division of Musculoskeletal Imaging, Madison, WI (United States)

    2006-06-15

    Hip pain is a common condition, and the work-up often includes imaging. This article reviews the normal MR anatomy of the hip and the imaging findings of internal derangements, snapping hip, and femoral acetabular impingement. We will describe the role of MR arthrography in evaluating the patient with suspected labral and articular cartilage abnormalities, as well as the pitfalls in interpretation. We will review the causes of a snapping hip, and the role of sonography in evaluating and guiding treatment of the snapping iliopsoas tendon. We will also review the radiographic and MRI signs of femoroacetabular impingement (FAI), a cause of early degenerative joint disease and hip pain. (orig.)

  3. 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.

  4. Finite element analysis of a modified short hip endoprosthesis

    Directory of Open Access Journals (Sweden)

    Augustin Semenescu

    2016-07-01

    Full Text Available A finite element simulation of the mechanical static features for a modified short hip endoprosthesis was performed. The corkscrew-like femoral stem was modified introducing more turns of the thread. By such an approach it is expected that for some cases the mechanical fixation of the prosthesis to the bone will be improved or the use of the cement for bonding is not necessary. Our scenario was estimated for titanium and stainless steel, and both materials show good safety factors. Mechanical stress is expected to be distributed more uniform in the bone for the new design with more turns of thread.

  5. PART II. HYDRATED CEMENTS

    Directory of Open Access Journals (Sweden)

    Milan Drabik

    2014-09-01

    Full Text Available Essential focus of the study has been to acquire thermoanalytical events, incl. enthalpies of decompositions - ΔH, of technological materials based on two types of Portland cements. The values of thermoanalytical events and also ΔH of probes of technological compositions, if related with the data of a choice of minerals of calcium-silicate-sulfate-aluminate hydrates, served as a valued input for the assessment of phases present and phase changes due to the topical hydraulic processes. The results indicate mainly the effects of "standard humidity" or "wet storage" of the entire hydration/hydraulic treatment, but also the presence of cement residues alongside calcium-silicate-sulfate-aluminate hydrates (during the tested period of treatment. "A diluting" effect of unhydrated cement residues upon the values of decomposition enthalpies in the studied multiphase system is postulated and discussed

  6. Total hip replacement in young adults with hip dysplasia

    OpenAIRE

    Engesæter, Ingvild Ø; Lehmann, Trude; Laborie, Lene B; Lie, Stein Atle; Rosendahl, Karen; Engesæter, Lars B

    2011-01-01

    Background and purpose Dysplasia of the hip increases the risk of secondary degenerative change and subsequent total hip replacement. Here we report on age at diagnosis of dysplasia, previous treatment, and quality of life for patients born after 1967 and registered with a total hip replacement due to dysplasia in the Norwegian Arthroplasty Register. We also used the medical records to validate the diagnosis reported by the orthopedic surgeon to the register. Methods Subjects born after Janua...

  7. 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.

  8. 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…

  9. Cement og politik

    DEFF Research Database (Denmark)

    Lund, Joachim

    2012-01-01

    as well as in the public sphere. Most of the extensive job creating measures he carried out as a minister for public works necessarily involved the use of great amounts of cement – the primary produce of F.L. Smidth & Co. Gunnar Larsen thus became an easy target for Communist propaganda, picturing him...... of the Soviet Union (including an F.L. Smidth & Co. cement plant in former Estonia). He spent the last 15 months of the occupation in Sweden and was arrested after having returned to Copenhagen in May, 1945. Although a Copenhagen city court prison sentence for economic collaboration was reversed, he had...

  10. Technology Roadmaps: Cement

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2009-07-01

    To support its roadmap work focusing on key technologies for emissions reductions, the International Energy Agency (IEA) also investigated one particular industry: cement. Cement production includes technologies that are both specific to this industry and those that are shared with other industries (e.g., grinding, fuel preparation, combustion, crushing, transport). An industry specific roadmap provides an effective mechanism to bring together several technology options. It outlines the potential for technological advancement for emissions reductions in one industry, as well as potential cross-industry collaboration.

  11. Cementing a wellbore using cementing material encapsulated in a shell

    Science.gov (United States)

    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.

  12. Heterotopic ossification after hip arthroscopy.

    Science.gov (United States)

    Amar, Eyal; Sharfman, Zachary T; Rath, Ehud

    2015-12-01

    Heterotopic ossification (HO) after hip arthroscopy is the abnormal formation of mature lamellar bone within extra skeletal soft tissues. HO may lead to pain, impaired range of motion and possibly revision surgery. There has been a substantial amount of recent research on the pathophysiology, prophylaxis and treatment of HO associated with open and arthroscopic hip surgery. This article reviews the literature on the aforementioned topics with a focus on their application in hip arthroscopy. PMID:27011859

  13. Heterotopic ossification after hip arthroscopy

    OpenAIRE

    Amar, Eyal; Sharfman, Zachary T.; Rath, Ehud

    2015-01-01

    Heterotopic ossification (HO) after hip arthroscopy is the abnormal formation of mature lamellar bone within extra skeletal soft tissues. HO may lead to pain, impaired range of motion and possibly revision surgery. There has been a substantial amount of recent research on the pathophysiology, prophylaxis and treatment of HO associated with open and arthroscopic hip surgery. This article reviews the literature on the aforementioned topics with a focus on their application in hip arthroscopy.

  14. New developments in calcium phosphate bone cements: approaching spinal applications

    OpenAIRE

    Vlad, Maria Daniela

    2009-01-01

    La presente tesis doctoral (i.e., “New developments in calcium phosphate bone cements: approaching spinal applications”) aporta nuevos conocimientos en el campo de los cementos óseos de fosfato de calcio (CPBCs) en relación a su aplicación clínica en el campo de la cirugía vertebral mínimamente invasiva. La hipótesis central de esta investigación fue formulada en los siguientes términos: “Los cementos apatíticos pueden ser (si se optimizan) una alternativa mejor (debido a sus propiedades d...

  15. Infant hip sonography: current concepts.

    Science.gov (United States)

    Harcke, H T; Grissom, L E

    1994-08-01

    Sonography of the infant hip has gained wide acceptance in the decade since its introduction. The two principle techniques of Graf and Harcke have been combined with the proposal of a Dynamic Standard Minimum Examination. Whereas sonography is used increasingly to manage developmental dislocation and/or displasia of the hip, there is no agreement on the use of sonography for universal newborn screening. This article describes in detail the Dynamic Standard Minimum Sonographic Examination of the infant hip. In addition, this article reviews the classification and management of infant hip disorders. PMID:7946476

  16. Produktie van cement

    NARCIS (Netherlands)

    Smit JRK; Coenen PWHG; Matthijsen AJCM; LAE; TAUW

    1995-01-01

    This document on cement production has been published within the SPIN project. In this project information has been collected on industrial plants or industrial processes to afford support to governmental policy on emission reduction. This document contains information on the processes, emission sou

  17. Osteotransductive bone cements.

    Science.gov (United States)

    Driessens, F C; Planell, J A; Boltong, M G; Khairoun, I; Ginebra, M P

    1998-01-01

    Calcium phosphate bone cements (CPBCs) are osteotransductive, i.e. after implantation in bone they are transformed into new bone tissue. Furthermore, due to the fact that they are mouldable, their osteointegration is immediate. Their chemistry has been established previously. Some CPBCs contain amorphous calcium phosphate (ACP) and set by a sol-gel transition. The others are crystalline and can give as the reaction product dicalcium phosphate dihydrate (DCPD), calcium-deficient hydroxyapatite (CDHA), carbonated apatite (CA) or hydroxyapatite (HA). Mixed-type gypsum-DCPD cements are also described. In vivo rates of osteotransduction vary as follows: gypsum-DCPD > DCPD > CDHA approximately CA > HA. The osteotransduction of CDHA-type cements may be increased by adding dicalcium phosphate anhydrous (DCP) and/or CaCO3 to the cement powder. CPBCs can be used for healing of bone defects, bone augmentation and bone reconstruction. Incorporation of drugs like antibiotics and bone morphogenetic protein is envisaged. Load-bearing applications are allowed for CHDA-type, CA-type and HA-type CPBCs as they have a higher compressive strength than human trabecular bone (10 MPa).

  18. Intraoperative measurement of rotational stability of femoral components of total hip arthroplasty.

    Science.gov (United States)

    Harris, W H; Mulroy, R D; Maloney, W J; Burke, D W; Chandler, H P; Zalenski, E B

    1991-05-01

    High out-of-plane forces acting on the hip joint can produce important rotational micromotion of the femoral component. This micromotion at the prosthesis interface may be detrimental to the stability of the implant. In cementless femoral implants this could prevent bone ingrowth, and in the cemented component this could cause generation of particulate debris, lysis, and loosening. The introduction of the torque wrench micrometer for assessment of intraoperative femoral component stability can quantify the initial stability of primary cementless femoral components and critically evaluate the stability (at either the initial or revision arthroplasty) of both cemented and cementless femoral components. It allows the surgeon to produce a known torque in the direction and magnitude of the out-of-plane forces that load the hip in vivo. PMID:2019039

  19. The effect of cement creep and cement fatigue damage on the micromechanics of the cement-bone interface.

    NARCIS (Netherlands)

    Waanders, D.; Janssen, D.; Mann, K.A.; Verdonschot, N.J.J.

    2010-01-01

    The cement-bone interface provides fixation for the cement mantle within the bone. The cement-bone interface is affected by fatigue loading in terms of fatigue damage or microcracks and creep, both mostly in the cement. This study investigates how fatigue damage and cement creep separately affect th

  20. The friction of explanted hip prostheses.

    Science.gov (United States)

    Hall, R M; Unsworth, A; Wroblewski, B M; Siney, P; Powell, N J

    1997-01-01

    Charnley prostheses, retrieved at revision surgery, were studied to assess the effects of friction on the total hip replacement procedure. Frictional resistance was measured using the Durham hip function simulator under both dry and lubricated conditions. The friction factor values (f) for the explanted prostheses were found to have a non-Gaussian distribution with medians of 0.13 [inter-quartile range (IQR) 0.10-0.16] and 0.06 (IQR 0.005-0.08) for dry and lubricated (n = 0.01 Pa s) regimes, respectively. New Charnley prostheses had values of f equal to 0.11 +/- 0.025 and 0.04 +/- 0.01 under the same conditions, and showed no large deviation from a Gaussian distribution. There was found to be a statistically significant difference in the medians of the friction factors for new and retrieved prostheses in the lubricated regime. Ingression of cement into the worn region of the cup was found to increase the friction factor significantly under dry conditions. There was no evidence of an increase in the friction factor or torque for those joints that had a loose socket with respect to those that were fixed at revision. A decrease in the frictional torque against number of cycles undergone by the joint in vivo may indicate that a fatigue-type process may have a role in the loosening of the socket. However, this relationship was found not to be significant for friction measured under lubricated conditions and it seems unlikely that the frictional torque generated in this type of prosthesis will contribute significantly to the long-term loosening of the socket.

  1. Hip-Hop Education Resources

    Science.gov (United States)

    Hall, Marcella Runell

    2009-01-01

    Hip-hop music and culture are often cited as being public pedagogy, meaning the music itself has intrinsic educational value. Non-profit organizations and individual educators have graciously taken the lead in utilizing hip-hop to educate. As the academy continues to debate its effectiveness, teachers and community organizers are moving forward.…

  2. Hip sonography in the newborn

    International Nuclear Information System (INIS)

    The authors report the data relative to 1507 cases studied with clinical and US examinations, in the neonatal period, in order to exclude hip dysplasia dislocation. US examination was carried out according to Graf's technique and the newborns were classified according to US hip type, to clinical examination and to possible risk factors. The patients were included in a protocol including orthopedic and US controls. Seventeen treated infants were considered as pathologic. Ten of them had IIc or D hips ar birth; the other 7, with IIa hips at birth, presented a X-ray pathologic hip after the 4th months of life. At about one year of age all infants could normally walk, excpet for one who was being treated with herness. No statistically significant differences were observed between the number of pathologic infants in the risk group (1.7%) and that in the no-risk group (0.8%). Clinical examination of the newborn has low sensitivity in detecting pathologic hips. On the basis of their results, thw authors belive US examination of the newborn to be a valuable screening method to diagnose hip dysplasia/dislocation. Moreover, Graf's morphologic method is the best one for US screening of the hip in the neonatal period

  3. Activation of Complement Following Total Hip Replacement.

    Science.gov (United States)

    Thordardottir, S; Vikingsdottir, T; Bjarnadottir, H; Jonsson, H; Gudbjornsson, B

    2016-03-01

    The aim of this study was to investigate whether complement activation, via the classical and alternative pathways, occurs following a cemented total hip replacement (THR) surgery due to osteoarthritis. Blood samples were collected systematically from 12 patients - six male and six women, with a median age of 75 (range: 59-90 years) - preoperatively, 6 h post-operatively and on the first, second and third post-operative day. Total function of classical (CH50) and alternative pathways (AH50) was evaluated, along with the determination of serum concentrations of the complement proteins C3, C4, C3d, the soluble terminal complement complex (sTCC) sC5b-9, as well as C-reactive protein (CRP) and albumin. Measurements of CRP and albumin levels elucidated a marked inflammatory response following the operation. The CH50, AH50 and C3 and C4 levels were significantly lower 6 h after the surgery compared with the preoperative levels, but elevated above the preoperative levels during the following 3 days. The complement activation product C3d levels increased continually during the whole observation period, from 13.5 AU/ml (range: 8-19 AU/ml) preoperative to 20 AU/ml (range: 12-34 AU/ml) on the third post-operative day. Furthermore, we observed an increase in the sC5b-9 levels between the preoperative and the third post-operative day. These results demonstrate a significant activation of the complement system following cemented THR. Further studies are needed to elucidate the time frame and the pathogenic role of this observed complement activation.

  4. POZZOLAN AND CEMENTS WITH POZZOLAN

    Directory of Open Access Journals (Sweden)

    Hasan KAPLAN

    1995-02-01

    Full Text Available Cement, one of the basic material of construction engineering, has an important place in view of strength and cost of structures. Cement consumption is increasing parallel to development of building construction sector. For cement producers, minimal cost is desired by using new and economical material sources. On the other hand, the controllers and contractors need cheaper, safer and higher strength materials. From this respect cement industry tends to use cement with pozzolan. In Türkiye, cement with pozzolan is produced by adding the pozzolan, which has a large reservoir in the country, in cement in sertain amount. However this type of cement is consumed in the construction sector, sortage of scientific investigation and speculative news on the subject.are worried the users and producers. In this paper, prior to an experimental study on the cements having pozzolan additive, historical development of pozzolan, reservoir of Turkiye, and comparison with portland cement is carried out. Advantages and disadvantages of pozzolan are also discussed in some points.

  5. 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.

  6. US cement industry

    Energy Technology Data Exchange (ETDEWEB)

    Nisbet, M.A.

    1997-12-31

    This paper describes the cement and concrete industry, and provides data on energy use and carbon dioxide emissions. The potential impact of an energy tax on the industry is briefly assessed. Opportunities identified for reducing carbon dioxide emissions include improved energy efficiency, alternative fuels, and alternative materials. The key factor in determining CO{sub 2} emissions is the level of domestic production. The projected improvement in energy efficiency and the relatively slow growth in domestic shipments indicate that CO{sub 2} emissions in 2000 should be about 5% above the 1990 target. However, due to the cyclical nature of cement demand, emissions will probably be above target levels during peak demand and below target levels during demand troughs. 7 figs., 2 tabs.

  7. Performance of Cement Containing Laterite as Supplementary Cementing Material

    Directory of Open Access Journals (Sweden)

    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

  8. Tympanoplasty with ionomeric cement.

    Science.gov (United States)

    Kjeldsen, A D; Grøntved, A M

    2000-01-01

    Patients with isolated erosion of the long incus process suffer from severe hearing loss caused by lack of continuity of the ossicular chain. This study is a retrospective evaluation of the hearing results using two different surgical procedures. Since January 1993, 12 consecutive patients with isolated erosion of the long incus process have been treated with a new surgical technique in which the ossicular chain was rebuilt with ionomeric cement. The results in hearing performance (mean pure-tone average (PTA) 0.5, 1 and 2 kHz) were evaluated pre- and post-surgery, and compared to those in a group of 20 historical controls who underwent surgery in 1991 and 1992 using incus autograft interposition. Among the 12 index patients, 7 (58%) achieved improvement in PTA of > 10 dB, in 3 there was no difference and in 2 a slight decline. Among the 20 controls, 14 (70%) achieved improvement in PTA of > 10 dB, in 4 there was a slight improvement and in 2 a decline. The difference was not statistically significant. Hearing improvement using ionomeric cement in type II tympanoplasty was satisfactory. Reconstruction of the ossicular chain with ionomeric cement is recommended, as the procedure is easy to perform, presents less risk of damage to the stapes and cochlea, requires less extensive surgery and does not exclude other surgical methods in cases of reoperation. PMID:10909000

  9. [Haemotoxicity of dental luting cements].

    Science.gov (United States)

    Anders, A; Welker, D

    1989-06-01

    A glass ionomer luting cement (AquaCem) shows a relatively low haemolytic activity in comparison with two zinc phosphate cements. Especially the initial irritation by this cement is smaller. Although it is possible that AquaCem particularly, in unfavourable cases, may damage the pulpa dentin system; this is due to the slowly decrease of the haemolytic activity with increasing of the probes. We found that Adhesor showed in dependence of the batches a varying quality. PMID:2626769

  10. Cement penetration after patella venting.

    Science.gov (United States)

    Jones, Christopher W; Lam, Li-On; Butler, Adam; Wood, David J; Walsh, William R

    2009-01-01

    There is a high rate of patellofemoral complications following total knee arthroplasty. Optimization of the cement-bone interface by venting and suction of the tibial plateau has been shown to improve cement penetration. Our study was designed to investigate if venting the patella prior to cementing improved cement penetration. Ten paired cadaver patellae were allocated prior to resurfacing to be vented or non-vented. Bone mineral density (BMD) was measured by DEXA scanning. In vented specimens, a 1.6 mm Kirschner wire was used to breach the anterior cortex at the center. Specimens were resurfaced with standard Profix instrumentation and Versabond bone cement (Smith and Nephew PLC, UK). Cement penetration was assessed from Faxitron and sectioned images by a digital image software package (ImageJ V1.38, NIH, USA). Wilcoxon rank sum test was used to assess the difference in cement penetration between groups. The relationship between BMD and cement penetration was analyzed by Pearson correlation coefficient. There was a strong negative correlation between peak BMD and cement penetration when analyzed independent of experimental grouping (r(2)=-0.812, p=0.004). Wilcoxon rank sum testing demonstrated no significant difference (rank sum statistic W=27, p=0.579) in cement penetration between vented (10.53%+/-4.66; mean+/-std dev) and non-vented patellae (11.51%+/-6.23; mean+/-std dev). Venting the patella using a Kirschner wire does not have a significant effect on the amount of cement penetration achieved in vitro using Profix instrumentation and Versabond cement. PMID:19010682

  11. Response Surfaces for Fresh and Hardened Properties of Concrete with E-Waste (HIPS

    Directory of Open Access Journals (Sweden)

    K. Senthil Kumar

    2014-01-01

    Full Text Available The fresh and hardened properties of concrete with E-waste plastic, that is, high impact polystyrene (HIPS, as a partial replacement for coarse aggregate were analyzed using response surface methodology (RSM. Face-centred central composite response surface design was used in this study. The statistical models were developed between the factors (HIPS and water cement ratio and their response variables (slump, fresh density, dry density, compressive strength, spilt tensile strength, and flexural strength. The Design-Expert 9.0.3 software package was used to analyze the experimental values. The relationships were established and final mathematical models in terms of coded factors from predicted responses were developed. The effects of factors on properties for all variables were seen visually from the response surface and contour plot. Validation of experiments has shown that the experimental value closely agreed with the predicted value, which validates the calculated response surface models with desirability = 1. The HIPS replacement influenced all the properties of concrete than water cement ratio. Even though all properties show the decline trend, the experimented values and predicted values give a hope that the E-waste plastic (HIPS can be used as coarse aggregate up to certain percentage of replacement in concrete which successively reduces the hazardous solid waste problem and conserves the natural resources from exhaustion.

  12. Developmental Dislocation (Dysplasia) of the Hip (DDH)

    Science.gov (United States)

    .org Developmental Dislocation (Dysplasia) of the Hip (DDH) Page ( 1 ) The hip is a “ball-and-socket” joint. In a normal hip, the ball at the ... American Academy of Orthopaedic Surgeons. .org Developmental Dislocation (Dysplasia) of the Hip cont. • Family history of DDH (parents or siblings) • ...

  13. Hip complications following chemoradiotherapy

    Energy Technology Data Exchange (ETDEWEB)

    Jenkins, P.J.; Sebag Montefiore, D.J.; Arnott, S.J. [Saint Bartholomew`s Hospital, London (United Kingdom)

    1995-12-01

    Chemoradiotherapy protocols are a recent development in the management of tumours where preservation of organ function is important. It is now recognized that such combined treatment may produce adverse effects below the accepted dose thresholds for either modality. This enhancement of toxicity is generally thought to reflect depletion of stem cells within the tissue concerned. We report four patients who have developed avascular necrosis or fractures of the hip following chemoradiotherapy for carcinoma of the vulva or anus. These complications developed after a radiation dose of 4500 cGy in 20 fractions. The possible role of cytotoxic agents in sensitizing bone to radiation damage is discussed, and a novel mechanism is proposed to account for this phenomenon. (author).

  14. Anterior hip pain.

    Science.gov (United States)

    O'Kane, J W

    1999-10-15

    Anterior hip pain is a common complaint with many possible causes. Apophyseal avulsion and slipped capital femoral epiphysis should not be overlooked in adolescents. Muscle and tendon strains are common in adults. Subsequent to accurate diagnosis, strains should improve with rest and directed conservative treatment. Osteoarthritis, which is diagnosed radiographically, generally occurs in middle-aged and older adults. Arthritis in younger adults should prompt consideration of an inflammatory cause. A possible femoral neck stress fracture should be evaluated urgently to prevent the potentially significant complications associated with displacement. Patients with osteitis pubis should be educated about the natural history of the condition and should undergo physical therapy to correct abnormal pelvic mechanics. "Sports hernias," nerve entrapments and labral pathologic conditions should be considered in athletic adults with characteristic presentations and chronic symptoms. Surgical intervention may allow resumption of pain-free athletic activity. PMID:10537384

  15. Respiratory Health among Cement Workers in Ethiopia

    OpenAIRE

    Zeleke, Zeyede K.

    2011-01-01

    Background: Little is known on dust exposure and respiratory health among cement cleaners. There are only a few follow-up studies on respiratory health among cement factory workers and also studies on acute effects of cement dust exposure are limited in numbers. Objective: This study aimed at assessing cement dust exposure and adverse respiratory health effects among Ethiopian cement production workers, with particular focus on cement cleaners. Method: The first paper was...

  16. Traumatic injuries of the hip.

    LENUS (Irish Health Repository)

    Marshall, Nina

    2009-11-01

    Traumatic lesions of the hip in athletes may be clinically challenging because of the overlap in clinical presentation due to differing pathologies and the presence of multiple injuries. Imaging of the hip in the athlete has undergone a recent resurgence of interest and understanding related to the increasing accessibility and use of hip arthroscopy, which expands the treatment options available for intra-articular pathology. MR imaging and MR arthrography have a unique role in diagnosis of these pathologies, guiding the surgeon, arthroscopist, and referring clinician in their management of bony and soft tissue injury.

  17. Thermal Shock-resistant Cement

    Energy Technology Data Exchange (ETDEWEB)

    Sugama T.; Pyatina, T.; Gill, S.

    2012-02-01

    We studied the effectiveness of sodium silicate-activated Class F fly ash in improving the thermal shock resistance and in extending the onset of hydration of Secar #80 refractory cement. When the dry mix cement, consisting of Secar #80, Class F fly ash, and sodium silicate, came in contact with water, NaOH derived from the dissolution of sodium silicate preferentially reacted with Class F fly ash, rather than the #80, to dissociate silicate anions from Class F fly ash. Then, these dissociated silicate ions delayed significantly the hydration of #80 possessing a rapid setting behavior. We undertook a multiple heating -water cooling quenching-cycle test to evaluate the cement’s resistance to thermal shock. In one cycle, we heated the 200 and #61616;C-autoclaved cement at 500 and #61616;C for 24 hours, and then the heated cement was rapidly immersed in water at 25 and #61616;C. This cycle was repeated five times. The phase composition of the autoclaved #80/Class F fly ash blend cements comprised four crystalline hydration products, boehmite, katoite, hydrogrossular, and hydroxysodalite, responsible for strengthening cement. After a test of 5-cycle heat-water quenching, we observed three crystalline phase-transformations in this autoclaved cement: boehmite and #61614; and #61543;-Al2O3, katoite and #61614; calcite, and hydroxysodalite and #61614; carbonated sodalite. Among those, the hydroxysodalite and #61614; carbonated sodalite transformation not only played a pivotal role in densifying the cementitious structure and in sustaining the original compressive strength developed after autoclaving, but also offered an improved resistance of the #80 cement to thermal shock. In contrast, autoclaved Class G well cement with and without Class F fly ash and quartz flour failed this cycle test, generating multiple cracks in the cement. The major reason for such impairment was the hydration of lime derived from the dehydroxylation of portlandite formed in the autoclaved

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

    Directory of Open Access Journals (Sweden)

    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.

  19. 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.

  20. Anterior Approach Total Hip Replacement

    Medline Plus

    Full Text Available ... the benefits of the Taperloc Microplasty stem and E-poly antioxidant-infused technology during a hip replacement ... to your questions that you send in by e-mail. The e- mail button is at the ...

  1. Anterior Approach Total Hip Replacement

    Medline Plus

    Full Text Available ... Taperloc Microplasty stem and E-poly antioxidant-infused technology during a hip replacement through the anterior supine ... renewed interest at this time due to several advantages that it brings. The approach that is performed ...

  2. Anterior Approach Total Hip Replacement

    Medline Plus

    Full Text Available ... means that I’m looking at using a Delta ceramic. So now we’re going to take ... out of bed and get to the commode. Delta ceramic hip, this is the next generation ceramic. ...

  3. Anterior Approach Total Hip Replacement

    Medline Plus

    Full Text Available ... we’re doing a right hip. She has mild dysplasia with cystic changes and loss of joint ... different. Yeah. But, you know, even with this mild dysplasia and slight anteversion. Yeah. The point here ...

  4. Canine Hip Dysplasia: Breed Effects

    OpenAIRE

    Martin, S W; Kirby, K.; Pennock, P W

    1980-01-01

    This paper is a refinement of previous studies in that only suitably radiographed dogs were included in the data base. The rate of hip dysplasia varied widely by breed from five percent in siberian huskies to eighty-three percent in english bulldogs. There was a significant difference in the prevalence of dysplasia within at least two breeds; golden retrievers and old english sheepdogs. Physical size per se did not appear to be an important determinant of hip dysplasia.

  5. The hip in cerebral palsy.

    Science.gov (United States)

    Bleck, E E

    1980-01-01

    Orthopedic surgery can alleviate the hip flexion, adduction, and medial rotation deformities of the hip and improve the function and appearance of gait. To accomplish this, however, careful examination and prudence in the operative procedure to avoid overdoing and overcorrecting are important. Orthopedic surgery can prevent subluxation and dislocation of the hip before the age of seven years, and consequently repetitive radiographic examinations of the hip in children who have spastic paralysis of the hip musculature should be a routine procedure. Subluxation and dislocation of the hip, when established, can be successfully treated with orthopedic surgical procedures. Physicians must keep in mind that the spastic paralysis of cerebral palsy originates in the brain, and therefore the spasticity cannot be eliminated. The best that can be done is to weaken or remove some muscles as deforming forces and to achieve compromises for continued function. The goal should be optimal independence for the child and adolescent during development, and freedom from pain with deteriorating function due to degenerative arthritis in the adult. PMID:7360505

  6. Neonatal hip dysplasia: Differental diagnosis

    Directory of Open Access Journals (Sweden)

    Vukašinović Zoran

    2010-01-01

    Full Text Available Introduction. Hip dysplasia is the elementary form of the developmental dysplasia of the hip (DDH. The diagnosis may be made by the ultrasound examination (types II a-, II b. Objective. The aim of the authors was to define the congenital structural neonatal hip dysplasia, and to differentiate hip hypoplasia, hip dysplasia and teratogenic anomalies. Methods. In all the cases, the uniform clinical and ultrasound tests were performed. All the patients were examined in the neonatal period of life (the first six weeks. The following clinical tests were used: Le Damany-Ortolany, Coleman-Barlow-Palmen and Weissman-Strinović. For the ultrasound examination, the Graph’s method was used. Results. The investigation was performed in the period 2007- 2008. 2,878 neonates were included. The distribution of the sonotypes, according to Graph, was as follows: Ia in 16.17%. Ib in 65.08%; IIa+ in 18.17%, IIc in 0.28%, IId in 0.19%; IIIa in 0.009%, IIIb in 0.02%; and IV in 0.01%. It was found that DDH was 8 times more frequent in girls; located more frequently at the left side than bilaterally. Conclusion. Hip sonoscreening has to be performed in all newborns in the first 72 hours. The suggested follow-up period is six weeks: for the diagnosis - the first three weeks, and for the prevention and treatment - all six weeks.

  7. Getting your home ready - knee or hip surgery

    Science.gov (United States)

    ... Hip joint replacement Knee arthroscopy Knee joint replacement Knee microfracture surgery Patient Instructions ACL reconstruction - discharge Hip fracture - discharge Hip or knee replacement - after - what to ...

  8. Total hip replacement for the treatment of end stage arthritis of the hip: a systematic review and meta-analysis.

    Directory of Open Access Journals (Sweden)

    Alexander Tsertsvadze

    Full Text Available Evolvements in the design, fixation methods, size, and bearing surface of implants for total hip replacement (THR have led to a variety of options for healthcare professionals to consider. The need to determine the most optimal combinations of THR implant is warranted. This systematic review evaluated the clinical effectiveness of different types of THR used for the treatment of end stage arthritis of the hip.A comprehensive literature search was undertaken in major health databases. Randomised controlled trials (RCTs and systematic reviews published from 2008 onwards comparing different types of primary THR in patients with end stage arthritis of the hip were included.Fourteen RCTs and five systematic reviews were included. Patients experienced significant post-THR improvements in Harris Hip scores, but this did not differ between impact types. There was a reduced risk of implant dislocation after receiving a larger femoral head size (36 mm vs. 28 mm; RR = 0.17, 95% CI: 0.04, 0.78 or cemented cup (vs. cementless cup; pooled odds ratio: 0.34, 95% CI: 0.13, 0.89. Recipients of cross-linked vs. conventional polyethylene cup liners experienced reduced femoral head penetration and revision. There was no impact of femoral stem fixation and cup shell design on implant survival rates. Evidence on mortality and complications (aseptic loosening, femoral fracture was inconclusive.The majority of evidence was inconclusive due to poor reporting, missing data, or uncertainty in treatment estimates. The findings warrant cautious interpretation given the risk of bias (blinding, attrition, methodological limitations (small sample size, low event counts, short follow-up, and poor reporting. Long-term pragmatic RCTs are needed to allow for more definitive conclusions. Authors are encouraged to specify the minimal clinically important difference and power calculation for their primary outcome(s as well CONSORT, PRISMA and STROBE guidelines to ensure better

  9. Magnesium oxychloride cement concrete

    Indian Academy of Sciences (India)

    A K Misra; Renu Mathur

    2007-06-01

    The scope of magnesium oxychloride (MOC) cement in concrete works has been evaluated. MOC cement concrete compositions of varying strengths having good placing and finishing characteristics were prepared and investigated for their compressive and flexural strengths, -values, abrasion resistance etc. The durability of MOC concrete compositions against extreme environmental conditions viz. heating–cooling, freezing–thawing, wetting–drying and penetration and deposition of salts etc were investigated. The results reveal that MOC concrete has high compressive strength associated with high flexural strength and the ratio of compressive to flexural strength varies between 6 and 8. The elastic moduli of the compositions studied are found to be 23–85 GPa and the abrasion losses between 0.11 and 0.20%. While alternate heating–cooling cycles have no adverse effect on MOC concrete, it can be made durable against freezing–thawing and the excessive exposure to water and salt attack by replacing 10% magnesium chloride solution by magnesium sulphate solution of the same concentration.

  10. Wear, bone density, functional outcome and survival in vitamin E-incorporated polyethylene cups in reversed hybrid total hip arthroplasty: design of a randomized controlled trial

    Directory of Open Access Journals (Sweden)

    van der Veen Hugo C

    2012-09-01

    Full Text Available Abstract Background Aseptic loosening of total hip arthroplasties is generally caused by periprosthetic bone resorption due to tissue reactions on polyethylene wear particles. In vitro testing of polyethylene cups incorporated with vitamin E shows increased wear resistance. The objective of this study is to compare vitamin E-stabilized highly cross-linked polyethylene with conventional cross-linked polyethylene in “reversed hybrid” total hip arthroplasties (cemented all-polyethylene cups combined with uncemented femoral stems. We hypothesize that the adjunction of vitamin E leads to a decrease in polyethylene wear in the long-term. We also expect changes in bone mineral density, less osteolysis, equal functional scores and increased implant survival in polyethylene cemented cups incorporated with vitamin E in the long-term. Design A double-blinded randomized controlled trial will be conducted. Patients to be included are aged under 70, suffer from non-inflammatory degenerative joint disease of the hip and are scheduled for a primary total hip arthroplasty. The study group will receive a reversed hybrid total hip arthroplasty with a vitamin E-stabilized highly cross-linked polyethylene cemented cup. The control group will receive a reversed hybrid total hip arthroplasty with a conventional cross-linked polyethylene cemented cup. Radiological follow-up will be assessed at 6 weeks and at 1, 3, 5, 7 and 10 years postoperatively, to determine polyethylene wear and osteolysis. Patient-reported functional status (HOOS, physician-reported functional status (Harris Hip Score and patients’ physical activity behavior (SQUASH will also be assessed at these intervals. Acetabular bone mineral density will be assessed by dual energy X-ray absorptiometry (DEXA at 6 weeks and at 1 year and 2 years postoperatively. Implant survival will be determined at 10 years postoperatively. Discussion In vitro results of vitamin E-stabilized polyethylene are promising

  11. Pathologic ligamentous constraint of the hip.

    Science.gov (United States)

    Crowninshield, R D; Johnston, R C; Brand, R A; Pedersen, D R

    1983-12-01

    A mathematic model of the hip capsule and lower extremity musculature was utilized to predict the forces present in the hip ligaments during locomotion. The results demonstrate principles and trends (rather than absolute results) in hip mechanics, the details of which are affected by the associated modeling assumptions. The active stretching of a hip joint capsule tightened by scarring or surgical transfer may appreciably increase the hip contact force. Capsular elements that prevent hip flexion and adduction play a major role in hip contact force exaggeration during common activities. The positive effect of maintaining the hip capsule to reduce total hip component dislocation contrasts with the potential negative effects of restricting joint motion and increasing the joint contact force. Increased joint loading due to capsular restriction may contribute to prosthetic component loosening. PMID:6641064

  12. CURBSIDE CONSULTATION IN HIP ARTHROPLASTY

    Directory of Open Access Journals (Sweden)

    Scott M. Sporer

    2009-03-01

    Full Text Available DESCRIPTION A user friendly reference for decision making in hip arthroplasty designed in a question formed clinical problem scenarios and answers format .The articles composed of the answers, containing current concepts and preferences of experts in primary and revision hip surgery are enhanced by several images, diagrams and references and written in the form of a curbside consultation by Scott M. Sporer, MD. and his collaborators. PURPOSE By this practical reference of hip arthroplasty, Scott M. Sporer, MD. and the contributors have aimed providing the reader practical and clinically relevant information, evidence-based advices, their preferences and opinions containing current concepts for difficult and controversial clinical situations in total hip replacement surgery which are often not addressed clearly in traditional references. FEATURES The book is composed of 9 sections and 49 articles each written by a different expert designed in a question and answers format including several images and diagrams and also essential references at the end of each article. In the first section preoperative questions is subjected. Second section is about preoperative acetabulum questions. Third section is about preoperative femur questions. Fourth section is about intraoperative questions. Intraoperative acetabulum question is subjected in the fifth section and the intraoperative femur questions in the sixth section. The seventh section is about postoperative questions. Eighth and ninth sections are about general questions about failure and failure of acetabulum in turn. AUDIENCE Mainly practicing orthopedic surgeons, fellows and residents who are interested in hip arthroplasty have been targeted but several carefully designed scenarios of controversial and difficult situations surrounding total hip replacement surgery and the current information will also be welcomed by experienced clinicians practicing in hip arthroplasty. ASSESSMENT Scott M. Sporer

  13. 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)...

  14. Osteochondritis Dissecans of the Hip

    Energy Technology Data Exchange (ETDEWEB)

    Linden, B. [Hoeglands Hospital, Eksjoe (Sweden). Dept. of Orthopedic Surgery; Jonsson, K. [Univ. Hospital, Lund (Sweden). Center for Medical Imaging and Physiology; Redlund-Johnell, I. [Univ. Hospital, Malmoe (Sweden). Dept. of Diagnostic Radiology

    2003-03-01

    Purpose: To investigate the clinical and radiological characteristics of osteochondritis dissecans (OD) of the hip and the outcome of this condition after treatment. Material and Methods: Twelve male and 3 female patients with OD were retrospectively studied. Six patients had a history of Legg-Calve-Perthes disease (LCPD) and among them 2 also had had a trauma to the hip. A further 5 had had trauma and 1 a developmental dislocation of the hip (DDH). The remaining 3 patients had no history of previous hip disease or trauma. All patients were examined with plain radiography, 7 with MR, 3 with CT and 2 with hip arthrography. Results: All OD lesions were detected at plain radiography, and most of them were located near the fovea. At MR the lesions had low signal intensity at T1-weighted sequences, and 6/7 had edema or fluid collection in or adjacent to the lesion on T2-weighted sequences. The early treatment in 7 patients was surgery, 2 had had conservative treatment and 6 no treatment. At follow-up 12 years after radiological diagnosis, 5 patients had hip arthrosis, 4 of whom were treated with arthroplasty. All but 3 had reduced hip rotation and all but 2 (with arthroplasty) had load pain. Three of the patients with earlier surgery had not developed arthrosis. Conclusions: OD lesions are usually well seen with plain radiography. There is a great risk of developing early arthrosis and it seems that early surgery is connected with arthrosis development. Thus only symptomatic treatment is recommended.

  15. 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.

  16. Fatigue crack growth rate does not depend on mantle thickness: an idealized cemented stem construct under torsional loading.

    Science.gov (United States)

    Hertzler, Justin; Miller, Mark A; Mann, Kenneth A

    2002-07-01

    Retrieval studies indicate that cemented stem loosening in femoral components of total hip replacement can initiate at the stem-cement interface. The etiology of the crack propagation process from the stem-cement interface is not well understood, but cracks are typically associated with thin cement mantles. In this study, a combination of experimental and computational methods was used to investigate the fatigue crack propagation process from the stem-PMMA cement interface using a novel torsional loading model. Constructs with thin (1 mm), medium (3 mm) or thick (7 mm) cement mantles were evaluated. Crack growth was stable for all cases and the rate of crack growth diminished with increasing crack length. Crack growth rate did not depend on mantle thickness (p > 0.05) over the first 1 mm of crack length, but cracks in thin mantles reached the full thickness of the mantle in the fewest number of loading cycles. The fracture mechanics-based finite element models indicated decreased stress intensity factors with increasing crack length and were consistent with the experimental findings. When combined with a fatigue crack growth Paris-law for PMMA cement, the finite element models provided reasonable predictions of the crack growth process.

  17. Cements in Radioactive Waste Disposal

    International Nuclear Information System (INIS)

    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

  18. Cement/slag chemistry studies

    International Nuclear Information System (INIS)

    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 IO3- species, but these differ sharply in sorption characteristics. The effect of ionizing radiation of the pH and Eh of cement matrices is reported. (author)

  19. Interface Micromotion of Cementless Hip Stems in Simulated Hip Arthroplasty

    Directory of Open Access Journals (Sweden)

    Mohammed R.A. Kadir

    2009-01-01

    Full Text Available Problem statement: The design of hip prostheses has evolved over time due to various complications found after hip replacement surgery. The currently commercially available cementless femoral stems can be categorized into one of three major types, straight cylindrical, tapered rectangular and anatomical. Each type proposes a unique concept to achieve primary stability-a major requirement for bone healing process. Virtual analyses have been made on individual implants, but comparison between the three major types is required to determine the strength and weaknesses of the design concepts. Approach: Three types of implants were modeled in three dimensions-the straight cylindrical, rectangular taper and anatomical. The size of the three implants was carefully designed to fit and fill the canal of a femur reconstructed from a computed tomography image dataset. Hip arthroplasty was simulated virtually by inserting the hip stem into the femoral canal. Finite element method was used in conjunction with a specialized sub-routine to measure micromotion at the bone-implant interface under loads simulating physiological walking and stair-climbing. Another sub-routine was used to assign bone properties based on the grayscale values of the CT image. Results: All the three types of cementless hip stems were found to be stable under both walking and stair climbing activities. Large micromotion values concentrated around the proximal and distal part of the stems. Conclusion/Recommendations: The three major types of hip stems were compared in this study and all of them were found to be stable after simulated physiological activities.

  20. Traumatic hip dislocations in children

    International Nuclear Information System (INIS)

    Objectives: To evaluate clinical features, treatment and relationship to the time period between dislocation, reduction and early complications of traumatic dislocation of hip in children. Methods: Case series conducted at Jinnah Post Graduate Medical Centre Karachi from July 2005 to August 2009. Children with traumatic hip dislocation up to fifteen years of age who presented in last four years were included in this study. Their clinical information, etiology, associated injuries, duration, method of reduction and early complications are evaluated through emergency room proforma and indoor record. Follow up of patient was updated in outpatient department. Results: We had eight patients, six boys and two girls. Youngest 2.4 years and eldest was 12 years with mean age of 6.2 +- 3.8 years. All presented with posterior hip dislocation. Etiology was road traffic accident in two and history of fall in remaining six patients. Average duration of time between dislocation and reduction was 19 hours range 3-72 hours. Dislocated hips were reduced under General Anaesthesia in two patients and under sedation analgesia in six patients. No complications were noted in eight cases with mean 18.75 +- 13.23 months follows up. Conclusion: Traumatic hip dislocation in children is not rare. Slight trauma causes dislocation in younger age and immediate closed reduction and Immobilization reduces complications. (author

  1. Transient Osteoporosis of the Hip

    Directory of Open Access Journals (Sweden)

    Farideh Shahandeh

    2009-01-01

    Full Text Available   "nTransient osteoporosis of the hip as originally described in women, almost exclusively involved the left hip with the third trimester of pregnancy. It is now recognized as actually being more common in middle-aged men and affecting either hip. "nSymptoms include severe hip pain and decreased range of motion that resolves spontaneously in 6 to 12 months. The etiology is poorly understood, and the disease has been associated with a type of reflex sympathetic dystrophy syndrome. It may be migratory, with subsequent involvement of the opposite hip on an adjacent joint. Radiological changes may simulate indolent infection, osteonecrosis or infiltrative neoplasm. The underlying pathologic condition appears to be bone marrow reaction or edema. Current terminology may refer to this entity as transient bone marrow edema syndrome. Radiographs usually show osteopenia, and bone scan reveals intense activity locally within the femoral head – unlike A.V.N which often displays central photopenia. MRI demonstrates diffuse marrow abnormalities that usually extend from the subchondral femoral head to the inter trochanteric and sub trochanteric regions. There is low signal intensity on T1 weighted MR images and high signal intensity on T2 weighted sequences. The MRI changes reflect the nonspecific marrow reaction or edema that is present. Focal osteoporotic bone marrow defects in the subchondral region or subtle femoral head flattening should be searched for diligently on MR images. Unlike the case with A.V.N. , these defects are usually absent in transient osteoporosis.   

  2. Developmental dysplasia of the hip

    Directory of Open Access Journals (Sweden)

    Shahryar Noordin

    2010-10-01

    Full Text Available Developmental dysplasia of the hip (DDH is a spectrum of anatomical abnormalities of the hip joint in which the femoral head has an abnormal relationship with the acetabulum. Most studies report an incidence of 1 to 34 cases per 1,000 live births and differences could be due to different diagnostic methods and timing of evaluation. Risk factors include first born status, female sex, positive family history, breech presentation and oligohydramnios. Clinical presentations of DDH depend on the age of the child. Newborns present with hip instability, infants have limited hip abduction on examination, and older children and adolescents present with limping, joint pain, and/or osteoarthritis. Repeated, careful examination of all infants from birth and throughout the first year of life until the child begins walking is important to prevent late cases. Provocative testing includes the Barlow and Ortolani maneuvers. Other signs, such as shorting of the femur with hips and knees flexed (Galeazzi sign, asymmetry of the thigh or gluteal folds, and discrepancy of leg lengths are potential clues. Treatment depends on age at presentation and outcomes are much better when the child is treated early, particularly during the first six months of life.

  3. Evaluation of the patient with hip pain.

    Science.gov (United States)

    Wilson, John J; Furukawa, Masaru

    2014-01-01

    Hip pain is a common and disabling condition that affects patients of all ages. The differential diagnosis of hip pain is broad, presenting a diagnostic challenge. Patients often express that their hip pain is localized to one of three anatomic regions: the anterior hip and groin, the posterior hip and buttock, or the lateral hip. Anterior hip and groin pain is commonly associated with intra-articular pathology, such as osteoarthritis and hip labral tears. Posterior hip pain is associated with piriformis syndrome, sacroiliac joint dysfunction, lumbar radiculopathy, and less commonly ischiofemoral impingement and vascular claudication. Lateral hip pain occurs with greater trochanteric pain syndrome. Clinical examination tests, although helpful, are not highly sensitive or specific for most diagnoses; however, a rational approach to the hip examination can be used. Radiography should be performed if acute fracture, dislocations, or stress fractures are suspected. Initial plain radiography of the hip should include an anteroposterior view of the pelvis and frog-leg lateral view of the symptomatic hip. Magnetic resonance imaging should be performed if the history and plain radiograph results are not diagnostic. Magnetic resonance imaging is valuable for the detection of occult traumatic fractures, stress fractures, and osteonecrosis of the femoral head. Magnetic resonance arthrography is the diagnostic test of choice for labral tears. PMID:24444505

  4. Cemented versus uncemented hemiarthroplasty for femoral neck fractures in elderly patients: a meta-analysis.

    Directory of Open Access Journals (Sweden)

    Tao Li

    Full Text Available OBJECTIVE: Controversy still exists regarding using cemented or uncemented hemiarthroplasty for femoral neck fractures in elderly patients. The aim of this study is to compare the effectiveness and safety of the two surgical techniques in femoral neck fracture patients over 70 years old. METHODS: We searched PUBMED, EMBASE, Cochrane Library, CNKI and VIP Database from inception to December 2012 for relevant randomized controlled trials (RCTs. Outcomes of interest include postoperative hip function, residue pain, complication rates, mortality, reoperation rate, operation time and intraoperative blood loss. Odds ratios (OR and weighted mean differences (WMD from each trial were pooled using random-effects model or fixed-effects model given on the heterogeneity of the included studies. RESULTS: 7 RCTs involving 1,125 patients (1,125 hips were eligible for meta-analysis. Our results demonstrate that cemented hemiarthroplasty is associated with better postoperative hip function (OR = 0.48, 95% CI, 0.31-0.76; P = 0.002, lower residual pain (OR = 0.43, 95%CI, 0.29-0.64; P<0.0001, less implant-related complications (OR = 0.15, 95%CI, 0.09-0.26; P<0.00001 and longer operation time (WMD = 7.43 min, 95% CI, 5.37-9.49 min; P<0.00001. No significant difference was observed between the two groups in mortality, cardiovascular and cerebrovascular complications, local complications, general complications, reoperation rate and intraoperative blood loss. CONCLUSIONS: Compared with uncemented hemiarthroplasty, the existing evidence indicates that cemented hemiarthroplasty can achieve better hip function, lower residual pain and less implant-related complications with no increased risk of mortality, cardiovascular and cerebrovascular complications, general complications, local complications and reoperation rate in treating elderly patients with femoral neck fractures.

  5. Cementing porcelain-fused-to-metal crowns.

    Science.gov (United States)

    Vadachkoria, D

    2009-12-01

    The clinical success of fixed prosthodontic restorations can be complex and involve multifaceted procedures. Preparation design, oral hygiene/micro flora, mechanical forces, and restorative materials are only a few of the factors which contribute to overall success. One key factor to success is choosing the proper cement. Popular use of cements for PFM crowns has shifted from zinc phosphate and glass ionomer cements to resin-reinforced glass ionomer, or RRGI, cements. This change has been rapid and profound. Dental cements have always been less than ideal materials, but this is shift to the relatively new RRGI category justified. Resin-reinforced glass ionomer (RRGI) cements appear to be better than zinc phosphate and glass ionomer cements when placing porcelain-to-metal crowns. RRGI cements, such as RelyX Luting, Fuji Plus and Vitremer Luting Cement, satisfy more of the ideal characteristics of PFM cementation than any other previous cement. Expansion of all three cements has not caused any apparent problems with the cements when used with PFM or metal crowns, but these cements, however, should be avoided when cementing all-ceramic crowns. PMID:20090144

  6. Developmental hip dysplasia in adolescence

    Directory of Open Access Journals (Sweden)

    Vukašinović Zoran

    2009-01-01

    Full Text Available The authors define adolescence and developmental dysplasia of the hip (DDH. Special attention is paid to pathological findings characteristic of DDH in adolescence (unrecognized and untreated DDH; treated DDH, but non-terminated treatment; DDH diagnosed with delay, inadequately treated, with complications. The authors emphasise that DDH treatment has to be successfully terminated well before the adolescence; possibilities are explained on management modes at the time of adolescence, and possible persons guilty for the persistence of later hip problems are indicated. Based on the authors' experience and having in mind all surgical possibilities for the treatment (pelvic osteotomies, femoral osteotomies, trochanteroplasties, leg length equalization procedures the authors propose treatment protocols. The intention is to provide better treatment results and to prevent secondary hip arthrosis. Furthermore, how to improve the struggle against DDH is suggested.

  7. Cementless Hydroxyapatite Coated Hip Prostheses

    Directory of Open Access Journals (Sweden)

    Antonio Herrera

    2015-01-01

    Full Text Available More than twenty years ago, hydroxyapatite (HA, calcium phosphate ceramics, was introduced as a coating for cementless hip prostheses. The choice of this ceramic is due to its composition being similar to organic apatite bone crystals. This ceramic is biocompatible, bioactive, and osteoconductive. These qualities facilitate the primary stability and osseointegration of implants. Our surgical experience includes the implantation of more than 4,000 cementless hydroxyapatite coated hip prostheses since 1990. The models implanted are coated with HA in the acetabulum and in the metaphyseal area of the stem. The results corresponding to survival and stability of implants were very satisfactory in the long-term. From our experience, HA-coated hip implants are a reliable alternative which can achieve long term survival, provided that certain requirements are met: good design selection, sound choice of bearing surfaces based on patient life expectancy, meticulous surgical technique, and indications based on adequate bone quality.

  8. 21 CFR 888.3400 - Hip joint femoral (hemi-hip) metallic resurfacing prosthesis.

    Science.gov (United States)

    2010-04-01

    ... prosthesis. 888.3400 Section 888.3400 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND... femoral (hemi-hip) metallic resurfacing prosthesis. (a) Identification. A hip joint femoral (hemi-hip) metallic resurfacing prosthesis is a device intended to be implanted to replace a portion of the hip...

  9. Assessment of Natural Radioactivity Levels of Cements and Cement Composites in the Slovak Republic

    OpenAIRE

    Adriana Eštoková; Lenka Palaščáková

    2013-01-01

    The radionuclide activities of 226Ra, 232Th and 40K and radiological parameters (radium equivalent activity, gamma and alpha indices, the absorbed gamma dose rate and external and internal hazard indices) of cements and cement composites commonly used in the Slovak Republic have been studied in this paper. The cement samples of 8 types of cements from Slovak cement plants and five types of composites made from cement type CEM I were analyzed in the experiment. The radionuclide activities in t...

  10. Assessment of the compatibility of wood and plastic with cement for their recycling in cement composites

    OpenAIRE

    Andrade, André De; Caldeira, Fernando

    2010-01-01

    The compatibility between maritime pine wood and cement, and between plastic (LDPE) and cement, was assessed for the recycling of wood and plastic in cement composites. Temperature vs. time profiles of cement setting were registered and compatibility indices were calculated. Results indicate that recycling of plastics in plastic-cement composites does not pose any questions regarding chemical compatibility. However, maritime pine hinders cement setting in some extent. So, in or...

  11. Dislocation of a dual mobility total hip replacement following fracture of the polyethylene liner.

    Science.gov (United States)

    Vedrine, Bertrand; Guillaumot, Pierre; Chancrin, Jean-Luc

    2016-05-18

    An eight-year-old male English Setter was referred for management of a dislocation of a cemented dual mobility canine total hip prosthesis that occurred four months after the initial surgery. Revision surgery showed that the dislocation was associated with fracture of the ultra-high molecular weight polyethylene liner. The dislocation was successfully reduced after replacing the liner. A dual mobility acetabular component is composed of a mobile polyethylene liner inside a metallic cemented cup. Chronic wear of the components of a canine dual mobility total hip replacement has not been described previously. The use of this type of implant is fairly recent and limited long term follow-up of the implanted cases may be the explanation. Acute rupture of a polyethylene liner has never been described in humans, the only case of rupture of a polyethylene liner occurred 10 years after implantation. The case presented here of rupture of the polyethylene liner of a dual mobility total hip replacement is a hitherto unreported failure mode in this model of acetabular cup in the dog. PMID:26991949

  12. A Particle Model for Prediction of Cement Infiltration of Cancellous Bone in Osteoporotic Bone Augmentation.

    Directory of Open Access Journals (Sweden)

    Ehsan Basafa

    Full Text Available Femoroplasty is a potential preventive treatment for osteoporotic hip fractures. It involves augmenting mechanical properties of the femur by injecting Polymethylmethacrylate (PMMA bone cement. To reduce the risks involved and maximize the outcome, however, the procedure needs to be carefully planned and executed. An important part of the planning system is predicting infiltration of cement into the porous medium of cancellous bone. We used the method of Smoothed Particle Hydrodynamics (SPH to model the flow of PMMA inside porous media. We modified the standard formulation of SPH to incorporate the extreme viscosities associated with bone cement. Darcy creeping flow of fluids through isotropic porous media was simulated and the results were compared with those reported in the literature. Further validation involved injecting PMMA cement inside porous foam blocks - osteoporotic cancellous bone surrogates - and simulating the injections using our proposed SPH model. Millimeter accuracy was obtained in comparing the simulated and actual cement shapes. Also, strong correlations were found between the simulated and the experimental data of spreading distance (R(2 = 0.86 and normalized pressure (R(2 = 0.90. Results suggest that the proposed model is suitable for use in an osteoporotic femoral augmentation planning framework.

  13. Computed tomography in abnormalities of the hip

    Energy Technology Data Exchange (ETDEWEB)

    Visser, J.D.; Jonkers, A.; Klasen, H.J. (Rijksuniversiteit Groningen (Netherlands). Academisch Ziekenhuis); Hillen, B. (Rijksuniversiteit Groningen (Netherlands). Lab. voor Anatomie en Embryologie)

    1982-06-26

    The value of computed tomography in the assessment of abnormalities of the hip is demonstrated with the aid of an anatomical preparation and in patients with, respectively, congenital dislocation of a hip, dislocation of the hip in spina bifida, an acetabular fracture and a Ewing tumour. The anteversion of the acetabulum and femur and the instability index of the hip joint can be measured by means of computed tomography.

  14. Computed tomography in abnormalities of the hip

    International Nuclear Information System (INIS)

    The value of computed tomography in the assessment of abnormalities of the hip is demonstrated with the aid of an anatomical preparation and in patients with, respectively, congenital dislocation of a hip, dislocation of the hip in spina bifida, an acetabular fracture and a Ewing tumour. The anteversion of the acetabulum and femur and the instability index of the hip join can be measured by means of computed tomography. (Auth.)

  15. TREATMENT OF NEUROLOGICAL CONGENITAL HIP LUXATION

    OpenAIRE

    Iulian ICLEANU; Mariana CORDUN

    2015-01-01

    Congenital hip luxation is a disorder which evolves in time. Teratological hip dislocation is a distinct form of hip luxation, which usually appears with other disorders. These hips are dislocated before birth. In this thesis we will try to elaborate a recovery program, through physical exercises, which will help us realize our treatment objectives: diminishing articular stiffness, increasing articular mobility, increasing muscle strength, recalibration of agonist and antagonist balances and ...

  16. SENILE OSTEOPOROSIS AND HIP FRACTURE

    Institute of Scientific and Technical Information of China (English)

    戴力扬

    1995-01-01

    A randomized block design was used to compare the Singh index, the cortical index of the femoral neck and the lateral cortical width of the femur of a group of patients with femoral neck fracture, a group with intertrochanterie fracture, and a normal contrrol group among a total of 102 postmenopausal women. The three irtdiees in fracture grotlp were very significantly (P<0. 01) or significantly (P<0. 05) different from those in the normal control subjects. The importance of osteopomosis in hip fracture of the aged is con-firmed. Radiographic measurement of bone mass was found to have some predictive value for the risk of hip fracture.

  17. Surrogate markers of long-term outcome in primary total hip arthroplasty

    Science.gov (United States)

    Malak, T. T.; Broomfield, J. A. J.; Palmer, A. J. R.; Hopewell, S.; Carr, A.; Brown, C.; Prieto-Alhambra, D.

    2016-01-01

    Objectives High failure rates of metal-on-metal hip arthroplasty implants have highlighted the need for more careful introduction and monitoring of new implants and for the evaluation of the safety of medical devices. The National Joint Registry and other regulatory services are unable to detect failing implants at an early enough stage. We aimed to identify validated surrogate markers of long-term outcome in patients undergoing primary total hip arthroplasty (THA). Methods We conducted a systematic review of studies evaluating surrogate markers for predicting long-term outcome in primary THA. Long-term outcome was defined as revision rate of an implant at ten years according to National Institute of Health and Care Excellence guidelines. We conducted a search of Medline and Embase (OVID) databases. Separate search strategies were devised for the Cochrane database and Google Scholar. Each search was performed to include articles from the date of their inception to June 8, 2015. Results Our search strategy identified 1082 studies of which 115 studies were included for full article review. Following review, 17 articles were found that investigated surrogate markers of long-term outcome. These included one systematic review, one randomised control trial (RCT), one case control study and 13 case series. Validated surrogate markers included Radiostereometric Analysis (RSA) and Einzel-Bild-Röntgen-Analyse (EBRA), each measuring implant migration and wear. We identified five RSA studies (one systematic review and four case series) and four EBRA studies (one RCT and three case series). Patient Reported Outcome Measures (PROMs) at six months have been investigated but have not been validated against long-term outcomes. Conclusions This systematic review identified two validated surrogate markers of long-term primary THA outcome: RSA and EBRA, each measuring implant migration and wear. We recommend the consideration of RSA in the pre-market testing of new implants. EBRA can

  18. Hip-Hop and the Academic Canon

    Science.gov (United States)

    Abe, Daudi

    2009-01-01

    Over the last 30 years, the hip-hop movement has risen from the margins to become the preeminent force in US popular culture. In more recent times academics have begun to harness the power of hip-hop culture and use it as a means of infusing transformative knowledge into the mainstream academic discourse. On many college campuses, hip-hop's…

  19. Ultrasonography of the painful hip in childhood

    NARCIS (Netherlands)

    S.G.F. Robben (Simon)

    1999-01-01

    textabstractThere are many diseases in childhood that affect the hip joint. Some diseases are systemic in origin and initially may present themselves as hip disorders, such as rheumatoid arthritis. other diseases are localized specifically in the hip joint, such as transient synovitis and Perthes' d

  20. Manufacture and properties of fluoride cement

    Science.gov (United States)

    Malata-Chirwa, Charles David

    This research work aimed at characterising composition, hydration and physical properties of fluoride cement, by studying samples of the cement obtained from Malawi, and comparing them to ordinary Portland cement. By confirming the suitable characteristics of fluoride cement through this work, the results of the research work provide a good basis for the wider adoption of fluoride cement as an alternative to ordinary Portland cement, especially in developing economies. Numerous accounts have been cited regarding the production and use of fluoride cement. Since there have not been conclusive agreement as to its properties, this study was limited to the theories of successful incorporation of fluoride compounds in the manufacture of fluoride cement. Hence, the properties and characteristics reported in this study relate to the cement currently manufactured in Malawi, and, on a comparative basis only, to that manufactured in other parts of the world. Samples of the fluoride cement used in the study were obtained by synthetic manufacture of the cement using common raw materials for the manufacture of fluoride cement that is limestone, silica sand, and fluorspar. These samples were subjected to several comparative tests used to characterise cements including examination under x-ray diffractometer, scanning electron microscopy and tests for setting time and compressive strength. Under similar laboratory conditions, it was possible to prove that fluoride cement hardens more rapidly than ordinary Portland cement. Also observed during the experimental work is that fluoride cement develops higher compressive strengths than ordinary Portland cement. The hardening and setting times are significantly different between the two cements. Also the nature of the hydration products, that is the microstructural development is significantly different in the two cements. The differences brought about between the two cements are because of the presence of fluorine during the clinkering

  1. Mid-term study of bone remodeling after femoral cemented stem implantation: comparison between DXA and finite element simulation.

    Science.gov (United States)

    Herrera, Antonio; Rebollo, Sarai; Ibarz, Elena; Mateo, Jesús; Gabarre, Sergio; Gracia, Luis

    2014-01-01

    This five-year prospective study was designed to investigate periprosthetic bone remodeling associated with two cemented stem models, ABG-II (Stryker) and VerSys (Zimmer), randomly implanted in patients older than 75 years. The sample consisted of 64 cases (32, ABG-II; 32, VerSys). Inclusion criterion was diagnosis of osteoarthritis recommended for cemented total hip arthroplasty. Besides clinical study, Finite Element (FE) simulation was used to analyze biomechanical changes caused by hip arthroplasty. Bone Mineral Density (BMD) measurements showed a progressive increase in bone mass throughout the entire follow-up period for both stems, well correlated with FE results except in Gruen zones 4, 5, 6 for ABG-II and in zones 4, 5 for VerSys, denoting that remodeling in those zones does not depend on mechanical factors but rather on biological or physiological ones. PMID:23725926

  2. 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

  3. 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.

  4. Does surface wettability influence the friction and wear of large-diameter CoCrMo alloy hip resurfacings?

    Science.gov (United States)

    Curran, Sarah; Hoskin, Tom; Williams, Sarah; Scholes, Susan C; Kinbrum, Amy; Unsworth, Anthony

    2013-08-01

    The role of surface tension in the lubrication of metal-on-metal (CoCrMo alloy) hip resurfacings has been investigated to try to explain why all metal joints fail to be lubricated with simple water-based lubricants (sodium carboxymethyl cellulose), which have similar rheology to synovial fluid, but are lubricated with the same fluid with the addition of a proportion of bovine serum. As part of this study, surfactants, in the form of detergents, when added to carboxymethyl cellulose, have been shown to produce a predominantly fluid-film lubrication mechanism with friction even lower than the biological lubricant containing serum. Friction factors were reduced by 80% when a detergent was added to the lubricant. It is considered that the failure of the water-based fluids to generate fluid-film lubrication is due to the fact that 'boundary slip' takes place where the fluid does not fully attach to the bounding solid surfaces as assumed in Reynolds' equation, thereby drawing in less lubricant than predicted from hydrodynamic theory. The addition of surfactants either in the form of natural materials such as serum or in the form of detergent reduces surface tension and helps the water-based lubricant to attach more fully to the bounding surfaces resulting in more fluid entrainment and thicker fluid-film formation. This was confirmed by up to 70% lower wear being found when these joints were lubricated in a detergent solution rather than 25% bovine serum. PMID:23852389

  5. Anterior Approach Total Hip Replacement

    Medline Plus

    Full Text Available ... and I’m able to use a modern generation highly cross-linked, highly eradiated, and then vitamin ... commode. Delta ceramic hip, this is the next generation ceramic. 32 enlarger, there’s been no reported fractures. ...

  6. Hip-Hop Pop Art

    Science.gov (United States)

    Talley, Clarence, Sr.

    2011-01-01

    Art has a way of helping students better understand and appreciate the world around them, particularly the things that are most important to them. Hip hop is one of those generational genres that capture the attention of young students like few other things do. Drawing on this genre to get students to create art is an excellent way to demonstrate…

  7. Anterior Approach Total Hip Replacement

    Medline Plus

    Full Text Available ... of the Taperloc Microplasty stem and E-poly antioxidant-infused technology during a hip replacement through the ... a little diaper so we’re seeing less skin and more -- Here we go. Here’s what we’ ...

  8. Fracture After Total Hip Replacement

    Science.gov (United States)

    ... Della Valle CJ, Haidukewych GJ, Callaghan JJ: Periprosthetic fractures of the hip and knee: a problem on the rise but better solutions. ... weeks in a skilled nursing facility or a rehabilitation center in order to improve your ... can be serious. The most common complications include: • ...

  9. Social inequality and hip fracture

    DEFF Research Database (Denmark)

    Harvey, N. C.; Hansen, L.; Judge, A.;

    2015-01-01

    was taken from their latest registered annual tax return (600,000 DKK). Poisson regression modeling was used to describe the association between income or education with rate of hip fracture, adjusting for confounders (smoking, alcohol, Charlson co-morbidity). Interactions were fitted between income...

  10. Cementation of Loose Sand Particles based on Bio-cement

    Institute of Scientific and Technical Information of China (English)

    RONG Hui; QIAN Chunxiang

    2014-01-01

    Loose sand particles could be cemented to sandstone by bio-cement (microbial induced magnesium carbonate). The bio-sandstone was firstly prepared, and then the compressive strength and the porosity of the sandstone cemented by microbial induced magnesium carbonate were tested to characterize the cementation effectiveness. In addition, the formed mineral composition and the microstructure of bio-sandstone were analyzed by X-ray diffraction (XRD) and scanning electron microscopy (SEM), respectively. The experimental results show that the feasibility of binding loose sand particles using microbial induced magnesium carbonate precipitation is available and the acquired compressive strength of bio-sandstone can be excellent at certain ages. Moreover, the compressive strength and the porosity could be improved with the increase of microbial induced magnesium carbonate content. XRD results indicate that the morphology of magnesium carbonate induced by microbe appears as needles and SEM results show that the cementation of loose sand particles to sandstone mainly relies on the microbial induced formation of magnesium carbonate precipitation around individual particles and at particle-particle contacts.

  11. Early periprosthetic femoral bone remodelling using different bearing material combinations in total hip arthroplasties: a prospective randomised study

    Directory of Open Access Journals (Sweden)

    Nygaard M.

    2004-12-01

    Full Text Available The present study was performed to test the hypothesis that different bearing materials have an impact on femoral bone remodelling within the first year after a total hip arthroplasty. A total of 225 patients with osteoarthrosis of the hip or avascular necrosis of the femoral head were included in this randomised prospective study. All patients had an identical hybrid total hip arthroplasty (cemented BiMetric stem and cementless RingLoc acetabular cup except for the bearing materials: polyethylene-on-zirconia (n = 78, CoCr-on-CoCr (n = 71, or alumina-on-alumina (n = 76. Bone mineral density (BMD was measured with Dual-energy X-ray absorptiometry (DEXA in seven Gruen zones adjacent to the femoral implant. The DEXA scan was performed within one week after surgery and was repeated one year postoperatively. There was no significant difference in periprosthetic BMD change between the three groups. After twelve months the relative BMD decrease was highest in the proximal part of the femur, - 6.2% in the greater trochanter region and - 12.7% in the lesser trochanter region. In the distal zones the relative BMD decrease was -5.3, -4.2, -2.1, -2.3, and -5.6%, respectively. The use of different bearing materials had no significant impact on femoral bone remodelling adjacent to the cemented hip stem within one year after surgery.

  12. 21 CFR 888.3027 - Polymethylmethacrylate (PMMA) bone cement.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Polymethylmethacrylate (PMMA) bone cement. 888... Polymethylmethacrylate (PMMA) bone cement. (a) Identification. Polymethylmethacrylate (PMMA) bone cement is a device...: Polymethylmethacrylate (PMMA) Bone Cement.”...

  13. Poor fixation of the Mittelmeier hip prosthesis

    International Nuclear Information System (INIS)

    We have evaluated 30 Mittelmeier hips on an average 3.3 years after the operation. Seven hips had been revised because of severe pain and mechanical loosening and one because of fracture of the threaded ceramic cup. Only five of the remaining 22 hips were asymptomatic. There was radiographic migration of the acetabular and femoral components in more than one third of the hips and increased scintimetric values around the femoral component in all but two hips. Unfavorable design of the Mittelmeier prosthesis may be an important etiologic factor contributing to poor component fixation and inferior clinical results. (author)

  14. Hip osteoarthritis and dysplasia in Chinese men.

    OpenAIRE

    Lau, E. M.; Lin, F.; Lam, D; Silman, A.; Croft, P.

    1995-01-01

    OBJECTIVE--To estimate the prevalence of hip osteoarthritis (OA hip) and hip dysplasia in a sample of Hong Kong men who were unselected with respect to hip symptoms. METHODS--The postmicturition films of 999 men aged 60-75 years, consecutive attenders for intravenous urography between 1987 and 1990 at a regional hospital, were reviewed. OA hip was diagnosed as the occurrence of two or more features of OA using a modified version of the Kellgren and Lawrence scale, or a minimal joint space of ...

  15. [Congenital hip dysplasia, screening and therapy].

    Science.gov (United States)

    Kolb, A; Windhager, R; Chiari, C

    2015-11-01

    Congenital hip dysplasia and hip dislocation are relatively common pathological conditions of the musculoskeletal system in infants. An early and certain diagnosis can now be achieved by sonographic hip screening within the framework of screening examination programs. This early diagnostic procedure in infants is essential particularly for a conservative treatment strategy. Therefore, apart from possessing in-depth knowledge, training of the examiner in specialist courses is of central importance. This article presents an overview of the entity of congenital hip dysplasia and hip dislocation, the diagnostics and treatment with special emphasis on recent developments. PMID:26489825

  16. Techniques and results for open hip preservation

    Directory of Open Access Journals (Sweden)

    David eLevy

    2015-12-01

    Full Text Available While hip arthroscopy grows in popularity, there are still many circumstances under which open hip preservation is most appropriately indicated. This article specifically reviews open hip preservation procedures for a variety of hip conditions. Femoral acetabular impingement may be corrected using an open surgical hip dislocation. Acetabular dysplasia may be corrected using a periacetabular osteotomy. Acetabular protrusio may require surgical hip dislocation with rim trimming and a possible valgus intertrochanteric osteotomy. Legg-Calve ́-Perthes disease produces complex deformities that may be better served with osteotomies of the proximal femur and/ or acetabulum. Chronic slipped capital femoral epiphysis (SCFE may also benefit from a surgical hip dislocation and/or proximal femoral osteotomy.

  17. Hip Imaging in Athletes: Sports Imaging Series.

    Science.gov (United States)

    Agten, Christoph A; Sutter, Reto; Buck, Florian M; Pfirrmann, Christian W A

    2016-08-01

    Hip or groin pain in athletes is common and clinical presentation is often nonspecific. Imaging is a very important diagnostic step in the work-up of athletes with hip pain. This review article provides an overview on hip biomechanics and discusses strategies for hip imaging modalities such as radiography, ultrasonography, computed tomography, and magnetic resonance (MR) imaging (MR arthrography and traction MR arthrography). The authors explain current concepts of femoroacetabular impingement and the problem of high prevalence of cam- and pincer-type morphology in asymptomatic persons. With the main focus on MR imaging, the authors present abnormalities of the hip joint and the surrounding soft tissues that can occur in athletes: intraarticular and extraarticular hip impingement syndromes, labral and cartilage disease, microinstability of the hip, myotendinous injuries, and athletic pubalgia. (©) RSNA, 2016. PMID:27429142

  18. Techniques and Results for Open Hip Preservation.

    Science.gov (United States)

    Levy, David M; Hellman, Michael D; Haughom, Bryan; Stover, Michael D; Nho, Shane J

    2015-01-01

    While hip arthroscopy grows in popularity, there are still many circumstances under which open hip preservation is the most appropriately indicated. This article specifically reviews open hip preservation procedures for a variety of hip conditions. Femoral acetabular impingement may be corrected using an open surgical hip dislocation. Acetabular dysplasia may be corrected using a periacetabular osteotomy. Acetabular protrusio may require surgical hip dislocation with rim trimming and a possible valgus intertrochanteric osteotomy. Legg-Calve-Perthes disease produces complex deformities that may be better served with osteotomies of the proximal femur and/or acetabulum. Chronic slipped capital femoral epiphysis may also benefit from a surgical hip dislocation and/or proximal femoral osteotomy. PMID:26649292

  19. 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.

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

    Science.gov (United States)

    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. PMID:18774136

  1. 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.

  2. 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...

  3. Experimental and analytical validation of a modular acetabular prosthesis in total hip arthroplasty

    Directory of Open Access Journals (Sweden)

    Aram Luke

    2007-05-01

    Full Text Available Abstract A finite element model has been developed to predict in vivo micro motion between a modular acetabular cup and liner after cement less total hip arthroplasty. The purpose of this study is to experimentally validate the model. Six LVDT sensors were used to monitor the micromotion of the liner when subjected to loading conditions ranging from 250 N to 5000 N. Deformations at points of interest for both the experiment and FEM were compared. Results of the FEM with different coefficient of friction between the liner and the cup were investigated to correlate with the experimental results.

  4. Tantalum-based multilayer coating on cobalt alloys in total hip and knee replacement

    International Nuclear Information System (INIS)

    Cobalt–chromium–molybdenum (CoCrMo) alloys are widely used in total hip and knee joint replacement, due to high mechanical properties and resistance to wear and corrosion. They are able to form efficient artificial joints by means of coupling metal-on-polymer or metal-on-metal contacts. However, a high concentration of stress and direct friction between surfaces leads to the formation of polyethylene wear debris and the release of toxic metal ions into the human body, limiting, as a consequence, the lifetime of implants. The aim of this research is a surface modification of CoCrMo alloys in order to improve their biocompatibility and to decrease the release of metal ions and polyethylene debris. Thermal treatment in molten salts was the process employed for the deposition of tantalum-enriched coating. Tantalum and its compounds are considered biocompatible materials with low ion release and high corrosion resistance. Three different CoCrMo alloys were processed as substrates. An adherent coating of about 1 μm of thickness, with a multilayer structure consisting of two tantalum carbides and metallic tantalum was deposited. The substrates and modified layers were characterized by means of structural, chemical and morphological analysis. Moreover nanoindentation, scratch and tribological tests were carried out in order to evaluate the mechanical behavior of the substrates and coating. The hardness of the coated samples increases more than double than the untreated alloys meanwhile the presence of the coating reduced the wear volume and rate of about one order of magnitude. - Highlights: ► Thermal treatment in molten salts deposits a Ta-based coating on Co-based alloys. ► Coating is composed by one or two tantalum carbides and/or metallic tantalum. ► The coating structure depends on thermal temperature and substrates carbon content. ► Coating is able to enhance biocompatibility, wear resistance and hardness.

  5. [50 years of total hip prosthesis--a tribute to Prof. Sir John Charnley].

    Science.gov (United States)

    Mikić, Zelimir Dj; Lesić, Aleksandar R

    2013-01-01

    November 2012 marked the 50th anniversary of the first implantation of a successful and long-lived hip endoprosthesis, which was performed by Prof Sir John Charnley in the "Centre for Hip Surgery" at a small country place in the north-west England. John Charnley (1911-1982) finished medical school at the Victoria University of Manchester in 1935, and than started training in orthopaedics at the Manchester Royal Infirmary, and completed it after the Second World War, in which he served as a volunteer. After that he continued working in the same hospital, and, apart from that he worked as a lecturer at the University of Manchester, and from 1949 as a visiting surgeon in the Wrightington Hospital. In 1958 Charnley decided to put his efforts into the development of hip replacement research and surgery, and initiated the foundation of the "Centre for Hip Surgery" with Biomechanical laboratory in the Wrightington Hospital in 1960, where the intesive basic and clinical research started, and becuase of that Charnley in 1962 left Manchester and moved with a full time practice at the Wrightington Hospital. That period of research time was not easy, there were many "trial and tribulations", but, owing to the tenacity and inventive mind of Charnley, in 1962 a new prosthesis consisting of a cemented metal stem with a 22 mm head articulating with a cemented polyethilene acetabular component, and with a low frictional torque was designed. The first such prosthesis, which later produced excellent long-term results, was implanted on November 22nd, 1962, and today, when we look back over a distance of fifty years, we can conclude that that day could be considered as a beginning of a modem aloarthroplastic surgery, and certainly as one of the greatest orthopaedic advance in the whole of the 20th century; and all that was initiated and promoted by Prof. Sir John Charnley.

  6. Cement radwaste solidification studies third annual report

    International Nuclear Information System (INIS)

    This report summarises cement radwaste studies carried out at AEE Winfrith during 1981 on the encapsulation of medium and low active waste in cement. During the year more emphasis has been placed on the work which is directly related to the solidification of SGHWR active sludge. Information has been obtained on the properties of 220 dm3 drums of cemented waste. The use of cement grouts for the encapsulation of solid items has also been investigated during 1981. (U.K.)

  7. 髋关节表面置换术治疗先天性髋关节发育不良%Hip resurfacing arthroplasty for secondary osteoarthrltis after developmental dysplasia of hip

    Institute of Scientific and Technical Information of China (English)

    王琦; 张先龙; 蒋垚; 陈云苏; 沈灏; 邵俊杰

    2008-01-01

    Objective To study the clinical results of metal on metal hip resurfacing arthroplasty for developmental dysplasia patients.Methods From March 2005 to December 2006, 34 eases of developmental dysplasia patients ( Crowe Ⅰ , Crowe Ⅱ ) were attempted to have metal on metal hip resurfacing arthroplasty.There were 29 females (32 hips), 5 males (5 hips).The average age was 45 (26-57 ) years old.Radiographic and clinical evaluations were taken at 6 weeks, 3 months, 1 year and then once a year postoperatively.The average Harris score was 35 (25-44).Hip flexion was 101°, abduction 24°,adduction 15°.Results Three patients were turned to total hip arthroplasty during operations.Thirty-one patients (34 hips) received hip resurfacing surgery. These 31 patients were followed for average 21.4 months (12-33 months).The average Harris score was 94 (82-100) at the latest follow-up, and there was statistical difference compared with the preoperative score ( P < 0.01 ).Hip flexion increased to 133°,abduction to 48°, adduction to 26°.No radiolueency line was found at both acetabular and femoral sides in all the patients.The average abduction angle of acetabular cup was 43°(40°-53°) , and the average stern shaft angle was 139°(130°-145°).Conclusions The short term result is excellent.While the mid to long term results for hip resurfscing arthroplasty in developmental dysplasia patients are still looking forward, and the rneticulous surgical technique and strict patient selection are the key of the good results.%目的 探讨髋关节表面置换术治疗先天性髋关节发育不良的临床疗效.方法 2005年3月至2006年12月对34例(37髋)先天性髋关节发育不良患者行髋关节表面置换术,其中Crowe Ⅰ型28例(31髋)、Crowe Ⅱ型6例(6髋).其中女性29例(32髋),男性5例(5髋),患者平均年龄45岁(26~57岁).患者在术后6周、3个月、1年,及此后每年1次进行随访,接受放射学及临床

  8. Neutron Scattering Studies of Cement

    Science.gov (United States)

    Allen, Andrew

    2010-03-01

    Despite more than a century of research, basic questions remain regarding both the internal structure and the role of water in Ordinary Portland cement (OPC) concrete, the world's most widely used manufactured material. Most such questions concern the primary hydration product and strength-building phase of OPC paste, the calcium silicate hydrate (C-S-H) gel. When cement and water are mixed, this phase precipitates as clusters of nanoscale (nearly amorphous) colloidal particles with an associated water-filled inter-particle pore system. Most attempts to characterize the C-S-H gel and the behavior of the associated water involve drying or other processes that, themselves, change the bound water content within and around the gel. Neutron scattering methods do not suffer from this disadvantage. Furthermore, the neutron isotope effect and the neutron's sensitivity to molecular motion have enabled considerable progress to be made in recent years by: (i) determining the C-S-H composition, density and gel structure in small-angle neutron scattering (SANS) H/D contrast variation studies; (ii) elucidating the changing state of water within cement as hydration progresses using quasielastic neutron scattering (QENS); and (iii) measuring the production and consumption of nanoscale calcium hydroxide (CH), a by-product of cement hydration that co-exists with the C-S-H gel, using inelastic neutron scattering (INS). These experiments have provided new insights into the physics and chemistry of cement hydration, and have implications for the design of new concretes with pozzolanic cement additions that are intended to address environmental concerns and sustainability issues.

  9. PERFORMANCE OF PULVERIZED SLAG-SUBSTITUTED CEMENT

    Institute of Scientific and Technical Information of China (English)

    1999-01-01

    The Portland cement is equivalently substituted by slag micropowders with various specific areas. The workability,activity and acid-corrosion resistance of the slag-substituted cements are investigated,the activation of gypsum is discussed,also the porosity and pore distribution of mortars of the slag micropowders cement are determined by mercury intrusion porosimetry.

  10. 21 CFR 872.3275 - Dental cement.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Dental cement. 872.3275 Section 872.3275 Food and... DENTAL DEVICES Prosthetic Devices § 872.3275 Dental cement. (a) Zinc oxide-eugenol—(1) Identification... filling or as a base cement to affix a temporary tooth filling, to affix dental devices such as crowns...

  11. ADVANCED CEMENTS FOR GEOTHERMAL WELLS

    Energy Technology Data Exchange (ETDEWEB)

    SUGAMA,T.

    2007-01-01

    Using the conventional well cements consisting of the calcium silicate hydrates (CaO-SiO{sub 2}-H{sub 2}O system) and calcium aluminum silicate hydrates (CaO-Al{sub 2}O{sub 3}-SiO{sub 2}-H{sub 2}O system) for the integrity of geothermal wells, the serious concern confronting the cementing industries was their poor performance in mechanically supporting the metallic well casing pipes and in mitigating the pipe's corrosion in very harsh geothermal reservoirs. These difficulties are particularly acute in two geological regions: One is the deep hot downhole area ({approx} 1700 m depth at temperatures of {approx} 320 C) that contains hyper saline water with high concentrations of CO{sub 2} (> 40,000 ppm) in conjunction with {approx} 100 ppm H{sub 2}S at a mild acid of pH {approx} 5.0; the other is the upper well region between the well's surface and {approx} 1000 m depth at temperatures up to 200 C. The specific environment of the latter region is characterized by highly concentrated H{sub 2}SO{sub 4} (pH < 1.5) brine containing at least 5000 ppm CO{sub 2}. When these conventional cements are emplaced in these harsh environments, their major shortcoming is their susceptibility to reactions with hot CO{sub 2} and H{sub 2}SO4, thereby causing their deterioration brought about by CO{sub 2}-catalyzed carbonation and acid-initiated erosion. Such degradation not only reduced rapidly the strength of cements, lowering the mechanical support of casing pipes, but also increased the extent of permeability of the brine through the cement layer, promoting the rate of the pipe's corrosion. Severely carbonated and acid eroded cements often impaired the integrity of a well in less than one year; in the worst cases, casings have collapsed within three months, leading to the need for costly and time-consuming repairs or redrilling operations. These were the reasons why the geothermal well drilling and cementing industries were concerned about using conventional well

  12. DMTA method in determining strength parameters of acrylic cements

    Directory of Open Access Journals (Sweden)

    J. Koszkul

    2007-05-01

    Full Text Available Purpose: The paper presents the results of investigations of dynamic properties for bone cement with different fillers by means of DMTA method. Addition of any substance causes the change in mechanical properties. Pure PALAMED® material and material filled with four different fillers have been analysed.Design/methodology/approach: One of the methods of thermal analysis for polymeric materials has been used for investigations. DMTA method is based on the analysis of the signal (reaction from the deformed material under particular conditions, at the changeable ambient temperature as well as vibrations frequency and amplitude. DMTA thermograms give information on change in storage modulus E’ and the mechanical loss factor tgδ, which is responsible for dissipation of energy during deformation. Pure cement as well as the cement filled with: BiO-OSS and PORESORB bone graft substitute materials, Al2O3 ceramic material and powdered animal bones. Method of specimen preparation and proportion in which the specimens were prepared are presented in the text.Practical implications: As it results from the literature analysis, no investigations of such a wide group of fillers, both organic and inorganic have been carried out yet. The investigations enabled the storage modulus and tgδ to be determined for each of the prepared materials, thus to indicate the material whose properties enable this material to be used in further alloplasty surgeries for hip joint. Practical application of the results of the investigations described in this paper will be possible after long and comprehensive clinical trials.Originality/value: Original value of this paper are the results of tests since such an analysis has never been conducted by scientific environment working on this subject.

  13. Economic viability of geriatric hip fracture centers.

    Science.gov (United States)

    Clement, R Carter; Ahn, Jaimo; Mehta, Samir; Bernstein, Joseph

    2013-12-01

    Management of geriatric hip fractures in a protocol-driven center can improve outcomes and reduce costs. Nonetheless, this approach has not spread as broadly as the effectiveness data would imply. One possible explanation is that operating such a center is not perceived as financially worthwhile. To assess the economic viability of dedicated hip fracture centers, the authors built a financial model to estimate profit as a function of costs, reimbursement, and patient volume in 3 settings: an average US hip fracture program, a highly efficient center, and an academic hospital without a specific hip fracture program. Results were tested with sensitivity analysis. A local market analysis was conducted to assess the feasibility of supporting profitable hip fracture centers. The results demonstrate that hip fracture treatment only becomes profitable when the annual caseload exceeds approximately 72, assuming costs characteristic of a typical US hip fracture program. The threshold of profitability is 49 cases per year for high-efficiency hip fracture centers and 151 for the urban academic hospital under review. The largest determinant of profit is reimbursement, followed by costs and volume. In the authors’ home market, 168 hospitals offer hip fracture care, yet 85% fall below the 72-case threshold. Hip fracture centers can be highly profitable through low costs and, especially, high revenues. However, most hospitals likely lose money by offering hip fracture care due to inadequate volume. Thus, both large and small facilities would benefit financially from the consolidation of hip fracture care at dedicated hip fracture centers. Typical US cities have adequate volume to support several such centers.

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

    OpenAIRE

    Yufei Yang; Jingchuan Xue; Qifei Huang

    2013-01-01

    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, ...

  15. The comparison between sulfate salt weathering of portland cement paste and calcium sulfoaluminate cement paste

    OpenAIRE

    Liu, Zanqun; Deng, Dehua; De Schutter, Geert

    2015-01-01

    In this paper, the damage performances of sulfate salt weathering of Portland cement paste and calcium sulfoaluminate (CSA) cement paste were compared according to authors' previous studies. It was found that the evaporation zone of speciments partially immersed in 10% Na2SO4 solution were both severely deteriorated for Portland cement and CSA cement. However, the differences were more significant: (1) the CSA cement paste were damaged just after 7 days exposure compared to the 5 months expos...

  16. Hip arthroplasty by matching cups.

    Science.gov (United States)

    Gerard, Y

    1978-01-01

    A total hip surface arthroplasty consisting of matching cups and uncemented prosthetic components is a noteworthy operation. The femoral cup obtains cylindrical support from the femoral head which is reamed in the shape of a cylinder. The acetabular cup is metallic with a polyethylene liner. It is mobile over the bone but its position is constrained by contact with the femoral cup and therefore "self-centering." On the femoral side, the cup must be placed strictly in the axis of the femoral neck. The main consideration in femoral head surface replacement is the vitality of the underlying bone. Necrosis was observed in the earliest clinical trials but there have been no cases of necrosis in the past 3 1/2 years. This is attributed to a more limited surgical approach in which only the anterior part of the gluteus medius is divided and all the posterior elements of the hip are preserved. The acetabulum is sufficiently reamed to receive the cup, which protrudes beyond the external margins of the acetabulum in all positions. Errors have been committed while perfecting the prosthetic material, but the results as determined by a 6 1/2 year follow-up on purely metallic cups are encouraging. Metal-polyethylene cups presently under investigation have almost a 2 year follow-up. The reaction of the acetabulum to an uncemented cup is not yet known. However, the existence of 2 sliding surfaces and the fact that the acetabular cup moves only during the extremes of hip movement, is reason to assume that if the acetabulum is not reamed to expose cancellous bone, the risks of protrusion are minimal or delayed. Total surface arthroplasty by concentric cups has been performed in 335 hips to date. The operation is especially recommended when osteotomy is no longer possible and disabling coxarthrosis is present in relatively young patients. PMID:729253

  17. Hip painful prosthesis: surgical view

    OpenAIRE

    SPINARELLI, ANTONIO; Patella, Vittorio; Conserva, Vito; Vicenti, Giovanni; Pesce, Vito; Patella, Silvio

    2011-01-01

    Painful hip prosthesis is the most feared immediate and remote complication of a primary implant and usually represents the failure of one or more therapeutic moments. In cases of aseptic implant failure, the causes invoked may be represented by an incorrect indication, the quality of materials, local and general condition of the patient and especially from a bad joint biomechanics. In cases of septic loosening, however, the cause of failure to be found in the location of pathogens within the...

  18. Cover Story: The Miseducation of Hip-Hop.

    Science.gov (United States)

    Evelyn, Jamilah

    2000-01-01

    Some higher education officials believe that hip-hop music is eating away at the morals, and ultimately the classroom experience, of today's college students. Discusses why the gap exists between student and faculty attitudes toward hip-hop, how hip-hop music represents blackness, how people perceive hip-hop youth, the positive side of hip-hop,…

  19. 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....

  20. Thoughts on the Current Cement Industry Development

    Institute of Scientific and Technical Information of China (English)

    Gan Zhihe

    2003-01-01

    According to the analysis of cement capacity andits relations with macro economy running index, the mainreasons for the present rapid development of cement capacityare the rapid development of economy and the shot up ofwhole society fixed asset investment. According to the presentspeed of economy development, cement still enjoys a po-tential increase, So here has not been an overall excessivepopularity of cement industry. The best way to prevent lowlevel repeated construction is to promote the development ofnew dry- process cement as well as try to get rid of blindness.

  1. Effect of temporary cements on the shear bond strength of luting cements

    Directory of Open Access Journals (Sweden)

    Marco Fiori-Júnior

    2010-02-01

    Full Text Available OBJECTIVE: The purpose of this study was to evaluate, by shear bond strength (SBS testing, the influence of different types of temporary cements on the final cementation using conventional and self-etching resin-based luting cements. Material and Methods: Forty human teeth divided in two halves were assigned to 8 groups (n=10: I and V (no temporary cementation; II and VI: Ca(OH2-based cement; III and VII: zinc oxide (ZO-based cement; IV and VIII: ZO-eugenol (ZOE-based cement. Final cementation was done with RelyX ARC cement (groups I to IV and RelyX Unicem cement (groups V to VIII. Data were analyzed statistically by ANOVA and Tukey's test at 5% significance level. RESULTS: Means were (MPa: I - 3.80 (±1.481; II - 5.24 (±2.297; III - 6.98 (±1.885; IV - 6.54 (±1.459; V - 5.22 (±2.465; VI - 4.48 (±1.705; VII - 6.29 (±2.280; VIII - 2.47 (±2.076. Comparison of the groups that had the same temporary cementation (Groups II and VI; III and VII; IV and VIII showed statistically significant difference (p0.05 for the different luting cements (RelyX TM ARC and RelyX TM Unicem. The groups that had no temporary cementation (Groups I and V did not differ significantly from each other either (p>0.05. CONCLUSION: When temporary cementation was done with ZO- or ZOE-based cements and final cementation was done with RelyX ARC, there was an increase in the SBS compared to the control. In the groups cemented with RelyX Unicem, however, the use of a ZOE-based temporary cement affected negatively the SBS of the luting agent used for final cementation.

  2. False set in aireated cements

    Directory of Open Access Journals (Sweden)

    Vázquez, T.

    1986-06-01

    Full Text Available The influence of aireation on the appearance or elimination of the false setting in industrial portland cements is studied by means of infrared spectroscopy.

    Se estudia por medio de la espectroscopia infrarroja la influencia de la aireación sobre la aparición o eliminación del fraguado, en cemento portland industriales.

  3. Trusted Hosts in Host Identity Protocol (HIP)

    OpenAIRE

    K.C., Amir

    2012-01-01

    The goal of the project was to study the possibilities to establish trusted hosts in Host Identity Protocol (HIP) and implement certificate handling in HIP packets. The time complexity and performance while using certificates in HIP packets was also measured. The research project was carried out at Arcada University of Applied Sciences in collaboration with Helsinki University. The project aimed to implement standard x.509 certification of the public key used as HI (Host Identity) to deri...

  4. Hip and Spine in Cerebral Palsy

    OpenAIRE

    Persson-Bunke, Måns

    2015-01-01

    Abstract Background: Children with cerebral palsy (CP) have an increased risk of scoliosis, contractures including windswept hip deformity (WS), and hip dislocation. In 1994, a follow-up program and registry for children and adolescents with CP (CPUP) was initiated in Sweden to allow the early detection and prevention of hip dislocations and other musculoskeletal deformities. Purpose: To analyze the prevalence of scoliosis and WS in children with CP and to study the effect of CPUP. To e...

  5. Influence of hip dysplasia on the development of osteoarthritis of the hip

    OpenAIRE

    Lievense, Annet; Bierma-zeinstra, Sita; Verhagen, Arianne; Verhaar, JAN; 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 OA. METHODS: A database search of Medline, Embase, and the Cochrane library was carried out, and articles that aimed at studying the relationship between HD and hip OA were identified. The methodo...

  6. Pressurization of bioactive bone cement in vitro.

    Science.gov (United States)

    Fujita, H; Iida, H; Kawanabe, K; Okada, Y; Oka, M; Masuda, T; Kitamura, Y; Nakamura, T

    1999-01-01

    We have developed a bioactive bone cement consisting of MgO-CaO-SiO2-P2O5-CaF2 glass-ceramic powder (AW glass-ceramic powder), silica glass powder as an inorganic filler, and bisphenol-a-glycidyl methacrylate (bis-GMA) based resin as an organic matrix. The efficacy of this bioactive bone cement was investigated by evaluating its pressurization in a 5-mm hole and small pores using a simulated acetabular cavity. Two types of acetabular components were used (flanged and unflanged sockets) and a commercially available polymethylmethacrylate (PMMA) bone cement (CMW 1 Radiopaque Bone Cement) was selected as a comparative control. Bioactive bone cement exerted greater intrusion volume in 5-mm holes than PMMA bone cement in both the flanged and unflanged sockets 10 minutes after pressurization (p anchor holes than PMMA bone cement.

  7. Leaching of tritium from a cement composite

    International Nuclear Information System (INIS)

    Leaching of tritium from cement composites into an aqueous phase has been studied to evaluate the safety of incorporation of the tritiated liquid waste into cement. Leaching tests were performed by the method recommended by the International Atomic Energy Agency. The Leaching fraction was measured as functions of waste-cement ratio (Wa/C), temperature of leachant and curing time. The tritium leachability of cement in the long term test follows the order: alumina cement portland cement slag cement. The fraction of tritium leached increases with increasing Wa/C and temperature and decreasing curing period. A deionized water as a leachant gives a slightly higher leachability than synthetic sea water. The amount leached of tritium from a 200 l drum size specimen was estimated on the basis of the above results. (author)

  8. Understanding cement mechanical behavior in SAGD wells

    Energy Technology Data Exchange (ETDEWEB)

    Xie, J.; Zahacy, T. A. [C-FER Technologies (Canada)

    2011-07-01

    In the heavy oil industry, the steam assisted gravity drainage process is often used to enhance oil recovery but it can cause cracks in the cement sheath. These cracks are the result of high steam temperatures and thermal expansion. In order to mitigate this risk, improved well designs are required. The aim of this paper is to present the mechanical behavior of the cement sheath during the heating phase. An analysis of the impact of design and operating parameters was conducted through thermal hydraulic and thermal mechanical analyses to assess cement integrity. These analyses were then performed on an example of an SAGD project in the southern part of the Athabasca oilsands region to assess the performance of the cement sheath. Results showed that potential damage to the cement can be reduced by slow heating and a lower Young's modulus cement blend. This paper makes recommendations for optimizing cement design in thermal recovery wells.

  9. COMPLEX FUNCTIONAL ASSESSMENT OF THE HIP JOINT.

    Directory of Open Access Journals (Sweden)

    Maya S. Krastanova

    2015-09-01

    Full Text Available Introduction: In relation to the study reporting the effects of applying phased complex rehabilitation in patients with total hip arthroplasty, it has been concluded that the everyday clinical practice in Bulgaria does not apply complex examination, giving an objective picture about the extent of functional status of patients with trauma and diseases of the hip. Aim: The main goal of this report is to present a test which incorporates all known and routine research and in which the total number of points determines the functional status of patients with trauma and diseases of the hip. Material and Methods: Based on the Hip dysfunction and Osteoarthritis Outcome Score, the Harris Hip Score modified test, scale D’Aubigne and Postel and Iowa’s test for complex functional evaluation of the hip joint, we have developed a test including information about the degree of pain; goniometry and manual muscle testing of the hip; locomotor test – type of gait and adjuvants; test for Daily Activities of Life. The test has been developed on the basis of expert assessment by doctors and physiotherapists of the proposed indicators for evaluation and determination of the weighting factors’ contribution to the general condition of the patient. Conclusion: The developed and tested method of complex functional assessment of the hip joint enables our colleagues, dealing with trauma and diseases of the hip, to use it in various research and scientific projects, as well as in general medical practice.

  10. Surgical hip dislocation: techniques for success.

    Science.gov (United States)

    Ricciardi, Benjamin F; Sink, Ernest L

    2014-01-01

    Surgical hip dislocation (SHD) is a versatile approach used to address both intra-articular and extra-articular pathology around the hip joint in both pediatric and adult patients. It allows anterior dislocation of the femoral head for direct visualization of the hip joint while preserving femoral head vascularity and minimizing trauma to the abductor musculature. Previously described indications for SHD include femoroacetabular impingement, deformity resulting from Legg-Calve-Perthes disease, slipped capital femoral epiphysis, periarticular trauma, benign lesions of the hip joint, and osteochondral lesions. In this review, we will describe current surgical techniques, indications, and clinical outcomes for SHD. PMID:25207733

  11. Mesoscale texture of cement hydrates.

    Science.gov (United States)

    Ioannidou, Katerina; Krakowiak, Konrad J; Bauchy, Mathieu; Hoover, Christian G; Masoero, Enrico; Yip, Sidney; Ulm, Franz-Josef; Levitz, Pierre; Pellenq, Roland J-M; Del Gado, Emanuela

    2016-02-23

    Strength and other mechanical properties of cement and concrete rely upon the formation of calcium-silicate-hydrates (C-S-H) during cement hydration. Controlling structure and properties of the C-S-H phase is a challenge, due to the complexity of this hydration product and of the mechanisms that drive its precipitation from the ionic solution upon dissolution of cement grains in water. Departing from traditional models mostly focused on length scales above the micrometer, recent research addressed the molecular structure of C-S-H. However, small-angle neutron scattering, electron-microscopy imaging, and nanoindentation experiments suggest that its mesoscale organization, extending over hundreds of nanometers, may be more important. Here we unveil the C-S-H mesoscale texture, a crucial step to connect the fundamental scales to the macroscale of engineering properties. We use simulations that combine information of the nanoscale building units of C-S-H and their effective interactions, obtained from atomistic simulations and experiments, into a statistical physics framework for aggregating nanoparticles. We compute small-angle scattering intensities, pore size distributions, specific surface area, local densities, indentation modulus, and hardness of the material, providing quantitative understanding of different experimental investigations. Our results provide insight into how the heterogeneities developed during the early stages of hydration persist in the structure of C-S-H and impact the mechanical performance of the hardened cement paste. Unraveling such links in cement hydrates can be groundbreaking and controlling them can be the key to smarter mix designs of cementitious materials. PMID:26858450

  12. Surgical hip dislocation for treatment of cam femoroacetabular impingement

    Directory of Open Access Journals (Sweden)

    Milind M Chaudhary

    2015-01-01

    Conclusion: Cam femoroacetabular Impingement causing pain and limitation of hip movements was treated by open osteochondroplasty after surgical hip dislocation. This reduced pain, improved hip motion and gave good to excellent results in the short term.

  13. State-of-the-Art Hip Surgeries for Active Adults

    Medline Plus

    Full Text Available ... that are available for patients suffering from hip arthritis that we do here at Thomas Jefferson University ... or ceramic. But, not every patient who has arthritis of their hip needs a hip replacement. There ...

  14. The association between hip fracture and hip osteoarthritis: A case-control study

    Directory of Open Access Journals (Sweden)

    Englund Martin

    2010-11-01

    Full Text Available Abstract Background There have been reports both supporting and refuting an inverse relationship between hip fracture and hip osteoarthritis (OA. We explore this relationship using a case-control study design. Methods Exclusion criteria were previous hip fracture (same side or contralateral side, age younger than 60 years, foreign nationality, pathological fracture, rheumatoid arthritis and cases were radiographic examinations were not found in the archives. We studied all subjects with hip fracture that remained after the exclusion process that were treated at Akureyri University Hospital, Iceland 1990-2008, n = 562 (74% women. Hip fracture cases were compared with a cohort of subjects with colon radiographs, n = 803 (54% women to determine expected population prevalence of hip OA. Presence of radiographic hip OA was defined as a minimum joint space of 2.5 mm or less on an anteroposterior radiograph, or Kellgren and Lawrence grade 2 or higher. Possible causes of secondary osteoporosis were identified by review of medical records. Results The age-adjusted odds ratio (OR for subjects with hip fracture having radiographic hip OA was 0.30 (95% confidence interval [95% CI] 0.12-0.74 for men and 0.33 (95% CI 0.19-0.58 for women, compared to controls. The probability for subjects with hip fracture and hip OA having a secondary cause of osteoporosis was three times higher than for subjects with hip fracture without hip OA. Conclusion The results of our study support an inverse relationship between hip fractures and hip OA.

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

    Energy Technology Data Exchange (ETDEWEB)

    Vossinakis, I.C. [General Hospital of Volos, Orthopaedic Department, Volos (Greece); Georgiades, G. [General Hospital of Tripoli, Tripoli Greece, Orthopaedic Department, Athens (Greece); Hartofilakidis, G. [University of Athens Medical School, Department of Orthopaedics, Athens (Greece); Kafidas, D.

    2008-10-15

    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.)

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

    International Nuclear Information System (INIS)

    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)

  17. Total hip arthroplasty in Malaysia--the Universiti Kebangsaan Malaysia and Hospital Kuala Lumpur experience.

    Science.gov (United States)

    Tay, B H; Masbah, O; Razak, M; Ruslan, G N

    2000-09-01

    The results of 109 primary total hip arthroplasties in 92 patients performed in Hospital Kuala Lumpur from January 1987 to December 1996 were reviewed after a mean follow-up of 30.8 months. There were 22 males and 70 females with the average age of 49.9 years (range 19 to 94 years). Chinese females comprised the largest group of patients (52.2%). Avascular necrosis was the most common diagnosis (33.1%) followed by hip dysplasia and primary osteoarthritis (17.4%). The procedure was performed more on the right hip (64.2%) compared to the left (35.8%). All patients received prophylactic antibiotics but none were given deep vein thrombosis prophylaxis. The Charnley prosthesis was most commonly used and the majority of the arthroplasties were cemented (60.5%). About 80% of the THA were performed via the lateral approach. The functional hip score improved from an average of 8.9 to 15.0 with 66.3% of the patients categorized as good and excellent results. There were 16 patients (17.4%) with poor outcome. The most common complications encountered were dislocation (10.1%), aseptic loosening (9.2%) and periprosthetic fracture (5.5%). Other complications were deep infection (1.8%), deep vein thrombosis (0.9%), trochanteric osteotomy complications (1.8%), superficial infection (7.3%), urinary tract infection (5.5%), pressure sore (3.7%) and respiratory complication (1.8%). Fifteen hips (13.8%) required revision. The causes for revision were aseptic loosening, dislocation and infection. Technical anomalies were recognized as one of the factors contributing to poor results. Five-year survival rate was 87.3%. Better results can be expected with increasing experience and technical skulls.

  18. 陶瓷对陶瓷人工髋关节的磨擦界面特征%Friction interface characteristics of ceramic-on-ceramic artificial hip joint

    Institute of Scientific and Technical Information of China (English)

    李强

    2013-01-01

    polyethylene, metal-on-metal and ceramic-on-ceramic artificial hip joint prostheses were analyzed to understand the structural characteristics of the alumina ceramic material, preparation process and wear parameters. The treatment effect of ceramic-on-ceramic artificial hip joint replacement was analyzed, and compared with other prosthesis materials. RESULTS AND CONCLUSION:The metal-to-ultra-high molecular weight polyethylene artificial hip joint prosthesis has the poor wear resistance, so the wear particles often go into the joint and surrounding tissue, and resulting in osteolysis and loosening. Metal-on-metal artificial hip joint prosthesis has better wear resistance than metal-to-ultra-high molecular weight polyethylene artificial hip joint prosthesis and has lower incidence of osteolysis. However, as the wear particles can be dispersed in various organs in the body and body fluids, the al ergic reactions and toxicity should be avoided. The in vitro and in vivo experiments indicate that ceramic-on-ceramic artificial hip joint prosthesis has good surface friction, wear and lubrication performance. Clinical long-term fol ow-up results show that there is no wear particle after ceramic-on-ceramic hip joint prosthesis replacement and thus no osteolysis can be observed. For the younger patients and the patients have higher requirements on hip activity, ceramic-on-ceramic artificial hip joint is preferred. With the development of the design and materials of ceramic-on-ceramic artificial hip joint prosthesis, the long-term clinical efficacy of ceramic-on-ceramic artificial hip joint prosthesis wil be more satisfactory through improving the mechanical properties of the prosthesis, as wel as the wear resistance and lubrication mechanism of friction interface.

  19. Reconstruction of the Acetabulum in Developmental Dysplasia of the Hip in total hip replacement

    OpenAIRE

    Vasileios Sakellariou; Michael Christodoulou; Gregory Sasalos; George Babis

    2014-01-01

    Developmental dysplasia of the hip (DDH) or congenital hip dysplasia (CDH) is the most prevalent developmental childhood hip disorder. It includes a wide spectrum of hip abnormalities ranging from dysplasia to subluxation and complete dislocation of the hip joint. The natural history of neglected DDH in adults is highly variable. The mean age of onset of symptoms is 34.5 years for dysplastic DDH, 32.5 years for low dislocation, 31.2 years for high dislocation with a false acetabulum, and 46.4...

  20. Bone and muscle assessment in patients undergoing total hip arthroplasty using HU based analysis

    Directory of Open Access Journals (Sweden)

    Þröstur Pétursson

    2012-09-01

    Full Text Available Total hip arthroplasty (THA is performed with or without the use of bone cement. The lack of reliable clinical guidelines for deciding which one to implement has encouraged this approach of joint clinical and engineering with the following objectives: 1. Validate quadriceps muscles and femur bone atrophy by extracting the mineral density from Computer Tomographic (CT images. 2. Validate computational processes based on 3-D modeling and Finite Element Methods (FEM. A clinical trial was started, where 36 volunteer patients underwent THA surgery for the first time: 18 receiving cemented implant and 18 receiving uncemented implant. The patients were CT scanned prior-, immediately after and 12 months post-surgery. The CT data are further processed to segment muscles and bones and to create 3D-models for the simulation and for calculating bone mineral density (BMD. Furthermore quadriceps muscle density Hounsfield (HU based value is calculated from the segmented file on healthy and operated leg. These preliminary results indicate computational tools and methods that are able to quantitatively analyse patient’s condition pre and post-surgery. The BMD and muscle density measurement in correlation with the fracture risk analysis display a potential method for eligibility to receive non-cemented implant; the preliminary results show that also elderly that according with current clinical evaluation receives a cemented implant are suitable for the non-cemented type. The risk for structural failure during THA surgery is estimated by calculating femoral bone fracture risk index (FRI as a ratio between compressive stress during surgery and estimated failure stress on bone. The correlations with the BMD observations during the clinical trial will assess and validate this potential predictor tool.

  1. Radiology of total hip replacement

    Energy Technology Data Exchange (ETDEWEB)

    Griffiths, H.J.; Lovelock, J.E.; McCollister Evarts, C.; Geyer, D.

    1984-06-01

    The radiology of total hip replacement (THR) and its complications is reviewed in conjunction with a long-term follow-up study on 402 patients with 501 prostheses. The indications, contraindications, biomechanics, and operative management of these patients is discussed. Clinical complications such as deep vein thrombosis, pulmonary embolism, and hemorrhage are mentioned. Postoperative infections including granulomatous pseudotumors, dislocations and fractures, true loosening of the prosthesis, and heterotopic bone formation (HBF) are discussed and illustrated. The importance of differentiating the lucent line from true loosening is stressed. Mechanical and other clinical complications which are largely ignored by radiologists are also discussed. The uses of arthrography and bone scanning are included.

  2. Computer simulation of metal-on-metal epitaxy

    NARCIS (Netherlands)

    Breeman, M; Barkema, G.T.; Langelaar, M.H; Boerma, D.O

    1996-01-01

    Atom-embedding calculations and Monte Carlo simulations are presented on various topics which are important for a better understanding of homoepitaxial growth of metals. Results of realistic simulations of the homoepitaxial growth on Cu(100) are presented for the submonolayer regime as well as for m

  3. Biomechanics of the Hip Capsule and Capsule Management Strategies in Hip Arthroscopy.

    Science.gov (United States)

    Nepple, Jeffrey J; Smith, Matthew V

    2015-12-01

    Recent advances in our understanding of the function of the hip capsule have clarified its importance to normal hip function and kinematics. The iliofemoral ligament is the primary stabilizing structure for controlling anterior translation and external rotation of the hip, and is violated by the arthroscopic interportal capsulotomy. Microinstability of the hip occurring after surgical trauma remains a poorly defined clinical entity. In certain at-risk populations, capsular repair should be considered as part of an arthroscopic hip procedure to achieve optimal outcomes and avoid iatrogenic instability (dislocation or microinstability). Despite a lack of conclusive evidence-based indications, we recommend capsular repair in the settings of borderline hip dysplasia (or dysplastic variants such as increased femoral anteversion), hip hypermobility, connective tissue disorders, and traumatic or atraumatic instability. With careful attention to arthroscopic capsular management, adequate exposure can be achieved and reproducibly allow for an effective capsular repair when indicated. PMID:26524549

  4. Dilemmas in Uncemented Total Hip Arthroplasty

    NARCIS (Netherlands)

    Goosen, J.H.M.

    2009-01-01

    In this thesis, different aspects that are related to the survivorship and clinical outcome in uncemented total hip arthroplasty are analysed. In Chapter 2, the survival rate, Harris Hip score and radiographic features of a proximally hydroxyapatite coated titanium alloy femoral stem (Bi-Metric, Bio

  5. Hip Arthroscopy: Tales From the Crypt.

    Science.gov (United States)

    Matsuda, Dean K; Philippon, Marc J; Safran, Marc R; Sampson, Thomas G

    2016-01-01

    Complications after hip arthroscopy vary in frequency and severity, even for experienced surgeons. It is important for surgeons to be aware of some of the more dramatic, often unusual, and always memorable (nightmarish) complications of hip arthroscopy and understand how they are caused, how they can be treated, and how they can be prevented.

  6. Hip Arthroscopy: Tales From the Crypt.

    Science.gov (United States)

    Matsuda, Dean K; Philippon, Marc J; Safran, Marc R; Sampson, Thomas G

    2016-01-01

    Complications after hip arthroscopy vary in frequency and severity, even for experienced surgeons. It is important for surgeons to be aware of some of the more dramatic, often unusual, and always memorable (nightmarish) complications of hip arthroscopy and understand how they are caused, how they can be treated, and how they can be prevented. PMID:27049210

  7. Acute cognitive dysfunction after hip fracture

    DEFF Research Database (Denmark)

    Bitsch, M S; Foss, N B; Kristensen, B B;

    2006-01-01

    Patients undergoing hip fracture surgery often experience acute post-operative cognitive dysfunction (APOCD). The pathogenesis of APOCD is probably multifactorial, and no single intervention has been successful in its prevention. No studies have investigated the incidence of APOCD after hip fract...... fracture surgery in an optimized, multimodal, peri-operative rehabilitation regimen....

  8. TREATMENT OF NEUROLOGICAL CONGENITAL HIP LUXATION

    Directory of Open Access Journals (Sweden)

    Iulian ICLEANU

    2015-11-01

    Full Text Available Congenital hip luxation is a disorder which evolves in time. Teratological hip dislocation is a distinct form of hip luxation, which usually appears with other disorders. These hips are dislocated before birth. In this thesis we will try to elaborate a recovery program, through physical exercises, which will help us realize our treatment objectives: diminishing articular stiffness, increasing articular mobility, increasing muscle strength, recalibration of agonist and antagonist balances and reeducating gait. The specific objectives of the study consist of the particularization of the recovery programs based on age, illness stage (dysplasia or luxation and either surgical or non-surgical intervention. To show the importance of physiotherapy in gait rehabilitation of a child with hip dislocation we started from the hypothesis: using an adequate rehabilitation program after an individualized methodology, optimizes the functional recovery and ensures the gains of hip stability and the formation of an engram of gait as close as it could be to the normal one. We present a case of neurological congenital hip dislocation where the treatment initiated early is showing good results. Results obtained are significantly different and we came to the conclusion that starting an untimely analytical kinetic treatment and globally personalizing it to every patient has better biomechanical results for the hip.

  9. Hip-hop and urban studies

    NARCIS (Netherlands)

    R. Jaffe

    2014-01-01

    How can urban studies research engage fruitfully with hip-hop? This contribution responds to the essays by David Beer and Martin Lamotte on ‘street music’, urban ethnography and ghettoized communities. It discusses how a social science engagement with hip-hop texts might differ from cultural studies

  10. Simultaneous and staged bilateral total hip arthroplasty

    DEFF Research Database (Denmark)

    Lindberg-Larsen, Martin; Joergensen, Christoffer Calov; Husted, Henrik;

    2013-01-01

    Bilateral total hip arthroplasty (BTHA) and bilateral simultaneous total hip arthroplasty (BSTHA) are done increasingly. Previous studies evaluating outcomes after bilateral procedures have found different results. The aim of this study was to investigate length of hospital stay (LOS), 30 days...

  11. Pressure ulcer risk in hip fracture patients

    NARCIS (Netherlands)

    Houwing, RH; Rozendaal, M; Wouters-Wesseling, W; Buskens, E; Keller, P; Haalboom, JRE

    2004-01-01

    Hip fracture patients have a high risk of pressure ulcers (PU). We followed 121 hip fracture patients for the development of pressure ulcers and evaluated a risk assessment tool for sensitivity and specificity. More than half of the patients presented with PU, mostly stage I. Risk factors for PU wer

  12. 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

  13. Pertunjukan Teater Karo Hip Hop Kontemporer KAI

    Directory of Open Access Journals (Sweden)

    Silvia Anggreni Purba

    2013-11-01

    Full Text Available Pertunjukan ini berawal dari sebuah ide untuk mengkolaborasikan tradisi Karo dengan budaya populer. Dengan cara seperti ini pertunjukan bisa dinikmati tanpa batasan bahasa dan budaya. Proses menggabungkan dua budaya yang berbeda merupakan bentuk budaya hibrida dan terjadi akibat proses globalisasi. Melalui proses pengendapan pengamatan dan kesan yang kuat, pertunjukan ini dibawa ke dalam bentuk Hip Hop. Pertunjukan ini merupakan bagian dari sebuah tragedi modern dengan karakter destruktif, mengeksplorasi emosi dan menyampaikannya kepada penonton. Eksplorasi budaya Karo dan tari Hip Hop sebagai bahasa simbol mampu memperkuat kata-kata. Gerak tidak diungkapkan dengan kata lisan tetapi disajikan melalui gerak tari Hip Hop. Penafsiran legenda dan teks ke dalam gerak, melalui proses pelatihan di laboratorium sebagai proses pencarian dan eksperimentasi diwujudkan dengan mempertimbangkan unsur-unsur dasar dari Hip Hop, unsur budaya Karo dan tontonan. Karo Hip Hop diharapkan menjadi bentuk estetika teater modern yang diinginkan tanpa kehilangan tradisi.Kata kunci: Tari Karo kontemporer, Hip-hop, budaya hibridaABSTRACTPertunjukan Teater Karo Hip Hop Kontemporer KAI. The performance of Karo Theater collaborated with Hip Hop stems from a simple idea to collaborate Karo cultural traditions with popular culture. The performances can be enjoyed without having limitation on the language and culture. The process of combining two different cultures is a form of hybrid culture, and it may occur due to the globalization process. Through the process of deposition of the observations and strong impression, this performance is then brought into the form of Hip Hop as a preferred form which is energetic, personal and global. This performance is part of a modern tragedy with its destructive character which has explored the emotion and has presented it to the audiences. The exploration of Karo cultural tradition and Hip Hop dance as a language of symbols is able to

  14. Unstable total hip arthroplasty: detailed overview.

    Science.gov (United States)

    Berry, D J

    2001-01-01

    Hip dislocation is one of the most common complications of THA. Good preoperative planning, good postoperative patient education, accurate intraoperative component positioning, rigorous intraoperative testing of hip stability, and good repair of soft tissues during closure all help prevent dislocation. Early postoperative dislocations and first or second dislocations usually are treated with closed reduction and a hip guide brace or hip spica cast, but when dislocation becomes recurrent, surgical treatment usually is needed. When possible, surgical treatment is based on identifying and treating a specific problem leading to the dislocation, such as implant malposition, inadequate soft-tissue tension, or impingement. In selected circumstances, constrained implants or bipolar or tripolar implants provide powerful tools to restore hip stability.

  15. Femoral head fracture without hip dislocation

    Institute of Scientific and Technical Information of China (English)

    Aditya K Aggarwal; Ashwani Soni; Daljeet Singh

    2013-01-01

    Femoral head fractures without dislocation or subluxation are extremely rare injuries.We report a neglected case of isolated comminuted fracture of femoral head without hip dislocation or subluxation of one year duration in a 36-year-old patient who sustained a high energy trauma due to road traffic accident.He presented with painful right hip and inability to bear full weight on right lower limb with Harris hip score of 39.He received cementless total hip replacement.At latest follow-up of 2.3 years,functional outcome was excellent with Harris hip score of 95.Such isolated injuries have been described only once in the literature and have not been classified till now.The purpose of this report is to highlight the extreme rarity,possible mechanism involved and a novel classification system to classify such injuries.

  16. WHITE CEMENT IN SUSTAINABLE DEVELOPMENT

    OpenAIRE

    Y.C.P RAMANA BABU; B.SAI DOONDI; N. M .V .VAMSI KRISHNA; K.Prasanthi

    2013-01-01

    India is one among the fast developing countries in the world in the areas of Infrastructure. Now a day, Carbon monoxide (CO) and carbon dioxide (CO2) are the temporary atmospheric pollutants in the environment chiefly emitted from the fuel burning vehicles and street lights which lead to global warming and pose a major threat tothe survival and sustainable development. This paper deals with the principal purpose of use of white cement in pavement design which will take care of the Green hous...

  17. ROTARY SCREW SYSTEMS IN CEMENT

    OpenAIRE

    Taratuta V. D.; Belokur K. A.; Serga G. V.

    2016-01-01

    The article presents results of research of rotary-screw systems in relation to the creation of rotary kilns for the annealing of-cuttings in the preparation of cement clinker. Using the proposed design, in comparison with known designs of similar purpose, it significantly improves performance, reduces size and power consumption through the use of rotary screw systems in the form of screw rotors and drums made hollow with sidewalls assembled from separate strips or plates of different geometr...

  18. IMAGING OF HIP JOINT PATHOLOGIES

    Directory of Open Access Journals (Sweden)

    Parul Dutta

    2016-08-01

    Full Text Available The hip joint is a large and complex articulation and can be involved by numerous pathologic conditions like congenital and developmental, infective, arthritic, and neoplastic. Early diagnosis and characterisation of pathology has vital role in proper management and follow up of the disease for the clinicians. Present study was conducted in 45 patients who underwent clinical, radiological, and pathological examination in GMCH. Maximum no of patient between age group of 10-30 yrs. male-female ratio was 1.8:1 and 30% cases are unilateral. FSE STAIR images were most useful in delineating pathologies. Gadolinium-enhanced scan were used to evaluate the extent of the disease and the pattern of involvement. AVN was the most common pathology detected comprising 29%. The next common abnormality detected was infective arthritis found in 26% of cases. In case of Legg-Calve-Perthes disease, there was abnormal linear increase in the signal intensity at junction of the epiphyseal cartilage. Ultrasonography is useful for the screening of paediatric hip cases and also for guided aspiration for histopathology. CT scan shows better resolution of soft tissue then the radiograph. The importance of early diagnosis can be gauzed from the fact that early initiation of treatment creates the difference between a responsible, worthwhile life, and a cripple handicapped life. The role of imaging can never be undermined considering the fact that early suspicion and detection is within the realms of imaging.

  19. WHITE CEMENT IN SUSTAINABLE DEVELOPMENT

    Directory of Open Access Journals (Sweden)

    Y.C.P RAMANA BABU

    2013-04-01

    Full Text Available India is one among the fast developing countries in the world in the areas of Infrastructure. Now a day, Carbon monoxide (CO and carbon dioxide (CO2 are the temporary atmospheric pollutants in the environment chiefly emitted from the fuel burning vehicles and street lights which lead to global warming and pose a major threat tothe survival and sustainable development. This paper deals with the principal purpose of use of white cement in pavement design which will take care of the Green house gases (i.e., CO and CO2 and also saves lot of money in the long run process. A small amount of these gases in environment can cause major problems over time. Use of white cement in composite pavement design where there is heavy traffic loads are acting as well as number of vehicles are more such as junctions, bus stops, check posts etc., can perform better and acts asenvironment friendly. Its light colour reflects more than bituminous pavement so that it can be easily identified and avoid accidents to some extent. White cement helps to lower the average bus stop, junction temperature providing comfort to the people because it has high solar reflectance there by reducing “urban heat island” effect. In addition to this it has some more advantages which increase the sustainability, durability and workability of the pavements.

  20. 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

    Directory of Open Access Journals (Sweden)

    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.

  1. Scanning electron microscopy analysis of dental cements

    Directory of Open Access Journals (Sweden)

    Radosavljević Radivoje D.

    2009-01-01

    Full Text Available The aim of this study was to compare in vitro the characteristics of different types of luting cements (zinc phosphate, glass-ionomer and resin based composite cement using scanning electron microscopy (SEM analysis and microleakage for the quality range of materials. Dental cements were mixed in accordance with the manufacturer's instructions and formed with posts in dental root canals of extracted teeth. The quality of cement was determined by SEM observation on horizontal sectioned roots with fixed posts according to specific pore and marginal gap diameter. The microleakage was measured on specimens immersed in Lofler (methylene blue solution. The mean values of the maximal diameter of pores, marginal gaps and microleakage of conventional cements are remarkably larger in comparison with composite luting agents. In conclusion, the quality and efficiency of composite luting agents in comparison with conventional cements are more successful in protecting the interior of tooth from penetration of oral fluids, bacteria and bacterial toxins into unprotected dentine.

  2. Cement replacement materials. Properties, durability, sustainability

    Energy Technology Data Exchange (ETDEWEB)

    Ramezanianpour, Ali Akbar [Amirkabir Univ. of Technology, Tehran (Iran, Islamic Republic of). Concrete Technology Center

    2014-04-01

    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.

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

    OpenAIRE

    Konstantin Sobolev

    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...

  4. Global Cement Industry: Competitive and Institutional Dimensions

    OpenAIRE

    Selim, Tarek; Salem, Ahmed

    2010-01-01

    The cement industry is a capital intensive, energy consuming, and vital industry for sustaining infrastructure of nations. The international cement market –while constituting a small share of world industry output—has been growing at an increasing rate relative to local production in recent years. Attempts to protect the environment in developed countries –especially Europe—have caused cement production plants to shift to countries with less stringent environmental regulations. Along with con...

  5. Characterization of cement composites with mineral additives

    OpenAIRE

    Korat, Lidija

    2015-01-01

    Doctoral dissertation is aimed at characterizing cement composites with mineral additives representing the industrial waste material (fly ash, granulated blast furnace slag and biomass fly ash). Their usage can replace high cement shares in individual cases and is, however, favourable due to the production costs reduction and environment burden decrease, including the decreased emission of greenhouse gases as well as lower energy use. Cement composites (in fresh or hardened state)...

  6. Premixed calcium silicate cement for endodontic applications

    OpenAIRE

    Persson, Cecilia; Engqvist, Håkan

    2011-01-01

    Calcium silicate-based materials (also called MTA) are increasingly being used in endodontic applications. However, the handling properties of MTA are not optimal when it comes to injectability and cohesion. Premixing the cements using glycerol avoids these issues. However, there is a lack of data on the effect of common cement variables on important properties of premixed cements for endodontic applications. In this study, the effects of liquid-to-powder ratio, amount of radiopacifier and am...

  7. Water dynamics in glass ionomer cements

    Science.gov (United States)

    Berg, M. C.; Jacobsen, J.; Momsen, N. C. R.; Benetti, A. R.; Telling, M. T. F.; Seydel, T.; Bordallo, H. N.

    2016-07-01

    Glass ionomer cements (GIC) are an alternative for preventive dentistry. However, these dental cements are complex systems where important motions related to the different states of the hydrogen atoms evolve in a confined porous structure. In this paper, we studied the water dynamics of two different liquids used to prepare either conventional or resin-modified glass ionomer cement. By combining thermal analysis with neutron scattering data we were able to relate the water structure in the liquids to the materials properties.

  8. Retention of Root Canal Posts: Effect of Cement Film Thickness, Luting Cement, and Post Pretreatment.

    Science.gov (United States)

    Sahafi, A; Benetti, A R; Flury, S; Peutzfeldt, A

    2015-01-01

    The aim of this study was to investigate the effect of the cement film thickness of a zinc phosphate or a resin cement on retention of untreated and pretreated root canal posts. Prefabricated zirconia posts (CosmoPost: 1.4 mm) and two types of luting cements (a zinc phosphate cement [DeTrey Zinc] and a self-etch adhesive resin cement [Panavia F2.0]) were used. After removal of the crowns of 360 extracted premolars, canines, or incisors, the root canals were prepared with a parallel-sided drill system to three different final diameters. Half the posts did not receive any pretreatment. The other half received tribochemical silicate coating according to the manufacturer's instructions. Posts were then luted in the prepared root canals (n=30 per group). Following water storage at 37°C for seven days, retention of the posts was determined by the pull-out method. Irrespective of the luting cement, pretreatment with tribochemical silicate coating significantly increased retention of the posts. Increased cement film thickness resulted in decreased retention of untreated posts and of pretreated posts luted with zinc phosphate cement. Increased cement film thickness had no influence on retention of pretreated posts luted with resin cement. Thus, retention of the posts was influenced by the type of luting cement, by the cement film thickness, and by the post pretreatment. PMID:25764045

  9. The mechanical effects of different levels of cement penetration at the cement-bone interface.

    NARCIS (Netherlands)

    Waanders, D.; Janssen, D.; Mann, K.A.; Verdonschot, N.J.J.

    2010-01-01

    The mechanical effects of varying the depth of cement penetration in the cement-bone interface were investigated using finite element analysis (FEA) and validated using companion experimental data. Two FEA models of the cement-bone interface were created from micro-computed tomography data and the p

  10. The influence of ultrasound on removal of prefabricated metal post cemented with different resin cements

    Directory of Open Access Journals (Sweden)

    Atiyeh Feiz

    2013-01-01

    Conclusion: Ultrasonic energy did not decrease the retention of posts cemented with Panavia or Maxcem Elite cements. Furthermore, it seems that there is no significant difference between removal force of self-etch (Panavia and the self-etch self-adhesive (Maxcem Elite resin cements.

  11. Case Study of the California Cement Industry

    OpenAIRE

    Coito, Fred; Powell, Frank; Worrell, Ernst; Price, Lynn; Friedmann, Rafael

    2005-01-01

    California is the largest cement producing state in the U.S., accounting for between 10 percent and 15 percent of U.S. cement production and cement industry employment. The cement industry in California consists of 31 sites that consume large amounts of energy, annually: 1,600 GWh of electricity, 22 million therms of natural gas, 2.3 million tons of coal, 0.25 tons of coke, and smaller amounts of waste materials, including tires. The case study summarized in this paper focused on providi...

  12. Shrinkage Properties of Cement Stabilized Gravel

    DEFF Research Database (Denmark)

    Lund, Mia Schou Møller; Hansen, Kurt Kielsgaard

    2014-01-01

    Cement stabilized gravel is an attractive material in road construction because its strength prop-erties are accommodating the increasingly higher requirements to the bearing capacity of a base course. However, reflection cracking of cement stabilized gravel is a major concern. In this pa......-per the shrinkage properties of cement stabilized gravel have been documented under various temperature and relative humidity conditions. Two cement contents corresponding to a 28-days compressive strength of 6.2 MPa and 12.3 MPa have been tested and compared. It is found that the coefficient of linear expansion...

  13. Immobilisation of radwaste in cement based matrices

    International Nuclear Information System (INIS)

    The solubilities and influence on cement pH are reported for calcium aluminate and aluminosulphate hydrates. The solubility of Ca(OH)2 is reported to 700 bars. Polymerization of C-S-H is investigated by NMR. Specific interactions of U6+ and iodine (I-, IO3-) with cement components are described. The impact of radiation on cements and the influence of higher temperature are documented. The role of dissolved Ca and CO2 in groundwaters as dissolution media for cements are reported. (author)

  14. Treatment of Arthritis Associated With Legg-Calve-Perthes Disease With Modular Total Hip Arthroplasty.

    Science.gov (United States)

    Seufert, Christopher R; McGrory, Brian J

    2015-10-01

    Legg-Calve-Perthes (LCP) disease can result in morphological deformities and associated adult hip arthritis. Thirty-five consecutive total hip arthroplasties (THA) were performed in 28 patients with a history of LCP using a non-cemented modular femoral component. There was one revision for late hematogenous infection and no evidence of prosthesis failure. Harris hip scores, on average, improved from 49.8 (26-73) to 93.9 (82-100) (P<0.05) after a minimum of 2 years follow-up (average, 8.2 years, range 2-14 years). Clinically, patients demonstrated diminished or no limping (94%, 33/35) and improved leg length equality post-operatively (100%, 35/35). This style of stem accommodated metaphyseal/diaphyseal size mismatch in 80% (28/35), allowed for abnormal anteversion in 71% (25/35), and resulted in radiographic improvements in trochanteric height (P<0.05), body weight lever arm (P<0.05), and leg length (P<0.05). PMID:25979188

  15. Acoustic evaluation of cementing quality using obliquely incident ultrasonic signals

    Institute of Scientific and Technical Information of China (English)

    Duan Wen-Xing; Qiao Wen-Xiao; Che Xiao-Hua; Xie Hui

    2014-01-01

    Ultrasonic cement bond logging is a widely used method for evaluating cementing quality. Conventional ultrasonic cement bond logging uses vertical incidence and cannot accurately evaluate lightweight cement bonding. Oblique incidence is a new technology for evaluating cement quality with improved accuracy for lightweight cements. In this study, we simulated models of acoustic impedance of cement and cementing quality using ultrasonic oblique incidence, and we obtained the relation between cementing quality, acoustic impedance of cement, and the acoustic attenuation coeffi cient of the A0-mode and S0-mode Lamb waves. Then, we simulated models of different cement thickness and we obtained the relation between cement thickness and the time difference of the arrival between the A0 and A0′ modes.

  16. Reconstruction of the Acetabulum in Developmental Dysplasia of the Hip in Total Hip Replacement

    Directory of Open Access Journals (Sweden)

    Vasileios Sakellariou

    2014-09-01

    Full Text Available Developmental dysplasia of the hip (DDH or congenital hip dysplasia (CDH is the most prevalent developmental childhood hip disorder. It includes a wide spectrum of hip abnormalities ranging from dysplasia to subluxation and complete dislocation of the hip joint. The natural history of neglected DDH in adults is highly variable. The mean age of onset of symptoms is 34.5 years for dysplastic DDH, 32.5 years for low dislocation, 31.2 years for high dislocation with a false acetabulum, and 46.4 years for high dislocation without a false acetabulum. Thorough understanding of the bony and soft tissue deformities induced by dysplasia is crucial for the success of total hip arthroplasty. It is important to evaluate the existing acetabular deformity three-dimensionally, and customize the correction in accordance with the quantity and location of ace tabular deficiencies. Acetabular reconstruction in patients with DDH is hallenging. Interpretation of published data is difficult and should be done with caution because most series include patients with different types of hip disease. In general, the complication rate associated with THA is higher in patients with hip dysplasia than it is in patients with osteoarthritis. Overall, clinical and functional outcomes following THA in patients hip dysplasia (DDH differ from those treated for primary hip osteoarthritis, possibly due to the lower age and level of activity. Although function scores decline with age, the scores for pain and range of motion presented with a statistically significant improvement in the long-term.

  17. Design and manufacture of Portland cement Application of statistical analysis

    OpenAIRE

    Svinning, Ketil

    2011-01-01

    The purpose of the work is to enable design and manufacture of cement with emphasis on the quality and the properties of cement. Data used in the design and manufacture were collected from predictions of properties and characteristics of cement. The properties of cement were predicted from its characteristics and from the production conditions in cement kiln and mill. The cement characteristics were in some investigations predicted from the production conditions. The design was based on sensi...

  18. Mechanical Evaluation of Polymer Composite Hip Protectors

    Directory of Open Access Journals (Sweden)

    Jose Daniel Diniz Melo

    2010-01-01

    Full Text Available Hip fractures often result in serious health implications, particularly in the geriatric population, and have been related to long-term morbidity and death. In most cases, these fractures are caused by impact loads in the area of the greater trochanter, which are produced in a fall. This work is aimed at developing hip protectors using composite materials and evaluating their effectiveness in preventing hip fractures under high impact energy (120 J. The hip protectors were developed with an inner layer of energy absorbing soft material and an outer rigid shell of fiberglass-reinforced polymer composite. According to the experimental results, all tested configurations proved to be effective at reducing the impact load to below the average fracture threshold of proximal femur. Furthermore, an addition of Ethylene Vinyl Acetate (EVA to the impacted area of the composite shell proved to be beneficial to increase impact strength of the hip protectors. Thus, composite hip protectors proved to be a viable alternative for a mechanically efficient and cost-effective solution to prevent hip fractures.

  19. State-of-the-Art Hip Surgeries for Active Adults

    Medline Plus

    Full Text Available ... resurfacing is similar but also different from hip -- standard hip replacement. If you saw the standard hip replacement video, we removed by using a ... techniques are similar -- actually, slightly larger than the standard small-incision hip. So in many respects it’s ...

  20. TOTAL HIP REPLACEMENT IN LEGG-CALVÉ-PERTHES DISEASE

    DEFF Research Database (Denmark)

    Froberg, Lonnie; Christensen, Finn; Pedersen, Niels Wisbech;

    2009-01-01

    to follow-up and 3) patients with previous surgery to pelvis or lower limbs. 135 patients (156 hips) were enrolled in this study and 32 patients (35 hips) were excluded. RESULTS 20 hips out of 156 hips in patients with LCP have had a THR. Mean age at operation for the women was 50 years and 44 years...

  1. Pain in the hip joint

    Directory of Open Access Journals (Sweden)

    Yuri Aleksandrovich Olyunin

    2013-01-01

    Full Text Available Pathological changes that develop in the hip joints (HJ have different origins and mechanisms of development, but their main manifestation is pain. The nature of this pain cannot be well established on frequent occasions. The English-language medical literature currently classifies such disorders as greater trochanter pain syndrome (GTPS. Its major signs are chronic pain and local palpatory tenderness in the outer part of HJ. The development of GTPS may be associated with inflammation of the synovial bursae situated in the greater tronchanter, as well as with tendinitis, myorrhexis, iliotibial band syndrome, and other local changes in the adjacent tissues or with systemic diseases. So GTPS may be characterized as regional pain syndrome that frequently mimics pain induced by different diseases, including myofascial pain syndrome, osteoarthrosis, spinal diseases, etc.

  2. Antibacterial activity of selected glass ionomer cements

    Directory of Open Access Journals (Sweden)

    Elżbieta Łuczaj-Cepowicz

    2014-01-01

    Full Text Available Introduction: The aim of the paper was to determine the antibacterial activity of four glass ionomer cements against bacteria of the genera Streptococcus and Lactobacillus. Material and methods: Four capsulated glass ionomer cements were applied in the study: Fuji Triage (GC, Fuji IX (GC, Ketac Molar (3M Espe and Ketac Silver (3M Espe. Four standard bacterial strains were used to assess the antibacterial activity of the studied cements: Streptococcus mutans, S. sanguis, S. salivarius and Lactobacillus casei. The antibacterial activity was determined by the agar diffusion method. The bacterial suspension was spread with a cotton swab on TSA plates. For each material six wells (7 mm diameter, 5 mm deep were made with a cork borer. Each well was then filled with freshly prepared cements. The results were obtained by measuring the bacterial growth inhibition zone after 1, 2, 3 and 7 days. Results: Fuji Triage cement inhibited the growth of all bacterial strains. Fuji IX cement demonstrated the most potent antibacterial activity against S. sanguis. Ketac Molar showed antibacterial activity against S. sanguis and S. salivarius, whereas Ketac Silver was efficient against S. mutans as well. Neither of the Ketac cements inhibited growth of the standard L. casei strain. Discussion: Antibacterial activity of glass ionomer cements has attracted the interest of scientists in recent years. Most authors, including us, carried out experiments using the agar diffusion method and demonstrated antibacterial activity of glass ionomer cements. Different antibacterial activity of glass ionomer cements, observed in our study and studies of other authors, depended on the evaluated cement, bacterial strain and period of evaluation.

  3. Microscopic evaluation regarding time behavior of orthodontic cements used for disjunctor cementing

    Directory of Open Access Journals (Sweden)

    Ruxandra Bartok

    2015-11-01

    Full Text Available In order to fulfill their function, orthodontic devices must be cemented on teeth using orthodontic rings. The retention of the orthodontic ring is influenced mainly by the type of dental-ring adhesion. This study was initiated to determine possible microleakage events while using zinc phosphate cement Adhesor (Spofa Dental, conventional glass ionomer Ketac Cem (3M ESPE and Fuji Ortho (GC and a compomer Transbond Plus (3M Unitek. The results of the study are consistent with those reported in the literature reference, the compomer is the preferred adhesive material for cementing the orthodontic rings, compared to conventional glass ionomer cements and zinc-phosphate cement.

  4. Consolidation behavior of cement-and lime/cement-mixed column foundations

    Institute of Scientific and Technical Information of China (English)

    蔡袁强; 徐长节

    2002-01-01

    The consolidation behavior of mixed in place cement- and lime/cement-mixed column was studied. Consolidation of the composite foundation was modeled as a three-dimensional axi-symmetric problem. The authors used the finite difference method to obtain the pore pressure variation with time at any location below the surface. A computer program developed by the authors was used to draw some interesting conclusions about the consolidation behaviors of cement- and lime/cement-mixed pile foundation. Finally, a combined model including the permeability coefficients of cement-mixed piles and soil, was studied and its feasibility was evaluated.

  5. 够胆,Hip-Hop欢迎你

    Institute of Scientific and Technical Information of China (English)

    E.B.

    2012-01-01

    Hip-Hop音乐至今不过30多年历史,这个从无到有杀出重围的野孩子,血液里跳动着的满是突破条条框框、建立新秩序的冲劲。一切没有的,我们皆生造。没有比Hip-Hop圈的进入门槛再低的了。不问出身不论背景,只要你够胆,Hip-Hop欢迎你。

  6. The hip abductors at MR imaging

    Energy Technology Data Exchange (ETDEWEB)

    Hoffmann, A., E-mail: adrienne.hoffmann@balgrist.ch [Department of Radiology, University Hospital Balgrist, Forchstrasse 340, CH-8008 Zürich (Switzerland); Pfirrmann, C.W.A., E-mail: christian.pfirrmann@balgrist.ch [Department of Radiology, University Hospital Balgrist, Forchstrasse 340, CH-8008 Zürich (Switzerland)

    2012-12-15

    Imaging of the hip abductors plays an increasing role for the evaluation of greater trochanteric pain in patients with and without total hip arthroplasty. This review article addresses the anatomy of the hip abductors and their intervening bursae. It highlights different possible imaging appearances such as tendinopathy or partial and full thickness tears of the gluteal tendons. Muscle atrophy or fatty degeneration of the gluteal muscles is an important reason for limping. Inflammatory diseases such as hydroxyapatite crystal deposition disease or spondylarthritis have to be considered. Knowledge of these different entities is important to achieve optimal treatment and outcomes.

  7. The prevalence of predisposing deformity in osteoarthritic hip joints

    DEFF Research Database (Denmark)

    Klit, Jakob; Gosvig, Kasper; Jacobsen, Steffen;

    2011-01-01

    relationship in both sexes with the clinical presentation. The study cohort which fulfilled these inclusion criteria consisted of 322 females (149 right hips and 173 left hips) and 162 males (77 right hips and 85 left hips) with osteoarthritis. We found an overall prevalence of predisposing hip deformities...... in females of 62.4% and in males of 78.9%. Minor and major deformities showed the same prevalence. Both sexes had a comparable prevalence of minor and major hip joint deformity, except for pistol grip deformity, which was more prevalent in men. We concluded that 'idiopathic osteoarthritis' is uncommon......, and that even minor predisposing deformities are associated with hip osteoarthritis....

  8. 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.

  9. 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...

  10. Neutron activation studies of the in-body corrosion of hip-joint prostheses made of Co-Cr alloys

    International Nuclear Information System (INIS)

    Using instrumental neutron activation analysis (INAA) the trace element composition of 18 elements was investigated in human tissues (articular capsule and fascia lata) of 36 persons after removal of hip-joint prostheses made of Co-Cr alloys. Normal trace element concentrations were determined studying a group of 26 patients before receiving their first artificial hip-joint. The tissues of patients with metal implants exhibited a heavy burdening by corrosion products (Co, Cr, Ni) from the prostheses as well as by Zr, Hf and Ba from the bone cements. Moreover, changes in the distribution of trace elements not contained in the steel were also observed. A comparison of the analytical results with those of model experiments of the corrosion of Co-Cr alloy in Ringer's solution demonstrates that the distribution pattern of corrosion products in the tissues are influenced by both, the biochemical properties as well as by selective dissolution of the alloy constituents. (author)

  11. Microbial analysis of biofilms on cement surfaces: An investigation in cement-associated peri-implantitis.

    Science.gov (United States)

    Korsch, Michael; Walther, Winfried; Marten, Silke-Mareike; Obst, Ursula

    2014-09-05

    The cementation of implant-supported restorations always poses the risk of excess cement retained in the peri-implant sulcus despite careful clinical control. Excess cement can become the basis of colonization by oral microorganisms. As a result of the biofilm formation peri-mucositis or peri-implantitis may develop. Complications were observed in the routine prosthetic restoration of implants when a methacrylate-based cement was used. These developed a few weeks after cementation of the suprastructure and caused bleeding on probing as well as suppuration from the peri-implant tissue. In the revision therapy, excess cement in the peri-implant sulcus was found in many cases. This excess cement was sampled from ten patients and investigated for biofilm formation. For this purpose, the cement samples were collected and analyzed for bacterial in situ colonization by 16S rDNA-based methods. In laboratory experiments, the methacrylate-based cement and two other dental cements were then investigated for their proneness to form biofilm. The results of the in situ and in vitro investigations revealed a strong tendency towards bacterial invasion of the methacrylate-based cement by opportunistic species and pathogens.

  12. Changes in Hip and Knee Muscle Strength in Patients Following Total Hip Arthroplasty

    OpenAIRE

    Fukumoto, Yoshihiro; Ohata, Koji; Tsukagoshi, Rui; Kawanabe, Keiich; Akiyama, Haruhiko; Mata, Toshihiro; Kimura, Misaka; Ichihashi, Noriaki

    2013-01-01

    Objective: To investigate changes in hip and knee muscle strength in patients before and after total hip arthroplasty (THA) in comparison with that in healthy adults. Methods: The study included 21 women who underwent unilateral THA (THA group) and 21 age-matched healthy women (healthy group). Maximal isometric strengths of hip flexors, extensors, and abductors, and knee extensors and flexors were measured before surgery and at 4 weeks and 6 months after surgery. Results: Before surgery, musc...

  13. UNCEMENTED PRIMARY TOTAL HIP ARTHROPLASTY FOR OSTEONECROSIS OF HIP WITH SECONDARY OSTEOARTHRITIS IN YOUNG ADULTS

    Directory of Open Access Journals (Sweden)

    Chatla

    2016-03-01

    Full Text Available BACKGROUND Osteonecrosis of the femoral head is a progressive disease that generally affects patients in the third through fifth decade of life, if left untreated. Currently, 18% of all Total Hip Arthroplasty performed in USA are done for Osteonecrosis.(1 The aetiology for the Osteonecrosis varies from idiopathic, alcohol intoxication, steroid abuse or due to childhood hip disorders and hip trauma. We have selected 40 patients suffering from advanced femoral head osteonecrosis with subchondral collapse leading to Osteoarthritis of hip in young adults, treated by uncemented primary total hip replacement. This study is aimed to suggest that uncemented total hip arthroplasty can be applied predictably to this younger, potentially more active patient population. MATERIAL AND METHODS We have done 54 uncemented primary hips in 40 cases with mean follow-up of 5.5 years. The average age of the patient at the time of surgery was 43 years. All the hips are clinically and radiologically examined both pre- and post-operatively. All the cases are operated through postero-lateral approach and have used the fully Hydroxyapatite coated femoral straight stem designed for press fit insertion and hemispherical HA-coated cup inserted with press fit and in few cases we used an HA-coated screw. The patients are under regular follow-up. RESULTS All the patients are reviewed at 6 weeks, 3 months, 6 months and yearly thereafter. The clinical and functional status was recorded using the Harris Hip Score and WOMAC Hip Score. The mean Harris score has improved from an average of 44 points to an average of 93 points postoperatively; 94% showed good-to-excellent results, 2% of cases had shortening, one case developed hip dislocation after two weeks due to unguarded physiotherapy. CONCLUSION The short-term results of cementless total hip arthroplasty in patients with Osteonecrosis of the femoral head were encouraging. We await further follow-up to see if these promising

  14. Hybrid SPECT/CT for the assessment of a painful hip after uncemented total hip arthroplasty

    OpenAIRE

    Dobrindt, Oliver; Amthauer, Holger; Krueger, Alexander; Ruf, Juri; Wissel, Heiko; Grosser, Oliver S.; Seidensticker, Max; Lohmann, Christoph H

    2015-01-01

    Background The diagnosis of hip pain after total hip replacement (THR) represents a highly challenging question that is of increasing concern to orthopedic surgeons. This retrospective study assesses bone scintigraphy with Hybrid SPECT/CT for the diagnosis of painful THR in a selected cohort of patients. Methods Bone SPECT/CT datasets of 23 patients (mean age 68.9 years) with a painful hip after THR were evaluated. Selection of the patients required an inconclusive radiograph, normal serum le...

  15. 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

    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......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...... 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....

  16. Copper Slag Blended Cement: An Environmental Sustainable Approach for Cement Industry in India

    Directory of Open Access Journals (Sweden)

    Jagmeet Singh

    2016-04-01

    Full Text Available Indian cement industry is facing environmental issue of emission of carbon dioxide (CO2, a greenhouse gas. Blended cements including supplementary cementitious materials are substitute of Portland cement to reduce CO2 emission. The present paper investigates theappropriateness of copper slag (CS as supplementary cementitious material. Strength properties and hydration of mixes were determined at different replacement levels of CS with cement. Compressive, flexural and tensile strength of each mix was found out at different curing periods. The hydration of cement was investigated through X-ray diffraction (XRD. The strength test results showed that substitution of up to 20% of CS can significantly replace Portland cement.XRD test results were corresponding to strength test results. The present study encourages the utilization of CS as supplementary cementitious material to make economical and environmentally sustainable blended cement

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

    International Nuclear Information System (INIS)

    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

  18. Alternative Fuels in Cement Production

    DEFF Research Database (Denmark)

    Larsen, Morten Boberg

    in particular is influenced by insufficient carbon burnout in the calciner system, which results in reducing conditions in the material inlet of the rotary kiln and consequently an increased tendency to form deposits induced by sticky eutectic melts. Clinker quality is mainly affected by minor components from...... a decisive influence on the fuel carbon burnout in cement kiln systems. The oxidation kinetics of a char from TDF was investigated experimentally and by mathematical modelling. Experiments were performed in a fixed bed reactor under well - iii - defined conditions, where small particles (102-212μm) of TDF...

  19. 时尚活力的Hip-hop

    Institute of Scientific and Technical Information of China (English)

    2008-01-01

    什么是Hip-hop Hip-hop起源于上世纪70年代中期的美国纽约,这个词语已经成为新生代族群的代名词。Hip-hop不是一个时代的热潮,它是一种感染了一代又一代的文化。总的来说Hip-hop是Hip-hop文化的统

  20. Changes in walking and running in patients with hip dysplasia

    OpenAIRE

    Jacobsen, Julie S; Nielsen, Dennis B; Sørensen, Henrik; Søballe, Kjeld; Mechlenburg, Inger

    2013-01-01

    Background and purpose Earlier studies have suggested that the hip extension angle and the hip flexor moment in walking are affected by hip dysplasia, but to our knowledge there have been no reports on running or evaluations of self-reported health. We evaluated differences in walking, running, and self-reported health between young adults with symptomatic hip dysplasia and healthy controls. Patients and methods Walking and running in 32 patients with hip dysplasia, mean 34 (18–53) years old,...

  1. A note on cement in asteroids

    Science.gov (United States)

    Bilalbegović, G.

    2016-09-01

    Cement mineral tobermorite was formed in hydrothermal experiments on alternation of calcium-aluminum-rich inclusions (CAIs) in carbonaceous chondrite meteorites. Unidentified bands at 14 μm were measured for CAIs and the matrix of the Allende meteorite sample, as well as for Hektor and Agamemnon asteroids. The presence of cement nanoparticles may explain the feature at 14 μm.

  2. Basic Chemistry for the Cement Industry.

    Science.gov (United States)

    Turner, Mason

    This combined student workbook and instructor's guide contains nine units for inplant classes on basic chemistry for employees in the cement industry. The nine units cover the following topics: chemical basics; measurement; history of cement; atoms; bonding and chemical formulas; solids, liquids, and gases; chemistry of Portland cement…

  3. Investigation of a Hardened Cement Paste Grout

    DEFF Research Database (Denmark)

    Esteves, Luis Pedro; Sørensen, Eigil Verner

    This report documents a series of tests performed on a hardened cement paste grout delivered by the client, Det Norske Veritas A/S.......This report documents a series of tests performed on a hardened cement paste grout delivered by the client, Det Norske Veritas A/S....

  4. A note on cement in asteroids

    CERN Document Server

    Bilalbegovic, G

    2016-01-01

    Cement mineral tobermorite was formed in hydrothermal experiments on alternation of calcium-aluminum-rich inclusions (CAIs) in carbonaceous chondrite meteorites. Unidentified bands at 14 microns were measured for CAIs and the matrix of the Allende meteorite sample, as well as for Hektor and Agamemnon asteroids. The presence of cement nanoparticles may explain the feature at 14 microns.

  5. Chloride ingress in cement paste and mortar

    DEFF Research Database (Denmark)

    Jensen, Ole Mejlhede; Hansen, Per Freiesleben; Coats, Alison M.;

    1999-01-01

    In this paper chloride ingress in cement paste and mortar is followed by electron probe microanalysis. The influence of several paste and exposure parameters on chloride ingress are examined (e.g., water-cement ratio, silica fume addition, exposure time, and temperature), The measurements...

  6. A Pause for China's Cement Industry

    Institute of Scientific and Technical Information of China (English)

    Li Zhen

    2009-01-01

    @@ Cement industry suffers excess productionWith the advent of global financial crisis,the Chinese government has laid out a stimulus package on infrastructure construction.Driven by the investment spree,China's cement makers are flocking to expand output capacity,which is now leading the industry into a much-higher-thanneeded state.

  7. Hip and ankle range of motion and hip muscle strength in young female ballet dancersand controls

    OpenAIRE

    Bennell, K; Khan, K. M.; Matthews, B.; De Gruyter, M.; Cook, E; Holzer, K; Wark, J D

    1999-01-01

    OBJECTIVES: To compare the hip and ankle range of motion and hip muscle strength in 8-11 year old novice female ballet dancers and controls. METHODS: Subjects were 77 dancers and 49 controls (mean (SD) age 9.6 (0.8) and 9.6 (0.7) years respectively). Supine right active hip external rotation (ER) and internal rotation (IR) were measured using an inclinometer. A turnout protractor was used to assess standing active turnout range. The measure of ER achieved from below the hip during turno...

  8. Energetically Modified Cement (EMC) - Performance Mechanism

    Energy Technology Data Exchange (ETDEWEB)

    Ronin, Vladimir; Elfgren, Lennart [Luleaa Univ. of Technology (Sweden). Centre for High Performance Cement

    2003-03-01

    Energetically Modified Cements, EMC, made of intensively milled cement (50%) and fillers (50%) of quartz or fly ash have been compared to blends of Ordinary Portland Cement, OPC, and fillers. The EMCs have better properties than other blends and are comparable to unblended OPC. This remarkable fact can probably be explained as follows. The grinding process reduces the size of both cement grains and fillers. This combined with the creation of micro defects gives the ground cement a very high degree of hydration. The increased early hydration and a better distribution of hydration products results in an extensive pore size refinement of the hardened binder. This pore size refinement leads to a favorably reduced permeability and diffusivity and very good mechanical properties.

  9. CO2 Capture by Cement Raw Meal

    DEFF Research Database (Denmark)

    Pathi, Sharat Kumar; Lin, Weigang; Illerup, Jytte Boll;

    2013-01-01

    The cement industry is one of the major sources of CO2 emissions and is likely to contribute to further increases in the near future. The carbonate looping process has the potential to capture CO2 emissions from the cement industry, in which raw meal for cement production could be used...... as the sorbent. Cyclic experiments were carried out in a TGA apparatus using industrial cement raw meal and synthetic raw meal as sorbents, with limestone as the reference. The results show that the CO2 capture capacities of the cement raw meal and the synthetic raw meal are comparable to those of pure limestone....... The CO2 capture capacity of limestone in the raw meal is lower than for pure limestone. The difference in the CO2 capture capacity decreases with an increase in cycle number. The calcination conditions and composition are major factors that influence the CO2 capture capacity of limestone. At 850 °C in N2...

  10. Conditioning of radioactive waste solutions by cementation

    International Nuclear Information System (INIS)

    For the cementation of the low and intermediate level evaporator concentrates resulting from the reprocessing of spent fuel numerous experiments were performed to optimize the waste form composition and to characterize the final waste form. Concerning the cementation process, properties of the waste/cement suspension were investigated. These investigations include the dependence of viscosity, bleeding, setting time and hydration heat from the waste cement slurry composition. For the characterization of the waste forms, the mechanical, thermal and chemical stability were determined. For special cases detailed investigations were performed to determine the activity release from waste packages under defined mechanical and thermal stresses. The investigations of the interaction of the waste forms with aqueous solutions include the determination of the Cs/Sr release, the corrosion resistance and the release of actinides. The Cs/Sr release was determined in dependence of the cement type, additives, setting time and sample size. (orig./DG)

  11. Microbial assisted High Impact Polystyrene (HIPS) degradation.

    Science.gov (United States)

    Mohan, Arya J; Sekhar, Vini C; Bhaskar, Thallada; Nampoothiri, K Madhavan

    2016-08-01

    The efficacy of newly isolated Pseudomonas and Bacillus strains to degrade brominated High Impact Polystyrene (HIPS) was investigated. Viability of these cultures while using e-plastic as sole carbon source was validated through Triphenyl Tetrazolium Chloride (TTC). Four days incubation of HIPS emulsion with Bacillus spp. showed 94% reduction in turbidity and was 97% with Pseudomonas spp. Confirmation of degradation was concluded by HPLC, NMR, FTIR, TGA and weight loss analysis. NMR spectra of the degraded film revealed the formation of aliphatic carbon chain with bromine and its release. FTIR analysis of the samples showed a reduction in CH, CO and CN groups. Surface changes in the brominated HIPS film was visualized through SEM analysis. Degradation with Bacillus spp showed a weight loss of 23% (w/w) of HIPS film in 30days.

  12. Hip-hop, Onegin - pop! / Tatjana Aleksandrova

    Index Scriptorium Estoniae

    Aleksandrova, Tatjana, 1945-

    2004-01-01

    Erateatrikooli KS, mida juhib Svetlana Krassman, lavastus A. Pushkini poeemi "Jevgeni Onegin" motiividel. Noortelavastuse muusikalises seades kasutatakse klassikalise muusika aranzheeringuid ja räppi, kostüümidraamat koos hip-hop rõivastiiliga

  13. Primary total hip arthroplasty for acetabular fracture

    Institute of Scientific and Technical Information of China (English)

    WANG Zi-ming; SUN Hong-zhen; WANG Ai-min; DU Quan-yin; WU Siyu; ZHAO Yu-feng; TANG Ying

    2006-01-01

    Objective: To explore the operative indications and operative methods of primary total hip arthroplasty for acetabular fracture and to observe the clinical curative effect.Methods: We retrospectively summarized and analyzed the traumatic conditions, fracture types, complications,operative time, operative techniques, and short-term curative effect of 11 patients( 10 males and 1 female, with a mean age of 42. 4 years ) with acetabular fracture who underwent primary total hip arthroplasty.Results: The patients were followed up for 6-45 months ( mean = 28 months). Their average Harris score of postoperative hip joint was 78.Conclusion: Under strict mastery of indications,patients with acetabular fracture may undergo primary total hip arthroplasty, but stable acetabular components should be made.

  14. Understanding and Treating the Snapping Hip.

    Science.gov (United States)

    Yen, Yi-Meng; Lewis, Cara L; Kim, Young-Jo

    2015-12-01

    Snapping hip, or coxa saltans is a palpable or auditory snapping with movement of the hip joint. Extra-articular snapping is divided into external and internal types, and is caused laterally by the iliotibial band and anteriorly by the iliopsoas tendon. Snapping of the iliopsoas usually requires contraction of the hip flexors and may be difficult to distinguish from intra-articular coxa saltans. Ultrasound can be a useful modality to dynamically detect tendon translation during hip movement to support the diagnosis of extra-articular snapping. Coxa saltans is typically treated with conservative measures including anti-inflammatories, stretching, and avoidance of inciting activities. Recalcitrant cases are treated with surgery to lengthen the iliopsoas or the iliotibial band. PMID:26524554

  15. Total Hip Replacement (Arthroplasty) (Beyond the Basics)

    Science.gov (United States)

    ... stiffening caused by extra bone formation, also called heterotopic ossification, is a process in which some soft ... replacement (prosthetic) parts, with the goal of relieving pain and improving function. ● Most patients require total hip ...

  16. Schizophrenia, antipsychotics and risk of hip fracture

    DEFF Research Database (Denmark)

    Sørensen, Holger J; Jensen, Signe O W; Nielsen, Jimmi

    2013-01-01

    In a nationwide study using linkage of Danish hospital registers we examined predictors of hip fracture (ICD-10: S72) in 15,431 patients with schizophrenia (ICD-10: F20 or ICD-8: 295) and 3,807,597 population controls. Shorter education, disability pension, lifetime alcohol abuse, somatic co-morb....... Preventive strategies should focus attention to severely ill patients with high likelihood of a receiving complex psychopharmacologic treatment and high doses of antipsychotics....... (matched to 1:3 to schizophrenia controls without hip fracture), antipsychotic polypharmacy predicted hip fracture. Analyses among antipsychotic monotherapy patients showed no differential effect of individual antipsychotics. A dose-response relationship of hip fracture and lifetime antipsychotics...

  17. Imaging findings in external snapping hip syndrome

    Energy Technology Data Exchange (ETDEWEB)

    Krishnamurthy, Ganesh; Connolly, Bairbre L. [The Hospital for Sick Children, Image Guided Therapy, Diagnostic Imaging, Toronto (Canada); Narayanan, Unni [The Hospital for Sick Children, Pediatric Orthopedic Surgery, Toronto (Canada); Babyn, Paul S. [The Hospital for Sick Children, Diagnostic Imaging, Toronto (Canada)

    2007-12-15

    We describe a case of external snapping hip diagnosed by dynamic sonography. The case prompted us to retrospectively review the imaging findings of children who clinically had presented with snapping hip. From this review we identified the features on MRI and CT of either thickening of the iliotibial band or thickening of the anterior edge of the gluteus maximus muscle as the cause of snapping and atrophy of the bulk of gluteus maximus muscle as an important secondary sign associated with snapping. (orig.)

  18. Painful Spastic Hip Dislocation: Proximal Femoral Resection

    OpenAIRE

    Albiñana, Javier; Gonzalez-Moran, Gaspar

    2002-01-01

    The dislocated hip in a non-ambulatory child with spastic paresis tends to be a painful interference to sleep, sitting upright, and perineal care. Proximal femoral resection-interposition arthroplasty is one method of treatment for this condition. We reviewed eight hips, two bilateral cases, with a mean follow-up of 30 months. Clinical improvement was observed in all except one case, with respect to pain relief and sitting tolerance. Some proximal migration was observed in three cases, despit...

  19. Osteoarthritis of the hip and acetabular dysplasia.

    OpenAIRE

    Croft, P.; Cooper, C.; Wickham, C; Coggon, D

    1991-01-01

    The relation between acetabular dysplasia and osteoarthritis of the hip was examined in a series of 1516 pelvic radiographs taken for non-skeletal indications. Osteoarthritis was assessed by measuring joint space, and dysplasia by the centre-edge angle and acetabular depth. In contrast with previous studies of patients with symptomatic osteoarthritis of the hip, no evidence that dysplasia predisposes to osteoarthritis was found. Possible reasons for the discrepancy are discussed. It was concl...

  20. Celiac Disease in Women with Hip Fractures

    Science.gov (United States)

    LeBoff, Meryl S.; Cobb, Haley; Gao, Lisa Y.; Hawkes, William; Yu-Yahiro, Janet; Kolatkar, Nikheel S.; Magaziner, Jay

    2014-01-01

    Objective Celiac disease is associated with decreased bone density, however, the risk of fractures in celiac disease patients is unclear. We compared the prevalence of celiac disease between a group of women with hip fractures and a group of women undergoing elective joint replacement surgery and the association between celiac disease and vitamin D levels. Methods Two hundred eight community dwelling and postmenopausal women were recruited from Boston, MA (n=81) and Baltimore, MD (n=127). We measured tissue transglutaminase IgA by ELISA to diagnose celiac disease and 25-hydroxyvitamin D (25(OH)D) levels by radioimmunoassay in both women with hip fractures (n=157) and the control group (n=51), all of whom were from Boston. Subjects were excluded if they took any medications or had medical conditions that might affect bone. Results Median serum 25(OH)D levels were significantly lower (p< 0.0001) in the hip fracture cohorts compared to the elective joint replacement cohort (14.1 ng/ml vs. 21.3 ng/ml, respectively). There were no differences in the percentage of subjects with a positive tissue transglutaminase in the women with hip fractures versus the control group (1.91% vs. 1.61%, respectively). Conclusion Vitamin D levels are markedly reduced in women with hip fractures, however hip fracture patients did not show a higher percentage of positive tissue transglutaminase levels compared with controls. These data suggest that routine testing for celiac disease among hip fracture patients may not prove useful, although larger prospective studies among hip fracture subjects are needed. PMID:23732553

  1. Epidemiology of hip fracture: Worldwide geographic variation

    Directory of Open Access Journals (Sweden)

    Dinesh K Dhanwal

    2011-01-01

    Full Text Available Osteoporosis is a major health problem, especially in elderly populations, and is associated with fragility fractures at the hip, spine, and wrist. Hip fracture contributes to both morbidity and mortality in the elderly. The demographics of world populations are set to change, with more elderly living in developing countries, and it has been estimated that by 2050 half of hip fractures will occur in Asia. This review conducted using the PubMed database describes the incidence of hip fracture in different regions of the world and discusses the possible causes of this wide geographic variation. The analysis of data from different studies show a wide geographic variation across the world, with higher hip fracture incidence reported from industrialized countries as compared to developing countries. The highest hip fracture rates are seen in North Europe and the US and lowest in Latin America and Africa. Asian countries such as Kuwait, Iran, China, and Hong Kong show intermediate hip fracture rates. There is also a north-south gradient seen in European studies, and more fractures are seen in the north of the US than in the south. The factors responsible of this variation are population demographics (with more elderly living in countries with higher incidence rates and the influence of ethnicity, latitude, and environmental factors. The understanding of this changing geographic variation will help policy makers to develop strategies to reduce the burden of hip fractures in developing countries such as India, which will face the brunt of this problem over the coming decades.

  2. Neurofibromatosis induced hip arthritis. An unusual presentation

    OpenAIRE

    Alrumaih, Husam; Ilyas, Imran; Kashif, Syed

    2014-01-01

    Patient: Male, 43 Final Diagnosis: Neurofibromatosis Symptoms: Hip pain Medication: — Clinical Procedure: — Specialty: Orthopedics and Traumatology Objective: Rare disease Background: Neurofibromatosis type 1 is a disease known for orthopedic manifestations such as spine deformities, congenital pseudarthrosis of the tibia and other bony dysplasias; joint dislocations are rare. Joint arthritis caused by neurofibromatosis, with a stable hip, has never been reported in the English literature bef...

  3. Cements with low Clinker Content

    Science.gov (United States)

    García-Lodeiro, I.; Fernández-Jiménez, A.; Palomo, A.

    2015-11-01

    Hybrid alkaline cements are multi-component systems containing a high percentage of mineral additions (fly ash, blast furnace slag), low proportions (alkaline activators. The substantially lower amount of clinker needed to manufacture these binders in comparison to ordinary Portland cement is both economically and ecologically beneficial. Their enormous versatility in terms of the raw materials used has made them the object of considerable interest. The present study explored the mechanical strength of binary blends mixes; B1= 20% clinker (CK) + 80% fly ash (FA) and B2=20% clinker + 80% blast furnace slag (BFS), both hydrated in the presence and absence of an alkaline activator specifically designed for this purpose. The use of the activator enhanced the development of early age strength considerably. All the hydrated matrices were characterised with XRD, SEM/EDX and (29Si and 27Al) NMR. The use of the alkaline activator generated reaction products consisting primarily of a mix of gels ((N,C)-A-S-H and C-A-S-H) whose respective proportions were found to depend upon system composition and initial reactivity.

  4. ROTARY SCREW SYSTEMS IN CEMENT

    Directory of Open Access Journals (Sweden)

    Taratuta V. D.

    2016-01-01

    Full Text Available The article presents results of research of rotary-screw systems in relation to the creation of rotary kilns for the annealing of-cuttings in the preparation of cement clinker. Using the proposed design, in comparison with known designs of similar purpose, it significantly improves performance, reduces size and power consumption through the use of rotary screw systems in the form of screw rotors and drums made hollow with sidewalls assembled from separate strips or plates of different geometrical shapes with form inside the screw breaks or smooth edges, screw surfaces and screw grooves. It is shown that the housing of the rotary kiln is expedient to produce helical surfaces whose centers of curvature are located within the housing. Using the proposed constructions rotary kiln during the firing when preparing cement wedge can increase the speed of rotation of the housing, furnaces 5-10 times due to changes in the rotary-screw systems increase efficiency and reduce the size of furnaces

  5. Pack cementation coatings for alloys

    Energy Technology Data Exchange (ETDEWEB)

    He, Yi-Rong; Zheng, Minhui; Rapp, R.A. [Ohio State Univ., Columbus, OH (United States)

    1996-08-01

    The halide-activated pack cementation process was modified to produce a Ge-doped silicide diffusion coating on a Cr-Cr{sub 2}Nb alloy in a single processing step. The morphology and composition of the coating depended both on the composition of the pack and on the composition and microstructure of the substrate. Higher Ge content in the pack suppressed the formation of CrSi{sub 2} and reduced the growth kinetics of the coating. Ge was not homogeneously distributed in the coatings. In cyclic and isothermal oxidation in air at 700 and 1050{degrees}C, the Ge-doped silicide coating protected the Cr-Nb alloys from significant oxidation by the formation of a Ge-doped silica film. The codeposition and diffusion of aluminum and chromium into low alloy steel have been achieved using elemental Al and Cr powders and a two-step pack cementation process. Sequential process treatments at 925{degrees}C and 1150{degrees}C yield dense and uniform ferrite coatings, whose compositions are close to either Fe{sub 3}Al or else FeAl plus a lower Cr content, when processed under different conditions. The higher content of Al in the coatings was predicted by thermodynamic calculations of equilibrium in the gas phase. The effect of the particle size of the metal powders on the surface composition of the coating has been studied for various combinations of Al and Cr powders.

  6. Hip adductors' strength, flexibility, and injury risk.

    Science.gov (United States)

    Hrysomallis, Con

    2009-08-01

    The hip adductor muscle group plays an important role in both movement and stability at the hip joint in many athletic pursuits. Injury to this muscle group has been reported in a number of sports, among them, ice hockey, soccer, Australian football, and swimming. The identification of muscle characteristics that predispose a muscle to injury is an important step in developing conditioning programs to reduce injury risk. Muscle strength and range of motion are 2 parameters that may influence injury risk. The aim of this review was to examine the relationship between hip adductors' strength, flexibility, and injury risk. Strength testing has involved isokinetic or hand-held dynamometry. Flexibility has usually been assessed by goniometry during maximal hip abduction. An association has been reported between adductor strength deficits and injury for ice hockey players. Low adductor flexibility has also been identified as a risk factor for injury in soccer players. An intervention program that strengthened the hip adductors had some success in reducing injury risk for ice hockey players. There is some low- to moderate-level evidence from cohort studies to suggest that flexibility and strength are related to injury risk in particular sports and that an intervention program may be effective in reducing injury risk. Higher level evidence from randomized controlled trials is required to firmly establish the link between hip adductor flexibility, strength, and injury. PMID:19620912

  7. Extraoral Cementation Technique to Minimize Cement-Associated Peri-implant Marginal Bone Loss: Can a Thin Layer of Zinc Oxide Cement Provide Sufficient Retention?

    Science.gov (United States)

    Frisch, Eberhard; Ratka-Krüger, Petra; Weigl, Paul; Woelber, Johan

    2016-01-01

    This report describes the use of laboratory-fabricated crown intaglio replicas for extraorally prepared cementation of fixed restorations to implants. This technique minimizes excess cement and may therefore reduce the risk of cement-related marginal peri-implant bone loss. It is unclear whether the remaining thin layer of luting agent provides sufficient retention if low-adhesive zinc oxide (ZnO) cement is used. In 85 consecutive patients, 113 single crowns were cemented to implants using extraoral cementation technique (ECT) and ZnO cement. All patients were followed for 6 months and investigated for decementation. Seven events of decementation (incidence: 6.19%) were found in 7 patients (8.24%). ECT may represent a viable cementation technique for implant-supported single crowns, even using low-adhesion cements. PMID:27479343

  8. Hip Reconstruction Osteotomy by Ilizarov Method as a Salvage Option for Abnormal Hip Joints

    Directory of Open Access Journals (Sweden)

    Masood Umer

    2014-01-01

    Full Text Available Hip joint instability can be secondary to congenital hip pathologies like developmental dysplasia (DDH or acquired such as sequel of infective or neoplastic process. An unstable hip is usually associated with loss of bone from the proximal femur, proximal migration of the femur, lower-extremity length discrepancy, abnormal gait, and pain. In this case series of 37 patients coming to our institution between May 2005 and December 2011, we report our results in treatment of unstable hip joint by hip reconstruction osteotomy using the Ilizarov method and apparatus. This includes an acute valgus and extension osteotomy of the proximal femur combined with gradual varus and distraction (if required for realignment and lengthening at a second, more distal, femoral osteotomy. 18 males and 19 females participated in the study. There were 17 patients with DDH, 12 with sequelae of septic arthritis, 2 with tuberculous arthritis, 4 with posttraumatic arthritis, and 2 with focal proximal femoral deficiency. Outcomes were evaluated by using Harris Hip Scoring system. At the mean follow-up of 37 months, Harris Hip Score had significantly improved in all patients. To conclude, illizarov hip reconstruction can successfully improve Trendelenburg’s gait. It supports the pelvis and simultaneously restores knee alignment and corrects lower-extremity length discrepancy (LLD.

  9. HIP HOP for HIV Awareness: Using Hip Hop Culture to Promote Community-Level HIV Prevention

    Science.gov (United States)

    Hill, Mandy J.; Hallmark, Camden J.; McNeese, Marlene; Blue, Nike; Ross, Michael W.

    2014-01-01

    The goal of this paper was to determine the effectiveness of the HIP HOP for HIV Awareness intervention, an innovative model utilising an exchange of an HIV test for a hip hop concert ticket, in a metropolitan city among African American youth and young adults. A subset of intervention participants participated in standardised testing, sex…

  10. 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

    .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...

  11. Do hip prosthesis related infection codes in administrative discharge registers correctly classify periprosthetic hip joint infection?

    DEFF Research Database (Denmark)

    Lange, Jeppe; Pedersen, Alma B; Troelsen, Anders;

    2015-01-01

    ) periprosthetic hip joint infection diagnosis code in the Danish National Patient Register. METHODS: Patients were identified with an ICD-10 discharge diagnosis code of T84.5 ("Infection and inflammatory reaction due to internal joint prosthesis") in association with hip-joint associated surgical procedure codes...

  12. 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

  13. Hip reconstruction osteotomy by Ilizarov method as a salvage option for abnormal hip joints.

    Science.gov (United States)

    Umer, Masood; Rashid, Haroon; Umer, Hafiz Muhammad; Raza, Hasnain

    2014-01-01

    Hip joint instability can be secondary to congenital hip pathologies like developmental dysplasia (DDH) or acquired such as sequel of infective or neoplastic process. An unstable hip is usually associated with loss of bone from the proximal femur, proximal migration of the femur, lower-extremity length discrepancy, abnormal gait, and pain. In this case series of 37 patients coming to our institution between May 2005 and December 2011, we report our results in treatment of unstable hip joint by hip reconstruction osteotomy using the Ilizarov method and apparatus. This includes an acute valgus and extension osteotomy of the proximal femur combined with gradual varus and distraction (if required) for realignment and lengthening at a second, more distal, femoral osteotomy. 18 males and 19 females participated in the study. There were 17 patients with DDH, 12 with sequelae of septic arthritis, 2 with tuberculous arthritis, 4 with posttraumatic arthritis, and 2 with focal proximal femoral deficiency. Outcomes were evaluated by using Harris Hip Scoring system. At the mean follow-up of 37 months, Harris Hip Score had significantly improved in all patients. To conclude, illizarov hip reconstruction can successfully improve Trendelenburg's gait. It supports the pelvis and simultaneously restores knee alignment and corrects lower-extremity length discrepancy (LLD). PMID:24895616

  14. Dermatoses in cement workers in southern Taiwan.

    Science.gov (United States)

    Guo, Y L; Wang, B J; Yeh, K C; Wang, J C; Kao, H H; Wang, M T; Shih, H C; Chen, C J

    1999-01-01

    Construction workers are known to have occupational dermatoses. The prevalence of such dermatoses was unknown in Taiwanese construction workers. The objective of this study was to determine the work exposure, prevalence of skin manifestations, and sensitivity to common contact allergens in cement workers of southern Taiwan. A total of 1147 current regular cement workers were telephone-interviewed about skin problems during the past 12 months, work exposure, and personal protection. Among those interviewed, 166 were examined and patch tested with common contact allergens. A high % of cement workers reported skin problems in the past 12 months. More men (13.9%) reported skin problems possibly related to work than women (5.4%). Prevalence was associated with lower use of gloves, duration of work as cement worker, and more time in jobs involving direct manual handling of cement, especially tiling. A high % of dermatitis was noted in the 166 workers examined, which correlated with reported skin problems. On patch testing, construction workers had a high frequency of sensitivity to chromate. Sensitivity to chromate or cobalt was associated with reported skin problems, or dorsal hand dermatitis on examination. These workers' dermatitis was under-diagnosed and inadequately managed. It is concluded that cement workers in southern Taiwan had a high prevalence of skin problems related to cement use. Protective measures, work practice, and physician education should be improved to prevent or manage such problems.

  15. Effect of cements on fracture resistance of monolithic zirconia crowns

    OpenAIRE

    Nakamura, Keisuke; Mouhat, Mathieu; Nergård, John Magnus; Lægreid, Solveig Jenssen; Kanno, Taro; Milleding, Percy; Örtengren, Ulf

    2016-01-01

    Abstract Objectives The present study investigated the effect of cements on fracture resistance of monolithic zirconia crowns in relation to their compressive strength. Materials and methods Four different cements were tested: zinc phosphate cement (ZPC), glass-ionomer cement (GIC), self-adhesive resin-based cement (SRC) and resin-based cement (RC). RC was used in both dual cure mode (RC-D) and chemical cure mode (RC-C). First, the compressive strength of each cement was tested according to a...

  16. Laboratory studies on the longevity of cement grouts

    International Nuclear Information System (INIS)

    This paper describes laboratory studies of the longevity of cement-based grouts being carried out as part of the International Stripa Project Phase III. The longevity properties determined for a reference grout (90% Sulphate Resistant Portland Cement, 10% silica fume, 0.4< water/cement<0.6 and superplasticizer) are compared with those of a slag cement grout. Laboratory tests have been carried out to determine the following: the mechanistic function of superplasticizer in fresh cement pastes; the leachability of the sorbed superplasticizer and its location in the structure of hardened cement paste; and the general leaching properties of selected cement-based grouts

  17. ELIGIBILITY FOR THE HIP-RESURFACING ARTHROPLASTY PROCEDURE: AN EVALUATION ON 592 HIPS

    Science.gov (United States)

    Queiroz, Roberto Dantas; Faria, Rafael Salomon Silva; Duarte, David Marcelo; Takano, Marcelo Itiro; Sugiyama, Mauricio Morita

    2015-01-01

    Objective: To investigate the percentage of ideal patients who would be eligible for hip-resurfacing surgery at a reference service for hip arthroplasty. Methods: Out of all the cases of hip arthroplasty operated at Hospital do Servidor Público Estadual de São Paulo (HSPE) between January 2009 and December 2010, we assessed a total of 592 procedures that would fit the criteria for indication for resurfacing arthroplasty, after clinical and radiological evaluation according to the criteria established by the Food and Drug Administration (FDA) and by Seyler et al. Results: Among the total number of hip replacement arthroplasty cases, 5.74% of the patients were eligible. Among the patients who underwent primary arthroplasty, we found that 8.23% presented ideal conditions for this procedure. Conclusion: The study demonstrated that this type of surgery still has a limited role among hip surgery methods. PMID:27047851

  18. Arthroscopic intervention in early hip disease.

    Science.gov (United States)

    McCarthy, Joseph C; Lee, Jo-Ann

    2004-12-01

    Advancement in diagnostic and therapeutic applications for hip arthroscopy have dispelled previous myths about early hip disease. Arthroscopic findings have established the following facts: Acetabular labral tears do occur; acetabular chondral lesions do exist; tears are most frequently anterior and often associated with sudden twisting or pivoting motions; and labral tears often occur in association with articular cartilage lesions of the adjacent acetabulum or femoral head, and if present for years, contribute to the progression of delamination process of the chondral cartilage. Magnetic resonance arthrography represents an improvement over conventional magnetic resonance imaging, it does have limitations when compared with direct observation. Although indications for hip arthroscopy are constantly expanding, the most common indications include: labral tears, loose bodies, chondral flap lesions of the acetabular or femoral head, synovial chondromatosis, foreign body removal, and crystalline hip arthropathy (gout, pseudogout, and others). Contraindications include conditions that limit the potential for hip distraction such as joint ankylosis, dense heterotopic bone formation, considerable protrusio, or morbid obesity. Complication rates have been reported between 0.5 and 5%, most often related to distraction and include sciatic or femoral nerve palsy, avascular necrosis, and compartment syndrome. Transient peroneal or pudendal nerve effects and chondral scuffing have been associated with difficult or prolonged distraction. Meticulous consideration to patient positioning, distraction time and portal placement are essential. Judicious patient selection and diagnostic expertise are critical to successful outcomes. Candidates for hip arthroscopy should include only those patients with mechanical symptoms (catching, locking, or buckling) that have failed to respond to conservative therapy. The extent of articular cartilage involvement has the most direct relationship

  19. Synthesis of pure Portland cement phases

    DEFF Research Database (Denmark)

    Wesselsky, Andreas; Jensen, Ole Mejlhede

    2009-01-01

    Pure phases commonly found in Portland cement clinkers are often used to test cement hydration behaviour in simplified experimental conditions. The synthesis of these phases is covered in this paper, starting with a description of phase relations and possible polymorphs of the four main phases...... in Portland cement, i.e. tricalcium silicate, dicalcium silicate, tricalcium aluminate and tetracalcium alumino ferrite. Details of the The process of solid state synthesis are is described in general including practical advice on equipment and techniques. Finally In addition, some exemplary mix compositions...

  20. Silica Transport and Cementation in Quartz Aggregates

    Science.gov (United States)

    Pebble, C.; Farver, J.; Onasch, C.; Winslow, D.

    2008-12-01

    Silica transport and cementation in quartz aggregates have been experimentally investigated. Starting materials include a natural quartz arenite (Pocono sandstone), sized clasts of synthetic quartz, and sized grains of disaggregated natural sandstones. Experimental charges consisted of amorphous silica powder (~25 mg), AlCl3 powder (~3 mg), 25 wt% NaCl brine solution (~20 mg), and the starting material (~150 mg). The charges were weld-sealed in gold capsules and run in cold-seal pressure vessels at 300°C to 600°C at 150 MPa confining pressure for up to 4 weeks. Detailed calibrations of the furnaces indicate the maximum temperature variation across the length of the sample charges (3-7mm) was vacuum impregnated with epoxy containing a blue dye and sawn in half along the long axis of the sample charge. The nature and amount of silica transport and cementation in the samples was determined by a combination of Cathodoluminescence (CL), Light Microscopy (LM), and Scanning Electron Microscopy (SEM). Photomosaics of the samples were collected and the amount of cement, porosity, and average grain sizes were determined by point-counting. The cement was easily recognized from the quartz grains by the difference in luminescence. The experiments indicate that the presence of amorphous silica results in rapid silica cementation in quartz aggregates (e.g., up to 12% cement by volume in 4 weeks at 450°C). The amount of cementation is a function of substrate type, time, temperature, and ionic strength of the brine. The rate of silica transport through the length of the experimental charge appears to be limited by the silica solubility and its rapid depletion by cementation. Although most of the cement was derived from the amorphous silica, evidence for local dissolution-precipitation was observed. The experiments demonstrate that the mobility of silica, and consequent precipitation of cement, does not require a temperature or pressure gradient as is commonly assumed. Rather

  1. INFLUENCE OF GLASS CULLET IN CEMENT PASTES

    Institute of Scientific and Technical Information of China (English)

    A.Karamberi; E.Chaniotakis; D.Papageorgiou; A.Moutsatsou

    2006-01-01

    The present study investigates glass and cement compatibility with a view to use glass as a cement replacement. Amber, flint and green glasses were chosen due to their prevalence in the Greek market as packaging materials. The factors under investigation were the pozzolanicity of the glass cullet, the hydration rate and the mechanical strength development of the cement pastes, as well as the expansion of the specimens due to alkali-silica reaction.Moreover, the potential enhancement of glass pozzolanic activity was examined. The results of the study were encouraging to show the potentiality of utilising glass cullet in cementitious products.

  2. Reinforcement of osteosynthesis screws with brushite cement.

    Science.gov (United States)

    Van Landuyt, P; Peter, B; Beluze, L; Lemaître, J

    1999-08-01

    The fixation of osteosynthesis screws remains a severe problem for fracture repair among osteoporotic patients. Polymethyl-methacrylate (PMMA) is routinely used to improve screw fixation, but this material has well-known drawbacks such as monomer toxicity, exothermic polymerization, and nonresorbability. Calcium phosphate cements have been developed for several years. Among these new bone substitution materials, brushite cements have the advantage of being injectable and resorbable. The aim of this study is to assess the reinforcement of osteosynthesis screws with brushite cement. Polyurethane foams, whose density is close to that of cancellous bone, were used as bone model. A hole was tapped in a foam sample, then brushite cement was injected. Trabecular osteosynthesis screws were inserted. After 24 h of aging in water, the stripping force was measured by a pull-out test. Screws (4.0 and 6.5 mm diameter) and two foam densities (0.14 and 0.28 g/cm3) were compared. Cements with varying solid/liquid ratios and xanthan contents were used in order to obtain the best screw reinforcement. During the pull-out test, the stripping force first increases to a maximum, then drops to a steady-state value until complete screw extraction. Both maximum force and plateau value increase drastically in the presence of cement. The highest stripping force is observed for 6.5-mm screws reinforced with cement in low-density foams. In this case, the stripping force is multiplied by 3.3 in the presence of cement. In a second experiment, cements with solid/liquid ratio ranging from 2.0 to 3.5 g/mL were used with 6.5-mm diameter screws. In some compositions, xanthan was added to improve injectability. The best results were obtained with 2.5 g/mL cement containing xanthan and with 3.0 g/mL cements without xanthan. A 0.9-kN maximal stripping force was observed with nonreinforced screws, while 1.9 kN was reached with reinforced screws. These first results are very promising regarding screw

  3. Operating experience with KRAFTWERK UNION cementation line

    International Nuclear Information System (INIS)

    A facility is described designed for fixation in a cement matrix of the radioactive concentrate produced by thickening waste water from the Bohunice nuclear power plant. The cementation line output is 0.6 m3 concentrate/h. The concentrate is put in 200 l drums. The individual operating units, cement management, air conditioning, dosimetric monitoring and the building part are described. The requirements for the operators and the assessment of the quality of raw materials and the product are discussed. (M.D.). 3 figs., 4 refs

  4. RAZVOJ OBLAČIL V HIP HOP KULTURI

    OpenAIRE

    Marić, Sanja

    2010-01-01

    V diplomskem delu smo raziskovali, kako so se hip hop oblačila razvijala skozi obdobja v hip hop kulturi. V teoretičnem deli smo ugotavljali ozadje in dejavnike, ki so vplivali na razvoj hip hop kulture, v empiričnem delu diplomske naloge pa smo izvedli anketni vprašalnik z glavnimi akterji hip hop kulture na slovenski hip hop sceni. Rezultati, ki smo jih dobili, kažejo da so imela oblačila velik vpliv na prepoznavnost in razvoj hip hop kulture po celem svetu. K temu so največ pripomogli ustv...

  5. Magnetic resonance imaging of hip joint cartilage and labrum

    Directory of Open Access Journals (Sweden)

    Christoph Zilkens

    2011-09-01

    Full Text Available Hip joint instability and impingement are the most common biomechanical risk factors that put the hip joint at risk to develop premature osteoarthritis. Several surgical procedures like periacetabular osteotomy for hip dysplasia or hip arthroscopy or safe surgical hip dislocation for femoroacetabular impingement aim at restoring the hip anatomy. However, the success of joint preserving surgical procedures is limited by the amount of pre-existing cartilage damage. Biochemically sensitive MRI techniques like delayed Gadolinium Enhanced MRI of Cartilage (dGEMRIC might help to monitor the effect of surgical or non-surgical procedures in the effort to halt or even reverse joint damage.

  6. Arthroscopic management of an intraarticular osteochondroma of the hip

    Directory of Open Access Journals (Sweden)

    Brian T. Feeley

    2009-04-01

    Full Text Available The role of hip arthroscopy in the management of femoroacetabular impingement (FAI has been advancing rapidly. In this case report, we describe the use of hip arthroscopy to successfully treat a femoral neck osteochondroma that caused a symptomatic labral tear in a 37 year old woman. Hip arthroscopy offers several advantages to surgical dislocation of the hip in the management of intra articular pathology and FAI. Hip arthroscopy is minimally invasive without the significant trauma to hip musculature, is useful in treatment of labral tears generated by FAI, and can be used to resect small lesions on the femoral head.

  7. Thermal behavior of asphalt cements

    International Nuclear Information System (INIS)

    Asphalt cements are highly complex mixtures of hydrocarbon molecules whose thermal behavior is of prime importance for petroleum and road industry. From DSC, the determination of several thermal properties of asphalts is given, e.g. glass-transition temperature and crystallized fraction content.The dissolution of a pure n-paraffin CnH2n+2 in an asphalt, as seen by DSC, should be a single peak. For 20g of these glasses change with time and temperature. The formation of the crystallized phases is superposed to the enthalpic relaxation of the glasses, making a kinetic study very difficult. (Copyright (c) 1998 Elsevier Science B.V., Amsterdam. All rights reserved.)

  8. Ability of lower teardrop edge to restore anatomical hip center height in total hip arthroplasty

    Institute of Scientific and Technical Information of China (English)

    Lu Yufeng; Cheng Liming; Guo Wanshou; Yu Qingsheng; Gao Fuqiang; Zhang Qidong; Liu Zhaohui

    2014-01-01

    Background The acetabular teardrop is often used to guide acetabular component placement in total hip arthroplasty (THA).Placing the lower acetabular component aspect at the same level as the lower teardrop edge was assumed to restore the hip center of rotation.Here we radiographically analyzed the relationship between cup center and normal contralateral acetabulum center height on unilateral THA using this placement method.Methods A total of 106 unilateral THA cases with normal contralateral acetabula were reviewed and the vertical and horizontal distances in relation to the lower acetabular teardrop edge from both hip joint centers,cup inclination,and anteversion were measured radiographically.The paired t-test was used to compare left and right hip center heights.Scatter plots and Pearson's correlation coefficients were used to evaluate differences in hip center heights,cup anteversion,inclination angles,and medialized cup center distance compared to the contralateral hip joint.Results Cup center height was significantly greater (P <0.01) than contralateral hip joint center height (93.4% in the 0-5 mm range,6.6% >5 mm).There was a weak correlation between hip center height difference and inclination (r=0.376,P <0.01) and between difference and anteversion (r=0.310,P <0.01) but no correlation between difference and outer cup diameter (r=0.184,P=0.058) or difference and medialized cup center distance (r=-0.098,P=0.318).Conclusions Although this method did not exactly replicate anatomic hip center height,the clinical significance of cup center height and anatomic hip center height differences is negligible.This acetabular component placement method has high simplicity,reliability,and stability.

  9. Preliminary study using pulsating water jet for bone cement demolition

    OpenAIRE

    S. Hloch; Kloc, J.; Foldyna, J.; Pude, F.; Smolko, I.; M. Zeleňák; Sitek, L. (Libor); Hvizdoš, P.; Monka, P.; Monková, K.; Kozak, D.; A. Stoić; A. Sedmak; Milosevic, M; Lehocká, D.

    2015-01-01

    The paper deals with the study of using the selective property of ultrasonic pulsating water jet for the disintegration of bone cement which creates the interface between femoral stem and trabecular bone tissue. For investigation, commercial bone cements were used. Bone cements were tested by nanoindentation in order to review their mechanical properties. A representative sample Palacos R+G was selected for disintegration of bone cement. Bone cements samples fixed between two plexiglass...

  10. ANALYSIS OF UNCERTAINTIES IN CEMENT INDUSTRY IN TURKEY

    OpenAIRE

    Kemal Yildirim; Omer Arioz

    2013-01-01

    Cement industry having 4,5 billion Dollars revenue and 1 billion Dollar export volume plays very important role in Turkey’s economy. Turkish cement industry is very sensitive to economic crisis and involves many uncertainties. In this study, price uncertainties, technological uncertainties, and price-technological uncertainties in Turkish cement industry were analyzed. The cement demand is mostly affected by demand to ready mixed concrete. Demand to cement is also related to the picture of co...

  11. Composite cements containing natural pozzolan and granulated blast furnace slag

    OpenAIRE

    Irassar, E. F.; Rahhal, V. F.; Donza, H. A.; Menéndez, G.; Bonavetti, V. L.

    2006-01-01

    For reasons of market demand and Portland cement production,the manufacture of cements with two or more separately ground additions to produce customized cements is becoming common practice.When pozzolan or slag content in this type of cements is high, however, the initial strength of the resulting product may be adversely impacted. This problem can be minimized by activating one or both of the replacement materials. The present study analyzes the effect of Portland cement additions such as p...

  12. Effect of Abutment Modification and Cement Type on Retention of Cement-Retained Implant Supported Crowns

    OpenAIRE

    Mitra Farzin; Kianoosh Torabi; Ahmad Hasan Ahangari; Reza Derafshi

    2014-01-01

    Objective: Provisional cements are commonly used to facilitate retrievability of cement-retained fixed implant restorations; but compromised abutment preparation may affect the retention of implant-retained crowns.The purpose of this study was to investigate the effect of abutment design and type of luting agent on the retentive strength of cement-retained implant restorations. Materials and Method: Two prefabricated abutments were attached to their corresponding analogs and embedded in an ac...

  13. Slagment Cement Improve the Cement Resistance Toward Acids Attack During Acidizing Treatment

    Directory of Open Access Journals (Sweden)

    Nik Khairul Irfan Bin Nik Ab. Lah.

    2013-05-01

    Full Text Available Acidizing treatment in past experience shows several zonal isolation problems after the treatment. This study presents the effect of the acid treatment toward class G cement and slagment cement as the improvement method to improve the cement resistance toward the acid. Lab experiments were conducted by immerge the respective cement cubes into 12% HCl/3% HF solution for 40 min before several analysis were conducted. Based on the result, the mass loss and compressive strength loss of the cement cubes decrease as the curing temperature and pressure increase due to more evenly distributed cement chemical composition crystal in high curing condition as shown in Scanning Electron Microscopy (SEM analysis. From X-Ray Diffraction (XRD and X-Ray Fluorescence (XRF analysis, only the first layer of the cement cubes shows chemical component change due to the reaction between the acid. This study found that, replacing class G cement to slagment cement can reduce the mass loss and compressive strength loss up to 72% and 82%, respectively.

  14. Exposure to cement dust at a Portland cement factory and the risk of cancer.

    OpenAIRE

    Vestbo, J; Knudsen, K.M.; Raffn, E; Korsgaard, B; Rasmussen, F V

    1991-01-01

    The relation between exposure to cement dust and cancer was examined in a population of 546 cement workers and a reference population of 858 randomly sampled men of similar age and area of residence. In 1974 all men gave lifelong occupational and smoking histories; information on incidence of cancer in the period 1974-85 was obtained from the Danish Cancer Registry. No increased risk of overall cancer was found among cement workers. Among men with more than 20 years exposure to cement dust, 1...

  15. INFLUENCE OF WINE ACID ON RHEOLOGICAL PROPERTIES OF WELL BORE CEMENT SLURRIES AND HARDENED CEMENT PROPERTIES

    Directory of Open Access Journals (Sweden)

    Nediljka Gaurina-Međimurec

    1989-12-01

    Full Text Available Adaptation of commercial types of domestic cements for use in cementing the deep wells is a process by which Yugoslav oil industry tends to solve problems of completion of those wells independently. In order to design a domestic, cheep and effective retarder, tests of applicability of wine acid on cement slurries have been carried out. Besides examining the necessary wine acid content to achieve desirable Theological properties, the influence of this additive on properties of hardened cement samples has been tested too (the paper is published in Croatian.

  16. Wear Performance of Ceramic-On-Metal Hip Bearings

    OpenAIRE

    Jörn Reinders; Robert Sonntag; Christian Heisel; Tobias Reiner; Leo Vot; Jan Philippe Kretzer

    2013-01-01

    Ceramic-on-metal (CoM) bearings are considered to be a promising alternative to polyethylene-based bearings or hard-on-hard bearings (Ceramic-on-Ceramic (CoC) and Metal-on-Metal (MoM)). Although, CoM shows lower wear rates than MoM, in-vitro wear testing of CoM shows widely varying results. This may be related to limitations of wear-measuring methods. Therefore, the aim of this study was to improve the gravimetric measurement technique and to test wear behaviour of CoM bearings compared to Co...

  17. Peri-acetabular bone mineral density in total hip replacement

    OpenAIRE

    Gauthier, L.(University of Illinois at Chicago (UIC), Chicago, USA); Dinh, L.; Beaulé, P. E.

    2013-01-01

    Objectives To quantify and compare peri-acetabular bone mineral density (BMD) between a monoblock acetabular component using a metal-on-metal (MoM) bearing and a modular titanium shell with a polyethylene (PE) insert. The secondary outcome was to measure patient-reported clinical function. Methods A total of 50 patients (25 per group) were randomised to MoM or metal-on-polyethlene (MoP). There were 27 women (11 MoM) and 23 men (14 MoM) with a mean age of 61.6 years (47.7 to 73.2). Measurement...

  18. Radiographic appearance of commonly used cements in implant dentistry.

    Science.gov (United States)

    Pette, Gregory A; Ganeles, Jeffrey; Norkin, Frederic J

    2013-01-01

    Cement-retained restorations allow for a conventional fixed partial denture approach to restoring dental implants. However, inadequate removal of excess cement at the time of cementation may introduce a severe complication: cement-induced peri-implantitis. Radiopaque cements are more easily detected on radiographs and should improve the recognition of extravasated cement at the time of insertion. The purpose of this study was to evaluate the radiopacity of commercially available cements in vitro. Eighteen different cements commonly used for luting restorations to implants were tested at both 0.5- and 1.0-mm thicknesses. The cements examined were zinc oxide eugenol, zinc oxide, zinc polycarboxylate, zinc phosphate, resin-reinforced glass ionomer, urethane resin, resin, and composite resin. Two samples of each cement thickness underwent standardized radiography next to an aluminum step wedge as a reference. The mean grayscale value of each of the nine 1-mm steps in the step wedge were used as reference values and compared to each of the cement samples. Temp Bond Clear (resin), IMProv (urethane resin), Premier Implant Cement (resin), and Temrex NE (resin) were not radiographically detectable at either sample thickness. Cements containing zinc were the most detectable upon radiographic analysis. There are significant differences in the radiopacity of many commonly used cements. Since cementinduced peri-implantitis can lead to late implant failure, cements that can be visualized radiographically may reduce the incidence of this problem.

  19. Instrumented hip implants: electric supply systems.

    Science.gov (United States)

    Soares dos Santos, Marco P; Ferreira, Jorge A F; Ramos, A; Simões, José A O; Morais, Raul; Silva, Nuno M; Santos, Paulo M; Reis, M J C S; Oliveira, T

    2013-10-18

    Instrumented hip implants were proposed as a method to monitor and predict the biomechanical and thermal environment surrounding such implants. Nowadays, they are being developed as active implants with the ability to prevent failures by loosening. The generation of electric energy to power active mechanisms of instrumented hip implants remains a question. Instrumented implants cannot be implemented without effective electric power systems. This paper surveys the power supply systems of seventeen implant architectures already implanted in-vivo, namely from instrumented hip joint replacements and instrumented fracture stabilizers. Only inductive power links and batteries were used in-vivo to power the implants. The energy harvesting systems, which were already designed to power instrumented hip implants, were also analyzed focusing their potential to overcome the disadvantages of both inductive-based and battery-based power supply systems. From comparative and critical analyses of the methods to power instrumented implants, one can conclude that: inductive powering and batteries constrain the full operation of instrumented implants; motion-driven electromagnetic energy harvesting is a promising method to power instrumented passive and active hip implants. PMID:24050511

  20. The Effect of Ligamentum Teres Integrity on Hip Scores

    Directory of Open Access Journals (Sweden)

    Engin Desteli

    2014-12-01

    Full Text Available We aimed to compare the clinical functioning of the hips with an intact Ligamentum Teres (LT to ruptured LT. Patients with resected LT have feelings of instability and discomfort. The effect of LT on hip stability in dysplastic hips and hyperlaxity has been emphasized before. Existence of sensory nerve endings demonstrates that LT has a function in joint proprioception and nociception. LT test was conducted to 92 consecutive patients with Grade 2-3 coxarthrosis. Pain on either internal or external rotation is consistent with a positive LT test result. Following LT test, Hip disability and osteoarthritis outcome score (HOOS and Harris Hip Score (HHS were conducted to all of the patients. Each patient underwent MRI Scanning of the involved hip. The efficacy of LT test was evaluated in comparison to MRI findings, sensitivity of the test was 87.37 % and spesificity was 73.47 positive and negative predictive values were found to be 74.51 % nd 80.43 % respectively. 36 hips which had intact LT according to MRI and LT test (Group 1 was compared to the 38 hips with ruptured LT in both LT test and MRI (Group 2 regarding HOOS and Harris Hip Scores. HOOS and Harris Hip Scores of Group 1 were found to be significantly higher than Group 2. As far as we know from the literature this is the first clinical study to investigate the effect of LT integrity on hip scores by comparing hips with ruptured LT to hips with intact LT.