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Sample records for hip spacer implantation

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

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    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.

  2. Hip Implant Systems

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

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

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

    2011-04-01

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

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

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    Hsu Wei-Hsiu

    2011-01-01

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

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

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    Babiak, Ireneusz

    2012-07-03

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

  6. A Hip Implant Energy Harvester

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    Pancharoen, K.; Zhu, D.; Beeby, S. P.

    2014-11-01

    This paper presents a kinetic energy harvester designed to be embedded in a hip implant which aims to operate at a low frequency associated with body motion of patients. The prototype is designed based on the constrained volume available in a hip prosthesis and the challenge is to harvest energy from low frequency movements (< 1 Hz) which is an average frequency during free walking of a patient. The concept of magnetic-force-driven energy harvesting is applied to this prototype considering the hip movements during routine activities of patients. The magnetic field within the harvester was simulated using COMSOL. The simulated resonant frequency was around 30 Hz and the voltage induced in a coil was predicted to be 47.8 mV. A prototype of the energy harvester was fabricated and tested. A maximum open circuit voltage of 39.43 mV was obtained and the resonant frequency of 28 Hz was observed. Moreover, the power output of 0.96 μW was achieved with an optimum resistive load of 250Ω.

  7. A Hip Implant Energy Harvester

    International Nuclear Information System (INIS)

    Pancharoen, K; Zhu, D; Beeby, S P

    2014-01-01

    This paper presents a kinetic energy harvester designed to be embedded in a hip implant which aims to operate at a low frequency associated with body motion of patients. The prototype is designed based on the constrained volume available in a hip prosthesis and the challenge is to harvest energy from low frequency movements (< 1 Hz) which is an average frequency during free walking of a patient. The concept of magnetic-force-driven energy harvesting is applied to this prototype considering the hip movements during routine activities of patients. The magnetic field within the harvester was simulated using COMSOL. The simulated resonant frequency was around 30 Hz and the voltage induced in a coil was predicted to be 47.8 mV. A prototype of the energy harvester was fabricated and tested. A maximum open circuit voltage of 39.43 mV was obtained and the resonant frequency of 28 Hz was observed. Moreover, the power output of 0.96 μW was achieved with an optimum resistive load of 250Ω

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

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    Dario Regis

    2013-01-01

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

  9. Staged Custom, Intramedullary Antibiotic Spacers for Severe Segmental Bone Loss in Infected Total Hip Arthroplasty

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    Atul F. Kamath

    2011-01-01

    Full Text Available Introduction. Total hip arthroplasty (THA infections with severe bone loss pose significant reconstructive challenges. We present our experience with two-stage hip reimplantation using an intramedullary, antibiotic-impregnated nail. Methods. Three patients with infected THA with severe proximal femoral bone loss (Mallory type IIIB or greater were treated using a custom antibiotic spacer. Clinical outcomes and any complications were recorded. Average followup was 49 months from final reimplantation. Results. Mean age at spacer placement (stage 1 was 53 years. The mean Harris Hip Score at final followup was 80. Two patients had asymptomatic heterotopic ossification, and one patient had a 2 cm leg-length discrepancy. Conclusions. A custom intramedullary nail antibiotic spacer is a reliable option in the staged management of the infected THA with severe proximal femoral bone loss. Benefits of this technique include limb salvage with maintenance of leg length, soft tissue tension, and functional status.

  10. Unconstrained tripolar hip implants: effect on hip stability.

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    Guyen, Olivier; Chen, Qing Shan; Bejui-Hugues, Jacques; Berry, Daniel J; An, Kai-Nan

    2007-02-01

    Tripolar implants were developed to treat unstable total hip arthroplasties. However, there is limited confirmation that they achieve this purpose despite their increasing use. Because they have a larger effective head size, these implants are expected to increase range of motion to impingement and improve stability in situations at risk for impingement compared with conventional implants. We assessed the range of motion to impingement using a tripolar implant mounted to an automated hip simulator using 22.2-mm and 28-mm femoral head sizes. The 22 and 28-mm tripolar implants provided increases of 30.5 degrees in flexion, 15.4 degrees in adduction, and 22.4 degrees in external rotation compared with the conventional 22.2-mm femoral head diameter implant. At the critical position of 90 degrees hip flexion, there was an increase of 45.2 degrees in internal rotation. At 0 degrees and 30 degrees external rotation, extension increases were 18.8 degrees and 7.8 degrees, respectively. Bony impingement was the limiting factor. Tripolar implants increased the arc of motion before impingement in positions at risk for dislocation and are expected to provide greater stability.

  11. Wear mechanisms in ceramic hip implants.

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    Slonaker, Matthew; Goswami, Tarun

    2004-01-01

    The wear in hip implants is one of the main causes for premature hip replacements. The wear affects the potential life of the prosthesis and subsequent removals of in vivo implants. Therefore, the objective of this article is to review various joints that show lower wear rates and consequently higher life. Ceramics are used in hip implants and have been found to produce lower wear rates. This article discusses the advantages and disadvantages of ceramics compared to other implant materials. Different types of ceramics that are being used are reviewed in terms of the wear characteristics, debris released, and their size together with other biological factors. In general, the wear rates in ceramics were lower than that of metal-on-metal and metal-on-polyethylene combinations.

  12. Insufficient sensitivity of joint aspiration during the two-stage exchange of the hip with spacers.

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    Boelch, Sebastian Philipp; Weissenberger, Manuel; Spohn, Frederik; Rudert, Maximilian; Luedemann, Martin

    2018-01-10

    Evaluation of infection persistence during the two-stage exchange of the hip is challenging. Joint aspiration before reconstruction is supposed to rule out infection persistence. Sensitivity and specificity of synovial fluid culture and synovial leucocyte count for detecting infection persistence during the two-stage exchange of the hip were evaluated. Ninety-two aspirations before planned joint reconstruction during the two-stage exchange with spacers of the hip were retrospectively analyzed. The sensitivity and specificity of synovial fluid culture was 4.6 and 94.3%. The sensitivity and specificity of synovial leucocyte count at a cut-off value of 2000 cells/μl was 25.0 and 96.9%. C-reactive protein (CRP) and erythrocyte sedimentation rate (ESR) values were significantly higher before prosthesis removal and reconstruction or spacer exchange (p = 0.00; p = 0.013 and p = 0.039; p = 0.002) in the infection persistence group. Receiver operating characteristic area under the curve values before prosthesis removal and reconstruction or spacer exchange for ESR were lower (0.516 and 0.635) than for CRP (0.720 and 0.671). Synovial fluid culture and leucocyte count cannot rule out infection persistence during the two-stage exchange of the hip.

  13. Biomimetic Composite-Metal Hip Resurfacing Implant

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    Habiba Bougherara

    2008-01-01

    Full Text Available Hip resurfacing technique is a conservative arthroplasty used in the young patient in which the femoral head is reshaped to accept metal cap with small guide stem. In the present investigation, a hybrid composite-metal resurfacing implant is proposed. The cup is made of carbon fiber/polyamide 12 (CF/PA12 covered with a thin layer of cobalt chrome (Co-Cr. Finite element (FE method was applied to analyze and compare the biomechanical performances of the hybrid hip resurfacing (HHR and the conventional Birmingham (BHR. Results of the finite element analysis showed that the composite implant leads to an increase in stresses in the cancellous bone by more than 15% than BHR, indicating a lower potential for stress shielding and bone fracture and higher potential for bone apposition with the HHR.

  14. Hip implants - Paper VI - Ion concentrations

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    Sargeant, A. [Department of Biological Sciences, Ohio Northern University, Ada, OH 45810 (United States); Goswami, T. [Department of Mechanical Engineering, Ohio Northern University, Ada, OH 45810 (United States)]. E-mail: t-goswami@onu.edu

    2007-07-01

    Total hip-joint arthroplasty is performed in increasing numbers where it translates to about 0.16-0.2% of population per year in industrial countries. In most cases, an implant is a metallic component articulating with a metal, ceramic or poly-ethylene liner as seen in the case of hip, knee and spine. The metal implants release ions in vivo. Therefore, there is a need to study metallic implants and ions released as a result. Toxic concentrations of ions can lead to many adverse physiological effects, including cytotoxicity, genotoxicity, carcinogenicity, and metal sensitivity. There is a need to map ion concentrations establishing boundaries between normal and toxic levels; which however, does not exist. Reference levels of ion concentrations in body fluids and tissues determined by many studies are compiled, reviewed, and presented in this paper. The concentrations of ions released from different alloys, including cobalt, chromium, nickel, molybdenum titanium, aluminum, and vanadium, are presented in this paper. This paper reviews the literature pertaining to clinical data on metal ion concentrations in patients with metal joint prostheses, and laboratory data on the physiological effects of the metals.

  15. Personalized hip implants manufacturing and testing

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    Croitoru, A. Sorin Mihai; Pacioga, B. Adrian; Comsa, C. Stanca

    2017-09-01

    Two models of Ti6Al4V personalized femoral stems for hip replacement have been designed and laser sintered with different sizes of fenestrated architecture that mimics the natural structure of bone, ensuring postoperative bone ingrowth and increasing the elasticity of the entire structure. They were tested statically and dynamically versus a commercial femoral stem. Mechanical tests were performed in order to determine the fatigue limit using the Locati method. The tests were conducted in a thermostatic bath (37°±1°) with the implants immersed in distilled water salted solution 0.91%. For probe embedment poly-methyl methacrylate (PMMA) was used. The characteristic curves of the two personalized fenestrated implants reveal an elastic behaviour by their nonlinear appearance. After dynamic tests an inverse relationship between displacements obtained in the static tests and the fatigue limit was observed. Large fenestrations conferred the desired elasticity to the implant, but contributed to a life service reduction. The fatigue limit for both implants was much above the minimum value specified by ISO 7602: 2010, so both models can be safely used in the medical practice, leading to increased life service of implants.

  16. A preliminary biomechanical study of a novel carbon-fibre hip implant versus standard metallic hip implants.

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    Bougherara, Habiba; Zdero, Rad; Dubov, Anton; Shah, Suraj; Khurshid, Shaheen; Schemitsch, Emil H

    2011-01-01

    Total hip arthroplasty is a widespread surgical approach for treating severe osteoarthritis of the human hip. Aseptic loosening of standard metallic hip implants due to stress shielding and bone loss has motivated the development of new materials for hip prostheses. Numerically, a three-dimensional finite element (FE) model that mimicked hip implants was used to compare a new hip stem to two commercially available implants. The hip implants simulated were a novel CF/PA12 carbon-fibre polyamide-based composite hip stem, the Exeter hip stem (Stryker, Mahwah, NJ, USA), and the Omnifit Eon (Stryker, Mahwah, NJ, USA). A virtual axial load of 3 kN was applied to the FE model. Strain and stress distributions were computed. Experimentally, the three hip stems had their distal portions rigidly mounted and had strain gauges placed along the surface at 3 medial and 3 lateral locations. Axial loads of 3 kN were applied. Measurements of axial stiffness and strain were taken and compared to FE analysis. The overall linear correlation between FE model versus experimental strains showed reasonable results for the lines-of-best-fit for the Composite (Pearson R(2)=0.69, slope=0.82), Exeter (Pearson R(2)=0.78, slope=0.59), and Omnifit (Pearson R(2)=0.66, slope=0.45), with some divergence for the most distal strain locations. From FE analysis, the von Mises stress range for the Composite stem was much lower than that in the Omnifit and Exeter implants by 200% and 45%, respectively. The preliminary experiments showed that the Composite stem stiffness (1982 N/mm) was lower than the metallic hip stem stiffnesses (Exeter, 2460 N/mm; Omnifit, 2543 N/mm). This is the first assessment of stress, strain, and stiffness of the CF/PA12 carbon-fibre hip stem compared to standard commercially-available devices. Copyright © 2010 IPEM. Published by Elsevier Ltd. All rights reserved.

  17. Controlling the Biomimetic Implant Interface: Modulating Antimicrobial Activity by Spacer Design

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    Wisdom, Cate; Vanoosten, Sarah Kay; Boone, Kyle W.; Khvostenko, Dmytro; Arnold, Paul M.; Snead, Malcolm L.; Tamerler, Candan

    2016-08-01

    Surgical site infection is a common cause of post-operative morbidity, often leading to implant loosening, ultimately requiring revision surgery, increased costs and worse surgical outcomes. Since implant failure starts at the implant surface, creating and controlling the bio-material interface will play a critical role in reducing infection while improving host cell-to-implant interaction. Here, we engineered a biomimetic interface based upon a chimeric peptide that incorporates a titanium binding peptide (TiBP) with an antimicrobial peptide (AMP) into a single molecule to direct binding to the implant surface and deliver an antimicrobial activity against S. mutans and S. epidermidis, two bacteria which are linked with clinical implant infections. To optimize antimicrobial activity, we investigated the design of the spacer domain separating the two functional domains of the chimeric peptide. Lengthening and changing the amino acid composition of the spacer resulted in an improvement of minimum inhibitory concentration by a three-fold against S. mutans. Surfaces coated with the chimeric peptide reduced dramatically the number of bacteria, with up to a nine-fold reduction for S. mutans and a 48-fold reduction for S. epidermidis. Ab initio predictions of antimicrobial activity based on structural features were confirmed. Host cell attachment and viability at the biomimetic interface were also improved compared to the untreated implant surface. Biomimetic interfaces formed with this chimeric peptide offer interminable potential by coupling antimicrobial and improved host cell responses to implantable titanium materials, and this peptide based approach can be extended to various biomaterials surfaces.

  18. Reduction of metallosis in hip implant using thin film coating

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    Rajeshshyam, R.; Chockalingam, K.; Gayathri, V.; Prakash, T.

    2018-04-01

    Hip implant finds its emerging attraction due to it continuous demand over the years. The hip implants (femoral head) and acetabulum cup) mainly fabricated by metals such as stainless steel, cobalt chrome and titanium alloys, other than that ceramics and polyethylene have been used. The metal-on-metal hip implant was found to be best implant material for most of the surgeons due to its high surface finish, low wear rate and low chance of dislocation from its position after implanting. Where in metal based hip implant shows less wear rate of 0.01mm3/year. Metal-on-metal implant finds its advantage over other materials both in its mechanical and physical stability against human load. In M-O-M Cobalt- chromium alloys induce metal allergy. The metal allergy (particulate debris) that is generated by wear, fretting, fragmentation and which is unavoidable when a prosthesis is implanted, can induce an inflammatory reaction in some circumstances. The objectives of this research to evaluate thin film coating with Nano particle additives to reduce the wear leads to regarding metal ion release. Experimental results reveals that thin film Sol-Gel coating with 4wt. % of specimen reduced the cobalt and chromium ion release and reduces the wear rate. Wear rate reduced by 98% for 4wt. % graphene in 20N and 95% for 4wt. % graphene in 10N.

  19. Muscle atrophy and metal-on-metal hip implants: a serial MRI study of 74 hips.

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    Berber, Reshid; Khoo, Michael; Cook, Erica; Guppy, Andrew; Hua, Jia; Miles, Jonathan; Carrington, Richard; Skinner, John; Hart, Alister

    2015-06-01

    Muscle atrophy is seen in patients with metal-on-metal (MOM) hip implants, probably because of inflammatory destruction of the musculo-tendon junction. However, like pseudotumors, it is unclear when atrophy occurs and whether it progresses with time. Our objective was to determine whether muscle atrophy associated with MOM hip implants progresses with time. We retrospectively reviewed 74 hips in 56 patients (32 of them women) using serial MRI. Median age was 59 (23-83) years. The median time post-implantation was 83 (35-142) months, and the median interval between scans was 11 months. Hip muscles were scored using the Pfirrmann system. The mean scores for muscle atrophy were compared between the first and second MRI scans. Blood cobalt and chromium concentrations were determined. The median blood cobalt was 6.84 (0.24-90) ppb and median chromium level was 4.42 (0.20-45) ppb. The median Oxford hip score was 34 (5-48). The change in the gluteus minimus mean atrophy score between first and second MRI was 0.12 (p = 0.002). Mean change in the gluteus medius posterior portion (unaffected by surgical approach) was 0.08 (p = 0.01) and mean change in the inferior portion was 0.10 (p = 0.05). Mean pseudotumor grade increased by 0.18 (p = 0.02). Worsening muscle atrophy and worsening pseudotumor grade occur over a 1-year period in a substantial proportion of patients with MOM hip implants. Serial MRI helps to identify those patients who are at risk of developing worsening soft-tissue pathology. These patients should be considered for revision surgery before irreversible muscle destruction occurs.

  20. Bone remodelling of the proximal femur after total hip arthroplasty with 2 different hip implant designs

    DEFF Research Database (Denmark)

    Christiansen, Janus D.; Laursen, Mogens B; Ejaz, Ashir

    2018-01-01

    INTRODUCTION: The thrust plate prosthesis (TPP) was introduced to preserve bone in patients undergoing total hip arthroplasty. We assessed the long-term results of hip arthroplasty in patients who received the TPP compared to a traditional intramedullary stem (Bi-Metric). METHODS......: In this prospective observational cohort study, we evaluated bone mineral density (BMD) using dual-energy X-ray absorptiometry (DXA), radiological imaging and clinical outcome using Harris Hip Score (HHS). Twenty patients received the TPP (group A) and 18 patients received the Bi-Metric stem (group B). Baseline......% (95% confidence interval [CI], 4-16; p = 0.003) and 8% (95% CI, 1-15; p = 0.03) at 8 years. Regarding ROI4, group A had a lesser decrease in general compared to group B. The radiological findings did not reveal any subsidence or detectable implant migration. HHS improved from 53 (23-69) to 93 (55...

  1. Oxidized zirconium: a potentially longer lasting hip implant

    International Nuclear Information System (INIS)

    Good, V.; Widding, K.; Hunter, G.; Heuer, D.

    2005-01-01

    Because younger, more active patients are receiving total hip replacements, it is necessary to develop materials, which would increase the life span of the implants and challenge their wear potential under adverse conditions. Oxidized zirconium (OxZr) is a metal with the surface transformed to ceramic by oxidation that offers low fracture risk and excellent abrasion resistance. This study compared wear of polyethylene (non-irradiated and highly crosslinked) with OxZr and CoCr heads under smooth and rough (clinically relevant) conditions. Wear was up to 15-fold less and up to 4-fold fewer particles were produced when coupled with OxZr than with CoCr, demonstrating that OxZr heads should increase clinical implant longevity

  2. High-tech hip implant for wireless temperature measurements in vivo.

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    Georg Bergmann

    Full Text Available When walking long distances, hip prostheses heat up due to friction. The influence of articulating materials and lubricating properties of synovia on the final temperatures, as well as any potential biological consequences, are unknown. Such knowledge is essential for optimizing implant materials, identifying patients who are possibly at risk of implant loosening, and proving the concepts of current joint simulators. An instrumented hip implant with telemetric data transfer was developed to measure the implant temperatures in vivo. A clinical study with 100 patients is planned to measure the implant temperatures for different combinations of head and cup materials during walking. This study will answer the question of whether patients with synovia with poor lubricating properties may be at risk for thermally induced bone necrosis and subsequent implant failure. The study will also deliver the different friction properties of various implant materials and prove the significance of wear simulator tests. A clinically successful titanium hip endoprosthesis was modified to house the electronics inside its hollow neck. The electronics are powered by an external induction coil fixed around the joint. A temperature sensor inside the implant triggers a timer circuit, which produces an inductive pulse train with temperature-dependent intervals. This signal is detected by a giant magnetoresistive sensor fixed near the external energy coil. The implant temperature is measured with an accuracy of 0.1°C in a range between 20°C and 58°C and at a sampling rate of 2-10 Hz. This rate could be considerably increased for measuring other data, such as implant strain or vibration. The employed technique of transmitting data from inside of a closed titanium implant by low frequency magnetic pulses eliminates the need to use an electrical feedthrough and an antenna outside of the implant. It enables the design of mechanically safe and simple instrumented implants.

  3. Influence of PEEK Coating on Hip Implant Stress Shielding: A Finite Element Analysis

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    Jesica Anguiano-Sanchez

    2016-01-01

    Full Text Available Stress shielding is a well-known failure factor in hip implants. This work proposes a design concept for hip implants, using a combination of metallic stem with a polymer coating (polyether ether ketone (PEEK. The proposed design concept is simulated using titanium alloy stems and PEEK coatings with thicknesses varying from 100 to 400 μm. The Finite Element analysis of the cancellous bone surrounding the implant shows promising results. The effective von Mises stress increases between 81 and 92% for the complete volume of cancellous bone. When focusing on the proximal zone of the implant, the increased stress transmission to the cancellous bone reaches between 47 and 60%. This increment in load transferred to the bone can influence mineral bone loss due to stress shielding, minimizing such effect, and thus prolonging implant lifespan.

  4. Unconstrained tripolar implants for primary total hip arthroplasty in patients at risk for dislocation.

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    Guyen, Olivier; Pibarot, Vincent; Vaz, Gualter; Chevillotte, Christophe; Carret, Jean-Paul; Bejui-Hugues, Jacques

    2007-09-01

    We performed a retrospective study on 167 primary total hip arthroplasty (THA) procedures in 163 patients at high risk for instability to assess the reliability of unconstrained tripolar implants (press-fit outer metal shell articulating a bipolar polyethylene component) in preventing dislocations. Eighty-four percent of the patients had at least 2 risk factors for dislocation. The mean follow-up length was 40.2 months. No dislocation was observed. Harris hip scores improved significantly. Six hips were revised, and no aseptic loosening of the cup was observed. The tripolar implant was extremely successful in achieving stability. However, because of the current lack of data documenting polyethylene wear at additional bearing, the routine use of tripolar implants in primary THA is discouraged and should be considered at the present time only for selected patients at high risk for dislocation and with limited activities.

  5. Sheep Hip Arthroplasty Model of Failed Implant Osseointegration

    DEFF Research Database (Denmark)

    Jakobsen, Thomas; Kold, Søren; Baas, Jørgen

    2015-01-01

    femoral condyles in ten sheep. The micromotion device consists of an anchor bearing a PMMA implant and a PE plug. During each gait cycle the PE plug will make the PMMA implant axially piston 0.5 mm. After 12 weeks of observation the bone specimens were harvested and a post-mortem control implant......Early secure stability of an implant is important for long-term survival. We examined whether micromotion of implants consistently would induce bone resorption and formation of a fibrous membrane and thereby prevent osseointegration. One micromotion implant was inserted into one of the medial...... was inserted into the contra-lateral medial femoral condyle. Histomorphometrical evaluation showed that the surface on the implant observed for 12 weeks was covered by fibrous tissue. The control implants were covered by lamellar bone. No difference was found with respect to the volume fraction of lamellar...

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

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    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.

  7. USING CUSTOM TRIFLANGE IMPLANT IN REVISION HIP ARTHROPLASTY IN PATIENT WITH PELVIC DISCONTINUITY (CASE REPORT

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    R. M. Tikhilov

    2016-01-01

    Full Text Available Revision hip arthroplasty rate is growing, and pelvic discontinuity rate ranges from 1% to 5% of acetabular component revision reasons. According to AAOS acetabular defects classification, pelvic discontinuity is fourth type defect in which cranial part of hip bone is separated from caudal part at acetabular level. Usually it occurs from bone loss secondary to osteolysis, infection, fracture or aseptic loosening. There are a lot of techniques for pelvis discontinuity treatment. Published results of bulk allografts and antiprotrusion cages have generally been poor. More preferable methods with acceptable rate of good results are cup-cage systems and custom triflange acetabular components(CTAC. CTACs are designed based on preoperative CT scans to build a custom titanium 3D-printed implant to address the patient's specific bone defect and provide secure fixation in the ilium, pubis, and ischium. We faced pelvic discontinuity, in which extensive iliac bone loss was added to caudal hip bone part medial displacement and pelvic ring deformity, in patient with multiple hip surgeries. Preoperative investigation called into question the possibility of using off-the-shelf hip implants, which could restore the biomechanics of the hip and provide reliable primary fixation at the same time. We present case report of the patient with pelvic discontinuity and massive bone loss treatment using a custom triflange component.

  8. Can finite element models detect clinically inferior cemented hip implants?

    NARCIS (Netherlands)

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

    2003-01-01

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

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

    Science.gov (United States)

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

    2017-11-02

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

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

    Science.gov (United States)

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

    2014-01-01

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

  11. Oral bisphosphonate use and total knee/hip implant survival

    DEFF Research Database (Denmark)

    Prieto-Alhambra, Daniel; Lalmohamed, Arief; Abrahamsen, Bo

    2014-01-01

    of disease-modifying antirheumatic drugs as well as patients with rheumatoid arthritis, Paget's disease, or hip fracture. Participants were classified as bisphosphonate users if they had been receiving treatment for ≥6 months. A time-varying exposure was used to avoid immortal time bias. Up to 6...... was conducted within the Danish nationwide registries (5.5 million residents). Using procedure codes of the International Statistical Classification of Diseases and Related Health Problems, Tenth Revision, we identified patients age ≥40 years undergoing total joint replacement in 1998-2007. We excluded users...

  12. Life expectancy of modular Ti6Al4V hip implants: Influence of stress and environment

    DEFF Research Database (Denmark)

    Chandra, A.; Ryu, J.J.; Karra, P.

    2011-01-01

    is semi-analytical and computational, where, based on the estimated Preston constant and other material and process parameters, the scratch propensity (consisting of magnitude of scratch depth and their frequency per unit area) due to micro-motion in modular hip implants is estimated. The third phase...... views these scratches as initial notches and utilizes a mixed-mode fatigue crack propagation model to estimate the critical crack length for onset of instability. The number of loading cycles needed to reach this critical crack length is then labeled as the expected life of the implant under given...... mechanical and chemical conditions. Implications of different material and process conditions to life expectancy of orthopedic implants are discussed. It is observed that transverse micro-motion, compared to longitudinal micro-motion, plays a far more critical role in determining the implant life. Patient...

  13. Polyethylene glycol hydrogel rectal spacer implantation in patients with prostate cancer undergoing combination high-dose-rate brachytherapy and external beam radiotherapy.

    Science.gov (United States)

    Yeh, Jekwon; Lehrich, Brandon; Tran, Carolyn; Mesa, Albert; Baghdassarian, Ruben; Yoshida, Jeffrey; Torrey, Robert; Gazzaniga, Michael; Weinberg, Alan; Chalfin, Stuart; Ravera, John; Tokita, Kenneth

    2016-01-01

    To present rectal toxicity rates in patients administered a polyethylene glycol (PEG) hydrogel rectal spacer in conjunction with combination high-dose-rate brachytherapy and external beam radiotherapy. Between February 2010 and April 2015, 326 prostate carcinoma patients underwent combination high-dose-rate brachytherapy of 16 Gy (average dose 15.5 Gy; standard deviation [SD] = 1.6 Gy) and external beam radiotherapy of 59.4 Gy (average dose 60.2 Gy; SD = 2.9 Gy). In conjunction with the radiation therapy regimen, each patient was injected with 10 mL of a PEG hydrogel in the anterior perirectal fat space. The injectable spacer (rectal spacer) creates a gap between the prostate and the rectum. The rectum is displaced from the radiation field, and rectal dose is substantially reduced. The goal is a reduction in rectal radiation toxicity. Clinical efficacy was determined by measuring acute and chronic rectal toxicity using the National Cancer Center Institute Common Terminology Criteria for Adverse Events v4.0 grading scheme. Median followup was 16 months. The mean anterior-posterior separation achieved was 1.6 cm (SD = 0.4 cm). Rates of acute Grade 1 and 2 rectal toxicity were 37.4% and 2.8%, respectively. There were no acute Grade 3/4 toxicities. Rates of late Grade 1, 2, and 3 rectal toxicity were 12.7%, 1.4%, and 0.7%, respectively. There were no late Grade 4 toxicities. PEG rectal spacer implantation is safe and well tolerated. Acute and chronic rectal toxicities are low despite aggressive dose escalation. Copyright © 2016 American Brachytherapy Society. Published by Elsevier Inc. All rights reserved.

  14. 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.

  15. 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.

  16. Limberg fasciocutaneous transposition flap for the coverage of an exposed hip implant in a patient affected by ewing sarcoma

    Directory of Open Access Journals (Sweden)

    Mario Faenza

    Full Text Available Introduction: Hemipelvectomy with immediate reconstruction with prosthetic devices for the surgical treatment of malignant tumors is an invasive procedure with many possible complications such as wound breakdown, seroma, hematoma and infection.The treatment of an exposed hip implant in these cluster of patient is extremely challenging and the literature shows how negative pressure wound therapy and myocutaneous, both pedicled and free, flaps are workhorses in these situations. Case report: In this paper we report a successful coverage of exposed prosthetic hip implant with a local fasciocutaneous flap in a patient in which any other kind of reconstruction was not feasible. Discussion: Fasciocutaneous flaps can be considered as an easily performed and minimally invasive surgical procedure, particularly reliable even in patients in poor general conditions, with preservation of future flap options. Keywords: Ewing sarcoma, Hemipelvectomy, Hip implant, Wound healing, Fasciocutaneous flap, Exposed implant

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

    Directory of Open Access Journals (Sweden)

    Simon S Jameson

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

  18. EXPERIMENTAL RESEARCH OF REGENERATIVE FEATURES IN BONE TISSUES AROUND IMPLANTS AFTER ONE-STAGE BILATERAL TOTAL HIP REPLACEMENT

    Directory of Open Access Journals (Sweden)

    V. M. Mashkov

    2012-01-01

    Full Text Available Objective: to research the specific features of regenerative processes of bone tissue around implants after one-stage bilateral total hip replacement in experiment. Material and methods: 27 total hip replacement operations have been performed in 18 rabbits of breed "chinchilla" to which bipolar femoral endoprosthesis made of titanic alloy PT-38, one type-size, with friction pair metal-on-metal and neck-shaft angle 165 degrees have been implanted: total unilateral hip replacement operations have been performed in 9 animals (control group, one-stage bilateral total hip replacement operations have been performed in 9 animals (experimental group. During research they have been on radiological and clinical checking-up. After the experiment the animals had histological tests of the tissues around endoprosthesis components. Results and conclusions: After one-stage bilateral total hip replacement in early terms of research more expressed changes of bone tissue in the form of its thinning and decompaction were found around implants. One-stage bilateral total hip replacement did not essentially influence on the speed of osteogenesis around endoprothesis components in comparison with unilateral total hip replacement, so in late terms of observation in both groups the fixing of endoprothesis components did not differ.

  19. Antibiotic impregnated total femur spacers: a technical tip

    Directory of Open Access Journals (Sweden)

    Colin D. Canham, MD

    2018-03-01

    Full Text Available Simultaneous prosthetic joint infection of ipsilateral hip and knee arthroplasties is often accompanied by significant bone loss and presents a challenging reconstructive problem. Two-stage reconstruction is favored and requires the placement of a total femur spacer, which is not a commercially available device. We describe a surgical technique, reporting on 2 cases in which a customized total femur antibiotic impregnated spacer was created by combining an articulating knee spacer and an articulating hip spacer with a reinforced cement dowel construct connecting the 2 spacers. Custom total femoral spacers are useful in the management of infected femoral megaprostheses and cases with ipsilateral injected hip and knee arthroplasties and severe femoral bone loss. Keywords: total femur spacer, revision arthroplasty, total hip arthroplasty, total knee arthroplasty, prosthetic joint infection

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

    Science.gov (United States)

    Nuño, N; Groppetti, R; Senin, N

    2006-11-01

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

  1. Fuel spacer

    International Nuclear Information System (INIS)

    Nishida, Koji; Yokomizo, Osamu; Kanazawa, Toru; Kashiwai, Shin-ichi; Orii, Akihito.

    1992-01-01

    The present invention concerns a fuel spacer for a fuel assembly of a BWR type reactor and a PTR type reactor. Springs each having a vane are disposed on the side surface of a circular cell which supports a fuel rods. A vortex streams having a vertical component are formed by the vanes in the flowing direction of a flowing channel between adjacent cylindrical cells. Liquid droplets carried by streams are deposited on liquid membrane streams flowing along the fuel rod at the downstream of the spacer by the vortex streams. In view of the above, the liquid droplets can be deposited to the fuel rod without increasing the amount of metal of the spacer. Accordingly, the thermal margin of the fuel assembly can be improved without losing neutron economy. (I.N.)

  2. LET spectra behind high-density titanium and stainless steel hip implants irradiated with a therapeutic proton beam

    Czech Academy of Sciences Publication Activity Database

    Oancea, Cristina; Ambrožová, Iva; Popescu, A. I.; Mytsin, G. V.; Vondráček, V.; Davídková, Marie

    2018-01-01

    Roč. 110, č. 3 (2018), s. 7-13 ISSN 1350-4487 R&D Projects: GA MŠk EF16_013/0001677 Institutional support: RVO:61389005 Keywords : proton therapy * metallic hip implant * titanium * stainless steel * track etched detectors Subject RIV: BG - Nuclear, Atomic and Molecular Physics, Colliders OBOR OECD: Nuclear physics Impact factor: 1.442, year: 2016

  3. Predictors of clinical outcome in total hip and knee replacement : a methodological appraisal of implants and patient factors

    NARCIS (Netherlands)

    Keurentjes, Johan Christiaan

    2014-01-01

    In this thesis, we studied both implants and patient and surgeon factors as predictors of clinical outcome after total hip and knee replacement. Additionally, we studied a number of methodological aspects of orthopaedic research, such as competing risks in estimating the probability of revision

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

    DEFF Research Database (Denmark)

    Junnila, Mika; Laaksonen, Inari; Eskelinen, Antti

    2016-01-01

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

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

    International Nuclear Information System (INIS)

    Hart, Alister J; Sandison, Ann; Quinn, Paul; Mosselmans, J Frederick W; Sampson, Barry; Atkinson, Kirk D; Skinner, John A; Goode, Angela; Powell, Jonathan J

    2009-01-01

    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.

  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. Assessing for Cardiotoxicity from Metal-on-Metal Hip Implants with Advanced Multimodality Imaging Techniques.

    Science.gov (United States)

    Berber, Reshid; Abdel-Gadir, Amna; Rosmini, Stefania; Captur, Gabriella; Nordin, Sabrina; Culotta, Veronica; Palla, Luigi; Kellman, Peter; Lloyd, Guy W; Skinner, John A; Moon, James C; Manisty, Charlotte; Hart, Alister J

    2017-11-01

    High failure rates of metal-on-metal (MoM) hip implants prompted regulatory authorities to issue worldwide safety alerts. Circulating cobalt from these implants causes rare but fatal autopsy-diagnosed cardiotoxicity. There is concern that milder cardiotoxicity may be common and underrecognized. Although blood metal ion levels are easily measured and can be used to track local toxicity, there are no noninvasive tests for organ deposition. We sought to detect correlation between blood metal ions and a comprehensive panel of established markers of early cardiotoxicity. Ninety patients were recruited into this prospective single-center blinded study. Patients were divided into 3 age and sex-matched groups according to implant type and whole-blood metal ion levels. Group-A patients had a ceramic-on-ceramic [CoC] bearing; Group B, an MoM bearing and low blood metal ion levels; and Group C, an MoM bearing and high blood metal-ion levels. All patients underwent detailed cardiovascular phenotyping using cardiac magnetic resonance imaging (CMR) with T2*, T1, and extracellular volume mapping; echocardiography; and cardiac blood biomarker sampling. T2* is a novel CMR biomarker of tissue metal loading. Blood cobalt levels differed significantly among groups A, B, and C (mean and standard deviation [SD], 0.17 ± 0.08, 2.47 ± 1.81, and 30.0 ± 29.1 ppb, respectively) and between group A and groups B and C combined. No significant between-group differences were found in the left atrial or ventricle size, ejection fraction (on CMR or echocardiography), T1 or T2* values, extracellular volume, B-type natriuretic peptide level, or troponin level, and all values were within normal ranges. There was no relationship between cobalt levels and ejection fraction (R = 0.022, 95% confidence interval [CI] = -0.185 to 0.229) or T2* values (R = 0.108, 95% CI = -0.105 to 0.312). Using the best available technologies, we did not find that high (but not extreme) blood cobalt and chromium levels

  8. Bone mineral density after implantation of a femoral neck hip prosthesis--a prospective 5 year follow-up.

    Science.gov (United States)

    Steens, Wolfram; Boettner, Friedrich; Bader, Rainer; Skripitz, Ralf; Schneeberger, Alberto

    2015-08-12

    Bone resorption in the proximal femur due to stress shielding has been observed in a number of conventional cementless implants used in total hip arthroplasty. Short femoral-neck implants are claiming less interference with the biomechanics of the proximal femur. The goal of this study was to prospectively investigate the in vivo changes of bone-mineral density as a parameter of bone remodeling around a short, femoral neck prosthesis over the first 5 years following implantation. The secondary goal was to report on its clinical outcome. We are reporting on the changes of bone mineral density of the proximal femur and the clinical outcome up to five years after implantation of a short femoral neck prosthesis. Bone mineral density was determined using dual energy x-ray absorptiometry, performed 10 days, three, 12 and 60 months after surgery. 20 patients with a mean age of 47 years (range 17 to 65) were clinically assessed using the Harris Hip Score. The WOMAC was used as a patient-relevant outcome-measure. In contrast to conventional implants DEXA-scans overall revealed a slight increase of bone mineral density in the proximal femur in the 12 months following the implantation. The Harris Hip Score improved from an average preoperative score of 46 to a postoperative score at 12 months of 91 points and 95 points at 60 months, the global WOMAC index from 5.3 preoperatively to 0.8 at 12 months and 0.6 at 60 months postoperatively. At 60 months after implantation of a short femoral neck prosthesis, all regions except one (region of interest #5) showed no significant changes in BMD compared to baseline measurements at 10 days which is less to the changes in bone mineral density seen in conventional implants.

  9. Development of an acoustic measurement protocol to monitor acetabular implant fixation in cementless total hip Arthroplasty: A preliminary study.

    Science.gov (United States)

    Goossens, Quentin; Leuridan, Steven; Henyš, Petr; Roosen, Jorg; Pastrav, Leonard; Mulier, Michiel; Desmet, Wim; Denis, Kathleen; Vander Sloten, Jos

    2017-11-01

    In cementless total hip arthroplasty (THA), the initial stability is obtained by press-fitting the implant in the bone to allow osseointegration for a long term secondary stability. However, finding the insertion endpoint that corresponds to a proper initial stability is currently based on the tactile and auditory experiences of the orthopedic surgeon, which can be challenging. This study presents a novel real-time method based on acoustic signals to monitor the acetabular implant fixation in cementless total hip arthroplasty. Twelve acoustic in vitro experiments were performed on three types of bone models; a simple bone block model, an artificial pelvic model and a cadaveric model. A custom made beam was screwed onto the implant which functioned as a sound enhancer and insertor. At each insertion step an acoustic measurement was performed. A significant acoustic resonance frequency shift was observed during the insertion process for the different bone models; 250 Hz (35%, second bending mode) to 180 Hz (13%, fourth bending mode) for the artificial bone block models and 120 Hz (11%, eighth bending mode) for the artificial pelvis model. No significant frequency shift was observed during the cadaveric experiment due to a lack of implant fixation in this model. This novel diagnostic method shows the potential of using acoustic signals to monitor the implant seating during insertion. Copyright © 2017 IPEM. Published by Elsevier Ltd. All rights reserved.

  10. Does aquatic exercise reduce hip and knee joint loading? In vivo load measurements with instrumented implants.

    Directory of Open Access Journals (Sweden)

    Ines Kutzner

    Full Text Available Aquatic exercises are widely used for rehabilitation or preventive therapies in order to enable mobilization and muscle strengthening while minimizing joint loading of the lower limb. The load reducing effect of water due to buoyancy is a main advantage compared to exercises on land. However, also drag forces have to be considered that act opposite to the relative motion of the body segments and require higher muscle activity. Due to these opposing effects on joint loading, the load-reducing effect during aquatic exercises remains unknown. The aim of this study was to quantify the joint loads during various aquatic exercises and to determine the load reducing effect of water. Instrumented knee and hip implants with telemetric data transfer were used to measure the resultant joint contact forces in 12 elderly subjects (6x hip, 6x knee in vivo. Different dynamic, weight-bearing and non-weight-bearing activities were performed by the subjects on land and in chest-high water. Non-weight-bearing hip and knee flexion/extension was performed at different velocities and with additional Aquafins. Joint forces during aquatic exercises ranged between 32 and 396% body weight (BW. Highest forces occurred during dynamic activities, followed by weight-bearing and slow non-weight-bearing activities. Compared to the same activities on land, joint forces were reduced by 36-55% in water with absolute reductions being greater than 100%BW during weight-bearing and dynamic activities. During non-weight-bearing activities, high movement velocities and additional Aquafins increased the joint forces by up to 59% and resulted in joint forces of up to 301%BW. This study confirms the load reducing effect of water during weight-bearing and dynamic exercises. Nevertheless, high drag forces result in increased joint contact forces and indicate greater muscle activity. By the choice of activity, movement velocity and additional resistive devices joint forces can be modulated

  11. In vitro simulation of fretting-corrosion in hip implant modular junctions: The influence of pH.

    Science.gov (United States)

    Royhman, Dmitry; Patel, Megha; Jacobs, Joshua J; Wimmer, Markus A; Hallab, Nadim J; Mathew, Mathew T

    2018-02-01

    The fretting-corrosion behavior of mixed metal contacts is affected by various mechanical and electrochemical parameters. Crevice conditions at the junction and patient-specific pathologies can affect the pH of the prosthetic environment. The main objective of this study is to understand the effect of pH variation at the stem/head junction of the hip implant under fretting corrosion exposure. We hypothesized that pH will have a significant influence on the fretting-corrosion behavior hip implant modular junctions. A custom-made setup was used to evaluate the fretting corrosion behavior of hip implant modular junctions. A Newborn calf serum solution (30 g/L protein content) was used to simulate the synovial fluid environment. A sinusoidal fretting motion, with a displacement amplitude of +50 µm, was applied to the Ti alloy rod. The effects of pathology driven, periprosthetic pH variation were simulated at four different pH levels (3.0, 4.5, 6.0 and 7.6). Electrochemical and mechanical properties were evaluated before, during, and after the applied fretting motion. The impedance of the system was increased in response to the fretting motion. The hysteresis tangential load/displacement behavior was not affected by pH level. The worn surfaces of CoCrMo pins exhibited the presence of tribolayer or organic deposits, in the pH 4.5 group, which may explain the lower drop in potential and mass loss observed in that group. Mechanically dominated wear mechanisms, namely, adhesive wear was shown in the pH 7.6 group, which may account for a higher potential drop and metal content loss. This study suggests that the fretting-corrosion mechanisms in hip implant are affected by the pH levels of the surrounding environment and patient-specific factors. Copyright © 2017. Published by Elsevier Ltd.

  12. Reduction of artefacts caused by hip implants in CT-based attenuation-corrected PET images using 2-D interpolation of a virtual sinogram on an irregular grid

    NARCIS (Netherlands)

    Abdoli, Mehrsima; de Jong, Johan R.; Pruim, Jan; Dierckx, Rudi A. J. O.; Zaidi, Habib

    2011-01-01

    Purpose Metallic prosthetic replacements, such as hip or knee implants, are known to cause strong streaking artefacts in CT images. These artefacts likely induce over-or underestimation of the activity concentration near the metallic implants when applying CT-based attenuation correction of positron

  13. Analysis of migration of the Nanos® short-stem hip implant within two years after surgery.

    Science.gov (United States)

    Budde, Stefan; Seehaus, Frank; Schwarze, Michael; Hurschler, Christof; Floerkemeier, Thilo; Windhagen, Henning; Noll, Yvonne; Ettinger, Max; Thorey, Fritz

    2016-08-01

    Short-stem implants provide a bone-preserving alternative in total hip arthroplasty. However, some evidence exists that the smaller implant-bone contact surface may compromise primary stability and impair osseo-integration. The purpose of this study was to analyse the migration characteristics of the Nanos® short stem over two years by means of model-based roentgen stereophotogrammetric analysis (MBRSA). Eighteen patients aged 53.6 ± 7.2 years were included. After being treated with a Nanos implant, 14 patients were followed-up radiologically at three, six, 12 and 24 months by means of MBRSA. Early implant migration was calculated. Clinical data have been assessed in addition. Highest translational migration was observed with a mean value of -0.22 ± 0.39 mm along the proximo-distal axis after three months and highest rotational migration with 0.8 ± 3.2° also around the y-axis after two years. The resulting total migration was 0.46 ± 0.31 mm, with the largest proportion occurring within three months after surgery (0.40 ± 0.34 mm). The Nanos short-stem hip implant shows only a slight initial migration within three months after implantation, followed by secondary stabilisation. These results suggest both good primary stability and osseo-integration, suggesting a low risk of aseptic loosening.

  14. Machine learning techniques for the optimization of joint replacements: Application to a short-stem hip implant.

    Science.gov (United States)

    Cilla, Myriam; Borgiani, Edoardo; Martínez, Javier; Duda, Georg N; Checa, Sara

    2017-01-01

    Today, different implant designs exist in the market; however, there is not a clear understanding of which are the best implant design parameters to achieve mechanical optimal conditions. Therefore, the aim of this project was to investigate if the geometry of a commercial short stem hip prosthesis can be further optimized to reduce stress shielding effects and achieve better short-stemmed implant performance. To reach this aim, the potential of machine learning techniques combined with parametric Finite Element analysis was used. The selected implant geometrical parameters were: total stem length (L), thickness in the lateral (R1) and medial (R2) and the distance between the implant neck and the central stem surface (D). The results show that the total stem length was not the only parameter playing a role in stress shielding. An optimized implant should aim for a decreased stem length and a reduced length of the surface in contact with the bone. The two radiuses that characterize the stem width at the distal cross-section in contact with the bone were less influential in the reduction of stress shielding compared with the other two parameters; but they also play a role where thinner stems present better results.

  15. Tribo-biological deposits on the articulating surfaces of metal-on-polyethylene total hip implants retrieved from patients

    Science.gov (United States)

    Cui, Zhiwei; Tian, Yi-Xing; Yue, Wen; Yang, Lei; Li, Qunyang

    2016-06-01

    Artificial total hip arthroplasty (THA) is one of the most effective orthopaedic surgeries that has been used for decades. However, wear of the articulating surfaces is one of the key failure causes limiting the lifetime of total hip implant. In this paper, Fourier transform infrared spectroscopy (FTIR), X-ray photoelectron spectroscopy (XPS) and atomic force microscopy (AFM) were employed to explore the composition and formation mechanism of the tribo-layer on the articulating surfaces of metal-on-polyethylene (MoPE) implants retrieved from patients. Results showed that, in contrast to conventional understanding, the attached tribo-layer contained not only denatured proteins but also a fraction of polymer particles. The formation of the tribo-layer was believed to relate to lubrication regime, which was supposed to be largely affected by the nature of the ultra-high-molecule-weight-polyethylene (UHMWPE). Wear and formation of tribo-layer could be minimized in elasto-hydrodynamic lubrication (EHL) regime when the UHMWPE was less stiff and have a morphology containing micro-pits; whereas the wear was more severe and tribo-layer formed in boundary lubrication. Our results and analyses suggest that enhancing interface lubrication may be more effective on reducing wear than increasing the hardness of material. This finding may shed light on the design strategy of artificial hip joints.

  16. Periprosthetic fungal infection of a hip caused by Trichosporon inkin

    Directory of Open Access Journals (Sweden)

    Federico José Burgo, MD

    2018-03-01

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

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

    Directory of Open Access Journals (Sweden)

    Manzi Giovanni

    2012-04-01

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

  18. N-Acetyl-Cysteine as Effective and Safe Chelating Agent in Metal-on-Metal Hip-Implanted Patients: Two Cases

    Directory of Open Access Journals (Sweden)

    Andrea Giampreti

    2016-01-01

    Full Text Available Systemic toxicity associated with cobalt (Co and chromium (Cr containing metal hip alloy may result in neuropathy, cardiomyopathy, and hypothyroidism. However clinical management concerning chelating therapy is still debated in literature. Here are described two metal-on-metal hip-implanted patients in which N-acetyl-cysteine decreased elevated blood metal levels. A 67-year-old male who underwent Co/Cr hip implant in September 2009 referred to our Poison Control Centre for persisting elevated Co/Cr blood levels (from March 2012 to November 2014. After receiving oral high-dose N-acetyl-cysteine, Co/Cr blood concentrations dropped by 86% and 87% of the prechelation levels, respectively, and persisted at these latter concentrations during the following 6 months of follow-up. An 81-year-old female who underwent Co/Cr hip implant in January 2007 referred to our Centre for detection of high Co and Cr blood levels in June 2012. No hip revision was indicated. After a therapy with oral high-dose N-acetyl-cysteine Co/Cr blood concentrations decreased of 45% and 24% of the prechelation levels. Chelating agents reported in hip-implanted patients (EDTA, DMPS, and BAL are described in few cases. N-acetyl-cysteine may provide chelating sites for metals and in our cases reduced Co and Cr blood levels and resulted well tolerable.

  19. Usefullness of three-dimensional templating software to quantify the contact state between implant and femur in total hip arthroplasty.

    Science.gov (United States)

    Inoue, Daisuke; Kabata, Tamon; Maeda, Toru; Kajino, Yoshitomo; Fujita, Kenji; Hasegawa, Kazuhiro; Yamamoto, Takashi; Takagi, Tomoharu; Ohmori, Takaaki; Tsuchiya, Hiroyuki

    2015-12-01

    It would be ideal if surgeons could precisely confirm whether the planned femoral component achieves the best fit and fill of implant and femur. However, the cortico-cancellous interfaces can be difficult to standardize using plain radiography, and therefore, determining the contact state is a subjective decision by the examiner. Few reports have described the use of CT-based three-dimensional templating software to quantify the contact state of stem and femur in detail. The purpose of this study was to use three-dimensional templating software to quantify the implant-femur contact state and develop a technique to analyze the initial fixation pattern of a cementless femoral stem. We conducted a retrospective review of 55 hips in 53 patients using a short proximal fit-and-fill anatomical stem (APS Natural-Hip™ System). All femurs were examined by density mapping which can visualize and digitize the contact state. We evaluated the contact state of implant and femur by using density mapping. The varus group (cases that had changed varus 2° by 3 months after surgery) consisted of 11 hips. The varus group showed no significant difference with regard to cortical contact in the proximal medial portion (Gruen 7), but the contact area in the distal portion (Gruen 3 and Gruen 5) was significantly lower than that of non-varus group. Density mapping showed that the stem only has to be press-fit to the medial calcar, but also must fill the distal portion of the implant in order to achieve the ideal contact state. Our results indicated that quantifying the contact state of implant and femur by using density mapping is a useful technique to accurately analyze the fixation pattern of a cementless femoral stem.

  20. The Cost-Effectiveness of Dual Mobility Implants for Primary Total Hip Arthroplasty: A Computer-Based Cost-Utility Model.

    Science.gov (United States)

    Barlow, Brian T; McLawhorn, Alexander S; Westrich, Geoffrey H

    2017-05-03

    Dislocation remains a clinically important problem following primary total hip arthroplasty, and it is a common reason for revision total hip arthroplasty. Dual mobility (DM) implants decrease the risk of dislocation but can be more expensive than conventional implants and have idiosyncratic failure mechanisms. The purpose of this study was to investigate the cost-effectiveness of DM implants compared with conventional bearings for primary total hip arthroplasty. Markov model analysis was conducted from the societal perspective with use of direct and indirect costs. Costs, expressed in 2013 U.S. dollars, were derived from the literature, the National Inpatient Sample, and the Centers for Medicare & Medicaid Services. Effectiveness was expressed in quality-adjusted life years (QALYs). The model was populated with health state utilities and state transition probabilities derived from previously published literature. The analysis was performed for a patient's lifetime, and costs and effectiveness were discounted at 3% annually. The principal outcome was the incremental cost-effectiveness ratio (ICER), with a willingness-to-pay threshold of $100,000/QALY. Sensitivity analyses were performed to explore relevant uncertainty. In the base case, DM total hip arthroplasty showed absolute dominance over conventional total hip arthroplasty, with lower accrued costs ($39,008 versus $40,031 U.S. dollars) and higher accrued utility (13.18 versus 13.13 QALYs) indicating cost-savings. DM total hip arthroplasty ceased being cost-saving when its implant costs exceeded those of conventional total hip arthroplasty by $1,023, and the cost-effectiveness threshold for DM implants was $5,287 greater than that for conventional implants. DM was not cost-effective when the annualized incremental probability of revision from any unforeseen failure mechanism or mechanisms exceeded 0.29%. The probability of intraprosthetic dislocation exerted the most influence on model results. This model

  1. Mating of a PROSTALAC spacer with an intramedullary nail for reconstruction of an infected interprosthetic femoral shaft fracture: a case report.

    Science.gov (United States)

    Kamath, Atul F; Austin, Daniel; Lee, Gwo-Chin

    2012-08-01

    Reconstruction for concurrent infection of an ipsilateral total hip arthroplasty (THA) and total knee arthroplasty (TKA) is a challenge. We report a 2-stage reconstruction of a THA for chronic infection of both the THA and TKA with severe femoral bone loss secondary to interprosthetic fractures. The reconstruction involved using a custom-made, temporary, antibiotic-impregnated PROSTALAC spacer mated with an intramedullary nail. The acetabulum was then exposed and the necrotic cartilage was removed and curetted. The acetabulum was reamed to accept a PROSTALAC acetabular shell. The shell was cemented into the acetabulum with antibiotic cement. The custom-made spacer was then inserted distally first into the tibia. The distal end of the intramedullary nail was interlocked with a bicortical bolt to minimise nail rotation. Antibiotic-impregnated cement was moulded around the nail and spacer. The proximal end of the spacer was then reduced into the acetabular socket, and the joint was irrigated and the wound closed. A customised abduction brace was fitted, and partial weight bearing was allowed. Sufficient leg length, soft-tissue tension, and range of hip motion were restored, and a total femur and constrained liner was re-implanted 4 months later. Mating of an intramedullary nail with a PROSTALAC spacer is a viable reconstructive option.

  2. Optimization of scan time in MRI for total hip prostheses. SEMAC tailoring for prosthetic implants containing different types of metals

    Energy Technology Data Exchange (ETDEWEB)

    Deligianni, X. [University of Basel Hospital, Basel (Switzerland). Div. of Radiological Physics; Merian Iselin Klinik, Basel (Switzerland). Inst. of Radiology; Bieri, O. [University of Basel Hospital, Basel (Switzerland). Div. of Radiological Physics; Elke, R. [Orthomerian, Basel (Switzerland); Wischer, T.; Egelhof, T. [Merian Iselin Klinik, Basel (Switzerland). Inst. of Radiology

    2015-12-15

    Magnetic resonance imaging (MRI) of soft tissues after total hip arthroplasty is of clinical interest for the diagnosis of various pathologies that are usually invisible with other imaging modalities. As a result, considerable effort has been put into the development of metal artifact reduction MRI strategies, such as slice encoding for metal artifact correction (SEMAC). Generally, the degree of metal artifact reduction with SEMAC directly relates to the overall time spent for acquisition, but there is no specific consensus about the most efficient sequence setup depending on the implant material. The aim of this article is to suggest material-tailored SEMAC protocol settings. Five of the most common total hip prostheses (1. Revision prosthesis (S-Rom), 2. Titanium alloy, 3. Mueller type (CoNiCRMo alloy), 4. Old Charnley prosthesis (Exeter/Stryker), 5. MS-30 stem (stainless-steel)) were scanned on a 1.5 T MRI clinical scanner with a SEMAC sequence with a range of artifact-resolving slice encoding steps (SES: 2 - 23) along the slice direction (yielding a total variable scan time ranging from 1 to 10 min). The reduction of the artifact volume in comparison with maximal artifact suppression was evaluated both quantitatively and qualitatively in order to establish a recommended number of steps for each case. The number of SES that reduced the artifact volume below approximately 300 mm{sup 3} ranged from 3 to 13, depending on the material. Our results showed that although 3 SES steps can be sufficient for artifact reduction for titanium prostheses, at least 11 SES should be used for prostheses made of materials such as certain alloys of stainless steel. Tailoring SES to the implant material and to the desired degree of metal artifact reduction represents a simple tool for workflow optimization of SEMAC imaging near total hip arthroplasty in a clinical setting.

  3. Optimization of scan time in MRI for total hip prostheses. SEMAC tailoring for prosthetic implants containing different types of metals

    International Nuclear Information System (INIS)

    Deligianni, X.; Wischer, T.; Egelhof, T.

    2015-01-01

    Magnetic resonance imaging (MRI) of soft tissues after total hip arthroplasty is of clinical interest for the diagnosis of various pathologies that are usually invisible with other imaging modalities. As a result, considerable effort has been put into the development of metal artifact reduction MRI strategies, such as slice encoding for metal artifact correction (SEMAC). Generally, the degree of metal artifact reduction with SEMAC directly relates to the overall time spent for acquisition, but there is no specific consensus about the most efficient sequence setup depending on the implant material. The aim of this article is to suggest material-tailored SEMAC protocol settings. Five of the most common total hip prostheses (1. Revision prosthesis (S-Rom), 2. Titanium alloy, 3. Mueller type (CoNiCRMo alloy), 4. Old Charnley prosthesis (Exeter/Stryker), 5. MS-30 stem (stainless-steel)) were scanned on a 1.5 T MRI clinical scanner with a SEMAC sequence with a range of artifact-resolving slice encoding steps (SES: 2 - 23) along the slice direction (yielding a total variable scan time ranging from 1 to 10 min). The reduction of the artifact volume in comparison with maximal artifact suppression was evaluated both quantitatively and qualitatively in order to establish a recommended number of steps for each case. The number of SES that reduced the artifact volume below approximately 300 mm 3 ranged from 3 to 13, depending on the material. Our results showed that although 3 SES steps can be sufficient for artifact reduction for titanium prostheses, at least 11 SES should be used for prostheses made of materials such as certain alloys of stainless steel. Tailoring SES to the implant material and to the desired degree of metal artifact reduction represents a simple tool for workflow optimization of SEMAC imaging near total hip arthroplasty in a clinical setting.

  4. A biomechanical testing system to determine micromotion between hip implant and femur accounting for deformation of the hip implant: Assessment of the influence of rigid body assumptions on micromotions measurements.

    Science.gov (United States)

    Leuridan, Steven; Goossens, Quentin; Roosen, Jorg; Pastrav, Leonard; Denis, Kathleen; Mulier, Michiel; Desmet, Wim; Vander Sloten, Jos

    2017-02-01

    Accurate pre-clinical evaluation of the initial stability of new cementless hip stems using in vitro micromotion measurements is an important step in the design process to assess the new stem's potential. Several measuring systems, linear variable displacement transducer-based and other, require assuming bone or implant to be rigid to obtain micromotion values or to calculate derived quantities such as relative implant tilting. An alternative linear variable displacement transducer-based measuring system not requiring a rigid body assumption was developed in this study. The system combined advantages of local unidirectional and frame-and-bracket micromotion measuring concepts. The influence and possible errors that would be made by adopting a rigid body assumption were quantified. Furthermore, as the system allowed emulating local unidirectional and frame-and-bracket systems, the influence of adopting rigid body assumptions were also analyzed for both concepts. Synthetic and embalmed bone models were tested in combination with primary and revision implants. Single-legged stance phase loading was applied to the implant - bone constructs. Adopting a rigid body assumption resulted in an overestimation of mediolateral micromotion of up to 49.7μm at more distal measuring locations. Maximal average relative rotational motion was overestimated by 0.12° around the anteroposterior axis. Frontal and sagittal tilting calculations based on a unidirectional measuring concept underestimated the true tilting by an order of magnitude. Non-rigid behavior is a factor that should not be dismissed in micromotion stability evaluations of primary and revision femoral implants. Copyright © 2017 Elsevier Ltd. All rights reserved.

  5. The manufacture of generic replicas of implants for arthroplasty of the hip and knee: is it regulated and will it save money?

    Science.gov (United States)

    Atrey, A; Heylen, S; Gosling, O; Porteous, M J L; Haddad, F S

    2016-07-01

    Joint replacement of the hip and knee remain very satisfactory operations. They are, however, expensive. The actual manufacturing of the implant represents only 30% of the final cost, while sales and marketing represent 40%. Recently, the patents on many well established and successful implants have expired. Companies have started producing and distributing implants that purport to replicate existing implants with good long-term results. The aims of this paper are to assess the legality, the monitoring and cost saving implications of such generic implants. We also assess how this might affect the traditional orthopaedic implant companies. Cite this article: Bone Joint J 2016;98-B:892-900. ©2016 The British Editorial Society of Bone & Joint Surgery.

  6. Fretting-corrosion behavior in hip implant modular junctions: The influence of friction energy and pH variation.

    Science.gov (United States)

    Royhman, Dmitry; Patel, Megha; Runa, Maria J; Wimmer, Markus A; Jacobs, Joshua J; Hallab, Nadim J; Mathew, Mathew T

    2016-09-01

    Recently, there has been increasing concern in the orthopedic community over the use of hip implant modular devices due to an increasing number of reports of early failure, failure that has been attributed to fretting-corrosion at modular interfaces. Much is still unknown about the electrochemical and mechanical degradation mechanisms associated with the use of such devices. Accordingly, the purpose of our study was to develop a methodology for testing the fretting-corrosion behavior of modular junctions. A fretting-corrosion apparatus was used to simulate the fretting-corrosion conditions of a CoCrMo hip implant head on a Ti6Al4V hip implant stem. The device features two perpendicularly-loaded CoCrMo pins that articulated against a Ti6Al4V rod. A sinusoidal fretting motion was applied to the rod at various displacement amplitudes (25, 50, 100, 150 and 200μm) at a constant load of 200N. Bovine calf serum at two different pH levels (3.0 and 7.6) was used to simulate the fluid environment around the joint. Experiments were conducted in two modes of electrochemical control - free-potential and potentiostatic. Electrochemical impedance spectroscopy tests were done before and after the fretting motion to assess changes in corrosion kinetics. In free potential mode, differences were seen in change in potential as a function of displacement amplitude. In general, VDrop (the drop in potential at the onset of fretting), VFretting, (the average potential during fretting), ΔVFretting (the change in potential from the onset of fretting to its termination) and VRecovery (the change in potential from the termination of fretting until stabilization) appeared linear at both pH levels, but showed drastic deviation from linearity at 100μm displacement amplitude. Subsequent EDS analysis revealed a large number of Ti deposits on the CoCrMo pin surfaces. Potentiostatic tests at both pH levels generally showed increasing current with increasing displacement amplitude. Electrochemical

  7. [Ex vivo microCT analysis of possible microfractures of the femoral head during implantation of a cementless hip resurfacing femoral component].

    Science.gov (United States)

    Lerch, M; Olender, G; von der Höh, N; Thorey, F; von Lewinski, G; Meyer-Lindenberg, A; Windhagen, H; Hurschler, C

    2009-01-01

    Microfractures of the femoral head during implantation of the femoral components are suspected to be a cause of fractures at the implant/neck junction which represent a common failure mode in hip resurfacing arthroplasty. Callus formation observed in femoral head retrievals suggests the occurrence of microfractures inside the femoral head, which might be inadvertently caused by the surgeon during implantation. The aim of this biomechanical study was to analyse whether or not the implantation of a cementless femoral component hip resurfacing system causes microfractures in the femoral head. After the preparation of 20 paired human cadaveric femoral heads, the cementless femoral component ESKA Typ BS (ESKA Implants GmbH & Co., Lübeck) was implanted on 9 specimens with an impaction device that generates 4.5 kN impaction force. On 9 specimens the femoral component was implanted by hand. One head was used as a fracture model, 1 specimen served as control without manipulation. The femoral component used for impaction was equipped with hinges to enable its removal without further interfering with the bone stock. Specimens were scanned with a microCT device before and after impaction and the microCT datasets before and after impaction were compared to identify possible microfractures. Twenty strikes per hand or with the impaction device provided sufficient implant seating. Neither the macroscopic examination nor the 2-dimensional microCT analysis revealed any fractures of the femoral heads after impaction. At least macroscopically and in the 2-dimensional microCT analysis, implantation of the cementless hip resurfacing femoral component ESKA Typ BS with 4.5 kN or by hand does not seem to cause fractures of the femoral head. Georg Thieme Verlag KG Stuttgart, New York.

  8. Characterization of wear debris from metal-on-metal hip implants during normal wear versus edge-loading conditions.

    Science.gov (United States)

    Kovochich, Michael; Fung, Ernest S; Donovan, Ellen; Unice, Kenneth M; Paustenbach, Dennis J; Finley, Brent L

    2018-04-01

    Advantages of second-generation metal-on-metal (MoM) hip implants include low volumetric wear rates and the release of nanosized wear particles that are chemically inert and readily cleared from local tissue. In some patients, edge loading conditions occur, which result in higher volumetric wear. The objective of this study was to characterize the size, morphology, and chemistry of wear particles released from MoM hip implants during normal (40° angle) and edge-loading (65° angle with microseparation) conditions. The mean primary particle size by volume under normal wear was 35 nm (range: 9-152 nm) compared with 95 nm (range: 6-573 nm) under edge-loading conditions. Hydrodynamic diameter analysis by volume showed that particles from normal wear were in the nano- (edge-loading conditions generated particles that ranged from Edge-loading conditions generated more elongated particles (4.5%) (aspect ratio ≥ 2.5) and more CoCr alloy particles (9.3%) compared with normal wear conditions (1.3% CoCr particles). By total mass, edge-loading particles contained approximately 640-fold more cobalt than normal wear particles. Our findings suggest that high wear conditions are a potential risk factor for adverse local tissue effects in MoM patients who experience edge loading. This study is the first to characterize both the physical and chemical characteristics of MoM wear particles collected under normal and edge-loading conditions. © 2017 Wiley Periodicals, Inc. J Biomed Mater Res Part B: Appl Biomater, 106B: 986-996, 2018. © 2017 Wiley Periodicals, Inc.

  9. Modular titanium alloy neck adapter failures in hip replacement - failure mode analysis and influence of implant material

    Directory of Open Access Journals (Sweden)

    Bloemer Wilhelm

    2010-01-01

    Full Text Available Abstract Background Modular neck adapters for hip arthroplasty stems allow the surgeon to modify CCD angle, offset and femoral anteversion intraoperatively. Fretting or crevice corrosion may lead to failure of such a modular device due to high loads or surface contamination inside the modular coupling. Unfortunately we have experienced such a failure of implants and now report our clinical experience with the failures in order to advance orthopaedic material research and joint replacement surgery. The failed neck adapters were implanted between August 2004 and November 2006 a total of about 5000 devices. After this period, the titanium neck adapters were replaced by adapters out of cobalt-chromium. Until the end of 2008 in total 1.4% (n = 68 of the implanted titanium alloy neck adapters failed with an average time of 2.0 years (0.7 to 4.0 years postoperatively. All, but one, patients were male, their average age being 57.4 years (36 to 75 years and the average weight 102.3 kg (75 to 130 kg. The failures of neck adapters were divided into 66% with small CCD of 130° and 60% with head lengths of L or larger. Assuming an average time to failure of 2.8 years, the cumulative failure rate was calculated with 2.4%. Methods A series of adapter failures of titanium alloy modular neck adapters in combination with a titanium alloy modular short hip stem was investigated. For patients having received this particular implant combination risk factors were identified which were associated with the occurence of implant failure. A Kaplan-Meier survival-failure-analysis was conducted. The retrieved implants were analysed using microscopic and chemical methods. Modes of failure were simulated in biomechanical tests. Comparative tests included modular neck adapters made of titanium alloy and cobalt chrome alloy material. Results Retrieval examinations and biomechanical simulation revealed that primary micromotions initiated fretting within the modular tapered neck

  10. Rationale for one stage exchange of infected hip replacement using uncemented implants and antibiotic impregnated bone graft.

    Science.gov (United States)

    Winkler, Heinz

    2009-09-04

    Infection of a total hip replacement (THR) is considered a devastating complication, necessitating its complete removal and thorough debridement of the site. It is undoubted that one stage exchange, if successful, would provide the best benefit both for the patient and the society. Still the fear of re-infection dominates the surgeons decisions and in the majority of cases directs them to multiple stage protocols. However, there is no scientifically based argument for that practice. Successful eradication of infection with two stage procedures is reported to average 80% to 98%. On the other hand a literature review of Jackson and Schmalzried (CORR 2000) summarizing the results of 1,299 infected hip replacements treated with direct exchange (almost exclusively using antibiotic loaded cement), reports of 1,077 (83%) having been successful. The comparable results suggest, that the major factor for a successful outcome with traditional approaches may be found in the quality of surgical debridement and dead space management. Failures in all protocols seem to be caused by small fragments of bacterial colonies remaining after debridement, whereas neither systemic antibiotics nor antibiotic loaded bone cement (PMMA) have been able to improve the situation significantly. Reasons for failure may be found in the limited sensitivity of traditional bacterial culturing and reduced antibiotic susceptibility of involved pathogens, especially considering biofilm formation. Whenever a new prosthesis is implanted into a previously infected site the surgeon must be aware of increased risk of failure, both in single or two stage revisions. Eventual removal therefore should be easy with low risk of additional damage to the bony substance. On the other hand it should also have potential of a good long term result in case of success. Cemented revisions generally show inferior long term results compared to uncemented techniques; the addition of antibiotics to cement reduces its

  11. Spacer st4ructure

    International Nuclear Information System (INIS)

    Masetti, W.R.

    1978-01-01

    A spacer structure is described for maintaining a spaced relation between a plurality of generally parallel fuel rods within a housing in a nuclear reactor. The spacer structure is comprised of a grid pattern of ribs slotted to interlock with each other. The slots are arranged in such a way that when the ribs are welded to each other, the weld shrinkage is distributed uniformly in all directions to reduce or eliminate the amount of rework necessary in manufacturing the spacer structure

  12. Fouling resistant membrane spacers

    KAUST Repository

    Ghaffour, Noreddine

    2017-10-12

    Disclosed herein are spacers having baffle designs and perforations for efficiently and effectively separating one or more membrane layers a membrane filtration system. The spacer (504) includes a body (524) formed at least in part by baffles (520) that are interconnected, and the baffles define boundaries of openings or apertures (525) through a thickness direction of the body of the spacer. Alternatively or additionally, passages or perforations (526A, 526B) may be present in the spacer layer or baffles for fluid flow there through, with the passages and baffles having a numerous different shapes and sizes.

  13. Mixing vane grid spacer

    International Nuclear Information System (INIS)

    Patterson, J.F.; Galbraith, K.P.

    1978-01-01

    An improved mixing vane grid spacer having enhanced flow mixing capability by virtue of mixing vanes being positioned at welded intersecting joints of the spacer wherein each mixing vane has an opening or window formed therein substantially directly over the welded joint to provide improved flow mixing capability is described. Some of the vanes are slotted, depending on their particular location in the spacers. The intersecting joints are welded by initially providing consumable tabs at and within each window, which are consumed during the welding of the spacer joints

  14. The effect of a single infusion of zoledronic acid on early implant migration in total hip arthroplasty. A randomized, double-blind, controlled trial.

    Science.gov (United States)

    Friedl, Gerald; Radl, Roman; Stihsen, Christoph; Rehak, Peter; Aigner, Reingard; Windhager, Reinhard

    2009-02-01

    Aseptic loosening is the most frequent cause of implant failure in total hip arthroplasty. While a direct link between aseptic loosening and periprosthetic bone loss remains elusive, there is plentiful evidence for a close association with early implant migration. The present trial was primarily designed to evaluate whether a single infusion of 4 mg of zoledronic acid prevented early implant migration in patients with osteonecrosis of the femoral head. Fifty patients were consecutively enrolled to receive either zoledronic acid or saline solution after cementless total hip arthroplasty. Radiographs, biochemical parameters of bone turnover, and the Harris hip-rating score were determined preoperatively and at each follow-up examination at seven weeks, six months, one year, and yearly thereafter. The median follow-up period was 2.8 years. We found a significant subsidence of the stem of up to a mean (and standard deviation) of -1.2 +/- 0.6 mm at two years within the control group, and the cups had a mean medialization of 0.6 +/- 1.0 mm and a mean cranialization of 0.6 +/- 0.8 mm (p < 0.001). Treatment with zoledronic acid effectively minimized the migration of the cups in both the transverse and the vertical direction (mean, 0.15 +/- 0.6 mm and 0.06 +/- 0.6 mm, respectively; p < 0.05), while only a trend to decreased subsidence of the stem was detected. Finally, the Harris hip score rapidly increased over time in both treatment groups, although this increase was significantly more pronounced in the zoledronate-treated group than in the control group (analysis of variance, p = 0.008). A single infusion of zoledronic acid shows promise in improving initial fixation of a cementless implant, which may improve the clinical outcome of total hip arthroplasty in patients with osteonecrosis of the femoral head.

  15. Failure of total hip implants: metals and metal release in 52 cases

    DEFF Research Database (Denmark)

    Jakobsen, Stig Storgaard; Lidén, Carola; Søballe, Kjeld

    2014-01-01

    Background . The pathogenesis of total joint replacement failure is multifactorial. One hypothesis suggests that corrosion and wear of alloys result in metal ion release, which may then cause sensitization and even implant failure, owing to the acquired immune reactivity. Objectives . To assess c...

  16. Experimental and numerical research of mechanical behaviour of titanium alloy hip implant

    Czech Academy of Sciences Publication Activity Database

    Čolić, K.; Sedmak, A.; Legweel, K.; Milošević, M.I.; Nitrović, N.; Mišković, Ž.; Hloch, Sergej

    2017-01-01

    Roč. 24, č. 3 (2017), s. 709-713 ISSN 1330-3651 Institutional support: RVO:68145535 Keywords : biomedical implant * digital image correlation * finite element method * Ti-6Al-4V alloy Subject RIV: JQ - Machines ; Tools OBOR OECD: Mechanical engineering Impact factor: 0.723, year: 2016 https://hrcak.srce.hr/index.php?id_clanak_jezik=269849&show=clanak

  17. Structural Stator Spacers

    DEFF Research Database (Denmark)

    Rasmussen, Peter Omand; Andreasen, Jens H.; Pijanowski, J. M.

    2001-01-01

    This paper presents a powerful new design aspect to reduce acoustic noise and vibration of electro-magnetic origin for electrical machines, by introducing improved slot wedges referred to as "Structural Stator Spacers". These spacers, by using a very stiff dielectric and non magnetic material...

  18. Natural History of Bone Response to Hydroxyapatite-Coated Hip Prostheses Implanted in Humans

    OpenAIRE

    Frayssinet, P.; Hardy, D.; Hanker, J. S.; Giammara, B. L.

    1995-01-01

    A series of 15 autopsied femurs containing hydroxyapatite- coated (HA-coated) prostheses was analysed histologically. Their implantation time ranged from 5 days up to 3 years. The coating thickness of some prostheses and the percentage of the coating in contact with bone at different levels were evaluated using an image analysis device. After the newly formed bone tissue had became mature, several bone morphotypes were identified at the coating contact. From the proximal to the distal part of...

  19. A Randomized Seven-Year Study on Performance of the Stemmed Metal M2a-Magnum and Ceramic C2a-Taper, and the Resurfacing ReCap Hip Implants

    DEFF Research Database (Denmark)

    Borgwardt, Arne; Borgwardt, Lotte; Zerahn, Bo

    2018-01-01

    BACKGROUND: The large-diameter metal-on-metal hip prostheses were expected to have low wear and reduced dislocation rate compared to the traditional metal-on-polyethylene implants. We compare 2 such prostheses, the ReCap resurfacing implant and the M2a-Magnum stemmed implant, with the C2a ceramic......-on-ceramic stemmed implant as to clinical performance, serum concentrations of prosthesis metals, and the durability of the implants in a randomized, controlled clinical trial at 7 years of follow-up. METHODS: All included patients had osteoarthritis. Preoperatively, the size of the implants was estimated from...... of the soft tissue adjacent to the implant as well as MRI with metal artifact reduction sequence (MARS-MRI) when indicated. RESULTS: One hundred fifty-two hips in 146 patients were included. The serum cobalt and chromium concentrations were significantly higher for the 2 metal-on-metal prostheses than...

  20. Advanced metal artifact reduction MRI of metal-on-metal hip resurfacing arthroplasty implants: compressed sensing acceleration enables the time-neutral use of SEMAC

    International Nuclear Information System (INIS)

    Fritz, Jan; Thawait, Gaurav K.; Fritz, Benjamin; Raithel, Esther; Nittka, Mathias; Gilson, Wesley D.; Mont, Michael A.

    2016-01-01

    Compressed sensing (CS) acceleration has been theorized for slice encoding for metal artifact correction (SEMAC), but has not been shown to be feasible. Therefore, we tested the hypothesis that CS-SEMAC is feasible for MRI of metal-on-metal hip resurfacing implants. Following prospective institutional review board approval, 22 subjects with metal-on-metal hip resurfacing implants underwent 1.5 T MRI. We compared CS-SEMAC prototype, high-bandwidth TSE, and SEMAC sequences with acquisition times of 4-5, 4-5 and 10-12 min, respectively. Outcome measures included bone-implant interfaces, image quality, periprosthetic structures, artifact size, and signal- and contrast-to-noise ratios (SNR and CNR). Using Friedman, repeated measures analysis of variances, and Cohen's weighted kappa tests, Bonferroni-corrected p-values of 0.005 and less were considered statistically significant. There was no statistical difference of outcomes measures of SEMAC and CS-SEMAC images. Visibility of implant-bone interfaces and pseudocapsule as well as fat suppression and metal reduction were ''adequate'' to ''good'' on CS-SEMAC and ''non-diagnostic'' to ''adequate'' on high-BW TSE (p < 0.001, respectively). SEMAC and CS-SEMAC showed mild blur and ripple artifacts. The metal artifact size was 63 % larger for high-BW TSE as compared to SEMAC and CS-SEMAC (p < 0.0001, respectively). CNRs were sufficiently high and statistically similar, with the exception of CNR of fluid and muscle and CNR of fluid and tendon, which were higher on intermediate-weighted high-BW TSE (p < 0.005, respectively). Compressed sensing acceleration enables the time-neutral use of SEMAC for MRI of metal-on-metal hip resurfacing implants when compared to high-BW TSE and image quality similar to conventional SEMAC. (orig.)

  1. Advanced metal artifact reduction MRI of metal-on-metal hip resurfacing arthroplasty implants: compressed sensing acceleration enables the time-neutral use of SEMAC

    Energy Technology Data Exchange (ETDEWEB)

    Fritz, Jan; Thawait, Gaurav K. [Johns Hopkins University School of Medicine, Russell H. Morgan Department of Radiology and Radiological Science, Section of Musculoskeletal Radiology, Baltimore, MD (United States); Fritz, Benjamin [University of Freiburg, Department of Radiology, Freiburg im Breisgau (Germany); Raithel, Esther; Nittka, Mathias [Siemens Healthcare GmbH, Erlangen (Germany); Gilson, Wesley D. [Siemens Healthcare USA, Inc., Baltimore, MD (United States); Mont, Michael A. [Cleveland Clinic Foundation, Department of Orthopedic Surgery, Cleveland, OH (United States)

    2016-10-15

    Compressed sensing (CS) acceleration has been theorized for slice encoding for metal artifact correction (SEMAC), but has not been shown to be feasible. Therefore, we tested the hypothesis that CS-SEMAC is feasible for MRI of metal-on-metal hip resurfacing implants. Following prospective institutional review board approval, 22 subjects with metal-on-metal hip resurfacing implants underwent 1.5 T MRI. We compared CS-SEMAC prototype, high-bandwidth TSE, and SEMAC sequences with acquisition times of 4-5, 4-5 and 10-12 min, respectively. Outcome measures included bone-implant interfaces, image quality, periprosthetic structures, artifact size, and signal- and contrast-to-noise ratios (SNR and CNR). Using Friedman, repeated measures analysis of variances, and Cohen's weighted kappa tests, Bonferroni-corrected p-values of 0.005 and less were considered statistically significant. There was no statistical difference of outcomes measures of SEMAC and CS-SEMAC images. Visibility of implant-bone interfaces and pseudocapsule as well as fat suppression and metal reduction were ''adequate'' to ''good'' on CS-SEMAC and ''non-diagnostic'' to ''adequate'' on high-BW TSE (p < 0.001, respectively). SEMAC and CS-SEMAC showed mild blur and ripple artifacts. The metal artifact size was 63 % larger for high-BW TSE as compared to SEMAC and CS-SEMAC (p < 0.0001, respectively). CNRs were sufficiently high and statistically similar, with the exception of CNR of fluid and muscle and CNR of fluid and tendon, which were higher on intermediate-weighted high-BW TSE (p < 0.005, respectively). Compressed sensing acceleration enables the time-neutral use of SEMAC for MRI of metal-on-metal hip resurfacing implants when compared to high-BW TSE and image quality similar to conventional SEMAC. (orig.)

  2. Membrane with integrated spacer

    NARCIS (Netherlands)

    Balster, J.H.; Stamatialis, Dimitrios; Wessling, Matthias

    2010-01-01

    Many membrane processes are severely influenced by concentration polarisation. Turbulence promoting spacers placed in between the membranes can reduce the diffusional resistance of concentration polarisation by inducing additional mixing. Electrodialysis (ED) used for desalination suffers from

  3. Colocación de implantes glúteos y de cadera: una alternativa para mejorar el contorno en hipoplasia glúteo-trocantérea Placement of buttock and hip implants: an alternative for contour improvement in buttock and hips hypoplasia

    Directory of Open Access Journals (Sweden)

    L. Cárdenas-Camarena

    2012-03-01

    Full Text Available La mejoría del contorno glúteo y de caderas en un paciente varón que desea un contorno femenino es difícil de conseguir cuando no es posible disponer de una cantidad de grasa suficiente para inyectar y lograr una mejoría integral. Presentamos la técnica quirúrgica utilizada en un paciente transexual masculino que había tenido dos intentos fallidos de feminizar su contorno de glúteos y caderas. Utilizamos implantes ovales de silicona cohesiva, tanto para la región glútea como para las caderas, inyectando grasa en las áreas de transición entre los dos implantes. Con esta combinación obtuvimos un contorno femenino integral, eliminando por completo el aspecto masculino de la región glúteo-trocantérea. En conclusión, pensamos que la combinación empleada supone una opción novedosa y no descrita hasta el momento para el tratamiento de pacientes transexuales que buscan un contorno glúteo más femenino de forma integral, con resultados predecibles y muy gratificantes, que mejora las deficiencias que los pacientes masculinos tienen en esta zona en comparación con el contorno de los glúteos femeninos.Improvement of the gluteal and hip contour in patients seeking a more feminine shape is difficult to achieve, specially for those who don't have enough fat to transfer from other areas of the body. We describe the surgical technique used to improve hips and buttocks contour in a genetic male transsexual. This patient previously underrwent two unsuccessful surgeries to feminize his hip and buttock contour. Our successful approach involved the use of an oval-shaped cohesive silicone gel implants placed in both, the hip and buttock areas, along with fat injection in the areas between the two implants. A natural, feminine contour was achieved using the combination of buttock and hip implants with lipofilling using patient's own fat. These procedures completely eliminated the male contour previously noted in the gluteal trochanteric region

  4. 21 CFR 888.3360 - Hip joint femoral (hemi-hip) metallic cemented or uncemented prosthesis.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Hip joint femoral (hemi-hip) metallic cemented or... 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 implanted...

  5. Two years follow-up study of the pain-relieving effect of gold bead implantation in dogs with hip-joint arthritis

    Directory of Open Access Journals (Sweden)

    Søli Nils

    2007-03-01

    Full Text Available Abstract Seventy-eight dogs with pain from hip dysplasia participated in a six-month placebo-controlled, double-blinded clinical trial of gold bead implantation. In the present, non-blinded study, 73 of these dogs were followed for an additional 18 months to evaluate the long-term pain-relieving effect of gold bead implantation. The recently-published results of the six month period revealed that 30 of the 36 dogs (83% in the gold implantation group showed significant improvement (p = 0.02, included improved mobility and reduction in the signs of pain, compared to the placebo group (60% improvement. In the long-term two-year follow-up study, 66 of the 73 dogs had gold implantation and seven dogs continued as a control group. The 32 dogs in the original placebo group had gold beads implanted and were followed for a further 18 months. A certified veterinary acupuncturist used the same procedure to insert the gold beads as in the blinded study, and the owners completed the same type of detailed questionnaires. As in the blinded study, one investigator was responsible for all the assessments of each dog. The present study revealed that the pain-relieving effect of gold bead implantation observed in the blinded study continued throughout the two-year follow-up period.

  6. Metal Ion Concentrations in Body Fluids after Implantation of Hip Replacements with Metal-on-Metal Bearing – Systematic Review of Clinical and Epidemiological Studies

    Science.gov (United States)

    Hartmann, Albrecht; Hannemann, Franziska; Lützner, Jörg; Seidler, Andreas; Drexler, Hans; Günther, Klaus-Peter; Schmitt, Jochen

    2013-01-01

    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 indication for hip

  7. 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

  8. Side insertable spacer

    International Nuclear Information System (INIS)

    Patterson, J.F.; Ewing, R.H.

    1992-01-01

    This patent describes a spacer for restraining the fuel rods of a nuclear fuel assembly, the assembly being formed of a plurality of parallel, elongated fuel rods so arranged that the assembly is bounded by a polygon having an even number of sides, the rods being so arranged as to lie in a plurality of sets of parallel rows, the rows of each set being perpendicular to one of the sides of the polygon. It comprises a number of spacer combs equal to at least half the number of the sides of the polygon, the spacer combs being superposed on each other, each of the spacer combs comprising: a single base strip having a length equal to that of one of the sides of the polygon and grid strips equal in number to the spaces between rows in one of the sets, and at least a majority of the grid strips being of a length sufficient to extend substantially the full length of the rows; the grid strips being provided with spring members positioned to engage each of the rods; the grid strips being provided with spring members positioned to engage each of the rods; the grid strips being secured to and extending at right angles to the base strip; the grid strips of different combs being positioned at angles to each other, so as to occupy the spaces between rows in different sets

  9. [Dislocated fracture of the lesser trochanter with malrotation of the stem after robot assisted implantation of a cementless hip prosthesis: a casuistic report].

    Science.gov (United States)

    Prymka, M; Hassenpflug, J

    2003-08-01

    This paper presents the case of a 63 year old female with a severe coxarthrosis. She got a robot assited implantation of a cementless hip prosthesis (Osteolock, Stryker-Howmedica, Mühlheim). As operation robot the CASPAR-System (Orto-Maquet, Rastatt) was used. Initially, the clinical progress of the patient was fine. She was nearly painfree within 14 days and showed an acceptable range of motion in the operated joint (flexion/ extension 90 degrees /05 degrees /00 degrees ). She was mobilized with crutches and 15 kg weight bearing at the operated leg. 3 weeks postoperative the patient complaint about increasing pain without trauma or intensification of the weight bearing. X-rays showed not only a dislocated fracture of the lesser trochanter, but also a sinking combined with a malrotation of the stem. A revision operation was necessary,where we implanted a cemented stem. Now clinical progress was completely satisfying.

  10. Effects of tibial plateau angle and spacer thickness applied during in vitro canine total knee replacement on three-dimensional kinematics and collateral ligament strain.

    Science.gov (United States)

    Baker, Katherine M; Foutz, Timothy L; Johnsen, Kyle J; Budsberg, Steven C

    2014-09-01

    To quantify the 3-D kinematics and collateral ligament strain of stifle joints in cadaveric canine limbs before and after cranial cruciate ligament transection followed by total knee replacement (TKR) involving various tibial plateau angles and spacer thicknesses. 6 hemi-pelvises collected from clinically normal nonchondrodystrophic dogs (weight range, 25 to 35 kg). Hemi-pelvises were mounted on a modified Oxford knee rig that allowed 6 degrees of freedom of the stifle joint but prevented mechanical movement of the hip and tarsal joints. Kinematics and collateral ligament strain were measured continuously while stifle joints were flexed. Data were again collected after cranial cruciate ligament transection and TKR with combinations of 3 plateau angles (0°, 4°, and 8°) and spacer thicknesses (5, 7, and 9 mm). Presurgical (ie, normal) stifle joint rotations were comparable to those previously documented for live dogs. After TKR, kinematics recorded for the 8°, 5-mm implant most closely resembled those of unaltered stifle joints. Decreasing the plateau angle and increasing spacer thickness altered stifle joint adduction, internal rotation, and medial translation. Medial collateral ligament strain was minimal in unaltered stifle joints and was unaffected by TKR. Lateral collateral ligament strain decreased with steeper plateau angles but returned to a presurgical level at the flattest plateau angle. Among the constructs tested, greatest normalization of canine stifle joint kinematics in vitro was achieved with the steepest plateau angle paired with the thinnest spacer. Furthermore, results indicated that strain to the collateral ligaments was not negatively affected by TKR.

  11. Fuel assembly spacer

    International Nuclear Information System (INIS)

    Shirakawa, Ken-etsu.

    1988-01-01

    Purpose: To reduce the pressure loss of coolants by fuel assembly spacers. Constitution: Spacers for supporting a fuel assembly are attached by means of a plurality of wires to an outer frame. The outer frame is made of shape memory alloy such that the wires are caused to slacken at normal temperature and the slacking of the wires is eliminated in excess of the transition temperature. Since the wires slacken at the normal temperature, fuel rods can be inserted easily. After the insertion of the fuel rods, when the entire portion or the outer frame is heated by water or gas at a predetermined temperature, the outer frame resumes its previously memorized shape to tighten the wires and, accordingly, the fuel rods can be supported firmly. In this way, since the fuel rods are inserted in the slacken state of the wires and, after the assembling, the outer frame resumes its memorized shape, the assembling work can be conducted efficiently. (Kamimura, M.)

  12. [The primary stability between manual and robot assisted implantation of hip prostheses: A biomechanical study on synthetic femurs].

    Science.gov (United States)

    Decking, J; Gerber, A; Kränzlein, J; Meurer, A; Böhm, B; Plitz, W

    2004-01-01

    We investigated the initial stability of cementless stems implanted with robotic milling and conventional manual broaching. Proximally porous structured stems (G2, ESKA-Implants, Luebeck, Germany) were implanted into synthetic femora. In one group, the femoral cavity was prepared by a CT-based robot (CASPAR, URS-Ortho, Germany) with a high-speed milling head. In the other group, femora were rasped manually with broaches. The broaches had 1 mm proximal press-fit, the robotic cavities 1.5 mm. The implants were exposed to 15 000 loading cycles with 1 000 +/- 500 N. The direction of forces on the implant head were chosen to simulate stair climbing. Internal rotation and translation (caudal, dorsal and lateral) of the implants were measured by linear transducers. The robotic group showed significantly less reversible motion regarding translation in caudal, dorsal and lateral directions. The standard deviations of implant motions were smaller in the robotic group. Using robotic preparation of the femur, initial stability was higher and more consistent than with manual broaching, but differences in undersizing of the cavities created in the femur in relation to the implant may have contributed to these differences for the most part. In-vitro-loading experiments focusing on femoral cavities with varying press-fits are recommended before the introduction of new implants or operating procedures.

  13. Cobalt deposition in mineralized bone tissue after metal-on-metal hip resurfacing: Quantitative μ-X-ray-fluorescence analysis of implant material incorporation in periprosthetic tissue.

    Science.gov (United States)

    Hahn, Michael; Busse, Björn; Procop, Mathias; Zustin, Jozef; Amling, Michael; Katzer, Alexander

    2017-10-01

    Most resurfacing systems are manufactured from cobalt-chromium alloys with metal-on-metal (MoM) bearing couples. Because the quantity of particulate metal and corrosion products which can be released into the periprosthetic milieu is greater in MoM bearings than in metal-on-polyethylene (MoP) bearings, it is hypothesized that the quantity and distribution of debris released by the MoM components induce a compositional change in the periprosthetic bone. To determine the validity of this claim, nondestructive µ-X-ray fluorescence analysis was carried out on undecalcified histological samples from 13 femoral heads which had undergone surface replacement. These samples were extracted from the patients after gradient time points due to required revision surgery. Samples from nonintervened femoral heads as well as from a MoP resurfaced implant served as controls. Light microscopy and µ-X-ray fluorescence analyses revealed that cobalt debris was found not only in the soft tissue around the prosthesis and the bone marrow, but also in the mineralized bone tissue. Mineralized bone exposed to surface replacements showed significant increases in cobalt concentrations in comparison with control specimens without an implant. A maximum cobalt concentration in mineralized hard tissue of up to 380 ppm was detected as early as 2 years after implantation. Values of this magnitude are not found in implants with a MoP surface bearing until a lifetime of more than 20 years. This study demonstrates that hip resurfacing implants with MoM bearings present a potential long-term health risk due to rapid cobalt ion accumulation in periprosthetic hard tissue. © 2016 Wiley Periodicals, Inc. J Biomed Mater Res Part B: Appl Biomater, 105B: 1855-1862, 2017. © 2016 Wiley Periodicals, Inc.

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

    International Nuclear Information System (INIS)

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

    1997-01-01

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

  15. Comparative effectiveness of ceramic-on-ceramic implants in stemmed hip replacement: a multinational study of six national and regional registries.

    Science.gov (United States)

    Sedrakyan, Art; Graves, Stephen; Bordini, Barbara; Pons, Miquel; Havelin, Leif; Mehle, Susan; Paxton, Elizabeth; Barber, Thomas; Cafri, Guy

    2014-12-17

    The rapid decline in use of conventional total hip replacement with a large femoral head size and a metal-on-metal bearing surface might lead to increased popularity of ceramic-on-ceramic bearings as another hard-on-hard alternative that allows implantation of a larger head. We sought to address comparative effectiveness of ceramic-on-ceramic and metal-on-HXLPE (highly cross-linked polyethylene) implants by utilizing the distributed health data network of the ICOR (International Consortium of Orthopaedic Registries), an unprecedented collaboration of national and regional registries and the U.S. FDA (Food and Drug Administration). A distributed health data network was developed by the ICOR and used in this study. The data from each registry are standardized and provided at a level of aggregation most suitable for the detailed analysis of interest. The data are combined across registries for comprehensive assessments. The ICOR coordinating center and study steering committee defined the inclusion criteria for this study as total hip arthroplasty performed without cement from 2001 to 2010 in patients forty-five to sixty-four years of age with osteoarthritis. Six national and regional registries (Kaiser Permanente and HealthEast in the U.S., Emilia-Romagna region in Italy, Catalan region in Spain, Norway, and Australia) participated in this study. Multivariate meta-analysis was performed with use of linear mixed models, with survival probability as the unit of analysis. We present the results of the fixed-effects model and include the results of the random-effects model in an appendix. SAS version 9.2 was used for all analyses. We first compared femoral head sizes of >28 mm and ≤28 mm within ceramic-on-ceramic implants and then compared ceramic-on-ceramic with metal-on-HXLPE. A total of 34,985 patients were included; 52% were female. We found a lower risk of revision associated with use of ceramic-on-ceramic implants when a larger head size was used (HR [hazard

  16. Patient-related predictors of implant failure after primary total hip replacement in the initial, short- and long-terms

    DEFF Research Database (Denmark)

    Johnsen, S.P.; Sørensen, H.T.; Lucht, Ulf

    2006-01-01

    replacement, an age of 80 years or more and hip replacement undertaken as a sequela of trauma, for avascular necrosis or paediatric conditions, were associated with an increased risk of failure. However, during six months to 8.6 years after surgery, being less than 60 years old was associated...

  17. Chemistry-driven structural alterations in short-term retrieved ceramic-on-metal hip implants: Evidence for in vivo incompatibility between ceramic and metal counterparts.

    Science.gov (United States)

    Zhu, Wenliang; Pezzotti, Giuseppe; Boffelli, Marco; Chotanaphuti, Thanainit; Khuangsirikul, Saradej; Sugano, Nobuhiko

    2017-08-01

    Ceramic-on-metal (CoM) hip implants were reported to experience lower wear rates in vitro as compared to metal-on-metal (MoM) bearings, thus hinting metal-ion release at lower levels in vivo. In this article, we show a spectroscopic study of two short-term retrieval cases of zirconia-toughened alumina (ZTA) femoral heads belonging to CoM hip prostheses, which instead showed poor wear performances in vivo. Metal contamination and abnormally high fractions of tetragonal-to-monoclinic (t→m) polymorphic transformation of the zirconia phase could be found on both ZTA heads, which contrasted with the optimistic predictions of in vitro experiments. At the molecular scale, incorporation of metal ions into the ceramic lattices could be recognized as due to frictionally assisted phenomena occurring at the ceramic surface. Driven by abnormal friction, diffusion of metal ions induced lattice shrinkage in the zirconia phases, while residual stress fields became stored at the surface of the femoral head. Diffusional alterations destabilized the chemistry of the ceramic surface and resulted in an abnormal increase in t→m phase transformation in vivo. Frictionally driven metal transfer to the ceramic lattice thus hinders the in vivo performance of CoM prostheses. © 2016 Wiley Periodicals, Inc. J Biomed Mater Res Part B: Appl Biomater, 105B: 1469-1480, 2017. © 2016 Wiley Periodicals, Inc.

  18. Spacer grid corner gusset

    International Nuclear Information System (INIS)

    Larson, J.G.

    1984-01-01

    There is provided a spacer grid for a bundle of longitudinally extending rods in spaced generally parallel relationship comprising spacing means for holding the rods in spaced generally parallel relationship; the spacing means includes at least one exterior grid strip circumscribing the bundle of rods along the periphery thereof; with at least one exterior grid strip having a first edge defining the boundary of the strip in one longitudinal direction and a second edge defining the boundary of the strip in the other longitudinal direction; with at least one exterior grid strip having at least one band formed therein parallel to the longitudinal direction; a plurality of corner gussets truncating each of a plurality of corners formed by at least one band and the first edge and the second edge

  19. Impaction grafting in the femur in cementless modular revision total hip arthroplasty: a descriptive outcome analysis of 243 cases with the MRP-TITAN revision implant

    Directory of Open Access Journals (Sweden)

    Wimmer Matthias D

    2013-01-01

    Full Text Available Abstract Background We present a descriptive and retrospective analysis of revision total hip arthroplasties (THA using the MRP-TITAN stem (Peter Brehm, Weisendorf, GER with distal diaphyseal fixation and metaphyseal defect augmentation. Our hypothesis was that the metaphyseal defect augmentation (Impaction Bone Grafting improves the stem survival. Methods We retrospectively analyzed the aggregated and anonymized data of 243 femoral stem revisions. 68 patients with 70 implants (28.8% received an allograft augmentation for metaphyseal defects; 165 patients with 173 implants (71.2% did not, and served as controls. The mean follow-up was 4.4 ± 1.8 years (range, 2.1–9.6 years. There were no significant differences (p > 0.05 between the study and control group regarding age, body mass index (BMI, femoral defects (types I-III as described by Paprosky, and preoperative Harris Hip Score (HHS. Postoperative clinical function was evaluated using the HHS. Postoperative radiologic examination evaluated implant stability, axial implant migration, signs of implant loosening, periprosthetic radiolucencies, as well as bone regeneration and resorption. Results There were comparable rates of intraoperative and postoperative complications in the study and control groups (p > 0.05. Clinical function, expressed as the increase in the postoperative HHS over the preoperative score, showed significantly greater improvement in the group with Impaction Bone Grafting (35.6 ± 14.3 vs. 30.8 ± 15.8; p ≤ 0.05. The study group showed better outcome especially for larger defects (types II C and III as described by Paprosky and stem diameters ≥ 17 mm. The two groups did not show significant differences in the rate of aseptic loosening (1.4% vs. 2.9% and the rate of revisions (8.6% vs. 11%. The Kaplan-Meier survival for the MRP-TITAN stem in both groups together was 93.8% after 8.8 years. [Study group 95.7% after 8.54 years ; control group 93

  20. Accounting for patient variability in finite element analysis of the intact and implanted hip and knee: a review.

    Science.gov (United States)

    Taylor, Mark; Bryan, Rebecca; Galloway, Francis

    2013-02-01

    It is becoming increasingly difficult to differentiate the performance of new joint replacement designs using available preclinical test methods. Finite element analysis is commonly used and the majority of published studies are performed on representative anatomy, assuming optimal implant placement, subjected to idealised loading conditions. There are significant differences between patients and accounting for this variability will lead to better assessment of the risk of failure. This review paper provides a comprehensive overview of the techniques available to account for patient variability. There is a brief overview of patient-specific model generation techniques, followed by a review of multisubject patient-specific studies performed on the intact and implanted femur and tibia. In particular, the challenges and limitations of manually generating models for such studies are discussed. To efficiently account for patient variability, the application of statistical shape and intensity models (SSIM) are being developed. Such models have the potential to synthetically generate thousands of representative models generated from a much smaller training set. Combined with the automation of the prosthesis implantation process, SSIM provides a potentially powerful tool for assessing the next generation of implant designs. The potential application of SSIM are discussed along with their limitations. Copyright © 2012 John Wiley & Sons, Ltd.

  1. Multi-Disciplinary Antimicrobial Strategies for Improving Orthopaedic Implants to Prevent Prosthetic Joint Infections in Hip and Knee

    Science.gov (United States)

    Getzlaf, Matthew A.; Lewallen, Eric A.; Kremers, Hilal M.; Jones, Dakota L.; Bonin, Carolina A.; Dudakovic, Amel; Thaler, Roman; Cohen, Robert C.; Lewallen, David G.; van Wijnen, Andre J.

    2016-01-01

    Like any foreign object, orthopaedic implants are susceptible to infection when introduced into the human body. Without additional preventative measures, the absolute number of annual prosthetic joint infections will continue to rise, and may exceed the capacity of health care systems in the near future. Bacteria are difficult to eradicate from synovial joints due to their exceptionally diverse taxonomy, complex mechanistic attachment capabilities, and tendency to evolve antibiotic resistance. When a primary orthopaedic implant fails from prosthetic joint infection, surgeons are generally challenged by limited options for intervention. In this review, we highlight the etiology and taxonomic groupings of bacteria known to cause prosthetic joint infections, and examine their key mechanisms of attachment. We propose that antimicrobial strategies should focus on the most harmful bacteria taxa within the context of occurrence, taxonomic diversity, adhesion mechanisms, and implant design. Patient-specific identification of organisms that cause prosthetic joint infections will permit assessment of their biological vulnerabilities. The latter can be targeted using a range of antimicrobial techniques that exploit different colonization mechanisms including implant surface attachment, biofilm formation, and/or hematogenous recruitment. We anticipate that customized strategies for each patient, joint, and prosthetic component will be most effective at reducing prosthetic joint infections, including those caused by antibiotic-resistant and polymicrobial bacteria. PMID:26449208

  2. [Experiences with the condition of resection of the hip joint following removal of the alloarthroplastic implantate (author's transl)].

    Science.gov (United States)

    Reflor, H J; Wirth, C J; Schreiner, B

    1979-10-01

    30 patients whose total endoprosthesis of the hip joint had been removed without any replacement, thus creating a so-called state of secondary resection, were followed up 6 months to 6 years after the operation. It was found that in almost two-thirds of the cases a subjective feeling of improved mobility was reported. The objective findings consisted in restrictions of the total rotation, abduction and adduction of 1/3 rd of the normal extent of mobility. An average value of 74.7 degrees was recorded for flexion. 28 patients stated that their walking performance was satisfactory to very good when using a walking-stick as support. More than three-quarters of the patients questioned stated their pain had been positively influenced by the creation of the state of secondary resection. Another objective finding was a difference between the length of the legs amounting to 4.2 cm on the average. We could prove the existence of a relationship between the difference in leg length and the roentgenologically visualised supporting of the resection area of the coxal end of the femur at the lateral pelvis. Since all the patients with the exception of two could resume their customary daily routine activities, the state of secondary resection after unsuccessful total endoprosthesis of the hip joint must be considered a reasonably acceptable alternative.

  3. (ISSR) and internal transcribed spacer

    African Journals Online (AJOL)

    Cladistic relationships within the genus Cinnamomum (Lauraceae) in Taiwan based on analysis of leaf morphology and inter-simple sequence repeat (ISSR) and internal transcribed spacer (ITS) molecular markers.

  4. Ertapenem Articulating Spacer for the Treatment of Polymicrobial Total Knee Arthroplasty Infection

    Directory of Open Access Journals (Sweden)

    Dragan Radoicic

    2016-01-01

    Full Text Available Introduction. Periprosthetic joint infections (PJIs are the primary cause of early failure of the total knee arthroplasty (TKA. Polymicrobial TKA infections are often associated with a higher risk of treatment failure. The aim of the study was to assess the efficacy of ertapenem loaded spacers in the treatment of polymicrobial PJI. Methods. There were 18 patients enrolled; nine patients with polymicrobial PJI treated with ertapenem loaded articulating spacers were compared to the group of 9 patients treated with vancomycin or ceftazidime loaded spacers. Results. Successful reimplantation with revision implants was possible in 66.67%. Ertapenem spacers were used in 6 cases in primary two-stage procedure and in 3 cases in secondary spacer exchange. Successful infection eradication was achieved in all cases; final reimplantation with revision knee arthroplasty implants was possible in 6 cases. Conclusion. Ertapenem can be successfully used as antimicrobial addition to the cement spacers in two-stage revision treatment of polymicrobial PJIs. However, this type of spacer may also be useful in the treatment of infections caused by monomicrobial extended spectrum beta-lactamases producing gram-negative bacilli. Further clinical studies are required to evaluate the efficacy and safety of ertapenem spacers in the treatment of polymicrobial and monomicrobial PJIs.

  5. Hip, Hip, Soret!

    Science.gov (United States)

    Müller-Plathe, Florian

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

  6. Nanoparticle-Based Brachytherapy Spacers for Delivery of Localized Combined Chemoradiation Therapy

    Energy Technology Data Exchange (ETDEWEB)

    Kumar, Rajiv, E-mail: r.kumar@neu.edu [Nanomedicine Science and Technology Center, Northeastern University, Boston, Massachusetts (United States); Department of Radiation Oncology, Brigham and Women' s Hospital, Dana-Farber Cancer Institute and Harvard Medical School, Boston, Massachusetts (United States); Belz, Jodi [Nanomedicine Science and Technology Center, Northeastern University, Boston, Massachusetts (United States); Markovic, Stacey [Department of Electrical and Computer Engineering, Northeastern University, Boston, Massachusetts (United States); Jadhav, Tej; Fowle, William [Nanomedicine Science and Technology Center, Northeastern University, Boston, Massachusetts (United States); Niedre, Mark [Department of Electrical and Computer Engineering, Northeastern University, Boston, Massachusetts (United States); Cormack, Robert; Makrigiorgos, Mike G. [Department of Radiation Oncology, Brigham and Women' s Hospital, Dana-Farber Cancer Institute and Harvard Medical School, Boston, Massachusetts (United States); Sridhar, Srinivas [Nanomedicine Science and Technology Center, Northeastern University, Boston, Massachusetts (United States); Department of Radiation Oncology, Brigham and Women' s Hospital, Dana-Farber Cancer Institute and Harvard Medical School, Boston, Massachusetts (United States)

    2015-02-01

    Purpose: In radiation therapy (RT), brachytherapy-inert source spacers are commonly used in clinical practice to achieve high spatial accuracy. These implanted devices are critical technical components of precise radiation delivery but provide no direct therapeutic benefits. Methods and Materials: Here we have fabricated implantable nanoplatforms or chemoradiation therapy (INCeRT) spacers loaded with silica nanoparticles (SNPs) conjugated containing a drug, to act as a slow-release drug depot for simultaneous localized chemoradiation therapy. The spacers are made of poly(lactic-co-glycolic) acid (PLGA) as matrix and are physically identical in size to the commercially available brachytherapy spacers (5 mm × 0.8 mm). The silica nanoparticles, 250 nm in diameter, were conjugated with near infrared fluorophore Cy7.5 as a model drug, and the INCeRT spacers were characterized in terms of size, morphology, and composition using different instrumentation techniques. The spacers were further doped with an anticancer drug, docetaxel. We evaluated the in vivo stability, biocompatibility, and biodegradation of these spacers in live mouse tissues. Results: The electron microscopy studies showed that nanoparticles were distributed throughout the spacers. These INCeRT spacers remained stable and can be tracked by the use of optical fluorescence. In vivo optical imaging studies showed a slow diffusion of nanoparticles from the spacer to the adjacent tissue in contrast to the control Cy7.5-PLGA spacer, which showed rapid disintegration in a few days with a burst release of Cy7.5. The docetaxel spacers showed suppression of tumor growth in contrast to control mice over 16 days. Conclusions: The imaging with the Cy7.5 spacer and therapeutic efficacy with docetaxel spacers supports the hypothesis that INCeRT spacers can be used for delivering the drugs in a slow, sustained manner in conjunction with brachytherapy, in contrast to the rapid clearance of the drugs when

  7. Nanoparticle-Based Brachytherapy Spacers for Delivery of Localized Combined Chemoradiation Therapy

    International Nuclear Information System (INIS)

    Kumar, Rajiv; Belz, Jodi; Markovic, Stacey; Jadhav, Tej; Fowle, William; Niedre, Mark; Cormack, Robert; Makrigiorgos, Mike G.; Sridhar, Srinivas

    2015-01-01

    Purpose: In radiation therapy (RT), brachytherapy-inert source spacers are commonly used in clinical practice to achieve high spatial accuracy. These implanted devices are critical technical components of precise radiation delivery but provide no direct therapeutic benefits. Methods and Materials: Here we have fabricated implantable nanoplatforms or chemoradiation therapy (INCeRT) spacers loaded with silica nanoparticles (SNPs) conjugated containing a drug, to act as a slow-release drug depot for simultaneous localized chemoradiation therapy. The spacers are made of poly(lactic-co-glycolic) acid (PLGA) as matrix and are physically identical in size to the commercially available brachytherapy spacers (5 mm × 0.8 mm). The silica nanoparticles, 250 nm in diameter, were conjugated with near infrared fluorophore Cy7.5 as a model drug, and the INCeRT spacers were characterized in terms of size, morphology, and composition using different instrumentation techniques. The spacers were further doped with an anticancer drug, docetaxel. We evaluated the in vivo stability, biocompatibility, and biodegradation of these spacers in live mouse tissues. Results: The electron microscopy studies showed that nanoparticles were distributed throughout the spacers. These INCeRT spacers remained stable and can be tracked by the use of optical fluorescence. In vivo optical imaging studies showed a slow diffusion of nanoparticles from the spacer to the adjacent tissue in contrast to the control Cy7.5-PLGA spacer, which showed rapid disintegration in a few days with a burst release of Cy7.5. The docetaxel spacers showed suppression of tumor growth in contrast to control mice over 16 days. Conclusions: The imaging with the Cy7.5 spacer and therapeutic efficacy with docetaxel spacers supports the hypothesis that INCeRT spacers can be used for delivering the drugs in a slow, sustained manner in conjunction with brachytherapy, in contrast to the rapid clearance of the drugs when

  8. Spacer device for nuclear reactor fuel elements

    International Nuclear Information System (INIS)

    Anthony, A.J.; Gaines, A.L.; Krawiec, D.M.

    1974-01-01

    The grid-type spacer device consists of two rows of main spacers arranged parallel to each other with some space in between, the first row extending perpendicular to the second row. Parallel to the respective rows of main spacers there are rows of secondary spacers interlocked with the main spacers. The individual spacers are welded together at their points of intersection. A large number of spring cages are installed within the spacer device to hold in place the main spacers which are oriented at right angles relative to each other. In addition, the spring cages serve for supporting the fuel elements. The spacers are made of zirconium which does not greatly influence the neutron capture cross section of the reactor. The material of the spring cages with the spring elements is a nickel alloy. It has the necessary stress relaxation properties to be able to force the fuel elements against the spacers under the action of the spring. (DG) [de

  9. Cementless Hydroxyapatite Coated Hip Prostheses

    Science.gov (United States)

    Herrera, Antonio; Mateo, Jesús; Gil-Albarova, Jorge; Lobo-Escolar, Antonio; Ibarz, Elena; Gabarre, Sergio; Más, Yolanda

    2015-01-01

    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. PMID:25802848

  10. 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.

  11. Success of Two-Stage Reimplantation in Patients Requiring an Interim Spacer Exchange.

    Science.gov (United States)

    George, Jaiben; Miller, Evan M; Curtis, Gannon L; Klika, Alison K; Barsoum, Wael K; Mont, Michael A; Higuera, Carlos A

    2018-03-23

    Some patients undergoing a 2-stage revision for a periprosthetic joint infection require a repeat spacer in the interim (removal of existing spacer with insertion of a new spacer or spacer exchange) due to persistent infection. The objectives of this study are to (1) determine the factors associated with patients who receive a repeat spacer and (2) compare the infection-free survival (overall and stratified by joint type) of reimplantation in patients who did or did not receive a repeat spacer. From 2001 to 2014, 347 hip or knee 2-stage revisions that finally underwent reimplantation and had a minimum 2-year follow-up were identified. An interim spacer exchange was performed in 59 (17%) patients (exchange cohort). Patient-related and organism-related factors were compared between the exchange and non-exchange cohorts. Kaplan-Meier survival curves were performed to assess the success (absence of signs of infection, reoperation for infection, periprosthetic joint infection-related mortality) of both cohorts. Patients in the exchange group had higher comorbidity score (P = .020), prolonged time to reimplantation (P exchange cohort, and 78% (knee 77%, hip 78%) in the non-exchange cohort (P = .020). Patients requiring an interim spacer exchange were found to have more comorbidities, prolonged treatment period, and were more likely to be infected with a resistant organism. About one-third of such patients became reinfected within 5 years compared to only one-fifth of the patients without an interim spacer exchange. Copyright © 2018 Elsevier Inc. All rights reserved.

  12. Polyetheretherketone (PEEK) Spacers for Anterior Cervical Fusion: A Retrospective Comparative Effectiveness Clinical Trial.

    Science.gov (United States)

    Lemcke, Johannes; Al-Zain, Ferass; Meier, Ullrich; Suess, Olaf

    2011-01-01

    Anterior cervical decompression and fusion (ACDF) is the standard surgical treatment for radiculopathy and myelopathy. Polyetheretherketone (PEEK) has an elasticity similar to bone and thus appears well suited for use as the implant in ACDF procedures. The aim of this study is to examine the clinical and radiographic outcome of patients treated with standing alone PEEK spacers without bone morphogenic protein (BMP) or plating and to examine the influence of the different design of the two spacers on the rate of subsidence and dislocation. This retrospective comparative study reviewed 335 patients treated by ACDF in a specialized urban hospital for radiculopathy or myelopathy due to degenerative pathologies. The Intromed PEEK spacer was used in 181 patients from 3/2002 to 11/2004, and the AMT SHELL spacer was implanted in 154 patients from 4/2004 to 12/2007. The follow-up rate was 100% at three months post-op and 82.7% (277 patients) at one year. The patients were assessed with the Japanese Orthopedic Association (JOA) questionnaire and radiographically. At the one-year follow-up there were 118/277 patients with an excellent clinical outcome on the JOA, 112/277 with a good outcome, 20/277 with a fair outcome, and 27/277 with a poor outcome. Subsidence was observed in 13.3% of patients with the Intromed spacer vs 8.4% of the patients with the AMT SHELL. Dislocation of the spacer was observed in 10 of the 181 patients with Intromed spacers but in none of the 154 patients with Shell spacers. The study demonstrates that ACDF with standing alone PEEK cages leads to excellent and good clinical outcomes. The differences we observed in the subsidence rate between the two spacers were not significant and cannot be related to a single design feature of the spacers.

  13. Spacer grid for fuel elements

    International Nuclear Information System (INIS)

    Hensolt, T.; Huenner, M.; Rau, P.; Veca, A.

    1978-01-01

    The spacer grid for fuel elements of a gas-cooled fast breeder reactor (but also for PWRs and BWRs) consists of a lattice field with dodecagonal meshes. These meshes are formed by three each adjacent hexagons grouped arround a central axis. The pairs of legs extending into the dodecagon and being staggered by 120 0 are designed as knubs with inclined abutting surfaces for the fuel rods. By this means there is formed a three-point bearing for centering the fuel rods. The spacer grid mentioned above is rough-worked from a single disc- resp. plate-shaped body (unfinished piece). (DG) [de

  14. Spacer grid for fuel elements

    International Nuclear Information System (INIS)

    Hensolt, T.; Huenner, M.; Rau, P.; Veca, A.

    1980-01-01

    The spacer grid for fuel elements of a gas-cooled fast breeder reactor (but also for PWRs and BWRs) consists of a lattice field with dodecagonal meshes. These meshes are formed by three each adjacent hexagons grouped arround a central axis. The pairs of legs extending into the dodecagon and being staggered by 120 are designed as knubs with inclined abutting surfaces for the fuel rods. By this means there is formed a three-point bearing for centering the fuel rods. The spacer grid mentioned above is rough-worked from a single disc- resp. plate-shaped body (unfinished piece). (orig.)

  15. Outcomes of different bearings in total hip arthroplasty - implant survival, revision causes, and patient-reported outcome

    DEFF Research Database (Denmark)

    Varnum, Claus

    2017-01-01

    ceramic-on-ceramic (CoC) THAs comparing them to those of "standard" metal-on-polyethylene (MoP) THAs. Study II: To compare the six-year revision risk for metal-on-metal (MoM) with that for MoP bearings in cementless stemmed THA, and further to study the revision risk for different designs of stemmed Mo...... for the outcome of THA is the type of bearings. This PhD thesis focuses on the influence of different types of bearings on implant survival, revision causes, PROMs, and noises from THA. The aims of the thesis were: Study I: To examine the revision risk and to investigate the causes of revision of cementless......M THAs and the causes of revision. Study III: To examine the association between CoC, MoM, and MoP bearings and both generic and disease-specific PROMs, and furthermore to examine the incidence and types of noises from the three types of bearings and identify the effect of noises on PROM scores. In study...

  16. A new finding on the in-vivo crevice corrosion damage in a CoCrMo hip implant.

    Science.gov (United States)

    Oskouei, Reza H; Barati, Mohammad Reza; Farhoudi, Hamidreza; Taylor, Mark; Solomon, Lucian Bogdan

    2017-10-01

    A detailed investigation was performed to characterize the fretting wear and corrosion damage to the neck component of a CoCrMo stem from a metal-on-polyethylene implant retrieved after 99months. The stem was a low-carbon (0.07wt%) wrought Co-28Cr-6Mo alloy with no secondary carbide phases in the matrix (γ-phase). The original design of the neck surface contained an intentionally fabricated knurled profile with a valley-to-peak range of approximately 11μm. Roughness measurements indicated that the tip of the knurled profile was significantly damaged, especially in the distal medial region of the neck, with up to a 22% reduction in the mean peak-to-valley height (R a ) compared to the original profile. As a new finding, the channels between the peaks of the profile created an additional crevice site in the presence of stagnant body fluid within the head-neck taper junction. These channels were observed to contain the most severe corroded areas and surface oxide layers with micro-cracks. SEM/EDS, XRD and XPS evaluations identified the formation of Cr 2 O 3 as a corrosion product. Also, decobaltification was found to occur in these corroded areas. The findings of this work indicate the important role of the knurled profile in inducing additional crevice corrosion. Copyright © 2017 Elsevier B.V. All rights reserved.

  17. Hip Fracture

    Science.gov (United States)

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

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

    NARCIS (Netherlands)

    Stolk, Jan

    2003-01-01

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

  19. What is the risk of death or severe harm due to bone cement implantation syndrome among patients undergoing hip hemiarthroplasty for fractured neck of femur? A patient safety surveillance study

    Science.gov (United States)

    Rutter, Paul D; Panesar, Sukhmeet S; Darzi, Ara; Donaldson, Liam J

    2014-01-01

    Objective To estimate the risk of death or severe harm due to bone cement implantation syndrome (BCIS) among patients undergoing hip hemiarthroplasty for fractured neck of femur. Setting Hospitals providing secondary and tertiary care throughout the National Health Service (NHS) in England and Wales. Participants Cases reported to the National Reporting and Learning System (NRLS) in which the reporter clearly describes severe acute patient deterioration associated with cement use in hip hemiarthroplasty for fractured neck of femur (assessed independently by two reviewers). Outcome measures Primary—number of reported deaths, cardiac arrests and periarrests per year. Secondary—timing of deterioration and outcome in relation to cement insertion. Results Between 2005 and 2012, the NRLS received 62 reports that clearly describe death or severe harm associated with the use of cement in hip hemiarthroplasty for fractured neck of femur. There was one such incident for every 2900 hemiarthroplasties for fractured neck of femur during the period. Of the 62 reports, 41 patients died, 14 were resuscitated from cardiac arrest and 7 from periarrest. Most reports (55/62, 89%) describe acute deterioration occurring during or within a few minutes of cement insertion. The vast majority of deaths (33/41, 80%) occurred on the operating table. Conclusions These reports provide narrative evidence from England and Wales that cement use in hip hemiarthroplasty for fractured neck of femur is associated with instances of perioperative death or severe harm consistent with BCIS. In 2009, the National Patient Safety Agency publicised this issue and encouraged the use of mitigation measures. Three-quarters of the deaths in this study have occurred since that alert, suggesting incomplete implementation or effectiveness of those mitigation measures. There is a need for stronger evidence that weighs the risks and benefits of cement in hip hemiarthroplasty for fractured neck of femur. PMID

  20. A new approach to managing patients with problematic metal hip implants: the use of an Internet-enhanced multidisciplinary team meeting: AAOS exhibit selection.

    Science.gov (United States)

    Berber, Reshid; Pappas, Yannis; Khoo, Michael; Miles, Jonathan; Carrington, Richard; Skinner, John; Hart, Alister

    2015-02-18

    Over one million patients worldwide are estimated to have a metal-on-metal hip arthroplasty. To improve the management of these patients and reduce surgeon uncertainty regarding decision-making, we designed an Internet-enhanced multidisciplinary team (iMDT) working approach. From August 2012 to April 2014, the iMDT discussed 215 patients with 266 metal-on-metal hip arthroplasties. Of these, 236 primary arthroplasties (132 hip resurfacing and 104 total hip) were analyzed. The remaining thirty cases involved problematic revised hips and were therefore excluded. The possible recommendations of the iMDT were monitoring, further investigation, or surgery. The concordance between the recommendation and the actual management was used to assess the usefulness of this approach in reducing uncertainty in surgeon-level decision-making. The median Oxford Hip Score was 35 (range, 4 to 48), and median cobalt and chromium levels in whole blood were 3.54 ppb (range, 0.18 to 161.46 ppb) and 3.17 ppb (range, 0.20 to 100.67 ppb), respectively. Magnetic resonance imaging revealed abductor muscle atrophy in ninety-two (39%) of the hips and a pseudotumor in eighty (34%). The iMDT recommended monitoring of 146 (61.9%) of the hips, further investigation of thirty (12.7%), and surgery in sixty (25.4%). The actual outcome was concordant with the recommendation in 211 (91.7%) of the hips. Our iMDT approach to the metal-on-metal hip burden combines the tacit knowledge of an expert panel, regulatory guidance, and up-to-date evidence to improve decision-making among surgeons. The high level of concordance between the recommendation and the actual outcome, combined with the feasibility of the methods used, suggest that this method effectively reduces uncertainty among surgeons and may lead to improved patient outcomes. Copyright © 2015 by The Journal of Bone and Joint Surgery, Incorporated.

  1. Hip pain

    Science.gov (United States)

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

  2. Hip joint replacement

    Science.gov (United States)

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

  3. Two pion correlation from SPACER

    International Nuclear Information System (INIS)

    Csoergoe, T.; Zimanyi, J.; Pratt, S.

    1989-12-01

    The correlation function for neutral and negative pions produced in ultrarelativistic heavy ion collisions was calculated without free parameters based on a space-time version of the LUND model, called SPACER: Simulation of Phase space distribution of Atomic nuclear Collisions in Energetic Reactions. This method includes the effect of Bose correlations for the emitted pion pair. Effects arising from correlations between space-time and momentum space distributions are investigated. The results are compared to the data of two different experiments. The role and interpretation of the chaocity parameter are discussed. (D.G.) 14 refs.; 4 figs

  4. Spacers for fuel rod clusters

    International Nuclear Information System (INIS)

    Jabsen, F.S.

    1978-01-01

    The proposition deals with the fixing of nuclear fuel element rods in a grid which consists of a number of crossed Zy-plates which form cells. The rectangular cells have projections which serve as spacers for the fuel rods. According to the invention there are additional butt straps which can be moved in such a way that insertion and extraction of the fuel rods can be done without obstruction and they can be spring-loaded hold in their final position. (UWI) [de

  5. Development of a High Performance Spacer Grid

    Energy Technology Data Exchange (ETDEWEB)

    Song, Kee Nam; Song, K. N.; Yoon, K. H. (and others)

    2007-03-15

    A spacer grid in a LWR fuel assembly is a key structural component to support fuel rods and to enhance the heat transfer from the fuel rod to the coolant. In this research, the main research items are the development of inherent and high performance spacer grid shapes, the establishment of mechanical/structural analysis and test technology, and the set-up of basic test facilities for the spacer grid. The main research areas and results are as follows. 1. 18 different spacer grid candidates have been invented and applied for domestic and US patents. Among the candidates 16 are chosen from the patent. 2. Two kinds of spacer grids are finally selected for the advanced LWR fuel after detailed performance tests on the candidates and commercial spacer grids from a mechanical/structural point of view. According to the test results the features of the selected spacer grids are better than those of the commercial spacer grids. 3. Four kinds of basic test facilities are set up and the relevant test technologies are established. 4. Mechanical/structural analysis models and technology for spacer grid performance are developed and the analysis results are compared with the test results to enhance the reliability of the models.

  6. How to use an inhaler - no spacer

    Science.gov (United States)

    ... MDI) administration - no spacer; Bronchial nebulizer; Wheezing - nebulizer; Reactive airway - nebulizer; COPD - ... 66. National Asthma Education and Prevention Program website. How to use a metered-dose inhaler. ...

  7. Perioperative blood saving measures in total hip and knee arthroplasty

    NARCIS (Netherlands)

    Horstmann, W.G.

    2011-01-01

    This dissertation explores and discusses different aspects of blood loss and blood-saving measures in total hip and knee arthroplasty. Background: Worldwide, approximately 1 million total hip and 1 million total knee prostheses are implanted each year. Total hip arthroplasty and total

  8. Spacer for supporting fuel element boxes

    International Nuclear Information System (INIS)

    Wild, E.

    1979-01-01

    A spacer plate unit arranged externally on each side and at a predetermined level of a polygonal fuel element box for mutually supporting, with respect to one another, a plurality of the fuel element boxes forming a fuel element bundle, is formed of a first and a second spacer plate part each having the same length and the same width and being constituted of unlike first and second materials, respectively. The first and second spacer plate parts of the several spacer plate units situated at the predetermined level are arranged in an alternating continuous series when viewed in the peripheral direction of the fuel element box, so that any two spacer plate units belonging to face-to-face oriented sides of two adjoining fuel element boxes in the fuel element bundle define interfaces of unlike materials

  9. Influence of an interpositional spacer on the behaviour of the tibiofemoral joint: a finite element study.

    Science.gov (United States)

    Checa, S; Taylor, M; New, A

    2008-10-01

    Interpositional arthroplasty is considered by many surgeons for the treatment of isolated medial compartment osteoarthritis of the knee. In this procedure, an interpositional spacer is inserted into the medial compartment of the joint with no bone resection and no mechanical fixation. Major problems such as implant dislocation, severe pain or need for revision have been reported post-operatively. In this study, the kinematics of a knee implanted with an interpositional spacer made of either polyurethane or cobalt-chrome during walking, stair ascent and squatting cycles have been predicted and compared to the normal knee using finite element analysis. In addition, articular cartilage stress histories have been examined to obtain distributions of cumulative stress, a measure of the likelihood of articular cartilage degeneration. The insertion of a polyurethane interpositional spacer in the medial side of the knee did not affect knee kinematics as compared to the normal knee, but caused an increase of articular cartilage cumulative contact stress exposures in the medial compartment of the joint. The knee implanted with the Co-Cr spacer exhibited similar trends in knee kinematics, however significantly different ranges of motion were observed during some periods of the activity cycles, specifically during the first half of the walking cycle where lower ranges of motion were predicted. In addition, higher articular cartilage cumulative contact stress exposures were observed in both compartments of the knee. In both cases, cumulative contact stress exposures of the tibial articular cartilage were more affected than those of the femoral articular cartilage. These results suggest implant material as an important parameter in the design phase of interpositional spacers.

  10. WE-FG-BRA-02: Docetaxel Eluting Brachytherapy Spacers for Local Chemo-Radiation Therapy in Prostate Cancer

    Energy Technology Data Exchange (ETDEWEB)

    Belz, J [Northeastern University, Boston, MA (United States); Kumar, R; Sridhar, S [Northeastern University & Dana Farber Cancer Institute, Boston, MA (United States); Makrigiorgos, G; Nguyen, P [Dana Farber Cancer Institute, Boston, MA (United States); D’Amico, A [Brigham & Women’s Hospital, Boston, MA (United States); Cormack, R [Harvard Medical School, Boston, MA (United States)

    2016-06-15

    Purpose: We propose an innovative combinatorial treatment strategy of Local ChemoRadiation Therapy (LCRT) using a sustained drug delivery platform in the form of a spacer to locally radio-sensitize the prostate with Docetaxel (DTX) enabling a synergistic cure with the use of lower radiation doses. These biodegradable spacers are physically similar to the inert spacers routinely used in prostate brachytherapy but are now loaded with formulations of DTX. Methods: Spacers were loaded with ∼500µg Docetaxel (DTX) for prostate cancer studies. The implants were characterized in vitro using SEM and HPLC. The release kinetic studies were carried out in buffer (pH 6.0) at 37°C. Subcutaneous PC3 tumors were xenografted in nude mice. Prostate cancer studies were done with and without radiation using SARRP at 5Gy, 10Gy, and 15Gy. Drug-loaded implants were injected once intratumorally using an 18G brachytherapy needle. Results: The release study in vitro showed a highly sustained release for multiple weeks at therapeutically relevant doses. The monotherapy with local DTX spacer showed sustained tumor inhibition compared to empty implants and an equivalent DTX dose given systemically. At 40 days, 89% survival was observed for mice treated with DTX implants compared with 0% in all other treatment groups. The combined treatment with local DTX spacer and radiation (10Gy) showed the highest degree of tumor suppression (significant tumor growth inhibition by day 90). The control mice showed continuous tumor growth and were scarified by day 56. Groups of mice treated with DTX-spacer or radiation alone showed initial tumor suppression but growth continued after day 60. A larger experiment is ongoing. Conclusion: This approach provides localized delivery of the chemotherapeutic sensitizer directly to the tumor and avoids the toxicities associated with both brachytherapy and current systemic delivery of docetaxel. Sustained release of DTX is an effective chemotherapy option alone or

  11. Effect of hydroxyapatite coating on risk of revision after primary total hip arthroplasty in younger patients: findings from the Danish Hip Arthroplasty Registry

    DEFF Research Database (Denmark)

    Paulsen, Aksel; Pedersen, Alma B; Johnsen, Søren P

    2007-01-01

    BACKGROUND: The effect of hydroxyapatite (HA) on implant survival in the medium and long term is uncertain. We studied the effect of HA coating of uncemented implants on the risk of cup and stem revision in primary total hip arthroplasty (THA). PATIENTS AND METHODS: Using the Danish Hip Arthropla......BACKGROUND: The effect of hydroxyapatite (HA) on implant survival in the medium and long term is uncertain. We studied the effect of HA coating of uncemented implants on the risk of cup and stem revision in primary total hip arthroplasty (THA). PATIENTS AND METHODS: Using the Danish Hip...

  12. 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.

  13. 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.

  14. MRI of hip prostheses using single-point methods : in vitro studies towards the artifact-free imaging of individuals with metal implants

    NARCIS (Netherlands)

    Ramos Cabrer, P.; Duynhoven, van J.P.M.; Toorn, van der A.; Nicolaij, K.

    2004-01-01

    Use of magnetic resonance imaging (MRI) in individuals with orthopedic implants is limited because of the large distortions caused by metallic components. As a possible solution for this problem, we suggest the use of single-point imaging (SPI) methods, which are immune to the susceptibility

  15. [Three-dimensional finite element analysis on mechanical behavior of the bone remodeling and bone integration between the bone-implant interface after hip replacement].

    Science.gov (United States)

    Li, Yong-Jiang; Zhang, Li-Cheng; Zhang, Mei-Chao; Yang, Guo-Jing; Lin, Rui-Xin; Cai, Chun-Yuan; Zhong, Shi-Zhen

    2014-04-01

    To discuss the primary stability of the fixed interface between the cementless prosthesis and femur, and its influence on bone ingrowth and secondary stability under the roughened surface and press fit of different prostheses by finite element analysis. :A three-dimensional finite element module of total hip arthroplasty (THA) was developed with Mimics software. There was a collection of data when simulating hip arthroplasty. The frictional coefficient between the fixed interface was 0,0.15,0.40 and 1.00 representing the roughness of prosthesis surface. The press fit was 0, 0.01,0.05 and 0.10 mm according to the operation. The Vion Mises stress distribution and the contact pressure,friction stress and relative sliding displacement between the interface were analysed and compared when simulating the maneuver of climbing stairs. At a fixed press fit of 0.05 mm,the contact pressure between the interface was 230 , 231, 222 and 275 MN under four different frictional coefficient (0,0. 15,0.40 and 1.00) with little change; the relative sliding displacement was 0.529, 0.129, 0.107 and 0.087 mm with a consistent and obvious decline. As the fixed frictional coefficient was 0.40,the contact pressure between the interface were 56.0,67.7 ,60.4 and 49.6 MN under four different press fit (0, 0.01, 0.05 and 0.10 mm) with a reduction; the relative sliding displacement was 0.064,0.062,0.043 and 0.042 mm with an obvious decline, and there was a maximal friction stress when press fit of 0.01 mm. There is a dynamic process of the bone remodeling and bone integration between the interface after hip replacement, determining the long-term outcome. The interface clearance and the frictional coefficient are the key factors of the bone integration.

  16. Cervical interfacet spacers and maintenance of cervical lordosis.

    Science.gov (United States)

    Tan, Lee A; Straus, David C; Traynelis, Vincent C

    2015-05-01

    OBJECT The cervical interfacet spacer (CIS) is a relatively new technology that can increase foraminal height and area by facet distraction. These offer the potential to provide indirect neuroforaminal decompression while simultaneously enhancing fusion potential due to the relatively large osteoconductive surface area and compressive forces exerted on the grafts. These potential benefits, along with the relative ease of implantation during posterior cervical fusion procedures, make the CIS an attractive adjuvant in the management of cervical pathology. One concern with the use of interfacet spacers is the theoretical risk of inducing iatrogenic kyphosis. This work tests the hypothesis that interfacet spacers are associated with loss of cervical lordosis. METHODS Records from patients undergoing posterior cervical fusion at Rush University Medical Center between March 2011 and December 2012 were reviewed. The FacetLift CISs were used in all patients. Preoperative and postoperative radiographic data were reviewed and the Ishihara indices and cervical lordotic angles were measured and recorded. Statistical analyses were performed using STATA software. RESULTS A total of 64 patients were identified in whom 154 cervical levels were implanted with machined allograft interfacet spacers. Of these, 15 patients underwent anterior-posterior fusions, 4 underwent anterior-posterior-anterior fusions, and the remaining 45 patients underwent posterior-only fusions. In the 45 patients with posterior-only fusions, a total of 110 levels were treated with spacers. There were 14 patients (31%) with a single level treated, 16 patients (36%) with two levels treated, 5 patients (11%) with three levels treated, 5 patients (11%) with four levels treated, 1 patient (2%) with five levels treated, and 4 patients (9%) with six levels treated. Complete radiographic data were available in 38 of 45 patients (84%). On average, radiographic follow-up was obtained at 256.9 days (range 48-524 days

  17. Fouling Resilient Perforated Feed Spacers for Membrane Filtration

    KAUST Repository

    Kerdi, Sarah; Qamar, Adnan; Vrouwenvelder, Johannes S.; Ghaffour, NorEddine

    2018-01-01

    drop across the spacer filled channel. The 3-Hole spacer was found to have the lowest pressure drop (50% - 61%) compared to 0-Hole spacer for various average flow velocities. Regarding permeate flux production, the 0-Hole spacer produced 5.7 L.m-2.h-1

  18. Hydrogel Spacer Prospective Multicenter Randomized Controlled Pivotal Trial: Dosimetric and Clinical Effects of Perirectal Spacer Application in Men Undergoing Prostate Image Guided Intensity Modulated Radiation Therapy

    Energy Technology Data Exchange (ETDEWEB)

    Mariados, Neil, E-mail: nmariados@ampofny.com [Associated Medical Professionals of New York, Syracuse, New York (United States); Sylvester, John [21st Century Oncology, East Bradenton, Florida (United States); Shah, Dhiren [Western New York Urology Associates, Cancer Care of WNY, Cheektowaga, New York (United States); Karsh, Lawrence [The Urology Center of Colorado, Denver, Colorado (United States); Hudes, Richard [Chesapeake Urology Research Associates, The Prostate Center, Owings Mills, Maryland (United States); Beyer, David [Arizona Oncology Services Foundation, Phoenix, Arizona (United States); Kurtzman, Steven [Urological Surgeons of Northern California, Campbell, California (United States); Bogart, Jeffrey [The Research Foundation of State University of New York, SUNY Upstate Medical University, Syracuse, New York (United States); Hsi, R. Alex [Peninsula Cancer Center, Poulsbo, Washington (United States); Kos, Michael [Urology Nevada, Reno, Nevada (United States); Ellis, Rodney [University Hospitals Case Medical Center, Cleveland, Ohio (United States); Logsdon, Mark [Sutter Health Sacramento Sierra Region, Sutter Institute for Medical Research, Sacramento, California (United States); Zimberg, Shawn [Advanced Radiation Centers of New York, Lake Success, New York (United States); Forsythe, Kevin [Oregon Urology Institute, Springfield, Oregon (United States); Zhang, Hong [University of Rochester, Rochester, New York (United States); Soffen, Edward [CentraState Medical Center, Freehold, New Jersey (United States); Francke, Patrick [Carolina Regional Cancer Center, 21st Century Oncology, Myrtle Beach, South Carolina (United States); Mantz, Constantine [21st Century Oncology, Fort Meyers, Florida (United States); Rossi, Peter [Emory University, Atlanta, Georgia (United States); DeWeese, Theodore [The Johns Hopkins University, Baltimore, Maryland (United States); and others

    2015-08-01

    Purpose: Perirectal spacing, whereby biomaterials are placed between the prostate and rectum, shows promise in reducing rectal dose during prostate cancer radiation therapy. A prospective multicenter randomized controlled pivotal trial was performed to assess outcomes following absorbable spacer (SpaceOAR system) implantation. Methods and Materials: Overall, 222 patients with clinical stage T1 or T2 prostate cancer underwent computed tomography (CT) and magnetic resonance imaging (MRI) scans for treatment planning, followed with fiducial marker placement, and were randomized to receive spacer injection or no injection (control). Patients received postprocedure CT and MRI planning scans and underwent image guided intensity modulated radiation therapy (79.2 Gy in 1.8-Gy fractions). Spacer safety and impact on rectal irradiation, toxicity, and quality of life were assessed throughout 15 months. Results: Spacer application was rated as “easy” or “very easy” 98.7% of the time, with a 99% hydrogel placement success rate. Perirectal spaces were 12.6 ± 3.9 mm and 1.6 ± 2.0 mm in the spacer and control groups, respectively. There were no device-related adverse events, rectal perforations, serious bleeding, or infections within either group. Pre-to postspacer plans had a significant reduction in mean rectal V70 (12.4% to 3.3%, P<.0001). Overall acute rectal adverse event rates were similar between groups, with fewer spacer patients experiencing rectal pain (P=.02). A significant reduction in late (3-15 months) rectal toxicity severity in the spacer group was observed (P=.04), with a 2.0% and 7.0% late rectal toxicity incidence in the spacer and control groups, respectively. There was no late rectal toxicity greater than grade 1 in the spacer group. At 15 months 11.6% and 21.4% of spacer and control patients, respectively, experienced 10-point declines in bowel quality of life. MRI scans at 12 months verified spacer absorption. Conclusions: Spacer

  19. Diagnosis Of Persistent Infection In Prosthetic Two-Stage Exchange: PCR analysis of Sonication fluid From Bone Cement Spacers.

    Science.gov (United States)

    Mariaux, Sandrine; Tafin, Ulrika Furustrand; Borens, Olivier

    2017-01-01

    Introduction: When treating periprosthetic joint infections with a two-stage procedure, antibiotic-impregnated spacers are used in the interval between removal of prosthesis and reimplantation. According to our experience, cultures of sonicated spacers are most often negative. The objective of our study was to investigate whether PCR analysis would improve the detection of bacteria in the spacer sonication fluid. Methods: A prospective monocentric study was performed from September 2014 to January 2016. Inclusion criteria were two-stage procedure for prosthetic infection and agreement of the patient to participate in the study. Beside tissues samples and sonication, broad range bacterial PCRs, specific S. aureus PCRs and Unyvero-multiplex PCRs were performed on the sonicated spacer fluid. Results: 30 patients were identified (15 hip, 14 knee and 1 ankle replacements). At reimplantation, cultures of tissue samples and spacer sonication fluid were all negative. Broad range PCRs were all negative. Specific S. aureus PCRs were positive in 5 cases. We had two persistent infections and four cases of infection recurrence were observed, with bacteria different than for the initial infection in three cases. Conclusion: The three different types of PCRs did not detect any bacteria in spacer sonication fluid that was culture-negative. In our study, PCR did not improve the bacterial detection and did not help to predict whether the patient will present a persistent or recurrent infection. Prosthetic 2-stage exchange with short interval and antibiotic-impregnated spacer is an efficient treatment to eradicate infection as both culture- and molecular-based methods were unable to detect bacteria in spacer sonication fluid after reimplantation.

  20. The effect of metal artefact reduction on CT-based attenuation correction for PET imaging in the vicinity of metallic hip implants. A phantom study

    International Nuclear Information System (INIS)

    Harnish, R.; Lang, T.F.; Prevrhal, S.; Alavi, A.; Zaidi, H.

    2014-01-01

    To determine if metal artefact reduction (MAR) combined with a priori knowledge of prosthesis material composition can be applied to obtain CT-based attenuation maps with sufficient accuracy for quantitative assessment of 18 F-fluorodeoxyglucose uptake in lesions near metallic prostheses. A custom hip prosthesis phantom with a lesion-sized cavity filled with 0.2 ml 18 F-FDG solution having an activity of 3.367 MBq adjacent to a prosthesis bore was imaged twice with a chrome-cobalt steel hip prosthesis and a plastic replica, respectively. Scanning was performed on a clinical hybrid PET/CT system equipped with an additional external 137 Cs transmission source. PET emission images were reconstructed from both phantom configurations with CT-based attenuation correction (CTAC) and with CT-based attenuation correction using MAR (MARCTAC). To compare results with the attenuation-correction method extant prior to the advent of PET/CT, we also carried out attenuation correction with 137 Cs transmission-based attenuation correction (TXAC). CTAC and MARCTAC images were scaled to attenuation coefficients at 511 keV using a trilinear function that mapped the highest CT values to the prosthesis alloy attenuation coefficient. Accuracy and spatial distribution of the lesion activity was compared between the three reconstruction schemes. Compared to the reference activity of 3.37 MBq, the estimated activity quantified from the PET image corrected by TXAC was 3.41 MBq. The activity estimated from PET images corrected by MARCTAC was similar in accuracy at 3.32 MBq. CTAC corrected PET images resulted in nearly 40% overestimation of lesion activity at 4.70 MBq. Comparison of PET images obtained with the plastic and metal prostheses in place showed that CTAC resulted in a marked distortion of the 18 F-FDG distribution within the lesion, whereas application of MARCTAC and TXAC resulted in lesion distributions similar to those observed with the plastic replica. (author)

  1. Outcome of total knee replacement following explantation and cemented spacer therapy

    Directory of Open Access Journals (Sweden)

    Ghanem, Mohamed

    2016-03-01

    Full Text Available Background: Infection after total knee replacement (TKR is one of the serious complications which must be pursued with a very effective therapeutic concept. In most cases this means revision arthroplasty, in which one-setting and two-setting procedures are distinguished. Healing of infection is the conditio sine qua non for re-implantation. This retrospective work presents an assessment of the success rate after a two-setting revision arthroplasty of the knee following periprosthetic infection. It further considers drawing conclusions concerning the optimal timing of re-implantation.Patients and methods: A total of 34 patients have been enclosed in this study from September 2005 to December 2013. 35 re-implantations were carried out following explantation of total knee and implantation of cemented spacer. The patient’s group comprised of 53% (18 males and 47% (16 females. The average age at re-implantation time was 72.2 years (ranging from 54 to 85 years. We particularly evaluated the microbial spectrum, the interval between explantation and re-implantation, the number of surgeries that were necessary prior to re-implantation as well as the postoperative course. Results: We reported 31.4% (11 reinfections following re-implantation surgeries. The number of the reinfections declined with increasing time interval between explantation and re-implantation. Patients who developed reinfections were operated on (re-implantation after an average of 4.47 months. Those patients with uncomplicated course were operated on (re-implantation after an average of 6.79 months. Nevertheless, we noticed no essential differences in outcome with regard to the number of surgeries carried out prior to re-implantation. Mobile spacers proved better outcome than temporary arthrodesis with intramedullary fixation.Conclusion: No uniform strategy of treatment exists after peri-prosthetic infections. In particular, no optimal timing can be stated concerning re-implantation

  2. Outcome of total knee replacement following explantation and cemented spacer therapy.

    Science.gov (United States)

    Ghanem, Mohamed; Zajonz, Dirk; Bollmann, Juliane; Geissler, Vanessa; Prietzel, Torsten; Moche, Michael; Roth, Andreas; Heyde, Christoph-E; Josten, Christoph

    2016-01-01

    Infection after total knee replacement (TKR) is one of the serious complications which must be pursued with a very effective therapeutic concept. In most cases this means revision arthroplasty, in which one-setting and two-setting procedures are distinguished. Healing of infection is the conditio sine qua non for re-implantation. This retrospective work presents an assessment of the success rate after a two-setting revision arthroplasty of the knee following periprosthetic infection. It further considers drawing conclusions concerning the optimal timing of re-implantation. A total of 34 patients have been enclosed in this study from September 2005 to December 2013. 35 re-implantations were carried out following explantation of total knee and implantation of cemented spacer. The patient's group comprised of 53% (18) males and 47% (16) females. The average age at re-implantation time was 72.2 years (ranging from 54 to 85 years). We particularly evaluated the microbial spectrum, the interval between explantation and re-implantation, the number of surgeries that were necessary prior to re-implantation as well as the postoperative course. We reported 31.4% (11) reinfections following re-implantation surgeries. The number of the reinfections declined with increasing time interval between explantation and re-implantation. Patients who developed reinfections were operated on (re-implantation) after an average of 4.47 months. Those patients with uncomplicated course were operated on (re-implantation) after an average of 6.79 months. Nevertheless, we noticed no essential differences in outcome with regard to the number of surgeries carried out prior to re-implantation. Mobile spacers proved better outcome than temporary arthrodesis with intramedullary fixation. No uniform strategy of treatment exists after peri-prosthetic infections. In particular, no optimal timing can be stated concerning re-implantation. Our data point out to the fact that a longer time interval between

  3. High corrosion-resistant fuel spacers

    International Nuclear Information System (INIS)

    Yoshida, Toshimi; Takase, Iwao; Ikeda, Shinzo; Masaoka, Isao; Nakajima, Junjiro.

    1986-01-01

    Purpose: To enable manufacturing BWR fuel spacers by prior-art production process, using a zirconium-base alloy having very excellent corrosion resistance. Method: A highly improved nodular-resistant, corrosion-resistant zirconium alloy is devised by adding a slight amount of niobium, titanium and vanadium to zircaloy, of which fuel spacers are produced. That is, there can be obtained an alloy having much more excellent nodular resistance than conventional zircaloy, and free from a large change in plasticity, workability, and weldability, by adding to zirconium about 1.5 % of tin, about 0.15 % of iron, about 0.05 % of chromium, about 0.05 % of nickel, and 0.05 to 0.5 % of at least one or two kinds of niobium, titanium and vanadium. Using this zirconium-base alloy can manufacture fuel spacers by the same manufacturing process, thus improving economy and reliability. (Kamimura, M.)

  4. The effect of metal artefact reduction on CT-based attenuation correction for PET imaging in the vicinity of metallic hip implants: a phantom study.

    Science.gov (United States)

    Harnish, Roy; Prevrhal, Sven; Alavi, Abass; Zaidi, Habib; Lang, Thomas F

    2014-07-01

    To determine if metal artefact reduction (MAR) combined with a priori knowledge of prosthesis material composition can be applied to obtain CT-based attenuation maps with sufficient accuracy for quantitative assessment of (18)F-fluorodeoxyglucose uptake in lesions near metallic prostheses. A custom hip prosthesis phantom with a lesion-sized cavity filled with 0.2 ml (18)F-FDG solution having an activity of 3.367 MBq adjacent to a prosthesis bore was imaged twice with a chrome-cobalt steel hip prosthesis and a plastic replica, respectively. Scanning was performed on a clinical hybrid PET/CT system equipped with an additional external (137)Cs transmission source. PET emission images were reconstructed from both phantom configurations with CT-based attenuation correction (CTAC) and with CT-based attenuation correction using MAR (MARCTAC). To compare results with the attenuation-correction method extant prior to the advent of PET/CT, we also carried out attenuation correction with (137)Cs transmission-based attenuation correction (TXAC). CTAC and MARCTAC images were scaled to attenuation coefficients at 511 keV using a trilinear function that mapped the highest CT values to the prosthesis alloy attenuation coefficient. Accuracy and spatial distribution of the lesion activity was compared between the three reconstruction schemes. Compared to the reference activity of 3.37 MBq, the estimated activity quantified from the PET image corrected by TXAC was 3.41 MBq. The activity estimated from PET images corrected by MARCTAC was similar in accuracy at 3.32 MBq. CTAC corrected PET images resulted in nearly 40 % overestimation of lesion activity at 4.70 MBq. Comparison of PET images obtained with the plastic and metal prostheses in place showed that CTAC resulted in a marked distortion of the (18)F-FDG distribution within the lesion, whereas application of MARCTAC and TXAC resulted in lesion distributions similar to those observed with the plastic replica. MAR combined

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

    Science.gov (United States)

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

    2016-11-01

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

  6. Adventure sports and sexual freedom hip replacement: the tripolar hip.

    Science.gov (United States)

    Pritchett, James W

    2018-01-01

    Certain athletic activities and lifestyles require a completely stable and very mobile hip. Total hip replacement with a natural femoral head size and two mobile-bearing surfaces (i.e., a "tripolar" prosthesis) is the most stable prosthesis. Elegant design and wear-resistant bearing surfaces are the keys to long-term implant survivorship. The hypothesis is that a ceramic-coated tripolar prosthesis using highly cross-linked polyethylene can provide full function and complete stability with low wear. This study sought to determine: (1) patient-reported outcomes, (2) functional outcomes, (3) implant survivorship and complications, and (4) postoperative sexual limitations. Between 1998 and 2011, the author performed 160 primary total hip replacements using tripolar prostheses in patients participating in adventure sports and other physically demanding activities. The institutional review board approved this study. The inclusion criteria were patients who needed unrestricted activity and who were not candidates for or did not choose hip resurfacing. Patients were followed every second year and assessed with radiographs, Harris Hip Score, WOMAC, SF-12, and UCLA functional outcome scores. Patients were asked about symptoms of instability and satisfaction with their hip replacement. Patients were asked both preoperatively and 2 years postoperatively four questions about their sexual activity. Mean follow-up was 11 years. At 2 years' postoperatively, 98% of patients reported their satisfaction as excellent or good and 99% were not limited for sexual activity following surgery. Seventy-four percent of patients reported they were recovered within 6 weeks of surgery. There were no dislocations. There were three revision procedures for implant loosening, infection, and periprosthetic fracture, but there were no failures of the tripolar articulation. The mean postoperative UCLA score was the highly athletic score of 8. There were no signs of osteolysis, wear, or metal

  7. Design of biped hip simulator using SolidWorks

    Science.gov (United States)

    Zainudin, M. R.; Yahya, A.; Fazli, M. I. M.; Syahrom, A.; Harun, F. K. C.; Nazarudin, M. S.

    2017-10-01

    The increasing number of people who underwent both hip implant surgery based on World Health Organization (WHO) has received massive attention from researchers lately to develop various types of hip simulators in order to test the hip implant. Various number of hip simulator have been developed with different functions and capabilities. This paper presents the design development of biped hip simulator using SolidWorks software by taking into consideration some improvement and modifications. The finite element method is used to test the design whether it is safe to be used or not. The biped hip simulator has been successfully designed and ready to be fabricated as the endurance testing shown a positive results. The von Mises stress induced in the material is an alloy steel which is 2,975,862.3 N/m2 lower than the yield strength. Thus, the design is safe to be used as it obey the safety criterion.

  8. Fouling Resilient Perforated Feed Spacers for Membrane Filtration

    KAUST Repository

    Kerdi, Sarah

    2018-04-24

    The improvement of feed spacers with optimal geometry remains a key challenge for spiral-wound membrane systems in water treatment due to their impact on the hydrodynamic performance and fouling development. In this work, novel spacer designs are proposed by intrinsically modifying cylindrical filaments through perforations. Three symmetric perforated spacers (1-Hole, 2-Hole, and 3-Hole) were in-house 3D-printed and experimentally evaluated in terms of permeate flux, feed channel pressure drop and membrane fouling. Spacer performance is characterized and compared with standard no perforated (0-Hole) design under constant feed pressure and constant feed flow rate. Perforations in the spacer filaments resulted in significantly lowering the net pressure drop across the spacer filled channel. The 3-Hole spacer was found to have the lowest pressure drop (50% - 61%) compared to 0-Hole spacer for various average flow velocities. Regarding permeate flux production, the 0-Hole spacer produced 5.7 L.m-2.h-1 and 6.6 L.m-2.h-1 steady state flux for constant pressure and constant feed flow rate, respectively. The 1-Hole spacer was found to be the most efficient among the perforated spacers with 75% and 23% increase in permeate production at constant pressure and constant feed flow, respectively. Furthermore, membrane surface of 1-Hole spacer was found to be cleanest in terms of fouling, contributing to maintain higher permeate flux production. Hydrodynamic understanding of these perforated spacers is also quantified by performing Direct Numerical Simulation (DNS). The performance enhancement of these perforated spacers is attributed to the formation of micro-jets in the spacer cell that aided in producing enough unsteadiness/turbulence to clean the membrane surface and mitigate fouling phenomena. In the case of 1-Hole spacer, the unsteadiness intensity at the outlet of micro-jets and the shear stress fluctuations created inside the cells are higher than those observed with

  9. Three-dimensional bone-implant movements in trochanteric hip fractures: Precision and accuracy of radiostereometric analysis in a phantom model.

    Science.gov (United States)

    Bojan, Alicja J; Bragdon, Charles; Jönsson, Anders; Ekholm, Carl; Kärrholm, Johan

    2015-05-01

    The accuracy and precision of RSA were evaluated in the experimental study of screw cut-out complication after fixation of trochanteric fractures. A plastic bone model of a two-part trochanteric fracture was constructed with a Gamma nail implant incorporating RSA markers. The femoral head fragment was attached to a separate rotational table and the femoral shaft was mounted on the micrometer. Three main motions were simulated: Femoral head translation and rotation along the axis of the lag screw and fracture fragment translation along anatomical axes. Accuracy and precision were determined according to ISO 16,087 and ASTM standard F2385-04. Translations along the lag screw axis were measured with a precision within  ±0.14 mm and an accuracy within ±0.03 mm. With simultaneous translations along all three anatomical axes, lowest precision was measured for the x-axis (±0.29, 0.07 mm, respectively), but improved when analyzed as a vector (±0.08, 0.03 mm). The precision and accuracy of femoral head rotations were within 0.5° and 0.18°, respectively. The resolution of the RSA method tested in this model was high, though it varied depending on the type of analyzed motion. This information is valuable when selecting and interpreting outcome parameters evaluating implant migration and osteosynthesis stability in future clinical RSA studies. © 2014 Orthopaedic Research Society. Published by Wiley Periodicals, Inc.

  10. Nuclear reactor fuel assembly spacer grids

    International Nuclear Information System (INIS)

    Jabsen, F.S.

    1977-01-01

    Designs of nuclear reactor fuel assembly spacer grids for supporting and spacing fuel elements are described which do not utilize resilient grid plate protrusions in the peripheral band but retain the advantages inherent in the combination resilient and rigid protrusion cells. (U.K.)

  11. Separator-spacer for electrochemical systems

    Science.gov (United States)

    Grimes, Patrick G.; Einstein, Harry; Newby, Kenneth R.; Bellows, Richard J.

    1983-08-02

    An electrochemical cell construction features a novel co-extruded plastic electrode in an interleaved construction with a novel integral separator-spacer. Also featured is a leak and impact resistant construction for preventing the spill of corrosive materials in the event of rupture.

  12. Nuclear reactor spring strip grid spacer

    International Nuclear Information System (INIS)

    Patterson, J.F.; Flora, B.S.

    1980-01-01

    An improved and novel grid spacer for maintaining the fuel rods of a nuclear reactor fuel assembly in substantially parallel array is described. The invention provides for spring strips to maintain the fuel elements in their desired orientation which have more positive alignment than previous types while allowing greater flexibility to counterbalance the effects of differential thermal expansion. (UK)

  13. 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.

  14. Pressure Drop Test of Hybrid Mixing Vane Spacer Grid

    Energy Technology Data Exchange (ETDEWEB)

    Oh, D. S.; Chang, S. K.; Kim, B. D.; Chun, S. Y.; Chun, T. H

    2007-08-15

    The pressure loss test has been accomplished in the test section containing 5x5 rod bundle with a length of 2 m including 3 spacer grids. The test has been performed for the 5 kinds of spacer grids to compare the pressure loss characteristics: 1. Plain spacer grid which has the same body of the Hybrid but without vane (Plain), 2. Hybrid Vane spacer grid (Hybrid), 3. Hybrid-SC spacer grid which is constructed with coined, chamfered strip and is fabricated by spot welding, 4. Hybrid-LC spacer grid which is constructed with coined, chamfered strip and is fabricated by line welding along intersection line, 5. Westinghouse spacer grid with split vane (Plus-7). The pressure loss coefficient of the Plain, Hybrid, Hybrid-SC, Hybrid-LC, and Plus-7 spacer grid is 0.93, 1.15, 1.02, 1.04, and 1.08, respectively.

  15. Peri-Prosthetic Knee Infection Management: Spacers Loaded with Two or Three Antibiotic Agents.

    Science.gov (United States)

    Ortola, David Joaquin; Fenga, Domenico; Marcellino, Sandra; Rosi, Massimiliano; Centofanti, Francesco; Rosa, Michele Attilio

    2017-07-01

    The purpose of this work was to compare pre-made antibiotic-loaded spacers with two commercially available antibiotic agents and custom-made cements with three antibiotic agents added. We evaluated: (a) the validity of our procedures, (b) the control of the rate of infection in the long term, (c) complications, and (d) quality of life and patient satisfaction. A retrospective cohort study was performed on 112 consecutively treated patients between January 2010 and December 2013; 56 patients were treated with a pre-formed cement spacer (clindamycin + gentamicin), and 56 patients were treated with a spacer loaded with three antibiotic agents (clindamycin + gentamicin + vancomycin). Demographic data were collected: Classification of infection according to criteria of Cierny-Mader; microbiologic results; number of previous operations; and years of disease. Infection control or relapse after at least 18 months of follow-up was evaluated. Complications were recorded. Every patient completed the SF-36 test and Oxford Knee Score. With a follow-up of 32.87 months (standard deviation 12.04), at the end of treatment, amputation occurred in three of 112 patients because of recurrence of infection, and one patient died from other causes not related to the infection. The study population presented a rate of recurrence of infection of 2.70%. Our results suggest that a two stage re-implant with three antibiotic agents added to the spacer should be considered to avoid rescue procedures, especially in patients with multi-resistant micro-organism infections.

  16. Hydraulic Design Criteria for Spacer Grids of Nuclear Fuel Element

    International Nuclear Information System (INIS)

    Juanico, Luis; Brasnarof, Daniel

    2000-01-01

    In this paper a hydraulic model for calculating the pressure drop on the CARA spacer grids is extended.This model is validated and feedback from experimental hydraulic test performed in a low pressure loop.The importance of the spacer grid geometric parameter (that is, its thickness and length, the number and kind of their fix spacer), developing hydraulic design criteria for spacer grid on fuel element

  17. Flow behavior of droplets downstream of the spacer

    International Nuclear Information System (INIS)

    Kodama, Eiichiro; Morishita, Kiyohide; Aritomi, Masanori; Yano, Takashi

    1998-01-01

    The fuel spacer, of which role is to maintain an appropriate rod-to-rod clearance, is one of the components of a Boiling Water Reactor (BWR) fuel rod bundles. The fuel spacer influences flow characteristics of the liquid film in fuel rod bundles, so that its geometry influences greatly thermal hydraulics such as critical power and pressure drop therein. The purpose of this study is to clarify the effect of the spacer geometry on the core flow split downstream of the spacer. Phase Doppler Anemometry (PDA) was used for their meausrement under the conditions of a small amount of droplets in mist flows. From the experimental results, the normalized droplet velocity profiles with a spacer were split by the spacer and were different between a wider and a narrower regions in the channel, however, they became uniform at the distance far 100mm from the spacer. In the case without a spacer, the velocity was monotonously increasing nearer the rod surface with going toward the center of the channel. In the case with a spacer, the velocity profile downstream of the spacer changed in the narrower region of the channel. This tendency became more remarkable with thickening the spacer and widening clearance between the spacer and the wall. In this paper, 'drift' velocity effect was applied for the spacer model, due to the gas flows were split by the spacer which is based on the momentum balance between the narrower and wider channels. This model was confirmed from the experimental results that the droplet flowed from a wider region to a narrower one. This drift effect appeared more strongly as the spacer became thicker and the clearance did narrower. The analytical results explained qualitatively the measured ones. It is clarified that the drift effect proposed in this work was a dominant factor on droplet deposition downstream of the spacer

  18. Hip Injuries and Disorders

    Science.gov (United States)

    Your hip is the joint where your femur (thigh bone) meets your pelvis (hip bone). There are two main parts: a ball ... fits in a socket in the pelvis. Your hip is known as a ball-and-socket joint. ...

  19. Hip Replacement Surgery

    Science.gov (United States)

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

  20. Heterogeneous diversity of spacers within CRISPR

    Science.gov (United States)

    Deem, Michael; He, Jiankui

    2011-03-01

    Clustered regularly interspaced short palindromic repeats (CRISPR) in bacterial and archaeal DNA have recently been shown to be a new type of anti-viral immune system in these organisms. We here study the diversity of spacers in CRISPR under selective pressure. We propose a population dynamics model that explains the biological observation that the leader-proximal end of CRISPR is more diversified and the leader-distal end of CRISPR is more conserved. This result is shown to be in agreement with recent experiments. Our results show that the CRISPR spacer structure is influenced by and provides a record of the viral challenges that bacteria face. 1) J. He and M. W. Deem, Phys. Rev. Lett. 105 (2010) 128102

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

    Science.gov (United States)

    Medenica, Ivica; Luković, Milan; Radoicić, Dragan

    2010-02-01

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

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

    Directory of Open Access Journals (Sweden)

    Medenica Ivica

    2010-01-01

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

  3. TOTAL HIP REPLACEMENTS AT KIKUYU HOSPITAL, KENYA

    African Journals Online (AJOL)

    equipments, few trained personnel and the high cost of implants. It is mainly in the ..... function more affected than the sensory a day after. There was a foot drop. .... 60: Issue 2, 217-. 220. 13. NIH Consensus Development Panel on Total Hip.

  4. Clinical observation on the reconstruction of large areas lower eyelid defect with Medpor spacer graft

    Directory of Open Access Journals (Sweden)

    Hai-Yan Li

    2014-08-01

    Full Text Available AIM: To observe the effects of porous polyethylene(Medporas a spacer graft in the reconstruction of large areas eyelid defect after the operation of malignant tumors of lower eyelids.METHODS: Nineteen cases(19 eyesof malignant tumors of lower eyelid underwent the eyelid reconstruction were selected. Medpor lower eyelid inserts implantation were used to replace tarsal joint sliding conjunctival flap and pedicle flap, and repaired full-thickness lower eyelid defects then underwent eyelid reconstruction. RESULTS: Appearance of eyelids and functional improvements were satisfactory with no stimulation on the eyeball and no effect on the visual function. Implants is with no absorption, shift, exclusion or infection and no tumor recurrence in all cases during the follow up for 6-36mo.CONCLUSION: Medpor lower eyelid inserts implantation can instead tarsal plate for the reconstruction of medium to large areas lower eyelid defect, which is easy performing with rare complications. It is an ideal alternatives of tarsal plate.

  5. Mechanical test for fuel assembly spacer grid

    International Nuclear Information System (INIS)

    Kang, Heung Seok; Jeong, Yeon Ho; Song, Kee Nam; Kim, Hyung Kyu; Yoon, Kyung Ho; Bang, Je Keun.

    1997-06-01

    In order to propose some tests for a new spacer grid, the grid mechanical tests performed by ABB-CE, KWU and Westinghouse have been investigated. It is known that a static compression test, a dynamic impact test, and a grid spring characteristic test were commonly carried out by the vendors when a prototype spacer grid was developed. The static compression test is to measure the stresses on the strips as well as to obtain the grid stiffness. The dynamic impact test is to get some basic data for accident analysis such as impact stiffness, impact strength, and coefficient of restitution. Since each fuel vendor has his theory on an accident analysis, every vendor employs his particular method for the dynamic impact test. The dynamic impact test can be divided into two in accordance with the number of impact face, and the duration of impact pulse. One is an one-sided impact test and the other is an through-gird impact test. The duration of the impact pulse for the former is considerably shorter than the latter. Therefore, the grid can endure much higher load under the one-sided impact condition than under the through-grid impact condition. The grid spring characteristic test is to obtain a force versus deflection curve. This curve is very important in designing the spacer grid to provide fuel rods with a sound supports in core. (author). 18 tabs., 26 figs

  6. Hip malformation is a very common finding in young patients scheduled for total hip arthroplasty

    DEFF Research Database (Denmark)

    Karimi, Dennis; Kallemose, Thomas; Troelsen, Anders

    2018-01-01

    and prevalences of hip malformations were; CAM-deformity 50.9 and 25.5%, coxa profunda 33 and 27.4%, acetabular retroversion 33 and 29.2%, and acetabular dysplasia 10.4 and 3.8%. All patients showed minimum of one malformation. Prevalences of Tönnis grade 0-1 were 22.6% and 2-3 were 77.4%. CONCLUSION: All......INTRODUCTION: In Denmark, 20% of all registered total hip arthroplasties (THA) from 1995 to 2014 has been patients younger than 60 years with primary idiopathic osteoarthritis (OA). It is speculated that hip malformations may be a major contributor to early OA development. It has been shown...... that hip malformation may compromise implant position and, therefore, identifying and knowing the incidence of malformations is important. Our aim was to assess the prevalence and type of hip malformations in a cohort of younger patients undergoing THA. MATERIALS AND METHODS: In this prospective two center...

  7. Preclinical investigations towards the first spacer gel application in prostate cancer treatment during particle therapy at HIT

    International Nuclear Information System (INIS)

    Ruciński, Antoni; Parodi, Katia; Jäkel, Oliver; Haberer, Thomas; Bauer, Julia; Campbell, Patrick; Brons, Stephan; Unholtz, Daniel; Habl, Gregor; Herfarth, Klaus; Debus, Jürgen; Bert, Christoph

    2013-01-01

    The application of spacer gel represents a promising approach to reliably spare the rectal frontal wall during particle therapy (IJROBP 76:1251-1258, 2010). In order to qualify the spacer gel for the clinical use in particle therapy, a variety of measurements were performed in order to ensure the biological compatibility of the gel, its physical stability during and after the irradiation, and a proper definition of the gel in terms of the Hounsfield Unit (HU) values for the treatment planning system. The potential for the use of the spacer gel for particle therapy monitoring with off-line Positron Emission Tomography (PET) was also investigated. The spacer gel implanted to the prostate patient in direct neighbourhood to the clinical target volume does not interfere with the particle therapy treatment planning procedure applied at Heidelberg Ion Beam Therapy Centre (HIT). The performed measurements show that Bragg-peak position of the particles can be properly predicted on the basis of computed tomography imaging with the treatment planning system used at HIT (measured water equivalent path length of 1.011 ±0.011 (2σ), measured Hounsfield Unit of 28.9 ±6.1 (2σ)). The spacer gel samples remain physically unchanged after irradiation with a dose exceeding the therapeutic dose level. The independently measured Bragg-Peak position does not change within the time interval of 10 weeks. As a result of the presented experiments, the first clinical application of spacer gel implant during prostate cancer treatment with carbon ions and protons was possible at HIT in 2012. The reported pre-clinical investigations demonstrate that use of spacer gel is safe in particle therapy in presence of therapy target motion and patient positioning induced particle range variations. The spacer gel injected between prostate and rectum enlarge the distance between both organs, which is expected to clinically significantly decrease the undesirable exposure of the most critical organ at risk

  8. [Technology of cementless hip endoprosthetics].

    Science.gov (United States)

    Ungethüm, M; Blömer, W

    1987-06-01

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

  9. Failure rate of cemented and uncemented total hip replacements

    DEFF Research Database (Denmark)

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

    2014-01-01

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

  10. Fouling resilient perforated feed spacers for membrane filtration.

    Science.gov (United States)

    Kerdi, Sarah; Qamar, Adnan; Vrouwenvelder, Johannes S; Ghaffour, Noreddine

    2018-04-24

    The improvement of feed spacers with optimal geometry remains a key challenge for spiral-wound membrane systems in water treatment due to their impact on the hydrodynamic performance and fouling development. In this work, novel spacer designs are proposed by intrinsically modifying cylindrical filaments through perforations. Three symmetric perforated spacers (1-Hole, 2-Hole, and 3-Hole) were in-house 3D-printed and experimentally evaluated in terms of permeate flux, feed channel pressure drop and membrane fouling. Spacer performance is characterized and compared with standard no perforated (0-Hole) design under constant feed pressure and constant feed flow rate. Perforations in the spacer filaments resulted in significantly lowering the net pressure drop across the spacer filled channel. The 3-Hole spacer was found to have the lowest pressure drop (50%-61%) compared to 0-Hole spacer for various average flow velocities. Regarding permeate flux production, the 0-Hole spacer produced 5.7 L m -2 .h -1 and 6.6 L m -2 .h -1 steady state flux for constant pressure and constant feed flow rate, respectively. The 1-Hole spacer was found to be the most efficient among the perforated spacers with 75% and 23% increase in permeate production at constant pressure and constant feed flow, respectively. Furthermore, membrane surface of 1-Hole spacer was found to be cleanest in terms of fouling, contributing to maintain higher permeate flux production. Hydrodynamic understanding of these perforated spacers is also quantified by performing Direct Numerical Simulation (DNS). The performance enhancement of these perforated spacers is attributed to the formation of micro-jets in the spacer cell that aided in producing enough unsteadiness/turbulence to clean the membrane surface and mitigate fouling phenomena. In the case of 1-Hole spacer, the unsteadiness intensity at the outlet of micro-jets and the shear stress fluctuations created inside the cells are higher than those

  11. Nuclear reactor fuel assembly spacer grid

    International Nuclear Information System (INIS)

    Jabsen, F.S.

    1977-01-01

    A spacer grid for a nuclear fuel assembly is comprised of a lattice of grid plates forming multiple cells that are penetrated by fuel elements. Resilient protrusions and rigid protrusions projecting into the cells from the plates bear against the fuel element to effect proper support and spacing. Pairs of intersecting grid plates, disposed in a longitudinally spaced relationship, cooperate with other plates to form a lattice wherein each cell contains adjacent panels having resilient protrusions arranged opposite adjacent panels having rigid protrusions. The peripheral band bounding the lattice is provided solely with rigid protrusions projecting into the peripheral cells. (Auth.)

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

    Science.gov (United States)

    Goldstein, Wayne M; Branson, Jill J

    2005-09-01

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

  13. Diagnosis of Persistent Infection in Prosthetic Two-Stage Exchange: Evaluation of the Effect of Sonication on Antibiotic Release from Bone Cement Spacers.

    Science.gov (United States)

    Mariaux, Sandrine; Furustrand Tafin, Ulrika; Borens, Olivier

    2018-01-01

    Introduction : When treating periprosthetic joint infection with a two-stage procedure, antibiotic-impregnated spacers can be used in the interval between prosthetic removal and reimplantation. In our experience, cultures of sonicated spacers are most often negative. The objective of the study was to assess whether that sonication causes an elution of antibiotics, leading to elevated antibiotic concentrations in the sonication fluid inhibiting bacterial growth and thus causing false-negative cultures. Methods : A prospective monocentric study was performed from September 2014 to March 2016. Inclusion criteria were a two-stage procedure for prosthetic infection and agreement of the patient to participate in the study. Spacers were made of gentamicin-containing cement to which tobramycin and vancomycin were added. Antibiotic concentrations in the sonication fluid were determined by mass-spectometry (LC-MS). Results : 30 patients were identified (15 hip and 14 knee and 1 ankle arthroplasties). No cases of culture positive sonicated spacer fluid were observed in our serie. In the sonication fluid median concentrations of 13.2µg/ml, 392 µg/ml and 16.6 µg/ml were detected for vancomycin, tobramycin and gentamicin, respectively. According to the European Committee on antimicrobial susceptibility testing (EUCAST), these concentrations released from cement spacer during sonication are higher than the minimal inhibitory concentrations (MICs) for most bacteria relevant in prosthetic joint infections. Conclusion: Spacer sonication cultures remained sterile in all of our cases. Elevated concentrations of antibiotics released during sonication could explain partly negative-cultured sonicated spacers. Indeed, the absence of antibiotic free interval during the two-stages can also contribute to false-negative spacers sonicated cultures.

  14. Nuclear reactor spring strip grid spacer

    International Nuclear Information System (INIS)

    Patterson, J.F.; Flora, B.S.

    1978-01-01

    A bimetallic grid spacer is described comprising a grid structure of zircaloy formed by intersecting striplike members which define fuel element openings for receiving fuel elements and spring strips made of Inconel positioned within the grid structure for cooperating with the fuel elements to maintain them in their desired position. A plurality of these spring strips extend longitudinally between sides of the grid structure, being locked in position by the grid retaining strips. The fuel rods, which are disposed in the fuel openings formed in the grid structure, are positioned by means of the springs associated with the spring strips and a plurality of dimples which extend from the zircaloy grid structure into the openings. In one embodiment the strips are disposed in a plurality of arrays with those spring strip arrays situated in opposing diagonal quadrants of the grid structure extending in the same direction and adjacent spring strip arrays in each half of the spacer extending in relatively perpendicular directions. Other variations of the spring strip arrangements for a particular fuel design are disclosed herein

  15. Spacers for use in nuclear fuel assembly

    International Nuclear Information System (INIS)

    Shiohata, Hironori; Nakamura, Shozo; Hasegawa, Kunio; Higuchi, Shigeo; Nagashima, Hideaki; Kawada, Yoshishige.

    1987-01-01

    Purpose: To prevent liquid film breakage at the surface of a fuel rod due to swirlings of steam flow generated at the upstream of a contact portion between the fuel rod and a spacer leaf spring, that is, below the contact portion. Constitution: Steam-hot water 2-phase streams flowing from the lower to the upper portions of a fuel assembly is hindered by leaf springs, thereby forming swirlings in the steam flow at the upstream of a contact portion between the fuel rod and the leaf springs, that is, below the contact portion. The horseshoe-like swirlings shed the liquid films at the surface of the fuel rod to remarkably decrease the heat cooling performance, by which the surface temperature of a fuel can is temporarily increased thereby possibly causing failures due to so-called burnout in view of the above, steps are formed to the spacer leaf spring for use in the fuel assembly, to reduce the pressure difference between the leaf spring and the fuel rod at the upstream of the springs relative to the 2-phase coolant stream. In this way, formation of the swirlings is moderated to prevent the liquid film breakage and improve the critical heat power. (Kamimura, M.)

  16. Development of structural technology for a high performance spacer grid

    International Nuclear Information System (INIS)

    Song, Kee Nam; Kim, H. K.; Kang, H. S.

    2003-03-01

    A spacer grid in a LWR fuel assembly is a key structural component to support fuel rods and to enhance the heat transfer from the fuel rod to the coolant. In this research, the main research items are the development of inherent and high performance spacer grid shapes, the establishment of mechanical/structural analysis and test technology, and the set-up of basic test facilities for the spacer grid. The main research areas and results are as follows. 1. 14 different spacer grid candidates have been invented and applied for domestic and US patents. Among the candidates six are chosen from the patent. 2. Two kinds of spacer grids are finally selected for the advanced LWR fuel after detailed performance tests on the candidates and commercial spacer grids from a mechanical/structural point of view. According to the test results the features of the selected spacer grids are better than those of the commercial spacer grids. 3. Four kinds of basic test facilities are set up and the relevant test technologies are established. 4. Mechanical/structural analysis models and technology for spacer grid performance are developed and the analysis results are compared with the test results to enhance the reliability of the models

  17. Pressure Drop of Chamfer on Spacer Grid Strap

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Euijae; Kim, Kanghoon; Kim, Kyounghong; Nahm, Keeyil [KEPCO Nuclear Fuel Co., Daejeon (Korea, Republic of)

    2014-05-15

    A swirl flow and cross flow are generated by the spacer grid with mixing vane that enhances the thermal performance and critical heat flux (CHF). The additional pressure drop makes it difficult to meet acceptance criteria for overall pressure drop in fuel assembly depending upon the pump capacity. The chamfer on the end of spacer grid strap is one solution to reduce additional pressure drop without any adverse effect on flow fields. In this research, the pressure drop tests for spacer grid with and without chamfer were carried out at the hydraulic test facility. The result can be applied to develop high performance nuclear fuel assemblies for Pressurized Water Reactor (PWR) plants. The pressure drop tests for 5x5 spacer grid with and without chamfer as well as 6x6 spacer grid with and without chamfer were carried out at the INFINIT test facility. The Reynolds number ranged about from 16000 to 75000. The sweep-up and sweep-down test showed that the direction of sweep did not affect the pressure drop. The chamfer on spacer grid strap reduced the pressure drop due to the decreased in ratio of inlet area to outlet area. The pressure loss coefficient for spacer grid with chamfer was by up to 13.8 % lower than that for spacer grid without chamfer. Hence, the chamfer on spacer grid strap was one of effective ways to reduce the pressure drop.

  18. 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.

  19. Innovations in the management of hip fractures.

    Science.gov (United States)

    Teasdall, Robert D; Webb, Lawrence X

    2003-08-01

    Hip fractures include fractures of the head, neck, intertrochanteric, and subtrochanteric regions. Head fractures commonly accompany dislocations. Neck fractures and intertrochanteric fractures occur with greatest frequency in elderly patients with a low bone mineral density and are produced by low-energy mechanisms. Subtrochanteric fractures occur in a predominantly strong cortical osseous region that is exposed to large compressive stresses. Implants used to address these fractures must accommodate significant loads while the fractures consolidate. Complications secondary to hip fractures produce significant morbidity and include infection, nonunion, malunion, decubitus ulcers, fat emboli, deep venous thrombosis, pulmonary embolus, pneumonia, myocardial infarction, stroke, and death.

  20. HIP JOINT AND HIP ENDOPROSTHESIS BIOMECHANICS

    OpenAIRE

    Jakub Gryka

    2017-01-01

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

  1. 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-center st......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...

  2. Spacer stability and prostate position variability during radiotherapy for prostate cancer applying a hydrogel to protect the rectal wall

    International Nuclear Information System (INIS)

    Pinkawa, Michael; Piroth, Marc D.; Holy, Richard; Escobar-Corral, Nuria; Caffaro, Mariana; Djukic, Victoria; Klotz, Jens; Eble, Michael J.

    2013-01-01

    Background and purpose: The aim was to evaluate the spacer dimensions and prostate position variability during the course of radiotherapy for prostate cancer. Materials and methods: CT scans were performed in a group of 15 patients (G1) after the 10 ml injection of a hydrogel spacer (SpaceOAR™) and 30 patients without a spacer (G2) before the beginning of treatment (CT1) and in the last treatment week, 10–12 weeks following spacer implantation (CT2). Spacer dimensions and displacements were determined and prostate displacements compared. Results: Mean volume of the hydrogel increased slightly (17%; p 2 cm 3 . The average displacement of the hydrogel center of mass was 0.6 mm (87% ⩽ 2.2 mm), −0.6 mm (100% ⩽ 2.2 mm) and 1.4 mm (87% ⩽ 4.3 mm) in the x-, y- and z-axes (not significant). The average distance between prostate and anterior rectal wall before/at the end of radiotherapy was 1.6 cm/1.5 cm, 1.2 cm/1.3 cm and 1.0 cm/1.1 cm at the level of the base, middle and apex (G1). Prostate position variations were similar comparing G1 and G2, but significant systematic posterior displacements were only found in G2. Conclusions: A stable distance between the prostate and anterior rectal wall results during the radiotherapy course after injection of the spacer before treatment planning. Larger posterior prostate displacements could be reduced

  3. Efficient thermal diode with ballistic spacer

    Science.gov (United States)

    Chen, Shunda; Donadio, Davide; Benenti, Giuliano; Casati, Giulio

    2018-03-01

    Thermal rectification is of importance not only for fundamental physics, but also for potential applications in thermal manipulations and thermal management. However, thermal rectification effect usually decays rapidly with system size. Here, we show that a mass-graded system, with two diffusive leads separated by a ballistic spacer, can exhibit large thermal rectification effect, with the rectification factor independent of system size. The underlying mechanism is explained in terms of the effective size-independent thermal gradient and the match or mismatch of the phonon bands. We also show the robustness of the thermal diode upon variation of the model's parameters. Our finding suggests a promising way for designing realistic efficient thermal diodes.

  4. Nuclear reactor spring strip grid spacer

    International Nuclear Information System (INIS)

    Patterson, J.F.; Flora, B.S.

    1980-01-01

    An improved and novel grid spacer was developed for use in nuclear reactor fuel assemblies. It is comprised of a series of intersecting support strips and a peripheral support band attached to the ends of the support strips. Each of the openings into which the fuel element is inserted has a number of protruding dimples and springs extending in different directions. The dimples coact with the springs to secure the fuel rods in the openings. Compared with previous designs, this design gives more positive alignment of the support stips while allowing greater flexibility to counterbalance the effects of thermal expansion. The springs are arranged in alternating directions so that the reaction forces tend to counterbalance each other, which in turn minimizes the reaction loads on the supporting structure. (D.N.)

  5. PCR-Internal Transcribed Spacer (ITS) genes sequencing and ...

    African Journals Online (AJOL)

    Methods: DNA extraction, purification, amplification and sequencing of Internal Transcribed Spacer (ITS) genes were per- formed using ... Keywords: Internal transcribed spacer genes, phylogenetic, genetic relationship, clinical and environmental fungi, HIV-TB. ... Nigeria. An Ethical clearance was obtained from the Eth-.

  6. Stress Analysis of Single Spacer Grid Support considering Fuel Rod

    Energy Technology Data Exchange (ETDEWEB)

    Yoo, Y. G.; Jung, D. H.; Kim, J. H. [Chungnam National University, Daejeon (Korea, Republic of); Park, J. K.; Jeon, K. L. [Korea Nuclear Fuel, Daejeon (Korea, Republic of)

    2010-10-15

    Pressurized water reactor (PWR) nuclear fuel assembly is mainly composed of a top-end piece, a bottom-end piece, lots of fuel rods, and several spacer grids. Among them, the main function of spacer grid is protecting fuel rods from Fluid Induced Vibration (FIV). The cross section of spacer grid assembled by laser welding in upper and lower point. When the fuel rod inserted in spacer gird, spring and dimple and around of welded area got a stresses. The main hypothesis of this analysis is the boundary area of HAZ and base metal can get a lot of damage than other area by FIV. So, design factors of spacer grid mainly considered to preventing the fatigue failure in HAZ and spring and dimple of spacer grid. From previous researching, the environment in reactor verified. Pressure and temperature of light water observed 15MPa and 320 .deg. C, and vibration of the fuel rod observed within 0 {approx} 50Hz. In this study, mechanical properties of zirconium alloy that extracted from the test and the spacer grid model which used in the PWR were applied in stress analyzing. General-purpose finite element analysis program was used ANSYS Workbench 12.0.1 version. 3-D CAD program CATIA was used to create spacer grid model

  7. Mechanical/structural performance test method of a spacer grid

    International Nuclear Information System (INIS)

    Yoon, Kyung Ho

    2000-06-01

    The spacer grid is one of the main structural components in the fuel assembly, which supports the fuel rods, guides cooling water, and protects the system from an external impact load, such as earthquakes. In order to develop the spacer grid with the high mechanical performance, the mechanical and structural properties of the spacer grids must be extensively examined while designing it. In this report, the mechanical/structural test methods, i.e. the characteristic test of a spacer grid spring or dimple, static buckling test of a partial or full size spacer grid and dynamic impact test of them are described. The characteristic test of a spacer grid spring or dimple is accomplished with universal tensile test machine, a specimen is fixed with test fixture and then applied compressive load. The characteristic test data is saved at loading and unloading event. The static buckling test of a partial or full size spacer grid is executed with the same universal tensile testing machine, a specimen is fixed between cross-heads and then applied the compressive load. The buckling strength is decided the maximum strength at load vs. displacement curve. The dynamic impact test of a partial or full size spacer grid is performed with pendulum type impact machine and free fall shock test machine, a specimen is fixed with test fixture and then applied the impact load by impact hammer. Specially, the pendulum type impact test machine is also possible under the operating temperature because a furnace is separately attached with test machine

  8. ATLAS barrel hadron tile calorimeter: spacers plates mass production

    International Nuclear Information System (INIS)

    Artikov, A.M.; Budagov, Yu.A.; Khubua, J.

    1999-01-01

    In this article we expose the main problems of the mass production of the so-called 'spacer plates' for the ATLAS Barrel Hadron Tile Calorimeter. We describe all practical solutions of these problems. Particularly we present the measurement procedures and calculation schemes we used for the spacers dimensions determination. The results of the calculations are presented

  9. CFD application to advanced design for high efficiency spacer grid

    Energy Technology Data Exchange (ETDEWEB)

    Ikeda, Kazuo, E-mail: kazuo3_ikeda@ndc.mhi.co.jp

    2014-11-15

    Highlights: • A new LDV was developed to investigate the local velocity in a rod bundle and inside a spacer grid. • The design information that utilizes for high efficiency spacer grid has been obtained. • CFD methodology that predicts flow field in a PWR fuel has been developed. • The high efficiency spacer grid was designed using the CFD methodology. - Abstract: Pressurized water reactor (PWR) fuels have been developed to meet the needs of the market. A spacer grid is a key component to improve thermal hydraulic performance of a PWR fuel assembly. Mixing structures (vanes) of a spacer grid promote coolant mixing and enhance heat removal from fuel rods. A larger mixing vane would improve mixing effect, which would increase the departure from nucleate boiling (DNB) benefit for fuel. However, the increased pressure loss at large mixing vanes would reduce the coolant flow at the mixed fuel core, which would reduce the DNB margin. The solution is to develop a spacer grid whose pressure loss is equal to or less than the current spacer grid and that has higher critical heat flux (CHF) performance. For this reason, a requirement of design tool for predicting the pressure loss and CHF performance of spacer grids has been increased. The author and co-workers have been worked for development of high efficiency spacer grid using Computational Fluid Dynamics (CFD) for nearly 20 years. A new laser Doppler velocimetry (LDV), which is miniaturized with fiber optics embedded in a fuel cladding, was developed to investigate the local velocity profile in a rod bundle and inside a spacer grid. The rod-embedded fiber LDV (rod LDV) can be inserted in an arbitrary grid cell instead of a fuel rod, and has the advantage of not disturbing the flow field since it is the same shape as a fuel rod. The probe volume of the rod LDV is small enough to measure spatial velocity profile in a rod gap and inside a spacer grid. According to benchmark experiments such as flow velocity

  10. CFD application to advanced design for high efficiency spacer grid

    International Nuclear Information System (INIS)

    Ikeda, Kazuo

    2014-01-01

    Highlights: • A new LDV was developed to investigate the local velocity in a rod bundle and inside a spacer grid. • The design information that utilizes for high efficiency spacer grid has been obtained. • CFD methodology that predicts flow field in a PWR fuel has been developed. • The high efficiency spacer grid was designed using the CFD methodology. - Abstract: Pressurized water reactor (PWR) fuels have been developed to meet the needs of the market. A spacer grid is a key component to improve thermal hydraulic performance of a PWR fuel assembly. Mixing structures (vanes) of a spacer grid promote coolant mixing and enhance heat removal from fuel rods. A larger mixing vane would improve mixing effect, which would increase the departure from nucleate boiling (DNB) benefit for fuel. However, the increased pressure loss at large mixing vanes would reduce the coolant flow at the mixed fuel core, which would reduce the DNB margin. The solution is to develop a spacer grid whose pressure loss is equal to or less than the current spacer grid and that has higher critical heat flux (CHF) performance. For this reason, a requirement of design tool for predicting the pressure loss and CHF performance of spacer grids has been increased. The author and co-workers have been worked for development of high efficiency spacer grid using Computational Fluid Dynamics (CFD) for nearly 20 years. A new laser Doppler velocimetry (LDV), which is miniaturized with fiber optics embedded in a fuel cladding, was developed to investigate the local velocity profile in a rod bundle and inside a spacer grid. The rod-embedded fiber LDV (rod LDV) can be inserted in an arbitrary grid cell instead of a fuel rod, and has the advantage of not disturbing the flow field since it is the same shape as a fuel rod. The probe volume of the rod LDV is small enough to measure spatial velocity profile in a rod gap and inside a spacer grid. According to benchmark experiments such as flow velocity

  11. A non-electrostatic spacer for aerosol delivery

    DEFF Research Database (Denmark)

    Bisgaard, H; Anhøj, J; Klug, B

    1995-01-01

    to 6 years, suspected to have asthma the non-electrostatic spacer delivered a mean total dose of budesonide aerosol of 39% of the nominal dose, which was significantly higher than the Babyhaler (28%), the Nebuhaler (21%), and the AeroChamber (19%). These differences were most pronounced in children......A pear shaped non-electrostatic spacer, composed of steel with a volume of 250 ml and equipped with a facemask containing integrated inlet and outlet valves for inspiration and expiration, was compared with three plastic spacers. The plastic spacers were primed with repeated puffs from a budesonide...... was 27 seconds and independent of the use of p-MDI. In vitro the maximum dose of budesonide from a p-MDI, expressed as a percentage of the nominal dose, was 56% from the non-electrostatic spacer, 61% from the Nebuhaler, 45% from the Babyhaler, and 30% from the AeroChamber. In 124 children, age 6 months...

  12. Hip fracture - discharge

    Science.gov (United States)

    ... neck fracture repair - discharge; Trochanteric fracture repair - discharge; Hip pinning surgery - discharge ... in the hospital for surgery to repair a hip fracture, a break in the upper part of ...

  13. Hip joint replacement - slideshow

    Science.gov (United States)

    ... this page: //medlineplus.gov/ency/presentations/100006.htm Hip joint replacement - series—Normal anatomy To use the ... to slide 5 out of 5 Overview The hip joint is made up of two major parts: ...

  14. Hip Labral Tear

    Science.gov (United States)

    ... that joint in the future. Prevention Hip labral tears are often associated with sports participation. If your sport puts a lot of strain on your hips, condition the surrounding muscles with strength and flexibility exercises. Try to avoid ...

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

    OpenAIRE

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

    2016-01-01

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

  16. TREATMENT OF HIP DYSPLASIA

    OpenAIRE

    Iulian ICLEANU; Mariana CORDUN

    2015-01-01

    In this thesis, our purpose is to show that using physiotherapy on patients with hip dysplasia from the very beginning, in the first months of life, helps treating them faster. Common literature proposes to use physiotherapy on patients with hip dysplasia either after their recovery or in the terminal phase of recovery, claiming that any earlier intervention will prolong the hip recovery. The effects of hip dysplasia reflect over the whole musculoskeletal system, while it hinders the knees (g...

  17. 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...

  18. Bursitis of the Hip

    Science.gov (United States)

    ... difficile (C. diff.) InfectionHerpes Home Diseases and Conditions Bursitis of the Hip Condition Bursitis of the Hip Share Print Table of Contents1. ... Prevention5. Treatment6. Everyday Life7. Questions8. Resources What is bursitis of the hip? Bursitis is the painful swelling ...

  19. HIPs at Ten

    Science.gov (United States)

    Kuh, George; O'Donnell, Ken; Schneider, Carol Geary

    2017-01-01

    2017 is the anniversary of the introduction of what are now commonly known as high-impact practices (HIPs). Many of the specific activities pursued under the HIPs acronym have been around in some form for decades, such as study abroad, internships, and student-faculty research. It was about ten years ago that, after conferring HIPs at Ten with…

  20. Managing infection in the revision total hip replacement patient.

    Science.gov (United States)

    Halley, D K

    1993-01-01

    Deep infection is one of the most devastating complications in total hip replacement. This dreaded complication is presented in considerable detail with special emphasis on prevention, diagnosis, and various methods of surgical and antibiotic treatment. Basic fundamentals of antibiotic therapy are reviewed. In addition, guidelines are given for the indications of surgical intervention, the type and staging of operative procedures, with detailed techniques of the various operative procedures used to treat the infected total hip implant patient.

  1. TOTAL HIP ARTHROPLASTY IN OSTEOPETROSIS – REPORT OF A CASE

    Directory of Open Access Journals (Sweden)

    Zmago Krajnc

    2004-04-01

    Full Text Available Background. Authors introduced a case of a 27-year men with osteopetrosis with hip arthrosis. He has an autosomal – dominant form of disease and he needed total hip arthroplasty. There are seven cases described in literature with developed hip arthrosis by osteopetrosis.Methods. TEP implantation represents the greates surgical challenge in this patients, especially creation of intramedullary canal in femur and implantation of the femoral stem because of the very dense and brittle bones. This article describes the operative technique used in the case involved. It proved to be a very good solution.Results. The patient was released from the hospital ten days after implantation of total hip endoprosthesis. Three months after the operation the patient started to walk without aid of canes, he had non pain, and his range of motion was almost normal.Conclusions. Severe coxarthrosis is a rare complication of osteopetrosis. Great care must be taken with implantation of total hip endoprosthesis, especially with preparation of medular canal. It was recommended hand drilling under x-rays to exercise maximal control because reaming can cause false root of stem and greater probability of fracture.

  2. Two-Stage Progressive Femoral Lowering Followed by Cementless Total Hip Arthroplasty for Treating Crowe IV-Hartofilakidis Type 3 Developmental Dysplasia of the Hip.

    Science.gov (United States)

    Binazzi, Roberto

    2015-05-01

    High developmental dysplasia of the hip is commonly treated with total hip arthroplasty and shortening osteotomy. We present a two stage technique, consisting of progressive femoral lowering followed by total hip arthroplasty. The clinico-radiographic results of eleven patients (twelve hips) who were operated on with the two-stage technique were evaluated at a mean follow-up of 11 ± 5 years. At the final follow-up, ten patients (eleven hips) had a mean Harris hip score of 85 ± 5 points with no implant loosening. One patient (one hip) was revised at 5 years due to infection. No neurovascular complications were observed in any patients. With this technique, we could place the cup in the anatomical position and obtain complete limb symmetry with excellent clinical results at long-term. Copyright © 2014 Elsevier Inc. All rights reserved.

  3. Hip arthroplasty in failed intertrochanteric fractures in elderly

    Directory of Open Access Journals (Sweden)

    Javahir A Pachore

    2013-01-01

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

  4. Effects of different rod spacers (helical types) on coolant crossmixing

    International Nuclear Information System (INIS)

    Zhukov, A.V.; Sviridenko, E.Ya.; Matyukhin, N.M.; Rymkevich, K.S.; Ushakov, P.A.

    1981-11-01

    The results of investigations (electromagnetic measuring method) on coolant cross mixing in rod clusters with spiral wire spacers with different winding directions, with alternating unfinned and finned rods (case 'fin to rod'), as well as in rod clusters with much space between the rods, (case 'fin to fin') are reported. The local fluid dynamics parameters (distribution of the transversal and longitudinal velocity component) that define the physical processes of the coolant exchange in the rod clusters with helical spacers are explained. The investigation results for different helical spacer types are compared with each other. (orig.) [de

  5. Grid spacers for use in a nuclear fuel assembly

    International Nuclear Information System (INIS)

    Kuwako, Akira.

    1987-01-01

    Purpose: To obtain spacers capable of reducing the pressure loss by enlarging coolant flow channels when the fuel temperature is high, while capable of reliably maintaining the fuel pins with no vibrations when the fuel temperature is low. Constitution: This invention concerns grid spacers for constituting fuel assemblies for use in water cooled reactors. Memory shape alloys are disposed at least a portion of a spacer element that takes such a shape as urging the pin when the fuel temperature is low, while enlarging the coolant flow channel to reduce the pressure loss when the fuel temperature is high. (Ikeda, J.)

  6. Preclinical Evaluation of Bioabsorbable Polyglycolic Acid Spacer for Particle Therapy

    International Nuclear Information System (INIS)

    Akasaka, Hiroaki; Sasaki, Ryohei; Miyawaki, Daisuke; Mukumoto, Naritoshi; Sulaiman, Nor Shazrina Binti; Nagata, Masaaki; Yamada, Shigeru; Murakami, Masao; Demizu, Yusuke; Fukumoto, Takumi

    2014-01-01

    Purpose: To evaluate the efficacy and safety of a polyglycolic acid (PGA) spacer through physical and animal experiments. Methods and Materials: The spacer was produced with surgical suture material made of PGA, forming a 3-dimensional nonwoven fabric. For evaluation or physical experiments, 150-MeV proton or 320-MeV carbon-ion beams were used to generate 60-mm width of spread-out Bragg peak. For animal experiments, the abdomens of C57BL/6 mice, with or without the inserted PGA spacers, were irradiated with 20 Gy of carbon-ion beam (290 MeV) using the spread-out Bragg peak. Body weight changes over time were scored, and radiation damage to the intestine was investigated using hematoxylin and eosin stain. Blood samples were also evaluated 24 days after the irradiation. Long-term thickness retention and safety were evaluated using crab-eating macaques. Results: No chemical or structural changes after 100 Gy of proton or carbon-ion irradiation were observed in the PGA spacer. Water equivalency of the PGA spacer was equal to the water thickness under wet condition. During 24 days' observation after 20 Gy of carbon-ion irradiation, the body weights of mice with the PGA spacer were relatively unchanged, whereas significant weight loss was observed in those mice without the PGA spacer (P<.05). In mice with the PGA spacer, villus and crypt structure were preserved after irradiation. No inflammatory reactions or liver or renal dysfunctions due to placement of the PGA spacer were observed. In the abdomen of crab-eating macaques, thickness of the PGA spacer was maintained 8 weeks after placement. Conclusions: The absorbable PGA spacer had water-equivalent, bio-compatible, and thickness-retaining properties. Although further evaluation is warranted in a clinical setting, the PGA spacer may be effective to stop proton or carbon-ion beams and to separate normal tissues from the radiation field

  7. Analysis of US patents on spacer grids

    International Nuclear Information System (INIS)

    Kim, Hyung Kyu; Song, Kee Nam; Yoon, Kyung Ho; Kang, Hong Seok; Kim, Hyung Kyu; Jeon, Tae Hyun; Oh, Dong Seok; In, Wang Ki; Bang, Jae Keun; Oh, Seung Eun; Seo, Jeong Min; Lee, Jin Seok; Park, Seong Keun

    1997-06-01

    The total of 137 US patents on spacer grids patented from 1968 through 1993 are analyzed and summarized. Database is constituted with designing the appropriate fields by which each patent can be identified. The fields consist of patent number, inventor, assignee, date of patent, title and major foci of the patent. The major foci are again classified by detailed subjects such as the fretting failure and fuel rod support-related, the strength-related, the fabrication-related as for mechanical subjects, while the cooling performance-related and the pressure drop-related as for thermal-hydraulic one. The 92% of the patents analyzed were issued form nuclear companies of USA, France and Germany. Among the patents dealing with mechanical subjects, the fretting failure and fuel rod support-related is more than the pressure drop-related among the patents of thermal-hydraulic subjects. The number of patents issued from Japan ranks just after Germany i.e., the 4th country. It is thought that much concern as well as investment should be increased in this field, the patent of nuclear components. (author). 2 tabs., 5 figs

  8. Analysis of US patents on spacer grids

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Hyung Kyu; Song, Kee Nam; Yoon, Kyung Ho; Kang, Hong Seok; Kim, Hyung Kyu; Jeon, Tae Hyun; Oh, Dong Seok; In, Wang Ki; Bang, Jae Keun [Korea Atomic Energy Research Institute, Taejon (Korea, Republic of); Oh, Seung Eun; Seo, Jeong Min; Lee, Jin Seok; Park, Seong Keun [Korea Nuclear Fuel Company, Taejon (Korea, Republic of)

    1997-06-01

    The total of 137 US patents on spacer grids patented from 1968 through 1993 are analyzed and summarized. Database is constituted with designing the appropriate fields by which each patent can be identified. The fields consist of patent number, inventor, assignee, date of patent, title and major foci of the patent. The major foci are again classified by detailed subjects such as the fretting failure and fuel rod support-related, the strength-related, the fabrication-related as for mechanical subjects, while the cooling performance-related and the pressure drop-related as for thermal-hydraulic one. The 92% of the patents analyzed were issued form nuclear companies of USA, France and Germany. Among the patents dealing with mechanical subjects, the fretting failure and fuel rod support-related is more than the pressure drop-related among the patents of thermal-hydraulic subjects. The number of patents issued from Japan ranks just after Germany i.e., the 4th country. It is thought that much concern as well as investment should be increased in this field, the patent of nuclear components. (author). 2 tabs., 5 figs.

  9. Medical implants and methods of making medical implants

    Science.gov (United States)

    Shaw, Wendy J; Yonker, Clement R; Fulton, John L; Tarasevich, Barbara J; McClain, James B; Taylor, Doug

    2014-09-16

    A medical implant device having a substrate with an oxidized surface and a silane derivative coating covalently bonded to the oxidized surface. A bioactive agent is covalently bonded to the silane derivative coating. An implantable stent device including a stent core having an oxidized surface with a layer of silane derivative covalently bonded thereto. A spacer layer comprising polyethylene glycol (PEG) is covalently bonded to the layer of silane derivative and a protein is covalently bonded to the PEG. A method of making a medical implant device including providing a substrate having a surface, oxidizing the surface and reacting with derivitized silane to form a silane coating covalently bonded to the surface. A bioactive agent is then covalently bonded to the silane coating. In particular instances, an additional coating of bio-absorbable polymer and/or pharmaceutical agent is deposited over the bioactive agent.

  10. Immunological Responses to Total Hip Arthroplasty.

    Science.gov (United States)

    Man, Kenny; Jiang, Lin-Hua; Foster, Richard; Yang, Xuebin B

    2017-08-01

    The use of total hip arthroplasties (THA) has been continuously rising to meet the demands of the increasingly ageing population. To date, this procedure has been highly successful in relieving pain and restoring the functionality of patients' joints, and has significantly improved their quality of life. However, these implants are expected to eventually fail after 15-25 years in situ due to slow progressive inflammatory responses at the bone-implant interface. Such inflammatory responses are primarily mediated by immune cells such as macrophages, triggered by implant wear particles. As a result, aseptic loosening is the main cause for revision surgery over the mid and long-term and is responsible for more than 70% of hip revisions. In some patients with a metal-on-metal (MoM) implant, metallic implant wear particles can give rise to metal sensitivity. Therefore, engineering biomaterials, which are immunologically inert or support the healing process, require an in-depth understanding of the host inflammatory and wound-healing response to implanted materials. This review discusses the immunological response initiated by biomaterials extensively used in THA, ultra-high-molecular-weight polyethylene (UHMWPE), cobalt chromium (CoCr), and alumina ceramics. The biological responses of these biomaterials in bulk and particulate forms are also discussed. In conclusion, the immunological responses to bulk and particulate biomaterials vary greatly depending on the implant material types, the size of particulate and its volume, and where the response to bulk forms of differing biomaterials are relatively acute and similar, while wear particles can initiate a variety of responses such as osteolysis, metal sensitivity, and so on.

  11. Comparative study of two materials for dynamic hip screw during fall and gait loading: titanium alloy and stainless steel.

    Science.gov (United States)

    Taheri, Nooshin S; Blicblau, Aaron S; Singh, Manmohan

    2011-11-01

    Internal fixation with dynamic hip screw is a choice of treatment for hip fractures to stabilize a femoral fracture. Choosing the proper implant and its material has a great effect on the healing process and failure prevention. The purpose of this analysis was to assess biomechanical behavior of dynamic hip screw with two different materials implanted in the femur during fall and gait. A 3D finite element model of an intact femur and a 3D implant within the same femur were developed. A finite element analysis was carried out to establish the effect of load conditions and implant material properties on biomechanical behavior of the dynamic hip screw after internal fixation. Two load configurations are chosen: one simulating the stance phase of the normal gait cycle, and the other replicating a low-energy fall. The implanted femur was investigated with two different materials for the dynamic hip screw: stainless steel and titanium alloy. During stance, more stress is placed on the implanted femur compared with the intact femur. During a fall, the implanted femur is in a greater state of stress, which mostly occurs inside the dynamic hip screw. Titanium alloy decreases stress levels by an average of 40% compared with stainless steel. However, deformation is slightly reduced with a stainless steel dynamic hip screw during both load cases. After internal fixation, dynamic hip screw generates greater stresses within the implanted femur compared with the intact femur under the same loading conditions. A titanium alloy implant appears to undergo less stress from a low-energy fall compared with stainless steel and can be considered the preferred implant material. The critical parts of the dynamic hip screw are the forth distal screw and the plate.

  12. Diagnostic value of with 111In-oxine or 99mTc-sulfur colloid labelled leukocytes in patients with infections following femoral fractures and implantation of hip joint endoprostheses, resp

    International Nuclear Information System (INIS)

    Kostadinowa, I.; Dontschew, M.; Dojtschinov, A.; Kynew, W.; Kowatschewa, S.; Medizinische Hochschule, Pleven

    1990-01-01

    Scintigraphy with leukocytes, labelled with 99m Tc-sulfur colloid or 111 In-oxine, in 41 patients with suspected inflammation in endoprothetic hip joints (n = 23) or infectious complications after femoral fracture (n = 18) has shown to be a highly specific and useful tool in orthopedic routine diagnosis. (author)

  13. Ion implantation

    International Nuclear Information System (INIS)

    Dearnaley, Geoffrey

    1975-01-01

    First, ion implantation in semiconductors is discussed: ion penetration, annealing of damage, gettering, ion implanted semiconductor devices, equipement requirements for ion implantation. The importance of channeling for ion implantation is studied. Then, some applications of ion implantation in metals are presented: study of the corrosion of metals and alloys; influence or ion implantation on the surface-friction and wear properties of metals; hyperfine interactions in implanted metals

  14. Bone-preserving total hip arthroplasty in avascular necrosis of the hip-a matched-pairs analysis.

    Science.gov (United States)

    Merschin, David; Häne, Richard; Tohidnezhad, Mersedeh; Pufe, Thomas; Drescher, Wolf

    2018-07-01

    Short-stem hip arthroplasty has the potential advantage of femoral bone stock preservation, especially in view of the expected revisions in the often relatively young patients. Despite short-stem hip prosthesis are increasingly used for total hip arthroplasty, there are no sufficient mid- and long-term results especially for patients with avascular femoral head osteonecrosis. The present study investigates mid-term functional results as well as the revision rate following implantation of a short-stem prosthesis. In the period 06/2005 until 12/2013, a total of 351 short-stem hip prostheses were implanted. The study included 331 complete data sets. A retrospective analysis was performed using the Oxford Hip Score. All revisions were registered. In a total of 331 prostheses, the Oxford Hip Score was "excellent" in 66.2%, "good" in 12.7%, "fair" in 13.0%, and "poor" in 8.2% with a mean follow-up of 57.4 months (SD ± 29.8; range 24-115). In 26 cases, aseptic osteonecrosis of the hip was the indication (7.9%). The Oxford Hip Score was "excellent" in 66.7%, "good" in 0.0%, "fair" in 20.8%, and "poor" in 12.5%. The cumulated five year survival rate was 96.7%. In mid-term observation, the Metha® short-stem prosthesis shows no disadvantage in functional outcome and in survival time compared to a standard hip stem. Providing a correct indication, the Metha® short stem is a valuable option in total hip arthroplasty for younger patients with avascular osteonecrosis of the femoral head. Evaluation has shown no significant differences between aseptic osteonecrosis and other indications.

  15. Hip Resurfacing: An Alternative to Conventional Hip Replacement?

    Science.gov (United States)

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

  16. Failure of Emperion modular femoral stem with implant analysis

    Directory of Open Access Journals (Sweden)

    Benjamin M. Stronach, MD, MS

    2016-03-01

    Full Text Available Modularity in total hip arthroplasty provides multiple benefits to the surgeon in restoring the appropriate alignment and position to a previously damaged hip joint. The vast majority of modern implants incorporate modularity into their design with some implants having multiple modular interfaces. There is the potential for failure at modular junctions because of fretting and crevice corrosion in combination with mechanical loading. This case report details the failure of an Emperion (Smith and Nephew, Memphis, TN femoral stem in a 67-year-old male patient 6 years after total hip replacement. Analysis of the implant revealed mechanically assisted crevice corrosion that likely accelerated fatigue crack initiation in the hip stem. The benefits of modularity come with the potential drawback of a combination of fretting and crevice corrosion at the modular junction, which may accelerate fatigue, crack initiation and ultimately reduce the hip longevity.

  17. Revision Total Hip Arthoplasty: Factors Associated with Re-Revision Surgery

    OpenAIRE

    Khatod, M; Cafri, G; Inacio, MCS; Schepps, AL; Paxton, EW; Bini, SA

    2015-01-01

    The survivorship of implants after revision total hip arthroplasty and risk factors associated with re-revision are not well defined. We evaluated the re-revision rate with use of the institutional total joint replacement registry. The purpose of this study was to determine patient, implant, and surgeon factors associated with re-revision total hip arthroplasty.A retrospective cohort study was conducted. The total joint replacement registry was used to identify patients who had undergone revi...

  18. USE OF ANTIBIOTIC CEMENT SPACERS/BEADS IN TREATMENT ...

    African Journals Online (AJOL)

    ABSTRACT. Background: Chronic musculoskeletal infection involving bone present a big challenge to orthopaedic surgeons. ... Current data has demonstrated that the use of .... Antibiotic spacers are effective and add value in the treament of ...

  19. Analytical prediction of fuel assembly spacer grid loss coefficient

    International Nuclear Information System (INIS)

    Lim, J. S.; Nam, K. I.; Park, S. K.; Kwon, J. T.; Park, W. J.

    2002-01-01

    The analytical prediction model of the fuel assembly spacer grid pressure loss coefficient has been studied. The pressure loss of gap between the test section wall and spacer grid was separated from the current model and the different friction drag coefficient on spacer straps from high Reynolds number region were used to low Reynolds number region. The analytical model has been verified based on the hydraulic pressure drop test results for the spacer grids of three types for 5x5, 16x16(or 17x17) arrays. The analytical model predicts the pressure loss coefficients obtained from test results within the maximum errors of 12% and 7% for 5x5 test bundle and full size bundle, respectively, at Reynolds number 500,000 of the core operating condition. This result shows that the analytical model can be used for research and design change of the nuclear fuel assembly

  20. Response of an electrostatic probe for a right cylindrical spacer

    DEFF Research Database (Denmark)

    Rerup, T; Crichton, George C; McAllister, Iain Wilson

    1994-01-01

    During the last decade many experimental studies of surface charge phenomena have been undertaken employing right cylindrical spacers. Measurement of the surface charge was performed using small electrostatic field probes to scan across the dielectric surface. Charges are electrostatically induced...

  1. Surface-Tethered Iterative Carbohydrate Synthesis (STICS): A spacer study

    Science.gov (United States)

    Ganesh, N. Vijaya; Fujikawa, Kohki; Tan, Yih Horng; Nigudkar, Swati S.

    2013-01-01

    Comparative study of STICS using HPLC-assisted experimental set-up clearly demonstrated benefits of using longer spacer-anchoring systems. The use of mixed self-assembled monolayers helps to provide the required space for glycosylation reaction around the immobilized glycosyl acceptor. Both extension of the spacer length and using mixed self-assembled monolayers help to promote reaction and the beneficial effects may include moving the glycosyl acceptor further out into solution and providing additional conformational flexibility. It is possible that surface-immobilized glycosyl acceptors with a longer spacer (C8-O-C8)-lipoic acid have a higher tendency to mimic a solution-phase reaction environment than that of acceptors with shorter spacers. PMID:23822088

  2. Optimized Design of Spacer in Electrodialyzer Using CFD Simulation Method

    Science.gov (United States)

    Jia, Yuxiang; Yan, Chunsheng; Chen, Lijun; Hu, Yangdong

    2018-06-01

    In this study, the effects of length-width ratio and diversion trench of the spacer on the fluid flow behavior in an electrodialyzer have been investigated through CFD simulation method. The relevant information, including the pressure drop, velocity vector distribution and shear stress distribution, demonstrates the importance of optimized design of the spacer in an electrodialysis process. The results show width of the diversion trench has a great effect on the fluid flow compared with length. Increase of the diversion trench width could strength the fluid flow, but also increase the pressure drop. Secondly, the dead zone of the fluid flow decreases with increase of length-width ratio of the spacer, but the pressure drop increases with the increase of length-width ratio of the spacer. So the appropriate length-width ratio of the space should be moderate.

  3. Orthognathic model surgery with LEGO key-spacer.

    Science.gov (United States)

    Tsang, Alfred Chee-Ching; Lee, Alfred Siu Hong; Li, Wai Keung

    2013-12-01

    A new technique of model surgery using LEGO plates as key-spacers is described. This technique requires less time to set up compared with the conventional plaster model method. It also retains the preoperative setup with the same set of models. Movement of the segments can be measured and examined in detail with LEGO key-spacers. Copyright © 2013 American Association of Oral and Maxillofacial Surgeons. Published by Elsevier Inc. All rights reserved.

  4. Bioinformatics analyses of Shigella CRISPR structure and spacer classification.

    Science.gov (United States)

    Wang, Pengfei; Zhang, Bing; Duan, Guangcai; Wang, Yingfang; Hong, Lijuan; Wang, Linlin; Guo, Xiangjiao; Xi, Yuanlin; Yang, Haiyan

    2016-03-01

    Clustered regularly interspaced short palindromic repeats (CRISPR) are inheritable genetic elements of a variety of archaea and bacteria and indicative of the bacterial ecological adaptation, conferring acquired immunity against invading foreign nucleic acids. Shigella is an important pathogen for anthroponosis. This study aimed to analyze the features of Shigella CRISPR structure and classify the spacers through bioinformatics approach. Among 107 Shigella, 434 CRISPR structure loci were identified with two to seven loci in different strains. CRISPR-Q1, CRISPR-Q4 and CRISPR-Q5 were widely distributed in Shigella strains. Comparison of the first and last repeats of CRISPR1, CRISPR2 and CRISPR3 revealed several base variants and different stem-loop structures. A total of 259 cas genes were found among these 107 Shigella strains. The cas gene deletions were discovered in 88 strains. However, there is one strain that does not contain cas gene. Intact clusters of cas genes were found in 19 strains. From comprehensive analysis of sequence signature and BLAST and CRISPRTarget score, the 708 spacers were classified into three subtypes: Type I, Type II and Type III. Of them, Type I spacer referred to those linked with one gene segment, Type II spacer linked with two or more different gene segments, and Type III spacer undefined. This study examined the diversity of CRISPR/cas system in Shigella strains, demonstrated the main features of CRISPR structure and spacer classification, which provided critical information for elucidation of the mechanisms of spacer formation and exploration of the role the spacers play in the function of the CRISPR/cas system.

  5. Iso-surface volume rendering for implant surgery

    NARCIS (Netherlands)

    van Foreest-Timp, Sheila; Lemke, H.U.; Inamura, K.; Doi, K.; Vannier, M.W.; Farman, A.G.

    2001-01-01

    Many clinical situations ask for the simultaneous visualization of anatomical surfaces and synthetic meshes. Common examples include hip replacement surgery, intra-operative visualization of surgical instruments or probes, visualization of planning information, or implant surgery. To be useful for

  6. Anchorage strategies in geriatric hip fracture management

    Directory of Open Access Journals (Sweden)

    Knobe Matthias

    2016-12-01

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

  7. Buckling behavior analysis of spacer grid by lateral impact load

    International Nuclear Information System (INIS)

    Yoon, Kyung Ho; Kang, Heung Seok; Kim, Hyung Kyu; Song, Kee Nam

    2000-05-01

    The spacer grid is one of the main structural components in the fuel assembly, Which supports the fuel rods, guides cooling water, and protects the system from an external impact load, such as earthquakes. Therefore, the mechanical and structural properties of the spacer grids must be extensively examined while designing it. In this report, free fall type shock tests on the several kinds of the specimens of the spacer grids were also carried out in order to compare the results among the candidate grids. A free fall carriage on the specimen accomplishes the test. In addition to this, a finite element method for predicting the critical impact strength of the spacer grids is described. FE method on the buckling behavior of the spacer grids are performed for a various array of sizes of the grids considering that the spacer grid is an assembled structure with thin-walled plates and imposing proper boundary conditions by nonlinear dynamic impact analysis using ABAQUS/explicit code. The simulated results results also similarly predicted the local buckling phenomena and were found to give good correspondence with the shock test results

  8. Fixation using alternative implants for the treatment of hip fractures (FAITH): Design and rationale for a multi-centre randomized trial comparing sliding hip screws and cancellous screws on revision surgery rates and quality of life in the treatment of femoral neck fractures

    NARCIS (Netherlands)

    2014-01-01

    textabstractBackground: Hip fractures are a common type of fragility fracture that afflict 293,000 Americans (over 5,000 per week) and 35,000 Canadians (over 670 per week) annually. Despite the large population impact the optimal fixation technique for low energy femoral neck fractures remains

  9. Structural differences between hip endoprostheses, and implications on a hip kinetics

    Directory of Open Access Journals (Sweden)

    Mirza Biščević

    2005-11-01

    Full Text Available We compared kinetic characteristic of unipolar, bipolar and total hip endoprostheses, implanted after dislocated femoral neck fracture. Ninety patients were divided into three groups (30 patients in each group; a group with unipolar partial hip endoprosthesis (UPEP, a group with bipolar partial hip endoprosthesis (BPEP and a group with total hip endoprosthesis (TEP. The patients from different groups were paired by parameters which could influence the long term functional result: follow up period, comorbidities, functional capabilities before injury, etc. After the average follow up 3.8 +/- 1.9 years, a measuring of range of hip motions (ROM was conducted. The largest mean amplitudes in flexion (104 degrees, extension (13 degrees, abduction (35 degrees and external rotation (38 degrees was achieved BPEP, the largest adduction (14 degrees was achieved UPEP, and internal rotation (34 degrees TEP. Differences in ROMs are partially related to the clinical parameters such as: level of the hip pain, gait pattern, age and rehabilitation period (P < 0.05. Measuring of ROMs is the most reliable part of the clinical exam and it does not depend on subjectivity of patient, as opposed to other clinical parameters (level of pain, walking distance, aids usage, etc. The results obtained are favorable for the bipolar hip endoprosthesis, and they can be related to the biomechanical differences between the three types of hip endoprostheses. Kinetic advantages of the BPEP as compared to the UPEP, can be explained by the BPEP's structure: two-level mobility and a thinner neck which delays impingement in the late motion phase. In comparison to the TEP, clinical advantages of the BPEP can be attributed to less extensive surgery and scarring.

  10. 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.

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

    International Nuclear Information System (INIS)

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

    2001-01-01

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

  12. The potential of standard and modified feed spacers for biofouling control

    KAUST Repository

    Araújo, Paula A.

    2012-06-01

    The impact of feed spacers on initial feed channel pressure (FCP) drop, FCP increase and biomass accumulation has been studied in membrane fouling simulators using feed spacers applied in commercially available nanofiltration and reverse osmosis spiral wound membrane modules. All spacers had a similar geometry.Our studies showed that biofouling was not prevented by (i) variation of spacer thickness, (ii) feed spacer orientation, (iii) feed spacer coating with silver, copper or gold and (iv) using a biostatic feed spacer. At constant feed flow, a lower FCP and FCP increase were observed for a thicker feed spacer. At constant linear flow velocity, roughly the same FCP development and biomass accumulation were found irrespective of the feed spacer thickness: hydrodynamics and substrate load were more important for development and impact of biofouling than the thickness of currently applied spacers. Use of biostatic and metal coated spacers were not effective for biofouling control. The same small reduction of biofouling rate was observed with copper and silver coated spacers as well as uncoated 45° rotated spacers.The studied modified spacers were not effective for biofouling prevention and control. The impact of biofouling on FCP increase was reduced significantly by a lower linear flow velocity, while spacer orientation and spacer thickness in membrane modules had a smaller but still significant effect. © 2012 Elsevier B.V.

  13. The potential of standard and modified feed spacers for biofouling control

    KAUST Repository

    Araú jo, Paula A.; Kruithof, Joop C.; van Loosdrecht, Mark C.M.; Vrouwenvelder, Johannes S.

    2012-01-01

    The impact of feed spacers on initial feed channel pressure (FCP) drop, FCP increase and biomass accumulation has been studied in membrane fouling simulators using feed spacers applied in commercially available nanofiltration and reverse osmosis spiral wound membrane modules. All spacers had a similar geometry.Our studies showed that biofouling was not prevented by (i) variation of spacer thickness, (ii) feed spacer orientation, (iii) feed spacer coating with silver, copper or gold and (iv) using a biostatic feed spacer. At constant feed flow, a lower FCP and FCP increase were observed for a thicker feed spacer. At constant linear flow velocity, roughly the same FCP development and biomass accumulation were found irrespective of the feed spacer thickness: hydrodynamics and substrate load were more important for development and impact of biofouling than the thickness of currently applied spacers. Use of biostatic and metal coated spacers were not effective for biofouling control. The same small reduction of biofouling rate was observed with copper and silver coated spacers as well as uncoated 45° rotated spacers.The studied modified spacers were not effective for biofouling prevention and control. The impact of biofouling on FCP increase was reduced significantly by a lower linear flow velocity, while spacer orientation and spacer thickness in membrane modules had a smaller but still significant effect. © 2012 Elsevier B.V.

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

    Science.gov (United States)

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

    2016-05-01

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

  15. Improved spacers for high temperature gas-cooled heat exchangers

    Energy Technology Data Exchange (ETDEWEB)

    Nordstroem, L A [Swiss Federal Institute for Reactor Research, Wuerenlingen (Switzerland)

    1984-07-01

    Experimental and analytical investigations in the field of heat exchanger thermohydraulics have been performed at EIR for many years, Basic studies have been carried out on heat transfer and pressure loss for tube bundles of different geometries and tube surfaces. As a part of this overall R+D programme for heat exchangers, investigations have been carried out on spacer pressure loss in bundles with longitudinal flow. An analytical spacer pressure loss model was developed which could handle different types of subchannel within the bundle. The model has been evaluated against experiments, using about 25 spacers of widely differing geometries. In a gas-cooled reactor it is important to keep the pressure loss over the primary circuit heat exchangers to a minimum. In exchangers with grid spacers these contribute a significant proportion of the overall bundle losses. For example, in the HHT Recuperator, with a shell-side pressure loss of 3.5 % of the inlet pressure, the spacers cause about one half of this loss. Reducing the loss to, say, 2.5 % results in an overall increase in plant efficiency by more than 1 % - a significant improvement Preliminary analysis identified 5 geometries in particular which were chosen for experimental evaluation as part of a joint project with the SULZER Company, to develop a low pressure-loss spacer for HHT heat exchangers (longitudinal counter-flow He/He and He/H{sub 2}O designs). The aim of the tests was to verify the low pressure-loss characteristics of these spacer grid types, as well as the quality of the results calculated by the computer code analytical model. The experimental and analytical results are compared in this report.

  16. 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.

  17. Hip arthroplasty for ochronosis

    International Nuclear Information System (INIS)

    Kerimoglu, S.; Onder, C.; Aynaci, O.; Malkoc, C. H.

    2005-01-01

    Alkaptonuria is a metabolic disorder in which homogentisic acid oxidase is absent. Therefore, homogentisic acid accumulates in cartilage and connective tissues. We can diagnose ochronotic arthropathy, a manifestation of long standing alkaptonuria, through careful radiological, physical, and laboratory examination. In this report, we describe 4 cases of ochronotic arthropathy to which we applied cementless total hip prosthesis due to severe hip involvement. (author)

  18. Hip resurfacing in a district general hospital: 6-year clinical results using the ReCap hip resurfacing system

    Directory of Open Access Journals (Sweden)

    van der Weegen Walter

    2012-12-01

    Full Text Available Abstract Background The purpose of our study was to prospectively report the clinical results of 280 consecutive hips (240 patients who received a ReCap Hip Resurfacing System implant (Biomet Inc., Warsaw, USA in a single district general hospital. Literature reports a large variation in clinical results between different resurfacing designs and published results using this particular design are scarce. Methods Mean follow up was 3.3 years (1.0 to 6.3 and four patients were lost to follow-up. All patients were diagnosed with end-stage hip osteoarthritis, their mean age was 54 years and 76.4% of all patients were male. Results There were 16 revisions and four patients reported a Harris Hip Score Conclusions This independent series confirms that hip resurfacing is a demanding procedure, and that implant survival of the ReCap hip resurfacing system is on a critical level in our series. In non-revised patients, reported outcomes are generally excellent. Trial registration ClinicalTrials.gov Identifier: NCT00603395

  19. Taking care of your new hip joint

    Science.gov (United States)

    Hip arthroplasty - precautions; Hip replacement - precautions; Osteoarthritis - hip; Osteoarthritis - knee ... After you have hip replacement surgery, you will need to be careful how you move your hip, especially for the first few months ...

  20. Numerical optimization of composite hip endoprostheses under different loading conditions

    Science.gov (United States)

    Blake, T. A.; Davy, D. T.; Saravanos, D. A.; Hopkins, D. A.

    1992-01-01

    The optimization of composite hip implants was investigated. Emphasis was placed on the effect of shape and material tailoring of the implant to improve the implant-bone interaction. A variety of loading conditions were investigated to better understand the relationship between loading and optimization outcome. Comparisons of the initial and optimal models with more complex 3D finite element models were performed. The results indicate that design improvements made using this method result in similar improvements in the 3D models. Although the optimization outcomes were significantly affected by the choice of loading conditions, certain trends were observed that were independent of the applied loading.

  1. Numerical analysis of the spacer grids' compression strength

    Energy Technology Data Exchange (ETDEWEB)

    Schettino, C.F.M.; Gouvea, J.P.; Medeiros, N., E-mail: carlosschettino@inb.gov.br, E-mail: jpg@metal.eeimvr.uff.br [Universidade Federal Fluminense (UFF), Volta Redonda, RJ (Brazil). Programa de Engenharia Metalurgica

    2013-07-01

    Among the components of the fuel assembly, the spacer grids play an important structural role during the energy generation process, mainly for their requirement to have enough structural strength to withstand lateral impact loads, due to fuel assembly shipping/handling and due to forces outcome from postulated accidents (earthquake and LOCA). This requirement ensures a proper geometry for cooling and for guide thimble straightness in the fuel assembly. In this way, the understanding of the macroscopic mechanical behavior of this component becomes essential even to any subsequent geometrical modifications to optimize the flue assemblies' structural behavior. In the present work, three-dimensional finite element models destined to provide consistent predictions of 16X16-type spacer grids lateral strength were proposed. Firstly, buckling tests based on results available in the literature were performed to establish a methodology for spacer grid finite element-based modeling. The, by considering a spacer grid interesting geometry and some possible variations associated to its fabrication, tolerance, the proposed numerical models were submitted to compression conditions to calculate the buckling force. Also, these models were validated for comparison with experimental buckling load results. Comparison of buckling predictions combined to observations of actual and simulated deformed spacer grids geometries permitted to verify the consistency and applicability of the proposed models. Thus, these numerical results show a good agreement between the and the experimental results. (author)

  2. Impact of spacer thickness on biofouling in forward osmosis

    KAUST Repository

    Valladares Linares, Rodrigo

    2014-06-01

    Forward osmosis (FO) indirect desalination systems integrate wastewater recovery with seawater desalination. Niche applications for FO systems have been reported recently, due to the demonstrated advantages compared to conventional high-pressure membrane processes such as nanofiltration (NF) and reverse osmosis (RO). Among them, wastewater recovery has been identified to be particularly suitable for practical applications. However, biofouling in FO membranes has rarely been studied in applications involving wastewater effluents. Feed spacers separating the membrane sheets in cross-flow systems play an important role in biofilm formation. The objective of this study was to determine the influence of feed spacer thickness (28, 31 and 46mil) on biofouling development and membrane performance in a FO system, using identical cross-flow cells in parallel studies. Flux development, biomass accumulation, fouling localization and composition were determined and analyzed. For all spacer thicknesses, operated at the same feed flow and the same run time, the same amount of biomass was found, while the flux reduction decreased with thicker spacers. These observations are in good agreement with biofouling studies for RO systems, considering the key differences between FO and RO. Our findings contradict previous cross-flow studies on particulate/colloidal fouling, where higher cross-flow velocities improved system performance. Thicker spacers reduced the impact of biofouling on FO membrane flux. © 2014 Elsevier Ltd.

  3. Impact of spacer thickness on biofouling in forward osmosis.

    Science.gov (United States)

    Valladares Linares, R; Bucs, Sz S; Li, Z; AbuGhdeeb, M; Amy, G; Vrouwenvelder, J S

    2014-06-15

    Forward osmosis (FO) indirect desalination systems integrate wastewater recovery with seawater desalination. Niche applications for FO systems have been reported recently, due to the demonstrated advantages compared to conventional high-pressure membrane processes such as nanofiltration (NF) and reverse osmosis (RO). Among them, wastewater recovery has been identified to be particularly suitable for practical applications. However, biofouling in FO membranes has rarely been studied in applications involving wastewater effluents. Feed spacers separating the membrane sheets in cross-flow systems play an important role in biofilm formation. The objective of this study was to determine the influence of feed spacer thickness (28, 31 and 46 mil) on biofouling development and membrane performance in a FO system, using identical cross-flow cells in parallel studies. Flux development, biomass accumulation, fouling localization and composition were determined and analyzed. For all spacer thicknesses, operated at the same feed flow and the same run time, the same amount of biomass was found, while the flux reduction decreased with thicker spacers. These observations are in good agreement with biofouling studies for RO systems, considering the key differences between FO and RO. Our findings contradict previous cross-flow studies on particulate/colloidal fouling, where higher cross-flow velocities improved system performance. Thicker spacers reduced the impact of biofouling on FO membrane flux. Copyright © 2014 Elsevier Ltd. All rights reserved.

  4. Analyses of the Collapse Behavior of a Spacer Grid

    International Nuclear Information System (INIS)

    Jang, Myung-Geun; Na, Geum Ju; Jag, Yeon-Hui; Kim, Hee Cheol; Kim, Jong-Bong; Kim, Jaeyoug

    2016-01-01

    In order to investigate the protection capability of a spacer grid assembly for impact load, a hammer impact test has been carried out. The crush strength is measured in the hammer impact test. Song et al. carried out the experiment and finite element analysis for the hammer impact test for various weld line depth. Park et al. designed the spacer grid shape to get required crush strength via finite element analysis. Song et al. also optimized the spacer grid shape to maximize the crush strength, and carried out the finite element analysis for the hammer impact test considering the weld properties. Kim et al. carried out finite element analysis for various guide tube hole shape and compared the crush shape and crush strength. In this study, the effect of shape defect on the crush behavior in the hammer impact test is investigated. The spacer grid cannot be exactly the square. Therefore a lateral displacement (imperfection) is imposed to square spacer grid and then hammer impact is carried out. The effect of the lateral imperfection on the crush strength is investigated. The effect of the shape defect on the crushing behavior in the hammer impact test is investigated by finite element analysis. It is shown that the collapse become severe as the lateral imperfection displacement increases, especially when the imperfection is greater than or equal to 0.7 mm

  5. Zircaloy spacer grid for boiling light water reactors

    International Nuclear Information System (INIS)

    Borgiani, F.; Cali', G.P.; Cerretti, P.; Pazzo, P.

    1975-01-01

    The need to increase the neutronic efficiency of the new cores of BWR's, lead to study types of spacer-grids made of low neutronic absorption materials as zircaloy-4. The particular mechanical behaviour of this material suggested to design a spacer-grids such as to utilize only blanking, slotting and bending operations as plastic forming and to avoid therefore drawing effects. The optimization of the bending procedures lead to a final spacer-grids configuration equally stiff in all directions and planes. Only for the ''elastic constraints'' nichel alloy sheets were used to made easy the whole spacer design. The ''rigid constraints'', supporting the rods, have been obtained directly from the spacer structure. Calculations were performed to verify the mechanical strength of the main grid components. In this framework a computer code was developed to find the best elastic characteristic of the ''elastic constraints'' taking into account the machining tolerances. Some original methods to test the integral behaviour of the grid assembled as well as the procedures to be adopted for its best maintenance, are described

  6. Numerical analysis of the spacer grids' compression strength

    International Nuclear Information System (INIS)

    Schettino, C.F.M.; Gouvea, J.P.; Medeiros, N.

    2013-01-01

    Among the components of the fuel assembly, the spacer grids play an important structural role during the energy generation process, mainly for their requirement to have enough structural strength to withstand lateral impact loads, due to fuel assembly shipping/handling and due to forces outcome from postulated accidents (earthquake and LOCA). This requirement ensures a proper geometry for cooling and for guide thimble straightness in the fuel assembly. In this way, the understanding of the macroscopic mechanical behavior of this component becomes essential even to any subsequent geometrical modifications to optimize the flue assemblies' structural behavior. In the present work, three-dimensional finite element models destined to provide consistent predictions of 16X16-type spacer grids lateral strength were proposed. Firstly, buckling tests based on results available in the literature were performed to establish a methodology for spacer grid finite element-based modeling. The, by considering a spacer grid interesting geometry and some possible variations associated to its fabrication, tolerance, the proposed numerical models were submitted to compression conditions to calculate the buckling force. Also, these models were validated for comparison with experimental buckling load results. Comparison of buckling predictions combined to observations of actual and simulated deformed spacer grids geometries permitted to verify the consistency and applicability of the proposed models. Thus, these numerical results show a good agreement between the and the experimental results. (author)

  7. A non-electrostatic spacer for aerosol delivery

    DEFF Research Database (Denmark)

    Bisgaard, H; Anhøj, J; Klug, B

    1995-01-01

    A pear shaped non-electrostatic spacer, composed of steel with a volume of 250 ml and equipped with a facemask containing integrated inlet and outlet valves for inspiration and expiration, was compared with three plastic spacers. The plastic spacers were primed with repeated puffs from a budesonide...... pressurised metered dose inhaler (p-MDI) to minimise the electrostatic charge on the plastic. The procedure prolonged the half life (t1/2) of the aerosol in the Nebuhaler from nine to 32 seconds. A normal cleaning procedure reduced the aerosol t1/2 back to baseline. The t1/2 of the aerosol in the metal spacer...... was 27 seconds and independent of the use of p-MDI. In vitro the maximum dose of budesonide from a p-MDI, expressed as a percentage of the nominal dose, was 56% from the non-electrostatic spacer, 61% from the Nebuhaler, 45% from the Babyhaler, and 30% from the AeroChamber. In 124 children, age 6 months...

  8. Impact of spacer thickness on biofouling in forward osmosis

    KAUST Repository

    Valladares Linares, Rodrigo; Bucs, Szilard; Li, Z.; AbuGhdeeb, M.; Amy, Gary L.; Vrouwenvelder, Johannes S.

    2014-01-01

    Forward osmosis (FO) indirect desalination systems integrate wastewater recovery with seawater desalination. Niche applications for FO systems have been reported recently, due to the demonstrated advantages compared to conventional high-pressure membrane processes such as nanofiltration (NF) and reverse osmosis (RO). Among them, wastewater recovery has been identified to be particularly suitable for practical applications. However, biofouling in FO membranes has rarely been studied in applications involving wastewater effluents. Feed spacers separating the membrane sheets in cross-flow systems play an important role in biofilm formation. The objective of this study was to determine the influence of feed spacer thickness (28, 31 and 46mil) on biofouling development and membrane performance in a FO system, using identical cross-flow cells in parallel studies. Flux development, biomass accumulation, fouling localization and composition were determined and analyzed. For all spacer thicknesses, operated at the same feed flow and the same run time, the same amount of biomass was found, while the flux reduction decreased with thicker spacers. These observations are in good agreement with biofouling studies for RO systems, considering the key differences between FO and RO. Our findings contradict previous cross-flow studies on particulate/colloidal fouling, where higher cross-flow velocities improved system performance. Thicker spacers reduced the impact of biofouling on FO membrane flux. © 2014 Elsevier Ltd.

  9. Hip arthroplasty. Part 1: prosthesis terminology and classification

    International Nuclear Information System (INIS)

    Pluot, E.; Davis, E.T.; Revell, M.; Davies, A.M.; James, S.L.J.

    2009-01-01

    Hip arthroplasty is an extremely common orthopaedic procedure and there is a wide array of implants that are in current use in the UK. The follow-up of patients who have undergone insertion of a hip prosthesis is shifting from a consultant-lead hospital service towards primary care. As this change in patient care continues it becomes increasingly important that an accurate description of the radiographic features is communicated to the primary-care practitioner so appropriate specialist input can be triggered. This review focuses on the terminology and classification of hip prostheses. This acts as a precursor for Part 2 of this series, which describes the normal and abnormal radiographic findings following hip prosthesis insertion.

  10. Experimental study of mechanical properties on spacer in NHR

    International Nuclear Information System (INIS)

    Jiang Yueyuan; Shi Jibing; Xu Yong

    2007-01-01

    The spacer of NHR-200 is composed mainly of the inner, outer and cornual strips which are ranged in egg-crate of 12 x 12-3. First, the pre-distortion of three kinds of three-arc springs on reactor working condition and their related clipping-force ranges are analyzed in this paper. Secondly, the mechanical experiments of 1:1 prototype, such as the load-distortion experiments, which the load and distortion are respectively measured by strain gauge and displacement sensor, of three kinds of springs, rigid supports and the spacers in two different directions are carried out on a special experimental facility. The experimental results show that the spacer can completely meet the design demands of mechanical properties of the fuel assemblies in NHR-200. (authors)

  11. Effect of a spacer moiety on radiometal labelled Neurotensin derivatives

    Energy Technology Data Exchange (ETDEWEB)

    Mascarin, A.; Valverde, I.E.; Mindt, T.L. [Univ. of Basel Hospital (Switzerland). Div. of Radiopharmaceutical Chemistry

    2013-07-01

    The binding sequence of the regulatory peptide Neurotensin, NT(8-13), represents a promising tumour-specific vector for the development of radiopeptides useful in nuclear oncology for the diagnosis (imaging) and therapy of cancer. A number of radiometal-labelled NT(8-13) derivatives have been reported, however, the effect of the spacer which connects the vector with the radiometal complex has yet not been investigated systematically. Because a spacer moiety can influence potentially important biological characteristics of radiopeptides, we synthesized three [DOTA({sup 177}Lu)]-X-NT(8-13) derivatives and evaluated the effect of a spacer (X) on the physico-chemical properties of the conjugate including lipophilicity, stability, and in vitro receptor affinity and cell internalization. (orig.)

  12. The history of biomechanics in total hip arthroplasty

    Directory of Open Access Journals (Sweden)

    Jan Van Houcke

    2017-01-01

    Full Text Available Biomechanics of the hip joint describes how the complex combination of osseous, ligamentous, and muscular structures transfers the weight of the body from the axial skeleton into the appendicular skeleton of the lower limbs. Throughout history, several biomechanical studies based on theoretical mathematics, in vitro, in vivo as well as in silico models have been successfully performed. The insights gained from these studies have improved our understanding of the development of mechanical hip pathologies such as osteoarthritis, hip fractures, and developmental dysplasia of the hip. The main treatment of end-stage degeneration of the hip is total hip arthroplasty (THA. The increasing number of patients undergoing this surgical procedure, as well as their demand for more than just pain relief and leading an active lifestyle, has challenged surgeons and implant manufacturers to deliver higher function as well as longevity with the prosthesis. The science of biomechanics has played and will continue to play a crucial and integral role in achieving these goals. The aim of this article, therefore, is to present to the readers the key concepts in biomechanics of the hip and their application to THA.

  13. Lower end fitting debris collector and end cap spacer grid

    International Nuclear Information System (INIS)

    Bryan, W.J.

    1990-01-01

    This patent describes a nuclear reactor having fuel assemblies including an upper end fitting and spaced nuclear fuel rod spacer grids for supporting and spacing a plurality of elongated nuclear fuel rods. Each includes a hollow active portion of nuclear fuel filled cladding intermediate the rod ends and tapering end cap of solid material with a circumferential groove on the rod end which first encounters reactor coolant flow, a lower end filtering debris collector and end cap spacer grid for capturing and retaining deleterious debris carried by reactor coolant before it enters the active region of a fuel assembly and creates fuel rod cladding damage

  14. Spacer grid for a nuclear reactor fuel assembly

    International Nuclear Information System (INIS)

    Jabsen, F.S.

    1978-01-01

    The spacer grid consists of pairs of plates forming rectangular cells and enclosing the cylindrical fuel assemblies. They have got rigid as well as elastic projections extending into the cells and holding the fuel assemblies. Additional pairs of plates are arranged in about the center of the grid of plates. They have got only elastic projections extending on both sides of the plates into one cell each. This spacer grid may be used for reactor cores with and without fuel channels. By the combination of spring-elastic and rigid projections there is obtained a reinforced outer tie. Hydraulic pressure losses, parasitic neutron capture, and hot spots are essentially reduced. (DG) [de

  15. Biomechanical Analysis of an Expandable Lumbar Interbody Spacer.

    Science.gov (United States)

    Soriano-Baron, Hector; Newcomb, Anna G U S; Malhotra, Devika; Palma, Atilio E; Martinez-Del-Campo, Eduardo; Crawford, Neil R; Theodore, Nicholas; Kelly, Brian P; Kaibara, Taro

    2018-06-01

    Recently developed expandable interbody spacers are widely accepted in spinal surgery; however, the resulting biomechanical effects of their use have not yet been fully studied. We analyzed the biomechanical effects of an expandable polyetheretherketone interbody spacer inserted through a bilateral posterior approach with and without different modalities of posterior augmentation. Biomechanical nondestructive flexibility testing was performed in 7 human cadaveric lumbar (L2-L5) specimens followed by axial compressive loading. Each specimen was tested under 6 conditions: 1) intact, 2) bilateral L3-L4 cortical screw/rod (CSR) alone, 3) WaveD alone, 4) WaveD + CSR, 5) WaveD + bilateral L3-L4 pedicle screw/rod (PSR), and 6) WaveD + CSR/PSR, where CSR/PSR was a hybrid construct comprising bilateral cortical-level L3 and pedicle-level L4 screws interconnected by rods. The range of motion (ROM) with the interbody spacer alone decreased significantly compared with the intact condition during flexion-extension (P = 0.02) but not during lateral bending or axial rotation (P ≥ 0.19). The addition of CSR or PSR to the interbody spacer alone condition significantly decreased the ROM compared with the interbody spacer alone (P ≤ 0.002); and WaveD + CSR, WaveD + PSR, and WaveD + CSR/PSR (hybrid) (P ≥ 0.29) did not differ. The axial compressive stiffness (resistance to change in foraminal height during compressive loading) with the interbody spacer alone did not differ from the intact condition (P = 0.96), whereas WaveD + posterior instrumentation significantly increased compressive stiffness compared with the intact condition and the interbody spacer alone (P ≤ 0.001). The WaveD alone significantly reduced ROM during flexion-extension while maintaining the axial compressive stiffness. CSR, PSR, and CSR/PSR hybrid constructs were all effective in augmenting the expandable interbody spacer system and improving its stability. Copyright © 2018 Elsevier Inc. All

  16. The Symmetry of Adverse Local Tissue Reactions in Patients with Bilateral Simultaneous and Sequential ASR Hip Replacement.

    Science.gov (United States)

    Madanat, Rami; Hussey, Daniel K; Donahue, Gabrielle S; Potter, Hollis G; Wallace, Robert; Bragdon, Charles R; Muratoglu, Orhun K; Malchau, Henrik

    2015-10-01

    The purpose of this study was to evaluate whether patients with bilateral metal-on-metal (MoM) hip replacements have symmetric adverse local tissue reactions (ALTRs) at follow-up. An MRI of both hips was performed at a mean time of six years after surgery in 43 patients. The prevalence and severity of ALTRs were found to be similar in simultaneous hips but differences were observed in sequential hips. The order and timing of sequential hip arthroplasties did not affect the severity of ALTRs. Thus, in addition to metal ion exposure from an earlier MoM implant other factors may also play a role in the progression of ALTRs. Bilateral implants should be given special consideration in risk stratification algorithms for management of patients with MoM hip arthroplasty. Copyright © 2015 Elsevier Inc. All rights reserved.

  17. Transient osteoporosis of the hip

    International Nuclear Information System (INIS)

    McWalter, Patricia; Hassan Ahmed

    2007-01-01

    Transient osteoporosis of the hip is an uncommon cause of hip pain, mostly affecting healthy middle-aged men and also women in the third trimester of pregnancy. We present a case of transient osteoporosis of the hip in a 33-year-old non-pregnant female patient. This case highlights the importance of considering a diagnosis of transient osteoporosis of the hip in patients who present with hip pain. (author)

  18. Total hip prosthesis complication, periprosthetic infection with external fistulizing due to Enterobacter cloacae complex multiple drugs resistance: A clinical case report

    Directory of Open Access Journals (Sweden)

    V. Amorese

    2017-01-01

    Conclusion: The patient was hospitalized in our facility and 2 months later she underwent another operation to remove the antibiotic spacer and to place a new total hip arthroprosthesis. Multiple swabs showed the complete healing from the infection, which was confirmed a couple of months later.

  19. Comparative studies of 111In-labeled monoclonal antibody using spacer-containing and non-spacer bifunctional chelates. 2

    International Nuclear Information System (INIS)

    Sun, Baofu

    1994-01-01

    Indium-111-labeled A7 monoclonal antibodies using two spacer-containing chelates, succinimido-EGS-DTPA (EGS-DTPA: diester spacer) and maleimido-C10-Bz-EDTA (C10-Bz-EDTA: hydrocarbon spacer) were investigated in human LS180 colon tumor bearing nude mice and were compared with two non-spacer chelates, cyclic DTPA dianhydride (cDTPAA) and isothiocyanatobenzyl-EDTA (SCN-Bz-EDTA). Compared with immunoconjugates using non-spacer chelates, immunoconjugates using spacer-containing chelates, especially C10-Bz-EDTA-A7 showed lower 111 In activity in normal organs. The radioactivity in the liver for C10-Bz-EDTA-A7 decreased continuously till 96 hrs postinjection, however, this liver radioactivity for EGS-DTPA-A7 showed little change after 24 hrs. Moreover, in liver subcellular distribution study, EGS-DTPA-A7 showed a higher activity retention in mitochondrial fraction which contained lysosome, a place for metabolizing and storing of 111 In labeled antibody, than that of C10-Bz-EDTA-A7. The C10-Bz-EDTA-A7 conjugate demonstrated more preferable tumor-to-non tumor contrast on the scintigrams than that found with other three immunoconjugates. Up to 96 hrs postinjection, tumor bearing nude mice injecting with immunoconjugates using spacer-containing chelates exreted twice radioactivity from whole body than that excreted by using non-spacer chelates. Interestingly, different from other three chelates, C10-Bz-EDTA-A7 were mainly excreted via feces. We conclude that the decrease of radioactivity in normal tissues in the case of EGS-DTPA-A7 was due to the rapid decrease of activity in the blood, while in the case of C10-Bz-EDTA-A7 it was due to the quickly excreted small metabolite through faces. 111 In labeled C10-Bz-EDTA conjugate is superior, at least when conjugated with A7, to other three chelate conjugates used in this study. (author)

  20. Transient osteoporosis of hip

    Directory of Open Access Journals (Sweden)

    Mahesh M Choudhary

    2015-01-01

    Full Text Available We report a case of transient osteoporosis of the hip (TOH in a 50-year-old man including the clinical presentation, diagnostic studies, management, and clinical progress. TOH is a rare self-limiting condition that typically affects middle-aged men or, less frequently, women in the third trimester of pregnancy. Affected individuals present clinically with acute hip pain, limping gait, and limited ranges of hip motion. TOH may begin spontaneously or after a minor trauma. Radiographs are typically unremarkable but magnetic resonance (MR imaging studies yield findings consistent with bone marrow edema. TOH is referred to as regional migratory osteoporosis (RMO if it travels to other joints or the contralateral hip. TOH often resembles osteonecrosis but the two conditions must be differentiated due to different prognoses and management approaches. The term TOH is often used interchangeably and synonymously with transient bone marrow edema (TBME.

  1. Danish Hip Arthroscopy Registry

    DEFF Research Database (Denmark)

    Mygind-Klavsen, Bjarne; Grønbech Nielsen, Torsten; Maagaard, Niels

    2016-01-01

    Danish Hip Arthroscopy Registry (DHAR) was initiated in 2012 as a web-based prospective registry. The purpose of this study was to evaluate and report the epidemiologic and perioperative data of the first 2000 procedures in a Danish hip arthroscopy population and to describe the development of DHAR...... was 0.65 and HAGOS sub-scores were 51 (pain), 49 (symptoms), 53 (ADL), 35 (sport), 20 (physical activity) and 29, respectively. We conclude that patients undergoing hip arthroscopy report considerable pain, loss of function, reduced level of activity and reduced quality-of-life prior to surgery....... The problems with development and maintaining a large clinical registry are described and further studies are needed to validate data completeness. We consider the development of a national clinical registry for hip arthroscopy as a successful way of developing and maintaining a valuable clinical...

  2. Osteoarthritis of the hip

    International Nuclear Information System (INIS)

    Kokubo, Takashi; Takatori, Yoshio; Sasaki, Yasuhito

    1993-01-01

    Magnetic resonance imaging (MRI) is the modality of choice for evaluation of joint disease. Forty-one hips in 33 patients with osteoarthritis of the hip joint were examined by MRI and the features were analyzed. MR examinations were performed on a 1.5 T superconducting unit using the spin echo (SE) technique with short TR (600 ms)/short TE (23, 28, 35 ms) and short TR (600 ms)/long TE (70, 75 ms) sequences. MRI revealed deformity of the femoral head in all hips. Some outgrowths, which were isointense with normal bone marrow, were shown on the periphery of the femoral head in 22 hips (54%). These outgrowths represented marginal osteophytes. Short TE images showed hypointense areas, which varied in size, in the superior or supero-anterior aspect of the femoral head in all hips, and in the opposite position of the acetabulum in 38 hips (93%). These lesions showed a heterogenous signal with predominant low signal on long TE images. These images may indicate the presence of several components including subchondral cysts, bony sclerosis and fibrous tissue. In the joint space, areas of low signal intensity were shown on short TE images, which were high to intermediate signal intensity on long TE images in 16 hips (39%). These areas were presumably consistent with synovial proliferation, cartilageous hypertrophy or joint effusion. Both MR images revealed a mass locating just anterior to the femoral head in 2 hips (5%). The mass showed a low signal on short TE images and a high signal on long TE images, representing the distended iliopsoas bursa. (author)

  3. Hip resurfacing arthroplasty: current status and future perspectives

    Directory of Open Access Journals (Sweden)

    K Corten

    2011-03-01

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

  4. Shelf life of pie caps with biodegradable films as spacers

    Directory of Open Access Journals (Sweden)

    Daniela Verónica Escobar Gianni

    2013-01-01

    Full Text Available Commonly pie caps at market use polyethylene films as spacers between them. This paper studies the conventional spacers replacement with edible and biodegradable films made with whey protein isolate (WPI and potassium sorbate as a preservative. Besides facilitating the separation of pie caps, with this application is intended to increase their shelf life. The films made by the compression molding method were used as spacers in pie caps without preservative in their formula (A and with preservative (B and they were compared with conventional polyethylene spacers (C. During four months, monthly sensory, microbiological and physicochemical (humidity evaluations were done on the pie caps, together with humidity and solubility evaluations of the films. None of the samples showed microbiological or sensory deterioration. The sensory attributes showed no or slight difference in study time. Between samples the differences were minor: the best scores were for sample A in color, sample C in flavor, and samples B and C in texture and overall liking. The edible films have an interesting potential for this application, although studies in disguise the flavor of serum should be done.

  5. Ribosomal DNA internal transcribed spacer 1 and internal ...

    African Journals Online (AJOL)

    USER

    2010-07-26

    Jul 26, 2010 ... in some East Asian countries such as China, Korea and. *Corresponding author. E-mail: soonkwan@kangwon.ac.kr. Tel: +82 33 250 6476. Fax: +82 33 250 6470. Abbreviations: nrDNA, Nuclear ribosomal DNA; ITS, internal transcribed spacer; PCR, polymerase chain reaction; BLAST, basic local alignment ...

  6. Deformation behavior of cell spring of an irradiated spacer grid

    International Nuclear Information System (INIS)

    Jin, Y. G.; Baek, S. J.; Ryu, W. S.; Kim, G. S.; Yoo, B. O.; Kim, D. S.; Ahn, S. B.; Chun, Y. B.; Choo, Y. S.

    2012-01-01

    Mechanical properties of a space grid of a fuel assembly are of great importance for fuel operation reliability in extended fuel burnup and duration of fuel life. The spacer grid with inner and outer straps has cell spring and dimples, which are in contact with the fuel rod. The spacer grids supporting the fuel rods absorb vibration impacts due to the reactor coolant flow and also grid spring force is decreasing under irradiation. This reduction of contact force might cause the grid to rod fretting wear. The fretting failure of the fuel rod is one of the significant issues recently in the nuclear industry from an economical as well as a safety concern. Thus, it is important to understand the characteristics of cell spring behavior for an irradiated spacer grid. In the present study, the stiffness test and dimensional measurement of cell springs were conducted to investigate the deformation behavior of cell springs of an irradiated spacer grid in a hot cell at IMEF (irradiated materials examination facility) of KAERI

  7. Hot fuel examination facility element spacer wire-wrap machine

    International Nuclear Information System (INIS)

    Tobias, D.A.; Sherman, E.K.

    1989-01-01

    Nondestructive examinations of irradiated experimental fuel elements conducted in the Argonne National Laboratory Hot Fuel Examination Facility/North (HFEF/N) at the Idaho National Engineering Laboratory include laser and contact profilometry (element diameter measurements), electrical eddy-current testing for cladding and thermal bond defects, bow and length measurements, neutron radiography, gamma scanning, remote visual exam, and photography. Profilometry was previously restricted to spiral profilometry of the element to prevent interference with the element spacer wire wrapped in a helix about the Experimental Breeder Reactor II (EBR-II)-type fuel element from end to end. By removing the spacer wire prior to conducting profilometry examination, axial profilometry techniques may be used, which are considerably faster than spiral techniques and often result in data acquisition more important to experiment sponsors. Because the element must often be reinserted into the nuclear reactor (EBR-II) for additional irradiation, however, the spacer wire must be reinstalled on the highly irradiated fuel element by remote means after profilometry of the wireless elements. The element spacer wire-wrap machine developed at HFEF is capable of helically wrapping fuel elements with diameters up to 1.68 cm (0.660 in.) and 2.44-m (96-in.) lengths. The machine can accommodate almost any desired wire pitch length by simply inserting a new wrapper gear module

  8. Knowledge of spacer device, peak flow meter and inhaler technique ...

    African Journals Online (AJOL)

    Background: Metered dose inhalers are cornerstone in effective management of bronchial asthma when correctly used. Most studies hitherto have focused on assessing patient's knowledge of inhaler technique. We sought to assess the knowledge of inhaler technique, spacer device and peak flow meter among doctors and ...

  9. Modes of failure of Osteonics constrained tripolar implants: a retrospective analysis of forty-three failed implants.

    Science.gov (United States)

    Guyen, Olivier; Lewallen, David G; Cabanela, Miguel E

    2008-07-01

    The Osteonics constrained tripolar implant has been one of the most commonly used options to manage recurrent instability after total hip arthroplasty. Mechanical failures were expected and have been reported. The purpose of this retrospective review was to identify the observed modes of failure of this device. Forty-three failed Osteonics constrained tripolar implants were revised at our institution between September 1997 and April 2005. All revisions related to the constrained acetabular component only were considered as failures. All of the devices had been inserted for recurrent or intraoperative instability during revision procedures. Seven different methods of implantation were used. Operative reports and radiographs were reviewed to identify the modes of failure. The average time to failure of the forty-three implants was 28.4 months. A total of five modes of failure were observed: failure at the bone-implant interface (type I), which occurred in eleven hips; failure at the mechanisms holding the constrained liner to the metal shell (type II), in six hips; failure of the retaining mechanism of the bipolar component (type III), in ten hips; dislocation of the prosthetic head at the inner bearing of the bipolar component (type IV), in three hips; and infection (type V), in twelve hips. The mode of failure remained unknown in one hip that had been revised at another institution. The Osteonics constrained tripolar total hip arthroplasty implant is a complex device involving many parts. We showed that failure of this device can occur at most of its interfaces. It would therefore appear logical to limit its application to salvage situations.

  10. Athletic Hip Injuries.

    Science.gov (United States)

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

    2017-04-01

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

  11. On the impact analysis of a PWR spacer grid

    International Nuclear Information System (INIS)

    Song, Kee Nam; Lee, S. H.

    2012-01-01

    A spacer grid, which is an interconnected array of slotted grid straps and is welded at the intersections to form an egg crate structure, is one of the most important structural components in a PWR fuel assembly. From a structural point of view, the spacer grid is required to have sufficient crush strength under lateral loads so that nuclear fuel rods are maintained in a cool able geometry, and that control rods can be inserted. The capacity of a spacer grid to resist lateral loads is usually characterized in terms of its crush strength, and it was reported that the lateral crush strength of the spacer grid is closely related with welding quality of the spacer grid. Microstructures in the weld zone, including a heat affected zone (HAZ), are different from that in a parent material. Consequently, the mechanical properties in the weld zone are different from those in the parent material to some extent. When a welded structure is loaded, the mechanical behavior of the welded structure might be different from the case of a structure with homogeneous mechanical properties. Nonetheless, mechanical properties in the welded structure have been neglected in many structural analyses of the spacer grid due to a lack of mechanical properties in the weld zone. When the weld zone is very narrow and the interfaces are not clear, it is difficult to take tensile test specimens in the weld zone. The reason for this is that the mechanical properties in the parent material are usually used in the structural analyses in the welded structure. As an aside, it has been recently determined that the ball indentation technique has the potential to be an excellent substitute for a standard tensile test, particularly in the case of small specimens or property gradient materials such as welds. In this study, to investigate the effect on the mechanical behavior of the spacer grid when using weld mechanical properties, strength analyses considering the weld mechanical properties recently obtained

  12. 3-D flow analyses for design of nuclear fuel spacer

    Energy Technology Data Exchange (ETDEWEB)

    Karouta, Z. [ABB Combustion Engineering, Windsor, CT (United States); GU, Chun-Yuan [ABB Corporate Research, Vaesteras (Sweden); Schoelin, B. [ABB Atom AB, Vaesteras (Sweden)

    1995-09-01

    The Computational Fluid Dynamics (CFD) code, CFDS-FLOW3D, was used to develop improved fuel designs for PWR cores. It was used primarily to understand the fluid dynamics of grid spacers, the mass transfer between subchannels caused by spacers and in the long term to develop two-phase models which enable prediction of critical heat flux in PWR fuel. A single subchannel of one grid span was modeled. In this model different spacer designs with mixing devices were analyzed. A special treatment of the boundary condition was developed making use of flow symmetry to model the mass transfer between different subchannels and minimize the size of the computational model. This reduced the computational model to a fraction of a subchannel using traditional periodic boundary conditions. The Navier-Stokes equation was solved for the liquid and the flow turbulence was modeled by k-{xi} turbulence model. The spacer and mixing device were treated as infinite thin surfaces in the model and a zero velocity condition and turbulent wall function were applied on each side of the thin surfaces. This approach simulated the swirl from the mixing devices well, but had the drawback of not predicting pressure drop accurately since the wake behind the plates and the acceleration effect of the spacers were ignored. CFDS-FLOW3D models with mixing devices were applied in the single-phase flow regime. Velocity profiles from the CFDS-FLOW3D models were compared to Laser Doppler Velocimeter measurements taken from the flow field downstream of spaces in a full scale, cold water test loop. The predicted axial and lateral velocity profiles were in good agreement with the measurements. The evaluation of the performance of different spacer devices was made by comparing the swirl ratio downstream of the grid spacers. It is planned to evaluate heat transfer coefficient downstream of the spaces, to implement two-phase flow models, and to model the superheated boundary layer on the surface of the fuel rod.

  13. CT osteodensitometry in the area directly adjacent to hip endoprotheses

    International Nuclear Information System (INIS)

    Sokiranski, R.; Marienfeld, D.; Felsenberg, D.; Rilinger, N.; Goerich, J.; Kalender, W.

    1996-01-01

    Purpose: The value of metal artifact reduction in quantitative bone density determination in the vicinity of metallic implants was studied. Method: Ten cadaver femora with hip endoprostheses implanted intra vitam were examined in CT with varying slice thicknesses, tube voltage, scan time and magnification factor. The artifact-laden images were then processed using a metal artifact reduction programme (MAR). The metallic implant was removed, allowing the bone slices to be examined again with the same imaging parameters, but without the bothersome metal artifacts. This allowed comparison of bone density values obtained before and after application of MAR with data obtained after implant removal. Results: A comparison of the bone density measurements between the sample group without implants and the group with indwelling implants prior to MAR showed an unexpected correlation coefficient r=0.975-0.977. The correlation coefficients after MAR rose to r=0.987-0.992 in 125 kV and r=0.989-0.991 in 85 kV modes. The reproducibility of the density measurements for the groups without implants and with implants following MAR showed variation coefficients (VC) of 1.16% and 0.75% respectively. The reproducibility of the manual definition of the region of interest (ROI) in bone showed a VC=2.19%. Conclusions: Bone density in the vicinity of metallic implants can be reliably and reproducibly determined using MAR. (orig.) [de

  14. Implementation of spacer therapy for acute asthma in children.

    LENUS (Irish Health Repository)

    Vandeleur, M

    2009-09-01

    The aim was to develop and implement an evidence based guideline for the treatment of acute asthma using a metered dose inhaler and spacer combination. Children admitted to Cork University Hospital Paediatric Department with acute asthma were identified during two identical 2 month seasonal periods before (2005) and after (2006) implementation of the new guidelines in September 2006. Pre-intervention and post-intervention audits by case note review were performed to determine the impact of and compliance with this evidence-based guideline emphasising patient assessment, spacer delivered bronchodilator and specific discharge criteria. Patients had similar characteristics during the two study periods. There was a raised threshold for admission after guideline implementation with 11\\/52 patients having mild exacerbations in 2006, compared to 21\\/36 in 2005. Duration of admission was less in the post-implementation group for equivalent exacerbation severity e.g. for moderate severity; 28 hours in 2005, 23 hours in 2006. Duration of bronchodilator therapy was shorter in 2006 and more likely to be given by spacer device earlier for equivalent levels of severity e.g. for moderate exacerbations, in 2006 the average length of salbutamol therapy was 18 hours with 12 hours by spacer device, in 2005 the average length of therapy was 25 hours with 3 hours by spacer. There was earlier initiation of oral corticosteroids; the average time to administration was 56 minutes in 2006 and 227 minutes in 2005. There was an improved documentation of asthma education in 2006 e.g. inhaler technique was reviewed in 37\\/52 in 2006, 21\\/35 in 2005 and better use of written action plans.

  15. Effect of spacer grids on CHF in tube bundles

    International Nuclear Information System (INIS)

    Jayanti, Sreenivas; Valette, Michel

    2004-01-01

    Spacers grids are used to support tube bundles in steam generators and in nuclear reactor fuel assemblies. These grids interface with the flow and heat transfer in a number of ways and their effect has been studied by a number of researchers. It is known that generally they have a beneficial effect on critical heat flux (CHF) in typical nuclear reactor assemblies. However, the enhancement obtained depends on the geometric characteristics of the spacer grids as well as on the parameter range in terms of pressure, local mass velocity and quality. In the present study, the problem is approached in the context of a one-dimensional three-field model. Unlike in previous approaches, no specific modeling of the constitutive laws is made to account for spacer effects and only the geometric details such as the reduction in the cross-sectional area and the hydraulic diameter are included in the calculation which is otherwise the same as that for flow through a single tube. It is shown by comparison with literature data that this approach leads to satisfactory prediction of the thermal-hydraulic effects of spacers and that the beneficial effects of spacers on dry out can be manifested only when the entrainment rate is neither too high nor too low. Their effect on reducing the post-dry out wall temperature is also limited to certain cases. The present work has been performed as part of the EDF-CEA Neptune project also supported by the Institut de Radioprotection et de Surete Nucleaire (IRSN, France) and FRAMATOME-ANP. NEPTUNE is a new set of two phase thermalhydraulic computer codes devoted to safety analysis of nuclear power plants. (author)

  16. Biofouling Control in Spiral-Wound Membrane Systems: Impact of Feed Spacer Modification and Biocides

    KAUST Repository

    Siddiqui, Amber

    2016-01-01

    was developed. The combination of modeling and experimental testing of 3D printed spacers is a promising strategy to develop advanced spacers aiming to reduce the impact of biofilm formation on membrane performance and to improve the cleanability of spiral

  17. Impact of feed spacer and membrane modification by hydrophilic, bactericidal and biocidal coating on biofouling control

    KAUST Repository

    Araú jo, Paula A.; Miller, Daniel J.; Correia, Patrí cia B.; van Loosdrecht, Mark C.M.; Kruithof, Joop C.; Freeman, Benny Dean; Paul, Donald; Vrouwenvelder, Johannes S.

    2012-01-01

    surface modification agents expected to resist protein and bacterial adhesion, while copper feed spacer coatings and biocides infused in feed spacers are expected to restrict biological growth. Our studies showed that polydopamine and polydopamine-. g

  18. Development and characterization of 3D-printed feed spacers for spiral wound membrane systems

    KAUST Repository

    Siddiqui, Amber; Farhat, Nadia; Bucs, Szilard; Valladares Linares, Rodrigo; Picioreanu, Cristian; Kruithof, Joop C.; van Loosdrecht, Mark C.M.; Kidwell, James; Vrouwenvelder, Johannes S.

    2016-01-01

    suggested that the impact of spacers on hydraulics and biofouling can be improved. A good agreement was found for the modeled and measured relationship between linear flow velocity and pressure drop for feed spacers with the same geometry, indicating

  19. Cochlear Implants

    Science.gov (United States)

    ... implant, including: • How long a person has been deaf, •The number of surviving auditory nerve fibers, and • ... Implant, Severe Sensoryneurial Hearing Loss Get Involved Professional Development Practice Management ENT Careers Marketplace Privacy Policy Terms ...

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

    Science.gov (United States)

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

    2014-04-01

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

  1. Biofouling Control in Spiral-Wound Membrane Systems: Impact of Feed Spacer Modification and Biocides

    KAUST Repository

    Siddiqui, Amber

    2016-12-01

    High-quality drinking water can be produced with membrane-based filtration processes like reverse osmosis and nanofiltration. One of the major problems in these membrane systems is biofouling that reduces the membrane performance, increasing operational costs. Current biofouling control strategies such as pre-treatment, membrane modification, and chemical cleaning are not sufficient in all cases. Feed spacers are thin (0.8 mm), complex geometry meshes that separate membranes in a module. The main objective of this research was to evaluate whether feed spacer modification is a suitable strategy to control biofouling. Membrane fouling simulator studies with six feed spacers showed differences in biofouled spacer performance, concluding that (i) spacer geometry influences biofouling impact and (ii) biofouling studies are essential for evaluation of spacer biofouling impact. Computed tomography (CT) was found as a suitable technique to obtain three-dimensional (3D) measurements of spacers, enabling more representative mathematical modeling of hydraulic behavior of spacers in membrane systems. A strategy for developing, characterizing, and testing of spacers by numerical modeling, 3D printing of spacers and experimental membrane fouling simulator studies was developed. The combination of modeling and experimental testing of 3D printed spacers is a promising strategy to develop advanced spacers aiming to reduce the impact of biofilm formation on membrane performance and to improve the cleanability of spiral-wound membrane systems.

  2. Lessons learned from study of congenital hip disease in adults.

    Science.gov (United States)

    Hartofilakidis, George; Lampropoulou-Adamidou, Kalliopi

    2016-12-18

    Orthopaedic surgeons specialising in adult hip reconstruction surgery often face the problem of osteoarthritis secondary to congenital hip disease (CHD). To achieve better communication among physicians, better treatment planning and evaluation of the results of various treatment options, an agreed terminology is needed to describe the entire pathology. Furthermore, a generally accepted classification of the deformities is necessary. Herein, the authors propose the use of the term "congenital hip disease" and its classification as dysplasia, low dislocation and high dislocation. Knowledge of the CHD natural history facilitates comprehension of the potential development and progression of the disease, which differs among the aforementioned types. This can lead to better understanding of the anatomical abnormalities found in the different CHD types and thus facilitate preoperative planning and choice of the most appropriate management for adult patients. The basic principles for improved results of total hip replacement in patients with CHD, especially those with low and high dislocation, are: Wide exposure, restoration of the normal centre of rotation and the use of special techniques and implants for the reconstruction of the acetabulum and femur. Application of these principles during total hip replacement in young female patients born with severe deformities of the hip joint has led to radical improvement of their quality of life.

  3. A Novel Murine Model of Established Staphylococcal Bone Infection in the Presence of a Fracture Fixation Plate to Study Therapies Utilizing Antibiotic-laden Spacers after Revision Surgery

    Science.gov (United States)

    Inzana, Jason A.; Schwarz, Edward M.; Kates, Stephen L.; Awad, Hani A.

    2014-01-01

    Mice are the small animal model of choice in biomedical research due to the low cost and availability of genetically engineered lines. However, the devices utilized in current mouse models of implant-associated bone infection have been limited to intramedullary or trans-cortical pins, which are not amenable to treatments involving extensive debridement of a full-thickness bone loss and placement of a segmental antibiotic spacer. To overcome these limitations, we developed a clinically faithful model that utilizes a locking fracture fixation plate to enable debridement of an infected segmental bone defect (full-thickness osteotomy) during a revision surgery, and investigated the therapeutic effects of placing an antibiotic-laden spacer in the segmental bone defect. To first determine the ideal time point for revision following infection, a 0.7 mm osteotomy in the femoral mid-shaft was stabilized with a radiolucent PEEK fixation plate. The defect was inoculated with bioluminescent Staphylococcus aureus, and the infection was monitored over 14 days by bioluminescent imaging (BLI). Osteolysis and reactive bone formation were assessed by X-ray and micro-computed tomography (micro-CT). The active bacterial infection peaked by 5 days post-inoculation, however the stability of the implant fixation became compromised by 10–14 days post-inoculation due to osteolysis around the screws. Thus, day 7 was defined as the ideal time point to perform the revision surgery. During the revision surgery, the infected tissue was debrided and the osteotomy was widened to 3 mm to place a poly-methyl methacrylate spacer, with or without vancomycin. Half of the groups also received systemic vancomycin for the remaining 21 days of the study. The viable bacteria remaining at the end of the study were measured using colony forming unit assays. Volumetric bone changes (osteolysis and reactive bone formation) were directly measured using micro-CT image analysis. Mice that were treated with

  4. Does exchange arthroplasty of an infected shoulder prosthesis provide better eradication rate and better functional outcome, compared to a permanent spacer or resection arthroplasty? a systematic review.

    Science.gov (United States)

    George, D A; Volpin, A; Scarponi, S; Haddad, F S; Romanò, C L

    2016-02-01

    The best surgical modality for treating chronic periprosthetic shoulder infections has not been established, with a lack of randomised comparative studies. This systematic review compares the infection eradication rate and functional outcomes after single- or two-stage shoulder exchange arthroplasty, to permanent spacer implant or resection arthroplasty. Full-text papers and those with an abstract in English published from January 2000 to June 2014, identified through international databases, such as EMBASE and PubMed, were reviewed. Those reporting the success rate of infection eradication after a single-stage exchange, two-stage exchange, resection arthroplasty or permanent spacer implant, with a minimum follow-up of 6 months and sample size of 5 patients were included. Eight original articles reporting the results after resection arthroplasty (n = 83), 6 on single-stage exchange (n = 75), 13 on two-stage exchange (n = 142) and 8 papers on permanent spacer (n = 68) were included. The average infection eradication rate was 86.7 % at a mean follow-up of 39.8 months (SD 20.8) after resection arthroplasty, 94.7 % at 46.8 months (SD 17.6) after a single-stage exchange, 90.8 % at 37.9 months (SD 12.8) after two-stage exchange, and 95.6 % at 31.0 months (SD 9.8) following a permanent spacer implant. The difference was not statistically significant (p = 0.650). Regarding functional outcome, patients treated with single-stage exchange had statistically significant better postoperative Constant scores (mean 51, SD 13) than patients undergoing a two-stage exchange (mean 44, SD 9), resection arthroplasty (mean 32, SD 7) or a permanent spacer implant (mean 31, SD 9) (p = 0.029). However, when considering studies comparing pre- and post-operative Constant scores, the difference was not statistically significant. This systematic review failed to demonstrate a clear difference in infection eradication and functional improvement between all four

  5. Minimally invasive treatment of lumbar spinal stenosis with a novel interspinous spacer

    Directory of Open Access Journals (Sweden)

    Shabat S

    2011-09-01

    Full Text Available Shay Shabat1, Larry E Miller2,3, Jon E Block3, Reuven Gepstein11Spinal Care Unit, Sapir Medical Center, Kfar Saba, Israel; 2Miller Scientific Consulting, Inc, Biltmore Lake, NC, USA; 3Jon E Block, PhD, Inc, San Francisco, CA, USAPurpose: To assess the safety and effectiveness of a novel, minimally invasive interspinous spacer in patients with moderate lumbar spinal stenosis (LSS.Methods: A total of 53 patients (mean age, 70 ± 11 years; 45% female with intermittent neurogenic claudication secondary to moderate LSS, confirmed on imaging studies, were treated with the Superion® Interspinous Spacer (VertiFlex, Inc, San Clemente, CA and returned for follow-up visits at 6 weeks, 1 year, and 2 years. Study endpoints included axial and extremity pain severity with an 11-point numeric scale, Zurich Claudication Questionnaire (ZCQ, back function with the Oswestry Disability Index (ODI, health-related quality of life with the Physical Component Summary (PCS and Mental Component Summary (MCS scores from the SF-12, and adverse events.Results: Axial and extremity pain each decreased 54% (both P < 0.001 over the 2-year follow-up period. ZCQ symptom severity scores improved 43% (P < 0.001 and ZCQ physical function improved 44% (P < 0.001 from pre-treatment to 2 years post-treatment. A statistically significant 50% improvement (P < 0.001 also was noted in back function. PCS and MCS each improved 40% (both P < 0.001 from pre-treatment to 2 years. Clinical success rates at 2 years were 83%–89% for ZCQ subscores, 75% for ODI, 78% for PCS, and 80% for MCS. No device infection, implant breakage, migration, or pull-out was observed, although two (3.8% patients underwent explant with subsequent laminectomy.Conclusion: Moderate LSS can be effectively treated with a minimally invasive interspinous spacer. This device is appropriate for select patients who have failed nonoperative treatment measures for LSS and meet strict anatomical criteria.Keywords: Superion, axial

  6. Ten different hip resurfacing systems: biomechanical analysis of design and material properties.

    Science.gov (United States)

    Heisel, Christian; Kleinhans, Jennifer A; Menge, Michael; Kretzer, Jan Philippe

    2009-08-01

    This study gives an overview of the main macro- and microstructural differences of ten commercially available total hip resurfacing implants. The heads and cups of resurfacing hip implants from ten different manufacturers were analysed. The components were measured in a coordinate measuring machine. The microstructure of the heads and cups was inspected by scanning electron microscopy. The mean radial clearance was 84.86 microm (range: 49.47-120.93 microm). The implants were classified into three groups (low, medium and high clearance). All implants showed a deviation of roundness of less than 10 microm. It was shown that all implants differ from each other and a final conclusion about the ideal design and material combination cannot be given based on biomechanical data. Widespread use of specific designs can only be recommended if clinical long-term follow-up studies are performed and analysed for each design.

  7. SU-E-J-230: Effect of Metal Hip Prosthesis On the Accuracy of Electromagnetic Localization and Tracking

    International Nuclear Information System (INIS)

    Butler, W; Merrick, G; Kurko, B; Bittner, N

    2014-01-01

    Purpose: To quantify the effect of metal hip prosthesis on the ability to track and localize electromagnetic transponders. Methods: Three Calypso transponders were implanted into two prostate phantoms. The geometric center of the transponders were identified on computed tomography and set as the isocenter. With the phantom stationary on the treatment table and the tracking array 14-cm above the isocenter, data was acquired by the Calypso system at 10 Hz to establish the uncertainty in measurements. Transponder positional data was acquired with unilateral hip prostheses of different metallic compositions and then with bilateral hips placed at variable separation from the phantom. Results: Regardless of hip prosthesis composition, the average vector displacement in the presence of a unilateral prosthesis was < 0.5 mm. The greatest contribution to overall vector displacement occurred in the lateral dimension. With bilateral hip prosthesis, the average vector displacement was 0.3 mm. The displacement in the lateral dimension was markedly reduced compared with a unilateral hip, suggesting that there was a countervailing effect with bilateral hip prosthesis. The greatest average vector displacement was 0.6 mm and occurred when bilateral hip prostheses were placed within 4 cm of the detector array. Conclusion: Unilateral and bilateral hip prostheses did not have any meaningful effect on the ability to accurately track electromagnetic transponders implanted in a prostate phantom. At clinically realistic distances between the hip and detection array, the average tracking error is negligible

  8. Modified cementless total coxofemoral prosthesis: development, implantation and clinical evaluation

    Directory of Open Access Journals (Sweden)

    S.A. Arias

    2013-12-01

    Full Text Available The aim of this study was to modify canine coxofemoral prostheses and the clinical evaluation of the implantation. Fifteen canine hips and femora of cadavers were used in order to study the surface points of modification in prostheses and develop a perforation guide. Femoral stems and acetabular components were perforated and coated with biphasic calcium phosphate layer. Twelve young adult male mongrel dogs were implanted with coxofemoral prostheses. Six were operated upon and implanted with cemented canine modular hip prostheses, establishing the control group. The remaining six were implanted with a novel design of cementless porous tricalcic phosphate-hydroxyapatite coated hip prostheses. Clinical and orthopedic performance, complications, and thigh muscular hypotrophy were assessed up to the 120th post-operatory day. After 120 days, animals with cementless prostheses had similar clinical and orthopedic performance compared to the cemented group despite the increased pain thigh hypotrophy. Animals that underwent cementless hip prosthesis evidenced more pain, compared to animals with cemented hip prosthesis that required longer recuperation time. No luxations, two fractures and two isquiatic neurapraxies were identified in the course of the study. Using both the cemented and the bioactive coated cementless model were suitable to dogs, showing clinical satisfactory results. Osseointegration and biological fixation were observed in the animals with the modified cementless hip prosthesis.

  9. The Hyperflexible Hip

    Science.gov (United States)

    Weber, Alexander E.; Bedi, Asheesh; Tibor, Lisa M.; Zaltz, Ira; Larson, Christopher M.

    2015-01-01

    Context: Dance, gymnastics, figure skating, and competitive cheerleading require a high degree of hip range of motion. Athletes who participate in these sports use their hips in a mechanically complex manner. Evidence Acquisition: A search of the entire PubMed database (through December 2013) and additional searches of the reference lists of pertinent articles. Study Design: Systematic review. Level of Evidence: Level 3. Results: Whether innate or acquired, dancers and gymnasts have some hypermobility that allows their hips to be placed in potentially impinging or unstable positions required for their given activity. Such extremes of motion can result in both intra-articular and extra-articular impingement as well as compensatory osseous and muscular pathology. In addition, dancers and gymnasts are susceptible to impingement-induced instability. Dancers with innate generalized hyperlaxity are at increased risk of injury because of their activities and may require longer recovery times to return to play. Both nonoperative and operative treatments (arthroscopic and open) have an important role in returning flexibility athletes to their preoperative levels of sport and dance. Conclusion: Because of the extreme hip motion required and the compensatory soft tissue laxity in dancers and gymnasts, these athletes may develop instability, impingement, or combinations of both. This frequently occurs in the setting of subtle pathoanatomy or in patients with normal bony anatomy. With appropriate surgical indications and the correct operative technique, the treating surgeon can anticipate high levels of return to play for the gymnast and dancer with hip pain. PMID:26137181

  10. Complications in Hip Arthroscopy

    Science.gov (United States)

    Nakano, Naoki; Khanduja, Vikas

    2016-01-01

    Summary Background Recent developments in hip arthroscopic techniques and technology have made it possible in many cases to avoid open surgical dislocation for treating a variety of pathology in the hip. Although early reports suggest favourable results’ using hip arthroscopy and it has been shown to be a relatively safe procedure, complications do exist and can sometimes lead to significant morbidity. Methods This is a review article. The aim of this manuscript is to present the most frequent and/or serious complications that could occur at or following hip arthroscopy and some guidelines to avoid these complications. Conclusion Most complications of hip arthroscopy are minor or transient but serious complications can occur as well. A lot of complication e.g. acetabular labral puncture go unreported. Appropriate education and training, precise and meticulous surgical technique with correct instrumentation, the right indication in the right patient and adherence to advice from mentors and experienced colleagues are all essential factors for a successful outcome. Level of evidence: V. PMID:28066747

  11. Hip Replacement: MedlinePlus Health Topic

    Science.gov (United States)

    ... invasive hip replacement (Medical Encyclopedia) Also in Spanish Topic Image MedlinePlus Email Updates Get Hip Replacement updates ... replacement - precautions Minimally invasive hip replacement Related Health Topics Hip Injuries and Disorders National Institutes of Health ...

  12. [Total hip endoprosthesis following resection arthroplasty].

    Science.gov (United States)

    Engelbrecht, E; Siegel, A; Kappus, M

    1995-08-01

    From 1976 to December 1994, a total of 347 patients underwent implantation of a hip prosthesis at the ENDO-Klinik for treatment of an unsatisfactory condition following resection arthroplasty. From 1976 to 1987, 143 patients were treated and in 1989 the results obtained in these patients were analysed: 99 of them were available for a follow-up examination in 1989, and 64 for a further examination in 1995. In 130 cases infection had been the reason for joint resection. At the time of the prosthesis operation (1-20 years later) intraoperative biopsy revealed that infection was still present in 41 cases (31.5%). Only 15 of these infections had been detected preoperatively by joint aspiration. This shows that the value of resection arthroplasty as a method of treating periprosthetic infection is limited and lends support to the one-stage exchange operation, which is the method we prefer in cases of infected hip prostheses. The operative technique and preparation for implantation of the prosthesis are described, as are septic and aseptic complications and the measures that can be taken to treat them. In spite of the patients' generally poor initial condition and with due consideration for the further revision operations, the medium-term results finally obtained are poor in only 9%.

  13. Sonography for hip joint effusion in adults with hip pain

    NARCIS (Netherlands)

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

    2000-01-01

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

  14. Sonography for hip joint effusion in adults with hip pain

    NARCIS (Netherlands)

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

    2000-01-01

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

  15. Technique of Injection of Hyaluronic Acid as a Prostatic Spacer and Fiducials Before Hypofractionated External Beam Radiotherapy for Prostate Cancer.

    Science.gov (United States)

    Boissier, Romain; Udrescu, Corina; Rebillard, Xavier; Terrier, Jean-Etienne; Faix, Antoine; Chapet, Olivier; Azria, David; Devonec, Marian; Paparel, Philippe; Ruffion, Alain

    2017-01-01

    To describe a technique combining the implantation of fiducials and a prostatic spacer (hyaluronic acid [HA]) to decrease the rectal toxicity after an image-guided external beam radiotherapy (EBRT) with hypofractionation for prostate cancer and to assess the tolerance and the learning curve of the procedure. Thirty patients with prostate cancer at low or intermediate risk were included in a phase II trial: image-guided EBRT of 62 Gy in 20 fractions of 3.1 Gy with intensity-modulated radiotherapy. A transrectal implantation of 3 fiducials and transperineal injection of 10 cc of HA (NASHA gel spacer, Q-Med AB, Uppsala, Sweden) between the rectum and the prostate was performed by 1 operator. The thickness of HA was measured at 10 points on magnetic resonance imaging to establish a quality score of the injection (maximum score = 10) and determine the learning curve of the procedure. The quality score increased from patients 1-10, 11-20, to 21-30 with respective median scores: 7 [2-10], 5 [4-7], and 8 [3-10]. The average thicknesses of HA between the base, middle part, and apex of the prostate and the rectum were the following: 15.1 mm [6.4-29], 9.8 mm [5-21.2], and 9.9 mm [3.2-21.5]. The injection of the HA induced a median pain score of 4 [1-8] and no residual pain at mid-long term. Creating an interface between the rectum and the prostate and the implantation of fiducials were feasible under local anesthesia with a short learning curve and could become a standard procedure before a hypofractionated EBRT for prostate cancer. Copyright © 2016 Elsevier Inc. All rights reserved.

  16. Hip arthroplasty today and tomorrow.

    Science.gov (United States)

    Amstutz, H C

    1987-12-01

    Acrylic-fixed total hip and surface replacement arthroplasty have been very effective in affording immediate relief of pain and providing improved function. Complications have been reduced by improvements in design, materials, and especially technique. They are now very low in the elderly, and the stem type acrylic-fixed design remains the procedure of choice. The failure rates in youthful patients and those with bone-stock deficiencies have been high in both THR and surface types, although the latter had the advantage of preserving femoral stock. On the femoral side, the new "macro" femoral designs from Europe and "micro" femoral porous designs have shown promise, but thigh pain, incomplete and difficult to predict bone ingrowth patterns, coupled with removal problems have influenced design and technique changes. Both press-fit stem types and porous surface replacements have produced promising initial results with less potential downside risks. On the acetabular side, both the cementless hemispherical with screw-type adjuvant fixation, or the chamfered cylinder designs, used primarily with the UCLA porous surface replacements, but also with stem-type devices, appear to achieve best short-term results, while the entire variety of screw rings are disappointing. The future will bring further refinements in technique and specific indications for certain types of replacement stem in specific types of bone stock deficiencies. The all ceramic-ceramic and ceramic-polyethylene bearings show promise of reducing wear and, hence, should improve longevity of implant fixation.

  17. Hip joint pathology

    DEFF Research Database (Denmark)

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

    2017-01-01

    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......-65 years) were included if they were referred to a physical therapist to gather pre-operative data and were then diagnosed during arthroscopy. Results of pre-operative patient history and physical tests were collected and compared to arthroscopy. Data of 77 active patients (mean age: 37 years) were...

  18. An insulating grid spacer for large-area MICROMEGAS chambers

    International Nuclear Information System (INIS)

    Bernard, D.; Delagrange, H.; D'Enterria, D.G.; Guay, M.L.M. Le; Martinez, G.; Mora, M.J.; Pichot, P.; Roy, D.; Schutz, Y.; Gandi, A.; Oliveira, R. de

    2002-01-01

    We present a novel design for large-area gaseous detectors based on the MICROMEGAS technology. This technology incorporates an insulating grid, sandwiched between the micro-mesh and the anode-pad plane, which provides a uniform 200 μm amplification gap. The uniformity of the amplification gap thickness has been verified. The gain performances of the detector are presented and compared to the values obtained with detectors using cylindrical micro spacers. The new design presents several technical and financial advantages

  19. Successful implementation of spacer treatment guideline for acute asthma

    OpenAIRE

    Powell, C; Maskell, G; Marks, M; South, M; Robertson, C; LENNEY, W.

    2001-01-01

    AIMS—To develop and implement an evidence based guideline for the treatment of acute asthma using a metered dose inhaler and spacer combination.
METHODS—Defined strategies were used for the development and implementation of a guideline, assessed by a prospective, descriptive, study using notes review, and patient, nursing, and medical staff telephone contact. The setting was a tertiary referral hospital in Victoria, Australia with 25 000 yearly admissions, and asthma acco...

  20. Device for a nuclear reactor. [Fuel element spacers

    Energy Technology Data Exchange (ETDEWEB)

    Foulds, R B; Kasberg, A H; Puechl, K H; Bleiberg, M L

    1972-03-08

    A spacer design for fuel element clusters for PWR type reactors is described. It consists of a frame supporting an egg-carton like grid each sector of which is provided with springs which grip the fuel pins. The spring design is such as to prevent fuel pin vibrations and at same time accommodate fuel pin deformations. Formulae for the calculation of natural frequencies, spring stiffness and friction loads are presented.

  1. Bimetallic spacer means for a nuclear fuel assembly

    International Nuclear Information System (INIS)

    Anthony, A.J.

    1981-01-01

    A bimetallic spacer means designed to be cooperatively associated with a nuclear fuel assembly and operative to resist the occurrence of in-reactor bowing of the nuclear fuel assembly. The subject bimetallic spacer means in accord with one embodiment of the invention includes a member formed, at least principally, of Zircaloy to which are attached a plurality of stainless steel strips. The latter stainless steel strips are located on the external surface of the Zircaloy member and with the major axis of each of the plurality of stainless steel strips extending substantially perpendicular to the major axis of the Zircaloy member. In accord with another embodiment of the invention, the subject bimetallic spacer means includes a member formed at least principally of Zircaloy to which a plurality of stainless steel strips are attached so as to be positioned thereon externally thereof and with the major axis of each of the plurality of stainless steel strips extending substantially parallel to the major axis of the Zircaloy member. In accord with a further embodiment of the invention, the stainless steel strips are attached to preselected members, each embodying at least a cladding of Zircaloy, which are located in the rows of fuel rods that define the perimeter of the fuel matrix of the nuclear fuel assembly. In each of the embodiments, the stainless steel strips during power production expand outwardly to a greater extent than do the members to which the stainless steel strips are attached, thereby forming stiff springs which abut against like bimetallic spacer means with which the other nuclear fuel assemblies are provided in a given nuclear reactor core to thus prevent the occurrence of in-reactor bowing of the nuclear fuel assemblies. Namely, the stainless steel strips expand laterally relative to the fuel assembly and thereby occupy the space adjacent to the external surface of the fuel assembly

  2. Impact of feed spacer and membrane modification by hydrophilic, bactericidal and biocidal coating on biofouling control

    KAUST Repository

    Araújo, Paula A.

    2012-06-01

    The influence of polydopamine- and polydopamine-. graft-poly(ethylene glycol)-coated feed spacers and membranes, copper-coated feed spacers, and commercially-available biostatic feed spacers on biofouling has been studied in membrane fouling simulators. Feed spacers and membranes applied in practical membrane filtration systems were used; biofouling development was monitored by feed channel pressure drop increase and biomass accumulation. Polydopamine and polydopamine-. g-PEG are hydrophilic surface modification agents expected to resist protein and bacterial adhesion, while copper feed spacer coatings and biocides infused in feed spacers are expected to restrict biological growth. Our studies showed that polydopamine and polydopamine-. g-PEG coatings on feed spacers and membranes, copper coatings on feed spacers, and a commercial biostatic feed spacer did not have a significant impact on feed channel pressure drop increase and biofilm accumulation as measured by ATP and TOC content. The studied spacer and membrane modifications were not effective for biofouling control; it is doubtful that feed spacer and membrane modification, in general, may be effective for biofouling control regardless of the type of applied coating. © 2012 Elsevier B.V.

  3. X-Ray Exam: Hip

    Science.gov (United States)

    ... for Educators Search English Español X-Ray Exam: Hip KidsHealth / For Parents / X-Ray Exam: Hip What's in this article? What It Is Why ... You Have Questions Print What It Is A hip X-ray is a safe and painless test ...

  4. Preliminary analysis of the effect of the grid spacers on the reflood heat transfer

    International Nuclear Information System (INIS)

    Sugimoto, Jun; Murao, Yoshio

    1982-02-01

    The results are described about the preliminary analysis of the effect of the grid spacers on the heat transfer during reflood phase of a PWR LOCA. Experiments at JAERI and other facilities showed substantial heat transfer enhancement near the grid spacers. The heat transfer enhancement decreases with the distance from the grid spacers in the downstream region of the grid spacers. Several mechanisms are discussed about the heat transfer enhancement near the grid spacers. A model of a coalescence of the water droplets downstream the spacers is proposed based on the review of the experimental data. The heat transfer correlation for the saturated film boiling is utilized to quantify the heat transfer augmentation by the grid spacers. (author)

  5. Eddy current monitoring of spacers in coolant channel assemblies of nuclear reactor

    International Nuclear Information System (INIS)

    Bhole, V.M.; Rastogi, P.K.; Kulkarni, P.G.; Vijayaraghavan, R.

    1993-01-01

    An eddy current testing method has been standardised for monitoring spacer springs which are used in coolant channel assemblies of pressurised heavy water nuclear reactors (PHWRs). The standard bobbin coil probe used for monitoring the spacer spring detects only the location but does not monitor the tilt orientation and tilt angle of a tilted spacer spring. The knowledge of location along with the tilt orientation of the spacer spring greatly improves the performance of repositioning methods. A modified probe with angular windings has been developed in laboratory tests for monitoring the location as well as the tilt orientation of the spacer springs. Experimental results are presented showing excellent performance of the modified probe in monitoring the exact location as well as tilt orientation of a spacer spring. The modified probe has also been used successfully in the field during repositioning of spacer springs in PHWRs before commissioning. (Author)

  6. Comparing contemporary revision burden among hip and knee joint replacement registries

    Directory of Open Access Journals (Sweden)

    Brian J. McGrory, MD, MS

    2016-06-01

    Conclusions: Revision burden has gradually decreased for hip replacements and has remained relatively constant for knee replacements both for the last 4 years and compared to historic controls. Knee revision burden was lower than hip revision burden for each period examined. Revision burden is one measure that may be helpful in following the effect of changes in surgical technique and implant design over time in registry populations and may be a helpful way to compare overall results between registries.

  7. Influence of prosthesis design and implantation technique on implant stresses after cementless revision THR

    Directory of Open Access Journals (Sweden)

    Duda Georg N

    2011-05-01

    Full Text Available Abstract Background Femoral offset influences the forces at the hip and the implant stresses after revision THR. For extended bone defects, these forces may cause considerable bending moments within the implant, possibly leading to implant failure. This study investigates the influences of femoral anteversion and offset on stresses in the Wagner SL revision stem implant under varying extents of bone defect conditions. Methods Wagner SL revision stems with standard (34 mm and increased offset (44 mm were virtually implanted in a model femur with bone defects of variable extent (Paprosky I to IIIb. Variations in surgical technique were simulated by implanting the stems each at 4° or 14° of anteversion. Muscle and joint contact forces were applied to the reconstruction and implant stresses were determined using finite element analyses. Results Whilst increasing the implant's offset by 10 mm led to increased implant stresses (16.7% in peak tensile stresses, altering anteversion played a lesser role (5%. Generally, larger stresses were observed with reduced bone support: implant stresses increased by as much as 59% for a type IIIb defect. With increased offset, the maximum tensile stress was 225 MPa. Conclusion Although increased stresses were observed within the stem with larger offset and increased anteversion, these findings indicate that restoration of offset, key to restoring joint function, is unlikely to result in excessive implant stresses under routine activities if appropriate fixation can be achieved.

  8. Development and characterization of 3D-printed feed spacers for spiral wound membrane systems

    KAUST Repository

    Siddiqui, Amber

    2016-01-02

    Feed spacers are important for the impact of biofouling on the performance of spiral-wound reverse osmosis (RO) and nanofiltration (NF) membrane systems. The objective of this study was to propose a strategy for developing, characterizing, and testing of feed spacers by numerical modeling, three-dimensional (3D) printing of feed spacers and experimental membrane fouling simulator (MFS) studies. The results of numerical modeling on the hydraulic behavior of various feed spacer geometries suggested that the impact of spacers on hydraulics and biofouling can be improved. A good agreement was found for the modeled and measured relationship between linear flow velocity and pressure drop for feed spacers with the same geometry, indicating that modeling can serve as first step in spacer characterization. An experimental comparison study of a feed spacer currently applied in practice and a 3D printed feed spacer with the same geometry showed (i) similar hydraulic behavior, (ii) similar pressure drop development with time and (iii) similar biomass accumulation during MFS biofouling studies, indicating that 3D printing technology is an alternative strategy for development of thin feed spacers with a complex geometry. Based on the numerical modeling results, a modified feed spacer with low pressure drop was selected for 3D printing. The comparison study of the feed spacer from practice and the modified geometry 3D printed feed spacer established that the 3D printed spacer had (i) a lower pressure drop during hydraulic testing, (ii) a lower pressure drop increase in time with the same accumulated biomass amount, indicating that modifying feed spacer geometries can reduce the impact of accumulated biomass on membrane performance. The combination of numerical modeling of feed spacers and experimental testing of 3D printed feed spacers is a promising strategy (rapid, low cost and representative) to develop advanced feed spacers aiming to reduce the impact of biofilm formation on

  9. Vibroacoustography for the assessment of total hip arthroplasty

    Directory of Open Access Journals (Sweden)

    Hermes A.S. Kamimura

    2013-04-01

    Full Text Available OBJECTIVES: This paper proposes imaging with 3-dimensional vibroacoustography for postoperatively assessing the uncovered cup area after total hip arthroplasty as a quantitative criterion to evaluate implant fixation. METHODS: A phantom with a bone-like structure covered by a tissue-mimicking material was used to simulate a total hip arthroplasty case. Vibroacoustography images of the uncovered cup region were generated using a two-element confocal ultrasound transducer and a hydrophone inside a water tank. Topological correction based on the geometry of the implant was performed to generate a 3-dimensional representation of the vibroacoustography image and to accurately evaluate the surface. The 3-dimensional area obtained by the vibroacoustography approach was compared to the area evaluated by a 3-dimensional motion capture system. RESULTS: The vibroacoustography technique provided high-resolution, high-contrast, and speckle-free images with less sensitivity to the beam incidence. Using a 3-dimensional-topology correction of the image, we accurately estimated the uncovered area of the implant with a relative error of 8.1% in comparison with the motion capture system measurements. CONCLUSION: Measurement of the cup coverage after total hip arthroplasty has not been well established; however, the covered surface area of the acetabular component is one of the most important prognostic factors. The preliminary results of this study show that vibroacoustography is a 3-dimensional approach that can be used to postoperatively evaluate total hip arthroplasty. The favorable results also provide an impetus for exploring vibroacoustography in other bone or implant surface imaging applications.

  10. Danish Hip Arthroscopy Registry

    DEFF Research Database (Denmark)

    Mygind-Klavsen, Bjarne; Lund, Bent; Nielsen, Torsten Grønbech

    2018-01-01

    PURPOSE: Predictors of outcome after femoroacetabular impingement (FAI) surgery are not well-documented. This study presents data from the Danish Hip Arthroscopy Registry (DHAR) for such analyses. The purpose of this study was to identify predictors of poor outcome after FAI surgery in a Danish FAI...

  11. Primary cemented total hip arthroplasty: 10 years follow-up

    Directory of Open Access Journals (Sweden)

    Nath Rajendra

    2010-01-01

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

  12. SU-F-J-122: Rectal Sparing Reproducibility in Prostate Cancer Patients Treated with Hydrogel Spacer and Proton Therapy

    Energy Technology Data Exchange (ETDEWEB)

    Hedrick, S; Robison, B; Blakey, M; Artz, M; Renegar, J; Schreuder, A; Fagundes, M [Provision Center for Proton Therapy, Knoxville, TN (United States); Case, S [Vanderbilt University, Nashville, TN (United States)

    2016-06-15

    Purpose: Rectal hydrogel spacer has been shown to improve rectal sparing in prostate radiotherapy. The purpose of this study was to determine the reproducibility of rectal sparing throughout treatment in patients undergoing proton therapy. Methods: At our facility, prostate cancer patients are treated with pencil beam scanning proton therapy, utilizing an endorectal balloon (ERB) or rectal spacer hydrogel (Gel) “SpaceOAR” implant. All patients were treated with a full bladder and empty rectum (low residue diet and stool softeners). A quality assurance CT (QACT) was performed periodically throughout treatment to ensure rectal filling consistency and sparing in 41 patients treated with Gel. The treatment planning (TP) dose was calculated on each QACT and the rectum V90%, V75%, V65%, V50%, and V40% were recorded. QACT scans were acquired on day 0, week 1, week 3, and week 5. Results: 144 QACT scans were analyzed, each patient receiving 3–4 QACTs. Rectum V90% was within +/−1% of the TP dose in 70% of the QACTs and within +/−5% in 95% of scans. From previous data analyses, our ERB rectum V90% average is 6%. This value was used as an upper threshold for the Gel QACT analysis. 5 of the 41 patients (12%), corresponding to 7 QACTs, had a rectum V90% that exceeded 6% on one or more QACTs. However, the average rectal V90% measured over multiple QACTs never exceeded 6%. 55% of the QACTs had a rectum volume within 5cc of the TPCT volume, 68% were within 10cc. Conclusion: In this study, we have shown that a majority of our prostate patients can maintain consistent rectal sparing when treated with a hydrogel spacer. QACT rectal V90% exceeding our threshold was most often related to increased rectal filling and gas, which was addressed with improved dietary compliance and the intensification of stool softeners or laxatives.

  13. SU-F-J-122: Rectal Sparing Reproducibility in Prostate Cancer Patients Treated with Hydrogel Spacer and Proton Therapy

    International Nuclear Information System (INIS)

    Hedrick, S; Robison, B; Blakey, M; Artz, M; Renegar, J; Schreuder, A; Fagundes, M; Case, S

    2016-01-01

    Purpose: Rectal hydrogel spacer has been shown to improve rectal sparing in prostate radiotherapy. The purpose of this study was to determine the reproducibility of rectal sparing throughout treatment in patients undergoing proton therapy. Methods: At our facility, prostate cancer patients are treated with pencil beam scanning proton therapy, utilizing an endorectal balloon (ERB) or rectal spacer hydrogel (Gel) “SpaceOAR” implant. All patients were treated with a full bladder and empty rectum (low residue diet and stool softeners). A quality assurance CT (QACT) was performed periodically throughout treatment to ensure rectal filling consistency and sparing in 41 patients treated with Gel. The treatment planning (TP) dose was calculated on each QACT and the rectum V90%, V75%, V65%, V50%, and V40% were recorded. QACT scans were acquired on day 0, week 1, week 3, and week 5. Results: 144 QACT scans were analyzed, each patient receiving 3–4 QACTs. Rectum V90% was within +/−1% of the TP dose in 70% of the QACTs and within +/−5% in 95% of scans. From previous data analyses, our ERB rectum V90% average is 6%. This value was used as an upper threshold for the Gel QACT analysis. 5 of the 41 patients (12%), corresponding to 7 QACTs, had a rectum V90% that exceeded 6% on one or more QACTs. However, the average rectal V90% measured over multiple QACTs never exceeded 6%. 55% of the QACTs had a rectum volume within 5cc of the TPCT volume, 68% were within 10cc. Conclusion: In this study, we have shown that a majority of our prostate patients can maintain consistent rectal sparing when treated with a hydrogel spacer. QACT rectal V90% exceeding our threshold was most often related to increased rectal filling and gas, which was addressed with improved dietary compliance and the intensification of stool softeners or laxatives.

  14. Selection of contact bearing couple materials for hip prosthesis using finite element analysis under static conditions

    Science.gov (United States)

    Arirajan, K. A.; Chockalingam, K.; Vignesh, C.

    2018-04-01

    Implants are the artificial parts to replace the missing bones or joints in human anatomy to give mechanical support. Hip joint replacement is an important issue in orthopaedic surgery. The main concern limiting the long-run success of the total hip replacement is the limited service life. Hip replacement technique is widely used in replacing the femur head and acetabular cup by materials that are highly biocompatible. The success of the artificial hip replacement depends upon proper material selection, structure, and shape of the hip prosthesis. Many orthopaedic analyses have been tried with different materials, but ended with partial success on the application side. It is a critical task for selecting the best material pair in the hip prosthesis design. This work develops the finite element analysis of an artificial hip implant to study highest von Mises stress, contact pressure and elastic strain occurs for the dissimilar material combination. The different bearing couple considered for the analysis are Metal on Metal, Metal on Plastic, Metal on Ceramic, Ceramic on Plastic, Ceramic on Ceramic combinations. The analysis is carried out at different static positions of a human (i.e) standing, sitting. The results reveals that the combination with metal in contact with plastic (i.e) Titanium femoral head paired with Ultra High Molecular Weight Poly Ethylene acetabular cup reduces maximum von Mises stress and also it gives lowest contact pressure than other combination of bearing couples.

  15. Static antibiotic spacers augmented by calcium sulphate impregnated beads in revision TKA: Surgical technique and review of literature.

    Science.gov (United States)

    Risitano, Salvatore; Sabatini, Luigi; Atzori, Francesco; Massè, Alessandro; Indelli, Pier Francesco

    2018-06-01

    Periprosthetic joint infection (PJI) is a serious complication in total knee arthroplasty (TKA) and represents one of the most common causes of revision. The challenge for surgeons treating an infected TKA is to quickly obtain an infection-free joint in order to re-implant, when possible, a new TKA. Recent literature confirms the role of local antibiotic-loaded beads as a strong bactericidal, allowing higher antibiotic elution when compared with antibiotic loaded spacers only. Unfortunately, classical Polymethylmethacrylate (PMMA) beads might allow bacteria adhesion, secondary development of antibiotic resistance and eventually surgical removal once antibiotics have eluted. This article describes a novel surgical technique using static, custom-made antibiotic loaded spacers augmented by calcium sulphate antibiotic-impregnated beads to improve the success rate of revision TKA in a setting of PJI. The use of calcium sulphate beads has several potential benefits, including a longer sustained local antibiotic release when compared with classical PMMA beads and, being resorbable, not requiring accessory surgical interventions.

  16. Cardiac transplant due to metal toxicity associated with hip arthroplasty

    Directory of Open Access Journals (Sweden)

    Sheldon Moniz, MBBS (UWA

    2017-09-01

    Full Text Available Concerns regarding metal-on-metal (MoM bearing couples in total hip arthroplasty are well documented in the literature with cobalt (Co and chromium (Cr toxicity causing a range of both local and systemic adverse reactions. We describe the case of a patient undergoing cardiac transplantation as a direct result of Co and Cr toxicity following a MoM hip replacement. Poor implant positioning led to catastrophic wear generating abundant wear particles leading to Co and Cr toxicity, metallosis, bony destruction, elevated metal ion levels, and adverse biological responses. Systemic symptoms continued for 3 years following cardiac transplantation with resolution only after revision hip arthroplasty. There was no realization in the initial cardiac assessment and subsequent transplant workup that the hip replacement was the likely cause of the cardiac failure, and the hip replacement was not recognized as the cause until years after the heart transplant. This case highlights the need for clinicians to be aware of systemic MoM complications as well as the importance of positioning when using these prostheses.

  17. Thin hydroxyapatite surface layers on titanium produced by ion implantation

    CERN Document Server

    Baumann, H; Bilger, G; Jones, D; Symietz, I

    2002-01-01

    In medicine metallic implants are widely used as hip replacement protheses or artificial teeth. The biocompatibility is in all cases the most important requirement. Hydroxyapatite (HAp) is frequently used as coating on metallic implants because of its high acceptance by the human body. In this paper a process is described by which a HAp surface layer is produced by ion implantation with a continuous transition to the bulk material. Calcium and phosphorus ions are successively implanted into titanium under different vacuum conditions by backfilling oxygen into the implantation chamber. Afterwards the implanted samples are thermally treated. The elemental composition inside the implanted region was determined by nuclear analysis methods as (alpha,alpha) backscattering and the resonant nuclear reaction sup 1 H( sup 1 sup 5 N,alpha gamma) sup 1 sup 2 C. The results of X-ray photoelectron spectroscopy indicate the formation of HAp. In addition a first biocompatibility test was performed to compare the growing of m...

  18. Ion implantation

    International Nuclear Information System (INIS)

    Johnson, E.

    1986-01-01

    It is the purpose of the present paper to give a review of surface alloy processing by ion implantation. However, rather than covering this vast subject as a whole, the survey is confined to a presentation of the microstructures that can be found in metal surfaces after ion implantation. The presentation is limited to alloys processed by ion implantation proper, that is to processes in which the alloy compositions are altered significantly by direct injection of the implanted ions. The review is introduced by a presentation of the processes taking place during development of the fundamental event in ion implantation - the collision cascade, followed by a summary of the various microstructures which can be formed after ion implantation into metals. This is compared with the variability of microstructures that can be achieved by rapid solidification processing. The microstructures are subsequently discussed in the light of the processes which, as the implantations proceed, take place during and immediately after formation of the individual collision cascades. These collision cascades define the volumes inside which individual ions are slowed down in the implanted targets. They are not only centres for vigorous agitation but also the sources for formation of excess concentrations of point defects, which will influence development of particular microstructures. A final section presents a selection of specific structures which have been observed in different alloy systems. (orig./GSCH)

  19. High-impact sport after hip resurfacing: The Ironman triathlon.

    Science.gov (United States)

    Girard, J; Lons, A; Pommepuy, T; Isida, R; Benad, K; Putman, S

    2017-09-01

    Returning to high-impact sport is an increasingly frequent functional demand following hip replacement. The literature, however, is sparse on the subject and nonexistent regarding triathlon. We therefore conducted a retrospective study of hip resurfacing in triathlon players, to determine: (1) whether it is possible to return to this kind of sport; (2) if so, whether it is possible to return to the same level; and (3) how a resurfaced hip behaves under these conditions. Hip resurfacing allows return to competition level in long-distance triathlon. A single-center single-operator retrospective study included patients undergoing hip resurfacing with the Conserve Plus implant inserted through a posterolateral approach, who had ceased long-distance triathlon practice due to osteoarthritis of the hip. Fifty-one of the 1688 patients undergoing resurfacing during the inclusion period were long-distance triathlon players. The series comprised 48 patients: 51 implants; 43 male, 5 female; mean age, 44.8 years (range, 28.2-58.9 years). At a mean 4.7 years' follow-up (range, 2.2-7.6 years), all clinical scores showed significant improvement; Merle d'Aubigné and Harris scores rose respectively from 12.3 (5-16) and 42 (37-56) preoperatively to 17.5 (13-18) and 93.2 (73-100) (Pdistance=70.3km and 19 with distance=140.6km. At follow-up, 28 patients had taken part in an Ironman competition: 21 with distance=70.3km and 7 with distance=140.6km. Mean competition performance did not differ between pre and postoperative periods. Return-to-sport rates were good following hip resurfacing. Non-impact sports (swimming, cycling) predominated postoperatively, whereas the rate of impact sport (running) diminished. Return to competition-level sport (extreme triathlon) was possible for 28/48 patients (58%). Implant survival seemed unaffected by this high-impact sports activity at a mean 4.7 years' follow-up. IV, retrospective, non-controlled. Copyright © 2017 Elsevier Masson SAS. All rights

  20. An insulating grid spacer for large-area MICROMEGAS chambers

    CERN Document Server

    Bernard, D; D'Enterria, D G; Le Guay, M; Martínez, G; Mora, M J; Pichot, P; Roy, D; Schutz, Y; Gandi, A; De Oliveira, R

    2002-01-01

    We present an original design for large area gaseous detectors based on the MICROMEGAS technology. This technology incorporates an insulating grid, sandwiched between the micro-mesh and the anode-pad plane, which provides an uniform 200 $\\mu$m amplification gap. The uniformity of the amplification gap thickness has been verified under several experimental conditions. The gain performances of the detector are presented and compared to the values obtained with detectors using cylindrical micro spacers. The new design presents several technical and financial advantages.

  1. Spacer grid with mixing blades for nuclear fuel assembly

    International Nuclear Information System (INIS)

    Noailly, J.

    1986-01-01

    The spacer grid for nuclear fuel assembly has two sets of intersecting metal plates provided with blades and defining cells. The plates are fitted only with half-blades associated with a single grid opening. The half-blades of adjacent cells are arranged at 90deg C to each other and each plate has at most one half-blade at each corner of a cell. The invention concerns fuel assemblies of pressurized water reactors. The blades arranged on a single side of the plate provide a good hydraulic uniformity. The invention provides a uniform distribution of blades (and thus of absorbing material in each hydraulic cell) [fr

  2. Tube spacer grid for a heat-exchanger tube bundle

    International Nuclear Information System (INIS)

    Scheidl, H.

    1976-01-01

    A tube spacer grid for a heat-exchanger tube bundle is formed by an annular grid frame having a groove formed in its inner surface in which the interspaced grid bars have their ends positioned and held in interspaced relationship by short sections of tubes passed through holes axially formed in the grid frame so that the tubes are positioned between the ends of the grid bars in the grooves. The tube sections may be cut from the same tubes used to form the tube bundle. 5 claims, 3 drawing figures

  3. Spine–hip relations in patients with hip osteoarthritis

    Science.gov (United States)

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

    2018-01-01

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

  4. In vitro microbiologic evaluation of PTFE and cotton as spacer materials.

    Science.gov (United States)

    Paranjpe, Avina; Jain, Sumita; Alibhai, Karim J; Wadhwani, Chandur P; Darveau, Richard P; Johnson, James D

    2012-09-01

    To microbiologically evaluate the efficacy of cotton and polytetrafluoroethylene (PTFE) tape used as spacer materials. Twenty-six extracted human molars were restored using either cotton or PTFE tape as spacers under a standardized provisional restorative material (Cavit). The teeth were incubated for 7 days in a culture of Streptococcus gordonii or in liquid media alone. The spacers were removed and tested for bacterial contamination. The access cavities were also evaluated for bacterial contamination. Nine of 10 teeth with cotton spacers and one of 10 teeth with PTFE spacers were positive for S gordonii growth. The nine teeth in the cotton group also showed contamination of the access cavities. Even under optimal conditions, cotton spacers may cause leakage into the access cavities. Cotton fibers may serve as a route for bacterial contamination of the access cavities and root canal space. In contrast, PTFE tape did not provide an avenue for bacterial contamination.

  5. A technical report on the evaluation of the integrity for the TIG welded spacer grid

    International Nuclear Information System (INIS)

    Song, Kee Nam; Yoo, Ho Sik; Lww, Chang Woo

    1994-07-01

    The spacer grid, which supports fuel rods, guide thimble and instrumentation tube, is classified into two types according to their strap material,.ie. inconel and zircaloy spacer grid. KOFA fuel of 14 x 14 and 17 x 17 type has seven and eight spacer grid respectively. Zircaloy spacer grid is assembled by straps whose cross points are welded by TIG welding method. This technical report provides to give some information about structure and function of the spacer grid and the basis and characteristic of the TIG welding method. A series of test which is conducted to evaluate the integrity of TIG welded zircaloy spacer grid and their results have been also studied. (Author) 18 refs., 23 figs., 3 tabs

  6. A technical report on the evaluation of the integrity for the TIG welded spacer grid

    Energy Technology Data Exchange (ETDEWEB)

    Song, Kee Nam; Yoo, Ho Sik; Lww, Chang Woo [Korea Atomic Energy Research Institute, Taejon (Korea, Republic of)

    1994-07-01

    The spacer grid, which supports fuel rods, guide thimble and instrumentation tube, is classified into two types according to their strap material,.ie. inconel and zircaloy spacer grid. KOFA fuel of 14 x 14 and 17 x 17 type has seven and eight spacer grid respectively. Zircaloy spacer grid is assembled by straps whose cross points are welded by TIG welding method. This technical report provides to give some information about structure and function of the spacer grid and the basis and characteristic of the TIG welding method. A series of test which is conducted to evaluate the integrity of TIG welded zircaloy spacer grid and their results have been also studied. (Author) 18 refs., 23 figs., 3 tabs.

  7. Transcriptional regulator-mediated activation of adaptation genes triggers CRISPR de novo spacer acquisition

    DEFF Research Database (Denmark)

    Liu, Tao; Li, Yingjun; Wang, Xiaodi

    2015-01-01

    Acquisition of de novo spacer sequences confers CRISPR-Cas with a memory to defend against invading genetic elements. However, the mechanism of regulation of CRISPR spacer acquisition remains unknown. Here we examine the transcriptional regulation of the conserved spacer acquisition genes in Type I......, it was demonstrated that the transcription level of csa1, cas1, cas2 and cas4 was significantly enhanced in a csa3a-overexpression strain and, moreover, the Csa1 and Cas1 protein levels were increased in this strain. Furthermore, we demonstrated the hyperactive uptake of unique spacers within both CRISPR loci...... in the presence of the csa3a overexpression vector. The spacer acquisition process is dependent on the CCN PAM sequence and protospacer selection is random and non-directional. These results suggested a regulation mechanism of CRISPR spacer acquisition where a single transcriptional regulator senses the presence...

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

    International Nuclear Information System (INIS)

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

    1985-01-01

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

  9. Impact of UHMWPE texture on friction and wear resistance of hip prosthesis

    Directory of Open Access Journals (Sweden)

    Eddoumy Fatima

    2013-11-01

    Full Text Available Ultra High Molecular Weight PolyEthylene (UHMWPE is a polymer widely used in hip implants (prostheses as a bearing surface against metal, because of its good mechanical properties and biocompatibility [1]. Nevertheless, the durability of such implants is limited because of failure resulting from osteolysis and aseptic loosening. These two phenomenons are due to the immune response of human body consecutive to the apparition of wear particles of UHMWPE with time.

  10. Integrity of the lateral femoral wall in intertrochanteric hip fractures: an important predictor of a reoperation

    DEFF Research Database (Denmark)

    Palm, Henrik; Jacobsen, Steffen; Sonne-Holm, Stig

    2007-01-01

    BACKGROUND: Reoperations after intertrochanteric fractures are often necessitated by fracture displacement following mobilization of the patient. The biomechanical complexity of the fracture, the position of the implant, and the patient's characteristics are known to influence postoperative outcome...... of the lateral femoral wall are not treated adequately with a sliding compression hip-screw device, and intertrochanteric fractures should therefore be classified according to the integrity of the lateral femoral wall, especially in randomized trials comparing fracture implants....

  11. Distraction of facets with intraarticular spacers as treatment for lumbar canal stenosis: report on a preliminary experience with 21 cases.

    Science.gov (United States)

    Goel, Atul; Shah, Abhidha; Jadhav, Madan; Nama, Santhosh

    2013-12-01

    The authors report their experience in treating 21 patients by using a novel form of treatment of lumbar degenerative disease that leads to canal stenosis. The surgery involved distraction of the facets using specially designed Goel intraarticular spacers and was aimed at arthrodesis of the spinal segment in a distracted position. The operation is based on the premise that subtle and longstanding facet instability, joint space reduction, and subsequent facet override had a profound and primary influence in the pathogenesis of degenerative lumbar canal stenosis. The surgical technique and the rationale for treatment are discussed. Between April 2006 and January 2011, 21 cases of lumbar degenerative disease resulting in characteristic lumbar canal stenosis were treated in the authors' department with the proposed technique. The patients were prospectively analyzed. There were 15 men and 6 women who ranged in age from 48 to 71 years (mean 58 years). Nine patients underwent 1-level and 12 patients underwent 2-level treatment. Surgery involved wide opening of the articular joint, denuding of the articular capsule/endplate cartilage, distraction of the facets, and forced impaction of Goel intraarticular spacers. Bone graft pieces obtained by sectioning the spinous processes were placed within and over the joint and in the midline over the adequately prepared host area of laminae. The Oswestry Disability Index and visual analog scale were used to clinically assess the patients before and after surgery and at follow-up. The alterations in the physical architecture of spinal canal and intervertebral foramen dimensions were evaluated before and after placement of the intrafacet implant and after at least 6 months of follow-up. All patients had varying degrees of relief from symptoms of local back pain and radiculopathy. Impaction of spacers within the facet joints resulted in an increase in the spinal canal and intervertebral root canal dimensions (mean 2.33 mm), reduction

  12. Revision hip preservation surgery with hip arthroscopy: clinical outcomes.

    Science.gov (United States)

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

    2014-05-01

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

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

    Directory of Open Access Journals (Sweden)

    Vladimir E. Baskov

    2017-03-01

    Full Text Available Introduction. Treating children with degenerative dystrophic diseases of the hip joint has become one of the most acute problems in contemporary orthopedics. Until recently, we performed arthroplasty by demineralized bone-cartilage allocups (DBCA in the Clinic of the Hip Joint Pathology of the Turner Scientific and Research Institute for Children’s Orthopedics for patients showing clinical and radiological signs of irreversible destruction of the hip joint; we carried out this procedure to preserve the function of the lower limb. However, over the last 8 years, we have changed our protocol for children older than 12 years of age and have replaced DBCA with total hip replacement. In a number of cases, total hip replacement was performed after a previous intervention involving arthroplasty with DBCA. Objective. To determine the technical peculiarities of total hip replacement after a previous intervention involving arthroplasty with DBCA. Material and methods. We analyzed the results of treatment involving various types of hip pathology in 13 children (100% aged between 15 and 16 years [8 girls (61.5% and 5 boys (38.5%]. The medical histories of all 13 children (100% showed repeated operations on the hip joint, ultimately resulting in arthroplasty with DBCA. All 13 children (100% underwent a total hip replacement. Upon hip replacement, all 13 patients (100% showed a pronounced thinning and hardening of the edges and the bottom of the acetabulum, which created some difficulties in the process of acetabular component implantation. The transformation of DBCA was not evident in any of the 13 cases (100%. Results. During the observation period of 3–5 years following total hip arthroplasty, all 13 cases (100% showed recovery in the range of motion and absence of pain. An important criterion for evaluating the quality of care was the complete social and domestic adaptation of all 13 children (100% during the period from 6 to 9 months following total

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

    Directory of Open Access Journals (Sweden)

    Vladimir E. Baskov

    2017-03-01

    Full Text Available Introduction. Treating children with degenerative dystrophic diseases of the hip joint has become one of the most acute problems in contemporary orthopedics. Until recently, we performed arthroplasty by demineralized bone-cartilage allocups (DBCA in the Clinic of the Hip Joint Pathology of the Turner Scientific and Research Institute for Children’s Orthopedics for patients showing clinical and radiological signs of irreversible destruction of the hip joint; we carried out this procedure to preserve the function of the lower limb. However, over the last 8 years, we have changed our protocol for children older than 12 years of age and have replaced DBCA with total hip replacement. In a number of cases, total hip replacement was performed after a previous intervention involving arthroplasty with DBCA. Objective. To determine the technical peculiarities of total hip replacement after a previous intervention involving arthroplasty with DBCA. Material and methods. We analyzed the results of treatment involving various types of hip pathology in 13 children (100% aged between 15 and 16 years [8 girls (61.5% and 5 boys (38.5%]. The medical histories of all 13 children (100% showed repeated operations on the hip joint, ultimately resulting in arthroplasty with DBCA. All 13 children (100% underwent a total hip replacement. Upon hip replacement, all 13 patients (100% showed a pronounced thinning and hardening of the edges and the bottom of the acetabulum, which created some difficulties in the process of acetabular component implantation. The transformation of DBCA was not evident in any of the 13 cases (100%. Results. During the observation period of 3–5 years following total hip arthroplasty, all 13 cases (100% showed recovery in the range of motion and absence of pain. An important criterion for evaluating the quality of care was the complete social and domestic adaptation of all 13 children (100% during the period from 6 to 9 months following total

  15. Influence of the spacer dielectric processes on PMOS junction properties

    International Nuclear Information System (INIS)

    Morin, Pierre; Wacquant, Francois; Juhel, Marc; Laviron, Cyrille; Lenoble, D.

    2005-01-01

    In this paper, the interaction observed in PMOS transistor between the boron lightly doped drain (LDD) extensions and the spacer oxide and nitride dielectrics have been studied, with a simple experimental methodology. Low thermal budget oxide obtained by sub-atmospheric chemical vapor deposition (SACVD) and nitride deposited by plasma process have been evaluated as spacer layers. The influence of the oxide liner hydrogen content is shown to be critical for the p type shallow junction. Indeed, during the activation anneal, hydrogen content increases the boron out diffusion from the extension into the oxide liner and yield to a significant dose loss in this area. Nitride porosity has also been studied. A lower boron dose loss is observed with a porous layer because hydrogen can degas out significantly from the oxide, during anneal, through the porous nitride film. These results confirm the model of boron out diffusion based on oxide hydrogen content proposed by Kohli. Finally, a boron diffusion mechanism driven by chemistry and enhanced by hydrogen defects is proposed

  16. Single-electron transistors fabricated with sidewall spacer patterning

    Science.gov (United States)

    Park, Byung-Gook; Kim, Dae Hwan; Kim, Kyung Rok; Song, Ki-Whan; Lee, Jong Duk

    2003-09-01

    We have implemented a sidewall spacer patterning method for novel dual-gate single-electron transistor (DGSET) and metal-oxide-semiconductor-based SET (MOSET) based on the uniform SOI wire, using conventional lithography and processing technology. A 30 nm wide silicon quantum wire is defined by a sidewall spacer patterning method, and depletion gates for two tunnel junctions of the DGSET are formed by the doped polycrystalline silicon sidewall. The fabricated DGSET and MOSET show clear single-electron tunneling phenomena at liquid nitrogen temperature and insensitivity of the Coulomb oscillation period to gate bias conditions. On the basis of the phase control capability of the sidewall depletion gates, we have proposed a complementary self-biasing method, which enables the SET/CMOS hybrid multi-valued logic (MVL) to operate perfectly well at high temperature, where the peak-to-valley current ratio of Coulomb oscillation severely decreases. The suggested scheme is evaluated by SPICE simulation with an analytical DGSET model, and it is confirmed that even DGSETs with a large Si island can be utilized efficiently in the multi-valued logic.

  17. Packaging design criteria modified fuel spacer burial box. Revision 1

    International Nuclear Information System (INIS)

    Stevens, P.F.

    1994-01-01

    Various Hanford facilities must transfer large radioactively contaminated items to burial/storage. Presently, there are eighteen Fuel Spacer Burial Boxes (FSBBs) available on the Hanford Site for transport of such items. Previously, the FSBBS were transported from a rail car to the burial trench via a drag-off operation. To allow for the lifting of the boxes into the burial trench, it will be necessary to improve the packagings lifting attachments and provide structural reinforcement. Additional safety improvements to the packaging system will be provided by the addition of a positive closure system and package ventilation. FSBBs that are modified in such a manner are referred to as Modified Fuel Spacer Burial Boxes (MFSBs). The criteria provided by this PDC will be used to demonstrate that the transfer of the MFSB will provide an equivalent degree of safety as would be provided by a package meeting offsite transportation requirements. This fulfills the onsite transportation safety requirements implemented in WHC-CM-2-14, Hazardous Material Packaging and Shipping. A Safety Analysis Report for Packaging (SARP) will be prepared to evaluate the safety of the transfer operation. Approval of the SARP is required to authorize transfer. Criteria are also established to ensure burial requirements are met

  18. A Study on Structural Strength of Irradiated Spacer Grid for PWR Fuel

    Energy Technology Data Exchange (ETDEWEB)

    Jin, Y. G.; Baek, S. J.; Kim, D. S.; Yoo, B. O.; Ahn, S. B.; Chun, Y. B. [Korea Atomic Energy Research Institute, Daejeon (Korea, Republic of); Kim, J. I.; Kim, Y. H.; Lee, J. J. [KEPCO NF, Daejeon (Korea, Republic of)

    2014-10-15

    A fuel assembly consists of an array of fuel rods, spacer grids, guide thimbles, instrumentation tubes, and top and bottom nozzles. In PWR (Pressurized light Water Reactor) fuel assemblies, the spacer grids support the fuel rods by the friction forces between the fuel rods and springs/dimples. Under irradiation, the spacer grids supporting the fuel rods absorb vibration impacts due to the reactor coolant flow, and also bear static and dynamic loads during operation inside the nuclear reactor and transportation for spent fuel storage. Thus, it is important to understand the characteristics of deformation behavior and the change in structural strength of an irradiated spacer grid.. In the present study, the static compression test of a spacer grid was conducted to investigate the structural strength of the irradiated spacer grid in a hot cell at IMEF (Irradiated Materials Examination Facility) of KAERI. To evaluate the structural strength of an irradiated spacer grid, hot cell tests were carried out at IMEF of KAERI. The fuel assembly was dismantled and the irradiated spacer grid was obtained for the compression test. The apparatus for measuring the compression strength of the irradiated spacer grid was developed and installed successfully in the hot cell.

  19. Research report on development of spacer grid strap for AFA 3G fuel assembly

    International Nuclear Information System (INIS)

    Ye Yuandong

    2004-11-01

    The current development and tendency for fuel assemblies being of low leakage, high burn-up and long cycle fuel reload in the world are presented, and the necessity and feasibility to develop the spacer grid for high burn-up fuel assembly are elaborated. Considering all the activities in implementing of spacer grid and the technical difficulties in machining of tools, the major technological processes are introduced; the research program and the approaches to develop the spacer grid while research targets and overall schedule are defined and some key technical points and applicable practices are discussed. Finally the requirements and the conditions necessary for developing of spacer grid are proposed. (authors)

  20. 21 CFR 888.3400 - Hip joint femoral (hemi-hip) metallic resurfacing prosthesis.

    Science.gov (United States)

    2010-04-01

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

  1. 21 CFR 888.3370 - Hip joint (hemi-hip) acetabular metal cemented prosthesis.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Hip joint (hemi-hip) acetabular metal cemented... HUMAN SERVICES (CONTINUED) MEDICAL DEVICES ORTHOPEDIC DEVICES Prosthetic Devices § 888.3370 Hip joint (hemi-hip) acetabular metal cemented prosthesis. (a) Identification. A hip joint (hemi-hip) acetabular...

  2. [Diagnosis and therapy of particle disease in total hip arthroplasty].

    Science.gov (United States)

    Müller, M; Wassilew, G; Perka, C

    2015-04-01

    Particle disease is caused by periarticular accumulation of attrition particles and the inflammatory reaction of the body's tissue. This process may result in osteolysis or soft tissue transformation which presents itself symptomless in the beginning and can proceed to aseptic implant loosening, fracture, implant breaking as a result of the inappropriate osseous support and to algetic and destructive soft tissue reactions as well. Attrition particles originate from tribological pairing, and the extent of the attrition or the particle concentration depend on different factors as there are the tribological pairing's material, the head size, the patient's level of activity, and the implant position. Attrition particles can also be found in the range of any modular connection. Particle disease and its resulting morphological alterations of the tribological pairing is one of the most frequent reasons for re-operation in hip endoprosthetics. Georg Thieme Verlag KG Stuttgart · New York.

  3. Modern radiological postoperative diagnostics of the hip joint in children and adults

    International Nuclear Information System (INIS)

    Weber, M.A.; Thierjung, H.; Kloth, J.K.; Egermann, M.

    2015-01-01

    The assessment of bone healing and loosening of endoprosthesis material was long the primary indication for postoperative projection radiography and CT imaging of the hip joint following trauma and endoprosthesis implantation. With the increasing number of joint-preserving surgery, e. g. of surgical hip luxation and hip arthroscopy for the treatment of femoroacetabular impingement (FAI), high-resolution imaging of intra-articular pathologies before and after surgery has become increasingly important. In this review article, diagnostic imaging of the hip joint is presented following common trauma surgery and orthopedic surgery interventions. The imaging modalities of projection radiography, CT and MRI including direct MR-arthrography are discussed with regard to their diagnostic capability in the postoperative assessment of the hip joint. Among others topics, imaging is discussed following hip arthroplasty, following surgical hip luxation and arthroscopic interventions for the treatment of FAI, as well as following core decompression for avascular necrosis of the femoral head. Moreover, orthopedic interventions of the hip joint in children and adolescents are presented and the dedicated reporting of postoperative imaging is outlined.

  4. Social inequality and hip fracture

    DEFF Research Database (Denmark)

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

    2015-01-01

    Social inequality appears to be increasing in many countries. We explored whether risk of hip fracture was associated with markers of inequality and whether these relationships changed with time, using data from Danish Health Registries. Methods: All patients 60 years or older with a primary hip...... fracture (ICD10: S720, S721, S722 and S729) were identified from 1 January 1995 to 31 December 2011. Hip fracture patients were matched 1:1 on age, gender and year of fracture to a non-hip fracture control. An individual's education attainment was defined as basic, secondary or higher, and their income...

  5. CUSTOMIZED ACETABULAR COMPONENTS IN REVISION HIP ARTHROPLASTY

    Directory of Open Access Journals (Sweden)

    G. M. Kavalersky

    2016-01-01

    Full Text Available In recent years, there is a trend of increasing demand for revision hip arthroplasty. Among these patients there are many with complex acetabular defects, including patients with pelvic discontinuity. To ensure stability for revised acetabular components in such cases becomes a challenging or unachievable task. Such defects give indications for printing customized tri-flange acetabular component. The authors analysed own experience of creating and applying custom made acetabular components in 3 patients with complex acetabular defects. Material and methods. Among the patients there were 2 women and 1 man. Average age was 60,3±19,4 years (38 to 78 years. Two patients had III B defects with pelvic discontinuity and one patient had III A defect by Paprosky classification. As the first step, the authors in collaboration with engineers printed a plaster full size pelvic 3D model, as the second step a customized tri-flange acetabular component was designed and printed. Harris Hip Score was evaluated preoperatively and 3 months postoperatively. Results. Average follow-up period was 5,3±2,5 months (3 to 8 months. The authors observed no cases of implant loosening, dislocation or deep periprosthetic infection. Average Harris Hip Score before surgery was 27,13 and after surgery – 74,1 indicating a significant improvement in 3 months postoperatively. Conclusion. Indications for use of individual acetabular components in reported patients correspond to indications formulated by Berasi et al. The authors obtained encouraging early follow-up outcomes that correspond to data of other authors. In one patient certain difficulties were reported due to insufficient pelvic distraction. Component’s flanges prevented achieving adequate pelvic distraction. Nevertheless, good primary stability was achieved. Modern software and 3D metal printers can significantly reduce the production cost of customized acetabular components. Application of this technology can be

  6. Metal-on-metal hip joint tribology.

    Science.gov (United States)

    Dowson, D; Jin, Z M

    2006-02-01

    The basic tribological features of metal-on-metal total hip replacements have been reviewed to facilitate an understanding of the engineering science underpinning the renaissance of these hard-on-hard joints. Metal-on-polymer hip replacements operate in the boundary lubrication regime, thus leading to the design guidance to reduce the femoral head diameter as much as is feasible to minimize frictional torque and volumetric wear. This explains why the gold-standard implant of this form from the past half-century had a diameter of only 22.225 mm (7/8 in). Metal-on-metal implants can operate in the mild mixed lubrication regime in which much of the applied load is supported by elastohydrodynamic films. Correct tribological design leads to remarkably low steady state wear rates. Promotion of the most effective elastohydrodynamic films calls for the largest possible head diameters and the smallest clearances that can reasonably be adopted, consistent with fine surface finishes, good sphericity and minimal structural elastic deformation of the cup on its foundations. This guidance, which is opposite in form to that developed for metal-on-polymer joints, is equally valid for solid (monolithic) metallic heads on metallic femoral stems and surface replacement femoral shells. Laboratory measurements of friction and wear in metal-on-metal joints have confirmed their potential to achieve a very mild form of mixed lubrication. The key lies in the generation of effective elastohydrodynamic lubricating films of adequate thickness compared with the composite roughness of the head and cup. The calculation of the film thickness is by no means easy, but the full procedure is outlined and the use of an empirical formula that displays good agreement with calculations based upon the full numerical solutions is explained. The representation of the lambda ratio, lambda, embracing both film thickness and composite roughness, is described.

  7. Carmustine Implant

    Science.gov (United States)

    ... works by slowing or stopping the growth of cancer cells in your body. ... are pregnant, plan to become pregnant, or are breast-feeding. If you become pregnant while receiving carmustine implant, call your doctor. Carmustine may harm the fetus.

  8. Cochlear Implants

    Science.gov (United States)

    ... NIDCD A cochlear implant is a small, complex electronic device that can help to provide a sense ... Hearing Aids Retinitis Pigmentosa - National Eye Institute Telecommunications Relay Services Usher Syndrome Your Baby's Hearing Screening News ...

  9. Measurement and CFD calculation of spacer loss coefficient for a tight-lattice fuel bundle

    International Nuclear Information System (INIS)

    In, Wang Kee; Shin, Chang Hwan; Kwack, Young Kyun; Lee, Chi Young

    2015-01-01

    Highlights: • Experiment and CFD analysis evaluated the pressure drop in a spacer grid. • The measurement and CFD errors for the spacer loss coefficient were estimated. • The spacer loss coefficient for the dual-cooled annular fuel bundle was determined. • The CFD prediction agrees with the measured spacer loss coefficient within 8%. - Abstract: An experiment and computational fluid dynamics (CFD) analysis were performed to evaluate the pressure drop in a spacer grid for a dual-cooled annular fuel (DCAF) bundle. The DCAF bundle for the Korean optimum power reactor (OPR1000) is a 12 × 12 tight-lattice rod array with a pitch-to-diameter ratio of 1.08 owing to a larger outer diameter of the annular fuel rod. An experiment was conducted to measure the pressure drop in spacer grid for the DCAF bundle. The test bundle is a full-size 12 × 12 rod bundle with 11 spacer grid. The test condition covers a Reynolds number range of 2 × 10 4 –2 × 10 5 by changing the temperature and flow rate of water. A CFD analysis was also performed to predict the pressure drop through a spacer grid using the full-size and partial bundle models. The pressure drop and loss coefficient of a spacer grid were predicted and compared with the experimental results. The CFD predictions of spacer pressure drop and loss coefficient agree with the measured values within 8%. The spacer loss coefficient for the DCAF bundle is estimated to be approximately 1.50 at a nominal operating condition of OPR1000, i.e., Re = 4 × 10 5

  10. Numerical investigation on practicability of reducing MCST by using grid spacer in a tight rod bundle

    International Nuclear Information System (INIS)

    Zhu, Xiaojing; Morooka, Shinichi; Oka, Yoshiaki

    2014-01-01

    Highlights: • Standard grid spacer design causes decreased heat transfer in a tight rod bundle. • Heat transfer is greatly enhanced by flow-enhancing features. • Swirling flow adversely affects the heat transfer downstream of grid spacer. • Enhanced heat transfer by existing grid spacer is limited in a short region. • Improved grid spacer can effectively reduce MCST. - Abstract: The numerical investigation was carried out to reveal the practicability of reducing the maximum cladding surface temperature (MCST) within the inner sub-channel of a tight, hexagon rod bundle using commercial CFD code STAR CCM+ 6.04. The special heat transfer and pressure drop characteristics caused by four existing grid spacer designs were discussed in detail by analyzing the effects of grid strap length, different flow enhancing features and different Reynolds numbers. It was found that the local heat transfer within the grid strap is greatly enhanced due to the raised flow velocity. Both the standard grid spacer and the grid spacer with split-vanes cause decreased heat transfer in the downstream region. The friction drag is very influential in the tight rod bundle and can eliminate the positive effect of flow blockage on the heat transfer performance. The grid spacer with flow blockage discs induces relatively good heat transfer performance and higher pressure drop within sub-channels, indicating a tradeoff between the heat transfer augmentation and the pressure drop. The combination of multiple existing grid spacers can reduce the MCST to a certain level, but the corresponding disadvantages cannot be ignored. The improved grid spacer design was proposed based on the overall considerations of heat transfer and pressure drop characteristics and has been proved more suitable to widely reduce MCST for SCWR than any other grid spacer designs involved in present study

  11. [Mechanical studies of lumbar interbody fusion implants].

    Science.gov (United States)

    Bader, R J; Steinhauser, E; Rechl, H; Mittelmeier, W; Bertagnoli, R; Gradinger, R

    2002-05-01

    In addition to autogenous or allogeneic bone grafts, fusion cages composed of metal or plastic are being used increasingly as spacers for interbody fusion of spinal segments. The goal of this study was the mechanical testing of carbon fiber reinforced plastic (CFRP) fusion cages used for anterior lumbar interbody fusion. With a special testing device according to American Society for Testing and Materials (ASTM) standards, the mechanical properties of the implants were determined under four different loading conditions. The implants (UNION cages, Medtronic Sofamor Danek) provide sufficient axial compression, shear, and torsional strength of the implant body. Ultimate axial compression load of the fins is less than the physiological compression loads at the lumbar spine. Therefore by means of an appropriate surgical technique parallel grooves have to be reamed into the endplates of the vertebral bodies according to the fin geometry. Thereby axial compression forces affect the implants body and the fins are protected from damaging loading. Using a supplementary anterior or posterior instrumentation, in vivo failure of the fins as a result of physiological shear and torsional spinal loads is unlikely. Due to specific complications related to autogenous or allogeneic bone grafts, fusion cages made of metal or carbon fiber reinforced plastic are an important alternative implant in interbody fusion.

  12. Hydroxyapatite coating does not improve uncemented stem survival after total hip arthroplasty!

    DEFF Research Database (Denmark)

    Hailer, N. P.; Lazarinis, S.; MaKela, K. T.

    2015-01-01

    Background and purpose - It is still being debated whether HA coating of uncemented stems used in total hip arthroplasty (THA) improves implant survival. We therefore investigated different uncemented stem brands, with and without HA coating, regarding early and long-term survival. Patients and m...

  13. Finite-element analysis of failure of the Capital Hip designs.

    NARCIS (Netherlands)

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

    2005-01-01

    The Capital Hip implant was a Charnley-based system which included a flanged and a roundback stem, both of which were available in stainless steel and titanium. The system was withdrawn from the market because of its inferior performance. However, all four of the designs did not produce poor rates

  14. The influence of the preliminary garter spring spacer simulator clamping force in the pressure tube spacer -calandria tube hook-up simulator aging behaviour

    International Nuclear Information System (INIS)

    Gyongyosi, T.; Deloreanu, G.; Puiu, D.; Corbescu, B.; Anghel, N.; Dinu, E.

    2016-01-01

    The garter spring spacer is a specially constructed torsion spring used to fit-out the CANDU 6 fuel channel. The pressure tube ageing decreases the gap to the calandria tube. Continuous gap decrease directly affects the garter spring spacers behavior during fuel channel assembly operation. The preliminary clamping force value of the garter spring spacer assembly is important for its ageing behavior. This paper briefly describes the experimental technological facilities used for conducted the experiments and highlights some of the important moments during an experiment carried out in laboratory conditions, without using pressurized boiled water and irradiation working conditions. The results analysis and some conclusions are outlined at the end, pointing out that a garter spring spacer preliminary clamping force increase reduces the vibration response signal amplitude, and does not lead to its relaxation. The paper is dedicated to specialists working in research and technological engineering. (authors)

  15. Metal-on-Metal Total Hip Resurfacing Arthroplasty

    Science.gov (United States)

    2006-01-01

    Executive Summary Objective The objective of this review was to assess the safety and effectiveness of metal on metal (MOM) hip resurfacing arthroplasty for young patients compared with that of total hip replacement (THR) in the same population. Clinical Need Total hip replacement has proved to be very effective for late middle-aged and elderly patients with severe degenerative diseases of the hips. As indications for THR began to include younger patients and those with a more active life style, the longevity of the implant became a concern. Evidence suggests that these patients experience relatively higher rates of early implant failure and the need for revision. The Swedish hip registry, for example, has demonstrated a survival rate in excess of 80% at 20 years for those aged over 65 years, whereas this figure was 33% by 16 years in those aged under 55 years. Hip resurfacing arthroplasty is a bone-conserving alternative to THR that restores normal joint biomechanics and load transfer. The technique has been used around the world for more than 10 years, specifically in the United Kingdom and other European countries. The Technology Metal-on-metal hip resurfacing arthroplasty is an alternative procedure to conventional THR in younger patients. Hip resurfacing arthroplasty is less invasive than THR and addresses the problem of preserving femoral bone stock at the initial operation. This means that future hip revisions are possible with THR if the initial MOM arthroplasty becomes less effective with time in these younger patients. The procedure involves the removal and replacement of the surface of the femoral head with a hollow metal hemisphere, which fits into a metal acetabular cup. Hip resurfacing arthroplasty is a technically more demanding procedure than is conventional THR. In hip resurfacing, the femoral head is retained, which makes it much more difficult to access the acetabular cup. However, hip resurfacing arthroplasty has several advantages over a

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

    Science.gov (United States)

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

    2018-03-01

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

  17. Comparison of total hip arthroplasty in osteoarthritis of mechanical and rheumatologic causes

    Science.gov (United States)

    Ejnisman, Leandro; Leonhardt, Nathalia Zalc; Fernandes, Laura Fillipini Lorimier; Leonhardt, Marcos de Camargo; Vicente, José Ricardo Negreiros; Croci, Alberto Tesconi

    2014-01-01

    Objective: To compare the use of uncemented implants in total hip arthroplasty in patients with rheumathologic diseases and mechanical osteoarthrosis. Methods: We retrospectively evaluated 196 patients who were operated by the Hip and Arthroplasty Surgery Group of the IOT-HCFMUSP between 2005 and 2009. Patients were divided into two groups: mechanical causes (165 patients) and rheumathologic causes (31 patients). Groups were compared between each other in age, gender and follow-up time. Osseointegration rate and percentage of failure in arthroplasty were evaluated. Results: No statistically significant difference was found in osseointegration rates (in both femoral and acetabular components) in both groups. The rates of revision surgery and implant survival also did not show statistically significant differences. Conclusion: The use of uncemented total hip arthroplasty did not show worse results in rheumathologic patients. Level of Evidence III, Retrospective Case Control Study. PMID:24644419

  18. Implantation, recoil implantation, and sputtering

    International Nuclear Information System (INIS)

    Kelly, R.

    1984-01-01

    The implantation and sputtering mechanisms which are relevant to ion bombardment of surfaces are described. These are: collision, thermal, electronic and photon-induced sputtering. 135 refs.; 36 figs.; 9 tabs

  19. Surface engineering by ion implantation

    International Nuclear Information System (INIS)

    Nielsen, Bjarne Roger

    1995-01-01

    Awidespread commercial applica tion iof particle accelerators is for ion implantation. Accelerator beams are used for ion implantation into metals, alloying a thin surface layer with foreign atoms to concentrations impossible to achieve by thermal processes, making for dramatic improvements in hardness and in resistance to wear and corrosion. Traditional hardening processes require high temperatures causing deformation; ion implantation on the other hand is a ''cold process'', treating the finished product. The ionimplanted layer is integrated in the substrate, avoiding the risk of cracking and delamination from normal coating processes. Surface properties may be ''engineered'' independently of those of the bulk material; the process does not use environmentally hazardous materials such as chromium in the surface coating. The typical implantation dose required for the optimum surface properties of metals is around 2 x 10 17 ion/cm 2 , a hundred times the typical doses for semiconductor processing. When surface areas of more than a few square centimetres have to be treated, the implanter must therefore be able to produce high beam currents (5 to 10 mA) to obtain an acceptable treatment time. Ion species used include nitrogen, boron, carbon, titanium, chromium and tantalum, and beam energies range from 50 to 200 keV. Since most components are three dimensional, it must be possible to rotate and tilt them in the beam, and control beam position over a large area. Examples of industrial applications are: - surface treatment of prostheses (hip and knee joints) to reduce wear of the moving parts, using biocompatible materials; - ion implantation into high speed ball bearings to protect against the aqueous corrosion in jet engines (important for service helicopters on oil rigs); - hardening of metal forming and cutting tools; - reduction of corrosive wear of plastic moulding tools, which are expensive to produce

  20. Indirect lateral surgical approach modified in hip arthroplasty

    International Nuclear Information System (INIS)

    Sanchez, Pedro Antonio; Arbelaez, William Rafael

    2006-01-01

    The authors show an another option to the surgical approach to the hip, a lateral indirect modified (ALIM) for the partial or total arthroplasty of primary hip replacement and for revision (RTC), in a retrospective study, series of cases, with average was 7,75 years of follow up (range 6 months-10 years); quick access, easy technically, provide a good orientation of the components of the placement of implants, and allow an excellent exhibition for the complex problems of the reconstruction of the acetabular and the femur. Leaves intact the greater trochanter, improving the rotational stability that is needed in its femoral implant, doesn't injured the gluteus medius and doesn't produces his deficit, reduce the time for the deambulation. This approach is designed for primary cases and complex cases of revision using the mini-incision, with better exposition and less morbid-mortality associated to the surgical technique due to the less bleeding, less incidence of dislocation, thromboembolism and infection because of the little damage and better control of the surrounding soft tissue; better stability, no paralysis or lesion of the sciatic or femoral nerve without incidence of heterotopic ossifications with a better range of external rotation in extension of the hip that with traditional approach of Hardinge, and greater versatility in its indications

  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. Total hip arthroplasty in Denmark

    DEFF Research Database (Denmark)

    Pedersen, Alma Becic; Johnsen, Søren Paaske; Overgaard, Søren

    2005-01-01

    The annual number of total hip arthroplasties (THA) has increased in Denmark over the past 15 years. There is, however, limited detailed data available on the incidence of THAs.......The annual number of total hip arthroplasties (THA) has increased in Denmark over the past 15 years. There is, however, limited detailed data available on the incidence of THAs....

  3. The Danish Hip Arthroplasty Register

    DEFF Research Database (Denmark)

    Gundtoft, Per Hviid; Varnum, Claus; Pedersen, Alma Becic

    2016-01-01

    AIM OF DATABASE: The aim of the Danish Hip Arthroplasty Register (DHR) is to continuously monitor and improve the quality of treatment of primary and revision total hip arthroplasty (THA) in Denmark. STUDY POPULATION: The DHR is a Danish nationwide arthroplasty register established in January 1995...

  4. Hip sonography in the newborn

    International Nuclear Information System (INIS)

    Riboni, G.; Serantoni, S.; De Simoni, M.; Bascape', P.; Facchini, R.; Pirovano, G.

    1991-01-01

    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

  5. Magnetic decoupling of ferromagnetic metals through a graphene spacer

    Energy Technology Data Exchange (ETDEWEB)

    Grimaldi, I.; Papagno, M. [Dipartimento di Fisica, Universitá della Calabria, Arcavacata di Rende (CS), 87036 (Italy); Ferrari, L. [Istituto dei Sistemi Complessi, Consiglio Nazionale delle Ricerche, Roma I-00133 (Italy); Istituto di Struttura della Materia, Consiglio Nazionale delle Ricerche, Trieste (Italy); Sheverdyaeva, P.M.; Mahatha, S.K. [Istituto di Struttura della Materia, Consiglio Nazionale delle Ricerche, Trieste (Italy); Pacilé, D., E-mail: daniela.pacile@fis.unical.it [Dipartimento di Fisica, Universitá della Calabria, Arcavacata di Rende (CS), 87036 (Italy); Istituto di Struttura della Materia, Consiglio Nazionale delle Ricerche, Trieste (Italy); Carbone, C. [Istituto di Struttura della Materia, Consiglio Nazionale delle Ricerche, Trieste (Italy)

    2017-03-15

    We study the magnetic coupling between different ferromagnetic metals (FMs) across a graphene (G) layer, and the role of graphene as a thin covalent spacer. Starting with G grown on a FM substrate (Ni or Co), we deposited on top at room temperature several FM metals (Fe, Ni, Co). By measuring the dichroic effect of 3p photoemission lines we detect the magnetization of the substrate and the sign of the exchange coupling in FM overlayer at room temperature. We show that the G layer magnetically decouples the FM metals. - Highlights: • The magnetic coupling between ferromagnets mediated by graphene is studied. • To this end, the linear dichroic effect in 3p photoemission lines is employed. • For selected junctions no magnetic coupling is attained through graphene. • Graphene inhibits the magnetic alignment that normally occurs between ferromagnets.

  6. Dark current of organic heterostructure devices with insulating spacer layers

    Science.gov (United States)

    Yin, Sun; Nie, Wanyi; Mohite, Aditya D.; Saxena, Avadh; Smith, Darryl L.; Ruden, P. Paul

    2015-03-01

    The dark current density at fixed voltage bias in donor/acceptor organic planar heterostructure devices can either increase or decrease when an insulating spacer layer is added between the donor and acceptor layers. The dominant current flow process in these systems involves the formation and subsequent recombination of an interfacial exciplex state. If the exciplex formation rate limits current flow, the insulating interface layer can increase dark current whereas, if the exciplex recombination rate limits current flow, the insulating interface layer decreases dark current. We present a device model to describe this behavior and illustrate it experimentally for various donor/acceptor systems, e.g. P3HT/LiF/C60.

  7. Optimized spacer layer thickness for plasmonic-induced enhancement of photocurrent in a-Si:H

    Energy Technology Data Exchange (ETDEWEB)

    Saleh, Z. M., E-mail: zaki.saleh@aauj.edu, E-mail: zakimsaleh@yahoo.com; Nasser, H.; Özkol, E.; Günöven, M.; Abak, K. [Middle East Technical University, Center for Solar Energy Research and Applications (GÜNAM) (Turkey); Canli, S. [Middle East Technical University, Central Laboratory (Turkey); Bek, A.; Turan, R. [Middle East Technical University, Center for Solar Energy Research and Applications (GÜNAM) (Turkey)

    2015-10-15

    Plasmonic interfaces consisting of silver nanoparticles of different sizes (50–100 nm) have been processed by the self-assembled dewetting technique and integrated to hydrogenated amorphous silicon (a-Si:H) using SiNx spacer layers to investigate the dependence of optical trapping enhancement on spacer layer thickness through the enhancements in photocurrent. Samples illuminated from the a-Si:H side exhibit a localized surface plasmon resonance (LSPR) that is red-shifted with the increasing particle size and broadened into the red with the increasing spacer layer thickness. The photocurrent measured in a-Si:H is not only consistent with the red-shift and broadening of the LSPR, but exhibits critical dependence on the spacer layer thickness also. The samples with plasmonic interfaces and a SiNx spacer layer exhibit appreciable enhancement of photocurrent compared with flat a-Si:H reference depending on the size of the Ag nanoparticle. Simulations conducted on one-dimensional square structures exhibit electric fields that are localized near the plasmonic structures but extend appreciably into the higher refractive index a-Si:H. These simulations produce a clear red-shift and broadening of extinction spectra for all spacer layer thicknesses and predict an enhancement in photocurrent in agreement with experimental results. The spectral dependence of photocurrent for six plasmonic interfaces with different Ag nanoparticle sizes and spacer layer thicknesses are correlated with the optical spectra and compared with the simulations to predict an optimal spacer layer thickness.

  8. Boiling transition phenomenon in BWR fuel assemblies effect of fuel spacer shape on critical power

    International Nuclear Information System (INIS)

    Yamamoto, Yasushi; Morooka, Shin-ichi; Mitsutake, Toru; Yokobori, Seiichi; Kimura, Jiro.

    1996-01-01

    A thorough understanding of the thermal-hydraulic phenomena near fuel spacer is necessary for the accurate prediction of the critical power of BWR fuel assemblies, and is thus essential for effective developments of a new BWR fuel assembly. The main purpose of this study is to develop an accurate method for predicting the effect of spacer shapes on critical power. Tests have been conducted under actual BWR operating conditions, using an annulus flow channel consisting of a heated rod and circular-tube channel, and BWR simulated 4x4 rod bundles with heater rods unheated just upsteam of spacer. The effect of spacer shapes on critical power was predicted analytically based on the droplet deposition rate estimation. The droplet deposition rate for different spacer shapes was calculated using a single-phase flow model. The prediction results were compared with the test results for the annulus flow channel using ring-type spacers. Analytical results of critical power agreed with measured critical power from point of the effects of changes in the rod-spacer clearance and the spacer thickness on critical power. (author)

  9. Modeling the effect of spacers and biofouling on forward osmosis performance

    KAUST Repository

    Mosqueira Santillá n, Marí a José

    2014-01-01

    and operational conditions. For this, a two dimensional numerical model for FO systems was developed using computational fluid dynamics (CFD). This model allowed the evaluation of the impact of (i) spacers and (ii) biofilm, and (iii) the combined impact of spacers

  10. Solution-processed organic tandem solar cells with embedded optical spacers

    NARCIS (Netherlands)

    Hadipour, Afshin; de Boer, Bert; Blom, Paul W. M.

    2007-01-01

    We demonstrate a solution-processed polymer tandem solar cell in which the two photoactive single cells are separated by an optical spacer. The use of an optical spacer allows for an independent optimization of both the electronic and optical properties of the tandem cell. The optical transmission

  11. Effect of plastic spacer handling on salbutamol lung deposition in asthmatic children

    DEFF Research Database (Denmark)

    Lipworth, Brian J; Lee, Daniel K C; Anhøj, Jacob

    2002-01-01

    AIMS: To study the effects of electrostatics in a plastic spacer on the lung deposition of salbutamol in asthmatic children. METHODS: Twenty-five children (5-12 years) with mild asthma were given salbutamol hydrofluoroalkane pressurized metered dose inhaler 400 micro g via a 750 ml plastic spacer...

  12. In-vivo degradation mechanism of Ti-6Al-4V hip joints

    DEFF Research Database (Denmark)

    Lomholt, Trine Colding; Pantleon, Karen; Somers, Marcel A. J.

    2011-01-01

    In-vivo exposed Ti-6Al-4V implants were investigated to determine the degradation mechanism occurring during the articulating movements of the hip joint in the human body. Failed implants were compared to Ti-6Al-4V samples, which were tested in the laboratory for their tribocorrosion performance....... The results strongly indicate that degradation of Ti-6Al-4V has occurred with the same mechanism for both the implants and the laboratory tested samples and, hence, block-on-ring tribocorrosion testing was found to be a useful tool for mimicking the degradation occurring in the body.The degradation mechanism...

  13. Radiographic study of the hip joint to determine anthropometric parameters for Indian population

    International Nuclear Information System (INIS)

    Bagaria, Vaibhav; Deshpande, Shirish; Kuthe, Abhay; Rasalkar, Darshana D.; Paunipagar, Bhawan K.; Madhugiri, Tanushree Subhash

    2012-01-01

    Hip replacement surgeries are on the rise in India. However, for these surgeries, most of the implants used are imported and manufactured entirely to suit the geometrical considerations of the western population. Studies in the past have shown that there are anatomical variations in the hip joint for different ethnic backgrounds and geographical locations. There is paucity of anthropometric hip joint data related to Indian population and anthropometric variations in skeletal geometry between Asian and Western counterparts have not yet been thoroughly reviewed and considered for implant manufacturing. The purpose of this anthropometric study is to determine any anatomical variations in the normal hip joint among the Indian population and to statistically compare the mean values with the existing data on western population. 422 Hip radiographs of 211 individuals (141 males and 70 females) with normal and healthy hip joints were evaluated to obtain the horizontal offset, vertical offset and neck shaft angle. For males, mean neck shaft angle was 127.68° (SD = 3.94), horizontal offset was 34.60 mm (SD = 6.55) and vertical offset was 39.17 mm (SD = 5.86). For females, mean neck shaft angle was 125.92° (SD = 4.75), horizontal offset was 32.96 mm (SD = 7.04) and vertical offset was 36.38 mm (SD = 6.28). When these parameters were compared to the data available from western world, there were significant anatomical variations and it was evident that there is a need to evaluate existing implants in relation to this data and possibly design the implants suited and relevant to Indian population.

  14. The CRISPR Spacer Space Is Dominated by Sequences from Species-Specific Mobilomes.

    Science.gov (United States)

    Shmakov, Sergey A; Sitnik, Vassilii; Makarova, Kira S; Wolf, Yuri I; Severinov, Konstantin V; Koonin, Eugene V

    2017-09-19

    Clustered regularly interspaced short palindromic repeats and CRISPR-associated protein (CRISPR-Cas) systems store the memory of past encounters with foreign DNA in unique spacers that are inserted between direct repeats in CRISPR arrays. For only a small fraction of the spacers, homologous sequences, called protospacers, are detectable in viral, plasmid, and microbial genomes. The rest of the spacers remain the CRISPR "dark matter." We performed a comprehensive analysis of the spacers from all CRISPR- cas loci identified in bacterial and archaeal genomes, and we found that, depending on the CRISPR-Cas subtype and the prokaryotic phylum, protospacers were detectable for 1% to about 19% of the spacers (~7% global average). Among the detected protospacers, the majority, typically 80 to 90%, originated from viral genomes, including proviruses, and among the rest, the most common source was genes that are integrated into microbial chromosomes but are involved in plasmid conjugation or replication. Thus, almost all spacers with identifiable protospacers target mobile genetic elements (MGE). The GC content, as well as dinucleotide and tetranucleotide compositions, of microbial genomes, their spacer complements, and the cognate viral genomes showed a nearly perfect correlation and were almost identical. Given the near absence of self-targeting spacers, these findings are most compatible with the possibility that the spacers, including the dark matter, are derived almost completely from the species-specific microbial mobilomes. IMPORTANCE The principal function of CRISPR-Cas systems is thought to be protection of bacteria and archaea against viruses and other parasitic genetic elements. The CRISPR defense function is mediated by sequences from parasitic elements, known as spacers, that are inserted into CRISPR arrays and then transcribed and employed as guides to identify and inactivate the cognate parasitic genomes. However, only a small fraction of the CRISPR spacers

  15. [Sport activity after hip and knee arthroplasty].

    Science.gov (United States)

    Keren, Amit; Berkovich, Yaron; Berkovitch, Yaron; Soudry, Michael

    2013-11-01

    Joint arthroplasty is one of the commonest surgical procedures in orthopedic surgery. In recent years there was an increase in the number of procedures, patient satisfaction and implant survival. Originally, these operations were designed for old patients in order to relieve pain and to enable ambulation. Over the past few years, these operations have become common in younger patients which desire to return to activity, including sports activities. The importance of physical activity is a well known fact. In recent years it became clear that with the proper physical activity the outcomes of the operations are better. There are several types of arthroplasty. Many factors influence the outcome of the operation apart from the post-surgery physical activity. These factors include patient factors, surgical technique and type of arthroplasty. This review summarizes the recommendations for sports activities after hip and knee arthroplasties. These activities are evaluated according to surgeons' recommendations, stress applied on the implant and long term outcomes. The recommended sports activities after joint arthroplasties are walking, swimming and cycling. Soccer, basketball and jogging are not advised. Tennis, downhill skiing and horse riding are recommended with previous experience. There are many more sports activities that patients can participate in, and it is important that the patient discuss the different options prior to the operation. Since these operations are so common, many non-orthopedic physicians encounter these patients in their practice. They should be acquainted with the recommendations for sports activities and encourage them.

  16. Pros and cons of symmetrical dual-k spacer technology in hybrid FinFETs

    Science.gov (United States)

    Pradhan, K. P.; Andrade, M. G. C.; Sahu, P. K.

    2016-12-01

    The symmetrical dual-k spacer technology in hybrid FinFETs has been widely explored for better electrostatic control of the fin-based devices in nanoscale region. Since, high-k tangible spacer materials are broadly became a matter of study due to their better immunity to the short channel effects (SCEs) in nano devices. However, the only cause that restricts the circuit designers from using high-k spacer is the unreasonable increasing fringing capacitances. This work quantitatively analyzed the benefits and drawbacks of considering two different dielectric spacer materials symmetrically in either sides of the channel for the hybrid device. From the demonstrated results, the inclusion of high-k spacer predicts an effective reduction in off-state leakage along with an improvement in drive current. However, these devices have paid the cost in terms of a high total gate-to-gate capacitance (Cgg) that consequently results poor cutoff frequency (fT) and delay.

  17. Improving stress shielding following total hip arthroplasty by using a femoral stem made of β type Ti-33.6Nb-4Sn with a Young's modulus gradation

    NARCIS (Netherlands)

    Yamako, Go; Janssen, Dennis; Hanada, Shuji; Anijs, Thomas; Ochiai, Kiyohide; Totoribe, Koji; Chosa, Etsuo; Verdonschot, Nico

    2017-01-01

    Stress shielding-related bone loss occurs after total hip arthroplasty because the stiffness of metallic implants differs from that of the host femur. Although reducing stem stiffness can ameliorate the bone resorption, it increases stress at the bone–implant interface and can inhibit fixation. To

  18. A combined experimental and finite element approach to analyse the fretting mechanism of the head-stem taper junction in total hip replacement

    NARCIS (Netherlands)

    Bitter, T.; Khan, I.; Marriott, T.; Lovelady, E.; Verdonschot, N.J.; Janssen, D.W.

    2017-01-01

    Fretting corrosion at the taper interface of modular hip implants has been implicated as a possible cause of implant failure. This study was set up to gain more insight in the taper mechanics that lead to fretting corrosion. The objectives of this study therefore were (1) to select experimental

  19. A randomised controlled trial of total hip arthroplasty versus resurfacing arthroplasty in the treatment of young patients with arthritis of the hip joint.

    Science.gov (United States)

    Achten, Juul; Parsons, Nick R; Edlin, Richard P; Griffin, Damian R; Costa, Matthew L

    2010-01-14

    Hip replacement (arthroplasty) surgery is a highly successful treatment for patients with severe symptomatic arthritis of the hip joint. For older patients, several designs of Total Hip Arthroplasty have shown excellent results in terms of both function and value for money. However, in younger more active patients, there is approximately a 50% failure rate at 25 years for traditional implants. Hip resurfacing is a relatively new arthroplasty technique. In a recent review of the literature on resurfacing arthroplasty it was concluded that the short-term functional results appear promising but some potential early disadvantages were identified, including the risk of femoral neck fracture and collapse of the head of the femur. The aim of the current study is to assess whether there is a difference in functional hip scores at one year post-operation between Total Hip Arthroplasty and Resurfacing Arthroplasty. Secondary aims include assessment of complication rates for both procedures as well cost effectiveness. All patients medically fit for surgery and deemed suitable for a resurfacing arthroplasty are eligible to take part in this study. A randomisation sequence will be produced and administered independently. After consenting, all patients will be clinically reviewed and hip function, quality of life and physical activity level will be assessed through questionnaires. The allocated surgery will then be performed with the preferred technique of the surgeon. Six weeks post-operation hip function will be assessed and complications recorded. Three, six and 12 months post-operation hip function, quality of life and physical activity level will be assessed. Additional information about patients' out-of-pocket expenses will also be collected. Current Controlled Trials ISRCTN33354155. UKCLRN portfolio ID 4093.

  20. Clinical Evaluation of Fused/Ankylosed Hip with Severe Flexion Deformity after Conversion to Total Hip Arthroplasty

    Directory of Open Access Journals (Sweden)

    Saroj Kumar Suwal

    2016-06-01

    Conclusions: THA is an effective treatment for ankylosed hip with severe flexion deformity although complications are noted more than routine hip arthroplasties. Keywords: ankylosed hip; fused hip; severe flexion deformity; total hip arthroplasty. | PubMed

  1. Corrosion and Tribology of Materials Used in a Novel Reverse Hip Replacement.

    Science.gov (United States)

    Braddon, Linda; Termanini, Zafer; MacDonald, Steven; Parvizi, Jay; Lieberman, Jay; Frankel, Victor; Zuckerman, Joseph

    2017-07-05

    Total hip arthroplasty has been utilized for the past 50 years as an effective treatment for degenerative, inflammatory and traumatic disorders of the hip. The design of these implants has generally followed the anatomy of the hip as a ball and socket joint with the femoral head representing the ball and the acetabulum representing the socket. We describe a novel hip arthroplasty design in which the "ball" is located on the acetabular side and the "socket" is located on the femoral side. The results of extensive biomechanical testing are described and document wear and corrosion characteristics that are at least equivalent to standard designs. These results support clinical assessment as the next step of the evaluation.

  2. Silver-based antibacterial surfaces for bone implants

    NARCIS (Netherlands)

    Necula, B.S.

    2013-01-01

    Total hip arthroplasty (THA) is the most effective and safest method for treating severe degenerative, post-traumatic and other diseases of the joints. With an aging population that is increasingly active, the use of biomedical implants will continue to rise. It is estimated that more than 1,000,000

  3. BWR fuel assembly with improved spacer and fuel bundle design for enhanced thermal-hydraulic performance

    International Nuclear Information System (INIS)

    Mildrum, C.M.; Taleyarkhan, R.P.

    1987-01-01

    In a fuel assembly having a bundle of elongated fuel rods disposed in side-by-side relationship so as to form an array of spaced fuel rods, an outer tubular flow channel surrounding the fuel rods so as to direct flow of coolant/moderator fluid along the fuel rods, a hollow water cross extending centrally through and interconnected with the outer flow channel so as to divide the channel into separate compartments and the bundle of fuelrods into a plurality of mini-bundles thereof being disposed in the compartments, and spacers axially displaced along the fuel rods in each of the mini-bundles thereof. Each spacer is composed of inner and outer means which together define spacer cells at corner, side and interior locations of the spacer and have respective protrusions formed thereon which extend into cells so as to maintain the fuel rods received through the spacer cells in laterally spaced relationships. The improvement is described which comprises: (a) a generally uniform poison coating within at least a majority of the fuel rods; (b) a predetermined pattern of fuel enrichment with respect to the fuel rods of each mini-bundle thereof which together with the uniform poison coating within the fuel rods ensures that the packing powers of the fuel rods in the corner and side cells of the spacers are less than the peaking power of a leading one of the fuel rods in the interior cells of the spacers; and (c) each of the fuel rods being received through the cells of each spacer having a diametric size smaller than that of each of the fuel rods received through the side and interior cells of each spacer, the diametric sizes of each of the fuel rods received through the side and interior cells of each spacer being generally equal

  4. Breast reconstruction - implants

    Science.gov (United States)

    Breast implants surgery; Mastectomy - breast reconstruction with implants; Breast cancer - breast reconstruction with implants ... harder to find a tumor if your breast cancer comes back. Getting breast implants does not take as long as breast reconstruction ...

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

    Science.gov (United States)

    Fousek, J; Indráková, P

    2007-02-01

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

  6. Near-infrared fluorescence imaging platform for quantifying in vivo nanoparticle diffusion from drug loaded implants.

    Science.gov (United States)

    Markovic, Stacey; Belz, Jodi; Kumar, Rajiv; Cormack, Robert A; Sridhar, Srinivas; Niedre, Mark

    2016-01-01

    Drug loaded implants are a new, versatile technology platform to deliver a localized payload of drugs for various disease models. One example is the implantable nanoplatform for chemo-radiation therapy where inert brachytherapy spacers are replaced by spacers doped with nanoparticles (NPs) loaded with chemotherapeutics and placed directly at the disease site for long-term localized drug delivery. However, it is difficult to directly validate and optimize the diffusion of these doped NPs in in vivo systems. To better study this drug release and diffusion, we developed a custom macroscopic fluorescence imaging system to visualize and quantify fluorescent NP diffusion from spacers in vivo. To validate the platform, we studied the release of free fluorophores, and 30 nm and 200 nm NPs conjugated with the same fluorophores as a model drug, in agar gel phantoms in vitro and in mice in vivo. Our data verified that the diffusion volume was NP size-dependent in all cases. Our near-infrared imaging system provides a method by which NP diffusion from implantable nanoplatform for chemo-radiation therapy spacers can be systematically optimized (eg, particle size or charge) thereby improving treatment efficacy of the platform.

  7. Predicting the impact of feed spacer modification on biofouling by hydraulic characterization and biofouling studies in membrane fouling simulators

    KAUST Repository

    Siddiqui, Amber; Lehmann, S.; Bucs, Szilard; Fresquet, M.; Fel, L.; Prest, E.I.E.C.; Ogier, J.; Schellenberg, C.; van Loosdrecht, M.C.M.; Kruithof, J.C.; Vrouwenvelder, Johannes S.

    2016-01-01

    Feed spacers are an essential part of spiral-wound reverse osmosis (RO) and nanofiltration (NF) membrane modules. Geometric modification of feed spacers is a potential option to reduce the impact of biofouling on the performance of membrane systems

  8. Fixing a fractured arthrodesed hip with rapid prototype templating and minimal invasive plate osteosynthesis

    Directory of Open Access Journals (Sweden)

    Christian Fang

    2015-12-01

    Full Text Available CASE:: We present an elderly lady with an intertrochanteric fracture of a previously fused hip. A 3D printed model of her pelvis and femur was used for implant templating before surgery. Minimal invasive fixation was performed with a spanning reversed distal femur locking plate without the need for removal of the previous implant. Multiple long locking screws were placed in the supra-acetabular region. The patient had union in 4 months, return to function and no complication. Conclusion:: The technique allowed us to optimize implant selection and insert screws safely at difficult trajectories using minimal invasive surgery. Keywords: Hip fusion, Fracture, Plating, Minimal invasive, 3D printing

  9. Titanium-Based Hip Stems with Drug Delivery Functionality through Additive Manufacturing.

    Science.gov (United States)

    Bezuidenhout, Martin B; Dimitrov, Dimitar M; van Staden, Anton D; Oosthuizen, Gert A; Dicks, Leon M T

    2015-01-01

    Postoperative infections are a major concern in patients that receive implants. These infections generally occur in areas with poor blood flow and pathogens do not always respond to antibiotic treatment. With the latest developments in nanotechnology, the incorporation of antibiotics into prosthetic implants may soon become a standard procedure. The success will, however, depend on the ability to control the release of antibiotics at concentrations high enough to prevent the development of antibiotic-resistant strains. Through additive manufacturing, antibiotics can be incorporated into cementless femoral stems to produce prosthetic devices with antimicrobial properties. With the emerging increase in resistance to antibiotics, the incorporation of antimicrobial compounds other than antibiotics, preferably drugs with a broader spectrum of antimicrobial activity, will have to be explored. This review highlights the microorganisms associated with total hip arthroplasty (THA), discusses the advantages and disadvantages of the latest materials used in hip implants, compares different antimicrobial agents that could be incorporated, and addresses novel ideas for future research.

  10. Weight-bearing radiography in total hip replacement

    International Nuclear Information System (INIS)

    Turula, K.B.; Haajanen, J.; Friberg, O.; Lindholm, T.S.; Tallroth, K.

    1985-01-01

    Serial anteroposterior (AP) radiographs of the weight-bearing pelvis and hips were taken of 29 patients with total hip replacement (THR). For constant positioning the patient stands with straight knees on a board with a block between the heels. A U-shaped mercury level strapped to the patient provides a horizontal reference line on the radiograph. On the average, individual variation of pelvic tilt in serial films was 1 0 and pelvic rotation 3.5 0 confirming satisfactory reproducibility. The horizontal reference enables estimation of pre- and postoperative leg length inequality (LLI) and of the angle of the acetabular cup (AA). Reproducibility allows assessment of the exact position of the femoral component and quantitative evaluation of radiolucency and bone resorption around the prosthetic implant in the follow-up of THR. (orig.)

  11. The association between metal allergy, total hip arthroplasty, and revision

    DEFF Research Database (Denmark)

    Thyssen, Jacob Pontoppidan; Jakobsen, Stig Storgaard; Engkilde, Kåre

    2009-01-01

    BACKGROUND AND PURPOSE: It has been speculated that the prevalence of metal allergy may be higher in patients with implant failure. We compared the prevalence and cause of revisions following total hip arthroplasty (THA) in dermatitis patients suspected to have contact allergy and in patients...... in general with THA. Furthermore, we compared the prevalence of metal allergy in dermatitis patients with and without THA. MATERIALS AND METHODS: The Danish Hip Arthroplasty Registry (DHAR) contained detailed information on 90,697 operations. The Gentofte patch-test database contained test results...... was similar in cases (12%) and in patients from the DHAR (13%). The prevalence of metal allergy was similar in cases and controls. However, the prevalence of metal allergy was lower in cases who were patch-tested after operation (6%) than in those who were patch-tested before operation (16%) (OR = 2.9; 95% CI...

  12. Recovery in mechanical muscle strength following resurfacing vs standard total hip arthroplasty - a randomised clinical trial

    DEFF Research Database (Denmark)

    Jensen, Carsten; Aagaard, Per; Overgaard, S

    2011-01-01

    rather than implant design per se. Thus, the present data failed to support the hypothesis that R-THA would result in an enhanced strength rehabilitation compared to S-THA. Further, between-limb asymmetry remained present for hip flexors and adductors after 52 wks. Trial registration: NCT01229293....... randomised into (A) standard total hip arthroplasty (S-THA) and (B) resurfacing total hip arthroplasty (R-THA). Pre-surgery assessment and follow-up were conducted (8, 26 and 52 wks). Maximal isometric muscle strength (Nm) and between-limb asymmetry for the knee extensors/flexors, hip adductors....../abductors, hip extensors/flexors were analysed. RESULTS: Maximal knee extensor and hip abductor strength were higher in S-THA than R-THA at 52 wks post-surgery (P ≤ 0.05) and hip extensors tended to be higher in S-THA at 52 wks (P = 0.06). All muscle groups showed substantial between-limb strength asymmetry (7...

  13. Fully porous 3D printed titanium femoral stem to reduce stress-shielding following total hip arthroplasty.

    Science.gov (United States)

    Arabnejad, Sajad; Johnston, Burnett; Tanzer, Michael; Pasini, Damiano

    2017-08-01

    Current hip replacement femoral implants are made of fully solid materials which all have stiffness considerably higher than that of bone. This mechanical mismatch can cause significant bone resorption secondary to stress shielding, which can lead to serious complications such as peri-prosthetic fracture during or after revision surgery. In this work, a high strength fully porous material with tunable mechanical properties is introduced for use in hip replacement design. The implant macro geometry is based off of a short stem taper-wedge implant compatible with minimally invasive hip replacement surgery. The implant micro-architecture is fine-tuned to locally mimic bone tissue properties which results in minimum bone resorption secondary to stress shielding. We present a systematic approach for the design of a 3D printed fully porous hip implant that encompasses the whole activity spectrum of implant development, from concept generation, multiscale mechanics of porous materials, material architecture tailoring, to additive manufacturing, and performance assessment via in vitro experiments in composite femurs. We show that the fully porous implant with an optimized material micro-structure can reduce the amount of bone loss secondary to stress shielding by 75% compared to a fully solid implant. This result also agrees with those of the in vitro quasi-physiological experimental model and the corresponding finite element model for both the optimized fully porous and fully solid implant. These studies demonstrate the merit and the potential of tuning material architecture to achieve a substantial reduction of bone resorption secondary to stress shielding. © 2016 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 35:1774-1783, 2017. © 2016 Orthopaedic Research Society. Published by Wiley Periodicals, Inc.

  14. In vitro performance of three combinations of spacers and pressurized metered dose inhalers for treatment in children

    DEFF Research Database (Denmark)

    Berg, E; Madsen, J; Bisgaard, H

    1998-01-01

    The performance of pressurized metered dose inhalers (pMDIs) and spacers in correct dose recommendations is important, but limited information on dose delivery and fine-particle dose from different combinations of spacers and pMDIs is available. In this study, three combinations of spacers and p...... and spacers, with the NebuChamber giving the highest dose, both as delivered dose and in droplets account for these differences....

  15. C-reactive protein, erythrocyte sedimentation rate and orthopedic implant infection.

    Directory of Open Access Journals (Sweden)

    Kerryl E Piper

    Full Text Available BACKGROUND: C-reactive protein (CRP and erythrocyte sedimentation rate (ESR have been shown to be useful for diagnosis of prosthetic hip and knee infection. Little information is available on CRP and ESR in patients undergoing revision or resection of shoulder arthroplasties or spine implants. METHODS/RESULTS: We analyzed preoperative CRP and ESR in 636 subjects who underwent knee (n=297, hip (n=221 or shoulder (n=64 arthroplasty, or spine implant (n=54 removal. A standardized definition of orthopedic implant-associated infection was applied. Receiver operating curve analysis was used to determine ideal cutoff values for differentiating infected from non-infected cases. ESR was significantly different in subjects with aseptic failure infection of knee (median 11 and 53.5 mm/h, respectively, p=<0.0001 and hip (median 11 and 30 mm/h, respectively, p=<0.0001 arthroplasties and spine implants (median 10 and 48.5 mm/h, respectively, p=0.0033, but not shoulder arthroplasties (median 10 and 9 mm/h, respectively, p=0.9883. Optimized ESR cutoffs for knee, hip and shoulder arthroplasties and spine implants were 19, 13, 26, and 45 mm/h, respectively. Using these cutoffs, sensitivity and specificity to detect infection were 89 and 74% for knee, 82 and 60% for hip, and 32 and 93% for shoulder arthroplasties, and 57 and 90% for spine implants. CRP was significantly different in subjects with aseptic failure and infection of knee (median 4 and 51 mg/l, respectively, p<0.0001, hip (median 3 and 18 mg/l, respectively, p<0.0001, and shoulder (median 3 and 10 mg/l, respectively, p=0.01 arthroplasties, and spine implants (median 3 and 20 mg/l, respectively, p=0.0011. Optimized CRP cutoffs for knee, hip, and shoulder arthroplasties, and spine implants were 14.5, 10.3, 7, and 4.6 mg/l, respectively. Using these cutoffs, sensitivity and specificity to detect infection were 79 and 88% for knee, 74 and 79% for hip, and 63 and 73% for shoulder arthroplasties, and 79 and

  16. The pelvis and hips

    International Nuclear Information System (INIS)

    Berquist, T.H.; Coventry, M.B.

    1985-01-01

    Radiographic evaluation of joint replacements requires close communication between the radiologist and referring physician. Routine films, radioisotope scans, and subtraction arthrography (including aspiration and injection of the pseudocapsule) may be indicated in different clinical situations. This paper summarizes the accuracy of these modalities. Most patients present with pain. One must exclude loosening, infection, and other problems. The arthrogram is most useful in defining anatomy and most causes of hip pain. Culture studies and diagnostic injections add to the versatility of subtraction arthrography and increase its accuracy. If plain films are negative, a Tc-99m scan can be obtained. If this is negative, loosening is unlikely. If pain persists or if the scan is positive, an arthrogram should be performed. Pain may be secondary to bursitis rather than loosening, and the arthrogram will assist in diagnosis and treatment. When films suggest loosening, arthrography is the procedure of choice to confirm the diagnosis and to exclude infection

  17. 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).

  18. Hip complications following chemoradiotherapy

    International Nuclear Information System (INIS)

    Jenkins, P.J.; Sebag Montefiore, D.J.; Arnott, S.J.

    1995-01-01

    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)

  19. 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....

  20. Numerical Simulation of Fatigue Crack Growth in Hip Implants

    Czech Academy of Sciences Publication Activity Database

    Colic, K.; Sedmak, A.; Grbovic, A.; Burzić, M.; Hloch, Sergej; Sedmak, S.

    2016-01-01

    Roč. 149, č. 149 (2016), s. 229-235 E-ISSN 1877-7058. [International Conference on Manufacturing Engineering and Materials, ICMEM 2016. Nový Smokovec, 06.06.2016-10.06.2016] R&D Projects: GA MŠk ED2.1.00/03.0082; GA MŠk(CZ) LO1406 Institutional support: RVO:68145535 Keywords : biomedical application design * extended finite element method (XFEM) * Ti-6Al-4V alloy * stress intensity factor (SIF) * fatigue crack growth Subject RIV: JQ - Machines ; Tools http://www.sciencedirect.com/science/article/pii/S1877705816311699

  1. Chronic infections in hip arthroplasties

    DEFF Research Database (Denmark)

    Lange, Jeppe; Troelsen, Anders; Thomsen, Reimar W

    2012-01-01

    Two-stage revision is regarded by many as the best treatment of chronic infection in hip arthroplasties. Some international reports, however, have advocated one-stage revision. No systematic review or meta-analysis has ever compared the risk of reinfection following one-stage and two-stage revisi......Two-stage revision is regarded by many as the best treatment of chronic infection in hip arthroplasties. Some international reports, however, have advocated one-stage revision. No systematic review or meta-analysis has ever compared the risk of reinfection following one-stage and two......-stage revisions for chronic infection in hip arthroplasties....

  2. 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.

  3. Primary total hip replacement versus hip resurfacing - hospital considerations.

    Science.gov (United States)

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

    2011-01-01

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

  4. Metallic Modular Taper Junctions in Total Hip Arthroplasty

    Directory of Open Access Journals (Sweden)

    Timothy McTighe

    2015-08-01

    Full Text Available The emergence of modularity in total hip arthroplasty (THA in the 1980s and 1990s was based on the fact that the benefit of these design features outweighed the risk. The use of metallic modular junctions presents a unique set of advantages and problems for use in THA. The advantages include improvement in fit and fill of the implant to bone, restoration of joint mechanics, reduced complications in revision surgery and reduction of costly inventory. However, the risks or concerns are a little harder to identify and deal with. Certainly corrosion, and fatigue failure are the two most prevalent concerns but now the specifics of fretting wear and corrosive wear increasing particulate debris and the potential biological response is having an impact on the design and potential longevity of the reconstructed hip. Material and designs are facing a shorter life expectancy than what was previously thought, mostly due to an increasing level of physical activity by the patient. Because there are no accurate laboratory test whereby the service life and performance of these implants can be predicted, early controlled clinical evaluations are necessary. Early publication of testing and clinical impressions should be encouraged in an attempt to reduce exposure to potential at risk patients, implants and material. The reduction and possible elimination of risks will require a balancing of all the variables requiring a multidisciplinary endeavor. This paper is designed to review the risk factors, and benefits of modular junctions in total hip arthroplasty (THA. Also some basic engineering principals that can reduce risk factors and improve functionality of modular junctions.

  5. Evaluation of spacer grid spring characteristics by means of physical tests and numerical simulation

    Energy Technology Data Exchange (ETDEWEB)

    Schettino, Carlos Frederico Mattos, E-mail: carlosschettino@inb.gov.br [Industrias Nucleares do Brasil (INB), Resende, RJ (Brazil)

    2017-11-01

    Among all fuel assemblies' components, the spacer grids play an important structural role during the energy generation process, mainly due for its primary functional requirement, that is, to provide fuel rod support. The present work aims to evaluate the spring characteristics of a specific spacer grid design used in a PWR fuel assembly type 16 x 16. These spring characteristics comprises the load versus deflection capability and its spring rate, which are very important, and also mandatory, to be correctly established in order to preclude spacer grid spring and fuel rod cladding fretting during operation, as well as prevent an excessive fuel rod buckling. This study includes physical tests and numerical simulation. The tests were performed on an adapted load cell mechanical device, using as a specimen a single strap of the spacer grid. Three numerical models were prepared using the Finite Element Method, with the support of the commercial code ANSYS. One model was built to validate the simulation according to the performed physical test, the others were built inserting a gradient of temperature (Beginning Of Life hot condition) and to evaluate the spacer grid spring characteristics in End Of Life condition. The obtained results from physical test and numerical model have shown a good agreement between them, therefore validating the simulation. The obtained results from numerical models make available information regarding the spacer grid design purpose, such as the behavior of the fuel rod cladding support during operation. Therewith, these evaluations could be useful to improve the spacer grid design. (author)

  6. System for measuring spacer pin pitch in a nuclear fuel assembly

    International Nuclear Information System (INIS)

    Isono, Kenji; Tateishi, Yoshinori; Mano, Tadashi.

    1975-01-01

    Object: To reduce the period for discriminating whether or not spacer pin pitch is satisfactory by simultaneously inserting a number of reference rods into a nuclear fuel assembly spacer ring element of a reactor and arranging them such that they can be simultaneously withdrawn to simplify the withdrawing operation. Structure: A spacer provided with a ring element which clamps a nuclear fuel element is supported on a spacer support with a rod secured to the support as a guide and is secured to the support by securing means. A vertically movable structure with a reference rod provided upright and thru-holes formed in two support plates provided in the same row as the spacer ring element is operated by a fluid pressure mechanism to simultaneously insert the reference rod into the spacer ring element. The reference rod is mounted in support plates via ball bearings such that it is slightly movable in the horizontal direction, and it is aligned with respect to the core of the ring element. The intercore distance of the reference rod is measured with the reference rod inserted in the ring element, thereby measuring the space pin pitch. From the results of measurement, discrimination as to whether the spacer is satisfactory or not is made. (Kamimura, M.)

  7. A Study on Cell Size of Irradiated Spacer Grid for PWR Fuel

    International Nuclear Information System (INIS)

    Jin, Y. G.; Kim, G. S.; Ryu, W. S. and others

    2014-01-01

    The spacer grids supporting the fuel rods absorb vibration impacts due to the reactor coolant flow, and grid spring force decreases under irradiation. This reduction of contact force might cause grid-to-rod fretting wear. The fretting failure of the fuel rod is one of the recent significant issues in the nuclear industry from an economical as well as a safety concern. Thus, it is important to understand the characteristics of cell spring behavior and the change in size of grid cells for an irradiated spacer grid. In the present study, the dimensional measurement of a spacer grid was conducted to investigate the cell size of an irradiated spacer grid in a hot cell at IMEF (Irradiated Materials Examination Facility) of KAERI. To evaluate the fretting wear performance of an irradiated spacer grid, hot cell tests were carried out at IMEF of KAERI. Hot cell examinations include dimensional measurements for the irradiated spacer grid. The change of cell sizes was dependent on the direction of the spacer grids, leading to significant gap variations. It was found that the change in size of the cell springs due to irradiation-induced stress relaxation and creep during the fuel residency in the reactor core affect the contact behavior between the fuel rod and the cell spring

  8. Antibiotic-impregnated articulating cement spacer for infected total knee arthroplasty

    Directory of Open Access Journals (Sweden)

    Parag Garg

    2011-01-01

    Full Text Available Background : Standard treatment of chronic infected total knee arthroplasty (TKA is a two-stage revision, the first step being placement of an antibiotic-impregnated cement spacer. Here we describe the results of a new technique (modification of the Goldstien′s technique for intraoperative manufacture of a customized articulating spacer at minimal cost and with relatively good conformity and longevity. Materials and Methods : Thirty-six infected knees underwent this procedure from June 2002 to May 2007. The technique consists of using the freshened femur and tibia interface as molds wrapped in a tin foil for manufacturing the two components of the spacer with antibiotic-impregnated methyl methycrylate cement. We used the spacer and the femoral component of the trial set of a TKA system to mold them to perfect articulation. We also reinforced the spacer with a K-wire scaffold to prevent fracture of the cement mantle in the last 21 cases. Results : All 36 knees showed excellent results in terms of infection control, mobility, and stability. There was significant improvement in the WOMAC and Knee Society Scores (20 and 39 points respectively. There were two fractures of the spacers in the initial 15 cases that did not have K-wire scaffolding but none in the last 21 that had reinforcement. Conclusion : This technique provides a more conforming spacer, with good range of motion and stability. The reinforcement helps in preventing the fracture of the cement mantle and is cost effective.

  9. Experimental investigation of turbulent flow through spacer grids in fuel rod bundles

    International Nuclear Information System (INIS)

    Caraghiaur, Diana; Anglart, Henryk; Frid, Wiktor

    2009-01-01

    This paper contains experimental data of pressure, velocity and turbulence intensity in a 24-rod fuel bundle with spacer grids. Detailed pressure measurements inside the spacer grid have been obtained by use of a sliding pressure-sensing rod. Laser Doppler Velocimetry technique was used to measure the local axial velocity and its fluctuating component upstream and downstream of the spacer grid in sub-channels with different blockage ratios. The measurements show a changing pattern in function of radial position in the cross-section of the fuel bundle. For sub-channels close to the box wall, the turbulence intensity suddenly increases just downstream of the spacer and then gradually decays. In inner sub-channels, however, the turbulence intensity downstream of the spacer decreases below its upstream value and then gradually increases until it reaches the maximum value at approximately two spacer heights. The present study reveals that spacer effects, such as local pressure distribution and turbulence intensity enhancement, not only depend exclusively on the local geometry details, but also on the location in the cross-section of the rod bundle.

  10. Experimental investigation of turbulent flow through spacer grids in fuel rod bundles

    Energy Technology Data Exchange (ETDEWEB)

    Caraghiaur, Diana [Royal Institute of Technology, Division of Nuclear Reactor Technology, Department of Physics, School of Engineering Sciences, AlbaNova University Center, SE-106 91 Stockholm (Sweden)], E-mail: dianac@kth.se; Anglart, Henryk [Royal Institute of Technology, Division of Nuclear Reactor Technology, Department of Physics, School of Engineering Sciences, AlbaNova University Center, SE-106 91 Stockholm (Sweden); Frid, Wiktor [Swedish Radiation Safety Authority, Reactor Technology and Structural Integrity, SE-171 16 Stockholm (Sweden)

    2009-10-15

    This paper contains experimental data of pressure, velocity and turbulence intensity in a 24-rod fuel bundle with spacer grids. Detailed pressure measurements inside the spacer grid have been obtained by use of a sliding pressure-sensing rod. Laser Doppler Velocimetry technique was used to measure the local axial velocity and its fluctuating component upstream and downstream of the spacer grid in sub-channels with different blockage ratios. The measurements show a changing pattern in function of radial position in the cross-section of the fuel bundle. For sub-channels close to the box wall, the turbulence intensity suddenly increases just downstream of the spacer and then gradually decays. In inner sub-channels, however, the turbulence intensity downstream of the spacer decreases below its upstream value and then gradually increases until it reaches the maximum value at approximately two spacer heights. The present study reveals that spacer effects, such as local pressure distribution and turbulence intensity enhancement, not only depend exclusively on the local geometry details, but also on the location in the cross-section of the rod bundle.

  11. Evaluation of spacer grid spring characteristics by means of physical tests and numerical simulation

    International Nuclear Information System (INIS)

    Schettino, Carlos Frederico Mattos

    2017-01-01

    Among all fuel assemblies' components, the spacer grids play an important structural role during the energy generation process, mainly due for its primary functional requirement, that is, to provide fuel rod support. The present work aims to evaluate the spring characteristics of a specific spacer grid design used in a PWR fuel assembly type 16 x 16. These spring characteristics comprises the load versus deflection capability and its spring rate, which are very important, and also mandatory, to be correctly established in order to preclude spacer grid spring and fuel rod cladding fretting during operation, as well as prevent an excessive fuel rod buckling. This study includes physical tests and numerical simulation. The tests were performed on an adapted load cell mechanical device, using as a specimen a single strap of the spacer grid. Three numerical models were prepared using the Finite Element Method, with the support of the commercial code ANSYS. One model was built to validate the simulation according to the performed physical test, the others were built inserting a gradient of temperature (Beginning Of Life hot condition) and to evaluate the spacer grid spring characteristics in End Of Life condition. The obtained results from physical test and numerical model have shown a good agreement between them, therefore validating the simulation. The obtained results from numerical models make available information regarding the spacer grid design purpose, such as the behavior of the fuel rod cladding support during operation. Therewith, these evaluations could be useful to improve the spacer grid design. (author)

  12. Characterization of feed channel spacer performance using geometries obtained by X-ray computed tomography

    KAUST Repository

    Haaksman, Viktor A.

    2016-09-09

    Spiral-wound membrane modules used in water treatment for water reuse and desalination make use of spacer meshes for keeping the membrane leaves apart and for enhancing the mass transfer. Computational fluid dynamics (CFD) has gained importance in the design of new spacers with optimized hydrodynamic characteristics, but this requires a precise description of the spacer geometry. This study developed a method to obtain accurate three-dimensional (3-D) geometry representations for any given spacer design from X-ray computed tomography (CT) scans. The method revealed that the filaments of industrial spacers have a highly variable cross-section size and shape, which impact the flow characteristics in the feed channel. The pressure drop and friction factors were calculated from numerical simulations on five commercially available feed spacers used in practice. Model solutions compared well to experimental data measured using a flow cell for average velocities up to 0.2 m/s, as used in industrial reverse osmosis and nanofiltration membrane operations. A newly-proposed spacer geometry with alternating strand thickness was tested, which was found to yield a lower pressure drop while being highly efficient in converting the pumping power into membrane shear. Numerical model solutions using CFD with geometries from CT scans were closer to measurements than those obtained using the traditional circular cross-section strand simplification, indicating that CT scans are very well suitable to approximate real feed spacer geometries. By providing detailed insight on the spacer filament shape, CT scans allow better quantification of local distribution of velocity and shear, possibly leading to more accurate estimations of fouling and concentration polarization. © 2016 Elsevier B.V.

  13. 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

  14. Detection of incorrect manufacturer labelling of hip components

    Energy Technology Data Exchange (ETDEWEB)

    Durand-Hill, Matthieu; Henckel, Johann; Skinner, John; Hart, Alister [University College London, Institute of Orthopaedics, London (United Kingdom); Burwell, Matthew [Royal United Hospital, Bath (United Kingdom)

    2017-01-15

    We describe the case of a 53-year-old man who underwent a left metal-on-metal hip resurfacing in 2015. Component size mismatch (CSM) was suspected because of the patient's immediate post-operative mechanical symptoms and high metal ion levels. Surgical notes indicated the appropriate combinations of implants were used. However, we detected a mismatch using computed tomography. Revision was performed and subsequent measurements of explanted components confirmed the mismatch. To our knowledge, this case is the first report of a CT method being used in a patient to pre-operatively identify CSM. (orig.)

  15. Dosimetric influence of hip prosthesis during radiotherapeutic treatment

    International Nuclear Information System (INIS)

    Gschwind, R.; Buffard, E.; Masset, H.; Makovicka, L.; David, C.; David, C.; Buffard, E.

    2008-01-01

    As the population become aged, many patients with hip prosthesis are treated for a pelvic cancer. The recommended ballistic must avoid to pass in the prosthesis, but sometimes it is inevitable. So it is essential to quantify with accuracy the dose modifications linked to the presence of metallic implant. The aim of this study is to analyze by Monte Carlo method these modifications in simple and complex models (anthropomorphic phantom) which take into account the geometry and the composition of the prosthesis and its coatings. Then, this methodology was used to study the behaviour of a treatment planning system in theses extreme conditions. (authors)

  16. Danish Hip Arthroscopy Registry (DHAR)

    DEFF Research Database (Denmark)

    Lund, Bent; Mygind-Klavsen, Bjarne; Grønbech Nielsen, Torsten

    2017-01-01

    The Danish Hip Arthroscopy Registry (DHAR) was initiated in January 2012 as a web-based prospective registry. The purpose of this study was to evaluate and report the first registry based outcome data of a national population with radiological and clinical femoroacetabular impingement (FAI......) undergoing hip arthroscopic treatment. Our primary hypothesis was that patients undergoing hip arthroscopy would improve significantly in pain, quality of life and sports related outcome measurements in Patient Related Outcome Measures (PROM). Peri-operative data and Patient Reported Outcome Measures (PROM......-5 D demonstrated improvement after 1 and 2 years from 0.66 pre-op to 0.78 at 2 years. HSAS improved significantly from 2.5 to 3.3. Pain score data demonstrated improvement in NRS-rest 39 to 17 and NRS Walk 49 to 22 at follow-up. We conclude that patients with FAI undergoing hip arthroscopy...

  17. APPLICATIONS OF SPACERS MADE WITH DOUBLE BAR RASCHEL MACHINE

    Directory of Open Access Journals (Sweden)

    DÍAZ-GARCÍA Pablo

    2016-05-01

    Full Text Available Nowadays, textile technologies develop to adapt their different techniques for creating new products for the different sectors of application every day. Particularly, warp knitted fabrics and warp-knitting technology have applications in all different groups of technical textiles. It could be the most applied technique, the most versatile technology to develop new textile products for the new textile market. Warp knitted fabrics play the most important role among the technical textile fabrics. This technology is used in different product groups such as mobile textiles (car seat covers, dashboard cover, industrial textiles (composites, medical textiles (anti-decubitus blankets, sports textiles and foundation garments (bra cups, pads for swimwear. This study presents some examples of the application of this technology in some markets Within the market of technical textile, medical textile has an increasing relevance and knitted fabrics and knitting technology, at the same time, play a very important role in the fields of technical and medical textiles. Studies have demonstrated that knitted structures possess excellent mechanical properties and can promote more effective regenerative medicine, tissue repair, ligament, tendon cartilage, reconstruction, etc. The aim of this paper is to present different possibilities of textiles developed with this kind of structures, to present different alternatives, different examples of products obtained with this kind of textile structure combined with the correct kind of textile fiber. In this kind of technology, double-bar Raschel machines used for producing three-dimensional textiles, spacers, play an important role.

  18. Mortality Following Periprosthetic Proximal Femoral Fractures Versus Native Hip Fractures.

    Science.gov (United States)

    Boylan, Matthew R; Riesgo, Aldo M; Paulino, Carl B; Slover, James D; Zuckerman, Joseph D; Egol, Kenneth A

    2018-04-04

    The number of periprosthetic proximal femoral fractures is expected to increase with the increasing prevalence of hip arthroplasties. While native hip fractures have a well-known association with mortality, there are currently limited data on this outcome among the subset of patients with periprosthetic proximal femoral fractures. Using the New York Statewide Planning and Research Cooperative System, we identified patients from 60 to 99 years old who were admitted to a hospital in the state with a periprosthetic proximal femoral fracture (n = 1,655) or a native hip (femoral neck or intertrochanteric) fracture (n = 97,231) between 2006 and 2014. Within the periprosthetic fracture cohort, the indication for the existing implant was not available in the data set. We used mixed-effects regression models to compare mortality at 1 and 6 months and 1 year for periprosthetic compared with native hip fractures. The risk of mortality for patients who sustained a periprosthetic proximal femoral fracture was no different from that for patients who sustained a native hip fracture at 1 month after injury (3.2% versus 4.6%; odds ratio [OR], 0.90; 95% confidence interval [CI], 0.68 to 1.19; p = 0.446), but was lower at 6 months (3.8% versus 6.5%; OR, 0.74; 95% CI, 0.57 to 0.95; p = 0.020) and 1 year (9.7% versus 15.9%; OR, 0.71; 95% CI, 0.60 to 0.85; p accounting for age and comorbidities. Prognostic Level III. See Instructions for Authors for a complete description of levels of evidence.

  19. Lifestyle and health-related quality of life in Asian patients with total hip arthroplasties.

    Science.gov (United States)

    Fujita, Kimie; Xia, Zhenlan; Liu, Xueqin; Mawatari, Masaaki; Makimoto, Kiyoko

    2014-09-01

    Total hip arthroplasty reduces pain and restores physical function in patients with hip joint problems. This study examined lifestyle and health-related quality of life before and after total hip arthroplasty in Japanese and Chinese patients. Two hospitals in China recruited 120 patients and 120 Japanese patients matched by age and operative status were drawn from a prospective cohort database. Oxford Hip Score, EuroQol, and characteristics of Asian lifestyle and attitudes toward the operation were assessed. There were no differences between patients from the two countries in quality-of-life-scale scores: postoperative patients had significantly better quality-of-life scores than preoperative patients in both countries. In China, patients who reported that living at home was inconvenient had significantly worse Oxford Hip Scores than those who did not. Mean scores for anxiety items concerning possible dislocation and durability of the implant were significantly higher in Japanese than in Chinese subjects. Our findings suggest that providing information about housing conditions and lifestyles would result in improved quality of life and reduced anxiety in patients with implanted joints. © 2014 Wiley Publishing Asia Pty Ltd.

  20. BIOMECHANICAL JUSTIFICATION OF THE THREADED ELEMENT’S FORM OF THE TOTAL HIP ENDOPROSTHESIS’ ACETABULAR COMPONENT

    Directory of Open Access Journals (Sweden)

    PANCHENKO S. P.

    2017-03-01

    Full Text Available Abstract. Formulation of the problem. Total hip replacement (THR remains to be responsible for the markable clinical achievements of contemporal orthopaedic surgery [1; 2; 4]. It should be noted, that numerous efforts to create an “ideal” uncemented hip endoprosthesis’ construction were failed, but led into wide diversity of implants. Such a diversity allowes to individualize implant type selection and to improve implant’s survival and total THR’s clinical outcomes [1; 4]. Outcomes mentioned above determine successful application of total hip replacement as a treatment method. Consequently, development of new and improvement of existing hip endoprosthesis’ constructions seems to be of current interest for contemporal orthopaedic surgery. Purpose. To determine optimal parametres of threaded element’s geometry of total hip endoprosthesis’ threaded acetabular component. Conclusion. There were revealed that threaded element model with right-angled triangle transverse section shape seems to be the most effective considering hardness, while the triangle is leaned on the bone massive with its cathetus. At the same time, results of calculations represent pelvic bone stress-strain state during THR quantitavely and stipulate further research.

  1. Imaging of the hip

    International Nuclear Information System (INIS)

    Karantanas, A.

    2012-01-01

    Full text: Standard radiographs represent the basic tool of hip joint imaging. For detailed analysis of abnormalities related to bone marrow, articular cartilage, labrum and periarticular soft tissues, MRI has become the method of choice. MR arthrography is superior to standard MRI with regard to depicting the intra-articular abnormalities. CT is supporting plain radiographs for accurate depiction of subtle bone details. Ultrasound is commonly used in postoperative hematoma, bursitis, initial diagnosis of cysts and solid soft tissue tumors as well as for image guided injections and biopsies. Bone scintigraphy is suitable for the mapping of multifocal disease, such as osseous metastatic deposits. PET and PET/CT may be able to differentiate malignant neoplasm and infection from other abnormalities. A common disorder often requested for evaluation, is osteoarthritis. MRI is able to depict early degenerative changes which are occult on plain radiographs. CT- or MR arthrography provide a better evaluation of these changes but should only be performed in cases in which conservative surgery is considered to offer a significant clinical improvement for the patient. These cases include cam type femoroacetabular impingement and traumatic chondrolysis. MRI is an imaging technique that allows direct visualization of the bone marrow. Marrow disorders of the hip may induce a variety of imaging findings and frequently are not detected by conventional radiographic techniques until they have reached an advanced clinical stage. The excellent spatial and contrast resolution provided by MRI facilitates early detection and evaluation of various disorders allowing thus prompt treatment. Imaging findings may alter or guide the correct treatment. In addition, the association of marrow changes and pain such as in osteonecrosis and osteoarthritis is clinically relevant. For imaging the bone marrow, we use a combination of pulse sequences, including T1-w spin echo, PD/T2-w turbo spin echo

  2. Total hip arthroplasty at the rothman institute.

    Science.gov (United States)

    Austin, Matthew S; Higuera, Carlos A; Rothman, Richard H

    2012-07-01

    Total hip arthroplasty (THA) is one of the most successful surgical interventions devised in modern times. Attempts to change the current THA procedure with unproven innovations bring the risk of increased failure rates while trying to improve the benefit of the surgery. This manuscript examines the evolution of THA at the Rothman Institute illustrating the key elements that lead the success of this procedure at this institution. These key elements include femoral stem design, use of highly crossed-linked polyethylene and use of pain and rehabilitation protocols. We attempted to describe the long-term results regarding safety, effectiveness, and durability of specific THA implant designs used at this institution drawing on reported evidence in the literature. The authors performed a review of peer-reviewed articles related to the Rothman Institute's experience with THA. Total hip arthroplasty is an efficient, safe, and durable procedure. It is a highly successful operation to restore function and improve pain. The survivorship of THA procedures at the Rothman Institute is higher than 99% at 10 years based on mechanical failure. The use of collarless, tapered wedge femoral stem, highly crossed-linked polyethylene, and improved pain rehabilitation protocols have contributed to this success. There is a well-documented long-term survivorship after THA. Future innovation in THA should address new challenges with younger and more demanding patients, rather than change current methods that have a proven good survivorship. This innovation depends mainly upon improvements in the bearing surfaces and advances in pain control and rehabilitation.

  3. Do "premium" joint implants add value?: analysis of high cost joint implants in a community registry.

    Science.gov (United States)

    Gioe, Terence J; Sharma, Amit; Tatman, Penny; Mehle, Susan

    2011-01-01

    Numerous joint implant options of varying cost are available to the surgeon, but it is unclear whether more costly implants add value in terms of function or longevity. We evaluated registry survival of higher-cost "premium" knee and hip components compared to lower-priced standard components. Premium TKA components were defined as mobile-bearing designs, high-flexion designs, oxidized-zirconium designs, those including moderately crosslinked polyethylene inserts, or some combination. Premium THAs included ceramic-on-ceramic, metal-on-metal, and ceramic-on-highly crosslinked polyethylene designs. We compared 3462 standard TKAs to 2806 premium TKAs and 868 standard THAs to 1311 premium THAs using standard statistical methods. The cost of the premium implants was on average approximately $1000 higher than the standard implants. There was no difference in the cumulative revision rate at 7-8 years between premium and standard TKAs or THAs. In this time frame, premium implants did not demonstrate better survival than standard implants. Revision indications for TKA did not differ, and infection and instability remained contributors. Longer followup is necessary to demonstrate whether premium implants add value in younger patient groups. Level III, therapeutic study. See Guidelines for Authors for a complete description of levels of evidence.

  4. Hip morphology predicts posterior hip impingement in a cadaveric model.

    Science.gov (United States)

    Morris, William Z; Fowers, Cody A; Weinberg, Douglas S; Millis, Michael B; Tu, Leigh-Anne; Liu, Raymond W

    2018-05-01

    Posterior hip impingement is a recently-identified cause of hip pain. The purpose of this study is to characterise posterior femoroacetabular and ischiofemoral impingement and identify its predisposing morphologic traits. Two hundred and six cadaveric hips were randomly selected and taken through controlled motion in two pure axes associated with posterior hip impingement: external rotation (through the mechanical axis) and adduction (coronal plane). The range of motion and location of impingement was noted for each specimen. Morphologic traits including femoral/acetabular version, and true neck-shaft angle (TNSA) were also measured. External rotation impingement occurred between the femoral neck and acetabulum in 83.0% of hips, and between the lesser trochanter and ischial tuberosity in 17.0%. Adduction impingement occurred between the lesser trochanter and ischial tuberosity in 78.6% of hips, and between the femoral neck and acetabulum in 21.4%. Multiple regression revealed that increased femoral/acetabular version predicted earlier external rotation and adduction impingement. Unstandardised betas ranging from -0.39 to -0.64 reflect that each degree of increased femoral/acetabular version individually accounts for a loss of external rotation or adduction of approximately half a degree before impingement ( p < 0.001 for each). Increased TNSA was associated with earlier adduction impingement only (unstandardised beta -0.35, p = 0.005). Relative femoral/acetabular anteversion was associated with earlier posterior hip impingement. Coxa valga was associated with earlier adduction impingement, but protective against external rotation impingement. These findings highlight the importance of monitoring correction during femoral/acetabular osteotomies, as overcorrection of retroversion may predispose to earlier posterior impingement.

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

    DEFF Research Database (Denmark)

    Heitmann, B L; Lissner, L

    2011-01-01

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

  6. Effects of grid spacer with mixing vane on entrainments and depositions in two-phase annular flows

    Directory of Open Access Journals (Sweden)

    Akimaro Kawahara

    2015-06-01

    Full Text Available The effects of mixing vanes (MVs attached to a grid spacer on the characteristics of air–water annular flows were experimentally investigated. To know the effects, a grid spacer with or without MV was inserted in a vertical circular pipe of 16-mm internal diameter. For three cases (i.e., no spacer, spacer without MV, and spacer with MV, the liquid film thickness, liquid entrainment fraction, and deposition rate were measured by the constant current method, single liquid film extraction method, and double liquid film extraction method, respectively. The MVs significantly promote the re-deposition of liquid droplets in the gas core flow into the liquid film on the channel walls. The deposition mass transfer coefficient is three times higher for the spacer with MV than for the spacer without MV, even for cases 0.3-m downstream from the spacer. The liquid film thickness becomes thicker upstream and downstream for the spacer with MV, compared with the thickness for the spacer without MV and for the case with no spacer.

  7. Short Implants: New Horizon in Implant Dentistry.

    Science.gov (United States)

    Jain, Neha; Gulati, Manisha; Garg, Meenu; Pathak, Chetan

    2016-09-01

    The choice of implant length is an essential factor in deciding the survival rates of these implants and the overall success of the prosthesis. Placing an implant in the posterior part of the maxilla and mandible has always been very critical due to poor bone quality and quantity. Long implants can be placed in association with complex surgical procedures such as sinus lift and bone augmentation. These techniques are associated with higher cost, increased treatment time and greater morbidity. Hence, there is need for a less invasive treatment option in areas of poor bone quantity and quality. Data related to survival rates of short implants, their design and prosthetic considerations has been compiled and structured in this manuscript with emphasis on the indications, advantages of short implants and critical biomechanical factors to be taken into consideration when choosing to place them. Studies have shown that comparable success rates can be achieved with short implants as those with long implants by decreasing the lateral forces to the prosthesis, eliminating cantilevers, increasing implant surface area and improving implant to abutment connection. Short implants can be considered as an effective treatment alternative in resorbed ridges. Short implants can be considered as a viable treatment option in atrophic ridge cases in order to avoid complex surgical procedures required to place long implants. With improvement in the implant surface geometry and surface texture, there is an increase in the bone implant contact area which provides a good primary stability during osseo-integration.

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

    OpenAIRE

    M Erceg; K Becic

    2014-01-01

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

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

    Directory of Open Access Journals (Sweden)

    M Erceg

    2014-01-01

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

  10. Tribology considerations for hip joint articulations in relation to the "new orthopaedic patient".

    Science.gov (United States)

    Rieker, C B

    2006-01-01

    The purpose of this review is to examine alternative bearings used in total hip arthroplasty (THA) and discuss the specific tribologic needs of the "New Orthopaedic Patient". As orthopaedic patients today are younger and more active, there is a clear need for hip joint implants and articulations minimising the amount of wear and guarantying better stability. Recent modern developments in tribology with highly cross-linked polyethylenes and hard-on-hard bearings allow the safe and effective use of larger diameter articulations in THA.

  11. Magnetic resonance imaging features of complications following hip replacement: A pictorial review

    Directory of Open Access Journals (Sweden)

    Khushboo Pilania

    2016-01-01

    Full Text Available Hip replacement surgery helps millions of people worldwide walk painlessly each year. With increasing life spans and decreased clinical threshold for surgery, this number will continue to rise. With the increase in the number of surgeries and the longevity of implants, the need for early and prompt diagnosis of complications is also rising. This essay underlines the fact that magnetic resonance imaging on a 1.5T scanner with specialized metal artefact reduction sequences is a viable technique to image the post-arthroplasty hip and has vast potential in the prompt and early diagnosis of complications in these patients.

  12. Magnetic resonance imaging features of complications following hip replacement: A pictorial review

    International Nuclear Information System (INIS)

    Pilania, Khushboo; Jankharia, Bhavin

    2016-01-01

    Hip replacement surgery helps millions of people worldwide walk painlessly each year. With increasing life spans and decreased clinical threshold for surgery, this number will continue to rise. With the increase in the number of surgeries and the longevity of implants, the need for early and prompt diagnosis of complications is also rising. This essay underlines the fact that magnetic resonance imaging on a 1.5T scanner with specialized metal artefact reduction sequences is a viable technique to image the post-arthroplasty hip and has vast potential in the prompt and early diagnosis of complications in these patients

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

    Science.gov (United States)

    Erceg, M; Becic, K

    2014-01-01

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

  14. A simulation methodology of spacer grid residual spring deflection for predictive and interpretative purposes

    International Nuclear Information System (INIS)

    Kim, K. T.; Kim, H. K.; Yoon, K. H.

    1994-01-01

    The in-reactor fuel rod support conditions against the fretting wear-induced damage can be evaluated by spacer grid residual spring deflection. In order to predict the spacer grid residual spring deflection as a function of burnup for various spring designs, a simulation methodology of spacer grid residual spring deflection has been developed and implemented in the GRIDFORCE program. The simulation methodology takes into account cladding creep rate, initial spring deflection, initial spring force, and spring force relaxation rate as the key parameters affecting the residual spring deflection. The simulation methodology developed in this study can be utilized as an effective tool in evaluating the capability of a newly designed spacer grid spring to prevent the fretting wear-induced damage

  15. The independent loss model with ordered insertions for the evolution of CRISPR spacers.

    Science.gov (United States)

    Baumdicker, F; Huebner, A M I; Pfaffelhuber, P

    2018-02-01

    Today, the CRISPR (clustered regularly interspaced short palindromic repeats) region within bacterial and archaeal genomes is known to encode an adaptive immune system. We rely on previous results on the evolution of the CRISPR arrays, which led to the ordered independent loss model, introduced by Kupczok and Bollback (2013). When focusing on the spacers (between the repeats), new elements enter a CRISPR array at rate θ at the leader end of the array, while all spacers present are lost at rate ρ along the phylogeny relating the sample. Within this model, we compute the distribution of distances of spacers which are present in all arrays in a sample of size n. We use these results to estimate the loss rate ρ from spacer array data for n=2 and n=3. Copyright © 2017 Elsevier Inc. All rights reserved.

  16. Biofouling patterns in spacer filled channels: High resolution imaging for characterization of heterogeneous biofilms

    KAUST Repository

    Staal, Marc; Siddiqui, Amber; van Loosdrecht, Mark; Vrouwenvelder, Johannes S.

    2017-01-01

    reverse osmosis (RO) and nanofiltration (NF) membrane filtration systems used for desalination and wastewater reuse to produce high quality (drinking) water. These spiral wound membrane modules contain mesh-like spacer structures used to create

  17. A Facile Technique to Make Articulating Spacers for Infected Total Knee Arthroplasty

    Directory of Open Access Journals (Sweden)

    Yu-Ping Su

    2009-03-01

    Conclusion: Treating infected total knee arthroplasty with these self-made articulating spacers eradicates infection effectively, improves the life quality before reimplantation and provides good final results without significant complications.

  18. Reentrainment of droplet from grid spacer in mist flow portion of LOCA reflood of PWR

    International Nuclear Information System (INIS)

    Lee, S.L.; Cho, S.K.; Sheen, H.J.

    1983-01-01

    An investigation is made on the influence of a quenched grid spacer on the greatly enhanced heat transfer from heated fuel rods during the mist flow phase of emergency reflood of loss of coolant accident (LOCA) of a pressurized water reactor (PWR). The situation for the case of a dry grid spacer before its quenching has not been covered in this study. The experimental technique used is a relatively simple optical scheme which combines the reference-mode laser-Doppler anemometry making use of the scattering of a light beam from a droplet. The results reveal that the large droplets in the mist flow, which are intercepted by the grid spacer, are responsible for the creation of a large number of smaller droplets. These small droplets, due to their large surface area to mass ratios, can serve as superb evaporative cooling agents to heat transfer downstream of the grid spacer

  19. Non linear fe analysis on the static buckling behavior of the spacer grid structures

    International Nuclear Information System (INIS)

    Song, K.N.; Yoon, K.H.

    2001-01-01

    In this study considered is the static buckling behavior of spacer grids in the fuel assembly, which are required to have a sufficient strength against an accident like earthquake. Special attention is given to the finite element modeling of the spot-welding and the constraints between the spacer strips assembled together: it is found that a proper treatment of the constraints is critical for accurate assessment of the buckling behavior including strain localization at the point of spot welding. The buckling strength of the 17 x 17 spacer grid, which is difficult to analyze due to a large number of degrees of freedom, is estimated from analysis for the smaller models 3 x 3, 5 x 5, 7 x 7, and 9 x 9 spacer grids. (authors)

  20. Spacer geometry and particle deposition in spiral wound membrane feed channels

    KAUST Repository

    Radu, A.I.

    2014-11-01

    Deposition of microspheres mimicking bacterial cells was studied experimentally and with a numerical model in feed spacer membrane channels, as used in spiral wound nanofiltration (NF) and reverse osmosis (RO) membrane systems. In-situ microscopic observations in membrane fouling simulators revealed formation of specific particle deposition patterns for different diamond and ladder feed spacer orientations. A three-dimensional numerical model combining fluid flow with a Lagrangian approach for particle trajectory calculations could describe very well the in-situ observations on particle deposition in flow cells. Feed spacer geometry, positioning and cross-flow velocity sensitively influenced the particle transport and deposition patterns. The deposition patterns were not influenced by permeate production. This combined experimental-modeling approach could be used for feed spacer geometry optimization studies for reduced (bio)fouling. © 2014 Elsevier Ltd.

  1. Computer-Aided Design Method of Warp-Knitted Jacquard Spacer Fabrics

    Directory of Open Access Journals (Sweden)

    Li Xinxin

    2016-06-01

    Full Text Available Based on a further study on knitting and jacquard principles, this paper presents a mathematical design model to make computer-aided design of warp-knitted jacquard spacer fabrics more efficient. The mathematical model with matrix method employs three essential elements of chain notation, threading and Jacquard designing. With this model, the processing to design warp-knitted jacquard spacer fabrics with CAD software is also introduced. In this study, the sports shoes which have separated functional areas according to the feet structure and characteristics of movement are analysed. The results show the different patterns on Jacquard spacer fabrics that are seamlessly stitched with jacquard technics. The computer-aided design method of warp-knitted jacquard spacer fabrics is efficient and simple.

  2. Spacer geometry and particle deposition in spiral wound membrane feed channels

    KAUST Repository

    Radu, A.I.; van Steen, M.S.H.; Vrouwenvelder, Johannes S.; van Loosdrecht, Mark C.M.; Picioreanu, C.

    2014-01-01

    Deposition of microspheres mimicking bacterial cells was studied experimentally and with a numerical model in feed spacer membrane channels, as used in spiral wound nanofiltration (NF) and reverse osmosis (RO) membrane systems. In-situ microscopic

  3. CRISPR Spacer Arrays for Detection of Viral Signatures from Acidic Hot Springs

    Science.gov (United States)

    Snyder, J. C.; Bateson, M. M.; Suciu, D.; Young, M. J.

    2010-04-01

    Viruses are the most abundant life-like entities on the planet Earth. Using CRISPR spacer sequences, we have developed a microarray-based approach to detecting viral signatures in the acidic hot springs of Yellowstone.

  4. Suppression of subthreshold characteristics variation for junctionless multigate transistors using high-k spacers

    International Nuclear Information System (INIS)

    Lou, Haijun; Zhang, Baili; Li, Dan; Lin, Xinnan; He, Jin; Chan, Mansun

    2015-01-01

    In this work, the high-k spacer is proposed to suppress the subthreshold characteristics variation of junctionless multigate transistor (JMT) with non-ideal sidewall angle for the first time. It is demonstrated that the variation of subthreshold characteristics induced by the changing sidewall angle is efficiently suppressed by high-k spacers due to the enhanced corner effect through the fringe capacitance, and the electrostatic integrity of JMTs is also improved at sub-22 nm gate length. Two key parameters of high-k spacer, the thickness and length, have been optimized in terms of the suppression of subthreshold characteristics variation. Then their optimal values are proposed. The benefit of high-k spacer makes JMTs more scalable. (paper)

  5. Effect of plastic spacer handling on salbutamol lung deposition in asthmatic children

    DEFF Research Database (Denmark)

    Lipworth, Brian J; Lee, Daniel K C; Anhøj, Jacob

    2002-01-01

    AIMS: To study the effects of electrostatics in a plastic spacer on the lung deposition of salbutamol in asthmatic children. METHODS: Twenty-five children (5-12 years) with mild asthma were given salbutamol hydrofluoroalkane pressurized metered dose inhaler 400 micro g via a 750 ml plastic spacer...... on separate days. Blood samples were taken for plasma salbutamol at 5, 10, 15 and 20 min after inhalation to measure lung bioavailability as a surrogate for relative lung dose. With immediate inhalation following actuation, a new rinsed spacer (NewRinsed ) was compared with a used spacer after repeated daily...... log transformed and expressed as geometric mean fold difference for the average plasma salbutamol concentration (Cav) over 20 min. RESULTS: There were significant differences (P NewRinsed 1.92 fold (95% CI 1.15, 3...

  6. Impact of a Protective Vest and Spacer Garment on Exercise-Heat Strain

    National Research Council Canada - National Science Library

    Cheuvront, Samuel N; Goodman, Daniel A; Kenefick, Robert W; Montain, Scott J; Sawka, Michael N

    2008-01-01

    ...). Volunteers wore the US Army battle dress uniform (trial B), B + protective vest (trial P), and B + P + spacer garment (trial S). Biophysical clothing properties were determined and found similar to many law enforcement, industry, and sports ensembles...

  7. A study on the characteristics of the spacer spring by finite element method

    Energy Technology Data Exchange (ETDEWEB)

    Park, Sung Keun; Kim, Hyung Kyu; Kim, Kyu Tae [Korea Atomic Energy Research Institute, Taejon (Korea, Republic of)

    1995-06-01

    The mechanical integrity of spacer springs in KOFA was certified through the mechanical tests by KWU. In this report, the spacer spring characteristics were obtained by using a commercial FEM code ANSYS, and the calculated results were compared with the mechanical test results. It has been found that the analytical results from ANSYS were in good agreement with the test results in the actual working range of the spacer springs even though some errors occurred in the range of initial spring deflection. The errors were thought to occur due to the simplified boundary conditions and the nominal dimensions which are used in calculations rather than the as-fabricated dimensions. Though the results from ANSYS are not fully satisfied, the analytical method in this report has been verified to be used as a method for investigating the characteristic of spacer springs roughly before conducting mechanical tests. 8 tabs., 25 figs (Author) .new.

  8. Femoral component loosening after hip resurfacing arthroplasty

    International Nuclear Information System (INIS)

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

    2010-01-01

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

  9. Allogenic bone graft viability after hip revision arthroplasty assessed by dynamic [18F]fluoride ion positron emission tomography

    International Nuclear Information System (INIS)

    Piert, M.; Becker, H.D.; Winter, E.; Becker, G.A.; Bilger, K.; Machulla, H.J.; Mueller-Schauenburg, W.; Bares, R.

    1999-01-01

    The biological fate of allogenic bone grafts in the acetabular cavity and their metabolic activity after acetabular augmentation is uncertain but is most important for the stability of hip implants after hip revision arthroplasty. The aim of this study was to quantify regional bone metabolism after hip replacement operations. Dynamic [ 18 F]fluoride ion positron emission tomography (PET) was used to investigate the metabolic activity of acetabular allogenic bone grafts and genuine bone, either 3-6 weeks (short-term group, n = 9) or 5 months to 9 years (long-term group, n = 10) after hip revision arthroplasty. Applying a three-compartment model, the fluoride influx constant was calculated from individually fitted rate constants (K nlf ) and by Patlak graphical analysis (K pat ). The results were compared with genuine cancellous and cortical acetabular bone of contralateral hips without surgical trauma (n = 7). In genuine cortical bone, K nlf was significantly increased in short- (+140.9%) and long-term (+100.0%) groups compared with contralateral hips. Allogenic bone grafts were characterised by a significantly increased K nlf in the short-term group (+190.9%) compared with contralateral hips, but decreased almost to the baseline levels of contralateral hips (+45.5%) in the long-term. Values of K nlf cor-related with the rate constant K 1 in genuine (r = 0.89, P pat values were highly correlated with K nlf measurements in all regions. (orig.)

  10. Biofouling patterns in spacer filled channels: High resolution imaging for characterization of heterogeneous biofilms

    KAUST Repository

    Staal, Marc

    2017-08-15

    Biofilms develop in heterogeneous patterns at a µm scale up to a cm scale, and patterns become more pronounced when biofilms develop under complex hydrodynamic flow regimes. Spatially heterogeneous biofilms are especially known in spiral wound reverse osmosis (RO) and nanofiltration (NF) membrane filtration systems used for desalination and wastewater reuse to produce high quality (drinking) water. These spiral wound membrane modules contain mesh-like spacer structures used to create an intermembrane space and improve water mixing. Spacers create inhomogeneous water flow patterns resulting in zones favouring biofilm growth, possibly leading to biofouling thus hampering water production. Oxygen sensing planar optodes were used to visualize variations in oxygen decrease rates (ODR). ODR is an indication of biofilm activity. In this study, ODR images of multiple repetitive spacer areas in a membrane fouling simulator were averaged to produce high resolution, low noise ODR images. Averaging 40 individual spacer areas improved the ODR distribution image significantly and allowed comparison of biofilm patterning over a spacer structure at different positions in an RO filter. This method clearly showed that most active biofilm accumulated on and in direct vicinity of the spacer. The averaging method was also used to calculate the deviation of ODR patterning from individual spacer areas to the average ODR pattern, proposing a new approach to determine biofilm spatial heterogeneity. This study showed that the averaging method can be applied and that the improved, averaged ODR images can be used as an analytical, in-situ, non-destructive method to assess and quantify the effect of membrane installation operational parameters or different spacer geometries on biofilm development in spiral wound membrane systems characterized by complex hydrodynamic conditions.

  11. Feasibility Study of Interactive Game Technologies to Improve Experience with Inhaler Spacer Devices in Young Children

    OpenAIRE

    Aslam, Tariq; Shakir, Savana; Murray, Clare

    2016-01-01

    IntroductionThe correct use of inhaler devices with facemasks and spacers in young children can be difficult for both children and parents, resulting in distress for both, poor adherence and ineffective drug delivery. The aim of this study was to develop and assess the utility and impact of an interactive electronic game designed to improve the experience of spacer devices in young asthmatic children.MethodsThe Respiratory Aid For Inhaler (RAFIhaler) technology consists of a smartphone mounte...

  12. Technology of electron beam welding for Zr-4 alloy spacer grid

    International Nuclear Information System (INIS)

    Pei Qiusheng; Wu Xueyi; Yang Qishun

    1989-10-01

    The welding technology for Zr-4 alloy spacer grid by using vacuum electron beam was studied. Through a series of welding technological experiments, metallographic examinations of seam structure and detecting tests for welding defect by X-ray defectoscopy, a good welding technology was selected to meet the requirements. The experimental results indicated that the Zr-4 alloy spacer grid welded by vacuum electron beam welding is feasible

  13. Osteochondritis Dissecans of the Hip

    International Nuclear Information System (INIS)

    Linden, B.; Jonsson, K.; Redlund-Johnell, I.

    2003-01-01

    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

  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. Implantation, recoil implantation, and sputtering

    International Nuclear Information System (INIS)

    Kelly, R.

    1984-01-01

    Underlying ion-beam modification of surfaces is the more basic subject of particle-surface interaction. The ideas can be grouped into forward and backward features, i.e. those affecting the interior of the target and those leading to particle expulsion. Forward effects include the stopping of the incident particles and the deposition of energy, both governed by integral equations which are easily set up but difficult to solve. Closely related is recoil implantation where emphasis is placed not on the stopping of the incident particles but on their interaction with target atoms with resulting implantation of these atoms. Backward effects, all of which are denoted as sputtering, are in general either of collisional, thermal, electronic, or exfoliational origin. (Auth.)

  16. 5 X 5 rod bundle flow field measurements downstream a PWR spacer grid

    Energy Technology Data Exchange (ETDEWEB)

    Castro, Higor F.P.; Silva, Vitor V A.; Santos, André A.C.; Veloso, Maria A.F., E-mail: higorfabiano@gmail.com, E-mail: mdora@nuclear.ufmg.br, E-mail: vitors@cdtn.br, E-mail: aacs@cdtn.br [Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, MG (Brazil); Centro de Desenvolvimento da Tecnologia Nuclear (CDTN/CNEN-MG), Belo Horizonte, MG (Brazil)

    2017-07-01

    The spacer grids are structures present in nuclear fuel assembly of Pressurized Water Reactors (PWR). They play an important structural role and also assist in heat removal through the assembly by promoting increased turbulence of the flow. Understanding the flow dynamics downstream the spacer grid is paramount for fuel element design and analysis. This paper presents water flow velocity profiles measurements downstream a spacer grid in a 5 x 5 rod bundle test rig with the objective of highlighting important fluid dynamic behavior near the grid and supplying data for CFD simulation validation. These velocity profiles were obtained at two different heights downstream the spacer grid using a LDV (Laser Doppler Velocimetry) through the top of test rig. The turbulence intensities and patterns of the swirl and cross flow were evaluated. The tests were conducted for Reynolds numbers ranging from 1.8 x 10{sup 4} to 5.4 x 10{sup 4}. This experimental research was carried out in thermo-hydraulics laboratory of Nuclear Technology Development Center – CDTN. Results show great repeatability and low uncertainties (< 1.24 %). Details of the flow field show how the mixture and turbulence induced by the spacer grid quickly decays downstream the spacer grid. It is shown that the developed methodology can supply high resolution low uncertainty results that can be used for validation of CFD simulations. (author)

  17. 5 X 5 rod bundle flow field measurements downstream a PWR spacer grid

    International Nuclear Information System (INIS)

    Castro, Higor F.P.; Silva, Vitor V A.; Santos, André A.C.; Veloso, Maria A.F.

    2017-01-01

    The spacer grids are structures present in nuclear fuel assembly of Pressurized Water Reactors (PWR). They play an important structural role and also assist in heat removal through the assembly by promoting increased turbulence of the flow. Understanding the flow dynamics downstream the spacer grid is paramount for fuel element design and analysis. This paper presents water flow velocity profiles measurements downstream a spacer grid in a 5 x 5 rod bundle test rig with the objective of highlighting important fluid dynamic behavior near the grid and supplying data for CFD simulation validation. These velocity profiles were obtained at two different heights downstream the spacer grid using a LDV (Laser Doppler Velocimetry) through the top of test rig. The turbulence intensities and patterns of the swirl and cross flow were evaluated. The tests were conducted for Reynolds numbers ranging from 1.8 x 10"4 to 5.4 x 10"4. This experimental research was carried out in thermo-hydraulics laboratory of Nuclear Technology Development Center – CDTN. Results show great repeatability and low uncertainties (< 1.24 %). Details of the flow field show how the mixture and turbulence induced by the spacer grid quickly decays downstream the spacer grid. It is shown that the developed methodology can supply high resolution low uncertainty results that can be used for validation of CFD simulations. (author)

  18. A study on improvement of analytical prediction model for spacer grid pressure loss coefficients

    International Nuclear Information System (INIS)

    Lim, Jonh Seon

    2002-02-01

    Nuclear fuel assemblies used in the nuclear power plants consist of the nuclear fuel rods, the control rod guide tubes, an instrument guide tube, spacer grids,a bottom nozzle, a top nozzle. The spacer grid is the most important component of the fuel assembly components for thermal hydraulic and mechanical design and analyses. The spacer grids fixed with the guide tubes support the fuel rods and have the very important role to activate thermal energy transfer by the coolant mixing caused to the turbulent flow and crossflow in the subchannels. In this paper, the analytical spacer grid pressure loss prediction model has been studied and improved by considering the test section wall to spacer grid gap pressure loss independently and applying the appropriate friction drag coefficient to predict pressure loss more accurately at the low Reynolds number region. The improved analytical model has been verified based on the hydraulic pressure drop test results for the spacer grids of three types with 5x5, 16x16, 17x17 arrays, respectively. The pressure loss coefficients predicted by the improved analytical model are coincident with those test results within ±12%. This result shows that the improved analytical model can be used for research and design change of the nuclear fuel assembly

  19. Numerical simulation of bubble motion about a grid spacer in a rod bundle

    International Nuclear Information System (INIS)

    Zhang, Zheng; Hosokawa, Shigeo; Hayashi, Kosuke; Tomiyama, Akio

    2009-01-01

    Numerical simulations based on a three-dimensional two-way bubble tracking method are carried out to predict bubble motions in a square duct with an obstacle and in a two-by-three rod bundle with a grid spacer. Comparisons between measured and predicted bubble motions demonstrate that the two-way bubble tracking method gives good predictions for trajectories of small bubbles in the upstream side of the grid spacer in the rod bundle geometry. The predicted bubble trajectories clearly show that bubbles are apt to migrate toward the rod surface in the vicinity of the bottom of the grid spacer. Analysis of forces acting on the bubbles confirms that pressure gradient force induced by the presence of the spacer is the main cause of the bubble lateral migration toward the rod surface. Motions of steam bubbles at a nominal operating condition of a pressurized water reactor (PWR) are also predicted by using the bubble tracking method, which indicates that steam bubbles also migrate toward the rod surface at the upstream side of the spacer due to the spacer-induced pressure gradient force. (author)

  20. Manipulation of recombination zone by utilizing the donor of electroplex as a spacer

    Energy Technology Data Exchange (ETDEWEB)

    Lü, Zhaoyue, E-mail: lvzhaoyue@ecust.edu.cn [Department of Physics, School of Science, East China University of Science & Technology, Shanghai 200237 (China); Yin, Yuehong [Department of Applied Physics, Institute of Physical Chemistry, Henan Polytechnic University, Jiaozuo, Henan Province 454000 (China); Xiao, Jing [Physics and Electronic Engineering College, Taishan University, Shandong Province 271021,China (China)

    2016-11-15

    The emission of electroplex is varied with applied voltages, leading to poor color stability of devices. In this work, the recombination region was investigated in organic light-emitting diodes (OLEDs) based on the electroplex between N,N’-diphenyl-N,N’-bis(1-naphthyl-phenyl)-1,1′-biphenyl-4,4′-diamine(NPB) and 2-(4-biphenylyl)-5-(4-tert-butylphenyl)-1,2,4-oxadiazole (PBD). Color stability was manipulated by introducing the donor of electroplex as a spacer, which plays an important role of recombination zone for electroplex-based OLEDs. The 5-nm-spacer-device brought out a tolerable chromaticity coordinate shift of less than 0.01 for both x- and y-value. White light emission with CIE coordinates of (0.37,0.28) and (0.33,0.26) at 12 V was achieved when the thickness of spacer was 7 and 10 nm, respectively. The 7-nm-spacer-device exhibited better color stability than the 10-nm-spacer-device. This proves that adjusting spacer thickness is a simple and efficient method to control recombination region and can be useful for fulfilling color-stable electroplex-based white emission.

  1. Manipulation of recombination zone by utilizing the donor of electroplex as a spacer

    International Nuclear Information System (INIS)

    Lü, Zhaoyue; Yin, Yuehong; Xiao, Jing

    2016-01-01

    The emission of electroplex is varied with applied voltages, leading to poor color stability of devices. In this work, the recombination region was investigated in organic light-emitting diodes (OLEDs) based on the electroplex between N,N’-diphenyl-N,N’-bis(1-naphthyl-phenyl)-1,1′-biphenyl-4,4′-diamine(NPB) and 2-(4-biphenylyl)-5-(4-tert-butylphenyl)-1,2,4-oxadiazole (PBD). Color stability was manipulated by introducing the donor of electroplex as a spacer, which plays an important role of recombination zone for electroplex-based OLEDs. The 5-nm-spacer-device brought out a tolerable chromaticity coordinate shift of less than 0.01 for both x- and y-value. White light emission with CIE coordinates of (0.37,0.28) and (0.33,0.26) at 12 V was achieved when the thickness of spacer was 7 and 10 nm, respectively. The 7-nm-spacer-device exhibited better color stability than the 10-nm-spacer-device. This proves that adjusting spacer thickness is a simple and efficient method to control recombination region and can be useful for fulfilling color-stable electroplex-based white emission.

  2. BWR fuel assembly having fuel rod spacers axially positioned by exterior springs

    International Nuclear Information System (INIS)

    Taleyarkhan, R.P.

    1988-01-01

    In a fuel assembly having spaced fuel rods, an outer hollow tubular flow channel surrounding the fuel rods so as to direct flow of coolant/moderator fluid there-along, and at least one spacer being disposed along the channel and about the fuel rods so as to maintain them in side-by-side spaced relationship, an arrangement for disposing the spacer in a desired axial position along the fuel rods is described comprising: yieldably resilient springs disposed between an interior side of the outer channel and an exterior side of the spacer. The springs have an inherent spring bias directed away from the exterior sides of the spacers and toward the interior side of the channel such that by contact with the channel and spacer the springs assume states in which they are deflected away from the channel interior side so as to exert sufficient compressive contacting force thereon to maintain the spacer substantially stationary in the desired axial position along the fuel rods

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

    Science.gov (United States)

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

    2015-03-04

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

  4. How accurate is image-free computer navigation for hip resurfacing arthroplasty? An anatomical investigation

    International Nuclear Information System (INIS)

    Schnurr, C.; Nessler, J.; Koenig, D.P.; Meyer, C.; Schild, H.H.; Koebke, J.

    2009-01-01

    The existing studies concerning image-free navigated implantation of hip resurfacing arthroplasty are based on analysis of the accuracy of conventional biplane radiography. Studies have shown that these measurements in biplane radiography are imprecise and that precision is improved by use of three-dimensional (3D) computer tomography (CT) scans. To date, the accuracy of image-free navigation devices for hip resurfacing has not been investigated using CT scans, and anteversion accuracy has not been assessed at all. Furthermore, no study has tested the reliability of the navigation software concerning the automatically calculated implant position. The purpose of our study was to analyze the accuracy of varus-valgus and anteversion using an image-free hip resurfacing navigation device. The reliability of the software-calculated implant position was also determined. A total of 32 femoral hip resurfacing components were implanted on embalmed human femurs using an image-free navigation device. In all, 16 prostheses were implanted with the proposed position generated by the navigation software; the 16 prostheses were inserted in an optimized valgus position. A 3D CT scan was undertaken before and after operation. The difference between the measured and planned varus-valgus angle averaged 1 deg (mean±standard deviation (SD): group I, 1 deg±2 deg; group II, 1 deg±1 deg). The mean±SD difference between femoral neck anteversion and anteversion of the implant was 4 deg (group I, 4 deg±4 deg; group II, 4 deg±3 deg). The software-calculated implant position differed 7 deg±8 deg from the measured neck-shaft angle. These measured accuracies did not differ significantly between the two groups. Our study proved the high accuracy of the navigation device concerning the most important biomechanical factor: the varus-valgus angle. The software calculation of the proposed implant position has been shown to be inaccurate and needs improvement. Hence, manual adjustment of the

  5. In-situ electrochemical study of interaction of tribology and corrosion in artificial hip prosthesis simulators.

    Science.gov (United States)

    Yan, Yu; Dowson, Duncan; Neville, Anne

    2013-02-01

    The second generation Metal-on-Metal (MoM) hip replacements have been considered as an alternative to commonly used Polyethylene-on-Metal (PoM) joint prostheses due to polyethylene wear debris induced osteolysis. However, the role of corrosion and the biofilm formed under tribological contact are still not fully understood. Enhanced metal ion concentrations have been reported widely from hair, blood and urine samples of patients who received metal hip replacements and in isolated cases when abnormally high levels have caused adverse local tissue reactions. An understanding of the origin of metal ions is really important in order to design alloys for reduced ion release. Reciprocating pin-on-plate wear tester is a standard instrument to assess the interaction of corrosion and wear. However, more realistic hip simulator can provide a better understanding of tribocorrosion process for hip implants. It is very important to instrument the conventional hip simulator to enable electrochemical measurements. In this study, simple reciprocating pin-on-plate wear tests and hip simulator tests were compared. It was found that metal ions originated from two sources: (a) a depassivation of the contacting surfaces due to tribology (rubbing) and (b) corrosion of nano-sized wear particles generated from the contacting surfaces. Copyright © 2012 Elsevier Ltd. All rights reserved.

  6. Hip resurfacing arthroplasty in treatment of avascular necrosis of the femoral head.

    Science.gov (United States)

    Pyda, Michał; Koczy, Bogdan; Widuchowski, Wojciech; Widuchowska, Małgorzata; Stołtny, Tomasz; Mielnik, Michał; Hermanson, Jacek

    2015-01-25

    Hip resurfacing is a conservative type of total hip arthroplasty but its use is controversial, especially in patients with osteonecrosis. The aim of this study was analysis of the clinical and radiographic outcomes of hip resurfacing in patients with osteonecrosis. Between 2007 and 2008, 30 hip resurfacing arthroplasties were performed due to osteoarthritis secondary to avascular necrosis of femoral head staged as Ficat III and IV. Patients were qualified to resurfacing arthroplasty when the extent of avascular necrosis using Kerboul's method was avascular necrosis and head-neck junction was >20°. All patients were evaluated clinically and radiologically before and 60 months after the operation. The mean Harris Hip Score (HHS) score increased from 47.8 to 94.25 (p<0.05). Physical activity level (University of California, Los Angeles activity score--UCLA activity score) improved from 3.7 to 7.55 (p<0.05). No implant migration was observed. Management of osteonecrosis of the hip with resurfacing arthroplasty seems to be effective in strictly-selected patients.

  7. Emerging topics on the hip: Ligamentum teres and hip microinstability

    International Nuclear Information System (INIS)

    Cerezal, Luis; Arnaiz, Javier; Canga, Ana; Piedra, Tatiana; Altónaga, José R.; Munafo, Ricardo; Pérez-Carro, Luis

    2012-01-01

    Microinstability and ligament teres lesions are emergent topics on the hip pathology. These entities are an increasingly recognized cause of persistent hip pain and should be considered in the differential diagnosis of the patient with hip pain. Conventional (non-arthrographic) CT and MR have a very limited role in the evaluation of these entities. CTa and MRa have emerged as the modalities of choice for pre-operative imaging of ligamentum teres injuries and microinstability. To date, pre-operative imaging detection of these pathologies is not widespread but with appropriate imaging and a high index of suspicion, preoperative detection should improve. This article discusses current concepts regarding anatomy, biomechanics, clinical findings, diagnosis and treatment of ligament teres lesions and microinstability.

  8. [Ceramic-on-ceramic bearings in total hip arthroplasty (THA)].

    Science.gov (United States)

    Sentürk, U; Perka, C

    2015-04-01

    The main reason for total hip arthroplasty (THA) revision is the wear-related aseptic loosening. Younger and active patients after total joint replacement create high demands, in particular, on the bearings. The progress, especially for alumina ceramic-on-ceramic bearings and mixed ceramics have solved many problems of the past and lead to good in vitro results. Modern ceramics (alumina or mixed ceramics containing alumina) are extremely hard, scratch-resistant, biocompatible, offer a low coefficient of friction, superior lubrication and have the lowest wear rates in comparison to all other bearings in THA. The disadvantage of ceramic is the risk of material failure, i.e., of ceramic fracture. The new generation of mixed ceramics (delta ceramic), has reduced the risk of head fractures to 0.03-0.05 %, but the risk for liner fractures remains unchanged at about 0.02 %. Assuming a non-impinging component implantation, ceramic-on-ceramic bearings have substantial advantages over all other bearings in THA. Due to the superior hardness, ceramic bearings produce less third body wear and are virtually impervious to damage from instruments during the implantation process. A specific complication for ceramic-on-ceramic bearings is "squeaking". The high rate of reported squeaking (0.45 to 10.7 %) highlights the importance of precise implant positioning and the stem and patient selection. With precise implant positioning this problem is rare with many implant designs and without clinical relevance. The improved tribology and the presumable resulting implant longevity make ceramic-on-ceramic the bearing of choice for young and active patients. Georg Thieme Verlag KG Stuttgart · New York.

  9. Brief concept of hip preservation

    Directory of Open Access Journals (Sweden)

    Sanjeev S. Madan

    2017-12-01

    Full Text Available Restoration of the anatomy of the hip joint and biomechanics across it, carry the immense importance to prevent future osteoarthritis of the joint. The aim of this review is to provide the brief concept of the methods to preserve the hip, especially in young adults. Attempts to preserve the hips start with the intense preoperative planning of the corrective procedure. Different parameters regarding the femur and acetabulum in all 3 dimensions need to be assessed. Especially, measurement of the anteversion of the femur and acetabulum is a significant step to avoid osteoarthritis. In addition, the suprapelvic and infrapelvic (spine and lower limb lengths alignment needs to be considered in the planning. Correction of the femoral side of the hip needs the understanding of the blood supply of the proximal femur which carries the risk of avascular necrosis more so with intracapsular osteotomies. Acetabular reorientation, to re-distribute the forces over the weight bearing part, can be carried out with re-directional osteotomy such as periacetabular osteotomy. It needs the understanding of the acetabular anatomy and the force distribution in it. To conclude, correction of both femoral and acetabular side parameters need to be considered in decision making depending on the alterations due to various etiologies causing the hip disorders.

  10. Traumatic hip dislocations in children

    International Nuclear Information System (INIS)

    Minhas, M.S.

    2010-01-01

    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

  11. Current and future biocompatibility aspects of biomaterials for hip prosthesis

    Directory of Open Access Journals (Sweden)

    Amit Aherwar

    2015-12-01

    Full Text Available The field of biomaterials has turn into an electrifying area because these materials improve the quality and longevity of human life. The first and foremost necessity for the selection of the biomaterial is the acceptability by human body. However, the materials used in hip implants are designed to sustain the load bearing function of human bones for the start of the patient’s life. The most common classes of biomaterials used are metals, polymers, ceramics, composites and apatite. These five classes are used individually or in combination with other materials to form most of the implantation devices in recent years. Numerous current and promising new biomaterials i.e. metallic, ceramic, polymeric and composite are discussed to highlight their merits and their frailties in terms of mechanical and metallurgical properties in this review. It is concluded that current materials have their confines and there is a need for more refined multi-functional materials to be developed in order to match the biocompatibility, metallurgical and mechanical complexity of the hip prosthesis.

  12. Effect of component design in retrieved bipolar hip hemiarthroplasty systems.

    Science.gov (United States)

    Hess, Matthew D; Baker, Erin A; Salisbury, Meagan R; Kaplan, Lige M; Greene, Ryan T; Greene, Perry W

    2013-09-01

    Primary articulation of bipolar hemiarthroplasty systems is at the femoral head-liner interface. The purpose of this study was to compare observed damage modes on 36 retrieved bipolar systems with implant, demographic, intraoperative, and radiographic data to elucidate the effects of component design, specifically locking mechanism, on clinical performance. Retrieved bipolar hip hemiarthroplasty systems of 3 different design types were obtained, disassembled, and evaluated macro- and microscopically for varying modes of wear, including abrasion, burnishing, embedding, scratching, and pitting. Clinical record review and radiographic analysis were performed by a senior orthopedic surgery resident. Average bipolar hip hemiarthroplasty system term of service was 46 months (range, 0.27-187 months). All devices contained wear debris captured within the articulating space between the femoral head and liner. In 31% of patients without infection, lucency was observed on immediate prerevision radiographs. The system with a leaf locking mechanism showed significantly increased radiographically observed osteolysis (P=.03) compared with a system with a stopper ring locking mechanism. In addition, implant design and observed damage modes, including pitting and third-body particle embedding, were significantly associated with radiographically observed osteolysis. Copyright 2013, SLACK Incorporated.

  13. Dental Implant Surgery

    Science.gov (United States)

    ... here to find out more. Dental Implant Surgery Dental Implant Surgery Dental implant surgery is, of course, ... to find out more. Wisdom Teeth Management Wisdom Teeth Management An impacted wisdom tooth can damage neighboring ...

  14. Time spans and spacers : Molecular phylogenetic explorations in the Cladophora complex (Chlorophyta) from the perspective of rDNA gene and spacer sequences

    NARCIS (Netherlands)

    Bakker, Frederik Theodoor

    1995-01-01

    In this study, phylogenetic relationships among genera, species and biogeographic representatives of single Cladophora species within the Cladophorales were analyzed using rDNA gene and spacer sequences. Based on phylogenetic analysis of 18S rRNA gene sequences, the Cladophora complex is shown to be

  15. Cochlear Implant

    Directory of Open Access Journals (Sweden)

    Mehrnaz Karimi

    1992-04-01

    Full Text Available People with profound hearing loss are not able to use some kinds of conventional amplifiers due to the nature of their loss . In these people, hearing sense is stimulated only when the auditory nerve is activated via electrical stimulation. This stimulation is possible through cochlear implant. In fact, for the deaf people who have good mental health and can not use surgical and medical treatment and also can not benefit from air and bone conduction hearing aids, this device is used if they have normal central auditory system. The basic parts of the device included: Microphone, speech processor, transmitter, stimulator and receiver, and electrode array.

  16. Predicting the impact of feed spacer modification on biofouling by hydraulic characterization and biofouling studies in membrane fouling simulators

    KAUST Repository

    Siddiqui, Amber

    2016-12-22

    Feed spacers are an essential part of spiral-wound reverse osmosis (RO) and nanofiltration (NF) membrane modules. Geometric modification of feed spacers is a potential option to reduce the impact of biofouling on the performance of membrane systems. The objective of this study was to evaluate the biofouling potential of two commercially available reference feed spacers and four modified feed spacers. The spacers were compared on hydraulic characterization and in biofouling studies with membrane fouling simulators (MFSs). The virgin feed spacer was characterized hydraulically by their resistance, measured in terms of feed channel pressure drop, performed by operating MFSs at varying feed water flow rates. Short-term (9 days) biofouling studies were carried out with nutrient dosage to the MFS feed water to accelerate the biofouling rate. Long-term (96 days) biofouling studies were done without nutrient dosage to the MFS feed water. Feed channel pressure drop was monitored and accumulation of active biomass was quantified by adenosine tri phosphate (ATP) determination. The six feed spacers were ranked on pressure drop (hydraulic characterization) and on biofouling impact (biofouling studies). Significantly different trends in hydraulic resistance and biofouling impact for the six feed spacers were observed. The same ranking for biofouling impact on the feed spacers was found for the (i) short-term biofouling study with nutrient dosage and the (ii) long-term biofouling study without nutrient dosage. The ranking for hydraulic resistance for six virgin feed spacers differed significantly from the ranking of the biofouling impact, indicating that hydraulic resistance of clean feed spacers does not predict the hydraulic resistance of biofouled feed spacers. Better geometric design of feed spacers can be a suitable approach to minimize impact of biofouling in spiral wound membrane systems.

  17. 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.

  18. MRI of the hip joint

    International Nuclear Information System (INIS)

    Czerny, C.; Noebauer-Huhmann, I.M.; Imhof, H.

    2005-01-01

    Magnetic resonance imaging (MRI) is performed to diagnose many pathologic conditions affecting the hip joint. Either conventional MRI (without contrast enhancement of the joint cavity) or MR arthrography is used to detect and most accurately differentiate hip joint pathologies. Conventional MRI is performed in cases of bone marrow edema, necrosis, arthrosis and especially the so-called ''activated arthrosis'', as well as in inflammatory and tumorous entities. MR arthography, which has only recently become available for use, is excellently suited for diagnosing lesions of the acetabular labrum, cartilage lesions, and free articular bodies. This article provides an overview about MRI characteristics and their accuracy of hip joint diseases and the impact on the therapeutic procedure. (orig.)

  19. Risks of hip and knee replacement

    Science.gov (United States)

    ... is normal to lose blood during and after hip or knee replacement surgery. Some people need a ... clot form are higher during and soon after hip or knee replacement surgery. Sitting or lying down ...

  20. Functional Recovery Following Pertrochanteric Hip Fractures Fixated with the Dynamic Hip Screw vs. the Percutaneous Compression Plate

    Directory of Open Access Journals (Sweden)

    Yocheved Laufer

    2005-01-01

    Full Text Available The Dynamic Hip Screw (DHS is currently the most frequently used implant for the treatment of pertrochanteric hip fractures. The Percutaneous Compression Plate (PCCP is a recently developed, alternative device that involves minimal invasive surgery. The objective of the present study was to compare functional recovery following these two surgical procedures. A total of 76 consecutive elderly subjects (mean age and standard deviation, 80.6 ± 5.5 following pertrochanteric hip fracture fixation were evaluated prospectively. Functional recovery was assessed 3 and 12 weeks and 2 years following surgery. Differences between groups 3 weeks postsurgery were found only in pain level during ambulation and in the weight-bearing capability of the operated extremity, which were both in favor of the PCCP. By 3 months, both groups had improved in all measures, but did not reach their preinjury level of independence. However, the PCCP group ambulated with fewer assistive devices and demonstrated better recovery of basic activities of daily living (BADL. While the majority of the subjects from both groups ambulated independently 2 years postsurgery, the PCCP group exhibited less pain during ambulation, was more independent in ADL, and required fewer assistive devices for ambulation. To summarize, the PCCP presents enhanced short- and long-term recovery of functional abilities in comparison to DHS. However, given the limited number of patients, further studies are necessary to substantiate these results.

  1. Exercise therapy may postpone total hip replacement surgery in patients with hip osteoarthritis

    DEFF Research Database (Denmark)

    Svege, Ida; Nordsletten, Lars; Fernandes, Linda

    2015-01-01

    Exercise treatment is recommended for all patients with hip osteoarthritis (OA), but its effect on the long-term need for total hip replacement (THR) is unknown.......Exercise treatment is recommended for all patients with hip osteoarthritis (OA), but its effect on the long-term need for total hip replacement (THR) is unknown....

  2. Process optimized minimally invasive total hip replacement

    Directory of Open Access Journals (Sweden)

    Philipp Gebel

    2012-02-01

    Full Text Available The purpose of this study was to analyse a new concept of using the the minimally invasive direct anterior approach (DAA in total hip replacement (THR in combination with the leg positioner (Rotex- Table and a modified retractor system (Condor. We evaluated retrospectively the first 100 primary THR operated with the new concept between 2009 and 2010, regarding operation data, radiological and clinical outcome (HOOS. All surgeries were perfomed in a standardized operation technique including navigation. The average age of the patients was 68 years (37 to 92 years, with a mean BMI of 26.5 (17 to 43. The mean time of surgery was 80 min. (55 to 130 min. The blood loss showed an average of 511.5 mL (200 to 1000 mL. No intra-operative complications occurred. The postoperative complication rate was 6%. The HOOS increased from 43 points pre-operatively to 90 (max 100 points 3 months after surgery. The radiological analysis showed an average cup inclination of 43° and a leg length discrepancy in a range of +/- 5 mm in 99%. The presented technique led to excellent clinic results, showed low complication rates and allowed correct implant positions although manpower was saved.

  3. Cobalt-alloy implant debris induce HIF-1α hypoxia associated responses: a mechanism for metal-specific orthopedic implant failure.

    Directory of Open Access Journals (Sweden)

    Lauryn Samelko

    Full Text Available The historical success of orthopedic implants has been recently tempered by unexpected pathologies and early failures of some types of Cobalt-Chromium-Molybdenum alloy containing artificial hip implants. Hypoxia-associated responses to Cobalt-alloy metal debris were suspected as mediating this untoward reactivity at least in part. Hypoxia Inducible Factor-1α is a major transcription factor involved in hypoxia, and is a potent coping mechanism for cells to rapidly respond to changing metabolic demands. We measured signature hypoxia associated responses (i.e. HIF-1α, VEGF and TNF-α to Cobalt-alloy implant debris both in vitro (using a human THP-1 macrophage cell line and primary human monocytes/macrophages and in vivo. HIF-1α in peri-implant tissues of failed metal-on-metal implants were compared to similar tissues from people with metal-on-polymer hip arthroplasties, immunohistochemically. Increasing concentrations of cobalt ions significantly up-regulated HIF-1α with a maximal response at 0.3 mM. Cobalt-alloy particles (1 um-diameter, 10 particles/cell induced significantly elevated HIF-1α, VEGF, TNF-α and ROS expression in human primary macrophages whereas Titanium-alloy particles did not. Elevated expression of HIF-1α was found in peri-implant tissues and synovial fluid of people with failing Metal-on-Metal hips (n = 5 compared to failed Metal-on-Polymer articulating hip arthroplasties (n = 10. This evidence suggests that Cobalt-alloy, more than other metal implant debris (e.g. Titanium alloy, can elicit hypoxia-like responses that if unchecked can lead to unusual peri-implant pathologies, such as lymphocyte infiltration, necrosis and excessive fibrous tissue growths.

  4. Complications after cardiac implantable electronic device implantations

    DEFF Research Database (Denmark)

    Kirkfeldt, Rikke Esberg; Johansen, Jens Brock; Nohr, Ellen Aagaard

    2013-01-01

    Complications after cardiac implantable electronic device (CIED) treatment, including permanent pacemakers (PMs), cardiac resynchronization therapy devices with defibrillators (CRT-Ds) or without (CRT-Ps), and implantable cardioverter defibrillators (ICDs), are associated with increased patient...

  5. Reverse hybrid total hip arthroplasty

    DEFF Research Database (Denmark)

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

    2017-01-01

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

  6. 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.

  7. Experimental investigations of turbulent flows in rod bundles with and without spacer grids

    International Nuclear Information System (INIS)

    Trippe, G.

    1979-07-01

    In the thermofluiddynamic design of liquid metal cooled reactor fuel elements the lack of experimentally confirmed knowledge of the three-dimensional flow events in rod bundles provided with spacer grids has appeared as a significant problem. To close this gap of knowledge, detailed measurements of the local velocities were made on a 19-rod bundle model. The Pitot method of differential pressure measurements was used as the measuring system. In the first part of the work the fully developed flow regime not influenced by spacers was investigated. A simple relation was derived for distributing the mass flow among the subchannels of a rod bundle; it is but slightly dependent on the Reynolds number. This relation allows a quick, coarse calculation of the distribution of the undisturbed, fully developed mass flow in bundles with similar geometries. By evaluation of further experiments known from the literature, empirical relationships were found for the local velocity distribution within the subchannels of such bundles. In the second part the effect of grid shaped spacers was investigated. The three-dimensional flow events caused by the spacers were completely recorded and interpreted physically. The deeper understanding of these flow processes can now serve to improve the model concept used in the present design computer programs. Single results of the investigations which take primary importance are the quantitative relations existing between the changes of mass flow in the bundle boundary zone, caused by a spacer, and the geometry of this spacer. The transferability to other bundle geometries was discussed and delimited. Moreover, it was shown that the mass flow in the bundle boundary zone can be successively reduced by spacers placed one behind the other in the bundle. A noticeable dependence of flow events on the Reynolds number was not found for the range relevant in practical application (30.000 [de

  8. A functional analysis of the spacer of V(DJ recombination signal sequences.

    Directory of Open Access Journals (Sweden)

    Alfred Ian Lee

    2003-10-01

    Full Text Available During lymphocyte development, V(DJ recombination assembles antigen receptor genes from component V, D, and J gene segments. These gene segments are flanked by a recombination signal sequence (RSS, which serves as the binding site for the recombination machinery. The murine Jbeta2.6 gene segment is a recombinationally inactive pseudogene, but examination of its RSS reveals no obvious reason for its failure to recombine. Mutagenesis of the Jbeta2.6 RSS demonstrates that the sequences of the heptamer, nonamer, and spacer are all important. Strikingly, changes solely in the spacer sequence can result in dramatic differences in the level of recombination. The subsequent analysis of a library of more than 4,000 spacer variants revealed that spacer residues of particular functional importance are correlated with their degree of conservation. Biochemical assays indicate distinct cooperation between the spacer and heptamer/nonamer along each step of the reaction pathway. The results suggest that the spacer serves not only to ensure the appropriate distance between the heptamer and nonamer but also regulates RSS activity by providing additional RAG:RSS interaction surfaces. We conclude that while RSSs are defined by a "digital" requirement for absolutely conserved nucleotides, the quality of RSS function is determined in an "analog" manner by numerous complex interactions between the RAG proteins and the less-well conserved nucleotides in the heptamer, the nonamer, and, importantly, the spacer. Those modulatory effects are accurately predicted by a new computational algorithm for "RSS information content." The interplay between such binary and multiplicative modes of interactions provides a general model for analyzing protein-DNA interactions in various biological systems.

  9. A functional analysis of the spacer of V(D)J recombination signal sequences.

    Science.gov (United States)

    Lee, Alfred Ian; Fugmann, Sebastian D; Cowell, Lindsay G; Ptaszek, Leon M; Kelsoe, Garnett; Schatz, David G

    2003-10-01

    During lymphocyte development, V(D)J recombination assembles antigen receptor genes from component V, D, and J gene segments. These gene segments are flanked by a recombination signal sequence (RSS), which serves as the binding site for the recombination machinery. The murine Jbeta2.6 gene segment is a recombinationally inactive pseudogene, but examination of its RSS reveals no obvious reason for its failure to recombine. Mutagenesis of the Jbeta2.6 RSS demonstrates that the sequences of the heptamer, nonamer, and spacer are all important. Strikingly, changes solely in the spacer sequence can result in dramatic differences in the level of recombination. The subsequent analysis of a library of more than 4,000 spacer variants revealed that spacer residues of particular functional importance are correlated with their degree of conservation. Biochemical assays indicate distinct cooperation between the spacer and heptamer/nonamer along each step of the reaction pathway. The results suggest that the spacer serves not only to ensure the appropriate distance between the heptamer and nonamer but also regulates RSS activity by providing additional RAG:RSS interaction surfaces. We conclude that while RSSs are defined by a "digital" requirement for absolutely conserved nucleotides, the quality of RSS function is determined in an "analog" manner by numerous complex interactions between the RAG proteins and the less-well conserved nucleotides in the heptamer, the nonamer, and, importantly, the spacer. Those modulatory effects are accurately predicted by a new computational algorithm for "RSS information content." The interplay between such binary and multiplicative modes of interactions provides a general model for analyzing protein-DNA interactions in various biological systems.

  10. Cobalt release from implants and consumer items and characteristics of cobalt sensitized patients with dermatitis

    DEFF Research Database (Denmark)

    Thyssen, Jacob Pontoppidan; Menne, Torkil; Liden, Carola

    2012-01-01

    -containing dental alloys and revised hip implant components.Results. Six of eight dental alloys and 10 of 98 revised hip implant components released cobalt in the cobalt spot test, whereas none of 50 mobile phones gave positive reactions. The clinical relevance of positive cobalt test reactions was difficult......-tested dermatitis patients in an attempt to better understand cobalt allergy.Materials and methods. 19 780 dermatitis patients aged 4-99 years were patch tested with nickel, chromium or cobalt between 1985 and 2010. The cobalt spot test was used to test for cobalt ion release from mobile phones as well as cobalt...

  11. Treatment of tuberculosis of the hip.

    African Journals Online (AJOL)

    The common presentation was a swollen hip, a limp, decreased range of hip movements, fixed flexion deformity and pain. Three patients had protrusio acetabuli and three had subluxed or dislocated hips. Twenty-three patients were anaemic and the erythrocyte sedimentation rate (ESR) was raised in all (mean. 6 5 d h r ...

  12. 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…

  13. 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'

  14. Integrity of the lateral femoral wall in intertrochanteric hip fractures: an important predictor of a reoperation

    DEFF Research Database (Denmark)

    Palm, Henrik; Jacobsen, Steffen; Sonne-Holm, Stig

    2007-01-01

    BACKGROUND: Reoperations after intertrochanteric fractures are often necessitated by fracture displacement following mobilization of the patient. The biomechanical complexity of the fracture, the position of the implant, and the patient's characteristics are known to influence postoperative outcome....... We investigated the importance of an intact lateral femoral wall as a factor in postoperative fracture displacement after fixation with a sliding compression hip screw. METHODS: Two hundred and fourteen consecutive patients with an intertrochanteric fracture were treated with a 135 degrees sliding...... compression hip screw with a four-hole side-plate between 2002 and 2004. The fractures were classified on preoperative radiographs according to the AO/OTA classification system. The status of the greater and lesser trochanters, the integrity of the lateral femoral wall, and the position of the implant were...

  15. 21 CFR 888.3390 - Hip joint femoral (hemi-hip) metal/polymer cemented or uncemented prosthesis.

    Science.gov (United States)

    2010-04-01

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

  16. 21 CFR 888.3380 - Hip joint femoral (hemi-hip) trunnion-bearing metal/polyacetal cemented prosthesis.

    Science.gov (United States)

    2010-04-01

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

  17. Knitting Technologies And Tensile Properties Of A Novel Curved Flat-Knitted Three-Dimensional Spacer Fabrics

    Directory of Open Access Journals (Sweden)

    Li Xiaoying

    2015-09-01

    Full Text Available This paper introduces a knitting technique for making innovative curved three-dimensional (3D spacer fabrics by the computer flat-knitting machine. During manufacturing, a number of reinforcement yarns made of aramid fibres are inserted into 3D spacer fabrics along the weft direction to enhance the fabric tensile properties. Curved, flat-knitted 3D spacer fabrics with different angles (in the warp direction were also developed. Tensile tests were carried out in the weft and warp directions for the two spacer fabrics (with and without reinforcement yarns, and their stress–strain curves were compared. The results showed that the reinforcement yarns can reduce the fabric deformation and improve tensile stress and dimensional stability of 3D spacer fabrics. This research can help the further study of 3D spacer fabric when applied to composites.

  18. Preliminary application of computer-assisted patient-specific acetabular navigational template for total hip arthroplasty in adult single development dysplasia of the hip.

    Science.gov (United States)

    Zhang, Yuan Z; Chen, Bin; Lu, Sheng; Yang, Yong; Zhao, Jian M; Liu, Rui; Li, Yan B; Pei, Guo X

    2011-12-01

    The considerable variation in anatomical abnormalities of hip joints associated with different types of developmental dysplasia of hip (DDH) makes reconstruction in total hip arthroplasty (THA) difficult. It is desirable to create patient-specific designs for THA procedures. In the cases of adult single DDH, an accuracy-improved method has been developed for acetabular cup prosthesis implantation of hip arthroplasty. From October 2007 to November 2008, 22 patients with single DDH (according to the Crowe standard, all dysplasia hips were classified as type I) were scanned with spiral CT pre-operatively. These patients scheduled for THA were randomly assigned to undergo either conventional THA (control group, n = 11) or navigation template implantation (NT group, n = 11). In the NT group, three-dimensional (3D) CT pelvis image data were transferred to a computer workstation and 3D models of the hip were reconstructed using the Mimics software. The 3D models were then processed by the Imageware software. In brief, a template that best fitted the location and shape of the acetabular cup was 'reversely' built from the 3D model, the rotation centre of the pathological hip determined by mirroring that of the healthy site, and a guiding hole in the template was then designed. The navigational templates were manufactured using a rapid prototyping machine. These navigation templates guide acetabular component placement. Based on the predetermined abduction angle 45° and anteversion angle 18°, after 1 year follow-up, the NT group showed significantly smaller differences (1.6° ± 0.4°, 1.9° ± 1.1°) from the predetermined angles than those in the control group (5.8° ± 2.9°, 3.9° ± 2.5°) (P < 0.05). The template designs facilitated accurate placement of acetabular components in dysplasia of acetabulum. The hip's center of rotation in DDH could be established using computer-aided design, which provides a useful method for the accurate

  19. Ion therapy of prostate cancer: daily rectal dose reduction by application of spacer gel

    International Nuclear Information System (INIS)

    Rucinski, Antoni; Brons, Stephan; Richter, Daniel; Habl, Gregor; Debus, Jürgen; Bert, Christoph; Haberer, Thomas; Jäkel, Oliver

    2015-01-01

    Ion beam therapy represents a promising approach to treat prostate cancer, mainly due to its high conformity and radiobiological effectiveness. However, the presence of prostate motion, patient positioning and range uncertainties may deteriorate target dose and increase exposure of organs at risk. Spacer gel injected between prostate and rectum may increase the safety of prostate cancer (PC) radiation therapy by separating the rectum from the target dose field. The dosimetric impact of the application of spacer gel for scanned carbon ion therapy of PC has been analyzed at Heidelberg Ion-Beam Therapy Center (HIT). The robustness of ion therapy treatment plans was investigated by comparison of two data sets of patients treated with and without spacer gel. A research treatment planning system for ion therapy was used for treatment plan optimization and calculation of daily dose distributions on 2 to 9 Computed Tomography (CT) studies available for each of the 19 patients. Planning and daily dose distributions were analyzed with respect to target coverage, maximal dose to the rectum (excluding 1 ml of the greatest dose; Dmax-1 ml) and the rectal volume receiving dose greater than 90% of prescribed target dose (V90 Rectum ), respectively. The application of spacer gel did substantially diminish rectum dose. Dmax-1 ml on the treatment planning CT was on average reduced from 100.0 ± 1.0% to 90.2 ± 4.8%, when spacer gel was applied. The robustness analysis performed with daily CT studies demonstrated for all analyzed patient cases that application of spacer gel results in a decrease of the daily V90 Rectum index, which calculated over all patient cases and CT studies was 10.2 ± 10.4 [ml] and 1.1 ± 2.1 [ml] for patients without and with spacer gel, respectively. The dosimetric benefit of increasing the distance between prostate and rectum using spacer gel for PC treatment with carbon ion beams has been quantified. Application of spacer gel substantially reduced rectal

  20. Periprosthetic fractures in the resurfaced hip--A case report and review of the literature.

    LENUS (Irish Health Repository)

    Brennan, Stephen A

    2013-02-01

    Traumatic periprosthetic fractures adjacent a hip resurfacing prosthesis are rare. When proximal fractures are encountered the obvious surgical solution is to revise to a large head stemmed femoral component. A previously well functioning implant may however be retained as various non-operative and operative treatment options exist. This paper reports the case history of a traumatic periprosthetic fracture successfully treated with cannulated screw fixation and reviews the current literature.