Objectives. Our study aimed to examine not only the incidence but also the
impact of
Industries such as agriculture, construction and military have stringent rules about hearing protection due to the risk of
Ceramic-on-ceramic (CoC) total hip arthroplasty (THA) can produce articular
Purpose of study. To determine the onset, incidence and associated symptoms of adverse
The aim of this study was to characterise
Surgeons working in orthopaedic operating theatres are exposed to significant
Hard-on-hard bearing surface have been accepted as a valuable alternative for young and active patients needing a hip replacement because these combinations are resistant to wear. Initial development of alumina-on-alumina bearings faced complications such as fractures, and socket loosening. But, with the increasing number of prostheses implanted,
The link between squeaking and ceramic on ceramic (CoC) bearings has been widely reported in orthopaedic literature and is described as a hard bearing phenomenon. We aim to look at the incidence of
The problem associated with ceramic on ceramic total hip replacement (THR) is audible
This study assesses the incidence of
Squeaking in ceramic total hip joint replacements has become a controversial topic. This study aims to document the incidence of squeaking and other
Introduction: With ceramic on ceramic bearing surfaces in total hip arthroplasty audible
Background/Purpose. Total hip arthroplasties (THAs) with ceramic bearings are widely performed in young, active patients and thus, long-term outcome in these population is important. Moreover, clinical implication of
Introduction: Increasing numbers and incidence rates of noisy (squeaking, scratching, clicking) ceramic-on-ceramic (CoC) total hip arthroplasties (THA) are being reported. The etiology seems to always involve stripe wear producing a stick-slip effect in the bearing which excites vibrations. As stripe wear is also found in silent CoC bearings, a theory has been developed that the vibrations become audible only via amplification through the vibrating stem (bell-clapper theory). This was supported by showing that the excitation frequency and the resonance frequency of the plain stem are similar. However, stem resonance in-vivo would be influenced by the periprosthetic bone damping and transmitting stem vibrations. Thus, if the bell-clapper theory were true, noisy CoC hips should show periprosthetic bone different to silent hips. This study compares stem fit&
fill and periprosthetic bone between noisy and silent CoC hips. Methods: In a consecutive series of 186 primary CoC hips with identical stems, cups (Stryker ABG-II) and femoral heads (Alumina V40, 28mm) a survey identified 38 noisy hips (incidence rate: 20.4%, squeakers: n=23). Stem fit&
fill and cortical wall thickness (CWT, medial and lateral) were measured on post-op AP x-rays according to the method of Kim &
Kim. Measurements were repeated by a single blinded observer in a control group of silent hips matched for gender, age, stem size and follow-up time (4.6yrs). Fit&
fill and CWT were compared between the noisy and silent group at proximal, mid-stem and distal level and on the medial and lateral side. Results: The endosteal canal width was equal in noisy (N) and silent hips (S) at all levels (e.g. proximal: N=39.7+/−5.5mm, S=41.3+/−5.7mm). On the lateral side also cortical wall thickness (CWT) was the same at all levels (e.g. proximal: N=2.0+/−0.8mm, S=1.9+/−0.9mm). However, on the medial side, noisy hips had higher CWT at proximal (N=4.9+/−2.8mm, S=3.0+/−2.1mm, p<
0.01) and mid-stem level (N=6.2+/−2.1mm, N=4.6+/−1.7mm, p<
0.001). Also Fit&
fill was slightly higher (proximal: N=66%, S=62%; mid-stem: N=63%, S=59%, p<
0.05). Differences and significance levels increased when only squeakers were considered. Discussion: Despite equal endosteal canal widths and lateral cortical wall thickness for noisy and silent hips, noisy hips had sign. thicker medial walls at proximal (+63%) and mid-stem level (+35%) where also fit&
fill was higher. This gives evidence that periprosthetic bone (PPB) may play a role in the development of audible
Monitoring the performance of hip replacements post-operatively is tedious and costly, necessitating radiological examinations as well as other specialized examinations such as whole blood metal ion levels. In an effort to control escalating costs, we conducted an ethically approved clinical trial to assess the efficacy of basic acoustic monitoring equipment to asses these implants. Method. An electronic stethoscope was successfully used to record sounds from the hips of participants with different bearing surfaces. The sounds were recorded while conducting a standardized movement sequence. A 5th order Savitzky-Golay filter with a window width of 21 points was used to remove background
Aim. While 16S rRNA PCR - Sanger sequencing has paved the way for the diagnosis of culture-negative bacterial infections, it does not provide the composition of polymicrobial infections. We aimed to evaluate the performance of the Nanopore-based 16S rRNA metagenomic approach using partial-length amplification of the gene, and to explore its feasibility and suitability as a routine diagnostic tool for bone and joint infections (BJI) in a clinical laboratory. Method. Sixty-two clinical samples from patients with BJI were sequenced on MinION* using the in-house partial amplification of the 16S rRNA gene. BJI were defined based on the ICM Philly 2018 and EBJIS 2021 criteria. Among the 62 samples, 16 (26%) were culture-positive, including 6 polymicrobial infections, and 46 (74%) were culture-negative from mono- and polymicrobial infections based on Sanger-sequencing. Contamination, background
Background. Orthopaedic surgeons are exposed to high levels of
Background. The accurate positioning of the total knee arthroplasty affects the survival of the implants(1). Alignment of the femoral component in relation to the native knee is best determined using pre- and post-operative 3D-CT reconstruction(2). Currently, the scans are visualised on separate displays. There is a high inter- and intra-observer variability in measurements of implant rotation and translation(3). Correct alignment is required to allow a direct comparison of the pre- and post-operative surfaces. This is prevented by the presence of the prostheses, the bone shape alteration around the implant, associated metal artefacts, and possibly a segmentation
Since 1977 we did implant ceramic on ceramic THR in younger and active population. In 1991 we published (JBJS B N°4) data's in a consecutive group of patients under 50 years of age. What about the same patients for more than 30 years? Eighty-six hips in 75 patients, 41 males 34 females, mean age 43 (18 to 50), mean weight 68 kg (36 to 100), Charnley class: 38 A, 28 (38 hips) B, 9 patients (10 hips) C. Sixty-six primary procedures, 20 revisions (18 failed arthroplasties: 6 THR, 5 resurfacing, four single cup, two hemiarthroplasty, one bipolar), one after acetabular fractures. Four hips previously infected. Eight Patients deceased (8 hips) prosthesis still in place, ten lost to follow-up before 2 years, eight hips in 8 patients were revised before the review, partially followed: from 2 to 20 years: 35, completely followed: 25 hips in 23 patients resuming in: No pain in 20, slight pain in 2, severe disability in 3 not related to the hip, no radiolucent lines in 22, radiolucent lines in 3, no osteolysis in 25. Revision for: early sepsis in one, socket loosening in 8 (3 revisions cases), femoral head fractures in 2: one extra small head (22mm) for Crowe 3 DDH, one fractured at 24 years. Inertness, stability related to fibrous tissue generation, no