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Orthopaedic Proceedings
Vol. 100-B, Issue SUPP_17 | Pages 74 - 74
1 Dec 2018
USE OF BIOMARKERS AND CELL COUNT ON SYNOVIAL FLUID IN THE DIAGNOSIS OF PROSTHETIC JOINT INFECTION
Meda M Penfold G Felstead AJ Sturridge S Hill P
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Aim

We report on the performance of a simple algorithm using a combination of synovial fluid White blood cell count(WBC), C-reactive protein(CRP) and α-Defensin(AD) tests to aid in the diagnosis of prosthetic joint infections.

Methods

Sixty-six synovial fluid samples were collected prospectively in patients with suspected PJI (hip and knee). All samples were tested by: WBC counts (read manually) and CRP test (Alere-Afinion™ validated in-house); and on 37 of these with AD test.

Synovial fluid samples were collected in 5 ml ethylenediaminetetraacetic acid (EDTA) tubes. Samples that were very viscous were pre-processed by the addition of 100µl of hyaluronidase solution. Grossly blood stained and clotted samples were excluded.

A clinical diagnosis of infection was based IDSA definitions1. Cut offs of >3000 × 106 cells/L for total synovial WBC count and >12mg/L for CRP were used to define infection2,3.

Orthopaedic Proceedings
Vol. 94-B, Issue SUPP_XL | Pages 79 - 79
1 Sep 2012
Stability and Strain Distribution for a New Conservative Hip Prosthesis: A Bone Preserving Option for the Younger Patient
Vanhegan I Jassim S Sturridge S Ahir S Hua J Witt J Nielsen P Blunn G
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Introduction

A new conservative hip stem has been designed to address the complex problem of total hip arthroplasty in the younger population.

Objectives

To assess the stability and strain distribution of a new conservative hip stem.

Orthopaedic Proceedings
Vol. 90-B, Issue SUPP_II | Pages 304 - 304
1 Jul 2008
A LABORATORY BASED ANALYSIS OF THE LONG TERM STABILITY OF A NEW CONSERVATIVE HIP PROSTHESIS.
Sturridge S Hua J Ahir S Witt J Nielsen P Bigsby R Blunn G
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Introduction & Aims: A new femoral component for hip arthroplasty has been designed for a younger patient population. The design makes use of a higher femoral cut, which conserves bone stock, increasing options for future revision surgery. It uses the existing load bearing properties of the proximal femur, and therefore distributes load more evenly. The stem is longer than that of a resurfacing, so will be easier to insert at the correct orientation, minimising failure rates in inexperienced hands. The cross-sectional dimensions have been designed to produce torsional stability. The collar maximises the loading of the calcar, reducing stress resorption. The surface is hydroxyapatite coated and porous, which will produce a long-term biological fixation.

This project assessed the long-term stability of this design at different orientations, by measuring the change in surface strain distribution following its insertion.

Methods: Ten composite bones were coated in a Photoelastic material, positioned at a simplified single leg stance, and loaded at 2.3 KN. The surface strain was measured at one-centimetre intervals down the medial cortex. Then the prostheses were inserted into the bone at 135°, 145° and 125° to the femoral shaft, and the surface strains reread.

Results: The results were compared with an FEA model, and analysed statistically using the Wilcox signed rank test. The prosthesis inserted at 135° produced no significant difference in surface strain distribution compared with the intact bone.

Conclusions: This study suggests this stem design will be stable in the long term following insertion, and there were no areas of excessively high or low strain.

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