Aims. This study investigates head-neck taper corrosion with varying head size in a novel
We have encountered patients who developed large joint fluid collections with massive elevations in chromium (Cr) and cobalt (Co) concentrations following metal-on-metal (MoM) hip arthroplasties. In some cases, retrieval analysis determined that these ion concentrations could not be explained simply by the wear rates of the components. We hypothesized that these effects may be associated with aseptic lymphocyte-dominated vasculitis-associated lesion (ALVAL). We examined the influence of the ALVAL grade on synovial fluid Co and Cr concentrations following adjustment for patient and device variables, including volumetric wear rates. Initially restricting the analysis to include only patients with one MoM hip resurfacing device, we performed multiple regression analyses of prospectively collected data. We then repeated the same statistical approach using results from a larger cohort with different MoM designs, including total hip arthroplasties.Objectives
Patients and Methods
Third-body wear is believed to be one trigger for adverse results
with metal-on-metal (MOM) bearings. Impingement and subluxation
may release metal particles from MOM replacements. We therefore
challenged MOM bearings with relevant debris types of cobalt–chrome
alloy (CoCr), titanium alloy (Ti6Al4V) and polymethylmethacrylate
bone cement (PMMA). Cement flakes (PMMA), CoCr and Ti6Al4V particles (size range
5 µm to 400 µm) were run in a MOM wear simulation. Debris allotments
(5 mg) were inserted at ten intervals during the five million cycle
(5 Mc) test. Objectives
Methods
In In a hip fracture experiment, nine pairs of human cadaver femurs
were tested in a paired study design. The femurs were then re-matched
according to BMD, creating two new test groups. Intra-pair variance
and paired correlations in fixation stability were calculated. A
hypothetical power analysis was then performed to explore the required sample
size for the two types of group allocation. Objective
Methods
The August 2013 Hip &
Pelvis Roundup360 looks at: are we getting it right first time?; tantalum augments in revision hip surgery; lower wear in dual mobility?; changing faces changes outcomes; synovial fluid aspiration in MOM hips; taper disease: the new epidemic of hip surgery; the super-obese and THR; and whether well fixed stems can remain in infected hips
Wear debris released from bearing surfaces has been shown to
provoke negative immune responses in the recipient. Excessive wear
has been linked to early failure of prostheses. Analysis using coordinate
measuring machines (CMMs) can provide estimates of total volumetric
material loss of explanted prostheses and can help to understand
device failure. The accuracy of volumetric testing has been debated,
with some investigators stating that only protocols involving hundreds
of thousands of measurement points are sufficient. We looked to
examine this assumption and to apply the findings to the clinical
arena. We examined the effects on the calculated material loss from
a ceramic femoral head when different CMM scanning parameters were
used. Calculated wear volumes were compared with gold standard gravimetric
tests in a blinded study. Objectives
Methods
The April 2012 Hip &
Pelvis Roundup360 looks at osteoporotic hip fractures, retrotrochanteric pain, fibrin adhesive and reattachment of articular cartilage, autologous bone marrow mononuclear cells and avascular necrosis, bearing surfaces, stability after THR, digital templating, pelvic tilt after THR, custom-made sockets for DDH, and dogs and THR