Aims. BoneMaster is a thin electrochemically applied
Objectives. We have observed clinical cases where bone is formed in the overlaying muscle covering surgically created bone defects treated with a
Aims. Biofilm formation is intrinsic to prosthetic joint infection (PJI). In the current study, we evaluated the effects of silver-containing
The success of long-term transcutaneous implants
depends on dermal attachment to prevent downgrowth of the epithelium
and infection.
An experimental rabbit model was used to test the null hypothesis,
that there is no difference in new bone formation around uncoated
titanium discs compared with coated titanium discs when implanted
into the muscles of rabbits. A total of three titanium discs with different surface and coating
(1, porous coating; 2, porous coating + Bonemaster (Biomet); and
3, porous coating + plasma-sprayed hydroxyapatite) were implanted
in 12 female rabbits. Six animals were killed after six weeks and
the remaining six were killed after 12 weeks. The implants with
surrounding tissues were embedded in methyl methacrylate and grinded
sections were stained with Masson-Goldners trichrome and examined
by light microscopy of coded sections.Objectives
Methods
Bone defects require implantable graft substitutes, especially porous and biodegradable biomaterial for tissue regeneration. The aim of this study was to fabricate and assess a 3D-printed biodegradable
Introduction. To evaluate the effect of
Targeted delivery of drugs is a major challenge in diseases such as infections and tumors. The aim of this study was to demonstrate that
Aims. This study reports the results of 38 total hip arthroplasties (THAs) in 33 patients aged less than 50 years, using the JRI Furlong
The long-term results of grafting with
Aims. There is a lack of biomaterial-based carriers for the local delivery of rifampicin (RIF), one of the cornerstone second defence antibiotics for bone infections. RIF is also known for causing rapid development of antibiotic resistance when given as monotherapy. This in vitro study evaluated a clinically used biphasic calcium sulphate/
Aims. The primary aim of this study is to assess the survival of the uncemented
Bone is a dynamic tissue with a quarter of the trabecular and a fifth of the cortical bone being replaced continuously each year in a complex process that continues throughout an individual’s lifetime. Bone has an important role in homeostasis of minerals with non-stoichiometric
Abstract. INTRODUCTION. Polyetheretherketone (PEEK) is a high-performance thermoplastic polymer which has found increasing application in orthopaedic implant devices and has a lot of promise for ‘made-to-measure’ implants produced through additive manufacturing [1]. However, a key limitation of PEEK is that it is bioinert and there is a requirement to functionalise its surface to make the material osteoconductive to ensure a more rapid, improved and stable fixation, in vivo. One approach to solving this issue is to modify PEEK with bioactive materials, such as
Abstract. Objectives. The objective of this study is to investigate the effect of solvents and rheological properties of PCL/
Carbonate-substituted
Osseointegration has been shown to be directly affected by surface roughness and bioactive coatings. This report compares bone response to
The aseptic loss of bone after hip replacement is a serious problem leading to implant instability.
Two calcium phosphate cements, brushite and
The feasibility of bone transport with bone substitute and the factors which are essential for a successful bone transport are unknown. We studied six groups of 12 Japanese white rabbits. Groups A to D received cylindrical autologous bone segments and groups E and F
Introduction: Polyethylene wear debris is the main contributing factor that leads to aseptic loosening and osteolysis. The main objective of this study was to evaluate the role of
Aim. Treatment principles of chronic osteomyelitis include debridement, clean sampling, excision of dead bone, stabilization, dead space management, soft tissue closure and systemic antibiotic therapy. Dead space management becomes very complicated, if the bone infection is caused by multi-resistant bacteria. The aim of this investigation was to evaluate the effect of a new vancomycin-loaded
A longitudinal study was done assessing the latest radiographs available in a series of collarless Corail uncemented stems which have reported survival rates of 95% at 20 years. Parameters scored included the degree of “Ghosting” or delamination, the Gruen, the stem fit in the femoral canal and the degree of calcar resorption. Patient and implant demographics were noted. At 3 years the loosening rate was 23% reaching 64% at 6 years after the index procedure. It was present in all age groups, with a peak in the 24 to 49 year age group. Males and females had the same occurrence. When it was present this was always in zone 1. It was present in 6% of patients in zone 7, but then always associated with zone 1 changes. High and standard off-set stems had the same loosening rates. The looser fit of the stem the higher the incidence of loosening. There was no correlation to the type of bearing surface or the degree of calcar resorption. Those patients with a BMI of 25 – 35 had lower loosening rates compared to those with higher or lower BMI's. We postulate that cancellous bone on-growth onto the
Introduction: The aetiology of dystrophic disc calcification in adult humans is unknown but a well-described clinical disorder with
In revision THA, the solid acetabular reconstruction in the true acetabulum is often challenging. We are using the Kerboull acetabular reinforcement devices after packing
Sixty-two consecutive primary total hip arthroplasties were prospectively randomized to receive either
Introduction: Polyethylene wear debris is the main contributing factor that leads to aseptic loosening and osteolysis. The main objective of this study was to evaluate the role of
Surgical failure, mainly caused by loosening implants, causes great mental and physical trauma to patients. Improving the physicochemical properties of implants to achieve favourable osseointegration will continue to be the focus of future research. Strontium (Sr), a trace element, is often incorporated into
The aim of this study was to evaluate the trochlear bone and cartilaginous regeneration of rabbits using a composite based on platelet rich plasma (PRP), chitosan and
Aims.
Aims: To investigate if coralline
Bone fractures are highly observed clinical situation in orthopaedic treatments. In some cases, there might be non-union problems. Therefore, recent studies have focused on tissue engineering applications as alternative methods to replace surgical procedures. Various biopolymer based scaffolds are produced using different fabrication techniques for bone tissue engineering applications. In this study,
Objective: To determine if a porous, coralline-derived
Aim. Bone and implant-associated infections caused by microorganisms that grow in biofilm are difficult to treat because of persistence and recurrence. Systemic administration of antibiotics is often inefficient because the poor vascularization of the site of infection. This issue has led to the development of biomaterials capable to locally deliver high doses of therapeutic agents to the injured bone with minimal systemic effects. In this context, calcium sulphate/
Aims: The bone – conductive proparties of
Purpose: Hinged knee prostheses are mainly used for reconstruction after major tumour resection. Aseptic loosening is the main problem with these implants. One of the solutions proposed to reduce the rate of loosening is to add a
Purpose: Despite excellent histological and biomechanical results proving the real efficacy of “biological” implant-bone fixation, use of
The success of uncemented arthroplasty depends on the achievement and maintenance of implant stability. Despite the use of modern instrumentation to obtain an accurate implant fit during total knee replacement, small gaps often remain visible at the bone-prosthesis interface on high quality fluroscopically-assisted radiographs. Although the clinical significance of these gaps is unclear, their presence delays bony fixation of the implant. In uncemented total hip arthroplasty,
Introduction and Aims: Titanium foam implants simulate the trabecular structure of bone to maximise porous space for bone ingrowth. Plasma-sprayed
Aims. Coatings for endo-osseous implants have been developed based on phospholipids. Such coatings promote the formation of a very thin superficial layer which is highly enriched with calcium phosphates. Aim of this study is a comparison of such coatings with an
Porous blocks of calcium
Introduction. We have investigated middle-term clinical results of total hip arthroplasty (THA) cemented socket with improved technique using
We report the histological findings in post-mortem specimens obtained ten days, 17 days and seven weeks after implantation of hydroxyapatite-coated femoral components of hip arthroplasties. There was early deposition of woven bone on the
A silver-containing
The durable fixation of an uncemented cup is due to two major factors: the primary stability obtained by the design of the cup and the secondary fixation obtained by the features of the surface of the cup. The CSF (cancellous screws fixation) cup is an emispheric press-fit
Introduction We report the clinical and radiographic outcome of a consecutive series of 138
The material most widely used in orthopaedics is
Introduction. The addition of
We studied two groups of femoral hip prostheses: 43 TiAlV ridged press-fit stems, and 26 with similar stems coated with
Worldwide 500,000 cases of maxillofacial cancer are diagnosed each year. After surgery, the reconstruction of large bone defect is often required. The induced membrane approach (Masquelet, 2000) is one of the strategies, but exhibits limitations in an oncological context (use of autografts with or without autologous cells and Bone Morphogenetic Proteins). The objectives of this work are to develop an injectable osteoinductive and osteoconductive composite matrix composed of doped strontium (Sr)
Introduction. We aimed to determine the extent of osseous integration of the
Introduction. Aseptic loosening is the most common mode of failure of massive endoprostheses. Introduction of
Introduction. Management of open fractures is challenging and requires a multidisciplinary team approach. Gustilo Anderson Type IIIB fractures reportedly have a higher infection rate (up to 52%) and up to 16% amputation rate. This study aims to evaluate outcomes of using Adjuvant Local Antibiotic
This study reports the results of 38 total hip
arthroplasties (THAs) in 33 patients aged <
50 years, using the
JRI Furlong
We report on 397 consecutive revision total hip
replacements in 371 patients with a mean clinical and radiological follow-up
of 12.9 years (10 to 17.7). The mean age at surgery was 69 years
(37 to 93). A total of 28 patients (8%) underwent further revision,
including 16 (4%) femoral components. In all 223 patients (56%,
233 hips) died without further revision and 20 patients (5%, 20
hips) were lost to follow-up. Of the remaining patients, 209 (221
hips) were available for clinical assessment and 194 (205 hips)
for radiological review at mean follow-up of 12.9 years (10 to 17.7). The mean Harris Hip Score improved from 58.7 (11 to 92) points
to 80.7 (21 to 100) (p <
0.001) and the mean Merle d’Aubigné and
Postel hip scores at final follow-up were 4.9 (2 to 6), 4.5 (2 to
6) and 4.3 (2 to 6), respectively for pain, mobility and function.
Radiographs showed no lucencies around 186 (90.7%) femoral stems
with stable bony ingrowth seen in 199 stems (97%). The survival
of the S-ROM femoral stem at 15 years with revision for any reason as
the endpoint was 90.5% (95% confidence interval (CI) 85.7 to 93.8)
and with revision for aseptic loosening as the endpoint 99.3% (95%
CI 97.2 to 99.8). We have shown excellent long-term survivorship and good clinical
outcome of a cementless
We have investigated the effectiveness of the transplantation of bone-marrow-derived mononuclear cells (BMMNCs) with interconnected porous calcium
Purpose: Exposure to polyethylene debris and bearing wear is a common feature of total hip prosthesis inserted with or without cement. Osteolysis depends on the number of particles involved and their size. This continuous series of total hip arthroplasties using a Corail prosthesis with 12 years follow-up was studied to assess the course of osteolysis around the prosthesis and the resistance of
In rabbits and goats, test implants with a porous surface of two layers of Tl-6A;-4V beads were examined at intervals for bond strength with bone. Half of the implants were coated with
Meniscus has many important functions in the knee joint such as load bearing, shock absorption, joint stability, joint lubrication and proprioception. In the recent years, meniscus injuries have been the focus of orthopaedic surgeons and musculoskeletal tissue engineering applications because of its avascular nature. In this study, we aimed to compare the regeneration capacities of two composite scaffolds in a New Zealand Rabbit meniscal defect model. The first scaffold consists Poly-Lactic Acid (PLA) + chitosan + loofah and the second PLA +
Statement of purpose. Cement fixation of total knee replacement (TKR) is commonly cited as being the gold standard, with better long-term survival rates when compared to uncemented fixation so the authors set out to analyse the longterm survivorship without aseptic loosening in a series of 471 uncemented TKR. Methods. A consecutive single surgeon series of patients undergoing routine follow up after a
The aim of this study was to evaluate the survival of a collarless, straight, hydroxyapatite-coated femoral stem in total hip arthroplasty (THA) at a minimum follow-up of 20 years. We reviewed the results of 165 THAs using the Omnifit HA system in 138 patients, performed between August 1993 and December 1999. The mean age of the patients at the time of surgery was 46 years (20 to 77). Avascular necrosis was the most common indication for THA, followed by ankylosing spondylitis and primary osteoarthritis. The mean follow-up was 22 years (20 to 31). At 20 and 25 years, 113 THAs in 91 patients and 63 THAs in 55 patients were available for review, respectively, while others died or were lost to follow-up. Kaplan-Meier analysis was performed to evaluate the survival of the stem. Radiographs were reviewed regularly, and the stability of the stem was evaluated using the Engh classification.Aims
Methods
Purpose. The purpose of this study is to compare using a novel cementing technique with
Current research efforts aim at enhancing osseointegration of cementless implants to improve early bone fixation. Purpose: The aim of the present study was to investigate whether bone morphogenic protein (BMP) 2 had a positive effect on the osseointegration of
Current research efforts aim at enhancing osseointegration of cementless implants to improve early bone fixation. The aim of the present study was to investigate whether bone morphogenic protein (BMP) 2 had a positive effect on the osseointegration of
Aims.
The outcome at ten years of 100 Freeman hip stems (Finsbury Orthopaedics, Leatherhead, United Kingdom) retaining the neck with a proximal
Since 1986 the JRI Furlong
For successful long-term result of non-cemented total hip arthroplasty (THA), direct biological bond between bone and implant through bony ingrowth into the implant is essential. To facilitate strong bond between bone and implant,
Aim. To evaluate the clinical outcome of a new absorbable, gentamycin loaded calcium sulfate/
Cemented stem fixation is a proven technique in total hip arthroplasty (THA), however, aseptic loosening is a noted complication. Cementless fixation is also popular in THA, however thigh pain and osteolysis are known problems with short-term and long-term follow- up, respectively. In order to improve the initial development and durability of the osseointegration of porous coated cementless implants,
Impacted morsellised allografts have been used successfully to address the problem of poor bone stock in revision surgery. However, there are concerns about the transmission of pathogens, the high cost and the shortage of supply of donor bone. Bone-graft extenders, such as tricalcium phosphate (TCP) and
Cemented Total Hip Arthroplasty gives good results for 10 or more years, but is too often complicated by a combination of mechanical loosening, wear debris and osteolysis. Patients require an implant which will last the rest of their life. Cemented hips may not survive and a better alternative is needed. Furlong
Introduction. Core decompression is used in precollapse lesions to forestall disease progression in avascular necrosis (AVN) of femoral head (FH). The author reports a new technique using reverse bone graft technique to effectuate core decompression. Aim. To prevent precollapse in Ficat Type 1&2 and revascularization using synthetic bone graft material. Methods. A 18 year female police trainee with Magnetic Resonance Imaging (MRI) confirming AVN Stage 2 Ficat, clinically painful hip not evident in x-rays consented to undergo this new technique. Reverse bone graft technique with a Coring reamer – Patent 5423823. A minimally invasive technique with lateral 2 cm incision introducing 8.5 mm core reamer to remove a core of bone up to the subchondral bone. The subchondral cyst decompressed and curetted under video recorded Image Intensifier (II). Demarcated avascular bone segment excised and bone graft reversed and inserted with cortical bone acting as a support to prevent collapse and the distal segment augmented using 5 grams of osteoconductive granular synthetic bone graft material based on calcium phosphate
Summary Statement. Parathytorid hormone-related protein (107–111) loaded onto biopolymer-coated nanocrystalline
Introduction: Modular metaphyseal-diaphyseal femoral stems are infrequent in primary total hip arthroplasty. We analyse the results of a proximally
We used
Introduction: Enchondromas are benign cartilaginous tumors, which are most often localized, in the small bones of the hand. Treatment methods fall into a broad spectrum ranging from conservative, medical therapies, to a variety of surgical procedures, which may or may not employ the use of local adjuvant treatment or bone grafting. Material &
Method: We present thirty four patients with hand enchondromas treated surgically in our department during the last eleven years. Their medical records and radiographs were reviewed retrospectively and the patients were contacted and interviewed by telephone. Results: The patients were treated operatively with an intralesional approach, with meticulous curettage of the bone lesion, use of phenol 5% and grafting using coralline
An experimental study was performed in order to investigate methods of preparation and mechanical properties of a potential bone graft substitute. This new composite material consists of porous hydoxyapatite coated with oxidised cellulose. Porous hydoxyapatite has excellent osteoconductive properties and promising strength characteristics. Drawbacks include its lack of osteoinductive properties and its brittle nature. Oxidised cellulose can be functionalised to provide binding sites for proteins, drugs and cells, which would allow for increased osteoinductive activity. It has good tensile strength. By creating a composite of these two substances, it was proposed that a graft substitute could be created.
Introduction: After more than 10 years of clinical experience,
We report the radiological and clinical outcome of a press-fit (SLF) acetabular component at two to three years in two groups of patients having primary total hip replacement. In 69 the implant was coated with
The use of mesenchymal stem cells (MSCs) for cartilage and bone tissue engineering needs to be supported by scaffolds that may release stimuli for modulate cell activity. The objective of this study was to asses if MSC undergo differentiation when cultured upon a membrane of nanofibers of poly-L-lactic acid loaded with
The proximally
Aims: To evaluate clinical and radiographicl results of
Background: Heel valgus and flattening of arch are common in rheumatoid arthritis (RA). The progression of hindfoot valgus deformity results in pain and debilitating disability, and causes the excessive stress on the ankle joint. Subtalar arthrodesis is often indicated in these cases to reduce the pain and to correct the talocalcaneal alignment. However, accurate correction is not easy without bone grafting, because bone defect often appears after correction. Bone grafting is necessary for accurate correction in these cases, but we have avoided it because of following reasons; donor site problem like insufficiency fractures of pelvis, supply limitation of autograft for possible multiple operations during long term disease progression of RA and the lack of bone graft substitutes, which possesses enough osteoconductivity. Now we have developed the interconnected porous calcium
In a rabbit model we investigated the efficacy of a silk fibroin/
A study was undertaken to see the efficacy of backfilling the iliac crest post harvesting on postoperative pain levels and overall functional outcomes. A randomized study was undertaken in which twenty patients were divided into two groups: one received backfilling of the iliac crest with corralline
Purpose of the study: The objective of this retrospective analysis was to examine the functional and radiographic results of 33 resvisions for femoral implants using a long locked stem inserted without cement and coated with
The medium term results of the JRI Furlong Total hip replacement have been very impressive to date. We report the longest prospective series to date of a
The clinical use of
We carried out a histological study of a proximally
Introduction. We evaluated the osteogenic potential of a novel biomimetic bone paste (DBSint®), made of a combination of a human demineralized bone matrix (hDBM) and a nano-structured magnesium-enriched
Diabetic foot problems are a common cause for hospitalisation in this group and up to 25% of diabetic patients will be affected. Prevalence of diabetes is rising, currently affecting 680000000 people worldwide. The enormity of this problem mandates any strategy that shortens therapeutic period and enhances success rates. Cerament G has been used in our unit as a treatment adjunct in diabetic foot treatment. Successful treatment is viewed as eradication of infection and a functional foot. Retrospective review of 40 months practice with 115 patients. Inclusion: all diabetic feet requiring surgery Cerament G used, protocol driven Microbiology pathway. Exclusion: Primary closure not possible. Cerament G not used. Outcome assessed in three groups: Total failure (further surgery required); slow to heal (healing by secondary intention); healed without problems. Healed 99 (eradication of infection and return to function), failure to heal 16 (success rate: 86.1%). Infection was the cause of failure in only in 2.6% (13 failures due to patient noncompliance or poor vascularity). Accepted success rate in treating osteomyelitis in diabetic feet is 68% (medical treatment only), combination of surgery and medical is 86%. Eradication of infection is the only end point return to function is not addressed. This study shows Cerament G with surgery/systemic antibiotics provides a 97.4% success rate. Therapeutic drivers in this field have been determined traditionally by Physicians and Vascular Surgeons (resection rather than reconstructive surgery.) Our assertion is that eradicating infection in a functionally useless foot is a waste of health resources. Our strategy is always the delivery of an intact functional foot residuum. Cerament G as an adjunct allows this goal in a cost-effective manner.
Purpose. We have compared the short-term clinical results of total hip arthroplasty (THA) using PMMA bone cement and
We reviewed the results of 51 patients with benign bone tumours treated by curettage and implantation of calcium
We report 60 benign bone tumours treated by resection and curettage followed by the implantation of calcium
Background. KAR™ prosthesis was introduced following the success of Corail® femoral stem to tackle difficult revision cases (Paprosky type1, 2a, 2b and 3a). The ARTO group reported a success rate of 94% at 17 years follow-up. Only two independent studies reported similar success rate to date. Purpose. To analyse the short-term performance of the KAR™ prosthesis used in our unit. Methods. This was a retrospective study of all KAR™ prosthesis between 2005 and 2013. Basic demographic, stem size, indications, failures and complications were recorded. X-rays were analysed for evidence of implant failure and distal cortical hypertrophy. Results. A total of 83 cases were analysed. The mean age was 68 (range 38–88 years) with an average follow-up was 3 years (range 1–8 years). The main indications for revision were aseptic loosening (83.7%), and periprosthetic fractures (7%). Kaplan-Meier Survival Rate for ‘all reasons of failure’ and ‘stem loosening’ was 93.83% and 100% respectively at 3 years follow-up. The most common reason for failure following KAR™ revision was periprosthetic fracture (3 cases). All three cases had radiographic evidence of proximal bone loss prior to index revision. Two patients developed deep infection and one patient had stem subsidence requiring revision. One patient sustained dislocation but revision surgery was not required. When comparing the effect of cortical hypertrophy, there were no significant differences in the measured distal canal/cortical diameter over the entire period of follow-up. Discussion. KAR™ prosthesis offers respectable clinical performance over a short-term period. Revision rate for this system was comparable to other ‘independent non-designer’ study. The three patients that sustained periprosthetic fracture may have been better served with a distally locked stem revision system. We believe that this HA coated implant encourages consistent osseointegration around the metaphysis region when there is evidence of a sound distal fixation. Conclusion. This study confirms that this fully coated
Background:
Several bisphosphonates are now available for the treatment of osteoporosis. Porous
We investigated the effects of