Aims. Isolated acetabular liner exchange with a highly crosslinked
Aims. The aim of our study was to investigate the effect of asymmetric crosslinked
Mid-level constraint designs for total knee arthroplasty (TKA) are intended to reduce coronal plane laxity. Our aims were to compare kinematics and ligament forces of the Zimmer Biomet Persona posterior-stabilized (PS) and mid-level designs in the coronal, sagittal, and axial planes under loads simulating clinical exams of the knee in a cadaver model. We performed TKA on eight cadaveric knees and loaded them using a robotic manipulator. We tested both PS and mid-level designs under loads simulating clinical exams via applied varus and valgus moments, internal-external (IE) rotation moments, and anteroposterior forces at 0°, 30°, and 90° of flexion. We measured the resulting tibiofemoral angulations and translations. We also quantified the forces carried by the medial and lateral collateral ligaments (MCL/LCL) via serial sectioning of these structures and use of the principle of superposition.Aims
Methods
Oxidized zirconium (Oxinium) and highly cross-linked
Aims. Oxidized zirconium (OxZi) and highly cross-linked
Aims. Micromotion of the
The benefits of HXLPE in total knee arthroplasty (TKA) have not been as evident as total hip arthroplasty (THA). A systematic review and meta-analysis to assess the impact of highly-crosslinked
Aims. The primary objective of this study was to compare the five-year tibial component migration and wear between highly crosslinked
Aims. The purpose of this study was to assess mid-term survivorship following primary total knee arthroplasty (TKA) with Optetrak Logic components and identify the most common revision indications at a single institution. Methods. We identified a retrospective cohort of 7,941 Optetrak primary TKAs performed from January 2010 to December 2018. We reviewed the intraoperative findings of 369 TKAs that required revision TKA from January 2010 to December 2021 and the details of the revision implants used. Kaplan-Meier analysis was used to determine survivorship. Cox regression analysis was used to examine the impact of patient variables and year of implantation on survival time. Results. The estimated survivorship free of all-cause revision was 98% (95% confidence interval (CI) 97% to 98%), 95% (95% CI 95% to 96%), and 86% (95% CI 83% to 88%) at two, five, and ten years, respectively. In 209/369 revisions there was a consistent constellation of findings with varying severity that included
Aims. The use of cementless total knee arthroplasty (TKA) components has increased during the past decade. The initial design of cementless metal-backed patellar components had shown high failure rates due to many factors. The aim of this study was to evaluate the clinical results of a second-generation cementless, metal-backed patellar component of a modern design. Methods. This was a retrospective review of 707 primary TKAs in 590 patients from a single institution, using a cementless, metal-backed patellar component with a mean follow-up of 6.9 years (2 to 12). A total of 409 TKAs were performed in 338 females and 298 TKAs in 252 males. The mean age of the patients was 63 years (34 to 87) and their mean BMI was 34.3 kg/m. 2. (18.8 to 64.5). The patients were chosen to undergo a cementless procedure based on age and preoperative radiological and intraoperative bone quality. Outcome was assessed using the Knee Society knee and function scores and range of motion (ROM), complications, and revisions. Results. A total of 24 TKAs (3.4%) in 24 patients failed and required revision surgery, of which five were due to patellar complications (0.71%): one for aseptic patellar loosening (0.14%) and four for
Aims. Implant waste during total hip arthroplasty (THA) represents a significant cost to the USA healthcare system. While studies have explored methods to improve THA cost-effectiveness, the literature comparing the proportions of implant waste by intraoperative technology used during THA is limited. The aims of this study were to: 1) examine whether the use of enabling technologies during THA results in a smaller proportion of wasted implants compared to navigation-guided and conventional manual THA; 2) determine the proportion of wasted implants by implant type; and 3) examine the effects of surgeon experience on rates of implant waste by technology used. Methods. We identified 104,420 implants either implanted or wasted during 18,329 primary THAs performed on 16,724 patients between January 2018 and June 2022 at our institution. THAs were separated by technology used: robotic-assisted (n = 4,171), imageless navigation (n = 6,887), and manual (n = 7,721). The primary outcome of interest was the rate of implant waste during primary THA. Results. Robotic-assisted THA resulted in a lower proportion (1.5%) of implant waste compared to navigation-guided THA (2.0%) and manual THA (1.9%) (all p < 0.001). Both navigated and manual THA were more likely to waste acetabular shells (odds ratio (OR) 4.5 vs 3.1) and
Aims. Robotic arm-assisted surgery offers accurate and reproducible guidance in component positioning and assessment of soft-tissue tensioning during knee arthroplasty, but the feasibility and early outcomes when using this technology for revision surgery remain unknown. The objective of this study was to compare the outcomes of robotic arm-assisted revision of unicompartmental knee arthroplasty (UKA) to total knee arthroplasty (TKA) versus primary robotic arm-assisted TKA at short-term follow-up. Methods. This prospective study included 16 patients undergoing robotic arm-assisted revision of UKA to TKA versus 35 matched patients receiving robotic arm-assisted primary TKA. In all study patients, the following data were recorded: operating time,
Aims. The use of vitamin E-infused highly crosslinked
Vitamin E-doped cross-linked
Aims. A significant reduction in wear at five and ten years was previously reported when comparing Durasul highly cross-linked
Aims. Transcription factor nuclear factor kappa B (NF-κB) plays a major role in the pathogenesis of chronic inflammatory diseases in all organ systems. Despite its importance, NF-κB targeted drug therapy to mitigate chronic inflammation has had limited success in preclinical studies. We hypothesized that sex differences affect the response to NF-κB treatment during chronic inflammation in bone. This study investigated the therapeutic effects of NF-κB decoy oligodeoxynucleotides (ODN) during chronic inflammation in male and female mice. Methods. We used a murine model of chronic inflammation induced by continuous intramedullary delivery of lipopolysaccharide-contaminated
The purpose of this study was to compare oxinium versus metal-on-polyethylene wear in two consecutive prospective randomized series of low friction total hip arthroplasty at a minimum 10-year follow-up. A total of 100 patients with a median age of 60.9 years were randomized to receive either oxinium (50 hips) or metal (50 hips) femoral head. The
The purpose of the study was to compare the mechanical properties, oxidation and wear resistance of a vitamin E blended and moderately crosslinked
Aims. This study investigates head-neck taper corrosion with varying head size in a novel hip simulator instrumented to measure corrosion related electrical activity under torsional loads. Methods. In all, six 28 mm and six 36 mm titanium stem-cobalt chrome head pairs with
Abstract. Cemented total hip arthroplasty (THA) in the younger patient has historically been associated with higher wear and revision rates. We carried out a retrospective study of a prospectively collected database of patients at Wrightington hospital undergoing cemented THA under 55 years of age to determine acetabular wear and revision rates. Between August 2005 and December 2021 a cohort of 110 patients, 56 males and 54 females, underwent Cemented Total Hip Replacement through a posterior approach. Mean age at operation was 50yrs (35–55). The mean follow up was 6 years 9 months (0–16 years). 3 patients were lost to follow-up. Of the remaining 107 patients, Conventional and cross lined
Aims. Uncemented metal acetabular components show good osseointegration, but material stiffness causes stress shielding and retroacetabular bone loss. Cemented monoblock
Introduction and Aims: To determine whether
Aims. Highly cross-linked
Aims. Vitamin E-infused highly cross-linked
The 2021 Australian Orthopaedic Association National Joint Replacement Registry report indicated that total shoulder replacement using both mid head (TMH) length humeral components and reverse arthroplasty (RTSA) had a lower revision rate than stemmed humeral components in anatomical total shoulder arthroplasty (aTSA) - for all prosthesis types and diagnoses. The aim of this study was to assess the impact of component variables in the various primary total arthroplasty alternatives for osteoarthritis in the shoulder. Data from a large national arthroplasty registry were analysed for the period April 2004 to December 2020. The study population included all primary aTSA, RTSA, and TMH shoulder arthroplasty procedures undertaken for osteoarthritis (OA) using either cross-linked
Dual Mobility (DM) Total Hip Replacements (THRs) were introduced to reduce dislocation risk, which is the most common cause of early revision. The in-vivo mechanics of these implants is not well understood, despite their increased use in both elective and trauma settings. Therefore, the aim of this study was to comprehensively assess retrieved DM
The aim of this study was to measure
Aims. The aim of this study was to compare the migration of the femoral component, five years postoperatively, between patients with a highly cross-linked
Aims. The primary outcome was investigating differences in wear, as measured by femoral head penetration, between cross-linked vitamin E-diffused
Aims. The aim of this study was to evaluate the performance of first-generation annealed highly cross-linked
Abstract. Objectives. Ultra-High Molecular Weight
Aims. Wear of the
Introduction. Total knee replacement (TKR) implant designs and materials have been shown to have a significant impact on tibial insert wear. A medial-pivot (MP) design theoretically should generate less wear due to a large contact area in the medial compartment and lower contact stresses. Synovial fluid aspiration studies have confirmed that a first generation MP TKR system (ADVANCE®, MicroPort Orthopedics Inc., Arlington, TN, USA) generates less wear debris than is seen with other implant designs articulating against conventional
Isolated liner exchange with highly crosslinked
Purpose: We compared two series of total hip arthroplasties (THA) at more than 12 years. The only difference between the two series was the nature of the femoral head: 28-mm zincronia head versus 32-mm alumina head. Material and method: All THAs were performed during the same period (1988–1990) and the
Purpose of the study: The limitations of conventional
This study assesses a method of optimizing the polyethylene-cement interface when cementing a constrained liner into a pre-existing acetabular shell. We tested several configurations of liner modification including random roughening, 2mm and 4mm wide grooves Statistical analysis showed that the grooved liners had significantly higher moment to failure than both the unmodified and roughened liners. There was no difference between the 2 and 4mm grooved liners. The purpose of this study was to answer the question: what liner preparation will provide the most stable
Dual mobility (DM) total hip replacements (THRs) were introduced to reduce dislocation risk, which is the most common cause of early revision. Although DM THRs have shown good overall survivorship and low dislocation rates, the mechanisms which describe how these bearings function in-vivo are not fully understood. Therefore, the study aim was to comprehensively assess retrieved DM
Introduction. Recently, tibial insert design of cruciate-substituting (CS)
Abstract. Introduction. The Oxford Unicompartmental Knee Replacement's (OUKR's) fully-congruent design minimises
Aims. Vitamin E-infused highly crosslinked
Aims. Radiostereometric analysis (RSA) is the most accurate radiological method to measure in vivo wear of highly cross-linked
Introduction. While advances in joint-replacement technology have made total ankle arthroplasty a viable treatment for end-stage arthritis, revision rates for ankle replacements are higher than in hip or knee replacements [1]. The questions asked in this study were (1) what retrieved ankle devices demonstrate about ankle arthroplasty failures, and (2) how do these failures compare to those seen in the hip and the knee?. Materials and Methods. An IRB-approved retrieval laboratory received retrieved
Aims. The aim of this study was to establish the results of isolated exchange of the tibial
Introduction. The interaction between the mobile components of total elbow replacements (TER) provides additional constraint to the elbow motion. Semi-constrained TER depend on a mechanical linkage to avoid dislocation and have greater constraint than unconstrained TER that rely primarily in soft tissue for joint stability. Greater constraint increases the load transfer to the implant interfaces and the stresses in the
Dual mobility hip arthroplasty utilizes a freely rotating
Aims. We aimed to investigate if the use of the largest possible cobalt-chromium head articulating with
Aims. The aim of this study was to evaluate the surface damage, the density of crosslinking, and oxidation in retrieved antioxidant-stabilized highly crosslinked
Abstract. Objectives. Oil-based fluids can be used to enhance the properties of
Aims. There is insufficient evidence to recommend the use of alternative
Aims. The aim of this study was to investigate whether wear and backside deformation of
Aims. We aimed to evaluate the long-term outcome of highly cross-linked
We present minimum 20 year results of a randomized, prospective double blinded trial (RCT) of cross-linked versus conventional
The purpose of this study was to precisely measure the 10-year
Knee arthroplasty surgery is a highly effective treatment for arthritis and disorders of the knee. There are a wide variety of implant brands and types of knee arthroplasty available to surgeons. As a result of a number of highly publicized failures, arthroplasty surgery is highly regulated in the UK and many other countries through national registries, introduced to monitor implant performance, surgeons, and hospitals. With time, the options available within many brand portfolios have grown, with alternative tibial or femoral components, tibial insert materials, or shapes and patella resurfacings. In this study we have investigated the effect of the expansion of implant brand portfolios and where there may be a lack of transparency around a brand name. We also aimed to establish the potential numbers of compatible implant construct combinations. Hypothetical implant brand portfolios were proposed, and the number of compatible implant construct combinations was calculated.Aims
Methods
Abstract. Introduction. At our national explant retrieval unit, we identified an unusual pattern of backside-deformation on
Wear of the tibial
Highly cross-linked
A high proportion of complications following TKR occur at the patellofemoral articulation secondary to delami-nation and adhesive/abrasive wear. Electron beam cross-linking and melting has been shown to substantially reduce delamination and adhesive/abrasive wear in
Aims. The aim of this study was to identify the effect of the manufacturing characteristics of
Aims. To investigate the effect of
Aims. Several short- and mid-term studies have shown minimal liner wear of highly cross-linked
The creep and wear behaviour of highly cross-linked
Introduction
We conducted a systematic review and meta-analysis of randomised controlled trials comparing cross-linked with conventional
Introduction. Wear phenomenon of ultra-high molecular weight
Aims. Vitamin E-diffused, highly crosslinked
Alpha Lipoic Acid (L.A.) is an effective natural antioxidant discovered in the human body in 1951 from L.J. Reed and I.C. Gunslaus from liver. It is inside broccoli, spinach and red meats, especially liver and spleen. Actually it is largely used as antioxidant in antiaging products according to the low toxicity level of the product. The present study take into consideration the possibility to reduce oxidation of medical irradiated UHMWPE GUR 1050, mixing together
With the introduction of highly crosslinked
Objectives. Our primary aim was to describe migration of the Exeter stem with a 32 mm head on highly crosslinked
Ultra-high-molecular-weight
Highly crosslinked
Introduction. Instability following total knee arthroplasty is a leading cause of failure and is often treated with component revision. The goal of this study was to determine if isolated tibial
Introduction. Ultra-high molecular weight
Aims. The most frequent indication for revision surgery in total hip arthroplasty (THA) is aseptic loosening. Aseptic loosening is associated with
Introduction. Robotically-assisted unicondylar knee arthroplasty (UKA) is intended to improve the precision with which the components are implanted, but the impact of alignment using this technique on subsequent
Aims. The primary aim of this study was to compare the wear properties of vitamin E-diffused, highly crosslinked
Introduction. Ultra-high molecular weight
The Oxford Unicompartmental Knee replacement (UKR) was introduced as a design to reduce
Aims. To report early (two-year) postoperative findings from a randomized controlled trial (RCT) investigating disease-specific quality of life (QOL), clinical, patient-reported, and radiological outcomes in patients undergoing a total shoulder arthroplasty (TSA) with a second-generation uncemented trabecular metal (TM) glenoid versus a cemented
Isolated liner and head exchange procedure has been an established treatment method for
Objectives. Bone void fillers are increasingly being used for dead space management in arthroplasty revision surgery. The aim of this study was to investigate the influence of calcium sulphate bone void filler (CS-BVF) on the damage and wear of total knee arthroplasty using experimental wear simulation. Methods. A total of 18 fixed-bearing U2 total knee arthroplasty system implants (United Orthopedic Corp., Hsinchu, Taiwan) were used. Implants challenged with CS-BVF were compared with new implants (negative controls) and those intentionally scratched with a diamond stylus (positive controls) representative of severe surface damage (n = 6 for each experimental group). Three million cycles (MC) of experimental simulation were carried out to simulate a walking gait cycle. Wear of the ultra-high-molecular-weight
Introduction: Highly cross-linked
Introduction. The optimum UHMWPE orthopaedic implant bearing surface must balance wear, oxidation and fatigue resistance. Antioxidant
Introduction. Despite the positive outcomes in shoulder joint replacements in the last two decades,
Introduction. Aseptic loosening is a major cause of revision of total joint arthroplasty (TJA). Although crosslinked Ultra-high molecular weight
Introduction. Selection of an optimum thickness of
Introduction. Reverse total shoulder arthroplasty (RTSA) is a semi-constrained joint replacement with an articulating cobalt-chromium glenosphere and ultra-high molecular weight
Introduction. It has been shown in vitro that human monocytes can phagocytose submicron
Background.
Increased femoral head size reduces the rate of dislocation after total hip arthroplasty (THA). With the introduction of highly crosslinked
Lewinnek's safe zone recommendation to minimise dislocations was a target of 5–25° for anteversion angle and 30–50° for inclination angle. Subsequently, it was demonstrated that mal-positioning of the acetabular cup can also lead to edge loading, liner fracture, and greater conventional
Background. Wear simulation in total knee arthroplasty (TKA) is currently based on the most frequent activity – level walking. A decade ago multi-station knee wear simulators were introduced leading to optimisations of TKA designs, component surface finish and bearing materials. One major limitation is that current wear testing is mainly focused on abrasive-adhesive wear and in vitro testing does not reflect “delamination” as an essential clinical failure mode. The objective of our study was to use a highly demanding daily activities wear simulation to evaluate the delamination risk of
Introduction. Highly cross-linked (HXL)
The purpose of this investigation is to assess the rate of wear the effect once the “bedding in period”/ poly creep had been eliminated. Creep is the visco-elastic deformation that
Background. Although the wear of conventional
Introduction. Wear debris induced osteolysis and loosening continue to cause clinical failure in total knee replacement (TKR). To improve longevity and reduce wear alternative materials have been examined. Carbon-fibre-reinforced poly–ether-ether-ketone (CFR-PEEK) has shown promising results in wear studies [1–2]. The aim of this study was to explore the use of CFR-PEEK and PEEK as alternative bearing materials for
Introduction. Highly cross-linked
Studies that have previously examined the relationship between inclination angle and