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Orthopaedic Proceedings
Vol. 100-B, Issue SUPP_15 | Pages 17 - 17
1 Nov 2018
Dalgarno K Benning M Partridge S Tulah A Ahmed S Dickinson A Genever P Pearson R Feichtinger G Loughlin J Ferreira-Duarte A
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This paper reports on a proof of concept project funded by the UK National Council for the Replacement, Refinement and Reduction of Animals in Research (NC3Rs), with the aim of developing an in vitro model to recapitulate the human osteoarthritic joint, based on a multiple human cell type co-culture system, for research and drug development in OA. The targets were: (i) the development of a cell culture platform that could produce a mixed stable cell culture of cell types that represent the key components of the human joint: synoviocytes – type I and type II; osteoblasts; osteoclasts; chondrocytes/cartilage or cartilage-like matrix; adipocytes; and immune cells. (ii) demonstration of cell phenotype stability and viability for at least 72 hours. In order to establish the cell culture platform we have developed an eight-channel cell printer, capable of accurately and reliably printing the required cell types to create osteochondral and synovial cell types within a transwell system. Two different sets of cells have been developed and processed using the cell printer: a set based on using an immortalised hTERT MSC line to create osteoblasts, chondrocytes and adipocytes, with commercial cells lines providing the other cell types, and a set obtained from tissue excised during orthopaedic surgery. This gives both a repeatable set of cells with which to undertake mode of action studies, and a bank of cell sets which will be representative of different stages of osteoarthritis. The co-cultures have been immunohistochemically assessed in order to demonstrate maintenance of phenotype.


Orthopaedic Proceedings
Vol. 99-B, Issue SUPP_5 | Pages 96 - 96
1 Mar 2017
Prudhon J Ferreira A Caton J Aslanian T Verdier R
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Introduction

Upper femoral fractures include intra and extra-capsular fracture (ECF). For intra-capsular fracture (ICF), hemi-arthroplasty (HA) is the most commonly used treatment. Interest in total hip arthroplasty (THA) is growing because THA yields less revision (4% versus 7%) associated to better functional results despite higher dislocation rate (9% versus 3%). Regarding ECF, internal fixation is the reference treatment. THA could represent a relevant alternative. This study evaluates the efficiency of THA using dual mobility cup (THA-DMC) as treatment of these fractures specially in elderly patients.

Material and method

70 patients were operated on for upper femoral fractures with Quattro THA-DMC between May 2012 and October 2013. Minimum follow-up is one year. Seven surgeons in 4 institutions were involved. Data collected were: age, gender, type of fracture, surgical approach, mortality, revision rate and dislocation rate.


Orthopaedic Proceedings
Vol. 98-B, Issue SUPP_9 | Pages 141 - 141
1 May 2016
Prudhon J Ferreira A Caton J Verdier R
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BACKGROUND PURPOSES

dislocation is a classical complication in total hip arthroplasty (THA) revision. Cup fixation is the second concern. Since 1998 we routinely use cementless Dual mobility cup (DMC) in revision surgery. In order to know outcomes at 2 years, we followed a prospective series of 78 patients treated in our institution. Purpose is to demonstrate that DMC used in revision THA is safe as regards dislocation risk and bone fixation.

MATERIAL METHODS

from January 2010 to January 2012 we collected cohort of 79 cases on 78 patients. Patients have been followed with a clinical and radio graphical standard examination. Mean delay between index surgery and revision was 12,9 years. Mean age at revision was 75,5 years. Two different types of DMC were used: standard DMC in 68 cases. In severe bone loss, a specific revision cup was used in 11 cases.


Orthopaedic Proceedings
Vol. 98-B, Issue SUPP_9 | Pages 142 - 142
1 May 2016
Prudhon J Caton J Ferreira A Verdier R
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Mid and long-term follow-up of Charnley total hip arthroplasty (THA) demonstrated good functional results with 85% survivorship at 25-year follow-up. However dislocation still remains an unsolved problem. Dislocation may occur all along the patient and implant life. The aim of this study is to answer the question: does Dual Mobility Cup (DMC) decrease the dislocation risk? Method: We report comparative results at ten years of follow-up of 2 groups of primary cemented Charnley-type THA, one with a standard polyethylene cup (group 1, n=215) and the other one with a DMC (group 2, n=105). Results: In group 1, twenty-six dislocations (12.9%) occurred. In group 2 only one dislocation (0.9%) occurred. This dislocation was successfully reduced by close reduction, without any recurrence. This difference was statistically significant (p=0.0018). In group 1, reason for revision was recurrent dislocation in twenty one cases. Five patients have been revised for other reasons. The global revision rate was 12.9%. In group 2, two patients needed revision surgery for aseptic loosening. The global revision rate was 2.1%. This difference was statistically significant (p=0.0054). The goal was reached for the patients of group 2 who had more risks factors of dislocation (age, aetiology, ASA and Devane scores) than those of group 1. When using a DMC, we observed a low rate of dislocation in primary THA (0.9%). This surgical choice seems to be a secure and effective technique in Charnley-type THA, especially in a high risk population.


Orthopaedic Proceedings
Vol. 98-B, Issue SUPP_7 | Pages 130 - 130
1 May 2016
Ferreira A Moutton N Aslanian T Prudhon J Caton J
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Introduction

Polyethylene (PE) wear is clearly linked to total hip arthroplasty (THA) failure, leading to osteolysis and decreasing survivorship rates. Dual mobility cups (DMC) are widely used to prevent or treat THA instability. However some studies have pointed PE wear risk as a “dual wear” risk. Hip wear simulation is usually used to understand factors influencing wear and to differentiate design, PE types and materials performances. To date, few works have been published studying dual mobility insert wear.

Objectives

Our objective was to evaluate wear of DMC with comparison with a fixed single articulating hip design and to measure wear under same conditions (loading cycle, temperature, sterilization, material and surface roughness).


Orthopaedic Proceedings
Vol. 98-B, Issue SUPP_7 | Pages 131 - 131
1 May 2016
Ferreira A
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INTRODUCTION

Total Knee Arthroplasty (TKA) survival is directly dependent on precise component placement. As showed by Mason meta-analysis in 2007, only 68.2% of TKAs achieved axis less than 3° with conventional methods versus 91% with Computer Assisted Surgery (CAS). However, if CAS seems to have more accuracy its use is in less than 10% procedures in United States because of its cost, operative time and need of extra pin sites. Smart technology, providing no requirement or arrays for registration, no need of pre operative images and lest cost effective seems to be an encouraging way.

OJBECTIVES

We report our experience of a new system that is an accelerometer-based portable navigation with a disposable display console and reference sensor; gyrometer is like smartphone ones. This system permits to realize femoral distal cut, and tibial proximal cut, adjusting varus-valgus, flexion-extension and tibial slope regardless implants used. Goal of the study was to determine accuracy and reliability of the system.


The Journal of Bone & Joint Surgery British Volume
Vol. 77-B, Issue 6 | Pages 943 - 950
1 Nov 1995
Ferreira-Alves A Resina J Palma-Rodrigues R

Between 1969 and 1989, we performed posterior segmental instrumentation on 38 patients with thoracic Scheuermann's kyphosis. We used a dynamic system without sublaminar fixation, and a kyphosis of 50 degrees was the main indication for surgery. The mean initial angle was 68 degrees (50 to 100) and the mean final kyphosis was 43 degrees at five-year follow-up, with a mean final loss after surgery of 3.7 degrees. Reconstruction of the vertebral bodies, vertebral wedging and the anterior-body height ratio were observed even in skeletally mature patients. There were no medical complications. There were three cases of loss of correction by more than 10 degrees and one of rod fracture with pseudarthrosis. The role of non-operative treatment is evaluated and early surgical treatment is advocated.