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Orthopaedic Proceedings
Vol. 99-B, Issue SUPP_3 | Pages 130 - 130
1 Feb 2017
Garcia-Rey E Cimbrelo EG Gomez-Barrena E
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Background and aim

Despite good survivorship analysis for most uncemented tapered straight stems, new proposals modifying stem design in total hip replacement (THR) are being introduced in order to facilitate femoral revision surgery.

We have evaluated the clinical and radiological results of four different designs of uncemented tapered straight stems implanted in our institution in order to assess: operative complications, clinical results, survivorship analysis for aseptic loosening and radiographic findings

Methods

1008 hips implanted from 1998 to 2006 were prospectively followed for a mean of 12 years (range, 10 to 17). Four uncemented femoral designs employing a tapered straight stem were included: 209 Alloclassic stems, 420 Cerafit, 220 SL-Plus and 159 Summit. All hips had a 28 or 32 mm femoral head, and polyethylene (PE)-on metal or ceramic-on-ceramic bearing surface. Radiological femoral type, stem position, femoral canal filling at three levels and the possible appearance of loosening and other bone remodelling changes were recorded in all hips.


Orthopaedic Proceedings
Vol. 94-B, Issue SUPP_XL | Pages 144 - 144
1 Sep 2012
Perez-Jorge C Perez-Tanoira R Arenas M Matykina E Conde A Gomez-Barrena E
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INTRODUCTION

Biomaterial-related infections are an important complication in orthopaedic surgery [1], and Staphylococcus sp. accounts for more than half of the prosthetic joint infection cases [2]. Adhesion of bacteria to biomaterial surfaces is a key step in pathogenesis of such infections [3]. Titanium alloys are widely used in orthopaedic implants because their biocompatibility [4]. Surface incorporation of ions with antimicrobial properties, like fluorine, is one strategy previously studied with good results [5].

MATERIAL AND METHODS

A 18mm diameter rod of Ti–6Al–4V alloy ELI grade according to the standard ASTMF136-02 supplied by SURGIVAL was cut into 2 mm thick disk specimens, ground through successive grades of SiC paper to 1200 grade, degreased with a conventional detergent and rinsed in tap water followed by deionised water. The specimens were then chemically polished (CP).

The disks were anodized only on one side by using a two electrode cell in a suitable electrolyte. TiO2 barrier layers, without fluoride (BL), were produced by anodizing in 1 M H2SO4 at 15 mA cm-2 to 90 V, reaching 200 nm of thickness.

Fluoride barrier layers (FBL) were produced in an electrolyte containing 1 M NH4H2PO4 and 0.15 M NH4F, at constant voltage controlled at 20 V for 120 min at 20°C; the thickness of the layer is 140 nm.

Laboratory biofilm-forming strains of Staphylococcus aureus 15981 [6] and Staphylococcus epidermidis ATCC 35984 were used in adherence studies, which were performed using the protocol by Kinnari et al [7]. Photographs obtained were studied by ImageJ software. Statistical analysis was performed by EPI-INFO software. The experiments were performed in triplicates


Orthopaedic Proceedings
Vol. 94-B, Issue SUPP_XL | Pages 112 - 112
1 Sep 2012
Molina-Manso D del Prado G Manrubia-Cobo M Ortiz-Pérez A Cordero-Ampuero J Gómez-Barrena E
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INTRODUCTION

Prosthetic joint related-infections (PJRI) are severe complications in orthopaedic surgery. Staphylococcus aureus and Staphylococcus epidermidis are the most commonly isolated pathogens from implants (1). The variable antimicrobial susceptibility found in these microorganisms, makes it necessary to perform individual susceptibility studies in order to select the best antibiotic combination for clinical management (2).

MATERIAL AND METHODS

35 staphylococcal strains (17 S. aureus, 18 S. epidermidis) were isolated from PJRI using a previously described sonication protocol (3). Biofilm-producing collection strains S. aureus 15981 (4) and S. epidermidis ATCC 35984 were also included in the study. In vitro susceptibility was evaluated against 7 antimicrobial agents: rifampin, vancomycin, ciprofloxacin, cotrimoxazole, cloxacillin, clindamycin, and daptomycin. Minimal Inhibitory Concentration (MIC) assays were determined according to EUCAST recommendations and breakpoints (5). Minimal Bactericidal Concentration (MBC) was also calculated by colony counting after plating the well contents.