Large head metal on metal total hip arthroplasty MOM THA have been consistently shown substantial improvement in wear performance compared with metal on polyethylene articulations. Large diameter femoral heads theoretically can reduce dislocation risk by increasing range of motion before impingement, increasing prosthetic jump distance. However, early failure associated with adverse local tissue reactions (ALTRs) to metal debris is an emerging problem after MOM THA. The purpose of this study was to evaluate mid-term results of MOM THA. Twenty-five patients, 28 hips were included in this study. The average age of the patients at the time of surgery was 66.9 years. Three patients were men and 22 were women. MOM THAs were performed using 28 PINNACLE Cup system (DepPuy) (C-STEM: 23, S-ROM: 5) with posterior approach and head size of 36mm. Twenty-five primary THAs due to osteoarthritis in 22 cases and rheumatoid arthritis (RA) in one, and two revisions due to recurrent dislocation THA patients, were performed. The average follow up was 56.7 months. Evaluation items are JOA score, cup anteversion /lateral opening angle, and complications. Indication of the system were applied for patients with high risk of dislocation such as recurrent dislocation in primary and/or THAs, posterior pelvic tilt, elderly, RA and mental disorders.Background
Materials and Methods
Macrophages phagocytes implant wear debris and produce various cytokines to evoke inflammation and periprosthetic osteolysis of aseptic loosening. It had been reported that expression of Toll-like receptor (TLR) 2 and other TLRs increased in periprosthetic tissues of aseptic loosening. Pathogen-associated molecular patterns (PAMPs) and damaged-associated molecular patterns (DAMPs) have been known as ligands of TLRs and considered to be involved in the osteolytic reactions TLR1, TLR2, TLR6, NLRP3, TNF-α and IL-1β of macrophages in aseptic loose periprosthetic tissues were immnohistorically evaluated and compared to osteoarthritic synovium. RAW264.7 cells, macrophagic cell line, were stimulated by titanium particles (Ti) and lipoteichoic acid (LTA)-coated Ti. The celluar reaction associated with TLR2 and NLRP3 and the correlation of them were analyzed at mRNA expression levels with small-interfering RNA of Introduction
Materials and methods
Biologic agents (BIO) drastically changed the rheumatoid arthritis (RA) therapy from starting to use biologics at 2003 in Japan. The rate of orthopaedic surgery, especially total joint arthroplasty (TJA) may reflect trends in disease severity, management and health outcomes. We surveyed the number and rate of orthopaedic surgeries and TJA in RA treatment with BIO in the last decade, so called BIO-era.Objectives
Methods
Although the treatment for infected total hip arthroplasty (THA) has been still controversial, some reports suggested two-stage revision THA seems to be more preferable rather than one-stage revision. The purpose of this study is to estimate the outcome of treatment for infected THA in our institutions. The medical records of patients who have been underwent surgical treatment for infected THA between 2006 and 2012 in two hospitals and followed more than one year after surgery were reviewed. 34 patients and 35 hips were included. Age at surgery, gender, a period until surgical treatment after diagnosis of infection, method of treatment (debridement, one-stage or two-stage revision THA) and the outcome are estimated for each hips. Remission was defined by the absence of local and systemic sign of implant related infection and the normalization of WBC and C-reactive protein value without antibiotics.Background and Purpose
Patients and methods
The tribological performance of grooved surfaces has been thoroughly analyzed, and such surfaces are thought to have great potential for hard-on-hard joint prosthesis. In related research, femtosecond laser-induced periodic surface structures (FLIPSSs) have been well developed to achieve grooved structures with submicron spacing (700nm) and amplitude (200nm). In this study, submicron-scale periodic grooved structures were made on SUS440C using a femtosecond laser, and its tribological performance was evaluated by both a pin-on-plate reciprocating sliding test and a ring-on-disk test. The pin-on-plate reciprocating test was performed using PAO6 (30.51cP at 37°C) as the lubricant. The pin and plate specimens were made of SUS440C and were polished to a surface roughness of 0.02μm Ra. The pin specimens were columnar in shape, and radial periodic grooved structures (700nm spacing x 200nm amplitude) were formed on the pin's outer periphery (from 4mm to 5mm in diameter). The ring-on-disk test was performed using lubricants with different viscosity: PAO6 and PAO2 (4.60cP at 37°C). The ring-on-disk specimens were made of SUS440C and were polished to a surface roughness of 0.03μm Ra. Along the surface of the ring specimens, material was removed to create 4 elevated sections at 0°, 90°, 180° and 270°. These 4 sections were then polished and concentric grooved structures (700nm spacing x 200nm amplitude) were created along a 1.4mm circumferential path within each of these areas.Introduction
Method
Nine children with chronic post-traumatic dislocation of the head of the radius were treated by an osteotomy of the ulna with over-correction of the angular deformity and with elongation of the bone. Satisfactory results were obtained in eight cases, the only poor outcome following a three-year delay between the initial injury and the reposition. The interosseous membrane of the forearm appeared to be the most important structure in maintaining the corrected position of the radial head.
