Aims. Giant cell tumours (GCTs) of the proximal femur are rare, and there is no consensus about the best method of filling the defect left by curettage. In this study, we compared the outcome of using a fibular strut allograft and
Aims. This study aimed to compare the effect of antibiotic-loaded
Aims. Antibiotic-loaded
Aims. The aim of this study was to investigate whether the use of antibiotic-loaded
We prospectively investigated a consecutive series of ten patients undergoing a cemented primary total hip replacement (THR) for osteoarthritis in order to establish the elution characteristics of Simplex-tobramycin
We used a rat model in vivo to study the effects of particulate
The fatigue failure of
A heavy infiltrate of foreign-body macrophages is commonly seen in the fibrous membrane which surrounds an aseptically loose cemented implant. This is in response to particles of polymethylmethacrylate (PMMA)
Coloured
The serum liver enzyme levels of 40 consecutive patients before and after cemented hip replacement were compared with a control group having operation without use of cement. Serum gammaglutamyl transferase (SGGT) was abnormally raised, for more than four days, in 12 of the 40 patients (32%) in whom
Aims. In the 1990s, a bioactive
Polymethylmethacrylate remains one of the most enduring materials in orthopaedic surgery. It has a central role in the success of total joint replacement and is also used in newer techniques such as percutaneous vertebroplasty and kyphoplasty. This article describes the current uses and limitations of polymethylmethacrylate in orthopaedic surgery. It focuses on its mechanical and chemical properties and links these to its clinical performance. The behaviour of antibiotic-loaded
Aims. Femoral cement-in-cement revision is a well described technique to reduce morbidity and complications in hip revision surgery. Traditional techniques for septic revision of hip arthroplasty necessitate removal of all
We performed a prospective, randomised study on 110 patients more than 50 years old with fractures of the distal radius to compare the outcome of conservative treatment with that using remodellable
We have tested the porosity and fatigue life of five commonly used
Aims. We propose a state-of-the-art temporary spacer, consisting of a cobalt-chrome (CoCr) femoral component and a gentamicin-eluting ultra-high molecular weight polyethylene (UHMWPE) tibial insert, which can provide therapeutic delivery of gentamicin, while retaining excellent mechanical properties. The proposed implant is designed to replace conventional spacers made from
Aims. Vancomycin is commonly added to acrylic bone cement during revision
arthroplasty surgery. Proprietary cement preparations containing
vancomycin are available, but are significantly more expensive.
We investigated whether the elution of antibiotic from ‘home-made’
cement containing vancomycin was comparable with more expensive
commercially available vancomycin impregnated cement. Materials and Methods. A total of 18 cement discs containing either proprietary CopalG+V;
or ‘home-made’ CopalR+G with vancomycin added by hand, were made.
Each disc contained the same amount of antibiotic (0.5 g gentamycin,
2 g vancomycin) and was immersed in ammonium acetate buffer in a
sealed container. Fluid from each container was sampled at eight
time points over a two-week period. The concentrations of gentamicin
and vancomycin in the fluid were analysed using high performance
liquid chromatography mass spectrometry. Results. The highest peak concentrations of antibiotic were observed from
the ‘home-made’ cements containing vancomycin, added as in the operating
theatre. The overall elution of antibiotic was, fivefold (vancomycin)
and twofold (gentamicin) greater from the ‘home-made’ mix compared
with the commercially mixed cement. The use of a vacuum during mixing
had no significant effect on antibiotic elution in any of the samples. Conclusion. These findings suggest that the addition of 2 g vancomycin powder
to gentamicin-impregnated
We used 99 strains of organisms representative of orthopaedic infections to examine the effectiveness of a
We have investigated whether the particle-stimulated release of inflammatory cytokines from human primary macrophages in vitro was dependent upon the type of