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The Journal of Bone & Joint Surgery British Volume
Vol. 73-B, Issue 1 | Pages 25 - 28
1 Jan 1991
Lalor P Revell P Gray A Wright S Railton G Freeman M

Tissues from five patients who underwent revision operations for failed total hip replacements were found to contain large quantities of particulate titanium. In four cases this metal must have come from titanium alloy screws used to fix the acetabular component; in the fifth case it may also have originated from a titanium alloy femoral head. Monoclonal antibody labelling showed abundant macrophages and T-lymphocytes, in the absence of B-lymphocytes, suggesting sensitisation to titanium. Skin patch testing with dilute solutions of titanium salts gave negative results in all five patients. However, two of them had a positive skin test to a titanium-containing ointment.


The Journal of Bone & Joint Surgery British Volume
Vol. 70-B, Issue 3 | Pages 367 - 372
1 May 1988
Samuelson K Freeman M Levack B Rassmussen G Revell P

Thirty-seven patients with extensive acetabular defects due to loose implants had revisions with uncemented components, the acetabulum being augmented with homograft bone. In six of these, a histological study of graft incorporation was made. At a mean follow-up of 1.5 years 34 patients were free of pain and 35 could walk for 30 minutes or longer. No graft had obviously sequestrated. Two components had radiological evidence of migration but remain asymptomatic. We conclude that cementless revision surgery with homograft supplementation of the acetabulum is clinically successful in the short-term. The long-term outcome is unknown.


The Journal of Bone & Joint Surgery British Volume
Vol. 69-B, Issue 4 | Pages 558 - 564
1 Aug 1987
Weightman B Freeman M Revell P Braden M Albrektsson B Carlson L

Mechanical and biomechanical testing of a new bone cement suggests that improved load transfer to the proximal femur could be achieved with the combination of a cement having a lower modulus, a greater ductility and a lower creep resistance than polymethylmethacrylate and a suitably shaped femoral component.


The Journal of Bone & Joint Surgery British Volume
Vol. 66-B, Issue 4 | Pages 557 - 559
1 Aug 1984
Bolton-Maggs B Helal B Revell P

A case of bilateral avascular necrosis of the capitate is presented. A review of the literature has identified a clear-cut clinical syndrome. The aetiology and pathology of this syndrome is discussed and a new method of treatment is proposed.


The Journal of Bone & Joint Surgery British Volume
Vol. 64-B, Issue 4 | Pages 489 - 493
1 Aug 1982
Freeman M Bradley G Revell P

The occurrence of a radiolucent line at the interface of bone and cement in total joint prostheses is a frequently observed, although little understood, phenomenon. Because of an operative technique utilised in instances of bone loss, we have, within a single implant mass used in each of a series of 18 total knee replacements, been able to observe two separate interfaces, one between bone and cement and the other between bone and cobalt chrome. The average period of observation was 32 months. All of the knees except one demonstrated a lucency at the bone-cement interface; only one of the knees had a similar lucency at the bone-CoCr interface. One of the knees was studied histologically. In the light of the universal observation of macrophages at bone-cement interfaces and the recent finding that osteoclasts are derived from macrophages, these observations are significant in relation to the aetiology of bone-cement lucencies.


The Journal of Bone & Joint Surgery British Volume
Vol. 64-B, Issue 3 | Pages 326 - 335
1 Jun 1982
Blaha J Insler H Freeman M Revell P Todd R