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Ekweariri N, White R, Brown N, Schmitt D. A rare case of taper junction corrosion in semi-constrained total knee arthroplasty. Knee 2024; 48:46-51. [PMID: 38507890 DOI: 10.1016/j.knee.2024.02.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/03/2023] [Revised: 12/19/2023] [Accepted: 02/26/2024] [Indexed: 03/22/2024]
Abstract
Metallosis is a known yet rare late complication of unicompartmental and total knee arthroplasty (TKA), usually secondary to either metal-backed patellar component failure, mobile-bearing polyethylene dislocation, or catastrophic polyethylene failure and wear through. The majority of literature surrounding metallosis has been published in relation to total hip arthroplasty (THA) metal on metal bearing wear or mechanically assisted crevice corrosion.This case report describes the development of metallosis in a 77-year-old male patient with advanced (Kellgren-Lawrence Grade 4) osteoarthritis with associated valgus deformity, who underwent index TKA with a semiconstrained revision knee system due to intraoperative medial collateral ligament laxity. The taper junction between the titanium alloy stem and cobalt chromium femoral component was the source of diffuse intra-articular metallosis.
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Affiliation(s)
- Nnadozie Ekweariri
- Department of Orthopaedic Surgery, Loyola University Medical Center, Maywood, IL, USA
| | - Ryan White
- Department of Orthopaedic Surgery, Loyola University Medical Center, Maywood, IL, USA
| | - Nicholas Brown
- Department of Orthopaedic Surgery, Loyola University Medical Center, Maywood, IL, USA
| | - Daniel Schmitt
- Department of Orthopaedic Surgery, Loyola University Medical Center, Maywood, IL, USA
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Rullán PJ, Grits D, Potluri A, Emara AK, Klika AK, Mont MA, Piuzzi NS. Identifying Trends and Quantifying Growth for Technological Innovation in Knee Arthroplasty: An Analysis of a Patent Database (1990 to 2020). J Knee Surg 2023; 36:1209-1217. [PMID: 36138534 DOI: 10.1055/s-0042-1756503] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Technological innovation is the key for surgical progress in knee arthroplasty and improvement in patient outcomes. Exploring patented technologies can help elucidate trends and growth for numerous innovative technologies. However, patent databases, which contain millions of patents, remain underused in arthroplasty research. Therefore, the present study aimed to: (1) quantify patent activity; (2) group patents related to similar technologies into well-defined clusters; and (3) compare growth between technologies in the field of knee arthroplasty over a 30-year period. An open-source international patent database was queried from January 1990 to January 2020 for all patents related to knee arthroplasty A search strategy identified 70,154 patents, of which 24,425 were unique and included analysis. Patents were grouped into 14 independent technology clusters using Cooperative Patent Classification (CPC) codes. Patent activity was normalized via a validated formula adjusting for exponential growth. Compound annual growth rates (CAGR) were calculated (5-year, 10-year, and 30-year CAGR) and compared for each cluster. Overall yearly patent activity increased by 2,023%, from 104 patents in 1990 to 2,208 patents in 2020. The largest technology clusters were "drugs" (n = 5,347; 23.8%), "components" (n = 4,343; 19.0%), "instruments" (n = 3,130; 13.7%), and "materials" (n = 2,378; 10.4%). The fastest growing technologies with their 5-year CAGR were: "user interfaces for surgical systems" (58.1%); "robotics" (28.6%); "modularity" (21.1%); "navigation" (15.7%); and "computer modeling" (12.5%). Since 1990, overall patent growth rate has been greatest for "computer modeling" (8.4%), "robotics" (8.0%), "navigation" (7.9%), and "patient-specific instrumentation" (6.4%). Most patents in knee arthroplasty for the last 30 years have focused on drugs, components, instruments, and materials. Recent exponential growth was mainly observed for user interfaces for surgical systems, robotics, modularity, navigation, and computer-assisted technologies. Innovation theory would suggest that these rapidly growing technologies are experiencing high innovation output, increased resource investments, growing adoption by providers, and significant clinical impact. Periodic monitoring of technological innovation via patent databases can be useful to establish trends and future directions in the field of knee arthroplasty.
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Affiliation(s)
- Pedro J Rullán
- Department of Orthopaedic Surgery, Cleveland Clinic Foundation, Cleveland, Ohio
| | - Daniel Grits
- Department of Orthopaedic Surgery, Cleveland Clinic Foundation, Cleveland, Ohio
| | - Ajay Potluri
- School of Medicine, Case Western Reserve University, Cleveland, Ohio
| | - Ahmed K Emara
- Department of Orthopaedic Surgery, Cleveland Clinic Foundation, Cleveland, Ohio
| | - Alison K Klika
- Department of Orthopaedic Surgery, Cleveland Clinic Foundation, Cleveland, Ohio
| | - Michael A Mont
- Center for Joint Preservation and Replacement, Rubin Institute for Advanced Orthopedics, Sinai Hospital of Baltimore, Baltimore, Maryland
| | - Nicolas S Piuzzi
- Department of Orthopaedic Surgery, Cleveland Clinic Foundation, Cleveland, Ohio
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Olšovská E, Čabanová K, Motyka O, Kryštofová HB, Matějková P, Voves J, Židlík V, Madeja R, Demel J, Halfar J, Kukutschová J. Simple method for quantification of metal-based particles in biopsy samples of patients with long bone implants - Pilot study. ENVIRONMENTAL TOXICOLOGY AND PHARMACOLOGY 2023; 103:104282. [PMID: 37769889 DOI: 10.1016/j.etap.2023.104282] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/30/2023] [Revised: 09/19/2023] [Accepted: 09/23/2023] [Indexed: 10/02/2023]
Abstract
The presence of particles fixed in tissue samples due to implant degradation or disintegration plays an important role in post-operative complications. The ability to determine the size, shape, chemical composition and, above all, the number of these particles can be used in many areas of medicine. This study presents a novel, simple metal-based particle detection method using scanning electron microscopy with energy dispersive spectrometer (SEM-EDS). The presence of metal particles in biopsy specimens from long bone nail-fixated implants (10 patients with titanium steel nails and 10 patients with stainless steel nails) was studied. The samples were analysed using automated area analysis based on image binarization and brightness to 255 grayscale. The results were supplemented with histological data and statistically analysed. The method based on the software used was found to be accurate and easy to use and, thus, appears to be very suitable for particle detection in similar samples.
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Affiliation(s)
- Eva Olšovská
- Nanotechnology Centre, CEET, VSB - Technical University of Ostrava, 17. listopadu 2172/15, Ostrava-Poruba 708 00, Czech Republic; Faculty of Material Science and Technology, Center for Advanced Innovation Technologies, VSB - Technical University of Ostrava, 17. listopadu 2172/15, Ostrava-Poruba 708 00, Czech Republic.
| | - Kristina Čabanová
- Faculty of Material Science and Technology, Center for Advanced Innovation Technologies, VSB - Technical University of Ostrava, 17. listopadu 2172/15, Ostrava-Poruba 708 00, Czech Republic; Faculty of Mining and Geology, VSB-Technical University of Ostrava, 17. listopadu 2172/15, Ostrava-Poruba 708 00, Czech Republic
| | - Oldřich Motyka
- Nanotechnology Centre, CEET, VSB - Technical University of Ostrava, 17. listopadu 2172/15, Ostrava-Poruba 708 00, Czech Republic; Faculty of Mining and Geology, VSB-Technical University of Ostrava, 17. listopadu 2172/15, Ostrava-Poruba 708 00, Czech Republic
| | - Hana Bielniková Kryštofová
- Faculty of Material Science and Technology, Center for Advanced Innovation Technologies, VSB - Technical University of Ostrava, 17. listopadu 2172/15, Ostrava-Poruba 708 00, Czech Republic; Institute of Molecular and Clinical Pathology and Medical Genetics, University Hospital Ostrava and Faculty of Medicine, 17. listopadu 1790/5, Ostrava-Poruba 708 52, Czech Republic; Institute of Emergency, Medicine Faculty of Medicine, University of Ostrava, Syllabova 19, Ostrava 703 00, Czech Republic
| | - Petra Matějková
- Faculty of Material Science and Technology, Center for Advanced Innovation Technologies, VSB - Technical University of Ostrava, 17. listopadu 2172/15, Ostrava-Poruba 708 00, Czech Republic
| | - Jiří Voves
- Department of Trauma Surgery, University Hospital Ostrava, 17. listopadu 1790/5, Ostrava-Poruba 708 52, Czech Republic; Institute of Emergency, Medicine Faculty of Medicine, University of Ostrava, Syllabova 19, Ostrava 703 00, Czech Republic
| | - Vladimír Židlík
- Institute of Molecular and Clinical Pathology and Medical Genetics, University Hospital Ostrava and Faculty of Medicine, 17. listopadu 1790/5, Ostrava-Poruba 708 52, Czech Republic; Institute of Emergency, Medicine Faculty of Medicine, University of Ostrava, Syllabova 19, Ostrava 703 00, Czech Republic
| | - Roman Madeja
- Department of Trauma Surgery, University Hospital Ostrava, 17. listopadu 1790/5, Ostrava-Poruba 708 52, Czech Republic; Institute of Emergency, Medicine Faculty of Medicine, University of Ostrava, Syllabova 19, Ostrava 703 00, Czech Republic
| | - Jiří Demel
- Department of Trauma Surgery, University Hospital Ostrava, 17. listopadu 1790/5, Ostrava-Poruba 708 52, Czech Republic; Institute of Emergency, Medicine Faculty of Medicine, University of Ostrava, Syllabova 19, Ostrava 703 00, Czech Republic; Faculty of Medicine, Masaryk University, Kamenice 753/5, Brno 625 00, Czech Republic
| | - Jan Halfar
- Faculty of Material Science and Technology, Center for Advanced Innovation Technologies, VSB - Technical University of Ostrava, 17. listopadu 2172/15, Ostrava-Poruba 708 00, Czech Republic; Faculty of Mining and Geology, VSB-Technical University of Ostrava, 17. listopadu 2172/15, Ostrava-Poruba 708 00, Czech Republic
| | - Jana Kukutschová
- Faculty of Material Science and Technology, Center for Advanced Innovation Technologies, VSB - Technical University of Ostrava, 17. listopadu 2172/15, Ostrava-Poruba 708 00, Czech Republic
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